Extracorporeal schok wave lithotripsy (ESWL) - experience of the Departament of Urology Republican Clinical Hospital

Introduction: In present days, in Republic of Moldova, extracorporeal shock wave lithotripsy (ESWL) is a usual form of treatment for renoureteral lithiasis. The purpose of this work is to evaluate the results after treatment of urolithiasis with extracorporeal shock wave lithotripsy in our clinic. Material and Methods: During August 2011 - December 2011, a number of 190 patients were treated by ESWL for renoureteral lithiasis and a number of 243 treatment procedures were performed. The device we have is a second generation MODULITH" SLK lithotripter, with radiological and ultrasonographic localization system. In a number of 115 patients the localization of calculi was renal (60,52%), in 75 cases (39,47%) was ureteral localization. Results: In a number of 120 patients (63,15%) ESWL was the single method used for therapy. A number of associated methods of treatment (percutaneous nephrostomy, ureteral catheter,) was necessary for 25 patients (13,15%). ESWL was made in 10 patients with a single kidney (5,26%). 40 (21,05%) patients were necessary two treatments, with in 3 (1,57%) patients three treatments or more were used. Severe complications occurred in 11 % cases (sepsis, anuria, perirenal hematoma, steinstrasse, etc.) Conclusions: 1. ESWL is a very common method of treatment of renoureteral lithiasis and indication of primary treatement is about 70%. 2. Associated methods (percutaneous nephrostomy, autostatic ureteral catheter, etc) were necessary before or after the procedure in case of non fragmentation or complications. 3. Severe complications lead to a adequate therapy (internal or external drainage of urinary system in urosepsis), and in the perirenal hematoma in evolution - open surgery

Transrectal ultrasound guided biopsy in diagnosis of prostatic cancer

Introduction: In nowadays prostate cancer (PC) is an important health problem, because of its high incidence and the increased number of deaths. The possibility of PSA screening and the use of transrectal biopsy of prostate (TRUS -P) decrease the mortality of these disease. Objectives: To evaluate the importance of transrectal biopsy of prostate in diagnosis of prostate cancer in the patients with increased level of PSA (normal level 4 ng/ml) and rectal examination of prostate. Material and methods: From January 2010 to December 2011, in the Republican Clinical Hospital 30 patients suspected of prostate cancer were investigated using standard method of prostate biopsy. The average age of the patients was 66,1 years (49-77 years). We performed 30 prostate biopsy, according the management of classic method (6 fragments from both prostate lobes). If „suspect” zones were detected at TRUS examination (hypoechoic zones), two more punctures were performed in those areas. Results: The general detection rate of PC using transrectal ultrasound guided prostate biopsy was 83,3 % (25 of 30 cases). In 5 (16,6%) patients the conclusion after histological examinations was benign prostatic hyperplasia (BPH). Conclusions: In our opinion, the main indications for prostatic puncture are: PSA level higher than normal and rectal examination with PC suspicion

On the possibility of producing true real-time retinal cross-sectional images using a graphics processing unit enhanced master-slave optical coherence tomography system

In a previous report, we demonstrated master-slave optical coherence tomography (MS-OCT), an OCT method that does not need resampling of data and can be used to deliver en face images from several depths simultaneously. In a separate report, we have also demonstrated MS-OCT's capability of producing cross-sectional images of a quality similar to those provided by the traditional Fourier domain (FD) OCT technique, but at a much slower rate. Here, we demonstrate that by taking advantage of the parallel processing capabilities offered by the MS-OCT method, cross-sectional OCT images of the human retina can be produced in real time. We analyze the conditions that ensure a true real-time B-scan imaging operation and demonstrate in vivo real-time images from human fovea and the optic nerve, with resolution and sensitivity comparable to those produced using the traditional FD-based method, however, without the need of data resampling. © 2015 The Authors

Novel software package to facilitate operation of any spectral (Fourier) OCT system

We present a novel software method (master-slave) to facilitate operation of any SDOCT system. This method relaxes constraints on dispersion compensation and k-domain re-sampling in SDOCT methods without requiring any changes in the hardware used

Resolution dependence on phase extraction by the Hilbert transform in phase calibrated and dispersion compensated ultrahigh resolution spectrometer based OCT

Ultrahigh resolution optical coherence tomography (UHR-OCT) is enabled by using a broad band source. Simultaneously, this makes the OCT image more sensitive to dispersion mismatch in the interferometer. In spectral domain OCT, dispersion left uncompensated in the interferometer and detector non-linearities lead together to an unknown chirp of the detected interferogram. One method to compensate for the chirp is to perform a pixel-wavenumber calibration versus phase that requires numerical extraction of the phase. Typically a Hilbert transform algorithm is employed to extract the optical phase versus wavenumber for calibration and dispersion compensation. In this work we demonstrate UHR-OCT at 1300 nm using a Super continuum source and highlight the resolution constraints in using the Hilbert transform algorithm when extracting the optical phase for calibration and dispersion compensation. We demonstrate that the constraints cannot be explained purely by the numerical errors in the data processing module utilizing the Hilbert transform but must be dictated by broadening mechanisms originating from the experimentally obtained interferograms

Analysis of the complications after ESWL in the treatment of renoureteral stones

IP USMF "Nicolae Testemiţanu", IMSP Spitalul Clinic Republican, Al VI-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (21-23 octombrie 2015)Rezumat Aproximativ 80-90% din calculii reno-ureterali au ca indicaţie pentru tratament Litotriţia Extracorporeală cu unde de Şoc (ESWL). Fiind o procedură terapeutică, după ESWL pot apărea anumite complicaţii. Majoritatea complicaţiilor sunt minore, dar pot fi întâlnite şi complicaţii majore. Hematomul este o complicaţie gravă, dar are o frecvenţă scăzută. Pielonefrita acută apare în urma existenţei infecţiei sau datorită eliberării germenilor din calcul după fragmentare. Summary Approximately 80-90% of reno-ureteral stones have for treatment indication Extra Corporeal Shock Wave Lithotripsy (ESWL). Like a therapeutic procedure, extracorporeal lithotripsy may be accompanied by complications. Most of this complications are minor complications, but in a lower percentage, major complications can be appear. Hematoma is the most serious complication of extracorporeal lithotripsy, with a low incidence. Acute pyelonephritis (PNA) occurs either due to a pre-existing urinary infection, or by the release of germs located into the calculi during fragmentation

Acute pyelonephritis in urological practice - etiology, diagnosis and treatment

Catedra Urologie şi Nefrologie Chirurgicală, USMF„Nicolae Testemiţanu", Secţia Urologie, IMSP SCR, Al VI-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (21-23 octombrie 2015)Rezumat Infecţia tractului urinar (ITU) reprezintă una dintre cele mai frecvente infecţii bacteriene în ţările industrializate, fiind o infecţie bacteriană nespecifică, ce poate fi cauzată de către o varietate de agenţi patogeni.Actualmente diagnosticul acestei patologii s-a îmbunătăţit graţie prezenţei metodelor moderne de diagnostic.ln lucrare sunt expuse rezultatele studiului literaturii de specialitate referitoare la diagnostic, evoluţie şi tratament a Pielonefritei acute şi Pielonefritei acute la gravide.Summary Urinary tract infection is one of the most frequent bacterial infection in the development countries.Crrently,the diagnosis of this pathology was significantly improved due to the varios methods of diagnosis and treatment.This scientific work analyses data available in specialized literature,evolution and treatment of acute pyelonephritis and acute pyelonephritis in pregnancy

Assessing embryo development using swept source optical coherence tomography

A detailed assessment of embryo development would assist biologists with selecting the most suitable embryos for transfer leading to higher pregnancy rates. Currently, only low resolution microscopy is employed to perform this assessment. Although this method delivers some information on the embryo surface morphology, no specific details are shown related to its inner structure. Using a Master-Slave Swept-Source Optical Coherence Tomography (SS-OCT), images of bovine embryos from day 7 after fertilization were collected from different depths. The dynamic changes inside the embryos were examined, in detail and in real-time from several depths. To prove our ability to characterize the morphology, a single embryo was imaged over 26 hours. The embryo was deprived of its life support environment, leading to its death. Over this period, clear morphological changes were observed

Acute pyelonephritis in urological practice – causes, diagnostic and treatment

Catedra Urologie şi Nefrologie Chirurgicală, Universitatea de Stat de Medicină şi Farmacie ,,Nicolae Testemiţanu”, Secţia de Urologie, IMSP Spitalul Clinic RepublicanPielonefrita acută (PNA) este o patologie care se poziţionează pe locul doi după infecțiile respiratorii, cu o incidenţă maximă între 20 și 50 ani. A fost studiat un lot de 216 bolnavi cu PNA și 32 paciente gravide cu pielonefrită acută (PNAG) trataţi timp de 5 ani în clinica de Urologie SCR. Vîrsta pacienților cu PNA a fost între 18 și 81 ani, vîrsta medie fiind de 34,6 ani; vîrsta pacientelor gravide cu PNA a fost între 18 și 32 ani, cu vîrsta medie de 22,9 ani. Tratament intervențional în PNA au necesitat 83 (38,4%) pacienți. În PNAG cateterizarea ureterului a fost efectuată în 15 (46,9%) cazuri și înstalarea stentului JJ în 10 (31,2%) cazuri. Urocultura și hemocultura, efectuată la internare, ar putea reduce costul și imbunătăţi eficacitatea tratamentului. Controlul sursei de infecție și drenarea căilor urinare în PNA și PNAG sunt o necesitate urgentă.Acute pyelonephritis (APN) is a pathology which is ranked second only to respiratory infections, with a maximum incidence between 20 and 50 years. We studied a group of 216 patients with APN and 32 pregnant women with acute pyelonephritis (APNP) hospitalized for 5 years in Urology Department. Age of patients with APN varied between 18 and 81 years, with an average age of 34,6 years, age of pregnant women with APN varied between 18 and 32 years, with a mean age of 22,9 years. APNP required interventional treatment in 83 (38,4%) patients. In APNP the catheterization of ureters was performed in 15 (46,9%) cases and installing JJ stent in 10 (31.2%) cases. Urine culture and blood culture, performed on admission, could reduce the cost and improve the effectiveness of treatment. Source control and urinary drainage in APN and APNP are urgently needed