Stone Dissolution Rate Research Articles

Determination of Total phenolic content and Antiurolithiatic activity of Sahasravatamulika (Hibiscus cannabinus Linn.) Extract and Fractions

The purpose of this study was to assess the total phenol content and invitro antiurolithiatic activity of Hibiscus cannabinus extract and various fractions. Kidney stones are one of the most painful and prevalent urinary tract disorders. Drug treatment and Extracorporeal Shock Wave Lithotripsy (ESWL) are used to treat kidney stones. Instead of dissolving the stone, these treatments may cause acute renal damage and an increase in stone production. Phenolic compounds show the best stone dissolution rate, i.e., they could dissolve calcium oxalate stones. In the present research Hibiscus cannabinus phenolic fraction was tested for its capacity to dissolve calcium phosphate stones, which is one of the many forms of kidney stones that can form. The highest phenolic content was found in the Ethyl acetate fraction of the plant, which was assessed using Gallic acid as a standard. This fraction was then tested for Antiurolithiatic activity in an in-vitro manner employing the egg's semipermeable membrane. The fraction can be evaluated for additional in-vivo and in-vitro investigations to determine its ability to dissolve Kidney stones developed in humans.

Choledochal cyst as an important risk factor for pediatric gallstones in low-incidence populations: A single-center review

Gallstones are uncommon in infants and children and Asian children are thought to have very low risk. Diagnoses have increased in recent years with the widespread use of ultrasonography (USG). This study aimed to review our experience with risk factors, complications, and treatment of pediatric gallstones in low-incidence populations. We retrospectively reviewed patients younger than 18 years old diagnosed with gallstones using USG between November 2006 and December 2012 in a tertiary referral hospital in Taiwan. Demographic information including age and sex, follow-up period, USG findings, predisposing factors, complications, treatment approaches and outcomes were recorded. Ninety-eight children with gallstones diagnosed with USG were enrolled and reviewed in our study. Females comprised 55% of patients, with no specific gender tendency. No risk factor could be identified in 30.8% of patients. The most common risk factors were cephalosporin (CS) use, presence of a choledochal cyst (CC), and spherocytosis. CS use was not associated with a higher dissolution rate. The presence of type IVa CC implied a high rate of gallstone recurrence after Roux-en-Y hepaticojejunostomy. Complications were seen in 22.4% of patients, but only two needed emergency stone removal. Expectant management was performed in 61% of patients and 62.5% of them achieved spontaneous resolution; the stone dissolution rate was not lower than in the group treated with ursodeoxycholic acid (UDCA). Stone size was significantly decreased after UDCA use if resolution did not occur. Pediatric gallstones showed high resolution rate, and the clinical course was largely benign. CS use was the most common risk factor and did not predict a higher dissolution rate. Type IVa CC was also an important risk factor associated with a high recurrence rate. Conservative treatment and oral UDCA may be reasonable strategies in most patients, unless complications are present.

In vitro litholytic activity of extracts and phenolic fractions of some medicinal plants on urinary stones

Objective: This study was carried out to evaluate the efficiency of plant extracts used in traditional medicine on the dissolution of oxalo-calcic and cystine stones. Also, the efficiency of phenolic fractions (Tannins and Flavonoids) for the plants that gave us the best stone dissolution rate. Subjects and methods: Kidney stone of oxalo-calcic and cystine stones were incubated in vitro for 8 weeks in the presence of five plants extracts (hydro-ethanolic and aqueous extracts). NaCl solution (0,9 %) used as negative control and sodium citrate solution at 3 mM/L as a positive control. The studied plants were Herniaria hirsuta L. aerial parts, Opuntia ficus-indica L. flowers, Zea mays L. stigmata, Ammi visnaga L. seeds and Ziziphus lotus L. fruits. After 2, 4, 6 and 8 weeks the stones were weighed after 18 h drying at 40°C and the dissolution rate of the stones and the pH of the solution were measured.Results: After eight weeks, all the plant extracts and phenolic fractions had revealed a significant effect to dissolve oxalo-calcic and cystine stones in comparison to the control solutions. The best result of cystine stones was showed with aqueous extract of H. hirsuta aerial parts which had a dissolution rate of 88,91 %. Concerning the dissolution rate of oxalo-calcic stones the aqueous extract of Z. mays had the best results with 68 % against 19 % for the sodium citrate solution. The dissolution rate of the fractions studied showed a better result for Z. mays flavonoids fraction toward oxalo-calcic stones, and Z. mays tannins fraction for cystine stones. The pH undergoes a non-negligible linear increase over the eight weeks for all extracts and phenolic fractions and both kidney stones.Conclusion: The tested plants' extracts and the phenolic fractions for the plants that gave us the best stone dissolution rate were able to dissolve oxalo-calcic and cystine stones. To confirm the efficiency of these plant extracts on the treatment of oxalo-calcic and cystine stones multiple in vivo tests could be made.

Does rock chemistry affect periphyton accrual in streams?

Stones of different rock types often accrue different amounts of periphytic algae. Although algal biomass may be positively related to stone roughness, the confounding role of rock chemistry is unclear. This independent effect of rock chemistry on benthic algae was tested using the nutrient-diffusing technique, by incorporating powdered stone, rather than nutrients, into the agar matrix. Rocks tested were sandstone, obsidian, schist, greywacke, pumice, gypsum, limestone, serpentine, and phosphorite. Petri-dishes containing powdered rock and agar, and covered with a permeable cellulose filter, were incubated in eight pools in a granitic stream. Algal biomass did not differ among any of the nine rock types and plain agar control, whereas biomass differed among the concurrently placed nutrient diffusing substrates (the stream was phosphorus-limited). Algal composition was more related to an upstream-downstream gradient (for filamentous algae) and pool-specific effects (deposition of fine sediment for diatoms) than rock chemistry. This minimal effect of rock chemistry may be caused by the low dissolution rate of stones.

Composition of gall bladder stones associated with octreotide: response to oral ursodeoxycholic acid.

Octreotide, an effective treatment for acromegaly, induces gall bladder stones in 13-60% of patients. Because knowledge of stone composition is essential for studies of their pathogenesis, treatment, and prevention, this was investigated by direct and indirect methods in 14 octreotide treated acromegalic patients with gall stones. Chemical analysis of gall stones retrieved at cholecystectomy from two patients, showed that they contained 71% and 87% cholesterol by weight. In the remaining 12 patients, localised computed tomography of the gall bladder showed that eight had stones with maximum attenuation scores of < 100 Hounsfield units (values of < 100 HU predict cholesterol rich, dissolvable stones). Gall bladder bile was obtained by ultrasound guided, fine needle puncture from six patients. All six patients had supersaturated bile (mean (SEM) cholesterol saturation index of 1.19 (0.08) (range 1.01-1.53)) and all had abnormally rapid cholesterol microcrystal nucleation times (< 4 days (range 1-4)), whilst in four, the bile contained cholesterol microcrystals immediately after sampling. Of the 12 patients considered for oral ursodeoxycholic acid (UDCA) treatment, two had a blocked cystic duct and were not started on UDCA while one was lost to follow up. After one year of treatment, five of the remaining nine patients showed either partial (n = 3) or complete (n = 2) gall stone dissolution, suggesting that their stones were cholesterol rich. This corresponds, by actuarial (life table) analysis, to a combined gall stone dissolution rate of 58.3 (15.9%). In conclusion, octreotide induced gall stones are generally small, multiple, and cholesterol rich although, in common with spontaneous gall stone disease, at presentation some patients will have a blocked cystic duct and some gall stones containing calcium.

Human gallstone dissolution accelerated by ultrasound application

Gallstones in appropriate chemical species subject to ultrasound exposure show accelerated dissolution over that accruing to the chemical alone. In vitro studies using a human gallstone submerged with monooctanoin (a cholesterol stone solvent) in a latex envelope show dissolution of a stone mass of 0.50 g with 6 min of total ultrasound exposure at a SPTP intensity of 15 W cm−2. Control stones in the monooctanoin show a weight loss of 0.05 g in the same overall treatment time. When a pressure of 350 lb in−2 is applied the stone dissolution rate declines by a factor of 3 from that at atmospheric pressure. The primary erosion mechanism is apparently of cavitation origin but a smaller but significant erosion acceleration occurs in the apparent absence of cavitation. A unique feature of this type of gallstone dissolution is the conversion of solid stone into a liquid state providing for ease of passage of gallbladder content in the clinical situation. That this accelerated dissolution occurs in vitro has been demonstrated on a series of pigs with human gallstones implanted in their gallbladder. [Work supported by Indiana Corporation for Science and Technology, I. C. F. A. R., and Labeco/Labsonics, Mooresville, IN.]

Homozygous Cystinuria—Evaluation of 35 Patients

We discuss the characteristics of 35 patients with cystinuria, which is a medically treatable disease. A successful stone dissolution rate of 55 per cent was observed. Most treatment failures were related to urinary tract infection, poor patient compliance or the presence of associated nondissolvable stones. Surgical intervention usually was required in these patients.

Chenodeoxycholic Acid

Chenodeoxycholic acid (chenic acid; CDCA) is 1 of the 3 major biliary bile acids in man. When administered in pharmacological doses it causes a decrease in cholesterol saturation of bile, which in turn may lead to gradual dissolution of cholesterol gallstones. The stone dissolution rate during CDCA therapy has varied considerably from about one-third of patients overall to 80 to 90% in a highly selected group of patients. Radiolucent gallstones in a functioning gallbladder are absolute requirements. CDCA is well tolerated; diarrhoea (sometimes requiring dosage reduction) is the only frequent side effect. Although hepatotoxicity has occurred in certain animal species, and slight hypertransaminasaemia has occurred in some patients, definite liver damage has not been observed in man. CDCA is considered contraindicated in pregnancy, and in those patients with the complications from gallstones which require immediate surgery. Care should be taken in patients with liver disease. The only other proven agent for dissolving gallstones is the 7 beta-epimer of CDCA, ursodeoxycholic acid (UDCA). Preliminary results show that UDCA is as effective as CDCA, but at one-half to two-thirds the dose, without causing diarrhoea. Further studies need to be done with both CDCA and UDCA to improve criteria for selection of patients most likely to respond, and to establish optimum schedules for dosage and duration of treatment.