• Title/Summary/Keyword: renal stones

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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.

Coexistent Parathyroid Adenoma and Well Differentiated Thyroid Careinoma (분화성 갑상선암과 공존한 부갑상선 선종)

  • Lee Joon-Ho;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.241-246
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    • 1997
  • It has become evident in recent years that parathyroid adenoma and well differentiated thyroid cancer occur together more than would be expected by chance alone. However, the association between them is not well understood. We have experienced 4 cases of coexistent parathyroid adenoma and well-differentiated thyroid cancer during the past 16 years. None of them had a familial incidence or a history of radiation exposure. Three cases showed symptomatic hypercalcemia(including renal stones, bone pain, joint pain) and in two of them(patient 1 and patient 2), thyroid abnormalities were detected preoperatively by neck ultrasonography or neck CT for evaluation of parathyroid lesions. However, in patient 3, a parathyoid humor was identified and removed incidentally during the course of thyroidectomy. In 3 cases, surgeries for thyroid carcinoma and parathyroid adenoma were performed during the same exploration of the neck, but in patient 4, thyroidectomy preceded parathyroidectomy; The interval between thyroidectomy and subsequent parathyroidectomy was 11 yeras. The thyroid tumors in 3 cases were papillary carcinoma, the sizes of which ranged from 1.0 cm to 1.5 cm in greatest diameter. The remaining case(patient 4) was minimal invasive follicular carcinoma. Total or near-total thyroidectomy with various types of cervical lymphnode dissection and bilateral neck exploration for the parathyroid lesion was performed in 3 cases with papillary carcinoma. Ipsilateral lobectomy and contralateral partial thyroidectomy with consequent unilateral neck exploration for the parathyroid tumor was performed in the case of follicular cancer. In our experience, parathyroid adenoma and well-differentiated thyroid carcinomas can be coexistent and we felt that the attention to the hypercalcemic patients would be needed for detection of this rare condition.

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Assessment of Relapsing Urolithiasis from K43 with Erosive Gastritis (미란성 위염 환자 K43에서 재발성 요로 결석에 관한 연구)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.44-52
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    • 1997
  • Nephrolithiasis is the most common disorder of the urinary tract in hospitalized patients, more frequently increased in 30~50 years of age, more common in males than in females, prior right stone to left side, and than upper ureteral stone is found in cultural country, while lower ureteral stone is increased in uncultural country. Stone components are classified as calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid, cystine, and their mixed stone, respectively. According to the pathophysiology of urinary stones, supersaturation/crystalization of inorganic salt concentration in urine, organic matrix, inhibitor deficiency, and epitaxy theory could be based on the stone formation. Not only hypercalciuria, hyperparathyroidism, hyperoxaluria, hyperuricosuria, and cystinuria, but also renal tubular acidosis, hypervitaminosis D, and peptic ulcer, are significantly associated with nephrolithiasis. In this study upper ureteral stone component were analyzed with chemical analysis, infrared spectrum, and image analyzer from K43 patient wit erosive gastritis. As the results, mixed stone of calcium oxalate dihydrate and calcium phosphate apatite was identified, the values of clinical test in blood and urine maintained normal revels. The relapsing urinary stone from K43 have no correlation between factors for stone formation reported early, also have no evidence for risk from erosive gastritis.

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Comparison of Northgate SD-3 and Modulith SLX Lithotriptors: Treatment Results with 2,000 Renal and Ureteral Stones (Northgate SD-3와 Modulith SLX 쇄석기를 이용한 체외충격파쇄석술의 비교분석: 단일 신결석 및 요로결석 2,000례의 치료결과 분석)

  • Lee, Jun-Young;Jung, Hee-Chang;Moon, Ki-Hak;Cho, Chul-Kyu;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.85-93
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    • 1999
  • Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1998. 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. And 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were calculated, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and Modulith SLX, the success rate according to the location was 91.0%(579/636) and 88.1%(236/268) in kidney: 93.2%(517/555) and 89.9%(258/287) in upper ureter: 83.3%10/12) and 94.4%167/177) in middle and lower ureter: 47.4%(18/38) and 55. 6%(15/27) in staghorn stone, respectively. The success rate according to the size of stone with Northgate SD-3 and Modulith SLX for stones with the size under 10mm was 96.1%(612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34): and for stones larger than 31mm was 69%(29/42) and 62.1%(18/29), respectively. Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.

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Accumulation and Depletion of Melamine Through Experimental Feeding in Catfish Silurus asotus (메기(Silurus asotus)에 투여한 멜라민의 체내함량 변화)

  • Kim, Poong-Ho;Jo, Mi-Ra;Lee, Hee-Jung;Kim, Kyoung-Duck;Ha, Kwang-Soo;Yoo, Hyun-Duk;Lee, Hong-Sik;Lee, Doo-Seog;Yoon, Ho-Dong
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.44 no.6
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    • pp.577-583
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    • 2011
  • In 2007, pet food contaminated with melamine caused hundreds of dogs and cats to develop renal failure all over the world. In 2008, over 294,000 infants consumed infant formula and developed kidney stones in China. Further investigation revealed that fish feed also contained melamine; this raised concerns about melamine residues in edible fish tissues, which could have caused the urinary tract stone epidemic. In Korea, catfish fed with assorted feed that included cuttlefish organs that contained melamine developed whitening syndrome and fell dead in some populations in 2008. This event raised suspicions about the toxicity of melamine and all feeds containing melamine were immediately recalled. In this study, we investigated the rates of melamine accumulation and depletion in muscle and viscera of catfish to propose proper withdrawal periods. One group of catfish was fed a commercially available diet that contained 30, 100 and 300 mg melamine per kg diet for 14 days. To investigate residual melamine contents in muscle and viscera, other experimental groups were fed a melamine free diet after being fed melamine for 7 days. The residual amount of melamine was analyzed by LC-MS/MS. The melamine concentration in muscle was estimated to be 3.7 mg/kg after 6 days of feeding with a diet containing 300 mg melamine/kg. After 2 days of culture with a melamine free diet, the residual melamine was depleted and the concentration had decreased from 1.15 mg/kg to 0.19 mg/kg in the muscle of catfish fed a diet containing 300 mg melamine/kg for 7 days. The residual amount of melamine was reduced to 0.03 mg/kg in muscle after 7 days of culture with a melamine free diet and was undetectable after a prolonged culture period of 14 days. Catfish tend to excrete melamine rapidly after oral administration and changes in body color were not observed during the short dosing period.

Breakthrough Urinary Tract Infection: A Clinical Study of Experience of a Single Center (예방적 항생제 사용중에 발생한 요로감염: 단일 병원에서 경험한 임상연구)

  • Bae, Sang-In;Cheon, Chong-Kun;Kim, Su-Young
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.203-209
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    • 2010
  • Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

Clinical findings of Glycogen Disease Type Ia Patients in Korea (당원병 제 Ia형 환아들의 임상적 고찰)

  • Park, Minju;Ahn, Hee Jae;Le, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.142-149
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    • 2014
  • Purpose: There are 15 types of Glycogen storage disease (GSD) that have been identified, and GSD type Ia is the most common type. There are several studies of Korean GSD type Ia patients' long-term complications. The aim of this study to find out clinical symptoms and prognosis of GSD type Ia patients. Methods: We performed clinical, biochemical and genetic analysis retrospectively on five patients diagnosed with GSD type Ia in a Soonchunhyang University Hospital from July 2002 to July 2014. Results: All patients had hepatomegaly at diagnosis, and they were all confirmed to have fatty liver at abdomen USG. They had no developmental delay, but two of them had growth retardation. Elevated blood lactate, triglyceride, and uric acid levels can find out all patients, but only one patient had hypoglycemia. They are diagnosed with GSD through gene analysis, and by gene analysis, they have c.648G>T (homozygote, splicing mutation), c.122G>A/c.648G>T, c.248G>A/c.648G>T mutations. Treatment with three times meals, three times snacks and four to six times use of uncooked constarch for all patients. Following the progress, one of them resulted in hypothyroidism, other one had renal stones. A patient diagnosed at 16 years old had liver cirrhosis and started having hemodialysis for ESRD. Conclusion: GSD type Ia patients had hepatomegaly, hyperlipidemia, hyperuricemia, and lactacidemia. Therefore patients who have such these symptoms are recommended gene analysis. A patient diagnosed at 16-years-old had liver cirrhosis and ESRD in progress, early diagnosis and treatment are important for GSD type Ia patients.