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We propose an artificial intelligence prediction method for extracorporeal shock wave lithotripsy treatment outcomes by analysis of a wide variety of variables. We retrospectively reviewed the records of 171 patients from between January 2009 and November 2019 that underwent shock wave lithotripsy at Wakayama Medical University, Japan, for ureteral stones shown on preoperative non-contrast computed tomography. This prediction method consisted of stone area extraction, stone analyzing factor extraction from non-contrast computed tomography images, and shock wave lithotripsy treatment result prediction by a non-linear support vector machine for analysis of 15 input and automatic measurement factors. Input factors included patient age, skin-to-stone distance, and maximum ureteral wall thickness, and the automatic measurement factors included 11 non-contrast computed tomography image texture factors in the stone area and stone volume. Permutation feature importance was also applied to the artificial intelligence prediction results to analyze the importance of each factor relating to estimate decision grounds. The prediction performance was evaluated by five-fold cross-validation, it obtained 0.742 of the mean area under the receiver operating characteristic curve. The proposed method is shown by these results to have robust data diversity and effective clinical application. As a result of permutation feature importance, some factors that showed high p-values in the significant difference tests were thought to have a high contribution to the proposed prediction method. Future issues include validation using a larger volume of high-resolution clinical non-contrast computed tomography image data and the application of deep learning. [ABSTRACT FROM AUTHOR]

Although green vegetables are valuable sources of essential elements, and are safe in that they lack harmful elements, they are high in oxalic acid, increasing the risk of urolithiasis. We performed elemental analyses on spinach (Spinacia oleracea L), Malabar nightshade (Basella alba), and water Morning Glory (Ipomoea aquatica), which contain large amounts of oxalic acid, and compared the data to those of Japanese mustard spinach (Brassica rapa var. perviridis), which is the second most commonly consumed green vegetable (after spinach) in Japan. We focused on concentrations of Ca, Mg, and Sr that suppress the formation of ureteral stones (calculi). The calcium concentration in spinach was 6 , 8 8 3 ± 3 6 7 μ g/g in leaves and 2 , 1 9 0 ± 1 5 9. 2 μ g/g in stalks, and the level in Japanese mustard spinach were 1 6 , 3 6 0 ± 9 5 7 μ g/g in leaves and 2 0 , 1 2 0 ± 1 , 2 2 6 μ g/g in stalks. The overall Sr concentration in Japanese mustard spinach was thus 10-fold higher than in spinach, but the Mg concentration was lower than that in spinach. The concentrations of Ca and Sr in Malabar nightshade and water Morning Glory were 3- to 5-fold higher than in spinach. As the former vegetables are consumed much less often than spinach, the risk of urolithiasis is low. We explored how the concentrations of these elements changed after boiling. [ABSTRACT FROM AUTHOR]

Objective. An antispasmodic agent and a medicine that facilitates stone expulsion are given commonly as conservative therapy for ureteral stones in Japan. The goal of this study was to compare the efficacy of the addition of various α1-blockers to the conservative therapy for spontaneous passage of ureteral stones. Material and methods. The subjects were 132 patients with stones from the upper to the lower ureter who were randomly placed into one of four groups and followed for 1 month to assess spontaneous passage of stones. The control group received daily doses of 240 mg flopropione as an antispasmodic agent and 1350 mg extract of Quercus salicina Blume/ Quercus stenophylla Makino as a medicine that facilitates stone expulsion. The other three groups received this therapy and daily doses of 30 mg urapidil, 0.2 mg tamsulosin or 50 mg naftopidil, respectively. The characteristics of the stones and stone expulsion were evaluated by urinalysis, a kidney, ureter and bladder (KUB) X-ray, ultrasound and computed tomography. Results. All patients completed the study and there were no major side-effects. There was no difference in age, stone position or stone size among the groups. Multivariate analysis using a Cox proportional hazards model indicated that the probability of stone expulsion for 1 month was increased 2.38 times (95% confidence interval 1.23-4.61) by naftopidil compared with control therapy alone ( p = 0.01). Conclusion. Naftopidil in combination with an antispasmodic agent and a medicine that facilitates stone expulsion produces a significantly increased rate of ureteral stone expulsion. [ABSTRACT FROM AUTHOR]