• Title/Summary/Keyword: Lithotripsy

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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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Acoustic outputs from clinical extracorporeal shock wave lithotripsy devices (임상에서 사용중인 체외충격파쇄석기의 음향 출력 분포)

  • Jong Min Kim;Oh Bin Kwon;Jin Sik Cho;Sung Joung Jeon;Ki Il Nam;Sung Yong Cho;Min Joo Choi
    • The Journal of the Acoustical Society of Korea
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    • v.42 no.5
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    • pp.469-490
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    • 2023
  • Survey was carried out on the acoustic outputs from 12 shock wave fields produced by the 10 extracorporeal shock wave lithotriptors whose technical documents are available, among the 33 devices approved by the Ministry of Food & Drug Safety (MFDS).The results show that the acoustic outputs (P+, P-, efd, and E), critical to the therapeutic efficacy and the patient safety, are largely different between the devices. The maximum values of P+, P-, efd, and E vary up to 2.08, 3.72, 3.89, and 15.98 times, respectively. The acoustic output parameters are not thoroughly provided in the technical documents, and some of data (eg. efd) are suspected to be abnormal outside usual ranges. The large device to device differences in the shock wave outputs are likely to undermine equivalence between the ESWL devices approved for the same indication. To verify the reliability of the data in the technical documents of the approved devices and to confirm if the acoustic outputs from the devices in clinical use are the same as those in their technical documents, an authorized test laboratory should be available. A postapproval monitoring led by the regulatory agency is suggested to maintain the acoustic outputs from the ESWL devices that suffer from degrading in performance due to aging.

Contemporary Interventional Approach to Calcified Coronary Artery Disease

  • Jonathan Gabriel Sung;Sidney TH Lo;Ho Lam
    • Korean Circulation Journal
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    • v.53 no.2
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    • pp.55-68
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    • 2023
  • Calcific coronary artery disease is an increasingly prevalent entity in the catheterization laboratory which has implications for stenting and expected outcomes. With new interventional techniques and equipment, strategies to favorably modify coronary calcium prior to stenting continue to evolve. This paper sought to review the latest advances in the management of severe coronary artery calcification in the catheterization laboratory and discuss contemporary percutaneous interventional approaches.

A Case Report on Improvement of Urolithiasis and Chronic Dyspepsia Using Ortho-Cellular Nutrition Therapy (OCNT) (세포교정영양요법(OCNT)을 이용한 요로결석 및 만성 소화불랑 개선 사례)

  • Min-Soo Son
    • CELLMED
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    • v.14 no.1
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    • pp.66.1-66.3
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    • 2024
  • Objective: To improve the symptoms of patients with urolithiasis and chronic dyspepsia using OCNT. Methods: A 60-year-old Korean male who had undergone extracorporeal shock wave lithotripsy six times without natural stone removal was treated with OCNT for two weeks. Results: The stones were removed through adequate hydration and light exercise while undergoing OCNT. Conclusion: The application of OCNT in patients with urolithiasis can be beneficial in alleviating symptoms.

Patients' Selection for Treatment of Caliceal Diverticular Stones with Extracorporeal Shock Wave Lithotripsy (신장게실결석 치료를 위한 체외충격파쇄석술 적용 환자의 선택)

  • Lee, Won-Hong;Lee, Hee-Jeong;Son, Soon-Yong;Kang, Seong-Ho;Cho, Cheong-Chan;Ryu, Meung-Sun;Kim, Seung-Kook
    • Journal of radiological science and technology
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    • v.24 no.1
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    • pp.11-15
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    • 2001
  • Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone- free. Of solitary stone 60% and multiple stones(more than 2) 17% became stone free. All patients rendered stone-free became symptom-free, and of patients with residual stones 44% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously.

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Gallbadder Dynamics Before and After Extracorporeal Shock Wave Lithotripsy (체외충격파 담석 쇄석술 전후의 담낭운동성의 변화)

  • Lee, Myung-Hae;Suk, Jae-Dong;Moon, Dae-Hyuk;Kim, Myung-Hwan;Min, Young-Il
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.53-60
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    • 1991
  • Extracorporeal shock wave lithotripsy (ESWL) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7mCi of $^{99m}Tc-DISIDA$, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (1 frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated. ESWL group were studied before, 1day after and 2weeks after ESWL, and WDCA group were studied before and 2weeks after starting oral medication. Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESWL group, mean EF and mean ER at lday after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recoverd to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

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Significance of albumin to globulin ratio as a predictor of febrile urinary tract infection after ureteroscopic lithotripsy

  • Yi, Seung Yun;Park, Dong Jin;Min, Kyungchan;Chung, Jae-Wook;Ha, Yun-Sok;Kim, Bum Soo;Kim, Hyun Tae;Kim, Tae-Hwan;Yoo, Eun Sang
    • Journal of Yeungnam Medical Science
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    • v.38 no.3
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    • pp.225-230
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    • 2021
  • Background: We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS). Methods: From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS. Results: Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%). Conclusion: This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.