MP11-04 NEW INSIGHTS INTO THE GENESIS AND ADHERENCE OF URINARY CALCULI USING HIGH RESOLUTION MICROSCOPY

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2015MP11-04 NEW INSIGHTS INTO THE GENESIS AND ADHERENCE OF URINARY CALCULI USING HIGH RESOLUTION MICROSCOPY Sunita Ho, Frances Allen, Andrew Minor, Sabra Djomehri, Ling Chen, Thomas Chi, Krishna Ramaswamy, and Marshall Stoller Sunita HoSunita Ho More articles by this author , Frances AllenFrances Allen More articles by this author , Andrew MinorAndrew Minor More articles by this author , Sabra DjomehriSabra Djomehri More articles by this author , Ling ChenLing Chen More articles by this author , Thomas ChiThomas Chi More articles by this author , Krishna RamaswamyKrishna Ramaswamy More articles by this author , and Marshall StollerMarshall Stoller More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.385AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It has been postulated that Randall's plaque (RP) is the nidus for calculus formation. What keeps the RP or the early “calculus” adherent to the papilla and allow it to grow? The purpose of this study is to provide insights by identifying mineral density variation and ultrastructure of the anchor between the calculus and parenchyma. METHODS 500 µm biopsies from non-stone forming and stone forming human papillae were obtained from patients and were immediately imaged using high resolution x-ray microscopy with a spatial resolution <1 µm. Post processing software was used to analyze tomograms to identify mineral density of the lumen, anchor and papillary interstitium. RESULTS A representative figure illustrates a 3-dimensional digital reconstruction (20x, far left) and virtual sections (40x, right two images) with a representative calculus emerging from a uriniferous tubule (yellow arrows). Multiple mineral gradients from higher to lower mineral densities (40X images) were observed. The mineral density of the approximately 200 µm formed “calculus” (1.3 g/cc, yellow arrow) was similar to that of the luminal wall (1.2 g/cc, white arrows). The 20–50 µm wide “anchor” (black arrow) attaching the formed “calculus” to the luminal wall illustrates similar heterogeneous mineral density (yellow arrows, 40X) as identified by a mixture of higher and lower x-ray attenuation regions. The rough surface morphology of the formed mineral/calculus (yellow arrow, 20X) was distinctly different than the mineralized structures within the luminal walls and the interstitium (red star) of the papilla (white arrows, 40X). CONCLUSIONS High resolution x-ray microscopy illustrates the anchor (attachment site) of urinary calculus emerging from the mineralized wall of a plaque-ridden uriniferous tubule. This anchor appears to be an integral part of the mineralized luminal wall. These results provide new insights and an appreciation for the genesis and attachment mechanism(s) of the calculus to the parenchyma. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e120 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunita Ho More articles by this author Frances Allen More articles by this author Andrew Minor More articles by this author Sabra Djomehri More articles by this author Ling Chen More articles by this author Thomas Chi More articles by this author Krishna Ramaswamy More articles by this author Marshall Stoller More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...