Renal ultrasonographic studies were done in 26 patients with acute tubular necrosis. Prominent findings were an increase in renal size, especially the anteroposterior diameter, and sharp delineation of swollen pyramids. The ratio of anteroposterior to longitudinal diameter (H/L) was correlated with serum creatinine levels and inversely correlated with urine osmolalities. It was well correlated with the recovery time of acute renal failure. The patient group having an increased H/L had a mean recovery time of 32.4 days and 11 of the 12 patients required hemodialysis (mean of 10 times). The patient group having a normal H/L had a mean recovery time of 15.5 days and 9 of the 14 required hemodialysis (mean of 3 times).
Chronically hemodialyzed patients who experienced ureteric pain were studied using ultrasonography and computer tomography. 6 of 45 dialysis patients complained of flank, lumbar or lower abdominal pain and 4 of these passed urinary stones. During the attack a transient hydronephrosis or an enlarged kidney was observed by either ultrasonography or computer tomography. Ultrasonography was diagnostically superior to computer tomography. Renal stones were observed in 23 out of 45 cases by computer tomography. Ultrasonographic images of small renal stones were sometimes equivocal as compared with computer tomography, but low density stones, not shown by computer tomography, were shown by ultrasonography in a few cases. Therefore, both methods, in combination, are of great value in the diagnosis of asymptomatic renal stones as well as ureteral obstruction in the contracted kidney.
A 57-year-old male showed an abnormal mass shadow in a pulmonary bulla. Thoracotomy was performed and it was ascertained histologically that the tumour was a giant cell type carcinoma. Clinical features, histological findings and prognosis are reported.
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