scholarly journals Treatment of Moderate-sized Kidney Stone with Third-generation Electromagnetic Shock Wave Lithotripter

2020 ◽  
Vol 8 (B) ◽  
pp. 851-857
Author(s):  
Ivica Stojanoski ◽  
Toni Krstev ◽  
Lazar Iievski ◽  
Nerhim Tufekgioski ◽  
Sotir Stavridis
Keyword(s):  
Shock Wave ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Renal Stones ◽  
Third Generation ◽  
Treatment Rate ◽  
Moderate Size ◽  
Non Invasive ◽  
Invasive Method ◽  
The Mean

BACKGROUND: The extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method in the treatment of urinary tract stones and its discovery has led to a complete change in the therapeutic strategy for urolithiasis. Due to the low morbidity and excellent fragmentation of the stones, ESWL has proven to be an effective and non-invasive method in the treatment of renal stones. AIM: The aim of this retrospective study is to evaluate the efficacy and safety of the ESWL as a monotherapy in the treatment of moderate size kidney stones with stone area (SA) of 100–300 mm². MATERIALS AND METHODS: We made a retrospective study of 98 patients with moderate size kidney stones with SA of 100–300 mm², divided into two subgroups, into a group with a SA of 100–200 mm² and with 200–300 mm², treated with ESWL in the period of November 2018–December 2019. The patients were treated with a third-generation electromagnetic lithotripter (Lithoskop®, Siemens Medical Systems, Erlangen, Germany), with a source of electromagnetic shocks (Pulso™) and dual ultrasonographic/fluoroscopic system for detection of the stones. The stone location, size, maximum energy used, localization technique, number of shock waves, sessions, re-treatment rate, and additional procedures were reviewed. All the patients before the intervention had a complete laboratory and radiological examinations. Postoperatively, patients were monitored on the 1st, 30th, and 90th post-operative days. RESULTS: Ninety-eight patients with solitary kidney stone with a SA of 100–300 mm² were treated with ESWL. The study included 58 men (59.18%) and 44 women (40.81%). The average length and width of the stone were 15.47 ± 2.68 mm and 12.99 ± 2.83 mm, respectively. The average surface area of the stones in our series was 203.78 ± 72.85 mm². The mean number of treatments for the entire series of patients was 1.82 ± 0.91. The mean number of shock waves for the total series of patients was 3899.11 ± 40. The mean energy used for the overall patient series was 110106.17 ± 21489.61 mJ. The total re-treatment rate was 47.95%. The entire rate of additional procedures was 19.38%. The overall success rate (SR) in our study was 77.55%. The efficiency quotient for the upper-middle and lower calyx was 55.57, 57.15, and 30.81, respectively. CONCLUSION: ESWL is a safe and effective method in the treatment of renal stones, and we recommend as the first method in the treatment of moderate size kidney stone with a surface area of 100–300 mm². The treatment of each patient should be individualized and take into account all favored and non-favored factors that influence the decision to choose extracorporeal lithotripsy as a method of treatment of medium-sized stones.

scholarly journals Outcome of Extracorporeal Shock Wave Lithotripsy in Western Region of Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 3-6 ◽  
Author(s):  
P Ghimire ◽  
N Yogi ◽  
GB Acharya
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Renal Stones ◽  
Successful Outcome ◽  
Stone Size ◽  
Non Invasive ◽  
Extracorporeal Shock Wave ◽  
Urinary Tract Stones ◽  
Invasive Method

Background: Extracorporeal shock wave lithotripsy (ESWL) is an effective non-invasive method for management of urinary tract stones. It was introduced for the first time in Pokhara 1 year back. This study aims to study the efficacy of ESWL in removal of renal and ureteric calculus in relation to the stone size and location and potential adverse effect of the procedure. Methods: It is a prospective observational study carried out in 112 cases undergoing elective ESWL for solitary urolithiasis during a period of 1 year (August 2010- August 2011). Number of sessions required for successful fragmentation and clearance of stones were studied according to their size and position along with the complications encountered. Results: The success rate of ESWL was found to be 91.1% for solitary urolithiasis. The mean number of sessions required for success was found to increase according to increase in size of the stones whereas it was almost similar for various locations. Complications were encountered in 25% of cases. Conclusion: Stone size was found to be the most important predictor in successful outcome of ESWL and the procedure is quite favorable for stones less than 20 mm. Keywords: ESWL; renal stones; ureteric stones DOI: http://dx.doi.org/10.3126/njms.v1i1.5787   Nepal Journal of Medical Sciences. 2012; 1(1): 3-6

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

scholarly journals Mid-stream clean catch urine collection in newborns: a non-invasive and safe technique

2019 ◽  
Vol 6 (2) ◽  
pp. 349 ◽  
Author(s):  
Rajendra Kumar ◽  
Nithin . ◽  
Sudha Rudrappa
Keyword(s):  
Success Rate ◽  
Urine Sample ◽  
Invasive Technique ◽  
Urine Collection ◽  
Non Invasive ◽  
Invasive Method ◽  
Safe Technique ◽  
The Mean ◽  
Invasive Techniques ◽  
Mean Time

Background: The aim of this study is to determine the success rate and safety of a non-invasive technique to obtain clean-catch midstream urine samples in newborns.Methods: Prospective bedside clinical study. After obtaining written informed consent,120 consecutive newborns admitted in NICU with no dehydration, poor feeding, need for immediate urine sample by invasive method  for whom urine collection was advised for various reasons who met the inclusion criteria were included in the study with consent being taken from the parents. After adequate milk intake supra pubic and lumbar para vertebral areas were stimulated in repeated cycles of 30 s until micturition began.Results: Success rate in obtaining a midstream urine sample within 5 min. The success rate was 90%. The mean time taken to collect urine was 64.24s, for males it was 62.55s and for females 65.93s.Conclusions: The technique has been demonstrated to be safe, quick and effective. The discomfort and time consumption usually associated with bag collection methods as well as invasive techniques can be avoided.

Testicular responsiveness to hCG during infancy measured by salivary testosterone

1990 ◽  
Vol 123 (6) ◽  
pp. 633-636 ◽  
Author(s):  
Leo Dunkel ◽  
Ilpo Huhtaniemi
Keyword(s):  
Serum Testosterone ◽  
Maximal Level ◽  
Salivary Testosterone ◽  
Non Invasive ◽  
Basal Serum ◽  
Age Related ◽  
Invasive Method ◽  
Prepubertal Boys ◽  
The Mean

Abstract. To investigate the role of gonadotropins in postnatal testicular activation, testosterone responsiveness to human chorionic gonadotropin was studied in 11 male infants (aged 5-180 days). The boys were given a single im injection of 5000 IU/1.7m2 hCG, and serum and salivary testosterone responses were then measured for 7 days. The results were compared with the serum testosterone responses of 8 older prepubertal boys (aged 1.7-10.4 years) studied with the same protocol. The mean (±sem) basal serum testosterone levels were 2.67±1.27 nmol/l in the infants and 0.09±0.02 nmol/l in the prepubertal boys (p<0.05). Both groups gave a significant response to hCG stimulation (p<0.001, ANOVA, one-way). The stimulated concentrations of serum testosterone were higher in the infants than in the prepubertal boys (p<0.001). The mean basal level of salivary testosterone was 30.5 ±7.0 and the mean maximal level was 97± 10.3 pmol/l in the infants (p<0.001). No age-related changes were observed in either basal or hCG-stimulated levels. In infants the mean (±sem) maximal hCG-stimulated increase was 25 ± 10-fold in serum and 8±4-fold in saliva (p=0.13). A clear stimulatory effect of hCG on testicular testosterone production was found, suggesting that the postnatal increase in serum testosterone concentration in male infants is gonadotropin-mediated. Salivary testosterone concentrations can be increased by hCG, indicating that measurements of salivary testosterone may provide an optional, non-invasive method for assessing gonadal function in children.

Acetabular component migration in total HIP arthroplasty using CT and a semiautomated program for volume merging

2002 ◽  
Vol 43 (5) ◽  
pp. 517-527 ◽  
Author(s):  
L. Olivecrona ◽  
J. Crafoord ◽  
H. Olivecrona ◽  
M. E. Noz ◽  
G. Q. Maguire ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Plain Radiography ◽  
Acetabular Cup ◽  
Visual Evaluation ◽  
Total Hip ◽  
Non Invasive ◽  
Invasive Method ◽  
The Mean ◽  
Component Migration

Purpose: To develop a non-invasive method for detection of acetabular cup migration after total hip arthroplasty (THA) with a higher degree of accuracy than routine plain radiography. Material and Methods: Two CT examinations, 10 min apart, were obtained from each of 10 patients that had undergone THA. Using an in-house developed semiautomated program for volume merging, the pelves in the two examinations were fused and the acetabular cup was visually and numerically evaluated to test the method's accuracy in detecting migration. Results: In the visual evaluation of the best match a 1-mm translation of the cup was detectable. The numerical evaluation, comparing landmarks placed in the images of the acetabular cup and the head of the femur component in the two examinations, showed the mean difference in orientation of acetabular axes to be 2.5°, the mean distance between centre of cup face to be 2.5 mm and the mean distance between centre of the head of the prosthetic femoral component to be 1 mm. Conclusion: This method has a significantly higher accuracy than routine plain radiography in detecting acetabular cup migration and could be used in clinical practice. It gives both a visual and a numerical correlate to migration.

scholarly journals Assessment the Adherence of Radiologists to the Thyroid Imaging Reporting and Data System (TIRADS)

2021 ◽  
Author(s):  
Fariba Zarei ◽  
Mohammad Reza Sasani ◽  
Banafsheh Zeinali Rafsanjani ◽  
Mahdi Saeedi Moghadam
Keyword(s):  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Data System ◽  
Fars Province ◽  
Non Invasive ◽  
Thyroid Imaging ◽  
Invasive Method ◽  
The Mean ◽  
Echogenic Foci

Introduction: Thyroid nodules are the most common findings among adults. Usually, Fine Needle Aspiration Biopsy (FNAB) can be used to distinguish the malignant and benign lesions. Application of a non-invasive method for determining the chance of malignancy in a nodule is desirable. Thyroid Imaging Reporting and Data System (TIRADS) was introduced to decrease the unnecessary FNABs and to optimize the management of these patients. The objective of this study was to assess the adherence of radiologist’s reports to TIRADS, after 10 years from the introduction of this system to radiologists in Fars Province. Methods: In this retrospective study, sonography report of the patients, who were referred to hospital for FNAB was assessed. If the patients did not have the previous sonography reports or the report was unreadable, they would be excluded from the study. Composition, echogenicity, shape, size, and margin were assessed and scored in this study. As the reports noted to each of the above-mentioned issues, score 1 was assigned to them. SPSS version 15 was used to analyze the data and calculated the standard deviation. Results: Sonography reports of 111 out of 250 patients was evaluated. The mean score of sonography reports from 5 was 2.63±0.86. The percentage of adherence of sonography reports to the expression of the first five categories was 52.61±17.25 %. Echogenic foci were also evaluated in the patients that it existed. The radiologists were reported them in almost 81% of cases. Conclusion: Overall adherence of sonographic report to TIRADS was 57.34%. The adherence can be definitely improved by training the radiologists.

Dynamics of bubbles near a rigid surface subjected to a lithotripter shock wave. Part 1. Consequences of interference between incident and reflected waves

2008 ◽  
Vol 616 ◽  
pp. 43-61 ◽  
Author(s):  
J. I. ILORETA ◽  
N. M. FUNG ◽  
A. J. SZERI
Keyword(s):  
Shock Wave ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Reflection Coefficients ◽  
Destructive Interference ◽  
Rigid Surface ◽  
Reflected Waves ◽  
The Face ◽  
Work Done ◽  
Cavitation Activity

In this paper we consider the dynamics of bubbles near a kidney stone subjected to a lithotripter shock wave. We address the effect of kidney stone geometry and composition on the cavitation potential near the stone in a shock wave lithotripter. The analysis is based on the previously developed work metric in which the work done on a bubble by the lithotripter shock wave (LSW) is used to determine the maximum radius the bubble achieves. Results of the reflection of the LSW from cylindrical kidney stones with proximal surfaces of varying geometry show that the presence of the stone enhances bubble growth near the stone and decreases growth further away, owing to constructive and destructive interference, respectively. These effects hold true regardless of the shape and curvature of the face, and are strongest for stones with concave faces and higher reflection coefficients. A consequence of the analysis is an elucidation of the mechanism for enhanced cavitation activity and creation of deep craters on the proximal side of a kidney stone, as have been observed in recent experiments.

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