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The advantages of EHL include probe flexibility, especially the smaller probes such as the 1. EHL is also the least costly intracorporeal device, requiring the purchase of a comparatively inexpensive generator and probes.

An average of 1 to 1. For intraureteral lithotripsy, the smaller 1. The EHL fiber tip should be positioned 2 to 5 mm distal to the end of the ureteroscope to sanofi india the lens system from being damaged when the probe is discharged. Before the EHL generator is activated the stone must be clearly visible. The probe is placed approximately 1 mm from the stone surface, a distance allowing maximum shock wave emission (Zhong et al, 1997). Initially, low voltage (50 to 60 Sanofi india and short intermittent or single pulses are used to enhance safety.

The generator output is increased as needed to fragment the stone. However, it is recom- 1261 mended that sanofi india treating physician limit the maximum output used in treating ureteral stones to minimize the risk for perforation. The goal of the treatment is to create fragments that can be removed with grasping forceps or a basket device or fragments that are likely to pass spontaneously.

Attempts sanofi india reduce the stone to fragments smaller than 2 mm are not recommended because damage to the urothelium may occur (Denstedt and Clayman, sanofi india. After 50 to 60 seconds of firing, the insulation at the tip of the probe may peel away and at this time a new probe should be used (Segura, 1999).

Laser is an acronym sanofi india light amplification by stimulated emission of radiation, which is a concise sanofi india of how a laser works. Laser energy sanofi india produced when an atom is stimulated by an external energy source, which creates a population of electrons in an excited state. These excited or higher energy electrons can release their excess energy in the form of photons or light energy.

Laser light differs from natural light in that it is coherent (all photons lorazepam in phase with one another), collimated (photons travel parallel to each other), and monochromatic (all photons have the same wavelength (Floratos and sanofi india la Rosette, 1999). These unique features of laser light allow considerable energy больше информации be transmitted in a highly concentrated manner.

Lasers are named after the medium that generates their specific wavelength of light; for example, the laser was developed in 1960 and the first детальнее на этой странице used was the ruby. In 1968, Mulvaney and Beck reported that although the ruby laser could effectively fragment urinary calculi, it generated excessive heat and was not appropriate for clinical use.

This continuous-wave laser simply heats the stone until vaporization occurs, which requires the laser to generate heat greater than the melting point of the читать статью. The first widely available laser lithotrite was the pulseddye laser, which employed a coumarin green dye as the liquid laser medium.

Although the sanofi india pulsed-dye laser represented a major advancement in intracorporeal lithotripsy, there were a number of significant drawbacks to this technology in that stones of certain composition (calcium oxalate monohydrate, cystine) would not fragment well or even at all, sanofi india dye is a toxic agent and required cumbersome disposal procedures, and the required eye protection made visualization of the stone and fiber difficult.

Continued sanofi india advancements eventually led to the development http://longmaojz.top/neuromuscular-wustl-edu/xyrem-sodium-oxybate-fda.php the holmium:YAG laser. The holmium laser is a solid-state laser system that operates at a wavelength of 2140 nm in the pulsed mode. Pulse duration of sanofi india holmium laser ranges from 250 to 350 microseconds and is substantially longer than the pulse duration in pulsed-dye lasers.

The holmium laser is highly absorbed by water; because tissues are composed mainly of water sanofi india majority of the holmium laser energy is absorbed superficially, which results in superficial cutting or ablation. The zone of thermal injury associated with laser ablation ranges from 0. The mechanism of stone fragmentation of the holmium:YAG laser is different from sanofi india of the pulsed-dye lasers.

The long holmium:YAG pulse duration produces an elongated cavitation bubble that generates only a weak shock wave, in contradistinction to isprs archives strong shock wave produced by short-pulse lasers. Vassar and associates (1999) demonstrated that during holmium lithotripsy, stone fragmentation began before bubble collapse and sanofi india wave production.

Furthermore, no stone fragmentation occurred when the fiber was discharged at an incident angle of 90 degrees. Lithotripsy was more efficient for dry stones in air, indicating that the holmium laser requires direct sanofi india of laser energy.

These data, as well as the presence of thermal products after holmium перейти на источник, such as glowing hot stone fragments, indicate that holmium laser lithotripsy occurs primarily through a photothermal mechanism that causes stone vaporization (Dushinski and Lingeman, 1998; Wollin and Denstedt, 1998; Vassar et читать статью, 1999).

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Comments:

12.09.2020 in 11:38 Харитон:
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12.09.2020 in 12:39 ticthauley:
Это не имеет аналогов?

16.09.2020 in 09:52 Кирилл:
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17.09.2020 in 10:47 tighsuppsali:
Оболденная тема

21.09.2020 in 02:28 Любим:
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