Biomedical subjects
Publications and source records attributed to P Dure-Smith.
The majority of fatal pulmonary emboli are believed to arise from the ilio-femoral segment. Paradoxically, this is the most difficult region to visualize well during leg venography. A simple modification of routine leg venography is described that almost always gives excellent visualization not only of the ilio-femoral segment but of the entire vena cava.
Causes for ureteral indentation are legion and mostly well documented. Two unusual cases which are believed to be undocumented are described. One was produced by an inferior vena cava clip and the other by a vaginal tampon. Neither produced significant ureteric obstruction but both resulted in a diagnostic conundrum.
Review of medical and veterinary literature reveals no complete gross or radiologic description of the canine kidney. Yet, this organ is often the recipient of urologic investigation. Therefore, a complete gross study of this organ was carried out and the results are presented.
Crush and devascularizing injuries were performed on proximal canine ureters. The pathogenesis of the reaction to these injuries was evaluated by using microbiologic, physiologic, radiologic, biophysical, histologic, and anatomic techniques. The results indicated that within 12 weeks after crush injuries lasting up to 60 min, renal function fully returned and radiologic demonstration of the crush area resolved, even through other radiologic and pathologic changes persisted in hte crushed ureters. The pathophsiologic results of devascularizing injuries that did not resolve spontaneously tended to progress more rapidly and case more serious renal impairment than any of the crush injuries. Devascularizing injuries that resolved tended to be benign in their effect.
Despite a lack of hard evidence, many radiologists continue to support the use of fluid restriction before urography. Based on increasing the urinary contrast medium concentration, this has been shown to be a poor index for renal opacification. The usual overnight restriction produces no significant change in urine osmolality or opacification. Effective fluid restriction may produce a just detectable increase in pyelographic density but the nephrogram in unaffected, even by active hydration. Fluid restriction may occasionally result in inadvertent dehydration with serious or fatal reactions. Since it is ineffectual in improving the urogram and potentially hazardous, it should be abandoned.
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