Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Symptoms and General Pathology

Neoplasms

Renal Insufficiency

Kidney Calculi

Nephrolithiasis

Calculi

Ureteral Neoplasms

Constriction, Pathologic

Kidney Neoplasms

Kidney Diseases

Urologic Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Male Urogenital Diseases

Pathological Conditions, Anatomical

Urolithiasis

Urinary Calculi

Urologic Neoplasms

Urogenital Neoplasms

Ureteral Diseases

Tumor part of the kidney or ureter and ureteral stricture is surgically removed or repaired and the kidney is restored and transplanted to a family member recipient

Restored Kidney Transplant Between Family Members

Yoshihide Ogawa, MD, PhD

Makoto Mannami, MD

Approximately 30,000 new patients are introduced into dialysis and about 20,000 of them die every year in Japan. At present, about 300,000 patients are on dialysis and more than 10,000 patients are registered with the Japan Organ Transplant Network (JOTN) with the hope for a renal transplantation. If the renal function is restored by transplantation, the quality of life (QOL) improves and more than 90% are reportedly comeback to their normal life activities and get relieved from the burden of dialysis. Furthermore, it can reduce the dialysis related medical cost by as much as 50%. However, only about 1,000 renal transplantation cases are annually carried out in Japan. Among them, 80-85% are living renal transplantations offered by family members or relatives, and the rest are from deceased donors.

Due to the fact that the number of deceased donors are scarce and only living renal transplantations between the family members or relatives are currently allowed in Japan, the approximate waiting time to receive a renal transplantation is 16 years. For that reason, many patients travel abroad to receive a renal transplantation.

There are reports that total nephrectomies are performed as a treatment for small size (4 cm or less) renal tumors, renal stones, ureteral tumors and ureteral strictures in many cases and that many of these nephrectomized kidneys can be successfully transplanted after surgical restoration with satisfactory results. However, due to the lack of necessary evidence it is currently not allowed in Japan.

Therefore, the investigators planned the present clinical study to evaluate the curative efficacy (renal function, QOL) and safety (side effects, complications or occurrence of renal cancer) of living renal transplantations between family members and relatives with restored donor kidneys after the surgical removal or repairment of a small size (4 cm or less) renal tumor or renal stone, ureteral tumor or ureteral stricture, in order to acquire necessary clinical data for potential enrichment of the renal donor pool in Japan as well as to develop useful medical care for our patients who are on dialysis for many years due to the renal failure.

A Clinical Study of the Living Renal Transplantation With Restored Kidneys Between Family Members

A Clinical Study of the Living-related Renal Transplantation With Restored Kidneys (Interventional Trial)

Tokushukai Medical Group

Yoshihide Ogawa

Recurrence

Cysts

Disease Attributes

No intervention

Hequn Chen, M.D.

Hequn Chen, Ph.D

Yu Cui, M.D.

Background of the project: The surgical treatment of parapelvic cysts is currently less researched and there is no gold standard for surgery. Previously, in percutaneous nephrolithotomy, we found that fenestration and fenestration drainage in the simultaneous treatment of pararenal pelvis cysts under nephroscopic nephroscopic surgery has clear curative effect, less trauma, and quicker recovery.

Objective: To clarify the safety, efficacy and long-term efficacy of percutaneous nephroscopy in the treatment of parapelvic cysts.

Nature: Retrospective case cohort study. Basic research process: Retrospective collection of cases in our hospital who underwent percutaneous nephroscopy for the treatment of parapelvic cysts, and comparison of preoperative and postoperative cyst size changes and long-term efficacy.

Percutaneous Nephroscopic Treatment of Parapelvic Cysts

Feasible Surgical Treatment of Peripelvic Cyst by Percutaneous Nephroscopy

Xiangya Hospital of Central South University

Heart and Blood Diseases

Nervous System Diseases

Nutritional and Metabolic Diseases

Gland and Hormone Related Diseases

Skin and Connective Tissue Diseases

Respiratory Tract (Lung and Bronchial) Diseases

Ear, Nose, and Throat Diseases

Musculoskeletal Diseases

Diseases and Abnormalities at or Before Birth

Infections

Rare Diseases

Coronary Artery Disease

Stroke

Diabetes Mellitus

Diabetic Foot

Lung Diseases

Ear Diseases

Joint Diseases

Congenital Abnormalities

Pneumonia

Coronary Disease

Myocardial Ischemia

Lung Diseases, Interstitial

Ulcer

Foot Ulcer

Hyperaldosteronism

Adrenocortical Adenoma

Labyrinth Diseases

Labyrinthitis

Intracranial Arteriovenous Malformations

Arteriovenous Malformations

Adenoma

Ischemia

Heart Diseases

Arteriosclerosis

Arterial Occlusive Diseases

Vascular Diseases

Respiratory Tract Diseases

Diabetic Angiopathies

Leg Ulcer

Skin Ulcer

Skin Diseases

Diabetes Complications

Endocrine System Diseases

Diabetic Neuropathies

Foot Diseases

Vascular Malformations

Cardiovascular Abnormalities

Adrenocortical Hyperfunction

Adrenal Gland Diseases

Otorhinolaryngologic Diseases

Adrenal Cortex Neoplasms

Adrenal Gland Neoplasms

Endocrine Gland Neoplasms

Adrenal Cortex Diseases

Otitis

Cerebrovascular Disorders

Brain Diseases

Central Nervous System Diseases

Central Nervous System Vascular Malformations

Nervous System Malformations

Intracranial Arterial Diseases

Adenoma of the Adrenal Gland

Intracranial Arteriovenous Malformation

Hyperadrenalism

Micronutrients

All Drugs and Chemicals

Zinc

Comparative intra-patients (each patient will have both types of scanner imaging done), clinical superiority study, evaluating the imaging performances (e.g. image quality and radiation dose) of SPCCT and standard DECT for several body regions/anatomical structures.

For the dual-layer spectral CT scanner (IQon®, Philips, Amsterdam, The Netherlands), the following parameters will be used for the acquisition:

* Tube potential 120 kVp;
* Tube current time product of 150 mAs;
* Gantry revolution time 0.33 s;
* Automatic exposure control (angular and longitudinal) combined xyz-axis;
* Beam collimation geometry 64 x 0.625 mm - scan field-of-view - 22 cm;

Spectral Photon Counting Computed Tomography (SPCCT)

The SPCCT scanner is a prototype spectral photon-counting computed tomography system derived from a modified clinical CT system with a field-of-view (FOV) of 168 mm in-plane, and a z-coverage of 20 mm. It is equipped with energy-sensitive photon-counting detectors relying on the direct conversion high band gap semiconductor of cadmium zinc telluride (CZT). The electronics comprises 5 rate counters with 5 different configurable energy thresholds. The SPCCT scanner has the following parameters:

* Base platform : iCT scanner
* Tube Voltage (kVp) : 120, capability for imaging at 80 and 100 kVp
* Tube current (mA) : 10 - 300
* Spatial Resolution : \> 30 lp/cm, ≤ 250 µm
* Z-coverage isocenter (mm) : 20 mm
* FOV (mm) : 500
* Minimum rotation time : 0.33 s/rotation
* Acquisition modes : Axial, Helical, Step \& Shoot

DECT (Dual Energy CT)

Philippe DOUEK, Pr

Adeline MANSUY

This pilot study wants to determine to which extent SPCCT allows obtaining images with improved quality and diagnostic confidence when compared to standard Dual Energy CT (DECT), both with and without contrast agent injection.

Depending on the anatomical structures/organs to be visualized during CT examinations, different scanning protocols are performed with quite variable ionizing radiation doses. Therefore, in order to obtain the most extensive and representative results of the improvement in image quality between SPCCT and DECT that will be performed CT imaging on several body regions and structures, including diabetic foot, diabetic calcium coronary scoring, adrenal glands, coronary arteries, lung parenchyma, kidney stones, inner ear, brain and joints, earl/temporal bone, colorectal carcinosis.

Comparison of Imaging Quality Between Spectral Photon Counting Computed Tomography (SPCCT) and Dual Energy Computed Tomography (DECT)

A single four-point scale will be used (1: unacceptable, 2: usable under limited conditions, 3: probably acceptable, 4: fully acceptable) based on the European guidelines on quality criteria for computed tomography

The diagnostic confidence grade will be calculated on a four-point scale (1: insufficient, 2: poor, 3: average, 4: good).

It will be calculated on a five-point scale (1: poor, 2: fair, 3: average, 4: good, 5: excellent) for each following criterion: noise, artifacts and sharpness.

To determine the radiation dose delivered to the patients during the DECT and SPCCT imaging procedures.

The CTDI is an estimation of the dose delivered to the organs for each acquired section that is based on acquisition parameters of a water phantom with a 32 cm diameter. The value is expressed in milligray (mGy).

To determine the radiation dose delivered to the patients during the DECT and SPCCT imaging procedures.

The DLP is obtained as follows: CTDI \* length of body explored = value in mGy.cm.

To determine the radiation dose delivered to the patients during the DECT and SPCCT imaging procedures.

The equivalent dose is obtained by multiplying the DLP to the specific organ conversion factor.

The noise by selecting regions of interest (ROI) will calculated.

The density (HU) by selecting regions of interest (ROI) will calculated.

The contrast-to-noise ratio (CNR) by selecting regions of interest (ROI) will calculated.

Depiction of anatomical structures of interest will be graded on a four-point scale (1: visualization just possible, 2: unclear borders but different structures already visible, 3: very good visualization, well-defined anatomy, 4: perfect delineation of anatomy).

An average radiation dose delivered to the patients for each clinical application will be calculated.

Statistical comparison between SPCCT and DECT will be performed over all images and anatomical structures globally and also for each clinical application of interest.

Hospices Civils de Lyon

Hematuria

Urination Disorders

Hemorrhage

Cardiotonic Agents

Respiratory System Agents

Isoproterenol

Adrenergic Agents

Adrenergic beta-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Bronchodilator Agents

Anti-Asthmatic Agents

Sympathomimetics

Protective Agents

ISO 0.1 microgram/ml, 8 ml/min irrigation compared to saline irrigation

Palle JS Osther, PhD, MD

The purpose of the study is to examine the effect of endoluminally administrated isoproterenol on pelvic pressure increase during flexible ureterorenoscopy in 14 humans. We propose that isoproterenol has potential of reducing intrarenal pressure during ureterorenoscopies. Lower intrarenal pressures may have the advantage of facilitating the procedure and reducing intraoperative complications as bleeding and infections.

Pharmacological Modulation of the Intrarenal Pressure During Endourological Procedures in the Upper Urinary Tract

Fredericia Hosptial

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
A Clinical Study of the Living Renal Transplantation With Restored Kidneys Between Family Members	NCT00994188	Kidney Neoplasm Kidney Stone Ureteral Tumor Ureteral Strict... Renal Insuffici...	Restored Kidney...	20 Years -	Tokushukai Medical Group
Percutaneous Nephroscopic Treatment of Parapelvic Cysts	NCT05504512	Kidney Stone Parapelvic Cyst Kidney Diseases Recurrence	No intervention	18 Years - 70 Years	Xiangya Hospital of Central South University
Comparison of Imaging Quality Between Spectral Photon Counting Computed Tomography (SPCCT) and Dual Energy Computed Tomography (DECT)	NCT04328181	Diabetic Foot U... Coronary Artery... Parenchymatous;... Kidney Stone Inner Ear Disea... Brain Stroke Joint Diseases Diabetes Adrenal Inciden... Hyperaldosteron... Macroadenoma Interstitial Lu... Intracranial Ar...	Spectral Photon... DECT (Dual Ener...	18 Years -	Hospices Civils de Lyon
Pharmacological Modulation of the Intrarenal Pressure During Endourological Procedures in the Upper Urinary Tract	NCT00428428	Kidney Stone Unexplained Hae... Benignant Tumou...	Isoproterenol	18 Years -	Fredericia Hosptial

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