The Impact of Endourological Experience on Flexible Ureteroscopy Outcomes and Performance at Different Levels of Expertise: Retrospective Multifactorial Analysis.

Introduction: The aim of this study was to analyze the influence of residents' participation in flexible ureteroscopy (fURS) on intra- and postoperative outcomes.

Materials And Methods: Intra- and postoperative parameters were compared in a retrospective monocentric setting between 3 groups: "resident group" (47 cases) for surgeries performed by experienced residents alone, "consultant group" (245 cases) for surgeries performed by consultants alone, "resident plus consultant group" (124 cases) for training surgeries between September 2013 and June 2017.

Results: Patients operated by residents alone had a significantly smaller median kidney stone diameter (5.

Laser fibre, rather than the stone, may harm the scope: retrospective monocentric analysis of 26 pre- and intraoperative factors of flexible ureteroscope (fURS) damage.

Purpose: The increasing number of flexible ureteroscopy procedures, the fragility of devices and their repair costs are a burden for urological departments worldwide. The objective was to investigate the impact of 26 pre- and intraoperative factors on reusable flexible ureteroscope (fURS) damage.

Methods: All procedures were conducted with reusable fURS: Karl Storz Flex-X2 or Olympus URF-V.

Exploiting the aiming beam to increase the safety of laser lithotripsy: Experimental evaluation of light reflection and fluorescence.

Background And Objectives: In Holmium laser lithotripsy, usually, the surgeon is guided by a visible beam superimposing the infrared (IR) treatment radiation. It has been shown that a green aiming beam excites stone autofluorescence. This fluorescence signal can be used for calculi detection to check the correct fiber position before triggering the IR laser, thus preventing damage to soft tissue and application devices.

Transient increased tumescence of the glans penis during penile erection after endovenous ablation of the great saphenous vein.

Objective: The primary objective of our study was to investigate the impact of endovenous ablation of the great saphenous vein (GSV) on the degree of tumescence of the glans penis during penile erection as well as on global erectile function (EF).

Methods: We included patients scheduled for one of three different methods of endoluminal treatment. Our questionnaire was composed of the EF domain of the International Index of Erectile Function, an additional question that has been validated for assessment of swelling (tumescence) of the glans penis, and a question on the use of erectogenic medication.

A New Automatically Fixating Stone Basket (2.5 F) Prototype with a Nitinol Spring for Accurate Ureteroscopic Stone Size Measurement.

Introduction: Intraoperative assessment of stone size is crucial for the successful and safe extraction of stones. The first automatically fixating measuring stone basket prototype showed a mismatch between the steel spring and the nitinol basket; therefore, to improve this prototype, the steel spring was replaced with a nitinol spring and a modified scale was implemented on the basket handle for accurate intraoperative stone size measurement.

Methods: The proposed tipped basket was composed of nitinol.

Scents in the stack: olfactometric proficiency testing with an emission simulation apparatus.

Olfactometry is globally acknowledged as a technique to determine odor concentrations, which are used to characterize odors for regulatory purposes, e.g., to protect the general public against harmful effects of air pollution.

Steep Infundibulopelvic Angle as a New Risk Factor for Flexible Ureteroscope Damage and Complicated Postoperative Course.

Objective: The increasing number of flexible ureterorenoscopy (fURS) procedures, the fragility of devices, and their growing repair costs represent a substantial burden for urological departments worldwide. No risk factors of flexible ureteroscope damage have been identified so far. The objective of this study was to investigate the impact of infundibulopelvic angle (IPA) on device damage and on other intraoperative and postoperative factors such as length of hospital stay, surgical complications, stone-free rate (SFR), operation, and fluoroscopy time.

Retrospective Cost Analysis of a Single-Center Reusable Flexible Ureterorenoscopy Program: A Comparative Cost Simulation of Disposable fURS as an Alternative.

Objective: The increasing number of flexible ureterorenoscopy (fURS) procedures, the fragility of devices, and their growing maintenance and repair costs represent a substantial burden for urologic departments. Disposable single-use fURS devices offer many advantages over reusable fURS. Among them, the LithoVue™ model shows the best clinical utility.

Stone/tissue differentiation for Holmium laser lithotripsy using autofluorescence: Clinical proof of concept study.

Background And Objectives: Holmium laser lithotripsy is the gold standard for intracorporeal fragmentation of urinary calculi. Usually, a visible beam is superimposed on the IR treatment laser as an aiming beam to guide the surgeon. In vitro tests showed that this aiming beam (532 nm, power <1 mW) excites strong fluorescence on human calculi.

A comparison between an in vitro ureteroscopic stone size estimation and the stone size measurement with the help of a scale on stone baskets.

Introduction: Endoscopic treatment of ureter stones and renal calculi relies on the surgeon's estimation of the stone size for both lithotripsy and removal of stones or stone fragments. We therefore compared precision and reliability of the endoscopic estimation of stone size by the surgeon with measurements on a scale on a stone basket.

Materials And Methods: Two surgeons (one high experienced and one low experienced) first estimated, then measured the size of 12 stones differing in size and color using different stone baskets (2.

Stone/tissue differentiation for holmium laser lithotripsy using autofluorescence.

Background And Objectives: Holmium laser lithotripsy is a safe and effective method to disintegrate urinary stones of all compositions in an endoscopic procedure. However, handling and safety could be improved by a real-time feedback system permanently monitoring the position of the treatment fiber. The laser is fired only when the fiber is identified as being placed in front of stone.

Light-controlled macrocyclization of tetrathiafulvalene with azobenzene: designing an optoelectronic molecular switch.

Macrocyclization between tetrathiafulvalene (TTF) dithiolates and bis-bromomethylazobenzenes/bis-bromomethylstilbenes is investigated under high dilution conditions. We show that macrocycles of different size can be formed depending on whether the (Z)- or (E)-isomers of azobenzene (AB) or stilbene are used. This represents the first example of a light-controllable cyclization reaction.

Stone/tissue differentiation during intracorporeal lithotripsy using diffuse white light reflectance spectroscopy: In vitro and clinical measurements.

Background And Objective: Holmium laser lithotripsy is the 'gold standard' for intracorporeal fragmentation of stones. However, there is a risk of damaging and perforating the ureter wall when the laser is accidentally fired while the fiber is in contact with tissue. The aim of this study was to evaluate if white illumination light, diffusely reflected back into the treatment fiber and spectrally analyzed, can be used for differentiating between stone and tissue.

Damage of stone baskets by endourologic lithotripters: a laboratory study of 5 lithotripters and 4 basket types.

Background. In some cases, the ureteral stone is simultaneously stabilized by a stone basket when endourologic lithotripsy is performed. This stabilization can be either on purpose or by accident.

1,7-diazaspiro[5.5]undecane--a neglected heterocycle.

A convenient and simple three step synthesis of 1,7-diazaspiro[5.5]undecane via Claisen condensation and acid catalyzed decarboxylation and spirocyclization of N-Boc-δ-valerolactam is described. Reactions of this spiroaminal with electrophiles including alkyl halides, alkane dihalides, acid chlorides, and sulfonyl chlorides gave either spirocyclic adducts or tetrahydropyridine derivatives.

Could titanium oxide coating from a sol-gel process make stone baskets more resistant to laser radiation at 2.1 μm?

Background: Stone baskets could be easily destroyed by Holmium:YAG-laser at an endourologic treatment, with respect to this, we try to improve the resistance by coating them with a titanium oxide layer. The layer was established by a sol-gel-process.

Materials And Methods: Six new baskets (Equadus, Opi Med, Ettlingen, Germany) were used: 1.

Palladium(0)-catalyzed allylic alkylation of diketoester-dioxinones with allyl acetates under neutral conditions: synthesis of hexasubstituted benzene derivatives.

Intermolecular palladium(0)-catalyzed allylic alkylation of diketoester-dioxinones was performed under neutral conditions with 2-alkenyl and 2-cycloalkenyl acetates. Subsequent aromatization using cesium carbonate gave rise to isopropylidene-protected hexasubstituted resorcylates.

Total syntheses of angelicoin A, hericenone J, and hericenol A via migratory prenyl- and geranylation-aromatization sequences.

A five-step synthesis of the natural product angelicoin A using a late stage highly regioselective palladium(0)-catalyzed decarboxylative prenyl migration and aromatization sequence as the key step is reported. The method was extended with geranyl migration in eight-step total syntheses of hericenone J and hericenol A from geraniol.

Destruction of stone extraction basket during an in vitro lithotripsy--a comparison of four lithotripters.

Background: Various techniques are available for intracorporeal disintegration of renal and ureteral stones, among them ballistic lithotripsy, ultrasonic lithotripsy and laser lithotripsy. The therapeutic effectiveness of these devices has been sufficiently studied and compared. This does not apply, however, to the risk of destroying the stone basket.

Synthesis of the isoquinocycline-pyrrolopyrrole substructure.

The synthesis of the pyrrolopyrrole substructure of the isoquinocyclines is reported. The pentacyclic (CDEFG) substructure of isoquinocycline A and B, which contains an unusual 2,4,5,6-tetrahydropyrrolo[2,3-b]pyrrole (FG) connected via an N,O-spiro acetal to the anthraquinoid core of the isoquinocycline aglycon has been synthesized. Key steps were a nickel(0)-mediated hydrocyanation of an alkynone, the conversion of an O,O-acetal into an N,O-acetal, and an intramolecular amidine alkylation.

A biological phantom for contrast-media-based perfusion studies with CT.

Objectives: Perfusion computed tomography (PCT) is increasingly getting popular with the advent of computed tomography (CT) systems with adequate temporal resolution and spatial coverage. We sought to develop a biological phantom for perfusion measurements in CT to design, improve, and validate scan protocols and postprocessing algorithms in vitro.

Materials And Methods: A special technique was applied to prepare and preserve a fresh porcine kidney.

Circular dichroism in ion yields of femtosecond-laser mass spectrometry.

Telling the difference quickly: Femtosecond laser pulses are not only suitable to distinguish structural isomers. They also provide access to the distinction of enantiomers by combination of circular dichroism and mass spectrometry [picture: see text].