{"id":2383,"date":"2022-02-09T13:03:18","date_gmt":"2022-02-09T12:03:18","guid":{"rendered":"https:\/\/www.newslab.sk\/moznosti-analyzy-mocovych-konkrementov\/"},"modified":"2022-02-10T02:21:33","modified_gmt":"2022-02-10T01:21:33","slug":"posibilities-in-urinary-concretion-analysis","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/posibilities-in-urinary-concretion-analysis\/","title":{"rendered":"Posibilities in urinary concretion analysis"},"content":{"rendered":"

*A rare case of autochthonous human dirofilariasis with the manifestation of pseudotumor of the epididymis caused by helminth Dirofilaria repens<\/strong><\/span><\/p>\n

\u00davod<\/h3>\n

S\u00fa\u010das\u0165ou mana\u017ementu pacienta s uroliti\u00e1zou je evalu\u00e1cia extrahovan\u00fdch alebo spont\u00e1nne vyl\u00fa\u010den\u00fdch mo\u010dov\u00fdch konkrementov. Toto hodnotenie m\u00e1 by\u0165 dostato\u010dne presn\u00e9 na to, aby sa dok\u00e1zala pr\u00edtomnos\u0165 majoritn\u00fdch zlo\u017eiek konkrementu. Konkrementy m\u00f4\u017eu by\u0165 analyzovan\u00e9 z h\u013eadiska chemick\u00e9ho zlo\u017eenia, tvaru kry\u0161t\u00e1lov, farby, tvrdosti a morfol\u00f3gie(1).
\nVlastnosti konkrementov \u00fazko s\u00favisia s\u00a0 prevl\u00e1daj\u00facim rizikov\u00fdm faktorom, preto je pre lie\u010dbu pacientov s uroliti\u00e1zou potrebn\u00e9 vykona\u0165 anal\u00fdzu spr\u00e1vne. Konkrementy m\u00f4\u017eu by\u0165 chemicky aj morfologicky homog\u00e9nne alebo pozost\u00e1vaj\u00fa z viacer\u00fdch frakci\u00ed. Homog\u00e9nne konkrementy s\u00fa v\u00fdsledkom jednoduch\u0161\u00edch procesov odohr\u00e1vaj\u00facich sa v prostred\u00ed s kon\u0161tantn\u00fdmi vlastnos\u0165ami. Viaczlo\u017ekov\u00e9 konkrementy vznikaj\u00fa v prostred\u00ed s variabilnej\u0161\u00edmi vlastnos\u0165ami. V\u00fdsledn\u00fd charakter konkrementu je z\u00e1visl\u00fd od charakteru prostredia, v ktorom konkrement vznik\u00e1, a od jeho variability v \u010dase. Evalu\u00e1cia jednotliv\u00fdch frakci\u00ed viaczlo\u017ekov\u00fdch konkrementov m\u00f4\u017ee odhali\u0165 probl\u00e9m (metabolick\u00fa zmenu), ktor\u00fd bol vy\u0161etren\u00edm krvi alebo mo\u010du nezisten\u00fd. Presnou anal\u00fdzou konkrementu dok\u00e1\u017eeme lep\u0161ie ur\u010di\u0165 rizikov\u00e9 faktory vzniku uroliti\u00e1zy. Vo vz\u0165ahu k rizikov\u00fdm faktorom dok\u00e1\u017eeme ur\u010di\u0165 rizikov\u00e9 potraviny a n\u00e1sledne upravi\u0165 stravovacie n\u00e1vyky tak, aby nedoch\u00e1dzalo k recid\u00edvam(1,2).
\nPreva\u017en\u00e9 mno\u017estvo laborat\u00f3ri\u00ed na Slovensku aj vo svete pou\u017e\u00edva zastaran\u00fa chemick\u00fa titra\u010dn\u00fa anal\u00fdzu. Pri vysokej miere nepresnost\u00ed a ch\u00fdb doch\u00e1dza \u010dasto k nespr\u00e1vnemu ur\u010deniu chemick\u00e9ho zlo\u017eenia konkrementu (viac ako 50 % konkrementov je ur\u010den\u00fdch chybne)(2).<\/p>\n

Materi\u00e1l a\u00a0metodika<\/h3>\n

V\u0161etky vzorky maj\u00fa hum\u00e1nny p\u00f4vod. Nie s\u00fa zn\u00e1me bli\u017e\u0161ie \u00fadaje o\u00a0pacientoch.
\nMorfologick\u00e9 \u0161t\u00fadie. Konkrementy boli pozorovan\u00e9 bino-kul\u00e1rnou lupou Nikon SZM 1500\u2008s SD-Fi2 kamerou s maxim\u00e1lnym zv\u00e4\u010d\u0161en\u00edm 11,25x z vonkaj\u0161ej, po sekcii konkrementu z vn\u00fatornej strany pri odrazenom svetle.
\nInfra\u010derven\u00e1 spektroskopia (FTIR). Vzorky boli homogenizovan\u00e9 na pr\u00e1\u0161ok. V\u00fdsledkom merania je spektrum s charakteristick\u00fdmi molekulov\u00fdmi vibr\u00e1ciami, ktor\u00e9 sa prejavuj\u00fa ako absorp\u010dn\u00e9 p\u00e1sy. Spektr\u00e1lny z\u00e1znam bol vyhotoven\u00fd pr\u00edstrojom Nicolet iS50 v rozmedz\u00ed 4\u2009000 \u2013 400\u2008cm\u20131 pou\u017eit\u00edm tech-niky zoslaben\u00e9ho \u00fapln\u00e9ho odrazu (ATR) na diamantovom kry\u0161t\u00e1le. Z\u00e1znam pozost\u00e1va zo 64 skenov v 2\u2008cm\u20131 krokoch.<\/p>\n

Ramanova spektroskopia (RAMAN). Anal\u00fdzy boli vykonan\u00e9 bez dodato\u010dnej \u00fapravy vzorky spektrometrom LabRAM-HR 800 \u2013 verzia UV-VIS-NIR vybaven\u00e9ho mikroskopom Olympus BX-41\u2008s maxim\u00e1lnym zv\u00e4\u010d\u0161en\u00edm 100x. Mikroskop pozost\u00e1va z CCD detektora Synapse chladen\u00e9ho Peltierov\u00fdm \u010dl\u00e1nkom (\u201370\u2008\u00b0C) s difrak\u010dnou mrie\u017ekou 600 vrypov\/mm. Na meranie boli pou\u017eit\u00e9 lasery s vlnovou d\u013a\u017ekou 532\u2008nm (Nd: YAG) a 633\u2008nm (He-Ne). Celkov\u00e1 d\u013a\u017eka z\u00e1znamu dosahovala 8 \u2013 120 min\u00fat.
\nPr\u00e1\u0161kov\u00e1 difrak\u010dn\u00e1 anal\u00fdza (PXRD). Pr\u00e1\u0161kov\u00e9 prepar\u00e1ty boli vlo\u017een\u00e9 do pr\u00edstrojovej komory tak, aby sa zabr\u00e1nilo horizont\u00e1lnemu usporiadaniu kry\u0161t\u00e1lov a analyzovan\u00e9 rtg. difraktometrom Bruker D8 Advance SolXE. \u017diarenie s\u00a0 nap\u00e4t\u00edm 40\u2008kV a pr\u00fadom 40\u2008mA z W vl\u00e1kna dopadalo na Cu an\u00f3du s \u03bb = 1,540562 \u00c5. Boli zaznamenan\u00e9 skeny v krokoch 0,02\u00b0\/0,8\u2008s\u00a0 v\u00a0 rozmedz\u00ed 2\u00a0 \u2013 65\u00b0. V\u00fdsledkom merania je difrak\u010dn\u00e1 tabu\u013eka, ktor\u00e1 ud\u00e1va hodnoty medzirovinn\u00fdch vzdialenost\u00ed a intenz\u00edt vo vz\u0165ahu k Millerov\u00fdm indexom. Priemern\u00e9 referen\u010dn\u00e9 hodnoty boli vypo\u010d\u00edtan\u00e9 z\u00a0 doposia\u013e publikovan\u00fdch hodn\u00f4t.
\nElektr\u00f3nov\u00e1 mikroskopia (SEM) a mikroanal\u00fdza (EDS). Na vzorky bola nanesen\u00e1 vrstva uhl\u00edka, v pr\u00edpade EDS boli vzorky narezan\u00e9. Anal\u00fdza bola vykonan\u00e1 mikroskopom JEOL JSM-6390LV. Prostredn\u00edctvom mikroanalyz\u00e1tora JEOL JXA 8530\u2008F so spektrometrom SDD a rozl\u00ed\u0161en\u00edm 133 eV sa vykonala distrib\u00facia prvkov v konkrementoch.<\/p>\n

V\u00fdsledky<\/h3>\n

Morfologick\u00e9 \u0161t\u00fadie<\/strong><\/p>\n

Pozorovanie vzoriek pod binokul\u00e1rom (obr\u00e1zok 1 A, B) odhalilo rozdiely v morfologick\u00fdch vlastnostiach konkrementov. Pozorujeme odli\u0161n\u00e9 sfarbenie, vn\u00fatorn\u00fa aj povrchov\u00fa \u0161trukt\u00faru. Pri konkrementoc s\u00fa pr\u00edtomn\u00e9 koncentrick\u00e9 vrstvy. Na ur\u010denie chemick\u00e9ho zlo\u017eenia bola vykonan\u00e1 anal\u00fdza FTIR.<\/p>\n

Infra\u010derven\u00e1 spektroskopia (FTIR) a\u00a0Ramanova spektroskopia (RAMAN)<\/strong>
\nMet\u00f3dou FTIR bol vo vzorke na obr\u00e1zku 1A identifikovan\u00fd whewellit Ca(C2O4) \u00b7 H2O. Rozdielne sfarbenie koncentrick\u00fdch vrstiev je sp\u00f4soben\u00e9 odli\u0161nou koncentr\u00e1ciou Ca. Whewellit bol ur\u010den\u00fd dvoma sp\u00f4sobmi:<\/p>\n

a) nameran\u00e9 spektrum bolo porovnan\u00e9 s\u00a0 datab\u00e1zou ATRIR \u2013 Inorganics 1 \u2013 Bio-Rad Sadtler a na z\u00e1klade najvy\u0161\u0161ej zhody ur\u010den\u00fd whewellit (obr\u00e1zok 2),<\/p>\n

b) bol identifikovan\u00fd whewellit na z\u00e1klade pr\u00edtomnosti funk\u010dn\u00fdch skup\u00edn charakteristick\u00fdch pre tento miner\u00e1l. Vibr\u00e1cie s \u03c3 = 652, 3\u2009000 \u2013 3\u2009500\u2008cm\u20131 reprezentuj\u00fa H2O. Absorp\u010dn\u00e9 maximum s \u03c3 = 779\u2008cm\u20131 je charakteristickou vibr\u00e1ciou C\u2013H v\u00e4zby a vibr\u00e1cie skup\u00edn C=O a C\u2013O sa prejavuj\u00fa v miestach s \u03c3 = 1\u2009313\u2008cm\u20131, resp. \u03c3 = 1\u2009606\u2008cm\u20131.
\nVo vzorke na obr\u00e1zku 1B boli svetl\u00e9 koncentrick\u00e9 vrstvy tvoren\u00e9 dihydr\u00e1tom kys. et\u00e1ndiovej C2H2O4 \u00b7 2H2O, tmav\u00e9 \u010dasti tvoril whewellit Ca(C2O4) \u00b7 H2O. V\u00fdsledok merania zobrazuje obr\u00e1zok 3. Vibr\u00e1cie s \u03c3 = 915 a 1\u2009539\u2008cm\u20131 zodpovedaj\u00fa NH2 skupine. Absorp\u010dn\u00e9 maximum s \u03c3 = 1\u2009316\u2008cm\u20131 patr\u00ed amidovej C\u2013N skupine. Vibr\u00e1cia s \u03c3 = 1\u2009457\u2008cm\u20131 reprezentuje CH2 skupinu. Karboxylov\u00e1 dvojit\u00e1 C=O v\u00e4zba je vyjadren\u00e1 vibr\u00e1ciou s \u03c3 = 1\u2009743\u2008cm\u20131. Ostatn\u00e9 absorp\u010dn\u00e9 maxim\u00e1 patria whewellitu.
\nMet\u00f3dou RAMAN (obr\u00e1zok 4) bola zisten\u00e1 pr\u00edtomnos\u0165 dahlitu Ca5(PO4,CO3)3(OH) (obr\u00e1zok 3) identifik\u00e1ciou vibr\u00e1ci\u00ed fosfore\u010dnanov\u00fdch (PO4)\u20133 molek\u00fal v miestach s \u03c3 = 433, 583, 961, 1026\u2008cm\u20131. Absorp\u010dn\u00e9 maximum s \u03c3 = 1\u2009099\u2008cm\u20131 je charakteristick\u00e9 pre (CO3)2\u2013 skupinu a\u00a0 vibr\u00e1cia s\u00a0 \u03c3 = 1\u2009565\u2008cm\u20131 je identifika\u010dn\u00e1 pre amidov\u00fa C\u2013N\u2013H skupinu. Vibr\u00e1cie s\u00fa typick\u00e9 pre dahlit.<\/p>\n

Pr\u00e1\u0161kov\u00e1 difrak\u010dn\u00e1 anal\u00fdza (PXRD)<\/strong>
\nObr\u00e1zok 5 zobrazuje difrak\u010dn\u00fd z\u00e1znam struvitu (NH4) Mg(PO4) \u00b7 6H2O a\u00a0porovnanie \u00fadajov s\u00a0referen\u010dn\u00fdm spektrom pre struvit z\u00edskan\u00e9 z\u00a0publikovan\u00fdch priemern\u00fdch hodn\u00f4t(3-6).<\/p>\n

Elektr\u00f3nov\u00e1 mikroskopia (SEM)<\/strong>
\nNa obr\u00e1zku 6 s\u00fa vidite\u013en\u00e9 prizmatick\u00e9 dypyramid\u00e1lne kry\u0161t\u00e1ly. Tento tvar je typick\u00fd pre weddellit Ca(C2O4) \u00b7 2H2O, aj ke\u010f podobn\u00e9 kry\u0161t\u00e1ly m\u00f4\u017ee vytv\u00e1ra\u0165 aj in\u00fd miner\u00e1l.<\/p>\n

Elektr\u00f3nov\u00e1 mikroanal\u00fdza (EDS)<\/strong>
\nV\u00fdsledky EDS anal\u00fdzy dokumentuje tabu\u013eka 1 a\u00a0 obr\u00e1zok 7. Tabu\u013eka 1 zobrazuje zast\u00fapenie prvkov a oxidov na vybran\u00fdch miestach vzorky. Zo z\u00edskan\u00fdch \u00fadajov predpoklad\u00e1me na z\u00e1klade stechiometrick\u00fdch v\u00fdpo\u010dtov a porovnania s datab\u00e1zou(7) vznik nasleduj\u00facich miner\u00e1lov: oxid v\u00e1penat\u00fd CaO, kreme\u0148 SiO2 a mal\u00e9 mno\u017estv\u00e1 apatitu Ca5(PO4)3(OH) a anhydritu CaSO4. V miestach (C a D) s dominantn\u00fdm obsahom N predpoklad\u00e1me vznik bli\u017e\u0161ie ne\u0161pecifikovanej organickej zlo\u017eky a kreme\u0148a SiO2. Obr\u00e1zok 7 zachyt\u00e1va rozmiestnenie prvkov vo vzorke a ich vz\u00e1jomn\u00fa afinitu. N a Ca preukazuj\u00fa vysok\u00fa afinitu k O, Si sa uklad\u00e1 v okrajov\u00fdch \u010das-tiach NO a CaO tvor\u00ed samostatn\u00fa jednotku.<\/p>\n

Diskusia a z\u00e1ver<\/h3>\n

Met\u00f3du morfologick\u00fdch \u0161t\u00fadi\u00ed vyu\u017e\u00edvame ako doplnkov\u00fa podobne ako in\u00ed autori (8). V\u00fdhodou je n\u00edzka cena anal\u00fdzy, jednoduchos\u0165 obsluhy, nen\u00e1ro\u010dn\u00e9 hodnotenie v\u00fdsledkov a kr\u00e1tky \u010das merania (do 10 min.). Ak na povrchu konkrementu nie s\u00fa dostato\u010dne vyvinut\u00e9 kry\u0161t\u00e1lov\u00e9 tvary, met\u00f3da neposta\u010duje na presn\u00fa anal\u00fdzu konkrementov.
\nMet\u00f3da FTIR sp\u013a\u0148a predpoklady na rutinn\u00e9 pou\u017e\u00edvanie a pova\u017eujeme ju za najlep\u0161iu met\u00f3du na anal\u00fdzu konkrementov(1,9). Poskytuje \u00fadaje na semikvantitat\u00edvnej \u00farovni (m\u00e1 vysok\u00fa \u0161pecificitu a senzitivitu) a minimalizuje mno\u017estvo ch\u00fdb v porovnan\u00ed s chemickou titra\u010dnou anal\u00fdzou(10,11). Je relat\u00edvne lacn\u00e1 (15\u2008\u20ac\/anal\u00fdza)(12), jednoduch\u00e1 na obsluhu, hodnotenie v\u00fdsledkov je stredne n\u00e1ro\u010dn\u00e9, vzorka vy\u017eaduje homogeniz\u00e1ciu a meranie trv\u00e1 < 10 min. Nameran\u00e9 hodnoty s\u00fa podobn\u00e9 ako publikovan\u00e9 \u00fadaje(13,14).
\nRAMAN poskytuje v porovnan\u00ed s FTIR v\u00fdsledky na kvantitat\u00edvnej \u00farovni so senzitivitou 96,3 % a \u0161pecificitou 98,5 \u2013 99,5 %(15). Cena anal\u00fdzy je 17\u2008\u20ac\/vzorku(16), merania mo\u017eno robi\u0165 bodovo, vzorky nevy\u017eaduj\u00fa \u0161peci\u00e1lnu \u00fapravu a anal\u00fdza aj n\u00e1sledn\u00e9 hodnotenie v\u00fdsledkov s\u00fa stredne n\u00e1ro\u010dn\u00e9. Nev\u00fdhodou je d\u013a\u017eka merania, ktor\u00e1 m\u00f4\u017ee by\u0165 v rozmedz\u00ed 10 \u2013 180 min. Na pou\u017eitie met\u00f3dy RAMAN a FTIR posta\u010duje mno\u017estvo vzorky \u2265 0,5\u2008mm3(17) a met\u00f3dy s\u00fa vhodn\u00e9 na anal\u00fdzu liekov\u00fdch a\u00a0 in\u00fdch menej \u010dast\u00fdch konkrementov. Hodnoty a\u00a0 intenzita vibr\u00e1ci\u00ed s\u00fa toto\u017en\u00e9 sa zhoduj\u00fa s meraniami in\u00fdch autorov(18).
\nPXRD anal\u00fdza je kvalitn\u00e1 kvantitat\u00edvna met\u00f3da na identifik\u00e1cii \u0161trukt\u00fary kry\u0161talickej l\u00e1tky. Meranie trv\u00e1 20\u00a0 \u2013 180 min a predl\u017euje sa s klesaj\u00facou hmotnos\u0165ou vzorky. Cena anal\u00fdzy je 50\u2008\u20ac\/vzorku(15), konkrement je potrebn\u00e9 homogenizova\u0165, anal\u00fdza je stredne n\u00e1ro\u010dn\u00e1 a hodnotenie v\u00fdsledkov n\u00e1ro\u010dn\u00e9. Nev\u00fdhodou je nemo\u017enos\u0165 merania amorfn\u00fdch konkrementov(19,20). Nameran\u00e9 hodnoty s\u00fa dostato\u010dne podobn\u00e9 priemern\u00fdm hodnot\u00e1m z doposia\u013e publikovan\u00fdch pr\u00e1c v r\u00e1mci datab\u00e1zy AMCSD(21).
\nMet\u00f3da SEM poskytuje fotografie vo vysokom rozl\u00ed\u0161en\u00ed (dok\u00e1\u017ee rozl\u00ed\u0161i\u0165 komponenty s ve\u013ekos\u0165ou od 1\u2008nm). D\u013a\u017eka anal\u00fdzy st\u00fapa so zvy\u0161ovan\u00edm chemickej heterogenity konkrementu a trv\u00e1 20 \u2013 120 min. Cena 1 anal\u00fdzy je 20\u2008\u20ac(16), je potrebn\u00e9 naparenie vzorky uhl\u00edkom, je n\u00e1ro\u010dn\u00e1 na obsluhu aj hodnotenie v\u00fdsledkov(22,23). Kry\u0161t\u00e1ly na SEM fotografii s\u00fa tvarom podobn\u00e9 kry\u0161t\u00e1lom weddellitu z in\u00fdch publik\u00e1ci\u00ed(24) a datab\u00e1z(25).
\nMet\u00f3da EDS pon\u00faka kvantitat\u00edvne v\u00fdsledky chemick\u00e9ho zlo\u017eenia a distrib\u00faciu vybran\u00fdch prvkov. D\u013a\u017eka anal\u00fdzy (30 \u2013 120 min.) podobne ako pri SEM st\u00fapa chemickou heterogenitou konkrementu. Povrch vzorky je potrebn\u00e9 upravi\u0165, aby bol hladk\u00fd, a napari\u0165 uhl\u00edkom. Cena 1 anal\u00fdzy je 20\u2008\u20ac, meranie a vyhodnocovanie v\u00fdsledkov je relat\u00edvne n\u00e1ro\u010dn\u00e9(16,23). V\u00fdsledky EDS tabu\u013eky pre jednotliv\u00e9 meran\u00e9 body s\u00fa pri porovnan\u00ed s datab\u00e1zou dostato\u010dne zhodn\u00e9(7). Obr\u00e1zok 7 zobrazuje rozlo\u017eenie prvkov a ich vz\u00e1jomn\u00fa afinitu a pom\u00e1ha lep\u0161ie pochopi\u0165 vznik konkrementu.
\nV porovnan\u00ed so zastaranou(1) chemickou titra\u010dnou anal\u00fdzou s\u00fa v\u0161etky op\u00edsan\u00e9 met\u00f3dy v\u00fdskumu mo\u010dov\u00fdch konkrementov kvalitat\u00edvne lep\u0161ie. Nedoch\u00e1dza k tak\u00e9mu vysok\u00e9mu mno\u017estvu ch\u00fdb \u2013 falo\u0161ne pozit\u00edvnym a falo\u0161ne negat\u00edvnym v\u00fdsledkom. V slovensk\u00fdch laborat\u00f3ri\u00e1ch v\u017edy preva\u017euje pou\u017e\u00edvanie chemickej titra\u010dnej anal\u00fdzy. T\u00fdmto sme chceli pon\u00faknu\u0165 in\u00e9, spo\u013eahlivej\u0161ie mo\u017enosti anal\u00fdz mo\u010dov\u00fdch konkrementov.<\/p>\n

Grantov\u00e1 podpora<\/strong>
\nV\u00fdskum bol podporen\u00fd grantmi KEGA 008UPJ\u0160-4\/2020, KEGA 010UPJ\u0160-4\/2021 a VVGS VUaVP35 2020-1653.<\/p>\n

 <\/p>\n

LITERAT\u00daRA<\/h3>\n

1. T\u00fcrk C, Neisius A, Petrik A, et al. EAU Guidelines on Urolithiasis. 2021st ed. EAU Guidelines Office; 2021.<\/p>\n

2. Gilad R, Williams JC, Usman KD, et al. Interpreting the results of chemical stone analysis in the era of modern stone analysis techniques. J Nephrol 2017; 30(1): 135-140.<\/p>\n

3. Ferraris G, Fuess H, Joswig W. Neutron diffraction study of MgN-H4PO4.6H2O (struvite) and survey of water molecules donating short hydrogen bonds 1986; 42(3): 253-258.<\/p>\n

4. Mathew M, Schroeder LW, IUCr. Crystal structure of a struvite analogue, MgKPO4.6H2O. Acta Cryst 1979; 35(1): 11-13.<\/p>\n

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6. Graeser S, Postl W, Bojar H-PB, et al. Struvite-(K), KMgPO46H2O, the potassium equivalent of struvite a new mineral. Eur J Mineral 2008; 20(4): 629-633<\/p>\n

7. http:\/\/webmineral.com\/chemical.shtml<\/p>\n

8. Cruz-May TN, Herrera A, Rodr\u00edguez-Hern\u00e1ndez J, et al. Structural and morphological characterization of kidney stones in patients from the Yu-catan Maya population. J Mol Struct 2021; 1235: 130267.<\/p>\n

9. Kravdal G, Helg\u00f8 D, Moe MK. Infrared spectroscopy is the gold standard for kidney stone analysis. Tidsskr Den Nor legeforening 2015; 135(4): 313-314.<\/p>\n

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22. Singh VK, Rai PK. Kidney stone analysis techniques and the role of major and trace elements on their pathogenesis: a review. Biophys Rev 2014; 6(3-4): 291-310.<\/p>\n

23. Racek M, Racek J, Hup\u00e1kov\u00e1 I. Scanning electron microscopy in analysis of urinary stones. Scand J Clin Lab Invest 2019; 79(3): 208-217.<\/p>\n

24. Saffo MB, Lowenstam HA. Calcareous Deposits in the Renal Sac of a Molgulid Tunicate. Science 1978; 200(4346): 1166-1168.<\/p>\n

25. https:\/\/www.mindat.org\/gm\/4254<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

*A rare case of autochthonous human dirofilariasis with the manifestation of pseudotumor of the epididymis caused by helminth Dirofilaria repens \u00davod S\u00fa\u010das\u0165ou mana\u017ementu pacienta s uroliti\u00e1zou je evalu\u00e1cia extrahovan\u00fdch alebo spont\u00e1nne vyl\u00fa\u010den\u00fdch mo\u010dov\u00fdch konkrementov. Toto hodnotenie m\u00e1 by\u0165 dostato\u010dne presn\u00e9 na to, aby sa dok\u00e1zala pr\u00edtomnos\u0165 majoritn\u00fdch zlo\u017eiek konkrementu. Konkrementy m\u00f4\u017eu by\u0165 analyzovan\u00e9 z h\u013eadiska<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[289],"tags":[1846,1845,719,1844,1843],"class_list":["post-2383","post","type-post","status-publish","format-standard","hentry","category-biochemistry","tag-electron-microanalysis","tag-electron-microscopy","tag-infrared-spectroscopy","tag-powder-diffraction-analysis","tag-urinary-concrements","typ_clanku-original-work"],"acf":{"abstrakt":"

Introduction:<\/strong><\/p>\n

Analysis of the chemical concretion composition is an inseparable part of managing a patient with urolithiasis. The exact results are essential for correctly identifying processes in the urine and metabolic abnormalities.<\/p>\n

Material and methods: <\/strong><\/p>\n

Urinary concrements had a human origin and were gained after urination after lithotripsy. In all samples of human urinary concretions, morphological signs were analysed. Subsequently, the samples were specially processed and analysed. We utilised spectroscopic methods \u2013 infrared (FITR) and Raman spectroscopy (RAMAN), powder X-ray diffraction analysis (PXRD) and electronic microscopy (SEM) and microanalysis (EDS).<\/p>\n

Results: <\/strong><\/p>\n

Internal and external structures of homogenous and mixed calcium-oxalate concretions were described. Based on molecular vibrations and their intensity identified by FTIR, a homogenous whewellit was detected. Data gained by the method RAMAN pointed to the presence of dahllit. Struvite was seen with the classification of interplanar distances and their intensity concerning the Miler index. Via images, crystal shapes of weddellit were observed. High content of Ca, O, and N and their distribution in the sample were detected by microanalysis.<\/p>\n

Discussion and conclusion: <\/strong><\/p>\n

FTIR might be considered the gold standard for routine analysis of urinary concretions thanks to its easy maintenance, speed, and preciseness compared to the chemical titration method. RAMAN, PXRD and EDS are more precise methods, but samples\u2018 measurement and preparation last longer, and the process is more financially demanding.<\/p>\n

Keywords:<\/strong> urinary concrements, infrared spectroscopy, powder diffraction analysis, electron microscopy, electron microanalysis<\/p>\n","casopis":[{"ID":2417,"post_author":"7","post_date":"2022-02-08 13:25:20","post_date_gmt":"2022-02-08 12:25:20","post_content":"Druh\u00e9 vydanie \u010dasopisu laborat\u00f3rnej medic\u00edny 2021\/2<\/strong>\r\n

    \r\n \t
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  • Extracelul\u00e1rne vezikuly a ich potenci\u00e1lne vyu\u017eitie v klinickej praxi<\/li>\r\n \t
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