Currently, the types of kidney stones before surgery are mainly identified by human beings, which directly leads to the problems of low classification accuracy and inconsistent diagnostic results due to the reliance on human knowledge. To address this issue, this paper proposes a framework for identifying types of kidney stones based on the combination of radiomics and deep learning, aiming to achieve automated preoperative classification of kidney stones with high accuracy. Firstly, radiomics methods are employed to extract radiomics features released from the shallow layers of a three-dimensional (3D) convolutional neural network, which are then fused with the deep features of the convolutional neural network. Subsequently, the fused features are subjected to regularization, least absolute shrinkage and selection operator (LASSO) processing. Finally, a light gradient boosting machine (LightGBM) is utilized for the identification of infectious and non-infectious kidney stones. The experimental results indicate that the proposed framework achieves an accuracy rate of 84.5% for preoperative identification of kidney stone types. This framework can effectively distinguish between infectious and non-infectious kidney stones, providing valuable assistance in the formulation of preoperative treatment plans and the rehabilitation of patients after surgery.
Humans ; Kidney Calculi/classification* ; Deep Learning ; Neural Networks, Computer ; Tomography, X-Ray Computed ; Imaging, Three-Dimensional ; Radiomics

We evaluated the feasibility and efficacy of intermediate-supine percutaneous nephrolithotomy (PCNL) in patients with renal calculi. Fifteen patients were included in this study. The intermediate-supine operative position was modified by using a 1-L saline bag below the ipsilateral upper flank. A nephrostomy and stone extraction were performed as usual. After completion of the stone removal, a nephrostomy tube was used when necessary according to the surgeon's decision. If there was no significant bleeding or renal pelvic injury, tubeless PCNL was performed. The mean stone size was 5.48+/-5.69 cm2, the mean operative time was 78.93+/-38.72 minutes, and the mean hospital stay was 2.60+/-1.29 days. Tubeless PCNL was performed in 13 cases (86.7%), and retrograde procedures were simultaneously performed without a change of position in 2 patients (ureteroscopic ureterolithotomy in one patient and transurethral placement of an occlusion catheter in one patient). There were two complications according to the Clavien-Dindo classification (Grade I in one patient and Grade II in one patient). The success rate was 80.0% and the complete stone-free rate was 73.3%. Three patients with a significant remnant stone were also successfully managed with additional procedures (one patient underwent a second-look operation, and the remaining two patients were treated with shock wave lithotripsy). In the treatment of renal calculi, intermediate-supine PCNL may be a safe and effective choice that offers several advantages with excellent outcomes. Thus, a prospective study with a larger population is needed to verify our outcomes.
Catheters ; Classification ; Hemorrhage ; Humans ; Kidney Calculi ; Length of Stay ; Nephrostomy, Percutaneous ; Operative Time ; Shock ; Supine Position

The analysis of urinary calculi is an essential step in the examination and initial treatment of the patient with urolithiasis. Among the various methods of stone analysis, we have used x-ray diffraction method for analyzing urinary calculi. The advantage of x-ray diffraction is its almost absolute identification of crystalline materials and mixtures of crystalline materials. The disadvantage of x-ray diffraction include initial high cost of equipment and inability to identify amorphous materials and constituents present in only minor or trace amounts. We have analyzed 127 urinary calculi by x-ray diffraction method, which were obtained from the patients who were admitted to the Department of Urology, Chosun University Hospital during the period of 5 years from Jan. l98l to Dec. l985. The following results were obtained: 1. In this studies, 8 crystalline components of urinary calculi were demonstrated: Calcium oxalate monohydrate, Calcium oxalate dehydrate, Calcium oxalate trihydrate, Hydroxyl-apatite, Magnesium ammonium phosphate hexahydrate, Calcium hydrogen phosphate dihydrate, Uric acid and Cystine. 2. Calculi of single component, comprising 73 (57.6%) of the total, was more common than those of mixed component, 54 (42.4%) of the total. Calcium oxalate monohydrate was the most common pure calculi, composing 46 (36.2 %) of all pure calculi and mixed calcium oxalate monohydratecalcium oxalate dihydrate calculi was the most common mixed calculi, constituting 20 (15.7%) of all mixed Calculi. 3. Classifying author`s results as Jensen`s classification, pure calcium oxalate and calcium oxalate apatite mixtures composed 87.3% of total, magnesium ammonium phosphate-apatite mixtures constituted 4.O%, uric acid comprised 6.5%. 4. Among the all urinary components analyzed in this studies, calcium oxalate monohydrate was the most common constituent, composing 78% of the total and calcium oxalate dihydrate was the second common constituent, comprising 37.6%, calcium oxalate was the most common component, composing 9l.3% of the total. 5. In the components associated with calcium oxalate monohydrate, calcium oxalate dihydrate was the most common associated component, in calcium oxalate dihydrate calcium oxalate monohydrate, in hydroxyl-apatite calcium oxalate monohydrate, in uric acid calcium oxalate monohydrate 6. According to the distribution of urinary component in each urinary organ, calcium oxalate (esp. calcium oxalate monohydrate exceeded 50%) was the most common component in entire urinary tract, which comprised 59.1% of all renal calculi, 69.4% of all ureteral calculi, 33.3% of all bladder calculi and 100% of all urethral calculi. 7. Of 44 renal calculi, 30 were composed of staghorn calculi, in which calcium oxalate was the most common component, constituting 56.6% of 30 staghorn calculi.
Ammonium Compounds ; Calcium ; Calcium Oxalate ; Calculi ; Classification ; Crystallins ; Cystine ; Humans ; Hydrogen ; Kidney Calculi ; Magnesium ; Ureteral Calculi ; Uric Acid ; Urinary Bladder Calculi ; Urinary Calculi* ; Urinary Tract ; Urolithiasis ; Urology ; X-Ray Diffraction*

Pyelographic examination is very essential in diagnosis of renal tuberculosis along with detection of tubercle bacilli in the urine and cystoscopic procedure. Furthermore, it is that the pyelography gives the very important and influencing information on therapeutic indication, surgical intervention how to and when to operate, and on forecasting prognosis. It therefore, is requested that grade of tuberculous invasion, its correct localization and its itemized classification be established most carefully. In the present study, 120 pyelograms made out of 197 cases of renal tuberculosis at the Department of Urology. Seoul National University Hospital, during the period January 1957 through June 1963, were collected and detailed pyelographic interpretation on plain films, intravenous pyelograms (I.V.P.) of individual tuberculous kidneys (from 120 patients) and on 50 retrograde pyelograms was attempted and the following results were obtained: Thereafter, an individual kidney will be counted as one case. 1) Of 152 cases of plain film, calcification in the kidney area was found in 6 cases or 3.9%, and renal calculus in 4 cases or 2.6%, kidney outline was observed in 24.3%. Plain film should be all made prior to perform pyelography. 2) Functional classification of intravenous pyelogram was made into 5 groups according to grade of visualization of contrast media as the following Group 1: Pelvio-calyceal system is well visualized, revealing the neighborhood of uretero-pelvic juncture precisely. Group 2: Most calyces are essentially visualized but no pelvis is outlined. The entire picture can not be drawn. Group 3: Only one to two calyces or cavities are filled with contrast media. They appear at most times round, oval or hazy figures. This group may stand for advanced group 2. Group 4: Contrast media seem to be visualized in traces but no outline of calyx nor pelvis observable. Group 5: Absence of visualization. 3) Most commonly observable urographic changes in intravenous pyelogram can be listed as: (1) absence of visualization, 43.1% ;(2) delayed visualization, 37%; (3) caliectasis, 36% ; (4) feathery, irregular or "moth-eaten" outline of calyces, 33.5%; (5) deformity, narrowing or dilation of the ureter, 26%; (6) obliteration of one or more calyces, 8.6% ; (7) cicatrical deformity of the calyces and "pinching off" of the tips of minor calyces, 7.2% ; (8) poor visualization with only one or two "globs" of contrast medium, 5.9% and (9) pyelectasis, 2.6%. 4) After injecting contrast media in intraveuous pyelography, the more the kidney involved, the lower the appearance and the intensity of nephrogram observed. 5) Retrograde pyelograms were classified into four grades after Lattimer and they were studied along with appearance of contrast media in intravenous pyelogram. The more invasion by retrograde pyelogram indicated, the later the appearance of contrast media and the poorer visualization observed. 6) Retrograde anatomical grading and intravenous functional classification were compared and it was almost likely that they paralleled pretty well. Nintythree per cent of I.V.P. below group 2. inclusive, showed more marked anatomical involvement than grade III of retrograde pyelogram.
Classification ; Congenital Abnormalities ; Contrast Media ; Diagnosis ; Forecasting ; Kidney ; Kidney Calculi ; Pelvis ; Prognosis ; Pyelectasis ; Residence Characteristics ; Seoul ; Tuberculosis, Renal* ; Ureter ; Urography ; Urology