Diabetes Mellitus Might Not Be Associated with Any Stone Component in a Local District.

BACKGROUND: Type II diabetes mellitus (DM) is a risk factor for urinary stones, but the pathogenesis remains unclear. The aim of our study was to present the distribution of stone components between DM and no DM group from a local stone center in China and to help the prevention department in decision-making. METHODS: We reviewed the records of patients with upper urinary stones attending our hospital from January 2015 to September 2018. The patients with complete information were divided into 2 groups: type II DM group (DM group) and without DM group (no DM group). The distribution of stone components was analyzed. RESULTS: Two hundred twenty-two patients were complicated with DM, whereas 1,894 (89%) were not. Significant difference was found in the distribution of hypertension and BMI (p = 0, p = 0, respectively). Distribution of sex, age, and stone components did not differ between the 2 groups. By the binary logistic analysis, increasing age and sex seemed to be the main risk factors influencing the stone components. Only the calcium stone seemed to be free of the -impact from age and sex. Occurrence of hypertension is a single risk factor for calcium stone from our analysis. Presence of diabetes and increasing BMI was not found to be significantly associated with the risk for any stone component. CONCLUSIONS: In a local district, DM might not be the main factor associated with an increased risk for uric acid stone formation or any stone component. We should also consider the local characteristics of the stone distribution.

MEMS-on-fiber ultrasonic sensor with two resonant frequencies for partial discharges detection.

A novel fiber optic extrinsic Fabry-Perot interferometric (EFPI) ultrasonic sensor with two resonant frequencies for detecting the partial discharges (PDs) in switchgear is demonstrated. The key sensing element consists of two 5-µm-thickness and beam-supported silicon diaphragms, whose natural frequencies are designed differently to enable the sensor to achieve the resonant responses at two different frequencies, thus obtaining a broadened frequency response. The sensing element is fabricated by employing the microelectromechanical systems (MEMS) technology on a silicon-on-insulator (SOI) wafer. The experimental results show that the sensor possesses two resonant frequencies of 31 kHz and 63 kHz, and obviously, shows a highly sensitive frequency response over a broader range compared with the approach composed of a single sensing diaphragm with only one resonant frequency. The noise-limited minimum detectable ultrasonic pressure (MDUP) reaches 251 µPa/Hz1/2@ 31 kHz and 316 µPa/Hz1/2@ 63 kHz, respectively.

Locating Ultrasonic Signals Employing MEMS-On-Fiber Sensors.

Sound sensing finds wide applications in various fields, such as underwater detection, structural health monitoring, and medical diagnosis, to name just a few. Based on our previously developed MEMS-on-fiber sensors, showing the advantages of low cost, small volume, and high performance, a three-dimensional ultrasonic localization system employing four such sensors was established in this work. A time difference of arrival (TDOA) algorithm was utilized to analyze the acquired data and then calculate the accurate position of the ultrasonic signal source. Plenty of practical measurements were performed, and the derived localization deviation in the region of 2 m × 2 m × 1 m was about 2-5 mm. Outside this region, the deviation tended to increase due to the directional sensitivity existing in these sensors. As a result, for a more accurate localization requirement, more sensing probes are needed in order to depict a completely suitable application situation for MEMS technology.

No Wound for Stones <2 cm in Horseshoe Kidney: A Systematic Review of Comparative Studies.

INTRODUCTION: No wound to the patients is the pursuit of surgeons. Extracorporeal shock wave lithotripsy (SWL) and ureteroscopy (URS) are minimally invasive modalities for treating horseshoe kidney (HSK) stone <2 cm. We aimed to review the outcomes and complications of comparing SWL and URS in HSK stone. METHODS: The literature was reviewed in the Embase, PubMed, and Cochrane Library up to March 1, 2018. Only 4 articles were available for analysis. Inclusion criteria were all English language articles reporting on the comparison between SWL and URS. RESULTS: URS tends to be performed in a relatively heavier stone burden. The higher initial stone-free rate and success rate were demonstrated for URS than for SWL (p < 0.00001, p = 0.02, respectively). The less retreatment rate was found in URS than SWL (p = 0.04). There was no difference in minor complications in the 2 groups (p = 0.57). Renal colic episodes were more likely to be observed in the SWL group (p = 0.02). There were no major complications found in the review. CONCLUSION: For a stone <2 cm in HSK, both SWL and URS are safe treatment modalities. URS alone is a more feasible and sufficient option for stone in HSK <2 cm than SWL with possibilities of a second session.

Low-Cost, High-Performance Fiber Optic Fabry⁻Perot Sensor for Ultrasonic Wave Detection.

This study describes a novel fiber optic extrinsic Fabry⁻Perot interferometric (EFPI) ultrasonic sensor comprising a low-cost and high-performance silicon diaphragm. A vibrating diaphragm, 5 µm thick, was fabricated by using the Microelectromechanical Systems (MEMS) processing technology on a silicon-on-insulator (SOI) wafer. The Fabry⁻Perot (FP) cavity length was solely determined during the manufacturing process of the diaphragm by defining a specific stepped hole on the handling layer of the SOI wafer, which made the assembly of the sensor easier. In addition, the use of cheap and commercially available components and MEMS processing technology in the development of the sensing system, limited the cost of the sensor. The experimental tests showed that the minimum detectable ultrasonic pressure was 1.5 mPa/sqrt(Hz) ⁻0.625 mPa/sqrt(Hz) between 20 kHz and 40 kHz. As a result, this sensor has the potential to successfully detect weak ultrasonic signals.

Analysis of Prestenting on Outcomes of Flexible Ureteroscopy for Upper Urinary Urolithiasis: A Historical Control Study.

OBJECTIVES: The aim of this study is to explore the efficacy and safety of flexible ureteroscopy (fURS) with prestenting (PS) for patients and a newly starting department. METHOD: The data of patients who underwent fURS for calculi with nonprestenting (NPS) after a clinical practice change was compared with PS patients before. RESULT: In all, 199 patients met the inclusion criteria. There was no significant difference for both groups in basic demography except that the NPS group included more proximal ureteral stone. Subgroup analysis was then used by a different site. There was no significance in sheath success (4/100 vs. 1/99, p = 0.369). Stone free rate (SFR) and success rate between PS and NPS group showed significant difference in total (96.94 vs. 89.58%, p = 0.048, 96.97 vs. 85.00%, p = 0.005 respectively). Better SFR and success rate were found only for the renal stones in subgroup analysis (97.67 vs. 80.49%, p = 0.014, 97.67 vs. 74.42%, p = 0.003 respectively). Operative time was significantly longer based on stenting status (45.969 ± 19.4732 vs. 30.553 ± 8.9645 min, p = 0.01) and there was no difference in subgroup analysis. More complications were found in the NPS group, but no severe complications were encountered. CONCLUSION: Intentional PS is a feasible try for an amateur fURS surgeon or a newly started department in order to gain a better outcome and lower complications in the whole time. It improves the outcomes when additional small surgery is not the trouble.

Spontaneous renal hemorrhage secondary to choriocarcinoma in a man with congenital hypospadias and cryptorchidism: a case report and literature review.

BACKGROUND: Choriocarcinoma is a rare malignant germ-cell tumour, most commonly found in adult women. It infrequently presents as spontaneous renal haemorrhage (SRH). Genital malformation and SRH secondary to choriocarcinoma has previously been only reported in females. We present what we believe to be the first case of a male patient with genital malformation (hypospadias and cryptorchidism) and SRH at presentation of choriocarcinoma. CASE PRESENTATION: A 25-year-old man presented to the department with intense pain in the right flank region and lower back. Initial investigations showed spontaneous renal haemorrhage, for which an emergency partial nephrectomy was performed. Clinical, radiological, and pathological investigations suggested a diagnosis of testicular choriocarcinoma with metastases to the right kidney, both lungs, and brain. Initial treatment was with a chemotherapy regimen of cisplatin, etoposide and bleomycin and whole brain radiotherapy; however, 6 months after diagnosis the patient developed liver metastasis, after which time the BEP protocol was switched to ITP with oral apatinib. Despite best efforts, the liver and lung metastasis continued to grow and a decision was made to discontinue active treatment and provide only palliative care until the patient passed away. CONCLUSION: Choriocarcinoma is a difficult cancer to diagnose pre-operatively. In male patients with early metastasis, prognosis may be much poorer than in the commoner gestational choriocarcinoma. A multidisciplinary with comprehensive post-surgical intervention is of great importance in the treatment of these patients.