Shock wave lithotripsy of salivary gland stones has become more and more efficient in the treatment of sialolithiasis during the last years. We use two different methods in our hospital: Extracorporeal shock wave lithotripsy (ESWL) and endoscopically intracorporeal lithotripsy (EISL). The results of both therapies are compatible; 60-70% could be successfully treated. The indication is different due to the localisation of the salivary gland stone. Stones that are located in the glandula or very proximal in the duct should be fragmented by extracorporeal lithotripsy. Stones located in the duct and multiple intraductal stones should be treated by the intracorporeal method. Clinical experiments showed that some salivary stones do not fragment easily. The reason is still unknown. We examined the ability of fragmentation in relation to the physicochemical analysis of the stone. The stones were examined by infrared spectroscopy. This study revealed that pure carbonate apatite stones are more difficult to destroy than stones containing some protein.
The action of lead on the intermediary metabolism, especially on the synthesis of heme, the red blood cell pigment, is well documented. Therefore biological monitoring of lead exposed persons by means of the urinary metabolites of porphyrin metabolism is very valuable. Biological monitoring through the urinary metabolite - aminolevulinic acid (ALAU) has been put to extensive use for over ten years by the Swiss National Accident Insurance Fund (Suva). At present there are over 3000 workers in 100 factories which are periodically screened for this metabolite. Urinary analyses are carried out at regular intervals of 2, 4 or 6 months according to the lead exposition with additional medical examinations once or twice a year. Due to biological monitoring, technical improvements and personal hygiene there have been no further lead poisoning recently in industrial plants supervised by Suva.
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