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  1. Bladder stones after bladder augmentation are not what they seem.

    Science.gov (United States)

    Szymanski, Konrad M; Misseri, Rosalia; Whittam, Benjamin; Lingeman, James E; Amstutz, Sable; Ring, Joshua D; Kaefer, Martin; Rink, Richard C; Cain, Mark P

    2016-04-01

    Bladder and renal calculi after bladder augmentation are thought to be primarily infectious, yet few studies have reported stone composition. The primary aim was to assess bladder stone composition after augmentation, and renal stone composition in those with subsequent nephrolithiasis. The exploratory secondary aim was to screen for possible risk factors for developing infectious stones. Patients treated for bladder stones after bladder augmentation at the present institution between 1981 and 2012 were retrospectively reviewed. Data were collected on demographics, surgeries and stone composition. Patients without stone analysis were excluded. Stones containing struvite, carbonate apatite or ammonium acid ureate were classified as infectious. The following variables were analyzed for a possible association with infectious bladder stone composition: gender, history of cloacal exstrophy, ambulatory status, nephrolithiasis, recurrent urea-splitting urinary tract infections, first vs recurrent stones, timing of presentation with a calculus, history of bladder neck procedures, catheterizable channel and vesicoureteral reflux. Fisher's exact test was used for analysis. Of the 107 patients with bladder stones after bladder augmentation, 85 met inclusion criteria. Median age at augmentation was 8.0 years (follow-up 10.8 years). Forty-four patients (51.8%) recurred (14 multiple recurrences, 143 bladder stones). Renal calculi developed in 19 (22.4%) patients with a bladder stone, and 10 (52.6%) recurred (30 renal stones). Overall, 30.8% of bladder stones were non-infectious (Table). Among patients recurring after an infectious bladder stone, 30.4% recurred with a non-infectious one. Among patients recurring after a non-infectious stone, 84.6% recurred with a non-infectious one (P = 0.005). Compared with bladder stones, renal stones were more likely to be non-infectious (60.0%, P = 0.003). Of patients with recurrent renal calculi after an infectious stone, 40.0% recurred with

  2. Voiding by Mandatory Position Changing: Giant Bladder Stone

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    Tufan Cicek

    2013-02-01

    Full Text Available Voiding by Mandatory Position Changing: Giant Bladder Stone Bladder Stones frequently develops on the base of neurogenic micturation disorders, infection, bladder outlet disorders, spinal cord injury and foreign bodies. BPH for men and previous incontinans surgery in women are risk factors for bladder Stone development according to gender. In this case report a 49 years old man, who can void by mandatory position changing owing to a giant bladder stone is presented . [Cukurova Med J 2013; 38(1.000: 120-122

  3. CASE REPORT: A GIANT URINARY BLADDER STONE IN A ...

    African Journals Online (AJOL)

    A vesical calculus weighing more than 100g is categorized as a giant urinary bladder stone. Male preponderance for urinary bladder calculi is well known. A rare case of a giant urinary bladder calculus weighing 1200g and occurring in a female patient is reported. The stone was removed by open vesicolithotomy.

  4. Epidemiology of bladder stone of children: precipitating events.

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    Halstead, Scott B

    2016-04-01

    Urological surgery evolved from the ancient practice of removing primary bladder stones from young boys. Bladder stones, once ubiquitous, long ago disappeared from the developed world while pockets of disease still exist in developing countries. Two epidemiological studies identified as precipitating events of bladder stone formation the practice of substitutive carbohydrate feedings to newborns. In Southeast Asia, masticated rice is fed to newborns in stone-endemic villages while in England, during the eighteenth and nineteenth centuries pap or panada was used to hand-feed infants when breast milk was not available. Fresh milk from dairy animals was deemed preferable to pap. Lack of access to dairy cattle enhanced need for hand-feeding. In an epidemiological study, during mid-nineteenth century in England the prevalence of dairy cattle was inversely related to the prevalence of bladder stones. These epidemiological data relate stone formation to nutrition during the first few days or weeks of life. It is surmised that frequent use of or exclusive reliance on carbohydrate foods replacing milk feedings leads to a relative dietary deficiency in phosphates and the formation of insoluble urinary salts. Girls, with short, nontortuous urethras may pass much of the calculus debris without retaining nuclei in the bladder. In some males, stone nuclei are formed and retained. The growth of stones is determined thereafter by the net effect of depository and resorptive mechanisms operating over time distributing over many years the age that patients present for surgical stone removal. The role of early introduction of carbohydrate foods and reduced milk intake of neonates has not been incorporated into recommendations for feeding newborns in endemic countries nor comprehensively modeled in animals.

  5. Urethral obstruction from dislodged bladder Diverticulum stones: a case report

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    Okeke Linus I

    2012-11-01

    Full Text Available Abstract Background Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. Case presentation A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. Conclusions Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy.

  6. Bladder stones in catheterized spinal cord-injured patients in Nigeria

    African Journals Online (AJOL)

    Objective: The objective was to determine the incidence of bladder stones in patients with spinal cord injury (SCI) and to assess if catheter encrustation or positive urinary culture of Proteus mirabilis is predictive of bladder stones. Background: Bladder stones are common urological complication in those with SCI managed ...

  7. Childhood bladder stones-an endemic disease of developing countries

    International Nuclear Information System (INIS)

    Lal, B.

    2015-01-01

    Bladder calculi are one of the commonest health problems in young children especially in rural and underprivileged areas. Methods: All children of bladder stones operated at District Headquarter Hospital Mithi from July 2009 to June 2012 were included in this cross-sectional study. Data was collected regarding age, sex, address (rural or urban), body weight, duration of breast feeding, weaning, detailed dietary history regarding milk type, volume, amount of water intake, recurrent diarrhoea, urinary tract infection (UTI), family history, and socioeconomic history. Urine analysis, complete blood count (CBC), renal function, ultra sound abdomen, X-ray kidney, ureter, and bladder (KUB) was done in all patients. All patients had cystolithotomy and were followed up till complete recovery. Results: A total of 113 children (97 males and 16 females) operated at District Headquarter Hospital Mithi Tharparker were included in study. All patients belonged to local desert areas of Tharparker. Age ranged from 18 months to 14 year (mean age 8.6 year). Most frequent symptom was difficulty in micturition in 76 (67.25%) patients, urinary retention in 18 (15.9%) and stone with pyuria and fever in 12 (10.6%) patients. Recurrent episodes of diarrhoea (more than 3 episodes per year) in 73(65%) patients, recurrent UTI in 51 (45.6%), family history of stone disease in 6 (5%) and associated rectal prolapse in 3(2.6%) patients. On x-ray KUB 111 (98%) patients had single stone in bladder, 2 (2%) had multiple stones and an associated renal and ureteric stone in 5 (4.5%). Mild anaemia (Hb 7-10 gm%) was seen in 35 (39.55%) patients, moderate anaemia (Hb 5-7 gm %) was seen in 21(24%) and severe anaemia (Hb less than 5 gm%) was seen in 14 (16%) patients. All patients had open cystolithotomy for removal of stones under general anaesthesia. Conclusion: Bladder stones are public health problem. Majority of affected patients were less than 5 years old. Low protein diet, dehydration, use of goat milk

  8. Single Large Bladder Stone in a Young Male Adult with Primary Hyperparathyroidism

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    Omar Halalsheh

    2017-07-01

    Full Text Available Bladder stones are caused when minerals are built up in the bladder, especially if the bladder is incompletely emptied. These stones will pass while they are small. Otherwise, they get stuck to the bladder wall or ureter. If this happens, they gradually gather more mineral crystals, becoming larger over time. Primary hyperparathyroidism is usually caused by a tumor within the parathyroid gland, and elevated calcium levels can cause digestive symptoms, psychiatric abnormalities, bone disease and multiple kidney stones.

  9. Management of bladder stones: the move towards non-invasive treatment

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    Isaac A. Deswanto

    2017-08-01

    Full Text Available Background: Bladder stone accounts for 5% of all cases of urolithiasis. Bladder stones management has evolved over the last decades from open bladder surgery (sectio alta to intracorporeal cystholithotripsy as well as extracorporeal shock wave lithotripsy (ESWL. ESWL presents to be a promising modality in the management of bladder calculi due to its simplicity and well tolerability. This study is thus conducted to present data on the safety and effectiveness of ESWL in the management of bladder stone patients.Methods: This is a retrospective study evaluating the medical records of 92 bladder calculi patients admitted to Cipto Mangunkusumo General Hospital (RSCM from January 2011 to April 2015. Patient’s age, gender, type of stone and procedure being done, status of stone disintegration, length of hospital stay, and any complications that may occur are noted down and statistically analyzed using SPSS v. 20.Results: Majority of the patients underwent ESWL (49 out of 92, 53.3%. The stone free rates for ESWL, intracorporeal lithotripsy, and sectio alta are 93.9%, 97.0% and 100% respectively. One patient had to repeat ESWL. The ESWL group had the smallest stone size average compared to the intracorporeal lithotripsy and section alta group (2.5 cm±2.0 cm vs 4.8 cm±3.7 cm vs 7.4 cm±5.4 cm respectively. The ESWL sessions were conducted in the outpatient clinic, and thus no hospital stay was required.Conclusion: ESWL can be suggested as an effective non-invasive approach in the disintegration of bladder stone of ≤25 mm with a promisingly high stone-free rate (93.9% Furthermore, ESWL can be performed on an outpatient basis with minimal complications.

  10. Bladder stone caused by an ectopic intrauterine contraceptive device: case report

    International Nuclear Information System (INIS)

    Atasoy, C.; Fitoz, S.; Akyar, S.

    2001-01-01

    Perforation of the uterus is a recognized complication associated with the use of an intrauterine contraceptive (IUCD). However, migration of an IUCD into the bladder, with or without stone formation, is exceptionally rare. We report the case of a patient with a displaced IUCD that acted as a nidus for bladder lithiasis. (author)

  11. Bladder stone caused by an ectopic intrauterine contraceptive device: case report

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    Atasoy, C.; Fitoz, S.; Akyar, S. [Ankara Univ. School of Medicine, Dept. of Radiology, Ibn-i Sina Hospital, Ankara (Turkey)

    2001-02-01

    Perforation of the uterus is a recognized complication associated with the use of an intrauterine contraceptive (IUCD). However, migration of an IUCD into the bladder, with or without stone formation, is exceptionally rare. We report the case of a patient with a displaced IUCD that acted as a nidus for bladder lithiasis. (author)

  12. Large bladder calculus masking a stone in single-system ureterocele.

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    Bhaskar, Ved; Sinha, Rahul Janak; Purkait, Bimalesh; Singh, Vishwajeet

    2017-06-14

    Ureterocele in an elderly is a rare entity. The presence of stone within ureterocele along with a large bladder calculus is an even rarer presentation. This phenomenon has not been reported so far to the best of our knowledge. We present an unusual case of a large bladder calculus with a concomitant stone in the associated ureterocele. The diagnosis was missed in the first instance due to the masking effect by the larger bladder calculus. Herein, we discuss this case and its management. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Morbidity and efficacy of ureteroscopic stone treatment in patients with neurogenic bladder.

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    Christman, Matthew S; Kalmus, Angela; Casale, Pasquale

    2013-10-01

    There is a lack of information on the safety and efficacy of ureteroscopy in the neurogenic bladder population. We hypothesized that ureteroscopy in patients with neurogenic bladder would be associated with an increased risk of complications and a lower stone clearance rate than in patients without neurological impairment. We reviewed a local registry of patients with ICD-9 codes for urolithiasis between 2004 and 2012. The study cohort was assembled from all eligible patients with neurogenic bladder and a randomly selected control group that had undergone ureteroscopy. Statistical analysis of demographic variables and surgical outcomes was performed. Complications were classified according to the Clavien system. Clearance was defined by computerized tomography, renal/bladder ultrasound or direct ureterorenoscopy. Ureteroscopy was performed a total of 173 times in 127 controls and a total of 45 times in 20 patients with neurogenic bladder. There was no difference between presenting episodes by gender (p = 1.0), race (p = 0.654) or body mass index (p = 0.519). Bacteriuria was associated with the stone episode in 16.4% of controls and 67% of neurogenic bladder cases (p neurogenic bladder (80.5 minutes, IQR 50-110.5 vs 52, IQR 33-78, p = 0.0003). The proportion of complications was significantly different (p = 0.013). Stones cleared in 86.6% of controls compared to 63% of neurogenic bladder cases (p = 0.004). Patients with neurogenic bladder have increased morbidity after ureteroscopy for upper tract calculi compared to neurologically unaffected controls. Infection has a role in this morbidity. The clearance rate is lower but the stone burden is more significant in those with neurogenic bladder. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Endoscopic Treatment of Intrauterine Device Migration into the Bladder with Stone Formation.

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    Sano, Masayuki; Nemoto, Kaoru; Miura, Takafumi; Suzuki, Yasutomo

    2017-01-01

    Background: An intrauterine device is commonly used for contraception globally. Although intrauterine device placement is an effective and safe method of contraception, migration into the bladder with stone formation is a rare and serious complication. The management approaches for an intrauterine device embedded in the bladder include endoscopic procedures and open surgical removal. In this study, we report the case of a patient with recurrent urinary tract infection associated with intrauterine device migration and urolithiasis, who successfully underwent endoscopic treatment combined with laser fragmentation. Case Presentation: A 22-year-old woman presented to our hospital with a 1-month history of lower abdominal pain, hematuria, and pain on urination. Transvaginal ultrasound showed a hyperechoic lesion in the bladder. A plain abdominal radiograph showed the presence of a T-shaped intrauterine device with calculus formation in the pelvis. CT revealed a vesical stone fixed to the top of the bladder wall, and there was no vesicovaginal fistula formation. She had undergone intrauterine device insertion several years previously. Cystoscopy confirmed the diagnosis. She underwent endoscopic lithotripsy, and the intrauterine device was extracted from the bladder wall. Repair of the bladder wall and disappearance of symptoms were confirmed. Conclusion: Endoscopic treatment combined with laser fragmentation of stones surrounding a migrated intrauterine device should be considered as a minimally invasive approach, which can be performed safely.

  15. Bladder stone formation over a partially migrated intrauterine ...

    African Journals Online (AJOL)

    The case of a 42-year-old woman with a forgotten intrauterine contraceptive device (IUCD) presenting with irritative bladder symptoms and cyclical haematuria is reported. The threads of the IUCD were seen in the vagina during speculum examination. Partial migration of the IUCD into the bladder and formation of a large ...

  16. The twin amplatz sheath method: a modified technique of percutaneous cystolithotripsy for large bladder stones in female patients.

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    Kumar, Amit; Dalela, Deepansh; Dalela, Divakar; Goel, Apul; Paul, Sagorika; Sankhwar, Satya N

    2013-07-01

    To minimize the operative time and to avoid open cystolithotomy in women with large bladder stone (>5 cm), we present here a modification of percutaneous cystolithotomy, a well-described standard procedure for urinary bladder stones. With this technique, suprapubic percutaneous access was achieved under cystoscopic guidance. The suprapubic tract was dilated and an Amplatz sheath of 30 Fr was placed. Simultaneously, the urethra was sequentially dilated with fascial dilators and a 28 Fr Amplatz sheath was guided into the bladder and the foot end of the table lowered to 20° to facilitate high-speed outflow of irrigant and stone particles. A 26.5 Fr nephroscope was passed through the suprapubic Amplatz sheath and the stone was fragmented by intracorporeal pneumatic device keeping the stone close to the proximal end of the urethral Amplatz. These maneuvers help in washing out stone fragments periurethrally and keeping the endoscopic vision clear while breaking the stone.

  17. Spatial distribution of major and trace elements in bladder and kidney stones

    International Nuclear Information System (INIS)

    Chaudhri, M.A.; Watling, J.; Khan, F.A.

    2007-01-01

    The spatial distribution of major and trace elements has been studied in a range of human kidney and bladder stones with well documented histories to understand their initiation and formation. The stones were cut in half using a clean diamond saw and further cleaned, to remove surface contamination, in an ultrasonic bath. The cut surfaces were analyzed using laser ablation inductively coupled plasma-mass spectrometry (LA-ICPMS). The spatial distribution of Li, B, Mg, Al, P, Ca, Cr, Mn, Zn, Rb, Sr, Ba and Pb has been determined across the width of each stone. (author)

  18. Bladder stones in catheterized spinal cord-injured patients in Nigeria

    African Journals Online (AJOL)

    2011-04-26

    Apr 26, 2011 ... Conclusions: This study shows that a large number of SCI patients have an indwelling urethral catheter and suggests that ultrasound scan for the presence of stone should be schedule in a catheterized SCI patient if catheter encrustation or a positive urine culture of P. mirabilis is noted. Key words: Bladder ...

  19. A large bladder stone caused by the intravesical migration of an intrauterine contraceptive device: a case report.

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    De Silva, W S L; Kodithuwakku, K A S U A; Aponsu, G U E; Rathnayake, R M M; Rajasegaram, E

    2017-10-22

    A wide variety of complications due to the extrauterine migration of intrauterine contraceptive devices have been reported in the literature. Here we describe the case of a large bladder stone formed around a migrated Copper T380A device that was neglected and detected 15 years after insertion. A 48-year-old Sri Lankan woman underwent a workup for lower urinary tract symptoms and recurrent urinary tract infections over the previous 6 months. The radiographs showed a large bladder stone with an imprint of an intrauterine contraceptive device in the center of it. The device had been inserted 15 years previously. Two years after the insertion, it was considered to be missing, but our patient did not comply with the recommended follow-up. She had been completely asymptomatic until she developed lower urinary tract symptoms. After confirming the location of the stone via ultrasonography, a vesicolithotomy was performed, revealing a stone with three limbs corresponding to the shape of the Copper T380A device. The device and the threads were fully covered with the stone material. Our patient was asymptomatic following the surgery. A migrated intrauterine contraceptive device can act as the nidus for the formation of a secondary bladder stone. The detailed imprint of the device inside the stone and the laminated appearance of the stone material were characteristic of a secondary bladder stone formed around an intrauterine contraceptive device. Radiography and ultrasonography are adequate for the diagnosis of intravesical migration of intrauterine contraceptive devices.

  20. Management of bladder stones associated with foreign bodies following incontinence and contraception surgery

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    Abdulmuttalip Simsek

    2014-06-01

    Full Text Available Aim of the study: To investigate success of endoscopic lithotripsy for bladder stone following stress urinary incontinance surgery and contraception surgery. Materials and methods: Charts of patients admitted in two centers between January 2006 and March 2013 were retrospectively reviewed and seven women were enrolled in our study. Patients demographic parameters including age, main complaint(s, previous surgery type, time to diagnosis were analyzed. Also operative time, hospitalisation lenght, perioperative and postoperative complication( s were evaluated. Results: Five patients had undergone tension free vaginal tape procedure and one patient had undergone transobturator tape procedure. Median age was 62 (50-71 years. In one patient bladder stone formed around an intrauterine device. Dysuria (85%, hematuria (57% and recurrent urinary tract infection (57% were the main complaints. The median diagnosis time was 44.1 months. Abdominal ultrasonography and non contrast enhanced computer tomography were performed for five and two patients respectively and diagnosis was confirmed cystoscopically. Endoscopic lithotripsy using Holmium laser lithotripter or pneumatic lithotripter was used for all cases. The mean operation time was 41.2 minutes (20-70 and success was 100%. There was no intraoperative complication. Only one patient had fever higher than 38ºC postoperatively and was treated by appropriate antibiotic. The median hospitalisation time was 1.57 day. Conclusion: In conclusion endoscopic lithotripsy is a safe and effective approach to manage bladder stone associated with mid-urethral synthetic slings and intrauterine devices.

  1. Prevalence of gall bladder stones among type 2 diabetic patients in Benghazi Libya: a case-control study

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    Behieh A

    2009-01-01

    Full Text Available Background: Diabetes mellitus and gall bladder stones are both common and costly diseases.Increasing age, female gender, overweight, familial history of the disease and type 2 diabetes mellitusis all associated with an increased risk of gallstones. Several studies from around the world reportedan increased prevalence of gall bladder stones in patients with diabetes mellitus. Aims andobjectives: The aim of this study was to define the frequency of gall bladder stones among Libyandiabetics and to evaluate the possible associated risk factors in these patients. Patients andmethods: A case-control study was performed during 2007 at Benghazi Diabetes and endocrinologyCenter. The study involved 161 randomly selected type-2 diabetic patients under regular follow up atthe center, and 166 age and sex matched non-diabetic outpatients at the 7th of October teachinghospital. Real-time abdominal ultrasound was performed by two radiologists to examine the abdomenafter an overnight fast. Results: About 40% of the diabetic cohort had gall bladder stones ascompared to 17.5% of non-diabetic patients. Females were significantly more affected than males.Patients with gall bladder stones were significantly older and had a significantly higher body massindex than those without stones. Conclusion: The prevalence of gallstones in Libyan diabeticpatients is higher than the rates reported in other parts of the world. Libyan diabetic patients withgallstones tend to be older and more obese than those without gallstones. Duration of diabetesmellitus and type of treatment does not seem to influence the frequency of gall bladder stones amongLibyan diabetics.

  2. Analyses of the Food Habits of the Red Fox and the Stone Marten in ...

    African Journals Online (AJOL)

    The dietary habits of red fox (Vulpes vulpes) and stone marten (Martes foina) were studied in central Greece in period 2003 - 2005. The stomach contents of 219 red fox and 106 stone marten were characterised for their various prey items. The prey species were classified depending on their origin in six diet groups ...

  3. Bladder Stones

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    ... and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health ...

  4. The role of polymer nanosurface roughness and submicron pores in improving bladder urothelial cell density and inhibiting calcium oxalate stone formation

    Science.gov (United States)

    Chun, Young Wook; Khang, Dongwoo; Haberstroh, Karen M.; Webster, Thomas J.

    2009-02-01

    Synthetic polymers have been proposed for replacing resected cancerous bladder tissue. However, conventional (or nanosmooth) polymers used in such applications (such as poly(ether) urethane (PU) and poly-lactic-co-glycolic acid (PLGA)) often fail clinically due to poor bladder tissue regeneration, low cytocompatibility properties, and excessive calcium stone formation. For the successful reconstruction of bladder tissue, polymer surfaces should be modified to combat these common problems. Along these lines, implementing nanoscale surface features that mimic the natural roughness of bladder tissue on polymer surfaces can promote appropriate cell growth, accelerate bladder tissue regeneration and inhibit bladder calcium stone formation. To test this hypothesis, in this study, the cytocompatibility properties of both a non-biodegradable polymer (PU) and a biodegradable polymer (PLGA) were investigated after etching in chemicals (HNO3 and NaOH, respectively) to create nanoscale surface features. After chemical etching, PU possessed submicron sized pores and numerous nanometer surface features while PLGA possessed few pores and large amounts of nanometer surface roughness. Results from this study strongly supported the assertion that nanometer scale surface roughness produced on PU and PLGA promoted the density of urothelial cells (cells that line the interior of the bladder), with the greatest urothelial cell densities observed on nanorough PLGA. In addition, compared to respective conventional polymers, the results provided evidence that nanorough PU and PLGA inhibited calcium oxalate stone formation; submicron pored nanorough PU inhibited calcium oxalate stone formation the most. Thus, results from the present study suggest the importance of nanometer topographical cues for designing better materials for bladder tissue engineering applications.

  5. Assessing Genetic Structure in Common but Ecologically Distinct Carnivores: The Stone Marten and Red Fox.

    Science.gov (United States)

    Basto, Mafalda P; Santos-Reis, Margarida; Simões, Luciana; Grilo, Clara; Cardoso, Luís; Cortes, Helder; Bruford, Michael W; Fernandes, Carlos

    2016-01-01

    The identification of populations and spatial genetic patterns is important for ecological and conservation research, and spatially explicit individual-based methods have been recognised as powerful tools in this context. Mammalian carnivores are intrinsically vulnerable to habitat fragmentation but not much is known about the genetic consequences of fragmentation in common species. Stone martens (Martes foina) and red foxes (Vulpes vulpes) share a widespread Palearctic distribution and are considered habitat generalists, but in the Iberian Peninsula stone martens tend to occur in higher quality habitats. We compared their genetic structure in Portugal to see if they are consistent with their differences in ecological plasticity, and also to illustrate an approach to explicitly delineate the spatial boundaries of consistently identified genetic units. We analysed microsatellite data using spatial Bayesian clustering methods (implemented in the software BAPS, GENELAND and TESS), a progressive partitioning approach and a multivariate technique (Spatial Principal Components Analysis-sPCA). Three consensus Bayesian clusters were identified for the stone marten. No consensus was achieved for the red fox, but one cluster was the most probable clustering solution. Progressive partitioning and sPCA suggested additional clusters in the stone marten but they were not consistent among methods and were geographically incoherent. The contrasting results between the two species are consistent with the literature reporting stricter ecological requirements of the stone marten in the Iberian Peninsula. The observed genetic structure in the stone marten may have been influenced by landscape features, particularly rivers, and fragmentation. We suggest that an approach based on a consensus clustering solution of multiple different algorithms may provide an objective and effective means to delineate potential boundaries of inferred subpopulations. sPCA and progressive partitioning

  6. Assessing Genetic Structure in Common but Ecologically Distinct Carnivores: The Stone Marten and Red Fox.

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    Mafalda P Basto

    Full Text Available The identification of populations and spatial genetic patterns is important for ecological and conservation research, and spatially explicit individual-based methods have been recognised as powerful tools in this context. Mammalian carnivores are intrinsically vulnerable to habitat fragmentation but not much is known about the genetic consequences of fragmentation in common species. Stone martens (Martes foina and red foxes (Vulpes vulpes share a widespread Palearctic distribution and are considered habitat generalists, but in the Iberian Peninsula stone martens tend to occur in higher quality habitats. We compared their genetic structure in Portugal to see if they are consistent with their differences in ecological plasticity, and also to illustrate an approach to explicitly delineate the spatial boundaries of consistently identified genetic units. We analysed microsatellite data using spatial Bayesian clustering methods (implemented in the software BAPS, GENELAND and TESS, a progressive partitioning approach and a multivariate technique (Spatial Principal Components Analysis-sPCA. Three consensus Bayesian clusters were identified for the stone marten. No consensus was achieved for the red fox, but one cluster was the most probable clustering solution. Progressive partitioning and sPCA suggested additional clusters in the stone marten but they were not consistent among methods and were geographically incoherent. The contrasting results between the two species are consistent with the literature reporting stricter ecological requirements of the stone marten in the Iberian Peninsula. The observed genetic structure in the stone marten may have been influenced by landscape features, particularly rivers, and fragmentation. We suggest that an approach based on a consensus clustering solution of multiple different algorithms may provide an objective and effective means to delineate potential boundaries of inferred subpopulations. sPCA and progressive

  7. A fragment of Foley catheter balloon as a cause of Bladder stone in ...

    African Journals Online (AJOL)

    Urinary bladder calculi are rarely seen in women and any history of previous pelvic surgery must, therefore, raise suspicion of an iatrogenic etiology. According to the literature, fewer than 2% of all bladder calculi occur in female subjects and, thus, their presence should provoke careful assessment of the etiology. We report ...

  8. Extraction of a bladder stone in a child as described by the renaissance physician Cristóbal Méndez.

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    Sánchez-Martín, F M; Hostalot, A M; Santillana, J M; Angerri, O; Millán, F; Villavicencio, H

    2014-09-01

    in his Libro del exercicio y de sus provechos (Book of exercise and profits), the Spanish Renaissance physician Christopher Mendez (1500-1553) describes extracting a bulk stone from the bladder of a child younger than 5 years in the land of colonial Mexico. This is the first description of a surgical procedure in America. Biographical data were collected on Christopher Mendez. The electronic facsimile of the Book of exercise and profits was read. The historical aspects of perineal lithotomy and etiology of bladder stones were analyzed. In chapter seven of the third treatise (page 120), Mendez speaks about the removal of a bladder stone in a boy named «Villaseñor». It uses the word «open» to describe the procedure, corresponding to a lithotomy more than a necropsy. It attributes the etiology of excess movements after ingestion and suggests a possible hereditary etiology. Perineal lithotomy was a common practice in ancient times for children due to the high incidence of bladder stones. The technique was very invasive and was improved over the centuries. The surgery described by Mendez for the child called Villaseñor most likely corresponds to a perineal lithotomy. A congenital cause could play a role in its etiology. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  9. A giant urinary bladder stone in the mummy of Lebanese Maronite Patriarch Joseph Tyan (1760–1820) and its environmental and nutritional implications

    International Nuclear Information System (INIS)

    Capasso, L.; Licata, M.; Pinto, A.; Fernianos, F.; Azizi, T.; Manzoli, L.; Centrella, D.; D'anastasio, R.

    2017-01-01

    Introduction: Historical sources and anthropological investigations, with the indispensable support of radiology, bring to light pathological evidence of the past. Case presentation: The purpose of this article is to present the radiological investigation conducted on the mummy of the Maronite Joseph Tyan (1760–1820), a famous patriarch who guided the Lebanese Maronite community during a critical period of its history. The natural mummy of the Patriarch was temporarily removed from its burial site to certify the degree of preservation. Conventional radiography was necessary to determine the state of the internal organs and any physical abnormalities, and to clarify the degree of conservation of the mummy. Discussion: Radiological analysis uncovered an exceptional case of a large urinary bladder stone. This pathological evidence confirms historical documentary sources that in the last years of his life the Patriarch suffered from abdominal pain and urinary problems. We can suppose that the environment and diet of the Maronite community, limited by restricted agricultural resources, was the possible cause of the urinary bladder stone, as today the epidemiology of these diseases demonstrates links with mainly cereal diets in rural areas. - Highlights: • Paleoradiological analysis: a radiological approach to study mummies. • The anthropological and radiological analysis of the Mummy of Patriarch Joseph Tyan • Urinary bladder stone: radiological investigations. • Paleopathological literature of urinary bladder stone.

  10. Stone risk after bladder substitution with the ileal-urethral Kock reservoir

    DEFF Research Database (Denmark)

    Osther, P J; Poulsen, A L; Steven, K

    2000-01-01

    OBJECTIVE: The study was carried out to compare urinary biochemical and physicochemical environments in patients who had undergone bladder substitution with the ileal-urethral Kock reservoir, and who had no actual urinary infection, with those of healthy subjects. MATERIAL AND METHODS: The partic......OBJECTIVE: The study was carried out to compare urinary biochemical and physicochemical environments in patients who had undergone bladder substitution with the ileal-urethral Kock reservoir, and who had no actual urinary infection, with those of healthy subjects. MATERIAL AND METHODS......: The participants were 23 male patients who had undergone bladder substitution with the ileal-urethral Kock reservoir and 25 healthy men. All subjects had sterile urine at the time of urine collection. Concentrations of calcium, magnesium, phosphorus, creatinine, citrate, oxalate, and ammonia in 24-h urine samples...

  11. "Belgian black and red marbles" as potential candidates for Global Heritage Stone Resource

    Science.gov (United States)

    Tourneur, Francis; Pereira, Dolores

    2016-04-01

    The Paleozoic substrate of South Belgium is rich in compact limestones, able to take a good polished finishing and to be used as "marbles". Among them, the black and red varieties were and still are of special importance, intensively exploited and largely exported, almost worldwide. The pure black marbles were extracted mostly from Frasnian (Upper Devonian) and Viséan (Lower Carboniferous) strata, in many localities like Namur, Dinant, Theux and Basècles. Today only the Frasnian variety is still exploited in a spectacular underground quarry in Golzinne, close to the town of Gembloux. These black marbles, already known in Antiquity, were exported since the Middle Age, first in Western Europe, then, from the 19th c., at a larger scale, almost worldwide. Among their most frequent uses figured of course funeral objects, like the epitaph of the Pope Adrian the 1st, offered by Charlemagne and preserved in the St-Pieter basilica in Rom. Another famous reference is the tombs of the Dukes of Burgundy in Dijon, with white crystalline marble and alabaster. The red marbles are limestones from reefal origin, forming mudmounds more or less rich in fossils of Late Frasnian (Late Devonian) age. They show a strong variability in colors, from dark red to light pinkish grey, and in texture, with many sedimentary structures and/or tectonic veins. The outcrops are non-stratified, which allows extraction of large blocks, for example for high columns. Known in the Roman time, they were intensively exploited since at least the 16th c. During the 19th and beginning of 20th c., more than hundred quarries were active in South Belgium, from Rance at West to Chaudfontaine at East, around Philippeville and Rochefort. They were largely used both in civil and religious buildings, mostly for inside decoration, for examples as altars or fireplaces. Among the most symbolic places, the Belgian red marbles were massively employed in Versailles, like in the famous "Galerie des Glaces". But many

  12. Solitary black pigment stones

    International Nuclear Information System (INIS)

    Wolpers, C.; Wosiewitz, U.

    1986-01-01

    Solitary pigment stones of the gall-bladder are rare (1.7%). 82,5% are radiopaque, 17.5% radiolucent. 64,8% of radiopaque solitary pigment stones have the structure of a cockade. Such cockades take years to develop. Solitary cholesterol stones with a nucleus of a radiopaque pigment stone should not be treated for litholysis. 8% of solitary cholesterol stones with a cross diameter below 15 mm. possess a radiolucent pigment stone nucleus. X-ray diagnosis for selecting litholytic treatment remains the safest method, especially if the radiologist compares his films regularly with the specimens after surgery. (orig.) [de

  13. Bladder Cancer

    Science.gov (United States)

    ... Bladder cancer care at Mayo Clinic Symptoms Bladder cancer signs and symptoms may include: Blood in urine (hematuria) Painful urination Pelvic pain If you have hematuria, your urine may appear bright red or cola colored. Sometimes, urine may not look any different, ...

  14. Study of the composition and viscosity of engobe and glazed from dimension stones wastes for application in red tile

    International Nuclear Information System (INIS)

    Hastenreiter, L.L. G.; Santos, J.C.; Taguchi, S.P.

    2014-01-01

    The dimension stones wastes has some constituents that may be employed in the ceramic. This work is about the production of engobe and glaze for ceramic coating. Chemical characterization of the residue and Clay (XRF) was performed. Several compositions were tested in order to decrease the melting temperature of the glaze to 980°C, enabling to produce the ceramic at 1100°C for 15 to 60 minutes, it presenting more uniform and better technological properties of the surface. The viscosities of some compositions of glaze and engobe were studied, to be applied on the red tile (100x100mm) to obtain the ceramic coating. These were analyzed for resistance to abrasion, according to NBR 13 818/1997 and it was found that the ceramic was classified as PEI 1 and may be used, eg in residential bathrooms and dormitories with no doors to the outside. (author)

  15. Pearsonema plica (Capillaria plica) infection and associated urinary bladder pathology in red foxes (Vulpes vulpes) from Bosnia and Herzegovina.

    Science.gov (United States)

    Alić, Amer; Hodžić, Adnan; Kadrić, Mirsad; Beširović, Hajrudin; Prašović, Senad

    2015-05-01

    Pearsonema plica is a widely distributed nematode parasite that occurs in the urinary tract of various domestic and wild carnivores. The aim of this study was to investigate the occurrence and geographical distribution of P. plica and associated urinary bladder pathology in 112 red foxes (70 males, 42 females; 87 adults >1 year, 25 juveniles <1 year) from six different geographical regions in Bosnia and Herzegovina. The urinary bladders of the red foxes were subjected to gross examination and histopathology. Urine content (n = 40) and mucosal smears (n = 71) of the urinary bladders were examined microscopically for the presence of P. plica. Overall, adults and eggs of P. plica were detected in 65 (58.0 %; 95% CI 48.9-67.2%) of the foxes. Out of the positive foxes, 42 were males (64.6%) and 23 females (35.3%). According to age, 49 adults (75.3%) and 16 juveniles (24.6%) were positive. There were no statistically significant differences in the infection prevalence between the geographical regions (p = 0.701), sex (p = 0.693), or age (p = 0.646) of the host. Also, no significant differences in the prevalence of parasites in urine content (48.7%; 20/41) and mucosal smears (63.3%; 45/71) were observed (p = 0.165). Eosinophilic cystitis characterized with mild to severe infiltrates of eosinophils in the propria of the bladder mucosa accompanied by hyperemia and edema was observed in 36 examined foxes, 24 of which were P. plica positive. Parasites attached and embedded into the mucosa and free in the lumen were recorded in both cystitis positive and negative foxes. Beside clear numerical differences, the influence of P. plica infection on the occurrence of cystitis was not significant (p = 0.309). The results of this study give the first insight into the distribution of P. plica infection among the red fox population in Bosnia and Herzegovina. Observed microscopic changes may contribute toward a better understanding of pathology caused by this

  16. Concentrations of trace elements in tissues of red fox (Vulpes vulpes) and stone marten (Martes foina) from suburban and rural areas in Croatia.

    Science.gov (United States)

    Bilandžić, Nina; Dežđek, Danko; Sedak, Marija; Dokić, Maja; Solomun, Božica; Varenina, Ivana; Knežević, Zorka; Slavica, Alen

    2010-11-01

    Trace elements concentrations (As, Cd, Cu, Pb and Hg) were determined in the liver, kidney and muscle of 28 red fox (Vulpes vulpes) and 16 stone marten (Martes foina) from suburban and rural habitats from Croatia. Rural and suburban habitats affected Cd and Hg levels in the muscle, liver and kidney of red fox. Significant differences in metal concentrations in the muscle, liver and kidney were detected among species. Suburban stone marten accumulated the highest levels of trace elements (mg/kg w.w.): in muscle 0.019 for Hg; in liver 0.161 for Cd, 36.1 for Cu and 0.349 for Pb; in kidney 1.34 for Cd and 0.318 for Pb. Values observed were higher than those found in suburban red fox and therefore, may represent an important bioindicator for the accumulation of toxic metals in urbanized habitats.

  17. Giant bladder lithiasis: case report and bibliographic review.

    Science.gov (United States)

    Gallego Vilar, Daniel; Beltran Persiva, José; Pérez Mestre, Mateo; Povo Martin, Iván José; Miralles Aguado, Jaume; Garau Perelló, Carmen; De Francia, Jose Antonio

    2011-05-01

    Urinary lithiasis is a very frequent urological disease but bladder lithiasis is very uncommon.Patients usually refer voiding symptoms and hematuria. The diagnosis is made after imaging tests. We report a clinical case describing a giant bladder stone and perform a bibliographic review. A 43 year old man with the diagnosis of giant bladder stone (more than 10 cm diameter). We searched Medline using the terms: giant bladder stone, giant bladder lithiasis, bladder lithiasis, giant bladder lithiasis. We made the diagnosis of giant bladder stone after a simple kidney, ureter and bladder (KUB) X Ray. The treatment for this patient was a cystolithotomy. We found more than 230 reports at Medline and chose the most referred ones and the last 10 years reports. Giant bladder lithiasis is a very rare pathology. The gold standard for diagnosis is cystoscopy but sometimes with a KUB Xray or an ultrasound is enough. Because of its size, cistolitotomy is the correct treatment for giant bladder stone.

  18. Extraction of urinary bladder stone as described by Abul-Qasim Khalaf Ibn Abbas Alzahrawi (Albucasis) (325-404 H, 930-1013 AD). A translation of original text and a commentary.

    Science.gov (United States)

    Abdel-Halim, Rabie E; Altwaijiri, Ali S; Elfaqih, Salah R; Mitwalli, Ahmad H

    2003-12-01

    This is a detailed study of the technique of cystolithotomy as practiced by the Muslim surgeon Alzahrawi (Albucasis) in Cordova more than 1000 years ago. In addition to translating the relevant chapter in his book Al-Tasreef, his technique is critically evaluated comparing it with that of his predecessors and his successors. The study confirmed the originality of Alzahrawi who described operative steps and invented operative instruments not known in the Greco-Roman era. He was also the first to describe, in details, the operative technique in women and to recommend the 2-stage operation in complicated cases. His modifications and innovations greatly influenced surgery in Middle Ages Europe up to the 18th century which witnessed the beginnings of the modern method using the suprapubic, instead of the perineal, approach. Alzahrawi's influence is vividly seen in the practice of the Italian lithotomist "Marianus Sanctus" (16th century), the French "Jack De Beaulieu" (17th century) and the English "Shelsden" (18th century). Alzahrawi is the founder of lithotripsy. He introduced Al-Kalaleeb forceps to crush large bladder stones and Al-Mishaab to drill and fragment an impacted urethral stone. Andreas a Cruce (18th century) only added screw action to Al-Kalaleeb lithotrite but Amussat managed in 1822 to apply it transurethrally. Similarly, by the notion of transurethrally getting at the stone while within the bladder, Alzahrawi's idea of drilling by Al-Mishaab was the foundation of the litholepte of Fournier de Lempdes (1812), the instrument of Gruithusien (1813), Civiale's trilabe (1818) and the brise coque of Rigal De Galliac (1829).

  19. Giant urinary bladder calculus: Case report | Otieno | East African ...

    African Journals Online (AJOL)

    A vertical calculus weighing more than 100 g is categorised as a giant urinary bladder stone. Giant urinary bladder stones are very rare and very few cases have been reported in English literature and only one case from Africa. This is a case report of a patient with a giant urinary bladder calculus presenting as a rectal ...

  20. Patient with Benign Prostatic Hypertrophy and Two Giant Stones in ...

    African Journals Online (AJOL)

    Giant urinary bladder stones are very rare; very few cases have been reported in English literature and only one case from Africa. Multiple giant bladder stones are extremely rare; no single case report has been found documenting this occasion. This report presents a patient of benign prostatic hypertrophy with two giant ...

  1. Gall bladder dysmotility : a risk factor for gall stone formation in hypertriglyceridaemia and reversal on triglyceride lowering therapy by bezafibrate and fish oil

    NARCIS (Netherlands)

    Jonkers, IJAM; Smelt, A.H.; Ledeboer, M; Hollum, ME; Biemond, I.; Kuipers, F; Stellaard, F; Boverhof, R; Meinders, AE; Lamers, CHBW; Masclee, AAM

    Background and aim: The aim of this study was to unravel the mechanisms responsible for the increased risk of gall stone disease in hypertriglycericlaemia (HTG) and to compare the effects of triglyceride lowering therapy by bezafibrate and fish oil on determinants of cholelithiasis (biliary lipid

  2. Urinary stones following renal transplantation.

    Science.gov (United States)

    Kim, H; Cheigh, J S; Ham, H W

    2001-06-01

    The formation of urinary tract stones following renal transplantation is a rare complication. The clinical features of stones after transplantation differ from those of non-transplant patients. Renal colic or pain is usually absent and rarely resembles acute rejection. We retrospectively studied 849 consecutive kidney transplant patients in The Rogosin Institute/The Weill-Cornell Medical Center, New York who were transplanted between 1980 and 1997 and had functioning grafts for more than 3 months, to determine the incidence of stone formation, composition, risk factors and patient outcome. At our center, urinary stones were diagnosed in 15 patients (1.8%) of 849 functioning renal grafts for 3 or more months. Of the 15 patients, 10 were males and 5 were females in their third and fourth decade. Eight patients received their transplant from living donors and 7 from cadaveric donors. The stones were first diagnosed between 3 and 109 months after transplantation (mean 17.8 months) and 5 patients had recurrent episodes. The stones were located in the bladder in 11 cases (73.3%), transplanted kidney in 3 cases and in multiple sites in one case. The size of stones varied from 3.4 mm to 40 mm (mean 12 mm). The composition of stones was a mixed form of calcium oxalate and calcium phosphate in 5 cases and 4 patients had infected stones consisting of struvite or mixed form of struvite and calcium phosphate. Factors predisposing to stone formation included tertiary hyperparathyroidism (n = 8), hypercalciuria (n = 5), recurrent urinary tract infection (n = 5), hypocitraturia (n = 4), and obstructive uropathy (n = 2). Many cases had more than one risk factor. Clinically, painless hematuria was observed in 6 patients and dysuria without bacteriuria in 5 patients. None had renal colic or severe pain at any time. There were no changes in graft function at diagnosis and after removal of stones. Five patients passed stones spontaneously and 8 patients underwent cystoscopy for stone

  3. Pathological findings in the red fox (Vulpes vulpes), stone marten (Martes foina) and raccoon dog (Nyctereutes procyonoides), with special emphasis on infectious and zoonotic agents in Northern Germany.

    Science.gov (United States)

    Lempp, Charlotte; Jungwirth, Nicole; Grilo, Miguel L; Reckendorf, Anja; Ulrich, Arlena; van Neer, Abbo; Bodewes, Rogier; Pfankuche, Vanessa M; Bauer, Christian; Osterhaus, Albert D M E; Baumgärtner, Wolfgang; Siebert, Ursula

    2017-01-01

    Anthropogenic landscape changes contributed to the reduction of availability of habitats to wild animals. Hence, the presence of wild terrestrial carnivores in urban and peri-urban sites has increased considerably over the years implying an increased risk of interspecies spillover of infectious diseases and the transmission of zoonoses. The present study provides a detailed characterisation of the health status of the red fox (Vulpes vulpes), stone marten (Martes foina) and raccoon dog (Nyctereutes procyonoides) in their natural rural and peri-urban habitats in Schleswig-Holstein, Germany between November 2013 and January 2016 with focus on zoonoses and infectious diseases that are potentially threatening to other wildlife or domestic animal species. 79 red foxes, 17 stone martens and 10 raccoon dogs were collected from traps or hunts. In order to detect morphological changes and potential infectious diseases, necropsy and pathohistological work-up was performed. Additionally, in selected animals immunohistochemistry (influenza A virus, parvovirus, feline leukemia virus, Borna disease virus, tick-borne encephalitis, canine adenovirus, Neospora caninum, Toxoplasma gondii and Listeria monocytogenes), next-generation sequencing, polymerase chain reaction (fox circovirus) and serum-neutralisation analysis (canine distemper virus) were performed. Furthermore, all animals were screened for fox rabies virus (immunofluorescence), canine distemper virus (immunohistochemistry) and Aujeszky's disease (virus cultivation). The most important findings included encephalitis (n = 16) and pneumonia (n = 20). None of the investigations revealed a specific cause for the observed morphological alterations except for one animal with an elevated serum titer of 1:160 for canine distemper. Animals displayed macroscopically and/or histopathologically detectable infections with parasites, including Taenia sp., Toxocara sp. and Alaria alata. In summary, wildlife predators carry zoonotic

  4. Pathological findings in the red fox (Vulpes vulpes), stone marten (Martes foina) and raccoon dog (Nyctereutes procyonoides), with special emphasis on infectious and zoonotic agents in Northern Germany

    Science.gov (United States)

    Grilo, Miguel L.; Reckendorf, Anja; Ulrich, Arlena; van Neer, Abbo; Bodewes, Rogier; Pfankuche, Vanessa M.; Bauer, Christian; Osterhaus, Albert D. M. E.; Baumgärtner, Wolfgang; Siebert, Ursula

    2017-01-01

    Anthropogenic landscape changes contributed to the reduction of availability of habitats to wild animals. Hence, the presence of wild terrestrial carnivores in urban and peri-urban sites has increased considerably over the years implying an increased risk of interspecies spillover of infectious diseases and the transmission of zoonoses. The present study provides a detailed characterisation of the health status of the red fox (Vulpes vulpes), stone marten (Martes foina) and raccoon dog (Nyctereutes procyonoides) in their natural rural and peri-urban habitats in Schleswig-Holstein, Germany between November 2013 and January 2016 with focus on zoonoses and infectious diseases that are potentially threatening to other wildlife or domestic animal species. 79 red foxes, 17 stone martens and 10 raccoon dogs were collected from traps or hunts. In order to detect morphological changes and potential infectious diseases, necropsy and pathohistological work-up was performed. Additionally, in selected animals immunohistochemistry (influenza A virus, parvovirus, feline leukemia virus, Borna disease virus, tick-borne encephalitis, canine adenovirus, Neospora caninum, Toxoplasma gondii and Listeria monocytogenes), next-generation sequencing, polymerase chain reaction (fox circovirus) and serum-neutralisation analysis (canine distemper virus) were performed. Furthermore, all animals were screened for fox rabies virus (immunofluorescence), canine distemper virus (immunohistochemistry) and Aujeszky’s disease (virus cultivation). The most important findings included encephalitis (n = 16) and pneumonia (n = 20). None of the investigations revealed a specific cause for the observed morphological alterations except for one animal with an elevated serum titer of 1:160 for canine distemper. Animals displayed macroscopically and/or histopathologically detectable infections with parasites, including Taenia sp., Toxocara sp. and Alaria alata. In summary, wildlife predators carry zoonotic

  5. Dimension stone

    Science.gov (United States)

    Dolley, T.P.

    2003-01-01

    Dimension stone can be defined as natural rock material quarried to obtain blocks or slabs that meet specifications as to size (width, length and thickness) and shape for architectural or engineering purposes. Color, grain texture and pattern, and surface finish of the stone are also normal requirements. Other important selection criteria are durability (based on mineral composition, hardness and past performance), strength and the ability of the stone to take a polish.

  6. Bladder Management

    Science.gov (United States)

    ... Catheterization • Urinary Tract Infections: Indwelling (Foley) Catheter Bladder Management [ Download this pamphlet: "Bladder Management" - (PDF, 499KB) ] The ... and medication or surgery may be helpful. Bladder Management Foley or Suprapubic Catheter A tube is inserted ...

  7. Neurogenic bladder

    Science.gov (United States)

    ... your bladder at all Have signs of a bladder infection (fever, burning when you urinate, frequent urination) Urinate small amounts, frequently Alternative Names Neurogenic detrusor overactivity; NDO; Neurogenic bladder sphincter dysfunction; NBSD ...

  8. Bladder Cancer

    Science.gov (United States)

    ... organ in your lower abdomen that stores urine. Bladder cancer occurs in the lining of the bladder. It ... urinate Low back pain Risk factors for developing bladder cancer include smoking and exposure to certain chemicals in ...

  9. Bladder Diseases

    Science.gov (United States)

    ... frequent, urgent urination Bladder cancer Doctors diagnose bladder diseases using different tests. These include urine tests, x- ... National Institute of Diabetes and Digestive and Kidney Diseases

  10. Biliary stones: Comparative study with sonography and ERCP

    International Nuclear Information System (INIS)

    Kang, In Young; Kim, Jong Chae; Park, Jung Suk; Kim, Se Jong; Park, Byung Lan; Kim, Byong Geun

    1990-01-01

    We analyzed findings of sonography and ERCP retrospectively to compare the diagnostic accuracy of sonography with ERCP in patients suspected with biliary stones. 88 patients underwent surgery who had studied with sonography and ERCP were evaluated in order of intrahepatic duct, extrahepatic duct and gall bladder. Of these patients, 80 cases were proved biliary stones. Sonography correctly diagnosed 19 of 19 patients with intrahepatic duct stones, 32 of 40 patients with extrahepatic duct stones and 35 of 41 patients with gall stones with sensitivities of 100%, 80% and 85% respectively. ERCP correctly identified 14 of 18 patients with intrahepatic duct stones, 26 of 37 patients with extrahepatic duct stones and 15 of 33 patients with gall stones with sensitivities of 78%, 70% and 45% respectively. Our results shows sonography is more sensitive to detect stones of biliary system than ERCP

  11. "Hair in the Bladder": An Unusual Finding.

    Science.gov (United States)

    Cindolo, Luca; Bada, Maida; Bellocci, Roberto; De Francesco, Piergustavo; Castellan, Pietro; Berardinelli, Francesco; Neri, Fabio; Schips, Luigi

    2017-01-01

    Trichobezoar is a rare condition whereby a hairball is found in the human stomach or gastrointestinal tract, most frequently in young women, mainly in association with a psychiatric disorder. Trichobezoar cases have also been reported in the bladder and represent a rare complication of foreign bodies, called "hair nidus or hair ball," in patients with chronic catheter. Approximately 10% to 15% of patients on long-term urethral catheter or clean intermittent self-catheterization develop urinary tract stones. In a small minority of cases, bladder stones can develop around a foreign body that was introduced into the bladder. In the literature, there are few cases of foreign bladder bodies that formed stones over a hair nidus. Recognizing this condition can optimize the patient's quality of life. Herein, we present a case of a 71-year-old Caucasian male with a long-term catheter in hypocontractile urinary bladder secondary to injury of pelvic plexus after rectal surgery. He had a bladder stone caused by hair encrusted together. Hair is introduced into the bladder either by adherence to the catheter directly or by overlying the urethral meatus and being pushed internally. Regular hygiene and shaving of pubic area represent effective preventive measures to reduce this kind of complications in patients with chronic indwelling catheter or under a self-catheterization regimen.

  12. Greco-Roman Stone Disease

    Science.gov (United States)

    Moran, Michael E.; Ruzhansky, Katherine

    2008-09-01

    Greek and Roman thought had a profound influence upon Western medical practice. From the fall of the Greek civilization to the fall of the Roman, remarkable progress of our understanding of human anatomy and physiology occurred. Here we review the attempts of Greek and Roman thinkers to develop the first understanding of the pathophysiology of urolithiasis, its epidemiology, differential diagnosis of renal versus bladder stones, medications for both colic and prevention, the role of familial syndromes, and dietary management.

  13. Seasonal changes of trophic niche overlap in the stone marten (Martes foina and the red fox (Vulpes vulpes in a mountainous area of the Northern Apennines (N-Italy

    Directory of Open Access Journals (Sweden)

    Anna Brangi

    1995-12-01

    Full Text Available Abstract Between 1989 and 1991, 284 scats of stone marten (Martes foina and 642 scats of red fox (Vulpes vulpes were collected in a 280 km² mountainous area in the northern Apennines. The scats were analyzed to identify differences between the two species' diets. The prey were grouped in 6 food categories: Fruits, Other Vegetables, Small Mammals, Other Vertebrates, Invertebrates and Garbage. Annual trophic niche was wider in the Red fox (0.62 than in the stone marten (0.53. We also found a large overlap between the two species with some small differences: Other Vertebrates, Small Mammals and Other Vegetables were more used by the Red fox, while Fruits were more used by the stone marten. Riassunto Variazioni stagionali della sovrapposizione di nicchia trofica della faina (Martes foina e della volpe (Vulpes vulpes in un'area montana degli Appennini settentrionali - Tra il 1989 e il 1991 sono state raccolte 284 feci di faina (Martes foina e 642 feci di volpe (Vulpes vulpes in un'area montuosa di 280 km² situata nell'Appennino settentrionale. Le feci sono state analizzate per evidenziare le eventuali differenze nella dieta delle due specie. Le singole prede sono state raggruppate in 6 categorie alimentari: Frutta, Altri Vegetali, Micromammiferi, Altri Vertebrati, Invertebrati, Rifiuti. L'ampiezza annuale della dieta è risultata maggiore nella Volpe (0,62 che non nella Faina (0,53. È stata trovata inoltre una larga sovrapposizione tra le due specie con alcune differenze nell'uso degli Altri Vertebrati, dei Micromammiferi e degli Altri Vegetali che è maggiore nella Volpe e della Frutta, maggiore nella Faina.

  14. Multiple colonizations, in situ speciation, and volcanism-associated stepping-stone dispersals shaped the phylogeography of the Macaronesian red fescues (Festuca L., Gramineae).

    Science.gov (United States)

    Díaz-Pérez, Antonio; Sequeira, Miguel; Santos-Guerra, Arnoldo; Catalán, Pilar

    2008-10-01

    Whereas examples of insular speciation within the endemic-rich Macaronesian hotspot flora have been documented, the phylogeography of recently evolved plants in the region has received little attention. The Macaronesian red fescues constitute a narrow and recent radiation of four closely related diploid species distributed in the Canary Islands (F. agustinii), Madeira (F. jubata), and the Azores (F. francoi and F. petraea), with a single extant relative distributed in mainland southwest Europe (F. rivularis). Bayesian structure and priority consensus tree approaches and population spatial correlations between genetic, geographical, and dispersal distances were used to elucidate the phylogeographical patterns of these grasses. Independent versus related origins and dispersal versus isolation by distance (IBD) hypotheses were tested to explain the genetic differentiation of species and populations, respectively. Genetic structure was found to be geographically distributed among the archipelagos and the islands endemics. The high number of shared AFLP fragments in all four species suggests a recent single origin from a continental Pliocene ancestor. However, the strong allelic structure detected among the Canarian, Madeiran, and Azorean endemics and the significant standardized residual values obtained from structured Bayesian analysis for pairwise related origin hypotheses strongly supported the existence of three independent continental-oceanic colonization events. The Canarian F. agustinii, the Madeiran F. jubata, and the two sister F. francoi and F. petraea Azorean species likely evolved from different continental founders in their respective archipelagos. Despite the short span of time elapsed since colonization, the two sympatric Azorean species probably diverged in situ, following ecological adaptation, from a common ancestor that arrived from the near mainland. Simple dispersal hypotheses explained most of the genetic variation at the species level better than

  15. Protecting Space Travelers from Kidney Stones: Renal Stone Risk During Space Flight

    Science.gov (United States)

    Whitson, Peggy; Bloomberg, Jacob; Lee, Angie (Technical Monitor)

    2002-01-01

    Renal stones, popularly known as kidney or bladder stones, are small rock-like objects formed in the kidneys or urinary tract by deposits of calcium and other minerals. The problem arises when the stones block the drainage of the kidney, resulting in urinary obstruction and pain. Passing these stones can be one of the most painful experiences a person will endure so doctors often prescribe pain relievers to ease the experience. Drinking plenty of fluids, which help flush waste out of the body, and eating a well-balanced diet are the first steps to preventing stones. For individuals at risk, this may not be enough, and a doctor may recommend a special diet and medications. Unfortunately, approximately 60 percent of people who have had a renal stone will experience a recurrence. This is particularly true of men, who are four to five times more likely to develop stones than women. Renal stones do not discriminate based on age; even children are at risk. Astronauts are particularly at risk of developing renal stones because they lose bone and muscle mass; calcium, other minerals, and protein normally used for bone and muscle end up in the bloodstream and then in the kidneys. Without plenty of fluid to wash them away, crystals can form and then grow into stones. This factor compounds the risk for astronauts, since they also perceive that they are less thirsty in space and will drink less than normal during the mission. To minimize all of these factors, doctors must instead treat the stone-forming compounds with medication. This study will use potassium citrate to reduce the risk of stone formation. Renal stones are never convenient, but they are a particular concern for astronauts who have limited access to treatment during flight. Researchers are examining how earthbound preventions for renal stone formation work in flight, ensuring missions are not ended prematurely due to this medical condition. During STS-107, earthbound preventions and treatments become astronauts

  16. UTIs in patients with neurogenic bladder.

    Science.gov (United States)

    Jahromi, Mona S; Mure, Amanda; Gomez, Christopher S

    2014-09-01

    Urinary tract infections (UTI) remain one of the most prevalent and frustrating morbidities for neurogenic bladder patients, and death attributed to urosepsis in the spinal cord injury (SCI) patient is higher when compared to the general population. Risk factors include urinary stasis, high bladder pressures, bladder stones, and catheter use. While classic symptoms of UTI include dysuria, increased frequency and urgency, neurogenic bladder patients present differently with increased spasticity, autonomic dysreflexia, urinary incontinence, and vague pains. Multiple modalities have been assessed for prevention including catheter type, oral supplements, bladder irrigation, detrusor injections and prophylactic antimicrobials. Of these, bladder inoculation with E. coli HU2117, irrigation with iAluRil(®), detrusor injections, and weekly prophylaxis with alternating antibiotics appear to have a positive reduction in UTI but require further study. Ultimately, treatment for symptomatic UTI should account for the varied flora and possible antibiotic resistances including relying on urine cultures to guide antibiotic therapy.

  17. A bladder diverticulum model in rabbits.

    Science.gov (United States)

    Çelebi, Süleyman; Kuzdan, Özgür; Özaydın, Seyithan; Başdaş, Cemile Beşik; Özaydın, İpek; Erdoğan, Cankat; Sander, Serdar

    2016-10-01

    Shuttling of some of the bladder volume into the bladder diverticulum (BD) can cause urinary retention, lower urinary tract dysfunction, infection, and stone formation. This experimental study is the first to create a rabbit BD to study micturition physiology (urodynamics and pathology) that mimics clinical findings. The study included 16 New Zealand adult male rabbits in the BD group and 16 sham-operated controls. BD creation consisted of a lower midline laparotomy and bladder entry via the spacing between the detrusor muscle fibers and the mucosa, posterolaterally from the bladder wall. The detrusor was excised to provide a mucosal prolapsus, creating a narrow BD neck (Figure). The sham group underwent bladder exposure with a midline incision. All rabbits underwent urodynamic study preoperatively and postoperatively, consisting of postmicturition residue (PMR), maximum bladder capacity (MBC), voiding detrusor pressure (VPdet), filling detrusor pressure (FPdet), compliance, and urine flow (Qflow). The animals were then sacrificed and their bladders assessed for pathology and stone formation. Preoperative MBC, Pdet, and Qmax were within reference ranges. No animals had PMR or urinary tract infections (UTIs). The BD group showed urodynamic and pathologic bladder changes, including decreased (28%) cystometric bladder capacity and compliance (Sham: 26.8 ± 0.4; BD: 4.46 ± 1.08, p = 0.0001) and increased post-void residual PMR (8.3 ± 2.4 mL). Pathology revealed increased bladder detrusor thickness correlated with urodynamic findings of increased filling detrusor pressures (Sham: 1.58 ± 0.2; BD: 4.89 ± 0.93, p = 0.0001). Urodynamics revealed intermittent BD bladder contraction during the filling phases. Eight BD group rabbits had UTIs; five had stone formation (4-9 mm). In the literature, it has not been determined whether lower urinary tract disorders (LUTD) could cause diverticula, or if a congenital diverticula could be reason for LUTD. Anatomical

  18. Is stone radiodensity a useful parameter for predicting outcome of extracorporeal shockwave lithotripsy for stones < 2 cm?

    Directory of Open Access Journals (Sweden)

    Mina S. Krishnamurthy

    2005-02-01

    Full Text Available PURPOSE: Several factors determine the success of extracorporeal shockwave lithotripsy (SWL for kidney stones: stone size, stone location within the collecting system, stone type, and the SWL machine used. It has been suggested that stone radiodensity, as determined either by plain radiography or computed tomography attenuation values, may be an independent predictor of SWL success. We examined the outcome of SWL for solitary stones less than or equal to 2 cm located within the renal pelvis, based on their radiodensity. MATERIALS AND METHODS: 211 patients with solitary renal pelvic stones measuring less than or equal to 2 cm were treated on a Dornier Doli 50 lithotriptor under general anesthesia. The radiodensity of the stone was determined to be either less than, equal to, or greater than the radiodensity of the ipsilateral 12th rib. Stone-free rates (SFR were determined at 3 months by kidney, ureters and bladder (KUB plain X-rays. Patients requiring re-treatment or auxiliary procedures were considered failures of SWL. RESULTS: Follow-up SFR information was available in all 211 patients. Stone composition was available in 158 (75% treated patients, but no correlation was found between stone radiodensity and stone composition. For stones 12th rib compared to a SFR of 71% if the stone radiodensity was < 12th rib. However, these differences in SFRs were not statistically significant. CONCLUSIONS: On the Doli machine, stone radiodensity alone does not predict lithotripsy treatment outcome for stones < 1 cm within the renal pelvis. This parameter is probably only useful as the stone size becomes larger than 1 cm, and should be used in conjunction with other stone parameters to select appropriate therapy.

  19. Ultrasonic evaluation of biliary stones: retrospective comparison with ERCP

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Kook; Lim, Jin Woo; Jeon, Hae Jeong; Cha, In Ho; Suh, Won Hyuck [College of Medicine, Korean University, Seoul (Korea, Republic of); Chung, Woun Kyun [Inha General Hospital, Incheon (Korea, Republic of)

    1987-06-15

    Ultrasound is the modality of choice for the diagnosis of cholelithiasis and for the evaluation of the intra-and extra hepatic biliary tree in the patient with jaundice, but its role in the diagnosis of choledocholithiasis is less certain. We retrospectively examined 127 patients who had undergone ERCP by performing right upper quadrant sonography immediately prior to ERCP and undergone surgery due to biliary stone. We assessed the size of the intra-and extrahepatic ducts and presence or absence of calculi, and compared the detection rate of ultrasound with that of ERCP in the patient with biliary stone in order of gall bladder, extrahepatic duct, and intrahepatic duct. The results are as follows : 1. Of all 127 patients with biliary stone, female were 75 (59%). 6th decades were most common. 2. Each numbers of patients in the order of biliary location are 43 in gall bladder, 17 in intrahepatic ducts, 23 in extrahepatic ducts, 44 in multiple locations. 3. Gall bladder stones were 81 in total and ultrasound detected stones in 75 patients (Sensitivity;93%). ERCP-in 35 patients (Sensitivity;43%). 4. Extrahepatic duct stones were 54 in total and ultrasound detected stones in 31 patients (Sensitivity;57%). ERCP-in 49 patients (Sensitivity;91%). 5. Intrahepatic duct stones were 45 in total and ultrasound detected stones in 38 patients (Sensitivity;84%). ERCP-in 41 patients (Sensitivity;91%). In summary, Ultrasound is much more sensitive to detect GB stones than ERCP (93%;43%). ERCP is much more sensitive to detect extrahepatic duct stones than ultrasound (91%;57%). Sensitivity of ultrasound and ERCP were almost equal in the intrahepatic duct stones (84%;91%)

  20. Ultrasonic evaluation of biliary stones: retrospective comparison with ERCP

    International Nuclear Information System (INIS)

    Park, Jeong Kook; Lim, Jin Woo; Jeon, Hae Jeong; Cha, In Ho; Suh, Won Hyuck; Chung, Woun Kyun

    1987-01-01

    Ultrasound is the modality of choice for the diagnosis of cholelithiasis and for the evaluation of the intra-and extra hepatic biliary tree in the patient with jaundice, but its role in the diagnosis of choledocholithiasis is less certain. We retrospectively examined 127 patients who had undergone ERCP by performing right upper quadrant sonography immediately prior to ERCP and undergone surgery due to biliary stone. We assessed the size of the intra-and extrahepatic ducts and presence or absence of calculi, and compared the detection rate of ultrasound with that of ERCP in the patient with biliary stone in order of gall bladder, extrahepatic duct, and intrahepatic duct. The results are as follows : 1. Of all 127 patients with biliary stone, female were 75 (59%). 6th decades were most common. 2. Each numbers of patients in the order of biliary location are 43 in gall bladder, 17 in intrahepatic ducts, 23 in extrahepatic ducts, 44 in multiple locations. 3. Gall bladder stones were 81 in total and ultrasound detected stones in 75 patients (Sensitivity;93%). ERCP-in 35 patients (Sensitivity;43%). 4. Extrahepatic duct stones were 54 in total and ultrasound detected stones in 31 patients (Sensitivity;57%). ERCP-in 49 patients (Sensitivity;91%). 5. Intrahepatic duct stones were 45 in total and ultrasound detected stones in 38 patients (Sensitivity;84%). ERCP-in 41 patients (Sensitivity;91%). In summary, Ultrasound is much more sensitive to detect GB stones than ERCP (93%;43%). ERCP is much more sensitive to detect extrahepatic duct stones than ultrasound (91%;57%). Sensitivity of ultrasound and ERCP were almost equal in the intrahepatic duct stones (84%;91%)

  1. Neurogenic bladder in spinal cord injury patients

    OpenAIRE

    Taweel, Waleed Al; Seyam, Raouf

    2015-01-01

    Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete...

  2. non absorbable sutures in the urinary bladder resulting

    African Journals Online (AJOL)

    The vesical calculus. Urol Clin North AM. 2000, 27:333-346. 3. Evans JW, Chapple CR, Ralph DJ, Millory EJ: Bladder calculus formation as a complication of the Stamey procedure. Br J Urol 1990,. 65:580-582. 4. Sheng-Tsun Su, He-Fu Haung, Shu-Fen. Chang. Encrusted Bladder stone on Non- absorbable sutures after a ...

  3. Acute management of stones

    DEFF Research Database (Denmark)

    Jung, Helene; Osther, Palle J S

    2015-01-01

    INTRODUCTION: Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention. MATERIAL AND METHODS......: In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood. RESULTS: Acute stone management should be planned...

  4. Neurogenic Bladder

    Directory of Open Access Journals (Sweden)

    Peter T. Dorsher

    2012-01-01

    Full Text Available Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

  5. [The treatment of bladder lithiasis with laser].

    Science.gov (United States)

    Arrabal Martín, Miguel; Nogueras Ocaña, Mercedes; Arrabal Polo, Miguel Angel; Miján Ortiz, José Luís; Valle Díaz de la Guardia, Francisco; Zuluaga Gómez, Armando

    2008-11-01

    The use of laser for endoscopic lithotripsy started in 1968 when Mulvaney tried a ruby laser without success; Later on, the CO2 laser and the Nd:YAG were tried. With the pulsed dye and alexandrite lasers energetic performances between 30 and 200 mJ are obtained, their capacity of fragmentation is not universal and is limited to small stones, generally ureteral stones, so that it has not been a therapeutic alternative for bladder lithiasis. The holmium laser generates energy pulses of 400-2500 mJ, it is able to fragment every type of stone. The objective of this work is to analyze the results of endoscopic bladder lithotripsy with holmium-YAG laser. In the period between 2006-2008 we treated 21 cases of bladder lithiasis, with a stone size between 1 and 4 cm in patients from 8-76 years, six women and 15 men, which correspond to: four cases of infantile lithiasis, 3 of uric acid, one case of cystine, seven cases of calcium oxalate and/or phosphate, five cases of bladder lithiasis growing around a double J catheter, and one case of lithiasis within on intravesical ureterocele. Treatment was performed with a 20W Dornier Medilas holmium-YAG equipment, applied using children/adult cystoscopes or 7-8.5 Ch ureteroscopes, both semirigid and flexible. Post operative control included KUB x-ray and ultrasound. We performed a study of lithogenic risk factors and stone fragments analysis. The 21 cases described are all secondary or type II bladder lithiasis. In all cases the absence of residual lithiasis was checked with imaging studies and the lithogenic risk factors were corrected with medical or surgical procedures. We consider that today bladder endoscopic lithotripsy with holmium laser is a therapeutic alternative. Despite there are multiple options for endoscopic treatment, transurethral lithotripsy with holmium laser offers good results with a low complication rate.

  6. PIXE analysis of chinese chicken-blood stone

    International Nuclear Information System (INIS)

    Lin, E.K.; Wang, C.W.; Yu, Y.C.; Liu, T.Y.; Cheng, H.S.; Zhu, H.X.; Yang, H.J.

    1999-01-01

    This paper reports the chemical compositions of chicken-blood stone Ji Xue Shi measured by Proton Induced X-ray Emission (PIXE). The experimental result show that for the red portion of chicken-blood stone, the concentration of Hg is as high as 20 wt%, and the concentration of S can be above 10 wt%. For the non-red portion the main chemical compositions are Al 2 O 3 and SiO 2 . The obtained chemical compositions are close to those of kaolinite for Balin chicken-blood stone, and of pyrophyllite for Changhua chicken-blood stone, respectively. So far many Changhua chicken-blood stones and Balin chicken-blood stones were found in China, the PIXE method can be used to explore the provenance of available chicken-blood stones. (author)

  7. Urinary Stone Analysis of 1,000 Patients in Southern Taiwan

    Directory of Open Access Journals (Sweden)

    Yii-Her Chou

    2007-02-01

    Full Text Available Urolithiasis is a common urologic disease. Stones may occur in the kidney, ureter, or urinary bladder. We collected 1,000 stone samples in the subtropical area of southern Taiwan. Stone components were analyzed by Fourier transform infrared spectroscopy. Mixed components of calcium oxalate and calcium phosphate were the most common form of stones (52.3%, followed by calcium oxalate (27.8% and calcium phosphate (9.3%. Uric acid stones accounted for 7.6%. Magnesium ammonium phosphate stones accounted for 3.0%. Only one cystine stone was found. In the study of urinary stone formation mechanism and prevention of recurrent urolithiasis, knowing the stone composition is important.

  8. Exogenous glycosaminoglycans coat damaged bladder surfaces in experimentally damaged mouse bladder

    Directory of Open Access Journals (Sweden)

    Hurst Robert E

    2005-03-01

    Full Text Available Abstract Background Interstital cystitis is often treated with exogenous glycosaminoglycans such as heparin, chondroitin sulphate (Uracyst, hyaluronate (Cystistat or the semi-synthetic pentosan polysulphate (Elmiron. The mechanism of action is presumed to be due to a coating of the bladder surface to replace the normally present chondroitin sulphate and heparan sulphate lost as a result of the disease. This study used fluorescent labelled chondroitin sulphate to track the distribution of glycosaminoglycans administered intravesically to mouse bladder that had been damaged on the surface. Methods The surfaces of mouse bladders were damaged by 3 mechanisms – trypsin, 10 mM HCl, and protamine sulphate. Texas Red-labeled chondroitin sulphate was instilled into the bladders of animals with damaged bladders and controls instilled only with saline. Bladders were harvested, frozen, and sectioned for examination by fluorescence. Results The normal mouse bladder bound a very thin layer of the labelled chondroitin sulphate on the luminal surface. Trypsin- and HCl-damaged bladders bound the labelled chondroitin sulphate extensively on the surface with little penetration into the bladder muscle. Protamine produced less overt damage, and much less labelling was seen, presumably due to loss of the label as it complexed with the protamine intercalated into the bladder surface. Conclusion Glycosaminoglycan administered intravesically does bind to damaged bladder. Given that the changes seen following bladder damage resemble those seen naturally in interstitial cystitis, the mechanisms proposed for the action of these agents is consistent with a coating of damaged bladder.

  9. Building-stone used in architectural heritage: red sandstone of Astorga cathedral (Leon); Materiales utilizados en el patrimonio arquitectonico: la arenisca roja de la catedral de Astorga (Leon)

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Martinez, R.; Alavarez Areces, E.; Menduina, J.; Martin Rubi, J. A.

    2009-07-01

    The unequivocal origin of the red sandstone used for Astorga cathedral was studied in this paper. This red sandstone presents distinctive hydrothermal minerals filling fractures, the most conspicuous are anatase crystals with characteristic habit, colour and transparency, quite rare in the region. The identification of fractures filled with this TiO{sub 2} polymorph in an abandoned sandstone quarry south of Astorga allowed us to confirm the origin of the rock used for one of the towers of Astorga cathedral. (Author) 10 refs.

  10. Stone fragmentation by ultrasound

    Indian Academy of Sciences (India)

    Unknown

    ported as 0⋅3 to 10 µs (Coleman and Saunders 1989)**. For a typical 1 cm diameter of the kidney stone, a wide range of focal beam areas permit focusing on a small part of the stone or completely enclosing the stone within the focal area. The radiation pressure exerted on the stone placed in the path of the sound wave is.

  11. Analysis of urinary stone composition in Eastern India by X-ray diffraction crystallography

    Directory of Open Access Journals (Sweden)

    Tarun Jindal

    2014-01-01

    Full Text Available Background: Stones in the urinary system are common in our country. This study was done to assess the composition of the urinary stones in eastern part of India. Materials and Methods: A prospective study was done over a period of thirty months. A total of 90 stones were analyzed in this time period by using X-ray diffraction crystallography. Results: Of the 90 stones analyzed, 77 were renal stones, 12 were ureteric stones and one was a bladder stone. Six stones (all renal did not have properties to be represented by X-ray diffraction crystallography. The overall prevalence of the oxalate containing stones was 85.7% with calcium oxalate monohydrate (COM being the major constituent. Calcium oxalate dihydrate (COD was the next most common constituent. Struvite stones constituted 9.5% of the stones analyzed. Pure calcium phosphate stones were found in 4.7% of the cases. Conclusion: Our study reveals that the stone composition in the eastern part of India is different from that in other parts of the country. We have a comparatively lower prevalence of oxalate stones while a higher prevalence of phosphate and struvite stones.

  12. Neurogenic bladder in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Al Taweel W

    2015-06-01

    Full Text Available Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

  13. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun [AMC, Seoul (Korea, Republic of); Kim, Seung Kook [Kwang-Ju Health College, Kwang-Ju (Korea, Republic of)

    2001-06-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously.

  14. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    International Nuclear Information System (INIS)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun; Kim, Seung Kook

    2001-01-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously

  15. Paediatric bladder augmentation and substitution: From diversions to tissue engineering.

    Science.gov (United States)

    Pike, John Grant

    2002-10-01

    To review the evolution of urinary diversion, bladder augmentation and bladder replacement in the paediatric population over the past century and to outline the possible direction of future management. Original and review articles obtained from a PubMed search of English language publications dating from 1970 to 2001. The search terms were "bladder augmentation", "bladder substitution", "bladder autoaugmentation", "ureterocystoplasty" and "bladder engineering". The age group was "all child 0-18". Articles selected were those with relevance to the scope of the topic. The articles were analyzed with the primary focus being the problems encountered with various forms of urinary diversion, bladder augmentation and bladder replacement, and the subsequent evolution of materials and techniques. Bladder tissue may need to be replaced in the paediatric population because of congenital malformation, disease or trauma. The unique structure and function of urothelium and bladder muscle make this a challenging task. Management has evolved from a mindset of attempting to divert urine from the bladder completely to that of trying to preserve what is salvageable of the organ. Historically and contemporarily, the gastrointestinal tract has provided the raw material for urinary diversion, bladder augmentation and bladder substitution. Experience, however, has highlighted the potential complications inherent in the use of the bowel in the urinary tract including mucus production, stone disease, metabolic abnormalities, growth retardation, spontaneous perforation and malignancy. However, despite these drawbacks, the bowel is the gold standard in terms of functional utility and longevity. In efforts to develop alternatives, research has focused on the use of both natural and synthetic materials. With these materials, a whole new list of potential problems has been characterized. Tissue engineering may hold promise in resolving the issues of bladder replacement or repair by providing

  16. 'Cutting for the stone': the ancient art of lithotomy.

    Science.gov (United States)

    Herr, Harry W

    2008-05-01

    Bladder stone was a common ailment plaguing mankind from antiquity to the 20th century. Largely forgotten today, lithotomy relieved the anguish of bladder stones and identified urology as a medical specialty nearly 2500 years ago. The historical literature pertaining to lithotomy was reviewed. Translated and original documents describing operative techniques and developments pertaining to the history of lithotomy were obtained through the internet and library sources. The ancient art of lithotomy was first recorded by the Greeks and evolved through five phases: the Celsian method, or 'lesser operation'; the Marian, or 'greater operation'; the lateral operation; suprapubic cystotomy, or 'high operation', and proctocystotomy. The practice of open lithotomy ceased to exist owing to better minimally invasive alternative methods and most notably by the virtual disappearance of bladder stones in modern man. The history of lithotomy is a fascinating story of how early surgeons forced by the culture and customs of the time dealt with common but devastating bladder stones. Out of their efforts, urology was born.

  17. In vitro dissolution of calcium oxalate stones with ethylenediaminetetraacetic acid and snake venom thrombin-like enzyme.

    Science.gov (United States)

    Zhou, Xiang-Jun; Zhang, Jie; Zhang, Ci; Xu, Chang-Geng

    2014-01-01

    The aim of this study was to determine the feasibility of using snake venom thrombin-like enzyme (SVTLE) and/or ethylenediaminetetraacetic acid (EDTA) to dissolve calcium oxalate stones in vitro. Seven calcium oxalate stones were incubated with various chemolytic agents [EDTA, Tris-HCl/EDTA (TE) buffer or SVTLE diluted in TE buffer]. The pH, calcium concentration, stone weight and stone surface integrity were recorded, as well as related pathological changes to bladder mucosae. Compared to all other solutions, those containing SVTLE and buffered EDTA had higher concentrations of mobilized calcium and caused significantly more stone weight loss, stone fragility and gaps in the calcium crystals. Also, there were no adverse pathological effects on rabbit bladder mucosae from any of the solutions. The data indicate that buffered EDTA and SVTLE can be used to dissolve calcium oxalate stones and, at the concentrations used here, do not damage tissue. 2013 S. Karger AG, Basel.

  18. A case report of ureteral cast stone and giant urethral stone, respectively

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Yung; Rhee, Song Joo; Choi, Ki Chul [School of Medicine, Jeongbug National University, Jeonju (Korea, Republic of)

    1980-12-15

    Urinary lithiasis is one of the most common disease of the urinary tract. It occurs more frequently in men than in women but rare in children and in blacks; a familial predisposition is often encountered. Ureteral stones originate in the kidney. Gravity and peristalis contribute to spontaneous passage into and down the ureter. Ureterovesical junction is the most frequent lodging site of stone. In our hospital one case of ureteral cast stone and giant urethral stone were found respectively and they were confirmed by radiological examination and surgery on Aug. 1978 and Jan. 1979. Ureteral cast stone which had been introduced and named first by Kiyonobu Tari and Kikjiro So in 1972 was very giant unusually. It may be the only one till now. Our patient was 36 years old female who has been suffered from intermittent right flank pain for 10 years. On KUB giant cylindrical radiopaque shadow was shown on RLQ extended to right minor pelvis and this was confirmed as a stone by retrograde ureteral catheterization. A stone measured 13cm x 1.5cm was found above the ureterovesical junction during operation. Follow up excretory urogram one year after operation showed no functional improvement of right kidney. Urethral stone is also unusual urinary lithiasis. This 60 years old male patient was been suffered from non-tender palpable hard mass on scrotal area and intermittent urinary retention. When urinary retention was occurred it was relieved by manipulation of the mass by himself. On plain film oval shaped giant radiopaque shadow was shown on cavernous urethral region. On urethrocystogram anterior urethra was opacified, but posterior urethra and bladder were not opacified and multiple fistulous leakage was identified. A stone measured 6.5cm x 3.5cm was found in cavernous urethra during operation.

  19. A case report of ureteral cast stone and giant urethral stone, respectively

    International Nuclear Information System (INIS)

    Song, Ho Yung; Rhee, Song Joo; Choi, Ki Chul

    1980-01-01

    Urinary lithiasis is one of the most common disease of the urinary tract. It occurs more frequently in men than in women but rare in children and in blacks; a familial predisposition is often encountered. Ureteral stones originate in the kidney. Gravity and peristalis contribute to spontaneous passage into and down the ureter. Ureterovesical junction is the most frequent lodging site of stone. In our hospital one case of ureteral cast stone and giant urethral stone were found respectively and they were confirmed by radiological examination and surgery on Aug. 1978 and Jan. 1979. Ureteral cast stone which had been introduced and named first by Kiyonobu Tari and Kikjiro So in 1972 was very giant unusually. It may be the only one till now. Our patient was 36 years old female who has been suffered from intermittent right flank pain for 10 years. On KUB giant cylindrical radiopaque shadow was shown on RLQ extended to right minor pelvis and this was confirmed as a stone by retrograde ureteral catheterization. A stone measured 13cm x 1.5cm was found above the ureterovesical junction during operation. Follow up excretory urogram one year after operation showed no functional improvement of right kidney. Urethral stone is also unusual urinary lithiasis. This 60 years old male patient was been suffered from non-tender palpable hard mass on scrotal area and intermittent urinary retention. When urinary retention was occurred it was relieved by manipulation of the mass by himself. On plain film oval shaped giant radiopaque shadow was shown on cavernous urethral region. On urethrocystogram anterior urethra was opacified, but posterior urethra and bladder were not opacified and multiple fistulous leakage was identified. A stone measured 6.5cm x 3.5cm was found in cavernous urethra during operation

  20. Treatment of urethral stones by retrograde manipulation and extracorporeal shock wave lithotripsy.

    Science.gov (United States)

    el-Sherif, A E; Prasad, K

    1995-12-01

    To assess the effect of retrograde manipulation and extracorporeal shock wave lithotripsy (ESWL) as a monotherapy for urethral stones that are not associated with urethral strictures. Between August 1993 and January 1995, 34 male patients (mean age 38.7 years, range 7-55) presented with urethral stones. No patient had a suggested or past history of urethral stricture. Lidocaine jelly (2%) was instilled and retained inside the urethra for 5 min. A 16 F urethral catheter was advanced gently to push the stone back to the urinary bladder. Twenty patients had ESWL of their stones in the bladder, using a Storz Modulith SL20, in the prone position. Tilting the patient about 15 degrees towards the side with the stone minimized movement of the stone during fragmentation. In-line co-axial echography (3.5 MHz) and intermittent pulsed fluoroscopy were used to monitor stone fragmentation. In situ fragmentation of posterior urethral stones was not possible because localization was difficult and the treatment was painful. Thirteen patients had cysto-urethroscopy and mechanical cystolitholapaxy under general anaesthesia. Stones impacted in the posterior urethra in 31 (91%) patients and in the anterior urethra in three (9%) patients. Stones ranged in size from 7 to 25 mm. One patient expelled an anterior urethral stone after the instillation of 2% lidocaine jelly. The urethral stones were pushed back to the bladder without complication in the remaining 33 patients. All 20 patients except one had their stones fragmented by ESWL in one session. The mean number of shock waves was 3600 +/- 1480 (range 1200-6000) and the generator voltage ranged between 5 kV (560 bar) to 8 kV (940 bar). No patient in the ESWL group required anaesthesia or analgesia. Thirteen patients had successful mechanical cystolitholapaxy with no complications. Both endoscopic lithotripsy and ESWL of urethral stones are safe and effective. However, transurethral lithotripsy requires general anaesthesia and carries a

  1. Neurogenic bladder in spinal cord injury patients.

    Science.gov (United States)

    Taweel, Waleed Al; Seyam, Raouf

    2015-01-01

    Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.

  2. Withdraw of the Ureteroscope Causes Fragmented Ureter Stones to Disperse

    Directory of Open Access Journals (Sweden)

    Onder Canguven

    2013-09-01

    Full Text Available Introduction Ureteroscopy has improved from the first use of ureteroscope in the 1970's. Although the success rate increased in the last years, (1 new treatment techniques are being developed for impacted and large proximal ureter stones (2. Pneumatic lithotripsy has high efficiency with low complication rates (2. However, in case of steinstrasse and large (> 1 cm ureter stones, fragmented small stones may obstruct insertion of a ureteroscope after initial lithotripsy. In order to triumph over this issue, multiple ureteroscopic passages and manipulations needed for extraction of these small stones by forceps or basket catheters. The overall incidence of stricture was found upto 14.2% when the fragments were removed with a grasping forceps or a basket (3. We present our technique to disperse small fragmented stones in order to contact non-fragmented rest stone. Materials and Methods Ureteral lithotripsy was performed with an 8-9.8F semirigid ureteroscope using a pneumatic lithotripter (Swiss LithoClast, EMS, Nyon, Switzerland. The stone was fragmented into small pieces as small as 2-3 mm. by pneumatic lithotripter. Eventually, these fragmented stones interfered with vision and the lithotripter to get in touch with the rest stone. After fragmenting distal part of the large stone, the ureteroscope was pulled back out of ureter. While pulling back, the operating channel was closed and irrigation fluid was flowing in order not to decrease pressure behind the stones. Simultaneously, a person tilted the operating table to about 30° in reverse Trendelenburg position. When the ureteroscope was out of ureteral orifice, the operating channel was opened and irrigation fluid was stopped. This maneuver aided decreasing pressure in the bladder more rapidly in addition to feeding tube. Stone dust and antegrade fluid flow were easily seen out of the ureteral orifice. Ureteroscope was re-inserted after 30-60 seconds. While reaching the rest of the stone, small

  3. Withdraw of the ureteroscope causes fragmented ureter stones to disperse.

    Science.gov (United States)

    Canguven, Onder; Boz, Mustafa; Bulbul, Mustafa; Selimoglu, Ahmet; Albayrak, Selami

    2013-01-01

    Ureteroscopy has improved from the first use of ureteroscope in the 1970' s. Although the success rate increased in the last years, new treatment techniques are being developed for impacted and large proximal ureter stones (2). Pneumatic lithotripsy has high efficiency with low complication rates. However, in case of steinstrasse and large (> 1 cm) ureter stones, fragmented small stones may obstruct insertion of a ureteroscope after initial lithotripsy. In order to triumph over this issue, multiple ureteroscopic passages and manipulations needed for extraction of these small stones by forceps or basket catheters. The overall incidence of stricture was found upto 14.2% when the fragments were removed with a grasping forceps or a basket. We present our technique to disperse small fragmented stones in order to contact non-fragmented rest stone. Ureteral lithotripsy was performed with an 8-9.8F semirigid ureteroscope using a pneumatic lithotripter (Swiss LithoClast, EMS, Nyon, Switzerland). The stone was fragmented into small pieces as small as 2-3 mm. by pneumatic lithotripter. Eventually, these fragmented stones interfered with vision and the lithotripter to get in touch with the rest stone. After fragmenting distal part of the large stone, the ureteroscope was pulled back out of ureter. While pulling back, the operating channel was closed and irrigation fluid was flowing in order not to decrease pressure behind the stones. Simultaneously, a person tilted the operating table to about 30 in reverse Trendelenburg position. When the ureteroscope was out of ureteral orifice, the operating channel was opened and irrigation fluid was stopped. This maneuver aided decreasing pressure in the bladder more rapidly in addition to feeding tube. Stone dust and antegrade fluid flow were easily seen out of the ureteral orifice. Ureteroscope was re-inserted after 30-60 seconds. While reaching the rest of the stone, small stone dust was seen at first. Bigger stones were approximately

  4. Kidney stones - lithotripsy - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000136.htm Kidney stones and lithotripsy - discharge To use the sharing features on this page, please enable JavaScript. A kidney stone is a solid mass made up of tiny ...

  5. Lower pole stones

    DEFF Research Database (Denmark)

    Sanguedolce, Francesco; Breda, Alberto; Millan, Felix

    2013-01-01

    PURPOSE: To assess efficacy and safety of prone- and supine percutaneous nephrolithotomy (PCNL) for the treatment of lower pole kidney stones. METHODS: Data from patients affected by lower pole kidney stones and treated with PCNL between December 2005 and August 2010 were collected retrospectively...... by seven referral centres. Variables analysed included patient demographics, clinical and surgical characteristics, stone-free rates (SFR) and complications. Statistical analysis was conducted to compare the differences for SFRs and complication rates between prone- and supine PCNL. RESULTS: One hundred...... seventeen patients underwent PCNL (mean stone size: 19.5 mm) for stones harboured only in the lower renal pole (single stone: 53.6 %; multiple stones: 46.4 %). A higher proportion of patients with ASA score ≥ 3 and harbouring multiple lower pole stones were treated with supine PCNL (5.8 vs. 23.1 %; p = 0...

  6. [Bladder lithiasis].

    Science.gov (United States)

    Sylla, C; Fall, P A; Ndoye, A; Diao, B; Diallo, A B; Gueye, S M; Ba, M; Diagne, B A

    2001-01-01

    to study the particularities of the bladder lithiasis in our countries. This was a retrospective study of 94 cases (62 men and 32 women) of bladder lithiasis over a period of 13 years. The lithogenic factors; clinic, paraclinic and therapeutic aspects have been studied. Morphoconstitutional analysis has been carded out in collaboration with Cristal Laboratory (St Cloud hospital center in France). mean age was 24.2+/-20.7 years old. The principals mains of consultation were: dysuria (n =36), mictionnal pain (n = 28), hematuria (n = 15). Facilitating factors have been found in 27% of cases. In 10 cases, there was an association bladdder lithiasis and bladdder-vaginal fistula. Radiologic test was dominated by intraveinous urographic (53.19 of cases). The metabolic test showed hypercalcemia and cristalluria in 2 cases. In 7,45 % of cases, we have founding a renal failure. An urinary tract infection have been noticed in 42 % of cases. Open surgery has been the main treatement (96 %) associating in 15 % of cases the treatement of an uropathy. In one case the bladder lithiasis weighed 1120 g. The morphologic and spectrophotometric analysis of the lithiasis have been achieved in 13 % of cases showing the predominance of struvite. the bladder lithiasis is still common in our countries; it could be good for us to access endoorporeals and extracorporeals therapeutic equipements in orderto reduce the indications of open surgery.

  7. Application of three-dimensional volumetric ultrasonography in patients with bladder cancer and its mimickers: A pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Sujin; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2017-05-15

    Various diseases of the urinary bladder can be demonstrated as being polypoid, a nodular bladder mass or as focal bladder wall thickening. This includes malignant or benign neoplasms, urinary stones, or other inflammatory bladder conditions. In daily practice many of these bladder diseases are easily confused with bladder cancer. On the other hand, ultrasonography (US) is safe and can be easily applied as a screening modality or an initial evaluating tool for urinary bladder disease. Furthermore, additional three-dimensional (3D) volumetric techniques can support more delicate delineation of these lesions. This study presents a 3D volumetric US for bladder lesions, and demonstrates various pathological conditions of the urinary bladder ranging from bladder cancer to other benign lesions.

  8. The History of Urinary Stones: In Parallel with Civilization

    Directory of Open Access Journals (Sweden)

    Ahmet Tefekli

    2013-01-01

    Full Text Available The roots of modern science and history of urinary stone disease go back to the Ancient Egyptians and Mesopotamia. Hippocrates defined the symptoms of bladder stones. The first recorded details of “perineal lithotomy” were those of Cornelius Celsus. Ancient Arabic medicine was based mainly on classical Greco-Roman works. Interestingly, the Fourth Lateran Council in 1215 forbade physicians from performing surgical procedures, as contact with blood or body fluids was viewed as contaminating to men. With Renaissance new procedures could be tried on criminals. The first recorded suprapubic lithotomy was carried out by Pierre Franco in 1561. In 1874, Bigelow developed a lithotrite, which was introduced into the bladder under anaesthesia (called as “litholopaxy”. Young was the first to report ureteroscopy (1929. With advances in intracorporeal lithotripsy techniques, ureteroscopy became the treatment of choice for ureteric stones. In 1976, Fernstrom and Johannson established percutaneous access to remove a renal stone. However, with the introduction of the first extracorporeal shock wave machine in 1980, a dramatic change in stone management was observed. Civilization in parallel with scientific developments has brought us to a point where we try not to “cut” our patients for stone disease, as Hippocrates admonishes, but rather manage them with minimal invasive alternatives.

  9. The effect of inclined position on stone free rates in patients with lower caliceal stones during SWL session

    Directory of Open Access Journals (Sweden)

    Basri Cakiroglu

    2015-03-01

    Full Text Available Objective: To compare the outcomes of shock wave lithotripsy (SWL combined with inclined position and SWL alone in patients with lower pole calyx stones. Methods: Seven hundred forty patients who underwent SWL treatment for lower pole renal stones with a total diameter of 2 cm or less were prospectively randomized into two groups. They were comparable in terms of age, sex, and stone diameters. Patients with lower calyceal stones (4-20 mm were randomized to SWL (368 patients or SWL with simultaneous inclination (372 patients with 30o head down Trendelenburg position. Shock wave and session numbers were standardized according to stone size. Additional standardized shock waves were given to patients with stone fragments determined by kidney urinary bladder film and ultrasound at weeks 1, 4, 10. Results: The overall stone free rate (SFR was 73% (268/368 in patients with SWL alone and 81% (300/372 in SWL with inclination at the end of 12th week (p = 0.015. No significant adverse events were noted in both treatment groups. Conclusion: Simultaneous inclination of patients during SWL session increase SFR in lower caliceal stones significantly compared to SWL treatment alone.

  10. The composition of urinary stones in central sindh

    International Nuclear Information System (INIS)

    Memon, J.M.; Naqvi, S.Q.H.

    2014-01-01

    To determine chemical analysis of urinary stones of central sindh. Study design: Prospective and randomized study. Setting: Department of Surgery and Pathology of Peoples University of Medical and Health Sciences Nawabshah. Duration of study: Three years from May 2008 to May 2011. Material and Methods: Total 106 urolith patients who underwent open stone surgery were included in the study. EDTA Titration used for determination of calcium ions and determination of oxalate, phosphate, magnesium, ammonia, uric acid and cystine stones was carried out using spectrophotometer. These patients were asked to fill out a proforma with parameters of age, sex, radiological location of stone and chemical composition of surgically recovered stones. The stone analysis findings were reviewed and compared with other reported series Results: In this study 75(70.75%) patients were male and 31 (29.25%) female. Male to female ratio was of 2.41:1. The age ranged from 1 to 70 years with the mean of 22.69 years. The peak incidence of upper urinary tract stone in 20-30 years and lower urinary tract stones in both sexes was under 10 years. Anatomical location of stone showed 48(45.29%) renal, 13(12.26%) ureteric and 45(42.45%) bladder calculi. Chemical analysis revealed 56(52.8%) calcium oxalate, 7(6.6%) calcium phosphate, 11(10.3%) ammonium urate, 18(16.9%) uric acid, 13(12.2%) Sturvite and 1(0.9%) cystine calculi. Conclusion: It was concluded that urolithiasis is predominantly male disease. No age group was spared to stone disease. Calcium oxalate, uric acid, ammonium urate and mixed calculi are the main types in our study due to poor nutritional status, poverty and inadequate health facilities. Considering that knowledge of stone composition is of utmost importance to modify the incidence of urolithiasis. (author)

  11. Cystocele (Prolapsed Bladder)

    Science.gov (United States)

    ... Navigation Bladder Control Problems in Women (Urinary Incontinence) Kegel Exercises Cystocele (Prolapsed Bladder) Cystocele (Prolapsed Bladder) What ... a vaginal pessary, or surgery. Pelvic floor, or Kegel, exercises involve strengthening pelvic floor muscles. Strong pelvic ...

  12. Neo bladder long term follow-up

    International Nuclear Information System (INIS)

    Fakhr, I.; Mohamed, A. M.; Moustafa, A.; Al-Sherbiny, M.; Salama, M.

    2013-01-01

    One of the commonest forms of orthotopic bladder substitution for bladder cancer surivors, used in our institute, is the use of ileocecal segment. Sometimes, the need for Indiana pouch heterotropic continent diversion arises. Aim: To compare the long-term effect of orthotopic ileocecal bladder and heterotropic Indiana pouch following radical cystectomy in bladder cancer patients. Patients and methods: Between January 2008 and December 2011, 91 patients underwent radical cystectomy/anterior pelvic exentration and ortho topic ileocecal bladder reconstruction (61 patients) and Indiana pouch (30 patients), when orthotopic diversion could not be technically or oncologically feasible. Results: Convalescence was uneventful in most patients. All minor and major urinary leakage cases, in both diversions groups, where successfully conservatively treated. Only one patient in the ileocecal group with major urinary leak required re-exploration with successful revision of uretro-colonic anastomosis. Only one patient in the Indiana pouch group had accidentally discovered sub-centimetric stone, which was simply expelled. The overall survival proportion of ileocecal group was 100% compared to 80% in the Indiana pouch group (p < 0.001). The disease free survival proportion of ileocecal group was 90.8% compared to 80% in the Indiana pouch group (p = 0.076). Effective comparative daytime and nighttime urinary continence as well as renal function deterioration were not statistically significant between both reconstruction types. Conclusion: Both ileocecal bladder and Indiana pouch are safe procedures in regard to long-term effects over kidney function following radical cystectomy

  13. A case-control study on the association between bladder cancer and prior bladder calculus.

    Science.gov (United States)

    Chung, Shiu-Dong; Tsai, Ming-Chieh; Lin, Ching-Chun; Lin, Herng-Ching

    2013-03-15

    Bladder calculus is associated with chronic irritation and inflammation. As there is substantial documentation that inflammation can play a direct role in carcinogenesis, to date the relationship between stone formation and bladder cancer (BC) remains unclear. This study aimed to examine the association between BC and prior bladder calculus using a population-based dataset. This case-control study included 2,086 cases who had received their first-time diagnosis of BC between 2001 and 2009 and 10,430 randomly selected controls without BC. Conditional logistic regressions were employed to explore the association between BC and having been previously diagnosed with bladder calculus. Of the sampled subjects, bladder calculus was found in 71 (3.4%) cases and 105 (1.1%) controls. Conditional logistic regression analysis revealed that the odds ratio (OR) of having been diagnosed with bladder calculus before the index date for cases was 3.42 (95% CI = 2.48-4.72) when compared with controls after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, and renal disease, tobacco use disorder, obesity, alcohol abuse, and schistosomiasis, bladder outlet obstruction, and urinary tract infection. We further analyzed according to sex and found that among males, the OR of having been previously diagnosed with bladder calculus for cases was 3.45 (95% CI = 2.39-4.99) that of controls. Among females, the OR was 3.05 (95% CI = 1.53-6.08) that of controls. These results add to the evidence surrounding the conflicting reports regarding the association between BC and prior bladder calculus and highlight a potential target population for bladder cancer screening.

  14. Concurrent stone stabilization improves ultrasonic and pneumatic efficacy during cystolithopaxy: an in vitro analysis

    Directory of Open Access Journals (Sweden)

    Shubha De

    2015-02-01

    Full Text Available Objective To identify whether stabilization of larger bladder stones would improve the efficacy of combination (ultrasonic/pneumatic lithotripsy in a phantom bladder stone model for percutaneous cystolithopaxy. Materials and Methods Using 1cm phantom Bego stones, a spherical model bladder was used to simulate percutaneous bladder access. A UroNet (US Endoscopy, USA was placed alongside a Swiss Lithoclast probe through the working channel of a Storz 26Fr rigid nephroscope. Using a 30Fr working sheath, the stone was captured, and fragmented for 60seconds. Resulting fragments and irrigation were filtered through a 1mm strainer, and recorded. Five trials were performed with and without the UN. Durability was then assessed by measuring net defects, and residual grasp strength of each instrument. Descriptive statistics (mean, standard deviations were used to summarize the data, and Student’s t-tests (alpha<0.05 were used to compare trials. Results The mean time to stone capture was 12s (8-45s. After fragmentation with UN stabilization, there were significant improvements in the amount of residual stone (22% dry weight reduction vs 8.1% without UN, p<0.001, number of fragments (17.5 vs 5.0 frag/stone, p=0.0029, and fragment size (3.6mm vs. 7.05 mm, p=0.035. Mesh defects were noted in all nets, ranging from 2-14 mm, though all but one net retained their original grip strength (36.8N. Conclusions Bladder stone stabilization improved fragmentation when used in conjunction with ultrasonic/pneumatic lithotripsy. However, due to limitations in maneuverability and durability of the UN, other tools need to identified for this indication.

  15. Unusual presentation of metastatic gall bladder cancer

    Directory of Open Access Journals (Sweden)

    Piyush Shukla

    2014-01-01

    Full Text Available To report the first case of rare isolated breast metastasis from carcinoma gall bladder. Single patient case report. A 35-year-old pre-menopausal female presented with 2 FNx01 2 cm right upper outer quadrant breast lump. Post-mastectomy, histology confirmed it to be metastatic adenocarcinoma positive for both Cytokeratin (CK 7 and CK20. Past history as told by the patient revealed that 2 years back, cholecystectomy was performed for gall stones, of which no histology reports were present; she had a port site scar recurrence which showed it to be adenocarcinoma. Adjuvant chemotherapy and radiotherapy was advised which the patient did not complete. This is probably the first case reported of isolated breast metastasis from gall bladder carcinoma, diagnosed retrospectively. It also highlights the importance of adjuvant treatment in gall bladder malignancy.

  16. The accuracy of noncontrast spiral computerized tomography in detecting lucent renal stones: A case report and literature review

    OpenAIRE

    Adwan, Ayman; Binsaleh, Saleh

    2015-01-01

    Renal stones are one of the most common diseases in the urology field that are easily diagnosed by one of the standard imaging techniques. Noncontrast spiral computerized tomography (CT) can detect up to 95% of the renal, ureteric and bladder stones, especially those with calcium composition, and considered nowadays one of the most accurate methods for detecting undetectable stones by other modalities. We report a case of a 60-year-old female who presented with colicky right flank pain due to...

  17. Epidemiology of Stone Disease

    OpenAIRE

    Curhan, Gary C.

    2007-01-01

    Epidemiology has improved our understanding and management of stone. These types of studies have quantified changes in patterns and burden of disease, while identification of risk factors has changed clinical practice and provided insight into pathophysiologic processes related to stone formation. Because nephrolithiasis is a complex disease, an understanding of the epidemiology, particularly the interactions among different factors, may help lead to approaches that reduce the risk of stone f...

  18. Investigation on laser induced salivary stone fragmentation

    Science.gov (United States)

    Sroka, Ronald; Pongratz, Thomas; Eder, Matthias; Domes, Mona; Vogeser, Michael; Johnson, Thorsten; Siedeck, Vanessa; Schroetzlmair, Florian; Zengel, Pamela

    2014-03-01

    Objective: It was the objective of this in-vitro study to investigate photon-based techniques for identifying the composition and fragmentation of salivary stones using a Ho:YAG laser. Materials and Method: Salivary stones (n=47) extracted from patients with clinical symptoms of sialolithiasis were examined in-vitro. After extraction, the stones were kept in Ringers solution until size and volume measurements could be performed. Thereafter, dual-energy CT scans (DECT) were performed to classify the composition of the stones. Subsequently, fluorescence measurements were performed by taking images under blue light excitation as well as by fluorescence spectroscopy, measuring excitation-emission-matrixes (EEM). Further investigation to identify the exact composition of the stone was performed by Raman spectroscopy and FTIR spectroscopy of stone fragments and debris. Fragmentation was performed in an aquarium set-up equipped with a mesh (hole: 1.5mm) using a Ho:YAG-laser to deliver laser pulses of 0.5, 1.0 and 1.5J/pulse at a frequency of 3Hz through a 200μm-fibre to the stone surface. The collected data were analyzed and fragmentation rates were calculated. Finally, correlation between stone composition and fragmentation was performed. Results: Blue light fluorescence excitation resulted in either fluorescence in the green spectral region or in a combination of green and red fluorescence emission. EEM-measurement showed the corresponding spectra. Raman spectroscopy showed a mixture of carbonate apatite and keratin. DECT results in evidence of calcium containing components. FTIR-spectroscopy results showed that carbonate apatite is the main component. Fragmentation experiment showed a dependency on the energy per pulse applied if the evaluation implies the ratio of fragmented weight to pulse, while the ratio fragmented weight to energy remains about constant for the three laser parameter used. Conclusion: The composition of salivary stones could be determined using

  19. The paediatric neuropathic bladder

    African Journals Online (AJOL)

    A neurogenic bladder can be defined as a dysfunctinal urinary bladder caused by disease of the central nervous system or peripheral nerves involved in the control of micturition (urination). In pathophysiological terms, a neurogenic bladder is caused by a spinal reflex arc that occurs when the bladder becomes autonomous.

  20. Chimpanzee accumulative stone throwing

    Science.gov (United States)

    Kühl, Hjalmar S.; Kalan, Ammie K.; Arandjelovic, Mimi; Aubert, Floris; D’Auvergne, Lucy; Goedmakers, Annemarie; Jones, Sorrel; Kehoe, Laura; Regnaut, Sebastien; Tickle, Alexander; Ton, Els; van Schijndel, Joost; Abwe, Ekwoge E.; Angedakin, Samuel; Agbor, Anthony; Ayimisin, Emmanuel Ayuk; Bailey, Emma; Bessone, Mattia; Bonnet, Matthieu; Brazolla, Gregory; Buh, Valentine Ebua; Chancellor, Rebecca; Cipoletta, Chloe; Cohen, Heather; Corogenes, Katherine; Coupland, Charlotte; Curran, Bryan; Deschner, Tobias; Dierks, Karsten; Dieguez, Paula; Dilambaka, Emmanuel; Diotoh, Orume; Dowd, Dervla; Dunn, Andrew; Eshuis, Henk; Fernandez, Rumen; Ginath, Yisa; Hart, John; Hedwig, Daniela; Ter Heegde, Martijn; Hicks, Thurston Cleveland; Imong, Inaoyom; Jeffery, Kathryn J.; Junker, Jessica; Kadam, Parag; Kambi, Mohamed; Kienast, Ivonne; Kujirakwinja, Deo; Langergraber, Kevin; Lapeyre, Vincent; Lapuente, Juan; Lee, Kevin; Leinert, Vera; Meier, Amelia; Maretti, Giovanna; Marrocoli, Sergio; Mbi, Tanyi Julius; Mihindou, Vianet; Moebius, Yasmin; Morgan, David; Morgan, Bethan; Mulindahabi, Felix; Murai, Mizuki; Niyigabae, Protais; Normand, Emma; Ntare, Nicolas; Ormsby, Lucy Jayne; Piel, Alex; Pruetz, Jill; Rundus, Aaron; Sanz, Crickette; Sommer, Volker; Stewart, Fiona; Tagg, Nikki; Vanleeuwe, Hilde; Vergnes, Virginie; Willie, Jacob; Wittig, Roman M.; Zuberbuehler, Klaus; Boesch, Christophe

    2016-01-01

    The study of the archaeological remains of fossil hominins must rely on reconstructions to elucidate the behaviour that may have resulted in particular stone tools and their accumulation. Comparatively, stone tool use among living primates has illuminated behaviours that are also amenable to archaeological examination, permitting direct observations of the behaviour leading to artefacts and their assemblages to be incorporated. Here, we describe newly discovered stone tool-use behaviour and stone accumulation sites in wild chimpanzees reminiscent of human cairns. In addition to data from 17 mid- to long-term chimpanzee research sites, we sampled a further 34 Pan troglodytes communities. We found four populations in West Africa where chimpanzees habitually bang and throw rocks against trees, or toss them into tree cavities, resulting in conspicuous stone accumulations at these sites. This represents the first record of repeated observations of individual chimpanzees exhibiting stone tool use for a purpose other than extractive foraging at what appear to be targeted trees. The ritualized behavioural display and collection of artefacts at particular locations observed in chimpanzee accumulative stone throwing may have implications for the inferences that can be drawn from archaeological stone assemblages and the origins of ritual sites. PMID:26923684

  1. The twelve colourful stones

    International Nuclear Information System (INIS)

    Doria, R.M.

    1983-01-01

    A dynamics with twelve colourful stones is created based on the concepts of gauge and colour. It is associated different gauge fields to the same group. A group of gauge invariant Lagrangians is established. A gauge invariant mass term is introduced. The colourful stones physical insight is to be building blocks for quarks and leptons. (Author) [pt

  2. URINARY STONES IN CHIULDREN

    African Journals Online (AJOL)

    Philip

    Urinary stones were previously thought to be uncommon in the paediatric age however this may be due to differences in presentation and evaluation of children with stones. There are variations in the incidence worldwide; affected by diet and climate. Common aetiological factors are metabolic changes, urinary tract ...

  3. Stone fragmentation by ultrasound

    Indian Academy of Sciences (India)

    Some delicate nerves and fibres in the surrounding areas of the stones present in the kidney are also damaged by high ultrasonic intensity used in such systems. In the present work, enhancement of the kidney stone fragmentation by using ultrasound is studied. The cavitation bubbles are found to implode faster, with more ...

  4. [Bladder calculi. Is extracorporeal shock wave lithotripsy the first choice treatment?].

    Science.gov (United States)

    García Cardoso, Juan Vicente; González Enguita, Carmen; Cabrera Pérez, Javier; Rodriguez Miñón, José Luis; Calahorra Fernández, Francisco Javier; Vela Navarrete, Remigio

    2003-12-01

    To evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) treatment of bladder stones using a retrospective study. Between February 1991 and June 2002, 45 patients with bladder stones were treated (41 males and 4 females). Age ranged from 23 to 87 years. 63% had previous renal-ureteral lithiasis and 29% had undergone upper urinary tract ESWL. We used the Storz Modulith SL 10/SL 20. Treatments were performed using intravenous analgesia on an outpatient basis. 83 sessions of ESWL were performed on 53 stones. Complete fragmentation and elimination was achieved in 55% of the patients after a single session, 26.7% of the patients after 2 sessions, 6.7% after 3 sessions, 8.8% four, and 2.2% five. Mean number of shock waves was 3196.3 with an average 7-8 Kv. 8.5% had stone recurrence due to residual lithiasis, whereas 79% achieved total elimination. 13% required endoscopic procedures to evacuate stone fragments impacted in urethra. 6.6% required transurethral prostatic resection after ESWL. ESWL therapy is an effective option for the treatment of patients with bladder stones, non invasive, with low morbidity, without need for anesthesia, and outpatient. The effectiveness is high (79% of the patients stone free) and even higher when treating smaller stones.

  5. Everybody Must Get Stones

    Directory of Open Access Journals (Sweden)

    Timothy Darvill

    2009-09-01

    Full Text Available It is now widely recognised that monument building in the fourth and third millennia cal BC often involved transporting selected blocks of preferred stone many kilometres over difficult terrain. Some structures incorporated blocks from several different sources, brought together as an ensemble in much the same way perhaps that assemblages of flint and stone axes reflect both local and distant sources. This article explores alternative models accounting for the selection of stones, contrasting those that foreground symbolic attachments and imposed meanings with those that focus on the intrinsic qualities of particular types of stone and their source. The assemblage of different stone types that accumulated at Stonehenge, Wiltshire, over a period of more than a thousand years is used as a case study.

  6. Can the CT planning image determine whether a kidney stone is radiopaque on a plain KUB?

    DEFF Research Database (Denmark)

    Graumann, Ole; Osther, Susanne S; Spasojevic, Diana

    2011-01-01

    Almost all kidney stones are CT positive. Before a CT scan can be done a CT planning image (CTI) is generated in order to select the exact scanning area. The CTI looks approximately like a normal kidney-ureter-bladder abdominal radiography (KUB) but with reduced quality. It has been used as a guide...... evaluated the images in plenum. The following was recorded regarding the kidney stones: X-ray positive (radiopaque on KUB), CTI positive (radiopaque on CTI), location (a kidney, b upper two-thirds of ureter and c lower one-thirds of ureter including the bladder), size and Hounsfield units (HU). We also...

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

    Science.gov (United States)

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

    2013-01-01

    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.

  8. The accuracy of noncontrast spiral computerized tomography in detecting lucent renal stones: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Ayman Adwan

    2015-01-01

    Full Text Available Renal stones are one of the most common diseases in the urology field that are easily diagnosed by one of the standard imaging techniques. Noncontrast spiral computerized tomography (CT can detect up to 95% of the renal, ureteric and bladder stones, especially those with calcium composition, and considered nowadays one of the most accurate methods for detecting undetectable stones by other modalities. We report a case of a 60-year-old female who presented with colicky right flank pain due to large calcium oxalate renal stone that is undetected by standard imaging technique including spiral CT scan. Uretroscopy diagnosed and ultimately treat this patient problem.

  9. The accuracy of noncontrast spiral computerized tomography in detecting lucent renal stones: A case report and literature review.

    Science.gov (United States)

    Adwan, Ayman; Binsaleh, Saleh

    2015-01-01

    Renal stones are one of the most common diseases in the urology field that are easily diagnosed by one of the standard imaging techniques. Noncontrast spiral computerized tomography (CT) can detect up to 95% of the renal, ureteric and bladder stones, especially those with calcium composition, and considered nowadays one of the most accurate methods for detecting undetectable stones by other modalities. We report a case of a 60-year-old female who presented with colicky right flank pain due to large calcium oxalate renal stone that is undetected by standard imaging technique including spiral CT scan. Uretroscopy diagnosed and ultimately treat this patient problem.

  10. Giant urethral stone in a patient using clean intermittant catheterization

    Directory of Open Access Journals (Sweden)

    Abdullah Gedik

    2011-06-01

    Full Text Available Urethral stone is a rare entity in clinical practice. Primary urethral stone happening directly in urethra is even rare, and it usually occurs as a result frequent urinary infection, urethral stricture and trauma.While the application of clear intermittant catheterization reliably protects bladder function, in long term use, it may cause various complications.In this case, we discussed giant urethral stone in a patient who has been acting clean intermittent catheterization regularly and without problem fort he last five years and who has had total loss of sensation in this lower extremity as a result of falling from height. Considering that the urethral calibration, in the patient acting clean intermittent catheterization is interesting, the giant urethra stone as much as examined such a case has not been presented in literature.In the patient acting clean intermittent catheterization and having loss of urethral sensation and with neurogenic bladder, we call attention to urethral pathologies the symptoms of which were seeing late

  11. Bladder sensation measures and overactive bladder.

    Science.gov (United States)

    Rapp, David E; Neil, Nancy J; Govier, Fred E; Kobashi, Kathleen C

    2009-09-01

    We performed a prospective multicomponent study to determine whether subjective and objective bladder sensation instruments may provide data on sensory dysfunction in patients with overactive bladder. We evaluated 70 prospectively enrolled patients with urodynamics and questionnaires on validated urgency (Urgency Perception Score), general overactive bladder (Urogenital Distress Inventory) and quality of life (Incontinence Impact Questionnaire). We first sought a correlation between sensory specific (Urgency Perception Score) and quality of life questionnaire scores. We then assessed a correlation between sensory questionnaire scores and urodynamic variables, exploring the hypothesis that certain urodynamic parameters may be bladder sensation measures. We evaluated 2 urodynamic derivatives (first sensation ratio and bladder urgency velocity) to increase sensory finding discrimination. We noted a moderate correlation between the Urgency Perception Score (0.56) and the Urogenital Distress Inventory (0.74) vs the Incontinence Impact Questionnaire (each p Perception Score and bladder capacity (-0.25, p sensation ratio and bladder urgency velocity statistically significantly correlated with the Urgency Perception Score despite the lesser or absent correlation associated with the individual components of these derivatives. Bladder sensation questionnaires may be valuable to identify patients with sensory dysfunction and provide additional data not obtained in generalized symptom questionnaires. Urodynamic variables correlated with bladder sensation questionnaire scores and may be an objective method to assess sensory dysfunction.

  12. Crushed Stone Operations

    Data.gov (United States)

    Department of Homeland Security — This map layer includes crushed stone operations in the United States. These data were obtained from information reported voluntarily to the USGS by the aggregate...

  13. Fire effects on flaked stone, ground stone, and other stone artifacts [Chapter 4

    Science.gov (United States)

    Krista Deal

    2012-01-01

    Lithic artifacts can be divided into two broad classes, flaked stone and ground stone, that overlap depending on the defining criteria. For this discussion, flaked stone is used to describe objects that cut, scrape, pierce, saw, hack, etch, drill, or perforate, and the debris (debitage) created when these items are manufactured. Objects made of flaked stone include...

  14. irradiated gem stones

    International Nuclear Information System (INIS)

    Salama, S.S.M

    2006-01-01

    gem stones are those stones which have beauty that can be based on its color, transparency, brilliance (degree to which light is scattered) and the crystalline perfection (no minerals or other inclusions). topaz AL 2 SiO 4 (F,OH) 2 Aluminum fluoro-hydroxyl -silicate, it belongs to class silicates and subclass cyclo silicates and it is used mainly as gemstones, it is most common irradiated gem on the market. high energy such as neutrons, have enough energy to produce color centres .irradiation is most often carried out in nuclear reactors (high-energy neutrons). irradiation of topaz in the egyptian research reactor (ETRR-2) by neutrons changes its cloudy white color to a reddish pink which could be changed to blue by heating. nuclear reactions inside the irradiated stones produce radioisotopes. resulting to residual radioactivity. residual radioactivity is potentially a problem;therefore stones have to be stored in storage for a period of time to reduce the residual radioactivity aiming to reach the safety level of transportation. the storage time of the stones is dependent on trace element concentrations connected with their life-times in topaz . therefore, inspection of the trace elements in the stones and their half-life times are essential before irradiation

  15. Bladder outlet obstruction (BOO) in female: etiology and management

    International Nuclear Information System (INIS)

    Shaikh, N.A.; Ahuja, K.; Shaikh, G.S.; Soomro, A.K.

    2015-01-01

    To determine the etiology and management outcome of bladder outlet obstruction (BOO) in female. Methodology: From 2009 to 2012, 37 females with a mean age of 40 (range 20-65) were investigated for etiology and management outcome of BOO. Typical complaints were slow urinary flow, difficulty in emptying bladder, frequency of micturition and urgency. Mean duration of symptoms was 6 month. Results: 15 women were confirmed as atrophic urethritis, 5 had functional bladder, 3 had urethral caruncle, 5 had cystocele, 7 had complete procedentia of uterus, and 2 had impacted urethral stone. Cystoscopy was performed in all patients to exclude other pathology like vesical stone and bladder growth. 12 patients were referred to Gynecology due to complete procedentia of uterus and cystocele. Three cases of urethral caruncle were treated by excision and biopsy, 2 patients with urethral stone were treated by endoscopic push back and litholapaxy while 5 required conservative treatment and 15 cases of atrophic urethritis were kept on Hormone Replacement Therapy (HRT). Conclusion: BOO is uncommon in female and management depends upon the etiology. (author)

  16. Bladder outlet obstruction

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002238.htm Bladder outlet obstruction To use the sharing features on this page, please enable JavaScript. Bladder outlet obstruction (BOO) is a blockage at the base ...

  17. Urinary Tract Stones and Osteoporosis: Findings From the Women's Health Initiative.

    Science.gov (United States)

    Carbone, Laura D; Hovey, Kathleen M; Andrews, Christopher A; Thomas, Fridtjof; Sorensen, Mathew D; Crandall, Carolyn J; Watts, Nelson B; Bethel, Monique; Johnson, Karen C

    2015-11-01

    Kidney and bladder stones (urinary tract stones) and osteoporosis are prevalent, serious conditions for postmenopausal women. Men with kidney stones are at increased risk of osteoporosis; however, the relationship of urinary tract stones to osteoporosis in postmenopausal women has not been established. The purpose of this study was to determine whether urinary tract stones are an independent risk factor for changes in bone mineral density (BMD) and incident fractures in women in the Women's Health Initiative (WHI). Data were obtained from 150,689 women in the Observational Study and Clinical Trials of the WHI with information on urinary tract stones status: 9856 of these women reported urinary tract stones at baseline and/or incident urinary tract stones during follow-up. Cox regression models were used to determine the association of urinary tract stones with incident fractures and linear mixed models were used to investigate the relationship of urinary tract stones with changes in BMD that occurred during WHI. Follow-up was over an average of 8 years. Models were adjusted for demographic and clinical factors, medication use, and dietary histories. In unadjusted models there was a significant association of urinary tract stones with incident total fractures (HR 1.10; 95% CI, 1.04 to 1.17). However, in covariate adjusted analyses, urinary tract stones were not significantly related to changes in BMD at any skeletal site or to incident fractures. In conclusion, urinary tract stones in postmenopausal women are not an independent risk factor for osteoporosis. © 2015 American Society for Bone and Mineral Research.

  18. Association of non-alcoholic fatty liver disease with renal stone disease detected on computed tomography

    International Nuclear Information System (INIS)

    Nam, In Chul

    2016-01-01

    To evaluate the association between Non-alcoholic fatty liver disease (NAFLD) with renal stone disease detected on computed tomography (CT). A total 1812 patients who underwent abdomen-pelvis CT in July 2015 were included in this study. The inclusion criteria for NAFLD were as follows: (i) lower average Hounsfield unit (HU) of hepatic right lobe, left medial and lateral segment when compared with that of spleen, (ii) patients who having urolithiasis in kidneys, ureters and urinary bladder, and (iii) patients underwent abdomen-pelvis CT including noncontrast image. The statistical significance of the association between NAFLD and renal stone disease was assessed using Chi Square Test. The Odds ratios and 95% CI were calculated to assess the propensity of renal stones disease for NAFLD by using Logistic Regression analysis. The frequency of renal stone disease in patients with NAFLD was higher approximately 19% than those who having renal stone disease without NAFLD. In addition, the presence of NAFLD was linked with renal stone disease showing that detection rate of renal stone disease in patients with NAFLD was markedly high (odds ratio: 5, 95% CI, 3–8.2) (p < 0.05) in multivariate analysis. The presence of significant association between NAFLD with renal stone disease and NAFLD may be considered to be an independent variable as a risk factor for renal stone disease

  19. Fasting and Urinary Stones

    Directory of Open Access Journals (Sweden)

    Ali Shamsa

    2013-11-01

    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.

  20. Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Nikhil Ranjan

    2015-01-01

    Full Text Available A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

  1. The Antimuscarinic Agent Tolterodine Regulates Bladder Extracellular Matrix in Partial Bladder Outlet Obstruction in Rats

    Directory of Open Access Journals (Sweden)

    Tong-Xin Yang

    2018-03-01

    Full Text Available Background/Aims: Antimuscarinic agents can delay the progression of bladder dysfunction caused by bladder outlet obstruction (BOO. To date, the relationship between muscarinic receptor activity and the bladder extracellular matrix (ECM remains unclear. Thus, an animal model of partial BOO (PBOO in female rats was established to explore the variation in bladder wall ECM proteins under PBOO conditions with antimuscarinic agent administration. Methods: Rats were randomly divided into three groups: sham, PBOO, and PBOO plus tolterodine. Picrosirius red staining was used to examine the smooth muscle and collagen content of bladder samples. Gene microarray and RT-PCR were performed to survey the expression of ECM proteins, receptors, and metabolism regulators in the rat bladder. Positive results were further evaluated by immunohistochemistry. Results: Picrosirius red staining showed that smooth muscle volume significantly increased in the PBOO and PBOO plus tolterodine groups (p < 0.05, while collagen significantly increased in the PBOO group (p < 0.05 but not in the PBOO plus tolterodine group. Gene microarray and RT-PCR revealed that none of the collagen subtypes exhibited significant changes after PBOO establishment and tolterodine administration. However, matrix metalloproteinases (MMPs increased significantly in the PBOO plus tolterodine group (p < 0.05. Additionally, PBOO inhibited the expression of non-collagen ECM proteins in the rat bladder wall, while tolterodine induced the expression of non-collagen ECM proteins and ECM receptors. Conclusions: Tolterodine decreased the volume of collagen in PBOO rat bladder wall, possibly via MMPs, and regulated the expression of ECM proteins and receptors.

  2. Prevalence of Gall Bladder Stones among Type 2 Diabetic Patients ...

    African Journals Online (AJOL)

    Conclusion: The prevalence of gallstones in Libyan diabetic patients is higher than the rates reported in other parts of the world. Libyan diabetic patients with gallstones tend to be older and more obese than those without gallstones. Duration of diabetes mellitus and type of treatment does not seem to influence the ...

  3. Bladder stone formation over a partially migrated intrauterine ...

    African Journals Online (AJOL)

    for the past 3 years and cyclical haematuria for the past 6 months. Menstrual cycles were regular. She had undergone puerperal sterilisation 20 years ago. Vaginal speculum examination revealed threads of an intrauterine contraceptive device (IUCD). The threads snapped during attempts to remove the device. The patient ...

  4. Giant bladder diverticulum : A rare cause of bladder outlet ...

    African Journals Online (AJOL)

    Giant bladder diverticula are rare causes of bladder outlet obstruction in children and have rarely been reported. In this paper, we present three children with giant bladder diverticula who presented with bladder outlet obstruction within a year. Micturating cystourethrogram is important for investigating bladder outlet ...

  5. Anholt Rosetta Stones

    DEFF Research Database (Denmark)

    Trempe Jr., Robert B.; Buthke, Jan

    2017-01-01

    This book records and celebrates the research finding of Anholt Island by students from Studio 2B, Arkitektskolen Aarhus, These mahogany constructions are our architectural versions of a Rosetta Stone. These are constructs that record layers of information about Anholt island through virtual...... and physical techniques, where each step and mechanic imparts and inscribes knowledge beyond the 1:1. These constructs are visual keys, used to inspire and influence all decision-making processes in a design project. These architectural Rosetta Stones document and amplify quantitative information about a site...

  6. Fragmentation of kidney stones

    International Nuclear Information System (INIS)

    Kovacs, K.; Kun, F.; Vertse, T.

    2005-01-01

    Complete text of publication follows. Fragmentation, i.e. the breaking of particulate materials into smaller pieces is abundant in nature and underlies several industrial processes, which attracted a continuous interest in scientific and engineering research over the past decades. In industrial applications, fragmentation processes are mostly used for the comminution of ores in various types of mills. Kidney stone is a well known human dis- ease which embitters the life of many people (in a country like the USA about 10 6 cases are registered yearly). In order to extract large kidney stones (diameter ≥ 1 cm) from the human body without operation, one of the most efficient treatment is the fragmentation of kidney stones by the so-called extracorporal shock wave lithography method: a shock wave penetrating the human body is generated by an electric pulse. The repeated application of the shock wave gradually fragments the stones into pieces of size ≤ 2 mm which then leave the body through the urine system. Recently, a novel type of lithographic method has been suggested by using widely focused shock waves which fragment the stones by a squeezing mechanism. Laboratory experiments showed that the widely focused squeezing waves achieve a higher fragmentation efficiency than the frequently used shock waves of sharp focus. Based on this method a novel medical treatment can be introduced which is less demanding for the patients. Before the application of the method in the clinical practice a detailed understanding of the fragmentation mechanism of kidney stones due to shock waves is required. Since analytic theoretical methods have serious limitations in this field, we develop a realistic model of the mechanical behavior of kidney stones and a simulation code which makes possible to study the mechanism of breakup under various external conditions. Computer simulations in two dimensions have revealed a peculiar way of crack formation, i.e. the crack which finally breaks

  7. Ultrasonographic finding of intrahepatic stones

    International Nuclear Information System (INIS)

    Lee, Wang Yul; Koh, Byung Hee; Cho, On Koo; Hahm, Chang Kok

    1983-01-01

    Correct diagnosis of intrahepatic stone with differentiation from extrahepatic stone is very important because of their different surgical procedure. The ultrasonography is very simple and noninvasive diagnostic method for detection of intrahepatic stone than other method. So the authors analysed the ultrasonographic findings of 30 patients with intrahepatic stones and the results are as follows: 1. Among 30 cases, 13(43.3%) were male, 17(56.7%) were female with predominancy in 5th and 6th decades. 2. 1) In distribution of stones 16 cases(53.5%) were in the left duct, 11 cases(36.7%) in both ducts, 3 cases(10%) in the right duct. 2) In location of intrahepatic stones, 9 cases(30%) were only in the intrahepatic ducts, 21 cases (70%) associated stones in the extrahepatic duct and or GB. 3. In sonography of 30 cases of intrahepatic stones 1) The shape of stone was round in 27 cases(90%) and tubular due to impacted stone in 3 cases (10%) 2) The echogenicity of stones was strong in 25 cases(83.3%) and weak in 5 cases(16.7%). 3) The shadow posterior to stones was strong in 23 cases(76.7%) and weak in 7 cases(23.3%) 4. As associated findings, metastatic lesion in liver 2 cases(6.7%), liver cirrhosis 2 cases(6.7%), hepatic and perihepatic abscess 4 cases(13.3%)were found liver(13.3%) were found

  8. Drropulli Stone and Gjirokastra World Heritage in Albania

    Science.gov (United States)

    Serjani, Afat; Kramar, Sabina

    2013-04-01

    Ancient Gjirokastra City and Dervician stone deposit, there are located next to each other, in south of Albania, at foots of eastern slope of "Wide Mountain". Building stone it is represented by micritic limestone of white, red and blue colour, formed during Palaeocene-Eocene Period. It contains fossils of rounded forms and it is known and exploited since the ancient times. Argjirokastra, Argjiro's City, appeared since the IV-th Century BC (V.Tola, 2011). Stone City has in its centre Majestic Fortress of a big cruiser view, which is seen from long distance, from all sides of Drinos Valley. "This Majestic Monument of Albanian vigour has an astonishing elegance" has written E. Hoxha (1983). Watching Gjirokastra you will remind "Chronic in Stone", the book of Ismail Kadare, great writer, born in Gjirokastra. All buildings here are of stone. The Large Fortress and high houses as castles are built by stone, and covered by stone tiles. The walls and minarets of religious buildings are of stone. The gates of houses and yards are of engraved stone, protected by metallic nets of artistic forms. The house's walls are built by big stone, while the walls of yards are by small stone of white colour, some times intercalated with lines of red, blue stone. The combination of different colour stone is another one artistic beauty of walls. The roads are paved by black cobblestones of flysch sandstone for protection by slips, some times combined with white limestone mosaics. Steps of houses and roads are by white stone, often reworked masterfully. "Such stones, reworked by very fine skilfully, can not be found in any other place of the World, only in Anadoll" has written on 1 665 Evliya Celepi (2003). Buildings are of specific architecture and by good style. The accounts of the basis are done to keep "houses as castle". The walls have wood antiseismic layers. The architecture of houses, gates, angles, windows, with predomination of arc forms, with engraved stones and ornaments it is

  9. Modeling Stone Columns.

    Science.gov (United States)

    Castro, Jorge

    2017-07-11

    This paper reviews the main modeling techniques for stone columns, both ordinary stone columns and geosynthetic-encased stone columns. The paper tries to encompass the more recent advances and recommendations in the topic. Regarding the geometrical model, the main options are the "unit cell", longitudinal gravel trenches in plane strain conditions, cylindrical rings of gravel in axial symmetry conditions, equivalent homogeneous soil with improved properties and three-dimensional models, either a full three-dimensional model or just a three-dimensional row or slice of columns. Some guidelines for obtaining these simplified geometrical models are provided and the particular case of groups of columns under footings is also analyzed. For the latter case, there is a column critical length that is around twice the footing width for non-encased columns in a homogeneous soft soil. In the literature, the column critical length is sometimes given as a function of the column length, which leads to some disparities in its value. Here it is shown that the column critical length mainly depends on the footing dimensions. Some other features related with column modeling are also briefly presented, such as the influence of column installation. Finally, some guidance and recommendations are provided on parameter selection for the study of stone columns.

  10. Anholt Rosetta Stones

    DEFF Research Database (Denmark)

    Trempe Jr., Robert B.; Buthke, Jan

    2017-01-01

    This book records and celebrates the research finding of Anholt Island by students from Studio 2B, Arkitektskolen Aarhus, These mahogany constructions are our architectural versions of a Rosetta Stone. These are constructs that record layers of information about Anholt island through virtual and ...

  11. Kidney Stones (For Parents)

    Science.gov (United States)

    ... may cause long-term damage to the kidney. Diagnosis If your child has pain in the side, blood in the urine, or ... as soon as possible. If your child has pain along with nausea, vomiting, ... away. To make a diagnosis of kidney stones, the doctor will ask about ...

  12. Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure

    Directory of Open Access Journals (Sweden)

    Hamid Shafi

    2013-01-01

    Full Text Available This study was conducted to determine the composition of staghorn stones and to assess the proportion of infected stones as well as the correlation between infection in the stones and bacteria grown in urine. Samples of 45 consecutive stones removed through anatrophic nephrolithotomic procedures were taken from the operation site and samples of urine were obtained by simultaneous bladder catheterization. The frequency of infection in the stones and correlation between infection of stone and urine samples were determined with respect to the composition of the stones. Twenty-two males and 23 females, with respective mean ages of 48.3 ± 15.6 years and 51 ± 7.4 years, were studied. The stone and urine cultures yielded positive results in ten and 16 patients, respectively, of a total of 45 patients (22.2% and 35.5%, respectively. Calcium oxalate was the main constituent of staghorn stones, seen in 31 patients (68.8%, uric acid in 12 patients (26.6% and struvite and/or calcium phosphate in 11 patients (24.4%. In seven of ten stones with bacterial growth, bacteria were isolated from urine cultures as well, which accounted for a concordance rate of 70%. The bacteria grown in the stone were the cause of urinary tract infection (UTI in 43.5% of the cases. Stone infection was significantly associated with UTI (OR = 6.47; 95% CI 1.43-31.7, P = 0.021 and presence of phosphate in the stones (OR = 18, 95% CI 3.28-99.6, P = 0.0006. E. coli was the most common bacteria grown from the stones, and was isolated in 50% of the cases; Ureaplasma urealyticum was the most common organism causing UTI, grown in 62.5% of the urine samples. There was a high concordance rate between bacteria in the stones and urine. These findings indicate that the urine culture can provide information for selection of an appropriate anti-microbial agent for stone sterilization. In addition, preventing re-growth or recurrence of stones and treatment of post-surgical infections would be

  13. Exstrophy of the bladder.

    Science.gov (United States)

    Mollohan, J

    1999-03-01

    Exstrophy of the bladder is a rare congenital defect that occurs when the abdominal wall and underlying structures, including the ventral wall of the bladder, fail to fuse in utero. As a result, the lower urinary tract is exposed, and the everted bladder appears through the abdominal opening. Various surgical interventions have been employed with variable success in the hope of achieving complete dryness, full control over delivery of urine, freedom from catheters and external appliances, and a protected upper urinary tract. The most popular surgical approach is the primary bladder closure with secondary bladder neck reconstruction. Comprehensive nursing, medical, and surgical care are necessary to preserve renal and sexual function. The many complex problems experienced by these infants and their families call for a multidisciplinary approach. This article reviews occurrence, clinical presentation, and management of exstrophy of the bladder.

  14. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has ex...... can be challenging, and misdiagnosis as a psychological problem, overactive bladder, or chronic urinary infection has plagued patients with the problem....

  15. Bladder augmentation and urinary diversion in patients with neurogenic bladder: surgical considerations.

    Science.gov (United States)

    Stein, Raimund; Schröder, Annette; Thüroff, Joachim W

    2012-04-01

    In patients with a neurogenic bladder, the primary goal is preservation of renal function and prevention of urinary tract infection, with urinary continence as the secondary goal. After failure of conservative treatment (clean intermittent catheterisation and pharmacotherapy) urinary diversion should be considered. In this review, the surgical options with their advantages and disadvantages are discussed. In patients with a hyper-reflexive, small-capacity and/or low-compliance bladder with normal upper urinary tract, bladder augmentation (bowel segments/ureter) is an option. To those who are unable to perform clean intermittent catheterisation via urethra, a continent cutaneous stoma can be offered. In patients with irreparable sphincter defects a continent cutaneous diversion is an option. For patients who are not suitable for a continent diversion (incompliant±chronic renal failure), a colonic conduit for incontinent diversion is preferred. Surgical complications specific to urinary diversion include: ureterointestinal stenosis, stomal stenosis, stone formation, bladder perforation, and shunt infection and obstruction. Surgical revision is required in around one third of patients. Careful lifelong follow-up of these patients is necessary, as some of these complications can occur late. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  16. Wanted: suitable replacement stones for the Lede stone (Belgium)

    Science.gov (United States)

    De Kock, T.; Dewanckele, J.; Boone, M. A.; De Boever, W.; De Schutter, G.; Jacobs, P.; Cnudde, V.

    2012-04-01

    The Lede stone is an arenaceous limestone with a Lutetian age, occurring as discrete (most of the times three) stone banks in the marine sandy sediments of the Lede Formation (Belgium). It has a quartz content of approximate 40%. This increases abrasion strength and together with the cementation results in an average compressive strength of about 80-85 MPa. The cement is a microsparitic calcite cement. Other carbonate particles are both microfossils (mainly foraminifers) and macrofossils (bivalves, serpulids, echinoderms, …). This great diversity gives the stone a heterogeneous, animated appearance. The intra- and interparticle porosity is in total 5-10 % in average and the apparent density is 2400-2550 kg/m3. Another important constituent is glauconite, present in a few percent. In fresh state, the stone has a greenish-grey colour, but when it is exposed to atmospheric conditions for a couple of years, the stone acquires a yellowish to rust-coloured patina due to the weathering of glauconite. Sulphatation causes severe damage to the stone, and black gypsum crusts are common in urban environments on stones protected from runoff. This stone was excavated in both open air and underground quarries in the areas of Brussels and Ghent. The proximity of main rivers such as the Scheldt and Zenne provided transport routes for export towards the north (e.g. Antwerp and The Netherlands). Its first known use dates back to Roman times but the stone flourished in Gothic architecture due to its easy workability and its 'divine' light coloured patina. This results nowadays in a dominant occurrence in the cultural heritage of northwestern Belgium and the south of The Netherlands. Socio-economical reasons caused several declines and revivals of Lede stone in use. In the beginning of the 20th century, only a few excavation sites remained, with as main quarry the one located at Bambrugge (Belgium). By the end of the first half of the 20th century, however, no quarry sites remained

  17. Stepping Stone Mobility.

    OpenAIRE

    Jovanovic, B.; Nyarko, Y.

    1996-01-01

    People at the top of an occupational ladder earn more partly because they have spent time on lower rungs, where they have learned something. But what precisely do they learn? There are two contrasting views: First, the Bandit model assumes that people are different, that experience reveals their characteristics, and that consequently an occupational switch can result. Second, in our Stepping Stone model, experience raises a worker's productivity on a given task and the acquired skill can in p...

  18. The twelve colourful stones

    International Nuclear Information System (INIS)

    Doria, R.M.

    1984-01-01

    The gauge symmetry is extended. It is associated differents matter and gauge fields to the same group. A group of gauge invariant Lagrangians is established. A gauge invariant mass term is introduced. A massive Yang Mills is obtained. A dynamics with twelve colourful stones is created based on the concepts of gauge and colour. Structures identified as quarks and leptons are generated. A discussion about colour meaning is presented. (Author) [pt

  19. Anholt Rosetta Stones

    DEFF Research Database (Denmark)

    Trempe Jr., Robert B.; Buthke, Jan

    2017-01-01

    This book records and celebrates the research finding of Anholt Island by students from Studio 2B, Arkitektskolen Aarhus, These mahogany constructions are our architectural versions of a Rosetta Stone. These are constructs that record layers of information about Anholt island through virtual and ...... on Anholt Island through qualitative means. They are tools for uncovering realities previously unseen or unimagined through the manipulation of data via personal experience....

  20. Ultrasonographic diagnosis of ureteral stones: Accuracy and factors influencing on diagnostic sensitivity

    International Nuclear Information System (INIS)

    Park, Young Mi; Han, Sang Seok; Chang, Seung Kuk; Joo, Sang Hoo; Lee, Jeong Sik; Eun, Choong Ki

    1999-01-01

    To determine the accuracy of ultrasonographic diagnosis in patients with clinically suspected ureteral stones and to evaluate the factors influencing on the diagnostic sensitivity for the detection of ureteral stone. The patients (115 cases) with proven presence or absence of ureteral stones were included in the study. At first, both sided kidney and proximal ureters were examined on each decubitus position and then middle ureters were done if proximal ureters were visualized. On the supine view, distal ureters and UVJ were scanned through the acoustic window of the filled bladder. KUB (20 cases), IVU (62 cases), AGP (7 cases), RGP (3 cases), ESWL (9 cases), CT (9 cases), and patients' history of spontaneous passage of stones (5 cases) were included as confirmation methods. The sensitivity, specificity, and accuracy of the ultrasonographic diagnosis of ureteral stones were calculated and the factors influencing on the sensitivity on the focus of the position and size of ureteral stone, visibility of ureter, the presence or absence of renal stone and hydronephrosis were analyzed. Of 82 cases with proven ureteral stone, 72 cases were revealed on ultrasonography and there was one false positive examination among 33 cases with proven absence of ureteral stone. The overall diagnostic accuracy was 90%. The ultrasonographic detection rates of ureteral stones as correlated with their locations were 83% (24/29), 100% (11/11), 80% (16/20), and 100% (21/21) of each group of proximal, middle, distal ureter, and UVJ stones. Of 61 stones, those as correlated with their sizes, were 82% (37/45) and 94% (15/16) of each group less than 10 mm and more than 11 mm. Those as correlated with the presence or absence of ureteral visualization on ultrasonography were 92% (69/75) and 43% (3/7) of each group. Those as correlated with presence of absence of renal stones were 85% (41/48) and 91% (31/34) of each group. Those as correlated with presence or absence of hydronephrosis were 89% (55

  1. Bladder necrosis: 'A man without a bladder'.

    Science.gov (United States)

    Bosschieter, Judith; Oudshoorn, Frederik H K; Meuleman, Eric J H; Nieuwenhuijzen, Jakko A

    2018-02-17

    Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtained despite intensive rinsing and placement of a suprapubic catheter. On surgical exploration necrosis of almost the entire bladder wall, except for the trigone, was encountered. Surgical debridement of the non-viable bladder wall without opening the abdominal cavity was conducted, and a TUC was placed in the Retzius cavity to ensure evacuation of urine. Since the patient was haemodynamically unstable, construction of a urinary diversion was waived and urinary drainage of the Retzius cavity by the TUC was accepted, resulting in adequate urinary drainage without compromising renal function. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Management of staghorn renal stones.

    Science.gov (United States)

    Diri, Akif; Diri, Banu

    2018-11-01

    Staghorn stones are large branching stones that fill part of all of the renal pelvis and renal calyces and they can be complete or partial depending on the level of occupancy of the collecting system. Although kidney stones are commoner in men, staghorn stones are less often reported in men compared to women and they are usually unilateral. Due to the significant morbidity and potential mortality attributed to staghorn stones, prompt assessment and treatment is mandatory. Conversely, conservative treatment has been shown to carry a mortality rate of 28% in 10-year period and 36% risk of developing significant renal impairment. Staghorn stones are, therefore, significant disease entity that should be managed aggressively and effectively. Generally, the gold standard treatment for staghorn stones is surgical with a view to achieve stone-free collecting system and preserve renal function. Percutaneous nephrolithotomy should be the recommended first-line treatment for staghorn stones. Other non-surgical options are usually considered in combination with surgery or as monotherapy only if patients are surgically unfit. The decision for optimal treatment of staghorn stones should be individualized according to the circumstances of the patient involved and in order to do so, a closer look at the advantages and disadvantages of each option is necessary.

  3. Lessons from a Stone Farm

    Science.gov (United States)

    Kavanagh, John P.; Rao, P. Nagaraj

    2007-04-01

    The stone farm is a system for measuring macroscopic stone growth of 12 calcium stones simultaneously. It is based on mixed suspension, mixed product removal continuous crystallization principles and the stones are grown continuously for about 500 hours or more. The growth of the stones follows a surface area dependent pattern and the growth rate constants are very similar irrespective of whether the stating materials are fragments of human stone or pieces of marble chip. Increasing citrate from 2mM to 6mM caused a significant growth inhibition which persisted in the presence of urinary macromolecules. Phytate was a very effective inhibitor (about 50% at sub-μM concentrations) but the effective concentration was increased by an order of magnitude in the presence of urinary macromolecules. The effective concentration for inhibition in a crystallization assay was a further two orders of magnitude higher. Urinary macromolecules or almost whole urine were also strongly inhibitory although neither human serum albumin nor bovine mucin had any great effect. The relationship between the size distribution of crystals in suspension and the stone enlargement rate suggests that the primary enlargement mechanism for these in vitro stones is through aggregation. The stone farm is a powerful tool with which to study crystallization inhibitors in a new light. Some differences between inhibition of crystallization and inhibition of stone growth have emerged and we have obtained quantitative evidence on the mechanism of stone enlargement in vitro. Our findings suggest that the interface between crystals in suspension and the stone surface is the key to controlling stone enlargement.

  4. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has...

  5. Ultrasound: Bladder (For Parents)

    Science.gov (United States)

    ... If You Have Questions Print en español Ultrasonido: vejiga What It Is A bladder ultrasound is a safe and painless test that ... Exam: Voiding Cystourethrogram (VCUG) Ultrasound: Renal (Kidneys, Ureters, Bladder) Urinary ... only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- The Nemours Foundation. All ...

  6. Long neglected neurogenic bladder.

    Science.gov (United States)

    Binnani, Pooja; Gupta, Ruchi; Kedia, Nikhil; Pattewar, Sainath; Bahadur, Madan Mohan

    2011-07-01

    Urinary diversion is indicated for the management of the neurogenic bladder. However, there is a risk for developing pyocystitis in this type of patients. We present a case of young female who presented with a history of frequent urinary tract infection (UTI) post urinary diversion for neurogenic bladder. Ever since she underwent simple cystectomy, there have been no further episodes of UTI.

  7. Long neglected neurogenic bladder

    OpenAIRE

    Pooja Binnani; Ruchi Gupta; Nikhil Kedia; Sainath Pattewar; Madan Mohan Bahadur

    2011-01-01

    Urinary diversion is indicated for the management of the neurogenic bladder. However, there is a risk for developing pyocystitis in this type of patients. We present a case of young female who presented with a history of frequent urinary tract infection (UTI) post urinary diversion for neurogenic bladder. Ever since she underwent simple cystectomy, there have been no further episodes of UTI.

  8. Developments in bladder cancer

    International Nuclear Information System (INIS)

    Denis, L.; Niijima, T.; Prout, G.; Schroder, F.H.

    1986-01-01

    This book contains 20 selections. Some of the titles are: Guidelines for Radiation Therapy in Clinical Research on Bladder Cancer; Transitional Cell Carcinoma in Situ; Policy on Monitoring and Reporting Results; Standardization of Protocol Formnd The Role of Cytology in the Diagnosis, Detection and Follow-up of Bladder Cancer

  9. A CLINICAL STUDY OF GALL STONE DISEASE

    Directory of Open Access Journals (Sweden)

    K. Lokesh

    2017-12-01

    Full Text Available BACKGROUND Gallbladder disorders rank among the most common and costly of all digestive system diseases. This disease is more common in Western world. Prevalence rates vary from 15– 25% in developed countries. In India, it varies from 5 – 10%. Incidence of cholelithiasis is increasing considerably in India, possibly due to change in the dietary habits, which is becoming westernized and changing life style. Northern India show 7 times more incidence than that in southern parts. Because of the extensive studies on aetiology of gallstones, better understanding of the pathogenesis in the past two decades, the management has become more appropriate and effective. The operations on biliary tree and gall bladder rank next only to hernia repair and appendicectomy. Minimally invasive surgery improves patient’s compliance and reduces morbidity rates. The objectives of this study were1. To study age and sex distribution, various types of clinical presentations in patients with gall stone disease, 2. To study the bacteriology of the bile collected from all cholecystectomy cases and 3. To determine the composition of gallstones removed from patients. MATERIALS AND METHODS Study Type- Prospective observational study, Study Setting- Department of General surgery, Narayana medical college and Hospital. Study Period- Study is done from November 2014 to October 2016. Study sample: 100 cases of clearly documented gall stones on USG abdomen. Inclusion Criteria- Patient aged > 11 years and <70 years, All patients of gallstone disease who got admitted to the hospital and who underwent cholecystectomy either open or laparoscopic procedures. Exclusion Criteria- Acalculous cholecystitis, Primary CBD stones. Method of Study- A detailed history of demographic data, clinical presentation, complications if any, and previous treatment are recorded in a proforma. Thorough clinical examination was done in them and was subjected to investigations. Relevant preoperative

  10. Iatrogenic gall bladder perforations in laparoscopic cholecystectomy: an audit of 200 cases

    DEFF Research Database (Denmark)

    Zubair, M; Habib, L; Mirza, M R

    2010-01-01

    of gall bladder, presence of adhesions in the right upper quadrant, timing of perforation, site of perforation, cause of perforation and spillage of stones were recorded. Data was entered and analyzed on SPSS 15. Pearson Chi Square test was applied to check the significance of these factors in IGBP where...

  11. "Theranostic" role of bile salt-capped silver nanoparticles - gall stone/pigment stone disruption and anticancer activity.

    Science.gov (United States)

    Mandal, Ranju Prasad; Mandal, Gunjan; Sarkar, Sudeshna; Bhattacharyya, Arindam; De, Swati

    2017-10-01

    Silver nanoparticles (AgNPs) have been synthesized in situ in micelles formed by the bile salt sodium deoxycholate (NaDC). The AgNPs exhibit "green" fluorescence. It has been shown in the present study that they can disrupt the components of gall stones/pigment stones. This unique ability of the AgNPs has been observed upon detailed study of the interaction between the endobiotic pigment bilirubin (BR) and bile salt (NaDC). In addition, these AgNPs show significant cytotoxicity towards the breast cancer cells (MCF-7). Thus the AgNPs synthesized in this work show important physiological activity and can serve as prospective "Theranostic Materials" in future. Their green fluorescence bears relevance to future diagnostic applications while their anticancer activity and disruptive action upon BR aggregates in bile salt micelles is extremely important for therapeutic purpose. This is the first report of the use of metal nanoparticles in disruption of components of gall stones/pigment stones and thus the present work has very important physiological significance. The detailed spectral studies indicate that bile salts increase the dimerization of BR which could be linked to increased solubilisation of BR in bile salt media and consequent bile stone/pigment stone formation. Importantly, an increase in red fluorescence was observed (upon dimerization of BR), which is important for cancer detection and studying the metabolism of biological tissues. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap

    Directory of Open Access Journals (Sweden)

    P Agarwal

    2011-01-01

    Full Text Available Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures.

  13. Photodynamic management of bladder cancer

    Science.gov (United States)

    Johansson, A.; Stepp, H.; Beyer, W.; Pongratz, T.; Sroka, R.; Bader, M.; Kriegmair, M.; Zaak, D.; Waidelich, R.; Karl, A.; Hofstetter, A.; Stief, C.; Baumgartner, R.

    2009-06-01

    Bladder cancer (BC) is among the most expensive oncological diseases. Any improvement in diagnosis or therapy carries a high potential for reducing costs. Fluorescence cystoscopy relies on a selective formation of Protoporphyrin IX (PpIX) or more general photoactive porphyrins (PAP) in malignant urothelium upon instillation of 5-aminolevulinic acid (5-ALA) or its hexyl-derivative h-ALA. Fluorescence cystoscopy equipment has been developed with the aim to compensate for the undesired distortion caused by the tissue optical properties by displaying the red fluorescence simultaneously with the backscattered blue light. Many clinical studies proved a high sensitivity in detecting flat carcinoma in situ and small papillary malignant tumours. As a result, recurrence rates were significantly decreased in most studies. The limitation lies in a low specificity, caused by false positive findings at inflamed bladder wall. Optical coherence tomography (OCT) is currently being investigated as a promising tool to overcome this limitation. H-ALA-PDT (8 or 16 mM h-ALA in 50 ml instillation for 1-2 h, white light source, catheter applicator) has recently been investigated in a phase I study. 17 patients were applied 100 J/cm2 (3 patients received incrementing doses of 25 - 50 - 100 J/cm2) during approx. 1 hour irradiation time in 3 sessions, 6 weeks apart. PDT was performed without any technical complications. Complete photobleaching of the PpIX-fluorescence, as intended, could be achieved in 43 of 45 PDT-sessions receiving 100 J/cm2. The most prominent side effects were postoperative urgency and bladder pain, all symptoms being more severe after 16 mM h-ALA. Preliminary evaluation shows complete response assessed at 3 months after the third PDT-session (i.e. 6 months after first treatment) in 9 of 12 patients. 2 of these patients were free of recurrence until final follow-up at 84 weeks.

  14. Fundamentals of bladder tissue engineering

    African Journals Online (AJOL)

    W. Mahfouz

    Stem cells;. Bladder tissue engineering;. Decellularization;. Bladder acellular matrix. Abstract. A wide range of injuries could affect the bladder and lead to eventual loss ... Tissue engineering relies upon three essential pillars; the scaffold, the cells seeded on scaffolds and lastly ..... Clinical trials in bladder tissue engineering.

  15. Villamayor stone (Golden Stone) as a Global Heritage Stone Resource from Salamanca (NW of Spain)

    Science.gov (United States)

    Garcia-Talegon, Jacinta; Iñigo, Adolfo; Vicente-Tavera, Santiago

    2013-04-01

    Villamayor stone is an arkosic stone of Middle Eocene age and belongs to the Cabrerizos Sandstone Formation that comprising braided fluvial systems and paleosoils at the top of each stratigraphic sequence. The sandstone is known by several names: i) the Villamayor Stone because the quarries are located in Villamayor de Armuña village that are situated at 7 km to the North from Salamanca city; ii) the Golden Stone due to its patina that produced a ochreous/golden color on the façades of monuments of Salamanca (World Heritage City,1988) built in this Natural stone (one of the silicated rocks utilised). We present in this work, the Villamayor Stone to be candidate as Global Heritage Stone Resource. The Villamayor Stone were quarrying for the construction and ornamentation of Romanesque religious monuments as the Old Cathedral and San Julian church; Gothic (Spanish plateresc style) as the New Cathedral, San Esteban church and the sculpted façade of the Salamanca University, one of the oldest University in Europe (it had established in 1250); and this stone was one of the type of one of the most sumptuous Baroque monuments is the Main Square of the its galleries and arcades (1729). Also, this stone was used in building palaces, walls and reconstruction of Roman bridge. Currently, Villamayor Stone is being quarried by small and family companies, without a modernized processing, for cladding of the façades of the new buildings until that the construction sector was burst (in 2008 the international economic crisis). However, Villamayor Stone is the main stone material used in the city of Salamanca for the restoration of monuments and, even in small quantities when compared with just before the economic crisis, it would be of great importance for future generations protect their quarries and the craft of masonry. Villamayor Stone has several varieties from channels facies to floodplains facies, in this work the selected varieties are: i) the fine-grained stone

  16. Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL Sonolith vision

    Directory of Open Access Journals (Sweden)

    Nakamura Kogenta

    2011-12-01

    Full Text Available Abstract Background The aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004. Methods The subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment. Results At 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]. Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each. Conclusions ESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.

  17. Endoscopic gold fiducial marker placement into the bladder wall to optimize radiotherapy targeting for bladder-preserving management of muscle-invasive bladder cancer: feasibility and initial outcomes.

    Directory of Open Access Journals (Sweden)

    Maurice M Garcia

    Full Text Available Bladder radiotherapy is a management option for carefully selected patients with muscle-invasive bladder cancer. However, the inability to visualize the tumor site during treatment and normal bladder movement limits targeting accuracy and increases collateral radiation. A means to accurately and reliably target the bladder during radiotherapy is needed.Eighteen consecutive patients with muscle-invasive bladder cancer (T1-T4 elected bladder-preserving treatment with maximal transurethral resection (TUR, radiation and concurrent chemotherapy. All underwent endoscopic placement of 24-K gold fiducial markers modified with micro-tines (70 [2.9×0.9 mm.]; 19 [2.1×0.7 mm. into healthy submucosa 5-10 mm. from the resection margin, using custom-made coaxial needles. Marker migration was assessed for with intra-op bladder-filling cystogram and measurement of distance between markers. Set-up error and marker retention through completion of radiotherapy was confirmed by on-table portal imaging.Between 1/2007 and 7/2012, a total of 89 markers (3-5 per tumor site were placed into 18 patients of mean age 73.6 years. Two patients elected cystectomy before starting treatment; 16/18 completed chemo-radiotherapy. All (100% markers were visible with all on-table (portal, cone-beam CT, fluoroscopy, plain-film, and CT-scan imaging. In two patients, 1 of 4 markers placed at the tumor site fell-out (voided during the second half of radiotherapy. All other markers (80/82, 98% were present through the end of radio-therapy. No intraoperative (e.g. uncontrolled bleeding, collateral injury or post-operative complications (e.g. stone formation, urinary tract infection, post-TUR hematuria >48 hours occurred. Use of micro-tined fiducial tumor-site markers afforded a 2 to 6-fold reduction in bladder-area targeted with high-dose radiation.Placement of the micro-tined fiducial markers into the bladder was feasible and associated with excellent retention-rate and no complications

  18. Paraganglioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Vinod Priyadarshi

    2015-01-01

    Full Text Available Paraganglioma of the urinary bladder are tumors of chromaffin tissue originating from the sympathetic innervations of the urinary bladder wall and are extremely rare. Being functional, in most of the cases they are recognized by their characteristic presentation of hypertensive crisis and postmicturition syncope. A silent presentation of a bladder paraganglioma is very unusual but quite dangerous as they are easily misdiagnosed and adequate peri-operative attention is not provided. Here, we are presenting one such silent paraganglioma in adult women who presented with only a single episode of hematuria and severe hypertensive crisis occur during its trans-urethral resection.

  19. Hyaluronan and Stone Disease

    Science.gov (United States)

    Asselman, Marino

    2008-09-01

    Kidney stones cannot be formed as long as crystals are passed in the urine. However, when crystals are retained it becomes possible for them to aggregate and form a stone. Crystals are expected to be formed not earlier than the distal tubules and collecting ducts. Studies both in vitro and in vivo demonstrate that calcium oxalate monohydrate crystals do not adhere to intact distal epithelium, but only when the epithelium is proliferating or regenerating, so that it possesses dedifferentiated cells expressing hyaluronan, osteopontin (OPN) and their mutual receptor CD44 at the apical cell membrane. The polysaccharide hyaluronan is an excellent crystal binding molecule because of its negative ionic charge. We hypothesized that the risk for crystal retention in the human kidney would be increased when tubular cells express hyaluronan at their apical cell membrane. Two different patient categories in which nephrocalcinosis frequently occurs were studied to test this hypothesis (preterm neonates and kidney transplant patients). Hyaluronan (and OPN) expression at the luminal membrane of tubular cells indeed was observed, which preceded subsequent retention of crystals in the distal tubules. Tubular nephrocalcinosis has been reported to be associated with decline of renal function and thus further studies to extend our knowledge of the mechanisms of retention and accumulation of crystals in the kidney are warranted. Ultimately, this may allow the design of new strategies for the prevention and treatment of both nephrocalcinosis and nephrolithiasis in patients.

  20. A study on the industrialization of building stones and industrial stone crafts - Study on the causes of stone contaminations

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Jeon Ki; Lee, Han Yeang [Korea Institute of Geology Mining and Materials, Taejon (Korea, Republic of)

    1996-12-01

    Causes of building stone contamination are acid rains in polluted areas, iron bearing minerals in stone itself, salts, sealants, cutting and grinding processes in stone factory and steel compounds structures such as stone anchors, bolts, rain culvert and guide frames. Contaminations on the building stone surface of Sejong culture center can be found around floor stones, stair stones, parterre stones, pillar stones and other outdoor stone panels. The parterre stones are contaminated by white tarnishes and rust flows are occurred on the surface of pillar stones and outdoor stone panels around entrance. Black tarnishes are cumulated on the pillar stones and other outdoor decorated stone panels and change the original granite color. Causes of building stone contaminations from Sejong culture center are wet method to attach stone panels, rust from steel compounds structures and air pollutants. Cement and mortar used from wet method react with sulfur dioxides in polluted air and from fine calcite crystals (white tarnish). Rusts from steel compounds structures such as rainwater culvert and steel guide frames can move to the stone surface by rain and leave rust flows on it. Pollutants (tar compounds, carbons, dusts, etc.) in air are cumulated with humidity on the stone surface and change color from white granite color to dusty dark color. Historical stone sculptures such as man and animal shaped stone crafts, tombstones, square stone tables in front of a tomb and guide and circumference stones around tomb in Royal Tombs (Donggu rung, Yung rung, Seoou rung and Hunin rung) distributed in Kyunggi province are contaminated by various moss and air pollutants and its original colors are deeply changed. (author). 21 refs., 11 tabs., 22 figs.

  1. Kidney stones - self-care

    Science.gov (United States)

    ... stone is a solid mass made up of tiny crystals. Your health care provider may ask you to take self-care steps to treat kidney stones or prevent them from returning. What to Expect at Home You visited your provider or the hospital because ...

  2. Bladder Diseases - Multiple Languages

    Science.gov (United States)

    ... PDF Health Information Translations Spanish (español) Expand Section Bladder Diseases: MedlinePlus Health Topic - English Enfermedades de la vejiga: Tema de salud de MedlinePlus - español (Spanish) National ...

  3. The exposome for kidney stones.

    Science.gov (United States)

    Goldfarb, David S

    2016-02-01

    The exposome is the assembly and measure of all the exposures of an individual in a lifetime. An individual's exposures begin before birth and include insults from environmental and occupational sources. The associated field is called exposomics, which relies on the application of internal and external exposure assessment methods. Exposomics has not yet been thoroughly applied to the study of kidney stones although much is known about how diet and fluid intake affect nephrolithiasis. Some other novel exposures that may contribute to kidney stones are discussed including use of antibiotics, urbanization and migration to urban heat islands, and occupation. People whose school and jobs limit their access to fluids and adequate bathroom facilities may have higher prevalence of stones. Examples include athletes, teachers, heathcare workers, and cab drivers. Occupational kidney stones have received scant attention and may represent a neglected, and preventable, type of stone. An exposomic-oriented history would include a careful delineation of occupation and activities.

  4. Date stones in broiler's feeding

    Directory of Open Access Journals (Sweden)

    Gualtieri, M.

    1990-01-01

    Full Text Available To evaluate date stones as dietary component for broilers, two trials were carried out. In the first trial, Tunisian Deglet date stones were used and in the second one, stones were the waste product of an Italian distillery. One-day-old Arbor Acres chickens were cage reared and fed for 6 weeks on 4 experimental diets, which were formulated to be isonitrogenous and isocaloric and differed in cereal component (maize or low tannin sorghum and in inclusion level (0 or 10 % of ground date stones. Birds ' performances were slightly different in the two trials, but overall results indicate that date stones are suitable for use in broiler's feeding under such conditions.

  5. Outlines on nanotechnologies applied to bladder tissue engineering.

    Science.gov (United States)

    Alberti, C

    2012-01-01

    Tissue engineering technologies are more and more expanding as consequence of recent developments in the field of biomaterial science and nanotechnology research. An important issue in designing scaffold materials is that of recreating the ECM (extra-cellular matrix) functional features - particularly ECM-derived complex molecule signalling - to mimic its capability of directing cell-growth and neotissue morphogenesis. In this way the nanotechnology may offer intriguing chances, biomaterial nanoscale-based scaffold geometry behaving as nanomechanotransducer complex interacting with different cell nanosize proteins, especially with those of cell surface mechanoreceptors. To fabricate 3D-scaffold complex architectures, endowed with controlled geometry and functional properties, bottom-up approaches, based on molecular self-assembling of small building polymer units, are used, sometimes functionalizing them by incorporation of bioactive peptide sequences such as RDG (arginine - glycine - aspartic acid, a cell-integrin binding domain of fibronectin), whereas the top-down approaches are useful to fabricate micro/nanoscale structures, such as a microvasculature within an existing complex bioarchitecture. Synthetic polymer-based nanofibers, produced by electrospinning process, may be used to create fibrous scaffolds that can facilitate, given their nanostructured geometry and surface roughness, cell adhesion and growth. Also bladder tissue engineering may benefit by nanotechnology advances to achieve a better reliability of the bladder engineered tissue. Particularly, bladder smooth muscle cell adhesion to nanostructured polymeric surfaces is significantly enhanced in comparison with that to conventional biomaterials. Moreover nanostructured surfaces of bladder engineered tissue show a decreased calcium stone production. In a bladder tumor animal model, the dispersion of carbon nanofibers in a polymeric scaffold-based tissue engineered replacement neobladder, appears to

  6. Isolated Inguinal Bladder Hernia

    OpenAIRE

    BAYSAL, Tamer; SOYLU, Ahmet; ERDOĞAN, Özgül

    2010-01-01

    Isolated urinary bladder herniation into the inguinal canal is rare. It is often diagnosed intraoperatively during surgery or is identified after intraoperative injury. Early diagnosis with radiologic imaging is important to avoid complications during repair surgery. Computed tomography seems the best imaging choice to outline the details of herniation. We report an incidentally discovered case of inguinal bladder herniation with intravenous pyelography and computed tomography findings. ...

  7. Long neglected neurogenic bladder

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2011-01-01

    Full Text Available Urinary diversion is indicated for the management of the neurogenic bladder. However, there is a risk for developing pyocystitis in this type of patients. We present a case of young female who presented with a history of frequent urinary tract infection (UTI post urinary diversion for neurogenic bladder. Ever since she underwent simple cystectomy, there have been no further episodes of UTI.

  8. Engineering functional bladder tissues.

    Science.gov (United States)

    Horst, Maya; Madduri, Srinivas; Gobet, Rita; Sulser, Tullio; Milleret, Vinzent; Hall, Heike; Atala, Anthony; Eberli, Daniel

    2013-07-01

    End stage bladder disease can seriously affect patient quality of life and often requires surgical reconstruction with bowel tissue, which is associated with numerous complications. Bioengineering of functional bladder tissue using tissue-engineering techniques could provide new functional tissues for reconstruction. In this review, we discuss the current state of this field and address different approaches to enable physiologic voiding in engineered bladder tissues in the near future. In a collaborative effort, we gathered researchers from four institutions to discuss the current state of functional bladder engineering. A MEDLINE® and PubMed® search was conducted for articles related to tissue engineering of the bladder, with special focus on the cells and biomaterials employed as well as the microenvironment, vascularisation and innervation strategies used. Over the last decade, advances in tissue engineering technology have laid the groundwork for the development of a biological substitute for bladder tissue that can support storage of urine and restore physiologic voiding. Although many researchers have been able to demonstrate the formation of engineered tissue with a structure similar to that of native bladder tissue, restoration of physiologic voiding using these constructs has never been demonstrated. The main issues hindering the development of larger contractile tissues that allow physiologic voiding include the development of correct muscle alignment, proper innervation and vascularization. Tissue engineering of a construct that will support the contractile properties that allow physiologic voiding is a complex process. The combination of smart scaffolds with controlled topography, the ability to deliver multiple trophic factors and an optimal cell source will allow for the engineering of functional bladder tissues in the near future. Copyright © 2012 John Wiley & Sons, Ltd.

  9. Urinary tract stone in patients with spinal cord injury: a retrospective radiological study

    International Nuclear Information System (INIS)

    Yun, Eun Joo; Lee, Jong Koo; Shin, Hyun Ja

    1995-01-01

    To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10 years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. Total patients were 257 with 186 (72.4%) paraplegia and 71 (27.6%) quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ; 5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows; 15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4 years, and another peak was in 12-16 years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation

  10. Bladder cancer and schistosomiasis

    International Nuclear Information System (INIS)

    Zaghloul, M.S.

    2012-01-01

    Schistosoma-associated bladder cancer was believed, for several decades, to be a completely unique entity of disease, different from urothelial cancer. This was probably due to its distinct clinico pathologic and demographic features that varied from those of urothelial entity. The carcinogenesis is an extremely complex process resulting from the accumulation of many genetic and epigenetic changes leading to alterations in the cell proliferation regulation process. In bladder cancer, many of these carcinogenic cascades were not fully documented or somewhat conflicting. In spite of the efforts performed, much is still needed to explore the presence or absence of the carcinogenic difference with a different etiology. The control of schistosomiasis in certain countries and the subsequent decrease in the intensity of infestation showed changing of features approaching that of urothelial tumors. However the schistosoma-associated bladder cancer presented in more advanced stages than schistosoma-non associated urothelial cancer. More recently, data are gathered that, upon applying the same treatment protocol and management care, stage by stage comparison of the treatment end-results were found to be similar in bladder cancer patients with a different etiology. All treatment options; including radical cystectomy with or without adjuvant or neoadjuvant chemo- or radiotherapy or tri modality bladder preserving treatment seem to lead to similar end-results regardless of etiologic factor(s) implicated in bladder cancer development.

  11. Bath Stone - a Possible Global Heritage Stone from England

    Science.gov (United States)

    Marker, Brian

    2014-05-01

    The Middle Jurassic strata of England have several horizons of oolitic and bioclastic limestones that provide high quality dimension stone. One of the most important is found in and near the City of Bath. The Great Oolite Group (Upper Bathonian) contains the Combe Down and Bath Oolites, consisting of current bedded oolites and shelly oolites, that have been used extensively as freestones for construction nearby, for prestigious buildings through much of southern England and more widely. The stone has been used to some extent since Roman times when the city, then known as Aquae Sulis, was an important hot spa. The stone was used to a limited extent through medieval times but from the early 18th century onwards was exploited on a large scale through surface quarrying and underground mining. The City was extensively redeveloped in the 18th to early 19th century, mostly using Bath Stone, when the spas made it a fashionable resort. Buildings from that period include architectural "gems" such as the Royal Crescent and Pulteney Bridge, as well as the renovated Roman Baths. Many buildings were designed by some of the foremost British architects of the time. The consistent use of this stone gives the City an architectural integrity throughout. These features led to the designation of the City as a World Heritage Site. It is a requirement in current City planning policy documents that Bath Stone should be used for new building to preserve the appearance of the City. More widely the stone was used in major houses (e.g. Buckingham Palace and Apsley House in London; King's Pavilion in Brighton); civic buildings (e.g. Bristol Guildhall; Dartmouth Naval College in Devon); churches and cathedrals (e.g. Truro Cathedral in Cornwall); and engineered structures (e.g. the large Dundas Aqueduct on the Kennet and Avon Canal). More widely, Bath Stone has been used in Union Station in Washington DC; Toronto Bible College and the Town Hall at Cape Town, South Africa. Extraction declined in

  12. Stone cladding engineering

    CERN Document Server

    Sousa Camposinhos, Rui de

    2014-01-01

    This volume presents new methodologies for the design of dimension stone based on the concepts of structural design while preserving the excellence of stonemasonry practice in façade engineering. Straightforward formulae are provided for computing action on cladding, with special emphasis on the effect of seismic forces, including an extensive general methodology applied to non-structural elements. Based on the Load and Resistance Factor Design Format (LRDF), minimum slab thickness formulae are presented that take into consideration stress concentrations analysis based on the Finite Element Method (FEM) for the most commonly used modern anchorage systems. Calculation examples allow designers to solve several anchorage engineering problems in a detailed and objective manner, underlining the key parameters. The design of the anchorage metal parts, either in stainless steel or aluminum, is also presented.

  13. The bioreceptivity of building stone

    Science.gov (United States)

    Mauko Pranjić, Alenka; Mulec, Janez; Muck, Tadeja; Hladnik, Aleš; Mladenovič, Ana

    2015-04-01

    Bioreceptivity is an intrinsic property of stone, and is defined as the ability of a material to be colonized by living organisms. The fouling and staining of building stone material due to the activity of microorganisms presents a serious problem in modern as well as historical buildings, not only due to the aesthetic impact but also due to the deterioration of the material. Biological colonisation on stone materials is influenced by a number of factors, e.g. the intrinsic properties of the stone (porosity, roughness, permeability, mineral composition), environmental parameters (e.g. solar radiation, temperature, water regime, climate, etc.), and specific microclimatic parameters (e.g. orientation, exposure to shadow, permanent capillary humidity, etc.). In order to assess the bioreceptivity of building stones, use is often made of artificial colonisation experiments compromising the inoculation of stones with a single species or a few isolated strains under laboratory conditions. In the present work the authors present the development of a method for the determination of bioreceptivity, as well as a study of the bioreceptivity of selected natural stone versus the latter's intrinsic properties. Field examples of biodeterioration are also presented. The study was supported by the Slovenian Research Agency (L1-5453).

  14. Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Daniel Cabezalí Barbancho

    2013-01-01

    Full Text Available Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

  15. Bladder activation: afferent mechanisms.

    Science.gov (United States)

    Andersson, Karl-Erik

    2002-05-01

    The major function of the lower urinary tract is to store and periodically evacuate urine from the bladder. This requires coordination of the smooth muscles of the bladder and urethra, and of the striated muscles of the outflow region and pelvic floor by a complex neural control system. Lumbosacral afferent fibers (pelvic afferents), but also afferents in the hypogastric and pudendal nerves, are of major importance for the regulation of the mechanisms for continence and micturition. In the bladder, afferent nerves have been identified suburothelially as well as in the detrusor muscle. Suburothelially, they form a plexus that lies immediately beneath the epithelial lining. This plexus is particularly dense in the bladder neck and the trigone. The most important afferents for the micturition process are myelinated Adelta-fibers and unmyelinated C-fibers. Immunocytochemical and tracing studies have revealed that numerous peptides, including substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide, enkephalins, and cholecystokinin are localized either alone, or in combination, in afferent pathways of the bladder and urethra. The receptors on these nerves include: vanilloid receptors, purinoceptors, tachykinin, and prostanoid receptors. Extracellular adenosine triphosphate (ATP) has been found to mediate excitation of small-diameter sensory neurons via P2X3 receptors, and it has been proposed that in the bladder, distention causes release of ATP from the urothelium. ATP, in turn, can activate P2X3 receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, it is most likely that a cascade of inhibitory and stimulatory transmitters/mediators, as well as ATP, are involved in the transduction mechanisms underlying the activation of afferent fibers during bladder filling.

  16. Grasping the Formless in Stones

    DEFF Research Database (Denmark)

    Aktor, Mikael

    2017-01-01

    Investigating the ritual and social aesthetics of "petromorphic gods" in a Hindu context, this chapter demonstrates that it is not a single theoretical key but rather the interpretive combination of theories which allows one to understand how stones connect religious knowledge, performative action...... and the repertoire of used forms. The chapter demonstrates that neither anthropomorphic perceptions nor the agency of the stone material alone make up the ritual aesthetics in which the stones are involved. Rather, applying concepts from landscape phenomenology and cognitive theories including the role of material...

  17. Genetics Home Reference: bladder cancer

    Science.gov (United States)

    ... Testing Registry: Malignant tumor of urinary bladder Other Diagnosis and Management Resources (1 link) MedlinePlus Encyclopedia: Bladder Cancer General Information from MedlinePlus (5 links) Diagnostic Tests ...

  18. Drugs Approved for Bladder Cancer

    Science.gov (United States)

    ... Ask about Your Treatment Research Drugs Approved for Bladder Cancer This page lists cancer drugs approved by the ... that are not listed here. Drugs Approved for Bladder Cancer Atezolizumab Avelumab Bavencio (Avelumab) Cisplatin Doxorubicin Hydrochloride Durvalumab ...

  19. Nutritional Management of Kidney Stones (Nephrolithiasis)

    Science.gov (United States)

    Segal, Adam M.; Seifter, Julian L.; Dwyer, Johanna T.

    2015-01-01

    The incidence of kidney stones is common in the United States and treatments for them are very costly. This review article provides information about epidemiology, mechanism, diagnosis, and pathophysiology of kidney stone formation, and methods for the evaluation of stone risks for new and follow-up patients. Adequate evaluation and management can prevent recurrence of stones. Kidney stone prevention should be individualized in both its medical and dietary management, keeping in mind the specific risks involved for each type of stones. Recognition of these risk factors and development of long-term management strategies for dealing with them are the most effective ways to prevent recurrence of kidney stones. PMID:26251832

  20. Laser cleaning of graffiti on stone

    Science.gov (United States)

    Atanassova, Victoria; Kostadinov, Ivan; Zahariev, Peter; Grozeva, Margarita; Miloushev, Ilko

    2016-01-01

    In present days graffiti is a common problem that many restorers have to deal with due to both its unaesthetic appearance and damaging nature for the surface beneath. We report laser cleaning of graffiti paints (black, white, blue, green and red) on limestone and granite. The efficiency of two laser systems is compared: high repetition rate (20 kHz) Copper Bromide Vapor Laser (CuBrVL) generating wavelength 510.6 nm and low repetition rate (up to 10 Hz) Q-switched Nd:YAG laser generating fundamental wavelength 1064 nm and its second harmonic 532 nm. The surface condition of the stone samples before and after cleaning is evaluated by means of optical microscopy. On that base, suitable working parameters are chosen in order to avoid under- or over-cleaning.

  1. The Swedish Bohus granite - a stone with a fascinating history

    Science.gov (United States)

    Schouenborg, Björn; Eliasson, Thomas

    2015-04-01

    One of the most well-known and well spread Swedish stone types used as building stones is the Bonus granite. It outcrops in an area north of Gothenburgh (SW Sweden), along the coastline, approximately 35 km wide and 85 km long. The granite continues into Norway as the Iddefjord granite. The Bohus granite is one of Sweden's youngest granites. Isotopic dating shows that the magma cooled at about 920 M years ago and thus marking the end of the Sveconorwegian orogoney. It is a composite granite massif area with several granitic intrusions but with rather homogeneous mineralogy. However, colour and texture varies quite a lot and the colour ranges from red to reddish grey although some pure grey varieties occur sparsely. The grain size ranges from medium grained to coarse grained and even with some porphyric parts. Quarrying in an industrial scale started 1842. The merchant A C Kullgren opened the first quarry and produced stones for the construction of the 86 km long Trollhättan channel connecting lake Vänern and the Atlantic ocean in the SW Sweden The stone was used for constructing harbors and wharves along the channel. Several quarries opened in the late 1800 around 1870 - 1890 and the export increased steadily with deliveries to Germany, Denmark, Holland, England and even to South America. The stone industries in Bohuslän (Bohus county), at its peak in 1929, engaged around 7 000 employees. During the depression in 1930 almost all of them became unemployed. However, as a curiosity, production and export continued to Germany for construction of Germania, the future World capital city ("Welthauptstadt Germania"), planned by Adolf Hitler and Albert Speer. About 500 stone workers were kept employed for this project during the late thirties. Today several varieties are still produced: Evja/Ävja, Tossene, Brastad, Näsinge, Broberg, Nolby, Allemarken and Skarstad. However, the number of stone workers is far from that of the early 1900. The Swedish production is mainly

  2. Outcome of shock wave lithotripsy as monotherapy for large solitary renal stones (>2 cm in size without stenting

    Directory of Open Access Journals (Sweden)

    Shanmugasundaram Rajaian

    2010-01-01

    Full Text Available Purpose : To evaluate the outcome of shock wave lithotripsy (SWL as monotherapy for solitary renal stones larger than 2 cm without ureteral stenting. Materials and Methods : Our retrospective study included patients with solitary renal radio opaque stones larger than 2 cm treated with SWL using electromagnetic Dornier Compact S lithotripter device (Wessling, Germany for a period of 3 years (September 2002-2005. Stone clearance was assessed at 1 week, 1 month, and 3 months with plain X-rays of kidney, ureter, and bladder region, ultrasonography, and tomograms. Stone-free status, morbidity of the procedure, and fate of clinically insignificant residual fragments (CIRF were studied. A stone-free state was defined as no radiologic evidence of stone. Success was defined as complete clearance + CIRF. Results : Fifty-five patients, aged 11-65 years (mean 49.8 underwent SWL. Of them, only two were children. Male-to-female ratio was 3:1. The stone size was 21-28 mm (average 24 mm. The mean number of shocks were 3732 (range 724-12,100 and average energy level was 14 kV (range 11-16 kV. The mean follow-up was 18 months (range 3-22 months. Over all, stone-free status was achieved in 50% and success in 81% at 3 months. Stone clearance was not affected by stone location. Stones 26 mm (P = -0.10. Of 54 patients, 39 developed steinstrasse with mean length of 3.2 cm (range 1.4-6.2 cm and only four required intervention. Effectiveness quotient (EQ for SWL monotherapy for solitary renal stones more than 2 cm was 25.3%. The EQ for stones <25 mm and those more than 25 mm were 28.4% and 10% (P = -0.12, respectively. There was a lesser trend of difference between stones with size <25 and more than 25 mm. During the last review, the overall stone-free rate was 67.2%. Conclusions : SWL monotherapy was safe but significantly less effective for solitary renal stones larger than 2 cm. It can only be suggested to those who refuse surgical intervention. Pretreatment DJ

  3. Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis.

    Science.gov (United States)

    Yoshimura, Naoki; Oguchi, Tomohiko; Yokoyama, Hitoshi; Funahashi, Yasuhito; Yoshikawa, Satoru; Sugino, Yoshio; Kawamorita, Naoki; Kashyap, Mahendra P; Chancellor, Michael B; Tyagi, Pradeep; Ogawa, Teruyuki

    2014-04-01

    Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis. © 2014 The Japanese Urological Association.

  4. Ptotic Gall Bladder with Hepatic Masses: A Case Report

    Directory of Open Access Journals (Sweden)

    Hasan Aydin

    2013-01-01

    Full Text Available Gall bladder (GB may be found in a variety of abnormal positions. Most of them are due to arrested development of embryonic growth at different stages. A 63-year-old female patient was admitted to our radiology unit for magnetic resonance imaging (MRI of the liver for the lesions identified in abdominal ultrasonography (US and computed tomography (CT. MRI showed that there was a lobulated heterogenous mass in the left lobe of the liver and a smaller one in the right lobe of the liver with the same appearance. The inferior pole of the liver was located in the pelvic space, and the GB, which contained sludges and stones, was lying down to the upper pelvic space. Hepatic masses were considered to be hemangiomas, and GB was diagnosed as ptotic GB with luminal sludge and stones. In this case, especially, MR imaging helped the surgeon to plan a proper approach to the GB in abnormal localization.

  5. Histopathology Predicts the Mechanism of Stone Formation

    Science.gov (United States)

    Evan, Andrew P.

    2007-04-01

    About 5% of American women and 12% of men will develop a kidney stone at some time in their life and these numbers appear to be on the rise. Despite years of scientific research into the mechanisms of stone formation and growth, limited advances have been made until recently. Randall's original observations and thoughts on the mechanisms for kidney stone formation have been validated for idiopathic calcium oxalate stone formers (ICSF) but not for most other stone forming groups. Our current studies on selected groups of human stone formers using intraoperative papillary biopsies has shown overwhelming evidence for the presence of Randall's plaque in ICSF and that stone formation and growth are exclusively linked to its availability to urinary ions and proteins. Intense investigation of the plaque-stone junction is needed if we are to understand the factors leading to the overgrowth process on exposed regions of plaque. Such information should allow the development of treatment strategies to block stone formation in ICSF patients. Patients who form brushite stones, or who form apatite stones because of distal renal tubular acidosis (dRTA), or patients with calcium oxalate stones due to obesity bypass procedures, or patients with cystinuria, get plugged inner medullary collecting ducts (IMCD) which leads to total destruction of the lining cells and focal sites of interstitial fibrosis. These stone formers have plaque but at levels equal to or below non-stone formers, which would suggest that they form stones by a different mechanism than do ICSF patients.

  6. Stone technology: intracorporeal lithotripters.

    Science.gov (United States)

    Scotland, Kymora B; Kroczak, Tadeusz; Pace, Kenneth T; Chew, Ben H

    2017-09-01

    Intracorporeal lithotripsy is becoming the most commonly used surgical method of stone treatment in Urology. The five major types of intracorporeal lithotripters are ultrasonic, ballistic, and combination lithotripters as well as laser and electrohydraulic lithotripters. The advantages and disadvantages of choosing each of these treatment modalities are reviewed. Extensive review of literature was performed to identify the types of intracorporeal lithotripters. An investigation was undertaken of the early development of each modality of intracorporeal lithotripsy and/or the mechanism of action. Challenges of each technique were identified and presented. Finally, a determination was made of how these lithotripters compare on the basis of effectiveness of action and cost based on information provided in primary literature as well as previous reviews of these modalities. Contemporary lithotripters have found widespread use in the management of urinary lithiasis. Holmium laser lithotripsy has become one of the most commonly used tools for intracorporeal lithotripsy. There is a wide variety of intracorporeal lithotripters which can be chosen based on the characteristics of each modality and the requirements of the urologist.

  7. The artificial bladder.

    Science.gov (United States)

    Desgrandchamps, F; Griffith, D P

    1999-04-01

    An artificial bladder should provide adequate urine storage, allow volitional complete evacuation of urine and preserve renal function. Moreover, its structure has to be biocompatible, resistant to urinary encrustation and tolerant to bacterial infection. Various solutions have been proposed over the years to achieve these multiple requirements. However, most of these solutions and their corresponding prototypes did not advance beyond the stage of a preliminary report of experimental data. This review will bring out the 'proof of principal' in alloplastic prosthetic bladder, including type of alloplast and design concept and the recent development in tissue engineering approaches.

  8. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has...... experienced the symptoms for at least 6 weeks in the absence of any confusable diseases that may give rise to the symptoms. Symptoms compatible with the diagnosis are now thought to affect up to 3% of the female population in the United States with a 5:1 female-to-male preponderance. Diagnosis and treatment...

  9. [Study on SHI's Bian stone comprehensive therapy for rehabilitation after induced abortion].

    Science.gov (United States)

    Ran, Qing-zhen; Shi, An-li

    2009-02-01

    To explore the rehabilitation effect of SHI's Bian stone comprehensive therapy on the patient after induced abortion. Thirty cases of induced abortion were treated with SHI's Bian stone comprehensive therapy in peri-operative period. Before the operation, scraping therapy was given at the parts of The Urinary Bladder Channel and The Governor Vessel on the back and 30 min after the operation, the patient took a rest in a horizontal position on a mild heat Bian stone blanket and hot compress with a Bian stone plate was given at the lower abdomen. They received thrice return visits respectively on 1, 2, 3 weeks after the operation and SHI's Bian stone comprehensive therapy, including warm massage on The Governor Vessel, scraping the channel, patting Baliao (BL 31, BL 32, BL 33, BL 34), penetration needling Sanyinjiao (SP 6), oblique needling Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), Zigong (EX-CA 1), and the Bian stone plate was placed on the needle hand for warm compress. Colporrhagia, menstrual return, soreness of waist and other symptoms after the operation were observed. After SHI's Bian stone comprehensive therapy, in the patient of induced abortion the colporrhagia volume was less within 3 days after the operation and the colporrhagia stopped more early; of the 30 cases, only 2 has soreness of waist, abdominal pain, fearing cool and other symptoms, and only one case had obviously delayed mestrual cycle. SHI's Bian stone comprehensive therapy used in peri-operative period of induced abortion has a good promoting action on post operative rehabilitation.

  10. Pathogenesis and prevention of residual gall bladder: Report of three cases and review of literature

    Directory of Open Access Journals (Sweden)

    Usha Dalal

    2014-01-01

    Full Text Available Cholecystectomy is a common surgery performed for uncomplicated symptomatic gall stones as a definitive procedure. For complicated cases, partial or modified subtotal cholecystectomy has been described as an easy, safe, and definitive option. But, insufficient cholecystectomy leaving behind gall bladder may lead to persistence or recurrence of the biliary symptoms. We are presenting three cases, in which open partial cholecystectomy had been performed at a peripheral hospital on patients admitted with agonizing biliary type of pain. All the patients underwent re-exploration and successful removal of residual gall bladder tissues, leading to complete resolution of symptoms. The patients were doing well at one year of follow-up.

  11. Purbeck Stone - A possible Global Heritage Stone from England

    Science.gov (United States)

    Marker, Brian

    2014-05-01

    By definition, a Global Heritage Stone Resource (GHSR) should have international significance. The Purbeck Group of uppermost Jurassic to lowermost Cretaceous age (Tithonian- Berriasian) outcrops mainly in the Purbeck area of Dorset, England. It was deposited in shallow freshwater to brackish lagoons with occasional marine incursions. Limestones, mainly biosparites, occur at 6 main levels. Differences in bed thickness, jointing and hardness make it suitable for a variety of purposes including dimension stone, monumental and ornamental stone, roofing tiles, paving, flooring and rockery stone. Near the top of the sequence is a dark gastropod biosparite, traditionally called Purbeck Marble, easily carved, which has been extensively used for decorative interior work in churches and cathedrals particularly for fonts, tombs, flooring and facings on columns for example in the medieval cathedrals of Salisbury, Exeter, Durham, York and Wells and Worcester and Westminster Abbey. The stone was extracted at least from Roman times (1st century AD) through the medieval period. Quarrying expanded from about 1700 reaching a peak in the late 18th and 19th centuries. Stone was transported first by sea but later by rail for wider use. Used in many local buildings, it gives an important element of local character. Many of the villages are designated conservation areas with a requirement for repair, maintenance and new building using local stone. Initially the stone was taken from quarries but was later mined. The number of operating companies declined from 15 to 5 over the past 40 years, with 10 active small quarries. Outputs are from few hundred tonnes to a few thousand tonnes per annum or about 9 to 12 years of permitted reserves but the Planning Authority intends to make sufficient provision for production at recent levels for their development plan period. The extraction sites are in an Area of Outstanding Natural Beauty and close to Jurassic Coast World Heritage Site. This might

  12. Regional differences in constituents of gall stones.

    Science.gov (United States)

    Ashok, M; Nageshwar Reddy, D; Jayanthi, V; Kalkura, S N; Vijayan, V; Gokulakrishnan, S; Nair, K G M

    2005-01-01

    The pathogenesis of pigment and mixed gall stone formation remains elusive. The elemental constituents of gall stones from southern states of Tamil Nadu, Kerala and Karnataka have been characterized. Our aim was to determine the elemental concentration of representative samples of pigment, mixed and cholesterol gall stones from Andhra Pradesh using proton-induced X-ray emission (PIXE) using a 3 MV horizontal pelletron accelerator. Pigment gall stones had significantly high concentrations of copper, iron and lead; chromium was absent. Except for iron all these elements were significantly low in cholesterol gall stones and intermediate levels were seen in mixed gall stones. Highest concentrations of chromium was seen in cholesterol and titanium in mixed gall stones respectively; latter similar to other southern states. Arsenic was distinctly absent in cholesterol and mixed gall stones. The study has identified differences in elemental components of the gall stones from Andhra Pradesh.

  13. Leiomyoma of Bladder

    Directory of Open Access Journals (Sweden)

    Sudhakar P

    2008-01-01

    Full Text Available A case of leiomyoma of urinary bladder, a rare benign tumor, is presented. The patient was a 45-year-old woman with long duration history of dysuria. Intravenous urography (IVU, ultrasound (US, computed tomography (CT and biopsy diagnosed this case accurately. The clinical presentation, imaging findings and management of this benign tumor are discussed.

  14. Postmenopausal overactive bladder

    Directory of Open Access Journals (Sweden)

    Jacek Tomaszewski

    2014-12-01

    Full Text Available Bladder storage symptoms have a severe impact on many areas as regards the quality of life including health-related, social, psychological and working functions. Pharmacotherapy of lower urinary tract stores (LUTS has been developed to optimize neural control of the lower urinary tract in pathologic states. The bladder can be overactive or underactive. Overactive bladder (OAB is highly prevalent and is associated with considerable morbidity, especially in aging population. Therefore, an effective treatment of OAB must result in a meaningful reduction in urinary symptoms. Pharmacotherapy for the OAB must be individualized based on the degree of bother, medication side-effect profile, concomitant comorbidities and current medication regimen. Antimuscarinic agents will continue to represent the current gold standard for the first-line pharmacological management of OAB. Alternatively to antimuscarinic therapy, 3-adrenergic receptor agonists, due to their efficacy and favorable adverse event profile, are a novel and attractive option of pharmacological treatment of overactive bladder symptoms. A combination of selective antimuscarinic and 3-adrenergic receptor agonists, agents with the different mechanism of action, gives a new treatment option for the patient with OAB according to its harms profile. A number of putative novel therapeutic agents is under clinical evaluations that may ultimately provide alternative or combination treatment options for OAB in the nearest future.

  15. Radiotherapy of bladder cancer

    International Nuclear Information System (INIS)

    Ikeda, Yoshiyuki

    1978-01-01

    Methods of treating bladder cancer include surgery, radiotherapy and chemotherapy, as well as various combinations of these. The author investigated clinically and histopathologically the therapeutic results of preoperative irradiation in cases of bladder cancer. 1. The survival rates (crude survival rates) in forty cases of bladder cancer were 90% after one year, 62.5% after three years and 46% after five years from the treatment. 2. As the result of irradiation, urogram improved in 25%, which was comparatively remarkable in high stage cases. There were no cases of deterioration of urogram findings caused by irradiation. Cystoscopy revealed disappearance or remarkable shrinkage of the tumors in 35% of the total cases and effects of the irradiation was observed not correlated to the stage and grade. 3. With respect to the histopathological changes, the changes became greater as the dosage increased and the higher the stage and grade were the more remarkable tendency was observed. 4. From our clinical observations such as urogram, cystoscopy and histopathologically, we estimated the optimum dosage of preoperative irradiation for bladder cancer is 3000 - 4000 rad. Thus, we concluded that the radiotherapy is effective in reducing both surgical invasion and postoperative recurrence. (author)

  16. Stepping Stones through Time

    Directory of Open Access Journals (Sweden)

    Emily Lyle

    2012-03-01

    Full Text Available Indo-European mythology is known only through written records but it needs to be understood in terms of the preliterate oral-cultural context in which it was rooted. It is proposed that this world was conceptually organized through a memory-capsule consisting of the current generation and the three before it, and that there was a system of alternate generations with each generation taking a step into the future under the leadership of a white or red king.

  17. A survey to assess body and self-image in individuals with bladder exstrophy: a call for psychosocial support.

    Science.gov (United States)

    Pennison, Melanie C; Mednick, Lauren; Grant, Rosemary; Price, Diane; Rosoklija, Ilina; Huang, Lin; Ziniel, Sonja; Borer, Joseph G

    2013-10-01

    Although research in patients with urological conditions indicates that functional limitations, pain, limited mobility and social restrictions can impact self-image, to our knowledge the influence of the visibility of the condition has not been examined. We assessed body image and self-image at school age through young adulthood in patients with bladder exstrophy compared to patients with kidney stones. Patients diagnosed with bladder exstrophy and kidney stones completed a 25-item multiple choice Urological Body Image Questionnaire for ages 13 to 25 years, which was created for the current study. It consists of questions on physical appearance, avoidance behaviors, urological condition disclosure, romantic relationships and future expectations. A modified Urological Body Image Questionnaire for patients 8 to 12 years old was created by removing questions on relationships and future expectations. A total of 24 patients with bladder exstrophy and 24 with kidney stones 8 to 25 years old completed the questionnaire. Compared to patients with kidney stones, patients with bladder exstrophy were significantly more likely to avoid changing clothes in front of peers and to not tell friends about the condition (each p = 0.0001). Patients with bladder exstrophy were also significantly more likely to think that the condition would prevent having future romantic relationships (p = 0.002) and children (p = 0.003). Differences in the visibility and privacy of the 2 conditions likely explain the discrepancy between the groups. Findings may call for an individual approach to assessing issues related to self-esteem and identity in patients with bladder exstrophy and may highlight the importance of receiving psychosocial support. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. [Giant lithiasis due to urinary stasis related to ileo-caecal bladder].

    Science.gov (United States)

    Dergamoun, Hamza; El Makhoukhi, Zayd El Boukili

    2017-01-01

    Bladder exstrophy is a malformation characterized by subumbilical anterior abdominal wall and anterior bladder wall deishence. It affects nearly 30.000-40.000 births per year, with a higher prevalence in boys. External continent urinary diversion creates a long-term outcome. However, it is not devoid of complications. We report the case of a 30-year old female patient who had undergone cystectomy with bladder replaced with ileo-caecal segment for bladder exstrophy 13 years earlier. She was followed up for 5 years and then lost to follow up. In March 2017 she presented with painful abdominal heaviness as well as constipation evolving in a context of apyrexy and good general condition. Clinical examination showed good general health, midline laparotomy scar, continent uninvaginated urinary pouch valve. Pelvic examination was unremarkable. Hypogastric palpation showed nonpainful stony-hard mass. Urinary tract without preparation showed calcic opacity 130*110 mm as well as symphysis disjunction. Renal and pelvic ultrasound showed several hyperechogen images with posterior shadow cone occupying the pelvis, two well differentiated kidneys of normal size without ureteric hydronephrosis. CT urography showed 5 big calcium stones with an average density of 730 UH, the most voluminous of which measured 112*101 mm, in the neobladder. Renal function was normal and cytobacteriological examination of urine showed ESBL-producing E coli urinary tract infection sensitive to carbapenems. Treatment was based on suitable antibiotic therapy associated with entero-cystolithotomy involving laborious extraction of 5 big stones. Spectrophotometric examination revealed phospho-ammonium-magnesium stones. The postoperative course was uneventful, post operative urinary tract without preparation showed no stones.

  19. Green stone beads at the dawn of agriculture

    Science.gov (United States)

    Bar-Yosef Mayer, Daniella E.; Porat, Naomi

    2008-01-01

    The use of beads and other personal ornaments is a trait of modern human behavior. During the Middle and Upper Paleolithic periods, beads were made out of shell, bone, ivory, egg shell, and occasionally of minerals. During the transition to agriculture in the Near East, stone, in particular green stone, was used for the first time to make beads and pendants. We observed that a large variety of minerals of green colors were sought, including apatite, several copper-bearing minerals, amazonite and serpentinite. There seems to be an increase with time of distance from which the green minerals were sought. Because beads in white, red, yellow, brown, and black colors had been used previously, we suggest that the occurrence of green beads is directly related to the onset of agriculture. Green beads and bead blanks were used as amulets to ward off the evil eye and as fertility charms. PMID:18559861

  20. Pebbles in Your Plumbing: Flushing Kidney Stones

    Science.gov (United States)

    ... your urine. Stones vary in size from tiny crystals that can only be seen with a microscope ... in the future. “Probably one of the most important reasons why people form stones is dehydration,” Kirkali ...

  1. Kidney Stones in Children and Teens

    Science.gov (United States)

    ... Email Print Share Kidney Stones in Children and Teens Page Content Article Body ​Kidney stones are hard ... age, even in premature infants , most occur in teens , with teen girls having the highest incidence. Types ...

  2. Treatment alternatives for urinary system stone disease in preschool aged children: results of 616 cases.

    Science.gov (United States)

    Sen, Haluk; Seckiner, Ilker; Bayrak, Omer; Erturhan, Sakip; Demirbağ, Asaf

    2015-02-01

    The treatment of stone disease is mostly similar in those adult and children. The standard treatment procedures are as follows: extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS), percutaneous nephrolithotomy (PCNL), and laparoscopic surgery in selected cases. Open surgery (OS) is another option particularly in such cases with anatomic abnormalities of urinary tract. The present study aims to provide comparative results of stone removal procedures in preschool aged patients who were diagnosed with urinary system stone disease. The retrospective data of 616 pediatric preschool patients consulted with urinary system stone disease between January 2009 and July 2013 were evaluated. All patients were evaluated with Kidney-Ureter-Bladder (KUB) Xray and abdomino-pelvic ultrasound. Intravenous pyelography, unenhanced computed tomography (CT), and renal scintigraphy were performed when needed. Patients were categorized according to the procedures as: Group ESWL, Group URS, Group PNL, Group micro-PNL and Group OS. Following the procedures, opaque residual stones were evaluated with KUB Xray, and non-opaque residual stones were evaluated with unenhanced CT. In groups (ESWL, URS, PNL, micro-PNL, OS), the stone-free rate was 68%, 66%, 85%, 100% and 94 %, respectively. The stone analysis were observed as, calcium oxalate in 377 patients (61.2%), uric acid in 106 patients (17.2%), infection stone in 73 patients (11.8 %), and cysteine in 60 patients (9.7%). There was no significant difference in stone analysis between the groups (p > 0.05) (Table). Minimally invasive procedures are frequently preferred in the pediatric age urinary system stone disease. These procedures are ESWL, PCNL, and ureteroscopy [10,11]. Open surgery is reserved only for rare cases [12]. Similarly the current literature, 18 (2.9%) patients had anatomical anomaly and had high complex stone burden were treated with open surgery in our study. ESWL is a preferred treatment method for pediatric

  3. Innovation in Bladder Cancer Immunotherapy.

    Science.gov (United States)

    Grossman, H Barton; Lamm, Donald L; Kamat, Ashish M; Keefe, Stephen; Taylor, John A; Ingersoll, Molly A

    2016-10-01

    Bladder cancer is understudied despite its high prevalence and its remarkable response to immunotherapy. Indeed, funding for studies to explore mechanisms of tumor immunity and novel new therapeutics is disproportionately lower for bladder cancer in comparison with malignancies of the breast, prostate, or lung. However, the recent successes of checkpoint blockade therapy suggest that new therapeutic strategies are on the horizon for bladder cancer. Here, we give a perspective into the evolution of bladder cancer therapy, focusing on strategies to treat high-risk nonmuscle invasive disease, followed by a discussion of recent advances in the treatment of muscle invasive bladder cancer and their potential applicability to lower stage disease. Finally, we explore immunotherapeutic strategies, which have been demonstrated to be successful in the treatment of other malignancies, for their potential to treat and cure patients with nonmuscle and muscle invasive bladder cancer.

  4. Radiotherapy in bladder cancer

    International Nuclear Information System (INIS)

    Rozan, R.

    1992-01-01

    In 1992, the problem of the vesical radiotherapy is not resolved. The author presents the situation and the different techniques of radiotherapy in bladder cancers: external radiotherapy, only and associated with surgery, interstitial curietherapy and non-classical techniques as per operative radiotherapy, neutron therapy and concurrent radiotherapy with chemotherapy. In order to compare their efficiency, the five-year survival are given in all cases.(10 tabs)

  5. Pathophysiology of overactive bladder.

    Science.gov (United States)

    Banakhar, Mai A; Al-Shaiji, Tariq F; Hassouna, Magdy M

    2012-08-01

    Overactive bladder (OAB) is a common disorder that negatively affects the quality of life of our patients and carries a large socioeconomic burden. According to the International Continence Society, it is characterized as urinary urgency, with or without urge incontinence, usually, with frequency and nocturia in the absence of causative infection. The pathophysiology of this disease entity varies between neurogenic, myogenic, or idiopathic factors. This paper provides a review of the contemporary theories behind the pathophysiology of OAB.

  6. The role of oxidative stress in bladder cancer

    Directory of Open Access Journals (Sweden)

    Ewa Sawicka

    2015-07-01

    Full Text Available The review of the knowledge concerning the impact of oxidative and nitrosative stress on signaling pathways and transcription factors involved in the formation of bladder cancer was prepared. In the industrialized countries, bladder cancer is the fourth most frequently occurring malignant tumors. Recent studies indicate the involvement of oxidative and nitrosative stress in the formation and development of this disease. Red-ox disorders are characteristic for both, the initiation and progression of bladder cancer. There are observed changes in the activity of transcription factors, such as nuclear factor NF-kB; transcription factors: AP-1, Nrf2 and STAT3 and hypoxia-inducible factor HIF-1α. In addition, studies indicate a role for oxidative stress in the regulation of MAPK cascade and its involvement in carcinogenesis consisting bladder. Examples of kinases belonging to the MAPK family are ERK kinases, which expression is proportional to the severity and malignant of bladder cancer. Nitric oxide also plays an important role in tumor biology. Overproduction of NO can both inhibit and promote tumor growth, depending on its concentration, duration of action and tumor microenvironment. Numerous studies show that the bladder cancer is characterized by an intensified production of NO. Reactive forms of nitrogen, similar to oxygen free radicals, could cause oxidative and nitrosative damage to DNA and have capacity to post-translational modification of proteins. In contrast to the ROS, which overproduction result from exposure to carcinogenic xenobiotic, nitrogen oxide in high level is produced during inflammation. Sustained iNOS activity therefore plays an important role in carcinogenesis associated with the inflammatory response, characteristic also for bladder cancer.

  7. Pathological diagnosis of bladder cancer by image analysis of hypericin induced fluorescence cystoscopic images

    Science.gov (United States)

    Kah, James C. Y.; Olivo, Malini C.; Lau, Weber K. O.; Sheppard, Colin J. R.

    2005-08-01

    Photodynamic diagnosis of bladder carcinoma based on hypericin fluorescence cystoscopy has shown to have a higher degree of sensitivity for the detection of flat bladder carcinoma compared to white light cystoscopy. The potential of the photosensitizer hypericin-induced fluorescence in performing non-invasive optical biopsy to grade bladder cancer in vivo using fluorescence cystoscopic image analysis without surgical resection for tissue biopsy is investigated in this study. The correlation between tissue fluorescence and histopathology of diseased tissue was explored and a diagnostic algorithm based on fluorescence image analysis was developed to classify the bladder cancer without surgical resection for tissue biopsy. Preliminary results suggest a correlation between tissue fluorescence and bladder cancer grade. By combining both the red-to-blue and red-to-green intensity ratios into a 2D scatter plot yields an average sensitivity and specificity of around 70% and 85% respectively for pathological cancer grading of the three different grades of bladder cancer. Therefore, the diagnostic algorithm based on colorimetric intensity ratio analysis of hypericin fluorescence cystoscopic images developed in this preliminary study shows promising potential to optically diagnose and grade bladder cancer in vivo.

  8. Superficial Bladder Cancer Therapy

    Directory of Open Access Journals (Sweden)

    Emmanuel Schenkman

    2004-01-01

    Full Text Available Bladder cancer treatment remains a challenge despite significant improvements in preventing disease progression and improving survival. Intravesical therapy has been used in the management of superficial transitional cell carcinoma (TCC of the urinary bladder (i.e. Ta, T1, and carcinoma in situ with specific objectives which include treating existing or residual tumor, preventing recurrence of tumor, preventing disease progression, and prolonging survival. The initial clinical stage and grade remain the main determinant factors in survival regardless of the treatment. Prostatic urethral mucosal involvement with bladder cancer can be effectively treated with Bacillus Calmette-Guerin (BCG intravesical immunotherapy. Intravesical chemotherapy reduces short-term tumor recurrence by about 20%, and long-term recurrence by about 7%, but has not reduced progression or mortality. Presently, BCG immunotherapy remains the most effective treatment and prophylaxis for TCC (Ta, T1, CIS and reduces tumor recurrence, disease progression, and mortality. Interferons, Keyhole-limpet hemocyanin (KLH, bropirimine and Photofrin-Photodynamic Therapy (PDT are under investigation in the management of TCC and early results are encouraging. This review highlights and summarizes the recent advances in therapy for superficial TCC.

  9. Clinical implications of underactive bladder

    Directory of Open Access Journals (Sweden)

    Kwang Jin Ko

    2017-12-01

    Full Text Available Underactive bladder (UAB is a common urologic condition but a complex disease that causes troublesome lower urinary tract symptoms. Currently, management of UAB remains unsatisfactory. Also, many urological diseases can be combined with UAB. In these combined cases, the treatment results may be affected by UAB component. This review focuses on the clinical implications of UAB in patients with common urologic conditions, including bladder outlet obstruction, overactive bladder syndrome and stress urinary incontinence.

  10. Interstitial cystitis: painful bladder syndrome

    OpenAIRE

    R F Sholan; G Sh Garaev; G M Nasrullaeva

    2018-01-01

    Interstitial cystitis, or painful bladder syndrome, is a chronic inflammatory disease of a bladder of unknown etiology. It negatively affects the quality of life, causes depressive disorders, anxiety, and sexual dysfunction. Despite numerous studies, the etiology of interstitial cystitis is still unclear and it’s considered as painful bladder syndrome with multifactorial origin. According to the US National Health and Nutrition Examination Survey, 470/100 000 people (60/100 000 men, 850/100 0...

  11. Contemporary Management of Bladder Cancer

    Science.gov (United States)

    Bell, David; Fradet, Yves

    1991-01-01

    Bladder cancer is currently the fifth most common cancer in Western society, and its incidence appears to be increasing. Important advances have recently occurred in both diagnostic and therapeutic approaches to bladder neoplasms. Presentation is not unique, and physician awareness is important to identify patients who are at risk for bladder neoplasia and consequently require further investigation. A diagnostic approach and contemporary management are discussed. ImagesFigure 1Figure 4 PMID:21229043

  12. Traumatic injury of the bladder and urethra

    Science.gov (United States)

    Injury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption ... Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  13. Permeability and ultrastructure of human bladder epithelium

    DEFF Research Database (Denmark)

    Eldrup, J; Thorup, Jørgen Mogens; Nielsen, S L

    1983-01-01

    Leakage of tight junctions as observed with electron microscopy and demonstration of solute transport across bladder epithelium was investigated in 13 patients with different bladder diseases: urinary retention and infection, bladder tumours and interstitial cystitis. The latter group showed cons...

  14. Bladder Outlet Obstruction: Causes in Men?

    Science.gov (United States)

    Bladder outlet obstruction: Causes in men? My doctor says I might have bladder outlet obstruction. What does that mean? Answers from Erik P. Castle, M.D. Bladder outlet obstruction in men is a blockage that slows ...

  15. Intraperitoneal stone migration during percutaneos nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Akif Diri

    2014-12-01

    Full Text Available Percutaneos nephrolithotomy (PNL is the standard care for renal stones larger than 2 cm. The procedure has some major and minor complications. Renal pelvis laceration and stone migration to the retroperitoneum is one of the rare condition. We report the first case of intraperitoneal stone migration during PNL.

  16. OVERACTIVE BLADDER SYNDROME IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E.L. Vishnevskiy

    2007-01-01

    Full Text Available Overactive bladder is a specific syndrome characterized by bladder dysfunction that is clinically manifested by imperative urination (pollakiuria, urgency, urgent incontinence and nocturia. This state is very widely spread among children: every fifth child aged 4 to 7 shows typical bladder dysfunction. Quite often if urinary distresses are not studied well enough such children are falsely diagnosed with monosymptom enuresis, which, according to our information, actually happens in only 3,9% of cases. When examining children with urinary disorders it is reasonable to be geared to the protocol of European urologist association. According to this protocol, treatment should be started with antimuscarinimedications. The only antimuscarinic medication for treating children with hyperactive bladder that is legal in Russia is oxybutinin (Driptane, that is presently considered to be the «golden standard» of pharmaceutical treatment of overactive bladder for patients of any age. This statement is based on the modern idea of overactive bladder pathogenesis, that presupposes detrusorhypersensibility to acetylcholine. However, in some cases it might be reasonable to use some other medications, physiotherapy, sometimes as part of complex therapy. If individual dosage is observed, which will enable preventing or significantly lowering possible side effects, oxybutinin will be still considered «the golden standard» for treating overactive bladder for years to come in cases when detrusor hypersensibility to acetylcholine is the key component of bladder dysfunction pathogenesis.Key words: overactive bladder, oxybutinin, urination disorder, children.

  17. The ground stones from Sphinx

    Czech Academy of Sciences Publication Activity Database

    Řídký, Jaroslav

    2017-01-01

    Roč. 2017, č. 21 (2017), s. 39-42 ISSN 1369-5770 Grant - others:GA ČR(CZ) GA17-03207S Institutional support: RVO:67985912 Keywords : Sudan * Mesolithic * ground stones Subject RIV: AC - Archeology, Anthropology, Ethnology OBOR OECD: Archaeology

  18. Grasping the Formless in Stones

    DEFF Research Database (Denmark)

    Aktor, Mikael

    2017-01-01

    Investigating the ritual and social aesthetics of "petromorphic gods" in a Hindu context, this chapter demonstrates that it is not a single theoretical key but rather the interpretive combination of theories which allows one to understand how stones connect religious knowledge, performative action...

  19. Diet for Kidney Stone Prevention

    Science.gov (United States)

    ... I eat or drink? Drinking enough liquid, mainly water, is the most important thing you can do to prevent kidney stones. Unless you have kidney failure , many health care professionals recommend that you drink six to eight, 8-ounce glasses a day. Talk with a health care professional about how ...

  20. Stones used in Milan architecture

    Directory of Open Access Journals (Sweden)

    Folli, Luisa

    2008-06-01

    Full Text Available The city of Milan lies in a plain with clayey soil well suited to brick-making, but no stone deposits. An ample supply of stone is available, however, in the surrounding hills and mountains, which are connected to the city via both natural and artificial waterways. The types of stone used since Roman times include: granite, marble and gneiss from Ossola Valley; dolomite from Lake Maggiore; detrital limestone from Ceresio Valley; sandstone from the Brianza Hills; black limestone and marble from Lake Como; and conglomerate and sandstone from the Adda River basin. Traditionally, the chief uses have been dimension stone (all stones, column shafts (granite, slabs (marble, moulding (dolomite, limestone and ornamental (marble, dolomite, limestone.La ciudad de Milán se encuentra en una llanura de suelo arcilloso adecuado para la fabricación de ladrillos pero en la cual no hay yacimientos de rocas. No obstante, en las colinas y montañas circundantes, que están comunicadas con la ciudad mediante vías navegables naturales y artificiales, sí existe una abundante cantidad de piedra. Entre los tipos de piedra utilizados desde la época de los romanos se encuentran granitos, mármoles y gneises del valle de Ossola, dolomías del lago Mayor, calizas detríticas del valle de Ceresio (Lugano, areniscas de las colinas de la Brianza, calizas negras y mármoles del lago Como y conglomerados y areniscas de la cuenca del río Adda. Tradicionalmente, los principales usos han sido la piedra de fábrica (todas ellas, fustes de columnas (granito, losas (mármol, molduras (dolomía, caliza y ornamental (mármol, dolomía, caliza.

  1. Association between chronic kidney disease and urinary calculus by stone location: a population-based study.

    Science.gov (United States)

    Keller, Joseph J; Chen, Yi-Kuang; Lin, Herng-Ching

    2012-12-01

    Study Type--Disease prevalence study (cohort design) Level of Evidence 2a. What's known on the subject? and What does the study add? Several studies have estimated the potential association of urinary calculus (UC) with chronic kidney disease (CKD). However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. We found that patients with CKD were consistently more likely than comparison subjects to have been previously diagnosed with kidney calculus (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified calculus (OR 1.89, 95% CI 1.74-2.06). We concluded that there was an association between CKD and UC regardless of stone location. • To explore the association of chronic kidney disease (CKD) with prior kidney calculus, ureter calculus, and bladder calculus using a population-based dataset in Taiwan. Several studies have estimated the potential association of urinary calculus (UC) with CKD. However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. • We identified 21,474 patients who received their first-time diagnosis of CKD between 2001 and 2009. • The 21,474 controls were frequency-matched with cases for sex, age group, and index year. • We used conditional logistic regression analyses to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) as an estimation of association between CKD and having been previously diagnosed with UC. • The results show that compared with controls, the OR of prior UC for cases was 1

  2. Clinical outcome of pediatric stone disease.

    Science.gov (United States)

    Pietrow, Paul K; Pope, John C; Adams, Mark C; Shyr, Yu; Brock, John W

    2002-02-01

    The natural history of stone disease in children is not well defined. We evaluated the clinical outcome in children with urinary calculi. An 8-year retrospective review of 129 pediatric patients with primary urinary lithiasis was performed. Age, renal versus ureteral stone location, stone size, spontaneous passage, recurrence and metabolic evaluation were considered. Patients were divided into groups 1-0 to 5, 2-6 to 10 and 3-11 to 18 years old. Of the 25 group 1 patients 17 (68%) had renal and 8 (32%) had ureteral stones. Of the 36 group 2 patients 13 (36%) had renal and 23 (64%) had ureteral stones. Of the 68 group 3 patients 12 (18%) had renal and 56 (82%) had ureteral stones. These differences in stone location according to age were not due to chance (p metabolic abnormalities believed responsible for stone disease was 50% in groups 1 and 2, and 38% in group 3. In all age groups there was symptomatic and/or radiographic stone recurrence in a third of the patients with an identifiable metabolic abnormality, such as hypercalciuria, hypocitruria, renal tubular acidosis and so forth. In children 10 years or younger this incidence increased to 50%. Less than 10% of those with no identifiable metabolic disorder have had recurrent stones to date. Younger patients are more likely to present with renal calculi and less likely to pass these stones, probably due to the relatively larger stone burden and location. The passage rate for ureteral calculi is surprisingly consistent in all age groups with stones greater than 5 mm. rarely passing spontaneously. Half of the children 10 years or younger who present with urinary calculi have an identifiable metabolic disorder. Thus, all children with stones should undergo metabolic evaluation. In addition, these children are nearly 5-fold more likely to have recurrent stones than those with no identifiable metabolic disorder. Thus, they should be followed aggressively.

  3. Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

    Science.gov (United States)

    Keay, Susan K.; Birder, Lori A.; Chai, Toby C.

    2014-01-01

    Understanding of the role of urothelium in regulating bladder function is continuing to evolve. While the urothelium is thought to function primarily as a barrier for preventing injurious substances and microorganisms from gaining access to bladder stroma and upper urinary tract, studies indicate it may also function in cell signaling events relating to voiding function. This review highlights urothelial abnormalities in bladder pain syndrome/interstitial cystitis (BPS/IC), feline interstitial cystitis (FIC), and nonneurogenic idiopathic overactive bladder (OAB). These bladder conditions are typified by lower urinary tract symptoms including urinary frequency, urgency, urgency incontinence, nocturia, and bladder discomfort or pain. Urothelial tissues and cells from affected clinical subjects and asymptomatic controls have been compared for expression of proteins and mRNA. Animal models have also been used to probe urothelial responses to injuries of the urothelium, urethra, or central nervous system, and transgenic techniques are being used to test specific urothelial abnormalities on bladder function. BPS/IC, FIC, and OAB appear to share some common pathophysiology including increased purinergic, TRPV1, and muscarinic signaling, increased urothelial permeability, and aberrant urothelial differentiation. One challenge is to determine which of several abnormally regulated signaling pathways is most important for mediating bladder dysfunction in these syndromes, with a goal of treating these conditions by targeting specific pathophysiology. PMID:24900993

  4. Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

    Directory of Open Access Journals (Sweden)

    Susan K. Keay

    2014-01-01

    Full Text Available Understanding of the role of urothelium in regulating bladder function is continuing to evolve. While the urothelium is thought to function primarily as a barrier for preventing injurious substances and microorganisms from gaining access to bladder stroma and upper urinary tract, studies indicate it may also function in cell signaling events relating to voiding function. This review highlights urothelial abnormalities in bladder pain syndrome/interstitial cystitis (BPS/IC, feline interstitial cystitis (FIC, and nonneurogenic idiopathic overactive bladder (OAB. These bladder conditions are typified by lower urinary tract symptoms including urinary frequency, urgency, urgency incontinence, nocturia, and bladder discomfort or pain. Urothelial tissues and cells from affected clinical subjects and asymptomatic controls have been compared for expression of proteins and mRNA. Animal models have also been used to probe urothelial responses to injuries of the urothelium, urethra, or central nervous system, and transgenic techniques are being used to test specific urothelial abnormalities on bladder function. BPS/IC, FIC, and OAB appear to share some common pathophysiology including increased purinergic, TRPV1, and muscarinic signaling, increased urothelial permeability, and aberrant urothelial differentiation. One challenge is to determine which of several abnormally regulated signaling pathways is most important for mediating bladder dysfunction in these syndromes, with a goal of treating these conditions by targeting specific pathophysiology.

  5. Kidney stones: pathophysiology, diagnosis and management.

    Science.gov (United States)

    Cunningham, Priscilla; Noble, Helen; Al-Modhefer, Abdul-Kadhum; Walsh, Ian

    2016-11-10

    The prevalence of kidney stones is increasing, and approximately 12 000 hospital admissions every year are due to this condition. This article will use a case study to focus on a patient diagnosed with a calcium oxalate kidney stone. It will discuss the affected structures in relation to kidney stones and describe the pathology of the condition. Investigations for kidney stones, differential diagnosis and diagnosis, possible complications and prognosis, will be discussed. Finally, a detailed account of management strategies for the patient with kidney stones will be given, looking at pain management, medical procedures and dietary interventions.

  6. Clinical experience with EDAP LT-01+ extracorporeal shock wave lithotripsy for radiolucent stones; a report of 27 cases

    International Nuclear Information System (INIS)

    Rim, Hee Kwan; Kim, Ho Sung; Rim, Joung Sik

    1994-01-01

    Between February 1990 and February 1993, Radiolucent stones of 27 renal units in 22 patients were treated by extracorporeal shock wave lithotripsy (ESWL) using the EDAP LT-01+. Intravenous urography was done in all patients for the diagnosis of radiolucent stones. Retrograde pyelography, ultrasonography and/or computed tomography was done, if needed. The locations of stones were kidney in 11(40.7 %), upper ureter in 8(29.6 %), lower ureter in 6(22.2 %), bladder in 1(3.7 %), ureteropelvic junction in 1(3.7 %). The average stone size was 10.9mm with a range of 5 to 32mm in maximum diameter. The average numbers of treatment were 2.7 sessions and average storage required was 34.8 in one session. The average treatment time was 40.4 minutes. All the patients showed complete removal of all calculous materials. Of 17 urinary stones analysed by chemical method, 8(47.1 %) were composed of uric acid, 5(29.4 %) of uric acid and calcium, 3 of phosphate and 1 of carbonate and phosphate. Therefore, we conclude that ESWL with EDAP LT-01+ lithotriptor is considered to be an effective noninvasive procedure for treatment of radiolucent stones. (Author)

  7. Postmortem MRI of bladder agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Brendan R. [St George' s Hospital, Radiology Department, London (United Kingdom); Weber, Martin A. [Great Ormond Street Hospital for Children, Department of Histopathology, London (United Kingdom); Bockenhauer, Detlef [Great Ormond Street Hospital for Children, Department of Nephrology, London (United Kingdom); Hiorns, Melanie P.; McHugh, Kieran [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom)

    2011-01-15

    We report a 35-week preterm neonate with bladder agenesis and bilateral dysplastic kidneys. A suprapubic catheter was inadvertently inserted into one of the larger inferior cysts of the left dysplastic kidney. A postmortem MRI scan was performed with the findings being confirmed on autopsy. We are unaware of another postmortem MRI study demonstrating bladder agenesis. (orig.)

  8. Molecular Diagnosis in Bladder Cancer

    NARCIS (Netherlands)

    T.C.M. Zuiverloon (Tahlita)

    2013-01-01

    textabstractEpidemiologyBladder cancer (BC) is the most prevalent type of urothelial cancer and is associated with thehighest costs of all cancer types due to intensive patient surveillance. Because bladder tumorsfrequently recur, patients need to be monitored extensively [1-4]. Incidence increases

  9. Vulvar Metastasis from Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Vulvar metastasis of urothelial carcinoma of the bladder is a very rare entity; few cases are reported in the English literature. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of a patient with vulvar metastasis of urothelial carcinoma of the bladder followed by a brief review of the reported cases in the literature.

  10. Postmortem MRI of bladder agenesis

    International Nuclear Information System (INIS)

    Barber, Brendan R.; Weber, Martin A.; Bockenhauer, Detlef; Hiorns, Melanie P.; McHugh, Kieran

    2011-01-01

    We report a 35-week preterm neonate with bladder agenesis and bilateral dysplastic kidneys. A suprapubic catheter was inadvertently inserted into one of the larger inferior cysts of the left dysplastic kidney. A postmortem MRI scan was performed with the findings being confirmed on autopsy. We are unaware of another postmortem MRI study demonstrating bladder agenesis. (orig.)

  11. Immunotherapy for bladder cancer

    Directory of Open Access Journals (Sweden)

    Fuge O

    2015-05-01

    Full Text Available Oliver Fuge,1 Nikhil Vasdev,1 Paula Allchorne,2 James SA Green2 1Department of Urology, Lister Hospital, Stevenage, UK; 2Department of Urology, Bartshealth NHS Trust, Whipps Cross Rd, London, UK Abstract: It is nearly 40 years since Bacillus Calmette–Guérin (BCG was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest

  12. Basic bladder neurophysiology.

    Science.gov (United States)

    Clemens, J Quentin

    2010-11-01

    Maintenance of normal lower urinary tract function is a complex process that requires coordination between the central nervous system and the autonomic and somatic components of the peripheral nervous system. This article provides an overview of the basic principles that are recognized to regulate normal urine storage and micturition, including bladder biomechanics, relevant neuroanatomy, neural control of lower urinary tract function, and the pharmacologic processes that translate the neural signals into functional results. Finally, the emerging role of the urothelium as a sensory structure is discussed. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

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    Shu-Yu Wu

    2016-12-01

    Conclusion: There are obvious differences in bladder CT scans of patients with symptoms of bladder pain due to different etiology. Increased BWT was associated with increased pain scores and decreased bladder capacity in patients with KC and IC. BWT on a CT scan might be considered a marker for the severity of bladder inflammation.

  14. Comparison of secondary signs as shown by unenhanced helical computed tomography in patients with uric acid or calcium ureteral stones

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    Yii-Her Chou

    2012-06-01

    Full Text Available Unenhanced helical computed tomography (UHCT has evolved into a well-accepted diagnostic method in patients with suspected ureterolithiasis. UHCT not only shows stones within the lumen of the ureter, it also permits evaluation of the secondary signs associated with ureteral obstruction from stones. However, there we could find no data on how secondary signs might differ in relation to different compositions of ureteral stones. In this study, we compared the degree of secondary signs revealed by UHCT in uric acid stone formers and in patients forming calcium stones. We enrolled 117 patients with ureteral stones who underwent UHCT examination and Fourier transform infra-red analysis of stone samples. Clinical data were collected as follows: age, sex, estimated glomerular filtration rate (eGFR, urine pH, and radiological data on secondary signs apparent on UHCT. The uric acid stone formers had significantly lower urine pH and eGFR in comparison to calcium stone formers, and on UHCT they also had a higher percentage of the secondary signs, including rim sign (78.9% vs. 60.2%, hydroureter (94.7% vs. 89.8%, perirenal stranding (84.2% vs. 59.2% and kidney density difference (73.7% vs. 50.0%. The radiological difference was statistically significant for perirenal stranding (p=0.041. In conclusion, we found that UHCT scanning reveals secondary signs to be more frequent in patients with uric acid ureteral stones than in patients with calcium stones, a tendency that might result from an acidic urine environment.

  15. Characterisation of urinary stones in the presence of iodinated contrast medium using dual-energy CT: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jia; Qu, Mingliang; Duan, Xinhui; Takahashi, Naoki; Kawashima, Akira; Leng, Shuai; McCollough, Cynthia H. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2012-12-15

    To develop a dual-energy CT (DECT) method for differentiating uric acid (UA) from non-UA stones in the presence of iodinated contrast medium. Thirty UA and 45 non-UA stones were selected after infra-red spectroscopic analysis and independently placed in a 1.5-ml vial, which was filled first with saline and then with increasing concentrations of iodine. For each condition, tubes were put in a 35-cm water phantom and examined using a dual-source CT system at 100 and 140 kV. Virtual unenhanced images created from CT data sets of the stones in iodine-containing solutions provided position and volume information. This map was used to calculate a CT number ratio to differentiate stone type. A region-growing method was developed to improve the ability to differentiate between UA and non-UA stones with iodinated contrast medium. The sensitivity for detecting UA stones was 100 % for unenhanced images but fell to 18 % with 20 mgI/ml iodine solution and 0 % for higher concentrations. With region growing, the sensitivity for detecting UA stones was increased to 100 %, 82 %, 57 %, 50 % and 21 % for iodine solutions of 20, 40, 60, 80 and 100 mgI/ml. The region-growing method improves differentiation of UA from non-UA stones on contrast-enhanced DECT urograms. (orig.)

  16. Characterisation of urinary stones in the presence of iodinated contrast medium using dual-energy CT: a phantom study

    International Nuclear Information System (INIS)

    Wang, Jia; Qu, Mingliang; Duan, Xinhui; Takahashi, Naoki; Kawashima, Akira; Leng, Shuai; McCollough, Cynthia H.

    2012-01-01

    To develop a dual-energy CT (DECT) method for differentiating uric acid (UA) from non-UA stones in the presence of iodinated contrast medium. Thirty UA and 45 non-UA stones were selected after infra-red spectroscopic analysis and independently placed in a 1.5-ml vial, which was filled first with saline and then with increasing concentrations of iodine. For each condition, tubes were put in a 35-cm water phantom and examined using a dual-source CT system at 100 and 140 kV. Virtual unenhanced images created from CT data sets of the stones in iodine-containing solutions provided position and volume information. This map was used to calculate a CT number ratio to differentiate stone type. A region-growing method was developed to improve the ability to differentiate between UA and non-UA stones with iodinated contrast medium. The sensitivity for detecting UA stones was 100 % for unenhanced images but fell to 18 % with 20 mgI/ml iodine solution and 0 % for higher concentrations. With region growing, the sensitivity for detecting UA stones was increased to 100 %, 82 %, 57 %, 50 % and 21 % for iodine solutions of 20, 40, 60, 80 and 100 mgI/ml. The region-growing method improves differentiation of UA from non-UA stones on contrast-enhanced DECT urograms. (orig.)

  17. Bariatric Surgery and Stone Disease

    Science.gov (United States)

    Lieske, John C.; Kumar, Rajiv

    2008-09-01

    Bariatric surgery is an effective treatment strategy for patients with morbid obesity that can result in effective weight loss, resolution of diabetes mellitus and other weight related complications, and even improved mortality. However, it also appears that hyperoxaluria is common after modern bariatric surgery, perhaps occurring in up to 50% of patients after Rouxen-Y gastric bypass. Although increasing numbers of patients are being seen with calcium oxalate kidney stones after bariatric surgery, and even a few with oxalosis and renal failure, the true risk of these outcomes remains unknown. The mechanisms that contribute to this enteric hyperoxaluria are also incompletely defined, although fat malabsorption may be an important component. Since increasing numbers of these procedures are likely to be performed in the coming years, further study regarding the prevalence and mechanisms of hyperoxaluria and kidney stones after bariatric surgery is needed to devise effective methods of treatment in order to prevent such complications.

  18. Use of a latex biomembrane for bladder augmentation in a rabbit model: biocompatibility, clinical and histological outcomes

    Directory of Open Access Journals (Sweden)

    Andre L. A. Domingos

    2009-04-01

    Full Text Available PURPOSE: To investigate histological features and biocompatibility of a latex biomembrane for bladder augmentation using a rabbit model. MATERIAL AND METHODS: After a partial cystectomy, a patch of a non-vulcanized latex biomembrane (2x4 cm was sewn to the bladder with 5/0 monofilament polydioxanone sulfate in a watertight manner. Groups of 5 animals were sacrificed at 15, 45 and 90 days after surgery and the bladder was removed. The 5-µm preparations obtained from grafted area and normal bladder were stained with hematoxylin-eosin. Immunohistochemical staining was performed with a primary antibody against alpha-actin to assess muscle regeneration. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. Macroscopically, after 90 days, the latex biomembrane was not identifiable and the patch was indistinguishable from normal bladder. A bladder stone was found in one animal (6.6%. On the 90th day, histology revealed continuity of transitional epithelium of host bladder tissue on the patch area. At this time, the muscle layers were well organized in a similar fashion to native bladder muscle layers. The inflammatory process was higher on grafted areas when compared to controls: 15 days - p < 0.0001, 45 days - p < 0.001, and 90 days - p < 0.01. The anti alpha-actin immunoexpression peaked at 45 days, when the graft was observed covered by muscle cells. CONCLUSION: The latex biomembrane is biocompatible and can be used in models for bladder augmentation in rabbits. It promotes epithelium and muscle regeneration without urinary leakage.

  19. Effect of Naftopidil on Bladder Microcirculation in a Rat Model of Bladder Outlet Obstruction.

    Science.gov (United States)

    Majima, Tsuyoshi; Yamamoto, Tokunori; Funahashi, Yasuhito; Takai, Shun; Matsukawa, Yoshihisa; Yoshida, Masaki; Gotoh, Momokazu

    2017-05-01

    To evaluate the effect of naftopidil on bladder capillary blood flow using bladder outlet obstruction model rats. Female Sprague-Dawley rats were divided into three groups: control group, bladder-outlet-obstruction group, and bladder-outlet-obstruction + naftopidil group. Bladder-outlet-obstruction surgery was performed in the bladder-outlet-obstruction and bladder-outlet-obstruction + naftopidil groups. The control group received sham-operation. The bladder-outlet-obstruction + naftopidil group were treated with naftopidil (30 mg/kg) for 14 days after bladder-outlet-obstruction operation, while the control and bladder-outlet-obstruction groups were treated with vehicle. Continuous cystometry was performed 14 days after the surgery. Bladder blood flow was measured after 14 days using a pencil lens charge-coupled device microscopy system. The bladder was then harvested for histology and measuring 8-hydroxy-2'-deoxyguanosine tissue level by enzyme-linked immunosorbent assay. In cystometry, the bladder-outlet-obstruction rats showed bladder overactivity, while naftopidil treatment improved the cystometric pattern. The blood flow through the submucosal capillaries of the bladder base in the bladder-outlet-obstruction group was lesser than that in the control, whereas the bladder-outlet-obstruction + naftopidil group showed significantly greater blood flow than the bladder-outlet-obstruction group. The bladder tissue in the bladder-outlet-obstruction group showed a tendency to contain more hypertrophic detrusor muscle and inflammatory cells compared to those in the control group, while naftopidil treatment suppressed these histological changes. The 8-hydroxy-2'-deoxyguanosine levels in the bladder tissue significantly differed among the three groups (the bladder-outlet-obstruction group > the bladder-outlet-obstruction + naftopidil group > the control group). Naftopidil improved bladder overactivity as well as the impaired bladder

  20. Giant bladder diverticulum in a boy

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    Esra Ozcakir

    2014-01-01

    Full Text Available Although the bladder diverticula in children are seen commonly which is association with infravesical obstruction or neurogenic bladder function, the case of giant congenital bladder diverticula are rare. In this paper, an 11 years old boy with giant bladder diverticula presenting urinary infections is evaluated in terms of diagnosis and management by current literature.

  1. Late Pleistocene/Early Holocene Evidence of Prostatic Stones at Al Khiday Cemetery, Central Sudan.

    Directory of Open Access Journals (Sweden)

    Donatella Usai

    Full Text Available The recovery of three stone-like ovoid objects within the burial of a pre-Mesolithic (Late Pleistocene/Early Holocene individual at Al Khiday cemetery (Central Sudan raises the question of the nature and origin of these objects. The position in which the objects were found in relation to the human skeleton suggested a pathological condition affecting the individual, possibly urinary bladder, kidney stones or gallstones. To solve this issue, a multi-analytical approach, consisting of tomographic, microstructural and compositional analyses, was therefore performed. Based on their microstructure and mineralogical composition, consisting of hydroxylapatite and whitlockite, the investigated stones were identified as primary (endogenous prostatic calculi. In addition, the occurrence of bacterial imprints also indicates on-going infectious processes in the individual. This discovery of the earliest known case of lithiasis extends the appearance of prostatic stones into the Late Pleistocene/Early Holocene, a disease which therefore can no longer be considered exclusive to the modern era, but which also affected prehistoric individuals, whose lifestyle and diet were significantly different to our own.

  2. Late Pleistocene/Early Holocene Evidence of Prostatic Stones at Al Khiday Cemetery, Central Sudan

    Science.gov (United States)

    Usai, Donatella

    2017-01-01

    The recovery of three stone-like ovoid objects within the burial of a pre-Mesolithic (Late Pleistocene/Early Holocene) individual at Al Khiday cemetery (Central Sudan) raises the question of the nature and origin of these objects. The position in which the objects were found in relation to the human skeleton suggested a pathological condition affecting the individual, possibly urinary bladder, kidney stones or gallstones. To solve this issue, a multi-analytical approach, consisting of tomographic, microstructural and compositional analyses, was therefore performed. Based on their microstructure and mineralogical composition, consisting of hydroxylapatite and whitlockite, the investigated stones were identified as primary (endogenous) prostatic calculi. In addition, the occurrence of bacterial imprints also indicates on-going infectious processes in the individual. This discovery of the earliest known case of lithiasis extends the appearance of prostatic stones into the Late Pleistocene/Early Holocene, a disease which therefore can no longer be considered exclusive to the modern era, but which also affected prehistoric individuals, whose lifestyle and diet were significantly different to our own. PMID:28122013

  3. Stone composition among first-time symptomatic kidney stone formers in the community

    Science.gov (United States)

    Singh, Prince; Enders, Felicity T.; Vaughan, Lisa E.; Bergstralh, Eric J; Knoedler, John J.; Krambeck, Amy E; Lieske, John C; Rule, Andrew D

    2015-01-01

    Objective To determine the variation in kidney stone composition and its relationship to risk factors and recurrence among first-time stone formers in the general population. Patients and Methods Medical records were manually reviewed and validated for symptomatic kidney stone episodes among Olmsted County, Minnesota residents from January 1, 1984 to December 31, 2012. Clinical and laboratory characteristics and the risk of symptomatic recurrence were compared between stone compositions. Results There were 2961 validated first-time symptomatic kidney stone formers. Stone composition analysis was obtained in 1508 (51%) at the first episode. Stone formers were divided into the following mutually exclusive groups: any brushite (0.9%), any struvite (0.9%), any uric acid (4.8%), majority calcium oxalate (76%) or majority hydroxyapatite (18%). Stone composition varied with clinical characteristics. A multivariable model had a 69% probability of correctly estimating stone composition, but assuming calcium oxalate monohydrate stone was correct 65% of the time. Symptomatic recurrence at 10 years was approximately 50% for brushite, struvite, and uric acid, but approximately 30% for calcium oxalate and hydroxyapatite stones (Pcomposition, they are of limited utility for estimating stone composition. Rarer stone compositions are more likely to recur. PMID:26349951

  4. Urethral morphology and bladder instability.

    Science.gov (United States)

    Hausegger, K A; Fotter, R; Sorantin, E; Schmidt, P

    1991-01-01

    In order to calculate the relationship between Spinning top urethra (STU) and bladder instability 160 voiding cystourethrogramms (VCU), performed in 102 girls, have been analysed retrospectively. 28 girls had STU, 16 of those had bladder instability as well (57%). We could not find the highly positive correlation between unstable bladder and STU as reported by other authors, although there was a statistically positive correlation between STU and bladder instability. However the confidence interval was very broad (38%-75%). We conclude that bladder instability may contribute to STU but cannot render the etiological explanation for all cases. STU seems to be a polyetiological sign. In our opinion only the combination of STU and bladder instability has a diagnostic impact, since several therapeutical concepts are available in cases of bladder instability. The finding of STU in the VCU should alert the examiner's attention to functional disorders of the lower urinary tract. If no instability can be found, STU should be considered to be a normal variant.

  5. Urethral morphology and bladder instability

    Energy Technology Data Exchange (ETDEWEB)

    Hausegger, K.A.; Fotter, R.; Sorantin, E. (Graz Univ. (Austria). Radiologische Klinik); Schmidt, P. (Rehabilitationszentrum, Schallerbach (Austria))

    1991-05-01

    In order to calculate the relationship between Spinning top urethra (STU) and bladder instability 160 voiding cystourethrogramms (VCU), performed in 102 girls, have been analysed retrospectively. 28 girls had STU, 16 of those had bladder instability as well (57%). We could not find the highly positive correlation between unstable bladder and STU as reported by other authors, although there was a statistically positive correlation between STU and bladder instability. However the confidence interval was very broad (38%-75%). We conclude that bladder instability may contribute to STU but cannot render the etiological explanation for all cases. STU seems to be a polyetiological sign. In our opinion only the combination of STU and bladder instability has a diagnostic impact, since several therapeutical concepts are available in cases of bladder instability. The finding of STU in the VCU should alert the examiner's attention to functional disorders of the lower urinary tract. If no instability can be found, STU should be considered to be a normal variant. (orig.).

  6. Bladder Injury During Cesarean Delivery

    Science.gov (United States)

    Tarney, Christopher M.

    2013-01-01

    Cesarean section is the most common surgery performed in the United States with over 30% of deliveries occurring via this route. This number is likely to increase given decreasing rates of vaginal birth after cesarean section (VBAC) and primary cesarean delivery on maternal request, which carries the inherent risk for intraoperative complications. Urologic injury is the most common injury at the time of either obstetric or gynecologic surgery, with the bladder being the most frequent organ damaged. Risk factors for bladder injury during cesarean section include previous cesarean delivery, adhesions, emergent cesarean delivery, and cesarean section performed at the time of the second stage of labor. Fortunately, most bladder injuries are recognized at the time of surgery, which is important, as quick recognition and repair are associated with a significant reduction in patient mortality. Although cesarean delivery is a cornerstone of obstetrics, there is a paucity of data in the literature either supporting or refuting specific techniques that are performed today. There is evidence to support double-layer closure of the hysterotomy, the routine use of adhesive barriers, and performing a Pfannenstiel skin incision versus a vertical midline subumbilical incision to decrease the risk for bladder injury during cesarean section. There is also no evidence that supports the creation of a bladder flap, although routinely performed during cesarean section, as a method to reduce the risk of bladder injury. Finally, more research is needed to determine if indwelling catheterization, exteriorization of the uterus, and methods to extend hysterotomy incision lead to bladder injury. PMID:24876830

  7. Emergency management of ureteral stones: Recent advances

    Directory of Open Access Journals (Sweden)

    Luis Osorio

    2008-01-01

    Full Text Available Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators′ experience, patients′ preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed.

  8. Emergency management of ureteral stones: Recent advances.

    Science.gov (United States)

    Osorio, Luis; Lima, Estêvão; Autorino, Riccardo; Marcelo, Filinto

    2008-10-01

    Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators' experience, patients' preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed.

  9. Investigations of stone consolidants by neutron imaging

    Science.gov (United States)

    Hameed, F.; Schillinger, B.; Rohatsch, A.; Zawisky, M.; Rauch, H.

    2009-06-01

    The chemical preservation and structural reintegration of natural stones applied in historical buildings is carried out by the use of different stone strengtheners. As these agents contain hydrogen, they offer good properties for neutron imaging. The main interest in the restoration process is the development of a suitable stone consolidant. In cooperation with the St. Stephans Cathedral and the geologists at Vienna University of Technology, we are investigating the penetration depth and distribution of different stone consolidants. These studies are being carried out with different stone samples, mostly porous natural building stones, limestones and sandstones. The two strengtheners used in this study are ethyl silicate ester (Wacker OH100) and dissolved polymethylmetacrylate (PMMA, Paraloid B72). Neutron radiography and neutron tomography can be used successfully to visualize the distribution of consolidants both in two and three dimensions.

  10. Quality Assessment of Urinary Stone Analysis

    DEFF Research Database (Denmark)

    Siener, Roswitha; Buchholz, Noor; Daudon, Michel

    2016-01-01

    After stone removal, accurate analysis of urinary stone composition is the most crucial laboratory diagnostic procedure for the treatment and recurrence prevention in the stone-forming patient. The most common techniques for routine analysis of stones are infrared spectroscopy, X-ray diffraction...... and chemical analysis. The aim of the present study was to assess the quality of urinary stone analysis of laboratories in Europe. Nine laboratories from eight European countries participated in six quality control surveys for urinary calculi analyses of the Reference Institute for Bioanalytics, Bonn, Germany......, between 2010 and 2014. Each participant received the same blinded test samples for stone analysis. A total of 24 samples, comprising pure substances and mixtures of two or three components, were analysed. The evaluation of the quality of the laboratory in the present study was based on the attainment...

  11. Bladder Diverticulitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Michael Silberman

    2011-01-01

    Full Text Available Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.

  12. Bladder Capacity is a Biomarker for a Bladder Centric versus Systemic Manifestation in Interstitial Cystitis/Bladder Pain Syndrome.

    Science.gov (United States)

    Walker, Stephen J; Zambon, João; Andersson, Karl-Erik; Langefeld, Carl D; Matthews, Catherine A; Badlani, Gopal; Bowman, Heather; Evans, Robert J

    2017-08-01

    Interstitial cystitis/bladder pain syndrome presents a significant clinical challenge due to symptom heterogeneity and the myriad associated comorbid medical conditions. We recently reported that diminished bladder capacity may represent a specific interstitial cystitis/bladder pain syndrome subphenotype. The objective of this study was to investigate the relationship between anesthetic bladder capacity, and urological and nonurological clinical findings in a cohort of patients with interstitial cystitis/bladder pain syndrome who had undergone therapeutic urinary bladder hydrodistention. This is a retrospective chart review of prospectively collected data on women diagnosed with interstitial cystitis/bladder pain syndrome between 2011 and 2015 who underwent bladder hydrodistention. Assessments in each patient included a detailed history and physical examination, ICPI (Interstitial Cystitis Problem Index), ICSI (Interstitial Cystitis Symptom Index) and PUF (Pelvic Pain and Urgency/Frequency Patient Symptom Scale). Bladder capacity was determined during bladder hydrodistention with the patient under general anesthesia. Mean age was 45.8 years and mean bladder capacity was 857 ml in the 110 enrolled patients. We found a significant inverse correlation between bladder capacity and scores on 3 gold standard interstitial cystitis/bladder pain syndrome metrics, including ICPI (p = 0.0014), ICSI (p = 0.0022) and PUF (p = 0.0009) as well as urination frequency (p = 0.0025). Women with higher bladder capacity were significantly more likely to report depression (p = 0.0059) and irritable bowel syndrome (p = 0.022). Low bladder capacity while under anesthesia was significantly associated with high symptom scores on 3 validated interstitial cystitis/bladder pain syndrome questionnaires as well as with urinary frequency. However, it was not associated with depression or other common systemic pain problems. These results suggest that low bladder capacity is a marker for a bladder

  13. Dose Distribution in Bladder and Surrounding Normal Tissues in Relation to Bladder Volume in Conformal Radiotherapy for Bladder Cancer

    International Nuclear Information System (INIS)

    Majewski, Wojciech; Wesolowska, Iwona; Urbanczyk, Hubert; Hawrylewicz, Leszek; Schwierczok, Barbara; Miszczyk, Leszek

    2009-01-01

    Purpose: To estimate bladder movements and changes in dose distribution in the bladder and surrounding tissues associated with changes in bladder filling and to estimate the internal treatment margins. Methods and Materials: A total of 16 patients with bladder cancer underwent planning computed tomography scans with 80- and 150-mL bladder volumes. The bladder displacements associated with the change in volume were measured. Each patient had treatment plans constructed for a 'partially empty' (80 mL) and a 'partially full' (150 mL) bladder. An additional plan was constructed for tumor irradiation alone. A subsequent 9 patients underwent sequential weekly computed tomography scanning during radiotherapy to verify the bladder movements and estimate the internal margins. Results: Bladder movements were mainly observed cranially, and the estimated internal margins were nonuniform and largest (>2 cm) anteriorly and cranially. The dose distribution in the bladder worsened if the bladder increased in volume: 70% of patients (11 of 16) would have had bladder underdosed to 70%, 80%, and 90% of the prescribed dose was 23%, 20%, and 15% for the rectum and 162, 144, 123 cm 3 for the intestines, respectively) than with a 'partially full' bladder (volume that received >70%, 80%, and 90% of the prescribed dose was 28%, 24%, and 18% for the rectum and 180, 158, 136 cm 3 for the intestines, respectively). The change in bladder filling during RT was significant for the dose distribution in the intestines. Tumor irradiation alone was significantly better than whole bladder irradiation in terms of organ sparing. Conclusion: The displacements of the bladder due to volume changes were mainly related to the upper wall. The internal margins should be nonuniform, with the largest margins cranially and anteriorly. The changes in bladder filling during RT could influence the dose distribution in the bladder and intestines. The dose distribution in the rectum and bowel was slightly better with

  14. Papillary Ductal Plugging is a Mechanism for Early Stone Retention in Brushite Stone Disease

    DEFF Research Database (Denmark)

    Williams, James C; Borofsky, Michael S; Bledsoe, Sharon B

    2018-01-01

    PURPOSE: Mechanisms of early stone retention in the kidney are under studied and poorly understood. To date attachment via Randall's plaque is the only widely accepted theory in this regard, which is best described in idiopathic calcium oxalate stone formers. Brushite stone formers are known...... to have distinct papillary morphology relative to calcium oxalate stone formers. As such we sought to determine whether stone attachment mechanisms in such patients may be similarly unique. MATERIALS AND METHODS: Patients undergoing percutaneous and or ureteroscopic procedures for stone removal consented...... to endoscopic renal papillary examination and individual stone collection. Each removed stone was processed using micro computerized tomography to assess the 3-dimensional microstructure and the minerals contained, and search for common structural features indicative of novel mechanisms of early growth...

  15. Increased bladder permeability in interstitial cystitis/painful bladder syndrome

    Science.gov (United States)

    Greenwood-Van Meerveld, Beverley; Wisniewski, Amy B.; VanGordon, Samuel; Lin, HsuehKung; Kropp, Bradley P.; Towner, Rheal A.

    2015-01-01

    The definition of interstitial cystitis (IC) has evolved over the years from being a well-defined entity characterized by diagnostic lesion (Hunner’s ulcer) in the urothelium to a clinical diagnosis by exclusion [painful bladder syndrome (PBS)]. Although the etiology is unknown, a central theme has been an association with increased permeability of the bladder. This article reviews the evidence for increased permeability being important to the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) and in treating the disorder. Recent work showing cross-communication among visceral organs is also reviewed to provide a basis for understanding IC/PBS as a systemic disorder of a complex, interconnected system consisting of the bladder, bowel and other organs, nerves, cytokine-responding cells and the nervous system. PMID:26751576

  16. Urethral orifice hyaluronic acid injections: a novel animal model of bladder outlet obstruction.

    Science.gov (United States)

    Wang, Yongquan; Xiong, Zhiyong; Gong, Wei; Zhou, Zhansong; Lu, Gensheng

    2015-02-21

    We produced a novel model of bladder outlet obstruction (BOO) by periurethral injection of hyaluronic acid and compared the cystometric features, postoperative complications, and histopathological changes of that model with that of traditional open surgery. Forty female Sprague-Dawley rats were divided into three groups. Fifteen rats were subcutaneously injected with 0.2 ml hyaluronic acid at 5, 7, and 12 o'clock around the urethral orifice. Another fifteen rats underwent traditional open partial proximal urethral obstruction surgery, and 10 normal rats used as controls. After 4 weeks, filling cystometry, postoperative complications, and histopathological features were evaluated in each group. Three rats were also observed for 12 weeks after hyaluronic acid injection to evaluate the long-term effect. Hyaluronic acid periurethral injection caused increased maximum cystometric capacity, maximum bladder pressure, micturition interval, and post-void residual urine volume compared with control (p injection group had significantly shorter operative time, less incidence of incision infection and bladder stone formation compared with the surgery group (p injection and surgery bladders; these were not observed in the control group. Bladder weight and thickness of smooth muscle in the injection and surgery groups were significantly greater than those in the control group (p injection or control groups. Rats periurethrally injected hyaluronic acid were stable the compound was not fully absorbed in any rat after 12 weeks. Hyaluronic acid periurethral injection generates a simple, effective, and persistent animal model of BOO with lower complications, compared with traditional surgery.

  17. Invasive bladder cancer: Our experience with bladder sparing approach

    International Nuclear Information System (INIS)

    Cervek, Jozica; Cufer, Tanja; Zakotnik, Branko; Kragelj, Borut; Borstnar, Simona; Matos, Tadeja; Zumer-Pregelj, Mirjana

    1998-01-01

    Purpose: Muscle-invasive bladder cancer (MIBC) is a disease associated with several unresolved therapeutic questions. Radical cystectomy still represents the most frequent treatment approach. The aim of our study was to evaluate the effect and feasibility of bladder-sparing treatment by transurethral resection (TUR) and sequential chemoradiotherapy in patients with biopsy-proven invasive bladder cancer. Methods and Materials: After maximal TUR, 105 patients were treated with two to four cycles of methotrexate, cisplatinum, and vinblastine polychemotherapy. In complete responders, the treatment was continued by radiotherapy (50 Gy to the bladder and 40 Gy to the regional lymph nodes), whereas in nonresponders, cystectomy was performed when feasible. Results: Complete response after TUR and chemotherapy was achieved in 52% of patients. After a median follow-up of 42 months, 52 of 75 patients (69%) selected for bladder preservation were without evidence of disease in the bladder. Freedom from local failure in complete responders to chemotherapy was 80% [95% confidence interval (CI), 69-91%) at 4 years. The actuarial survival of the entire group was 58% (95% CI, 47-69%), whereas the survival rate with the bladder intact was 45% (95% CI, 34-56%) at 4 years. Survival was significantly better in patients who responded to chemotherapy (79%) than in nonresponders (35%, p < 0.0001). There was no significant difference in survival between nonresponders who underwent cystectomy and nonresponders who completed treatment with radiotherapy (approximately 30% at 3 years). Conclusion: The present study confirms that MIBC is a heterogeneous disease, and that in more than half of patients who are affected, a bladder-sparing approach is safe. Our study has also demonstrated that in nonresponders, radical cystectomy as the treatment of choice is questionable

  18. Preventive kidney stones: Continue medical education

    Directory of Open Access Journals (Sweden)

    Farahnak Assadi

    2017-01-01

    Full Text Available Nephrolithiasis is a common health problem across the globe with a prevalence of 15%–20%. Idiopathic hypercalciuria is the most common cause of nephrolithiasis, and calcium oxalate stones are the most common type of stones in idiopathic hypercalciuric patients. Calcium phosphate stones are frequently associated with other diseases such as renal tubular acidosis type 1, urinary tract infections, and hyperparathyroidism. Compared with flat abdominal film and renal sonography, a noncontrast helical computed tomography scan of the abdomen is the diagnostic procedure of choice for detection of small and radiolucent kidney stones with sensitivity and specificity of nearly 100%. Stones smaller than 5 mm in diameter often pass the urinary tract system and rarely require surgical interventions. The main risk factors for stone formation are low urine output, high urinary concentrations of calcium, oxalate, phosphate, and uric acid compounded by a lower excretion of magnesium and citrate. A complete metabolic workup to identify the risk factors is highly recommended in patients who have passed multiple kidney stones or those with recurrent disease. Calcium oxalate and calcium phosphate stones are treated by the use of thiazide diuretics, allopurinol, and potassium citrate. Strategies to prevent kidney stone recurrence should include the elimination of the identified risk factors and a dietary regimen low in salt and protein, rich in calcium and magnesium which is coupled with adequate fluid intake.

  19. Building stones can be of geoheritage significance

    Science.gov (United States)

    Brocx, Margaret; Semeniuk, Vic

    2017-04-01

    Building stones have generally been assigned values according to their cultural, aesthetic, and rarity significance, amongst other criteria, but they also may have geoheritage significance. This is akin to the geoheritage significance ascribed to minerals and fossils housed as ex situ specimens in museums. We proffer the notion that building stones can be of geoheritage value particularly where they comprise permanent buildings, they illustrate significant windows into the history of the Earth, and they can be visited as an ex situ museum locality (e.g., the "Blue Granite" of Iceland) for education as part of building-stone tours. For some rocks the quarries that supplied the building stone are no longer in existence and hence the building stones provide the only record of that type of material; for other rocks, the building stone may illustrate features in the lithology no longer present in the quarry itself (e.g., rare and large xenoliths). Building stones are particularly significant as they are often polished and manifest structures, fabrics, and textures not evident in outcrop. We illustrate here examples of building stone of geoheritage significance using Australian and International examples. Australian designated stones could include the "Sydney Sandstone" or "Victorian Bluestone". For international examples, there is the famous "Carrara Marble" in Italy and the widely known "Portland Limestone" from southern England, the latter having been utilized for St Pauls Cathedral in London and the UN building in New York City.

  20. A comparison between an in vitro ureteroscopic stone size estimation and the stone size measurement with the help of a scale on stone baskets.

    Science.gov (United States)

    Cordes, Jens; Teske, Lisa; Nguyen, Felix; Pinkowski, Wolfhard; Sievert, Karl-Dietrich; Vonthein, Reinhard

    2016-09-01

    Endoscopic treatment of ureter stones and renal calculi relies on the surgeon's estimation of the stone size for both lithotripsy and removal of stones or stone fragments. We therefore compared precision and reliability of the endoscopic estimation of stone size by the surgeon with measurements on a scale on a stone basket. Two surgeons (one high experienced and one low experienced) first estimated, then measured the size of 12 stones differing in size and color using different stone baskets (2.5, 3.0, 4.0 Ch) each via a semirigid renoscope in an artificial ureter under water repeatedly on two different days. All together, we had 288 measurements and 288 estimations. On the whole, the accuracy of the estimation diminished with bigger stones. There is an increasing underestimation with increasing stone size. Factors, which significantly influence the estimation, are the operating surgeon, the color of the stone, the time sequence, and the size of the closed basket, which was held beside the stone. The accuracy of the measurement of the stone baskets is not as good as the estimation. The small 2.5-Ch basket is the most accurate in measuring big stones (>6 mm), the 3.5 Ch in intermediate stones (3-6 mm), the big basket (4.0 Ch) in small stones (estimation of the surgeons is better than the measurement, but it is also influenced by factors like the surgeon or the color of the stone.

  1. Interstitial Cystitis / Painful Bladder Syndrome

    Science.gov (United States)

    ... Vesicoureteral Reflux The Urinary Tract & How It Works Interstitial Cystitis (Painful Bladder Syndrome) View or Print All Sections Definition & Facts Interstitial cystitis (IC) is a chronic, or long-lasting, condition ...

  2. Inhibition of HIF Reduces Bladder Hypertrophy and Improves Bladder Function in Murine Model of Partial Bladder Outlet Obstruction.

    Science.gov (United States)

    Iguchi, Nao; Malykhina, Anna P; Wilcox, Duncan T

    2016-04-01

    Posterior urethral valves are the most common cause of partial bladder outlet obstruction in the pediatric population. However, to our knowledge the etiology and the detailed mechanisms underlying pathological changes in the bladder following partial bladder outlet obstruction remain to be elucidated. Recent findings suggest that hypoxia and associated up-regulation of HIFs (hypoxia-inducible factors) have a key role in partial bladder outlet obstruction induced pathology in the bladder. We examined the effects of pharmacological inhibition of HIF pathways by 17-DMAG (17-(dimethylaminoethylamino)-17-demethoxygeldanamycin) in pathophysiological phenotypes after partial bladder outlet obstruction. Partial bladder outlet obstruction was surgically created in male C57BL/6J mice. The animals received oral administration of 17-DMAG or vehicle daily starting from the initiation of obstruction up to 5 days. Sham operated mice served as controls. Bladders were harvested from each group 2, 4 and 7 days postoperatively, and analyzed for histological and biochemical changes. Bladder function was assessed by in vitro muscle contractility recordings. Partial bladder outlet obstruction caused a significant increase in the bladder mass accompanying enhanced collagen deposition in the bladder wall while 17-DMAG treatment suppressed those increases. Treatment with 17-DMAG attenuated the degree of up-regulation of HIFs and their target genes involving the development of tissue fibrosis in obstructed bladders. Treatment with 17-DMAG improved the decreased responses of obstructed bladder strips to electrical field stimulation and KCl. In vivo 17-DMAG treatment decreased partial bladder outlet obstruction induced pathophysiological changes in the bladder. HIF pathway inhibition has a potential clinical implication for the development of novel pharmacological therapies to treat bladder pathology associated with partial bladder outlet obstruction. Copyright © 2016 American Urological

  3. The effects of visual fluorescence marking induced by 5-aminolevulinic acid for endoscopic diagnosis of urinary bladder cancer

    Science.gov (United States)

    Daniltchenko, Dmitri I.; Koenig, Frank; Schnorr, Dietmar; Valdman, Alexander; Al-Shukri, Salman; Loening, Stefan A.

    2003-10-01

    During cystoscopy procedure, fluorescence diagnostics induced by 5-ALA improves visual detection of the bladder cancer. Macroscopic ALA-fluorescence allows visualizing of small flat tumors, carcinoma in situ, true neoplasm margins and dysplasias of the bladder. Following ALA instillation, cystoscopy has been performed under both standard and blue light illumination. Totally, 153 biopsies have been carried out at 53 patients with suspicion of bladder cancer. The results were compared to ALA-fluorescence data. In 13% of the patients, bladder cancer and dysplasia were found out in addition, due to red fluorescence. The sensitivity and specificity of ALA-fluorescence technique aggregated 96% and 52% respectively. The sensitivity and specificity of 5-ALA-fluorescent detection exceeded standard endoscopy under white light on 20%. The new method does not exclude a false positive and a false negative fluorescent luminescence. The ALA-based fluorescence detection system enhances the diagnosis of malignant/dysplastic bladder lesions significantly.

  4. A Lion of a Stone

    Science.gov (United States)

    2004-01-01

    This approximate true-color image of the rock called 'Lion Stone' was acquired by the Mars Exploration Rover Opportunity's panoramic camera on sol 104 (May 9, 2004). The rock stands about 10 centimeters tall (about 4 inches) and is about 30 centimeters long (12 inches). Plans for the coming sols include investigating the rock with the spectrometers on the rover's instrument arm. This image was generated using the camera's L2 (750-nanometer), L5 (530-nanometer) and L6 (480-nanometer) filters.

  5. Intrahepatic stones: a case report

    International Nuclear Information System (INIS)

    Santos, A.M. dos; Borba Filho, P.

    1992-01-01

    A 23-year-old man from Palmares - Pernambuco, presented to our center with a 7-month history of jaundice and right upper quadrant abdominal pain. His past medical history revealed similar bouts since adolescence. Physical examination revealed icteric sclerae, soft abdomen with a palpable liver. An ultrasound examination showed a normal gallbladder and multiple echogenic areas with acoustic shadow in the liver. A percutaneous cholangiogram demonstrated dilated intrahepatic bile ducts with multiple stones. The patient underwent an exploratory laparotomy and cholecystectomy and a Roux-en-Y hepatic jejunostomy were performed. (author)

  6. Structural study of the bladder in fetuses with prune belly syndrome.

    Science.gov (United States)

    Julio Junior, Helce R; Costa, Suelen F; Costa, Waldemar S; Barcellos Sampaio, Francisco J; Favorito, Luciano A

    2018-01-01

    To study the bladder structure of fetuses with prune belly syndrome (PBS). We studied three bladders obtained from three male fetuses with PBS and seven bladders from seven male fetuses without anomalies. Each bladder was dissected and embedded in paraffin, from which 5 μm thick sections were obtained and stained with Masson's trichrome (to quantify connective tissue and smooth muscle) and picrosirius red with polarization (to observe collagen). Immunohistochemistry with tubulin (Tubulin, beta III, Mouse Monoclonal Antibody) was applied to observe the bladder nerves. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image Pro and Image J programs, using a grid to determine volumetric densities (Vv). Means were statistically compared using the Mann-Whitney test (P < 0.05). Quantitative analysis documented that smooth muscle fibers were significantly smaller (P = 0.04) in PBS fetuses (9.67% to 17.75%, mean = 13.2%) compared to control group (13.33% to 26.56%, mean = 17.43%). The analysis of collagen fibers showed predominance of green in the control group, suggesting collagen type III presence, and predominance of red in the in PBS fetal bladders, suggesting collagen type I presence in this group. The qualitative analysis of the nerves with immunohistochemistry with tubulin showed predominance of nerves in the control group. The bladder in PBS had lower concentrations of smooth muscle fibers, collagen type III, and nerves. These structural alterations can be one of the factors involved in urinary tract abnormality such as distended bladder in patients with PBS. © 2017 Wiley Periodicals, Inc.

  7. Intraspinal schwannoma and neurogenic bladder.

    Science.gov (United States)

    Yang, K S; Ho, C S; Tai, P A; Kung, W M

    2018-04-01

    Most lumbar intradural schwannomas present initially as radiculopathies with sensory disturbances. However, neurogenic bladder dysfunction may be one of the earliest manifestations and can cause long-term disability. We present the case of a patient with a L3-4 schwannoma (newly diagnosed owing to recurrent urinary retention and urinary tract infection) who finally underwent surgical resection. Improvement of bladder sensation was documented by urodynamic study and the patient was subsequently weaned off her Foley catheter with satisfactory outcome.

  8. Microsatellite instability in bladder cancer

    DEFF Research Database (Denmark)

    Gonzalez-Zulueta, M; Ruppert, J M; Tokino, K

    1993-01-01

    Somatic instability at microsatellite repeats was detected in 6 of 200 transitional cell carcinomas of the bladder. Instabilities were apparent as changes in (GT)n repeat lengths on human chromosome 9 for four tumors and as alterations in a (CAG)n repeat in the androgen receptor gene on the X...... or larger (> 2 base pairs) alterations in repeat length. All six tumors were low stage (Ta-T1), suggesting that these alterations can occur early in bladder tumorigenesis....

  9. Neurogenic bladder in Hunter's syndrome.

    Science.gov (United States)

    Koyama, K; Moda, Y; Sone, A; Tanaka, H; Hino, Y

    1994-01-01

    We encountered a rare patient with Hunter's syndrome who exhibited urinary retention as a result of a neurogenic bladder, uninhibited detrusor contractions, and detrusor-sphincter dyssynergia. Neurological findings were consistent with cervical myelopathy and cervical MR imaging showed very narrow segments at the cord level C2-4. We speculate that this Hunter's syndrome patient has cervical myelopathy and that this neurological dysfunction causes the neurogenic bladder. PMID:8014981

  10. Interstitial cystitis: painful bladder syndrome

    Directory of Open Access Journals (Sweden)

    R F Sholan

    2018-02-01

    Full Text Available Interstitial cystitis, or painful bladder syndrome, is a chronic inflammatory disease of a bladder of unknown etiology. It negatively affects the quality of life, causes depressive disorders, anxiety, and sexual dysfunction. Despite numerous studies, the etiology of interstitial cystitis is still unclear and it’s considered as painful bladder syndrome with multifactorial origin. According to the US National Health and Nutrition Examination Survey, 470/100 000 people (60/100 000 men, 850/100 000 women are diagnosed with interstitial cystitis. Diagnosis of the disease is difficult and is substantially based on clinical symptoms. Pelvic pain, urinary urgency, frequency and nocturia are the basic complaints in this pathology. The diagnosis requires exclusion of diseases with similar manifestations. So interstitial cystitis is frequently misdiagnosed as urinary tract infection, overactive bladder, urethral obstruction or diverticulosis, chronic prostatitis, bladder cancer, vulvodynia, endometriosis, and chronic pelvic pain. Etiopathogenesis of the disease is uncertain, which makes etiologic treatment impossible. Currently scientific discussions on the causes of disease continue as well as different treatment regimens are offered, but are often ineffective, palliative and temporary. The treatment for intersticial cystitis should focus on restoring normal bladder function, prevention of relapse of symptoms and improvement of patients’ quality of life. The literature review presents current view on the terminology, epidemiology, diagnosis and treatment of interstitial cystitis.

  11. Bladder Dysfunction and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Ulla Sillén

    2008-01-01

    Full Text Available In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB and the dysfunctional voiding (DV, have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome, most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES are more severe than the genuine filling phase dysfunction (OAB, with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed.

  12. Ships on hero stones from the west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Tripati, S.

    have been using since long period. Local sculptors might have carved these depictions. No external influences on carving of the hero stones and boat motives have been noticed on these hero stones. The systematic research on the hero stones can...

  13. Mitomycin C Intravesical Chemotherapy in Conjunction With Synergo® Radiofrequency-Induced Hyperthermia for Treatment of Carcinoma in Situ Non-Muscle Invasive Bladder Cancer Patients Unresponsive to Bacillus Calmette-Guérin, With or Without Papillary Tumors.

    Science.gov (United States)

    2018-03-20

    Bladder Cancer; Bladder Neoplasm; Bladder Tumors; Cancer of Bladder; Cancer of the Bladder; Malignant Tumor of Urinary Bladder; Neoplasms, Bladder; Urinary Bladder Cancer; Carcinoma in Situ of Bladder; Papillary Carcinoma of Bladder (Diagnosis); BCG-Unresponsive Bladder Cancer

  14. New developments in percutaneous stone surgery

    African Journals Online (AJOL)

    S. Derisavifard

    2016-08-01

    Aug 1, 2016 ... toxin content in renal calculi. J Urol 2003;169:1813–4. [20] Larson J, Roth E, Desai A, editor. Comparative analysis of stone com- position and stone culture after percutaneous nephrolithotomy. Podium session presented at: The 2014 Meeting of the American Urological. Association; May 20, 2014. Orlando ...

  15. Metabolic Characteristics and Risks Associated with Stone Recurrence in Korean Young Adult Stone Patients.

    Science.gov (United States)

    Kang, Ho Won; Seo, Sung Pil; Kim, Won Tae; Kim, Yong-June; Yun, Seok-Joong; Kim, Wun-Jae; Lee, Sang-Cheol

    2017-08-01

    The aim of this study was to assess the metabolic characteristics and risks of stone recurrence in young adult stone patients in Korea. The medical records of 1532 patients presenting with renal or ureteric stones at our stone clinic between 1994 and 2015 were retrospectively reviewed. Patients were grouped according to age (young adult, 18-29 years; intermediate onset, 30-59 years; old age, ≥60 years) at first presentation, and measurements of clinicometabolic characteristics and risks of stone recurrence were compared. Overall, excretion of urinary stone-forming substances was highest in the intermediate onset group, followed by the young adult and old age groups. Importantly, excretion of urinary citrate was lowest in the young adult group. Kaplan-Meier analyses identified a significant difference between the three age groups in terms of stone recurrence (log rank test, p young adult stone patients. Younger age (18-29 years) at first stone presentation was a significant risk factor for stone recurrence, and urinary citrate excretion was an independent risk factor affecting recurrence in this group. Metabolic evaluation and potassium citrate therapy should be considered for young adult stone patients to prevent recurrence.

  16. Contribution of stone size to chronic kidney disease in kidney stone formers.

    Science.gov (United States)

    Ahmadi, Farrokhlagha; Etemadi, Samira Motedayen; Lessan-Pezeshki, Mahbob; Mahdavi-Mazdeh, Mitra; Ayati, Mohsen; Mir, Alireza; Yazdi, Hadi Rokni

    2015-01-01

    To determine whether stone burden correlates with the degree of chronic kidney disease in kidney stone formers. A total of 97 extracorporeal shockwave lithotripsy candidates aged 18 years and older were included. Size, number and location of the kidney stones, along with cumulative stone size, defined as the sum of diameters of all stones) were determined. Estimated glomerular filtration rate was determined using the Chronic Kidney Disease Epidemiology Collaboration cystatin C/creatinine equation, and chronic kidney disease was defined as estimated glomerular filtration rate chronic kidney disease. The relationship persisted even after adjustment for age, sex, body mass index, C-reactive protein, fasting plasma glucose, thyroid stimulating hormone, presence of microalbuminuria, history of renal calculi, history of extracorporeal shockwave lithotripsy, number and location of the stones (odds ratio 1.24, 95% confidence interval 1.02-1.52). The same was not observed for individuals with a cumulative stone size ≥ 20 mm. In kidney stone formers with a cumulative stone size up to 20 mm, estimated glomerular filtration rate linearly declines with increasing cumulative stone size. Additionally, cumulative stone size is an independent predictor of chronic kidney disease in this group of patients. © 2014 The Japanese Urological Association.

  17. [Asymptomatic kidney stones: active surveillance vs. treatment].

    Science.gov (United States)

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Bladder preservation using chemoradiation therapy for locally invasive bladder cancer

    International Nuclear Information System (INIS)

    Abe, Toyofumi; Yoshioka, Toshiaki; Sato, Mototaka; Mori, Naoki; Sekii, Ken-Ichiro; Itatani, Hiroaki

    2011-01-01

    We investigated the long-term results and molecular markers of outcome with selective organ preservation in invasive bladder cancer using chemoradiation therapy. We examined locally invasive bladder cancer in 32 patients (30 men, 2 women; mean age at treatment 68.1 years) who underwent bladder-sparing protocols in the Department of Urology at Sumitomo Hospital between 2000 and 2005. The clinical stage was T2, T3, and T4 in 13, 16, and 3 patients, respectively. Our protocol includes aggressive transurethral resection of the bladder tumor (TURBT) and 46 Gy radiotherapy (2 Gy/fraction, 5 fractions/week) to the pelvis with concurrent cisplatin chemotherapy (20 mg/body/day, 5 days/week, the first and fourth week, intravenously). The initial evaluation included magnetic resonance imaging (MRI), urine cytology, and cystoscopy with a biopsy. During follow-up, if the patients developed superficial recurrence, they was treated with TURBT and intravesical Bacillus Calmette-Guerin (BCG), while patients with invasive recurrence were advised to undergo a salvage cystectomy. We examined the association between the expression of the Bcl-2 family in pretreatment TUR specimens and patient outcome. The mean follow-up was 54.6 months. The first assessment after the induction chemoradiotherapy showed that bladder preservation was achieved in 27 patients (84.4%). The actuarial local control rate with an intact bladder was 56.3% (18 patients) at 3 years. The 1-, 3-, and 5-year cancer-specific survival rate was 90.6, 84.0, and 66.9%, respectively. The 5-year cancer-specific survival rate was 75.0, 67.2, and 33.3% in T2, T3, and T4, respectively. Bcl-x positivity was significantly associated with a poor cancer-specific survival rate (log-rank test, p=0.038). Chemoradiation therapy for invasive bladder cancer can achieve survival rates similar to those in patients treated with radical cystectomy, with successful bladder preservation. Our results suggest that the expression of Bcl-x is a

  19. Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone.

    Science.gov (United States)

    el-Nahas, Ahmed R; Eraky, Ibrahim; Shokeir, Ahmed A; Shoma, Ahmed M; el-Assmy, Ahmed M; el-Tabey, Nasr A; Soliman, Shady; Elshal, Ahmed M; el-Kappany, Hamdy A; el-Kenawy, Mahmoud R

    2012-06-01

    To determine factors affecting the stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones. The computerized database of patients who underwent PNL for treatment of staghorn stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting stone-free and complication rates. The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral stones). The stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual stones were complete staghorn stone and presence of secondary calyceal stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Factors affecting the incidence of residual stones after PNL are complete staghorn stones and the presence of secondary calyceal stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Imaging of urinary bladder tumors

    International Nuclear Information System (INIS)

    Hadjidekov, G.

    2015-01-01

    Full text: Primary bladder neoplasms account for 2%-6% of all tumors, with urinary bladder cancer ranked as the fourth most common cancer in males. Transitional cell carcinoma (TCC) is the most common subtype of urothelial tumour accounting for approximately 90% of all urothelial cancers. It is typically observed in men aged 50-70 years with history of smoking or occupational exposure to carcinogens. Most urothelial neoplasms are low-grade papillary tumors, with high incidence of recurrence, requires rigorous follow-up but have a relatively good prognosis. Other bladder neoplasm include squamous cell carcinoma accounts for 2%-15% mainly according to geographic location; adenocarcinoma - less than 2% /both occurring in the context of chronic bladder infection and irritation/; mesenchymal tumors in 5%, with the most common examples being rhabdomyosarcoma in children and leiomyosarcoma in adults. More rare mesenchymal tumors include paraganglioma, lymphoma, leiomyoma and solitary fibrous tumor which have no specific typical imaging findings to be differentiated. Multidetector computed tomography urography is an efficient tool for diagnosis and follow-up in patients with transitional cell carcinoma and it can be considered the primary radiologic method for detection, staging and assessment of the entire urothelium regarding the multicentric nature of TCC. MRI is rapidly expanding modality of choice especially in locally staging the tumor and in controversies. Accurate TNM staging is primordial in choosing treatment and prognosis for patients with bladder carcinoma. Correct interpretation and classification of the tumour is helpful for the urologists to determine further management in these cases. The learning objectives of the presentation are: to illustrate the spectrum of CT and MRI findings and to assess their clinical value in patients with transitional cell carcinoma and some other bladder neoplasm; to discuss the TNM staging based on the imaging findings; to be

  1. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    NARCIS (Netherlands)

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-01-01

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is

  2. Medical management of overactive bladder

    Directory of Open Access Journals (Sweden)

    Sarvpreet S Ubee

    2010-01-01

    Full Text Available Overactive bladder (OAB, as defined by the International Continence Society, is characterized by a symptom complex including urinary urgency with or without urge incontinence, usually associated with frequency and nocturia. OAB syndrome has an incidence reported from six European countries ranging between 12-17%, while in the United States; a study conducted by the National Overactive Bladder Evaluation program found the incidence at 17%. In Asia, the prevalence of OAB is reported at 53.1%. In about 75%, OAB symptoms are due to idiopathic detrusor activity; neurological disease, bladder outflow obstruction (BOO intrinsic bladder pathology and other chronic pelvic floor disorders are implicated in the others. OAB can be diagnosed easily and managed effectively with both non-pharmacological and pharmacological therapies. The first-line treatments are lifestyle interventions, bladder training, pelvic floor muscle exercises and anticholinergic drugs. Antimuscarinics are the drug class of choice for OAB symptoms; with proven efficacy, and adverse event profiles that differ somewhat.

  3. In bits, bytes and stone

    DEFF Research Database (Denmark)

    Sabra, Jakob Borrits; Andersen, Hans Jørgen

    designs'. Urns, coffins, graves, cemeteries, memorials, monuments, websites, applications and software services, whether cut in stone or made of bits, are all influenced by discourses of publics, economics, power, technology and culture. Designers, programmers, stakeholders and potential end-users often....... The findings in this paper are contextualized through a qualitative ethnographic research design based on Danish cemetery users and mourners and their different experiences with and attitudes towards new online grief, mourning and remembrance designs, platforms, services and initiatives. Additionally...... constitute parts of an intricately weaved and interrelated network of practices dealing with death, mourning, memorialization and remembrance. Design pioneering company IDEO'S recent failed attempt to 'redesign death' is an example of how delicate and difficult it is to work with digital and symbolic 'death...

  4. Apparatus for disintegrating kidney stones

    Science.gov (United States)

    Angulo, E. D. (Inventor)

    1984-01-01

    The useful life of the wire probe in an ultrasonic kidney stone disintegration instrument is enhanced and prolonged by attaching the wire of the wire probe to the tip of an ultrasonic transducer by means of a clamping arrangement. Additionally, damping material is applied to the wire probe in the form of a damper tube through which the wire probe passes in the region adjacent the transducer tip. The damper tube extends outwardly from the transducer tip a predetermined distance, terminating in a resilient soft rubber joint. Also, the damper tube is supported intermediate its length by a support member. The damper system thus acts to inhibit lateral vibrations of the wire in the region of the transducer tip while providing little or no damping to the linear vibrations imparted to the wire by the transducer.

  5. Bladder hernia: Multidetector computed tomography findings

    Directory of Open Access Journals (Sweden)

    Ankur Gadodia

    2011-01-01

    Full Text Available Herniation of bladder in inguinal hernia is rare, with most cases diagnosed intraoperatively. Preoperative diagnosis is even rarer. We report a case of bladder as content of inguinal hernia diagnosed using multidetector computed tomography.

  6. Bladder Morphology Using 2 Different Catheter Designs

    Science.gov (United States)

    2017-04-10

    Urologic Injuries; Urologic Diseases; Bladder Infection; Urinary Tract Infections; Mucosal Inflammation; Mucosal Infection; Bladder Injury; Catheter-Related Infections; Catheter Complications; Catheter; Infection (Indwelling Catheter); Pelvic Floor Disorders; Urinary Incontinence

  7. Stone orientation affects the mechanism of failure in artificial kidney stones subject to shock waves

    Science.gov (United States)

    van Cauwelaert, Javier; Cleveland, Robin O.

    2003-10-01

    Micro computed tomography (CT) imaging was used to follow the progressive development of cracks in artificial kidney stones. The artificial stones were made from U30 cement with a cylindrical shape (6.5 mm diameter and 8.5 mm long). The stones were held within a polypropylene vial in one of three orientations: vertical, horizontal, and angled at 45 deg. The stones were treated with an electromagnetic lithotripter and the initiation and growth of cracks was observed using microCT. The images show that the orientation of the stones with respect to the shock changes the dominant mechanism for fragmentation. Vertical stones developed a spall-like crack near the distal surface, which propagated from the surface to the interior of the stone. Initiation of a secondary spall-like crack was observed proximal to the first crack. Little surface damage was observed. Horizontal stones presented pitting in the proximal surface and erosion in lateral faces, indicating the action of cavitation. Angled stones presented both spall-like fracture in either the leading or the distal corners and surface damage (pitting) in the proximal surface. Experiments are being performed to follow the development of cracks in human kidney stones. [Work supported by the Whitaker Foundation.

  8. Shock Wave Lithotripsy in Ureteral Stones: Evaluation of Patient and Stone Related Predictive Factors

    Directory of Open Access Journals (Sweden)

    Ozgur Yazici

    2015-08-01

    Full Text Available ABSTRACTPurpose:To evaluate the patient and stone related factors which may influence the final outcome of SWL in the management of ureteral stones.Materials and Methods:Between October 2011 and October 2013, a total of 204 adult patients undergoing SWL for single ureteral stone sizing 5 to 15 mm were included into the study program. The impact of both patient (age, sex, BMI, and stone related factors (laterality, location, longest diameter and density as CT HU along with BUN and lastly SSD (skin to stone distance on fragmentation were analysed by univariate and multivariate analyses. Results: Stone free rates for proximal and distal ureteral stones were 68.8% and 72.7%, respectively with no statistically significant difference between two groups (p=0.7. According to univariate and multivariate analyses, while higher BMI (mean: 26.8 and 28.1, p=0.048 and stone density values (mean: 702 HU and 930 HU, p<0.0001 were detected as statistically significant independent predictors of treatment failure for proximal ureteral stones, the only statistically significant predicting parameter for the success rates of SWL in distal ureteral stones was the higher SSD value (median: 114 and 90, p=0.012.Conclusions:Our findings have clearly shown that while higher BMI and increased stone attenuation values detected by NCCT were significant factors influencing the final outcome of SWL treatment in proximal ureteral stones; opposite to the literature, high SSD was the only independent predictor of success for the SWL treatment of distal ureteral stones.

  9. Modifying factors in urinary bladder carcinogenesis

    OpenAIRE

    Ito, Nobuyuki; Fukushima, Shoji; Shirai, Tomoyuki; Nakanishi, Keisuke; Hasegawa, Ryohei; Imaida, Katsumi

    1983-01-01

    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...

  10. Characterization of Technetium Speciation in Cast Stone

    Energy Technology Data Exchange (ETDEWEB)

    Um, Wooyong; Jung, Hun Bok; Wang, Guohui; Westsik, Joseph H.; Peterson, Reid A.

    2013-11-11

    This report describes the results from laboratory tests performed at Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE) EM-31 Support Program (EMSP) subtask, “Production and Long-Term Performance of Low Temperature Waste Forms” to provide additional information on technetium (Tc) speciation characterization in the Cast Stone waste form. To support the use of Cast Stone as an alternative to vitrification for solidifying low-activity waste (LAW) and as the current baseline waste form for secondary waste streams at the Hanford Site, additional understanding of Tc speciation in Cast Stone is needed to predict the long-term Tc leachability from Cast Stone and to meet the regulatory disposal-facility performance requirements for the Integrated Disposal Facility (IDF). Characterizations of the Tc speciation within the Cast Stone after leaching under various conditions provide insights into how the Tc is retained and released. The data generated by the laboratory tests described in this report provide both empirical and more scientific information to increase our understanding of Tc speciation in Cast Stone and its release mechanism under relevant leaching processes for the purpose of filling data gaps and to support the long-term risk and performance assessments of Cast Stone in the IDF at the Hanford Site.

  11. Intraoperative cholangiographic findings of intrahepatic duct stones

    International Nuclear Information System (INIS)

    Kim, Mi Young; Suh, Chang Hae; Choi, Hye Ran; Ahn, Byeong Yeob; Chung, Woun Kyun; Lee, Yong

    1989-01-01

    Operative cholangiography is considered essential during biliary operation in order to minimise the chance of negative exploration and to demonstrate the anatomy and pathology of intra and extrahepatic biliary tree. Although many authors have evaluated and accepted various techniques for operative cholangiography, the image of operative cholangiography is affected mainly by intrahepatic duct stones and anatomic characteristic of biliary tree. In case of intrahepatic duct stones accurate evaluation of the operative cholangiographic findings is important for a plan of further treatment including interventional procedures. We reviewed 45 operative cholangiograms of 30 patients with intrahepatic duct stones from January,1986 to September, 1988, and analysed operative cholangiographic findings with a special attention to the correlation between cholangiographic findings and the location of intrahepatic duct stones. The results were as follows: 1. Common bile duct stones were found in 72%, and generalized cholangitis was combined in 43% of patient with intrahepatic duct stones. 2. Incomplete ductal filling of contrast media was the most frequent findings of left intrahepatic duct stones in operative cholangiograms with four different cholangiogram catheters. 3. Nonfilling and partial filling were the most frequent findings; nonfilling was prevalent in right anterior and left medial ducts, and partial filling was prevalent in left medial and left lateral ducts

  12. Pathophysiology of the underactive bladder

    Directory of Open Access Journals (Sweden)

    Naoki Aizawa

    2017-12-01

    Full Text Available Underactive bladder (UAB, which has been described as a symptom complex suggestive of detrusor underactivity, is usually characterized by prolonged urination time with or without a sensation of incomplete bladder emptying, usually with hesitancy, reduced sensation on filling, and slow stream often with storage symptoms. Several causes such as aging, bladder outlet obstruction, diabetes mellitus, neurologic disorders, and nervous injury to the spinal cord, cauda equine, and peripheral pelvic nerve have been assumed to be responsible for the development of UAB. Several contributing factors have been suggested in the pathophysiology of UAB, including myogenic failure, efferent and/or afferent dysfunctions, and central nervous system dysfunction. In this review article, we have described relationships between individual contributing factors and the pathophysiology of UAB based on previous reports. However, many pathophysiological uncertainties still remain, which require more investigations using appropriate animal models.

  13. Trigonalgia: An overlooked cause of bladder pain

    African Journals Online (AJOL)

    S. Aminu

    2015-12-04

    Dec 4, 2015 ... has shown a mean prevalence of 61% due to bladder pain syndrome excluding pregnancy and cancer [2]. E-mail address: sani aminu@hotmail.com. Peer review under responsibility of Pan African Urological Surgeons'. Association. Bladder pain denotes painful experience arising from the bladder.

  14. Tumour cell expansion in bladder epithelium

    NARCIS (Netherlands)

    J.M.J. Rebel (Annemarie)

    1995-01-01

    textabstractBladder cancer is common in western society. The major problem of patients with superficial bladder cancer is the high recurrence rate and multifocality of these tumours. In 70 % of the patients superficial bladder cancer recurs after local resection of the tumour within 15 years. The

  15. Button Cystostomy: Is it Really a Safe and Effective Therapeutic Option in Pediatric Patients With Neurogenic Bladder?

    Science.gov (United States)

    Mosiello, Giovanni; Lopes Mendes, Ana Ludy; Capitanucci, Maria Luisa; Zaccara, Antonio Maria; De Gennaro, Mario

    2017-03-01

    To define safety and effectiveness of cystostomy button in the management of bladder drainage in pediatric patients with neurogenic bladder, and report our personalized surgical technique. This study is a retrospective analysis of patients undergoing cystostomy button placement for bladder drainage from October 2009 to December 2015. Endoscopic and open surgical techniques and medium-term complication were analyzed and indications were recorded. Thirty-five patients, 16 (45.7%) females and 19 (54.3%) males, underwent cystostomy button placement for bladder drainage with a mean age of 8.6 ± 4.8 years (standard deviation) and a mean follow-up time of 37 months. There were 91.4% of patients who had a neurogenic bladder; a nonobstructive urinary retention was diagnosed in the remainder of cases. A medium-term complication was mostly represented by urinary tract infection observed in 10 of 35 patients that was the most representative cause of button removal (4 of 35). Other observed complications were button leakage (n = 2), decubitus (n = 1), and bladder stone (n = 1). No postoperative complication was observed and no differences were found in terms of complications in the two surgical approaches performed. Cystostomy button is a safe and effective treatment for bladder drainage in neurogenic pediatric patients and it is also well accepted by patients and caregivers. Cystostomy button, which may avoid mechanical concerns and most of the social discomfort, should be considered an alternative method to other bladder drainage modalities. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Multiple Urethral Stones Causing Penile Gangrene

    Directory of Open Access Journals (Sweden)

    Michael J. Ramdass

    2014-01-01

    Full Text Available Penile urethral stones are a rare occurrence resulting from a number of causes including migration of stones within the urinary tract, urethral strictures, meatal stenosis, and obstructing tumours such as adenomatous metaplasia of the uroepithelium, hypospadias, urethral diverticulum, and very rarely primary fossa navicularis calculi. We report the case of a 54-year-old male presenting with penile gangrene and sepsis resulting from impaction of multiple stones within the penile urethra. This paper summarises the topic and discusses the pathophysiology of this unusual condition.

  17. Choledocholithiasis without stones in the gallbladder

    International Nuclear Information System (INIS)

    Bergen, A.N.L.M. van; Rosenbusch, G.; Boer, H.H.M. de; Yap, S.H.

    1986-01-01

    In 4 out of 190 patients, who underwent a cholecystectomy, stones were only found in the common bile duct and none in the gallbladder. The radiological data of these 4 patients were retrospectively analysed. In 2/3 patients sonography showed a dilatation of the common bile duct, whereas stones in the common bile duct were shown by IVC in 2/2 patients, ERCP in 3/3 patients and PTC in 1/1 patients. In 1/3 patients also, in whom an ERCP had been performed, stones were suspected in the gallbladder, but could not be verified during cholecystectomy. (orig.)

  18. Choledocholithiasis without stones in the gallbladder

    Energy Technology Data Exchange (ETDEWEB)

    Bergen, A.N.L.M. van; Rosenbusch, G.; Boer, H.H.M. de; Yap, S.H.

    1986-11-01

    In 4 out of 190 patients, who underwent a cholecystectomy, stones were only found in the common bile duct and none in the gallbladder. The radiological data of these 4 patients were retrospectively analysed. In 2/3 patients sonography showed a dilatation of the common bile duct, whereas stones in the common bile duct were shown by IVC in 2/2 patients, ERCP in 3/3 patients and PTC in 1/1 patients. In 1/3 patients also, in whom an ERCP had been performed, stones were suspected in the gallbladder, but could not be verified during cholecystectomy.

  19. Thomas Young and the Rosetta Stone.

    Science.gov (United States)

    Robinson, Andrew

    2007-06-01

    Who deciphered the Rosetta Stone and the Egyptian hieroglyphs? The usual answer is Jean-François Champollion, beginning in 1822. But ever since that time, Egyptologists have debated the role of his rival, the polymath Thomas Young, the first person to publish a partially correct translation of the Rosetta Stone. A recent BBC television dramatisation rekindled the controversy by presenting Champollion as a 'lone genius' who succeeded independently of Young. While there is no doubt that Champollion deciphered the hieroglyphic script as a whole, the evidence suggests that Young's early detailed study of the Rosetta Stone created the conceptual framework that made possible Champollion's later breakthrough.

  20. Biliary stone removal: The interventional radiologist's role

    International Nuclear Information System (INIS)

    Schwarz, W.; Long, W.B.; Ring, E.J.; Rosato, E.F.

    1983-01-01

    Despite the recent popularity of endoscopic techniques, the interventional radiologist retains an important role in the non-surgical management of biliary duct stones. In the cases where endoscopic sphincterotomy is difficult, the radiologist can be of great assistance to the endoscopist. When endoscopic stone removal is not feasible, the radiologist can treat patients percutaneously. When surgery is performed in patients with recurrent stone disease, the radiologist can maintain biliary toilet. The various approaches to biliary removal through non-surgical tracts are discussed. (orig.)

  1. Nursing Care of Women With Interstitial Cystitis/Painful Bladder Syndrome.

    Science.gov (United States)

    MacMullen, Nancy J; Dulski, Laura A; Martin, Patricia B; Blobaum, Paul

    2016-01-01

    Interstitial cystitis/painful bladder syndrome is a chronic condition affecting approximately 3.3 million women in the United States. It is defined by the National Institute of Diabetes and Digestive and Kidney Diseases as "urinary pain that can't be attributed to other causes such as infection or urinary stones." Because of the intimate nature of the symptoms, women are often reluctant to seek treatment. When they do, they require a care provider with specialized nursing skills. Nursing practice based on carefully reviewed literature will result in the provision of comprehensive and compassionate nursing care for women with interstitial cystitis/painful bladder syndrome. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  2. Giant liver abscess due to almost asymptomatic common bile duct stone

    Directory of Open Access Journals (Sweden)

    Čolović Radoje B.

    2002-01-01

    Full Text Available Solitary pyogenic liver abscess is usually caused by a meta-static infection through the portal blood flow or through the hepatic arterial blood flow from extra-abdominal pyogenic foci. Besides, it may be the result of local inflammatory diseases, such as cholecystitis, hydatid cyst, haematomas particularly with retained foreign bodies, etc. Suppurative cholangitis usually causes multiple pyogenic liver abscesses. Solitary pyogenic abscess is rarely caused by cholangitis, but practically always by suppurative cholangitis. Giant pyogenic liver abscess due to asymptomatic or mild cholangitis is a rarity. We present on a 63 year old man who developed a giant solitary pyogenic liver abscess in whom no other possible cause could be found or anticipated except practically almost asymptomatic choledocholithiasis accompanied with mild elevation of bilirubin content alkaline phosphatase and gamma-GT. The patient was successfully treated operatively. Over 1800 ml. of pus was aspirated from the abscess cavity. Operative cholangiography performed in spite of the absence of gall bladder stones undilated and noninflamed common bile duct stone showed a small nonobstructing distal common bile duct stone. The duct was not dilated, the bile was clear and there were no signs of cholangitis in the inside of the common bile duct. Cholecystectomy and abscess cavity drainage led to uneventful recovery. The patient has been symptom-free for more than 3.5 years.

  3. Bladder Dysfunction and Urinary Incontinence

    OpenAIRE

    F. faizi

    2009-01-01

      "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 ...

  4. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    OBJECTIVE: The newer flexible ureteroscopes, 150-200-microm holmium YAG laser fibres and superflexible Dormia baskets have made it possible to reach and treat stones in all parts of the kidney. The object of this evaluation was to study the outcome of retrograde intrarenal stone surgery (RIRS......) for extracorporeal shock-wave lithotripsy (ESWL)-resistant kidney stones. MATERIAL AND METHODS: A total of 38 consecutive patients (18 males, 20 females) participated in the study. All patients had undergone ESWL prior to RIRS without success. In all cases the stones could be reached with the endoscope. Calculi...... ranged in size from 3 to 20 mm (mean 9 mm). In 32 cases the stones were fragmented using a holmium YAG laser and in six the stones could be extracted using zero-tip Dormia baskets without fragmentation. Sixteen patients had lower calyceal calculi and eight had an abnormal anatomy of the upper urinary...

  5. Factors affecting lower calyceal stone clearance after Extracorporeal ...

    African Journals Online (AJOL)

    shanker

    have been identified [1,3]. These include stone characteristics, the type of lithotripter used, LPC anatomy and body habitus. For iso- lated LPC stones, the pelvicalyceal angle, infundibulum length and width are considered important determinants for stone clearance. The impact of body habitus on stone clearance has so far ...

  6. Bladder augmentation using the gastrointestinal tract. Indication, follow up and complications.

    Science.gov (United States)

    Escudero, R Molina; Patiño, G Escribano; Fernández, E Rodríguez; Gil, M J Cancho; García, E Lledó; Alonso, A Husillos; Piniés, G Ogaya; Sánchez, J Piñeiro; Fernández, C Hernández

    2011-12-01

    The purpose of bladder augmentation using the gastrointestinal tract is to create a low-pressure and high-capacity reservoir, permitting suitable continence and voiding, preserving the upper urinary tract. To analyze the indications, complications and results of our series of augmentation enterocystoplasties. We retrospectively reviewed patients undergoing augmentation enterocystoplasty in our department between 1997 and 2010, both included. The indications were: Interstitial cystitis, neurogenic bladder and inflammatory bladder retraction. In all cases a cystography, urethrocystoscopy, urodynamic study and studies of each condition. Bladder release is performed by means of medial laparotomy and an extraperitoneal approach with bivalve opening to the urethral orifices. The bladder augmentation is performed with a 15-20 cm segment of detubularized ileum obtained at 20 cm from the ileocecal valve; in cases of kidney failure, a 7-cm gastric body wedge is added. The bladder catheter was removed following cystogram after 15 days. Monitoring was performed by means of ultrasound with postvoid residual, blood analyses, urine culture and voiding diary. We performed a descriptive study of the demographic characteristics, postoperative complications according to the Clavien classification and in the long term. We included 24 patients, 19 women and 5 men with a mean age of 48.5 years and a median of 47 (21-77). Mean follow up was 7.5 years with a median of 8 (1-11). The indications were: 7 interstitial cystitis, 8 bladder retraction and 7 neurogenic bladder. There were no intraoperative complications. The postoperative complications were 3 Clavien I, 2 type II, 2 IIIA and 1 IIIB. In the long term, 3 patients presented urinary incontinence, 2 mild metabolic acidosis, 5 required self-catheterization, 6 bladder stones, 2 febrile urinary tract infections and 1 stricture of the anastomotic mouth. In three cases, an ileogastrocystoplasty was performed without hydroelectrolytic

  7. Portugues Marbles as Stone Heritage

    Science.gov (United States)

    Lopes, Luis; Martins, Ruben

    2013-04-01

    The main objective of this paper is to present and justify the reasons for the worldwide recognition of Portuguese Marbles as Stone Heritage. These marbles are also known as "Estremoz Marble" since was the first county were exploited. In the Estremoz Anticline marbles occupy an intermediate stratigraphic position being part of a volcano-sedimentary sequence of Cambrian age. The anticlinal structure has a Precambrian core and the younger rocks aged Devonian Period. This sequence has deformed by the Variscan Orogeny, which performed twice with different intensities both in ductile and brittle tension fields. The early Alpine Cycle also acts in the region and cause more fracturing of the marble. Practically in all the quarries is possible to perceive the spatial-temporal continuity of the deformation where one can describe a complete Wilson Cycle. Together all these geological features imprint the marbles beautiful aesthetic patterns that can be highlighted when used as dimension stone. Nowadays most of the quarries are placed in the counties of Borba and mainly in Vila Viçosa. This last city claims for itself the "Capital of the Marble" title and named the marble as "White Gold". In fact, according to the historical record, the marbles were quarried in Portuguese Alentejo's Province since the fourth century BC. Locally these geological materials are available easily accessible. Exhibit physical properties that allow the fabrication of structural and decorative elements and so were used since humans settled in the region and developed a structured Society. In the Roman period, the pieces of art made with Estremoz Marbles were exported abroad and today are represented in Museums and Archaeological Sites throughout Europe and North Africa countries. The Portuguese Marbles and Limestones, transformed into altars, stairways, columns, statues and pieces of wall cladding, were carried as ballast in the holds of ships. At the destination the Portuguese People had built

  8. A Case of Recurrent Renal Aluminum Hydroxide Stone

    Directory of Open Access Journals (Sweden)

    Basri Cakıroglu

    2014-01-01

    Full Text Available Renal stone disease is characterized by the differences depending on the age, gender, and the geographic location of the patients. Seventy-five percent of the renal stone components is the calcium (Ca. The most common type of the stones is the Ca oxalate stones, while Ca phosphate, uric acid, struvite, and sistine stones are more rarely reported. Other than these types, triamterene, adenosine, silica, indinavir, and ephedrine stones are also reported in the literature as case reports. However, to the best of our knowledge, aluminum hydroxide stones was not reported reported before. Herein we will report a 38-years-old woman with the history of recurrent renal colic disease whose renal stone was determined as aluminum hydroxide stone in type. Aluminum mineral may be considered in the formation of kidney stones as it is widely used in the field of healthcare and cosmetics.

  9. Compositions of stone and stone surface materials of historical monuments from Vidzeme and Zemgale

    International Nuclear Information System (INIS)

    Actins, A.; Spricis, A.; Zekunde, A.; Nemerova, A.

    2004-01-01

    By means of x-ray analysis composition of stone and stone surface materials of historical monuments from Vidzeme and Zemgale was investigated. Corrosion products of tuffa materials were identified on surfaces of some investigated monuments. Similarity of composition of products of stone corrosion for monuments from Latvia and Poland was recognised. Content of heavy metals at stone materials of historical monuments and at the surface layers of these monuments was investigated by means of atomic absorption and potentiometric stripping methods. Reasons of formation of compounds and pollution of investigated samples were discussed. (full text)

  10. Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Wang, Ralph C; Smith-Bindman, Rebecca; Whitaker, Evans; Neilson, Jersey; Allen, Isabel Elaine; Stoller, Marshall L; Fahimi, Jahan

    2017-03-01

    Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone. MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design. Meta-analysis was conducted with a random-effects model and subgroup analyses were conducted to determine sources of heterogeneity. Eight randomized controlled trials (N=1,384) contained sufficient information for inclusion. The pooled risk of stone passage in the tamsulosin arm was 85% versus 66% in the placebo arm, but substantial heterogeneity existed across trials (I 2 =80.2%; Ptamsulosin (risk difference=22%; 95% confidence interval 12% to 33%; number needed to treat=5). The meta-analysis of the small stone subgroup (Tamsulosin significantly improves stone passage in patients with larger stones, whereas the effect of tamsulosin is diminished in those with smaller stones, who are likely to pass their stone regardless of treatment. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  11. IGCP 637 Heritage Stone Designation: A UNESCO and IUGS project on natural stones

    Science.gov (United States)

    Pereira, Dolores; Cooper, Barry; Schouenborg, Björn; Marker, Brian; Kramar, Sabina

    2017-04-01

    IGCP 637 was approved in 2015 to facilitate establishment of a new international geological standard for building and ornamental stones. Formal international recognition of those natural stone types that have achieved widespread utilization in human culture is now underway and the term "Global Heritage Stone Resource" (GHSR) has been proposed for this designation. Stones that have been used in heritage construction, sculptural masterpieces, as well as in utilitarian (yet culturally important) applications are obvious GHSR candidates. In co-ordination with these aims the project has an associated role to promote the adoption and use of the GHSR designation. Consequently an interim list of potential GHSRs is maintained and a register of GHSR approved stones is being created. IGCP 637 also enhances the capacity of the International Union of Geological Sciences (IUGS) in the realm of dimension stone and geological standards as it is the first IUGS involvement in this subject. As a consequence, the largest known international grouping of dimension stone professionals has been established. Within IGCP 637 a web page has been created at www.globalheritagestone.com, including information on the Working Group and also specific information on the evolution of the project. Several researchers were funded to attend the Heritage Stone working group activities, including researchers from Algeria, Malawi, India, Italy and Russia. We also have produced many publications, both as individual papers and special issues in journals included in the Journal Citation Reports. Monographs are being prepared at present. Hopefully, IGCP 637 will help to widen the circle of researchers interested in natural stones as part of our geoheritage. Heritage Stone references: articles and special issues - Pereira, D. and Marker, B. (2016) The value of original natural stone in the context of architectural heritage. Geosciences, 6, 13. - Heritage Stone 1. Ed. Pereira and Pratt. (2016). Geoscience

  12. CT findings of common bile duct stones

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Byung Hee; Lee, Sang Kil; Kim, Jong Sung; Joo, Kyung Bin; Cho, On Koo; Hahm, Chang Kok; Kim, Yong Il [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1992-11-15

    A retrospective study on computed tomographic (CT) findings in 35 surgically confirmed cases of common bile duct stones was performed to analyze the characteristic CT findings. Choledocholithiasis was correctly diagnosed by CT in 33 out of 35 cases (sensitivity, 94.3%) and among these CT demonstrated calculi of high attenuation in 32 and of soft tissue density in one case. The thirty two included 23 totally calcified. 5 rim calcified and 4 laminated stones. The target sign was observed in 30 out of 33 CT positive cases (90.1%). We concluded that CT is an accurate modality in the diagnosis of common bile duct stones with its' reliable display of the calcified or the laminated stone itself and its' characteristic target sign.

  13. CT findings of common bile duct stones

    International Nuclear Information System (INIS)

    Koh, Byung Hee; Lee, Sang Kil; Kim, Jong Sung; Joo, Kyung Bin; Cho, On Koo; Hahm, Chang Kok; Kim, Yong Il

    1992-01-01

    A retrospective study on computed tomographic (CT) findings in 35 surgically confirmed cases of common bile duct stones was performed to analyze the characteristic CT findings. Choledocholithiasis was correctly diagnosed by CT in 33 out of 35 cases (sensitivity, 94.3%) and among these CT demonstrated calculi of high attenuation in 32 and of soft tissue density in one case. The thirty two included 23 totally calcified. 5 rim calcified and 4 laminated stones. The target sign was observed in 30 out of 33 CT positive cases (90.1%). We concluded that CT is an accurate modality in the diagnosis of common bile duct stones with its' reliable display of the calcified or the laminated stone itself and its' characteristic target sign

  14. Production and characterization of composite stone

    International Nuclear Information System (INIS)

    Leirose, G.D.; Lameiras, F.S.

    2012-01-01

    Composite stone is a product similar to natural granite or marble, produced with particles of these materials. This material is used like natural stone as lining. The fabrication of artificial stones using residues of banded iron formations is a promising alternative to its actual destination (storage in dam). This research aims the characterization of composite stone to prove the efficacy of this kind of processing. It was used first, natural quartz as a raw material. The patterns of the samples were confirmed by IR spectra and XRD patterns, ensuring the reproducibility of processing applied. Moreover, this material is homogeneous, with low porosity and high flexural strength, confirmed by its structural characterization. Thus, it can be affirmed that the process chosen is suitable, enabling the application of this methodology to the use of waste. (author)

  15. A laparoscopic approach to CBD stones.

    Science.gov (United States)

    Khanzada, Zubair; Morgan, Richard

    2013-12-01

    : This study aimed to evaluate single-stage surgical (laparoscopic or open) approach to the management of common bile duct (CBD) stones, as treatment of choice. Prospectively collected data to assess outcomes of CBD clearance, morbidity, mortality, and hospital stay, and compared with published data. Successful clearance of CBD stones was achieved in 96% cases, laparoscopic exploration successful in 83%. Retained stones were found in 4% cases and another 5% developed postoperative complications. Common length of stay in hospital was 2 days, although mean stay was 4 days. Seventy-three percent of cases were elective, 27% were emergencies. Conversion rate to open surgery was 14%, which was mainly in emergency cases. Postoperative mortality was 1.2%, not directly related to the procedure. Good outcomes can be achieved, comparing favorably with those of other modalities, when laparoscopic bile duct exploration is chosen as treatment for CBD stones; the best results can be anticipated in elective patients.

  16. Extracorporeal shock wave lithotripsy for urinary stones

    International Nuclear Information System (INIS)

    Shinn, Kyung Sub; Kim, Hyun; Byun, Jae Young; Lee, Myung Hee; Bahk, Yong Whee; Park, Yong Hyun

    1988-01-01

    Extracorporeal shock wave lithotripsy (ESWL) is a new noninvasive treatment modality for urinary stones, and it sometimes is to necessitate endourologic techniques. ESWL with an Edap lithotripter which uses piezo-electric elements, was performed in 142 cases (130 patients) with urinary stones including 68 in calices, 30 in pelves, and 44 in ureters. Technical factors were 100 storages at 5 to 10 pulse rates/sec and 70-100% adjustable power for about 60 minutes (15-90) for renal stones, and 200 storages at 20 pulse rates/sec and 100% adjustable power for about 60 minutes for ureteral stones in a single treatment under stone localization by 5 MHz ultrasonic sector scanner. All patients were treated at Kangnam St.Mary's Hospital of Catholic University Medical College during the 5 months period from May 1, 1987. Every patient had pre-treatment chest, plain abdomen, intravenous urogram and ultrasonogram studies and post-treatment follow-up abdominal radiograms in 1 to 3 months after ESWL.The overall success rate of ESWL in 142 cases was 94.4%. Eight out of 142 cases were successful. Thus, 134 cases were analysed. Of these, 58 cases (43.3%) received one treatment, 33 cases (24.6%) two treatments, 16 cases (11.9%) three treatments and 27 cases (20.2%) more than four treatments. Renal stones were more successfully treated (98.0%) than ureteral stones (88.1%), and calyceal stones presented the highest success rate (98.5%). The stones as small as 5 to 10 mm in size were easily fragmented and the stones of round of oval shape were more easily pulverized than those of staghorn or amorphous shape. The adjunctive endourlogic techniques such as percutaneous nephrostomy, ureteral catheterization or internal ureteral stenting with a double pigtail catheter were required in 17 cases (11.9%). Complications of ESWL for urolithiasis included hematuria (84.5%), flank pain (8.5%) and fever (5.6%), which were controlled without specific treatment. ESWL using ultrasonic localization was

  17. Bariatric Surgery and Urinary Stone Disease

    Directory of Open Access Journals (Sweden)

    Cevahir Ozer

    2016-07-01

    Full Text Available Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.

  18. Evidence Report: Risk of Renal Stone Formation

    Science.gov (United States)

    Sibonga, Jean D.; Pietrzyk, Robert

    2017-01-01

    The formation of renal stones poses an in-flight health risk of high severity, not only because of the impact of renal colic on human performance but also because of complications that could potentially lead to crew evacuation, such as hematuria, infection, hydronephrosis, and sepsis. Evidence for risk factors comes from urine analyses of crewmembers, documenting changes to the urinary environment that are conducive to increased saturation of stone-forming salts, which are the driving force for nucleation and growth of a stone nidus. Further, renal stones have been documented in astronauts after return to Earth and in one cosmonaut during flight. Biochemical analysis of urine specimens has provided indication of hypercalciuria and hyperuricemia, reduced urine volumes, and increased urine saturation of calcium oxalate and calcium phosphate. A major contributor to the risk for renal stone formation is bone atrophy with increased turnover of the bone minerals. Dietary and fluid intakes also play major roles in the risk because of the influence on urine pH (more acidic) and on volume (decreased). Historically, specific assessments on urine samples from some Skylab crewmembers indicated that calcium excretion increased early in flight, notable by day 10 of flight, and almost exceeded the upper threshold for normal excretion (300mg/day in males). Other crewmember data documented reduced intake of fluid and reduced intake of potassium, phosphorus, magnesium, and citrate (an inhibitor of calcium stone formation) in the diet. Hence, data from both short-duration and long-duration missions indicate that space travel induces risk factors for renal stone formation that continue to persist after flight; this risk has been documented by reported kidney stones in crewmembers.

  19. Pathobiology and Chemoprevention of Bladder Cancer

    Science.gov (United States)

    Tanaka, Takuji; Miyazawa, Katsuhito; Tsukamoto, Tetsuya; Kuno, Toshiya; Suzuki, Koji

    2011-01-01

    Our understanding of the pathogenesis of bladder cancer has improved considerably over the past decade. Translating these novel pathobiological discoveries into therapies, prevention, or strategies to manage patients who are suspected to have or who have been diagnosed with bladder cancer is the ultimate goal. In particular, the chemoprevention of bladder cancer development is important, since urothelial cancer frequently recurs, even if the primary cancer is completely removed. The numerous alterations of both oncogenes and tumor suppressor genes that have been implicated in bladder carcinogenesis represent novel targets for therapy and prevention. In addition, knowledge about these genetic alterations will help provide a better understanding of the biological significance of preneoplastic lesions of bladder cancer. Animal models for investigating bladder cancer development and prevention can also be developed based on these alterations. This paper summarizes the results of recent preclinical and clinical chemoprevention studies and discusses screening for bladder cancer. PMID:21941546

  20. Leiomyoma of the bladder and MRI

    International Nuclear Information System (INIS)

    Kabbaj, N.; Dafiri, R.; Imani, F.; Benslimane, L.; Benchekroun, A.

    1998-01-01

    Unlike epithelial tumors, connective tissue tumors are uncommon, representing only 3 % of all bladder tumors. Leiomyoma of the bladder is the most frequent non-epithelial benign tumor of the bladder. Magnetic resonance imaging (MIR) is highly useful for diagnostic purposes and to determine the degree of extension. Only few reports of sonographic findings have been reported for leiomyoma of the bladder. The tumor usually develops within the bladder. Extra-vesicular formations have also been reported as well as a few intramural localizations. The characteristic feature is the absence of mucosal involvement. We analyzed the MRI findings in a case of leiomyoma of the bladder with intra and extra-vesicular development inflammatory reaction of the bladder wall and uterine adherences in a woman with a past history of chronic cystitis. The role of diagnostic MRI is discussed. (author)

  1. Bladder Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing bladder cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  2. Bladder-type hydropneumatic accumulators

    International Nuclear Information System (INIS)

    Anigas, F.

    1985-01-01

    Hydropneumatic pressure accumulators allow liquids to be stored under pressure, their operating principle being based on the inherent compressibility of elements in a liquid and gaseous state. A wide range of fluids can be covered by means of the appropriate choice of the material for the body and bladder. Their main applications are: energy accumulation, safety reserve, suspension. (author)

  3. Bladder carcinoma. Apport MR imaging

    International Nuclear Information System (INIS)

    Roy, C.; Spittler, G.; Jacqmin, D.; Morel, M.

    1991-01-01

    Bladder carcinoma is the second most commun cause of urogenital tumor. It is suspected by abdominal ultrasound and prouved by cystoscopy with biopsy. At present, MR Imaging is the most accurate diagnostic modality for loco-regional staging. Urography is still useful to appreciate urinary tract [fr

  4. Fundamentals of bladder tissue engineering

    African Journals Online (AJOL)

    W. Mahfouz

    promote angiogenesis and neurogenesis of the regenerated organs. The choice of the scaffold and the type of cells is a crucial and fundamental step in regenerative medicine. In this review article, we demonstrated these three crucial factors of bladder tissue engineering, with the pros and cons of each scaffold type and.

  5. Female stone disease: the changing trend.

    Science.gov (United States)

    Marickar, Y M Fazil; Vijay, Adarsh

    2009-12-01

    This paper has attempted to assess the changes noted in the trends in the incidence and biochemical pattern of female urolithiasis patients during the period 1971-2008. A prospective descriptive clinical study was done on 8,590 stone patients belonging to both sexes treated at the urinary stone clinic. The incidence of stone disease among the two sexes was plotted. The various metabolic parameters including 24-h urine volume, urine calcium, phosphorus, uric acid, oxalate, magnesium, creatinine and citrate, serum creatinine, calcium, phosphorus, uric acid and magnesium and calculated parameter calcium:magnesium ratio were studied. The possible causes for the change in incidence of stone disease in the female sex were elucidated. Of the patients studied, 12.7% (1,091) were females. There was a definite increase in the incidence of female urolithiasis over the past 37 years (P urine biochemical parameters. There was a definite increase in the excretion of urinary calcium over the years (P urine of females also increased steadily over the years (P urine of females reduced over the years (P phosphorus (P phosphorus and magnesium also increased significantly with the passage of time. Serum uric acid did not vary significantly through the years. The decrease in the excretion rate of magnesium which is inhibitory to stone genesis, together with the increased excretion of calcium and oxalate may have contributed to the increasing incidence of stone disease in females. This might be due to changes in living standards and dietary habits.

  6. Frequency of Metabolic Risk Factors in Children with Urinary Tract Stones Referred to Hamadan Pediatric Nephrology Clinic

    Directory of Open Access Journals (Sweden)

    H.E. Momtaz

    2012-07-01

    Full Text Available Introduction & Objective: Urinary stones are among the most common complaints referred to nephrologist and urologists. Although incidence of urolithiasis is low in children compared to adults and only 7% of all urinary stones are diagnosed before the age of 16 but stones are detected more frequently in pediatric age group in recent years. Metabolic derangements, infection, neurogenic bladder and urinary obstruction are major risk factors of urolithiasis. Common metabolic risk factors of urolithiasis in children are hypercalciuria, uricosuria, hypocitraturia, hyperoxaluria, metabolic acidosis and cystinuria. There are many clinical studies about the frequency of these metabolic risk factors with different results reflecting difference in diet, geographic area and genetics in study populations. In this study we tried to evaluate the frequency of metabolic causes of urinary stones in children referred to Hamadan pediatric nephrology clinic.Materials & Methods: In this cross sectional-descriptive study 156 patients referred due to urinary stones to pediatric nephrology clinic underwent thorough metabolic evaluations including: serum calcium,phosphorus, uric acid, creatinine and non fasting random urine sample for calcium, creatinine , uric acid , oxalate, citrate and cystine . urine solute: creatinine ratios were calculated and compared with normative data.Results: Of 156 patients 136(87.2% had metabolic derangements including: hyperuricosuria in 71 (45.5%, hypercalciuria in 41(26.3%, hypocitraturia in 26 (16.7%, hyperoxaluria in 16(10.3%,cystinuria in 1(0.6% and metabolic acidosis in 39 (25%.Conclusion: High rate of metabolic derangement in pediatric urinary stone patients mandates proper metabolic evaluation in all of them. hyperuricosuria was the most common metbolic finding instead of hypercalciuria in this study. This could be due to differences in diet, geographic area and genetic background in various populations.(Sci J Hamadan Univ Med Sci

  7. Percutaneous lithotripsy for removing difficult bile duct stones using endoscopy

    International Nuclear Information System (INIS)

    Kim, See Hyung; Sohn, Chul Ho; Kim, Young Hwan

    2008-01-01

    To describe efficacy of percutaneous lithotripsy for removing difficult bile duct stones using endoscopy. A total of 88 patients with difficulties for the removal of bile duct stones using endoscopy (an impacted stone, stone size > 15 mm, intrahepatic duct (IHD) stone, stone size to bile duct diameter ratio > 1.0), were enrolled in this study. A 12 Fr sheath was inserted through the percutaneous transhepatic biliary drainage (PTBD) tract, and then nitrol stone baskets and a 0.035' snare wire were used to capture, fragment and remove the stones. The technical and clinical success rates were analyzed, together with an analysis of any complications. The overall technical success rate of stone removal was achieved in 79 of 88 patients (89.8%). In five of nine patients with failed stone removal, small residual IHD stones were noted on a cholangiogram. Even if stone removal failed in these cases, cholangitic symptoms were improved and the drainage catheter was successfully removed. Therefore, clinical success was achieved in 84 of 88 patients (95.5%). There were no significant procedure-related complications, except for sepsis in one case. Billiary stone removal using the stone basket and guide-wire snare technique through the PTBD tract is a safe and effective procedure that can be used as a primary method in patients with difficulties for the removal of bile duct stones using endoscopy

  8. CTC staining and counting of actively respiring bacteria in natural stone using confocal laser scanning microscopy.

    Science.gov (United States)

    Bartosch, S; Mansch, R; Knötzsch, K; Bock, E

    2003-01-01

    A method was established for staining and counting of actively respiring bacteria in natural stone by using the tetrazolium salt 5-cyano-2,3-ditolyltetrazolium chloride (CTC) in combination with confocal laser scanning microscopy (CLSM). Applying 5 mM CTC for 2 h to pure cultures of representative stone-inhabiting microorganisms showed that chemoorganotrophic bacteria and fungi-in contrast to lithoautotrophic nitrifying bacteria-were able to reduce CTC to CTF, the red fluorescing formazan crystals of CTC. Optimal staining conditions for microorganisms in stone material were found to be 15 mM CTC applied for 24 h. The cells could be visualized on transparent and nontransparent mineral materials by means of CLSM. A semi-automated method was used to count the cells within the pore system of the stone. The percentage of CTC-stained bacteria was dependent on temperature and humidity of the material. At 28 degrees C and high humidity (maximum water holding capacity) in the laboratory, about 58% of the total bacterial microflora was active. On natural stone exposed for 9 years at an urban exposure site in Germany, 52-56% of the bacterial microflora was active at the east, west, and north side of the specimen, while only 18% cells were active at the south side. This is consistent with microclimatic differences on the south side which was more exposed to sunshine thus causing UV and water stress as well as higher temperatures on a microscale level. In combination with CLSM, staining by CTC can be used as a fast method for monitoring the metabolic activity of chemoorganotrophic bacteria in monuments, buildings of historic interest or any art objects of natural stone. Due to the small size of samples required, the damage to these objects and buildings can be minimized.

  9. Introductory Overview of Stone Heritages in Japan

    Science.gov (United States)

    Kato, Hirokazu; Oikawa, Teruki; Fujita, Masayo; Yokoyama, Shunji

    2013-04-01

    As one contribution to 'Global Heritage Stone Resources' (GHSR), some stone heritages in Japan, which are nominated in the interim list, are briefly introduced. The geology of Japanese Islands where are the one of the most active areas in the history of the Earth, is very complicated. Therefore Japanese Islands consist of various kinds of minerals and rocks. Some of them were used to make stone implements and accessories. Japanese people also used to the best possible advantage to built tombstone, gate, pavement ,and the basement and wall of the large building such as temples, shrines, castles and modern buildings. 1. Stone Heritages of Pre-historical age: In the late Pleistocene and the early Holocene, ancient Japanese used obsidian cooled rapidly from rhyolitic magma.to make small implements and accessories. For example, Shirataki, Hokkaido (north island) is the largest place producing obsidian in Japan where Paleolithic people made arrowhead, knives and so on. Another example, Jade yielded in Itoigawa City, Japan Sea coast of central Japan, was made in the metamorphic rock about five hundred million years ago. Itoigawa area is only one place where jade is abundantly produced in Japan. Ancient people had been already collected and processed to ornaments although it is very hard and traded in wide area more than several thousand years ago. 2. Stone Heritages of Historical age: 2.1 Archaeological remains: In the Kofun (old mound) period (250 to 538 AD), stone burial chambers were used for old mounds to preserve against the putrefaction and to protect from the theft. For example, Ishibutai Kofun ("ishi" means "stone" and "butai" means "stage") in Nara old capital city, southwest Japan, is the largest known megalithic structure made of granite in Japan. 2.2 Stone walls of some typical castles Stones used is because of not only the rich reserves of rocks but also restriction of transportation. Osaka (second biggest city) castle, are composed of Cretaceous granite

  10. Red Hill

    Science.gov (United States)

    Information about the Red Hill Bulk Fuel Storage Facility in Hawaii Administrative Order on Consent (AOC), an enforceable agreement of the Hawaii Department of Health, the Environmental Protection Agency, and the U.S. Navy -- Defense Logistics Agency.

  11. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    OBJECTIVE: The newer flexible ureteroscopes, 150-200-microm holmium YAG laser fibres and superflexible Dormia baskets have made it possible to reach and treat stones in all parts of the kidney. The object of this evaluation was to study the outcome of retrograde intrarenal stone surgery (RIRS...

  12. Photo induced hexylaminolevulinate destruction of rat bladder cells AY-27.

    Science.gov (United States)

    Ekroll, Ingvild Kinn; Gederaas, Odrun Arna; Helander, Linda; Hjelde, Astrid; Melø, Thor Bernt; Johnsson, Anders

    2011-06-01

    Photodynamic therapy (PDT) is of increasing interest as a relevant treatment for human urinary bladder cancer. In the present experiments, the rat bladder transitional carcinoma cell line AY-27 was used as a model to study cell destruction mechanisms induced by PDT. Red LED light (630 nm) PDT with hexylaminolevulinate (HAL) as precursor for the photosensitizer protoporphyrin IX (PpIX) was used in treatment of the cells. Flow cytometry with fluorescent markers annexin V, propidium iodide and YO-PRO-1, as well as MTT assay and confocal microscopy, were used to map cell inactivation after PDT. Dark toxicity of HAL alone was low in these procedures and LD(50) (24 h, MTT assay) was approximately 1.6 J cm(-2) for standard red light (LED) irradiation (36 mW cm(-2)). Measurements done 1 h after HAL-PDT showed a maximum apoptotic level of about 10% at 6 J cm(-2), however the dominating mode of cell death was necrosis. Forward light scattering indicated an increase in cell size at low doses, possibly due to necrosis. Survival curves had a dual-slope shape, a fit to single hit, multi-target approximation gave a parameter estimate of n = 10 and D(0) about 2.6 J cm(-2). Replacing continuous light with fractionated light delivery (45 s light/60 s darkness) did not affect the treatment outcome.

  13. Modifying factors in urinary bladder carcinogenesis

    Science.gov (United States)

    Ito, Nobuyuki; Fukushima, Shoji; Shirai, Tomoyuki; Nakanishi, Keisuke; Hasegawa, Ryohei; Imaida, Katsumi

    1983-01-01

    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 hyperplasia (PN hyperplasia) is found to be a preneoplastic lesion of the rat urinary bladder. Therefore, the promoting and inhibitory effects of various chemicals in two-stage urinary bladder carcinogenesis were judged by measuring PN hyperplasia in rats. Dose-dependent and organ-specific effects of the urinary bladder promoter, saccharin, in the induction of PN hyperplasia were shown in rats after initiation by BBN. The promoting effect of saccharin was seen more clearly in the urinary bladder of rats after potent initiation. A strain difference in susceptibility of the urinary bladder to the promoter was also shown. These results suggest that the above various factors may also have modifying activities on urinary bladder carcinogenesis in man. PMID:6832095

  14. Management of vesicoureteral reflux in neurogenic bladder

    Directory of Open Access Journals (Sweden)

    Charlotte Q. Wu

    2017-06-01

    Full Text Available Vesicoureteral reflux (VUR is a significant risk factor for pyelonephritis and renal scarring. VUR can occur through a defective ureterovesical junction (UVJ or an overwhelmed normal UVJ mechanism such as in bladder dysfunction of congenital, acquired, or behavioral etiology. There are numerous causes for the development of a neurogenic bladder from spinal dysraphisms to spinal cord trauma and even centrally based abnormalities in children with apparently normal motor function (inappropriately termed nonneurogenic neurogenic bladder. The foundation of managing reflux in these neurogenic bladders is to maintain low bladder pressures which will commonly mean that compliance will be normal as well. There have been several publications that have shown that if bladder pressures are lowered simply with clean intermittent catheterization and medications that the reflux can resolve spontaneously. Alternatively, the patients that are in need of bladder augmentation can have spontaneous resolution of their reflux with the resulting increase in capacity. Surgical intervention is called for when bladder capacity is adequate and the reflux persists or if it is part of a larger operation to increase capacity and to manage outlet resistance. In some instances, reimplantation is necessary because the ureters interfere with the bladder neck procedure. Aside from open and robotic surgical intervention the use of endoscopic injectable agents is beginning to become more popular especially when combined with intravesical botulinum toxin A injections. Great strides are being made in the management of patients with neurogenic bladders and we are seeing more choices for the urologist to be able to manage these patients.

  15. A stone mould from Klinovac

    Directory of Open Access Journals (Sweden)

    Bulatović Aleksandar

    2002-01-01

    Full Text Available A two-piece stone mould that reached the National Museum at Vranje in 1966 had been recovered from a depth of about one meter at the site known as Tri Kruške (Three Pear-trees, the village of Klinovac. The site is situated on a river terrace on the right bank of the Krševica River some 15 kilometers south of Vranje. The mould was carved out of metamorphic rock from the class of schist, more exactly, of greenschist (with chlorite and mica as its constituent minerals that is widespread in the area, which geologically belongs to the upper (Vlasina complex of the Serbian-Macedonian mass. The mould was intended for casting four kinds of bronze weapons: three chisels and a winged axe. More sensitive as dating evidence, the winged axe (Ärmchenbeil may be broadly dated to the last three centuries of the second millennium BC. The type is geographically related with the Aegean, while its northernmost findspot so far is Pobit Kamak in northern Bulgaria. The chisels cast in this mould do not have direct analogies, although many hoards of similar tools have been registered in Croatia, Romania and Central Europe. Apparently the mould was made by a local workshop and from the locally available raw material. The possible activity of local workshops in the above mentioned period has already been presumed by scholars, and the Klinovac mould constitutes yet another corroboration of the hypothesis. Nevertheless its Aegean origin should not be ruled out completely, because cultural contacts between the Late Bronze Age population inhabiting the region and their southern neighbours seem quite certain, as evidenced by Mycenaean pottery discovered on the site of Resulja at Lučani near Bujanovac.

  16. [Tableau de l'opération de la taille by Marin Marais (1725)--a bladder calculus operation represented in music].

    Science.gov (United States)

    Evers, S

    1993-05-01

    The piece "Tableau de l'opération de la taille", written for viola by the French composer Marin Marais in 1725, presents an operation for removal of a stone in the bladder in musical form. Musicological analysis shows that in the early 18th century the lateral perineal approach was normally used for such operations in France. Medico-historical annotations complement the musicological analysis.

  17. Challenges in a larger bladder replacement with cell-seeded and unseeded small intestinal submucosa grafts in a subtotal cystectomy model.

    Science.gov (United States)

    Zhang, Yuanyuan; Frimberger, Dominic; Cheng, Earl Y; Lin, Hsueh-Kung; Kropp, Bradley P

    2006-11-01

    To evaluate small intestinal submucosa (SIS), unseeded or seeded, as a possible augmentation material in a canine model of subtotal cystectomy. In all, 22 male dogs had a 90% partial cystectomy and were then divided into three groups. At 1 month after the initial cystectomy, dogs in group 1 (unseeded, six) and group 2 (seeded, six) received a bladder augmentation with a corresponding SIS graft. The dogs in group 3 (ten) received no further surgery and were considered the surgical control group. All dogs were evaluated before and after surgery with blood chemistry, urine culture, intravenous urography, cystograms and cystometrograms. After surgery (at 1, 5 and 9 months), the bladders were examined using routine histology and immunohistochemistry. All 22 dogs survived the subtotal cystectomy, and 18 survived their intended survival period. One dog, in group 2 (seeded), was killed at 1 month after augmentation due to bladder perforation caused by a large piece of incompletely absorbed SIS. Three other dogs (group 1, two; and group 2, one) were killed within 2 months after augmentation due to bladder obstruction by stones. Group 1 and group 2 SIS grafts had moderate to heavy adhesion, graft shrinkage, and some had bone and calcification at the graft site. Histologically, there was limited bladder regeneration in both groups. Interestingly, dogs in group 3 at 1 month after cystectomy (when group 1 and 2 received their augmentations) had severely shrunken bladders and histologically had severe inflammation, fibroblast infiltration and muscle hypertrophy. These results verify the subtotal cystectomy model. The use of seeded or unseeded SIS in a subtotal cystectomy model does not induce the same quality and quantity of bladder regeneration that is seen in the 40% non-inflammatory cystectomy model. This study provides important insights into the process of regeneration in a severely damaged bladder. The results led us to re-evaluate the critical elements required for a

  18. "Sydney sandstone": Heritage Stone from Australia

    Science.gov (United States)

    Cooper, Barry; Kramar, Sabina

    2014-05-01

    Sydney is Australia's oldest city being founded in 1788. The city was fortunate to be established on an extensive and a relatively undeformed layer of lithified quartz sandstone of Triassic age that has proved to be an ideal building stone. The stone has been long identified by geologists as the Hawkesbury Sandstone. On the other hand the term "Sydney sandstone" has also been widely used over a long period, even to the extent of being utilised as the title of published books, so its formal designation as a heritage stone will immediately formalise this term. The oldest international usage is believed to be its use in the construction of the Stone Store at Kerikeri, New Zealand (1832-1836). In the late 19th century, public buildings such as hospitals, court houses as well as the prominent Sydney Town Hall, Sydney General Post Office, Art Gallery of New South Wales, State Library of New South Wales as well as numerous schools, churches, office building buildings, University, hotels, houses, retaining walls were all constructed using Sydney sandstone. Innumerable sculptures utilising the gold-coloured stone also embellished the city ranging from decorative friezes and capitals on building to significant monuments. Also in the late 19th and early 20th century, Sydney sandstone was used for major construction in most other major Australian cities especially Melbourne, Adelaide and Brisbane to the extent that complaints were expressed that suitable local stone materials were being neglected. Quarrying of Sydney sandstone continues today. In 2000 it was recorded noted that there were 33 significant operating Sydney sandstone quarries including aggregate and dimension stone operations. In addition sandstone continues to be sourced today from construction sites across the city area. Today major dimension stone producers (eg Gosford Quarries) sell Sydney sandstone not only into the Sydney market but also on national and international markets as cladding and paving products

  19. Impact of stone density on outcomes in percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Anastasiadis, Anastasios; Onal, Bulent; Modi, Pranjal

    2013-01-01

    were assigned to a low stone density [LSD, ≤ 1000 Hounsfield units (HU)] or high stone density (HSD, > 1000 HU) group based on the radiological density of the primary renal stone. Preoperative characteristics and outcomes were compared in the two groups. Results. Retreatment for residual stones...... was more frequent in the LSD group. The overall stone-free rate achieved was higher in the HSD group (79.3% vs 74.8%, p = 0.113). By univariate regression analysis, the probability of achieving a stone-free outcome peaked at approximately 1250 HU. Below or above this density resulted in lower treatment...

  20. Percutaneous Nephrolithotomy for Paediatric Stone Disease

    Directory of Open Access Journals (Sweden)

    Hüseyin Çelik

    2015-06-01

    Full Text Available We evaluated the outcomes and complications occurring following percutaneous nephrolithotomy (PCNL procedures performed in paediatric patients. There were 291 paediatric patients (293 renal units included in the current study and who underwent PCNL in our clinic between March 1999 and December 2014. We evaluated stone burden, duration of surgery and complications, success (stone-free rate, residual fragments and auxilliary procedures, and follow-up details. The stone-free rate following PCNL was 88.3%. Early postoperative complications included excessive bleeding and transfusion in nine patients, and prolonged urinary extravasation following removal of the nephrostomy tube and requiring JJ stent placement in eight patients. The mean time to catheter removal was 2.8 days and the mean hospitalisation time was 3.5 days. The aim of kidney stone treatment is to achieve minimal kidney damage with the highest success rate. Therefore, minimally invasive procedures are important in the paediatric age group where life expectancy is high. PCNL is a safe and effective procedure for the treatment of kidney stones in children.

  1. Ground stone percussion tools from Maltese Islands

    Directory of Open Access Journals (Sweden)

    Felice Larocca

    2016-10-01

    Full Text Available A few lithic percussion tools, probably related to construction and craftsmanship, are stored in the National Museum of Archaeology of Valletta (Malta. Dated to the Temple Period (about 4000-2500 BCE, many are typologically similar to artefacts from the continental area, but others look distinctive and probably developed in loco in response to specific needs. This paper examines five stone hammers with different hafting methods (three of them show grooves or holes and two both grooves and holes. A huge double hand grip percussion tool belongs to a different and unusual typology: the double grip allowed two opposite-standing men, steadily holding it, to strike with strength on other surfaces, probably when heavy blows were needed. Grooved stone hammers are widespread in various European regions and are mostly associated with mining activities. In the Maltese archipelago the limestone lacks ore deposits, and thus their presence may be reflect other uses, although still associated to the work of stone on stone: earthworks, quarrying, finishing of stone surfaces, hydraulic works, excavation of burial and rituals structures, and others. The double grip lithic percussor (ID 9120 has no precise parallel and may be unique.This paper aims to fill a gap in the current literature about prehistoric lithic tools, as in many studies the focus is often placed on the results of specific activities rather than on the typological features of the artefacts that made these activities possible.

  2. Microsatellite instability in bladder cancer

    DEFF Research Database (Denmark)

    Gonzalez-Zulueta, M; Ruppert, J M; Tokino, K

    1993-01-01

    Somatic instability at microsatellite repeats was detected in 6 of 200 transitional cell carcinomas of the bladder. Instabilities were apparent as changes in (GT)n repeat lengths on human chromosome 9 for four tumors and as alterations in a (CAG)n repeat in the androgen receptor gene on the X...... chromosome for three tumors. Single locus alterations were detected in three tumors, while three other tumors revealed changes in two or more loci. In one tumor we found microsatellite instability in all five loci analyzed on chromosome 9. The alterations detected were either minor 2-base pair changes...... or larger (> 2 base pairs) alterations in repeat length. All six tumors were low stage (Ta-T1), suggesting that these alterations can occur early in bladder tumorigenesis....

  3. Bladder injuries frequently missed in polytrauma patients

    Directory of Open Access Journals (Sweden)

    Tanweer Karim

    2010-05-01

    Full Text Available Tanweer Karim, Margaret Topno, Vinod Sharma, Raymond Picardo, Ankur HastirSurgery, MGM Medical College, Kamothe, Navi Mumbai, IndiaAbstract: Bladder injuries are very common in patients who have had road traffic accidents. The method of diagnosis and management of such injuries is well established and accepted. However, trauma to the bladder can be associated with other life-threatening injuries which are frequently missed, and often diagnosed during laparotomy for other reasons. The aim of this study was to diagnose bladder injury in polytrauma patients as early as possible, taking into consideration the fact that these patients are hemodynamically unstable and require rapid evaluation and management. In order to achieve our objective, we used bedside sonography with retrograde instillation of normal saline to diagnose bladder injury in addition to use of the conventional retrograde cystogram.Keywords: bladder injury, bladder rupture, retrograde cystogram

  4. SOX4 expression in bladder carcinoma

    DEFF Research Database (Denmark)

    Aaboe, Mads; Birkenkamp-Demtroder, Karin; Wiuf, Carsten

    2006-01-01

    The human transcription factor SOX4 was 5-fold up-regulated in bladder tumors compared with normal tissue based on whole-genome expression profiling of 166 clinical bladder tumor samples and 27 normal urothelium samples. Using a SOX4-specific antibody, we found that the cancer cells expressed...... in the clinical bladder material and a small subset of the genes showed a high correlation to SOX4 expression. The present data suggest a role of SOX4 in the bladder cancer disease....... the SOX4 protein and, thus, did an evaluation of SOX4 protein expression in 2,360 bladder tumors using a tissue microarray with clinical annotation. We found a correlation (P bladder cell line HU609, SOX4...

  5. Scrotal Herniation of Bladder: A Case Report

    Directory of Open Access Journals (Sweden)

    Ali Hamidi Madani

    2013-03-01

    Full Text Available Inguinal bladder hernia is a rare clinical condition, with 1–3% of all inguinal hernias involving the bladder. Any portion of the bladder may herniate, from a small portion or a diverticulum to most of the bladder. We present a 55-year-old male with an intermittent right scrotal mass of 6 months’ duration. The mass lesion protruded through the right inguinal canal before voiding and reduced after that. Scrotal sonography revealed a hypoechoic lesion in the scrotum that stretched cranially to the intra-abdominal portion of the bladder. Excretory urography showed a duplicated system in the left kidney and deviation of the left orifice to the right side of the trigon. Finally, cystography illustrated herniation of the bladder to the right scrotum. Surgical repair of the hernia was done with mesh. Follow-up cystography one month postoperatively revealed no herniation.

  6. Analysis of intravesical recurrence after bladder-preserving therapy for muscle-invasive bladder cancer

    International Nuclear Information System (INIS)

    Onozawa, Mizuki; Miyanaga, Naoto; Hinotsu, Shiro

    2012-01-01

    The aim of the present study was to analyze the pattern of recurrences after bladder-preserving therapy for muscle-invasive bladder cancer. The subjects were 77 patients with T2-3N0M0 bladder cancer whose bladder was preserved by intra-arterial chemotherapy and radiation. The patterns of the first recurrences were retrospectively analyzed. With a median follow-up of 38.5 months, 17 patients (22.1%) experienced intravesical recurrence without metastasis, 14 (82.4%) of which were cases of non-muscle-invasive bladder cancer recurrence and 3 (17.6%) of which were muscle-invasive bladder cancer recurrences. Muscle-invasive bladder cancer recurred at the same site as the initial tumor site in all three cases, whereas non-muscle-invasive bladder cancer recurred at different sites in 64% of the patients in that group. The peak hazard of the non-muscle-invasive bladder cancer recurrence was observed at around a year after treatment. Recurrent non-muscle-invasive bladder cancer was of a significantly lower histological grade with lower Ki-67-labeling indices than the initial muscle-invasive bladder cancer. Twelve (85.7%) of 14 patients with non-muscle-invasive bladder cancer recurrence achieved disease-free status. The multivariate analysis revealed that multiplicity, grade and tumor size were significantly correlated with the recurrence (P=0.0001, 0.0442 and 0.0412, respectively). Most of the recurrences after bladder-preserving therapy were cases of non-muscle-invasive bladder cancer. The recurrence pattern and characteristics of the tumors did not differ from those of primary non-muscle-invasive bladder cancer. Patients with high-risk factors would be candidates for prophylactic intravesical therapy for non-muscle-invasive bladder cancer recurrence. (author)

  7. The Effect of Stone Composition on the Efficacy of Retrograde Intrarenal Surgery: Kidney Stones 1 - 3 cm in Diameter.

    Science.gov (United States)

    Xue, Yuquan; Zhang, Peng; Yang, Xiaojie; Chong, Tie

    2015-05-01

    The goal of this study was to analyze the effect of stone composition on the efficacy of retrograde intrarenal surgery (RIRS) with kidney stones of 1-3 cm, 1-2 cm, and 2-3 cm in diameter. We undertook a retrospective analysis of 74 patients with kidney stones who underwent RIRS. The patients were divided into two groups based on stone composition: Group I (n=47) (calcium oxalate monohydrate and calcium phosphate) was the hard to fragment stone group and group II (n=27) (calcium oxalate dihydrate, magnesium ammonium phosphate, and uric acid) was the easy to fragment stone group. Forty-six patients with kidney stones 1 to 2 cm in diameter were divided into group A (n=30) (smaller than 20 mm, hard to fragment stones) and group B (n=16) (smaller than 20 mm, easy to fragment stones). Twenty-eight patients with stones 2 to 3 cm in diameter were divided into group C (n=17) (larger than 20 mm, hard to fragment stones) and group D (n=11) (larger than 20 mm, easy-to-crush stones). The stone clearance rates of group I and group II were 66.0% and 88.9%, respectively (Pstone clearance rates of group A and group B were 73.3% and 100% (Pstone clearance rates of group C and group D were 52.9% and 72.7%, respectively. Stone composition has a significant impact on the efficacy of RIRS in the management of 1 to 3 cm kidney stones. For 2-3 cm calcium oxalate dihydrate stones, uric acid stones, and magnesium ammonium phosphate stones, the outcome of RIRS treatment was relatively good, and RIRS is recommended.

  8. Epitheloid hemangioendothelioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Narmada P Gupta

    2008-01-01

    Full Text Available Epitheloid hemangioendothelioma is an uncommon vascular neoplasm and has an unpredictable clinical behavior. It is characterized by round or spindle-shaped endothelial cells with cytoplasmic vacuolation. Most often, epitheloid hemangioendothelioma arise from the soft tissues of the upper and lower extremities and it has borderline malignant potential. We describe the first reported case of epitheloid hemangioendothelioma in the urinary bladder, which was treated by transurethral resection. The diagnosis was confirmed by immunohistochemistry.

  9. Outpatient simultaneous treatment of benign prostatic hyperplasia and bladder lithiasis with GreenLight™ and holmium laser.

    Science.gov (United States)

    de la Torre, Germán; Barusso, Gabriel; Chernobilsky, Víctor; Borghi, Marcelo; Montes de Oca, Luis; Becher, Edgardo

    2012-02-01

    To evaluate our experience in the combined treatment of benign prostatic hyperplasia (BPH) and bladder lithiasis with GreenLight(™) and holmium laser, respectively, on an outpatient basis. From August 2006 to May 2009, 20 patients with prostatic hyperplasia and bladder lithiasis were treated. First, the lithiasis was treated, and then the GreenLight laser vaporization of the prostate was performed, both at the same surgical time and under general anesthesia. Discharge of patients was scheduled 3 to 4 hours after completion of the procedure. The procedure was simultaneously completed in 19 of 20 patients. The mean stone size was 2.3 (1-4) cm, and the mean prostate volume was 56.5 (30-108) cc. The mean operating time was 115 (50-190) minutes. There was a significant percentage change in maximum flow, postmicturition residual volume, and International Prostate Symptom Score, which were 129.5%, 88.4%, and 68.3%, respectively. All patients were stone free after the procedure. The combined transurethral treatment of BPH associated with bladder lithiasis by means of GreenLight laser vaporization and holmium laser lithotripsy on an outpatient basis can be performed safely and yields excellent results.

  10. Expression of VEGF and collagen using a latex biomembrane as bladder replacement in rabbits

    Directory of Open Access Journals (Sweden)

    André Luís Alonso Domingos

    2012-08-01

    Full Text Available OBJECTIVE: To investigate the VEGF expression and collagen deposition using a latex biomembrane as bladder replacement in rabbits. MATERIALS AND METHODS: After partial cystectomy, a patch of a non-vulcanized latex biomembrane (2 x 2 cm was sewn to the bladder of rabbits with 5/0 monofilament polydioxanone sulfate sutures in a watertight manner. Groups of 5 animals were killed at 15, 45 and 90 days after surgery and the bladder was removed. Sections of 5µm were cut and stained with picrosirius-red in order to estimate the amount of extracellular matrix in the graft. To confirm the presence of VEGF in tissues, protein expression was determined by immunohistochemistry. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. A progressive reduction in the amount of collagen occurred in the graft area and was negatively and linearly correlated with time (p < 0.001. VEGF expression was higher in grafted areas when compared to controls at 15 and 45 days after surgery and decreased with time (p < 0.001. CONCLUSION: The latex biomembrane as a matrix for partial bladder replacement in rabbits promotes temporary collagen deposition and stimulates the angiogenic process.

  11. Dog Ear-Like Bladder Herniation

    Directory of Open Access Journals (Sweden)

    Ferhat Cuce

    2014-06-01

    Full Text Available The hernia content involving a bladder segment occurs in 1-4 % of cases of the inguinal hernias. Inguinoscrotal bladder hernias are usually found incidentally on radiological examinations or at the time of herniorrhaphy. We present an adult case that has a left inguinal bladder hernia detected and evaluated by sonography, intravenous pyelography (IVP, and computerized tomography (CT. [Arch Clin Exp Surg 2014; 3(3.000: 187-189

  12. Pathogenesis of reduced or increased bladder sensation.

    Science.gov (United States)

    Tsunoyama, Kuniko; Sakakibara, Ryuji; Yamaguchi, Chiharu; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori; Takahashi, Osamu; Sugiyama, Megumi; Kishi, Masahiko; Ogawa, Emina

    2011-03-01

    Pathogenesis of reduced or increased bladder sensation is not well known. Hence, we systematically investigated the frequency of reduced or increased bladder sensation in neurologic/mental diseases. We analyzed 911 patients who were referred from within our hospital. Data registries included a diagnosis, a lower urinary tract symptom questionnaire, a urodynamic study, and neurological examinations. Reduced bladder sensation is defined as bladder volume at the first sensation >300 ml. Increased bladder sensation is defined as bladder volume at the first sensation sensation (33.3-43.8% in diabetic neuropathy, etc.). Myelopathies are the second most common cause (17.4-25.0% in multiple sclerosis, etc.). Less common is brain diseases (9.6% in multiple system atrophy, etc.). In contrast, myelopathies are the most common cause of increased bladder sensation without DO (25.0-40.0% in spinal forms of systemic lupus erythematosus, Sjogren's syndrome, etc.). Neuropathies are the second most common (17.3-22.2% in post-pelvic organ surgery, diabetic neuropathy, etc.). Less common is brain/mental diseases (20.0% in psychogenic bladder dysfunction, 8.1% in Parkinson's disease, etc.). The present study revealed that neuropathies are the most common cause of reduced bladder sensation in neurologic/mental diseases. Increased bladder sensation without DO occurs mainly in peripheral and central sensory pathway lesions, as well as in basal ganglia lesions and psychogenic bladder dysfunction. Reduced and increased bladder sensation should be a major treatment target for maximizing patients' quality of life. Copyright © 2011 Wiley-Liss, Inc.

  13. Bladder Management in Children: Intermittent Catheterization Education.

    Science.gov (United States)

    Fortuna, Suzanne Marie; Korcal, Layna; Thomas, Ginger

    2018-03-01

    Clean intermittent catheterization (IC) of the bladder is one example of advanced medical care required by students with special health care needs. The success of a child's intermittent catheterization program in a community setting such as a school is dependent on an educated team. This article discusses indications and problems that arise with IC bladder management in the pediatric population. The article also provides information about current best practice for IC management to assist school nurses in the optimization of bladder health.

  14. Occupational exposure to solvents and bladder cancer

    DEFF Research Database (Denmark)

    Hadkhale, Kishor; Martinsen, Jan Ivar; Weiderpass, Elisabete

    2017-01-01

    The objective of the study was to assess the relationship between exposure to selected solvents and the risk of bladder cancer. This study is based on the Nordic Occupational Cancer (NOCCA) database and comprises 113,343 cases of bladder cancer diagnosed in Finland, Iceland, Norway and Sweden...... of occupational exposure to trichloroethylene, perchloroethylene, aromatic hydrocarbon solvents, benzene and toluene and the risk of bladder cancer....

  15. Treatment and prevention of kidney stones: an update.

    Science.gov (United States)

    Frassetto, Lynda; Kohlstadt, Ingrid

    2011-12-01

    The incidence of nephrolithiasis (kidney stones) is rising worldwide, especially in women and with increasing age. Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved, urine pH and 24-hour urine assessment provide information about stone-forming factors that can guide prevention. Medications, such as protease inhibitors, antibiotics, and some diuretics, increase the risk of some types of kidney stones, and patients should be counseled about the risks of using these medications. Managing diet, medication use, and nutrient intake can help prevent the formation of kidney stones. Obesity increases the risk of kidney stones. However, weight loss could undermine prevention of kidney stones if associated with a high animal protein intake, laxative abuse, rapid loss of lean tissue, or poor hydration. For prevention of calcium oxalate, cystine, and uric acid stones, urine should be alkalinized by eating a diet high in fruits and vegetables, taking supplemental or prescription citrate, or drinking alkaline mineral waters. For prevention of calcium phosphate and struvite stones, urine should be acidified; cranberry juice or betaine can lower urine pH. Antispasmodic medications, ureteroscopy, and metabolic testing are increasingly being used to augment fluid and pain medications in the acute management of kidney stones.

  16. EUROPEAN INTEGRATION: TREATMENT OF STONE PROCESSING ENTERPRISES WASTE IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Korobiіchuk V. V.

    2017-04-01

    Full Text Available Ukraine Stone industry is undergoing dramatic changes. Today is a restructuring of the industry. In a market economy, modernization of existing stone processing enterprises, the use of new technologies in the production of stone products is actually. Analysis of stone processing enterprise activity shows a large variation in quantitative and qualitative indicators, low competitiveness. However, the demand for stone products with traditional characteristics is stored. Waste stone processing enterprises often exported to landfills that are not suited to the storage of waste or unauthorized, and remain there, taking up more and more land area. During the Earth Summit in Rio de Janeiro independent Ukraine declared its intention to be actively involved in global environmental policy and development strategy of sustainable development, implementing guidelines defining international instruments at the national level. Consequently, there is an urgent need for real action on comprehensive recycling stone processing enterprises to obtain a secondary product. It should be noted that the use of modern methods of stone processing enterprises will waste the protection of nature and natural resources, improve the quality of life, restore lost harmony between man and nature. This publication analyzes the level of recycling waste stone processing enterprises. These volumes of industrial waste stone processing enterprises and highlights stone processing companies hand waste I-IV classes of danger Zhitomir region (Ukraine. These waste composition and properties of stone processing enterprises. Principles of artificial and natural lighting water are noted. Mathematical and economical model of the stone processing enterprises are constructed.

  17. Bladder wash cytology, quantitative cytology, and the qualitative BTA test in patients with superficial bladder cancer

    NARCIS (Netherlands)

    van der Poel, H. G.; van Balken, M. R.; Schamhart, D. H.; Peelen, P.; de Reijke, T.; Debruyne, F. M.; Schalken, J. A.; Witjes, J. A.

    1998-01-01

    Two new methods for the detection of transitional tumor cells in bladder wash (karyometry: QUANTICYT) and voided urine material (BARD BTA test) were compared with bladder wash cytology for the prediction of histology and tumor recurrence. Bladder wash material and voided urine were sampled from 138

  18. Percutaneous electrohydraulic lithotripsy of bile duct stones

    International Nuclear Information System (INIS)

    Juliani, E.; Righi, D.; Cesarani, F.; Regge, D.; Gandini, G.

    1988-01-01

    The results are reported of percutaneous transhepatic tratment with an electrohydraulic stone disintegrator in 4 cases of bile duct lithiasis. An electri discharge, generated by a bipolar electrode, gives origin to high-amplitude and low-frequency shoc waves in the fluid medium-which cause the stone to fragment. Complete resolution of lithiasis was obtained in 2 patients with intrahepatic calculosis. In the other 2 cases of massive lithiasis of intra and extrahepatic bile ducts the treatment, however incomplete, proved to be useful, as the biliary flux was reabilitated and clinical symptoms disappeared. No relevant immediate side-effects were observed, except for well-tolerated pain during the discharges, and transitory hemobilia which solved spontaneously. No complications were observed in this series of patients. Electrohydraulic lithotripsy proves thus to be useful for supporting standard interventional radiology techniques in very complex cases of intra and extrahepatic bile duct stones

  19. Meteorites as 'Sacred stones' from sky

    International Nuclear Information System (INIS)

    Oezmaya, S.

    2005-01-01

    Meteorites which are stony and iron remnants from early solar system are falling on the planetary surfaces including Earth, since the birt of Solar System, about 4.5 billion years ago. Several of the meteorites have also been used as sacred stones from gods, throughout the human history. Most famous contemporary example still having a sacred function is in the Kaaba, at Mecca. There are other examples of historical records where such stones are mentioned and sometimes, sacrificed. Artemis Temple of Ephesus is known to contain such a stone which is still not recovered. Dating of such celestial artifacts through modern techniques with examples from Turkey is expected to provide much useful information to historical as well as scientific ends

  20. Bladder Control Problems and Bedwetting in Children

    Science.gov (United States)

    ... Prevention Clinical Trials Hematuria: Blood in the Urine Interstitial Cystitis (Painful Bladder Syndrome) Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Kidney Infection Definition & ...

  1. [Ultraminipercutaneous nephrolithotripsy in treating kidney stones].

    Science.gov (United States)

    Martov, A G; Dutov, S V; Andronov, A S

    2016-04-01

    Percutaneous nephrolithotripsy (PNL) is the recommended method of surgical treatment of kidney stones of size greater than 2 cm. Trends in the development of modern urology have been steadily toward less traumatic method to treat nephrolithiasis - minimally invasive PNL. The present work aimed to explore of the possibilities of one of the modern variants of minimally invasive PNL - ultra-mini-PNL in treating nephrolithiasis. The study included 60 patients (mean age 45.6+/-7.2 years) with isolated kidney calculus, up to 2.0 cm or several stones with a total size of up to 2.5 cm. All patients were found to have 77 kidney stones, six of which had a size of 10 mm, 51 had a size of 11-15 mm and 20 had a size of 16-20 mm. 45% of patients had isolated renal pelvic stones and 28.3% had stones in the renal pelvis and lower calyx. All patients underwent ultra-mini-PNL using nephroscope size 7.5 Ch and tube size 12 Fr. The average duration of surgery from the moment of the puncture of the pyelocaliceal system to installing the nephrostomy tube was 65.4 minutes. Complete clearance of stones after single-stage ultra-mini-PNL was observed in 80% of cases. Nephrostomy tube was removed on days 2-3. The average postoperative hospital stay was 5.1 days. The most common complication was postoperative exacerbation of pyelonephritis (13.3% of patients), successfully treated with conservative measures. There were no cases of postoperative bleeding, accompanied by anemia and needed a blood transfusion. Considering high effectiveness and low rate of complications of ultra-mini-PNL, it can be successfully used in treating nephrolithiasis among a wide group of patients.

  2. Strides in Preservation of Malawi's Natural Stone

    Science.gov (United States)

    Kamanga, Tamara; Chisenga, Chikondi; Katonda, Vincent

    2017-04-01

    The geology of Malawi is broadly grouped into four main lithological units that is the Basement Complex, the Karoo Super group, Tertiary to Quaternary sedimentary deposits and the Chilwa Alkaline province. The basement complex rocks cover much of the country and range in age from late Precambrian to early Paleozoic. They have been affected by three major phases of deformation and metamorphism that is the Irumide, Ubendian and The Pan-African. These rocks comprise gneisses, granulites and schists with associated mafic, ultramafic, syenites and granite rocks. The Karoo System sedimentary rocks range in age from Permian to lower Jurassic and are mainly restricted to two areas in the extreme North and extreme Alkaline Province - late Jurassic to Cretaceous in age, preceded by upper Karoo Dolerite dyke swarms and basaltic lavas, have been intruded into the Basement Complex gneisses of southern Malawi. Malawi is endowed with different types of natural stone deposits most of which remain unexploited and explored. Over twenty quarry operators supply quarry stone for road and building construction in Malawi. Hundreds of artisanal workers continue to supply aggregate stones within and on the outskirts of urban areas. Ornamental stones and granitic dimension stones are also quarried, but in insignificant volumes. In Northern Malawi, there are several granite deposits including the Nyika, which is the largest single outcrop occupying approximately 260.5 km2 , Mtwalo Amazonite an opaque to translucent bluish -green variety of microcline feldspar that occurs in alkali granites and pegmatite, the Ilomba granite (sodalite) occurring in small areas within biotite; apatite, plagioclase and calcite. In the Center, there are the Dzalanyama granites, and the Sani granites. In the South, there are the Mangochi granites. Dolerite and gabbroic rocks spread across the country, treading as black granites. Malawi is also endowed with many deposits of marble. A variety of other igneous

  3. Bilateral kidney matrix stones: a rare case.

    Science.gov (United States)

    Lahyani, Mounir; Rhannam, Yassine; Slaoui, Amine; Touzani, Alae; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdellatif; Andaloussi, Ahmed Ibn Attya

    2016-01-01

    Kedney matrix stones are a rare form of calculi. Flank pain and urinary tract infections (UTI) are the most common presentations of matrix calculi. The diagnosis is usually made at surgery, but some preoperative radiographic findings might be suggestive. Open surgery was the method of choice for treatment. However, combination of ureterorenoscopy and percutaneous nephrolithotomy (PCNL) was found to be safe and effective. We report a rare case of renal and ureteral matrix stones that were diagnosed and treated by open surgery. We also describe its clinical, radiological and therapeutic features through a review of the literature.

  4. Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

    Reyes, David; Locke, James

    2016-01-01

    Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain

  5. Cutting for stone: Roman lithotomy instruments in the Museo Nazionale Romano.

    Science.gov (United States)

    Jackson, Ralph

    2010-01-01

    Bladder stones, one of the scourges of the past, have been recorded as far back as 6,500 BC. Lithotomy was famously proscribed in the Hippocratic Oath, but it was certainly being undertaken in Hellenistic Alexandria by the 3rd century BC. However, the earliest surviving description of the operation is that of Celsus in the early 1st century AD, while identifiable instrumentation currently dates between the 2nd and early 5th century AD. Finds from Rimini, Marcianopolis, Ephesus and Cyrene illustrate how widespread the operation was at the time of the Roman Empire, but the majority of lithotomy instruments, of which those in the Museo Nazionale Romano are an important part, have been discovered in Rome itself doubtless a reflection of the size of the city's medical 'market'.

  6. Postural therapy for renal stones in children: A Rolling Stones procedure.

    Science.gov (United States)

    Faure, A; Dicrocco, E; Hery, G; Boissier, R; Bienvenu, L; Thirakul, S; Maffei, P; Panait, N; Karsenty, G; Merrot, T; Alessandrini, P; Guys, J-M; Lechevallier, E

    2016-08-01

    Despite many advances, the management of renal stones - especially lower caliceal stones (LCS) - remains a challenge. The gravity-dependent location of the lower calices hinders the spontaneous clearance of fragments, which can be a nidus for future growth and symptomatic recurrence. Currently, there is no standard adjunctive therapy to facilitate fragment passage. To report the safety and effectiveness of mechanical percussion diuresis and inversion (PDI) therapy for eliminating renal stones in children. Since November 2013, children with residual fragments (after shock wave lithotripsy or flexible ureteroscopy) or native symptomatic renal stones were prospectively included in a protocol of four PDI sessions. After giving written consent, the children drank 10 ml/kg of water 30 min before therapy. They then laid in a prone Trendelenburg position on a couch angled at 45° and received continuous 10-min mechanical percussion applied over the affected flank by a physiotherapist (Figure summary). Tolerance stone burden reduction and stone clearance were documented with ultrasound 4 weeks after the last session. Seventeen participants, with a median age of 10.8 years (range 18 months to 18 years), received 82 PDI sessions performed over 22 months. The median stone diameter was 5 mm (range 3-9). All children tolerated the PDI therapy well. Over a median follow-up of 11 months (range 3-18), no significant adverse effects were noted. The overall stone-free rate was 65%. Four of the six patients with residual fragment passed their fragments. The patients who did not become stone free by PDI experienced a decrease in fragment size of 57% (range 34-71). The observance rate was 100%. Many studies have demonstrated that the gravity-dependent position of the lower calyces appears to be an important factor limiting the clearance of LCS. Positioning patients with a degree of inversion in order to put the collecting system beyond the horizontal plane affected the LCS

  7. 'Saurashtra stone anchors' (Ring-stones) from Dwarka and Somnath, west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Gaur, A.S.; Sundaresh; Tripati, S.; Gudigar, P.; Bandodkar, S.N.

    , semi-curved top with an axial hole; diameter of the hole is same at both ends. Often the chisel marks have been noticed on the surface and in the hole. The 'Saurashtra Stone Anchors' (Ring-stones) Dwarka and Somnath 133 average estimated weight... chisel marks have also been noticed on some of the anchors. The average weight of this group is 98 kg. The heaviest anchor (no. 8) weighs 205 kg and the lightest (no. 14) 64 kg. Group III: Ring-stone numbers 1, 6, 11, 18 and 22 fall in this last...

  8. Surgical versus endoscopic treatment of bile duct stones

    DEFF Research Database (Denmark)

    Martin, D J; Vernon, D R; Toouli, J

    2006-01-01

    10% to 18% of patients undergoing cholecystectomy for gallstones have common bile duct (CBD) stones. Treatment options for these stones include pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP) or open or laparoscopic surgery....

  9. Clinical characteristics of potential kidney donors with asymptomatic kidney stones

    OpenAIRE

    Lorenz, Elizabeth C.; Lieske, John C.; Vrtiska, Terri J.; Krambeck, Amy E.; Li, Xujian; Bergstralh, Eric J.; Melton, L. Joseph; Rule, Andrew D.

    2011-01-01

    Background. Patients with symptomatic kidney stones are characterized by older age, male gender, white race, hypertension, obesity, metabolic syndrome and chronic kidney disease. Whether these characteristics differ in patients with asymptomatic kidney stones is unknown.

  10. Prevention of Renal Stone Complications in Space Exploration Project

    Data.gov (United States)

    National Aeronautics and Space Administration — AIM 1. Refine ultrasound probes to detect, reposition, and fragment kidney stones. Task 1.1. Select imaging probe for stone repositioning. Clinical trials are...

  11. Enhanced angiogenesis and relaxation of bladder as early response to bladder outlet obstruction.

    Science.gov (United States)

    Song, Yun Seob; Lee, Hong Jun; Doo, Seung Whan; An, Jin; Kim, Seung U

    2013-01-01

    To provide insights into the pathogenesis of bladder insult secondary to bladder outlet obstruction. Six-week-old female Sprague-Dawley rats (n = 80) were divided into eight groups, 10 rats each, according to the duration of bladder outlet obstruction, including 0, 3, 6, 12, 24, 48, 72 h and 1 week. Cystometric parameters were evaluated at 72 h and 1 week after bladder outlet obstruction. Bladder tissues were harvested and Masson's trichrome staining was carried out. Each slide was inspected microscopically and the mean percent collagen area was examined. Changes of collagen deposition and pathological expression of several factors including hypoxia inducible factor-1α, vascular endothelial growth factor, transforming growth factor-β1 and nitric oxide synthase messenger ribonucleic acid of bladders were evaluated. A significant time-dependent increase in the bladder weight after 6 h and the percent of collagen area after 24 h of bladder outlet obstruction were found. Increase in hypoxia inducible factor-1α, transforming growth factor-β1, inducible nitric oxide synthase messenger ribonucleic acid expression, time-dependent increase in vascular endothelial growth factor, neuronal nitric oxide synthase and endothelial nitric oxide synthase messenger ribonucleic acid expression after 6 h of bladder outlet obstruction was found. The intercontraction interval decreased significantly after 72 h of bladder outlet obstruction. Cellular remodeling in the bladder secondary to bladder outlet obstruction starts in the early hours and it includes enhanced angiogenesis and bladder relaxation. Early relief from bladder outlet obstruction is helpful to preserve bladder structure and function. © 2012 The Japanese Urological Association.

  12. Edible oil adulterants, argemone oil and butter yellow, as aetiological factors for gall bladder cancer.

    Science.gov (United States)

    Mishra, Vivek; Mishra, Manjari; Ansari, Kausar M; Chaudhari, Bhushan P; Khanna, Raj; Das, Mukul

    2012-09-01

    Carcinogenic potential of argemone oil (AO) and butter yellow (BY), the adulterants encountered in edible oil, in gall bladder of Swiss albino mice was undertaken to investigate the potential aetiological factors of gall bladder carcinoma (GBC) in the Indo-Gangetic basin. Twice weekly intraperitoneal (ip) administration of AO (5 ml/kg body wt) and BY (25 mg/kg body wt) to Swiss albino male and female mice for 30 and 60 days indicated that females were more vulnerable to these adulterants in terms of responses to inflammatory markers. Subsequent experiments with dietary exposure of AO (1%) and BY (0.06%) for 6 months in female mice showed symptoms related to cachexia, jaundice and anaemia. High levels of total cholesterol, low density lipoprotein (LDL), TG, bilirubin and low level of high density lipoprotein (HDL) as well as gallstone formation was shown by AO exposure only, leading to the development of adenocarcinoma. BY exposure resulted in adenoma and hyperplasia without stone formation. The cyclooxygenase (COX-2) overexpression was found to be related to prostaglandin E2 (PGE2) production in AO treated mice but not in BY exposed animals, thereby indicating a differential pathway specific carcinogenicity. PGE2 stimulates the secretion of secreted mucins (MUC5AC), which is involved in stone formation following AO exposure. Enhanced secretion of membrane bound mucins (MUC4) in BY and AO exposed mice resulted in the activation of ErbB2 and downstream signalling such as p-AKT, p-ERK and p-JNK, which ultimately affects the target proteins, p53 and p21 leading to adenoma and adenocarcinoma, respectively. The study suggests that AO and BY are responsible for producing GBC in mice along with stone formation in the AO exposed animals. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Efficacy of the lithotripsy in treating lower pole renal stones.

    Science.gov (United States)

    Cui, Helen; Thomee, Eeke; Noble, Jeremy G; Reynard, John M; Turney, Benjamin W

    2013-06-01

    Use of extracorporeal lithotripsy is declining in North America and many European countries despite international guidelines advocating it as a first-line therapy. Traditionally, lithotripsy is thought to have poor efficacy at treating lower pole renal stones. We evaluated the success rates of lithotripsy for lower pole renal stones in our unit. 50 patients with lower pole kidney stones ≤15 mm treated between 3/5/11 and 19/4/12 were included in the study. Patients received lithotripsy on a fixed-site Storz Modulith SLX F2 lithotripter according to a standard protocol. Clinical success was defined as stone-free status or asymptomatic clinically insignificant residual fragments (CIRFs) ≤3 mm at radiological follow-up. The mean stone size was 7.8 mm. The majority of stones (66 %) were between 5 and 10 mm. 28 % of stones were between 10 and 15 mm. For solitary lower pole stones complete stone clearance was achieved in 63 %. Total stone clearance including those with CIRFs was achieved in 81 % of patients. As expected, for those with multiple lower pole stones the success rates were lower: complete clearance was observed in 39 % and combined clearance including those with CIRFs was 56 %. Overall, complete stone clearance was observed in 54 % of patients and clearance with CIRFs was achieved in 72 % of patients. Success rate could not be attributed to age, stone size or gender. Our outcome data for the treatment of lower pole renal stones (≤15 mm) compare favourably with the literature. With this level of stone clearance, a non-invasive, outpatient-based treatment like lithotripsy should remain the first-line treatment option for lower pole stones. Ureteroscopy must prove that it is significantly better either in terms of clinical outcome or patient satisfaction to justify replacing lithotripsy.

  14. The case study in the applicability of the improvements in the treatment of urinary system stone diseases in Anatolia: the last ten years with the sample of Western Black Sea region.

    Science.gov (United States)

    Turkan, Sadi; İrkılata, Lokman; Ekmekçioğlu, Ozan; Canat, Halil Lütfi; Dilmen, Cem; Özkaya, Muharrem

    2015-09-01

    The prevalence of stone diseases is high in Turkey. Thanks to the technological improvements and to the increase in the number of qualified and experienced specialists in the last thirty years, there has been an increase in the application of minimally invasive methods in the stone disease surgery. This study, with a sample survey of Western Black Sea region, aims at revealing the changes and improvements in the treatment of stone diseases in different centers in Anatolia within the last ten years. Six centers in 4 of the provinces of the Western Black Sea Region were selected and the patients' files were retrospectively analyzed. The treatment methods that were recommended for and/or applied to the patients diagnosed with urinary stone diseases were recorded by years. The urinary stone diseases were divided into three separate groups; kidney, ureters and bladder. Treatment options were recorded into categories as open surgery, percutaneous nephrolithotripsy, retrograde intrarenal surgery, semirigid ureterorenoscopy, flexible ureterorenoscopy, and ESWL. A total of 26044 patients with stone diseases have been treated in the above-mentioned centers for the last 10 years. The distributions of the stone diseases in relation to their localization were as follows: - kidney stones: 9040 (34.7%), ureter stones: 15264 (58.6%), and bladder stones: 1740 (6.7%). As for the distribution of the treatment in relation to the treatment methods, it was seen that open surgery for 1032 (4%) patients, endoscopic surgery for 15038 (58%) patients, and ESWL for 9974 (38%) patients had been applied. While URS and PCNL are currently the commonly used treatment methods in the Western Black Sea Region, RIRS has begun to be used in a limited number of patients for the last 3 years. Though being a little late, the advances in endrourology offer practical applications in the Western Black Sea region as well. Although this study suggests implications for the evaluating of the periphery outcomes

  15. DASH-style diet associates with reduced risk for kidney stones.

    Science.gov (United States)

    Taylor, Eric N; Fung, Teresa T; Curhan, Gary C

    2009-10-01

    The impact of the Dietary Approaches to Stop Hypertension (DASH) diet on kidney stone formation is unknown. We prospectively examined the relation between a DASH-style diet and incident kidney stones in the Health Professionals Follow-up Study (n = 45,821 men; 18 yr of follow-up), Nurses' Health Study I (n = 94,108 older women; 18 yr of follow-up), and Nurses' Health Study II (n = 101,837 younger women; 14 yr of follow-up). We constructed a DASH score based on eight components: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains and low intake of sodium, sweetened beverages, and red and processed meats. We used Cox hazards regression to adjust for factors that included age, BMI, and fluid intake. Over a combined 50 yr of follow-up, we documented 5645 incident kidney stones. Participants with higher DASH scores had higher intakes of calcium, potassium, magnesium, oxalate, and vitamin C and had lower intakes of sodium. For participants in the highest compared with the lowest quintile of DASH score, the multivariate relative risks for kidney stones were 0.55 (95% CI, 0.46 to 0.65) for men, 0.58 (95% CI, 0.49 to 0.68) for older women, and 0.60 (95% CI, 0.52 to 0.70) for younger women. Higher DASH scores were associated with reduced risk even in participants with lower calcium intake. Exclusion of participants with hypertension did not change the results. In conclusion, consumption of a DASH-style diet is associated with a marked decrease in kidney stone risk.

  16. Product (RED)

    DEFF Research Database (Denmark)

    Ponte, Stefano

    2011-01-01

    for a better world) by enrolling consumers in ways that do not rely on accurate knowledge of the products or specific understanding of the cause that The Global Fund engages but, instead, rely on a system of more general, affective affinity between the ‘aid celebrities’ who are behind RED (such as Bono...

  17. An Unusually Large Submandibular Gland Stone. A Case Report ...

    African Journals Online (AJOL)

    The latter was incised and drained, while excision of the right submandibular gland and calculus was carried out three weeks later. 5.0cm - sized stone was excised. This turned out to be the second largest salivary gland stone recorded in literature. Conclusion Giant salivary gland stone which ( greater than 1.5cm) is rare.

  18. Quantitative Prediction of Stone Fragility From Routine Dual Energy CT

    DEFF Research Database (Denmark)

    Ferrero, Andrea; Montoya, Juan C; Vaughan, Lisa E

    2016-01-01

    RATIONALE AND OBJECTIVES: Previous studies have demonstrated a qualitative relationship between stone fragility and internal stone morphology. The goal of this study was to quantify morphologic features from dual-energy computed tomography (CT) images and assess their relationship to stone fragil...

  19. Durability and Testing of Stone for use in Rubblemound structures

    DEFF Research Database (Denmark)

    Magoon, O.T.; Baird, W.F.; Ahrends, J.P.

    1993-01-01

    Rubblemound structures protected from wave action by a layer of quarried rock (stones) are the most common form of breakwaters. While extensive guidelines and procedures exist to select the size of stone there is very little information available on procedures to be followed to assure the quality...... of the in-place stone....

  20. Stone anchors from the Okhamandal region, Gujarat Coast, India

    Digital Repository Service at National Institute of Oceanography (India)

    Sundaresh; Gaur, A.S.; Gudigar, P.; Tripati, S.; Vora, K.H.; Bandodkar, S.N.

    period particularly on south-western coast of the island while stone anchors were noticed on the eastern coast of the island where medieval period remains can be noticed in the form of pottery, cannons and a few stone structures. Similar type of stone...

  1. Cover stones on liquefiable soil bed under waves

    DEFF Research Database (Denmark)

    Sumer, B. Mutlu; Hatipoglu, Figen; Fredsøe, Jørgen

    2010-01-01

    of stone layers (including the effect of an intermediate filter layer) were investigated. Pore pressure was measured across the soil depth. The experiments show that the soil liquefaction depended mainly on two parameters: the packing density of stones, and the number of stone layers. When the liquefaction...

  2. Urinary Nerve Growth Factor Levels in Overactive Bladder Syndrome and Lower Urinary Tract Disorders

    Directory of Open Access Journals (Sweden)

    Hsin-Tzu Liu

    2010-12-01

    Full Text Available Overactive bladder (OAB is a syndrome based on self-reported symptoms of urgency and frequency with or without urge incontinence. Although urgency is the core symptom of OAB, patients might have difficulty to distinguish urgency from the urge to void. Urodynamic study is a useful diagnostic tool to discover detrusor overactivity (DO in patients with OAB; however, not all OAB patients have DO. Therefore, a more objective and non-invasive way to diagnose and assess OAB including DO is needed. Recent research has focused on urinary biomarkers in assessment of OAB. Urinary nerve growth factor (NGF level increases in patients with OAB-wet, bladder outlet obstruction, mixed urinary incontinence and urodynamic DO. Urinary NGF levels are correlated with severity of OAB symptoms. In patients with OAB and DO who have been well treated with antimuscarinics or botulinum toxin injection, urinary NGF levels have been shown to decrease significantly in association with reduction of urgency severity. However, not all patients with OAB have an elevated urinary NGF level. It might also be increased in patients with interstitial cystitis/painful bladder syndrome, cerebrovascular accident and lower urinary tract diseases such as urinary tract stone, bacterial infection and urothelial tumor. It is possible to use urinary NGF levels as a bio-marker for diagnosis of OAB as well as for the assessment of therapeutic outcome in patients with OAB or DO. Here, we review the latest medical advances in this field.

  3. Medical Expulsive Therapy for Distal Ureteral Stones

    NARCIS (Netherlands)

    Tzortzis, Vassilios; Mamoulakis, Charalampos; Rioja, Jorge; Gravas, Stavros; Michel, Martin C.; de La Rosette, Jean J. M. C. H.

    2009-01-01

    Although minimally invasive treatments for ureteral stones are efficacious, they are not free of complications and are associated with high cost. Medical expulsive therapy (MET) has recently emerged as an alternative strategy for the initial management of small distal ureteral stories. A MEDLINE

  4. Stone Stability in Non-uniform Flow

    NARCIS (Netherlands)

    Hoan, N.T.; Stive, M.J.F.; Booij, R.; Hofland, B.; Verhagen, H.J.

    2011-01-01

    This paper presents the results of an experimental study on stone stability under nonuniform turbulent flow, in particular expanding flow. Detailed measurements of both flow and turbulence and the bed stability are described. Than various manners of quantifying the hydraulic loads exerted on the

  5. Male Urethral Diverticulum Having Multiple Stones

    African Journals Online (AJOL)

    muscle fibers in their wall, commonly encountered in adults, and involve the posterior urethra. Differential diagnosis for UD includes syringoceles (cystic dilatation of the Cowper's gland), sequestration cysts, epidermoid and epithelial inclusion cysts. Male Urethral Diverticulum Having Multiple Stones. Mohanty D, Garg PK, ...

  6. Frequency of stone clearance after extracorporeal shockwave ...

    African Journals Online (AJOL)

    A. Khalique

    2017-02-24

    Feb 24, 2017 ... on plain radiographic imaging and ultrasonography, which was per- formed 1 month after the ESWL session. Repeated treatment with. ESWL was offered if there was no fragmentation of the stone or a residual fragment larger than 4 mm in maximum diameter. X-ray abdomen and renal ultrasound was ...

  7. Large proximal ureteral stones: Ideal treatment modality?

    Directory of Open Access Journals (Sweden)

    B Kadyan

    2016-01-01

    Conclusion: Laparoscopic transperitoneal ureterolithotomy is a minimally invasive, safe and effective treatment modality and should be recommended to all patients of impacted large proximal stones, which are not amenable to URS or extracorporeal shock-wave lithotripsy or as a primary modality of choice especially if patient is otherwise candidate for open surgery.

  8. Childhood cancer: Early warning signs | Stones | Continuing ...

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 28, No 7 (2010) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Childhood cancer: Early warning signs. DK Stones. Abstract.

  9. Automated visual inspection for polished stone manufacture

    Science.gov (United States)

    Smith, Melvyn L.; Smith, Lyndon N.

    2003-05-01

    Increased globalisation of the ornamental stone market has lead to increased competition and more rigorous product quality requirements. As such, there are strong motivators to introduce new, more effective, inspection technologies that will help enable stone processors to reduce costs, improve quality and improve productivity. Natural stone surfaces may contain a mixture of complex two-dimensional (2D) patterns and three-dimensional (3D) features. The challenge in terms of automated inspection is to develop systems able to reliably identify 3D topographic defects, either naturally occurring or resulting from polishing, in the presence of concomitant complex 2D stochastic colour patterns. The resulting real-time analysis of the defects may be used in adaptive process control, in order to avoid the wasteful production of defective product. An innovative approach, using structured light and based upon an adaptation of the photometric stereo method, has been pioneered and developed at UWE to isolate and characterize mixed 2D and 3D surface features. The method is able to undertake tasks considered beyond the capabilities of existing surface inspection techniques. The approach has been successfully applied to real stone samples, and a selection of experimental results is presented.

  10. Systemic sclerosis in a stone cutter

    Directory of Open Access Journals (Sweden)

    Khanna N

    1997-01-01

    Full Text Available Several occupational hazards especially exposure to silica have been implicated as eliciting factors for the development of scleroderma-like disorders. We here report a case of manual stone-cutter who developed progressive scleroderma, interstitial lung disease and decreased oesophageal motility after several years of exposure to silica dust.

  11. Bladder exstrophy associated with complete urethral duplication ...

    African Journals Online (AJOL)

    J.E. Mensah

    ees.elsevier.com/afju · www.sciencedirect.com. Case report. Bladder exstrophy associated with complete urethral duplication: Bladder can be augmented with dorsal urethral mucosa. J.E. Mensaha,∗. , K.N. Ampadua, M.Y. Kyeia, B. Edusieb.

  12. Suprapubic prostatectomy with and without continuous bladder ...

    African Journals Online (AJOL)

    ... without continuous bladder irrigation is simple to perform, safe and easy to learn. This procedure permits patient ambulation as soon as spinal anesthesia wears out, reducing the risk of the occurrence of deep venous thrombosis. With the radical removal of bladder infusion solutions and reduced need for nursing attention ...

  13. Non-muscle-invasive bladder cancer

    DEFF Research Database (Denmark)

    Malmström, Per-Uno; Agrawal, Sachin; Bläckberg, Mats

    2017-01-01

    The management of non-muscle-invasive bladder cancer (NMIBC) has evolved from the first reports on bladder endoscopy and transurethral resection to the introduction of adjuvant intravesical treatment. However, disease recurrence and progression remain an ongoing risk, placing a heavy burden on he...

  14. Bladder diverticulitis on PET/CT

    OpenAIRE

    Wosnitzer, Brian

    2015-01-01

    Diverticula are commonly seen in hollow viscous organs. One common complication of diverticula is infection, known as diverticulitis. Although diverticulitis has been extensively described with respect to the colon, not many cases describe diverticulitis of the urinary bladder. We report a case of diverticulitis of the bladder to emphasize the imaging findings on PET/CT and to discuss management and possible complications.

  15. Bladder pressure sensors in an animal model

    NARCIS (Netherlands)

    Koldewijn, E. L.; van Kerrebroeck, P. E.; Schaafsma, E.; Wijkstra, H.; Debruyne, F. M.; Brindley, G. S.

    1994-01-01

    Urinary incontinence due to detrusor hyperreflexia might be inhibited on demand if changes in bladder pressure could be detected by sensors and transferred into pudendal nerve electrostimulation. The aim of this study is to investigate how the bladder wall reacts on different sensor implants.

  16. NEOADJUVANT RADIOTHERAPY FOR BLADDER CARCINOMA IN ...

    African Journals Online (AJOL)

    Objective To evaluate the impact of preoperative accelerated hyperfractionated radiotherapy in the management of bladder carcinoma in Egyptian patients. Patients and Methods Between December 1996 and February 2000, 104 Egyptian patients with pathologically proven infiltrative bladder carcinoma were enrolled in ...

  17. Squamous cell carcinoma in bladder extrophy

    OpenAIRE

    Cabral-Ribeiro, J; Silva, C; Sousa, L; Pérez García, D; Ribeiro dos Santos, A

    2005-01-01

    Bladder extrophy is a rare congenital malformation that nowadays is surgically corrected in neonatal period. We present a case report of a 71-year-old male with a verrucous squamous cell carcinoma arising in a classical uncorrected form of bladder extrophy.

  18. Bladder dysfunction in advanced Parkinson's disease

    DEFF Research Database (Denmark)

    Winge, Kristian; Nielsen, Kurt K

    2012-01-01

    Parkinson's disease (PD) patients often have lower urinary tract symptoms. Seventy-four percent of patients with early-to-moderate disease report more than one bladder disturbance symptom. Severe bladder symptoms are reported in 27-39% of PD patients. The aim of this study was to evaluate...

  19. Laser lithotripsy of salivary stones: Correlation with physical and radiological parameters.

    Science.gov (United States)

    Schrötzlmair, Florian; Müller, Mona; Pongratz, Thomas; Eder, Matthias; Johnson, Thorsten; Vogeser, Michael; von Holzschuher, Vanessa; Zengel, Pamela; Sroka, Ronald

    2015-04-01

    Sialolithiasis is a common disease of the major salivary glands. Owing to the variety of conservative and minimally invasive techniques, it is now possible to treat most cases of sialolithiasis without removal of the affected salivary gland. One treatment option is the endoscopic removal of the calculi. In cases of larger concretions, intraductal disintegration using laser-induced shock waves can be appropriate to allow endoscopic removal. In the present study, we investigated whether physical and radiological parameters of salivary stones can effectively predict the applicability of laser lithotripsy. Furthermore, we determined to what extent the applied laser energy resulted in tissue damage. In addition to basic parameters like size and density, we analysed 47 salivary stones using fluorescence spectroscopy, infrared spectroscopy, Raman spectroscopy, and dual-energy computed tomography. Subsequent fragmentation of all stones was performed with a Ho:YAG laser in a near-contact manner. Fragmentation rates were calculated and correlated with the previously measured physical and radiological parameters. Finally, to test for tissue damage, we performed HE-histology of salivary duct mucosa treated with the same laser energy used for stone fragmentation. Blue light excitation induced either green or red fluorescence emission. Dual-energy CT resulted in evidence of calcium-containing material. Infrared spectroscopy and Raman spectroscopy, both identified carbonate apatite as the main component of salivary stones. Disintegration into pieces smaller than 2 mm was possible in all cases. Fragmentation rates depended on the energy per pulse applied but not on any of the analysed physical and radiological parameters. In contrast to lithotripsy with 500 mJ per pulse, which was associated with no tissue damage, lithotripsy with 1,000 mJ per pulse resulted in damage of salivary duct mucosa. This suggests that the optimal laser energy for stone fragmentation is between 500

  20. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model.

    Science.gov (United States)

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-06-21

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  1. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    International Nuclear Information System (INIS)

    Chai Xiangfei; Hulshof, Maarten; Bel, Arjan; Van Herk, Marcel; Betgen, Anja

    2012-01-01

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  2. Ureteral Stenting after Uncomplicated Ureteroscopy for Distal Ureteral Stones: A Randomized, Controlled Trial

    Directory of Open Access Journals (Sweden)

    Y. El Harrech

    2014-01-01

    Full Text Available Objectives. We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents. Materials and Methods. 117 patients, prospectively divided into three groups to receive a double j stent (group 1, 42 patients, ureteral stent (group 2, 37 patients, or no stent (group 3, 38 patients, underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS, analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied. Results. There were no significant differences in preoperative data. There was no significant difference between the three groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 3, patients with double j stents had statistically significantly more bladder pain (P=0.003, frequency/urgency (P=0.002, dysuria (P=0.001, and need of analgesics (P=0.001. All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture. Conclusions. Uncomplicated ureteroscopy for distal ureteral calculi without intraoperative ureteral dilation can safely be performed without placement of a ureteral stent.

  3. Overactive bladder syndrome - management and treatment options.

    Science.gov (United States)

    Arnold, Janine; McLeod, Nicholas; Thani-Gasalam, Ruban; Rashid, Prem

    2012-11-01

    Overactive bladder syndrome is a symptom-based clinical diagnosis. It is characterised by urinary urgency, frequency and nocturia, with or without urge urinary incontinence. These symptoms can often be managed in the primary care setting. This article provides a review on overactive bladder syndrome and provides advice on management for the general practitioner. Overactive bladder syndrome can have a significant effect on quality of life, and affects 12-17% of the population. Prevalence increases with age. The management of overactive bladder syndrome involves exclusion of underlying pathology. First line treatment includes lifestyle interventions, pelvic floor exercises, bladder training and antimuscarinic agents. Failure of conservative management necessitates urology referral. Second line therapies are more invasive, and include botulinum toxin, neuromodulation or surgical interventions such as augmentation cystoplasty or urinary diversion.

  4. [Etiology and pathogenesis of overactive bladder].

    Science.gov (United States)

    Bschleipfer, T; Wagenlehner, F; Weidner, W

    2011-04-01

    The symptom complex"overactive bladder" (OAB) affects more than 10% of adult individuals. The etiopathology is complex and multifactorial. Foremost, urinary tract infection, bladder cancer, foreign bodies, and history of radiation or intravesical instillation of chemotherapeutics must be excluded. In many cases, OAB is caused by neurogenic disorders that activate involuntary detrusor contractions (detrusor overactivity, DO). Also, non-neurogenic disorders such as bladder outlet obstruction or dysfunctions of the female pelvic floor/slack ligaments that affect the urothelium, suburothelium, detrusor and bladder afferents are substantially involved in the pathogenesis of OAB. Until now, circulatory disorders have not been adequately taken into consideration but seem to be another etiological factor that causes OAB. Henceforth, molecular changes of bladder afferents and circulatory disorders in patients suffering from OAB have to be investigated in more detail.

  5. Occupational variation in incidence of bladder cancer

    DEFF Research Database (Denmark)

    Hadkhale, Kishor; MacLeod, Jill; Demers, Paul A.

    2017-01-01

    Objectives: The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada. Methods: In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person......: Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic...... countries; no risk estimates for these categories were given from the CanCHEC cohort. Conclusion: We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking...

  6. Compatibility study and adaption of stone repair mortars for the Lede stone (Belgium)

    Science.gov (United States)

    De Kock, T.; Vandevoorde, D.; Boone, M. A.; Dewanckele, J.; De Boever, W.; Lanzón, M.; De Schutter, G.; Van Hoorebeke, L.; Jacobs, P.; Cnudde, V.

    2012-04-01

    One of the main historic building materials in northern Belgium is the Lede stone. This arenaceous limestone from Lutetian age was excavated in the region of Ghent and Brussels and was transported northwards by main rivers such as the Scheldt and Zenne. Thanks to this natural transport route, the stone in also found in many cities which lie abroad the excavation area, such as Antwerp (Belgium) and various cities in the Netherlands (Breda, Zierikzee, …). Due to its dominant occurrence in our cultural heritage, it is frequently subjected to restoration and renovation works. Depending on the degree of decay, most frequent stone operations are cleaning, healing with mortar or replacing it by (often exotic) fresh blocks. Originally, this limestone has a greenish-gray colour, but when being exposed to atmospheric conditions it acquires a yellowish to rusty coloured patina. The origin of the latter is most likely the oxidation of glauconite minerals which are present in a few percent in the stone. In addition, the stone often demonstrates black crust formation due to sulphation. Cleaning of the stone often results in an excess removal of this black gypsum crusts and patina, thus exposing deeper parts of the stone which appear more greenish-gray again. When the stone is subsequently healed by adding repair mortar to damaged parts, the question rises which mortar colour is more appropriate. The choice of repair mortar is greatly depending on commercial aspects. When handling entire facades on monuments, a mineral mortar based on ZnCl is most often applied in Belgium. The big advantage of this mortar is its fast curing. Three colour types have been developed for the Lede stone in specific. However, the hardness of this mortar is sometimes in conflict with reversibility. For the handling of individual sculptures some conservators choose for the application of (hydraulic) lime mortars. The advantage of using such mortars is their high compatibility and reversibility. The

  7. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...... metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available...

  8. Metabolic syndrome: a multifaceted risk factor for kidney stones.

    Science.gov (United States)

    Domingos, Fernando; Serra, Adelaide

    2014-10-01

    Kidney stones and metabolic syndrome (MetS) are common conditions in industrialized countries. There is growing evidence of associations between kidney stone disease and MetS or some of its components. The link between uric acid stones and MetS is well understood, but the link with calcium oxalate (CaOx) stones, the most common kidney stone composition, is more complex, and MetS is frequently overlooked as a risk factor for calcium nephrolithiasis. The physiopathological mechanisms of kidney stone disease in MetS are reviewed in this article. Uric acid stones are a consequence of the excessively acidic urine that results from insulin resistance. The pathophysiology of CaOx stones may include: increased excretion of lithogenesis promoters and decreased excretion of inhibitors; increased risk of Randall's plaque development; and inflammatory damage to renal epithelia by oxidative stress, as a consequence of the insulin-resistant milieu that characterizes MetS. The last mechanism contributes to the adhesion of CaOx crystals to subepithelial calcium deposits working as anchor sites where stones can grow. The predominant MetS features could determine the chemical composition of the stones in each patient. Kidney stones may be a renal manifestation of MetS and features of this syndrome should be looked for in patients with idiopathic nephrolithiasis.

  9. Kidney stones: Composition, frequency and relation to metabolic diagnosis.

    Science.gov (United States)

    Spivacow, Francisco R; Del Valle, Elisa E; Lores, Ernesto; Rey, Paula G

    Nephrolithiasis is one of the most frequent urologic diseases. The aim of this paper is to study the composition and frequency of 8854 patient kidney stones and in a subset of them their metabolic risk factors to be related to their type of calculi. Physicochemical and crystallographic methods were used to assess kidney stone composition. In a subset of 715 patients, we performed an ambulatory metabolic protocol with diagnostic purposes. From the total sample 79% of stones were made of calcium salts (oxalate and phosphate), followed by uric acid stones in 16.5%, calcium salts and uric acid in 2%, other salts in 1.9% and cystine in 0.6%. Male to female ratio was almost three times higher in calcium salts and other types of stones, reaching a marked male predominance in uric acid stones, M/F 18.8 /1.0. The major risk factors for calcium stones are idiopathic hypercalciuria, followed by unduly acidic urine pH and hyperuricosuria. In uric acid stones unduly acidic urine pH and less commonly hyperuricosuria are the most frequent biochemical diagnosis. Our results show that analysis of kidney stones composition and the corresponding metabolic diagnosis may provide a scientific basis for the best management and prevention of kidney stone formation, as well as it may help us to study the mechanisms of urine stone formation.

  10. Diversity in protein profiles of individual calcium oxalate kidney stones.

    Science.gov (United States)

    Okumura, Nobuaki; Tsujihata, Masao; Momohara, Chikahiro; Yoshioka, Iwao; Suto, Kouzou; Nonomura, Norio; Okuyama, Akihiko; Takao, Toshifumi

    2013-01-01

    Calcium oxalate kidney stones contain low amounts of proteins, some of which have been implicated in progression or prevention of kidney stone formation. To gain insights into the pathophysiology of urolithiasis, we have characterized protein components of calcium oxalate kidney stones by proteomic approaches. Proteins extracted from kidney stones showed highly heterogeneous migration patterns in gel electrophoresis as reported. This was likely to be mainly due to proteolytic degradation and protein-protein crosslinking of Tamm-Horsfall protein and prothrombin. Protein profiles of calcium oxalate kidney stones were obtained by in-solution protease digestion followed by nanoLC-MALDI-tandem mass spectrometry, which resulted in identification of a total of 92 proteins in stones from 9 urolithiasis patients. Further analysis showed that protein species and their relative amounts were highly variable among individual stones. Although proteins such as prothrombin, osteopontin, calgranulin A and calgranulin B were found in most stones tested, some samples had high contents of prothrombin and osteopontin, while others had high contents of calgranulins. In addition, calgranulin-rich stones had various neutrophil-enriched proteins such as myeloperoxidase and lactotransferrin. These proteomic profiles of individual kidney stones suggest that multiple systems composed of different groups of proteins including leucocyte-derived ones are differently involved in pathogenesis of individual kidney stones depending on situations.

  11. Approach to Residual Kidney Stone Fragments After Shock Wave Therapy

    Directory of Open Access Journals (Sweden)

    Tumay Ižpekci

    2014-04-01

    Full Text Available For kidney stones up to 2 cm in diameter shock wave therapy (SDT is safely applied and kidney stones smaller than 5mm remaining in the kidney after treatment are regarded as clinically insignificant. Management of this condition is still controversial among clinicians. These stones in the kidney may continue to persist without any clinical symptoms or begin to cause clinical signs. In the event that the clinical symptoms are present, it requires detailed urological examination and treatment. The aim in the surgical treatment of urinary tract stones is completely stone clearance but in stones that are not infected, not causing urinary tract obstruction and without clinical symptoms medical treatment is also beneficial fort he prevention of growth and recurrence. In addition, surgical intervention is also possible for the residual stone fragments which become symptomatic during follow-up.

  12. Stones in the lacrimal gland: a rare condition

    DEFF Research Database (Denmark)

    Halborg, Jakob; Prause, Jan Ulrik; Toft, Peter Bjerre

    2009-01-01

    PURPOSE: Stones (dacryoliths) in the lacrimal drainage system are relatively common. However, stones in the lacrimal gland itself are very rare. We present three cases of lacrimal gland stones and describe the clinical and histopathological characteristics and composition of the stones. METHODS...... of the excised material showed an eosinophilic, amorphic material organized in lamellae and localized in a ductule. The findings were consistent with a stone in the lacrimal gland in all three cases. All stones were composed of proteins of similar types. After surgery, the three patients healed without...... complications. CONCLUSIONS: Lacrimal gland stones represent a very rare but relevant differential diagnosis when a patient presents with unilateral persistent conjunctivitis or with a tumour in the lateral canthus. Treatment is excision under local anaesthesia....

  13. Treatment of intrahepatic stones with shock wave lithotripsy

    International Nuclear Information System (INIS)

    Martin, L.G.; Amerson, J.R.; Ambrose, S.S.; Alspaugh, J.P.; Chuang, V.P.; Casarella, W.J.

    1987-01-01

    Extracorporeal shock wave lithotripsy administered with a renal lithotriptor was used for the successful removal of intrahepatic biliary stones in two patients with Oriental cholangiohepatitis. Both patients had undergone multiple surgical explorations and multiple attempts at percutaneous stone removal. Targeting of the stones was facilitated by placing the tip of an angiographic guide wire, inserted through a transhepatic catheter, adjacent to the stone. Shock waves of 16-18 keV were applied. The patients were monitored with serial vital signs, chest radiography, liver chemistry profiles, and MR imaging. No major adverse reaction was detected in either patient. Limitations to the use of lithography for intrahepatic stone removal include patient body size, target-skin disease, location of the stones, and potential injury to the lung base. The authors' preliminary experience suggests that the lithtripsy can greatly facilitate the treatment of intrahepatic stones in selected patients

  14. Non-bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome.

    Science.gov (United States)

    Fan, Yu-Hua; Lin, Alex T L; Lu, Shing-Hwa; Chuang, Yao-Chi; Chen, Kuang-Kuo

    2014-08-01

    To detect non-bladder conditions in patients with interstitial cystitis/hypersensitive bladder syndrome. A total of 122 female interstitial cystitis/hypersensitive bladder syndrome patients and a control group of 122 age-matched female patients with stress urinary incontinence completed screening questionnaires for irritable bowel syndrome, temporomandibular disorder, multiple chemical sensitivities, tension and migraine headache, localized myofascial pain disorder, and fibromyalgia. Interstitial cystitis/hypersensitive bladder syndrome patients also completed questionnaires on interstitial cystitis/hypersensitive bladder syndrome symptom severity, including the O'Leary-Sant symptom index, and the visual analog scale for pain and urgency. Interstitial cystitis/hypersensitive bladder syndrome patients were more likely to meet diagnostic criteria for irritable bowel syndrome than controls (37.5% vs 11.5%), and tension/migraine headache (38.7% vs 15.7%; all P interstitial cystitis/hypersensitive bladder syndrome symptoms as measured by the visual analog scale of pain (P = 0.008) and O'Leary-Sant bother index (P = 0.035). Interstitial cystitis/hypersensitive bladder syndrome patients are more likely to have multiple non-bladder conditions. These conditions correlate with the severity of interstitial cystitis/hypersensitive bladder syndrome symptoms. © 2014 The Japanese Urological Association.

  15. The Danish Bladder Cancer Database

    DEFF Research Database (Denmark)

    Hansen, Erik; Larsson, Heidi Jeanet; Nørgaard, Mette

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Bladder Cancer Database (DaBlaCa-data) is to monitor the treatment of all patients diagnosed with invasive bladder cancer (BC) in Denmark. STUDY POPULATION: All patients diagnosed with BC in Denmark from 2012 onward were included in the study. Results......-intended radiation therapy. DESCRIPTIVE DATA: One-year mortality was 28% (95% confidence interval [CI]: 15-21). One-year cancer-specific mortality was 25% (95% CI: 22-27%). One-year mortality after cystectomy was 14% (95% CI: 10-18). Ninety-day mortality after cystectomy was 3% (95% CI: 1-5) in 2013. One......-year mortality following curative-intended radiation therapy was 32% (95% CI: 24-39) and 1-year cancer-specific mortality was 23% (95% CI: 16-31) in 2013. CONCLUSION: This preliminary DaBlaCa-data report showed that the treatment of MIBC in Denmark overall meet high international academic standards. The database...

  16. Lymphoma of the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Anthony Kodzo-Grey Venyo

    2014-01-01

    Full Text Available Background. Lymphoma of the urinary bladder (LUB is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18(q21: 21. Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment.

  17. Complex bladder-exstrophy-epispadias management: Causes of failure of initial bladder closure

    Directory of Open Access Journals (Sweden)

    Kouame Dibi Bertin

    2014-01-01

    Full Text Available The success of the initial closure of the complex bladder-exstrophy remains a challenge in pediatric surgery. This study describes a personal experience of the causes of failure of the initial closure and operative morbidity during the surgical treatment of bladder-exstrophy complex. From April 2000 to March 2014, four patients aged 16 days to 7 years and 5 months underwent complex exstrophy-epispadias repair with pelvic osteotomies. There were three males and one female. Three of them had posterior pelvic osteotomy, one had anterior innominate osteotomy. Bladder Closure: Bladder closure was performed in three layers. Our first patient had initial bladder closure with polyglactin 4/0 (Vicryl ® 4/0, concerning the last three patients, initial bladder closure was performed with polydioxanone 4/0 (PDS ® 4/0. The bladder was repaired leaving the urethral stent and ureteral stents for full urinary drainage for three patients. In one case, only urethral stent was left, ureteral drainage was not possible, because stents sizes were more important than the ureteral diameter. Out of a total of four patients, initial bladder closure was completely achieved for three patients. At the immediate postoperative follow-up, two patients presented a complete disunion of the abdominal wall and bladder despite an appropriate postoperative care. The absorbable braided silk (polyglactin used for the bladder closure was considered as the main factor in the failure of the bladder closure. The second cause of failure of the initial bladder closure was the incomplete urine drainage, ureteral catheterisation was not possible because the catheters sizes were too large compared with the diameters of the ureters. The failure of the initial bladder-exstrophy closure may be reduced by a closure with an absorbable monofilament silk and efficient urine drainage via ureteral catheterisation.

  18. Complex bladder-exstrophy-epispadias management: causes of failure of initial bladder closure.

    Science.gov (United States)

    Bertin, Kouame Dibi; Serge, Kouame Yapo Guy; Moufidath, Sounkere; Maxime, Koffi; Hervé, Odehouri Koudou Thierry; Baptiste, Yaokreh Jean; Samba, Tembely; Gaudens, Dieth Atafi; Ossenou, Ouattara; Ruffin, Dick

    2014-01-01

    The success of the initial closure of the complex bladder-exstrophy remains a challenge in pediatric surgery. This study describes a personal experience of the causes of failure of the initial closure and operative morbidity during the surgical treatment of bladder-exstrophy complex. From April 2000 to March 2014, four patients aged 16 days to 7 years and 5 months underwent complex exstrophy-epispadias repair with pelvic osteotomies. There were three males and one female. Three of them had posterior pelvic osteotomy, one had anterior innominate osteotomy. Bladder Closure: Bladder closure was performed in three layers. Our first patient had initial bladder closure with polyglactin 4/0 (Vicryl ® 4/0), concerning the last three patients, initial bladder closure was performed with polydioxanone 4/0 (PDS ® 4/0). The bladder was repaired leaving the urethral stent and ureteral stents for full urinary drainage for three patients. In one case, only urethral stent was left, ureteral drainage was not possible, because stents sizes were more important than the ureteral diameter. Out of a total of four patients, initial bladder closure was completely achieved for three patients. At the immediate postoperative follow-up, two patients presented a complete disunion of the abdominal wall and bladder despite an appropriate postoperative care. The absorbable braided silk (polyglactin) used for the bladder closure was considered as the main factor in the failure of the bladder closure. The second cause of failure of the initial bladder closure was the incomplete urine drainage, ureteral catheterisation was not possible because the catheters sizes were too large compared with the diameters of the ureters. The failure of the initial bladder-exstrophy closure may be reduced by a closure with an absorbable monofilament silk and efficient urine drainage via ureteral catheterisation.

  19. Sensory Hyperinnervation Distinguishes Bladder Pain Syndrome/Interstitial Cystitis from Overactive Bladder Syndrome.

    Science.gov (United States)

    Regauer, Sigrid; Gamper, Marianne; Fehr, Mathias K; Viereck, Volker

    2017-01-01

    Pain is the key symptom that distinguishes bladder pain syndrome/interstitial cystitis from overactive bladder syndrome but overlap occurs. To find a discriminating marker for these bladder diseases we examined sensory hyperinnervation and neurotrophin receptor expression in bladder biopsies as well as nerve growth factor levels in urine. Bladder biopsies from patients with bladder pain syndrome/interstitial cystitis, including 12 with and 19 without Hunner lesions, 13 with overactive bladder syndrome and 12 healthy controls, were analyzed by immunohistochemistry with antibodies to the nerve cell marker PGP9.5 (neuron-specific protein gene product 9.5), p75 NTR (p75 neurotrophin receptor), the B-lymphocyte marker CD20 and mast cell tryptase. Urinary nerve growth factor was quantified by enzyme-linked immunosorbent assay. Subepithelial sensory hyperinnervation on PGP9.5 staining had 97% sensitivity and 76% specificity, increased lymphocytic infiltration had 90% sensitivity and 80% specificity, and urothelial defects had 97% sensitivity and 76% specificity to distinguish bladder pain syndrome/interstitial cystitis with and without Hunner lesions from overactive bladder syndrome and healthy controls. Increased sensory innervation was associated with submucosal mast cell localization. Staining of p75 NTR in basal urothelial cells was indicative of bladder pain syndrome/interstitial cystitis. Urinary nerve growth factor levels were below the detection level and did not differentiate bladder diseases from healthy controls. Sensory hyperinnervation and basal urothelial p75 NTR staining together with assessment of inflammatory lymphocytes and urothelial integrity allow for the differentiation of bladder pain syndrome/interstitial cystitis and overactive bladder syndrome even in the absence of Hunner lesions. Furthermore, these histopathological criteria enable the identification of early disease stages or oligosymptomatic/asymptomatic cases and may permit timely treatment

  20. Hematuria screening test for urinary bladder mucosal infiltration in cervical cancer.

    Science.gov (United States)

    Chuttiangtum, Ayuth; Udomthavornsuk, Banchong; Chumworathayi, Bandit

    2012-01-01

    To determine the diagnostic performance of hematuria as a screening test for urinary bladder infiltration in cervical cancer patients with a prospective study design. Newly diagnosed cervical cancer patients at Srinagarind hospital from 14 June 2011 to 30 April 2012 were enrolled in this study. We collected midstream urine samples for urinalysis from every patient before routine cystoscopic exam for clinical staging. The presence of 3 or more red blood cells (RBCs) per high power field was defined as positive for hematuria. A two-by-two table was used to determine the diagnostic performance of hematuria to detect urinary bladder mucosal infiltration using cystoscopy and biopsy as the gold standard. A total of 130 were patients included, 54 of which (41.5%) had hematuria. Of these, four patients (3.08%) had pathological report from cystoscopic biopsy confirmed metastatic squamous cell carcinoma. The sensitivity, specificity, PPV, NPV, and accuracy of hematuria as a screening test to detect urinary bladder mucosal infiltration of cervical cancer were 100%, 60.3%, 7.4%, 100%, and 61.5%, respectively. There was no single case of urinary bladder mucosal infiltration in patients initially staged less than stage III. Hematuria can be used as a screening test to detect urinary bladder mucosal infiltration of cervical cancer. This can reduce the number of cervical cancer patients who really need to undergo cystoscopy as a staging procedure to less than half and to less than 20% if stage III or more were included without missing a single case of urinary bladder mucosal infiltration.

  1. Environmental non-occupational risk factors associated with bladder cancer.

    Science.gov (United States)

    Ferrís, J; Berbel, O; Alonso-López, J; Garcia, J; Ortega, J A

    2013-10-01

    Bladder carcinoma (BC), due its high morbidity and relapsing course, generates significant economic and health care costs. Accordingly, review the environmental nonoccupational risk factors (RF), more or less evidence-based, in the etiology and pathogenesis of BC, because the involvement of urologists is essential for prevention. Review of the peer-reviewed literature (1987-2012) on nonoccupational environmental RF associated with BC retrieved from Medline, Embase and Science Citation Index. The search profiles have been "Risk factors/Epidemiology/Tobacco-smoking/Diet-nutrition-water-liquids/Radiation/Infectious/Farmacological drugs" and "Bladder cancer". Smoking was associated with 50% of BC in both sexes. Smokers have a 2-5 times higher risk than nonsmokers, directly proportional to the amount and duration of addiction. Drinking water contaminated with arsenic and chromium chlorination byproducts increases the risk of BC. High consumption of red meat and saturated fat may increase the risk, while high intake of fruits and vegetables decreases it. Patients treated with cyclophosphamide, ifosfamide and ionizing radiation have an increased risk of BC. Frequent and prolonged use of hair dyes and Schistosoma haematobium infestation increases the risk of BC. The reduction or the cessation of smoking decrease BC. The contaminant-free water consumption with the increase of vegetal foods favour BC prevention. Cancer survivors treated with cyclophosphamide, ifosfamide and radiation therapy should be monitored for early diagnosis of BC. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  2. Kidney stones in primary hyperoxaluria: new lessons learnt.

    Science.gov (United States)

    Jacob, Dorrit E; Grohe, Bernd; Geßner, Michaela; Beck, Bodo B; Hoppe, Bernd

    2013-01-01

    To investigate potential differences in stone composition with regard to the type of Primary Hyperoxaluria (PH), and in relation to the patient's medical therapy (treatment naïve patients versus those on preventive medication) we examined twelve kidney stones from ten PH I and six stones from four PH III patients. Unfortunately, no PH II stones were available for analysis. The study on this set of stones indicates a more diverse composition of PH stones than previously reported and a potential dynamic response of morphology and composition of calculi to treatment with crystallization inhibitors (citrate, magnesium) in PH I. Stones formed by PH I patients under treatment are more compact and consist predominantly of calcium-oxalate monohydrate (COM, whewellite), while calcium-oxalate dihydrate (COD, weddellite) is only rarely present. In contrast, the single stone available from a treatment naïve PH I patient as well as stones from PH III patients prior to and under treatment with alkali citrate contained a wide size range of aggregated COD crystals. No significant effects of the treatment were noted in PH III stones. In disagreement with findings from previous studies, stones from patients with primary hyperoxaluria did not exclusively consist of COM. Progressive replacement of COD by small COM crystals could be caused by prolonged stone growth and residence times in the urinary tract, eventually resulting in complete replacement of calcium-oxalate dihydrate by the monohydrate form. The noted difference to the naïve PH I stone may reflect a reduced growth rate in response to treatment. This pilot study highlights the importance of detailed stone diagnostics and could be of therapeutic relevance in calcium-oxalates urolithiasis, provided that the effects of treatment can be reproduced in subsequent larger studies.

  3. Polyps in continent catheterizable bladder channels.

    Science.gov (United States)

    Groth, Travis W; Mitchell, Michael E; Balcom, Anthony H

    2013-02-01

    We describe our experience with polyps encountered in bladder continent catheterizable channels. An IRB-approved retrospective study was conducted on all patients at Children's Hospital of Wisconsin with continent catheterizable channels managed by a single physician over a 16-year time period. Fifty-five patients were identified with bladder channels. During a median follow-up of 7 years (range 3-16 years), 20% (11/55) of bladder channels developed polyps. The time to diagnosis of a polyp in bladder channels from initial surgery ranged from 3 months to 8 years (median of 29 months). Fifty-five percent (6/11) of patients who developed bladder polyps were symptomatic. All patients' symptoms resolved after treatment by endoscopic resection. Forty-five percent (5/11) of polyps recurred after resection. The time of recurrence ranged from 4 months to 7 years (median of 19 months). Polyps were universally benign inflammatory granulomatous tissue. This is the first series reporting the incidence of polyps in bladder catheterizable channels. Patients with continent catheterizable bladder channels can develop symptomatic polyps in their channels, of unknown long-term significance and risk. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. Thrombomodulin expression regulates tumorigenesis in bladder cancer

    International Nuclear Information System (INIS)

    Wu, Chun-Te; Chang, Ying-Hsu; Lin, Paul- Yang; Chen, Wen-Cheng; Chen, Miao-Fen

    2014-01-01

    The identification of potential tumor markers will help improve therapeutic planning and patient management. Thrombomodulin (TM) is a sensitive urothelial marker. TM was reported to be one of the endogenous anti-metastatic factors and has diagnostic and prognostic values for the progression of carcinoma. In the present study, we examine the role of TM in bladder cancer. We studied the role of TM in tumor behavior and related signaling pathways in vitro using the human bladder cancer cell lines HT1376, HT1197, J82 and T24, and in vivo using animal models. We also selected clinical specimens from 100 patients with bladder cancer for immunohistochemical staining to evaluate the predictive capacity of TM in tumor invasiveness. The data revealed that positive immunoreactivity for TM was inversely correlated with clinical stage and DNA methyltransferase 1 immunoreactivity. Decreased TM expression could predict the aggressive tumor growth and advanced clinical stage in bladder cancer. When TM was inhibited, tumor growth rate and invasion ability were augmented in vitro and in vivo. The underlying changes included increased cell proliferation, enhanced epithelial-mesenchymal transition (EMT) and angiogenesis. Moreover, inhibition of NF-κB activation significantly increased TM expression and attenuated tumor aggressiveness in bladder cancer. TM plays an important role in bladder cancer tumor aggressiveness in vitro and in vivo and is a clinically significant predictor that may represent a suitable therapeutic target for bladder cancer

  5. Urinary bladder cancer: role of MR imaging.

    Science.gov (United States)

    Verma, Sadhna; Rajesh, Arumugam; Prasad, Srinivasa R; Gaitonde, Krishnanath; Lall, Chandana G; Mouraviev, Vladimir; Aeron, Gunjan; Bracken, Robert B; Sandrasegaran, Kumaresan

    2012-01-01

    Urinary bladder cancer is a heterogeneous disease with a variety of pathologic features, cytogenetic characteristics, and natural histories. It is the fourth most common cancer in males and the tenth most common cancer in females. Urinary bladder cancer has a high recurrence rate, necessitating long-term surveillance after initial therapy. Early detection is important, since up to 47% of bladder cancer-related deaths may have been avoided. Conventional computed tomography (CT) and magnetic resonance (MR) imaging are only moderately accurate in the diagnosis and local staging of bladder cancer, with cystoscopy and pathologic staging remaining the standards of reference. However, the role of newer MR imaging sequences (eg, diffusion-weighted imaging) in the diagnosis and local staging of bladder cancer is still evolving. Substantial advances in MR imaging technology have made multiparametric MR imaging a feasible and reasonably accurate technique for the local staging of bladder cancer to optimize treatment. In addition, whole-body CT is the primary imaging technique for the detection of metastases in bladder cancer patients, especially those with disease that invades muscle. © RSNA, 2012.

  6. Experimental electrical stimulation of the bladder using a new device

    DEFF Research Database (Denmark)

    Petersen, T; Christiansen, P; Nielsen, B

    1986-01-01

    Repeated bladder contractions were evoked during a six month period in three unanaesthetized female minipigs by using unipolar carbon fiber electrodes embedded in the bladder wall adjacent to the ureterovesical junction. In contrast to bipolar and direct bladder muscle stimulation unipolar...... electrodes at each ureterovesical junction evoked bladder pressure increase similar to those produced in previous investigations in dogs. Sacral nerve stimulation of S2 evoked bladder contraction at a minimal current. Microscopic examination revealed no cellular reactions to the carbon fibers...

  7. Evaluating Variations of Bladder Volume Using an Ultrasound Scanner in Rectal Cancer Patients during Chemoradiation: Is Protocol-Based Full Bladder Maintenance Using a Bladder Scanner Useful to Maintain the Bladder Volume?

    Directory of Open Access Journals (Sweden)

    Hong In Yoon

    Full Text Available The maintenance of full bladder is important to reduce radiation-induced toxicities and maintain the therapeutic consistency in locally advanced rectal cancer patients who underwent radiotherapy (RT. So, the aim of this study was to evaluate the effectiveness of protocol-based full bladder maintenance by assessing bladder volume variation using an ultrasound bladder scanner to maintain bladder volume.From March 2011 to May 2011, twenty consecutive rectal cancer patients receiving external beam RT participated in this prospective study. Protocol-based full bladder maintenance consisted of education, training and continuous biofeedback by measuring bladder volume. Bladder volume was measured by bladder scan immediately before simulation CT scan and before each treatment three times weekly during the RT period. The relative bladder volume change was calculated. Intra-patient bladder volume variations were quantified using interquartile range (IQR of relative bladder volume change in each patient. We compared intra-patient bladder volume variations obtained (n=20 with data from our previous study patients (n=20 performing self-controlled maintenance without protocol.Bladder volumes measured by bladder scan highly correlated with those on simulation CT scan (R=0.87, p<0.001. Patients from this study showed lower median IQR of relative bladder volume change compared to patients of self-controlled maintenance from our previous study, although it was not statistically significant (median 32.56% vs. 42.19%, p=0.058. Upon logistic regression, the IQR of relative bladder volume change was significantly related to protocol-based maintenance [relative risk 1.045, 95% confidence intervals (CI 1.004-1.087, p=0.033]. Protocol-based maintenance included significantly more patients with an IQR of relative bladder volume change less than 37% than self-controlled maintenance (p=0.025.Our findings show that bladder volume could be maintained more consistently during

  8. Red Sky

    OpenAIRE

    Young, John

    2015-01-01

    Red Sky is scored for alto flute (Kingma system), Clarinet in B-flat/bass clarinet), piano and 14 channel digital audio files (48 kHz/24 bit). A MAX patch for triggering the sound files in performance is available. Permission to include oral history recordings of First World War survivors was kindly granted by the Imperial War Museum, London. The work was created to mark the close of the New Walk Museum and Art Gallery’s ‘Leicester at War 1914-15’ exhibition. The work is in 31 movem...

  9. Bladder exstrophy: current management and postoperative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pierre, Ketsia [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Borer, Joseph [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Phelps, Andrew [University of California, San Francisco, Department of Pediatric Radiology, San Francisco, CA (United States); Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2014-07-15

    Bladder exstrophy is a rare malformation characterized by an infra-umbilical abdominal wall defect, incomplete closure of the bladder with mucosa continuous with the abdominal wall, epispadias, and alterations in the pelvic bones and muscles. It is part of the exstrophy-epispadias complex, with cloacal exstrophy on the severe and epispadias on the mild ends of the spectrum. Bladder exstrophy is the most common of these entities and is more common in boys. The goal of this paper is to describe common methods of repair and to provide an imaging review of the postoperative appearances. (orig.)

  10. Primary signet cell adenocarcinoma of bladder

    Directory of Open Access Journals (Sweden)

    Prateek Kinra

    2017-01-01

    Full Text Available Primary signet cell cancer of the urinary bladder is a relatively rare entity. Since there is no mucinous epithelium in the bladder, It is proposed that the tumor arises from metaplastic urothelium. Two thirds of the tumours are mucin secreting, in most of which the site of the deposition is either extracellular or intracellular displacing the nucleus to a peripheral crescent, giving the cells a signet ring appearance. The tumours are most often infiltrative and diffusely involving the majority of the bladder akin to its name sake in stomach. It is essential to distinguish this carcinoma from gastrointestinal metastases as different therapeutic strategies are often necessary.

  11. Modelling Creep (Relaxation of the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Zdravkovic Nebojsa

    2017-12-01

    Full Text Available We first present the results of an experiment in which the passive properties of the urinary bladder were investigated using strips of rabbit bladder. Under the assumption that the urinary bladder had orthopaedic characteristics, the strips were taken in the longitudinal and in the circumferential directions. The material was subjected to uniaxial tension, and stress-stretch curves were generated for various rates of deformation. We found that the rates did not have a significantly effect on the passive response of the material. Additionally, the stress-stretch dependence during relaxation of the material when exposed to isometric conditions was determined experimentally.

  12. Full-thickness endometriosis of the bladder

    DEFF Research Database (Denmark)

    Kjer, Jens Jørgen; Kristensen, Jens; Hartwell, Dorthe

    2014-01-01

    OBJECTIVE: To draw attention to the rare condition of endometriosis in the bladder. This is correlated with symptoms not normally connected to endometriosis and therefore often remains underdiagnosed for years. DESIGN AND SETTING: Retrospective study in a university teaching hospital, one of two...... and March 2011. We included only patients with symptomatic full-thickness bladder detrusor endometriosis and mucosal involvement. All patients had had bladder symptoms for two to seven years. MAIN OUTCOME MEASURES: Symptoms after surgery and recurrence rate. RESULTS: The main preoperative symptom...

  13. Ground stone percussion tools from Maltese Islands

    OpenAIRE

    Felice Larocca

    2016-01-01

    A few lithic percussion tools, probably related to construction and craftsmanship, are stored in the National Museum of Archaeology of Valletta (Malta). Dated to the Temple Period (about 4000-2500 BCE), many are typologically similar to artefacts from the continental area, but others look distinctive and probably developed in loco in response to specific needs. This paper examines five stone hammers with different hafting methods (three of them show grooves or holes and two both grooves and h...

  14. Surface analysis of stone and bone tools

    Science.gov (United States)

    Stemp, W. James; Watson, Adam S.; Evans, Adrian A.

    2016-03-01

    Microwear (use-wear) analysis is a powerful method for identifying tool use that archaeologists and anthropologists employ to determine the activities undertaken by both humans and their hominin ancestors. Knowledge of tool use allows for more accurate and detailed reconstructions of past behavior, particularly in relation to subsistence practices, economic activities, conflict and ritual. It can also be used to document changes in these activities over time, in different locations, and by different members of society, in terms of gender and status, for example. Both stone and bone tools have been analyzed using a variety of techniques that focus on the observation, documentation and interpretation of wear traces. Traditionally, microwear analysis relied on the qualitative assessment of wear features using microscopes and often included comparisons between replicated tools used experimentally and the recovered artifacts, as well as functional analogies dependent upon modern implements and those used by indigenous peoples from various places around the world. Determination of tool use has also relied on the recovery and analysis of both organic and inorganic residues of past worked materials that survived in and on artifact surfaces. To determine tool use and better understand the mechanics of wear formation, particularly on stone and bone, archaeologists and anthropologists have increasingly turned to surface metrology and tribology to assist them in their research. This paper provides a history of the development of traditional microwear analysis in archaeology and anthropology and also explores the introduction and adoption of more modern methods and technologies for documenting and identifying wear on stone and bone tools, specifically those developed for the engineering sciences to study surface structures on micro- and nanoscales. The current state of microwear analysis is discussed as are the future directions in the study of microwear on stone and bone tools.

  15. Quantification of Renal Stone Contrast with Ultrasound in Human Subjects.

    Science.gov (United States)

    Cunitz, Bryan W; Harper, Jonathan D; Sorensen, Mathew D; Haider, Yasser A; Thiel, Jeff; May, Philip C; Liu, Ziyue; Bailey, Michael R; Dunmire, Barbrina; Bruce, Matthew

    2017-11-01

    Greater visual contrast between calculi and tissue would improve ultrasound (US) imaging of urolithiasis and potentially expand clinical use. The color Doppler twinkling artifact has been suggested to provide enhanced contrast of stones compared with brightness mode (B-mode) imaging, but results are variable. This work provides the first quantitative measure of stone contrast in humans for B-mode and color Doppler mode, forming the basis to improve US for the detection of stones. Using a research ultrasound system, B-mode imaging was tuned for detecting stones by applying a single transmit angle and reduced signal compression. Stone twinkling with color Doppler was tuned by using low-frequency transmit pulses, longer pulse durations, and a high-pulse repetition frequency. Data were captured from 32 subjects, with 297 B-mode and Doppler images analyzed from 21 subjects exhibiting twinkling signals. The signal to clutter ratio (i.e., stone to background tissue) (SCR) was used to compare the contrast of a stone on B-mode with color Doppler, and the contrast between stone twinkling and blood-flow signals within the kidney. The stone was the brightest object in only 54% of B-mode images and 100% of Doppler images containing stone twinkling. On average, stones were isoechoic with the tissue clutter on B-mode (SCR = 0 dB). Stone twinkling averaged 37 times greater contrast than B-mode (16 dB, p < 0.0001) and 3.5 times greater contrast than blood-flow signals (5.5 dB, p = 0.088). This study provides the first quantitative measure of US stone to tissue contrast in humans. Stone twinkling contrast is significantly greater than the contrast of a stone on B-mode. There was also a trend of stone twinkling signals having greater contrast than blood-flow signals in the kidney. Dedicated optimization of B-mode and color Doppler stone imaging could improve US detection of stones.

  16. Piezoelectric extracorporeal lithotripsy of gallbladder stones: New inclusion criteria

    International Nuclear Information System (INIS)

    Han, Joon Koo; Choi, Byung Ihn; Shin, Yong Moon; Yoon, Yong Kyu; Yoon, Yong Bum; Park, Yong Hyun; Kim, Chu Wan; Han, Man Chung

    1994-01-01

    To establish the optimal inclusion criteria for the patients with gallbladder stones to extracorporeal shock wave lithotripsy(ESWL) by retrospectively analyzed our current results. Data obtained from 201 patients with gallbladder stones treated with ESWL and oral chemolytic agent from November 1988 to July 1992 were retrospectively analyzed. Ninety-six had radiolucent stones and 105 had radiopaque stones. We used piezoelectric lithotriptor(EDAP LT. 01) and there were no limitation in number of sessions or total number of shock waves. ESWL was repeated until the size of the largest fragment is smaller than 4 mm. Follow up ultrasound was done in every three months after the successful fragmentation. Average length of the follow up was 205 days. We analyzed the rate of successful fragmentation, number of shock waves needed to achieve successful fragmentation according to the size, number of stones as well as the presence of the calcification. Stone-free rate after 6 months was also calculated from all subgroups and compared to each other. The rate of successful fragmentation was 76.2% for radiolucent stones and 65.6% for radiopaque stones(p> 0.05) after 46,731 and 56,111 shock wave respectively(p > 0.05) The rate of successful fragmentation was highest in patients with single, radiolucent stone smaller than 2 cm(91.7%) followed by single radiolucent stone larger than 2 cm(83.3%), multiple calcified stones smaller than 2 cm (77.4%) and single calcified stone smaller than 2 cm(72.1%). The rate of complete stone clearance after 6 month follow-up was highest in patients with single radiolucent stone smaller than 2 cm (63.3%) and followed by multiple calcified stones smaller than 2 cm(37.3%), single calcified stone smaller than 2 cm(33.9%)(p < 0.05). To obtain better results with ESWL in patients with gallbladder stone, the authors propose a more strict inclusion criteria, which is the patient with a single, radiolucent stone smaller than 2 cm

  17. Correlation of gene expression with bladder capacity in interstitial cystitis/bladder pain syndrome.

    Science.gov (United States)

    Colaco, Marc; Koslov, David S; Keys, Tristan; Evans, Robert J; Badlani, Gopal H; Andersson, Karl-Erik; Walker, Stephen J

    2014-10-01

    Interstitial cystitis and bladder pain syndrome are terms used to describe a heterogeneous chronic pelvic and bladder pain disorder. Despite its significant prevalence, our understanding of disease etiology is poor. We molecularly characterized interstitial cystitis/bladder pain syndrome and determined whether there are clinical factors that correlate with gene expression. Bladder biopsies from female subjects with interstitial cystitis/bladder pain syndrome and female controls without signs of the disease were collected and divided into those with normal and low anesthetized bladder capacity, respectively. Samples then underwent RNA extraction and microarray assay. Data generated by these assays were analyzed using Omics Explorer (Qlucore, Lund, Sweden), GeneSifter® Analysis Edition 4.0 and Ingenuity® Pathway Analysis to determine similarity among samples within and between groups, and measure differentially expressed transcripts unique to each phenotype. A total of 16 subjects were included in study. Principal component analysis and unsupervised hierarchical clustering showed clear separation between gene expression in tissues from subjects with low compared to normal bladder capacity. Gene expression in tissue from patients with interstitial cystitis/bladder pain syndrome who had normal bladder capacity did not significantly differ from that in controls without interstitial cystitis/bladder pain syndrome. Pairwise analysis revealed that pathways related to inflammatory and immune response were most involved. Microarray analysis provides insight into the potential pathological condition underlying interstitial cystitis/bladder pain syndrome. This pilot study shows that patients with this disorder who have low compared to normal bladder capacity have significantly different molecular characteristics, which may reflect a difference in disease pathophysiology. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc

  18. Researchers studying alternative to bladder removal for bladder cancer patients | Center for Cancer Research

    Science.gov (United States)

    A new phase I clinical trial conducted by researchers at the Center for Cancer Research (CCR) is evaluating the safety and tolerability, or the degree to which any side effects can be tolerated by patients, of a two-drug combination as a potential alternative to bladder removal for bladder cancer patients. The trial targets patients with non-muscle invasive bladder cancer (NMIBC) whose cancers have stopped responding to traditional therapies. Read more...

  19. Fourier transform infrared spectroscopy for analysis of kidney stones.

    Science.gov (United States)

    Khan, Aysha Habib; Imran, Sheharbano; Talati, Jamsheer; Jafri, Lena

    2018-01-01

    To compare the results of a chemical method of kidney stone analysis with the results of Fourier transform infrared (FT-IR) spectroscopy. Kidney stones collected between June and October 2015 were simultaneously analyzed by chemical and FT-IR methods. Kidney stones (n=449) were collected from patients from 1 to 81 years old. Most stones were from adults, with only 11.5% from children (aged 3-16 years) and 1.5% from children aged stone type, calcium oxalate monohydrate (COM, n=224), was the most common crystal, followed by uric acid and calcium oxalate dihydrate (COD, n=83). In children, the most frequently occurring type was predominantly COD (n=21), followed by COM (n=11), ammonium urate (n=10), carbonate apatite (n=6), uric acid (n=4), and cystine (n=1). Core composition in 22 stones showed ammonium urate (n=2), COM (n=2), and carbonate apatite (n=1) in five stones, while uric acid crystals were detected (n=13) by FT-IR. While chemical analysis identified 3 stones as uric acid and the rest as calcium oxalate only. Agreement between the two methods was moderate, with a kappa statistic of 0.57 (95% confidence interval, 0.5-0.64). Disagreement was noted in the analysis of 77 stones. FT-IR analysis of kidney stones can overcome many limitations associated with chemical analysis.

  20. Bladder filling variation during conformal radiotherapy for rectal cancer

    International Nuclear Information System (INIS)

    Sithamparam, S; Ahmad, R; Sabarudin, A; Othman, Z; Ismail, M

    2017-01-01

    Conformal radiotherapy for rectal cancer is associated with small bowel toxicity mainly diarrhea. Treating patients with a full bladder is one of the practical solutions to reduce small bowel toxicity. Previous studies on prostate and cervix cancer patients revealed that maintaining consistent bladder volume throughout radiotherapy treatment is challenging. The aim of this study was to measure bladder volume variation throughout radiotherapy treatment. This study also measured the association between bladder volume changes and diarrhea. Twenty two rectal cancer patients were recruited prospectively. Patients were planned for treatment with full bladder following departmental bladder filling protocol and the planning bladder volume was measured during CT-simulation. During radiotherapy, the bladder volume was measured weekly using cone-beam computed tomography (CBCT) and compared to planning bladder volume. Incidence and severity of diarrhea were recorded during the weekly patient review. There was a negative time trend for bladder volume throughout five weeks treatment. The mean bladder volume decreased 18 % from 123 mL (SD 54 mL) during CT-simulation to 101 mL (SD 71 mL) on the 5th week of radiotherapy, but the decrease is not statistically significant. However, there was a large variation of bladder volume within each patient during treatment. This study showed an association between changes of bladder volume and diarrhea (P = 0.045). In conclusion bladder volume reduced throughout radiotherapy treatment for conformal radiotherapy for rectal cancer and there was a large variation of bladder volume within patients. (paper)

  1. Bladder filling variation during conformal radiotherapy for rectal cancer

    Science.gov (United States)

    Sithamparam, S.; Ahmad, R.; Sabarudin, A.; Othman, Z.; Ismail, M.

    2017-05-01

    Conformal radiotherapy for rectal cancer is associated with small bowel toxicity mainly diarrhea. Treating patients with a full bladder is one of the practical solutions to reduce small bowel toxicity. Previous studies on prostate and cervix cancer patients revealed that maintaining consistent bladder volume throughout radiotherapy treatment is challenging. The aim of this study was to measure bladder volume variation throughout radiotherapy treatment. This study also measured the association between bladder volume changes and diarrhea. Twenty two rectal cancer patients were recruited prospectively. Patients were planned for treatment with full bladder following departmental bladder filling protocol and the planning bladder volume was measured during CT-simulation. During radiotherapy, the bladder volume was measured weekly using cone-beam computed tomography (CBCT) and compared to planning bladder volume. Incidence and severity of diarrhea were recorded during the weekly patient review. There was a negative time trend for bladder volume throughout five weeks treatment. The mean bladder volume decreased 18 % from 123 mL (SD 54 mL) during CT-simulation to 101 mL (SD 71 mL) on the 5th week of radiotherapy, but the decrease is not statistically significant. However, there was a large variation of bladder volume within each patient during treatment. This study showed an association between changes of bladder volume and diarrhea (P = 0.045). In conclusion bladder volume reduced throughout radiotherapy treatment for conformal radiotherapy for rectal cancer and there was a large variation of bladder volume within patients.

  2. Risk Factors for Stone Recurrence after Percutaneous Nephrolithotomy

    Science.gov (United States)

    Krambeck, Amy E.; Rangel, Laureano J.; LeRoy, Andrew J.; Patterson, David E.; Gettman, Matthew T.

    2008-09-01

    Recent studies have demonstrated more than 30% of percutaneous nephrolithotomy (PCNL) patients will experience a stone recurrence over a 20 year period. The goal of our study was to identify risk factors for stone recurrence after PCNL. Chart review identified 754 patients treated with PCNL for urolithiasis from March of 1983 to July 1984 at our institution. Of this cohort, 87 patients continued to receive medical care at our clinic and had been evaluated within the last 5 years. Of the 87 patients, 80 had recent radiographic imaging. Average follow-up was 19.2 years and 32 (40.0%) experienced at least 1 stone recurrence. There was no difference in preoperative BMI (p = 0.453) or change in BMI (p = 0.964) between patients that did and did not have a stone recurrence. Renal stone location (p = 0.605) and stone size (p = 0.238) were not predictive of recurrence. Patients with calcium oxalate monohydrate stones were less likely to recur (38.7% vs. 41.6%, p = 0.004) and those with calcium oxalate dihydrate (COD) were more likely to recur (31.1% vs. 19.6%, p = 0.006) compared to other compositions. Diabetes mellitus was not associated with recurrent stones (p = 0.810). Those patients with residual stones or fragments renal insufficiency (25% vs. 2.1%, p = 0.002). In conclusion, stone composition, as well as the presence of residual fragments was associated with recurrent symptomatic stone events after PCNL. Recurrent stone events were significantly associated with the risk of developing renal insufficiency, further stressing the need for complete stone clearance at time of PCNL.

  3. Bladder filling variation during radiation treatment of prostate cancer: can the use of a bladder ultrasound scanner and biofeedback optimize bladder filling?

    Science.gov (United States)

    Stam, Marcel R; van Lin, Emile N J Th; van der Vight, Lisette P; Kaanders, Johannes H A M; Visser, Andries G

    2006-06-01

    To investigate the use of a bladder ultrasound scanner in achieving a better reproducible bladder filling during irradiation of pelvic tumors, specifically prostate cancer. First, the accuracy of the bladder ultrasound scanner relative to computed tomography was validated in a group of 26 patients. Next, daily bladder volume variation was evaluated in a group of 18 patients. Another 16 patients participated in a biofeedback protocol, aiming at a more constant bladder volume. The last objective was to study correlations between prostate motion and bladder filling, by using electronic portal imaging device data on implanted gold markers. A strong correlation between bladder scanner volume and computed tomography volume (r = 0.95) was found. Daily bladder volume variation was very high (1 SD = 47.2%). Bladder filling and daily variation did not significantly differ between the control and the feedback group (47.2% and 40.1%, respectively). Furthermore, no linear correlations between bladder volume variation and prostate motion were found. This study shows large variations in daily bladder volume. The use of a biofeedback protocol yields little reduction in bladder volume variation. Even so, the bladder scanner is an easy to use and accurate tool to register these variations.

  4. [A case of bladder hemangioma showing bladder tamponade during late pregnancy].

    Science.gov (United States)

    Maekawa, S; Okubo, K; Aoki, Y; Okada, T; Maeda, H; Arai, Y

    2000-07-01

    We report a case of bladder hemangioma manifesting bladder tamponade during pregnancy. A 25-year-old woman at 36 weeks of gestation was admitted with a two-week history of gross hematuria and clot retention. Blood hemoglobin concentration was 6.3 g/dl. After blood transfusion and Caesarian section, cystoscopy was performed. Bleeding was noticed from a strawberry-like tumor 5 mm in diameter near the right ureteral orifice, which was easily resected endoscopically. Histopathological diagnosis was cavernous hemangioma of the urinary bladder. This is the first report of a case of bladder hemangioma during pregnancy.

  5. Is an excretory urogram mandatory in patients with small to medium-sized renal and ureteric stones treated by extra corporeal shock wave lithotripsy?

    Directory of Open Access Journals (Sweden)

    Akhtar Sobia

    2004-04-01

    Full Text Available Abstract Background An intravenous urogram (IVU has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL. This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique. Methods This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i IVU; ii non-contrast enhanced helical computed tomography (UHCT; and iii ultrasound (US + X-ray kidney, ureter and bladder (KUB. The groups were matched in terms of age and gender, as well as location, side and size of stones. Results There was no statistically significantly difference for number of ESWL sessions, number of shock waves and use of ancillary procedures between the three groups. The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group. Conclusions The complication rate and need for ancillary procedures was comparable across the three groups. Patients imaged by UHCT or US + X-ray KUB prior to ESWL for uncomplicated renal and ureteric stones do not require IVU.

  6. Is an excretory urogram mandatory in patients with small to medium-sized renal and ureteric stones treated by extra corporeal shock wave lithotripsy?

    Science.gov (United States)

    Ather, M Hammad; Faruqui, Nuzhat; Akhtar, Sobia; Sulaiman, M Nasir

    2004-01-01

    Background An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique. Methods This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray kidney, ureter and bladder (KUB). The groups were matched in terms of age and gender, as well as location, side and size of stones. Results There was no statistically significantly difference for number of ESWL sessions, number of shock waves and use of ancillary procedures between the three groups. The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group. Conclusions The complication rate and need for ancillary procedures was comparable across the three groups. Patients imaged by UHCT or US + X-ray KUB prior to ESWL for uncomplicated renal and ureteric stones do not require IVU. PMID:15115545

  7. Clinical observation of radiation urinary bladder disease

    International Nuclear Information System (INIS)

    Jin Yuke; Liu Libo; Zhang Haiying; Liang Shuo; Chen Dawei; Wu Zhenfeng; Dong Lihua; Lu Xuejun

    2004-01-01

    Objective: Clinical characteristic, diagnosis and treatment of radiation urinary bladder disease induced by radiation therapy for cancers in the pelvis were inquired into for providing diagnostic basis. Methods: Statistical analysis for the clinical cases was carried out. Results: The incidence of radiation bladder diseases induced by radiation therapy of cervix cancer are about 0.8%-2.96%, with an average of 2.14%. Radiation bladder disease is divided into acute radiation cystitis, chronic radiation cystitis and radiation vesical fistula. Chronic radiation cystitis is seen most often in the clinic and its main clinical symptom is painless macroscopic hematuria, which is again subdivided into slight and severe degrees. Diagnosis should include history of exposure to radiation, which dose exceed the dose threshold, and typical clinical characteristics. Conclusion: The characteristics, types and diagnostic basis of radiation urinary bladder disease analyzed in this study can provide the reference for drawing up diagnostic standard

  8. Epidemiology of bladder cancer. A second look

    Energy Technology Data Exchange (ETDEWEB)

    Wynder, E.L.; Goldsmith, R.

    1977-09-01

    A case-control study among 574 male and 158 female bladder cancer patients and equal numbers of matched controls was conducted between 1969 and 1974 in 17 hospitals in six United States cities. We determined that cigarette smokers of both sexes were at higher relative risk than nonsmokers. Cigarette smoking was responsible for about one-half of male and one-third of female bladder cancer. There was an excess of bladder cancer patients with some previous occupational exposure, such as rubber, chemicals, and textiles. A weak association with coffee drinking, which appeared to be independent of smoking, was found for males. Users of artificial sweetners were not over-represented among the cases. The authors conclude that the epidemiologic pattern of bladder cancer cannot be fully accounted for by cigarette smoking and occupational exposure and suggest a series of metabolic studies to assess the role of additional factors, such as nutrition.

  9. The epidemiology and pathophysiology of neurogenic bladder.

    Science.gov (United States)

    Ginsberg, David

    2013-01-01

    Neurogenic bladder is a disorder of the lower urinary tract created by damage to or diseases of the nervous system. Found in many patients with neurologic disorders, including multiple sclerosis, Parkinson's disease, spinal cord injury, and spina bifida among others, neurogenic bladder can lead to problematic symptoms and complications including urinary incontinence, frequency, and urgency, along with risk for infection and involvement of the upper urinary tract and kidney disease. The disorder can also create substantial embarrassment resulting in social isolation for affected patients. Healthcare utilization may be excessive in patients with neurogenic bladder, including office and emergency department visits and subsequent hospitalizations. Because of its significant effects on quality of life, it is important to reassess the epidemiology and physiology of neurogenic bladder, its diagnosis and assessment, and the impact of the symptoms and complications associated with it to better manage patients with this disorder and improve outcomes.

  10. Tetrachloroethylene exposure and bladder cancer risk

    DEFF Research Database (Denmark)

    Vlaanderen, Jelle; Straif, Kurt; Ruder, Avima

    2014-01-01

    BACKGROUND: In 2012, the International Agency for Research on Cancer classified tetrachloroethylene, used in the production of chemicals and the primary solvent used in dry cleaning, as "probably carcinogenic to humans" based on limited evidence of an increased risk of bladder cancer in dry...... cleaners. OBJECTIVES: We assessed the epidemiological evidence for the association between tetrachloroethylene exposure and bladder cancer from published studies estimating occupational exposure to tetrachloroethylene or in workers in the dry-cleaning industry. METHODS: Random-effects meta-analyses were......-analysis demonstrates an increased risk of bladder cancer in dry cleaners, reported in both cohort and case-control studies, and some evidence for an exposure-response relationship. Although dry cleaners incur mixed exposures, tetrachloroethylene could be responsible for the excess risk of bladder cancer because...

  11. SMP Bladder Tooling for Manufacturing Composites Project

    Data.gov (United States)

    National Aeronautics and Space Administration — CRG's shape memory polymer (SMP) Bladder Tooling is a cutting-edge manufacturing technology that can meet the manufacturing needs of the Ares launch vehicles. This...

  12. Asymptomatic Bladder Metastasis from Breast Cancer

    Directory of Open Access Journals (Sweden)

    Luigi Cormio

    2014-01-01

    Full Text Available Introduction. Breast cancer is the most common nondermatologic cancer in women. Common metastatic sites include lymph nodes, lung, liver, and bone. Metastases to the bladder are extremely rare, with all reported cases presenting with urinary symptoms. Case Report. Herein, we report the first case of completely asymptomatic bladder metastasis from breast cancer, occasionally revealed, 98 months after the initial diagnosis of lobular breast carcinoma, by a follow-up computed tomography scanning showing thickening of left bladder wall and grade II left hydronephrosis. A positive staining for estrogen and progesterone receptors was confirmed by immunohistochemistry. Discussion. The reported case confirms that bladder metastases from breast cancer tend to occur late after the diagnosis of the primary tumor and, for the first time, points out they can be asymptomatic. Conclusion. Such data support the need for careful follow-up and early intervention whenever such clinical situation is suspected.

  13. Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones.

    Science.gov (United States)

    Aydemir, Hüseyin; Budak, Salih; Kumsar, Şükrü; Köse, Osman; Sağlam, Hasan Salih; Adsan, Öztuğ

    2014-09-01

    In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm(2) in the PNL, 1.4±0.1 cm(2) in the RIRS, and 3.1±0.9 cm(2) in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups. PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.

  14. Dual-Energy CT for Quantification of Urinary Stone Composition in Mixed Stones: A Phantom Study.

    Science.gov (United States)

    Leng, Shuai; Huang, Alice; Cardona, Juan Montoya; Duan, Xinhui; Williams, James C; McCollough, Cynthia H

    2016-08-01

    The purpose of this study was to assess the feasibility of using dual-energy CT to accurately quantify uric acid and non-uric acid components in urinary stones of mixed composition. A total of 24 urinary stones were analyzed with micro CT to serve as the reference standard for uric acid and non-uric acid composition. These stones were placed in water phantoms to simulate body attenuation of slim to obese adults and scanned with a third-generation dual-source CT scanner by use of dual-energy modes adaptively selected on the basis of phantom size. CT number ratio, which is distinct for different materials, was calculated for each pixel of the stones. Each pixel was then classified as uric acid and non-uric acid by comparison of the CT number ratio with preset thresholds ranging from 1.10 to 1.70. Minimal, maximal, and root-mean-square errors were calculated by comparing composition with the reference standard, and the threshold with the minimal root-mean-square error was determined. A paired t test was performed to compare the stone composition determined with dual-energy CT with the reference standard obtained with micro CT. The optimal CT number ratio threshold ranged from 1.27 to 1.55, dependent on phantom size. The root-mean-square error ranged from 9.60% to 12.87% across all phantom sizes. Minimal absolute error ranged from 0.04% to 1.24% and maximal absolute error from 22.05% to 35.46%. Dual-energy CT and the reference micro CT did not differ significantly on uric acid and non-uric acid composition (paired t test, p = 0.20-0.96). Accurate quantification of uric acid and non-uric acid composition in mixed stones is possible with dual-energy CT.

  15. Quantification of Urinary Stone Composition in Mixed Stones Using Dual-Energy CT: A Phantom Study

    Science.gov (United States)

    Leng, Shuai; Huang, Alice; Montoya, Juan; Duan, Xinhui; Williams, James C.; McCollough, Cynthia H.

    2016-01-01

    Purpose To demonstrate the feasibility of using dual-energy computed tomography to accurately quantify uric acid and non-uric-acid components in urinary stones having mixed composition. Materials and Methods A total of 24 urinary stones were analyzed with microCT to serve as the reference standard for uric acid and non-uric-acid composition. These stones were placed in water phantoms to simulate body attenuation of slim to obese adults and scanned on a third-generation dual-source scanner using dual-energy modes adaptively selected based on phantom size. CT number ratio, which is distinct for different materials, was calculated for each pixel of the stones. Each pixel was then classified as uric acid and non-uric-acid by comparing the CT number ratio with preset thresholds ranging from 1.1 to 1.7. Minimal, maximal and root-mean-square errors were calculated by comparing composition to the reference standard and the threshold with the minimal root-mean-square-error was determined. A paired t-test was performed to compare the stone composition determined with dual-energy CT with the reference standard obtained with microCT. Results The optimal CT number ratio threshold ranged from 1.27 to 1.55, dependent on phantom size. The root-mean-square error ranged from 9.60% to 12.87% across all phantom sizes. Minimal and maximal absolute error ranged from 0.04% to 1.24% and from 22.05% to 35.46%, respectively. Dual-energy CT and the reference microCT did not differ significantly on uric acid and non-uric-acid composition (P from 0.20 to 0.96, paired t-test). Conclusion Accurate quantification of uric acid and non-uric-acid composition in mixed stones is possible using dual-energy CT. PMID:27224260

  16. Quantifying the Use of stones in the stone age Fireplaces of Estonia

    OpenAIRE

    Sikk, Kaarel

    2017-01-01

    Fireplaces and burnt stones related to them are common features found at Stone Age settlement sites. Although information about them is present in archaeological reports and also available in publications, there has been no general research done regarding combustion features specifically. The purpose of this study was to fill the gap of relevant research and to test the hypothesis that the structural features of fireplaces reveal information on the subsistence model of settlements.The study is b...

  17. Integrated irradiation and cystectomy for bladder cancer

    International Nuclear Information System (INIS)

    Whitmore, W.F. Jr.

    1980-01-01

    Planned pre-operative irradiation and cystectomy for selected patients with bladder cancer was initiated approximately 20 years ago by a number of centres on the basis of the disappointing end results of treatment of bladder cancer by either irradiation or surgery and the empirical hope that the combination might lead to better results. This is a brief review of the logical basis for integrated treatment and of the Memorial Sloan-Kettering Cancer Center (MSKCC) experience with such therapy. (author)

  18. Melting behaviour of raw materials and recycled stone wool waste

    DEFF Research Database (Denmark)

    Schultz-Falk, Vickie; Agersted, Karsten; Jensen, Peter Arendt

    2018-01-01

    Stone wool is a widely used material for building insulation, to provide thermal comfort along with fire stability and acoustic comfort for all types of buildings. Stone wool waste generated either during production or during renovation or demolition of buildings can be recycled back into the stone...... indicates that the wool waste initiates melting at a lower temperature than the conventional charge. Also DSC measurements show that the wool waste requires less energy for heating and melting than the conventional charge, making stone wool waste recycling desirable both for environmental and for process...... wool melt production. This study investigates and compares the thermal response and melting behaviour of a conventional stone wool charge and stone wool waste. The study combines differential scanning calorimetry (DSC), hot stage microscopy (HSM) and X-ray diffraction (XRD). DSC reveals...

  19. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    Renal acidification ability was examined in 90 recurrent renal stone formers, using fasting morning urinary pH levels followed by a short ammonium chloride loading test in subjects with pH levels above 6.0. Fifteen patients (16.6%) revealed a distal renal tubular acidification defect: one patient...... (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...... metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available...

  20. Selective bladder preservation with curative intent for muscle-invasive bladder cancer. A contemporary review

    International Nuclear Information System (INIS)

    Koga, Fumitaka; Kihara, Kazunori

    2012-01-01

    Radical cystectomy plus urinary diversion, the reference standard treatment for muscle-invasive bladder cancer, associates with high complication rates and compromises quality of life as a result of long-term effects on urinary, gastrointestinal and sexual function, and changes in body image. As a society ages, the number of elderly patients unfit for radical cystectomy as a result of comorbidity will increase, and thus the demand for bladder-sparing approaches for muscle-invasive bladder cancer will also inevitably increase. Trimodality bladder-sparing approaches consisting of transurethral resection, chemotherapy and radiotherapy (Σ55-65 Gy) yield overall survival rates comparable with those of radical cystectomy series (50-70% at 5 years), while preserving the native bladder in 40-60% of muscle-invasive bladder cancer patients, contributing to an improvement in quality of life for such patients. Limitations of the trimodality therapy include muscle-invasive bladder cancer recurrence in the preserved bladder, which most often arises in the original muscle-invasive bladder cancer site; potential lack of curative intervention for regional lymph nodes; and increased morbidity in the event of salvage radical cystectomy for remaining or recurrent disease as a result of high-dose pelvic irradiation. Consolidative partial cystectomy with pelvic lymph node dissection followed by induction chemoradiotherapy at lower dose (exempli gratia (e.g.) 40 Gy) is a rational strategy for overcoming such limitations by strengthening locoregional control and reducing radiation dosage. Molecular profiling of the tumor and functional imaging might play important roles in optimal patient selection for bladder preservation. Refinement of radiation techniques, intensified concurrent or adjuvant chemotherapy, and novel sensitizers, including molecular targeting agent, are also expected to improve outcomes and consequently provide more muscle-invasive bladder cancer patients with favorable

  1. Bladder reconstruction--from cells to materials.

    Science.gov (United States)

    Southgate, J; Cross, W; Eardley, I; Thomas, D F M; Trejdosiewicz, L K

    2003-01-01

    Surgical reconstruction of the urinary bladder is performed on patients of all ages for a diverse range of conditions, including congenital abnormalities, bladder dysfunction, trauma and cancer. The most common material utilized to augment or replace the bladder during these procedures is a segment of the patient's own intestine. However, this procedure ('enterocytoplasty') is associated with significant clinical complications that arise due to the exposure of the epithelial lining of the intestine to urine. A number of alternative approaches are being actively developed to find a practical and functional substitute for native bladder tissue. These range from 'composite enterocystoplasty', where the de-epithelialized intestine wall is lined with bladder epithelial cells that have been propagated in vitro, to augmenting the urinary system with natural or synthetic biomaterials that may incorporate in vitro-propagated cells. However, if tissue-engineered products are to have therapeutic application in bladder reconstruction, a number of issues remain to be addressed; these issues are discussed briefly below.

  2. Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy

    Directory of Open Access Journals (Sweden)

    S. Azab

    2013-03-01

    Conclusions: There is no statistically significant effect of stone size, anatomy of the lower calyx and BMI on stone clearance after ESWL of lower calyceal stones. However, small stone size (≤2 cm, a shorter and wider infundibulum and a larger lower-pole infundibulopelvic angle seem to promote a more rapid and more complete stone clearance.

  3. Clearance of refractory bile duct stones with extracorporeal shockwave lithotripsy

    OpenAIRE

    Ellis, R; Jenkins, A; Thompson, R; Ede, R

    2000-01-01

    BACKGROUND—Extracorporeal shockwave lithotripsy (ESWL) has been used since the mid-1980s to fragment bile duct stones which cannot be removed endoscopically. Early machines required general anaesthesia and immersion in a waterbath.
AIMS—To investigate the effectiveness of the third generation Storz Modulith SL20 lithotriptor in fragmenting bile duct stones that could not be cleared by mechanical lithotripsy.
METHODS—Eighty three patients with retained bile duct stones were treated. All patien...

  4. EVALUATION OF CONSISTENCY AND SETTING TIME OF IRANIAN DENTAL STONES

    Directory of Open Access Journals (Sweden)

    F GOL BIDI

    2000-09-01

    Full Text Available Introduction. Dental stones are widely used in dentistry and the success or failure of many dental treatments depend on the accuracy of these gypsums. The purpose of this study was the evaluation of Iranian dental stones and comparison between Iranian and foreign ones. In this investigation, consistency and setting time were compared between Pars Dendn, Almas and Hinrizit stones. The latter is accepted by ADA (American Dental Association. Consistency and setting time are 2 of 5 properties that are necessitated by both ADA specification No. 25 and Iranian Standard Organization specification No. 2569 for evaluation of dental stones. Methods. In this study, the number and preparation of specimens and test conditions were done according to the ADA specification No. 25 and all the measurements were done with vicat apparatus. Results. The results of this study showed that the standard consistency of Almas stone was obtained by 42ml water and 100gr powder and the setting time of this stone was 11±0.03 min. Which was with in the limits of ADA specification (12±4 min. The standard consistency of Pars Dandan stone was obrianed by 31ml water and 100 gr powder, but the setting time of this stone was 5± 0.16 min which was nt within the limits of ADA specification. Discussion: Comparison of Iranian and Hinrizit stones properties showed that two probable problems of Iranian stones are:1- Unhemogrnousity of Iranian stoned powder was caused by uncontrolled temperature, pressure and humidity in the production process of stone. 2- Impurities such as sodium chloride was responsible fo shortening of Pars Dendens setting time.

  5. Epidemiologic Insights into Stone Disease as a Systemic Disorder

    Science.gov (United States)

    Curhan, Gary C.

    2007-04-01

    Examining the epidemiology of stone disease can provide insight into etiology. There is a growing body of evidence that stone disease is not simply a disorder of the kidney. In fact, nephrolithiasis is clearly a systemic disorder. Conditions associated with stone disease include the classic ones such as inflammatory bowel disease and primary hyperparathyroidism. More recent studies have demonstrated strong associations with obesity, gout, diabetes and hypertension. Future studies will help uncover the underlying common pathophysiologic abnormalities.

  6. Natural stones of historic and future importance in Sweden

    Science.gov (United States)

    Schouenborg, Björn; Andersson, Jenny; Göransson, Mattias

    2013-04-01

    Several activities and responsibilities of the Geological Survey of Sweden (SGU) are related to the work of the newly formed international Heritage Stone Task Group (HSTG) for designating historically important stones. SGU is among other things a referral organization, frequently dealing with the preparation of statements in connection with the quarrying permit applications of stone producers. When preparing these statements, SGU takes into account a number of parameters, e.g. the importance for local and regional business development, historic importance, area of occurrence, quality of the geological documentation of the stone type, peculiarities of the stone types and technical properties relevant for the intended use. Traditionally, SGU has not worked with bedrock mapping looking at the potential of natural stones production but more commonly looking at the potential production of aggregates, industrial minerals and metals. The competence is, therefore, presently being built up with new databases over important natural stone types and definition of criteria for their selection etc. In this respect the criteria defined by the HSTG provide important help. This work goes hand in hand with the task of proposing stone-deposits and quarries of "national interest". The criteria for selection of a stone type, quarry etc as one of national interest are currently being revised. SGU plays an important role in this work. However, the final decision and appointment lies in the hands of the Swedish Board of Housing, Building and Planning (Boverket), an authority dealing with sustainable land use and regional development, town and country planning. Boverket supervises how the planning legislation is handled by the municipal authorities and the county administrative boards. The two latter organizations are those in charge of giving extraction permits for stone quarrying. The "Hallandia gneiss", of SW Sweden, is described as a case story and presented in this paper. Keywords

  7. DsRed2 transient expression in Culex quinquefasciatus mosquitoes

    Directory of Open Access Journals (Sweden)

    Andre Barretto Bruno Wilke

    2013-06-01

    Full Text Available Culex quinquefasciatus mosquitoes have been successfully genetically modified only once, despite the efforts of several laboratories to transform and establish a stable strain. We have developed a transient gene expression method, in Culex, that delivers plasmid DNA directly to the mosquito haemolymph and additional tissues. We were able to express DsRed2 fluorescent protein in adult Cx. quinquefasciatus mosquitoes by injecting plasmids directly into their thorax. The expression of DsRed2 in adult Cx. quinquefasciatus mosquitoes is an important stepping stone to genetic transformation and the potential use of new control strategies and genetic interactions.

  8. Bladder filling variation during radiation treatment of prostate cancer: can the use of a bladder ultrasound scanner and biofeedback optimize bladder filling?

    NARCIS (Netherlands)

    Stam, M.R.; Lin, E.N.J.T. van; Vight, L.P. van der; Kaanders, J.H.A.M.; Visser, A.G.

    2006-01-01

    PURPOSE: To investigate the use of a bladder ultrasound scanner in achieving a better reproducible bladder filling during irradiation of pelvic tumors, specifically prostate cancer. METHODS AND MATERIALS: First, the accuracy of the bladder ultrasound scanner relative to computed tomography was

  9. Uric acid stones increase the risk of chronic kidney disease.

    Science.gov (United States)

    Li, Ching-Chia; Chien, Tsu-Ming; Wu, Wen-Jeng; Huang, Chun-Nung; Chou, Yii-Her

    2018-02-28

    The aim of this study was to compare the clinical characteristics of uric acid stones and their potential risk for chronic kidney disease (CKD). A total of 401 patients (196 with uric acid stone and 205 without) were enrolled from our database of patients with urolithiasis. We analyzed the clinical demographic features, stone location, urine chemistries, and renal function. There was a significant difference (p uric acid group. Patients with uric acid stones had much lower pH of urine (p uric acid level (p = 0.002). Notably, those with uric acid stones had worse eGFR than those with non-uric acid stones. Multivariate analysis confirmed that age over 60 years (ORs = 9.19; 95% CI 3.5-24.3), female sex (ORs = 4.01; 95% CI 1.8-9.0), hyperuricemia (ORs = 8.47; 95% CI 1.6-43.5), and uric acid stone (OR = 2.86; 95% CI 1.2-6.7) were the independent predictors of poor prognoses in CKD. Therefore, an association exists between uric acid stones and higher prevalence of CKD. Patients with uric acid stones may need close monitoring of renal function during follow-up.

  10. Dietary supplementation with olive stone meal in growing rabbits

    Directory of Open Access Journals (Sweden)

    Gerolamo Xiccato

    2010-01-01

    Full Text Available Olive stone meal is a low-digested fibre source potentially useful in the prevention of digestive troubles in growing rabbit permitting a better balance of dietary fibre fractions. To evaluate its efficacy, three experimental diets containing 0, 3 or 6% olive stone meal were fed to 222 rabbits from weaning (28 d to slaughter (73 d. Olive stone inclusion increased the proportion of large dietary particles while did not affect growth performance, digestive physiology and carcass and meat quality. Due to optimum health status observed in all experimental groups, the preventive action of olive stone meal against the occurrence of digestive troubles was not proven.

  11. Can Hounsfield Unit Value Predict Type of Urinary Stones?

    Directory of Open Access Journals (Sweden)

    Alper Gok

    2014-03-01

    Full Text Available Aim: Aim of this study is to determine the role of Hounsfield unit (HU in predicting results of stone analysis. Material and Method: This study included 199 patients to whom percutaneous nephrolithotomy (PNL procedures were applied between January 2008 and May 2011 in our clinic. Before the procedure HU values of kidney stones were measured using non-contrast computed tomography. After the operation, obtained stone samples were analysed using X-ray diffraction technique. HU values were compared with stone analysis results. Results: Stone analysis revealed eight different stone types. Distribution of stone types and HU value ranges were as follows: 85% calcium oxalate monohydrate, 730-1130 HU; 38% calcium oxalate dihydrate, 510-810 HU; 21% uric acid, 320-550 HU; 23% struvite, 614-870 HU; 7% calcium hydrogene phosphate, 1100-1365 HU; 3% cystine, 630-674 HU; 15% mixed uric acid plus calcium oxalate, 499-840 HU; and 7% mixed cystine plus calcium phosphate, 430-520 HU. HU values of all stone types ranged between 320 and 1365. There was a statistically significant relation between HU values of uric acid and non uric acid stones (p

  12. Mold attack on frescoes and stone walls of Gradac monastery

    Directory of Open Access Journals (Sweden)

    Stupar Miloš Č.

    2011-01-01

    Full Text Available Microfungi can colonize stone surfaces and form sub-aerial biofilms which can lead to biodeterioration of historic monuments. In this investigation samples for mycological analyses were collected from stone material with visible alteration on stone walls of Gradac monastery exterior. The prevailing fungi found on stone walls were dematiaceous hyphomycetes with melanized hyphae and reproductive structures (Alternaria, Aureobasidium, Cladosporium and Epicoccum species. The frescoes inside the monastery building were also analyzed for the presence of mycobiota. The predominant fungi found on frescoes were osmophilic species from genera Aspergillus and Penicillium. The significant result is identification of human pathogen species Aspergillus fumigatus on frescoes.

  13. Novelda Stone: widely used within the Spanish architectural heritage

    OpenAIRE

    Fort, R.; Bernabeu, A.; García del Cura, M. A.; López de Azcona, M. C.; Ordóñez, S.; Mingarro, F.

    2002-01-01

    Novelda Stone is a calcareous rock, of the biocalcarenite type. It is extracted from the «Vinalopó Medio» area (Alicante, eastern Spain). Novelda stone is known as construction material from the 13th century. From final of the 19th century until the present time, it has been used in Madrid, Valencia and Alicante. In the past, the main quarries from which this type of rock was extracted were located in the municipal districts of Monóvar (Almorquí Stone), Sax (Portazgo Stone) and Elda (Bateig S...

  14. Strength Improvement of Clay Soil by Using Stone Powder

    Directory of Open Access Journals (Sweden)

    Ahmed Sameer Abdulrasool

    2015-05-01

    Full Text Available Soil stabilization with stone powder is a good solution for the construction of subgrade for road way and railway lines, especially under the platforms and mostly in transition zones between embankments and rigid structures, where the mechanical properties of supporting soils are very influential. Stone powder often has a unique composition which justifies the need for research to study the feasibility of using this stone powder type for ground improvement applications. This paper presents results from a comprehensive laboratory study carried out to investigate the feasibility of using stone powder for improvement of engineering properties of clays. The stone powder contains bassanite (CaSO4. ½ H2O, and Calcite (CaCO3. Three percentages are used for stone powder (1%, 3% and 5% by dry weight of clay. Several tests are made to investigate the soil behavior after adding the stone powder (Atterberg limits, Standard Proctor density, Grain size distribution, Specific gravity, Unconfined Compressive test, and California bearing ratio test. Unconfined Compressive tests conducted at different curing. The samples are tested under both soaked and unsoaked condition. Chemical tests and X-ray diffraction analyses are also carried out. Stone powder reacts with clay producing decreasing in plasticity and The curves of grain size distribution are shifted to the coarse side as the stone powder percentage increase; the soil becomes more granular, and also with higher strength.

  15. Current trends in the management of urinary stones

    International Nuclear Information System (INIS)

    Smith, T.P.; Castaneda-Zuniga, W.R.; Darcy, M.D.; Cragg, A.H.; Hunter, D.W.; Amplatz, K.

    1988-01-01

    The treatment of renal and ureteral stones has undergone rapid and major changes over the past ten years. Extracorporeal shockwave lithotripsy has become the most commonly used modality for the treatment of renal and upper ureteral stones. Lower ureteral stones are more commonly being approached by retrograde techniques. Percutaneous nephrolithotomy, medical therapy, and open surgical nephrolithotomy offer viable alternatives in given situations. Presented here is the current application of each of these techniques, both alone and in combination, for the treatment of urinary stones. (orig.)

  16. Renal stone risk assessment during Space Shuttle flights

    Science.gov (United States)

    Whitson, P. A.; Pietrzyk, R. A.; Pak, C. Y.

    1997-01-01

    PURPOSE: The metabolic and environmental factors influencing renal stone formation before, during, and after Space Shuttle flights were assessed. We established the contributing roles of dietary factors in relationship to the urinary risk factors associated with renal stone formation. MATERIALS AND METHODS: 24-hr. urine samples were collected prior to, during space flight, and following landing. Urinary and dietary factors associated with renal stone formation were analyzed and the relative urinary supersaturation of calcium oxalate, calcium phosphate (brushite), sodium urate, struvite and uric acid were calculated. RESULTS: Urinary composition changed during flight to favor the crystallization of calcium-forming salts. Factors that contributed to increased potential for stone formation during space flight were significant reductions in urinary pH and increases in urinary calcium. Urinary output and citrate, a potent inhibitor of calcium-containing stones, were slightly reduced during space flight. Dietary intakes were significantly reduced for a number of variables, including fluid, energy, protein, potassium, phosphorus and magnesium. CONCLUSIONS: This is the first in-flight characterization of the renal stone forming potential in astronauts. With the examination of urinary components and nutritional factors, it was possible to determine the factors that contributed to increased risk or protected from risk. In spite of the protective components, the negative contributions to renal stone risk predominated and resulted in a urinary environment that favored the supersaturation of stone-forming salts. Dietary and pharmacologic therapies need to be assessed to minimize the potential for renal stone formation in astronauts during/after space flight.

  17. Significance of analysing chemical composition of renal stones

    Directory of Open Access Journals (Sweden)

    S Koirala

    2014-04-01

    Full Text Available Background: This article aims to decipher chemical composition of renal stones and briefly outline laboratory tests and dietary habitual changes aimed at preventing stone recurrence. It is based on analysis of 95 renal stones received in a private lab in Kathmandu over a period of 1 year. Materials and Methods: Renal stones were analysed using simple qualitative biochemical tests.The stones were checked for presence of calcium, magnesium, ammonium, oxalate, phosphate, uric acid, cystine and carbonate. Results: Calcium was present in 97.8%, ammonium was present in 98.9%, phosphate was present in 25.2%, uric acid was present in 17.8%, magnesium was present in 10.5%, carbonate was present in 2.1% and cystine was not present in any of the stones. Most of the stones were composed of mixture of two or more than two of the above mentioned elements. Conclusion: Most stones are mixture of more than two cations and anions. Studies on larger test samples and if possible in correlation with routine examination of urine and urinary electrolyte excretion in a 24 hr urine sample would further aid in efforts aimed at preventing stone recurrence. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10314 Journal of Pathology of Nepal (2014 Vol. 4, 560-564  

  18. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use...

  19. Nerve growth factor (NGF): a potential urinary biomarker for overactive bladder syndrome (OAB)?

    Science.gov (United States)

    Seth, Jai H; Sahai, Arun; Khan, Mohammad S; van der Aa, Frank; de Ridder, Dirk; Panicker, Jalesh N; Dasgupta, Prokar; Fowler, Clare J

    2013-03-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The search for a biomarker in overactive bladder syndrome (OAB) is an emerging field of interest, as bladder dysfunction is a common complaint that causes significant morbidity. A biomarker may give us insight as a diagnostic tool, and also inform us about how severe the condition is, how it may progress and how it may best be treated. The protein of interest here is nerve growth factor (NGF) and it has been shown to be a dynamic molecule in the bladder of patients with OAB. Urinary levels have been seen to rise in patients with OAB and fall in those who respond to treatment. However, there have also been many studies that examine this trend in numerous other conditions, e.g. interstitial cystitis, bladder outflow obstruction, renal stone disease and patients with neurological impairment after stroke. As a result the specificity of this as a potential urinary biomarker for OAB is questioned. This is a review of published studies, which discusses the pros and cons of NGF as a potential urinary biomarker. The evidence is examined and the studies are summarised together in a Table. Questions remain about the reliability, practicality and specificity of NGF as a biomarker for OAB. These questions need to be addressed by further studies that could clarify the points raised. To review the current literature on the use of urinary nerve growth factor (NGF) as a potential biomarker for overactive bladder syndrome (OAB). A comprehensive electronic literature search was conducted using the PubMed database to identify publications relating to urinary NGF. There are a growing number of publications that have measured urinary NGF levels in different types of bladder dysfunction. These range from OAB, bladder pain syndrome, idiopathic and neurogenic detrusor overactivity, bladder oversensitivity and bladder outflow obstruction. Urinary NGF levels do appear to be raised in these pathological states when compared with

  20. Radiodiagnosis of anomalies, diseases and injuries of urinary bladder in children

    International Nuclear Information System (INIS)

    Lyul'ko, A.V.

    1985-01-01

    Problems of radiodiagnosis of such urinary bladder diseases as ureter and urinary bladder anomalies, congenital fistulae, urinary bladder calcicosis, calculuses, foreign bodies and injuries of urinary bladder tuberculosis and tumors neurogenic disorder of urination in children are considered

  1. Recurrent urinary tract infection and risk of bladder cancer in the Nijmegen bladder cancer study

    NARCIS (Netherlands)

    Vermeulen, S.; Hanum, N.; Grotenhuis, A.J.; Castano-Vinyals, G.; Heijden, A.G. van der; Aben, K.K.H.; Mysorekar, I.U.; Kiemeney, L.A.L.M.

    2015-01-01

    BACKGROUND: Controversy exists on whether urinary tract infection (UTI) is a risk factor for urinary bladder cancer (UBC). Here, the association is investigated using data from one of the largest bladder cancer case-control studies worldwide. METHODS: Information on (i) history and age at onset of

  2. Bladder biomechanics and the use of scaffolds for regenerative medicine in the urinary bladder

    DEFF Research Database (Denmark)

    Ajalloueian, Fatemeh; Lemon, Greg; Hilborn, Jöns

    2018-01-01

    in vitro and in vivo, including in the treatment of clinical conditions. The biomechanical properties of the native bladder can be investigated using a range of mechanical tests for standardized assessments, as well as mathematical and computational bladder biomechanics. Despite a large body of research...

  3. Can we improve transurethral resection of the bladder tumour for nonmuscle invasive bladder cancer?

    NARCIS (Netherlands)

    Liem, Esmee Iml; de Reijke, Theo M.

    2017-01-01

    Purpose of review The recurrence rate in patients with nonmuscle invasive bladder cancer is high, and the quality of transurethral resection of the bladder (TURB) tumour influences recurrence risk. We review new methods that aim to improve the effectiveness of TURB, and highlight studies of the past

  4. Promising long-term outcome of bladder autoaugmentation in children with neurogenic bladder dysfunction.

    Science.gov (United States)

    Hansen, Eva Lund; Hvistendahl, Gitte Møller; Rawashdeh, Yazan F H; Olsen, L Henning

    2013-11-01

    We evaluated the long-term outcome of bladder autoaugmentation in children with neurogenic bladder dysfunction. Data were compiled from the records of 25 children with a median age of 9.3 years (range 0.9 to 14.2) who underwent detrusor myotomy between 1992 and 2008. All patients were diagnosed with small bladder capacity, low compliance and high end filling pressures, and were unresponsive to clean intermittent catheterization and anticholinergics. Median followup was 6.8 years (range 0.1 to 15.6). Median postoperative bladder capacity was unchanged or decreased to 95 ml (range 25 to 274) during the first 3 months compared to a median preoperative capacity of 103 ml (14 to 250). At 5 months postoperatively median bladder capacity increased significantly to 176 ml (range 70 to 420, pbladder compliance doubled after 1 year to 10 ml/cm H2O (range 1 to 31, pBladder autoaugmentation in children with neurogenic bladder dysfunction offers, after a transient decrease in bladder capacity, a long lasting increase in capacity and compliance, while the end filling pressure decreases. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Finite element based bladder modeling for image-guided radiotherapy of bladder cancer

    NARCIS (Netherlands)

    Chai, Xiangfei; van Herk, Marcel; van de Kamer, Jeroen B.; Hulshof, Maarten C. C. M.; Remeijer, Peter; Lotz, Heidi T.; Bel, Arjan

    2011-01-01

    Purpose: A biomechanical model was constructed to give insight into pelvic organ motion as a result of bladder filling changes. Methods: The authors used finite element (FE) modeling to simulate bladder wall deformation caused by urine inflow. For ten volunteers, a series of MRI scans of the pelvic

  6. Capture myopathy in red deer and wild goat

    Directory of Open Access Journals (Sweden)

    Mirian, J.

    2011-12-01

    Full Text Available This syndrome is a shock-like hyper metabolic myopathy triggered in susceptible animals by stress. Capture myopathy (C.M. is a commonly occurring condition in mammals following trapping and ransportation. In this case 12 to 24 hours after transportation of red deer (Cevus elaphus and wild goats (Capra ibex clinical signs such as: muscular tremor, ataxia, recumbency, hyperthermia, tachycardia, hyperventilation and red brown urine observed. According to symptoms Capture myoparthy was diagnosed Treatment was ineffective on one red deer and one wild goat. Necropsy findings of dead animals were included: hyperemia, petechial hemorrhage in pericardium and heart muscle, pale foci of leg and heart muscles and red brown urine in bladder. This case report represents the attention to Capture myopathy in wild animals and particular caution that should be exercised in capturing and handling of these animals.

  7. Comparison of Different Methods of Denim Stone Washing by Pumice Stone, Acid Cellulases and Neutral Cellulases

    Directory of Open Access Journals (Sweden)

    M. Montazer

    2007-10-01

    Full Text Available Denim is a casual garment normally used by young people and extremely influential in shaping the fashion industry. Among various garments, these garments are subjected to innovations. This work is an attempt to compare the different methods of stone washing using pumice stones, acid cellulases and neutral cellulases or in combination of these methods. The effects of different processing conditions on the garment are compared and reported. Color differences of samples are probed by reflective colorimeter on the front side as well as the backside and also the white pocket of the garment.The abrasion resistance, tensile strength and crease recovery angle of samples are also reported. The XRD spectra are used to calculate the crystalline degrees of the selected samples. Moreover, fiber surfaces of some treated samples have been observed by SEM. The results indicate that treatment of denim with pumice stone with equal weight of garment causes a small color differences. The addition of cellulases to the washing, however, accelerates the color fading. Also, lower staining observed on the white pocket when the garment was treated with cellulases. However, the neutralcellulases increase the garment fading and decrease the staining on the white pocket. It is also observed that pumice stone with cellulases damages the fabric surface, although it is of a minimal damage.

  8. Building stones from a muddy delta: Native natural stone from The Netherlands

    NARCIS (Netherlands)

    Nijland, T.G.; Dubelaar, C.W.; Tolboom, H.J.; Hees, R.P.J. van

    2006-01-01

    Most of the Netherlands a Quaternary delta, local supplies of natural stone suitable for building are rare. These include: Quaternary bog iron ores used in early medieval times (until c. 1200); erratics, deposited in boulder clay during the Saalian ice age in the northern Netherlands and gravel from

  9. Multiple broods from a hole in the wall: breeding Red-and-yellow ...

    African Journals Online (AJOL)

    Nesting and breeding behaviour of Red-and-yellow Barbets Trachyphonus erythrocephalus was recorded from a nest in the brick stone-wall of a house in Nanyangacor, south-eastern Sudan in 2005. There were at least five breeding attempts throughout the year, with at least four broods from this single nesting hole.

  10. Image-guided radiotherapy of bladder cancer: bladder volume variation and its relation to margins

    DEFF Research Database (Denmark)

    Muren, Ludvig; Redpath, Anthony Thomas; Lord, Hannah

    2007-01-01

    : The correlation between the relative bladder volume (RBV, defined as repeat scan volume/planning scan volume) and the margins required to account for internal motion was first studied using a series of 20 bladder cancer patients with weekly repeat CT scanning during treatment. Both conformal RT (CRT) and IGRT......BACKGROUND AND PURPOSE: To control and account for bladder motion is a major challenge in radiotherapy (RT) of bladder cancer. This study investigates the relation between bladder volume variation and margins in conformal and image-guided RT (IGRT) for this disease. MATERIALS AND METHODS...... these patients were given fluid intake restrictions on alternating weeks during treatment. RESULTS: IGRT gave the strongest correlation between the RBV and margin size (R(2)=0.75; p10mm were required in only 1% of the situations when the RBV1, whereas isotropic margins >10...

  11. Renal effects of percutaneous stone removal

    Energy Technology Data Exchange (ETDEWEB)

    Eshghi, M.; Schiff, R.G.; Smith, A.D.

    1989-02-01

    Preoperative and postoperative renography with 99mTechnetium-diethylene-triamine pentaacetic acid was performed on 33 patients who were free of renal scarring, infection, and obstruction and who underwent percutaneous renal stone removal. Although there was a transient decrease in renal function postoperatively in some patients, statistically significant reductions in renal function occurred only in 1 patient with an arteriovenous malformation that was embolized and in 1 patient who had a postoperative ureteropelvic junction stricture. The creation of more than one nephrostomy tract did not affect the results. In the absence of serious complications, percutaneous nephrostomy does not have a significant effect on renal function.

  12. Microstructural characterization of stone wool fibre network

    DEFF Research Database (Denmark)

    Chapelle, Lucie; Brøndsted, Povl; Kusano, Yukihiro

    2014-01-01

    as the number density of fibre contacts. The methods are based on image analysis of 3D datasets which have been obtained by x-ray tomography. Validation of the proposed methods was demonstrated by testing generated virtual fibrous network with known fibre characteristics.......Understanding the mechanical properties of fibrous network as complex as stone wool materials requires a relevant description of their microstructure and architecture. In this study, different methods have been proposed to characterize the fibre orientation, diameter and length of fibres as well...

  13. Towards the Rosetta Stone of planet formation

    Directory of Open Access Journals (Sweden)

    Schmidt T.O.B.

    2011-02-01

    Full Text Available Transiting exoplanets (TEPs observed just ~10 Myrs after formation of their host systems may serve as the Rosetta Stone for planet formation theories. They would give strong constraints on several aspects of planet formation, e.g. time-scales (planet formation would then be possible within 10 Myrs, the radius of the planet could indicate whether planets form by gravitational collapse (being larger when young or accretion growth (being smaller when young. We present a survey, the main goal of which is to find and then characterise TEPs in very young open clusters.

  14. Stone anchors from Minicoy Island, Lakshadweep, India

    Digital Repository Service at National Institute of Oceanography (India)

    Tripati, S.

    and Ali Rajas of Kerala. It appears that the mainland had contact with these islands during the early centuries of the Christian era, if not earlier (Sila Tripati, 1999). Though Islam came to Lakshadweep after the 11th and 12th centuries AD... by fishermen. In Divehi, the local language, ring-stone anchors are known as fanaa. Of 40–50 cm diameter, they are made of coral fashioned in the form of a slightly concave disc. The width of the hole in which the wooden stock is inserted is 6–10 cm...

  15. Cone Beam CT Imaging Analysis of Interfractional Variations in Bladder Volume and Position During Radiotherapy for Bladder Cancer

    International Nuclear Information System (INIS)

    Yee, Don; Parliament, Matthew; Rathee, Satyapal; Ghosh, Sunita; Ko, Lawrence; Murray, Brad

    2010-01-01

    Purpose: To quantify daily bladder size and position variations during bladder cancer radiotherapy. Methods and Materials: Ten bladder cancer patients underwent daily cone beam CT (CBCT) imaging of the bladder during radiotherapy. Bladder and planning target volumes (bladder/PTV) from CBCT and planning CT scans were compared with respect to bladder center-of-mass shifts in the x (lateral), y (anterior-posterior), and z (superior-inferior) coordinates, bladder/PTV size, bladder/PTV margin positions, overlapping areas, and mutually exclusive regions. Results: A total of 262 CBCT images were obtained from 10 bladder cancer patients. Bladder center of mass shifted most in the y coordinate (mean, -0.32 cm). The anterior bladder wall shifted the most (mean, -0.58 cm). Mean ratios of CBCT-derived bladder and PTV volumes to planning CT-derived counterparts were 0.83 and 0.88. The mean CBCT-derived bladder volume (± standard deviation [SD]) outside the planning CT counterpart was 29.24 cm 3 (SD, 29.71 cm 3 ). The mean planning CT-derived bladder volume outside the CBCT counterpart was 47.74 cm 3 (SD, 21.64 cm 3 ). The mean CBCT PTV outside the planning CT-derived PTV was 47.35 cm 3 (SD, 36.51 cm 3 ). The mean planning CT-derived PTV outside the CBCT-derived PTV was 93.16 cm 3 (SD, 50.21). The mean CBCT-derived bladder volume outside the planning PTV was 2.41 cm 3 (SD, 3.97 cm 3 ). CBCT bladder/ PTV volumes significantly differed from planning CT counterparts (p = 0.047). Conclusions: Significant variations in bladder and PTV volume and position occurred in patients in this trial.

  16. Work Capacity of the Bladder During Voiding: A Novel Method to Evaluate Bladder Contractile Function and Bladder Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Ning Liu

    2015-01-01

    Full Text Available Background: Work in voiding (WIV of the bladder may be used to evaluate bladder status throughout urination rather than at a single time point. Few studies, however, have assessed WIV owing to the complexity of its calculations. We have developed a method of calculating work capacity of the bladder while voiding and analyzed the associations of bladder work parameters with bladder contractile function and bladder outlet obstruction (BOO. Methods: The study retrospectively evaluated 160 men and 23 women, aged >40 years and with a detrusor pressure at maximal flow rate (P det Q max of ≥40 cmH 2 O in men, who underwent urodynamic testing. The bladder power integration method was used to calculate WIV; WIV per second (WIV/t and WIV per liter of urine voided (WIV/v were also calculated. In men, the relationships between these work capacity parameters and P det Q max and Abrams-Griffiths (AG number were determined using linear-by-linear association tests, and relationships between work capacity parameters and BOO grade were investigated using Spearman′s association test. Results: The mean WIV was 1.15 ± 0.78 J and 1.30 ± 0.88 J, mean WIV/t was 22.95 ± 14.45 mW and 23.78 ± 17.02 mW, and mean WIV/v was 5.59 ± 2.32 J/L and 2.83 ± 1.87 J/L in men and women, respectively. In men, WIV/v showed significant positive associations with P det Q max (r = 0.845, P = 0.000, AG number (r = 0.814, P = 0.000, and Schafer class (r = 0.726, P = 0.000. Conversely, WIV and WIV/t showed no associations with P det Q max or AG number. In patients with BOO (Schafer class > II, WIV/v correlated positively with increasing BOO grade. Conclusions: WIV can be calculated from simple urodynamic parameters using the bladder power integration method. WIV/v may be a marker of BOO grade, and the bladder contractile function can be evaluated by WIV and WIV/t.

  17. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction

    Science.gov (United States)

    Andersson, Karl-Erik; Boedtkjer, Donna B.; Forman, Axel

    2016-01-01

    The vascular supply to the human bladder is derived mainly from the superior and inferior vesical arteries, the latter being directly connected to the internal iliac artery. Aging is associated with an impairment of blood vessel function and changes may occur in the vasculature at the molecular, cellular and functional level. Pelvic arterial insufficiency may play an important role in the development of bladder dysfunctions such as detrusor overactivity (DO) and the overactive bladder syndrome. Chronic ischemia-related bladder dysfunction may progress to bladder underactivity and it would be desirable to treat not only lower urinary tract symptoms (LUTS) induced by chronic ischemia, but also the progression of the morphological bladder changes. Studies in experimental models in rabbits and rats have shown that pelvic arterial insufficiency may result in significant bladder ischemia with reduced bladder wall oxygen tension. In turn, this will lead to oxidative stress associated with upregulation of oxidative stress-sensitive genes, increased muscarinic receptor activity, ultrastructural damage, and neurodegeneration. The phosphodiesterase type 5 (PDE5) inhibitor tadalafil, the α1-adrenoceptor (AR) blocker silodosin, the β3-AR agonist mirabegron, and the free radical scavenger melatonin, exerted a protecting effect on urodynamic parameters, and on functional and morphological changes of the bladder demonstrable in vitro. Since the agents tested are used clinically for relieving LUTS, the results from the animal models seem to have translational value, and may be of relevance for designing clinical studies to demonstrate if the drugs may prevent progression of ischemia-related functional and morphological bladder changes. PMID:28042309

  18. Chromium in urothelial carcinoma of the bladder.

    Science.gov (United States)

    Golabek, Tomasz; Socha, Katarzyna; Kudelski, Jacek; Darewicz, Barbara; Markiewicz-Zukowska, Renata; Chlosta, Piotr; Borawska, Maria

    2017-12-23

    Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, the involvement of heavy metals in tumourigenesis of urothelial carcinoma of the bladder has been poorly investigated. Therefore, the aim of this study was to examine the relationship between chromium (Cr) and bladder cancer. Chromium concentration in two 36-sample series of bladder cancer tissue and sera from patients with this neoplasm were matched with those of a control group. The amount of trace elements in every tissue sample was determined using atomic absorption spectrometry. This was correlated with tumour stage. While the median chromium concentration levels reached statistically higher values in the bladder cancer tissue, compared with the non-cancer tissue (99.632ng/g and 33.144ng/g, respectively; p<0.001), the median Cr levels in the sera of the patients with this carcinoma showed no statistical difference when compared to those of the control group (0.511μg/l and 0.710μg/l, respectively; p=0.408). The median levels of Cr in the bladder tissue, depending on the stage of the tumour, compared with the tissue without the neoplasm, observed the same relationship for both non-muscle invasive and muscle-invasive tumours (p<0.001 and p<0.01, respectively). This study shows that patients with urothelial carcinoma of the bladder had higher tissue Cr levels than people without tumour, while no difference was found in the Cr serum levels between the two groups of patients under investigation.

  19. Prevalence of renal uric acid stones in the adult.

    Science.gov (United States)

    Trinchieri, Alberto; Montanari, Emanuele

    2017-12-01

    The aim of this study was to estimate uric acid renal stone prevalence rates of adults in different countries of the world. PubMed was searched for papers dealing with "urinary calculi and prevalence or composition" for the period from January 1996 to June 2016. Alternative searches were made to collect further information on specific topics. The prevalence rate of uric acid stones was computed by the general renal stone prevalence rate and the frequency of uric acid stones in each country. After the initial search, 2180 papers were extracted. Out of them, 79 papers were selected after the reading of the titles and of the abstracts. For ten countries, papers relating to both the renal stone prevalence in the general population and the frequency of uric stones were available. Additional search produced 13 papers that completed information on 11 more countries in 5 continents. Estimated prevalence rate of uric acid stones was >0.75% in Thailand, Pakistan, Saudi Arabia, Iran, South Africa (white population), United States and Australia; ranged 0.50-0.75% in Turkey, Israel, Italy, India (Southern), Spain, Taiwan, Germany, Brazil; and uric acid stone formation. A hot and dry climate increases fluid losses reducing urinary volume and urinary pH. A diet rich in meat protein causes low urinary pH and increased uric acid excretion. On the other hand, uric acid stone formation is frequently associated with obesity, metabolic syndrome and diabetes type 2 that are linked to dietary energy excess mainly from carbohydrate and saturated fat and also present with low urine pH values. An epidemic of uric acid stone formation could be if current nutritional trends will be maintained both in developed countries and in developing countries and the areas of greater climatic risk for the formation of uric acid stones will enlarge as result of the "global warming".

  20. A radiographic correlation between systemic disorders and pulp stones

    Directory of Open Access Journals (Sweden)

    Nayak Moksha

    2010-01-01

    Full Text Available Aim: The purpose of this study was to determine the correlation between pulp stones and cardiovascular disorders, Type II diabetes mellitus, autoimmune disorders and dental wear defects. This study also aims to evaluate the frequency of pulp stone in population of Dakshina Kannada district (Karnataka, India and to determine association of pulp stones in different sexes, tooth type, dental arches and sides. Patients and Methods: A total of 1432 teeth of five groups were examined, comprising of patients with C.V.S. disorders; Type II diabetes mellitus, autoimmune disorders, dental wear defects and control group. Teeth were examined under 2Χ magnification on radio visiograph (RVG and conventional intra-oral periapical radiograph. The presence or absence of pulp stones were recorded. Statistical Analysis Used: Chi-square analysis was used to compare the frequency of occurrence of pulp stones between sexes, tooth type, dental arches and sides. Results: Pulp stones were found in 134 (9.35% of 1432 teeth detected. Significantly, higher numbers of pulp stones were recorded in patients with cardiovascular disorder (15.86% than other groups. The occurrence of pulp stones were significantly higher in molars (18.29% than premolars (6.6% and in maxillary arch (12.36% than in mandibular arch (5.95%. No significant difference was found between sexes and sides. Conclusion: Positive correlation was found between systemic disorder and pulp stones. Cardiovascular patients had maximum number of pulp stones followed by dental-wear defects and least number of pulp stones were evident in control group.