Causes and prevention of calcium-containing renal calculi.

Kidney stones are common, and recurrences are the rule. At least 90% of patients with kidney stones probably have some identifiable metabolic risk factor. Effective prophylaxis is often available, but with the relatively low rate of recurrence, compliance with the treatment may be a problem. Studies are required to determine the cost-effectiveness of metabolic investigation and prophylactic therapy versus the possible need for repeated treatment by means of extracorporeal lithotripsy, especially in patients having a first calcium oxalate stone.     

Laser lithotripsy in the treatment of ureteral calculi.

We examined the effectiveness of laser lithotripsy with a flash-lamp-pumped tunable dye laser in the treatment of ureteral calculi that were too large for direct extraction and that could not be treated with or had not responded to extracorporeal shock-wave lithotripsy (ESWL) or forms of ureteroscopic lithotripsy other than laser lithotripsy. In 20 (74%) of the 27 patients the laser alone successfully fragmented the calculi into pieces small enough to pass spontaneously or to be easily extracted with a basket. In five (19%) laser lithotripsy was partially successful: another procedure (ESWL in three and fragment extraction with a basket in two) was needed. In two patients (7%) the stones could not be fragmented with the laser, and either ESWL or percutaneous antegrade extraction was performed. At follow-up 3 months after treatment there was no sign of stone fragments in 26 (96%) of the patients. We believe that laser lithotripsy is a safe and effective method of ureteral stone fragmentation.     

B超引导经皮肾镜气压弹道联合超声碎石术治疗开放手术后复发肾结石

目的:探讨B超引导经皮肾镜气压弹道联合超声碎石术治疗开放手术后复发肾结石的可行性与疗效.方法:对46例开放手术后复发肾结石患者施以经皮肾镜气压弹道联合超声碎石术治疗,其中全鹿角状结石13例,部分鹿角状结石26例.多发性结石7例.结果:46例手术均成功,平均手术时间92rain;30例一期取净结石(65.2%),5例因穿刺出血仅建立经皮肾通道,12例接受二期PCNL,术后结石清率82.6%.7例术后发热,2例需要输血,1例气胸,经保守治疗均好转.结论:经皮肾镜气压弹道联合超声碎石术治疗开放手术后肾结石创伤小、并发症少、恢复快、结石清除率高,可以作为开放手术后复发肾结石的首选治疗方案.     

The spindle pole body of yeast

Microtubule organizing centers play an essential cellular role in nucleating microtubule assembly and establishing the microtubule array. The microtubule organizing center of yeast, the spindle pole body (SPB), shares many functions and properties with those other organisms. In recent years considerable new information has been generated concerning components associated with the SPB, and the mechanism by which it duplicates. This article reviews our current view of the cytology and molecular composition of the SPB of the budding yeast, Saccharomyces cerevisiae, and the fission yeast, Schizosaccharomyces pombe. Genetic studies in these organisms has revealed information about how the SPB duplicates and separates, and its roles during vegetative growth, mating and meiosis.     

The parascapular flap for treatment of lower extremity disorders

The parascapular flap was used as a free microvascular transfer for soft-tissue resurfacing of 11 lower extremities. The diagnoses included four cases of osteomyelitis, three cases of vascular ulceration, one case of combined osteomyelitis and vascular ulceration, two cases of posttraumatic heel defects, and one case of extensive soft-tissue contracture overlying a posttraumatic defect of the femur. All cases were successful clinically. Anatomically, the parascapular flap is supplied by the cutaneous parascapular artery, a branch of the circumflex scapular artery, which itself derives from the subscapular artery. Flap territory may reach 15 x 30 cm, and the vascular pedicle can extend 14 cm if the subscapular artery is taken. Advantages of this flap include the constancy, length, and caliber of the vascular pedicle; the length and width attributes, which allow both coverage of large wounds and primary closure of the donor defect; and an absence of disruption of musculoskeletal function.     

The prevention and treatment of lower lid ectropion following blepharoplasty

Ectropion and scleral show are the most common complications following lower lid blepharoplasty. Certain conditions predispose patients to ectropion, and these should be evaluated. In some cases, the addition of a wedge tarsectomy or tarsal strip procedure to a blepharoplasty in association with careful technique and postoperative measures is important in prevention of postblepharoplasty ectropion. Postoperative ectropion should initially be treated conservatively with massage. This may be effective up to 6 months postoperatively. If conservative measures fail, the etiology of the ectropion should be addressed. Laxity of the tarsus and canthal ligaments benefit from a horizontal lid-shortening procedure. Where there is vertical shortening from excessive skin resection or scarring of the orbital septum, there should be release and grafting of the deficiency.     

Plasma levels and urinary excretion of amino acids by subjects with renal calculi

Plasma levels and urinary amino acid excretions were estimated by high-performance liquid chromatography in 15 control subjects and 36 stone formers (SFs) classified according to the stone type: (1) 22 cases with calcium oxalate stones; (2) four cases with pure uric acid stones; (3) 10 cases with magnesium-ammonium phosphate stones, either pure or mixed with apatite. Some types of stones (namely oxalate and uric acid calculi) are mainly formed as a result of a metabolic deficiency that may affect the amino acid metabolism, and thus may be reflected in the urinary amino acid pattern. Data demonstrated clearly that there is a general tendency towards decreased amino acid excretions in all SFs with all types of stones. As a whole, one can observe a higher percentage of patients with calcium oxalate and phosphate calculosis, who have low urine excretions of amino acids; about 50% are the SFs with lower urine excretion of serine, glycine, taurine and i-leucine; the high percentage of patients with CaOX calculi shows lower urine excretions of tyrosine and ornithine.