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We report three cases of serious renal injuries due to blunt abdominal trauma within the context of multiple organ trauma. The renal involvement was not initially suspected, with resulting serious consequences. We suggest that infusion pyelography be performed prior to or shortly after surgery in all cases with extensive abdominal trauma. A retroperitoneal hematoma on explorative laparotomy in cases of multiple trauma should raise the suspicion of a concomitant serious renal injury, and an immediate diagnostic investigation should be conducted.

Knox reported that the short-term effects of the carcinogen methylnitrosourea (MNU) were due to the formation of its decomposition product, the cyanate ion. He showed that cell survival and DNA synthesis decreased as the concentration of MNU and the cyanate ion (NCO-) increased in the medium. Further, the product of MNU decomposition comigrated with NCO- when added to his chromatographic test system. However, Knox did not study the mutagenicity of MNU or its breakdown products. We compared the mutagenicity of MNU and potassium cyanate (KNCO) in mammalian cells. Our results demonstrate that, although it is toxic to cells, KNCO does not induce ouabain-resistant mutants in cultured Chinese hamster cells (V79).

Since 1973 intermittent catheterisation was introduced in our centre and this practically eliminated pathology of the urethra. More than half of the patients had a high and complete lesion. It is our impression that 5 years following injury more than half of the patients preserved a normal upper urinary tract; however, only 39 of the 92 patients had a follow-up of over 5 years. Nephrolithiasis was rare in comparison to other reports in spite of belonging to the stone belt area. Complications of the lower urinary tract including a 10 per cent incidence of vesico-ureteric reflux were compatible with other series. Narrowing of the external sphincter on voiding cystogram should be substantiated by a profile pressure record. One female patient is a candidate for ileal conduit. Most of the patients have some form of erection but the data on ejaculation should be accepted with reserve. Two patients in this series died more than 10 years after injury, one due to a myocardial infarction and the other due to chronic renal failure following secondary amyloidosis.

A patient with unilateral infection of the kidney due to Salm. cholerase-suis is presented. Long-term treatment with ampicillin was of no avail. Nephrectomy terminated the infection. The extirpated kidney showed severe obstruction, stones and tissue damage.