Although there are a number of literature on the chemical composition of urinary stones, problems of the urolithiasis, particularly concerning [the pathogenesis of stone formation, are yet to be solved. This paper is to study the chemical composition of urinary stones from Korean patients with urolithiasis. The stones were analyzed by the spectroscopic method (infrared absorption spectra and X-ray diffraction). All of the 68 cases who were subjected to this study had been admitted to the Department of Urology, Seoul National University Hospital. The observed results are as follows: 1) In the cases of oxalate stones, only the monohydrates were found in this study. This finding is inconsistent with the reports from the other countries, that is, in most other studies, dihydrates and mixed stones were reported much more frequently. 2) In the cases with urate stones, there was no case with hydrate or salt forms. Only the pure crystalline forms of uric acid stone were found in this study. 3) In this series, not a single case of cystine or xanthine stone was found 4) Qualitative analysis of phosphate and oxalate stones were carried out by the infrared absorption spectra, and in some degree quantitative analysis were possible by the intensity of absorption spectra. 5) X-ray diffraction method, by which we analyzed the chemical composition and the crystal types, seemed to be the better method in studying the urinary stones in connection with the pathogenesis of urolitbiasis Differences in the chemical composition and crystalline forms of urinary calculi in this study from the report of the other countries suggest that geographic, racial and dietary factors may play important roles in the pathogenesis of urolithiasis.
Absorption ; Crystallins ; Cystine ; Humans ; Seoul ; Spectrum Analysis ; Uric Acid ; Urinary Calculi* ; Urolithiasis ; Urology ; X-Ray Diffraction ; Xanthine

One hundred thirty-seven urinary calculi were analyzed by means of X-ray, diffraction, ultraviolet spectroscopy and chemical method. 1. The most frequently found constituent in these 137 calculi was calcium oxalate that was found in 101 calculi (76.0% of the series). Of these 104 calculi pure calcium oxalate was identified in 41, of which 14 (10.2%) were composed of pure monohydrate and 27(19.7%) were mixtures of monohydrate and dihydrate. The dihydrates were only found to be mixed with monohydrates and the two hydrates could be identified only by X-ray diffraction but not by chemical method. 2. Identification of phosphate by X-ray diffraction was difficult because of its low peak intensity, while chemical method was proved to be more sensitive and accurate for phosphate. Calcium phosphate was found not in the pure state but in the: mixed form with calcium oxalate in 39 calculi (28.5%). 3. Pure uric acid constituent was very rare, being oily found in 2 calculi (1.5%). But there were 41 calculi (29.9%) mixed with a minute amount of uric acid, of which 28 (68.3%) were associated with calcium oxalate monohydrate. Only one calculus of uric acid, which did not appear to be crystallized, was detected by ultraviolet spectroscopy. 4. There were 23 calculi (16.8%) of magnesium ammonium phosphate, of which 13 (56.5%) were mixed with calcium phosphate and only 3 (13. 0%) were found to be in the pure state. 5. Xanthine was found as a minor constituent in t calculi, all coexistent with uric acid. There was no calculus of cystine detected. 6. X-ray diffraction method bad the advantages of providing a permanent record and a semiquantitative result and of identifying minute components. However it was unsatisfactory for detecting phosphate constituent.
Ammonium Compounds ; Calcium ; Calcium Oxalate ; Calculi ; Cystine ; Magnesium ; Spectrum Analysis ; Uric Acid ; Urinary Calculi* ; Urolithiasis ; X-Ray Diffraction ; Xanthine

BACKGROUNDS: Stone analysis is essential to determine the possible cause of stone formation and treatment of urolithiasis. Physical analysis using Fourier transform infrared spectroscopy(FT-IR), compared to chemical analysis, requires minimal sample volume, shows uniform sensitivity and specificity to all components and provides quantitiative results with greater reproducibility. We compared urinary stone analysis using FT-IR and chemical ananlysis. METHODS: From January 1996 to May 1999, 515 urinary stones were analyzed. For physical anlaysis, we used FT-IR system 2000(Perkin-Elmer Co., U.S.A.) and SpectrumTM software(Perkin-Elmer Co., U.S.A.). Chemical analyses for calcium, phosphate, uric acid, carbonate, magnesium, ammonia, oxalate and cystine were performed. Stone analyses with FT-IR were compared to those with chemical analysis. Clinical findings and the other laboratory findings including routine urinalysis, serum tests, and 24 hour urine test were also investigated. RESULTS: We analyzed 515 urinary stones from 501 patients. Sex ratio was 2.8: 1 and mean age was 48 years. Physical analyses were performed in 515(100%) stones and 81.2% of them showed mixed composition. And 79.4% included calcium oxalate monohydrate or dihydrate. Calcium oxalate monohydrate(63.3%), uric acid(11.3%), calcium oxalate dihydrate(9.9%), and carbonate apatite(8.3%) were commonly found as a major component. Chemical analyses could be done in only 454 cases(88.2%) due to insufficient sample and the most common positive findings were calcium(50.0%), phosphate(33.0%), and uric acid(18.5%). Seventy-one cases(15.6%) with negative chemical reactions to all components were mixed stones except 9 cases. When the stone components were analyzed by FT-IR and chemical method, we found full agreements in only 2.3%, partial agreements in 56.3%, poor agreements in 11.5% and no agreements in 4.3% of total cases. Hypercalciuria and natriuresis were found in 36.1% and 23.0%, respectively. The pH of urine shows significant differences in uric acid and struvite stones compared to the pH of the others(P<0.05). CONCLUSIONS: We found difficulties in detecting minor or mixed components of urinary stone and in analyzing small sized stone by chemical methods. Physical analysis using FT-IR can provide more accurate determinations of composition of urinary stones and can be significantly useful in diagnosis, treatment and prevention of urolithiasis.
Ammonia ; Calcium ; Calcium Oxalate ; Carbon ; Cystine ; Diagnosis ; Fourier Analysis ; Humans ; Hydrogen-Ion Concentration ; Hypercalciuria ; Magnesium ; Natriuresis ; Sensitivity and Specificity ; Sex Ratio ; Uric Acid ; Urinalysis ; Urinary Calculi* ; Urolithiasis

Accurate analysis of urinary calculi is fundamental for study of the etiology of stone formation and essential for treatment of urinary stone and its prevention. Among various methods for stone analysis, infrared spectroscopy analysis may be an ideal method to determine the accurate composition of urinary calculi by simple procedure in a short time. We have analyzed 100 urinary calculi by infrared spectroscopy with KBr tablet method. Stones were obtained from the patients visited our hospital during the period from January, 1980 to December, 1981. The following results were obtained: 1. Mixed stone (68%) is more common than pure stone (32%) . The most common type of calculus is calcium oxalate-tribasic calcium phosphate (57%) . The common type of component is calcium oxalate (47.3%) . 2. Calcium oxalate and tribasic calcium phosphate are contained most frequently in renal, ureteral and bladder stones. 3. Uric acid and cystine stones are found in acid urine, and most of magnesium ammonium phosphate and tribasic phosphate stones were found in alkaline urine. Calcium oxalate stones are found in urine with wider range of pH. 4. 30 of 100 patients have bacteriuria on culture. 10 of 13 patients with struvite stones showed bacteriuria and most of them are urea-splitting organisms.5. 5 cases of 16 laminated calculi contain the different components in nucleus and outer layer.
Ammonium Compounds ; Bacteriuria ; Calcium ; Calcium Oxalate ; Calculi ; Cystine ; Humans ; Hydrogen-Ion Concentration ; Magnesium ; Spectrum Analysis* ; Ureter ; Uric Acid ; Urinary Bladder Calculi ; Urinary Calculi*

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

BACKGROUND: The left internal thoracic artery (LITA) has been used as the first conduit of choice in coronary artery bypass grafting (CABG) because of excellent long-term patency and outcomes. However, no studies have examined substances other than nitric oxide that could be beneficial for the bypass conduit, native coronary artery or ischemic myocardium. This study was conducted to evaluate differences in metabolic profiles between the LITA and ascending aorta using gas chromatography-time of flight-mass spectrometry (GC-TOF-MS). METHODS: Twenty patients who underwent CABG using the LITA were prospectively enrolled. Plasma samples were collected simultaneously from the LITA and ascending aorta. GC-TOF-MS based untargeted metabolomic analyses were performed and a 2-step volcano plot analysis was used to identify distinguishable markers from two plasma metabolome profiles. Semi-quantitative and quantitative analyses were performed using GC-TOF-MS and enzyme-linked immunosorbent assay, respectively, after selecting target metabolites based on the metabolite set enrichment analysis. RESULTS: Initial volcano plot analysis demonstrated 5 possible markers among 851 peaks detected. The final analysis demonstrated that the L-cysteine peak was significantly higher in the LITA than in the ascending aorta (fold change = 1.86). The concentrations of intermediate metabolites such as L-cysteine, L-methionine and L-cystine in the ‘cysteine and methionine metabolism pathway' were significantly higher in the LITA than in the ascending aorta (2.0-, 1.4- and 1.2-fold, respectively). Quantitative analysis showed that the concentration of hydrogen sulfide (H2S) was significantly higher in the LITA. CONCLUSION: The plasma metabolome profiles of the LITA and ascending aorta were different, particularly higher plasma concentrations of L-cysteine and H2S in the LITA.
Aorta ; Chromatography, Gas ; Coronary Artery Bypass ; Coronary Vessels ; Cysteine ; Cystine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hydrogen Sulfide ; Mammary Arteries ; Mass Spectrometry ; Metabolism ; Metabolome ; Metabolomics ; Methionine ; Myocardium ; Nitric Oxide ; Plasma ; Prospective Studies ; Spectrum Analysis

PURPOSE: To document the experiences of a single institution in evaluating the clinical courses and treatment outcomes of patients with cystine stones. MATERIALS AND METHODS: The clinical data of 14 patients with cystine stones who were treated at our institution from March 1994 to July 2012 were reviewed. These data included age at first visit, gender, family history, body mass index, presence of a single kidney, stone locations, stone burden, routine urinalysis, and culture. In addition, we also analyzed data on surgery, shock wave lithotripsy, medical treatment, stone recurrence or regrowth, and overall treatment success rates. RESULTS: The mean age of our patients at their first visit was 19.6+/-5.0 years, and eight patients were males. The median stone burden and mean urine pH before each surgery were 6.5 cm2 and 6.5+/-0.9, respectively. Two patients had a family history of cystine stones. Patients underwent surgery an average of 2.7 times. The median interval between surgeries was 27.3 months, and 1 open surgery, 12 percutaneous nephrolithotomies, and 25 ureterorenoscopies were performed. Potassium citrate or sodium bicarbonate was used in nine cases. D-Penicillamine was continuously used in three patients. Patients had an average incidence of 3.2 recurrences or regrowth of stones during the median follow-up period of 60.5 months. CONCLUSIONS: Patients with cystine stones have high recurrence or regrowth rates and relatively large stone burdens. Adequate treatment schedules must therefore be established in these cases to prevent possible deterioration of renal function.
Adolescent ; Adult ; Child ; Combined Modality Therapy ; Cystine/*analysis ; Cystinuria/complications ; Female ; Humans ; Hydrogen-Ion Concentration ; Kidney Calculi/chemistry/pathology/therapy ; Lithotripsy/methods ; Male ; Nephrostomy, Percutaneous/methods ; Recurrence ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi/chemistry/pathology/therapy ; Urinary Calculi/chemistry/etiology/pathology/*therapy ; Young Adult