| Brittleness of gallstones to lithotripsy: effect of physicochemical and ultrastructural characteristics. | |
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MedLine Citation:
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PMID: 8187804 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Why some gallstones do not fragment easily to lithotripsy is unclear. The aim of the present study was to determine gallstone factors associated with resistance to fragmentation. Seventy-six cholesterol rich gallstones were subjected to physical evaluation, in vitro computed tomography, chemical analysis by infra red spectroscopy, and ultrastructural studies (of 26 matched stones) by scanning electron microscopy and energy dispersive X-ray microanalysis. In vitro lithotripsy was performed with the Siemens Lithostar Plus machine at a constant energy level. Of 76 stones, 33 required > 1000 shocks for effective fragmentation (largest diameter < or = 5 mm); they had significantly higher maximum diameter (P < 0.001), volume (P < 0.001), weight (P < 0.001) and lower stone density distribution (SDD) index (P < 0.05) and lower calcium bilirubinate content (P < 0.001) than those requiring < or = 1000 shocks. Large (> 15 mm; P < 0.05), round stones (P < 0.02) and gallstones with SDD index of < 50 HU (P < 0.02) and gallstones with SDD index of < 50 HU (P < 0.05) were more difficult to fragment. Clinical application of these parameters may help in better selection of patients for this non-surgical mode of therapy for gallstones. |
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Authors:
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G Choudhuri; D K Agarwal; R V Phadke; V Ramesh; W Hauser; J Kumar; T S Negi; A Kulshreshtha |
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Publication Detail:
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Type: In Vitro; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of clinical investigation Volume: 24 ISSN: 0014-2972 ISO Abbreviation: Eur. J. Clin. Invest. Publication Date: 1994 Jan |
Date Detail:
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Created Date: 1994-06-23 Completed Date: 1994-06-23 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0245331 Medline TA: Eur J Clin Invest Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 22-7 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Chemistry, Physical Cholelithiasis / chemistry, therapy*, ultrastructure Cholesterol / analysis, chemistry Crystallization Electron Probe Microanalysis Humans Lithotripsy* Microscopy, Electron, Scanning Physicochemical Phenomena Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
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57-88-5/Cholesterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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