The results of extracorporeal shock wave lithotripsy (ESWL*) and percutaneous nephrostolithotomy for the treatment of lower pole nephrolithiasis were examined in 32 consecutive patients undergoing percutaneous nephrostolithotomy at the Methodist Hospital of Indiana and through meta-analysis of publications providing adequate stratification of treatment results. Of 101 cases managed with percutaneous nephrostolithotomy 91 (90%) were stone-free, a result significantly better than that achieved with ESWL (1,733 of 2,927 stone-free, 59%). Stone-free rates with percutaneous nephrostolithotomy were independent of stone burden, whereas stone-free rates with ESWL were inversely correlated to the stone burden treated. The morbidity of patients undergoing percutaneous nephrostolithotomy at our hospital was minimal, with a mean hospital stay of 4.7 +/- 2.8 days. No blood transfusions were required. All patients became stone-free. The percentage of urolithiasis patients with lower pole calculi is increasing. Because of the significantly greater efficacy of percutaneous nephrostolithotomy for lower pole calculi, particularly stones larger than 10 mm. in diameter, further consideration should be given to an initial approach with percutaneous nephrostolithotomy.
Complete metabolic evaluation was performed in 21 patients with infected renal lithiasis. Patients with pure struvite stones (struvite +/- carbonate apatite) were significantly less likely to have metabolic abnormalities than patients who had struvite +/- carbonate apatite+calcium oxalate (2 of 14 v 7 of 7, P = 0.0003). Urine calcium excretion was markedly higher in the mixed stone group than the pure struvite group (342 +/- 98 mg/24 h v 136 +/- 82 mg/24 h; P < 0.0001). The differing opinions among researchers regarding the likelihood of finding metabolic abnormalities in patients with urolithiasis and infection probably reflect differences in the definitions of the populations studied. If patients with calculi containing only struvite +/- carbonate apatite are evaluated, we believe that few significant metabolic abnormalities will be identified.
Over the past 15 years the Massachusetts Institute of Technology, Lincoln Laboratory (MIT/LL), Defense Advanced Research Projects Agency (DARPA) and private industry have been developing airborne LiDAR systems based on arrays of Geiger-mode Avalanche Photodiode (GmAPD) detectors capable of detecting a single photon. The extreme sensitivity of GmAPD detectors allows operation of LiDAR sensors at unprecedented altitudes and area collection rates in excess of 1,000 km 2 /hr. Up until now the primary emphasis of this technology has been limited to defense applications despite the significant benefits of applying this technology to non-military uses such as mapping, monitoring critical infrastructure and disaster relief. This paper briefly describes the operation of GmAPDs, design and operation of a Geiger-mode LiDAR, a comparison of Geiger-mode and traditional linear mode LiDARs, and a description of the first commercial Geiger-mode LiDAR system, the IntelliEarth™ Geospatial Solutions Geiger-mode LiDAR sensor.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.