Renal Damage induced by Doxorubicin-Lipiodol Emulsion infused into Rabbit Renal Artery: Comparison with CT andHistologic Findings

PURPOSE: The purpose of this study was to evaluate the utility of renal CT scanning and to histologicallycorrelate renal damage induced by renal arterial infusion of 0.2 ml/kg of doxorubicin-lipiodol emulsion. MATERIALS AND METHODS: Renal CT scans of 20 rabbit kidneys were obtained 15 days after transcatheter arterialchemoembolization and were classified into four grades, as follows : Grade 0 - no fleck, Grade 1 - one to threenodular flecks ; Grade 2 - four or more nodular flecks, or one semilunar fleck ; and Grade 3 - two or moresemilunar flecks. The percentage of histological section occupied by lesion was determined using squared paper,and compared with the grades determined on the basis of CT. RESULTS: The histologic findings were interstitialinflammatory cell infiltration, intratubular lipiodol droplets, dystrophic calcification, and cellular necrosis.The mean sizes of grade 0, 1, 2 and 3 histological lesions were 2.2%(n=5), 4.5%(n=4), 21.9%(n=7), and 24%(n=4),respectively. Grades 0 and 1 accounted for nine cases(3.2%), while grades 2 and 3 accounted for 11(22.6%) ; thisdifference was statistically significant(p<0.01). CONCLUSION: CT findings showing nodular or semilunar flecks 15days after infusion into the renal artery of doxorubicin-lipiodol emulsion correlate with the size of the damagedkidney, as seen on histological specimens.

The significance of double contrast retrograde urethrocystography in prostatic tumors

DRUC( Double Contrast Retrograde Urethrocystography), which was a combination of air cystography andretrograde urethrography with the patient in an exaggerated Trendelenburg's position allowing the contrast mediuminjected into bladder to be accumulated at the bladder base and dome far from trigone, showed good visualization of the prostatic urethra, bladder neck, bladder base and wall in contrast to the conventional, retrogradeurethrography. The authors analyzed DRUC findings of 32 cases of benign prostatic hypertrophy, 3 case of prostaticcancer and 50 cases of normal healthy men performed at Pusan National University Hospital for 9 months from Jan.1984 to Sept. 1984. The results obtained were as follows: 1. DRUC findings of normal control group were normalpattern of prostatic urethra, semioval shaped bladder wall. 2. DRUC findings of B.P.H. were spreading of prostaticurethra, spreading, displacement, smooth multidirectional compression of bladder neck, widening of inner orificeof bladder neck, smooth elevation of bladder base, traveculation of bladder wall and variable type of intravesicalstream such as normal, broad, double central stream, associated peripheral umbrella stream and no intravesicalstream. 3. DRUC findings of prostatic cancer were rigidity of prostatic urethra, nodular multidirectionalcompression of bladder neck, multiseptation of peripheral intravesical stream, nodularity of bladder base andtrabeculation of bladder wall. 4. DRUC, which added to double contrast method and postion change of patient,showed more delicate changes of baldder neck, base and wall as well as prostatic urethra in contrast to simpleRUG. We observed that changes of bladder neck and intravesical stream were significant in analzing abnormalenlarged prostate, and could differentiate B.P.H. from prostatic cancer simply by noting sharply demarcatedbladder base.

Percutaneous Antegrade Pyelography Guided by Ultrasound

The authors performed percutaneous antegrade pyelography guided by ultrasound on 33 patients, from J une 1982 to October 1984, at the department of radiology, Busan National University Hospital. The results obtained were as follows: 1. Of the 31 cases,17 cases (5 1.5%) were female and 16 cases (48.5 %)were male,and age distribution was nearly even, but most prevalent age group was third decade. 2. Comparing intravenous pyelographic findings with ultrasonographic findings, pyelographically non. visualized kidney 15 cases (45 .5%) were hydronephrosis 12 cases, multiple cysts 2 cases, and intrarenal cystic mass 1 case, ultrasonographically. Pyelographically hydronephrosis 9 cases (27.3%) were all hydronephrosis, ultrasonographically. Intrarenal mass 5 cases (15.2%) were all intrarenal cystic mass, NVK with air in kidney 1 case (3.0%) was air in perirenal space, partial NVK 1 case (3.0%) was per. irenal fluid , suprarenal mass 1 case (3 .0%) was suprarenal intrarenal and huge perirenal cystic masses, ultraso nograp h ically. 3. On technical reliability of antegrade pyelography under ultrasound gUide, 31 cases (93 .9%) could be done fluid aspiration and visualization, and 2 cases (6.1 %) could be only done fluid aspiration but failed visualization . 31 successful cases were visualization of collecting systems 23 cases, visualization of cyst 6 cases, i!nd visualization of perirenal space 2 cases. 2 partial successful cases were perirenal injection 1 case and parenchymal injection 1 case. 4. On fluid aspiration, 22 cases (66.7%) were clear, but 11 cases (33.3%) were not clear, which were pus 7 cases, turbid urine 2 cases, bloody urine 1 case, and bloody pus and air 1 case. 5. Comparing ultrasonographic findings with antegrade pyelographic findings, ultrasonographically hydronephrosis 21 cases revealed obstruction in 16 cases, antegrade pyelographically, which were consisted of ureteral stricture 14 cases, ureteral stone 1 case, and ureteral mass 1 case, non-obstruction in 4 cases, which were consisted of pyonephrosis 2 cases, posterior urethral valve 1 case, and megaureter 1 case, and other 1 case was visualization failure. Ultrasonographically intrarenal cystic mass 6 cases were simple renal cyst 4 cases, and infected renal cyst 2 cases, antegrade pyelographically. Multiple cysts 2 cases were lobulated huge renal cyst 1 case, and visualization failure 1 case, which was multi.cystic kidney. Air in perirenal space 1 case was emphysematous pyelone. phritis, suprarenal cystic mass 1 case was complete duplication with ectopic ureteral orifice, perirenal fluid 1 case due to kidney fracture was perirenal fluid , and intrarenal and perirenal cystic mass was per irenal abscess, antegrade pyelographically. 6. On ana lysis of anteg rade pyelography result as next diagnostic step of ultrasound, 31 successful cases were 27 conclusive diagnostic cases (87.1%), and 4 heplful diagnostic cases (12.9%) with percutaneous antegrade pyelography guided by ultrasound . 7. Antegrade pyelography provides significant diagnostic information on the nature of the obstructive lesion and can be performed as an adjunct to retrograde study or as an alterative to a pyelogram. 8. Ultrasonographic examination could be performed easiJy in diagnosis of renal and perirenal diseases as non.invasive method without risk of radiation hazard , and was not influenced by renal function. 9. Ultrasound is considered a most advantageous aid to the performance of antegrade pyelography and has yie lded valuab le diagnostic information in patients with obstructive hydronephrosis.