BACKGROUND AND PURPOSE: The surgical treatment of kidney and proximal ureteral stones in morbidly obese patients (>14 kg/m2) remains difficult because shockwave lithotripsy is precluded by weight limitations and percutaneous nephrolithotomy is associated with difficult access and a high (9%) rate of transfusion. We review our experience with retrograde ureteroscopic ...

STUDY OBJECTIVES: The study evaluated the impact of the additional imposed work of breathing (WBimp) generated by two different spirometers on postoperative incentive spirometry performance in patients at high risk and moderate risk for postoperative pulmonary complications (PPCs). Additionally, we investigated whether maximal inspiratory pressure (PImax) is an easy estimate ...

We performed N-isopropyl-p (I-123) iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) on 28 patients with severe cerebrovascular disease before rehabilitation, and compared the degree of redistribution and the assessment of activities of daily living (ADL). We calculated a redistribution (RD) ratio in the central and peripheral parts of the lesions: ...

OBJECTIVES: To review our early experience with the use of a gastric segment for lower ureteral replacement in patients with bilateral ureteral stenosis after pelvic radiotherapy. METHODS: Four adult patients (three women and one man) underwent bilateral ureteral substitution using stomach. All patients received whole pelvic irradiation for malignant disease ...

The results of a hepaticojejunostomy as a biliary-enteric bypass for benign disease are usually excellent. On the other hand, hepatolithiasis features a high rate of residual and recurrent stones with cholangitis after surgery. This study aims to evaluate the long-term results of a hepaticojejunostomy for hepatolithiasis regarding both the degree ...

OBJECTIVES: Extracorporeal shock wave lithotripsy (ESWL) is effective and safe for the treatment of upper urinary tract calculi in adults. Some speculations concerning possible damages from ESWL on the growing kidney have been raised. METHODS: From January 1990 to December 1998, 64 children (30 girls and 34 boys; 8 months ...

PURPOSE: A prospective randomized controlled trial was performed to determine whether stents may be eliminated after uncomplicated ureteroscopic lithotripsy for ureteral stones. MATERIALS AND METHODS: A total of 58 patients underwent uncomplicated ureteroscopic intracorporeal lithotripsy. After stone fragmentation patients were randomized to a nonstented (29) or a stented (29) treatment ...

OBJECTIVE: Citric acid, in varying concentrations, has been used in the dissolution treatment of struvite renal calculi. Solution R (Uro-trainer), which contains 6% citric acid, is a solution licensed for use in the management of struvite stone disease in the UK. We report our experience. METHODS: 23 kidneys in 22 ...

AIM: We investigated the occurrence and thrombin generating mechanisms of circulating microparticles (MP) in patients with multiple organ dysfunction syndrome (MODS) and sepsis. METHODS: MP, isolated from blood of patients (n = 9) and healthy controls (n = 14), were stained with cell-specific monoclonal antibodies (MoAbs) or anti-tissue factor (anti-TF) ...

We determined the incidence of persistent back pain (PBP) after non-obstetrical spinal anaesthesia (SPA) and investigated factors predisposing to such pain in a prospective 1 yr follow-up study in 245 patients undergoing elective general or trauma surgery (218 patients undergoing single SPA, 27 undergoing two to six SPAs). All patients ...

PATIENTS AND METHODS: Between January 1996 and December 1999, 749 patients underwent electromagnetic SWL. Among them, 23 patients, 19 with renal and 4 with ureteral stones, were receiving antithrombotic drugs (aspirin, ticlopidine, dipyridamole). According to the cardiologist and hematologist, we divided these patients into two groups: Group 1 had a ...

The effect of the anti-marine-borer timber preservative chromated copper arsenate (CCA) (a pressure impregnated solution of copper, chromium and arsenic compounds) on non-target marine fouling animals was investigated during a subtidal exposure trial. Panels of Scots pine treated to target retentions of 12, 24 and 48 kg CCA per m-3 ...

OBJECTIVE: To evaluate our experience with percutaneous suprapubic cystolithotripsy (PCCL) in Yemeni children with endemic urinary bladder stones. PATIENTS AND METHODS: Between January 1993 and December 1998, 117 children underwent percutaneous suprapubic lithotripsy in Arabia Felix Modern Hospital, Sana'a Republic of Yemen. The patients' ages ranged from 8 months to ...

AIM: Despite the extensive experience with minimal invasive stone therapy, there are still different views on the ideal management of renal stones. MATERIALS AND METHODS: Analysis of the literature includes more than 14,000 patients. We have compared these data with long-term results of two major stone centers in Germany. The ...

<b>Introduction:</b> Renal stones with chronic renal failure (CRF) is a complex problem due to various inherent problems associated with CRP. Treating these stones is a challenge and therapy has to be tailored accordingly. Although there are many studies in the literature regarding the optimum management of staghorn stones with Percutaneous ...

BACKGROUND/AIMS: We compared the results of treatment of gallbladder stones by extracorporeal shock wave lithotripsy with dissolution during two periods to different criteria of indication. In the first period (1990-1991) we treated patients with stones up to 3 cm in diameter. In the second period (1992-1994) the indication included stones ...

BACKGROUND: Extracorporeal shock-wave lithotripsy (ESWL) is a treatment that preserves the gallbladder. Problems after ESWL treatment include stone recurrence and the development of biliary symptoms. METHODS: Two hundred and sixty-two patients with cholesterol-type gallstones, the best indication for ESWL treatment, and 42 control patients with cholesterol-type gallstones who received no ...

OBJECTIVE: To report a prospective, randomized study to determine whether prophylactic extracorporeal shockwave lithotripsy (ESWL) is justified as a treatment for small, asymptomatic calyceal stones. PATIENTS AND METHODS: The study included 228 patients with small (< 15 mm total diameter) asymptomatic calyceal stones; 113 patients were randomized to undergo ESWL ...

OBJECTIVE: To explore homicide trends for Wisconsin over the period 1985-1998 and assess the state's progress towards meeting its year 2000 health objectives. METHODS: Wisconsin and US homicide data from the Centers for Disease Control's Web-based Injury Statistics Query and Reporting System (WISQARS) were analyzed for the period 1985-1998. RESULTS: ...

Repeated sessions of unilateral extracorporeal shock wave lithotripsy (ESWL) were performed in a patient with multiple bilateral calycolithiasis who suffered from Crohn's disease of long duration and from recurrent gastric ulcers. To achieve complete clearance of stones from the left kidney it was necessary to apply 10,000 shock waves during ...

OBJECTIVE: Several studies reported increased blood pressure (BP) values following extracorporeal shock wave lithotripsy (ESWL) treatment of renal stones. It is unclear, however, whether this is due to ESWL, since nephrolithiasis itself increases the relative risk of developing hypertension. Therefore we prospectively studied the BPs of stone patients undergoing different ...

PURPOSE: We determined the number of shock wave lithotripsy treatments that should be given for a single ureteral stone before alternate modalities are used. MATERIALS AND METHODS: We compared the stone-free rate of initial shock wave lithotripsy for ureteral calculi with that of subsequent treatments. We evaluated 1,593 ureteral stones ...

OBJECTIVE: To test whether extracorporal shock wave therapy (ESWT) has an effect in the treatment of Peyronie's disease. METHODS: 22 patients with Peyronie's disease and previous unsuccessful oral drug therapy were treated with ESWT in a prospective design with a follow-up of at least 3 months; 23 age-matched patients without ...

The increasing popularity of 3-D planning leads to procedural alterations as both workload and resource utilization increase. Although the complexity of the techniques has increased (as well as the set-up and treatment times), the workload statistics must still include the number of fields treated. It is commonly known that machine ...

OBJECTIVE: To determine whether there is a significance of the choice of prone versus supine position in the treatment of proximal ureter stones with extracorporeal shock wave lithothripsy (ESWL). METHODS: Ninety-six patients with proximal ureter stones underwent ESWL. The procedure was performed in the supine position in 48 of them ...

BACKGROUND: The standard treatment for Mirizzi syndrome is surgical, although endoscopic and percutaneous management have also been described. The aim of this study was to evaluate the usefulness of shock wave lithotripsy combined with peroral cholangioscopy and its long-term outcome in patients with Mirizzi syndrome. METHODS: The records of 25 ...

Endoscopic lithotripsy is an essential part of the armamentarium at any complete stone treatment center. It is first-line therapy for complicated upper urinary tract calculi and for patients who fail primary extracorporeal shock wave lithotripsy. In the presented series, ureteroscopy is defined as a safe and particularly effective treatment for ...

Ninety-six patients treated successively for symptomatic cholelithiasis with extracorporeal shock wave lithotripsy (ESWL) and oral bile acid therapy consisting of ursodeoxycholic acid in daily dosages of 600 mg were prospectively followed for gallstone recurrence for a median of 13 months. Ultrasonography was performed to detect stone recurrence at 3, 6, ...

OBJECTIVES: To evaluate the effectiveness of medical therapy during watchful waiting in patients with distal ureter stones. METHODS: Ninety-six patients with radiopaque stones located in the distal tract of the ureter and with stone sizes of 1 cm or smaller were involved in the study. The patients were randomly divided ...

PURPOSE: The aim of this study is to report the initial experience with needlescopic surgery (2-mm optics and instrumentation exclusively) for the cryptorchid testicle. METHODS: Ten patients (age 8 months to 37 years) underwent 12 needlescopic procedures: orchiopexy (n = 8), orchiectomy (n = 2), and diagnostic exploration with attempted ...

BACKGROUND: When bile duct stones cannot be removed after sphincterotomy by balloon or basket extraction, stent placement can serve as a bridge to additional procedures. Biliary stents may also fragment large stones, allowing them to pass spontaneously or making them easier to extract at a later time. METHODS: Twenty patients ...

OBJECTIVE: To evaluate prospectively the efficacy of extracorporeal shock wave therapy (ESWT) as a conservative treatment for Peyronie's disease. PATIENTS AND METHODS: After obtaining ethical committee approval, 37 patients with Peyronie's disease were treated using ESWT. Before treatment the degree of angulation was assessed by artificially inducing an erection with ...

PURPOSE: The American Urological Association (AUA) published clinical guidelines for the treatment of ureteral calculi in adults and note that up to 98% of stones less than 5 mm. in diameter will pass spontaneously. Ureteroscopy and shock wave lithotripsy were acceptable treatment choices for stones less than 10 mm. in ...

PURPOSE: The Dornier MFL-5000* is a multifunctional lithotriptor unit that has been purported to be highly efficacious for treating stones. Our experience led us to believe that the actual success rates are not as high as those reported by others. We objectively reexamined the efficacy of this device and factors ...

Sudden immersion in cold water initiates an inspiratory gasp response followed by uncontrollable hyperventilation and tachycardia. It is known that this response, termed the "cold shock" response, can be attenuated following repeated immersion. In the present investigation we examined how long this habituation lasts. Twelve healthy male volunteers participated in ...

OBJECTIVES: The purpose of this study was to evaluate whether repair of the ureteropelvic junction (UPJ) obstruction reduces the incidence of stones in stone-forming patients with concurrent UPJ obstruction. METHODS: We performed a retrospective study evaluating 90 patients with UPJ obstruction who underwent endopyelotomy and simultaneous stone extraction (group A) ...

Acropora palmata, a branching coral abundant on shallow reef environments throughout the Caribbean, is susceptible to physical disturbance caused by storms. Accordingly, the survivorship and propagation of this species are tied to its capability to recover after fragmentation. Fragments of A. palmata comprised 40% of ramets within populations that had ...

PURPOSE: We reviewed our experience with retrograde endoscopy using a small caliber ureteroscope and a laser lithotriptor in 104 consecutive patients with impacted ureteral stones and also analyzed the associated endoscopic findings. MATERIALS AND METHODS: From July 1993 to October 1999 we performed retrograde endoscopic treatment in 104 patients with ...

BACKGROUND: Little information is available on the outcomes of endoscopic sphincterotomy for choledocholithiasis in patients of advanced age (>/=90 years). METHODS: Endoscopic sphincterotomy was performed for choledocholithiasis in 22 patients aged 90 years or more (group A) and 381 aged 70 to 89 years (group B). Clinical features and early ...

Not only is the diagnosis of isolated premature thelarche difficult to distinguish from other variants of premature sexual maturation, but within the subgroups of isolated premature thelarche, there are probably at least two subgroups: "classical" and "atypical". We do not appreciate how potential treatment could affect each group, although it ...

PURPOSE: We report our experience with the treatment and incidence of metabolic abnormalities in patients presenting with caliceal diverticular stones. MATERIALS AND METHODS: We retrospectively evaluated 49 patients with caliceal diverticular stones (group 1) and 44 with simple renal stones (group 2). Each group successfully underwent percutaneous treatment. Mean stone ...

PURPOSE: To evaluate transdiverticular percutaneous nephrolithotomy (TDPN) with creation of a neoinfundibulum in the treatment of caliceal diverticular stones. PATIENTS AND METHODS: Between 1990 and 1998, 18 patients with symptomatic calculi in caliceal diverticula underwent TDPN. Transdiverticular puncture into the renal collecting system with creation of a neoinfundibulum was used, ...

The aim of the study was to measure the effect of a short course of recombinant human deoxyribonuclease I (rhDNase) on ciliary and cough clearance in a group of cystic fibrosis patients, using a radioaerosol and gamma camera technique. Patients were initially randomized to receive either rhDNase (2.5 mg qd) ...

BACKGROUND AND PURPOSE: Shock wave therapy has been shown to improve many tendinopathies at the tendon-bone junction. The purpose of this study was to investigate the safety and effectiveness of extracorporeal shock wave therapy for the treatment of painful heels. METHODS: Sixty-six patients, including 45 women and 21 men with ...

PURPOSE: The score to predict the risk of post-extracorporeal shock wave lithotripsy (ESWL) pyelonephritis was evaluated. The score was based on the multivariate analysis of risk factors available pre-operatively. Stone size, pyuria, bacteriuria, previous pyelonephritis and other adjunctive procedures had been selected and scored. METHODS: Three-hundred and forty-eight adult patients ...

OBJECTIVE: To assess risk factors for gallstone recurrence following non-surgical treatment. DESIGN: A prospective follow-up of a multicentre cohort of post-dissolution gallstone patients. SETTING: Six gastroenterology units in the UK and Italy. PARTICIPANTS: One hundred and sixty-three patients with confirmed gallstone dissolution following non-surgical therapy (bile acids or lithotripsy plus ...

BACKGROUND: There are a few reports regarding the long-term results of endoscopic sphincterotomy (EST). However, little data is available on the recurrence of biliary symptoms after EST for choledocholithiasis, in patients with gall bladder stones. METHODS: All patients had gall bladder and common bile duct stones (n = 60; age ...

BACKGROUND: Although endoscopic papillotomy is now considered established treatment for choledocholithiasis, therapeutic results of endoscopic papillotomy alone without subsequent cholecystectomy in patients with cholecystolithiasis have not been well evaluated. The aim of this study was to assess the long-term outcome of endoscopic papillotomy for these patients. METHODS: Patients admitted with ...

PURPOSE: We evaluated long-term results of a contemporary medical therapeutic regimen in patients with cystinuria and analyzed factors predictive of therapeutic success. MATERIALS AND METHODS: A total of 27 adults with cystine urolithiasis were treated at our institution for 1.3 to 32 years (mean 11.6, overall 312 patient-years). We obtained ...

PURPOSE: To compare the treatment options for lower ureteral stones larger than 1 cm. METHODS: The records of 449 patients with lower ureteral calculi larger than 1 cm were reviewed retrospectively. Of these patients 342 (76.1%) were treated with extracorporeal shock wave lithotripsy (ESWL) (group 1), 66 (14.7%) with pneumatic ...