1992, The British Journal of Radiology, 65, 731-732
Correspondence (The Editors do not hold themselves responsible for opinions expressed by correspondents)
Spontaneous disappearance of staghorn calculus THE EDITOR—SIR,
I read with interest the report by McGann et al (1991). There are earlier reports than theirs of spontaneous disappearance of staghorn calculi. Elliot (1954) reviewed the literature to that date and collected 13 cases of spontaneous dissolution of renal calculi to which he added a further four cases. Not all of these fulfilled McGann's criteria, but all involved large stones which disappeared without treatment. I append figures of another case given to me by T. H. Cullen, FRCS. They show complete disappearance of a large right staghorn calculus and partial regression of a left staghorn calculus over a period of 4 years and 8 months in an adult female (Figs 1 & 2). She received no treatment. As Elliot (1954) commented, "it seems likely that spontaneous dissolution of renal calculi occurs more commonly than one might expect from the literature". Yours etc.,
Figure 2.
L. SHEPPARD
Author's reply Acknowledgment I am grateful to T. H. Cullen for the radiographs. Kettering and District General Hospital, Rothwell Road, Kettering, Northamptonshire NN16 8UZ (Received 2 March 1992 and accepted 8 April 1992) References ELLIOT, J. S., 1954. Spontaneous dissolution of renal calculi. The Journal of Urology, 72, 331-336. MCGANN, G., GRANT, D., MILLER, R., 1991. Spontaneous disap-
pearance of a staghorn calculus. British Journal of Radiology, 64, 1161-1162.
THE EDITOR—SIR,
We are grateful to Dr Sheppard for drawing our attention to Dr Elliot's (1954) review of the literature. As acknowledged in Dr Sheppard's letter, not all of these cases fulfilled the criteria specified in our report. In particular, the rapidity of dissolution (7 months) was particularly striking in our case. This has implications for the management of patients scheduled for percutaneous nephrolithotomy and emphasizes the need for pre-operative imaging to be performed immediately prior to admission for surgery. Yours etc., D. S. GRANT
Department of Imaging, Whittington Hospital, Highgate Hill, London N19 5NF (Received 19 March 1992 and accepted 8 April 1992) Reference Elliot, J. S., 1954. Spontaneous dissolution of renal calculi. The Journal of Urology, 72, 331-336.
Radiation damage to mouse skin and oesophagus THE EDITOR—SIR,
Figure 1.
Vol. 65, No. 776
I read with great interest the article by Marino et al (1990) and would like to dispute some of the statements and conclusions of it, especially those related to radiation damage to the oesophagus. Many experimenters either proposed or accepted as true the claim that early cumulative mortality of whole thorax-irradiated rodents is mainly or entirely due to radiation damage to the oesophagus and Marino et al (1990) seem to subscribe to this view. It has, however, been found by autopsy of all succumbing mice so treated followed by light microscopic examination of their thoracic
731
Correspondence (The Editors do not hold themselves responsible for opinions expressed by correspondents)
Spontaneous disappearance of staghorn calculus THE EDITOR—SIR,
I read with interest the report by McGann et al (1991). There are earlier reports than theirs of spontaneous disappearance of staghorn calculi. Elliot (1954) reviewed the literature to that date and collected 13 cases of spontaneous dissolution of renal calculi to which he added a further four cases. Not all of these fulfilled McGann's criteria, but all involved large stones which disappeared without treatment. I append figures of another case given to me by T. H. Cullen, FRCS. They show complete disappearance of a large right staghorn calculus and partial regression of a left staghorn calculus over a period of 4 years and 8 months in an adult female (Figs 1 & 2). She received no treatment. As Elliot (1954) commented, "it seems likely that spontaneous dissolution of renal calculi occurs more commonly than one might expect from the literature". Yours etc.,
Figure 2.
L. SHEPPARD
Author's reply Acknowledgment I am grateful to T. H. Cullen for the radiographs. Kettering and District General Hospital, Rothwell Road, Kettering, Northamptonshire NN16 8UZ (Received 2 March 1992 and accepted 8 April 1992) References ELLIOT, J. S., 1954. Spontaneous dissolution of renal calculi. The Journal of Urology, 72, 331-336. MCGANN, G., GRANT, D., MILLER, R., 1991. Spontaneous disap-
pearance of a staghorn calculus. British Journal of Radiology, 64, 1161-1162.
THE EDITOR—SIR,
We are grateful to Dr Sheppard for drawing our attention to Dr Elliot's (1954) review of the literature. As acknowledged in Dr Sheppard's letter, not all of these cases fulfilled the criteria specified in our report. In particular, the rapidity of dissolution (7 months) was particularly striking in our case. This has implications for the management of patients scheduled for percutaneous nephrolithotomy and emphasizes the need for pre-operative imaging to be performed immediately prior to admission for surgery. Yours etc., D. S. GRANT
Department of Imaging, Whittington Hospital, Highgate Hill, London N19 5NF (Received 19 March 1992 and accepted 8 April 1992) Reference Elliot, J. S., 1954. Spontaneous dissolution of renal calculi. The Journal of Urology, 72, 331-336.
Radiation damage to mouse skin and oesophagus THE EDITOR—SIR,
Figure 1.
Vol. 65, No. 776
I read with great interest the article by Marino et al (1990) and would like to dispute some of the statements and conclusions of it, especially those related to radiation damage to the oesophagus. Many experimenters either proposed or accepted as true the claim that early cumulative mortality of whole thorax-irradiated rodents is mainly or entirely due to radiation damage to the oesophagus and Marino et al (1990) seem to subscribe to this view. It has, however, been found by autopsy of all succumbing mice so treated followed by light microscopic examination of their thoracic
731
