To analyze types of urinary calculi and patients' clinical characteristics, and to explore the strategies for prevention and treatment of urinary calculi.
 Methods: A total of 1 849 patients with urinary calculi were treated in the Department of Urology, the Third Xiangya Hospital of Central South University. The components were analyzed by infrared spectroscopy. The relationship between stone composition and clinical parameters was analyzed according to the clinical characteristics of the patients.
 Results: The proportion of calcium oxalate stone or uric acid stone in male (84.1% or 7.7%) was higher than that in female (78.4% or 4.2%). The older patients were more likely to be diagnosed as uric acid stone. The proportions of uric acid stone in patients <18 years old, 18-<41 years old, 41-<66 years old, and ≥66 years old were 0.0%, 1.6%, 6.6%, and 12.4%, respectively. There was no significant difference in the proportion of stones in patients with different BMI. There were no significant difference in the stone composition between the patients with or without urinary tract infection, hypertension or diabetes. The proportion of uric acid stones in patients with acidic urine was higher than the other types. The proportion of uric acid stones in patients with elevated creatinine (12.1%) was higher than that in the patients with normal creatinine (4.5%).
 Conclusion: Elderly patients, or patients with high uric acid and renal insufficiency are more prone to uric acid stones. Regulation of urinary pH may be an important strategy for preventing and treating urinary calculi in Hunan Province.
Adolescent ; Adult ; Age Factors ; Aged ; Body Mass Index ; Calcium Oxalate ; analysis ; Creatinine ; urine ; Female ; Humans ; Hydrogen-Ion Concentration ; Kidney Calculi ; chemistry ; therapy ; Male ; Middle Aged ; Sex Factors ; Spectrophotometry, Infrared ; Uric Acid ; analysis ; Urinary Calculi ; chemistry ; therapy ; urine

Objective: To explore the etiological factors for calculus-associated seminal vesiculitis by analyzing the composition of seminal vesicle calculus samples. METHODS: This retrospective study included 6 cases of recurrent hematospermia diagnosed with seminal vesicle calculus by non-contrast pelvic CT. The patients were aged 28 to 69 years, with persistent or recurrent hematospermia for 3 months to 6 years, and 5 of them with a history of acute urethritis. All the patients underwent seminal vesiculoscopy, which confirmed calculus-associated seminal vesiculitis. The calculus samples were obtained with a spiral dislodge and their composition was determined with a second-generation infrared calculus composition analyzer. The patients were followed up for 2 to 12 weeks postoperatively, during which non-contrast pelvic CT was employed for observation of recurrent calculus in the reproductive tract. RESULTS: Pelvic CT scanning indicated recurrence of seminal vesicle calculus in 3 cases at 12 weeks postoperatively, of which, 2 were accompanied with recurrent hematospermia, both observed at 4 weeks after operation. As for the composition of the calculus, the infrared calculus composition analyzer revealed struvite (magnesium ammonium phosphate hexahydrate) in 5 cases and a mixture of calcium oxalate dihydrate, calcium oxalate monohydrate, and carbonate apatite in the other one. CONCLUSIONS Seminal vesicle calculi are most commonly composed of struvite, and infection is the main etiological factor for calculus-associated seminal vesiculitis.
Adult ; Aged ; Apatites ; analysis ; Calcium Oxalate ; analysis ; Calculi ; chemistry ; complications ; diagnostic imaging ; Genital Diseases, Male ; diagnostic imaging ; etiology ; Hemospermia ; etiology ; Humans ; Male ; Middle Aged ; Postoperative Period ; Recurrence ; Retrospective Studies ; Seminal Vesicles ; diagnostic imaging ; Struvite ; analysis ; Tomography, X-Ray Computed ; Urethritis ; etiology

PURPOSE: To assess the potential of dual-energy computed tomography (DECT) to identify urinary stone components, particularly uric acid and calcium oxalate monohydrate, which are unsuitable for extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: This clinical study included 246 patients who underwent removal of urinary stones and an analysis of stone components between November 2009 and August 2013. All patients received preoperative DECT using two energy values (80 kVp and 140 kVp). Hounsfield units (HU) were measured and matched to the stone component. RESULTS: Significant differences in HU values were observed between uric acid and nonuric acid stones at the 80 and 140 kVp energy values (p<0.001). All uric acid stones were red on color-coded DECT images, whereas 96.3% of the nonuric acid stones were blue. Patients with calcium oxalate stones were divided into two groups according to the amount of monohydrate (calcium oxalate monohydrate group: monohydrate> or =90%, calcium oxalate dihydrate group: monohydrate<90%). Significant differences in HU values were detected between the two groups at both energy values (p<0.001). CONCLUSIONS: DECT improved the characterization of urinary stone components and was a useful method for identifying uric acid and calcium oxalate monohydrate stones, which are unsuitable for ESWL.
Adult ; Aged ; Calcium Oxalate/analysis ; Female ; Humans ; Kidney Calculi/*chemistry/*radiography/therapy ; *Lithotripsy ; Male ; Middle Aged ; Patient Selection ; Radiography, Dual-Energy Scanned Projection ; Tomography, X-Ray Computed/*methods ; Ureteral Calculi/*chemistry/*radiography/therapy ; Uric Acid/analysis

PURPOSE: This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the composition of urinary calculi. MATERIALS AND METHODS: A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner by use of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and image noise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extraction by Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values and DE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groups were identified by receiver operating characteristic curve analysis. RESULTS: A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite (n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonate apatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p<0.001). The DE ratio could confidently differentiate uric acid, struvite, calcium oxalate, and carbonate apatite calculi (p<0.001) with cutoff values of 1.12, 1.34, and 1.66, respectively, giving >80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-COD calculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv. CONCLUSIONS: Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposure without compromising study quality.
Adult ; Apatites/analysis ; Calcium Oxalate/analysis ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods ; Kidney Calculi/chemistry/pathology/*radiography ; Magnesium Compounds/analysis ; Male ; Middle Aged ; Phosphates/analysis ; Prospective Studies ; Radiation Dosage ; Tomography, X-Ray Computed/methods ; Ureteral Calculi/chemistry/pathology/*radiography ; Uric Acid/analysis ; Waist Circumference ; Young Adult

The prevalence of kidney stone disease is increasing, and newer research is finding that stones are associated with several serious morbidities. These facts suggest that emphasis needs to be placed not only on stone treatment but also stone prevention. However, there is a relative dearth of information on dietary and medical therapies to treat and avoid nephrolithiasis. In addition, studies have shown that there are many misconceptions among both the general community and physicians about how stones should be managed. This article is meant to serve as a review of the current literature on dietary and drug therapies for stone prevention.
Allopurinol/therapeutic use ; Calcium Oxalate/analysis ; Cystine/analysis ; *Diet ; Humans ; Kidney Calculi/chemistry/*prevention & control ; Potassium Citrate/therapeutic use ; Sodium Chloride Symporter Inhibitors/therapeutic use ; Uric Acid/analysis ; Urological Agents/*therapeutic use

OBJECTIVEThe microscopic structure and histochemical localization of the Polygonatum sibiricum, P. cytonema, P. filipes, P. zanlanscianense and P. odoratum was studied.

METHODScanning electron microscope (SEM) and digital biological microscope (DBM) were applied in the research.

RESULTVenation bundle showed in three types included collateral, amphivasal and incomplete amphivasal bundles. Morphological differences of venation bundles could be seen under the fluorescence microscope. Calcium oxalate existed in the mucilage cells looked similar to columnar crystals under SEM. In rhizome of Polygonatum, polysaccharides presented in mucilage cells, saponins and volatile oil were found in ground tissue.

CONCLUSIONMicrostructure difference of rhizomes would be used for identification of the Polygonatum plants. Polysaccharides and saponins are distributed in different cells of Polygonatum plants.

Calcium Oxalate ; analysis ; Histocytochemistry ; Microscopy, Electron, Scanning ; Oils, Volatile ; analysis ; Polygonatum ; chemistry ; ultrastructure ; Polysaccharides ; analysis ; Rhizome ; chemistry ; ultrastructure ; Saponins ; analysis

PURPOSE: We evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones. MATERIALS AND METHODS: Patients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST). RESULTS: A total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1+/-8.2 minutes and the mean stone size was 1.15+/-0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6+/-8.3 minutes) than in the COM group (24.0+/-7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size. CONCLUSIONS: The results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component.
Accounting ; Apatites ; Calcium Oxalate ; Carbon ; Humans ; Lithotripsy ; Magnesium Compounds ; Male ; Multivariate Analysis ; Odds Ratio ; Phosphates ; Ureter ; Ureteroscopes ; Ureteroscopy ; Uric Acid ; Urinary Calculi

PURPOSE: Recently, the whole DNA sequence of Bacillus subtilis (B. subtilis) was identified, revealing the existence of the YvrK gene encoding a 43 kD oxalate decarboxylase (OXDC), which degrades oxalate by a simple pathway. The objective of this study was to develop recombinant Escherichia coli (E. coli) expressing the Yvrk gene from B. subtilis. MATERIALS AND METHODS: After the extraction of total DNA from B. subtilis, the YvrK gene was cloned by polymerase chain reaction. The cloned DNA encoding OXDC was inserted into the pBAD/gIII-A vector, downstream of the L-arabinose promotor. The plasmid vector was transformed into TOP 10 E. coli, and the transformants were selected with ampicillin. The recombinant E. coli, named pBy, was then analyzed by DNA sequencing and Western blot. To evaluate the oxalate-degrading function of pBy, pBy was cultured in LB broth containing oxalate, and then the amount of oxalate in the medium was assessed. The oxalate-degrading activity of homogenates of pBy was evaluated. RESULTS: DNA sequencing showed the successful transformation of the YvrK gene into TOP 10 E. coli. Western blot analyses showed that pBy expressed OXDC. pBy removed oxalate during the overnight culture in oxalate-containing LB broth, and the homogenate of pBy degraded 90% of oxalate under acidic conditions. CONCLUSIONS: A recombinant E. coli expressing the YvrK gene was successfully produced. The bacteria showed potent oxalate-degrading activity. The results of this study will provide a solution to the treatment of calcium oxalate stones and hyperoxaluria, for which there are few medical treatment modalities.
Ampicillin ; Arabinose ; Bacillus subtilis ; Bacteria ; Base Sequence ; Blotting, Western ; Calcium Oxalate ; Carboxy-Lyases ; Clone Cells ; DNA ; Escherichia coli ; Hyperoxaluria ; Oxalates ; Plasmids ; Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVEElucidating the detoxification mechanism of the raw Pinellia ternata processed by alum solution or alkaline solution (pH > 12).

METHODRaw Pinellia ternata was immersed in alum solution and alkaline solution according to Chinese pharmacopoeia. Observed the shape's changing of needle-like calcium oxalate crystals by scanning electro-microscopy. Determinating the contents of calcium oxalate crystals by applying oxidation reduction titration. Measured the irritations of raw P. ternata and various processing products on the model of rabbits'eyes.

RESULTAfter processed by 8% alum solution prescribed in Chinese pharmacopoeia or 10% sodium carbonate solution, the needle-like shape of raphides in raw Pinellia ternata were changing and the sting barb of raphides were rusted and dissolved, the contents of calcium oxalate crystal in raw Pinellia ternata were sharply declined from more than 1% to less than 0.5%. the decline of contents is relative to the irritation decline of P. ternata on rabbit's eyes. Less than 0.5% calcium oxalate crystals of P. ternata almost had no irritation.

CONCLUSIONAfter processed by 8% alum solution or sodium carbonate solution (pH > 12) , the irritation components in raw P. ternata could be rusted and dissolved, the needle point of raphides was broken, which led to the raphides'content declining and the irritation disappearing. The micro-structures, shapes and contents of calcium oxalate crystals in different medicine plants were not same. These properties of calcium oxalate crystal in India Madder Root and yam et al were very different from those in raw P. ternata.

Alum Compounds ; chemistry ; Animals ; Calcium Oxalate ; analysis ; isolation & purification ; toxicity ; Carbonates ; chemistry ; Conjunctiva ; drug effects ; Crystallization ; Drug Interactions ; Eye Diseases ; chemically induced ; Pinellia ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Powders ; Rabbits ; Technology, Pharmaceutical ; methods

Plants in Acaceae family are often considered as ornamental and medicines. However many of them have irritation properties. As medicinal plants some of them are recorded in Chinese Pharmacopoeia and they are figured as poisonous. Through investigating the domestic and overseas studied paper, the needle-like calcium oxalate crystal exits in the plants of Acaceae family could be thought as irritation components of them. This conclusion is same with the studied conclusion of our study group in the medicines plant of Pinellia ternate belonging to the Acaceae family and our studies showed that the needle-like calcium oxalate crystal was the main irritation component of raw P. ternate. The irritated mechanism of raphides is relevant to its special shape, the protein enzyme adhering to it and idioblasts in plants.
Araceae ; chemistry ; Calcium Oxalate ; analysis ; poisoning ; Conjunctival Diseases ; chemically induced ; Crystallization ; Dermatitis, Contact ; etiology ; Humans ; Mucous Membrane ; drug effects ; Pinellia ; chemistry ; Plants, Medicinal ; chemistry