摘要:

There is no absolute clinical picture distinguishing renovascular hypertension from essential hypertension. The most useful clues have been the onset of hypertension in persons under thirty or over fifty, an accelerated course or a history of unexplained flank or abdominal pain. Upper abdominal bruits exist in 50% or more of cases of renal artery stenosis with a higher incidence being observed in patients with fibromuscular dysplasias than with atherosclerotic stenosis. The radioactive renogram is a useful screening device, positive in approximately 86% of patients but subject to many false positive interpretations. When all parameters of the intravenous urogram are considered, 90% of patients with proven renal artery stenosis show a positive correlation. The divided kidney function test is useful in providing functional information of the kidneys, but lacks definitive exactitude. The renal arteriogram is a sine qua non to provide anatomical definition of a stenosing lesion but functional significance of a stenosis can only be surmised by the degree of luminal compromise. Renal biopsy has been useful in demonstrating tubular atrophy, small vessel disease and changes in the juxta glomerular apparatus. Severe ipsilateral tubular atrophy suggests the need for nephrectomy rather than revascularization and in this regard appears to have prognostic value. Measurement of pressure gradient and renal blood flow are highly desirable in determining the functional significance of an anatomical stenosing lesion. The combination of pressure gradient and renal blood flow provides the best information since either test individually may give misleading information.

ISSN:0042-1138    

DOI:10.1159/000279594

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

The history of operations to correct renal artery stenosis is reviewed and the results of surgical treatment in 125 cases are described. Nephrectomy is indicated for severe degrees of renal atrophy, multiple branch lesions and unsuccessful previous arterioplasty. The results of partial nephrectomy for branch disease are generally poor. Endarterectomy is indicated for well defined atherosclerotic plaques and resection and reanastomosis is useful for discrete and short stenosing lesions but bypass grafts are the most popular and useful reconstructive operations. Generally good results have been obtained with dacron bypass grafts but long term evaluation is needed to determine late patency. The sþlenorenal bypass is an excellent choice for lesions of the left renal artery when the splenic artery is normal. General guides in the performance of operations on the renal vessels are given and the future of renovascular surgery is discussed with reference to possible usefulness of autotransplantation of the kidney and selection of medical vs. surgical therapy for patients with diffuse vascular disease, advanced age and irremediable renovascular lesions

ISSN:0042-1138    

DOI:10.1159/000279595

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

Indwelling teflon catheters were introduced percutaneously into femoral artery and vein and then advanced into the aorta and inferior vena cava for the performance of 148 haemodialyses in 30 cases of severe acute renal failure. The patency of the catheters between dialysis was maintained by a teflon external shunt. The blood flow rates varied according to blood pressure. A poor blood flow necessitating the use of a roller pump was constantly observed when systolic B.P. was below 100 mmHg. Clinical side effects have been found in only 2 cases of acute renal failure and severe arterial hypertension. In general this technique has been shown to be safe and of rapid application, usefully indicated in acute renal failure necessitating repeated haemodialysis.

ISSN:0042-1138    

DOI:10.1159/000279596

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

This article describes the mechanism of Hippuran-I-131 renography. If performed with sufficient care quantitative renography may inform the clinician about the procentual effective renal blood flow and the Hippuran transit time of both kidneys. The influence of possible sources of error on the results is discussed.

ISSN:0042-1138    

DOI:10.1159/000279597

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

Mannitol administration and therapeutic dénervation of the kidney were combined in post-ischaemic experiments. Ischaemic shock was brought about by transitory clamping of the renal artery. Hibernation combined with mannitol administration was the most effective therapeutic measure (others were mannitol only, hibernation only, novocain, novocain+mannitol) in renal failure. This was attributed to the inhibitory effect of hibernation upon vasoconstrictive impulses coming by way of the preglomerular ateries, thus facilitating the intrarenal action of mannitol. Hydropic degeneration, a side effect of mannitol, was found to be a transitory lesion not affecting renal function very much

ISSN:0042-1138    

DOI:10.1159/000279598

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

Bericht über zwei Fälle einer geburtsmechanischen Nierenverletzung beim Neugeborenen. Hingewiesen wird auf die gemeinsamen Zeichen bei beiden Kindern: komplikationslose Geburt aus 3. bzw. 4. Schwangerschaft, überdurchschnittliches Geburtsgewicht, freies Intervall von 4–5 Tagen, akutes Auftreten der Symptome, Unruhe, Ablehnen der Nahrung, Exsikose, Anämie, Leukozytose, Fieber, Anstieg des Rest-N, palpabler Tumor, Verdrängung der Darmschlingen im Leerbild, radiologische Merkmale eines raumfordernden Prozesses im Retroperitoneum, Fehlen einer Hämaturie. Röntgenzeichen werden beschrieben und bildlich dargestellt. Operationspräparate und histologische Befunde werden demonstriert. Differenzialdiagnostische Probleme werden besprochen und Schwierigkeiten bei der Abgrenzung der Diagnosen Nierentumor, Nebennierenruptur, Nierenvenenthrombose und Nierenruptur betont. Die Berechtigung des chirurgischen Vorgehens und die mögliche Prognose der geburtstraumatischen Nierenverletzung werden diskutiert. Es wird betont, dass der Mangel an Erfahrungen keine eindeutigen Schlussfolgerungen hinsichtlich Therapie und Progno

ISSN:0042-1138    

DOI:10.1159/000279599

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

Es wurde bei 8 Harnsteinträgern, 4 Pyelonephritis-Patienten und 4 Gesunden die Pyrophosphat-spaltende Enzymaktivität im Nierenhomogenat gemessen. Normale Nieren spalten bei pH 7,4, 37° C, 0,5 mM Pyrophosphat und 5 mM Mg++ 32 µMol Pyrophosphat/min und g Frischgewicht, Bei Pyelonephritis-Patienten ist die Enzymaktivität nicht verändert, in Steinnieren jedoch signifikant niedriger als n

ISSN:0042-1138    

DOI:10.1159/000279600

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

Es wird ein Fall von Verlust der Harnröhre infolge Geburtstrauma beschrieben. Sie wurde aus einem Scheidenlappen durch eine Abwandlung der Martiusschen Methode wiederhergestellt. Vollständige Kontinenz wurde erreich

ISSN:0042-1138    

DOI:10.1159/000279601

出版商:S. Karger AG    

年代:1969

数据来源: Karger

摘要:

Ultrastructural differences between normal adrenal medulla and pheochromocytoma were studied. Medullary cells exhibit almost the same appearance revealing cytoplasm filled with numerous catecholamine granules. However, the ultrastructures of pheochromocytomas are quite variable, being composed of two major cell types: Type I with catecholamine granules and Type II without them. Type I cells are divided into three sub-groups according to their cytoplasmic catecholamine granules and vacuoles, which can be seen in the same section. This fact can be interpreted as the expression of cellular activities. The co-existence of these cell types in pheochromocytoma would be one of the ultrastructural evidences of the catecholamine metabolism disorders. In order to compare the catecholamine granules, their sizes were measured, calculating their mean diameter in each cell type. Significant differences were shown on their mean value and distribution curve between normal medullary cells and each cell type of pheochromocytoma. These differences were discussed in relation to the catecholamine abnormalities in pheochromocytoma.

ISSN:0042-1138    

DOI:10.1159/000279602

出版商:S. Karger AG    

年代:1969

数据来源: Karger

ISSN:0042-1138    

DOI:10.1159/000279603

出版商:S. Karger AG    

年代:1969

数据来源: Karger