Lege Artis Medicinae

[Dilemma of the use of ionic or nonionic contrast media]

POKORNY Lajos1, VADON Gábor2

AUGUST 28, 1991

Lege Artis Medicinae - 1991;1(14)

[The conventional contrast media are cheaper, the newer contrast media - apparently more favourable for the patients – are more expensive. On the basis of large clinical and experimental material authors are analysing the effects and usability of the different contrast agents. The examinations were performed on 812 patients and on 140 dog kidneys. On the patients different angiographies were carried out. After the injection of the contrast medium we registered the the subjective sensations, side effects, complications as well as the changes of blood pressure, pulse rate, UN, Se Bi, SGOT and the qualitative changes of the protein content of the urine. On the dogs selective renal angiographies were performed, 3 and 24 hours later histological examinations were made. The patients tolerated better the new low osmolality contrast media, the number of side effects was significantly smaller. In experiment we saw the fewest irregular angiogramms and the fewest histological changes after the use of the new nonionic contrast media. According to the calculations of some authors it would be worth to use the nonionic contrast media of new type in all examinations because of not requiring general anaesthesia, medicaments to fight off complications and decrease the nursing period. In today's economical situation we can't afford in our country not to use the cheaper, conventional contrast media. Use of the new low osmolarity contrast media intravasculary is justified, but it is imperative on the patients of high risk groups, in the examination of children and sensitive organs (nervous system, coronary vessels, kidney).]

AFFILIATIONS

  1. egyetemi docens Szent-Györgyi Albert Orvostudományi Egyetem Radiológiai Klinika
  2. egyetemi tanár Szent-Györgyi Albert Orvostudományi Egyetem Radiológiai Klinika

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SZENTGYÖRGYI Ervin, KONDÁS József, KONDÉR Gyula

[A horseshoe kidney is diagnosed usually after the onset of its complication or the symptoms caused by an arising tumor from it. A tumour was diagnosed in the right half of the horseshoe kidney in a 68 year old female patient by excretory urography, ultrasound examination and renovasography. The tumour was removed by radical nephrectomy. The kidney was exposed through a horizontal abdominal approach. Special attention was given to the separate renal arteries supplying the right half of the horseshoe kidney and to the resection of the isthmus and also regional lymphadenectomy. In the diagnosis of a horseshoe kidney excretion urography had exclusively been used earlier but nowadays ultrasound is playing an increasingly important role. Reno vasography is usually needed only before resection or nephrectomy. The appropriate treatment of a horseshoe kidney tumour - in case of a well functioning contralateral kidney - is radical ablastic tumour nephrectomy including regional lymphadenectomy. ]

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