PurposeWe aimed to compare the effects of a fast shock wave rate (120 shocks per minute) and a slow shock wave rate (60 shocks per minute) on the shock wave lithotripsy (SWL) success rate, patient's pain tolerance, and complications.Materials and MethodsA total of 165 patients with radiopaque renal pelvis or upper ureter stones were included in the study. Patients were classified by use of a random numbers table. Group I (81 patients) received 60 shock waves per minute and group II (84 patients) received 120 shock waves per minute. For each session, the success rate, pain measurement, and complication rate were recorded.ResultsNo statistically significant differences were observed in the patients according to age, sex, body mass index, stone size, side, location, total energy level, or number of shocks. The success rate of the first session was greater in group I than in group II (p=0.002). The visual analogue pain scale was lower in group I than in group II (p=0.001). The total number of sessions to success and the complication rate were significantly lower in group I than in group II (p=0.001).ConclusionsThe success rate of SWL is dependent on the interval between the shock waves. If the time between the shock waves is short, the rate of lithotripsy success decreases, and the pain measurement score and complications increase. We conclude slow SWL is the optimal shock wave rate.
Purpose: The aim of this study is to identify the risk factors for development of sepsis in patients with obstructive acute pyelonephritis (APN) associated with urinary tract calculi. Materials and Methods: Between January 2004 and December 2013, 73 patients with obstructive APN associated with upper urinary tract calculi were admitted to our institution. Medical records of 73 patients (14 men and 59 women, mean age of 57 years) were reviewed retrospectively. The risk factors for sepsis were analyzed using multivariate logistic regression analysis. Results: Of 73 patients, 37 (50.7%) developed sepsis. Old age and history of hypertension were more common in the sepsis group than in the non-sepsis group (p<0.001 and p=0.018). The white blood cell count, neutrophil count, plateletto-lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein level were significantly higher in the sepsis group (p=0.011, p=0.001, p=0.042, p<0.001 and p=0.006, respectively). Lymphocyte count, platelet count, and albumin level were significantly lower in the sepsis group (p<0.001, p=0.008 and p<0.001, respectively). Multivariate logistic regression analysis indicated that old age (odds ratio [OR], 2.13; p=0.023), decrease in serum albumin level (OR, 4.27; p=0.041), and high NLR (OR, 3.83; p=0.037) were independent risk factors for development of sepsis. Conclusions: Elderly patients with obstructive APN associated with urinary tract calculi who have low serum albumin levels and high NLR should be treated carefully against development of sepsis.
PurposeThe aim of this study was to investigate the changing pattern in the use of intravenous pyelogram (IVP), conventional computed tomography (CT), and non-contrast-enhanced computed tomography (NECT) for evaluation of patients with acute flank pain.Materials and MethodsWe retrospectively reviewed the medical records of 2,180 patients with acute flank pain who had visited Bundang Jesaeng General Hospital between January 2008 and December 2012 and analyzed the use of IVP, conventional CT, and NECT for these patients.ResultsDuring the study period there was a significant increase in NECT use (p<0.001) and a significant decrease in IVP use (p<0.001). Conventional CT use was also increased significantly (p=0.001). During this time the proportion of patients with acute flank pain who were diagnosed with urinary calculi did not change significantly (p=0.971).ConclusionsThere was a great shift in the use of imaging study from IVP to NECT between 2008 and 2012 for patients with acute flank pain.
Controlling both the spectral bandwidth and directionality of emitted thermal radiation is a fundamental challenge in contemporary photonics. Recent work has shown that materials with a spatial gradient in the frequency range of their epsilon‐near‐zero (ENZ) response can support broad spectrum directionality in their emissivity, enabling high total radiance to specific angles of incidence. However, this capability is limited spectrally and directionally by the availability of materials with phonon‐polariton resonances over long‐wave infrared wavelengths. Here, an approach is designed and experimentally demonstrated using doped III–V semiconductors that can simultaneously tailor spectral peak, bandwidth, and directionality of infrared emissivity. InAs‐based gradient ENZ photonic structures that exhibit broadband directional emission with varying spectral bandwidths and directional ranges as a function of their doping concentration profile and thickness are epitaxially grown and characterized. Due to its easy‐to‐fabricate geometry, it is believed that this approach provides a versatile photonic platform to dynamically control broadband spectral and directional emissivity for a range of emerging applications in heat transfer and infrared sensing.
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