Renal surgery on anatomical basis: II Study of the arterial system

A study of the renal arterial anatomy of the kidneys by plastic corrosion casts, macro-opaque radiological and thick white gelatine methods has been carried out on 70 kidneys obtained from post- mortem bodies from stillbirth till 65 years old. Both sexes are represented. Examination of these specimens showed that the renal artery is single in 79.9% of cases, double in 22.8% of cases, triple in 2.9% of cases and in 1.4% of cases there are four renal arteries. The mode of division of the renal artery is classified into 5 patterns. The branching patterns of the anterior division showed many different variations and that of the posterior division showed 3 different types. The relation of these various arteries to the renal parenchyma and different renal calyces is investigated and discussed. The accessory or aberrant renal arteries are normal 1ry or 2ry intrarenal branches with a precocious origin i.e. the multiplicity of the artery is due to an early proximal division of the main renal artery rather than a true multiplication of the arteries. The branches of the renal arteries, single or multiple, are essentially "End arteries" with no significant intercommunication in between. There is no constant arterial segmental pattern of the kidney i.e. there are great variations in the branching patterns of the renal vessels. So, there are some important clinical suggestions and facts to be considered before and during the renal operations e.g. kidney transplantation and nephrotomy

Renal surgery on anatomical basis: I Study of pelvic-alyceal system

150 human kidneys of different ages and sex [60 specimens for plastic corrosion, 20 specimens for thick white gelatine methods] were used as well as 70 I.V.U. [Intra- Venous Urography] of normal persons were studied. The careful examination of these specimens showed 5 pelvi- calyceal patterns and 3 types of the renal pelvis. It is of extreme importance to put in consideration the number and direction of the minor calyces to help the urosurgeon and radiologist in the process of percutaneous nephrolithotomy or partial nephrectomy. Also, to have some experience to be able to distinguish posterior calyces "en face" from anterior calyces "in profile" on an antero- posterior radiograph

study in renal infarction I experimental renal embolization

Twenty male dogs were used in this study. Twelve animals with normal circulation were subjected to introduction of emboli [tobacco seeds] by special a obturator and cannula. The remaining 8 animals were used as a control. Gross and microscopic examinations showed that the infarct of the kidney of the dogs was first hyperaemic then hemorrhagic and finally became pale from coagulation necrosis. Th e degenerative changes more rapidly and reached their height in the central part of the infarct before the marginal part which also showed areas of calcium deposition and calcification and later on fibrous tissue appeared in the center of the large infarct. At the end of 5 weeks, the infarcted areas became completely fibrosed and in some organs complete calcification occurred. There was epithelial proliferation after complete necrosis of the infarcted kidney but no true tubular reproduction or new glomerular formation. The enzymatic activities [alkaline and acid phosphatases] were severely affected by introducing the emboli into renal arterial branches. The decrease in the activity of the different enzyme was first observed in the convoluted tubules which were relatively more sensitive than the other segment of the nephron. The subcapsular cortical zone of the renal parenchyma escaped infarction due to the presence of small communicating vessels i. E. perforating, capsular, ureteric and adiposal branches