[Pseudodiverticula of the ureter: a precancerous lesion?].

Ureteral diverticula belong to the group of acquired diverticula even though their pathogenesis and clinical significance are still debated. They are occasionally detected during urography or retrograde pyelography and appear as small spicular or saccate wall outpouchings, single or more often multiple, mostly limited to the upper third of the ureter. The frequent association of these lesions with transitional cell carcinoma of the urinary tract is a problem of great clinical interest since they might represent a preneoplastic manifestation.

Dialysis-related amyloidosis in a large CAPD population.

We studied 212 patients from 13 Italian dialysis centers to evaluate the clinical aspects of dialysis-related amyloidosis in continuous ambulatory peritoneal dialysis (CAPD). The mean age was 64.2 +/- 12.

[Bullous pneumopathy and spontaneous pneumothorax. Atypical radiologic patterns of Pneumocystis carinii pneumonia].

Pneumocystis carinii pneumonia (PCP) is certainly the most frequent opportunistic pulmonary infection in AIDS patients. Besides the conventional radiographic features demonstrating bilateral infiltrates and airspace consolidation, atypical radiologic patterns are reported in the literature, which are characterized by spontaneous pneumothorax and by the presence of bullae, cysts and areas of pulmonary cavitation. Forty consecutive PCP patients were investigated, ten of them presenting with atypical radiographic findings: 1 case of spontaneous pneumothorax with no evidence of bullae and 9 cases of bullous lung disease--5 of them complicated by spontaneous pneumothorax.

[Bone cysts and continuous ambulatory peritoneal dialysis].

The clinical and radiologic patterns of amyloid osteoarthropathy in long-term hemodialysis patients are well known. However, few studies about the incidence of dialysis-associated amyloidosis in continuous ambulatory peritoneal dialysis (CAPD) patients have been published to date. In a series of 27 CAPD patients, the authors found bone cysts in 63.

[Color-Doppler and angioplasty in renovascular hypertension].

Renovascular hypertension is defined as a kind of hypertension secondary to altered renal perfusion with the activation of the renin-angiotensin system. Since a large number of these patients benefits from treatment--be it medical, surgical or angioplastic--a non-invasive low-cost method allowing accurate screening was looked for. Color-Doppler was employed by many authors to evaluate renovascular hypertension, for both the early diagnosis of the condition and the evaluation of treatment results in renal artery stenoses.

[Importance of specific prostatic antigen to prostatic volume ratio in the selection of patients for ultrasonography-guided biopsy of the prostate].

US-guided biopsy was performed in 94 patients with suspected lesions at transrectal US. Histology demonstrated carcinoma in 43 cases, benign hyperplasia in 44, and prostatitis in 7. In all cases the prostate specific antigen (PSA) was calculated, by means of US, together with prostatic volume (V).

Acute bilateral renal vein thrombosis superimposed on calcified thrombus of the inferior vena cava in a patient with membranous lupus nephritis.

We report a case of membranous lupus nephritis with a previous history of long-standing nephrotic syndrome which developed an acute renal failure due to bilateral renal-vein thrombosis superimposed on a calcified thrombus of the inferior vena cava eight years after the diagnosis. The occurrence of acute renal-vein thrombosis is a possible but rarely described complication of systemic lupus erythematosus. The presence of a calcified thrombus of the inferior vena cava has been described in only one adult patient until now.

[Surgical ultrasonography of the seminal vesicles in andrologic pathology. Research in progress].

The authors describe their experience with percutaneous transperineal puncture (PTP) of the seminal vesicles in andrologic pathologic conditions, using transrectal US guidance. Three cases are reported: 2 anomalies of the genital ducts and one prostatic-vesicular abscess. In the first two cases PTP allowed a diagnosis to be reached on the basis of the analysis of vesicular fluid.

[Ultrasonography in syringocele of the male urethra (ultrasound-urethrography)].

The authors have studied 5 patients with syringocele--or cystic dilatation of the excretory ducts in Cowper's glands--using a 7.5 MHz linear high-definition US probe. The urethra was distended with a saline solution introduced through a small Foley's balloon catheter placed in the navicular fossa.

[Carpal cysts in hemodialysis patients].

A new type of amyloidosis due to beta 2-microglobulin depositions has been recently described in long-term hemodialysis patients. This systemic complication mainly affects the osteoarticular system, with diffuse articular symptoms; among them carpal tunnel syndrome is the most frequent. The syndrome etiopathology is unknown, even though many causal factors have been identified, among which the repeated use of non-biocompatible dialytic membranes.

[Course of acquired renal cystic disease. An ultrasonic follow-up study].

The authors evaluated the evolution of acquired renal cystic disease with a 40-month US follow-up. Eighty-one patients were examined by US: 66 of them were hemodialysis patients, and 15 transplant recipients. Cystic kidney disease had progressed in 52/66 hemodialysis patients, whereas the picture was unmodified in 14/15 transplant recipients.

[Obstructive bladder neck syndrome in women].

Primary bladder neck obstruction in women is quite rare and its symptoms--dysuria, frequency, and urgency--are equivocal. Routine radiological investigations alone do not allow a diagnosis to be made, due to the lack of simultaneous measurements of detrusor pressure and urine flow. A precise diagnosis is thus to be obtained by synchronous video urodynamic studies which allow the depiction of nonfunneling or tight bladder neck during the entire phase of detrusor contraction, of bladder trabeculae and diverticula, vesico-ureteral reflux, long micturition time and incomplete voiding.

US-guided prostatic biopsy in 63 cases.

Over a 20-months period, 63 patients with prostatic lesions less than or equal to 2 cm in size, detected at palpation or at ultrasonography (US), were followed-up with US-guided transperineal biopsy. Within the nodules located in the peripheral parts of the gland, and still confined within the capsule, focal cancer, chronic prostatitis and benign atypical hyperplasia were detected, but typical echo patterns were not seen. All nodules located in the periurethral gland were benign hyperplasia.

[Angiographic study of the complications of vascular access in patients under hemodialysis].

Periodic hemodialysis requires the vascular access to be capable of functioning perfectly for a long time; therefore early diagnosis of the most common complications is very important. Fifty-four patients in dialysis treatment for end-stage renal failure (ESRF) were examined over a six-year period for vascular access (VA) complications. Eighty vascular accesses were studied: 68 arteriovenous fistulas and 12 arteriovenous grafts.

[Ureteral obstruction secondary to aortofemoral bypass].

Hydroureteronephrosis is reported as a frequent late complication of aorto-femoral bypass grafts in patients with aorto-iliac obstruction. To define the actual incidence of this potentially critical complication, renal ultrasonography (US) was performed on 79 asymptomatic patients who had previously undergone aortic reconstruction, after a mean interval of 71.6 months.

[Diverticula of the female urethra. A radiological and ultrasound study].

The authors analyzed the clinical, radiographic and sonographic findings of diverticulum of the female urethra, reporting on 47 cases. Lower urinary tract infections, urgency and post-urinary dribbling were the most common symptoms. Either voiding cystourethrography or positive pressure urethrography was carried out in all patients, while US was performed in 18 cases only.

[Has echography modified the occurrence of kidney carcinoma? Considerations on 316 cases].

An analysis of 316 renal carcinomas over an 11-year period has shown an increase in the incidence of tumors per year, together with a progressive decrease in the size of the lesions at the time of diagnosis. This effect occurred especially after the introduction of renal ultrasonography in diagnostic practice. The tumor size is an important prognostic factor, because the 5-year survival rate was 80% for tumors less than 5 cm and 30% for tumors greater than 10 cm.

[Syringocele or cystic diagnosis of Cowper's gland ducts].

Cystic dilatation of bulbo-urethral gland ducts (Cowper's syringocele) is an uncommon abnormality, frequently asymptomatic, showing various radiographic patterns. The lesion is more commonly seen in children, but it may be found in adults too, and may cause dysuria, pollakiuria, stranguria and posturinary dribbling. Fourteen patients with syringocele were observed: 6 of them were asymptomatic, while in 8 the most common symptoms were posturinary dribbling and stranguria.

[Echostructural polymorphism of prostatic carcinoma. Anatomo-pathologic correlations in various developmental stages].

The sonographic appearance of prostatic carcinoma was correlated with the corresponding histopathologic studies in 57 patients after transperineal biopsy. In 21 cases the lesions observed were less than or equal to 2 cm (circumscribed) and in 36 were greater than 2 cm (diffuse). Within the first group there was a prevalence of hypoechoic forms (61,9%).