ABSTRACT
ObjectiveTo summarize the research and manufacturing ideas of precise positioning instrument and its feasibility and safety in the minimally invasive percutaneous nephrolithotripsy.Methods The precise positioning instrument was preliminarily made by integrating ruler with protractor.Fifty cases of kidney stones or upper ureteral stones were recruited in the study.There were 32 males and 18 females with mean age of 47 years (21 -75 years).Of them,6 cases had open surgery history and 31 cases had different degrees of hydronephrosis.The distance from the mid-point of renal pelvis to the plane of the dorsal surface and the distance from the incident point of the mid-point of pelvis on the dorsal surface to spinous process were measured by ruler on the preoperative CT images.According to the measured results,the point,angle,direction and depth of needle were calculated by geometric formula,and then fix position puncture and percutaneous puncture channel expansion were completed by precise positioning instrument and calibrated by Carm X-ray machine.ResultsThe puncture channels were established successfully in all of the 50 cases.Forty-six cases were punctured successfully by just one try,and the success rate of one puncture only was 92.0％.C-arm was used in none of the cases during the channel establishing process.Each patient was Xrayed 1 -3 times,and the average was 1.4 times.Targeting deflection or renal pelvis injury occurred in none of these cases.ConclusionThe application of the homemade precise positioning instrument is a safe and quick method for the establishment of puncture channel during percutaneous nephrolithotripsy,meanwhile the surgeons can reduce the exposure to radiation.
ABSTRACT
BACKGROUND AND PURPOSE: Avulsion of the ureteral mucosa is one of the most serious complications of ureteroscopy and considered challenging for urologic surgeons. In this study, we developed two novel methods to reconstruct the impaired ureter. MATERIALS AND METHODS: After ureteral mucosal avulsion in a canine model, ureteral reconstruction was performed in one of three ways: free tabularized peritoneal grafts (group A, n = 6); bladder mucosal grafts (group B, n = 6); or simple stenting technique (control group [n = 3]). At postoperative week 10, evaluation with intravenous urography (IVU) was followed by harvesting of reconstructed ureter segments for pathologic analysis. RESULTS: IVU showed nonvisualization of the collecting system of the affected side and histologic evaluation showed imperforation or stenosis in all animals in the control group. IVU showed good visualization of the reconstructed ureter without stenosis in group A and in most animals in group B. There was a mild dilation but no obvious stenosis in one animal in group B. Microscopically, all the reconstructed ureteral lumens were uniformly lined with transitional epithelium. Extensive neovascularity was evident in the subepithelial layer with a streaming of fibroblasts toward the neomucosa. CONCLUSION: Replacing the avulsed mucosa in the injured ureter with tubularized peritoneal free grafts or bladder mucosal grafts may be an optimal method to manage avulsion of the ureteral mucosa.
Subject(s)
Mucous Membrane/transplantation , Peritoneum/transplantation , Ureter/surgery , Animals , Dogs , Female , Ureter/injuries , Ureteroscopy/adverse effectsABSTRACT
Objective To investigate the effects of D-limonene on the proliferation and ras P21 expression in human bladder carcinoma EJ cell.Methods The cell proliferation was measured by XTT assay.The expression of ras mRNA was detected by real-time PCR,and the expression of its protein product was analyzed by Western Blot.Results The proliferation of EJ cell was inhibited by exposure to 2 mmol/L and 4 mmol/L D-limonene for 48h.The optical density (A) was 0.801±0.016 and 0.148±0.008,respectively.There were significant differences between the experimental groups and the control group (1.2181±0.031,P<0.05).The expressions of ras P21 and its protein product of EJ cell were decreased obviously when exposure to 1 mmol/L of D-limonene for 48h.The expres-sions were significantly different compared with the control group(P<0.05).Conclusions D-limo-nene could inhibit human bladder carcinoma EJ cell proliferation,which is in a dose-dependant man-ner.In a lower dose (<1 mmol/L),D-limonene can decrease the expression of ras mRNA and its protein product.
ABSTRACT
50 ml in Stamey and TVT groups were 15%(4/26) and 9%(2/23),respectively.Urinary urgency and frequent micturition were present in 54%(14/26) and 17%(4/23) of the patients in Stamey and TVT groups.Conclusions The Stamey and TVT procedures both have high initial cure rates,but the postoperative evaluation indexes of TVT group are significantly better than those of Stamey group.
