Document Detail

The use of chemical treatments for improved comminution of artificial stones.
MedLine Citation:
PMID:  15076279     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The acoustic and mechanical properties of various stone compositions are significantly different and thus result in varying degrees of fragility. Consequently, results to shock wave lithotripsy (SWL) are influenced accordingly. We report the results of a study of fragility of various stone compositions, and the influence on each stone's baseline physical properties and fragility when exposed to various chemolytic solutions. MATERIALS AND METHODS: Before SWL artificial stones of differing compositions were irrigated with various chemolytic solutions. Calcium oxalate monohydrate (COM) stones were treated with ethylenediaminetetraacetic acid (EDTA), stones composed of magnesium ammonium phosphate hydrogen were treated with hemiacidrin, and stones made of uric acid (UA) were treated with tromethamine. Synthetic urine served as a control for all stone groups. Using an ultrasound transmission technique, longitudinal wave propagation speed was measured in all groups of artificial stones. Stone density was also measured by using a pycnometer (based on Archimedes' principle). Based on these measurements transverse (shear) wave speed (assuming a constant Poisson's ratio), wave impedance and dynamic mechanical properties of the artificial stones were calculated. Moreover, the microhardness of these artificial stones was measured, and fragility testing using SWL with and without pretreatment with the previously mentioned chemolytic solutions, was performed. RESULTS: Wave speed, wave impedance, dynamic mechanical properties and microhardness of EDTA treated COM stones and tromethamine treated UA stones were found to decrease compared to untreated (synthetic urine) control groups. The suggestion that chemolytic pretreatment increases stone fragility was verified by the finding of increased stone comminution after SWL testing. Combining this medical pretreatment and SWL, the findings demonstrate a significant impact of various solvents on stone comminution, in particular EDTA treated COM stones, tromethamine treated UA stones and hemiacidrin treated magnesium ammonium phosphate hydrogen stones. These data suggest that by altering the chemical environment of the fluid surrounding the stones it is possible to increase the fragility of renal calculi in vitro. CONCLUSIONS: These results indicate that appropriate chemical treatments may provide a useful adjunctive modality for improving the efficacy of stone comminution during shock wave lithotripsy.
D Heimbach; J Kourambas; P Zhong; J Jacobs; A Hesse; S C Mueller; F C Delvecchio; F H Cocks; G M Preminger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of urology     Volume:  171     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-12     Completed Date:  2004-05-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1797-801     Citation Subset:  AIM; IM    
Department of Urology, Section of Experimental Urology, University of Bonn, Bonn, Germany.
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MeSH Terms
Citrates / therapeutic use*
Combined Modality Therapy
Edetic Acid / therapeutic use*
Kidney Calculi / therapy*
Tromethamine / therapeutic use*
Grant Support
Reg. No./Substance:
0/Citrates; 0/hemiacidrin; 60-00-4/Edetic Acid; 77-86-1/Tromethamine

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

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