Induction of Microdamage Through Application of Acoustic Energy to Cortical Bone

2004 ◽  
Author(s):  
Andrea E. Tami ◽  
Melissa L. Knothe Tate ◽  
Jamie R. Streem ◽  
Ryan S. Comisford ◽  
Jared M. O’Leary ◽  
...  
Keyword(s):  
Shock Wave ◽  
Confocal Microscopy ◽  
Shock Waves ◽  
Bone Turnover ◽  
Cortical Bone ◽  
Kidney Stones ◽  
Acoustic Energy ◽  
Wave Number ◽  
Extracorporeal Shock Waves ◽  
Naturally Occurring

Extracorporeal shock waves (ESW) are used routinely to break up kidney stones. Recently ESW has been implemented in the orthopaedic arena to treat heel spurs, although the mechanism underlying this therapeutic effect is not known. Acoustic energy has been shown to increase transport in bone. Furthermore, naturally occurring microdamage in bone has been implicated as a trigger for the onset of remodeling. We hypothesize that controlled application of ESW to bone tissue increases transport and stimulates bone turnover through production of low-level microdamage. The goal of this study was to identify the bandwidth and the application regime of acoustic energy to produce such damage. Transverse sections of sheep metacarpi (1 cm) were subjected to acoustic loading regimes of varying shock wave number and intensity. Thereafter, the blocks were bulk-stained with procion dye, embedded in PMMA, and sectioned into 100 mm slices for confocal microscopy and analysis. The blocks loaded with the highest energy regimes showed marked diffuse microdamage and microcracks, usually at sites of discontinuity along the periosteal edge. These results provide a first step in testing our hypothesis and ultimately may provide a basis for the exploitation of ESW to prevent osteopenia and/or osteoporosis.

scholarly journals Extracorporeal shock waves act by shock wave-gas bubble interaction

1998 ◽  
Vol 24 (7) ◽  
pp. 1055-1059 ◽  
Author(s):  
Michael Delius ◽  
Friedrich Ueberle ◽  
Wolfgang Eisenmenger
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Gas Bubble ◽  
Extracorporeal Shock Waves ◽  
Bubble Interaction

Shock Wave Treatment of Peyronie'S Disease: Our Experience

1998 ◽  
Vol 65 (1_suppl) ◽  
pp. 96-98
Author(s):  
M. Luciano ◽  
C. Bondavalli ◽  
B. Dall'Oglio ◽  
L. Schiavon ◽  
P. Bernardini ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Peyronie’S Disease ◽  
Induratio Penis Plastica ◽  
Wave Treatment ◽  
Extracorporeal Shock Waves ◽  
Shock Wave Treatment ◽  
Peyronie's Disease ◽  
Methods Of Application

From September 1997 to April 1998, 40 patients with induratio penis plastica were treated with extracorporeal shock waves (ESWT). This work compares our results with those of the main Italian centres that first used this method. The aim of this study is to assess the efficiency of the treatment in the period before the main guidelines were laid down: guidelines which from now on should standardise indications and methods of application whilst optimising results.

Innovative Piezoelectric Extracorporeal Lithotripter

2008 ◽  
pp. 745-753
Author(s):  
Achim M. Loske ◽  
Francisco Fernández ◽  
Gilberto Fernández
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Kidney Stones ◽  
Open Surgery ◽  
Shock Wave Lithotripsy ◽  
Renal Tissue ◽  
The Body ◽  
Extracorporeal Shock Wave ◽  
Tissue Trauma ◽  
Salivary Gland Stones

Before 1980, the majority of patients with urolithiasis and nephrolithiasis needed surgery (Kerbl, Rehman, Landman, Lee, Sundaram, & Clayman, 2002; Soucie et al., 1994). Fortunately, percutaneous nephrolithotomy, ureteroscopic intrarenal surgery, laparoscopic surgery, and extracorporeal shock wave lithotripsy (SWL) now allow almost any calculus to be removed without open surgery. SWL refers to the use of high intensity pressure pulses, generated outside the body, to break up kidney stones (Chaussy, Brendel, & Schmiedt, 1980; Loske, 2007). It has become the standard treatment for the majority of patients and an alternative in the management of gallbladder stones, pancreatic concrements, and salivary gland stones. Even though initial studies concluded that shock waves had no damaging effect on renal tissue, later several authors reported that shock waves may cause tissue trauma (Evan, Willis, Connors, McAteer, & Lingeman, 1991; Evan, Willis, & Lingeman, 2003 Willis et al., 1999). Fortunately, techniques and devices are still evolving and improvements to increase stone fragmentation efficiency and reduce tissue trauma are being constantly sought.

scholarly journals Effects of Reversed Shock Waves on Operation Mode in H2/O2 Rotating Detonation Chambers

Energies ◽  
2021 ◽  
Vol 14 (24) ◽  
pp. 8296
Author(s):  
Yanliang Chen ◽  
Xiangyang Liu ◽  
Jianping Wang
Keyword(s):  
Numerical Simulation ◽  
Shock Wave ◽  
Shock Waves ◽  
Detonation Wave ◽  
Operation Mode ◽  
Wave Number ◽  
Mode Switching ◽  
Rotating Waves ◽  
Operation Modes ◽  
Rotating Detonation

Operation modes are an important topic in the research of Rotating Detonation Chamber (RDC) as it can affect the stability of RDC. However, they have not been discussed in detail due to the limitation of measurement means in experiments. The aim of this research is to investigate the mechanism of different operation modes by numerical simulation. In this paper, a numerical simulation for RDCs with separate injectors is carried out. Different operation modes and mode switching are analyzed. There is a series of reversed shock waves in the flow field. It was found that they have great effects on operation mode and mode switching in RDCs. A reversed shock wave can transit into a detonation wave after passing through isolated fresh gas region where fresh gas and burnt gas distribute alternatively. This shock-to-detonation transition (SDT) phenomenon will influence the ignition process, contra-rotating waves mode and mode switching in RDCs. SDT makes the number of detonation wave increases, resulting in multi-wave mode with one ignition. Moreover, quenching of detonation waves after collision and SDT after passing through isolated fresh gas region are the mechanism of contra-rotating waves mode in RDCs with separate injectors. In addition, when the inlet total temperature increases, a shock wave is easier to transit into a detonation wave. The distance that a shock wave travels before SDT decreases when temperature increases. This will result in mode switching. Therefore, SDT determines that there is a lower bound of detonation wave number.

scholarly journals Exposure of Zebra Mussels to Radial Extracorporeal Shock Waves: Implications for Treatment of Fracture Nonunions

2021 ◽  
Author(s):  
Wenkai Wu ◽  
Nicola Maffulli ◽  
John Furia ◽  
Lukas Meindlhumer ◽  
Katharina Sternecker ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Signal Intensity ◽  
Extracorporeal Shock Wave Therapy ◽  
Zebra Mussels ◽  
Fluorescence Signal ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave ◽  
Direct Energy ◽  
Fracture Nonunions

Background Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biomineralization after exposure to focused extracorporeal shock waves (fESWs) is not restricted to the region of direct energy transfer into calcified tissue. This study tested the hypothesis that radial extracorporeal shock waves (rESWs) also induce biomineralization in regions not directly exposed to the shock wave energy in zebra mussels. Methods Zebra mussels were exposed on the left valve to 1000 rESWs at different air pressure (between 0 and 4 bar), followed by incubation in calcein solution for 24 hours. Biomineralization was evaluated by investigating the fluorescence signal intensity found on sections of the left and right valves prepared two weeks after exposure. Results General linear model analysis demonstrated statistically significant (p < 0.05) effects of the applied shock wave energy as well as of the side (left/exposed vs. right/unexposed) and the investigated region of the valve (at the position of exposure vs. positions at a distance to the exposure) on the mean fluorescence signal intensity values, as well as statistically significant combined energy × region and energy × side × region effects. The highest mean fluorescence signal intensity value was found next to the umbo, i.e., not at the position of direct exposure to rESWs. Conclusions As in the application of fESWs, induction of biomineralization by exposure to rESWs may not be restricted to the region of direct energy transfer into calcified tissue. Furthermore, the results of this study may contribute to better understand why the application of higher energy flux densities beyond a certain threshold does not necessarily lead to higher success rates when treating fracture nonunions with extracorporeal shock wave therapy.

scholarly journals Underwater Shock Waves to Medicine

2000 ◽  
Author(s):  
Kazuyoshi Takayama
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Kidney Stones ◽  
Research Topics ◽  
Bladder Stones ◽  
Wave Research ◽  
Underwater Shock

Abstract Application of underwater shock waves to medicine is one of the most interesting research topics in shock wave research. The facility of disintegrating bladder stones by using spark generated shock waves was invented by Yutkin in 1950. Later his method was combined with an endoscope to disintegrate kidney stones.

scholarly journals The Efficacy of Unfocused Extracorporeal Shock Waves for the Treatment of Achilles Tendinopathy

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Ashraf M. Fansa ◽  
Martin J. O’Malley ◽  
Eoghan T. Hurley ◽  
John G. Kennedy
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave

Category: Sports Introduction/Purpose: Extracorporeal shock wave therapy (ESWT) may be a viable non-invasive treatment modality for patients suffering from Achilles Tendinopathy. There seems to be a relationship between the ESWT protocol and patient outcomes. Data suggest that higher energy levels of shock waves together with adequate treatment delivery to the affected area is necessary to achieve favorable outcomes. The aim of this study is present our experience with the use of electrohydraulically produced unfocused extracorporeal shock waves for the treatment of Achilles Tendinopathy. Methods: A retrospective analysis of prospectively collected data was performed, including all patients who had received ESWT for plantar fasciitis heel pain between January 2013 and September 2018. The primary outcomes included change in pain intensity on the visual analog pain scale and patient satisfaction at final follow-up. Pre and post-procedure Foot and Ankle Outcome Scores were also assessed for change. Results: A total of 158 patients (179 heels) were followed-up for a mean duration of 17 +- 6.8 months post ESWT. The mean pre-ESWT pain VAS improved from 7.2 +- 1.4 to 2.3 +- 2.1 (p< 0.001) at final follow-up. The FAOS Symptoms, Pain, Function of Daily Living, Function of Sports and Recreational activities and Quality of Life domains improved from 57.7 +- 12.7 to 79.7 +- 13.6 (p< 0.001), from 35 +- 15.8 to 72.6 +- 22 (p< 0.001), from 43.8 +- 15.3 to 81.4 +- 11 (p< 0.001), from 41.2 +- 21.3 to 66.4 +- 18.3 (p< 0.001) and from 33.9 +- 17.4 to 78 +- 24.4 (p< 0.001), respectively. Overall, 85.4% were satisfied with the procedure at final follow-up. Conclusion: For patients with Achilles tendinopathy, unfocussed extracorporeal shock wave therapy appears to be a safe and viable non-invasive treatment option with a patient satisfaction rate of 85.4% and a 68% reduction in patient reported pain intensity.

Shock Wave Lithotripters With Broad Focus Result in Greater Stress in Human Kidney Stones: Numerical Simulation

2008 ◽  
Author(s):  
Haibiao Luo ◽  
Robin O. Cleveland ◽  
James C. Williams
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Kidney Stones ◽  
Three Dimensional ◽  
Kidney Tissue ◽  
Human Kidney ◽  
Micro Computed Tomography ◽  
Displacement Fields ◽  
Computed Tomography Images ◽  
Shock Wave Lithotripters

Shock wave lithotripsy (SWL) has been used to treat kidney stones for decades. However, there is growing recognition that shock waves induces trauma to kidney tissue [1, 2]. The poor understanding of stone comminution mechanisms means that the design of new lithotripters is principally a practice of empiricism [3]. A mechanistic understanding of stone comminution would provide a criterion to develop new lithotripsy systems. In this work, a three-dimensional finite-difference time-domain (FDTD) solution to the linear elastic equations was employed [4] to investigate the stress and displacement fields of kidney stones subject to lithotripsy shock waves. The kidney stone models were obtained from micro-computed tomography images (resolution of 20 μm) and have diameters from 2 mm to 5 mm.

scholarly journals Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wenkai Wu ◽  
Nicola Maffulli ◽  
John P. Furia ◽  
Lukas Meindlhumer ◽  
Katharina Sternecker ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Signal Intensity ◽  
Extracorporeal Shock Wave Therapy ◽  
Zebra Mussels ◽  
Fluorescence Signal ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave ◽  
Direct Energy ◽  
Fracture Nonunions

Abstract Background Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biomineralization after exposure to focused extracorporeal shock waves (fESWs) is not restricted to the region of direct energy transfer into calcified tissue. This study tested the hypothesis that radial extracorporeal shock waves (rESWs) also induce biomineralization in regions not directly exposed to the shock wave energy in zebra mussels. Methods Zebra mussels were exposed on the left valve to 1000 rESWs at different air pressure (between 0 and 4 bar), followed by incubation in calcein solution for 24 h. Biomineralization was evaluated by investigating the fluorescence signal intensity found on sections of the left and right valves prepared two weeks after exposure. Results General linear model analysis demonstrated statistically significant (p < 0.05) effects of the applied shock wave energy as well as of the side (left/exposed vs. right/unexposed) and the investigated region of the valve (at the position of exposure vs. positions at a distance to the exposure) on the mean fluorescence signal intensity values, as well as statistically significant combined energy × region and energy × side × region effects. The highest mean fluorescence signal intensity value was found next to the umbo, i.e., not at the position of direct exposure to rESWs. Conclusions As in the application of fESWs, induction of biomineralization by exposure to rESWs may not be restricted to the region of direct energy transfer into calcified tissue. Furthermore, the results of this study may contribute to better understand why the application of higher energy flux densities beyond a certain threshold does not necessarily lead to higher success rates when treating fracture nonunions with extracorporeal shock wave therapy.

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