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High detail radiography and histology of the centrodistal tarsal joint of Icelandic horses age 6 months to 6 years.

REASONS FOR PERFORMING STUDY: Osteoarthrosis (OA) in the distal tarsal joints, bone spavin, is a well known condition which is common in Icelandic horses age 6-12 years. OBJECTIVES: To determine the nature, location and age of appearance of early radiographic and histological changes in the centrodistal tarsal joint (CD) of young Icelandic horses. METHODS: Slab sections from the CD of young Icelandic horses were examined by high detail radiography (age 6 months to 6 years, n = 111) and histology (age 6 months to 4 years, n = 82) to detect and describe the early changes indicative of OA. Horses younger than 5 years were unridden. RESULTS: Chondronecrotic lesions histologically similar to those described in the early pathogenesis of OA were seen in 33% of the joints, located both medially and laterally. Radiographic sclerosis of the subchondral bone was recorded in 60% of the specimens, most often medially. Medial location was not associated with chondronecrosis, but was strongly related to age. Sclerosis was an infrequent finding on the lateral side, and was probably secondary to chondronecrosis in the corresponding part of the joint. Small defects in the subchondral bone were considered to be the most specific radiographic sign of OA as they were strongly associated with chondronecrosis. CONCLUSIONS: The high prevalence of chondronecrosis in the young horses indicates an early onset and slow progression of the disease. The early appearance also shows that the initiation of the disease is unrelated to the use of horses for riding. As clinical manifestation of OA in the distal tarsal joints is most often described in mature or old horses, the first stages of the disease are not likely to result in clinical signs. Subchondral bone sclerosis did not appear to be a primary factor in the development of OA in the CD but was considered to reflect an uneven distribution of biomechanical forces within the joint. POTENTIAL RELEVANCE: The development of OA in the CD of young Icelandic horses seems to be due to poor conformation or joint architecture rather than trauma or overloading. These aetiological factors are likely to be of importance for OA in the distal tarsal joints in other breeds as well. The influence of hindlimb conformation and the architecture of the distal tarsal joints on the biomechanics of joints need to be investigated, preferably by locomotion analysis in young horses.

Age Factors↗

A prospective comparative study of clinical and pathological characteristics in Icelandic and Danish patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. II. Histological results.

The occurrence of gastritis in antral and body mucosa is compared in an Icelandic and a Danish group of patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. In all 93 Icelandic and 88 Danish patients were examined. All signs of antral gastritis were more frequent in Icelandic than in Danish patients, but only the incidence of superficial inflammation and decreased mucus content in surface and crypt epithelium differed significantly. In body mucosa pseudopyloric metaplasia was more frequent in Iceland and occurred equally freqeuntly in all three diseases. A statistically significant correlation was found between macroscopic gastritis and occurrence of antral superficial inflammation and between smoking and superficial inflammation and decreased mucus content in the pyloric biopsy specimen. The presence of histological gastritis was not correlated to the intake of alcohol and salicylic acid, nor to the presence of pain at the time of investigation.

Adult↗

Survey of prescriptions for peptic ulcer drugs (ACT class AOB2) in Iceland.

BACKGROUND: The consumption of peptic ulcer drugs in Iceland is 20 DDD/1000/day, which is two to three times higher than in other Scandinavian countries. This study was done to register the pattern of use and possibly to find reasons for the high consumption. METHODS: Prescriptions for peptic ulcer drugs (ACT class AO2B) were surveyed in Iceland during 1 month in 1991. All pharmacies in Iceland participated in the study, and information was obtained on about 90% of peptic ulcer drugs used outside hospitals. The pharmacists registered all prescriptions of peptic ulcer drugs with regard to the age and sex of the patient, speciality of the prescribing physician, and name, dose, and quantity of the drug. RESULTS: A total of 2021 prescriptions were registered, accounting for 15.4 DDD/1000/day. The prevalence of peptic ulcer drug use was 1.52%, but female use was 52.5%. The maximal use, 2.91% was in the age group 70-79 years. H2 blockers accounted for 79%, omeprazole for 17%, and other drugs for 4%. General practitioners prescribed 65% of the drugs, gastroenterologists 15%, and other specialists 14%. If the patient himself collected the drug, he was asked to fill out a questionnaire with regard to the reason for the prescription, previous prescriptions, and investigations. A total of 1131 (56%) of patient questionnaires were received. Only 1% of the patients did not know the reason for the prescription. The patients registered that 30% of the prescriptions were for peptic ulcer, 29% for heartburn, 21% for gastritis, 9% for dyspepsia, and 7% for prevention of side effects of other drugs. It was estimated from the data that about 40% of the prescriptions were for non-ulcer dyspepsia. Investigations were done in 67% of the patients, but 33% received the prescription only after an appointment with a physician. CONCLUSIONS: The results of the survey suggest that the extensive use of peptic ulcer drugs in Iceland is mostly due to excessive use in non-ulcer dyspepsia.

Adult↗

Seroprevalence of Helicobacter pylori in south Sweden and Iceland.

BACKGROUND: Seroepidemiologic studies on the prevalence of Helicobacter pylori infection have been reported from several European countries but not from Sweden or Iceland. METHODS: Serum samples were collected from 443 persons in Sweden and 387 persons in Iceland. All the 830 sera were tested with the same enzyme immunoassay test with an acid glycine extract of H. pylori surface proteins as antigen. RESULTS: The antibody levels were low in the young age groups in both Sweden and Iceland, with increasing levels with age. CONCLUSIONS: The results are consistent with previous studies from other comparable countries, but with important differences. The prevalence was lower in Sweden than in other, previously studied, Western European countries, but, on the other hand, the prevalence was slightly higher in Iceland.

Adolescent↗

Prescription of digitalis in a health centre serving a defined rural population in Iceland.

The use of digitalis glycosides in the Egilsstadir district in eastern Iceland was studied. The district which has a well-defined catchment area has a health centre with three general practitioners serving a registered population of 2802 inhabitants. This is 1.2% of the total population of Iceland with similar age and sex distribution. Twenty-four patients (0.9%) were treated with digitalis glycosides. The most common patient complaint before starting therapy was shortness of breath. The general practitioners started therapy in 17 cases, consultants in seven. Ecg was taken before therapy in 22 cases and showed 15 patients with sinus rhythm. The most common diagnosis was heart failure (62%). The only glycoside used was digoxin. The use of cardiac glycosides in the Egilsstadir health district was low both compared with Iceland as a whole and with other Nordic countries. Considering studies on discontinuation of maintenance digoxin therapy in general practice and also the findings in this study it is suggested that the use of digitalis glycosides in the Egilsstadir health district and in Iceland could be even lower.

Adolescent↗

On content of practice. An Icelandic multicentre study, population, practices and contacts.

To establish data on the content of Icelandic family practice, a prospective practice audit was made of all Icelandic health centres with computerized contact data from 1 January to 31 December 1988. The study comprised 17 community health centres in Iceland and their target populations, 13 rural and four urban. The main subjects for study were population characteristics, practice sizes, types of health care providers, and contacts. The study population, 50,865 subjects, comprised 20.2% of the Icelandic population. Rural and urban populations were different and are described separately. The 17 health centres had a mean of 1,152 subjects/doctor. The target population had a total of 257,188 contacts: 155,526 rural contacts, 5.1/subject (3.3 office-, 1.1 phone-, and 0.4 home-contacts); 101662 urban contacts, 5.1/subjects (2.8 office-, 1.6 phone-, and 0.4 home-contacts). During 1988, 88.9% of the rural target population made contact. These data are comparable to data from other countries; the observed office and home contact rates were similar, but phone-calls were more frequent. Computer systems in family practice provide a feasible way to collect data on a regular basis for epidemiological purposes and for performance review.

Community Health Centers↗

Incidence of total hip replacement for primary osteoarthrosis in Iceland 1982-1996.

We report the incidence of total hip replacements performed in Iceland between 1982 and 1996. During this period, 3,403 hip arthroplasties were done. The annual number of procedures increased from 94 hips in 1982 to 323 hips in 1996. Annual rates of total hip replacements due to primary osteoarthrosis per 10(5) inhabitants were 68 in 1982-1986, 90 in 1987-1991, and 114 in 1992-1996. In the years 1992-1996, the age-standardized incidence of total hip replacements for primary osteoarthrosis was 3/10(5) among patients younger than 39 years of age, while it was 621/10(5) among those 70-79 years of age. The mean age at surgery for primary osteoarthrosis was 69 years in both men and women. Incidence rates in various countries are difficult to compare, but by using age-standardized data and correction for differences in population structures between Iceland and Sweden, we find that the incidence of total hip replacement for primary osteoarthrosis of the hip is at least 50% higher in Iceland than in Sweden. This difference is consistent with the higher prevalence of hip osteoarthrosis observed in Iceland than in Sweden.

Adult↗

The Icelandic and Nordic cervical screening programs: trends in incidence and mortality rates through 1995.

BACKGROUND: The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. This study evaluates the effectiveness of cervical screening and the UICC and EC screening recommendations based on the Nordic screening experience. METHODS: The study analyzes the features of the Icelandic and the Nordic screening programs and the observed trends in the incidence and mortality rates in these countries through 1995. RESULTS: Organized screening started in all the Nordic countries soon after 1960 and had nation-wide coverage in all these countries, except in Denmark (45% coverage in 1991), by around 1973 but in Norway screening was only spontaneous up to late in 1994. Up to 1985 the target age group and screening interval were most intensive in Iceland, followed by Finland, Sweden and Denmark. All countries except Finland lowered the lower age limit and intensified the screening intervals after 1985. Through the period 1986-1995 the reduction in both the mortality and the incidence rates was greatest in Iceland (mortality: 76% and incidence: 67%) and Finland (73% and 75%, respectively), intermediate in Sweden (60% and 55%, respectively) and Denmark (55% and 54%, respectively), and lowest in Norway (43% and 34%, respectively). The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland, where the yearly registered age-specific incidence has been increasing in the targeted 30-54 age group since 1991. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno- and adenosquamous carcinomas. In fact the rate of adenocarcinoma has been increasing. CONCLUSIONS: Organized screening is more effective than spontaneous screening in reducing the risk of cervical cancer. Although differences in environmental, biological and ethnic factors may call for different screening strategies, screening should preferably start soon after age 20 with a screening interval of 2-3 years.

Adult↗

Biosamples, genomics, and human rights: context and content of Iceland's Biobanks Act.

In recent years, human DNA sampling and collection has accelerated without the development of enforceable rules protecting the human rights of donors. The need for regulation of biobanking is especially acute in Iceland, whose parliament has granted a for-profit corporation, deCODE Genetics, an exclusive license to create a centralized database of health records for studies on human genetic variation. Until recently, how deCODE Genetics would get genetic material for its genotypic-phenotypic database remained unclear. However, in May 2000, the Icelandic Parliament passed the Icelandic Biobanks Act, the world's earliest attempt to construct binding rules for the use of biobanks in scientific research. Unfortunately, Iceland has lost an opportunity for bringing clear and ethically sound standards to the use of human biological samples in deCODE's database and in other projects: the Biobanks Act has extended a notion of "presumed consent" from the use of medical records to the use of patients' biological samples; worse, the act has made it possible--perhaps likely--that a donor's wish to withdraw his/her sample will be ignored. Inadequacies in the Act's legislative process help account for these deficiencies in the protection of donor autonomy.

Blood Specimen Collection↗

[Organ donations in Iceland 1992-2002].

OBJECTIVE: To acquire information of organ donations and organ waiting lists in Iceland 1992-2002, the beginning of an organ procurement system. MATERIAL AND METHODS: Records of all patients treated at the ICU at LSH in Fossvogur 1992-2002 were studied. Information of organ donations at other units and number on organ waiting lists was attained. Results are shown as medians (25th, 75th percentile). RESULTS: 527 patients died at the ward 1992-2002 (48 (45, 52) annually). Of them 68 (13%) were declared deceased because of brain death. Permission for organ procurement was requested from relatives in 50 cases (74% of brain deaths) and was obtained in 30 (60%). Four of these were not suitable as organ donors. Organ donation was denied in 40% of cases and refusal seemed to increase during the period. Potential organ donors that were not recognised as such were 18A (3% of all deaths). During the period six organ donations occurred at others units. The total number of organ donors was 32 (3 (1, 5) annually) in Iceland 1992-2002. Number of organs donated was 109 (11 (4, 15) annually). Each year there were 7 (5, 9) individuals on waiting lists for organs and 3 (2, 5) were transplanted. CONCLUSIONS: 87% of organ donations in Iceland come from patients with cerebral haemorrhage, traumatic brain injury or ischaemic stroke. Organ donations in Iceland seem to fulfill the nations need of organs. It is a possible worry that refusal of organ donation by relatives seemed to increase during the period.

Brain Death↗

[Epidemiological study of functional bowel disorders in Iceland].

OBJECTIVE: The aim of the present study was to evaluate the prevalence of functional bowel disorders (FBD) in a population-based sample and to assess FBD-related health care seeking and medication in Iceland. MATERIAL AND METHODS: A self-report questionnaire was sent to a random sample of 2000 inhabitants, 18-75 years of age. The questionnaire addressed 46 gastrointestinal symptoms and 42 other health related, sociodemographic and psychosomatic symptom items. The questionnaire classified subjects into two symptom categories, dyspepsia and irritable bowel syndrome. RESULTS: The response rate was 67% which represents 1% of the 18-75 year old population of Iceland. Dyspepsia in the year prior to the study was reported by 17.8% who had symptoms that were defined as moderate or severe (15.3% male, 20% female). Based on the Manning Criteria, which define IBS as having two or more abdominal symptoms out of six at least six times in the previous year in addition to abdominal pain, the crude prevalence of IBS was 30.9% (25.3% men, 35.8% women) (Chi2=15.77, p<0.05). Both symptom categories were more common in women and the prevalence decreased with age. No correlation with socioeconomic status was found. There was more than 90% overlap between the two diagnostic categories. Irritable bowel syndrome was found to be associated with depression, appendectomy and dysmenorrhea. CONCLUSIONS: This population-based study shows a high prevalence of functional bowel disorders in Iceland and higher than reported in other studies that use similar criteria. It can be speculated that the reasons for this high prevalence are associated with special features of the socio-psychological profile of the Icelandic society.

Adult↗

[Prevalence of disability pension related to obesity in Iceland 1992-2004].

OBJECTIVES: To investigate changes in the prevalence of disability pension related to obesity in Iceland from 1992 to 2004. MATERIAL AND METHODS: Data were obtained from the disability register of the State Social Security Institute and Statistics Iceland for the years 1992 and 2004. Prevalence of disability pension related to obesity and of disability pension in general was calculated for both years. Statistical significance was assessed by calculating chi square and standardized risk ratios. RESULTS: From 1992 to 2004 the number of recipients of disability pension with obesity as a primary diagnosis increased from 37 to 111, amounting to 183% increase for females and 263% for males. This increase is significantly greater than the increase in disability pension in general during this period. Age standardized risk ratio showed increased disability related to obesity for both genders. Among males it was greater than the general increase in disability, while among females it was less. There was a significantly greater increase in disability related to obesity in areas outside the capital compared with Reykjavík and surrounding areas among females. The increase in disability related to obesity far surpasses the increase in obesity in the population, according to population surveys, suggesting that severe and morbid obesity may be particularly on the rise. CONCLUSION: There has been a significant increase in the prevalence of disability pension related to obesity in Iceland from 1992 to 2004. It is possible that increased social awareness of obesity during the study period has influenced diagnostic habits of physicians and thus increased the use of obesity as a diagnosis in medical certificates and disability assessment. In all likelihood, however, there has been an increase in disabling obesity in Iceland, indicating that obesity is an increasing public health problem demanding appropriate intervention.

Chi-Square Distribution↗

Mental health of octogenarians in Iceland. An epidemiological study.

The purpose of this work was to study the prevalence and incidence of mental disorders in octogenarians in Iceland and the relation of these variables to several sociodemographic variables. Beside this a comparison between two different methods of collecting clinical data on mental health were done. In chapter 2 recent research on the epidemiology of mental disorders in the very old population is reviewed. A comparison between different studies is very difficult but most studies agree on the prevalence of severe dementia. In chapter 3 the material and methods of the study is described. The sample consists of all Icelanders borne in the years of 1895-1897. Two methods of data collection are described, the indirect method where information from general practitioners, hospital files and other sources are used to make a mental diagnosis, and the Geriatric Mental States Schedule, which is a semi-structured interview. In chapter 4 demography of the cohort is described and in chapter 5 the reliability of the Icelandic translation of the Geriatric Mental States Schedule is discussed and the reliability of the Icelandic translation of G.M.S. is within acceptable limits. In chapter 6 two methods of making mental diagnosis in the elderly are compared. In chapter 7 the prevalence of dementia at the age of 81.5 and 87 years is discussed. There is a considerable increase in prevalence of severe dementia, or from 7.8% at the age of 81.5 years to 15.1% at the age of 87 years. The incidence of dementia in the age period 74-85 years is discussed in chapter 8. At the age of 84 years the incidence is about one case per 100 per year, but at the age of 85 the incidence is about 4 cases per 100 per year. In chapter 9 the mortality of dementia in the age period from 74-85 years is discussed. The standard mortality ratio is 2.46 for males and 2.29 for females in this age period. In chapter 10 and 11 the prevalence, incidence and mortality of affective disorders are discussed. The prevalence of affective disorders does not change significantly with age from 81.5-87 years, being 8-9%, while the mortality of affective disorders in the age period of 74-85 years is similar to that in the general population. The incidence does not change significantly from 74-85 years being about 0.6 case per 100 per year for males and about 1.1 cases per 100 per year for females.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

Tumours in Iceland. 7. Malignant epithelial tumours of the lung. A histological classification, epidemiological considerations and relation to smoking.

All malignant epithelial tumours of the lung submitted for a histological diagnosis in Iceland during the 20 years, 1955-1974, and available for review, were typed histologically according to the World Health Organization Classification originally published in 1967 and later revised and republished in 1981. The series includes 355 tumours, 217 from males and 138 from females, and 78 per cent of all registered malignant tumours of the lung. Among males the incidence of squamous cell carcinoma and small cell carcinoma was about equal and adenocarcinoma was in the third place. Among females the incidence of adenocarcinoma was the highest and that of small cell carcinoma in second place, other types being much less frequent. During the period there was a rise in the incidence of all the major histological types in both sexes and the greatest rise was in adenocarcinoma, where the incidence doubled in males and tripled in females. Among European nations the incidence of lung carcinoma is the lowest for Icelandic males and the highest for Icelandic females. There is a close correlation between the sale of cigarettes and the incidence of lung carcinoma in Iceland. Among those lung carcinoma patients with known smoking histories, all with small cell carcinoma, almost all with squamous cell carcinoma and four out of five with adenocarcinoma were smokers.

Adenocarcinoma↗

Familial transitional cell carcinoma among the population of Iceland.

PURPOSE: Several case reports have described familial aggregation of transitional cell carcinoma of the urinary tract but to our knowledge only 1 epidemiological study specifically addressed the issue of familial bladder cancer. We evaluated the extent of familial aggregation of transitional cell carcinoma among the population of Iceland. MATERIALS AND METHODS: The first to third degree relatives of 190 patients with bladder, ureter or renal pelvis transitional cell carcinoma diagnosed between 1983 and 1992 in Iceland were identified through the Icelandic Cancer Family Resource. The records of these 12,328 relatives were subsequently linked to the 1965 to 1994 cancer registry. The observed occurrence of transitional cell carcinoma of the urinary tract was compared to the expected occurrence based on age, gender and calendar specific incidence rates. Observed-to-expected ratios and 95% confidence intervals were calculated. RESULTS: In 41 of the 190 pedigrees at least 1 relative had transitional cell carcinoma of the urinary tract. Of the probands 38 had only 1 and 3 had 2 affected relatives. The prevalence of family history of transitional cell carcinoma was 3% in first degree and 10% in first or second degree relatives. The risk of transitional cell carcinoma among all relatives was slightly elevated (observed-to-expected ratio 1.24, 95% confidence interval 0.90 to 1.67). The observed-to-expected ratio was greater among second and third degree relatives than among first degree relatives. CONCLUSIONS: The risk of transitional cell carcinoma among relatives of patients is somewhat increased. However, the greater risk for more distant relatives argues against the existence of a hereditary subtype of bladder transitional cell carcinoma, at least in the founder population of Iceland.

Adult↗

Organochlorines in Greenland glaucous gulls (Larus hyperboreus) and Icelandic gulls (Larus glaucoides).

Glaucous gulls (Larus hyperboreus) and Icelandic gulls (Larus glaucoides) were sampled in 1994 from four different areas in Greenland, three on the west coast and one on the east coast. Livers of 93 glaucous gulls and seven Icelandic gulls were analysed for polychlorinated biphenyls (PCBs, IUPAC Nos. 28, 31, 52, 101, 105, 118, 138, 153, 156 and 180), DDTs (p,p'-DDE, p,p'-DDD, p,p'-DDT), hexachlorocyclohexanes (alpha-, beta- and gamma-HCH), hexachlorobenzene (HCB) and trans-nonachlor (TNC). The overall geometric means of the concentrations found in glaucous gull liver were for sigma PCBs 388 (range 20-5557), for sigma DDTs 363 (17-8604), sigma HCHs 7.4 (1-53), HCB 47 (4-594) and trans-nonachlor 19 (3-187) micrograms kg-1 wet wt., respectively. The geometric means of concentrations in Icelandic gull liver were for sigma PCBs 112 (24-435), for sigma DDTs 95 (25-298), sigma HCHs 2.9 (1.4-5.2), HCB 22 (8-58) and trans-nonachlor 5.1 (2.4-8.6) micrograms kg-1 wet wt., respectively. Significantly (P = 0.05) higher concentrations of PCBs, DDTs and HCHs were found in glaucous gulls at Ittoqqortoormiit at the east coast than in gulls from Qeqertarsuaq at the west coast of Greenland. This tendency was also seen for HCB and trans-nonachlor, but the differences were not statistically significant (P = 0.05). A decreasing trend in organochlorine concentrations followed the East Greenland Current, flowing from north to south down the east coast and to the north on the west coast. Gulls taken from the most northerly sampling area of the west coast, however, showed slightly higher concentrations than those from the central west coast. There appeared to be a tendency for higher concentrations to be found in males than females, and in adults compared to young glaucous gulls, but the differences were not statistically significant (P = 0.05). The concentration ranges found in gulls from Greenland were similar to those reported previously for gulls from northern Norway and Russia. A principal component analysis revealed no obvious link between the presence of higher chlorinated PCBs and higher PCB concentrations in glaucous gulls. Significantly higher proportions of higher chlorinated PCBs were found in glaucous gulls than in Icelandic gulls, and in adult glaucous gulls compared to young gulls of 1-2 calendar years. As no such difference was found between female and male gulls it seems that PCBs of all degrees of chlorination may be passed equally well from mother to offspring.

Animals↗

[Icelandic moss lozenges in the prevention or treatment of oral mucosa irritation and dried out throat mucosa].

BACKGROUND: Icelandic Moss (Cetraria islandica) has been used to treat inflammation and dryness of the pharyngeal mucosa in the naturopathy for many years. It contains substances with protective and antiinflammatory effects for the oral mucosa. The necessary concentration of Icelandic Moss and its therapeutic effectiveness were analysed in this clinical study. METHODS: Sixty-one patients who recently underwent surgery of nasal septum were evaluated for this randomized study. These patients suffer especially from dryness and inflammation of the oral cavity due to breathing only through the mouth while the nose is permanently closed by a nasal package. Three groups of patients treated with three different concentrations of the active substance were compared, Coating, dryness, and inflammation of the mucosa, lymph nodes, tongue, the tolerance of the drug, and symptoms like hoarseness and sore throat were documented. The oral application was performed from the first to the fifth day after the operation. RESULTS: The treatment with Icelandic Moss caused a direct reduction of the observed pathological changes. There were no significant differences between the three test groups. A dose of 0.48 g per day (10 Isla-Moos lozenges per day) is a sufficient treatment. CONCLUSIONS: Icelandic Moss is an advisable therapeutic opportunity without interactions and side effects for the treatment of inflammation of the oral mucosa occurring after nasal surgery, after intubation, and for simple infections of the throat.

Adolescent↗

Applicability of Iceland spar as a stone model standard for lithotripsy devices.

The identification of a universal stone model standard would enable reproducible fragmentation data useful for the design, evaluation, and comparison of various lithotripsy devices. The clinical benefits of such a stone model include the elucidation of setting parameters that would optimize fragmentation strategies. Iceland spar is a pure form of calcite (CaCO3) that was subjected to experimental disintegration by electrohydraulic lithotripsy and extracorporeal shockwave lithotripsy. Iceland spar was fragmented with both lithotripsy methods in a reproducible fashion. The degree of fragmentation was directly related to alterations in either power or shock frequency. Iceland spar is radiopaque, inexpensive, easily obtained, homogenous in composition, and sizable. Iceland spar meets a variety of stone model criteria, warranting its continued investigation as a potential stone model standard.

Calcium Carbonate↗