Renal artery injury is an uncommon complication of blunt abdominal trauma. We present a case of a 19-year-old man who developed acute cortical necrosis in a congenital single kidney after a motorcycle accident. On initial presentation, he had signs of splenic injury and required immediate laparotomy and splenectomy. His renal function deteriorated, and he became dialysis dependent. Computed tomography followed by percutaneous angiography showed a dissection of a single renal artery causing the formation of a large pseudoaneurysm. A second angiogram showed an increase in the size of the pseudoaneurysm. We performed a laparotomy and attempted in situ vein graft repair of the renal artery. A wedge biopsy specimen taken at laparotomy revealed acute cortical necrosis, and plain radiographs showed cortical calcification. Renal artery dissection and pseudoaneurysm formation are rare events after blunt trauma. Iatrogenic damage is the most common cause of pseudoaneurysm. Traumatic pseudoaneurysms have a poor prognosis without prompt surgical intervention. Renal arterial damage may occur after blunt trauma, and early imaging and intervention are essential to salvage renal function. © 2002 by the National Kidney Foundation, Inc.

Circumcision is a simple operation often performed under general anaesthesia. In this study, we assessed the suitability of local anaesthesia in 38 adult patients, 79.4% of whom suffered little or no discomfort. Infiltration of local anaesthesia caused moderate pain in 10 patients (29.4%) and severe pain in only one. The circumcision itself caused moderate pain in three patients and severe pain in another three (8.8%); 85% of patients expressed complete satisfaction.

Photodynamic therapy (PDT) represents a novel method of selectively treating atherosclerosis using a combination of photosensitizer drug, low power laser light, and molecular oxygen. In this preliminary study, PDT was used to treat atherosclerotic lesions in a miniswine model. Yucatan miniswine weighing between 20-30 kg, were rendered atherosclerotic by a combination of balloon endothelial injury and dietary supplementation with 2% cholesterol and 15% lard diet for 7 weeks. Following this, miniswine were given a porphyrin-type photosensitizer, Photofrin 2.5 mg/kg IV. Twenty-four hours after receiving Photofrin, swine received a general anesthetic and the infrarenal abdominal aorta was exposed. Through a longitudinal aortotomy, the posterior aortic wall was irradiated with 630 nm laser light at one of the following light doses: 60, 120, and 240 J/cm2. Four weeks after PDT, swine were killed and perfusion- fixed with glutaraldehyde. Light microscopy showed a decrease in intimal thickness for all light doses. Decreased cellular elements were seen in the irradiated zones as the laser power was increased. Non-irradiated sites showed typical atherosclerotic lesions with foam cells, fibrosis and calcification. This study demonstrated the feasibility of using PDT for atherosclerotic lesions.