Addition of Sodium Bicarbonate to Irrigation Solution May Assist in Dissolution of Uric Acid Fragments During Ureteroscopy

Introduction: We hypothesized that adding sodium bicarbonate (bicarb) to normal saline (NS) irrigation during ureteroscopy in patients with uric acid (UA) nephrolithiasis may assist in dissolving small stone fragments produced during laser lithotripsy. In vitro testing was performed to determine whether dissolution of UA fragments could be accomplished within 1 hour. Materials and Methods: In total 100% UA renal calculi were fragmented, filtered, and separated by size. Fragment sizes were <0.5 mm and 0.5 to 1 mm. Similar amounts of stone material were agitated in solution at room temperature. Four solutions were tested (NS, NS +1 ampule bicarb/L, NS +2, NS +3). Both groups were filtered to remove solutions after fixed periods. Filtered specimens were dried and weighed. Fragment dissolution rates were calculated as percent removed per hour. Additional testing was performed to determine whether increasing the temperature of solution affected dissolution rates. Results: For fragments <0.5 mm, adding 2 or 3 bicarb ampules/L NS produced a dissolution rate averaging 91% ± 29% per hour. This rate averaged 226% faster than NS alone. With fragments 0.5 to 1 mm, addition of 2 or 3 bicarb ampules/L NS yielded a dissolution rate averaging 22% ± 7% per hour, which was nearly five times higher than NS alone. There was a trend for an increase in mean dissolution rate with higher temperature but this increase was not significant (p = 0.30). Conclusions: The addition of bicarbonate to NS more than doubles the dissolution rate of UA stone fragments and fragments less than 0.5 mm can be completely dissolved within 1 hour. Addition of bicarb to NS irrigation is a simple and inexpensive approach that may assist in the dissolution of UA fragments produced during ureteroscopic laser lithotripsy. Further studies are needed to determine whether a clinical benefit exists

Stress waves in transversely isotropic media: The homogeneous problem

The homogeneous problem of stress wave propagation in unbounded transversely isotropic media is analyzed. By adopting plane wave solutions, the conditions for the existence of the solution are established in terms of phase velocities and directions of particle displacements. Dispersion relations and group velocities are derived from the phase velocity expressions. The deviation angles (e.g., angles between the normals to the adopted plane waves and the actual directions of their propagation) are numerically determined for a specific fiber-glass epoxy composite. A graphical method is introduced for the construction of the wave surfaces using magnitudes of phase velocities and deviation angles. The results for the case of isotropic media are shown to be contained in the solutions for the transversely isotropic media

Apollo applications program data archives

Apollo applications program data archives to collect, store, retrieve, and distribute experiments-related dat

Wave propagation in anisotropic medium due to an oscillatory point source with application to unidirectional composites

The far-field displacements in an infinite transversely isotropic elastic medium subjected to an oscillatory concentrated force are derived. The concepts of velocity surface, slowness surface and wave surface are used to describe the geometry of the wave propagation process. It is shown that the decay of the wave amplitudes depends not only on the distance from the source (as in isotropic media) but also depends on the direction of the point of interest from the source. As an example, the displacement field is computed for a laboratory fabricated unidirectional fiberglass epoxy composite. The solution for the displacements is expressed as an amplitude distribution and is presented in polar diagrams. This analysis has potential usefulness in the acoustic emission (AE) and ultrasonic nondestructive evaluation of composite materials. For example, the transient localized disturbances which are generally associated with AE sources can be modeled via this analysis. In which case, knowledge of the displacement field which arrives at a receiving transducer allows inferences regarding the strength and orientation of the source, and consequently perhaps the degree of damage within the composite

What can the microstructure of stones tell us?

How stones are retained within the kidney while small in size is still not fully understood. In this paper, we show two examples of how stones are retained during early growth: one is growth on Randall's (interstitial) plaque, and the other is growth on mineral that has formed as a luminal plug in a terminal collecting duct. These two mechanisms of stone retention during early growth have distinctive morphologic features that can be seen by methods that show the microscopic structure of the stones. Stones growing on Randall's plaque display an apatite region that is typically not large in size (1 mm long and >0.5 mm wide), and they are solid, without spaces running through them. We propose that knowing the mechanisms of stone retention during early stone formation could allow for better treatment of stone diseases

Parameterized materials and dynamic response characterizations in unidirectional composites

The values of phase velocities of ultrasonic waves in transversely isotropic media are presented in terms of the fiber volume fraction of a unidirectional fiberglass epoxy composite with constant matrix properties and the ratio between extensional moduli in the longitudinal and transverse directions of the composite when the properties of the fibers are changed, at a constant fiber volume fraction. The model of a homogeneous transversely isotropic medium is adopted to describe the relations between elastic properties and velocities. The displacements due to an oscillatory point source in an infinite medium are used as one measure of comparison of the behavior of the unidirectional composite according to the variations of the parameters, as described above. Values of phase velocities, elastic moduli, Poisson's ratios and displacements due to a point source can be read from the parameterized plots for a known fiber volume fraction or a known ratio between extensional moduli of the composite. Alternatively fiber volume fraction and the ratio between extensional moduli can be inferred from the plots when the values of the phase velocities are known; for example from experimental measurements. Therefore, such parameterized curves may be useful in nondestructive mechanical property and material degradation characterizations

An investigation of the existence of a surface water layer on aircraft radomes during simulated flight in heavy precipitation

An experiment to investigate the electromagnetic attenuation effects of an impacting water spray on an aircraft weather radome was conducted in Langley's 4 X 7 m. wind tunnel equipped with a water spray system. Results indicate no significant liquid water film formed at the stagnation point of the radome under the test conditions. However, a water sheath was observed standing away from the radome surface, which could possibly have significant attenuation properties of its own. Due to the lack of fidelity in modeling both the natural environment with the tunnel apparatus and the water sheath, it is recommended that further studies be undertaken to better define the water distribution in the vicinity of the radome and measure its effect on weather radar performance

APOLLO: the Apache Point Observatory Lunar Laser-ranging Operation: Instrument Description and First Detections

A next-generation lunar laser ranging apparatus using the 3.5 m telescope at the Apache Point Observatory in southern New Mexico has begun science operation. APOLLO (the Apache Point Observatory Lunar Laser-ranging Operation) has achieved one-millimeter range precision to the moon which should lead to approximately one-order-of-magnitude improvements in the precision of several tests of fundamental properties of gravity. We briefly motivate the scientific goals, and then give a detailed discussion of the APOLLO instrumentation.Comment: 37 pages; 10 figures; 1 table: accepted for publication in PAS

In vitro evaluation of the Lithoclast Ultra Vario combination lithotrite

Rigid intracorporeal lithotrites can be invaluable in the removal of large stone burdens during percutaneous nephrolithotomy. One such device, the Lithoclast Ultra Vario (LUV) has an outer ultrasound probe and inner pneumatic-ballistic probe. The ballistic probe can be advanced or retracted and run at 1-12 Hz. Since it can be difficult to predict optimal settings with any new device, we asked if in vitro testing could give insight into how best to operate this lithotrite. We tested the LUV under hands-free conditions that simulate treatment of fixed stones and freely movable stones. A fixed-stone test system measured the time to penetrate a gypsum model stone placed atop the probe and a movable-stone system determined time for comminution of a stone within a confined space. In addition, the time to evacuate 2-mm stone particles was measured. For hands-on testing, model stones were placed in a plastic dish submerged in water and the time to comminution was measured. Penetration time of fixed stones was faster with the ballistic probe extended 2.5 mm than when retracted (5.30 ± 0.85 vs. 8.75 ± 1.07 s, p < 0.0001). Comminution of free stones was faster with the ballistic probe retracted than when it was extended 1 mm or 2.5 mm (9.7 ± 0.9, 13.8 ± 1.3, 23.7 ± 3.2 s, p < 0.0001). In hands-on testing, extending the ballistic probe substantially reduced the efficiency of comminution (36.7 ± 6.4 vs. 131.3 ± 15.3 s, p < 0.0001). Clearance of fragments was considerably faster when the pneumatic-ballistic rate was 12 Hz compared to 1 Hz (12.3 ± 1.1 vs. 28.3 ± 2.2 s, p < 0.0001). These in vitro findings suggest ways to take advantage of the positive features while minimizing potential limitations of this lithotrite. Extending the ballistic probe is an advantage when the stone is immobile, as would be the case in treating a large stone that can be isolated against the wall of the pelvicalyceal system, but is a distinct disadvantage--due to retropulsion--when the stone is free to move. Operation of the LUV at fast ballistic rate significantly improved its ability to aspirate stone fragments