The Journal of stone disease最新文献_第5页

Biliary lithotripsy can be enhanced with proper ultrasound probe position. 适当的超声探头位置可加强胆道碎石术。

The Journal of stone disease Pub Date : 1992-04-01

J Affronti, T Flournoy, S Akers, J Baillie

{"title":"Biliary lithotripsy can be enhanced with proper ultrasound probe position.","authors":"J Affronti, T Flournoy, S Akers, J Baillie","doi":"","DOIUrl":"","url":null,"abstract":"We have demonstrated in our in vitro system that an extracorporeal lithotripter utilizing a movable ultrasound probe can fragment gallstones more effectively when the ultrasound probe is not partially blocking shock waves. Using a pressure transducer we measured the pressures in the focal volume of a Wolf Piezolith 2300 lithotripter with the ultrasound probe fully extended and fully retracted. We also chose 12 pairs of twin gallstones, each taken from the same gallbladder. One stone from each pair was subjected to shock waves while the ultrasound probe was fully extended and the other treated while the probe was fully retracted. Shock wave pressures (which are converted to a measurable voltage output by our transducer) were clearly lower when the ultrasound probe was extended (5.45 volts; SEM = 0.10 volts) as compared to when the ultrasound scanner was retracted (6.7 volts: SEM = 0.08 volts). Significantly more shock waves were required to completely fragment stones when the ultrasound scanner was extended than when it was retracted (p = 0.01 using the nonparametric Wilcoxon's signed rank test). These results show that, in the lithotripter tested, an extended in-line ultrasound scanner can partially block shock waves. Retraction of an extendible ultrasound probe may enhance stone fragmentation when operating at the highest shock wave intensity.","PeriodicalId":80218,"journal":{"name":"The Journal of stone disease","volume":"4 2","pages":"141-4"},"PeriodicalIF":0.0,"publicationDate":"1992-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21021409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Experiences with lithotripters: measurements of standardized fragmentation. 碎石机的经验:标准化碎块的测量。

The Journal of stone disease Pub Date : 1992-04-01

W Sass, K Steffen, E Matura, W Folberth, H Dreyer, J Seifert

引用次数: 0

Stratification of gallstone fragments: the key to more effective fragmentation. 胆石碎片分层:更有效碎片化的关键。

The Journal of stone disease Pub Date : 1992-04-01

J T Alderfer, I Laufer, F Wisniewski, P F Malet

{"title":"Stratification of gallstone fragments: the key to more effective fragmentation.","authors":"J T Alderfer, I Laufer, F Wisniewski, P F Malet","doi":"","DOIUrl":"","url":null,"abstract":"During previous experiments with in vitro fragmentation in a simulated gallbladder, we noticed that stone fragments tended to stratify with the dust and smaller fragments settled to the dependent portion, while the larger fragments settled on top. We reviewed the oral cholecystogram (OCG) of 10 patients examined 6 months following gallstone lithotripsy. In all cases with adequate visualization of stone fragments, the stratification phenomenon was observed. We hypothesized that adjusting the shock wave focus to target on these large fragments would improve the efficiency of fragmentation. To test this hypothesis, we fragmented three matched pairs of gallstones in vitro. For each pair, the stones were removed from the same gallbladder and the stone weights of the two stones were within 10%. The smaller member of each pair was fragmented using the \"old method\" with the focus on the fragment line. The larger stone was fragmented with the \"new method\" with the focus in the acoustic shadow deep to the echogenic line caused by the dust and small fragments in the dependent portion. The distribution of fragments was analyzed by passing the fragments through a series of filters. With the new method of targeting, the proportion of fragments less than 1.5 mm was doubled while the fragments greater than 5 mm were eliminated. The new method of targeting, taking into account the stratification of stone fragments, produces more effective fragmentation and should lead to more rapid clearance of fragments from the gallbladder.","PeriodicalId":80218,"journal":{"name":"The Journal of stone disease","volume":"4 2","pages":"158-63"},"PeriodicalIF":0.0,"publicationDate":"1992-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21021410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What makes a shock wave efficient in lithotripsy? 是什么使冲击波在碎石术中有效?

The Journal of stone disease Pub Date : 1992-04-01

B Granz, G Köhler

引用次数: 0

Reflex transmission imaging improves ultrasonic visualization and characterization of calculi for lithotripsy applications. 反射透射成像改善了碎石应用中结石的超声可视化和表征。

The Journal of stone disease Pub Date : 1992-01-01

K W Marich, A Stein, J W Pell, J F Jensen, P Schattner, P S Green

引用次数: 0

Pressure distribution and energy flow in the focal region of two different electromagnetic shock wave sources. 两种不同电磁激波源震源区域的压力分布和能量流动。

The Journal of stone disease Pub Date : 1992-01-01

W Folberth, G Köhler, A Rohwedder, E Matura

引用次数: 0

Extracorporeal piezoelectric shock wave lithotripsy of salivary gland stones: first clinical experiences. 体外压电冲击波碎石治疗唾液腺结石的初步临床经验。

The Journal of stone disease Pub Date : 1992-01-01

H Iro, N Nitsche, G Waitz, T Schneider, J Benninger, C Ell

引用次数: 0

The use of transcutaneous electrical nerve stimulation during the biliary lithotripsy procedure. 经皮神经电刺激在胆道碎石术中的应用。

The Journal of stone disease Pub Date : 1992-01-01

W E Torres, N P Fraser, B R Baumgartner, R C Nelson, G R Evans, V Jones, J Peterson

{"title":"The use of transcutaneous electrical nerve stimulation during the biliary lithotripsy procedure.","authors":"W E Torres, N P Fraser, B R Baumgartner, R C Nelson, G R Evans, V Jones, J Peterson","doi":"","DOIUrl":"","url":null,"abstract":"Transcutaneous electrical nerve stimulation (TENS) has been suggested as a means to reduce the amount of intravenous analgesia/sedation in patients undergoing extracorporeal shock wave lithotripsy (ESWL). A retrospective analysis of 79 ESWL procedures on 73 consecutive unselected patients was done in an attempt to determine the effectiveness of TENS in reducing the amount of intravenous fentanyl citrate and/or midazolam HCl needed to control pain and anxiety during the ESWL procedure. The study was divided into two parts: (1) all patients receiving TENS (n = 44) versus a non-TENS group (n = 35), and (2) comparison of the early (n = 22) and late non-TENS (n = 22) groups against each other; separately the late non-TENS group was compared to the entire TENS group. In the study, TENS reduce the amount of fentanyl citrate needed to control anxiety by 22.9% (P less than 0.025). No difference was noted when the early and late non-TENS group of patients were compared to each other. A gender difference was noted with a significant reduction in the dose of fentanyl citrate only in female patients receiving TENS (45.4%). Likewise, there was a significant reduction in the dose of midazolam HCl only in males who had TENS (38.9%). The data suggests that TENS may be a useful addition to reduce the amount of sedation and analgesia during ESWL.","PeriodicalId":80218,"journal":{"name":"The Journal of stone disease","volume":"4 1","pages":"41-5"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21021404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of supine versus prone biliary lithotripsy: an in vitro study. 仰卧位与俯卧位胆道碎石的疗效:一项体外研究。

The Journal of stone disease Pub Date : 1991-12-01 DOI: 10.1097/00004424-199112000-00168

B. R. Baumgartner, J. H. Goldstein, W. Torres

{"title":"Efficacy of supine versus prone biliary lithotripsy: an in vitro study.","authors":"B. R. Baumgartner, J. H. Goldstein, W. Torres","doi":"10.1097/00004424-199112000-00168","DOIUrl":"https://doi.org/10.1097/00004424-199112000-00168","url":null,"abstract":"Clinical extracorporeal shock wave lithotripsy (ESWL) results have shown that the smaller the gallstone fragments following ESWL, the faster the patient will become stone-free. At ESWL, an attempt is made to produce sand-like fragments that will easily pass through the cystic and common bile ducts. Sixteen pairs of gallstones of equal shape, size, and composition were harvested from cholecystectomy specimens and then fragmented on the Dornier MPL-9000 lithotripter (Dornier Medical Systems, Inc.), individually, in a phantom oriented to duplicate either supine or prone patient positions. The number and size of remaining fragments were compared following the supine versus prone treatments. The 32 stones, ranging from 5-15 mm in diameter, received 1,500 shock waves at 21 kV. Fragments with a maximal diameter of greater than or equal to 4 mm were measured and counted after 750 and 1,500 shock waves. Fragments greater than or equal to 4 mm were found in four out of 16 stones treated supine (25%) and 16 out of 16 stones treated prone (100%). The largest residual fragment regardless of size for each stone pair occurred in the prone group in 14 out of 16 cases (88%). Biliary lithotripsy performed with supine positioning results in more efficacious gallstone fragmentation in this in vitro model; these findings suggest that supine positioning for patients could improve fragmentation and treatment success.","PeriodicalId":80218,"journal":{"name":"The Journal of stone disease","volume":"4 4 1","pages":"301-5"},"PeriodicalIF":0.0,"publicationDate":"1991-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00004424-199112000-00168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61661589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0