Document Detail


Physical laws of cholesterol gallstone fragmentation.
MedLine Citation:
PMID:  9088860     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Efficient fragmentation is the most important prerequisite for successful treatment of gallstones by extracorporeally induced shock waves. No data are available on the amount of energy necessary for stone disintegration and on the threshold energy below which no further fragmentation occurs. We therefore performed an in vitro investigation on human cholesterol gallstones to elucidate physical laws governing shock-wave lithotripsy. First, the focal pressure of the lithotripter was measured to calculate the energy traversing a stone. Second, 96 gallstones from 16 gall bladders were analysed with respect to physicochemical composition, radiological features and ultrasound before fragmentation was performed. Energy for stone disintegration was constant within each stone family but varied between 4.6 mL-1 and 36.8J mL-1 in different families. This energy correlated linearly with stone volume. None of the radiological and physicochemical factors revealed a clear-cut correlation of the different energies necessary for similar stone disintegration. The threshold energy differed between 0.26 mJ and 1.04 mJ per pulse. In conclusion, stone volume was the best parameter predicting stone fragmentation. However, in cholesterol stones with a similar composition the required energy per volume varies considerably together with the threshold energy. Radiological and ultrasound parameters appear to be of minor importance in explaining these differences.
Authors:
M Neubrand; I Greinwald; H Lobentanzer; G Paumgartner; H Hermeking; T Sauerbruch
Publication Detail:
Type:  In Vitro; Journal Article    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  27     ISSN:  0014-2972     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-06-20     Completed Date:  1997-06-20     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  234-41     Citation Subset:  IM    
Affiliation:
II. Medizinische Klinik, Klinikum Grosshadern, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Acoustics
Biophysical Phenomena
Biophysics
Cholelithiasis / chemistry*,  therapy*,  ultrasonography
Cholesterol / analysis*
Humans
Lithotripsy*
Chemical
Reg. No./Substance:
57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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