RESUMO
Objective: The ectopic ureter frequently drains an ectopic dysplastic or hypoplastic kidney. The present study aims at defining the role of MRU in establishing the diagnosis of this anomaly
Patients and Methods: Between February 1996 and March 2000, 11 girls presented or were referred to our department for management of urinary incontinence. Their age at presentation ranged from 4-9 years [mean 6.5 years]. Radiological work up included abdominal ultrasound [US], excretory urogram [IVU], voiding cystourethrography [VCUG], [99 m] technetium-dimercaptosuccinic acid [[99m] Tc-DMSA] renal scan, enhanced spiral computed tomography [CT] and magnetic resonance urography [MRU]
Results: Ultrasound showed evidence of a solitary kidney with failure to visualize a contralateral kidney in 7/11 patients. In the remaining 4 patients [36.4%], US revealed a pelvic kidney in two and a pelvic cystic mass in another two patients. IVU revealed only one functioning renal unit in all cases. None of the patients showed vesicoureteral reflux on VCUG. On [99 m] Tc-DMSA, a single kidney was seen in 9/11 patients and ectopic pelvic kidneys with normal contralateral kidneys in 2/11 patients. The 7 patients, in whom US and [99m] Tc-DMSA scan had failed to localize the kidney, underwent CT scanning which visualized a pelvic hypoplastic kidney with a normal contralateral kidney in 2/7 patients. The remaining 5 patients underwent MRU that disclosed a normal kidney with a contralateral lumbar hypoplastic kidney in one and a pelvic ectopic kidney in four. The patients were managed by nephrectomy [n=9] and ureteroneocystostomy [n=2]
Conclusions: A single system ectopic ureter should be suspected in all girls with continuous urinary dribbling after the age of successful toilet training. With the inclusion of MRU into radiological workup, dysplastic or hypoplastic kidneys can be accurately localized. MRU is indicated for the diagnosis and for therapeutic planning in such cases
RESUMO
Objective: To evaluate the efficacy of intra-lesional verapamil injection in the treatment of Peyronie's disease
Patients and Methods: Twenty-six patients with Peyronie's disease were divided into two groups: the verapamil treatment group [study group] including 13 patients and the saline group [control group] including another 13 patients. The patients' age ranged from 35 to 58 years with a mean age of 43.75 years. The patients in the study group were subjected to a weekly injection of 10 mg verapamil hydrochloride [5 mg / 2 ml] into the plaque for the duration of six weeks. At the same time, the patients in the control group received a weekly injection of normal saline into the plaque, also for the duration of six weeks. The patients' response to the injections was evaluated subjectively with respect to pain and sexual dysfunction and objectively with respect to the plaque volume and the degree of curvature
Results: Following therapy, pain was improved in 8 of 9 patients [88.9] of the patients in the verapamil group, while in the control group it was stationary in 6 of 8 patients [75%] and had progressed in 2 of 8 patients [25%]. Curvature was improved in 5 of 10 patients [50%] and remained unchanged in 5 of 10 patients [50%] of the study group, while no improvement could be recorded in any of the patients of the control group. Three of five patients [60%] of the study group reported an improvement in sexual function, while no improvement was reported in the control group
Conclusion: Verapamil may be considered a safe, effective non-surgical remedy for the treatment of Peyronie's disease with an acceptable outcome in selected patients
RESUMO
Thoracic injury is the cause of death in approximately one quarter of all trauma victims and is a frequent factor in the morbidity encountered in multiply injured patients. Regardless to the mechanism of injury, chest trauma is common and take different forms. In this study 40 patients ranged in age from 4 to 55 years with male to female ratio 7: 1 clinical examination was beneficial in diagnosis as symptoms like dyspnea and chest pain represent the main complaint in our series 70% and 87.5% respectively while diminished movements and air entry 90%, tenderness on the affected side 77.5% were the most common signs. Plain x-ray was done to all cases, followed by diagnostic aspiration for 85%, bronchoscopy [17.5], C. T scan [5%] of cases and barium contrast study in 5% of cases. Intercostal tube drainage was done initially in 80% of cases, while thoracotomy was done in 25% of cases and cervical mediastinotomy was done in 5% of cases. Emergency thoracotomy was done in 20 of cases. Mortality rates was 15% and mainly due to thoracic and extra-thoracic injuries