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1.
Rev. med. Risaralda ; 27(1): 101-106, ene.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280500

ABSTRACT

Resumen Introducción: El Síndrome de Mirizzi es una complicación infrecuente de la enfermedad litiásica biliar, con una incidencia menor al 1% en países desarrollados, puede desarrollarse en cinco variantes, siendo menos frecuente la variante tipo V. La literatura actual discrepa sobre el manejo de esta condición, afirmando que la cirugía laparoscópica no es segura como procedimiento estándar. Caso Clínico: Se presenta el caso de Síndrome de Mirizzi en un hombre de 80 años, que es remitido al departamento de urgencias por sospecha de sepsis de origen abdominal, con estudio ecográfico de colelitiasis, neumobilia y dilatación de las vías biliares. Se realizó Colangiopancreatografía retrógrada endoscópica con imposibilidad técnica para la movilización y extracción de los cálculos por gran tamaño, recurriéndose a exploración a través de técnica laparoscópica, obteniéndose resultados satisfactorios. Conclusión: Para tratar el Síndrome de Mirizzi, es necesario considerar las características del paciente y la experiencia del cirujano ya que ambos factores influyen directamente en la modalidad del tratamiento, sus complicaciones y tasas de éxito. En el presente caso, la experiencia del autor principal en el manejo de procedimientos mínimamente invasivos y la consideración de reducir el riesgo de complicaciones como infecciones en un paciente frágil, fueron los factores que influyeron para la decisión de intervención laparoscópica.


Abstract Introduction: Mirizzi's syndrome is an infrequent complication of biliary lithiasic disease, with an incidence of less than 1% in developed countries, being even less frequent the type V variant. Current literature disagrees on the management of this condition, stating that laparoscopic surgery is not safe as a standard procedure. Clinical Case: We present the case of Mirizzi's Syndrome in an 80-year-old man, which is referred to the emergency department for suspicion of sepsis of abdominal origin, with ultrasound study of cholelithiasis, pneumoobilia and dilation of the bile ducts. Retrograde endoscopic cholangiopancreatography was performed with technical impossibility for the mobilization and extraction of large-size stones, resorting to exploration through laparoscopic technique, obtaining satisfactory results. Conclusion: It is necessary to emphasize that the type of Mirizzi syndrome, the patient's characteristics and the surgeon's experience directly influence the treatment modality, its complications and/or success rates. In the present case, the experience of the main author in the management of minimally invasive procedures and the consideration of reducing the risk of complications such as infections in a fragile patient, were the factors that influenced the decision for laparoscopic intervention.


Subject(s)
Humans , Male , Aged, 80 and over , Cholelithiasis , Cholangiopancreatography, Endoscopic Retrograde , Laparoscopy , Mirizzi Syndrome , Therapeutics , Bile Ducts , Calculi , Sepsis , Emergencies , Emergency Service, Hospital , Infections
2.
Rev. cientif. cienc. med ; 23(1): 97-101, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1126285

ABSTRACT

Caso de litiasis renal por oxalato de calcio asociado a enfermedad de Crohn de reciente debut en paciente masculino 43 años proveniente del Canton las Piñas, Provincia El Oro en Ecuador, sin antecedentes patológicos en relación a su enfermedad. En enero 2020 acude a consulta particular con dolor en fosa iliaca derecha, fiebre, fatiga, hiporexia, pérdida de peso, tenesmo y diarrea. Gastroenterólogo observó colon derecho con úlceras, áreas de mucosa infiltrada, y el estudio anatomopatológico identifica ulceraciones en subserosa, abscesos, infiltrado inflamatorio mixto, granulomas epitelioides con células gigantes multinucleadas. Previo consentimiento se realiza ecosonografía, detectándose un cálculo renal derecho de 5 mm de tamaño y otro de 4 mm en el izquierdo. El análisis de orina reporta aciduria, cristales oxalato de calcio y la radiografía simple demostró sombra de los cálculos. El estudio metabólico la 1,25 dihidroxivitamina D y la hormona paratiroidea resultó negativo. La evolución fue favorable y continua en control periódico que de ameritar se ordenaría tomografía helicoidal sin contraste o urograma excretorio.


We present a case of kidney stones due to calcium oxalate stones associated with Crohn's disease of recent debut in a 43-year-old male patient from the Piñas canton-El Oro Province-Ecuador with no personal and family pathological history in relation to his disease and that in January 2020 he went to a private medical consultation for presenting colic-type abdominal pain located in the right iliac fossa, fever, fatigue, hyporexia, weight loss, tenesmus and sometimes diarrhea. The gastroenterologist observed: right colon with ulcers and infiltrated mucosa areas; samples are taken for histopathological study. Anatomopathology It was identified ulcerations in subserosa, abscesses, mixed inflammatory infiltrate, epithelioid granulomas with multinucleated giant cells diagnosed with Crohn's disease. With the patient's consent, an echo-sonographic study was made, detecting a right kidney stone 5 mm in size and 4 mm in the left. Urinalysis showed aciduria, calcium oxalate crystals, and plain abdominal radiography showed shadow of the stones. In the metabolic study the 1,25 dihydroxyvitamin D and parathyroid hormone was negative. The evolution was favorable and he continuous in periodic control that, if it's required, would be ordered a helical computed tomography without contrast or excretory urogram.


Subject(s)
Ulcer , Calculi , Kidney Calculi , Lithiasis , Giant Cells , Colon
3.
Con-ciencia (La Paz) ; 8(2): 35-59, 2020. ilus., tab.
Article in Spanish | LILACS, LIBOCS | ID: biblio-1147988

ABSTRACT

INTRODUCCIÓN: se realizó un estudio teórico computacional de la ciprofloxacina calculando detalladamente las propiedades moleculares del mismo. Se caracterizó este antibiótico, presentado valores de longitudes de enlace y ángulos, así como de propiedades químicas de interés en estudios QSAR, de energías y de reactividad, obtenidos por métodos mecano cuánticos utilizando la teoría funcional de densidad DFT B3LYP/6-31G*. OBJETIVO: determinar las propiedades moleculares, de QSAR y de reactividad de la Ciprofloxacina usando el método teórico de cálculo denominado: Teoría del Funcional de la Densidad (DFT) MÉTODO: la estructura de la ciprofloxacina fue trazada usando la interfaz de SPARTAN; esta fue sometida a cálculos de optimización geométrica inicialmente de Mecánica Molecular para obtener la estructura más estable, posteriormente todas las estructuras fueron analizadas utilizando la teoría de Hartree-Fock para obtener valores más confiables de energía y geometría. Posteriormente sobre estas estructuras se aplica la Teoría de Funcional de Densidad DFT usándose la base 6-31G*. Con esta estructura se realizaron cálculos de energía en conjunto con un análisis de población natural (NPA) para la molécula neutra e ionizada (positiva y negativa) para determinar los centros nucleofílicos, electrofílicos y radicalarios, y obtener posteriormente los descriptores de la reactividad local y las funciones de Fukui nucleofílica y electrofílica. RESULTADOS: Los valores experimentales de longitud de enlace para los enlaces C=C aromático del fenilo de 1.400 Å, respecto a longitudes de enlace C(10q)-C(5)=1.401 Å y C(8)- C(9q)=1.406 Å mostraron diferencias de 0.001 y 0.006. El enlace característico con el flúor F-C aromático reportado de 1.363Å, respecto al calculado en este estudio de 1.353Å muestra una diferencia de 0.01 del valor experimental. La longitud de enlace N1 de la quinolina y el C9 del ciclopropil reportado con 1.465Å y el calculado 1.450Å muestra una diferencia de 0.015. La longitud de enlace experimental C=O aromático de 1.230Å respecto al encontrado O(3)-C(4) de 1.227Å, muestra una diferencia de 0.003. Finalmente, en el anillo piperazina la longitud experimental C-N reportado de 1.465 Å, la calculada 1.463 Å diferencia de 0.002 De acuerdo con los datos calculados y reportados experimentalmente, se puede concluir que existe una buena correlación en los valores de las longitudes de enlace a nivel DFT B3LYP/6-31G*. Los ángulos entre átomos de carbono del sistema aromático encontrados en la ciprofloxacina oscilan entre 120.02° a 122.27°, en relación al valor teórico de este tipo de átomos de carbono con hibridación sp2 cuentan con un ángulo de 120°. En cuanto a la reactividad química, los índices descriptores de reactividad química global y local, el orbital HOMO es el dador y el orbital LUMO el aceptor. Un band-gap de 4.65 ev indica claramente que la molécula es muy estable. CONCLUSIÓN: se establecieron valores de las propiedades moleculares y así como de propiedades químicas de interés en estudios de estructura actividad QSAR, de energías y de reactividad del antibiótico ciprofloxacina.


INTRODUCTION: a theoretical computational study of ciprofloxacin was performed, calculating in detail the molecular properties of it. This antibiotic was characterized, presenting values of link lengths and angles as well as chemical properties of interest in QSAR, energy and reactivity studies, obtained by quantum mechanic methods using the Functional Density Theory DFT B3LYP / 6-31G *. OBJECTIVE: to determine the molecular, QSAR and reactivity properties of Ciprofloxacin using the theoretical calculation method called: Density Functional Theory (DFT). METHOD: the structure of ciprofloxacin was mapped using the SPARTAN interface; This was initially subjected to calculations of geometric optimization of Molecular Mechanics to obtain the most stable structure, later all the structures were analyzed using the Hartree-Fock theory to obtain more reliable values of energy and geometry. Subsequently on these structures the DFT Density Functional Theory is applied using the 6-31G * base. With this structure, energy calculations were performed in conjunction with a natural population analysis (NPA) for the neutral and ionized molecule (positive and negative) to determine the nucleophilic, electrophilic and radical centers, and subsequently obtain the descriptors of the local reactivity and the nucleophilic and electrophilic Fukui functions. RESULTS: The experimental values of bond length for the aromatic C = C bonds of the phenyl of 1,400 Å, with respect to link lengths C (10q) -C (5) = 1,401 Å and C (8) -C (9q) = 1,406 Å showed differences of 0.001 and 0.006. The characteristic link with the reported aromatic F-C fluorine of 1,363Å, compared to that calculated in this study of 1,353Å shows a difference of 0.01 of the experimental value. The linkage length N1 of the quinoline and the C9 of the cyclopropyl reported with 1,465Å and the calculated 1,450Å shows a difference of 0.015. The experimental aromatic C = O link length of 1,230Å with respect to the found O (3) -C (4) of 1,227Å, shows a difference of 0.003. Finally, in the piperazine ring, the reported CN experimental length of 1,465 Å, the calculated 1,463 Å difference of 0.002 According to the data calculated and reported experimentally, it can be concluded that there is a good correlation in the values of the link lengths at the DFT level B3LYP / 6-31G *. The angles between carbon atoms of the aromatic system found in ciprofloxacin range from 120.02 ° to 122.27 °, in relation to the theoretical value of this type of carbon atoms with sp2 hybridization have an angle of 120 °. Regarding chemical reactivity, the indexes describing global and local chemical reactivity [2], the HOMO orbital is the donor and the LUMO orbital is the acceptor. A band-gap of 4.65 ev clearly indicates that the molecule is very stable. The chemical potential obtained for the neutral ciprofloxacin of (-3,715ev) indicates that the electronic density of the system can vary spontaneously, since it has a negative value. The hardness gave the value of 2,325ev, indicates that ciprofloxacin will have little tendency to give or receive electrons, that is, the hardness has been associated with the stability of the chemical system. CONCLUSION: molecular and chemical properties values of interest were established in QSAR activity structure studies, energies and reactivity of the antibiotic ciprofloxacin.


Subject(s)
Calculi , Ciprofloxacin , Chemical Properties , Piperazine , Fluorine , Density Functional Theory , Hardness
4.
Article in Chinese | WPRIM | ID: wpr-878810

ABSTRACT

In this study, 10 batches of samples of cultured Bovis Calculus(cow-bezoar) were determined for the investigation of chemical profile of bile acids with the UPLC-QDA method established. The results showed that nine common bile acids, cholic acid(CA), deoxycholic acid(DCA), chenodeoxycholic acid(CDCA), taurocholic acid(TCA), taurodeoxycholic acid(TDCA), taurochenodeoxycholic acid(TCDCA), glycocholic acid(GCA), glycodeoxycholic acid(GDCA) and glycochenodeoxycholic acid(GCDCA), were founded in samples and 7 bile acids were quantified except GDCA and GCDCA. In these samples, unconjugated bile acids, the major type of bile acids, accounted for more than 97% of all types of bile acids. As for unconjugated bile acids, CA was the most major bile acid in cultured cow-bezoar and it was about twice as much as DCA. The relative low-cost method established in the current study is accurate, rapid and sensitive, which is suitable for the studies of other drugs from animal bile.


Subject(s)
Animals , Bile , Bile Acids and Salts , Calculi , Cattle , Female
5.
Rev. colomb. gastroenterol ; 34(1): 38-51, ene.-mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1003836

ABSTRACT

Resumen La pancreatitis crónica es un trastorno irreversible y progresivo del páncreas caracterizado por inflamación, fibrosis y cicatrización. Las funciones exocrinas y endocrinas se pierden, lo que a menudo conduce al dolor crónico. La etiología es multifactorial, aunque el alcoholismo es el factor de riesgo más importante en los adultos. Si se sospecha pancreatitis crónica, la tomografía computarizada con contraste es la mejor modalidad de diagnóstico por imágenes. Aunque los narcóticos y los antidepresivos proporcionan el mayor alivio del dolor, más de la mitad de los pacientes eventualmente requiere una intervención por endoscopia o cirugía. La colangiopancreatografía retrógrada endoscópica es una alternativa eficaz para una variedad de terapias en el tratamiento de enfermedades benignas y malignas del páncreas. En los últimos 50 años, la endoterapia ha evolucionado hasta convertirse en la terapia de primera línea en la mayoría de las enfermedades inflamatorias agudas y crónicas del páncreas. A medida que avanza este campo, es importante que los gastroenterólogos mantengan un conocimiento adecuado de la indicación del procedimiento, mantengan el volumen de procedimiento suficiente para manejar la endoterapia pancreática compleja y comprendan enfoques alternativos a las enfermedades pancreáticas, incluidos el tratamiento médico, la terapia guiada por ecografía endoscópica, el manejo de las estenosis sintomáticas y cálculos, las intervenciones sobre el plexo celíaco y el drenaje de los pseudoquistes pancreáticos.


Abstract Chronic pancreatitis is an irreversible and progressive disorder of the pancreas characterized by inflammation, fibrosis and scarring. Exocrine and endocrine functions are lost often leading to chronic pain. Its etiology is multifactorial, although alcoholism is the most important risk factor in adults. If chronic pancreatitis is suspected, computed tomography with contrast is the best imaging modality. Although narcotics and antidepressants provide the greatest pain relief, more than half of all patients eventually require intervention by endoscopy or surgery. Endoscopic retrograde cholangiopancreatography (ERCP) is an effective alternative for a variety of therapies for treating benign and malignant diseases of the pancreas. In the last 50 years, endoscopic treatment has evolved to become the first-line therapy for most acute and chronic inflammatory diseases of the pancreas. As this field progresses, it has become important for gastroenterologists to keep their knowledge of indications for this procedure up-to-date and to perform a sufficient volume of procedures to allow them to manage complex pancreatic endoscopic therapy. Keeping up-to-date should include an understanding of alternative approaches to pancreatic diseases including medical treatment, therapy guided by endoscopic ultrasound, management of symptomatic stenoses and stones, interventions on the celiac plexus, and drainage of pancreatic pseudocysts.


Subject(s)
Humans , Pancreas , Calculi , Cholangiopancreatography, Endoscopic Retrograde , Pancreatitis, Chronic , Pancreatic Pseudocyst
6.
Rev. colomb. gastroenterol ; 34(1): 73-75, ene.-mar. 2019. graf
Article in Spanish | LILACS | ID: biblio-1003840

ABSTRACT

Resumen Se presenta el caso de un paciente con pancreatitis crónica y hallazgo de lesión quística en el ducto pancreático principal, a quien se le realizó colangioscopia directa tipo Spyglass y se encontró un gran cálculo impactado a nivel de la cabeza del páncreas, condicionando una formación pseudoquística. Se realizó litotricia láser y se logró la extracción en su totalidad, con lo cual se logró la remisión sintomática.


Abstract We present the case of a patient with chronic pancreatitis. After finding a cystic lesion in the main pancreatic duct, the patient underwent direct cholangioscopy using the SpyGlass DS System. A large impacted calculus and pseudocyst formation was found in the head of the pancreas. Laser lithotripsy was used to extract the entire calculus and symptomatic remission was achieved.


Subject(s)
Humans , Male , Adult , Pancreatic Ducts , Calculi , Lithotripsy, Laser , Pancreatitis, Chronic
7.
Article in English | WPRIM | ID: wpr-785948

ABSTRACT

BACKGROUND: The primary aims of periodontal disease treatment is to remove dental plaque and calculus, the main causes of tooth loss, and restore periodontal tissue destroyed by inflammation. Periodontal disease treatment should also help maintain the alveolar bone, alleviate inflammation, and promote periodontal ligament cell proliferation, which is essential for tissue regeneration. Conventional antibiotics and anti-inflammatories have adverse side effects, especially during long-term use, so there is a need for adjunct treatment agents derived from natural products. The purpose of this study was to investigate whether the herbal flavone baicalein has the osteogenic activity under inflammatory conditions, and assess the involvement of osteoblast immediate early response 3 (IER3) expression.METHODS: Human osteoblastic MG-63 cells were cultured with the pro-inflammatory cytokines tumor necrosis factor α and interleukin 1β in the presence and absence of baicalein. Proliferation was assessed using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, and expression of IER3 mRNA was assessed using real-time polymerase chain reaction. The expression of IER3 protein levels and activation of associated signal transduction pathways were assessed using western blotting.RESULTS: Baicalein increased IER3 mRNA and protein expression synergistically. In addition, baicalein reversed the suppression of cell proliferation, and the downregulation of osteogenic transcription factor runt-related transcription factor 2 and osterix induced by pro-inflammatory cytokines. Baicalein also upregulated the phosphorylation of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK 1/2). The upregulation of IER3 by pro-inflammatory cytokines was blocked by pretreatment with inhibitors of AKT, p38, JNK, and ERK 1/2.CONCLUSION: Baicalein mitigates the deleterious responses of osteoblasts to pro-inflammatory cytokines. Further, IER3 enhanced the effect of baicalein via activation of AKT, p38, JNK, and ERK pathways.


Subject(s)
Anti-Bacterial Agents , Anti-Inflammatory Agents , Biological Products , Blotting, Western , Calculi , Cell Proliferation , Cytokines , Dental Plaque , Down-Regulation , Humans , Inflammation , Interleukins , JNK Mitogen-Activated Protein Kinases , MAP Kinase Signaling System , Osteoblasts , Osteogenesis , Periodontal Diseases , Periodontal Ligament , Phosphorylation , Phosphotransferases , Real-Time Polymerase Chain Reaction , Regeneration , RNA, Messenger , Signal Transduction , Tooth Loss , Transcription Factors , Tumor Necrosis Factor-alpha , Up-Regulation
8.
Article in English | WPRIM | ID: wpr-762700

ABSTRACT

The da Vinci surgical system released its new pure single-port platform, the da Vinci SP, offering improvements and refinements for established robotic single-site procedures. Herein, we present the first case of robotic single-site cholecystectomy using the da Vinci SP system (RSPC) demonstrating its safety and technical feasibility. A 59-year-old female with chronic calculus cholecystitis was admitted for elective RSPC. Docking time took 6 minutes. The patient underwent successful RSPC with a total operation time of 89 minutes. There was no significant intraoperative event. The patient had unremarkable postoperative course. Multijoint instruments, simple docking process, and third-arm functionality are among the RSPC's advantages. Absence of the port for an assistant surgeon can be a hindrance in performing more complicated surgeries. The present case suggests that RSPC is safe and feasible. The promising features and potential application of da Vinci SP in hepatobiliary and pancreas surgery need further study.


Subject(s)
Calculi , Cholecystectomy , Cholecystitis , Female , Humans , Middle Aged , Pancreas
9.
Article in Korean | WPRIM | ID: wpr-742105

ABSTRACT

PURPOSE: The purpose of this study was to compare the clinical outcomes of lithium disilicate ceramic pressed zirconia prostheses and monolithic zirconia prostheses and to investigate the complications after two years of follow-up in posterior edentulous site. MATERIALS AND METHODS: A total 17 patients (male: 12, female: 5) were treated with 60 posterior fixed implant-supported prostheses (LP. lithium disilicate ceramic pressed zirconia prostheses: n = 30, MZ. monolithic zirconia prostheses: n = 30). After 24-month, clinical examination of Implant survival rate, marginal bone resorption, probing depth, plaque index, bleeding index, calculus and complications were evaluated. RESULTS: There were no failed implants and all implants were normal in function without mobility. Marginal bone resorption was lower in LP group than MZ group at 12-month (P < .05), and 12-month probing depth and calculus deposit in LP group were significantly higher than MZ group (P < .05). Most common complications in MZ were marginal bone resorptions more than 1.5.mm and 2 chipping occurred in LP group. CONCLUSION: Within the limitations of the present study, lithium disilicate ceramic pressed zirconia is considered as a predictable treatment option as much as monolithic zirconia in posterior fixed implant-supported prostheses.


Subject(s)
Bone Resorption , Calculi , Ceramics , Dental Implants , Female , Follow-Up Studies , Hemorrhage , Humans , Lithium , Prospective Studies , Prostheses and Implants , Survival Rate
10.
Article in Korean | WPRIM | ID: wpr-760177

ABSTRACT

Pancreatic calculi associated with chronic pancreatitis lead to severe abdominal pain, which significantly reduces the quality of life of patients. Pancreatic calculi, especially those that obstruct the main pancreatic duct and cause abdominal pain, are considered to be treated. First, if pancreatic calculi are located in the head or body and the size is less than 5 mm, endoscopic removal can be attempted. If the size is greater than 5 mm, extracorporeal shockwave lithotripsy may be performed first, and subsequent endoscopic removal may be considered depending on the results. If such treatment fails, pancreatoscopic lithotripsy or surgery should be considered. Pancreatic duct stenting may be used as a bridge therapy during this process.


Subject(s)
Abdominal Pain , Calculi , Head , Humans , Lithotripsy , Pancreatic Ducts , Pancreatitis, Chronic , Quality of Life , Stents
11.
Int. braz. j. urol ; 44(6): 1234-1242, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-975655

ABSTRACT

ABSTRACT Background: Formation of struvite stones is associated with urinary tract infection by urease-producing bacteria. Biogenic crystal growth in natural and synthetic materials is regulated by the action of inhibitors, ranging from small ions, molecules to large macromolecules. Materials and Methods: We report the dynamics of in vitro crystallization of struvite in presence of vitamin C in synthetic urine using single diffusion gel growth technique. Sodium metasilicate gel of specific gravity 1.05 and the aqueous solution of ammonium dihydrogen phosphate were used as the medium for growing the struvite crystals. The crystallization process was induced by a urease positive struvite stone associated Pseudomonas aeruginosa to mimic the infection leading to stone formation. The grown crystals were characterized by ATR-FTIR and powder XRD. The surface morphology was analysed through FE-SEM for comparison between treatments. Results: We observed decrease in number, dimension, and growth rate of struvite crystals with the increasing concentrations of vitamin C. Crystals displayed well-defined faces and dendritic morphology of struvite in both control and biogenic systems. Conclusion: The results strongly suggest that, vitamin C can modulate the formation of struvite crystals in the presence of uropathogenic bacteria.


Subject(s)
Humans , Pseudomonas aeruginosa/drug effects , Ascorbic Acid/pharmacology , Urine/microbiology , Vitamins/pharmacology , Calculi/prevention & control , Struvite/chemistry , Time Factors , Crystallization
12.
National Journal of Andrology ; (12): 128-132, 2018.
Article in Chinese | WPRIM | ID: wpr-775208

ABSTRACT

Objective@#To explore the etiological factors for calculus-associated seminal vesiculitis by analyzing the composition of seminal vesicle calculus samples.@*METHODS@#This retrospective study included 6 cases of recurrent hematospermia diagnosed with seminal vesicle calculus by non-contrast pelvic CT. The patients were aged 28 to 69 years, with persistent or recurrent hematospermia for 3 months to 6 years, and 5 of them with a history of acute urethritis. All the patients underwent seminal vesiculoscopy, which confirmed calculus-associated seminal vesiculitis. The calculus samples were obtained with a spiral dislodge and their composition was determined with a second-generation infrared calculus composition analyzer. The patients were followed up for 2 to 12 weeks postoperatively, during which non-contrast pelvic CT was employed for observation of recurrent calculus in the reproductive tract.@*RESULTS@#Pelvic CT scanning indicated recurrence of seminal vesicle calculus in 3 cases at 12 weeks postoperatively, of which, 2 were accompanied with recurrent hematospermia, both observed at 4 weeks after operation. As for the composition of the calculus, the infrared calculus composition analyzer revealed struvite (magnesium ammonium phosphate hexahydrate) in 5 cases and a mixture of calcium oxalate dihydrate, calcium oxalate monohydrate, and carbonate apatite in the other one.@*CONCLUSIONS@#Seminal vesicle calculi are most commonly composed of struvite, and infection is the main etiological factor for calculus-associated seminal vesiculitis.


Subject(s)
Adult , Aged , Apatites , Calcium Oxalate , Calculi , Chemistry , Diagnostic Imaging , Genital Diseases, Male , Diagnostic Imaging , Hemospermia , Humans , Male , Middle Aged , Postoperative Period , Recurrence , Retrospective Studies , Seminal Vesicles , Diagnostic Imaging , Struvite , Tomography, X-Ray Computed , Urethritis
13.
Article in English | WPRIM | ID: wpr-766073

ABSTRACT

PURPOSE: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. METHODS: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009–2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. RESULTS: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. CONCLUSIONS: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.


Subject(s)
Calculi , Dental Caries , Dental Clinics , Diagnosis , Diagnosis, Oral , Humans , Inflammation , Mass Screening , National Health Programs , Radiography, Dental , Radiography, Panoramic , Root Caries , Sensitivity and Specificity , Survival Rate , Tooth , Tooth Loss
14.
Urol. colomb ; 27(3): 260-265, 2018. Tab
Article in Spanish | LILACS | ID: biblio-981531

ABSTRACT

La nefrolitotomía percutánea (PCNL), es un procedimiento mínimamente invasivo, considerado como el tratamiento de elección para el manejo de los cálculos renales de gran tamaño o de formación compleja. Esa técnica fue introducida en la urología desde hace más de 30 años. Inicialmente fue Goodwin en 1955 quien realizó el primer abordaje percutáneo en un riñón.1 Posteriormente en 1976 Fernstórm y Johansson, efectuaron la primera extracción de un cálculo renal por vía percutánea2; permitiendo así el inicio y desarrollo de una nueva técnica mínimamente invasiva para el manejo de la litiasis renal. Aquella técnica, si bien presenta menor morbilidad que la cirugía abierta, no es un procedimiento libre de complicaciones, por lo cual se han realizado una seria de modificaciones de la técnica inicial.


Percutaneous nephrolithotomy (PCNL) is a procedure minimally invasive, considered to be the treatment of choice for the handling of large kidney stones size or complex formation. This technique was introduced into urology over 30 years ago. Initially it was Goodwin in 1955 who made the first percutaneous approach in a kidney.1 Subsequently in 1976 Fernstórm and Johansson, carried out the first extraction of the a percutaneous renal stone2; thus allowing the initiation and development of a new technique minimally invasive for the management of renal lithiasis. This technique, although it presents less morbidity than the open surgery, it is not a procedure free of complications, for which a series of tests have been carried out. modifications to the initial technique


Subject(s)
Nephrolithotomy, Percutaneous , Pain, Postoperative , Calculi , Morbidity
15.
Rev. colomb. gastroenterol ; 33(1): 74-79, 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-900731

ABSTRACT

Resumen Las complicaciones de la colangiopancreatografía retrógrada endoscópica (CPRE) ocurren entre el 5% y 10% de los pacientes, de los cuales menos del 1% sufre perforaciones. El uso de stents metálicos autoexpandibles totalmente cubiertos para el cierre de perforaciones no complicadas se ha convertido en una estrategia opcional y segura para el manejo inicial de estos pacientes, así como una terapia de rescate para quienes el manejo conservativo ha fallado. Presentamos el caso de una paciente de 73 años con coledocolitiasis residual que fue sometida a una CPRE terapéutica con esfinterotomía y remoción de los cálculos. 12 horas después de la intervención, consultó al servicio de urgencias donde se confirmó una perforación de la vía biliar tipo II secundaria a esfinterotomía. Ulteriormente, se ofreció un manejo conservador con retiro de la ingesta oral, terapia con inhibidor de la bomba de protones, antibióticos, evaluación quirúrgica y observación médica. Sin embargo, ante la falla del manejo no quirúrgico, se consideró la colocación del stent metálico autoexpandible totalmente cubierto como terapia de rescate con evolución satisfactoria en el postoperatorio y salida 8 días después de la colocación del stent.


Abstract Complications occur in 5% to 10% of patients who undergo endoscopic retrograde cholangiopancreatography (ERCP), but less than 1% suffer perforations. The use of fully covered self-expanding metal stents (SEMS) to close uncomplicated perforations has become a safe optional strategy for initial management of these patients, as well as for rescue therapy when conservative management has failed. We present the case of a 73-year-old patient with residual choledocholithiasis who underwent therapeutic ERCP with sphincterotomy and stone removal. Twelve hours after the intervention, the patient returned to the emergency department where a biliary tract type II perforation secondary to sphincterotomy was confirmed. Subsequent conservative management included suspension of oral feeding, administration of proton pump inhibitors and antibiotics, surgical evaluation and medical observation. Failure of non-surgical management led to consideration of placement of a fully covered SEMS as rescue therapy. The patient's postoperative evolution was with satisfactory, and she was discharged eight days after stent placement.


Subject(s)
Humans , Female , Aged , Cholangiopancreatography, Endoscopic Retrograde , Choledocholithiasis , Self Expandable Metallic Stents , Bile Ducts , Calculi , Emergencies
16.
National Journal of Andrology ; (12): 525-528, 2018.
Article in Chinese | WPRIM | ID: wpr-689697

ABSTRACT

<p><b>Objective</b>To explore the practicability and safety of the F4.8 visual miniature nephroscope in the diagnosis and treatment of hematospermia.</p><p><b>METHODS</b>This study included 12 cases of refractory hematospermia accompanied by perineal or lower abdominal pain and discomfort. All the patients failed to respond to two months of systemic anti-inflammatory medication and local physiotherapy. Seminal vesicle tumor and tuberculosis were excluded preoperatively by rectal seminal vesicle ultrasonography, MRI or CT. Under epidural anesthesia, microscopic examination was performed with the F4.8 miniature nephroscope through the urethra and ejaculatory duct orifice into the seminal vesicle cavity, the blood clots washed out with normal saline, the seminal vesicle stones extracted by holmium laser lithotripsy and with the reticular basket, the seminal vesicle polyps removed by holmium laser ablation and vaporization, and the seminal vesicle cavity rinsed with diluted iodophor after operation.</p><p><b>RESULTS</b>Of the 10 patients subjected to bilateral seminal vesiculoscopy, 3 with unilateral and 2 with bilateral seminal vesicle stones were treated by holmium laser lithotripsy, saline flushing and reticular-basket removal, 2 with seminal vesicle polyps by holmium laser ablation and vaporization, and the other 3 with blood clots in the seminal vesicle cavity by saline flushing for complete clearance. The 2 patients subjected to unilateral seminal vesiculoscopy both received flushing of the seminal vesicle cavity for clearance of the blood clots. The operations lasted 10-55 (25 ± 6) minutes. There were no such intra- or post-operative complications as rectal injury, peripheral organ injury, and external urethral sphincter injury. The urethral catheter was removed at 24 hours, anti-infection medication withdrawn at 72 hours, and regular sex achieved at 2 weeks postoperatively. The patients were followed up for 6-20 (7 ± 2.3) months, during which hematospermia and related symptoms disappeared in 10 cases at 3 months and recurrence was observed in the other 2 at 4 months after surgery but improved after antibiotic medication.</p><p><b>CONCLUSIONS</b>The F4.8 visual miniature nephroscope can be applied to the examination of the seminal vesicle cavity and treatment of seminal vesicle stones and polyps, with the advantages of minimal invasiveness, safety and reliability.</p>


Subject(s)
Calculi , Diagnostic Imaging , General Surgery , Ejaculatory Ducts , Endoscopes , Endoscopy , Genital Neoplasms, Male , Hemospermia , Diagnosis , Therapeutics , Holmium , Humans , Lasers, Solid-State , Lithotripsy , Magnetic Resonance Imaging , Male , Natural Orifice Endoscopic Surgery , Neoplasm Recurrence, Local , Postoperative Complications , Reproducibility of Results , Seminal Vesicles , Diagnostic Imaging , Urethra
17.
Article in English | WPRIM | ID: wpr-742349

ABSTRACT

Prostatic calculi often occur in middle-aged and old men. Prostatic calculi are usually classified as primary/endogenous stones or secondary/extrinsic stones. Endogenous stones are commonly caused by obstruction of the prostatic ducts around the enlarged prostate by benign prostatic hyperplasia (BPH) or by chronic inflammation. Extrinsic stones occur mainly around the urethra, because they are caused by urine reflux. The exact prevalence of prostatic calculi is not known, and it has been reported to vary widely, from 7% to 70%. Most cases of prostatic calculi are not accompanied by symptoms. Therefore, most cases are found incidentally during the diagnosis of BPH using transrectal ultrasonography (TRUS). However, prostatic calculi associated with chronic prostatitis may be accompanied by chronic pelvic pain. Rare cases have been reported in which extrinsic prostatic calculi caused by urine reflux have led to voiding difficulty due to their size. More than 80% of prostatic calculi are composed of calcium phosphate. Prostatic calculi can be easily diagnosed using TRUS or computed tomography. Treatment is often unnecessary, but if an individual experiences difficulty in urination or chronic pain, prostatic calculi can be easily removed using a transurethral electroresection loop or holmium laser.


Subject(s)
Calcium , Calculi , Chronic Pain , Diagnosis , Humans , Inflammation , Lasers, Solid-State , Male , Pelvic Pain , Prevalence , Prostate , Prostatic Hyperplasia , Prostatitis , Ultrasonography , Urethra , Urination
18.
Article in Korean | WPRIM | ID: wpr-740578

ABSTRACT

OBJECTIVES: The purpose of this study was to evaluate the periodontal status of adolescents aged 15 years in Jinju city. METHODS: The study subjects were 506 adolescents aged 15 years in Jinju city. We investigated the prevalence and severity of periodontal disease using the Community Periodontal Index (CPI) recommended by the WHO. Data on the frequency of daily tooth-brushing were collected through self-reported questionnaires. The information obtained on both the periodontal health status and frequency of daily toothbrushing of adolescents in Jinju city was compared with the data from the 6th Korea National Health and Nutrition Examination Survey 2013-2015 (KNHANES-VI). The software utilized in the analysis was SPSS version 23. Statistical significance was set at P < 0.05. RESULTS: The rate of healthy periodontal status in Jinju city was lower compared to KNHANES-VI (57.7% versus 63.7%). The rate of gingival bleeding in Jinju city and KNHANES-VI was 11.3% and 10.8%, respectively. The rate of calculus in Jinju city and KNHANES-VI was 31.0% and 25.6%, respectively. The rates of gingival bleeding and calculus were not significantly different between Jinju city and KNHANES-VI. The healthy periodontal segments in Jinju city were more than those in KNHANES-VI (5.43 versus 5.25). The bleeding periodontal segments in Jinju city were less than those in KNHANES-VI (0.25 versus 0.45). However, the periodontal segments with calculus in Jinju city were not significantly different from those of KNHANES-VI (0.31 versus 0.30). The frequency of daily tooth-brushing in Jinju city was more than that in KNHANES-VI (2.67 versus 2.47). CONCLUSIONS: These findings suggest that appropriate oral health education should be widely conducted to promote periodontal health in adolescents.


Subject(s)
Adolescent , Calculi , Education , Hemorrhage , Humans , Korea , Nutrition Surveys , Oral Health , Periodontal Diseases , Periodontal Index , Prevalence , Toothbrushing
19.
Article in Korean | WPRIM | ID: wpr-714525

ABSTRACT

Intrahepatic duct (IHD) stone is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. This stone is characterized by its intractable nature and frequent recurrence, requiring multiple therapeutic interventions. Without proper treatment, biliary strictures and retained stones can lead to repeated episodes of cholangitis, liver abscesses, secondary biliary cirrhosis, portal hypertension, and death from sepsis or hepatic failure. The ultimate treatment goals for IHD stones are complete removal of the stone, the correction of the associated strictures, and the prevention of recurrent cholangitis. A surgical resection can satisfy the goal of treatment for hepatolithiasis, i.e., complete removal of the IHD stones, stricture, and the risk of cholangiocarcinogenesis. On the other hand, in some cases, such as bilateral IHD stones, surgery alone cannot achieve these goals. Therefore, the optimal treatments require a multidisciplinary approach, including endoscopic and radiologic interventional procedures before and/or after surgery. Percutaneous transhepatic cholangioscopic lithotomy (PTCS-L) is particularly suited for patients at poor surgical risk or who refuse surgery and those with previous biliary surgery or stones distributed in multiple segments. PTCS-L is relatively safe and effective for the treatment of IHD stones, and complete stone clearance is mandatory to reduce the sequelae of IHD stones. An IHD stricture is the main factor contributing to incomplete clearance and stone recurrence. Long-term follow-up is required because of the overall high recurrence rate of IHD stones and the association with cholangiocarcinoma.


Subject(s)
Bile Ducts, Intrahepatic , Calculi , Cholangiocarcinoma , Cholangitis , Constriction, Pathologic , Follow-Up Studies , Hand , Hepatectomy , Hepatic Duct, Common , Humans , Hypertension, Portal , Liver Abscess , Liver Cirrhosis, Biliary , Liver Failure , Recurrence , Sepsis
20.
Article in Korean | WPRIM | ID: wpr-718507

ABSTRACT

Urolithiasis is suspected by flank pain, costovertebral angle tenderness, and hematuria, and confirmed by computed tomography (CT). Treatment strategy and likelihood of spontaneous passage of a stone were determined by size and position of ureteral calculi and complication detected by CT. In general, the purpose of urinalysis for urolithiasis is to confirm the hematuria and pyuria. However, sometimes albumin is detected by urine dipstick test in urolithiasis. Therefore, I performed this study to investigate the clinical significance of urine dipstick positive for albuminuria in urolithiasis. This study was a retrospective review of medical records of 150 patients who visited the emergency department and diagnosed with urolithiasis by CT between March 2010 and February 2014. The patients were divided into a albuminuria group and non-albuminuria group. General chracteristics, clinical features, laboratory results, and CT findings were compared. The incidence of stones >5 mm in diameter, hydronephrosis (≥grade 2) and upper ureter stone were significantly higher in albuminuria group than non-albuminuria group. In multivariate logistic regression analysis, hydronephrosis (≥grade 2) and upper ureter stone were significantly associated with albuminuria. Upper ureter stone and hydronephrosis (≥grade 2) are also known as predictors for failure of spontaneous passage of ureter calculi. If further studies are done, urine dipstick positive for albumin in urolithiasis can be used as a predictor for failure of spontaneous passage of ureter calculi.


Subject(s)
Albuminuria , Calculi , Emergency Service, Hospital , Flank Pain , Hematuria , Humans , Hydronephrosis , Incidence , Logistic Models , Medical Records , Pyuria , Retrospective Studies , Ureter , Ureteral Calculi , Urinalysis , Urolithiasis
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