Browsing by Author "Williams, James C. Jr."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Geobiology reveals how human kidney stones dissolve in vivo
    (Springer Nature, 2018-09-13) Sivaguru, Mayandi; Saw, Jessia J.; Williams, James C. Jr.; Lieske, John C.; Krambeck, Amy E.; Romero, Michael F.; Chia, Nicholas; Schwaderer, Andrew L.; Alcalde, Reinaldo E.; Bruce, Wililam J.; Wildman, Derek E.; Fried, Glenn A.; Werth, Charles J.; Reeder, Richard J.; Yau, Peter M.; Sanford, Robert A.; Fouke, Bruce W.; Anatomy and Cell Biology, IU School of Medicine
    More than 10% of the global human population is now afflicted with kidney stones, which are commonly associated with other significant health problems including diabetes, hypertension and obesity. Nearly 70% of these stones are primarily composed of calcium oxalate, a mineral previously assumed to be effectively insoluble within the kidney. This has limited currently available treatment options to painful passage and/or invasive surgical procedures. We analyze kidney stone thin sections with a combination of optical techniques, which include bright field, polarization, confocal and super-resolution nanometer-scale auto-fluorescence microscopy. Here we demonstrate using interdisciplinary geology and biology (geobiology) approaches that calcium oxalate stones undergo multiple events of dissolution as they crystallize and grow within the kidney. These observations open a fundamentally new paradigm for clinical approaches that include in vivo stone dissolution and identify high-frequency layering of organic matter and minerals as a template for biomineralization in natural and engineered settings.
  • Thumbnail Image
    Item
    A Proposed Grading System to Standardize the Description of Renal Papillary Appearance at the Time of Endoscopy in Patients with Nephrolithiasis
    (Mary Ann Liebert, Inc., 2016-01) Borofsky, Michael S.; Paonessa, Jessica E.; Evan, Andrew P.; Williams, James C. Jr.; Coe, Fredric L.; Worcester, Elaine M.; Lingeman, James E.; Department of Urology, IU School of Medicine
    BACKGROUND AND PURPOSE: The appearance of the renal papillae in patients with nephrolithiasis can be quite variable and can range from entirely healthy to markedly diseased. The implications of such findings remain unknown. One potential reason is the lack of a standardized system to describe such features. We propose a novel grading scale to describe papillary appearance at the time of renal endoscopy. METHODS: Comprehensive endoscopic renal assessment and mapping were performed on more than 300 patients with nephrolithiasis. Recurring abnormal papillary characteristics were identified and quantified based on degree of severity. RESULTS: Four unique papillary features were chosen for inclusion in the PPLA scoring system- ductal Plugging, Pitting, Loss of contour, and Amount of Randall's plaque. Unique scores are calculated for individual papillae based on reference examples. CONCLUSIONS: The description and study of renal papillary appearance in stone formers have considerable potential as both a clinical and research tool; however, a standardized grading system is necessary before using it for these purpose