Biomedical subjects

J W Dushinski

Publications and source records attributed to J W Dushinski.

4 recordsLinked to original sources

PubMed1999

Expanding role of flexible nephroscopy in the upper urinary tract.

Flexible nephroscopy has become an important diagnostic and therapeutic modality for urologists. We have applied the flexible nephroscope in four clinical settings: as an adjunct to rigid instruments during primary percutaneous nephrolithotomy (PCNL); in a second-look procedure to remove residual renal calculi; as the primary endoscope to treat renal calculi; and to diagnose and treat other upper urinary tract pathology. The most common application of flexible nephroscopy in our experience has been during primary PCNL after the bulk of the stone burden has been removed with the rigid nephroscope. Liberal use of the flexible endoscope in these settings may increase the stone-free rate and decrease the need for additional access tracts and procedures. In addition, patients with conduit urinary diversions may be managed using flexible nephroscopy to diagnose and treat upper tract tumors.

Carcinoma, Transitional Cell↗

PubMed1998

High-speed photographic evaluation of holmium laser.

Little information has been published regarding the relative contributions and exact mechanisms involved in stone fragmentation during holmium laser lithotripsy. High-speed photography has been used to evaluate other intracorporeal lithotripsy devices, and we chose this method to evaluate the holmium laser. High-speed photographic evaluation of cavitation bubbles produced by the four fiber sizes (200, 365, 550, and 1000 microm) showed a moderate degree of correlation (n = 0.71 for 1 J pulses, r = 0.80 for 4 J pulses) between maximal bubble size and fiber diameter. Eliminating the data from the eroded 550 microm fiber strengthened the correlation to r = 0.94 for 1 J pulses and r = 0.99 for 4 J pulses. The importance of keeping fiber tips in good working condition was thereby demonstrated. Evidence of a thermal effect of the laser on stone and chalk was also obtained. In a parallel study, no correlation (r = -0.08) was found between fiber diameter and stone fragmentation efficiency using chalk as an in vitro stone model.

Calcium Carbonate↗

PubMed1997

Simultaneous bilateral percutaneous nephrolithotomy.

PURPOSE: We evaluate the results of simultaneous bilateral percutaneous nephrolithotomy. MATERIALS AND METHODS: The charts of 52 patients scheduled for simultaneous bilateral percutaneous nephrolithotomy at the Methodist Hospital of Indiana were retrospectively reviewed. The results of the 48 patients who underwent the procedure were tabulated and analyzed. RESULTS: Mean operative time was 269 minutes and mean hospital stay was 5.6 days. Of the patients 45 were rendered stone-free (96.9% of 96 renal units) and 3 had insignificant debris (fragments less than 4 mm.) unilaterally. Complications were infrequent and included hydrothorax in 5 cases, ureteral obstruction by fragment migration in 2, hematuria causing clot retention in 2, blood transfusion in 2 and ureteral perforation with a guide wire in 1. CONCLUSIONS: Simultaneous bilateral percutaneous nephrolithotomy is a well tolerated, safe, cost-effective and expeditious approach to patients with bilateral renal calculi requiring percutaneous nephrolithotomy.

Adolescent↗

PubMed1997

Urologic applications of the Holmium laser.

The Holmium laser has now been in clinical use in urology for several years. The indications for its use continue to expand, and now include lithotripsy and urothelial tumor ablation anywhere in the urinary tract, resection of the prostate, incision of various urinary tract strictures, and vaporization of cutaneous lesions of the external genitalia. The 2100-nm wavelength provides the Holmium laser with a unique combination of vaporization and coagulation, allowing a precise cutting action when higher energy levels are applied. A shallow depth of penetration (< 0.5 mm) in water and tissue allows precise energy application and provides a margin of safety. The machine's user-friendly setup facilitates its operation by urologists and assistance by allied health-care personnel. The multiple urologic applications make the Holmium laser an attractive instrument for everyday utilization by any medium to large urological unit.

Clinical Trials as Topic↗