Quantitative and multicomponent analysis of prevalent urinary calculi using Raman spectroscopy

This study established a quantitative micro‐Raman spectroscopic (MRS) method for measuring multicomponents (binary and ternary compositions) of prevalent urine calculi extracted from the ureter after the ureteroscopic lithotripsy (URSL) procedure. The analysis used calibration curves of known mixtures of synthetically prepared calcium oxalate monohydrate (COM), hydroxyapatite (HAP), calcium oxalate dehydrate (COD), dicalcium phosphate dehydrate (DCPD), and uric acid. A variety of samples of binary and ternary mixtures including COM/HAP, COM/COD, COD/HAP, COM/uric acid, COD/uric acid, HAP/uric acid, HAP/DCPD, and COM/COD/HAP were prepared in various concentration ratios for use as the basis of the quantitative analysis. Intensities of the characteristic bands at 961 cm⁻¹ (I_HAP), 986 cm⁻¹ (I_DCPD), 1402 cm⁻¹ (I_UricAcid), 1462 cm⁻¹ (I_COM), and 1477 cm⁻¹ (I_COD) were used for the calculation. We derived a set of quantitative analysis equations for the ternary composition COD/COM/HAP group by combining two binary equations from the groups COM/COD and the HAP/COM. This study quantitatively measured 18 urine samples extracted from the 18 patients' ureters after the URSL procedure. Fifteen samples were binary mixtures, whereas three samples were ternary mixtures. This research successfully applied the quantitative MRS‐based analysis technique from bench to bedside. Copyright © 2012 John Wiley & Sons, Ltd.     

Laser spectroscopy and imaging of gallbladder stones, tissue and bile

Laser spectroscopic study of billary calculi and tissues is described. Fluorescence spectra of human gallbladder stones, bile and tissues were recorded with streak camera in the frequency and time domain. Potential of fluorescence as a diagnostic tool to discriminate between the intended target and the surrounding tissues and bile is evaluated. Initiation of fragmentation process is visualized by high-speed shadowgraphy, interferometry performed during the laser impact and generation of plasma causing growth and collapse of bubbles.     

Micro‐Raman spectroscopy identification of urinary stone composition from ureteroscopic lithotripsy urine powder

Urolithiasis is a prevalent, disturbing, and highly recurrent disease. Knowing the composition of a urinary stone is important for prevention purposes. Traditional urinary stone analysis methods need large stone fragments for analysis. However, the advancement of ureteroscopic lithotripsy (URSL) has resulted in micro‐stone fragments and unapparently expelled urinary stone powder. In this study, we developed a micro‐Raman spectroscopy (MRS) based diagnosis method for detecting micro‐stones or stone powders in urine after URSL. In our experiment, urine samples of 10 ml each were collected from 12 patients over the fragmented stone site in the ureter after the URSL procedure. The post‐URSL urine sediments extracted from urine were analyzed by MRS. The small urinary stones caught by grasping forceps were analyzed by both MRS and Fourier‐transform infrared (FTIR) spectroscopy. We have identified common urinary stone compositions: calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), dicalcium phosphate dihydrate (DCPD), calcium phosphate hydroxide (hydroxyl apatite or HAP), and uric acid, by using a 632.8 nm He‐Ne laser for excitation, a 100× microscope objective lens for irradiation and collection, and a short photobleaching time for fluorescent background reduction. Thus, we developed an MRS‐based method for analyzing the composition of urinary stone powders directly from the urine samples after the URSL procedure. This approach provides a quick and convenient method for urinary stone analysis. Copyright © 2009 John Wiley & Sons, Ltd.     

激光感应等离子体冲击波碎石

文章对激光感应等离子体冲击波碎石技术的物理机理、发展现状及未来趋势做了综合性评述，并结合作者的实验研究对激光碎石中存在的重要技术问题进行了探讨，同时提出了一些可能的解决办法．     

Quantitative Schlieren measurements of a high energy electromagnetic transducer acoustic shock field

Schlieren photography has been used to analyse quantitatively the acoustic field of an electromagnetic acoustic transducer (EMAT). By measuring the angle through which the rays are refracted it is possible to compute the refractive index gradient and thus determine both the absolute and complex pressure related structures of the images. Using this method, planar and focused shock transients generated by the EMAT have been evaluated and compared with transducer derived pressure measurements. The peak pressure in the unfocused shock was found to be 3.2 MPa and 4.6 MPa for the Schlieren and piezoelectric transducer measurements respectively. Corresponding values for the focused shock-wave agreed to within experimental error at about 19 MPa.     

Sound field prediction of ultrasonic lithotripsy in water with spheroidal beam equations

With converged shock wave,extracorporeal shock wave lithotripsy(ESWL)has become a preferable way to crush human calculi because of its advantages of efficiency and non-intrusion.Nonlinear spheroidal beam equations(SBE)are employed to illustrate the acoustic wave propagation for transducers with a wide aperture angle.To predict the acoustic field distribution precisely,boundary conditions are obtained for the SBE model of the monochromatic wave when the source is located on the focus of an ESWL transducer.Numerical results of the monochromatic wave propagation in water are analyzed and the influences of half-angle,fundamental frequency,and initial pressure are investigated.According to our results,with optimization of these factors,the pressure focal gain of ESWL can be enhanced and the effectiveness of treatment can be improved.     

脉冲激光等离子体冲击波碎石机理分析

利用自行研制的Nd:YAG激光器产生的纳秒和微秒激光脉冲,分别在水中和空气中对几种人体结石进行了粉碎实验,激光被耦合到芯径为400μm的石英光纤中,耦合效率达70%.实验研究和分析计算表明脉冲激光等离子体冲击的产生是激光碎石的主要动力,而热分解作用只是促进了等离子体的形成并不是粉碎结石的主要原因,体液冲流和周围介质对等离子体的约束加速了碎石过程,脉冲激光碎石的过程是这几个方面共同作用的结果。     

Modified shock waves for extracorporeal shock wave lithotripsy: a simulation based on the Gilmore formulation

Extracorporeal shock wave lithotripsy (SWL) is a reliable therapy for the treatment of urolithiasis. Nevertheless, improvements to enhance stone fragmentation and reduce tissue damage are still needed. During SWL, cavitation is one of the most important stone fragmentation mechanisms. Bubbles with a diameter between about 7 and 55 μm have been reported to expand and collapse after shock wave passage, forming liquid microjets at velocities of up to 400 m/s that contribute to the pulverization of renal calculi. Several authors have reported that the fragmentation efficiency may be improved by using tandem shock waves. Tandem SWL is based on the fact that the collapse of a bubble can be intensified if a second shock wave arrives tenths or even a few hundredths of microseconds before its collapse. The object of this study is to determine if tandem pulses consisting of a conventional shock wave (estimated rise time between 1 and 20 ns), followed by a slower second pressure profile (0.8 μs rise time), have advantages over conventional tandem SWL. The Gilmore equation was used to simulate the influence of the modified pressure field on the dynamics of a single bubble immersed in water and compare the results with the behavior of the same bubble subjected to tandem shock waves. The influence of the delay between pulses on the dynamics of the collapsing bubble was also studied for both conventional and modified tandem waves. For a bubble of 0.07 mm, our results indicate that the modified pressure profile enhances cavitation compared to conventional tandem waves at a wide range of delays (10-280 μs). According to this, the proposed pressure profile could be more efficient for SWL than conventional tandem shock waves. Similar results were obtained for a ten times smaller bubble.     

The influence of single-pulse and tandem shock waves on bacteria

Tandem shock waves have shown to enhance kidney stone fragmentation during in vitro and in vivo extracorporeal shock wave lithotripsy (SWL). The purpose of this research was to study the influence of shock waves on the viability of two strains of bacteria in solution, and to verify if tandem shock waves increase microorganism death. A piezoelectric shock wave generator was modified to generate either standard (single-pulse) or tandem (dual-pulse) shock waves. E. coli and Listeria monocytogenes were exposed in vitro to thousands of standard shock waves. Another group was subjected to the same number of tandem shock waves with a delay of 450 μs. A third group was exposed to tandem shock waves having a 900-μs delay. No inactivation was observed for both microorganisms at up to 8,000 standard shock waves. About 40% of L. monocytogenes and 50% of E. coli were inactivated after treatment with tandem waves at a delay of 900 μs. Inactivation was less efficient for a delay of 400 μs. Our results could be useful in medicine, because infection stones are still a significant cause of morbidity and mortality after SWL. The use of tandem shock waves to treat persistent localized infections or as a novel non-thermal food-preservation method also might be possible.