PURPOSE: To compare the stone clearance rate, efficiency quotient (EQ), and early complications of shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) for solitary lower-pole renal stones measuring 15 to 20 mm. MATERIALS AND METHODS: This was a retrospective matched-pair analysis of 142 patients (78 in the SWL and 64 in the PCNL group). Preoperative imaging was done by use of noncontrast computed tomography (CT kidney, ureter, and bladder [KUB]), intravenous urogram, or plain X-ray and ultrasound KUB to assess the largest dimension of the stones. Only patients with radiopaque stones were included. The stone-free rates were assessed with plain X-ray and ultrasound at 4 weeks. Data were analyzed by use of SPSS ver. 19. RESULTS: The patients' demographic profiles (age, body mass index) and the stone sizes were comparable in the two groups. The mean stone size was 17.4+/-2.12 in the PCNL group compared with 17.67+/-2.04 in the SWL group (p=0.45). At 4 weeks, 83% of patients undergoing PCNL were stone-free compared with 51% in the SWL group (p<0.001). The EQ for the PCNL group was 76% compared with 44% for the SWL group (p<0.001). Ancillary procedures were required by 9% of patients in the PCNL group compared with 15% in the SWL group. The complication rate was 19% in both groups. The SWL complications were minor. CONCLUSIONS: Stone clearance from the lower pole of solitary stones sized 15 to 20 mm at the greatest diameter following SWL is poorer. These calculi can be better managed with percutaneous surgery owing to its higher efficacy and acceptably low morbidity.
Calculi ; Humans ; Kidney ; Kidney Calculi ; Lithotripsy ; Matched-Pair Analysis ; Nephrostomy, Percutaneous ; Retrospective Studies ; Shock ; Ureter ; Urinary Bladder

Current FDA-approved kinase inhibitors cause diverse adverse effects, some of which are due to the me-chanism-independent effects of these drugs. Identifying these mechanism-independent interactions could improve drug safety and support drug repurposing. Here, we develop iDTPnd (integrated Drug Target Predictor with negative dataset), a computational approach for large-scale discovery of novel targets for known drugs. For a given drug, we construct a positive structural signature as well as a negative structural signature that captures the weakly conserved structural features of drug-binding sites. To facilitate assessment of unintended targets, iDTPnd also provides a docking-based interaction score and its statistical significance. We confirm the interactions of sorafenib, imatinib, dasatinib, sunitinib, and pazopanib with their known targets at a sensitivity of 52％and a specificity of 55％. We also validate 10 predicted novel targets by using in vitro experiments. Our results suggest that proteins other than kinases, such as nuclear receptors, cytochrome P450, and MHC class I molecules, can also be physiologically relevant targets of kinase inhibitors. Our method is general and broadly applicable for the identification of protein–small molecule interactions, when sufficient drug–target 3D data are available. The code for constructing the structural signatures is available at https://sfb.kaust.edu.sa/Documents/iDTP.zip.