Computed tomography in the evaluation of regional metastases of lung cancer

The rate of metastatic spread of different groups of intrathoracic lymph nodes has been studied in depending on localization of the tumor by the nodes using CT method. 126 patients were examined with verified diagnosis of lung cancer. The central form was diagnosed in 55 (43.6%) patients, peripheral--in 71 (56.4%), a tumor was located in the upper lobe in 72 (57.1%), in the lower lobe--in 47 (37.4%), and in the middle lobe--in 7 (5.5%). CT-semiotic of metastatic lymph nodes was studied. The indices of the efficiency of diagnostic imaging when using CT were analyzed as well. The analysis of data obtained has shown that CT has great possibilities in evaluation of regional metastases of lung cancer.     

Capacities of examination of renal function at excretory urography

The study was undertaken to enhance the diagnostic capacities of excretory urography in evaluating renal function, by determining the renal clearance of a contrast medium. The main task of the study was to develop bloodless and rather reliable ways of estimating the volume of the body's distributed contrast medium and its urinary concentration in the patient at urography. Excretory urography was performed in 248 patients aged 12 to 75 years. The specific gravity of excreted urine was determined with a standard laboratory urometer to 0.001 g/cm3. Absoption spectrophotometry was used to determine the serum concentration of contrast medium in 67 patients. The values of concentrations were plotted in the semilogarithmic ordinate system, followed by extrapolation of the initial segment of the plot to the so-called zero point determining the value of the concentration of contrast medium at the moment of its complete distribution in the intercellular space. The derived value was compared with the medium's dose coming into the body, which made it possible to determine the degree of dilution of the substance, i.e. the volume of its distribution in the organism. There was a linear relationship between the concentrations of renally eliminated contrast medium and the specific gravity of excreted urine. The numerical value of the constant reflecting this relationship is equal to 6. There was evidence for that such studies could be made by routine urometry. A high correlation was found between the body mass and the volume of distribution of contrast medium in the intercellular space. The discovery of the above regularities permitted the procedure for measuring the values of two most important physiological renal process (glomerular filtration and trabecular water reabsorption) to be simplified and widely available. The paper outlines the great promises for using excretory urography as a scanning functional test during a primary study and a follow-up of the patient's status.     

Principles in the X-ray diagnosis of early stages of renal failure

The study was undertaken to impart better functional capacities to a urographic study and to convert its results to quantitative characteristics in order to realize its new capacities, namely, to detect early and latent renal functions. Three hundred and fifty-eight patients (165 males and 193 females) aged 3 to 74 years underwent excretory urography using the contrast agent Urografin. In 173 patients, X-ray planimetry determined the index of the renal parenchymatous area and estimated its size in relation to the individual normal value, i.e. the area of the body of the first lumbar vertebra. During urographic studies, 185 patients had a X-ray functional test that was used to determine the glomerular filtration by X-ray contrast agent clearance. A high correlation was established between the area of the parenchyma of the unaffected kidney and the X-ray planimetric area of the body of the first lumbar vertebra (a ratio of 3:1), which offered possibilities of estimating the normal value of parenchymatous tissue for each specific person. A procedure was developed to determine the individual normal glomerular filtration rate by contrast agent clearance. There was evidence for the fact that there was a close relationship of the anatomic parameters of the normal kidneys to their functional ones, which suggests that the filtrability of the glomerular apparatus corresponds to the mass of the intact parenchyma. This has allowed the authors to discover a basic principle of the X-ray diagnosis of renal failure, which consists in recording the parenchymatous tissue size-filtrability imbalance occurring in this condition; this fact may suggest the death of acting nephrons or a temporary reduction in their physiological potential.