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1

Analyses of urinary calculi  

International Nuclear Information System (INIS)

Urinary calculi have been analysed at Birmingham University using three separate techniques: autoradiographic analysis using charged particle activation, scanning electron microscopy (SEM) with accompanying X-ray microanalysis, and proton induced characteristic X-ray emission spectroscopy (PIXE). This latter technique has been developed as a method for quantitative analysis of biological material for trace and minor elements. Closer examinations on the SEM have revealed several interesting and unexpected trace elements particularly in the nuclear region of the stones formed in the bladder or the kidney. The results of the PIXE analyses are important since trace elements (i.e. Ti, Fe, S, Sr, Cu, Cl, K, Zn) have been determined which have been undetectable by previous methods of stone analysis. The analyses have lead to a better understanding of the pathogenesis of stone formation. The techniques have also been used successfully with investigations on biliary calculi (gall stones). (author)

1981-06-19

2

[Urinary calculi and infection].  

Science.gov (United States)

Infection urinary stones resulting from urease-producing bacteria are composed by struvite and/or carbonate apatite. Bacterial urease splits urea and promotes the formation of ammonia and carbon dioxide leading to urine alkalinization and formation of phosphate salts. Proteus species are urease-producers, whereas a limited number of strains of other Gram negative and positive species may produce urease. Ureaplasma urealyticum and Corynebacterium urealyticum are urease-producers that are not isolated by conventional urine cultures, but require specific tests for identification. Primary treatment requires surgical removal of stones as complete as possible. Extracorporeal and endoscopic treatments are usually preferred, while open surgery is actually limited to few selected cases. Residual stones or fragments should be treated by chemolysis via ureteral catheter or nephrostomy or administration of citrate salts in order to achieve a stone-free renal unit. Postoperatively, recurrent urinary tract infection should be treated with appropriate antibiotic treatment although long-term antibiotic prophylaxis can cause resistance. Urinary acidification has been proposed for the prophylaxis of infection stones, but long-term acidification is difficult to achieve in urine infected by urease-producing bacteria. Urease inhibitors lead to prevention and/or dissolution of stones and encrustations in patients with infection by urea-splitting bacteria, but their use is limited by their toxicity. The administration of citrate salts involves an increase of the value of nucleation pH (pHn), that is the pH value at which calcium and magnesium phosphate crystallization occurs, in a greater way than the corresponding increase in the urinary pH due to its alkalinizing effect and resulting in a reduction of the risk of struvite crystallization. In conclusion prevention of the recurrence of infection stones can be achieved by an integrated approach tailored on the single patient. Complete clearance of the stone must be achieved by primary surgical procedure and residual fragments should be extensively treated. In the case of persistent infection, conservative measures, such as acidification and urease inhibitors or citrate administration, should be adopted to minimize its effect on urinary saturation with respect to struvite. PMID:24874306

Trinchieri, Alberto

2014-06-13

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Computed tomographic analysis of urinary calculi  

Energy Technology Data Exchange (ETDEWEB)

Excised urinary calculi were subjected to computed tomographic (CT) scanning in an attempt to determine whether CT attenuation values would allow accurate analysis of stone composition. The mean, maximum, and modal pixel densities of the calculi were recorded and compared; the resulting values reflected considerable heterogeneity in stone density. Although uric acid and cystine calculi could be identified by their discrete ranges on one or more of these criteria, calcium-containing stones of various compositions, including struvite, could not be distinguished reliably. CT analysis of stone density is not likely to be more accurate than standard radiography in characterizing stone composition in vivo.

Newhouse, J.H.; Prien, E.L.; Amis, E.S. Jr.; Dretler, S.P.; Pfister, R.C.

1984-03-01

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Computed tomographic analysis of urinary calculi  

International Nuclear Information System (INIS)

Computed tomography (CT) was employed in an effort to analyze the chemical composition of urinary calculi. Twenty-three surgically removed calculi were scanned in a water bath (in vitro study). Forteen of them in the body were scanned (in vivo study). The calculi consisted of four types: mixed calcium oxalate and phosphate, mixed calcium carbonate and phosphate, magnesium ammonium phosphate, and uric acid. The in vitro study showed that the mean and maximum CT values of uric acid stones were significantly lower than those of the other three types of stones. This indicated that stones with less than 450 HU are composed of uric acid. In an in vivo study, CT did not help to differentiate the three types of urinary calculi, except for uric acid stones. Regarding the mean CT values, there was no correlation between in vitro and in vivo studies. An experiment with commercially available drugs showed that CT values of urinary calculi were not dependent upon the composition, but dependent upon the density of the calculi. (Namekawa, K.)

1986-01-01

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Management of urinary calculi in pregnant women.  

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The incidence and predisposing factors of urinary calculi are generally the same in both pregnant and non pregnant women, but anatomic changes during pregnancy make diagnosis and treatment a more challenging issue. We reviewed 16 patients (22 stones) of urinary stone during pregnancy between 1986 and 1996 at Kyung Hee Medical Center. The most common symptom was flank pain, seen in 81.3% of patients, while 68.8% of patients were displayed microscopic hematuria. In all cases, diagnosis was made...

Lee, S. J.; Rho, S. K.; Lee, C. H.; Chang, S. G.; Kim, J. I.

1997-01-01

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CT findings of melamine caused urinary calculi  

International Nuclear Information System (INIS)

Objective: To analyze the CT findings of melamine induced urinary calculi. Methods: Nineteen children with a history of ingestion of melamine contaminated infant formula milk were studied, including 12 males and 7 females, age ranged from 50 days to 5 years. Results: CT demonstrated renal pelvic and ureteral stones in 13 cases, with urinary obstruction in 9 of them. The size of the stones ranged from 0.3 cm x 0.3 cm to stag-horn calculus. Tine density of the stones measured from a low of 40-70 HU up to a high of 410 HU with an average density of 160 HU. Conclusion: CT scan is an excellent modality in demonstrating urinary tract calculi caused by melamine. It is the method of choice when ultrasound examinations are equivocal. (authors)

2009-04-01

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Evaluation of Urinary Calculi by Infrared Spectroscopy  

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Full Text Available

Purpose: To analyze urinary calculi composition and its relationship with gender, age, calculus weight, color, and location.

Materials and Methods: Two hundred and forty one patients with urinary calculus, who had undergone open lithotomy from June 1999 to April 2001, were enrolled in this prospective study which was performed by Tehran and Oroomieh Medical Sciences Universities. The calculi compositions were analyzed by infrared spectroscopy in Bonn University. Statistical analyses were made by paired t test

Results: One hundred and forty five males with a mean age of 40.4 years and 96 females with a mean age of 42.5 years were enrolled in this study. Mean calculus weight was 4.28 gr. Mean calculus number was 4.33. Thirty four (14.1% calculi were pure (carbonate apatite: 2, brushite: 1, uric acid: 19, cystine: 3, weddellite: 6, mono-NH4-urate: 2, struvite: 1, 207(85.6% were mixed and none of them contained octa-ca-phosphate, apatite, newberyte, 2,8-dihydroxyadenine, mono-Na-urate, or xanthine. Weddellite was found in 77% of calculi. It comprised more than 50% of them in 26% of cases. Whewellite crystals were found in 78% of calculi. It comprised more than 50% of them in 46% of cases. The most common pure calculus was uric acid and the most common component of calculi was whewellite followed by weddellite.

Conclusion: Although there is no comprehensive study on urolithiasis incidence and prevalence in Iran, it can be concluded that whewellite and weddellite may be the most common components of urolithiasis in Iran and uric acid calculi are the most common pure calculi. There was no significant difference in calculi composition in our study.

Abdolrasool Mehrsai

2004-06-01

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Computer tomography and urinary calculi, 2  

International Nuclear Information System (INIS)

To find whether computer tomography (CT) can determine the composition of urinary calculi, we measured the CT values of 47 calculi in vitro and 26 calculi in situ. The results are as follows; 1) CT values (Hounsfield Unit) of various stones which were measured in vitro (mean ± s.d.) were as follows; mixed calcium oxalate and calcium phosphate (the mixed stone) 1555 ± 193 H, magnecium ammonium phosphate (MAP) 1285 ± 248 H, cystine 757 ± 114 H, uric acid 480 H. 2) In situ the peak CT values of various calculi were almost the same as those in vitro, but the mean CT values were slightly less. 3) From these results we concluded that cystine and uric acid stones can be identified by the CT value. With regard to the mixed stone and MAP, it is almost impossible to identify these stones especially when they reveal the CT values of 1100 - 1500 H. However, stones with the peak CT values of more than 1500 H were rarely MAP and often the mixed stone, and those with the mean CT values of 1000 - 1100 H were rarely the mixed stone and often MAP. (author)

1986-01-01

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Evaluation of Urinary Calculi by Infrared Spectroscopy  

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Purpose: To analyze urinary calculi composition and its relationship with gender, age, calculus weight, color, and location.

Materi...

Abdolrasool Mehrsai; Ali Taghizadeh Afshari; Zohrevand, R.; Hooman Djaladat; Steffes, H. J.; Hesse, A.; Gholamreza Pourmand

2004-01-01

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Percutaneous retrieval of upper urinary tract foreign bodies and calculi  

Energy Technology Data Exchange (ETDEWEB)

To determine, when extracorporeal shockwave lithotripsy is contraindicated, the usefulness and safety of percutaneous management in the removal from the upper urinary tract of foreign bodies and calculi, or small remnants of these, retained after percutaneous nephrolithotomy. Between January 1996 and May 2001, We attempted to retrieve foreign bodies or calculi from the upper urinary tract of 20 patients, using various percutaneous technique. There were eleven foreign bodies, namely fragmented nephrostomy catheters (n=2), migrated ureteric stents inaccessible to retrograde ureteroscopic management (n=8), and one metallic radiopaque marker which was separated from the pusher of the internal ureteral stent. Nine urinary tract calculi were present. These ranged in radiographically measured size from 4 to 8 mm in their largest diameter, and were found in the renal pelvis or calyx (n=5) and ureter (n=4). After percutaneous nephrostomy, all procedures involved the use of a 7-F to 14-F sheath, inserted under fluoroscopic guidance. Devices used for the retrieval of these objects include a stone basket retriever, loop snare, grasping forceps, and balloon catheter. In all cases except one, it was possible to retrieve calculi or other items from the upper urinary tract. No surgical procedure was required and no significant complications were encountered in any of the cases during or after the procedures. The percutaneous technique can be useful and safe in the management of foreign bodies or calculi present in the upper urinary tract.

Shin, Tae Beom; Seong, Chang Kyu; Kim, Yong Joo [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

2002-07-01

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Percutaneous retrieval of upper urinary tract foreign bodies and calculi  

International Nuclear Information System (INIS)

To determine, when extracorporeal shockwave lithotripsy is contraindicated, the usefulness and safety of percutaneous management in the removal from the upper urinary tract of foreign bodies and calculi, or small remnants of these, retained after percutaneous nephrolithotomy. Between January 1996 and May 2001, We attempted to retrieve foreign bodies or calculi from the upper urinary tract of 20 patients, using various percutaneous technique. There were eleven foreign bodies, namely fragmented nephrostomy catheters (n=2), migrated ureteric stents inaccessible to retrograde ureteroscopic management (n=8), and one metallic radiopaque marker which was separated from the pusher of the internal ureteral stent. Nine urinary tract calculi were present. These ranged in radiographically measured size from 4 to 8 mm in their largest diameter, and were found in the renal pelvis or calyx (n=5) and ureter (n=4). After percutaneous nephrostomy, all procedures involved the use of a 7-F to 14-F sheath, inserted under fluoroscopic guidance. Devices used for the retrieval of these objects include a stone basket retriever, loop snare, grasping forceps, and balloon catheter. In all cases except one, it was possible to retrieve calculi or other items from the upper urinary tract. No surgical procedure was required and no significant complications were encountered in any of the cases during or after the procedures. The percutaneous technique can be useful and safe in the management of foreign bodies or calculi present in the upper urinary tract

2002-07-01

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Chemometric examination of trace elements analysis in urinary calculi  

International Nuclear Information System (INIS)

The content of Pb, Cd, Ni, Fe, Na and K was determined in sixteen samples of urinary calculi taken from patients in Macedonia. The trace elements were determined by atomic absorption spectrophotometry and by flame emission spectrometry. The chemometric examination of the calculi was done by factor analysis. This chemometric method has been extensively used for classification purposes while solving different multidimensional problems. The results obtained from the analysis revealed that the highest correlation exists between the concentrations of lead and potassium. No significant correlation among other analyzed elements was found. The examination of the first two principal components (with 67 % variance captured) calculated from the auto scaled data matrix showed a clear separation between the composition of the calculi taken from male and from female patients, especially in the case of the calculi consisting of the two oxalates (whewellite and weddelite) and those composed of carbonate apatite in mixture with oxalates.

2006-01-01

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Factors affecting urinary calculi treatment by extracorporeal shock wave lithotripsy  

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Extracorporeal Shock Wave Lithotripsy (ESWL) is still the treatment of choice for most renal and upper ureteric stones; however the outcome depends on multiple factors. The objective of this study was to investigate the effects of stone density, as measured by Hounsfield Units (H.U) by non-contrast Computerized Tomography (CT), stone size and stone location on ESWL treatment outcome of urinary calculi in Jordanian patients. 65 patients underwent clinical, biochemical and radiological assessme...

Tarawneh Emad; Awad Zeyad; Hani Audy; Haroun Azmi; Hadidy Azmi; Mahafza Waleed; Samarah Osama

2010-01-01

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In vitro characterization of urinary calculi: Dual-energy technique  

International Nuclear Information System (INIS)

Using a dual-energy program implemented on a Siemens Somatom DR3 CT unit, the authors attempted to discriminate between urinary calculi of different chemical compositions by means of selective image reconstruction based on their high kVp(125 keV), low kVp (85 keV), 65 keV, and electron density values. Simultaneous dual-energy images were obtained using a technique of rapid kVp switching (85 and 125 keV) and advanced evaluation algorithms. Representative stones of pure and mixed composition were scanned in a water bath. Computer printouts of electron density and CT attenuation values at each kVp setting were obtained. Preliminary observations indicate readily feasible discrimination between uric acid and all other calculi and between struvite stones and brushite or calcium oxalate stones

1986-12-05

15

Study of cystine urinary calculi in dogs.  

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The composition and structure of 48 canine cystine urinary stones were determined by infrared spectroscopy, scanning electron microscopy and electron dispersive X-ray analysis. The infrared analysis showed that about 45% of the specimens were composed of pure cystine. The remainder also contained calcium oxalate (mono and/or dihydrate), magnesium ammonium phosphate hexadydrate (struvite), calcium hydrogen phosphate dihydrate (brushite) and complex urates (ammonium, ammonium potassium and/or p...

1991-01-01

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Nondestructive analysis of urinary calculi using micro computed tomography  

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Full Text Available Abstract Background Micro computed tomography (micro CT has been shown to provide exceptionally high quality imaging of the fine structural detail within urinary calculi. We tested the idea that micro CT might also be used to identify the mineral composition of urinary stones non-destructively. Methods Micro CT x-ray attenuation values were measured for mineral that was positively identified by infrared microspectroscopy (FT-IR. To do this, human urinary stones were sectioned with a diamond wire saw. The cut surface was explored by FT-IR and regions of pure mineral were evaluated by micro CT to correlate x-ray attenuation values with mineral content. Additionally, intact stones were imaged with micro CT to visualize internal morphology and map the distribution of specific mineral components in 3-D. Results Micro CT images taken just beneath the cut surface of urinary stones showed excellent resolution of structural detail that could be correlated with structure visible in the optical image mode of FT-IR. Regions of pure mineral were not difficult to find by FT-IR for most stones and such regions could be localized on micro CT images of the cut surface. This was not true, however, for two brushite stones tested; in these, brushite was closely intermixed with calcium oxalate. Micro CT x-ray attenuation values were collected for six minerals that could be found in regions that appeared to be pure, including uric acid (3515 – 4995 micro CT attenuation units, AU, struvite (7242 – 7969 AU, cystine (8619 – 9921 AU, calcium oxalate dihydrate (13815 – 15797 AU, calcium oxalate monohydrate (16297 – 18449 AU, and hydroxyapatite (21144 – 23121 AU. These AU values did not overlap. Analysis of intact stones showed excellent resolution of structural detail and could discriminate multiple mineral types within heterogeneous stones. Conclusions Micro CT gives excellent structural detail of urinary stones, and these results demonstrate the feasibility of identifying and localizing most of the common mineral types found in urinary calculi using laboratory CT.

Lingeman James E

2004-12-01

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Results of urinary dissolution therapy for radiolucent calculi  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Purpose In this paper we present our experience with dissolution therapy of radiolucent calculi. Materials and Methods This was a retrospective analysis of patients who were offered urinary dissolution therapy between January 2010 and June 2011. Patients were treated with ta [...] blets containing potassium citrate and magnesium oxide. Partial dissolution was defined as at least a 50% reduction in stone size. Patients with complete or partial dissolution were classified in the successful dissolution group. Patients with no change, inadequate reduction, increase in stone size and those unable to tolerate alkali therapy were classified as failures. Patient sex, stenting before alkalinization, stone size, urine pH at presentation and serum uric acid levels were analyzed using Fisher t-test for an association with successful dissolution. Results Out of 67, 48 patients reported for follow up. 10 (15%) had complete dissolution and 13 (19%) had partial dissolution. Alkalinization was unsuccessful in achieving dissolution in 25 (37%). Stenting before alkalinization, patient weight ( 75kg) and serum uric acid levels (? 6 vs. > 6) were the only factors to significantly affected dissolution rates (p = 0.039, p 0.035, p 0.01 respectively). CONCLUSIONS A policy of offering dissolution therapy to patients with radiolucent calculi had a successful outcome in 34% of patients.

Sinha, Maneesh; Prabhu, Kumar; Venkatesh, Prasanna; Krishnamoorthy, Venkatesh.

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Usefulness of reversed display of soft-copy abdominal radiographs for urinary calculi detection  

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PURPOSE: To determine the usefulness of reversed display of soft-copy abdominal radiographs for urinary calculi detection. MATERIAL AND METHODS: Sixty radiographs with a single urinary calculus less than 5 mm in the long diameter (15 in the kidney; 15 in the proximal ureter; 15 in the mid-ureter, 15 in the distal ureter) and 15 radiographs without calculi were evaluated. Four readers blinded to the presence or absence of urinary calculi on each radiograph reviewed the radiographs in the conventional display, reversed display, and combination of conventional and reversed displays at 1-week intervals. All images were evaluated in random order and the presence or absence of urinary calculi was interpreted using the confidence score from 1 to 5. RESULTS: Multireader analysis for calculi in all locations showed a greater area under the receiver operating curve for combination of the two displays (0.764) than for the conventional display alone (0.655) (P=0.031). In the single-reader analysis for calculi in all locations, the third reader showed a greater area under the receiver operating curve for the reversed display (0.784) than for the conventional display (0.622) (P=0.027). Multireader analysis of the calculi in the kidney showed a greater area under the receiver operating curve for combination of the two displays (0.824) than for the conventional display alone (0.703) (P=0.043). CONCLUSION: The reversed display of soft-copy abdominal radiographs may be useful for urinary calculi detection.

Kang, S.S.; Kim, J.K.; Ryu, J.A.; Choi, N.; Bae, S.J.; Kim, B. [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Radiology

2004-05-01

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Factors affecting urinary calculi treatment by extracorporeal shock wave lithotripsy  

Directory of Open Access Journals (Sweden)

Full Text Available Extracorporeal Shock Wave Lithotripsy (ESWL is still the treatment of choice for most renal and upper ureteric stones; however the outcome depends on multiple factors. The objective of this study was to investigate the effects of stone density, as measured by Hounsfield Units (H.U by non-contrast Computerized Tomography (CT, stone size and stone location on ESWL treatment outcome of urinary calculi in Jordanian patients. 65 patients underwent clinical, biochemical and radiological assessments followed by ESWL treatment. Statistical analyses including chi-square, analysis of variance (ANOVA, correlation, regression were performed for statistical significance between ESWL treatment, stone fragmentation and stone density, size and location in the renal pelvis. ESWL success rate was high (94% for low density stones (< 500 Hounsfield units. In general CT densities of 750 Hounsfield units or less were almost always successfully treated by ESWL. An inverse association between ESWL treatment outcome and stone size was also documented. CT stone density and stone size combined account for nearly 73% of the variation in the number of shock waves required to attain fragmentation. Stones located in lower calyceal area had less success rates. In conclusion, stones with higher density, large size and lower location may better be managed by percutaneous nephrolithotomy.

Tarawneh Emad

2010-01-01

20

Unenhanced CT findings can predict the development of urinary calculi in stone-free patients  

International Nuclear Information System (INIS)

To determine if calcium deposits in the papillae can be identified by unenhanced computed tomography (uCT) even before renal stones develop. A retrospective review of 413 patients with calculi identified 31 patients (stone-forming group) with a history of urinary tract calculi with a calculus demonstrated by uCT and a stone-free uCT before calculi had developed. The control group (n = 31) was composed of live kidney donors with no history of calculi and a stone-free uCT. CT attenuation was measured in all CTs using two regions of interest of 0.05 cm2 and 0.1 cm2 over the tip and the neighbouring area of the papillae. Student's and Wilcoxon t-tests were used for comparing results in the two groups. The attenuation of the tip of the papilla was higher in the stone-forming group when compared to the controls after (45.2 HU versus 32.1 HU, P = 0.001) and even before frank calculi had developed (44.2 HU versus 32.1 HU, P = 0.003). There was no significant difference in papillary attenuation in the stone group before and after calculi had developed (45.2 HU versus 44.2 HU, P = 0.82). Stone-forming patients exhibit higher papillary density even before calculi develop. This could define a population at risk of developing calculi. (orig.)

2012-09-01

 
 
 
 
21

Unenhanced CT findings can predict the development of urinary calculi in stone-free patients  

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To determine if calcium deposits in the papillae can be identified by unenhanced computed tomography (uCT) even before renal stones develop. A retrospective review of 413 patients with calculi identified 31 patients (stone-forming group) with a history of urinary tract calculi with a calculus demonstrated by uCT and a stone-free uCT before calculi had developed. The control group (n = 31) was composed of live kidney donors with no history of calculi and a stone-free uCT. CT attenuation was measured in all CTs using two regions of interest of 0.05 cm{sup 2} and 0.1 cm{sup 2} over the tip and the neighbouring area of the papillae. Student's and Wilcoxon t-tests were used for comparing results in the two groups. The attenuation of the tip of the papilla was higher in the stone-forming group when compared to the controls after (45.2 HU versus 32.1 HU, P = 0.001) and even before frank calculi had developed (44.2 HU versus 32.1 HU, P = 0.003). There was no significant difference in papillary attenuation in the stone group before and after calculi had developed (45.2 HU versus 44.2 HU, P = 0.82). Stone-forming patients exhibit higher papillary density even before calculi develop. This could define a population at risk of developing calculi. (orig.)

Ciudin, Alexandru; Luque Galvez, Maria Pilar; Franco de Castro, Agustin; Garcia-Cruz, Eduardo; Alcover Garcia, Juan; Alvarez-Vijande Garcia, Jose Ricardo; Alcaraz Asensio, Antonio [Hospital Clinic Barcelona, Urology Department, Barcelona (Spain); Salvador Izquierdo, Rafael; Nicolau, Carlos [Hospital Clinic Barcelona, Radiology Department, Barcelona (Spain)

2012-09-15

22

[Clinical application of a third generation lithotripter (Modulith SL20) for urinary tract calculi].  

Science.gov (United States)

A third generation lithotripter (Modulith SL20) was used for disintegration of upper urinary tract calculi. From April 1991 through March 1993, a total of 281 sessions were carried out on 212 patients with upper urinary tract calculi at Seichoukai Fuchu Hospital. One month after the last session, of the 141 patients evaluated, 55 (39.0%) were free from stone fragments and 52 (36.9%) had stone fragments equal to or smaller than 4 mm. The over-all successful rate was 75.9% and the success rate was excellent for lower ureteral stones. As side effects, there were no serious complications other than perinephritic hematoma which occurred in 2 patients. These findings clearly indicated that the Modulith SL20 lithotripter was highly useful for disintegration of calculi of the upper urinary tract. PMID:8191965

Iseki, T; Tanaka, T; Goto, T; Maekawa, T; Nishio, S

1994-04-01

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Percutaneous Management of Urinary Calculi in Horseshoe Kidneys  

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Full Text Available Urolithiasis in horseshoe kidney presents a unique challenge in decision-making and technical aspects of calculus treatment. We present our experience with a group of patients with symptomatic calculi in their horseshoe kidneys. We had 8 patients with 9 horseshoe kidneys bearing calculi. They all underwent percutaneous nephrolithotomy. The median size of the calculi was 21 mm (range, 12 to 45 mm. Auxiliary therapeutic procedures were required in 2 patients who had residual calculi on control imaging. The stone-free status was observed in 6 patients (75.0% at discharge, and in 7 (87.5% after 3 months of follow-up. Surgical complications included bleeding in 2 patients that was controlled with complete bed rest and blood transfusion, and pleural injury in 1 which was managed conservatively.

Vahid Yousefinejad

2008-11-01

24

Optimization of supervised self-organizing maps with genetic algorithms for classification of urinary calculi  

Science.gov (United States)

Supervised self-organizing maps were used for classification of 160 infrared spectra of urinary calculi composed of calcium oxalates (whewellite and weddellite), pure or in binary or ternary mixtures with carbonate apatite, struvite or uric acid. The study was focused to such calculi since more than 80% of the samples analyzed contained some or all of the above-mentioned constituents. The classification was done on the basis of the infrared spectra in the 1450-450 cm -1 region. Two procedures were used in order to find the most suitable size and for optimizing the self-organizing map of which that using the genetic algorithms gave better results. Using this procedure several sets of solutions with zero misclassifications were obtained. Thus, the self-organizing maps may be considered as a promising tool for qualitative analysis of urinary calculi.

Kuzmanovski, Igor; Trpkovska, Mira; Šoptrajanov, Bojan

2005-06-01

25

Failure of holmium:yttrium-aluminum-garnet laser lithotripsy in two horses with calculi in the urinary bladder.  

Science.gov (United States)

Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy was attempted in a mare and a gelding with calculi in the urinary bladder. The procedure was unsuccessful in producing adequate fragmentation of the calculi. In the gelding, pulsed dye laser lithotripsy was subsequently used to fragment the urolith. Manual removal of the urolith via the urethra was performed in the mare. PMID:11601793

May, K A; Pleasant, R S; Howard, R D; Moll, H D; Duesterdieck, K F; MacAllister, C G; Bartels, K E

2001-10-01

26

Bacteriological and crystallographical analysis of urinary calculi: aid to patient management.  

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In an analysis, by both crystallographic and microbiological methods, of 50 urinary calculi recently removed by surgical operation, 33 proved to be of metabolic origin (mostly calcium oxalate and some uric acid or urate) and 17 of 'infective' origin (struvite, apatite or a mixture of the two). Metabolic stones were usually bacteriologically sterile or contained only small numbers (less than 10(3)/g of stone) of bacteria which did not produce urease, while infective stones always contained ure...

Rosenstein, I.; Osborn, R. S.; Hopewell, J. P.; Hamilton-miller, J. M.; Brumfitt, W.

1984-01-01

27

Medullary Sponge Kidney and Urinary Calculi Aeromedical Concerns  

Science.gov (United States)

Medullary Sponge Kidney (MSK) is a benign disorder associated with renal stones in 60% of patients. Patients frequently have episodic painless hematuria but are otherwise asymptomatic unless renal calculi or infections complicate the disease. Nephrolithiasis is a relative, but frequently enforced, contraindication to space or other high performance flight. Two case reports of asymptomatic NASA flight crew with MSK and three cases of military aviators diagnosed with MSK are reviewed, all cases resulted in waiver and return to flight status after treatment and a vigorous follow up and prophylaxis protocol. MSK in aviation and space flight necessitates a highly case-by-case dependent evaluation and treatment process to rule out other potential confounding factors that might also contribute to stone formation and in order to re-qualify the aviator for flight duties.

Jones, Jeffrey A.; Cherian, Sebastian F.; Barr, Yael R.; Stocco, Amber

2008-01-01

28

Percutaneous Imaging-Guided Access for the Treatment of Calculi in Continent Urinary Reservoirs  

International Nuclear Information System (INIS)

Purpose: To describe our long-term experience with percutaneous access to continent urinary reservoirs for calculus removal. Patients and Methods: A retrospective study of 13 procedures in 10 patients was performed. In 2 of the 13 procedures, access and calculus removal was performed in a single session. In the other 11 procedures, initial access was obtained using ultrasonography,fluoroscopy, and/or computed tomography. The patients then returned ata later date for a second step where the access was dilated and the calculi were removed. Results: Access was achieved successfully in all cases with no complications. At mean follow-up time of 13.6 months (range 1-94 months) one patient had died of complications unrelated to her continent urinary reservoir. Another patient had been placed on suppressive antibiotics for recurrent calculi. The remaining patients were stone free and without late complication. Conclusions: Percutaneous removal of reservoir calculi can be performed safely, avoiding potential injury to the continence valve mechanism by a direct cystoscopic approach. We propose a two-stage procedure using CT guidance for initial access as the preferred technique

2002-03-01

29

Structure and Composition of Non-Infectious Phosphate Calculi Formed in Patients with Low and High Urinary Phosphate Concentrations  

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Full Text Available Objective: The aim of this paper was to assess the relationships among chemical, phase and structural composition and etiopathogenic factors of non-infectious phosphate calculi formed in patients with low and high urinary phosphate concentrations, and to characterize the mechanism of their formation related on biochemical results. Material and Methods: Twelve samples of phosphate renal calculi were obtained, 4 from patients with low phosphaturia and 6 from patients with high urinary phosphate concentrations. Their chemical composition was determined qualitatively by energy dispersive X-ray analysis and quantitatively by spectrophotometric and thermal analysis; and their phase composition was determined by Fourier transform infrared transmission spectroscopy and X-ray diffraction. The structure of the calculi was assessed by scanning electron microscopy. Results: Non-infectious phosphate renal calculi of patients with low phosphaturia consist of poorly crystalline carbonate hydroxyapatite, whereas those of patients with high urinary phosphate concentrations consist of poorly crystalline hydroxyapatite with some amount of calcium oxalate crystals. Calculi of patients with high urinary phosphate concentrations are formed at urinary supersaturation with respect to hydroxyapatite and calcium oxalate about 4 times higher than in patients with low phosphaturia. Conclusion: In patients with low phosphaturia, the non-infectious phosphate renal calculi are formed in urine near pH 7 and contain only poorly crystalline carbonate hydroxyapatite. In patients with high urinary phosphate concentrations and hypercalciuria, the calculi are formed in urine near pH 6 and consist of both poorly crystalline hydroxyapatite and some amount of calcium oxalate crystals.

Isabel Gomila

2013-02-01

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Trace element studies in urolithiasis; preliminary investigation on mixed calcium oxalate-struvite urinary calculi  

International Nuclear Information System (INIS)

In this study the levels of the trace elements copper , zinc, lead, iron, aluminum, nickel, chromium along with magnesium, sodium and potassium were estimated in fifteen mixed calcium oxalate-struvite (CaOx/STR) urinary stones. The mean values of the combined results were, copper 4.24, zinc 1302, zinc 1302.10, lead 23.25, iron 36.83,nickel 0.69, chromium 1.93, magnesium 4530441, sodium 54.13 and potassium 5.93 ng mg/sup -1/. It was observed that zinc, aluminum and potassium levels were higher than in calcium oxalate(CaOx) calculi 0.05>P>0.02 and potassium levels were higher than in mixed calcium oxalate-hydroxy appetite (CaOx/APA) calculi, P<0.01. A combination of all the results was also compared with similar data from South Africa, Turkey, Austria, India, U.S.A and Japan. (author)

1999-10-01

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Techniques used in trace element analysis of urinary calculi by atomic absorption spectroscopy  

International Nuclear Information System (INIS)

Atomic absorption spectroscopy (AAS) was found to be a suitable method for the estimation of iron, copper, zinc, magnesium, aluminium and lead in urinary calculi: graphite furnace electrothermal atomization was required for lead and flame atomization for the others. A standard urinary stone solution was made up and calibrated for each element using the method of standard additions. In all case, absorption varied linearly with concentration; reproducibility, accuracy and recovery were satisfactory for all elements. Conventional atomic absorption standards in 1% nitric acid solution had low apparent values as a percentage of the true values would be: Fe, 108.5; Cu, 103.1; Zn, 106.4; Mg, 125.0; Al, 103.6; Pb, 102.2%. Also, apparent concentrations of magnesium, zinc and copper in dilute nitric acid solution varied significantly with acid strength. It was concluded that in order to minimise matrix and Ph effects, urinary stone analysis should be done against the standard urinary stone solution. (author)

1994-03-01

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Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithot [...] ripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal shock-wave lithotripsy (SWL) occurred in 14 (32%) patients, unilateral multiple stones in 18 (41%) patients, and multiple bilateral stones in 3 (7%). In 29 (66%) patients, the stone was located in the inferior calyx. Perioperative and financial outcomes were also evaluated. RESULTS: 50 procedures were performed in 44 patients. The mean stone burden on preoperative CT scan was 11.5 ± 5.8 mm. The mean operative time was 61.3 ± 29.4 min. The stone free rate was 93.1% after one procedure and 97.7% after a second procedure, with overall complication rate of 8%. Therapeutic success occurred in 92% and 93% of patients with lower pole stones and SWL failure, respectively. Treatment failure of a single session was associated with presence of a stone size larger than 15 mm (p = 0.007), but not associated with inferior calyx location (p = 0.09). Surgical disposables were responsible for 78% of overall costs. CONCLUSION: Flexible ureteroscopy using holmium laser is a safe and effective option for the treatment of upper urinary tract calculi. In addition, it can be considered an attractive option as salvage therapy after SWL failure or kidney calculi associated with ureteral stones. Stone size larger than 15 mm is associated with single session treatment failure.

Marcello, Cocuzza; Jose R., Colombo Jr; Antonio L., Cocuzza; Frederico, Mascarenhas; Fabio, Vicentini; Eduardo, Mazzucchi; Miguel, Srougi.

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Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi  

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Full Text Available OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithotripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34% patients, failed extracorporeal shock-wave lithotripsy (SWL occurred in 14 (32% patients, unilateral multiple stones in 18 (41% patients, and multiple bilateral stones in 3 (7%. In 29 (66% patients, the stone was located in the inferior calyx. Perioperative and financial outcomes were also evaluated. RESULTS: 50 procedures were performed in 44 patients. The mean stone burden on preoperative CT scan was 11.5 ± 5.8 mm. The mean operative time was 61.3 ± 29.4 min. The stone free rate was 93.1% after one procedure and 97.7% after a second procedure, with overall complication rate of 8%. Therapeutic success occurred in 92% and 93% of patients with lower pole stones and SWL failure, respectively. Treatment failure of a single session was associated with presence of a stone size larger than 15 mm (p = 0.007, but not associated with inferior calyx location (p = 0.09. Surgical disposables were responsible for 78% of overall costs. CONCLUSION: Flexible ureteroscopy using holmium laser is a safe and effective option for the treatment of upper urinary tract calculi. In addition, it can be considered an attractive option as salvage therapy after SWL failure or kidney calculi associated with ureteral stones. Stone size larger than 15 mm is associated with single session treatment failure.

Marcello Cocuzza

2008-03-01

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Application of physico-chemical procedures in the analysis of urinary calculi  

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All physico-chemical techniques used in the analysis of urinary calculi have inherent advantages and limitations. Although x-ray powder diffraction can identify constituents unambiguously, certain minor components can be missed. Infrared spectroscopy is more sensitive but band assignment at low concentrations is difficult. Scanning electron microscopy together with energy dispersive x-ray analysis permits the simultaneous investigation of morphology and chemical microstructure. With the electron microprobe, minor constituents can be detected but tedious sample preparation procedures are required. Transmission electron microscopy is extremely useful in determining constituent inter-relationships and ultrastructure but ultramicrotomy is very difficult. Thermal gravimetric analysis gives quantitative information easily but does not satisfactorily distinguish between struvite and brushite. In an attempt to assess the accuracy of chemical analyses, 62 calculi were investigated applying several chemical tests. Those for MgS , PO4(T ), NHU and uric acid proved highly reliable while that for CaS often yielded an incorrect result. The test for oxalate was totally unsatisfactory. Investigators of stone composition and structure should include x-ray diffraction (or infrared spectroscopy) and scanning electron microscopy as their methods of first choice. In addition, chemical or thermogravimetric analyses should be utilized in an auxiliary capacity.

Rodgers, A.L.

1985-01-01

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Struvite infection calculi in dogs: problems with urinary calculus identification, and the value of the results  

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Full Text Available SciELO South Africa | Language: English Abstract in english Identifying the crystalline components of a urinary calculus is a valuable aid to correct diagnosis, and subsequent treatment of the underlying cause of the problem. Calculus formation is often an end product brought about by urine with a high concentration of insoluble material causing bladder irri [...] tation. This promotes bacterial infection by Proteus, which not only raises the pH in the bladder and generates ammonia, but also provides sites for mineral nucleation and crystal growth. Treating the infection and removing the stone will not necessarily cure the disorder. Correct identification of a calculus as struvite and even its potassium analogue can be critical in choice of curative protocols, but this is not always straightforward. Our experience with 'problem calculi' is described.

Dunlevey, John; Laing, Michael.

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Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol  

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The efficiency and radiation dose of a low-dose dual-energy (DE) CT protocol for the evaluation of urinary calculus disease were evaluated. A low-dose dual-source DE-CT renal calculi protocol (140 kV, 46 mAs; 80 kV, 210 mAs) was derived from the single-energy (SE) CT protocol used in our institution for the detection of renal calculi (120 kV, 75 mAs). An Alderson-Rando phantom was equipped with thermoluminescence dosimeters and examined by CT with both protocols. The effective doses were calculated. Fifty-one patients with suspected or known urinary calculus disease underwent DE-CT. DE analysis was performed if calculi were detected using a dedicated software tool. Results were compared to chemical analysis after invasive calculus extraction. An effective dose of 3.43 mSv (male) and 5.30 mSv (female) was measured in the phantom for the DE protocol (vs. 3.17/4.57 mSv for the SE protocol). Urinary calculi were found in 34 patients; in 28 patients, calculi were removed and analyzed (23 patients with calcified calculi, three with uric acid calculi, one with 2,8-dihyxdroxyadenine-calculi, one patient with a mixed struvite calculus). DE analysis was able to distinguish between calcified and non-calcified calculi in all cases. In conclusion, dual-energy urinary calculus analysis is effective also with a low-dose protocol. The protocol tested in this study reliably identified calcified urinary calculi in vivo. (orig.)

Thomas, C. [University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Patschan, O.; Nagele, U.; Stenzl, A. [University of Tuebingen, Department of Urology, Tuebingen (Germany); Ketelsen, D.; Tsiflikas, I.; Reimann, A.; Brodoefel, H.; Claussen, C.; Kopp, A.; Heuschmid, M.; Schlemmer, H.P. [University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Buchgeister, M. [University of Tuebingen, Medical Physics, Department of Radiation Oncology, Tuebingen (Germany)

2009-06-15

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Litiasis urinaria en adultos con mielomeningocele / Urinary calculi in myelomeningocele adults  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción y objetivos: Los avances en el tratamiento de los nacidos con mielomeningocele (MMC) han logrado un gran aumento en su supervivencia, permitiéndoles una longevidad nunca antes alcanzada, pero todavía son escasos los datos concernientes a los problemas urológicos que estos enfermos plant [...] ean durante su vida adulta. Hemos evaluado las características de la litiasis urinaria en adultos nacidos con MMC así como los tratamientos empleados en la misma. Material y métodos: Revisamos 52 pacientes nacidos con MMC de entre 18 y 40 años, atendidos durante los últimos 14 años en nuestro hospital, con una media de seguimiento de 6,7 años. Resultados: Se diagnosticaron de litiasis urinaria 10 pacientes (19,2%). Tres formaron cálculos renales (5,7%), y uno de ellos, junto con 7 pacientes más, desarrollaron cálculos vesicales (15,3%). El nivel neurológico fue S1 en otros dos. El tipo de disfunción neurógena del tracto urinario inferior fue de lesión múltiple pura de neurona motora inferior en 6 casos, de neurona motora superior en 1, lesión múltiple mixta en otro, no pudiéndose valorar en el restante. Dos pacientes tenían una ampliación vesical y uno de estos junto con otros 3 pacientes era portador de AMS-800 no funcionantes. La litiasis vesical se trató endoscopicamente en 14 ocasiones y mediante cistolitotomía suprapúbica en 4, junto a la retirada de AMS-800 en 3 de ellas. Un paciente expulsó un pequeño cálculo. En un paciente fueron necesarias 2 litotricias extracorpóreas y 2 nefrolitotomías percutáneas. Tres pacientes tuvieron múltiples recidivas. Conclusiones: La litiasis urinaria es frecuente en los adultos con MMC. Determinadas características de estos pacientes, junto con su configuración anatómica y algunos tratamientos empleados en ellos, ocasionan problemas de diagnostico, tratamiento y prevención de los cálculos que forman. Abstract in english Introduction and objectives: the improvements in the management of newborns with myelomeningocele (MMC) have obtained a big increase in survival, allowing them to get longevity like never before, but data regarding urologic diseases during adult age are still missing. We herein evaluate the features [...] of urinary lithiasis in adults born with MMC and the therapies used for its treatment. Material and method: we review 52 patients diagnosed at birth of MMC, between 18 and 40 years old, treated in our institution, with a mean follow-up of 6.7 years. Results: 10 patients (19.2%) were diagnosed of urolithiasis. Three developed kidney calculi and one of them, with 7 more patients, developed bladder calculi (15.3%). The neurological level was S1 in the other two. The type of neurogenic dysfunction of inferior urinary tract was multiple lesion of lower motor neurone in 6 cases, upper motor neurone in 1 case, multiple mixed lesion in 1 case and in case it was impossible to determine. Two patients had a bladder augmentation procedure and one of these with other 3 patients had a non-functional AMS-800 artificial urinary sphincter. Bladder stones were treated endoscopically in 14 procedures and by suprapubic cystolithotomy in 4 procedures, combined with removal of AMS-800 in 3 of them. One patient spontaneously passed a small stone. In one case, 2 ESWL and 2 percutaneous nephrolithotomies were needed. Three patients developed multiple recurrences during follow-up. Conclusions: urinary lithiasis is common in adults with MMC. Some distinct features of these patients, together with their anatomical configuration and some therapies used in them, cause diagnostic, therapeutic and prophylaxis issues for the calculi they may develop.

Verdú Tartajo, F.; Salinas Casado, J.; Herranz Amo, F.; Díez Cordero, J.M.; Durán Merino, R.; Hernández Fernández, C..

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Scintigraphy and Doppler ultrasonography for the evaluation of obstructive urinary calculi  

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Full Text Available SciELO Brazil | Language: English Abstract in english Forty-seven patients with unilateral obstructive calculi (12 males and 35 females) were submitted to 99mTc-diethylene triamine pentaacetic acid (DTPA) or 99mTc-dimercaptosuccinic acid (DMSA) scans for assessment of renal function. The scans revealed unilateral functional deficit in 68 and 66% of the [...] patients, respectively. A calculus size of 1.1 to 2.0 cm was significantly associated with deficit detected by DTPA, but duration of obstruction and calculus localization were not. After relief of the obstruction, the mean percent renal function of the affected kidney was found to be significantly increased from 25 ± 12% to 29 ± 12% in DTPA and from 21 ± 15% to 24 ± 12% in DMSA. Initial Doppler ultrasonography performed in 35 patients detected an increased resistive index in 10 (29%). In the remaining patients with a normal resistive index, ureteral urinary jet was observed, indicating partial obstruction. The high frequency of renal function impairment detected by DTPA and of tubulointerstitial damage detected by DMSA as well as the slight amelioration of unilateral renal function after relief of obstruction suggest that scintigraphy assessment may help evaluate the unilateral percentage of renal function and monitor renal function recovery when it occurs. The presence of a urinary jet detected by Doppler ultrasonography further indicates the severity of obstruction and the recovery prognosis.

L., Gandolpho; M., Sevillano; A., Barbieri; S., Ajzen; N., Schor; V., Ortiz; I.P., Heilberg.

39

Scintigraphy and Doppler ultrasonography for the evaluation of obstructive urinary calculi  

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Full Text Available Forty-seven patients with unilateral obstructive calculi (12 males and 35 females were submitted to 99mTc-diethylene triamine pentaacetic acid (DTPA or 99mTc-dimercaptosuccinic acid (DMSA scans for assessment of renal function. The scans revealed unilateral functional deficit in 68 and 66% of the patients, respectively. A calculus size of 1.1 to 2.0 cm was significantly associated with deficit detected by DTPA, but duration of obstruction and calculus localization were not. After relief of the obstruction, the mean percent renal function of the affected kidney was found to be significantly increased from 25 ± 12% to 29 ± 12% in DTPA and from 21 ± 15% to 24 ± 12% in DMSA. Initial Doppler ultrasonography performed in 35 patients detected an increased resistive index in 10 (29%. In the remaining patients with a normal resistive index, ureteral urinary jet was observed, indicating partial obstruction. The high frequency of renal function impairment detected by DTPA and of tubulointerstitial damage detected by DMSA as well as the slight amelioration of unilateral renal function after relief of obstruction suggest that scintigraphy assessment may help evaluate the unilateral percentage of renal function and monitor renal function recovery when it occurs. The presence of a urinary jet detected by Doppler ultrasonography further indicates the severity of obstruction and the recovery prognosis.

Gandolpho L.

2001-01-01

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[Removal of staghorn calculi from the urinary tract with extracorporeal shock wave lithotripsy and endourologic treatment methods].  

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ESWL has been accepted as a method for treatment of urinary tract calculosis. In most cases with urinary tract calculi, the method has replaced the classic surgical procedure. Staghorn calculi are still too large to be simply managed with classic procedure; however, they may be successfully disintegrated (crushed) with the available lithotriptors, particularly with second generation lithotriptors such as LITHOSTAR. Technological innovations which appeared during the last two decades have induced sudden changes in the treatment of urinary tract calculosis. They were enabled by extracorporeal shock wave lithotripsy, which is a method associated with the lower morbidity rate. The method is readily accepted by most of the patients. It is effective in removal of calculi of different size and chemical composition. During the last decade, ESWL has been widely applied in a large proportion of patients with stag-horn calculi. Since the "STEINSTRASSE" phenomenon may develop following disintegration of the more massive stones, double J catheter (DJC) is always placed preventively before the staghorn calculi treatment. The clinicians well know how surgical treatment of staghorn calculosis is technically hard to perform, since there is a risk of renal blood vessels injuries and renal function impairment. Moreover, complete stage-horn urinary tract concrements are the most problematic stones with respect to kidney injuries, surgical treatment and rate of later complications. After the introduction into the clinical practice ESWL has become a treatment of choice for stag-horn calculi in approximately 85% of patients. It is performed in several steps. Over the last two years, 41 patients with partial or complete stag-horn calculi were treated in our institution. In 63% of cases, three treatments were performed per each patient, while 37% of our patients underwent more than three sessions. In a very small percentage, even seven treatments were performed. At the very beginning of the treatment, DJC was placed in 52% of patients, due to the expected "STEINSTRASSE" phenomenon, DJC enabled internal urine drainage and decreased the necessity of perdutaneous nephrostomy. Introduction of DJC reduced the number of cases with ureteral obstruction as well as the number of candidates for nephrostomy to below 29%. Percutaneous nephrostomy was performed in only a small number of patients, enabling satisfactory ureteral peristaltic with very good elimination of disintegrated stone detritus. Twenty-three of our patients developed urinary infections. In our series, the number of residual concrements was directly proportional to the degree of hydronephrosis before ESWL treatment (Table 1, 2, 3, 4). It may be concluded that in sity ESWL treatment of staghorn calculi with prophylactic placement of ureteral catheters is associated with lower complications rate when compared to patients who underwent the combined treatment using ESWL and percutaneous nephrolithotripsy. Single ESWL treatment should be carried out in all cases of uninfected stag-horn stones, clearly visualized upon X-ray examination, with mild hydronephrosis. In prominent hydronephrosis, with high probability of retaining of stone fragments in the lower renal calices, the therapeutical approach should include a combination of ESWL and nephrostolithotripsy. In draining stag-horn renal calculosis, disintegration should be initiated with the parts of the stone localized in the renal pelvis and upper renalc calices. Using such disintegration procedure, large stones in the urinary tract may be eliminated in several steps, which is always associated with the presence of sufficient fragments to be eliminated; however the intervals between the treatment are free of problems. In this way, stag-horn stones may be treated in out-patient wards with previous DJC catheter placement, which is a wise precaution. PMID:9132970

Zogovi?, J; Mladenovi?, Lj

1996-01-01

 
 
 
 
41

Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density  

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The aim of this study was to evaluate the efficacy of helical CT using a combination of CT-attenuation values and visual assessment of stone density as well as discriminant linear analysis to predict the chemical composition of urinary calculi. One hundred human urinary calculi were obtained from a stone-analysis laboratory and placed in 20 excised pig kidneys. They were scanned at 80, 120 and 140 kV with 3-mm collimation. Average, highest and lowest CT-attenuation values and CT variability were recorded. The internal calculus structure was assessed using a wide window setting, and visual assessment of stone density was recorded. A stepwise discriminant linear analysis was performed. The following three variables were discriminant: highest CT-attenuation value, visual density, and highest CT-attenuation value/area ratio, all at 80 kV. The probability of correctly classifying stone composition with these three variables was 0.64, ranging from 0.54 for mixed calculi to 0.69 for pure calculi. The probabilities of correctly classifying calculus composition were: 0.91 for calcium oxalate monohydrate and brushite, 0.89 for cystine, 0.85 for uric acid, 0.11 for calcium oxalate dihydrate, 0.10 for hydroxyapatite, and 0.07 for struvite calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, 81% of the calculi were correctly classified. Assessment at 80 kV of the highest CT-attenuation value, visual density and the highest CT-attenuation value/area ratio accurately predicts the chemical composition of 64-81% of urinary calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, all cystine, calcium oxalate monohydrate and brushite calculi were correctly classified. (orig.)

Bellin, Marie-France; Meric, Jean-Baptiste [AP-HP, Department of Radiology, Hopital Paul-Brousse, Villejuif Cedex (France); Renard-Penna, Raphaelle; Grenier, Philippe [AP-HP, Department of Radiology, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Conort, Pierre; Richard, Francois [AP-HP, Department of Urology, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Bissery, Anne; Mallet, Alain [AP-HP, Department of Biostatistics, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Daudon, Michel [AP-HP, Department of Biochemistry, Hopital Necker, Paris Cedex 15 (France)

2004-11-01

42

Analyses of 99Tcm-DTPA dynamic kidney imaging on 346 patients of upper urinary tract calculi  

International Nuclear Information System (INIS)

Objective: To explore the clinical value of 99Tcm-DTPA renal dynamic imaging in evaluating renal function of the patients with upper urinary tract calculi. Methods: The results of 99Tcm-DTPA renal dynamic imaging, glomerular filtration rate (GFR), intravenous pyelography (IVP), blood urea nitrogen (BUN) and serum creatinine (SCr) in 346 patients with upper urinary tract calculi diseases were analyzed retrospectively. These 346 patients were divided into four groups according to their total GFR value. Results: (1) The renal dynamic imaging in 346 patients could accurately reflect the function of the two kidneys. GFR was negatively related to the serum BUN and SCr levels (r=-0.458, P=0.000 and r=-0.542, P=0.000). (2) The BUN and SCr levels showed significant difference among the four groups (F=49.23, P=0.000 and F=80.66, P=0.000). There were no significant difference of the BUN and SCr levels found between group 1 and group 2 (P=0.119, P=0.088, respectively), while significant difference of the BUN and SCr levels found among the other groups (P99Tcm-DTPA renal dynamic imaging, the mean GFR was (21.89±12.81)ml/min. Conclusion: 99Tcm-DTPA renal dynamic imaging is valuable to early evaluate the renal function, especially for the sick renal function in IVP detection failed patients. (authors)

2010-05-01

43

The management of upper urinary tract calculi by piezoelectric extracorporeal shock wave lithotripsy in spinal cord injury patients.  

Science.gov (United States)

From May 1988 to September 1994, 15 spinal cord injury patients were treated by piezoelectric extracorporeal shock wave lithotripsy. Aged from 23 to 71 years (mean = 39), they presented with a total of 23 stones, of which 18 were located in the calyces, three in the renal pelvis and two in the proximal ureter. The maximum dimensions of calculi varied from 5 to 35 mm (mean = 11). Patients were placed in a dorsal decubitus position during the sessions, three being sedated with diazepam, while the other 12 remained unsedated. All were treated routinely with systemic antibiotics. Auxiliary procedures consisted of two pyelocalyceal flushings, three double J ureteral stenting and three ureteroscopies with fragment removal with a Dormia basket. No episode of autonomic dysreflexia was observed. Short term side effects were limited to a few cases of gross haematuria which regressed spontaneously. Overall, eight successes (53%), and seven failures (47%), were registered. Of the failures, one was the result of a partial fragmentation, while six were related to intrarenal retention of residual fragments resulting in four cases in rapid recurrences. Extracorporeal shock wave lithotripsy can be easily applied to spinal cord injury patients. Its usefulness and limitations need to be well understood and a global consideration must be applied to the prevention and early detection of the upper urinary calculi in this exposed population of patients. PMID:7784114

Robert, M; Bennani, A; Ohanna, F; Guiter, J; Avérous, M; Grasset, D

1995-03-01

44

Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi  

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OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithotripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal shock-wave lithotripsy (SWL) occurred in 14 (32%) patients, unilate...

2008-01-01

45

[Search for a new rinsing solution for the local lysis of calcium-containing urinary calculi].  

Science.gov (United States)

Due to improved rinsing techniques local chemolitholysis is again becoming more important. Good result good results in the local chemolysis of phosphate calculi (calculi caused by remains of Struvit) with Renacidin and other rinsing solutions (Fam, Rossier, Gittes, Jacobs, Smith, Royle, Nemoy, Stamey) have led to a revival chemolitholysis (Alken) in the last 4--5 years, however only in the case of phosphate calculi, which account for 60--80%, cannot be dissolved by Renacidin, as is explicitly pointed out by the manufacturer. The experiments carried out by the group headed by Kallistratos and Timmermann in the 60's using rinsing solutions based on EDTA were discontinued, probably because of physiological reservations concerning the chemicals used and the long duration of treatment at physiologically tolerable concentrations and pH values. In order to extend the range of rinsing solutions to be tested, we tested new substances, including some which complex not only the anion (oxalate) but also the cation (Ca). Alternating treatment with oxalate binding and Ca binding rinsing solutions has been found to give particularly good results. PMID:7102135

Leskovar, P; Hropot, M; Wellnhofer, E

1982-04-01

46

Scintigraphy and Doppler ultrasonography for the evaluation of obstructive urinary calculi  

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Forty-seven patients with unilateral obstructive calculi (12 males and 35 females) were submitted to 99mTc-diethylene triamine pentaacetic acid (DTPA) or 99mTc-dimercaptosuccinic acid (DMSA) scans for assessment of renal function. The scans revealed unilateral functional deficit in 68 and 66% of the patients, respectively. A calculus size of 1.1 to 2.0 cm was significantly associated with deficit detected by DTPA, but duration of obstruction and calculus localization were not. After relief of...

Gandolpho, L.; Sevillano, M.; Barbieri, A.; Ajzen, S.; Schor, N.; Ortiz, V.; Heilberg, I. P.

2001-01-01

47

Comparison of Non-contrast-Enhanced Computed Tomography and Intravenous Pyelogram for Detection of Patients With Urinary Calculi  

Science.gov (United States)

Purpose The aim of this study was to investigate the changing pattern in the use of intravenous pyelogram (IVP), conventional computed tomography (CT), and non-contrast-enhanced computed tomography (NECT) for evaluation of patients with acute flank pain. Materials and Methods We retrospectively reviewed the medical records of 2,180 patients with acute flank pain who had visited Bundang Jesaeng General Hospital between January 2008 and December 2012 and analyzed the use of IVP, conventional CT, and NECT for these patients. Results During the study period there was a significant increase in NECT use (p<0.001) and a significant decrease in IVP use (p<0.001). Conventional CT use was also increased significantly (p=0.001). During this time the proportion of patients with acute flank pain who were diagnosed with urinary calculi did not change significantly (p=0.971). Conclusions There was a great shift in the use of imaging study from IVP to NECT between 2008 and 2012 for patients with acute flank pain.

Lim, Go San; Jang, Seok Heun; Son, Jeong Hwan; Lee, Jae Won; Hwang, Jae Seung; Lim, Chae Hong; Kim, Dae Ji

2014-01-01

48

In vitro studies of epithelium-associated crystallization caused by uropathogens during urinary calculi development.  

Science.gov (United States)

Infectious urinary stones account for about 10% of all urinary stones. In 50% of cases urolithiasis is a recurrent illness, which can lead to the loss of a kidney if not properly treated. One of the reasons for recurrence of the disease may be the ability of bacteria to invade urothelial cells, persist in the host cells and serve as potential reservoirs for infection. Various uropathogens are associated with the formation of bacteria-induced urinary stones but Proteus mirabilis is the most commonly isolated (70%). An in vitro model was used in this study to analyze intracellular growth and crystallization in the presence of P. mirabilis, Klebsiella pneumoniae and Escherichia coli. Human ureter (Hu 609) and bladder (HCV 29) epithelial cell lines were infected with bacteria and incubated (3-72 h) in the presence of synthetic urine and amikacin to prevent extracellular bacterial growth. During the incubation the number of bacteria (CFU/ml) inside epithelial cells and the intensity of crystallization were established. Crystallization was determined as an amount of a calcium radioisotope. The chosen strains of uropathogens were able to invade both types of epithelial cells but the Hu 609 cells were invaded to a higher extent. However, crystallization occurred only in the presence of P. mirabilis strains which were invasive and urease-positive. The highest intensity of cell-associated crystallization was observed when the number of bacteria within the urothelium remained stable during the time of incubation. These results show that P. mirabilis has an ability to form crystals inside the host cells. Under these conditions bacteria are protected from antibiotic killing, which leads to persistent and recurrent infections. We also suspect that this phenomenon may be an important stage of kidney stones formation. PMID:24803200

Torzewska, Agnieszka; Budzy?ska, Aleksandra; Bia?czak-Kokot, Magdalena; Ró?alski, Antoni

2014-01-01

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Extracorporeal shock wave lithotripsy of urinary calculi. Theory, efficacy, and adverse effects.  

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Extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper urinary tract stone disease is held in high regard by the public and the profession. Although the efficacy is good (77.4% to 100%) for the treatment of 1- to 2-cm stones in select patients, ESWL may require the assistance of adjuvant procedures in as many as 26% of patients and may need repeating in as many as 32% of patients. These represent more difficult situations in which larger, more numerous, or harder stones may b...

1990-01-01

50

Segmentation of Ureteric and Bladder Calculi in Ultrasound Images  

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Problem statement: The framework for segmenting calculi in ureter and bladder using ultrasound images is proposed in this study. Calculi are due to abnormal collection of certain chemicals like oxalate, phosphate and uric acid. These calculi can be present in kidney, urethra or in urinary bladder. The extraction of calculi in medical images is a difficult task as no standard algorithms are available. This poses a serious a problem for successful diagnosis of calculi disease. The propos...

Sridhar, S.

2012-01-01

51

Clinical characteristics and risk factors for septic shock in patients receiving emergency drainage for acute pyelonephritis with upper urinary tract calculi  

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Full Text Available Abstract Background Acute pyelonephritis (APN is a common complication of ureteral obstruction caused by urolithiasis, and it can be lethal if it progresses to septic shock. We investigated the clinical characteristics of patients undergoing emergency drainage and assessed risk factors for septic shock. Methods A retrospective study was performed of 98 patients (101 events requiring emergency drainage at our urology department for obstructive APN associated with upper urinary tract calculi from January 2003 to January 2011. Clinical characteristics were summarized, and risk factors for septic shock were assessed by logistic regression analysis. Results Objective evidence of sepsis was found in 64 (63.4% events, and 21 events (20.8% were categorized as septic shock. Ninety-six patients recovered, but 2 patients died of septic shock. Multivariate analysis revealed that age and the presence of paralysis were independent risk factors for septic shock. Conclusions APN associated with upper urinary tract calculi is a severe disease that should be treated with caution, particularly when risk factors are present.

Yamamoto Yoshiyuki

2012-03-01

52

Prostatic calculi.  

Science.gov (United States)

The presence of calculi in 300 whole prostates from consecutive autopsies were investigated by the Faxitron imaging technique. Calculi were found in 99% of the prostates, their number and size increasing with age. They were mainly localized in the ducts in the borderzone between the middle lobes and the periferal prostate posterolaterally, but often some were also found anteriorly in the centreline. Calculi were never seen in the middle lobes. We found no statistically significant relation between the number, size or localization of calculi and other morphological or pathological parameters. Prostatic calculi seem to be a part of the normal process of aging, and do in only exceedingly rare cases assume any clinical importance. PMID:2440234

Søndergaard, G; Vetner, M; Christensen, P O

1987-05-01

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The use of a fully integrated electronic medical record to minimize cumulative lifetime radiation exposure from CT scanning to detect urinary tract calculi.  

Science.gov (United States)

In order to determine the effects of implementation of an electronic medical record on rates of repeat computed tomography (CT) scanning in the emergency department (ED) setting, we analyzed the utilization of CT of the kidneys, ureters, and bladder (CT KUB) for the detection of urinary tract calculi for periods before and after the implementation of a hospital-wide electronic medical record system. Rates of repeat CT scanning within a 6-month period of previous scan were determined pre- and post-implementation and compared. Prior to implementation, there was a 6-month repeat rate of 6.2 % compared with the post-implementation period, which was associated with a 6-month repeat rate of 4.1 %. Statistical analysis using a two-sample, one-tailed t test for difference of means was associated with a p value of 0.00007. This indicates that the implementation of the electronic medical record system was associated with a 34 % decrease in 6-month repeat CT KUB scans. We conclude that the use of an electronic medical record can be associated with a decrease in utilization of unnecessary repeat CT imaging, leading to decreased cumulative lifetime risk for cancer in these patients and more efficient utilization of ED and radiologic resources. PMID:23361445

Kohler, Steven W; Chen, Richard; Kagan, Alex; Helvey, Dustin W; Buccigrossi, David

2013-06-01

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Ureteral Calculi : The Diagnostic Value of Combined KUB and Ultrasound  

International Nuclear Information System (INIS)

To evaluate the diagnostic value of combined KUB and ultrasound in patients with ureteral calculi. We retrospectively reviewed the KUB and ultrasound findings in 71 cases of clinically,radiologically, and surgically confirmed ureteral calculi. We evaluated the diagnostic sensitivity of each method respectively, and then compared the sensitivity of each method with that of combined studies. The overall diagnostic sensitivities in detection of the ureteral calculi were 92.9% for KUB and 78.8% for ultrasound.The sensitivities in detection of the upper ureteral calculi were 95.1 (39 / 41) and 82.9% (34 / 41), and those in detection of the lower ureteral calculi were 90.0 (27 / 30) and 73.3% (22 / 30), respectively. On the ultrasonography, the false negative rate in detection of ureteral calculi was 21.1%. The sensitivity of ultrasound in detection of acute urinary obstruction by ureteral calculi was 87.3%. When both studies were combined, the diagnostic sensitivities were 92.9 (66 / 71), 97.5 (40 / 41) and 86.6% (26 / 30) for overall, upper and lower ureteral calculi, respectively. Combined KUB and ultrasound was a sensitive method for detection of ureteral calculi and for determination of acute urinary obstruction by reducing the number of false negative ultrasound results in patients with ureteral calculi

1996-12-01

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Extracorporeal shock wave lithotripsy of urinary calculi. Results from the first 306 patients treated at the Copenhagen Municipal Stone Center with a second generation lithotriptor.  

DEFF Research Database (Denmark)

The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29% had residual stones. Corresponding rates after 3 and 6 months were 58%, 24% and 18% and 70%, 21% and 9% respectively. Septicemia occurred in 4 patients and cardial arrhythmia in 34 patients (11%). No serious intra- or perirenal hematomas were registered. In 9% additional procedures were required and 11 patients had residual stones removed at open surgery. The used second generation lithotriptor with X-ray based stone localisation is effective for treatment of both renal calculi and ureteral calculi in situ in all three segments of the ureter.

Andersen, J T; Mogensen, P

1991-01-01

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Clinical effectiveness of the PolyScope(TM) endoscope system combined with holmium laser lithotripsy in the treatment of upper urinary calculi with a diameter of less than 2 cm  

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The aim of this study was to evaluate the clinical value of the PolyScope™ endoscope system in the treatment of upper urinary calculi with a diameter of calculi were included. The patients were placed under general or spinal anesthesia and in a lithotomy position. Following the dilation of the ureter, a guide wire was inserted under the direct vision of an F8/9.8 rigid ureteroscope, and an F12/14 flexible ureteral access sheath was positioned along the guide wire. Holmium laser lithotripsy was subsequently performed, using an F8.0 ‘PolyScope’ modular flexible ureteroscope. Plain film of the kidney-ureter-bladder (KUB) was performed 1 day subsequent to the surgery, in order to determine the result of the lithotripsy and the position of the double-J stent which was inserted after after holmium laser lithotripsy. In addition, in certain patients, KUB radiography was performed 2–4 weeks subsequent to the surgery, and extracorporeal shockwave lithotripsy (ESWL) was performed if the diameter of the residual stones was >6 mm. Lithotripsy was successful in 77 patients and the duration of the surgery ranged between 25 and 80 min (mean duration, 42 min). Little bleeding was observed. Three patients presented with a slight fever following the surgery; however, no ureteral perforation, high fever or septicemia was observed among the patients following anti-inflammatory treatment. The stone-free rate (SFR) of the single-pass lithotripsy was 89.5% (77/86) and the SFR with ESWL was 96.5% (83/86). The study demonstrated that the F8 modular flexible ureteroscope was safe, convenient and effective for the lithotripsy of upper-tract calculi.

GU, SI-PING; HUANG, YUN-TENG; YOU, ZHI-YUAN; ZHOU, XIAOMING; LU, YI-JIN; HE, CAO-HUI; QI, JUAN

2013-01-01

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Segmentation of Ureteric and Bladder Calculi in Ultrasound Images  

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Full Text Available Problem statement: The framework for segmenting calculi in ureter and bladder using ultrasound images is proposed in this study. Calculi are due to abnormal collection of certain chemicals like oxalate, phosphate and uric acid. These calculi can be present in kidney, urethra or in urinary bladder. The extraction of calculi in medical images is a difficult task as no standard algorithms are available. This poses a serious a problem for successful diagnosis of calculi disease. The proposed technique is specific for the extraction of calculi in ureter and bladder. This constitutes the first stage in the successful treatment of calculi disease. Approach: An algorithm is proposed to detect calculus based on the shadow it casts in ultrasound image. Calculi are present in ultrasound images as bright spots. But noise in the image also can be bright spots. So it is easy to misinterpret the presence of noise as calculi. The proposed framework thus has two phases. In phase one, five standard algorithms are modified and are used to segment the bright spots present in the ultrasound images using the intensity profile. Calculi are having intensity in the range of 10-40. So all the potential calculi as well as the noise that appear as bright spots are segmented in phase one. In phase two,a validation procedure is used to validate the presence of calculi using its acoustic shadow property in the ultrasound images. Results: Ultrasound images of twenty-seven ureteric and bladder calculi patients are used for testing the framework. The detected calculi by the proposed framework are validated against a group of experts. The Performance of the proposed method is thoroughly investigated and the accuracy of the framework is determined. The framework incorporating automated seed selected region growing algorithm is able to detect the calculi with the efficiency of 78.57%. Conclusion: The extracted calculi can further be analyzed for taking decision about the treatment procedures. The proposed system is helpful for taking decision about the treatment procedures. The proposed system is helpful for clinicians as a decision support tool. This system can also be useful as educational aid for assisting or decision making in the treatment of calculus disease.

S. Sridhar

2012-01-01

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Factores predictivos de éxito tras una sesión única de litotricia extracorpórea de cálculos urinarios a las tres semanas de seguimiento: Factors Predicting Success after Three Weeks of Follow-Up / Single-Session Extracorporeal Shock Wave Lithotripsy for Urinary Calculi  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Identificar factores predictivos de éxito después de una sesión única de litotricia extracorpórea por ondas de choque (LEOC) a las tres semanas de seguimiento. Material y métodos: Se revisaron los registros clínicos de 116 pacientes con cálculos urinarios únicos sometidos a LEOC entre octu [...] bre 2007 y agosto 2009. Las tomografías axiales computarizadas preoperatorias de todos los pacientes fueron revisadas por dos radiólogos en desconocimiento del desenlace clínico. El éxito fue definido como la desaparición completa del cálculo o la persistencia de fragmentos Abstract in english Introduction: The aim of this study was to identify predictive factors of success following a single-session of shock wave lithotripsy (SWL) at 3 weeks of follow-up in our center. Material and methods: The medical records of 116 patients with solitary urinary calculi who underwent single-session SWL [...] in our department between October 2007 and August 2009 were reviewed. All preoperative unenhanced computed axial tomographies were reviewed by two radiologists blinded to clinical outcome. Success was defined as complete clearance or the persistence of fragments

B., Vivaldi; M.I., Fernández; J.F., López; F., Fuentes; C., Urzúa; A., Krebs; A., Domenech; P.A., Figueroa; P., Pizzi; M., Westendarp; N., Zambrano; M., Castro; L.F., Coz.

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Typed Ï?-calculi  

DEFF Research Database (Denmark)

A large variety of process calculi extend the pi-calculus with more general notions of messages. Bengtson et al. have shown that many of these pi-like calculi can be expressed as so-called psi-calculi. In this paper, we describe a simple type system for psi-calculi. The type system satisfies a subject reduction property and a general notion of channel safety. A number of existing systems are shown to be instances of our system, and other, new type systems can also be obtained. We first present a new type system for the calculus of explicit fusions by Wischik and Gardner, then one for the distributed pi-calculus of Hennessy and Riely and finally show how existing type systems for secrecy and authenticity in the spi calculus can be represented and shown to be safe.

Hüttel, Hans

2011-01-01

60

Medial thigh pain: An unusual presentation of giant calculi in sigmoid neobladder  

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Calculi in a neobladder usually present with irritative lower urinary tract symptoms, flank pain, and haematuria. We report a case of giant stones in a sigmoid neobladder, who presented with medial thigh pain.

Abrol, Nitin; Gupta, Narmada; Kumar, Rajeev

2011-01-01

 
 
 
 
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A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm  

Science.gov (United States)

Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6?Fr mininephroscope through an 11–13?Fr metal sheath to perform holmium: YAG laser lithotripsy. Methods. The medical records of 36 patients with moderate-sized (<20?mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status. Results. The mean stone size was 14.9 ± 4.1?mm (rang: 6–20). The average operative time was 59.8 ± 15.9 (30–90)?min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2–5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion. Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

Zeng, Guohua; Zhao, Zhijian; Zhong, Wen; Chen, Wenzhong; Wu, Wenqi

2013-01-01

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Urinary Tract Imaging  

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This article reviews the current imaging investigations usually required in the work-up of common urinary tract problems such as urinary tract infection, colic, trauma, hematuria and renal failure. Radiological therapeutic techniques such as percutaneous nephrostomy for drainage of obstructed systems and percutaneous nephrolithotomy for treatment of renal calculi are briefly mentioned. The virtual elimination of percutaneous or open surgery for renal and upper urinary tract stones, resulting ...

Rowley, V. Allen

1986-01-01

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Proteus mirabilis viability after lithotripsy of struvite calculi  

Science.gov (United States)

Urinary calculi composed of struvite harbor urease-producing bacteria within the stone. The photothermal mechanism of holmium:YAG lithotripsy is uniquely different than other lithotripsy devices. We postulated that bacterial viability of struvite calculi would be less for calculi fragmented with holmium:YAG irradiation compared to other lithotripsy devices. Human calculi of known struvite composition (greater than 90% magnesium ammonium phosphate hexahydrate) were incubated with Proteus mirabilis. Calculi were fragmented with no lithotripsy (controls), or shock wave, intracorporeal ultrasonic, electrohydraulic, pneumatic, holmium:YAG or pulsed dye laser lithotripsy. After lithotripsy, stone fragments were sonicated and specimens were serially plated for 48 hours at 38 C. Bacterial counts and the rate of bacterial sterilization were compared. Median bacterial counts (colony forming units per ml) were 8 X 106 in controls and 3 X 106 in shock wave, 3 X 107 in ultrasonic, 4 X 105 in electrohydraulic, 8 X 106 in pneumatic, 5 X 104 in holmium:YAG and 1 X 106 in pulsed dye laser lithotripsy, p less than 0.001. The rate of bacterial sterilization was 50% for holmium:YAG lithotripsy treated stones versus 0% for each of the other cohorts, p less than 0.01. P. mirabilis viability is less after holmium:YAG irradiation compared to other lithotripsy devices.

Prabakharan, Sabitha; Teichman, Joel M.; Spore, Scott S.; Sabanegh, Edmund; Glickman, Randolph D.; McLean, Robert J.

2000-05-01

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Ureteral fibroepithelial polyps with calculi: a case series  

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Abstract Introduction Fibroepithelial polyps of the ureter are benign tumors arising from the mesodermal tissue in the ureteral wall. Their etiology remains unknown. Hematuria and obstructive urinary symptoms are the most common findings. The treatment of choice is endoscopic resection, and the prognosis for patients with these lesions is excellent. Case presentation We present three cases of fibroepithelial polyps associated with calculi in the distal part of t...

Turunc Tahsin; Kuzgunbay Baris; Canpolat Tuba

2008-01-01

65

Urethral calculi managed with transurethral Holmium laser ablation.  

Science.gov (United States)

In situ Holmium laser lithotripsy is a safe, effective procedure for the treatment of impacted urethral stones. This procedure can be performed transurethrally as an outpatient with minimal tissue trauma and render patients stone free. The authors utilized this procedure in 2 patients whose anatomy did not allow the calculi to be manipulated into the urinary bladder in a retrograde manner. Because of its successful use elsewhere in the urinary tract, we believe that Holmium laser lithotripsy may be the treatment of choice for impacted urethral stones. PMID:11528633

Walker, B R; Hamilton, B D

2001-09-01

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Factors affecting calcium oxalate dihydrate fragmented calculi regrowth  

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Full Text Available Abstract Background The use of extracorporeal shock wave lithotripsy (ESWL to treat calcium oxalate dihydrate (COD renal calculi gives excellent fragmentation results. However, the retention of post-ESWL fragments within the kidney remains an important health problem. This study examined the effect of various urinary conditions and crystallization inhibitors on the regrowth of spontaneously-passed post-ESWL COD calculi fragments. Methods Post-ESWL COD calculi fragments were incubated in chambers containing synthetic urine varying in pH and calcium concentration: pH = 5.5 normocalciuria (3.75 mM, pH = 5.5 hypercalciuria (6.25 mM, pH = 6.5 normocalciuria (3.75 mM or pH = 6.5 hypercalciuria (6.25 mM. Fragment growth was evaluated by measuring increases in weight. Fragment growth was standardized by calculating the relative mass increase. Results Calcium oxalate monohydrate (COM crystals formed on COD renal calculi fragments under all conditions. Under pH = 5.5 normocalciuria conditions, only COM crystals formed (growth rate = 0.22 ± 0.04 ?g/mg·h. Under pH = 5.5 hypercalciuria and under pH = 6.5 normocalciuria conditions, COM crystals and a small number of new COD crystals formed (growth rate = 0.32 ± 0.03 ?g/mg·h and 0.35 ± 0.05 ?g/mg·h, respectively. Under pH = 6.5 hypercalciuria conditions, large amounts of COD, COM, hydroxyapatite and brushite crystals formed (growth rate = 3.87 ± 0. 34 ?g/mg·h. A study of three crystallization inhibitors demonstrated that phytate completely inhibited fragment growth (2.27 ?M at pH = 5.5 and 4.55 ?M at pH = 6.5, both under hypercalciuria conditions, while 69.0 ?M pyrophosphate caused an 87% reduction in mass under pH = 6.5 hypercalciuria conditions. In contrast, 5.29 mM citrate did not inhibit fragment mass increase under pH = 6.5 hypercalciuria conditions. Conclusion The growth rate of COD calculi fragments under pH = 6.5 hypercalciuria conditions was approximately ten times that observed under the other three conditions. This observation suggests COD calculi residual fragments in the kidneys together with hypercalciuria and high urinary pH values may be a risk factor for stone growth. The study also showed the effectiveness of specific crystallization inhibitors in slowing calculi fragment growth.

Sanchis P

2006-07-01

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PHARMACOLOGICAL SCREENING OF MUSA PARADISICA LINN AGAINST ETHYLENE GLYCOL INDUCED RENAL CALCULI  

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Full Text Available The effect of ethanol extract of dried roots of Musa paradisica Linn against ethylene glycol induced renal calculi in albino wistar rats are studied in this research. A renal calculus was induced in rats by ingesting 0.75% ethylene glycol in drinking water for 28 days and was manifested by high urinary calcium, oxalate, and low urinary magnesium contents. Simultaneous administration of 1ml (1 in 10 Musa paradisica Linn orally for 28 days along with ethylene glycol (0.75% v/v reduced urinary calcium, oxalate and elevated urinary magnesium level. It also increased urinary volume thereby reducing the tendency for crystallization. The histopathological studies confirmed the induction as degenerated glomeruli, necrotic tubule and inflammatory cells was observed in section of kidney from animals treated with ethylene glycol. This was reduced; however after treatment with Musa paradisica Linn. These observations enable to conclude that Musa paradisica Linn is effective against ethylene glycol induced renal calculi.

Jha U

2011-03-01

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How accurate is unenhanced multidetector-row CT (MDCT) for localization of renal calculi?  

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Purpose: To investigate the correlation between unenhanced MDCT and intraoperative findings with regard to the exact anatomical location of renal calculi. Design, setting, and participants: Fifty-nine patients who underwent unenhanced MDCT for suspected urinary stone disease, and who underwent subsequent flexible ureterorenoscopy (URS) as treatment of nephrolithiasis were included in this retrospective study. All MDCT data sets were independently reviewed by three observers with different degrees of experience in reading CT. Each observer was asked to indicate presence and exact anatomical location of any calcification within pyelocaliceal system, renal papilla or renal cortex. Results were compared to intraoperative findings which have been defined as standard of reference. Calculi not described at surgery, but present on MDCT data were counted as renal cortex calcifications. Results: Overall 166 calculi in 59 kidneys have been detected on MDCT, 100 (60.2%) were located in the pyelocaliceal system and 66 (39.8%) in the renal parenchyma. Of the 100 pyelocaliceal calculi, 84 (84%) were correctly located on CT data sets by observer 1, 62 (62%) by observer 2, and 71 (71%) by observer 3. Sensitivity/specificity was 90-94% and 50-100% if only pyelocaliceal calculi measuring >4 mm in size were considered. For pyelocaliceal calculi {<=}4 mm in size diagnostic performance of MDCT was inferior. Conclusion: Compared to flexible URS, unenhanced MDCT is accurate for distinction between pyelocaliceal calculi and renal parenchyma calcifications if renal calculi are >4 mm in size. For smaller renal calculi, unenhanced MDCT is less accurate and distinction between a pyelocaliceal calculus and renal parenchyma calcification is difficult.

Goetschi, Stefan, E-mail: goetschi@gmx.net [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Umbehr, Martin, E-mail: martin.umbehr@triemli.ch [Urology Clinic, Department of Surgery, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Ullrich, Stephan, E-mail: stephan.ullrich@triemli.ch [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Glenck, Michael, E-mail: michael.glenck@triemli.ch [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Suter, Stefan, E-mail: stefan.suter@triemli.ch [Urology Clinic, Department of Surgery, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Weishaupt, Dominik, E-mail: dominik.weishaupt@triemli.ch [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland)

2012-11-15

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Treatment of Renal Calculi with Extracorporeal Shock Wave Lithotripsy: How applications of this method have expanded  

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In 12 years, extracorporeal shock wave lithotripsy has replaced other treatment techniques for most surgical calculi in the upper urinary tract. Worldwide clinical series have documented its efficacy. Technological advances and modifications have significantly expanded the clinical applications of this technique.

1992-01-01

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Comparison of Computerized Spiral Tomography with Ultrasonography for Detection of Ureteral Calculi  

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Full Text Available Objectives: We aimed to compare accuracy levels of ultrasonography and spiral computerized tomography for detection of the ureteral calculi in patients admitted to the emergency department with flank pain. Methods: The patients presented with either unilateral or bilateral flank pain to the emergency department over a four-month period and who were suspected to be renal colic were included into the study. All of the study patients with distended bladder after hydration had ultrasonography (USG and unhanced helical computerized tomography (UHCT performed by two independent radiologists. Results: Of the 76 patients with flank pain, CT detected ureteral calculi in 47 out of 48 patients (97.9% and USG detected ureteral calculi in 34 out of the 48 patients (70.83%. CT detected uretral calculi in 14 patients which was not detected by USG. CT also detected renal calculi in 7 patients which was not detected by USG. A kappa value of 0.62 (p<0.001 was determined, indicating a moderate concordance between CT and USG in detecting ureteral calculi. Also a kappa value of 0.65 (p<0.001 was determined in the overall diagnostic performance of the both imaging tools in detecting renal calculi. Conclusions: Computerized tomography is better than ultrasonography in detecting urinary calculus in patients presented to the emergency department with flank pain. However, as a bedside, non-invasive and non-ionized tool, USG should be preffered as the first line diagnostic choice in ED for detecting urinary calculus. CT should be used as an second choice in patients with negative USG exam in ED.

Sezgin SARIKAYA

2010-01-01

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Clinical experience with the Swiss LithoClast® Master in treatment of bladder calculi  

DEFF Research Database (Denmark)

Introduction and objective. Bladder calculi account for 5% of urinary tract calculi in the western world and many different treatment modalities have been presented throughout the decades. We report our clinical experience using the Swiss LithoClast® Master (SLM). Materials and Methods. The SLM is a rigid, hand-held endourological probe including a pneumatic lithotriptor and an ultrasonic lithotriptor. Attached to the ultrasonic modality is a suction system. The two lithotriptor modalities are controlled by a footswitch, and can be activated separately or simultaneously. The SLM is used via a rigid endoscope. Indications for treatment were medical complaints like hematuria, lower urinary tract symptoms (LUTS), pain, recurrent urinary tract infections (UTI), recurrent bursts of balloon in indwelling catheters, and difficulties performing clean intermittent self-catheterisation (CISC). Results. From August 1st 2009 to August 1st 2011, 27 patients were treated for bladder calculi (24 men). Five had a neurogenic voiding dysfunction, 3 had a prostate cancer, and 19 suffered from benign prostatic enlargement (BPE) or detrusor muscle insufficiency. Median age was 74 years (range 45-86 years). Stone clearance was obtained in 26 (96%) patients. Stone burden was one or multiple bladder calculi. Median stone size of the largest stone in each patient was 20 (5 - 40) mm. Under the same anaesthesia two patients underwent a TURP due to a very large prostate. Median lithotripsy time was 60 (range 20-144) minutes. All patients were discharged within 24 hours. Conclusion. The method described is a safe and quick method for endoscopic lithotripsy of bladder calculi rendering the patients stone free in the vast majority of cases. The procedure can be performed as day case surgery. Keywords: Bladder calculi, lithotripsy, Swiss Lithoclast, transurethral prostatectomy.

Kingo, Pernille Skjold; Ryhammer, Allan Maltha

2013-01-01

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Ureteral fibroepithelial polyps with calculi: a case series  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Fibroepithelial polyps of the ureter are benign tumors arising from the mesodermal tissue in the ureteral wall. Their etiology remains unknown. Hematuria and obstructive urinary symptoms are the most common findings. The treatment of choice is endoscopic resection, and the prognosis for patients with these lesions is excellent. Case presentation We present three cases of fibroepithelial polyps associated with calculi in the distal part of the ureter. The patients were all women, aged 20, 45 and 52 years. Two patients were suffering from flank pain and dysuria while one patient was asymptomatic at the time of diagnosis. The patients were fully treated with endoscopic resection. To the best of our knowledge, this is the fourth report of adult ureteral fibroepithelial polyps associated with ureteral calculi in the English literature. The etiology, clinical features, diagnosis, and management of fibroepithelial polyps are discussed in this report. Conclusion Whenever polypoid lesions are detected especially at the distal part of the ureter, benign fibroepithelial polyps should be kept in mind for differential diagnosis. Additionally, although rarely seen, the co-existence of ureteral calculi with fibroepithelial polyps should be borne in mind.

Turunc Tahsin

2008-08-01

73

Computed tomographic analysis of renal calculi  

Energy Technology Data Exchange (ETDEWEB)

An in vitro study sought to determine the feasibility of using computed tomography (CT) to analyze the chemical composition of renal calculi and thus aid in selecting the best treatment method. Sixty-three coded calculi were scanned in a water bath. Region-of-interest measurements provided the mean, standard deviation, and minimum and maximum pixel values for each stone. These parameters were correlated with aspects of the stones' chemical composition. A multivariate analysis showed that the mean and standard deviation of the stones' pixel values were the best CT parameters for differentiating types of renal calculi. By using computerized mapping techniques, uric acid calculi could be perfectly differentiated from struvite and calcium oxalate calculi. The latter two types also were differentiable, but to a lesser extent. CT has a potential role as an adjunct to clinical and laboratory methods for determining the chemical composition of renal calculi in an effort to select optimal treatment.

Hillman, B.J.; Drach, G.W.; Tracey, P.; Gaines, J.A.

1984-03-01

74

In situ lithotripsy of ureteral calculi  

International Nuclear Information System (INIS)

Over 7,000 kidneys and ureters have been treated with lithotripsy at the authors institution. Included among this group were 541 ureters containing single calculi that were treated in situ after retrograde manipulations had failed. One hundred thirty-five (25%) of these calculi were located in the distal ureter, below the superior border of the SI joint. The remainder were located in the middle or upper ureter. All but one of these calculi were successfully treated with lithotripsy and combined radiologic and urologic interventions. The number and type of interventions have been examined. In situ lithotripsy of ureteral calculi after unsuccessful retrograde manipulation has been shown to be feasible

1988-12-02

75

Verification of Stochastic Process Calculi  

DEFF Research Database (Denmark)

Stochastic process calculi represent widely accepted formalisms within Computer Science for modelling nondeterministic stochastic systems in a compositional way. Similar to process calculi in general, they are suited for modelling systems in a hierarchical manner, by explicitly specifying subsystems as well as their interdependences and communication channels. Stochastic process calculi incorporate both the quantified uncertainty on probabilities or durations of events and nondeterministic choices between several possible continuations of the system behaviour. Modelling of a system is often performed with the purpose to verify the system. In this dissertation it is argued that the verification techniques that have their origin in the analysis of programming code with the purpose to deduce the properties of the code's execution, i.e. Static Analysis techniques, are transferable to stochastic process calculi. The description of a system in the syntax of a particular stochastic process calculus can be analysed in a compositional way, without expanding the state space by explicitly resolving all the interdependencies between the subsystems which may lead to the state space explosion problem. In support of this claim we have developed analysis methods that belong to a particular type of Static Analysis { Data Flow / Pathway Analysis. These methods have previously been applied to a number of non-stochastic process calculi. In this thesis we are lifting them to the stochastic calculus of Interactive Markov Chains (IMC). We have devised the Pathway Analysis of IMC that is not only correct in the sense of overapproximating all possible behaviour scenarios, as is usual for Static Analysis methods, but is also precise. This gives us the possibility to explicitly decide on the trade-o between precision and complexity while post-processing the analysis results. Another novelty of our methods consists in the kind of properties that we can verify using the results of the Pathway Analysis. We can check both qualitative and quantitative properties of IMC systems. In particular, we have developed algorithms for constructing bisimulation relations, computing (overapproximations of) sets of reachable states and computing the expected time reachability, the last for a linear fragment of IMC. In all the cases we have the complexities of algorithms which are low polynomial in the size of the syntactic description of a system. The presented methods have a clear application in the areas of embedded systems, (randomised) protocols run between a fixed number of parties etc.

Skrypnyuk, Nataliya

2011-01-01

76

In situ extracorporeal shock wave lithotripsy of ureteral calculi with the MPL-9000X lithotriptor.  

Science.gov (United States)

Within the wide armamentarium of urinary stone treatment modalities extracorporeal shock wave lithotripsy (ESWL) has been established as the first line procedure. With the Dornier MPL-9000X lithotriptor one has the choice of ultrasound or fluoroscopic localization of calculi throughout the entire urinary tract. Except for the kidney, ultrasound guidance is preferred for calculi in the distal ureter, while fluoroscopy is generally used on the proximal two-thirds of the ureter. Between January and December 1990, 123 ESWL treatments were performed on 83 patients suffering from ureteral calculi with an average stone size of 9.3 x 6 mm. Median treatment parameters were 1,597 shock waves at 19.3 kv. for 43 minutes. For stones in the upper two-thirds of the ureter sedation analgesia was given, while ESWL on the pelvic ureter did not create intolerable pain. Of the treatments 69% were done on an outpatient basis. In situ ESWL treatment of urinary calculi was successful in 72 patients (86.7%), and 20 patients (24.1%) were treated with multiple treatment sessions. ESWL therapy for 47 stones in the distal ureter showed better results than for 33 stones plus 2 steinstrasse in the proximal part (95.5% versus 80% stone-free rate). Of 4 patients with mid ureteral calculi 2 could be rendered stone-free by ESWL alone. Auxiliary procedures, such as percutaneous nephrostomy or ureteral splints, had to be performed in 15.7%. Final endoscopic stone extraction was done in 7 cases and open surgery in 4, constituting a 13.3% failure rate for ESWL therapy. The results prove that the MPL-9000X lithotriptor is effective for primary noninvasive stone treatment. PMID:1507342

Rauchenwald, M; Colombo, T; Petritsch, P H; Vilits, P; Hubmer, G

1992-09-01

77

Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Extracorporeal shockwave lithotripsy (ESWL) has revolutionized the treatment of urinary calculi and became the accepted standard therapy for the majority of stone patients. Only for stones located in the lower calix, ESWL displayed a limited efficacy. Since the stone-free rate seemed to be preferential, endoscopic maneuvers like percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) have been proposed as the primary approach for this stone localization.

2008-01-01

78

Analysis of renal calculi by X-ray diffraction and electron microprobe: a comparison of two methods  

Energy Technology Data Exchange (ETDEWEB)

We analyzed 48 renal calculi by X-ray powder diffraction and electron microprobe techniques. In 35 of these, the presence of a minor constituent, not detected by X-ray diffraction, was revealed--hydroxyapatite was found in 24 stones, struvite in 6, and calcium oxalate in 5. The results of this study, as well as others, show that incomplete assignment of the crystalline constituents of urinary calculi is an inherent risk of the X-ray method and that conclusions concerning total chemical composition should be based on X-ray diffraction analyses coupled with data obtained from other analytical procedures.

Rodgers, A.L.

1981-07-01

79

Holmium laser lithotripsy of bladder calculi  

Science.gov (United States)

Although the overall incidence of bladder calculi has been decreasing, it is still a significant disease affecting adults and children. Prior treatment options have included open cystolitholapaxy, blind lithotripsy, extracorporeal shock wave lithotripsy, and visual lithotripsy with ultrasonic or electrohydraulic probes. The holmium laser has been found to be extremely effective in the treatment of upper tract calculi. This technology has also been applied to the treatment of bladder calculi. We report our experience with the holmium laser in the treatment of bladder calculi. Twenty- five patients over a year and a half had their bladder calculi treated with the Holmium laser. This study was retrospective in nature. Patient demographics, stone burden, and intraoperative and post-operative complications were noted. The mean stone burden was 31 mm with a range of 10 to 60 mm. Preoperative diagnosis was made with either an ultrasound, plain film of the abdomen or intravenous pyelogram. Cystoscopy was then performed to confirm the presence and determine the size of the stone. The patients were then taken to the operating room and given a regional or general anesthetic. A rigid cystoscope was placed into the bladder and the bladder stone was then vaporized using the holmium laser. Remaining fragments were washed out. Adjunctive procedures were performed on 10 patients. These included transurethral resection of the prostate, transurethral incision of the prostate, optic internal urethrotomy, and incision of ureteroceles. No major complications occurred and all patients were rendered stone free. We conclude that the Holmium laser is an effective and safe modality for the treatment of bladder calculi. It was able to vaporize all bladder calculi and provides a single modality of treating other associated genitourinary pathology.

Beaghler, Marc A.; Poon, Michael W.

1998-07-01

80

Algebraic Properties of Qualitative Spatio-Temporal Calculi  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Qualitative spatial and temporal reasoning is based on so-called qualitative calculi. Algebraic properties of these calculi have several implications on reasoning algorithms. But what exactly is a qualitative calculus? And to which extent do the qualitative calculi proposed meet these demands? The literature provides various answers to the first question but only few facts about the second. In this paper we identify the minimal requirements to binary spatio-temporal calculi ...

Dylla, Frank; Mossakowski, Till; Schneider, Thomas; Wolter, Diedrich

2013-01-01

 
 
 
 
81

Flow Logic for Process Calculi  

DEFF Research Database (Denmark)

Flow Logic is an approach to statically determining the behavior of programs and processes. It borrows methods and techniques from Abstract Interpretation, Data Flow Analysis and Constraint Based Analysis while presenting the analysis in a style more reminiscent of Type Systems. Traditionally developed for programming languages, this article provides a tutorial development of the approach of Flow Logic for process calculi based on a decade of research. We first develop a simple analysis for the Ï?-calculus; this consists of the specification, semantic soundness (in the form of subject reduction and adequacy results), and a Moore Family result showing that a least solution always exists, as well as providing insights on how to implement the analysis. We then show how to strengthen the analysis technology by introducing reachability components, interaction points, and localized environments, and finally, we extend it to a relational analysis. A Flow Logic is a program logic---in the same sense that a Hoareâ??s logic is. We conclude with an executive summary presenting the highlights of the approach from this perspective including a discussion of theoretical properties as well as implementation considerations. The electronic supplements present an application of the analysis techniques to a version of the Ï?-calculus incorporating distribution and code mobility; also the proofs of the main results can be found in the electronic supplements.

Nielson, Hanne Riis; Nielson, Flemming

2012-01-01

82

Urinary stone detection and characterisation with dual-energy CT urography after furosemide intravenous injection: preliminary results  

International Nuclear Information System (INIS)

To investigate the added advantage of IV furosemide injection and the subsequent urine dilution in the detection of urinary calculi in the excretory phase of dual-source dual-energy (DE) computed tomography (CT) urography, and to investigate the feasibility of characterising the calculi through diluted urine. Twenty-three urinary calculi were detected in 116 patients who underwent DECT urography for macroscopic haematuria with a split bolus two- or three-acquisition protocol, including a true unenhanced series and at least a mixed nephrographic excretory phase. Virtual unenhanced images were reconstructed from contrast-enhanced DE data. Calculi were recorded on all series and characterised based on their X-ray absorption characteristics at 100 kVp and 140 kVp in both true unenhanced and nephrographic excretory phase series. All calculi with a diameter more than 2 mm were detected in the virtual unenhanced phase and in the nephrographic excretory phase. Thirteen of these calculi could be characterised in the true unenhanced phase and in the mixed nephrographic excretory phase. The results were strictly identical for both phases, six of them being recognised as non-uric acid calculi and seven as uric acid calculi. Mixed nephrographic excretory phase DECT after furosemide administration allows both detection and characterisation of clinically significant calculi, through the diluted urine. (orig.)

2014-03-01

83

Percutaneous management of staghorn renal calculi  

Energy Technology Data Exchange (ETDEWEB)

During a four year period, ending May 1987, 154 cases of symptomatic staghorn calculi have been treated by percutaneous nephrolithotomy. Of these patients,86% were discharged completely stone free with the remainder having fragments less than 5 mm in greatest diameter. More than one operative procedure during the same hospitalizations was required in 24% of patients and multiple percutaneous tracts were established in excess of 73% of them. Significant complications occurred in 16% of patients and there was one death. Most complications can be generally by minimized by careful approach and manageable by interventional radiological means. The management of patients with staghorn calculi requires a comprehensive understanding of the renal anatomy, selection of appropriate percutaneous nephrostomy tract sites, and radiologic-urologic expertise needed to remove the large stone mass. The advent of extracorporeal shock wave lithotripsy will not abolish the need for nephrolithotomy, particularly complex stones such as staghorn calculi.

Lee, Won Jay [Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York (United States)

1989-10-15

84

A criterion for separating process calculi  

CERN Multimedia

We introduce a new criterion, replacement freeness, to discern the relative expressiveness of process calculi. Intuitively, a calculus is strongly replacement free if replacing, within an enclosing context, a process that cannot perform any visible action by an arbitrary process never inhibits the capability of the resulting process to perform a visible action. We prove that there exists no compositional and interaction sensitive encoding of a not strongly replacement free calculus into any strongly replacement free one. We then define a weaker version of replacement freeness, by only considering replacement of closed processes, and prove that, if we additionally require the encoding to preserve name independence, it is not even possible to encode a non replacement free calculus into a weakly replacement free one. As a consequence of our encodability results, we get that many calculi equipped with priority are not replacement free and hence are not encodable into mainstream calculi like CCS and pi-calculus, t...

Banti, Federico; Tiezzi, Francesco; 10.4204/EPTCS.41.2

2010-01-01

85

Bisimulation for higher-order process calculi  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A higher-order process calculus is a calculus for communicating systems which contains higher-order constructs like communication of terms. We analyse the notion of bisimulation in these calculi. We argue that %, if static binding is assumed, both the standard definition of bisimulation (i.e., the one for CCS and related calculi), as well as higher-order bisimulation \\cite{AsGi88,Bou89,Tho90} are in general unsatisfactory, because over-discriminating. We propose and study a new form of bisimu...

1995-01-01

86

The value of ultrasound in diagnosis of ureteral calculi  

International Nuclear Information System (INIS)

To determine the diagnostic value of ultrasound in patient with clinically suspected ureteral calculi, a prospective study was performed on 58 patients. Of these, 42 patients had 44 ureteral calculi and 16 patients had no calculi. The sonographic of a distal shadowign highly echogenic reflector along the ureter, with or without dilatation of the proximal ureter. Ultrasound correctly diagnosed 42 stones among 44 calculi and there was one false positive examination. The overall diagnostic accuracy was 95% Ultrasonography appears to be a very useful adjunct for the diagnosis of ureteral calculi when excretory urography is equivocal or contraindicated. Also ultrasonography was valuable in monitoring passage of radiolucent ureteral stones

1990-12-01

87

Ureteroscopic pneumatic lithotripsy of impacted ureteral calculi  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCTION: This work evaluates the results of ureteroscopic treatment of impacted ureteral stones with a pneumatic lithotripter. MATERIALS AND METHODS: From March 1997 to May 2002, 42 patients with impacted ureteral stones were treated by retrograde ureteroscopic pneumatic lithotripsy. Twenty-eight patients were female and 14 were male. The stone size ranged from 5 to 20 mm. The ureteral sites of the stones were distal in 21, middle in 12 and proximal in 9. RESULTS: Considering stones with distal location in the ureter, 1 patient had ureteral perforation and developed a stricture in the follow-up (4.7%. As for stones in the middle ureter, 2 perforations and 1 stricture were observed (8.3% and regarding stones located in the proximal ureter, 5 perforations and 4 strictures occurred (44%. In the mid ureter, 1 ureteral avulsion was verified. In 34 patients without ureteral perforation, only 1 developed a stricture (2.9%. Of 8 patients who had perforation, 6 developed strictures. The overall incidence of stricture following treatment of impacted ureteral calculi was 14.2%. CONCLUSIONS: Ureteroscopy for impacted ureteral calculi is associated with a higher incidence of ureteral perforation and stricture. Ureteroscopy of proximal ureteral calculi is associated with a high risk of perforation, when compared to mid or distal ureteral calculi. Ureteral perforation at the site of the stone seems to be the primary risk factor for stricture formation in these cases.

Artur H. Brito

2006-06-01

88

Radiologic findings in acute urinary tract obstruction.  

Science.gov (United States)

Acute urinary tract obstruction, a common disease in daily practice, often requires performance of emergency intravenous urography (IVU). However, the spectrum of urographic abnormalities seen with acute obstruction has not been thoroughly addressed. The purpose of this study was to explore the IVU findings in patients with acute urinary tract obstruction. Records of 380 patients who underwent IVU in our hospital during a 6-mo period were reviewed for IVU evidence of acute urinary tract obstruction. Of the 380 patients, 53 (14%; 39 men, 14 women; average age = 43 yr) had acute urinary tract obstruction. All obstructions except one were located in the lower one-third of the ureter. The causes of acute urinary obstruction included ureteral stones in 34 (64%), ureteral edema or lucent stones in 16 (30%), neoplasms in 2 (4%), and inflammatory disease in 1 (2%). Abnormal radiologic findings were hydroureter in 46, nephropyelographic delay in 36, hydronephrosis in 35, interureteric ridge edema in 11, persistent dense nephrogram in 6, urine extravasation in 5, vicarious excretion in 1, striation in 1, and stricture in 1. Radiographic results were normal in one patient. The most common clinical indications of acute ureteral obstruction are flank pain and hematuria, and calculi are the major cause. In one-third of patients, radiopaque calculi are not detectable with IVU during acute urinary tract obstruction. A careful and thorough evaluation of the IVU should be performed in patients with clinical indications of acute urinary obstruction. PMID:9258784

Chen, M Y; Zagoria, R J; Dyer, R B

1997-01-01

89

Spectroscopic study of the inhibition of calcium oxalate calculi by Larrea tridentata  

Science.gov (United States)

The causes of urolithiasis include such influences as diet, metabolic disorders, and genetic factors which have been documented as sources that aggravate urinary calculi depositions and aggregations, and, implicitly, as causes of urolithiasis. This study endeavors to detail the scientific mechanisms involved in calcium oxalate calculi formation, and, more importantly, their inhibition under growth conditions imposed by the traditional medicinal approach using the herbal extract, Larrea tridentata. The calculi were synthesized without and with Larrea tridentata infusion by employing the single diffusion gel technique. A visible decrease in calcium oxalate crystal growth with increasing amounts of Larrea tridentata herbal infusion was observed in photomicrographs, as well as a color change from white-transparent for pure crystals to light orange-brown for crystals with inhibitor. Analysis of the samples, which includes Raman, infrared absorption, scanning electron microscopy (SEM), and X-ray powder diffraction (XRD) techniques, demonstrate an overall transition in morphology of the crystals from monohydrate without herbal extract to dihydrate with inhibitor. Furthermore, the resulting data from Raman and infrared absorption support the possibilities of the influences, in this complex process, of NDGA and its derivative compounds from Larrea tridentata, and of the bonding of the magnesium of the inhibitor with the oxalate ion on the surface of the calculi crystals. This assumption corroborates well with the micrographs obtained under higher magnification, which show that the separated small crystallites consist of darker brownish cores, which we attribute to the dominance of growth inhibition by NDGA, surrounded by light transparent thin shells, which possibly correspond to passivation of the crystals by magnesium oxalate. The SEM results reveal the transformation from the dominant monoclinic structure of the calcium oxalate crystals grown alone to the tetragonal dipyramidal crystal structure of the calcium oxalate crystals grown with Larrea tridentata. Comparison between XRD experimental and simulated data, besides corroborating with our previous results, show that each sample is a combination of different structures.

Pinales, Luis Alonso

90

Classification of bicovariant differential calculi on quantum groups  

International Nuclear Information System (INIS)

Suppose that q is not a root of unity. We classify all bicovariant differential calculi of dimension greater than one on the quantum groups GLq(N), Oq(N) and Spq(N) for which the differentials duij of the matrix entries uij generate the left module of first order forms. Our first classification theorem asserts that there are precisely two one-parameter families of such calculi on GLq(N) for N?3. In the limit q ? 1 only two of these calculi give the ordinary differential calculus on GL(N). Our second main theorem states that apart from finitely many q there exist precisely two differential calculi with these properties on Oq(N) and Spq(N) for N?4. There are four such calculi on Oq(3). We introduce two new 4-dimensional bicovariant differential calculi on Oq(3). (orig.)

1995-06-01

91

Computational applications of calculi based on monads  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This thesis studies various manifestations of monads in the mathematics of computation and presents three applications of calculi based on monads. The view that monads provide abstract mathematical interpretations of computational phenomena led E. Moggi to use the internal language of a category with a strong monad, which he called the computational lambda calculus, for describing denotational semantics of programming languages. Moggi argued that models of complicated forms of computation...

Cenciarelli, Pietro

1996-01-01

92

Cyclic and Inductive Calculi are equivalent  

CERN Document Server

Brotherston and Simpson [citation] have formalized and investigated cyclic reasoning, reaching the important conclusion that it is at least as powerful as inductive reasoning (specifically, they showed that each inductive proof can be translated into a cyclic proof). We add to their investigation by proving the converse of this result, namely that each inductive proof can be translated into an inductive one. This, in effect, establishes the equivalence between first order cyclic and inductive calculi.

Voicu, Razvan

2011-01-01

93

More on differential calculi on bicrossproducts  

International Nuclear Information System (INIS)

We extend a previous classification of differentials and Cartan calculus on the bicrossproduct quantum group k(M)-blacktriangleright triangleleft-kG to its dual Hopf algebra H = kM-triangleright blacktriangleleft-k(G). It turns out that the usual bicovariant differential calculi on kM and on k(G) extend naturally to H. We explicitly work out the examples of kZ2-triangleright blacktriangleleft (Z3) and kZ6-triangleright 3). (author)

2005-01-01

94

Intersection Type Systems and Explicit Substitutions Calculi  

Science.gov (United States)

The ?-calculus with de Bruijn indices, called ? dB , assembles each ?-class of ?-terms into a unique term, using indices instead of variable names. Intersection types provide finitary type polymorphism satisfying important properties like principal typing, which allows the type system to include features such as data abstraction (modularity) and separate compilation. To be closer to computation and to simplify the formalisation of the atomic operations involved in ?-contractions, several explicit substitution calculi were developed most of which are written with de Bruijn indices. Although untyped and simply types versions of explicit substitution calculi are well investigated, versions with more elaborate type systems (e.g., with intersection types) are not. In previous work, we presented a version for ? dB of an intersection type system originally introduced to characterise principal typings for ?-normal forms and provided the characterisation for this version. In this work we introduce intersection type systems for two explicit substitution calculi: the ?? and the ?s e . These type system are based on a type system for ? dB and satisfy the basic property of subject reduction, which guarantees the preservation of types during computations.

Ventura, Daniel Lima; Ayala-Rincón, Mauricio; Kamareddine, Fairouz

95

Logic of programming and calculi of discrete design  

Energy Technology Data Exchange (ETDEWEB)

The book gives an overview of the state of the art in formal methods of program design. The book treats both logic in programming and formal calculi in the discrete design of programs and systems, including foundations of logic, equational logic, modal logics, support systems for logical reasoning, and design calculi for programs and program specifications.

Broy, M.

1987-01-01

96

Brane Calculi Systems: A Static Preview of their Possible Behaviour  

CERN Multimedia

We improve the precision of a previous Control Flow Analysis for Brane Calculi, by adding information on the context and introducing causality information on the membranes. This allows us to prove some biological properties on the behaviour of systems specified in Brane Calculi.

Bodei, Chiara

2011-01-01

97

A standardisation proof for algebraic pattern calculi  

Directory of Open Access Journals (Sweden)

Full Text Available This work gives some insights and results on standardisation for call-by-name pattern calculi. More precisely, we define standard reductions for a pattern calculus with constructor-based data terms and patterns. This notion is based on reduction steps that are needed to match an argument with respect to a given pattern. We prove the Standardisation Theorem by using the technique developed by Takahashi and Crary for lambda-calculus. The proof is based on the fact that any development can be specified as a sequence of head steps followed by internal reductions, i.e. reductions in which no head steps are involved.

Delia Kesner

2011-02-01

98

A standardisation proof for algebraic pattern calculi  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This work gives some insights and results on standardisation for call-by-name pattern calculi. More precisely, we define standard reductions for a pattern calculus with constructor-based data terms and patterns. This notion is based on reduction steps that are needed to match an argument with respect to a given pattern. We prove the Standardisation Theorem by using the technique developed by Takahashi and Crary for lambda-calculus. The proof is based on the fact that any development can be sp...

2011-01-01

99

The Evaluation of Ureteroscopy and Pneumatic Lithotripsy Results in Pregnant Women With Urethral Calculi  

Science.gov (United States)

Background Urinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases. Objectives The aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones. Patients and Methods From 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography. Results The mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation. Conclusions In conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients’ symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones.

Keshvari Shirvan, Maliheh; Darabi Mahboub, Mohammad Reza; Rahimi, Hamid Reza; Seyedi, Ali

2013-01-01

100

Renal calculi: emergency department diagnosis and treatment.  

Science.gov (United States)

The acute treatment of kidney stones (urolithiasis) addresses pain management and focuses on the effects of the morbidity associated with an obstructed renal system. Minimal fluid intake, resulting in decreased urine production and a high concentration of stone-forming salts, is a leading factor in renal calculi development. Radio-opaque calcareous stones account for 70% to 75% of renal calculi. Microscopic hematuria in the presence of acute flank pain is suggestive of renal colic, but the absence of red blood cells does not exclude urolithiasis. Furthermore, many inflammatory and infectious conditions cause hematuria, demonstrating the low specificity of urinalysis testing. The diagnostic modality of choice is a noncontrast computed tomography (CT); ultrasonography s preferred in pregnant patients and children. Combining opioids with non-steroidal anti-inflammatory drugs (NSAIDs) is the optimal evidence-based regimen to treat severe symptoms. Rapid intravenous (IV) hydration has not shown a benefit. Potentially life-threatening diagnoses including abdominal aortic aneurysm, ovarian torsion, and appendicitis may mimic renal colic and must be ruled out. PMID:22164398

Carter, Michelle R; Green, Brad R

2011-07-01

 
 
 
 
101

Accuracy of Radiological Features for Predicting Extracorporeal Shock Wave Lithotripsy Success for Treatment of Kidney Calculi  

Directory of Open Access Journals (Sweden)

Full Text Available

Introduction: Our aim was to assess the accuracy of radiological characteristics observed by the urologist in estimating the success rate of extracorporeal shock wave lithotripsy (SWL in patients with kidney calculi.

Materials and Methods: Patients with kidney calculi sized 10 mm to 15 mm who underwent SWL in our center were enrolled. One urologist estimated the success chance of SWL based on plain abdominal radiography. Accordingly, the patients were categorized into 2 groups with more than 75% chance of fragmentation (group 1 and with 50% to 75% estimated chance of fragmentation (group 2. Factors used for estimation included calculus shape, homogeneity, and density as compared with the adjacent 12th rib. The estimations were compared with the resulted stone-free rate after a 3-month follow-up.

Results: A total of 137 patients were studied, of whom, 92 (67.2% were categorized in group 1 and 45 (32.8% in group 2, before the lithotripsy. Successful treatment was recorded in 101 patients (73.7%. Eighty-five patients with favorable estimated chance of successful lithotripsy (92.4% had successful SWL, and 29 with less favorable estimate (64.4% did not have successful fragmentation following 2 sessions of SWL (P < .001. The sensitivity and specificity of radiological parameters for prediction of treatment success were 84.2% and 80.6%, respectively.

Conclusion: We found that certain radiographic features of urinary calculi such as calculus density, as compared with the adjacent bone, and calculus shape could have predictive impression for the success rate of SWL.

Hamid Arshadi

2009-05-01

102

Diagnosis of ureteral calculi using ultrasonography, intravenous urography and unenhanced Helical Computed Tomography  

Directory of Open Access Journals (Sweden)

Full Text Available Ultrasonography Ultrasonography is an efficient tool in the detection of calculi in the pyelocalyx system, but it may not be sufficient for the area of renal pelvis and ureter, as well as for the ureter and the ureterovesical junction. Intravenous urography Radiolucent stones, dilatation of the ureter and of the pyelocalyx system were identified on the urogram, which are common signs of ureter calctilosis. Defects in the contrast can be caused by blood clots and papillary or malignant tumors of the ureter, thus causing a differential diagnosis problem. Unenhanced Helical Computed Tomography Noncontrast spiral CT is useful for detection for calculi as small as 3mm. It can identify their localization and size without enlargements. The primary and secondary CT signs also confirm the established diagnosis. Conclusion The noncontrast spiral CT is a highly precise method for assessment of kidney pain. It is a reliable and rapid diagnostic modality for the detection of urinary stones which differentiates them from blood clots, tumors, air and other factors which create a differential diagnosis problem.

Govor?in Mira

2005-01-01

103

Laser lithotripsy in the treatment of ureteral calculi.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We examined the effectiveness of laser lithotripsy with a flash-lamp-pumped tunable dye laser in the treatment of ureteral calculi that were too large for direct extraction and that could not be treated with or had not responded to extracorporeal shock-wave lithotripsy (ESWL) or forms of ureteroscopic lithotripsy other than laser lithotripsy. In 20 (74%) of the 27 patients the laser alone successfully fragmented the calculi into pieces small enough to pass spontaneously or to be easily extrac...

1990-01-01

104

Ureteral jets in patients with unilateral ureteral calculi: Using color doppler ultrasonography  

International Nuclear Information System (INIS)

Sonographic detection of ureteral jets entering the urinary bladder is a well-known procedure. Color doppler ultrasound was used to image the ureteral jets in 28 patients with unilateral ureteral calculi proved by intravenous urography. Three major findings of ureteral jets were obtained in the affected ureter with a stone: less frequency (26 patients), weak reflection (20 patients), and lower grade in length (27 patients) that were significant different from the unaffected side in the same patient. No significant differences were found between the ureteral jets and the degree of hydronephrosis or the location of a stone. In conclusion, these results suggest that ureteral jets should be checked routinely during the procedure of color doppler ultrasonogram in patients with possible unilateral ureteral obstruction. Color doppler examination of ureteral jets may be an important adjunct in routine pelvic ultrasonogram especially in patients who have absolute or relative contraindications of intravenous urography

1993-05-01

105

99mTc-DTPA renography before and after extracorporeal shock wave lithotripsy for renal calculi  

International Nuclear Information System (INIS)

This study was undertaken to evaluate 99mTc-DTPA renography before and after extracorporeal shock wave lithotripsy (ESWL). Twelve patients with renal calculi were examined in this study. In three patients, bilateral kidneys were treated with ESWL. Sequential renal images of the vascular phase, and the functional and excretory phases were taken using a gamma camera (ZLC 7500, Siemens), after intravenous injection of 555 MBq of 99mTc-DTPA. Renograms were generated using data stored every 10 seconds for a period of 30 minutes by computer (Scintipac-2400, Shimadzu). Some treated kidneys were enlarged and/or showed uniform retention of radioactivity on sequential images, within a week after ESWL. Renogram patterns after ESWL were varied in each patient. The renogram findings after ESWL seemed to be affected by the presence or absence of stone fragments in the urinary tract. (author)

1988-01-01

106

Unenhanced helical CT in the evaluation of the urinary tract in children and young adults following urinary tract reconstruction: comparison with sonography  

Energy Technology Data Exchange (ETDEWEB)

Purpose. To compare the accuracy of unenhanced, helical CT with sonography for the detection of complications of urinary tract reconstruction. Materials and methods. Forty-six kidneys in 24 patients were examined with CT and sonography. All scans were assessed for ease of renal visualization, presence of renal, ureteral, and bladder calculi, renal scars, hydronephrosis, and abdominal wall hernia. The results of both imaging modalities were independently reported. Results. CT provided excellent visualization of all 46 kidneys, while sonography provided poor visualization of 8 kidneys (17 %) (P < 0.001). CT detected calculi in 10 kidneys, 1 ureter, and 7 bladders. Sonography detected calculi in only 2 kidneys, and 2 bladders. Overall, CT detected significantly more calculi than US (18 vs 4, P = 0.01). CT detected scarring in 15 kidneys, while sonography detected scarring in 10. Hydronephrosis was detected in 6 kidneys by CT and in 8 kidneys by sonography. Three abdominal wall hernias were seen at CT that were not seen at sonography. Conclusion. CT is superior to sonography for the detection of urinary tract calculi and renal scarring. CT will demonstrate abdominal wall hernias that are unsuspected. (orig.)

Myers, M.T.; Elder, J.S.; Sivit, C.J.; Applegate, K.E. [Dept. of Radiology, Rainbow Babies and Children' s Hospital, Cleveland, OH (United States)

2001-03-01

107

New chemolysis for urological calcium phosphate calculi – a study in vitro  

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Full Text Available Abstract Background Advances in techniques have left very few indications for open surgical extraction of urinary stones currently. These advances notwithstanding, the search continues for medical approaches to urinary stone management. In this study, we perform an in vitro study analyzing the efficiency and prospect of two new complex solutions in urological calcium phosphate calculi dissolution. Methods Eighteen stones composed mainly of calcium phosphates were taken from patients who underwent kidney stone surgery. These stones were large enough (weight range 0.514–0.928 g to be fragmented and matched equally into six groups. Chemolysis of phosphate stones was done with six different solvents and was repeated 3 times with 6 stones for each solution. At 24, 48 and 72 h, reduction in weight, percentage weight change, and dissolution rate; the dissolution rates at pH 5.0, 7.0 and 8.5 for each solution, using different cations (Na+, K+ or Ca2+, according to different dilutions (1:1, 1:2, 1:3, 1:4 of S1 and S2 were simultaneously determined. Results Calcium phosphate calculi were poorly dissolved by Phys and Art, and they had a low dissolution rate in pH 8.5 EDTA. The most effective solutions were S1, S2 and R, with 72 h mean dissolution rates: 5.75 ± 0.44 mg/hr (S1, 5.2 ± 0.63 mg/hr (S2, 4.55 ± 0.46 mg/hr (R ( ± s, p p ± s, p +, K+ or Ca2+ greatly reduced the dissolution rates of S1, S2. Conclusion Our data indicate that test solutions S1 and S2 are effective solvents in the chemolysis of calcium phosphate stones. At twice dilutions, these solutions are even more useful in the treatment of stone disease.

Jian-min Duan

2005-05-01

108

Evaluation of the Raphanus sativus effect on urinary pH  

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BACKGROUND: According to urology texts, urinary calculi are the third most common affliction of the urinary tract and they pose great expenses on health services. The use of oral herbal medication is one of the cheapest ways of treating this disease (in some societies black radish plant is used as a treatment). The ...

Hamid Mazdak; Mohammad Masoud Nikkar; Linda Ghanea

2007-01-01

109

On the Expressiveness of Markovian Process Calculi with Durational and Durationless Actions  

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Several Markovian process calculi have been proposed in the literature, which differ from each other for various aspects. With regard to the action representation, we distinguish between integrated-time Markovian process calculi, in which every action has an exponentially distributed duration associated with it, and orthogonal-time Markovian process calculi, in which action execution is separated from time passing. Similar to deterministically timed process calculi, we show that these two opt...

2010-01-01

110

Existence families, functional calculi and evolution equations  

CERN Document Server

This book presents an operator-theoretic approach to ill-posed evolution equations. It presents the basic theory, and the more surprising examples, of generalizations of strongly continuous semigroups known as 'existent families' and 'regularized semigroups'. These families of operators may be used either to produce all initial data for which a solution in the original space exists, or to construct a maximal subspace on which the problem is well-posed. Regularized semigroups are also used to construct functional, or operational, calculi for unbounded operators. The book takes an intuitive and constructive approach by emphasizing the interaction between functional calculus constructions and evolution equations. One thinks of a semigroup generated by A as etA and thinks of a regularized semigroup generated by A as etA g(A), producing solutions of the abstract Cauchy problem for initial data in the image of g(A). Material that is scattered throughout numerous papers is brought together and presented in a fresh, ...

deLaubenfels, Ralph

1994-01-01

111

Aeromedical certification of aircrew and controllers with renal calculi.  

Science.gov (United States)

Acute renal colic is an incapacitating condition. Advances in understanding the pathogenesis of calculi and their detection and treatment require a new approach to aeromedical risk assessment. Can this new information support the stratification of aeromedical risk into "High" and "Low" categories, and fulfill the paramount responsibility of the Civil Aviation Safety Authority, Australia's aviation regulator, which isthe maintenance of aviation safety? This article reviews the epidemiology of calculi and finds 2-10% annual risk of a symptomatic event following incidental detection of a calculus. While calculi 4 mm or less in size may not require surgical intervention, this does not equate to a pain-free passage. Similarly, calculus recurrence rates may vary in different anatomical locations, but no location can be considered "safe." The recognition of parenchymal calcification and Randall's plaques as precursors to the development of calculi places such individuals at elevated risk of developing calculi. More recently evidence has supported a link between metabolic syndrome and calculus formation. In an occupational group where there is potential for elevated radiation exposure, appropriate imaging is of particular importance. CT, X-ray, and ultrasound modalities are reviewed with recommendations presented for aeromedical assessment and surveillance based on identification of those at high risk of colic and minimization of investigational radiation exposure. PMID:24261061

Drane, A Michael C; Navathe, Pooshan; Clem, Peter

2013-10-01

112

Intracorporeal Lithotripsy for Ureteral Calculi Using Swiss Lithoclast : SKIMS Experience  

Directory of Open Access Journals (Sweden)

Full Text Available At present the techniques available for performing intracorporeal lithotripsy include electrohydraulic,ultrasonic, laser, and ballistic lithotripsy. We present our experience with a unique technology forperforming intracorporeal lithotripsy, namely the Swiss lithoclast, which is a form of ballistic lithotripsy.This simple and inexpensive device uses compressed air to activate a solid probe in a manner similarto that of a jackhammer. We report the use of this lithoclast in 92 patients involving a total of 95ureteral calculi. The lithoclast successfully fragmented 81 of the 95 calculi, a success rate of 85.26%.There were no major complications directly related to the use of this device. The Swiss lithoclastseems to be a safe, effective and an inexpensive means of performing intracorporeal lithotripsy forureteral calculi

Arif Hamid, M. Saleem Wani, B. S. Wazir

2005-10-01

113

Treatment of giant ureterocele calculi by Holmium Laser Lithotripsy  

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Full Text Available Aim: Most ureteral stones pass spontaneously. But patients who have a calculi in an ureterocele could not pass their stone, because of narrow ureteral orifice. These stones may remain asymptomatic until hematuria or obstruction occurs.Materials and Methods: Holmium laser has many uses in urology, including soft tissue incision and calculus fragmentation. These properties are ideal for endoscopic management of the ureterocele calculusResults: We present a young patient who has no spesific and severe symptoms with a hypofunctional left kidney because of giant calculi in an ureterocele Conclusion: Its imaging characteristics on intravenous pyelography and endoscopic treatment were emphasized.

Haluk Söylemez

2009-01-01

114

Urinary Diversion  

Science.gov (United States)

... the urinary tract kidney, ureter, or bladder stones tumors of the genitourinary tract––which includes the urinary tract and reproductive organs––or adjacent tissues and organs conditions causing external pressure to the ...

115

Análise do impacto do progresso tecnológico nos custos do tratamento hospitalar: o caso do tratamento para litíase urinária no Hospital Universitário de Brasília / Analysis of the technological change impact in the costs in hospital treatment: the case study of the treatment for urinary calculi in hospital in university hospital of Brasília  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O progresso tecnológico na área de saúde tem provocado a elevação dos custos da assistência médica, preocupando a população mundial, os agentes privados e os responsáveis pelas políticas públicas. Estetrabalho apresenta uma análise do impacto do progresso tecnológico - delimitado, neste estudo, à in [...] corporação de equipamentos médicos - nos custos do tratamento hospitalar. Para cumprir o objetivo, foram escolhidos ostratamentos médicos para litíase urinária - litotripsia e cirurgia - devido ao histórico de relevantes avanços tecnológicos. O estudo de caso foi realizado no Serviço de Litotripsia e no Centro Cirúrgico do Hospital Universitário de Brasília (HUB), no período de 2001 a 2003. Foram comparados os custos e as receitas diferenciais das alternativas de tratamento para calculose urinária em quatro opções de decisão. Para testar a robustez dos resultados, foi incorporada a variável incerteza, por meio de simulações no sistema Crystall Ball, realizando 50.000 iterações. Os principais impactos do progresso tecnológico nos custos do tratamento paralitíase urinária são: aumento da capacidade instalada, geração de despesa com obsolescência e aumento das receitas. Abstract in english The technological progress in the field of health has been triggering rises of medical assistance costs, worrying the world-wide population, private agents and the responsible ones for public policies. This search presents an analysis of technological evolution impact - here, bounded to the medical [...] equipments incorporation - on thehospital treatment costs. In order to accomplish the objective, the medical care for urinary lithiasis - lithotripsyand surgery - had been chosen due to the record of meaningful technological advances. The case study wascarried through at the Lithotripsy Service and Hospital Universitário de Brasília (HUB) Surgical Center from 2001to 2003. The costs and incomes - differential items inherent to options for urinary calculosis treatment - were compared in four proposals. As a means to prove the results robustness the variable uncertainty wasincorporated through simulations at the Crystal Ball system, achieving 50.000 iterations. The main impacts from technological progress on the medical care for urinary lithiasis costs are: increase of the installed capacity, generation of expense with obsolescence and increase of revenues.

Patrícia de Souza, Costa; César Augusto Tibúrcio, Silva.

116

Análise do impacto do progresso tecnológico nos custos do tratamento hospitalar: o caso do tratamento para litíase urinária no Hospital Universitário de Brasília Analysis of the technological change impact in the costs in hospital treatment: the case study of the treatment for urinary calculi in hospital in university hospital of Brasília  

Directory of Open Access Journals (Sweden)

Full Text Available O progresso tecnológico na área de saúde tem provocado a elevação dos custos da assistência médica, preocupando a população mundial, os agentes privados e os responsáveis pelas políticas públicas. Estetrabalho apresenta uma análise do impacto do progresso tecnológico - delimitado, neste estudo, à incorporação de equipamentos médicos - nos custos do tratamento hospitalar. Para cumprir o objetivo, foram escolhidos ostratamentos médicos para litíase urinária - litotripsia e cirurgia - devido ao histórico de relevantes avanços tecnológicos. O estudo de caso foi realizado no Serviço de Litotripsia e no Centro Cirúrgico do Hospital Universitário de Brasília (HUB, no período de 2001 a 2003. Foram comparados os custos e as receitas diferenciais das alternativas de tratamento para calculose urinária em quatro opções de decisão. Para testar a robustez dos resultados, foi incorporada a variável incerteza, por meio de simulações no sistema Crystall Ball, realizando 50.000 iterações. Os principais impactos do progresso tecnológico nos custos do tratamento paralitíase urinária são: aumento da capacidade instalada, geração de despesa com obsolescência e aumento das receitas.The technological progress in the field of health has been triggering rises of medical assistance costs, worrying the world-wide population, private agents and the responsible ones for public policies. This search presents an analysis of technological evolution impact - here, bounded to the medical equipments incorporation - on thehospital treatment costs. In order to accomplish the objective, the medical care for urinary lithiasis - lithotripsyand surgery - had been chosen due to the record of meaningful technological advances. The case study wascarried through at the Lithotripsy Service and Hospital Universitário de Brasília (HUB Surgical Center from 2001to 2003. The costs and incomes - differential items inherent to options for urinary calculosis treatment - were compared in four proposals. As a means to prove the results robustness the variable uncertainty wasincorporated through simulations at the Crystal Ball system, achieving 50.000 iterations. The main impacts from technological progress on the medical care for urinary lithiasis costs are: increase of the installed capacity, generation of expense with obsolescence and increase of revenues.

Patrícia de Souza Costa

2006-03-01

117

Renal calculi with retrocaval ureter: is percutaneous nephrolithotomy sufficient?  

Science.gov (United States)

A 60-year-old woman presented with complaints of intermittent right flank pain which had begun one year ago. Ultrasonography and intravenous urogram showed right pelvic (15 mm) and inferior calyceal (6 mm) calculi along with suspected retrocaval course of right ureter, which was confirmed by contrast CT scan. Tc-99m diethylene-triamine-penta-acetic acid (DTPA) scan showed normal function and normal drainage of right kidney. Percutaneous nephrolithotomy (PCNL) was performed for right renal calculi. Because of curved ureteric course, negotiation of ureteric catheter in pelvis was anticipated to be troublesome, so intraoperative retrograde pyelogram (RGP) was performed to delineate the anatomy. Puncture was performed safely after air contrast pyelography. No complications occurred intraoperatively and postoperatively. On follow-up of up to 1 year patient was asymptomatic and renal scan showed normal function and drainage. So in the presence of retrocaval ureter and associated renal calculi, PCNL is a safe and optimal procedure and in condition of non-obstructive drainage, management of calculi only is adequate. PMID:23536623

Prakash, Jai; Raj, Anubhav; Sankhwar, Satyanarayan; Singh, Vishwajeet

2013-01-01

118

Biologically Inspired Process Calculi, Petri Nets and Membrane Computing  

CERN Multimedia

This volume represents the proceedings of the 5th Workshop on Membrane Computing and Biologically Inspired Process Calculi (MeCBIC 2011), held together with the 12th International Conference on Membrane Computing on 23rd August 2011 in Fontainebleau, France.

Ciobanu, Gabriel

2011-01-01

119

Continued Use of Zonisamide Following Development of Renal Calculi.  

Science.gov (United States)

The reported incidence of renal calculi complicating Zonisamide (ZNS) therapy for epilepsy ranges from 0.2 to 4.4%(exp 1-3) Typically this complication leads to discontinuation of the drug. For patients uniquely responsive to Zonisamide, the benefits of c...

K. C. Richards M. C. Smith A. Verma

2004-01-01

120

Development of a urinary lithiasis localizer mechanism to couple ultrasound and extracorporeal lithotripsy equipment in canine model  

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INTRODUCTION: Due to the evolution of extracorporeal lithotripsy equipment (ESWL) and presently, the fact that most part of the equipment does not present ultrasound to localize urinary calculi, a system that allows adapting ultrasound equipment to ESWL equipment was developed, disposing only of fluoroscopy. Thus, this equipment was developed and was tested in urinary stones in canine models, to check its precision in relation to fluoroscopy. METHOD: Seven male dogs were utilized with the int...

Enrico Andrade; Gustavo Alarcon; Eduardo Pompeu; Archimedes Nardozza Jr.; Claro, Joaquim A.; Valdemar Ortiz; Miguel Srougi

2006-01-01

 
 
 
 
121

Major Constituents, Free Amino Acids and Metal Levels in Renal Calculi from Multan Region  

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Full Text Available Renal calculi collected from adult male/female patients of Multan, Pakistan were analyzed for major constituents, free amino acids and metallic contents. Composition of calculi (whole powder was determined by chemical method using stone analysis kit. Thirteen distinct types of renal calculi were identified. Most of the calculi were compound in nature, however, some simple calculi containing calcium oxalate only were also found. Two dimensional descending paper chromatography was used to identify free amino acids in some prominent classes of renal calculi. Arginine, aspartinine, glycine, leucine, isoleucine and tryptophan were found in nearly all the calculi whereas glutamic acid, histidine, hydroxyproline, phenylalanine, threonine and tryosine occurred randomly. Analysis of major (Na, K, Ca and Mg and trace (Fe, Zn, Cu, Ni, Pb and Mn elements in the calculi was carried out by flame atomic absorption spectrometry. Elements such as Na, K, Ca, Mg, Fe and Zn have shown their presence in nearly all the calculi however Pb, Ni, Mn and Cu levels were below the limit of detection. This study has revealed useful information about the chemical nature of renal calculi from Multan region. It will be helpful in adopting preventive strategies to minimize stone formation and their reoccurrence.

Muhammad Aslam Shad

2001-01-01

122

Experiencia clínica y resultados en el tratamiento de 4402 pacientes con cálculos urinarios únicos con el litotritor extracorpóreo Dornier MFL-5000 / Clinical experience and results iun the treatment of 4402 patients with solitary urinary calculi with the extracorporeal shock wave lithotripter Dornier MFL-500  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Presentamos la casuística de nuestro servicio en el tratamiento de la litíasis urinaria así como la efectividad del litotritor Dornier MFL-5000 Métodos: Tratamos en 12 años un total de 6602 pacientes con un número total de sesiones de litotricia de 17120. Realizamos el estudio del éxito de [...] l tratamiento de los 4402 pacientes que presentaban un cálculo, según el tamaño y la localización. Resultados: No hubo complicaciones mayores y apenas 43 pacientes tuvieron calle litiásica. Realizamos el tratamiento de 4402 cálculos. Para todos los cálculos independientemente de su localización y tamaño supone que 2615 (59,4%) se han tratado en una sesión, 801 (18,2%) en dos, 379 (8,6%) en tres, 213 (4,8%) en cuatro y 372 (8,4%) en cinco o más sesiones. Conclusiones: El litotritor MFL-5000 ha permitido el tratamiento de la litiasis urinaria en todas las edades, con unos porcentajes de retratamiento y un número de tratamientos por cálculo similar a otros autores, sin necesidad de analgesia ni medidas anestésicas, salvo en apenas aquellos pacientes de menor edad. Abstract in english Objectives: To report the series of our Urology Department in the treatment of urinary stone disease with extracorporeal lithotripsy as well as the effectiveness of the Dornier lithotripter MFL-5000. Methods: 6.602 patients were treated by extracorporeal lithotripsy during 12 years with a total of 1 [...] 7.120 sessions. We examined the treatment outcome of 4.402 patients with a solitary stone, accordingly to stone size and localization. Results: There were no major complications and only 43 patients experienced "calle litiásica". We treated 4.402 stones. For all stones, independently of size and localization, 2615 (59.4%) were treated in one session, 801 (18.2%) required two sessions, 379 (8.6%) 3 sessions, 213 (4.8%) 4 sessions and 373 (8.4%) 5 or more sessions. Conclusion: The Dornier MFL-5000 lithotripter successfully treated urinary stone disease in patients of all age groups with a retreatment rate and number of sessions per stone similar to other studies, without analgesia or anesthetic procedures, except in the younger age group.

Alberto, Palacios; Filipe, Rodrigues; Mário Jorge, Soares; Adérito, Morais; Apolinário, Mendes; Jorge, Pinheiro.

123

Potentialities of polyposition procedures in the X-ray diagnosis of renal and ureteral calculi and associated complications  

International Nuclear Information System (INIS)

A comprehensive radiation examination of 47 apparently healthy patients has ascertained that one of the angles formed by the renal lateral axis and the body's frontal plane (BFP) is 35-45 Deg and medially open, the second made by the long axis of the kidney and BFP is 28-32 Deg and caudally open. The densitometric findings from the X-ray films of 17 patients with ureteral calculi (UC) significantly suggest that a contrast medium rapidly moves to the dilated lower urinary tract due to changes in the relative position of the renal cavities against BFP. Excretory urography followed by measurements of the mean ureteral diameter was performed in 36 patients with dilated ureters and in 31 control subjects. There was a close correlation between the size of ureteral lumen and diuretic values and there was an inverse relationship to the magnitude of tubular reabsorption

1995-01-01

124

/sup 99m/Tc-DTPA renography before and after extracorporeal shock wave lithotripsy for renal calculi  

Energy Technology Data Exchange (ETDEWEB)

This study was undertaken to evaluate /sup 99m/Tc-DTPA renography before and after extracorporeal shock wave lithotripsy (ESWL). Twelve patients with renal calculi were examined in this study. In three patients, bilateral kidneys were treated with ESWL. Sequential renal images of the vascular phase, and the functional and excretory phases were taken using a gamma camera (ZLC 7500, Siemens), after intravenous injection of 555 MBq of /sup 99m/Tc-DTPA. Renograms were generated using data stored every 10 seconds for a period of 30 minutes by computer (Scintipac-2400, Shimadzu). Some treated kidneys were enlarged and/or showed uniform retention of radioactivity on sequential images, within a week after ESWL. Renogram patterns after ESWL were varied in each patient. The renogram findings after ESWL seemed to be affected by the presence or absence of stone fragments in the urinary tract.

Ohtake, Eiji; Murata, Hajime; Kanemura, Mikio; Yokoyama, Masao

1988-09-01

125

Epidural anesthesia is effective for extracorporeal shock wave lithotripsy of pancreatic and biliary calculi  

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AIM: To evaluate the efficacy of thoracic epidural analgesia for extracorporeal shock wave lithotripsy (ESWL).METHODS: ESWL is an effective, non-invasive technique for the treatment of difficult pancreatic and large bile duct calculi. The procedure is often painful and requires large doses of analgesics. Many different anesthetic techniques have been used. Patients with either large bile duct calculi or pancreatic duct calculi which could not be extracted by routine endoscopic methods were se...

2010-01-01

126

Equivalence of Algebraic Lambda-Calculi - work in progress -  

CERN Document Server

We examine the relationship between the algebraic lambda-calculus Lalg, a fragment of the differential lambda-calculus, and the linear-algebraic lambda-calculus Llin, a candidate lambda-calculus for quantum computation. Both calculi are algebraic: each one is equipped with an additive and a scalar-multiplicative structure, and the set of terms is closed under linear combinations. We answer the conjectured question of the simulation of Lalg by Llin and the reverse simulation of Llin by Lalg. Our proof relies on the observation that Llin is essentially call-by-value, while Lalg is call-by-name. The former simulation uses the standard notion of thunks, while the latter is based on an algebraic extension of the continuation passing style. This result is a step towards an extension of call-by-value / call-by-name duality to algebraic lambda-calculi.

Díaz-Caro, Alejandro; Tasson, Christine; Valiron, Benoît

2010-01-01

127

The role of laparoscopic surgery for renal calculi management  

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To date, most cases of renal calculi have been managed with extracorporeal shockwave lithotripsy and endoscopic procedures. However, for complex renal stone conditions, these minimally invasive procedures may require multiple operative sessions. Open surgery is usually reserved as a salvage procedure, although it is invasive in nature. Laparoscopic treatment is well accepted in renal surgery. For stone disease, it can duplicate open surgical techniques such as pyelolithotomy, pyeloplasty, ana...

Kijvikai, Kittinut

2011-01-01

128

Measurements and confluence in quantum lambda calculi with explicit qubits  

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This paper demonstrates how to add a measurement operator to quantum lambda-calculi. A proof of the consistency of the semantics is given through a proof of confluence presented in a sufficiently general way to allow this technique to be used for other languages. The method described here may be applied to probabilistic rewrite systems in general, and to add measurement to more complex languages such as QML or Lineal, which is the subject of further research.

Di?az-caro, Alejandro; Arrighi, Pablo; Gadella, Manuel; Grattage, Jonathan

2008-01-01

129

Ureteroscopy - First-line Treatment Alternative in Ureteral Calculi During Pregnancy?  

Science.gov (United States)

Background: Urolithiasis during pregnancy is not common butremains both a diagnostic and treatment challenge. The aim ofthe study was to assess the ureteroscopy results as definitivetreatment option in pregnant women with obstructive ureteralcalculi.Material Methods: Between 2006 and 2012, in our clinicaldepartment, 54 pregnant women underwent active treatmentfor ureteral lithiasis and in 38 of these cases ureteroscopy wasapplied as definitive therapy. The average patientsâ?? age was27.2 years (range 20-37 years) and the gestation period variedbetween 9 to 35 weeks. Flank pain was the commonpresenting symptom (52 54 cases), 4 women had associatedfever, and 14 complained of irritative voiding symptoms.Semirigid ureteroscopy was the first choice alternative for thefirst 2 trimesters while flexible approach or double J indwellingwere preferred for patients in the last trimester of pregnancy.Results: Semirigid ureteroscopy allowed stone treatment in28 32 cases. In 17 patients, calculi fragmentation usingHo:YAG laser or ballistic lithotripsy were performed, while in11 cases, the stone was removed intact. Minor intraoperativecomplications were encountered in 5 patients. Postoperatively,urinary tract infection developed in 4 patients, renal colic in 2and prolonged hematuria in one case, while 4 patientscomplained of stent-induced bladder irritation. Flexibleureteroscopy was successfully completed in all patients. Therewere no complications related to this procedure. All pregnancieswere carried out to full term.Conclusions: Ureteroscopy may be considered a safe andeffective first-line definitive therapeutic option in pregnantpatients requiring intervention for ureteral stone. PMID:24742417

Georgescu, D; Mul?escu, R; Geavlete, B; Geavlete, P; Chiu?u, L

2014-01-01

130

Ureteral calculi as a source of low back pain- a case report  

Directory of Open Access Journals (Sweden)

Full Text Available This case report describes a 49 year old male with complaints of back pain that was diagnosed as degenerative low back pain and referred to the physical therapist. The mode of onset was insidious and the pain was intermittent with no relief from specific intervention as in rest, heat or analgesics. There was no report of changes in urinary frequency or color, and any vomiting sensation. This patient was appropriately screened by a physical therapist who suspected a pain origin that could potentially be of a viscerogenic origin. He was referred back to the primary care physician who ordered an ultrasound and a CT-KUB (Computerized Tomography-Kidney, Ureter, Bladder which revealed a 10.5 mm calculi in the left upper ureter. The patient was then referred to a urologist who confirmed the findings and performed a ureterorenoscopy (URS lithoclast fragmentation and J-J stenting under spinal anaesthesia. The result was an excellent symptomatic and functional outcome. The need for lateral thinking in the evaluation of non specific low back pain is enumerated. The treatment based classification system is a referenced model. The emerging role of the physical therapist in screening of back pain as a first contact practitioner and the responsibility therein, is described.

Satishkumar Anandan

2010-07-01

131

Safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children  

International Nuclear Information System (INIS)

Objective: To determine the safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children. Method: The study included 100 children up to 15 years of age undergoing pneumatic cystolithoclast for bladder stones. The descriptive study was conducted from September 2006 to February 2007 at the Sindh Institute of Urology and Transplantation, Karachi. The inclusion criteria was children up to 15 years of age with a bladder stone of up to 3 cm, pre-operative negative urine culture, no coagulopathy and fit for general anaesthesia. An X-ray and ultrasound of Kidney and Urinary Bladder (KUB) was mandatory. The procedure was done under general anaesthesia with a single dose of pre-operative antibiotic. A mini-scope of 4 FR or a semi-rigid ureteroscope of 7/8.5 FR with pneumatic wolf lithoclast was used for the fragmentation of stones. Duration of procedure, any per-operative and post-operative complications and the duration of hospital stay were recorded. Post-operatively, the patient underwent ultrasound Kidney and Urinary Bladder at the first follow-up to assess stone clearance after one week. Result: Mean patients age was 4.95+-3.3 years. The male-to-female ratio was 11.5: 1 The mean hospital stay was 9.2 +- 2.5 hours. The mean operating time was 25 (10 -65) minutes. Ten (10%) patients developed minor complications out of which 5 (5%) developed haematuria and 4 (4%) developed difficulty in passing urine. One (1%) of the patients developed post-operative retention of urine. All the patients were stone free after the procedure. Conclusion: The transurethral pneumatic lithoclast is very effective and safe in children with bladder stones up to 3 cm. (author)

2012-12-01

132

Unusual Clinical Presentation of Bilateral Adult Non-Obstructing Ureteroceles Containing Urinary Stones  

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Ureterocele, while not an uncommon pediatric urologic problem, has been reported only rarely in adults. Adult bilateral ureteroceles with calculi is an uncommon and well tolerated, relatively rare clinical entity. Although ureteroceles in adults are usually asymptomatic, various symptoms tend to appear in ureteroceles with stones, such as flank pain, urinary tract infections and bladder irritability. While ureteroceles occur more commonly in women, stones in ureteroceles tend to be more commo...

Mustafa Ho?can; Mehmet Ekinci; Ahmet Tunçk?ran; Meriç Menek?e

2010-01-01

133

Combined electrohydraulic and holmium: YAG laser ureteroscopic nephrolithotripsy of large (>2 cm) renal calculi  

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Percutaneous nephrolithotripsy (PCL) is a standard treatment for renal calculi >2 cm. Modern flexible ureteroscopes and accessories employing the complementary effects of electrohydraulic lithotripsy (EHL) and Ho:YAG laser lithotrites can treat these renal calculi in a minimally invasive fashion with similar or superior results.

Mariani, Albert J.

2008-01-01

134

Classification of bicovariant differential calculi on quantum groups of type A, B, C and D  

International Nuclear Information System (INIS)

Under the assumptions that q is not a root of unity and that the differentials duij of the matrix entries span the left module of first order forms, we classify bicovariant differential calculi on quantum groups An-1, Bn, Cn and Dn. We prove that apart one dimensional differential calculi and from finitely many values of q, there are precisely 2n such calculi on the quantum group An-1 = SLq(n) for n ? 3. All these calculi have the dimension n2. For the quantum groups Bn, Cn and Dn we show that except for finitely many q there exist precisely two N2-dimensional bicovariant calculi for N ? 3, where N = 2n + 1 for Bn and N = 2n for Cn, Dn. The structure of these calculi is explicitly described and the corresponding ad-invariant right ideals of ker ? are determined. In the limit q ? 1 two of the 2n calculi for An-1 and one of the two calculi for Bn, Cn and Dn contain the ordinary classical differential calculus on the corresponding Lie group as a quotient. (orig.)

1995-02-01

135

Obstructive ejaculatory duct calculi in a patient with bladder augmentation and myelomeningocele.  

Science.gov (United States)

Symptomatic ejaculatory duct (ED) calculi, typically composed of uric acid, carbonate apatite and calcium phosphate, or calcium phosphate in the form of hydroxyapatite, are rare occurrences. We report a case of bilateral, large ED calculi in a patient with spina bifida myelomeningocele and an augmented neurogenic bladder. A 25-year-old Caucasian male, not compliant with his urological management, presented with abdominal pain, difficulty in self-catheterization, nausea and vomiting. Two of eight large struvite calculi, which blocked the urethra, were identified at the right ED. After endoscopic calculi removal, further management included bladder irrigation and infection control modalities. This case highlights the importance of clean intermittent catheterization, bladder irrigation, and routine urologic management necessary for patients with myelodysplasia and neurogenic bladder. It is the first recorded case to demonstrate the augmented bladder as an initiator of ejaculatory duct calculi in patients with an open bladder neck and spastic external sphincter. PMID:20970384

Gor, Ronak A; Woodhouse, Christopher R J; Schober, Justine M

2011-04-01

136

Comparative study of minimally invasive endoscopic surgery and extracorporeal shock wave lithotripsy (ESWL for proximal ureteral calculi in pilots  

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Full Text Available Objective?To observe and compare the therapeutic effect of extracorporeal shock wave lithotripsy (ESWL and minimally invasive endoscopic surgery (URL/PCNL for proximal urinary calculi in pilots. Methods?A retrospective analysis was conducted for the clinical data of 115 pilots who had received ESWL, URL and PCNL for the treatment of proximal urinary tract calculi from Sep, 2005 to Sep, 2012. The patients were divided into two groups according to the way of treatment: ESWL group (n=83 and URL/PCNL group (n=32. In ESWL group, the patients received ESWL for a maximum of 3 times. In URL/PCNL group, the patients received URS or PCNL after ESWL for 3 times without lithecbole. Results?All the patients were male and the mean age was 36.1±9.1 years. The average diameter of the stones was 0.68±0.22cm in ESWL group and 0.78±0.25cm in URL/PCNL group. There was no significant difference in stone diameter between the two groups (P=0.526. The rate of qualification for flying was 68.7% in ESWL group and 81.3% in URL/PCNL group (URL 80.0%, PCNL 100%, showing a significant difference (P=0.002. In ESWL group, the rate of qualification for flying of pilots harboring renal and proximal ureteral stone, middle ureteral stone and distal ureteral stone was 64.3%, 88.9% and 33.3% respectively, with a significant difference (P=0.023. The rate of flying qualification of pilots harboring proximal ureteral stone, middle ureteral stone and distal ureteral stone was 71.4%, 86.7% and 87.5% respectively after URL, and there was no significant difference (P=0.174. Among the five patients who received URL but did not achieve satisfactory effect, two had stones retreated to the renal pelvis during the operation, and in two patients distal ureter was too narrow to allow passage of ureteroscope, and the ureteroscope was enveloped by inflammatory polyp in one patient. Conclusion?URL/PCNL maybe more effective than ESWL in the treatment of proximal urinary calculus in pilots, and it may enable them to fly again. DOI: 10.11855/j.issn.0577-7402.2013.12.14

He-qing GUO

2014-01-01

137

Unusual Clinical Presentation of Bilateral Adult Non-Obstructing Ureteroceles Containing Urinary Stones  

Directory of Open Access Journals (Sweden)

Full Text Available Ureterocele, while not an uncommon pediatric urologic problem, has been reported only rarely in adults. Adult bilateral ureteroceles with calculi is an uncommon and well tolerated, relatively rare clinical entity. Although ureteroceles in adults are usually asymptomatic, various symptoms tend to appear in ureteroceles with stones, such as flank pain, urinary tract infections and bladder irritability. While ureteroceles occur more commonly in women, stones in ureteroceles tend to be more common in men. Most ureteroceles can be safely managed transurethrally endoscopically which is generally well tolerated by most patients. We present an unusual clinical presentation of bilateral adult non-obstructing ureteroceles containing urinary stones.

Mustafa Ho?can

2010-01-01

138

Urinary ascites.  

Science.gov (United States)

A middle-aged male presented with abdominal pain and ascites following a fall in alcoholic intoxicated state. Evaluation revealed microscopic hematuria and severe renal failure. Ascitic fluid analysis showed high urea and creatinine values suggesting it to be a urinary ascites. Retrograde cystography confirmed intraperitoneal bladder rupture. Following continuous bladder drainage ascites subsided and serum creatinine has reduced to 3 mg/dL. This case report highlights the importance of ascitic fluid analysis as a pointer to diagnose urinary ascites secondary to intraperitoneal bladder rupture. PMID:22787320

Abirami, K; Sivaramakrishna, G; Lakshmi, A Y; Sivakumar, V

2012-03-01

139

[Clinical application of Modulith SL20 on extracorporeal shock wave lithotripsy for upper urinary tract calculi].  

Science.gov (United States)

Thirty-nine patients, 27 males and 12 females with renal and ureteral stones, were treated using the Modulith SL 20 between October 1990 and January 1991. Thirty-three of the 39 cases had a single session of extracorporeal shockwave lithotripsy (ESWL) and the other six cases had two sessions. The pulverization rate of ESWL by this device was 84.6%. According to the X-rays taken 21 days after ESWL, of the 37 cases, 14 (37.8%) were stone-free, 18 (48.7%) had residual sandy stones less than 4 mm in diameter, five (13.5%) had residual stone fragments larger than 4.1 mm in diameter, and two cases were not clear. Using the criterion of cases which can be expected to have spontaneous passage, in other words, residual stones less than 4 mm in diameter, lithotripsy with the Modulith SL 20 was regarded as "effective" in 32 of the 37 cases (86.5%). As side effects of this treatment, hematuria was observed for several days after ESWL in all patients, but not other serious complications were observed. Among the 37 cases in which the grade could be evaluated the evaluation for 24 (64.9%) was "useful" and that for 13 (35.1%) "useful to some extent". Therefore, ESWL was performed very successfully. PMID:1785405

Tanda, H; Kato, S; Ohnishi, S; Nakajima, H; Ujiie, T; Maruta, H

1991-12-01

140

Management patterns of medicare patients undergoing treatment for upper urinary tract calculi.  

Science.gov (United States)

Abstract Purpose: We conducted this study to identify differences in the re-treatment rates and ancillary procedures for the two most commonly utilized stone treatment procedures in the Medicare population: ureteroscopy (URS) and shock wave lithotripsy (SWL). Materials and Methods: A retrospective claims analysis of the Medicare standard analytical file 5% sample was conducted to identify patients with a new diagnosis of urolithiasis undergoing treatment with URS or SWL from 2009-2010. Outcomes evaluated: (1) repeat stone removal procedures within 120 days post index procedure, (2) stent placement procedures on the index date, 30 days prior to and 120 days post index date, and (3) use of general anesthesia. Results: We identified 3885 eligible patients, of which 2165 (56%) underwent SWL and 1720 (44%) underwent URS. Overall, SWL patients were 1.73 times more likely to undergo at least one repeat procedure than URS patients, and twice as likely to require multiple re-treatments compared to URS. Among those with ureteral stones, SWL patients were 2.27 times more likely to undergo repeat procedures. The difference was not statistically significant in renal stone patients. Overall, SWL patients were 1.41 times more likely than URS patients to have a stent placed prior to index procedure, and 1.33 times more likely to have a stent placed subsequent to the index procedure. The majority of URS patients (77.8%) had a stent placed at the time of index procedure. There was no significant difference in anesthetic approaches between SWL and URS. Conclusions: Patients undergoing SWL are significantly more likely to require re-treatments than URS patients. SWL patients are also significantly more likely to require ureteral stent placement as a separate event. SWL and URS patients have similar rates of general anesthesia. PMID:24344933

Matlaga, Brian R; Meckley, Lisa M; Kim, Micheline; Byrne, Thomas W

2014-06-01

 
 
 
 
141

Comparative spectroscopic analysis of urinary calculi inhibition by Larrea Tridentata infusion and NDGA chemical extract  

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In the present comparative spectroscopic study we try to understand calcium oxalate kidney stone formation as well as its inhibition by using a traditional medicine approach with Larrea Tridentata (LT) herbal extracts and nordihydroguaiaretic acid (NDGA), which is a chemical extract of the LT bush. The samples were synthesized without and with LT or NDGA using a simplified single diffusion gel growth technique. While the use of infusion from LT decreases the sizes of calcium oxalate crystals and also changes their structure from monohydrate for pure crystals to dihydrate for crystals grown with different amounts of inhibitor, both Raman and infrared absorption spectroscopic techniques, which are the methods of analysis employed in this work, reveal that NDGA is not responsible for the change in the morphology of calcium oxalate crystals and does not contribute significantly to the inhibition process. The presence of NDGA slightly affects the structure of the crystals by modifying the strength of the C-C bonds as seen in the Raman data. Also, the current infrared absorption results demonstrate the presence of NDGA in the samples through a vibrational line that corresponds to the double bond between carbon atoms of the ester group of NDGA.

Manciu, Felicia

2012-10-01

142

Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review  

Science.gov (United States)

Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of various ailments. Today large number of population suffers from kidney stone, gall stone and urinary calculi. Stone disease has gained increasing significance due to changes in living conditions i.e. industrialization and malnutrition. Changes in prevalence and incidence, the occurrence of stone types and stone location, and the manner of stone removal are explained. Medicinal plants are used from centuries due to its safety, efficacy, cultural acceptability and lesser side effects as compared to synthetic drugs. The present article deals with measures to be adopted for the potential of medicinal plants in stone dissolving activity. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

Alok, Shashi; Jain, Sanjay Kumar; Verma, Amita; Kumar, Mayank; Sabharwal, Monika

2013-01-01

143

Sequent Calculi for the classical fragment of Bochvar and Halldén's Nonsense Logics  

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Full Text Available In this paper sequent calculi for the classical fragment (that is, the conjunction-disjunction-implication-negation fragment of the nonsense logics B3, introduced by Bochvar, and H3, introduced by Halldén, are presented. These calculi are obtained by restricting in an appropriate way the application of the rules of a sequent calculus for classical propositional logic CPL. The nice symmetry between the provisos in the rules reveal the semantical relationship between these logics. The Soundness and Completeness theorems for both calculi are obtained, as well as the respective Cut elimination theorems.

Marcelo E. Coniglio

2013-03-01

144

Differential calculi on quantum (sub)groups and their classical limit  

CERN Document Server

For the two-parameter matrix quantum group GLp,q(2) all bicovariant differential calculi (with a four-dimensional space of 1-forms) are known. They form a one-parameter family. Here, we give an improved presentation of previous results by using a different parametrization. We also discuss different ways to obtain bicovariant calculi on the quantum subgroup SLq(2). For those calculi, we do not obtain the ordinary differential calculus on SL(2) in the classical limit. The structure which emerges here can be generalized to a nonstandard differential calculus on an arbitrary differentiable manifold and exhibits relations with stochastic calculus and "proper time" relativistic quantum theories.

Müller-Hoissen, F

1994-01-01

145

Urinary ascites  

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A middle-aged male presented with abdominal pain and ascites following a fall in alcoholic intoxicated state. Evaluation revealed microscopic hematuria and severe renal failure. Ascitic fluid analysis showed high urea and creatinine values suggesting it to be a urinary ascites. Retrograde cystography confirmed intraperitoneal bladder rupture. Following continuous bladder drainage ascites subsided and serum creatinine has reduced to 3 mg/dL. This case report highlights the importance of asciti...

Abirami, K.; Sivaramakrishna, G.; Lakshmi, A. Y.; Sivakumar, V.

2012-01-01

146

Radiologic contribution to the extracorporeal lithotripsy treatment of calyceal diverticular calculi  

International Nuclear Information System (INIS)

The authors reviewed the radiologic studies in 19 patients with calyceal diverticular calculi treated with extracorporeal lithotripsy (EL) in order to establish criteria predicting successful outcome. Pre-EL imaging was performed to evaluate the size of calculus in relation to the diverticular cavity, and the width of the connection of the diverticulum to the adjacent calyx. Post-EL studies were performed to assess fragmentation and passage of fragments. EL fragmented calculi in 15 diverticula with cavities larger than stone volume. Complete passage of fragments was shown in five patients and partial passage in two, all with wide diverticular necks. No passage was seen in eight diverticular with fragmented calculi, five of which had narrow or nondemonstrable necks. The radiologic demonstration of large diverticular correlates well with effective EL fragmentation, and a wide neck results in satisfactory fragment passage. Calculi in tight, narrowly communicating diverticula are unlikely to respond to EL

1987-12-04

147

The treatment of ureteric calculi before and after the introduction of extracorporeal shockwave lithotripsy.  

DEFF Research Database (Denmark)

Indications and treatment results of ureteric calculi one year before and one year after the introduction of ESWL were analysed in 169 consecutive patients. Sex, age, former stone operation, stone localisation and stone size were not significantly different in the two groups. Before ESW1 47% of the patients received treatment against 54% after the introduction (p > 0.3). There was no tendency towards treatment of smaller calculi. Expectedly, the number of endoscopies and ureterolithotomies was significantly reduced (p < 0.05). The treatment period (from first contact till final control) was longer with ESWL, but not significantly. Judged from the length of the hospital stay there was no major economic benefit from ESWL. In conclusion, ESWL with a second generation lithotriptor is suitable for in situ treatment of ureteric calculi. It should be first choice for ureteric calculi.

Gade, J; Holtveg, H

1995-01-01

148

A Syntactic Correspondence between Context-Sensitive Calculi and Abstract Machines  

DEFF Research Database (Denmark)

We present a systematic construction of environment-based abstract machines from context-sensitive calculi of explicit substitutions, and we illustrate it with ten calculi and machines for applicative order with an abort operation, normal order with generalized reduction and call/cc, the lambda-mu-calculus, delimited continuations, stack inspection, proper tail-recursion, and lazy evaluation. Most of the machines already exist but have been obtained independently and are only indirectly related to the corresponding calculi. All of the calculi are new and they make it possible to directly reason about the execution of the corresponding machines. In connection with the functional correspondence between evaluation functions and abstract machines initiated by Reynolds, the present syntactic correspondence makes it possible to construct reduction-free normalization functions out of reduction-based ones, which was an open problem in the area of normalization by evaluation.

Biernacka, Malgorzata; Danvy, Olivier

2005-01-01

149

Percutaneous displacement of calyceal calculi. Adjunct to percutaneous nephrolithotripsy.  

Science.gov (United States)

Two cases are presented of successful percutaneous removal of adherent calyceal calculi which were initially inaccessible for removal with the rigid nephroscope. In each case, the calculus was dislodged from the calyceal wall by the direct force of a needle introduced percutaneously against the stone. In the first patient, a wedged calyceal calculus was dislodged percutaneously and manipulated into the renal pelvis the day before extraction using the rigid nephroscope. In the second patient, the adherent calculus was dislodged percutaneously at the same time of endoscopic removal. In both patients, prior carbon dioxide pyelography was helpful in determining the optimum direction for advancing the needle against the calculus. Percutaneous stone dislodgement technique is a useful adjunct to percutaneous nephroscopic removal of the difficult calyceal calculus. PMID:4049614

Chang, R; Marshall, F F; Auster, M; Mitchell, S E

1985-10-01

150

Arithmetical proofs of strong normalization results for symmetric lambda calculi  

CERN Multimedia

We give arithmetical proofs of the strong normalization of two symmetric $\\lambda$-calculi corresponding to classical logic. The first one is the $\\bar{\\lambda}\\mu\\tilde{\\mu}$-calculus introduced by Curien & Herbelin. It is derived via the Curry-Howard correspondence from Gentzen's classical sequent calculus LK in order to have a symmetry on one side between "program" and "context" and on other side between "call-by-name" and "call-by-value". The second one is the symmetric $\\lambda \\mu$-calculus. It is the $\\lambda \\mu$-calculus introduced by Parigot in which the reduction rule $\\mu'$, which is the symmetric of $\\mu$, is added. These results were already known but the previous proofs use candidates of reducibility where the interpretation of a type is defined as the fix point of some increasing operator and thus, are highly non arithmetical.

David, René

2009-01-01

151

Porfirinas en Cálculos Renales (Revisión) / Porphyrins in renal calculi (Review)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Hemos realizado una revisión del contenido de porfirinas en una clase peculiar de cálculos renales. Estos son negros como el carbón y presentan un espectro infrarrojo (EIR) similar al conocido como "materia orgánica", el cual no indica la clase de sustancia a la que corresponde. Otros tipos de cálcu [...] los renales, principalmente de pequeño tamaño y eliminados espontáneamente, pueden tener un compuesto oscuro o negro de forma difusa o aislada y presentan un espectro de IR similar al de "materia orgánica". Después de observar que la hemoglobina presentaba un espectro de IR de "materia orgánica", estudiamos, por cromatografía en capa fina, un método sensible para la determinación de porfirinas, la presencia de porfirinas en diversos tipos de cálculos renales negros y oscuros, ya que las porfirinas son los precursores del grupo hemo. Este trabajo ha puesto de manifiesto dos tipos de porfirinas: la coproporfirina, en pacientes que padecen hepatopatías, y la uroporfirina y heptacarboxilporfirina en pacientes con algún tipo de porfiria o bien con fracaso renal crónico. Abstract in english We performed a review of the porphyrines content in a type of black, charcoal-like, renal calculi exhibiting infrarred spectra (IRS) similar to those characteristic of "organic material" which has not yet been fully elucidate. Several other types of renal calculi, mainly those of small size, spontan [...] eous passage renal stone, may also have diffuse or isolated dark charcoal components showing "organic material" IRS. After observing that haemoglobin has an "organic material" IRS, we studied, by a sensitive thin layer chromatography method, the presence of porphyrines in several types of dark or charcoal renal stones, since porphyrines are the physiological precursors of haemo group biosynthesis. We found two types of porphyrine content: coproporphyrin, in patients suffering from hepatopathy, and uroporphyrin and heptacarboxil-porphyrin in patients with some types of porphyria or with chronic renal failure.

Traba Villameytide, MªL..

152

US and MDCT findings in a caudal blind ending bifid ureter with calculi  

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Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU) and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US) and mainly with multidetector computerized tomography (MDCT) imaging using multiplanar reformats and 3-D reconstructions wh...

Evren Ustuner; Ebru Dusunceli Atman; Cemil Yagci; Zafer Nida Tokatli; Caglar Uzun

2011-01-01

153

Comparison of treatment of renal calculi by open surgery, percutaneous nephrolithotomy, and extracorporeal shockwave lithotripsy.  

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This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) pa...

1986-01-01

154

Reflections on the Future of Concurrency Theory in General and Process Calculi in Particular  

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In this report we review the current state of concurrency theory with respect to its industrial impact. This review is both retrospective and prospective, and naturally encompasses process calculi, which are a major vector for spreading concurrency theory concepts. Considering the achievements, but also the failures, we try to identify the causes that, so far, prevented a larger dissemination of process calculi. This suggests a new generation of formal specification languages that would combi...

Garavel, Hubert

2007-01-01

155

Urinary Incontinence in Men  

Science.gov (United States)

... of Topics and Titles : Urinary Incontinence in Men Urinary Incontinence in Men On this page: What causes UI ... Kegel exercises? Hope through Research For More Information Urinary incontinence (UI) is the accidental leakage of urine. At ...

156

Association of minor and trace elements with mineralogical constituents of urinary stones: a hard nut to crack in existing studies of urolithiasis.  

Science.gov (United States)

The role of metals in urinary stone formation has already been studied in several publications. Moreover, urinary calculi can also be used for assessing exposure of humans to minor and trace elements in addition to other biological matrices, for example, blood, urine, or hair. However, using urinary calculi for biomonitoring of trace elements is limited by the association of elements with certain types of minerals. In this work, 614 samples of urinary calculi were subjected to mineralogical and elemental analysis. Inductively coupled plasma mass spectrometry and thermo-oxidation cold vapor atomic absorption spectrometry were used for the determination of major, minor, and trace elements. Infrared spectroscopy was used for mineralogical analysis, and additionally, it was also employed in the calculation of mineralogical composition, based on quantification of major elements and stoichiometry. Results demonstrate the applicability of such an approach in investigating associations of minor and trace elements with mineralogical constituents of stones, especially in low concentrations, where traditional methods of mineralogical analysis are not capable of quantifying mineral content reliably. The main result of this study is the confirmation of association of several elements with struvite (K, Rb) and with calcium phosphate minerals, here calculated as hydroxylapatite (Na, Zn, Sr, Ba, Pb). Phosphates were proved as the most important metal-bearing minerals in urinary calculi. Moreover, a significantly different content was also observed for Fe, Zr, Mo, Cu, Cd, Se, Sn, and Hg in investigated groups of minerals. Examination of such associations is essential, and critical analysis of mineral constituents should precede any comparison of element content among various groups of samples. PMID:23430472

Kuta, J; Machát, J; Benová, D; ?ervenka, R; Zeman, J; Martinec, P

2013-08-01

157

Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients.  

Science.gov (United States)

Phyllanthus niruri is a plant used for years in Brazil to treat urinary calculi. We prospectively evaluated the effect of P. niruri intake on 24 h urinary biochemical parameters in an attempt to assess its in vivo effect in calcium stone forming (CSF) patients. A total of 69 CSF patients (39 males and 30 females, 38+/-8 years old) were randomized to take either P. niruri ( n=33) (450 mg capsules, td) or placebo ( n=36) for 3 months. Blood calcium, uric acid, citrate, magnesium, oxalate, sodium and potassium were determined at baseline and at the end of the study. A subset analysis was made in patients classified according to the presence of metabolic abnormalities (hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia and hypomagnesiuria). Overall, there were no significant differences in the mean values of urinary parameters between the urine samples before and after P. niruri intake, except for a slight reduction in mean urinary magnesium after P. niruri, which was within the normal range. However, in the subset analysis, we observed that P. niruri induced a significant reduction in the mean urinary calcium in hypercalciuric patients (4.8+/-1.0 vs 3.4+/-1.1 mg/kg/24 h, P<0.05). In this short-term follow-up, no significant differences in calculi voiding and/or pain relief between the groups taking P. niruri or the placebo were detected. Our data suggest that P. niruri intake reduces urinary calcium based on the analysis of a subset of patients presenting with hypercalciuria. Larger trials including primary hypercalciuric stone formers should be performed in order to confirm these findings and to determine the possible clinical consequences of urinary calcium reduction during P. niruri administration. PMID:15221244

Nishiura, J L; Campos, A H; Boim, M A; Heilberg, I P; Schor, N

2004-10-01

158

Urinary incontinence - injectable implant  

Science.gov (United States)

... repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

159

Transureteral Lithotripsy of Ureteral Calculi in Children with Holmium: Yttrium Aluminium Garnet Laser  

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Full Text Available INTRODUCTION: Surgical management of pediatric urinary calculi evolved dramatically over the past two decades. However, with the miniaturization of equipment and with improvisation of endourologic techniques, access to the entire pediatric urinary system is possible. Ho: YAG laser provides more maneuverability during transuretereal lithotripsy (TUL than the pneumatic system which uses a metal probe, especially when used in pediatrics urinary systems. In this study, we report our experience about treatment of pediatric ureteral stone with HO: YAG laser.METHODS: Between 2008 -2011, 41 children ? 12 years of age with ureteral stones were included in our study. Using K.U.B, sonography, and intravenous urogram, diagnoses were established for all patients. 6F or 8F wolf semi rigid ureteroscope was used for ureteroscopy under general anesthesia and stone fragmentation was implemented by Ho: YAG laser. For the evaluation of stone free rate, we used the following day & week confirmatory KUB, and sonograms additional to the direct visualization of the ureter during ureteroscopy. The patients were scheduled to be followed by control sonograms 2 weeks and 2 months after the operation to rule out past operational ureteral stenosis.RESULTS: From our 40 patients whose ages were in the range of 8 months and twelve years of old with a mean age 3.5 years, 18 patients (45% had distal ureteral stones, ten (25% in mid ureter, and twelve of them (30% had the stone in their proximal ureter. The mean diameter of stones was 9.3 mm (3.5-11 mm. Three patients had encrusted double j stents (DJS. Our overall stone free rate was 89.35% at the end of 1 week. The complications were fever in 5 patients (12.5% and ureteral stricture due to ureteral perforation in one patient, while one patient had long hospital stay due to refractory pain and nausea. The mean time of post-surgical hospital stay was 42 hours, while for only 20% of patients (8 patients and in the rest of patients (30 patients this period was only 24hours.DISCUSSION: Endoscopic lithotripsy in children has gradually become a major technique for the treatment of ureteral stones. This progression has been on the basis of the development of appropriate endoscopes and effective working instruments. The stone-free rate following urteroscopic lithotripsy for ureteral stones has been reported in as high as 98.5-100%. In this study, overall stone free rate was 89.35%. The complications after ureteroscopic laser lithotripsy are uncommon and usually related to passage of the ureteroscope than from laser action. Fever was the most common complication which occurred in 5 (12.5% of our patients despite the fact that all patients were hospitalized the day before the procedure and were under parenteral antibiotic therapy. Postoperative stenting after ureteroscopic lithotripsy remained controversial. Most children were able to tolerate the attached string and the stent could be removed 5-7 days after without the use of an additional anesthetic. We used suitable ureteral catheters for 24 hours in all patients.CONCLUSION: Although HO: YAG laser lithotripsy is safe in children, we need more controlledtrials to show the best method of lithotripsy in pediatric ureteral stones.

Farzin Sheikh Monazzah

2012-02-01

160

The frequency of kidney and urinary tract diseases in a defined population.  

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The frequencies of kidney and urinary tract diseases (KUTD) in a defined population are presented. Rates of first hospitalizations with KUTD in the 5-year period, 1971 through 1975, were determined among over 1 million members of the Kaiser Foundation Health Plan (KFHP) of Northern California. Cases were identified from computer-stored ICDA-coded final discharge diagnoses for hospitalizations. Kidney and other urinary tract diseases were final diagnoses in 35.7 first hospitalizations per 10,000 members per year in the period 1971 through 1975. Disease-specific rates were highest for urinary tract infections, benign prostatic hypertrophy, and renal and ureteral calculi. The frequency of KUTD in this population is compared to available rates from other sources. PMID:6181284

Hiatt, R A; Friedman, G D

1982-07-01

 
 
 
 
161

Clinical observation of different minimally invasive surgeries for the treatment of impacted upper ureteral calculi.  

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Objective: To compare the clinical effects of three minimally invasive surgeries on the treatment of impacted upper ureteral calculi. Methods: 135 patients with impacted upper ureteral calculi were selected and randomly divided into three groups (Group A-C) (n=45), which were treated with transurethral ureteroscopic lithotripsy, minimally invasive percutaneous nephrolithotomy, and retroperitoneal laparoscopic ureterolithotomy respectively. Relevant results of the three groups were compared. Results: The surgery time of Group C was significantly longer than those of Group A and Group B (P extracorporeal shock wave lithotripsy, being significantly more than those in Group B (6.67%, 3/45) and Group C (0, 0/45) (P 0.05). Conclusion: The three surgical methods for impacted upper ureteral calculi should be selected according to practical conditions to improve therapeutic effects and to ensure safe surgery. PMID:24550953

Liu, Yuanhua; Zhou, Zhangyan; Xia, An; Dai, Haitao; Guo, Linjie; Zheng, Jiang

2013-11-01

162

Proceedings Fourth Workshop on Membrane Computing and Biologically Inspired Process Calculi 2010  

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The 4th Workshop on Membrane Computing and Biologically Inspired Process Calculi (MeCBIC 2010) is organized in Jena as a satellite event of the Eleventh International Conference on Membrane Computing (CMC11). Biological membranes play a fundamental role in the complex reactions which take place in cells of living organisms. The importance of this role has been considered in two different types of formalisms introduced recently. Membrane systems were introduced as a class of distributed parallel computing devices inspired by the observation that any biological system is a complex hierarchical structure, with a flow of biochemical substances and information that underlies their functioning. The modeling and analysis of biological systems has also attracted considerable interest of the process algebra research community. Thus the notions of membranes and compartments have been explicitly represented in a family of calculi, such as ambients and brane calculi. A cross fertilization of these two research areas has ...

Ciobanu, Gabriel; 10.4204/EPTCS.40

2010-01-01

163

US and MDCT findings in a caudal blind ending bifid ureter with calculi  

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Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US and mainly with multidetector computerized tomography (MDCT imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

Caglar Uzun

2011-07-01

164

US and MDCT findings in a caudal blind ending bifid ureter with calculi  

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Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US and mainly with multidetector computerized tomography (MDCT imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

Caglar Uzun

2011-09-01

165

Analytical scanning electron microscopy and x-ray microdiffractometry of renal calculi using etched plastic sections  

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We describe the technique and illustrate results of renal calculi analyses utilizing correlative analytical scanning electron microscopy and x-ray microdiffractometry on the same 100 micrometer Spurr embedded sections. Essential to the technique is the employment of an extremely sensitive x-ray microdiffractometer, and for morphological analysis, pretreatment of the sections with a sodium ethoxide etching solution. This technique facilitates more precise identification of crystalline constituents especially calcium apatite and magnesium ammonium phosphate hexahydrate (struvite). Further, the technique permits detection and mapping of both crystalline and amorphous constituents within calculi.

Cheng, P.T.; Pritzker, K.P.; Tausch, J.; Pittaway, A.; Millard, J.

1981-01-01

166

Transitional cell carcinoma of the ureter and struvite calculi  

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CONTEXT: The association of primary carcinoma of the ureter and lithiasis is extremely rare. We report a rare case of a primary carcinoma of the ureter with corariform calculus. CASE REPORT: 60-year-old phaeodermal female, reported a history of right-side nephritic colic, hyperthermia and pyuria during the past 20 years and had received treatment for urinary infections a number of times. The first clinical presentation was related to lithiasis and the tumor had not been shown up by excretory ...

Danielo Garcia de Freitas; Adriano Scaff Garcia; Osvaldo de Freitas Filho

1999-01-01

167

Urinary incontinence products  

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There are many products to help you manage urinary incontinence . You can decide which product to choose based ... clean and dry your skin. WHERE TO BUY URINARY INCONTINENCE PRODUCTS You can find most products at your ...

168

O que há de novo no diagnóstico e tratamento da litíase urinária? What's new in the diagnosis and management of urinary lithiasis?  

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Full Text Available OBJETIVO. Atualizar aspectos do diagnóstico e do tratamento da litíase urinária. MÉTODOS. Uma revisão dos principais artigos publicados sobre o tema em revistas indexadas no "Medline" entre 1979 e 2009. RESULTADOS. A ocorrência de cálculos é maior em pacientes com IMC > 30. A TC sem contraste promove o diagnóstico correto em até 98% dos casos. O uso de bloqueadores alfa-adrenérgicos aumenta a eliminação de cálculos ureterais menores que 8 mm em 29%. O índice de pacientes livres de cálculo após LEOC varia entre 35% e 91%, conforme seu tamanho e localização. Cálculos renais maiores que 2 cm são eliminados pela NLPC entre 60% e 100% dos casos. Cálculos de ureter distal são tratados com sucesso em até 94% dos casos pela ureteroscopia semirrígida contra 74% da LEOC. Já para cálculos de ureter superior as taxas de sucesso situam-se entre 77% e 91% para ureteroscopia e 41% e 82% para a LEOC. CONCLUSÃO. A associação da calculose urinária com obesidade e Diabetes mellitus está bem estabelecida. A TC sem contraste é atualmente o padrão-ouro no diagnóstico da litíase urinária. A LEOC é o método de eleição em nosso meio para tratamento de cálculos renais menores que 2 cm e com densidade tomográfica OBJECTIVE. To review developments in the diagnosis and treatment of urinary lithiasis. METHODS. A review of the most important articles on the subject published in Medline indexed periodicals between 1979 and 2009.RESULTS. Stones occur with greater frequency among people with BMI > 30. Computerized tomography without contrast provides the correct diagnosis in up to 98% of cases. Alpha-adrenergic blockers increase elimination of ureteral calculi smaller than 8 mm by 29%. The proportion of patients free from calculi after ESWL varies from 35% to 91%, depending on size and location. In between 60% and 100% of cases, renal calculi larger than 2 cm are eliminated with PCNL. Calculi of the distal ureter are successfully treated in up to 94% of cases using semi-rigid ureteroscopy, compared to 74% using ESWL. For calculi of the upper ureter success rates are around 77% and 91% for ureteroscopy and 41% and 82% for ESWL. CONCLUSION. The association between urinary lithiasis and Diabetes mellitus, is well-established. Computerized tomography without contrast is currently the gold standard for diagnosis of urinary lithiasis. In Brazil, ESWL is the method of choice for treating renal calculi smaller than 2 cm and with tomographic density < 1000 HU, except those of the lower pole, where the ideal limit for treatment is 1 cm. Percutaneous nephrolithotripsy is the best method of treating renal calculi larger than 2 cm and semi-rigid ureteroscopy is the best treatment for calculi of the distal ureter. Flexible ureteroscopy is an option for calculi of the upper ureter and renal calculi smaller than 1.5 cm that do not respond to ESWL or where PCNL is contraindicated.

Eduardo Mazzucchi

2009-01-01

169

Ureteropyeloscopy and homium: YAG laser lithotripsy for treatment of ureteral calculi (report of 356 cases)  

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Objective: To evaluate the efficacy and safety of holmium YAG laser lithotripsy for the treatment of ureteral calculi. Methods: A total of 356 patients underwent ureteropyeloscopic lithotripsy using holmium YAG laser with a semirigid uretesopyeloscope, 93 upper, 135 middle, and 128 lower ureteral stones were treated. Results: The overall successful fragmentation rate for all ureteral stones in a single session achieved 98% (349/356). The successful fragmentation rate stratified by stone location was 95% 88/93 in the upper ureter, 99% (134/135) in the mid ureter , and 99%(127/128) in the distal ureter. 12 cases with bilateral ureteral stones which caused acute renal failure and anuria were treated rapidly and effectively by the holmium YAG laser lithotripsy. No complications such as perforation and severe trauma were encountered during the operations. 2 weeks 17months (with an average of 6.8 month ) follow up postoperatively revealed that the overall stone-free rate was 98%(343/349) and no ureteral stenosis was found. Conclusions Holmium YAG laser lithotripsy is a highly effective, minimally invasive and safe therapy for ureteral calculi. It is indicated as a first choice of treatment for patients with ureteral calculi, especially for the ones with mid- lower levels of ureteral calculi.

Wu, Zhong; Din, Qiang; Jiang, Hao-wen; Zen, Jing-cun; Yu, Jiang; Zhang, Yuanfang

2005-07-01

170

Epidural anesthesia is effective for extracorporeal shock wave lithotripsy of pancreatic and biliary calculi  

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Full Text Available AIM: To evaluate the efficacy of thoracic epidural analgesia for extracorporeal shock wave lithotripsy (ESWL.METHODS: ESWL is an effective, non-invasive technique for the treatment of difficult pancreatic and large bile duct calculi. The procedure is often painful and requires large doses of analgesics. Many different anesthetic techniques have been used. Patients with either large bile duct calculi or pancreatic duct calculi which could not be extracted by routine endoscopic methods were selected. Thoracic epidural anesthesia (TEA was routinely used in all the subjects unless contraindicated. Bupivacaine 0.25% with or without clonidine was used to block the segments D6 to D12. The dose was calculated depending on the age, height and weight of the patient. It was usually 1-2 mL per segment blocked.RESULTS: Ninety eight percent of the 1509 patients underwent ESWL under TEA. The subjects selected were within American Society of Anesthesiologists grade?I?to?III. ESWL using EA permitted successful elimination of bile duct or pancreatic calculi with minimal morbidity. The procedure time was shorter in patients with TEA than in those who underwent ESWL under total intravenous anesthesia.CONCLUSION: Almost all patients undergoing ESWL with EA had effective blocks with a single catheter insertion and local anesthetic injection.

Santosh Darisetty

2010-05-01

171

Elementos no frecuentes en cálculos renales / Unusual elements in renal calculi  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Se analizó un grupo de 54 cálculos expulsados espontáneamente después de padecer un cólico nefrítico. Dos grupos de cálculos fueron encontrados: papilares y no papilares. Todos los cálculos fueron analizados por espectroscopia infrarroja y por microscopia electrónica de barrido y EDAX. Al ser analiz [...] ados los cálculos por EDAX se detectaron los siguientes elementos químicos; C, N, O, Na, S, Mg, Al, Si, Cl, K, Ca, Mn, Fe, Ni, Zn. El posible origen de estos elementos es analizado en este trabajo. Abstract in english A group of 54 renal calculi were spontaneously passed renal stone after a nephritic colic. Two groups of calculi were found: papillary and non-papillary calculi. All calculi were analyzed by infrared spectroscopy and electronic microscopy scan (EMS) and EDAX. When the stones were analyzed with EDAX, [...] elements such as C, N, O, Na, S, Mg, Al, Si, Cl, K, Ca, Mn, Fe, Ni, Zn were detected. The possible origin of these elements is discussed in this work.

Rodríguez-Miñón Cifuentes, J.L.; Salvador, E.; Traba Villameytide, MªL..

172

Male urinary incontinence and the urinary sheath.  

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This article addresses the assessment and management of male incontinence with a specific focus on the use of the male external catheter (MEC) or urinary sheath. Education and expertise when dealing with a man with urinary incontinence, as well as a tactful and sensitive attitude towards this embarrassing problem, are essential for a successful outcome. The urinary sheath is often perceived by nurses and patients as a difficult product to master and is prone to failure owing to incorrect fitting and management. With correct usage it can make a great difference to a patient's quality of life and avoid problems often associated with urinary catheters and pads such as urinary infection and skin excoriation. Detailed assessment of the patient as well as his suitability for the MEC is essential for a successful outcome. PMID:24820510

Smart, Clare

2014-05-01

173

Polycystic kidney disease with renal calculi treated by percutaneous nephrolithotomy: a report of 11 cases.  

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Objective: To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the treatment of congenital autosomal dominant polycystic kidney disease (ADPKD) with renal calculi. Methods: A total of 11 cases of ADPKD with renal calculi were retrospectively studied. All cases were treated by PCNL and clinical parameters such as age, sex, stone burden, operation time, blood loss, complications and perioperative serum creatinine levels were collected and analyzed. All patients were routinely followed up for 36 months postoperatively and the efficacy and safety of PCNL in the management of ADPKD with renal calculi were assessed. Results: All procedures were successful without conversion to open surgery. The mean stone burden was 3.4 ± 0.7 cm (range 2.5-4.6 cm). The overall stone clearance rate was 81.8% (9/11). Two patients received extracorporeal shock wave lithotripsy postoperatively because of residual calculi. The mean operation time was 77 ± 23.5 min (range 45-128 min) and the mean blood loss was 147 ± 56 ml (range 80-260 ml). The mean preoperative serum creatinine level was 15.13 ± 3.30 mg/dl (range 9.90-20.14 mg/dl) and the mean postoperative serum creatinine level was 14.28 ± 2.24 mg/dl (range 10.76-17.28 mg/dl). Four cases had fever postoperatively (36.4%). Three patients had hemorrhage and two patients received blood transfusion. No patient had peripheral viscera injury. Statistical comparison showed that PCNL had no impact on perioperative renal function (p > 0.05). Conclusions: In spite of anatomical deformation and impairment of renal function, PCNL is an effective and safe procedure in managing ADPKD with renal calculi. © 2014 S. Karger AG, Basel. PMID:24481047

Zhang, Junhui; Zhang, Jianzhong; Xing, Nianzeng

2014-01-01

174

O que há de novo no diagnóstico e tratamento da litíase urinária? / What's new in the diagnosis and management of urinary lithiasis?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO. Atualizar aspectos do diagnóstico e do tratamento da litíase urinária. MÉTODOS. Uma revisão dos principais artigos publicados sobre o tema em revistas indexadas no "Medline" entre 1979 e 2009. RESULTADOS. A ocorrência de cálculos é maior em pacientes com IMC > 30. A TC sem contraste promov [...] e o diagnóstico correto em até 98% dos casos. O uso de bloqueadores alfa-adrenérgicos aumenta a eliminação de cálculos ureterais menores que 8 mm em 29%. O índice de pacientes livres de cálculo após LEOC varia entre 35% e 91%, conforme seu tamanho e localização. Cálculos renais maiores que 2 cm são eliminados pela NLPC entre 60% e 100% dos casos. Cálculos de ureter distal são tratados com sucesso em até 94% dos casos pela ureteroscopia semirrígida contra 74% da LEOC. Já para cálculos de ureter superior as taxas de sucesso situam-se entre 77% e 91% para ureteroscopia e 41% e 82% para a LEOC. CONCLUSÃO. A associação da calculose urinária com obesidade e Diabetes mellitus está bem estabelecida. A TC sem contraste é atualmente o padrão-ouro no diagnóstico da litíase urinária. A LEOC é o método de eleição em nosso meio para tratamento de cálculos renais menores que 2 cm e com densidade tomográfica Abstract in english OBJECTIVE. To review developments in the diagnosis and treatment of urinary lithiasis. METHODS. A review of the most important articles on the subject published in Medline indexed periodicals between 1979 and 2009.RESULTS. Stones occur with greater frequency among people with BMI > 30. Computerized [...] tomography without contrast provides the correct diagnosis in up to 98% of cases. Alpha-adrenergic blockers increase elimination of ureteral calculi smaller than 8 mm by 29%. The proportion of patients free from calculi after ESWL varies from 35% to 91%, depending on size and location. In between 60% and 100% of cases, renal calculi larger than 2 cm are eliminated with PCNL. Calculi of the distal ureter are successfully treated in up to 94% of cases using semi-rigid ureteroscopy, compared to 74% using ESWL. For calculi of the upper ureter success rates are around 77% and 91% for ureteroscopy and 41% and 82% for ESWL. CONCLUSION. The association between urinary lithiasis and Diabetes mellitus, is well-established. Computerized tomography without contrast is currently the gold standard for diagnosis of urinary lithiasis. In Brazil, ESWL is the method of choice for treating renal calculi smaller than 2 cm and with tomographic density

Eduardo, Mazzucchi; Miguel, Srougi.

175

Aphallia with urethrorectal fistula, bladder and urethral calculi  

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Full Text Available Introduction: Aphallia is a very rare urogenital anomaly with incidence rate of 1 in 30,000,000. It usually coexists with other anomalies such as cardiovascular anomalies which are incompatible with normal life, and therefore infants are delivered stillbirth or live for a very short period of time. Methods: We present an 18 months old boy with aphallia associated with congenital urethrorectal fistula, bladder and urethral stones. All stones were removed endourologically, recto-urethral fistula was repaired and perincal urethrostomy was performed. Results: The stones were composed of calcium phosphate colonized by klebiella pneumonia and proteus mirabilis. Urethrorectal fistula repairment was confirmed by cystography. Patient was discharged without a urinary catheter. Conclusion: In developed countries, management of such patients is to raise them as females. However, we must consider socio-cultural conditions, parents preference and patients tendency in management of aphallia.

M Movarrekh

2006-04-01

176

Development of a urinary lithiasis localizer mechanism to couple ultrasound and extracorporeal lithotripsy equipment in canine model  

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Full Text Available SciELO Brazil | Language: English Abstract in english INTRODUCTION: Due to the evolution of extracorporeal lithotripsy equipment (ESWL) and presently, the fact that most part of the equipment does not present ultrasound to localize urinary calculi, a system that allows adapting ultrasound equipment to ESWL equipment was developed, disposing only of flu [...] oroscopy. Thus, this equipment was developed and was tested in urinary stones in canine models, to check its precision in relation to fluoroscopy. METHOD: Seven male dogs were utilized with the introduction, in the bladder through the ureteral route, of chalkstones, with initial localization by fluoroscopy, with a further ultrasound coincidence check localization of the vesical stones, being submitted to ESWL with a 3-hour, 21 days and 60 days follow-up after the procedure. RESULTS: Success of localization in all animals was verified presenting elimination of stones in the first micturitions, after ESWL. No complications were verified in those animals for 60 days. CONCLUSION: We verified that this equipment can lead to an update of the equipment that use only fluoroscopy, increasing in this way, their technical capacity in the treatment of urinary calculi, mainly in cases of non-radiopaque stones.

Enrico, Andrade; Gustavo, Alarcon; Eduardo, Pompeu; Archimedes, Nardozza Jr; Joaquim A., Claro; Valdemar, Ortiz; Miguel, Srougi.

177

Development of a urinary lithiasis localizer mechanism to couple ultrasound and extracorporeal lithotripsy equipment in canine model  

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Full Text Available INTRODUCTION: Due to the evolution of extracorporeal lithotripsy equipment (ESWL and presently, the fact that most part of the equipment does not present ultrasound to localize urinary calculi, a system that allows adapting ultrasound equipment to ESWL equipment was developed, disposing only of fluoroscopy. Thus, this equipment was developed and was tested in urinary stones in canine models, to check its precision in relation to fluoroscopy. METHOD: Seven male dogs were utilized with the introduction, in the bladder through the ureteral route, of chalkstones, with initial localization by fluoroscopy, with a further ultrasound coincidence check localization of the vesical stones, being submitted to ESWL with a 3-hour, 21 days and 60 days follow-up after the procedure. RESULTS: Success of localization in all animals was verified presenting elimination of stones in the first micturitions, after ESWL. No complications were verified in those animals for 60 days. CONCLUSION: We verified that this equipment can lead to an update of the equipment that use only fluoroscopy, increasing in this way, their technical capacity in the treatment of urinary calculi, mainly in cases of non-radiopaque stones.

Enrico Andrade

2006-10-01

178

FT-IR Analysis of Urinary Stones: A Helpful Tool for Clinician Comparison with the Chemical Spot Test  

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Background. Kidney stones are a common illness with multifactorial etiopathogenesis. The determination of crystalline and molecular composition and the quantification of all stone components are important to establish the etiology of stones disease but it is often laborious to obtain using the chemical method. The aim of this paper is to compare chemical spot test with FT-IR spectroscopy, for a possible introduction in our laboratory. Methods. We analyzed 48 calculi using Urinary Calculi Analysis kit in accordance with the manufacturer's instructions. The same samples were analyzed by FT-IR using the Perkin Elmer Spectrum One FT-IR Spectrometer. All FT-IR spectra of kidney stones were then computer matched against a library of spectra to generate a report on the various components. Results. On the basis of FT-IR analysis, the 48 calculi were divided into three groups: pure stone, mixed stone, and pure stone with substances in trace. Results of each group were compared with those obtained with chemical spot test. A general disagreement between methods was observed. Conclusions. According to our data, the introduction of the FT-IR technique in clinical chemistry laboratory may be more responsive to clinician expectations.

Primiano, Aniello; D'Addessi, Alessandro; Cocci, Andrea; Schiattarella, Arcangelo; Zuppi, Cecilia

2014-01-01

179

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) for the treatment of distal ureteral calculi with respect to patient satisfaction. MATERIALS AND MHETODS: This is a prospective study where a total of 212 patients with solitary, radiopaque dis [...] tal ureteral calculi were treated with ESWL (n = 92) using Dornier lithotriptor S (MedTech Europe GmbH) or URS (n = 120). Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p

Ibrahim F., Ghalayini; Mohammed A., Al-Ghazo; Yousef S., Khader.

180

Swapping: a natural bridge between named and indexed explicit substitution calculi  

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Full Text Available This article is devoted to the presentation of lambda_rex, an explicit substitution calculus with de Bruijn indexes and a simple notation. By being isomorphic to lambda_ex -- a recent formalism with variable names --, lambda_rex accomplishes simulation of beta-reduction (Sim, preservation of beta-strong normalization (PSN and meta-confluence (MC, among other desirable properties. Our calculus is based on a novel presentation of lambda_dB, using a swap notion that was originally devised by de Bruijn. Besides lambda_rex, two other indexed calculi isomorphic to lambda_x and lambda_xgc are presented, demonstrating the potential of our technique when applied to the design of indexed versions of known named calculi.

Ariel Mendelzon

2011-02-01

 
 
 
 
181

Primary Giant Cell Malignant Fibrous Histiocytoma of the Kidney with Staghorn Calculi  

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Full Text Available Malignant fibrous histiocytomas (MFH as primary renal tumours are rare, with less than 50 cases described in the literature. We report a case of primary renal MFH of giant cell type in a 56-year-old man, who presented with bilateral dull flank pain, intermittent gross haematuria and body weight loss (6 kg in 3 months. Intravenous urography, computerized tomography (CT and magnetic resonance image (MRI showed right ureteral stones with mild hydronephrosis, and a solid mass at the lower pole of the left kidney associated with staghorn calculi, as well as tumour thrombi in the left renal vein and inferior vena cava. Left radical nephrectomy and evacuation of tumour thrombi from the left renal vein and inferior vena cava were performed. Histopathologic examination revealed malignant fibrous histiocytoma (MFH of giant cell type. To the best of our knowledge, this is the first report of primary renal MFH associated with staghorn calculi.

Chen C

2003-01-01

182

Continuation-Passing Style and Strong Normalisation for Intuitionistic Sequent Calculi  

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The intuitionistic fragment of the call-by-name version of Curien and Herbelin's lambda-mu-mu-tilde-calculus is isolated and proved strongly normalising by means of an embedding into the simply-typed lambda-calculus. Our embedding is a continuation-and-garbage-passing style translation, the inspiring idea coming from Ikeda and Nakazawa's translation of Parigot's lambda-mu-calculus. The embedding strictly simulates reductions while usual continuation-passing-style transformations erase permutative reduction steps. For our intuitionistic sequent calculus, we even only need "units of garbage" to be passed. We apply the same method to other calculi, namely successive extensions of the simply-typed lambda-calculus leading to our intuitionistic system, and already for the simplest extension we consider (lambda-calculus with generalised application), this yields the first proof of strong normalisation through a reduction-preserving embedding. The results obtained extend to second and higher-order calculi.

Santo, Jose Espirito; Pinto, Luis

2009-01-01

183

Diagnosis of ureteral calculi using ultrasonography, intravenous urography and unenhanced Helical Computed Tomography  

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Ultrasonography Ultrasonography is an efficient tool in the detection of calculi in the pyelocalyx system, but it may not be sufficient for the area of renal pelvis and ureter, as well as for the ureter and the ureterovesical junction. Intravenous urography Radiolucent stones, dilatation of the ureter and of the pyelocalyx system were identified on the urogram, which are common signs of ureter calctilosis. Defects in the contrast can be caused by blood clots and papillary or malignant tumors ...

Govor?in Mira; Stojanovi? Sanja; Hadna?ev Dušan; Lu?i? Zorka; Luka? Ilona

2005-01-01

184

Clinical comparison of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy in treating renal calculi.  

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STUDY OBJECTIVE: To compare extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy for efficacy in treating renal calculi. DESIGN: Non-randomised multicentre cohort study with 3 month follow up and 13 month data collection period. SETTING: Lithotripter centre in London, tertiary referral hospital, and urological clinics in several secondary and tertiary care centres. PATIENTS: 933 of 1001 patients treated by lithotripsy at the lithotripter centre were compared with 195 treated...

1988-01-01

185

Adult bilateral non-obstructing orthotopic ureteroceles with multiple calculi: endoscopic management with review of literature.  

Science.gov (United States)

We describe and report two cases of bilateral symptomatic ureterocele with calculi in two young adult women. They were successfully managed endoscopically by a transverse meatotomy and stone extraction done bilaterally in a single operative session. The 6th month postoperative voiding cystourethrogram showed no reflux. The literature regarding the incidence, occurrence, diagnosis and management of this uncommon condition in adults has been reviewed and discussed. PMID:17268900

Singh, Iqbal

2007-01-01

186

Extracorporeal shock wave lithotripsy for renal calculi, experience of first 100 cases at Jinnah Hospital, Lahore  

International Nuclear Information System (INIS)

Extracorporeal shock wave lithotripsy (ESWL), where available, has become the preferred treatment modality for majority of renal calculi. Nevertheless because of low morbidity and strong patient endorsement there is a natural tendency of over using it. We report the experience of first 100 patients of renal calculi treated at Lithotripsy Center, Jinnah Hospital, Lahore between November 1993 and October 1995.. All patients were treated on an out patients basis. In this prospective study patients were divided into three groups depending upon the initial stone size (Group 1 2.1 to 3 cm). Twenty-eight patients were lost to follow-up. Analysis of data revealed a success rate of 89.5%, 65.8% and 33.3% in Group-I, II and III respectively at the end of 3 months follow-up. Morbidity was directly procedures to stone burden, while success was inversely related to stone burden. Complications requiring auxiliary procedures were seen in none of the patients of Group-I while in 17.1% and 25% of the patients of Group-II and III respectively. Failure of the procedure demanding for an open intervention was seen in none of the patients of Group II and III respectively. We concluded that selection of patients is key to successful management of the renal calculi with ESWL. (author)

1999-01-01

187

The Comparison of Ultrasonography and Non Enhanced Helical Computed Tomography in the Diagnosis of Ureteral Calculi  

Directory of Open Access Journals (Sweden)

Full Text Available Intravenous urography, ultrasonography, and non-contrast spiral computed tomography have been used to diagnose ureteral calculi. We aimed to compare the accuracy of non-contrast spiral computed tomography with ultrasonography in the evaluation of patients with renal colic.Fourty-one patients with flank pain were examined with both computed tomography and ultrasonography over a period of 11 months. Findings of ultrasonography and computed tomography of 28 patients in whom üreteral stones were confirmed by standart methods were comparedUreteral calculi were diagnosed in 28 of 41 patients. Ureteral stones could be demonstrated in 18 patients by ultrasonography and in 27 patients by computed tomography. Ultrasonography showed 64.3% sensitivity and 100% specificity in the diagnosis of ureterolithiasis; computed tomography showed 96.4% and 100%, respectively. Spiral computed tomography is superior to ultrasonography in the demonstration of ureteral calculi in patients with renal colic. But because of higher cost and higher radiation dose, it should be reserved for symptomatic cases in whom ultrasonography is non-diagnostic.

?lhan K?l?nç

2007-01-01

188

El artefacto de centelleo en la caracterización de los cálculos urinarios / Role of twinkling artifact in characterization of urinary calculi  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: La caracterización de los cálculos renales está cada vez cobrando mayor importancia como paso previo a la toma de decisiones terapéuticas tales como la nefrolitotomía percutánea (NLP) y la litotricia extracorpórea por ondas de choque (LEOC). En algunos estudios se ha publicado que el a [...] rtefacto de centelleo (artefacto de ecografía de flujo en color) puede ser de utilidad en la detección de piedras en el riñón. En este estudio se pretende dilucidar si la presencia o ausencia del artefacto de centelleo tendría alguna relación con la composición química de los cálculos. Material y método: En un estudio prospectivo se incluyó a pacientes con cálculos renales de > 0,5cm. Se examinó a 70 pacientes mediante rayos X, pielografía intravenosa, tomografía computarizada sin contraste y ecografía doppler espectral y a color. El artefacto se consideró de grado 1 si sólo ocupaba una parte de la sombra acústica, considerándose de grado 2 si ocupaba la totalidad de la sombra. Se trató a los pacientes con cálculos de menos de 2cm con LEOC, y a aquellos con piedras de mayor tamaño se les derivó a tratamiento con NLP. Resultados: No se detectó artefacto alguno (grado 0) en 11 sujetos, detectándose el grado 1 en 25 y el grado 2 en 24. Se encontró una relación significativa entre el aumento en artefactos de centelleo y tamaño del cálculo (p Abstract in english Introduction: Stone characterization is becoming important before decision of treatment such as percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL). Some studies have reported that the twinkling artifact (color-flow ultrasonography artifact) may be useful to detect u [...] rinary stones. This study aims to determine whether the presence or absence of the twinkling artifact is correlated with the chemical composition of the stones. Material and method: Patients with renal stones > 0.5cm were included in a prospective study. Sixty patients were examined with x-ray film, intravenous pyelography, non-contrast computerized tomography, and color and spectral doppler ultrasonography. The artifact was considered grade 1 when occupied only one portion of the acoustic shadowing and when the artifact occupied the entire acoustic shadowing was considered grade 2. Patients with stones smaller than 2 cm were treated with SWL and patients with stones larger than 2cm were treated with PCNL. Results: No artifact (grade 0) was detected in 11 subjects, grade 1 in 25 and grade 2 in 24. Significant relationship was found between the increase in twinkling artifact and stone size (p

C., Alan; H., Koçoglu; S., Kosar; O., Karatag; A., Resit Ersay; A., Erhan.

189

Urinary incontinence during pregnancy  

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Objectives: To investigate incidence and prevalence of urinary incontinence during pregnancy, and associated risk factors.Method: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health. We present questionnaire data about urinary incontinence obtained from 43,279 women (response rate 45%) by week 30. We report data on any incontinence in addition to type, frequency and amount of incont...

Wesnes, Stian Langeland; Rørtveit, Guri; Bø, Kari; Hunska?r, Steinar

2007-01-01

190

Urinary incontinence during pregnancy  

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Objectives: To investigate incidence and prevalence of urinary incontinence during pregnancy, and associated risk factors.

Method: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health. We present questionnaire data about urinary incontinence obtained from 43,279 women (response rate 45%) by week 30. We report data on any incontinence in addition to type, frequency and amount of incontinence. Pote...

Wesnes, Stian Langeland; Rørtveit, Guri; Bø, Kari; Hunska?r, Steinar

2007-01-01

191

Genito-urinary tuberculosis  

International Nuclear Information System (INIS)

Tuberculosis continues to be one of the most frequently recurring specific infectious diseases. In this context, genito-urinary tuberculosis, followed by lymph node tuberculosis, presents itself as the most important extrapulmonary organ manifestation. Due to its steady incidence rate, an often insidious disease process as well as the increasing number of immunosuppressed patients, it is more important than ever to focus our clinical attention on the knowledge of epidemiology, pathogenesis, diagnosis and therapy of genito-urinary tuberculosis. (orig.)

1997-05-02

192

URINARY MELATONIN IN DEPRESSION  

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This report is based on a study of 12 cases of depression (8 endogenous, 4 neurotic) with a view to explore the possible association between urinary melatonin and the illness prior to and following treatment. While cases of endogenous depression had low 24 hour as well as nocturnal urinary melatonin levels, the neurotic depressives showed higher than normal levels. A rise in the 24 hour melatonin levels occurred in all cases of endogenous depression though this did not apply, to the nocturnal...

Rao, A. Venkoba; Devi, S. Parvathi; Srinivasan, V.

1983-01-01

193

Evaluation of the Raphanus sativus effect on urinary pH  

Directory of Open Access Journals (Sweden)

Full Text Available

BACKGROUND: According to urology texts, urinary calculi are the third most common affliction of the urinary tract and they pose great expenses on health services. The use of oral herbal medication is one of the cheapest ways of treating this disease (in some societies black radish plant is used as a treatment. The scientific term for black radish is Raphanus sativus nigra. Urinary pH is a prominent factor in any crystallization process in urine. This study was conducted to determine the possible effects of Raphanus on urinary pH as a factor in stone formation and crystallization.

METHODS: Thirty healthy people including 11 males and 19 females without any history of drug consumption or urinary calculi in their first degree relatives were chosen and underwent a four days trial. The experiment included 2 days of Raphanus juice consumption during which urinary pH was measured 4 times a day. The averages of Urinary pH with or without Raphanus juice consumption were compared by t-paired test.

RESULTS: The Study was carried out using 30 participants including 11 males and 19 females with the mean ± SD age of 28.66 ± 10.8 (range 19-55. Out of the eight pairs of urinary pH, only in two pairs P values were 0.05 and 0.028 and the rest were all greater than 0.05 which is not sufficient to show a significant difference between urinary pH with or without Raphanus juice consumption.

CONCLUSIONS: In this study, the effect of Raphanus sativus nigra on urinary pH was not proved. However, according to the proved effects of Raphanus as a diuretic and dissolution agent in Rats, it would be reasonable to repeat the same study in a human population.

KEY WORDS: Raphanus sativus, urinary pH, urinary calculus.

Hamid Mazdak

2007-06-01

194

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction  

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Full Text Available OBJECTIVE: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL and ureteroscopy (URS for the treatment of distal ureteral calculi with respect to patient satisfaction. MATERIALS AND MHETODS: This is a prospective study where a total of 212 patients with solitary, radiopaque distal ureteral calculi were treated with ESWL (n = 92 using Dornier lithotriptor S (MedTech Europe GmbH or URS (n = 120. Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p < 0.0001. In addition, 88% of patients who underwent ESWL versus 20% who underwent URS were discharged home the day of procedure. Minor complications occurred in 3.3% and 8.3% of the ESWL and URS groups, respectively (p = 0.127. No ureteral perforation or stricture occurred in the URS group. Postoperative flank pain and dysuria were more severe in the URS than ESWL group, although the differences were not statistically significant (p = 0.16. Patient satisfaction was high for both groups, including 94% for URS and 80% for ESWL (p = 0.002. CONCLUSIONS: URS is more effective than ESWL for the treatment of distal ureteral calculi. ESWL was more often performed on an outpatient basis, and showed a trend towards less flank pain and dysuria, fewer complications and quicker convalescence. Patient satisfaction was significantly higher for URS according to the questionnaire used in this study.

Ibrahim F. Ghalayini

2006-12-01

195

Hodge and Laplace-Beltrami Operators for Bicovariant Differential Calculi on Quantum Groups  

CERN Multimedia

For bicovariant differential calculi on quantum matrix groups a generalisation of classical notions such as metric tensor, Hodge operator, codifferential and Laplace-Beltrami operator for arbitrary k-forms is given. Under some technical assumptions it is proved that Woronowicz' external algebra of left-invariant differential forms either contains a unique form of maximal degree or it is infinite dimensional. Using Jucys-Murphy elements of the Hecke algebra the eigenvalues of the Laplace-Beltrami operator for the Hopf algebra O(SLq(N)) are computed.

Heckenberger, I

1999-01-01

196

Asynchronous Process Calculi for Specification and Verification of Information Hiding Protocols  

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The work presented in this document in an account of my work as a PhD student at LIX, Ecole Polytechnique, in the COMETE team under the supervision of Catuscia Palamidessi. During these studies, I have been in interested in the various aspects of concurrency covered by the COMETE team activities. The initial goal of my thesis was to investigate the aspects related to process calculi based formalisms to express and analyze Security Protocols. The ultimate goal was to makes some advances toward...

Beauxis, Romain

2009-01-01

197

Extracorporeal Shock Wave Lithotripsy in Prone and Supine Positions for Patients with Upper Ureteral Calculi  

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Introduction: The aim of this study was to evaluate the treatment of upper ureteral calculi with extracorporeal shock wave lithotripsy (SWL) in the supine and prone positions.

Afshar Zomorrodi; Amirreza Elahian; Nematollah Ghorbani; Anahita Tavoosi

2006-01-01

198

Drug-induced MR urography: the effects of furosemide and intravenous saline injection on MR urography of obstructed and non-obstructed urinary tract  

International Nuclear Information System (INIS)

To determine the usefulness of MR urography technique for the evaluation of urinary systems in patients with obstructed urinary tract and normal volunteers with non-obstructed urinary tract after intravenous normal saline and diuretic injection. Three normal volunteers and 12 patients with urinary tract obstruction [ureteral calculi (n=8), extraurinary mass (n=1), ureteral tumor invasion (n=3)] underwent MR urography using a 1.0T scanner and a 2D non-breath-hold heavily T2-weighted fast spin-cho sequence. These acquisition were post-processed with a maximum intensity projection (MIP) algorithm. Two acquisitions were performed, the first prior to saline solution infusion following standard MR urography procedures, and the second, within 2-3 minutes of the infusion of 250 ml saline solution followed by 20 mg of Lasix administered intravenously. For this latter, drug-induced MR urography procedures were followed. In healthy volunteer (n=3) and those experiencing partial obstruction (n=4) by a urinary stone, drug-induced MR urography provided better images of the urinary tract than did standard MR urography. In those in whom a urinary stone or tumor had caused complete obstruction (n=8), standard MR urography provided good images, as did drug-induced MR urography. In patients with a partially or non-obstructed urinary tract, drug-induced MR urography provided better anatomic and functional details of the kidney and urinary tract than did standard MR urography. In those experiencing complete obstruction of the urinary tract, however, standard or drug-induced MR urography permitted very adequate evaluation of the tract, and drug-induced MR urography was unnecessary

2001-10-01

199

Fasting and Urinary Stones  

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Full Text Available Introduction: Fasting is considered as one of the most important practices of Islam, and according to Prophet Mohammad, fasting is obligatory upon Muslims. The aim of this study is to evaluate the effects of fasting on urinary stones. Materials and Methods: Very few studies have been carried out on urinary stones and the effect of Ramadan fasting. The sources of the present study are Medline and articles presented by local and Muslim researchers. Meanwhile, since we are acquainted with three well-known researchers in the field of urology, we contacted them via email and asked for their professional opinions. Results: The results of studies about the relationship of urinary stones and their incidence in Ramadan are not alike, and are even sometimes contradictory. Some believe that increased incidence of urinary stones in Ramadan is related not to fasting, but to the rise of weather temperature in hot months, and an increase in humidity. Conclusion: Numerous biological and behavioral changes occur in people who fast in Ramadan and some researchers believe that urinary stone increases during this month.

Ali Shamsa

2013-11-01

200

Imaging of transitional cell carcinomas of the urinary tracts  

International Nuclear Information System (INIS)

Full text: Transitional cell carcinoma (TCC) is the most common urothelial neoplasm to involve the upper urinary tract and bladder. Prognosis significantly worsens with deeper invasion. The role of imaging is to detect the tiniest urothelial neoplasms while still potentially resectable and curable. In case of advance disease, imaging should identify the extent of disease. Intravenous or retrograde urography, ultrasonography, computed tomography or magnetic resonance imaging have been used for diagnosis of TCC. The diagnostic performances of these imaging modalities differ from each other. A recent review regarding imaging of TCC by Razavi et al states that the retrieved sensitivity/specificity for the detection of TCC of upper urinary tract for CT urography (CTU), MR urography, excretory urography, and retrograde urography were 96%/99%, 69%/97%, 80%/81%, and 96%/96%, respectively. For detecting bladder cancer, the retrieved sensitivity/specificity for CT cystography, MR cystography, and ultrasonography were 94%/98%, 91%/95%, and 78%/96%, respectively. They conclude that CT urography is the best imaging technique for confirming or excluding malignancy in the upper urinary tract, whereas CT cystography has the best diagnostic performance for diagnosing bladder cancer. While cystoscopy is still considered by most to be the gold-standard for evaluation of the urinary bladder, CTU is playing an increasing role in the detection of urinary bladder urothelial neoplasms. As with the upper urinary tract, bladder urothelial neoplasms typically present as a filling defect, a focal mass, or an area of abnormal focal wall thickening. Magnetic resonance imaging is superior for evaluation of the depth of tumour invasion into the bladder wall, but this knowledge may not ultimately affect treatment as feasibility for radical cystectomy depends on staging by a combination of clinical, histopathological and imaging findings. Radical cystectomy may include resection of adjacent organs and regional lymph nodes. The current purpose of CT or MR imaging is to detect T3b disease or higher and, especially, locoregional lymph node metastases. Upper tract urothelial neoplasms commonly present as a single or as multiple irregular filling defects on CTU. Focal urinary tract wall thickening is another finding that can suggest the presence of urothelial neoplasm. CTU is accepted as a gold standard for the diagnosis and staging of upper urinary tract TCC by European Association of Urology. The multicentric nature of TCC makes assessment of the entire urothelium essential before treatment. Vigilant urologic and radiologic follow-up is warranted to assess for metachronous lesions and recurrence. The emerging technique of CT urography allows detection of urinary tract tumors and calculi, assessment of perirenal tissues, and staging of lesions; it may offer the opportunity for one-stop evaluation in the initial assessment of hematuria and in follow-up of TCC

2012-11-01

 
 
 
 
201

Urinary incontinence surgery - female - discharge  

Science.gov (United States)

... Blaivas JM, Gormley EA, et al; Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ... EB, Kobashi KC. Minimally invasive treatment of stress urinary incontinence and vaginal prolapse. Urol Clin North Am . 2007; ...

202

When you have urinary incontinence  

Science.gov (United States)

You have urinary incontinence. This is when you are not able to keep urine from leaking from your urethra, the tube that ... urine out of your body from your bladder. Urinary incontinence may occur as your age or after a ...

203

Urinary incontinence - vaginal sling procedures  

Science.gov (United States)

... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ... Vaginal sling procedures are done to treat stress urinary incontinence. Before discussing surgery, your doctor will have you ...

204

Artifical urinary sphincters  

International Nuclear Information System (INIS)

A small selected group of patients with urinary incontinence can be treated effectively with an artificial urinary sphincter. Since the fluid in the hydraulic system of this device is radiopaque, radiography is useful in its evaluation. An immediate postoperative radiogram should be performed to control the position and integrity of the system. It also serves as a useful baseline study in case of later complications. It should include radiograms both in the deactivated and activated state. A few cases of tube kinking may be overlooked when exposures in only one projection are used. Experience with 110 implanted sphincters is presented. (orig.)

1987-01-01

205

Urinary albumin in space missions.  

Science.gov (United States)

Proteinuria was hypothesized for space mission but research data are missing. Urinary albumin, as index of proteinuria, was analyzed in frozen urine samples collected by astronauts during space missions onboard MIR station and on ground (control). Urinary albumin was measured by a double antibody radioimmunoassay. On average, 24h urinary albumin was 27.4% lower in space than on ground; the difference was statistically significant. Low urinary albumin excretion could be another effect of exposure to weightlessness (microgravity). PMID:15002544

Cirillo, Massimo; De Santo, Natale G; Heer, Martina; Norsk, Peter; Elmann-Larsen, Benny; Bellini, Luigi; Stellato, Davide; Drummer, Christian

2002-07-01

206

In vitro studies on the role of glycosaminoglycans in crystallization intensity during infectious urinary stones formation.  

Science.gov (United States)

Proteus mirabilis cause urinary tract infections which are recurrent and can lead to formation of urinary calculi. Both bacterial and the host factors are involved in the development of urolithiasis. To determine the impact of glycosaminoglycans (GAGs) in the formation of P. mirabilis-induced urinary stones, we investigated the in vitro crystallization, aggregation and adhesion of crystals in the presence of GAGs naturally appearing in urine. Crystallization experiments were performed in synthetic urine infected with P. mirabilis in the presence of: hyaluronic acid (HA), heparan sulfate (HS), chondroitin sulfate A, B and C (ChSA, ChSB, ChSC). The intensity of crystallization and aggregation were established by counting particles and phase-contrast microscopy. To analyze the adhesion of crystals, we used normal urothelium and (45) Ca isotope-labeled crystals. In the presence of ChSC, both the size of the crystals formed and their number were higher compared with the control. GAGs increased crystals adhesion to the cells, but only for ChSA this effect was significant. Chondroitin sulfates, which accelerate the first stages of infection-induced stones formation, may play an important role in the pathogenesis of infectious urolithiasis. PMID:24164670

Torzewska, Agnieszka; Ró?alski, Antoni

2014-06-01

207

Kidneys and urinary system  

International Nuclear Information System (INIS)

Nuclear medicine studies, through primarily concerned with the functional aspects of the organ, can also provide useful information about the anatomy. An understanding of the anatomy and physiology of the kidneys and urinary system greatly helps in the interpretation of data from radionuclide studies

1992-01-01

208

Urinary mucopolysaccharides in acheiropodia.  

Science.gov (United States)

Urinary mucopolysaccharides from three patients with acheiropodia were qualitatively and quantitatively analysed by agar gel electrophoresis coupled with enzymatic degradation. Although no abnormal pattern was characterized, eventual metabolic dysfunction detected only in bone/cartilage tissues could not be ruled out. PMID:906767

Mourão, P A; Toledo, S P; Dietrich, C P

1977-01-01

209

Use of holmium laser in conjunction with electrohydraulic lithotripsy in the treatment of bladder calculi  

Science.gov (United States)

Drawbacks to the treatment of bladder calculi demolition include excessive mucosal trauma and bleeding with the use of the electrohydraulic lithotripsy (EHL) and prolonged operating room times with the low wattage holmium laser (HOL). The outcome of bladder stones treated by combining the use of HOL and the EHL is reported. Via the cystoscope, the bladder stones were identified in five male patients and the HOL was used to bore to the center of each stone. The EHL probe was then inserted into each borehole and was used to fragment the stones into pieces which could be removed with an Ellik evacuator. All the stones were fragmented to pieces, which were removed without difficulty. Upon completion, minimal mucosal trauma and stone dust were visualized. No complications were observed.

Terranova, Steven A.; Despradel, Vidal M.; Mian, Badar M.; Averch, Timothy D.

2001-05-01

210

Should upper ureteral calculi be manipulated before extracorporeal shock wave lithotripsy? A prospective controlled trial.  

Science.gov (United States)

Whether all upper ureteral stones must be manipulated before extracorporeal shock wave lithotripsy (ESWL*) is an ongoing controversy. In a prospective trial, symptomatic patients with solitary upper ureteral calculi less than 1 year in duration were alternated between ESWL in situ and pre-ESWL stone manipulation. Pretreatment excretory urograms were assessed for stone size and degree of proximal hydroureteronephrosis, which was graded from zero (no dilatation) to 3 (severe dilatation). Stone manipulation was done with the patient under intravenous sedation and local anesthesia. A total of 4,000 shock waves was given in a single session using Siemens Lithostar Plus, and treatment was repeated on days 4, 15 and 30 if required. The patients were evaluated 3 months after onset of therapy with excretory urogram and urine culture. Seventy patients qualified for the study (group 1-35 in situ and group 2-35 stone manipulation) and were comparable in relation to age and sex, stone size and degree of hydronephrosis. There was no significant difference between the 2 groups regarding the number of sessions (group 1-1.86 +/- 1.2 and group 2-2.03 +/- 1.2) or shock wave requirement (group 1-5,705.8 +/- 3,536.9 and group 2-5,549.1 +/- 3,837.2) for stone fragmentation. The degree of proximal dilatation did not contribute significantly towards the outcome (F ratio 0.675, p = 0.57). A total of 30 patients (85.5%) in group 1 had a satisfactory outcome at 3 months, while 3 (8.5%) had significant residual calculi and 2 stones could not be fragmented. Of the manipulated stones 33 (94%) were successfully cleared, while 2 patients required auxiliary procedures. Ureteroscopy was required in 1 patient for upward migration of the stent. Morbidity in both groups was comparable. We conclude that upper ureteral stones should be treated in situ to avoid the morbidity of manipulation. PMID:8015061

Kumar, A; Kumar, R V; Mishra, V K; Ahlawat, R; Kapoor, R; Bhandari, M

1994-08-01

211

Factors affecting treatment success of staghorn calculi: stone burden or stone locations  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: We aimed to evaluate the results and comlications of percutaneous nephrolithotomy (PCNL treatment in patients with staghorn calculi.Materials and methods: We performed multi-access PCNL in 54 patients with staghorn stones in our department between 2004 to 2007. Of these patients, 2 access tracts were used for 41, 3 access tracts for 8, and 4 access tracts for 5 patients. The mean stone burden was 10.7 cm2 for 2 access group, 11.7 cm2 for 3 access group, and 11.2 cm2 for 4 access group. Preoperative data including stone surface area, stone locations, and patient demograghics were recorded. Access number, transfusion rate, and operative duration were recorded intraoperatively. Stone-free rates and need for opioids were determined postoperatively.Results: Transfusion rate was 24.3% in 2 access group, 37.5% in 3 access group, and 80% in 4 access group. The mean operative duration was 145, 157, and 189 sec in 2, 3, and 4 access groups, respectively. Stone-free rate was 63.4%, 50%, and 20%; need of opioids was 4.8%, 25%, and 60% in three groups. Two A-V fistulas, one in 3 access group and the other in 4 access group, were treated by chemoembolisation.Conclusion: Stone burden is not the most important factor for stone-free rates in complex and branched renal calculi. Different caliceal locations of stones is more predictive for stone-free rates for staghorn stones. Increased access number is associated with more blood transfusion, long operative duration, more complications, and more opioid needs.

M. Bahad?r Can Balc?

2011-09-01

212

Urinary incontinance in childhood  

Directory of Open Access Journals (Sweden)

Full Text Available Most common cause of childhood incontinence is enuresis nocturna which is characterized with spontaneus resolution and physiologically normal voiding. Although most cases are not related to any structural or neurological abnormality, it is important to properly diagnose a child who presents with wetting. A thorough medical history will delineate the pattern of incontinence and additional investigations are indicated in only selected patients. If the physician can identify the voiding disorder and treat the cause not the symptom, will minimize the effects of the condition on the child's social development and also prevent the possible injuries to upper urinary tract. Therefore, this review will mostly focus on differential diagnosis of the causes of urinary incontinence. (Turk Arch Ped 2009; 44 Suppl: 90-3

Sibel Tiryaki

2010-05-01

213

A unique complication of urethral catheterization: pubic hair associated with struvite bladder calculi.  

Science.gov (United States)

Bladder stones account for 5% of all urinary stone disease and can develop on a foreign body, such as a misplaced suture, eroded surgical mesh, or ureteral stent. In this case study, the authors present a patient with bladder stones associated with pubic hairs introduced during a monthly indwelling Foley catheter change. Clinicians have an important role in instructing patients on the use of proper technique and hygiene practices during urethral catheterization to minimize the potential for urinary complications. PMID:24354112

Perz, Sarah; Ellimoottil, Chandy; Rao, Manoj; Bresler, Larissa

2013-01-01

214

Female urinary incontinence  

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Urinary incontinence affects approximately a quarter of a billion people worldwide. It is associated with high economic costs, psychological morbidity and adverse effects on the quality of life. Despite this, few women seek help for this condition either due to embarrassment and unwillingness to discuss the symptom with their family member or friend or, acceptance of the disorder as a natural part of aging or being unaware that treatment exists. More resources are utilised in maintaining pati...

Abdool, Zeelha

2007-01-01

215

Recurrent Urinary Bladder Paraganglioma  

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A 39-year-old male presented with recurrent attacks of painless haematuria. The patient has a history of partial cystectomy for bladder paraganglioma 10 years prior to the presentation. Imaging study and cystoscopic examination revealed a small anterior wall bladder tumor. The histological examination of the lesion confirmed that it was a urinary paraganglioma. Partial cystectomy was performed to this recurrent lesion. This case report stresses the importance of life-long follow-up of these l...

Al-zahrani, Ali A.

2010-01-01

216

Pheochromocytoma of urinary bladder  

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Pheochromocytoma of urinary bladder are rare tumors. They present with nonspecific clinical signs and symptoms, so imaging plays an important role in diagnosing and localizing the tumor. We present two cases of bladder pheochromocytoma, one of them presented with vague abdominal pain and the other with hematuria. Biphasic CT in both the cases showed hypervascular intravesical mass suggestive of bladder pheochromocytoma. The lesions were confirmed biochemically or on postoperative histopatholo...

Vyas, S.; Kalra, N.; Singh, S. K.; Agarwal, M. M.; Mandal, A. K.; Khandelwal, N.

2011-01-01

217

Managing urinary tract infections  

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Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-sta...

Saadeh, Sermin A.; Mattoo, Tej K.

2011-01-01

218

The Sound and Complete R-Calculi with Respect to Pseudo-Revision and Pre-Revision  

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Full Text Available The AGM postulates ([1] are for the belief revision (revision by a single belief, and the DP postulates ([2] are for the iterated revision (revision by a finite sequence of beliefs. Li [3] gave an R-calculus for R-configurations ?|?, where ? is a set of literals, and ? is a finite set of formulas. We shall give two R-calculi such that for any consistent set ? and finite consistent set ? of formulas in the propositional logic, in one calculus, there is a pseudo-revision ? of ? by ? such that   is provable and  and in another calculus, there is a pre-revision ? of ? by ? such that  is provable,  and  for some pseudo-revision ?; and prove that the deduction systems for both the R-calculi are sound and complete with the pseudo-revision and the pre-revision, respectively.

Wei Li

2013-04-01

219

Trans-Ureteral Ureterolithotripsy of Ureteral Calculi:Which is the Best; Pneumatic or Holmium Laser Technique?  

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 Please cite this article as follows:

Razaghi MR, Razi A, Mazloomfard MM, Mokhtarpour H, Javanmard B, Mohammadi R.Trans-ureteral ureterolithotripsy of ureteral calculi: which is the best; pneumatic or holmium laser technique? J Lasers Med Sci.2011;2(2):59-62

*Corresponding Author: Mohammad Mohsen Mazloomfard, M.D; Shohada Tajrish Medical Center, Tajrish Sq, Tehran, Iran. Tel: +98-21-22718001-9,Fax:...

2011-01-01

220

Telocytes in the urinary system  

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Abstract Background Telocytes, a new type of interstitial cells, have been identified in many organs in mammals. The present studies aimed at investigating the ultrastructure, distribution and interactions of telocytes with surrounding cells in the urinary system of rats, to confirm the existence of telocytes in kidneys, ureter and urinary bladder. Methods Samples of kidney, ureter, or urinary bladder were harvested for the ultrastructure by the electron microsc...

Zheng Yonghua; Zhu Tongyu; Lin Miao; Wu Duojiao; Wang Xiangdong

2012-01-01

 
 
 
 
221

Diagnosis of urinary tract diseases  

International Nuclear Information System (INIS)

Radiological exploration of the urinary tract has become highly sophisticated. The information provided by the new imaging techniques is extremely accurate and useful in the diagnosis and pretherapeutic assessment of most urinary tract diseases. Interventional radiology has given radiologists an important role in the treatment of some types of pathology. The authors describe the value of modern imaging and its different aspects in each of the principal branches of urinary tract pathology. viz.: tumours, obstructions, infections, vascular and prostatic diseases

1989-01-01

222

Management of ureteral calculi and medical expulsive therapy in emergency departments  

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Full Text Available Introduction : Ureteral stones are a common problem in daily emergency department practice. Patients may be offered medical expulsive therapy (MET1 to facilitate stone expulsion and this should be offered as a treatment for patients with distal ureteral calculi, who are amenable to waiting management. Emergency department clinicians and family practitioners are often in the front line regarding the diagnosis and treatment of symptomatic nephrolithiasis and this commentary is dedicated to them because their decisions directly influence the outcome of the acute stone episode and appropriate referral patterns. Materials and Methods : The aim of this systematic review and meta-analysis was to understand the role of MET in the treatment of obstructing ureteral calculi. A bibliographic search covering the period from January 1980 to March 2010 was conducted in PubMed, MEDLINE and EMBASE. The searches were restricted to publications in English. This analysis is based on the 21 studies that fulfilled the predefined inclusion criteria. Results : A metaregression analysis of expulsion time showed a statistically significant advantage in the experimental group, in which the mean expulsion time was 6.2 days compared to 10.3 days in controls. The treatment effect on expulsion rate (P = 0.53 was partially lost as the size of the stones decreased because of the high spontaneous expulsion rate of small stones and the expulsion time was not influenced by pharmacological treatment (P = 0.76 if the stone size was smaller than 5 mm. Analysis of the tamsulosin database : A total of 1283 participants were included in the 17 studies. These studies showed that compared to standard therapy or placebo, tamsulosin had significant benefits, being associated with both a higher stone expulsion rate (P < 0.001 and reduction of the expulsion time (P = 0.02. Reductions in the need for analgesic therapy, hospitalization and surgery are also shown. Analysis of the nifedipine database : The number of participants in each trial ranged from 25 to 70. Compared to standard therapy, the use of nifedipine significantly improved the spontaneous stone expulsion rate (P < 0.001. The mean expulsion time was slightly, but not statistically significantly, different (P = 0.19 between the treatment and control groups. A possible benefit of nifedipine, in terms of significantly reducing the doses of analgesics required, was reported in three studies. There was no difference between the tamsulosin- and nifedipine-treated groups with regard to expulsion time (P = 0.17 or expulsion rate (P = 0.79. Conclusions : Despite all its advantages, MET is rarely used, representing a failure of the translation of medical science into practice. These data raise concerns not only about the quality of care of patients who could benefit from resolution of stones without anaesthetic and surgical risks but also with regard to potential cost savings. MET should be offered as a treatment for patients with distal ureteral calculi who are amenable to a waiting management.

Stefano Picozzi C

2011-01-01

223

[Management of urinary incontinence after orthotopic urinary diversion].  

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Orthotopic urinary diversion (OUD) is performed in almost half of all radical cystectomies. This review presents an overview of the incidence, pathophysiology, and management of urinary incontinence (UI) after OUD. Daytime and nighttime UI are reported in up to 15% and 45% of cases after OUD, respectively. UI after OUD is more frequent in women. Stress incontinence is the most common reason for daytime urinary leakage, while an absent vesicourethral reflex with reduced external sphincter muscle tone is associated with nighttime UI. Conservative management has limited therapeutic value in UI after OUD. Surgical approaches include adjustable and nonadjustable slings as well as the ProACT® system in mild stress UI. Implantation of the artificial urinary sphincter system AMS 800® is the standard treatment for stress UI after OUD. Very limited data exist regarding results after implantation of newer artificial urinary sphincter systems such as the FlowSecure® and the Zephyr® ZSI 375 after OUD. PMID:22476800

Soave, A; Dahlem, R; Rink, M; Ahyai, S; Fisch, M

2012-04-01

224

Stress urinary incontinence as a rare presentation of large prostatic stones in neurogenic bladder: implications and management.  

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We report a case of a 38-year-old man with a background of a neglected neurogenic bladder, who presented with a recent onset history of stress urinary incontinence. He was diagnosed as having large prostatic stones along with a low-compliance, small capacity bladder and bilateral hydronephrosis with deranged renal functions. As self-catheterisation was not possible due to obstructing prostatic stones, holmium-YAG laser lithotripsy of prostatic stones was performed as initial procedure that resulted in complete resolution of stress incontinence as well. Successful gastrocystoplasty was performed as a second step to deal with the underlying condition of neurogenic poorly compliant bladder. The present case describes the successful endoscopic management of prostatic calculi using holmium-laser lithotripsy and draws attention to other important issues that need to be addressed in certain special situations like neurogenic bladder. PMID:23749833

Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan

2013-01-01

225

Pattern of urinary tract findings on helical computed tomography in cases of ureterolithiasis  

International Nuclear Information System (INIS)

Objective: To determine the pattern of urinary tract changes in cases of ureterolithiasis as detected on helical computed tomography. Study Design: Descriptive study. Setting: Radiology Department Combined Military Hospital Lahore from Jun 2007 to Jan 2008. Material and Methods: Thirty patients with proven ureterolithiasis on IVU were included. All these patients underwent non contrast enhanced helical computed tomography (CT) scan. Data was analyzed for both quantitative as well as qualitative data and expressed as mean with standard deviation and percentages respectively. Results: All 30 patients had ureteric calculi. Among our study group the frequency expressed as percentages of various secondary signs of ureterolithiasis were hydroureter 25 (83.33%), hydronephrosis of the affected kidney in 23 (76.67%), nephromegaly 16 (53.33%), periureteral edema 19 (63.33%), perinephric stranding 21 (70%), a difference in attenuation between the kidneys 25 (83.33%) while soft tissue rim sign was present in 14 (46.67%) patients. Only one patient lacked the secondary signs. Conclusion: Establishing the pattern of secondary urinary tract findings enables a brisk diagnosis in cases of obstructive ureterolithiasis, thus improving the diagnostic capabilities as well as patient outcome. (author)

2012-12-01

226

In vitro crystallization, characterization and growth-inhibition study of urinary type struvite crystals  

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The formation of urinary stones, known as nephrolithiasis or urolithiasis, is a serious, debilitating problem throughout the world. Struvite—NH4MgPO4·6H2O, ammonium magnesium phosphate hexahydrate, is one of the components of urinary stones (calculi). Struvite crystals with different morphologies were grown by in vitro single diffusion gel growth technique with different growth parameters. The crystals were characterized by powder XRD, FT-IR, thermal analysis and dielectric study. The powder XRD results of struvite confirmed the orthorhombic crystal structure. The FT-IR spectrum proved the presence of water of hydration, metal-oxygen bond, N-H bond and P-O bond. For thermal analysis TGA, DTA and DSC were carried out simultaneously. The kinetic and thermodynamic parameters of dehydration/decomposition process were calculated. Vickers micro-hardness and related mechanical parameters were also calculated. The in vitro growth inhibition studies of struvite by the juice of Citrus medica Linn as well as the herbal extracts of Commiphora wightii, Boerhaavia diffusa Linn and Rotula aquatica Lour were carried out and found potent inhibitors of struvite.

Chauhan, Chetan K.; Joshi, Mihir J.

2013-01-01

227

Urinary stone size estimation: a new segmentation algorithm-based CT method  

International Nuclear Information System (INIS)

The size estimation in CT images of an obstructing ureteral calculus is important for the clinical management of a patient presenting with renal colic. The objective of the present study was to develop a reader independent urinary calculus segmentation algorithm using well-known digital image processing steps and to validate the method against size estimations by several readers. Fifty clinical CT examinations demonstrating urinary calculi were included. Each calculus was measured independently by 11 readers. The mean value of their size estimations was used as validation data for each calculus. The segmentation algorithm consisted of interpolated zoom, binary thresholding and morphological operations. Ten examinations were used for algorithm optimisation and 40 for validation. Based on the optimisation results three segmentation method candidates were identified. Between the primary segmentation algorithm using cubic spline interpolation and the mean estimation by 11 readers, the bias was 0.0 mm, the standard deviation of the difference 0.26 mm and the Bland-Altman limits of agreement 0.0±0.5 mm. The validation showed good agreement between the suggested algorithm and the mean estimation by a large number of readers. The limit of agreement was narrower than the inter-reader limit of agreement previously reported for the same data. (orig.)

2012-04-01

228

Crosstalk among dietary polyunsaturated fatty acids, urolithiasis, chronic inflammation, and urinary tract tumor risk.  

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Based on a consistent bulk of experimental and epidemiologic works, we proposed that abnormal metabolism and/or dietary deprivation of essential polyunsaturated fatty acids by inducing a chronic and subclinical essential fatty acid deficiency (EFAD) in urothelial cell membranes may enhance the risk for urinary tract tumor (UTT) development. This threat may be enhanced by the unusual fact that the fatty-acid profile of the normal urothelium is similar to that reported in EFAD. The risk for UTT may be worsened when coexisting with a low-grade chronic inflammation (LGCI) state induced by urolithiasis or disbalance management of peroxides, free radical molecules, and their quenchers. There is cumulative evidence linking the LGCI of the urinary tract mucosa, calculi, and UTT, due to the long-standing release of promitotic, promutagen, and pro-inflammatory antiapoptotic cytokines in these conditions. The dual role played by pro- and anti-inflammatory eicosanoids and bioactive lipids, cytokines, and the disbalance of lipid peroxidation is discussed, concluding that the moderate, long-standing consumption or dietary supplementation of ?-3 PUFAs may improve the chances of avoiding UTT development. PMID:23594581

Eynard, Aldo R; Navarro, Alicia

2013-01-01

229

Acute Urinary Retention in Children  

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Purpose: Acute urinary retention in children is a relatively rare entity. There are a variety of causes that are poorly defined in the literature. We review our cases of acute urinary retention in children at three major pediatrics centers in Iran. ...

Seyyed Alaeddin Asgari; Mandana Mansour Ghanaie; Nasser Simforoosh; Abdolmajid Kajbafzadeh; Alireza Zare

2005-01-01

230

Braided Lie algebras and bicovariant differential calculi over coquasitriangular Hopf algebras  

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We show that if $g_\\Gamma$ is the quantum tangent space (or quantum Lie algebra in the sense of Woronowicz) of a bicovariant first order differential calculus over a co-quasitriangular Hopf algebra $(A,r)$, then a certain extension of it is a braided Lie algebra in the category of $A$-comodules. This is used to show that the Woronowicz quantum universal enveloping algebra $U(g_\\Gamma)$ is a bialgebra in the braided category of $A$-comodules. We show that this algebra is quadratic when the calculus is inner. Examples with this unexpected property include finite groups and quantum groups with their standard differential calculi. We also find a quantum Lie functor for co-quasitriangular Hopf algebras, which has properties analogous to the classical one. This functor gives trivial results on standard quantum groups $O_q(G)$, but reasonable ones on examples closer to the classical case, such as the cotriangular Jordanian deformations. In addition, we show that split braided-Lie algebras define `generalised-Lie alg...

Gómez, X

2001-01-01

231

An assessment of the pulsed dye laser for fragmenting calculi in the pig ureter.  

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The pulsed dye laser was used to fragment ureteric calculi in 10 pig ureters, compared to electrohydraulic disintegration in six pig ureters. The stones were impacted in the proximal ureter and approached by rigid ureteroscopy. Four ureters did not have stones impacted but had ureteroscopes passed. The stones were fragmented and the particles left to pass spontaneously. The degree of inflammatory reaction was graded at the site of fragmentation as well as in the middle and lower ureter. The degree of inflammation seen at the site of fragmentation was significantly less in the laser group than in the electrohydraulic group (p = 0.0027). It was noted that the degree of inflammation seen in the lower ureter was significantly greater than that seen at the site of fragmentation (p = 0.01), and that this grade of inflammation correlated well with the size of ureteroscope used (p = 0.0026). Further, the degree of dilatation of the ureter and pelvicalyceal system was significantly greater when the larger calibre ureteroscope had been used (p = 0.0056) ranging up to hydronephrosis with flattening of the papillae. If there is any parallel which can be drawn between the pig ureter and the human ureter then it suggests that ureteroscopy is more significant than the modality of fragmentation used. The contribution of the laser may therefore be more by the miniaturization of instrumentation which will be made possible than by any advantage it may have as a fragmenter. PMID:2885427

Watson, G; Murray, S; Dretler, S P; Parrish, J A

1987-07-01

232

Minimally Invasive Radiologically Guided Intervention for the Treatment of Salivary Calculi  

International Nuclear Information System (INIS)

Purpose: To describe the technique and examine the value of salivary stone extraction using a minimally invasive, radiologically guided approach as an alternative to salivary gland surgery for the treatment of benign salivary gland obstruction. Methods: Eighty-six cases of sialolithiasis (83 patients) were treated by stone removal using a Dormia basket under local anesthesia and fluoroscopic guidance. Postoperative assessment was made clinically at review, by sialogram and by questionnaire. Results: Of 86 cases of sialolithiasis treated, in 55 (64%)it was possible to remove all stones. In 12 cases (14%) part of a stone or some of a number of calculi were removed and in 19 cases (22%) the procedure failed. The commonest reason for failure was fixation of the stone within the duct. Symptoms at review (range 1-49 months, mean 17 months) were relieved in 55 of 67 (82%) of cases where a stone or portion of stone was removed. Conclusions:Stone removal from the salivary duct system by radiologically guided,minimally invasive approach is a simple procedure with low morbidity and high patient acceptance when appropriate selection criteria are applied. These criteria are considered and recommendations made

2002-10-01

233

The Beneficial Effect of CynodonDactylonFractionson Ethylene Glycol-Induced Kidney Calculi in Rats  

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Full Text Available Purpose: To assess the beneficial effect of different fractions of Cynodondactylon (C. dactylon on ethylene glycol-induced kidney calculi in rats. Materials and Methods: Male Wistar rats were randomly divided intocontrol, ethylene glycol, curative, and preventive groups. The control group received tap drinking water for 35 days. Ethylene glycol, curative, and preventive groups received 1% ethylene glycol for induction of calcium oxalate (CaOx calculus formation. Preventive and curative subjects also received different fractions of C. dactylon extract in drinking water at 12.8mg/kg, since day 0 and day 14, respectively. After 35 days, the kidneys were removed and examined for histopathological findings and counting the CaOx deposits in 50 microscopic fields. Results: In curative protocol, treatment of rats with C. dactylonN-butanol fraction and N-butanol phase remnant significantly reduced the number of the kidney CaOx deposits compared to ethylene glycol group. In preventive protocol, treatment of rats with C. dactylonethyl acetate fraction significantly decreased the number of CaOx deposits compared to ethylene glycol group. Conclusion: Fractions of C. dactylon showed a beneficial effect on preventing and eliminating CaOx deposition in the rat kidney. These results provide ascientific rational for preventive and treatment roles of C. dactylonin human kidney stone disease.

Abolfazl Khajavi Rad

2011-09-01

234

Litotricia extracorpórea en litiasis en pacientes con derivación urinaria / Extracorporeal shock wave lithotripsy of urolithiasis in patients with urinary diversion  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Exponemos nuestra experiencia en el tratamiento de litiasis en pacientes con derivación urinaria. Hemos tratado 5 pacientes con litiasis en el tracto urinario superior tras cistectomía y derivación urinaria. El tratamiento se ha hecho con monoterapia por ondas de choque con el litotritor Lithostar M [...] odularis de Siemens. El tamaño medio de las litiasis fue de 1,95 cm (rango 1 a 3,5 cm). El número medio de sesiones ha sido 2,6, con 3961 ondas de choque de media por sesión. Hemos conseguido un 100% de pacientes libres de litiasis, indicando que la litotricia extracorpórea tiene unos buenos resultados en el tratamiento de las litiasis en pacientes con derivación urinaria, siendo el tratamiento de elección en estos pacientes, con muy baja morbilidad y alta eficacia, comparable a los pacientes sin derivación urinaria. Abstract in english We evaluate the efficacy of ESWL in the management of calculi in patients with urinary diversion. We treated 5 patients who suffered from urinary lithiasis after urinary diversion post cistectomy. We managed the patients with extracorporeal shock wave lithotripsy in monotherapy with a Siemens Lithos [...] tar Modularis device. Mean stone size (long axis) was 1.95 cm (range 1 to 3.5 cm). The mean shockwave number per session was 2.6 per patient. Stone free result was 100%. We conclude that ESWL technique can provide acceptable results in patients with urinary diversion and can be used as first choice treatment in these type of patients due to its minimal morbidity and excellent results, equivalent to those achieved in patients without urinary diversion.

A., Vega Vega; D., García Alonso; L., Parra Muntaner; J.M., Sánchez Merino; J., García Alonso.

235

Avicenna’s Canon of Medicine and Modern Urology: Part II: Bladder Calculi  

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Full Text Available

In the previous issue of the Urology Journal, a comparison of Avicenna’s Canon of Medicine with modern urologic findings was done in part I of this article, addressing bladder anatomy and physiology and bladder calculi. In part II of this review, the remaining chapters of the Canon of Medicine on bladder calculi are reviewed. Avicenna points to perineal urethrostomy (preineostomy, which is today performed as the last therapeutic line or as a temporary remedy before surgical treatment. He also describes surgery via transperineal route and warns the surgeon of the proximity of vasa deferentia, prostate gland, and neurovascular bundle and their exposure in this position. Usage of grasping forceps for removal of bladder calculus and emphasis on removing all calculus fragments are the interesting points of this chapter. Avicenna explains a technique similar to the use of a babcock for prevention of calculus migration. Complications of bladder calculus surgery and cystostomy are also addressed with scientific precision in the Canon.

Sayed Mohammad Ali Madineh

2009-02-01

236

Urinary incontinence in Norwegian nursing home residents  

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Urinary incontinence is a multi-factorial condition that has a high impact on older persons living in nursing homes. While urinary incontinence is common, only a small percentage of nursing home residents have an official diagnosis. Factors influencing urinary incontinence in this population are poorly understood. The aim of this study was to evaluate the prevalence of urinary incontinence in Norwegian nursing home residents and to study the factors associated with urinary incontinence in thi...

Liv Heidi Skotnes; Ragnhild Omli; Ulla Romild; Ove Hellzèn; Esther Kuhry

2012-01-01

237

Technologies for Managing Urinary Incontinence.  

Science.gov (United States)

The case study describes the problem of urinary incontinence and its costs to the medical care system and society as a whole. Effectiveness of alternative approaches to the management of this major health problem are outlined, with particular emphasis on ...

J. Ouslander R. Kane S. Vollmer M. Menezes

1985-01-01

238

Controversies in urinary iodine determinations  

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Iodine deficiency (ID) is associated with increased prevalence of goiter, increased risk for neurodevelopmental disorders, and is the world’s leading cause of intellectual deficits. Iodine nutritional status of a population is assessed by measurements of urinary iodine concentrations which are also used to define, indicate, survey and monitor iodine deficiency and consequently its treatment. Several methods are available for urinary iodine determination. Discussed here are some of the limit...

Soldin, Offie Porat

2002-01-01

239

Telocytes in the urinary system  

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Full Text Available Abstract Background Telocytes, a new type of interstitial cells, have been identified in many organs in mammals. The present studies aimed at investigating the ultrastructure, distribution and interactions of telocytes with surrounding cells in the urinary system of rats, to confirm the existence of telocytes in kidneys, ureter and urinary bladder. Methods Samples of kidney, ureter, or urinary bladder were harvested for the ultrastructure by the electron microscope. The primary culture of telocytes was performed to investigate the dynamic alterations. Results Telocytes mainly located in the sub-capsular space of kidney, or between smooth muscle bundles and in the lamina propria of ureter and urinary bladder. Telocytes established numerous contacts with macrophages in the sub-capsular space of kidney, or with smooth muscle cells, nerve endings as well as blood capillaries in the ureter and urinary bladder. The complete morphology of telocytes with telopodes was observed clearly through the primary cell culture from the kidney tissues of rats. Conclusions Our data evidenced the existence of telocytes in the urinary system, which may contribute to the tissue reparation and regeneration.

Zheng Yonghua

2012-09-01

240

Trans-Ureteral Ureterolithotripsy of Ureteral Calculi:Which is the Best; Pneumatic or Holmium Laser Technique?  

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Full Text Available INTRODUCTION: Our aim was compare of two types of lithotripter include holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL for the management of ureteral calculi ?1 cm.METHODS: 112 patients with ureteral calculi more than 1 cm were selected in randomized order for pneumatic or holmium: YAG laser transurethral ureterolithotripsy (56 patients in each group. Ultrasonography and intravenous urography were performed for all patients before surgery. Complete clearance and success was defined as the absence of any fragments on post operation KUB and ultrasonography images.RESULTS: Success rate was 85.7% in pneumatic group and 100% in holmium: YAG laser group (p =0.003. Stone migration up in the pelvicalyceal system was observed only in 8 cases of pneumatic group. No statically differences were observed in terms of patient’s age, hospital stay, and complications between two groups.CONCLUSION: According to our experience, for ureteral stone larger than 1 Cm treatment with ureteroscopy and laser lithotripsy is a preferring approach with favorable operation time and hospital admission, and no more significant complication.

Reza Mohammadi

2011-06-01

 
 
 
 
241

La incontinencia urinaria Urinary incontinence  

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Full Text Available La incontinencia urinaria, entendida como cualquier pérdida involuntaria de orina, constituye un problema médico y social importante. Puede clasificarse en incontinencia urinaria de esfuerzo, incontinencia urinaria de urgencia e incontinencia urinaria mixta, principalmente. Las proporciones de estos tres tipos principales de incontinencia urinaria son difíciles de establecer y varían notablemente según las fuentes, pero, podrían estar en torno a 40, 33 y 20%, respectivamente. Su diagnóstico requiere una correcta historia clínica y exploración física, junto con algunas exploraciones complementarias. El primer escalón terapéutico lo constituyen las medidas higiénico-dietéticas y las técnicas de modificación de la conducta. El tratamiento farmacológico es específico para cada tipo de incontinencia urinaria, utilizándose anticolinérgicos e inhibidores de la recaptación de serotonina. Por último, las diferentes técnicas quirúrgicas tienen su papel ante el fracaso de los tratamientos conservadores o frente a incontinencia urinaria severa.Urinary incontinence, understood as any involuntary loss of urine, constitutes an important medical and social problem. It can be classified as stress urinary incontinence, urgent urinary incontinence or mixed urinary incontinence. The proportions of these three types of urinary incontinence are difficult to establish and vary notably between sources, but they might be about 40, 33 and 20% respectively. Its diagnosis requires a correct clinical history and physical exploration, together with some complementary explorations. The first therapeutic step consists of hygienic-dietary measures and behaviour modification techniques. Pharmacological treatment is specific for each type of urinary incontinence, using anticholinergics and inhibitors of serotonin reuptake. Finally, different surgical techniques have a role in cases where conservative treatments fail or when dealing with severe urinary incontinence.

J. E. Robles

2006-08-01

242

Ethanolic Extract of Nigella Sativa L Seeds on Ethylene Glycol-Induced Kidney Calculi in Rats  

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Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Introduction: The aim of this study was to investigate the effects of the ethanolic extract of Nigella sativa L (NS seeds on kidney calculi in rats. Materials and Methods: Thirty-two Wistar rats were randomly divided into 4 groups: group A received tap drinking water for 30 days (intact control. Groups B, C, and D received 1% ethylen glycol for induction of calcium oxalate calculus formation. As the preventive, and treatment subjects, rats in groups C and D received ethanolic extract of NS, 250 mg/kg, in drinking water since day 0 and day 14, respectively. Urine was collected on days 0, 7, 14, and 30 of the study period. After 30 days, the kidneys were removed and prepared for histologic evaluation of calcium oxalate deposits. Urine calcium oxalate concentrations were determined by atomic absorption. Results: The number of CaOx deposits was significantly greater in group B (P = .001. Calcium oxalate concentrations in the urine on days 14 and 30 increased significantly in group B and were higher than those in group C (P = .006 and P = .002, respectively. Urine oxalate concentration in group D decreased on day 30 and was lower than that in group B (P = .04. Conclusion: Treatment of rats with ethanolic extract of NS reduced the number of calcium oxalate deposits in a group of rats that received ethanolic extract of NS. The NS could also lower the urine concentration of calcium oxalate. We suggest further studies on the therapeutic and preventive effects of the NS on kidney calculus formation in human.

Mohammadreza Parizady

2007-02-01

243

Clinical characteristics and risk factors for septic shock in patients receiving emergency drainage for acute pyelonephritis with upper urinary tract calculi  

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Abstract Background Acute pyelonephritis (APN) is a common complication of ureteral obstruction caused by urolithiasis, and it can be lethal if it progresses to septic shock. We investigated the clinical characteristics of patients undergoing emergency drainage and assessed risk factors for septic shock. Methods A retrospective study was performed of 98 patients (101 events) requiring emergency drainage at our urology department for obstructive APN associated wi...

Yamamoto Yoshiyuki; Fujita Kazutoshi; Nakazawa Shigeaki; Hayashi Takuji; Tanigawa Go; Imamura Ryoichi; Hosomi Masahiro; Wada Daiki; Fujimi Satoshi; Yamaguchi Seiji

2012-01-01

244

Changes in Urinary Stone Composition in the Tunisian Population: A Retrospective Study of 1,301 Cases  

Science.gov (United States)

Background Studies that evaluate the effect of age on stone composition are scarce. The aim of this study was to highlight the changes in epidemiological characteristics (stone composition and location) of urolithiasis according to patients' age. Methods We studied 1,301 urolithiasis patients with age ranging from 6 months to 92 yr (781 males and 520 females). Stone analysis was performed using a stereomicroscope and infrared spectroscopy to determine the morphological type and molecular composition of each stone. Results The annual average incidence of new stone formation was 31.7 per 100,000 persons. In 71.8% of cases, calculi were located in the upper urinary tract. Compared to other age groups, children and old men were more affected by bladder stones. Calcium oxalate monohydrate was the most frequent stone component, even though its frequency decreased with age (59.5% in young adults and 43.7% in the elderly, PStruvite stones were rare (3.8%) and more frequent in children than in adults. Conclusions The analysis of these data showed that urinary stones in Tunisian patients are tending to evolve in the same direction as the stones in patients from industrialized countries.

Nouri, Abdellatif; Belgith, Mohsen; Saad, Hammadi; Jouini, Riadh; Najjar, Mohamed Fadhel

2012-01-01

245

Urinary trypsinogen-2 dipstick in acute pancreatitis  

DEFF Research Database (Denmark)

In acute pancreatitis (AP), rapid diagnosis and early treatment are of importance for clinical outcome. Urinary trypsinogen-2 has been suggested as a promising diagnostic marker; however, studies using the urinary trypsinogen-2 dipstick test (UTDT) have provided varying results.

Andersen, Anders Møller; Novovic, Srdan

2010-01-01

246

A Surprising Attempt for Urinary Incontinence  

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Although there are various treatment types, majority of women with urinary incontinence do not seek care for that disorder. We present a case of woman who used a walnut for the treatment of urinary incontinence by herself.

Mustafa Hoscan; Mehmet Ekinci; Ahmet Tunçk?ran

2012-01-01

247

Urinary incontinence - what to ask your doctor  

Science.gov (United States)

You have urinary incontinence. This means that you are not able to keep urine from leaking from your urethra, the tube that ... urine out of your body from your bladder. Urinary incontinence may occur as you get older. It can ...

248

Urgency Urinary Incontinence/Overactive Bladder  

Science.gov (United States)

... urgency incontinence, usually with frequency and nocturia ." Urgency urinary incontinence (UUI): is defined as the unwanted urine loss ... after the sudden, intense desire to urinate. Urgency Urinary Incontinence is a more severe symptom of OAB but ...

249

Urinary incontinence - tension-free vaginal tape  

Science.gov (United States)

... vaginal tape is surgery to help control stress urinary incontinence . This is urine leakage that happens when you ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

250

A Surprising Attempt for Urinary Incontinence  

Directory of Open Access Journals (Sweden)

Full Text Available Although there are various treatment types, majority of women with urinary incontinence do not seek care for that disorder. We present a case of woman who used a walnut for the treatment of urinary incontinence by herself.

Ahmet Tunçk?ran

2012-01-01

251

Radiology of continent urinary diversions  

International Nuclear Information System (INIS)

Continent urinary diversions are gaining wide acceptance as alternatives to the ideal conduit following cystectomy. Clean intermittent catheterization of the pouch at regular intervals obviates the inconvenience of an external stomal appliance. A variety of surgical techniques have been described for continent pouches. These use the small bowel alone or a combination of the cecum and the terminal ileum. The optimum pouch protects upper tracts by preventing reflux, provides urinary continence, and has sufficient capacity to require infrequent catheterization. Simplified construction techniques for the common pouches are graphically presented, and methods are suggested for identification and study of continent diversions

1988-12-02

252

[Clinical application of Sonolith 2000 on Extracorporeal Shock Wave Lithotripsy for renal and ureteral calculi].  

Science.gov (United States)

The collaborate studies of clinical application of Extracorporeal Shock Wave Lithotripsy (ESWL) using Sonolith 2000, performed at Departments of Urology of Nara Medical University, the University of Tokai School of Medicine and Wakayama Medical College between March and August 1987, were reported. In total 155 ESWL sessions were carried out on 111 patients suffering from in total 119 upper urinary tract stones. The localization system using ultrasound imaging with a computer assisted multiarticulated arm were evaluated as excellent or effective in 117 cases (98.3%). The stone fragmentations were evaluated as excellent (less than or equal to 3 mm) or effective (less than or equal to 5 mm) in 101 cases (84.9%). On the X-ray film obtained six weeks after the final ESWL treatments, 61 cases (51.3%) were free from stone fragments, 20 cases (16.8%) had sand-like fragments and 18 cases (15.1%) had stone fragments less than 5 mm. 99 cases (83.2%) without stone or with stone fragments less than 5 mm were considered to be with satisfactory results. No serious adverse effect was observed, but petchia on the flanks where shock wave penetrated and mild hematuria were observed in all cases. It is concluded that ESWL treatment using Sonolith 2000 is applicable in the managements of patients with the upper urinary tract stones without serious adverse effects. PMID:2747093

Hirao, Y; Sasaki, K; Yoshida, K; Okajima, E; Tanikawa, K; Nishizawa, K; Okada, K; Matsushita, K; Kawamura, N; Morimoto, S

1989-04-01

253

Predictors of Success for Stone Fragmentation and Stone-Free Rate After Extracorporeal Shockwave Lithotripsy in the Treatment of Upper Urinary Tract Stones  

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Full Text Available PURPOSE: To evaluate factors affecting the success rate of stone fragmentation and stone-free rate after extracorporeal shockwave lithotripsy (SWL in treatment of upper urinary tract stones. MATERIALS AND METHODS: A total of 121 patients with upper urinary tract calculi underwent SWL treatment. RESULTS: Success rate of stone fragmentation after SWL was 73.6% (89/121. In 89 patients who had success of breaking stones, 71 patients were followed up for the assessment of stone-free status, of whom 51 (71.8% patients were stone-free at 3-month follow-up. Among four prognostic factors, including body mass index (BMI, stone size, stone position, and hydronephrosis, BMI and stone position had a significant impact on the success rate of stone fragmentation (P = .04 and U1: P = .0108, respectively. Among five prognostic factors of BMI, stone size, stone position, hydronephrosis, and times of SWL treatments, stone size was the only factor with significant impact on the stone-free rate (middle: P = .0229. CONCLUSION: Our study suggests that stone fragmentation and stone-free rate after SWL treatment for upper urinary tract stones can be predicted.

Kiyoshi Takahara

2012-08-01

254

Urinary incontinence in Norwegian nursing home residents  

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Full Text Available Urinary incontinence is a multi-factorial condition that has a high impact on older persons living in nursing homes. While urinary incontinence is common, only a small percentage of nursing home residents have an official diagnosis. Factors influencing urinary incontinence in this population are poorly understood. The aim of this study was to evaluate the prevalence of urinary incontinence in Norwegian nursing home residents and to study the factors associated with urinary incontinence in this population. Residents from six different nursing homes were included in this study. Data on sex, age, medication, comorbid illnesses, urinary incontinence and the use of absorbent pads was collected. Barthel`s Index of Activities of Daily Living (ADL was used to estimate residents’ functional levels. Post-voiding residual urine was measured by means of a portable ultrasound. A questionnaire was completed by the nursing staff for each of the residents. In total, 173 residents participated in the study. One hundred and twenty-two residents (69% were incontinent for urine and 144 used absorbent pads (83%. Fourteen percent of residents used absorbent pads ‘just to make sure’. They did not have a history of urinary incontinence. Low ADL score, dementia and urinary tract infection were significantly associated with incontinence for urine. The prevalence of urinary incontinence in Norwegian nursing homes is high. Absorbent products are frequently used without a history of urinary incontinence. Physical impairment, dementia and urinary tract infections are significantly associated with urinary incontinence.

Ove Hellzèn

2012-06-01

255

The Current Role of the Artificial Urinary Sphincter in Male and Female Urinary Incontinence  

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The evolution of the artificial urinary sphincter has affected the current surgical options for urinary incontinence. With its unique features, the artificial urinary sphincter (AUS) has been an attractive option for the treatment of urinary incontinence regardless of gender. The current paper discusses the indications, contraindications, types of devices, surgical approaches, outcomes, and complications of the AUS in the treatment of both male and female urinary incontinence. A PubMed review...

Islah, Mar; Cho, Sung Yong; Son, Hwancheol

2013-01-01

256

Correlations Between the Composition of Moroccan Urinary Stones and the Risk Factors (Food Habit  

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Full Text Available The aim of this study is to characterize and to analyze the likely factors to influence the composition of the Morocco urinary calculi, we took a study between July 2002 and June 2007 with 283 lithiasis patients that gave their sample (stone for analyzes by infrared spectroscopy and replied to the questionnaire. Different informations were recorded: epidemiological characteristic (sex, age, residence zone and profession, food habits (tea; rich products in calcium, oxalate, animal proteins and spicy meals and consumption. The results show: a strong liaison between the different studied factors and the stone mainly composed of Weddelite, Whewellite and uric acid; the age effect on the stone mainly composed of Weddelite and uric acid was confirmed. Significant correlations were noted, positive between the stone mainly composed of Weddelite and the consumption of oxalate and negative between the stone mainly composed of calcium phosphate or magnesium ammonium phosphate and tea and spicy meals. This research shows equally that the consumption of the rich products in oxalate is frequents and that the consumption of the rich products in calcium is weak. This nutrition type would be responsible to the preponderance of the stone calcium oxalate (Whewellite, Weddelite observed in our country.

Laziri Fatiha

2009-01-01

257

Use of traditional Chinese medicine in the management of urinary stone disease  

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Full Text Available Objective: To assess the evidence-based literature supporting the use of traditional Chinese medicine Kampo herbal and Acupuncture in stone disease management. Materials and Methods: Four of the most commonly used herbal components of Kampo medicine in the treatment of stone disease are described according to their in vitro and in vivo effects. We also reviewed the role of Acupuncture in urologic clinical setting as well as its proposed mechanisms of action and results. Medline database was assessed using isolated and conjugated key words (Chinese Medicine, Kampo, Chinese Herbal, Calculi, Stone Disease, Kidney, Acupuncture, Herbal Medicine. Articles were reviewed and summarized. Results: Herbal medicine has been proven to be free from side-effects and therefore suitable for long term use therapy. Its antilithic beneficial effects include increased urinary volume, increased magnesium excretion (Takusya, inhibitory activity on calcium oxalate aggregation (Takusya, Wulingsan and Desmodyum styracyfolium, inhibition of calcium oxalate nucleation and hydroxyapatite internalization (Wulingsan. In contrast, acupuncture, has shown to be effective as a pre-treatment anxiolytic and analgesic during colic pain and extracorporeal shock wave lithotripsy treatment, reducing the need for complementary sedative drugs. Conclusion: Chinese traditional medicine is promising as regards its role in stone prevention. An effort must be made in order to standardize study protocols to better assess acupuncture results since each procedure differs in regards to selected acupoints, electrostimulation technique and adjunct anesthetics. Similarly, standardization of Kampo formulations and acceptable clinical endpoints (imaging vs. symptomatic events is needed.

Ricardo Miyaoka

2009-08-01

258

Paraganglioma of the Urinary Bladder.  

Science.gov (United States)

A series of 24 previously unreported cases of paraganglioma involving the urinary bladder are described and compared with the 34 other neoplasms of this type reported or referred to in the literature. Bladder paragangliomas represent about 0.06% of all bl...

E. B. Price J. E. Leestma

1971-01-01

259

Aeromonas popoffii Urinary Tract Infection  

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Aeromonas popoffii is a recently described species isolated mainly from freshwater. An isolate of Aeromonas popoffii was found to be responsible for a urinary tract infection in a 13-year-old boy suffering from spina bifida with enterocystoplasty. This is the first reported case of human infection attributed to this species.

Hua, Huy Thong; Bollet, Claude; Tercian, Stephane; Drancourt, Michel; Raoult, Didier

2004-01-01

260

The history of urinary diversion  

Directory of Open Access Journals (Sweden)

Full Text Available The earliest attempt to divert urine flow from the ureters to the intestine, was performed in 1851 by John Simon. In the absence of antibiotics, ureterosigmoidostomy and its modifications during the 19th and early 20th century have been associated with high rate of surgical and metabolic complications. In 1910, Robert Coffey demonstrated a new method for ureterointestinal anastomosis, which renovated primary enthusiasm in ureterosigmoidostomy and it gained broad popularity during the next forty years. In 1950, Ferris and Odel reported 80% incidence of hyperchloremic metabolic acidosis following ureterosigmoidostomy. Based on further investigations by Lapides in 1951, Parsons, Powel and Pyrah in 1952, and Stamey in 1956, which clearly demonstrated that hyperchloremic metabolic acidosis is inevitable complication of ureterosigmoidostomy, this urinary diversion lost its popularity. In 1950’s ileal conduit, popularized by Bricker, became the gold standard for the subsequent 35 years. Early attempts for continent urinary diversion occurred form 1888, by Guido Tizzoni and Alfonso Poggi, while the first reservoir-type ileal loop urinary diversion was performed by Cuneo in 1911. By better understanding of principles of detubularization, based on works of Kock and principles of clean intermittent catheterization, established by Lapides, interest in continent urinary diversion has increased. Up to date, various continent cutaneous stomal reservoirs, sigmoidorectal pouches and orthotopic bladder substitutes have been described. Regarding encouraging improvements in biocompatible materials, alloplastic bladder replacement could be the next step for the future in bladder replacement surgery.

Hadži-?oki? Jovan B.

2007-01-01

 
 
 
 
261

[The ureter in urinary diversion].  

Science.gov (United States)

Ureteral pathology is reviewed in 297 urinary diversions, which were performed consecutively in our Department, in the last 9 years. Either cutaneous or intestinal anastomosis stricture was the most common complication. Our attempts to cure definitely this problem by endourological techniques were unsatisfactory. So the Authors conclude that surgery is usually the best option. PMID:8475394

da Pozzo, G P; Simeone, C; Zambolin, T; Cancarini, G; Magri, V; Aulenti, V; Tosana, M

1993-03-01

262

Mullerianosis of the urinary bladder.  

Science.gov (United States)

Mullerianosis of the urinary bladder is a rare and morphologically complex tumor-like lesion, composed of several types of mullerian lesions like endometriosis, endocervicosis, and endosalpingiosis. This disease occurs in women of reproductive age group. Implantative and metaplastic origins have been suggested in the pathogenesis. PMID:22919142

Kudva, Ranjini; Hegde, Padmaraj

2012-04-01

263

Mullerianosis of the Urinary Bladder  

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Mullerianosis of the urinary bladder is a rare and morphologically complex tumor-like lesion, composed of several types of mullerian lesions like endometriosis, endocervicosis, and endosalpingiosis. This disease occurs in women of reproductive age group. Implantative and metaplastic origins have been suggested in the pathogenesis.

2012-01-01

264

Tamsulosin and doxazosin as adjunctive therapy following shock-wave lithotripsy of renal calculi: randomized controlled trial.  

Science.gov (United States)

Alpha-blockers have been established as medical expulsive therapy for urolithiasis. We aimed to assess the effect of tamsulosin and doxazosin as adjunctive therapy following SWL for renal calculi. We prospectively included 150 patients who underwent up to four SWL sessions for renal stones from June 2008 to 2009. Patients were randomized into three groups of 50 patients each, group A (phloroglucinol 240 mg daily), group B (tamsulosin 0.4 mg once daily plus phloroglucinol), and group C (doxazosin 4 mg plus phloroglucinol). The treatment continued up to maximum 12 weeks. Patients were evaluated for stone expulsion, colic attacks, amount of analgesics and side-effects of alpha-blockers. There were no significant differences between the groups regarding stone expulsion rates (84; 92 and 90%, respectively). The mean expulsion time of tamsulosin was significantly shorter than both control group (p = 0.002) and doxazosin (p = 0.026). Both number of colic episodes and analgesic dosage were significantly lower with tamsulosin as compared to control and doxazosin. Steinstrasse was encountered in 10 (6.7%) patients with no significant difference between the groups. 16 patients on tamsulosin and 21 on doxazosin experienced adverse effects related to postural hypotension. Moreover, 2 (4%) patients in the tamsulosin group reported ejaculatory complaints. In conclusion, adjunction of tamsulosin or doxazosin after SWL for renal calculi decreases the time for stone expulsion, amount of the analgesics and number colic episodes. There was no benefit regarding the overall stone expulsion rate. The side-effects of these agents are common and should be weighted against the benefits of their usage. PMID:21837534

Zaytoun, Osama M; Yakoubi, Rachid; Zahran, Abdel Rahman M; Fouda, Khaled; Marzouk, Essam; Gaafar, Salah; Fareed, Khaled

2012-08-01

265

Unusual Vesical Calculus in Rhesus Monkey (Macaca mulatta)  

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Several cases of urinary calculi have been reported in cynomolgus monkeys but vesical calculi were not reported in rhesus monkeys. The adult male rhesus monkey (Macaca mulatta) presented here had a vesical calculi which was entire urate.

2012-01-01

266

Major Odorants Released as Urinary Volatiles by Urinary Incontinent Patients  

Directory of Open Access Journals (Sweden)

Full Text Available In this study, volatile urinary components were collected using three different types of samples from patients suffering from urinary incontinence (UI: (1 urine (A; (2 urine + non-used pad (B; and (3 urine + used pad (C. In addition, urine + non-used pad (D samples from non-patients were also collected as a reference. The collection of urinary volatiles was conducted with the aid of a glass impinger-based mini-chamber method. Each of the four sample types (A through D was placed in a glass impinger and incubated for 4 hours at 37 °C. Ultra pure air was then passed through the chamber, and volatile urine gas components were collected into Tedlar bags at the other end. These bag samples were then analyzed for a wide range of VOCs and major offensive odorants (e.g., reduced sulfur compounds (RSCs, carbonyls, trimethylamine (TMA, ammonia, etc.. Among the various odorants, sulfur compounds (methanethiol and hydrogen sulfide and aldehydes (acetaldehyde, butylaldehyde, and isovaleraldehyde were detected above odor threshold and predicted to contribute most effectively to odor intensity of urine incontinence.

In Young Sa

2013-07-01

267

Urinary catheterization in medical wards  

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Aims : The study aims to determine the: 1. frequency of inappropriate catheterization in medical wards and the reasons for doing it. 2. various risk factors associated with inappropriate catheterization, catheter associated urinary tract infections (CAUTI) and bacterial colonization on Foley?s catheters (BCFC). Settings and Design: Hospital-based prospective study. Materials and Methods: One hundred and twenty five patients admitted consecutively in the medical...

2010-01-01

268

Management of male urinary incontinence  

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The majority of male urinary incontinence seen is secondary to sphincter weakness following prostatic surgery. As there is a rising elderly population and increasing numbers of surgical interventions for prostate cancer, incidence of male incontinence is increasing. Hence, management of male incontinence has become a subject of increased interest for urologists. Various non-surgical and surgical approaches have been suggested for this devastating condition. Non-invasive therapies are suggeste...

Moore, Katie C.; Lucas, Malcolm G.

2010-01-01

269

Acute urinary retention: which catheter?  

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There is no scientific data on which is the best method and catheter to use in acute urinary retention in males. We therefore compared the efficiency of a size 12 G latex rubber balloon catheter with a similar calibre but more expensive catheter made of polyvinyl-chloride (PVC). A total of 50 patients was studied and a 100% successful catheterisation rate was recorded at first attempt with both catheters, with no significant complications. The importance of the correct management of acute uri...

Allardice, J. T.; Standfield, N. J.; Wyatt, A. P.

1988-01-01

270

Primary amyloidosis of urinary bladder  

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Full Text Available Primary amyloidosis of the bladder is a rare pathologicalcondition, which the etiology is unknown. The signsand symptoms suggests bladder tumor. In some patients,lower urinary tract symptoms such as lower abdominalpain, frequent urination, dysuria and complaints of grosspainless hematuria occur. In this study, a case of primarylocalized amyloidosis of the bladder in a 66 years oldfemale who had gross painless hematuria as the initialsymptom is described.Key words: Amyloidosis, bladder, hematuria

Basri Çak?ro?lu

2013-03-01

271

E.A.E.S. multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi.  

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BACKGROUND: The current management of patients with gallstone disease and ductal calculi consists of endoscopic stone extraction (ESE) followed by laparoscopic cholecystectomy (LC). Following the advent of techniques of laparoscopic ductal stone clearance, an alternative single-stage laparoscopic treatment was introduced for these patients. The European Association of Endoscopic Surgery (E.A. E.S.) set up a ductal stone trial to compare the relative efficacy and outcome of these two managemen...

1999-01-01

272

Neurogenic lower urinary tract dysfunction.  

Science.gov (United States)

The two roles of the lower urinary tract are storage of urine and emptying at appropriate times. Optimal and coordinated activity of the bladder and urethra is subject to complex neural control which involves all levels of the nervous system, from cortex to peripheral nerve. This explains the high prevalence of urinary disturbances in neurological disease. Information obtained from history taking and supplemented by use of a bladder diary forms the cornerstone of evaluation. Ultrasonography is used to assess the degree of incomplete bladder emptying, and for assessing the upper tracts. Urodynamic tests, with or without simultaneous fluoroscopic monitoring, assess detrusor and bladder outlet function and give fundamental information about detrusor pressure and thus the risk of upper tract damage. Impaired emptying is most often managed by clean-intermittent self-catheterization, which should be initiated if the postvoid residual urine exceeds one-third of bladder capacity or is greater than 100mL, or rarely if spontaneous voiding is dangerous due to high detrusor pressure. Storage symptoms are most often managed using antimuscarinic medications. Intradetrusor injection of botulinum toxin type A is emerging as an effective treatment for managing detrusor overactivity. Understanding of the underlying mechanism of lower urinary tract dysfunction is crucial for effective management. PMID:23312642

Panicker, Jalesh N; De Sèze, Marianne; Fowler, Clare J

2013-01-01

273

A novel ureter dilatation method for replacing hydromantic perfusion pump during ureteroscopic lithotripsy in patients with ureteral calculi and ibroepithelial polyps  

Science.gov (United States)

This study aimed to evaluate the clinical value of a novel ureter dilatation method during ureteroscopic pneumatic lithotripsy in patients with ureteral calculi and polyps. Clinical information of 86 patients with ureter calculi and polyps who underwent ureteroscopic pneumatic lithotripsy was reviewed. A cavity-distention machine was used in 44 cases to inject normal saline for keeping clear operation view (cavity-distention machine-assisted group). A high handled water bag with artificial water injection (traditional pneumatic lithotripsy group) was used in 42 cases. The total operation time, time of stone removal, stone clearance rate and surgery complications were compared between two groups. All operations were successful with no patients transferred to open surgery. No ureter breakage or avulsion occurred in two groups. Two patients in traditional pneumatic lithotripsy group suffered from ureter perforation. In cavity-distention machine-assisted group and traditional pneumatic lithotripsy group, the total operation time was 30.1±4.8 min and 36.2±6.0 min, respectively (t=-5.22, Pureter stone immigrated to the renal pelvis in 2, and extraorgan shock wave lithotripsy was performed), respectively. Thus, intraoperative infusion of saline with a cavity-distention machine may replace the hydromantic perfusion pump to maintain a clear operation view and favor the stone removal in lesser time. This method has important clinical value in the treatment of ureteral calculi and polyps.

Li, Tengcheng; Fang, Youqiang; Wu, Jieying; Zhou, Xiangfu

2014-01-01

274

Quantum Orthogonal Planes $ISO_{q,r}(n+1,n-1)$ and $SO_{q,r}(n+1,n-1)$ - bicovariant Calculi  

CERN Multimedia

We construct differential calculi on multiparametric quantum orthogonal planes in any dimension $N$. These calculi are bicovariant under the action of the full inhomogeneous (multiparametric) quantum group $ISO_{q,r}(N)$, and do contain dilatations. If we require bicovariance only under the quantum orthogonal group $SO_{q,r}(N)$, the calculus on the $q$-plane can be expressed in terms of its coordinates $x^a$, differentials $dx^a$ and partial derivatives to the multiparametric case. Using a real form which exists only in even dimensions, we find $ISO_{q,r}(n+1,n-1)$ and $SO_{q,r}(n+1,n-1)$ bicovariant calculi on the multiparametric quantum spaces. The particular case of the quantum Minkowski space $ISO_{q,r}(3,1)/SO_{q,r}(3,1)$ is treated in detail. The conjugated partial derivatives $\\partial_a^*$ can be expressed as linear combinations of the $\\partial_a$. This allows a deformation of the phase-space where no additional operators(besides $x^a$ and $p_a$) are needed.

Aschieri, Paolo; Aschieri, Paolo; Castellani, Leonardo

1997-01-01

275

Large impacted upper ureteral calculi: A comparative study between retrograde ureterolithotripsy and percutaneous antegrade ureterolithotripsy in the modified lateral position  

Science.gov (United States)

Context: The treatment for patients with large impacted proximal ureteral stone remains controversial, especially at institutions with limited resources. Aim: The aim of this study is to compare and to evaluate the outcome and complications of two main treatment procedures for impacted proximal ureteral calculi, retrograde ureterolithotripsy (URS), and percutaneous antegrade ureterolithotripsy (Perc-URS). Settings and Design: Our inclusion criteria were solitary, radiopaque calculi, >15 mm in size in a functioning renal unit. Only those patients in whom the attempt at passing a guidewire or catheter beyond the calculus failed were included in this study. Patients and Methods: Between January 2007 and July 2011, a total of 52 patients (13 women and 39 men) with large impacted upper-ureteral calculi >15 mm and meeting the inclusion criteria were selected. Of these, Perc-URS was done in 22 patients (group 1) while retrograde ureteroscopy was performed in 30 patients (group 2). We analyzed operative time, incidence of complications during and after surgery, the number of postoperative recovery days, median total costs associated per patient per procedure, and the stone-free rate immediately after 5 days and after 1 month. Statistical Analysis Used: Bivariate analysis used the Student t-test and the Mann-Whitney test to compare two means and Chi-square and Fisher's exact tests to compare two percentages. The significance level was set at 0.05. Results: The mean age was 42.3 years (range 22-69). The mean stone sizes (mm) were 34 ± 1.2 and 29.3 ± 1.8 mm in group 1 and 2, respectively. In the Perc-URS group, 21 patients (95.45%) had complete calculus clearance through a single tract in one session of percutaneous surgery, whereas in the URS group, only 20 patients (66.7%) had complete stone clearance (P = 0.007). The mean operative time was higher in the Perc-URS group compared to group 2 (66.5 ± 21.7 vs. 52.13 ± 17.3 min, respectively; P = 0.013). Complications encountered in group 1 included transient postoperative fever (2 pts) and simple urine outflow (2 pts). Ten patients (33%) of group 2 experienced failure: Migration to the kidney (3 pts), ureteral perforation (2 pts), tortuosity of the ureter (2 pts), and epithelial polyps (2 patients). Group 1 patients had an average visual analog (VAS) pain score of 47 mm compared with 31 mm in group 2 patients. The mean hospital stay (days) in group 1 was higher than the group 2 (2.27 ± 0.8 vs. 1.67 ± 0.6, respectively; P = 0.01). The mean analgesia requirement for group 1 (paracetamol chlorhydrate + codeine 12 ± 3 g) was significantly more compared with group B (6.8 ± 2 g) (P 0.05). After 1 month, the stone free-rate remained higher in group 1 (95.5% vs. 66.7%, respectively; P = 0.012). Conclusions: In our series, Perc-URS is a safe and efficient treatment option for proximal ureteral stone, especially when the stone size is superior to 15 mm with the presence of moderate or severe hydronephrosis.

Moufid, Kamal; Abbaka, Najib; Touiti, Driss; Adermouch, Latifa; Amine, Mohamed; Lezrek, Mohammed

2013-01-01

276

Recurrent Multifocal Primary Amyloidosis of Urinary Bladder  

Directory of Open Access Journals (Sweden)

Full Text Available Primary localized amyloidosis of bladder is rare. We report a case of recurrence of multifocal primary amyloidosis of urinary bladder. Cystoscopy revealed a diffuse left lateral wall lesion with normal surrounding mucosa. Histopathological examination of the specimen revealed urinary bladder amyloidosis with negative surgical margins. Recurrent urinary bladder amyloidosis was confirmed 3 months after the first resection. Close follow-up is recommended.

Patel S

2008-01-01

277

Modifying factors in urinary bladder carcinogenesis  

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N-Butyl-N-(4-hydroxybutyl)nitrosamine (BBN) is a potent carcinogen in the urinary bladder of animals. The BBN model of bladder cancer is an excellent model of human urinary bladder cancer and has already led to a greater knowledge of its pathogenesis. In our studies, histogenesis and morphological characteristics of BBN urinary bladder cancer were analyzed in different animal species such as rats, mice, hamsters and guinea pigs and also in different rat strains. Papillary or nodular hyperplas...

1983-01-01

278

Lower urinary tract dysfunction in childhood.  

Science.gov (United States)

Lower urinary tract syndrome is common in children. Incontinence, urinary tract infection, vesicoureteral reflux, and constipation are commonly associated with this syndrome. Examining the clinical history of the afflicted patient plays a major role in the accurate diagnosis and treatment of lower urinary tract disorder. Along with pharmacologic treatment, pelvic floor muscle retraining, biofeedback therapy, and adaptation of a healthy lifestyle are advocated for rapid recovery of patients. PMID:20569800

Ballek, Nathaniel K; McKenna, Patrick H

2010-05-01

279

Computed tomography of the urinary bladder  

International Nuclear Information System (INIS)

Out of one hundred cases of the urinary bladder abnormalities examined by this method, CT staging and pathological correlations were investigated in 61 cases of the urinary bladder neoplasms. Accuracy of CT staging was 87% in this series with possible exception of 6 cases involving the bladder base and dome. CT scan using this method is the most reliable procedure to determine the treatment modalities of the urinary bladder tumors. (author)

1982-01-01

280

Cranberries and lower urinary tract infection prevention  

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Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and...

Marcelo Hisano; Homero Bruschini; Antonio Carlos Nicodemo; Miguel Srougi

2012-01-01

 
 
 
 
281

Mechanism of Urinary Calcium Regulation by Urinary Magnesium and pH  

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Urinary magnesium and pH are known to modulate urinary calcium excretion, but the mechanisms underlying these relationships are unknown. In this study, the data from 17 clinical trials in which urinary magnesium and pH were pharmacologically manipulated were analyzed, and it was found that the change in urinary calcium excretion is directly proportional to the change in magnesium excretion and inversely proportional to the change in urine pH; a regression equation was generated to relate thes...

Bonny, Olivier; Rubin, Adam; Huang, Chou-long; Frawley, William H.; Pak, Charles Y. C.; Moe, Orson W.

2008-01-01

282

FEMALE URINARY INCONTINENCE IN CANADA  

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In Canada, Urinary Incontinence (UI) is a significant medical and social problem which can be devastating to a women’s physical, social and emotional well being. As in other developed countries our population is aging. In 1993, 11.8 per cent of all Canadians were over age 65; by the year 2011, the proportion of this age group will be 14.0 per cent; by 2031, it will be 21.7 per cent (1). It is estimated that between 1.5 to 2.0 million Canadians (out of a population of just over 30 millio...

Drutz, Harold P.

2010-01-01

283

URINARY TRACT INFECTIONS IN PREGNANCY  

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Full Text Available Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

N Sivalingam

2007-01-01

284

URINARY TRACT OBSTRUCITON FOLLOWING ESWL  

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Full Text Available Among 2379 patients with upper urinary tract stones who underwent ESWL (Extracorporeal Shock Wave Lithotripsy at Sina Hospitál using the Siemens Lithostar, 638 developed Stone Street (SteinStrasse. Of these, 516 (81% passed all of the stone fragments spontaneously and no treatment was required, 90 cases (14% had more ESWL sessions to complete the treatment, and 30 (4.7% required further interventional procedures. Only two cases (0.3% needed an open ureterolithotomy."nIn this paper, we report the results of our experience in treating Stein Strasse as a complication of the ESWL.

Gholamreza Pourmand

1994-06-01

285

Müllerianosis of the urinary bladder.  

Science.gov (United States)

Müllerianosis of the urinary bladder is a rare condition that encompasses 3 histological entities (endometriosis, endocervicosis, and endosalpingiosis). The authors report 2 patients with bladder müllerianosis, one of whom had endometriosis and the other a history of past pelvic surgery, describe the histological and cystoscopic features, and review the literature on this condition. Mucosal hyperemia and submucosal nodules or cysts with associated fibrosis and distortion of the bladder wall may mimic malignancy on cystoscopy, as may the infiltrative growth pattern sometimes evident histologically. Recognition of this complex diagnostic entity is important to avoid misdiagnosis and inappropriate investigation. There is a clinical association with endometriosis and past pelvic surgery. PMID:21632636

Olivia Vella, Josefa Elizabeth; Nair, Nithin; Ferryman, Stephen Robert; Athavale, Ramanand; Latthe, Pallavi; Hirschowitz, Lynn

2011-08-01

286

A rare urinary bladder tumour.  

Science.gov (United States)

This case report describes a 54-year-old man who presented to his primary care physician with low back pain. During his workup, an incidental finding of a bladder mass was diagnosed. He underwent transurethral resection of the bladder tumour and the resulting pathology was consistent with extra nodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Presentation of MALT lymphoma in the urinary bladder is rare. This malignancy is more commonly found in the stomach. The prognosis for this rare tumour is excellent. Our patient showed no sign of recurrence with transurethral excision and radiation alone. PMID:24835803

Haddad-Lacle, Judella Edwina Maria; Haddad, Charles Joseph; Villas, Bruce

2014-01-01

287

A meta-analysis of the efficacy of ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy on ureteral calculi  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: To re-evaluated the clinic efficacy of ureteroscopic lithotripsy (URS) and extracorporeal shock wave lithotripsy (ESWL) on ureteral calculi with Cochrane systematic reviews in this paper. METHODS: We searched clinical randomized controlled trials and prospective controlled trials in d [...] atabases such as Cochrane library, Medline, Springer, Elsevier Science Direct, PubMed. Pooled estimate of risk ratios (RRs), standard mean difference (SMD) with 95% confidence intervals (CIs) were used as measure of effect sizes. Summary effect estimates were also stratified by sample size, study design and study region. The overall effect sizes were derived using a random-effects model or fixed-effects model when appreciated, and meta-analysis were conducted with software RewMan 5.0. RESULTS: The meta-analysis suggested that there were significant differences of post-treatment stone free rate, repeat treatment rate, patients' satisfaction, incidence of postoperative complications, operation time and hospital stays between ESWL treatment cases and URS treatment cases. But in the sample sizes analysis, there were no significant differences of the post-treatment stone free rate and repeat treatment rate when the sample sizes were less than 100. CONCLUSIONS: Compared to the ureteroscopic lithotripsy treatment, extracorporeal shock wave lithotripsy treatment provided a significantly lower post-treatment stone free rate, but it also obviously brought out less postoperative complications, shorter operation time and hospital stays.

Yahong, Xu; Yi, Lu; Jian, Li; Shunwen, Luo; Yang, Liu; Zhigang, Jia; Ping, Chen; Yu, Guo; Qihua, Zhao; Xiaoping, Ma; Shufang, Jia.

288

A pheochromocytoma of the urinary bladder  

International Nuclear Information System (INIS)

This case report describes a patient with a pheochromocytoma of the urinary bladder. The patient demonstrated an excessive increase of blood pressure and plasma catecholamines immediately after micturition. Ultrasound and CT-scanning confirmed the localisation of the tumour in the urinary bladder. (orig.)

1987-01-01

289

Urinary Incontinence: Management and Treatment Options  

Science.gov (United States)

Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

Griebling, Tomas L.

2009-01-01

290

Urinary tract infection in children - aftercare  

Science.gov (United States)

Symptoms of urinary tract infection should begin to improve within 1 to 2 days. ... If diagnosed with a urinary tract infection (UTI), your child will take antibiotic medicines by mouth at home. These may come as pills, capsules, or a liquid. ...

291

Bladder Dysfunction and Urinary Incontinence  

Directory of Open Access Journals (Sweden)

Full Text Available   "nIn the name of God. Dear colleagues, ladies and gentlemen, it is a great honor to be here. Bladder dysfunction is serious enough to seek serious help. If you may know I am working in a private clinic which it is impossible to follow the patients so this lecture is based on unusual and rare cases who came to me. Bladder dysfunction (BD is common among 30% of young and old people who are suffering from it, however it is more common in old ages. According to a research, women are more involved as in men which prostate has a role is more common. The usual cases were: "n1. A young girl, aged 20, who had to wake up five times during the night to micturate. "n2. Also a lady said when I roll in bed I wet myself. "n3. A young lady who always had to use a pad. "n4. A man said I can’t use underground. "n5. I cannot go out since I have to micturate every hour. "n6. One said I have to wake up every hour at night. "n7. Young people say we have to micturate 3-4 times at night. "n8. A young man said as soon as I feel to micturate I empty my bladder before I’ve reached the WC and I wet myself to the ankle, how could I have a job? "n9. Some women wet themselves when they cough. "nIn order to know and diagnosis, the physiology of bladder function must be known. "nThe bladder is divided into two parts: "nThe Dom, which is innervated by Beta-Adrenergic. It relaxes the bladder in order to comply the urine. "nFrom the orifice of the urether and posterior ridge of the trigon to the bladder neck or internal sphincter. The prostatic urethra plays a major role in conti- nence. It has two parts,   "n1: From the bladder neck to V.M. this is enclaved by extension of detrusor muscles like a sleeve. These muscles contract during ejaculation to prevent retrograde ejaculation. "nDistal urethra from V.M. to the external sphincter which is covered by voluntary muscles. "nThe internal pressure of the urethra is higher than the bladder. If the pressure of the bladder rises, the internal pressure of the urethra should also increase. In women, the internal pressure of the urethra is short, and even if it has poorly developed they wet themselves when they cough. "nThe causes of BD: "nAs you see there are 17 causes, which 11 are related to the bladder. The bladder is responsible for retaining the urine and voiding. "nPathophysiology: "nThe bladder and sphincter should work in a coordinated manner: "nDuring the course of a day, an average person will void approximately 4-8 times. The urinary bladder is in storage mode for most of the day, allowing an individual to engage in more important activities than urination. "nNormal bladder function consists of 2 phases—filling and emptying. The normal micturition cycle requires the urinary bladder and the urethral sphincter working together as a coordinated unit to store and empty urine. During urinary storage, the bladder acts as a low-pressure receptacle, while the urinary sphincter maintains high resistance to urinary flow to keep the bladder outlet closed. During urine elimination, the bladder contracts to expel urine while the urinary sphincter opens (low resistance to allow unobstructed urinary flow and bladder emptying. "nFilling phase: "nDuring the filling phase, the bladder accumulates increasing volumes of urine while the pressure inside the bladder remains low. The pressure within the bladder must be lower than the urethral pressure during the filling phase. If the bladder pressure is greater than the urethral pressure (resistance, urine will leak out. "nThe filling of the urinary bladder depends on the intrinsic viscoelastic properties of the bladder and the inhibition of the parasympathetic nerves. Thus, bladder filling is primarily a passive event. "nSympathetic nerves also facilitate urine storage in the following ways: "nSympathetic nerves inhibit the parasympathetic nerves from triggering bladder contractions. "

F. faizi

2009-01-01

292

Urinary catheterization in medical wards  

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Full Text Available Aims : The study aims to determine the: 1. frequency of inappropriate catheterization in medical wards and the reasons for doing it. 2. various risk factors associated with inappropriate catheterization, catheter associated urinary tract infections (CAUTI and bacterial colonization on Foley?s catheters (BCFC. Settings and Design: Hospital-based prospective study. Materials and Methods: One hundred and twenty five patients admitted consecutively in the medical wards of a tertiary care hospital, who underwent catheterization with a Foley?s catheter, at admission, have been included in the study. Patient profiles were evaluated using the following parameters: age, sex, diagnosis, functional status, mental status, indication, duration and place of catheterization, development of BCFC and CAUTI. Statistical tests used: Chi-square test. Results: Thirty-six out of 125 (28.8% patients included were inappropriately catheterized. BCFC developed in 52.8% and 22.4% were diagnosed with a CAUTI. The most frequent indication for inappropriate catheterization was urinary incontinence without significant skin breakdown (27.8%. The risk factors for inappropriate catheterization were female sex (RR=1.29, 95% CI=0.99, 1.69, P< 0.05 and catheterization in the emergency (RR=0.74, 95% CI=0.61, 0.90, P< 0.05. The risk factors for developing a BCFC were age>60 years (RR=0.65, 95% CI=0.48, 0.89, P< 0.05, non-ambulatory functional status (RR=0.57, 95% CI=0.39, 0.84, P< 0.01, catheterization in the emergency (RR=2.01, 95% CI=1.17, 3.46, P< 0.01 and duration of catheterization>3 days (RR=0.62, 95% CI=0.43, 0.89, P< 0.01. The risk factors for acquiring a CAUTI were age>60 years (RR=0.47, 95% CI=0.25, 0.90, P< 0.05, impaired mental status (RR=0.37, 95% CI=0.18, 0.77, P< 0.01 and duration of catheterization>3 days (RR=0.24, 95% CI=0.10, 0.58, P< 0.01. Conclusions : Inappropriate catheterization is highly prevalent in medical wards, especially in patients with urinary incontinence. The patients catheterized in the medical emergency and female patients in particular are at high risk. Careful attention to these factors can reduce the frequency of inappropriate catheterization and unnecessary morbidity.

Bhatia Nirmanmoh

2010-01-01

293

Urinary retention secondary to Listeria meningitis.  

Science.gov (United States)

We report a rare case of urinary retention secondary to Listeria meningitis. A 90-year-old woman presented with high fever, nausea, diarrhea, and incontinence of urination and feces. Lumbar puncture was performed. The total cell number of the cerebrospinal fluid (CSF) was elevated indicating that the glucose level was decreased. A CSF culture and a blood culture revealed Listeria monocytogenes (L. monocytogenes). We treated this bacterial meningitis with antibiotic medicine. One month after onset, stiff neck and laboratory data greatly improved and only urinary retention continued. Lumbar magnetic resonance imaging (MRI) showed no responsible lesions for the urinary retention. She received urological examination for urinary retention and was diagnosed with a neurogenic bladder. Two months later, she was able to walk after rehabilitation. However, the urinary retention continued despite urological therapy. We are not aware of descriptions on urinary retention resulting from bacterial meningitis in the recent literature. This is a rare case of prolonged urinary retention caused by bacterial meningitis. PMID:18552472

Fujita, Kohei; Tanaka, Tomotaka; Kono, Syoichiro; Narai, Hisashi; Omori, Nobuhiko; Manabe, Yasuhiro; Abe, Koji

2008-01-01

294

Use of traditional Chinese medicine in the management of urinary stone disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Objective: To assess the evidence-based literature supporting the use of traditional Chinese medicine Kampo herbal and Acupuncture in stone disease management. Materials and Methods: Four of the most commonly used herbal components of Kampo medicine in the treatment of stone disease are described ac [...] cording to their in vitro and in vivo effects. We also reviewed the role of Acupuncture in urologic clinical setting as well as its proposed mechanisms of action and results. Medline database was assessed using isolated and conjugated key words (Chinese Medicine, Kampo, Chinese Herbal, Calculi, Stone Disease, Kidney, Acupuncture, Herbal Medicine). Articles were reviewed and summarized. Results: Herbal medicine has been proven to be free from side-effects and therefore suitable for long term use therapy. Its antilithic beneficial effects include increased urinary volume, increased magnesium excretion (Takusya), inhibitory activity on calcium oxalate aggregation (Takusya, Wulingsan and Desmodyum styracyfolium), inhibition of calcium oxalate nucleation and hydroxyapatite internalization (Wulingsan). In contrast, acupuncture, has shown to be effective as a pre-treatment anxiolytic and analgesic during colic pain and extracorporeal shock wave lithotripsy treatment, reducing the need for complementary sedative drugs. Conclusion: Chinese traditional medicine is promising as regards its role in stone prevention. An effort must be made in order to standardize study protocols to better assess acupuncture results since each procedure differs in regards to selected acupoints, electrostimulation technique and adjunct anesthetics. Similarly, standardization of Kampo formulations and acceptable clinical endpoints (imaging vs. symptomatic events) is needed.

Ricardo, Miyaoka; Manoj, Monga.

295

Safety and Efficacy of Pneumatic Lithotripters Versus Holmium Laser in Management of Ureteral Calculi: A Randomized Clinical Trial  

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Full Text Available PURPOSE: To compare efficacy and safety of holmium:YAG laser and pneumatic lithotripter in the management of ureteral stones.MATERIALS AND METHODS:One hundred and twelve patients with 1 to 2 cm ureteral calculi were selected for pneumatic or holmium:YAG laser transurethral ureterolithotripsy (56 patients in each group. Ultrasonography and plain abdominal x-ray were performed for all the patients before the operation. The pneumatic lithoclast was Swiss LithoClast, while in laser lithotripsy, holmium:YAG laser frequency was used, which was usually set between 5 and 10 Hz at a power of 10 to 15 Watt. Intravenous urography was performed for all the patients at 3 months to assess functional status and to delineate the ureteral anatomy.RESULTS: The mean patients’ age and stones’ size were the same in both groups, and there were no statistical differences. Mean duration of lithotripsy was 13.7 ± 12.6 minutes in laser group and 7.9 ± 4.2 minutes in pneumatic lithotripsy group. Immediate stone-free rate was 100% and 82.1% in the laser and pneumatic groups, respectively (P = .001. Stone pushing back occurred only in 10 (17.9% patients in pneumatic group. In terms of complications, such as perforation, mucosal injury, and bleeding, there were no differences between the two groups. No intravenous pyelography related complication was seen at 3-month follow-up.CONCLUSION:Laser lithotripsy is a superior approach for the management of upper ureteral stones of 1 to 2 cm in size due to its higher rate of stone clearance.

Reza Valipour

2013-03-01

296

Effective management in male urinary incontinence.  

Science.gov (United States)

Effective assessment is key to the effective management of male urinary incontinence. Identification of the specific type of incontinence being experienced by the patient will inform the treatment plan, and the holistic needs of the patient need to be considered before making a decision in this regard. This article describes the different types of male lower urinary tract symptoms and gives recommendations for managing and treating each specific type. It will also consider potential issues surrounding treatment of male urinary incontinence, such as communication issues from the perspective of the health-care professional and the patient themselves, before giving containment strategies and methods. PMID:25039338

Fawcett, Julie

2014-07-01

297

[What to do with a normal urinary strip in case of lower urinary tract symptoms?].  

Science.gov (United States)

Patients very often consult for lower urinary tract symptoms, that do not necessarily equate to common cystitis. When urinary leucocytes and nitrites are absent, the urinary strip has a very good negative predictive value and makes the diagnosis of a lower urinary tract infection very unlikely. One then has to search for other diagnoses and to clarify the nature of the symptoms, irritating or obstructive ones, their duration and to correlate them to the patient's age and gender. In sexually active young patients, infectious diseases predominate, such as uretritis or vaginitis, while, with age, the prevalence of dysfunction of vesical emptying, benign prostatic hyperplasia or atrophic vaginitis increase. PMID:23097864

Sabeh, N; Gambirasio, I Kaelin; Caviezel, A; Delémont, C

2012-09-26

298

Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital  

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OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patient...

Oliver Rojas Claros; Carlos Hirokatsu Watanabe Silva; Horacio Consolmagno; Americo Toshiaki Sakai; Rodrigo Freddy; Oscar Eduardo Hidetoshi Fugita

2012-01-01

299

Urinary plutonium excretion following plutonium exposure  

International Nuclear Information System (INIS)

Following an accidental 238,239Pu release, one employee was adjudged to have had a plutonium exposure which merited chemical chelation and, as such, was so treated roughly four hours post incident. After the chelation (with Na3CaDTPA), this employee's first 24 h plutonium urinary excretion was at a level of 13,000 pCi and during the first eight days post incident, he was chelated a total of four times. For the period 10 to 70 days post incident, the employee's urinary plutonium excretion declined at an exponential rate. Thereafter, the plutonium urinary excretion evidenced an apparent leveling out at a total 238,239Pu activity level of i/24 h. Urinary voidings of this employee showed parallel rates of 238Pu and 239Pu excretion. This data will be reported as will excretion data of employees involved in this exposure and to whom no chelation treatment was administered. (author)

1978-12-01

300

State of the Science on Urinary Incontinence.  

Science.gov (United States)

Despite widely disseminated guidelines for urinary incontinence (UI), it remains underreported and underdiagnosed. To raise awareness about UI and to develop a nursing agenda for research and clinical practice an invitational symposium for nurse researche...

M. H. Palmer

2002-01-01

 
 
 
 
301

[Pathogenetic aspects of urinary tract infection].  

Science.gov (United States)

Most urinary tract infections are caused by Enterobacteriaceae; E. coli-strains dominating in 50 to 80% of primary infections. Microorganisms possessing the ability to colonize the uroepithelium (fimbriae/pili) and to cytotoxically damage of cells (hemolysin) may initiate acute infections. On the other hand, properties favouring the survival of these strains in the tissue (K-antigen, iron sequestering/aerobactin) tend to produce relapse and/or chronic infection. A variety of host-specific factors, especially glycosphingolipids, on the surface of epithelial cells determine the virulence of pathogenic microorganisms in the urinary tract and the course of a disease. Structural damages resulting from intra- or extrarenal obstructions, disturbances of the urinary flow and metabolic disorders are essential, predisposing factors of a host organism. These different factors and interactions of these mechanisms determine the manifestation and course of urinary tract infections. PMID:9471845

Fünfstück, R; Stein, G

1997-01-01

302

An Unusual Case of Urinary Incontinence  

Directory of Open Access Journals (Sweden)

Full Text Available Urinary incontinence and hematuria are frequent complaints evaluated by urologists often with readily identifiable etiologies. Occasionally, an unlikely source is found. We present an unusual case of urinary incontinence and hematuria in an elderly female. Evaluation revealed that the complaints were due to a large cyst emanating from her right hip which was the result of a previous right hip arthroplasty in 1970 with three subsequent revisions. Her symptoms resolved spontaneously and the cyst has remained unchanged.

Eric R. Anderson

2011-02-01

303

Care of urinary catheters and drainage systems.  

Science.gov (United States)

A question about the reuse of drainable urinary catheter night drainage bags in a patient's home promoted the South East Thames continence advisory group to examine the evidence for the management of urinary catheter drainage systems. The objective of this review was to establish if there is evidence available to support clinical practice and provide recommendations to staff and patients to ensure best practice. PMID:17985750

Jones, Sarah; Brooks, Anthony; Foxley, Sue; Dunkin, Judith

304

Continent urinary tract reconstruction - the Lund experience.  

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The Department of Urology in Lund, Sweden, has a long association with innovations in reconstructive urology. The authors from that department describe their experience over a long period with orthotopic bladder substitution and continent cutaneous urinary diversion. They conclude that continent urinary tract reconstruction is associated with a high incidence of early and late complications. They also found that for storage and emptying, their Lundiana pouch was superior to the Goldwasser neo...

2003-01-01

305

Urinary diversion after cystectomy: An Indian perspective  

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Radical cystectomy remains the standard treatment for muscle-invasive carcinoma bladder. Various methods have been described for the urinary diversion. In the last 150 years urinary diversion has evolved from cutaneous ureterostomy to the orthotopic neobladder. Especially during the last 20 years, much advancement has been made. We hereby have reviewed the current approaches being used at different centers in India. We have also analyzed the evolution of diversion from conduit to the orthotop...

Jain, Deepak; Raghunath, S. K.; Khanna, Samir; Kumar, Prem; Rawal, Sudhir

2008-01-01

306

Urinary Tract Injures: Recognition and Management  

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Iatrogenic injury to the urinary tract during colorectal surgery can be a source of significant morbidity. Although most cases of ureteral injury occur in patients without significant risk factors, the incidence of urinary tract injuries increases in patients with prior pelvic operations, inflammatory bowel disease, infection, and in patients with extensive neoplasms causing distortion of normal surgical planes. The most commonly injured locations are the ureter, bladder, and urethra. Mechani...

Delacroix, Scott E.; Winters, J. C.

2010-01-01

307

A murine model of urinary tract infection  

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Urinary tract infections (UTIs) inflict extreme pain and discomfort to those affected and have profound medical and socioeconomic impact. Although acute UTIs are often treatable with antibiotics, a large proportion of patients suffer from multiple recurrent infections. Here, we describe and provide a protocol for a robust murine UTI model that allows for the study of uropathogens in an ideal setting. The infections in the urinary tract can be monitored quantitatively by determining the bacter...

2009-01-01

308

Mechanisms of urinary tract sterility maintenance.  

Science.gov (United States)

Physiologically, urine and the urinary tract are maintained sterile because of physical and chemical properties of urine and the innate immune system's action. The urinary tract is constantly exposed to the invasion of microorganisms from the exterior environment, also because of the anatomical placement of the urethra, in the vicinity of the rectum. Particularly vulnerable to urinary tract infections (UTI) are women (an additional risk factor is pregnancy), but also the elderly and children. The main pathogens causing UTI are bacteria; in 70-95% of cases it is the bacterium Escherichia coli. Infections caused by viruses and fungi are less common and are associated with decreased immunity, pharmacotherapy, or some diseases. Bacteria have evolved a number of factors that facilitate the colonization of the urinary tract: the cover and cell membrane antigens O and K1, lipopolysaccharide (LPS), fimbriae, pile and cilia. On the other hand, the human organism has evolved mechanisms to hinder colonization of the urinary tract: mechanisms arising from the anatomical structure of the urinary tract, the physicochemical properties of the urine and the activity of the innate immune system, also known as non-specific, which isolates and destroys pathogens using immunological processes, and the mechanisms for release of antimicrobial substances such as Tamm-Horsfall protein, mucopolysaccharides, immunoglobulins IgA and IgG, lactoferrin, lipocalin, neutrophils, cytokines and antimicrobial peptides. This review aims to analyze the state of knowledge on the mechanisms to maintain the sterility of the urinary tract used by the human organism and bacterial virulence factors to facilitate the colonization of the urinary tract. PMID:24934526

Okr?g?a, Emilia; Szychowska, Katarzyna; Wolska, Lidia

2014-01-01

309

Neural Mechanisms Underlying Lower Urinary Tract Dysfunction  

Science.gov (United States)

This article summarizes anatomical, neurophysiological, and pharmacological studies in humans and animals to provide insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract and alterations in these mechanisms in lower urinary tract dysfunction. The functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the bladder, urethra, and external urethral sphincter. During urine storage, the outlet is closed and the bladder smooth muscle is quiescent. When bladder volume reaches the micturition threshold, activation of a micturition center in the dorsolateral pons (the pontine micturition center) induces a bladder contraction and a reciprocal relaxation of the urethra, leading to bladder emptying. During voiding, sacral parasympathetic (pelvic) nerves provide an excitatory input (cholinergic and purinergic) to the bladder and inhibitory input (nitrergic) to the urethra. These peripheral systems are integrated by excitatory and inhibitory regulation at the levels of the spinal cord and the brain. Therefore, injury or diseases of the nervous system, as well as disorders of the peripheral organs, can produce lower urinary tract dysfunction, leading to lower urinary tract symptoms, including both storage and voiding symptoms, and pelvic pain. Neuroplasticity underlying pathological changes in lower urinary tract function is discussed.

Ogawa, Teruyuki; Miyazato, Minoru; Kitta, Takeya; Furuta, Akira; Chancellor, Michael B.; Tyagi, Pradeep

2014-01-01

310

A heterotopic autoinnervated urinary neosphincter.  

Science.gov (United States)

Twenty-six female adult New Zealand white rabbits underwent surgical denervation of a gracilis muscle to study the possibility of developing an autologous neosphincter innervated by the pudendal nerve. The study was conducted in 2 phases. In both Phase I and Phase II, the study group had the motor nerve to the gracilis, a branch of the obturator nerve and the pudendal nerve coapted in the perineum. The control group was left denervated. In Phase I, all muscle flaps were wrapped around the urogenital sinus. In Phase II, the muscle flaps were returned to their anatomic location. With bulbocavernosus reflex testing, 89% of the reinnervated group and 60% of the denervated group from Phase I and 86% of the reinnervated group and none of the denervated group from Phase II had a contractile response in the muscle flap. In Phase II, histologic examination of the gracilis muscle was suggestive of an early change in muscle myofiber physiology from fast twitch to slow twitch in the reinnervated group only. In the rabbit, a transplanted vascularized muscle flap, cross-innervated by the pudendal nerve has a reproducible response to bulbocavernosus reflex testing. This suggests that a transplanted muscle might be able to assume some of the characteristics of the voluntary urinary sphincter. The rabbit is a useful model in which to investigate the potential of the heterotopic neosphincter. PMID:7752385

Vukovich, J G; McKenna, P H; Grice, G P; Docimo, S G

1995-06-01

311

Metabolic consequences after urinary diversion.  

Science.gov (United States)

Metabolic disturbances are well-known, but sometimes neglected immediate consequences or late sequelae following urinary diversion (UD) using bowel segments. Whereas subclinical disturbances appear to be quite common, clinically relevant metabolic complications, however, are rare. Exclusion of bowel segments for UD results in loss of absorptive surface for its physiological function. Previous studies demonstrated that at least some of the absorptive and secreting properties of the bowel are preserved when exposed to urine. For each bowel segment typical consequences and complications have been reported. The use of ileal and/or colonic segments may result in hyperchloremic metabolic acidosis, which can be prevented if prophylactic treatment with alkali supplementation is started early. The resection of ileal segments may be responsible for malabsorption of vitamin B12 and bile acids with subsequent neurological and hematological late sequelae as well as potential worsening of the patient's bowel habits. Hence, careful patient and procedure selection, meticulous long-term follow-up, and prophylactic treatment of subclinical acidosis is of paramount importance in the prevention of true metabolic complications. PMID:24653981

Stein, Raimund; Rubenwolf, Peter

2014-01-01

312

Metabolic Consequences after Urinary Diversion  

Science.gov (United States)

Metabolic disturbances are well-known, but sometimes neglected immediate consequences or late sequelae following urinary diversion (UD) using bowel segments. Whereas subclinical disturbances appear to be quite common, clinically relevant metabolic complications, however, are rare. Exclusion of bowel segments for UD results in loss of absorptive surface for its physiological function. Previous studies demonstrated that at least some of the absorptive and secreting properties of the bowel are preserved when exposed to urine. For each bowel segment typical consequences and complications have been reported. The use of ileal and/or colonic segments may result in hyperchloremic metabolic acidosis, which can be prevented if prophylactic treatment with alkali supplementation is started early. The resection of ileal segments may be responsible for malabsorption of vitamin B12 and bile acids with subsequent neurological and hematological late sequelae as well as potential worsening of the patient’s bowel habits. Hence, careful patient and procedure selection, meticulous long-term follow-up, and prophylactic treatment of subclinical acidosis is of paramount importance in the prevention of true metabolic complications.

Stein, Raimund; Rubenwolf, Peter

2014-01-01

313

Radioimmunoassay of human urinary kallikrein  

International Nuclear Information System (INIS)

Using a human urinary kallikrein, purified by means of Trasylol sepharose, it has been possible to develop a radioimmunoassay of kallikrein capable of detecting the substance down to a concentration of 0.5 ng/ml. The specific activity of the tracer labelled with 125-iodine using the Chloramine-T method was 30-70 nCi/ng of kallikrein. The antiserum titres for the antikallikrein serum were 1:20.000 up to 1:50.000. Human urine, submandibular and parotid salivae as well as pancreatic secretion in this RIA reacted in the same manner as the kallikrein standard solution. The kallikrein content in urine, as determined by the RIA was between 0 and 300 ng/ml, in the saliva between 400 and 2.000 ng/ml, and in the pancreatic juice between 300 and 12.000 ng/ml. Using human serum, only an incomplete immunological cross-reaction could be achieved. In human liquor as well as in animal preparation, no cross-reacting substances could be detected. (orig.)

1980-01-01

314

Urinary tract injuries in children  

International Nuclear Information System (INIS)

As shown by literature data, abdominal trauma in children is responsible for 14% of deaths, whereas in adults for 10%. Although abdominal traumas in children can be severe and lead to massive blood loss, most children die because of accompanying traumas of the thorax and head. It validates the surgical rule concerning abdominal traumas 'investigate aggressively, manage conservatively'. Posttraumatic injury of the urinary system is not frequent in children and its specificity (compared with adults), depends on greater susceptibility to external aggressive factors. Blunt trauma is the cause of renal parenchyma injury and acceleration/deceleration injury affects the excretory system and vessels. Extension mechanism is the cause of ureter avulsion and/or thrombus formation in stretched renal vessels- it is characteristic in children with non-accidental traumas. Bladder and urethra injuries are rare in children. During car accidents, a rupture of full bladder (seat belt injury) or bladder perforation by fractured bones of the pelvis is possible. We analyzed all hospitalizations of abdominal trauma in our surgical ward in the year 2004 (70 cases). Renal injuries were found in 6 children (8.6%). Thanks to five-year clinical experience of our hospital, on the average only 1-2 cases per annum needed operation. The management of renal injuries involves first of all conservative treatment. This publication has educational character and may serve as a valuable reminder of the useful knowledge in daily cooperation between the emergency room, radiology department and surgical ward. Based on available literature from recent few years, we quote suggested renal injuries classifications and procedures.This publication contains only images from our department of radiology archives. Clinical symptoms are often not appropriate for blunt abdominal traumas diagnosis. Owing to clinical status, which is difficult to interpret, fast and complete radiological diagnosis is necessary for proper treatment of children after abdominal trauma. Further complications of renal injuries may affect the further growth of the child. (author)

2006-01-01

315

Urinary infection before and after prostatectomy  

Directory of Open Access Journals (Sweden)

Full Text Available To determine the prevalence of pre and post prostatectomy related urinary tract in-fection and its correlation with peri-operative events, we studied 120 patients who underwent pros-tatectomy due to benign prostatic hypertrophy from September 2005 to September 2006. Urine cultures were performed before the operations, after a week, and three months later. Data including prostate volume, prostatic specific antigen (PSA, post voiding residue (PVR and histopathological reports as well as the duration of urinary leak, bladder irrigation, hospitalization, and catheterization were studied. The mean age of the studied patients was 70.5 ± 8 years. Significant preoperative bac-teriuria was revealed in 18 (15% patients of whom 14(77% patients developed negative cultures following the operation. Postoperative bacteriuria was detected in 9(7.5% patients who negative urine cultures preoperatively. Pre and post operative micro-organisms were different in the majority of the cases. The mean PSA was higher in patients with a positive history of infection. Following prostatectomy, patients with positive urine cultures had significantly longer urinary leakage, cathe-terization, and hospital stays compared with those who remained culture negative. We conclude that the incidence of positive urine culture pri-prostatectomy for BPH can be improved by appropriate antibiotic therapy, and the risk factors for postoperative urinary infection include preoperative infec-tion, prolonged urinary leakage, catheterization, and hospital stay. The elevated PSA may be a risk factor.

Pourmand Gholamreza

2010-01-01

316

Validity of urinary monoamine assay sales under the “spot baseline urinary neurotransmitter testing marketing model”  

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Full Text Available Marty Hinz1, Alvin Stein2, Thomas Uncini31Clinical Research, Neuro Research Clinics Inc, Cape Coral, FL; 2Stein Orthopedic Associates, Plantation, FL; 3Laboratory, Fairview Regional Medical Center-Mesabi, Hibbing, MN, USAAbstract: Spot baseline urinary monoamine assays have been used in medicine for over 50 years as a screening test for monoamine-secreting tumors, such as pheochromocytoma and carcinoid syndrome. In these disease states, when the result of a spot baseline monoamine assay is above the specific value set by the laboratory, it is an indication to obtain a 24-hour urine sample to make a definitive diagnosis. There are no defined applications where spot baseline urinary monoamine assays can be used to diagnose disease or other states directly. No peer-reviewed published original research exists which demonstrates that these assays are valid in the treatment of individual patients in the clinical setting. Since 2001, urinary monoamine assay sales have been promoted for numerous applications under the “spot baseline urinary neurotransmitter testing marketing model”. There is no published peer-reviewed original research that defines the scientific foundation upon which the claims for these assays are made. On the contrary, several articles have been published that discredit various aspects of the model. To fill the void, this manuscript is a comprehensive review of the scientific foundation and claims put forth by laboratories selling urinary monoamine assays under the spot baseline urinary neurotransmitter testing marketing model.Keywords: monoamine, serotonin, dopamine, norepinephrine, epinephrine, urine, urinary

Hinz M

2011-07-01

317

Herbs In Treatment Of Urinary Tract Infections  

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Full Text Available It is known that urinary tract is very common source of infection and UTIs are second most common reason people visit their doctors each year. Escherichia coli is responsible for large majority of UTIs. UTIs is most commonly diagnosed bacterial infection in woman. Population at risk of complication include older woman, pregnant woman. Continuous antibiotics prophylaxis are used to treat and prevent recurrent urinary tract infections, frequent antibiotic use can result in vaginal and intestinal dysbiosis as well as antibiotic resistance. Thus, it is desirable to seek alternative methods of prevention and treatment of simple UTIs. Few herbal antimicrobial agents Vaccinium macrocarpon (Cranberry, Vaccinium myrtillus (Bilberry; Blueberry, Berberine, Arctostaphylos uva ursi (Bearberry are proved to be very effective in preventing and treating urinary tract infections.

Manish Wasamwar

2012-10-01

318

Differences in urinary trichloroethylene metabolites of animals.  

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Full Text Available Differences in urinary excretion of trichloroethylene were studied in rabbits, rats and mice. Trichloretylene (1 m mole/kg was injected intra-peritoneally, then urinary trichloroacetic acid and trichloroethanol glucuronide were measured. The results were: 1. The ratio of total excretion of trichloroethylene metabolites to the administered trichloroethylene decreased in the order of mice, rats and rabbits. 2. The ratio of total trichloroethanol to trichloroacetic acid in urine decreased in the order of rabbits (69.2, mice (12.8 and rats (2.3. The high ratio in rabbits was due to the extremely small amount of trichloroacetic acid in the urine. 3. Differences in these two urinary metabolites in the three kinds of animals and in human subjects were discussed.

Ogata,Masana

1979-12-01

319

[Cranberry juice and urinary tract infection].  

Science.gov (United States)

Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). Cranberries contain two compounds with anti-adherence properties, which prevent fimbriated E. coli from adhering to uroepithelial cells in the urinary tract. Approximately a dozen clinical trials have been performed testing the effects of cranberries on the urinary tract. However, these trials have a number of apparent limitations. Most importantly, the trials have used a wide variety of cranberry products, such as cranberry juice concentrate, juice cocktail, and cranberry capsules, and have employed different dosing regimens. Further research is required to clarify unanswered questions regarding the role of cranberries in protecting against UTI in general and in women with anatomical abnormalities in particular. PMID:15666710

Raz, R; Chazan, B; Dan, M

2004-12-01

320

Cranberry juice and urinary tract infection.  

Science.gov (United States)

Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). Cranberries contain 2 compounds with antiadherence properties that prevent fimbriated Escherichia coli from adhering to uroepithelial cells in the urinary tract. Approximately 1 dozen clinical trials have been performed testing the effects of cranberries on the urinary tract. However, these trials suffer from a number of limitations. Most importantly, the trials have used a wide variety of cranberry products, such as cranberry juice concentrate, cranberry juice cocktail, and cranberry capsules, and they have used different dosing regimens. Further research is required to clarify unanswered questions regarding the role of cranberries in protecting against UTI in general and in women with anatomical abnormalities in particular. PMID:15156480

Raz, R; Chazan, B; Dan, M

2004-05-15

 
 
 
 
321

Regulation of urinary thromboxane B2 in man: influence of urinary flow rate and tubular transport  

Energy Technology Data Exchange (ETDEWEB)

Thromboxane B2 (TxB) is excreted in human urine, but the mechanism of renal excretion and the quantitative relationship of urinary TxB to the active parent compound, thromboxane A2, of renal or extrarenal origin is not established. To determine the effects of vasoactive hormones, uricosuric agents and urinary flow rate on TxB excretion, urinary TxB was measured by radioimmunoassay and mass spectrometry, and renal metabolism of blood TxB was determined by radiochromatography of urine after i.v. (3H)-TxB infusions. Basal TxB was 6.7 +/- 1.1 ng/h during an oral water load, and TxB fell with s.g. antidiuretic hormone (to 3.4 +/- 0.4 ng/h, P less than 0.01) and with fluid restriction (to 2.6 +/- 0.5 ng/hr, P . 0.001) in parallel with urinary volume. Urinary excretion of unmetabolized (3H)-TxB also fell (by 56%) with fluid restriction, implicating altered metabolism rather than synthesis as the mechanism of the urinary flow effect. Angiotensin II infusions slightly reduced both TxB and urine volume, consistent with a flow effect. In contrast, probenecid did not alter urine volume, but increased urinary uric acid (by 244%), TxB (from 5.6 +/- 0.9 to 11.1 +/- 2.9 ng/h) and urinary excretion of blood (3H)-TxB (by 243%) by similar amounts (all P less than 0.05), suggesting that TxB is actively reabsorbed in the proximal tubule, similarly to uric acid. Thus, urinary excretion of TxB of renal and extrarenal origin is regulated by proximal and distal tubule factors.

Zipser, R.D.; Smorlesi, C.

1984-02-01

322

Regulation of urinary thromboxane B2 in man: influence of urinary flow rate and tubular transport  

International Nuclear Information System (INIS)

Thromboxane B2 (TxB) is excreted in human urine, but the mechanism of renal excretion and the quantitative relationship of urinary TxB to the active parent compound, thromboxane A2, of renal or extrarenal origin is not established. To determine the effects of vasoactive hormones, uricosuric agents and urinary flow rate on TxB excretion, urinary TxB was measured by radioimmunoassay and mass spectrometry, and renal metabolism of blood TxB was determined by radiochromatography of urine after i.v. [3H]-TxB infusions. Basal TxB was 6.7 +/- 1.1 ng/h during an oral water load, and TxB fell with s.g. antidiuretic hormone (to 3.4 +/- 0.4 ng/h, P less than 0.01) and with fluid restriction (to 2.6 +/- 0.5 ng/hr, P . 0.001) in parallel with urinary volume. Urinary excretion of unmetabolized [3H]-TxB also fell (by 56%) with fluid restriction, implicating altered metabolism rather than synthesis as the mechanism of the urinary flow effect. Angiotensin II infusions slightly reduced both TxB and urine volume, consistent with a flow effect. In contrast, probenecid did not alter urine volume, but increased urinary uric acid (by 244%), TxB (from 5.6 +/- 0.9 to 11.1 +/- 2.9 ng/h) and urinary excretion of blood [3H]-TxB (by 243%) by similar amounts (all P less than 0.05), suggesting that TxB is actively reabsorbed in the proximal tubule, similarly to uric acid. Thus, urinary excretion of TxB of renal and extrarenal origin is regulated by proximal and distal tubule factors

1984-01-01

323

What I Need to Know about Urinary Tract Infections  

Science.gov (United States)

... need to know about Urinary Tract Infections What I need to know about Urinary Tract Infections On ... provider or urologist gives you. [ Top ] How can I prevent repeat UTIs? In addition to taking antibiotics, ...

324

Binary Vegetative Management of the Lower Urinary Tract Function  

Directory of Open Access Journals (Sweden)

Full Text Available In this article, we review the neurophysiology of the bladder and the lower urinary tract function and discuss logical concepts for the development of novel drug therapy for patients with lower urinary tract dysfunction.

Vadim B. Berdichevskii

2013-09-01

325

Radiology of trauma to kidney and lower urinary tract  

International Nuclear Information System (INIS)

The contents are trauma to kidney, imaging of kidney trauma, management of renal trauma, delayed complications, trauma to the lower urinary tract, trauma to urinary bladder, radiologic diagnosis, ethiology of blunt bladder injury, urethal injury (6 refs.)

1995-06-01

326

Infection rislks associated with urinary catheters.  

Science.gov (United States)

Urinary catheterisation can kill. It is one of the most common healthcare interventions but carries the risk of 'significant danger' to patients from infection (Pratt et al 2001). While essential for some patients, this invasive procedure is sometimes unjustified and even forgotten once in place (Saint et al 2005). Accountability for the safe management of urinary catheters by using evidence-based guidelines is emphasised. New ways of examining practice and planning for improvement (Department of Health 2005), and new technology (Tambyah 2004) will contribute to better outcomes for those patients for whom the procedure is essential. PMID:16281542

Tew, Lauren; Pomfret, Ian; King, Debbie

327

Management of failed stress urinary incontinence surgery.  

Science.gov (United States)

With the increasing volume of surgery being performed for the treatment of female stress urinary incontinence (SUI), especially with the widespread use of midurethral slings (MUS), recurrent urinary incontinence is becoming an increasingly common condition. Various preoperative and intraoperative factors have been associated with failed SUI surgery. Treatment options for failed SUI surgery include conservative management and/or surgical management, which include pubovaginal sling, MUS, retropubic suspension, periurethral bulking agents, and artificial sphincters. The choice of treatment option will depend on the etiology of the patient's failure, patient comorbidities, and patient preference. PMID:24916327

MacLachlan, Lara S; Rovner, Eric S

2014-08-01

328

Urinary Tract Infections and Asymptomatic Bacteriuria in Renal Transplant Recipients  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Asymptomatic bacteriuria and urinary tract infection are common complications after kidney transplantation. In this population, if urinary tract infection occurred in the first six months post procedure, it carries a grave impact on both graft and patient survival. Renal transplant recipients with urinary tract infection are often clinically asymptomatic as a consequence of immunosuppression. Urinary tract infection, however, may progress to acute pyelonephritis, bacteremia and the full blown...

Yacoub, Rabi; Akl, Nader Kassis

2011-01-01

329

Decreasing urinary PAH metabolites and 7-methylguanine after smoking cessation.  

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OBJECTIVE: Humans are exposed to various carcinogens by smoking. Urinary metabolites of polycyclic aromatic hydrocarbons (PAH), one of the major carcinogens in cigarette smoke, were measured as the environmental carcinogen exposure marker for humans. We evaluated urinary exposure markers for smoking cessation. METHOD: In this study, we measured cigarette smoke exposure markers, such as urinary cotinine, PAH exposure markers, such as urinary 1-hydroxypyrene (1-OHP), 2-naphthol (2-NP) and 1-nap...

Ichiba, M.; Matsumoto, A.; Kondoh, T.; Horita, M.; Tomokuni, K.

2006-01-01

330

The artificial urinary sphincter. A new solution for incontinent patients.  

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Treatment of urinary incontinence with the artificial urinary sphincter has been available in centres such as London and Liverpool for a number of years. This service is now available in the department of urology of the Belfast City Hospital. Twelve patients have had successful implantation of an artificial urinary sphincter for urinary incontinence, and ten are now fully continent. One patient with Wegener's granulomatosis developed active disease in his urethra which has precluded activatio...

Keane, P. F.; Walsh, I. K.; Kernohan, R. M.

1993-01-01

331

Lower urinary tract dysfunction in pregnancy: a review.  

Science.gov (United States)

It has long been observed that pregnancy may influence the development and course of urinary tract disorders. The physiological and anatomical changes inherent in normal pregnancy and the changing hormonal environment are generally assumed to play a role in the pathogenesis of urinary tract symptomatology. The purpose of this review is to examine the reported effect(s) of pregnancy on the lower urinary tract and to evaluate the possible role of pregnancy and delivery in lower urinary tract dysfunction. PMID:7478419

Mikhail, M S; Anyaegbunam, A

1995-09-01

332

Scintigraphic detection of urinary leakage after kidney transplantation  

International Nuclear Information System (INIS)

Urinary leakage after kidney transplantation is a serious complication. In a retrospective study we analyzed 8 relevant cases of 14 patients with urinary leakage. In these eight patients kidney scintigraphy indicated the presence of urinary extravasation. Compared with other imaging modalities such as IV urography, cystography and ultrasound, scintigraphy seems to be an easy and safe method to detect urinary leakage. Moreover scintigraphic examination may suggest leakage, while this may not be clinically evident or suspected. (orig.)

1982-01-01

333

Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus  

Energy Technology Data Exchange (ETDEWEB)

Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented. (orig.)

Subramanian, Subramanian; Sharma, Raju; Gamanagatti, Shivanand [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Agarwala, Sandeep [All India Institute of Medical Sciences, Department of Pediatric Surgery, New Delhi (India); Gupta, Prerna; Kumar, Sunesh [All India Institute of Medical Sciences, Department of Obstetrics and Gynaecology, New Delhi (India)

2006-10-15

334

Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus.  

Science.gov (United States)

Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented. PMID:16810498

Subramanian, Subramanian; Sharma, Raju; Gamanagatti, Shivanand; Agarwala, Sandeep; Gupta, Prerna; Kumar, Sunesh

2006-10-01

335

Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus  

International Nuclear Information System (INIS)

Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented. (orig.)

2006-10-01

336

Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results?  

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Urinary catheters are widely used for hospitalized patients and are often associated with high rates of urinary tract infection. We evaluated in vitro the antiadherence activity of a novel antiseptic Gendine-coated urinary catheter against several multidrug-resistant bacteria. Gendine-coated urinary catheters were compared to silver hydrogel-coated Foley catheters and uncoated catheters. Bacterial biofilm formation was assessed by quantitative culture and scanning electron microscopy. These d...

Hachem, Ray; Reitzel, Ruth; Borne, Agatha; Jiang, Ying; Tinkey, Peggy; Uthamanthil, Rajesh; Chandra, Jyotsna; Ghannoum, Mahmoud; Raad, Issam

2009-01-01

337

Polysubstance abuse related subacute urinary retention and Hutch diverticulum of urinary bladder  

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Full Text Available The present case highlights the presentation and management of hyperkalemia and acute renal failure secondary to polysubstance abuse related subacute urinary retention due to ?-adrenergic and µ-receptor activation in a patient with Hutch diverticulum.

Shiva S. Rau

2011-03-01

338

Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%. The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs (p = 0.014. Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

Oliver Rojas Claros

2012-01-01

339

Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital  

Science.gov (United States)

OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p?=?0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

Claros, Oliver Rojas; Silva, Carlos Hirokatsu Watanabe; Consolmagno, Horacio; Sakai, Americo Toshiaki; Freddy, Rodrigo; Fugita, Oscar Eduardo Hidetoshi

2012-01-01

340

Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interview [...] ed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p = 0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

Claros, Oliver Rojas; Silva, Carlos Hirokatsu Watanabe; Consolmagno, Horacio; Sakai, Americo Toshiaki; Freddy, Rodrigo; Fugita, Oscar Eduardo Hidetoshi.

 
 
 
 
341

Environmentally related diseases of the urinary tract  

Energy Technology Data Exchange (ETDEWEB)

Nephrotoxicity from exposure to therapeutic agents and chemicals in the environment and workplace results in a broad spectrum of clinical renal disease that may mimic disorders from other causes. Nephrotoxic agents may, in fact, be responsible for some fraction of renal disease of undetermined etiology. Specific diagnosis and treatment by removal from exposure to the toxic agent is more likely in the early phase of the disorder. Measurement and characterization of proteinuria provides the most sensitive and reliable method of early detection. Increased urinary excretion of serum proteins with molecular weight in excess of 50,000, such as albumin and transferrin, is an early indicator of glomerular injury. Low-molecular-weight proteinuria (beta 2-microglobulin or retinol-binding protein) and enzymuria, particularly excretion of NAG, are sensitive indicators of renal tubular cell injury. Tests that reflect hypersensitivity reactions are often indicative of immunologically mediated nephrotoxicity but are not specific for the kidney. Cancers of the kidney and urinary bladder appear to be increasing and are most common among the socially active and affluent. Susceptibility of the urinary tract to toxicity and carcinogenicity reflect contact of excreted toxins with the epithelial cells of nephrons and urinary bladder. 45 references.

Goyer, R.A. (Univ. of Western Ontario, London (Canada))

1990-03-01

342

Urinary Incontinence: Causes and Methods of Evaluation  

Science.gov (United States)

This article presents the third of a multi-part series offering the most timely educational information, innovative approaches, products and technology solutions as well as coping and stigma-fighting approaches available on the subject of incontinence. Here, the author introduces the types and physiology of urinary incontinence. The author also…

Griebling, Tomas L.

2008-01-01

343

Urinary Tract Infection in Children: A Review  

Directory of Open Access Journals (Sweden)

Full Text Available Urinary tract infection (UTI is one of the most common paediatric infections. By the time children are 5 years old, about 8% of girls and about 1-2% of boys have had at least one episode of UTI. UTIs are caused mainly by colonic bacteria, such as Escherichia coli, followed by Klebsiella and Proteus. However, any organism that gains access to the urinary tract system may cause infection, including fungi (Candida species and viruses. In some instances, UTI results in recognition of an important underlying structural abnormality of the urinary tract. The febrile infant or child with clinically significant bacteriuria and no other site of infection to explain the fever, even in the absence of systemic symptoms has UTI. Signs and symptoms of UTIs vary depending on the child's age and on which part of the urinary tract is infected. The diagnosis of UTI is based on routine microscopic examination and culture of a properly collected urine specimen. Imaging studies are done in selected patients to identify anatomic abnormalities. Most cases of uncomplicated UTI respond readily to outpatient antibiotic treatment without further sequelae. All patients should have close follow-up to evaluate response to antibiotics and to prevent the development of long term complication.

Farzana Hamid

2013-07-01

344

Arsenic and urinary bladder cell proliferation  

International Nuclear Information System (INIS)

Epidemiologic studies have demonstrated that a close association exists between the elevated levels of arsenic in drinking water and the incidence of certain cancers, including transitional cell carcinomas of the urinary bladder. We have employed in vitro and in vivo models to examine the effects of sodium arsenite on the urinary bladder epithelium. Mice exposed to 0.01% sodium arsenite in drinking water demonstrated hyperproliferation of the bladder uroepithelium within 4 weeks after initiating treatment. This occurred in the absence of amorphous precipitates and was accompanied by the accumulation of trivalent arsenite (iAs3+), and to a lesser extent dimethylarsenic (DMA), arsenate (iAs5+), and monomethylarsenic (MMA) in bladder tissue. In contrast to the bladder, urinary secretion was primarily in the form of DMA and MMA. Arsenic-induced cell proliferation in the bladder epithelium was correlated with activation of the MAP kinase pathway, leading to extracellular signal-regulated kinase (ERK) kinase activity, AP-1 activation, and expression of AP-1-associated genes involved in cell proliferation. Activation of the MAP kinase pathway involved both epidermal growth factor (EGF) receptor-dependent and -independent events, the latter involving Src activation. Studies summarized in this review suggest that arsenic accumulates in urinary bladder epithelium causing activation of specific signaling pathways that lead to chronic increased cell proliferation. This may play a non-epigenetic role in carcinogenesis by increasing the proliferation of initiated cells or increasing the mutational rate

2004-08-01

345

The medical management of urinary incontinence.  

Science.gov (United States)

Urinary incontinence is the involuntary leakage of urine; it affects millions of people worldwide, causing significant detrimental effects on their quality of life. Direct expenses, such as containment products, long-term drug prescriptions and surgery, complemented by indirect costs, such as reduced employment productivity, result in overall expenditure running to billions of dollars. Stress urinary incontinence (SUI) occurs on physical exertion, and results from weakness of the bladder outlet. Urgency urinary incontinence (UUI) results from inability to resist a sudden compelling desire to pass urine, arising as a consequence of bladder dysfunction. Clinical evaluation clarifies the underlying mechanisms and excludes diseases causing similar symptoms. Urodynamic studies to measure bladder and abdominal pressures and deduce the bladder and outlet function are undertaken when invasive treatments are being considered or when the nature of the incontinence is not entirely clear. Initial management of SUI involves pelvic floor muscle exercise training; if insufficient symptom improvement results, surgical measures are needed. UUI treatment commences with advice on suitable fluid intake and measures to improve ability to defer voiding, followed by antimuscarinic drugs. Refractory UUI is a difficult problem, currently managed with a range of surgical interventions, including bladder injections of botulinum-A neurotoxin, augmentation cystoplasty and nerve stimulation methods. New treatment options are needed, because of the risk of impeding voiding function, resulting in urinary retention. Persistent leakage is controlled with containment products, such as pads, or collection devices, such as catheters. PMID:19900845

Shaban, Ahmed; Drake, Marcus J; Hashim, Hashim

2010-01-15

346

Management of endosalpingiosis of urinary bladder.  

Science.gov (United States)

We report on a 48-year-old woman who presented with abnormal uterine bleeding secondary to uterine fibroids and who was found to have incidental endosalpingiosis of the urinary bladder. Follow-up is necessary for bladder endosalpingiosis because of its tendency to recur. Follow-up should include cystoscopy and renal, and possibly pelvic, ultrasonography. PMID:15533512

Smith, Cortney; Sabet, Laila; Izawa, Jonathan I

2004-11-01

347

Constipation and reversible urinary tract abnormalities.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Urinary tract anomalies were prospectively investigated with ultrasound in 29 children with functional constipation. These children were compared before and after treatment with 451 age matched healthy controls without constipation. The bladder residue and upper renal tract dilatation after micturition were significantly increased in the group with constipation and improved after treatment.

Dohil, R.; Roberts, E.; Jones, K. V.; Jenkins, H. R.

1994-01-01

348

Urinary proteome analysis in congenital bilateral hydronephrosis  

DEFF Research Database (Denmark)

Abstract Objective. A proteomics strategy was applied to map protein changes in urine after relief of congenital bilateral hydronephrosis to identify proteins correlated with the pathophysiological processes in congenital obstructive nephropathy as potential urinary biomarkers. Material and methods. Urine samples from 10 infants with bilateral abnormal drainage from the kidneys were collected at the time of relief from obstruction, and after 2 and 4 weeks. Proteomics techniques were used on samples from three patients for identification of protein changes between the three time-points, and enzyme-linked immunosorbent assay (ELISA) was used on samples from all 10 patients for validation of five selected proteins. Results. Mass spectrometry quantified 315 protein hits, out of which 33 proteins showed significantly changed urinary excretion between the time-points. Validation by ELISA showed high urinary excretion of fibrinogen, plasminogen, transthyretin and transferrin at the time of relief from obstruction, followed by a significant reduction. In contrast, Tamm-Horsfall protein exhibited the reverse pattern. Conclusion. Using a mass spectrometry-based proteomics approach, this study identified 33 proteins related to congenital bilateral hydronephrosis, and pinpointed a panel of five proteins consistently linked to this congenital kidney disorder as potential urinary biomarkers.

Stødkilde, Lene; Madsen, Mia Gebauer

2012-01-01

349

Adenocarcinoma of the urinary bladder: CT features  

Energy Technology Data Exchange (ETDEWEB)

Adenocarcinoma of the urinary bladder, including urachal carcinoma, is a rear tumor with incidence in the range between 0.5% and 2.2% of all epithelial bladder neoplasms. Ten cases of adenocarcinoma of the urinary bladder(eight cases of primary adenocarcinoma and two cases of urachal carcinoma) are presented. We describe the computed tomography(CT) appearance of adenocarcinoma of the urinary bladder and tried to find out the characteristic CT findings of urachal carcinoma. CT scans were evaluated for the location of the tumors, presence of calcification in the tumor, and the tumor extension. Seven tumors were located at the dome of the bladder(70%), two were at lateral walls, and one was at calcifications scattered within the tumor were detected in four cases(40%); three of the eight, primary adenocarcinoma, and one of the two, urachal carcinoma. Two urachal carcinoma were characterized by midline position and predominantly extravascular growth along the urachus. Gross extravesical extension with distant metastasis were presented in seven cases(70%) at the time of initial diagnosis. CT may be useful in evaluating the adenocarcinoma of the urinary bladder and differentiating urachal carcinoma from bladder cancer.

Moon, Woo Kyung; Kim, Seung Hyup; Choi, Chung Gon; Choi, Dae Seob; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Young [Cheungbuk National University College of Medicine, Chungju (Korea, Republic of)

1992-07-15

350

Fungus ball pieloureteral en pacientes con litiasis urinaria: Tratamiento con ureterorrenoscopia / Pyelo-ureteral fungus ball in patients with urinary lithiasis: Ureterorrenoscopic management  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish INTRODUCCIÓN: C. albicans es el hongo que con mayor frecuencia produce infecciones oportunistas del tracto urinario. Cuando las hifas se aglutinan alrededor de un núcleo de tejido necrótico (necrosis papilar), hebras mucosas, restos de suturas quirúrgicas y/o material litiásico, se forma una pelota [...] fúngica que puede obstruir cualquier tramo del tracto urinario. CASOS CLÍNICOS: Presentamos dos pacientes formadores crónicos de cálculos que en ausencia de otros factores de riesgo para las infecciones fúngicas oportunistas, desarrollan fungus balls en el tracto urinario superior dilatado por una litiasis ureteral obstructiva. La paciente 1 tuvo afectación bilateral y en ningún momento hubo manifestaciones sistémicas. El tratamiento consistió en ureterorrenoscopia con extracción de las bolas fúngicas, derivación bilateral y anfotericina B sistémica y en irrigaciones tópicas. El paciente 2, en el contexto de una sepsis candidiásica, se trató con anfotericina B sistémica, desobstrucción mediante ureterorrenoscopia con extracción de un cálculo ureteral y de pelotas fúngicas, y colocación de catéter JJ y nefrostomía con irrigaciones de anfotericina B. DISCUSIÓN: La litiasis urinaria constituye por sí sola un factor de riesgo para la infección fúngica del tracto urinario superior, en ausencia de otros factores favorecedores de las infecciones fúngicas oportunistas. El mecanismo por el cual el cálculo favorece el crecimiento de los hongos es, por un lado, la obstrucción pieloureteral con éstasis retrógrado y, por otro lado, la nucleación alrededor de una matriz de material cálcico sobre la que crecen, se agregan y se ramifican los micelios. La vía de infección es probablemente ascendente y puede complicarse con funguemia y sepsis. Los antimicóticos sistémicos, la derivación con catéteres ureterales o de nefrostomía que permitan irrigación local con antifúngicos, y las técnicas endourológicas, constituyen los tres pilares básicos del tratamiento. La ureterorrenoscopia juega aquí un papel importante al ser una técnica diagnóstica y al mismo tiempo terapéutica al permitir la desobstrucción litiásica y la limpieza de las masas fúngicas. Abstract in english INTRODUCTION: C. albicans is the most frequent fungus causing opportunist infections of the urinary tract. Agglutination of necrotic tissue nucleus (papilar necrosis), mucosus debri and chirurgic or lithiasic debri, originates a fungus ball, which can obstruct the urinary tract at any level. CLINICA [...] L DATA: We present 2 patients with obstructive urinary lithiasis developing fungus ball in the dilated upper urinary tract. Patient 1 was bilaterally affected and never had systemic symptoms. Treatment consisted of uretherorrenoscope for removal of fungus ball, bilateral urinary diversion and anphotericine B irrigations and systemic. Patient 2 developed a candidemia and was treated with systemic liposomal anphotericine B, uretherorrenoscopy with removal of ureteric calculus and fungus ball, and placement of a double J catheter and nephrostomy tube for anphotericine B irrigation. DISCUSSION: Urinary lithiasis is a risk factor for fungal infection of the upper urinary tract, provided there is no other predisponent factor for opportunistic fungal infections. Calculi facilitates fungal growth by means of obstruction and subsequent retrograde estasis and creating a nucleus for growth, aggregation and ramification of mycelium. The infection pathway is probably ascendent and may turn into fungemia and septicaemia. Systemic antimicotics, urinary diversion and local irrigations with antimicotics, and endourologic technics, are the three basic items in the treatment. Ureterorrenoscopy plays an important roll as a diagnostic and terapeutic tool as it may solve the obstruction and allows removal of fungus ball.

J.P., Burgués Gasión; J.M., Alapont Alacreu; F., Oliver Amorós; A., Benedicto Redón; F., Boronat Tormo; J.F., Jiménez Cruz.

351

[Lower urinary tract dysfunction and degenerative brain disease].  

Science.gov (United States)

Although lower urinary tract dysfunction and dementia are classically associated, some patients with advanced dementia do not experience incontinence. Management of these patients must be based on careful assessment of the respective roles of ageing of the urinary tract and dementia in the pathogenesis of incontinence. It is also important to distinguish those dementia syndromes that are inevitably accompanied by urinary incontinence (such as normal pressure hydrocephalus) and those in which urinary incontinence is a late phenomenon (such as Alzheimer's disease). The diagnostic and therapeutic strategy must then be based on a stepwise approach, by eliminating all simple causes of lower urinary tract dysfunction and preferring the most conservative treatments possible. PMID:17622067

Robain, G; Chartier-Kastler, E; Ruffion, A

2007-05-01

352

Are urinary PAHs biomarkers of controlled exposure to diesel exhaust?  

Science.gov (United States)

Abstract Urinary polycyclic aromatic hydrocarbons (PAHs) were evaluated as possible biomarkers of exposure to diesel exhaust (DE) in two controlled-chamber studies. We report levels of 14 PAHs from 28 subjects in urine that were collected before, immediately after and the morning after exposure. Using linear mixed-effects models, we tested for effects of DE exposure and several covariates (time, age, gender and urinary creatinine) on urinary PAH levels. DE exposures did not significantly alter urinary PAH levels. We conclude that urinary PAHs are not promising biomarkers of short-term exposures to DE in the range of 106-276?µg/m(3). PMID:24754404

Lu, Sixin S; Sobus, Jon R; Sallsten, Gerd; Albin, Maria; Pleil, Joachim D; Gudmundsson, Anders; Madden, Michael C; Strandberg, Bo; Wierzbicka, Aneta; Rappaport, Stephen M

2014-06-01

353

Myeloma progression and urinary gammaglobulin affect the urinary cystatin C to diagnose acute kidney injury in multiple myeloma.  

Science.gov (United States)

Aims: Urinary cystatin C has been suggested as a useful biomarker for diagnosis of acute kidney injury (AKI). Multiple myeloma is often complicated by AKI. Therefore, we investigated whether the urinary cystatin C was available for diagnosis of AKI in multiple myeloma. Materials and methods: This study included 39 patients with monoclonal gammopathy of undetermined significance (MGUS) or multiple myeloma. We reviewed the medical records retrospectively and investigated whether urinary ?-globulin and myeloma progression had effects on urinary cystatin C excretion. Results: Spearman's correlation analysis showed that serum ?2-microglobulin and serum cystatin C had a significant positive correlation with the urinary cystatin C excretion (r = 0.513, p = 0.001, r = 0.659, p multiple myeloma. In addition, urinary ?-globulin is believed to be the most significant factor to influence on urinary cystatin C. PMID:24780555

Kim, Jae Seok; Yang, Jae Won; Park, Hyeoncheol; Kim, Young Sub; Lee, Jun Young; Lee, Jong In; Han, Byoung Geun; Choi, Seung Ok

2014-05-01

354

Segmental Urethral Dosimetry and Urinary Toxicity in Patients With No Urinary Symptoms Before Permanent Prostate Brachytherapy  

International Nuclear Information System (INIS)

Purpose: To determine whether segmental urethral dosimetry is predictive for the degree of urinary morbidity after prostate brachytherapy in patients with no urinary symptoms before prostate brachytherapy. Methods and Materials: Between May 2000 and November 2005, 1,107 patients underwent iodine-125 monotherapy with urethral sparing techniques. A total of 166 patients fulfilled the selection criteria: baseline (International Prostate Symptom Score) IPSS ?5, no androgen deprivation therapy, and prostate ultrasound planning volumes (PUTV) <45 mL. The median follow-up was 44 months. Urinary morbidity was defined by maximum increase in IPSS, time to IPSS resolution, maximum Radiation Therapy Oncology Group (RTOG) score, time to RTOG resolution, and urinary retention. Surrogate deviated urethra was contoured and doses calculated at the base, mid-prostate, apex, and urogenital diaphragm. Univariate and multivariate analysis was used to evaluate urethral and prostate dosimetry, age, PUTV, and number of needles for their association with urinary morbidity. Results: Urethral dose was fairly constant in all urethra segments except prostate base, where the variation in does was large. On multivariate analysis, higher urethral base D50, V100, and larger PUTV were predictive for higher maximum increase in IPSS. Higher urethral base V100 and larger PUTV predicted for prolonged IPSS resolution. Higher urethral base D50 and larger needle number predicted for longer RTOG resolution. Higher urethral base V100 predicted for RTOG ?2 toxicity. Conclusions: Radiation dose to the urethral base, larger PUTV, and needle number, predicted for increased urinary toxicity after prostate brachytherapy. Correlation between urinary morbidity and urethral base dosimetry may reflect a large variation in urethral dose observed at the prostate base

2008-10-01

355

Urinary nitrite excretion and urinary variables in patients with primary nocturnal frequency of micturition: effects of indomethacin suppositories.  

Science.gov (United States)

Urinary nitrite excretion was measured in patients with primary nocturnal frequency of micturition (PNFM) and in normal individuals. Effects of indomethacin suppository on urine volume and other urinary variables were evaluated. The study comprised seven patients with PNFM and seven healthy control (age range 30-45 years). Nitrite was assayed in spot morning urine samples; urine volume, urine osmolality and electrolytes, serum osmolality and electrolytes and functional bladder capacity (FBC) were assayed. Both groups were then given 100 mg of indomethacin suppository daily for a maximum of 10 days and urinary variables were re-evaluated during day 10. Results showed that urinary nitrite excretion of patients with PNFM was greater than that of the normal subjects (230+/-62 umol/l vs. 42+/-30 umol/l, PFEK), and urinary excretion of glucose and potassium were lower in patients with PNFM as compared with normal individuals, although not statistically significantly so, except for FBC that was significantly lower in the patients. Urinary excretion of sodium, calcium, chloride, phosphorus, magnesium, day-night urinary volume ratio, spot morning osmolality, nocturnal index, and nocturnal polyuria index were higher in patients with PNFM. Indomethacin decreased the 24 h urinary volume by 21%, creatinine clearance by 12%, osmolar clearance by 14% and urinary protein excretion by 38% in the patients. These variables decreased by 26, 45, 17 and 12% respectively in the healthy subjects, whereas 24 h urinary protein excretion increased mildly by 9%. Indomethacin increased day-night urinary volume ratio by 73% in the healthy subjects. It might be concluded that urinary nitrite excretion, urinary excretion of sodium, chloride, phosphorus, calcium, and magnesium increased and FBC decreased in patients with PNFM; Indomethacin decreased urinary volume, FENa, FEK, osmolar clearance, and free water clearance in the healthy subjects and the patients. These might explain the mechanism of action of indomethacin to reduce frequency of voiding. The possible interaction of prostaglandin and NO in the pathogenesis of PNFM is discussed. PMID:16187117

Al-Waili, Noori S; Al-Waili, Thia N; Al-Waili, Ali N; Saloom, Khelod Y

2005-09-01

356

Urothelial carcinoma of the upper urinary tract  

International Nuclear Information System (INIS)

During the last ten years, 16 patients have been treated for urothelial carcinoma of the upper urinary tract, ten carcinomas of the renal pelvis and six carcinomas of the ureter. Mean age at the time of diagnosis was 64.3 years. The most common symptoms were hematuria, flank pain and loss of weight. The diagnosis was established by intravenous pyelography and retrograde ureteropyelography. Ureteral carcinomas were operated with local resection of the ureter, while carcinomas of the renal pelvis were treated with a nephroureterectomia. Most tumours were highly malignant. Four tumours were non-invasive and could, in retrospect, have been treated with a local resection only. Only 35% of patients with urothelial carcinoma in the upper urinary tract are alive five years after diagnosis. 19 refs.; 3 figs.; 5 tabs

1990-01-01

357

Current Staging Procedures in Urinary Bladder Cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Currently computed tomography (CT represents the most widely used standard imaging modality in muscle-invasive urinary bladder cancer. Visualization of local tumor or depth of invasion as well as lymph node staging, however, is often impaired. Magnetic resonance imaging (MRI with diffusion-weighted sequences, determination of apparent diffusion coefficient (ADC values or utilization of superparamagnetic iron nanoparticles potentially exhibits advantages in the assessment of local tumor or lymph node involvement and therefore might play a role in routine staging of urinary bladder cancer in the future. Likewise, positron emission tomography (PET with the currently utilized tracers 18F-FDG, 11C-choline and 11C-acetate is investigated in bladder cancer patients—mostly in combination with diagnostic CT. Although promising results could be obtained for these PET/CT examinations in smaller series, their true value cannot be determined at present.

Ambros J. Beer

2013-06-01

358

Purinergic signalling in the lower urinary tract.  

Science.gov (United States)

The aim of this review is to describe the conceptual steps contributing to our current knowledge of purinergic signalling and to consider its involvement in the physiology and pathophysiology of the lower urinary tract. The voiding reflex involves ATP released as a cotransmitter with acetylcholine from parasympathetic nerves supplying the bladder and ATP released from urothelial cells during bladder distension to initiate the voiding reflex via P2X3 receptors on suburothelial low threshold sensory nerve fibres. This mechanosensory transduction pathway also participates, via high threshold sensory nerve fibres, in the initiation of pain in bladder and ureter. Treatment of prostate and bladder cancer with ATP is effective against the primary tumours in animal models and human cell lines, via P2X5 and P2X7 receptors, and also improves the systemic symptoms associated with advanced malignancy. Acupuncture is widely used for the treatment of urinary disorders, and a purinergic hypothesis is discussed for the underlying mechanism. PMID:23176070

Burnstock, G

2013-01-01

359

Small cell carcinoma of the urinary bladder  

International Nuclear Information System (INIS)

Small cell carcinoma of the urinary bladder (SCCUB) is an extremely rare tumor that exhibits aggressive behavior and accounts for approximately less than 1% of all primary bladder tumors. Small cell carcinoma generally occurs in the lung, accounting for 25% of all pulmonary malignancies. SCCUB exhibits a similar microscopic and immunohistochemical appearance to that of small cell carcinoma of the lung. There is no consensus about the standard therapy, owing to its rarity. Surgical resection seems to be the mainstay of treatment for patients with limited stage, together with neoadjuvant or adjuvant platinum-based chemotherapy. Radiation therapy has same small effect for palliative purposes, as well as being an alternative to radical cystectomy. Patients with advanced stage, although given platinum-based chemotherapy, have a poor prognosis. We herein review epidemiology, clinical presentation, diagnosis, pathological features, and current management of small cell carcinoma of the urinary bladder. (author)

2011-11-01

360

Management of urinary incontinence in women.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Control of micturition is a complex physiological and anatomical process which often fails in women. The sequelae of urinary incontinence in women range from inconvenience to social and psychological stigmatization. Surprisingly, many women are tolerant of often quite severe sequelae, despite a range of management techniques that exist to alleviate or cure incontinence. Some of the more successful techniques are well suited to general practice management and can be carried out by the patient ...

O Dowd, T. C.

1993-01-01

 
 
 
 
361

Improved method to measure urinary alkoxyacetic acids  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVES: To simplify the current preparation of samples, and to improve the specificity and reliability of the conventional analytical methods to measure urinary alkoxyacetic acids. METHODS: Samples containing alkoxyacetic acids including methoxy, ethoxy, and butoxyacetic acids (MAA, EAA, and BAA) were acidified with HCl and extracted with a mixed solvent of methylene chloride and isopropyl alcohol, then analysed by gas chromatography/mass spectrometry (GC/MS). RESULTS: Optimal resul...

1999-01-01

362

Profile of urinary arsenic metabolites during pregnancy.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Chronic exposure to inorganic arsenic (In-As) from drinking water is associated with different health effects, including skin, lung, bladder, and kidney cancer as well as vascular and possibly reproductive effects. In-As is metabolized through the process of methylation, resulting in the production and excretion of methylated species, mainly monomethylarsenate (MMA) and dimethylarsenate (DMA). Because a large percentage of the dose is excreted in urine, the distribution of urinary In-As, MMA,...

Hopenhayn, Claudia; Huang, Bin; Christian, Jay; Peralta, Cecilia; Ferreccio, Catterina; Atallah, Raja; Kalman, David

2003-01-01

363

Neurotrophins as regulators of urinary bladder function  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Increased voiding frequency and urgency are among the most prevalent storage lower urinary tract symptoms (LUTS), often diagnosed as part of overactive bladder syndrome (OAB). It has been suggested that these symptoms are caused by excessive sensory activation of the neural micturition circuit. It seems likely that sensory pathway remodelling is also responsible for pain perception upon bladder filling in patients with bladder pain syndrome (BPS). Neurotrophins-including nerve growth factor (...

Ochodnicky, Peter; Cruz, Celia D.; Yoshimura, Naoki; Cruz, Francisco

2012-01-01

364

The surgical opportunity in urinary tuberculosis  

International Nuclear Information System (INIS)

The surgical opportunity in urinary tuberculosis was performed in two hundred and five patients at the Clinical Hospital of the University of de State of Rio de Janeiro (UERJ), in the period of 1962 to 1982. Clinical, radiological and pathological findings of ten cases of pionephrosis submitted to nephrectomy, and two cases of vesical enlargement by coloncystoplasty were related. Excretory urograms constitutes the most important radiological exam in reaching a diagnosis, followed by retrograde urograms. (author)

1983-01-01

365

Radiation treatment of urinary bladder carcinoma  

Energy Technology Data Exchange (ETDEWEB)

A series of 602 patients with verified urinary bladder cancer have been treated with full irradiation in the period 1957 to 1970. As expected, the survival rate decreased with increasing stage of the tumour. Another group was randomized and treated according to either of two fractionation schemes. This trial started in 1971 and shows that there is increased survival and tumour clearance rate with superfractionation.

Edsmyr, F.; Esposti, P.L.; Giertz, G.; Littbrand, B.

1978-11-28

366

Animal Models of Stress Urinary Incontinence  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Stress urinary incontinence (SUI) is a common health problem significantly affecting the quality of life of women worldwide. Animal models that simulate SUI enable the assessment of the mechanism of risk factors for SUI in a controlled fashion, including childbirth injuries, and enable preclinical testing of new treatments and therapies for SUI. Animal models that simulate childbirth are presently being utilized to determine the mechanisms of the maternal injuries of childbirth that lead to S...

2011-01-01

367

Granular cell tumors of the urinary bladder  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins. Materials...

2007-01-01

368

Primary posterior perineal herniation of urinary bladder.  

Science.gov (United States)

Primary perineal hernia is a rare clinical condition wherein herniation of viscera occurs through pelvic diaphragm. They are usually mistaken for sciatic hernia, rectal prolapse or other diseases in the perineum. Correct identification of the type of hernia by imaging is crucial for planning treatment. We present a case of primary posterior herniation of urinary bladder and rectal wall through levator ani repaired laparoscopically using a mesh repair. PMID:24019691

Prakash, Kurumboor; Kamalesh, Palanisami N

2013-07-01

369

Initial Treatment Decisions in Urinary Tract Infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Family physicians commonly deal with urinary symptoms in their female patients, but there is no valid method of achieving a firm diagnosis at the initial visit. Records of 654 episodes reported as UTI during a three year period were reviewed; the accuracy of the therapeutic decision at the initial visit was found to be 45.8%. In reaching this decision, it is possible that physicians overestimated the probability of UTI. The desire to relieve symptoms may also affect therapeutic decisions.

Anderson, John E.

1981-01-01

370

Urinary Tract Infection in Postmenopausal Women  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it i...

Raz, Raul

2011-01-01

371

An association between urinary cadmium and urinary stone disease in persons living in cadmium-contaminated villages in northwestern Thailand: A population study  

International Nuclear Information System (INIS)

Excessive urinary calcium excretion is the major risk of urinary stone formation. Very few population studies have been performed to determine the relationship between environmental cadmium exposure and urinary stone disease. This population-based study examined an association between urinary cadmium excretion, a good biomarker of long-term cadmium exposure, and prevalence of urinary stones in persons aged 15 years and older, who lived in the 12 cadmium-contaminated villages in the Mae Sot District, Tak Province, northwestern Thailand. A total of 6748 persons were interviewed and screened for urinary cadmium and urinary stone disease in 2009. To test a correlation between urinary excretion of cadmium and calcium, we measured urinary calcium content in 1492 persons, who lived in 3 villages randomly selected from the 12 contaminated villages. The rate of urinary stones significantly increased from 4.3% among persons in the lowest quartile of urinary cadmium to 11.3% in the highest quartile. An increase in stone prevalence with increasing urinary cadmium levels was similarly observed in both genders. Multiple logistic regression analysis revealed a positive association between urinary cadmium levels and stone prevalence, after adjusting for other co-variables. The urinary calcium excretion significantly increased with increasing urinary cadmium levels in both genders, after adjusting for other co-variables. Elevated calciuria induced by cadmium might increase the risk of urinary stone formation in this environmentally exposed population. - Research highlights: ? Excessive calciuria is the major risk of urinary stone formation. ? We examine cadmium-exposed persons for urinary cadmium, calcium, and stones. ? The rate of urinary stones increases with increasing urinary cadmium. ? Urinary calcium excretion increases with increasing urinary cadmium. ? Elevated calciuria induced by cadmium may increase the risk of urinary stones.

2011-05-01

372

Genetics of human congenital urinary bladder disease.  

Science.gov (United States)

Lower urinary tract and/or kidney malformations are collectively the most common cause of end-stage renal disease in children, and they are also likely to account for a major subset of young adults requiring renal replacement therapy. Advances have been made regarding the discovery of the genetic causes of human kidney malformations. Indeed, testing for mutations of key nephrogenesis genes is now feasible for patients seen in nephrology clinics. Unfortunately, less is known about defined genetic bases of human lower urinary tract anomalies. The focus of this review is the genetic bases of congenital structural and functional disorders of the urinary bladder. Three are highlighted. First, prune belly syndrome, where mutations of CHRM3, encoding an acetylcholine receptor, HNF1B, encoding a transcription factor, and ACTA2, encoding a cytoskeletal protein, have been reported. Second, the urofacial syndrome, where mutations of LRIG2 and HPSE2, encoding proteins localised in nerves invading the fetal bladder, have been defined. Finally, we review emerging evidence that bladder exstrophy may have genetic bases, including variants in the TP63 promoter. These genetic discoveries provide a new perspective on a group of otherwise poorly understood diseases. PMID:23584850

Woolf, Adrian S; Stuart, Helen M; Newman, William G

2014-03-01

373

Urinary ?-hydroxybutyrate concentrations in 1126 female subjects.  

Science.gov (United States)

?-Hydroxybutyrate (GHB) and its metabolic precursor ?-butyrolactone (GBL) are often implicated in cases of drug-facilitated sexual assault (DFSA), although definitive confirmation of GHB/GBL ingestion is complicated by GHB's endogenous nature and rapid elimination following ingestion. Multiple studies have attempted to establish a discriminant limit (generally 10 mg/L) above which urinary GHB concentrations can be considered consistent with GHB/GBL consumption. To supplement the currently available data, a rapid gas chromatography-mass spectrometry method was developed and validated for the analysis of GHB (following acidic conversion to GBL) and used to analyze urine samples collected from 1126 women (mean = 0.84 mg/L, median = 0.68 mg/L, range = 0.00-5.5 mg/L). GHB concentrations were shown to be independent of urinary pH (within the range 4.6-9.3), age (within the range 18-35 years), body mass index (within the range 13.8-36.3), and race. Adjusting GHB concentrations with respect to urinary specific gravity had little effect on the mean value (0.91 mg/L) and range (0.0-7.76 mg/L), although a statistically significant trend of increasing GHB concentration with specific gravity could be observed. Our results can be taken to offer further support for the 10 mg/L discriminant limit for GHB administration in antemortem urine samples. PMID:21073808

Brailsford, Alan D; Cowan, David A; Kicman, Andrew T

2010-11-01

374

Training and 24-hr urinary catecholamine excretion.  

Science.gov (United States)

We examined the effects of 28 weeks of training on 24-hr urinary catecholamine excretion and mood (evaluated using the Recovery-Stress Questionnaire for Athletes RESTQ-Sport) among seven national young female tennis players. Data were collected after a 1-month rest (September, T (1)), 3 months after T1(T2) and 7 months after T1(T3). Standardized Stress and Standardized Recovery scores and RESTQ-Index were computed. The training load increased by 161 % between T1 and T2 and by 55 % between T2 and T3. The performance (wins/total number of matches) decreased throughout the study. Urinary catecholamine excretion presented an U-shaped curve with a significant increase in 24-hr urinary catecholamine excretions, and epinephrine/norepinephrine ratio from T1 to T2 (T1 vs. T2: epinephrine: + 100 %, p RESTQ-Index throughout the study was mainly based on a large increase in the Standardized Stress score. Changes in specific stress and recovery scales of the RESTQ-Sport for athletes and changes in catecholamine values indicated a state of heavy training stress and incomplete recovery at the end of the study. PMID:18651370

Filaire, E; Rouveix, M; Duclos, M

2009-01-01

375

Smooth muscle electromyography of the urinary bladder.  

Science.gov (United States)

To elucidate smooth muscle activity of the urinary bladder, we utilized an optimized animal model and a specially developed, computer-aided data acquisition and analysis system for bioelectrical signals. Twenty-five Wistar rats were pharmacologically paralyzed and artificially respirated. The urinary bladder was exposed by a suprapubic midabdominal incision, and both ureters were ligated to prevent physiological filling of the bladder. The bladder was initially emptied by slight manual pressure and was then filled via a transurethral catheter in 0.1-ml steps to a maximum of 0.45 ml with physiological saline. A custom-made, gold-plated needle electrode was tangentially guided by a micromanipulator to the smooth muscle of the bladder dome, and the recordings commenced. Furthermore, smooth muscle EMG recordings of the bladder were performed after pharmaco-stimulation of the detrusor with carbachol. Initial results demonstrate that, with the animal model presented here, it is possible to record reproducible and almost artifact-free smooth muscle activity from the urinary bladder. All experiments displayed a stochastic distribution of similar electrical events, increasing in appearance and amplitude with increased bladder volume and after pharmacostimulation with carbachol. Two-dimensional power spectrum analysis revealed a main signal frequency below 1 Hz. PMID:9453693

Scheepe, J R; Wipfler, G; Schumacher, S; Bross, S; Zendler, S; Jünemann, K P; Alken, P

1998-01-01

376

Recurrent urinary tract infections in females  

International Nuclear Information System (INIS)

Uncomplicated Urinary tract infections are common in adult women across the entire age spectrum, with mean annual incidence of 15% and 10% in those aged 15-39 and 40-79 years, respectively. Urinary tract infection (UTI), with its diverse clinical syndromes and affected host groups, remains one of the most common but widely misunderstood and challenging infectious diseases encountered in clinical practice. Recurrent urinary tract infections (UTIs) present a significant problem for women and a challenge for the doctors who care for them. The diagnosis of uncomplicated UTI can be achieved best by a thorough assessment of patient symptoms with or without the addition of a urine dipstick test. Treatment should be based on the most recent guidelines, taking into account resistance patterns in the local community. The patient who suffers from recurrent UTIs can be treated safely and effectively with continuous antibiotic prophylaxis, post-coital therapy, or self-initiated treatment. This review article covers the latest trends in the management of recurrent UTI among women. Further research is needed regarding rapid diagnosis of UTI, accurate presumptive identification of patients with resistant pathogens, and development of new antimicrobials for drug-resistant UTI. (author)

2010-01-01

377

Mirabegron for male lower urinary tract symptoms.  

Science.gov (United States)

Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. Patients with BPH often present with a combination of obstructive and overactive bladder (OAB) symptoms. It is postulated that bladder outlet obstruction (BOO) from BPH results in concomitant OAB symptoms through ischemic induced variations in the response to neurotransmitters of both the detrusor and the urothelium. This altered response leads to the pathologic activation of the micturition reflex, generating sensory dysfunction and involuntary bladder contractions. Alpha-1 adrenoceptor antagonists (alpha-blockers) and 5-alpha reductase inhibitors (5-ARIs) are commonly used to treat the BOO caused by BPH. Anticholinergic agents are frequently used to treat concurrently OAB symptoms caused by the BOO. Unfortunately, anticholinergic medications demonstrate bothersome side effects and a theoretical risk of urinary retention. Basic science and clinical research has led to the development of a new class of pharmaceuticals for the treatment of overactive bladder with diminished risk of urinary retention and lacking many anticholinergic side effects. This novel compound, mirabegron (Mybertriq, Astellas Pharma US, Inc.), is a ??-adrenoceptor agonist and represents a promising new class of oral agents designed for the treatment of OAB symptoms, with minimal effect on voiding. PMID:23913200

Suarez, Oscar; Osborn, David; Kaufman, Melissa; Reynolds, W Stuart; Dmochowski, Roger

2013-12-01

378

CT endoscopy in urinary bladder lesions detection  

Directory of Open Access Journals (Sweden)

Full Text Available Aim: To evaluate applicability and efficacy CT vurtual cystoscopy in detection of urinary bladder tumors. Material and methods: During the period of 14 months, 17 patients with suspicion or present of some urinary bladder lesions has undergone CT virtual and conventional cystoscopy. After examination, all data were moved to the workstation for interactive endoluminal navigation. After that, radiologist analyzed transversal and virtual images without results of conventional cystoscopy and made conclusion. Results: Results were divided according to their basic clinical application. By using this method, all lesions over 5 mm in size were revealed. In the group of patients that were followed up for urinary bladder tumors, three patients with carcinomatous lesion were revealed. Two tumors of bladder vault that were missed on transversal scan were visualized by virtual cystoscopy. Useful additional information about tumor spread was given in two patient. One tumor inside the bladder diverticulum was detected, that was not seen by conventional cystoscopy. In two patients, endoluminal origin of mass that could not be confirmed by conventional radiologic methods, was determined. Conclusion: CT virtual cystoscopy is useful method and technique that promise a lot, especially in following situations: a follow up of bladder tumors; b supplemental estimation of endoscopically hardly accessible regions; c differential diagnosis between intravesical and exravesical lesions. Optimal estimation offers adequate bladder distension with patient positioned on the back and on the belly and interpretation as well as on transversal and virtual images. .

Mašulovi? D.M.

2007-01-01

379

Relationship between lower urinary tract symptoms and urinary ATP in patients with benign prostatic hyperplasia or overactive bladder.  

Science.gov (United States)

We investigated whether the improvement of lower urinary tract symptoms (LUTS) and urinary adenosine triphosphate (ATP) level were related. Fifty-seven patients and 13 normal controls were enrolled in this study. All of the male patients had benign prostatic hyperplasia (BPH), and all of the female patients had overactive bladder (OAB). We administered an alpha-1 adrenergic receptor antagonist (tamsulosin hydrochloride) for BPH, while OAB patients received an anti-muscarinic agent (propiverine hydrochloride). Before and after treatment, we examined LUTS and urinary ATP/creatinine ratio. The urinary ATP/creatinine ratio was lower in males than females in both controls and patients. In the BPH patients, administration of the alpha-1 receptor antagonist decreased LUTS and urinary ATP/creatinine ratio, and improvement of LUTS was greater in patients with a high baseline urinary ATP level. In the OAB patients, administration of the anti-muscarinic agent decreased LUTS and urinary ATP/creatinine ratio, and improvement of LUTS was greater in patients with a high baseline urinary ATP level. Improvement of LUTS by treatment with the alpha-1 receptor antagonist or the anti-muscarinic agent was related to the decrease of urinary ATP/creatinine ratio in patients with BPH or OAB. Measurement of urinary ATP can be used as a marker of pathologic bladder function. PMID:19887725

Sugaya, Kimio; Nishijima, Saori; Kadekawa, Katsumi; Miyazato, Minoru; Mukouyama, Hideki

2009-10-01

380

Adjustment of urinary mercury in health risk assessment of mercury.  

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The determination of adjustment method of urinary mercury in spot urine is one of the important issues in assessing the health risks of mercury workers. But there have been debates about whether creatinine or other forms of correction for urinary concentration are better in reducing the variation of urinary mercury. We evaluated four adjustment methods-specific gravity, creatinine, log creatinine and excretion rate-by correlation between values adjusted by the four methods and individual expo...

Lee, E.; Park, H. K.; Kim, H. J.

1996-01-01

 
 
 
 
381

Nephrogenic adenoma arising from the urinary bladder: a case report  

Energy Technology Data Exchange (ETDEWEB)

Nephrogenic adenoma is a benign metaplastic lesion of the urinary tract occurring most frequently at the urinary bladder. It is very rare, especially in children. We describe the US, CT and MRI findings of nephrogenic adenoma arising from the urinary bladder in an 8-year-old girl who suffered rupture of the bladder, urethra and vagina after a traffic accident and whose condition was complicated by urethral stricture and vesicoureteral reflux.

Chung, Sun Hee; Lee, Sun Wha; Han, Woon Seup [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

2001-03-01

382

Determinants of urinary 1-hydroxypyrene glucuronide in South Korean children.  

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OBJECTIVES: This study was conducted to investigate the dominant sources of the urinary pyrene metabolite, 1-hydroxypyrene glucuronide (1-OHPG), in South Korean children. METHODS: Urine samples were collected from 102 non-smoking children (aged 10-14). Urinary 1-OHPG was assayed by synchronous fluorescence spectroscopy, following immuno-affinity purification using monoclonal antibody 8E11. Urinary cotinine, a metabolite of nicotine, was measured by GC/MS. Information on environmental tobacco ...

Lee, K. H.; Vermeulen, R. C. H.; Lenters, V. C.; Cho, Soo-hun; Strickland, Paul T.; Kang, D.

2009-01-01

383

Selective serotonin reuptake inhibitor-induced urinary incontinence  

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PURPOSE: Irrespective of its cause, urinary incontinence is a medical condition seriously affecting quality of life and is increasingly recognized. In this study, we examined the association between the use of selective serotonin reuptake inhibitors (SSRIs) and urinary incontinence. METHODS: A retrospective follow-up study among starters with an SSRI was performed to estimate the relative and absolute risk for urinary incontinence associated with SSRI use. Data came from the PHARMO database, ...

Movig, K. L. L.; Leufkens, H. G. M.; Belitser, S.; Lenderink, A. W.; Egberts, A. C. G.

2002-01-01

384

Intraperitoneal rupture of the bladder after urinary catheterization  

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Intraperitoneal rupture of the bladder is a rare cause of peritonitis. Intraperitoneal rupture of the bladder was diagnosed during an emergency laparotomy for suspected mesenteric ischemia. The patient had undergone iterative urinary catheterization after a vascular bypass. The perforation was excised and sutured and the patient was catheterized for urinary rest for 15 days. Urinary catheterization is a possible cause of intraperitoneal rupture of the bladder.

Sophie Jambet; Olivier Facy; Pierre Landreau; Céline Duperron; Benjamin Kretz

2011-01-01

385

Ascending urinary tract infection in rats caused by Proteus mirabilis  

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A model for ascending unobstructed urinary tract infection was developed in female rats to study the pathogenesis of urinary tract infection by Proteus mirabilis. Urinary bladders of rats were inoculated by I. V. cannula with 0.5 ml ofbrainheart infusion broth containing approximataly 3 x 108 living bacteria. Kidney, blood and urine samples collected at days 2, 4 and weeks 1-8 intervals were studied for renal infection as well as renal function tests. The results indicated the variation an...

Al Murayati, H. Y. A.

1997-01-01

386

Antibiotic-laced urinary catheter helps prevent costly infections.  

Science.gov (United States)

Treating urinary tract infections at the source: Urinary tract infection is a common problem in hospitals, particularly among patients who require long-term management with indwelling urinary catheters. A new Foley catheter, made of silicon imbedded with a broad-spectrum antibiotic, shows a 10-fold reduction in UTI within three days of use. Its maker claims hospitals can save $68,000 to $438,000 per 1,000 catheters. PMID:10185345

1998-09-01

387

Estudio de un cálculo intestinal en un paciente con adenocarcinoma de colón: ¿es similar a los cálculos renales? / Study of a intestinal enteroliths in human patient with colon adenocarcinome: Is it similar to renal calculi?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Este trabajo muestra el estudio realizado a enterolitos intestinales procedentes de un paciente de 91 años que padecía una enterolitiasis múltiple confirmada por estudio radiológico abdominal y TAC, mostrando cálculos en el tracto intestinal, renal y biliar. Además esta enterolitiasis estaba asociad [...] a a un adenocarcinoma de colon. Los enterolitos analizados proceden de una intervención quirúrgica en la que se practicó una hemicolectomía derecha. Los enterolitos se sometieron a un análisis por espectrometría de infrarrojos (IR) observándose un espectro de carbonato apatita no-estequiométrica, tipo whitloquita, posiblemente con materia orgánica. Con el fin de estudiar el posible contenido de diversos elementos químicos, se practicó un análisis por espectrometría de emisión atómica encontrándose, fundamentalmente, los iones Ca, Mg, K, Na y K (del orden de mg/100 mg de cálculo) y Zn, Ba, Mn, Fe, Cu, Si, Ti y Br en menor proporción (del orden de µg/100 mg de cálculo). Dada la morfología del cálculo y su espectro de IR (carbonato apatita no estequiométrica) se determinó la posible presencia de porfirinas por cromatografía líquida de alta resolución (HPLC) encontrándose, fundamentalmente, coproporfirina (µg/g de cálculo) y en menor proporción uroporfirina, protoporfirina y hepta-carboxi porfirina. El estudio se completó con el análisis de los enterolitos mediante microscopía electrónica de barrido y EDX. El análisis por difracción de rayos X detectó la presencia de CaP4O11. Los resultados obtenidos de los diferentes análisis muestran que la composición de los enterolitos es similar a la de los cálculos renales, aunque su morfología difiera de estos. Abstract in english This work shows the study performance to intestinal enterolithis from a 91 year old patient with multiple enterolithiasis confirmed by abdominal X-ray and TAC analyses showing the presence of intestinal, renal and bile stones. This enterolithis is associated with colon adenocarcinoma. The enterolith [...] s were obtained by hemicolectomia and were analyzed by infrared spectroscopy (IR), giving nonstoichiometry carbonate apatite whitloquite-like with, possibly, organic material. By atomic emission spectroscopy we found Ca, Mg, K, Na y K (mg/100 mg of calculi) and Zn, Ba, Mn, Fe, Cu, Si, Ti and Br in minor proportion (µg/100 mg of calculi). Because of calculi morphology and the IR spectra (non-stoichiometry carbonate apatite) we carried out analysis by high performance liquid chromatography (HPLC) and found coproporphyrin (about µg/g of calculi) and uroporphyrin, protoporphyrin and heptacarboxy-porphyrin in minor extent. Calculi were also studied by scanning electronic microscopy and EDX and X-ray diffraction giving crystals of CaP4O11. All these results show that intestinal enteroliths composition are similar to renal calculi although its morphology differs from renal calculi.

Traba Villameytide, M.L.; Orts Costa, J.A.; Morell, M..

388

Update on duloxetine for the management of stress urinary incontinence  

Directory of Open Access Journals (Sweden)

Full Text Available Maya Basu, Jonathan RA DuckettDepartment of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent, UKAbstract: Duloxetine is a relatively balanced serotonin and noradrenaline reuptake inhibitor (SNRI, which is the first drug with widely proven efficacy to have been licensed for the medical treatment of women with stress urinary incontinence (SUI. Despite favorable results from randomized controlled trials, surgical management continues to be the mainstay of treatment for SUI. In this review we explore the pharmacology of duloxetine in the nervous system and lower urinary tract, and the evidence for its use in the management of women with urinary incontinence.Keywords: duloxetine, stress urinary incontinence, overactive bladder

Maya Basu

2008-11-01

389

The correlation between urinary and liver taurine levels and between pre-dose urinary taurine and liver damage.  

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Analysis of data from several studies has shown that urinary taurine levels are highly significantly correlated with liver taurine concentration in control rats. Furthermore, urinary taurine levels measured before dosing with various hepatotoxic agents are significantly correlated with serum AST and ALT values measured after dosing with hepatotoxicants. That is, animal with low urinary taurine values and therefore low liver taurine concentrations tend to show greater hepatic damage. These dat...

1993-01-01

390

Non-Surgical Treatments for Urinary Incontinence: A Review of the Research for Women  

Science.gov (United States)

... Summary – Apr. 9, 2012 Non-surgical Treatments for Urinary Incontinence: A Review of the Research for Women Formats ... best for you. Understanding Your Condition What is urinary incontinence? Urinary incontinence or UI is a condition where ...

391

Antibiotic Resistance in Urinary Isolates of Escherichia coli from College Women with Urinary Tract Infections?  

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Of 176 urine isolates from female students positive for Escherichia coli, 29.6% were trimethoprim-sulfamethoxazole resistant and none were nitrofurantoin resistant. Among students with a history of urinary tract infection (UTI) (n = 119), resistance to ciprofloxacin was 11.8%, compared to 1.8% among those without prior UTI. Nitrofurantoin should be considered for empirical therapy of lower tract UTI.

Olson, Ronald P.; Harrell, Lizzie J.; Kaye, Keith S.

2009-01-01

392

Microtomographic analysis of lower urinary tract obstruction.  

Science.gov (United States)

Prenatal obstruction of the lower urinary tract may result in megacystis, with subsequent development of hydroureter, hydronephrosis, and renal damage. Oligo- or anhydramnios, pulmonary hypoplasia, and prune belly syndrome are lethal consequences. Causes and mechanisms responsible for obstruction remain unclear but might be clarified by anatomic study at autopsy. To this end, we employed 2 methods of tomographic imaging-optical projection tomography and contrast-enhanced microCT scanning-to elucidate the anatomy of the intact urinary bladder and urethra in 10 male fetuses with lower urinary tract obstruction. Images were compared with those from 9 age-matched controls. Three-dimensional images, rotated and sectioned digitally in multiple planes, permitted thorough examination while preserving specimens for later study. Both external and internal features of the bladder and urethra were demonstrated; small structures (ie, urethral crest, verumontanum, prostatic utricle, ejaculatory ducts) were seen in detail. Types of obstruction consisted of urethral atresia (n ?=? 5), severe urethral stenosis (n ?=? 2), urethral diaphragm (n ?=? 2), or physical kinking (n ?=? 1); classic (Young type I) posterior urethral valves were not encountered. Traditional light microscopy was then used to verify tomographic findings. The prostate gland was hypoplastic or absent in all cases; in 1, prostatic tissue was displaced inferior to the verumontanum. Findings support previous views that dissection may produce valve-like artifacts (eg, bisection of an obstructing diaphragm) and that deformation of an otherwise normal urethra may result in megacystis. The designation "posterior urethral valves" should not be used as a generic expression of urethral obstruction unless actual valves are demonstrated. PMID:23977847

Siebert, Joseph R; Smith, Kenneth J; Cox, Liza L; Glass, Ian A; Cox, Timothy C

2013-01-01

393

Urinary porphyrin excretion in normal children and adults.  

Science.gov (United States)

The relationship of random urinary porphyrin and creatinine values as functions of age and sex was examined in a normal population. Total urinary porphyrin was measured by a solvent extraction technique, while urinary creatinine was evaluated by an alkaline picrate method. Random urine specimens from 120 healthy patients (81 children and 39 adults) were evaluated. In both pediatric and adult populations, a strong correlation was found between urinary concentrations of porphyrin and creatinine (r = 0.7, P less than 0.0001). Urinary porphyrin excretion in mumol/mol creatinine (micrograms/g) was inversely related to both age (r = -0.59, P less than 0.0001) and weight (r = -0.61, P less than 0.0001) until approximately 9 years of age or 30 kg. Urinary porphyrin excretion in children 9 to 18 years of age was lower than that of younger children (P less than 0.0001) and approached adult values. Sex was not found to be a factor until 9 to 18 years of age, when females had higher urinary creatinine concentrations (P less than 0.05), but lower urinary porphyrin excretions (P less than 0.05) than similarly aged males. The converse was observed when similar values of adult women were compared with those of adult men. Men also had higher urinary porphyrin concentrations than women (P less than 0.01). Men had increased urinary creatinine concentration (P less than 0.05) and decreased porphyrin excretion ratios (P less than 0.05) when compared with males 9 to 18 years of age. Women had significantly lower urinary creatinine (P less than 0.001) and porphyrin (P less than 0.001) concentrations than females 9 to 18 years of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1928067

Bloom, K E; Zaider, E F; Morledge, L J; Poh-Fitzpatrick, M B

1991-10-01

394

Degeneration of the symphysis pubis presenting as a submucosal urinary bladder tumour  

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Urinary bladder sonography is a sensitive diagnostic technique used for visualizing urinary bladder tumours. The aim of our communication is to present a case of a pseudotumour of the urinary bladder originating from the symphysis pubis syndesmosis. A 58-year-old woman was seen by a urologist with symptoms of lower urinary tract infection. Urinary bladder sonography was performed, followed by magnetic resonance imaging. Sonographic images of the bladder showed an exophytic mass on the urinary...

2012-01-01

395

Use of gastric segment in urinary bladder replacement after total cystectomy  

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Drainage of urine by abnormal way is urinary derivation. Various forms of urinary derivations are available for urinary bladder replacement after radical cystectomy for invasive bladder tumor. Construction of continent urinary reservoir, so called pouch, from different bowel segments is named continent urinary derivations. If such urinary reservoir is connected with urethra, then it is about orthotopic derivation and reservoir is defined as neobladder. Upon satisfactory results of introductio...

Stijelja Borislav; Mladenovi? Ljubiša; Aleksi? Predrag; Soldatovi? Živko

2006-01-01

396

Introital ultrasonography in female urinary incontinence  

International Nuclear Information System (INIS)

To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. Introital ultrasonography was performed in fifteen with stress urinary incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittal section of the anterior pelvis in the plane of the symphysis pubis the posterior urethrovesical angle, the pubourethral distance and the pubo-yregrak abgle were measured at rest and during stress(Valsalva's maneuver state). The student T-test and the ANOVA test were used in statistical analysis. The posterior urethrovesical angels of the controls were 125.3 deg (±10.9) at rest and 125.7 deg (±7.6) during stress. In the patients, the corresponding angles were135.3 deg (±11.3) and 139.6 deg(±10.8). The posterior urethrovesical angles increased 0.3 deg (±4.7) in the controls and 5.6 deg (±4.0) in the patients(p=0.018). In the controls, the pubo-urethral distances were 21.8 mm(±5.8) at rest and 18.2 mm(±7.1) during stress, while in the patients these distances were 18.4 mm(±3.9) and 12.6 mm(±4.4). The pubo-urethral distance decreased 3.5 mm (±1.5) in the controls and 5.8 mm (±2.3) in the patients(p=0.039). In the patients with mild incontinence(Grade I), the posterior urethrovesical angles increased 3.4 deg (±2.8) : 132.3 deg (±12.5) at rest and 135.6 deg (12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 deg(±3.8) : 136.0 deg(±6.5) at rest and 144.1 deg((±5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p<0.05). There was no statistical significancy in the pubo-urethral angle (p=0.315). Introital ultrasonography may be useful for assessment of stress urinary incontinence

1996-06-01

397

Retroperitoneal lipoma arising from the urinary bladder  

Directory of Open Access Journals (Sweden)

Full Text Available Retroperitoneal benign lipomas are extremely rare and represent about 2.9% of all primary retroperitoneal tumors. About 80% of the tumors in the retroperitoneal cavities are malignant neoplasms. We experienced a case of a retroperitoneal lipoma simulating an ovarian mature cystic teratoma. A diagnosis was correctly made by magnetic resonance imaging (MRI prior to surgery, and a total tumorectomy was performed. The retroperitoneal lipoma was recognized to have arisen from the urinary bladder. Histological sections revealed a tumor consisting of typical adipose cells without atypia. These types of lipomas should be carefully followed-up because they often recur and undergo malignant transformations.

Hisato Kobayashi

2009-07-01

398

Introital ultrasonography in female urinary incontinence  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. Introital ultrasonography was performed in fifteen with stress urinary incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittal section of the anterior pelvis in the plane of the symphysis pubis the posterior urethrovesical angle, the pubourethral distance and the pubo-yregrak abgle were measured at rest and during stress(Valsalva's maneuver state). The student T-test and the ANOVA test were used in statistical analysis. The posterior urethrovesical angles of the controls were 125.3 deg ({+-}10.9) at rest and 125.7 deg ({+-}7.6) during stress. In the patients, the corresponding angles were 135.3 deg ({+-}11.3) and 139.6 deg({+-}10.8). The posterior urethrovesical angles increased 0.3 deg ({+-}4.7) in the controls and 5.6 deg ({+-}4.0) in the patients(p=0.018). In the controls, the pubo-urethral distances were 21.8 mm({+-}5.8) at rest and 18.2 mm({+-}7.1) during stress, while in the patients these distances were 18.4 mm({+-}3.9) and 12.6 mm({+-}4.4). The pubo-urethral distance decreased 3.5 mm ({+-}1.5) in the controls and 5.8 mm ({+-}2.3) in the patients(p=0.039). In the patients with mild incontinence(Grade I), the posterior urethrovesical angles increased 3.4 deg ({+-}2.8) : 132.3 deg ({+-}12.5) at rest and 135.6 deg (12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 deg({+-}3.8) : 136.0 deg({+-}6.5) at rest and 144.1 deg({+-}5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p<0.05). There was no statistical significancy in the pubo-urethral angle (p=0.315). Introital ultrasonography may be useful for assessment of stress urinary incontinence.

Weon, Young Cheol; Cho, Kyoung Sik; Lee, Jin Seong; Choi, Sang Hee; Kim, Keon Seok; Choo, Myung Soo [Ulsan Univ. Asan Medical Center, Seoul (Korea, Republic of)

1996-06-01

399

Calcifying nanoparticles associated encrusted urinary bladder cystitis  

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Tomislav M Jelic1, Rod Roque1, Uzay Yasar2, Shayna B Tomchin1, Jose M Serrato2, Samuel G Deem3, James P Tierney3, Ho-Huang Chang11Department of Pathology Charleston Area Medical Center, Charleston WV, USA; 2Urology Center of Charleston, Charleston WV, USA; 3Urologic-Surgical Assoc. of Charleston, Charleston WV, USAAbstract: Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder...

2008-01-01

400

Urinary metabolites of busulfan in the rat  

International Nuclear Information System (INIS)

After ip administration of 15 mg/kg [1,4-14C]busulfan to rats, the urinary excretion was 70% of the total radioactivity after 72 hr. Three major metabolites were isolated and quantified by HPLC. Of the total radioactivity in the urine, unchanged busulfan was excreted as a minor amount (6%) and the following metabolites were identified as: 3-hydroxysulfolane (39%), tetrahydrothiophene 1-oxide (20%), and sulfolane (13%) using GC/MS and NMR spectroscopy. The cytotoxicity of busulfan and its major metabolites was examined using a V79 Chinese hamster cell line

1987-01-01

 
 
 
 
401

Urinary metabolites of busulfan in the rat  

Energy Technology Data Exchange (ETDEWEB)

After ip administration of 15 mg/kg (1,4-/sup 14/C)busulfan to rats, the urinary excretion was 70% of the total radioactivity after 72 hr. Three major metabolites were isolated and quantified by HPLC. Of the total radioactivity in the urine, unchanged busulfan was excreted as a minor amount (6%) and the following metabolites were identified as: 3-hydroxysulfolane (39%), tetrahydrothiophene 1-oxide (20%), and sulfolane (13%) using GC/MS and NMR spectroscopy. The cytotoxicity of busulfan and its major metabolites was examined using a V79 Chinese hamster cell line.

Hassan, M.; Ehrsson, H.

1987-05-01

402

Urinary polyomavirus infections in neurodevelopmental disorders  

Directory of Open Access Journals (Sweden)

Full Text Available We have recently reported enhanced frequencies of polyomavirus infection in post-mortem brain tissue of autistic patients compared to controls. To further explore potential contributions to neurodevelopmental disorders by polyomaviruses, we have employed specie-specific TaqMan assays to assess the prevalence and titres of BKV, JCV and SV40 inthe urines of 87 patients with autism spectrum disorder, 84 controls matched by sex and age with the autistic sample, 15 subjects with Down syndrome and 13 fragile X individuals. Prevalence rates of urinary BKV infection were significantly greater in Down syndrome and fragile X patients compared to autistic and control individuals (P

Ivan Gentile

2013-04-01

403