A 29-year-old woman presented with right-sided abdominal pain and jaundice. The patient was postpartum but otherwise healthy. Her total bilirubin level was 74μmol/L. Abdominal ultrasound revealed a 9-mm dilated proximal common bile duct (CBD), a suspected CBD stone and a distended gallbladder with gallstones. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP); however, ...

Data from the Hospital In-patient Enquiry were used to define the regional patterns of hospital discharge rates for upper urinary tract stones and renal colic in England and Wales. By combining the rates for stones and colic, and by distinguishing emergency from planned admissions, the biases produced by repeated admissions of the same patient and by regional variations in diagnosis and coding ...

BACKGROUND Recent data have suggested that upfront cholecystectomy should be performed even in the presence of moderately abnormal liver function tests (LFTs). As a consequence, more common bile duct (CBD) stones are discovered on intra-operative cholangiogram. We assessed the presentation and management of such patients to refine their management plan. METHODS Adult patients (>16 years) with...

A patient with Wilson's disease presented at the age of 41 with a neurological defect and gross osteomalacia secondary to a defect of renal tubular reabsorption. He also showed the unusual features of a renal stone in the presence of the Fanconi syndrome and a relatively low alkaline phosphatase level, possibly due to the additional inherited defect of hypophosphatasia. During four years of tre...

The development of fuel cells as clean-energy technologies is largely limited by the prohibitive cost of the noble-metal catalysts needed for catalyzing the oxygen reduction reaction (ORR) in fuel cells. A fundamental understanding of catalyst design principle that links material structures to the catalytic activity can accelerate the search for highly active and abundant nonmetal catalysts to ...

Defects are inevitably present in graphene and can alter its properties and thus its applications. Interestingly, we find that commonly observed Stone-Wales and double vacancy defects do not affect graphene's hydrophilic and hydrophobic properties and that an adsorbed single water layer does not noticeably affect the defect-containing graphene's electronic properties. Our findings are based on ...