• Journal of Haehwa Medicine
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• v.14 no.2
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• pp.143-151
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• 2005

Gobjectives and Methods to investigate into the course of incurable and relapse renal stones' differentiation of symptoms and signs and to effectively improve treatment of incurable and relapse renal stones through Oriental Medicine. To search for the papers about treatment of incurable and relapse renal stones from 1994 till 2004, and re-search papers about treatment for indicated differentiation of disease. Result and conclusions : 1. It is the kidney vacuity additionally the deficiency of qi(氣) in middle-burner that the incurable and relapse renal stones' differentiation of disease. 2. The cause is taking an overdose of attacking renal stones to eliminate dampness and heat medicine, aging, chrome disease. a sex act excess, insufficiency of congenital qi(氣), insufficient exercise, wrong treatment and stress. 3. Herb medicines are constituted supplementing kidney drugs for inhibition of renal stone's creation, drugs to diuresis and dissolve calculi, and drugs 10 exclude stasis blood(瘀血) on account of renal stones. 4. Anti-renal stone measures me sufficiently drinking water, not eating greasy food. taking medicine for supplementing kidney, diuresis and dissolve calculi by periods, and drinking substitute water to boll down medical herb as Lysimachiae Herba (金錢草) Polygoni Avicularis Herba(篇蓄).

• 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.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.122-126
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• 2013

Cystinuria is an autosomal recessive disease characterized by impaired transport of cystine and dibasic amino acids in the proximal renal tubule, resulting in the formation of cystine stones. It is believed to account for about 1% of all kidney stones and up to 10% of pediatric stones. Here we report a case of cystinuria with multiple renal stones confirmed by genetic mutational analysis. An 8-month-old girl was admitted to AMC with persistent fever and multiple renal stones. A renal sonogram showed multiple stones at the right renal pelvis, right distal ureter, and left renal medullary portion. An approximately 1 cm renal stone was extracted spontaneously, and stone analysis revealed it to be composed entirely of cystine. Cystinuria was confirmed by increased urine dibasic amino acid levels, including cysteine, and genetic mutational analysis showed the patient to be a homozygote for the pathogenic c. 1820del (p.L607fs) of SLC3A1. Despite treatment with oral hydration and urinary alkalinization, and restricted intake of animal protein, the stones increased in size and number. The patient has since been treated with tiopronin.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.204-207
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• 2005

Ketogenic diet is a high-fat, low-carbohydrate, low-protein diet used in the treatment of epilepsy since 1920's. Recently, it's use for intractable epilepsy in childhood has increased. Complications of ketogenic diet are known to include dehydration, vomiting, diarrhea, renal stones, metabolic derangement, hypercholesterolemia and refusal to eat. We experienced two cases of renal stones in children with intractable epilepsy during ketogenic diet.

• 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.

• Advances in Traditional Medicine
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• v.10 no.2
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• pp.134-140
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• 2010

Dolichos biflorus Linn. (Fabaceae), commonly known as Horse gram is a medicinal plant, used in folk medicine for treating kidney stones and diabetes mellitus. The purpose of the present study was to investigate the effects of daily oral feeding of various doses of methanolic extract of Dolichos biflorus seeds (DB) for 42 days on blood glucose concentrations and kidney functions in Alloxan-diabetic rats. Plasma glucose levels, body weight, serum creatinine, and urinary albumin levels were monitored on $15^{th}$, $29^{th}$, $43^{rd}$ day. Renal hypertrophy was assessed as the ratio between the kidney weight and body weight of the rats. Plasma glucose concentrations in Alloxan-diabetic rats were significantly reduced by the administration of DB (350 mg/kg) and DB (700 mg/kg) on day 15 and onwards (P < 0.01). After 15 days of Alloxan administration urinary albumin levels (UAE) were over 5 fold higher in diabetic controls as compared to normal controls. Treatment with DB significantly prevented the rise in UAE levels from day 15 to 43 in comparison to diabetic controls (P < 0.01). Renal hypertrophy was significantly higher in diabetic controls as compared to non-diabetic controls. Treatments with DB (350 mg/kg) and DB (700 mg/kg) significantly prevented renal hypertrophy (P < 0.01) as compared to diabetic controls. DB (175 mg/kg) failed to modify renal hypertrophy. Thus the present study indicates that methanolic extract of Dolichos biflorus may be useful in management of hyperglycemia and kidney functions in Alloxan-diabetic rats.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8293-8298
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• 2016

Background: Urinary stones are known predisposing factors for upper urinary tract carcinoma (UUTC) which are commonly detected at advanced stage with poor outcome because of rarity and lack of specific criteria for early detection. Aims and objectives: The main aim was to evaluate the impact of age, gender andstone characteristics on risk of developing UUTC in patients with chronic nephrolithiasis. We also discuss the role of aberrant angiogenesis (AA) and immunohistochemical expression of p53, p16INK4a, CK20 and Ki-67 in diagnosis of pelvicalyceal neoplastic (NL) and pre-neoplastic lesions (PNL) in these patients. Materials and Methods: Retrospective analysis of pelvicalyceal urothelial lesions from 88 nephrectomy specimens were carried out in a tertiary care centre from June 2012 to December 2014. Immunohistochemistry (IHC) was performed on 37 selected cases. Computed image analysis was performed to analyse aberrant angiogenesis. Results: All UUTC (5.7%) and metaplastic lesions were found to be associated with stones. Some 60% were pure squamous cell carcinoma and 40% were transitional cell carcinoma. Odd ratios for developing NL and PNL lesions in presence of renal stone, impacted stones, multiple and large stag horn stones were 9.39 (95% CI 1.15-76.39, p value 0.05), 6.28 (95% CI 1.59-24.85, p value 0.000) and 7.4 (95% CI, 2.29-23.94, p value 0.001) respectively. When patient age was ${\geq}55$, the odds ratio for developing NL was 3.43 (95% CI 1.19-9.88, p value 0.019). IHC analysis showed that mean Ki-67 indices were $3.15{\pm}3.63%$ for non-neoplastic lesions, $10.0{\pm}9.45%$ for PNL and $28.0{\pm}18.4%$ for NL. Sensitivity and specificity of CK20, p53, p16INK4a, AA were 76% and 95.9%; 100% and 27.5%; 100% and 26.5%; 92.3 % and 78.8% respectively. Conclusions: Age ${\geq}55years$, large stag horn stones, multiple stones and impacted stones are found to be associated with increased risk of NL and PNL in UUT. For flat lesions, a panel of markers, Ki 67 index >10 and presence of aberrant angiogenesis were more useful than individual markers.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.923-933
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• 2023

Purpose To evaluate the sensitivity of corticomedullary-phase imaging for detecting urinary stones in patients with renal colic who visited the emergency department. Materials and Methods This retrospective study included 253 patients with suspected renal colic from two tertiary hospitals in South Korea, who visited the emergency department and underwent CT urography. Two radiologists blinded to the clinical history independently reviewed the corticomedullary-phase images. The sensitivity for identifying urinary stones were evaluated for each reviewer. After the initial evaluation, the images were re-evaluated based on patient history. The sensitivity of re-evaluation were recorded. Results Of 253 patients, 150 (59%) had urinary stones. Among them, significant stones were observed in 138 patients (92%), and obstructive changes on CT in 124 patients (82.7%). For identifying significant urinary stones, the sensitivity was 98.6% (136/138) for both the reviewers. For identifying significant urinary stones with urinary obstruction, the sensitivity was 99.2% (123/124) for reviewer 1, and 100% (124/124) for reviewer 2. The sensitivity for identifying significant stones increased from 98.6% to 100% for reviewer 1, and from 98.6% to 99.3% for reviewer 2 in the re-evaluation session. Conclusion The corticomedullary-phase CT urography was sensitive for diagnosing urolithiasis in patients with acute renal colic who visited the emergency department.

• Childhood Kidney Diseases
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• v.25 no.1
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• pp.44-48
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• 2021

Idiopathic renal hypouricemia (iRHUC) is a rare hereditary disease caused by a defect in urate handling of renal tubules. Type 1 renal hypouricemia (RHUC1) is diagnosed with confirmation of a mutation in SLC22A12 gene which encodes a renal urate-anion exchanger (URAT1). The majority of iRHUC patients are asymptomatic, especially during childhood, and thus many cases go undiagnosed or they are diagnosed late in older age with complications of hematuria, renal stones, or acute kidney injury (AKI). We report a case of a 7-year-old boy with subtle symptoms such as general weakness and dizziness and revealed hypouricemia and incidental nephrolithiasis. Homozygous mutations were detected in the SLC22A12 (c.774G>A) by molecular analysis. The present case suggests that fractional excretion of uric acid (FEUA) screening could be better followed by the coincidental discovery of hypouricemia, to prevent conflicting complications of iRHUC, even with normal urine uric acid to creatinine ratio (U_UA/U_Cr), and sequential genetic analysis if needed.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.280-287
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• 2007

Purpose : Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases. Methods : A total of 73 children(male:female=42:31, mean age $6.6{\pm}5.3$ years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children's Hospital. The medical records were reviewed retrospectively. Results : The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%). and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology. Conclusion : The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.