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[en] To compare the accuracy of artificial neural network (ANN) analysis and multivariate regression analysis (MVRA) for renal stone fragmentation by extracorporeal shock wave lithotripsy (ESWL). A total of 276 patients with renal calculus were treated by ESWL during December 2001 to December 2006. Of them, the data of 196 patients were used for training the ANN. The predictability of trained ANN was tested on 80 subsequent patients. The input data include age of patient, stone size, stone burden, number of sittings and urinary pH. The output values (predicted values) were number of shocks and shock power. Of these 80 patients, the input was analyzed and output was also calculated by MVRA. The output values (predicted values) from both the methods were compared and the results were drawn. The predicted and observed values of shock power and number of shocks were compared using 1:1 slope line. The results were calculated as coefficient of correlation (COC) (r2 ). For prediction of power, the MVRA COC was 0.0195 and ANN COC was 0.8343. For prediction of number of shocks, the MVRA COC was 0.5726 and ANN COC was 0.9329. In conclusion, ANN gives better COC than MVRA, hence could be a better tool to analyze the optimum renal stone fragmentation by ESWL (Author).
[en] Percutaneous Transluminal Angioplasty (PTA) is an effective initial treatment modality in renovascular hypertension. For determination of PTA effect, the pulse pressure recording of renal artery is not simple as compared with in femoral artery stenosis. We tried to evaluate the PTA effect of renal artery stenosis with tracing the pressure of distal renal artery. We used the cardiac catheterization apparatus (VR-12 Honeywell) as a pressure monitor in two cases of focal renal arterial stenosis. The renal artery pressure was doubled after first attempt of ballooning, and the pressure elevated up to 94% and 79% of aorta pressure in two cases, respectively, after third attempt. We believe that renal artery pressure monitoring is a good method of determination of PTA effect in renovascular hypertension.
[en] To retrospectively evaluate the diagnostic value of ultrasonographic differentiation of small angiomyolipomas (AMLs) from renal cell carcinomas (RCCs) by measuring relative echogenicity (RE) on PACS. Thirty-six cases of < 3 cm, pathologically-proven RCCs and 42 cases of size-matched AMLs were enrolled. We measured the grayscale representing echogenicity of the mass, the renal cortex, and the sinus fat on PACS using a ROI cursor. The RE of the tumor was calculated by setting the grayscale of the renal cortex and sinus fat as 0% and 100%, respectively. We compared REs of AMLs and RCCs, including subgroups of each tumor. ROC analyses between RCCs and AMLs or non-fatty AMLs were performed for obtaining diagnostic performance (Az value) of RE measurement and for extracting sensitivities of RE with fixed specificities of 90% and 95%. The RE of AMLs was higher than RCCs (p < 0.05). The RE of non-fatty AMLs was significantly lower than fatty AMLs, and higher than any subgroups of RCCs (p < 0.05). RE measurement provided good diagnostic performance (Az ≥ 0.840, p < 0.05) with competitive sensitivity/specificity for differentiating AMLs from RCCs regardless of AML subgroups. RE measurement on PACS can be helpful in the differential diagnosis of small AMLs and RCCs with the intrinsic merits of ultrasonography
[en] The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using 131I-ortho-iodohippurate and hippuran renogram was analysed means of quantitative and qualitative methods in 26 patients of Korean hemorrhagic fever. The results obtained with this study were as follows;1) During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairment of renal function and grave prognosis than the group with obstructive pattern of renogram. 2) During the diuretic phase, the renogram showed obstructive or dysfunction ar normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3) During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4) The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5) There was significant correlationship between the pattern of renogram and the decrease of renal plasma flow in the patients with Korean hemorrhagic fever. The decrease of renal plasma flow was marked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairment, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.
[en] Horseshoe kidney is an important urological anomaly when it is complicated or accompanied by other diseases. Recently we have experienced four cases of horseshoe kidney which were complicated with hydronephrosis, renal stone and adrenal pheochromocytoma. With review of literatures, we emphasize the importance of detection of these complications.
[en] The double tracer study on erythrokinetics was carried out experimentally with radioactive iron(59Fe) and chromium (51Cr) in rabbits. The 0.1% cantharidin solution and 1% pot. perchlomate solution was given subcutaneously to 20 rabbits respectively. 3 and 6 days after injection, the blood chemistry, urine examination, ferrokinetics and apparent half survival time of RBC were (51Cr T-1/2) determined. Following were the results: 1) Red blood cell hematocrit and hemoglobin values were moderately reduced and B.U.N. and serum creatinine values were slightly increased in the cantharidin group, while B.U.N. and serum creatinine values were within normal limits in the pot. perchlomate group. Reticulocyte values were slightly increased in the cantharidin group, while was normal range in the pot. perchlomate group. 2) Blood chemistry finding was not significant statistically in both experimental groups, but serum iron value was moderately reduced in both group. 3) Plasma volume was unchanged in both group, but red cell volume and whole blood volume were slightly reduced in both groups. 4) Results of ferrokinetics were as follows: i) The plasma iron disappearance rate was delayed in both groups. Plasma iron turnover rate, red cell iron utilization and red cell iron turnover rate were decreased in both groups, and then red cell iron turnover rate was more decreased than plasma iron turnover rate in both groups. Circulating red cell iron was slightly increased in cantharidin group and red cell iron concentration was within normal range in both groups. ii) P.I.T.R.-R.C.I.T. value moderately increased in the cantharidin group and slightly increased in the pot. perchlomate group. Reticulocyte index, red cell iron turnover index, plasma iron turnover index and effective erythropoiesis index were wholly reduced in both groups. iii) The red cell life span was slightly shortened in the cantharidin group while was within normal range in pot. perchlomate group. The pathologic finding of renal biopsy of the cantharidin group shows a selective damage in glomerulus, while shows almost normal range or slight damage in tubules. And that of the pot. perchlomate group shows a selective damage in tubules with slight damage of glomerulus.
[en] Partial parathyroidectomy (PTX) was carried out 20 times in 15 dialitic patients with chronic renal failure. The operation was suggested by marked radiological abnormalities due to severe secondary hyperparathyroidism, that developed despite aggressive medical and dietetic management. The skeletal x-ray examination showed significant improvement following PTX, that was clearly visible already one month postoperatively at the level of the second and third phalanges of the hands. The improvement of the skeletal osteodystrophic patterns was always associated to a fall of parathyroid hormon and plasma alkaline phosphatase levels. The radiological examination of the hands may represent a usefull and simple method in the follow-up of patients after surgery to assess the efficacy of PTX
[en] An intrahepatic portosystemic venous shunt is a rare condition that was initially reported by Doehner et al. in 1956. In addition, the occurrence of midgut malrotation is rare in adulthood. The association of a portosystemic shunt along with a midgut malrotation and a renal rotational anomaly has not yet been described. We report a case of an intrahepatic portosystemic shunt, midgut malrotation, and renal rotation anomaly