Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system.They may be composed of metabolic or infection stone types.They are often associated with specific metaboli...Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system.They may be composed of metabolic or infection stone types.They are often associated with specific metabolic defects.Infection stones are associated with urease-producing bacterial urinary tract infections.The ideal treatment for staghorn calculi is maximal surgical removal.However,some patients are either unwilling or unable to proceed with that modality of treatment,and therefore other management must be used.One such technique is the metabolic evaluation with directed medical management.Based on contemporary evidence that the majority of staghorn stones are metabolic in etiology,and furthermore that even infection stones are usually associated with metabolic abnormalities,metabolic evaluation with directed medical management is recommended for all staghorn stone formers.The scientific basis of this recommendation is reviewed in the present work.展开更多
Nephrolithiasis is a common source of morbidity with a lifetime prevalence of 5%-10%. Despite technical advances in the treatment ofnephrolithiasis, the prevalence of stone disease appears to be increasing. Raised ser...Nephrolithiasis is a common source of morbidity with a lifetime prevalence of 5%-10%. Despite technical advances in the treatment ofnephrolithiasis, the prevalence of stone disease appears to be increasing. Raised serum and/or urinary uric acid are a well-established risk factor for calculogenesis.展开更多
Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between sin...Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between single and recurrent stone formers,and develop a schema for metabolic and radiologic follow-up.A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis.Both single and recurrent stone formers share many similarities in metabolic profiles.The study group determined that based on an assessment of risk for stone recurrence and metabolic activity,single and recurrent stone formers should be evaluated comprehensively,including two 24 h urine studies on a random diet.Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence.Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient,the risk of chronic kidney disease and the risk of osteoporosis/osteopenia.A standard scheme includes a baseline metabolic profile,a repeat study 3e6 months after initiation of treatment,and then yearly when stable,with abdominal imaging obtained every 1-2 years.展开更多
BACKGROUND:The signal of choline containing compounds（Cho）in proton magnetic resonance spectroscopy（1H-MRS）is elevated in brain tumors.[<sup>11</sup>C]choline uptake as assessed using positron emission...BACKGROUND:The signal of choline containing compounds（Cho）in proton magnetic resonance spectroscopy（1H-MRS）is elevated in brain tumors.[<sup>11</sup>C]choline uptake as assessed using positron emission tomography（PET）has also been suggested to be higher in brain tumors than in the normal brain.We examined whetherquantitative analysis of choline accumulation and content using these 1wo novel techniques would be helpful innon-invasive,preoperative evaluation of suspected brain tumors and tumor malignancy grade.METHODS:12patients with suspected brain tumor were studied using[<sup>11</sup>C]choline PET,gadolinium enhanced 3-D magneticresonance imaging and<sup>1</sup>H-MRS prior to diagnostic biopsy or resection.Eleven normal subjects served as展开更多
文摘Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system.They may be composed of metabolic or infection stone types.They are often associated with specific metabolic defects.Infection stones are associated with urease-producing bacterial urinary tract infections.The ideal treatment for staghorn calculi is maximal surgical removal.However,some patients are either unwilling or unable to proceed with that modality of treatment,and therefore other management must be used.One such technique is the metabolic evaluation with directed medical management.Based on contemporary evidence that the majority of staghorn stones are metabolic in etiology,and furthermore that even infection stones are usually associated with metabolic abnormalities,metabolic evaluation with directed medical management is recommended for all staghorn stone formers.The scientific basis of this recommendation is reviewed in the present work.
文摘Nephrolithiasis is a common source of morbidity with a lifetime prevalence of 5%-10%. Despite technical advances in the treatment ofnephrolithiasis, the prevalence of stone disease appears to be increasing. Raised serum and/or urinary uric acid are a well-established risk factor for calculogenesis.
文摘Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between single and recurrent stone formers,and develop a schema for metabolic and radiologic follow-up.A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis.Both single and recurrent stone formers share many similarities in metabolic profiles.The study group determined that based on an assessment of risk for stone recurrence and metabolic activity,single and recurrent stone formers should be evaluated comprehensively,including two 24 h urine studies on a random diet.Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence.Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient,the risk of chronic kidney disease and the risk of osteoporosis/osteopenia.A standard scheme includes a baseline metabolic profile,a repeat study 3e6 months after initiation of treatment,and then yearly when stable,with abdominal imaging obtained every 1-2 years.
文摘BACKGROUND:The signal of choline containing compounds（Cho）in proton magnetic resonance spectroscopy（1H-MRS）is elevated in brain tumors.[<sup>11</sup>C]choline uptake as assessed using positron emission tomography（PET）has also been suggested to be higher in brain tumors than in the normal brain.We examined whetherquantitative analysis of choline accumulation and content using these 1wo novel techniques would be helpful innon-invasive,preoperative evaluation of suspected brain tumors and tumor malignancy grade.METHODS:12patients with suspected brain tumor were studied using[<sup>11</sup>C]choline PET,gadolinium enhanced 3-D magneticresonance imaging and<sup>1</sup>H-MRS prior to diagnostic biopsy or resection.Eleven normal subjects served as
