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Sample records for stone clinic effect

  1. Quantificação do stone clinic effect em pacientes com nefrolitíase Quantification of the stone clinic effect in patients with nephrolithiasis

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    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

  2. Clinical effect of anatomical hepatectomy in treatment of intrahepatic bile duct stones

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    WANG Dianbei

    2017-01-01

    Full Text Available ObjectiveTo investigate the clinical effect of anatomical hepatectomy in the treatment of intrahepatic bile duct stones. Methods A retrospective analysis was performed for the clinical data of 117 patients with intrahepatic bile duct stones who underwent hepatectomy in The Affiliated Hospital of Zunyi Medical College from July 2013 to December 2015. Among these patients, 66 underwent anatomical hepatectomy (anatomical hepatectomy group and 51 underwent irregular hepatectomy (irregular hepatectomy group. The time of operation, intraoperative blood loss, volume of drainage on the day after surgery, serum levels of aspartate aminotransferase (AST, alanine aminotransferase (ALT, and total bilirubin (TBil, and length of postoperative hospital stay were recorded, as well as the patients′ general status, liver function parameters, and abdominal ultrasound, and CT or MRI findings from 2 months to 2 years after discharge, to observe the presence or absence of residual stones or stone recurrence. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the irregular hepatectomy group, the anatomical hepatectomy group had a significantly longer time of operation (303.1±51.6 min vs 246.5±36.2 min, t=6.963, P<0.01, but it had significantly less intraoperative blood loss (467.9±80.6 ml vs 565.9±92.0 ml, t=6.026, P<0.01, a significantly lower volume of drainage on the day after surgery (212.6±54.9 ml vs 358.3±69.4 ml, t=12.682, P<0.01, a significantly lower incidence rate of complications (10.6% vs 25.5%, χ2=4.497, P=0.034, a significantly lower rate of postoperative residual stones (4.5% vs 15.7%, χ2=4.192, P=0.041, and a significantly shorter length of hospital stay (13.4±2.6 d vs 21.9±3.2 d, t=15.427, P<001. On day 3 after surgery, the anatomical hepatectomy group had significantly lower serum levels of ALT, AST, and

  3. Developing a stone database for clinical practice.

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    Turney, Benjamin W; Noble, Jeremy G; Reynard, John M

    2011-09-01

    Our objective was to design an intranet-based database to streamline stone patient management and data collection. The system developers used a rapid development approach that removed the need for laborious and unnecessary documentation, instead focusing on producing a rapid prototype that could then be altered iteratively. By using open source development software and website best practice, the development cost was kept very low in comparison with traditional clinical applications. Information about each patient episode can be entered via a user-friendly interface. The bespoke electronic stone database removes the need for handwritten notes, dictation, and typing. From the database, files may be automatically generated for clinic letters, operation notes. and letters to family doctors. These may be printed or e-mailed from the database. Data may be easily exported for audits, coding, and research. Data collection remains central to medical practice, to improve patient safety, to analyze medical and surgical outcomes, and to evaluate emerging treatments. Establishing prospective data collection is crucial to this process. In the current era, we have the opportunity to embrace available technology to facilitate this process. The database template could be modified for use in other clinics. The database that we have designed helps to provide a modern and efficient clinical stone service.

  4. Do Urinary Cystine Parameters Predict Clinical Stone Activity?

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    Friedlander, Justin I; Antonelli, Jodi A; Canvasser, Noah E; Morgan, Monica S C; Mollengarden, Daniel; Best, Sara; Pearle, Margaret S

    2018-02-01

    An accurate urinary predictor of stone recurrence would be clinically advantageous for patients with cystinuria. A proprietary assay (Litholink, Chicago, Illinois) measures cystine capacity as a potentially more reliable estimate of stone forming propensity. The recommended capacity level to prevent stone formation, which is greater than 150 mg/l, has not been directly correlated with clinical stone activity. We investigated the relationship between urinary cystine parameters and clinical stone activity. We prospectively followed 48 patients with cystinuria using 24-hour urine collections and serial imaging, and recorded stone activity. We compared cystine urinary parameters at times of stone activity with those obtained during periods of stone quiescence. We then performed correlation and ROC analysis to evaluate the performance of cystine parameters to predict stone activity. During a median followup of 70.6 months (range 2.2 to 274.6) 85 stone events occurred which could be linked to a recent urine collection. Cystine capacity was significantly greater for quiescent urine than for stone event urine (mean ± SD 48 ± 107 vs -38 ± 163 mg/l, p stone activity (r = -0.29, p r = -0.88, p r = -0.87, p stone quiescence. Decreasing the cutoff to 90 mg/l or greater improved sensitivity to 25.2% while maintaining specificity at 90.9%. Our results suggest that the target for capacity should be lower than previously advised. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Effect of blind treatment on stone disease.

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    Fazil Marickar, Y M; Salim, Abiya; Vijay, Adarsh

    2010-06-01

    Most of the drugs administered to stone patients appear to be inappropriate and doing more harm than good to the patients. The objective of this paper is to identify the prevalence of blind chemotherapy among the stone patients and find out the real indication for the drugs administered. Patients who attended the stone clinic for the first time were interviewed to find out what drugs they had been taking before the attendance at the stone clinic. 350 patients consuming specific drugs relevant to stone formation at least for a period of 15 days were selected for a detailed assessment. The type of drug consumed, the dose, the duration, the side effects, compliance rate and effect on stone disease were assessed. The biochemical profile of the patients was assessed to identify the role of the therapeutic modalities utilised. Conclusions regarding the utility of drugs in the process of stone formation were made. The values were compared with those of patients not on medication and considering laboratory standards. Of the 350 patients studied, 96 patients were consuming potassium citrate in different doses, 50 were consuming allopurinol, 44 cystone, 27 potassium citrate + magnesium, 25 calcury, 24 rowatinex, 21 ayurvedic drugs, 17 dystone, 17 homeopathic medicines and 17 other drugs. The longest duration of compliance was for cystone-2.5 years. All other drugs were stopped by the patients themselves due to recurrence of symptoms. As much as 93% of the patients did not feel that there was any significant relief of symptoms. The side effects which prompted the patients to stop medicine were gastro intestinal upset, particularly with potassium citrate, rowatinex and potassium citrate + magnesium combination. The relevant biochemical changes noted were increased urinary citrate levels in patients consuming potassium citrate alone or in combination with magnesium. Serum uric acid was within normal limits in patients consuming allopurinol. Urine uric acid levels were also

  6. RIRS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and cost-effective analysis in Chinese medical setting.

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    Pan, Jiahua; Chen, Qi; Xue, Wei; Chen, Yonghui; Xia, Lei; Chen, Haige; Huang, Yiran

    2013-02-01

    The aim of the study was to compare the clinical outcome and the cost-effectiveness between retrograde intra renal surgery (RIRS) and mini-percutaneous nephrolithotripsy (mPCNL) for the management of single renal stone of 2-3 cm in Chinese medical setting. From May 2005 to February 2011, 115 patients with solitary renal calculi were treated either by RIRS or mPCNL. 56 patients were in RIRS group while 59 were in mPCNL group. Patients' demographics between the two groups, in terms of gender, age, BMI, history of ESWL as well as stone side, stone location and stone size were comparable. Peri-operative course, clinical outcome, complication rates and medical cost were compared. The effective quotient (EQ) of two groups was calculated. Data were analyzed using Fisher's exact test, Chi-square test and Student's t test. EQ for RIRS and mPCNL were 0.52 and 0.90. The initial stone-free rate (SFR) of RIRS group and mPCNL group was 71.4 and 96.6 %, respectively (P = 0.000). The mean procedure number was 1.18 in RIRS group and 1.03 in mPCNL group, respectively (P = 0.035). The operative time for RIRS was longer (P = 0.000) while the mean hospital stay was shorter (P = 0.000). There was no statistical difference in peri-operative complications between the groups. The initial hospitalization cost, laboratory and radiology test cost of RIRS group were lower (P = 0.000). However, counting the retreatment cost in the two groups, the total medical expenditure including the overall hospitalization cost, overall laboratory and radiology test cost and post-operative out-patient department (OPD) visit cost was similar between two groups. In conclusion, with similar total medical cost, mPCNL achieved faster stone clearance and lower retreatment rate without major complications, which implied higher cost-effectiveness for the treatment of single renal stone of 2-3 cm in Chinese medical setting. RIRS is also a safe and reliable choice for patients having contraindications or

  7. Effect of stone coverage on soil erosion

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    Jomaa, S.; Barry, D. A.; Heng, B. P.; Brovelli, A.; Sander, G. C.; Parlange, J.

    2010-12-01

    Soil surface coverage has a significant impact on water infiltration, runoff and soil erosion yields. In particular, surface stones protect the soils from raindrop detachment, they retard the overland flow therefore decreasing its sediment transport capacity, and they prevent surface sealing. Several physical and environmental factors control to what extent stones on the soil surface modify the erosion rates and the related hydrological response. Among the most important factors are the moisture content of the topsoil, stone size, emplacement, coverage density and soil texture. Owing to the different inter-related processes, there is ambiguity concerning the quantitative effect of stones, and process-based understanding is limited. Experiments were performed (i) to quantify how stone features affect sediment yields, (ii) to understand the local effect of isolated surface stones, that is, the changes of the soil particle size distribution in the vicinity of a stone and (iii) to determine how stones attenuate the development of surface sealing and in turn how this affects the local infiltration rate. A series of experiments using the EPFL 6-m × 2-m erosion flume were conducted at different rainfall intensities (28 and 74 mm h-1) and stone coverage (20 and 40%). The total sediment concentration, the concentration of the individual size classes and the flow discharge were measured. In order to analyze the measurements, the Hairsine and Rose (HR) erosion model was adapted to account for the shielding effect of the stone cover. This was done by suitably adjusting the parameters based on the area not covered by stones. It was found that the modified HR model predictions agreed well with the measured sediment concentrations especially for the long time behavior. Changes in the bulk density of the topsoil due to raindrop-induced compaction with and without stone protection revealed that the stones protect the upper soil surface against the structural seals resulting in

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

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    Krista Deal

    2012-01-01

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

  9. The Cost-Effectiveness of Treatment Modalities for Ureteral Stones

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    Justin Ji-Yuen Siu MD

    2016-10-01

    Full Text Available Additional intervention and medical treatment of complications may follow the primary treatment of a ureteral stone. We investigated the cost of the treatment of ureteral stone(s within 45 days after initial intervention by means of retrospective analysis of the National Health Insurance Research Database of Taiwan. All patients of ages ≥20 years diagnosed with ureteral stone(s( International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-9-CM: 592.1 from January 2001 to December 2011 were enrolled. We included a comorbidity code only if the diagnosis appeared in at least 2 separate claims in a patient’s record. Treatment modalities (code included extracorporeal shock-wave lithotripsy (SWL; 98.51, ureteroscopic lithotripsy (URSL; 56.31, percutaneous nephrolithotripsy (PNL; 55.04, (open ureterolithotomy (56.20, and laparoscopy (ie, laparoscopic ureterolithotomy; 54.21. There were 28 513 patients with ureteral stones (13 848 men and 14 665 women in the randomized sample of 1 million patients. The mean cost was 526.4 ± 724.1 United States Dollar (USD. The costs of treatment were significantly increased in patients with comorbidities. The costs of treatment among each primary treatment modalities were 1212.2 ± 627.3, 1146.7 ± 816.8, 2507.4 ± 1333.5, 1533.3 ± 1137.1, 2566.4 ± 2594.3, and 209.8 ± 473.2 USD in the SWL, URSL, PNL, (open ureterolithotomy, laparoscopy (laparoscopic ureterolithotomy, and conservative treatment group, respectively. In conclusion, URSL was more cost-effective than SWL and PNL as a primary treatment modality for ureteral stone(s when the possible additional costs within 45 days after the initial operation were included in the calculation.

  10. Clinical experience for radiolucent stones; A report of 27 cases

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    Kim, Hyung Jee; Lee, Gil Ho [Dankook University, Seoul (Korea, Republic of)

    1997-02-01

    The cause of radiolucent filling defects in the upper urinary tract are malignant tumor, radiolucent stones, blood clots, air bubbles, congenital deformities of renal parenchyme, and various specific and non-specific infection and their sequence. So the differential diagnosis between malignancy and radiolucent stones is very important, and the exact and fast diagnosis of radiolucent stones is useful in excluding the possibility of malignancy. 27 cases with radiolucent stones were evaluated retrospectively for exact diagnosis and appropriate treatment method. Intravenous urography was done in all cases, and retrograde pyelography, ultrasonography, computed tomography and/or ureterorenoscopy were performed for diagnosis, if needed. Size of stones were measured below 10mm by transverse length in 19 cases (70.4%) with a range of 3 to 30mm. The locations of stones were pelvicalyceal system in 8 cases (29.6%) and ureter in 19 cases (70.4%). Among the diagnostic methods, computed tomography was used most frequency. ESWL with retrograde pyelography was most frequent used method of treatment, also simple hydration to small stone was effective. (author).

  11. Clinical experience for radiolucent stones; A report of 27 cases

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    Kim, Hyung Jee; Lee, Gil Ho

    1997-01-01

    The cause of radiolucent filling defects in the upper urinary tract are malignant tumor, radiolucent stones, blood clots, air bubbles, congenital deformities of renal parenchyme, and various specific and non-specific infection and their sequence. So the differential diagnosis between malignancy and radiolucent stones is very important, and the exact and fast diagnosis of radiolucent stones is useful in excluding the possibility of malignancy. 27 cases with radiolucent stones were evaluated retrospectively for exact diagnosis and appropriate treatment method. Intravenous urography was done in all cases, and retrograde pyelography, ultrasonography, computed tomography and/or ureterorenoscopy were performed for diagnosis, if needed. Size of stones were measured below 10mm by transverse length in 19 cases (70.4%) with a range of 3 to 30mm. The locations of stones were pelvicalyceal system in 8 cases (29.6%) and ureter in 19 cases (70.4%). Among the diagnostic methods, computed tomography was used most frequency. ESWL with retrograde pyelography was most frequent used method of treatment, also simple hydration to small stone was effective. (author)

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

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

    2017-03-01

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

  13. Clinical experience in treatment of complex intrahepatic bile duct stones by regular hepatectomy

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    WU Xiao

    2016-09-01

    Full Text Available Objective To investigate the clinical effect of regular hepatectomy in patients with complex intrahepatic bile duct stones. Methods A retrospective analysis was performed for the clinical data of 98 patients with complex intrahepatic bile duct stones who were treated in our hospital from January to December, 2013. The distribution characteristics of intrahepatic bile duct stones, clinical manifestations, extent of operation, time of operation, complications, and surgical outcome were analyzed. Results All the 98 patients completed regular hepatectomy. Of all patients, 37 underwent choledocholithotomy with T-tube drainage and segmental hepatectomy, 6 underwent resection of the left lateral lobe of the liver, 1 underwent left hemihepatectomy, 7 underwent resection of a single hepatic segment in the right lobe of the liver combined with segmental hepatectomy, 45 underwent combined segmental hepatectomy of the left and right lobes of the liver, and 2 underwent biliary-enteric basin anastomosis after hilar bile duct reconstruction. No patients died during the perioperative period. The mean time of operation was 65.0±5.0 min, and the mean intraoperative blood loss was 83.0±6.2 ml. No patients experienced residual stones after surgery. Of all patients, 5 (5.1% experienced complications, among whom 3 experienced bile leakage and 2 experienced blood exudation on the surface of the wound in the liver; 3 patients were diagnosed with intrahepatic cholangiocarcinoma by postoperative pathological examination. All the patients for followed up for 5 years, and 11 (11.2% experienced recurrence of stones after surgery. Conclusion Regular hepatectomy is safe and effective in the treatment of complex intrahepatic bile duct stones, with few complications and a low recurrence rate of stones. Therefore, it holds promise for wide clinical application.

  14. Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome.

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    Iqbal, Muhammad Waqas; Youssef, Ramy F; Neisius, Andreas; Kuntz, Nicholas; Hanna, Jonathan; Ferrandino, Michael N; Preminger, Glenn M; Lipkin, Michael E

    2016-07-01

    Struvite stones have been associated with significant morbidity and mortality, yet there has not been a report on the medical management of struvite stones in almost 20 years. We report on the contemporary outcomes of the surgical and medical management of struvite stones in a contemporary series. A retrospective review of patients who were treated with percutaneous nephrolithotomy (PCNL) for struvite stones at Duke University Medical Center between January 2005 and September 2012 identified a total of 75 patients. Of these, 43 patients had adequate follow-up and were included in this analysis. Stone activity, defined as either stone recurrence or stone-related events, and predictors of activity were evaluated after combined surgical and medical treatment. The study included 43 patients with either pure (35%) or mixed (65%) struvite stones with a median age of 55±15 years (range 21-89 years). The stone-free rate after PCNL was 42%. Stone recurrence occurred in 23% of patients. Postoperatively, 30% of patients had a stone-related event, while 60% of residual stones remained stable with no growth after a median follow-up of 22 months (range 6-67 mos). Kidney function remained stable during follow-up. Independent predictors of stone activity included the presence of residual stones >0.4 cm(2), preoperative large stone burden (>10 cm(2)), and the presence of medical comorbidities (P<0.05). Struvite stones can be managed safely with PCNL followed by medical therapy. The majority of patients with residual fragments demonstrated no evidence of stone growth on medical therapy. With careful follow-up and medical management, kidney function can be maintained and stone morbidity can be minimized. Initial large stone burden, residual stones after surgery, and associated medical comorbidities may have deleterious effect on stone recurrence or residual stone-related events.

  15. Effectiveness of Treatment Modalities on Kidney Stone Recurrence.

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    Zisman, Anna L

    2017-10-06

    Nephrolithiasis is highly prevalent across all demographic groups in the Western world and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Across the majority of stone types, increased fluid intake and targeted dietary modifications are mainstays of therapy. Specific dietary interventions associated with reduced calcium stone risk include adequate dietary calcium intake and restriction of sodium, protein, and oxalate intake, among others. Pharmaceutical therapy may be required if lifestyle changes are insufficient to minimize risk of stone recurrence, and must be targeted to the specific metabolic abnormalities portending risk for a given patient. Therapeutic options for idiopathic calcium stone disease include thiazides, citrate salts, and uric acid-lowering agents. Alkali salts are also the treatment of choice for uric acid stone disease. Management of struvite stone disease is largely surgical, but acetohydroxamic acid is a proven second line therapy. Cystinuria requires lifestyle modifications and may call for thiol-binding agents. Significant heterogeneity of the clinical population with stone disease has previously limited opportunities for large randomized controlled trials. However, as clinical phenotypes and genotypes are increasingly clarified, there are mounting opportunities for targeted randomized controlled trials in stone prevention. In the meantime, the currently available evidence for both lifestyle and pharmacologic interventions is reviewed herein. Copyright © 2017 by the American Society of Nephrology.

  16. Effect of Stone Size and Composition on Ultrasonic Propulsion Ex Vivo.

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    Janssen, Karmon M; Brand, Timothy C; Bailey, Michael R; Cunitz, Bryan W; Harper, Jonathan D; Sorensen, Mathew D; Dunmire, Barbrina

    2018-01-01

    To evaluate in more detail the effectiveness of a new designed more efficient ultrasonic propulsion for large stones and specific stone compositions in a tissue phantom model. In the first clinical trial of noninvasive ultrasonic propulsion, urinary stones of unknown compositions and sizes up to 10 mm were successfully repositioned. The study included 8- to 12-mm stones of 4 different primary compositions (calcium oxalate monohydrate, ammonium acid urate, calcium phosphate, and struvite) and a renal calyx phantom consisting of a 12 mm × 30 mm well in a 10-cm block of tissue-mimicking material. Primary outcome was the number of times a stone was expelled over 10 attempts, with ultrasonic propulsion burst duration varying from 0.5 seconds to 5 seconds. Overall success rate at expelling stones was 95%. All calcium oxalate monohydrate and ammonium acid urate stones were expelled 100% of the time. The largest stone (12 mm) became lodged within the 12-mm phantom calyx 25% of the time regardless of the burst duration. With the 0.5-second burst, there was insufficient energy to expel the heaviest stone (0.88 g), but there was sufficient energy at the longer burst durations. With a single burst, ultrasonic propulsion successfully moved most stones at least 3 cm and, regardless of size or composition, expelled them from the calyx. Ultrasonic propulsion is limited to the stones smaller than the calyceal space, and for each burst duration, related to maximum stone mass. Published by Elsevier Inc.

  17. Extracorporeal shock wave lithotripsy for gallbladder stones - an experimental and clinical study -

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    Kim, Kun Sang; Park, Sil Moo; Lee, Jung Hyo; Kim, Young Goo; Song, Kounn Sik; Lee, Kwan Seh; Lee, Jong Beum; Kim, Sang Joon; Chang, Sun Taik

    1988-01-01

    Although many alternative treatment technics have been proposed recently for gallstone to substitute cholecystectomy, the extracorporeal shock wave lithotripsy (ESWL) for gallbladder stones has rarely been tried. We have carried out a series of experiments to evaluate how effective the ESWL for gallbladder stones in and how safe this procedure is. At first, in vitro shock were application was carried out to 10 gallbladder stones which were obtained from human gallbladder. Secondly, gallbladder stones were implanted to canine gallbladder and treated with shock wave. Lastly, a total of 41 volunteers with confirmed gallbladder stones were treated with shock wave and combined oral administration of ursodeoxycholic acid. In the in vitro experiment, all of the 10 gallstones were fragmented with variable firing rates and duration. In animal experiment, the implanted stones were successfully fragmented and the organs included in the pathway of shock wave were proved to be intact histologically. In human study, complete disappearance of gallstones was noted in 78.6% of patients with single radiolucent gallbladder stones, smaller than 2.5cm in the longest diameter. Two patients underwent cholecystectomy after ESWL due to sudden colic attack. One patient had experienced an episode of mild transient obstructive jaundice. It may be concluded that the ESWL for gallbladder stones is an effective and safe method of treatment of gallbladder stones in the selected cases, for example, small radiolucent stones, and the further study is needed to establish improved technology of the ESWL for gallbladder stones.

  18. Extracorporeal shock wave lithotripsy for gallbladder stones - an experimental and clinical study -

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Sang; Park, Sil Moo; Lee, Jung Hyo; Kim, Young Goo; Song, Kounn Sik; Lee, Kwan Seh; Lee, Jong Beum; Kim, Sang Joon; Chang, Sun Taik [Chung-Ang University College of Medicine, Seoul (Korea, Republic of)

    1988-08-15

    Although many alternative treatment technics have been proposed recently for gallstone to substitute cholecystectomy, the extracorporeal shock wave lithotripsy (ESWL) for gallbladder stones has rarely been tried. We have carried out a series of experiments to evaluate how effective the ESWL for gallbladder stones in and how safe this procedure is. At first, in vitro shock were application was carried out to 10 gallbladder stones which were obtained from human gallbladder. Secondly, gallbladder stones were implanted to canine gallbladder and treated with shock wave. Lastly, a total of 41 volunteers with confirmed gallbladder stones were treated with shock wave and combined oral administration of ursodeoxycholic acid. In the in vitro experiment, all of the 10 gallstones were fragmented with variable firing rates and duration. In animal experiment, the implanted stones were successfully fragmented and the organs included in the pathway of shock wave were proved to be intact histologically. In human study, complete disappearance of gallstones was noted in 78.6% of patients with single radiolucent gallbladder stones, smaller than 2.5cm in the longest diameter. Two patients underwent cholecystectomy after ESWL due to sudden colic attack. One patient had experienced an episode of mild transient obstructive jaundice. It may be concluded that the ESWL for gallbladder stones is an effective and safe method of treatment of gallbladder stones in the selected cases, for example, small radiolucent stones, and the further study is needed to establish improved technology of the ESWL for gallbladder stones.

  19. 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

  20. Effects of microgravity on renal stone risk assessment

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    Pietrzyk, R. A.; Pak, C. Y. C.; Cintron, N. M.; Whitson, P. A.

    1992-01-01

    Physiologic changes induced during human exposure to the microgravity environment of space may contribute to an increased potential for renal stone formation. Renal stone risk factors obtained 10 days before flight and immediately after return to earth indicated that calcium oxalate and uric acid stone-forming potential was increased after space flights of 4-10 days. These data describe the need for examining renal stone risk during in-flight phases of space missions. Because of limited availability of space and refrigerated storage on spacecraft, effective methods must be developed for collecting urine samples in-flight and for preserving (or storing) them at temperatures and under conditions commensurate with mission constraints.

  1. Study of stone composition changes in melamine-related urinary calculi and its clinical significance.

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    Li, Yuan; Chen, YiRong; Zhang, Wei; Huang, XiaoGang; Li, WenHui; Ru, XiaoRui; Meng, Min; Xi, Xinsheng; Huang, Gang; Shi, BaoGuang; Liu, Gang; Li, WeiHua; Xu, Hui

    2011-08-01

    To investigate the composition changes in melamine-related urinary calculi and their clinical significance. A total of 49 melamine-related urinary calculi were included from 49 children (age 4-82 months, mean 22). The qualitative analysis of stone composition was determined using Fourier transform infrared. The quantitative analysis of the stone computed tomography (CT) attenuation value, stone uric acid level, and stone calcium level were measured using spiral CT, high-performance liquid chromatography, and flame atomic absorption spectrum, respectively. Fourier transform infrared showed that 41 (84%) of the 49 stones contained uric acid and 25 (51%) contained calcium compounds. The data from the qualitative and quantitative analysis were available for 15 stones because of sample consumption in the detection process (Fourier transform infrared, atomic absorption spectrum, and high-performance liquid chromatography). A negative correlation was observed between stone uric acid level and stone calcium level (n = 15, r = -0.629, P = .009). A positive correlation was observed between the stone calcium level and stone CT attenuation value (n = 25, r = 0.855, P = .000). Compared with the ≤1-year-age group and the 1-2-year-age group, the stone calcium level in the >2-year-age group was significantly greater (27.51% ± 12.65% vs 1.60% ± 1.68% or 10.12% ± 8.69%, P = .000 and P = .003, respectively). Compared with the alkalization-alone group, the stone calcium level in the nonalkalization-alone group was significant greater (19.83% ± 7.48% vs 1.25% ± 1.43%, n = 19, P = .000). The stones from children >2 years old were not amenable to medical treatment because they contained greater levels of calcium, which can be demonstrated by the radiologic "positive stone image" or stone CT attenuation value. We believe that surgical invention will be the best choice for such patients if extracorporeal shock wave lithotripsy has failed. Copyright © 2011 Elsevier Inc. All rights

  2. The challenge of cystine and struvite stone formers: clinical, metabolic and surgical assessment

    Science.gov (United States)

    Yamaçake, Kleiton G. R.; Marchini, Giovanni S.; Reis, Sabrina; Danilovic, Alexandre; Vicentini, Fábio C.; Torricelli, Fábio C. M.; Srougi, Miguel; Mazzucchi, Eduardo

    2016-01-01

    ABSTRACT Purpose: To compare the clinical, metabolic, and calculi characteristics of cystine and struvite stone patients after percutaneous nephrolithotripsy (PCNL). Material and Methods: Between January/2006-July/2013, 11 cystine stone patients were treated in our clinic. Of those, 3 were excluded due to incomplete follow-up. Eight cystine stone patients (2 with bilateral disease; 10 renal units-RU) were considered for further analysis. A cohort of 8 struvite stone formers (10RU) was matched having the same age, gender, body mass index (BMI) and Guys stone score. Analyzed parameters comprised demographic data, serum/urinary metabolic evaluation and surgical outcomes. Results: Both groups had 6 female patients. Groups were similar in regards to age, gender, BMI, stone burden, and serum creatinine (p=NS). All patients had PCNL as the first surgical treatment modality. Stone free rate (SFR) after the first PCNL tended to be lower (0%) in the cystine compared to the struvite group (40%)(p=0.08). Final SFR after secondary procedures increased to 70% in cystine and 80% in struvite patients (p=1.0); mean number of procedures to achieve stone free status was higher in the first group (3.57 vs. 2.0;p=0.028). Hypocitraturia was found in all patients, but struvite cases presented with lower mean urinary citrate levels (p=0.016). Other common abnormalities were elevated urinary pH (cystine 75% and struvite 62.5%;p=1.0) and low urinary volume (62.5%,37.5%;p=0.63). Conclusion: Multiple interventions and suboptimal stone free rates are trait of the significant stone burden of struvite and cystine patients. Underlying metabolic abnormalities characterized by increased urinary pH, hypocitraturia and low urinary volume are often encountered in both populations. PMID:27622279

  3. Laser induced fragmentation of salivary stones: an in vitro comparison of two different, clinically approved laser systems.

    Science.gov (United States)

    Siedek, Vanessa; Betz, Christian S; Hecht, Volkmar; Blagova, Radka; Vogeser, Michael; Zengel, Pamela; Berghaus, Alexander; Leunig, Andreas; Sroka, Ronald

    2008-04-01

    Clinical laser lithotripsy in urology promises a good fragmentation combined with a minimal risk of soft tissue damage and low medical complications. This in vitro study investigates the fragmentation of salivary stones by means of two clinically used laser systems. The effects induced by the FREDDY laser (WOM, Germany, lambda = 532 nm/1,064 nm, E(pulse) = 120-160 mJ/pulse) and the Ho:YAG (AURIGA, StarMedTec, Germany, lambda = 2,100 nm, E(pulse) = 300-800 mJ/pulse) on clinical salivary calculi (n = 15) and on salivary gland tissue were investigated using clinical laser parameter settings. All experiments were performed in an under water experimental set-up using flexible fibres (core diameter 230 microm) positioned in front of each specimen. In order to assess fragmentation efficacy, each stone was placed on a grating (rhombic mash-diameter 1-3 mm). The fragmentation rate was calculated with respect to the energy applied (mg/J), to the number of pulses (mg/pulse), and to the time needed (mg/minute). In addition the composition of the stones were analysed spectrographically. The soft tissue interaction on human salivary duct mucosa was examined histologically (HE-staining). Spectrographic composition of the salivary stones showed a two component ratio of protein/carbonate apatite varying between 5/95 and 25/75. Stones treated by the Ho:YAG were vaporised in a milling-like process, while using the FREDDY laser stones are cracked into pieces and fragmentation failed in two cases. The fragmentation rates achieved by the FREDDY laser were greater than those of the Ho:YAG laser, but fragments mainly bigger. A dependency on the composition of the stones could not be found. Laser pulse effects on soft tissue were found slightly beyond the mucosa. This study clearly demonstrated the different processes of destroying salivary stones using two different laser systems. While the Ho:YAG vaporises the calculi in a more milling and soft sense, the FREDDY shows a more cracking and

  4. Effects of Sex on Intra-Individual Variance in Urinary Solutes in Stone-Formers Collected from a Single Clinical Laboratory.

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    Guy M L Perry

    Full Text Available Our work in a rodent model of urinary calcium suggests genetic and gender effects on increased residual variability in urine chemistries. Based on these findings, we hypothesized that sex would similarly be associated with residual variation in human urine solutes. Sex-related effects on residuals might affect the establishment of physiological baselines and error in medical assays.We tested the effects of sex on residual variation in urine chemistry by estimating coefficients of variation (CV for urinary solutes in paired sequential 24-h urines (≤72 hour interval in 6,758 females and 9,024 males aged 16-80 submitted to a clinical laboratory.Females had higher CVs than males for urinary phosphorus overall at the False Discovery Rate (P0.3. Males had higher CVs for citrate (P<0.01 from ages 16-45 and females higher CVs for citrate (P<0.01 from ages 56-80, suggesting effects of an extant oestral cycle on residual variance.Our findings indicate the effects of sex on residual variance of the excretion of urinary solutes including phosphorus and citrate; differences in CV by sex might reflect dietary lability, differences in the fidelity of reporting or genetic differentiation in renal solute consistency. Such an effect could complicate medical analysis by the addition of random error to phenotypic assays. Renal analysis might require explicit incorporation of heterogeneity among factorial effects, and for sex in particular.

  5. Fad diets and their effect on urinary stone formation.

    Science.gov (United States)

    Nouvenne, Antonio; Ticinesi, Andrea; Morelli, Ilaria; Guida, Loredana; Borghi, Loris; Meschi, Tiziana

    2014-09-01

    The influence of unhealthy dietary habits on urinary stone formation has been widely recognized in literature. Dietary advice is indeed the cornerstone prescription for prevention of nephrolithiasis as well. However, only a small amount of medical literature has addressed the influence of popular or fad diets, often self-prescribed for the management of obesity and overweight or for cultural beliefs, on the risk of kidney stones. Thereby in this paper we analyze the current knowledge on the effects of some popular diets on overall lithogenic risk. High-protein diets, like Dukan diet, raise some concerns, since animal proteins are able to increase urinary calcium and to decrease urinary citrate excretion, thus leading to a high overall lithogenic risk. Low-carbohydrate diets, like Atkins diet or zone diet, may have a protective role against kidney stone formation, but there are also evidences stating that this dietary approach may rise calciuria and decrease citraturia, since it is generally associated to a relatively high intake of animal proteins. Vegan diet can be harmful for urinary stone disease, especially for the risk of hyperuricemia and micronutrient deficiencies, even if only few studies have addressed this specific matter. On the other side, the benefits of a lacto-ovo-vegetarian diet on kidney stone prevention have been largely emphasized, provided that the intake of calcium and oxalate is balanced. Traditional Mediterranean diet should exert a protective effect on nephrolithiasis as well, even if specific studies have not been carried out yet. High phytate and antioxidant content of this diet have however demonstrated to be beneficial in preventing the formation of new or recurrent calculi. Anyway, at the current state of knowledge, the most effective dietary approach to prevent kidney stone disease is a mild animal protein restriction, a balanced intake of carbohydrates and fats and a high intake of fruit and vegetables. Other fundamental aspects

  6. Fad diets and their effect on urinary stone formation

    Science.gov (United States)

    Nouvenne, Antonio; Ticinesi, Andrea; Morelli, Ilaria; Guida, Loredana; Meschi, Tiziana

    2014-01-01

    The influence of unhealthy dietary habits on urinary stone formation has been widely recognized in literature. Dietary advice is indeed the cornerstone prescription for prevention of nephrolithiasis as well. However, only a small amount of medical literature has addressed the influence of popular or fad diets, often self-prescribed for the management of obesity and overweight or for cultural beliefs, on the risk of kidney stones. Thereby in this paper we analyze the current knowledge on the effects of some popular diets on overall lithogenic risk. High-protein diets, like Dukan diet, raise some concerns, since animal proteins are able to increase urinary calcium and to decrease urinary citrate excretion, thus leading to a high overall lithogenic risk. Low-carbohydrate diets, like Atkins diet or zone diet, may have a protective role against kidney stone formation, but there are also evidences stating that this dietary approach may rise calciuria and decrease citraturia, since it is generally associated to a relatively high intake of animal proteins. Vegan diet can be harmful for urinary stone disease, especially for the risk of hyperuricemia and micronutrient deficiencies, even if only few studies have addressed this specific matter. On the other side, the benefits of a lacto-ovo-vegetarian diet on kidney stone prevention have been largely emphasized, provided that the intake of calcium and oxalate is balanced. Traditional Mediterranean diet should exert a protective effect on nephrolithiasis as well, even if specific studies have not been carried out yet. High phytate and antioxidant content of this diet have however demonstrated to be beneficial in preventing the formation of new or recurrent calculi. Anyway, at the current state of knowledge, the most effective dietary approach to prevent kidney stone disease is a mild animal protein restriction, a balanced intake of carbohydrates and fats and a high intake of fruit and vegetables. Other fundamental aspects

  7. [Clinical study of influential factors on renal scarring after ESWL monotherapy for renal stone disease].

    Science.gov (United States)

    Ishito, Noritaka; Takamoto, Hitoshi; Kunitomi, Kimito; Satoh, Eiichi; Ishii, Ayano; Shiotuka, Youichi; Sako, Shinichi; Ohta, Naoki; Araki, Tohru

    2002-11-01

    ESWL is now widely used for the treatment of renal stone disease. Although ESWL has many advantages for patients' quality of life, few reports have demonstrated the long-term outcomes of the alterations of renal morphology after ESWL. We reported renal scarring after ESWL monotherapy in patients with renal calyceal stones. In this study, we evaluated a large series of patients' cohort treated at our institution, and assessed the causal effect of ESWL on the late occurrence of renal scar formation. ESWL was performed with EDAP (LT-01,02) that generates shock wave energy by piezoelectric discharge. We analyzed the records of 285 kidneys treated between Dec. 1986 and Nov. 1998. Renal scarring was noted in 44 kidneys and not in 241 kidneys with periodical ultrasonography. We compared the backgrounds of the two groups using chi-square or non-parametric analysis. The Kaplan-Meier method and Cox regression model determined the analysis of renal scar formation. Univariate and multiple regression analysis revealed that the total amount of ESWL emission and hyperuricemia independently affected the probability of renal scar formation. Over-emission of ESWL (over 10,000 shots) must be care for the prevention of renal scarring in patients with renal calyceal calculi, especially when associated with hyperuricemia. After ESWL, periodical checkups with ultrasonography will provide useful information for the clinical diagnosis of renal scarring.

  8. Reservoir effects in a Stone Age fjord on Lolland, Denmark

    DEFF Research Database (Denmark)

    Philippsen, Bente

    2018-01-01

    to be known for accurate radiocarbon dating of samples with possible aquatic carbon sources, such as human bones or food residues on pottery. Therefore, this paper attempts at calculating the local reservoir effect for the study area. I will discuss the possibilities and limitations when analysing radiocarbon...... for building chronologies and for reconstructing the environment of the Stone Age fjord. Finally, I will discuss the pitfalls and uncertainties associated with radiocarbon dates for sea level reconstruction....

  9. Is Tamsulosin Effective after Shock Wave Lithotripsy for Pediatric Renal Stones? A Randomized, Controlled Study.

    Science.gov (United States)

    Shahat, Ahmed; Elderwy, Ahmad; Safwat, Ahmed S; Abdelkawi, Islam F; Reda, Ahmed; Abdelsalam, Yasser; Sayed, Mohamed; Hammouda, Hisham

    2016-04-01

    We assessed the effect of tamsulosin as an adjunctive therapy after shock wave lithotripsy for pediatric single renal pelvic stones. A total of 120 children with a unilateral single renal pelvic stone were included in a prospective randomized, controlled study. All children were randomized to 2 equal groups. Group 1 received tamsulosin (0.01 mg/kg once daily) as adjunctive therapy after shock wave lithotripsy in addition to paracetamol while group 2 received paracetamol only. Stone clearance was defined as no renal stone fragments or fragments less than 3 mm and no pelvicalyceal system dilatation. Our study included 69 boys and 51 girls with a median age of 3.5 years and a median stone size of 1.2 cm. There was no statistically significant difference between groups 1 and 2 in stone or patient criteria. Of the children 99 (82.5%) achieved stone clearance after the first session, including 50 in group 1 and 49 in group 2. All children in each group were cleared of stones after the second session. The overall complication rate was 14.2%. There was no statistically significant difference between single session stone clearance rates (p = 0.81) and complications rates (p = 0.432) in either group. On multivariate analysis using logistic regression smaller stone size (p = 0.016) and radiopaque stones (p = 0.019) were the only predictors of stone clearance at a single shock wave lithotripsy session. Tamsulosin therapy did not affect stone clearance (p = 0.649). Tamsulosin does not seem to improve renal stone clearance. Smaller and radiopaque renal stones have more chance of clearance after shock wave lithotripsy for pediatric single renal pelvic stones. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Evaluating factors that dictate struvite stone composition: A multi-institutional clinical experience from the EDGE Research Consortium

    Science.gov (United States)

    Battison, Andrew; De, Shubha; Humphreys, Mitchell R.; Bader, Markus; Lellig, Ekaterina; Monga, Manoj; Chew, Ben H.; Lange, Dirk

    2018-01-01

    Introduction Struvite stones account for 15% of urinary calculi and are typically associated with urease-producing urinary tract infections and carry significant morbidity. This study aims to characterize struvite stones based on purity of stone composition, bacterial speciation, risk factors, and clinical features. Methods Retrospective data was collected from patients diagnosed with infection stones between 2008 and 2012. Stone analysis, perioperative urine cultures, bacterial speciation, and clinical data were collected and analyzed. The purity of struvite stones was determined. Statistical comparisons were made among homogeneous and heterogeneous struvite stones. Results From the four participating centres, 121 struvite stones were identified. Only 13.2% (16/121) were homogenous struvite. Other components included calcium phosphate (42.1%), calcium oxalate (33.9%), calcium carbonate (27.3%), and uric acid (5.8%). Partial or full staghorn calculi occurred in 23.7% of cases. Urease-producing bacteria were only present in 30% of cases. Proteus, E. coli, and Enterococcus were the most common bacterial isolates from perioperative urine, and percutaneous nephrolithotomy was the most common modality of treatment. Only 40% of patients had a urinalysis that was nitrite-positive, indicating that urinalysis alone is not reliable for diagnosing infection stones. The study’s limitation is its retrospective nature; as such, the optimal timing of cultures with respect to stone analysis or treatment was not always possible, urine cultures were often not congruent with stone cultures in the same patient, and our findings of E. coli commonly cultured does not suggest causation. Conclusions Struvite stones are most often heterogeneous in composition. Proteus remains a common bacterial isolate; however, E. coli and Enterococcus were also frequently identified. This new data provides evidence that patients with struvite stones can have urinary tract pathogens other than urease

  11. Effect of Diuretics on Ureteral Stone Therapy with Extracorporeal Shock Wave Lithotripsy

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    Zomorrodi A

    2008-01-01

    Full Text Available To evaluate the effect of diuretics on ureteral stone fragmentation and clearance during therapy with extra corporeal shock wave lithotripsy (ESWL, we studied 87 patients with ureteral stone at different levels and treated with ESWL. The patients were randomized into two groups treated by standard ESWL; the treatment protocol included 3500 shock wave per patient in each session, energy of the shock in two groups was 13 to 9 kv per patient, and the number of sessions was 3 per patient. The first group included 43 patients who received only ESWL, while the second group of 44 patients received as well 40 mg of furosemide. Stone fragmentation rate was 81% and 93.1% and stone clearance rate was 68.2% and 88.4% for the first and the second groups, respectively. With diuretics, fragmentation was18.8% more in the middle ureteral stones, 16.9% more in the upper tract stones, and 5.4% more in the distal stones. Moreover, clearance of fragmented stones was 38%, 28%, 15.4% more at middle and upper and distal ureteral stone, respectively. We conclude that the stone fragmentation and clearance were higher with ESWL and diuretics than without diuresis. Diuresis is safe and has some advantage at increasing the effect of ESWL on ureteral stones especially the middle ureteral calculi.

  12. Preoperative JJ stent placement in ureteric and renal stone treatment: results from the Clinical Research Office of Endourological Society (CROES) ureteroscopy (URS) Global Study.

    Science.gov (United States)

    Assimos, Dean; Crisci, Alfonso; Culkin, Daniel; Xue, Wei; Roelofs, Anita; Duvdevani, Mordechai; Desai, Mahesh; de la Rosette, Jean

    2016-04-01

    To compare outcomes of ureteric and renal stone treatment with ureteroscopy (URS) in patients with or without the placement of a preoperative JJ stent. The Clinical Research Office of the Endourological Society (CROES) URS Global Study collected prospective data for 1 year on consecutive patients with ureteric or renal stones treated with URS at 114 centres around the world. Patients that had had preoperative JJ stent placement were compared with those that did not. Inverse-probability-weighted regression adjustment (IPWRA) was used to examine the effect of preoperative JJ stent placement on the stone-free rate (SFR), length of hospital stay (LOHS), operative duration, and complications (rate and severity). Of 8 189 patients with ureteric stones, there were 978 (11.9%) and 7 133 patients with and without a preoperative JJ stent, respectively. Of the 1 622 patients with renal stones, 590 (36.4%) had preoperative stenting and 1 002 did not. For renal stone treatment, preoperative stent placement increased the SFR and operative time, and there was a borderline significant decrease in intraoperative complications. For ureteric stone treatment, preoperative stent placement was associated with longer operative duration and decreased LOHS, but there was no difference in the SFR and complications. One major limitation of the study was that the reason for JJ stent placement was not identified preoperatively. The placement of a preoperative JJ stent increases SFRs and decreases complications in patients with renal stones but not in those with ureteric stones. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  13. What can clinical teachers learn from Harry Potter and the Philosopher's Stone?

    Science.gov (United States)

    Conn, Jennifer J

    2002-12-01

    Many clinical teachers acquire a working knowledge of the principles of teaching and learning through observation, by adopting positive and rejecting negative examples of clinical instruction. Well selected vignettes of teaching behaviours taken from contemporary film and literature may provide rich substrate by which to engage clinical teachers in discourse about instructional technique. This paper draws on J K Rowling's novel and its companion film, Harry Potter and the Philosopher's Stone, and critically analyses the teaching styles of the staff at Hogwarts School of Wizardry and Witchcraft in the context of contemporary generic and medical education literature. Specifically, it argues that effective teachers demonstrate not only an in-depth knowledge of their discipline but possess a keen appreciation of the cognitive changes that occur in their students during the learning process. They are, furthermore, proficient in core instructional skills such as small group facilitation, feedback and questioning. Most importantly, effective teachers model appropriate attitudes in their professional setting and possess highly developed personal qualities such as creativity, flexibility and enthusiasm.

  14. Clinical models are inaccurate in predicting bile duct stones in situ for patients with gallbladder.

    Science.gov (United States)

    Topal, B; Fieuws, S; Tomczyk, K; Aerts, R; Van Steenbergen, W; Verslype, C; Penninckx, F

    2009-01-01

    The probability that a patient has common bile duct stones (CBDS) is a key factor in determining diagnostic and treatment strategies. This prospective cohort study evaluated the accuracy of clinical models in predicting CBDS for patients who will undergo cholecystectomy for lithiasis. From October 2005 until September 2006, 335 consecutive patients with symptoms of gallstone disease underwent cholecystectomy. Statistical analysis was performed on prospective patient data obtained at the time of first presentation to the hospital. Demonstrable CBDS at the time of endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography (IOC) was considered the gold standard for the presence of CBDS. Common bile duct stones were demonstrated in 53 patients. For 35 patients, ERCP was performed, with successful stone clearance in 24 of 30 patients who had proven CBDS. In 29 patients, IOC showed CBDS, which were managed successfully via laparoscopic common bile duct exploration, with stone extraction at the time of cholecystectomy. Prospective validation of the existing model for CBDS resulted in a predictive accuracy rate of 73%. The new model showed a predictive accuracy rate of 79%. Clinical models are inaccurate in predicting CBDS in patients with cholelithiasis. Management strategies should be based on the local availability of therapeutic expertise.

  15. The effectiveness of ESWL in the management of lower pole kidney stones

    Directory of Open Access Journals (Sweden)

    Tufan Süelözgen

    2015-03-01

    Full Text Available Objective: The developments in the endourological treatments of urinary system stone diseases led to the discussions about the first choice treatment methods. We have evaluated the results of extracorporeal shock wave treatments being applied in our clinics for the lower pole stones which has the most of the those discussions. Methods: The records of 271 stone patients who were applied ESWL according to CT results between January 2013 and July 2013 to our clinics were examined. In the controls after the procedure, who could not be evaluated with the non-contrast computerized tomography (CT and ESWL treatment not completed, were excluded from the study. 52 patients with lower pole stone in total were divided into two according to the success of the ESWL treatment. ESWL success or unsuccessful groups, the size of the stone, density of the stone and the distance between the stone and skin was recorded by examining the abdominal non-contrast computed tomography (CT of the patient. Results: Of all, 28 of the patients in the study (54% were male and 24 of them (46% were female. The average age was 46±12.3 (21-73 years. Among the 52 patients included in the study after ESWL treatment, the stones of the 24 patients (46.2% were successfully treated. ESWL treatment was unsuccessful in total 28 patients (53.8%. The average size of the stone was 9.8 mm (6-17 mm, the distance between the stone and the skin was 93 mm in average (50-140. The stone density was measured as 845 HU (353-1600. Conclusion: The ESWL treatment is still a noninvasive and successful method for the lower pole kidney stones. While the ESWL success is being determined, the imaging method chosen is important, the use of abdominal CT provides accurate evaluation. The higher success rates of minimal invasive surgery methods is promising and might change the treatment methods in the future.

  16. Ultrasonic propulsion of kidney stones.

    Science.gov (United States)

    May, Philip C; Bailey, Michael R; Harper, Jonathan D

    2016-05-01

    Ultrasonic propulsion is a novel technique that uses short bursts of focused ultrasonic pulses to reposition stones transcutaneously within the renal collecting system and ureter. The purpose of this review is to discuss the initial testing of effectiveness and safety, directions for refinement of technique and technology, and opinions on clinical application. Preclinical studies with a range of probes, interfaces, and outputs have demonstrated feasibility and consistent safety of ultrasonic propulsion with room for increased outputs and refinement toward specific applications. Ultrasonic propulsion was used painlessly and without adverse events to reposition stones in 14 of 15 human study participants without restrictions on patient size, stone size, or stone location. The initial feasibility study showed applicability in a range of clinically relevant situations, including facilitating passage of residual fragments following ureteroscopy or shock wave lithotripsy, moving a large stone at the ureteropelvic junction with relief of pain, and differentiating large stones from a collection of small fragments. Ultrasonic propulsion shows promise as an office-based system for transcutaneously repositioning kidney stones. Potential applications include facilitating expulsion of residual fragments following ureteroscopy or shock wave lithotripsy, repositioning stones prior to treatment, and repositioning obstructing ureteropelvic junction stones into the kidney to alleviate acute renal colic.

  17. Journey of a cystinuric patient with a long-term follow-up from a medical stone clinic: necessity to be SaFER (stone and fragments entirely removed).

    Science.gov (United States)

    Moore, Sacha L; Somani, Bhaskar K; Cook, Paul

    2018-04-25

    There is a lack of studies looking at the longitudinal follow-up of patients with cystine stones. We wanted to assess the journey of cystinuric patients through our specialist metabolic stone clinic to improve the understanding of episodes, interventions and current outcomes in this patient cohort. After ethical approval, all patients who attended our metabolic stone clinic from 1994 to 2014 with at least one cystine stone episode were included in our study. Data were retrospectively analysed for patient demographics, stone episodes or intervention, clinical parameters and patient compliance. Over a period of 21 years, 16 patients with a median age of 15.5 years underwent a mean follow-up of 8.6 years (1-21 years). The mean number of surgical interventions was 3.1 (1-8/patient), but patients who were stone free after their first treatment had lower recurrences (p = 0.91) and lower number of interventions during their follow-up (2.7/patient, compared to those who were not stone free at 4/patient). During their follow-up period, patients with stone episodes (r 2  = 0.169). It was also noted that patients who began early medical management remained stone free during follow-up compared to those who had medical management after ≥ 2 stone episodes, of whom all had a recurrent episode. Our long-term longitudinal study of cystine stone formers highlights that patients who are stone free and receive early metabolic stone screening and medical management after their initial presentation have the lowest recurrence rates and tend to preserve their renal function. Hence, prompt referral for metabolic assessment, and the stone and fragments entirely removed (SaFER) principles are key to preventing stone episodes and improving long-term function.

  18. Clinical use of patient decision-making aids for stone patients.

    Science.gov (United States)

    Lim, Amy H; Streeper, Necole M; Best, Sara L; Penniston, Kristina L; Nakada, Stephen Y

    2017-08-01

    Patient decision-making aids (PDMAs) help patients make informed healthcare decisions and improve patient satisfaction. The utility of PDMAs for patients considering treatments for urolithiasis has not yet been published. We report our experience using PDMAs developed at our institution in the outpatient clinical setting in patients considering a variety of treatment options for stones. Patients with radiographically confirmed urolithiasis were given PDMAs regarding treatment options for their stone(s) based on their clinical profile. We assessed patients' satisfaction, involvedness, and feeling of making a more informed decision with utilization of the PDMAs using a Likert Scale Questionnaire. Information was also collected regarding previous stone passage, history and type of surgical intervention for urolithiasis, and level of education. Patients (n = 43; 18 males, 23 females and two unknown) 53 +/- 14years old were included. Patients reported that they understood the advantages and disadvantages outlined in the PDMAs (97%), that the PDMAs helped them make a more informed decision (83%) and felt more involved in the decision making process (88%). Patients reported that the aids were presented in a balanced manner and used up-to-date scientific information (100%, 84% respectively). Finally, a majority of the patients prefer an expert's opinion when making a treatment decision (98%) with 73% of patients preferring to form their own opinion based on available information. Previous stone surgery was associated with patients feeling more involved with the decision making process (p = 0.0465). PDMAs have a promising role in shared decision-making in the setting of treatment options for nephrolithiasis.

  19. Effects of disinfecting alginate impressions on the scratch hardness of stone models.

    Science.gov (United States)

    Hiraguchi, Hisako; Nakagawa, Hisami; Wakashima, Mitsuru; Miyanaga, Kohichi; Saigo, Masataka; Nishiyama, Minoru

    2006-03-01

    This study investigated the effects of disinfecting alginate impressions on the scratch depth of resultant stone models. Eleven brands of alginate impression material and two disinfectants, 1% sodium hypochlorite and 2% glutaraldehyde, were used. Impressions were immersed in disinfectant solutions or stored in sealed bags after spraying with disinfectants, and then poured with a type V dental stone. The scratch depth of the stone model obtained from disinfected impression was measured. The storage of alginate impressions after spraying with disinfectants did not increase the scratch depth of resultant stone models. However, the effect of immersion in disinfectants on scratch depth varied with the brand of the alginate impression material.

  20. Effect of Ferrous Additives on Magnesia Stone Hydration

    Science.gov (United States)

    Zimich, V.

    2017-11-01

    The article deals with the modification of the magnesia binder with additives containing two- and three-valent iron cations which could be embedded in the chloromagnesium stone structure and also increase the strength from 60 MPa in a non-additive stone to 80MPa, water resistance from 0.58 for clear stone to 0.8 and reduce the hygroscopicity from 8% in the non-additive stone to 2% in the modified chloromagnesium stone. It is proposed to use the iron hydroxide sol as an additive in the quantities of up to 1% of the weight of the binder. The studies were carried out using the modern analysis methods: the differentialthermal and X-ray phase analysis. The structure was studied with an electron microscope with an X-ray microanalyzer. A two-factor plan-experiment was designed which allowed constructing mathematical models characterizing the influence of variable factors, such as the density of the zatcher and the amount of sol in the binder, on the basic properties of the magnesian stone. The result of the research was the magnesia stone with the claimed properties and formed from minerals characteristic for magnesian materials as well as additionally formed from amachenite and goethite. It has been established that a highly active iron hydroxide sol the ion sizes of which are commensurate with magnesium ions is actively incorporated into the structure of pentahydroxychloride and magnesium hydroxide changing the habit of crystals compacting the structure of the stone and changing its hygroscopicity.

  1. A pilot study of the effect of sodium thiosulfate on urinary lithogenicity and associated metabolic acid load in non-stone formers and stone formers with hypercalciuria.

    Directory of Open Access Journals (Sweden)

    Onyeka W Okonkwo

    Full Text Available BACKGROUND AND OBJECTIVES: Sodium thiosulfate (STS reduced calcium stone formation in both humans and genetic hypercalciuric stone forming (GHS rats. We sought to measure urine chemistry changes resulting from STS administration in people. DESIGN SETTING PARTICIPANTS MEASUREMENTS: STS was given to healthy and hypercalciuric stone forming adults. Five normal non-stone forming adults (mean age 33 years, and 5 people with idiopathic hypercalciuria and calcium kidney stones (mean age 66 years participated. Two baseline 24-hour urine collections were performed on days 2 and 3 of 3 days of self-selected diets. Subjects then drank STS 10 mmol twice a day for 7 days and did urine collections while repeating the self-selected diet. Results were compared by non-parametric Wilcoxon signed rank test. The primary outcome was the resulting change in urine chemistry. RESULTS: STS administration did not cause a significant change in urinary calcium excretion in either group. In both groups, 24 hour urinary ammonium (P = 0.005 and sulfate excretion (P = 0.007 increased, and urinary pH fell (P = 0.005; citrate excretion fell (P<0.05 in hypercalciuric participants but not in non-stone formers. Among stone formers with hypercalciuria, 3 of 5 patients had measurement of serum HCO3 concentration after the STS period: it did not change. The net effect was an increase in supersaturation of uric acid, and no change in supersaturation of calcium oxalate or calcium phosphate. CONCLUSIONS: The basis for studies demonstrating that STS prevented stones in rats and people was not reflected by the changes in urine chemistry reported here. Although serum HCO3 did not change, urine tests suggested an acid load in both non-stone forming and hypercalciuric stone-forming participants. The long term safety of STS needs to be determined before the drug can be tested in humans for long-term prevention of stone recurrence.

  2. Effect of Repeated Microwave Disinfection on Surface Hardness and Dimensional Accuracy of Two Dental Stone Materials

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    Mahmood Robati Anaraki

    2015-01-01

    Full Text Available There is controversial evidence in relation to the effect of microwave on mechanical properties of stone casts. The present study was designed to evaluate the effect of repeated microwave disinfection on surface hardness and dimensional accuracy of dental stone. In this in vitro study, 48 cylindrical stone samples were prepared using two products of type IV stone to assess surface hardness and 48 impressions were taken from a model and poured by these stones to assess the dimensional accuracy. The evaluation of the samples was carried out consequently by a micro-hardness tester and a digital caliper after the stone samples were exposed to 7 consecutive rounds of 900 watts (W microwave irradiation for five minutes each time after cooling. Data were analyzed by t-test and ANOVA. According to the obtained results, multiple disinfections of the stone casts by microwave do not negatively affect their surface hardness and dimensional accuracy.   Key words: Dental stone; Dimensional accuracy; Hardness; Microwave

  3. Significance of lower-pole pelvicaliceal anatomy on stone clearance after shockwave lithotripsy in nonobstructive isolated renal pelvic stones.

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    Sozen, Sinan; Kupeli, Bora; Acar, Cenk; Gurocak, Serhat; Karaoglan, Ustunol; Bozkirli, Ibrahim

    2008-05-01

    To investigate the probable effect of lower-pole pelvicaliceal anatomy on stone clearance after shockwave lithotripsy (SWL) in patients with nonobstructive renal pelvic stones. The clinical records of patients with isolated renal pelvic stones who underwent SWL between 1996 and 2005 were reviewed. After excluding patients with obstruction leading to dilatation, major anatomic abnormalities, noncalcium stones, metabolic abnormalities, history of recurrent stone disease, multiple stones, and previous renal surgery, 153 patients were enrolled in the study. Lower pole infundibulopelvic angle (IPA) and infundibular length and width were measured from intravenous urography. Patients were classified into three groups according to stone burden (group 1, renal pelvis, and both in 50 (32.6%), 29 (18.9%), and 8 (5.2%) patients, respectively. There was no statistically significant difference in pelvicaliceal anatomic features except narrower IPA (P=0.02) in group 1 patients with residual stones. The falling of stone fragments to the lower calix in spite of the ureter whether clinically significant or not after SWL of pelvic stones initially seems to be related to stone burden rather than lower caliceal anatomy. However, existence of a more narrow IPA in group 1 patients with residual fragments led us to believe that lower-pole IPA can play a role in stone clearance, especially for smaller stones, probably because of smaller residual fragment size or the more mobile nature of the primary stone.

  4. Sodium Sulphate Effect on Cement Produced with Building Stone Waste

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    Emre Sancak

    2015-01-01

    Full Text Available In this study, the blended cements produced by using the building stone waste were exposed to sulphate solution and the cement properties were examined. Prepared mortar specimens were cured under water for 28 days and then they were exposed to three different proportions of sodium sulphate solution for 125 days. Performances of cements were determined by means of compressive strength and tensile strength tests. The broken parts of some mortar bars were examined with scanning electron microscope (SEM. Besides, they were left under moist atmosphere and their length change was measured and continuously monitored for period of 125 days. In blended cements, solely cements obtained by replacing 10–20% of diatomites gave similar strength values with ordinary Portland cement (CEM I 42.5R at the ages of 7, 28, and 56 days. In all mortar specimens that included either waste andesite (AP or marble powder (MP showed best performance against very severe effective sodium sulphate solutions (13500 mg/L.

  5. The Effect of Tamsulosin in the Medical Treatment of Distal Ureteral Stones

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    Alizadeh, M.; Magsudi, M.

    2014-01-01

    Introduction: Renal stones are common disorders that affect approximately 5% to 10% of the population and the incidence of renal stones is rising. Treatment of ureteral stones is an important part of urologists and minimally invasive procedures such as ESWL and ureteroscopy effectiveness has been proven in various studies. However, these methods are not completely safe and are expensive and can be complicated. Purpose of this study is to evaluate the effectiveness of tamsulosin in the medical treatment of distal ureteral stones. Patients and methods: A total of 96 patients with distal ureteral stones or UVj are randomly divided into two study group (50 patients) and control group (46 patients). Patients in the control group allowed to freely consuming fluids (hydration) and indomethacin 100 mg PRN. Study group in addition to indomethacin and daily analgesic 0.4 mg tamsulosin was administered. All subjects in terms of analgesic dose, duration of expulsion and expulsion were studied. Results: Spontaneous expulsion of stone was occurred in 62.5% (30 patients out of 46) of control group patients and 82% (41 patients out of 50) that there was no significant difference (P>0.05). Average time to fix the stone in control group 4.7±8.03 days (range 2 to 28 days) and in the study group, 3.7±5.70 days (range 1 to 23 days) is significantly different (P>0.05). The average amount of analgesic consumption in the control group was 2.3±4.31and in the study group was 1.48±2.15 that showed significant differences (Ptamsulosin to conservative treatment of distal ureteral stones in the distal ureteral stone expulsion showed no significant difference between the two groups, but the reduction in the duration of expulsion, reduce pain and reduce the need for analgesic has been beneficial. PMID:25363178

  6. Effect of Fibers on Mixture Design of Stone Matrix Asphalt

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    Yanping Sheng

    2017-03-01

    Full Text Available Lignin fibers typically influence the mixture performance of stone matrix asphalt (SMA, such as strength, stability, durability, noise level, rutting resistance, fatigue life, and water sensitivity. However, limited studies were conducted to analyze the influence of fibers on the percent voids in mineral aggregate in bituminous mixture (VMA during the mixture design. This study analyzed the effect of different fibers and fiber contents on the VMA in SMA mixture design. A surface-dry condition method test and Marshall Stability test were applied on the SMA mixture with four different fibers (i.e., flocculent lignin fiber, mineral fiber, polyester fiber, blended fiber. The test results indicated that the bulk specific gravity of SMA mixtures and asphalt saturation decreased with the increasing fiber content, whilst the percent air voids in bituminous mixtures (VV, Marshall Stability and VMA increased. Mineral fiber had the most obvious impact on the bulk specific gravity of bituminous mixtures, while flocculent lignin fiber had a minimal impact. The mixture with mineral fiber and polyester fiber had significant effects on the volumetric properties, and, consequently, exhibited better VMA over the conventional SMA mixture with lignin fiber. Modified fiber content range was also provided, which will widen the utilization of mineral fiber and polyester fiber in the applications of SMA mixtures. The mixture evaluation suggested no statistically significant difference between lignin fiber and polyester fiber on the stability. The mineral fiber required a much larger fiber content to improve the mixture performance than other fibers. Overall, the results can be a reference to guide SMA mixture design.

  7. Predicting stone composition before treatment – can it really drive clinical decisions?

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    Bres–Niewada, Ewa; Radziszewski, Piotr

    2014-01-01

    Introduction Determination of stone composition is considered to be crucial for the choice of an optimal treatment algorithm. It is especially important for uric acid stones, which can be dissolved by oral chemolysis and for renal stones smaller than 2 cm, which can be treated with extracorporeal shockwave lithotripsy (ESWL). Material and methods This short review identifies the latest papers on radiological assessment of stone composition and presents a comprehensive evaluation of current scientific findings. Results Stone chemical composition is difficult to predict using standard CT imaging, however, attenuation index measured in Hounsfield units (HU) is related to ESWL outcome. Stone density >1000 HU can be considered predictive for ESWL failure. It seems that stone composition is meaningless in determining the outcome of ureterolithotripsy and percutaneous surgery. Alternative imaging techniques such as Dual–Energy CT or analysis of shape, density and homogeneity of stones on plain X–rays are used as promising methods of predicting stone composition and ESWL outcome. Conclusions New imaging techniques facilitate the identification of uric acid stones and ESWL–resistant stones. Therefore, they may help in selecting the best therapeutic option. PMID:25667761

  8. Do JJ Stents Increase the Effectiveness of Extracorporeal Shock Wave Lithotripsy for Pediatric Renal Stones?

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    Gündüz, Metin; Sekmenli, Tamer; Ciftci, İlhan; Elmacı, Ahmet Midhat

    2017-01-01

    We aimed to evaluate the effects of preoperative urinary catheterization in nephrolithiasis treatment with extracorporeal shock wave lithotripsy (SWL). Patients admitted to the Department of Pediatric Surgery for renal stones between June 2012 and June 2014 were evaluated retrospectively. Patients were divided into 2 groups based on JJ stent placements. Group 1 did not receive JJ stents, while group 2 did. The recorded demographic data for each group included age, gender, stone size, location, sessions, and complications. The Elmed Complit ESWL system was used with 11-13 kV, and 1,000-1,200 shots in patients 2-4 years of age, and 11-14 kV, and 1,000-1,500 shots for patients over 4 years. In group 1, 18 sessions of SWL were performed on 8 female and 2 male children with a mean age of 4.5 (range 2-12) years and stone diameter of 9 (range 7-15) mm. The locations of the renal stones were in the upper pole in 1 patient, 7 in the lower pole, and 2 in the pelvis renalis. Postoperatively, 1 patient had hematuria, 2 had dysuria, and one had a stone in the external urethral meatus. Eighty percent of patients were stone free; there were no fragmentations in 2 patients, and 1 patient discontinued treatment. In group 2, 15 SWL sessions were performed on 5 female and 5 male children aged 4 (range 3-5) and the stone diameter was 9 (range 7-16) mm. The locations of the renal stones were in the upper pole in 6 patients, in the lower pole in 3 patients, and in the ureteropelvic junction in one patient. JJ stents were placed in all patients preoperatively. Postoperatively, 3 patients had hematuria and one had dysuria. At the end of the study, all of the patients were stone free. Statistically, there were no differences in age, gender, stone size, location, and the number of sessions. Our results indicate that SWL without preoperative ureteral stenting is an effective and safe procedure that can be carried out in the pediatric population. Preoperative JJ stenting is unnecessary in

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

    International Nuclear Information System (INIS)

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

    1994-01-01

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

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

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    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.

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

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    H.E. Momtaz

    2012-07-01

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

  12. Effect of animal and vegetable protein intake on oxalate excretion in idiopathic calcium stone disease.

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    Marangella, M; Bianco, O; Martini, C; Petrarulo, M; Vitale, C; Linari, F

    1989-04-01

    Oxalate excretion was measured in healthy subjects and idiopathic calcium stone-formers on dietary regimens which differed in the type and amount of protein allowed; 24-h urine collections were obtained from 41 practising vegetarians and 40 normal persons on a free, mixed, "mediterranean" diet. Twenty idiopathic calcium stone-formers were also studied while on two low calcium, low oxalate diets which differed in that animal protein was high in one and restricted in the other. Vegetarians had higher urinary oxalate levels than controls and although the calcium levels were markedly lower, urinary saturation with calcium/oxalate was significantly higher. This mild hypercalciuria was interpreted as being secondary to both a higher intake and increased fractional intestinal absorption of oxalate. Changing calcium stone-formers from a high to a low animal protein intake produced a significant decrease in calcium excretion but there was no variation in urinary oxalate. As a result, the decrease in calcium oxalate saturation was only marginal and not significant. It was concluded that dietary animal protein has a minimal effect on oxalate excretion. Mild hyperoxaluria of idiopathic calcium stone disease is likely to be intestinal in origin. Calcium stone-formers should be advised to avoid an excess of animal protein but the risks of a vegetable-rich diet should also be borne in mind.

  13. Calcium oxalate stone and gout.

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    Marickar, Y M Fazil

    2009-12-01

    Gout is well known to be produced by increased uric acid level in blood. The objective of this paper is to assess the relationship between gout and calcium oxalate stone formation in the humans. 48 patients with combination of gout and calcium oxalate stone problem were included. The biochemical values of this group were compared with 38 randomly selected uric acid stone patients with gout, 43 stone patients with gout alone, 100 calcium oxalate stone patients without gout and 30 controls, making a total of 259 patients. Various biochemical parameters, namely serum calcium, phosphorus and uric acid and 24-h urine calcium, phosphorus, uric acid, oxalate, citrate and magnesium were analysed. ANOVA and Duncan's multiple-range tests were performed to assess statistical significance of the variations. The promoters of stone formation, namely serum calcium (P stone patients and gouty calcium oxalate stone patients compared to the non-gouty patients and controls. Urine oxalate (P stones patients. The inhibitor urine citrate (P stone gouty patients, followed by the gouty uric acid stone formers and gouty calcium oxalate stone patients. The high values of promoters, namely uric acid and calcium in the gouty stone patients indicate the tendency for urinary stone formation in the gouty stone patients. There is probably a correlation between gout and calcium oxalate urinary stone. We presume this mechanism is achieved through the uric acid metabolism. The findings point to the summation effect of metabolic changes in development of stone disease.

  14. [Clinical analysis of percutaneous nephrolithotomy for staghorn calculi with different stone branch number].

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    Qi, Shi-yong; Zhang, Zhi-hong; Zhang, Chang-wen; Liu, Ran-lu; Shi, Qi-duo; Xu, Yong

    2013-12-01

    To investigate the impact of staghorn stone branch number on outcomes of percutaneous nephrolithotomy (PNL). From January 2009 to January 2013, the 371 patients with staghorn stones who were referred to our hospital for PNL were considered for this study. All calculi were showed with CT 3-dimentional reconstruction (3-DR) imaging. The computerized database of the patients had been reviewed. Our exclusion criterion was patients with congenital renal anomalies, such as horse-shoe and ectopic kidneys. And borderline stones that branched to one major calyx only were also not included. From 3-DR images, the number of stone branching into minor renal calices was recorded. We made "3" as the branch breakdown between groups. And the patients were divided into four groups. The number of percutaneous tract, operative time, staged PNL, intra-operative blood loss, complications, stone clearance rate, and postoperative hospital day were compared. The 371 patients (386 renal units) underwent PNL successfully, included 144 single-tract PNL, 242 multi-tract PNL, 97 staged PNL. The average operative time was (100 ± 50) minutes; the average intra-operative blood loss was (83 ± 67) ml. The stone clearance rate were 61.7% (3 days) and 79.5% (3 months). The postoperative hospital stay was (6.9 ± 3.4) days. A significantly higher ratio of multi-tract (χ(2) = 212.220, P PNL (χ(2) = 49.679, P PNL for calculi with stone branch number ≥ 5. There was no statistically meaningful difference among the 4 groups based on Clavien complication system (P = 0.460). The possibility of multi-tract and staged PNL, lower rate of stone clearance and longer postoperative hospital day increase for staghorn calculi with stone branch number more than 5.

  15. Effect of size and site on the outcome of extracorporeal shock wave lithotripsy of proximal urinary stones in children.

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    Habib, Enmar I; Morsi, Hany A; Elsheemy, Mohammed S; Aboulela, Waseem; Eissa, Mohamed A

    2013-06-01

    To determine the effect of location and size of stones on the outcome of extracorporeal shock wave lithotripsy (ESWL) in children. In 2008-2010, 150 children (median age 6.6 years) with radio-opaque ureteric and renal stones measuring ≤4 cm were treated. Exclusion criteria were coagulation disorders, pyelonephritis, distal obstruction, non-functioning kidney and hypertension. ESWL was performed under general anesthesia. Follow up period was 5-22 months. 186 stones were treated: 76 calyceal, 92 pelvic and 18 proximal ureteral. Mean stone size was 1.3 cm. A total of 312 sessions were performed (mean per stone = 1.67 sessions). The mean number of shock waves per session was 2423.68. Overall stone-free rate was 89.24%. Having a calyceal location did not significantly affect the stone-free rate (p = 0.133). The failure rate was significantly higher (66.7%) in stones >3 cm in size (p auxillary ureteroscopy and 4 uretrolithotomy for treatment of steinstrasse. ESWL is a safe and effective method for treatment of stones up to 2 cm in children. Rate of auxillary procedures increases in stones >2 cm in size. About 80% of failures were associated with stone size >1.35 cm while 52.3% of completely cleared stones were associated with size <1.35 cm. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  16. Effects and outcome of Tamsulosin more than just stone clearance after extracorporeal shock wave lithotripsy for renal calculi

    International Nuclear Information System (INIS)

    Qadri, S. S. U.; Khalid, S. E.; Mahmud, S. M.

    2014-01-01

    Objective: To determine the effect of Tamsulosin, as adjunctive medical therapy after Extracorporeal Shock Wave Lithotripsy for renal stones on rate of stone clearance, clearance time, pain intensity during stone clearance, steinstrasse formation and auxiliary surgical intervention required. Method: A prospective randomized controlled study was carried out in 120 patients who underwent ESWL for renal stones of 0.5-2.0 cm. They were randomized into study and control group in which Tamsulosin 0.4mg/day was given in former as an adjunctive medical therapy. All patients underwent ESWL every 2 weeks until complete stone clearance for 8 weeks. The parameters assessed were stone clearance, clearance time, pain intensity and effect on steinstrasse. Results: Of the 120 patients 60 were in each group. The stone clearance rate was greater in study than in control group, 58(96.7%) vs. 48(80%) respectively, (p<0.004). The mean stone clearance time was observed earlier in study group as compared to control group with significant statistical difference in stone size between 0.6-1.5 cm. The mean intensity of pain patients experienced according to Visual analogue scale (VAS) was significantly less in study group (p<0.002). The rate of steinstrasse formation was observed to be higher in control than in study group 15(25%) vs 6(10%) respectively(p<0.003), while its spontaneous clearance was higher in study group than in control group 83.3% vs 33.3% (p<0.03). Conclusion: Tamsulosin significantly increases stone clearance after shock wave lithotripsy for renal stones. It also appeared to facilitate earlier stone clearance, reduces severity of pain, reduces the incidence of steinstrasse formation and tends to facilitate its spontaneous clearance. (author)

  17. Effects of disinfection of combined agar/alginate impressions on the dimensional accuracy of stone casts.

    Science.gov (United States)

    Hiraguchi, Hisako; Nakagawa, Hisami; Kaketani, Masahiro; Hirose, Hideharu; Nishiyama, Minoru

    2007-05-01

    This study investigated the effects of disinfection of combined agar/alginate impressions on the dimensional accuracy of resultant stone casts. Impressions of a master cast designed to simulate an abutment tooth were prepared by combining each of two brands of cartridge-form agar impression materials with an alginate impression material. The impressions were immersed in 1% sodium hypochlorite for 10 minutes or 2% glutaraldehyde for 30 minutes. The remaining impressions were sprayed with these two disinfectants and then stored in sealed bags for 10, 30, 60, and 120 minutes. Stone casts obtained from the non-disinfected impressions were also prepared as control. Changes in diameter of the stone casts were then measured. Results indicated that storage for 10 minutes after spraying with 1% sodium hypochlorite was an appropriate disinfection method for combined agar/alginate impressions, as well as immersion in 1% sodium hypochlorite for 10 minutes.

  18. Effect of Hydrogen Adsorption on the Stone-Wales Transformation in Small-Diameter Carbon Nanotubes

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    Openov, L. A.; Podlivaev, A. I.

    2018-04-01

    The effect of hydrogenation of (4, 0) and (3, 0) carbon nanotubes on the Stone-Wales transformation is studied in the framework of the nonorthogonal tight-binding model. It is shown that the atomic hydrogen adsorption can lead to both a decrease and an increase in the barriers for the direct and inverse transformations depending on the orientation of a rotating C-C bond with respect to the nanotube axis. The characteristic times of formation and annealing the Stone-Wales defects have been estimated. The Young's moduli have been calculated.

  19. The effects of previous open renal stone surgery types on PNL outcomes.

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    Ozgor, Faruk; Kucuktopcu, Onur; Ucpinar, Burak; Sarilar, Omer; Erbin, Akif; Yanaral, Fatih; Sahan, Murat; Binbay, Murat

    2016-01-01

    Our aim was to demonstrate the effect of insicion of renal parenchyma during open renal stone surgery (ORSS) on percutaneous nephrolithotomy (PNL) outcomes. Patients with history of ORSS who underwent PNL operation between June 2005 and June 2015 were analyzed retrospectively. Patients were divided into two groups according to their type of previous ORSS. Patients who had a history of ORSS with parenchymal insicion, such as radial nephrotomies, anatrophic nephrolithotomy, lower pole resection, and partial nephrectomy, were included in Group 1. Other patients with a history of open pyelolithotomy were enrolled in Group 2. Preoperative characteristics, perioperative data, stone-free status, and complications were compared between the groups. Stone-free status was defined as complete clearance of stone(s) or presence of residual fragments smaller than 4 mm. The retrospective nature of our study, different experience level of surgeons, and lack of the evaluation of anesthetic agents and cost of procedures were limitations of our study. 123 and 111 patients were enrolled in Groups 1 and 2, respectively. Preoperative characteristics were similar between groups. In Group 1, the mean operative time was statistically longer than in Group 2 (p=0.013). Stone-free status was significantly higher in Group 2 than in Group 1 (p=0.027). Complication rates were similar between groups. Hemorrhage requiring blood transfusion was the most common complication in both groups (10.5% vs. 9.9%). Our study demonstrated that a history of previous ORSS with parenchymal insicion significantly reduces the success rates of PNL procedure.

  20. Dietary Plants for the Prevention and Management of Kidney Stones: Preclinical and Clinical Evidence and Molecular Mechanisms

    Science.gov (United States)

    Nirumand, Mina Cheraghi; Hajialyani, Marziyeh; Rahimi, Roja; Farzaei, Mohammad Hosein; Nabavi, Seyed Mohammad

    2018-01-01

    Kidney stones are one of the oldest known and common diseases in the urinary tract system. Various human studies have suggested that diets with a higher intake of vegetables and fruits play a role in the prevention of kidney stones. In this review, we have provided an overview of these dietary plants, their main chemical constituents, and their possible mechanisms of action. Camellia sinensis (green tea), Rubus idaeus (raspberry), Rubia cordifolia (common madder), Petroselinum crispum (parsley), Punica granatum (pomegranate), Pistacia lentiscus (mastic), Solanum xanthocarpum (yellow-fruit nightshade), Urtica dioica (stinging nettle), Dolichos biflorus (horse gram), Ammi visnaga (khella), Nigella sativa (black-cumin), Hibiscus sabdariffa (roselle), and Origanum vulgare (oregano) have received considerable interest based on scientific evidence. Beside these dietary plants, phytochemicals—such as catechin, epicatechin, epigallocatechin-3-gallate, diosmin, rutin, quercetin, hyperoside, and curcumin—as antioxidant dietary phyto-phenols were found to be effective for the prevention of urolithiasis (the process of stone formation in the urinary tract). The main underlying mechanisms of these dietary plants and their isolated phytonutrients in the management of urolithiasis include diuretic, antispasmodic, and antioxidant activity, as well as an inhibitory effect on crystallization, nucleation, and aggregation of crystals. The results as presented in this review demonstrate the promising role of dietary plants and phytophenols in the prevention and management of kidney stones. Further investigations are required to confirm the safety and efficacy of these compounds. PMID:29518971

  1. Dietary Plants for the Prevention and Management of Kidney Stones: Preclinical and Clinical Evidence and Molecular Mechanisms.

    Science.gov (United States)

    Nirumand, Mina Cheraghi; Hajialyani, Marziyeh; Rahimi, Roja; Farzaei, Mohammad Hosein; Zingue, Stéphane; Nabavi, Seyed Mohammad; Bishayee, Anupam

    2018-03-07

    Kidney stones are one of the oldest known and common diseases in the urinary tract system. Various human studies have suggested that diets with a higher intake of vegetables and fruits play a role in the prevention of kidney stones. In this review, we have provided an overview of these dietary plants, their main chemical constituents, and their possible mechanisms of action. Camellia sinensis (green tea), Rubus idaeus (raspberry), Rubia cordifolia (common madder), Petroselinum crispum (parsley), Punica granatum (pomegranate), Pistacia lentiscus (mastic), Solanum xanthocarpum (yellow-fruit nightshade), Urtica dioica (stinging nettle), Dolichos biflorus ( horse gram ), Ammi visnaga (khella), Nigella sativa (black-cumin), Hibiscus sabdariffa (roselle), and Origanum vulgare (oregano) have received considerable interest based on scientific evidence. Beside these dietary plants, phytochemicals-such as catechin, epicatechin, epigallocatechin-3-gallate, diosmin, rutin, quercetin, hyperoside, and curcumin-as antioxidant dietary phyto-phenols were found to be effective for the prevention of urolithiasis (the process of stone formation in the urinary tract). The main underlying mechanisms of these dietary plants and their isolated phytonutrients in the management of urolithiasis include diuretic, antispasmodic, and antioxidant activity, as well as an inhibitory effect on crystallization, nucleation, and aggregation of crystals. The results as presented in this review demonstrate the promising role of dietary plants and phytophenols in the prevention and management of kidney stones. Further investigations are required to confirm the safety and efficacy of these compounds.

  2. Dietary Plants for the Prevention and Management of Kidney Stones: Preclinical and Clinical Evidence and Molecular Mechanisms

    Directory of Open Access Journals (Sweden)

    Mina Cheraghi Nirumand

    2018-03-01

    Full Text Available Kidney stones are one of the oldest known and common diseases in the urinary tract system. Various human studies have suggested that diets with a higher intake of vegetables and fruits play a role in the prevention of kidney stones. In this review, we have provided an overview of these dietary plants, their main chemical constituents, and their possible mechanisms of action. Camellia sinensis (green tea, Rubus idaeus (raspberry, Rubia cordifolia (common madder, Petroselinum crispum (parsley, Punica granatum (pomegranate, Pistacia lentiscus (mastic, Solanum xanthocarpum (yellow-fruit nightshade, Urtica dioica (stinging nettle, Dolichos biflorus (horse gram, Ammi visnaga (khella, Nigella sativa (black-cumin, Hibiscus sabdariffa (roselle, and Origanum vulgare (oregano have received considerable interest based on scientific evidence. Beside these dietary plants, phytochemicals—such as catechin, epicatechin, epigallocatechin-3-gallate, diosmin, rutin, quercetin, hyperoside, and curcumin—as antioxidant dietary phyto-phenols were found to be effective for the prevention of urolithiasis (the process of stone formation in the urinary tract. The main underlying mechanisms of these dietary plants and their isolated phytonutrients in the management of urolithiasis include diuretic, antispasmodic, and antioxidant activity, as well as an inhibitory effect on crystallization, nucleation, and aggregation of crystals. The results as presented in this review demonstrate the promising role of dietary plants and phytophenols in the prevention and management of kidney stones. Further investigations are required to confirm the safety and efficacy of these compounds.

  3. Uricosuric effect of Roselle (Hibiscus sabdariffa) in normal and renal-stone former subjects.

    Science.gov (United States)

    Prasongwatana, Vitoon; Woottisin, Surachet; Sriboonlue, Pote; Kukongviriyapan, Veerapol

    2008-05-22

    The Roselle (Hibiscus sabdariffa) was investigated for its uricosuric effect. A human model with nine subjects with no history of renal stones (non-renal stone, NS) and nine with a history of renal stones (RS) was used in this study. A cup of tea made from 1.5 g of dry Roselle calyces was provided to subjects twice daily (morning and evening) for 15 days. A clotted blood and two consecutive 24-h urine samples were collected from each subject three times: (1) at baseline (control); (2) on days 14 and 15 during the tea drinking period; and (3) 15 days after the tea drinking was stopped (washout). Serum and 24-h urinary samples were analyzed for uric acid and other chemical compositions related to urinary stone risk factors. All analyzed serum parameters were within normal ranges and similar; between the two groups of subjects and among the three periods. Vis-à-vis the urinary parameters, most of the baseline values for both groups were similar. After taking the tea, the trend was an increase in oxalate and citrate in both groups and uric acid excretion and clearance in the NS group. In the RS group, both uric acid excretion and clearance were significantly increased (pRoselle calyces. Since the various chemical constituents in Roselle calyces have been identified, the one(s) exerting this uricosuric effect need to be identified.

  4. Effect of Microwave Disinfection on Compressive and Tensile Strengths of Dental Stones

    Directory of Open Access Journals (Sweden)

    Mahmood Robati Anaraki

    2013-03-01

    Full Text Available Background and aims. Although microwave irradiation has been used for disinfection of dental stone casts, there are concerns regarding mechanical damage to casts during the process. The aim of this study was to evaluate the effect of microwave irradiation on the compressive strength (CS and diametral tensile strength (DTS of stone casts. Materials and methods. In this in vitro study, 80 cylindrical type III and IV stone models (20 × 40 mm were prepared and divided into 8 groups of 10. The DTS and CS of the specimens were measured by a mechanical testing machine at a crosshead speed of 0.5 cm/min after 7 times of frequent wetting, irradiating at an energy level of 600 W for 3 minutes and cooling. Data were analyzed by Student’s t-test. Results. Microwave irradiation significantly increased DTS of type III and IV to 5.23 ± 0.64 and 8.17 ± 0.94, respectively (P < 0.01. Conclusion. According to the results, microwave disinfection increases DTS of type III and IV stone casts without any effects on their CS.

  5. Visualization and quantification of weathering effects on capillary water uptake of natural building stones by using neutron imaging

    International Nuclear Information System (INIS)

    Raneri, Simona; Barone, Germana; Mazzoleni, Paolo; Rabot, Eva

    2016-01-01

    Building stones are frequently subjected to very intense degradation due to salt crystallization, often responsible for strong modifications of their pore network. These effects have a great influence on the mechanical properties and durability of the materials, and on the penetration of water. Therefore, the quantification and visualization of water absorption into the pore network of degraded stones could provide useful information to better understand the weathering process. In this study, neutron radiography has been used (1) to monitor and visualize in two dimensions the capillary water uptake in a Sicilian calcarenite widely used as building and replace stone (namely Sabucina stone) and (2) to quantify the water content distribution, as a function of time and weathering degree. Additionally, traditional experiments based on gravimetric methods have been performed, following the standard recommendations. Results demonstrated a change in the physical properties of Sabucina stones with the intensification of the degradation process, with severe effects on the capillary imbibition dynamics. The water penetration depth at the end of the experiment was substantially higher in the fresh than in the weathered stones. The water absorption kinetics was faster in the weathered samples, and the amount of water absorbed increased with the number of weathering cycles. Good agreement between classical and neutron imaging data has also been evidenced. However, neutron radiography has allowed retrieving additional spatial information on the water absorption process, and to better understand how salt weathering affects the petrophysical properties of the studied stone and how it influences then the stone response against water. (orig.)

  6. Visualization and quantification of weathering effects on capillary water uptake of natural building stones by using neutron imaging

    Energy Technology Data Exchange (ETDEWEB)

    Raneri, Simona; Barone, Germana; Mazzoleni, Paolo [University of Catania, Department of Biological, Geological and Environment Sciences, Catania (Italy); Rabot, Eva [Laboratoire Leon Brillouin (CNRS/CEA), Gif-Sur-Yvette (France)

    2016-11-15

    Building stones are frequently subjected to very intense degradation due to salt crystallization, often responsible for strong modifications of their pore network. These effects have a great influence on the mechanical properties and durability of the materials, and on the penetration of water. Therefore, the quantification and visualization of water absorption into the pore network of degraded stones could provide useful information to better understand the weathering process. In this study, neutron radiography has been used (1) to monitor and visualize in two dimensions the capillary water uptake in a Sicilian calcarenite widely used as building and replace stone (namely Sabucina stone) and (2) to quantify the water content distribution, as a function of time and weathering degree. Additionally, traditional experiments based on gravimetric methods have been performed, following the standard recommendations. Results demonstrated a change in the physical properties of Sabucina stones with the intensification of the degradation process, with severe effects on the capillary imbibition dynamics. The water penetration depth at the end of the experiment was substantially higher in the fresh than in the weathered stones. The water absorption kinetics was faster in the weathered samples, and the amount of water absorbed increased with the number of weathering cycles. Good agreement between classical and neutron imaging data has also been evidenced. However, neutron radiography has allowed retrieving additional spatial information on the water absorption process, and to better understand how salt weathering affects the petrophysical properties of the studied stone and how it influences then the stone response against water. (orig.)

  7. Kidney stone formation and antioxidant effects of Cynodon dactylon decoction in male Wistar rats.

    Science.gov (United States)

    Golshan, Alireza; Hayatdavoudi, Parichehr; Hadjzadeh, Mousa Al-Reza; Khajavi Rad, Abolfazl; Mohamadian Roshan, Nema; Abbasnezhad, Abbasali; Mousavi, Seyed Mojtaba; Pakdel, Roghayeh; Zarei, Batool; Aghaee, Azita

    2017-01-01

    The antioxidant capacity impairs in kidney and urinary bladder of animals with stone disease. Herbal medicine can improve the antioxidant condition of renal tissue. Cynodon dactylon ( C. dactylon ) is a medicinal plant with antioxidative and diuretic properties and different preparations of this plant have shown promising effects in stone disease. Assessment of the whole plant decoction to prevent kidney stone disease as well as its antioxidant effects was the aim of this paper. Fifty male Wistar rats were randomly divided into 5 experimental groups (n=10). One group was left without treatment and four groups received ethylene glycol (1% v/v) in drinking water for 6 weeks. Three doses of Cynodon dactylon aqueous decoction (12.5, 50 and 200 mg/kg BW) were added to the drinking water of groups 3-5. Finally, water intake, 24-hour urine volume, MDA, total thiol concentration and FRAP value were measured in the serum and kidney tissues. The CaOx depositions were evaluated by hematoxylin and eosin staining. Compared to the ethylene glycol-treated group, 200 mg/kg C. dactylon , lowered stone incidents, decreased urine volume, increased FRAP/g Cr (43%) and thiol content (p<0.05) with no significant alteration of water intake, MDA decreased significantly compared to C. dactylon 12.5 (p<0.01). Kidney weight increased and body weight decreased in ethylene glycol-treated group compared to the control group (p<0.05). A minimum dose of 200 mg/kg C. dactylon reduced stone formation and simultaneously increased total antioxidant power of serum and preserved MDA content and water.

  8. Furosemide/Fludrocortisone Test and Clinical Parameters to Diagnose Incomplete Distal Renal Tubular Acidosis in Kidney Stone Formers.

    Science.gov (United States)

    Dhayat, Nasser A; Gradwell, Michael W; Pathare, Ganesh; Anderegg, Manuel; Schneider, Lisa; Luethi, David; Mattmann, Cedric; Moe, Orson W; Vogt, Bruno; Fuster, Daniel G

    2017-09-07

    Incomplete distal renal tubular acidosis is a well known cause of calcareous nephrolithiasis but the prevalence is unknown, mostly due to lack of accepted diagnostic tests and criteria. The ammonium chloride test is considered as gold standard for the diagnosis of incomplete distal renal tubular acidosis, but the furosemide/fludrocortisone test was recently proposed as an alternative. Because of the lack of rigorous comparative studies, the validity of the furosemide/fludrocortisone test in stone formers remains unknown. In addition, the performance of conventional, nonprovocative parameters in predicting incomplete distal renal tubular acidosis has not been studied. We conducted a prospective study in an unselected cohort of 170 stone formers that underwent sequential ammonium chloride and furosemide/fludrocortisone testing. Using the ammonium chloride test as gold standard, the prevalence of incomplete distal renal tubular acidosis was 8%. Sensitivity and specificity of the furosemide/fludrocortisone test were 77% and 85%, respectively, yielding a positive predictive value of 30% and a negative predictive value of 98%. Testing of several nonprovocative clinical parameters in the prediction of incomplete distal renal tubular acidosis revealed fasting morning urinary pH and plasma potassium as the most discriminative parameters. The combination of a fasting morning urinary threshold pH 3.8 mEq/L yielded a negative predictive value of 98% with a sensitivity of 85% and a specificity of 77% for the diagnosis of incomplete distal renal tubular acidosis. The furosemide/fludrocortisone test can be used for incomplete distal renal tubular acidosis screening in stone formers, but an abnormal furosemide/fludrocortisone test result needs confirmation by ammonium chloride testing. Our data furthermore indicate that incomplete distal renal tubular acidosis can reliably be excluded in stone formers by use of nonprovocative clinical parameters. Copyright © 2017 by the American

  9. Effectiveness of percutaneous biliary stone removal as primary treatment in case with difficulties in the use of an endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sin Ae; Han, Young Min; Jin, Gong Yong; Lee, Seung Ok; Yu, Hee Chul [Chonbuk National University Medical School and Hospital, Jeonju(Korea, Republic of)

    2014-03-15

    To evaluate the effectiveness of percutaneous biliary stone removal as a primary treatment in cases with difficulties to use an endoscopy. From March 2004 to May 2011, 17 patients who underwent primary percutaneous biliary stone removal (Group 1) and 34 case-matched patients who underwent primary endoscopic biliary stone removal were selected (Group 2). The inclusion criteria were as follows: patients who had 1) ≥ 15 mm bile duct stones, 2) intrahepatic bile duct stones, 3) bile duct stones with a history of previous gastrointestinal bypass surgery. In the present study were analyzed the success rates, the length of postprocedural hospital stay, the change of Amylase/Lipase values and complications post procedure. Statistical analysis was performed using paired t-test and unpaired t-test. The success rate was higher in Group 1 (94.1%) than in Group 2 (85.3%). Length of post procedural hospital stay and the post procedural amylase level were significantly increased in Group 2 (p = 0.036 and p = 0.017, respectively). In cases of bile duct stones with difficulties in the use of an endoscopy a percutaneous biliary stone removal can be efficient as a primary treatment.

  10. Effect of immersion disinfection of alginate impressions in sodium hypochlorite solution on the dimensional changes of stone models.

    Science.gov (United States)

    Hiraguchi, Hisako; Kaketani, Masahiro; Hirose, Hideharu; Yoneyama, Takayuki

    2012-01-01

    This study investigated the effect of the immersion of alginate impressions in 0.5% sodium hypochlorite solution for 15 min on the dimensional changes of stone models designed to simulate a sectional form of a residual ridge. Five brands of alginate impression materials, which underwent various dimensional changes in water, were used. A stone model made with an impression that had not been immersed was prepared as a control. The immersion of two brands of alginate impressions that underwent small dimensional changes in water did not lead to serious deformation of the stone models, and the differences in the dimensional changes between the stone models produced with disinfected impressions and those of the control were less than 15 µm. In contrast, the immersions of three brands of alginate impressions that underwent comparatively large dimensional changes in water caused deformation of the stone models.

  11. Computerized tomography magnified bone windows are superior to standard soft tissue windows for accurate measurement of stone size: an in vitro and clinical study.

    Science.gov (United States)

    Eisner, Brian H; Kambadakone, Avinash; Monga, Manoj; Anderson, James K; Thoreson, Andrew A; Lee, Hang; Dretler, Stephen P; Sahani, Dushyant V

    2009-04-01

    We determined the most accurate method of measuring urinary stones on computerized tomography. For the in vitro portion of the study 24 calculi, including 12 calcium oxalate monohydrate and 12 uric acid stones, that had been previously collected at our clinic were measured manually with hand calipers as the gold standard measurement. The calculi were then embedded into human kidney-sized potatoes and scanned using 64-slice multidetector computerized tomography. Computerized tomography measurements were performed at 4 window settings, including standard soft tissue windows (window width-320 and window length-50), standard bone windows (window width-1120 and window length-300), 5.13x magnified soft tissue windows and 5.13x magnified bone windows. Maximum stone dimensions were recorded. For the in vivo portion of the study 41 patients with distal ureteral stones who underwent noncontrast computerized tomography and subsequently spontaneously passed the stones were analyzed. All analyzed stones were 100% calcium oxalate monohydrate or mixed, calcium based stones. Stones were prospectively collected at the clinic and the largest diameter was measured with digital calipers as the gold standard. This was compared to computerized tomography measurements using 4.0x magnified soft tissue windows and 4.0x magnified bone windows. Statistical comparisons were performed using Pearson's correlation and paired t test. In the in vitro portion of the study the most accurate measurements were obtained using 5.13x magnified bone windows with a mean 0.13 mm difference from caliper measurement (p = 0.6). Measurements performed in the soft tissue window with and without magnification, and in the bone window without magnification were significantly different from hand caliper measurements (mean difference 1.2, 1.9 and 1.4 mm, p = 0.003, window settings with magnification. For uric acid calculi the measurement error was observed only in standard soft tissue window settings. In vivo 4.0x

  12. Application thinking on Bian-stone of the acousto-optic effect in the treatment of primary dysmenorrhea

    Science.gov (United States)

    Ge, Shu; Chen, Gui-Zhen; Liu, Song-Hao

    2009-08-01

    In order to identify the relations between the Si-Bin Bian-stone of the mineral composition characteristics and Bian-stone of the good infrared emission features. A detailed study of the Sibin Bian-stone samples was conducted by using the laser Raman spectroscopy and high-resolution transmission electron microscopy (HRTEM). The study is to provide theoretical physical support for Bian-stone in the treatment of primary dysmenorrhea. And Thermal tomography technology (TTM) is intended to be carried out to assess the effects of Bian-stone. The Raman spectroscopic study confirmed the existence of fine-grained pyrite, anatase, calcitepyrite and graphite. It is believed that the combination of good thermal properties of the above 4 minerals make the Sibin Bian-stone as a useful material with very good physiotherapical functions. The ultrasonic has a resonance with the body's biological molecules so that it can improve meridians microcirculation. Hence, the Sibin Bian-stones can be used to make acupuncture tools for stimulating the circulation of the blood in vessels and relieving pains of human beings by utilizing its infrared thermal radiation property. TTM which accepts the heat produced by the metabolism process of life can reflect the energy status information, TTM will be introduced to evaluate effect at the overall level of the abdomen from the thermal image and analyze to derive a comprehensive diagnosis. In sum, this experiment is explored to provide a new idea for the modernization of traditional Chinese medicine.

  13. Pollution effects on stone benches of the Eagle Warriors Precinct at the Major Temple, Mexico City

    International Nuclear Information System (INIS)

    Miranda, J.; Gallardo, M.L.; Grimaldi, D.M.; Roman-Berrelleza, J.A.; Ruvalcaba-Sil, J.L.; Ontalba Salamanca, M.A.; Morales, J.G.

    1999-01-01

    During Major Temple archaeological site excavations in Downtown Mexico City, the precinct of one of the most important Mexica military caste, the Eagle Warriors, was discovered. The ceremonial enclosure is composed of three rooms surrounded by paintings on 11 stone benches placed against the walls. Nowadays, these paintings and the stones present the effects of different deterioration processes produced by the underground water level, high humidity, and the presence of soil, water, and air pollutants. Ion beam analysis of samples from the benches and wall paintings was performed using PIXE and RBS techniques. Using enrichment factors of elements relative to iron concentrations, possible contamination by sulfur and chlorine salts was found, as well as airborne zinc scavenged by rain

  14. Warming and pCO2 effects on Florida stone crab larvae

    Science.gov (United States)

    Gravinese, Philip M.; Enochs, Ian C.; Manzello, Derek P.; van Woesik, Robert

    2018-05-01

    Greenhouse gas emissions are increasing ocean temperatures and the partial pressure of CO2 (pCO2), resulting in more acidic waters. It is presently unknown how elevated temperature and pCO2 will influence the early life history stages of the majority of marine coastal species. We investigated the combined effect of elevated temperature (30 °C control and 32 °C treatment) and elevated pCO2 (450 μatm control and 1100 μatm treatment) on the (i) growth, (ii) survival, (iii) condition, and (iv) morphology of larvae of the commercially important Florida stone crab, Menippe mercenaria. At elevated temperature, larvae exhibited a significantly shorter molt stage, and elevated pCO2 caused stage-V larvae to delay metamorphosis to post-larvae. On average, elevated pCO2 resulted in a 37% decrease in survivorship relative to the control; however the effect of elevated temperature reduced larval survivorship by 71%. Exposure to both elevated temperature and pCO2 reduced larval survivorship by 80% relative to the control. Despite this, no significant differences were detected in the condition or morphology of stone crab larvae when subjected to elevated temperature and pCO2 treatments. Although elevated pCO2 could result in a reduction in larval supply, future increases in seawater temperatures are even more likely to threaten the future sustainability of the stone-crab fishery.

  15. The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers.

    Science.gov (United States)

    Pinheiro, Vivian Barbosa; Baxmann, Alessandra Calábria; Tiselius, Hans-Göran; Heilberg, Ita Pfeferman

    2013-07-01

    To evaluate the effects of oral sodium bicarbonate (NaBic) supplementation upon urinary citrate excretion in calcium stone formers (CSFs). Sixteen adult calcium stone formers with hypocitraturia were enrolled in a randomized, double-blind, crossover protocol using 60 mEq/day of NaBic during 3 days compared to the same period and doses of potassium citrate (KCit) supplementation. Blood and 24-hour urine samples were collected at baseline and during the third day of each alkali salt. NaBic, similarly to KCit supplementation, led to an equivalent and significant increase in urinary citrate and pH. Compared to baseline, NaBic led to a significant increase in sodium excretion without concomitant increases in urinary calcium excretion, whereas KCit induced a significant increase in potassium excretion coupled with a significant reduction in urinary calcium. Although NaBic and KCit both reduced calcium oxalate supersaturation (CaOxSS) significantly vs baseline, KCit reduced calcium oxalate supersaturation significantly further vs NaBic. Both KCit and NaBic significantly reduced urinary phosphate and increased calcium phosphate supersaturation (CaPSS) compared to baseline. Finally, a significantly higher sodium urate supersaturation (NaUrSS) was observed after the use of the 2 drugs. This short-term study suggests that NaBic represents an effective alternative for the treatment of hypocitraturic calcium oxalate stone formers who cannot tolerate or afford the cost of KCit. In view of the increased sodium urate supersaturation, patients with pure uric acid stones and high urate excretion may be less suited for treatment with NaBic. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Organizational diagnosis, the stepping stone to organizational effectiveness

    Directory of Open Access Journals (Sweden)

    Patsy Govender

    2016-08-01

    Full Text Available Organizational survival, success and effectiveness depend on the ability of the organization to adapt to continuous challenges, competition and change. However, improving and changing organizations demand properly understanding and diagnosing them. So, where does diagnosis start and how can we measure effectiveness? Diagnosis starts with assessing key tasks, structure, people relationships, motivation, support, management leadership, attitude towards change and performance to identify gaps towards effectiveness. Effectiveness is evaluated in terms of the extent to which people have the right skills and competencies and are trained and strategically managed to enhance profitability (finance, the organization’s marketing strategy, operations/service and, measurement of the corporate/business development and growth achieved as a result of planned efforts to ensure organizational viability, stability and maturity. This study uses an integrated system evaluation process to diagnose the extent to which key tasks, structure, people relationships, motivation, support, management leadership, attitude towards change and performance impact on organizational effectiveness respectively. The population for the study comprised of all staff in a provincial trade and investment promotion agency in South Africa and a consensus approach was used through a cluster sampling technique, which secured an 85.4% response rate. In this quantitative, cross-sectional study data was collected using questionnaires and analyzed using both descriptive and inferential statistics. The results reflect that the diagnostic variables impact on organizational effectiveness in varying degrees. The important diagnostic dimensions and areas for improvement are identified and suggestions for corrective action are presented in order to enhance overall organizational effectiveness.

  17. The effects of ozone and NOx on the deterioration of calcareous stone

    International Nuclear Information System (INIS)

    Massey, S.W.

    1999-01-01

    This paper looks at the changes in urban air quality and the effect on building materials with particular regard to their deterioration arising from pollution due to vehicles. The paper aims to review basic information on the likely effect of NO x and ozone on calcareous building materials (limestone, marble, dolomite, calcareous cemented sandstone) by examining experimental and fieldwork relating to the principle reaction of the oxidation of the sulphite to sulphate. NO 2 is only one of many possible oxidants present in the urban and rural environment. A brief synopsis of the effects of other oxidants and inhibitors is given along with a review of the processes involved in aqueous phase oxidation, which seems to be the phase where the reactions take place. Controlling factors in the reaction and oxidation of sulphite to sulphate are the type and porosity of the stone, the level of humidity, the nature of the oxidants and to a lesser extent the presence of other extraneous reactants, e.g. metal oxides, chlorine and ammonia salts. For freshly cut stone unpolished marble is much less reactive than porous limestone and the degree of activity has different relative humidity thresholds. Reaction of the stone with the gaseous compounds occurs during the process of absorption onto the surface. The oxidation is accelerated at the gas-water interface by the presence of NO x , and seems to depend on the NO 2 component but it is clear that NO x is only one of many possible oxidants in the urban and rural environments. Correlation studies of the damage to stone materials are unlikely to pick up the effects of NO x due to the nature of their duration and the rather transient nature of the appearance and removal of nitrates on the stone. Presence of other oxidants and catalysts such as H 2 O 2 , O 2 (catalysed by Fe 3+ and Mn 2+ ), OH, HSO 5 - , SO 4 2- , O 3 , HO 2 , NO 2 - , NO 3 , O 2 - and PAN, plus the fact that the reactions are pH and ionic strength sensitive, add greatly

  18. The effects of ozone and NO{sub x} on the deterioration of calcareous stone

    Energy Technology Data Exchange (ETDEWEB)

    Massey, S.W. [Building Research Establishment Ltd, Garston, Watford (United Kingdom)

    1999-03-09

    This paper looks at the changes in urban air quality and the effect on building materials with particular regard to their deterioration arising from pollution due to vehicles. The paper aims to review basic information on the likely effect of NO{sub x} and ozone on calcareous building materials (limestone, marble, dolomite, calcareous cemented sandstone) by examining experimental and fieldwork relating to the principle reaction of the oxidation of the sulphite to sulphate. NO{sub 2} is only one of many possible oxidants present in the urban and rural environment. A brief synopsis of the effects of other oxidants and inhibitors is given along with a review of the processes involved in aqueous phase oxidation, which seems to be the phase where the reactions take place. Controlling factors in the reaction and oxidation of sulphite to sulphate are the type and porosity of the stone, the level of humidity, the nature of the oxidants and to a lesser extent the presence of other extraneous reactants, e.g. metal oxides, chlorine and ammonia salts. For freshly cut stone unpolished marble is much less reactive than porous limestone and the degree of activity has different relative humidity thresholds. Reaction of the stone with the gaseous compounds occurs during the process of absorption onto the surface. The oxidation is accelerated at the gas-water interface by the presence of NO{sub x}, and seems to depend on the NO{sub 2} component but it is clear that NO{sub x} is only one of many possible oxidants in the urban and rural environments. Correlation studies of the damage to stone materials are unlikely to pick up the effects of NO{sub x} due to the nature of their duration and the rather transient nature of the appearance and removal of nitrates on the stone. Presence of other oxidants and catalysts such as H{sub 2}O{sub 2}, O{sub 2} (catalysed by Fe{sup 3+} and Mn{sup 2+}), OH, HSO{sub 5}{sup -}, SO{sub 4}{sup 2-}, O{sub 3}, HO{sub 2}, NO{sub 2}{sup -}, NO{sub 3}, O

  19. The effects of ozone and NO{sub x} on the deterioration of calcareous stone

    Energy Technology Data Exchange (ETDEWEB)

    Massey, S.W. [Building Research Establishment Ltd., Garston, Watford (United Kingdom)

    1999-03-09

    This paper looks at the changes in urban air quality and the effect on building materials with particular regard to their deterioration arising from pollution due to vehicles. The paper aims to review basic information on the likely effect of NO{sub x} and ozone on calcareous building materials (limestone, marble, dolomite, calcareous cemented sandstone) by examining experimental and fieldwork relating to the principle reaction of the oxidation of the sulphite to sulphate. NO{sub 2} is only one of many possible oxidants present in the urban and rural environment. A brief synopsis of the effects of other oxidants and inhibitors is given along with a review of the processes involved in aqueous phase oxidation, which seems to be the phase where the reactions take place. Controlling factors in the reaction and oxidation of sulphite to sulphate are the type and porosity of the stone, the level of humidity, the nature of the oxidants and to a lesser extent the presence of other extraneous reactants, e.g. metal oxides, chlorine and ammonia salts. For freshly cut stone unpolished marble is much less reactive than porous limestone and the degree of activity has different relative humidity thresholds. Reaction of the stone with the gaseous compounds occurs during the process of absorption onto the surface. The oxidation is accelerated at the gas-water interface by the presence of NO{sub x}, and seems to depend on the NO{sub 2} component but it is clear that NO{sub x} is only one of many possible oxidants in the urban and rural environments. Correlation studies of the damage to stone materials are unlikely to pick up the effects of NO{sub x} due to the nature of their duration and the rather transient nature of the appearance and removal of nitrates on the stone. Presence of other oxidants and catalysts such as H{sub 2}O{sub 2}, O{sub 2} (catalysed by Fe{sup 3+} and Mn{sup 2+}), OH, HSO{sub 5}{sup -}, SO{sub 4}{sup 2-}, O{sub 3}, HO{sub 2}, NO{sub 2}{sup -}, NO{sub 3}, O

  20. The Effect of Glycemic Status on Kidney Stone Disease in Patients with Prediabetes

    Directory of Open Access Journals (Sweden)

    Tzu-Hsien Lien

    2016-04-01

    Full Text Available BackgroundWhile the evidence supporting a positive association between diabetes mellitus and kidney stone disease (KSD is solid, studies examining the association between impaired fasting glucose (IFG and KSD show inconsistent results. Currently, there are no studies examining the relationship between impaired glucose tolerance (IGT and KSD. The objective of this study is to investigate the effects of different glycemic statuses on KSD. The results may help to motivate patients with diabetes to conform to treatment regimens.MethodsWe conducted a cross sectional study of a population that underwent health check-ups between January 2000 and August 2009 at the Health Evaluation Center of National Cheng Kung University Hospital. A total of 14,186 subjects were enrolled. The following categories of glycemic status were used according to the criteria of the 2009 American Diabetes Association: normal glucose tolerance, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes. The existence of KSD was evaluated using renal ultrasonography, and the presence of any hyperechoic structures causing acoustic shadowing was considered to be indicative of KSD.ResultsThe prevalence of KSD was 7.4% (712/9,621, 9.3% (163/1,755, 10.8% (78/719, 12.0% (66/548, and 11.3% (174/1,543 in subjects with NGT, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes, respectively. Isolated IFG, combined IFG/IGT, and diabetes were associated with KSD after adjusting for other clinical variables, but isolated IGT was not. Age (41 to 64 years vs. ≤40 years, ≥65 years vs. ≤40 years, male gender, hypertension, and hyperuricemia were also independently associated with KSD.ConclusionIsolated IFG, combined IFG/IGT, and diabetes, but not isolated IGT, were associated with a higher risk of KSD.

  1. Prediction of the Effect of Using Stone Column in Clayey Soil on the Behavior of Circular Footing by ANN Model

    Directory of Open Access Journals (Sweden)

    Omar Khaleel Ismael Al-Kubaisi

    2018-05-01

    Full Text Available Shallow foundations are usually used for structures with light to moderate loads where the soil underneath can carry them. In some cases, soil strength and/or other properties are not adequate and require improvement using one of the ground improvement techniques. Stone column is one of the common improvement techniques in which a column of stone is installed vertically in clayey soils. Stone columns are usually used to increase soil strength and to accelerate soil consolidation by acting as vertical drains. Many researches have been done to estimate the behavior of the improved soil. However, none of them considered the effect of stone column geometry on the behavior of the circular footing. In this research, finite element models have been conducted to evaluate the behavior of a circular footing with different stone column configurations. Moreover, an Artificial Neural Network (ANN model has been generated for predicting these effects. The results showed a reduction in the bending moment, the settlement, and the vertical stresses with the increment of the stone column length, while both the horizontal stress and the shear force were increased. ANN model showed a good relationship between the predicted and the calculated results.

  2. Endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy is safe and effective

    DEFF Research Database (Denmark)

    Jakobsen, Henrik Loft; Vilmann, Peter; Rosenberg, Jacob

    2011-01-01

    Management strategy for common bile duct (CBD) stones is controversial with several treatment options if stones in the CBD are recognized intraoperatively. The aim of this study was to report our experience with same-session combined endoscopic-laparoscopic treatment of gallbladder and CBD stones...

  3. Stone composition and metabolic status.

    Science.gov (United States)

    Bibilash, B S; Vijay, Adarsh; Fazil Marickar, Y M

    2010-06-01

    This paper aims to study the correlation between biochemical risk factors of the stone former and the type of oxalate stone formed, namely calcium oxalate monohydrate (COM) and calcium oxalate dehydrate (COD). A retrospective study of 487 patients who had been attending the urinary stone clinic, Trivandrum during 1998-2007 was conducted. The stones retrieved from them were subjected to chemical analysis and FTIR spectrographic analysis. They were categorized into COM, COD, mixed COM+COD and others. Of 142 pure calcium oxalate stone patients, 87 were predominantly COM stone formers and 55 COD stone formers. Their metabolic status of 24 h urine and serum was assessed. The values of urine calcium, phosphorus, uric acid, magnesium, creatinine, oxalate, citric acid, sodium and potassium, serum values of calcium, phosphorus, uric acid, magnesium and creatinine and calculated values of creatinine clearance, tubular reabsorption of phosphate, calcium magnesium ratio and calcium oxalate ratio were recorded. Comparison was made between the COM stone group and the COD stone group. Patients forming COM stones had significantly higher mean values for urine calcium (P stone forming patients. All other values failed to show significant difference. Patients, with higher urine oxalate, formed COM stones. Those with low magnesium (which is an inhibitor) formed more of COD stones. Urine calcium was high in both groups without showing significant variation from the mean. In patients with high calcium-oxalate and calcium-magnesium ratios, there is higher chance of forming a COD stone than COM. Identification of the crystallization pattern of the calcium stone will help in selecting treatment modalities.

  4. Endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy is safe and effective

    DEFF Research Database (Denmark)

    Jakobsen, Henrik Loft; Vilmann, Peter; Rosenberg, Jacob

    2011-01-01

    Management strategy for common bile duct (CBD) stones is controversial with several treatment options if stones in the CBD are recognized intraoperatively. The aim of this study was to report our experience with same-session combined endoscopic-laparoscopic treatment of gallbladder and CBD stones....... We retrospectively evaluated 31 patients with cholecystolithiasis and CBD stones undergoing same-session combined endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and endoscopic stone extraction and laparoscopic cholecystectomy. Same-session ERCP and sphincterotomy were...... performed in all patients, and stone extraction was successfully performed in 29 patients (93%) with 2 failures (7%) due to impacted stones. In 8 patients (26%), the laparoscopic procedure was converted to open cholecystectomy because of dense adhesions or unclear anatomy. Two patients (7%) developed mild...

  5. ORIGINAL PAPER ORIG ORIG Percutaneous stone removal

    African Journals Online (AJOL)

    Percutaneous nephrolithotomy (PCNL) is an effective procedure to treat patients with complex renal stones,. e.g. staghorn calculi and stones greater than 20 mm in diameter. The treatment of choice for small, less com- plex renal stones is extracorporeal shock-wave litho- tripsy (ESWL).1 We have treated renal stones mainly.

  6. Effectiveness of stone treatments in enhancing the durability of bioclastic calcarenite in (Granada, Spain

    Directory of Open Access Journals (Sweden)

    Sebastián, E.

    2008-12-01

    Full Text Available Santa Pudia limestone, a biocalcarenite highly sensitive to decay, is one of the most commonly used building materials in historical monuments in the city of Granada, Spain. The compatibility between a variety of stone treatments (consolidants and/or water repellents and this calcarenite was analyzed and the resulting improvement in durability assessed. To this end, a two-stage accelerated ageing process was implemented. In the first, freshly quarried, undamaged specimens were altered to resemble the weathered stone in buildings. The second was conducted after applying the various treatments to the artificially aged stone to test their effectiveness. While all the treatments studied (Tegosivin HL100, Silo 111, Estel 1100 and Tegovakon V enhanced stone resistance to decay while barely affecting chromatic parameters, the most effective was Tegowakon V, as it provided the best results in the hydric tests on the limestone.La calcarenita de Santa Pudia es uno de los materiales rocosos de construcción más empleados en las edificaciones monumentales de la ciudad de Granada (España. Se ha evaluado la compatibilidad de diversos productos de tratamiento (de consolidación y/o hidrofugación con esta calcarenita y como son capaces de mejorar su durabilidad. Para ello, se han realizado dos fases de envejecimiento acelerado: la primera tenía el objetivo de acercar el material de cantera sin alterar (“sano” a las condiciones reales del material puesto en obra y actualmente deteriorado; la segunda, efectuada después de aplicar los tratamientos sobre la calcarenita deteriorada, con el fin de determinar su grado de eficacia. Se ha podido comprobar que aunque, en general, todos los productos de tratamiento seleccionados (Tegosivin HL100, Silo 111, Estel 1100 y Tegovakon V mejoran las propiedades del material frente al deterioro y apenas modifican sus parámetros cromáticos, el más eficaz es el Tegovakon V ya que es el que proporciona mejores resultados

  7. The effect of climate variability on urinary stone attacks: increased incidence associated with temperature over 18 °C: a population-based study.

    Science.gov (United States)

    Park, Hyoung Keun; Bae, Sang Rak; Kim, Satbyul E; Choi, Woo Suk; Paick, Sung Hyun; Ho, Kim; Kim, Hyeong Gon; Lho, Yong Soo

    2015-02-01

    The aim of this study was to evaluate the effect of seasonal variation and climate parameters on urinary tract stone attack and investigate whether stone attack is increased sharply at a specific point. Nationwide data of total urinary tract stone attack numbers per month between January 2006 and December 2010 were obtained from the Korean Health Insurance Review and Assessment Service. The effects of climatic factors on monthly urinary stone attack were assessed using auto-regressive integrated moving average (ARIMA) regression method. A total of 1,702,913 stone attack cases were identified. Mean monthly and monthly average daily urinary stone attack cases were 28,382 ± 2,760 and 933 ± 85, respectively. The stone attack showed seasonal trends of sharp incline in June, a peak plateau from July to September, and a sharp decline after September. The correlation analysis showed that ambient temperature (r = 0.557, p r = 0.513, p stone attack cases. However, after adjustment for trends and seasonality, ambient temperature was the only climate factor associated with the stone attack cases in ARIMA regression test (p = 0.04). Threshold temperature was estimated as 18.4 °C. Risk of urinary stone attack significantly increases 1.71% (1.02-2.41 %, 95% confidence intervals) with a 1 °C increase of ambient temperature above the threshold point. In conclusion, monthly urinary stone attack cases were changed according to seasonal variation. Among the climates variables, only temperature had consistent association with stone attack and when the temperature is over 18.4 °C, urinary stone attack would be increased sharply.

  8. Microwave radiation is effective at disinfecting dental stone surfaces without changing their physical properties.

    Science.gov (United States)

    Bona, Ariel José; Amaral-Brito, Mauro Gustavo; Rodrigues, José Augusto; Peruzzo, Daiane Cristina; França, Fabiana Mantovani Gomes

    2017-01-01

    The aims of this study were to evaluate the effectiveness of different microwave radiation regimens for disinfection of type IV dental stone surfaces and to assess the influence of these regimens on surface roughness and dimensional change following disinfection. Three hundred cylindrical (20 × 2-mm) test specimens were made in type IV stone and divided into subgroups of 20 according to the microorganisms tested (Staphylococcus aureus, Escherichia coli, or Candida albicans) and the 900-W microwave radiation protocol (cycles of 3, 5, or 7 minutes; a positive control; or a negative control). To test physical changes, 80 test specimens were made with the same dimensions except that they had 2 parallel and symmetrical indentations measuring 8 × 4 mm. These specimens were divided into 4 subgroups of 20 each (a subgroup for each radiation time and a negative control). The mean dimensional change and roughness data were analyzed by mixed models for repeated measures and Tukey-Kramer tests. Disinfection was analyzed with descriptive statistics. For E coli and C albicans, all radiation times proved effective at sterilizing the test specimens. For S aureus, sterilization was achieved with 5 and 7 minutes of exposure; however, colonies were observed in 10 Petri dishes (50%) exposed to 3 minutes of microwave radiation. No statistically significant difference in dimensional change or surface roughness was observed for any radiation regimen (P > 0.05).

  9. Effect of drinking parsley leaf tea on urinary composition and urinary stones' risk factors.

    Science.gov (United States)

    Alyami, Fahad A; Rabah, Danny M

    2011-05-01

    To investigate the effect of parsley leaf tea on urine composition and the inhibitors of urinary tract stones formation, we studied 20 healthy volunteers who were divided into two groups: the first group of 10 subjects drank daily 1,200 mL of parsley leaf tea for 2 weeks, while the second group drank at least 1,200 mL daily of bottled water for the same period. This was followed by a 2-week "washout" period before the two groups were crossed over for another 2 weeks. During the experimental phase, 24-h urine samples were collected at baseline, on day 14, and at the end of the 6-week period and different urinary parameters were measured and analyzed statistically. We found no significant difference in the urine volume, pH, sodium, potassium, chloride, urea, creatinine, phosphorus, magnesium, uric acid, cystine, or citric acid. Further research is needed to evaluate the effects of parsley leaf tea on urinary parameters in healthy and stone-forming patients.

  10. Effects and radiation dose to patients during extracorporeal shock wave lithotripsy for kidney stones

    International Nuclear Information System (INIS)

    Weng Zhigen; Shao Songsheng; Shao Min

    1991-01-01

    Extracorporeal shock wave lithotripsy (ESWL) is rapidly becoming an accepted treatment of renal calculi. Since fluoroscopy is involved in it to image the stones, it is important to know how much radiation and effects the patients receive during ESWL. Surface radiation exposure to 134 patients and medical personnel were measured during the course of ESWL using LiF(Mg, P, Cu) thermoluminescent dosimeters. Initial results showed an average skin exposure of 162 mSv per case, with a wide range of 5 to 2360 mSv. Factors influencing exposure levels include stone characteristics (location, size and opacity), physician's experience and number of shocks required. The monthly radiation dose to personnel working in the ESWL suite averaged 0.07-0.54 mSv. The effects of radiation to patients were observed pre-and post-ESWL by using white blood cell counts, lyphocyte micronucleus assays and chromosome aberration analysis. White blood cell counts rose or reduced to > 1000 cells in 50 per cent of cases and rose in one third of cases. Lymphocyte micronuclei and chromosome aberrations were observed in 20 patients during the cources. The average frequency of micronuclei was 0.5 per mille pre-ESWL and 1 per mille post-ESWL (P < 0.05). The dicentric chromosomes were markedly increased as compared with those of pre-ESWL with statistically significant difference (P < 0.05)

  11. Mathematical solution of the stone column effect on the load bearing capacity and settlement using numerical analysis

    Science.gov (United States)

    Madun, A.; Meghzili, S. A.; Tajudin, SAA; Yusof, M. F.; Zainalabidin, M. H.; Al-Gheethi, A. A.; Dan, M. F. Md; Ismail, M. A. M.

    2018-04-01

    The most important application of various geotechnical construction techniques is for ground improvement. Many soil improvement project had been developed due to the ongoing increase in urban and industrial growth and the need for greater access to lands. Stone columns are one of the best effective and feasible techniques for soft clay soil improvement. Stone columns increase the bearing capacity and reduce the settlement of soil. Finite element analyses were performed using the program PLAXIS 2D. An elastic-perfectly plastic constitutive relation, based on the Mohr–Coulomb criterion, governs the soft clay and stone column behaviour. This paper presents on how the response surface methodology (RSM) software is used to optimize the effect of the diameters and lengths of column on the load bearing capacity and settlement of soft clay. Load tests through the numerical modelling using Plaxis 2D were carried out on the loading plate at 66 mm. Stone column load bearing capacity increases with the increasing diameter of the column and settlement decreases with the increasing length of the column. Results revealed that the bigger column diameter, the higher load bearing capacity of soil while the longer column length, the lower settlement of soil. However, the optimum design of stone column was varied with each factor (diameter and length) separately for improvement.

  12. Bondonic effects in group-IV honeycomb nanoribbons with Stone-Wales topological defects.

    Science.gov (United States)

    Putz, Mihai V; Ori, Ottorino

    2014-04-03

    This work advances the modeling of bondonic effects on graphenic and honeycomb structures, with an original two-fold generalization: (i) by employing the fourth order path integral bondonic formalism in considering the high order derivatives of the Wiener topological potential of those 1D systems; and (ii) by modeling a class of honeycomb defective structures starting from graphene, the carbon-based reference case, and then generalizing the treatment to Si (silicene), Ge (germanene), Sn (stannene) by using the fermionic two-degenerate statistical states function in terms of electronegativity. The honeycomb nanostructures present η-sized Stone-Wales topological defects, the isomeric dislocation dipoles originally called by authors Stone-Wales wave or SWw. For these defective nanoribbons the bondonic formalism foresees a specific phase-transition whose critical behavior shows typical bondonic fast critical time and bonding energies. The quantum transition of the ideal-to-defect structural transformations is fully described by computing the caloric capacities for nanostructures triggered by η-sized topological isomerisations. Present model may be easily applied to hetero-combinations of Group-IV elements like C-Si, C-Ge, C-Sn, Si-Ge, Si-Sn, Ge-Sn.

  13. Bondonic Effects in Group-IV Honeycomb Nanoribbons with Stone-Wales Topological Defects

    Directory of Open Access Journals (Sweden)

    Mihai V. Putz

    2014-04-01

    Full Text Available This work advances the modeling of bondonic effects on graphenic and honeycomb structures, with an original two-fold generalization: (i by employing the fourth order path integral bondonic formalism in considering the high order derivatives of the Wiener topological potential of those 1D systems; and (ii by modeling a class of honeycomb defective structures starting from graphene, the carbon-based reference case, and then generalizing the treatment to Si (silicene, Ge (germanene, Sn (stannene by using the fermionic two-degenerate statistical states function in terms of electronegativity. The honeycomb nanostructures present η-sized Stone-Wales topological defects, the isomeric dislocation dipoles originally called by authors Stone-Wales wave or SWw. For these defective nanoribbons the bondonic formalism foresees a specific phase-transition whose critical behavior shows typical bondonic fast critical time and bonding energies. The quantum transition of the ideal-to-defect structural transformations is fully described by computing the caloric capacities for nanostructures triggered by η-sized topological isomerisations. Present model may be easily applied to hetero-combinations of Group-IV elements like C-Si, C-Ge, C-Sn, Si-Ge, Si-Sn, Ge-Sn.

  14. A simulation-optimization model for Stone column-supported embankment stability considering rainfall effect

    International Nuclear Information System (INIS)

    Deb, Kousik; Dhar, Anirban; Purohit, Sandip

    2016-01-01

    Landslide due to rainfall has been and continues to be one of the most important concerns of geotechnical engineering. The paper presents the variation of factor of safety of stone column-supported embankment constructed over soft soil due to change in water level for an incessant period of rainfall. A combined simulation-optimization based methodology has been proposed to predict the critical surface of failure of the embankment and to optimize the corresponding factor of safety under rainfall conditions using an evolutionary genetic algorithm NSGA-II (Non-Dominated Sorted Genetic Algorithm-II). It has been observed that the position of water table can be reliably estimated with varying periods of infiltration using developed numerical method. The parametric study is presented to study the optimum factor of safety of the embankment and its corresponding critical failure surface under the steady-state infiltration condition. Results show that in case of floating stone columns, period of infiltration has no effect on factor of safety. Even critical failure surfaces for a particular floating column length remain same irrespective of rainfall duration

  15. A simulation-optimization model for Stone column-supported embankment stability considering rainfall effect

    Energy Technology Data Exchange (ETDEWEB)

    Deb, Kousik, E-mail: kousik@civil.iitkgp.ernet.in [Associate Professor, Department of Civil Engineering, IIT Kharagpur, Kharagpur-721302 (India); Dhar, Anirban, E-mail: anirban@civil.iitkgp.ernet.in [Assistant Professor, Department of Civil Engineering, IIT Kharagpur, Kharagpur-721302 (India); Purohit, Sandip, E-mail: sandip.purohit91@gmail.com [Former B.Tech Student, Department of Civil Engineering, NIT Rourkela, Rourkela (India)

    2016-02-01

    Landslide due to rainfall has been and continues to be one of the most important concerns of geotechnical engineering. The paper presents the variation of factor of safety of stone column-supported embankment constructed over soft soil due to change in water level for an incessant period of rainfall. A combined simulation-optimization based methodology has been proposed to predict the critical surface of failure of the embankment and to optimize the corresponding factor of safety under rainfall conditions using an evolutionary genetic algorithm NSGA-II (Non-Dominated Sorted Genetic Algorithm-II). It has been observed that the position of water table can be reliably estimated with varying periods of infiltration using developed numerical method. The parametric study is presented to study the optimum factor of safety of the embankment and its corresponding critical failure surface under the steady-state infiltration condition. Results show that in case of floating stone columns, period of infiltration has no effect on factor of safety. Even critical failure surfaces for a particular floating column length remain same irrespective of rainfall duration.

  16. Enhanced affordable methods for assessment of material characteristics and consolidation effects on stone and mortar

    Science.gov (United States)

    Drdacky, M.; Slizkova, Z.

    2012-04-01

    In situ considerate testing of surface cohesion of historic stone and mortar materials suffers from a lack of suitable affordable non-destructive methods. The problem is mainly important for assessment of surface degradation characteristics and/or evaluation of effectiveness of consolidation treatment of degraded historic materials. The paper presents two innovations of simple testing methods which provide reliable data on material cohesion and water uptake. The so called "Scotch Tape Test" or peeling test has been introduced into the field of conservation for testing the cohesion qualities of historic materials mainly stone and renders in sixties without any standards or reliably verified recommendations for the above mentioned application in the conservation practice. Licentious use without adequate knowledge and sufficient understanding leads to non-comparable and non-reproducible as well as in many cases incorrect and severely biased results and assessments. Therefore, the authors after a research and comparative testing have established limits for its application, reliable procedures and a "standard" protocol for testing of cohesion characteristics of brittle and quasi brittle materials mainly mortars and stones. This article presents a detailed analysis of the peeling test procedures, and suggests recommendations for performing peeling tests and for evaluating the obtained results. Also in situ testing of material water uptake is a very basic and indispensable technique in conservation practice and it correlates significantly with some other material characteristics. The capillary properties of porous materials can be measured in situ using a Karsten tube and modified tools or methods which are quite cumbersome, and cannot be performed on inclined surfaces, e.g. vaults or ceilings. There are other difficulties with Karsten tube measurements, e.g. problems with fixing a heavy glass tube on vertical surfaces, a need for two operators, and soiling of the surface

  17. Nonoperative options for management of residual stones after cholecystostomy in high-risk patients

    Science.gov (United States)

    Reed, David M.; Daye, S. S.; Lincer, R. M.

    1993-05-01

    Cholecystostomy is frequently performed to obtain control of sepsis in high risk patients with acute cholecystitis. Retained stones in the gallbladder may cause future clinical problems. We present two patients with cholecystostomy tubes managed non-operatively. A review of other reported methods for stone extraction or destruction is also presented. Knowledge of safe and effective techniques for removal of these stones, using minimally invasive techniques is useful to the general surgeon.

  18. Effects of dietary interventions on 24-hour urine parameters in patients with idiopathic recurrent calcium oxalate stones

    Directory of Open Access Journals (Sweden)

    Mustafa Kıraç

    2013-02-01

    Full Text Available The aim of this study is to investigate the effects of dietary factors on 24-hour urine parameters in patients with idiopathic recurrent calcium oxalate stones. A total of 108 of idiopathic recurrent calcium oxalate stones were included in the study. A 24-hour urinalysis was performed and metabolic abnormalities were measured for all of the patients. All of the patients were given specialized diets for their 24-hour urine abnormalities. At the end of first month, the same parameters were examined in another 24-hour urinalysis. Hyperoxaluria, hypernatruria, and hypercalciuria were found in 84 (77%, 43 (39.8%, and 38 (35.5% of the patients, respectively. The differences between the oxalate, sodium, volume, uric acid, and citrate parameters before and after the dietary intervention were significant (p < 0.05. The calcium parameters were not significantly different before and after the intervention. We found that oxalate, sodium, volume, uric acid, and citrate—but not calcium—abnormalities in patients with recurrent calcium oxalate stones can be corrected by diet. The metabolic profiles of idiopathic calcium oxalate stone patients should be evaluated and the appropriate dietary interventions should be implemented to decrease stone recurrence.

  19. Medical expulsive therapy for ureteral stones: where do we go from here?

    NARCIS (Netherlands)

    Somani, Bhaskar K.; Aboumarzouk, Omar; Traxer, Olivier; Baard, Joyce; Kamphuis, Guido; de la Rosette, Jean

    2016-01-01

    Despite two decades of clinical use, the effectiveness of medical expulsive therapy (MET) for the noninvasive management of patients with ureteral stones has, in the past year, been called into in question. The primary aim of MET is to expedite stone passage, although it has also shown effectiveness

  20. 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.

  1. Carbon nanotube as NEMS sensor - effect of chirality and stone-wales defect intend

    International Nuclear Information System (INIS)

    Gayathri, V; Geetha, R

    2006-01-01

    Having nanosize and unique electrical properties, carbon nanotubes (CNTs) attract lot of interest among scientific community all over the world. One of the recent observations is its role as nanosensors. Obviously the nanosize and high strength of CNT are most preferred parameter for technical and electromechanical field in the industrial point of view. The defects in CNT structure have a vital role in determining their electrical and mechanical properties. Our earlier study indicates an effective role played by the topological defects like pentagon and octagon on the electromechanical properties of these nanostructures. Here our aim is to look in to the effect of Stone-wales defect and chirality on this property of nanotubes deformed under applied pressure. Among the three kinds of tubes considered for this study, we observed that armchair (5, 5) tube is more suitable for sensor applications

  2. Behaviour of a cement stone with chemical additions under short high temperature effects

    International Nuclear Information System (INIS)

    Falikman, V.R.; Veselova, V.I.; Ershov, V.Yu.; Muzalevskij, L.P.

    1987-01-01

    The purpose of the paper is to investigate the influence of different chemical additions used in NPP construction on thermal stability of a cement stone under short- and high-temperature effects. S-3 and dihydroxyphenyl utilized as peptizing agents for increase of placeability of concrete mixtures as well as sodium nitrite utilized as an antifreezing addition at conccreting at low temperatures are used as additions. The investigations were conducted in the 0-900 deg C temperature range divided into 4 ranges. Shrinkage and mass losses of specimens were determined. The obtained data show that specimens with additions are subjected to smaller shrinkage and mass losses as compared with specimens without additions. The highest positive effect is attained in portland cements with active mineral additions

  3. BIOCHEMICAL EFFECTS IN NORMAL AND STONE FORMING RATS TREATED WITH THE RIPE KERNEL JUICE OF PLANTAIN (MUSA PARADISIACA)

    Science.gov (United States)

    Devi, V. Kalpana; Baskar, R.; Varalakshmi, P.

    1993-01-01

    The effect of Musa paradisiaca stem kernel juice was investigated in experimental urolithiatic rats. Stone forming rats exhibited a significant elevation in the activities of two oxalate synthesizing enzymes - Glycollic acid oxidase and Lactate dehydrogenase. Deposition and excretion of stone forming constituents in kidney and urine were also increased in these rats. The enzyme activities and the level of crystalline components were lowered with the extract treatment. The extract also reduced the activities of urinary alkaline phosphatase, lactate dehydrogenase, r-glutamyl transferase, inorganic pyrophosphatase and β-glucuronidase in calculogenic rats. No appreciable changes were noticed with leucine amino peptidase activity in treated rats. PMID:22556626

  4. Frequency and factors effecting non clearance of lower pole renal stones

    International Nuclear Information System (INIS)

    Ullah, A.; Zubair, M.; Khan, N.; Malik, A.

    2015-01-01

    Renal stone disease is a major health hazard in Pakistan and extra-corporeal shockwave lithotripsy is one of comprehensive method used to treat these stones. The aim of this study is to determine the frequency of factors affecting the non-clearance of stone fragments of lower pole renal stone after extra corporeal shockwave lithotripsy. The study was done with the objective to determine the frequency the spatial anatomical factors which can influence the non-clearance of lower pole stone fragments after ESWL. Methods: One and nineteen (119) patients with lower pole renal stone less than 10 mm were subjected to maximum 3 sessions of extracorporeal shock wave lithotripsy. KUB radiographs, ultrasonography and intravenous urography were used as investigative tools for lower pole renal calyceal anatomy. X ray KUB and ultrasound were done after a week for clearance. Data was analysed with the help of SPSS version 10.0 and presented in the forms of tables and graphs. Results: There were 77 (64.71%) males and 42 (35.29%) females. Infundibulo-pelvic angle (IPA)>40 degree was present in 93 (78.15%), Infundibular length (IL) <22 mm in 107 (89.92%) and Infundibular width (IW) >4 mm was present in 100 (84.03%) patients. The frequency of stone non clearance was noted in 31 (26.05%). Infundibulo-pelvic angle (IPA)>40 degree (p=0.000), Infundibular length (IL)<22 mm (p=0.001) and Infundibular width (IW)>4 mm (p=0.046) were significant variables affecting stone clearance. Conclusion: The frequency of non-clearance of lower calyx of kidney stone is 26.05%. The clearance of fragments of the lower calyx kidney stones is affected by three spatial anatomical factors, i.e., Infundibulopelvic angle, Infundibular width and infundibular length. (author)

  5. Quantification of the Range of Motion of Kidney and Ureteral Stones During Shockwave Lithotripsy in Conscious Patients.

    Science.gov (United States)

    Harrogate, Suzanne R; Yick, L M Shirley; Williams, James C; Cleveland, Robin O; Turney, Benjamin W

    2016-04-01

    Effective shockwave lithotripsy requires accurate targeting of the stone throughout the course of treatment. Stone movement secondary to respiratory movement can make this more difficult. In vitro work has shown that stone motion outside the focal region reduces the efficacy of stone fragmentation; however, there are few clinical data on the degree of stone movement in patients during treatment. To investigate this, X-ray fluoroscopic images of the kidney and ureteral stones at the upper and lower limits of the normal respiratory cycle were acquired during shock wave lithotripsy of 58 conscious patients, and stone excursion was calculated from these images. In addition, the respiration rate and patient perceived pain were recorded during the course of the treatment. It was found that stone motion secondary to respiration was 7.7 ± 2.9 mm for kidney stones and 3.6 ± 2.1 mm for ureteral stones-less than has been reported in studies with anesthetized patients. There was no significant change of motion over the course of treatment although pain was found to increase. These data suggest that stone motion in conscious patients is less than in anesthetized patients. Furthermore, it suggests that lithotripters with focal regions of 8 mm or greater should not suffer from a marked drop in fragmentation efficiency due to stone motion.

  6. Open stone surgery: a still-in-use approach for complex stone burden.

    Science.gov (United States)

    Çakici, Özer Ural; Ener, Kemal; Keske, Murat; Altinova, Serkan; Canda, Abdullah Erdem; Aldemir, Mustafa; Ardicoglu, Arslan

    2017-06-30

    Urinary stone disease is a major urological condition. Endourologic techniques have influenced the clinical approach and outcomes. Open surgery holds a historic importance in the management of most conditions. However, complex kidney stone burden may be amenable to successful results with open stone surgery. In this article, we report our eighteen cases of complex urinary stone disease who underwent open stone removal. A total of 1701 patients have undergone surgical treatment for urinary stone disease in our clinic between July 2012 and July 2016, comprising eighteen patients who underwent open stone surgery. Patients' demographic data, stone analysis results, postoperative clinical data, and stone status were evaluated retrospectively. The choice of surgical approach is mostly dependent on the surgeon's preference. In two patients, open surgery was undertaken because of perioperative complications. We did not observe any Clavien-Dindo grade 4 or 5 complications. Three patients were managed with a course of antibiotics due to postoperative fever. One patient had postoperative pleurisy, one patient had urinoma, and two patients had postoperative ileus. Mean operation time was 84 (57-124) minutes and mean hospitalization time was 5.5 (3-8) days. Stone-free status was achieved in 15 patients (83.3%). Endourologic approaches are the first options for treatment of urinary stone disease. However, open stone surgery holds its indispensable position in complicated cases and in complex stone burden. Open stone surgery is also a valid alternative to endourologic techniques in all situations.

  7. Kidney Stones (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Kidney Stones KidsHealth / For Parents / Kidney Stones What's in ... other treatments to help remove the stones. How Kidney Stones Form It's the kidneys' job to remove ...

  8. Effects of immersion disinfection of agar-alginate combined impressions on the surface properties of stone casts.

    Science.gov (United States)

    Iwasaki, Yukiko; Hiraguchi, Hisako; Iwasaki, Eriko; Yoneyama, Takayuki

    2016-01-01

    This study investigated the effects of disinfection of agar-alginate combined impressions on the surface properties of the resulting stone casts. Two brands of cartridge-form agar impression material and one alginate impression material were used. Agar-alginate combined impressions of smooth glass plates were prepared. The impressions were immersed in 0.55% ortho-phthalaldehyde solution or 0.5% sodium hypochlorite solution for 1, 3, 5 and 10 min. A stone cast made with an impression that had not been immersed was prepared as a control. The surface roughness (Ra) of the stone casts was measured, and the cast surfaces were observed by SEM. Immersion of agar-alginate combined impressions in 0.5% sodium hypochlorite solution for up to 10 min had no serious adverse effects on the surface properties of the stone casts. In contrast, even 1 min of immersion in 0.55% ortho-phthalaldehyde solution caused deterioration of the cast surface properties.

  9. 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.

  10. Effect of pore structure on chemico-osmotic, diffusion and hydraulic properties of mud-stones

    International Nuclear Information System (INIS)

    Takeda, M.; Manaka, M.; Ito, K.; Miyoshi, S.; Tokunaga, T.

    2012-01-01

    Formations in the Horonobe research area of Japan, where the Japan Atomic Energy Agency (JAEA) has been operating an Underground Research Laboratory. The rock samples are of cylindrical shape with 50 mm in diameter and 10 mm in length. The rock samples were immersed in 0.1 M NaCl solutions before experiments. The densities, specific surface area and cation exchange capacity were measured for the remains of drill cores from which the samples were taken. Pore radius distribution, average pore radius and porosity were also evaluated for each drill cores by mercury porosimetry. The permeability and chemical-osmosis experiments were performed in sequence on each rock sample under the confining pressures simulating in-situ effective stress condition. 0.1 M NaCl solution was used as permeant fluid in the permeability experiment, and the same solution was used as initial solution in the subsequent chemical-osmosis experiment. In the permeability experiment, a constant pressure was applied to the upper surface of rock sample. In the chemical-osmosis experiment, the bottom reservoir solution was replaced with 0.6 M NaCl solution. Both experiments were performed with the bottom reservoir isolated from the pressure buffer tank, and the progress of each experiment was monitored by measuring the bottom reservoir pressure. Figure 2 shows the chemico-osmotic, diffusion and hydraulic parameters determined for the Koetoi and Wakkanai mud-stone samples as functions of porosity. The diffusion and hydraulic parameters of these samples generally decrease with the decrease of porosity, while the osmotic efficiency is not a simple function of porosity. A relatively large osmotic efficiency was obtained only from a Wakkanai mud-stone sample with porosity of 0.33. The Wakkanai mud-stone samples have similar average pore radius, ranging from 6.8 to 7.6 nm; however, the Wakkanai mud-stone samples without large osmotic efficiency have bimodal pore structures. These suggest that even if small size pores

  11. In vitro study of transmission of bacteria from contaminated metal models to stone models via impressions

    DEFF Research Database (Denmark)

    Sofou, A.; Larsen, T.; Öwall, B.

    2002-01-01

    Dental impression, stone model, bacterial contamination, cross-infection, dental clinic, dental laboratory......Dental impression, stone model, bacterial contamination, cross-infection, dental clinic, dental laboratory...

  12. Two birds with one stone: experiences of combining clinical and research training in addiction medicine

    OpenAIRE

    Klimas, J.; McNeil, R.; Ahamad, K.; Mead, A.; Rieb, L.; Cullen, W.; Wood, E.; Small, W.

    2017-01-01

    Background Despite a large evidence-base upon which to base clinical practice, most health systems have not combined the training of healthcare providers in addiction medicine and research. As such, addiction care is often lacking, or not based on evidence or best practices. We undertook a qualitative study to assess the experiences of physicians who completed a clinician-scientist training programme in addiction medicine within a hospital setting. Methods We interviewed physicians from the S...

  13. Laparoscopic transperitoneal ureterolithotomy for large ureteric stones

    Directory of Open Access Journals (Sweden)

    Ahmed Al-Sayyad

    2012-01-01

    Conclusion: Laparoscopic transperitoneal ureterolithotomy is a safe and effective approach for selected patients with large proximal ureteric stones with reduced postoperative pain and short hospital stay, and should be considered as a treatment option for such stones.

  14. Stone coalgebras

    NARCIS (Netherlands)

    C.A. Kupke (Clemens); A. Kurz (Alexander); Y. Venema

    2003-01-01

    textabstractIn this paper we argue that the category of Stone spaces forms an interesting base category for coalgebras, in particular, if one considers the Vietoris functor as an analogue to the power set functor on the category of sets. We prove that the so-called descriptive general frames, which

  15. Impaction and Prediction: Does Ureteral Wall Thickness Affect the Success of Medical Expulsive Therapy in Pediatric Ureteral Stones?

    Science.gov (United States)

    Tuerxun, Aierken; Batuer, Abudukahaer; Erturhan, Sakip; Eryildirim, Bilal; Camur, Emre; Sarica, Kemal

    2017-01-01

    The study aimed to evaluate the predictive value of ureteral wall thickness (UWT) and stone-related parameters for medical expulsive therapy (MET) success with an alpha blocker in pediatric upper ureteral stones. A total of 35 children receiving MET ureteral stones (Hounsfield unit), degree of hydronephrosis, and UWT were evaluated with patient demographics and recorded. The possible predictive value of these parameters in success rates and time to stone expulsion were evaluated in a comparative manner between the 2 groups. The overall mean patient age and stone size values were 5.40 ± 0.51 years and 6.24 ± 0.28 mm, respectively. Regarding the predictive values of these parameters for the success of MET, while stone size and UWT were found to be highly predictive for MET success, patients age, body mass index, stone density, and degree of hydronephrosis had no predictive value on this aspect. Our findings indicated that some stone and anatomical factors may be used to predict the success of MET in pediatric ureteral stones in an effective manner. With this approach, unnecessary use of these drugs that may cause a delay in removing the stone will be avoided, and the possible adverse effects of obstruction as well as stone-related clinical symptoms could be minimized. © 2017 S. Karger AG, Basel.

  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. Comparative Study between Digital Tomosynthesis and Endoscopic Retrograde Cholangio pancreatography for the Evaluation of Common Bile Duct Stones: Focus on Detection and Stone Conspicuity

    International Nuclear Information System (INIS)

    Huh, Ji Mi; Baek, Seung Yon; Hwang, Yun Mi; Lee, Jeong Kyong; Kim, Yoo Kyung; Yi, Sun Young

    2011-01-01

    To compare digital tomosynthesis with endoscopic retrograde cholangiopancreatography (ERCP) for the evaluation of common bile duct (CBD) stones as a complementary diagnostic tool. Ninety six consecutive patients clinically suspected of having CBD stones underwent ERCP and digital tomosynthesis over 22 months, from December, 2008 to May, 2010. Fourteen patients were excluded. Therefore 82 patients were included in this study. The images were retrospectively reviewed to compare the results with the final analysis based on the consensus of two abdominal radiologists. An evaluation of the presence of CBD stones was followed by a determination of the margins for the stones, scored with a five-point conspicuity scale. Among the 82 patients, 54 collectively had 89 CBD stones and 28 had no stones. The sensitivity and specificity for the detection of CBD stones were 91.0% and 80.6% for ERCP, 92.1% and 93.5% for digital tomosynthesis, respectively. The average score was 3.29 for ERCP and 3.89 for digital tomosynthesis in 77 similar detected stones. Digital tomosynthesis demonstrated significantly better conspicuity than ERCP (p = 0.001). Digital tomosynthesis is an effective and complementary diagnostic method for the evaluation of CBD stones.

  18. ZEOLITE: "THE MAGIC STONE"; MAIN NUTRITIONAL, ENVIRONMENTAL, EXPERIMENTAL AND CLINICAL FIELDS OF APPLICATION.

    Science.gov (United States)

    Laurino, Carmen; Palmieri, Beniamino

    2015-08-01

    zeolites (clinoptilolites) are a family of alluminosilicates and cations clustered to form macro aggregates by small individual cavities. In the medical area they are involved in detoxification mechanisms capturing ions and molecules into their holes. Actually, we classify about 140 types of natural and 150 synthetic zeolites, for specific and selective use. Clinoptilolite is a natural zeolite and it is the most widespread compound in the medical market. this review analyzes the main fields of zeolite utilization. we searched Pubmed/Medline using the terms "zeolite" and "clinoptilolite". in zoothechnology and veterinary medicine zeolite improves the pets' fitness, removes radioactive elements, aflatoxines and poisons. Zeolite displays also antioxidant, whitening, hemostatic and anti-diarrhoic properties, projected in human care. However very scanty clinical studies have been run up to now in immunodeficiency, oncology after chemotherapy and radiotherapy as adjuvants. further clinical investigations are urgently required after this review article publication which updates the state of the art. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  19. Two birds with one stone: experiences of combining clinical and research training in addiction medicine.

    Science.gov (United States)

    Klimas, J; McNeil, R; Ahamad, K; Mead, A; Rieb, L; Cullen, W; Wood, E; Small, W

    2017-01-23

    Despite a large evidence-base upon which to base clinical practice, most health systems have not combined the training of healthcare providers in addiction medicine and research. As such, addiction care is often lacking, or not based on evidence or best practices. We undertook a qualitative study to assess the experiences of physicians who completed a clinician-scientist training programme in addiction medicine within a hospital setting. We interviewed physicians from the St. Paul's Hospital Goldcorp Addiction Medicine Fellowship and learners from the hospital's academic Addiction Medicine Consult Team in Vancouver, Canada (N = 26). They included psychiatrists, internal medicine and family medicine physicians, faculty, mentors, medical students and residents. All received both addiction medicine and research training. Drawing on Kirkpatrick's model of evaluating training programmes, we analysed the interviews thematically using qualitative data analysis software (Nvivo 10). We identified five themes relating to learning experience that were influential: (i) attitude, (ii) knowledge, (iii) skill, (iv) behaviour and (v) patient outcome. The presence of a supportive learning environment, flexibility in time lines, highly structured rotations, and clear guidance regarding development of research products facilitated clinician-scientist training. Competing priorities, including clinical and family responsibilities, hindered training. Combined training in addiction medicine and research is feasible and acceptable for current doctors and physicians in training. However, there are important barriers to overcome and improved understanding of the experience of addiction physicians in the clinician-scientist track is required to improve curricula and research productivity.

  20. [Solitary stones of the lower renal calyx: how to treat?

    Science.gov (United States)

    Martov, A G; Ergakov, D V; Andronov, A S; Dutov, S V; Takhaev, R A; Kil'chukov, Z I; Moskalenko, S A

    2017-06-01

    The choice of treatment for the stones of the lower renal calyx is one of the challenging issues of modern urology. The aim of this retrospective and prospective study was to investigate the clinical effectiveness and safety of 3 modern minimally invasive techniques for treating renal stones: percutaneous (PNL) and transurethral (TNL) nephrolithotripsy and extracorporeal shock wave lithotripsy (ESWL) in patients with solitary lower calyx stones sized from 10 to 15 mm. The study included 136 patients with symptomatic stones of the lower calyces, who underwent ESWL, PNL and TNL from November 2010 to the present day. The criteria for inclusion in the study were: the presence of a solitary stone of the lower calyx, the stone size of 10 mm to 15 mm, the performance of the classical (standard) PNL in the prone position (puncture access 28-30 Fr) and the follow-up examination at 3 months after the operation. Forty-six patients underwent ESWL, 49 - PNL, and 41 - TNL. Postoperative follow-up was done at 3 months and included a plain radiography, ultrasound and non-contrast-enhanced computed tomography. The stone free rate (SFR) was used as a criterion for the effectiveness of the intervention, where the stone size of 3 mm was taken as the upper limit for the possible presence of fragments. Besides, the rate of repeat interventions, complications and subjective assessment of patients treatment satisfaction (0 to 10) by using visual analogue scale (VAS) were investigated. The effectiveness analysis of the three methods for treating the lower calyx stones sized 10-15 mm showed that PNL was no more effective than TNL (SFR 95.9% and 85.4%, respectively), but both methods were significantly more effective than ESWL (SFR 69.5%). 29.3% of patients who underwent TNL required repeat interventions (TNL or ESWL), while among those treated with ESWL, 45.6% required repeat ESWL sessions. PNL resulted in stone clearance in one stage. Postoperative inflammatory complications were most

  1. Automated astatination of biomolecules - a stepping stone towards multicenter clinical trials

    DEFF Research Database (Denmark)

    Aneheim, Emma; Albertsson, Per; Bäck, Tom

    2015-01-01

    To facilitate multicentre clinical studies on targeted alpha therapy, it is necessary to develop an automated, on-site procedure for conjugating rare, short-lived, alpha-emitting radionuclides to biomolecules. Astatine-211 is one of the few alpha-emitting nuclides with appropriate chemical...... vector, which can guide the radiation to the cancer cells. Consequently, an appropriate method is required for coupling the nuclide to the vector. To increase the availability of astatine-211 radiopharmaceuticals for targeted alpha therapy, their production should be automated. Here, we present a method...... challenging, alpha-emitting radionuclide. In this work, we describe the process platform, and we demonstrate the production of both astaine-211, for preclinical use, and astatine-211 labelled antibodies....

  2. Do stone size and impaction influence therapeutic approach to proximal ureteral stones?

    Directory of Open Access Journals (Sweden)

    Radulović Slobodan

    2009-01-01

    Full Text Available Background/Aim. Primary therapeutic approach to lumbar ureteral stones is still contraversial. The aim of the study was to investigate the influence of stone impaction and size on the effectiveness of proximal ureteral stone lithotripsy. Methods. A total of 123 patients with proximal ureteral stones were investigated in this prospective study performed in a 10- month period. The patients were divided into the group I - 86 patients treated with extracorporeal shock wave lithotripsy (ESWL and the group II - 37 patients treated with 'Swiss' Lithoclast. In the group I, 49 stones (57% were classified as impacted, while 20 stones (23.3% were larger than 100 mm2. In the group II, 26 stones (70.3% were impacted, and 11 stones (29.7% were larger than 100 mm2. Stones were defined as impacted by the radiographic, echosonographic as well as endoscopic findings in the group II of patients. Stone size was presented in mm2. Chemical composition of stones were almost the same in both groups of the patients. Results. Generally, there was no statistically significant difference in the treatment success between the groups. However, stones larger than 100 mm2 were statistically more successfully treated endoscopically, while there was no statistical difference in the treatment success of impacted stones between these two groups. Conclusion. ESWL can by considered as primary first therapeutic approach in treatment of all proximal ureteral stones except for stones larger than 100 mm2 that should primarily be treated endoscopically.

  3. Anisotropy indices and the effects on the hydric behaviour of natural stone

    Science.gov (United States)

    Fort, Rafael; Alvarez de Buergo, Monica; Varas, Maria Jose; Gomez-Heras, Miguel

    2010-05-01

    Building stone is an anisotropic material. Each type of rock (granite, limestone, slate, marble, etc.) has a different anisotropy, which is related to its own geological history, i.e. formation conditions and alteration processes. Knowing the anisotropy of natural stone is a matter of interest for determining the most adequate way to extract it from the quarry, for a better use during its manufacture or processing, to determine the quality of elements to be used as ashlars/masonry or as ornamental elements carving, as well to their arrangement in a structure. At the same time, materiaĺs anisotropy will condition the placing of, for instance, anchorages in dressing stone slabs. Anisotropy of natural stone controls water entry and its mobility, together with atmospheric pollutantśs, processes that favour the stone decay in building works, mainly those that shows a marked directional component, as it is the case of capillary water absorption. Water tends to be absorbed differently along the distinct main anisotropy directions, which are principally marked due to the arrangement and distribution of porosity in the rock. The aim of this study is to perform a comparative analysis of the various anisotropy indices commonly used when dealing with natural stone, determined by ultrasonic propagation techniques, in order to establish how anisotropy (by means of these indices) affect the process of capillary water absorption. Different type of natural stones have been selected, according to their traditional use for the construction of buildings in the region of Madrid (Spain). Their petrophysical properties have been determined (density, porosity, water absorption, etc), as well as ultrasonic transmission velocity has been measured along the three spatial directions of the test specimens (from 50 to 100 for each petrological type). According to this, the stone specimens were classified in different anisotropy levels or classes. Results show that stones with the highest

  4. Cost-effectiveness analysis of endoscopic ultrasound versus magnetic resonance cholangiopancreatography in patients with suspected common bile duct stones.

    Directory of Open Access Journals (Sweden)

    Stephen Morris

    Full Text Available Patients with suspected common bile duct (CBD stones are often diagnosed using endoscopic retrograde cholangiopancreatography (ERCP, an invasive procedure with risk of significant complications. Using endoscopic ultrasound (EUS or Magnetic Resonance CholangioPancreatography (MRCP first to detect CBD stones can reduce the risk of unnecessary procedures, cut complications and may save costs.This study sought to compare the cost-effectiveness of initial EUS or MRCP in patients with suspected CBD stones.This study is a model based cost-utility analysis estimating mean costs and quality-adjusted life years (QALYs per patient from the perspective of the UK National Health Service (NHS over a 1 year time horizon. A decision tree model was constructed and populated with probabilities, outcomes and cost data from published sources, including one-way and probabilistic sensitivity analyses.Using MRCP to select patients for ERCP was less costly than using EUS to select patients or proceeding directly to ERCP ($1299 versus $1753 and $1781, respectively, with similar QALYs accruing to each option (0.998, 0.998 and 0.997 for EUS, MRCP and direct ERCP, respectively. Initial MRCP was the most cost-effective option with the highest monetary net benefit, and this result was not sensitive to model parameters. MRCP had a 61% probability of being cost-effective at $29,000, the maximum willingness to pay for a QALY commonly used in the UK.From the perspective of the UK NHS, MRCP was the most cost-effective test in the diagnosis of CBD stones.

  5. Numerical analysis of stone columns in mitigating liquefaction effects in embankment fills

    Energy Technology Data Exchange (ETDEWEB)

    Borghei, Z.; Soroush, A. [Amirkabir University of Technology, Tehran, (Iran, Islamic Republic of); Noorzad, A. [Power and Water University of Technology, Tehran, (Iran, Islamic Republic of)

    2010-07-01

    The traditional approach to liquefaction in embankment fills is to use in-situ densification. The use of stone columns offers the possibility of preventing liquefaction and associated settlements while reducing the cost and time required for treatment. This paper investigated the behaviour of stone columns using a numerical method. The study focused on a case study, a sand layer beneath two wall tanks, butane and propane NGL, located on Siri Island, Persian Gulf, Iran. Numerical analyses were carried out to evaluate the rate of excess pore pressure build-up in the improved ground. The numerical model results were compared to the simulation results from a centrifuge test for a uniform 19m-thick liquefiable sand layer. The numerical methodology was verified. The results showed that the stone columns can significantly increase the rate of pore pressure dissipation and reduce the settlement. It was found that the installation process densifies the surrounding soil, decreasing the liquefaction potential.

  6. 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

  7. The effect of disinfection of alginate impressions with 35% beetle juice spray on stone model linear dimensional changes

    Directory of Open Access Journals (Sweden)

    Anggra Yudha Ramadianto

    2007-07-01

    Full Text Available Dimensional stability of alginate impression is very important for treatment in dentistry. This study was to find the effect of the beetle juice spray procedure on alginate impression on gypsum model linear dimensional changes. This experimental study used 25 samples, divided into 5 groups. The first group, as control, were the alginate impressions filled with dental stone immediately after forming. The other four groups were the alginate impressions gel spray each 1,2,3, and 4 times with 35% beetle juice and then filled with dental stone. Dimensional changes were measured in the lower part of the plaster model from buccal-lingual and mesial-distal direction and also measured in the outer distance between the upper part of the stone model by using Mitutoyo digital micrometre and profile projector scaled 0,001 mm. The results of mesial-distal diameter average of the control group and group 2,3,4, and 5 were 9.909 mm, 9.852 mm, 9.845 mm, 9.824 mm, and 9.754 mm. Meanwhile, the results of buccal-lingual diameter average were 9.847 mm, 9.841 mm, 9.826 mm, 9.776 mm, and 9.729 mm. The results of the outer distance between the upper part of the stone model were 31.739 mm, 31.689 mm, 31.682 mm, 31.670 mm, and 31.670 mm. The data of this study was evaluated statistically based on the variant analysis. The conclusion of this study was statistically, there was no significant effect on gypsum model linear dimensional changes obtained from alginate impressions sprayed with 35% beetle juice.

  8. 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

  9. Effect of rock fragment embedding on the aeolian deposition of dust on stone-covered surfaces

    NARCIS (Netherlands)

    Goossens, D.

    2005-01-01

    Many stone-covered surfaces on Earth are subject to aeolian deposition of atmospheric dust. This study investigates how the deposition of dust is affected when rock fragments become gradually more embedded in the ground or, inversely, become more concentrated on the surface. Experiments were

  10. Effect on stone lines on soil chemical characteristics under continuous sorghum cropping in semiarid Burkina Faso

    NARCIS (Netherlands)

    Zougmore, R.; Gnankambary, Z.; Guillobez, L.S.; Stroosnijder, L.

    2002-01-01

    In the semiarid Sahel, farmers commonly lay stone lines in fields to disperse runoff. This study was conducted in northern Burkina Faso to assess the chemical fertility of soil under a permanent, non-fertilised sorghum crop, which is the main production system in this area, 5 years after laying

  11. Effect of substitution of sand stone dust for quartz and clay in triaxial ...

    Indian Academy of Sciences (India)

    Few quartz grains (20–40μm) are associated with circumferential cracks around them. Keywords. Environmental pollutant; sand stone dust; ceramic tiles; pavement block; vitrification; ... increased risk of tuberculosis. Moreover, exposure ..... Health. 14 94. Hamano K, Nakagawa Z and Hasegawa M 1992 J. Ceram. Soc. Jap.

  12. Effect of stylolites on the durability of building stones : Two case studies

    NARCIS (Netherlands)

    Larbi, J.A.

    2003-01-01

    The mechanical properties and the durability of natural building stones are influenced to a large extent by inherent inhomogeneities. One of such inhomogeneities is a stylolite, particularly when it occuts in carbonate-rich rocks. Stylolites are irregular surfaces in which small tooth-like

  13. Enhanced affordable methods for assessing material characteristics and consolidation effects on stone and mortar

    International Nuclear Information System (INIS)

    Drdácký, Miloš; Slížková, Zuzana

    2013-01-01

    It is rather difficult to set up non-destructive or considerate in situ tests for assessing material characteristics and consolidation effects on historic stone and mortar. However, some simple methods have proved to be helpful when applied appropriately and this paper provides brief information about two such methods: peeling tests, also known as the ‘Scotch tape’ method, and surface water uptake measurements using a digitized microtube. Both methods have some history of development and use Mora and Torraca (1965 Bollettino Istituto Centrale del Restauro (Rome) pp 109–32), Giorgi et al (2000 Stud. Conserv. 45 154–61), Tiano et al (2006 J. Cult. Heritage 7 49–55), Lehmann (2004 Thesis, Hochschule für Bildende Künste, Dresden pp 33–34), Drdácký et al (2011 Proc. European Workshop on Cultural Heritage Preservation pp 126–30) and Zíma (2011 Proc. 49th Int. Scientific Conf. on Experimental Stress Analysis pp 441–8) without any standardized support. This lack of a validated procedure can lead to some deficiencies and misinterpretations for applying the peeling test. Also, in the case of the digitized micro-tube, there can be some difficulties when the device is applied, which could prevent its wider adoption or even lead to rejection of the micro-tube technique. The paper summarizes basic principles for the application of both methods and reports illustrative results for laboratory and historic building investigations. (paper)

  14. Effects of acid deposition on dissolution of carbonate stone during summer storms in the Adirondack Mountains, New York, 1987-89

    Science.gov (United States)

    Schuster, Paul F.; Reddy, Michael M.; Sherwood, S.I.

    1994-01-01

    This study is part of a long-term research program designed to identify and quantify acid rain damage to carbonate stone. Acidic deposition accelerates the dissolution of carbonate-stone monuments and building materials. Sequential sampling of runoff from carbonate-stone (marble) and glass (reference) microcatchments in the Adirondack Mountains in New York State provided a detailed record of the episodic fluctuations in rain rate and runoff chemistry during individual summer storms. Rain rate and chemical concentrations from carbonate-stone and glass runoff fluctuated three to tenfold during storms. Net calcium-ion concentrations from the carbonatestone runoff, a measure of stone dissolution, typically fluctuated twofold during these storms. High net sulfate and net calcium concentrations in the first effective runoff at the start of a storm indicated that atmospheric pollutants deposited on the stone surface during dry periods formed calcium sulfate minerals, an important process in carbonate stone dissolution. Dissolution of the carbonate stone generally increased up to twofold during coincident episodes of low rain rate (less than 5 millimeters per hour) and decreased rainfall (glass runoff) pH (less than 4.0); episodes of high rain rate (cloudbursts) were coincident with a rapid increase in rainfall pH and also a rapid decrease in the dissolution of carbonate-stone. During a storm, it seems the most important factors causing increased dissolution of carbonate stone are coincident periods of low rain rate and decreased rainfall pH. Dissolution of the carbonate stone decreased slightly as the rain rate exceeded about 5 millimeters per hour, probably in response to rapidly increasing rainfall pH during episodes of high rain rate and shorter contact time between the runoff and the stone surface. High runoff rates resulting from cloudbursts remove calcium sulfate minerals formed during dry periods prior to storms and also remove dissolution products formed in large

  15. Management of ureteric stone in pediatric patients

    Directory of Open Access Journals (Sweden)

    Eugene Minevich

    2010-01-01

    Full Text Available The management of ureteral stones in children is becoming more similar to that in adults. A number of factors must be taken into account when selecting one′s choice of therapy for ureteral stone in children such as the size of the stone, its location, its composition, and urinary tract anatomy. Endoscopic lithotripsy in children has gradually become a major technique for the treatment of ureteral stones. The stone-free rate following urteroscopic lithotripsy for ureteral stones has been reported in as high as 98.5-100%. The safety and efficacy of Holmium:YAG laser lithotripsy make it the intracorporeal lithotriptor of choice. Given its minimally invasive features, extracorporeal shock wave lithotripsy (ESWL has become a primary mode of treatment for the pediatric patients with reno-ureteral stones. Stone-free rates have been reported from 59% to 91% although some patients will require more than one treatment session for stone clearance. It appears that the first-line of therapy in the child with distal and mid-ureteral stones should be ureteroscopic lithotripsy. While ESWL is still widely considered the first-line therapy for proximal ureteral calculi, there is an increasing body of evidence that shows that endoscopic or ESWL are equally safe and efficacious in those clinical scenarios. Familiarity with the full spectrum of endourological techniques facilitates a minimally invasive approach to pediatric ureteral stones.

  16. Effect of hydrogen adsorption on the formation and annealing of Stone-Wales defects in graphene

    Science.gov (United States)

    Podlivaev, A. I.; Openov, L. A.

    2015-12-01

    The heights of energy barriers preventing the formation and annealing of Stone-Wales defects in graphene with a hydrogen atom adsorbed on the defect or in its immediate vicinity have been calculated using the atomistic computer simulation. It has been shown that, in the presence of hydrogen, both barriers are significantly lower than those in the absence of hydrogen. Based on the analysis of the potential energy surface, the frequency factors have been calculated for two different paths of the Stone-Wales transformation, and the temperature dependences of the corresponding annealing times of the defects have been found. The results obtained have been compared with the first-principles calculations and molecular dynamics data.

  17. Adverse effect of diesel engine produced particulate matter on various stone types and concrete: a laboratory exposure experiment

    Science.gov (United States)

    Farkas, Orsolya; Szabados, György; Antal, Ákos; Török, Ákos

    2015-04-01

    The effect of particulate matter on construction materials have been studied under laboratory conditions. For testing the adverse effects of diesel soot and particulate matter on stone and concrete a small scale laboratory exposure chamber was constructed. Blocks of 9 different stone types and concrete was placed in the chamber and an exhaust pipe of diesel engine was diverted into the system. Tested stones included: porous limestone, cemented non-porous limestone, travertine, marble, rhyolite tuff, andesite and granite. The engine was operated for 10 hours and the produced particulate matter was diverted directly to the surface of the material specimens of 3 cm in diameter each. Working parameters of the engine were controlled; the composition of the exhaust gas, smoke value and temperature were continuously measured during the test. Test specimens were documented and analysed prior to exposure and after the exposure test. Parameters such colorimetric values, weight, surface properties, mineralogical compositions of the test specimens were recorded. The working temperature was in the order of 300°C-320°C. The gas concentration was in ppm as follows: 157 CO; 5.98 CO2, 34.3 THC; 463 NOx; 408 NO; 12.88 O2. Our tests have demonstrated that significant amount of particulate matter was deposited on construction materials even at a short period of time; however the exposure was very intense. It also indicates that that the interaction of particulate matter and aerosol compounds with construction materials in urban areas causes rapid decay and has an adverse effect not only on human health but also on built structures.

  18. Determination of Radon-222 and Thoron Concentration in Decorative Stone Warehouses Indoor Air and the Received Effective Dose by Staff

    Directory of Open Access Journals (Sweden)

    Amir Hossein Mahvi

    2015-06-01

    Full Text Available Background: Radon is a colorless, odorless, and radioactive gas that can be emitted from decorative stones such as granite, marble, etc. Inhaling radon gas in a long period may cause for incidence of lung cancer among peoples. Material and Methods: In this cross-sectional descriptive study, Radon 222 and Thoron concentrations in background and indoor air were measured in four decorative stones warehouse using portable radon meter(RTM1688-2 model. Totally, 24 samples of 24- hours concentrations in indoor air and 24 samples of 4-hours concentrations of Radon 222 and thoron in the background air at three stages were measured. Then, received effective dose of Radon 222 and Thoron was calculated by UNSCEAR equations. Results: The mean radon concentrations for indoor and background air were 74±37 and 34±16 Bq/m3, respectively. The mean radon concentrations for indoor air in decorative stones warehouses for DSW1, DSW2, DSW3 and DSW4 were 72.50±34, 98.25±43, 34.42±18 and 88.92±51 Bq/m3, respectively. The received effective dose mean of Radon 222 and Thoron by the staff at 8 working hours was 0.53±0.18 and 0.05±0.03 mSv/y and in 16 working hours was 1.05±0.36 and 0.11±0.07 mSv/y, respectively. Generally, the mean received effective dose by staff from Radon at 8 and 16 working hours was 0.58±0.2  and 1.16±0.41 mSv/y, respectively. Conclusions: Radon concentration mean in indoor air and the received effective dose mean by staff was lower than the standards level. Decorative stone warehouses were the resources for accumulation of Radon gas that can be reduced by corrective actions.

  19. Is the gravity effect of radiographic anatomic features enough to justify stone clearance or fragments retention following extracorporeal shock wave lithotripsy (SWL).

    Science.gov (United States)

    Mustafa, Mahmoud

    2012-08-01

    We determined whether the gravity effect of radiographic anatomic features on the preoperative urography (IVP) are enough to predict fragments clearance after shock wave lithotripsy (SWL). A Total of 282 patients with mean age 45.8 ± 13.2 years (189 male, 93 female), who underwent SWL due to renal calculi between October 2005 and August 2009 were enrolled. The mean calculi load was 155.72 ± 127.66 mm². The patients were stratified into three groups: patients with pelvis calculi (group 1); patients with upper or middle pole calculi (group 2) and patients with lower pole calculi (group 3). Three angles on the pretreatment IVP were measured: the inner angle between the axis of the lower pole infundibular and ureteropelvic axis (angle I); the inner angle between the lower pole infundibular axis and main axis of pelvis-ureteropelvic (UP) junction point (angle II) and the inner angle between the lower pole infundibular axis and perpendicular line (angle III). Multivariate analysis was used to define the significant predictors of stone clearance. The overall success rate was 85.81%. All angles, sessions number, shock waves number and stone burden were significant predictors of success in patients in group 1. However, in group 2 only angle II and in group 3 angles I and II had significant effect on stone clearance. Radiographic anatomic features have significant role in determining the stone-free rate following satisfactory fragmentation of renal stones with SWL. The measurement of infundibulopelvic angle in different manner helps to predict the stone-free status in patients with renal calculi located not only in lower pole, but also in renal pelvis and upper or middle pole. Gravity effect is not enough to justify the significant influence of the radiographic anatomic features on the stone clearance and fragments retention after SWL.

  20. 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: I...... 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....

  1. Assessment of exposure to hand-arm vibration and its related health effects in workers employed in stone cutting workshops of Hamadan city

    Directory of Open Access Journals (Sweden)

    Roya Bayat

    2016-06-01

    Full Text Available Introduction: The workers employed in stone cutting workplace are exposed to hand-arm vibration and its complications. The aim of this study was to evaluate the exposure to hand-arm vibration and its health effects on workers in the stone cutting workshops. Methods: In this descriptive-analytic study, 40 workers of Hamadan city stone cutting who worked with stone cutting machines were examined. Measuring exposure to hand-arm vibration was performed by standard methods ISO 5349. Symptoms related hand-arm vibration syndrome using a questionnaire construction was studied. Data were analyzed using SPSS software. Results: Results showed that 8-hour equivalent acceleration of hand-arm vibration exposure in stonecuttingworkers was exceeds the permissible exposure levels of country (Pv<0.05. Most average hand and arm vibration acceleration was measured in the Z axis. The average vibration acceleration hand-arm and cutting transverse and longitudinal cutting significant difference was observed (Pv<0.05. Conclusion: In regard to exposure level of stone cutting workers compared with the national exposure limit, the training of health care, non-smoking, and use of anti-vibration gloves, work rotations canthe effective in reducing the risk of health effects. Furthermore, it seems essential to track the health effects associated with human vibration by use of screening tests in the work place seem.

  2. Efficacy and Safety of Tamsulosin in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial.

    Science.gov (United States)

    Ye, Zhangqun; Zeng, Guohua; Yang, Huan; Tang, Kun; Zhang, Xiaochun; Li, Hong; Li, Weibing; Wu, Zhong; Chen, Lingwu; Chen, Xingfa; Liu, Xiankui; Deng, Yaoliang; Pan, Tiejun; Xing, Jinchun; Wang, Shusheng; Cheng, Yue; Gu, Xiaojian; Gao, Wenxi; Yang, Jianggen; Zhang, Yonghai; Mi, Qiwu; Qi, Lin; Li, Jiongming; Hu, Weilie; Liang, Peiyu; Sun, Zhaolin; Xu, Changbao; Long, Yongfu; Liao, Yongbin; Liu, Siping; Liu, Guoqing; Xu, Xun; He, Wei; Chen, Zhiqiang; Xu, Hua

    2017-11-12

    Recent large high-quality trials have questioned the clinical effectiveness of medical expulsive therapy using tamsulosin for ureteral stones. To evaluate the efficacy and safety of tamsulosin for distal ureteral stones compared with placebo. We conducted a double-blind, placebo-controlled study of 3296 patients with distal ureteral stones, across 30 centers, to evaluate the efficacy and safety of tamsulosin. Participants were randomly assigned (1:1) into tamsulosin (0.4mg) or placebo groups for 4 wk. The primary end point of analysis was the overall stone expulsion rate, defined as stone expulsion, confirmed by negative findings on computed tomography, over a 28-d surveillance period. Secondary end points included time to stone expulsion, use of analgesics, and incidence of adverse events. Among 3450 patients randomized between September 1, 2011, and August 31, 2013, 3296 (96%) were included in the primary analysis. Tamsulosin benefits from a higher stone expulsion rate than the placebo (86% vs 79%; ptamsulosin for the treatment of large distal ureteral stones (>5mm). Considering the secondary end points, tamsulosin-treated patients reported a shorter time to expulsion (ptamsulosin use benefits distal ureteral stones in facilitating stone passage and relieving renal colic. Subgroup analyses find that tamsulosin provides a superior expulsion rate for stones >5mm, but no effect for stones ≤5mm. In this report, we looked at the efficacy and safety of tamsulosin for the treatment of distal ureteral stones. We find that tamsulosin significantly facilitates the passage of distal ureteral stones and relieves renal colic. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. ESWL for difficult bile duct stones: a 15-year single centre experience.

    Science.gov (United States)

    Muratori, Rosangela; Azzaroli, Francesco; Buonfiglioli, Federica; Alessandrelli, Flavio; Cecinato, Paolo; Mazzella, Giuseppe; Roda, Enrico

    2010-09-07

    To evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) for the management of refractory bile duct cholelithiasis in a third level referral centre. The clinical records of all patients treated with a second generation electromagnetic lithotripter (Lithostar Plus, SIEMENS) from October 1990 to April 2005 were evaluated. All patients were monitored during the procedure and antibiotics were administered in case of cholangitis. The chi(2) test and logistic regression analysis were performed as appropriate. Two hundred and fourteen patients (102 males, 112 females; mean age 74.8 +/- 0.84 years--single stone 97, multiple stones 117) underwent ESWL. The mean number of sessions and shock waves were 3.5 +/- 0.13 and 3477.06 +/- 66.17, respectively. The maximum stone size was 5 cm. Complete stone clearance was achieved in 192 (89.7%) patients. Of the remaining patients 15 required surgery, 2 a palliative stent and in 5 patients stone fragmentation led to effective bile drainage with clinical resolution despite incomplete clearance. Age, sex and stone characteristics were not related to treatment outcome. Major complications occurred in two patients (haemobilia and rectal bleeding) and minor complications in 25 (3 vomiting, 22 arrhythmias). No procedure-related deaths occurred. ESWL is a safe and effective technique for clearance of refractory bile duct stones.

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

    Science.gov (United States)

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

    2017-08-01

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

  5. MiniJFil®: A New Safe and Effective Stent for Well-Tolerated Repeated Extracorporeal Shockwave Lithotripsy or Ureteroscopy for Medium-to-Large Kidney Stones?

    Science.gov (United States)

    Vogt, Benoit; Desfemmes, Francois-Noel; Desgrippes, Arnaud; Ponsot, Yves

    2016-01-01

    Background Percutaneous nephrolithotomy (PCNL) is recommended for treating staghorn stones or stones measuring > 20 mm. Extracorporeal shockwave lithotripsy (ESWL) or flexible ureteroscopy (URS) may be used as a complement. However, PCNL can cause trauma to the kidney parenchyma, and patients may find a noninvasive procedure, such as ESWL, to be more attractive. Objectives The aim of this study was to evaluate the clinical efficiency of MiniJFil® stenting associated with ESWL or second-line URS for the treatment of medium-to-large kidney stones. The MiniJFil® is a stent reduced to a suture of 0.3F attached to a renal pigtail. The entire ureter is occupied only by the suture of the stent. Methods We retrospectively analyzed the data of 28 patients. Twenty-four patients had kidney stones measuring > 15 mm (group 1) and four patients had staghorn stones (group 2). All of the patients were fitted with MiniJFil® 2 - 3 weeks before any treatment. ESWL was always our first-line therapy. Stone-free (SF) status was defined as no evidence of stones. Results In group 1, the mean largest and cumulative stone diameters, respectively, were 18.7 ± 5.7 mm and 45.0 ± 12.0 mm. In group 2, the mean volume was 6,288.4 ± 2,733.0 mm3. The overall SF was 96.4% (100% for group 1 and 75% for group 2). The mean number of sessions of ESWL and URS, respectively, was 1.4 ± 0.7 and 0.8 ± 0.9 in group 1 and 4.0 ± 2.0 and 1.5 ± 1.3 in group 2. The mean times to achieve these rates were 3.2 ± 1.7 months and 5.6 ± 2.3 months for groups 1 and 2, respectively. One patient in group 2 was treated with only three sessions of ESWL. Renal colic was observed in only five patients (17.9%). Conclusions MiniJFil® stenting is safe and may be an alternative for the treatment of kidney stones during minimally invasive procedures. PMID:27878116

  6. Effect of mortar joint thickness on deformability in medieval stone walls

    Directory of Open Access Journals (Sweden)

    Cassinello, M. J.

    2006-12-01

    Full Text Available An analysis of the stone walls in Gothic cathedrals revealed that Medieval master builders varied mortar joint thicknesses from one structural member to another. This fact, which has gone largely unnoticed to date, has a considerable impact on the structural behavior of cathedrals,due to its direct effect on two fundamental parameters,deformability and strength. In the absence offield data, an experimental test program was conducted at the INTEMAC Central Laboratory to determine the possible variations in deformability of Medieval masonry with changes in joint mortar thickness in the range found in the structural members of Spanish Gothic cathedrals. The results obtained show —further to an observation by Eduardo Torroja— that mortar joints are a determinant in the structural behavior of masonry. The modulus of deformation varied from 169.7 to 5,632.7 N/mm2at joint thicknesses ranging from 17.00 to 5.50 mm. Structural models should be adapted to accommodate this behavior pattern via parametric sensitivity analysis to obtain a clearer understanding of structural behaviour in Gothic cathedrals.El análisis desarrollado sobre las fábricas pétreas de las catedrales góticas revela que los maestros medievales utilizaron diferentes espesores de juntas de mortero en cada uno de sus elementos estructurales. Este hecho —no tenido en cuenta hasta la fecha— tiene una gran repercusión en el comportamiento estructural de la catedral,ya que influye directamente en sus parámetros fundamentales: deformabilidad y resistencia. Dada la inexistencia de datos, realizamos un programa experimental de ensayos en el laboratorio central de INTEMAC, para establecerlos posibles rangos de variabilidad de la deformabilidad de las fábricas medievales en función de la variabilidad del espesor del mortero de juntas que detectamos en los diferentes elementos estructurales de las catedrales góticas españolas. Los resultados obtenidos demuestran

  7. Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy

    Directory of Open Access Journals (Sweden)

    S. Azab

    2013-03-01

    Conclusions: There is no statistically significant effect of stone size, anatomy of the lower calyx and BMI on stone clearance after ESWL of lower calyceal stones. However, small stone size (≤2 cm, a shorter and wider infundibulum and a larger lower-pole infundibulopelvic angle seem to promote a more rapid and more complete stone clearance.

  8. 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.

  9. Infection (urease) stones.

    Science.gov (United States)

    Griffith, D P; Osborne, C A

    1987-01-01

    Infection-induced stones in man probably form solely as a consequence of urealysis which is catalyzed by the bacterial protein urease. Urease stones composed of struvite and carbonate-apatite may form primarily, or as secondary stones or pre-existent metabolic stones. Struvite stones form and grow rapidly owing to (a) supersaturation of urine with stone forming salts, (b) 'salting out' of poorly soluble organic substances normally dissolved in urine and (c) ammonia-induced destruction of the normally protective urothelial glycosaminoglycan layer. Immature (predominantly organic) matrix stones mature into densely mineralized stones. Curative treatment is possible only by eliminating all of the stone and by eradicating all urinary and parenchymal infection. A variety of operative and pharmaceutical approaches are available. Patient treatment must be individualized inasmuch as some patients are better candidates for one type of treatment than another.

  10. Effect of Mineral Filler Type and Particle Size on the Engineering Properties of Stone Mastic Asphalt Pavements

    Directory of Open Access Journals (Sweden)

    R Muniandy

    2013-12-01

    Full Text Available This study examines four types of industrial and by-product waste fillers, namely limestone dust (LSD, which was the reference filler; ceramic waste dust (CWD; coal fly ash (CFA, and steel slag mixture (SSD. The filler consisted of an aggregate (10% of total weight with three proportions: 100% passing 75μm, 50% passing 75μm/20μm, and 100% passing 20μm. Comprehensive laboratory tests were performed to determine the impact of different types and particle sizes of fillers on the engineering and mechanical properties of fine mastics and stone mastic asphalt mixture. The results indicate that the application of industrial by-products used as fillers improves the engineering properties of stone mastic asphalt mixtures. The increased stiffness due to the addition of the filler is represented by an increase in the softening point, viscosity, stability, and resilient modulus, as well as a decrease in penetration. The optimum asphalt content increased with the decrease in filler particle size for LSD and SSD, and decreased for CWD and CFA. It was also determined that the filler type and particle size has a significant effect on the mixture properties. Among these three proportions, the samples prepared with the filler size proportion of 50/50 gave the best value in terms of stability, Marshall quotient, and resilient modulus than the other filler size proportions.

  11. The effect of carbon dioxide on the twinkling artifact in ultrasound imaging of kidney stones: A pilot study

    Science.gov (United States)

    Simon, Julianna C.; Wang, Yak-Nam; Cunitz, Bryan W.; Thiel, Jeffrey; Starr, Frank; Liu, Ziyue; Bailey, Michael R.

    2016-01-01

    Bone demineralization, dehydration, and stasis put astronauts at an increased risk of forming kidney stones in space. The color-Doppler ultrasound “twinkling artifact”, which highlights kidney stones with color, can make stones readily detectable with ultrasound; however our previous results suggest twinkling is caused by microbubbles on the stone surface which could be affected by the elevated levels of carbon dioxide found on space vehicles. Four pigs were implanted with kidney stones and imaged with ultrasound while the anesthetic carrier gas oscillated between oxygen and air containing 0.8% carbon dioxide. Upon exposing pigs to 0.8% carbon dioxide, twinkling was significantly reduced after 9–25 minutes and recovered when the carrier gas returned to oxygen. These trends repeated when pigs were again exposed to 0.8% carbon dioxide followed by oxygen. The reduction of twinkling from exposure to elevated carbon dioxide may make kidney stone detection with twinkling difficult in current space vehicles. PMID:28190622

  12. ESWL treatment of urinary stones in children--the overview of 14 years of experience.

    Science.gov (United States)

    Kuvezdić, Hrvoje; Tucak, Antun; Perić, Nikica; Prlić, Damir; Zorić, Ivan; Galić, Radoslav

    2003-01-01

    Extracorporeal shock wave lithotripsy (ESWL) treatment has been used at Department of Urology, University Hospital "Osijek", Croatia, since July 1988. Until December 2001 seven thousand and eight hundred patients underwent ESWL for urinary stones, 68 of them were children (0.87%). Sixty-eight children aged 4 to 15 years (average 10.14 years) underwent ESWL. They were treated for the total of 91 stones: 35 (38.46%) caliceal, 23 (25.27%) in pyelon, 7 (7.69%) in pyeloureteric segment and 14 (15.38%) ureteral. Staghorn calculi were found in 6 (6.59%) patients and multiple stones (four or more stones in the same kidney) in 6 (6.59%). There was total of 95 ESWL sessions performed in 68 patients (1.39 session per patient). Fifty-six patients (82.35%) without residual stones found at the control plain film and sonography of urinary tract were considered "stone free". Addition of 5 patients with clinically insignificant residual fragments (less than 4 mm) increases overall success rate to 89.70%. ESWL is a simple, safe and effective procedure in the management of urolithiasis in childhood. Clinical experience of our institution confirms ESWL as the first line treatment for kidney stones in the pediatric age patients.

  13. Assessment of stone composition in the management of urinary stones

    NARCIS (Netherlands)

    Kijvikai, Kittinut; de la Rosette, J. J. M.

    2011-01-01

    Several explanations have been suggested to account for the failure of extracorporeal shockwave lithotripsy (ESWL) treatment in patients with urinary stones, including large stone volume, unfavorable stone location or composition and the type of lithotriptor used. Unfavorable stone composition is

  14. The accelerating effects of the microorganisms on biodeterioration of stone monuments under air pollution and continental-cold climatic conditions in Erzurum, Turkey

    International Nuclear Information System (INIS)

    Nuhoglu, Y.; Oguz, E.; Uslu, H.; Ozbek, A.; Ipekoglu, B.; Ocak, I.; Hasenekoglu, I.

    2006-01-01

    The aim of this research was to determine the accelerating effects of microorganisms on the biodeterioration of stone under air pollution and continental-cold climatic region in Erzurum, Turkey. Studies have been carried out on specimens of the Rustempasa Bazaar, the Lalapasa Mosque, the Erzurum Castle Mosque, the Double Minarets-Madrasah, the Great Mosque and the Haji Mehmet Fountain aged from 441 to 823 years old. The results showed that vegetative and reproductive (generative) forms of the microorganisms could develop during the winter months when the night time average temperature was even - 25 deg. C. Also the reproductive forms had developed and the whole stone surface was covered with a biofilm caused by the microorganisms. Silicon, aluminum, calcium, potassium, titanium, magnesium, zinc, sulfur, iron, sodium, and niobium were found in the stones of the historical buildings with varying amounts through the SEM-EDS analysis. Some of these elements could be used as an energy resource for the microorganisms together with the air pollutants such as sulfur dioxide, nitrogen oxides and particles on the stone surfaces. Of 21 isolates, 15 species from 6 bacterium genera and 5 species from 5 fungi genera plus 1 fungi genera were identified on the deteriorated stone surfaces even during the coldest months by microbial identification system (MIS) and these findings were tested by SEM investigations

  15. Comparison of effect of body position, prone or supine, on the result of extracorporeal shock wave lithotripsy in patients with stones in the proximal ureter

    International Nuclear Information System (INIS)

    Zomorrodi, A.; Elahian, A.; Ghorbani, N.; Tavoosi, A.

    2007-01-01

    The aim of this study was to determine whether positioning of patient, prone or supine, plays a significant role on the treatment of stones in the proximal ureter with extracorporeal shock wave lithotripsy (ESWL). 68 patients with proximal ureteric stones underwent ESWL. The procedure was performed in the supine position in 35 (Group1) and the prone position in 33 patients (Group2). Stone-free rates, repeat ESWL rates, shocks per patient and shocks per session were compared in both groups. The mean session number per patient was 1.93+-0.82 in Group 1 and 1.88+-0.79 in Group 2 (P=0.786). The stone free rates, three months after ESWL, were 81.8% in group 1 and 82.9% in Group 2 (P=>0.05). Thus these two parameters were similar in both groups. Also, the number of shocks per session was 3066.1 +- 346.3 in Group 1 and 3148+-621.0 in Group 2. This difference was no significant (P=0.49). Our study suggests that the treatment of proximal ureteric stones with ESWL in the prone position is a safe and effective as when the patient is placed in the supine position. (author)

  16. Cover stones on liquefiable soil bed under waves

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... 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...

  17. Effects of acidic deposition on the erosion of carbonate stone - experimental results from the U.S. National Acid Precipitation Assessment Program (NAPAP)

    Science.gov (United States)

    Baedecker, P.A.; Reddy, M.M.; Reimann, K.J.; Sciammarella, C.A.

    1992-01-01

    One of the goals of NAPAP-sponsored research on the effects of acidic deposition on carbonate stone has been to quantify the incremental effects of wet and dry deposition of hydrogen ion, sulfur dioxide and nitrogen oxides on stone erosion. Test briquettes and slabs of freshly quarried Indiana limestone and Vermont marble have been exposed to ambient environmental conditions in a long-term exposure program. Physical measurements of the recession of test stones exposed to ambient conditions at an angle of 30?? to horizontal at the five NAPAP materials exposure sites range from ~15 to ~30?? ??m yr-1 for marble, and from ~25 to ~45 ??m yr -1 for limestone, and are approximately double the recession estimates based on the observed calcium content of run-off solutions from test slabs. The difference between the physical and chemical recession measurements is attributed to the loss of mineral grains from the stone surfaces that are not measured in the run-off experiments. The erosion due to grain loss does not appear to be influenced by rainfall acidity, however, preliminary evidence suggests that grain loss may be influenced by dry deposition of sulfur dioxide between rainfall events. Chemical analyses of the run-off solutions and associated rainfall blanks suggest that ~30% of erosion by dissolution can be attributed to the wet deposition of hydrogen ion and the dry deposition of sulfur dioxide and nitric acid between rain events. The remaining ~70% of erosion by dissolution is accounted for by the solubility of carbonate stone in rain that is in equilibrium with atmospheric carbon dioxide ('clean rain'). These results are for marble and limestone slabs exposed at an angle of 30?? from horizontal. The relative contribution of sulfur dioxide to chemical erosion is significantly enhanced for stone slabs having an inclination of 60?? or 85??. The dry deposition of alkaline particulate material has a mitigating effect at the two urban field exposure sites at Washington, DC

  18. Effect of processing parameters on Cu-Co-Fe-based diamond impregnated metal matrix composite for stone cutting

    International Nuclear Information System (INIS)

    Mawani, K.; Shahid, M.; Arshad, S.N.; Hasaini, M.H.; Khan, B.S.

    2005-01-01

    Diamond Impregnated Metal Matrix Composites (DIMMC), manufactured by powder metallurgy route, playa major role in stone cutting tool industry. Unfortunately, these diamond tools are not manufactured locally. Our industry relies heavily on the import of these diamond tools to meet the local demand. This study was undertaken as a first step towards indigenous development of these diamond tools. Most of the diamond tools exist in the form of a composite structure with diamond grits embedded in a metallic matrix. This paper investigates the effect of various processing variables on the properties of DIMMC. Effect of pressure on the compaction behavior, sintering time and temperature has been investigated. Relatively better homogeneity has been observed with dry mixing of individual powders using zinc stearate as lubricant compared to wet mixing. A linear increase in green density has been found by increasing compaction pressure up to 400 MPa. (author)

  19. A Boy with a Large Bladder Stone

    Directory of Open Access Journals (Sweden)

    Kuo-Shen Chow

    2008-08-01

    Full Text Available Despite the frequent association of urinary tract infection with vesicoureteral reflux and urinary calculi, since vesicouretal reflux is induced by bladder stones, the coexistence of vesicoureteral reflux and bladder stones is rare. Because of its occurrence in children belonging to poor socioeconomic groups, it is believed to be a deficiency disorder. Most cases of bladder stones occur between the ages of 2 and 5 years. Common clinical presentations of bladder stones include urinary dribbling and enuresis, frequency of micturition, pain during micturition, pelvic pain and hematuria. We report the occurrence of a large bladder stone in a boy, who experienced intermittent lower abdominal pain and urinary incontinence, both during the day and at night. He had been diagnosed with enuresis and treated in pediatric clinics for 1 year. Delayed diagnosis resulted in bladder stone formation. The stone was larger than 2.5 cm and open vesicolithotomy was therefore selected as the best and safest treatment choice. His symptoms disappeared after surgery. Thorough metabolic and environmental evaluations of such cases are required on an individual basis. Bladder stones should be considered as a possible diagnosis in children presenting with urinary incontinence.

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

    Science.gov (United States)

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

    2013-06-01

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

  1. Extracorporeal shock wave lithotripsy on pancreatic duck stones in patients with chronic pancreatitis: evaluation of therapeutic results with CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Moon Gyu [Asan Medical Center, Seoul (Korea, Republic of); Lee, Yong Suk [Gunpo Medical Center, Gunpo (Korea, Republic of)

    2003-03-01

    To demonstrate by CT scanning the effect of extracorporeal shock wave lithotripsy (ESWL) on pancreatic duct stones in patients with chronic pancreatitis. Pancreatic duct stones in 11 patients with chronic pancreatitis were subject to ESWL using an electrohydraulic lithotripter. Endoscopic stone removal using a basket had failed in ten patients, and in one, endoscopy was impossible due to a previous Whipple's operation. CT scans obtained before and after ESWL were evaluated by two radiologists: the longest and shortest diameters of the target stone were measured, and according to the degree of fragmentation, determined by comparing the area of the stone before and after ESWL, a grade (1-5) was assigned. In each case, the pre- and post- treatment diameter of the main pancreatic duct, measured at the pancreatic body, was also compared. Disintegration of the target stone was achieved in all patients: grade 1 (over 75% of the area remained, compared with that of the initial stone) was assigned in two patients; grade 2 (51-75% of the original area) in one; grade 3 (26-50%) in four; grade 4 (under 25%) in two; and grade 5 (complete clearance of the target stone) in two. The mean area decreased from 175 mm{sup 2} to 69 mm{sup 2} after ESWL (p<0.05); a decrease of more than 50% was observed in eight patients (73%). The mean diameter of the main pancreatic duct decreased from 7.36 to 4.81 mm (p<0.05). No severe adverse effects or complications were noted, and all patients showed clinical improvement. Follow-up studies indicated that pancreatic duct stones recurred in three patients. ESWL can cause the fragmentation of pancreatic duct stones without significant complications, and should be considered where endoscopic stone removal has failed. CT is a suitable non-invasive and accurate tool for evaluating the therapeutic results of ESWL.

  2. Extracorporeal shock wave lithotripsy on pancreatic duck stones in patients with chronic pancreatitis: evaluation of therapeutic results with CT

    International Nuclear Information System (INIS)

    Lee, Moon Gyu; Lee, Yong Suk

    2003-01-01

    To demonstrate by CT scanning the effect of extracorporeal shock wave lithotripsy (ESWL) on pancreatic duct stones in patients with chronic pancreatitis. Pancreatic duct stones in 11 patients with chronic pancreatitis were subject to ESWL using an electrohydraulic lithotripter. Endoscopic stone removal using a basket had failed in ten patients, and in one, endoscopy was impossible due to a previous Whipple's operation. CT scans obtained before and after ESWL were evaluated by two radiologists: the longest and shortest diameters of the target stone were measured, and according to the degree of fragmentation, determined by comparing the area of the stone before and after ESWL, a grade (1-5) was assigned. In each case, the pre- and post- treatment diameter of the main pancreatic duct, measured at the pancreatic body, was also compared. Disintegration of the target stone was achieved in all patients: grade 1 (over 75% of the area remained, compared with that of the initial stone) was assigned in two patients; grade 2 (51-75% of the original area) in one; grade 3 (26-50%) in four; grade 4 (under 25%) in two; and grade 5 (complete clearance of the target stone) in two. The mean area decreased from 175 mm 2 to 69 mm 2 after ESWL (p<0.05); a decrease of more than 50% was observed in eight patients (73%). The mean diameter of the main pancreatic duct decreased from 7.36 to 4.81 mm (p<0.05). No severe adverse effects or complications were noted, and all patients showed clinical improvement. Follow-up studies indicated that pancreatic duct stones recurred in three patients. ESWL can cause the fragmentation of pancreatic duct stones without significant complications, and should be considered where endoscopic stone removal has failed. CT is a suitable non-invasive and accurate tool for evaluating the therapeutic results of ESWL

  3. Effect of temperature on the containment properties of argillaceous rocks: The case study of Callovo-Oxfordian clay-stones

    International Nuclear Information System (INIS)

    Savoye, S.; Goutelard, F.; Beaucaire, C.; Charles, Y.; Fayette, A.; Herbette, M.; Larabi, Y.; Coelho, D.

    2011-01-01

    Heat generated by high level radioactive wastes could alter the performance of a clay repository. It was intended to investigate the effect of such a thermal period on the diffusive properties of Callovo-Oxfordian clay-stones. Thus, through-diffusion experiments with HTO, 36 Cl, 22 Na and 137 Cs were performed before, during and after stages of heating at 80 degrees C that lasted for up to one year. A special attention was paid to limit the occurrence of any chemical disturbance. Therefore (i) the temperature was raised to 80 degrees C, then progressively brought back to 21 degrees C, thanks to three intermediate temperature stages, and (ii) specific synthetic solutions were used for each temperature, chemistry of which being close to the equilibrium state, especially with respect to the carbonate and sulphate minerals. It was found that experiments carried out at 80 degrees C showed a clear increase of the effective diffusion coefficient values for the four tracers with respect to those obtained at 21 degrees C (by a factor of 3 for HTO and 36 Cl, 5 for 22 Na and 2 for 137 Cs). On the other hand, the porosity and rock capacity values did not exhibit any significant discrepancy between 21 degrees C and 80 degrees C, indicating no observable damage of both the pore conducing network and the sorption properties of clay minerals. The Stokes-Einstein relationship, based on the temperature dependency of the viscosity of bulk water, could be used to describe the temperature dependence of the diffusion of HTO and 36 Cl but failed to describe the diffusive evolution of the two sorbing cations, 22 Na and 137 Cs. Furthermore, experiments performed after the thermal period led to diffusive properties well matching those obtained before heating. All these results suggest that at the lab scale the heating of rock samples would not alter the clay-stone containment properties. (authors)

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

    Directory of Open Access Journals (Sweden)

    Isaac A. Deswanto

    2017-08-01

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

  5. Sculpture: Stone Shapes, Art: 6683.08.

    Science.gov (United States)

    Dubocq, Edward R.

    This elective course for grades 7-12 was created with a three fold purpose: 1) to create in the student an awareness of the effect of sculptural forms on his environment; 2) to introduce the student to an appreciation of stone sculpture; and 3) to further enhance the artistic abilities of the student through sculpting in stone. Course content…

  6. Developing Effective Clinical Trainers

    Directory of Open Access Journals (Sweden)

    Kevin Khamarko

    2012-05-01

    Full Text Available Continuing education and training provides a means to improve performance among health care professionals (HCP. Research shows, however, that continuing professional education activities have inconsistent effects on HCP competence, performance, and patient health outcomes. Furthermore, the trainer’s role as a facilitator of knowledge translation (KT has been understudied. To understand how clinical trainers support their trainees in translating what they learned into practice, we conducted 16 in-depth interviews with expert trainers. These interviews yielded a variety of KT-enhancing strategies, including tailoring training activities to their trainees’ needs. In addition, participants recommended trainers familiarize themselves with their trainees’ work environments, be able to identify their knowledge deficits, and devote time to provide trainees with post-training support. Creating an effective training, one that leads to transfer, requires active planning, communication, and command of the training topic by skilled trainers.

  7. Role of alpha-1 blocker in expulsion of stone fragments after extracorporeal shock wave lithotripsy for renal stones

    International Nuclear Information System (INIS)

    Pirzada, A.J.; Anwar, A.; Javed, A.; Memon, I.; Mohammad, A.

    2011-01-01

    Background: Renal stone disease is a significant and worldwide health problem. Recent advances in stone management have allowed kidney stones to be treated using extracorporeal shock wave lithotripsy (ESWL), uretero-renoscopy (URS), and percutaneous nephrostolithotomy (PCNL). Recently, medical expulsion therapy (MET) has been investigated as a supplement to observation in an effort to improve spontaneous stone passage rates. Patients and Methods: This study was a randomized, controlled, prospective study to determine whether the administration of Alpha-1-adrenergic receptor antagonists as an adjunctive medical therapy, increases the efficacy of ESWL to treat renal stones. Sixty patients with renal stones of 0.5-1.5 Cm in size (average size 1.2 Cm) were included in this study underwent ESWL followed by administration of Alpha-1-adrenergic receptor antagonists at department of Urology Liaquat National Hospital Karachi from Feb 2008 to Sept 2008. This was a comparative study and patients were divided into two groups. In group A patients received conventional treatment Diclofenac sodium, Anti Spasmodic (Drotaverine HCl) as required and Proton Pump inhibitor (Omeprazole 20 mg) once daily after shock wave lithotripsy. In group B patients received alpha-1 blocker, Alfuzosin HCl 5 mg twice daily in addition to conventional treatment. All patients were instructed to drink a minimum of 2 litres water daily. Ultrasound guided Dornier Alpha Impact Lithotripter was utilised for shock wave lithotripsy. Results: Of the 60 patients, 76.7% of those receiving Alfuzosin and 46.7% of controls had achieved clinical success at 1 month (p=0.01). The mean cumulative diclofenac dose was 485 mg per patient in the Alfuzosin group and 768 mg per patient in the control group (p=0.002). This difference was statistically significant. Conclusion: Alfuzosin therapy as an adjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal

  8. [Relational database for urinary stone ambulatory consultation. Assessment of initial outcomes].

    Science.gov (United States)

    Sáenz Medina, J; Páez Borda, A; Crespo Martinez, L; Gómez Dos Santos, V; Barrado, C; Durán Poveda, M

    2010-05-01

    To create a relational database for monitoring lithiasic patients. We describe the architectural details and the initial results of the statistical analysis. Microsoft Access 2002 was used as template. Four different tables were constructed to gather demographic data (table 1), clinical and laboratory findings (table 2), stone features (table 3) and therapeutic approach (table 4). For a reliability analysis of the database the number of correctly stored data was gathered. To evaluate the performance of the database, a prospective analysis was conducted, from May 2004 to August 2009, on 171 stone free patients after treatment (EWSL, surgery or medical) from a total of 511 patients stored in the database. Lithiasic status (stone free or stone relapse) was used as primary end point, while demographic factors (age, gender), lithiasic history, upper urinary tract alterations and characteristics of the stone (side, location, composition and size) were considered as predictive factors. An univariate analysis was conducted initially by chi square test and supplemented by Kaplan Meier estimates for time to stone recurrence. A multiple Cox proportional hazards regression model was generated to jointly assess the prognostic value of the demographic factors and the predictive value of stones characteristics. For the reliability analysis 22,084 data were available corresponding to 702 consultations on 511 patients. Analysis of data showed a recurrence rate of 85.4% (146/171, median time to recurrence 608 days, range 70-1758). In the univariate and multivariate analysis, none of the factors under consideration had a significant effect on recurrence rate (p=ns). The relational database is useful for monitoring patients with urolithiasis. It allows easy control and update, as well as data storage for later use. The analysis conducted for its evaluation showed no influence of demographic factors and stone features on stone recurrence.

  9. Investigation of intact rock geomechanical parameters' effects on commercial blocks' productivity within stone reserves: A case history of some quarries in Isfahan, Iran

    Science.gov (United States)

    Yarahmadi, Reza; Bagherpour, Raheb; Tabaei, Morteza; Sousa, Luis M. O.

    2017-10-01

    One of the common methods to determine commercial blocks productivity (CBP) in reserves of dimension stone is through the study of the discontinuities' network. However, this determination remains a difficult task due to geographical heterogeneity and lack of access to all reserves' formations. This study presents a new method based on various geomechanical tests performed on intact rocks that assessed the CBP of a dimension stones' rock mass. Assuming that a dimension stone's rock mass comprised a large block of an intact rock, due to tectonics, the geomechanical properties of this block had direct effects on the discontinuities created within it. Therefore, the geomechanical properties of the intact rock may be related to the CBP of a stone reserve. Based on this factor, this study explored the relationship among some geomechanical properties, including failure angle, uniaxial compressive strength, and modulus of elasticity, and CBP by using data acquired from 21 dimension stone quarries consisting of travertine, marble, and onyx groups. According to the results obtained from the analysis of the Isfahan province's Iranian quarries, failure angle was not highly related to the reserve's CBP. In marble quarries, CBP may decrease, if the compressive strength of an intact rock exceeds 60 MPa. Among the studied parameters, the saturated-to-dry ratio's modulus of elasticity had the greatest relationship to the CBP. Generally, the presented diagrams displayed that the correlation between geomechanical properties and the CBP were an appropriate guide in determining the potential cost-effectiveness of a accessing a particular rock reserve during the early exploration phase.

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

    Science.gov (United States)

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

    2016-04-01

    a non-infectious one. No clinical variables were significantly associated with infectious stone composition on univariate (≥0.28) or bivariate analysis (≥0.36). This study had several limitations: it was not possible to accurately assess adherence with bladder irrigations, and routine metabolic evaluations were not performed. The findings may not apply to patients in all clinical settings. While stone analysis was available for 3/4 of the stones, similar rates of incomplete stone analyses have been reported in other series. In patients with bladder augmentation, 1/3 of bladder stones and >1/2 of renal stones were non-infectious. Furthermore, an infectious stone does not imply an infectious recurrent stone and no known clinical variables appear to be associated with stone composition, suggesting that there is a possible metabolic component in stone formation after bladder augmentation. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  11. Pancreatic Stones: Treat or Ignore?

    Directory of Open Access Journals (Sweden)

    DA Howell

    1999-01-01

    Full Text Available Painful, chronic pancreatitis is of complex etiology, but increasing clinical experience suggests that removal of pancreatic duct stones in many cases significantly improves patients’ symptoms. The development and refinement of therapeutic endoscopic retrograde choledochopancreatography have permitted improved access to the pancreatic duct, which makes the development of new techniques of stone fragmentation and fragment removal a much more successful nonsurgical intervention. A major step forward has been the understanding of the safety and efficacy of pancreatic sphincterotomy, which is necessary for the removal of these difficult stones. The recognition that extracorporeal shock wave lithotripsy can be delivered safely with good efficacy has revolutionized the nonsurgical management of pancreatic duct stones. Nevertheless, advanced and sophisticated therapeutic endoscopy is necessary to achieve clearance of the duct, which can generally be accomplished in the majority of selected patients. State-of-the-art treatments are described, and some new approaches using pancreatoscopy and electrohydrolic lithotripsy are discussed. Newly recognized long term complications are reviewed. Finally, it must be recognized that chronic pancreatitis is an ongoing disease that does not have a simple treatment or cure, and frequently represents a process of remissions and relapses requiring interventions and problem solving.

  12. Assessment of stone columns as a mitigation technique of liquefaction-induced effects during Italian earthquakes (May 2012).

    Science.gov (United States)

    Forcellini, Davide; Tarantino, Angelo Marcello

    2014-01-01

    Soil liquefaction has been observed worldwide during recent major earthquakes with induced effects responsible for much of the damage, disruption of function, and considerable replacement expenses for structures. The phenomenon has not been documented in recent time with such damage in Italian context before the recent Emilia-Romagna Earthquake (May 2012). The main lateral spreading and vertical deformations affected the stability of many buildings and impacted social life inducing valuable lessons on liquefaction risk assessment and remediation. This paper aims first of all to reproduce soil response to liquefaction-induced lateral effects and thus to evaluate stone column mitigation technique effectiveness by gradually increasing the extension of remediation, in order to achieve a satisfactory lower level of permanent deformations. The study is based on the use of a FE computational interface able to analyse the earthquake-induced three-dimensional pore pressure generation adopting one of the most credited nonlinear theories in order to assess realistically the displacements connected to lateral spreading.

  13. Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with concomitant gallbladder stones and common bile duct stones: a randomized controlled trial.

    Science.gov (United States)

    Bansal, Virinder Kumar; Misra, Mahesh C; Rajan, Karthik; Kilambi, Ragini; Kumar, Subodh; Krishna, Asuri; Kumar, Atin; Pandav, Chandrakant S; Subramaniam, Rajeshwari; Arora, M K; Garg, Pramod Kumar

    2014-03-01

    The ideal method for managing concomitant gallbladder stones and common bile duct (CBD) stones is debatable. The currently preferred method is two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy (LC). This prospective randomized trial compared the success and cost effectiveness of single- and two-stage management of patients with concomitant gallbladder and CBD stones. Consecutive patients with concomitant gallbladder and CBD stones were randomized to either single-stage laparoscopic CBD exploration and cholecystectomy (group 1) or endoscopic retrograde cholangiopancreatography (ERCP) for endoscopic extraction of CBD stones followed by LC (group 2). Success was defined as complete clearance of CBD and cholecystectomy by the intended method. Cost effectiveness was measured using the incremental cost-effectiveness ratio. Intention-to-treat analysis was performed to compare outcomes. From February 2009 to October 2012, 168 patients were randomized: 84 to the single-stage procedure (group 1) and 84 to the two-stage procedure (group 2). Both groups were matched with regard to demographic and clinical parameters. The success rates of laparoscopic CBD exploration and ERCP for clearance of CBD were similar (91.7 vs. 88.1 %). The overall success rate also was comparable: 88.1 % in group 1 and 79.8 % in group 2 (p = 0.20). Direct choledochotomy was performed in 83 of the 84 patients. The mean operative time was significantly longer in group 1 (135.7 ± 36.6 vs. 72.4 ± 27.6 min; p ≤ 0.001), but the overall hospital stay was significantly shorter (4.6 ± 2.4 vs. 5.3 ± 6.2 days; p = 0.03). Group 2 had a significantly greater number of procedures per patient (p gallbladder and CBD stones had similar success and complication rates, but the single-stage strategy was better in terms of shorter hospital stay, need for fewer procedures, and cost effectiveness.

  14. Optimum nutrition for kidney stone disease.

    Science.gov (United States)

    Heilberg, Ita P; Goldfarb, David S

    2013-03-01

    We summarize the data regarding the associations of individual dietary components with kidney stones and the effects on 24-hour urinary profiles. The therapeutic recommendations for stone prevention that result from these studies are applied where possible to stones of specific composition. Idiopathic calcium oxalate stone-formers are advised to reduce ingestion of animal protein, oxalate, and sodium while maintaining intake of 800 to 1200 mg of calcium and increasing consumption of citrate and potassium. There are few data regarding dietary therapy of calcium phosphate stones. Whether the inhibitory effect of citrate sufficiently counteracts increasing urine pH to justify more intake of potassium and citrate is not clear. Reduction of sodium intake to decrease urinary calcium excretion would also be expected to decrease calcium phosphate stone recurrence. Conversely, the most important urine variable in the causation of uric acid stones is low urine pH, linked to insulin resistance as a component of obesity and the metabolic syndrome. The mainstay of therapy is weight loss and urinary alkalinization provided by a more vegetarian diet. Reduction in animal protein intake will reduce purine ingestion and uric acid excretion. For cystine stones, restriction of animal protein is associated with reduction in intake of the cystine precursor methionine as well as cystine. Reduction of urine sodium results in less urine cystine. Ingestion of vegetables high in organic anion content, such as citrate and malate, should be associated with higher urine pH and fewer stones because the amino acid cystine is soluble in more alkaline urine. Because of their infectious origin, diet has no definitive role for struvite stones except for avoiding urinary alkalinization, which may worsen their development. Published by Elsevier Inc.

  15. Effects of magnesium minerals representative of the Callovian-Oxfordian clay-stone on borosilicate glass alteration

    International Nuclear Information System (INIS)

    Debure, M.

    2012-01-01

    Borosilicate glasses dissolution has been studied in presence of magnesium minerals. Those minerals (dolomite, illite, smectite...) belong to the Callovo-Oxfordian (COx) clay-stone layer, studied in France as a potential site for nuclear waste disposal. Such minerals contain magnesium, an element able to sustain glass alteration when it is available in solution. In the confined media of the wastes disposal, the solids reactivity controls the solution composition and can be the driving force of nuclear glass alteration. Experiments show that magnesium carbonates (hydro-magnesite and dolomite) increase in the glass alteration: the precipitation of magnesium silicates consumes silicon which slows down the formation of the glass passivating layer. The lower the magnesium mineral solubility, the lower the glass alteration. The purified clay phases (illite, smectite...) from the COx layer increase the glass alteration. Half the magnesium was replaced by sodium during the purification process. In such conditions, the effect of clay phases on glass alteration is in part due to the acidic pH-buffering effect of the clay fraction. The GRAAL model implemented in the geochemical transport code HYTEC has confirmed and quantified the mechanisms put in evidence in the experiments. Cells diffusion experiments where the two solids were separated by an inert diffusion barrier allow to valid reactive transport modelling. Such experiments are more representative of the glass package which will be separated from the COx by corrosion products. They show that glass alteration rate is reduced when solids are not close. (author) [fr

  16. Nonlinear effects in ultrasound fields of diagnostic-type transducers used for kidney stone propulsion: Characterization in water

    International Nuclear Information System (INIS)

    Karzova, M.; th Street, Seattle, WA 98105 (United States))" data-affiliation=" (Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States))" >Cunitz, B.; th Street, Seattle, WA 98105 (United States))" data-affiliation=" (Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States))" >Kreider, W.; th Street, Seattle, WA 98105 (United States))" data-affiliation=" (Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States))" >Bailey, M.; Yuldashev, P.; Andriyakhina, Y.; th Street, Seattle, WA 98105 (United States))" data-affiliation=" (Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States))" >Sapozhnikov, O.; th Street, Seattle, WA 98105 (United States))" data-affiliation=" (Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States))" >Khokhlova, V.

    2015-01-01

    Newer imaging and therapeutic ultrasound technologies require higher in situ pressure levels compared to conventional diagnostic values. One example is the recently developed use of focused ultrasonic radiation force to move kidney stones and residual fragments out of the urinary collecting system. A commercial diagnostic 2.3 MHz C5-2 array probe is used to deliver the acoustic pushing pulses. The probe comprises 128 elements equally spaced at the 55 mm long convex cylindrical surface with 38 mm radius of curvature. The efficacy of the treatment can be increased by using higher intensity at the focus to provide stronger pushing force; however, nonlinear acoustic saturation can be a limiting factor. In this work nonlinear propagation effects were analyzed for the C5-2 transducer using a combined measurement and modeling approach. Simulations were based on the 3D Westervelt equation; the boundary condition was set to match the focal geometry of the beam as measured at a low power output. Focal waveforms simulated for increased output power levels were compared with the fiber-optic hydrophone measurements and were found in good agreement. It was shown that saturation effects do limit the acoustic pressure in the focal region of the transducer. This work has application to standard diagnostic probes and imaging

  17. Nonlinear effects in ultrasound fields of diagnostic-type transducers used for kidney stone propulsion: Characterization in water

    Energy Technology Data Exchange (ETDEWEB)

    Karzova, M., E-mail: masha@acs366.phys.msu.ru [Laboratoire de Mécanique des Fluides et d’Acoustique, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, 69134 Ecully (France); Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Cunitz, B.; Kreider, W.; Bailey, M. [Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40" t" h Street, Seattle, WA 98105 (United States); Yuldashev, P.; Andriyakhina, Y. [Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Sapozhnikov, O.; Khokhlova, V. [Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40" t" h Street, Seattle, WA 98105 (United States)

    2015-10-28

    Newer imaging and therapeutic ultrasound technologies require higher in situ pressure levels compared to conventional diagnostic values. One example is the recently developed use of focused ultrasonic radiation force to move kidney stones and residual fragments out of the urinary collecting system. A commercial diagnostic 2.3 MHz C5-2 array probe is used to deliver the acoustic pushing pulses. The probe comprises 128 elements equally spaced at the 55 mm long convex cylindrical surface with 38 mm radius of curvature. The efficacy of the treatment can be increased by using higher intensity at the focus to provide stronger pushing force; however, nonlinear acoustic saturation can be a limiting factor. In this work nonlinear propagation effects were analyzed for the C5-2 transducer using a combined measurement and modeling approach. Simulations were based on the 3D Westervelt equation; the boundary condition was set to match the focal geometry of the beam as measured at a low power output. Focal waveforms simulated for increased output power levels were compared with the fiber-optic hydrophone measurements and were found in good agreement. It was shown that saturation effects do limit the acoustic pressure in the focal region of the transducer. This work has application to standard diagnostic probes and imaging.

  18. Effects of acidic deposition on the erosion of carbonate stone — experimental results from the U.S. National Acid Precipitation Assessment Program (NAPAP)

    Science.gov (United States)

    Baedecker, Philip A.; Reddy, Michael M.; Reimann, Karl J.; Sciammarella, Cesar A.

    One of the goals of NAPAP-sponsored research on the effects of acidic deposition on carbonate stone has been to quantify the incremental effects of wet and dry deposition of hydrogen ion, sulfur dioxide and nitrogen oxides on stone erosion. Test briquettes and slabs of freshly quarried Indiana limestone and Vermont marble have been exposed to ambient environmental conditions in a long-term exposure program. Physical measurements of the recession of test stones exposed to ambient conditions at an angle of 30° to horizontal at the five NAPAP materials exposure sites range from ˜ 15 to ˜ 30 μm yr -1 for marble, and from ˜ 25 to ˜ 45 μm yr -1 for limestone, and are approximately double the recession estimates based on the observed calcium content of run-off solutions from test slabs. The difference between the physical and chemical recession measurements is attributed to the loss of mineral grains from the stone surfaces that are not measured in the run-off experiments. The erosion due to grain loss does not appear to be influenced by rainfall acidity, however, preliminary evidence suggests that grain loss may be influenced by dry deposition of sulfur dioxide between rainfall events. Chemical analyses of the run-off solutions and associated rainfall blanks suggest that ˜ 30% of erosion by dissolution can be attributed to the wet deposition of hydrogen ion and the dry deposition of sulfur dioxide and nitric acid between rain events. The remaining ˜ 70% of erosion by dissolution is accounted for by the solubility of carbonate stone in rain that is in equilibrium with atmospheric carbon dioxide ("clean rain"). These results are for marble and limestone slabs exposed at an angle of 30° from horizontal. The relative contribution of sulfur dioxide to chemical erosion is significantly enhanced for stone slabs having an inclination of 60° or 85°. The dry deposition of alkaline particulate material has a mitigating effect at the two urban field exposure sites at

  19. Kidney stones - self-care

    Science.gov (United States)

    ... self-care; Nephrolithiasis and self-care; Stones and kidney - self-care; Calcium stones and self-care; Oxalate ... provider or the hospital because you have a kidney stone. You will need to take self-care ...

  20. The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems: a randomized controlled trial

    OpenAIRE

    Kleefman, Marijke; Jansen, Daniëlle EMC; Stewart, Roy E; Reijneveld, Sijmen A

    2014-01-01

    Background Children with borderline to mild intellectual disability (BMID) have been shown to be at increased risk for psychosocial problems. The presence of these psychosocial problems leads to parenting stress. Stepping Stones Triple P (SSTP) is a parenting support program to support parents with children with BMID and psychosocial problems. The aim of this study was to evaluate the effectiveness of SSTP compared to Care as Usual (CAU) in reducing psychosocial problems in children with BMID...

  1. The prevalence and distribution of radiopaque, calcified pulp stones: A cone-beam computed tomography study in a northern Taiwanese population

    Directory of Open Access Journals (Sweden)

    Chen-Yu Hsieh

    2018-06-01

    Conclusion: Pulp stones are more frequent in maxillary teeth compared to mandibular teeth. Pulp stones in molar teeth were significantly more common than premolars and incisors. CBCT could be a sensitive tool to detect pulp stones, especially simplifying identification of pulp stones in radicular pulp. Knowledge of pulp stones distribution can aid dentists in clinical endodontic treatment.

  2. The twelve colourful stones

    International Nuclear Information System (INIS)

    Doria, R.M.

    1983-01-01

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

  3. 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.

  4. Everybody Must Get Stones

    Directory of Open Access Journals (Sweden)

    Timothy Darvill

    2009-09-01

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

  5. A novel technique of percutaneous stone extraction in choledocholithiasis after cholecystostomy.

    Science.gov (United States)

    Lim, Kyoung Hoon; Kim, Yong Joo

    2013-05-01

    To evaluate the technical feasibility and clinical efficacy of percutaneous common bile duct stone extraction via cystic duct after percutaneous cholecystostomy. Twenty-five consecutive patients with choledocholithiasis underwent percutaneous stone extraction under conscious sedation. The stones were extracted through the 12-Fr sheath using Wittich nitinol stone basket under fluoroscopic guidance via cystic duct after percutaneous trnas-hepatic cholecystostomy. Common bile duct stones were successfully removed in 22 of the 25 patients (88%) by this new technique. The causes of failure in three patients were bile leakage, hematoma of the gallbladder and failure of cystic duct cannulation. Cystic duct injury during this procedure did not occur and there was no post-procedure mortality. The mean period of indwelling catheter was 8.7±4.6 days and the mean duration of hospitalization was 13.4±5.9 days. Percutaneous commmon bile duct stone extraction via the cystic duct through percutaneous cholecystostomy route is effective and feasible for treating choledocholithiasis.

  6. Effects of acidic deposition on the erosion of carbonate stone - experimental results from the U. S. National Acid Precipitation Assessment Program (NAPAP)

    Energy Technology Data Exchange (ETDEWEB)

    Baedecker, P.A.; Reddy, M.M.; Reimann, K.J.; Sciammarella, C.A. (US Geological Survey, Reston, VA (USA))

    1992-06-01

    Test briquettes and slabs of freshly quarried limestone and marble have been exposed to the environment to quantify the incremental effects of wet and dry deposition of hydrogen ion, sulphur dioxide, and nitrogen oxides on stone erosion. Erosion due to grain loss did not seem to be influenced by rainfall acidity, but may be influenced by dry deposition of sulphur dioxide between rainfall events. Chemical analyses of the run-off solutions suggest that around 30% of erosion by dissolution can be attributed to the wet deposition of hydrogen ion and the dry deposition of sulphur dioxide and nitric acid between rain events. The remaining 70% of erosion by dissolution is accounted for by the solubility of carbonate stone in 'clean' rain. 17 refs., 4 figs., 7 tabs.

  7. Female stone disease: the changing trend.

    Science.gov (United States)

    Marickar, Y M Fazil; Vijay, Adarsh

    2009-12-01

    This paper has attempted to assess the changes noted in the trends in the incidence and biochemical pattern of female urolithiasis patients during the period 1971-2008. A prospective descriptive clinical study was done on 8,590 stone patients belonging to both sexes treated at the urinary stone clinic. The incidence of stone disease among the two sexes was plotted. The various metabolic parameters including 24-h urine volume, urine calcium, phosphorus, uric acid, oxalate, magnesium, creatinine and citrate, serum creatinine, calcium, phosphorus, uric acid and magnesium and calculated parameter calcium:magnesium ratio were studied. The possible causes for the change in incidence of stone disease in the female sex were elucidated. Of the patients studied, 12.7% (1,091) were females. There was a definite increase in the incidence of female urolithiasis over the past 37 years (P stone genesis, together with the increased excretion of calcium and oxalate may have contributed to the increasing incidence of stone disease in females. This might be due to changes in living standards and dietary habits.

  8. Effects of Orthosiphon grandiflorus, Hibiscus sabdariffa and Phyllanthus amarus extracts on risk factors for urinary calcium oxalate stones in rats.

    Science.gov (United States)

    Woottisin, Surachet; Hossain, Rayhan Zubair; Yachantha, Chatchai; Sriboonlue, Pote; Ogawa, Yoshihide; Saito, Seiichi

    2011-01-01

    We evaluated the antilithic effect of Orthosiphon grandiflorus, Hibiscus sabdariffa and Phyllanthus amarus extracts on known risk factors for calcium oxalate stones in rats. We divided 30 male Wistar rats into 5 equal groups. Controls were fed a standard diet and the remaining groups received a 3% glycolate diet for 4 weeks to induce hyperoxaluria. One glycolate fed group served as the untreated group and the others were given oral extracts of Orthosiphon grandiflorus, Hibiscus sabdariffa or Phyllanthus amarus at a dose of 3.5 mg daily. We collected 24-hour urine and blood samples. Kidneys were harvested for histological examination. We measured the renal tissue content of calcium and oxalate. The Hibiscus sabdariffa group showed significantly decreased serum oxalate and glycolate, and higher oxalate urinary excretion. The Phyllanthus amarus group showed significantly increased urinary citrate vs the untreated group. Histological examination revealed less CaOx crystal deposition in the kidneys of Hibiscus sabdariffa and Phyllanthus amarus treated rats than in untreated rats. Those rats also had significantly lower renal tissue calcium content than untreated rats. All parameters in the Orthosiphon grandiflorus treated group were comparable to those in the untreated group. Hibiscus sabdariffa and Phyllanthus amarus decreased calcium crystal deposition in the kidneys. The antilithic effect of Hibiscus sabdariffa may be related to decreased oxalate retention in the kidney and more excretion into urine while that of Phyllanthus amarus may depend on increased urinary citrate. In contrast, administering Orthosiphon grandiflorus had no antilithic effect. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Pattern of family history in stone patients.

    Science.gov (United States)

    Marickar, Y M Fazil; Salim, Abiya; Vijay, Adarsh

    2009-12-01

    Genetic predisposition to urolithiasis is a much discussed topic. The objective of this paper is to identify the types of family members of proved urinary stone patients, who have a history of urinary stone formation. The study population consisted of 2,157 urinary stone patients interviewed in 2003-2007 in the urinary stone clinic. Family members with stone history were classified as group 1--first order single (one person in the immediate family-father, mother, siblings, or children), group 2--first order multiple (more than one member in the above group), group 3--second order single (one person in the blood relatives in family--grandparents, grandchildren, uncles, aunts, cousins, etc.) and group 4--second order multiple (more than one member in the above group). Of the 2,157 patients studied, 349 patients gave positive history of stone disease constituting 16.18%. Of these, 321 were males and 28 were females. Subdivision of the family members showed that 282 patients (80.80%) had single family member with stones and the rest 67 (19.20%) had multiple family members with history of stone disease. Group 1 which constituted one family member in the immediate family had 255 involvements (father: 88, mother: 16, brother: 135, sister: 2, son: 10, and daughter: 4); Group 2 with multiple members in the immediate family constituted 51 relatives; of these, father and brother combination was the most common with 35 occurrences. Group 3 with one person in the distant relatives in family namely grandparents, grand children, uncles, aunts, cousins, etc. constituted 27 occurrences and Group 4 with more than one member in the distant family constituted 16 occurrences. It is concluded that single family member involvement was more than multiple involvements. Males predominated. Stone occurrence was more in the immediate family members than distant relatives. Brothers formed the most common group to be involved with stone disease. Study of stone risk in the family members should

  10. Renal geology (quantitative renal stone analysis) by 'Fourier transform infrared spectroscopy'.

    Science.gov (United States)

    Singh, Iqbal

    2008-01-01

    To prospectively determine the precise stone composition (quantitative analysis) by using infrared spectroscopy in patients with urinary stone disease presenting to our clinic. To determine an ideal method for stone analysis suitable for use in a clinical setting. After routine and a detailed metabolic workup of all patients of urolithiasis, stone samples of 50 patients of urolithiasis satisfying the entry criteria were subjected to the Fourier transform infrared spectroscopic analysis after adequate sample homogenization at a single testing center. Calcium oxalate monohydrate and dihydrate stone mixture was most commonly encountered in 35 (71%) followed by calcium phosphate, carbonate apatite, magnesium ammonium hexahydrate and xanthine stones. Fourier transform infrared spectroscopy allows an accurate, reliable quantitative method of stone analysis. It also helps in maintaining a computerized large reference library. Knowledge of precise stone composition may allow the institution of appropriate prophylactic therapy despite the absence of any detectable metabolic abnormalities. This may prevent and or delay stone recurrence.

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

    Science.gov (United States)

    Chung, Ho Seok; Jung, Seung Il; Yu, Ho Song; Hwang, Eu Chang; Oh, Kyung Jin; Kwon, Dong Deuk; Park, Kwangsung

    2016-01-01

    We hypothesized that modified totally tubeless percutaneous nephrolithotomy (PNL) without indwelling ureteral stent would minimize postoperative discomfort without complications. 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. 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. 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. 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.

  12. Value of non-contrast CT examination of the urinary tract (stone ...

    African Journals Online (AJOL)

    Mohamed Samir Shaaban

    2015-09-04

    Sep 4, 2015 ... detection of abdominal pathologies other than stones, whether or not simulating the clinical picture of urolithiasis, and .... detector CT Siemens Somatom Sensation, with no oral or intravenous ..... of kidney stones in children.

  13. 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.

  14. Age Effects in Second Language Learning: Stepping Stones toward Better Understanding

    Science.gov (United States)

    DeKeyser, Robert M.

    2013-01-01

    The effect of age of acquisition on ultimate attainment in second language learning has been a controversial topic for years. After providing a very brief overview of the ideas that are at the core of the controversy, I discuss the two main reasons why these issues are so controversial: conceptual misunderstandings and methodological difficulties.…

  15. Thermoluminescence of pyramid stones

    International Nuclear Information System (INIS)

    Gomaa, M.A.; Eid, A.M.

    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 0 C, respectively. The TL glow peaks of samples annealed at 600 0 C, then exposed to 60 Co γ-rays were observed at 120, 190 and 310 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. (author)

  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. Kidney stone erosion by micro scale hydrodynamic cavitation and consequent kidney stone treatment.

    Science.gov (United States)

    Perk, Osman Yavuz; Şeşen, Muhsincan; Gozuacik, Devrim; Koşar, Ali

    2012-09-01

    The objective of this study is to reveal the potential of micro scale hydrodynamic bubbly cavitation for the use of kidney stone treatment. Hydrodynamically generated cavitating bubbles were targeted to the surfaces of 18 kidney stone samples made of calcium oxalate, and their destructive effects were exploited in order to remove kidney stones in in vitro experiments. Phosphate buffered saline (PBS) solution was used as the working fluid under bubbly cavitating conditions in a 0.75 cm long micro probe of 147 μm inner diameter at 9790 kPa pressure. The surface of calcium oxalate type kidney stones were exposed to bubbly cavitation at room temperature for 5 to 30 min. The eroded kidney stones were visually analyzed with a high speed CCD camera and using SEM (scanning electron microscopy) techniques. The experiments showed that at a cavitation number of 0.017, hydrodynamic bubbly cavitation device could successfully erode stones with an erosion rate of 0.31 mg/min. It was also observed that the targeted application of the erosion with micro scale hydrodynamic cavitation may even cause the fracture of the kidney stones within a short time of 30 min. The proposed treatment method has proven to be an efficient instrument for destroying kidney stones.

  18. Treatment of gallbladder stone with common bile duct stones in the laparoscopic era.

    Science.gov (United States)

    Zhang, Wei-jie; Xu, Gui-fang; Huang, Qin; Luo, Kun-lun; Dong, Zhi-tao; Li, Jie-ming; Wu, Guo-zhong; Guan, Wen-xian

    2015-01-26

    Laparoscopic common bile duct exploration (LCBDE) for stone can be carried out by either laparoscopic transcystic stone extraction (LTSE) or laparoscopic choledochotomy (LC). It remains unknown as to which approach is optimal for management of gallbladder stone with common bile duct stones (CBDS) in Chinese patients. From May 2000 to February 2009, we prospective treated 346 consecutive patients with gallbladder stones and CBDS with laparoscopic cholecystectomy and LCBDE. Intraoperative findings, postoperative complications, postoperative hospital stay and costs were analyzed. Because of LCBDE failure,16 cases (4.6%) required open surgery. Of 330 successful LCBDE-treated patients, 237 underwent LTSE and 93 required LC. No mortality occurred in either group. The bile duct stone clearance rate was similar in both groups. Patients in the LTSE group were significantly younger and had fewer complications with smaller, fewer stones, shorter operative time and postoperative hospital stays, and lower costs, compared to those in the LC group. Compared with patients with T-tube insertion, patients in the LC group with primary closure had shorter operative time, shorter postoperative hospital stay, and lower costs. In cases requiring LCBDE, LTSE should be the first choice, whereas LC may be restricted to large, multiple stones. LC with primary closure without external drainage of the CBDS is as effective and safe as the T-tube insertion approach.

  19. Practical issues in laser cleaning of stone and painted artefacts: optimisation procedures and side effects

    Science.gov (United States)

    Pouli, Paraskevi; Oujja, Mohamed; Castillejo, Marta

    2012-02-01

    In the last twenty years lasers have acquired an important role in the study and the preservation of Cultural Heritage (CH) objects and Monuments, as they have effectively illuminated a number of complex diagnostic and restoration problems. Their unique properties have enabled their use in a wide range of conservation applications, since they ensure interventions with precise control, material selectivity and immediate feedback. Surface cleaning, based on laser ablation, is a delicate, critical and irreversible process, which, given the multitude of materials that may be present on a CH object and the often fragile or precarious condition of the original surfaces, is fraught with many potential complications. Therefore it is crucial to choose the best possible laser cleaning methodology for each individual case, which involves optimising the laser parameters according to material properties, as well as the thorough knowledge of the ablation mechanisms involved. In this context the systematic investigation and elucidation of potential damage or side effects occurring upon cleaning is essential, as it delineates the possibilities and limitations of laser ablation and allows the fine-tuning of the operating parameters for a successful cleaning intervention. This paper is an overview of studies investigating the mechanisms which are responsible for the laser-induced discoloration effects. Emphasis is given on the yellowing coloration observed on stonework upon infrared (IR) ablation of pollution encrustations, while the various theories introduced to approach the different physical and/or chemical processes and mechanisms responsible for such side effects are discussed. In this respect the different laser cleaning methodologies, which are based on the use of laser systems with different pulse durations and wavelength characteristics, introduced in order to rectify or prevent discoloration on stonework are presented. In parallel, the darkening phenomena which occur upon

  20. [Pharmacotherapy for preventing calcium containing stone formation].

    Science.gov (United States)

    Nagata, Masao; Takayama, Tatsuya; Mugiya, Souichi; Ohzono, Seiichiro

    2011-10-01

    Many urinary tract stones consist of calcium, and has high relapse rate. Accordingly, it is very important to prevent calcium-containing stone formation. This paper describes about effects and mechanisms for Xanthine oxidase inhibitor, citrate formulation, magnesium formulation, thiazides, vitamin B(6), extract of Quercus salicina Blume and chorei-to (medical herb) . Recent new drugs and the elucidation of new metabolic pathways may lead to the development of prevention of urolithiasis.

  1. Stone fragmentation by ultrasound

    Indian Academy of Sciences (India)

    Unknown

    In the present work, enhancement of the kidney stone fragmentation by using ultrasound is studied. The cavi- ... ment system like radiation pressure balance, the power is given by ... Thus the bubble size has direct relationship with its life and.

  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. 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 .

  4. Uric acid stones increase the risk of chronic kidney disease.

    Science.gov (United States)

    Li, Ching-Chia; Chien, Tsu-Ming; Wu, Wen-Jeng; Huang, Chun-Nung; Chou, Yii-Her

    2018-02-28

    The aim of this study was to compare the clinical characteristics of uric acid stones and their potential risk for chronic kidney disease (CKD). A total of 401 patients (196 with uric acid stone and 205 without) were enrolled from our database of patients with urolithiasis. We analyzed the clinical demographic features, stone location, urine chemistries, and renal function. There was a significant difference (p uric acid group. Patients with uric acid stones had much lower pH of urine (p uric acid level (p = 0.002). Notably, those with uric acid stones had worse eGFR than those with non-uric acid stones. Multivariate analysis confirmed that age over 60 years (ORs = 9.19; 95% CI 3.5-24.3), female sex (ORs = 4.01; 95% CI 1.8-9.0), hyperuricemia (ORs = 8.47; 95% CI 1.6-43.5), and uric acid stone (OR = 2.86; 95% CI 1.2-6.7) were the independent predictors of poor prognoses in CKD. Therefore, an association exists between uric acid stones and higher prevalence of CKD. Patients with uric acid stones may need close monitoring of renal function during follow-up.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Effects of olive maturation and stoning on quality indices and antioxidant content of extra virgin oils (cv. Coratina) during storage.

    Science.gov (United States)

    Gambacorta, G; Faccia, M; Previtali, M A; Pati, S; La Notte, E; Baiano, A

    2010-04-01

    Quality indices, antioxidant compounds, and antioxidant activities of extra-virgin oils from Coratina olives were evaluated during a 12-mo storage. Whole and stoned olives, picked at 2 different maturation index (MI), were submitted to malaxation for 45 min and extracted by a 3-phase continuous system. A 90-min malaxation trial was also performed for the stoned olives. The following parameters were monitored: free acidity, peroxide value, K(232) and K(270) indices, sensory profile, total phenolic content (TPC), phenolic profiles, tocopherol compounds, and antioxidant activity (AA). The highest TPC, AA, and sensory score were found for the oils obtained by olives picked at low MI and by stoned olives. After 12 mo, all the oils were still included into the "extra-virgin" category, and those deriving from whole olives picked at the lowest MI showed the best sensory characteristics due to high fruity and well-balanced pungent and bitter tastes. This study could represent a helpful tool for oil-makers to improve the marketing of extra-virgin olive oils produced from cultivars with very high phenolic contents, such as Coratina, generally not adequately appreciated by consumers because of their excessive bitterness and pungent taste. These oils, when extracted from whole olives, are generally consumed after a certain period of time (at least 6 mo) during which a decrease in the phenolic content occurs. The results of the present work demonstrate that oils extracted from olives picked at low maturation index can be marketed immediately after production if subjected to stoning and malaxed for a short time. This procedure allows to adjust the phenolic content and to obtain a high flavor and a well-balanced taste.

  7. Effect of palm oil fuel ash on compressive strength of palm oil boiler stone lightweight aggregate concrete

    Science.gov (United States)

    Muthusamy, K.; Zamri, N. A.; Kusbiantoro, A.; Lim, N. H. A. S.; Ariffin, M. A. Mohd

    2018-04-01

    Both palm oil fuel ash (POFA) and palm oil boiler stone (POBS) are by-products which has been continuously generated by local palm oil mill in large amount. Both by products is usually disposed as profitless waste and considered as nuisance to environment. The present research investigates the workability and compressive strength performance of lightweight aggregate concrete (LWAC) made of palm oil boiler stone (POBS) known as palm oil boiler stone lightweight aggregate concrete (POBS LWAC) containing various content of palm oil fuel ash. The control specimen that is POBS LWAC of grade 60 were produced using 100% OPC. Then, another 4 mixes were prepared by varying the POFA percentage from 10%, 20%, 30% and 40% by weight of cement. Fresh mixes were subjected to slump test to determine its workability before casted in form of cubes. Then, all specimens were subjected to water curing up to 28 days and then tested for its compressive strength. It was found out that utilizing of optimum amount of POFA in POBS LWAC would improve the workability and compressive strength of the concrete. However, inclusion of POFA more than optimum amount is not recommended as it will increase the water demand leading to lower workability and strength reduction.

  8. The effect of the addition of ground olive stones on the physical and mechanical properties of clay bricks

    Directory of Open Access Journals (Sweden)

    Arezki, S.

    2016-06-01

    Full Text Available This study deals with the effect of ground olive stones (GOS on the performance of fired clay bricks. Seven different clay-GOS mixes with 0, 1, 2, 3, 4, 5 and 10 wt % of GOS respectively were used for making fired brick samples. All samples were fired at 900 °C. The technological properties of the resultant material were then determined, including shrinkage, apparent density, pore size distribution, thermal conductivity, water absorption, and compressive and flexural strength. The addition of GOS to the mixture reduced the compressive strength of fired clay bricks. All clay brick pieces exhibited low firing shrinkage. It was apparent that as the percentage of GOS increased in the body, there was a noticeable increase in porosity. The water absorption coefficient decreased with increasing additions. The results indicated that thermal conductivity decreases with decrease in density and increase in porosity in fired clay bricks.En este trabajo se ha estudiado el efecto de la incorporación de huesos de aceituna triturados en las prestaciones de ladrillos de arcilla cocida. Se utilizaron siete proporciones de huesos de aceituna 0 %, 1 %, 2 %, 3 %, 4 %, 5 % y 10 % en peso. Todas las muestras se calcinaron a 900 °C y posteriormente se determinaron las propiedades resultantes, incluyendo la densidad aparente, retracción, distribución de tamaños de poro, conductividad térmica, absorción de agua y resistencias mecánicas. La adición de huesos de aceituna molidos a la mezcla redujo la resistencia a la compresión de los ladrillos de arcilla cocida. Además se observó que todas las piezas de ladrillo mostraron baja retracción tras exposición a altas temperaturas. Como era de esperar a medida que el porcentaje de huesos de aceituna molidos aumentó, la porosidad se incrementó de manera evidente. El coeficiente de absorción de agua disminuyó con el aumento del porcentaje de sustitución. Los resultados indicaron que la conductividad t

  9. Extracorporeal shock wave lithotripsy for urinary stones

    International Nuclear Information System (INIS)

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

    1988-01-01

    the effective procedure for treatment of the urinary stones

  10. Extracorporeal shock wave lithotripsy for urinary stones

    Energy Technology Data Exchange (ETDEWEB)

    Shinn, Kyung Sub; Kim, Hyun; Byun, Jae Young; Lee, Myung Hee; Bahk, Yong Whee; Park, Yong Hyun [Kangnam St. Mary' s Hospital, Catholic University Medical College, Seoul (Korea, Republic of)

    1988-06-15

    was the effective procedure for treatment of the urinary stones.

  11. TISU: Extracorporeal shockwave lithotripsy, as first treatment option, compared with direct progression to ureteroscopic treatment, for ureteric stones: study protocol for a randomised controlled trial.

    Science.gov (United States)

    McClinton, Samuel; Cameron, Sarah; Starr, Kathryn; Thomas, Ruth; MacLennan, Graeme; McDonald, Alison; Lam, Thomas; N'Dow, James; Kilonzo, Mary; Pickard, Robert; Anson, Ken; Keeley, Frank; Burgess, Neil; Clark, Charles Terry; MacLennan, Sara; Norrie, John

    2018-05-22

    Urinary stone disease is very common with an estimated prevalence among the general population of 2-3%. Ureteric stones are associated with severe pain as they pass through the urinary tract and have significant impact on patients' quality of life due to the detrimental effect on their ability to work and need for hospitalisation. Most ureteric stones can be expected to pass spontaneously with supportive care. However, between one-fifth and one-third of cases require an intervention. The two standard active intervention options are extracorporeal shockwave lithotripsy (ESWL) and ureteroscopic stone retrieval. ESWL and ureteroscopy are effective in terms of stone clearance; however, they differ in terms of invasiveness, anaesthetic requirement, treatment setting, complications, patient-reported outcomes (e.g. pain after intervention, time off work) and cost. There is uncertainty around which is the most clinically effective in terms of stone clearance and the true cost to the NHS and to society (in terms of impact on patient-reported health and economic burden). The aim of this trial is to determine whether, in adults with ureteric stones, judged to require active intervention, ESWL is not inferior and is more cost-effective compared to ureteroscopic treatment as the initial management option. The TISU study is a pragmatic multicentre non-inferiority randomised controlled trial of ESWL as the first treatment option compared with direct progression to ureteroscopic treatment for ureteric stones. Patients aged over 16 years with a ureteric stone confirmed by non-contrast computed tomography of the kidney, ureter and bladder (CTKUB) will be randomised to either ESWL or ureteroscopy. The primary clinical outcome is resolution of the stone episode (no further intervention required to facilitate stone clearance) up to six months from randomisation. The primary economic outcome is the incremental cost per quality-adjusted life years (QALYs) gained at six months from

  12. Can Hounsfield Unit Value Predict Type of Urinary Stones?

    Directory of Open Access Journals (Sweden)

    Alper Gok

    2014-03-01

    Full Text Available Aim: Aim of this study is to determine the role of Hounsfield unit (HU in predicting results of stone analysis. Material and Method: This study included 199 patients to whom percutaneous nephrolithotomy (PNL procedures were applied between January 2008 and May 2011 in our clinic. Before the procedure HU values of kidney stones were measured using non-contrast computed tomography. After the operation, obtained stone samples were analysed using X-ray diffraction technique. HU values were compared with stone analysis results. Results: Stone analysis revealed eight different stone types. Distribution of stone types and HU value ranges were as follows: 85% calcium oxalate monohydrate, 730-1130 HU; 38% calcium oxalate dihydrate, 510-810 HU; 21% uric acid, 320-550 HU; 23% struvite, 614-870 HU; 7% calcium hydrogene phosphate, 1100-1365 HU; 3% cystine, 630-674 HU; 15% mixed uric acid plus calcium oxalate, 499-840 HU; and 7% mixed cystine plus calcium phosphate, 430-520 HU. HU values of all stone types ranged between 320 and 1365. There was a statistically significant relation between HU values of uric acid and non uric acid stones (p

  13. Circular Raft Footings Strengthened by Stone Columns under Static Loads

    OpenAIRE

    R. Ziaie Moayed; B. Mohammadi-Haji

    2016-01-01

    Stone columns have been widely employed to improve the load-settlement characteristics of soft soils. The results of two small scale displacement control loading tests on stone columns were used in order to validate numerical finite element simulations. Additionally, a series of numerical calculations of static loading have been performed on strengthened raft footing to investigate the effects of using stone columns on bearing capacity of footings. The bearing capacity of single and group of ...

  14. The Guy's stone score--grading the complexity of percutaneous nephrolithotomy procedures.

    Science.gov (United States)

    Thomas, Kay; Smith, Naomi C; Hegarty, Nicholas; Glass, Jonathan M

    2011-08-01

    To report the development and validation of a scoring system, the Guy's stone score, to grade the complexity of percutaneous nephrolithotomy (PCNL). Currently, no standardized method is available to predict the stone-free rate after PCNL. The Guy's stone score was developed through a combination of expert opinion, published data review, and iterative testing. It comprises 4 grades: grade I, solitary stone in mid/lower pole or solitary stone in the pelvis with simple anatomy; grade II, solitary stone in upper pole or multiple stones in a patient with simple anatomy or a solitary stone in a patient with abnormal anatomy; grade III, multiple stones in a patient with abnormal anatomy or stones in a caliceal diverticulum or partial staghorn calculus; grade IV, staghorn calculus or any stone in a patient with spina bifida or spinal injury. It was assessed for reproducibility using the kappa coefficient and validated on a prospective database of 100 PCNL procedures performed in a tertiary stone center. The complications were graded using the modified Clavien score. The clinical outcomes were recorded prospectively and assessed with multivariate analysis. The Guy's stone score was the only factor that significantly and independently predicted the stone-free rate (P = .01). It was found to be reproducible, with good inter-rater agreement (P = .81). None of the other factors tested, including stone burden, operating surgeon, patient weight, age, and comorbidity, correlated with the stone-free rate. The Guy's stone score accurately predicted the stone-free rate after PCNL. It was easy to use and reproducible. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. [Usefullness of the StoneBreaker lithotripter for percutaneous nephrolithotomy].

    Science.gov (United States)

    del Peso, Almudena Coloma; González, Inmaculada Fernández; Gálvez, Milagros Jiménez; Abad, Pablo Garrido; Fajardo, Gloria Bocardo; Fernández, Luis Miguel Herranz; Arjona, Manuel Fernández; Torres, Lorenzo Herrero; Sanz, Ignacio Pereira

    2008-01-01

    Throughout the history, many devices have been used for breaking urinary tract stones. StoneBreaker (LMA Urology, Gland, Switzerland) is a second generation of intracorporeal lithotripter, pneumatic and portable, which adds several new advantages, like effectiveness in stone fragmentation and easy handling, very useful during percutaneous lithotripsy. We report the case of a 40 year-old male patient, with a left kidney pyelic lithiasis, who was treated by percutaneous lithotripsy, under general anaesthesia, with StoneBreaker (LMA Urology, Gland, Switzerland) as lithotripter. StoneBreaker (LMA Urology, Gland, Switzerland) is a lithotripter usable with rigid and semirigid ureteroscopes, much more powerful than its predecessors. It is able to decrease the number of shocks necessary for stone fragmentation, without bigger tissue reaction. It also has a more comfortable design due to the absence of connections, and its power by replaceable carbon dioxide cartridges.

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

    African Journals Online (AJOL)

    A. Khalique

    2017-02-24

    Feb 24, 2017 ... (SIUT-ERC-B4-2013). All clinical and radiological data were collected and analyzed using. Statistical Package for Social Sciences Program (SPSS) version. 18.0 (SPSS Inc., Chicago, Illinois, USA). Descriptive statistics were used. Continuous variables such as age, size of stones, serum cre- atinine were ...

  17. Estimation of urinary stone composition by automated processing of CT images.

    Science.gov (United States)

    Chevreau, Grégoire; Troccaz, Jocelyne; Conort, Pierre; Renard-Penna, Raphaëlle; Mallet, Alain; Daudon, Michel; Mozer, Pierre

    2009-10-01

    The objective of this article was developing an automated tool for routine clinical practice to estimate urinary stone composition from CT images based on the density of all constituent voxels. A total of 118 stones for which the composition had been determined by infrared spectroscopy were placed in a helical CT scanner. A standard acquisition, low-dose and high-dose acquisitions were performed. All voxels constituting each stone were automatically selected. A dissimilarity index evaluating variations of density around each voxel was created in order to minimize partial volume effects: stone composition was established on the basis of voxel density of homogeneous zones. Stone composition was determined in 52% of cases. Sensitivities for each compound were: uric acid: 65%, struvite: 19%, cystine: 78%, carbapatite: 33.5%, calcium oxalate dihydrate: 57%, calcium oxalate monohydrate: 66.5%, brushite: 75%. Low-dose acquisition did not lower the performances (P < 0.05). This entirely automated approach eliminates manual intervention on the images by the radiologist while providing identical performances including for low-dose protocols.

  18. [The effiectiveness of extracorporeal shock wave lithotripsy in treating proxima ureteral stones].

    Science.gov (United States)

    Kogan, M I; Belousov, I I; Yassine, A M

    2017-10-01

    Extracorporeal shock wave lithotripsy (ESWL) has proven efficacy in the treatment of proximal ureteral stones. The research to date has not been able to establish real time to spontaneous stone clearance after ESWL and the appropriateness and effectiveness of -blockers in stimulating residual stone clearance after ESWL. To conduct a comprehensive assessment of the effectiveness of ESWL in treating proximal ureteral stones and determine the appropriateness of using -blockers to stimulate residual stone clearance. ESWL was performed in 40 patients with X-ray positive proximal ureteral stones. Before ESWL and at 3 months after the treatment all patients underwent multispiral computed tomography. ESWL was considered successful if there was a complete clearance of the stones with no residual fragments on the control MSCT. If a residual ureteral stone was found at 3 months after ESWL, a 2-week course of silodosin was administered. Complete stone clearance was achieved in 37.5% of patients. Silodosin therapy for residual stones resulted in stone clearance in 68.4% of cases. Taken together, ESWL monotherapy and additional 3 months of lithokinetic therapy resulted in stone clearance in 70.0% of patients. The remaining patients underwent contact ureteral lithotripsy. Spontaneous stone passage after ESWL for proximal ureteral stones occurs not in all patients. Most commonly it occurred during the first three weeks after ESWL, and thereafter stone passage was not observed. In half of the patients with residual stones they were asymptomatic. The effectiveness of ESWL as a monotherapy for ureteral stones greater than 15 mm is incomplete. Adding silodosin during the long-term post ESWL period improves the passage of asymptomatic residual stones in 2/3 of patients, which makes its use promising.

  19. Anholt Rosetta Stones

    DEFF Research Database (Denmark)

    Trempe Jr., Robert B.; Buthke, Jan

    2017-01-01

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

  20. Stone comminution correlates with the average peak pressure incident on a stone during shock wave lithotripsy.

    Science.gov (United States)

    Smith, N; Zhong, P

    2012-10-11

    To investigate the roles of lithotripter shock wave (LSW) parameters and cavitation in stone comminution, a series of in vitro fragmentation experiments have been conducted in water and 1,3-butanediol (a cavitation-suppressive fluid) at a variety of acoustic field positions of an electromagnetic shock wave lithotripter. Using field mapping data and integrated parameters averaged over a circular stone holder area (R(h)=7 mm), close logarithmic correlations between the average peak pressure (P(+(avg))) incident on the stone (D=10 mm BegoStone) and comminution efficiency after 500 and 1000 shocks have been identified. Moreover, the correlations have demonstrated distinctive thresholds in P(+(avg)) (5.3 MPa and 7.6 MPa for soft and hard stones, respectively), that are required to initiate stone fragmentation independent of surrounding fluid medium and LSW dose. These observations, should they be confirmed using other shock wave lithotripters, may provide an important field parameter (i.e., P(+(avg))) to guide appropriate application of SWL in clinics, and facilitate device comparison and design improvements in future lithotripters. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Percutaneous nephrolithotomy for the treatment of radiolucent renal stones in children: is it different opaque stone treatment?

    Science.gov (United States)

    Adanur, Şenol; Ziypak, Tevfik; Sancaktutar, Ahmet Ali; Tepeler, Abdülkadir; Reşorlu, Berkan; Söylemez, Haluk; Dağgülli, Mansur; Özbey, İsa; Unsal, Ali

    2014-02-01

    We aimed to evaluate the effectiveness of percutaneous nephrolithotomy (PNL), stone-free rates, and related complications in children with radiolucent renal stones. A total of 56 patients aged auxillary treatment method was detected as 94.6%. The total complication rate was 19.6% (11 patients). No adjacent organ injury was observed. All of the complications that occurred were minor according to the Clavien classification (Clavien Grades I-II). PNL can be applied to radiolucent pediatric renal stones in children with similar success, and complication rates as noted for radiopaque stones.

  2. Healing stone ... by infection

    OpenAIRE

    Micallef, Roderick

    2014-01-01

    Roderick Micallef has a long family history within the construction industry. He coupled this passion with a fascination with science when reading for an undergraduate degree in Biology and Chemistry (University of Malta). http://www.um.edu.mt/think/healing-stone-by-infection/

  3. Modeling Stone Columns.

    Science.gov (United States)

    Castro, Jorge

    2017-07-11

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

  4. The effectiveness of Stepping stones Triple P: the design of a randomised controlled trial on a parenting programme regarding children with mild intellectual disability and psychosocial problems versus care as usual

    Science.gov (United States)

    2011-01-01

    Background Children with an intellectual disability are at increased risk of psychosocial problems. This leads to serious restrictions in the daily functioning of the children and to parental stress. Stepping Stones Triple P aims to prevent severe behavioural, emotional and developmental problems in children with a (intellectual) disability by enhancing parenting knowledge and skills, and the self-confidence of parents. This paper aims to describe the design of a study of the effectiveness of parenting counselling using Stepping Stones Triple P compared to Care as Usual. Methods/Design The effects of Stepping Stones Triple P will be studied in a Randomised Controlled Trial. Parents of children aged 5-12 years with an IQ of 50-85 will be recruited from schools. Prior to randomisation, parents complete a screening questionnaire about their child's psychosocial problems and their parenting skills. Subsequently, parents of children with increased levels of psychosocial problems (score on Strengths and Difficulties Questionnaire ≥ 14) will be invited to participate in the intervention study. After obtaining consent, parents will be randomised either to the experimental group (Stepping Stones Triple P) or to Care as Usual. The primary outcome is a change in the child's psychosocial problems according to parents and teachers. The secondary outcome is a change in parenting skills. Data will be collected before the start of the intervention, immediately after the intervention, and six months after. Discussion This paper presents an outline of the background and design of a randomised controlled trial to investigate the effectiveness of Stepping Stones Triple P, which aims to decrease psychosocial problems in children with a mild intellectual disability. Stepping Stones Triple P seems promising, but evidence on its effectiveness for this population is still lacking. This study provides evidence about the effects of this intervention in a community-based population of

  5. The effectiveness of Stepping Stones Triple P: the design of a randomised controlled trial on a parenting programme regarding children with mild intellectual disability and psychosocial problems versus care as usual.

    Science.gov (United States)

    Kleefman, Marijke; Jansen, Daniëlle E M C; Reijneveld, Sijmen A

    2011-08-30

    Children with an intellectual disability are at increased risk of psychosocial problems. This leads to serious restrictions in the daily functioning of the children and to parental stress. Stepping Stones Triple P aims to prevent severe behavioural, emotional and developmental problems in children with a (intellectual) disability by enhancing parenting knowledge and skills, and the self-confidence of parents. This paper aims to describe the design of a study of the effectiveness of parenting counselling using Stepping Stones Triple P compared to Care as Usual. The effects of Stepping Stones Triple P will be studied in a Randomised Controlled Trial. Parents of children aged 5-12 years with an IQ of 50-85 will be recruited from schools. Prior to randomisation, parents complete a screening questionnaire about their child's psychosocial problems and their parenting skills. Subsequently, parents of children with increased levels of psychosocial problems (score on Strengths and Difficulties Questionnaire ≥ 14) will be invited to participate in the intervention study. After obtaining consent, parents will be randomised either to the experimental group (Stepping Stones Triple P) or to Care as Usual. The primary outcome is a change in the child's psychosocial problems according to parents and teachers. The secondary outcome is a change in parenting skills. Data will be collected before the start of the intervention, immediately after the intervention, and six months after. This paper presents an outline of the background and design of a randomised controlled trial to investigate the effectiveness of Stepping Stones Triple P, which aims to decrease psychosocial problems in children with a mild intellectual disability. Stepping Stones Triple P seems promising, but evidence on its effectiveness for this population is still lacking. This study provides evidence about the effects of this intervention in a community-based population of children with a mild intellectual

  6. The effectiveness of Stepping stones Triple P: the design of a randomised controlled trial on a parenting programme regarding children with mild intellectual disability and psychosocial problems versus care as usual

    Directory of Open Access Journals (Sweden)

    Jansen Daniëlle EMC

    2011-08-01

    Full Text Available Abstract Background Children with an intellectual disability are at increased risk of psychosocial problems. This leads to serious restrictions in the daily functioning of the children and to parental stress. Stepping Stones Triple P aims to prevent severe behavioural, emotional and developmental problems in children with a (intellectual disability by enhancing parenting knowledge and skills, and the self-confidence of parents. This paper aims to describe the design of a study of the effectiveness of parenting counselling using Stepping Stones Triple P compared to Care as Usual. Methods/Design The effects of Stepping Stones Triple P will be studied in a Randomised Controlled Trial. Parents of children aged 5-12 years with an IQ of 50-85 will be recruited from schools. Prior to randomisation, parents complete a screening questionnaire about their child's psychosocial problems and their parenting skills. Subsequently, parents of children with increased levels of psychosocial problems (score on Strengths and Difficulties Questionnaire ≥ 14 will be invited to participate in the intervention study. After obtaining consent, parents will be randomised either to the experimental group (Stepping Stones Triple P or to Care as Usual. The primary outcome is a change in the child's psychosocial problems according to parents and teachers. The secondary outcome is a change in parenting skills. Data will be collected before the start of the intervention, immediately after the intervention, and six months after. Discussion This paper presents an outline of the background and design of a randomised controlled trial to investigate the effectiveness of Stepping Stones Triple P, which aims to decrease psychosocial problems in children with a mild intellectual disability. Stepping Stones Triple P seems promising, but evidence on its effectiveness for this population is still lacking. This study provides evidence about the effects of this intervention in a community

  7. Sonography as an initial study in patients with suspected ureteral stone

    International Nuclear Information System (INIS)

    Lee, Jae Gue; Lim, Joo Won; Ko, Young Tae; Lee, Dong Ho; Lee, Hye Won; Oh, Joo Hyeong; Yoon, Yup; Lee, Sun Ju

    1999-01-01

    To evaluate the usefulness of sonography as an initial study in patients with suspected ureteral stone. We have undertaken a prospective study for 106 patients with suspected ureteral stone during 15 months. All the patients subsequently underwent urography at a mean interval of 1.8 days after the abdominopelvic sonography. We had only a clinical impression at the sonography and didn't refer to the other study such as KUB. We observed the degree of hydronephrosis using a grading system by Ellenbogen et aland location and size of stone. Seventy four patients had ureteral stone disease. The sonographic findings of these 74 patients showed a stone with hydronephrosis in 61 patients, a stone without hydronephrosis in 9, only hydronephrosis without stone in 2, and unremarkable finding in 2. In 3 of the remaining 32 patients, sonography showed hydronephrosis without stone. Locations of stone were 9 patients of ureteropelvic junction(UPJ), 19 of proximal ureter, 30 of distal ureter, and 16 of ureterovesical junction(UVJ). The sensitivity of sonography for stone was 95% and the specificity was 100%. When a ureteral stone was present, ipsilateral hydronephrosis was detected in 85% of cases on sonography. When only hydronephrosis without stone was detected on sonography, a ureteral stone was diagnosed in 2(40%) of 5 patients. Mean discrepancy of stone size between sonography and KUB was 3.1mm and stone size on sonography was larger. Grade of hydronephrosis between sonography and urography was the same in 32(59%) of 54 patients, whose stones were not expelled until urography after sonography. Sonography could be used as an initial study in patients with suspected ureteral stone.

  8. Development of pulsed dye lasers for kidney stone fragmentation

    International Nuclear Information System (INIS)

    Hsia, J.

    1990-01-01

    The idea of using lasers to break stones inside the body was first proposed soon after the appearance of the pulsed ruby laser in 1960. Early work of pioneers in the field such as Mulvaney Pensel, and Tanahashi did not lead to a useful clinical protocol. In 1982, Dr. Graham Watson started a systematic search for the right laser. He soon came to the conclusion that CW lasers that relied on thermal effects were not clinically effective. Q-switched lasers such as ruby and Nd:YAG were eliminated because available optical fibers could not handle the high peak powers they emitted. Animal tests were completed and the first human was successfully treated at MGH by Dr. Stephen Dretler in October, 1985. This was soon followed by treatments at the Institute of Urology in London by Dr. Watson and Dr. Wickham. Today, lasertripsy is the treatment of choice for lower ureteral stones. In this paper the work leading to the development of the first clinically effective laser lithotripsy system is reviewed

  9. 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

  10. The twelve colourful stones

    International Nuclear Information System (INIS)

    Doria, R.M.

    1984-01-01

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

  11. Anholt Rosetta Stones

    DEFF Research Database (Denmark)

    Trempe Jr., Robert B.; Buthke, Jan

    2017-01-01

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

  12. Efficacy and safety of minor endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in treatment of elderly patients with multiple large common bile duct stones

    Directory of Open Access Journals (Sweden)

    HE Yongfeng

    2018-02-01

    Full Text Available Objective To investigate the clinical effect and safety of minor endoscopic sphincterotomy (mEST combined with endoscopic papillary large balloon dilation (EPLBD in the treatment of elderly patients with multiple large common bile duct stones. MethodsA retrospective analysis was performed for 229 patients with multiple large common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP in Endoscopy Center, Ankang Municipal Central Hospital, from January 2012 to December 2016, and the surgical procedure was selected based on the size of stones and the morphology of the common bile duct. According to the endoscopic surgical procedure, the patients were divided into mEST+EPLBD group (treatment group with 136 patients and endoscopic phincterotomy (EST group (control group with 93 patients. The two groups were compared in terms of the success rate of first stone removal, use rate of mechanical lithotripsy (ML, time spent on stone removal, and the incidence rate of complications. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in the success rate of first stone removal between the treatment group and the control group (91.17% vs 87.10%, χ2=0.980, P>0.05, while there were significant differences in the time spent on stone removal (18.2±4.3 min vs 37.4±6.7 min, χ2=37.1526, P<0.01 and use rate of ML (6.71% vs 40.00%, t=24.411, P<0.01. There were no significant differences in the incidence rates of pancreatitis (2.94% vs 6.45%, χ2=1.630, P>0.05 and bleeding (2.21% vs 2.15%, χ2=0.001, P>0.05 between the two groups, and no patient experienced perforation or infection. ConclusionmEST+EPLBD has a good clinical effect in the treatment of elderly patients with multiple large common bile duct stones and can effectively shorten the time spent on stone removal, reduce the

  13. Risk factors for pancreatic stone formation in autoimmune pancreatitis over a long-term course.

    Science.gov (United States)

    Maruyama, Masahiro; Arakura, Norikazu; Ozaki, Yayoi; Watanabe, Takayuki; Ito, Tetsuya; Yoneda, Suguru; Maruyama, Masafumi; Muraki, Takashi; Hamano, Hideaki; Matsumoto, Akihiro; Kawa, Shigeyuki

    2012-05-01

    Autoimmune pancreatitis (AIP) has the potential to progress to a chronic state that forms pancreatic stones. The aim of this study was to clarify the risk factors underlying pancreatic stone formation in AIP. Sixty-nine patients with AIP who had been followed for at least 3 years were enrolled for evaluation of clinical and laboratory factors as well as computed tomography and endoscopic retrograde cholangiopancreatography findings. During the course of this study, increased or de novo stone formation was seen in 28 patients, who were defined as the stone-forming group. No stones were observed in 32 patients, who were defined as the non-stone-forming group. Nine patients who had stones at diagnosis but showed no change during the course of this study were excluded from our cohort. Univariate analysis revealed no significant differences in clinical or laboratory factors associated with AIP-specific inflammation between the two groups. However, pancreatic head swelling (P = 0.006) and narrowing of both Wirsung's and Santorini's ducts in the pancreatic head region (P = 0.010) were significantly more frequent in the stone-forming group. Furthermore, multivariate analysis identified Wirsung and Santorini duct narrowing at diagnosis as a significant independent risk factor for pancreatic stone formation (OR 4.4, P = 0.019). A primary risk factor for pancreatic stone formation in AIP was narrowing of both Wirsung's and Santorini's ducts, which most presumably led to pancreatic juice stasis and stone development.

  14. [Ultraminipercutaneous nephrolithotripsy in treating kidney stones].

    Science.gov (United States)

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

    2016-04-01

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

  15. Extracorporeal shock wave lithotripsy for renal stone with infundibular stenosis

    International Nuclear Information System (INIS)

    Lee, Won Hong; Son, Soon Yong; Kang, Seong Ho; Lee, Yong Moon; Yoon, Seok Hwan

    2006-01-01

    We analyzed retrospectively our experience to evaluate an effect of extracorporeal shock wave lithotripsy (ESWL) for renal stone with infundibular stenosis. From January 2002 to August 2005, 35 patients with renal stone with infundibular stenosis were treated with ESWL. The diagnosis of infundibular stenosis was made by intravenous pyelography or retrograde pyelography. The final follow-up check was performed by simple abdominal film or computed tomography and interview after 6 months to 24 months (mean 10 months). 7 (20.0%) of 35 patients was freed completely, but Stone free rate including less than 2 mm size was 80% (28/35). 30 (85.7%) patients became asymptomatic, 4 (11.4%) patients were continued, and 1 (2.9%) patient was required the percutaneous nephrostolithotomy. Although ESWL has a low complete stone free rate, We suggest that renal stone with infundibular stenosis should be treated with ESWL, because that is likely to produce a high symptom free and low complications

  16. Extracorporeal shock wave lithotripsy for renal stone with infundibular stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hong; Son, Soon Yong; Kang, Seong Ho; Lee, Yong Moon [Asan Medical Center, Seoul (Korea, Republic of); Yoon, Seok Hwan [Dongnam Health College, Suwon (Korea, Republic of)

    2006-06-15

    We analyzed retrospectively our experience to evaluate an effect of extracorporeal shock wave lithotripsy (ESWL) for renal stone with infundibular stenosis. From January 2002 to August 2005, 35 patients with renal stone with infundibular stenosis were treated with ESWL. The diagnosis of infundibular stenosis was made by intravenous pyelography or retrograde pyelography. The final follow-up check was performed by simple abdominal film or computed tomography and interview after 6 months to 24 months (mean 10 months). 7 (20.0%) of 35 patients was freed completely, but Stone free rate including less than 2 mm size was 80% (28/35). 30 (85.7%) patients became asymptomatic, 4 (11.4%) patients were continued, and 1 (2.9%) patient was required the percutaneous nephrostolithotomy. Although ESWL has a low complete stone free rate, We suggest that renal stone with infundibular stenosis should be treated with ESWL, because that is likely to produce a high symptom free and low complications.

  17. Advances in percutaneous stone surgery

    OpenAIRE

    Hartman, Christopher; Gupta, Nikhil; Leavitt, David; Hoenig, David; Okeke, Zeph; Smith, Arthur

    2015-01-01

    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, ...

  18. Advances in percutaneous stone surgery.

    Science.gov (United States)

    Hartman, Christopher; Gupta, Nikhil; Leavitt, David; Hoenig, David; Okeke, Zeph; Smith, Arthur

    2015-01-01

    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.

  19. The economics of stone disease.

    Science.gov (United States)

    Canvasser, Noah E; Alken, Peter; Lipkin, Michael; Nakada, Stephen Y; Sodha, Hiren S; Tepeler, Abdulkadir; Lotan, Yair

    2017-09-01

    The rising prevalence of kidney stone disease is associated with significant costs to healthcare systems worldwide. This is in part due to direct procedural and medical management costs, as well as indirect costs to health systems, patients, and families. A number of manuscripts evaulating the economics of stone disease have been published since the 2008s International Consultation on Stone Disease. These highlight costs associated with stone disease, including acute management, surgical management, and medical management. This work hopes to highlight optimization in care by reducing inefficient treatments and maximizing cost-efficient preventative strategies.

  20. 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

  1. Can a dual-energy computed tomography predict unsuitable stone components for extracorporeal shock wave lithotripsy?

    Science.gov (United States)

    Ahn, Sung Hoon; Oh, Tae Hoon; Seo, Ill Young

    2015-09-01

    To assess the potential of dual-energy computed tomography (DECT) to identify urinary stone components, particularly uric acid and calcium oxalate monohydrate, which are unsuitable for extracorporeal shock wave lithotripsy (ESWL). This clinical study included 246 patients who underwent removal of urinary stones and an analysis of stone components between November 2009 and August 2013. All patients received preoperative DECT using two energy values (80 kVp and 140 kVp). Hounsfield units (HU) were measured and matched to the stone component. Significant differences in HU values were observed between uric acid and nonuric acid stones at the 80 and 140 kVp energy values (penergy values (p<0.001). DECT improved the characterization of urinary stone components and was a useful method for identifying uric acid and calcium oxalate monohydrate stones, which are unsuitable for ESWL.

  2. Utility of Flexible Ureterorenoscopy and Laser Lithotripsy in the Treatment of Multiple Intrarenal Stones

    Directory of Open Access Journals (Sweden)

    Hasan Yılmaz

    2017-09-01

    Full Text Available Objective: We aimed to determine the safety and efficacy of flexible ureterorenoscopy and Holmium laser lithotripsy in treating multiple intrarenal stones. Materials and Methods: We identified 32 consecutive patients with multiple intrarenal stones who underwent flexible ureterorenoscopy and/or laser lithotripsy performed by a single surgeon. Informed consent was obtained from all participants before treatment. Each patient was evaluated in terms of stone location, stone number, stone size, stone burden (cumulative stone length, body mass index, operative time, stone-free rate, and perioperative complications. Results: The median age of the patients was 38 years [interquartile range (IQR, 34.25-52.00]. The patients had a total of 75 intrarenal calculi. The average number of stones per patient was 2.50 (IQR, 2.0-3.0. The median total stone burden per patient was 23.0 mm (IQR, 19.0-28.0 mm. Twenty-one patients (65.5% had stone burdens >20 mm, and 11 (34.5% had burdens ≤20 mm. The overall final stone-free rate was 78.1%. The stone-free rates for patients with stone burdens ≤20 mm and >20 mm were 81.8% (9/11 and 76.2% (16/21, respectively (p=0.544. A perioperative complication (urinary leakage occurred in one patient. Postoperative complications were recorded in four (12.5% patients; a urinary tract infection in one, pain requiring parenteral medication in two, and hematuria in one. Conclusion: Flexible ureterorenoscopy combined with laser lithotripsy may be an effective treatment option for patients with multiple intrarenal stones; we noted only a few minor complications. The success rate was higher in patients with stone burdens ≤20 mm.

  3. Extracorporeal shock wave lithotripsy of intrahepatic stones with piezoelectric lithotriptor: in vitro study

    International Nuclear Information System (INIS)

    Choi, Byung Ihn; Yoon, Chong Hyun; Park, Yong Hyun; Han, Joon Koo; Yoon, Yong Bum; Shin, Yong Moon; Kim, Jin Q; Kim, Chu Wan; Han, Man Chung

    1992-01-01

    This study was designed to investigate effectiveness of fragmentation during lithotripsy using 103 intrahepatic stones collected from 10 patients, who had previously undergone biliary surgery. The size of each stone was measured and sonography was performed for the evaluation of the sonographic type of the stones. In vitro lithotripsy was performed on individual stones using piezoelectric lithotriptor to evaluate the fragmentation rate and average number of shock waves for fragmentation. Chemical analysis of each stone was done to determine chemical composition including calcium, bilirubin, and cholesterol. The size of the stones was from 5 mm to 20 mm in diameter. Sonographic type I (echo of whole stone with posterior acoustic shadow) was 68, and type II (are-like strong surface echo of stone with clear posterior acoustic shadow) was 35 in number. The majority (78%) of stones in group I (5-9 mm in diameter) showed sonographic type I characteristics, and 62% of stones in group 3 (larger than 15 mm in diameter) showed sonographic type II characteristics. There was a positive correlation between the size and sonographic type of stones. Fragmentation rates of stones were 100% in group I, 71.9% in group 2 (10-15 mm in diameter), 43.8% in group 3, respectively. Fragmentation rates of stones with sonographic type I and II were 91.2%, 65.7%, respectively. The average number of shock waves for partial and complete fragmentation was 2753 ± 4937 and 6219 ± 10133, respectively. There was a positive correlation between the number of shock waves for fragmentation and diameter of stones (r = 0.618, ρ < 0.05). There was no correlation between the number of shock waves for fragmentation and chemical composition of stones. In conclusion, the most important variable determining the degree of fragmentation of intrahepatic stones using ESWL is not their chemical composition but their size and sonographic characteristics

  4. Extracorporeal shock wave lithotripsy of intrahepatic stones with piezoelectric lithotriptor: in vitro study

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn; Yoon, Chong Hyun; Park, Yong Hyun; Han, Joon Koo; Yoon, Yong Bum; Shin, Yong Moon; Kim, Jin Q; Kim, Chu Wan; Han, Man Chung [Seoul National University, College of Medicine, Seoul (Korea, Republic of)

    1992-05-15

    This study was designed to investigate effectiveness of fragmentation during lithotripsy using 103 intrahepatic stones collected from 10 patients, who had previously undergone biliary surgery. The size of each stone was measured and sonography was performed for the evaluation of the sonographic type of the stones. In vitro lithotripsy was performed on individual stones using piezoelectric lithotriptor to evaluate the fragmentation rate and average number of shock waves for fragmentation. Chemical analysis of each stone was done to determine chemical composition including calcium, bilirubin, and cholesterol. The size of the stones was from 5 mm to 20 mm in diameter. Sonographic type I (echo of whole stone with posterior acoustic shadow) was 68, and type II (are-like strong surface echo of stone with clear posterior acoustic shadow) was 35 in number. The majority (78%) of stones in group I (5-9 mm in diameter) showed sonographic type I characteristics, and 62% of stones in group 3 (larger than 15 mm in diameter) showed sonographic type II characteristics. There was a positive correlation between the size and sonographic type of stones. Fragmentation rates of stones were 100% in group I, 71.9% in group 2 (10-15 mm in diameter), 43.8% in group 3, respectively. Fragmentation rates of stones with sonographic type I and II were 91.2%, 65.7%, respectively. The average number of shock waves for partial and complete fragmentation was 2753 {+-} 4937 and 6219 {+-} 10133, respectively. There was a positive correlation between the number of shock waves for fragmentation and diameter of stones (r = 0.618, {rho} < 0.05). There was no correlation between the number of shock waves for fragmentation and chemical composition of stones. In conclusion, the most important variable determining the degree of fragmentation of intrahepatic stones using ESWL is not their chemical composition but their size and sonographic characteristics.

  5. Aging and Curing Temperature Effects on Compressive Strength of Mortar Containing Lime Stone Quarry Dust and Industrial Granite Sludge

    Directory of Open Access Journals (Sweden)

    Muhammad Nasir Amin

    2017-06-01

    Full Text Available In this study, the researchers investigated the potential use of locally available waste materials from the lime stone quarry and the granite industry as a partial replacement of cement. Quarry sites and granite industry in the eastern province of Saudi Arabia produces tons of powder wastes in the form of quarry dust (QD and granite sludge (GS, respectively, causing serious environmental problems along with frequent dust storms in the area. According to ASTM C109, identical 50-mm3 specimens were cast throughout this study to evaluate the compressive strength development of mortars (7, 28 and 91 days containing these waste materials. Experimental variables included different percentage replacement of cement with waste materials (GS, QD, fineness of GS, various curing temperatures (20, 40 and 60 °C as local normal and hot environmental temperatures and curing moisture (continuously moist and partially moist followed by air curing. Finally, the results of mortar containing waste materials were compared to corresponding results of control mortar (CM and mortar containing fly ash (FA. The test results indicated that under normal curing (20 °C, moist cured, the compressive strength of mortar containing the different percentage of waste materials (QD, GS, FA and their combinations remained lower than that of CM at all ages. However, the compressive strength of mortar containing waste materials slightly increased with increased fineness of GS and significantly increased under high curing temperatures. It was recommended that more fineness of GS be achieved to use its high percentage replacement with cement (30% or more incorporating local environmental conditions.

  6. Nanobacteria: An Infectious Cause for Salivary Stone Formation and Recurrence

    Directory of Open Access Journals (Sweden)

    Amr A El Badry

    2010-01-01

    Full Text Available Nanobacteria (NB contribute to pathological calcification in the human and animal body. It has been isolated from salivary stones and suggested that it may act as a nucleus for the initiation of these stones. In the present study, we examined its role in the recurrent salivary gland stones using immunodetection with NB-specific monoclonal antibodies and scanning electron microscopy (SEM hoping to provide a method for preventing the recurrence of these stones in the patient that has suffered from salivary stones. Our study comprised 30 patients with recurrent salivary gland stones (group I and 30 patients with salivary gland stones for the first time (group II, in addition to 30 normal controls (group III. We could detect 100–500 nm nanoparticles in 24/30 (80% cases in group I with significant difference <0.05 and <0.01 when compared with group II and group III in which they were detected in 19/30 (63.3% and 6/30 (20% respectively. Also there was a significant difference <0.05 between group II and group III. We proposed that salivary stone formation is a nanobacterial disease initiated by bacterial infection. This bacteria may play an important role in the recurrence of salivary stone. So the use of calcium chelator, ethylene diamine tetra acetic acid (EDTA, before or in combination with the suitable antibiotic that is given in an amount effective to inhibit or prevent the growth and development of nanobacteria may eradicate these stones and prevent their recurrence.

  7. Retroperitoneoscopy for treatment of renal and ureteral stones

    Directory of Open Access Journals (Sweden)

    Rodrigo S. Soares

    2005-04-01

    Full Text Available OBJECTIVE: To assess the efficacy of retroperitoneoscopy for treating stones in the renal pelvis and proximal ureter. MATERIALS AND METHODS: In the period from August 2003 to August 2004, 35 retroperitoneoscopies for treatment of urinary stones were performed on 34 patients. Fifteen patients (42% had stones in the renal pelvis, and in 2 cases, there were associated stones in the upper caliceal group. Twenty patients (58% had ureteral stones, all of them located above the iliac vessel. Twenty-five patients (71% had previously undergone at least one session of extracorporeal lithotripsy and 8 patients (26% also underwent ureteroscopy to attempt to remove the stone. Eight patients underwent retroperitoneoscopy as a primary procedure. Stone size ranged from 0.5 to 6 cm with a mean of 2.1 cm. RESULTS: Retroperitoneoscopy was performed by lumbar approach with initial access conducted by open technique and creation of space by digital dissection. We used a 10-mm Hasson trocar for the optics, and 2 or 3 additional working ports placed under visualization. Following identification, the urinary tract was opened with a laparoscopic scalpel and the stone was removed intact. The urinary tract was closed with absorbable 4-0 suture and a Penrose drain was left in the retroperitoneum. In 17 patients (49%, a double-J stent was maintained postoperatively. Surgical time ranged from 60 to 260 minutes with a mean of 140 minutes. The mean hospital stay was 3 days (1-10 days. The mean length of retroperitoneal urinary drainage was 3 days (1-10 days. There were minor complications in 6 (17.6% patients and 1 case of conversion due to technical difficulty. Thirty-three patients (94% became stone free. CONCLUSION: Retroperitoneoscopy is an effective, low-morbidity alternative for treatment of urinary stones.

  8. Retroperitoneoscopy for treatment of renal and ureteral stones.

    Science.gov (United States)

    Soares, Rodrigo S; Romanelli, Pedro; Sandoval, Marcos A; Salim, Marcelo M; Tavora, Jose E; Abelha, David L

    2005-01-01

    To assess the efficacy of retroperitoneoscopy for treating stones in the renal pelvis and proximal ureter. In the period from August 2003 to August 2004, 35 retroperitoneoscopies for treatment of urinary stones were performed on 34 patients. Fifteen patients (42%) had stones in the renal pelvis, and in 2 cases, there were associated stones in the upper caliceal group. Twenty patients (58%) had ureteral stones, all of them located above the iliac vessel. Twenty-five patients (71%) had previously undergone at least one session of extracorporeal lithotripsy and 8 patients (26%) also underwent ureteroscopy to attempt to remove the stone. Eight patients underwent retroperitoneoscopy as a primary procedure. Stone size ranged from 0.5 to 6 cm with a mean of 2.1 cm. Retroperitoneoscopy was performed by lumbar approach with initial access conducted by open technique and creation of space by digital dissection. We used a 10-mm Hasson trocar for the optics, and 2 or 3 additional working ports placed under visualization. Following identification, the urinary tract was opened with a laparoscopic scalpel and the stone was removed intact. The urinary tract was closed with absorbable 4-0 suture and a Penrose drain was left in the retroperitoneum. In 17 patients (49%), a double-J stent was maintained postoperatively. Surgical time ranged from 60 to 260 minutes with a mean of 140 minutes. The mean hospital stay was 3 days (1-10 days). The mean length of retroperitoneal urinary drainage was 3 days (1-10 days). There were minor complications in 6 (17.6%) patients and 1 case of conversion due to technical difficulty. Thirty-three patients (94%) became stone free. Retroperitoneoscopy is an effective, low-morbidity alternative for treatment of urinary stones.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-01

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

  10. A 1 year retrospective audit of quality indicators of clinical pharmacological advice for personalized linezolid dosing: one stone for two birds?

    Science.gov (United States)

    Pea, Federico; Cojutti, Piergiorgio; Dose, Lucia; Baraldo, Massimo

    2016-02-01

    This study explored the clinical and economic impact of clinical pharmacological advice (CPA) (based on therapeutic drug monitoring [TDM] results, and on patients' characteristics and co-medications) on personalized linezolid therapy in a tertiary care hospital. A 1 year retrospective analysis of quality indicators of CPA (clinicians' adherence rate to CPA, pre-post rate of linezolid trough concentrations within the desired range and cost balance analysis) was conducted. Five hundred and forty-four CPAs were provided to clinicians during 2014 for personalizing linezolid therapy in 168 patients. Clinicians' adherence to CPAs was very high (94.7%). The pre-post rate of linezolid Cmin distribution showed a favourable impact of CPA on patient care (pre-post ratio of Cmin within the desired range + 23.4%, pre, 51.2% vs. post, 74.6%). Overall, linezolid dosage was mainly reduced (56.9% of cases), whereas dose augmentation was needed only in a minority of cases (7.7%). Cost balance analysis showed that overall 1258 standard doses of linezolid (unitary dose 600 mg) were spared for treating 168 patients with a personalized dosage for a median duration of 11 days (range 3-128 days) with a cost saving of 60038.05 €. Active computerized advice elaborated by the clinical pharmacologist on the basis of TDM results and of patient's pathophysiological data and co-medications may be cost-effective for personalizing linezolid treatment. © 2015 The British Pharmacological Society.

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

    Directory of Open Access Journals (Sweden)

    Fan Zhang

    2016-10-01

    Full Text Available 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, Bax and Caspase3 mRNA also increased while the level of Bcl2 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.

  12. Role of computerized tomography in diagnosis of atypical gall bladder and common bile duct stones

    International Nuclear Information System (INIS)

    El-Husseni, Tareq K.; Al-Shebrein, Ibrahim A.

    2001-01-01

    Objective was to assess the value of computerized tomography as an adjuvant to ultrasound in the diagnosis of atypical gallbladder and common duct stone disease. Real time ultrasound scanning for the gallbladder and common duct was performed in the routine manner. High resolution computerized tomography images were subsequently obtained for the region of interest. Computerized tomography resolved undetermined results as follows: 1. Non shadowing gallbladder debris (6 points), 2. Focal gallbladder wall thickening (2 points), 3. Stone obscured by calcified gallbladder wall (3 points), 4. Non visualized gallbladder double arc shadow (4 points), 5 and 6. Impacted gallbladder neck and common duct stones (18 points), computerized tomography gave false positive diagnosis in (2 points). Computerized tomography provided an effective and reliable means for the diagnosis of atypical gallbladder calculi when ultrasound was imprecise or the findings contradicted the clinical presentation. Finally if gallbladder neck or common duct stones are suspected, in addition to computerized tomography other imaging techniques such as magnetic resonance cholangio pancreatography or endoscopic retrograde cholangiopancreatography in addition to computerized tomography may be needed to avoid false positive diagnosis prior to surgery. (author)

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

    Science.gov (United States)

    Younesi Rostami, Mehdi; Taghipour-Gorgikolai, Mehrdad; Sharifian, Rayka

    2012-01-01

    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.

  14. Upper urinary tract stone disease in patients with poor performance status: active stone removal or conservative management?

    Science.gov (United States)

    Yamashita, Shimpei; Kohjimoto, Yasuo; Hirabayashi, Yasuo; Iguchi, Takashi; Iba, Akinori; Higuchi, Masatoshi; Koike, Hiroyuki; Wakamiya, Takahito; Nishizawa, Satoshi; Hara, Isao

    2017-11-16

    It remains controversial as to whether active stone removal should be performed in patients with poor performance status because of their short life expectancy and perioperative risks. Our objectives were to evaluate treatment outcomes of active stone removal in patients with poor performance status and to compare life prognosis with those managed conservatively. We retrospectively reviewed 74 patients with Eastern Cooperative Oncology Group performance status 3 or 4 treated for upper urinary tract calculi at our four hospitals between January 2009 and March 2016. Patients were classified into either surgical treatment group or conservative management group based on the presence of active stone removal. Stone-free rate and perioperative complications in surgical treatment group were reviewed. In addition, we compared overall survival and stone-specific survival between the two groups. Cox proportional hazards analysis was performed to investigate predictors of overall survival and stone-specific survival. Fifty-two patients (70.3%) underwent active stone removal (surgical treatment group) by extracorporeal shock wave lithotripsy (n = 6), ureteroscopy (n = 39), percutaneous nephrolithotomy (n = 6) or nephrectomy (n = 1). The overall stone-free rate was 78.8% and perioperative complication was observed in nine patients (17.3%). Conservative treatment was undergone by 22 patients (29.7%) (conservative management group). Two-year overall survival rates in surgical treatment and conservative management groups were 88.0% and 38.4%, respectively (p performance status could be performed safely and effectively. Compared to conservative management, surgical stone treatment achieved longer overall survival and stone-specific survival.

  15. 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.

  16. Hyaluronan and Stone Disease

    Science.gov (United States)

    Asselman, Marino

    2008-09-01

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

  17. Endoscopic Stone Measurement During Ureteroscopy.

    Science.gov (United States)

    Ludwig, Wesley W; Lim, Sunghwan; Stoianovici, Dan; Matlaga, Brian R

    2018-01-01

    Currently, stone size cannot be accurately measured while performing flexible ureteroscopy (URS). We developed novel software for ureteroscopic, stone size measurement, and then evaluated its performance. A novel application capable of measuring stone fragment size, based on the known distance of the basket tip in the ureteroscope's visual field, was designed and calibrated in a laboratory setting. Complete URS procedures were recorded and 30 stone fragments were extracted and measured using digital calipers. The novel software program was applied to the recorded URS footage to obtain ureteroscope-derived stone size measurements. These ureteroscope-derived measurements were then compared with the actual-measured fragment size. The median longitudinal and transversal errors were 0.14 mm (95% confidence interval [CI] 0.1, 0.18) and 0.09 mm (95% CI 0.02, 0.15), respectively. The overall software accuracy and precision were 0.17 and 0.15 mm, respectively. The longitudinal and transversal measurements obtained by the software and digital calipers were highly correlated (r = 0.97 and 0.93). Neither stone size nor stone type was correlated with error measurements. This novel method and software reliably measured stone fragment size during URS. The software ultimately has the potential to make URS safer and more efficient.

  18. Grasping the Formless in Stones

    DEFF Research Database (Denmark)

    Aktor, Mikael

    2017-01-01

    and the repertoire of used forms. The chapter demonstrates that neither anthropomorphic perceptions nor the agency of the stone material alone make up the ritual aesthetics in which the stones are involved. Rather, applying concepts from landscape phenomenology and cognitive theories including the role of material...

  19. Automated visual inspection for polished stone manufacture

    Science.gov (United States)

    Smith, Melvyn L.; Smith, Lyndon N.

    2003-05-01

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

  20. CT Texture Analysis of Ex Vivo Renal Stones Predicts Ease of Fragmentation with Shockwave Lithotripsy.

    Science.gov (United States)

    Cui, Helen W; Devlies, Wout; Ravenscroft, Samuel; Heers, Hendrik; Freidin, Andrew J; Cleveland, Robin O; Ganeshan, Balaji; Turney, Benjamin W

    2017-07-01

    Understanding the factors affecting success of extracorporeal shockwave lithotripsy (SWL) would improve informed decision-making on the most appropriate treatment modality for an individual patient. Although stone size and skin-to-stone distance do correlate with fragmentation efficacy, it has been shown that stone composition and architecture, as reflected by structural heterogeneity on CT, are also important factors. This study aims to determine if CT texture analysis (CTTA), a novel, nondestructive, and objective tool that generates statistical metrics reflecting stone heterogeneity, could have utility in predicting likelihood of SWL success. Seven spontaneously passed, intact renal tract stones, were scanned ex vivo using standard CT KUB and micro-CT. The stones were then fragmented in vitro using a clinical lithotripter, after which, chemical composition analysis was performed. CTTA was used to generate a number of metrics that were correlated to the number of shocks needed to fragment the stone. CTTA metrics reflected stone characteristics and composition, and predicted ease of SWL fragmentation. The strongest correlation with number of shocks required to fragment the stone was mean Hounsfield unit (HU) density (r = 0.806, p = 0.028) and a CTTA metric measuring the entropy of the pixel distribution of the stone image (r = 0.804, p = 0.039). Using multiple linear regression analysis, the best model showed that CTTA metrics of entropy and kurtosis could predict 92% of the outcome of number of shocks needed to fragment the stone. This was superior to using stone volume or density. CTTA metrics entropy and kurtosis have been shown in this experimental ex vivo setting to strongly predict fragmentation by SWL. This warrants further investigation in a larger clinical study for the contribution of CT textural metrics as a measure of stone heterogeneity, along with other known clinical factors, to predict likelihood of SWL success.

  1. Fracture mechanics model of stone comminution in ESWL and implications for tissue damage

    Science.gov (United States)

    Lokhandwalla, Murtuza; Sturtevant, Bradford

    2000-07-01

    Focused shock waves administered during extracorporeal shock-wave lithotripsy (ESWL) cause stone fragmentation. The process of stone fragmentation is described in terms of a dynamic fracture process. As is characteristic of all brittle materials, fragmentation requires nucleation, growth and coalescence of flaws, caused by a tensile or shear stress. The mechanisms, operative in the stone, inducing these stresses have been identified as spall and compression-induced tensile microcracks, nucleating at pre-existing flaws. These mechanisms are driven by the lithotripter-generated shock wave and possibly also by cavitation effects in the surrounding fluid. In this paper, the spall mechanism has been analysed, using a cohesive-zone model for the material. The influence of shock wave parameters, and physical properties of stone, on stone comminution is described. The analysis suggests a potential means to exploit the difference between the stone and tissue physical properties, so as to make stone comminution more effective, without increasing tissue damage.

  2. Scanning electron microscopy of real and artificial kidney stones before and after Thulium fiber laser ablation in air and water

    Science.gov (United States)

    Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2018-02-01

    We investigated proposed mechanisms of laser lithotripsy, specifically for the novel, experimental Thulium fiber laser (TFL). Previous lithotripsy studies with the conventional Holmium:YAG laser noted a primary photothermal mechanism (vaporization). Our hypothesis is that an additional mechanical effect (fragmentation) occurs due to vaporization of water in stone material from high absorption of energy, called micro-explosions. The TFL irradiated calcium oxalate monohydrate (COM) and uric acid (UA) stones, as well as artificial stones (Ultracal30 and BegoStone), in air and water environments. TFL energy was varied to determine the relative effect on the ablation mechanism. Scanning electron microscopy (SEM) was used to study qualitative and characteristic changes in surface topography with correlation to presumed ablation mechanisms. Laser irradiation of stones in air produced charring and melting of the stone surface consistent with a photothermal effect and minimal fragmentation, suggesting no mechanical effect from micro-explosions. For COM stones ablated in water, there was prominent fragmentation in addition to recognized photothermal effects, supporting dual mechanisms during TFL lithotripsy. For UA stones, there were minimal photothermal effects, and dominant effects were mechanical. By increasing TFL pulse energy, a greater mechanical effect was demonstrated for both stone types. For artificial stones, there was no significant evidence of mechanical effects. TFL laser lithotripsy relies on two prominent mechanisms for stone ablation, photothermal and mechanical. Water is necessary for the mechanical effect which can be augmented by increasing pulse energy. Artificial stones may not provide a predictive model for mechanical effects during laser lithotripsy.

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

    Directory of Open Access Journals (Sweden)

    Okeke Linus I

    2012-11-01

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

  4. Accurately Diagnosing Uric Acid Stones from Conventional Computerized Tomography Imaging: Development and Preliminary Assessment of a Pixel Mapping Software.

    Science.gov (United States)

    Ganesan, Vishnu; De, Shubha; Shkumat, Nicholas; Marchini, Giovanni; Monga, Manoj

    2018-02-01

    Preoperative determination of uric acid stones from computerized tomography imaging would be of tremendous clinical use. We sought to design a software algorithm that could apply data from noncontrast computerized tomography to predict the presence of uric acid stones. Patients with pure uric acid and calcium oxalate stones were identified from our stone registry. Only stones greater than 4 mm which were clearly traceable from initial computerized tomography to final composition were included in analysis. A semiautomated computer algorithm was used to process image data. Average and maximum HU, eccentricity (deviation from a circle) and kurtosis (peakedness vs flatness) were automatically generated. These parameters were examined in several mathematical models to predict the presence of uric acid stones. A total of 100 patients, of whom 52 had calcium oxalate and 48 had uric acid stones, were included in the final analysis. Uric acid stones were significantly larger (12.2 vs 9.0 mm, p = 0.03) but calcium oxalate stones had higher mean attenuation (457 vs 315 HU, p = 0.001) and maximum attenuation (918 vs 553 HU, p uric acid stones. A combination of stone size, attenuation intensity and attenuation pattern from conventional computerized tomography can distinguish uric acid stones from calcium oxalate stones with high sensitivity and specificity. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Use of drug therapy in the management of symptomatic ureteric stones in hospitalised adults: a multicentre, placebo-controlled, randomised controlled trial and cost-effectiveness analysis of a calcium channel blocker (nifedipine) and an alpha-blocker (tamsulosin) (the SUSPEND trial).

    Science.gov (United States)

    Pickard, Robert; Starr, Kathryn; MacLennan, Graeme; Kilonzo, Mary; Lam, Thomas; Thomas, Ruth; Burr, Jennifer; Norrie, John; McPherson, Gladys; McDonald, Alison; Shearer, Kirsty; Gillies, Katie; Anson, Kenneth; Boachie, Charles; N'Dow, James; Burgess, Neil; Clark, Terry; Cameron, Sarah; McClinton, Samuel

    2015-08-01

    -week participant self-reported questionnaire. The primary economic outcome was the incremental cost per quality-adjusted life-year (QALY) gained over 12 weeks. We estimated costs from NHS sources and calculated QALYs from participant completion of the European Quality of Life-5 Dimensions health status questionnaire 3-level response (EQ-5D-3L™) at baseline, 4 weeks and 12 weeks. Primary outcome analysis included 97% of the 1167 participants randomised (378/391 tamsulosin, 379/387 nifedipine and 379/399 placebo participants). The proportion of participants who spontaneously passed their stone did not differ between MET and placebo [odds ratio (OR) 1.04, 95% confidence interval (CI) 0.77 to 1.43; absolute difference 0.8%, 95% CI -4.1% to 5.7%] or between tamsulosin and nifedipine [OR 1.06, 95% CI 0.74 to 1.53; absolute difference 1%, 95% CI -4.6% to 6.6%]. There was no evidence of a difference in QALYs gained or in cost between the trial groups, which means that the use of MET would be very unlikely to be considered cost-effective. These findings were unchanged by extensive sensitivity analyses around predictors of stone passage, including sex, stone size and stone location. Tamsulosin and nifedipine did not increase the likelihood of stone passage over 4 weeks for people with ureteric colic, and use of these drugs is very unlikely to be cost-effective for the NHS. Further work is required to investigate the phenomenon of large, high-quality trials showing smaller effect size than meta-analysis of several small, lower-quality studies. Current Controlled Trials ISRCTN69423238. European Clinical Trials Database (EudraCT) number 2010-019469-26. This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 63. See the NIHR Journals Library website for further project information.

  6. 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

  7. Predictors for kidney stones recurrence following extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL).

    Science.gov (United States)

    Chongruksut, Wilaiwan; Lojanapiwat, Bannakij; Tawichasri, Chamaiporn; Paichitvichean, Somboon; Euathrongchit, Jantima; Ayudhya, Vorvat Choomsai Na; Patumanond, Jayanton

    2012-03-01

    Stone recurrence after extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL) are common. Predictors for kidney stones vary among populations and areas. To determine predictors for kidney stones recurrence after ESWL or PCNL. A retrospective cohort study was conducted at a university hospital. The study cohort was patients aged more than 18 years, diagnosed with kidney stones, who were treated with ESWL or PCNL between 2006 and 2009. Medical files were reviewed for clinical profiles, stone characteristics, composition, type of treatment, presence of stone after treatment, stone reappearance, and related laboratory data. Predictors were determined by a multivariable poisson regression and presented as incidence rate ratios (IRRs) with 95% confidence interval. From a cohort of 252 patients, 240 who had at least one follow-up and with complete plain kidney ureters and bladder (KUB) film or intravenous pyelogram (IVP) were included in analysis. At three years, the total incidence rate of recurrence was 46 per 1,000 person-months. After a multivariable poisson regression clustering by type of stone composition, independent predictors for stone recurrence were age ESWL treatment (adjusted IRR = 2.1, 95% CI = 2.1-2.2, p < 0.001), stones located in lower calyx as compared to renal pelvis (adjusted IRR = 8.7, 95% CI = 2.9-25.9, p = 0.001), multiple stones (adjusted IRR = 5.9, 95% CI = 4.8-7.5, p < 0.001), and stone size larger than 20 mm (adjusted IRR = 1.4, 95% CI = 1.2-1.6, p < 0.001). After stone removals, patients with these predictors should closely be followed up for regular clinical evaluations.

  8. The bioreceptivity of building stone

    Science.gov (United States)

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

    2015-04-01

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

  9. SU-G-IeP2-15: Virtual Insertion of Digital Kidney Stones Into Dual-Source, Dual- Energy CT Projection Data

    International Nuclear Information System (INIS)

    Ferrero, A; Chen, B; Huang, A; Montoya, J; Yu, L; McCollough, C

    2016-01-01

    Purpose: In order to investigate novel methods to more accurately estimate the mineral composition of kidney stones using dual energy CT, it is desirable to be able to combine digital stones of known composition with actual phantom and patient scan data. In this work, we developed and validated a method to insert digital kidney stones into projection data acquired on a dual-source, dual-energy CT system. Methods: Attenuation properties of stones of different mineral composition were computed using tabulated mass attenuation coefficients, the chemical formula for each stone type, and the effective beam energy at each evaluated tube potential. A previously developed method to insert lesions into x-ray CT projection data was extended to include simultaneous dual-energy CT projections acquired on a dual-source gantry (Siemens Somatom Flash). Digital stones were forward projected onto both detectors and the resulting projections added to the physically acquired sinogram data. To validate the accuracy of the technique, digital stones were inserted into different locations in the ACR CT accreditation phantom; low and high contrast resolution, CT number accuracy and noise properties were compared before and after stone insertion. The procedure was repeated for two dual-energy tube potential pairs in clinical use on the scanner, 80/Sn140 kV and 100/Sn140 kV, respectively. Results: The images reconstructed after the insertion of digital kidney stones were consistent with the images reconstructed from the scanner. The largest average CT number difference for the 4 insert in the CT number accuracy module of the phantom was 3 HU. Conclusion: A framework was developed and validated for the creation of digital kidney stones of known mineral composition, and their projection-domain insertion into commercial dual-source, dual-energy CT projection data. This will allow a systematic investigation of the impact of scan and reconstruction parameters on stone attenuation and dual

  10. Trends in urological stone disease.

    Science.gov (United States)

    Turney, Benjamin W; Reynard, John M; Noble, Jeremy G; Keoghane, Stephen R

    2012-04-01

    To summarize the changes in prevalence and treatment of upper urinary tract stone disease in the UK over the last 10 years. Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.nhs.uk) were extracted, summarized and presented. The number of upper urinary tract stone hospital episodes increased by 63% to 83,050 in the 10-year period. The use of shock wave lithotripsy (SWL) for treating all upper tract stones increased from 14,491 cases in 2000-2001 to 22,402 cases in 2010 (a 55% increase) with a 69% increase in lithotripsy for renal stones. There was a 127% increase in the number of ureteroscopic stone treatments from 6,283 to 14,242 cases over the 10-year period with a 49% increase from 2007/2008 to 2009/2010. There was a decline in open surgery for upper tract stones from 278 cases in 2000/2001 to 47 cases in 2009/2010 (an 83% reduction). Treatment for stone disease has increased substantially in comparison with other urological activity. In 2009/2010, SWL was performed almost as frequently as transurethral resection of the prostate or transurethral resection of bladder tumour, ureteroscopy for stones was performed more frequently than nephrectomy, radical prostatectomy and cystectomy combined, and percutaneous nephrolithotomy was performed more frequently than cystectomy. The present study highlights the increase in prevalence and treatment of stone disease in the UK over the last 10 years. If this trend continues it has important implications for workforce planning, training, service delivery and research in the field of urolithiasis. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  11. Dual-energy CT for the evaluation of urinary calculi: Image interpretation, pitfalls and stone mimics

    International Nuclear Information System (INIS)

    Jepperson, M.A.; Cernigliaro, J.G.; Sella, D.; Ibrahim, E.; Thiel, D.D.; Leng, S.; Haley, W.E.

    2013-01-01

    Urolithiasis is a common disease with a reported prevalence between 4% and 20% in developed countries. Determination of urinary calculi composition is a key factor in preoperative evaluation, treatment, and stone recurrence prevention. Prior to the introduction of dual-energy computed tomography (DECT), available methods for determining urinary stone composition were only available after stone extraction, and thereby unable to aid in optimized stone management prior to intervention. DECT utilizes the attenuation difference produced by two different x-ray energy spectra to quantify urinary calculi composition as uric acid or non-uric acid (with likely further classification in the future) while still providing the information attained with a conventional CT. Knowledge of DECT imaging pitfalls and stone mimics is important, as the added benefit of dual-energy analysis is the determination of stone composition, which in turn affects all aspects of stone management. This review briefly describes DECT principles, scanner types and acquisition protocols for the evaluation of urinary calculi as they relate to imaging pitfalls (inconsistent characterization of small stones, small dual-energy field of view, and mischaracterization from surrounding material) and stone mimics (drainage devices) that may adversely impact clinical decisions. We utilize our clinical experience from scanning over 1200 patients with this new imaging technique to present clinically relevant examples of imaging pitfalls and possible mechanisms for resolution

  12. Gypsum accumulation on carbonate stone

    Science.gov (United States)

    McGee, E.S.; Mossotti, V.G.

    1992-01-01

    The accumulation of gypsum on carbonate stone has been investigated through exposure of fresh samples of limestone and marble at monitored sites, through examination of alteration crusts from old buildings and through laboratory experiments. Several factors contribute to gypsum accumulation on carbonate stone. Marble or limestone that is sheltered from direct washing by rain in an urban environment with elevated pollution levels is likely to accumulate a gypsum crust. Crust development may be enhanced if the stone is porous or has an irregular surface area. Gypsum crusts are a surficial alteration feature; gypsum crystals form at the pore opening-air interface, where evaporation is greatest.

  13. The effect of ultrasonic and HNO3 treatment of activated carbon from fruit stones on capacitive and pseudocapacitive energy storage in electrochemical supercapacitors.

    Science.gov (United States)

    Venhryn, B Ya; Stotsko, Z A; Grygorchak, I I; Bakhmatyuk, B P; Mudry, S I

    2013-09-01

    The effect of ultrasonic treatment and modification with nitric acid of activated carbon obtained from fruit stones, on the parameters of electric double-layer (EDL) as well as on farad-volt characteristics of its boundary with electrolyte 7.6 m KОН, 4 m KI and 2 m ZnI2 aqueous solutions has been studied by means of precision porometry, cyclic voltamperometry, electrochemical impedance spectroscopy and computer simulation methods. It is shown that HNO3 treatment results in an increase of the electrostatic capacitance up to 202 F/g in 7.6 m KОН-solution as well as pseudocapacitance up to 1250 F/g in 4 m KI. This increase is supposed to be related both with hydrophilicity and with an increase of the density of states on Fermi level. The ultrasonic treatment enables one to significantly increase (more than 200 times) the density of states on Fermi level which in turn causes both quantitative and qualitative changes in farad-volt dependences. A hybrid supercapacitor with specific capacitance of 1100 F/g and specific energy of 49 Wh/kg per active mass of two electrodes was developed. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones.

    Science.gov (United States)

    Aydemir, Hüseyin; Budak, Salih; Kumsar, Şükrü; Köse, Osman; Sağlam, Hasan Salih; Adsan, Öztuğ

    2014-09-01

    In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm(2) in the PNL, 1.4±0.1 cm(2) in the RIRS, and 3.1±0.9 cm(2) in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups. PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.

  15. Comparison of STONE, CROES and Guy's nephrolithometry scoring systems for predicting stone-free status and complication rates after percutaneous nephrolithotomy in obese patients.

    Science.gov (United States)

    Ozgor, Faruk; Yanaral, Fatih; Savun, Metin; Ozdemir, Harun; Sarilar, Omer; Binbay, Murat

    2017-07-29

    In this study, we aim to evaluate the accuracy of STONE (stone size, tract length, obstruction, number of involved calyces, and essence/stone density), Clinical Research Office of the Endourological Society (CROES), and Guy's nephrolithometry scoring systems (NSS) in obese patients. The charts of patients who underwent percutaneous nephrolithotomy (PNL) between June 2008 and June 2016 were retrospectively analyzed. Calculations of the STONE, CROES, and Guy's NSS were performed by a resident who was well informed regarding each NSS. Patients were classified under nine scores according to STONE, four grades according to CROES, and four grades according to Guy's NSS. In total, 248 obese patients were enrolled in the study. Stone size was significantly higher in patients without stone-free status (p = 0.001). In patients who were stone-free and those with residual stones, the mean STONE score was 9.71 and 9.23 (p = 0.160), CROES was 172 and 129 (p = 0.001), and Guy's NSS was 1.67 and 2.75 (p = 0.001). Multivariate regression analysis identified the CROES and Guy's NSS were independent factors for PNL success in obese patients (p = 0.01 and p = 0.01, respectively). The CROES and Guy's NSS showed good accuracy with PNL success (AUC = 0.777 and AUC = 0.844, respectively). None of the three NSS systems were statically associated with a complication rate (p = 0.23 for STONE, p = 0.14 for CROES, and p = 0.51 for Guy's NSS). Our study demonstrated that CROES and Guy's NSS were independent predictors of stone-free rate following PNL in obese patients. Our study also revealed that three of the NSSs were not useful for predicting PNL complications in obese patients.

  16. Effects of crumb rubber content and curing time on the properties of asphalt concrete and stone mastic asphalt using dry process

    Directory of Open Access Journals (Sweden)

    H.T. Tai Nguyen

    2018-05-01

    Full Text Available Along with the rapid increase in the number of road vehicles, a large amount of waste tires have been created, causing negative effects to the environment. Many attempts have been made to effectively reduce this type of solid waste including the reuse of recycled rubber powder from waste tires as an additive for improving the performance of asphalt mixtures. In this work, the authors aim to study the effects of crumb rubber (CR on the mechanical properties, especially the rutting resistance, of CR modified asphalt concrete (AC and stone mastic asphalt (SMA by varying two factors-namely, the content of additive and the curing time. The dimension of used CR ranges from 0 to 2.36 mm, which is not too coarse for promoting the CR–bitumen interaction and not too fine for facilitating the production of CR. The content of CR was increased gradually from 0 to 3% to examine the effects of CR content on the engineering properties and determine the optimal content in the mixture. It was observed that the optimal content is 1.5–2%, while the optimal curing time that contributes to the maximal increase in the mechanical characteristics of both mixtures could not be determined. In the range of 0–5 h of curing time, the longer the asphalt mixture is maintained at a high temperature, the better the performance of mixture will be. Ageing was found to have influence on the performance of asphalt mixtures; however, its effects are not as important as those of CR modification. Keywords: Crumb rubber, Dry process, Asphalt concrete, SMA, Curing time

  17. The role of trapped bubbles in kidney stone detection with the color Doppler ultrasound twinkling artifact

    Science.gov (United States)

    Simon, Julianna C.; Sapozhnikov, Oleg A.; Kreider, Wayne; Breshock, Michael; Williams, James C., Jr.; Bailey, Michael R.

    2018-01-01

    The color Doppler ultrasound twinkling artifact, which highlights kidney stones with rapidly changing color, has the potential to improve stone detection; however, its inconsistent appearance has limited its clinical utility. Recently, it was proposed stable crevice bubbles on the kidney stone surface cause twinkling; however, the hypothesis is not fully accepted because the bubbles have not been directly observed. In this paper, the micron or submicron-sized bubbles predicted by the crevice bubble hypothesis are enlarged in kidney stones of five primary compositions by exposure to acoustic rarefaction pulses or hypobaric static pressures in order to simultaneously capture their appearance by high-speed photography and ultrasound imaging. On filming stones that twinkle, consecutive rarefaction pulses from a lithotripter caused some bubbles to reproducibly grow from specific locations on the stone surface, suggesting the presence of pre-existing crevice bubbles. Hyperbaric and hypobaric static pressures were found to modify the twinkling artifact; however, the simple expectation that hyperbaric exposures reduce and hypobaric pressures increase twinkling by shrinking and enlarging bubbles, respectively, largely held for rough-surfaced stones but was inadequate for smoother stones. Twinkling was found to increase or decrease in response to elevated static pressure on smooth stones, perhaps because of the compression of internal voids. These results support the crevice bubble hypothesis of twinkling and suggest the kidney stone crevices that give rise to the twinkling phenomenon may be internal as well as external.

  18. The role of trapped bubbles in kidney stone detection with the color Doppler ultrasound twinkling artifact.

    Science.gov (United States)

    Simon, Julianna C; Sapozhnikov, Oleg A; Kreider, Wayne; Breshock, Michael; Williams, James C; Bailey, Michael R

    2018-01-09

    The color Doppler ultrasound twinkling artifact, which highlights kidney stones with rapidly changing color, has the potential to improve stone detection; however, its inconsistent appearance has limited its clinical utility. Recently, it was proposed stable crevice bubbles on the kidney stone surface cause twinkling; however, the hypothesis is not fully accepted because the bubbles have not been directly observed. In this paper, the micron or submicron-sized bubbles predicted by the crevice bubble hypothesis are enlarged in kidney stones of five primary compositions by exposure to acoustic rarefaction pulses or hypobaric static pressures in order to simultaneously capture their appearance by high-speed photography and ultrasound imaging. On filming stones that twinkle, consecutive rarefaction pulses from a lithotripter caused some bubbles to reproducibly grow from specific locations on the stone surface, suggesting the presence of pre-existing crevice bubbles. Hyperbaric and hypobaric static pressures were found to modify the twinkling artifact; however, the simple expectation that hyperbaric exposures reduce and hypobaric pressures increase twinkling by shrinking and enlarging bubbles, respectively, largely held for rough-surfaced stones but was inadequate for smoother stones. Twinkling was found to increase or decrease in response to elevated static pressure on smooth stones, perhaps because of the compression of internal voids. These results support the crevice bubble hypothesis of twinkling and suggest the kidney stone crevices that give rise to the twinkling phenomenon may be internal as well as external.

  19. 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.

  20. 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......, 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...... spectra and qualification of the staff for an accurate analysis of stone composition. Regular quality control is essential in carrying out routine stone analysis....

  1. Combined use of flexible ureteroscopic lithotripsy with micro-percutaneous nephrolithotomy in pediatric multiple kidney stones.

    Science.gov (United States)

    Li, Jun; Wang, Wenying; Du, Yuan; Tian, Ye

    2018-03-28

    We investigated the clinical value of treating pediatric multiple kidney stones with extensive distribution using flexible ureteroscopic lithotripsy (FUL) combined with micro-percutaneous nephrolithotomy (micro-PNL). In total, 21 pediatric patients with multiple renal calculi between May 2016 and June 2017 received FUL combined with micro-PNL. The group included 13 boys and eight girls; the patients' mean age was 3.8 years (range 1-8 years). The maximum stone diameter ranged from 1.0 to 1.5 cm. FUL was first performed in the lithotomy position to fragment stones that were located in the renal pelvis, and upper and mid-renal calyx. Patients were then moved to a prone position, and micro-PNL was performed to treat lower pole stones that could not be reached by the flexible ureteroscope during FUL. Percutaneous renal access to the lower calyx was achieved using a 4.8F "all-seeing needle" with ultrasound guidance, and stone fragmentation was performed with a 200-μm holmium laser at different settings to disintegrate 1- to 2-mm fragments. All 21 pediatric patients with multiple kidney stones underwent combined FUL and micro-PNL. The stone free rate (SFR) was 85.7% (18/21). The mean surgical time was 45 min (range 30-70 min). The mean volume of irrigation fluid used was 480 mL (range 300-1200 mL). The mean surgical time for FUL and micro-PNL was 31 min and 14 min, respectively, and the mean volume of fluid used for FUL and micro-PNL was 360 mL and 120 mL, respectively. According to the modified Clavien classification, grade 1 and 2 postoperative complications occurred in five and one patients, respectively. The mean decrease in the level of hemoglobin was 0.4 g/dL (0-0.7 g/dL), and no patients required a transfusion. The average hospital stay was 3 days (range 2-5 days). Combined FUL and micro-PNL is a safe, effective, and minimally invasive operation to remove multiple renal calculi with extensive distribution in children in selected cases. Copyright © 2018

  2. Topological anisotropy of stone-wales waves in graphenic fragments.

    Science.gov (United States)

    Ori, Ottorino; Cataldo, Franco; Putz, Mihai V

    2011-01-01

    Stone-Wales operators interchange four adjacent hexagons with two pentagon-heptagon 5|7 pairs that, graphically, may be iteratively propagated in the graphene layer, originating a new interesting structural defect called here Stone-Wales wave. By minimization, the Wiener index topological invariant evidences a marked anisotropy of the Stone-Wales defects that, topologically, are in fact preferably generated and propagated along the diagonal of the graphenic fragments, including carbon nanotubes and graphene nanoribbons. This peculiar edge-effect is shown in this paper having a predominant topological origin, leaving to future experimental investigations the task of verifying the occurrence in nature of wave-like defects similar to the ones proposed here. Graph-theoretical tools used in this paper for the generation and the propagation of the Stone-Wales defects waves are applicable to investigate isomeric modifications of chemical structures with various dimensionality like fullerenes, nanotubes, graphenic layers, schwarzites, zeolites.

  3. Edge scour in current adjacent to stone covers

    DEFF Research Database (Denmark)

    Petersen, Thor Ugelvig; Sumer, B. Mutlu; Meyer, Knud Erik

    The present paper reports some early results of an experimental investigation of edge scour in currents. Two kinds of measurements are made (1) Particle Image Velocimetry (PIV) measurements of secondary currents that take place near a junction between the stone cover and the sand bed in a clear......-water experiment; and (2) scour measurements in actual scour experiment in the live-bed regime. The early results indicate that edge scour in a steady current propagating in-line with a stone layer is caused by the combined action of two effects; (1) Primary flow and (2) Secondary flow. The primary flow stirs up...... the sediment and puts into suspension, and the secondary flow carries it away from the junction between the stone layer and the sand bed, resulting in a scour hole forming adjacent to the toe of the stone layer....

  4. 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.

  5. Ultrasonic propulsion of kidney stones: preliminary results of human feasibility study.

    Science.gov (United States)

    Bailey, Michael; Cunitz, Bryan; Dunmire, Barbrina; Paun, Marla; Lee, Franklin; Ross, Susan; Lingeman, James; Coburn, Michael; Wessells, Hunter; Sorensen, Mathew; Harper, Jonathan

    2014-09-03

    One in 11 Americans has experienced kidney stones, with a 50% average recurrence rate within 5-10 years. Ultrasonic propulsion (UP) offers a potential method to expel small stones or residual fragments before they become a recurrent problem. Reported here are preliminary findings from the first investigational use of UP in humans. The device uses a Verasonics ultrasound engine and Philips HDI C5-2 probe to generate real-time B-mode imaging and targeted "push" pulses on demand. There are three arms of the study: de novo stones, post-lithotripsy fragments, and the preoperative setting. A pain questionnaire is completed prior to and following the study. Movement is classified based on extent. Patients are followed for 90 days. Ten subjects have been treated to date: three de novo , five post-lithotripsy, and two preoperative. None of the subjects reported pain associated with the treatment or a treatment related adverse event, beyond the normal discomfort of passing a stone. At least one stone was moved in all subjects. Three of five post-lithotripsy subjects passed a single or multiple stones within 1-2 weeks following treatment; one subject passed two (1-2 mm) fragments before leaving clinic. In the pre-operative studies we successfully moved 7 - 8 mm stones. In four subjects, UP revealed multiple stone fragments where the clinical image and initial ultrasound examination indicated a single large stone.

  6. Shielding features of quarry stone

    International Nuclear Information System (INIS)

    Hernandez V, C.; Contreras S, H.; Hernandez A, L.; Baltazar R, A.; Escareno J, E.; Mares E, C. A.; Vega C, H. R.

    2010-10-01

    Quarry stone lineal attenuation coefficient for gamma-rays has been obtained. In Zacatecas, quarry stone is widely utilized as a decorative item in buildings, however its shielding features against gamma-rays unknown. The aim of this work is to determine the shielding properties of quarry stone against γ-rays using Monte Carlo calculations where a detailed model of a good geometry experimental setup was carried out. In the calculations 10 pieces 10 X 10 cm 2 of different thickness were utilized to evaluate the photons transmission as the quarry stone thickness is increased. It was noticed that transmitted photons decay away as the shield thickness is increased, these results were fitted to an exponential function were the linear attenuation coefficient was estimated. Also, using XCOM code the linear attenuation coefficient from several keV up to 100 MeV was estimated. From the comparison between Monte Carlo results and XCOM calculations a good agreement was found. For 0.662 MeV γ-rays the attenuation coefficient of quarry stone, whose density is 2.413 g-cm -3 , is 0.1798 cm -1 , this mean a X 1/2 = 3.9 cm, X 1/4 = 7.7 cm, X 1/10 = 12.8 cm, and X 1/100 = 25.6 cm. Having the information of quarry stone performance as shielding give the chance to use this material to shield X and γ-ray facilities. (Author)

  7. Kidney Stones and Ceftriaxone

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-01-01

    Full Text Available Metabolic causes such as hypercalciuria, urinary tract infection, and obstruction are the most common aetiologies of urolithiasis, and drugs, although important in this regard, are rarely the cause of urolithiasis. Administration of one of these drugs, ceftriaxone (CTX, has been associated with biliary pseudolithiasis in adult and paediatric patients, and rarely may cause urolithiasis. Several factors, including drug concentration and incubation time, are very important for determining the degree of CTX/calcium (Ca crystallisation in the urine. According to this data, CTX crystallisation was a dose and time-dependent reaction. It is particularly important to monitor patients on high-dose long-term CTX treatment with the urinary Ca to creatinine ratios, ultrasound sonography, and renal function testing, as these individuals may be at greater risk of large stones and renal damage. This type of screening may help prevent permanent complications in the future. This underlying review will help to educate readers on the pathophysiology and interaction between CTX and urolithiasis.

  8. Medical expulsive treatment of distal ureteral stone using tamsulosin

    International Nuclear Information System (INIS)

    Ahmad, H.; Azim, W.; Akmal, M.; Murtaza, B.

    2015-01-01

    Many minimally invasive interventional techniques as well as expectant treatments exist for the management of lower ureteric calculi. This study was conducted to evaluate the efficacy of tamsulosin as an expulsive pharmacologic therapy for the treatment of distal ureteral stone. Methods: This randomized control trial included 100 patients over 18 years of age with stone Size = 8mm in distal 1/3 of ureter. Patients were randomly assigned into two groups (A and B). Group A Patients were given Capsule Tamsulosin 0.4 mg, 1 daily up to 4 weeks while group B patients were given placebo, 1 Capsule daily up to 4 weeks. The primary endpoint was expulsion rate. A written informed consent was taken from all the patients. Expulsion time, need for analgesics, need for hospitalization and drug side effects were secondary endpoints. Results: A total of 49 patients in group A and 48 patients in group B reported back, therefore 97 out of 100 patients were evaluated. Mean age of the patients was 36.34 years (range 18-57 years). Mean stone size was 5.78 mm (range 4-8 mm) in greatest dimension. A stone expulsion rate of 85.71% (42 patients) was noted in group A and 54.20% (26 patients) in group B. Group A revealed a statistically significant advantage in term of stone expulsion rate (p=0.032). Considering expulsion time in days group A showed statistically significant advantage (p=0.015). Regarding age, sex, stone size and stone lateralization (right/left), there was no significant difference between the group A and B. No drug side effects were noted in both the groups. Conclusion: By using tamsulosin a higher stone expulsion rates can be achieved in a shorter time. More randomized control trials are required to establish tamsulosin as a standard medical expulsive treatment for small distal ureteric calculus. (author)

  9. Sustainable materials used as stone column filler: A short review

    Science.gov (United States)

    Zukri, Azhani; Nazir, Ramli

    2018-04-01

    Stone columns (also known as granular piles) are one of the methods for soft soil stabilization and typically used to increase bearing capacity and stability of slope.; Apart from decreasing the compressibility of loose and fine graded soils, it also accelerates the consolidation effect by improving the drainage path for pore water pressure dissipation and reduces the liquefaction potential of soils during earthquake event. Stone columns are probably the most “natural” ground treatment method or foundation system in existence to date. The benefit of stone columns is owing to the partial replacement of compressible soil by more competent materials such as stone aggregate, sand and other granular materials. These substitutes also act as reinforcement material, hence increasing overall strength and stiffness of the soft soil. Nowadays, a number of research has been conducted on the behaviour and performance of stone columns with various materials utilized as column filler replacing the normal aggregate. This paper will review extensively on previously conducted research on some of the materials used as stone column backfill materials, its suitability and the effectiveness as a substitute for regular aggregates in soft soil improvement works.

  10. Ultrasonography, CT, and ERCP in the diagnosis of choledochal stones

    International Nuclear Information System (INIS)

    Pasanen, P.; Partanen, K.; Pikkarainen, P.; Alhava, E.; Pirinen, A.; Janatuinen, E.

    1992-01-01

    A prospective study of jaundiced (n = 187) and nonjaundiced (n = 33) cholestatic patients was carried out to evaluate the sensitivity of ultrasonography (US), CT and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of choledochal stone disease. Altogether 83 patients had the final diagnosis of choledocholithiasis. In the jaundiced patients, the sensitivity of US, CT, and ERCP was 22,5%, 23,2%, and 80,6%, respectively. In cases of cholestasis without jaundice, the values were 20%, 37,5%, and 66,7%. In patients in whom all 3 imaging studies were done (n = 64), the differences between US and ERCP and between CT and ERCP were statistically significant (p < 0.0001). In most false-negative ERCP studies (10/15), the clinical course of the disease strongly suggested a passed choledochal stone. On the basis of this study, we recommend prompt ERCP to be performed if choledochal stone disease is suspected on clinical grounds. (orig.)

  11. Symptomatic gallbladder stones. Cost-effectiveness of treatment with extracorporeal shock-wave lithotripsy, conventional and laparoscopic cholecystectomy

    NARCIS (Netherlands)

    Go, P. M.; Stolk, M. F.; Obertop, H.; Dirksen, C.; van der Elst, D. H.; Ament, A.; van Erpecum, K. J.; van Berge Henegouwen, G. P.; Gouma, D. J.

    1995-01-01

    In order to strike the most favorable balance between health benefits and costs, three treatment modalities for symptomatic cholelithiasis were compared in a cost-effectiveness study: extracorporeal shock-wave lithotripsy (ESWL), conventional cholecystectomy (CC), and laparoscopic cholecystectomy

  12. The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems : A randomized controlled trial

    NARCIS (Netherlands)

    Kleefman, Marijke; Jansen, Danielle E. M. C.; Stewart, Roy E.; Reijneveld, Sijmen A.

    2014-01-01

    Background: Children with borderline to mild intellectual disability (BMID) have been shown to be at increased risk for psychosocial problems. The presence of these psychosocial problems leads to parenting stress. Stepping Stones Triple P (SSTP) is a parenting support program to support parents with

  13. 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

  14. Comparison of Different Methods of Denim Stone Washing by Pumice Stone, Acid Cellulases and Neutral Cellulases

    Directory of Open Access Journals (Sweden)

    M. Montazer

    2007-10-01

    Full Text Available Denim is a casual garment normally used by young people and extremely influential in shaping the fashion industry. Among various garments, these garments are subjected to innovations. This work is an attempt to compare the different methods of stone washing using pumice stones, acid cellulases and neutral cellulases or in combination of these methods. The effects of different processing conditions on the garment are compared and reported. Color differences of samples are probed by reflective colorimeter on the front side as well as the backside and also the white pocket of the garment.The abrasion resistance, tensile strength and crease recovery angle of samples are also reported. The XRD spectra are used to calculate the crystalline degrees of the selected samples. Moreover, fiber surfaces of some treated samples have been observed by SEM. The results indicate that treatment of denim with pumice stone with equal weight of garment causes a small color differences. The addition of cellulases to the washing, however, accelerates the color fading. Also, lower staining observed on the white pocket when the garment was treated with cellulases. However, the neutralcellulases increase the garment fading and decrease the staining on the white pocket. It is also observed that pumice stone with cellulases damages the fabric surface, although it is of a minimal damage.

  15. Regional differences in constituents of gall stones.

    Science.gov (United States)

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

    2005-01-01

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

  16. Getter Incorporation into Cast Stone and Solid State Characterizations

    Energy Technology Data Exchange (ETDEWEB)

    Asmussen, Robert M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lawter, Amanda R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stephenson, John R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bowden, Mark E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Washton, Nancy M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Neeway, James J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Du, Yingge [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pearce, Carolyn I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clayton, Ray E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Saslow, Sarah A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Buck, Edgar C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Cordova, Elsa [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Qafoku, Nikolla [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-09-28

    Washington River Protection Solutions (WRPS) is collecting relevant available data on waste forms for use as a supplemental immobilization technology, to provide the additional capacity needed to treat low-activity waste (LAW) in Hanford Site tanks and complete the tank waste cleanup mission in a timely and cost-effective manner. One candidate supplemental waste form, fabricated using a low-temperature process, is a cementitious grout called Cast Stone. Cast Stone has been under investigation for this application at Pacific Northwest National Laboratory (PNNL) since initial screening tests in FY13. This report is the culmination of work to lower the diffusivities of Tc and I from Cast Stone using getters. Getters are compounds added to a system designed to selectively sequester a species of interest to provide increased stability to the species. The work contained within this report is related to waste form development and testing, and does not directly support the 2017 integrated disposal facility (IDF) performance assessment. However, this work contains valuable information which may be used in performance assessment maintenance past FY17, and in future waste form development. This report on performance characterization of Tc and I getters in Cast Stone fabricated with simulated LAW covers several areas of interest and major findings to WRPS: investigating performance of potassium metal sulfide (KMS-2-SS) and tin (II) apatite (Sn-A) as Tc getters when incorporated into Cast Stone; investigating performance of silver exchanged zeolite (Ag-Z) and argentite (Arg) as I getters when incorporated into Cast Stone; utilizing sequential addition of Tc and I getters to overcome any deleterious interactions between the getters in solution; determining, for the first time, Tc distribution within the cured Cast Stone and its evolution during leaching; and performing solid state characterization of getters and Cast Stone samples to support leach test findings and develop a

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

    Directory of Open Access Journals (Sweden)

    Shashi Alok

    2013-12-01

    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. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

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

    Science.gov (United States)

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

    2013-01-01

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

  19. A novel stone retrieval basket for more efficient lithotripsy procedures.

    Science.gov (United States)

    Salimi, N; Mahajan, A; Don, J; Schwartz, B

    2009-01-01

    This paper presents the development of an improved stone retrieval device that uses a newly designed cage of Nitinol wires encompassing a mesh basket made of a material that is laser resistant. Current methods to extract large stones involve imaging, using a laser to fragment the stones and then using existing cage-like baskets to trap the fragments individually and extracting them one at a time. These procedures are tedious, and may result in leaving some fragments behind that can reform causing the need for another procedure. The device presented in this paper will have a mesh-like sack which will consist of a laser resistant material of polytetrafluoroethylene (PTFE) enclosed within a newly designed Nitinol cage. Two alternate designs are provided for the cage in this paper. The handle of the device is revised to allow for a 3 Fr (1 mm) opening such that a laser's fiber optic cable can enter the device. Using this device a laser can be used to fragment the stone, and all the fragments are retained in the basket in both the design options. The basket can then be retracted allowing for the retrieval of all the fragments in one shot. The stone retrieval basket presented in this paper will significantly improve the efficiency and effectiveness of lithotripsy procedures for removal of large kidney and biliary tract stones.

  20. Stone clearance after extracorporeal shockwave lithotripsy in patients with solitary pure calcium oxalate stones smaller than 1.0 cm in the proximal ureter, with special reference to monohydrate and dihydrate content.

    Science.gov (United States)

    Ichiyanagi, Osamu; Nagaoka, Akira; Izumi, Takuji; Kawamura, Yuko; Tsukigi, Masaaki; Ishii, Tatsuya; Ohji, Hiroshi; Kato, Tomoyuki; Tomita, Yoshihiko

    2013-04-01

    The aim of this study was to assess stone-free rates following extracorporeal shockwave lithotripsy (ESWL) of pure calcium oxalate (CaOx) stones in the proximal ureter. The investigators retrospectively examined 53 patients with 5-10 mm pure CaOx stones in the proximal ureter from the medical archives of 593 consecutive patients treated with ESWL. The compositions of calcium oxalate monohydrate (COM) and dihydrate (COD) in a given stone were determined by infrared spectrometry. Stone size, attenuation number and stone-to-skin distance (SSD) were measured using plain radiography and computed tomography (CT). ESWL success was evaluated by stone-free status after the first single session. On average, calculi were 8.0 × 5.3 mm in size, with an SSD of 11.0 cm. The mean CT attenuation value was 740.1 HU. Attenuation numbers correlated significantly with stone diameter (r = 0.49), but had no correlation with the stone content of COM or COD. A negative correlation was observed between COM and COD content (r = -0.925). With regard to patients' physical characteristics and COM and COD content, no differences were found between study subgroups with stone-free and residual status (n = 38 and 15, respectively). There were also no differences in clinical features between patient subgroups with COM- or COD-predominant stones (n = 22 and 31, respectively). The findings indicated that the differences in COM and COD content of CaOx stones had no impact on stone clearance after ESWL and that a favorable stone-free rate of the stones treated with ESWL may be achieved independently of CaOx hydration.

  1. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong Sung; Kim, Ji Hyung; Choi, Young Woo; Lee, Tae Hee; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keum Won [Konyang University Hospital, Daejeon (Korea, Republic of)

    2005-12-15

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful.

  2. Tamsulosin and the spontaneous passage of ureteral stones in children: A multi-institutional cohort study

    Science.gov (United States)

    Tasian, Gregory E.; Cost, Nicholas G.; Granberg, Candace F.; Pulido, Jose E.; Rivera, Marcelino; Schwen, Zeyad; Schulte, Marion; Fox, Janelle A.

    2014-01-01

    Purpose Tamsulosin is associated with increased passage of ureteral stones in adults, but its effectiveness in children is uncertain. We determined the association between tamsulosin and the spontaneous passage of ureteral stones in children. Methods We performed a multi-institutional retrospective cohort study of children ≤ 18 years who presented between 2007 and 2012 with a ureteral stone ≤ 10 mm and were managed with tamsulosin or oral analgesics alone. The outcome was spontaneous stone passage defined as radiographic clearance and/or patient report of passage. Subjects prescribed tamsulosin were matched with subjects prescribed analgesics alone using nearest neighbor propensity score matching to adjust for treatment selection. Conditional logistic regression models were used to estimate the association between tamsulosin and spontaneous passage of ureteral stones, adjusting for stone size and location. Results Of 449 children with ureteral stones, 334 were eligible for inclusion, and complete data were available for 274 children from 4 institutions (99 tamsulosin; 175 analgesics alone). Following case matching, there were no differences in patient age, gender, weight, height, stone size, or stone location between the 99 subjects prescribed tamsulosin and the 99 propensity-score matched subjects prescribed analgesics alone. In the tamsulosin cohort, 55% of ureteral stones passed versus 44% in the analgesics alone cohort (p = 0.03). In multivariate analysis adjusting for stone size and location, tamsulosin was associated with spontaneous passage of ureteral stones (OR 3.31; 95% CI 1.49–7.34). Conclusions The odds of spontaneous passage of ureteral stones were higher in children prescribed tamsulosin versus analgesics alone. PMID:24518765

  3. Tamsulosin and spontaneous passage of ureteral stones in children: a multi-institutional cohort study.

    Science.gov (United States)

    Tasian, Gregory E; Cost, Nicholas G; Granberg, Candace F; Pulido, Jose E; Rivera, Marcelino; Schwen, Zeyad; Schulte, Marion; Fox, Janelle A

    2014-08-01

    Tamsulosin is associated with increased passage of ureteral stones in adults but its effectiveness in children is uncertain. We determined the association between tamsulosin and the spontaneous passage of ureteral stones in children. We performed a multi-institutional retrospective cohort study of patients 18 years or younger who presented between 2007 and 2012 with ureteral stones up to 10 mm and who were treated with tamsulosin or oral analgesics alone. The outcome was spontaneous stone passage, defined as radiographic clearance and/or patient report of passage. Subjects prescribed tamsulosin were matched with subjects prescribed analgesics alone, using nearest neighbor propensity score matching to adjust for treatment selection. Conditional logistic regression models were used to estimate the association between tamsulosin and spontaneous passage of ureteral stones, adjusting for stone size and location. Of 449 children with ureteral stones 334 were eligible for inclusion, and complete data were available for 274 patients from 4 institutions (99 receiving tamsulosin, 175 receiving analgesics alone). Following case matching, there were no differences in age, gender, weight, height, stone size or stone location between the 99 subjects prescribed tamsulosin and the 99 propensity score matched subjects prescribed analgesics alone. In the tamsulosin cohort 55% of ureteral stones passed, compared to 44% in the analgesics alone cohort (p=0.03). In multivariate analysis adjusting for stone size and location tamsulosin was associated with spontaneous passage of ureteral stones (OR 3.31, 95% CI 1.49-7.34). The odds of spontaneous passage of ureteral stones were greater in children prescribed tamsulosin vs analgesics alone. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Efficacy of extracorporeal shockwave lithotripsy using Dornier SII in different levels of ureteral stones

    Science.gov (United States)

    Elkholy, Mohamed M.; Ismail, Hassan; Abdelkhalek, Mohamed A.; Badr, Mohamad M.; Elfeky, Mohamed M.

    2014-01-01

    Objective: The objective of this study was to evaluate the efficacy and safety of the Dornier lithotripter S II system in the treatment of ureteral calculi. Patients and Methods: A total of 97 cases which consists of 54 males and 43 females with ureteral stones were treated by extracorporeal shock wave lithotripsy (ESWL). Mean age was 42.6 years. Inclusion criteria were solitary radiopaque ureteral stones of radiological stone size of ≤1 cm. The stones were not impacted, with normal kidney functions. Procedure time, number of shocks, energy used, number of sessions and complications were reported. The outcome of ESWL was also recorded. Results: Stones were in the abdominal (upper ureter) in 50% of patients, in pelvic (middle ureter) in 47% of patients. All patients had unilateral stones and the mean stone size in maximum length was) 10 mm). Good dye excretion passing the stone was noted in all patients. Mild hydronephrosis was found in 85% of cases. A total of 49 cases were treated by a single session, while in 35% of cases two sessions were enough and 16% received three sessions. The average number of shocks per session was 3125. The average number of shocks per patient was 5962.5 shocks and average energy was 204.3 Joules. The overall stone-free rate 3 months after lithotripsy was 94%. After a single session of lithotripsy, 49 patients (49%) became stone-free. Stone free rates after ESWL for upper, middle ureteral stones were 94%, 95.7% respectively. Additional procedures were needed in only 6 cases (6%) to render patients stone-free after lithotripsy. No serious complications occurred. Conclusion: The Dornier lithotripter S II is very effective in the treatment of ureteral calculi with no major complications. PMID:25371614

  5. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    International Nuclear Information System (INIS)

    Park, Yong Sung; Kim, Ji Hyung; Choi, Young Woo; Lee, Tae Hee; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keum Won

    2005-01-01

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful

  6. Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

    Directory of Open Access Journals (Sweden)

    Vittorio Imperatore

    2014-06-01

    Full Text Available Objectives: To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET of distal ureteric stones. Patients and methods: Observational data were collected retrospectively from patients who received silodosin (N = 50 or tamsulosin (N = 50 as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Results: Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant. Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant. Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant. The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant. Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Conclusions: Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

  7. Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin.

    Science.gov (United States)

    Imperatore, Vittorio; Fusco, Ferdinando; Creta, Massimiliano; Di Meo, Sergio; Buonopane, Roberto; Longo, Nicola; Imbimbo, Ciro; Mirone, Vincenzo

    2014-06-30

    To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones. Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant). The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant). Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

  8. 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.)

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

    International Nuclear Information System (INIS)

    Berkovitz, Nadav; Simanovsky, Natalia; Hiller, Nurith; Katz, Ran; Salama, Shaden

    2010-01-01

    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.)

  10. The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems: a randomized controlled trial.

    Science.gov (United States)

    Kleefman, Marijke; Jansen, Daniëlle E M C; Stewart, Roy E; Reijneveld, Sijmen A

    2014-10-28

    Children with borderline to mild intellectual disability (BMID) have been shown to be at increased risk for psychosocial problems. The presence of these psychosocial problems leads to parenting stress. Stepping Stones Triple P (SSTP) is a parenting support program to support parents with children with BMID and psychosocial problems. The aim of this study was to evaluate the effectiveness of SSTP compared to Care as Usual (CAU) in reducing psychosocial problems in children with BMID. We conducted a randomized controlled trial in the Northern provinces of the Netherlands. Parents of children aged 5 to 12 with borderline (IQ 70 to 85) or mild (IQ 70 to 50) ID and psychosocial problems were invited. Psychosocial problems were identified using the Strengths and Difficulties Questionnaire (SDQ) parent report (≥14). Measurements were assessed before the intervention (T0), immediately after the intervention (T1) and after a follow-up of six months (T2). SSTP takes 8 to 10 individual sessions of 40-90 minutes, provided over 10 to 12 weeks. CAU concerned any service, except SSTP. Primary outcomes were the child's psychosocial problems (SDQ parent and teacher forms and the Eyberg Child Behavior Inventory, ECBI). Secondary outcomes were parenting stress (Parenting Stress Index, PSI) and parenting skills (Alabama Parenting Questionnaire, APQ). In total 209 parents of children aged 5 to 12 with BMID were allocated blindly to either SSTP (n =111) or CAU (n =98). In the intention to treat analyses, SSTP achieved no significantly better effect than CAU for the SDQ parent report, the ECBI and the APQ on the short- and long- term. In the short term, SSTP was significantly more effective than CAU for the SDQ teacher report (B = -2.25, 95% CI -3.79 to -0.71) and the PSI (B = -7.06, 95% CI -12.11 to -2.01). For both SDQ teacher report and PSI, there was no statistically significant effect in the long term. Dropout from SSTP was considerable (49%), with the effects being

  11. [Gallbladder Stone Types in Patients with Cholelithiasis and Clonorchis sinensis Infection in the Endemic Area of Clonorchiasis].

    Science.gov (United States)

    Ma, Rui-hong; Qiao, Tie; Luo, Zhen-liang; Luo, Xiao-bing; Zheng, Pei-ming; Yang, Liu-qing

    2015-06-01

    To investigate the relationship between Clonorchis sinensis infection and the gallbladder stone type in patients with cholelithiasis in the endemic area of clonorchiasis. Gallbladder stones were collected from 598 patients with cholelithiasis through minimally invasive gallbladder-preserving cholelithotomy in the Sixth People's Hospital of Nansha District from May 2009 to October 2012. The stone samples were analyzed for composition by Fourier transform infrared spectroscopy to identify their types. The Clonorchis sinensis eggs were detected in the stones by microscopic examination, and the detection rates of eggs were calculated for different stone types. Then the clinical characteristics and biochemical indicators were compared among patients with different types of stones, as well as between Clonorchis sinensis egg-positive and -negative patients with the calcium-carbonate type of stones. Some calcium-carbonate stones positive for Clonorchis sinensis eggs were randomly selected for further scanning electron microscopy (SEM) examination. Of the stones from 598 patients, 234 (39.1%) were cholesterol type, 133 (22.2%) bile pigment type, 112(18.7%) calcium-carbonate type, 86 (14.4%) mixed types and 33(5.5%) were others. The detection rate of Clonorchis sinensis eggs in these types was 6% (15/234), 44% (59/133), 60% (67/112), 36% (31/ 86) and 30% (10/33), respectively, being highest in calcium-carbonate stones while lowest in cholesterol stones. The Co2-combining power of the plasma was higher in patients with calcium-carbonate and mixed stones than in those with cholesterol stones (P Clonorchis sinensis eggs to calcium-carbonate crystals. The infection rate of Clonorchis sinensis is higher in patients with calcium-carbonate gallbladder stones than in those with other types of stones.

  12. Combined retrograde flexible ureteroscopic lithotripsy with holmium YAG laser for renal calculi associated with ipsilateral ureteral stones.

    Science.gov (United States)

    Cocuzza, Marcello; Colombo, Jose R; Ganpule, Arvind; Turna, Burak; Cocuzza, Antonio; Dhawan, Divyar; Santos, Bruno; Mazzucchi, Eduardo; Srougi, Miguel; Desai, Mahesh; Desai, Mihir

    2009-02-01

    The purpose of this study was to evaluate the effectiveness of combined ureteroscopic holmium YAG lithotripsy for renal calculi associated with ipsilateral ureteral stones. Between August 2002 and March 2007, retrograde flexible ureteroscopic stone treatment was attempted in 351 cases. Indication for treatment was concurrent symptomatic ureteral stones in 63 patients (group I). Additional operative time and perioperative complication rates were compared to a group of 39 patients submitted to ureteroscopic treatment for ureteral calculi exclusively (group II). Mean ureteral stone size was 8.0 +/- 2.6 mm and 8.1 +/- 3.4 mm for groups I and II, respectively. Mean operative time for group I was 67.9 +/- 29.5 minutes and for group 2 was 49.3 +/- 13.2 minutes (p stone size was 10.7 +/- 6.4 mm, overall stone free rate in group I was 81%. However, considering only patients with renal stones smaller than 15 mm, the stone free rate was 88%. Successful treatment occurred in 81% of patients presenting lower pole stones, but only 76% of patients with multiple renal stones became stone free. As expected, stone free rate showed a significant negative correlation with renal stone size (p = 0.03; r = -0.36). Logistic regression model indicated an independent association of renal stones smaller than 15 mm and stone free rate (OR = 13.5; p = 0.01). Combined ureteroscopic treatment for ureteral and ipsilateral renal calculi is a safe and attractive option for patients presenting for symptomatic ureteral stone and ipsilateral renal calculi smaller than 15 mm.

  13. Determination of minor and trace elements in kidney stones by x-ray fluorescence analysis

    Science.gov (United States)

    Srivastava, Anjali; Heisinger, Brianne J.; Sinha, Vaibhav; Lee, Hyong-Koo; Liu, Xin; Qu, Mingliang; Duan, Xinhui; Leng, Shuai; McCollough, Cynthia H.

    2014-03-01

    The determination of accurate material composition of a kidney stone is crucial for understanding the formation of the kidney stone as well as for preventive therapeutic strategies. Radiations probing instrumental activation analysis techniques are excellent tools for identification of involved materials present in the kidney stone. In particular, x-ray fluorescence (XRF) can be very useful for the determination of minor and trace materials in the kidney stone. The X-ray fluorescence measurements were performed at the Radiation Measurements and Spectroscopy Laboratory (RMSL) of department of nuclear engineering of Missouri University of Science and Technology and different kidney stones were acquired from the Mayo Clinic, Rochester, Minnesota. Presently, experimental studies in conjunction with analytical techniques were used to determine the exact composition of the kidney stone. A new type of experimental set-up was developed and utilized for XRF analysis of the kidney stone. The correlation of applied radiation source intensity, emission of X-ray spectrum from involving elements and absorption coefficient characteristics were analyzed. To verify the experimental results with analytical calculation, several sets of kidney stones were analyzed using XRF technique. The elements which were identified from this techniques are Silver (Ag), Arsenic (As), Bromine (Br), Chromium (Cr), Copper (Cu), Gallium (Ga), Germanium (Ge), Molybdenum (Mo), Niobium (Nb), Rubidium (Rb), Selenium (Se), Strontium (Sr), Yttrium (Y), Zirconium (Zr). This paper presents a new approach for exact detection of accurate material composition of kidney stone materials using XRF instrumental activation analysis technique.

  14. Prognostic factors of success of extracorporeal shock wave lithotripsy (ESWL) in the treatment of renal stones.

    Science.gov (United States)

    Al-Ansari, Abdulla; As-Sadiq, Khalid; Al-Said, Sami; Younis, Nagy; Jaleel, Osama A; Shokeir, Ahmed A

    2006-01-01

    To evaluate the factors that affect the success rate of extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stones. Between January 2000 and December 2003, 427 patients with single or multiple renal stones (ESWL monotherapy using Storz SL 20 lithotriptor. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments ESWL auxiliary procedures were required in 36 patients (8.4%). Post-ESWL complications were recorded in 16 patients (3.7%). Of the 10 prognostic factors studied, 5 had a significant impact on the success rate, namely: renal morphology, congenital anomalies, stone size, stone site and number of treated stones. Other factors including age, sex, nationality, stone nature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. The success rate of ESWL for the treatment of renal stones could be predicted by stone size, location and number, radiological renal features and congenital renal anomalies.

  15. 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

  16. Current approach for urinary system stone disease in pregnant women

    Directory of Open Access Journals (Sweden)

    Orcun Celik

    2016-01-01

    Full Text Available Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

  17. Treatment Approaches to Urinary Stones Caused by Forgotten DJ Stents

    Directory of Open Access Journals (Sweden)

    Ergun Alma

    2015-03-01

    Full Text Available Ureteral DJ stents have been used widely for years in urology practice. With increased use, complications have been increased and forgotton stents have started to cause problems. The most common complications are early pain and irritative symptoms. Late complications are bacterial colonization and stone formation because of the biofilm covering the stents. Treatment for a forgotten stent varies on many factors, such as stent localization and stone formation. In this article, we aimed to discuss our clinic approach on two different cases in light to current literature. [Cukurova Med J 2015; 40(Suppl 1: 58-63

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

    Energy Technology Data Exchange (ETDEWEB)

    Park, Young Mi; Han, Sang Seok; Chang, Seung Kuk; Joo, Sang Hoo; Lee, Jeong Sik; Eun, Choong Ki [Pusan Paik Hospital, Inje University College of Medicine, Pusan (Korea, Republic of)

    1999-12-15

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

  19. Kidney Stones in Children and Teens

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Kidney Stones in Children and Teens Page Content Article ... teen girls having the highest incidence. Types of Kidney Stones There are many different types of kidney ...

  20. 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.

  1. Bilateral same-session ureterorenoscopy: A feasible approach to treat pan-urinary stone disease

    Directory of Open Access Journals (Sweden)

    Bora Özveren

    2017-12-01

    Full Text Available Objectives: To assess treatment effectiveness and safety of bilateral same-session ureterorenoscopy (BSSU for the management of stone disease involving the entire urinary system. Patients and methods: We reviewed the records of 64 patients who underwent BSSU for the treatment of bilateral ureteric and/or kidney stones. Size, number, location per side, and the total burden of stones were recorded. Data on stenting, lithotripsy, and stone retrieval, and details of hospital stay and operation times were investigated. Treatment results were assessed using intraoperative findings and postoperative imaging. The outcome was considered successful in patients who were completely stone-free or who had only residual fragments of ≤2 mm. Results: The outcome was successful in 82.8% of the patients who received BSSU (54.7% stone-free and 28.1% insignificant residual fragments. The success rate per renal unit was 89.8%. There were no adverse events in 73.4% of the patients. The most common intraoperative complication was mucosal injury (36%. The complications were Clavien–Dindo Grade I in 9.4% and Grade II in 7.8%. Grade IIIa and IIIb (9.4% complications required re-treatments. Statistical evaluation showed no association between complication grades and stone, patient, or operation features. Stone burden had no negative impact on BSSU results. The presence of impacted proximal ureteric stones was significantly related to unsuccessful outcomes. Conclusion: BSSU is safe and effective for the management of bilateral urolithiasis. BSSU can prevent recurrent surgeries, reduce overall hospital stay, and achieve a stone-free status and complication rates that are comparable to those of unilateral or staged bilateral procedures. Keywords: Ureteroscopy, Bilateral, Kidney stones, ureter stones, Flexible ureterorenoscopy, Treatment outcomes

  2. Extracorporeal shock wave lithotripsy in the treatment of ureteric stones: Experience from Twam Hospital, United Arab Emirates

    International Nuclear Information System (INIS)

    Ghafoor, M.; Halim, A.

    2002-01-01

    The optimal treatment of ureteric stones, especially the lower ureteric stone, remains controversial. The purpose of this study was to evaluate the role of extracorporeal shock wave lithotripsy (ESWL) in the management of ureteric stones. A total of 99 patients with ureteric stones at different levels were treated with ESWL from 1994 through 1998 at our hospital. All patients were treated using Siemen Lithostar-II Plus Lithotripter. Of 99 patients, 22 were excluded from the study because they had no follow-up records of their stone-free status. The clearance rates for ureteric stones of the other 79 patients treated were stratified according to the site, size and the number of treatment sessions required per stone. The stone size was determined by the widest diameters. Based on stone size, the patients were divided into two groups: A ( 1 0 mm) and B (11-20 mm). The overall all clearance rate for ureteric stones treated with ESWL, irrespective of its site and size, was 78.5%. The overall clearance rate for size A (<-10 mm) stone was 82% and size B (11-20 mm) was 58% regardless of the site of the stone in the ureter. A total of 17 upper ureteric stones were treated with ESWL. The overall clearance rate for upper ureteric stones was 94%. Thirteen patients with mid-ureteric stones were treated with ESWL. The overall clearance rate for the lower ureteric stones was 69.3%. ESWL is safe, effective, noninvasive and a convenient way of treatment for all ureteric stones. The clearance rate for stones in the upper and mid-ureter is above 90%. ESWL being an outpatient procedure without ant need for anesthesia or any pretreatment intervention. It should be considered as the first line of treatment for all stones in the upper and mid-ureter. The clearance for small stones (<1 mm) in the lower third of ureter was 73.8% in our study and for these, ESWL may be considered as a primary therapy. For stones larger than 10 mm in the distal third of ureter, the clearance rate was low

  3. Comparison of ESWL and ureteroscopic holmium laser lithotripsy in management of ureteral stones.

    Science.gov (United States)

    Cui, Yon; Cao, Wenzhou; Shen, Hua; Xie, Jianjun; Adams, Tamara S; Zhang, Yuanyuan; Shao, Qiang

    2014-01-01

    There are many options for urologists to treat ureteral stones that range from 8 mm to 15 mm, including ESWL and ureteroscopic holmium laser lithotripsy. While both ESWL and ureteroscopy are effective and minimally invasive procedures, there is still controversy over which one is more suitable for ureteral stones. To perform a retrospective study to compare the efficiency, safety and complications using ESWL vs. ureteroscopic holmium laser lithotripsy in management of ureteral stones. Between October 2010 and October 2012, 160 patients who underwent ESWL or ureteroscopic holmium laser lithotripsy at Suzhou municipal hospital for a single radiopaque ureteral stone (the size 8-15 mm) were evaluated. All patients were followed up with ultrasonography for six months. Stone clearance rate, costs and complications were compared. Similarity in stone clearance rate and treatment time between the two procedures; overall procedural time, analgesia requirement and total cost were significantly different. Renal colic and gross hematuria were more frequent with ESWL while voiding symptoms were more frequent with ureteroscopy. Both procedures used for ureteral stones ranging from 8 to 15 mm were safe and minimally invasive. ESWL remains first line therapy for proximal ureteral stones while ureteroscopic holmium laser lithotripsy costs more. To determining which one is preferable depends on not only stone characteristics but also patient acceptance and cost-effectiveness ratio.

  4. Experience of extracorporeal shock wave lithotripsy for kidney and upper ureteric stones by electromagnetic lithotripter

    International Nuclear Information System (INIS)

    Wazir, B.G.; Haq, M.I.H.; Faheem-ul-Haq; Nawaz, A.; Nawaz, A.; Ikramullah; Jamil, M.

    2010-01-01

    Background: Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive treatment of urinary stones which breaks them, by using externally applied, focused, high intensity acoustic pulse, into smaller pieces so that they can pass easily through ureter. Shock wave generation, focusing, coupling and stone localisation by fluoroscope or ultrasound are the basic components of ESWL. ESWL has some complications and is contraindicated in certain situations. The aim of this study was to evaluate the effectiveness and safety of ESWL in kidney and upper ureteric stones by Electromagnetic Lithotriptor. Methods: All adult patients with renal and upper ureteric stones having a diameter of up to 1 Cm were included in the study. Basic evaluation such as history, examination, ultrasound and excretory urography were performed. Electromagnetic lithotripsy was done and data were collected on a printed proforma from January 1, 2008 to March 30, 2009 in Institute of Kidney Diseases, Peshawar. Results: Out of a total of 625 patients 463 were male and 162 were female; 67.36% of patients were having renal stones, 23.84% upper ureteric and 8.8% both renal and ureteric stones. Complications noted were renal colic in 9.76%, haematuria in 3.2%, stein strasse in 2.72%, and fever in 1.12% of patients. The stone free rate was 89% and 7% of patients were having stone fragments <4 mm. ESWL failed in 4% of patients. Conclusion: ESWL is a safe and effective way of treating kidney and upper ureteric stones. (author)

  5. Comparison of ESWL and ureteroscopic holmium laser lithotripsy in management of ureteral stones.

    Directory of Open Access Journals (Sweden)

    Yon Cui

    Full Text Available BACKGROUND: There are many options for urologists to treat ureteral stones that range from 8 mm to 15 mm, including ESWL and ureteroscopic holmium laser lithotripsy. While both ESWL and ureteroscopy are effective and minimally invasive procedures, there is still controversy over which one is more suitable for ureteral stones. OBJECTIVE: To perform a retrospective study to compare the efficiency, safety and complications using ESWL vs. ureteroscopic holmium laser lithotripsy in management of ureteral stones. METHODS: Between October 2010 and October 2012, 160 patients who underwent ESWL or ureteroscopic holmium laser lithotripsy at Suzhou municipal hospital for a single radiopaque ureteral stone (the size 8-15 mm were evaluated. All patients were followed up with ultrasonography for six months. Stone clearance rate, costs and complications were compared. RESULTS: Similarity in stone clearance rate and treatment time between the two procedures; overall procedural time, analgesia requirement and total cost were significantly different. Renal colic and gross hematuria were more frequent with ESWL while voiding symptoms were more frequent with ureteroscopy. Both procedures used for ureteral stones ranging from 8 to 15 mm were safe and minimally invasive. CONCLUSION: ESWL remains first line therapy for proximal ureteral stones while ureteroscopic holmium laser lithotripsy costs more. To determining which one is preferable depends on not only stone characteristics but also patient acceptance and cost-effectiveness ratio.

  6. Effective use of technology in clinical supervision

    Directory of Open Access Journals (Sweden)

    Priya Martin

    2017-06-01

    Full Text Available Clinical supervision is integral to continuing professional development of health professionals. With advances in technology, clinical supervision too can be undertaken using mediums such as videoconference, email and teleconference. This mode of clinical supervision is termed as telesupervision. While telesupervision could be useful in any context, its value is amplified for health professionals working in rural and remote areas where access to supervisors within the local work environment is often diminished. While telesupervision offers innovative means to undertake clinical supervision, there remain gaps in the literature in terms of its parameters of use in clinical practice. This article outlines ten evidence-informed, practical tips stemming from a review of the literature that will enable health care stakeholders to use technology effectively and efficiently while undertaking clinical supervision. By highlighting the “how to” aspect, telesupervision can be delivered in the right way, to the right health professional, at the right time.

  7. How should patients with cystine stone disease be evaluated and treated in the twenty-first century?

    DEFF Research Database (Denmark)

    Andreassen, Kim Hovgaard; Pedersen, Katja Venborg; Osther, Susanne Sloth

    2016-01-01

    will have a life long risk of stone formation, repeated surgery, impaired renal function and quality of life. Therapy to reduce stone formation is directed towards lowering urine cystine concentration and increasing cystine solubility. Different molecules that could play a role in promoting nucleation...... and have a modulating effect on cystine solubility may represent new targets for cystinuria research. Investigation of newer thiol-containing drugs with fewer adverse effects is also warranted. Determining cystine capacity may be an effective tool to monitor the individual patient's response. Compliance...... in cystinuric patients concerning both dietary and pharmacological intervention is poor. Frequent clinical follow-up visits in dedicated centres seem to improve compliance. Cystinuric patients should be managed in dedicated centres offering the complete range of minimal invasive treatment modalities, enabling...

  8. Anti-miss-shot control device for selective stone disintegration in extracorporeal shock wave lithotripsy

    Science.gov (United States)

    Kuwahara, M.; Ioritani, N.; Kambe, K.; Orikasa, S.; Takayama, K.

    1991-06-01

    A new device to prevent erroneously focused shock waves to the renal parenchyma during extracorporeal shock wave lithotripsy (ESWL) has been developed; an anti-miss-shot control device (AMCD) and experiments have been conducted to evaluate its effectiveness. For shock wave generation and stone localization, piezoceramic elements (PSE) and ultrasound localization, respectively were used. After stone localization, probing ultrasounds (PU) were emmitted from the PSE towards the focal region and the reflected sound levels (RSL) were monitored by the PSE which also functioned as a microphone. A direct hit by the PU to the stone or a miss was judged from the RSL, i.e. a high RSL indicates a direct hit and a low RSL indicates a miss. Shock waves were generated only when the RSL exceeded the level which indicated a direct hit. The experimental results showed that the injury to the renal parenchyma was decreased by using the AMCD. Clinical application of the AMCD is expected to increase the safety of ESWL.

  9. 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.

  10. Stone stability under non-uniform flow

    NARCIS (Netherlands)

    Hoan, N.T.

    2008-01-01

    Despite the fact that many studies on the stability of stones in bed protections under flowing water have been conducted, our knowledge is still far from advanced and reliable. Issues like how to quantify the hydraulic loads exerted on the stones on a bed and the associated stability of the stones

  11. Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm.

    Science.gov (United States)

    Koyuncu, Hakan; Yencilek, Faruk; Kalkan, Mehmet; Bastug, Yavuz; Yencilek, Esin; Ozdemir, Ahmet Tunc

    2015-01-01

    To compare the efficacy of RIRS and PNL in lower pole stones ≥ 2 cm. Materials and and Methods: A total of 109 patients who underwent PNL or RIRS for solitary lower pole stone between April 2009 and December 2012, were retrospectively analyzed. Lower pole stone was diagnosed with CT scan. Stone size was assessed as the longest axis of the stone. All patients were informed about the advantages, disadvantages and probable complications of both PNL and RIRS before the selection of the procedure. Patients decided the surgery type by themselves without being under any influences and written informed consent was obtained from all patients prior to the surgery. Patients were divided into two groups according to the patients' preference of surgery type. Group 1 consisted of 77 patients who underwent PNL and Group 2 consisted of 32 patients treated with RIRS. Stone free statuses, postoperative complications, operative time and hospitalization time were compared in both groups. There was no statistical significance between the two groups in mean age, stone size, stone laterality, mean follow-up periods and mean operative times. In PNL group, stone-free rate was 96.1% at first session and 100% after the additional procedure. In Group 2, stone-free rate was 90.6% at the first procedure and 100% after the additional procedure. The final stone-free rates and operative times were similar in both groups. RIRS should be an effective treatment alternative to PNL in lower pole stones larger than 2 cm, especially in selected patients.

  12. Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm

    Directory of Open Access Journals (Sweden)

    Hakan Koyuncu

    2015-04-01

    Full Text Available Purpose To compare the efficacy of RIRS and PNL in lower pole stones ≥2 cm. Materials and and Methods: A total of 109 patients who underwent PNL or RIRS for solitary lower pole stone between April 2009 and December 2012, were retrospectively analyzed. Lower pole stone was diagnosed with CT scan. Stone size was assessed as the longest axis of the stone. All patients were informed about the advantages, disadvantages and probable complications of both PNL and RIRS before the selection of the procedure. Patients decided the surgery type by themselves without being under any influences and written informed consent was obtained from all patients prior to the surgery. Patients were divided into two groups according to the patients’ preference of surgery type. Group 1 consisted of 77 patients who underwent PNL and Group 2 consisted of 32 patients treated with RIRS. Stone free statuses, postoperative complications, operative time and hospitalization time were compared in both groups. Results There was no statistical significance between the two groups in mean age, stone size, stone laterality, mean follow-up periods and mean operative times. In PNL group, stone-free rate was 96.1% at first session and 100% after the additional procedure. In Group 2, stone-free rate was 90.6% at the first procedure and 100% after the additional procedure. The final stone-free rates and operative times were similar in both groups. Conclusions RIRS should be an effective treatment alternative to PNL in lower pole stones larger than 2 cm, especially in selected patients.

  13. Treatment of gallbladder stone with common bile duct stones in the laparoscopic era

    OpenAIRE

    Zhang, Wei-jie; Xu, Gui-fang; Huang, Qin; Luo, Kun-lun; Dong, Zhi-tao; Li, Jie-ming; Wu, Guo-zhong; Guan, Wen-xian

    2015-01-01

    Background: Laparoscopic common bile duct exploration (LCBDE) for stone can be carried out by either laparoscopic transcystic stone extraction (LTSE) or laparoscopic choledochotomy (LC). It remains unknown as to which approach is optimal for management of gallbladder stone with common bile duct stones (CBDS) in Chinese patients. Methods: From May 2000 to February 2009, we prospective treated 346 consecutive patients with gallbladder stones and CBDS with laparoscopic cholecystectomy and LCBDE....

  14. The ground stones from Sphinx

    Czech Academy of Sciences Publication Activity Database

    Řídký, Jaroslav

    2017-01-01

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

  15. Histology and cell wall biochemistry of stone cells in the physical defence of conifers against insects.

    Science.gov (United States)

    Whitehill, Justin G A; Henderson, Hannah; Schuetz, Mathias; Skyba, Oleksandr; Yuen, Macaire Man Saint; King, John; Samuels, A Lacey; Mansfield, Shawn D; Bohlmann, Jörg

    2016-08-01

    Conifers possess an array of physical and chemical defences against stem-boring insects. Stone cells provide a physical defence associated with resistance against bark beetles and weevils. In Sitka spruce (Picea sitchensis), abundance of stone cells in the cortex of apical shoots is positively correlated with resistance to white pine weevil (Pissodes strobi). We identified histological, biochemical and molecular differences in the stone cell phenotype of weevil resistant (R) or susceptible (S) Sitka spruce genotypes. R trees displayed significantly higher quantities of cortical stone cells near the apical shoot node, the primary site for weevil feeding. Lignin, cellulose, xylan and mannan were the most abundant components of stone cell secondary walls, respectively. Lignin composition of stone cells isolated from R trees contained a higher percentage of G-lignin compared with S trees. Transcript profiling revealed higher transcript abundance in the R genotype of coumarate 3-hydroxylase, a key monolignol biosynthetic gene. Developing stone cells in current year apical shoots incorporated fluorescent-tagged monolignol into the secondary cell wall, while mature stone cells of previous year apical shoots did not. Stone cell development is an ephemeral process, and fortification of shoot tips in R trees is an effective strategy against insect feeding. © 2015 John Wiley & Sons Ltd.

  16. Development of an instrument to assess the health related quality of life of kidney stone formers.

    Science.gov (United States)

    Penniston, Kristina L; Nakada, Stephen Y

    2013-03-01

    Urolithiasis is associated with pain and other decreases in health related quality of life, yet there is no urolithiasis specific instrument to measure quality of life. Quality of life is an important end point in the management of urolithiasis. Therefore, we developed the Wisconsin StoneQOL, a disease specific instrument to assess the quality of life of patients with urolithiasis. Patients and urology providers identified important concepts related to quality of life of stone formers in groups and in individual cognitive interviews. Patients were recurrent stone formers including those with and those without current stones. A preliminary instrument was created, followed by patient feedback and item reduction. A 28-question instrument was ultimately developed which was tested for reliability as well as internal face, construct and discriminant validity in 248 stone formers. The internal consistency (for questions within domains) was high (mean Cronbach's α = 0.81). Correlation between domains was confirmed (Cronbach's α = 0.86). Discriminant validity was shown as stone formers with current stones scored lower than those who were stone-free. Among patients with active stones, those with symptoms scored lower on most questions and for the total score (p instrument that captures the unique symptoms and challenges associated with urolithiasis. As such, the Wisconsin StoneQOL is capable of assessing the health related quality of life of stone formers at various points along the disease continuum. Future assessment will establish minimal clinically important differences for use in individual patients. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  18. Stones used in Milan architecture

    Directory of Open Access Journals (Sweden)

    Folli, Luisa

    2008-06-01

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

  19. Use of drug therapy in the management of symptomatic ureteric stones in hospitalized adults (SUSPEND), a multicentre, placebo-controlled, randomized trial of a calcium-channel blocker (nifedipine) and an α-blocker (tamsulosin): study protocol for a randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Urinary stone disease is common, with an estimated prevalence among the general population of 2% to 3%. Ureteric stones can cause severe pain and have a significant impact on quality of life, accounting for over 15,000 hospital admissions in England annually. Uncomplicated cases of smaller stones in the lower ureter are traditionally treated expectantly. Those who fail standard care or develop complications undergo active treatment, such as extracorporeal shock wave lithotripsy or ureteroscopy with stone retrieval. Such interventions are expensive, require urological expertise and carry a risk of complications. Growing understanding of ureteric function and pathophysiology has led to the hypothesis that drugs causing relaxation of ureteric smooth muscle, such as the selective α-blocker tamsulosin and the calcium-channel blocker nifedipine, can enhance the spontaneous passage of ureteric stones. The use of drugs in augmenting stone passage, reducing the morbidity and costs associated with ureteric stone disease, is promising. However, the majority of clinical trials conducted to date have been small, poor to moderate quality and lacking in comprehensive economic evaluation. This trial aims to determine the clinical and cost-effectiveness of tamsulosin and nifedipine in the management of symptomatic urinary stones. Methods/design The SUSPEND (Spontaneous Urinary Stone Passage ENabled by Drugs) trial is a multicentre, double-blind, randomized controlled trial evaluating two medical expulsive therapy strategies (nifedipine or tamsulosin) versus placebo. Patients aged 18 to 65 with a ureteric stone confirmed by non-contrast computed tomography of the kidney, ureter and bladder will be randomized to receive nifedipine, tamsulosin or placebo (400 participants per arm) for a maximum of 28 days. The primary clinical outcome is spontaneous passage of ureteric stones at 4 weeks (defined as no further intervention required to facilitate stone passage). The

  20. Use of drug therapy in the management of symptomatic ureteric stones in hospitalized adults (SUSPEND), a multicentre, placebo-controlled, randomized trial of a calcium-channel blocker (nifedipine) and an α-blocker (tamsulosin): study protocol for a randomized controlled trial.

    Science.gov (United States)

    McClinton, Sam; Starr, Kathryn; Thomas, Ruth; McLennan, Graeme; McPherson, Gladys; McDonald, Alison; Lam, Thomas; N'Dow, James; Kilonzo, Mary; Pickard, Robert; Anson, Ken; Burr, Jennifer

    2014-06-20

    Urinary stone disease is common, with an estimated prevalence among the general population of 2% to 3%. Ureteric stones can cause severe pain and have a significant impact on quality of life, accounting for over 15,000 hospital admissions in England annually. Uncomplicated cases of smaller stones in the lower ureter are traditionally treated expectantly. Those who fail standard care or develop complications undergo active treatment, such as extracorporeal shock wave lithotripsy or ureteroscopy with stone retrieval. Such interventions are expensive, require urological expertise and carry a risk of complications.Growing understanding of ureteric function and pathophysiology has led to the hypothesis that drugs causing relaxation of ureteric smooth muscle, such as the selective α-blocker tamsulosin and the calcium-channel blocker nifedipine, can enhance the spontaneous passage of ureteric stones. The use of drugs in augmenting stone passage, reducing the morbidity and costs associated with ureteric stone disease, is promising. However, the majority of clinical trials conducted to date have been small, poor to moderate quality and lacking in comprehensive economic evaluation.This trial aims to determine the clinical and cost-effectiveness of tamsulosin and nifedipine in the management of symptomatic urinary stones. The SUSPEND (Spontaneous Urinary Stone Passage ENabled by Drugs) trial is a multicentre, double-blind, randomized controlled trial evaluating two medical expulsive therapy strategies (nifedipine or tamsulosin) versus placebo.Patients aged 18 to 65 with a ureteric stone confirmed by non-contrast computed tomography of the kidney, ureter and bladder will be randomized to receive nifedipine, tamsulosin or placebo (400 participants per arm) for a maximum of 28 days. The primary clinical outcome is spontaneous passage of ureteric stones at 4 weeks (defined as no further intervention required to facilitate stone passage). The primary economic outcome is a

  1. Random effects models in clinical research

    NARCIS (Netherlands)

    Cleophas, T. J.; Zwinderman, A. H.

    2008-01-01

    BACKGROUND: In clinical trials a fixed effects research model assumes that the patients selected for a specific treatment have the same true quantitative effect and that the differences observed are residual error. If, however, we have reasons to believe that certain patients respond differently

  2. Investigations on stone fragmentation in different extracorporeal shock wave lithotripsy sound fields in vitro

    Science.gov (United States)

    Dreyer, Thomas; Liebler, Marko; Riedlinger, Rainer

    2005-04-01

    The mechanism of stone fragmentation in ESWL applications is still under investigation. Devices showing a wide focal area and comparably low focal pressure amplitudes have been reported to disintegrate stones more efficiently as current clinical devices with high amplitudes and small focal areas. From this the question is raised whether the underlying different physical mechanisms or treatment issues, like stone localization and movement, are responsible for these results. In this paper fragmentation experiments in vitro with different stone types (e.g., HMT and BegoStone, 15 mm diam.) under different sound fields are presented. A self focusing piezoelectric transducer with a small focal area and peak pressure amplitudes of up to 125 MPa is used. The number of pulses was counted until a complete fragmentation through a 2 mm wire mesh is reached. In order to simulate wide-focus low-pressure conditions, the stones were placed in the prefocal region. Fragmentation results are compared to the case of focal placement. Initial breakage occurs earlier in the prefocal region for the HMT stones, whereas complete fragmentation is reached significantly earlier in the focus for all stone types.

  3. Evaluation of Extracorporeal Shock Wave Lithotripsy (ESWL): Efficacy in Treatment of Urinary System Stones.

    Science.gov (United States)

    Junuzovic, Dzelaludin; Prstojevic, Jelena Kovacevic; Hasanbegovic, Munira; Lepara, Zahid

    2014-10-01

    Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (x2 = 11.47, p = 0.009). There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter.

  4. 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.

  5. Successful topical dissolution of cholesterol gallbladder stones using ethyl propionate.

    Science.gov (United States)

    Hofmann, A F; Amelsberg, A; Esch, O; Schteingart, C D; Lyche, K; Jinich, H; Vansonnenberg, E; D'Agostino, H B

    1997-06-01

    Topical dissolution of cholesterol gallbladder stones using methyl tert-butyl ether (MTBE) is useful in symptomatic patients judged too ill for surgery. Previous studies showed that ethyl propionate (EP), a C5 ester, dissolves cholesterol gallstones rapidly in vitro, but differs from MTBE in being eliminated so rapidly by the liver that blood levels remain undetectable. Our aim was to test EP as a topical dissolution agent for cholesterol gallbladder stones. Five high-risk patients underwent topical dissolution of gallbladder stones by EP. In three patients, the solvent was instilled via a cholecystostomy tube placed previously to treat acute cholecystitis; in two patients, a percutaneous transhepatic catheter was placed in the gallbladder electively. Gallstone dissolution was assessed by chromatography, by gravimetry, and by catheter cholecystography. Total dissolution of gallstones was obtained in four patients after 6-10 hr of lavage; in the fifth patient, partial gallstone dissolution facilitated basketing of the stones. In two patients, cholesterol dissolution was measured and averaged 30 mg/min. Side effects were limited to one episode of transient hypotension and pain at the infusion site; no patient developed somnolence or nausea. Gallstone elimination was associated with relief of symptoms. EP is an acceptable alternative to MTBE for topical dissolution of cholesterol gallbladder stones in high-risk patients. The lower volatility and rapid hepatic extraction of EP suggest that it may be preferable to MTBE in this investigational procedure.

  6. The effectiveness of stone ash and volcanic ash of mount Sinabung as a filler on the initial strength of self-compacting concrete

    Science.gov (United States)

    Karolina, R.; Muhammad, W.; Saragih, M. D. S. M.; Mustaqa, T.

    2018-02-01

    Self Compacting Concrete is a concrete variant that has a high degree of workability and also has great initial strength, but low water cement factor. It is also self-flowable that can be molded on formwork with a very little or no compacted use of compactors. This concrete, using a variety of aggregate sizes, aggregate portions and superplasticizer admixture to achieve a special viscosity that allows it to flow on its own without the aid of a compactor. Lightweight concrete brick is a type of brick made from cement, sand, water, and developers. Lightweight concrete bricks are divided into 2 based on the developed materials used are AAC (Autoclave Aerated Concrete) using aluminum paste and CLC (Cellular Lightweight Concrete) that use Foaming Agent from BASF as a developer material. In this experiment, the lightweight bricks that will be made are CLC type which uses Foaming Agent as the developer material by mixing the Ash Stone produced by Stone Crusher machine which has the density of 2666 kg / m3 as Partial Pair Substitution. In this study the variation of Ash Stone used is 10%, 15%, and 20% of the planned amount of sand. After doing the tasting the result is obtained for 10% variation. Compressive Strength and Absorption Increase will decrease by 25.07% and 39.005% and Variation of 15% compressive strength will decrease by 65,8% and decrease of absorbtion equal to 17,441% and variation of 20% compressive strength will decreased by 67,4 and absorption increase equal to 17,956%.

  7. [Comparison of the effects of the intervention with electric thermal bian stone and air suction cup on blood perfusion at meridian points].

    Science.gov (United States)

    Zhao, Pengna; Wang, Yanping; Gu, Feifei; Li, Chaozheng; Wei, Yulong; Wang, Guangjun; Zhang, Weibo

    2018-02-12

    To observe the impacts of the intervention with electric thermal bian stone and air suction cup on blood perfusion (BP) at meridian points and explore the approach of accurate measurement and regulation of meridian qi and blood balance in "precise acupuncture". The laser Doppler line scanner (LDLS) was used to measure BP at bilateral yua n-primary points at the pericardium meridian, the triple energizer meridian, the gallbladder meridian and the liver meridian (small cycle of jueyin to shaoyang meridians) at 31 healthy receptors. The bias ratio of blood perfusion (BPBR) deviated to the reference value was calculated. The electric thermal bian stone and air suction cup were used in the intervention at the he -sea points of the affected meridians in which BPBR was relatively higher at the yuan -primary points. The electric thermal bian stone therapy was used when BPBR was less than -30% and the air suction cupping therapy was used when BPBR was higher than 30%. BP was measured twice before intervention and it was measured separately at the moment after intervention and in 20 min after intervention. The means of BP before and after intervention and the change ratio of blood perfusion (BPCR) before intervention, at the moment after intervention and 20 min after intervention were calculated. 1. After the intervention of electric thermal bian stone, BP mean was increased from (103.51±41.21) PU to (121.97±56.22) PU ( P 0.05), but the change ratio was highly remained. 2. After intervention with air suction cup, BP mean was reduced from (194.83±81.14) PU to (173.88±88.26) PU. Before intervention, at the moment after intervention and 20 min after intervention, separately, BPCR were (7.62±30.49)%, (-12.12±18.20)% and (-14.35±21.25)%. BPCR at the moment after intervention and in 20 min after intervention were significantly different from that before intervention (both P cup is opposite.

  8. Multiphase fluid-solid coupled analysis of shock-bubble-stone interaction in shockwave lithotripsy.

    Science.gov (United States)

    Wang, Kevin G

    2017-10-01

    A novel multiphase fluid-solid-coupled computational framework is applied to investigate the interaction of a kidney stone immersed in liquid with a lithotripsy shock wave (LSW) and a gas bubble near the stone. The main objective is to elucidate the effects of a bubble in the shock path to the elastic and fracture behaviors of the stone. The computational framework couples a finite volume 2-phase computational fluid dynamics solver with a finite element computational solid dynamics solver. The surface of the stone is represented as a dynamic embedded boundary in the computational fluid dynamics solver. The evolution of the bubble surface is captured by solving the level set equation. The interface conditions at the surfaces of the stone and the bubble are enforced through the construction and solution of local fluid-solid and 2-fluid Riemann problems. This computational framework is first verified for 3 example problems including a 1D multimaterial Riemann problem, a 3D shock-stone interaction problem, and a 3D shock-bubble interaction problem. Next, a series of shock-bubble-stone-coupled simulations are presented. This study suggests that the dynamic response of a bubble to LSW varies dramatically depending on its initial size. Bubbles with an initial radius smaller than a threshold collapse within 1 μs after the passage of LSW, whereas larger bubbles do not. For a typical LSW generated by an electrohydraulic lithotripter (p max  = 35.0MPa, p min  =- 10.1MPa), this threshold is approximately 0.12mm. Moreover, this study suggests that a noncollapsing bubble imposes a negative effect on stone fracture as it shields part of the LSW from the stone. On the other hand, a collapsing bubble may promote fracture on the proximal surface of the stone, yet hinder fracture from stone interior. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Humidity sorption on natural building stone

    Science.gov (United States)

    Franzen, C.; Mirwald, P.

    2003-04-01

    processes, physical, chemical or biological, depend on the presence of water. Like most porous materials building stone respond on humidity by water uptake. The sorption isotherm represents the equilibrium moisture, specific for each material. The determination of the isotherm for stone of low and small porosity like marble is difficult. With the help of a newly developed water sorption analysis chamber [2], which allows the simultaneous measurement of 11 samples, good results on stone/rock samples have been obtained. Even at marble species with pore volumes lower than 0.4 % isotherms are measured. This analytical method offers new insights in the pore behaviour of low porosity materials. The advantages of this technique which supplements other techniques (e.g. BET, Hg-porosimetry) are: i) the testing agent is identical to the weathering agent, water; ii) the atmospheric parameters at the measurement reflect the natural conditions - thus no changes to the material properties have to be considered; iii) due to the small diameter of the water molecule (~0.28 nm), smaller pores are reached than e.g. with N2 (~0.31 nm). Sorption isotherms of sandstone (Baumberg, Obernkirchen, Groeden), granite (Brixen), and marble (Sterzing, Laas) are presented. Particular as to marbles the resolution is considerably higher. A previously observed negative hysteresis [3] seems an effect due to limited data resolution. [1] Snethlage, R. (1984) Steinkonservierung, Bayer. LA Denkmalpflege, Ah. 22, 203 S. [2] Griesser, U.J., Dillenz, J. (2002) Neuartiges, vollautomatisches Feuchtesorptionsprüfgerät mit hohem Probendurchsatz, Feuchtetag 2002, Weimar, 85-93. [3] Fimmel, R. (1996) Verwitterungsverhalten der alpinen Marmore von Laas und Sterzing, Diss. Univ. Ibk, 116 S.

  10. Stone Formation and Fragmentation in Forgotten Ureteral Double J Stent

    Directory of Open Access Journals (Sweden)

    Okan Bas

    2014-02-01

    Full Text Available Aim: Nowadays, ureteral stents play an essential role in various endourological and open surgical procedures and common procedures performed in daily urological practice. However, stents can cause significant complications such as migration, infection, fragmentation, stone formation and encrustation, especially when forgotten for a long period. Objectives: We present our experience in endoscopic management of forgotten ureteral stents with a brief review of current literature. Case presentation: A total of 2 patients with forgotten ureteral stents were treated with endourological approaches in our department. Indwelling durations were 18 months and 36 months. After treatment both patients were stone and stent free. Conclusion: An endourological approach is effective for stent and stone removal after a single anesthesia session with minimal morbidity and short hospital stay. However, therapeutic strategy is also determined by the technology available. The best treatment would be the prevention of this complication by providing detailed patient education.

  11. Validating automated kidney stone volumetry in computed tomography and mathematical correlation with estimated stone volume based on diameter.

    Science.gov (United States)

    Wilhelm, Konrad; Miernik, Arkadiusz; Hein, Simon; Schlager, Daniel; Adams, Fabian; Benndorf, Matthias; Fritz, Benjamin; Langer, Mathias; Hesse, Albrecht; Schoenthaler, Martin; Neubauer, Jakob

    2018-06-02

    To validate AutoMated UroLithiasis Evaluation Tool (AMULET) software for kidney stone volumetry and compare its performance to standard clinical practice. Maximum diameter and volume of 96 urinary stones were measured as reference standard by three independent urologists. The same stones were positioned in an anthropomorphic phantom and CT scans acquired in standard settings. Three independent radiologists blinded to the reference values took manual measurements of the maximum diameter and automatic measurements of maximum diameter and volume. An "expected volume" was calculated based on manual diameter measurements using the formula: V=4/3 πr³. 96 stones were analyzed in the study. We had initially aimed to assess 100. Nine were replaced during data acquisition due of crumbling and 4 had to be excluded because the automated measurement did not work. Mean reference maximum diameter was 13.3 mm (5.2-32.1 mm). Correlation coefficients among all measured outcomes were compared. The correlation between the manual and automatic diameter measurements to the reference was 0.98 and 0.91, respectively (pvolumetry is possible and significantly more accurate than diameter-based volumetric calculations. To avoid bias in clinical trials, size should be measured as volume. However, automated diameter measurements are not as accurate as manual measurements.

  12. Clinical effectiveness of garlic (Allium sativum).

    Science.gov (United States)

    Pittler, Max H; Ernst, Edzard

    2007-11-01

    The objective of this review is to update and assess the clinical evidence based on rigorous trials of the effectiveness of garlic (A. sativum). Systematic searches were carried out in Medline, Embase, Amed, the Cochrane Database of Systematic Reviews, Natural Standard, and the Natural Medicines Comprehensive Database (search date December 2006). Our own files, the bibliographies of relevant papers and the contents pages of all issues of the review journal FACT were searched for further studies. No language restrictions were imposed. To be included, trials were required to state that they were randomized and double blind. Systematic reviews and meta-analyses of garlic were included if based on the results of randomized, double-blind trials. The literature searches identified six relevant systematic reviews and meta-analysis and double-blind randomized trials (RCT) that were published subsequently. These relate to cancer, common cold, hypercholesterolemia, hypertension, peripheral arterial disease and pre-eclampsia. The evidence based on rigorous clinical trials of garlic is not convincing. For hypercholesterolemia, the reported effects are small and may therefore not be of clinical relevance. For reducing blood pressure, few studies are available and the reported effects are too small to be clinically meaningful. For all other conditions not enough data are available for clinical recommendations.

  13. The possibility of use of Kremicj granitoid (Serbia) as an architectural stone

    International Nuclear Information System (INIS)

    Kureshevicj, Lidja

    2010-01-01

    The stone from the granitoid pluton of Kremić in southern Serbia has been examined in order to evaluate the possibility of its use as an architectural stone. Both field observations and laboratory testing of specimens have been performed. Although the specimens were collected from the field surface level, their physicomechanical lab test results have shown that the rock mass itself fulfils all the requirements for use as an architectural stone set by the State through Serbian standards. Also, the stone quality is higher in deeper ground levels, where the weathering agents have less intense effects. This stone does not have high ornamental properties, but it has a finegrained texture and low mica content which has a positive effect on its technical characteristics and susceptibility to processing. (Author)

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

    Science.gov (United States)

    Nakamura, Kogenta; Tobiume, Motoi; Narushima, Masahiro; Yoshizawa, Takahiko; Nishikawa, Genya; Kato, Yoshiharu; Katsuda, Remi; Zennami, Kenji; Aoki, Shigeyuki; Yamada, Yoshiaki; Honda, Nobuaki; Sumitomo, Makoto

    2011-12-12

    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. 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. 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. 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.

  15. 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.

  16. 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.

  17. Modeling elastic wave propagation in kidney stones with application to shock wave lithotripsy.

    Science.gov (United States)

    Cleveland, Robin O; Sapozhnikov, Oleg A

    2005-10-01

    A time-domain finite-difference solution to the equations of linear elasticity was used to model the propagation of lithotripsy waves in kidney stones. The model was used to determine the loading on the stone (principal stresses and strains and maximum shear stresses and strains) due to the impact of lithotripsy shock waves. The simulations show that the peak loading induced in kidney stones is generated by constructive interference from shear waves launched from the outer edge of the stone with other waves in the stone. Notably the shear wave induced loads were significantly larger than the loads generated by the classic Hopkinson or spall effect. For simulations where the diameter of the focal spot of the lithotripter was smaller than that of the stone the loading decreased by more than 50%. The constructive interference was also sensitive to shock rise time and it was found that the peak tensile stress reduced by 30% as rise time increased from 25 to 150 ns. These results demonstrate that shear waves likely play a critical role in stone comminution and that lithotripters with large focal widths and short rise times should be effective at generating high stresses inside kidney stones.

  18. 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.

  19. EFFECTIVENESS AND SAFETY OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR UNCOMPLICATED PELVIC CONCREMENTS

    Directory of Open Access Journals (Sweden)

    A. V. Khasigov

    2017-01-01

    Full Text Available Introduction. Extracorporeal shockwave lithotripsy (ESWL allowed to improve the treatment results for patients suffering from the kidney stone disease (KSD, decrease the number of complications, optimize the nearest and distant therapy results; however, its success depends on the initial size and shape of the stone. Purpose of the study. Тo examine the clinical effectiveness and safety of electromagnetic ESWL used on simple renal calculi taking their sizes into account. Materials and methods. The survey included 110 patients with simple renal calculi who passed electromagnetic ESWL procedures. The first group consisted of 75 patients with calculi ≤ 15 mm in diameter, the second group included 35 patients with stones > 15 mm. Results. Complete disintegration of stones ≤ 15 mm was accomplished in 74,7% of cases in 1-2 lithotripsy sessions, and after 3 months residual fragments were found in 4% of cases only. Elimination of stones > 15 mm from the renal collecting system takes considerably longer, all patients require more than 1 lithotripsy session. In 3 months following the ESWL residual stones were found in 17,2% of analysed cases. Stone sizes had no bearing on the pain syndrome frequency and severity as well as activation of urinary infection. Macrohematuria, renal haematomas, and an increase of blood creatinine level compared with the original value were more frequent in patients with stones > 15 mm. Conclusions. Electromagnetic ESWL is an efficient and safe method for monotherapy of patients with uncomplicated pelvic concrements. Clinical ESWL effectiveness for stones ≤15 mm by the 3rd month of monitoring reaches 96,0%, for stones > 15 mm it is 82,8% (р<0,05. The level and severity of complications is higher in case of pelvic stones >15 mm compared with the stones < 15 mm in diameter (р<0,05.

  20. Stone cladding engineering

    National Research Council Canada - National Science Library

    Camposinhos, Rui de Sousa

    2014-01-01

    .... 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...

  1. Ultrasound versus liver function tests for diagnosis of common bile duct stones.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Giljaca, Vanja; Takwoingi, Yemisi; Higgie, David; Poropat, Goran; Štimac, Davor; Davidson, Brian R

    2015-02-26

    Ultrasound and liver function tests (serum bilirubin and serum alkaline phosphatase) are used as screening tests for the diagnosis of common bile duct stones in people suspected of having common bile duct stones. There has been no systematic review of the diagnostic accuracy of ultrasound and liver function tests. To determine and compare the accuracy of ultrasound versus liver function tests for the diagnosis of common bile duct stones. We searched MEDLINE, EMBASE, Science Citation Index Expanded, BIOSIS, and Clinicaltrials.gov to September 2012. We searched the references of included studies to identify further studies and systematic reviews identified from various databases (Database of Abstracts of Reviews of Effects, Health Technology Assessment, Medion, and ARIF (Aggressive Research Intelligence Facility)). We did not restrict studies based on language or publication status, or whether data were collected prospectively or retrospectively. We included studies that provided the number of true positives, false positives, false negatives, and true negatives for ultrasound, serum bilirubin, or serum alkaline phosphatase. We only accepted studies that confirmed the presence of common bile duct stones by extraction of the stones (irrespective of whether this was done by surgical or endoscopic methods) for a positive test result, and absence of common bile duct stones by surgical or endoscopic negative exploration of the common bile duct, or symptom-free follow-up for at least six months for a negative test result as the reference standard in people suspected of having common bile duct stones. We included participants with or without prior diagnosis of cholelithiasis; with or without symptoms and complications of common bile duct stones, with or without prior treatment for common bile duct stones; and before or after cholecystectomy. At least two authors screened abstracts and selected studies for inclusion independently. Two authors independently collected data from

  2. [Sialoendoscopy-assisted sialolithectomy for large parotid stones].

    Science.gov (United States)

    Zhao, Jian; Zhang, Lei; Liu, Deng-gao; Zhang, Zu-yan; Yu, Guang-yan

    2014-02-18

    To explore the clinical application of endoscope-assisted operative retrieval of large parotid stones as a minimally invasive alternative. From January 2010 to April 2013, 6 patients (male: 5, female: 1, age from 30-62 years, and median age: 49.5 years)suffering from recurred swelling of parotid gland due to sialoliths were treated by endoscope-assisted parotid surgery in Peking University School and Hospital of Stomatology. All of the patients underwent clinical, ultrasonographic and cone-beam CT (CBCT) examinations to get the detailed information of the number, location and size of stones, which was recorded in the medical records. endoscope-assisted parotid surgery was performed under general anesthesia in all the 6 cases after the failure of basket or forcep retrieval firstly. During the operation, sialoendoscope was used to locate the stone exactly and then the calculus was exposed through a pre-auricular approach and released by incising the duct. The postoperative complications were recorded and observed during the follow-up periods. Preoperative radiological examinations showed that all of the sialoliths were near the hilum of parotid gland ducts in the 6 cases, which were 5-9 mm in diameter. All of the stones were removed successfully by endoscope-assisted operative retrieval. The incisions healed smoothly in all the 6 cases. There were no cases of facial nerve weakness, infection or salivary fistula. After a mean follow-up of 19 months (ranging from 6-36 months), 5 patients remained asymptomatic and 1 patient had mild obstructed or infective symptoms. The final results were satisfied. It is suggested that endoscope-assisted operative retrieval is a viable minimally invasive alternative to remove the large or recalcitrant parotid stones with a high successful rate and low complications.

  3. Acute renal infarction Secondary to Atrial Fibrillation Mimicking Renal Stone Picture

    International Nuclear Information System (INIS)

    Salih, Salih Bin; Al-Durihim, H.; Al-Jizeeri, A.; Al-Maziad, G.

    2006-01-01

    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 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. (author)

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

    Directory of Open Access Journals (Sweden)

    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

  5. Safety and efficacy of staged retrograde intrarenal surgery for large stone burden of renal stones in selected patients: A single-center experience

    Directory of Open Access Journals (Sweden)

    Cheng-Feng Lin

    2017-06-01

    Conclusion: To the best of our knowledge, RIRS for large renal stone manipulation is an effective and safe treatment modality currently. In our study, the single RIRS SFR was superior to PNL or SWL even when the stone burden was between 2.0 cm and 3.0 cm (80.2%. For those patients whose stone burden was over 3.0 cm or for those with comorbidities, staged RIRS resulted in a lower complication rate, reduced hospital stay, and better SFR (76.5%.

  6. Extracorporeal shock wave lithotripsy of biliary and pancreatic stones

    NARCIS (Netherlands)

    R. den Toom (Rene)

    1993-01-01

    textabstractThe aim of the study was to answer the following questions: Is extracorporeal shock wave lithotripsy for gallbladder stones a safe and effective therapy? (Chapter 2) Is simultaneous treatment with extracorporeal shock wave lithotripsy and the solvent methyl te.rt-butyl ether feasible,

  7. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones.

    Science.gov (United States)

    Gökce, Mehmet İlker; Ibiş, Arif; Sancı, Adem; Akıncı, Aykut; Bağcı, Uygar; Ağaoğlu, Eylül Asya; Süer, Evren; Gülpınar, Ömer

    2017-12-01

    Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases. Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups. The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group. PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.

  8. Emergency management of ureteral stones: Recent advances

    Directory of Open Access Journals (Sweden)

    Luis Osorio

    2008-01-01

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

  9. Emergency management of ureteral stones: Recent advances.

    Science.gov (United States)

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

    2008-10-01

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

  10. Diabetes in relation to biliary tract cancer and stones: a population-based study in Shanghai, China

    Science.gov (United States)

    Shebl, F M; Andreotti, G; Rashid, A; Gao, Y-T; Yu, K; Shen, M-C; Wang, B-S; Li, Q; Han, T-Q; Zhang, B-H; Fraumeni, J F; Hsing, A W

    2010-01-01

    Background: Biliary tract cancers are rare but fatal malignancies. Diabetes has been related to biliary stones, but its association with biliary tract cancers is less conclusive. Methods: In a population-based case–control study of 627 cancers, 1037 stones, and 959 controls in Shanghai, China, we examined the association between diabetes and the risks of biliary tract cancer and stones, as well as the effect of potential mediating factors, including serum lipids and biliary stones (for cancer), contributing to the causal pathway from diabetes to biliary diseases. Results: Independent of body mass index (BMI), diabetes was significantly associated with gallbladder cancer and biliary stones ((odds ratio (OR) (95% confidence interval)=2.6 (1.5–4.7) and 2.0 (1.2–3.3), respectively). Biliary stones and low serum levels of high-density lipoprotein (HDL) were significant mediators of the diabetes effect on gallbladder cancer risk, accounting for 60 and 17% of the diabetes effect, respectively. High-density lipoprotein was also a significant mediator of the diabetes effect on biliary stones, accounting for 18% of the diabetes effect. Conclusions: Independent of BMI, diabetes is a risk factor for gallbladder cancer, but its effect is mediated in part by biliary stones and serum HDL levels, suggesting that gallbladder cancer risk may be reduced by controlling diabetes, stones, and HDL levels. PMID:20517308

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  12. [Analysis of clinical effectiveness and risk factors for complication of percutaneous nephrolototripsia in patients with a solitary kidney].

    Science.gov (United States)

    Arustamov, L D; Katibov, M I; Merinov, D S; Gurbanov, Sh Sh; Artemov, A V; Epishov, V A

    2017-12-01

    Management of patients with large and staghorn stones of a solitary kidney is widely debated among urologists and has not been sufficiently investigated, which determined the relevance of this study. The study comprised 80 patients with large (>20 mm) and staghorn stones of an anatomically or functionally solitary kidney. Of them, 58 patients underwent percutaneous nephrolithotripsy (PNL), and 22 had open surgery. The criterion of the treatment effectiveness was the complete stone clearance or small residual fragments sized less than 3 mm. The safety criterion was the absence of intra- and postoperative complications, according to Clavien-Dindo grading system. The study analyzed the following factors influencing the effectiveness and safety of PNL: the number of accesses; nephroscope diameter; use of a nephroscope sheath; type of lithotripter; size, density, type and composition of the stone. Percutaneous nephrolithotripsy demonstrated statistically significantly better safety results compared with open surgery with comparable effectiveness. Long-term stone recurrence rate after PNL and open surgery was 10.4 and 18.2%, respectively. PNL resulted in a statistically significant improvement in the kidney function while it worsened after open surgery. The effectiveness of PNL depends on the stone type and size and the kind of lithotripter. It was 7.5 times greater for a large stone than for staghorn calculi and 4.6 times higher for stones sized less or equal 45 mm than for those sized > 45 mm. Ultrasonic lithotripter was 2.2 times more effective than another type of lithotripter. The safety of PNL depends on the nephroscope diameter, of a sheath, the number of accesses, the type of lithotripter and the type of stone. Using a 24-Ch nephroscope was 3.6 times safer than that with a diameter greater than 24-Ch; not using a sheath was 3.2 times safer than using it; one access was 3 times safer than at multiple ones; using an ultrasound lithotripter was 2.7 times safer than

  13. COMORBIDITY OF KIDNEY STONES AND PYCHIATRIC DISEASE

    OpenAIRE

    Bilić, Vedran; Marčinko, Darko

    2010-01-01

    This paper describes a patient who is suffering from PTSD with elements of hypochondria, panic attacks and episodes of 0depression in comorbidity with kidney stones. Kidney stones provoked egzacerbation of psychiatric symptoms. Kidney stones and frustration about them have taken part of provoking factor, the last drop, which led to regression of otherwise precarious, but compensated patient’s mental functioning which resulted in development of psychiatric symptoms.

  14. Clinical effectiveness and cost effect analysis of quadrivalent HPV vaccine

    OpenAIRE

    Lekić, Nataša

    2008-01-01

    1 ABSTRACT Quadrivalent Human Papillomavirus Vaccine- Evaluation of clinical effectiveness and national vaccine programs Author: Nataša Lekić Research Advisor: PharmDr. Lenka Práznovcová, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague. SUMMARY QUADRIVALENT HPV VACCINE- EVALUATION OF CLINICAL EFFECTIVENESS AND NATIONAL VACCINE PROGRAMS Background: Human papillomavirus types 6, 11,16 and 18 cause majority of genital warts an...

  15. Building stones can be of geoheritage significance

    Science.gov (United States)

    Brocx, Margaret; Semeniuk, Vic

    2017-04-01

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

  16. 77 FR 27245 - Big Stone National Wildlife Refuge, Big Stone and Lac Qui Parle Counties, MN

    Science.gov (United States)

    2012-05-09

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R3-R-2012-N069; FXRS1265030000S3-123-FF03R06000] Big Stone National Wildlife Refuge, Big Stone and Lac Qui Parle Counties, MN AGENCY: Fish and... plan (CCP) and environmental assessment (EA) for Big Stone National Wildlife Refuge (Refuge, NWR) for...

  17. Probabilistic Modeling of the Renal Stone Formation Module

    Science.gov (United States)

    Best, Lauren M.; Myers, Jerry G.; Goodenow, Debra A.; McRae, Michael P.; Jackson, Travis C.

    2013-01-01

    randomly sampling the probability distributions of the electrolyte concentrations and system parameters that are inputs into the deterministic model. The total urine chemistry concentrations are used to determine the urine chemistry activity using the Joint Expert Speciation System (JESS), a biochemistry model. Information used from JESS is then fed into the deterministic growth model. Outputs from JESS and the deterministic model are passed back to the probabilistic model where a multivariate regression is used to assess the likelihood of a stone forming and the likelihood of a stone requiring clinical intervention. The parameters used to determine to quantify these risks include: relative supersaturation (RS) of calcium oxalate, citrate/calcium ratio, crystal number density, total urine volume, pH, magnesium excretion, maximum stone width, and ureteral location. Methods and Validation: The RSFM is designed to perform a Monte Carlo simulation to generate probability distributions of clinically significant renal stones, as well as provide an associated uncertainty in the estimate. Initially, early versions will be used to test integration of the components and assess component validation and verification (V&V), with later versions used to address questions regarding design reference mission scenarios. Once integrated with the deterministic component, the credibility assessment of the integrated model will follow NASA STD 7009 requirements.

  18. Computer aided detection of ureteral stones in thin slice computed tomography volumes using Convolutional Neural Networks.

    Science.gov (United States)

    Längkvist, Martin; Jendeberg, Johan; Thunberg, Per; Loutfi, Amy; Lidén, Mats

    2018-06-01

    Computed tomography (CT) is the method of choice for diagnosing ureteral stones - kidney stones that obstruct the ureter. The purpose of this study is to develop a computer aided detection (CAD) algorithm for identifying a ureteral stone in thin slice CT volumes. The challenge in CAD for urinary stones lies in the similarity in shape and intensity of stones with non-stone structures and how to efficiently deal with large high-resolution CT volumes. We address these challenges by using a Convolutional Neural Network (CNN) that works directly on the high resolution CT volumes. The method is evaluated on a large data base of 465 clinically acquired high-resolution CT volumes of the urinary tract with labeling of ureteral stones performed by a radiologist. The best model using 2.5D input data and anatomical information achieved a sensitivity of 100% and an average of 2.68 false-positives per patient on a test set of 88 scans. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. A Lion of a Stone

    Science.gov (United States)

    2004-01-01

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

  20. Do You Have Symptoms of a Kidney Stone?

    Science.gov (United States)

    ... Or, the stone will be removed with treatment. Dogs, Cats, and Kidney Stones Humans aren't the only ones affected by kidney and bladder stones. Dogs, cats, and other animals can also have kidney ...

  1. Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi.

    Science.gov (United States)

    Lee, Joo Yong; Kim, Jae Heon; Kang, Dong Hyuk; Chung, Doo Yong; Lee, Dae Hun; Do Jung, Hae; Kwon, Jong Kyou; Cho, Kang Su

    2016-04-01

    We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841-0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994-0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008-1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility.

  2. The erosion of carbonate stone by acid rain: Laboratory and field investigations

    International Nuclear Information System (INIS)

    Baedecker, P.A.; Reddy, M.M.

    1993-01-01

    This paper describes a laboratory experiment on the effects of acidic deposition on carbonate stone erosion. It can serve as the basis for an undergraduate (or pre college) experiment in environmental chemistry. Recent field investigations are described that provide measurements of carbonate stone dissolution and mechanical erosion under weathering conditions that are prevalent in the eastern US. The purpose of the laboratory work is to answer questions concerning the effects of hydrogen ion deposition on stone erosion processes that were difficult to resolve on the basis of field experiments alone

  3. Emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla.

    Science.gov (United States)

    Zheng, Mingwei; Liu, Xufeng; Li, Ning; Li, Wei-Zhi

    2018-03-01

    To evaluate the efficacy and safety of emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla. Between January 2010 and January 2015, 118 cases of acute severe cholangitis with impacted common bile duct stones at the native papilla underwent emergency endoscopic retrograde cholangiopancreatography (ERCP) and early needle-knife precut papillotomy in a tertiary referral center. Precut techniques were performed according to the different locations of stones in the duodenal papilla. Clinical data about therapy and recovery of the 118 patients were recorded and analyzed. One hundred and eighteen patients underwent emergency ERCP within 24 h after hospitalization, with a total success rate of 100%. The mean operating time was 6.4 ± 4.1 min. Postoperative acute physiology and chronic health evaluation (APACHE) II scores, white blood cell count and liver function improved significantly. The complication rate was 4.2% (5/118); two with hemorrhage and three with acute pancreatitis. There was no procedure-related mortality. Emergency endoscopic needle-knife precut papillotomy is effective and safe for acute severe cholangitis resulting from impacted common bile duct stones at the duodenal papilla. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Percutaneous suprapubic stone extraction for posterior urethral stones in children: efficacy and safety.

    Science.gov (United States)

    Safwat, Ahmed S; Hameed, Diaa A; Elgammal, Mohamed A; Abdelsalam, Yasser M; Abolyosr, Ahmad

    2013-08-01

    To evaluate the safety and efficacy of percutaneous suprapubic stone extraction (PSPSE) for pediatric posterior urethral stones. Between July 2007 and June 2010, 54 boys presenting with acute urinary retention due to posterior urethral stones underwent PSPSE. Patients were a mean age of 66.4 months (range, 8-180 months). The stone size was 0.7-1.9 cm. Patients were placed under general anesthesia, and a 7F urethroscope was used to pushback the stone to the bladder. A 3-mm suprapubic puncture with a scalpel was performed, followed by insertion of a straight narrow hemostat through the puncture aided with cystoscopic guidance. The stone was grasped with the hemostat in its narrowest diameter and was extracted percutaneously or crushed if friable. The suprapubic puncture was closed with a single 4-0 Vicryl (Ethicon) suture. Intact stone retrieval was achieved in 45 patients, and the stone was crushed into minute fragments in 9 patients. Intraperitoneal extravasation developed in 1 patient that required open surgical intervention. Mean operative time was 22 minutes. Patients were monitored for up to 17 months, with complete resolution of symptoms and stone clearance. PSPSE provides a minimally invasive approach for the extraction of urethral and bladder stones in the pediatric population. The use of a straight hemostat for suprapubic stone extraction or crushing is a good alternative to suprapubic tract dilation, with minimal morbidity. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Evolution of stone management in Australia.

    Science.gov (United States)

    Lee, Ming-Chak; Bariol, Simon Virgil

    2011-11-01

    What's known on the subject? and What does the study add? There is very little contemporary data regarding stone management in Australia. This study assesses the impact of technological advances on stone management practises, and raises questions as to why there is an increasing rate of intervention for stone disease in Australia. Knowledge of management trends as demonstrated in this paper give individual surgeons a guideline for contemporary practise in this country. • To examine trends in the operative management of upper urinary tract stone disease in Australia over the past 15 years. • The Medicare Australia and Australian Institute of Health and Welfare databases were used to determine the annual number of renal colic presentations and procedural interventions undertaken for stone disease. • In Australia over the past 15 years, the annual number of procedural interventions for upper urinary tract stones has increased, primarily due to the rising number of endoscopic procedures performed. • During this period, shock wave lithotripsy numbers have remained steady whilst open and percutaneous procedures have been in decline. • The introduction of and subsequent preference for less invasive techniques has changed the management pathway of patients presenting with stone disease in Australia. • Further studies are necessary to determine whether this escalation in endoscopic procedures is due to an increase in the incidence of stone disease, earlier detection, a lower intervention threshold or a higher retreatment rate. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

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

    African Journals Online (AJOL)

    Objective: To determine the rate of stone clearance after extracorporeal shockwave lithotripsy (ESWL) for renal stones in adult patients with renal insufficiency. Subjects and methods: This is a cross-sectional descriptive study of 117 adult patients who underwent ESWL. The indications for ESWL were determined by the ...

  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. Percutaneous Nephrolithotomy for Kidney Stones in Patients with Hematological Malignancy

    Directory of Open Access Journals (Sweden)

    Baris Kuzgunbay

    2016-07-01

    Full Text Available Aim: To define the alterations in the outcomes of percutaneous nephrolithotomy (PNL operations for kidney stones in patients with history of hematological malignancy (HM. Material and Method: Between 2000 and 2013, 1700 adult patients underwent PNL for the treatment of kidney stones in our institution. Four of these patients had a history of HM and considered to be HM group (n=4. Ten elderly (>65 years patients who had no history of operation, HM or any other co-morbide diseases were chosen as the control group (n=10. Surgical parameters, success rates, additional treatments and complications were evaluated. Results: Statistical analyses showed no significant differences between HM and control group according to stone area, operation time, fluoroscopy time, hospitalization time, %u2206Hb, blood transfusion rates and INR values (p>0.05. Statistical analyses revealed no significant differences between HM and control groups according to the success rates (p=0.470. Statistical analyses revealed no significant difference between groups for additional treatment requirements (p=0.882. No major perioperative complication was seen in both of the groups. Discussion: The treatment of kidney stone disease by PNL in patients with hematological malignancy is feasible, safe and effective. However, close cooperation with the Hematology Department before the operation is mandatory.

  10. Pancreatic duct stones in patients with chronic pancreatitis: surgical outcomes.

    Science.gov (United States)

    Liu, Bo-Nan; Zhang, Tai-Ping; Zhao, Yu-Pei; Liao, Quan; Dai, Meng-Hua; Zhan, Han-Xiang

    2010-08-01

    Pancreatic duct stone (PDS) is a common complication of chronic pancreatitis. Surgery is a common therapeutic option for PDS. In this study we assessed the surgical procedures for PDS in patients with chronic pancreatitis at our hospital. Between January 2004 and September 2009, medical records from 35 patients diagnosed with PDS associated with chronic pancreatitis were retrospectively reviewed and the patients were followed up for up to 67 months. The 35 patients underwent ultrasonography, computed tomography, or both, with an overall accuracy rate of 85.7%. Of these patients, 31 underwent the modified Puestow procedure, 2 underwent the Whipple procedure, 1 underwent simple stone removal by duct incision, and 1 underwent pancreatic abscess drainage. Of the 35 patients, 28 were followed up for 4-67 months. There was no postoperative death before discharge or during follow-up. After the modified Puestow procedure, abdominal pain was reduced in patients with complete or incomplete stone clearance (P>0.05). Steatorrhea and diabetes mellitus developed in several patients during a long-term follow-up. Surgery, especially the modified Puestow procedure, is effective and safe for patients with PDS associated with chronic pancreatitis. Decompression of intraductal pressure rather than complete clearance of all stones predicts postoperative outcome.

  11. Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature.

    Science.gov (United States)

    Eisner, Brian H; Dretler, Stephen P

    2009-01-01

    Stone retropulsion during ureteroscopic lithotripsy leads to additional procedures for residual calculi. The Stone Cone (Boston Scientific, Natick, Mass., USA) is a device designed to prevent stone migration. To determine the incidence of calculus retropulsion and additional procedures after ureteroscopy with intracorporeal lithotripsy while using the Stone Cone. A retrospective review of patients with obstructing ureteral calculi who underwent ureteroscopy and holmium:YAG laser lithotripsy using the Stone Cone as a backstop over a 3-year period at an academic medical center was performed. 133 patients underwent ureteroscopy with holmium:YAG laser lithotripsy using the Stone Cone to prevent calculus retroplusion. Success was defined as no residual fragments >2 mm in size, no changes from semirigid to flexible ureteroscope, and no additional procedures. Post-operative imaging was abdominal plain radiography or computed tomography. A MEDLINE search was performed to indentify all English clinical studies of the Stone Cone. Of the 133 uses of the Stone Cone, there were 2 (1.5%) residual retropulsed fragments >2 mm which required an additional procedure. There were no changes to flexible ureteroscope secondary to stone retropulsion in 105 cases of semirigid ureteroscopy. There was no instance of ureteral obstruction from residual 2-mm fragments. There were no ureteral strictures or hydronephrosis among 91 patients with long-term follow-up imaging. A review of the literature was performed which yielded 4 clinical publications and 90 reported cases using the Stone Cone with 100% success. Two of these studies showed statistically significant improvement when compared with control patients. The Stone Cone minimized stone retropulsion during ureteroscopic laser lithotripsy. The Stone Cone offers the urologist greater certainty during ureteroscopy and may decrease the number of clinically significant residual calculi. Copyright 2009 S. Karger AG, Basel.

  12. Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores.

    Science.gov (United States)

    Capaccio, P; Gaffuri, M; Rossi, V; Pignataro, L

    2017-04-01

    It has been suggested that a conservative trans-oral approach to proximal and hilo-parenchymal submandibular stones (HPSMS) is a valid alternative to the more frequently used sialadenectomy. The aim of this study was to evaluate the surgical, ultrasonographic and patients' subjective outcomes of results of the trans-oral removal of HPSMS. Between January 2003 and September 2015, sialendoscope-assisted trans-oral surgery was used to remove symptomatic, large (> 7 mm), fixed and palpable HPSMS from 479 patients under general anaesthesia. All patients were followed clinically and ultrasonographically to investigate symptom relief and recurrence of stones, and were telephonically interviewed to assess saliva-related subjective outcomes with a questionnaire. Stones were successfully removed from 472 patients (98.5%); the seven failures (1.5%) concerned pure parenchymal stones. One year after the procedure, 408 patients (85.1%) were symptom free, 59 (12.3%) had recurrent obstructive symptoms and 12 (2.6%) had recurrent infections. Of the 54 patients who developed a recurrent stone (11.2%), 52 underwent a second procedure: 29 interventional sialendoscopies, two sialendoscope-assisted intra-corporeal pneumatic lithotripsy, eight secondary transoral surgery to remove residual stones, six a cycle of extra-corporeal lithotripsy and seven submandibular sialadenectomy. Most patients (75.2%) reported mild surgery-related pain. The symptoms of 454 patients (94.8%) improved after adjunctive treatment and, at the end of follow-up, the affected gland was preserved in 98.5% of patients. A sialendoscope-assisted trans-oral removal of large HPSMS is a safe, effective, conservative surgical procedure, and functional preservation of the main duct and parenchyma of the obstructed gland allows sialendoscopic access through the natural ostium in case of recurrence. Combining a trans-oral approach with other minimally invasive, conservative procedures ensures symptomatic relief and salivary

  13. Instrumental neutron activation analysis of kidney stones

    International Nuclear Information System (INIS)

    Sarmani, S.; Kuan, L.L.; Bakar, M.A.A.

    1990-01-01

    Kidney stone samples of the types calcium oxalate, uric acid, and xanthine were analyzed for their elemental contents by neutron activation analysis to study both the elemental correlation and influence of element on stone precipitation processes. Elements, such as Al, Au, Br, Ca, Cl, Co, Cr, Fe,H, I, K, Mg, Na, Sb, Se, Sr, and Zn, were determined quantitatively. Calcium oxalate stones contained higher concentration of all the elements analyzed compared to uric acid or xanthine stones. The concentrations of Cl, Fe, K, Na, Sr, and Zn were relatively higher than Au, Co, Cr, and Sb. A positive correlation exists between Ca and Zn, whereas a negative correlation exists between Sr and Ca. Zinc may play an important role in the formation of calcium oxalate stone

  14. Extracorporeal Shockwave Lithotripsy of Primary Intrahepatic Stones

    Science.gov (United States)

    Kim, Myung Hwan; Lee, Sung Koo; Min, Young Il; Lee, Mun Gyu; Sung, Kyu Bo; Cho, Kyung Sik; Lee, Sung Gyu; Min, Pyung Chul

    1992-01-01

    Extracorporeal shockwave lithothripsy (ESWL) was performed in intrahepatic stone patients (n = 18) by Dornier MPL 9,000 with ultrasound guidance. The patients had T-tube (n = 9) or percutaneous transhepatic biliary drainge tube (n = 9). Average treatment session was four and shock-wave numbers were in the range of 3,064 to 12,000 (average 6,288 shocks). Intrahepatic stones were removed completely in 16 patients over a 3 month period by ESWL and combined stone extraction maneuver such as cholangioscopic or interventional radiologic method. Extracorporeal shockwave lithothripsy was very helpful in facilitating extraction of stones in unfavorable locations or located above the severe stricture. In summary, extracorporeal Shockwave lithotripsy, followed by percutaneous stone extraction, will provide an improvement in the success rate and duration of treatment required for complete removal of primary hepatolithiasis. PMID:1477027

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

    Science.gov (United States)

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

    2012-06-01

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

  16. Outcome of bilateral ureteroscopic retrieval of stones in a single session

    Directory of Open Access Journals (Sweden)

    Majid Mushtaque

    2012-01-01

    Conclusion: Bilateral same-session ureteroscopy is a safe and effective procedure in the management of bilateral ureteral stones. The results are comparable to unilateral or staged bilateral procedures.

  17. Cast Stone Formulation At Higher Sodium Concentrations

    International Nuclear Information System (INIS)

    Fox, K. M.; Edwards, T. A.; Roberts, K. B.

    2013-01-01

    A low temperature waste form known as Cast Stone is being considered to provide supplemental Low Activity Waste (LAW) immobilization capacity for the Hanford site. Formulation of Cast Stone at high sodium concentrations is of interest since a significant reduction in the necessary volume of Cast Stone and subsequent disposal costs could be achieved if an acceptable waste form can be produced with a high sodium molarity salt solution combined with a high water to premix (or dry blend) ratio. The objectives of this study were to evaluate the factors involved with increasing the sodium concentration in Cast Stone, including production and performance properties and the retention and release of specific components of interest. Three factors were identified for the experimental matrix: the concentration of sodium in the simulated salt solution, the water to premix ratio, and the blast furnace slag portion of the premix. The salt solution simulants used in this study were formulated to represent the overall average waste composition. The cement, blast furnace slag, and fly ash were sourced from a supplier in the Hanford area in order to be representative. The test mixes were prepared in the laboratory and fresh properties were measured. Fresh density increased with increasing sodium molarity and with decreasing water to premix ratio, as expected given the individual densities of these components. Rheology measurements showed that all of the test mixes produced very fluid slurries. The fresh density and rheology data are of potential value in designing a future Cast Stone production facility. Standing water and density gradient testing showed that settling is not of particular concern for the high sodium compositions studied. Heat of hydration measurements may provide some insight into the reactions that occur within the test mixes, which may in turn be related to the properties and performance of the waste form. These measurements showed that increased sodium

  18. Cast Stone Formulation At Higher Sodium Concentrations

    International Nuclear Information System (INIS)

    Fox, K. M.; Roberts, K. A.; Edwards, T. B.

    2014-01-01

    A low temperature waste form known as Cast Stone is being considered to provide supplemental Low Activity Waste (LAW) immobilization capacity for the Hanford site. Formulation of Cast Stone at high sodium concentrations is of interest since a significant reduction in the necessary volume of Cast Stone and subsequent disposal costs could be achieved if an acceptable waste form can be produced with a high sodium molarity salt solution combined with a high water to premix (or dry blend) ratio. The objectives of this study were to evaluate the factors involved with increasing the sodium concentration in Cast Stone, including production and performance properties and the retention and release of specific components of interest. Three factors were identified for the experimental matrix: the concentration of sodium in the simulated salt solution, the water to premix ratio, and the blast furnace slag portion of the premix. The salt solution simulants used in this study were formulated to represent the overall average waste composition. The cement, blast furnace slag, and fly ash were sourced from a supplier in the Hanford area in order to be representative. The test mixes were prepared in the laboratory and fresh properties were measured. Fresh density increased with increasing sodium molarity and with decreasing water to premix ratio, as expected given the individual densities of these components. Rheology measurements showed that all of the test mixes produced very fluid slurries. The fresh density and rheology data are of potential value in designing a future Cast Stone production facility. Standing water and density gradient testing showed that settling is not of particular concern for the high sodium compositions studied. Heat of hydration measurements may provide some insight into the reactions that occur within the test mixes, which may in turn be related to the properties and performance of the waste form. These measurements showed that increased sodium

  19. Cast Stone Formulation At Higher Sodium Concentrations

    Energy Technology Data Exchange (ETDEWEB)

    Fox, K. M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Roberts, K. A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Edwards, T. B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2014-02-28

    A low temperature waste form known as Cast Stone is being considered to provide supplemental Low Activity Waste (LAW) immobilization capacity for the Hanford site. Formulation of Cast Stone at high sodium concentrations is of interest since a significant reduction in the necessary volume of Cast Stone and subsequent disposal costs could be achieved if an acceptable waste form can be produced with a high sodium molarity salt solution combined with a high water to premix (or dry blend) ratio. The objectives of this study were to evaluate the factors involved with increasing the sodium concentration in Cast Stone, including production and performance properties and the retention and release of specific components of interest. Three factors were identified for the experimental matrix: the concentration of sodium in the simulated salt solution, the water to premix ratio, and the blast furnace slag portion of the premix. The salt solution simulants used in this study were formulated to represent the overall average waste composition. The cement, blast furnace slag, and fly ash were sourced from a supplier in the Hanford area in order to be representative. The test mixes were prepared in the laboratory and fresh properties were measured. Fresh density increased with increasing sodium molarity and with decreasing water to premix ratio, as expected given the individual densities of these components. Rheology measurements showed that all of the test mixes produced very fluid slurries. The fresh density and rheology data are of potential value in designing a future Cast Stone production facility. Standing water and density gradient testing showed that settling is not of particular concern for the high sodium compositions studied. Heat of hydration measurements may provide some insight into the reactions that occur within the test mixes, which may in turn be related to the properties and performance of the waste form. These measurements showed that increased sodium

  20. Cast Stone Formulation At Higher Sodium Concentrations

    Energy Technology Data Exchange (ETDEWEB)

    Fox, K. M.; Edwards, T. A.; Roberts, K. B.

    2013-10-02

    A low temperature waste form known as Cast Stone is being considered to provide supplemental Low Activity Waste (LAW) immobilization capacity for the Hanford site. Formulation of Cast Stone at high sodium concentrations is of interest since a significant reduction in the necessary volume of Cast Stone and subsequent disposal costs could be achieved if an acceptable waste form can be produced with a high sodium molarity salt solution combined with a high water to premix (or dry blend) ratio. The objectives of this study were to evaluate the factors involved with increasing the sodium concentration in Cast Stone, including production and performance properties and the retention and release of specific components of interest. Three factors were identified for the experimental matrix: the concentration of sodium in the simulated salt solution, the water to premix ratio, and the blast furnace slag portion of the premix. The salt solution simulants used in this study were formulated to represent the overall average waste composition. The cement, blast furnace slag, and fly ash were sourced from a supplier in the Hanford area in order to be representative. The test mixes were prepared in the laboratory and fresh properties were measured. Fresh density increased with increasing sodium molarity and with decreasing water to premix ratio, as expected given the individual densities of these components. Rheology measurements showed that all of the test mixes produced very fluid slurries. The fresh density and rheology data are of potential value in designing a future Cast Stone production facility. Standing water and density gradient testing showed that settling is not of particular concern for the high sodium compositions studied. Heat of hydration measurements may provide some insight into the reactions that occur within the test mixes, which may in turn be related to the properties and performance of the waste form. These measurements showed that increased sodium

  1. Cast Stone Formulation At Higher Sodium Concentrations

    Energy Technology Data Exchange (ETDEWEB)

    Fox, K. M.; Roberts, K. A.; Edwards, T. B.

    2013-09-17

    A low temperature waste form known as Cast Stone is being considered to provide supplemental Low Activity Waste (LAW) immobilization capacity for the Hanford site. Formulation of Cast Stone at high sodium concentrations is of interest since a significant reduction in the necessary volume of Cast Stone and subsequent disposal costs could be achieved if an acceptable waste form can be produced with a high sodium molarity salt solution combined with a high water to premix (or dry blend) ratio. The objectives of this study were to evaluate the factors involved with increasing the sodium concentration in Cast Stone, including production and performance properties and the retention and release of specific components of interest. Three factors were identified for the experimental matrix: the concentration of sodium in the simulated salt solution, the water to premix ratio, and the blast furnace slag portion of the premix. The salt solution simulants used in this study were formulated to represent the overall average waste composition. The cement, blast furnace slag, and fly ash were sourced from a supplier in the Hanford area in order to be representative. The test mixes were prepared in the laboratory and fresh properties were measured. Fresh density increased with increasing sodium molarity and with decreasing water to premix ratio, as expected given the individual densities of these components. Rheology measurements showed that all of the test mixes produced very fluid slurries. The fresh density and rheology data are of potential value in designing a future Cast Stone production facility. Standing water and density gradient testing showed that settling is not of particular concern for the high sodium compositions studied. Heat of hydration measurements may provide some insight into the reactions that occur within the test mixes, which may in turn be related to the properties and performance of the waste form. These measurements showed that increased sodium

  2. Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones.

    Science.gov (United States)

    Resorlu, Berkan; Unsal, Ali; Ziypak, Tevfik; Diri, Akif; Atis, Gokhan; Guven, Selcuk; Sancaktutar, Ahmet Ali; Tepeler, Abdulkadir; Bozkurt, Omer Faruk; Oztuna, Derya

    2013-12-01

    To compare the outcomes of shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), and retrograde intrarenal surgery (RIRS) for 10-20 mm radiolucent renal calculi by evaluating stone-free rates and associated complications. A total of 437 patients at 7 institutions who underwent SWL (n = 251), PNL (n = 140), or RIRS (n = 46) were enrolled in our study. Clinical success was defined as stone-free status or asymptomatic insignificant residual fragments PNL, and RIRS (p PNL and RIRS (21.9 vs 5.7 vs 8.7%, respectively; p PNL, and RIRS were 7.6, 22.1, and 10.9%, respectively (p PNL group received blood transfusions, while none of the patients in RIRS and SWL groups transfused. Hospitalization time per patient was 1.3 ± 0.5 days in the RIRS group, while it was 2.6 ± 0.9 days in the PNL group (p PNL group compared to RIRS (145.7 ± 101.7 vs 28.7 ± 18.7 s, and 57.5 ± 22.1 vs 43.1 ± 17 min, respectively). For treatment of moderate-sized radiolucent renal stones, RIRS and PNL provide significantly higher success and lower retreatment rate compared with SWL. Although PNL is effective, its biggest drawback is its invasiveness. Blood loss, radiation exposure, hospital stay, and morbidities of PNL can be significantly reduced with RIRS technique.

  3. Stepping Stones Triple P: an RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder.

    Science.gov (United States)

    Whittingham, Koa; Sofronoff, Kate; Sheffield, Jeanie; Sanders, Matthew R

    2009-05-01

    Whilst the Triple P Positive Parenting Program has a large evidence base (Sanders, Clinical Child and Family Psychology Review 2:71-90, 1999; Sanders, Journal of Consulting and Clinical Psychology 68:624-640, 2000) and preliminary evidence indicates that Stepping Stones Triple P is also efficacious (Roberts, Journal of Clinical Child and Adolescent Psychology, 35(2):180-193, 2006), to date Stepping Stones has not been evaluated with the ASD population. Fifty-nine families with a child with ASD aged between 2 and 9 participated in this randomized controlled trial. The results demonstrate significant improvements in parental reports of child behaviour and parenting styles with the treatment effects for child behaviour, parental over reactivity and parental verbosity being maintained at follow-up 6 months later. Further, the results suggest significant improvements in parental satisfaction and conflict about parenting as well as a sleeper effect for parental efficacy. The results indicate that Stepping Stones Triple P is a promising intervention for parents of children with ASD. Limitations and future research are also addressed.

  4. Hereditary Causes of Kidney Stones and Chronic Kidney Disease

    Science.gov (United States)

    Edvardsson, Vidar O.; Goldfarb, David S.; Lieske, John C.; Beara-Lasic, Lada; Anglani, Franca; Milliner, Dawn S.; Palsson, Runolfur

    2013-01-01

    Adenine phosphoribosyltransferase (APRT) deficiency, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) and primary hyperoxaluria (PH) are rare but important causes of severe kidney stone disease and/or chronic kidney disease in children. Recurrent kidney stone disease and nephrocalcinosis, particularly in pre-pubertal children, should alert the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition and knowledge of the five disorders has frequently resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. A high index of suspicion coupled with early diagnosis may reduce or even prevent the serious long-term complications of these diseases. In this paper, we review the epidemiology, clinical features, diagnosis, treatment and outcome of patients with APRT deficiency, cystinuria, Dent disease, FHHNC and PH with emphasis on childhood manifestations. PMID:23334384

  5. Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study.

    Science.gov (United States)

    ElSheemy, Mohammed S; Elmarakbi, Akram A; Hytham, Mohammed; Ibrahim, Hamdy; Khadgi, Sanjay; Al-Kandari, Ahmed M

    2018-03-16

    To compare the outcome of mini-percutaneous nephrolithotomy (Mini-PNL) versus standard-PNL for renal stones. Retrospective study was performed between March 2010 and May 2013 for patients treated by Mini-PNL or standard-PNL through 18 and 30 Fr tracts, respectively, using pneumatic lithotripsy. Semirigid ureteroscope (8.5/11.5 Fr) was used for Mini-PNL and 24 Fr nephroscope for standard-PNL. Both groups were compared in stone free rate(SFR), complications and operative time using Student-t, Mann-Whitney, Chi square or Fisher's exact tests as appropriate in addition to logistic regression analysis. P PNL (378) and standard-PNL (151) were nearly comparable in patients and stones criteria including stone burden (3.77 ± 2.21 vs 3.77 ± 2.43 cm 2 ; respectively). There was no significant difference in number of tracts or supracostal puncture. Mini-PNL had longer operative time (68.6 ± 29.09 vs 60.49 ± 11.38 min; p = 0.434), significantly shorter hospital stay (2.43 ± 1.46 vs 4.29 ± 1.28 days) and significantly higher rate of tubeless PNL (75.1 vs 4.6%). Complications were significantly higher in standard-PNL (7.9 vs 20.5%; p PNL (89.9 vs 96%; p = 0.022). This significant difference was found with multiple stones and large stone burden (> 2 cm 2 ), but the SFR was comparable between both groups with single stone or stone burden ≤ 2 cm. Logistic regression analysis confirmed significantly higher complications and SFR with standard-PNL but with significantly shorter operative time. Mini-PNL has significantly lower SFR when compared to standard-PNL (but clinically comparable) with markedly reduced complications and hospital stay. Most of cases can be performed tubeless. The significant difference in SFR was found with multiple stones or large stone burden (> 2 cm 2 ), but not with single stones or stone burden ≤ 2 cm 2 .

  6. Carrara Marble: a nomination for Global Heritage Stone Resource

    Science.gov (United States)

    primavori, piero

    2014-05-01

    In the collective memory, in ordinary people, or in any technical office not devoted expressly to stone, marble is automatically associated with the word Carrara (Italy). Indisputably, for decades and decades, there has been this word association: marble means Carrara and Carrara means marble. In few other commodity sectors is a word so automatically associated with a name, engendering an identification process that, despite the inexorable onslaught of globalization, continues to exist. Carrara Marble, probably one of the most famous dimension stone in the world, has been recently designated as a suitable "Global Heritage Stone Resource". The additional designation of "Global Ornamental Stone" has also been proposed. Quarried since pre-Roman times, this marble is the testimonial of an area/industry that was able - for a variety of reasons not easily repeatable in future stone history - from the dawn of the stone sector to trigger a flywheel-effect on a global scale. The term Carrara Marble, geographically referable to the marbles extracted in the sorroundings of Carrara town, is in reality a general one, erroneously used since long time to define a multitude of different marbles (more than two hundred commercial varieties) extracted in the whole Apuane Alps region, Nortwestern Tuscany, Italy. The district of Carrara Marble is part of a wider territory where five important extractive areas can be recognized: Lunigiana, Garfagnana, Versilia, Massa and the Carrara area sensu stricto. This region is approximately 30 km long and 12 km wide, with marble outcrops, useful for commercial purposes, covering over 75 km2. The Carrara Marble is currently excavated in more than 100 quarries, at a rate of about 1.500.000 tons per year, is processed almost everywhere, and sold all over the world. The most important commercial designations are the following: 1) "Marmo Bianco"/"Marmo Ordinario" (Carrara White marble/Ordinary marble); 2) "Marmo Venato" (Veined marble); 3) "Marmo

  7. Calcium hypochlorite as a disinfecting additive for dental stone.

    Science.gov (United States)

    Twomey, Jonathan O; Abdelaziz, Khalid M; Combe, Edward C; Anderson, Dwight L

    2003-09-01

    Dental casts come into direct contact with impression materials and other items that are contaminated by saliva and blood from a patient's mouth, leaving the casts susceptible to cross-contamination. Topical methods of disinfecting casts are difficult to control, while immersion methods are potentially destructive. Thus, an additional method to control cross-contamination between patients and laboratory personnel is needed. This study was undertaken in an attempt to develop a dental stone with disinfecting properties and adequate compressive and tensile strengths. Calcium hypochlorite [Ca(OCl)(2)] in aqueous solution in concentrations from 0 to 1.5% was tested as a disinfecting additive to type V dental stone. The compressive and tensile strength properties of the modified stone were measured (MPa) using a universal testing machine at a consistency similar to unmodified stone. Strength data were analyzed by 1-way ANOVA and post hoc Tukey-Kramer procedure (alpha CaviCide, and 3 impressions rinsed in water served as controls. In general, the effect of adding the disinfectant to the stone was a decrease in strength. Exceptions were the dry compressive strength, for which there was a significant increase in strength (P=.048) at 0.5%, and the wet compressive and wet tensile strength, which showed no significant difference between the 1.5% and the control. When Ca(OCl)(2) was added at the concentration 0.5% (2765 ppm available chlorine), the gypsum had acceptable mechanical properties; dry compressive strength was 78.86 +/- 4.12 MPa, and dry tensile strength was 10.64 +/- 1.27 MPa, compared to control values of 67.85 +/- 6.28 and 13.41 +/- 1.24 MPa, respectively. At concentrations of 0.3% and higher (36 1650 ppm of available chlorine), calcium hypochlorite was able to completely inactivate phi29. It is possible to prepare a type V dental stone that contains a disinfectant, has adequate mechanical properties, and will reduce numbers of residual microorganisms. For example

  8. Residual intrahepatic stones after percutaneous biliary extraction : longterm follow up of complications

    International Nuclear Information System (INIS)

    Yoo, Seung Min; Shim, Hyung Jin; Lee, Hwa Yeon; Lim, Sang Jun; Park, Hyo Jin; Kim, Yang Soo; Choi, Young Hee; Kwak, Byung Kuck; Park, Ji Young

    1997-01-01

    To evaluate and compare the radiologic and clinical follow-up of complications between a group in whom stone removal after percutaneous biliary extraction had been complete, and a group in whom this had been incomplete. Twenty-two patients in whom stone removal had been incomplete, and 20 from whom stones had been completely removed were evaluated with particular attention to complications such as cholangitis, liver abscess, biliary sepsis, and pain. Cholangitis was diagnosed on the basis of typical clinical symptoms such as pain, high fever, jaundice and leukocytosis. Pain without other cholangitic symptoms was excluded. Liver abscess was diagnosed by percutaneous aspiration of pus, and biliary sepsis by bacterial growth on blood culture, or laboratory findings such as increased fibrinogen products, decreased fibrinogen, and increased prothrombin time with cholangitic symptoms. 'Complete removal' means no residual stones on follow-up sonogram and cholangiogram performed within three to seven days after pecutaneous biliary extraction. Mean follow-up period was 26.5 months in the incomplete removal group and 34.2 months in the complete removal group. In twelve of 22 patients (54.5%) in the incomplete removal group, complications occurred, as follows:cholangitis, ten cases (45.5%);liver absces, one (4.5%);biliary sepsis, one (4.5%);and pain, seven(31.8%). In contrast, only two of twenty patients (10%) in the complete removal group suffered complications, all of which involved the recurrence of stones in the common duct, and cholangitis. Complete removal of intrahepatic stones significantly helps to reduce the incidence of possible complications. Even in the case of an impacted stone, aggressive interventional procedures, aimed at complete removal, should be considered. If nonsurgical procedures fail, early partial hepatectomy should be considered, particulary for the stones localized in the left intrahepatic duct

  9. Percutaneous Transhepatic Cutting Balloon Papillotomy for Removal of Common Bile Duct Stones

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Ozkan, Ugur; Gumus, Burcak

    2009-01-01

    We report the case of a 66-year-old female who presented with jaundice secondary to recurrent adenocarcinoma of the gallbladder and several common bile duct stones. Percutaneous papillary dilatation was planned to remove the common bile duct stones. Papilla was dilated through the percutaneous approach with an 8-mm peripheral cutting balloon instead of a standard balloon. All the stones were pushed successfully into the duodenum with a saline flush. No complications were encountered. Use of a peripheral cutting balloon for dilatation of the papilla seems to be safe and effective because it has the advantage of controlled incision and dilatation of the target at low pressures.

  10. Differentiation of uric acid versus non-uric acid kidney stones in the presence of iodine using dual-energy CT

    Science.gov (United States)

    Wang, J.; Qu, M.; Leng, S.; McCollough, C. H.

    2010-04-01

    In this study, the feasibility of differentiating uric acid from non-uric acid kidney stones in the presence of iodinated contrast material was evaluated using dual-energy CT (DECT). Iodine subtraction was accomplished with a commercial three material decomposition algorithm to create a virtual non-contrast (VNC) image set. VNC images were then used to segment stone regions from tissue background. The DE ratio of each stone was calculated using the CT images acquired at two different energies with DECT using the stone map generated from the VNC images. The performance of DE ratio-based stone differentiation was evaluated at five different iodine concentrations (21, 42, 63, 84 and 105 mg/ml). The DE ratio of stones in iodine solution was found larger than those obtained in non-iodine cases. This is mainly caused by the partial volume effect around the boundary between the stone and iodine solution. The overestimation of the DE ratio leads to substantial overlap between different stone types. To address the partial volume effect, an expectation-maximization (EM) approach was implemented to estimate the contribution of iodine and stone within each image pixel in their mixture area. The DE ratio of each stone was corrected to maximally remove the influence of iodine solutions. The separation of uric-acid and non-uric-acid stone was improved in the presence of iodine solution.

  11. The triphasics: insights for effective clinical use.

    Science.gov (United States)

    Youngkin, E Q; Miller, L G

    1987-02-01

    Three triphasic oral contraceptive preparations are currently being widely used in the United States. These are Ortho-Novum 7/7/7 (Ortho Pharmaceutical), Tri-Norinyl (Syntex) and Triphasil (Wyeth). The hormone manipulation in these formulations more closely mimics the normal menstrual cycle and decreases the total amount of hormone delivered. These drugs were formulated to decrease menstrual irregularities and nuisance side effects and increase menstrual control, while maintaining efficacy and safety. This article describes these products, their mechanisms of action, efficacy and selected areas of concern for clinical practice in relation to side effects, safety and menstrual control. Findings and suggestions related to the therapeutic administration, patient use, counseling and management of these newer oral contraceptives will assist the nurse practitioner in providing optimum care to the consumer.

  12. Clinical evaluation based on cost-effectiveness

    International Nuclear Information System (INIS)

    Inoue, Takehiro; Inoue, Toshihiko

    1998-01-01

    We carried out two Phase III clinical trials using high dose rate (HDR) remote afterloading brachytherapy unit. We evaluated the clinical results based not only on the medical but also the economical standpoint. The first trial is the Phase III trial for cervical cancer treated with HDR or medium dose rate (MDR) intracavitary radiotherapy. The second one is the Phase III trial for tongue cancer treated with HDR or low dose rate (LDR) interstitial radiation. For cervical cancer, the survival rate of patients treated with HDR brachytherapy is the some as for LDR brachytherapy. The average total cost of treatment for the HDR group was 1.47 million yen, while that for the MDR group was 1.58 million yen. The average total admission days was 63. For tongue cancer, the local control rate of the HDR group is almost the same as that of the LDR groups. The average total cost for the HDR group was 780 thousand yen, and that for the LDR group was 830 thousand yen. The average total admission days was 34. According to the cost-effectiveness, HDR brachytherapy for cervical cancer has the same result as MDR, and HDR brachytherapy for tongue cancer has the same result as LDR. However, HDR can be treated without admission for patients who live near the hospital. HDR can be applied for these patients with less expense. We must be aware of not only the medical results but also the cost-effectiveness. (author)

  13. Percutaneous Transhepatic Removal of Bile Duct Stones: Results of 261 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ozcan, Nevzat, E-mail: nevzatcan@yahoo.com; Kahriman, Guven, E-mail: guvenkahriman@hotmail.com; Mavili, Ertugrul, E-mail: ertmavili@yahoo.com [Erciyes University, Department of Radiology, Medical Faculty (Turkey)

    2012-08-15

    Purpose: To determine the effectiveness of percutaneous transhepatic removal of bile duct stones when the procedure of endoscopic therapy fails for reasons of anatomical anomalies or is rejected by the patient. Methods: Between April 2001 and May 2010, 261 patients (138 male patients and 123 female patients; age range, 14-92 years; mean age, 64.6 years) with bile duct stones (common bile duct [CBD] stones = 248 patients and hepatolithiasis = 13 patients) were included in the study. Percutaneous transhepatic cholangiography was performed, and stones were identified. Percutaneous transhepatic balloon dilation of the papilla of Vater was performed. Then stones were pushed out into the duodenum with a Fogarty balloon catheter. If the stone diameter was larger than 15 mm, then basket lithotripsy was performed before balloon dilation. Results: Overall success rate was 95.7%. The procedure was successful in 97.5% of patients with CBD stones and in 61.5% of patients with hepatolithiasis. A total of 18 major complications (6.8%), including cholangitis (n = 7), subcapsular biloma (n = 4), subcapsular hematoma (n = 1), subcapsular abscess (n = 1), bile peritonitis (n = 1), duodenal perforation (n = 1), CBD perforation (n = 1), gastroduodenal artery pseudoaneurysm (n = 1), and right hepatic artery transection (n = 1), were observed after the procedure. There was no mortality. Conclusion: Our experience suggests that percutaneous transhepatic stone expulsion into the duodenum through the papilla is an effective and safe approach in the nonoperative management of the bile duct stones. It is a feasible alternative to surgery when endoscopic extraction fails or is rejected by the patient.

  14. Percutaneous Transhepatic Removal of Bile Duct Stones: Results of 261 Patients

    International Nuclear Information System (INIS)

    Ozcan, Nevzat; Kahriman, Guven; Mavili, Ertugrul

    2012-01-01

    Purpose: To determine the effectiveness of percutaneous transhepatic removal of bile duct stones when the procedure of endoscopic therapy fails for reasons of anatomical anomalies or is rejected by the patient. Methods: Between April 2001 and May 2010, 261 patients (138 male patients and 123 female patients; age range, 14–92 years; mean age, 64.6 years) with bile duct stones (common bile duct [CBD] stones = 248 patients and hepatolithiasis = 13 patients) were included in the study. Percutaneous transhepatic cholangiography was performed, and stones were identified. Percutaneous transhepatic balloon dilation of the papilla of Vater was performed. Then stones were pushed out into the duodenum with a Fogarty balloon catheter. If the stone diameter was larger than 15 mm, then basket lithotripsy was performed before balloon dilation. Results: Overall success rate was 95.7%. The procedure was successful in 97.5% of patients with CBD stones and in 61.5% of patients with hepatolithiasis. A total of 18 major complications (6.8%), including cholangitis (n = 7), subcapsular biloma (n = 4), subcapsular hematoma (n = 1), subcapsular abscess (n = 1), bile peritonitis (n = 1), duodenal perforation (n = 1), CBD perforation (n = 1), gastroduodenal artery pseudoaneurysm (n = 1), and right hepatic artery transection (n = 1), were observed after the procedure. There was no mortality. Conclusion: Our experience suggests that percutaneous transhepatic stone expulsion into the duodenum through the papilla is an effective and safe approach in the nonoperative management of the bile duct stones. It is a feasible alternative to surgery when endoscopic extraction fails or is rejected by the patient.

  15. [Intraoperative choledochoscopy usefulness in the treatment of difficult biliary stones].

    Science.gov (United States)

    Cuendis-Velázquez, A; Rojano-Rodríguez, M E; Morales-Chávez, C E; González Angulo-Rocha, A; Fernández-Castro, E; Aguirre-Olmedo, I; Torres-Ruiz, M F; Orellana-Parra, J C; Cárdenas-Lailson, L E

    2014-01-01

    Choledocholithiasis presents in 5-10% of the patients with biliary lithiasis. Numerous treatment algorithms have been considered for this disease, however, up to 10% of these therapeutic procedures may fail. Intraoperative choledochoscopy has become a useful tool in the treatment of patients with difficult-to-manage choledocholithiasis. To determine the usefulness of intraoperative choledochoscopy in the laparoendoscopic treatment of difficult stones that was carried out in our service. A cross-sectional study was conducted. The case records were reviewed of the patients that underwent intraoperative choledochoscopy during biliary tree exploration plus laparoscopic choledochoduodenal anastomosis within the time frame of March 1, 2011 and May 31, 2012, at the Hospital General Dr. Manuel Gea González. Transabdominal choledochoscopies were performed with active stone extraction when necessary, followed by peroral choledochoscopies through the recently formed bilioenteric anastomosis. The data were analyzed with descriptive statistics and measures of central tendency. The mean age was 71 years, 57% of the patients were women, and the ASA III score predominated. Active extraction of stones with 7 to 35mm diameters was carried out in 4 of the cases and the absence of stones in the biliary tract was corroborated in all the patients. The mean surgery duration was 18 minutes (range: 4 to 45min). Choledochoscopy is a safe and effective minimally invasive procedure for the definitive treatment of difficult stones. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  16. Natural radioactivity of Turkish natural stones as building materials

    International Nuclear Information System (INIS)

    Yaprak, Guenseli; Yasar, Oezden

    2008-01-01

    Full text: The Turkey has very important natural stones potential with over 5 billion m 3 marble reserves. According to 2002 giving data the number of Turkish stones export is 303 million US Dollars. In this regards, the present study deals with 90 Turkish natural stones. The studied samples were analyzed and the concentrations in Bq/kg dry weight of radioisotopes were determined by gamma-ray spectrometry using HPGe detector. The radon exhalation rates of natural stones were also measured by using solid state nuclear track detectors (LR-115 ). The radium equivalent activity varied from 183 Bq/kg to 522 Bq/kg for granite samples and from 1 Bq/kg to 37 Bq/kg for marble samples. The value of radon exhalation rate ranged from 0.003 Bq/m 2 h -1 to 0.768 Bq/m 2 h -1 for granite samples and from 0.001 Bq/m 2 h -1 to 0.02 Bq/m 2 h -1 for marble samples. The total absorbed dose rates in air ranged from 22 to 61 n Gy h -1 for one quarter utilization of granite samples. The annual effective dose rates per person indoors were determined to be between 108 and 298 μSv y -1 for of for one quarter utilization of the materials. Applying the dose criteria recently recommended by UNSCEAR for building materials, the natural stones meet the upper dose limit of 1mSvy -1 . So, there are not restrictions for use of any Turkish commercial marble as covering materials, including Turkish granites. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Usefulness of Early Extracorporeal Shock Wave Lithotripsy in Colic Patients with Ureteral Stones

    Science.gov (United States)

    Choi, Hyeung Joon; Jung, Jin-Hee; Bae, Jungbum; Cho, Min Chul; Lee, Hae Won

    2012-01-01

    Purpose To compare efficacy and safety between early extracorporeal shock wave lithotripsy (eESWL) and deferred ESWL (dESWL) in colic patients with ureteral stones and to investigate whether eESWL can play a critical role in improving treatment outcomes. Materials and Methods A total of 279 patients who underwent ESWL for single radio-opaque ureteral stones of 5 to 20 mm in size were included in this retrospective study. The patients were categorized into two groups according to the time between the onset of colic and ESWL: eESWL (ESWL sessions and less time to achieve stone-free status than did the dESWL group. For 241 patients with stones ESWL complication rates were comparable between the two groups. In the multivariate analysis, smaller stone size and a time to ESWL of <48 hours were independent predictors of success. Conclusions Our data suggest that eESWL in colic patients with ureteral stones is an effective and safe treatment with accelerated stone clearance. PMID:23301130

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

    Directory of Open Access Journals (Sweden)

    Yii-Her Chou

    2012-06-01

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

  20. The Meteoritical Quincentennial: The Stone of Ensisheim 1492-1992

    Science.gov (United States)

    Marvin, U. B.

    1992-07-01

    This year marks the 500th anniversary of the fall of a meteorite at Ensisheim in Alsace. In at least two respects this event is unique in the history of meteoritics. First, this was the earliest witnessed meteorite fall in the West from which pieces are preserved. Second, it is the only meteorite of which a continuous five-century public record exists in manuscripts and books. Beginning with newsheets printed in 1492, writings about this event illuminate the evolution of ideas from a 15th century belief that stones from the sky were of miraculous origin, to an 18th century conviction that stones do not fall from the sky, to our present view that they fall in abundance, originating in interplanetary space (Marvin, 1992). This paper will highlight certain previously unexamined aspects of the story and address problems inherent in historical analysis. Unusable Maps. The fall of the stone was heralded by an explosion which, according to Sebastian Brant (1492), was heard along the valleys of the Danube, Neckar, Aare, Ill, and Rhine and in the alpine cantons of Schwyz and Uri. Contemporary maps, such as that published in The Nuremberg Chronicle of 1493, so distorted the regional geography that a fireball trajectory cannot be reconstructed on them. On modern maps, however, the areas Brant listed stretch about 150 km to the southeast of Ensisheim, a distance well within the range of sounds reported from other exploding fireballs. Newton (1891) and Marvin (1992) worked out possible trajectories that could account for the sound being heard in all named localities. This suggests that, far from exaggerating distances for dramatic effect, Brant's description may well have been accurate. If so, he compiled his information from word-of-mouth reports without reference to the rudimentary maps available in his time. The Language of Wonder. A document mounted beside the stone in the Ensisheim church stated that learned men did not know what it was: it must be supernatural, a wonder

  1. 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.

  2. 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......, 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...... 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....

  3. 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...... the respondents and interviewees are engaged with a prototype design that encompasses digitally enhanced experiences and interactions regarding mourning, memory and remembrance. The design is situated in a traditional public place of death, the Almen Cemetery of Aalborg in Denmark....

  4. The impact of erosion protection by Stone Dams on Salt-Marsh vegetation on Two Wadden Sea Barrier Islands

    NARCIS (Netherlands)

    Loon-Steensma, van J.M.; Slim, P.A.

    2013-01-01

    This paper describes and quantifies the effect of low stone dams on the extent and composition of salt-marsh habitats on two Dutch Wadden islands: Terschelling and Ameland. The stone dams were built to prevent erosion of the salt-marsh edge. Analyses of a series of aerial photographs taken between

  5. In vitro head-to-head comparison of the durability, versatility and efficacy of the NGage and novel Dakota stone retrieval baskets.

    Science.gov (United States)

    Bechis, Seth K; Abbott, Joel E; Sur, Roger L

    2017-12-01

    To compare head to head two end-engaging nitinol stone retrieval devices available to urologists, in terms of durability, versatility and efficacy. For durability testing, 30 NGage and Dakota baskets were cycled 20 times between grasping and releasing synthetic stone models and evaluated for damage or device failure. For versatility and efficacy testing, baskets were assessed in their ability to capture and release stone models from 1 to 11 mm. Each stone was raised above the capture site and the basket was opened to passively release the stone. If the stone did not release, the basket handle was shaken and the OpenSure feature employed if needed. Manual release was used as a last resort. Durability-the Cook NGage demonstrated a statistically significant increased rate of visible device breakdown (P=0.0046) in 8 of 30 (26.7%) devices vs. 0 of 30 Dakota devices, with mean damage at 13.5 cycles. Versatility and efficacy-both 8 mm baskets successfully captured stones from 1-8 mm. The Dakota more effectively released 7-8 mm stones (PDakota. For 11 mm baskets, the Dakota released all stones up to 10 mm with simple opening, while the NGage released 10 of 15 (67%) of 9 mm stones and 1 of 15 (7%) of 10 mm stones by simple opening. For 11 mm stones, the Dakota captured 100% whereas NGage could not capture any. Both baskets showed similar durability characteristics. The Dakota basket more effectively captured and released stones over 7 mm, as compared to the NGage basket. The OpenSure aspect conferred an advantage in handling and release of larger stones. These in vitro results demonstrate potential versatility, durability and efficacy of the Dakota basket.

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

    DEFF Research Database (Denmark)

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

    1996-01-01

    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...

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

    African Journals Online (AJOL)

    shanker

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  9. A comparison of nifedipine and tamsulosin as medical expulsive therapy for the management of lower ureteral stones without ESWL

    Science.gov (United States)

    Cao, Dehong; Yang, Lu; Liu, Liangren; Yuan, Haichao; Qian, Shenqiang; Lv, Xiao; Han, Pin; Wei, Qiang

    2014-01-01

    Administration of nifedipine or tamsulosin has been suggested to augment stone expulsion rates. We aimed to compare the stone expulsion rates and adverse effects associated with the use of nifedipine or tamsulosin as medical expulsive therapy (MET) for the management of lower ureteral stones (LUS) without extracorporeal shock wave lithotripsy (ESWL) via a literature review and meta-analysis. Relevant randomized controlled trials (RCTs) were identified from the Medline, EMBASE, Cochrane CENTRAL, and Google Scholar databases. Finally, a total of 7 RCTs with 3897 patients were included. Our meta-analysis showed that tamsulosin could significantly increase the stone expulsion rate relative to nifedipine in patients with LUS (random-effects model; risk ratio [RR] = 0.81; 95% confidence interval [CI] = 0.75–0.88; P tamsulosin was more effective than nifedipine in patients with LUS, as evidenced by the higher stone expulsion rate. Tamsulosin treatment should therefore be considered for patients with LUS. PMID:24919112

  10. Digitization of simulated clinical dental impressions: virtual three-dimensional analysis of exactness.

    Science.gov (United States)

    Persson, Anna S K; Odén, Agneta; Andersson, Matts; Sandborgh-Englund, Gunilla

    2009-07-01

    To compare the exactness of simulated clinical impressions and stone replicas of crown preparations, using digitization and virtual three-dimensional analysis. Three master dies (mandibular incisor, canine and molar) were prepared for full crowns, mounted in full dental arches in a plane line articulator. Eight impressions were taken using an experimental monophase vinyl polysiloxane-based material. Stone replicas were poured in type IV stone (Vel-Mix Stone; Kerr). The master dies and the stone replicas were digitized in a touch-probe scanner (Procera) Forte; Nobel Biocare AB) and the impressions in a laser scanner (D250, 3Shape A/S), to create virtual models. The resulting point-clouds from the digitization of the master dies were used as CAD-Reference-Models (CRM). Discrepancies between the points in the pointclouds and the corresponding CRM were measured by a matching-software (CopyCAD 6.504 SP2; Delcam Plc). The distribution of the discrepancies was analyzed and depicted on color-difference maps. The discrepancies of the digitized impressions and the stone replicas compared to the CRM were of similar size with a mean+/-SD within 40microm, with the exception of two of the digitized molar impressions. The precision of the digitized impressions and stone replicas did not differ significantly (F=4.2; p=0.053). However, the shape affected the digitization (F=5.4; p=0.013) and the interaction effect of shape and digitization source (impression or stone replica) was pronounced (F=28; pimpressions varied with shape. Both impressions and stone replicas can be digitized repeatedly with a high reliability.

  11. Introduction. Leave no stone unturned: Perspectives on ground stone artefact research

    OpenAIRE

    Danny Rosenberg; Yorke Rowan; Tatjana Gluhak

    2016-01-01

    Ground stone tools served in many physical and social contexts through millennia, reflecting a wide variety of functions. Although ground stone tool studies were neglected for much of early archaeology, the last few decades witnessed a notable international uptick in the way archaeologists confront this multifaceted topic. Today, with the advance of archaeology as a discipline, research into ground stone artefacts is moving into a new phase that integrates high resolution documentation with n...

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  13. 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

  14. Clinical effects of Bofutsushosan to obese patients

    International Nuclear Information System (INIS)

    Shintani, Takahiro; Tahara, Eiichi; Moriyama, Kenzou; Nakao, Kikuyo; Takaya, Yutaka; Amatsu, Akinori; Izutani, Satoru; Tsukioka, Yasuyuki; Sowa, Tomoko

    2007-01-01

    Performed was a clinical open trial to examine the anti-obesity effect of Bofutsushosan, a Japanese OTC, oriental herbal medicine (ROHTO Pharma. Co., Ltd.) used for constipation release. Subjects were 40-65 years old, 20 females with the body mass index 25-35, who t.i.d. ingested 3 tablets of the medicine, which corresponding to 3.0 g of dried extract of the Bofutsusho material per day, for 6 months (Sep. 2006-Feb. 2007). Before, 3 and 6 months after the beginning of the study, CT imaging was done to measure the fat areas on umbilical cross section for efficacy evaluation, with Siemens SOMATOM Sensation 16. Total, subcutaneous and inter-visceral fat areas were found to be significantly reduced by medication as well as improvement in other body-measure, hematological and biochemical parameters related with obesity and metabolism. No significant adverse effects were found. The medicine can be useful for improvement of the so-called metabolic syndrome not only for obesity and constipation. (R.T.)

  15. Production and characterization of composite stone

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  16. Robust Detection of Stepping-Stone Attacks

    National Research Council Canada - National Science Library

    He, Ting; Tong, Lang

    2006-01-01

    The detection of encrypted stepping-stone attack is considered. Besides encryption and padding, the attacker is capable of inserting chaff packets and perturbing packet timing and transmission order...

  17. 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

  18. Comparative efficacy of tamsulosin versus tadalafil as medical expulsive therapy for distal ureteric stones.

    Science.gov (United States)

    Goyal, Suresh Kumar; Singh, Vikash; Pandey, Himanshu; Chhabra, Mahaveer Kumar; Aggarwal, Satinder Pal; Bhat, Amilal

    2018-01-01

    The objective of this study was to compare the relative efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteric stones. This was a prospective study performed between December 2014 and February 2016. A total of 123 adult patients (>18 years of age) presenting with distal ureteric stones sized 6-10 mm were randomized to treatment with tamsulosin 0.4 mg once daily (Group A) or tadalafil10 mg once daily (Group B). Therapy was given for a maximum of 4 weeks. The stone expulsion rate was the primary endpoint. Time to stone expulsion, number of colic episodes, analgesic use, number of hospital visits for pain, endoscopic treatment, and adverse effects of the drugs were noted. Statistical analyses were done using Fisher's exact test and Chi-square test. A total of 61 patients were included in tamsulosin group and 62 patients in tadalafil group. A statistically insignificant difference was found for stone clearance rate between both groups as a whole (Group A-73.77%, Group B-69.35%, P = 0.690) as well as when we considered both subgroups (A1-78.05%, B1-75.0%, P = 0.802; A2-65.0%, B2-55.6%, P = 0.741). All the primary and secondary outcome measures were more in favour of stones ≤8 mm size than stones >8 mm size. No statistical difference was found for adverse drug effects except for retrograde ejaculation, which was significantly high in tamsulosin group ( P tamsulosin is more effective for stone clearance than tadalafil, but this difference was not significant ( P = 0.690).

  19. 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.

  20. 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.

  1. Use of the Escape nitinol stone retrieval basket facilitates fragmentation and extraction of ureteral and renal calculi: a pilot study.

    Science.gov (United States)

    Kesler, Stuart S; Pierre, Sean A; Brison, Daniel I; Preminger, Glenn M; Munver, Ravi

    2008-06-01

    Advances in ureteroscope and stone basket design have catapulted ureteroscopy to the forefront of surgical stone management; however, persistent problems such as stone migration continue to challenge urologists. The Escape nitinol stone retrieval basket (Boston Scientific, Natick, MA) is a stone basket designed to capture calculi and facilitate simultaneous laser lithotripsy in situ. We report our initial experience with the Escape basket for the management of urinary calculi and compare the use of this device with other methods of optimizing ureteroscopic stone management. A prospective evaluation of 23 patients undergoing ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy of urinary calculi was performed at two institutions by two surgeons (R.M. and G.M.P). The Escape basket was used to prevent retrograde ureteral stone migration or to facilitate fragmentation and extraction of large renal calculi. Patient demographics and perioperative parameters were assessed. Twenty-three patients (16 men, 7 women), with a mean age of 55.5 years (range 33-74 yrs) were treated for renal (n = 9) or ureteral (n = 14) calculi. The mean stone diameter was 1.4 cm (range 0.4-2.5 cm), mean fragmentation time was 44.1 minutes (range 10-75 min), and mean energy used was 3.1 kJ (range 0.4-10.6 kJ). No complications were encountered. Eighty-seven percent (20/23) of patients were rendered completely stone free after ureteroscopic laser lithotripsy using the Escape basket. Of the three patients with residual calculi, one patient with a 2.5-cm renal calculus had residual fragments larger than 3 mm, and two patients with large renal calculi had residual fragments smaller than 3 mm. The Escape basket appears to be safe and effective in preventing stone migration and facilitating ureteroscopic laser lithotripsy and stone extraction.

  2. Early occupational hearing loss of workers in a stone crushing industry: Our experience in a developing country

    Directory of Open Access Journals (Sweden)

    Emmanuel D Kitcher

    2012-01-01

    Full Text Available Noise-induced hearing loss (NIHL is an irreversible sensorineural hearing loss associated with exposure to high levels of excessive noise. This paper aims to assess the prevalence of early NIHL and the awareness of the effects of noise on health among stone crushing industry workers. This was a comparative cross-sectional study in Ghana of 140 workers from the stone crushing industry compared with a control group of 150 health workers. The stone workers and controls were evaluated using a structured questionnaire, which assessed symptoms of hearing loss, tinnitus, knowledge on the health hazards associated with work in noisy environment and the use of hearing protective device. Pure tone audiometric assessment was carried out for stone workers and controls. Noise levels at the work stations of the stone workers and of the controls were measured. Statistical Analysis of data was carried out using SPSS package version 16. The mean age of stone workers and controls was 42.58±7.85 and 42.19±12 years, respectively. Subjective hearing loss occurred in 21.5% of the workers and in 2.8% of the controls. Tinnitus occurred in 26.9% of stone workers and 21.5% of controls, while 87.5% stone workers had sound knowledge on the health hazards of a noisy environment. Early NIHL in the left ear occurred in 19.3% of the stone workers compared with 0.7% in controls and in the right ear, it occurred in 14.3% of the stone workers and in 1.3% of the controls; P<0.005. In conclusion, the prevalence rate of early NIHL among stone crushing workers is about 19.3% for the left ear and 14.3% for the right ear.

  3. Daily Cycle of Air Temperature and Surface Temperature in Stone Forest

    Science.gov (United States)

    Wang, K.; Li, Y.; Wang, X.; Yuan, M.

    2013-12-01

    Urbanization is one of the most profound human activities that impact on climate change. In cities, where are highly artificial areas, the conflict between human activity and natural climate is particularly prominent. Urban areas always have the larger area of impervious land, the higher consumption of greenhouse gases, more emissions of anthropogenic heat and air pollution, all contribute to the urban warming phenomena. Understanding the mechanisms causing a variety of phenomena involved in the urban warming is critical to distinguish the anthropogenic effect and natural variation in the climate change. However, the exact dynamics of urban warming were poorly understood, and effective control strategies are not available. Here we present a study of the daily cycle of air temperature and surface temperature in Stone Forest. The specific heat of the stones in the Stone Forest and concrete of the man-made structures within the cities are approximate. Besides, the height of the Stone Forest and the height of buildings within the city are also similar. As a scenic area, the Stone Forest is being preserved and only opened for sightseeing. There is no anthropogenic heat, as well air pollution within the Stone Forest. The thermal environment in Stone Forest can be considered to be a simulation of thermal environment in the city, which can reveal the effect of man-made structures on urban thermal environment. We conducted the field studies and numerical analysis in the Stone Forest for 4 typical urban morphology and environment scenarios, including high-rise compact cities, low-rise sparse cities, garden cities and isolated single stone. Air temperature and relative humidity were measured every half an hour in 15 different locations, which within different spatial distribution of stones and can represent the four urban scenarios respectively. At the same time, an infrared camera was used to take thermal images and get the hourly surface temperatures of stones and

  4. 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.

  5. Geomorphology's role in the study of weathering of cultural stone

    Science.gov (United States)

    Pope, Gregory A.; Meierding, Thomas C.; Paradise, Thomas R.

    2002-10-01

    Great monumental places—Petra, Giza, Angkor, Stonehenge, Tikal, Macchu Picchu, Rapa Nui, to name a few—are links to our cultural past. They evoke a sense of wonderment for their aesthetic fascination if not for their seeming permanence over both cultural and physical landscapes. However, as with natural landforms, human constructs are subject to weathering and erosion. Indeed, many of our cultural resources suffer from serious deterioration, some natural, some enhanced by human impact. Groups from the United Nations to local civic and tourism assemblies are deeply interested in maintaining and preserving such cultural resources, from simple rock art to great temples. Geomorphologists trained in interacting systems, process and response to thresholds, rates of change over time, and spatial variation of weathering processes and effects are able to offer insight into how deterioration occurs and what can be done to ameliorate the impact. Review of recent literature and case studies presented here demonstrate methodological and theoretical advances that have resulted from the study of cultural stone weathering. Because the stone was carved at a known date to a "baseline" or zero-datum level, some of the simplest methods (e.g., assessing surface weathering features or measuring surface recession in the field) provide useful data on weathering rates and processes. Such data are difficult or impossible to obtain in "natural" settings. Cultural stone weathering studies demonstrate the importance of biotic and saline weathering agents and the significance of weathering factors such as exposure (microclimate) and human impact. More sophisticated methods confirm these observations, but also reveal discrepancies between field and laboratory studies. This brings up two important caveats for conservators and geomorphologists. For the conservator, are laboratory and natural setting studies really analogous and useful for assessing stone damage? For the geomorphologist, does

  6. Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience.

    Science.gov (United States)

    Sanguedolce, Francesco; Breda, Alberto; Millan, Felix; Brehmer, Marianne; Knoll, Thomas; Liatsikos, Evangelos; Osther, Palle; Traxer, Olivier; Scoffone, Cesare

    2013-12-01

    To assess efficacy and safety of prone- and supine percutaneous nephrolithotomy (PCNL) for the treatment of lower pole kidney stones. Data from patients affected by lower pole kidney stones and treated with PCNL between December 2005 and August 2010 were collected retrospectively by seven referral centres. Variables analysed included patient demographics, clinical and surgical characteristics, stone-free rates (SFR) and complications. Statistical analysis was conducted to compare the differences for SFRs and complication rates between prone- and supine PCNL. One hundred seventeen patients underwent PCNL (mean stone size: 19.5 mm) for stones harboured only in the lower renal pole (single stone: 53.6%; multiple stones: 46.4%). A higher proportion of patients with ASA score ≥ 3 and harbouring multiple lower pole stones were treated with supine PCNL (5.8 vs. 23.1%; p = 0.0001, and 25 vs. 81.5%; p = 0.0001, respectively, for prone- and supine PCNL). One-month SFR was 88.9%; an auxiliary procedure was needed in 6 patients; the 3-month SFR was 90.2%. There were 9 post-operative major complications (7.7%). No differences were observed in terms of 1- and 3-month SFRs (90.4 vs. 87.7%; p = 0.64; 92.3 vs. 89.2%; p = 0.4) and complication rates (7.6 vs. 7.7%; p = 0.83) when comparing prone- versus supine PCNL, respectively. The results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, regardless the position used. Supine PCNL was more frequently offered in case of patients at higher ASA score and in case of multiple lower pole stones.

  7. Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones?

    Science.gov (United States)

    Lim, Ki Hong; Jung, Jin-Hee; Kwon, Jae Hyun; Lee, Yong Seok; Bae, Jungbum; Cho, Min Chu