Extracorpreal shockwave lithotripsy in treatment of bilateral ureteral calculi with renal colic during emergency / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of extracorporeal shockwave lithotripsy (ESWL) for bilateral ureteral stones with renal colic in emergency.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 86 patients suffered with sudden renal colic due to bilateral ureteral stones and treated with ESWL between January 2005 and January 2009.</p><p><b>RESULTS</b>The success rate was 74.4% after a single ESWL session, and the overall success rate was 82.6%. Significant difference in stone length was observed between successful group and failed group (P<0.01). The stone position did not produce significant impact on the outcome of the treatment (P>0.05).</p><p><b>CONCLUSION</b>ESWL is an effective treatment modality in emergency for small-length and short-term obstruction bilateral ureteral stones with remal colic.</p>

Factors affecting the outcome of extracorporeal shockwave lithotripsy for upper urinary tract stones / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the factors affecting the efficacy of extracorporeal shockwave lithotripsy (ESWL) for upper urinary tract stones.</p><p><b>METHODS</b>Between January 2003 and January 2006, 366 patients with upper urinary tract stone underwent ESWL, and the results were identified by regular KUB/IVU or ultrasonography and evaluated 3 months after the treatment. The treatment success was defined as complete clearance of the stones without residual fragments. The stone-free rate was analyzed in relation to the stone features and the patients' clinical characteristics, and the factors identified to significant affect the results were further analyzed using multivariate regression analysis.</p><p><b>RESULTS</b>Three months after the treatment, the overall stone-free (success) rate was 63.4% (232/366) in these patients. Chi square test and t test identified the disease course, stone length and width as the factors with significant impact on the stone-free rate. Multivariate analysis excluded the disease course and stone width from the logistic regression model, and identified the stone length as the independent factor affecting the outcome of ESWL.</p><p><b>CONCLUSION</b>The stone length is an independent factor influencing the efficacy of ESWL for upper urinary tract stones.</p>

Analysis of the outcome of extracorporeal shock wave lithotripsy for renal calculia / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) for renal calculi.</p><p><b>METHODS</b>Between January, 2004 and January, 2007, 316 patients (212 men and 104 women) with renal stone underwent ESWL. The correlations of the patients' age, gender, body mass index (BMI), disease course, pain, hematuria, stone size, location, side, number and hydronephrosis to the outcome of the treatment was analyzed. The treatment success was defined as complete clearance of the stones or residual stone fragments <0.4 cm, and ESWL was considered unsuccessful with residual stones>0.4 cm.</p><p><b>RESULTS</b>The overall success rate was 75.3% (238/316) in these patients. Significant difference in stone clearance rates was observed in patients with stone size of 0.5-1.0 cm (90.3%, 167/185), 1.0-2.0 cma(69.6%, 55/79), and >2.0 cm (30.8%, 16/52) (P<0.05). The success rates differed significantly between cases of pelvic stones (83.1%, 118/142) and those of caliceal stones (69.0%, 120/174) (P<0.05). But in cases of caliceal stones, the success rates were comparable between cases with stones at the upper calyx (71.7%, 43/60), middle calyx (68.9%, 31/45), and lower calix (66.7%, 46/69) (P>0.05). Patients with single stones had significantly higher success rate (82.9%,170/205) than those with multiple stones (61.3%, 68/111) (P<0.05). The patients' gender, age, disease course, pain, hematuria, stone side and hydronephrosis did not produce significant impact on the outcome of the treatment (P>0.05).</p><p><b>CONCLUSION</b>Stone size, location and quantity are significant independent factors affecting the outcome of ESWL for renal stones.</p>

The effects of extracorporeal shock waves on the lumbar spinal cord / 中华物理医学与康复杂志

Objective To investigate whether or not extracorporeal shock wave (ESW) treatment is safe for treating low back pain caused by lumbar facet joint degeneration by observing its effects on the lumbar segment of the spinal cord.Methods Five adult dogs were used for this study.ESWs were focused on their right L_(4～5) facet joints. The energy output was set at 40% of the maximum output,and a total of 1000 shocks were delivered at a frequency of 120/min.Before and 3 days after the treatment,the somatosensory evoked potentials (SEPs) induced by stimulating the tibial nerve were recorded from the animals' scalps,and the motor function of their hind limbs was evaluated with Tarlov's scale.The animals were then sacrificed and the L_(4～5) segments of their spinal cords were taken for histopatho- logical observation,with the T_(12) segments taken as controls.Results Three days after ESW treatment,the left and the right hind limbs scored 5 and 4 on the Tarlov scale.The amplitude of SEPs decreased and their latency increased. Histopathological observation showed mild swelling of the L_(4～5) segment of the spinal cord with congested veins on the surface.Erythrocyte and leukocyte exudation as well as myelin sheath swelling in the spinal cord were also observed un- der the microscope,but with no demyelination.Conclusion ESW had some adverse effects on the spinal cord when focused on the facet joint.Further studies of the safety range of ESW energy and distance are needed.