Horseshoe kidney and its therapeutic problems. (A review of seventy-one clinical cases).

A review of 71 cases of horseshoe kidney accounting for 0.12% of the total number of patients seen at the Department of Urology, Semmelweis University Medical School, Budapest, over 25 years is presented. The incidence of the abnormality has been found twice as high in males as in females. The proportion of surgical cases has been 57.8%, in agreement with published data. The radiodiagnostic investigations, particularly the functional diagnostic studies, are dealt with in detail. Their decisive importance in the considerations for or against surgery is emphasized.

[Distension treatment of the urinary bladder]. / Distensionsbehandlung der Harnblase.

Three patients were treated with hydrostatic pressure therapy (bladder distension) for different pathology, two with success, and one without effect. On the basis of preliminary results authors suggest the procedure in selected cases.

[The double-pyelon kidney with special regard to the transport function (author's transl)]. / Uber die Doppelnieren mit besonderer Rücksicht auf die Funktion des Transportsystems

The double-pyelon kidney, i.e. the total or partial duplication of the urinary transport system may involve both diagnostic and therapeutic difficulties. Observations are presented on the strength of 398 cases with total or partial duplication of the upper urinary tract. The incidence rate was 0.7 percent. The various types of duplication are presented with the diagnostic and therapeutic features involved. Transport function is discussed in detail as investigated under ideal physiologic conditions: during excretory urography under the amplifier screen. Aiming at early detection of the congenital anomaly and specification of the appropriate management, a urologic check-up is suggested even with mild presenting symptoms. Special emphasis is given to the consistent day-time enuresis in children over 3 years old, as a possible sign of ectopic ureter. Both children and parents are saved much unpleasantness by early detection, proper management and considerate surgery.

[Limb-body wall malformation complex: an unusual developmental abnormality of the abdominal wall. Case report, clinicopathological and etiological implications]. / Végtag-testfal malformációs komplexum: egy ritka hasfali fejlödési rendellenesség. Esetismertetés, klinikopatológiai és etiológiai vonatkozások.

Anterior abdominal wall defects are not too rare between developmental abnormalities. A case of abdominal wall defect associated with complex malformations diagnosed prenatally is reported in the paper. In the present case of limb-body wall complex a right sided abdominoschisis was associated with rotational abnormality of the lower limbs, clubfoot, scoliosis, meningomyelocele, lack of developed pelvic organs, consecutive dilatation of the upper urinary tract, anal atresia, lack of external genitalia, lack of diaphragm and hypoplastic lungs. Review of the pertinent literature has revealed over 100 cases that clearly indicate the possible phenotypic variation of the limb-body wall complex. These data add further evidence to support the existence of two different phenotypes and possibly pathogenesis under the heading of limb-body wall complex. The three principal theories on the possible aetiology of the complex are also discussed. Because the limb-body wall complex is incompatible with life, it is important to diagnose the lesions prenatally, and to differentiate them from other anterior abdominal wall defects. Serum alpha-fetoprotein measurement, and ultrasonographic examination are the key to prenatal diagnosis.

[Use of sodium diclofenac in acute renal colic]. / A diclofenac natrium alkalmazása akut vesekólikában.

31 patients with symptoms of acute renal colic were treated with diclofenac natrium. According to preliminary results this drug is more effective for relieving pain of acute renal colic than the traditional combination of spasmolytics and analgetics. This might be due to the blocking effect of diclofenac natrium on the renal PG synthesis and release, thus decreasing the diuresis. Side effects were minimal, as nausea, vomiting etc. Authors highly recommend this drug as the first choice of treatment in acute renal colic.

[Double kidney and ureterocele associated with kidney calculi]. / Kövel szövödött kettös vese ureterokelével.

The simultaneous occurrence of infrequent alterations--double kidney, ureterocele and calculi--is reported. Following the operation performed in 2 steps the patient became free of complaints and according to the repeated controls the dilatation of the efferent system regressed, no reflux was observed.

[Significance of nuchal edema in fetuses of pregnant women under 35 years of age]. / A tarkótáji ödéma jelentósége 35 év alatti gravidák magzatain.

The aim of this study was to survey the connection between the fetal nuchal oedema and the increased risk of the aneuploidies. According to the prenatal care the thickness of the nuchal fold was measured on the 11-12th gestational week by 6.5 MHz transvaginal transducer (ATL-HDI and Hitachi EUB-450). Cases were underlined where the presence of nuchal oedema (> or = 3 mm) made the indication for chromosomal analysis among the 280 single pregnancies and fetal karyotyping was carried out. Nuchal oedema was observed in 72/280 cases of pregnant women under 35 years old and in 20/280 cases of that above 35 years old, the nuchal oedema was another indication beside the age. Abnormal karyotype was observed in 9/72 (12.5%) cases among the pregnant women under 35 years old and in 10/92 (10.87%) cases among the pregnancies with fetal nuchal oedema. It was also observed abnormal karyotype in 6/188 (3.19%) cases of pregnancies without nuchal oedema and in 16/280 (5.71%) cases of chromosomal analyses with or without nuchal oedema. This can be an effective method for screening the fetal aneuploidies and other fetal anomalies, both in the high risk and the normal pregnant population, especially in cases of pregnant women under 35 years old belonging to the normal genetical risk population.

The use of Voltaren (diclofenac sodium, Ciba) in acute renal colic.

Thirty-one patients with acute renal colic were treated with Voltaren (Diclofenac Sodium, Ciba). The drug proved to be suitable for relieving, and stopping pain. Adverse effects were observed but in few cases. For this reason authors suggest a more extensive use of the drug.

The role of Melipramine in the treatment of bladder instability.

Observations with Melipramine (imipramine) coated tablet used in the treatment of bladder instability are reported. The patients were selected on the basis of urodynamic examinations. Five men and 45 women were treated for 2 and 4 weeks. The patients recorded the number of urinations and urgency as well as the quantity of voided urine. The effectivity of treatment was controlled by urodynamic examinations. Melipramine (3 x 2 coated tablet) given in 60-mg daily doses, favourably influenced the symptoms. The effectivity of treatment reached 90% in the selected patients. Side-effects developed in 5 cases: in 3 patients the treatment had to be discontinued because of palpitation, feeling weakness. According to the authors' opinion Melipramine is a useful therapeutic means in the treatment of bladder instability.