Persistent acute renal failure with renal artery stenosis: cure following reconstructive arterial operation

A case of acute renal failure is reported in which renal function returned after surgical correction of renal artery stenosis to the sole functioning kidney. Acute renal failure associated with renal vascular lesions is reviewed. Although often clinically apparent vascular obstruction may be asymptomatic and should be considered in cases of prolonged acute renal failure.     

Topical corticosteroid therapy complicating congenital glaucoma

A 4-month-old infant with congenital glaucoma had been treated with a topical antibiotic-corticosteroid for three months. This fact complicated initial management, delaying definitive diagnosis and therapy. Topical steroid therapy in infants can produce a condition simulating congenital glaucoma. Since there is little rationale for using topical steroids to treat most infantile external disease processes, they are best avoided. When steroids are used for a prolonged period, some strategy for detecting glaucoma should be adopted.     

Ventricular aneurysmectomy for the treatment of intractable angina pectoris

Resection of a large postinfarctional ventricular aneurysm led to termination of intractable angina pectoris in one patient. The patient has been followed for 5 years and remains angina-free, even though aorto-coronary bypass surgery was not performed in this patient. The patient presented no evidence of congestive heart failure, arterial emboli, or cardiac arrhythmia before or after the surgery. Intractable angina alone in the absence of congestive heart failure, systemic embolism, and refractory ventricular tachyarrhythmia may constitute another indication for ventricular aneurysmectomy with or without concomitant aorto-coronary bypass surgery.     

Silicon diode detectors used in radiological physics measurements. Part II: Measurement of dosimetry data for high-energy photons

Initial calibration of a linear accelerator requires physics instruments to measure accurately central axis depth-dose and off-axis data, both in and out of the beam. These data for an 8- MeV unit were first measured using film, a Farmer 0.6-cm3 ion chamber, a 0.3-cm3 ion chamber, and a 0.1-cm3 silicon diode. Both small probes and film gave a high response compared to the Farmer probe, which has a uniform energy response. Measurements with the diode interfaced to an X-Y recorder required only a fraction of the time required with the chambers, minimizing error due to change in machine output, and permitted resolution of isodose lines in the penumbra. However, corrections required at points in depth due to nonuniform energy response of the unshielded diode were laborious. Construction of a partially shielded diode which duplicates the response of the Farmer probe eliminated the necessity for corrections, permitting rapid accumulation of a wide range of depth-dose and off-axis data.     

Therapeutic comparison of thiol compounds in severe paracetamol poisoning

Twelve patients with toxic blood concentrations of paracetamol were treated with either cysteamine or amino-acid solution. None of the patients developed severe liver damage, although transient mild biochemical abnormalities developed in three. None of the patients treated with amino-acid solution had side effects due to therapy, whereas all those treated with cysteamine did. It is recommended that amino-acid solutions be used as a temporary measure in patients suspected of massive paracetamol overdose while awaiting estimation of blood paracetamol concentration.     

Squamous cell carcinoma of the urachus

The third documented case of primary squamous cell carcinoma of the urachus in the English literature is reported. The interesting coincidental occurrence of the dermoid cyst of the right ovary and a complete longitudinal septum of the vagina and uterine cervix is described.