A pact has been announced for the first lithotripter in the state.

The same effect is used to treat kidney stones in a lithotripter.

Many other states have at least one lithotripter.

Should the hospital acquire a lithotripter that uses shock waves to destroy kidney stones, or stay with surgery or other techniques?

From the earliest experiments, doctors have known that the lithotripter can make the kidneys bleed and can cause a temporary loss of some kidney function.

In 1985, Virginia Mason installed the first lithotripter in the Pacific Northwest.

The study is sponsored by lithotripter manufacturers through the National Electrical Manufacturers Association in Washington.

Dr. Krambeck's team sent questionnaires to the survivors among the first group treated with a lithotripter machine at the Mayo Clinic in 1985.

Because most urologists use the newer models, Dr. Krambeck said, "we can't say that every lithotripter causes" the diabetes and hypertension complications.

Among them are drugs, lithotripter machines that smash gallstones with shock waves andeven a type of ether that can dissolve them.

In the lithotripter trials, researchers investigated a range of possible complications, even checking to see if the injection of radioactive substances used in imaging posed risks.

Because of the advances in science and technology of lithotripter techniques, it was presented as a simpler alternative to surgery, and the piezoceramic device proved very effective.

FEW medical devices have been adopted as quickly and widely as the lithotripter, a machine that smashes kidney stones and spares a patient from major surgery.

The triggered spark gaps - precision switches that send short, large bursts of electricity - are in fact used by a machine called a lithotripter to break up kidney stones.

"Its nice to have a lithotripter in Outer Snowshoe, but that money comes from somewhere else," said Dr. Adam Linton, a kidney specialist in London, Ontario.

Control on Lithotripters The state's two medical-school hospitals, Yale-New Haven and John Dempsey at UConn in Farmington, had each wanted a lithotripter.

Benefit of Sharing The cost of putting in an M.R.I. or a lithotripter is about $2 million, Ms. Hills said, making them strong candidates for hospitals to share the cost.

Pulverization by the lithotripter -the word is derived from the Greek words meaning to crush stones - results from ignition of spark-plug-type electrodes to produce shock waves that vaporize a small amount of water.

Dr. Vaughan said that although he did not participate in the design of the original studies to evaluate the lithotripter in the United States, he was one of the chief investigators in the original trial.

Her team did not want to release the findings early because the Mayo Clinic is one of a very few medical centers that still uses the same model lithotripter, Dornier HM3, in use in 1985, she said.

The first lithotripter was developed in West Germany, by Dornier Medical Systems of Munich, after researchers discovered that shock waves created by raindrops striking an aircraft in supersonic flight can disintegrate solid materials.

For example, Mr. Owen said, patients might find it difficult to gain access to lithotripter machines, used to break up kidney stones without surgery, or to new drugs like TPA, which can dissolve harmful blood clots.

The aim is to determine the safety and usefulness of the therapy for gallstones and to determine which among the 20 million Americans with gallstones would benefit from lithotripter therapy instead of surgery or dissolution with solvents.

A raffle organised by the Triangle Community Association of Grove Hill, Middlesbrough, raised more than £2,256 to be split between the TCA and South Cleveland Hospital's appeal for a lithotripter machine to break up kidney stones.

Except in cases of dire emergency, Canadians wait for weeks to months for a wide variety of expensive procedures, including advanced radiology scans, heart bypass and brain tumor operations and the destruction of painful kidney stones with a sound wave machine called a lithotripter.