ESWL monotherapy has been considered a valid initial treatment for staghorn calculi. In an effort to reduce post-ESWL obstruction, many urologists place ureteral stents before ESWL. The use of ureteral stents has proved to contribute to successful stone passage and to reduce post- ESWL morbidity but there also have been reports of complications that might have been caused by indwelling ureteral stents. From January 1989 to December 1995, we reviewed 29 patients with ureteral obstruction after ESWL (EDAP LT-01 & 02) monotherapy without ureteral stenting in 47 patients with staghorn calculi. Ureteral obstruction was occurred in 29 patients (61.7%); 16 (55.2%) in the upper ureter, 11 (37.9%) in the lower ureter, and 2 (6.9%) in the mid-ureter. Steinstrasse was occurred in 13 patients (13/29, 44.8%); 8 (61.5%) in the lower ureter, 4 (30.7%) in the upper ureter, and 1 (7.7%) in the mid-ureter. Ureteral obstruction was occurred regardless of the size of the staghorn calculi(length, breadth, volume). The method of resolving ureteral obstruction was additional ESWL (21 patients, 72.4%), and auxillary procedures including PCN (4 patients, 13.8%), push up procedure (1 patient, 3.4%), push up & double J stenting (1 patient, 3.4%), and ureterolithotomy (2 patient, 6.9%). Mean number of session of ESWL resolving ureteral obstruction was 3.27. Overall complete stone-free rate of staghorn calculi was 55.3%(26 patients). Our results indicate that postoperative ureteral obstruction is easily relieved without major complication by additional ESWL or auxillary procedures. Therefore, ie believe that ESWL monotherapy without ureteral stenting may be adequate treatment modality of staghorn calculi.
Calculi* ; Humans ; Pregnenolone Carbonitrile ; Stents* ; Ureter* ; Ureteral Obstruction*

The effects on renal function following percutaneous nephrolithotomy(PNL) were investigated on 37 patients. The overall success rate was 76%. The success rate on renal stone(79% ) was better than on upper ureter stone(67% ). The complication rate was much lower on later cases according to the increasing experiences and improved technique. The renal function was evaluated on 15 cases using DMSA renal scan and separate creatinine clearance rate pre-and post-operatively. Fourteen cases out of fifteen cases showed no significant renal functional change statistically. However, only one case who had massive renal bleeding for eight days postoperatively showed about 18% reduction of renal function and which case was considered due to major renal vascular damage during PCN tract creation. Conclusively, PNL seemed to be safer and has lower morbidity rate than surgical removal of stone if carried out by experienced hands.
Creatinine ; Hand ; Hemorrhage ; Humans ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Succimer ; Ureter

Researching synthetic method of Dehydropregnenolon acetat (DPA, 3β-acetoxy-pregn-5, 16-dien-20-on) from 3β- acetoxy-pregn-5-en 17β-ol-20-yn, a conclusion is given that using this method dicobalt hexacarbonyl was created in the first time in group acethylen, 3β- acetoxy-pregn-5-en 17β-ol-20-yn is synthesized with good output from equivalent 17β- hydroxy derivative. Respond not attach generates auxiliary products like known methods. Through two methods hydrating and hydrating in gentle conditions, dehydro pregnenolon acetat is synthesized with quite good output from 3β- acetoxy-pregn-5-en 17β-ol-20-yn. Intermediary compounds and final products characterized by melt point, infared spectrum, proton magnetic spectrum and weight spectrum
Pregnenolone ; Pharmaceutical Preparations

Palliative endourologic treatment was done in 94 cases for ureteral obstruction secondary to advanced malignancy The average survival was 4.2 months. The obstruction were caused by metastases or invasion of cancer in all patients. First we tried to insert a double J stent(STENT), when it failed percutaneous nephrostomy(PCN) was performed. Initially 16 patients were treated by STENT and 8 patients by PCN. The SIENT was changed 2.2 times on the average in all patients. 75% of the patients who had been treated by STENT experienced only one or two times of STENT changes before dying. Patency period of the STENT was 57.6 days on the average. The patency period was shorter in the patients who showed gross hematuria at the time of STENT insertion. Although survival was not so long, 60.6% patients were able to return to their homes. The endourologic management of the upper urinary tract obstruction will play a more important role and offer a better quality of life for end stage cancer patients.
Hematuria ; Humans ; Neoplasm Metastasis ; Pregnenolone Carbonitrile ; Quality of Life ; Stents ; Ureteral Obstruction ; Urinary Tract*

For the past two years, nephropexy using PCN was underwent in 9 cases of nephroptosis (8 patients) with variable degrees of flank pain. All were female and 6 on right, 1 on left and 1 on bilateral. All patients had a very mobile kidney and exact distance of movement measured on the film was greater than 6cm (6 to 15 cm). After this operation, 14-20 Fr. nephrostomy catheter was indwelled for about two weeks. All patients were followed at least 3 months(3 to 32, median 17 months). We followed the patients with symptom relief and IVP after 3 months. Nephropexy was regarded as success if she remained asymptomatic for more than 3 months. Five cases were successful and four cases felt recurrent flank pain within 1 month after the surgery. Among four cases of recurrence, one had repeated PCN and got successful result, another had open nephropexy and the others have been followed so far So overall success rate was 67% (6/9). In conclusion, nephropexy using PCN is less invasive, needs shorter period of admission and leaves ignorable scars postoperatively. Furthermore it can be repeated even in the case of failure or recurrence, which would make this new technique available as the first step for the surgical treatment of nephroptosis. And the success rate could be increased if the nephrostomy tract is dilated upto 30 Fr. and the PCN catheter is placed about 4 weeks.
Catheters ; Cicatrix ; Female ; Flank Pain ; Humans ; Kidney ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Recurrence

INTRODUCTION AND OBJECTIVES: A kidney in the growing state and the possibility of spontaneous improvement are characteristics of the pediatric ureteropelvic junction obstruction (UPJO) that make the treatment of this disease difficult. We have tried to determine the histopathologic changes of the kidneys with UPJO relating to age, differential renal function and urinary tract infection (UTI). METHODS: The total number of patients was 38 (40 kidneys). The age at the operation time was under 3 months in 9 cases (9 kidneys), 3 to 12 months in 10 cases (10 kidneys), and 1 to 18 years in 20 cases (21 kidneys). Needle biopsies from 3 different sites at the lower pole of the kidney were taken. The tissue was blindly observed for the presence of irreversible change (arteriolar thickening, glomerulosclerosis, interstitial fibrosis and periglomerular fibrosis) and reversible change (inflammatory cell infiltration) by light microscopy. Each pathological finding was graded as I, II or III, and each grade was given a numerical value. Statistical analysis was done with ANOVA. RESULTS: Although the kidneys from patients under 3 months tended to show better histopathologic findings, there was no statistically significant difference in all 5 pathologic findings regardless of patient age. 5 cases (5 kidneys) with previous percutaneous nephrostomy (PCN) were not included in any group for analysis due to possible histologic changes of the renal parenchyma. Inflammatory cell infiltration, arteriolar thickening, glomerulosclerosis and periglomerular fibrosis were statistically significant in patients with previous or present UTI (14 kidneys) compared to the patients without UTI (26 kidneys). The patients with a mean differential renal function less than 30% (7 kidneys) as measured by DTPA or DMSA renal scan showed statistically significant changes in all of the 5 histopathologic findings compared to the patients with differential renal function greater than 30% (27 kidneys). 4 cases with bilateral UPJO (6 kidneys) were excluded from comparing the differential renal function. 5 kidneys with previous PCN had statistically significant degree of glomerulosclerosis compared to others. CONCLUSIONS: Although we did not determine whether pediatric UPJO affects renal growth, it is probable that statistically significant irreversible histopathologic changes do not occur according to age. Considering histopathologic findings only, differential renal function and UTI Should be key factors in deciding the management of pediatric UPJO. In addition, PCN seems to induce more severe histopathologic changes of the kidney.
Biopsy, Needle ; Fibrosis ; Humans ; Kidney* ; Microscopy ; Nephrostomy, Percutaneous ; Pentetic Acid ; Pregnenolone Carbonitrile ; Succimer ; Urinary Tract Infections

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies

PURPOSE: Tuberculous ureteral stricture causing a progressive obstructive uropathy is a common complication of renal tuberculosis. The aim of our study was to evaluate the effectiveness of early ureteral stenting or percutaneous nephrostomy (PCN) in patients with tuberculous ureteral stricture. MATERIALS AND METHODS: Seventy seven patients (84 renal units) with tuberculous ureteral strictures were analysed respectively. We evaluated the final outcome of involved kidneys according to the two different managements; medication only versus medication plus ureteral stenting or medication plus PCN. RESULTS: In our series, nephrectomy rate was about 51%. In cases treated with medication only, the nephrectomy rate was about 73%. While the nephrectomy rate was about 34% when treated with medication plus early ureteral stenting or PCN. The rate of reconstructive surgery for ureteral strictures was significantly different between the cases treated with medication only (8%) and medication plus early ureteral stenting or PCN (49%). Moreover, spontaneous resolution of the ureteral strictures was noted in 6 out of 12 renal units which had strictures in the course of medical therapy and were managed with early ureteral stenting. CONCLUSIONS: Early ureteral stenting or PCN in patients with tuberculous ureteral stricture may increase the opportunity for later reconstructive surgery and decrease the possibility of renal loss.
Constriction, Pathologic* ; Humans ; Kidney ; Nephrectomy ; Nephrostomy, Percutaneous ; Pregnenolone Carbonitrile ; Stents ; Tuberculosis ; Tuberculosis, Renal ; Ureter*

Recent years, various percutaneous procedures including cervical nucleoplasty have been developed for disc decompressions to relieve radicular pains caused by disc herniations. We report the application of percutaneous cervical nucleoplasty (PCN) by using the navigable disc decompression device in two patients of cervical herniated intervertebral discs (HIVD). A 38-year-old female diagnosed with C4-C5 disc extrusion with bilateral C5 roots impingement received nucleoplasty twice at C4-C5 disc level. After second procedure, her pain was improved from 6-7/10 to 1-2/10 by visual analog scale (VAS). The second case, a 51-year-male was diagnosed with C6-C7 disc extrusion with right C7 roots impingement and received the procedure at C6-C7 disc level. The pain improved from 8/10 to 3-4/10 by VAS. Successfully, we decompressed cervical herniated discs in 2 HIVD patients without major complications. The PCN with the navigable device will be recommended as an alternative treatment method for cervical HIVD.
Adult ; Decompression* ; Female ; Humans ; Intervertebral Disc Displacement ; Intervertebral Disc* ; Neck Pain ; Pregnenolone Carbonitrile

We treated 4 patients with uric acid calculi in the renal pelvis or ureter with alkaline fluid irrigation through percutaneous nephrostomy (PCN) tube. Initial presentations were anuria or severe flank discomfort, we performed PCN to relieve such obstructive symptoms caused by uric acid calculi. We tried to dissolve uric acid calculi with normal saline mixed to sodium bicarbonate through a PCN tube. The success of therapy is believed to be related to the direct and constant urinary alkalinization effect obtained with irrigation compared to be the intermittent alkalization that occurs when oral agent are used.
Anuria ; Calculi* ; Humans ; Kidney Pelvis ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Sodium Bicarbonate ; Ureter ; Uric Acid*