• Proceedings of the Korean Society of Radiological Science
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• 1992.05a
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• pp.17-19
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• 1992

• Proceedings of the Acoustical Society of Korea Conference
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• spring
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• pp.389-392
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• 2002

체외 충격파 쇄석술 (ESWL)은 인체 외부에서 발생된 충격파를 인체 내부의 결석 부위에 집속하여 결석을 분쇄하고 치료 효과를 얻는 혁신적 치료술이다. 충격파의 압력 및 파형은 결석의 분쇄 효과 즉 치료 효과를 좌우한다. 체외에서 충격파의 압력은 고감도 하이드로폰을 이용하여 측정할 수 있지만, 인체 체내에서, 특히, 비침습적으로 충격파를 측정하기는 매우 어렵다. 본 논문에서는 ESWL 충격파에 의해 활성화된 체내의 기포군으로부터 방출된 음향 신호 (CIAE)를 측정하여 비침습적으로 충격파의 압력을 추정하는 방법을 실험하였다. 충격파 압력의 추정은 측정된 CIAE 신호에서 1차 기포군 파열음과 2차 파열음 간의 시간 지연은 충격파의 압력과 선형적인 관련성 가진다는 실험 결과 (Coleman et al 1996)에 근거하고 있다. 본 논문에서는 충격파 압력 측정 시스템을 구성하여 생체 외 실험을 수행하였고, 개발된 시스템의 임상적인 활용 가능성을 확인하였다.

• Childhood Kidney Diseases
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• v.27 no.2
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• pp.127-132
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• 2023

Cystinuria, a genetically inherited disorder, is a rare cause of kidney stones. It is characterized by impaired transport of cystine and amino acids in the proximal renal tubule and the small intestine. Most patients develop cystine stones throughout their lifetime. Recurrent renal stones need to be extracted by repeated urologic interventions. Treatment options of cystinuria for preventing stone recurrence are limited and poorly tolerated. In this study, we report a pediatric case of cystinuria with a heterozygous SLC3A1 mutation diagnosed by stone analysis, measurement of urine cystine excretion, and genetic analysis. There were recurrent renal stones despite repetitive shock wave lithotripsy and retrograde intrarenal surgery. However, the rate of stone formation seemed to be slower after D-penicillamine was added into adequate hydration and urinary alkalinization.

• Clinical Endoscopy
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• v.56 no.3
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• pp.375-380
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• 2023

Cholecystectomy is the best method for treating gallstone diseases. However, 10%-30% of patients who undergo a cholecystectomy continue to complain of upper abdominal pain, dyspepsia, or jaundice-this is referred to as postcholecystectomy syndrome. Cystic duct stump stones are a troublesome cause of postcholecystectomy syndrome. Conventionally, surgery is mainly performed to remove cystic duct stump stones. However, repeated surgery can cause complications, such as postoperative bleeding, biliary injury, and wound infection. As an alternative method of surgery, endoscopic retrograde cholangiopancreatography is sometimes used to remove cystic duct stump stones, although the success rate is not high due to technical difficulties. Recently, peroral cholangioscopy, which can directly observe the bile duct, has been suggested as an alternative method. We report two cases in which a cystic duct stump stone was successfully removed via a single-operator cholangioscopy, after failure with an endoscopic retrograde cholangiopancreatography.

• Journal of radiological science and technology
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• v.28 no.2
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• pp.105-110
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• 2005

Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

• Journal of the Korean Society of Radiology
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• v.8 no.7
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• pp.461-466
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• 2014

The advantages and disadvantages of the various models of crushed ESWL (Extracorporeal Shock Wave Lithotripsy) and their various side effects due to pre-treatment have been reported. We look for the appropriate intensity of the shock wave in the electromagnetic ESWL treatment of patients with lower Inferior Ureter Stones and measure the total running time of C-arm saw. This study is based on the January-June 2014 launch of 65 patients of C university hospital located in Gyeongbuk, who conducted ESWL without pre-treatment. Patients are composed of 48 male and 17 female which were more common in men, while the most common age is 50s. The occurrence of lower urinary tract stones were left and they were more absent than 5mm in size in 39 of the most common. Optimal intensity is one of the suitable intensity of pain, and it is possible to switch the strength of impact to C if one appeals pain. In addition, the C-arm of the total operating time showed $241.73{\pm}30.37$ seconds, which is the size of the lower urinary tract that showed a significant difference (p <0.05). Therefore, ESWL treatment without pre-enforce treatment, the standard for the impact frequency and impact strength depending on the site of ureteral stones is required. The standard for total operating time of C-arm generated for ureteral stones is needed in order to reduce radiation exposure, and the standard for the total operating time for the criteria is needed depending on the site in order to minimize the exposure.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.343-350
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• 2010

We measured the radiation exposure for 55 persons (male: 36, female: 19) who was diagnosed with kidney and ureter stones and received ESWL. The absorbed dose was measured at the organ which is expected to absorb relatively much radiation (kidney, bladder, liver). The radiation dose measurement voltage 80kVp, current of 5mA as a fixed model of the human body by using the Rando phantom with Radiophotoluminescent Glass Dosimeter. Absorbed dose was measured for two times (5 minute and 10 minute, each) and converted to effective dose. Mean number of treatment was 1.8 times (1~4) per patient was the mean time of radiation exposure533 seconds (248-2516). For the treatment of right renal stone, the effective dose of right kidney, left kidney, liver and bladder was 2.458mSv, 0.152mSv, 1.404 mSv and 0.019mSv, respectively. For the treatment of left renal stone, the effective dose of right kidney, left kidney, liver and bladder was 2.496mSv, 0.252mSv, 0.178 mSv, and 0.017mSv, respectively. For the treatment of distal ureter stone, the effective dose of right kidney, left kidney and bladder was 0.009mSv, 0.01mSv and 3.742mSv, respectively.

• Journal of radiological science and technology
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• v.29 no.2
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• pp.71-74
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• 2006

We analyzed retrospectively our experience to evaluate an effect of extracorporeal shock wave lithotripsy (ESWL) for renal stone with infundibular stenosis. From January 2002 to August 2005, 35 patients with renal stone with infundibular stenosis were treated with ESWL. The diagnosis of infundibular stenosis was made by intraveneous pyelography or retrograde pyelography. The final follow-up check was performed by simple abdominal film or computed tomography and interview after 6 months to 24 months (mean 10 months). 7(20.0%) of 35 patients was freed completely, but Stone free rate including less than 2 mm size was 80%(28/35). 30(85.7%) patients became asymptomatic, 4(11.4%) patients were continued, and 1(2.9%) patient was required the percutaneous nephrostolithotomy. Although ESWL has a low complete stone free rate, We suggest that renal stone with infundibular stenosis should be treated with ESWL, because that is likely to produce a high symptom free and low complications.

• Journal of the Korean Society of Radiology
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• v.4 no.1
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• pp.11-17
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• 2010

A urolithiasis, also called calculus, is one of the brutal illnesses, which has constantly harassed humanbeings from time immemorial. However, there is no appropriate method of prevention so far. So, Urological therapy must be followed upon those patients. The biggest problem of urolithiasis is usually causing harsh pain, fever, and throw up. The pain would be more intensified when something came through the ureter or the moment of convulsion caused beyond transmission of urinary calculus. Even strong painkillers, such as fentanyl and Pethidine, can not handle those harshly pain easily. Therefore, a prompt action of medical check up and its therapy must be required to those patients. This thesis paper has put the accent on the specific therapy, known as ESWL (Extracorpereal Shock Wave Lithotripsy), which have generated quite optimum resolution to patients, who received harsh pain from Proximal ureteral stone and Mid ureteral stone and because of its low provability of pulverization. The results of the experiment confirmed that the stone, located between Proximal and Mid ureter, has lower provability of pulverization than distal ureter, because its accuracy rate on shock wave, in respect of breathing, are low. However, decrease in discharge interval have enhanced provability of pulverization. it can also intensify probability of pulverization and its safety by discharging high power with appropriate intervals, and that is more efficient than discharging low power with frequent time.

• Clinical Endoscopy
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• v.51 no.6
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• pp.596-599
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• 2018

An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.