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Sample records for renal stone tracking

  1. Renal stone disease: Pathogenesis, prevention, and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Pak, C.Y.C.

    1987-01-01

    This book contains 10 chapters. Some of the chapter titles are: Radiologic considerations; Physiochemistry of urinary stone formations; Nutritional aspects of stone disease; Prevention of recurrent nephrolithiasis; Struvite stones; and Contemporary approaches to removal of renal and ureteral calculi.

  2. 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...

  3. 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...

  4. 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.

  5. 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

  6. 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

  7. Calcium Oxalate Stone Agglomeration Inhibition [tm] Reflects Renal Stone-Forming Activity.

    Science.gov (United States)

    Lindberg, J S; Cole, F E; Romani, W; Husserl, F E; Fuselier, H A; Kok, D J; Erwin, D T

    2000-04-01

    Louisiana and other Gulf South states comprise a "Stone Belt" where calcium oxalate stone formers (CaOx SFs) are found at a high rate of approximately 5%. In these patients, the agglomeration of small stone crystals, which are visible in nearly all morning urine collections, forms stones that can become trapped in the renal parenchyma and the renal pelvis. Without therapy, about half of CaOx SFs repeatedly form kidney stones, which can cause excruciating pain that can be relieved by passage, fragmentation (lithotripsy), or surgical removal. The absence of stones in "normal" patients suggests that there are stone inhibitors in "normal" urines.At the Ochsner Renal Stone Clinic, 24-hour urine samples are collected by the patient and sent to the Ochsner Renal Stone Research Program where calcium oxalate stone agglomeration inhibition [tm] measurements are performed. Urine from healthy subjects and inactive stone formers has demonstrated strongly inhibited stone growth [tm] in contrast to urine from recurrent CaOx SFs. [tm] data from 1500 visits of 700 kidney stone patients have been used to evaluate the risk of recurrence in Ochsner's CaOx SF patients. These data have also been used to demonstrate the interactive roles of certain identified urinary stone-growth inhibitors, citrate and Tamm-Horsfall protein (THP), which can be manipulated with medication to diminish recurrent stone formation. Our goal is to offer patients both financial and pain relief by reducing their stones with optimized medication, using medical management to avoid costly treatments.

  8. Lunar Tractive Forces and Renal Stone Incidence

    Directory of Open Access Journals (Sweden)

    Spyridon Arampatzis

    2011-01-01

    Full Text Available Background. Several factors are implicated in renal stone formation and peak incidence of renal colic admissions to emergency departments (ED. Little is known about the influence of potential environmental triggers such as lunar gravitational forces. We conducted a retrospective study to test the hypothesis that the incidence of symptomatic renal colics increases at the time of the full and new moon because of increased lunar gravitational forces. Methods. We analysed 1500 patients who attended our ED between 2000 and 2010 because of nephrolithiasis-induced renal colic. The lunar phases were defined as full moon ± 1 day, new moon ± 1 day, and the days in-between as “normal” days. Results. During this 11-year period, 156 cases of acute nephrolithiasis were diagnosed at the time of a full moon and 146 at the time of a new moon (mean of 0.4 per day for both. 1198 cases were diagnosed on “normal” days (mean 0.4 per day. The incidence of nephrolithiasis in peak and other lunar gravitational phases, the circannual variation and the gender-specific analysis showed no statistically significant differences. Conclusion. In this adequate powered longitudinal study, changes in tractive force during the different lunar phases did not influence the incidence of renal colic admissions in emergency department.

  9. Calcium Oxalate Stone Agglomeration Inhibition [tm] Reflects Renal Stone-Forming Activity

    Science.gov (United States)

    Lindberg, Jill S.; Cole, Francis E.; Romani, William; Husserl, Fred E.; Fuselier, Harold A.; Kok, Dirk J.; Erwin, Donald T.

    2000-01-01

    Louisiana and other Gulf South states comprise a “Stone Belt” where calcium oxalate stone formers (CaOx SFs) are found at a high rate of approximately 5%. In these patients, the agglomeration of small stone crystals, which are visible in nearly all morning urine collections, forms stones that can become trapped in the renal parenchyma and the renal pelvis. Without therapy, about half of CaOx SFs repeatedly form kidney stones, which can cause excruciating pain that can be relieved by passage, fragmentation (lithotripsy), or surgical removal. The absence of stones in “normal” patients suggests that there are stone inhibitors in “normal” urines. At the Ochsner Renal Stone Clinic, 24-hour urine samples are collected by the patient and sent to the Ochsner Renal Stone Research Program where calcium oxalate stone agglomeration inhibition [tm] measurements are performed. Urine from healthy subjects and inactive stone formers has demonstrated strongly inhibited stone growth [tm] in contrast to urine from recurrent CaOx SFs. [tm] data from 1500 visits of 700 kidney stone patients have been used to evaluate the risk of recurrence in Ochsner's CaOx SF patients. These data have also been used to demonstrate the interactive roles of certain identified urinary stone-growth inhibitors, citrate and Tamm-Horsfall protein (THP), which can be manipulated with medication to diminish recurrent stone formation. Our goal is to offer patients both financial and pain relief by reducing their stones with optimized medication, using medical management to avoid costly treatments. PMID:21811395

  10. Acute renal infarction secondary to atrial fibrillation - mimicking renal stone picture.

    Science.gov (United States)

    Salih, Salih Bin; Al Durihim, Huda; Al Jizeeri, Ahmed; Al Maziad, Ghassan

    2006-06-01

    Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation.

  11. Estimating the Rate of Occurrence of Renal Stones in Astronauts

    Science.gov (United States)

    Myers, J.; Goodenow, D.; Gokoglu, S.; Kassemi, M.

    2016-01-01

    Changes in urine chemistry, during and post flight, potentially increases the risk of renal stones in astronauts. Although much is known about the effects of space flight on urine chemistry, no inflight incidence of renal stones in US astronauts exists and the question "How much does this risk change with space flight?" remains difficult to accurately quantify. In this discussion, we tackle this question utilizing a combination of deterministic and probabilistic modeling that implements the physics behind free stone growth and agglomeration, speciation of urine chemistry and published observations of population renal stone incidences to estimate changes in the rate of renal stone presentation. The modeling process utilizes a Population Balance Equation based model developed in the companion IWS abstract by Kassemi et al. (2016) to evaluate the maximum growth and agglomeration potential from a specified set of urine chemistry values. Changes in renal stone occurrence rates are obtained from this model in a probabilistic simulation that interrogates the range of possible urine chemistries using Monte Carlo techniques. Subsequently, each randomly sampled urine chemistry undergoes speciation analysis using the well-established Joint Expert Speciation System (JESS) code to calculate critical values, such as ionic strength and relative supersaturation. The Kassemi model utilizes this information to predict the mean and maximum stone size. We close the assessment loop by using a transfer function that estimates the rate of stone formation from combining the relative supersaturation and both the mean and maximum free stone growth sizes. The transfer function is established by a simulation analysis which combines population stone formation rates and Poisson regression. Training this transfer function requires using the output of the aforementioned assessment steps with inputs from known non-stone-former and known stone-former urine chemistries. Established in a Monte Carlo

  12. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

    OpenAIRE

    Robert Marcovich; Smith, Arthur D.

    2003-01-01

    Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial...

  13. Influence of mineral water consumption and renal stone formation

    Directory of Open Access Journals (Sweden)

    IRSAY Laszlo

    2014-02-01

    Full Text Available The intake of minerals are very important in maintaining health, but in returning to health either. Mineral waters represents a source of minerals with high bioavailability. There are evidence based studies for the efficency of mineral waters in a series of disorders for both internal and external cures. The advantage of mineral waters in renal lithiasis are significant and the risks of stone formation are neglectable if medical advise is respected. Amongst the patients- but unfortunately also the medical staff- there is the incorrect oppinion that mineral water is a factor that causes renal stones in all consumers. The purpose of the present paper is to present the factors that favour the renal stones, but also scientific arguments that support the value of mineral water, that has a part not only in ensuring the right mineral balance but also, in certain situations, even in preventing renal stones.

  14. Monitoring for Renal Stone Recurrence in Astronauts With History of Stone

    Science.gov (United States)

    Reyes, David P.; Sargsyan, Ashot; Locke, James; Davis, Jeffrey

    2014-01-01

    After an initial stone episode persons are at increased risk for future stone formation. A systematic approach is required to monitor the efficacy of treatment and preventive measures, and to assess the risk of developing new stones. This is important for persons working in critical jobs or austere environments, such as astronauts. A literature review of the current standards of care for renal stone monitoring and imaging was done. Military and civil aviation standards were also reviewed, as well as the medical precedents from the space program. Additionally, a new, more effective, renal stone ultrasound protocol has been developed. Using this work, a monitoring algorithm was proposed that takes into consideration the unique mission and operational environment of spaceflight. The approach to imaging persons with history of renal stones varies widely in the literature. Imaging is often done yearly or biannually, which may be too long for mission critical personnel. In the proposed algorithm astronauts with a history of renal stone, who may be under consideration for assignment, are imaged by a detailed, physiciandriven, ultrasound protocol. Unassigned personnel are monitored by yearly ultrasound and urine studies. Any positive ultrasound study is then followed by low-dose renal computed tomography scan. Other criteria are also established. The proposed algorithm provides a balanced approach between efficacy and reduced radiation exposure for the monitoring of astronauts with a renal stone history. This may eventually allow a transition from a risk-averse, to a risk-modifying approach that can enable continued service of individuals with history of renal stone that have adequately controlled risk factors.

  15. Milk of calcium renal stone: a case report

    OpenAIRE

    守屋, 賢治; 西尾, 正一; 前川, 正信; 小早川, 等; 安本, 亮二

    1989-01-01

    A case of milk of calcium renal stone is reported. The patient was a 24-year-old woman who complained of dull flank pain on the right side. A plain film of the abdomen revealed a right renal stone, which showed peculiar radiopacity of a half-moon shape in the upright position. The operation was performed on July 6, 1984. Postoperative chemical analysis of sand granules showed calcium oxalate and calcium phosphate.

  16. Renal-Stone Risk Assessment During Space Shuttle Flights

    Science.gov (United States)

    Whitson, Peggy A.; Pietrzyk, Robert A.; Pak, Charles Y. C.

    1996-01-01

    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. 24-hr urine samples were collected prior to, during space flight, and following landing. Urinary factors associated with renal stone formation were analyzed and the relative urinary supersaturation ratios of calcium oxalate, calcium phosphate (brushite), sodium urate, struvite and uric acid were calculated. Food and fluid consumption was recorded for a 48-hr period ending with the urine collection. Urinary composition changed during flight to favor the crystallization of stone-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. 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. The importance of the hypercalciuria was noted since renal excretion was high relative to the intake.

  17. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Robert Marcovich

    2003-06-01

    Full Text Available Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken in to account. This article will review current knowledge and suggest an algorithm for the rational management of renal calculi with shock wave lithotripsy and percutaneous nephrolithotomy.

  18. Screening and Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

    Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen

    2017-01-01

    Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

  19. Screening and Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

    Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen

    2017-01-01

    Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

  20. Prevalence of renal uric acid stones in the adult.

    Science.gov (United States)

    Trinchieri, Alberto; Montanari, Emanuele

    2017-03-03

    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".

  1. Post-renal acute renal failure due to a huge bladder stone.

    Science.gov (United States)

    Celik, Orcun; Suelozgen, Tufan; Budak, Salih; Ilbey, Yusuf Ozlem

    2014-06-30

    A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.

  2. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Water jet renal stone dislodger system. 876.4650... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4650 Water jet renal stone dislodger system. (a) Identification. A water jet renal stone dislodger system is a device used to...

  3. Renal Stone Risk during Spaceflight: Assessment and Countermeasure Validation

    Science.gov (United States)

    Whitson, Peggy A.; Pietrzyk, Robert A.; Jones, Jeffery A.; Sams, Clarence F.; Hudson, Ed K.; Nelman-Gonzalez, Mayra

    2009-01-01

    NASA's Vision for Space Exploration centers on exploration class missions including the goals of returning to the moon and landing on Mars. One of NASA's objectives is to focus research on astronaut health and the development of countermeasures that will protect crewmembers during long duration voyages. Exposure to microgravity affects human physiology and results in changes in the urinary chemical composition favoring urinary supersaturation and an increased risk of stone formation. Nephrolithiasis is a multifactorial disease and development of a renal stone is significantly influenced by both dietary and environmental factors. Previous results from long duration Mir and short duration Shuttle missions have shown decreased urine volume, pH, and citrate levels and increased calcium. Citrate, an important inhibitor of calcium-containing stones, binds with urinary calcium reducing the amount of calcium available to form stones. Citrate inhibits renal stone recurrence by preventing crystal growth, aggregation, and nucleation and is one of the most common therapeutic agents used to prevent stone formation. Methods: Thirty long duration crewmembers (29 male, 1 female) participated in this study. 24-hour urines were collected and dietary monitoring was performed pre-, in-, and postflight. Crewmembers in the treatment group received two potassium citrate (KCIT) pills, 10 mEq/pill, ingested daily beginning 3 days before launch, all in-flight days and through 14 days postflight. Urinary biochemical and dietary analyses were completed. Results: KCIT treated subjects exhibited decreased urinary calcium excretion and maintained the levels of calcium oxalate supersaturation risk at their preflight levels. The increased urinary pH levels in these subjects reduced the risk of uric acid stones. Discussion: The current study investigated the use of potassium citrate as a countermeasure to minimize the risk of stone formation during ISS missions. Results suggest that supplementation

  4. Renal struvite stones--pathogenesis, microbiology, and management strategies.

    Science.gov (United States)

    Flannigan, Ryan; Choy, Wai Ho; Chew, Ben; Lange, Dirk

    2014-06-01

    Infection stones-which account for 10-15% of all urinary calculi-are thought to form in the presence of urease-producing bacteria. These calculi can cause significant morbidity and mortality if left untreated or treated inadequately; optimal treatment involves complete stone eradication in conjunction with antibiotic therapy. The three key principles of treating struvite stones are: removal of all stone fragments, the use of antibiotics to treat the infection, and prevention of recurrence. Several methods to remove stone fragments have been described in the literature, including the use of urease inhibitors, acidification therapy, dissolution therapy, extracorporeal shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy (PCNL), and anatrophic nephrolithotomy. PCNL is considered to be the gold-standard approach to treating struvite calculi, but adjuncts might be used when deemed necessary. When selecting antibiotics to treat infection, it is necessary to acquire a stone culture or, at the very least, urine culture from the renal pelvis at time of surgery, as midstream urine cultures do not always reflect the causative organism.

  5. Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney

    Directory of Open Access Journals (Sweden)

    Wael Mohamed Gamal

    2016-01-01

    Full Text Available Introduction: Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS in these children were determined. Patients and Methods: Records of children with renal stones who were treated at our institute between August 2011 and August 2014 were retrospectively assessed. Inclusion criteria were: Children with single renal stone <2 cm size, in a solitary kidney. A 7.5 Fr flexible ureteroscope (FURS was introduced into the ureter over a hydrophilic guidewire under visual and fluoroscopic guidance - applying a back-loading technique. The stone was completely dusted using 200 μm laser fiber (0.2-0.8 joules power and10-30 Hz frequency. At the end of the maneuver, a 5 Fr JJ stent was inserted into the ureter. The children were discharged home 24 h postoperative - provided that no complications were detected. Results: Fourteen children (3 girls and 11 boys with median age 9.5 years (range 6-12 were included. The mean stone burden was 12.2 ± 1.5 mm (range 9-20. Stones were successfully accessed in all of the cases by the FURS except for 2 cases in whom a JJ stent was inserted into the ureter and left in place for 2 weeks to achieve passive dilatation. All of the stones were dusted completely. The immediate postoperative stone-free rate (SFR was 79%, and the final SFR was 100% after 3 weeks. No intraoperative complications were observed. Conclusions: RIRS for renal stone <2 cm in children with a solitary kidney is a single-session procedure with a high SFR, low complication rate, and is a minimally invasive, natural orifice technique.

  6. Impact of Residual Fragments following Endourological Treatments in Renal Stones

    Directory of Open Access Journals (Sweden)

    Cenk Acar

    2012-01-01

    Full Text Available Today, shock wave lithotripsy (SWL, percutaneous nephrolithotomy (PCNL, and flexible ureterorenoscopy (URS are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelography which are less sensitive than CT that leads to be diversity of study results in reporting outcome. Residual fragments (RFs after interventional therapies may cause pain, infection, or obstruction. The size and location of RFs following SWL and PCNL are the major predictors for clinical significant symptoms and stone events requiring intervention. There is no consensus regarding schedule for followup of SWL, PCNL, and flexible URS. Active monitoring can be recommended when the stones become symptomatic, increase in size, or need intervention. RFs <4 mm after SWL and <2 mm after PCNL and flexible URS could be actively monitored on an annual basis with CT. Early repeat SWL and second-look endoscopy are recommended after primary SWL and PCNL, respectively. There is insufficient data for flexible URS, but RFs can be easily treated with repeat URS. Finally, medical therapy should be tailored based on the stone analysis and metabolic workup that may be helpful to prevent regrowth of the RFs.

  7. THE FIRST CHOICE OF TREATMENT FOR URINARY INFECTED RENAL STONES

    Institute of Scientific and Technical Information of China (English)

    JIA Jian-ye; HUANG Yun-teng; JIANG Ning; WANG Guo-zeng; SHI Quan; HE Wei; ZHENG Jing-cun; YE Min; ZHU Ying-jian; WANG Wei-ming

    2007-01-01

    Objective To investigate the appropriate treatment of infectious renal stones. Methods Between April 1999 and June 2006, 60 patients presented to our department with infectious renal stones. Twentynine patients were treated by extracorporeal shock-wave lithortripsy( ESWL ) only, 31 patients were given a combination therapy. Thirty-four males and 26 females were evaluated by routine urine tests including urine culture and sensitivity before ESWL treatments. The total number of shock waves varied from 1 600 to 2 800 and the energy levels ranged from 1 to 6 unit. Results The fragmentation after ESWL was 61.6%; 18. 3% after 2 ESWL sessions,8.3% after 3 ESWL sessions, 5.0% after 4 ESWL sessions, 3. 3% after 7 ESWL sessions and 1.66% after 9 ESWL sessions. Only one ( 1. 66% ) patient failed and changed to open surgery. Conclusion ESWL is an effective and reliable treatment for patients with infectious renal stones. However, better effects and shorter treatment time is obtained by the combination therapy of ESWL with other therapy options.

  8. Antegrade ureteroscopic assistance during percutaneous nephrolithotomy for complete renal staghorn stone: Technique and outcomes

    Directory of Open Access Journals (Sweden)

    Yuh-Shyan Tsai

    2015-03-01

    Conclusion: Such an ancillary procedure might be suitable for the management of complete staghorn stones or other complex renal stones in patients in whom adequate intracalyceal space was not available for the creation of nephrostomy access.

  9. Changes in Renal Function and Blood Pressure in Patients with Stone Disease

    Science.gov (United States)

    Worcester, Elaine M.

    2007-04-01

    Stone disease is a rare cause of renal failure, but a history of kidney stones is associated with an increased risk for chronic kidney disease, particularly in overweight patients. Loss of renal function seems especially notable for patients with stones associated with cystinuria, hyperoxaluria, and renal tubular acidosis, in whom the renal pathology shows deposits of mineral obstructing inner medullary collecting ducts, often diffusely. However, even idiopathic calcium oxalate stone formers have a mild but significant decrease in renal function, compared to age, sex and weight-matched normals, and appear to lose renal function with age at a slightly faster rate than non-stone formers. There is also an increased incidence of hypertension among stone formers, although women are more likely to be affected than men.

  10. Renal stones on portal venous phase contrast-enhanced CT: does intravenous contrast interfere with detection?

    Science.gov (United States)

    Dym, R. Joshua; Duncan, Dameon R.; Spektor, Michael; Cohen, Hillel W.; Scheinfeld, Meir H.

    2015-01-01

    Purpose To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6%) examinations with at least one renal stone on the “gold standard” noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81%; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88%, 95%, 99%, and 98%, respectively. Sensitivity for stone disease on a per-kidney basis was 94% when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96%, 99%, and 100%, respectively. Specificity for stone disease on a per-kidney basis was 98% overall, 99% when considering only stones ≥2 mm, and 100% when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions. PMID:24504541

  11. [Factors affecting residual stones after percutaneous nephrolithotomy in patients with renal calculus].

    Science.gov (United States)

    Qiao, Mingzhou; Zhang, Haifang; Zhou, Chenlong

    2015-11-24

    To explore the factors affecting the residual stones after percutaneous nephrolithotomy (PCNL) in patients with renal calculus. A retrospective analysis was performed for 1 200 patients who were affected by renal calculus and treated with PCNL between Jan 2008 and May 2014 in People's Hospital of Anyang City. Among those patients, 16 were diagnosed as bilateral renal stone and had two successive operations. The size, location and number of stones, previous history of surgery, the degree of hydronephrosis, urinary infection were included in the univariate analysis. Significant factors in univariate analysis were included in the multivariate analysis to determine factors affecting stone residual. A total of 385 cases developed stone residual after surgery. The overall residual rate was 31.7%. In univariate analysis, renal pelvis combined with caliceal calculus (P=0.006), stone size larger than 4 cm (P=0.005), stone number more than 4 (P=0.002), the amount of bleeding more than 200 ml (P=0.025), operation time longer than 120 minutes (P=0.028) were associated with an increased rate of stone residual. When subjected to the Cox multivariate analysis, the independent risk factors for residual stones were renal pelvis combined with caliceal calculus (P=0.049), stone size larger than 4 cm (P=0.038) and stone number more than 4 (P=0.018). Factors affecting the incidence of residual stones after PCNL are the size, location and number of stones. Larger size stone and the presence of renal pelvis combined with caliceal calculus are significantly associated with residual stones. Nevertheless, stone number less than 4 indicates an increased stone clearance rate.

  12. In vivo determination of renal stone composition with dual-energy computed tomography

    Directory of Open Access Journals (Sweden)

    John-Henry Corbett

    2014-04-01

    Full Text Available Background: Composition of renal stones influences management of patients with renal stone disease. Currently stone composition can only be analysed ex vivo after stone extraction or passage, but recent introduction of dual-energy computed tomography (CT to clinical practice has raised interest in the ability of this technology to determine composition of renal stones in vivo.Objectives: To determine renal stone composition in patients using single-source dual-energy rapid-peak kilovolt (kVp switching CT.Method: Nineteen patients with renal stones for percutaneous nephrolithotomy were evaluated with single-source dual-energy computed tomography on a Discovery CT 750HD. The Gemstone Spectral Imaging (GSI effective atomic number (Zeff and attenuation at 70 keV monochromatic energy were used to predict the stone composition. Infrared spectroscopy and x-ray diffraction of stones after extraction served as the reference standard.Results: Two (10.5% of the 19 stones had uric acid as major component. The other 17 (89.5% were calcium-based stones. No statistically significant difference between the GSI Zeff and calculated effective atomic number (Z for stone compounds was found. The GSI Zeff and attenuation could differentiate between uric acid and non-uric acid stones. No differentiation between different calcium stones could be made.Conclusion: Uric acid and non-uric acid renal stones can be differentiated with single-source dual-energy in vivo. The GSI Zeff reflects the dominant material in polycrystalline stones.

  13. MSCT renal stone protocol; dose penalty and influence on management decision of patients: Is it really worth the radiation dose?

    Directory of Open Access Journals (Sweden)

    Ahmed Hamimi

    2016-03-01

    Conclusions: Considering time is of the essence; MSCT renal stone protocol using low dose technique is crucial in the management of renal stone in acute setting including the diagnosis and management decision.

  14. Proteomic analysis of renal calculi indicates an important role for inflammatory processes in calcium stone formation.

    Science.gov (United States)

    Merchant, Michael L; Cummins, Timothy D; Wilkey, Daniel W; Salyer, Sarah A; Powell, David W; Klein, Jon B; Lederer, Eleanor D

    2008-10-01

    Even though renal stones/calculi occur in approximately 10% of individuals, they are an enormous economic burden to the entire US health system. While the relative metabolic composition of renal calculi is generally known, there is no clear understanding of the genetics of renal stone formation, nor are there clear prognostic indicators of renal stone formation. The application of proteomics to the analysis of renal calculi axiomatically holds that insight into renal stone pathobiology can be gained by a more comprehensive understanding of renal calculus protein composition. We analyzed isolated renal stone matrix proteins with mass spectrometric and immunohistochemical methods identifying 158 proteins with high confidence, including 28 common proteins. The abundant proteins included those identified previously in stones and proteins identified here for the first time, such as myeloid lineage-specific, integral membrane and lipid regulatory proteins. Pathway analyses of all proteins identified suggested that a significant fraction of the most abundant matrix proteins participate in inflammatory processes. These proteomic results support the hypothesis that stone formation induces a cellular inflammatory response and the protein components of this response contribute to the abundant stone matrix proteome.

  15. Role of Transport and Kinetics in Growth of Renal Stones

    Science.gov (United States)

    Kassemi, Mohammad; Iskovitz, Ilana

    2012-01-01

    Renal stone disease is not only a concern on earth but could conceivably pose as a serious risk to the astronauts health and safety in Space. In this paper, a combined transport-kinetics model for growth of calcium oxalate crystals is presented. The model is used to parametrically investigate the growth of renal calculi in urine with a focus on the coupled effects of transport and surface reaction on the ionic concentrations at the surface of the crystal and their impact on the resulting growth rates. It is shown that under nominal conditions of low solution supersaturation and low Damkohler number that typically exist on Earth, the surface concentrations of calcium and oxalate approach their bulk solution values in the urine and the growth rate is most likely limited by the surface reaction kinetics. But for higher solution supersaturations and larger Damkohler numbers that may be prevalent in the microgravity environment of Space, the calcium and oxalate surface concentrations tend to shift more towards their equilibrium or saturation values and thus the growth process may be limited by the transport through the medium. Furthermore, parametric numerical studies suggest that changes to the renal biochemistry of astronauts due in space may promote development of renal calculi during long duration space expeditions.

  16. Potential etiologic role of brushite in the formation of calcium (renal) stones

    Science.gov (United States)

    Pak, Charles Y. C.

    1981-05-01

    Brushite may play an important regulatory role in the formation of calcium -containing renal stones. The urinary environment from patients with hypercalciuric nephrolithiasis is typically supersaturated and shows an increased propensity for the spontaneous nucleation of brushite. Brushite has been identified in "stone-forming" urine and in stones. This crystalline phase may undergo phase transformation to hydroxyapatite or cause heterogeneous nucleation or epitaxial growth of calcium oxalate. Thus, brushite may also participate in the formation of stones of hydroxypatite or calcium oxalate.

  17. Simplified methods for the evaluation of the risk of forming renal stones and the follow-up of stone-forming propensity during the preventive treatment of stone-formation.

    Science.gov (United States)

    Grases, Fèlix; Costa-Bauzá, Antonia

    2016-02-01

    Renal lithiasis is a complex multifactorial disease in which recurrence is common. Thus, simple and reliable procedures are needed to evaluate patients with previous kidney stones to determine the risk of recurrence. In this paper we review simple biochemical procedures that can be used to determine the risk for renal stone formation when the stone is available or unavailable for analysis. Our present knowledge of renal lithiasis indicates that renal stones form due to several well-defined factors. Analysis of the renal stone itself can provide important information about clinical factors that require further investigation. When the stone is unavailable, it is necessary to perform a general evaluation of main urinary risk factors associated to renal stone formation, but this study should be complemented considering information related to direct familial antecedents, recidivant degree, radiological images, medical history, and life style habits. Finally, tools for patient follow-up of stone-forming propensity during the preventive treatment are discussed .

  18. Gallstones increase the risk of developing renal stones: a nationwide population-based retrospective cohort study.

    Science.gov (United States)

    Li, C-H; Sung, F-C; Wang, Y-C; Lin, D; Kao, C-H

    2014-06-01

    This study identifies the effects of gall stone on the risks of developing renal stone in a nationwide cohort study. Studies on the association between gall stone and renal stone are scarce. We identified patients with gallstones using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD). We selected a comparison cohort, random frequency-matched by age, sex and index year, from the general population. We analyzed the risk of renal stones by using Cox proportional hazards regression models for sex, age and comorbidities. Of the 23.74 million people in the database, we followed 25 258 gallstone patients (54.5% female) and 101 029 control patients. The risk of developing renal stones was 1.68-fold greater in gallstone patients, compared with patients without gallstones after adjusting for age, sex and comorbidities. The substantially increased risk of renal stones was also significant in gallstone patients regardless of comorbidities. In the follow-up period gallstone group. The cumulative incidence of renal stone in the gallstone group was higher than in the non-gallstone group (P gallstone patients, compared with the general population. This study provides information to enable physicians to implement adequate prevention measures to decrease both stones formation. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Renal stone in crossed fused renal ectopia and its laparoscopic management: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Santosh Agrawal

    2016-01-01

    Full Text Available Management of renal stone in crossed fused renal ectopia (CFRE is difficult because of abnormal location, malrotation, and its relations with vertebral column and small bowel. Management is not standardized because of the paucity of literature and variable anatomy. We managed an 8-year-old boy with multiple renal stones in right side crossed kidney by laparoscopic pyelolithotomy and nephro pyeloscopy with the help of ureteroscope. Until now, there is only one prior report of laparoscopic pyelolithotomy in CFRE. We share our experience in this case and review the literature regarding the management of kidney stones in this rare anomaly.

  20. Programmatic Considerations to Reduce the Risk of Adverse Renal Stone Events in Spaceflight

    Science.gov (United States)

    Antonsen, Erik; Pietrzyk, Robert

    2017-01-01

    Introduction: Microgravity exposure may alter the likelihood that astronauts will experience renal stones. The potential risk includes both acute and chronic health issues, with the potential for significant impact on mission objectives. Methods: To understand the role of the NASA's Human Research Program (HRP) research agenda in both preventing and addressing renal stones in spaceflight, current astronaut epidemiologic data and a summary of programmatic considerations are reviewed. Results: Although there has never been a symptomatic renal stone event in a U.S. crewmember during spaceflight, urine chemistry has been altered - likely due to induced changes in renal physiology as a result of exposure to microgravity. This may predispose astronauts to stone formation, leading the HRP to conduct and sponsor research to: 1) understand the risk of stone formation in space; 2) prevent stones from forming; and 3) address stones that may form by providing novel diagnostic and therapeutic approaches. Discussion: The development of a renal stone during spaceflight is a significant medical concern that requires the HRP to minimize this risk by providing the ability to prevent, diagnose, monitor and treat the condition during spaceflight. A discussion of the risk as NASA understands it is followed by an overview of the multiple mitigations currently under study, including novel ultrasound techniques for stone detection and manipulation, and how they may function as part of a larger exploration medical system.

  1. Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease

    Science.gov (United States)

    ZENGIN, KURSAD; TANIK, SERHAT; SENER, NEVZAT CAN; ALBAYRAK, SEBAHATTIN; EKICI, MUSA; BOZKURT, IBRAHIM HALIL; BAKIRTAS, HASAN; GURDAL, MESUT; IMAMOGLU, MUHAMMED ABDURRAHIM

    2015-01-01

    The objective of This study was to report our pathological findings in nephrectomy specimens from patients treated for non-functioning hydronephrotic kidney due to renal pelvic stone disease. A total of 97 patients who underwent nephrectomy for non-functioning hydronephrotic kidneys between January, 2011 and June, 2014 were retrospectively reviewed. A non-functioning kidney was defined as one having paper-thin parenchyma on urinary ultrasound or computed tomography, exhibiting no contrast visualization in the collecting duct system on intravenous urography and having a split renal function of <10% on nuclear renal function studies. Following pathological evaluation, 9 patients were diagnosed with xanthogranulomatous pyelonephritis, 9 with malignant tumors and 79 with chronic pyelonephritis. Of the patients with chronic pyelonephritis, 2 also had renal adenomas. The malignant tumors included 3 transitional cell carcinomas (TCC), 2 squamous cell carcinomas (SCC), 3 renal cell carcinomas (RCC) (1 sarcomatoid, 1 papillary and 1 clear cell RCC), whereas 1 patient had concurrent RCC and TCC. In conclusion, non-functioning kidneys, particularly those with kidney stones, should be managed as possible malignancies, due to the higher incidence of malignant tumors in such patients compared with the normal population. PMID:26171211

  2. TREATMENT OF RENAL STONES WITH PERCUTANEOUS NEPHROLITHOTOMY IMPROVES RENAL FUNCTIONS IN CHRONIC KIDNEY DISEASE PATIENTS

    Directory of Open Access Journals (Sweden)

    Ekrem Akdeniz

    2016-01-01

    Full Text Available Objective:In this study, we aimed to investigate the impact of percutaneous nephrolitotomy on kidney functions in stage III or higher chronic renal failure patients using glomerular filtration rate and serum creatinine level. Material and Method:Between 2010 and 2014, percutaneous nephrolithotomy was applied to patients who had glomerular filtration rate below 60 mL/min/1.73m2. Pre-operative demographic features, stone burden and localization, urine analysis and microbial test, serum creatinine level, direct urinary system graphy, and spiral non-enhanced computerized tomography were obtained. Intraoperative renal unit counts, anesthesia and surgery time, and X-ray exposure time were calculated. Early and late post-operative complications, hospitalization time, stone-free rate, and glomerular function rate were evaluated, retrospectively. Findings:Pre-operatively, mean creatinine value was 2,42±0.76 mg/dL, mean glomerular filtration rate was 45.3±13mL/min/1.73m2, mean stone burden was 393±40 mm², mean intervention time was 79±34 min and 12 patients were stone free (70.5%. Decrease of hemoglobin 1,6 g/dL and transfusion was done only two patients (11.8% due to excessive bleeding. In early and long term follow-up, mean creatinine values and glomerular filtration rate were 1.98±0.72mg/dL, 2.16±0.78mL/dL and 54.1±14 mL/min/1.73m2and 51.8±15 mL/min/1.73m2, respectively. Comparison of pre-operative and post-operative creatinine and glomerular filtration rates revealed significant decrease in creatinine level and increase in glomerular filtration rate. Results:Percutaneous nephrolithotomy which eliminates urinary obstruction is safely used in the treatment of kidney stones with minimal damage on kidney functions. Stage III or higher renal failure patients who have obstructive kidney stones or recurrent urinary tract infections can effectively be treated and this may help patients to prevent progression to end-stage renal failure.

  3. Pathophysiology of incomplete renal tubular acidosis in recurrent renal stone formers: evidence of disturbed calcium, bone and citrate metabolism

    DEFF Research Database (Denmark)

    Osther, P J; Bollerslev, Jens; Hansen, A B

    1993-01-01

    Urinary acidification, bone metabolism and urinary excretion of calcium and citrate were evaluated in 10 recurrent stone formers with incomplete renal tubular acidosis (iRTA), 10 recurrent stone formers with normal urinary acidification (NUA) and 10 normal controls (NC). Patients with iRTA had......-carbonic acidosis during fasting may be a pathophysilogical factor of both nephrolithiasis and disturbed bone metabolism in stone formers with iRTA....

  4. Estimating the Risk of Renal Stone Events During Long-Duration Spaceflight

    Science.gov (United States)

    Reyes, David; Kerstman, Eric; Locke, James

    2014-01-01

    Introduction: Given the bone loss and increased urinary calcium excretion in the microgravity environment, persons participating in long-duration spaceflight may have an increased risk for renal stone formation. Renal stones are often an incidental finding of abdominal imaging studies done for other reasons. Thus, some crewmembers may have undiscovered, asymptomatic stones prior to their mission. Methods: An extensive literature search was conducted concerning the natural history of asymptomatic renal stones. For comparison, simulations were done using the Integrated Medical Model (IMM). The IMM is an evidence-based decision support tool that provides risk analysis and has the capability to optimize medical systems for missions by minimizing the occurrence of adverse mission outcomes such as evacuation and loss of crew life within specified mass and volume constraints. Results: The literature of the natural history of asymptomatic renal stones in the general medical population shows that the probability of symptomatic event is 8% to 34% at 1 to 3 years for stones renal stones may be one of the top drivers for medical evacuation of an International Space Station (ISS) mission. Discussion: Although the likelihood of a stone event is low, the consequences could be severe due to limitations of current ISS medical capabilities. Therefore, these risks need to be quantified to aid planning, limit crew morbidity and mitigate mission impacts. This will be especially critical for missions beyond earth orbit, where evacuation may not be an option.

  5. Laparoscopic surgery for renal stones: is it indicated in the modern endourology era?

    Directory of Open Access Journals (Sweden)

    Andrei Nadu

    2009-02-01

    Full Text Available Purpose: To report the outcomes of laparoscopic surgery combined with endourological assistance for the treatment of renal stones in patients with associated anomalies of the urinary tract. To discuss the role of laparoscopy in kidney stone disease. Materials and Methods: Thirteen patients with renal stones and concomitant urinary anomalies underwent laparoscopic stone surgery combined with ancillary endourological assistance as needed. Their data were analyzed retrospectively including stone burden, associated malformations, perioperative complications and outcomes. Results: Encountered anomalies included ureteropelvic junction obstruction, horseshoe kidney, ectopic pelvic kidney, fussed-crossed ectopic kidney, and double collecting system. Treatment included laparoscopic pyeloplasty, pyelolithotomy, and nephrolithotomy combined with flexible nephroscopy and stone retrieval. Intraoperative complications were lost stones in the abdomen diagnosed in two patients during follow up. Mean number of stones removed was 12 (range 3 to 214. Stone free status was 77% (10/13 and 100% after one ancillary treatment in the remaining patients. One patient had a postoperative urinary leak managed conservatively. Laparoscopic pyeloplasty was successful in all patients according to clinical and dynamic renal scan parameters. Conclusions: In carefully selected patients, laparoscopic and endourological techniques can be successfully combined in a one procedure solution that deals with complex stone disease and repairs underlying urinary anomalies.

  6. A prospective randomized trial of open surgery versus endourological stone removal in patients of staghorn stones with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Anant Kumar

    2001-01-01

    Conclusion: In view of the better clearance rate and lesser cost of treatment, open surgery still has a place in the management of staghorn stones with chronic renal failure even in a tertiary urological center. However postoperative pain and a larger scar cannot be ignored.

  7. Aggregation of Calcium Phosphate and Oxalate Phases in the Formation of Renal Stones

    OpenAIRE

    2014-01-01

    The majority of human kidney stones are comprised of multiple calcium oxalate monohydrate (COM) crystals encasing a calcium phosphate nucleus. The physiochemical mechanism of nephrolithiasis has not been well determined on the molecular level; this is crucial to the control and prevention of renal stone formation. This work investigates the role of phosphate ions on the formation of calcium oxalate stones; recent work has identified amorphous calcium phosphate (ACP) as a rapidly forming initi...

  8. Percutaneous nephrolithotomy in adult patients with spina bifida, severe spinal deformity and large renal stones.

    Science.gov (United States)

    Alsinnawi, M; Torreggiani, W C; Flynn, R; McDermott, T E D; Grainger, R; Thornhill, J A

    2013-09-01

    To present our experience in patients with spina bifida with severe spinal abnormality undergoing percutaneous nephrolithotomy (PCNL) for large stone burden. A retrospective review identified five spina bifida patients with abnormal spinal curvature who had a PCNL for large kidney stones. The mean age was 28 years. In two patients, stones were on the concave side of the scoliotic spine further limiting percutaneous access. Mean stone burden was 940 mm2. All patients were paraplegic, three patients had symptomatic stone disease. We performed initial percutaneous renal access in radiology department and staged nephrolithotomy in operating room. Tract dilatation was accomplished using Amplatz dilators and a 24 Ch or 26 Ch nephroscope was used. Fragmentation and stone removal were accomplished in all patients using pneumatic and or ultrasound lithotripter and a retrieval grasper. No anaesthetic complications were recorded. One patient required multiple percutaneous tracts, four had single tract to access stones. Three patients were stone free after PCNL. One required second PCNL through the same tract and another patient had multiple adjunctive ESWL. All five patients were stone clear after the final procedure. Two patients required blood transfusion. No patient had major complication or admission to intensive care unit. Percutaneous nephrolithotomy in patients with spina bifida is challenging but safe. Detailed pre-operative anaesthetic assessment and precise uroradiological evaluation of renal anatomy is essential. Second-look PCNL and additional ESWL/URS treatment may be required to completely clear stones.

  9. 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...

  10. Coupled CFD-PBE Predictions of Renal Stone Size Distributions in the Nephron in Microgravity

    Science.gov (United States)

    Kassemi, Mohammad; Griffin, Elise; Thompson, David

    2017-01-01

    In this paper, a deterministic model is developed to assess the risk of critical renal stone formation for astronauts during space travel. A Population Balance Equation (PBE) model is used to compute the size distribution of a population of nucleating, growing and agglomerating renal calculi as they are transported through different sections of the nephron. The PBE model is coupled to a Computational Fluid Dynamics (CFD) model that solves for steady state flow of urine and transport of renal calculi along with the concentrations of ionic species, calcium and oxalate, in the nephron using an Eulerian two-phase mathematical framework. Parametric simulation are performed to study stone size enhancement and steady state volume fraction distributions in the four main sections of the nephron under weightlessness conditions. Contribution of agglomeration to the stone size distribution and effect of wall friction on the stone volume fraction distributions are carefully examined. Case studies using measured astronaut urinary calcium and oxalate concentrations in microgravity as input indicate that under nominal conditions the largest stone sizes developed in Space will be still considerably below the critical range for problematic stone development. However, results also indicate that the highest stone volume fraction occurs next to the tubule and duct walls. This suggests that there is an increased potential for wall adhesion with the possibility of evolution towards critical stone sizes.

  11. Nephrolithiasis: Molecular Mechanism of Renal Stone Formation and the Critical Role Played by Modulators

    Directory of Open Access Journals (Sweden)

    Kanu Priya Aggarwal

    2013-01-01

    Full Text Available Urinary stone disease is an ailment that has afflicted human kind for many centuries. Nephrolithiasis is a significant clinical problem in everyday practice with a subsequent burden for the health system. Nephrolithiasis remains a chronic disease and our fundamental understanding of the pathogenesis of stones as well as their prevention and cure still remains rudimentary. Regardless of the fact that supersaturation of stone-forming salts in urine is essential, abundance of these salts by itself will not always result in stone formation. The pathogenesis of calcium oxalate stone formation is a multistep process and essentially includes nucleation, crystal growth, crystal aggregation, and crystal retention. Various substances in the body have an effect on one or more of the above stone-forming processes, thereby influencing a person’s ability to promote or prevent stone formation. Promoters facilitate the stone formation while inhibitors prevent it. Besides low urine volume and low urine pH, high calcium, sodium, oxalate and urate are also known to promote calcium oxalate stone formation. Many inorganic (citrate, magnesium and organic substances (nephrocalcin, urinary prothrombin fragment-1, osteopontin are known to inhibit stone formation. This review presents a comprehensive account of the mechanism of renal stone formation and the role of inhibitors/promoters in calcium oxalate crystallisation.

  12. Nephrolithiasis: molecular mechanism of renal stone formation and the critical role played by modulators.

    Science.gov (United States)

    Aggarwal, Kanu Priya; Narula, Shifa; Kakkar, Monica; Tandon, Chanderdeep

    2013-01-01

    Urinary stone disease is an ailment that has afflicted human kind for many centuries. Nephrolithiasis is a significant clinical problem in everyday practice with a subsequent burden for the health system. Nephrolithiasis remains a chronic disease and our fundamental understanding of the pathogenesis of stones as well as their prevention and cure still remains rudimentary. Regardless of the fact that supersaturation of stone-forming salts in urine is essential, abundance of these salts by itself will not always result in stone formation. The pathogenesis of calcium oxalate stone formation is a multistep process and essentially includes nucleation, crystal growth, crystal aggregation, and crystal retention. Various substances in the body have an effect on one or more of the above stone-forming processes, thereby influencing a person's ability to promote or prevent stone formation. Promoters facilitate the stone formation while inhibitors prevent it. Besides low urine volume and low urine pH, high calcium, sodium, oxalate and urate are also known to promote calcium oxalate stone formation. Many inorganic (citrate, magnesium) and organic substances (nephrocalcin, urinary prothrombin fragment-1, osteopontin) are known to inhibit stone formation. This review presents a comprehensive account of the mechanism of renal stone formation and the role of inhibitors/promoters in calcium oxalate crystallisation.

  13. Making renal stones change size-impact of CT image post processing and reader variability.

    Science.gov (United States)

    Lidén, Mats; Andersson, Torbjörn; Geijer, Håkan

    2011-10-01

    The objectives of this study were to quantify the impact of image post-processing parameters on the apparent renal stone size, and to quantify the intra- and inter-reader variability in renal stone size estimation. Fifty CT datasets including a renal or ureteral stone were included retrospectively during a prospective inclusion period. Each of the CT datasets was post-processed in different ways regarding slice thickness, slice increment and window setting. In the first part of the study a single reader repeated size estimations for the renal stones using different post-processing parameters. In the intra-reader variability experiment one reader reported size estimations for the same images with a one-week interval. The inter-reader variability data were obtained from 11 readers reporting size estimations for the same renal stones. The apparent stone size differed according to image post-processing parameters with the largest mean differences seen with regard to the window settings experiment (1.5 mm, p reader variability was considerably larger than the intra-reader variability. Our results indicate a need for the standardisation of making measurements on CT images.

  14. Study of renal stones complications in 200 patients in Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Hamid Noshad

    2014-11-01

    Full Text Available Introduction: Urinary stones are the third most common disease of the urinary. Renal stones may lead to some preventable complications. This study was designed to investigation and prediction of these complications. Methods: In this cross-sectional study, 200 patients with kidney stones were enrolled. Kidney stone was confirmed and proven in all patients referred to Sina and Shaikh Al-Rais clinics. Their demographic characteristics like gender, age, stone number, stone type, renal failure and bio-chemistry data were evaluated. Results: Of 200 patients, 130 cases (65.0% were male and 70 cases (35.0% were female. The mean age of patients was 41.30 ± 16.06 years. Type of stone was (when evaluation was possible was mixed (11.5%. However, the type of stone was not analyzed in 112 cases (56.0%. Among complications, recurrent infection was seen (16.0%, and staghorn stones were seen in 2.5% of patients. Dialysis was positive in 3 patients (1.5%. History of surgery was positive in 3 patients (1.5%. Extracorporeal shock wave lithotripsy (ESWL history was positive in 8%. In evaluated patients, the mean level of calcium was 8.83 ± 0.27, phosphorus was 4.60 ± 0.33, parathyroid hormone (PTH was 35.20 ± 14.22, uric acid was 4.98 ± 1.57, creatinine was 1.38 ± 1.02 and blood urea nitrogen level was 16.69 ± 11.54 mg/dl. Staghorn stones are significantly associated with progression to renal failure and subsequent complications such as hemodialysis (P = 0.001, surgery (P = 0.001. Recurrent infection was more frequent in calcium-containing stones (P = 0.001 and ESWL undergoing patients (P = 0.030. Stone numbers were more than 3 in hemodialyzed (HD patients (P = 0.001. Uric acid stones were more seen in HD patients (P = 0.170. Conclusion: According to results hemodialysis and recurrent infections are seen in patients with renal stones, and they may be detected in earlier with close periodic follow-up.

  15. Determination of the chemical composition of human renal stones with MDCT: influence of the surrounding media

    Science.gov (United States)

    Grosjean, Romain; Sauer, Benoît; Guerra, Rui; Kermarrec, Isabelle; Ponvianne, Yannick; Winninger, Daniel; Daudon, Michel; Blum, Alain; Felblinger, Jacques; Hubert, Jacques

    2007-03-01

    The selection of the optimal treatment method for urinary stones diseases depends on the chemical composition of the stone and its corresponding fragility. MDCT has become the most used modality to determine rapidly and accurately the presence of stones when evaluating urinary lithiasis treatment. That is why several studies have tempted to determine the chemical composition of the stones based on the stone X-ray attenuation in-vitro and invivo. However, in-vitro studies did not reproduce the normal abdominal wall and fat, making uncertain the standardization of the obtained values. The aim of this study is to obtain X-ray attenuation values (in Hounsfield Units) of the six more frequent types of human renal stones (n=217) and to analyze the influence of the surrounding media on these values. The stones were first placed in a jelly, which X-ray attenuation is similar to that of the human kidney (30 HU at 120 kV). They were then stuck on a grid, scanned in a water tank and finally scanned in the air. Significant differences in CT-attenuation values were obtained with the three different surrounding media (jelly, water, air). Furthermore there was an influence of the surrounding media and consequently discrepancies in determination of the chemical composition of the renal stones. Consequently, CT-attenuation values found in in-vitro studies cannot really be considered as a reference for the determination of the chemical composition except if the used phantom is an anthropomorphic one.

  16. Changes in renal uptake of Tc-99m methylene diphosphonate (MDP) in stone-forming rats

    Energy Technology Data Exchange (ETDEWEB)

    McAfee, J.G.; Thomas, F.D.; Roskopf, M.; Ritter, K.; Lyons, B.; Lilien, O.M.; Schoonmaker, J.E.

    A pyridoxine (vitamin B6)-deficient diet in rats was used as a model of early renal lithiasis to find out if stone-formers could be identified from control animals by differences in the biodistribution of Tc-99m MDP. The mean renal uptake of this agent at 3 hours was about 70% higher in test animals than in controls, but there was considerable overlap between the upper limits of the normal range and lower values in stone-formers. If these results were valid for humans, the metabolic abnormality in males with early stone-forming disease could not be identified with certainty by in vivo measurements of Tc-99m MDP renal uptake alone. However, the skeletal uptake of MDP in the stone-forming animals was depressed by 28 to 35%, compared with control rats. Consequently, the renal to skeletal MDP concentration ratio was invariably elevated in stone-formers beyond the 95 percentile normal range. Unexpectedly, 76% of the pyridoxine-deficient animals had a higher accumulation of MDP in the myocardium than the upper limit of the normal range. The pyridoxine-deficient diet induced no remarkable early changes in the biodistribution or renal clearance of I-131 Hippuran.

  17. Diagnosis of rare inherited glyoxalate metabolic disorders through in-situ analysis of renal stones

    Science.gov (United States)

    Jacob, D. E.; Grohe, B.; Hoppe, B.; Beck, B. B.; Tessadri, R.

    2012-04-01

    The primary hyperoxalurias type I - III constitute rare autosomal-recessive inherited disorders of the human glyoxylate metabolism. By mechanisms that are ill understood progressive nephrocalcinosis and recurrent urolithiasis (kidney stone formation) often starting in early childhood, along with their secondary complications results in loss of nephron mass which progresses to end-stage renal failure over time. In the most frequent form, end-stage renal failure (ESRF) is the rule and combined liver/kidney transplantation respectively pre-emptive liver transplantation are the only causative treatment today. Hence, this contributes significantly to healthcare costs and early diagnosis is extremely important for a positive outcome for the patient. We are developing a stone-based diagnostic method by in-detail multi-methods investigation of the crystalline moiety in concert with urine and stone proteomics. Stone analysis will allow faster analysis at low-impact for the patients in the early stages of the disease. First results from combined spectroscopic (Raman, FTIR)and geochemical micro-analyses (Electron Microprobe and Laser Ablation ICP-MS) are presented here that show significant differences between stones from hyperoxaluria patients and those formed by patients without this disorder (idiopathic stones). Major differences exist in chemistry as well as in morphology and phase composition of the stones. Ca/P ratios and Mg contents differentiate between oxalate-stones from hyperoxaluria patients and idiopathic stones. Results show that also within the different subtypes of primary hyperoxaluria significant differences can be found in stone composition. These imply differences in stone formation which could be exploited for new therapeutic pathways. Furthermore, the results provide important feedback for suspected but yet unconfirmed cases of primary hyperoxaluria when used in concert with the genetic methods routinely applied.

  18. Retrograde Intrarenal Surgery for Small Renal Calyx Stones

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    Nevzat Sener

    2014-04-01

    Full Text Available Lower pole kidney stones are one of the most common problems is urology practice. For this group of patients, shock wave lithotripsy (SWL and retrograde intrarenal surgery (RIRS are established treatments with low morbidity and high efficacy. SWL has relatively lower success rates for lower pole stones. On the other hand, RIRS has as high as 100% success rates for lower pole stones. With advances in technology and experience we believe RIRS may be the first treatment option over SWL in the following years.

  19. Successful treatment of recurrent renal stones with Cinacalcet in a patient with primary hyperparathyroidism.

    Science.gov (United States)

    Chauhan, Priyesh; Gittoes, Neil J; Geberhiwot, Tarekegn

    2016-08-12

    A man aged 72 years with long-standing primary hyperparathyroidism (HPT), a background of recurrent bilateral renal stones and failed parathyroid surgery is described. During the 27 months preceding treatment, episodes of renal colic became increasingly frequent and he required multiple surgical interventions. Given the lack of medical therapies to definitively treat his symptoms, he was started on a trial of the calcimimetic, Cinacalcet. Cinacalcet has previously been shown to reduce hypercalcaemia in patients with primary HPT. Despite this, there is a paucity of evidence to suggest that its use is associated with a long-term reduction in urinary calcium excretion and renal stone recurrence. In our case, within 4 months of starting treatment, serum and urinary calcium had normalised and parathyroid hormone concentrations were within reference ranges. To date, over a 50-month treatment period, there has been a complete cessation in stone formation, and no further urological intervention has been required.

  20. A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone

    Science.gov (United States)

    Berardinelli, Francesco; Proietti, Silvia; Cindolo, Luca; Pellegrini, Fabrizio; Peschechera, Roberto; Derek, Hennessey; Dalpiaz, Orietta; Schips, Luigi; Giusti, Guido

    2016-01-01

    ABSTRACT Purpose The aim of this study was to describe the outcomes and the complications of retrograde intrarenal surgery (RIRS) for renal stones in a multi-institutional working group. Materials and Methods From 2012 to 2014, we conducted a prospective study including all RIRS performed for kidney stones in 4 European centers. Demographic information, disease characteristics, and perioperative and postoperative data were gathered. Patients and stone data, procedure characteristics, results and safety outcomes were analyzed and compared by descriptive statistics. Complications were reported using the standardized Clavien system. Results Three hundred and fifty-six patients underwent 377 RIRS with holmium laser lithotripsy for renal stones. The RIRS was completed in all patients with a mean operative time of 63.5 min. The stone-free status was confirmed endoscopically and through fluoroscopic imaging after the first procedure in 73.6%. The second procedure was performed in twenty patients (5.6%) achieving an overall stone free rate of 78.9%. The overall complication rate was 15.1%. Intra-operative and post-operative complications were seen in 24 (6.7%) and 30 (8.4%) cases, respectively. Conclusions RIRS is a minimally invasive procedure with good results in terms of stone-free and complications rate. PMID:27286110

  1. Sensory and biomechanical responses to distension of the renal pelvis in kidney stone patients

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Liao, Donghua; Osther, Susanne Sloth

    in order to describe the geometric and mechanical properties of the renal pelvis in patients with kidney stone disease. Pressure measurement in the renal pelvis was done during CT-pyelography in 15 patients who underwent percutaneus nephrolithotomy. The sensory intensity was recorded at the thresholds...... pressure in the renal pelvis corresponded positively to the sensory ratings but the referred pain area was diffuse located and varied in size. The present study provides a method for describing the mechanosensory properties and 3D deformation of the complex renal pelvis geometry. Although...

  2. Distension of the renal pelvis in kidney stone patients: sensory and biomechanical responses

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Liao, Donghua; Osther, Susanne Sloth

    2012-01-01

    in order to describe the geometric and mechanical properties of the renal pelvis in patients with kidney stone disease. Pressure measurement in the renal pelvis was done during CT-pyelography in 15 patients who underwent percutaneus nephrolithotomy. The sensory intensity was recorded at the thresholds...... pressure in the renal pelvis corresponded positively to the sensory ratings but the referred pain area was diffuse located and varied in size. The present study provides a method for describing the mechanosensory properties and 3D deformation of the complex renal pelvis geometry. Although...

  3. Extracorporeal shock wave lithotripsy in the treatment of renal pelvicalyceal stones in morbidly obese patients

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    V. A. Mezentsev

    2005-04-01

    Full Text Available INTRODUCTION: Management of urolithiasis in morbidly obese patients is usually associated with higher morbidity and mortality compared to non-obese patients. In morbidly obese patients, since the kidney and stone are at a considerable distance from the skin (compared to non-obese patients difficulty may be found in positioning the patient so that the stone is situated at the focal point of the lithotripter. OBJECTIVE: To evaluate the outcomes and cost-efficiency of extracorporeal shock wave lithotripsy (ESWL in the treatment of renal pelvicalyceal stones sized between 6 and 20 mm in morbidly obese patients. MATERIALS AND METHODS: Using various aids, such as mobile overtable module, extended shock pathway and abdominal compression 37 patients with body mass index more than 40 kg/m2 were treated using the Siemens Lithostar-plus third generation lithotripter. The size of renal pelvicalyceal stones was between 6 and 20 mm. Treatment costs for shock wave lithotripsy were calculated. RESULTS: The overall stone free rate at 3 months of 73% was achieved. The mean number of treatments per patient was 2.1. The post-lithotripsy secondary procedures rate was 5.4%. No complications, such as subcapsular haematoma or acute pyelonephritis were recorded. The most effective (87% success rate and cost-efficient treatment was in the patients with pelvic stones. The treatment of the patients with low caliceal stones was effective in 60% only. The cost of the treatment of the patients with low calyceal stones was in 1.8 times higher than in the patients with pelvic stones. CONCLUSION: We conclude that ESWL with the Siemens Lithostar-plus is the most effective and cost-efficient in morbidly obese patients with pelvic stones sized between 6 and 20 mm. 87% success rate was achieved. The increased distance from the skin surface to the stone in those patients does not decrease the success rate provided the stone is positioned in the focal point or within 3 cm of it on the

  4. Delayed Migration of Embolized Coil with Large Renal Stone Formation: A Rare Presentation

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    Santosh Kumar

    2014-01-01

    Full Text Available Delayed bleeding following percutaneous nephrolithotomy (PCNL usually occurs due to development of the pseudoaneurysm which can be successfully managed with coil embolization. However very few cases of such complications have been reported in the literature. Here we are reporting a case of delayed post-PCNL bleeding that occurred in a 53-year-old diabetic patient operated on for renal stone. Computed tomography scan revealed a presence of the pseudoaneurysm in the segmental branch of right renal artery, which was successfully managed with coiling. Patient remained asymptomatic for the next 9 years after which he again presented with similar complaints. X-ray KUB was done which revealed a 2.7 cms renal pelvic calculus with the migrated coil in its center and a left upper ureteric calculus. His routine haemogram, coagulogram, serum electrolytes, and liver function tests, renal function tests, vitamin D3, and PTH (parathyroid hormone were within normal limits. He underwent left laparoscopic ureterolithotomy and right percutaneous nephrolithotomy (PCNL. Intraoperatively the migrated stainless steel embolization coil was seen engulfed all around by the multiple stones in the right renal pelvis. Postoperative period was uneventful. Later he was followed in the outpatient department and was doing well. To conclude, this is the only case report of development of a large calculus around a migrated embolization coil which was successfully managed with PCNL. PCNL offers better stone clearance in cases of stones being formed over foreign bodies like fragmented double J stents, fragmented nephrostomies, or migrated embolization coil.

  5. Use of Potassium Citrate to Reduce the Risk of Renal Stone Formation During Spaceflight

    Science.gov (United States)

    Whitson, P. A.; Pietrzyk, R. A.; Sams, C. F.; Jones, J. A.; Nelman-Gonzalez, M.; Hudson, E. K.

    2008-01-01

    Introduction: NASA s Vision for Space Exploration centers on exploration class missions including the goals of returning to the moon and landing on Mars. One of NASA s objectives is to focus research on astronaut health and the development of countermeasures that will protect crewmembers during long duration voyages. Exposure to microgravity affects human physiology and results in changes in the urinary chemical composition favoring urinary supersaturation and an increased risk of stone formation. Nephrolithiasis is a multifactorial disease and development of a renal stone is significantly influenced by both dietary and environmental factors. Previous results from long duration Mir and short duration Shuttle missions have shown decreased urine volume, pH, and citrate levels and increased calcium. Citrate, an important inhibitor of calcium-containing stones, binds with urinary calcium reducing the amount of calcium available to form stones. Citrate inhibits renal stone recurrence by preventing crystal growth, aggregation, and nucleation and is one of the most common therapeutic agents used to prevent stone formation. Methods: Thirty long duration crewmembers (29 male, 1 female) participated in this study. 24-hour urines were collected and dietary monitoring was performed pre, in, and postflight. Crewmembers in the treatment group received two potassium citrate (KCIT) pills, 10 mEq/pill, ingested daily beginning 3 days before launch, all inflight days and through 14 days postflight. Urinary biochemical and dietary analyses were completed. Results: KCIT treated subjects exhibited decreased urinary calcium excretion and maintained the levels of calcium oxalate supersaturation risk at their preflight levels. The increased urinary pH levels in these subjects reduced the risk of uric acid stones. Discussion: The current study investigated the use of potassium citrate as a countermeasure to minimize the risk of stone formation during ISS missions. Results suggest that

  6. Increased oxidative DNA damage seen in renal biopsies adjacent stones in patients with nephrolithiasis.

    Science.gov (United States)

    Kittikowit, Wipawee; Waiwijit, Uraiwan; Boonla, Chanchai; Ruangvejvorachai, Preecha; Pimratana, Chaowat; Predanon, Chagkrapan; Ratchanon, Supoj; Tosukhowong, Piyaratana

    2014-10-01

    Urinary excretion of 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative DNA damage, is significantly higher in nephrolithiasis patients than in healthy individuals, indicating that these patients have higher degree of oxidative stress. In the present study, we investigated 8-OHdG expression in renal biopsies of patients with nephrolithiasis and in renal tubular cells (HK-2 cells) exposed to calcium oxalate monohydrate (COM). We performed immunohistochemical staining for 8-OHdG in renal biopsies adjacent stones obtained from 28 patients with nephrolithiasis. Controls were noncancerous renal tissues from nephrectomies of patients with renal cancer. 8-OHdG was overexpressed in the nucleus of renal tubular cells in patients with nephrolithiasis compared with controls. Only one nephrolithiasis biopsy was negative for 8-OHdG, whereas in 19 cases 8-OHdG was highly expressed. The level of expression of 8-OHdG among patients with calcium oxalate (mostly mixed with calcium phosphate) and uric acid stones was not significantly different. Increased leukocyte infiltration was observed in renal tissues from patients with nephrolithiasis. Exposure of HK-2 cells to COM caused increased intracellular reactive oxygen species and nuclear expression of 8-OHdG. To our knowledge, this is the first report of increased 8-OHdG expression in renal tubular cells of patients with nephrolithiasis. In vitro, COM crystals were capable of inducing oxidative damage of DNA in the proximal renal tubular cells.

  7. Hyaluronan Biology and Regulation in Renal Tubular Epithelial Cells and its Role in Kidney Stone Disease

    NARCIS (Netherlands)

    M. Asselman (Marino)

    2008-01-01

    textabstractRenal stone disease is a widespread problem afflicting more and more people throughout the world. Epidemiological studies show an increase in incidence and prevalence rates. In North America and Europe the yearly incidence is estimated to be about 0.5% 1, 2. The prevalence of kidney ston

  8. Hyaluronan Biology and Regulation in Renal Tubular Epithelial Cells and its Role in Kidney Stone Disease

    NARCIS (Netherlands)

    M. Asselman (Marino)

    2008-01-01

    textabstractRenal stone disease is a widespread problem afflicting more and more people throughout the world. Epidemiological studies show an increase in incidence and prevalence rates. In North America and Europe the yearly incidence is estimated to be about 0.5% 1, 2. The prevalence of kidney ston

  9. Renal Transplantation Using Stone-bearing Deceased Donor Kidneys-Experience of a Transplant Center in China.

    Science.gov (United States)

    Chen, Chuan-Bao; Zhao, Liang; Han, Ming; Wang, Xiao-Ping; Zhou, Jian; Yuan, Xiao-Peng; Wang, Chang-Xi

    2017-09-01

    To evaluate the outcomes of transplantation of deceased donor stone-bearing kidneys. A total of 32 patients who received renal transplantation at our center from July 2011 to June 2016 were included. Eight recipients received kidneys with incidental renal stone(s) (stone group). Twenty-four recipients received kidneys without renal stones (non-stone group). The transplantation outcomes of the 2 groups were compared. There was 1 case of postoperative urinary tract infection in the stone group, and 2 cases in the non-stone group. No ureteral obstruction or hydronephrosis occurred in either group. No significant difference was found in the incidence of complications, serum creatinine level, and estimated glomerular filtration rate between the groups (all, P >.05). No deaths occurred in either group during the follow-up period. One recipient had postoperative calculi recurrence, and 4 recipients had residual calculi before transplantation. However, these patients had no symptomatic nephrolithiasis or obstruction, and their renal functions were normal. Transplantation of deceased donor stone-bearing kidneys can achieve comparable outcomes of deceased donor non-stone-bearing kidneys. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Metabolic evaluation in first-time renal stone formers in north India: A single center study

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    Akhil Joshi

    2013-01-01

    Full Text Available The risk of stone recurrence in first-time stone formers (FTSF varies from 26% to 53%. There is no consensus regarding metabolic evaluation in these individuals. We evaluated the metabolic abnormalities in first-time renal stone forming patients in North India. Thirty-nine patients, (29 males and 10 females with mean age 39.3 ± 12.9 years who presented with nephrolithiasis for the first time were evaluated. We evaluated the calcium homeostasis [serum corrected total calcium, phosphorous, creatinine, alkaline phosphatase, albumin, parathormone (iPTH, 25-hydroxy cholecalciferol (25(OHD 3 , 1-25 di-hydroxy cholecalciferol (1,25(OH 2 D 3 ] and performed the calcium load test also. Two 24-h urine collections were taken for citrate, oxalate, calcium and uric acid. Ammonium chloride loading test for diagnosis of distal renal tubular acidosis was performed in all patients. For each of the diagnostic categories, descriptive statistics were computed for all biochemical variables. A two-tailed P-value <0.05 was regarded as significant. Metabolic abnormalities were detected in 92.3% of the patients (n = 39 studied. Of them, almost 60% had two or more metabolic abnormalities. The most common metabolic abnormality was hypo-citraturia (82%, followed by hyper-oxaluria (56% and hyper-calciuria (41%. Five percent of the patients had incomplete renal tubular acidosis, signifying the importance of the ammonium chloride loading test in patients with renal stones. None of the study patients were detected to have primary hyperparathyroidism. In three patients, the etiology could not be detected. Our findings suggest that an underlying disorder is present in majority of first-time renal stone formers. Intervention with appropriate treatment can prevent recurrences. Hence, comprehensive metabolic evaluation is recommended in all FTSF.

  11. Bone metabolism and renal stone risk during International Space Station missions.

    Science.gov (United States)

    Smith, Scott M; Heer, Martina; Shackelford, Linda C; Sibonga, Jean D; Spatz, Jordan; Pietrzyk, Robert A; Hudson, Edgar K; Zwart, Sara R

    2015-12-01

    Bone loss and renal stone risk are longstanding concerns for astronauts. Bone resorption brought on by spaceflight elevates urinary calcium and the risk of renal stone formation. Loss of bone calcium leads to concerns about fracture risk and increased long-term risk of osteoporosis. Bone metabolism involves many factors and is interconnected with muscle metabolism and diet. We report here bone biochemistry and renal stone risk data from astronauts on 4- to 6-month International Space Station missions. All had access to a type of resistive exercise countermeasure hardware, either the Advanced Resistance Exercise Device (ARED) or the Interim Resistance Exercise Device (iRED). A subset of the ARED group also tested the bisphosphonate alendronate as a potential anti-resorptive countermeasure (Bis+ARED). While some of the basic bone marker data have been published, we provide here a more comprehensive evaluation of bone biochemistry with a larger group of astronauts. Regardless of exercise, the risk of renal stone formation increased during spaceflight. A key factor in this increase was urine volume, which was lower during flight in all groups at all time points. Thus, the easiest way to mitigate renal stone risk is to increase fluid consumption. ARED use increased bone formation without changing bone resorption, and mitigated a drop in parathyroid hormone in iRED astronauts. Sclerostin, an osteocyte-derived negative regulator of bone formation, increased 10-15% in both groups of astronauts who used the ARED (p<0.06). IGF-1, which regulates bone growth and formation, increased during flight in all 3 groups (p<0.001). Our results are consistent with the growing body of literature showing that the hyper-resorptive state of bone that is brought on by spaceflight can be countered pharmacologically or mitigated through an exercise-induced increase in bone formation, with nutritional support. Key questions remain about the effect of exercise-induced alterations in bone

  12. Treatment of renal stones with flexible ureteroscopy in preschool age children.

    Science.gov (United States)

    Erkurt, Bulent; Caskurlu, Turhan; Atis, Gokhan; Gurbuz, Cenk; Arikan, Ozgur; Pelit, Eyup Sabri; Altay, Bulent; Erdogan, Firat; Yildirim, Asif

    2014-06-01

    The aim of the study is to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) to treat renal stones in preschool age (4 mm, a second-stage RIRS was performed. The pre-operative, operative and post-operative data of the patients were retrospectively analyzed. A total of 65 patients with a mean age of 4.31 ± 1.99 years (6 months-7 years) were included in the present study. The mean stone size was 14.66 ± 6.12 mm (7-30 mm). The mean operative time was 46.47 ± 18.27 min. In 5 (7.69%) patients, the initial procedure failed to reach the renal collecting system and ended with the insertion of a pigtail stent. The stone-free rates were 83.07 and 92.3% after the first and second procedures, respectively. Complications were observed in 18 (27.7%) patients and classified according to the Clavien system. Post-operative hematuria (Clavien I) occurred in 6 (9.2%) patients, post-operative urinary tract infection with fever (Clavien II) was observed in 10 (15.4%) patients, and ureteral wall injury (Clavien III) was noted in 2 (3%) patients. RIRS is an effective and safe procedure that can be used to manage renal stones in preschool age children.

  13. The preventive effect of sodium pentosan polysulfate against renal stone formation in hyperoxaluric rats.

    Science.gov (United States)

    Nakatani, Tatsuya; Ishii, Keiichi; Yoneda, Yukio; Kamikawa, Sadanori; Kanazawa, Toshinao; Sugimoto, Toshikado; Osswald, Hartmut

    2002-10-01

    Sodium pentosan polysulfate (SPP), a semi-synthetic glycosaminoglycan, was administered to rats with hyperoxaluria, induced by a vitamin B6 deficient diet, as a model of calcium oxalate stone formation. We studied the preventive effects of SPP on stone formation as well as its inhibitory effects on stone growth by autoradiography and radioluminography after intravenous injection of (14)C-oxalate. The rats were divided into non-treated and SPP-treated groups. The non-treated rats were divided into three groups: one group was fed a regular diet, while the other two groups were fed a vitamin B6 deficient diet for 2 and 4 weeks, respectively. The SPP-treated rats were divided into two groups: one group was intravenously injected with SPP from the start of the vitamin B6 deficient diet for a total of 4 weeks and the other group was injected with the same amount of SPP after 2 weeks of the diet for 2 weeks. (14)C-oxalate renal macroautoradiograms were prepared, and calcium oxalate deposits in the renal tissues were compared between the non-treated and SPP-treated groups. The preventive effects on calcium oxalate stone formation were clearly observed in the group injected with SPP for 4 weeks. Even in the other SPP-treated group, in which the administration of SPP was started at 2 weeks after the start of the diet when calcium oxalate stone formation was already observed, the size of the calcium oxalate deposits observed after 4 weeks was smaller than that in the non-treated group fed a vitamin B6 deficient diet for 4 weeks. In conclusion, our results show that SPP has not only preventive effects on calcium oxalate stone formation but also growth inhibitory effects on stones in hyperoxaluric rats.

  14. A pica case confused with renal and bladder stones.

    Science.gov (United States)

    Gulum, Mehmet; Yeni, Ercan; Savas, Murat; Sahin, Mehmet Akif; Kati, Mahmut

    2012-12-01

    Pica is considered as an eating-nutritional disorder in childhood and is generally analysed within obsessive-compulsive disorders. A 15-year-old female patient was admitted to the urology clinic with nausea, vomiting, and stomach-ache. A 23 x 23 mm opacity was identified in left T-11-12 level in direct urinary graph. Full abdomen ultrasonography was reported to be normal. Later, it was learned that the patient had the habit of eating stone. The patient was diagnosed with obsessive-compulsive disorder following psychiatric consultation, and appropriate treatment was given.

  15. A Comparative Study on Several Models of Experimental Renal Calcium Oxalate Stones Formation in Rats

    Institute of Scientific and Technical Information of China (English)

    LIU Jihong; CAO Zhenggno; ZHANG Zhaohui; ZHOU Siwei; YE Zhangqun

    2007-01-01

    In order to compare the effects of several experimental renal calcium oxalate stones formation models in rats and to find a simple and convenient model with significant effect of calcium oxalate crystals deposition in the kidney, several rat models of renal calcium oxalate stones formation were induced by some crystal-inducing drugs (CID) including ethylene glycol (EG), ammonium chloride (AC), vitamin D3 [1α(OH)VitD3, alfacalcidol], calcium gluconate, ammonium oxalate, gentamicin sulfate, L-hydroxyproline. The rats were fed with drugs given singly or unitedly. At the end of experiment, 24-h urines were collected and the serum creatinine (Cr), blood urea nitrogen (BUN), the extents of calcium oxalate crystal deposition in the renal tissue, urinary calcium and oxalate excretion were measured. The serum Cr levels in the stone-forming groups were significantly higher than those in the control group except for the group EG+L-hydroxyproline, group calcium gluconate and group oxalate. Blood BUN concentration was significantly higher in rats fed with CID than that in control group except for group EG+L-hydroxyproline and group ammonium oxalate plus calcium gluconate. In the group of rats administered with EG plus Vitamin D3, the deposition of calcium oxalate crystal in the renal tissue and urinary calcium excretion were significantly greater than other model groups. The effect of the model induced by EG plus AC was similar to that in the group induced by EG plus Vitamin D3. EG plus Vitamin D3 or EG plus AC could stably and significantly induced the rat model of renal calcium oxalate stones formation.

  16. Usefulness of measuring renal papillae in Hounsfield units in stone - forming patients

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    Miguel Angel Arrabal-Polo

    Full Text Available ABSTRACT Introduction: The aim of this work is to study the density of the renal papillae in stone-forming patients and to determine its usefulness. Materials and Methods: This study included a total of 79 patients diagnosed with renal stones and on whom a computed tomography without contrast was performed from June 2014 to May 2015. The patients were divided into two groups: Group 1 (single episode included 43 patients, and Group 2 (recurrent episodes included 36 patients. The density of six renal papillae (3 per kidney was measured, and the means obtained were compared between Groups 1 and 2. Statistical analysis was performed using SPSS 20.0. Results: The mean papillary density in Group 1 was 32.26 (SD 4.07 HU compared to 42.36 (SD 8.03 HU in Group 2 (P=00001. A ROC curve was constructed, obtaining an optimal cut-off point of 36.8HU [area under the curve, 0.881 (95% CI; 0.804-0.958; P=0001], with a sensitivity of 80% and a specificity of 90%. The relative risk was estimated at 40.3 (95% CI; 10.8-151.1, meaning that a patient with a mean papillary density greater than 36.8HU would have a 40 times greater risk of having recurrent renal stones. The positive predictive value (PPV was 81% and the negative predictive value (NPV was 90%. Conclusion: The measurement of renal papillary density could be useful in predicting recurrent stone-formers. These results need to be confirmed in future studies with a greater number of patients and a longer follow-up.

  17. Usefulness of measuring renal papillae in Hounsfield units in stone - forming patients

    Science.gov (United States)

    Arrabal-Polo, Miguel Angel; Cano-Garcia, Maria del Carmen; Huerta-Brunel, Juan Esteban; Hidalgo-Agullo, Guillermo; Roletto-Salmo, Luis; Arrabal-Martín, Miguel

    2016-01-01

    ABSTRACT Introduction: The aim of this work is to study the density of the renal papillae in stone-forming patients and to determine its usefulness. Materials and Methods: This study included a total of 79 patients diagnosed with renal stones and on whom a computed tomography without contrast was performed from June 2014 to May 2015. The patients were divided into two groups: Group 1 (single episode) included 43 patients, and Group 2 (recurrent episodes) included 36 patients. The density of six renal papillae (3 per kidney) was measured, and the means obtained were compared between Groups 1 and 2. Statistical analysis was performed using SPSS 20.0. Results: The mean papillary density in Group 1 was 32.26 (SD 4.07) HU compared to 42.36 (SD 8.03) HU in Group 2 (P=00001). A ROC curve was constructed, obtaining an optimal cut-off point of 36.8HU [area under the curve, 0.881 (95% CI; 0.804-0.958); P=0001], with a sensitivity of 80% and a specificity of 90%. The relative risk was estimated at 40.3 (95% CI; 10.8-151.1), meaning that a patient with a mean papillary density greater than 36.8HU would have a 40 times greater risk of having recurrent renal stones. The positive predictive value (PPV) was 81% and the negative predictive value (NPV) was 90%. Conclusion: The measurement of renal papillary density could be useful in predicting recurrent stone-formers. These results need to be confirmed in future studies with a greater number of patients and a longer follow-up. PMID:27622277

  18. Blood purification therapy in treatment of acute renal failure in infants with melamine-induced stones

    Institute of Scientific and Technical Information of China (English)

    SHEN Ying; LIU Xiao-rong; ZHANG Gui-ju; ZHOU Nan

    2009-01-01

    Background In 2008, infants in some areas of China suffered from stones of the urinary system which were caused by melamine-contaminated milk formula. Most of the infants were asymptomatic, and a few suffered from acute renal failure induced by urinary obstruction by stones. This study aimed to assess the significance of blood purification therapy in treatment of infants with acute obstructive oligo-anuric renal failure. Corrective perception, timely diagnosis, and active treatment of this complex disease are critical factors that guarantee a quick recovery of renal function of infants and help them to prevent multiple organ system failure.Methods Thirteen infants with acute renal failure induced by urinary multiple obstruction caused by melamine-containing stones who had been admitted to Beijing Children's Hospital Affiliated to Capital Medical University in 2008 were investigated for the epidemiological characteristics, image features and indications of dialysis. All these infants were treated with dialysis. The efficacy of dialysis was compared with that of two control groups treated with cystoscopic retrograde catheterization into the ureter and medical treatment for the recovery of renal function.Results The 13 infants with life-threatening complications treated with dialysis showed a blood urea nitrogen (BUN) level of (30.9±7.9) mmol/L and a creatinine (Cr) level of (572+173) pmol/L. Of these infants, 8 were treated with peritoneal dialysis (PD), and 5 with hemodialysis (HD). Ten infants recovered to urinate 24-72 hours after dialysis and 3 infants with persistent ureteral obstruction were further treated with cystoscopic retrograde catheterization into the ureter for drainage, and urination resumed soon after the operation. The average time of PD and HD were (2.1±0.8) days and (1.2±0.4) days, respectively. The total average time of PD and HD dialysis was (1.77±0.83) days. The recovery time of renal function of infants after dialysis was (3.08±1.20) days

  19. Effect of potential renal acid load of foods on urinary citrate excretion in calcium renal stone formers.

    Science.gov (United States)

    Trinchieri, Alberto; Lizzano, Renata; Marchesotti, Federica; Zanetti, Giampaolo

    2006-02-01

    The aim of this study was to investigate the influence of the potential renal acid load (PRAL) of the diet on the urinary risk factors for renal stone formation. The present series comprises 187 consecutive renal calcium stone patients (114 males, 73 females) who were studied in our stone clinic. Each patient was subjected to an investigation including a 24-h dietary record and 24-h urine sample taken over the same period. Nutrients and calories were calculated by means of food composition tables using a computerized procedure. Daily PRAL was calculated considering the mineral and protein composition of foods, the mean intestinal absorption rate for each nutrient and the metabolism of sulfur-containing amino acids. Sodium, potassium, calcium, magnesium, phosphate, oxalate, urate, citrate, and creatinine levels were measured in the urine. The mean daily PRAL was higher in male than in female patients (24.1+/-24.0 vs 16.1+/-20.1 mEq/day, P=0.000). A significantly (P=0.01) negative correlation (R=-0.18) was found between daily PRAL and daily urinary citrate, but no correlation between PRAL and urinary calcium, oxalate, and urate was shown. Daily urinary calcium (R=0.186, P=0.011) and uric acid (R=0.157, P=0.033) were significantly related to the dietary intake of protein. Daily urinary citrate was significantly related to the intakes of copper (R=0.178, P=0.015), riboflavin (R=0.20, P=0.006), piridoxine (R=0.169, P=0.021) and biotin (R=0.196, P=0.007). The regression analysis by stepwise selection confirmed the significant negative correlation between PRAL and urinary citrate (P=0.002) and the significant positive correlation between riboflavin and urinary citrate (P=0.000). Urinary citrate excretion of renal stone formers (RSFs) is highly dependent from dietary acid load. The computation of the renal acid load is advisable to investigate the role of diet in the pathogenesis of calcium stone disease and it is also a useful tool to evaluate the lithogenic potential of

  20. Retroperitoneal laparoscopic pyelolithotomy versus extra corporeal shock-wave lithotripsy for management of renal stones

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    Chander Jagdish

    2010-01-01

    Full Text Available Aim: The purpose of this study was to evaluate the role of retroperitoneal laparoscopic pyelolithotomy (RPPL and its comparison with extra corporeal shock wave lithotripsy in the management of renal calculi. Materials and Methods: The study was carried out in the Department of surgery, Maulana Azad Medical College, New Delhi, India. The study included 86 cases of solitary renal calculi in the retroperitoneoscopic (RPPL group and 82 cases in the shock wave lithotripsy (SWL group. The parameters compared were stone clearance, hospital stay, number of postoperative visits, mean time to resume normal activities, number of man days lost, and analgesic requirement. Results : The RPPL group showed better stone clearance, fewer hospital visits, low analgesic requirement, fewer number of man days lost, and early resumption of normal activities, as compared to the SWL group. Conclusions : Shock wave lithotripsy, being a noninvasive modality, is an established procedure all over the world. However RPPL achieves comparable or better results in high volume centers.

  1. Renal acidification defects in patients with their first renal stone episode

    DEFF Research Database (Denmark)

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

    1988-01-01

    tubular acidosis, the rest had normal urinary acidification. In view of the short duration of stone disease in the patients studied, the acidification defects were considered to be primary, and the stone formation secondary. The results justify extension of these simple screening procedures for unmasking...

  2. The role of imaging in the diagnosis and management of renal stone disease in pregnancy.

    Science.gov (United States)

    Masselli, G; Weston, M; Spencer, J

    2015-12-01

    The distinction of pain in pregnancy due to urolithiasis from that related to physiological dilation of the renal tract is a common conundrum as renal colic is one of the commonest causes for non-obstetric pain in pregnancy. Ultrasound is the first-line imaging test but although it may demonstrate renal dilation, it may not show the cause. Magnetic resonance imaging (MRI) is able to make the distinction. Physiological dilation will show smooth tapering of the ureter in the middle third as it is compressed between the gravid uterus and the retroperitoneum. Obstruction due to calculi causes renal enlargement and perinephric oedema. When a stone is lodged in the lower ureter, a standing column of dilated ureter will be seen below the physiological constriction. The stone itself may be shown. Computed tomography (CT) is an acceptable alternative if there is a contraindication to MRI, but even low-dose regimes involve some ionising radiation. This paper serves to highlight the role of MRI compared to US and CT in the imaging of renal colic in pregnancy. Multidisciplinary collaboration between obstetricians, urologists, and radiologists is required for effective management.

  3. Proficiency of virtual reality simulator training in flexible retrograde ureteroscopy renal stone management

    Institute of Scientific and Technical Information of China (English)

    CAI Jian-liang; ZHANG Yi; SUN Guo-feng; LI Ning-chen; YUAN Xue-li; NA Yan-qun

    2013-01-01

    Background Minimally invasive flexible ureteroscopy techniques have widely adopted in the management of patients with renal stones.We performed this study to investigate the value of virtual reality simulator training in retrograde flexible ureteroscopy renal stone treatment for catechumen.Methods Thirty catechumen,included 17 attending physicians and 13 associate chief physicians,were selected for study.The trainees first underwent 1-hour basic training to get familiar with the instrument and basic procedures,then followed by 4-hour practice on virtual reality simulators.Before and after the 4-hour training,all trainees undertake an assessment with task 7 program (right low pole calyces stone management).We documented for each trainee the total time of procedure,time of progressing from the orifice to stone,stone translocation and fragmentation time,laser operate proficiency scale,total laser energy,maximal size of residual stone fragments,number of trauma from the scopes and tools,damage to the scope and global rating scale (GRS).The proficiency of this training program was analyzed by the comparison of the first and second assessment outcomes.Results Significant improvement was observed in retrograde flexible ureteroscopy management of renal stone on virtual reality simulators after finishing the 4 hour special-purpose training.This was demonstrated by improvement in total procedure time ((18.37±2.59) minutes vs.(38.67±1.94) minutes),progressing time from the orifice to stone ((4.00±1.08) minutes vs.(13.80±2.01) minutes),time of stone translocation ((1.80±0.71) minutes vs.(6.57±1.01) minutes),fragmentation time ((4.43±1.25) minutes vs.(13.53±1.46) minutes),laser operate proficiency scale (8.47±0.73 vs.3.77±0.77),total laser energy ((3231.6±401.4) W vs.(5329.8±448.9) W),maximal size of residual stone fragments ((2.66±0.39) mm vs.(5.77±0.63) mm),number of trauma from the scopes and tools (3.27±1.01 vs.10.37±3.02),damage to the scope (0 vs.0.97±0

  4. Renal histopathology and crystal deposits in patients with small bowel resection and calcium oxalate stone disease.

    Science.gov (United States)

    Evan, Andrew P; Lingeman, James E; Worcester, Elaine M; Bledsoe, Sharon B; Sommer, Andre J; Williams, James C; Krambeck, Amy E; Philips, Carrie L; Coe, Fredric L

    2010-08-01

    We present here the anatomy and histopathology of kidneys from 11 patients with renal stones following small bowel resection, including 10 with Crohn's disease and 1 resection in infancy for unknown cause. They presented predominantly with calcium oxalate stones. Risks of formation included hyperoxaluria (urine oxalate excretion greater than 45 mg per day) in half of the cases, and acidic urine of reduced volume. As was found with ileostomy and obesity bypass, inner medullary collecting ducts (IMCDs) contained crystal deposits associated with cell injury, interstitial inflammation, and papillary deformity. Cortical changes included modest glomerular sclerosis, tubular atrophy, and interstitial fibrosis. Randall's plaque (interstitial papillary apatite) was abundant, with calcium oxalate stone overgrowth similar to that seen in ileostomy, idiopathic calcium oxalate stone formers, and primary hyperparathyroidism. Abundant plaque was compatible with the low urine volume and pH. The IMCD deposits all contained apatite, with calcium oxalate present in three cases, similar to findings in patients with obesity bypass but not an ileostomy. The mechanisms for calcium oxalate stone formation in IMCDs include elevated urine and presumably tubule fluid calcium oxalate supersaturation, but a low calcium to oxalate ratio. However, the mechanisms for the presence of IMCD apatite remain unknown.

  5. Renal stone characterization using high resolution imaging mode on a photon counting detector CT system

    Science.gov (United States)

    Ferrero, A.; Gutjahr, R.; Henning, A.; Kappler, S.; Halaweish, A.; Abdurakhimova, D.; Peterson, Z.; Montoya, J.; Leng, S.; McCollough, C.

    2017-03-01

    In addition to the standard-resolution (SR) acquisition mode, a high-resolution (HR) mode is available on a research photon-counting-detector (PCD) whole-body CT system. In the HR mode each detector consists of a 2x2 array of 0.225 mm x 0.225 mm subpixel elements. This is in contrast to the SR mode that consists of a 4x4 array of the same subelements, and results in 0.25 mm isotropic resolution at iso-center for the HR mode. In this study, we quantified ex vivo the capabilities of the HR mode to characterize renal stones in terms of morphology and mineral composition. Forty pure stones - 10 uric acid (UA), 10 cystine (CYS), 10 calcium oxalate monohydrate (COM) and 10 apatite (APA) - and 14 mixed stones were placed in a 20 cm water phantom and scanned in HR mode, at radiation dose matched to that of routine dual-energy stone exams. Data from micro CT provided a reference for the quantification of morphology and mineral composition of the mixed stones. The area under the ROC curve was 1.0 for discriminating UA from CYS, 0.89 for CYS vs COM and 0.84 for COM vs APA. The root mean square error (RMSE) of the percent UA in mixed stones was 11.0% with a medium-sharp kernel and 15.6% with the sharpest kernel. The HR showed qualitatively accurate characterization of stone morphology relative to micro CT.

  6. Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group.

    Science.gov (United States)

    Prezioso, Domenico; Strazzullo, Pasquale; Lotti, Tullio; Bianchi, Giampaolo; Borghi, Loris; Caione, Paolo; Carini, Marco; Caudarella, Renata; Ferraro, Manuel; Gambaro, Giovanni; Gelosa, Marco; Guttilla, Andrea; Illiano, Ester; Martino, Marangella; Meschi, Tiziana; Messa, Piergiorgio; Miano, Roberto; Napodano, Giorgio; Nouvenne, Antonio; Rendina, Domenico; Rocco, Francesco; Rosa, Marco; Sanseverino, Roberto; Salerno, Annamaria; Spatafora, Sebastiano; Tasca, Andrea; Ticinesi, Andrea; Travaglini, Fabrizio; Trinchieri, Alberto; Vespasiani, Giuseppe; Zattoni, Filiberto

    2015-07-07

    stone risk profile is uncertain. Sports beverage do not affect the urinary stone risk profile. HYPEROXALURIA: A diet low in oxalate and/or a calcium intake normal to high (800-1200 mg/day for adults) reduce the urinary excretion of oxalate, conversely a diet rich in oxalates and/or a diet low in calcium increase urinary oxalate. A restriction in protein intake may reduce the urinary excretion of oxalate although a vegetarian diet may lead to an increase in urinary oxalate. Adding bran to a diet low in oxalate cancels its effect of reducing urinary oxalate. Conversely, the addition of supplements of fruit and vegetables to a mixed diet does not involve an increased excretion of oxalate in the urine. The intake of pyridoxine reduces the excretion of oxalate. HYPERURICOSURIA: In patients with renal calcium stones the decrease of the urinary excretion of uric acid after restriction of dietary protein and purine is suggested although not clearly demonstrated. HYPOCITRATURIA: The administration of alkaline-citrates salts is recommended for the medical treatment of renal stone-formers with hypocitraturia, although compliance to this treatment is limited by gastrointestinal side effects and costs. Increased intake of fruit and vegetables (excluding those with high oxalate content) increases citrate excretion and involves a significant protection against the risk of stone formation. Citrus (lemons, oranges, grapefruit, and lime) and non citrus fruits (melon) are natural sources of dietary citrate, and several studies have shown the potential of these fruits and/or their juices in raising urine citrate levels. There are enought basis to advice an adequate fluid intake also in children. Moderate dietary salt restriction and implementation of potassium intake are useful in limiting urinary calcium excretion whereas dietary calcium restriction is not recommended for children with nephrolithiasis. It seems reasonable to advice a balanced consumption of fruit and vegetables and a low

  7. Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group

    Directory of Open Access Journals (Sweden)

    Domenico Prezioso

    2015-07-01

    different origin decreases calciuria, but their impact on the urinary stone risk profile is uncertain. Sports beverage do not affect the urinary stone risk profile. Hyperoxaluria: A diet low in oxalate and/or a calcium intake normal to high (800-1200 mg/day for adults reduce the urinary excretion of oxalate, conversely a diet rich in oxalates and/or a diet low in calcium increase urinary oxalate. A restriction in protein intake may reduce the urinary excretion of oxalate although a vegetarian diet may lead to an increase in urinary oxalate. Adding bran to a diet low in oxalate cancels its effect of reducing urinary oxalate. Conversely, the addition of supplements of fruit and vegetables to a mixed diet does not involve an increased excretion of oxalate in the urine. The intake of pyridoxine reduces the excretion of oxalate. Hyperuricosuria: In patients with renal calcium stones the decrease of the urinary excretion of uric acid after restriction of dietary protein and purine is suggested although not clearly demonstrated. Hypocitraturia: The administration of alkaline-citrates salts is recommended for the medical treatment of renal stone-formers with hypocitraturia, although compliance to this treatment is limited by gastrointestinal side effects and costs. Increased intake of fruit and vegetables (excluding those with high oxalate content increases citrate excretion and involves a significant protection against the risk of stone formation. Citrus (lemons, oranges, grapefruit, and lime and non citrus fruits (melon are natural sources of dietary citrate, and several studies have shown the potential of these fruits and/or their juices in raising urine citrate levels. Children: There are enought basis to advice an adequate fluid intake also in children. Moderate dietary salt restriction and implementation of potassium intake are useful in limiting urinary calcium excretion whereas dietary calcium restriction is not recommended for children with nephrolithiasis. It seems

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

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    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

  9. Retroperitoneoscopic pyelolithotomy: A minimally invasive alternative for the management of large renal pelvic stone

    Directory of Open Access Journals (Sweden)

    Saurabh Sudhir Chipde

    2014-01-01

    Full Text Available Introduction: Large stones in renal pelvis can be treated with percutaneous nephrolithotomy (PCNL or pyelolithotomy (either by open or laparoscopic techniques. PCNL is difficult in undilated system. For pyelolithotomy, laparoscopy is more preferable over the open surgery. Surgeons are more familiar with the tansperitoneoscopic anatomy than retroperitoneoscopic one, but retroperitoneoscopic approach can be attempted if we anticipate the problems in the transperitoneal route. Case: A fifty years old gentleman presented to us with the complaint of dull aching right flank pain. On ultrasonographic examination, he was found to have a large stone in renal pelvis with minimal hydronephrosis and thickened omentum on right side. Xray KUB showed a large radio-opaque shadow in renal area. We did the CECT-Urogram of the patient to know the detailed anatomy, which showed a stone of 5.3 x 3.7 cm in right extra-rena pelvis without hydronephrosis and a large focal area of marked fat stranding in omentum on the right side in mid and lower abdomen with swirling of fat stranding on the superior aspect suggestive of omental infarction and torsion. Due to undilated caliceal system, we preferred laparoscopic surgery over the PCNL in this patient. As whole of the omental tissue was stuck on right side we decided to proceed with transperitoneoscopic route instead of retroperitoneoscopic one. The DJ stent was inserted preoperatively.The surgery was performed in the flank position with three ports, one 10mm port just antero-inferior to tip of 12th rib for camera and two 5mm working ports, one at anterior axillary line and other at renal angle. We created the retroperitoneal space with the customized balloon, made with the glove-fingure. Results: The operative time was 1 hour 40 minutes, and there were no intra or post-operative complications. The stone was removed in toto. Patient was orally allowed on first postoperative day and foleys was removed on second day. patient

  10. Predictors of Clinical Outcomes of Flexible Ureterorenoscopy with Holmium Laser for Renal Stone Greater than 2 cm

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    Saeed M. Al-Qahtani

    2012-01-01

    Full Text Available Objective. To evaluate the clinical outcome of flexible ureterorenoscopy (F-URS with holmium laser in managing renal stone greater than 2 cm. Patients and Methods. Records of 120 patients (123 renal units with renal stone greater than 2 cm who underwent F-URS with holmium laser iwere evaluated. The mean stone size was 26.3 mm. Patient and stone characteristics, perioperative outcomes and complications were evaluated. The outcome was determined at 4 weeks on plain radiograph (KUB and Non-contrast CT scan (NCCT. Follow-up visit was up to 6 months to evaluate the clinical outcome and patients symptoms. Results. Stone burden was an independent predictor of FURS results. After first session of treatment, success rate was obtained in 72 renal units (58.5%. On the other hand, significant residual fragment was encountered in 51 renal units (41.5%. This was improved with “staged-therapy” to 87% and 96.7% after second and third session of treatment, respectively. Complications were recorded. They were managed in proper manner accordingly. Conclusion. This is an attractive, safe and effective technique. It is an ideal option for low volume complex stone with average burdens of 2 to 3 cm. Patient should be informed and consented about staged-therapy.

  11. Optimizing RNA Extraction of Renal Papilla Biopsy Tissue in Kidney Stone Formers: A New Methodology for Genomic Study.

    Science.gov (United States)

    Taguchi, Kazumi; Usawachintachit, Manint; Hamamoto, Shuzo; Unno, Rei; Tzou, David T; Sherer, Benjamin A; Wang, Yongmei; Okada, Atsushi; Stoller, Marshall L; Yasui, Takahiro; Chi, Thomas

    2017-08-11

    Endoscopic tools have provided versatile examination and treatment for kidney stone procedures. Despite endourologists researching urinary stone disease using endoscopes to collect tissue, this tissue collection method is limited. Endoscopically removed tissues are small in size, restricting the types of genome-based examination possible. We investigated a new method of renal papilla biopsy and RNA extraction to establish a genomic research methodology for kidney stone disease. We conducted a prospective multi-institutional study and collected renal papilla specimens from consecutive percutaneous nephrolithotomy and ureteroscopy (URS) cases performed for removal of upper urinary tract stones. Renal papilla tissue was extracted using ureteroscopic biopsy forceps after stone removal. RNA was extracted using two different extraction kits, and their quantity and quality were examined. Additionally, the impact of biopsy on surgical complications was compared between cases performed with and without biopsy by matched case-control analysis adjusted for age, gender, body mass index, bilaterality, and stone burden. A total of 90 biopsies from 49 patients were performed, and the median duration between specimen collection and RNA extraction was 61 days. Both univariate and multivariate analyses showed BIGopsy(®) forceps usage significantly increased the total yield (p = 0.004) and quality (p = 0.001 for A260/280, p = 0.004 for A260/A230) of extracted RNA. Extraction using the RNeasy Micro Kit(®) also improved A260/A230, whereas reduced RNA integrity number of extracted RNA by univariate and multivariate analyses (p = 0.002 and p case-control study demonstrated that endoscopic renal papilla biopsy caused no significant surgical complications, including bleeding, decreased stone clearance and hematocrit, and renal dysfunction. Biopsies during URS imparted an average of 20 minutes of procedure time over nonbiopsy cases. We demonstrate a safe methodology for

  12. Dual roles of brushite crystals in calcium oxalate crystallization provide physicochemical mechanisms underlying renal stone formation.

    Science.gov (United States)

    Tang, R; Nancollas, G H; Giocondi, J L; Hoyer, J R; Orme, C A

    2006-07-01

    Calcium oxalate monohydrate (COM) crystals are the major mineral component of most kidney stones, and thus have an important role in chronic human disease. However, the physicochemical mechanisms leading to calcium oxalate (CaOx) stone disease are only partially defined. As spontaneous precipitation of CaOx is rare under renal conditions, an alternative pathway for CaOx crystallization seems necessary to resolve this central issue. We performed kinetic studies using the dual constant composition method to simultaneously analyze the crystallization of COM and brushite, the form of calcium phosphate that is most readily formed in the typical slightly acidic urinary milieu. These studies were supported by parallel analysis by scanning electron and atomic force microscopy. In these studies, mineralization of a thermodynamically stable phase (COM) was induced by the presence of brushite, a more readily precipitated inorganic phase. Furthermore, once formed, the COM crystals grew at the expense of brushite crystals causing the dissolution of the brushite crystals. These studies show that brushite may play crucial roles in the formation of COM crystals. The definition of these two roles for brushite thereby provides physicochemical explanations for the initiation of COM crystallization and also for the relative paucity of calcium phosphate detected in the majority of CaOx renal stones.

  13. Comparative Study between Slow Shock Wave Lithotripsy and Fast Shock Wave Lithotripsy in the Management of Renal Stone

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    AKM Zamanul Islam Bhuiyan

    2013-01-01

    Full Text Available Background: Renal calculi are frequent causes of ureteric colic. Extracorporeal shock wave lithotripsy is the most common treatment of these stones. It uses focused sound waves to break up stones externally. Objective: To compare the efficiency of slow and fast delivery rate of shock waves on stone fragmentation and treatment outcome in patients with renal calculi. Materials and Methods: This prospective study was done in the department of Urology, National Institute of Kidney diseases and Urology, Sher-e-Bangla Nagar, Dhaka from July 2006 to June 2007. Total 90 patients were treated using the Storz Medical Modulith ® SLX lithotripter. Patients were divided into Group A, Group B and Group C – each group having 30 subjects. Group A was selected for extracorporeal shockwave lithotripsy (ESWL by 60 shock waves per minute, Group B by 90 shock waves per minute and Group C by 120 shock waves per minute. Results: Complete clearance of stone was observed in 24 patients in Group A and 13 patients in both Group B and Group C in first session. In Group A only 3 patients needed second session but in Group B and Group C, 12 and 8 patients needed second session. In Group A only one patient needed third session but third session was required for 3 patients in Group B and 5 patients in Group C for complete clearance of stone. In Group A, subsequent sessions were performed under spinal anesthesia and in Group B under sedation and analgesia (p>0.001. Mean number of sessions for full clearance of stones in group A was 1.37 ± 0.85, in Group B was 1.8 ± 0.887 and in Group C was 2.0 ± 1.083. Significant difference was observed in term of sessions among groups (p>0.05. In first follow-up, complete clearance of stones was seen in 24 patients in Group A and 13 in both Group B and Group C. In second follow-up, 3 patients in Group A, 12 in Group B and 8 in Group C showed complete clearance of stones. It was observed that rate of stone clearance was higher in Group A

  14. Comparative Study for the Effect of Tamsulosin on Biomarkers between Renal and Urethral Stone Lithotripsy

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    Mohammed Khalid Abood

    2015-10-01

    Full Text Available Nephrolithiasis are multi-factorial diseases that result from the combined influence of epidemiological, biochemical and genetically risk factors. Defective drainage due to urinary tract obstruction at the narrowest part (ureterovesical junction, ureteropelvic junction, and near the pelvic brim via stones will eventually cause the agonizing renal colic pain. Therapeutic managements of nephrolithiasis to relief acute colic pain are the primary objective. Non-steroidal anti-inflammatory drugs are the most commonly used drugs as suggested by many studies. It is very important to consider side effects of the drugs used in the treatment of colic pain. In order to preserve renal function and to relief obstruction, medical expulsion therapy are used for urethral calculi as a conservative management. These medications will aid the passage urethral calculi, an area that currently seems to be a field for continuous investigation.

  15. [Acute renal failure due to obstructive ureteral stone associated with norovirus gastroenteritis in an infant with congenital solitary kidney].

    Science.gov (United States)

    Kato, Taiki; Hamano, Atsushi; Kawamura, Hideki

    2014-10-01

    We report a 35 month-old boy with acute renal failure caused by an obstructive ureteral stone associated with norovirus gastroenteritis. He visited his family physician because of fever, abdominal pain and vomiting. He was diagnosed as acute gastroenteritis. The symptoms relieved once, but abdominal pain and vomiting recurred two days after the visit and the volume of urine decreased. He was diagnosed as norovirus gastoenteritis and acute renal failure which was unresponsive to fluid replacement. Ultrasound study of the abdomen showed a solitary kidney with mild hydronephrosis. He was then admitted to our hospital. He was finally diagnosed as acute postrenal failure due to obstructive ureteral stone with left solitary kidney by abdominal computer tomography (CT). We performed transurethral catheterization immediately. The creatinine and blood urea nitrogen returned to normal level in 2 days. The CT performed on the 28th day post operation showed disappearance of the stone after uric alkalization. Recently, some cases of postrenal failure due to bilateral obstructive ureteral stones, mainly ammonium acid urate stones, associated with viral gastroenteritis were reported. As clinical features, they are common in boys three years or younger after an episode of rotavirus gastroenteritis with high uric acid concentration. By far, the most common cause of acute renal failure in patients with severe gastroenteritis is prerenal failure resulting from hypovolemia. But postrenal cause due to bilateral obstructive stones should be taken in a consideration.

  16. Uric acid versus non-uric acid renal stones: in vivo differentiation with spectral CT.

    Science.gov (United States)

    Lombardo, F; Bonatti, M; Zamboni, G A; Avesani, G; Oberhofer, N; Bonelli, M; Pycha, A; Pozzi Mucelli, R; Bonatti, G

    2017-06-01

    To differentiate uric acid from non-uric acid renal stones based on their spectral attenuation values. The present study was approved by the institutional review board and the need for informed consent was waived. Thirty-three consecutive patients (21 men, 12 women; mean age 55 years) with symptomatic urolithiasis underwent dual-energy computed tomography (DECT) using a second-generation dual-source CT system. Stone composition was assessed by means of chemical analysis after extraction or spontaneous expulsion. The composition of one stone was considered to represent all remaining stones in patients presenting with more than one stone. Image-domain virtual monoenergetic images were generated from the dual-energy datasets. One radiologist evaluated stone attenuation values from 40 to 190 keV; attenuation curves were created and 40/190 keV attenuation ratios calculated. Qualitative evaluation of the spectral attenuation curves was also performed. Imaging findings were compared with laboratory results. Sixty-two stones were considered in 33 patients (mean diameter 6.5 mm). Fifteen of the 62 stones were mainly composed of uric acid and 47/62 of cysteine or calcium oxalates/phosphates. Forty to 190 keV attenuation ratios were significantly lower for uric acid stones (mean 0.87±0.3) than for non-uric acid stones (mean 3.80±0.6; puric acid and non-uric acid stones. Spectral CT quantitatively and qualitatively differentiates uric acid from non-uric acid stones. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Renal intratubular crystals and hyaluronan staining occur in stone formers with bypass surgery but not with idiopathic calcium oxalate stones.

    Science.gov (United States)

    Evan, Andrew P; Coe, Fredric L; Gillen, Daniel; Lingeman, James E; Bledsoe, Sharon; Worcester, Elaine M

    2008-03-01

    Whether idiopathic calcium oxalate (CaOx) stone formers form inner medullary collecting duct (IMCD) crystal deposits bears on pathogenetic mechanisms of stone formation. In prior work, using light and transmission electron microscopy, we have found no IMCD crystal deposits. Here, we searched serial sections of papillary biopsies from a prior study of 15 idiopathic calcium oxalate stone formers, 4 intestinal bypass patients with CaOx stones, and 4 non-stone-forming subjects, and biopsies from an additional hitherto unreported 15 idiopathic calcium oxalate stone formers and 1 bypass patient using polarized light oil immersion optics, for deposits overlooked in our original study. We found no IMCD deposits in any of 1,500 serial sections from the 30 idiopathic calcium oxalate stone formers, nor in 87 additional sections from a frozen idiopathic calcium oxalate stone former biopsy sample processed without exposure to aqueous solutions. Among 4 of the 5 bypass patients but in none of the 30 idiopathic calcium oxalate stone formers or 4 normal stone formers, we found tiny birefringent thin crystalline overlays on scattered IMCD cell membranes. We also found IMCD lumen deposits in two bypass patients that contained mixed birefringent and nonbirefringent crystals, presumably CaOx and apatite. In the bypass patients, we observed focal apical IMCD cell hyaluronan staining, which was absent in idiopathic calcium oxalate stone formers. The absence of any IMCD deposits in 1,500 serial sections of biopsies from 30 idiopathic calcium oxalate stone formers allows us to place the upper limit on the probability of their occurrence at approximately 0.002 and place the lower limit of their size at the resolution of the optics (crystal lesion.

  18. External validation of a preoperative renal stone grading system: reproducibility and inter-rater concordance of the Guy's stone score using preoperative computed tomography and rigorous postoperative stone-free criteria.

    Science.gov (United States)

    Ingimarsson, Johann P; Dagrosa, Lawrence M; Hyams, Elias S; Pais, Vernon M

    2014-01-01

    To validate the Guy's stone score (GSS) using preoperative computed tomography (CT) and to assess its inter-rater concordance and association with rigorous definitions of stone clearance. The preoperative CT scans of 166 consecutive percutaneous nephrolithotomy (PCNL) patients treated by a single surgeon were independently reviewed by 2 urology residents and graded according to GSS. Concordance was calculated using Cohen's kappa score. Residual fragments (RFs) were evaluated on CT or plain radiography on postoperative day 1. GSS was correlated with 3 different outcomes; RFs II and III and 20 of 36 cases (56%) pertained to unclear definitions of "partial staghorn stone" and "abnormal anatomy." The GSS is a straightforward grading system of the complexity of renal stones. When applied to preoperative CT scans, it offers good inter-rater concordance and is associated with rigorous endpoints of stone clearance. The inter-rater concordance could be further improved by explicit definitions of abnormal anatomy, partial vs complete staghorn stones, and the size of a calculus that constitutes a separate stone. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. A rapid food screener ranks potential renal acid load of renal stone formers similarly to a diet history questionnaire.

    Science.gov (United States)

    Trinchieri, Alberto

    2013-02-01

    Dietary acid load was reported to be inversely related to urinary citrate excretion. The calcium renal stone formers (RSFs) should be recommended to lower their dietary potential renal acid load (PRAL) to reduce stone recurrence. Reduction of dietary PRAL also showed a promising role for the prevention of other metabolic diseases. However, clinicians often fail to provide nutritional screening and counseling due to lack of simple tools to obtain a reliable dietary history. A one-page food screener (LAKE score) was recently designed to obtain a reliable measure of dietary PRAL in short time. We report the testing of such an instrument in the evaluation of PRAL: in a population of 135 healthy subjects (60 males, 75 females; age range 18-73), living in the area of Milan, Italy. Each participant received both the one-page LAKE food screener and an extensive 24-h dietary questionnaire. We examined agreement between the LAKE food screener scores, and estimates of PRAL and other nutrients produced by the computerized processing of thorough 24-h dietary histories. Spearman rank order correlation coefficient (r > 0.50) showed that LAKE score ranked subjects quite well with respect to dietary PRAL. LAKE positive subscore ranked patients with respect to dietary intake of total protein (r = 0.642) and phosphate (r = 0.648). We also obtained an excellent correlation of LAKE negative subscore with potassium intake (r = -0.531) and vitamin C (r = -0.554) as estimated by 24 h recalls. The LAKE score ranked patients similar to the estimates of 24-h dietary recalls, used as the "gold standard" for the evaluation of dietary PRAL. This rapid, simple and inexpensive food screener for the evaluation of dietary PRAL could provide a "snapshot" of the diet of the RSFs to allow an immediate feedback to the patient during office consultation.

  20. The comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy in the treatment of solitary large renal pelvic stones.

    Science.gov (United States)

    Tefekli, Ahmet; Tepeler, Abdulkadir; Akman, Tolga; Akçay, Muzaffer; Baykal, Murat; Karadağ, Mert Ali; Muslumanoglu, Ahmet Y; de la Rosette, Jean

    2012-10-01

    The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could find a place in the management of large renal pelvic stones which are generally considered as excellent indications for percutaneous nephrolithotomy (PNL). Between 2006 and 2009, 26 consecutive patients with large (>4 cm(2)) renal pelvic stones were treated by LPL and their charts were compared to 26 match-paired patients treated with PNL during the same period. The patients were matched for age, BMI, stone size and location as well as presence of congenital anomalies. Perioperative and postoperative findings were compared. The mean age, mean stone size, rate of congenital anomalies, history open renal surgery and shock wave lithotripsy were similar in both groups (p > 0.05). The mean operation time was 138.40 ± 51.19 (range 70-240) min in LPL group as compared to 57.92 ± 21.12 (range 40-110) min in PNL group (p PNL group (p = 0.024). Hospitalization was significantly shorter in PNL than LPL group (p = 0.0001). Stone-free rates were similar. Laparoscopic pyelolithotomy is associated with a longer operation time, is more invasive, and requires more skills when compared to PNL. However, LPL is associated with less blood loss. Laparoscopic pyelolithotomy is indicated for congenitally anomalous kidneys and especially in patients with concomitant UPJ.

  1. The association between renal stone disease and cholesterol gallstones: the easy to believe and not hard to retrieve theory of the metabolic syndrome.

    Science.gov (United States)

    Ahmed, Mohamed H; Barakat, Salma; Almobarak, Ahmed O

    2014-07-01

    Renal stone disease and gallstone disease are widely prevalent and costly disease across the globe. Both renal stone disease and gallstone disease are associated with a variety of diseases including obesity, metabolic syndrome, dyslipidemia, hypertension, insulin resistance diabetes and gout. Importantly, the presence of either renal stone disease or gallstone disease is associated with an increased risk of cardiovascular disease. In a recent study of the Atherosclerosis Risk in Communities (ARIC), individuals with a history of gallstones were 54% more likely to report a history of nephrolithiasis after adjusting for age, gender, body size and other factors. Furthermore, in three large cohorts including over 240,000 subjects: the Nurses' Health Studies (NHS) I and II and the Health Professionals Follow-up Study (HPFS), showed that gallstone disease is independently associated with nephrolithiasis. The mechanisms linking gallstone disease and renal stone disease are complex and not yet established. Insulin resistance, lithogenic diets, alterations of transporters in gallbladder and urinary system, and pH are possible potential mechanisms for future exploration. How the liver communicates with kidney in individuals with renal stone disease and gallstone disease is not well known and whether this communication is similar as in hepto-renal syndrome is subject for future research. Further research is needed to determine: (i) the underlying mechanisms of renal stone disease and gallstone disease; (ii) the potential treatment of renal stone disease and gallstone disease.

  2. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2-3 cm in Diameter

    Directory of Open Access Journals (Sweden)

    Kursad Zengin

    2015-01-01

    Full Text Available Objective. Retrograde intrarenal surgery (RIRS performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL. However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter. Materials and Methods. The medical records of 154 patients (74 PNL, 80 RIRS were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2. Results. The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P=0.061. The respective complication rates (evaluated using the Clavien system were 13.5% and 8.8% (P=0.520. Conclusions. RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings.

  3. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2-3 cm in Diameter

    Science.gov (United States)

    Zengin, Kursad; Tanik, Serhat; Sener, Nevzat Can; Albayrak, Sebahattin; Tuygun, Can; Bakirtas, Hasan; Imamoglu, M. Abdurrahim; Gurdal, Mesut

    2015-01-01

    Objective. Retrograde intrarenal surgery (RIRS) performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL). However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter. Materials and Methods. The medical records of 154 patients (74 PNL, 80 RIRS) were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2. Results. The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P = 0.061). The respective complication rates (evaluated using the Clavien system) were 13.5% and 8.8% (P = 0.520). Conclusions. RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings. PMID:25821828

  4. Effect of biomolecules from human renal matrix of calcium oxalate monohydrate (CaOx stones on in vitro calcium phosphate crystallization

    Directory of Open Access Journals (Sweden)

    Priyadarshini Pathak

    2010-10-01

    Full Text Available PURPOSE: Investigate the activity of high and low molecular weight biomolecules present in the matrix of human calcium oxalate (CaOx stones not only on the initial mineral phase formation of calcium and phosphate (CaP but also on its growth and demineralization of the preformed mineral phase. MATERIALS AND METHODS: Surgically removed renal stones were analyzed by Fourier Transform Infra Red (FTIR spectroscopy and only CaOx stones were extracted with 0.05M EGTA, 1 mM PMSF and 1% ß-mercaptoethanol. Renal CaOx stone extract was separated into > 10 kDa and 10 kDa and 10 kDa fraction lane. CONCLUSION: Both high and low molecular weight biomolecules extracted from human renal matrix of calcium oxalate (CaOx stones have a significant influence on calcium and phosphate (CaP crystallization.

  5. The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis.

    Science.gov (United States)

    Tanaka, Yoshimi; Hatakeyama, Shingo; Tanaka, Toshikazu; Yamamoto, Hayato; Narita, Takuma; Hamano, Itsuto; Matsumoto, Teppei; Soma, Osamu; Okamoto, Teppei; Tobisawa, Yuki; Yoneyama, Tohru; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Takahashi, Ippei; Nakaji, Shigeyuki; Terayama, Yuriko; Funyu, Tomihisa; Ohyama, Chikara

    2017-01-01

    To determine the influence of serum uric acid (UA) levels on renal impairment in patients with UA stone. We retrospectively analyzed 463 patients with calcium oxalate and/or calcium phosphate stones (CaOx/CaP), and 139 patients with UA stones. The subjects were divided into the serum UA-high (UA ≥ 7.0 mg/dL) or the UA-low group (UA analysis 1), and between patients with CaOx/CaP and with UA stone (analysis 2). Logistic regression analysis was used to evaluate the impact of the hyperuricemia on the development of stage 3 and 3B chronic kidney disease (CKD) (analysis 3). The renal function was significantly associated with serum UA levels in the controls and patients with CaOx/CaP and UA stones. In pair-matched subgroups, patients with UA stone had significantly lower renal function than the control subjects (analysis 1) and patients with CaOx/CaP stones (analysis 2) regardless of hyperuricemia. Multivariate logistic regression analysis revealed that patients with UA stone, CaOx/CaP, hyperuricemia, presence of cardiovascular disease, higher body mass index, older age and lower hemoglobin had significantly higher risk of stage 3 and 3B CKD (analysis 3). Patients with UA stones had significantly worse renal function than controls and CaOx/CaP patients regardless of hyperuricemia. Urolithiasis (CaOx/CaP and UA stone) and hyperuricemia had an association with impaired renal function. Our findings encourage clinicians to initiate intensive treatment and education approaches in patients with urolithiasis and/or hyperuricemia in order to prevent the progression of renal impairment.

  6. Peeping into human renal calcium oxalate stone matrix: characterization of novel proteins involved in the intricate mechanism of urolithiasis.

    Directory of Open Access Journals (Sweden)

    Kanu Priya Aggarwal

    Full Text Available BACKGROUND: The increasing number of patients suffering from urolithiasis represents one of the major challenges which nephrologists face worldwide today. For enhancing therapeutic outcomes of this disease, the pathogenic basis for the formation of renal stones is the need of hour. Proteins are found as major component in human renal stone matrix and are considered to have a potential role in crystal-membrane interaction, crystal growth and stone formation but their role in urolithiasis still remains obscure. METHODS: Proteins were isolated from the matrix of human CaOx containing kidney stones. Proteins having MW>3 kDa were subjected to anion exchange chromatography followed by molecular-sieve chromatography. The effect of these purified proteins was tested against CaOx nucleation and growth and on oxalate injured Madin-Darby Canine Kidney (MDCK renal epithelial cells for their activity. Proteins were identified by Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF MS followed by database search with MASCOT server. In silico molecular interaction studies with CaOx crystals were also investigated. RESULTS: Five proteins were identified from the matrix of calcium oxalate kidney stones by MALDI-TOF MS followed by database search with MASCOT server with the competence to control the stone formation process. Out of which two proteins were promoters, two were inhibitors and one protein had a dual activity of both inhibition and promotion towards CaOx nucleation and growth. Further molecular modelling calculations revealed the mode of interaction of these proteins with CaOx at the molecular level. CONCLUSIONS: We identified and characterized Ethanolamine-phosphate cytidylyltransferase, Ras GTPase-activating-like protein, UDP-glucose:glycoprotein glucosyltransferase 2, RIMS-binding protein 3A, Macrophage-capping protein as novel proteins from the matrix of human calcium oxalate stone which play a critical role in kidney stone

  7. Urine alkalinization may be enough for the treatment of bilateral renal pelvis stones associated with Lesch-Nyhan syndrome.

    Science.gov (United States)

    Oh, Mi Mi; Ham, Byeong Kuk; Kang, Seok Ho; Bae, Jae Hyun; Kim, Je Jong; Yoo, Ki Hwan; Yoon, Duck Ki; Moon, Du Geon

    2011-10-01

    Lesch-Nyhan syndrome is a rare sex-linked disorder of purine metabolism that is caused by a mutation in the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene which causes marked hyperuricemia and hyperuricosuria, with signs of gouty arthritis and uric acid stone disease in early childhood. We report a case of renal pelvis calculi which was dissolved within 10 days of urine alkalinization and hydration.

  8. Simultaneous management for retrocaval ureter and ipsilateral renal stone using retroperitoneoscopic approach: report of a case

    OpenAIRE

    Suzuki, Shouji; Sawada, Norifumi; Haheda,Yaburu; Zakoji, Hidenori; Tsuchida, Takayuki; Aikawa,Masami; Adaki ,Isao; Takeda, Masayuki

    2009-01-01

    A 32-year-old male presented with a month history of right back and flank pain and a possibility of gross hematuria. As part of the initial evaluation abdominal ultrasound revealed marked right hydronephrosis. An excretion urogram showed delayed excretion of contrast material extending to the L4 level distally. Computed omography revealed right renal pelvic stone and right retrocaval ureter. At surgery, a right-sided ouble-J ureteric stent was placed under fluoroscopic guidance. Retroperitone...

  9. Pears and renal stones: possible weapon for prevention? A comprehensive narrative review.

    Science.gov (United States)

    Manfredini, R; De Giorgi, A; Storari, A; Fabbian, F

    2016-01-01

    Urinary stones have been recognized as a human disease since dawn of history and treatment of this condition is reported by Egyptian medical writings. Also, pears have a very long history, being one of the earliest cultivated fruit trees and also known for medicinal use. Urinary tract stone formation represents a common condition and also a significant burden for health care service, due also to possible frequent relapses. Furthermore, urinary stones have been reported to have relationship with different metabolic derangements, and appropriate diet could contribute to avoid or reduce urinary stone formation. Citrate is an inhibitor of crystal growth in the urinary system, and hypocitraturia represents a main therapeutical target in stone formers. Pears contain a significant amount of malic acid, a precursor of citrate, and have antioxidant activity as well. A diet supplemented with pears, and associated with low consumption of meat and salt could impact positively cardiometabolic risk and urinary tract stone formation. However, very few studies evaluated the impact of pears utilization on health, and none on urinary tract stone formation in particular. High content in malate could warrant protection against stone formation, avoiding patients at high risk to be compelled to assume a considerable and expensive amount of pills.

  10. Effect of Hydrophilic Extract of Allium Jesdianum on Ethylene Glycol-Induced Renal Stone in Male Wistar Rats

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    R Vahdani

    2012-02-01

    Full Text Available Background & Aim: Considering the evidence which show the effect of herbal medicine on renal stone treatment, the aim of this study was to evaluate the efficacy of Allium Jesdianum on prevention and treatment of calcium oxalate stone in rats. Methods: In the present experimental study, forty-four male Wistar rats were randomly divided into four groups (each group 11 rats and then studied for 30 days. The Healthy control group only received normal water and a regular diet. The negative control group received 1% ethylene glycol in water during the study. The low dose and high dose preventive groups received 750 mg/kg and 1500 mg/kg of Allium Jesdianum with 1% ethylene glycol every day. The 24-hour urine samples of rats were collected on days 1, 15 and 30 of the study. Then, under anesthesia, blood samples were taken directly from the heart. All rats were then killed and pathology of kidneys was checked for crystals of calcium oxalates in renal tubules. Data analysis was done by the SPSS software using One-way ANOVA. Results: The number of calcium oxalate crystals in the negative control group (18.7 ±26.1, the low dose preventive group (5.3±8.2 and high dose preventive group (80.6±82.8 in comparison to the healthy control group were increased and this difference in the high dose preventive group and healthy control group was significant (p <0.05 . Urinary oxalate in the 30th day was more in both preventive groups and negative control group in comparison to healthy control group and this diference was statistically significant (p <0.05. Conclusion: This study showed that Allium Jesdianum doesn't have a preventive effect on the formation of renal stones, and it also increases calcium oxalate crystals in kidney of male wistar rats that need more studies.

  11. Gist of medicinal plants of Pakistan having ethnobotanical evidences to crush renal calculi (kidney stones).

    Science.gov (United States)

    Nasim, Muhammad Jawad; Bin Asad, Muhammad Hassham Hassan; Durr-e-Sabih; Ikram, Raja Muhammad; Hussain, Muhammad Sikandar; Khan, Muhammad Tajammal; Ahamad, Ghafoor; Karim, Sabiha; Khan, Shujaat Ali; Murtaza, Ghulam

    2014-01-01

    Human civilization is facing the problem of kidney stones since ancient ages. Although mortality rate is not so high, yet it affects the victim's quality of life. The patient suffers from intense pain and many other symptoms modifying his life style and affecting his socioeconomic status. Many drugs and invasive methods have also been developed for the treatment, but these are highly costly and unaffordable for poor people and the rate of reoccurrence is also high. The use of medicinal plants is both affordable and effective in this respect. In this article, 35 medicinal plants of Pakistan origin and their crucial information have been enumerated in alphabetical order of plant's scientific name, family, place (distribution), part used, local name, habit, major constituents and references. It can also be seen that all parts are used for the treatment of kidney stones. Leaves represent 28% contribution, whole plants and seeds 12%, fruits and roots 11% contribution in this respect. Flowers contribute 8% in the treatment of kidney stone while branches, bark, bushes, buds, milk and shoots contribute only 3% in the removal of kidney stones. Habits of plants were also taken under consideration. It was noticed that herbs are the most useful life form in this regard which contributed 63% for the removal of kidney stone. Shrubs contributed 20%, trees 11% while bushes and weeds contributed 3% for the removal of kidney stones.

  12. Modified totally tubeless percutaneous nephrolithotomy: Is it an effective and safe treatment option for renal and upper ureteral stones?

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    Ho Seok Chung

    2016-12-01

    Full Text Available Introduction: We hypothesized that modified totally tubeless percutaneous nephrolithotomy (PNL without indwelling ureteral stent would minimize postoperative discomfort without complications. Aim : To evaluate the safety, efficacy, and morbidity of standard, tubeless, and modified totally tubeless PNL as well as the usefulness of modified totally tubeless PNL. Material and methods: From November 2011 to February 2015, 211 patients who underwent PNL consecutively were enrolled in this study and divided into 3 groups (group 1: standard, group 2: tubeless, group 3: modified totally tubeless PNL. Patient and stone characteristics, operation time, hemoglobin change, length of hospitalization, stone-free rate, analgesic requirement, and perioperative complications were analyzed and compared among the 3 groups. Results: There were no significant differences in preoperative patient characteristics among the three groups. In the postoperative analysis, the three groups had similar operation time, stone-free rate, perioperative fever and transfusion rate, but group 2 showed superior results in terms of length of hospitalization (p = 0.001. Group 2 and group 3 had a lower analgesic requirement (p = 0.010. Immediate postoperative hemoglobin change (p = 0.001 and tube site complications (p = 0.001 were more common in group 1. Conclusions : Modified totally tubeless PNL was not inferior in terms of postoperative outcomes and safety compared with the standard and tubeless PNL, and avoided the postoperative stent-related symptoms and cystoscopy for double-J stent removal. Modified totally tubeless PNL could be an alternative treatment of choice for management of renal or upper ureteral stones in selected patients.

  13. Tracking of radiation exposure in pediatric stone patients: The time is now.

    Science.gov (United States)

    Ristau, B T; Dudley, A G; Casella, D P; Dwyer, M E; Fox, J A; Cannon, G M; Schneck, F X; Ost, M C

    2015-12-01

    Despite the increasing incidence of pediatric nephrolithiasis, there is little data quantifying the radiation exposure associated with treatment of this disease. In this study, pediatric patients with nephrolithiasis who were managed at a single institution were identified, and the average fluoroscopy time and estimated radiation exposure associated with their procedures were reported. Stone procedures performed on pediatric patients between 2005 and 2012 were retrospectively identified. Procedures were classified as primary ureteroscopy (URS), stent placement prior to ureteroscopy (SURS), percutaneous nephrolithotomy (PCNL), and bilateral ureteroscopy (BLURS). Patient demographic information, stone size, stone location, number of radiographic images, and fluoroscopy times were analyzed. A total of 152 stone procedures were included in the final analysis (92 URS, 38 SURS, eight BLURS and 14 PCNL). Mean patient age at time of stone treatment was 15.94 ± 4.1 years. Median fluoroscopy times were 1.6 (IQR 0.8-2.4), 2.1 (IQR 1.6-3.0), 2.5 (IQR 2.0-2.9), and 11.7 (IQR 5.0-18.5) minutes for URS, SURS, BLURS and PCNL, respectively. There was a moderate correlation between stone size and fluoroscopy time (r = 0.33). When compared with ureteroscopic procedures, PCNL was associated with a significantly higher fluoroscopy time (11.7 vs 2.1 min, P < 0.001). The estimated median effective dose was 3 mSv for ureteroscopic procedures and 16.8 mSv for PCNL. In addition to radiation exposure during treatment, patients in this cohort were exposed to an average of one (IQR1-3) CT scan and three (IQR 1-8) abdominal X-rays. No new malignancies were identified during the limited follow-up period. Radiation exposure during treatment of pediatric stone disease is not trivial, and is significantly greater when PCNL is performed. Given the recommended maximum effective dose of 50 mSv in any one year, urologists should closely monitor the amount of fluoroscopy used, and consider

  14. Evaluation of the efficacy of tamsulosin with or without deflazacort for stone clearance after extracorporeal shockwave lithotripsy for upper ureteral and renal calculi

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    Rajeev T. P.

    2016-02-01

    Conclusions: Addition of alpha-blocker tamsulosin along with deflazacort post ESWL for renal and upper ureteric calculi increases the stone expulsion rate and reduces the expulsion duration as shown by highly statistically significant results in group C. [Int J Res Med Sci 2016; 4(2.000: 643-648

  15. The outcome of open renal stone surgery calls for limitation of its use ...

    African Journals Online (AJOL)

    I. Khalaf

    Stone features. No. cases ... Follow-up data covering at least two years after the date of surgery or after ... included intra-operative and early post-operative bleeding (Table 7). .... ure of less invasive therapies due to a narrow diverticular neck, a.

  16. Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones

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    Fábio César Miranda Torricelli

    2015-02-01

    Full Text Available The use of certain technical principles and the selection of favorable cases can optimize the results of extracorporeal shock wave lithotripsy (ESWL. The aim of this study is to review how ESWL works, its indications and contraindications, predictive factors for success, and its complications. A search was conducted on the Pubmed® database between January 1984 and October 2013 using "shock wave lithotripsy" and "stone" as key-words. Only articles with a high level of evidence, in English, and conducted in humans, such as clinical trials or review/meta-analysis, were included. To optimize the search for the ESWL results, several technical factors including type of lithotripsy device, energy and frequency of pulses, coupling of the patient to the lithotriptor, location of the calculus, and type of anesthesia should be taken into consideration. Other factors related to the patient, stone size and density, skin to stone distance, anatomy of the excretory path, and kidney anomalies are also important. Antibiotic prophylaxis is not necessary, and routine double J stent placement before the procedure is not routinely recommended. Alpha-blockers, particularly tamsulosin, are useful for stones >10mm. Minor complications may occur following ESWL, which generally respond well to clinical interventions. The relationship between ESWL and hypertension/diabetes is not well established.

  17. Management of forgotten double J stent and severe multiple large encrusted stones in the bladder and renal pelvis

    Science.gov (United States)

    Kelkar, Vidhyadhar

    2012-01-01

    A female patient from a remote village and poor socioeconomic background presented to our clinic with abdominal pain at the right flank. She had a history of endoscopic double J stent placement four years prior. However, the details were not available, as neither the patient nor her relatives were aware of the history. An ultrasonography was performed and revealed moderate hydronephrosis of the right kidney with two calculi measuring 2.9 cm at the pyeloureteral junction (PUJ), a 2.6 cm calculus in the renal pelvis, and a 4 cm vesicle calculus. An intravenous urography revealed delayed excretion of contrast medium in the right kidney. A cystoscopy was then performed and the lower end of the forgotten double J stent was cut along with the encrusted stone in bladder [1, 2]. Removal of the large encrusted bladder stone was aided by lithotripsy. This was followed by the removal of the two PUJ calculi and the remaining portion of the encrusted double J stent, which was extracted with relative ease via a right-sided open pyelolithotomy [3]. The post-operative course was uneventful and her kidney function test was absolutely normal following the procedures. The patient was found to be stone-free and was discharged home. In light of this situation we have deemed it necessary to maintain contact and ensure regular follow-up visits for patients with double J stent placements in order to avoid such dangerous complications in the future. By following this custom, we aim to reduce the patient morbidity and avoid any unnecessary inconvenience. PMID:24578973

  18. A comparison of micro-PERC and retrograde intrarenal surgery results in pediatric patients with renal stones.

    Science.gov (United States)

    Sen, Haluk; Seckiner, Ilker; Bayrak, Omer; Dogan, Kazim; Erturhan, Sakip

    2017-06-19

    With advancements in endoscopic surgery, open surgical techniques for urinary system stones have paved the way for the application of less invasive treatment modalities in patients with pediatric kidney stone disease. These treatment options include extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS). We aimed to compare the efficacy and safety of RIRS and micro-PCNL techniques in the surgical treatment of kidney stones in pediatric patients. A total of 48 pediatric patients, who underwent RIRS or micro-PERC for pediatric kidney stone disease, were retrospectively analyzed. Urinalysis, urine culture, serum creatinine (Cr), blood urea nitrogen (BUN), calcium, phosphorus, parathyroid hormone, 24-hour urine sample, complete blood count (CBC), urinary system X-ray, kidney ureter bladder (KUB), and urinary system ultrasonography (USG) test results were evaluated prior to the procedure. Intravenous pyelography (IVP), non-contrast computed tomography (CT), and renal scintigraphy evaluations were also performed, if necessary. The patients were divided into two groups: micro-PERC group (n = 25) and RIRS group (n = 23). Data relating to the duration of the operation, duration of fluoroscopy, length of hospitalization, complication rates, and stone-free rates were recorded. The mean ages of the micro-PERC and RIRS groups were 4 ± 2.3 and 10.9 ± 3 years, respectively (p = 0.001). However, the mean stone sizes were 12.2 ± 2.8 and 13.7 ± 3.5 mm, respectively (p > 0.05). The mean duration of operation was 75.1 ± 18.9 min in the micro-PERC group and 62.3 ± 15.3 min in the RIRS group (p > 0.05). In addition, the mean duration of fluoroscopy was 115 ± 35.4 s in the micro-PERC group and 39.9 ± 15.3 s in the RIRS group. The stone-free rates in the micro-PERC and RIRS groups following the procedure were reported to be 84% (21/25) and 82.6% (19/23), respectively (p > 0

  19. Management of lower pole renal stones: the devil is in the details

    Science.gov (United States)

    Issi, Yasar; Onem, Kadir; Germiyanoglu, Cankon

    2016-01-01

    Shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) and minimally invasive percutaneous nephrolithotomy (MIP) are highly effective treatment options for lower pole stones up to 2 cm. Selecting the best treatment modality represents a controversial area in urology, because each treatment methods have their own advantages and disadvantages. Donaldson and co-workers have recently published a very comprehensive review and meta-analysis to compare the benefits and harms of SWL, RIRS and PNL techniques. PMID:27047957

  20. A comparative study of artificial neural network and multivariate regression analysis to analyze optimum renal stone fragmentation by extracorporeal shock wave lithotripsy

    Directory of Open Access Journals (Sweden)

    Goyal Neeraj

    2010-01-01

    Full Text Available To compare the accuracy of artificial neural network (ANN analysis and multi-variate regression analysis (MVRA for renal stone fragmentation by extracorporeal shock wave lithotripsy (ESWL. A total of 276 patients with renal calculus were treated by ESWL during December 2001 to December 2006. Of them, the data of 196 patients were used for training the ANN. The predictability of trained ANN was tested on 80 subsequent patients. The input data include age of patient, stone size, stone burden, number of sittings and urinary pH. The output values (predicted values were number of shocks and shock power. Of these 80 patients, the input was analyzed and output was also calculated by MVRA. The output values (predicted values from both the methods were compared and the results were drawn. The predicted and observed values of shock power and number of shocks were compared using 1:1 slope line. The results were calculated as coefficient of correlation (COC (r2 . For prediction of power, the MVRA COC was 0.0195 and ANN COC was 0.8343. For prediction of number of shocks, the MVRA COC was 0.5726 and ANN COC was 0.9329. In conclusion, ANN gives better COC than MVRA, hence could be a better tool to analyze the optimum renal stone fragmentation by ESWL.

  1. Anatomy of the collecting system of lower pole of the kidney in patients with a single renal stone: a comparative study with individuals with normal kidneys.

    Science.gov (United States)

    Zomorrodi, Afshar; Buhluli, Abulfazel; Fathi, Samad

    2010-07-01

    At least 5% of women and 12% of men during their lives will experience renal colic, at least once. Many theories have been suggested for the etiology of renal stones and variations in the anatomy of the collecting system have been suggested to have a role in stone formation. This study was conducted to examine the role of variation of lower pole collecting system in patients with lower pole kidney stone and compared the same in normal persons (kidney donors). Investigation for the anatomy of the lower pole of the kidney (angle between lower infundibulum and pelvis, length and diameter of the infundibulum and number and pattern distribution of calyces) was carried out using intravenous pyelogram (IVP) in 100 cases with urinary stone (study cases) and 400 persons with normal kidneys (control subjects). The study was a retrospective cross-sectional case control study. Results were analyzed by Mann-Whitney and independent sample chi square tests. The mean infundibulum-pelvic angle (IPA) in control subjects and in patients was 112.5 +/- 10.7 and 96.6 +/- 28.8, respectively. There was significant correlation between reduced angle and stone formation (P= kidney (IPIL) in controls and study patients was 22.5 +/- 4.1 and 27.5 +/- 7.7, respectively, which was statistically significant (Pkidney (LPCN) in controls and study patients was 2.6 +/- 0.6 and 3 +/- 0.9, respectively, which was statistically significant (P = or kidney stone and should be considered a risk factor for forming lower pole kidney stone.

  2. Anatomy of the collecting system of lower pole of the kidney in patients with a single renal stone: a comparative study with individuals with normal kidneys

    Directory of Open Access Journals (Sweden)

    Zomorrodi Afshar

    2010-01-01

    Full Text Available At least 5% of women and 12% of men during their lives will experience renal colic, at least once. Many theories have been suggested for the etiology of renal stones and va-riations in the anatomy of the collecting system have been suggested to have a role in stone formation. This study was conducted to examine the role of variation of lower pole collecting system in patients with lower pole kidney stone and compared the same in normal persons (kidney donors. Investigation for the anatomy of the lower pole of the kidney (angle between lower infundibulum and pelvis, length and diameter of the infundibulum and number and pattern distribution of calyces was carried out using intravenous pyelogram (IVP in 100 cases with urinary stone (study cases and 400 persons with normal kidneys (control subjects. The study was a retrospective cross-sectional case control study. Results were analyzed by Mann-Whiteny and independent sample chi square tests. The mean infundibulum-pelvic angle (IPA in control subjects and in patients was 112.5 ± 10.7 and 96.6 ± 28.8, respectively. There was significant correlation between reduced angle and stone formation (P= < 0.001. The mean infundibulum-uretero-pelvic angle (IUPA in control subjects and study cases was 53.5 ± 12.7 and 42.6 ± 13.4, respectively. There was significant correlation between decreased angle and stone formation (P= < 0.001. The mean length of infundibulum of lower pole of kidney (IPIL in controls and study patients was 22.5 ± 4.1 and 27.5 ± 7.7, respectively, which was statistically significant (P< 0.001. The mean number of calyces in lower pole of the kidney (LPCN in controls and study patients was 2.6 ± 0.6 and 3 ± 0.9, respectively, which was statistically significant (P= < 0.002. There was no significant correlation between distribution of calyces and stone formation (P= 0.366. Our study suggests that abnormal renal anatomy was more common in patients with lower pole kidney stone and should

  3. Sensory and biomechanical responses to distension of the renal pelvis in kidney stone patients

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Liao, Donghua; Osther, Susanne Sloth;

    pressure in the renal pelvis corresponded positively to the sensory ratings but the referred pain area was diffuse located and varied in size. The present study provides a method for describing the mechanosensory properties and 3D deformation of the complex renal pelvis geometry. Although...... there was a relation between pressure and pain score, the non-homogenous spatial strain distribution suggests that the 3D biomechanical properties of the renal pelvis are not reflected by simple estimates of tension based on pressure and volume....... for first sensation and for pain. 3D deformation and strain were calculated in five patients. The deformation of pelvis during distension was not uniform due to the complex geometry. The pelvis deformed to 113 ± 6% and 115 ± 11% in the longitudinal and circumferential directions, respectively. Endoluminal...

  4. Pathogenesis of Stone Disease

    Science.gov (United States)

    Worcester, Elaine M.; Evan, Andrew P.; Coe, Fredric L.

    2008-09-01

    All stones share similar presenting symptoms, and urine supersaturation with respect to the mineral phase of the stone is essential for stone formation. However, recent studies using papillary biopsies of stone formers provide a view of the histology of renal crystal deposition which suggests that the early sequence of events leading to stone formation may differ depending on the type of stone and on the urine chemistry leading to supersaturation. Three general patterns of crystal deposition are seen: interstitial apatite plaque in idiopathic calcium oxalate stone formers, which is the site of stone attachment; tubule deposition of apatite, seen in all calcium phosphate stone formers; and mixtures of apatite and another crystal phase, such as cystine or calcium oxalate, seen in patients with cystinuria or enteric hyperoxaluria. The presence of apatite crystal in either the interstitial or tubule compartment (and sometimes both) of the renal medulla in stone formers is the rule, and has implications for the initial steps of stone formation and the potential for renal injury.

  5. An Understanding of Renal Stone Development in a Mixed Oxalate–Phosphate System

    Science.gov (United States)

    Guan, Xiangying; Wang, Lijun; Dosen, Anja; Tang, Ruikang; Giese, Rossman F.; Giocondi, Jennifer L.; Orme, Christine A.; Hoyer, John R.; Nancollas, George H.

    2009-01-01

    The in vivo formation of calcium oxalate concretions having calcium phosphate nidi is simulated in an in vitro (37 °C, pH 6.0) dual constant composition (DCC) system undersaturated (σDCPD = −0.330) with respect to brushite (DCPD, CaHPO4 · 2H2O) and slightly supersaturated (σCOM = 0.328) with respect to calcium oxalate monohydrate (COM, CaC2O4 · H2O). The brushite dissolution provides calcium ions that raise the COM supersaturation, which is heterogeneously nucleated either on or near the surface of the dissolving calcium phosphate crystals. The COM crystallites may then aggregate, simulating kidney stone formation. Interestingly, two intermediate phases, anhydrous dicalcium phosphate (monetite, CaHPO4) and calcium oxalate trihydrate (COT), are also detected by X-ray diffraction during this brushite–COM transformation. In support of clinical observations, the results of these studies demonstrate the participation of calcium phosphate phases in COM crystallization providing a possible physical chemical mechanism for kidney stone formation. PMID:18557638

  6. An understanding of renal stone development in a mixed oxalate-phosphate system.

    Science.gov (United States)

    Guan, Xiangying; Wang, Lijun; Dosen, Anja; Tang, Ruikang; Giese, Rossman F; Giocondi, Jennifer L; Orme, Christine A; Hoyer, John R; Nancollas, George H

    2008-07-15

    The in vivo formation of calcium oxalate concretions having calcium phosphate nidi is simulated in an in vitro (37 degrees C, pH 6.0) dual constant composition (DCC) system undersaturated (sigma DCPD = -0.330) with respect to brushite (DCPD, CaHPO 4 . 2H 2O) and slightly supersaturated (sigma COM = 0.328) with respect to calcium oxalate monohydrate (COM, CaC2O4 . H2O). The brushite dissolution provides calcium ions that raise the COM supersaturation, which is heterogeneously nucleated either on or near the surface of the dissolving calcium phosphate crystals. The COM crystallites may then aggregate, simulating kidney stone formation. Interestingly, two intermediate phases, anhydrous dicalcium phosphate (monetite, CaHPO4) and calcium oxalate trihydrate (COT), are also detected by X-ray diffraction during this brushite-COM transformation. In support of clinical observations, the results of these studies demonstrate the participation of calcium phosphate phases in COM crystallization providing a possible physical chemical mechanism for kidney stone formation.

  7. Advances in percutaneous stone surgery

    Directory of Open Access Journals (Sweden)

    Christopher Hartman

    2015-01-01

    Full Text Available Treatment of large renal stones has changed considerably in recent years. The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before, and this has been met with improvements in percutaneous stone surgery. In this review paper, we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, exit strategies, and post-operative antibiotic prophylaxis.

  8. 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...... with careful consideration of stone size and location, symptoms, patient comorbidity and radiation dose. CONCLUSION: In case of infective hydronephrosis, compromised renal function or persistent pain despite adequate analgesic treatment acute intervention is indicated....

  9. An open source framework for tracking and state estimation ('Stone Soup')

    Science.gov (United States)

    Thomas, Paul A.; Barr, Jordi; Balaji, Bhashyam; White, Kruger

    2017-05-01

    The ability to detect and unambiguously follow all moving entities in a state-space is important in multiple domains both in defence (e.g. air surveillance, maritime situational awareness, ground moving target indication) and the civil sphere (e.g. astronomy, biology, epidemiology, dispersion modelling). However, tracking and state estimation researchers and practitioners have difficulties recreating state-of-the-art algorithms in order to benchmark their own work. Furthermore, system developers need to assess which algorithms meet operational requirements objectively and exhaustively rather than intuitively or driven by personal favourites. We have therefore commenced the development of a collaborative initiative to create an open source framework for production, demonstration and evaluation of Tracking and State Estimation algorithms. The initiative will develop a (MIT-licensed) software platform for researchers and practitioners to test, verify and benchmark a variety of multi-sensor and multi-object state estimation algorithms. The initiative is supported by four defence laboratories, who will contribute to the development effort for the framework. The tracking and state estimation community will derive significant benefits from this work, including: access to repositories of verified and validated tracking and state estimation algorithms, a framework for the evaluation of multiple algorithms, standardisation of interfaces and access to challenging data sets. Keywords: Tracking,

  10. H+, Water and Urea Transport in the Inner Medullary Collecting Duct and Their Role in the Prevention and Pathogenesis of Renal Stone Disease

    Science.gov (United States)

    Wall, Susan M.; Klein, Janet D.

    2008-09-01

    The inner medullary collecting duct (IMCD) is the final site within the kidney for the reabsorption of urea, water and electrolytes and for the secretion of H+ before the luminal fluid becomes the final urine. Transporters expressed in the IMCD contribute to the generation of the large ion gradients that exist between the interstitium and the collecting duct lumen. Thus, the luminal fluid within the human IMCD can reach an osmolality of 1200 mOsm/kg H2O and a pH of 4. This ability of the human nephron to concentrate and acidify the urine might predispose to stone formation. However, under treatment conditions that predispose to stone formation, such as during hypercalciuria, the kidney mitigates stone formation by reducing solute concentration by reducing H2O reabsorption. Moreover, the kidney attenuates stone formation by tightly controlling acid-base balance, which prevents the bone loss, hypocitraturia and hypercalciuria observed during metabolic acidosis by augmenting net H+ excretion by tightly regulating H+ transporter function and through luminal buffering, particularly with NH3. This article will review the ion transporters present in the mammalian IMCD and their role in the prevention and in the pathogenesis of renal stone formation.

  11. [The effects of Cinacalcet in renal stone formers with primary hyperparathyroidism].

    Science.gov (United States)

    Vitale, Corrado; Bermond, Francesca; Rodofili, Amelia; Soragna, Giorgio; Marcuccio, Cristina; Tricerri, Alberto; Marangella, Martino

    2016-01-01

    Primary hyperparathyroidism (PHPT) may favor nephrolithiasis mainly through an increase in calcium and phosphate urinary excretion. Cinacalcet exhibits good efficacy to control hypercalcemia in PHPT, but it is not so far known whether it might be a useful tool to prevent stone recurrences. Of 67 patients with PHPT and recurrent nephrolithiasis, 55 underwent parathyroidectomy (PTX) and 12, not eligible to PTX, were prescribed Cinacalcet. All the patients were evaluated for mineral metabolism, including estimation of state of saturation for calcium oxalate (CaOx) and brushite (bsh), both at baseline and after either PTX or Cinacalcet. PTX compared to baseline reduced PTH (4617 vs 15786 pg/mL, p<0.01), calcemia (9.40.5 vs 11.30.9 mg/dL, p<0.01), calciuria (3.62.3 vs 9.24.5 mmol/24h, p<0.01), phosphaturia (18.47.1 vs 21.99.9 mmol/24h, p<0.05), CaOx (4.73.9 vs 9.86.8, p<0.01) and bsh (1.10.9 vs 3.22.2, p<0.01). Cinacalcet decreased both PTH (13379 vs 17187 pg/mL, p<0.05) and calcemia (9.70.6 vs 11.20.8 mg/dL, p<0.001), whereas no change was seen in calciuria (7.42.2 vs 7.42.4 mmol/24h, p=ns), phosphaturia (21.97.3 vs 23.06.5 mmol/24h, p=ns), CaOx (6.92.7 vs 5.42.5, p=ns) and bsh (1.71.1 vs 1.31.3, p=ns). We conclude that in patients with PHPT, PTX is able to decrease the risk for crystallization of calcium salts, whereas calcimimetic Cinacalcet did not. Therefore, in patients with PHPT complicated with nephrolithiasis only PTX can improve urine biochemistries thereby reducing the risk for recurrent calcium stone disease.

  12. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars; Jørgensen, Christoffer Calov; Kehlet, Henrik

    2016-01-01

    BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length o...

  13. Like a rolling stone: naturalistic visual kinematics facilitate tracking eye movements.

    Science.gov (United States)

    Souto, David; Kerzel, Dirk

    2013-02-06

    Newtonian physics constrains object kinematics in the real world. We asked whether eye movements towards tracked objects depend on their compliance with those constraints. In particular, the force of gravity constrains round objects to roll on the ground with a particular rotational and translational motion. We measured tracking eye movements towards rolling objects. We found that objects with rotational and translational motion that was congruent with an object rolling on the ground elicited faster tracking eye movements during pursuit initiation than incongruent stimuli. Relative to a condition without rotational component, we compared objects with this motion with a condition in which there was no rotational component, we essentially obtained benefits of congruence, and, to a lesser extent, costs from incongruence. Anticipatory pursuit responses showed no congruence effect, suggesting that the effect is based on visually-driven predictions, not on velocity storage. We suggest that the eye movement system incorporates information about object kinematics acquired by a lifetime of experience with visual stimuli obeying the laws of Newtonian physics.

  14. Idiopathic recurrent calcium urolithiasis (IRCU: variation of fasting urinary protein is a window to pathophysiology or simple consequence of renal stones in situ?

    Directory of Open Access Journals (Sweden)

    Schwille PO

    2009-09-01

    Full Text Available Abstract Background In IRCU it is uncertain whether variation of urinary protein, especially non-albumin protein (NAlb-P, is due to the presence of stones or reflects alteration of oxidative metabolism. Aims To validate in a tripartite cross-sectional study of 187 ambulatory male patients, undergoing a standardized laboratory programme, whether stones impact on N-Alb-P or the state of oxidative metabolism interferes with IRCU pathophysiology. Methods In part 1 the strata low and high of fasting urinary excretion rate per 2 h of N-Alb-P, malonedialdehyde, hypoxanthine, xanthine, pH and other urine components were compared, and association with renal stones in situ evaluated; in part 2 the co-variation of oxidatively modulated environment, fasting urinary pH, calcium (Ca salt crystallization risk and the number of patients with stones in situ was examined; in part 3, the nucleation of Ca oxalate and Ca phosphate was tested in undiluted postprandial urine of patients and related to the state of oxidative metabolism. Results In part 1, N-Alb-P excretion > 4.3 mg was associated with increase of blood pressure, excretion of total protein, hypoxanthine (a marker of tissue hypoxia, malonedialdehyde (a marker of lipid peroxidation, sodium, magnesium, citrate, uric acid, volume, pH, and increase of renal fractional excretion of both NAlb-P and uric acid; when stones were present, urinary pH was elevated but other parameters were unaffected. Significant predictors of N-Alb-P excretion were malonedialdehyde, fractional N-Alb-P and hypoxanthine. In part 2, urine pH > 6.14 was associated with unchanged blood pressure and plasma vasopressin, increase of blood pH, urinary volume, malonedialde hyde, fractional excretion of N-Alb-P, uric acid, Ca phosphate, but not Ca oxalate, supersaturation; this spectrum was accompanied by decrease of concentration of urinary total and free magnesium, total and complexed citrate, plasma uric acid (in humans the major

  15. Shock wave lithotripsy, retrograde intrarenal surgery or percutaneous nephrolithotomy for lower pole renal stones?

    Directory of Open Access Journals (Sweden)

    Alejandro Rojas

    2015-09-01

    Full Text Available Dentro de las alternativas terapéuticas disponibles para el tratamiento de la litiasis renal de polo inferior se encuentran la litotricia extracorpórea, la nefrolitotomía percutánea y la cirugía intrarrenal retrógrada. Existe controversia sobre cuál de estas técnicas es más efectiva, sobre todo en cálculos menores de 20 milímetros. Utilizando la base de datos Epistemonikos, la cuál es mantenida mediante búsquedas en 30 bases de datos, identificamos cuatro revisiones sistemáticas que en conjunto incluyen 19 estudios. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. La nefrolitotomía percutánea probablemente aumenta la tasa libre de cálculos, pero no es claro si disminuye la necesidad de retratamiento comparada con la litotricia extracorpórea. En comparación con cirugía intrarrenal retrógrada podría aumentar la tasa libre de cálculos, pero no es claro si disminuye la necesidad de retratamiento. La cirugía intrarrenal retrógrada podría aumentar la tasa libre de cálculos, y probablemente disminuye la necesidad de retratamiento, comparada con la litotricia extracorpórea.

  16. 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.

  17. Meier–Gorlin syndrome: An additional Egyptian patient with gastroesophageal reflux, hydronephrosis, renal stones and hypoplastic labia majora and minora with clitromegaly

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2016-10-01

    Full Text Available We report a 4.5 year old female child with the classical triad of Meier–Gorlin syndrome (microtia, absent patella and short stature with normal mentality. She had small triangular face, long peaked nose, high nasal bridge, bilateral low set very small ears (microtia, retromicrognathia, high arched palate, maxillary hypoplasia, decayed teeth, and bilateral partial syndactyly between 2nd and 3rd toes. Our patient had a gastroesophageal reflux, renal stones, hydronephrosis and hypoplastic labia majora and minora with clitromegaly.

  18. Diagnosis and treatment of carcinoma of renal pelvis accompanied with kidney stones%肾结石并发肾盂癌的诊治

    Institute of Scientific and Technical Information of China (English)

    陈合群; 黄初阳; 李深基; 王桂林

    2010-01-01

    目的 提高肾结石并发肾盂癌的诊治水平.方法 肾结石并发肾盂癌患者21例.病史10 d~24年,平均27个月,临床表现反复寒战、发热、消瘦3例;全程肉眼血尿17例,其中2例有典型的血尿、疼痛、腹部肿块表现.CT检查17例,提示肾盂肿瘤9例,疑肾下极肿瘤4例,肾门淋巴结肿大2例.MRU检查10例,诊断为肾结石并发肾盂癌9例.21例IVU检查.患肾显影浅淡13例,其中3例显示肾盂内充盈缺损,不显影8例.术前确诊9例,行患肾根治性肾切除及局部淋巴结清扫术;5例因脓肾先行肾造瘘术,二期行包膜下肾切除术,其中2例术后证实为肾盂移行细胞癌,加行残端输尿管全切加膀胱袖状切除;3例因肾多发结石无功能术中黏连严重,行包膜下肾切除术;3例术前诊断为肾脏复杂多发性结石,因肾脏无功能或功能差行患肾切除加输尿管部分切除,其中2例术后证实为肾盂移行细胞癌,加行残端输尿管全切加膀胱袖状切除;1例B超引导下行微创经皮肾镜取石术,发现肾盂肿物,术中病理切片考虑为肾盂黏液腺癌,二期行根治术及肾门淋巴结清扫术. 结果 21例均经术后病理诊断证实,其中移行细胞癌4例、鳞状细胞癌16例、黏液腺癌1例.21例均顺利出院.获随访9例,随访时间4~28个月.死亡6例,术后生存时间3~21个月,其中死于心肌梗死2例,癌肿转移4例. 结论 高龄、结石病史长、患肾积液及感染明显的肾结石,术前应考虑合并肾盂癌的可能;CT与MRU检查对诊断肾结石合并肾盂癌有重要价值;早期诊断、早期处理肾结石并发肾盂癌可延长患者存活期.%Objective To discuss the diagnosis and treatment of carcinoma of renal pelvis ac-companied with kidney stones. Methods Twenty-one cases of carcinoma of renal pelvis with kidney stones were reviewed. The urinary stones history was from 10 d to 24 years with an average of 27 months. Four cases had recurrent fever

  19. The Healthy Start Renal Clinic: Benefits of Tracking and Early Intervention in Pre-End Stage Renal Disease Patients

    Science.gov (United States)

    Self, Ida; Lindberg, Jill; Filangeri, Judith; Anderson, Shannon; Szerlip, Marjorie; Best, Julie; Sadler, Rebecca; Savoie, Judy; Jackson, Dina; James, Carla; Husserl, Fred; Copely, J. Brian

    1999-01-01

    Several studies have demonstrated a strong association between the benefits of pre-end stage renal disease (ESRD) education and decreased length of hospital stay (LOS) and hospital charges, delay of renal replacement therapy (RRT), and a smooth transition to RRT. The Ochsner Healthy Start Renal Clinic (HSRC) is a multidisciplinary early education and tracking program for pre-ESRD patients and their families. We identified and educated pre-ESRD patients about kidney disease, allowing them to discuss and make informed decisions about their treatment and be better prepared to cope with the transition to RRT and the changes in their lives resulting from kidney failure. HSRC patients demonstrated a significant decrease in length of hospital stay (p = 0.05), a trend towards decreased hospital episodes and charges, decreased use of temporary venous access, and a smooth transition to RRT. The control group was made up of patients who had either refused the structured education or had been referred to HSRC late and received only conventional instruction by a social worker at the point where dialysis was imminent. We compared the number of episodes of hospitalization, LOS, and overall hospital charges for the period immediately surrounding initiation of chronic dialysis (2 months before and 1 month following onset) of all 36 patients who began chronic hemodialysis in our facility between November 1997 and November 1998. HSRC patients had LOS half as long (p=0.05), fewer hospital episodes, and hospital charges of $5,000 less per patient than the non-HSRC group. Initial data strongly suggest that early education and intervention through the coordination of a multidisciplinary team maximize the continuity of patient care. PMID:21845139

  20. Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in management of lower-pole renal stones with a diameter of smaller than 15 mm.

    Science.gov (United States)

    Kirac, Mustafa; Bozkurt, Ömer Faruk; Tunc, Lutfi; Guneri, Cagri; Unsal, Ali; Biri, Hasan

    2013-06-01

    The aim of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PNL) in management of lower-pole renal stones with a diameter smaller than 15 mm. Between December 2009 and July 2012, the patients with the diagnosis of lower-pole stones were evaluated by ultrasonography, intravenous pyelography and computed tomography. The records of 73 evaluable patients who underwent mini-PNL (n = 37) or RIRS (n = 36) for lower-pole (LP) stones with diameter smaller than 15 mm were reviewed retrospectively. Of the 73 patients, 37 underwent mini-PNL and 36 underwent RIRS. The stone-free rates were 89.1 and 88.8 % for mini-PNL and RIRS groups, respectively. The mean operation time was 53.7 ± 14.5 in the mini-PNL group but 66.4 ± 15.8 in the RIRS group (P = 0.01). The mean fluoroscopy times and hospitalization times were significantly higher in the mini-PNL group. There was no major complication in any patient. RIRS and mini-PNL are safe and effective methods for treatment of LP calculi with a diameter smaller than 15 mm. RIRS is a non-invasive and feasible treatment option, and has also short hospitalization time, low morbidity and complication rate. It may be an alternative of mini-PNL in the treatment LP calculi with smaller than 15 mm.

  1. COMPARATIVE STUDY OF CULTURE AND SENSITIVITY PATTERNS OF PRE OPERATIVE MID STREAM URINE WITH RENAL PELVIC URINE AND STONE TO PREDICT UROSEPSIS FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY: A PROSPECTIVE CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Bhargava Vardhana Reddy

    2015-11-01

    Full Text Available INTRODUCTION : Percutaneous nephrolithotomy (PCNL is the most frequently performed surgery for stone disease at our institution. Nearly 100 PCNL procedures are being performed in a year at our institution. Septicemia following PCNL can be catastrophic despite sterile preoperative urine and prophylactic antibiotics. Infected stones, obstructed kidneys , and comorbidit y have been held responsible. In this study we analyzed various culture specimens, namely Mid - stream urine (MSU, renal pelvic urine and crushed stones. MATERIALS AND METHODS : We performed a prospective clinical study in all our patients undergoing PCNL b etween January 2013 and December 2014. MSU was sent for culture and sensitivity testing (C&S one day prior to surgery. Percutaneous access into the ipsilateral pelvicaliceal system is achieved under image intensification using a fine, 14 gauge Kellet need le. Urine from the pelvicaliceal system is first aspirated and sent as pelvic urine C&S. Stone fragments are collected to be proces0sed for C&S. The data collected were divided into 3 main groups, that is MSU C&S, pelvic urine C&S and stone C&S. RESULTS : A total of 83 patients were included in the study, of this MSU C&S was positive in 9/83 (10.8% patients, Pelvic C&S in 10 /73 (13.7% patients and Stone C&S in 25/83 (30.1% patients. Out of 25 cases of stone culture positive patients 17 patients develope d Systemic Inflammatory Response Syndrome (SIRS but only 2 patients developed SIRS in MSU C & S positive patients. CONCLUSIONS: The results of our study suggest that positive stone C&S is the better predictor of potential urosepsis than MSU. Stone cultur e is available only after surgery but appears to be the best guide for antibiotic therapy in case of sepsis. So the routine collection of stone for C&S will be beneficial

  2. Analysis of clinical laboratory data by biplot methods using a three-dimensional display: discrimination of renal stone-patients with idiopathic hypercalciuria and primary hyperparathyroidism.

    Science.gov (United States)

    Tschöpe, W; Schmidt-Gayk, H; Ritz, E; Weber, E; Berger, J

    1979-08-01

    The biplot technique is a very useful graphical method to display the relationships between row and column characteristics in two-way tables. This method is applicable as long as the rank-2 approximation explains a large part (e.g. 95%) of the whole variability. However, since in large tables only a rank-3 approximation will yield such a high degree of explanation, a three-dimensional biplot technique has been introduced, using a 3d-screen as a matter of presentation of clinical laboratory data. The value of such a procedure is illustrated using as a clinical example a patient population with recurrent renal stone formation due either to primary hyperparathyroidism or to idiopathic hypercalciuria.

  3. Adjunctive medical therapy with α-blocker after extracorporeal shock wave lithotripsy of renal and ureteral stones: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mingchao Li

    Full Text Available Although some trials assessed the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after extracorporeal shock wave lithotripsy (ESWL, the role of the α-blocker in facilitating upper urinary calculi expulsion after ESWL remain controversial.To determine the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after ESWL.A literature search was carried out using the PubMed database, EMBASE and the Cochrane Library database to identify relevant studies. Two reviewers independently extracted data and assessed methodological quality. Pooled effect estimates were obtained using a fixed- and random-effects meta-analysis.The meta-analysis included 23 RCTs, α-blocker significantly enhanced expulsion rate of upper urinary tract calculi after ESWL (P<0.00001; RR 1.21; 95% CI 1.12-1.31, significantly promoted steinstrasse expulsion (P=0.03; RR 1.25; 95% CI 1.03-1.53, significantly shortened the discharge time of upper urinary tract calculi (P=0.0001; MD -2.12; 95% CI -3.20--1.04, significantly reduced the patient's pain VAS score (P=0.001; RR -1.0; 95% CI -1.61--0.39. Compared with the control group, dizziness (P=0.002; RR 5.48; 95% CI 1.91-15.77, anejaculation (P=0.02; RR 12.17; 95% CI 1.61-91.99 and headache (P=0.04; RR 4.03; 95% CI 1.04-15.72 in the α-blocker group was associated with a higher incidence.Treatment with α-blocker after ESWL appears to be effective in enhancing expulsion rate of upper urinary tract calculi, shortening the discharge time of upper urinary tract calculi, reducing the patient's pain. The side effects of α-blocker were light and few.

  4. NEW FRONTIERS ON NEPHROLITHIASIS: PATHOPHYSIOLOGY AND MANAGEMENT OF KIDNEY STONES

    OpenAIRE

    Malan Rajat; Walia Anu; Gupta Sumeet

    2011-01-01

    Nephrolithiasis (also known as kidney stones, renal stones, urinary stones, urolithiasis, and renal calculi) affects a great number of patients worldwide. These can be of different types like calcium-oxalate, struvite, uric acid, cysteine. Larger stones in the urinary tract can cause extreme pain in the lower back or side. Urinary tract infections, kidney disorders and certain metabolic disorders such as hyperparathyroidism are also linked to stone formation. Cystinuria, hyperoxaluria, Hyperc...

  5. New developments in percutaneous stone surgery

    Directory of Open Access Journals (Sweden)

    S. Derisavifard

    2016-09-01

    Full Text Available Percutaneous stone surgery is the gold standard in removing large renal calculi. In light of the increase in prevalence and size of renal stones being addressed in recent years, numerous advances have been made in attempts of improving the morbidity, efficacy, and technical ease of stone clearance. In this review article, we assess new advancements in percutaneous stone surgery including diagnosis and surgical planning, methods of renal access, patient positioning, tract dilation, nephroscopes, lithotripsy, and post-operative drainage and antibiotic prophylaxis.

  6. 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.

  7. Application of inversion-table in the treatment of lower pole renal stones%倒置排石床在肾下盏结石治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    余虓; 陈志强; 杨为民; 刘继红; 周惜才; 王少刚; 郭辉; 叶章群

    2009-01-01

    目的 探讨倒置排石床在治疗肾下盏结石中的作用.方法 2006年3月至2008年9月,收治的36例肾下盏结石患者,其中结石直径>4 mm且<2 cm者13例,进行体外冲击波碎石术(ESWL)同时配合倒置排石床治疗,直径≤4 mm且≥2 mm的单纯肾下盏结石或输尿管镜钬激光碎石术及后下盏残石23例,仅进行倒置排石床治疗.3个月后复查尿路平片,了解结石排尽情况.结果 所有36例患者均顺利完成排石床排石治疗,倒置排石过程中未出现严重的心脑血管意外,3个月复查结石排净率83.3%(30/36),残石率16.7%(6/36).结论 采用倒置排石床可以提高肾下盏结石排石率,可作为结石微创治疗的辅助手段.%Objective To investigate the effect of inversion-table in the treatment of lower pole renal stones.Methods From March 2006 to September 2008,36 patients with lower pole renal calculi were treated by inversion-table,13 cases with stone diameter from 4 mm to 20 mm received extracoporeal shock wave lithotripsy (ESWL) combined with inversion-table treatment and other 23 cases with stone diameter from 2 mm to 4 mm received inversion-table treatment alone.Results All of 36 cases underwent inversion-table treatment successfully and no one had cardio-cerebral accident.After following up 3 months,the radiologically documented complete stone clearance rate at 3 months group was 83.3%.Conclusion Inversion-table treatment is a safe and valuable adjunct in assisting passage of lower pole renal stone fragments after mini-invasive treatment of stone and can improve stone-free rate.

  8. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty; a detailed observational cohort study

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length...... postoperatively. Seven complications . (0.08 %) were urological, mainly haematuria after bladder catheterisation, whereas 5 (0.06 were urosepsis/pyelonephritis. CONCLUSION: The overall incidence of serious RU complications after fast-track THA and TKA was 0.61 %. AKI occurred in 0.49% and was most often due...

  9. Tracking sub-clonal TP53 mutated tumor cells in human metastatic renal cell carcinoma.

    Science.gov (United States)

    Bousquet, Guilhem; El Bouchtaoui, Morad; Leboeuf, Christophe; Battistella, Maxime; Varna, Mariana; Ferreira, Irmine; Plassa, Louis-François; Hamdan, Diaddin; Bertheau, Philippe; Feugeas, Jean-Paul; Damotte, Diane; Janin, Anne

    2015-08-07

    Renal Cell Carcinomas (RCCs) are heterogeneous tumors with late acquisition of TP53 abnormalities during their evolution. They harbor TP53 abnormalities in their metastases. We aimed to study TP53 gene alterations in tissue samples from primary and metastatic RCCs in 36 patients followed up over a median of 4.2 years, and in xenografted issued from primary RCCs. In 36 primary RCCs systematically xenografted in mice, and in biopsies of metastases performed whenever possible during patient follow-up, we studied p53-expressing tumor cells and TP53 gene abnormalities.We identified TP53 gene alterations in primary tumors, metastases and xenografts. Quantification of tumors cells with TP53 gene alterations showed a significant increase in the metastases compared to the primary RCCs, and, strikingly, the xenografts were similar to the metastases and not to the primary RCCs from which they were derived.Using laser-microdissection of p53-expressing tumor cells, we identified TP53-mutated tumor cells in the xenografts derived from the primary RCC, and in a lung metastasis later developed in one patient. The mutation enabled us to track back their origin to a minority sub-clone in the primary heterogeneous RCC. Combining in situ and molecular analyses, we demonstrated a clonal expansion in a living patient with metastatic RCC.

  10. Use of flexible ureteroscopy in the clinical practice for the treatment of renal stones: results from a large European survey conducted by the EAU Young Academic Urologists-Working Party on Endourology and Urolithiasis.

    Science.gov (United States)

    Sanguedolce, F; Liatsikos, E; Verze, P; Hruby, S; Breda, A; Beatty, J D; Knoll, T

    2014-08-01

    Treatment of renal stones using flexible ureteroscopy (fURS) is increasingly common despite the poor evidence in literature supporting its use and indications. With this study, we wanted to investigate the current use and indication of fURS for the treatment of renal stones in the clinical practice across the European countries. A survey was conducted using an emailed questionnaire consisting of 21 items; 2,894 recipients were selected via the EAU membership database. The questionnaires were collected through the SurveyMonkey system and the data were processed with the SPSS statistical package. Frequencies, cross tabs and Pearson correlation coefficients were applied as appropriate. 1,168 questionnaires were collected (response rate 40.4%). fURS was performed in 72.9% of the respondents' institutions, and 54.2% of the respondents were performing the procedure. For 95% of the users, fURS was considered first-line treatment, for stone of lower pole stone (45.9%) and <1 cm (44.2%) and 2 cm (43.8%) in size. The ureteral access sheaths were used routinely by more than 70% of the respondents. Lower pole stone repositioning technique was routinely performed by 45.9% of the surgeons. After fragmentation, 47.2% of the responders preferred to retrieve only the bigger fragments. At the end of fURS, lower volume surgeons were more likely to place routinely a double-J stent (p = 0.001). Higher volume surgeons estimated a higher durability of devices, both optical and digital ones (p < 0.001), and were more prone to consider fURS cost-effective when compared to other treatment modalities (p < 0.001). fURS is widely used for the treatment of renal stones and its use and indication can vary according to the age and surgeons' case volume. Higher volume surgeons are more prompt to extend international guidelines indications and to consider the technology cost-effective.

  11. Modern Approach to Ureteral Stones

    Directory of Open Access Journals (Sweden)

    Geert G. Tailly

    2003-01-01

    Full Text Available Urolithiasis is a very common affliction of mankind. In western countries incidence is increasing steadily. An increasing proportion of patients are presenting with ureteral stones, of which renal colic most often is the first complaint and the most common reason for an emergency visit to a urologist. Proper imaging strategy is of paramount importance in the diagnosis of acute flank pain and in the subsequent therapy planning once a ureteral stone is diagnosed. Renal colic during pregnancy poses specific problems, both in imaging and therapy. Apart from the adequate treatment of renal colic, modern therapy of those ureteral calculi that will not pass spontaneously will consist of a judicious combination of ESWL (extracorporeal shock wave lithotripsy, endourology, and laparoscopy. Open surgery should only be reserved for limited and very specific indications. Although beyond the scope of this article, metaphylaxis should take an important role in the follow-up of stone patients in general.

  12. [Management of adult's renal and ureteral stones. Update of the Lithiasis Committee of the French Association of Urology (CLAFU). General considerations].

    Science.gov (United States)

    Chabannes, É; Bensalah, K; Carpentier, X; Bringer, J-P; Conort, P; Denis, É; Dore, B; Estrade, V; Gautier, J-R; Hadjadj, H; Hubert, J; Hoznek, A; Lechevallier, É; Meria, P; Mozer, P; Saussine, C; Yonneau, L; Traxer, O

    2013-12-01

    The Lithiasis Committee of the French Association of Urology (CLAFU) aimed to update the current knowledge about urolithiasis. This update will be divided into four parts: 1) general considerations; 2) the management of ureteral stones; 3) the management of kidney stones; 4) metabolic assessment and medical treatment of urolithiasis. Recent technicals advances helped the urologists to improve stones management: new extracorporeal shockwave lithotripsy (ESWL) devices, new flexible ureterorenoscopes, development of laser fragmentation. ESWL, semi-rigid and flexible ureteroscopy and the percutaneous nephrolithotomy (PCNL) remain currently the main therapeutic options. The first part of this update deals with the description and classification of stones, preoperative assessment, post-operative management and clinical follow-up. Main criteria of therapeutic choices are stone location, stone composition and stone size. Stone composition is assessed with infrared spectrophotometry analysis and its hardness is correlated with U.H. density on CT scan assessment. Preoperative assessment consists in urinary cytobacteriological examine, urinary PH, blood creatininemia, hemostasis. Low-dose CT scan is recommended before urological treatment. The result of the treatment must be done 1 or 3 months later with plain abdominal film and ultrasonography. Medical management of urolithiasis will be based on stone composition, metabolic and nutritional evaluation. Treatment success is definited by absence of residual fragments. Annual follow-up is recommended and based either on plain abdominal film and ultrasonography or low-dose CT scan.

  13. [Rare cases of bladder stones].

    Science.gov (United States)

    Sampalmieri, Gregorio; Moretti, Antonello; Sampalmieri, Matteo

    2014-01-01

    We present here two special cases of urolithiasis. The first one shows a giant bladder lithiasis resulting in severe renal insufficiency in a 63-year-old patient, who had previously had nicturia (2-3 times), occasional episodes of urinary frequency and burning micturition, in the absence of renal colic, hematuria or interrupted urination. The second case referes to an 85-year-old man suffering from prostatic enlargement and bladder stones, hospitalized to undergo intervention of trans-vesical prostatic adenomectomy, during which two star-shaped stones were found without obvious symptoms.

  14. Treatment of sodium bicarbonate combined with extracorporeal shock wave lithotripsy for renal uric acid stone and review of the literature%碳酸氢钠联合ESWL治疗双J管末端尿酸结石1例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    李浩勇; 梁培育; 周治彦; 宋鹏; 彭晓晖; 颜毅; 刘继红

    2012-01-01

    目的:探讨采用1.5%碳酸氢钠溶液联合ESWL治疗尿酸结石的疗效.方法:采用ESWL联合输尿管导管逆行插管后持续灌注1.5%碳酸氢钠溶石治疗1例43岁双肾尿酸结石男性患者.结果:治疗1周后,尿酸结石完全消失,双J管顺利拔出,无逆行感染.结论:1.5%碳酸氢钠溶液联合ESWL治疗尿酸结石疗程短,费用低,疗效确切,是一种治疗尿酸结石快速、安全和有效的治疗方法.%Objective:To investigate the treatment effects of 1. 5% sodium bicarbonate combined with extracorporeal shock wave lithotripsy(ESWL) for renal uric acid stone. Method: A single case of renal uric acid stone was report, a 43-year-old male patients with bilateral renal uric acid stone, and extremity of bilateral double J tube formed uric stone. Patient was treated by ESWL and 1. 5% sodium bicarbonate dissolution therapy. Result: All uric acid stone disappeared without any retrograde infection, bilateral double J tube were extracted successfully after a week. Conclusion:This method is perfect for renal uric acid stone. It might also served as an optimal treat procedure of sodium bicarbonate combined with ESWL for renal uric acid stone.

  15. Kidney stones during pregnancy.

    Science.gov (United States)

    Semins, Michelle J; Matlaga, Brian R

    2014-03-01

    Kidney stones affect 10% of people at some point in their lives and, for some unfortunate women, this happens during pregnancy. Pregnancy is a complex state and both physiological and mechanical changes alter risk factors for kidney stone formation. When a pregnant woman develops acute nephrolithiasis, the situation is more complicated than in nonpregnant women. Imaging limitations and treatment restrictions mean that special diagnostic and management algorithms are needed upon presentation. Ultrasonography remains the gold-standard first-line diagnostic imaging modality for kidney stones during pregnancy but several second-line alternatives exist. Acute renal colic during pregnancy is associated with risks to both mother and fetus. As such, these patients need to be handled with special attention. First-line management is generally conservative (trial of passage and pain management) and is associated with a high rate of stone passage. Presentation of obstructive nephrolithiasis with associated infection represents a unique and serious clinical situation requiring immediate drainage. If infection is not present and conservative management fails, ureteroscopy can be offered if clinically appropriate, but, in some circumstances, temporary drainage with ureteral stent or nephrostomy tube might be indicated. Shockwave lithotripsy and percutaneous nephrolithotomy are contraindicated during pregnancy.

  16. 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.

  17. 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...

  18. Analysis of Risk Factors of SIRS Following Flexible Ureteroscopy in the Treatment of Renal Stones%输尿管软镜碎石术后SIRS发生的高危因素分析

    Institute of Scientific and Technical Information of China (English)

    高小峰; 张威; 彭泳涵; 李凌; 施晓磊; 刘敏; 孙颖浩

    2014-01-01

    Objective Analyze the risk factors that affect the development of postoperative systemic inflam-matory response syndrome (SIRS)following flexible ureteroscopy (f-URS)in the treatment of renal stones. Patients and methods We retrospectively analyzed the data of f-URS in the treatment of renal stones between October 2011 and February 2013 . The patients were divided into two groups as patients developing SIRS and not developing SIRS. Univariate and multivariate statistical analyses were performed to determine factors affecting the development of SIRS. Results The study included 561 patients (381 male and 180 female),among whom 5. 2%(29/561)developed SIRS. In the univariate analysis,there was significant difference between the two groups in bilateral operation (P = 0 . 032 ),history of chronic renal insufficiency (P = 0 . 041 ),kidney anatomic de-formity (P = 0 . 035 ),a recent history of stone related fever (P < 0 . 001 ),operation history of the same side urinary stones (P = 0 . 010 ),preoperative positive urine culture (P < 0 . 001 ),endoscopic signs of infection (P < 0. 001),the stone of magnesium ammonium phosphate (P < 0. 001). While age,gender,BMI,opera-tive time,stone burden,history of diabetes,proportion of the isolated kidney,preoperative creatinine level, proportion of preoperative double-J placement,proportion of ureteral access sheath placement were not related to the development of SIRS. Multivariate analysis further confirmed that without preoperative placement of double-J (P = 0 . 021 ),a recent history of stone related fever (P < 0 . 001 ),and endoscopic signs of infection (P< 0. 001)were the high risks of SIRS following f-URS in the treatment of renal stones. Conclusions Without preoperative placement of double-J,a recent history of stone related fever,and endoscopic signs of infection are significant predictors of SIRS following f-URS in the treatment of renal stones. Attention should be paid to ask the related history and improve preoperative

  19. [Renal transplantation and urinary lithiasis].

    Science.gov (United States)

    Lechevallier, E; Saussine, C; Traxer, O

    2008-12-01

    Renal lithiasis in renal donors is rare. A renal stone in a donor, or in a renal transplant, is not a contraindication for harvesting nor transplantation. If possible, the stone must be removed at the time of the transplantation. The risk of lithiasis is increased in the renal transplant recipient, with a frequency of 2-6%. Metabolic abnormalities for lithiasis are frequent and can be induced by the immunosuppressive treatment, anticalcineurins. Lithiasis can have a poor prognosis in the renal recipient with a risk for infection or renal dysfunction. Small (renal transplant can be followed-up. Stones of 0.5-1.5cm need an extracorporeal lithotripsy with a previous safety JJ stent. Stones greater than 1.5cm can be treated by ureteroscopy or percutaneous surgery.

  20. Multidimensional Interactive Radiology Report and Analysis: standardization of workflow and reporting for renal mass tracking and quantification

    Science.gov (United States)

    Hwang, Darryl H.; Ma, Kevin; Yepes, Fernando; Nadamuni, Mridula; Nayyar, Megha; Liu, Brent; Duddalwar, Vinay; Lepore, Natasha

    2015-12-01

    A conventional radiology report primarily consists of a large amount of unstructured text, and lacks clear, concise, consistent and content-rich information. Hence, an area of unmet clinical need consists of developing better ways to communicate radiology findings and information specific to each patient. Here, we design a new workflow and reporting system that combines and integrates advances in engineering technology with those from the medical sciences, the Multidimensional Interactive Radiology Report and Analysis (MIRRA). Until recently, clinical standards have primarily relied on 2D images for the purpose of measurement, but with the advent of 3D processing, many of the manually measured metrics can be automated, leading to better reproducibility and less subjective measurement placement. Hence, we make use this newly available 3D processing in our workflow. Our pipeline is used here to standardize the labeling, tracking, and quantifying of metrics for renal masses.

  1. Bladder Stones

    Science.gov (United States)

    ... does not include routine preventive screening for bladder cancer.If you do not treat bladder stones, you can have lasting damage. This includes repeat UTIs or injury to your bladder, kidney, or urethra. Questions to ask your doctor How do I ...

  2. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jørgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    postoperatively. Seven complications . (0.08 %) were urological, mainly haematuria after bladder catheterisation, whereas 5 (0.06 were urosepsis/pyelonephritis. CONCLUSION: The overall incidence of serious RU complications after fast-track THA and TKA was 0.61 %. AKI occurred in 0.49% and was most often due...

  3. Clinical value analysis of renal tubular epithelium and renal local pathological changes on kidney stone formation%肾小管上皮及肾脏局部病理改变对肾结石形成的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    邓武成

    2015-01-01

    目的:探讨肾小管上皮及肾脏局部病理改变在肾结石形成中的作用机制。方法:选取89例肾结石患者作为实验组,90例肾癌患者的肾标本作为对照组,检测两组肾小管上皮的骨桥蛋白、骨形成蛋白‐2(BM P‐2)和II型胶原的表达情况。结果:实验组患者结石多以混合的形式存在;两组肾小管上皮及肾脏局部病理改变中均可见骨桥蛋白表达,实验组高于对照组,差异有统计学意义,骨桥蛋白主要在肾集合管和肾小管上皮细胞胞浆内表达;BM P‐2、II型胶原在肾小管上皮及肾脏病理局部组织中均未见表达。结论:骨桥蛋白在肾结石患者的肾小管上皮细胞中表达, BM P‐2、II型胶原未见表达,因此肾小管上皮及肾脏局部病理改变时骨桥蛋白可能促进肾结石的形成。%Objective:To study the role of renal tubular epithelium and kidney local pathological changes in kidney stone formation .Methods:89 cases of renal calculi patients were selected as the experimental group ,90 cases of patients with renal cell carcinoma renal specimens as control group ,the expression of renal tubular epithelial osteopontin ,bone morphogenetic protein‐2 (BMP‐2) and type II collagen were detected .Results:The calculi mostly existed in the form of mixture ,including of mixture was the calcium calculi (91 .01% ) ,calcium oxalate calculi (84 .27% ) ,uric acid/uric acid salt (14 .61% ) ,carbonate apatite (8 .99% ) ,and ammonium magnesium phosphate hexahydrate (11 .24% ) .Osteopontin was expressed in both two groups and the experimental group was significantly higher than that in the control group .Osteopontin was mainly expressed in the cytoplasm of renal collecting renal tu‐bular epithelial cells .Expression of BMP‐2 and collagen II were not observed in renal tubular epithelial or renal path‐ological local tissues .Conclusion:Osteopontin is expressed in the renal tubular epithelial cells

  4. Sulfate but not thiosulfate reduces calculated and measured urinary ionized calcium and supersaturation: implications for the treatment of calcium renal stones.

    Directory of Open Access Journals (Sweden)

    Allen Rodgers

    Full Text Available Urinary sulfate (SO4(2- and thiosulfate (S2O3(2- can potentially bind with calcium and decrease kidney stone risk. We modeled the effects of these species on the concentration of ionized calcium (iCa and on supersaturation (SS of calcium oxalate (CaOx and calcium phosphate (CaP, and measured their in vitro effects on iCa and the upper limit of stability (ULM of these salts.Urine data from 4 different types of stone patients were obtained from the Mayo Nephrology Clinic (Model 1. A second data set was obtained from healthy controls and hypercalciuric stone formers in the literature who had been treated with sodium thiosulfate (STS (Model 2. The Joint Expert Speciation System (JESS was used to calculate iCa and SS. In Model 1, these parameters were calculated as a function of sulfate and thiosulfate concentrations. In Model 2, data from pre- and post STS urines were analyzed. ULM and iCa were determined in human urine as a function of sulfate and thiosulfate concentrations.Calculated iCa and SS values for all calcium salts decreased with increasing sulfate concentration. Thiosulfate had no effect on these parameters. In Model 2, calculated iCa and CaOx SS increased after STS treatment, but CaP SS decreased, perhaps due to a decrease in pH after STS treatment. In confirmatory in vitro experiments supplemental sulfate, but not thiosulfate, significantly increased the calcium needed to achieve the ULM of CaP and tended to increase the oxalate needed to reach the ULM of CaOx. Sulfate also significantly decreased iCa in human urine, while thiosulfate had no effect.Increasing urinary sulfate could theoretically reduce CaOx and CaP stone risk. Although STS may reduce CaP stone risk by decreasing urinary pH, it might also paradoxically increase iCa and CaOx SS. As such, STS may not be a viable treatment option for stone disease.

  5. Sulfate but Not Thiosulfate Reduces Calculated and Measured Urinary Ionized Calcium and Supersaturation: Implications for the Treatment of Calcium Renal Stones

    Science.gov (United States)

    Rodgers, Allen; Gauvin, Daniel; Edeh, Samuel; Allie-Hamdulay, Shameez; Jackson, Graham; Lieske, John C.

    2014-01-01

    Background Urinary sulfate (SO42−) and thiosulfate (S2O32−) can potentially bind with calcium and decrease kidney stone risk. We modeled the effects of these species on the concentration of ionized calcium (iCa) and on supersaturation (SS) of calcium oxalate (CaOx) and calcium phosphate (CaP), and measured their in vitro effects on iCa and the upper limit of stability (ULM) of these salts. Methods Urine data from 4 different types of stone patients were obtained from the Mayo Nephrology Clinic (Model 1). A second data set was obtained from healthy controls and hypercalciuric stone formers in the literature who had been treated with sodium thiosulfate (STS) (Model 2). The Joint Expert Speciation System (JESS) was used to calculate iCa and SS. In Model 1, these parameters were calculated as a function of sulfate and thiosulfate concentrations. In Model 2, data from pre- and post STS urines were analyzed. ULM and iCa were determined in human urine as a function of sulfate and thiosulfate concentrations. Results Calculated iCa and SS values for all calcium salts decreased with increasing sulfate concentration. Thiosulfate had no effect on these parameters. In Model 2, calculated iCa and CaOx SS increased after STS treatment, but CaP SS decreased, perhaps due to a decrease in pH after STS treatment. In confirmatory in vitro experiments supplemental sulfate, but not thiosulfate, significantly increased the calcium needed to achieve the ULM of CaP and tended to increase the oxalate needed to reach the ULM of CaOx. Sulfate also significantly decreased iCa in human urine, while thiosulfate had no effect. Conclusion Increasing urinary sulfate could theoretically reduce CaOx and CaP stone risk. Although STS may reduce CaP stone risk by decreasing urinary pH, it might also paradoxically increase iCa and CaOx SS. As such, STS may not be a viable treatment option for stone disease. PMID:25061988

  6. 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...

  7. Urinary stone composition in Oman: with high incidence of cystinuria.

    Science.gov (United States)

    Al-Marhoon, Mohammed S; Bayoumi, Riad; Al-Farsi, Yahya; Al-Hinai, Abdullhakeem; Al-Maskary, Sultan; Venkiteswaran, Krishna; Al-Busaidi, Qassim; Mathew, Josephkunju; Rhman, Khalid; Sharif, Omar; Aquil, Shahid; Al-Hashmi, Intisar

    2015-06-01

    Urinary stones are a common problem in Oman and their composition is unknown. The aim of this study is to analyze the components of urinary stones of Omani patients and use the obtained data for future studies of etiology, treatment, and prevention. Urinary stones of 255 consecutive patients were collected at the Sultan Qaboos University Hospital. Stones were analyzed by Fourier transform infrared spectrophotometer. The biochemical, metabolic, and radiological data relating to the patients and stones were collected. The mean age was 41 years, with M:F ratio of 3.7:1. The common comorbidities associated with stone formation were hypertension; diabetes, benign prostate hyperplasia; urinary tract infection; obesity; and atrophic kidney. The common presentation was renal colic and flank pain (96%). Stones were surgically retrieved in 70% of patients. Mean stone size was 9 ± 0.5 mm (range 1.3-80). Stone formers had a BMI ≥ 25 in 56% (P = 0.006) and positive family history of stones in 3.8%. The most common stones in Oman were as follows: Calcium Oxalates 45% (114/255); Mixed calcium phosphates & calcium oxalates 22% (55/255); Uric Acid 16% (40/255); and Cystine 4% (10/255). The most common urinary stones in Oman are Calcium Oxalates. Overweight is an important risk factor associated with stone formation. The hereditary Cystine stones are three times more common in Oman than what is reported in the literature that needs further genetic studies.

  8. Doença de Crohn e cálculo renal: muito mais que coincidência? Crohn’s disease and kidney stones: much more than coincidence?

    Directory of Open Access Journals (Sweden)

    Maria Lenise Lopes Viana

    2007-09-01

    hipocitratúria e a hipomagnesiúria, que representam fatores de risco reconhecido para a formação de cálculos, devem ter participação ativa nestes resultados. O impacto dessas alterações, medido pela saturação urinária elevada de oxalato e fosfato de cálcio, representa uma das maneiras de se demonstrar como estes fatores predispõem à nucleação de cristais e, conseqüentemente, à formação de cálculos nas vias urinárias.BACKGROUND: Crohn’s disease is an inflammatory bowel disease associated with a wide variety of complications and manifestations secondary to the effects of underlie inflammatory process. In about 30% of the patients with Crohn’s disease can be found extra-intestinals symptoms. Nephrolithiasis is one of them and the appearance of kidney stones, mainly of oxalate of calcium, is more common in these patients than in general population. AIM: To evaluate urinary metabolic factors potentially involved in renal stones formation on patients with Crohn’s disease. METHODS: We evaluated 29 patients with Crohn’s disease followed in the Outpatient Bowel Inflammatory Disease Clinics of State University Hospital, Londrina, PR, Brazil, from January to December of 2004. The metabolic evaluation included measured of blood and urine substances related to renal stones formation, kidneys, ureters and bladder ultrassonography and calculation of urinary supersaturation for calcium oxalate, uric acid and calcium phosphate. RESULTS: Twenty-nine of the evaluated patients were female or 65.5% and 34.5% were males. Among the metabolic urinary studied, we identified the following potential disturbances associated with nephrolithiasis: hypocitraturia in 21 patients (72.4%, hypomagnesuria in 12 (41.4%, hyperoxaluria in 4 (13.6% and urinary volume low in 5 (17.2%. Renal stones were identified in 13 patients (44.8%. Oxalate urinary excretion was higher in patients submitted to bowel surgery and also in patients with ileum resection. The urinary supersaturation of

  9. Leave no "stone" unturned: understanding the genetic bases of calcium-containing urinary stones in children.

    Science.gov (United States)

    Thomas, S E; Stapleton, F B

    2000-01-01

    Urinary stones in children are being recognized with increasing frequency. Formerly thought to be the result of dehydration, urinary obstruction, or infection, most urinary calculi in children now are recognized to have an underlying metabolic abnormality. A number of challenges face pediatricians in evaluating and treating children with urinary stone disease. Often the clinical symptomatology is nonspecific and lacks the excruciating renal colic seen in adults. Furthermore, diagnostic clinical laboratory values vary with age and must be differentiated from normal values reported for adult patients. Both environmental and genetic factors are responsible for urinary stones. Many stones have a hereditary basis. Exciting new information is developing about the genetic propensity for urinary stones. Current medical therapies attempt either to reduce the production of a lithogenic solute or to increase urinary solubility. New therapies for prevention and treatment of urinary stone disease are likely to evolve as our understanding of the pathogenesis of these conditions grows.

  10. 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.

  11. New non-renal congenital disorders associated with medullary sponge kidney (MSK) support the pathogenic role of GDNF and point to the diagnosis of MSK in recurrent stone formers.

    Science.gov (United States)

    Ria, Paolo; Fabris, Antonia; Dalla Gassa, Alessandra; Zaza, Gianluigi; Lupo, Antonio; Gambaro, Giovanni

    2016-08-29

    Medullary sponge kidney (MSK) is a congenital renal disorder. Its association with several developmental abnormalities in other organs hints at the likelihood of some shared step(s) in the embryogenesis of the kidney and other organs. It has been suggested that the REarranged during Transfection (RET) proto-oncogene and the Glial cell line-Derived Neurotrophic Factor (GDNF) gene are defective in patients with MSK, and both RET and GDNF are known to have a role in the development of the central nervous system, heart, and craniofacial skeleton. Among a cohort of 143 MSK patients being followed up for nephrolithiasis and chronic kidney disease at our institution, we found six with one or more associated non-renal anomalies: one patient probably has congenital hemihyperplasia and hypertrophic cardiomyopathy with adipose metaplasia and mitral valve prolapse; one has Marfan syndrome; and the other four have novel associations between MSK and nerve and skeleton abnormalities described here for the first time. The discovery of disorders involving the central nervous system, cardiovascular system and craniofacial skeleton in MSK patients supports the hypothesis of a genetic alteration on the RET-GDNF axis having a pivotal role in the pathogenesis of MSK, in a subset of patients at least. MSK seems more and more to be a systemic disease, and the identification of extrarenal developmental defects could be important in arousing the suspicion of MSK in recurrent stone formers.

  12. Assessment of kidney stone and prevalence of its chemical compositions.

    Science.gov (United States)

    Pandeya, A; Prajapati, R; Panta, P; Regmi, A

    2010-09-01

    Kidney stone analysis is the test done on the stone which cause problems when they block the flow of urine through or out of the kidneys. The stones cause severe pain and are also associated with morbidity and renal damage. There is also no clear understanding on the relative metabolic composition of renal calculi. Hence, the study is aimed to find out the chemical composition of it which can guide treatment and give information that may prevent more stones from forming. The study was carried out on the stones that had been sent to the department of Biochemistry (n = 99; M = 61; F = 38; Mean age: 33.6 +/- 14.4 years) Approximately 98.9% of stones were composed of oxalate, 95.9% of Calcium, 85.8% of phosphate, 62.6% of Urate, 46.4% of Ammonium and very few percentages of Carbonate.

  13. A RARE CONDITION OF MULTIPLE URETHRAL STONES WITH MEATAL STENOSIS

    Directory of Open Access Journals (Sweden)

    Navkiran Kaur

    2016-07-01

    Full Text Available Multiple urethral stones are a rare occurrence commonly resulting from migration of renal stones and rarely arising de novo secondary to the other pathology such as urethral diverticulum, strictures, neurogenic bladder, meatal stenosis, and obstructing tumours such as adenomatous metaplasia of the uroepithelium and hypospadias. We report the case of a 47-year-old male presenting with difficulty in micturition resulting from impaction of multiple stones within the urethra. On retrograde urethrogram, meatal stenosis was also seen along with multiple urethral stones. On ultrasonography of patient, renal stones were also found. Patient was managed surgically and stones were extracted. This paper summarises the topic and discusses the radiological and its clinical implication of this unusual condition.

  14. Renal calculus disease.

    Science.gov (United States)

    Schulsinger, D A; Sosa, R E

    1998-03-01

    We have seen an explosion in technical innovations for the management of urolithiasis. Today, the endourologist possesses an assortment of minimally invasive tools to treat renal stones. Most patients receive fast, safe and effective treatment in the outpatient setting. Despite the many technical advances, however, anatomical malformations and complex stones still provide significant challenges in diagnosis, access to a targeted stone, fragmentation, and clearance of the resulting fragments. This review examines a variety of urinary stone presentations and treatment strategies for cost-effective management.

  15. Measuring stone volume - three-dimensional software reconstruction or an ellipsoid algebra formula?

    Science.gov (United States)

    Finch, William; Johnston, Richard; Shaida, Nadeem; Winterbottom, Andrew; Wiseman, Oliver

    2014-04-01

    To determine the optimal method for assessing stone volume, and thus stone burden, by comparing the accuracy of scalene, oblate, and prolate ellipsoid volume equations with three-dimensional (3D)-reconstructed stone volume. Kidney stone volume may be helpful in predicting treatment outcome for renal stones. While the precise measurement of stone volume by 3D reconstruction can be accomplished using modern computer tomography (CT) scanning software, this technique is not available in all hospitals or with routine acute colic scanning protocols. Therefore, maximum diameters as measured by either X-ray or CT are used in the calculation of stone volume based on a scalene ellipsoid formula, as recommended by the European Association of Urology. In all, 100 stones with both X-ray and CT (1-2-mm slices) were reviewed. Complete and partial staghorn stones were excluded. Stone volume was calculated using software designed to measure tissue density of a certain range within a specified region of interest. Correlation coefficients among all measured outcomes were compared. Stone volumes were analysed to determine the average 'shape' of the stones. The maximum stone diameter on X-ray was 3-25 mm and on CT was 3-36 mm, with a reasonable correlation (r = 0.77). Smaller stones (15 mm towards scalene ellipsoids. There was no difference in stone shape by location within the kidney. As the average shape of renal stones changes with diameter, no single equation for estimating stone volume can be recommended. As the maximum diameter increases, calculated stone volume becomes less accurate, suggesting that larger stones have more asymmetric shapes. We recommend that research looking at stone clearance rates should use 3D-reconstructed stone volumes when available, followed by prolate, oblate, or scalene ellipsoid formulas depending on the maximum stone diameter. © 2013 The Authors. BJU International © 2013 BJU International.

  16. Endourological Evaluation and Management of Leukoplakia of the Renal Pelvis

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    Hidehiro Kakizaki

    1996-01-01

    Full Text Available Since August 1989, we have seen 4 patients with leukoplakia of the renal pelvis associated with a longstanding renal stone. In 2 of them, excretory or retrograde pyelography revealed multiple filling defects in the left renal pelvis as well as a renal stone, although urine cytological examination was negative. One of the other 2 patients underwent extracorporeal shock wave lithotripsy (ESWL for the renal stone, but this was not followed by the passage of stone fragments. The renal stone in the remaining patient was associated with staghorn calculi. For stone extraction as well as endoscopic evaluation of the intrapelvic lesion, percutaneous nephroscopy was performed. A small to large amount of tissue-like white debris in sheets characteristic of leukoplakia was found in the renal pelvis with stones embedded in it and was removed directly by forceps or suction and then by irrigating with saline. We propose that 1 the endourological approach should be recommended for patients with renal pelvic lesions associated with longstanding renal stones or for patients who show difficulty in passing stone fragments after ESWL and 2 this entity of leukoplakia should be kept in mind for the differential diagnosis of renal pelvic lesions associated with renal stones.

  17. Kidney stones and crushed bones secondary to hyperparathyroidism.

    Science.gov (United States)

    Sreelesh, K P; Sreejith, G Nair; Pranab, K Prabhakaran

    2016-01-01

    Here we report a 65-year-old woman with multiple brown tumors and renal stones secondary to primary hyperparathyroidism. This case highlights the need for early recognition of parathyroid hyperactivity.

  18. Anatomical factors predicting lower calyceal stone clearance after ...

    African Journals Online (AJOL)

    M. Khan

    2016-02-17

    Feb 17, 2016 ... Conclusions: This study shows that lower infundibular length and width are ... Stone disease is endemic in Pakistan and constitutes 60% of the ... lithotripsy session by plane X-ray abdomen and renal ultrasound. ... Pain was.

  19. 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.

  20. Crystal sedimentation and stone formation.

    Science.gov (United States)

    Baumann, Johannes Markus; Affolter, Beat; Meyer, Rolf

    2010-02-01

    Mechanisms of crystal collision being the first step of aggregation (AGN) were analyzed for calcium oxalate monohydrate (COM) directly produced in urine. COM was produced by oxalate titration in urine of seven healthy men, in solutions of urinary macromolecules and in buffered distilled water (control). Crystal formation and sedimentation were followed by a spectrophotometer and analyzed by scanning electron microscopy. Viscosity of urine was measured at 37 degrees C. From results, sedimentation rate (v (S)), particle diffusion (D) and incidences of collision of particles in suspension by sedimentation (I (S)) and by diffusion (I (D)) were calculated. Calculations were related to average volume and urinary transit time of renal collecting ducts (CD) and of renal pelvis. v (S) was in urine 0.026 +/- 0.012, in UMS 0.022 +/- 0.01 and in control 0.091 +/- 0.02 cm min(-1) (mean +/- SD). For urine, a D of 9.53 +/- 0.97 mum within 1 min can be calculated. At maximal crystal concentration, I (S) was only 0.12 and I (D) was 0.48 min(-1) cm(-3) which, even at an unrealistic permanent and maximal crystalluria, would only correspond to less than one crystal collision/week/CD, whereas to the same tubular wall being in horizontal position 1.3 crystals/min and to a renal stone 624 crystals/cm(2) min could drop by sedimentation. Sedimentation to renal tubular or pelvic wall, where crystals can accumulate and meet with a tissue calcification or a stone, is probably essential for stone formation. Since v (S) mainly depends on particle size, reducing urinary supersaturation and crystal growth by dietary oxalate restriction seems to be an important measure to prevent aggregation.

  1. New developments in percutaneous stone surgery

    African Journals Online (AJOL)

    S. Derisavifard

    2016-08-01

    Aug 1, 2016 ... Percutaneous stone surgery is the gold standard in removing large renal calculi. In light of the .... tailoring antibiotics if a patient were to develop sepsis. ..... small size of the micro-PCNL instrumentation, it is best suited for.

  2. 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.

  3. Application of Inversion Table in Treatment of Lower Pole Renal Stone Fragments%倒置排石床治疗肾下盏残石的临床研究

    Institute of Scientific and Technical Information of China (English)

    王博涵; 刘军; 姚炜敏; 夏丁; 余虓; 郭小林; 陈志强; 叶章群

    2012-01-01

    Objective To evaluate the effect of inversion table dealing with lower pole renal stone fragments. Methods Seventy-nine patients with renal fragments less than 4 mm after initial percutaneous nephrolithotomy(PCNL) , shock wave litho-tripsy(SWL) ,or ureteroscopic lithotripsy(URL) were randomly divided into two groups. Study group(n = 40) was given inversion table, while control group (n= 39) was given dieresis therapy with patients' urine volume more than 2 000 mL every day. Plain abdominal radiography(KUB)was performed one month after therapy. Results All patients in study group were treated with inversion table successfully. There was no statistically significant difference in gender, age, body mass index, stone diameter, infundibular length, infundibular pelvic angle or infundibular width between two groups. The stone clearance rate in study group and control group was 75% and 41% respectively(P<0. 05). Conclusion The inversion table is an effective option for lower residual caliceal fragments after SWL,PCNL or URL.%目的 探讨倒置排石床辅助治疗肾下盏残石的作用.方法 79例经皮肾镜取石术(PCNL)、体外冲击波碎石术(SWL)和输尿管镜碎石术(URL)后出现肾下盏残石患者,残石直径小于4 mm,随机、对照、单盲分为实验组和对照组.实验组40例患者使用倒置排石床治疗.对照组39例患者每日多饮水,保持尿量2 000 mL以上.1个月后行腹部平片复查残石情况.结果 实验组患者均顺利完成倒置排石床治疗.实验组和对照组患者年龄、性别、BMI及残石的大小差异无统计学意义(P>0.05).肾脏的解剖参数如肾下盏长度、肾下盏肾盂夹角和肾下盏盏颈宽度实验组和对照组差异无统计学意义(P>0.05).1个月后实验组的残石清除率达到75%而对照组仅为41% (P<0.05).结论 倒置排石床可提高肾下盏残石的清除率,可以作为PCNL、SWL和URL术后的辅助治疗方法.

  4. The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

    Directory of Open Access Journals (Sweden)

    Wilson R. Molina

    2014-01-01

    Full Text Available Objective: To develop a user friendly system (S.T.O.N.E. Score to quantify and describe stone characteristics provided by computed axial tomography scan to predict ureteroscopy outcomes and to evaluate the characteristics that are thought to affect stone free rates. Materials and Methods: The S.T.O.N.E. score consists of 5 stone characteristics: (Size, (Topography (location of stone, (Obstruction, (Number of stones present, and (Evaluation of Hounsfield Units. Each component is scored on a 1-3 point scale. The S.T.O.N.E. Score was applied to 200 rigid and flexible ureteroscopies performed at our institution. A logistic model was applied to evaluate our data for stone free rates (SFR. Results: SFR were found to be correlated to S.T.O.N.E. Score. As S.T.O.N.E. Score increased, the SFR decreased with a logical regression trend (p 90% and typically falls off by 10% per point thereafter. Conclusions: The S.T.O.N.E. Score is a novel assessment tool to predict SFR in patients who require URS for the surgical therapy of ureteral and renal stone disease. The features of S.T.O.N.E. are relevant in predicting SFR with URS. Size, location, and degree of hydronephrosis were statistically significant factors in multivariate analysis. The S.T.O.N.E. Score establishes the framework for future analysis of the treatment of urolithiasis.

  5. Canada's National Building Stone: Tyndall Stone from Manitoba

    Science.gov (United States)

    Pratt, Brian R.; Young, Graham A.; Dobrzanski, Edward P.

    2016-04-01

    Tyndall Stone is a distinctively mottled and highly fossiliferous dolomitic limestone that belongs to the Selkirk Member of the Red River Formation, of Late Ordovician (Katian) age. It has been quarried at Garson, Manitoba, 37 km northeast of Winnipeg, since 1895, although other quarries in the area go back to 1832. Tyndall Stone, so named because it was shipped by rail from nearby Tyndall, is currently produced by Gillis Quarries Limited. It has various uses as a dimension stone. Large slabs, most often cut parallel to bedding, face the exterior or interior of many important buildings such as the Parliament Buildings and the Canadian Museum of Civilization in the Ottawa area, the Empress Hotel in Victoria, and the provincial legislatures in Winnipeg and Regina, as well as many commercial buildings especially in the Canadian prairies. At the quarries, the stone is cut vertically, using eight foot (2.44 m) diameter saws mounted on one hundred foot (30.5 m) tracks, then split into 6-8 tonne blocks that are moved using front-end loaders. Gillis Quarries operates a large finishing plant with an area of about 4000 m2. Stone is processed along advanced cutting lines that feature eight primary saws and six gantry saw stations, allowing it to be made into a variety of sizes, shapes, and finishes. The Selkirk Member is 43 m thick and the stone is extracted from a 6-8 m thick interval within the lower part. The upper beds tend to be more buff-coloured than the grey lower beds due to weathering by groundwater. The stone is massive, but extracted blocks are less than ~1m thick due to splitting along stylolites. Consisting of bioturbated wackestone to packstone, the Tyndall Stone was deposited in a shallow-marine environment within the photic zone, in the central part of the vast equatorial epicontinental sea that covered much of Laurentia. Scattered thin, bioclastic grainstone lenses record brief, low-energy storm events. The distinctive mottles are formed by dolomitized

  6. Use of hemiacidrin in management of infection stones.

    Science.gov (United States)

    Nemoy, N J; Stamey, T A

    1976-12-01

    Unless all fragments are removed at the time of surgery for struvite stones a high incidence of recurrent infection and stone formation is likely. To reduce the recurrence rate of such stones the renal pelvis is irrigated postoperatively with 10 per cent hemiacidrin solution for at least 48 hours or until all fragments have been dissolved. We have managed successfully 35 patients (36 kidneys) without enxountering any complications. Included in our most recent series are 2 patients with solitary kidneys who had successful dissolution of stone fragments. Absolute contraindications to the use of hemiacidrin are infected urine, fever or flank discomfort. Although we have found hemiacidrin dissolution of renal stones to be safe and effective it is essential that the clinician be aware of the proper technique and its possible complications.

  7. The comparative study of clinical efficacy between the flexible ureteroscope combination of rigid ureteroscope and the percutaneous nephrolithotomy holmium laser lithotripsy for the treatment of renal pelvis stones%输尿管软镜联合硬镜与经皮肾镜钬激光治疗肾盂大结石临床疗效对比研究

    Institute of Scientific and Technical Information of China (English)

    杨健; 傅发军

    2013-01-01

    目的 输尿管软镜联合硬镜与经皮肾镜钬激光治疗肾盂大结石临床疗效对比研究.方法 回顾和分析本院2010年7月~2012年8月应用输尿管软镜联合硬镜碎石术治疗肾盂大结石33例与采用经皮肾镜钬激光治疗肾盂大结石37例的治疗效果对比.结果 采用输尿管软镜结合硬镜碎石术治疗肾盂大结石的碎石率为95.3%,高于经皮肾镜钬激光法碎石术的90.5%.输尿管软镜结合硬镜的碎石排净时间为12d,显著少于经皮肾镜钬激光碎石术的14d.结论 采用输尿管软镜结合硬镜碎石术治疗肾盂大结石临床效果相比于经皮肾镜钬激光碎石术较好.%Objectives The comparison of clinical efficacy studies between the flexible ureteroscope combination of rigid ureteroscope and the percutaneous nephrolithotomy holmium laser lithotripsy for the treatment of renal pelvis stones.Methods To review and analysis the contrast between the flexible ureteroscope combination of rigid ureteroscope lithotripsy for the treatment of renal pelvis stones in 33 cases,and the percutaneous nephrolithotomy holmium laser lithotripsy for treatment of the renal pelvis stones in 37 cases at our hospital in July 2010 to August 2012.Results The flexible ureteroscope combination of rigid ureteroscope lithotripsy for the treatment of renal pelvis stones gravel was 95.3%,higher than the 90.5% from the ureteroscopic combined with the transcutaneous nerve holmium laser lithotripsy.The flexible ureteroscope combined with the rigid ureteroscope lithotripsy gravel clear time is 12d,significantly less than the 14d for the percutaneous nephrolithotomy holmium laser lithotripsy.Conclusions The clinical effect of flexible ureteroscope combined with rigid ureteroscope lithotripsy for the treatment of renal pelvis stones is better than the percutaneous nephrolithotomy holmium laser lithotripsy.

  8. Efficacy of electronic fexible ureteroscopy holmium laser lithotripsy in treating renal stones in a solitary kidney%电子输尿管软镜钬激光碎石治疗孤立肾结石疗效分析

    Institute of Scientific and Technical Information of China (English)

    王锐; 宋超; 廖文彪; 刘凌琪; 杨嗣星

    2014-01-01

    目的::探讨电子输尿管软镜钬激光碎石术治疗孤立肾肾结石的临床疗效.方法:回顾性分析2012年3月~2014年8月应用电子输尿管软镜治疗12例孤立肾结石患者临床资料,男5例,女7例,年龄21~73岁,平均64岁.7例为功能性孤立肾,5例为单侧肾切除术后.所有患者均行泌尿系CTU检查以明确结石大小及位置,术前常规行尿常规、尿培养及血肌酐检查,尿培养阳性者使用敏感抗生素治疗3天.所有患者术前均预置F7双J管2周作输尿管被动扩张.分析手术时间、清石率、并发症以及血清肌酐的变化.结果:12例患者结石大小为1.6~3.2 cm,平均(2.1±0.6)cm,术前肌酐92~178μmol/L,平均(141.90±27.9)μmol/L;手术时间40~200 min,平均117 min,一期结石清除率达83.3%(10/12).2例诊断为全身炎症反应综合征,1例为尿脓毒血症,其中1例出现明显尿量减少,患者经积极治疗后,生命体征逐渐平稳,痊愈出院.术后随访1个月,肌酐为69~182μmol/L,平均(109.8±25.2)μmol/L,与术前比较差异有统计学意义(P<0.05).结论:电子输尿管软镜图像清晰,治疗孤立肾结石安全高效,值得推广.%Objective:To evaluate the efficacy of electronic fexible ureteroscopy holmium laser lithotripsy in trea-ting renal stones in a solitary kidney.Methods:From March 2012 to August 2014,12 patients with a solitary kidney underwent electronic fexible ureteroscopy holmium laser lithotripsy.All patients received computed tomography to understand the location and size of the stones preoperatively.Preoperative urine culture were done and positive pa-tients were treated by sensitive antibiotics for three days.F7 double-J tube were inserted in all patients to dilate the u-reter for 2 weeks preoperatively.Factors such as operation duration,complications and stone-free rate (SFR)were analysed.Results:The mean age was 64 years (range,21-73 years).The mean stone size was (2.1±0.6)cm (range 1.6-3.2 cm).The mean

  9. [Unusual elements in renal calculi].

    Science.gov (United States)

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

    2006-01-01

    A group of 54 renal calculi were spontaneously passed renal stone after a nephritic colic. Two groups of calculi were found: papillary and non-papillary calculi. All calculi were analyzed by infrared spectroscopy and electronic microscopy scan (EMS) and EDAX. When the stones were analyzed with EDAX, elements such as C, N, O, Na, S, Mg, Al, Si, Cl, K, Ca, Mn, Fe, Ni, Zn were detected. The possible origin of these elements is discussed in this work.

  10. Music does not reduce alfentanil requirement during patient-controlled analgesia (PCA) use in extracorporeal shock wave lithotripsy for renal stones.

    Science.gov (United States)

    Cepeda, M S; Diaz, J E; Hernandez, V; Daza, E; Carr, D B

    1998-12-01

    To evaluate the impact of music on opioid requirements and pain levels during renal lithotripsy using alfentanil patient-controlled analgesia (PCA), we conducted a prospective, blinded, randomized controlled trial. Patients undergoing lithotripsy were instructed in PCA use and asked to rate their anxiety and select their preferred type of music. They were then premedicated with morphine and ketorolac and randomly allocated into two groups. Group 1 (n = 97) had music started 10 min before the procedure and maintained until 10 min after its conclusion. Group 2 (n = 96) had music begun at the conclusion of lithotripsy and continued for 10 min. Pain intensity, alfentanil requirement, side effects, quality of analgesia, patient satisfaction, and acceptance of the technique were evaluated. Demographics, alfentanil requirement, pain levels, side effects, quality of analgesia, and patient satisfaction were similar in both groups. The addition of music did not provide any benefit. This result raises the possibility that some nonpharmacologic therapies have minimal impact in settings where the painful stimulus is moderate to severe and adequate pharmacotherapy is available.

  11. Rejoinder to Lynda Stone.

    Science.gov (United States)

    Blum, Mark E.

    1997-01-01

    Responds to Lynda Stone's comments on the author's essay on the interpretation of history. Demonstrates the linkages between his argument and those of Stone. Concludes by contesting some of her interpretations of his philosophical forebear, Edmund Husserl, and by pointing to the common objectives of both his and Stone's research. (DSK)

  12. Rejoinder to Lynda Stone.

    Science.gov (United States)

    Blum, Mark E.

    1997-01-01

    Responds to Lynda Stone's comments on the author's essay on the interpretation of history. Demonstrates the linkages between his argument and those of Stone. Concludes by contesting some of her interpretations of his philosophical forebear, Edmund Husserl, and by pointing to the common objectives of both his and Stone's research. (DSK)

  13. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  14. Staghorn cystine stone in a 72-year-old recurrent calcium stone former.

    Science.gov (United States)

    Cupisti, Adamasco; Farnesi, Ilaria; Armillotta, Nicola; Francesca, Francesco

    2012-07-01

    This case deals with the first diagnosis of Type B cystinuria with cystine nephrolithiasis in a 72-year-old male. Cystinuria is an inherited disease that consists of congenital abnormalities of renal and intestinal transport of dibasic amino acids. It often leads to frequent recurrent stone formation. Cystine stones most frequently occur in the 1st through 3rd decades of life with a decreased incidence in old age. This case shows that the first diagnosis of cystinuria may be made even in the 8th decade, without any family history, and in a patient with a history of recurrent calcium stone disease. Therefore, the chance of cystinuria must be always considered, even in older calcium stone formers.

  15. Therapy for renal calculi via percutaneous nephrostomy: dissolution and extraction.

    Science.gov (United States)

    Newhouse, J H; Pfister, R C

    1981-01-01

    Nephrostomy catheters offer nonsurgical modes of therapy for some renal stones. Continuous lavage of the stones using hemiacidrin (Renacidin) for struvite stones, THAM-E or acetylcysteine for cystine stones, and bicarbonate solution for uric acid stones may dissolve either entire stones or stone fragments remaining after surgery. Although irrigation is not without potential complications, recent developments in technique have minimized these. Nephrostomy tubes can also be used to transmit stone baskets through steerable catheters to snare stones from the upper collecting system or from the ureter; any stone that can be engaged and withdrawn through the tube tract can be removed; stones larger than those which can be safely extracted through the ureterovesical junction can be so treated. Neither of these procedures requires general anesthesia, the rate of serious morbidity is low, and the required hospital stay is often less than that for surgery; these modes of therapy are therefore valuable for certain patients.

  16. Renal lithiasis and nutrition.

    Science.gov (United States)

    Grases, Felix; Costa-Bauza, Antonia; Prieto, Rafel M

    2006-09-06

    Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified through diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine) is discussed.

  17. Renal lithiasis and nutrition

    Directory of Open Access Journals (Sweden)

    Prieto Rafel M

    2006-09-01

    Full Text Available Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine is discussed.

  18. Evaluating the definition of "stone free status" in contemporary urologic literature.

    Science.gov (United States)

    Deters, L A; Jumper, C M; Steinberg, P L; Pais, V M

    2011-11-01

    There is no standardized definition of stone free after renal stone surgery. The lack of standardization prompted a review of the current urologic literature, to assess the definitions of stone free status, and how imaging is used to determine stone free status. A literature search on PubMed for the MeSH terms for percutaneous nephrolithotomy (PCNL), ureteroscopy with lithotripsy, shock wave lithotripsy (SWL), and laser lithotripsy, published in English between January 2007 and January 2010 was performed. Case reports, articles not evaluating stone free outcomes, and review articles were excluded. Articles were evaluated for the treatment modality, definition of stone free status, and the imaging modality employed to determine stone free status. This search yielded 417 articles of which 249 met inclusion criteria. Stone free was defined in 169 articles (68%). The most common definition of stone free was "no stones" (47%), but a total of seven different definitions were encountered. The most common treatment modality was PCNL (47%), followed by SWL (33%), and URS (13%). The most common detection modality was KUB alone (28%), the second most common being KUB and US combined (22%). Nearly one-third of articles evaluating surgical management of urinary calculi do not define stone free status; when stone free is defined, there is wide variation as to that definition. Furthermore, vast differences exist in the type of imaging used to define stone free status. The urologic community should standardize the reporting of stone free outcomes in the urologic literature.

  19. Encrustation and stone formation: complication of indwelling ureteral stents.

    Science.gov (United States)

    Schulze, K A; Wettlaufer, J N; Oldani, G

    1985-06-01

    Severe encrustation and stone formation on indwelling ureteral stents in 2 patients with a lithogenic history are reported. In both cases this complication occurred in the presence of sterile urine and treatment required pyelolithotomy in one and renal pelvic irrigation with urologic G solution in the other. Analyses of these stones revealed struvite and apatite, respectively. Dissolution of encrustations and stones via renal pelvic irrigation is suggested as a viable alternative to surgical intervention for this problem. A review of the literature shows a correlation between chronic stone formers and stent encrustation, rather than from bacteriuria alone. Long-term antibiotic suppression, more frequent followup with abdominal roentgenograms, and shorter periods of internal stenting are suggested for patients with a lithogenic history.

  20. Impaired longitudinal deformation measured by speckle-tracking echocardiography in children with end-stage renal disease

    NARCIS (Netherlands)

    van Huis, Maike; Schoenmaker, Nikki J.; Groothoff, Jaap W.; van der Lee, Johanna H.; van Dyk, Maria; Gewillig, Marc; Koster, Linda; Tanke, Ronald; Lilien, Marc|info:eu-repo/dai/nl/271538899; Blom, Nico A.; Mertens, Luc; Kuipers, Irene M.

    2016-01-01

    Background: Left ventricular dysfunction is an important co-morbidity of end-stage renal disease (ESRD) and is associated with a poor prognosis in the adult population. In pediatric ESRD, left ventricular function is generally well preserved, but limited information is available on early changes in

  1. The clinical effect of percutaneous renal micro colostomy ureteroscopy holmium laser lithotripsy in the treatment of senile kidney stones%经皮肾微造瘘输尿管镜钬激光碎石术治疗老年肾结石效果观察

    Institute of Scientific and Technical Information of China (English)

    赵锐

    2014-01-01

    目的:探讨经皮肾微造瘘输尿管镜钬激光碎石术治疗老年肾结石的临床疗效。方法:2010年2月-2013年2月收治老年肾结石患者46例,对其行经皮肾微造瘘输尿管镜钬激光碎石术,选择同期非老年肾结石患者50例作为对照组,给予经皮肾微造瘘输尿管镜钬激光碎石术。比较两组治疗效果。结果:老年组1次彻底碎石成功率80.43%,对照组1次碎石成功率78.00%,两组比较差异无统计学意义(P>0.05)。老年组与对照组手术时间、术中出血量及住院时间差异无统计学意义(P>0.05)。两组均未出现严重并发症。结论:经皮肾微造瘘输尿管镜钬激光碎石术具有微创、术中出血量少、清石率高、恢复快等特点,既有效又安全,值得在老年肾结石治疗中推广。%Objective:To discuss the clinical effect of percutaneous renal micro colostomy ureteroscopy holmium laser lithotripsy in the treatment of senile kidney stones.Methods:46 old cases with senile kidney stones were selected from February 2010 to February 2013 as the elderly group.They were given percutaneous renal micro colostomy ureteroscopy holmium laser lithotripsy.50 young cases with senile kidney stones were selected at the same time,and they were given percutaneous renal micro colostomy ureteroscopy holmium laser lithotripsy as the control group.The treatment effects were compared between two groups. Results:The once completely crushed stone success rate of the elderly group was 80.43%. The once completely crushed stone success rate of the control group was 78.00%.The differences of the operation time,intraoperatve blood soss and hospitalization time between the elderly group and the control group had statistical significance(P>0.05).The two groups had no serious complications.Conclusion:The percutaneous renal micro colostomy ureteroscopy holmium laser lithotripsy has the characteristics, such as minimally invasive,less intraoperatve

  2. Cystone® for 1 year did not change urine chemistry or decrease stone burden in cystine stone formers.

    Science.gov (United States)

    Erickson, Stephen B; Vrtiska, Terri J; Canzanello, Vincent J; Lieske, John C

    2011-06-01

    Cystine kidney stones frequently recur because inadequate prevention exists. We recruited documented recurrent cystine kidney stone formers (6 men, 4 women, 44 ± 17 years) into a 2-phased study to assess safety and effectiveness of Cystone®, a herbal treatment used to prevent and facilitate passage of cystine kidney stones. The first phase was a randomized double-blinded 12 weeks crossover study assessing the effect of Cystone® versus placebo (2 tablets BID) on urinary chemistries. The second phase was an open label 1 year study of Cystone® to determine if renal stone burden decreased, as assessed by quantitative and subjective assessment of CT. There was no statistically significant change of urinary composition from baseline short (6 weeks) or long (52 weeks) term on Cystone®, including volume (2525, 2611, 2730 ml), pH (6.7, 6.7, 7.05), and cystine excretion (2770, 2889, 4025 μmol). Pre and post-CT was available in nine patients. Although seven kidneys lost stones spontaneously or surgically, overall stone burden increased in seven kidneys, was unchanged in nine, and fell in only two. Quantitative scoring increased in both the left and right kidneys (1602-1667 and 301-2064 volumetric units, respectively). Therefore, this study does not suggest that Cystone® has a favorable effect on urinary chemistries that could decrease cystine stone formation, nor does it appear to prevent stone growth or promote stone passage over a 1-year period.

  3. DURABILITY OF DIMENSION STONE

    OpenAIRE

    Branko Crnković

    1991-01-01

    The paper presents a survey of the possible origins of the strain and deformation of stone. A range of origins which can be influenced is suggested, from those occurring under natural conditions in the deposit to those resulting from technologies applied in quarrying, stone processing and dressing, including environment with natural and technogenic factors. No new information can be given on the behavior of the stone processed and used in building according to the most recent technologies, be...

  4. NEW FRONTIERS ON NEPHROLITHIASIS: PATHOPHYSIOLOGY AND MANAGEMENT OF KIDNEY STONES

    Directory of Open Access Journals (Sweden)

    Malan Rajat

    2011-03-01

    Full Text Available Nephrolithiasis (also known as kidney stones, renal stones, urinary stones, urolithiasis, and renal calculi affects a great number of patients worldwide. These can be of different types like calcium-oxalate, struvite, uric acid, cysteine. Larger stones in the urinary tract can cause extreme pain in the lower back or side. Urinary tract infections, kidney disorders and certain metabolic disorders such as hyperparathyroidism are also linked to stone formation. Cystinuria, hyperoxaluria, Hypercalciuria, drinking less water, consuming more salty food can cause stone formation in urinary tract. Various precautions and treatment are available includes life style changing (drinking more water or more fluid intake and reducing calcium rich diet intake, avoid junk food, Medical therapy (use of diuretics and other medicines, the over use of synthetic drugs which results in higher incidence of adverse drug reaction has motivated humans to return to nature for safe remedies and surgical treatment The present article revealed the update knowledge about remedy and treatment of nephrolithiasis for all those peoples who is having renal colic pain.

  5. Estudio exploratorio-ecológico sobre las concentraciones de sales de calcio en el agua para consumo humano y la litiasis renal en Costa Rica Exploratory-ecological study on the relationship between the concentration of calcium salts in water for human consumption and the incidence of renal stones in Costa Rica

    Directory of Open Access Journals (Sweden)

    Darner A Mora Alvarado

    2007-12-01

    approximately 6000 cases per year of kidney stones in Costa Rica which implies an average rate of 1.7 cases per 1000 inhabitants; this pathology involves the formation of hard concretions resembling rock in any part of the urinary system. Etiology is multifactorial and involves anatomic, genetic, infectious as well as environmental factors such as the frequent intake of water with excess calcium salts also known as hard water. We carried out a county-based exploratory study of the ecologic type for the years 2001 to 2003 whereby a relationship was sought between the ingestion of calcium carbonate content in water for human consumption (which we abbreviate as (ACH and the incidence of renal calculi. With this objective in mind, we used on the one hand, data on county-based, average water-hardness from the National Water Laboratory (LNA from 4,000 water sources and, on the other, hospital discharges with the diagnosis of nephrolithiasis from 29 hospitals in the Costa Rican Social Security System. Statistical analysis was based on the Standardized Morbidity Index (which we abbreviate as IME adjusted by the indirect method as well as the Pearson correlation coefficient taken to a 95% degree of confidence. To present the data, county maps of water hardness and IME of renal calculi were used. The results indicate an ecological association between the two variables; in other words, when there is greater consumption of hard water, there exists a greater risk of renal calculi in the population with an excess risk of 27% in those places having high levels of water hardness and a Pearson coefficient for the ecological correlation of r=0,25. On the other hand, in the areas where the water predominantly is not hard, the risk is inferior to the national average. The results obtained open up new questions regarding the relationship between water hardness as well as its consumption and the incidence of kidney stones which should be answered by future studies.

  6. 腹腔镜下非萎缩性肾实质切开取石术治疗鹿角形肾结石的初步探讨%A preliminary study on laparoscopic anatrophic nephrolithotomy for renal staghorn stone

    Institute of Scientific and Technical Information of China (English)

    钟思文; 陈方敏; 石家齐; 李登宝; 孙发; 姜锡男; 陈绪龙; 唐帅; 胡瑞洁

    2016-01-01

    目的 探讨腹腔镜下非萎缩性肾实质切开取石术治疗鹿角形肾结石的可行性和有效性.方法 回顾性分析2011年5月至2015年1月收治的40例鹿角形肾结石患者的临床资料,男24例,女16例.年龄17~ 73岁,中位年龄46岁.体重指数18.4 ~ 27.3 kg/m2.40例均行腹腔镜下非萎缩性肾实质切开取石术.记录手术时间、术中热缺血时间、术中出血量、结石最大径、结石表面积、无石率、手术并发症发生率、住院时间.比较患者术前及术后6个月的患侧肾小球滤过率(glomerular filtration rate,GFR)、血肌酐(SCr)、肾皮质厚度等.结果 本组40例的手术时间为87~142 min,中位值102.5 min.术中热缺血时间14 ~36 min,中位值20.3 min.术中出血量20 ~120 ml,中位值50 ml,无输血病例.无中转开放手术.结石表面积550 ~ 1583mm2,中位值796 mm2.结石最大径34~ 72 mm,中位值59 mm.住院时间6~12d,平均(9.2±2.1)d.手术并发症发生率为17.5%(7/40),其中漏尿4例,菌血症3例,无尿源性脓毒血症、延迟性出血等严重并发症,无死亡病例.术后3d复查KUB或腹部CT,5例有残留结石,于术后3个月行体外冲击波碎石,3例排石效果好,余2例部分排石,一期结石清除率为87.5%.40例均获随访,术后6个月患侧肾GFR较术前下降(13.3±3.7) ml/min,SCr较术前平均下降27.5 μmol/L,差异均有统计学意义(P<0.05).随访IVU及CT检查示患肾皮质萎缩不明显,肾积水较术前减轻,总肾功能有改善.结论 腹腔镜下非萎缩性肾实质切开取石术治疗鹿角形肾结石是可行的治疗方式之一,具有结石清除率高、术后并发症较少、肾功能影响小等优点.%Objective To evaluate the feasibility and effectiveness of laparoscopic anatrophic nephrolithotomy (LAN) managing renal staghorn stone.Methods Forty patients whose age ranged from 17 to 73 years (median 46 years),who underwent LAN for renal staghorn stone were included in the

  7. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty; a detailed observational cohort study

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    postoperatively. Seven complications . (0.08 %) were urological, mainly haematuria after bladder catheterisation, whereas 5 (0.06 were urosepsis/pyelonephritis. CONCLUSION: The overall incidence of serious RU complications after fast-track THA and TKA was 0.61 %. AKI occurred in 0.49% and was most often due...

  8. The Efficacy of Medical Expulsive Therapy (MET) in Improving Stone-free Rate and Stone Expulsion Time, After Extracorporeal Shock Wave Lithotripsy (SWL) for Upper Urinary Stones: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Skolarikos, Andreas; Grivas, Nikolaos; Kallidonis, Panagiotis; Mourmouris, Panagiotis; Rountos, Thomas; Fiamegos, Alexandros; Stavrou, Sotirios; Venetis, Chris

    2015-12-01

    In this meta-analysis, we included randomized studies on medical expulsive therapy implemented following shock wave lithotripsy for renal and ureteral stones. Pooled results demonstrated the efficacy of α-blockers, nifedipine, Rowatinex, and Uriston in increasing stone clearance. In addition, the time to stone elimination, the intensity of pain, the formation of steinstrasse, and the need for auxiliary procedures were reduced mainly with α-blockers. Expulsion rate was not correlated with the type of α-blocker, the diameter, and the location of stone. Our results show that medical expulsive therapy for residual fragments after shock wave lithotripsy should be implemented in clinical practice.

  9. Mysterious Jiana Stone Compound

    Institute of Scientific and Technical Information of China (English)

    GuBingshu

    2004-01-01

    In Tibetan-inhabited areas, visitors can often find piles of stone carved with six-word mystic teaching of truth or Buddhist sutras at lakesides, mountain entrances, monasteries, roadsides or burial sites. Those ubiquitous stone piles, painted in white, red or blue, are the mysterious and world famous Manipile, or called “holy pile”.

  10. 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 retrospectivel...

  11. Complex cystine kidney stones treated with combined robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy.

    Science.gov (United States)

    Meggiato, Luca; Cattaneo, Francesco; Zattoni, Fabio; Dal Moro, Fabrizio; Beltrami, Paolo; Zattoni, Filiberto

    2017-02-18

    Cystinuria, a rare autosomal recessive disease characterized by a defect in cystine renal reabsorption, can often determine complex cystine renal calculi, leading to important complications such as urinary obstruction, urinary infections, and impaired kidney function. Complex kidney stones can have a difficult management and can be very arduous to treat. We present the case of a 20-year-old Jeowah's witness woman with complex cystine renal stones treated with combined robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy. The combination of robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy can be useful to achieve an immediate high stone clearance rate also in complex renal stones. This combined technique could be indicated to minimize intraoperative bleeding. Moreover, it can also be used in pediatric cases or when there is no ureteral compliance. However, this strategy can be performed only in hospital referral centers by expert surgeons.

  12. Detection of Asymptomatic Renal Calcifications in Astronauts Using a Novel Ultrasound Protocol

    Science.gov (United States)

    Garcia, Kathleen; Sargsyan, Ashot; Reyes, David; Locke, James

    2017-01-01

    Ultrasound (US) specifically looking for asymptomatic renal calcifications that may be renal stones is typically not done in the terrestrial setting. Standard abdominal US without a renal focus may discover incidental, mineralized renal material (MRM); however punctate solid areas of MRM is less than 3 mm are usually considered subclinical. Detecting these early calcifications before they become symptomatic renal stones is critical to prevent adverse medical and mission outcomes during spaceflight.

  13. Contrasting histopathology and crystal deposits in kidneys of idiopathic stone formers who produce hydroxy apatite, brushite, or calcium oxalate stones.

    Science.gov (United States)

    Evan, Andrew P; Lingeman, James E; Worcester, Elaine M; Sommer, Andre J; Phillips, Carrie L; Williams, James C; Coe, Fredric L

    2014-04-01

    Our previous work has shown that stone formers who form calcium phosphate (CaP) stones that contain any brushite (BRSF) have a distinctive renal histopathology and surgical anatomy when compared with idiopathic calcium oxalate stone formers (ICSF). Here we report on another group of idiopathic CaP stone formers, those forming stone containing primarily hydroxyapatite, in order to clarify in what ways their pathology differs from BRSF and ICSF. Eleven hydroxyapatite stone formers (HASF) (2 males, 9 females) were studied using intra-operative digital photography and biopsy of papillary and cortical regions to measure tissue changes associated with stone formation. Our main finding is that HASF and BRSF differ significantly from each other and that both differ greatly from ICSF. Both BRSF and ICSF patients have significant levels of Randall's plaque compared with HASF. Intra-tubular deposit number is greater in HASF than BRSF and nonexistent in ICSF while deposit size is smaller in HASF than BRSF. Cortical pathology is distinctly greater in BRSF than HASF. Four attached stones were observed in HASF, three in 25 BRSF and 5-10 per ICSF patient. HASF and BRSF differ clinically in that both have higher average urine pH, supersaturation of CaP, and calcium excretion than ICSF. Our work suggests that HASF and BRSF are two distinct and separate diseases and both differ greatly from ICSF.

  14. 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.

  15. Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD in obese and morbid patients

    Directory of Open Access Journals (Sweden)

    Alexandre Pompeo

    2013-09-01

    Full Text Available Purpose The purpose of this study is to determine if body mass index (BMI and stone skin distance (SSD affect stone free rate (SFR in obese and morbid obese patients who underwent flexible URS for proximal ureteral or renal stones < 20 mm. Materials and Methods A retrospective chart review was performed of consecutive patients that underwent flexible URS. Inclusion criteria were: proximal ureteral stones and renal stones less than 20 mm in the preoperative computed tomography (CT. SFR were then compared according to SSD and BMI. Results A total of 153 patients were eligible for this analysis, 49 (32.02% with SSD < 10 cm and 104 (67.97% with SSD ≥ 10 cm. The mean stone size was 10.5 ± 6.4 mm. The overall SFR in our study was 82.4%. The SFR for the SSD < 10 and ≥ 10 were 79.6% and 83.7% respectively (p = 0.698 and for BMI < 30, ≥ 30 and < 40 and ≥ 40 were 82.9%, 81.7% and 90.9% respectively. Regression analysis showed no affect between BMI or SSD regarding SFR. Conclusion Ureteroscopy should be considered as a first-line of treatment for renal/proximal stones in obese and morbid obese patients. URS may be preferable to SWL in obese patients independently of the SSD, BMI or the location of proximal stones.

  16. Thermoluminescence of pyramid stones

    Energy Technology Data Exchange (ETDEWEB)

    Gomaa, M.A.; Eid, A.M. (Atomic Energy Establishment, Cairo (Egypt))

    1982-01-01

    It is the aim of the present study to investigate some thermoluminescence properties of pyramid stones. Using a few grammes of pyramid stones from Pyramids I and II, the TL glow peaks were observed at 250 and 310/sup 0/C, respectively. The TL glow peaks of samples annealed at 600/sup 0/C, then exposed to /sup 60/Co ..gamma..-rays were observed at 120, 190 and 310/sup 0/C, respectively. The accumulated dose of natural samples is estimated to be around 310 Gray (31 krad). By assuming an annual dose is 1 mGy, the estimated age of pyramid stones is 0.31 M year.

  17. DURABILITY OF DIMENSION STONE

    Directory of Open Access Journals (Sweden)

    Branko Crnković

    1991-12-01

    Full Text Available The paper presents a survey of the possible origins of the strain and deformation of stone. A range of origins which can be influenced is suggested, from those occurring under natural conditions in the deposit to those resulting from technologies applied in quarrying, stone processing and dressing, including environment with natural and technogenic factors. No new information can be given on the behavior of the stone processed and used in building according to the most recent technologies, because the time-span of its exposure to the influence of natural and technogenic factors has been too short.

  18. Acid-base metabolism: implications for kidney stones formation.

    Science.gov (United States)

    Hess, Bernhard

    2006-04-01

    The physiology and pathophysiology of renal H+ ion excretion and urinary buffer systems are reviewed. The main focus is on the two major conditions related to acid-base metabolism that cause kidney stone formation, i.e., distal renal tubular acidosis (dRTA) and abnormally low urine pH with subsequent uric acid stone formation. Both the entities can be seen on the background of disturbances of the major urinary buffer system, NH3+ NH4+. On the one hand, reduced distal tubular secretion of H+ ions results in an abnormally high urinary pH and either incomplete or complete dRTA. On the other hand, reduced production/availability of NH4+ is the cause of an abnormally low urinary pH, which predisposes to uric acid stone formation. Most recent research indicates that the latter abnormality may be a renal manifestation of the increasingly prevalent metabolic syndrome. Despite opposite deviations from normal urinary pH values, both the dRTA and uric acid stone formation due to low urinary pH require the same treatment, i.e., alkali. In the dRTA, alkali is needed for improving the body's buffer capacity, whereas the goal of alkali treatment in uric acid stone formers is to increase the urinary pH to 6.2-6.8 in order to minimize uric acid crystallization.

  19. Renal injury, nephrolithiasis and Nigella sativa: A mini review

    Directory of Open Access Journals (Sweden)

    Parichehr Hayatdavoudi

    2016-01-01

    Full Text Available Objective: The incidence and prevalence of kidney stone is increasing worldwide. After the first recurrence the risk of subsequent relapses is higher and the time period between relapses is shortened. Urinary stones can be severely painful and make a huge economic burden. The stone disease may increase the vulnerability of patients to other diseases such as renal failure. Medicinal herbs are rich sources of antioxidants which are increasingly consumed globally for their safety, efficacy and low price. Nigella sativa is a spice plant that is widely used for prevention and treatment of many ailments in Muslim countries and worldwide. This review aims at investigation of the effects of Nigella sativa on renal injury and stone formation. Materials and Method: The scientific resources including PubMed, Scopus, and Google scholar were searched using key words such as: nephrolithiasis, urolithiasis, kidney/renal stone, renal injury, renal failure, urinary retention and black seed, black cumin, Nigella sativa and thymoquinone.    Results: N. sativa and its main component, thymoquinone showed positive effects in prevention or curing kidney stones and renal failure through various mechanism such as antioxidative, anti-inflammatory, anti-eicosanoid and immunomodulatory effects. The putative candidate in many cases has been claimed to be thymoquinone but it seems that at least in part, particularly in kidney stones, the herbal melanin plays a role which requires further investigation to prove. Conclusion: N. sativa and its components are beneficial in prevention and curing of renal diseases including nephrolithiasis and renal damages.

  20. Pharmacotherapy of kidney stones.

    Science.gov (United States)

    Pak, Charles Y C

    2008-06-01

    Kidney stones are associated with various biochemical disturbances in urine. Various drugs and dietary changes have been recommended to halt stone recurrence. To determine whether a correction of urinary abnormalities by appropriate pharmacological agents and dietary modification may ameliorate stone disease. A review of the literature was conducted on the role of diet, metabolic disorders and drugs for stone prevention. Metabolic risk factors are hypercalciuria, hypocitraturia, hyperoxaluria, hyperuricosuria, and abnormally low urinary pH. Dietary-environmental risk factors include high urinary sodium and low urine volume. Rare or less commonly encountered risk factors are high urinary cystine, and alkaline urine from an infection with urea-splitting organisms. To ameliorate or correct the above disturbances, all patients should be offered dietary modification, including restricted intake of sodium, oxalate and animal proteins. Useful drugs include thiazide or indapamide to control hypercalciuria, potassium citrate to correct hypocitraturia and undue urinary acidity, and allopurinol for co-existing hyperuricemia or marked hyperuricosuria.

  1. Stone fragmentation by ultrasound

    Indian Academy of Sciences (India)

    S K Shrivastava; Kailash

    2004-08-01

    The presence of kidney stone in the kidney causes discomfort to patients. Hence, removal of such stones is important which is commonly done these days, non-destructively, with lithotripters without surgery. Commercially, lithotripters like extra-corporeal shock wave lithotripters (ESWL) made by Siemens etc are in routine use. These methods are very cumbersome and expensive. Treatment of the patients also takes comparatively more time because of more number of sittings. 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 disintegration efficiency of the lithotripters, which give better treatment to the patients.

  2. 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...

  3. Kidney Stones (For Parents)

    Science.gov (United States)

    ... en los riñones Kidney stones are small, solid masses that can develop in the urinary tract . Also ... of salt and protein in their diet limit consumption of soda/soft/sports drinks If dietary changes ...

  4. Kidney Stones in Children

    Science.gov (United States)

    ... drinking the wrong types of fluids, such as soft drinks or drinks with caffeine, may cause substances in ... such as chocolate, peanut butter, and dark-colored soft drinks. Children who form uric acid or cystine stones ...

  5. Spontaneous stone passage: is it Ammi visnaga effect?

    Science.gov (United States)

    Kilicaslan, Isa; Coskun, Selcuk

    2012-12-01

    Ammi visnaga was used in Ancient Egypt as an herbal remedy for renal colic. "Khellin", a chemical obtained from Ammi visnaga, was used as a smooth muscle relaxant and has been thought to have pleiotropic effects on urolithiasis. We report a case with multiple ureteral stone passages possibly as a result of medication with an herb preparation, Khellin.

  6. Determinants of brushite stone formation: a case-control study.

    Directory of Open Access Journals (Sweden)

    Roswitha Siener

    Full Text Available PURPOSE: The occurrence of brushite stones has increased during recent years. However, the pathogenic factors driving the development of brushite stones remain unclear. METHODS: Twenty-eight brushite stone formers and 28 age-, sex- and BMI-matched healthy individuals were enrolled in this case-control study. Anthropometric, clinical, 24 h urinary parameters and dietary intake from 7-day weighed food records were assessed. RESULTS: Pure brushite stones were present in 46% of patients, while calcium oxalate was the major secondary stone component. Urinary pH and oxalate excretion were significantly higher, whereas urinary citrate was lower in patients as compared to healthy controls. Despite lower dietary intake, urinary calcium excretion was significantly higher in brushite stone patients. Binary logistic regression analysis revealed pH>6.50 (OR 7.296; p = 0.035, calcium>6.40 mmol/24 h (OR 25.213; p = 0.001 and citrate excretion <2.600 mmol/24 h (OR 15.352; p = 0.005 as urinary risk factors for brushite stone formation. A total of 56% of patients exhibited distal renal tubular acidosis (dRTA. Urinary pH, calcium and citrate excretion did not significantly differ between patients with or without dRTA. CONCLUSIONS: Hypercalciuria, a diminished citrate excretion and an elevated pH turned out to be the major urinary determinants of brushite stone formation. Interestingly, urinary phosphate was not associated with urolithiasis. The increased urinary oxalate excretion, possibly due to decreased calcium intake, promotes the risk of mixed stone formation with calcium oxalate. Neither dietary factors nor dRTA can account as cause for hypercalciuria, higher urinary pH and diminished citrate excretion. Further research is needed to define the role of dRTA in brushite stone formation and to evaluate the hypothesis of an acquired acidification defect.

  7. Stone dusting process advance

    Energy Technology Data Exchange (ETDEWEB)

    Matt Ryan; David Humphreys [Mining Attachments (Qld.) Pty Ltd. (Australia)

    2009-01-15

    The coal mining industry has, for many years, used dry stone dust or calcium carbonate (CaCO{sub 3}) in the prevention of the propagation of coal dust explosions throughout their underground mines in Australia. In the last decade wet stone dusting has been introduced. This is where stone dust and water are mixed together to form a paste like slurry. This mixture is pumped and sprayed on to the underground roadway surfaces. This method solved the contamination of the intake airways but brought with it a new problem known as 'caking'. Caking is the hardened layer that is formed as the stone dust slurry dries. It was proven that this hardened layer compromises the dispersal characteristics of the stone dust and therefore its ability to suppress a coal dust explosion. This project set out to prove a specially formulated, non toxic slurry additive and process that could overcome the caking effect. The slurry additive process combines dry stone dust with water to form a slurry. The slurry is then treated with the additive and compressed air to create a highly vesicular foam like stone dusted surface. The initial testing on a range of additives and the effectiveness in minimising the caking effect of wet dusting were performed at Applied Chemical's research laboratory in Melbourne, Victoria and independently tested at the SGS laboratory in Paget, Queensland. The results from these tests provided the platform to conduct full scale spraying trials at the Queensland Mines Rescue Station and Caledon Coal's Cook Colliery, Blackwater. The project moved into the final stage of completion with the collection of data. The intent was to compare the slurry additive process to dry stone dusting in full-scale methane explosions at the CSIR Kloppersbos explosion facility in Kloppersbos, South Africa.

  8. Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis : A Case Report

    OpenAIRE

    種田, 建史; 金光, 俊行; 林, 哲也; 藤本, 宜正; 小出, 卓生

    2016-01-01

    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0....

  9. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

    Science.gov (United States)

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC.

  10. Biochemical Risk Factors for Stone Formation in Healthy School Children

    Directory of Open Access Journals (Sweden)

    Maasumeh Mohkam

    2012-12-01

    Full Text Available Prevalence of urolithiasis in childhood is increasing. The wide geographic variation in the incidence of lithiasis in childhood is related to climatic, dietary, and socioeconomic factors. Many children with stone disease have a metabolic abnormality. In Southeast Asia, urinary calculi are endemic and are related to dietary factors. The main aim of this study was to determine the prevalence of renal stone, urine metabolic abnormality, control of blood pressure and demographic character in elementary school children of Qom. A cross sectional study was performed on 110 primary school children (56 girls and 54 boys aged 7 to 11 years old. Demographic data such as age, height, weight were gathered, and systolic and diastolic blood pressure, Urine analysis and culture, urinary levels of calcium, creatinine, phosphorus, magnesium, sodium, potassium, uric acid, cystine, citrate, oxalate, protein and sonographic findings were evaluated. The mean (±SD of age was 8.85±1.51 years. Only one child had renal stone (1%, but the prevalence of abnormal renal sonography was 7%. The most prevalent urine metabolic abnormalities were hypercalciuria (23% and hypocitraturia (100%. 11.2% of children had positive urine culture that all were female. The prevalence of high blood pressure was 7.1% for girls and 11.1% for boys. The prevalence of renal stone in children in this study was 1%, which means the accurate judgment about the prevalence of renal stone in Qom city needs more comprehensive studies. Similar to other studies in Iran this study shows that the prevalence of hypercalciuria is significantly higher comparing to other countries, it may be associated with excessive intake of sodium.

  11. Design of the Dual Stone Locating System on an Extracorporeal Shock Wave Lithotriptor

    Directory of Open Access Journals (Sweden)

    Chien-Chen Chang

    2013-01-01

    Full Text Available Extracorporeal Shock Wave Lithotriptors are very popular for the treatment of urinary stones all over the world. They depend basically upon either X-ray fluoroscopy or ultrasound scans to detect the stones before therapy begins. To increase the effectiveness of treatment this study took advantage of both X-ray and ultrasound to develop a dual stone locating system with image processing modules. Its functions include the initial stone locating mode with stone detection by fluorescent images and the follow-up automatic stone tracking mode made by constant ultrasound scanning. The authors have integrated both apparatus and present the operating principles for both modes. The system used two in vitro experiments to justify its abilities of stone location in all procedures.

  12. [Composition of 359 kidney stones from the East region of Algeria].

    Science.gov (United States)

    Bouslama, S; Boutefnouchet, A; Hannache, B; Djemil, T; Kadi, A; Dahdouh, A; Saka, S; Daudon, M

    2016-01-01

    Determine stones composition of the upper urinary tract in the eastern region of Algeria. Our study focuses on a set of 359 stones of the upper urinary tract collected between January 2007 and December 2012 at hospitals in the eastern region of Algeria and analyzed by Fourier transform infrared spectroscopy. The male/female ratio was only 1.32. Calcium oxalate prevailed in 68.5% of stones and 49.3% of nuclei, mainly as whewellite (51.8% of stones and 37.9% of nuclei vs 16.7% and 11.4% respectively for weddellite). Carbapatite prevailed in 15% of stones and 29.8% of nuclei. The struvite, identified in 11.1% of calculi, prevailed in 3.9% of stones and 3.1% of nuclei. Among purines, uric acid prevailed with frequencies quite close to 8.9% and 7% respectively in the stone and in the nucleus while the ammonium urate prevailed in only 0.3% of stones and 3.3% of nuclei. The cystine frequency was 3.6% in both stone and nucleus. The frequency of stone with umbilication was 26.2%. Whewellite was the main component of umbilicated stones with Randall's plaque. Our results suggest that stones of the urinary tract in the Algerian east region resemble those observed in industrialized countries. Some features such as stones location, the whewellite prevalence, the frequencies of main components in both the stone and the nucleus as well as the formation of stones on renal papilla confirm this trend. 4. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Clinical efficacy of flexible ureteroscopic lithotripsy in the treatment of renal stones complicated with urinary tract infection%输尿管软镜治疗肾结石合并复杂尿路感染的疗效分析

    Institute of Scientific and Technical Information of China (English)

    徐明曦; 达骏; 张明; 董国勤; 卢慕峻; 姚海军; 张克; 王忠

    2015-01-01

    目的:评价输尿管软镜碎石取石术治疗肾结石伴难治性尿路感染的疗效和安全性。方法回顾分析2011年10月至2014年6月15例感染性肾结石应用输尿管软镜下钬激光碎石取石治疗的临床资料,与同期行输尿管软镜手术且无明显尿路感染患者进行对照。感染组15例患者术前均有尿路感染及发热症状,术前根据尿培养选用敏感抗生素治疗2周,尿中白细胞仍维持在100个/μL以上。手术使用Storz Flex‐X2 F7.5输尿管软镜进行碎石取石术,钬激光功率设置为0.8~1.0 J /5~10 Hz ,术中留置F6双J管。术后观察体温变化、血常规及KUB。术后2周复查尿常规及尿路CT 平扫,评估尿路感染控制情况及排石效果。术后2~4周拔除双J管。结果所有患者均一次碎石成功。术中发现感染组15例患者肾盂内尿液浑浊、伴有絮状物,其中有2例结石被脓苔样组织包裹。术中用钬激光碎石,用套石篮取出碎石,取净脓苔样组织,平均手术时间(30±21)(15~50) min ,术后结石清除率为93.3%(14/15);有2例(13.3%)出现术后发热,均在术后6 h内发生,最高体温在39℃以下,抗炎对症治疗后好转。结论敏感抗生素保护下行输尿管软镜碎石取石术是治疗感染性肾结石的安全有效的方法,其结石清除率高、并发症低,但术中需低压冲洗,且术后仍有出现发热的风险,需要密切关注。%ABSTRACT:Objective To study the efficacy and safety of flexible ureteroscopic lithotripsy for renal stones complicated with recurrent urinary tract infection (UTI) .Methods Clinical data of 15 patients with renal stones and recurrent UTI (UTI group) were retrospectively reviewed .The patients were treated with flexible ureteroscopic lithotripsy during Oct .2011 to June 2014 .A group of 15 patients with renal stones but without any sign of UTI were included as controls .All

  14. Endourological renal salvage in patients with calculus nephropathy and advanced uraemia.

    Science.gov (United States)

    Agrawal, M S; Aron, M; Asopa, H S

    1999-08-01

    To document our experience with percutaneous nephrolithotripsy (PCNL) for the treatment of calculus nephropathy and advanced renal failure. Between October 1989 and April 1996, 78 patients with calculus nephropathy (51 males and 27 females, mean age 42 years, range 16-67; mean serum creatinine level 663.8 micromol/L, range 282.8-1449.7) were treated in our department. Forty-six of the patients had bilateral upper urinary calculi, while the remaining 32 had a solitary functioning kidney obstructed by stone. Thirty-two patients had a normal urine output, 26 were oliguric and 20 presented with anuria. A preliminary percutaneous nephrostomy (PCN) was performed under local anaesthesia in 64 patients, and stone retrieved subsequently through the same nephrostomy track after improvement in their uraemic status. In the remaining 14 patients, the stones were removed at the first session. Of the 46 patients with bilateral stones, 21 underwent stone retrieval by PCNL on the contralateral side after an interval of 2-3 weeks, while 25 patients underwent simultaneous JJ stenting on the contralateral side, followed, after improvement in uraemic status, by delayed PCNL or extracorporeal shock wave lithotripsy on that side. There were three deaths, caused by overwhelming sepsis; 64 of the remaining 75 patients recovered well from uraemia, while 11 showed no improvement, suggesting irreversible renal damage. Complications included five patients with nonfatal sepsis and five with secondary haemorrhage. At the last follow-up 2.5-9 years after presentation, the mean serum creatinine level (271.3 micromol/L) was significantly better than the mean preoperative level. Six patients are on maintenance haemodialysis. It is not uncommon in developing countries for patients with urolithiasis to present with advanced uraemia caused by long-standing obstruction, almost invariably complicated by infection. A percutaneous endourological approach offers the best hope for these patients, and in our

  15. Management of complete staghorn stone in a developing country

    Directory of Open Access Journals (Sweden)

    Anant Kumar

    2002-01-01

    Renal failure patients had higher clearance rates with open procedures compared to PNL (80% vs 62.5% respec-tively. Moreover these patients had higher incidence of major bleeding with PNL compared to open procedures (31.3% vs 10%. Conclusions: Advantages of endourological procedures in the management of staghorn stones is offset by the need of ancillary treatments, which are expensive and which require frequent visits to the hospital. In view of high clear-ance rates, lesser treatment cost and lesser incidence of complications, open surgery still has a place in the man-agement of staghorn renal stones in patients who have economic constraints and live in remote areas where medi-cal facilities are not freely available. These advantages are also seen in the renal failure patients where complica-tions with endourologic procedures were significantly more than that with open surgery. However postoperative mor-bidity and larger scar should be discussed with the pa-tients.

  16. 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.

  17. Fasting and urinary stones

    Directory of Open Access Journals (Sweden)

    Ali Shamsa

    2013-12-01

    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.

  18. Relationship Between Milk Adulterated With Melamine and the Appearance of Renal Stones in a Childhood Population: A Review of the Literature of the Cases That Occurred in the People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Jasmina Bordón-González

    2014-05-01

    Full Text Available Introduction: Melamine is a chemical substance used in the production of resins. When melamine is added to milk, nitrogen concentration increases, which suggest an increase the amount of false proteins and consequently causing kidney diseases in some population subgroups. The objective of this study is to document the possible connection in between adulterated industrial milk with melamine and the appearance of kidney stones in children under 12 years old by reviewing cases occurred in the People’s Republic of China.Material and methods: A literature review was carried out on articles published on dated between 2005-2010, and an extensive analysis was made on the results found.Results: A total of 20 articles were reviewed, of which 11 met the criteria for inclusion, There were 9 cross-sectional studies, one follow-up study and a case-control study. Four studies calculated odds ratio (OR in their analysis to evaluate the relative risk of having stones in those children exposed to melamine formula. In the case-control study, children exposed to melamine formula were 5.17 times as likely to have kidney stones as children exposed to a non-melamine formula (95% confidence interval, 3.28-8.14; P<.001.Conclusions: Melamine adulteration in milk is a preventable public health issue which suggests the establishing of greater control measures and the implementation of food regulations by the food industry and Health and Food Institutions.

  19. Stones from bowel disease.

    Science.gov (United States)

    Worcester, Elaine M

    2002-12-01

    Kidney stones are increased in patients with bowel disease, particularly those who have had resection of part of their gastrointestinal tract. These stones are usually CaOx, but there is a marked increase in the tendency to form uric acid stones, as well, particularly in patients with colon resection. These patients all share a tendency to chronic volume contraction due to loss of water and salt in diarrheal stool, which leads to decreased urine volumes. They also have decreased absorption, and therefore diminished urinary excretion, of citrate and magnesium, which normally act as inhibitors of CaOx crystallization. Patients with colon resection and ileostomy form uric acid stones, as loss of bicarbonate in the ileostomy effluent leads to formation of an acid urine. This, coupled with low urine volume, decreases the solubility of uric acid, causing crystallization and stone formation. Prevention of stones requires treatment with alkalinizing agents to raise urine pH to about 6.5, and attempts to increase urine volume, which increases the solubility of uric acid and prevents crystallization. Patients with small bowel resection may develop steatorrhea; if the colon is present, they are at risk of hyperoxaluria due to increased permeability of the colon to oxalate in the presence of fatty acids, and increased concentrations of free oxalate in the bowel lumen due to fatty acid binding of luminal calcium. EH leads to supersaturation of urine with respect to CaOx, in conjunction with low volume, hypocitraturia and hypomagnesuria. Therapy involves a low-fat, low-oxalate diet, attempts to increase urine volume, and agents such as calcium given to bind oxalate in the gut lumen. Correction of hypocitraturia and hypomagnesuria are also helpful.

  20. Diet for Kidney Stone Prevention

    Science.gov (United States)

    ... from foods Uric Acid Stones Limit animal protein Reduce sodium Talk with a health care professional about how ... MSG sodium alginate sodium nitrate or nitrite To reduce sodium to help prevent kidney stones, avoid processed and ...

  1. Distal Renal Tubular Acidosis and Calcium Nephrolithiasis

    Science.gov (United States)

    Moe, Orson W.; Fuster, Daniel G.; Xie, Xiao-Song

    2008-09-01

    Calcium stones are commonly encountered in patients with congenital distal renal tubular acidosis, a disease of renal acidification caused by mutations in either the vacuolar H+-ATPase (B1 or a4 subunit), anion exchanger-1, or carbonic anhydrase II. Based on the existing database, we present two hypotheses. First, heterozygotes with mutations in B1 subunit of H+-ATPase are not normal but may harbor biochemical abnormalities such as renal acidification defects, hypercalciuria, and hypocitraturia which can predispose them to kidney stone formation. Second, we propose at least two mechanisms by which mutant B1 subunit can impair H+-ATPase: defective pump assembly and defective pump activity.

  2. Effect of catheter-based renal denervation on left ventricular function, mass and (un)twist with two-dimensional speckle tracking echocardiography.

    Science.gov (United States)

    Feyz, Lida; van Dalen, Bas M; Geleijnse, Marcel L; Van Mieghem, Nicolas M; van Domburg, Ron T; Daemen, Joost

    2017-05-11

    Speckle tracking echocardiography (STE) is an echocardiography modality that is able to measure left ventricular (LV) characteristics, including rotation, strain and strain rate. Strain measures myocardial fibre contraction and relaxation. This study aims to assess the effect of renal sympathetic denervation (RDN) on functional myocardial parameters, including STE, and to identify potential differences between responders and non-responders. The study population consisted of 31 consecutive patients undergoing RDN in the context of treatment for resistant hypertension. Patients were included between December 2012 and June 2014. Transthoracic echocardiography and speckle tracking analysis was performed at baseline and at 6 months follow-up. The study population consisted of 31 patients with treatment-resistant hypertension treated with RDN (mean age 64 ± 10 years, 15 men). The total study population could be divided into responders (n = 19) and non-responders (n = 12) following RDN. RDN reduced office blood pressure by 18.9 ± 26.8/8.5 ± 13.5 mmHg (p < 0.001). A significant decrease was seen in LV posterior wall thickness (LVPWd) (0.47 ± 1.0 mm; p = 0.020), without a significant change in the LV mass index (LVMI). In the total cohort, only peak late diastolic filling velocity (A-wave velocity) decreased significantly by 5.3 ± 13.2 cm/s (p = 0.044) and peak untwisting velocity decreased significantly by 14.5 ± 28.9°/s (p = 0.025). RDN reduced blood pressure and significantly improved functional myocardial parameters such as A-wave velocity and peak untwisting velocity in patients with treatment-resistant hypertension, suggesting a potential beneficial effect of RDN on myocardial mechanics.

  3. Renal lithiasis and nutrition

    OpenAIRE

    Prieto Rafel M; Costa-Bauza Antonia; Grases Felix

    2006-01-01

    Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of...

  4. 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.

  5. The history of urinary stones: in parallel with civilization.

    Science.gov (United States)

    Tefekli, Ahmet; Cezayirli, Fatin

    2013-11-20

    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.

  6. Modeling Stone Columns

    Directory of Open Access Journals (Sweden)

    Jorge Castro

    2017-07-01

    Full Text Available 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.

  7. Modeling Stone Columns

    Science.gov (United States)

    2017-01-01

    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. PMID:28773146

  8. Noninvasive management of obstructing ureteral stones using electromagnetic extracorporeal shock wave lithotripsy.

    Science.gov (United States)

    Sighinolfi, M C; Chiara, S M; Micali, S; Salvatore, M; De Stefani, S; Stefano, D S; Saredi, G; Mofferdin, A; Grande, M; Bianchi, G; Giampaolo, B

    2008-05-01

    Extracorporeal shock wave lithotripsy (ESWL) represents noninvasive management of urolithiasis. Since the first HM3 model, technological progress has improved the efficacy and safety of this treatment. The current study aimed to evaluate the role of ESWL as a first-line emergency therapy of renal colic due to ureteral stone with impaired renal function. This prospective study enrolled all the patients admitted from the emergency room with acute renal colic meeting the following criteria: serum creatinine level ranging from 1.5 to 2.5 mg/dl, hydronephrosis, ureteral stones 6 to 15 mm in size, body mass index less than 30, normal renal function at baseline, and no evidence of urinary tract infection. The patients were submitted to a single-session emergency treatment using Dornier Litothripter S. Follow-up assessment, performed at 24 and 72 h, included radiologic and ultrasound examinations with renal function serum assessment. The end points were a decrease in creatinine level and a stone-free condition. A total of 40 patients were eligible for the study. The mean creatinine level at admission was 1.93 +/- 0.26 mg/dl. After the treatment, renal function recovery occurred for 34 subjects (85%), with a significant global decrease in creatinine levels (p = 0.00). The global stone-free rate 72 h after SWL was 67.5% (27/40). The patients with residual fragments were managed using re-SWL (n = 7) and endoscopic technique (n = 6). Emergency SWL represents an effective tool in the treatment of ureteral stones with hydronephrosis and slight renal impairment. Although complete stone clearance after one treatment still remains a difficult target, the actual role of SWL in the management of acute obstruction is to obtain ureteral canalization and renal function recovery.

  9. A Stone and a Diamond

    Institute of Scientific and Technical Information of China (English)

    司亮

    2010-01-01

    一、故事内容 After a storm, a dry river is filled with water again. Many stones fall down into the river from the hill. Most of the stones are very happy. They sing and dance together. There are two special (特别的) stones. One is black, and the other is white. The white stone is as white as snow. She is proud of herself and she looks down on all the other stones. So no one wants to play with her.

  10. 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.

  11. 输尿管软镜联合钬激光碎石术治疗孤立肾结石的疗效及安全性%Safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney

    Institute of Scientific and Technical Information of China (English)

    张寅生; 肖河; 纪志刚; 刘广华; 张学斌

    2016-01-01

    目的 探讨输尿管软镜联合钬激光碎石术治疗孤立肾结石的安全性及有效性.方法 回顾性分析北京协和医院泌尿外科2014年5月-2016年6月采用输尿管软镜联合钬激光碎石术治疗的17例孤立肾结石患者的临床资料.其中男性10例,女性7例,年龄32~ 67岁,平均45.8岁.左侧9例,右侧8例.功能性孤立肾6例,解剖性孤立肾11例.其中肾盂结石8例,上中盏结石5例,下盏结石4例.结石平均直径为(1.2±0.3) cm.临床主要表现为:无症状10例、腰痛5例、发热2例,人院后完善血尿常规、肝肾功能、凝血功能、心电图、胸部X线片等术前相关检查,同时行清洁中段尿培养.结果 手术时间为(74.2±23.6) min,术中出血量为5~15 ml,平均8 ml,住院时间为3~12 d,平均4.5d.术后1例出现尿脓毒血症,经积极抗感染治疗后痊愈.其余患者无严重并发症发生.17例患者术前肌酐78~421 μmol/L,平均(161 ±103) μmol/L,术后1个月复查肌酐85 ~ 341 μmol/L,平均(124±63)μmol/L,与术前比较差异有统计学意义(P<0.05).一期结石完全清除率为82.3%(14/17),二期结石清除率达94.1%.结论 输尿管软镜联合钬激光碎石术治疗孤立肾结石,具有创伤小、出血少、并发症少、术后恢复快等优点,是一种安全、有效的方法.%Objective To investigate the safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney.Methods Between May 2014 and June 2016,Clinical records of 17 cases of stones in a solitary kidney who underwent flexible ureteroscopy and holmium laser lithotripsy were reviewed.10 of these cases were male and the others female;mean age of these cases was 45.8 (32-67) years.9 were on the left side while 8 were on the right.6 cases were with functional solitary kidney (with the GFR of the contralateral kidney less than 10ml/min),while 11 others were with anatomical solitary

  12. Coronal reconstruction of unenhanced abdominal CT for correct ureteral stone size classification

    Energy Technology Data Exchange (ETDEWEB)

    Berkovitz, Nadav; Simanovsky, Natalia; Hiller, Nurith [Hadassah Mount Scopus - Hebrew University Medical Center, Department of Radiology, Jerusalem (Israel); Katz, Ran [Hadassah Mount Scopus - Hebrew University Medical Center, Department of Urology, Jerusalem (Israel); Salama, Shaden [Hadassah Mount Scopus - Hebrew University Medical Center, Department of Emergency Medicine, Jerusalem (Israel)

    2010-05-15

    To determine whether size measurement of a urinary calculus in coronal reconstruction of computed tomography (CT) differs from stone size measured in the axial plane, and whether the difference alters clinical decision making. We retrospectively reviewed unenhanced CT examinations of 150 patients admitted to the emergency room (ER) with acute renal colic. Maximal ureteral calculus size was measured on axial slices and coronal reconstructions. Clinical significance was defined as an upgrading or downgrading of stone size according to accepted thresholds of treatment: {<=}5 mm, 6-9 mm and {>=}10 mm. There were 151 stones in 150 patients (male:female 115:34, mean age 41 years). Transverse stone diameters ranged from 1 to 11 mm (mean 4 mm). On coronal images, 56 (37%) stones were upgraded in severity; 46 (30%) from below 5 mm to 6 mm or more, and ten (7%) from 6-9 mm to 10 mm or more. Transverse measurement on the axial slices enabled correct categorization of 95 stones (63%). Transverse calculus measurement on axial slices often underestimates stone size and provides incorrect clinical classification of the true maximal stone diameter. Coronal reconstruction provides additional information in patients with renal colic that may alter treatment strategy. (orig.)

  13. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience.

    Science.gov (United States)

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL.

  14. 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

  15. AB094. Upper urinary stone management in China

    Science.gov (United States)

    Wang, Shaogang; Liu, Jihong; Ye, Zhangqun

    2015-01-01

    upper urinary stone with a low complication rate. With the development of technology, flexible ureteroscopy has become one of the main actors in clinical practice over the past several years. Flexible ureteroscopy can reach most parts of the kidney so that all stones can be removed or vaporised provided they are of an appropriate size and accessible. Moreover, flexible ureteroscopy is well tolerated and effective which allows us to obtain a high success rate, low morbidity, and a brief hospital stay. It could be the best option in managing the special patients with multiple intrarenal stones, stone-bearing caliceal diverticula, anticoagulated history, obesity, anomalous kidneys and pregnancy, which are not applicable for ESWL or PCNL. However, the flexible ureteroscopy is much more difficult to handle than the rigid ureteroscope. In addition, the flexible ureteroscope is expensive and easy to be damaged or broken, the treatment cost usually higher than ordinary treatment. In the past decades, some Chinese urologists and engineers have put in a great effort to design novel types of flexible ureteroscope which is cheaper and easier to operate. The integrated flexible and rigid ureteroscope is one of the new designed instruments of which the body is an ordinary rigid ureteroscope but have a flexible end. This novel device could be operated as easy as rigid ureteroscope and the end of ureteroscope could move flexiblely after its entry of the renal pelvis. Several different types of the Chinese flexible ureteroscope have completed the clinical trials and are going to be commercially available. Conclusions Generally, upper urinary stone is one of the most common diseases in urologic department in China and some novel treatment methods with Chinese characteristics has been developed. Each treatment method has advantages and disadvantages. The urologists’ choice of the treatment strategy should be made individually according to the properties of stone and the patient’s body

  16. 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.

  17. Phenotypic characterization of kidney stone formers by endoscopic and histological quantification of intrarenal calcification.

    Science.gov (United States)

    Linnes, Michael P; Krambeck, Amy E; Cornell, Lynn; Williams, James C; Korinek, Mark; Bergstralh, Eric J; Li, Xujian; Rule, Andrew D; McCollough, Cynthia M; Vrtiska, Terri J; Lieske, John C

    2013-10-01

    Interstitial Randall's plaques and collecting duct plugs are distinct forms of renal calcification thought to provide sites for stone retention within the kidney. Here we assessed kidney stone precursor lesions in a random cohort of stone formers undergoing percutaneous nephrolithotomy. Each accessible papilla was endoscopically mapped following stone removal. The percent papillary surface area covered by plaque and plug were digitally measured using image analysis software. Stone composition was determined by micro-computed tomography and infrared analysis. A representative papillary tip was biopsied. The 24-h urine collections were used to measure supersaturation and crystal growth inhibition. The vast majority (99%) of stone formers had Randall's plaque on at least 1 papilla, while significant tubular plugging (over 1% of surface area) was present in about one-fifth of patients. Among calcium oxalate stone formers the amount of Randall's plaque correlated with higher urinary citrate levels. Tubular plugging correlated positively with pH and brushite supersaturation but negatively with citrate excretion. Lower urinary crystal growth inhibition predicted the presence of tubular plugging but not plaque. Thus, tubular plugging may be more common than previously recognized among patients with all types of stones, including some with idiopathic calcium oxalate stones.

  18. Diagnosis of obstruction and stone passage after extracorporeal shock-wave lithotripsy (ESWL)

    Energy Technology Data Exchange (ETDEWEB)

    Vorwerk, D.; Auffermann, W.; Fischer, N.

    1987-09-01

    78 patients with ureteral formations of stone fragments after ESWL therapy have been controlled by both ultrasound and plain abdominal films. Detection of renal stone fragments was possible similarly by sonography or radiographs. The plain films demonstrated well location and length of the 'Steinstrasse', which did not necessarily cause obstruction. Combination of sonography and plain abdominal film allows an easy follow-up after ESWL therapy, so i.v. urogramm is not acquired routinely.

  19. Efficacy and safety of retrograde flexible ureteroscopic lithotripsy with holmium:YAG laser in the treatment of renal stones%逆行软性输尿管镜下钬激光碎石术治疗肾结石的有效性与安全性分析

    Institute of Scientific and Technical Information of China (English)

    曾国华; 李佳胜; 赵志健; 刘陈黎; 刘旸; 曾滔; 刘永达; 陈文忠; 吴文起

    2015-01-01

    Objective To evaluate the efficacy and safety of retrograde flexible ureteroscopic lithotripsy ( RFUL) with holmium:YAG laser for the treatment of renal stones with a large series.Methods The data of 466 patients who underwent RFUL with holmium:YAG laser for the treatment of kidney stones between January 2013 and December 2013 were collected.The maximum diameter of stone was 23 ±16 mm.The stone free rate, complications, retreatment rate were evaluated.Results Out of the 466 patients, the mean operative time and postoperative hospital stay were 33.5 ±18.8 min and 2.3 ±2.0 d.The stone free rate was 67.6% ( 315/466 ) after single procedure, which increased to 69.5% ( 324/466 ) via re-treatments after 3 months.The retreatment rate was 4.3%(20/466), with a total of 493 RFUL procedures performed and 1.06 times per patient.There were 67 (14.4%) cases undergoing complications.Five cases had false passage of ureter orifice causing slight ureteral wall injuries.Steinstrasse occurred in 9 cases, ureteral perforation in 3 cases and perirenal hematoma in 1 case.Overall postoperative fever rate was 10.7%(50/466) with urosepsis in 16 cases (3.4%).When the stone size was≤10, 11-20, 21-30, 31-40, and >40 mm, the stone free rates after a single procedure were 97.0% ( 65/67 ) , 84.2% ( 160/190 ) , 63.1%(70/111), 29.2%(14/48), 12.0%(6/50) (P<0.001), and the postoperative fever rates were 1.5%(1/67), 9.5%(18/190), 13.5% (15/111), 14.6% (7/48), 18.0% (9/50), respectively. The postoperative fever rates were 19.3%(27/140) and 7.1%(23/326) (P<0.001) in the patient with positive and negative preoperative urine leukocyte, and 22.0% ( 22/100 ) and 7.7% ( 28/366 ) ( P <0.001) in patients with positive and negative preoperative urine culture.Conclusions RFUL with holmium:YAG laser is a safe and effective treatment for kidney stones.The postoperative fever rate would increase and stone free rate would reduce with the increased stone size.%目的:评价逆行软性输尿管镜下钬激

  20. DIMENSION STONE DEPOSITS IN CROATIA

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    Branko Crnković

    1993-12-01

    Full Text Available The geology, petrographycal composition and properties of dimension stone deposits in Croatia are described. Dimension stone deposits in the conception of mobilistic view of the genesis and structure of Dinarides, as well as after stratigraphic units, are considered. Valuation of the dimension stones of the active quarries is exposed. The marketable categories of dimension stone in Croatia are different varietes of limestones and calcareous clastites, primarly of Cretaceous age, and to lesser degree of Jurassic and Paleogene. The greatest part of deposits is concentrated in the Adriatic carbonate platform or Adriaticum.

  1. 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

  2. Should flexible ureteroscope be added to our armamentarium to treat stone disease?

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    Anand Dharaskar

    2008-01-01

    Full Text Available The field of Urology in Medicine has witnessed tremendous advancement in technology and in accordance with it. Endourology has taken a leap ahead in terms of stone management. Most of the stones could be treated with semi-rigid ureteroscopy, percutaneous nephrolithotomy (PNL and ESWL and some would need Flexible ureteroscopy. Flexible ureteroscopy has been primarily indicated to treat ESWL resistant renal stones but with changes in the technology of incorporating secondary active deflection and availability of laser fibres, its horizon for indications to treat stones is being widened. Though Flexible ureteroscopy is being used to treat stones of various sizes and locations, its cost effectiveness is debatable. Should it be used ubiquitously to treat stones amenable to PNL or ESWL is a big question we need to answer. As of now true indications of Flexible ureteroscopy are limited and there is an urgent need for a randomized trial to compare its efficacy with ESWL and PNL for renal and upper ureteric stones.

  3. Biopsy proven medullary sponge kidney: clinical findings, histopathology, and role of osteogenesis in stone and plaque formation.

    Science.gov (United States)

    Evan, Andrew P; Worcester, Elaine M; Williams, James C; Sommer, Andre J; Lingeman, James E; Phillips, Carrie L; Coe, Fredric L

    2015-05-01

    Medullary sponge kidney (MSK) is associated with recurrent stone formation, but the clinical phenotype is unclear because patients with other disorders may be incorrectly labeled MSK. We studied 12 patients with histologic findings pathognomonic of MSK. All patients had an endoscopically recognizable pattern of papillary malformation, which may be segmental or diffuse. Affected papillae are enlarged and billowy, due to markedly enlarged inner medullary collecting ducts (IMCD), which contain small, mobile ductal stones. Patients had frequent dilation of Bellini ducts, with occasional mineral plugs. Stones may form over white (Randall's) plaque, but most renal pelvic stones are not attached, and have a similar morphology as ductal stones, which are a mixture of calcium oxalate and apatite. Patients had no abnormalities of urinary acidification or acid excretion; the most frequent metabolic abnormality was idiopathic hypercalciuria. Although both Runx2 and Osterix are expressed in papillae of MSK patients, no mineral deposition was seen at the sites of gene expression, arguing against a role of these genes in this process. Similar studies in idiopathic calcium stone formers showed no expression of these genes at sites of Randall's plaque. The most likely mechanism for stone formation in MSK appears to be crystallization due to urinary stasis in dilated IMCD with subsequent passage of ductal stones into the renal pelvis where they may serve as nuclei for stone formation.

  4. The systematic classification of gallbladder stones.

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    Tie Qiao

    Full Text Available BACKGROUND: To develop a method for systematic classification of gallbladder stones, analyze the clinical characteristics of each type of stone and provide a theoretical basis for the study of the formation mechanism of different types of gallbladder stones. METHODOLOGY: A total of 807 consecutive patients with gallbladder stones were enrolled and their gallstones were studied. The material composition of gallbladder stones was analyzed using Fourier Transform Infrared spectroscopy and the distribution and microstructure of material components was observed with Scanning Electron Microscopy. The composition and distribution of elements were analyzed by an X-ray energy spectrometer. Gallbladder stones were classified accordingly, and then, gender, age, medical history and BMI of patients with each type of stone were analyzed. PRINCIPAL FINDINGS: Gallbladder stones were classified into 8 types and more than ten subtypes, including cholesterol stones (297, pigment stones (217, calcium carbonate stones (139, phosphate stones (12, calcium stearate stones (9, protein stones (3, cystine stones (1 and mixed stones (129. Mixed stones were those stones with two or more than two kinds of material components and the content of each component was similar. A total of 11 subtypes of mixed stones were found in this study. Patients with cholesterol stones were mainly female between the ages of 30 and 50, with higher BMI and shorter medical history than patients with pigment stones (P<0.05, however, patients with pigment, calcium carbonate, phosphate stones were mainly male between the ages of 40 and 60. CONCLUSION: The systematic classification of gallbladder stones indicates that different types of stones have different characteristics in terms of the microstructure, elemental composition and distribution, providing an important basis for the mechanistic study of gallbladder stones.

  5. AB109. Upper urinary stone management in China

    Science.gov (United States)

    Wang, Shaogang; Liu, Jihong; Ye, Zhangqun

    2015-01-01

    all parts of the kidney so that all stones can be removed or vaporised provided they are of an appropriate size and accessible. Moreover, flexible ureteroscopy is well tolerated and effective which allowed us to obtain a high success rate, low morbidity, and a brief hospital stay. It could be the best option in managing the special patients with multiple intrarenal stones, stone-bearing caliceal diverticula、anticoagulated history, obesity, anomalous kidneys and pregnancy, which are not applicable for ESWL or PCN. However, the flexible ureteroscope is much more difficult to handle than the rigid ureteroscope. In addition, the flexible ureteroscope is expensive and easy to damage or break, the treatment cost usually higher than ordinary treatment. In past decades, some Chinese urologists and engineers have put in a great effort to design novel types of flexible ureteroscope which more cheap and easy to operate. The integrated flexible and rigid uroteroscope is the one of the new designed instruments of which the body is the ordinary rigid ureteroscope but have a flexible end. This novel device could be operated as easy as rigid ureterosope and the end of uroteroscope could move flexible after it entry the renal pelvis. Several different types of the Chinese flexible uroteroscope have completed the clinical trials and are going to be commercially available. Conclusions Generally, Upper urinary stone is one of the most common diseases in urologic department in China. Each treatment has advantages and disadvantages. The urologist’s choice of the treatment strategy should be made individually according to the properties of stone and the patient’s body condition.

  6. Econophysics of precious stones

    CERN Document Server

    Watanabe, A; Uchida, N

    2006-01-01

    The importance of the power law has been well realized in econophysics over the last decade. For instance, the distribution of the rate of stock price variation and of personal assets show the power law. While these results reveal the striking scale invariance of financial markets, the behaviour of price in real economy is less known in spite of its extreme importance. As an example of markets in real economy, here we take up the price of precious stones which increases with size while the amount of their production rapidly decreases with size. We show for the first time that the price of natural precious stones (quartz crystal ball, gemstones such as diamond, emerald, and sapphire) as a function of weight obeys the power law. This indicates that the price is determined by the same evaluation measure for different sizes. Our results demonstrate that not only the distribution of an economical observable but also the price itself obeys the power law. We anticipate our findings to be a starting point for the qua...

  7. Recumbent Stone Circles

    Science.gov (United States)

    Ruggles, Clive L. N.

    During the 1970s and early 1980s, British archaeoastronomers were striving to bridge the interpretative gulf between the "megalithic observatories" of Alexander Thom and an archaeological mainstream that, generally speaking, was hostile to any mention of astronomy in relation to the megalithic monuments of Neolithic and Early Bronze Age Britain. The Scottish recumbent stone circles (RSCs) came to represent an example where sounder methodology could overcome many of the data selection issues that had beset earlier studies and, with due restraint, produce credible interpretations. Systematic studies of their orientations consistently concluded that the RSCs had a strong lunar connection, and it was widely envisaged that they were the setting for ceremonies associated with the appearance of the moon over the recumbent stone. Other evidence such as the presence of white quartz and the spatial distribution of cupmarks appeared to back up this conclusion. New archaeological investigations since 1999 have challenged and modified these conclusions, confirming in particular that the circles were built to enclose cairns rather than to demarcate open spaces. Yet the restricted pattern of orientations of these structures could only have been achieved by reference to the basic diurnal motions of the skies, and orientation in relation to simple observations of the midsummer moon remains the most likely reading of the alignment evidence taken as a whole. On the other hand, a consideration of the broader context, which includes the nearby Clava cairns, highlights instead the symbolic importance of the sun.

  8. Scottish Short Stone Rows

    Science.gov (United States)

    Ruggles, Clive L. N.

    Short stone rows received a good deal of attention during the 1980s and 1990s, at a time when archaeoastronomy in prehistoric Britain and Ireland was moving beyond reassessments of Alexander Thom's "megalithic observatories" by identifying coherent groups of similar monuments with clear orientation trends. Many such rows are found in western Scotland, with the main concentration in Argyll and the island of Mull. Systematic analyses of their orientations produced credible evidence of an awareness of the 18.6-year lunar node cycle, within a "primary-secondary" pattern whereby isolated rows were oriented close to moonrise or moonset at the southern major standstill limit, while others oriented in this way were accompanied by a second row oriented in a declination range that could be interpreted either as lunar or solar. A detailed investigation of the landscape situation of the sites in northern Mull, accompanied by excavations at two of the sites, suggested that they were deliberately placed in locations where critical moonsets would be seen against prominent distant landscape features, but where the distant horizon in most or all other directions was hidden from view. A lack of independent archaeological evidence may help to explain why archaeoastronomical investigations at short stone rows have never progressed beyond "data-driven" studies of orientations and landscape situation. Nonetheless, the work that was done at these sites raised important general methodological issues, and pioneered techniques, that remain relevant across archaeoastronomy today.

  9. 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.

  10. Four years follow-up of 101 children with melamine-related urinary stones.

    Science.gov (United States)

    Yang, Li; Wen, Jian Guo; Wen, Jian Jun; Su, Zhi Qiang; Zhu, Wen; Huang, Chen Xu; Yu, Si Long; Guo, Zhan

    2013-06-01

    The melamine-contaminated milk powder incidence occurred in China in 2008. Many studies have been published regarding the epidemiology, clinical symptoms, diagnosis and treatment of melamine-related urinary stones. The objective of this study is to follow-up the effects of melamine-contaminated milk powder consumption on kidney and body growth in children with melamine-related urinary stones 4 years ago. One hundred and one children with melamine-related urinary stones were followed up by urinalysis, renal function tests and urinary ultrasonography. The data of body weight and height, clinical signs and complications were collected. Eighty normal children without the history of consuming melamine-contaminated milk powder were collected as controls. Eighty-one children with melamine-related urinary stones were successfully followed up. Of 45 cases with melamine-related urinary stones treated conservatively after discharge, 34 disappeared completely, 6 dissolved partially, 1 increased in size and 4 did not change at 4 years follow-up. The percentages of under-height and under-weight infants were significantly higher in melamine-related urinary stones group compared to the controls, respectively (p urinary stones on kidney and bladder was found at 4 years follow-up. However, whether or not melamine-related urinary stones had effect on body growth needs follow-up in future.

  11. Nephrolithiasis-induced end stage renal disease

    Science.gov (United States)

    Ounissi, M; Gargueh, T; Mahfoudhi, M; Boubaker, K; Hedri, H; Goucha, R; Abderrahim, E; Ben Hamida, F; Ben Abdallah, T; El Younsi, F; Ben Maiz, H; Kheder, A

    2010-01-01

    Introduction: Nephrolithiasis still remains a too frequent and underappreciated cause of end stage renal disease (ESRD). Methods and patients: Of the entire cohort of 7128 consecutive patients who started maintenance dialysis in our nephrology department between January 1992 and December 2006, a total of 45 patients (26 women, 19 men) had renal stone disease as the cause of ESRD. The type of nephrolithiasis was determined in 45 cases and etiology in 42. The treatment and evolution of stone disease and patient’s survival were studied. Results: The overall proportion of nephrolithiasis related ESRD was 0.63%. The mean age was 48.4 years. Infection stones (struvite) accounted for 40%, calcium stones, 26.67% (primary hyperparathyroidism:15.56%; familial hypercalciuria: 4.44%, unknown etiology: 6.66%), primary hyperoxaluria type 1, 17.78% and uric acid lithiasis in 15.56% of cases. The mean delay of the evolution of the stone renal disease to chronic renal failure was 85.8 months. The feminine gender, obesity and elevated alkaline phosphatases >128 IU/L were significantly correlated with fast evolution of ESRD. The median evolution to ESRD was 12 months. The normal body mass index (BMI), medical treatment of stone and primary hyperoxaluria type 1 were correlated with fast evolution to ESRD. All patients were treated by hemodialysis during a mean evolution of 60 months. Sixteen patients died. The patient's survival rate at 1, 3 and 5 years was 97.6, 92.8 and 69% respectively. Hypocalcemia, cardiopathy and normal calcium-phosphate product were significantly correlated with lower survival rate. Conclusion: Severe forms of nephrolithiasis remain an underestimated cause of ESRD. These findings highlight the crucial importance of accurate stone analysis and metabolic evaluation to provide early diagnosis and efficient treatment for conditions leading to ESRD. PMID:21694924

  12. 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

  13. Effect of catheter-based renal denervation on left ventricular function, mass and (un)twist with two-dimensional speckle tracking echocardiography

    NARCIS (Netherlands)

    L. Feyz (Lida); B.M. van Dalen (Bas); M.L. Geleijnse (Marcel); N.M. van Mieghem (Nicolas); R.T. van Domburg (Ron); J. Daemen (Joost)

    2017-01-01

    markdownabstractBackground: Speckle tracking echocardiography (STE) is an echocardiography modality that is able to measure left ventricular (LV) characteristics, including rotation, strain and strain rate. Strain measures myocardial fibre contraction and relaxation. This study aims to assess the

  14. 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.

  15. Variability of the calcium ion activity with pH in stone-forming and non-stone-forming urine.

    Science.gov (United States)

    Thode, J; Holgersen, R B; Gerstenberg, T

    1993-01-01

    In recurrent renal stone-formers (N = 20) and matched healthy adults (N = 20), the actual activity of ionized calcium (alpha Ca2+) and pH were determined in whole urine with an ion-selective electrode. No significant difference was found for the actual median activity of ionized calcium, however the actual median pH was significantly higher in stone-formers compared to healthy adults (pH = 5.57 vs. pH = 5.24; p titration with HCl/NaOH. In all urines the Ca2+ activity decreased with increasing pH in a typical bifasic manner. All curves showed a characteristic "breaking point" at a similar median pH in the stone-formers and in the healthy adults (pH = 6.81 vs. pH = 6.77) (NS). However the slope of the curves in the stone-formers and healthy adults changed from a median value of delta lg alpha Ca2+/delta pH of -0.139 and -0.173 (NS) respectively, to a highly significant difference of -1.326 and -1.053 (p < 0.0001) between the groups, indicating increased binding/precipitation of Ca2+ in stone-formers than in healthy adults supporting the theory of the lack of inhibitors in stone-formers. The strong relationship between the activity of ionized calcium and pH, combined with a higher actual pH and a higher decrease of ionized calcium with pH in stone-formers than in healthy adults, indicates hydrogen ion as a major factor in stone-formation. The close relationship between Ca2+ activity and pH indicates the need for simultaneous measurements of the pH in order to interpret data for the Ca2+ activity. In order to preserve a low urinary pH, where Ca2+ is predominantly in a free ionic state, our results suggest that treatment with acidifying salts could be a logical choice in order to prevent stone-formation.

  16. Simulation of calcium oxalate stone in vitro

    Institute of Scientific and Technical Information of China (English)

    欧阳健明; 姚秀琼; 苏泽轩; 崔福斋

    2003-01-01

    Crystallization of calcium oxalate is studied mainly in the diluted healthy urine using scanning electron microscopy (SEM), and is compared with the crystallization in the diluted pathological urine. It suggests that the average sizes of calcium oxalate crystals are not in direct proportion to the concentrations of Ca2+ and Ox2- ions. Only in the concentration range of 0.60-0.90 mmol/L can larger size of CaOx crystals appear. When the concentrations of Ca2+ and Ox2- ions are 1.20, 0.80, 0.60, 0.30 and 0.15 mmol/L in the healthy urine, the average sizes of calcium oxalate crystallites are 9.5 × 6.5, 20.0 × 13.5 and 15.0 μm × 10.0 μm, respectively, for the former three samples after 6 d crystallization. No crystal appears even after 30 d crystallization for the samples of concentrations of 0.30 and 0.15 mmol/L due to their low supersaturations. The results theoretically explain why the probability of stone forming is clinically not in direct proportion to the concentrations of Ca 2+ and Ox2- ions. Laser scattering technology also confirms this point. The reason why healthy human has no risk of urinary stone but stone-formers have is that there are more urinary macromolecules in healthy human urines than that in stone-forming urines. These macromolecules may control the transformation in CaOx crystal structure from monohydrate calcium oxalate (COM) to dihydrate calcium oxalate (COD). COD has a weaker affinity for renal tubule cell membranes than COM. No remarkable effect of the crystallization time is observed on the crystal morphology of CaOx. All the crystals are obtuse hexagon. However, the sizes and the number of CaOx crystals can be affected by the crystallization time. In the early stage of crystallization (1-6 d), the sizes of CaOx crystals increase and the number of crystal particles changes little as increasing the crystallization time due to growth control. In the middle and late stages (6-30 d), the number of crystals increases markedly while the

  17. Asymptomatic common bile duct stones.

    Science.gov (United States)

    Rosseland, A R; Glomsaker, T B

    2000-11-01

    Patients with asymptomatic bile duct stones exhibit typical signs, such as elevated liver function tests, dilated bile ducts on ultrasound, a history of jaundice, or pancreatitis. The incidence of asymptomatic bile duct stones is about 10%, but up to 2% of patients show no signs of the disease. Bile duct stones can be diagnosed by using clinical judgement, scoring systems, or discriminant function tests. Which diagnostic modality is most reliable, cost-effective and safe, varies with different hospitals. Which therapy is most effective, safe and the cheapest also varies with different departments, but in the future an increasing number of departments will use the one-stage laparoscopic approach.

  18. 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

  19. [Renal toxicity of antiviral drugs].

    Science.gov (United States)

    Frasca', Giovanni M; Balestra, Emilio; Tavio, Marcello; Morroni, Manrico; Manarini, Gloria; Brigante, Fabiana

    2012-01-01

    Highly effective and powerful antiviral drugs have been introduced into clinical practice in recent years which are associated with an increased incidence of nephrotoxicity. The need of combining several drugs, the fragility of the patients treated, and the high susceptibility of the kidney are all factors contributing to renal injury. Many pathogenetic mechanisms are involved in the nephrotoxicity of antiviral drugs, including drug interaction with transport proteins in the tubular cell; direct cytotoxicity due to a high intracellular drug concentration; mitochondrial injury; and intrarenal obstruction or stone formation due to the low solubility of drugs at a normal urinary pH. As a result, various clinical pictures may be observed in patients treated with antiviral drugs, ranging from tubular dysfunction (Fanconi syndrome, renal tubular acidosis, nephrogenic diabetes insipidus) to acute renal failure (induced by tubular necrosis or crystal nephropathy) and kidney stones. Careful attention should be paid to prevent renal toxicity by evaluating the glomerular filtration rate before therapy and adjusting the drug dosage accordingly, avoiding the combination with other nephrotoxic drugs, and monitoring renal parameters on a regular basis while treating patients.

  20. [The long-term "stone trail": treatment experience using ureterorenoscopy].

    Science.gov (United States)

    Martov, A G; Kamalov, A A; Gushchin, B L

    1994-01-01

    A residual "stone trace" is not a rare finding after impulse destruction of large stones. A complex of conservative treatment of lithotripsy of the fragments and sand which comprise the sand trace are not universally effective. Long-standing "stone trace" is characterized by a single or several large fragments of the crushed stone, failure of both conservative and lithotripsy treatment, the trace existence surpassing 1 month. Ureterorenoscopy was used for the trace management in 41 patients. The trace (2-6.5 cm in length) was localized in the lower, middle and upper third of the ureter in 28, 10 and 3 patients, respectively. Transureteral lithotripsy and lithoextraction were made by ureterorenoscopes (11.5 and 12.5 Tr) and miniscope (9.5 Tr). Lithotripsy was made using ultrasonic electrohydraulic and pneumatic lithotriptors. In transureteral endoscopic destruction of long-standing traces the authors point out apparent inflammation in the ureteral wall at the trace side, ready-to-bleed ureteral mucosa, poor endoscopic image, preferable initial use of atraumatic pneumatic lithotripsy followed by lithoextraction, previous renal drainage by means of transcutaneous puncture nephrostomy in acute inflammation or advanced retention changes of the kidney, etc. Ureterorenoscopy proved able to eliminating the traces. Side effects were reported in the form of an episode of pyelonephritis aggravation cured conservatively in 17% of the cases.

  1. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  2. A Survey of Epidemiologic Factors in Patients with Urinary Stones in Hamadan

    Directory of Open Access Journals (Sweden)

    H.R. Ghasemi Basir

    2016-07-01

    Full Text Available Introduction & Objective: After urinary tract infection and prostatic disorders , the urine stones are the third common genitourinary diseases. Demographic, environmental and genetic factors affect urine stone formation. The aim of our study is to survey epidemiologic factors in pa-tients with urinary stones referring to educational hospitals of Hamadan during 2010-2013. Materials & Methods: In this analytic-cross-sectional study, we studied 500 cases of urinary stones referring to educational hospitals of Hamadan. The data were collected from electronic patient records system of laboratory. The results were registered in a check list and analyzed by spss16 and descriptive statistical indicators. Results: The patients were between 0.5-84 years. The average age of them was 40.36 years. In our study of 500 cases, 348 cases were male (69.6% and 152 cases were female (30.4%. The male to female ratio was 2.3 to 1. Urinary stones were more prevalent in 25- 45 year old men and 30-50 year old women. Among 500 patients, 466 cases had only one type of renal stones and 34 cases had 2 types. The calcium oxalate was the most common stone (386 cases, 72.5%. The other common stone types were uric acid (130 cases, 24.3 %, cystine (14 cases,2.6 % ,calcium carbonate (3 cases,0.5 % and calcium phosphate (1 case,0.1 % Conclusion: Urinary stones are twice as common in men as in women. Most patients are be-tween 38-42 years old. The most common stone in both sexes and all ages was calcium ox-alate. (Sci J Hamadan Univ Med Sci 2016; 23 (2:157-163

  3. Postoperative Infection Rates in Patients with a Negative Baseline Urine Culture Undergoing Ureteroscopic Stone Removal

    DEFF Research Database (Denmark)

    Martov, Alexey; Gravas, Stavros; Etemadian, Masoud;

    2015-01-01

    Abstract Purpose: To examine the effects of antibiotic prophylaxis on postoperative infection rate in patients with negative urine cultures undergoing ureteroscopy (URS). Patients and Methods: Using the Clinical Research Office of the Endourological Society (CROES) URS Global Study database...... in both groups. Factors predictive of postoperative UTI or fever were female gender, Crohn's and cardiovascular disease, a high stone burden, and an ASA score of II or higher. Conclusions: In patients with a negative baseline urine culture undergoing URS for ureteral or renal stones, rates......, patients with a negative baseline urine culture undergoing URS for ureteral stones (n=1141) or kidney stones (n=184) not receiving antibiotic prophylaxis were matched with those who were predefined by risk factors, including gender, American Society of Anesthesiologists (ASA) score, and ureteral stent...

  4. Urinary pH as a Risk Factor for Stone Type

    Science.gov (United States)

    Sakhaee, Khashayar

    2007-04-01

    A high urinary pH is main risk factor for the calcium phosphate stone formation; however, its pathophysiologic mechanism has not been fully understood. The introduction of Topiramate in the treatment of various neurological disorders has been complicated by metabolic acidosis, significant hypocitraturia, elevated urinary pH, and calcium phosphate stone formation. This model provides a probe to investigate the pathophysiologic mechanism of calcium phosphate stone formation and perhaps to develop appropriate countermeasures in the future. On the other hand an unduly acidic urine predisposes one to uric acid nephrolithiasis. Our recent investigation linking low urinary pH, and defective renal ammoniagenesis to insulin resistance provides new knowledge to unfold the pathophysiology of uric acid nephrolithiasis. The metabolic profile leading to uric acid stone may emerge as one of the components of metabolic syndrome.

  5. Ureteroscopy for management of stone disease: an up to date on surgical technique and disposable devices.

    Science.gov (United States)

    Torricelli, Fabio C; Marchini, Giovanni S; Pedro, Renato N; Monga, Manoj

    2016-12-01

    The surgical management of urinary stone disease developed substantially over the past decades and advanced minimally invasive techniques have been successfully introduced into clinical practice. Retrograde ureteroscopy and ureterorrenoscopy have become the first-line option for treatment of ureteral and renal stones worldwide with high success rates allied with a low morbidity profile. In this review, we will discuss some key points in ureteroscopy for stone disease, such as the access to upper urinary tract, including balloon and catheter dilation; how to choose and use some disposable devices (hydrophilic versus PTFE guide wires, ureteral catheters, and laser fiber setting); and lastly present and compare different techniques for kidney or ureteral stone treatment (dusting versus basketing).

  6. Renal arteriography

    Science.gov (United States)

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Review Date 1/5/2016 Updated by: Jason Levy, ...

  7. Topiramate induced metabolic acidosis and kidney stones - a case study.

    Science.gov (United States)

    Salek, Tomas; Andel, Ivan; Kurfurstova, Irena

    2017-06-15

    The aim of this study is to present a case of 44 years old woman with topiramate induced metabolic acidosis and kidney stones. The laboratory features of topiramate caused renal tubular acidosis in blood and urine during topiramate treatment, with correction of metabolic acidosis by potassium citrate, and after topiramate withdrawal are presented. Differential diagnosis of all possible causes of metabolic acidosis is discussed. The results revealed negative base excess in extracellular fluid of - 9.2 mmol/L, low serum HCO3(-) concentration (18.6 mmol/L), trend to alkaline urine (pH 6.39) and low urine citrate concentration (0.3 mmol/24h). After topiramate withdrawal, all parameters of the internal environment normalized. This study has shown that long-term topiramate administration could induce metabolic acidosis and consequently urholithiasis. Thus, we could recommend testing blood acid base balance, urinary pH and citrates in patients taking topiramate and suffering from kidney stones.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  9. “Die Another Day”: A Qualitative Analysis of Hmong Experiences with Kidney Stones

    Directory of Open Access Journals (Sweden)

    Kathleen A. Culhane-Pera

    2007-01-01

    Full Text Available Background: A chart review at a urological office revealed that Hmong patients present with higher rates of kidney stones, uric acid stones, and complications from kidney stones than non-Hmong patients. In order to ultimately redress this health disparity, a conferenceof Hmong and non-Hmong health care providers decided that we needed to first understand the pertinent social, cultural, economic, and biological factors contributing to the disparity. This research project sought to elicit Hmong patients and family members’explanatory models, decision-making processes, and experiences with the health care system.Methods: We conducted in–depth interviews with 10 Hmong kidney stone patients, 11 family members of 9 patients, and 4 traditional healers. All 10 patients had received urological interventions, including ureteroscopy (8, percutaneous lithotomy (5 and nephrectomy (2. Some patients had postponed medical assistance (6 and had refusedprocedures (4. We qualitatively analyzed the transcribed and translated interviews with an Excel spread sheet and N6 computer software. Results were discussed with patients and a community advisory council.Results: Hmong concepts of kidney function and explanatory models of kidney stones are a blend of traditional and biomedical concepts. Kidney stones are understood as acute health problems caused by hard substances in water and food that stick to the kidney, which weak kidneys cannot excrete. Kidney stone sufferers do not know they have stones until they pass a stone or they see stones on X-rays, as pain or hematuria are non-specific symptoms. They prefer medications, including herbal medicines, to invasive urologicalprocedures. In making decisions about urological interventions, Hmong patients balance fear of disease (pain and renal failure with fear of doctors (complications from interventions and anesthesia. While patients have variable balance points to accept interventions, the basic philosophy of

  10. The relation between stone disease and obesity in Jordan

    Directory of Open Access Journals (Sweden)

    Lara Alex Abu Ghazaleh

    2013-01-01

    Full Text Available Obesity forms a growing challenge in medicine worldwide. In Jordan, the obese and the overweight population form 49.7% of the total population. The latest national male to female ratio in Jordan is 1:1.06. There is a relation between obesity and renal stone formation. This study is conducted to study the relation of renal stone and obesity in the Jordanian popu-lation. All patients with urolithiasis that attended the urology clinic at Prince Hussein Bin Abdullah Urology Center at King Hussein Medical Center, Jordan, over the period from January 2006 to January 2011 were included in the study and analyzed for age, gender, body weight, number of visits to the clinic and number of procedures. Over a period of 60 months from January 2006 through January 2011, 8346 patients were treated for urolithiasis. The median age was 43.2 years. The male to female ratio was 1.46:1. 42.3% of the patients were obese, with body mass index (BMI >30 kg/m 2 and 25.8% of the patients were overweight, with BMI >25 kg/m 2 . The normal body weight population formed 31.9% of the total population. The majority of our urolithiasis patients were obese and overweight, forming 68.1% of the population, with a higher number of clinical visits and higher number of surgical procedures. In the Jordanian population, there is a clear relation between obesity and stone formation, where the majority of stone formers was obese.

  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. [Update for the management of kidney stones in 2013. Lithiasis Committee of the French Association of Urology].

    Science.gov (United States)

    Carpentier, X; Meria, P; Bensalah, K; Chabannes, E; Estrade, V; Denis, E; Yonneau, L; Mozer, P; Hadjadj, H; Hoznek, A; Traxer, O

    2014-04-01

    Since the publication of the latest recommendations of the Lithiasis Comity of the French Association of Urology (CLAFU) on the management of ureteral and renal stones, practices have evolved. This text provides an update for the treatment of kidney stones. It is especially the important advances in the field of laser-ureterorenoscopy that changed practices. Percutaneous nephrolithotomy has been enriched by technical modifications and extracorporeal shockwave lithotripsy confirmed its predominant place in the first line of treatment. For stones less than 20mm, extracorporeal lithotripsy remains the standard, but in some cases the possibility of recommending a flexible ureterorenoscopy is possible in first line. For stones more than 20mm, percutaneous nephrolithotomy is the standard treatment, but optional flexible ureteroscopy and extracorporeal lithotripsy are possible. The treatment carried out, collect the stone fragments for a morpho-constitutional analysis and achieve a metabolic evaluation is necessary, to investigate etiologic and give dietary advices to prevent recurrence.

  13. Calculating the number of shock waves, expulsion time, and optimum stone parameters based on noncontrast computerized tomography characteristics.

    Science.gov (United States)

    Foda, Khaled; Abdeldaeim, Hussein; Youssif, Mohamed; Assem, Akram

    2013-11-01

    To define the parameters that accompanied a successful extracorporeal shock wave lithotripsy (ESWL), namely the number of shock waves (SWs), expulsion time (ET), mean stone density (MSD), and the skin-to-stone distance (SSD). A total of 368 patients diagnosed with renal calculi using noncontrast computerized tomography had their MSD, diameter, and SSD recorded. All patients were treated using a Siemens lithotripter. ESWL success meant a stone-free status or presence of residual fragments 934 HUs and SSD >99 mm. The required number of SWs and the expected ET can be anticipated. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Laparoscopic cholecystectomy. Leave no (spilled) stone unturned.

    Science.gov (United States)

    Wilton, P B; Andy, O J; Peters, J J; Thomas, C F; Patel, V S; Scott-Conner, C E

    1993-01-01

    Stones are sometimes spilled at the time of cholecystectomy. Retrieval may be difficult, especially during laparoscopic cholecystectomy. Little is known about the natural history of missed stones which are left behind in the peritoneal cavity. We present a case in which a patient developed an intraabdominal abscess around such a stone. The abscess recurred after drainage and removal of the stone was needed for resolution. This case suggests that care should be taken to avoid stone spillage, and that stones which are spilled into the abdomen should be retrieved.

  15. [Unusual clinical presentations of tumours of the renal pelvis. Report of two cases ].

    Science.gov (United States)

    Fekak, Hamid; Rabii, Redouane; Moufid, Kamal; Joual, Abdenri; Dahami, Zakaria; el Mrini, Mohammed

    2002-06-01

    Chronic irritation induced by stones and urinary stasis can be responsible for squamous and sometimes glandular metaplasia of the urothelial epithelium with secondary carcinomatous transformation. The authors report two cases of tumour of the renal pelvis associated with stone pyonephrosis in one case and ureteropelvic junction syndrome in the other.

  16. Contemporary Management of Renal Transplant Recipients With De Novo Urolithiasis: A Single Institution Experience and Review of the Literature.

    Science.gov (United States)

    Harraz, Ahmed M; Zahran, Mohamed H; Kamal, Ahmed I; El-Hefnawy, Ahmed S; Osman, Yasser; Soliman, Shady A; Kamal, Mohamed M; Ali-El-Dein, Beder; Shokeir, Ahmed A

    2017-06-01

    We report on the long-term follow-up of managing allograft stones at a single tertiary referral institution and review the relevant literature. A retrospective analysis of renal allograft recipient charts was performed to identify patients who developed allograft lithiasis between 1974 and 2009. Patient and stone characteristics, diagnoses, treatments, and outcomes were described. Sixteen patients developed 22 stones after a median follow-up of 170 months (range, 51-351 mo). The mean (standard deviation) and median diameter of the stones were 13.8 (8.5) mm and 11 mm. Among these, 3 stones were treated conservatively, 3 by shock-wave lithotripsy, and 7 by cystolitholapaxy. Seven patients underwent percutaneous treatment in the form of percutaneous nephrostomy tube fixation and spontaneous passage of stone (1 stone), shock-wave lithotripsy (1 stone), antegrade stenting (1 stone), and percutaneous nephrolithotomy (6 stones). All patients were stone free after treatment, except for 2 patients whose stones were stable and peripheral on long-term follow-up. Allograft lithiasis requires a multimodal treatment tailored according to stone and graft characteristics. Protocols regarding spontaneous passage can be adopted if there is no harm to the graft and the patient is compliant. Careful attention to the anatomy during percutaneous nephrostomy tube placement is mandatory to avoid intestinal loop injury. A more attentive follow-up is required for early stone management.

  17. Effect ofHuayu-Niaoshidecoction on renal injury in the patients with kidney stones after extra corporeal lithotripsy%化瘀尿石汤对肾结石患者体外碎石术后肾损伤的影响

    Institute of Scientific and Technical Information of China (English)

    沈建武; 高瞻; 李奇; 曾凡雄; 邵魁卿; 李丁; 王桂云; 吕双喜; 张林

    2016-01-01

    ObjectiveTo investigate the effect ofHuayu-Niaoshidecoction on renal injury in the patients with kidney stones after extra corporeal lithotripsy (ESWL). MethodsAccording to the inclusion criteria, 120 patients diagnosed with kidney stones were randomly divided into 2 groups with the random number table method, 60 patients in each group. Both groups were treated with double pulse extracorporeal shock wave lithotripsy (ESWL). Based on the ESWL, the control group was added with levofloxacin mesylate tablets for 3 days with the start of the day of the gravel; and the treatment group was treated withHuayu-Niaoshi decoction for 14 days based on the treatment of control group. The levels of serum endothelial endothelin 1 (ET-1), malondialdehyde (MDA), urinary N-acetyl-β-Dglucosaminidase (NAG) N-acetyl-beta-d Glucosaminidase and urine beta 2 microspheres protein (beta eukaryotic 2-mg) were detected at time of gravel, 2 hours after gravel and 2 weeks after gravel. ResultsAfter 2 weeks treatment, the levels of urinary NAG (7.33 ± 4.39 U/L vs. 9.93 ± 5.10 U/L;Z=2.587,P=0.002), serum MDA (4.63 ± 0.90 nmol/mlvs. 7.29 ± 2.16 nmol/ml;Z=5.520, P=0.001), serum ET-1 (35.06 ± 10.51 pg/mlvs. 46.90 ± 18.74 pg/ml;Z=3.315,P=0.001) and urineβ2-MG (0.14 ± 0.19) mg/Lvs. 0.19 ± 0.19 mg/L;Z=1.759,P=0.079) in the treatment group were significantly lower than those in the control group. Conclusions TheHuayu-Niaoshidecoction can improve renal injury in the patients with kidney stones after extra corporeal lithotripsy.%目的:探讨化瘀尿石汤对肾结石患者体外碎石术后肾损伤的影响。方法将符合入选标准的120例肾结石患者按随机数字表法分为2组,每组60例。2组均采用复式脉冲体外冲击波碎石,对照组于碎石当日开始服用甲磺酸左氧氟沙星片,连续服用3 d;治疗组在对照组基础上加服化瘀尿石汤14 d。分别于碎石前、碎石当日,碎石后2周检测血清内皮素1(Endothelin-1, ET-1)、MDA

  18. Timelines of the “free-particle” and “fixed-particle” models of stone-formation: theoretical and experimental investigations

    NARCIS (Netherlands)

    Kok, D.J.; W.P.A. Boellaard; Y. Ridwan (Yanto); Levchenko, V.A.

    2017-01-01

    textabstractTwo major theories on renal stone formation will be reviewed, the “free-particle” and “fixed-particle” mechanisms. These theories combine data on intrinsic factors (inborn metabolic errors), extrinsic factors (diet), renal cell responses and the physico-chemistry and biochemistry of urin

  19. Melamine Impairs Renal and Vascular Function in Rats.

    Science.gov (United States)

    Tian, Xiao Yu; Wong, Wing Tak; Lau, Chi Wai; Wang, Yi-Xiang; Cheang, Wai San; Liu, Jian; Lu, Ye; Huang, Huihui; Xia, Yin; Chen, Zhen Yu; Mok, Chuen-Shing; Lau, Chau-Ming; Huang, Yu

    2016-06-21

    Melamine incident, linked to nephrotoxicity and kidney stone in infants previously exposed to melamine-contaminated milk products, was unprecedentedly grave in China in 2008 as little was known about the mechanistic process leading to renal dysfunction in affected children. This study investigates whether neonatal ingestion of melamine leads to renal and vascular dysfunction in adulthood; and whether ingestion of melamine in pregnant rats leads to renal dysfunction in their offspring. A combination of approaches employed includes functional studies in rat renal arteries, renal blood flow measurement by functional magnetic resonance imaging, assay for pro-inflammatory and fibrotic biomarkers, immunohistochemistry, and detection of plasma and renal melamine. We provide mechanistic evidence showing for the first time that melamine reduces renal blood flow and impairs renal and vascular function associated with overexpression of inflammatory markers, transforming growth factor-β1, bone morphogenic protein 4 and cyclooxygenase-2 in kidney and renal vasculature. Melamine also induces renal inflammation and fibrosis. More importantly, melamine causes nephropathies in offsprings from pregnant rat exposed to melamine during pregnancy, as well as in neonatal rat exposed to melamine afterbirth, thus supporting the clinical observations of kidney stone and acute renal failure in infants consuming melamine-contaminated milk products.

  20. [Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis: A Case Report].

    Science.gov (United States)

    Oida, Takeshi; Kanemitsu, Toshiyuki; Hayashi, Tetsuya; Fujimoto, Nobumasa; Koide, Takuo

    2016-02-01

    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0.17-1.8%, for which PNL and TUL are frequently used. Although considered to be accompanied with risks of bleeding, bowel injury, and renal dysfunction, PNL is effective for urinary lithiasis after renal transplantation. TUL is less invasive, but access may be difficult when the ureter has an unusual course or ureteral stricture exists, as in our patient.

  1. Ipsilateral synchronous renal pelvic transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    韩平; 魏强; 石明; 杨宇如

    2004-01-01

    @@ Reports of multiple synchronous primary renal neoplasms in the literature are rare. Although primary renal tumors of 2 distinctively dissimilar origins have been sporadically described,1-6 to our knowledge there have been no reported cases of triple primary renal neoplasms in the same kidney. Here we report a very rare case of ipsilateral synchronous renal pelvic transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma with marked hydronephrosis and multiple stones in the same kidney.

  2. Infrared Spectroscopy in the Study of Renal Lithiasis

    Science.gov (United States)

    Fernández-Almeida, Jesús; Fernández-Gacio, Ana; Marcos, Carlos F.; Fernández-Gacio, Maira

    2003-08-01

    Infrared spectroscopic analysis of urinary stones is presented as a laboratory experiment for undergraduate students studying life sciences. Infrared spectroscopy, usually combined with the observation of macroscopic and microscopic features, is the preferred tool for unequivocal determination of renal stones composition. In this paper we represent and discuss the IR spectra of some of the most common types of urinary calculi occurring in humans and domestic animals.

  3. 77 FR 27245 - Big Stone National Wildlife Refuge, Big Stone and Lac Qui Parle Counties, MN

    Science.gov (United States)

    2012-05-09

    ... Fish and Wildlife Service Big Stone National Wildlife Refuge, Big Stone and Lac Qui Parle Counties, MN... comprehensive conservation plan (CCP) and environmental assessment (EA) for Big Stone National Wildlife Refuge...: r3planning@fws.gov . Include ``Big Stone Draft CCP/ EA'' in the subject line of the message. Fax:...

  4. Stone size limits the use of Hounsfield units for prediction of calcium oxalate stone composition.

    Science.gov (United States)

    Stewart, Gregory; Johnson, Lewis; Ganesh, Halemane; Davenport, Daniel; Smelser, Woodson; Crispen, Paul; Venkatesh, Ramakrishna

    2015-02-01

    To evaluate the role of stone size in predicting urinary calculus composition using Hounsfield units on noncontrasted computed tomography (CT) scan. A retrospective review was performed for all patients who underwent ureteroscopy or percutaneous nephrolithotomy during a 1-year period, had a stone analysis performed, and had CT imaging available for review. All CT scans were reviewed by a board-certified radiologist. Variables evaluated included age, sex, body mass index, stone size, stone location, Hounsfield units (HUs), and stone composition. We identified a total of 91 patients (41 men and 50 women) with CT imaging and stone analysis available for review. Stone analysis showed 41 calcium oxalate monohydrate (CaOxMH), 13 calcium oxalate dihydrate, 29 calcium phosphate, 5 uric acid, 2 struvite, and 1 cystine stone. Average age was 46 years, and average body mass index was 32 kg/m2. Measured HUs varied significantly with size for CaOxMH and calcium oxalate dihydrate stones (P values 10 mm) stones (55%). For calcium stones, the ability of CT HUs to predict stone composition was limited, likely due to the mixed stone composition. Within a cohort of CaOxMH stone formers, measured HUs varied linearly with stone size. All stones <5 mm were below thresholds for CaOxMH composition. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. CASE REPORT OF AN UNUSUALLY LARGE RENAL CALCULUS

    Directory of Open Access Journals (Sweden)

    Samir

    2015-01-01

    Full Text Available Renal calculus is a solid or crystal aggregation formed in the kidneys from minerals in the u rine . Many calculi are formed and passed without causing symptoms. A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Renal calculi affect all geographical, racial and groups with a worldwide prevalence of bet ween 2 and 20%. Majority of the patients are usually between the 20 - 55 years of age. The highest incidence of kidney stone is in 30 - 45 years of age group and the incidence declines after the age of 50 years of age. Stones that obstruct the ureter or renal pelvis cause excruciating, intermittent pain.

  6. Ultrastructural Analysis of Urinary Stones by Microfocus Computed Tomography and Comparison with Chemical Analysis

    Directory of Open Access Journals (Sweden)

    Tolga Karakan

    2016-06-01

    Full Text Available Objective: To investigate the ultra-structure of urinary system stones using micro-focus computed tomography (MCT, which makes non-destructive analysis and to compare with wet chemical analysis. Methods: This study was carried out at the Ankara Train­ing and Research hospital. Renal stones, removed from 30 patients during percutaneous nephrolithotomy (PNL surgery, were included in the study. The stones were blindly evaluated by the specialists with MCT and chemi­cal analysis. Results: The comparison of the stone components be­tween chemical analysis and MCT, showed that the rate of consistence was very low (p0.05. It was also seen that there was no significant relation between its 3D structure being heterogeneous or homogenous. Conclusion: The stone analysis with MCT is a time con­suming and costly method. This method is useful to un­derstand the mechanisms of stone formation and an im­portant guide to develop the future treatment modalities.

  7. [Treatment of infection stones. I. Dissolution of experimental infection stones in rats].

    Science.gov (United States)

    Takeuchi, H; Tomoyoshi, T

    1983-03-01

    The in vivo solubility of struvite stones experimentally induced in rats was investigated. The struvite stones implanted into bladders of normal rats were reduced in weight; and, they were dissolved by oral administration of ammonium chloride. Cefmetazone cured pyelonephritis and dissolved the bladder stones when it was administered to rats with urinary tract infection caused by Proteus mirabilis. Normalization of urine by antibiotics and acidifying agents may dissolve struvite stones, and help treat infection stones.

  8. Stone Bracelet Production in Mali

    Directory of Open Access Journals (Sweden)

    Anne Garin Carmagnani

    2009-09-01

    Full Text Available In order to understand the manufacture of stone bangles in Neolithic France, we visited the Hombori region of Mali, to study the last surviving generation of makers of stone bangles there. From our field observations and from many interviews with various artisans, we obtained a considerable amount of information about a tradition of manufacture that has, until recently, been largely unknown. The details gathered cover every stage of the manufacturing process, from the way in which outcrops of the raw material are selected, to the manner in which the calcareous stone is worked in the manufacture of the bracelets. We documented the various phases involved in the chaîne opératoire and the ways in which the finished products are dispersed from their place of manufacture. Much still remains to be discovered, notably about the past history of bangle manufacture in Hombori, and the ways in which the finished bracelets were perceived by the people who acquired and used them. Nevertheless, we have been able to develop models that help us to understand the societies in post-Linearbandkeramik Europe that adopted the practice of wearing stone bracelets.

  9. Renal Osteodystrophy

    Directory of Open Access Journals (Sweden)

    Aynur Metin Terzibaşoğlu

    2004-12-01

    Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

  10. Stones used in Milan architecture

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    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.

  11. Spontaneous dissolution of a guaifenesin stone.

    Science.gov (United States)

    Nguyen, Thai T; Fallon, Bernard; Winfield, Howard N

    2005-08-01

    Guaifenesin is a commonly used expectorant whose use may lead to the occasional formation of guaifenesin urinary stones. We herein describe a patient who was taking 2400 mg Guaifenesin per day as part of his treatment for asthma. He had a past history of a guaifenesin stone removed ureteroscopically. His current presentation was with a 9 mm by 6 mm stone in the upper left ureter, seen on CT scan, and treated initially with a ureteral stent and hydration. After 3 weeks, the stone had disappeared, as confirmed by repeat CT scan. The genesis and treatment of guaifenesin stones is discussed.

  12. The White Stone Worship of Qiang People

    Institute of Scientific and Technical Information of China (English)

    陈卓

    2013-01-01

    The White Stone worship is an inseparable cultural part among Qiang People in the history and their daily lives. It has relationship with the God, with Qiang people’s fondness of the white color, with the fire-making, with the function of white stones as the tool and weapon for survival, and with the worship for Snow Mountain. The White Stone is the oblation in Qiang Families, the architecture—Blockhouse relating to the white stone is famous worldwide. The essay also discusses the links be⁃tween the white stone worship with Qiang people in the past and in the future

  13. The White Stone Worship of Qiang People

    Institute of Scientific and Technical Information of China (English)

    陈卓

    2013-01-01

    The White Stone worship is an inseparable cultural part among Qiang People in the history and their daily lives. It has relationship with the God, with Qiang people’ s fondness of the white color, with the fire-making, with the function of white stones as the tool and weapon for survival, and with the worship for Snow Mountain. The White Stone is the oblation in Qiang Families, the architecture—Blockhouse relating to the white stone is famous worldwide. The essay also discusses the links be⁃tween the white stone worship with Qiang people in the past and in the future.

  14. Forming a stone in pelviureteric junction obstruction: cause or effect?

    Science.gov (United States)

    Stasinou, Theodora; Bourdoumis, Andreas; Masood, Junaid

    2017-01-01

    ABSTRACT Objectives To investigate a possible causal relationship for stone formation in pelviureteric junction obstruction and to outline management options. Materials and Methods A literature search and evidence synthesis was conducted via electronic databases in the English language using the key words pelviureteric junction obstruction; urolithiasis; hyperoxaluria; laparoscopic pyeloplasty; flexible nephroscopy; percutaneous nephrolithotomy, alone or in combination. Relevant articles were analysed to extract conclusions. Results Concomitant pelviureteric junction obstruction (PUJO) and renal lithiasis has been reported only scarcely in the literature. Although PUJO has been extensively studied throughout the years, the presence of calculi in such a patient has not received equal attention and there is still doubt surrounding the pathophysiology and global management. Conclusions Metabolic risk factors appear to play an important role, enough to justify metabolic evaluation in these patients. Urinary stasis and infection are well known factors predisposing to lithiasis and contribute to some extent. The choice for treatment is not always straightforward. Management should be tailored according to degree of obstruction, renal function, patient symptoms and stone size. Simultaneous treatment is feasible with the aid of minimally invasive operative techniques and laparoscopy in particular.

  15. Differences in quantitative urine composition in stone-forming versus unaffected mate kidneys

    Directory of Open Access Journals (Sweden)

    Michael L Eisenberg

    2009-08-01

    Full Text Available Michael L Eisenberg1, Keith L Lee1, Benjamin N Breyer1, Thomas J Walsh2, Badrinath R Konety1, Marshall L Stoller11Department of Urology, University of California San Francisco, San Francisco, CA, USA; 2Department of Urology, University of Washington, Seattle, WA, USAObjectives: Many patients present with bilateral stones. There is a unique group of patients, however, that presents with stones exclusively on one side. We hypothesize that in such situations, 24-hour urine collections may not reveal specific defects on the affected stone-bearing kidney. We therefore evaluated selective 12-hour urine collections after percutaneous nephrolithotomy (PNL to help determine if there is differential renal excretion.Methods: We collected urine specimens from patients with nephrolithiasis who underwent unilateral PNL. Urine samples were collected and analyzed from nephrostomy tubes, representing the affected kidneys, and from Foley bladder catheters, representing the contralateral mate kidney.Results: Thirty-one patients were studied (14 with unilateral nephrolithiasis and 17 with bilateral. Treated kidneys from patients with unilateral nephrolithiasis displayed lowered urine excretion of uric acid, sodium, chloride, calcium, and total osmoles when compared to patients with bilateral nephrolithiasis. Stone size and length of procedure were not predictive of urine composition after PNL.Conclusions: Treated kidneys from patients with a history of unilateral stone disease revealed marked differences in urine excretion compared to those with bilateral nephrolithiasis after unilateral PNL. These findings could be secondary to the surgical insult, urinary stone disease, or could be a responsible factor for stone pathogenesis.Keywords: percutaneous nephrolithotomy, kidney, stone, nephrolithiasis

  16. [Common bile duct stones and their complications].

    Science.gov (United States)

    Millat, B; Borie, F

    2000-12-01

    At the time of cholecystectomy for symptomatic cholelithiasis, 7-20% of patients have common bile duct stones. Nearly one third of them are asymptomatic. Routine cholangiography during cholecystectomy allows the diagnosis and treatment of common bile duct stones during the same operation. Selective indication for the diagnosis of common bile duct stones based on the positive predictive value of indicators limits treatment to symptomatic cases. No single indicator is however completely accurate in predicting common bile duct stones and the natural history of asymptomatic cases is uncertain. Endoscopic stone extraction preceding cholecystectomy is not superior to one-stage surgical treatment. Diagnosis and treatment of common bile duct stones are feasible laparoscopically. Complications of common bile duct stones are cholangitis and acute pancreatitis; if severe, they require specific therapeutic approaches.

  17. Treatment of Kidney Stones Using Extracorporeal Shock Wave Lithotripsy (ESWL and Double-J Stent in Infants

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    Mehdi Younesi Rostami

    2012-01-01

    Full Text Available Background. Extracorporeal shock wave lithotripsy (ESWL has progressively acquired popularity as being the gold standard treatment for upper urinary tract lithiasis in infants since 1980. Our aim was to evaluate the outcome of ESWL for kidney stones and the use of double-J stent in infants. Material and Methods. A prospective clinical trial study performed on 50 infants with renal calculi at pelvic admitted in the Urology ward of Shafa Hospital, Sari, Iran, between 2001 and 2010. Main outcome measure of our study was clearing stones after one or more consecutive sessions of ESWL. Results. The study included 50 patients with renal calculi at pelvic. Among them, there were 35 (70% boys and 15 (30% girls with the age ranging from 1 to 13 months (mean of 7 month ± 3 days. All of them were treated by standard ESWL using Simons Lithostor plus machine. The stone sizes ranged from 6 mm to 22 mm. Double-J stents were placed in 11 infants (22% with stones larger than 13 mm. Most of the patients required only one ESWL session. Conclusion. Since there were no complications following ESWL treatment, we can conclude that, in short term, ESWL is an effective and safe treatment modality for renal lithiasis in infants. In addition, we recommend double-J stent in infants with stones larger than 13 mm.

  18. Does previous open renal surgery or percutaneous nephrolithotomy affect the outcomes and complications of percutaneous nephrolithotomy.

    Science.gov (United States)

    Ozgor, Faruk; Kucuktopcu, Onur; Sarılar, Omer; Toptas, Mehmet; Simsek, Abdulmuttalip; Gurbuz, Zafer Gokhan; Akbulut, Mehmet Fatih; Muslumanoglu, Ahmet Yaser; Binbay, Murat

    2015-11-01

    In this study, we aim to evaluate the effectiveness and safety of PNL in patients with a history of open renal surgery or PNL by comparing with primary patients and to compare impact of previous open renal surgery and PNL on the success and complications of subsequent PNL. Charts of patients, who underwent PNL at our institute, were analyzed retrospectively. Patients were divided into three groups according to history of renal stone surgery. Patients without history of renal surgery were enrolled into Group 1. Other patients with previous PNL and previous open surgery were categorized as Group 2 and Group 3. Preoperative characteristic, perioperative data, stone-free status, and complication rates were compared between the groups. Stone-free status was accepted as completing clearance of stone and residual fragment smaller than 4 mm. Eventually, 2070 patients were enrolled into the study. Open renal surgery and PNL had been done in 410 (Group 2) and 131 (Group 3) patients, retrospectively. The mean operation time was longer (71.3 ± 33.5 min) in Group 2 and the mean fluoroscopy time was longer (8.6 ± 5.0) in Group 3 but there was no statistically significant difference between the groups. Highest stone clearance was achieved in primary PNL patients (81.62%) compared to the other groups (77.10% in Group 2 and 75.61% in Group 3). Stone-free rate was not significantly different between Group 2 and Group 3. Fever, pulmonary complications, and blood transfusion requirement were not statically different between groups but angioembolization was significantly higher in Group 2. Percutaneous nephrolithotomy is a safe and effective treatment modality for patients with renal stones regardless history of previous PNL or open renal surgery. However, history of open renal surgery but not PNL significantly reduced PNL success.

  19. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  20. Nephrolithiasis-induced end stage renal disease

    Directory of Open Access Journals (Sweden)

    M Ounissi

    2010-03-01

    Full Text Available M Ounissi¹, T Gargueh², M Mahfoudhi¹, K Boubaker¹, H Hedri¹, R Goucha¹, E Abderrahim¹, F Ben Hamida¹, T Ben Abdallah¹, F El Younsi¹, H Ben Maiz³, A Kheder¹1Internal Medicine Department, 2Pediatric Department, 3Laboratory of Kidney Diseases, Charles Nicolle Hospital, Tunis, TunisiaIntroduction: Nephrolithiasis still remains a too frequent and underappreciated cause of end stage renal disease (ESRD.Methods and patients: Of the entire cohort of 7128 consecutive patients who started maintenance dialysis in our nephrology department between January 1992 and December 2006, a total of 45 patients (26 women, 19 men had renal stone disease as the cause of ESRD. The type of nephrolithiasis was determined in 45 cases and etiology in 42. The treatment and evolution of stone disease and patient’s survival were studied.Results: The overall proportion of nephrolithiasis related ESRD was 0.63%. The mean age was 48.4 years. Infection stones (struvite accounted for 40%, calcium stones, 26.67% (primary hyperparathyroidism:15.56%; familial hypercalciuria: 4.44%, unknown etiology: 6.66%, primary hyperoxaluria type 1, 17.78% and uric acid lithiasis in 15.56% of cases. The mean delay of the evolution of the stone renal disease to chronic renal failure was 85.8 months. The feminine gender, obesity and elevated alkaline phosphatases >128 IU/L were significantly correlated with fast evolution of ESRD. The median evolution to ESRD was 12 months. The normal body mass index (BMI, medical treatment of stone and primary hyperoxaluria type 1 were correlated with fast evolution to ESRD. All patients were treated by hemodialysis during a mean evolution of 60 months. Sixteen patients died. The patient's survival rate at 1, 3 and 5 years was 97.6, 92.8 and 69% respectively. Hypocalcemia, cardiopathy and normal calcium-phosphate product were significantly correlated with lower survival rate.Conclusion: Severe forms of nephrolithiasis remain an underestimated cause of

  1. Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi

    Directory of Open Access Journals (Sweden)

    Jie Ding

    2015-08-01

    Full Text Available ABSTRACTPurpose:To evaluate the clinical efficacy of flexible ureteroscope (F-URS combined with holmium laser lithotripter in treating renal calculi in horseshoe kidney.Materials and Methods:From November 2010 to December 2013, the medical history and charts of sixteen patients (mean age 42.9±11.6 years, range 26-66 years, including 13 males and 3 females were analyzed retrospectively. Mean stone burden was 29±8 mm (range 17-42 mm2. Mean stone digitized surface area (DSA was 321±94 mm2 (range 180-538 mm2. Under spinal anesthesia in a modified lithotomy position with the head down, rigid ureteroscope was placed firstly into the ureter to reach the level of the pelvis, a zebra guide wire was inserted and following the removal of the rigid ureteroscope, an ureteral access sheath was positioned along the guide wire, then passed the URF P-5 flexible ureteroscope into the renal cavities over the guidewire. After locating the stones, holmium laser lithotripsy was performed.Results:The average operative time was 92±16 minutes (range 74-127 min.. No major complications were encountered. Ten patients obtained stone-free status with one session, four obtained stone-free status after two sessions. Single session stone-free rate was 62.5%, overall stone-free rate was 87.5%. Two patients have small residual stones in the lower pole.Conclusions:F-URS combined with holmium laser lithotripter and nitinol basket, is safe and effective in dealing with moderate stone diameter (<30 mm in HSKs with high clearance rates and low complication rates.

  2. Biochemical and dietary factors of uric acid stone formation.

    Science.gov (United States)

    Trinchieri, Alberto; Montanari, Emanuele

    2017-02-28

    The aim of this study was to compare the clinical characteristics of "pure" uric acid renal stone formers (UA-RSFs) with that of mixed uric acid/calcium oxalate stone formers (UC-RSFs) and to identify which urinary and dietary risk factors predispose to their formation. A total of 136 UA-RSFs and 115 UC-RSFs were extracted from our database of renal stone formers. A control group of 60 subjects without history of renal stones was considered for comparison. Data from serum chemistries, 24-h urine collections and 24-h dietary recalls were considered. UA-RSFs had a significantly (p = 0.001) higher body mass index (26.3 ± 3.6 kg/m(2)) than UC-RSFs, whereas body mass index of UA-RSFs was higher but not significantly than in controls (24.6 ± 4.7) (p = 0.108). The mean urinary pH was significantly lower in UA-RSFs (5.57 ± 0.58) and UC-RSFs (5.71 ± 0.56) compared with controls (5.83 ± 0.29) (p = 0.007). No difference of daily urinary uric acid excretion was observed in the three groups (p = 0.902). Daily urinary calcium excretion was significantly (p = 0.018) higher in UC-RSFs (224 ± 149 mg/day) than UA-RSFs (179 ± 115) whereas no significant difference was observed with controls (181 ± 89). UA-RSFs tend to have a lower uric acid fractional excretion (0.083 ± 0.045% vs 0.107+/-0.165; p = 0.120) and had significantly higher serum uric acid (5.33 ± 1.66 vs 4.78 ± 1.44 mg/dl; p = 0.007) than UC-RSFs. The mean energy, carbohydrate and vitamin C intakes were higher in UA-SFs (1987 ± 683 kcal, 272 ± 91 g, 112 ± 72 mg) and UC-SFs (1836 ± 74 kcal, 265 ± 117, 140 ± 118) with respect to controls (1474 ± 601, 188 ± 84, 76 ± 53) (p = 0.000). UA-RSFs should be differentiated from UC-RSFs as they present lower urinary pH, lower uric acid fractional excretion and higher serum uric acid. On the contrary, patients with UC-RSFs show urinary risk factors

  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 (P<.001). Recurrence was similar across different proportions of calcium oxalate and hydroxyapatite (P-trend=.10). However, among calcium oxalate stones, 10-year recurrence rate ranged from 38% for 100% calcium oxalate dihydrate to 26% for 100% calcium oxalate monohydrate (P-trend=.007). Conclusion Calcium stones are more common (94% of stone formers) than has been previously reported. While clinical and laboratory factors associate with the stone composition, they are of limited utility for estimating stone composition. Rarer stone compositions are more likely to recur. PMID:26349951

  4. Guaifenesin stone matrix proteomics: a protocol for identifying proteins critical to stone formation.

    Science.gov (United States)

    Kolbach-Mandel, A M; Mandel, N S; Cohen, S R; Kleinman, J G; Ahmed, F; Mandel, I C; Wesson, J A

    2017-04-01

    Drug-related kidney stones are a diagnostic problem, since they contain a large matrix (protein) fraction and are frequently incorrectly identified as matrix stones. A urine proteomics study patient produced a guaifenesin stone during her participation, allowing us to both correctly diagnose her disease and identify proteins critical to this drug stone-forming process. The patient provided three random midday urine samples for proteomics studies; one of which contained stone-like sediment with two distinct fractions. These solids were characterized with optical microscopy and Fourier transform infrared spectroscopy. Immunoblotting and quantitative mass spectrometry were used to quantitatively identify the proteins in urine and stone matrix. Infrared spectroscopy showed that the sediment was 60 % protein and 40 % guaifenesin and its metabolite guaiacol. Of the 156 distinct proteins identified in the proteomic studies, 49 were identified in the two stone-components with approximately 50 % of those proteins also found in this patient's urine. Many proteins observed in this drug-related stone have also been reported in proteomic matrix studies of uric acid and calcium containing stones. More importantly, nine proteins were highly enriched and highly abundant in the stone matrix and 8 were reciprocally depleted in urine, suggesting a critical role for these proteins in guaifenesin stone formation. Accurate stone analysis is critical to proper diagnosis and treatment of kidney stones. Many matrix proteins were common to all stone types, but likely not related to disease mechanism. This protocol defined a small set of proteins that were likely critical to guaifenesin stone formation based on their high enrichment and high abundance in stone matrix, and it should be applied to all stone types.

  5. Smad signaling pathway in pathogenesis of kidney injury induced by calcium oxalate stone in rats

    Institute of Scientific and Technical Information of China (English)

    Fan Zhang

    2016-01-01

    Objective:To investigate the involvement of Smad signaling pathway in the pathogenesis of kidney injury induced by calcium oxalate stone in rats to provide a reference for clinical treatment.Methods: Clean SD rats were randomly divided into 3 group, namely the control group, model group and pirfenidone group. Ethylene glycol + αhydroxy vitamin D3 was used as a stone-inducing agent to replicate the renal calcium oxalate stone model. Rats in the pirfenidone group were treated with pirfenidone intragastric administration. The serum Cr, BUN and 24-hour oxalate and calcium in renal tissues were assayed. The expressions of Bax/Bcl2 protein, Caspase3 protein, TGFβ, Smad1, Smad2 and Smad3 proteins were detected by the fluorescent quantitation PCR method.Results:Compared with the rats of the control group, the results showed that the levels of serum BUN, Cr and 24-hour oxalate in rats of the model group were increased greatly,BaxandCaspase3 mRNA also increased while the level ofBcl2 decreased significantly, and the expressions of TGFβ, Smad1, Smad2 and Smad3 proteins increased distinctly as well (P<0.01). These abnormal parameters could be normalized effectively by pirfenidone.Conclusions:Activated TGFβ/Smad signaling pathway is involved in the pathogenesis of kidney injury induced by calcium oxalate stone in rats.

  6. Investigations of stone consolidants by neutron imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hameed, F. [Atomic Institute of the Austrian Universities, Vienna University of Technology, Vienna (Austria)], E-mail: hameed@ati.ac.at; Schillinger, B. [Technische Universitaet Muenchen, FRM II and Physics Department E21, Garching (Germany); Rohatsch, A. [Institute for Engineering Geology, Vienna University of Technology, Vienna (Austria); Zawisky, M.; Rauch, H. [Atomic Institute of the Austrian Universities, Vienna University of Technology, Vienna (Austria)

    2009-06-21

    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.

  7. 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...

  8. 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.

  9. The Fifth National Day of Viewing Stone will Opening Soon

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    In order to carry forward the culture of the viewing stone and spread the ideas of viewing stone appreciation as well as promote the cultural undertakings and industry of viewing stone towards the healthy development trend,Viewing Stone Association of China pioneered and established the National Day of Viewing Stone.With the background of national cultural development strategies,the

  10. Study on the Elasticity-Plasticity-Stickiness of the Railway Crushed Stone Ballast

    Institute of Scientific and Technical Information of China (English)

    Gao Liang

    2004-01-01

    This paper is mainly aimed at the mechanics characteristic elas of ticity-plasticitystickiness existed in the CWR (continuously welded rails) track plane of the railway crushed stone ballast. As an important mechanics parameter of the CWR track plane, the ballast resistance is mainly influenced by this mechanics characteristic. Through the systematic experimental research and the theoretical analysis, this mechanics characteristic of the ballast resistance is revealed and a reasonable theoretical model is built for it. This study set a sound foundation for further studying the CWR track deformation property. It will be beneficial to the development of high-speed railway in China.

  11. CT diagnosis of gall stone ileus

    Energy Technology Data Exchange (ETDEWEB)

    Leen, G.L.S.; Finlay, M. (Royal Victoria Infirmary, Newcastle upon Tyne (UK). Dept. of Radiology Newcastle General Hospital, Newcastle upon Tyne (UK). Dept. of Radiology)

    1990-09-01

    We report a case of gall stone ileus in which only small bowel obstruction was seen on the conventional abdominal film and the diagnosis was made by computed tomography (CT). With the availability of CT and its increasing use in the investigation of the acute abdomen, CT examination will occasionally be performed on gall stone ileus patients. Awareness of the CT findings in gall stone ileus will result in early diagnosis leading to a reduction in the mortality rate. (orig.).

  12. Rare calcium oxalate monohydrate calculus attached to the wall of the renal pelvis.

    Science.gov (United States)

    Grases, Felix; Costa-Bauza, Antonia; Prieto, Rafael M; Saus, Carlos; Servera, Antonio; García-Miralles, Reyes; Benejam, Joan

    2011-04-01

    Most renal calculi can be classified using well-established criteria in a manner that reflects both composition and fine structure under specific pathophysiological conditions. However, when a large patient population is considered, rare renal calculi invariably appear, some of which have never been classified; careful study is required to establish stone etiology in such cases. The patient in the present case report formed two types of calculi. One was attached on the wall of the renal pelvis near the ureter and part of the calculus was embedded inside pelvic renal tissue. The calculus developed on an ossified calcification located in the pelvis tissue. Current knowledge on the development of calcification in soft tissues suggests a pre-existing injury as an inducer of its development. A mechanism of calculus formation is proposed. The second stone was a typical jack-stone calculus.

  13. STONE 6: Artificial Sedimentary Meteorites in Space

    Science.gov (United States)

    Westall, F.; Demets, R.; Brandstetter, F.; Edwards, H. G. M.; Cockell, C. S.; Parnell, J.; Pillinger, J.; Sancisi-Frey, S.; Franchi, I. A.; Kurat, G.; Brack, A.

    2008-03-01

    The STONE 6 experiment demonstrated the survivability of carbonaceous and microfossiliferous martian analogue sediments during atmospheric re-entry. Doped endoliths died but their carbonised cells remained.

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

    DEFF Research Database (Denmark)

    Andersen, J T; Mogensen, P

    1991-01-01

    The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments...... were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29...

  15. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2012-01-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  16. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    lesion. Three cases of renal angiomyolipoma, 2 of which underwent perfusion-fixation, were studied by electron microscopy to clarify the cellular composition of this lesion. In the smooth muscle cells abundant accumulation of glycogen was found, whereas the lipocytes disclosed normal ultrastructural......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  17. Laparoscopy assisted percutaneous stone surgery can be performed in multiple ways for pelvic ectopic kidneys.

    Science.gov (United States)

    Soylemez, Haluk; Penbegül, Necmettin; Utangac, Mehmet Mazhar; Dede, Onur; Çakmakçı, Süleyman; Hatipoglu, Namık Kemal

    2016-08-01

    Pelvic kidney stones remain a unique challenge to the endourologists. Treatment options include open surgery, extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy (PNL), retrograde intrarenal surgery, and laparoscopy assisted PNL (LA-PNL). As a minimal invasive option, LA-PNL can decrease the risk for bowel and major vessel injury. Here, we describe our experience using the LA-PNL procedures with different combinations, to treat kidney stones in multiple patients with a pelvic ectopic kidney (PEK). Eight patients, with PEK, kidney stones, and no other treatment choice, but open surgery, were included in the study. Two different laparoscopic techniques such as mesocolon dissection and transmesocolic, and four different percutaneous procedures such as standard-PNL, mini-PNL, micro-PNL, and a PNL through the renal pelvis were used for stone extraction in these patients. The mean age of patients was 25.6 ± 12.9 years and mean stone size was 524.1 ± 430.3 mm(2). Mean operation time was 150.5 ± 40.0 (77-210) min which was composed of retrograde catheterization (14.8 ± 2.9 min), laparoscopic procedure (48.7 ± 20.6 min) and PNL procedure (86.8 ± 31.1 min). Residual stones were seen in two patients (no additional treatment was need), while a 'stone-free' procedure was achieved in six patients (75.0 %). On the post-operative first month visit, a stone was observed on radiological examinations in only one patient (87.5 % stone-free). Mean hospitalization time was 2.8 ± 0.9 days. No perioperative or post-operative complication was observed in all patients. LA-PNL surgery is a safe and effective option for treatment of PEK stones, and has several alternative approaches.

  18. Brushite Stone Disease as a Consequence of Lithotripsy?

    OpenAIRE

    2010-01-01

    The incidence of calcium phosphate (CaP) stone disease has increased over the last three decades; specifically, brushite stones are diagnosed and treated more frequently than in previous years. Brushite is a unique form of CaP, which in certain patients can form into large symptomatic stones. Treatment of brushite stones can be difficult since the stones are resistant to shock wave and ultrasonic lithotripsy, and often require ballistic fragmentation. Patients suffering from brushite stone di...

  19. Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study.

    Science.gov (United States)

    Khadgi, Sanjay; Shrestha, Babu; Ibrahim, Hamdy; Shrestha, Sunil; ElSheemy, Mohammed S; Al-Kandari, Ahmed M

    2016-10-04

    To evaluate safety and efficacy of minipercutaneous nephrolithotomy (Mini-PNL) in management of stones in different types of renal anomalies. Patients with stones ≥2 cm or SWL-resistant stones in anomalous-kidneys treated by Mini-PNL between March 2010 and September 2012 were included prospectively. Mini-PNL was done under regional anesthesia in prone position with fluoroscopic guidance through 18 Fr sheath using semirigid ureteroscope (8.5/11.5 Fr) and pneumatic lithotripter. All patients were followed-up for 2-3 years. Stone-free rate was defined as absence of residual fragments ≥2 mm. Student-T, Mann-Whitney, Chi square (χ (2)), Fisher-exact, one way ANOVA or Kruskal-Wallis test were used for analysis. Mini-PNL was performed for 59 patients (20 horseshoe, 15 malrotated, 7 polycystic, 13 duplex and 4 ectopic pelvic-kidneys). Mean age was 40.18 ± 12.75 (14-78) years. Mean stone burden was 31.72 ± 21.43 (7.85-141.3) mm(2). Two tracts were required in 7 (11.9 %) patients. Tubeless Mini-PNL with double-J insertion was performed in all patients except two. Operative time was 50.17 ± 18.73 (15-105) min. Hemoglobin loss was 0.44 ± 0.30 (0-1.4) g/dL. Complications were reported in 15 (25.4 %) patients. No pleural injury, sepsis, perinephric-collection or renal-pelvis perforation were reported. Stone-free rate was 89.8 % (converted to open-surgery in one patient, second-look PNL in two patients, auxiliary SWL in three patients). Stone-free rate improved to 98.3 % after retreatment and auxiliary SWL. Site of puncture was mostly upper calyceal in horseshoe-kidney (80 %), mid calyceal in polycystic-kidney (85.7 %) and lower calyceal in duplex-kidney (46.2 %). Punctures were also significantly infracostal in horseshoe-kidney (100 %) and supracostal in both duplex (53.8 %) and malrotated-kidneys (66.7 %). Mini-PNL is safe for management of stones in anomalous-kidney with SFR comparable to standard-PNL but with less complications.

  20. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowle

  1. Renal fallure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  2. Renal cancer.

    NARCIS (Netherlands)

    Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  3. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  4. Mourning in Bits and Stone

    DEFF Research Database (Denmark)

    Sabra, Jakob Borrits

    We mourn our dead, publicly and privately, online and offline. Cemeteries, web memorials and social network sites make up parts of todays intricately weaved and interrelated network of death, grief and memorialization practices [1]–[5]. Whether cut in stone or made of bits, graves, cemeteries, me...... and memorialization by discussing the publicly and privately digital and social death from a spatial, temporal, physical and digital angle. Further the paper will reflect on how to encompass shifting trends and technologies in ‘traditional’ spaces of mourning and remembrance.......We mourn our dead, publicly and privately, online and offline. Cemeteries, web memorials and social network sites make up parts of todays intricately weaved and interrelated network of death, grief and memorialization practices [1]–[5]. Whether cut in stone or made of bits, graves, cemeteries......, memorials, monuments, websites and social networking services (SNS) all are alterable, controllable and adaptive. They represent a certain rationale contrary to the emotive state of mourning (e.g. gravesites function as both spaces of internment and places of spiritual and emotional recollection). Following...

  5. Elemental Content of Calcium Oxalate Stones from a Canine Model of Urinary Stone Disease.

    Directory of Open Access Journals (Sweden)

    David W Killilea

    Full Text Available One of the most common types of urinary stones formed in humans and some other mammals is composed of calcium oxalate in ordered hydrated crystals. Many studies have reported a range of metals other than calcium in human stones, but few have looked at stones from animal models such as the dog. Therefore, we determined the elemental profile of canine calcium oxalate urinary stones and compared it to reported values from human stones. The content of 19 elements spanning 7-orders of magnitude was quantified in calcium oxalate stones from 53 dogs. The elemental profile of the canine stones was highly overlapping with human stones, indicating similar inorganic composition. Correlation and cluster analysis was then performed on the elemental profile from canine stones to evaluate associations between the elements and test for potential subgrouping based on elemental content. No correlations were observed with the most abundant metal calcium. However, magnesium and sulfur content correlated with the mineral hydration form, while phosphorous and zinc content correlated with the neuter status of the dog. Inter-elemental correlation analysis indicated strong associations between barium, phosphorous, and zinc content. Additionally, cluster analysis revealed subgroups within the stones that were also based primarily on barium, phosphorous, and zinc. These data support the use of the dog as a model to study the effects of trace metal homeostasis in urinary stone disease.

  6. Guaifenesin- and ephedrine-induced stones.

    Science.gov (United States)

    Assimos, D G; Langenstroer, P; Leinbach, R F; Mandel, N S; Stern, J M; Holmes, R P

    1999-11-01

    We report a new type of drug-induced stone that is caused by overconsumption of preparations containing guaifenesin and ephedrine. Clinical and stone analysis data from the Molecular Structure Laboratory at the Veterans Affairs Medical Center in Milwaukee, Wisconsin, were reviewed. Stone analysis was performed by Fourier transform infrared spectroscopy, high-resolution X-ray crystallographic powder diffraction, or both. The urine and stone material from one of the subjects were analyzed with high-performance liquid chromatography. Stone analysis from seven patients demonstrated metabolites of guaifenesin. High-performance liquid chromatography revealed that the stone and urine from one subject had a high content of guaifenesin metabolites and a small amount of ephedrine. Demographic data were available on five patients. Three had a history of alcohol or drug dependency. All were consuming over-the-counter preparations containing ephedrine and guaifenesin. Four admitted to taking excessive quantities of these agents, mainly as a stimulant. Hypocitraturia was identified in two individuals subjected to urinary metabolic testing. These stones are radiolucent on standard X-ray imaging but can be demonstrated on unenhanced CT. Shockwave lithotripsy was performed in two patients, and the calculi fragmented easily. Individuals consuming large quantities of preparations containing ephedrine and guaifenesin may be at risk to develop stones derived mainly from metabolites of guaifenesin and small quantities of ephedrine. These patients may be prone to drug or alcohol dependency.

  7. Ventricular candidiasis in stone curlews (Burhinus oedicnemus).

    Science.gov (United States)

    Caliendo, Valentina; Bull, Andrew

    2011-09-01

    Ventricular candidiasis is consistently one of the most prominent pathologic conditions diagnosed in stone curlews (Burhinus oedicnemus) in the United Arab Emirates, predominately affecting the captive population. Predisposing factors are a humid environment, stress, immunosuppression, inadequate nutrition, and an extended use of oral antibiotics. In this report, we describe the clinical signs, diagnosis, and pathologic result in stone curlews with ventricular candidiasis.

  8. Stone Formation in the Infected Pediatric Enterocystoplasty

    NARCIS (Netherlands)

    R.B. Mathoera (Rejiv)

    2003-01-01

    markdownabstract__Abstract__ Proteus mirabilis is one of the most frequent bacterial agents that can induce infection stone formation by urease production. In recent years the influence of Proteus mirabilis on stone formation in enterocystoplasties has been primarily related to the presence of

  9. Gallstone Ileus following Endoscopic Stone Extraction

    Directory of Open Access Journals (Sweden)

    Yoshiya Yamauchi

    2014-01-01

    Full Text Available An 85-year-old woman was an outpatient treated at Tokyo Rosai Hospital for cirrhosis caused by hepatitis B. She had previously been diagnosed as having common bile duct stones, for which she underwent endoscopic retrograde cholangiopancreatography (ERCP. However, as stone removal was unsuccessful, a plastic stent was placed after endoscopic sphincterotomy. In October 2012, the stent was replaced endoscopically because she developed cholangitis due to stent occlusion. Seven days later, we performed ERCP to treat recurring cholangitis. During the procedure, the stone was successfully removed by a balloon catheter when cleaning the common bile duct. The next day, the patient developed abdominal pain, abdominal distension, and nausea and was diagnosed as having gallstone ileus based on abdominal computed tomography (CT and abdominal ultrasonography findings of an incarcerated stone in the terminal ileum. Although colonoscopy was performed after inserting an ileus tube, no stone was visible. Subsequent CT imaging verified the disappearance of the incarcerated stone from the ileum, suggesting that the stone had been evacuated naturally via the transanal route. Although it is extremely rare for gallstone ileus to develop as a complication of ERCP, physicians should be aware of gallstone ileus and follow patients carefully, especially after removing huge stones.

  10. Stability of Reshaping Breakwaters with Special Reference to Stone Durability

    DEFF Research Database (Denmark)

    Frigaard, Peter; Hald, Tue; Burcharth, H. F.;

    1996-01-01

    to the stone motion a description of the overall wave climate during the structural lifetime must be derived involving knowledge of transport rates, movement patterns, stone velocities and stone quality. The main objective of the paper is to describe a tool enabling calculation of the anticipated armour stone...... inherently cause some breakage and abrasion of the individual stones and thereby also reduced stability. In order to avoid excessive abrasion a high stone quality is demanded or larger stones must be applied when constructed. To allow the designer to account for abrasion and armour stone breakage due...

  11. Kidney stone risk following modern bariatric surgery.

    Science.gov (United States)

    Gonzalez, Ricardo D; Canales, Benjamin K

    2014-05-01

    Over the past 10 years, a variety of reports have linked bariatric surgery to metabolic changes that alter kidney stone risk. Most of these studies were retrospective, lacked appropriate controls, or involved bariatric patients with a variety of inclusion criteria. Despite these limitations, recent clinical and experimental research has contributed to our understanding of the pathophysiology of stone disease in this high-risk population. This review summarizes the urinary chemistry profiles that may be responsible for the increased kidney stone incidence seen in contemporary epidemiological bariatric studies, outlines the mechanisms of hyperoxaluria and potential therapies through a newly described experimental bariatric animal model, and provides a focused appraisal of recommendations for reducing stone risk in bariatric stone formers.

  12. Urolithiasis in renal transplantation: Diagnosis and management

    Directory of Open Access Journals (Sweden)

    Elisa Cicerello

    2014-12-01

    Full Text Available Obiectives: To report our experience of diagnosis and multimodal management of urolithiasis in renal transplantation. Patients and Methods: From January 1995 to December 2012, 953 patients underwent renal transplantation in the Kidney Transplant Unit of Treviso General Hospital. Ten (10% of them developed urinary calculi and were referred at our institution. Their mode of presentation, investigation and treatment were recorded. Results: Seven had renal and 3 ureteral calculi. Urolithiasis was incidentally discovered on routine ultrasound in 6 patients, 1 presented with oliguria, 1 with anuria and acute renal failure and in 2 urolithiasis was found at removal of the ureteral stent. Nephrostomy tube was placed in 5 patients. Hypercalcemia with hyperparathyroidism (HPT was present in 5 patients and hyperuricemia in 3. Two patients were primary treated by shock wave lithotripsy (SWL and one of them was stone-free after two sessions. Two patients, one with multiple pielocaliceal calculi and the other with staghorn calculus in the lower calyx, were treated with percutaneous nephrolitothotomy (PCNL. Three patients were treated by ureteroscopy (URS and in one of them two treatments were carried out. One patient had calculus impacted in the uretero-vesical anastomosis and surgical ureterolithotomy with re-do ureterocystoneostomy was performed after failure of URS. Two patients with calculi discovered at removal of the ureteral stent were treated by URS. Conclusions: The incidence of urolithiasis in renal transplantation is uncommon. In the most of patients the condition occurs without pain. Metabolic anomalies and medical treatment after renal transplantation may cause stone formation. Advancements in endourology and interventional radiology have influenced the management of urolithiasis that can be actually treated with a minimal incidence of risk for the renal allograft.

  13. Long-term incidence and risk factors for recurrent stones following percutaneous nephrostolithotomy or percutaneous nephrostolithotomy/extracorporeal shock wave lithotripsy for infection related calculi.

    Science.gov (United States)

    Streem, S B

    1995-03-01

    A study was done to determine the long-term incidence and cause of recurrent stones following percutaneous nephrostolithotomy alone (13 patients) or combined with extracorporeal shock wave lithotripsy (31) for management of documented infection related struvite renal calculi. The patients were followed for 12 to 111 months (mean 41.7) to censorship or time of new stone formation. Of these patients 12 (27%) had recurrent stones at 12 to 61 months (mean 32.3) after treatment. As determined by a Kaplan-Meier estimate, the risk of new stone formation 5 years after treatment was 36.8%. Potential risk factors for recurrence, including history of stones, associated anatomical abnormalities, procedure used, radiographic status at completion of treatment and recurrent infection during followup, were analyzed with Cox's proportional hazards model. Of these potential risk factors, only an associated anatomical abnormality was found to influence significantly the rate of recurrent stone formation (p = 0.005). We conclude that continued surveillance for recurrent stones is mandatory even for patients initially rendered stone-free and those who maintain sterile urine. In addition, because the presence of a significant anatomical or functional urinary tract abnormality places a patient at much higher risk for recurrence, we suggest that subsequent studies be stratified as to the presence or absence of these abnormalities.

  14. Gallstone ileus with a giant stone and associated multiple stones.

    Science.gov (United States)

    Ozbalci, G S; Tanrikulu, Y; Kismet, K; Dinc, S; Akkus, M A

    2012-01-01

    Gallstone ileus is an uncommon cause of small bowel obstruction. Gallstone ileus accounts for only about 1-3 % of cases of mechanical obstructions of the small bowel. It usually occurs in the elderly with a female predominance and may result in high mortality rates. The diagnosis is difficult and early diagnosis reduces the mortality. Terminal ileum is the most common site of gallstone impaction. We report a case of gallstone ileus in an 81-year-old female patient who was admitted to our clinic for abdominal pain, vomiting and constipation. The ultrasonography of abdomen revealed a decrease in bowel motion, and dilated bowel segments. Intraoperatively, a giant gallstone and associated multiple stones were found in the ileum 80 cm from the ileocecal valve and extracted from a longitudinal enterotomy (Fig. 4, Ref. 24).

  15. Renal teratogens.

    Science.gov (United States)

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O

    2014-09-01

    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures.

  16. In bits, bytes and stone

    DEFF Research Database (Denmark)

    Sabra, Jakob Borrits; Andersen, Hans Jørgen

    The digital spheres of Information and Communication Technologies (ICT) and Social Network Services (SNS) are influencing 21st. century death. Today the dying and the bereaved attend mourning and remembrance both online and offline. Combined, the cemeteries, web memorials and social network sites...... 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...... do not recognize the need or potential of working with or using, specific 'death-services/products', since they find little or no comfort in contemplating, working or playing around with the concept of death and its life changing consequences. Especially not while being alive and well...

  17. 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.

  18. Precise renal artery segmentation for estimation of renal vascular dominant regions

    Science.gov (United States)

    Wang, Chenglong; Kagajo, Mitsuru; Nakamura, Yoshihiko; Oda, Masahiro; Yoshino, Yasushi; Yamamoto, Tokunori; Mori, Kensaku

    2016-03-01

    This paper presents a novel renal artery segmentation method combining graph-cut and template-based tracking methods and its application to estimation of renal vascular dominant region. For the purpose of giving a computer assisted diagnose for kidney surgery planning, it is important to obtain the correct topological structures of renal artery for estimation of renal vascular dominant regions. Renal artery has a low contrast, and its precise extraction is a difficult task. Previous method utilizing vesselness measure based on Hessian analysis, still cannot extract the tiny blood vessels in low-contrast area. Although model-based methods including superellipsoid model or cylindrical intensity model are low-contrast sensitive to the tiny blood vessels, problems including over-segmentation and poor bifurcations detection still remain. In this paper, we propose a novel blood vessel segmentation method combining a new Hessian-based graph-cut and template modeling tracking method. Firstly, graph-cut algorithm is utilized to obtain the rough segmentation result. Then template model tracking method is utilized to improve the accuracy of tiny blood vessel segmentation result. Rough segmentation utilizing graph-cut solves the bifurcations detection problem effectively. Precise segmentation utilizing template model tracking focuses on the segmentation of tiny blood vessels. By combining these two approaches, our proposed method segmented 70% of the renal artery of 1mm in diameter or larger. In addition, we demonstrate such precise segmentation can contribute to divide renal regions into a set of blood vessel dominant regions utilizing Voronoi diagram method.

  19. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal

    Directory of Open Access Journals (Sweden)

    Madhu Sudan Agrawal

    2016-01-01

    Full Text Available Introduction: Percutaneous nephrolithotomy (PCNL has witnessed rapid advancements, the latest being ultra-mini-percutaneous nephrolithotomy (UMP, which makes the use of 11-13F sheaths as compared to 24-30F sizes used in conventional PCNL. This miniaturization aims to reduce morbidity and improve patient outcomes. We evaluated the safety and efficacy of UMP and report our ourtcomes. Patients and Methods: A total of 120 patients underwent UMP from July 2012 to March 2014. These patients had a single unilateral renal stone measuring between 8 and 20 mm. All patients underwent UMP using a 3F nephroscope, 7.5F inner sheath, and 11F or 13F outer metallic cannula, which served as the Amplatz sheath. Stone fragmentation and clearance were achieved with holmium laser. No nephrostomy or stent was used routinely. Results: Complete stone fragmentation was achieved in 114 out of 120 patients (95% using UMP; whereas the remaining 6 were converted into mini-PCNL using a 12.5F nephroscope and 15F Amplatz sheath. The mean operative time was 39.7 ± 15.4 min, and the mean postoperative hospital stay was 22.3 ± 2.2 h. Postoperatively, 6 (5% patients had residual fragments measuring ≤4 mm. At the 2 weeks follow-up, the stone-free status was >99% (119/120. There were no significant postoperative complications. Conclusion: This study shows UMP to be an effective and safe procedure for managing stones up to 20 mm. This procedure offers an attractive alternative to shock wave lithotripsy and retrograde intrarenal surgery for managing small stones.

  20. 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.

  1. Sarcoidose renal

    Directory of Open Access Journals (Sweden)

    AQUINO MARIA ENEDINA CLAUDINO DE

    2001-01-01

    Full Text Available Em uma mulher de 62 anos, branca, em avaliação pré-operatória de facectomia, foram detectadas alterações urinárias, tendo sido firmados os diagnósticos de calculose renal esquerda e exclusão renal homolateral. No pré-operatório da nefrectomia foram evidenciados processo pulmonar intersticial bilateral e adenopatia torácica, cuja investigação foi adiada para após a cirurgia. No rim retirado foram detectados granulomas epitelióides não necrotizantes, o mesmo ocorrendo posteriormente em biópsia transbrônquica. A paciente foi tratada com metilprednisolona, com discreta melhora pulmonar, o que não ocorreu com a função renal. O diagnóstico final foi de sarcoidose com envolvimento pulmonar, ganglionar torácico e renal.

  2. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  3. Pitfalls in urinary stone identification using CT attenuation values: Are we getting the same information on different scanner models?

    Energy Technology Data Exchange (ETDEWEB)

    Grosjean, Romain, E-mail: r.grosjean@chu-nancy.fr [IADI Laboratory, INSERM-U947, Nancy-University, Allée du Morvan, 54500 Vandoeuvre-les-Nancy (France); Daudon, Michel, E-mail: michel.daudon@tnn.aphp.fr [IADI Laboratory, INSERM-U947, Nancy-University, Allée du Morvan, 54500 Vandoeuvre-les-Nancy (France); Chammas, Mario F., E-mail: mariochammas@usp.br [University of Sao Paulo – Division of Urology, Av. Dr. Enéas de Carvalho Aguiar, 255, 7" o Andar – s. 7123, São Paulo (Brazil); Claudon, Michel, E-mail: m.claudon@chu-nancy.fr [IADI Laboratory, INSERM-U947, Nancy-University, Allée du Morvan, 54500 Vandoeuvre-les-Nancy (France); Eschwege, Pascal, E-mail: peschwege@yahoo.com [Department of Urology, Brabois Hospital, University Hospital of Nancy, Allée du Morvan, 54511 Vandoeuvre-les-Nancy (France); Felblinger, Jacques, E-mail: j.felblinger@chu-nancy.fr [IADI Laboratory, INSERM-U947, Nancy-University, Allée du Morvan, 54500 Vandoeuvre-les-Nancy (France); Hubert, Jacques, E-mail: j.hubert@chu-nancy.fr [Department of Urology, Brabois Hospital, University Hospital of Nancy, Allée du Morvan, 54511 Vandoeuvre-les-Nancy (France)

    2013-08-15

    Introduction: Evaluate the capability of different Computed Tomography scanners to determine urinary stone compositions based on CT attenuation values and to evaluate potential differences between each model. Methods: 241 human urinary stones were obtained and their biochemical composition determined. Four different CT scanners (Siemens, Philips, GEMS and Toshiba) were evaluated. Mean CT-attenuation values and the standard deviation were recorded separately and compared with a t-paired test. Results: For all tested CT scanners, when the classification of the various types of stones was arranged according to the mean CT-attenuation values and to the confidence interval, large overlappings between stone types were highlighted. The t-paired test showed that most stone types could not be identified. Some types of stones presented mean CT attenuation values significantly different from one CT scanner to another. At 80 kV, the mean CT attenuation values obtained with the Toshiba Aquilion were significantly different from those obtained with the Siemens Sensation. On the other hand, mean values obtained with the Philips Brilliance were all significantly equal to those obtained with the Siemens Sensation and with the Toshiba Aquilion. At 120 kV mean CT attenuation values of uric acid, cystine and struvite stones obtained with the Philips model are significantly different from those obtained with the Siemens and the Toshiba but equal to those obtained with the GE 64. Conclusions: According to our study, there is a great variability when different brands and models of scanners are compared directly. Furthermore, the CT scan analysis and HU evaluation appears to gather insufficient information in order to characterize and identify the composition of renal stones.

  4. Famous building stones of our Nation's capital

    Science.gov (United States)

    ,

    2012-01-01

    The buildings of our Nation's Capital are constructed with rocks from quarries located throughout the United States and many distant lands. The earliest Government buildings, however, were constructed with stones from nearby sources because it was too difficult and expensive to move heavy materials such as stone any great distance without the aid of modern transportation methods, including large cargo ships, trains, and trucks. This fact sheet describes the source and appearance of three frequently used local stones employed in building Washington, D.C., and the geologic environment in which they were formed.

  5. 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.

  6. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  7. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  8. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  9. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt

    2015-03-01

    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  10. Identification of medicinal plants for the treatment of kidney and urinary stones

    Science.gov (United States)

    Bahmani, Mahmoud; Baharvand-Ahmadi, Babak; Tajeddini, Pegah; Rafieian-Kopaei, Mahmoud; Naghdi, Nasrollah

    2016-01-01

    Introduction: Kidney stones are the third most common urinary tract problems after urinary tract infections and prostate pathology. Kidney stones may cause extreme pain and blockage of urine flow. They are usually treated with medications that may cause a number of side-effects. Medicinal herbs are used in different cultures as a reliable source of natural remedies. Objectives: This study aimed to determine native medicinal plants used by traditional healers of Shiraz for the treatment of kidney stones. Materials and Methods: The ethno-medicinal data were collected between July and September 2012 through face-to-face interview with local herbalist. Results: A total of 18 species belonging to 19 botanical families were recorded in study area. Species with the highest frequency of mentions were Alhagi maurorum (51.58%), Tribulus terrestris (51.58%), and Nigella sativa (48.14). The most frequently used plant parts were aerial parts (38%), leaf (33%) and fruits (17%). Decoction (68%) was the most frequently prescribed method of preparation. Most of the medicinal plants recommended by Shirazian herbalists have not been investigated in animal and humane models of renal stone which provides a new area of research. Conclusion: In the case of safety and effectiveness, they can be refined and processed to produce natural drugs. PMID:27689108

  11. Severe renal bleeding caused by a ruptured renal sheath: case report of a rare complication of percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Gunes Ali

    2002-09-01

    Full Text Available Abstract Background Percutaneous nephrolithotomy is a minimally invasive intervention for renal stone disease. Complications, which are rare and usually presented as case reports, are diversified as the utilization of the procedure is expanded. The procedure causes less blood loss and less morbidity when compared to open surgical procedures. Yet, there are some reports involving severe bleeding and relevant morbidity during surgery. These are usually related with the surgical technique or experience of the surgeon. Renal sheaths are designed to cause minimal trauma inside the kidney and, to our knowledge, there are no reports presenting the rupture of a sheath causing severe bleeding during the procedure. Case report We present an adult patient who had severe bleeding during percutaneous nephrolithotomy due to parenchymal injury caused by a ruptured renal sheath. During retrieval, due probably to rough handling of the equipment, a piece of stone with serrated edges ruptured the tip of the sheath, and this tip caused damage inside the kidney. The operation was terminated and measures were taken to control bleeding. The patient was transfused with a total of 1600 ml of blood, and the stones were cleared in a second look operation. Conclusion Although considered to be a minimally invasive procedure, some unexpected complications may arise during percutaneous nephrolithotomy. After being fragmanted, stone pieces may damage surgical equipment, causing acute and severe harm to the kidney. Surgeons must manipulate the equipment with fine and careful movements in order to prevent this situation.

  12. 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

  13. 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

  14. Kidney Stones in Children and Teens

    Science.gov (United States)

    ... blood but sometimes it is visible to the naked eye. Young children with kidney stones are usually ... Your doctor may also recommend that your child see a pediatric nephrologist or urologist who has experience ...

  15. The nutrition consult for recurrent stone formers.

    Science.gov (United States)

    Penniston, Kristina L

    2015-07-01

    Diet is implicated in stone formation and growth. Whether alone or in concert with pharmacologics, dietary changes may be useful in reducing recurrence but only when they correct dietary stone-forming risks. Patients benefit from recommendations individualized to their food preferences as well as to lifestyle, age, food knowledge and access, preparation skills, and cultural and ethnic identities. Urologists can provide general dietary recommendations but often lack the time to provide the full complement of individualized nutrition care offered by a registered dietitian nutritionist (RDN). Urologists can partner with and refer patients to a RDN for any component of the nutrition care process: assessment of diet, diagnosis of dietary factors that contribute to stone risk factors, intervention formulation and implementation, and monitoring the effectiveness of the intervention and modifying it as needed to maintain suitably low dietary risk for stone recurrence.

  16. Primary liquid intake and urinary stone disease.

    Science.gov (United States)

    Shuster, J; Finlayson, B; Scheaffer, R L; Sierakowski, R; Zoltek, J; Dzegede, S

    1985-01-01

    This investigation indicates that there are important associations between urinary stone disease and a person's primary liquid intake. Based on data collected from 2295 caucasian male patients from two geographical regions, the Carolinas (both North and South) and the Rockies (including Colorado, Idaho, Nevada, Montana, Utah and Wyoming) an important (p less than 0.01) positive association was found between urinary stone disease and soda (carbonated beverage) consumption within both geographical regions. It was also found that negative associations exist between urinary stone disease and both beer consumption and coffee consumption in the Rockies and that no important associations exist between urinary stone disease and any of milk, water, or tea, when these beverages represent a person's primary liquid intake. Moreover, soda can be viewed almost synonymously as sugared cola, since few subjects had diet sodas or sugared non-cola soda as primary fluid. No cause/effect relationships are implied in this paper.

  17. Comparing non contrast computerized tomography criteria versus dual X-ray absorptiometry as predictors of radio-opaque upper urinary tract stone fragmentation after electromagnetic shockwave lithotripsy.

    Science.gov (United States)

    Hameed, Diaa A; Elgammal, Mohammed A; ElGanainy, Ehab O; Hageb, Adel; Mohammed, Khaled; El-Taher, Ahmed Mohamed; Mostafa, Mostafa Mohamed; Ahmed, Abdelfatah Ibrahim

    2013-11-01

    The objective of this study was to assess the value of dual X-ray absorptiometry (DXA) in comparison to non contrast computed tomography (NCCT) density as possible predictors of upper urinary tract stone disintegration by shock wave lithotripsy (SWL). This study included 100 consecutive patients, with solitary renal stone 0.5-2 cm or upper ureteral stone up to 1 cm. DXA to calculate stone mineral density (SMD) and stone mineral content (SMC) was done. NCCT was performed to measure Hounsfield units (HU). SWL was performed with an electromagnetic lithotripsy, plain X-ray documented disintegration after SWL. Successful treatment was defined as stone free or complete fragmentation after 1 or 2 sessions of SWL. The impact of patients age, sex, body mass index, stone laterality, location, volume, length, mean SMC and SMD, HU and Hounsfield density (HD), skin to stone distance (SSD) and number of shock waves were evaluated by univariate and multivariate analysis. Only 76 patients were available for follow-up. Success of disintegration was observed in 50 out of 76 patients (65.8 %). On multivariate analysis, SMC and number of shock wave were the significant independent factors affecting SWL outcome (p = 0.04 and p = 0.000, respectively). SMC as detected by DXA is a significant predictor of success of stone disintegration by SWL. SMC measured by DXA is more accurate than HU measured by CT. Patients with high stone mineral content (SMC greater than 0.65 g) should be directly offered another treatment option.

  18. 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.

  19. Stone structures in the Syrian Desert

    CERN Document Server

    Sparavigna, Amelia Carolina

    2011-01-01

    An arid land, known as the Syrian Desert, is covering a large part of the Middle East. In the past, this harsh environment, characterized by huge lava fields, the "harraat", was considered as a barrier between Levant and Mesopotamia. When we observe this desert from space, we discover that it is crossed by some stone structures, the "desert kites", which were the Neolithic traps for the game. Several stone circles are visible too, as many Stonehenge sites dispersed in the desert landscape.

  20. Low-cost semirigid ureteroscopy is effective for ureteral stones: Experience of a single high volume center

    Directory of Open Access Journals (Sweden)

    Roberto Giulianelli

    2014-06-01

    Full Text Available Aim of the study: To demonstrate how, in a center with a large number of patients, as our center is, it is possible to perform ureterolithotripsy using a limited set of instruments. Methods: We evaluated medical charts of our center related to semirigid ureteral ureteroscopy (URS with ureterolithotripsy using Holmium laser performed from July 2004 to July 2011. Overall, 658 URS for ureteral stones were performed in 601 patients, of which 204 in proximal ureter (31%, 86 in the mid (13.06% and 368 (57.76% in the distal ureter. In 504 patients (76.5% ureterohydronephrosis (Grade II-III was observed. In 57 patients (8.6%, we performed a bilateral approach at the same time, but most patients had a solitary distal ureteral stone. 106 patients (16.1% had more than one stone in their distal ureter and 96 (14.8% had a proximal ureteral stone treated in the same surgery as well. Results: The overall stone-free rate for ureteral stones was 86.1% (567/658. Success rates for proximal, medial and distal ureteral stones were 68.13% (139/204 patients, 84.8% (73/86 patients and 96.4% (355/368 patients, respectively. One hundred and twenty patients (18.3% required additional surgical treatment for their stones beyond the initial URS, including a second URS in 97 patients (14.74% and URS plus Retrograde Intra-Renal Surgery (RIRS in 23 patients (3.54%. The overall stonefree rate after the second treatment was 99.3%. Intra-operative complications accounted for 5.92% and consisted of ureteral perforations in 16 pts (2.4%, erosions of urothelium leading to significant bleeding in 15 pts (2.27%, severe pain in 4 pts (0.6%, fever in 3 pts (0.45% and one case of ureteral avulsion (0.15%. Conclusions: This study demonstrates that the use of Holmium laser lithotripsy is a safe and effective means of treating ureteral stones regardless of sex, age, stone location, or stone size. The instrumentation we used was extremely limited, in order to reduce costs related to the

  1. Endoscopic management of bile duct stones.

    Science.gov (United States)

    Sivak, M V

    1989-09-01

    Endoscopic sphincterotomy is the procedure of choice for choledocholithiasis in patients who have had a cholecystectomy. The bile duct is cleared of stones in about 80 to 90 percent of patients. Available data, largely retrospective, suggest that surgery and endoscopic sphincterotomy are about equal with respect to removal of stones, morbidity, and mortality. Certain technical problems are discussed, including inability to insert the papillotome, the large stone, and problems relating to anatomy such as peripapillary diverticulum and prior gastrectomy. The treatment of patients with bile duct stones who have not had a cholecystectomy, with and without cholelithiasis, is controversial. Endoscopic sphincterotomy without subsequent cholecystectomy is adequate treatment for the majority of patients who are unfit for surgery, even if there are stones in the gallbladder, provided they are asymptomatic after endoscopic removal of stones from the bile ducts. Endoscopic sphincterotomy has been performed in the treatment of gallstone-induced pancreatitis, acute obstructive cholangitis, and sump syndrome. The complication rate for endoscopic sphincterotomy ranges from 6.5 to 8.7 percent, with a mortality rate of 0 to 1.3 percent. The most common serious complications are perforation, hemorrhage, acute pancreatitis, and sepsis.

  2. Water hardness and urinary stone disease.

    Science.gov (United States)

    Shuster, J; Finlayson, B; Scheaffer, R; Sierakowski, R; Zoltek, J; Dzegede, S

    1982-08-01

    On the macrogeographic scale, a strong negative association exists in the United States between water hardness and urinary stone disease. This investigation studies the association on the microgeographical scale, where it is possible to control for confounding environmental factors. The study was conducted on 2,295 patients from 2 regions: the Carolinas which had soft water and high stone incidence, and the Rockies which had hard water and low stone incidence. Home tap water samples from urinary stone patient hospitalizations were compared with that of controls, concurrent inguinal hernia patient hospitalization. After adjusting for environmental factors, no significant difference (p = 0.59) between the 2 groups was obtained in tap water calcium, magnesium, and sodium concentrations. An incidental but potentially important finding was that those consuming water from a private well had an estimated relative risk of 1.5 (p less than 0.01) compared to those using public water. While no cause-effect relationship is suggested, stone-formers might consider avoiding private well water. On the other hand, water hardness should be a minor concern with respect to stone formation.

  3. Famous Stone Patients and Their Disease

    Science.gov (United States)

    Moran, Michael E.

    2007-04-01

    The fact that stone patients have endured much throughout the ages and that prior to our current era, when the ultimate horror, "being cut for the stone" was the only alternative to the repeated episodes of colic, should be recalled from time to time. Urolithiasis has affected humanity throughout the ages and has been indiscriminate to those lives it touched. A full accounting of those who have suffered and recorded their agonies is beyond the scope of this investigation; however, even a partial accounting is valuable for present day physicians who care for those with stone disease. For the present work, the historical accounts of stone disease literature were scrutinized for individual sufferers who could be cross-referenced from other sources as legitimately afflicted by stones. Only those patients that could be documented and were (or are) well known were included, because the internet is now a verdant repository of thousands of "not so well knowns." Reliable historical data was found for a variety of persons from the pre-Christian era to the present, including those remembered as philosophers and scientists, physicians, clergy, leaders and rulers, entertainers, athletes and fictitious/Hollywood-type individuals. Verified accounts of famous stone formers were chosen for this paper, and are presented in chronological order. The list of urolithiasis sufferers presented here is undoubtedly incomplete, but it is not through lack of trying that they are missing. Most often, the suffering do so silently, and that is always allowed.

  4. Nephrolithiasis Anotaciones sobre litiasis renal

    Directory of Open Access Journals (Sweden)

    Gonzálo Mejía

    1989-03-01

    Full Text Available

    Nephrolithiasis is a relatively common disease in medical practice. There are no recent, updated reviews on this topic in Colombian literature and to fill this need the present one was written. The different aspects of calcium lithiasis are analyzed in a practical and simplified although comprehensive way, emphasizing pathophysiology, patient evaluation, management of lithiasis (fluids, diet and drug therapy and new methods for stone removal. Other types of calculi are briefly discussed. Management of the renal colic is not included.

    La litiasis renal es un trastorno relativamente frecuente en la práctica médica. No existe en la literatura colombiana una revisión reciente y actualizada acerca de este tema por lo cual se escribió la presente. En una forma práctica y simplificada, pero completa, se analizan los diferentes aspectos relacionados con la litiasis por calcio y, brevemente, se mencionan otros tipos de cálculos. Se hace énfasis en fisiopatología, evaluación del paciente, manejo de la litiasis (líquidos, dieta y drogas y nuevos métodos de extracción del cálculo. No se incluye el manejo del cólico renal.

  5. 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

  6. Ureolytic Citrobacter freundii infection of the urine as a cause of dissolution of cystine renal calculi.

    Science.gov (United States)

    Gutierrez Millet, V; Praga, M; Miranda, B; Bello, I; Ruilope, L; Diaz Gonzalez, R; Leyva, O; Alcazar, J M; Barrientos, A; Rodicio, J L

    1985-03-01

    We report a case of cystinuria with staghorn renal lithiasis in a solitary right kidney and chronic renal failure. Right nephropyelolithotomy was performed and although 29 renal calculi were extracted many stones remained in situ. A permanent nephrostomy was left in the kidney. Several months later the urine was infected chronically with a ureolytic Citrobacter freundii bacteria and urinary pH oscillated between 8.0 and 9.2. Spontaneous dissolution of the cystine calculi was observed and many tiny fragments of cystine were expulsed through the nephrostomy, following which renal function improved. Despite the conditions favoring struvite calculi, formation did not occur.

  7. 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

    ) 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...

  8. Stones in 2015: Changes in stone management - suspending belief for evidence.

    Science.gov (United States)

    Ambani, Sapan N; Ghani, Khurshid R

    2016-02-01

    In 2015, population-based studies in patients with urinary stones informed us of the changing trends in contemporary stone management and identified areas for improvement. Although meta-analyses aim to provide the highest level of evidence, a randomized controlled trial of medical expulsive therapy challenged current paradigms and was the defining publication of the year.

  9. Prediction of renal crystalline size distributions in space using a PBE analytic model. 1. Effect of microgravity-induced biochemical alterations.

    Science.gov (United States)

    Kassemi, Mohammad; Thompson, David

    2016-09-01

    An analytical Population Balance Equation model is developed and used to assess the risk of critical renal stone formation for astronauts during future space missions. The model uses the renal biochemical profile of the subject as input and predicts the steady-state size distribution of the nucleating, growing, and agglomerating calcium oxalate crystals during their transit through the kidney. The model is verified through comparison with published results of several crystallization experiments. Numerical results indicate that the model is successful in clearly distinguishing between 1-G normal and 1-G recurrent stone-former subjects based solely on their published 24-h urine biochemical profiles. Numerical case studies further show that the predicted renal calculi size distribution for a microgravity astronaut is closer to that of a recurrent stone former on Earth rather than to a normal subject in 1 G. This interestingly implies that the increase in renal stone risk level in microgravity is relatively more significant for a normal person than a stone former. However, numerical predictions still underscore that the stone-former subject carries by far the highest absolute risk of critical stone formation during space travel.

  10. Brushite stone disease as a consequence of lithotripsy?

    Science.gov (United States)

    Krambeck, Amy E; Handa, Shelly E; Evan, Andrew P; Lingeman, James E

    2010-08-01

    The incidence of calcium phosphate (CaP) stone disease has increased over the last three decades; specifically, brushite stones have been diagnosed and treated more frequently than in previous years. Brushite is a unique form of CaP, which in certain patients can form into large symptomatic stones. Treatment of brushite stones can be difficult since the stones are resistant to shock wave and ultrasonic lithotripsy, and often require ballistic fragmentation. Patients suffering from brushite stone disease are less likely to be rendered stone free after surgical intervention and often experience stone recurrence despite maximal medical intervention. Studies have demonstrated an association between brushite stone disease and shock wave lithotripsy (SWL) treatment. Some have theorized that many brushite stone formers started as routine calcium oxalate (CaOx) stone formers who sustained an injury to the nephron (such as SWL). The injury to the nephron leads to failure of urine acidification and eventual brushite stone formation. We explore the association between brushite stone disease and iatrogenic transformation of CaOx stone disease to brushite by reviewing the current literature.

  11. [Flexible ureterorenoscopy and laser lithotripsy for upper urinary tract stones in neurologic patients with severe motor disability].

    Science.gov (United States)

    Madec, F-X; Suply, E; Luyckx, F; Nedelec, M; Chowaniec, Y; Branchereau, J; Le Normand, L; Glemain, P

    2017-05-01

    The study's objective was to evaluate the effectiveness and morbidity of flexible ureterorenoscopy and laser lithotripsy for upper urinary tract stones in patients with a nervous system pathology including severe motor disability. Between 2006 and 2013, we retrospectively analyzed 83 flexible ureterorenoscopy to treat 63 kidneys in 42 patients. Stone free (SF) kidneys defined as an absence of stones on computerized tomography, renal ultrasound, X-ray or direct ureterorenoscopy, were considered a surgical success. Complications were classified according to the Clavien-Dindo system. Success rates were 49.2 %, 57.1 % and 58.7 %, respectively after first, second and third flexible ureterorenoscopy procedure. Clearance after one procedure was achieved in 64.3 % of cases involving less than 20mm stones. No major complication (Clavien-Dindo>2) was described (0 %). Complication rates were 44.7 %, with 31.6 % Clavien-Dindo 2. The main complication was urosepsis, which occurred in 27.6 % of cases. Flexible ureteroscopy and laser lithotripsies for upper urinary tract stones in neurologic patients with severe motor disability are associated with a lower success rate and some frequent low grade complications compared to overall population. In clinical practice, the indications of flexible ureterorenoscopy for these patients seem restricted. 5. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Forty-five-year follow-up on the renal function after spinal cord injury

    DEFF Research Database (Denmark)

    Elmelund, M; Oturai, P S; Toson, B;

    2016-01-01

    STUDY DESIGN: Retrospective chart review. OBJECTIVES: To investigate the extent of renal deterioration in patients with spinal cord injury (SCI) and to identify risk indicators associated with renal deterioration. SETTING: Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbæk, Denmark. METHODS......: This study included 116 patients admitted to our clinic with a traumatic SCI sustained between 1956 and 1975. Results from renography and (51)Cr-EDTA plasma clearance were collected from medical records from time of injury until 2012, and the occurrence of renal deterioration was analysed by cumulative...... increased the risk of moderate and severe renal deterioration. CONCLUSION: Renal deterioration occurs at any time after injury, suggesting that lifelong follow-up examinations of the renal function are important, especially in patients with dilatation of UUT and/or renal/ureter stones....

  13. Efficacy and safety of totally tubeless standard percutaneous nephrolithotomy in patients with kidney stones

    Directory of Open Access Journals (Sweden)

    Cemil Aydın

    2014-09-01

    Full Text Available Objective: Percutaneous nephrolithotomy (PNL is the first- line treatment for large and complex renal calculi. In this study, we aimed to compare the efficacy and safety of the totally tubeless PNL versus the standard PNL. Methods:Between January 2012 and July 2013, 73 selected patients were treated standard or totally tubeless PNL, nephrostomy tube and ureteral stent was not placed at the end of the operation in 35 (39.7% (Group 1 of them and 38 (43.1% (Group 2 patient underwent standard PNL. Stone disintegration was performed with a pneumatic lithotripter. We retrospectively compared patient and stone characteristics, operation time, duration of hospitalization, analgesia requirements, stone-free rate, operative findings, blood loss, and perioperative complications between two groups. Results:The mean operation time, excluding the preparation course, was 38,3±15,4 minutes vs 51,2±12,9 minutes and mean fluoroscopy time was 4,5±2,4 minutes vs 4,8±2,1 minutes, respectively. No significant intraoperative complication or indication additional access or second-look PNL due to residual stones was observed. In both groups none of the patients demonstrated a urinoma, hemorrhage or residual stones in postoperative ultrasonography and plain radiograph. Blood transfusion was needed only in a patient vs two patients for group 1 and 2, respectively. There were no significant differences in preoperative patient characteristics, postoperative complications between two groups, but the totally tubeless PNL group showed a shorter hospitalization and a lesser analgesic requirement compared with other group. Conclusion: Absence of the nephrostomy tube and ureteral stent may help in keeping the patient comfortable after the operation and reduction in the analgesia requirement and length of hospital stay. We believe totally tubeless PNL is safe and effective management option in properly selected cases.

  14. Renal Cysts

    Science.gov (United States)

    ... as “simple” cysts, meaning they have a thin wall and contain water-like fluid. Renal cysts are fairly common in ... simple kidney cysts, meaning they have a thin wall and only water-like fluid inside. They are fairly common in ...

  15. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  16. Drug-induced renal injury

    African Journals Online (AJOL)

    Drugs can cause acute renal failure by causing pre-renal, intrinsic or post-renal toxicity. Pre-renal ... incidence of drug dose adjustment in renal impairment in the SAMJ. ... Fever, haemolytic anaemia, thrombocytopenia, renal impairment and.

  17. Biliary stenting for management of common bile duct stones.

    Science.gov (United States)

    Choudhuri, G; Sharma, B C; Saraswat, V A; Agarwal, D K; Baijal, S S

    1998-06-01

    Large and multiple common bile duct stones may defy extraction despite an adequate endoscopic papillotomy. We treated 65 patients with symptomatic bile duct stones with endoscopic stents after failed attempts at stone extraction. Of the 65 patients, bile duct stones were extracted in eight at a second attempt, 29 underwent elective surgery and 28 patients were followed with the stent in situ for 21-52 months (median 42 months). During follow up, two patients had recurrent pain and two required surgery. The remaining 24 patients remained asymptomatic. Biliary stenting is a safe and effective mode of treatment for common bile duct stones in patients who have failed stone extraction after endoscopic papillotomy.

  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. Endoscopic Management of Difficult Bile Duct Stones

    Directory of Open Access Journals (Sweden)

    Christian Ell

    1992-01-01

    Full Text Available More than 90% of all common bile duct concrements can be removed via the endoscopic retrograde route via endoscopic sphincterotomy, stone extraction by baskets and balloon catheters, or mechanical lithotripsy. Oversized, very hard or impacted stones, however, often still resist conventional endoscopic therapy. Promising new or improved approaches for the treatment of these stones are intracorporeal or extracorporeal shock wave lithotripsy. Shockwave lithotriptors for extracorporeal shockwave lithotripsy are currently available worldwide. However, for the waterbath first generation devices, general anesthesia is required since shockwaves are very painful. Furthermore, an x-ray localization system is essential to visualize the stones after having filled the bile duct over a nasobiliary catheter. An average of two shockwave treatments with additional two to four endoscopic sessions are required. ln tracorporeal lithotripsy promises more comfort and less effort for the patient. Shockwaves are generated either by means of the spark gap principle (electrohydraulic probes or by laser-induced plasma generation. Laser-induced shockwave lithotripsy appears to be more safer, since with dye and solid state lasers, athermal, well-controlled shockwaves can be generateJ without the risks for duct perfo ration (as described for the electrohydraulic system. Furthermore, a recently developed stone-tissue detection system integrated in a new dye laser system enchances the safety of laser-induced lithotripsy. ln consequence, lithotripsy without direct endoscopic control appears possible in selected cases.

  20. Prospective prediction of the major component of urinary stone composition with dual-source dual-energy CT in vivo.

    Science.gov (United States)

    Zhang, G-M-Y; Sun, H; Xue, H-D; Xiao, H; Zhang, X-B; Jin, Z-Y

    2016-11-01

    To prospectively evaluate the diagnostic accuracy of dual-source dual-energy computed tomography (DSDECT) for predicting the major component and determining the composition of urinary calculi in patients with urolithiasis, using postoperative in vitro Fourier transform infrared spectroscopy (FT-IR) analysis as the reference standard. Patients with known urolithiasis underwent preoperative DSDECT evaluation, and subsequently, underwent surgical removal of the stones. All patients were examined using the dual-energy renal stone protocol. Material-specific chromatic images were made using dedicated post-processing software. The final determination of stone composition was made using FT-IR postoperatively. Diagnostic parameters of DSDECT for predicting the major component and detecting the presence of four composition types were calculated. A total of 81 urinary calculi were included in this study. Forty-three were pure stones and 38 were mixed stones according to FT-IR. DSDECT correctly identified the major component of all pure stones and 36 mixed stones. The major component of two mixed stones with uric acid as the major component was falsely interpreted as calcium oxalate. The overall accuracy of DSDECT for predicting the major component of stones was 97.5% (79/81). The accuracy of DSDECT for detecting the presence of four types of composition, uric acid, cysteine, hydroxyapatite, and calcium oxalate, was 97.5% (79/81), 93.8% (76/81), 80.2% (65/81), and 93.8% (76/81), respectively. DSDECT could accurately predict the major component of urinary calculi and detect uric acid, cysteine, and calcium oxalate with a satisfactory accuracy. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. Renal sonographic findings of type I glycogen storage disease in infancy and early childhood

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Chun-Chen; Lin, Shuan-Pei [Mackay Memorial Hospital, Department of Pediatrics, Taipei (Taiwan); Tsai, Jeng-Daw; Lee, Hung-Chang [Mackay Memorial Hospital, Department of Pediatrics, Taipei (Taiwan); Taipei Medical University, Department of Pediatrics, Taipei (Taiwan)

    2005-08-01

    Type I glycogen storage disease (GSD-I) is an inherited disorder affecting glycogenolysis and gluconeogenesis. The characteristic manifestations are hepatomegaly, hypoglycemia, hyperlacticacidemia, hyperuricemia, and hyperlipidemia. Renal disease is regarded as a long-term complication and is reported mainly in older patients. We report the renal manifestations and renal ultrasonographic findings of GSD-I in infancy and early childhood in order to assess the role of renal sonography in the diagnosis of GSD-I. We retrospectively reviewed our hospital's database for patients with GSD-I from January 1993 to September 2004. The records of five patients were reviewed for this study. These five patients were diagnosed when they were younger than 3 years old. Data extracted from the charts included the initial extrarenal and renal manifestations, laboratory data, and imaging studies. We analyzed the indications for, and results of, renal sonography. In addition to the clinical presentations and laboratory abnormalities, all five children had nephromegaly and increased echogenicity on ultrasonography on their first visit, although only a minor degree of tubular dysfunction was noted clinically. Three of these five patients had nephrocalcinosis or renal stones or both. Hyperechoic large kidneys, nephrocalcinosis, and renal stones are common in GSD-I. They can be present in early infancy. Abnormalities on renal sonography might suggest GSD-I in a patient with suspected inborn errors of metabolism. (orig.)

  2. Ramadan fasting and patients with renal diseases: A mini review of the literature.

    Science.gov (United States)

    Emami-Naini, Afsoon; Roomizadeh, Peyman; Baradaran, Azar; Abedini, Amin; Abtahi, Mohammad

    2013-08-01

    Fasting during the month of Ramadan is one of the five pillars of Islam. During this month, adult Muslims are obligated to refrain from eating and drinking from dawn to dusk. Although based on Islamic principles patients are exempted from fasting, each year, many Muslim patients express their willingness to observe the fast in Ramadan month to respect the cultural customs. There are concerns about the impact of fluid restriction and dehydration during Ramadan fasting for patients with renal diseases. In this study, we reviewed the PubMed, Google Scholar, EBSCO, SCIRUS, Embase, and DOAJ data sources to identify the published studies on the impact of Ramadan fasting on patients with renal diseases. Our review on published reports on renal transplant recipients revealed no injurious effect of Ramadan fasting for the renal graft function. Nearly all studies on this topic suggest that Ramadan fasting is safe when the function of the renal graft is acceptable and stable. Regarding the impact of Ramadan fasting on patients with chronic kidney disease, there is concern about the role of renal hypoperfusion in developing tubular cell injury. Finally, there is controversy between studies about the risk of dehydration in Ramadan in developing renal stones. There are uncertainties about the change in the incidence of renal colic in Ramadan month compared with the other periods of the year. Despite such discrepancies, nearly all studies are in agreement on consuming adequate amounts of water from dusk to dawn to reduce the risk of renal stone formation.

  3. Large orthotopic reservoir stone burden: Role of open surgery

    Directory of Open Access Journals (Sweden)

    Madbouly Khaled

    2010-01-01

    Full Text Available Purpose: To present our experience in open poucholithotomy as a primary management of large orthotopic reservoir stone burden and discuss different management options. Materials and Methods: Records of men underwent radical cystectomy and orthotopic urinary diversion were retrospectively reviewed as regards pouch stone formation. Patients with large reservoir stone burden managed by open poucholithotomy were further selected. Results: Large reservoir stone burden was encountered in 12 post radical cystectomy men. All underwent open poucholithotomy as a primary management of their reservoir stones. Median age at cystectomy was 46 (range: 32-55 years with a median total follow up period of 214.15 (range: 147-257 months and a median interval to stone detection of 99 (range: 63-132 months. The median stone burden was 5260 (range: 3179-20410 mm 2 . All patients were continent during the day while 5 showed nocturnal enuresis; 2 of them became continent after removal of the stones. Post poucholithotomy, all patients had sterile urine cultures except one who showed occasional colonization. None of the 12 patients showed stone recurrence after poucholithotomy. Two patients underwent revision of a dessuscepted nipple valve in association with stone removal. Conclusions: Open poucholithotomy for large reservoir stone burden is a feasible and safe option. It saves the reservoir mesentery and adjacent bowel. It allows complete removal of the stone(s leaving no residual fragments. Furthermore, it permits correction of concomitant reservoir abnormalities.

  4. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  5. Infarction of middle third posterior cortex of kidney: a complication of extended pyelolithotomy, intra-operative electrohydraulic lithotripsy and extraction of calyceal stones under vision using stone basket and flexible cystoscope in a spinal cord injury patient – a case report

    Science.gov (United States)

    2009-01-01

    Background Spinal cord injury produces multiple systemic and metabolic alterations. A decrease in micro vascular blood flow to liver, spleen and muscle has been described following spinal cord injury. Case presentation We present a 46-year-old male patient with C-4 complete tetraplegia, who developed a large stag horn calculus with branches in upper, middle and lower calyces of left kidney. This patient underwent Gil-Vernet extended pyelolithotomy and required intra-operative electrohydraulic lithotripsy and retrieval of stones from upper, middle and lower calyces using flexible cystoscope and stone basket. Computed tomography, performed eighteen days after surgery, showed multiple areas of non-enhancing cortex posteriorly and in the upper pole, suggestive of focal infarction. Magnetic resonance imaging of left kidney confirmed the presence of an area of infarction in middle third of posterior cortex, but there was no evidence of trauma to posterior division of renal artery. Therefore, we postulate that compression of renal parenchyma by Gil-Vernet retractors during surgery, and firm pressure that was applied over the middle of kidney for prolonged periods while several attempts were being made to retrieve fragments of calculi from renal calyces, led to ischaemia and subsequently, infarction of mid-third posterior cortex of left kidney. Conclusion This case illustrates importance of gentle handling of kidney during extended pyelolithotomy in order to prevent subtle renal trauma, which may be detected only by advanced imaging studies. Further, spinal cord physicians should take a pragmatic approach to management of stones located inside renal calyces. Both spinal cord injury patients and their physicians should remember that in our enthusiasm to achieve complete clearance of stones embedded deeply within renal calyces, we could produce irreversible injury to kidney, as indeed happened in this patient. Therefore, emphasis should be placed on prevention of struvite

  6. Quality Assessment of Urinary Stone Analysis

    DEFF Research Database (Denmark)

    Siener, Roswitha; Buchholz, Noor; Daudon, Michel

    2016-01-01

    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......, fulfilled the quality requirements. According to the current standard, chemical analysis is considered to be insufficient for stone analysis, whereas infrared spectroscopy or X-ray diffraction is mandatory. However, the poor results of infrared spectroscopy highlight the importance of equipment, reference...

  7. Pyramidal anchor stone from Baga waters of Goa, west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Tripati, S.

    Underwater exploration in the coastal region off Baga (Goa, India) led to the recovery of an isolated stone artefact, which resembles a pyramidal type of anchor stone. This anchor stone is unlike to other pyramidal anchor stones found elsewhere...

  8. Sclerotherapy for a simple renal cyst causing hydronephrosis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Hun; Park, Sang Woo; Chang, Il Soo; Hwang, Jin Ho; Jung, Sung Il [Dept. Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2017-05-15

    A simple renal cyst usually remains asymptomatic and requires no invasive treatment. Occasionally, however, some cysts may cause pain, hematuria, hypertension, or obstruction of the collecting system. We describe a case of a 50-year-old man who presented with hydronephrosis caused by an ipsilateral simple renal cyst without any stone or significant mass in the urinary system. The patient was eventually treated successfully with sclerotherapy.

  9. Stability of Reshaping Breakwaters with Special Reference to Stone Durability

    DEFF Research Database (Denmark)

    Frigaard, Peter; Hald, Tue; Burcharth, H. F.

    1998-01-01

    Traditionally, conventional rubble mound breakwaters are designed with stable armour units, and consequently, very large stones or even artificial armour units are required. reshaping breakwater designs allow reshaping of the seaward slope thus involving stone movements. Ultimately, dependent...

  10. Dental pulp stone formation during orthodontic treatment: A ...

    African Journals Online (AJOL)

    2015-06-21

    Jun 21, 2015 ... to determine the relationship between the pulp stone formation and orthodontic treatment. Key words: ... blood flow or vascular tissue pressure can affect the health of the dental pulp. ..... Prevalence of pulp stones in a teenage.

  11. SAFETY AND EFFICACY OF PERCUTANEOUS NEPHROLITHOTOMY IN INFANTS PRESENTING WITH OBSTRUCTIVE RENAL CALCULI AND ANURIA

    Directory of Open Access Journals (Sweden)

    Yugesh

    2015-04-01

    Full Text Available BACKGROUND : Urolithiasis in infancy is rare but important health issue. Etiology is multi factorial . Optimal management of pediatric stone disease is still evolving . Infants with bilateral obstructive renal stones are unique group of patients in whom prompt evaluation and management is necessary. AI MS AND OBJECTIVE: To evaluate safety and efficacy of PCNL in infants presenting with bilateral obstructive renal calculi and anuria . MATERIALS AND METHOD S: From N ov . 2012 to M arch 2014, 18 renal units with calculi in 9 infants (6 boys, 3 girls were treated with PCNL ( P ercutaneous N ephrolithotomy at our institution. All infants presented with anuria, rised serum creatinin (mean 6.1mg/dl and uremic symptoms due to bilateral obstructive renal calculi. All patients managed initially with peritoneal dialysis a t nephrology u nit, followed by bilateral DJ (D ouble J stenting, then bilateral PCNL performed in two sittings. Mean age 8.5 months (4m to 12m, mean stone burden 1.7 cm (0.6cm to 3.0 cm, 20 F pediatric nephroscope through 22F percutaneous access was used . Stones were fragmented with pneumatic lithotripter. RESULTS: Mean operative time was 60.22 mins (30 mins to 90 mins. Complete stone clearance was done in all cases without need for second look PCNL. Mean post op serum creatinin is 0.6 mg/dl. No patient r equired blood transfusion, developed urosepsis, or had a procedure related complications. CONCLUSION: When performed by experienced urologists, PCNL is safe and effective procedure in infants presenting with bilateral obstructive renal calculi and anuria, provided these patients managed preoperatively with peritoneal dialysis and DJ stenting to optimise renal function and to relieve sepsis.

  12. Renale Osteopathie

    OpenAIRE

    Horn S

    2001-01-01

    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  13. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G

    2008-01-01

    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  14. Litholytic property of Kulattha (Dolichous biflorus) vs potassium citrate in renal calculus disease: a comparative study.

    Science.gov (United States)

    Singh, Rana Gopal; Behura, Sanjeev Kumar; Kumar, Rakesh

    2010-05-01

    Renal calculus disease is associated with recurrence after its surgical removal in large number of cases. Kulattha is acclaimed to have litholytic property in ayurvedic literature. We decided to compare the litholytic property of Kulattha with potassium citrate, an agent used to reduce stone recurrence in modern medicine. Forty seven patients with diagnosis of calcium oxalate renal calculi were taken in study. Twenty four patients received Kulattha (Group I) and 23 patients were given potassium citrate(Group II) for a period of 6 months. The size of renal calculi was studied by periodic ultrasound assessment in both groups. Mean size of stone in group I at 0 month and at 6 month were 5.42 +/- 1.55 mm and 4.26 +/- 1.2 mm. mean size of stone in group II at 0 month and at 6 month was 6.46 +/- 3.08 mm and 4.64 +/- 1.40 mm. Statistical analysis showed that P value of less than 0.05 was seen in the first group from 0 to 6 month. There was no significant difference in the stone size within group II when the 3rd month and 6th month visit was compared with initial visit. Kulattha can be used to reduce the recurrence of calcium oxalate stone and it is shown to have a better result than the use of conventional potassium citrate in such patients.

  15. Kinetic versus thermodynamic factors in calcium renal lithiasis.

    Science.gov (United States)

    Grases, F; Costa-Bauzá, A; Königsberger, E; Königsberger, L C

    2000-01-01

    Calcium renal lithiasis formation depends on the balance between thermodynamic (supersaturation) and kinetic (inhibitors, nucleants) factors. In this paper, the importance of both groups was evaluated using (a) the complete urine analysis data obtained from 32 healthy volunteers and 141 active stone-formers, and (b) a comprehensive computer model to calculate the supersaturation values of calcium oxalate monohydrate, hydroxyapatite and brushite in each urine sample. The results of this evaluation were used to assess the possible effectiveness of a given pharmacological treatment.

  16. Calcium renal lithiasis: metabolic diagnosis and medical treatment

    OpenAIRE

    Miguel Angel Arrabal-Polo; Miguel Arrabal-Martin; Juan Garrido-Gomez

    2013-01-01

    Calcium renal lithiasis is a frequent condition that affects the worldwide population and has a high recurrence rate. Different metabolic changes may trigger the onset of calcium stone disorders, such as hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and others. There are also other very prevalent disorders that are associated with calcium calculi, such as arterial hypertension, obesity and loss of bone mineral density. A correct diagnosis needs to be obtained through examinin...

  17. 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.......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....

  18. Determinants of Brushite Stone Formation: A Case-Control Study

    OpenAIRE

    2013-01-01

    PURPOSE: The occurrence of brushite stones has increased during recent years. However, the pathogenic factors driving the development of brushite stones remain unclear. METHODS: Twenty-eight brushite stone formers and 28 age-, sex- and BMI-matched healthy individuals were enrolled in this case-control study. Anthropometric, clinical, 24 h urinary parameters and dietary intake from 7-day weighed food records were assessed. RESULTS: Pure brushite stones were present in 46% of patients, while ca...

  19. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  20. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  1. Microhematuria after renal transplantation in children.

    Science.gov (United States)

    Butani, Lavjay; Berg, Gerre; Makker, Sudesh P

    2002-12-01

    The renal transplant (Tx) recipient is at risk for developing various complications including urolithiasis, the only manifestation of which may be hematuria. However, there are no data on the prevalence of microscopic hematuria in renal Tx recipients. The objective of our study was to determine the prevalence of microhematuria in our pediatric Tx patients and to investigate the causes of microhematuria. Records of all pediatric renal Tx recipients followed at our center from September 1999 to September 2000 were retrospectively reviewed; of the 21 patients, seven (33%) had persistent microscopic hematuria that was first noted 2.9 years post-Tx. Patients with and without hematuria had similar baseline characteristics. Only one patient had pre-existing hematuria that continued post-Tx. The etiology of hematuria in the other six patients was: recurrent IgA nephropathy (one patient), CMV nephritis (one patient), and unexplained (four patients). None had renal calculi or hypercalciuria. Three of the four patients with unexplained hematuria have chronic allograft nephropathy, and the fourth (original disease dysplasia) has hypocomplementemia. At their last follow-up, 5.3 years after onset of hematuria, all patients are alive with stable allograft function. In conclusion, microscopic hematuria is not uncommon in pediatric renal Tx recipients. While causes of post-Tx hematuria are diverse, stones are not commonly seen. Whether chronic allograft nephropathy per se can be implicated as a cause of hematuria remains to be determined. Renal biopsies should be considered at the onset of hematuria if proteinuria and/or deterioration in renal function are seen concomitantly, to look for recurrent or de novo glomerulonephritis.

  2. Definition and Facts for Kidney Stones in Adults

    Science.gov (United States)

    ... their lifetime. 1 Who is more likely to develop kidney stones? Men are more likely to develop kidney stones than women. If you have a ... of kidney stones, you are more likely to develop them. You are also more likely to develop ...

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

    Digital Repository Service at National Institute of Oceanography (India)

    Tripati, S.

    (Maharashtra, India) show naval warfare. The Old Goa stones belong to the Kadambas who ruled Goa from 950–1300 AD. The Eksar stones to the reign of king Bhoja of Malwa in 1020 AD. Similar hero stones with boat motifs of the 18th to 19th centuries AD have been...

  4. Summary of: Salivary stones: symptoms, aetiology, biochemical composition and treatment

    NARCIS (Netherlands)

    Kraaij, S.; Karagozoglu, K.H.; Forouzanfar, T.; Veerman, E.C.I.; Brand, H.S.

    2014-01-01

    Salivary stones, also known as sialoliths, are calcified concrements in the salivary glands. Sialoliths are more frequently located in the submandibular gland (84%), than in the parotid gland (13%). The majority of the submandibular stones are located in Wharton's duct (90%), whereas parotid stones

  5. Salivary stones: symptoms, aetiology, biochemical composition and treatment

    NARCIS (Netherlands)

    Kraaij, S.; Karagozoglu, K.H.; Forouzanfar, T.; Veerman, E.C.I.; Brand, H.S.

    2014-01-01

    Salivary stones, also known as sialoliths, are calcified concrements in the salivary glands. Sialoliths are more frequently located in the submandibular gland (84%), than in the parotid gland (13%). The majority of the submandibular stones are located in Wharton's duct (90%), whereas parotid stones

  6. Big Stone National Wildlife Refuge & Big Stone Wetland Management District: Annual Narrative Report: Calendar year 1998

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Big Stone National Wildlife Refuge summarizes refuge activities during the 1998 calendar year. The report begins with a summary of...

  7. 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.

  8. Honors Education and Stone-Campbell Heritage

    Science.gov (United States)

    Willerton, Chris

    2010-01-01

    In this article, the author explores the Stone-Campbell tradition, which produced the North American Disciples of Christ and Churches of Christ. In this tradition he finds the distinctive combination of three emphases to promote civic virtues in an honors context: (1) the individual pursuit of truth; (2) reliance on Scripture; and (3) the drive…

  9. Honors Education and Stone-Campbell Heritage

    Science.gov (United States)

    Willerton, Chris

    2010-01-01

    In this article, the author explores the Stone-Campbell tradition, which produced the North American Disciples of Christ and Churches of Christ. In this tradition he finds the distinctive combination of three emphases to promote civic virtues in an honors context: (1) the individual pursuit of truth; (2) reliance on Scripture; and (3) the drive…

  10. Sign Plan : Big Stone National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Big Stone NWR Sign Plan explains how signs are used on the Refuge to help guide and educate visitors. An inventory of current signs is given as well as a list of...

  11. 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 sto

  12. Effect of moisture on tuff stone degradation

    NARCIS (Netherlands)

    Lubelli, B.A.; Nijland, T.G.

    2016-01-01

    Tuff stone elements with a large length/width ratio often suffer damage in the form of cracks parallel to the surface and spalling of the outer layer. The response of tuff to moisture might be a reason for this behaviour. This research aimed at verifying if differential dilation between parts with d

  13. 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.

  14. Precious Stone Sparkles in All over Africa

    Institute of Scientific and Technical Information of China (English)

    Bai Yifeng; Wu Wenbin

    2006-01-01

    @@ Baoshi is the name of Precious Stone in Chinese.It is also used as the name of a domestic sewing machine company. Zhejiang Gemsy Sewing Machine Co.,Ltd.(Gemsy) is also called Baoshi Sewing Machine Co.,Ltd.in Chinese.

  15. Microstructural characterization of stone wool fibre network

    DEFF Research Database (Denmark)

    Chapelle, Lucie; Brøndsted, Povl; Kusano, Yukihiro;

    2014-01-01

    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...

  16. Improvement of the stone elimination roller mill

    Institute of Scientific and Technical Information of China (English)

    SunGuofeng

    2005-01-01

    Elimination roller mill as raw materials preparing equipments is universally used in brick making industry. Stone Elimination Roller Mill should have following characteristics: high machine strength and good wearresistant of roller shell, safety reliability, high machinery intensity (impact strength) and rigidity, reliable hermetically sealed construction.

  17. A CASE OF GALL STONE ILEUS

    Directory of Open Access Journals (Sweden)

    Husain M.

    2015-07-01

    Full Text Available Gall stone ileus causing intestinal obstruction is seen in 1 - 4% of cases. [ 1 ] We present a case of 66 years female presenting to us with features of acute intestinal obstruction. Investigations showed the features of cholecystoduodenal fistula with intestinal obstruction secondary to large gallstone in the ileum. We discussed here the presentation and management of patient with gallstone ileus.

  18. Development of fatty acid calcium stone ileus after initiation of human milk fortifier.

    Science.gov (United States)

    Murase, Masahiko; Miyazawa, Tokuo; Taki, Motohiro; Sakurai, Motoichiro; Miura, Fumihiro; Mizuno, Katsumi; Itabashi, Kazuo; Toki, Akira

    2013-02-01

    We report a case who was born with extremely low birth weight infant and had experienced abdominal operation for necrotizing enterocolitis, eventually developed ileus due to fatty acid calcium stones after giving human milk fortifier. He had developed necrotizing enterocolitis on day 30 of his age, such that we performed enterectomy and ileostomy. He could not tolerate enteral feeding fully, because intestinal fistula infection was repeated. Although we administered hindmilk, he grew up slowly and he suffered cholestasis as well. We performed end-to-end anastomosis to prevent fistula infections on day 87. After this operation, breast milk feeding volume was increased easily. However, we started to add HMF of half-strength on day 124, because his body weight gain remained very poor. And we confirmed to intensify the ratio of HMF full-strength on day 128. After that his abdomen had distended on day 131. As there is no effect of conservative therapy to occlusive ileus, we did emergency laparotomy on day 139. Intestinal calculi were impacted at anastomic portion. Although all stones were removed, he died on 144 days due to disseminated intravascular coagulation and renal failure. Calculi analysis revealed that all of them were fatty acid calcium stones. There is no report about like our case. We speculate that the construction of fatty acid calcium result from either high concentration of calcium/phosphorus or rapid increase in the fortification. We could have prevented this case happened by slower increment of fortification.

  19. Melamine-induced renal toxicity is mediated by the gut microbiota.

    Science.gov (United States)

    Zheng, Xiaojiao; Zhao, Aihua; Xie, Guoxiang; Chi, Yi; Zhao, Linjing; Li, Houkai; Wang, Congrong; Bao, Yuqian; Jia, Weiping; Luther, Mike; Su, Mingming; Nicholson, Jeremy K; Jia, Wei

    2013-02-13

    Melamine poisoning has become widely publicized after a recent occurrence of renal injury in infants and children exposed to melamine-tainted milk in China. This renal damage is believed to result from kidney stones formed from melamine and uric acid or from melamine and its cocrystallizing chemical derivative, cyanuric acid. However, the composition of the stones and the mechanism by which the stones are formed in the renal tubules are unknown. We report that cyanuric acid can be produced in the gut by microbial transformation of melamine and serves as an integral component of the kidney stones responsible for melamine-induced renal toxicity in rats. Melamine-induced toxicity in rats was attenuated and melamine excretion increased after antibiotic suppression of gut microbial activity [corrected]. We further demonstrated that melamine is converted to cyanuric acid in vitro by bacteria cultured from normal rat feces; Klebsiella was subsequently identified in fecal samples by 16S ribosomal DNA sequencing. In culture, Klebsiella terrigena was shown to convert melamine to cyanuric acid directly. Rats colonized by K. terrigena showed exacerbated melamine-induced nephrotoxicity. Cyanuric acid was detected in the kidneys of rats administered melamine alone, and the concentration after Klebsiella colonization was increased. These findings suggest that the observed toxicity of melamine may be conditional on the exact composition and metabolic activities of the gut microbiota.

  20. A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

    Directory of Open Access Journals (Sweden)

    Shuichi Abe

    2017-01-01

    Full Text Available Prior literature suggests that ceftriaxone causes formation of gallbladder stones at a relatively high frequency, and when abdominal symptoms occur, prompt investigation of the gallbladder is required with institution of appropriate treatment. Aging, malnutrition, renal impairment, and sepsis are risk factors for pseudolithiasis, and prevention of these is important to suppress gallstone development.

  1. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  2. Distal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  3. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  4. Clear Cell Adenocarcinoma of the Renal Pelvis in a Male Patient

    Directory of Open Access Journals (Sweden)

    Sarawut Kongkarnka

    2013-01-01

    Full Text Available Carcinoma of the renal pelvis is an uncommon renal neoplasm. Clear cell adenocarcinoma in the urinary tract is rare and has a histomorphology resembling that of the female genital tract. We herein present a case of clear cell adenocarcinoma of the renal pelvis, which is the first example in a male patient to our knowledge. A 54-year-old man presented with right flank pain. The tumor was associated with renal stones and hydronephrosis and invaded into the peripelvic fat tissue with regional lymph node metastasis. The patient died of metastatic disease six months postoperatively. Histologically, the tumor showed complex papillary architecture lined with clear and hobnail cells. Clear cell adenocarcinoma of the renal pelvis may pose a diagnostic challenge on histological grounds, particularly in the distinction from renal cell carcinoma. The immunohistochemical stains could help confirm the diagnosis. Due to its rarity, an effective treatment regimen remains to be determined.

  5. Renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  6. Herbal medicines for urinary stone treatment. A systematic review

    Directory of Open Access Journals (Sweden)

    Elena Monti

    2016-03-01

    = 4.12, P < 0.0001; I2 = 0% and size reduction (mean difference: DP preparation, 4.93 mm lower; 95% CI: -9.18 to -0.67; Z = 2.27, P = 0.02; I2 = 99% of renal and ureteral stones after 3 months of therapy. No significant differences in the inter-arm variation of excretion rates of urinary calcium or urate were found as result of the pooled phytotherapy- placebo comparison. Herbal remedies were in general devoid of side effects and in few cases citrate appeared to induce GI disturbances in a higher fraction of patients. Most reports did not provide inferential data concerning AE, and meta-analysis was not feasible. Conclusions: Citrate is more effective than phytotherapy in decreasing the size of existing calculi in the urinary tract and in decreasing the urinary excretion rate of uric acid. A preparation containing Didymocarpus pedicellata combined with other herbal agents induces stone size reduction and clearance significantly better than placebo. Mayor limitations in the applicability of these results are the low quality of the evidence and the multiple sources of bias assessed in the studies included in the present review.

  7. Modern concepts in the management of biliary stones (gallstones).

    Science.gov (United States)

    Bhattacharyya, M

    2001-06-01

    Biliary stones or gallstones are concretions formed anywhere in the biliary tree. Asymptomatic gall bladder stones do not need treatment except the conditions mentioned in this article. Symptomatic uncomplicated gall bladder stones may be treated by laparoscopic or open cholecystectomy or by non-surgical methods. Symptomatic complicated gall bladder stones need cholecystectomy or percutaneous cholecystolithotomy. Common bile duct stones once detected should always be removed and only in difficult cases drainage operations should be done. Treatment of some special conditions arising in gallstone disease has been discussed. Prevention of gallstones is in the experimental stage.

  8. A child with a large bladder stone: A case report

    Directory of Open Access Journals (Sweden)

    Hulya Ozturk

    2014-07-01

    Full Text Available Bladder stones account for approximately 5% of all urinary system stones and are prevalent among children living in poor or rural regions. The symptoms and findings in children with bladder stones are usually urgency, frequency, incontinence, dysuria, pyuria, difficulty voiding, and fever, small caliber of urinary stream, lower abdominal pain and urinary intermittency. Most bladder stones are composed of calcium oxalate, followed by calcium phosphate, and they are usually larger than 2.5 cm in diameter. We present a case of a larger-than 2.5-cm bladder stone in a child.

  9. 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

  10. Renale Osteopathie

    Directory of Open Access Journals (Sweden)

    Horn S

    2001-01-01

    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  11. Renal disease in pregnancy.

    Science.gov (United States)

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  12. Prevention Of Chronic Renal Diseases

    Directory of Open Access Journals (Sweden)

    Fejzi Alushi

    2011-10-01

    Full Text Available It is easier to prevent a disease than to cure it. This postulate is a foundation stone of the contemporary medicine, furthermore its mission. The Chronic Kidney Diseases (CKD, amongst them the Chronic Pyelonephrites (CP and the mass kidney reduction  take an important  place in human pathologies in general, and in particular in renal ones. The Chronic Pyelonephrites  are chronic renal pathologies, which on one side are of various causes and on the other side are multi systemic. At the same time they tend, earlier or later, depending on their course, to bring the patient towards the Chronic Kidney Insufficiency  in stage of uremia, consequently in need of substitution therapies e.g. dialysis, peritoneum dialysis or transplant. It is worthy to emphasize that from the prevention and correct cure of CP make profit the patients, the family, the state and in the last analyses  the entire society, because in that way the budget expense destined for the fore going substitution cures, dialysis, peritoneum dialysis or transplant, is considerably  reduced. The same should be mentioned  in relation to the CP and the mass kidney reduction, speaking about our country, which are still at the first place as the very cause of Chronic Kidney  Insufficiencies (CRI, later on advancing toward uremia and terminal uremia along with its grave consequences. In general  the very foundation of the CP is on  the  infections of urinary roads, in particular on the complicated ones, among them it should be mentioned-congenital kidney anomalies, renal calculosis  so much present in our country, and pathologies of segment or vesical-ureteral reflux, and rarely the pathologies of prostate.

  13. Sepsis complicated by brain abscess following ESWL of a caliceal kidney stone: a case report

    Science.gov (United States)

    Capitanini, Alessandro; Rosso, Luca; Giannecchini, Laura; Meniconi, Ophelia; Cupisti, Adamasco

    2016-01-01

    ABSTRACT A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL) of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU). Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT). Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred. The patient was then discharged but three day later the patient returned to the hospital to seek treatment for left facial hemiparesis and hypotonia of his left arm. The brain computed tomography showed a wide abscess (55×75mm) in the frontal right parietal region. A neurosurgical intervention was then performed and the culture of the drained material resulted positive for Escherichia coli. The guidelines of European and American Associations of Urology do not suggest a prophylactic antibiotic therapy for pre-ESWL (except in the presence of risk factors). The serious complication that occurred in the described low risk patient raises the question of whether routine culture and/or antibiotic prophylaxis, is appropriate. PMID:27583356

  14. Sepsis complicated by brain abscess following ESWL of a caliceal kidney stone: a case report

    Directory of Open Access Journals (Sweden)

    Alessandro Capitanini

    Full Text Available ABSTRACT A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU. Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT. Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred. The patient was then discharged but three day later the patient returned to the hospital to seek treatment for left facial hemiparesis and hypotonia of his left arm. The brain computed tomography showed a wide abscess (55×75mm in the frontal right parietal region. A neurosurgical intervention was then performed and the culture of the drained material resulted positive for Escherichia coli. The guidelines of European and American Associations of Urology do not suggest a prophylactic antibiotic therapy for pre-ESWL (except in the presence of risk factors. The serious complication that occurred in the described low risk patient raises the question of whether routine culture and/or antibiotic prophylaxis, is appropriate.

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

    Directory of Open Access Journals (Sweden)

    Francisco R. Spivacow

    2016-12-01

    Full Text Available 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.

  16. Environmental factors of urinary stones mineralogy, Khouzestan Province, Iran

    Science.gov (United States)

    Zarasvandi, Alireza; Carranza, E. J. M.; Heidari, Majid; Mousapour, Esmaeil

    2014-09-01

    Urinary stone diseases in the Khouzestan province (southwest Iran) are growing in number and it required extensive studies on various factors of the urinary stones formation in this province. In this research, in addition to distribution of urinary stones in different areas of province, the role of bioenvironmental (race), climate (temperature) and geology (water hardness) factors in urinary stones diversity has been studied. Mineralogical studied using X-ray diffraction showed that uricite and whewellite are the most frequency mineral phases. Struvite, Cystine, hydroxyapatite, weddellite, and Niahite can be observed as urinary stones, too. These data show that the urinary stone in the Khouzestan province can divide into 7 groups: calcium oxalate, phosphate, calcium oxalate/ phosphate, Urate, Urate/calcium, Urate/calcium oxalate/phosphate, Cystine/calcium oxalate. Also the results which attained from temperature effect investigation on the mineralogy of urinary stones, confirms that from Mediterranean sub-humid climates (northeastern area) to warm and dry climates (south and southwest area), calcium oxalate stones and urate stones concentration decreases and increases respectively. Comparison of data related to the drinking water hardness and mineralogy of urinary stones in different areas of Khouzestan province show that the combination of drinking water (especially water hardness) affects mineralogy of urinary stones in some areas (such az Ramhormoz and Hendijan). Finally, the data suggest that frequency of calcium oxalate in women is more than that of men. Moreover, there is direct relationship between the age (>45 years) and the increase in frequency of Urate minerals.

  17. Quantificação do stone clinic effect em pacientes com nefrolitíase Quantification of the stone clinic effect in patients with nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Maurício Carvalho

    2004-01-01

    Full Text Available O termo stone clinic effect refere-se ao efeito do aumento da ingestão hídrica e aconselhamento dietético na evolução clínica da doença calculosa renal. OBJETIVO: O nosso objetivo foi quantificar esta variável em pacientes portadores de nefrolitíase. MÉTODOS: Vinte e cinco pacientes (11 mulheres e 14 homens; 47,64±10,55 anos com nefrolitíase recorrente foram acompanhados com consultas trimestrais por um ano. Orientações sobre aumento da ingestão hídrica, diminuição do consumo de sal e proteína foram rotineiramente fornecidas. Nenhum paciente foi submetido à terapia farmacológica. Foram coletados no início (S1 e no final do seguimento (S2 os seguintes parâmetros: atividade clínica e radiológica da doença litiásica, urina de 24 horas com dosagem de creatinina, cálcio, sódio, ácido úrico, citrato, oxalato e magnésio. A supersaturação (SS para o oxalato de cálcio foi calculada pelo índice de Tiselius. RESULTADOS: Onze (44% pacientes apresentaram hipocitratúria, nove (36% hipercalciúria e cinco (20% hiperuricosúria. Houve aumento do volume urinário (1903±811 vs 2381±919 ml/dia, pBACKGROUND: The ''stone clinic effect'' refers to the effect of encouraging a high intake of fluid and diet counseling in the clinical evolution of kidney stone disease. Objective: Our objective was to determine the extent of this variable in patients with nephrolithiasis. METHODS: Twenty-five patients (11 female and 14 male; 47.64±10.55 years old with recurrent nephrolithiasis were prospectively followed for one year, with 3-month interval medical evaluation. Patients were advised to increase the fluid intake, and to limit the intake of salt and protein. No patient was submitted to pharmacological therapy. Two 24-hour urine samples were collected at baseline (S1 and in the end of follow-up (S2 for the measurement of creatinine, calcium, sodium, uric acid, citrate, oxalate and magnesium. Metabolic and radiological activity was also

  18. 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...... occurs, stones sink in the soil. Mechanisms of liquefaction and sinking are described, and practical guidelines are recommended.......The paper describes the results of an experimental study on the behavior of cover stones on a liquefiable soil bed exposed to a progressive wave. The soil was silt with d50=0.098mm. Stones, the size of 4cm, were used as cover material. The effect of packing density of stones, and that of number...

  19. 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.

  20. POTENTIAL OF MEDICINAL PLANTS IN KIDNEY, GALL AND URINARY STONES

    Directory of Open Access Journals (Sweden)

    Choubey Ankur

    2010-06-01

    Full Text Available 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.

  1. Composition of common bile duct stones in Chinese patients during and after endoscopic sphincterotomy

    Institute of Scientific and Technical Information of China (English)

    Wei-Lun Tsai; Kwok-Hung Lai; Chiun-Ku Lin; Hoi-Hung Chan; Ching-Chu Lo; Ping-I Hsu; Wen-Chi Chen; Jin-Shiung Cheng; Gin-Ho Lo

    2005-01-01

    AIM: Endoscopic sphincterotomy (ES) is a well-established therapeutic modality for the removal of common bile duct (CBD) stones. After ES there are still around 10% of patients that experience recurrent CBD stones. The aim of this study is to investigate the composition of CBD stones before and after ES and its clinical significance in Chinese patients.METHODS: From January 1996 to December 2003, 735Veterans General Hospital and stone specimens from 266patients were sent for analysis. Seventy-five patients had recurrent CBD stones and stone specimens from 44patients were sent for analysis. The composition of the stones was analyzed by infrared (IR) spectrometry and they were classified as cholesterol or bilirubinate stones according to the predominant composition. Clinical data were analyzed.RESULTS: In the initial 266 stone samples, 217 (82%)were bilirubinate stones, 42 (16%) were cholesterol stones,3 were calcium carbonate stones, 4 were mixed cholesterol and bilirubinate stones. Patients with bilirubinate stones were significantly older than patients with cholesterol stones (66±13 years vs 56±17 years, P= 0.001). In the 44 recurrent stone samples, 38 (86%) were bilirubinate stones, 3 (7%) were cholesterol stones, and 3 were mixed cholesterol and bilirubinate stones. In 27 patients, bothinitial and recurrent stone specimens can be obtained,23 patients had bilirubinate stones initially and 2 became cholesterol stones in the recurrent attack. In the four patients with initial cholesterol stones, three patients had bilirubinate stones and one patient had a cholesterol stone in the recurrent attack.CONCLUSION: Bilirubinate stone is the predominant composition of initial or recurrent CBD stone in Chinese patients. The composition of CBD stones may be different from initial stones after ES.

  2. 超声引导建立经皮肾镜通道处理肾盏结石的技巧%B-ultrasonography-guided percutaneous nephrolithotomy for treatment of renal caliceal calculi

    Institute of Scientific and Technical Information of China (English)

    湛海伦; 周祥福; 杨飞; 陆敏华; 卢杨柏; 黄洁夫

    2011-01-01

    Objective: To summarize the skills in establishment of work tract for percutaneous nephrolithotomy under the guidance of B-ultrasonography for patients with renal caliceal calculi. Methods: Data of 78 cases of renal caliceal calculi, underwent percutaneous nephrolithotripsy under the guidance of B-ultrasonography from May 2006 to October 2010 were retrospectively analyzed. The number and location of percutaneous track, operative time, in-traoperative blood loss, and stone-free rate were analyzed. Results; All operations were successful without serious complications. Single, dual and trial tract were established in 58, 15 and 5 cases, respectively, with most tracts through the middle calyx. The stone-free rate was 92. 3%. The mean operative time was 45 - 180 min, and the in-traoperative blood loss was 80 ~ 350 ml. Conclusions; Improved efficacy and fewer complications in percutaneous nephrolithotomy come with the familiarity of anatomy of renal calices and the location of renal calculus, sufficient operative plan of optimal percutaneous track, and the skilled application of B-ultrasonography.%目的:总结B超引导建立经皮肾镜通道处理肾盏结石的技巧.方法:收集2006年5月-2010年10月行B超引导经皮肾镜钬激光碎石取石术的78例肾盏结石患者的手术资料,观察穿刺通道位置及数目、手术时间、术中失血量和结石清除率.结果:全部手术均获成功,其中单通道取石58例,双通道15例,三通道5例,并以穿刺肾后组中盏为主,结石清除率92.3%.手术时间45~180 min,中位时间75 min;出血80~350 ml,中位出血量110ml.无严重并发症发生.结论:熟悉肾盏结构和结石的相对位置关系、术前拟定最佳经皮肾穿刺通道、术中注重B超操作技巧可提高经皮肾镜处理肾盏结石疗效,降低并发症的发生率.

  3. 连续个性化追踪对农民工新生儿遗传性肾小球疾病肾功能恢复的影响%Influence of Continuous Personalized Tracking on Renal Function Recovery of Migrant Workers' Newborns with Hereditary Glomerular Diseases

    Institute of Scientific and Technical Information of China (English)

    黄笑群; 宋敏; 于生友; 于力

    2016-01-01

    Objective To evaluate the effect of continuous personalized tracking on renal function recovery of migrant workers' newborns with hereditary glomerular diseases. Methods Migrant worker parents of 76 newborns with hereditary glomerular diseases were divided into two groups equally. The control group accepted conventional telephone interviews and regular back-to-hospital reviews, while the observation group accepted continuous personalized tracking given by the responsible nurse for extended care service. Results Six months after discharge, the Cys C, Urea and SCR levels of observation were significantly lower than those of control group, and parents' awareness rate of health education and satisfaction degree to extended care service were significantly higher than those of control group (P<0.01). Conclusions Continuous personalized tracking can improve parents' compliance, nurses' behaviors and parents' satisfaction degree, which has a positive impact on renal function recovery of newborns.%目的:探讨连续个性化追踪对农民工新生儿遗传性肾小球疾病肾功能恢复的效果。方法将76例农民工新生儿遗传性肾小球疾病患儿及其家长均分为两组,对照组进行常规电话回访及定期来院复查,观察组由责任护士以连续个性化追踪形式进行延续护理服务。结果6个月后,观察组患儿的Cys C、 Urea、 SCR水平显著低于对照组,观察组家长对健康教育内容的知晓率、对延续护理服务的满意度均显著高于对照组,差异均有显著统计学意义(P<0.01)。结论连续个性化追踪可以提高家长依从性、护士执行力及家长满意度,有利于患儿肾功能的恢复。

  4. Kidney stones in primary hyperoxaluria: new lessons learnt.

    Directory of Open Access Journals (Sweden)

    Dorrit E Jacob

    Full Text Available 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.

  5. Direct pelvic access percutaneous nephrolithotomy in management of ectopic kidney stone: a case report and literature review.

    Science.gov (United States)

    Mehmet, Rifaioglu Murat; Rustu, Yalcinkaya Fatih; Hanefi, Bayarogullari; Mursel, Davarci; Fusun, Aydogan; Mehmet, Inci

    2013-01-01

    Percutaneous nephrolithotomy (PNL) is an effective procedure for the treatment of patients with large or complex stones. PNL is challenging in anomalous kidneys, certain patients, such as those with renal ectopia. It is unable to undergo PNL in conventional technique safely in these cases. We presented a case report of laparoscopic-assisted PNL via direct pelvic puncture in a pelvic kidney stone and discussed previous published literature. A 49-year-old man presented with right lower quadrant pain and hematuria. Intravenous pyelography and three-dimensional computerized tomography revealed an opaque 2.7 × 1.7 cm pelvis renalis stone in a right side ectopic pelvic kidney with grade III hydronephrosis. Laparoscopic-assisted tubeless PNL was performed to remove the calculus. Laparoscopic-assisted PNL as a minimally invasive therapy in ectopic kidney has many advantages. Our case showed that, in pelvic ectopic kidney with pelvic stones greater than 1.5 cm in size, laparoscopic-assisted PNL via direct pelvis puncture is a safe and effective technique.

  6. Pitfalls and Limitations of Radionuclide Renal Imaging in Adults.

    Science.gov (United States)

    Keramida, Georgia; James, Jacqueline M; Prescott, Mary C; Peters, Adrien Michael

    2015-09-01

    To understand pitfalls and limitations in adult renography, it is necessary to understand firstly the physiology of the kidney, especially the magnitude and control of renal blood flow, glomerular filtration rate and tubular fluid flow rate, and secondly the pharmacokinetics and renal handling of the three most often used tracers, Tc-99m-mercaptoacetyltriglycine (MAG3), Tc-99m-diethylene triamine pentaacetic acid (DTPA) and Tc-99m-dimercaptosuccinic acid (DMSA). The kidneys may be imaged dynamically with Tc-99m-MAG3 or Tc-99m-DTPA, with or without diuretic challenge, or by static imaging with Tc-99m-DMSA. Protocols are different according to whether the kidney is native or transplanted. Quantitative analysis of dynamic data includes measurement of renal vascularity (important for the transplanted kidney), absolute tracer clearance rates, differential renal function (DRF) and response to diuretic challenge. Static image reveals functional renal parenchymal damage, both focal and global, is useful in the clinical management of obstructive uropathy, renal stone disease and hypertension (under angiotensin converting enzyme inhibition), and is the preferred technique for determining DRF. Diagnosis based on morphological appearances is important in transplant management. Even though nuclear medicine is now in the era of hybrid imaging, renal imaging remains an important subspecialty in nuclear medicine and requires a sound basing in applied physiology, the classical supporting discipline of nuclear medicine.

  7. The effectiveness of the treatment of kidney stones by the technique of the soft stone of the ureter and the stone of the percutaneous%经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的有效性

    Institute of Scientific and Technical Information of China (English)

    李胜武

    2016-01-01

    目的:探讨经输尿管软镜取石术(FUL)与经皮肾镜取石术(PNL)对肾结石患者治疗的有效性。方法:收治肾结石患者75例,分两组,FUL组37例行经输尿管软镜取石术,PNL组38例行经皮肾镜取石术,对两组清石率、住院时间、并发症等比较分析。结果:清石率方面PNL组(94.74%)高于FUL组(83.78%),住院时间、并发症等方面,FUL组少于PNL组(P<0.05)。结论:经输尿管软镜取石术清石率虽不及经皮肾镜取石术,但并发症少、住院时间短,安全性高。%Objective:To evaluate the effectiveness of the treatment of patients with renal calculi by percutaneous lithotripsy(FUL) and percutaneous renal stone removal(PNL).Methods:75 patients with renal calculus were selected.They were divided into two groups.FUL group with 37 cases were treated by ureter soft mirror.PNL group with 38 cases were treated by percutaneous renal stone surgery.The two groups of stone rate,hospital stay,complications,and so on were compared.Results:The stone rate of the PNL group(94.74%)was higher than that of group FUL(83.78%).The hospital stay,complications of the FUL group were less than PNL group(P<0.05).Conclusion:Through flexible ureteroscope lithotripsy stone clearance rate is inferior to percutaneous nephrolithotomy,but with fewer complications,shorter hospitalization time,and high safety.

  8. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  9. Report of an unusual renal mass:Primary renal lympho-ma---Difficult procedure for laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Seyedeh Atefeh Emadi; Marzieh Akbarpour; Shahram Azhdari

    2008-01-01

    Lymphomas form a heterogenous group of clonal(neoplastic)diseases.Primary renal lymphoma(PRL)is rare. Diagnosis of primary renal lymphoma is important for the patients to receive appropriate therapy.Laparoscopic nephrectomy should be the standard procedure in most cases of both malignant and benign,renal tumors with the possible exception of tumor >10cm.Probably this case report of laparoscopic surgery of primary renal lym-phoma is the first report of this kind and may be useful for the other laparoscopic surgeons.A 53 years-old man with unilateral primary renal lymphoma who had a history of renal colic and ESWL(Extracorporeal Shock Wave Lithotripsy)of the left kidney stone 3 years ago,he underwent laparoscopic radical left nephrectomy and chem-otherapy.The patient was monitored for follow up for 4 months and had a significant improvement.Although treatment of lymphoma is now guided by phenotype of tumor,we found that appropriate treatment is possible af-ter radical nephrectomy and assessment of pathology.Renal lesions may compeletly regress by appropriate treatment.There was not any report of laparoscopic surgery of PRL in our literature.We are reporting the first case of successful laparoscopic surgery of PRL successfully.

  10. Biologically active substances of stone crop fruits

    Directory of Open Access Journals (Sweden)

    Margarita Makarkina

    2014-04-01

    Full Text Available Stone fruit crops are successfully cultivated in many regions of Russia. Their fruits contain a great diversity of biologically active and mineral substances. The stone fruit varietal collection of the All Russia Research Institute of Fruit Crop Breeding has been estimated on the content of biologically active substances (ascorbic acid and phenolic compounds in fruits: 80 sour cherry varieties, 28 sweet cherry varieties, 29 plum varieties and 24 apricot varieties. High cultivar variability of the content of ascorbic acid and P-active sub-stances in fruits has been determined in each crop. The best genotypes have been singled out according to each biochemical component and a complex of characters.

  11. 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

  12. Tracking Porters

    DEFF Research Database (Denmark)

    Bruun, Maja Hojer; Krause-Jensen, Jakob; Saltofte, Margit

    2015-01-01

    Anthropology attempts to gain insight into people's experiential life-worlds through long-term fieldwork. The quality of anthropological knowledge production, however, does not depend solely on the duration of the stay in the field, but also on a particular way of seeing social situations. The an...... the students followed the work of a group of porters. Drawing on anthropological concepts and research strategies the students gained crucial insights about the potential effects of using tracking technologies in the hospital....

  13. TRANSPLANTE RENAL

    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  14. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  15. Traumatismo renal

    OpenAIRE

    Rocha, Sofia Rosa Moura Gomes da

    2009-01-01

    Introdução: A realização deste trabalho visa a elaboração de uma revisão sistematizada subordinada à temática da traumatologia renal. Objectivos: Os principais objectivos deste trabalho são: apurar a etiologia, definir a classificação, analisar o diagnóstico e expôr o tratamento e as complicações. Desenvolvimento: Os traumatismos são a principal causa de morte antes dos 40 anos. O rim é o órgão do aparelho génito-urinário mais frequentemente atingido. Os traumatismos renais são mais fre...

  16. Spontaneous rupture of renal pelvis as a rare complication of ureteral lithiasis.

    Science.gov (United States)

    Porfyris, Orestis; Apostolidi, Elena; Mpampali, Andromachi; Kalomoiris, Paraskevas

    2016-03-01

    Spontaneous rupture of renal pelvis with urine extravasation is a rare condition and usually associated with obstructing ureteric calculus. It poses diagnostic and therapeutic dilemmas, while a stepwise approach for the confirmation of diagnosis, treatment and follow up is needed. We present a case of a 75-year old male patient who had a renal pelvis rupture with perirenal extravasation of urine due to a 4 mm stone located at the right ureterovesical junction. Diagnosis was confirmed by computed tomography, while the patient was treated successfully with the placement of a percutaneous nephrostomy. A week later a CT- nephrostomography showed the healing of renal pelvis with no extravasation and no evidence of the obstructing stone.

  17. Papillary and Nonpapillary Calcium Oxalate Monohydrate Renal Calculi: Comparative Study of Etiologic Factors

    Directory of Open Access Journals (Sweden)

    Enrique Pieras

    2006-01-01

    Full Text Available Calcium oxalate monohydrate (COM renal calculi can be classified into two groups: papillary and nonpapillary. In this paper, a comparative study between etiologic factors of COM papillary and nonpapillary calculi is performed. The study included 40 patients with COM renal calculi. The urine of these individuals was analyzed. Case history, lifestyle, and dietetic habits were obtained.No significant differences between urinary biochemical data of both groups were observed; 50% of COM papillary stone formers and 40% of COM nonpapillary stone formers had urolithiasis family history. A low consumption of phytate-rich products was observed for both groups. A relationship between profession with occupational exposure to cytotoxic products and COM papillary renal lithiasis was detected.The results suggest that COM papillary calculi would be associated to papillary epithelium alterations together with a crystallization inhibitors deficit, whereas COM nonpapillary calculi would be associated to the presence of heterogeneous nucleants and a crystallization inhibitors deficit.

  18. 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.

  19. Stone tools from locality Crkvine in Stubline

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    Antonović Dragana

    2011-01-01

    Full Text Available Stone artifacts from excavations in Crkvine in 2008. originate from two stratigraphic units, both chronologically defined as the final stage of the Vinča culture: 1. distruction layer above and 2. from the floor of House 1/2008. None of the stone artifact types showed any specific regularity in vertical distribution. However, in the southern part of the Structure/House 1 there is higher abundance in horizontal distribution of both types of tools. Abundance of cores, blades for rejuvenation of the cores and unretouched blades among the chipped artifacts suggest that, most probably, this object was a working place where the artifacts were made (Fig. 9/1. Ground stone artifacts - all rought-out and final products, whole and fragmented pieces, ground-edge and abrasive tools, are equally distributed in the House 1/2008 as well as in the distruction layer above it. Only non-determined fragments and pieces of raw material, both defined as products of making stone tools, are far more numerous in the distruction layer above the House 1/2008. Higher concentrations of finds are situated in the House 1/2008, especially in its southern part, on the floor and above it, while the number of finds out of the House significantly decreases (Fig. 9/2. Such distribution of ground stone artifacts indicates that the production of stone artifacts was done within the household (large number of flakes of „light white stone“, presence of grindstone and whetstone, as well as that there occurred active preparation of food within the Vinča’s objects (querns and pounders within the houses. Findings of numerous quartzite, chert and jasper pebbles out of the House 1/2008, 2 metres away from the northeastern angle of the House (pottery group 1, could not be connected with production of chipped and ground stone artifacts. There are no any traces of treatment and utilization on the pebbles, and the pebbles themselves do not belong to raw material of good quality due to

  20. Experimental investigations on dry stone masonry walls

    OpenAIRE

    2006-01-01

    Brick unreinforced masonry walls have been widely studied both from experimental and numerical point of view, but scarce experimental information is available for dry stone masonry walls that constitute the material more frequently used in the construction of ancient historical constructions. Therefore, the present work aims at increasing the insight about the behavior of typical ancient masonry walls under cyclic loading. To attain such goal, different experimental approaches are consi...

  1. [A case of palatine tonsil stone].

    Science.gov (United States)

    Wedrychowicz, B; Pogorzelski, A

    1993-01-01

    The authors presented a case of big stone of palatine tonsil surgical treated successfully. Qualitative and quantitative examination of tonsillith chemical composition was carried out with a LINK 90 spectrometer. It was found that the main components were calcium (Ca/K alpha), (Ca/K beta) about 60% and phosphorus (P) about 30%. Potassium (K), chlorine (Cl), sulphur (S), aluminum (Al and magnesium (Mg) were found in trace amounts.

  2. Extracorporeal shock-wave lithotripsy of bile duct stones

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kim, Myung Joon; Yoo, Hyung Sik; Suh, Jung Ho; Lee, Moo Sang; Jo, Jang Hwan; Kim, Byung Ro [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    During the past one and half year, we performed ESWL therapy in 13 patients with common bile duct and intrahepatic duct stones, applying Lithostar-R (Siemens co. West Germany) and analyzed their results. In 13 patients, 9 residual common bile duct stones and 7 intrahepatic duct stones were selected postoperatively. The size of stones were ranged from 0.7 cm to 3.5 cm in diameter. 2 stones were multiple and the remained 14 were single in number. The visualization of stones were done with fluoroscopy after the injection of contrast media via cholangiographic T-tube or ERCP. ESWL were applied continuously until stone disintegration was visible, or upto maximum number of 3500 discharge of shock wave. If not disintegrated upto 3500, patients were underwent second or third lithotripsy session with interval of one week. Our results showed that among 9 common bile duct stones, 4 were completely disintegrated and passed out spontaneously, but 3 partially fragmented and removed by the additional procedure. 2 were failed. Among 7 intrahepatic stones, 3 completely and 2 partially were succeeded. One stone partially fragmented were retained without removal and other one were failed. Skin petechia in all patients were revealed on the entry port of shock wave, but no serous complication was not occurred.

  3. Extracorporeal piezoelectric lithotripsy for complicated bile duct stones.

    Science.gov (United States)

    Weber, J; Adamek, H E; Riemann, J F

    1991-02-01

    Today, common bile duct stones are extracted endoscopically. After endoscopic sphincterotomy, nearly 90% of all stones can be removed with a Dormia basket or a mechanical lithotripter. Problems are encountered if there are larger stones or a duct stenosis. New conservative therapies do serve as an alternative to surgical intervention for those few patients in whom endoscopic measures have failed. Stone fragmentation can be achieved by extracorporeal shock wave lithotripsy, and remaining fragments can be removed endoscopically. So far, authors of most reports on the successful disintegration of common bile duct stones used the Dornier lithotripter. Stone localization is thus achieved with x-rays, and the shock waves are generated by an underwater spark discharge. We report on our experiences and results with extracorporeal piezoelectric shock wave lithotripsy (EPL) in 19 patients with complicated bile duct stones. With this lithotripter, stones are visualized by ultrasound, and shock waves are produced by a piezoelectric acoustic generator. Fragmentation was achieved in 84.2%, and complete stone removal in 78.9%. These results show that piezoelectric lithotripsy is also a useful method for the treatment of complicated bile duct stones, as has already been proved for the electrohydraulic- and electromagnetic-generated shock waves systems. However, the renunciation of general anesthesia and the need for analgesia or sedation in only 25% of the treatments render this lithotripter system attractive, especially for elderly and frail patients.

  4. Pneumatic v electrokinetic lithotripsy in treatment of ureteral stones.

    Science.gov (United States)

    Vorreuther, R; Klotz, T; Heidenreich, A; Nayal, W; Engelmann, U

    1998-06-01

    Recently, a new device (Combilith) for electrokinetic lithotripsy (EKL) has become available which is very similar to the well-known device for pneumatic (ballistic) lithotripsy (Swiss Lithoclast). The Lithoclast uses air pressure to push a projectile within the handpiece against the end of a metal probe, which is thereby accelerated and thrown like a jackhammer against the stone. In principle, the same stroking movement of a small metal probe is provided by EKL; the difference is that instead of a projectile, a magnetic core within the handpiece is accelerated by the electromagnetic principle. This paper compares the clinical efficacy and the features of the two devices. Testing the devices on a stone model, taking into account stone propulsion, the systems turned out to equally effective regarding stone disintegration. However, stone displacement was more pronounced with the Lithoclast applied on easily breaking stones. In a second experiment, an optoelectronic movement-measuring apparatus (Zimmer camera) was employed to measure the range and velocity of the movement of the probe tip without any contact. The linear acceleration velocity ranged from 5 to a maximum of 12.5 m/sec with both systems, but the maximum height of the stroke was 2.5 mm with the Lithoclast and 1 mm with EKL. After the initial break-up of soft stones, further impact of the probe tip against the stone resulted merely in propulsion; thus, the greater probe stroke height is the cause of the stone displacement. In a clinical trial, 22 ureteral stones were treated with the Lithoclast and 35 with the EKL. The two devices were equally effective in terms of stone disintegration and safety margin. Fixation using a Dormia basket was necessary in 12 cases (8 Lithoclast, 4 EKL). Although a difference in probe stroke height was noted when comparing pneumatic and electrokinetic lithotripsy, there were no clinically significant differences in the efficacy of stone fragmentation or stone-free rates. At the

  5. Low power laser in the management of ureteral stones.

    Science.gov (United States)

    Tayib, Abdulmalik M

    2010-03-01

    To evaluate the outcome of the low power Holmium-Yag laser in management of ureteral stones, and to report the incidence rate of different types of stones. One hundred and seventy patients underwent ureteroscopy and fragmentation of ureteral stones at the International Medical Center, Jeddah, Kingdom of Saudi Arabia between March 2007 and August 2009. Stones were measured by their largest diameter on CT and classified according to their location from the ureter to the proximal middle and distal ureteral stones. We utilized 8-11 F Semi rigid or 7.5 F flexible ureteroscopes to identify the stones, and all stones were fragmented and evaporated using a 10 watt lower power Holmium-yag laser lithotripter. All stones were completely evaporated and fragmented using the Holmium-yag laser through ureteroscopy. The age of the patients varied between 21-76 years with a mean age of 38.6 years (males 113, and females 57). The largest diameter of the largest stone was 6-12mm (mean 8 mm) and classified according to its location in the ureter into proximal (93 [54.7%]), middle (26 [15.3%]), or distal ureteral stones (51 [30%]). We performed stone analysis in 122 patients (oxalate [n=87], uric acid [n=16], cystine [n=11], and calcium phosphate [n=8]). Laser lithotripsy using low power 10 watt laser lithotripter is safe and effective method for stone evaporation and disintegration, and can be carried out as a day care procedure. The types of stones in Saudi Arabia are same as it has been reported before in the literature.

  6. Can infundibular height predict the clearance of lower pole calyceal stone after extracorporeal shockwave lithotripsy?

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    M. Arzoz-Fabregas

    2009-04-01

    Full Text Available PURPOSE: To evaluate the efficacy of extracorporeal shock wave lithotripsy (SWL on lower calyceal calculi in relation to the renal anatomical factors and determine which of these factors can be used to select patients who will benefit from SWL. MATERIAL AND METHODS: We analyzed retrospectively 78 patients with single radiopaque lower calyceal stones treated with SWL. The patients were evaluated 3 months after lithotripsy with a simple abdominal X-ray and a kidney ultrasound scan. The success of the treatment, removal of all fragments, was correlated with renal anatomical factors measured in the pre-treatment intravenous urography: infundibulopelvic angle, lower infundibulum width, lower infundibulum length, ratio length/width, infundibulum height, and number of minor calyces in the lower calyceal group. RESULTS: Three months after SWL treatment, 39 patients were stone-free (NR group and 39 had residual fragments (R group. Both groups presented no differences in relation to infundibulopelvic angle, width and length of the lower calyceal infundibulum, length/width ratio of the lower infundibulum or number of lower calyces. Height of the infundibulum, described as the distance between the line passing through the lowest part of the calyx containing the calculus and the highest point of the lower lip of renal pelvis, was the only parameter in which significant differences (p = 0.002 were found between the NR and R groups. CONCLUSIONS: Lower Infundibular height could be a good measurement tool for deciding which patients with lower calyceal lithiasis would benefit from SWL treatment. Height of less than 22 mm suggests a good outcome from lithotripsy.

  7. Renal peroxidative changes mediated by oxalate: the protective role of fucoidan.

    Science.gov (United States)

    Veena, Coothan Kandaswamy; Josephine, Anthony; Preetha, Sreenivasan P; Varalakshmi, Palaninathan; Sundarapandiyan, Rajaguru

    2006-10-04

    Oxalate, one of the major constituents of renal stones is known to induce free radicals which damage the renal membrane. Damaged epithelia might act as nidi for stone formation aggravating calcium oxalate precipitation during hyperoxaluria. In the present study, the beneficial effects of fucoidan on oxalate-induced free radical injury were investigated. Male Wistar rats were divided into four groups. Hyperoxaluria was induced in two groups by administration of 0.75% ethylene glycol in drinking water for 28 days and one of them was treated with fucoidan from Fucus vesiculosus at a dose of 5 mg/kg b.wt subcutaneously commencing from the 8th day of induction. A control and drug control (fucoidan alone) was also included in the study. The extent of renal injury in hyperoxaluria was evident from the increased activities of alkaline phosphatase, gamma-glutamyl transferase, beta-glucuronidase, N-acetyl-beta-D-glucosaminidase in urine. There was a positive correlation between plasma malondialdehyde levels and renal membrane damage indicating a striking relation between free radical formation and cellular injury. Increased protein carbonyl and decreased thiols further exemplified the oxidative milieu prevailing during hyperoxaluria. Decreased renal membrane ATPases accentuated the renal membrane damage induced by oxalate. Renal microscopic analysis showed abnormal findings in histology as an evidence of oxalate damage. The above biochemical and histopathological discrepancies were abrogated with fucoidan administration, indicating its protective role in oxalate mediated peroxidative injury.

  8. Evaluation of the effect of triterpenes on urinary risk factors of stone formation in pyridoxine deficient hyperoxaluric rats.

    Science.gov (United States)

    Vidya, Lakshminarasimhan; Lenin, Mahimainathan; Varalakshmi, Palaninathan

    2002-09-01

    Investigations were carried out to evaluate the efficacy of the pentacyclic triterpene, lupeol and its ester, lupeol linoleate, against calcium oxalate urolithiasis in rats. Administration of a pyridoxine deficient diet containing 3% glycollic acid for 21 days led to increased excretion of stone forming constituents such as calcium, oxalate and uric acid. Crystal deposition and subsequent renal tubular damage resulted in increased excretion of the tubular enzymes alkaline phosphatase, lactate dehydrogenase, gamma glutamyl transferase, beta glucuronidase and N-acetyl glucosaminidase along with reduced fibrinolytic enzymes. A reduction in the urinary inhibitory factors magnesium and glycosaminoglycans was also observed. Treatment with lupeol and lupeol linoleate reduced the extent of tubular damage as evidenced from reduced enzymuria and minimized the excretion of stone forming constituents.

  9. 微创经皮肾镜气压弹道碎石术与开放手术治疗复杂肾结石的疗效比较%Comparision of complicated renal stone treatment between tradional operation and MPCNL

    Institute of Scientific and Technical Information of China (English)

    赵亚冰; 庞悦平

    2011-01-01

    目的 比较微创经皮肾镜气压弹道碎石术(MPCNL)与开放手术治疗肾结石的疗效.方法 分析MPCNL和肾切开取石的治疗效果,比较两种术式在手术时间、术中出血量、结石清除率、术后住院时间等方面的差异.结果 开放手术组及MPCNL组平均手术时间、平均出血量、术后住院时间分别为(147±31)min和(299±121)min、(257±135)ml和(163±90)ml、(12.5±2.8)d和(8.2±2.6)d,差异均有统计学意义(P<0.05).结论 MPCNL相比开放手术治疗肾结石更安全、快速、有效,是治疗肾结石的理想方法.%Objective To investigate the therapeutic effect of the minimally invisive percutaneous nephrolithotomy(MPCNL) in the treatment of kidney nephrolithiasis comparing with open surgery. Methods To analyze and compare the therapeutic effect between the operation and MPCNL. The differences in operating time, average bleeding volume during operation, stone clearance, postoperative hospital stay of the two procedures were compared. Results The mean operation time, average bleeding volume during operation, postoperative hospital stay of the PCNL and surgery group were(147±31)min vs (299±121)min, (257±135)ml vs (163±90)ml, and(12.5±2.8)d vs (8.2±2.6)d, respectively.The differences between the two groups were significant(P<0.05). Conclusions MPCNL is an excellent form of treatment for kidney nephrolithiasis. It is more reliable, highly effective, rapid and safe procedure than open surgery.

  10. Introduction: Kidney Stone Research, Lessons From Human Studies

    Science.gov (United States)

    Coe, Fredric L.

    2007-04-01

    About 5% of American women and 12% of men will develop a kidney stone at some time in their life, the prevalence has been rising in both sexes. Approximately 80% of stones are composed of calcium oxalate, and calcium phosphate; 10% of struvite; 9% of uric acid; and the remaining 1% are composed of cystine or ammonium acid urate or are diagnosed as drug-related stone. Stones ultimately arise because of an unwanted phase change of these substances from liquid to solid state. In this introduction, I have outlined our current thinking of the possible mechanisms involved in stone formation based on our biopsy data collected from a series of human kidney stone formers. In addition, I have presented a set of questions as a means of focusing future research in this field.

  11. Raw Materials, Production and Distribution of Xuejiagang Stone Tools

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    Zhuang Lina

    2010-09-01

    Full Text Available The Xuejiagang culture is associated with the latter part of the Neolithic period in southern China. Since the 1970s, we have found many cemeteries associated with this culture, in which stone implements make up an important and significant part of the funerary objects. The perforated stone knife, the yue axe and the adze were especially important. Analysis of the frequency and relationships between raw material, technology and tool types provides a basis for distinguishing between the different production sites associated with the Xuejiagang stone industry. This article discusses the relationship between rock types and stone tools, and between stone artefacts from different production sites. Thin-section analysis was used to identify and characterise stone used for implement manufacture.

  12. 7 CFR 330.301 - Stone and quarry products from certain areas in Canada.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Stone and quarry products from certain areas in Canada...; PLANT PESTS; SOIL, STONE, AND QUARRY PRODUCTS; GARBAGE Movement of Soil, Stone, And Quarry Products § 330.301 Stone and quarry products from certain areas in Canada. Stone and quarry products from...

  13. The incidence and location of prostatic calculi on noncontrast computed tomography images in patients with renal calculi.

    Science.gov (United States)

    Balasar, Mehmet; Poyraz, Necdet; Göğer, Yunus Emre; Unal, Yunus; Pişkin, Mehmet Mesut

    2015-08-01

    In this study, the incidence and location of prostatic calculi on noncontrast abdominal computed tomography (NCACT) images of patients with and without renal stones were investigated. Between 2006 and 2013, NCACT images were taken of 133 patients treated for renal stones (Group I) and of 100 age-matched control patients with putative urinary stone disease (Group II) in our clinic. The incidence and location of prostatic calculi on these images were determined. The location of prostatic calculus was classified as type A if they were located in the main prostatic ducts, and type B if they were located outside the ducts. Prostatic calculi were present in 44.4% of patients in Group I and 21.0% of patients in Group II. The incidence of prostatic calculi was significantly higher in patients with urinary stones compared with those without (Pincidence of prostatic calculi is more prevalent in patients with renal stones. On NCACT images, prostatic calculi were mostly detected in the main prostatic ducts, which were defined as type A.

  14. Biomimetic Randall's plaque as an in vitro model system for studying the role of acidic biopolymers in idiopathic stone formation.

    Science.gov (United States)

    Chidambaram, Archana; Rodriguez, Douglas; Khan, Saeed; Gower, Laurie

    2015-01-01

    Randall's plaque (RP) deposits seem to be consistent among the most common type of kidney stone formers, idiopathic calcium oxalate stone formers. This group forms calcium oxalate renal stones without any systemic symptoms, which contributes to the difficulty of understanding and treating this painful and recurring disease. Thus, the development of an in vitro model system to study idiopathic nephrolithiasis, beginning with RP pathogenesis, can help in identifying how plaques and subsequently stones form. One main theory of RP formation is that calcium phosphate deposits initially form in the basement membrane of the thin loops of Henle, which then fuse and spread into the interstitial tissue, and ultimately make their way across the urothelium, where upon exposure to the urine, the mineralized tissue serves as a nidus for overgrowth with calcium oxalate into a stone. Our group has found that many of the unusual morphologies found in RP and stones, such as concentrically laminated spherulites and mineralized collagenous tissue, can be reproduced in vitro using a polymer-induced liquid precursor (PILP) process, in which acidic polypeptides induce a liquid phase amorphous precursor to the mineral, yielding non-equilibrium crystal morphologies. Given that there are many acidic proteins and polysaccharides present in the renal tissue and urine, we have put forth the hypothesis that the PILP system may be involved in urolithiasis. Therefore, our goal is to develop an in vitro model system of these two stages of composite stone formation to study the role that various acidic macromolecules may play. In our initial experiments presented here, the development of "biomimetic" RP was investigated, which will then serve as a nidus for calcium oxalate overgrowth studies. To mimic the tissue environment, MatriStem(®) (ACell, Inc.), a decellularized porcine urinary bladder matrix was used, because it has both an intact epithelial basement membrane surface and a tunica propria

  15. Genetics Home Reference: renal hypouricemia

    Science.gov (United States)

    ... hypouricemia , they have an increased risk of developing kidney stones (nephrolithiasis) formed from uric acid crystals. These uric acid ... of the mutated gene will develop uric acid kidney stones. Related Information What does it mean if a ...

  16. Dissolution of struvite urinary stones. Experimental studies in vitro.

    Science.gov (United States)

    Griffith, D P; Bragin, S; Musher, D M

    1976-03-01

    Previous studies from our laboratory have shown that struvite crystals form primarily as a result of urease-induced alkalinity and supersaturation. In vitro perfusion of struvite crystals with undersaturated urine caused crystal dissolution. The investigations reported herein demonstrate complete dissolution of human struvite urinary stones during 6 weeks of perfusion in vitro with undersaturated human urine. Human hydroxyapatite stones perfused similarly underwent only slight dissolution. A glycoprotein precipitated as the stones dissolved; the pathogenic significance of the glycoprotein is unknown.

  17. 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

  18. A Single Nucleotide Polymorphism (rs4236480) in TRPV5 Calcium Channel Gene Is Associated with Stone Multiplicity in Calcium Nephrolithiasis Patients.

    Science.gov (United States)

    Khaleel, Anas; Wu, Mei-Shin; Wong, Henry Sung-Ching; Hsu, Yu-Wen; Chou, Yii-Her; Chen, Hsiang-Yin

    2015-01-01

    Nephrolithiasis is characterized by calcification of stones in the kidneys from an unknown cause. Animal models demonstrated the functional roles of the transient receptor potential vanilloid member 5 (TRPV5) gene in calcium renal reabsorption and hypercalciuria. Therefore, TRPV5 was suggested to be involved in calcium homeostasis. However, whether genetic polymorphisms of TRPV5 are associated with kidney stone multiplicity or recurrence is unclear. In this study, 365 Taiwanese kidney-stone patients were recruited. Both biochemical data and DNA samples were collected. Genotyping was performed by a TaqMan allelic discrimination assay. We found that a TRPV5 polymorphism (rs4236480) was observed to be associated with stone multiplicity of calcium nephrolithiasis, as the risk of stone multiplicity was higher in patients with the TT+CT genotype than in patients with the CC genotype (p = 0.0271). In summary, despite the complexity of nephrolithiasis and the potential association of numerous calcium homeostatic absorption/reabsorption factors, TRPV5 plays an important role in the pathogenesis of calcium nephrolithiasis.

  19. A Single Nucleotide Polymorphism (rs4236480 in TRPV5 Calcium Channel Gene Is Associated with Stone Multiplicity in Calcium Nephrolithiasis Patients

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    Anas Khaleel

    2015-01-01

    Full Text Available Nephrolithiasis is characterized by calcification of stones in the kidneys from an unknown cause. Animal models demonstrated the functional roles of the transient receptor potential vanilloid member 5 (TRPV5 gene in calcium renal reabsorption and hypercalciuria. Therefore, TRPV5 was suggested to be involved in calcium homeostasis. However, whether genetic polymorphisms of TRPV5 are associated with kidney stone multiplicity or recurrence is unclear. In this study, 365 Taiwanese kidney-stone patients were recruited. Both biochemical data and DNA samples were collected. Genotyping was performed by a TaqMan allelic discrimination assay. We found that a TRPV5 polymorphism (rs4236480 was observed to be associated with stone multiplicity of calcium nephrolithiasis, as the risk of stone multiplicity was higher in patients with the TT+CT genotype than in patients with the CC genotype (p=0.0271. In summary, despite the complexity of nephrolithiasis and the potential association of numerous calcium homeostatic absorption/reabsorption factors, TRPV5 plays an important role in the pathogenesis of calcium nephrolithiasis.

  20. Can Hounsfield Unit Value Predict Type of Urinary Stones?

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    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