ABSTRACT
The current practice for the management of upper ureteral stones is to push the stone back into the renal pelvis before extracorporeal shock wave lithotripsy. But recent treatment modality for urinary stone is required to be less invasive and morbid. We evaluated 194 patients with upper ureter stones for the effectiveness or push-back. When in situ treatment was performed in 122 patients, the stone free rate at 3 months was 83.6% and the storage for complete fragmentation was 153.5. Push back was tried in 72 patients randomly. Out of them, 13 cases(18.6 %) were manupulated into the renal pelvis successfully and operation was required in 2 cases due to ureteral perforation. The stone free rate was 79.6% and storage for complete fragmentation was 153.7 in push back success group. There was no significant difference between two groups. We think that the primary treatment of choice for upper urinary stone is in situ ESWL. The treatment modality of push back is secondary choice in the case that was railed by primary in situ ESWL.
Subject(s)
Humans , Kidney Pelvis , Kidney , Lithotripsy , Shock , Ureter , Urinary CalculiABSTRACT
Intravesical instillation of Bacillus Calmette-Guerin(BCG) currently is considered the most effective treatment for recurrent superficial bladder cancer, but little is known about the mechanism of action. Total 21 patients receiving intravesical BCG treatment for superficial bladder cancer were entered into this study to investigate the cellular immune response with T-subsets and NK cell activity in peripheral blood before and after intravesical BCG instillation consisted of weekly administration with BCG for six consecutive weeks. Among the 21 patients. 11 had Grade 1 and 10 had Grade 2 bladder cancer and 14 of them had history of recurrence more than 2 times. The results showed that there were no significant differences in the changes of CD4 cell. CD8 cell as T- subsets and NK cell activity before and after treatment(P greater than 0.06 in all). Among 7 patients with recurrence after BCG treatment, there was also no difference in any immune response (P greater than 0.05 in all). Considering the response of the individual patients. We observed that recurrence rates were similar between a group containing the patients with increased value more than 20% after treatment and other in all immune parameters such as CD4. CD8, CD4/CD8 ratio and NK cell activity(P greater than 0.0S in all). We conclude that these parameters are not major contributors to the antitumor activity of BCG and had no prognostic value for the clinical outcome after BCG treatment.