ABSTRACT
PURPOSE: Urea-splitting organisms have known to participate in the formation of infected calculi, but sometimes, causative organisms were not detected in urine culture. We compared results of polymerase chain reaction which detect urease gene in infected calculi to urine culture, to follow pathogens which involved in the formation of infected calculi and establish preventive antimicrobial therapy. MATERIALS AND METHODS: Urine culture were performed in 25 patients who were diagnosed as infected calculi. The DNA was extracted from the PBS solution that was used for washing stones and lysis solution which inserted after calculi crushing. And then, PCR were performed with universal primers for beta-globin gene, 16S ribosomal RNA gene, and primers for urease gene of Proteus mirabilis and Ureaplasma urealyticum which synthesized by order. Stone analysis was performed using infrared spectroscopy. RESULTS: Proteus mirabilis and Ureaplasma urealyticum were not detected in urine culture. All results of PCR to beta-globin gene and 16S ribosomal RNA gene were negative in calculi washing solution. In 18 of 25 cases(72.0%), the result of PCR to 16S ribosomal RNA gene were positive in calculi lysis solution. Each 2 and 3 of 18 cases(total; 27.7%) which were positive in PCR to 16S ribosomal RNA gene, Proteus mirabilis and Ureaplasma urealyticum were cultured respectively. From 16 cases which were available to perform infrared spectroscopic stone analysis, 7 cases were shown to have specfic absorbance band of infected calculi and were positive in PCR to 16S ribosomal RNA gene. CONCLUSIONS: We detected urea-splitting organisms in crushed calculi specimen using PCR. It suggests that PCR for urea-splitting organisms will be helpful to identify process of infected calculi and causative organisms.
Subject(s)
Humans , beta-Globins , Calculi , DNA , Polymerase Chain Reaction , Proteus mirabilis , RNA, Ribosomal, 16S , Spectrum Analysis , Ureaplasma urealyticum , UreaseABSTRACT
PURPOSE: In situ SWL has become the preferred treatment modality for proximal ureteral calculi. However, reported rate of retreatment and need for stone manipulation such as stenting or push back were considerably high. We tried to determine the clinical factors affecting retreatment rate for effective in situ SWL. MATERIALS AND METHODS: One hundred seven patients with upper ureteral calculi underwent in situ SWL by using the Dornier MPL 9000 with ultrasound locating system. We evaluated the factors such as size and texture of the stone, degree of obstruction, distance from ureteropelvic junction and duration of symptom by comparing success rate of 1st session SWL. RESULTS: The overall stone free rate was 93.9% at 3 months. Average number of session of SWL was 1.35. Sucess rate of 1st session was 71%(76/107). Retreatment rate after 1st session was 29%(31/107). The significant clinical factors affecting retreatment rate of SWL were size of stones( 1.2cm), texture(rough shape) and complete ureteral obstruction. CONCLUSIONS: From these results we conclude that upper ureteral calculi with these factors should be performed primary in situ SWL more carefully to improved the therapeutic result.
Subject(s)
Humans , Lithotripsy , Retreatment , Shock , Stents , Ultrasonography , Ureter , Ureteral Calculi , Ureteral ObstructionABSTRACT
To date, the unilateral single vaginal ectopic ureter has been regarded as the rarest form of ureteral ectopia because 80 per cent of all ectopic ureters are associated with a duplicated system and most of the ectopic ureters occur in male patients. This malformation may take the form of but is not limited to any ombination of abnormal development of the mesonephric and paramesonephric ducts. We report a case of unilateral single vaginal ectopic ureter with ipsilateral hypoplastic kidney in a 9 year-old female patient who has been suffered from diaper dermatitis due to persistent urinary incontinence since birth.