Exposure of zebra mussels to extracorporeal shock waves demonstrates formation of new mineralized tissue inside and outside the focus zone

AbstractA substantial body of evidence supports the use of extracorporeal shock wave therapy (ESWT) for fracture nonunions in human medicine. However, the success rate (i.e., radiographic union at six months after ESWT) is only approximately 75%. Detailed knowledge regarding the underlying mechanisms that induce bio-calcification after ESWT is limited. The aim of the present study was to analyze the biological response within mineralized tissue of a new invertebrate model organism, the zebra mussel Dreissena polymorpha, after exposure with extracorporeal shock waves (ESWs). Mussels were exposed to ESWs with positive energy density of 0.4 mJ/mm2 or were sham exposed. Detection of newly calcified tissue was performed by concomitantly exposing the mussels to fluorescent markers. Two weeks later, the fluorescence signal intensity of the valves was measured. Mussels exposed to ESWs showed a statistically significantly higher mean fluorescence signal intensity within the shell zone than mussels that were sham exposed. Additional acoustic measurements revealed that the increased mean fluorescence signal intensity within the shell of those mussels that were exposed to ESWs was independent of the size and position of the focal point of the ESWs. These data demonstrate that induction of bio-calcification after ESWT may not be restricted to the region of direct energy transfer of ESWs into calcified tissue. The results of the present study are of relevance for better understanding of the molecular and cellular mechanisms that induce formation of new mineralized tissue after ESWT. Specifically, bio-calcification following ESWT may extend beyond the direct area of treatment.Summary statementThe use of zebra mussels in research on extracorporeal shock wave (ESW) therapy for fracture nonunions allows new insights into the complex process of induction of biomineralization by ESWs.

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

10.20944/preprints202111.0032.v1 ◽

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.

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02852-1 ◽

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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Osteogenetic effect of extracorporeal shock waves in human

International Journal of Surgery ◽

10.1016/j.ijsu.2015.09.068 ◽

2015 ◽

Vol 24 ◽

pp. 115-119 ◽

Cited By ~ 9

Author(s):

L. Gerdesmeyer ◽

W. Schaden ◽

L. Besch ◽

M. Stukenberg ◽

L. Doerner ◽

...

Keyword(s):

Shock Waves ◽

Extracorporeal Shock Waves

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The In Vitro and In Vivo Effects of Extracorporeal Shock Waves on Tumor Cells

Shock Wave Lithotripsy ◽

10.1007/978-1-4757-1977-2_72 ◽

1988 ◽

pp. 351-355

Author(s):

Gerhard J. Fuchs ◽

Randall F. Randazzo ◽

Anna M. Fuchs ◽

Arnulf Stenzl ◽

Christian G. Chaussy

Keyword(s):

Shock Waves ◽

Tumor Cells ◽

Extracorporeal Shock Waves ◽

In Vivo Effects

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Experimental Effects of Extracorporeal Shock Waves on the Rat Ovary and Fetus

Shock Wave Lithotripsy ◽

10.1007/978-1-4757-1977-2_67 ◽

1988 ◽

pp. 327-328 ◽

Cited By ~ 1

Author(s):

David L. McCullough ◽

Leslie D. Yeaman ◽

Walter J. Bo ◽

Roy L. Kroovand ◽

Dean G. Assimos ◽

...

Keyword(s):

Shock Waves ◽

Extracorporeal Shock Waves ◽

Rat Ovary

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The repeated extracorporeal shock waves and the renal parenchyma injury on normal and diabetic rats

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502007000400010 ◽

2007 ◽

Vol 22 (4) ◽

pp. 285-290 ◽

Cited By ~ 2

Author(s):

Vicente Massaji Kira ◽

Djalma José Fagundes ◽

César Orlando Peralta Bandeira ◽

Anna Tereza Negrini Fagundes ◽

Valdemar Ortiz

Keyword(s):

Shock Waves ◽

Renal Cortex ◽

Diabetic Rats ◽

Renal Parenchyma ◽

Interstitial Tissue ◽

Accumulated Damage ◽

Histological Sections ◽

Extracorporeal Shock Waves

PURPOSE: To assess the effect of repeated extracorporeal shock waves (ESW) on renal parenchyma of normal and diabetic rats. METHODS: 40 normal rats (A) and 40 diabetic rats (B) were assigned for ESW (Direx Tripter X1® - 14 KVA) as follow: A1/B1 and A3/B3 no ESW; A2/B2 one ESW (2,000 SW); A4/B4 two ESW (4,000 SW) in an elapsed 14 days. All the animals were sacrificed 3 days after the ESW and samples of renal parenchyma were histological prepared, stained by H&E. For each animal the frequency of hemorrhage focus (HF) in the subcapasular, interstitial and glomerulus area was calculated (porcentage) on 20 randomly histological sections. RESULTS: No one HF was identified in all normal or diabetic animals without ESW (A1, A3 and B1, B3). In the normal rats the HF frequency was similar to one ESW (subcapsular =15%; interstitial =20% and glomerular =10%) or repetead ESW (subcapsular =25%; interstitial =20%; glomerular=10%). In diabetic rats the occurence of HF with repetead ESW was more frequent (subcapsular =40%; interstitial =30% and glomerular =10%) than with a single ESW (subcapsular =25%; interstitial =15% and glomerular =15%). CONCLUSION: A single ESW or a repeated ESW caused a mild and similar damage on renal cortex of normal rats. In diabetic rats the repetead ESW may result in an accumulated damage, especially with focus of hemorrhage in subcapsular and interstitial tissue and glomerulus edema.

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The effect of urinary tract calculosis to levels of low molecular inhibitors of crystallization in the urine

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0602040m ◽

2006 ◽

Vol 134 (1-2) ◽

pp. 40-43

Author(s):

Dragica Milenkovic ◽

Natasa Lalic

Keyword(s):

Urinary Tract ◽

Shock Waves ◽

Stone Formation ◽

Upper Urinary Tract ◽

Therapeutic Procedure ◽

Residual Stone ◽

Extracorporeal Shock Waves ◽

Urinary Levels ◽

Urinary Tract Stones ◽

Pre Treatment

The incidence of urinary tract calculosis continuously progresses. The triggering event in the process of stone formation is decreased urinary level of crystallizing inhibitors. The aim of our study was to investigate whether the existing stone or applied therapeutic procedure - extracorporeal shock waves lithotripsy (ESWL) - has effect to urinary levels of Mg, citrate and pyrophosphate. Study included 128 patients with the upper urinary tract stones. ESWL using the Lithostar (Siemens) device was used as a mode of treatment. Out of all patients, 76 (59%) were free of stone particles before 1 month, while 52 (41%) had residual stone fragments even 3 months after ESWL. Mg, citrate and pyrophosphate were measured in 24hurine specimens: before, between days 2 and 3, as well as 1 and 3 months after ESWL. The analysis of the results revealed that stone itself had no effect on urinary crystallizing inhibitors. Detected increased urinary levels of Mg, citrate and pyrophosphate after ESWL, compared with pre-treatment values, could be attributed to applied therapeutic procedure.

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