• Title/Summary/Keyword: Ureter Stone

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Extracorporeal Shock Wave Lithotripsy for Proximal Ureter Stone with Complete Obstruction : Analysis of the Appropriate Session for Changing Treatment Modality According to Stone Size (완전 폐색을 동반한 상부 요관 결석에 대한 체외충격파쇄석술 : 결석의 크기에 따른 적절한 치료 전환 시기 분석)

  • Son, Soon-Yong;Lee, Won-Hong
    • Journal of radiological science and technology
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    • v.28 no.4
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    • pp.287-291
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    • 2005
  • To determine the appropriate session for changing treatment modality according to the size of proximal ureter stone with complete obstruction, We analyzed 201 patients with proximal ureter stone primarily treated by Dornier MPL 9000 lithotripter from January, 2002 to August, 2004. Of total 201 patients, the patients without complete obstruction were 142, and with complete obstruction were 59. In the patients without complete obstruction, the accumulative stone free rate of the first, second, and third session were 68.3%, 86.6%, and 94.4%, respectively. The accumulative stone free rate according to the stone size at third session were 100%, 90.5%, 00.0% in stones less than 10 mm, 10 to less than 20 mm, and larger than or 20 mm, respectively. In the patients with complete obstruction, the accumulative stone free rate of the first, second, and third session were 44.1%, 66.1%, and 76.3%, respectively. The accumulative stone free rate according to the stone size at third session were 100%, 65.5%, 33.3% in stones less than 10 mm, 10 to less than 20 mm, and larger than or 20 mm, respectively. In our study, the size of proximal ureter stone with complete obstruction influenced noticeably on the success rate of extracorporeal shock wave lithotripsy (ESWL). We propose that the proximal ureter stones larger than or 10 mm with complete obstruction are treated by ureteroscopic manipulation than ESWL as the first line treatment modality.

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Take advantage of ESWL in comparison measurement of Proximal stone against Mid Ureteral Stone according to its provability of pulverization (ESWL을 이용한 Proximal, Mid Ureteral Stone의 쇄석시 각 조건에 대한 쇄석율의 비교 측정)

  • Kang, Kwang-Soo;Lee, Sang-Bok;Lee, Jun-Haeng
    • 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.

Usefulness of Twinkling Artifacts in Color Doppler Ultrasonography (컬러 도플러 초음파에서 Twinkling artifacts의 유용성)

  • Sim, Hyun-Sun;Kwon, Kyung-Tae
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.291-298
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    • 2016
  • The aim of the study was to investigate the diagnostic value of the color Doppler twinkling artifact in disease of urinary system. The intensity of twinkling artifact(TA) with color Doppler was classified into 3 levels, 0(non-TA) to 3(distinct TA). In the in vitro study, acorn jelly with various materials on top was examined using color Doppler at B-mode sonography in a water bath for TA. 31 patients with diagnosis of urinary calculi(renal stones 16, urinary stones 15) based on B-mode sonography were studied in vivo for TA. The materials with rough surfaces such as salt, screw and cubics at B-mode sonography with color Doppler contributed to causing TA. At B-mode sonography without color Doppler 37% of renal stones and 60% of ureter stones were detected. but at B-mode sonography with color Doppler TA was demonstrated for all cases. Superficial roughness of materials affected occurrence of TA at B-mode sonography with color Doppler. Therefore, TA at B-mode sonography without color Doppler could play a role in confident diagnosis of the disease of urinary system.

Usefulness of Color Doppler for Non-dilatational Ureteral Stone (비확장성 요관결석에 대한 컬러 도플러의 유용성)

  • Sim, Hyun-Sun
    • The Journal of the Korea Contents Association
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    • v.17 no.1
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    • pp.120-128
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    • 2017
  • Acute flank pain from urolithiasis is the most common condition in people visiting emergency rooms. This study is to evaluate the usefulness of color Doppler in detecting ureteral stones in patients without hydronephrosis. We performed ultrasonography and retrospective analysis on 161 patients who were suspected of urinary stones through plain radiography of the kidney, ureter, and bladder examination or urine tests that showed positive signs of hematuria. In ultrasonography, a total of 154 (95.6%) cases from the 161 patients were diagnosed with ureteral stones. In color Doppler, ureteral stones with twinkling artifact (TA) in the absence of hydronephrosis was shown in 18 (85.7%) cases of the 21 patients(p<0.001). The use of color Doppler has a high diagnostic efficacy for the detection of indistinguishable stones, non-dilatational ureteral stones, and middle ureter stones.

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data

  • Jung, Joon Se;Han, Chang Hee;Bae, Sangrak
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.383-391
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    • 2018
  • Purpose: We aimed to analyze the incidence and prevalence of urolithiasis in Korea over the last decade using the National Health Insurance (NHI) sample cohort data. Materials and Methods: From January 2002 to December 2013, we enrolled sample cohort data from the NHI. Patients diagnosed with international classification of diseases code N20 or N13.2 were included. The incidence and prevalence rate was counted from the same period and patients previously diagnosed with urolithiasis were excluded. We compared the incidence and prevalence of urolithiasis by region, age, and sex, and identified the changes. Results: Total 1,111,828 subjects were included. Of these subjects, 36,857 had urolithiasis. The male-to-female ratio was 1.57:1, and total incidence rate was 3.27 per 1,000 person-years (1,000p-yrs). The annual incidence was lowest in 2013 (3,138 patients) and highest in 2005 (3,751 patients). Incidence rate by diagnostic code was highest in ureter stone only (2.49 per 1,000p-yrs) and was lowest in kidney and ureter stone both (0.17 per 1,000p-yrs). Prevalence gradually increased from 3,172 in 2002 and 5,758 in 2013. Jeollanam-do had the highest incidence rate of 3.70 persons per 1,000p-yrs, and Jeju had the lowest rate of 2.84 persons per 1,000p-yrs. In gender analysis, Daegu had the highest incidence (4.56) in males, Jeollanam-do had the highest incidence (3.20) in females. Conclusions: Annual incidence remained stable, whereas prevalence gradually increased. The incidence in male was 1.57 times higher than female, and the peak incidence age was 45-49 years, with the highest incidence occurring in Jeollanam-do and the lowest in Jeju.

Transurethral Dormia Dislodging in Patients with Lower Ureteral Stone (하부 요관결석 환자에서 Dormia Stone Dislodger를 이용한 경뇨도적 요관배석술의 의의)

  • Kim, Eun-Gill;Suh, Jun-Kyu;Kim, Young-Soo;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.81-85
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    • 1985
  • Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial Herem we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 4-6 mm, and 33% in 6-10mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained In the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And In the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

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Radiation Dose during Fluoroscopy at the Organ from Extracorporeal Shock Wave Lithotripsy (체외충격파쇄석술에서 투시 시 주요 장기별 방사선 피폭선량)

  • Moon, Sung-Ho;Jung, Hong-Ryang;Lim, Cheong-Hwan
    • 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.

Primary Hyperparathyroidism due to Parathyroid Adenoma (부갑상선 선종에 의한 원발성 부갑상선 기능 항진증)

  • Park, Woo-Hyun;Bae, Byung-Jin;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.68-69
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    • 2000
  • A case of primary hyperparathyroidism due to parathyroid adenoma is presented. A 14 year-old male was admitted to the hospital comptaining of voiding difficulty. The intravenous pyelogram demonstrated a stone in the proximal one third of the left ureter and marked hydronephrosis of the left kidney. The Tc-99m sestamibi nuclear scan demonstrated a hot spot below the lower pole of the left lobe of the thyroid. Laboratory study demonstrated hypercalcemia (12.4 mg/dL) and elevated parathyroid hormone (143.67 pg/mL). A parathyroid gland located below the lower pole of the left lobe of the thyroid was excised. A parathyroid adenoma, consisting of mainly chief cells was found on pathologic examination. Postoperatively the patient had transient hypocalcemic symptoms, which resolved with administration of calcium preparation and vitamin D.

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Emphysematous pyelonephritis associated with calcium oxalate uroliths detected on computed tomography in an awake dog

  • Kwak, Ho-Hyun;Hussein, Kamal Hany;Woo, Heung-Myong;Park, Kyung-Mee
    • Korean Journal of Veterinary Research
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    • v.60 no.2
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    • pp.93-96
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    • 2020
  • An 11-year-old female mixed-breed dog admitted due to anorexia and vomiting. Radiography showed 7.6-mm uroliths in the right proximal ureter and an enlarged kidney. Type 1 emphysematous pyelonephritis (EPN) was diagnosed using computed tomography (CT) in the awake dog. Right ureteronephrectomy was performed, and Escherichia coli was isolated. The stone was consisted of 80% calcium oxalate. At the 6-month follow-up, no complications were observed. This is the first report of EPN caused by calcium oxalate in a dog. In addition, we suggest performing CT in weak animals to diagnose EPN without anesthesia.

Clinical Study of Augmentin (Augmentin 의 임상효과)

  • Kim, Hyeong-Muk;Im, Chang-Yeong
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.174-179
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    • 1986
  • Augmentin is a formulation of amoxycillin trihydrate and potassium clavulanate, a fused beta-lactam molecule produced by the fermentation of Streptomyces clavuligerus. Most clinically important resistance is due to the production by bacteria of antibiotic destroying enzymes. In the case of penicillins and cephalosporins these enzymes are termed beta-lactamase as they destroy the beta-lectern ring of these antibiotics, completely inactivating them. The presence of clavulanic acid extends the spectrum of amoxycillin to include bet On clinical study of the intravenous Augmentin in the field of thoracic and cardiovascular surgical cases, we selected randomly 30 patients, 21 male and 9 female, age from 13 to 72, in the period from April to December 1985. Among the total 30 patients, 22 were preoperatively infected [11 thoracic empyema, 5 lobar pneumonia, 2 lung abscess, 2 bronchiectasis, one acute pyelonephritis with ureter stone and one rheumatic carditis], and 8 were not infected preoperatively [Table 1, 2]. Of the preoperatively infected group, 11 cases [50%] were culture positive [4 staphylococcus, 3 pseudomonas, 2 Serratia group, and one E. coli], and preoperatively non-infected group [8 cases] revealed expectedly negative findings on bacterial culture. All of the culture positive bacteria were sensitive to Augmentin on disc culture sensitivity test except one case of E. coli. Daily doses of intravenous Augmentin were 2.-1-6.0gm divided in 2-5 injections. Every injection administered [1.2gm at Augmentin dissolved in 20ml distilled water] slowly for more than 20 minutes. Duration of injection was variable according to the clinical conditions from minimum 5 to maximum 31 days. The results of antibiotic treatment with Augmentin and some other antibiotic combinations pre- and postoperatively were subgrouped as EXCELLENT, EFFECTIVE, and FAILURE. Clinical criteria of the therapeutic result were symptomatic, objective and laboratory improvement. 8 cases were excellent, 13 effective, and one failure among the preoperatively infected group, and all 8 cases of the preoperatively non-infected group were effective as pro;hylactive antibiotic therapy. Overall effective ratio was 97% in both subgroup. There was no side effect clinically and laboratory study including liver and kidney function test during and after the I.V. administration of Augmentin. Oral swallow tablets which were administered after discharge from hospital also revealed good effects with some degree of gastrointestinal trouble.

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