Noriaki Hirao

Computerized tomography in acute pyelonephritis: the clinical correlations.

Computerized tomography was performed on 19 patients diagnosed as having uncomplicated acute pyelonephritis. The relationship was investigated among the laboratory findings, presence of flank pain, clinical course and severity of the lesions detected by computerized tomography. In patients febrile for less than 2 weeks healing as assessed by computerized tomography took an average of 76 days. However, in patients with repeated febrile episodes occurring for longer than 2 weeks healing was delayed until an average 232 days after onset. Computerized tomography findings generally correlated well with the erythrocyte sedimentation rate, C-reactive protein level, and presence of pyuria and flank pain. However, in patients with a prolonged course computerized tomography proved to be a more reliable indicator of progress than either the results of laboratory tests or the symptoms. In conclusion, computerized tomography was useful in the diagnosis, assessment of severity and evaluation of healing of acute pyelonephritis.

A new technique of ureteric catheterization.

Insertion of an indwelling stent catheter or ureteric catheterization using a new guide wire (the Radiofocus guide wire) was carried out in a total of 24 subjects. The subjects comprised 16 patients in whom insertion of a conventional guide wire and ureteric catheter was not possible due to previous use of an indwelling stent catheter for extracorporeal shock-wave lithotripsy (ESWL), 2 cases in whom a conventional guide wire could not be inserted due to post-ESWL formation of a stone street, 4 patients with ureteric stenosis and 2 patients with normal ureters in whom catheterization was impossible by the usual methods. Insertion of a Radifocus guide wire into the renal pelvis was successfully accomplished in all 24 cases and an indwelling catheter could be passed in 21 cases. These results suggest that the Radifocus guide wire should make a useful contribution to ESWL therapy. It can also be applied to retrograde pyelography, ureteric obstruction, and the dilation of ureteric stenosis.