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Sample records for in-situ extracorporeal shock

  1. Extracorporeal Shock Wave Therapy before Urethral Calculi in Situ%体外冲击波治疗原位前尿道结石

    Institute of Scientific and Technical Information of China (English)

    游加芹; 沈金秀

    2015-01-01

    Objective To analyze extracorporeal shock wave lithotripsy Eswl treatment effect for the treatment of urethral calculi before.Methods Selection in our hospital between January 2011 and January 2013, 23 patients with former urethral calculi in situ as the research object, al patients prone position, the implementation of extracorporeal shock wave lithotripsy treatment.Results 23 cases of urethral calculi before al the pieces, success rate 100%, no serious complications. Postoperative folow-up of 12 months, without the occurrence of impotence and urethral stricture.Conclusion Urethral calculi before taking Eswl treatment effect is significant, economic, convenient and damage in patients with smal, safe and reliable, has the value of clinical application.%目的 分析探讨体外冲击波碎石术Eswl治疗前尿道结石的治疗效果.方法 选取本院2011年1月~2013年1月收治的原位前尿道结石患者23例为本组研究对象,所有患者采用俯卧位,实施体外冲击波碎石治疗.结果 23例前尿道结石均全部粉碎,成功率100%,无严重并发症.术后随访12个月,无阳痿与尿道狭窄的发生.结论 前尿道结石采取Eswl治疗效果显著,经济方便,对患者的损伤小,安全可靠,具有临床推广应用的价值.

  2. Extracorporeal shock wave lithotripsy in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Kroovand, R.L.; Harrison, L.H.; McCullough, D.L.

    1987-10-01

    Extracorporeal shock wave lithotripsy is the treatment of choice for the majority of upper urinary calculi in adults. Technical limitations, including patient size and concerns over post-treatment stone fragment passage, have made the application of extracorporeal shock wave lithotripsy in children less clearly defined. We report the successful application of the Dornier lithotriptor in the management of 18 children (22 kidneys) with upper urinary calculi.

  3. State of the art extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kandel, L.B. (State Univ. of New York at Stony Brook, Stony Brook, NY (US)); Harrison, L.H.; McCullough, D.L. (Wake Forest Univ. Medical Center, Winston-Salem, NC (US))

    1987-01-01

    This book contains 16 chapters. Some of the topics that are covered are: Extracorporeal Shock Wave Lithotripsy Development; Laser-Generated Extracorporeal Shock Wave Lithotripter; Radiation Exposure during ESWL; Caliceal Calculi; and Pediatric ESWL.

  4. Unfocused Extracorporeal Shock Waves Induce Anabolic Effects in Rat Bone

    NARCIS (Netherlands)

    O.P. van der Jagt (Olav); T.M. Piscaer (Tom); W. Schaden (Wolfgang); J. Li; N. Kops (Nicole); H. Jahr (Holger); J.C. van der Linden (Jacqueline); J.H. Waarsing (Jan); J.A.N. Verhaar (Jan); M. de Jong (Marion); H.H. Weinans (Harrie)

    2011-01-01

    textabstractAbstract. BACKGROUND: Extracorporeal shock waves are known to stimulate the differentiation of mesenchymal stem cells toward osteoprogenitors and induce the expression of osteogenic-related growth hormones. The aim of this study was to investigate if and how extracorporeal shock waves af

  5. Unfocused Extracorporeal Shock Waves Induce Anabolic Effects in Rat Bone

    NARCIS (Netherlands)

    O.P. van der Jagt (Olav); T.M. Piscaer (Tom); W. Schaden (Wolfgang); J. Li; N. Kops (Nicole); H. Jahr (Holger); J.C. van der Linden (Jacqueline); J.H. Waarsing (Jan); J.A.N. Verhaar (Jan); M. de Jong (Marion); H.H. Weinans (Harrie)

    2011-01-01

    textabstractAbstract. BACKGROUND: Extracorporeal shock waves are known to stimulate the differentiation of mesenchymal stem cells toward osteoprogenitors and induce the expression of osteogenic-related growth hormones. The aim of this study was to investigate if and how extracorporeal shock waves

  6. Extracorporeal shock wave lithotripsy of biliary and pancreatic stones

    NARCIS (Netherlands)

    R. den Toom (Rene)

    1993-01-01

    textabstractThe aim of the study was to answer the following questions: Is extracorporeal shock wave lithotripsy for gallbladder stones a safe and effective therapy? (Chapter 2) Is simultaneous treatment with extracorporeal shock wave lithotripsy and the solvent methyl te.rt-butyl ether feasible, sa

  7. Extracorporeal shock wave therapy for tendinopathies.

    Science.gov (United States)

    Seil, Romain; Wilmes, Philippe; Nührenbörger, Christian

    2006-07-01

    Shock waves, as applied in urology and gastroenterology, were introduced in the middle of the last decade in Germany to treat different pathologies of the musculoskeletal system, including epicondylitis of the elbow, plantar fasciitis, and calcifying and noncalcifying tendinitis of the rotator cuff. With the noninvasive nature of these waves and their seemingly low complication rate, extracorporeal shock wave therapy (ESWT) seemed a promising alternative to the established conservative and surgical options in the treatment of patients with chronically painful conditions. However, the apparent advantages of the method led to a rapid diffusion and even inflationary use of ESWT; prospective, randomized studies on the mechanisms and effects of shock waves on musculoskeletal tissues were urgently needed to define more accurate indications and optimize therapeutic outcome. This review covers recent international research in the field and presents actual indications and results in therapy of musculoskeletal conditions with ESWT.

  8. Extracorporeal shock wave therapy (ESWT) in urology

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz Lukasz; Thiessen, Stefan; Osther, Palle Jörn Sloth

    2017-01-01

    PURPOSE: The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders. METHODS: We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline...... and PubMed was carried out. The systematic review was performed according to PRISMA guidelines. RESULTS: We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie's disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile......i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard...

  9. Extracorporeal shock-wave lithotripsy of gallstones. Results and perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Staritz, M.; Rambow, A.; Meyer zum Bueschenfelde, K.H.; Floth, A.; Hohenfellner, R.; Mildenberger, P.; Thelen, M.; Goebel, M.

    1987-12-01

    Recently extracorporeal shock-wave lithotripsy became a noteworthy alternative in the treatment of choledocolithiasis and cholecystolithiasis, in particular since the introduction of the second-generation shock-wave technique which allows to dispense with the positioning of the patient in the water bath required sofar and to place the patient on an examination table in freely movable way so as to position the gall stone to be disintegrated in the focus of the shock waves. Despite the beneficial treatment results, extracorporeal shock-wave lithotripsy still needs further improvement as a method especially in terms of the option of 'pulverizing' the stones. (orig./TRV)

  10. [Extracorporeal shock-wave therapy. Experimental basis, clinical application].

    Science.gov (United States)

    Rompe, J D; Küllmer, K; Vogel, J; Eckardt, A; Wahlmann, U; Eysel, P; Hopf, C; Kirkpatrick, C J; Bürger, R; Nafe, B

    1997-03-01

    The purpose of our studies was to investigate experimentally the dose-dependent effects of extracorporeal shock waves on tendon and bone and to unveil therapeutic possibilities in tendinopathies and pseudarthroses. In animal experiments, both positive and negative influences were exerted by shock waves, depending on the initial situation and on the power of the applied shock waves. In prospective clinical trials positive effects were found in the treatment of persistent tennis elbow, plantar fasciitis, calcifying tendinitis, and pseudarthrosis. Our data show that extracorporeal shock waves may provide analgesic, resorptive and osteo-inductive reactions with nearly no side effects. However, the high cost of apparatus and staff prevents a routine application. Extracorporeal shock waves thus remain a last alternative before the indication is made for an operative procedure.

  11. Exact focusing of extracorporeal shock wave therapy for calcifying tendinopathy.

    Science.gov (United States)

    Haake, Michael; Deike, Barbara; Thon, Alexander; Schmitt, Jan

    2002-04-01

    A controlled prospective randomized study was designed to analyze the effect of extracorporeal shock wave therapy on calcifying tendinopathy of the shoulder focused on the calcified area or the origin of the supraspinatus tendon. Fifty patients were included in the study and were treated with a Storz Minilith Sl-1 shock wave generator. The first group of patients received 4000 impulses (positive energy flux density, 0.78 mJ/mm2) in two treatment sessions after receiving local anesthesia at the origin of the supraspinatus tendon. Patients in the second group received extracorporeal shock wave therapy at the calcified area. Follow-ups were done 12 weeks and 1 year after treatment by an independent observer. An increase of function and a reduction of pain occurred in both groups. Statistical analyses showed a significant superiority of extracorporeal shock wave application at the calcified area in the primary end point (Constant and Murley score). Therefore, exact fluoroscopic focusing of extracorporeal shock wave therapy at the calcific deposit for treatment of calcifying tendinopathy of the supraspinatus muscle is recommended. Based on these results, extracorporeal shock wave application should be focused fluoroscopically with appropriate shock wave generators.

  12. The effects of extracorporeal shock wave therapy on frozen shoulder patients’ pain and functions

    OpenAIRE

    2015-01-01

    [Purpose] The present study was conducted to examine the effects of extracorporeal shock wave therapy on frozen shoulder patients’ pain and functions. [Subjects] In the present study, 30 frozen shoulder patients were divided into two groups: an extracorporeal shock wave therapy group of 15 patients and a conservative physical therapy group of 15 patients. [Methods] Two times per week for six weeks, the extracorporeal shock wave therapy group underwent extracorporeal shock wave therapy, and th...

  13. In situ local shock speed and transit shock speed

    Directory of Open Access Journals (Sweden)

    S. Watari

    Full Text Available A useful index for estimating the transit speeds was derived by analyzing interplanetary shock observations. This index is the ratio of the in situ local shock speed and the transit speed; it is 0.6–0.9 for most observed shocks. The local shock speed and the transit speed calculated for the results of the magnetohydrodynamic simulation show good agreement with the observations. The relation expressed by the index is well explained by a simplified propagation model assuming a blast wave. For several shocks the ratio is approximately 1.2, implying that these shocks accelerated during propagation in slow-speed solar wind. This ratio is similar to that for the background solar wind acceleration.

    Keywords. Interplanetary physics (Flare and stream dynamics; Interplanetary shocks; Solar wind plasma

  14. Extracorporeal Shock Wave Therapy for Nonunion of the Tibia

    Science.gov (United States)

    2010-03-01

    Zoellner J, Nafe B. Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orrhop Relar Res. 200...I ;387:72-82. 26. Wang CJ, Yang KD, Wang FS. ct al. Shock wave therapy for culcific tendinitis of the shoulder: a prospective clinical study with...Selvi E, ct al. Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulder: single blind study. Ann Rheum Dis. 2(K13;62:248

  15. [Extracorporeal shock wave therapy in chronic prostatitis].

    Science.gov (United States)

    Kul'chavenya, E V; Shevchenko, S Yu; Brizhatyuk, E V

    2016-04-01

    Chronic prostatitis is a prevalent urologic disease, but treatment outcomes are not always satisfactory. As a rule, chronic prostatitis results in chronic pelvic pain syndrome, significantly reducing the patient's quality of life. Open pilot prospective non-comparative study was conducted to test the effectiveness of extracorporeal shock wave therapy (ESWT) using Aries (Dornier) machine in patients with chronic prostatitis (CP) of IIIb category. A total of 27 patients underwent ESWL as monotherapy, 2 times a week for a course of 6 sessions. Exposure settings: 5-6 energy level (by sensation), the frequency of 5 Hz, 2000 pulses per session; each patient received a total energy up to 12000 mJ. per procedure. Treatment results were evaluated using NIH-CPSI (National Institute of Health Chronic Prostatitis Symptom Index) upon completing the 3 week course of 6 treatments and at 1 month after ESWT. Immediately after the ESWT course positive trend was not significant: pain index decreased from 9.1 to 7.9, urinary symptom score remained almost unchanged (4.2 at baseline, 4.1 after treatment), quality of life index also showed a slight improvement, dropping from 7.2 points to 6.0. Total NIH-CPSI score decreased from 20.5 to 18.0. One month post-treatment pain significantly decreased to 3.2 points, the urinary symptom score fell to 2.7 points, the average quality of life score was 3.9 points. ESWT, performed on Aries (Dornier) machine, is highly effective as monotherapy in patients with category IIIb chronic prostatitis.

  16. Unfocused extracorporeal shock waves induce anabolic effects in osteoporotic rats

    NARCIS (Netherlands)

    van der Jagt, Olav P.; Waarsing, Jan H.; Kops, Nicole; Schaden, Wolfgang; Jahr, Holger; Verhaar, Jan A. N.; Weinans, Harrie

    2013-01-01

    Unfocused extracorporeal shock waves (UESW) have been shown to have an anabolic effect on bone mass. Therefore we investigated the effects of UESW on bone in osteoporotic rats with and without anti-resorptive treatment. Twenty-week-old rats were ovariectomized (n=27). One group was treated with sali

  17. Stenting and extracorporeal shock wave lithotripsy in chronic pancreatitis

    DEFF Research Database (Denmark)

    Holm, M; Matzen, Peter

    2003-01-01

    BACKGROUND: Early observational studies of endoscopic treatment and extracorporeal shock wave lithotripsy (ESWL) reported considerable or complete relief of pain in 50%-80% of patients with chronic pancreatitis. There is no consensus on the measurement of pain, making comparison of observational...

  18. EKSTRAKORPOREAL ŞOK DALGA TEDAVİSİ/EXTRACORPOREAL SHOCK WAVE THERAPY

    OpenAIRE

    2014-01-01

    Extracorporeal shock wave therapyExtracorporeal shock wave therapy (ESWT) is a therapy method which is applied acoustic pressure to thebody. Shock wave was first used in urology for renal stones in 1980s. Research has been started in orthopedicsin 1990s. Today it has been used for most of the diagnosis in different clinics. In this review it has summarizedthat the action mechanism, indications, contraindications, complications and current studies in the literatureabout extracorporeal shock wa...

  19. Analgesic effect of extracorporeal shock wave therapy versus ultrasound therapy in chronic tennis elbow

    OpenAIRE

    2015-01-01

    [Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue ...

  20. Patient information leaflets for extracorporeal shock wave lithotripsy: questionnaire survey

    OpenAIRE

    Askari, A.; Shergill, I.

    2012-01-01

    Objectives To compare the level of information provided in extracorporeal shock wave lithotripsy (ESWL) patient information leaflets in the London and East of England Deaneries Design All trusts in the London and East of England Deanery who offer an ESWL service were contacted and leaflets were compared Setting London and East of England Deanery Participants Alan Askari, Iqbal Shergill Main outcome measures Examination of key information that was communicated to ESWL patients via leaflets Res...

  1. Kidney changes after extracorporeal shock wave lithotripsy; MR evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Hiroyasu; Shindo, Hiroshi; Mabuchi, Nobuhisa; Kawakami, Akira; Fujii, Koichi; Hamada, Tatsumi; Ishida, Osamu; Umekawa, Toru; Kohri, Kenjiro (Kinki Univ., Osakasayama, Osaka (Japan). School of Medicine)

    1991-02-01

    MRI was performed before and after extracorporeal shock wave lithotripsy (ESWL) to determine the effects of ESWL on the kidney and perinephric tissues. Of the 40 kidneys studied, 24 showed one or more changes on MRI: loss of the corticomedullary junction (n=15), subcapsular fluid (n=14), subcapsular hematoma (n=1), thickening of bridging septa (n=8), high intensity area in the muscle (n=8). These relatively subtle changes detected on MRI may not be apparent with other imaging techniques. (author).

  2. Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes.

    Science.gov (United States)

    McAdams, Sean; Shukla, Aseem R

    2010-10-01

    Extracorporeal shock wave lithotripsy (ESWL) is currently a first-line procedure of most upper urinary tract stones ionizing radiation, perhaps utilizing advancements in ultrasound and magnetic resonance imaging. This report provides a review of the current literature evaluating the patient attributes and stone factors that may be predictive of successful ESWL outcomes along with reviewing the role of pre-operative imaging and considerations for patient safety.

  3. Analgesic effect of extracorporeal shock wave therapy versus ultrasound therapy in chronic tennis elbow.

    Science.gov (United States)

    Lizis, Paweł

    2015-08-01

    [Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue scale during grip strength evaluation, palpation of the lateral epicondyle, Thomsen test, and chair test. Resting pain was also recorded. The scores were recorded and compared within and between groups pre-treatment, immediately post-treatment, and 3 months post-treatment. [Results] Intra- and intergroup comparisons immediately and 3 months post-treatment showed extracorporeal shock wave therapy decreased pain to a significantly greater extent than ultrasound therapy. [Conclusion] Extracorporeal shock wave therapy can significantly reduce pain in patients with chronic tennis elbow.

  4. Radial extracorporeal shock wave therapy for heterotopic ossification

    OpenAIRE

    Ryu, Byung-Ju; Ha, Kang-Wook; Lee, Jin-Young; Kim, Sung-Hwan; Kwak, Ho-Jun; Seol, Pyong-Hwa

    2016-01-01

    [Purpose] To report the effects of radial extracorporeal shock wave therapy (RSWT) on heterotopic ossification (HO). [Subjects and Methods] Two cases of neurogenic HO in the upper extremity were administered RSWT using the MASTER PLUS® MP 2000 (Storz, Tägerwilen, Switzerland) and ultrasonographic guidance. The RSWT protocol consisted of 3,000 pulses at a frequency of 12 Hz during each treatment. The intensity level ranged from 2–5 bars, and it was administered 5 times a week for 4 weeks, a to...

  5. CT appearance of renal hemorrhage after extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kanazawa, Susumu; Araki, Toru; Takamoto, Hitoshi; Hata, Kazuhiro

    1988-07-01

    Computed Tomography (CT) was performed in three patients who were suspicious of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). Post-ESWL scans demonstrated subcapsular hematoma in all three cases, and intrarenal hemorrhage in two cases, one of which had fluid collection in the pararenal space and hemorrhage in the posterior pararenal space on CT. Thickening of gerota fascia and bridging septa in the perirenal space was visualized on CT in all of them. CT demonstrated clearly the anatomic distribution and extent of renal hemorrhage, and it is important to comprehend the imaging anatomy of the perirenal area for CT evaluation.

  6. Extracorporeal shock wave therapy in periodontics: A new paradigm.

    Science.gov (United States)

    Venkatesh Prabhuji, Munivenkatappa Lakshmaiah; Khaleelahmed, Shaeesta; Vasudevalu, Sujatha; Vinodhini, K

    2014-05-01

    The quest for exploring new frontiers in the field of medical science for efficient and improved treatment modalities has always been on a rise. Extracorporeal shock wave therapy (ESWT) has been enormously used in medical practice, principally, for the management of urolithiasis, cholelithiasis and also in various orthopedic and musculoskeletal disorders. The efficacy of ESWT in the stimulation of osteoblasts, fibroblasts, induction of neovascularization and increased expression of bone morphogenic proteins has been well documented in the literature. However, dentistry is no exception to this trend. The present article enlightens the various applications of ESWT in the field of dentistry and explores its prospective applications in the field of periodontics, and the possibility of incorporating the beneficial properties of shock waves in improving the treatment outcome.

  7. Extracorporeal shock wave therapy in periodontics: A new paradigm

    Directory of Open Access Journals (Sweden)

    Munivenkatappa Lakshmaiah Venkatesh Prabhuji

    2014-01-01

    Full Text Available The quest for exploring new frontiers in the field of medical science for efficient and improved treatment modalities has always been on a rise. Extracorporeal shock wave therapy (ESWT has been enormously used in medical practice, principally, for the management of urolithiasis, cholelithiasis and also in various orthopedic and musculoskeletal disorders. The efficacy of ESWT in the stimulation of osteoblasts, fibroblasts, induction of neovascularization and increased expression of bone morphogenic proteins has been well documented in the literature. However, dentistry is no exception to this trend. The present article enlightens the various applications of ESWT in the field of dentistry and explores its prospective applications in the field of periodontics, and the possibility of incorporating the beneficial properties of shock waves in improving the treatment outcome.

  8. Extracorporeal shock wave therapy does not improve hypertensive nephropathy.

    Science.gov (United States)

    Caron, Jonathan; Michel, Pierre-Antoine; Dussaule, Jean-Claude; Chatziantoniou, Christos; Ronco, Pierre; Boffa, Jean-Jacques

    2016-06-01

    Low-energy extracorporeal shock wave therapy (SWT) has been shown to improve myocardial dysfunction, hind limb ischemia, erectile function, and to facilitate cell therapy and healing process. These therapeutic effects were mainly due to promoting angiogenesis. Since chronic kidney diseases are characterized by renal fibrosis and capillaries rarefaction, they may benefit from a proangiogenic treatment. The objective of our study was to determine whether SWT could ameliorate renal repair and favor angiogenesis in L-NAME-induced hypertensive nephropathy in rats. SWT was started when proteinuria exceeded 1 g/mmol of creatinine and 1 week after L-NAME removal. SWT consisted of implying 0.09 mJ/mm(2) (400 shots), 3 times per week. After 4 weeks of SWT, blood pressure, renal function and urinary protein excretion did not differ between treated (LN + SWT) and untreated rats (LN). Histological lesions including glomerulosclerosis and arteriolosclerosis scores, tubular dilatation and interstitial fibrosis were similar in both groups. In addition, peritubular capillaries and eNOS, VEGF, VEGF-R, SDF-1 gene expressions did not increase in SWT-treated compared to untreated animals. No procedural complications or adverse effects were observed in control (C + SWT) and hypertensive rats (LN + SWT). These results suggest that extracorporeal kidney shock wave therapy does not induce angiogenesis and does not improve renal function and structure, at least in the model of hypertensive nephropathy although the treatment is well tolerated.

  9. Extracorporeal shock waves as curative therapy for varicose veins?

    Directory of Open Access Journals (Sweden)

    Fiorenzo Angehrn

    2008-03-01

    Full Text Available Fiorenzo Angehrn1, Christoph Kuhn1, Ortrud Sonnabend2, Axel Voss31Klinik Piano, Biel, Switzerland; 2Pathodiagnostics, Herisau, Switzerland; 3SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: In this prospective design study the effects of low-energy partially focused extracorporeal generated shock waves (ESW onto a subcutaneous located varicose vein – left vena saphena magna (VSM – are investigated. The treatment consisted of 4 ESW applications within 21 days. The varicose VSM of both sides were removed by surgery, and samples analyzed comparing the treated and untreated by means of histopathology. No damage to the treated varicose vein in particular and no mechanical destruction to the varicose vein’s wall could be demonstrated. However, an induction of neo-collagenogenesis was observed. The thickness of the varicose vein’s wall increased. Optimization of critical application parameters by investigating a larger number of patients may turn ESW into a non-invasive curative varicose treatment.Keywords: curative therapy, extra-cellular matrix (ECM, histopathologic changes of varicose veins, extracorporeal shock wave (ESW, progenitor cells

  10. Effects of extracorporeal shock wave therapy on fracture nonunions.

    Science.gov (United States)

    Vulpiani, Maria C; Vetrano, Mario; Conforti, Federica; Minutolo, Lucia; Trischitta, Donatella; Furia, John P; Ferretti, Andrea

    2012-09-01

    The purpose of this study was to examine the effect of focused extracorporeal shock wave therapy (ESWT) on the treatment of nonunions. As part of a prospective study, we included 143 patients (average age, 41.4 years) with a diagnosis of nonunion (mean, 14.1 months; range, 6-84 months). High-energy shock wave treatment was applied using shock wave generator. The shock waves were applied in 3-5 sessions of 2500 to 3000 impulses each given at 0.25-0.84 mJ/mm(2), at intervals of 48-72 hours between sessions. A maximum of 3 cycles of treatment was given, at 3-month intervals. The patients were followed during a 12-month period until fracture healing or, in case of failure, until another therapy was adopted. Complete healing was observed in 80 of 143 cases (55.9%) at an average time of 7.6 months (range 2-24 months). Partial healing occurred in 41 cases (28.7%) and no healing was observed in 22 cases (15.4%). Patients with trophic nonunions had a better success rate than patients with atrophic nonunions (Pextracorporeal shock wave therapy is a safe and effective treatment for nonunion. ESWT is more effective for trophic nonunions than atrophic nonunions.

  11. Radial extracorporeal shock wave treatment harms developing chicken embryos

    Science.gov (United States)

    Kiessling, Maren C.; Milz, Stefan; Frank, Hans-Georg; Korbel, Rüdiger; Schmitz, Christoph

    2015-01-01

    Radial extracorporeal shock wave treatment (rESWT) has became one of the best investigated treatment modalities for cellulite, including the abdomen as a treatment site. Notably, pregnancy is considered a contraindication for rESWT, and concerns have been raised about possible harm to the embryo when a woman treated with rESWT for cellulite is not aware of her pregnancy. Here we tested the hypothesis that rESWT may cause serious physical harm to embryos. To this end, chicken embryos were exposed in ovo to various doses of radial shock waves on either day 3 or day 4 of development, resembling the developmental stage of four- to six-week-old human embryos. We found a dose-dependent increase in the number of embryos that died after radial shock wave exposure on either day 3 or day 4 of development. Among the embryos that survived the shock wave exposure a few showed severe congenital defects such as missing eyes. Evidently, our data cannot directly be used to draw conclusions about potential harm to the embryo of a pregnant woman treated for cellulite with rESWT. However, to avoid any risks we strongly recommend applying radial shock waves in the treatment of cellulite only if a pregnancy is ruled out. PMID:25655309

  12. Radial extracorporeal shock wave therapy for heterotopic ossification.

    Science.gov (United States)

    Ryu, Byung-Ju; Ha, Kang-Wook; Lee, Jin-Young; Kim, Sung-Hwan; Kwak, Ho-Jun; Seol, Pyong-Hwa

    2016-01-01

    [Purpose] To report the effects of radial extracorporeal shock wave therapy (RSWT) on heterotopic ossification (HO). [Subjects and Methods] Two cases of neurogenic HO in the upper extremity were administered RSWT using the MASTER PLUS(®) MP 2000 (Storz, Tägerwilen, Switzerland) and ultrasonographic guidance. The RSWT protocol consisted of 3,000 pulses at a frequency of 12 Hz during each treatment. The intensity level ranged from 2-5 bars, and it was administered 5 times a week for 4 weeks, a total of 20 treatments. [Results] RSWT improved pain, range of motion, and hand function in 2 patients with neurogenic HO in the upper extremity. [Conclusion] Further studies are needed to support these results and to understand the mechanism and to devise the protocol of RSWT for neurogenic HO.

  13. Patient information leaflets for extracorporeal shock wave lithotripsy: questionnaire survey

    Science.gov (United States)

    Askari, A; Shergill, I

    2012-01-01

    Objectives To compare the level of information provided in extracorporeal shock wave lithotripsy (ESWL) patient information leaflets in the London and East of England Deaneries Design All trusts in the London and East of England Deanery who offer an ESWL service were contacted and leaflets were compared Setting London and East of England Deanery Participants Alan Askari, Iqbal Shergill Main outcome measures Examination of key information that was communicated to ESWL patients via leaflets Results 12 trusts responded across the two deaneries. There was significant variation in the amount of information provided in the leaflets with some leaflets not containing an adequate level of instruction or information to patients Conclusions The authors propose that a national standardised information leaflet should be incorporated with the British Association of Urological Surgeons (BAUS) procedure specific information leaflet for ESWL procedures PMID:22666532

  14. [Severe pulmonary contusion after extracorporeal shock wave lithotripsy].

    Science.gov (United States)

    Samkaoui, M A; Ziadi, A; Harifi, G; El Adib, A Rhassan; Younous, S

    2009-03-01

    Extracorporeal shock wave lithotripsy (ESWL) is a simple and effective treatment of urinary stones. Renowned less aggressive than surgery, it knew a wide success and constitutes therefore the treatment of first intention of the majority of the kidney stones. Nevertheless, traumatic renal and extrarenal complications notably in lung can arise after ESWL. We report the case of a 28-year-old patient who had a pulmonary contusion following a lithotripsy for a left kidney stone and whose evolution was favourable after two weeks in intensive care unit. Through this observation and the analysis of the rare reported cases in the literature, we insist on the different varieties of pulmonary complications of the ESWL, the hypothesis explaining the mechanisms of their arising as well as the precautions to take to avoid them.

  15. Stenting and extracorporeal shock wave lithotripsy in chronic pancreatitis

    DEFF Research Database (Denmark)

    Holm, M; Matzen, Peter

    2003-01-01

    BACKGROUND: Early observational studies of endoscopic treatment and extracorporeal shock wave lithotripsy (ESWL) reported considerable or complete relief of pain in 50%-80% of patients with chronic pancreatitis. There is no consensus on the measurement of pain, making comparison of observational...... studies difficult, and little attention has been paid to the type and amount of analgesics used by patients before and after decompressive treatment. METHODS: We performed a retrospective study of all patients with chronic pancreatitis and large-duct disease and receiving decompressing treatment between 1...... November 1994 and 31 July 1999. Primary parameters were type and amount of analgesics used. RESULTS: Forty-nine patients with chronic pancreatitis and large-duct disease received stenting of the pancreatic duct (28 patients), ESWL (6 patients) or both (15 patients). After a median follow-up of 21 months...

  16. Extracorporeal shock wave treatment for chronic lateral epicondylitis (tennis elbow).

    Science.gov (United States)

    Ho, C

    2007-01-01

    (1) Electrohydraulic, electromagnetic, or piezoelectric devices are used to translate energy into acoustic waves during extracorporeal shock wave treatment (ESWT) for chronic lateral epicondylitis (CLE) of the elbow (elbow tendonitis or tennis elbow). These waves may help to accelerate the healing process via an unknown mechanism. (2) Results from randomized controlled trials have been conflicting. Half of the studies showed statistically significant improvement in pain in the treatment group, and half of the studies had data showing no benefit over placebo for any measured outcomes. (3) Limited evidence shows that ESWT is cheaper than arthroscopic surgery, open surgery, and other conservative therapies, such as steroid infiltrations and physiotherapy, that continue for more than six weeks. (4) The lack of convincing evidence regarding its effectiveness does not support the use of ESWT for CLE.

  17. Shoulder function after extracorporal shock wave therapy for calcific tendinitis.

    Science.gov (United States)

    Rompe, J D; Bürger, R; Hopf, C; Eysel, P

    1998-01-01

    We report a controlled, prospective study that explored the effect of extracorporal shock waves of low- versus high-energy density in patients with chronic shoulder pain and calcific tendinitis. We assigned at random 100 patients who had had calcific tendinitis for more than 12 months to 2 groups to receive shock wave therapy either of a low- or high-energy density. Group 1 received 1500 impulses of 0.06 mJ/mm2, whereas group 2 received 1500 impulses of 0.28 mJ/mm2. Unlike group 1, in which the shock wave application could be performed without local anesthesia, all patients in group 2 required brachial plexus anesthesia. The patients were reviewed at 6 and 24 weeks. Partial or complete disintegration of the calcareous deposit was observed in 50% of the patients in group 1 and 64% of the patients in group 2 (P < .01). According to the Constant score, ratings increased from 48 to 71 points in group 1 (P < .001) and from 53 to 88 in group 2 (P < .001) (out of a total possible 100 points), the end values of both groups differing significantly (P < .01). After 24 weeks, 52% of the patients in group 1 rated the results of treatment as good or excellent, compared with 68% in group 2 (P < .01). No improvement was reported by 24% versus 10%, respectively, at the 24-week follow-up.

  18. Liver fibrosis after extracorporeal shock-wave lithotripsy of gallbladder stones - A case report

    NARCIS (Netherlands)

    P.W. Plaisier; J.F. Hamming (Jaap); R.L. van der Hul (René); R. den Toom (Rene); H.A. Bruining (Hajo)

    1994-01-01

    textabstractWe encountered significant liver fibrosis in a healthy young patient undergoing laparoscopic cholecystectomy for symptomatic gallstone disease. Twelve months prior to cholecystectomy the patient underwent multiple extracorporeal shock-wave lithotripsy (ESWL) sessions with adjuvant oral b

  19. Extracorporeal shock wave therapy for musculoskeletal pathology--a literature review.

    Science.gov (United States)

    Saw, A

    2005-07-01

    For more than two decades extracorporeal shock wave lithotripsy has emerged as the standard therapy for calculi in the kidney and urinary tract, and biliary system. Application of extracorporeal shock waves in orthopaedics involves treatment of recalcitrant chronic pain of plantar fasciitis, tennis elbow and calcifying tendonitis of the shoulder. This review explores current evidence-based issues related to its potential use as a treatment option for some musculoskeletal conditions.

  20. Can cellulite be treated with low-energy extracorporeal shock wave therapy?

    OpenAIRE

    Fiorenzo Angehrn; Christoph Kuhn; Axel Voss

    2008-01-01

    Fiorenzo Angehrn1, Christoph Kuhn1, Axel Voss21Klinik Piano, Gottstattstrasse 24, Biel, Switzerland; 2SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: The present study investigates the effects of low-energy defocused extracorporeal generated shock waves on collagen structure of cellulite afflicted skin. Cellulite measurement using high-resolution ultrasound technology was performed before and after low-energy defocused extracorporeal shock wave therapy (ESWT) in 21 female subjects. ESWT...

  1. The effects of extracorporeal shock wave therapy on frozen shoulder patients' pain and functions.

    Science.gov (United States)

    Park, Chan; Lee, Sangyong; Yi, Chae-Woo; Lee, Kwansub

    2015-12-01

    [Purpose] The present study was conducted to examine the effects of extracorporeal shock wave therapy on frozen shoulder patients' pain and functions. [Subjects] In the present study, 30 frozen shoulder patients were divided into two groups: an extracorporeal shock wave therapy group of 15 patients and a conservative physical therapy group of 15 patients. [Methods] Two times per week for six weeks, the extracorporeal shock wave therapy group underwent extracorporeal shock wave therapy, and the conservative physical therapy group underwent general physical therapy. Visual analog scales were used to measure frozen shoulder patients' pain, and patient-specific functional scales were used to evaluate the degree of functional disorders. [Results] In intra-group comparisons, the two groups showed significant decreases in terms of visual analog scales and patient-specific functional scales, although the extracorporeal shock wave therapy group showed significantly lower scores than the conservative physical therapy group. [Conclusion] Extracorporeal shock wave therapy is considered an effective intervention for improving frozen shoulder patients' pain and functions.

  2. Pressure Distribution for Piezoelectric Extracorporeal Shock Wave Lithotripsy

    Science.gov (United States)

    Yanagida, Yuji; Iwama, Nobuyuki; Okazaki, Kiyoshi

    1993-05-01

    The objective of this study is to develop a safer and more effective extracorporeal shock wave lithotripter. The first stage of the study shows the sound pressure field of the shock wave made by an ECHOLITH ESL-500A. The sound pressure distribution is in a ring configuration on a 60 mm plane in front of the focal plane. As the plane approaches the focal plane, the sound pressure relatively increases at the cross point with the axis of the transducer and decreases at the ring. The focal zone is 2.5 mm × 16.1 mm at 60 V driving voltage and 1.8 mm × 14.2 mm at “INTENSITY 2.” In the next stage we propose a method for changing the field by electronic driving control of each piezoceramic element for effective therapy. The focal zone can be changed from 3.1 mm × 19.1 mm to 3.9 mm × 32.4 mm at 60 V driving voltage with this method. These focal zones are calculated by means of computer simulation.

  3. Effect of extracorporeal shock wave therapy on the shoulder joint functional status of patients with calcific tendinitis

    OpenAIRE

    2016-01-01

    [Purpose] This study aimed to analyze the effect of extracorporeal shock wave therapy on the shoulder function of patients with calcific tendinitis through a 12-week follow-up. [Subjects and Methods] A total of 34 patients with calcific tendinitis participated in this study. In the extracorporeal shock wave therapy group, 18 patients received 6-week extracorporeal shock wave therapy and 12-week follow-up. The Constant-Murley scale was used to evaluate shoulder joint function. [Results] Analys...

  4. Extracorporeal shock wave therapy for calcifying tendinitis of the shoulder.

    Science.gov (United States)

    Hsu, Chin-Jung; Wang, Der-Yean; Tseng, Kuo-Fung; Fong, Yi-Chin; Hsu, Horng-Chaung; Jim, Yick-Fung

    2008-01-01

    We prospectively studied extracorporeal shock wave therapy (ESWT) for calcific tendinitis of the shoulder in 46 consecutive patients. All patients were randomly divided into 2 groups: treatment and control. The 33 patients in the treatment group received 2 courses of ESWT at the energy density of 0.55 mJ/mm(2) (1000 impulses). The control group underwent sham treatment with a dummy electrode (13 patients). Evaluation included the Constant score, pain scale, and radiographs. The ESWT results were good to excellent in 87.9% of shoulders (29/33) and fair in 12.1% (4/33), and the control results were fair in 69.2% (9/13) and poor in 30.1% (4/13). Among ESWT patients, calcium deposits were completely eliminated in 7 cases (21.2%), partially eliminated in 11 (36.3%), and unchanged in 15 (45.4%). In contrast, elimination was partial in 2 control patients (15.3%) and unchanged in 11 (84.7%). There was no significant difference between Gärtner type I and type II groups in the Constant score (P > .05). ESWT shows promise for pain relief and functional restoration of calcific tendinitis with negligible complications.

  5. Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes

    Directory of Open Access Journals (Sweden)

    Sean McAdams

    2010-01-01

    Full Text Available Extracorporeal shock wave lithotripsy (ESWL is currently a first-line procedure of most upper urinary tract stones <2 cm of size because of established success rates, its minimal invasiveness and long-term safety with minimal complications. Given that alternative surgical and endourological options exist for the management of stone disease and that ESWL failure often results in the need for repeat ESWL or secondary procedures, it is highly desirable to identify variables predicting successful outcomes of ESWL in the pediatric population. Despite numerous reports and growing experience, few prospective studies and guidelines for pediatric ESWL have been completed. Variation in the methods by which study parameters are measured and reported can make it difficult to compare individual studies or make definitive recommendations. There is ongoing work and a need for continuing improvement of imaging protocols in children with renal colic, with a current focus on minimizing exposure to ionizing radiation, perhaps utilizing advancements in ultrasound and magnetic resonance imaging. This report provides a review of the current literature evaluating the patient attributes and stone factors that may be predictive of successful ESWL outcomes along with reviewing the role of pre-operative imaging and considerations for patient safety.

  6. Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head.

    Science.gov (United States)

    Ma, Yue Wen; Jiang, Dong Lei; Zhang, Dai; Wang, Xiao Bei; Yu, Xiao Tong

    2016-09-01

    This case report describes the first patient with avascular necrosis of the femoral head of Association Research Circulation Osseous stage IV, treated with radial extracorporeal shock wave therapy. By contrast, previous studies demonstrated the efficacy of a single treatment of focused extracorporeal shock wave therapy in improving pain and Harris Hip Scale in patients with avascular necrosis of the femoral head of Association Research Circulation Osseous stage I to III. The affected hip was treated with 6000 impulses of radial extracorporeal shock wave therapy at 10 Hz and an intensity ranging from 2.5 to 4.0 bar at 7-day intervals for 24 mos. The Harris Hip Scale values were 33, 43, 56, 77, 81, 88, and 92 at baseline and 1, 3, 6, 12, 18, and 24 mos, respectively. The radiographs showed that the subluxation of the right hip was slightly aggravated. Joint effusion was reduced, bone marrow edema disappeared, the density became more uniform, and the gluteal muscles were more developed based on magnetic resonance imaging. Increased tracer uptake was evident along the joint margin and superolateral aspect of the head both before and after radial extracorporeal shock wave therapy. This case report demonstrates the feasibility of long-term radial extracorporeal shock wave therapy in Association Research Circulation Osseous stage IV patients.

  7. [Extracorporeal shock wave therapy as a treatment of a non-healing chronic leg ulcer].

    Science.gov (United States)

    Stieger, M; Schmid, J-P; Bajrami, S; Hunziker, T

    2013-06-01

    Extracorporeal shock waves are defined as a sequence of sonic pulses characterized by high peak pressure over 100 MPa, fast pressure rise, and short lifecycle. In the 1980s extracorporeal shock wave lithotripsy (ESWL) was first used for the treatment of urolithiasis. Orthopedic surgeons use extracorporeal shock wave therapy (ESWT) to treat non-union fractures, tendinopathies and osteonecrosis. The first application of ESWT in dermatology was for recalcitrant skin ulcers. Several studies in the last 10 years have shown that ESWT promotes angiogenesis, increases perfusion in ischemic tissues, decreases inflammation, enhances cell differentiation and accelerates wound healing. We successfully treated a non-healing chronic venous leg ulcer with ESWT. Furthermore we observed an improvement of the lymphatic drainage after application of ESWT. We are confident that ESWT is a non-invasive, practical, safe and efficient physical treatment modality for recalcitrant leg ulcers.

  8. Fragmentation of common bile duct and pancreatic duct stones by extracorporeal shock-wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan Junior College, Seoul (Korea, Republic of); Son, Soon Yong; Lee, Won Hong [Asan Medical Center, Seoul (Korea, Republic of)

    1998-06-01

    To determine its usefulness and safety of extracorporeal shock-wave lithotripsy in common bile duct and pancreatic duct stones, we analyzed the results of 13 patients with common bile duct stones and 6 patients with pancreatic duct stones which were removed by endoscopic procedures using the balloon or basket, who was performed the extracorporeal shock-wave lithotripsy using the ultrasonography for stone localization with a spark gap type Lithotriptor(Dornier MPL 9000, Germany). Fragmentation and complete clearance of the common bile duct and pancreatic duct stones were obtained in 19 of 19 patients(100%). Apart from transient attacks of fever in 2 of 13 patients with common bile duct stones(15%) and mild elevation of serum amylase and lipase in 2 of 6 patients with pancreatic duct stones(33%), no other serious side effects were observed. In our experiences, extracorporeal shock-wave lithotripsy is a safe and useful treatment for endoscopically unretrievable common bile duct and pancreatic duct stones.

  9. Extracorporeal shock wave treatment of capsular fibrosis after mammary augmentation - Preliminary results.

    Science.gov (United States)

    Heine, Norbert; Prantl, Lukas; Eisenmann-Klein, Marita

    2013-12-01

    Extracorporeal shock wave therapy has undergone continuous development and has become a well-established therapy option both in urology and in orthopaedics/trauma surgery. Experimental and clinical studies have proved the effectiveness of extracorporeal shock wave therapy in the treatment of connective tissue diseases such as fibromatosis. The pathomechanism of capsular fibrosis after augmentation of the female breast with silicone implants presents a series of analogies with mechanisms that are generally recognised to be associated with fibroproliferative diseases. The starting point of the disease is the inflammatory reaction caused by the silicone and/or by the sub-clinical bacterial contamination of the implant surface and can create an inflammatory reaction and fibrosis. A total of 19 cases of capsular fibrosis in 12 patients following insertion of mammary implants were treated with extracorporeal shock wave therapy. The therapy was performed with the Duolith SD1 system manufactured by Storz Medical. Shock waves were applied with the C-Actor handpiece designed for planar shock waves. Extracorporeal shock wave therapy appears to be a non-invasive, well-tolerated and easy-to-use procedure for pain reduction and fibrotic tissue softening, especially after aesthetic breast implant augmentation.

  10. Extracorporeal shock wave therapy in calcific tendinitis of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Peters, Jutta [Bethanien Krankenhaus, Department of Radiology, Frankfurt am Main (Germany); University Hospital Frankfurt, Department of Radiology, Frankfurt am Main (Germany); Luboldt, Wolfgang; Schwarz, Wolfram; Jacobi, Volkmar; Herzog, Christopher; Vogl, Thomas J. [University Hospital Frankfurt, Department of Radiology, Frankfurt am Main (Germany)

    2004-12-01

    To investigate clinical (pain, mobility) and radiological (resolution of calcium deposits) efficacy of different energy levels of extracorporeal shock wave therapy (ESWT) in calcific tendinitis of the shoulder. There were 90 study subjects with radiographically verified calcific tendinitis of one shoulder, mean age 52{+-}6 years (range 29 - 65 years; females:males=55:35), all of whom had had symptoms for at least 6 months and substantial restriction of shoulder mobility and pain that required taking anti-inflammatory drugs. Calcium deposits were of type I or type II (clearly circumscribed and dense) and ranged from 1 cm to 3 cm in diameter. Subjects were divided into three groups to receive ESWT at one of two energy levels (E{sub 1}=0.15 mJ/mm{sup 2}, E{sub 2}=0.44 mJ/mm{sup 2}) or sham treatment. Treatment was given at 6 weekly intervals until symptoms resolved, five treatments had been given or the subject dropped out of the programme. All subjects in groups E{sub 1} and E{sub 2} completed the programme. Those in group E{sub 1} had significantly less pain during treatment but more treatments than those in group E{sub 2}, and at 6 month follow-up had residual calcification and recurrence of pain (87%). Subjects in group E{sub 2} had no residual calcification or recurrence of pain. Sham treatment had no effect. There were no side effects except a small number of haematomas (2 in E{sub 1}, 6 in E{sub 2}; maximum size 2 cm). ESWT in calcific tendinitis of the shoulder is very effective. It does not have significant side effects at an energy level of E=0.44 mJ/mm{sup 2}, which can therefore be recommended. (orig.)

  11. Gallbladder Dynamics Before and After Extracorporeal Shock Wave Lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hea; Suk, Jae Dong; Moon, Dae Hyuk; Kim, Myung Hwan; Min, Young Il [Asian Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    1991-03-15

    Extracorporeal shock wave lithotripsy (ESWI.) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, {sup 99m}Tc-DISIDA hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7 mCi of {sup 99m}Tc-DISIDA, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (I frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated, ESWL group were studied before, l day after and 2 weeks after ESWL, and UDCA group were studied before and 2 weeks after starting oral medication Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESlVL group, mean EF and mean ER at 1 day after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recovered to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

  12. [THE BONE DEFECT HEALING UNDER THE INFLUENCE OF RADIAL EXTRACORPOREAL SHOCK-WAVE THERAPY IN EXPERIMENT].

    Science.gov (United States)

    Gertsen, G I; Se-Fey; Ostapchuk, R M; Lesovoy, A V; Zherebchuk, V V

    2016-03-01

    In experiment on 24 rabbits the processes of reparative osteogenesis in perforated defect of proximal tibial metaphysis under the influence of extracorporeal shock-wave therapy were studied. In accordance to data of clinical, roentgenological and morphological investiagations, conducted in terms 5, 15, 30 and 45 days of observation, there was established, that under the influence of extracorporeal shock-wave therapy in the bone marrow in the traumatic region a vasodilatation, as well as the blood cells exit from capillaries and sinusoid vessels with creation of massive regions of osseous endostal regenerate, guaranteeing the tibial integrity restoration, occurs.

  13. Low-Intensity Extracorporeal Shock Wave as a Novel Treatment for Erectile Dysfunction.

    Science.gov (United States)

    Pan, Michael M; Raees, Ayman; Kovac, Jason R

    2016-03-01

    The paradigm of erectile dysfunction (ED) treatment was fundamentally altered following the introduction of oral phosphodiesterase type 5 inhibitors. Unfortunately, a significant number of men exhibit a suboptimal response and require additional management strategies. One of the novel, minimally invasive strategies being developed is low-intensity extracorporeal shock wave therapy. Used in the hope of delaying placement of an inflatable penile prosthesis, the final phase of ED treatment, low-intensity extracorporeal shock wave therapy is a unique application of an established technology that may hopefully one day expand the medical options for patients with ED. This commentary will highlight the physiology underlying this technique and summarize the most recent studies.

  14. Can cellulite be treated with low-energy extracorporeal shock wave therapy?

    Science.gov (United States)

    Angehrn, Fiorenzo; Kuhn, Christoph; Voss, Axel

    2007-01-01

    The present study investigates the effects of low-energy defocused extracorporeal generated shock waves on collagen structure of cellulite afflicted skin. Cellulite measurement using high-resolution ultrasound technology was performed before and after low-energy defocused extracorporeal shock wave therapy (ESWT) in 21 female subjects. ESWT was applied onto the skin at the lateral thigh twice a week for a period of six weeks. Results provide evidence that low-energy defocused ESWT caused remodeling of the collagen within the dermis of the tested region. Improving device-parameters and therapy regimes will be essential for future development of a scientific based approach to cellulite treatment. PMID:18225463

  15. THE USE OF NORMOTHERMIC EXTRACORPOREAL PERFUSION IN SITU IN KIDNEY ASYSTOLIC DONORS

    Directory of Open Access Journals (Sweden)

    Y.. A. Shcherbuk

    2010-01-01

    Full Text Available Deficit of donor organs is the limiting factor in organ transplantation. One way of solving this problem is the use of donors with sudden irreversible circulatory arrest. Obtaining organs from this category of donors is pos- sible only through the use of normothermic extracorporal perfusion in situ (NECP with oxygenation and leu- cocyte depletion. The article presents the implementation of NECP in 11 uncontrolled non heart beating donor (uNHBD kidneys (age of 43,1 ± 2,98 years and the results of transplantation in 22 recipients of such transplants in comparison with the results of the 20 recipients of kidney transplants from 20 donors to the death of the brain (age 45,65 ± 1,8 years. Despite the initially high rate of delayed function and more significant number of hemo- dialysis in uNHBD group (group of investigation, serum creatinine at 21st day was the same level as in BDD group (comparison group: 0,198 ± 0,002 mmol/L and 0,151 ± 0,002 mmol/L (p > 0,05. The use of NECP with oxygenation and leucocyte depletion is an effective practice for recovery kidney from donors with a sudden ir- reversible circulatory arrest with warm ischemic time one hour and more before the operation explantation. 

  16. Shock waves do more than just crush stones: extracorporeal shock wave therapy in plantar fasciitis.

    Science.gov (United States)

    Rajkumar, P; Schmitgen, G F

    2002-12-01

    Heel pain is a common orthopaedic problem, The cause of this clinical entity remains an enigma. The overall prognosis is good, however, and the symptoms generally settle well with time. There appears to be little evidence of the effectiveness of local steroid injections and dorsiflexion night splints. Extracorporeal shock wave therapy (ECSW) has been used in orthopaedics since the 1980s. With this, a new tool has become available for the treatment of plantar fasciitis, achillis tendinitis, shoulder pain and tendinosis of the elbow. In our pilot study we found good results with the use of ECSW therapy in resistant plantar fasciitis. Additional controlled studies are required to define the precise role of this new modality in the treatment of chronic plantar fasciitis.

  17. The effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis.

    Science.gov (United States)

    Lee, Ji-Hyun; Lee, Sangyong; Choi, SeokJoo; Choi, Yoon-Hee; Lee, Kwansub

    2017-03-01

    [Purpose] The purpose of this study was to identify the effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis. [Subjects and Methods] Twenty patients with degenerative knee arthritis were divided into a conservative physical therapy group (n=10) and an extracorporeal shock wave therapy group (n=10). Both groups received general conservative physical therapy, and the extracorporeal shock wave therapy was additionally treated with extracorporeal shock wave therapy after receiving conservative physical therapy. Both groups were treated three times a week over a four-week period. The visual analogue scale was used to evaluate pain in the knee joints of the subjects, and the Korean Western Ontario and McMaster Universities Osteoarthritis Index was used to evaluate the function of the subjects. [Results] The comparison of the visual analogue scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores within each group before and after the treatment showed statistically significant declines in scores in both the conservative physical therapy group and extracorporeal shock wave therapy group. A group comparison after the treatment showed statistically significant differences in these scores in the extracorporeal shock wave therapy group and the conservative physical therapy group. [Conclusion] extracorporeal shock wave therapy may be a useful nonsurgical intervention for reducing the pain of patients with degenerative knee arthritis and improving these patients' function.

  18. The effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis

    Science.gov (United States)

    Lee, Ji-Hyun; Lee, Sangyong; Choi, SeokJoo; Choi, Yoon-Hee; Lee, Kwansub

    2017-01-01

    [Purpose] The purpose of this study was to identify the effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis. [Subjects and Methods] Twenty patients with degenerative knee arthritis were divided into a conservative physical therapy group (n=10) and an extracorporeal shock wave therapy group (n=10). Both groups received general conservative physical therapy, and the extracorporeal shock wave therapy was additionally treated with extracorporeal shock wave therapy after receiving conservative physical therapy. Both groups were treated three times a week over a four-week period. The visual analogue scale was used to evaluate pain in the knee joints of the subjects, and the Korean Western Ontario and McMaster Universities Osteoarthritis Index was used to evaluate the function of the subjects. [Results] The comparison of the visual analogue scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores within each group before and after the treatment showed statistically significant declines in scores in both the conservative physical therapy group and extracorporeal shock wave therapy group. A group comparison after the treatment showed statistically significant differences in these scores in the extracorporeal shock wave therapy group and the conservative physical therapy group. [Conclusion] extracorporeal shock wave therapy may be a useful nonsurgical intervention for reducing the pain of patients with degenerative knee arthritis and improving these patients’ function. PMID:28356649

  19. Non-intubated recovery from refractory cardiogenic shock on percutaneous VA-extracorporeal membrane oxygenation

    NARCIS (Netherlands)

    van Houte, J; Donker, D W; Wagenaar, L J; Slootweg, A P; Kirkels, J H; van Dijk, D

    2015-01-01

    We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified h

  20. Effectiveness of extracorporeal shock wave therapy for tennis elbow (lateral epicondylitis).

    Science.gov (United States)

    Stasinopoulos, D; Johnson, M I

    2005-03-01

    Randomised controlled trials were reviewed to evaluate the evidence of the effectiveness of extracorporeal shock wave therapy in the management of tennis elbow. Seven relevant trials were found, which had satisfactory methodology but conflicting results. Further research with well designed randomised control trials is needed to establish the absolute and relative effectiveness of this intervention for tennis elbow.

  1. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    ) for extracorporeal shock-wave lithotripsy (ESWL)-resistant kidney stones. MATERIAL AND METHODS: A total of 38 consecutive patients (18 males, 20 females) participated in the study. All patients had undergone ESWL prior to RIRS without success. In all cases the stones could be reached with the endoscope. Calculi...

  2. A histomorphometric study of necrotic femoral head in rabbits treated with extracorporeal shock waves

    Science.gov (United States)

    Ma, Huan-Zhi; Zhou, Dong-Sheng; Li, Dong; Zhang, Wei; Zeng, Bing-Fang

    2017-01-01

    [Purpose] This study aimed to determine the effectiveness and mechanisms of extracorporeal shock wave therapy in the treatment of femoral head osteonecrosis. [Subjects and Methods] Histomorphometric analysis of necrotic femoral head in rabbits treated with shock waves was performed. Bilateral osteonecrosis of femoral heads was induced with methylprednisolone and lipopolysaccharide in eight rabbits. The left limb (study side) received shock waves to the femoral head. The right limb (control side) received no shock waves. Biopsies of the femoral heads were performed at 12 weeks after shock wave therapy. [Results] Necrotic femoral heads treated with shock waves, compared with controls, had higher bone volume per tissue volume, trabecular thickness, trabecular number, osteoblast surface/bone surface, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineralizing apposition rate, and bone formation rate. However, trabecular separation was lower in shock wave-treated femoral heads than in controls. Eroded surface/bone surface and osteoclast surface/bone surface did not differ significantly between groups. [Conclusion] The bone mass of necrotic femoral heads treated with shock waves increases. Extracorporeal shock wave may promote bone repair in necrotic femoral heads through the proliferation and activation of osteoblasts. PMID:28210032

  3. Fractionated Repetitive Extracorporeal Shock Wave Therapy: A New Standard in Shock Wave Therapy?

    Directory of Open Access Journals (Sweden)

    Tobias Kisch

    2015-01-01

    Full Text Available Background. ESWT has proven clinical benefit in dermatology and plastic surgery. It promotes wound healing and improves tissue regeneration, connective tissue disorders, and inflammatory skin diseases. However, a single treatment session or long intervals between sessions may reduce the therapeutic effect. The present study investigated the effects of fractionated repetitive treatment in skin microcirculation. Methods. 32 rats were randomly assigned to two groups and received either fractionated repetitive high-energy ESWT every ten minutes or placebo shock wave treatment, applied to the dorsal lower leg. Microcirculatory effects were continuously assessed by combined laser Doppler imaging and photospectrometry. Results. In experimental group, cutaneous tissue oxygen saturation was increased 1 minute after the first application and until the end of the measuring period at 80 minutes after the second treatment (P<0.05. The third ESWT application boosted the effect to its highest extent. Cutaneous capillary blood flow showed a significant increase after the second application which was sustained for 20 minutes after the third application (P<0.05. Placebo group showed no statistically significant differences. Conclusions. Fractionated repetitive extracorporeal shock wave therapy (frESWT boosts and prolongs the effects on cutaneous hemodynamics. The results indicate that frESWT may provide greater benefits in the treatment of distinct soft tissue disorders compared with single-session ESWT.

  4. Extracorporeal shock waves lithotripsy of urinary organs in patients with one kidney

    Directory of Open Access Journals (Sweden)

    Zogović Jezdimir

    2002-01-01

    Full Text Available Extracorporeal Shock Waves Lithotripsy (ESWL is a method of choice in the treatment of lithiasis. Surgical treatment is reduced to minimum, which in our case means 1-2%. Contraindications for using this method are: blood coagulation disorders, manifest tuberculosis, pregnancy, over obesity. Thanks to appropriate indications and technique which is used in an adequate way as well as to various endurological manipulations, removal of a stone by this method is safe, trauma is minimised, which is very important for patients with one kidney. During the last three years, usually in hospital conditions, 57 patients were treated in this way. Removal of a stone was performed by Extracorporeal Shock Waves Lithotripsy as mono therapy in 30 (53% patients; Extracorporeal Shock Waves Lithotripsy by using Double-J catheter in 16 (28% patients; Extracorporeal Lithotripsy with urine derivation by percutaneous nephrostome in 11 (19% patients. Endurological methods were used in 27 patients. Disintegration of stone was performed in the proper way. Full success was reached. Two patients had incrustation of ureteral catheter which had to be removed by surgery. In two other patients with inferior function of one kidney, after brief obstruction, hemodialisis was performed. Our results confirm that this method is nonaggressive, tech nically perfect for disintegration of urineorgans stone on all levels followed by small complications which are often solved by endoscopie manipulations.

  5. Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.

    Science.gov (United States)

    Gerdesmeyer, Ludger; Mittermayr, Rainer; Fuerst, Martin; Al Muderis, Munjed; Thiele, Richard; Saxena, Amol; Gollwitzer, Hans

    2015-12-01

    Chronic Achilles tendinopathy has been described as the most common overuse injury in sports medicine. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. After failed conservative therapy, invasive treatment may be considered. Extracorporeal shock wave therapy (ESWT) has been successfully used in soft-tissue pathologies like lateral epicondylitis, plantar fasciitis, tendinopathy of the shoulder and also in bone and skin disorders. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is still lacking. In plantar fasciitis as well as in calcific shoulder tendinopathy shock wave therapy is recently the best evaluated treatment option. This article analysis the evidence based literature of ESWT in chronic Achilles tendinopathy. Recently published data have shown the efficacy of focused and radial extracorporeal shock wave therapy. Copyright © 2015 IJS Publishing Group Limited. All rights reserved.

  6. Extracorporeal shock wave therapy (ESWT) for wound healing: technology, mechanisms, and clinical efficacy.

    Science.gov (United States)

    Mittermayr, Rainer; Antonic, Vlado; Hartinger, Joachim; Kaufmann, Hanna; Redl, Heinz; Téot, Luc; Stojadinovic, Alexander; Schaden, Wolfgang

    2012-01-01

    For almost 30 years, extracorporeal shock wave therapy has been clinically implemented as an effective treatment to disintegrate urinary stones. This technology has also emerged as an effective noninvasive treatment modality for several orthopedic and traumatic indications including problematic soft tissue wounds. Delayed/nonhealing or chronic wounds constitute a burden for each patient affected, significantly impairing quality of life. Intensive wound care is required, and this places an enormous burden on society in terms of lost productivity and healthcare costs. Therefore, cost-effective, noninvasive, and efficacious treatments are imperative to achieve both (accelerated and complete) healing of problematic wounds and reduce treatment-related costs. Several experimental and clinical studies show efficacy for extracorporeal shock wave therapy as means to accelerate tissue repair and regeneration in various wounds. However, the biomolecular mechanism by which this treatment modality exerts its therapeutic effects remains unclear. Potential mechanisms, which are discussed herein, include initial neovascularization with ensuing durable and functional angiogenesis. Furthermore, recruitment of mesenchymal stem cells, stimulated cell proliferation and differentiation, and anti-inflammatory and antimicrobial effects as well as suppression of nociception are considered important facets of the biological responses to therapeutic shock waves. This review aims to provide an overview of shock wave therapy, its history and development as well as its current place in clinical practice. Recent research advances are discussed emphasizing the role of extracorporeal shock wave therapy in soft tissue wound healing.

  7. Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis.

    Science.gov (United States)

    Beyazal, Münevver Serdaroğlu; Devrimsel, Gül

    2015-12-01

    [Purpose] This study aimed to determine and compare the effectiveness of extracorporeal shock wave therapy and local corticosteroid injection in patients with lateral epicondylitis. [Subjects and Methods] Sixty-four patients with lateral epicondylitis were randomly divided into extracorporeal shock wave therapy and steroid injection groups. Patients were evaluated using hand grip strength, visual analog scale, and short-form McGill pain questionnaire at baseline and at 4 and 12 weeks post-treatment. [Results] Both groups showed statistically significant increase in hand grip strength and decreases on the visual analog scale and short form McGill pain questionnaire overtime. There was no statistically significant difference in the percentage of improvement in hand grip strength and on the short-form McGill pain questionnaire between groups at 4 weeks post-treatment, whereas the extracorporeal shock wave therapy group showed better results on the visual analog scale. The percentages of improvements in all 3 parameters were higher in the extracorporeal shock wave therapy group than in the injection group at 12 weeks post-treatment. [Conclusion] Both the extracorporeal shock wave therapy and steroid injection were safe and effective in the treatment of lateral epicondylitis. However, extracorporeal shock wave therapy demonstrated better outcomes than steroid injection at the long-term follow-up.

  8. The efficacy of extracorporeal shock wave lithotripsy on single dense calcified gallstones according to computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Takao (Mie Univ., Tsu (Japan). School of Medicine); Shimono, Kazuko; Moriyama, Shigeru; Masuda, Touru; Ikeda, Tetsuya; Umegae, Satoru; Nagata, Norikazu

    1993-05-01

    The efficacy and complications of extracorporeal shock wave lithotripsy (ESWL) for single gallstones were compared between 15 patients with a CT-lucent stone and 18 patients with a dense calcified stone. In all of five patients with a stone smaller than 10 mm in diameter, complete or sufficient clearance was observed, regardless of calcification. However, in 28 patients with a stone larger than 11 mm in diameter, the rates of complete or sufficient clearance were lower in those with a dense calcified stone (64%) than in those with a computed tomography (CT) lucent stone (93%). There was no difference in the rate of complications between patients with a CT-lucent stone and those with a dense calcified stone. These results thus suggest that extracorporeal shock wave lithotripsy may be safely employed for patients with a single calcified gallstone. (author).

  9. Radiation dose to patient and personnel during extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Bush, W.H.; Jones, D.; Gibbons, R.P.

    1987-10-01

    Radiation dose to the patient and personnel was determined during extracorporeal shock wave lithotripsy treatment of 60 patients. Surface radiation dose to the patient's back from the fluoroscopy unit on the side with the kidney stone averaged 10 rem (100 mSv.) per case, although the range was wide (1 to 30 rem). The surface dose from the opposing biplane x-ray unit was less, averaging 5.5 rem (55 mSv.) per case but again with a wide range (0.1 to 21 rem). Exit dose at the lower abdomen averaged 13 mrem. (0.13 mSv.) per case and estimated female gonad dose averaged 100 mrem. (1.2 mSv.). Radiation dose to personnel working in the extracorporeal shock wave lithotripsy suite averaged less than 2 mrem. (0.02 mSv.) per case, making it a procedure that is safe in regard to radiation exposure.

  10. Extracorporeal shock-wave treatment for tennis elbow. A randomised double-blind study.

    Science.gov (United States)

    Melikyan, E Y; Shahin, E; Miles, J; Bainbridge, L C

    2003-08-01

    The efficacy of extracorporeal shock-wave therapy for tennis elbow was investigated using a single fractionated dosage in a randomised, double-blind study. Outcomes were assessed using the Disabilities of Arm, Shoulder and Hand questionnaire, measurements of grip strength, levels of pain, analgesic usage and the rate of progression to surgery. Informed consent was obtained before patients were randomised to either the treatment or placebo group. In the final assessment, 74 patients (31 men and 43 women) with a mean age of 43.4 years (35 to 71), were included. None of the outcome measures showed a statistically significant difference between the treatment and control groups (p > 0.05). All patients improved significantly over time, regardless of treatment. Our study showed no evidence that extracorporeal shock-wave therapy for tennis elbow is better than placebo.

  11. Use of extracorporeal shock waves in the treatment of tendinopathy and other orthopedic diseases

    Directory of Open Access Journals (Sweden)

    Dushyant Nadar

    2000-01-01

    Full Text Available Objective: Use of extracorporeal shock waves in the treatment of tendinopathy and other orthopedic diseases. Patients and methods: 35 patients received shock wave therapy using Econolith 2000 lithotripter 19 patients had isolated lateral epicondylitis, 12 medical epicondylitis and 4 plantar fascitis. A total of 120 shock waves were given in the first sitting. Each patient received a total of three sittings with a gap of one week between each of them. Results: Based on the patients′ self-assessment, about 75% pain relief was observed in 60% of the patients. Fur-ther, in patients having isolated tendinopathies, the pain relief was better. Conclusion: The study indicated that the application of shock waves is not restricted to the fragmentation of urinary calculi. The shock waves can be effectively used for the pain relief in the common orthopedic diseases. Thus, the urologists can widen the application of lithotripters, in a cost-effective manner, to the other medical speciali-ties.

  12. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue

    OpenAIRE

    Notarnicola, Angela; Moretti, Biagio

    2012-01-01

    There is currently great interest in the use of Extracorporeal Shock Wave Therapy (ESWT) and in clarifying the mechanisms of action in tendon pathologies. The success rate ranges from 60% to 80% in epicondylitis, plantar fasciitis, cuff tendinitis, trocanteritis, Achilles tendinitis or jumper’s knee. In contrast to urological treatments (lithotripsy), where shockwaves are used to disintegrate renal stones, in musculoskeletal treatments (orthotripsy), shockwaves are not being used to disintegr...

  13. Herpes zoster reactivation after extracorporeal shock wave lithotripsy: A case report

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    Krishnamoorthy Hariharan

    2016-01-01

    Full Text Available Herpes zoster is a reactivated varicella-zoster virus (VZV infection of the sensory nerve ganglion, peripheral nerve, and its branches. Mechanical trauma to the nervous system can reactivate VZV. It is well known that extracorporeal shock wave lithotripsy (SWL can produce mechanical damage to the tissue. We report a rare case of herpes zoster reactivation after SWL for treatment of 1.2 cm size renal stone in a 63-year-old male patient.

  14. A neural model for chronic pain and pain relief by extracorporeal shock wave treatment.

    Science.gov (United States)

    Wess, Othmar J

    2008-12-01

    The paper develops a new theory of chronic pain and pain relief by extracorporeal shock wave treatment. Chronic pain without underlying anatomical disorder is looked at as a pathological control function of memory. Conditioned reflexes are considered to be engraved memory traces linking sensory input of afferent signals with motor response of efferent signals. This feature can be described by associative memory functions of the nervous system. Some conditioned reflexes may cause inappropriate or pathological reactions. Consequently, a circulus vitiosus of pain sensation and muscle and/or vessel contraction is generated when pain becomes chronic (pain spiral). The key feature is a dedicated engram responsible for a pathological (painful) reaction. The pain memory may be explained by the concept of a holographic memory model published by several authors. According to this model it is shown how nervous systems may generate and recall memory contents. The paper shows how extracorporeal shock wave treatment may reorganize pathologic memory traces, thus giving cause to real and permanent pain relief. In a generalized manner, the idea of associative memory functions may help in the understanding of conditioning as a learning process and explain extracorporeal shock wave application as an efficient treatment concept for chronic pain. This concept may open the door for new treatment approaches to chronic pain and several other disorders of the nervous system.

  15. The effects of extracorporeal shock wave therapy on stroke patients with plantar fasciitis.

    Science.gov (United States)

    Kim, Tae Gon; Bae, Sea Hyun; Kim, Gye Yeop; Kim, Kyung Yoon

    2015-02-01

    [Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30 min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients.

  16. Can cellulite be treated with low-energy extracorporeal shock wave therapy?

    Directory of Open Access Journals (Sweden)

    Fiorenzo Angehrn

    2008-01-01

    Full Text Available Fiorenzo Angehrn1, Christoph Kuhn1, Axel Voss21Klinik Piano, Gottstattstrasse 24, Biel, Switzerland; 2SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: The present study investigates the effects of low-energy defocused extracorporeal generated shock waves on collagen structure of cellulite afflicted skin. Cellulite measurement using high-resolution ultrasound technology was performed before and after low-energy defocused extracorporeal shock wave therapy (ESWT in 21 female subjects. ESWT was applied onto the skin at the lateral thigh twice a week for a period of six weeks. Results provide evidence that low-energy defocused ESWT caused remodeling of the collagen within the dermis of the tested region. Improving device-parameters and therapy regimes will be essential for future development of a scientific based approach to cellulite treatment.Keywords: cellulite (gynoid lipodystrophy, collagen structure of dermis, collagenometry high-resolution ultrasound of skin, low-energy defocused extracorporeal shock wave therapy (ESWT, septa of subcutaneous connective tissue

  17. Safety and efficacy of extracorporeal shock wave therapy for chronic lateral epicondylitis.

    Science.gov (United States)

    Furia, John P

    2005-01-01

    Efficacy and safety of extracorporeal shock wave therapy (ESWT) were investigated in 36 patients with chronic lateral epicondylitis--9 patients receiving and 27 patients not receiving worker's compensation. All patients were treated with a single application of 3200 shock waves. Twelve weeks after treatment, the mean visual analog scale score for the entire group improved from 8.0 to 2.5 (P elbows (77.8%) were rated excellent or good on the Roles and Maudsley scale. There were no significant differences in outcome measures among the subgroups. There were no significant complications. ESWT is an effective treatment for chronic lateral epicondylitis. Worker's compensation status did not affect outcomes.

  18. Computational Models of Material Interfaces for the Study of Extracorporeal Shock Wave Therapy

    CERN Document Server

    Fagnan, Kirsten; Matula, Thomas J

    2012-01-01

    Extracorporeal Shock Wave Therapy (ESWT) is a noninvasive treatment for a variety of musculoskeletal ailments. A shock wave is generated in water and then focused using an acoustic lens or reflector so the energy of the wave is concentrated in a small treatment region where mechanical stimulation enhances healing. In this work we have computationally investigated shock wave propagation in ESWT by solving a Lagrangian form of the isentropic Euler equations in the fluid and linear elasticity in the bone using high-resolution finite volume methods. We solve a full three-dimensional system of equations and use adaptive mesh refinement to concentrate grid cells near the propagating shock. We can model complex bone geometries, the reflection and mode conversion at interfaces, and the the propagation of the resulting shear stresses generated within the bone. We discuss the validity of our simplified model and present results validating this approach.

  19. Cellulite and extracorporeal Shockwave therapy (CelluShock-2009)--a randomized trial.

    Science.gov (United States)

    Knobloch, Karsten; Joest, Beatrice; Vogt, Peter M

    2010-10-26

    Cellulite is a widespread problem involving females' buttocks and thighs based on the female specific anatomy. Given the higher number of fat cells stored in female fatty tissue in contrast to males, and the aging process of connective tissue leads to an imbalance between lipogenesis and lipolysis with subsequent large fat cells bulging the skin. In addition, microcirculatory changes have been suggested, however remain largely unknown in a controlled clinical setting. We hypothesize that the combination of extracorporeal shockwave and a daily gluteal muscle strength program is superior to the gluteal muscle strength program alone in cellulite. Randomized-controlled trial. IRB approval was granted at Hannover Medical School, Germany on May 22, 2009. For allocation of participants, a 1:1 ratio randomization was performed using opaque envelopes for the concealment of allocation. Reporting: according to CONSORT 2010. Eligible patients were females aged 18 or over and 65 or younger with cellulite with documented cellulite 1°-4° according to the Nürnberger score. Exclusion criteria were suspected or evident pregnancy, no cellulite, no informed consent or age under 18 years or above 65 years. Patients were recruited by advertisements in local regional newspapers and via the Internet. Intention-to-treat. a) Photonumeric severity scale, b) Nürnberger Score, c) circumference measurements, d) capillary blood flow, e) tissue oxygen saturation, f) postcapillary venous blood flow. Intervention group: Six sessions of extracorporeal focused shock wave for six sessions (2000 impulses, 0,25 mJ/m2 every 1-2 weeks) at both gluteal and thigh regions plus a specific gluteal strength exercise training. Six sessions of sham extracorporeal focused shock wave for six sessions (2000 impulses, 0,01 mJ/m2 every 1-2 weeks) at both gluteal and thigh regions plus a specific gluteal strength exercise training. 12 weeks. Blinding was achieved for all participants enrolled in the trial, the

  20. Cellulite and extracorporeal Shockwave therapy (CelluShock-2009) - a Randomized Trial

    Science.gov (United States)

    2010-01-01

    Background Cellulite is a widespread problem involving females' buttocks and thighs based on the female specific anatomy. Given the higher number of fat cells stored in female fatty tissue in contrast to males, and the aging process of connective tissue leads to an imbalance between lipogenesis and lipolysis with subsequent large fat cells bulging the skin. In addition, microcirculatory changes have been suggested, however remain largely unknown in a controlled clinical setting. We hypothesize that the combination of extracorporeal shockwave and a daily gluteal muscle strength program is superior to the gluteal muscle strength program alone in cellulite. Methods/Design Study design: Randomized-controlled trial. IRB approval was granted at Hannover Medical School, Germany on May 22, 2009. For allocation of participants, a 1:1 ratio randomization was performed using opaque envelopes for the concealment of allocation. Reporting: according to CONSORT 2010. Eligible patients were females aged 18 or over and 65 or younger with cellulite with documented cellulite 1°-4° according to the Nürnberger score. Exclusion criteria were suspected or evident pregnancy, no cellulite, no informed consent or age under 18 years or above 65 years. Patients were recruited by advertisements in local regional newspapers and via the Internet. Analysis: Intention-to-treat. Outcome parameters: a) Photonumeric severity scale, b) Nürnberger Score, c) circumference measurements, d) capillary blood flow, e) tissue oxygen saturation, f) postcapillary venous blood flow. Intervention group: Six sessions of extracorporeal focused shock wave for six sessions (2000 impulses, 0,25 mJ/m2 every 1-2 weeks) at both gluteal and thigh regions plus a specific gluteal strength exercise training. Control group: Six sessions of sham extracorporeal focused shock wave for six sessions (2000 impulses, 0,01 mJ/m2 every 1-2 weeks) at both gluteal and thigh regions plus a specific gluteal strength exercise training

  1. Cellulite and extracorporeal Shockwave therapy (CelluShock-2009 - a Randomized Trial

    Directory of Open Access Journals (Sweden)

    Joest Beatrice

    2010-10-01

    Full Text Available Abstract Background Cellulite is a widespread problem involving females' buttocks and thighs based on the female specific anatomy. Given the higher number of fat cells stored in female fatty tissue in contrast to males, and the aging process of connective tissue leads to an imbalance between lipogenesis and lipolysis with subsequent large fat cells bulging the skin. In addition, microcirculatory changes have been suggested, however remain largely unknown in a controlled clinical setting. We hypothesize that the combination of extracorporeal shockwave and a daily gluteal muscle strength program is superior to the gluteal muscle strength program alone in cellulite. Methods/Design Study design: Randomized-controlled trial. IRB approval was granted at Hannover Medical School, Germany on May 22, 2009. For allocation of participants, a 1:1 ratio randomization was performed using opaque envelopes for the concealment of allocation. Reporting: according to CONSORT 2010. Eligible patients were females aged 18 or over and 65 or younger with cellulite with documented cellulite 1°-4° according to the Nürnberger score. Exclusion criteria were suspected or evident pregnancy, no cellulite, no informed consent or age under 18 years or above 65 years. Patients were recruited by advertisements in local regional newspapers and via the Internet. Analysis: Intention-to-treat. Outcome parameters: a Photonumeric severity scale, b Nürnberger Score, c circumference measurements, d capillary blood flow, e tissue oxygen saturation, f postcapillary venous blood flow. Intervention group: Six sessions of extracorporeal focused shock wave for six sessions (2000 impulses, 0,25 mJ/m2 every 1-2 weeks at both gluteal and thigh regions plus a specific gluteal strength exercise training. Control group: Six sessions of sham extracorporeal focused shock wave for six sessions (2000 impulses, 0,01 mJ/m2 every 1-2 weeks at both gluteal and thigh regions plus a specific gluteal

  2. Assessment of the Effectiveness of Extracorporeal Shock Wave Therapy (ESWT) For Soft Tissue Injuries (ASSERT): An Online Database Protocol

    OpenAIRE

    Maffulli, G; Hemmings, Steph; Maffulli, Nicola

    2014-01-01

    Background Soft tissue injuries and tendinopathies account for large numbers of chronic musculoskeletal disorders. Extracorporeal shockwave therapy (ESWT) is popular, and effective in the management of chronic tendon conditions in the elbow, shoulder, and pain at and around the heel. Methods/Design Ethical approval was granted from the South East London Research Ethics Committee to implement a database for the Assessment of Effectiveness of Extracorporeal Shock Wave Therapy for Soft Tis...

  3. Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite

    Directory of Open Access Journals (Sweden)

    Schlaudraff KU

    2014-05-01

    Full Text Available Kai-Uwe Schlaudraff,1 Maren C Kiessling,2 Nikolaus BM Császár,2 Christoph Schmitz21Concept Clinic, Geneva, Switzerland; 2Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, GermanyBackground: Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient's individual cellulite grade at baseline, individual patient age, body mass index (BMI, weight, and/or height.Methods: Fourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast® device (Electro Medical Systems, S.A., Nyon, Switzerland. Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right, totaling eight treatments on the selected side. Treatment was performed at 3.5–4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area. Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires.Results: The mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades. Compared with baseline, no patient's condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, P<0

  4. Refractory Septic Shock Treated with Nephrectomy under the Support of Extracorporeal Membrane Oxygenation

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    Young Kun Lee

    2015-08-01

    Full Text Available Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN, for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.

  5. Lung contusion and cavitation with exudative plural effusion following extracorporeal shock wave lithotripsy in an adult: a case report

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    Nouri-Majalan Nader

    2010-08-01

    Full Text Available Abstract Introduction Among the complications of extracorporeal shock wave lithotripsy are perinephric bleeding and hypertension. Case presentation We describe the case of a 31-year-old Asian man with an unusual case of hemoptysis and lung contusion and cavitation with exudative plural effusion due to pulmonary trauma following false positioning of extracorporeal shock wave lithotripsy. Differential diagnoses included pneumonia and pulmonary emboli, but these diagnoses were ruled out by the uniformly negative results of a lung perfusion scan, Doppler ultrasound, and culture of bronchoalveolar lavage and plural effusion, and because our patient showed spontaneous improvement. Conclusions False positioning of extracorporeal shock wave lithotripsy can cause lung trauma presenting as pulmonary contusion and cavitation with plural effusion.

  6. Low-energy extracorporal shock wave therapy for persistent tennis elbow.

    Science.gov (United States)

    Rompe, J D; Hopf, C; Küllmer, K; Heine, J; Bürger, R; Nafe, B

    1996-01-01

    Fifty patients who suffered from persistent tennis elbow for more than 12 months, and were referred for surgical treatment, were assigned at random to 2 groups of low-energy extracorporal shock wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm2; group II (controls) 30 impulses of 0.08 mJ/mm2. Follow up was after 3 and 12 weeks. We found no significant differences between the 2 groups before treatment, there was but significant relief of pain and improvement of function in group I with good or excellent outcome in 56% at the last evaluation.

  7. Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital

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    Mohammed S. Al-Marhoon

    2013-07-01

    Full Text Available Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones.Methods: Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance.Results: Of the 225 initial consecutive patients who underwent extracorporeal shock wave lithotripsy, 192 (85% had renal stones and 33 (15% had ureteric stones. The mean±SD stone size was 11.3 ± 4.5 mm, while the mean age of the patients was 39.9 ± 12.8 years with 68.5% males. The mean renal stone size was 11.6 ± 4.7 mm; a mean of 1.3 sessions was required. The mean ureteric stone size was 9.9 ± 3 mm; and a mean of 1.3 sessions was required. Treatment success (defined as complete clearance of ureteric stones, stone-free or clinically insignificant residual fragments of <4 mm for renal stones was 74% for renal stones and 88% for ureteric stones. Additional extracorporeal shock wave lithotripsy and ureteroscopy were the most adjunctive procedures used for stone clearance. Complications occurred in 74 patients (38.5% with renal stones and 13 patients (39.4% with uretetric stones. The most common complication was loin pain (experienced by 16.7% with renal stones and 21% with ureteric stones. Severe renal colic mandating admission occurred in 2% of patients with renal stones and 6% of patients with ureteric stones. In patients with renal stone, steinstrasse occurred in 3.6% and infection post extracorporeal shock wave lithotripsy in 0.5%. Using Multivariate Logistic Regression analysis, factors found to have significant effect on complete stone clearance were serum creatinine (p=0.004 and the number of

  8. Emphysematous pyelonephritis: A rare life-threatening complication after extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Ho; Chung, Dong Jin; Yeo, Dong Myung; Sonh, Dong Wan; Hahn, Sung Tae [Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-09-15

    Emphysematous pyelonephritis (EPN), caused by extracorporeal shock wave lithotripsy (ESWL), has not been reported in the literature; and the mechanism of this disease is unknown. Although many studies have conjectured about the various causes of EPN, ESWL was not one of them. The patient in this report was a 65-year-old woman with a past medical history of diabetes; the patient underwent an ESWL that caused the EPN. To the best of our knowledge, this is the first report of an EPN case that was caused by ESWL.

  9. Extracorporeal shock-wave lithotripsy of bile duct stones

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kim, Myung Joon; Yoo, Hyung Sik; Suh, Jung Ho; Lee, Moo Sang; Jo, Jang Hwan; Kim, Byung Ro [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    During the past one and half year, we performed ESWL therapy in 13 patients with common bile duct and intrahepatic duct stones, applying Lithostar-R (Siemens co. West Germany) and analyzed their results. In 13 patients, 9 residual common bile duct stones and 7 intrahepatic duct stones were selected postoperatively. The size of stones were ranged from 0.7 cm to 3.5 cm in diameter. 2 stones were multiple and the remained 14 were single in number. The visualization of stones were done with fluoroscopy after the injection of contrast media via cholangiographic T-tube or ERCP. ESWL were applied continuously until stone disintegration was visible, or upto maximum number of 3500 discharge of shock wave. If not disintegrated upto 3500, patients were underwent second or third lithotripsy session with interval of one week. Our results showed that among 9 common bile duct stones, 4 were completely disintegrated and passed out spontaneously, but 3 partially fragmented and removed by the additional procedure. 2 were failed. Among 7 intrahepatic stones, 3 completely and 2 partially were succeeded. One stone partially fragmented were retained without removal and other one were failed. Skin petechia in all patients were revealed on the entry port of shock wave, but no serous complication was not occurred.

  10. [Extracorporeal shock wave therapy--an alternative concept for the treatment of epicondylitis of the humerus and radius?].

    Science.gov (United States)

    Richter, D; Ekkernkamp, A; Muhr, G

    1995-06-01

    In a prospective study, 16 patients with chronic, painful epicondylitis humeri radialis were treated with extracorporal high-energy shock waves. A complaint-free period of 3 months was achieved in 13 patients. In 2 of them complete release from pain was achieved for more than 3 months. We conclude that release from the symptoms is achieved by local hyperemia in the area of tendinitis. In contrast to the encouraging observations of other authors, our results suggest that a critical view of extracorporal shock waves for the treatment of chronic epicondylitis radialis of the elbow is reasonable.

  11. Extracorporeal Membrane Oxygenation as a Bridge for Heart Failure and Cardiogenic Shock.

    Science.gov (United States)

    Zhong, Zhao-Peng; Wang, Hong; Hou, Xiao-Tong

    2016-01-01

    Heart failure (HF) can be defined as cardiac structural or functional abnormality leading to a series of symptoms due to deficiency of oxygen delivery. In the clinical practice, acute heart failure (AHF) is usually performed as cardiogenic shock (CS), pulmonary edema, and single or double ventricle congestive heart failure. CS refers to depressed or insufficient cardiac output (CO) attributable to myocardial infarction, fulminant myocarditis, acute circulatory failure attributable to intractable arrhythmias or the exacerbation of chronic heart failure, postcardiotomy low CO syndrome, and so forth. Epidemiological studies have shown that CS has higher in-hospital mortality in patients with AHF. Besides, we call the induced, sustained circulatory failure even after administration of high doses of inotropes and vasopressors refractory cardiogenic shock. In handling these cases, mechanical circulatory support devices are usually needed. In this review, we discuss the current application status and clinical points in utilizing extracorporeal membrane oxygenation (ECMO).

  12. Extracorporeal Membrane Oxygenation as a Bridge for Heart Failure and Cardiogenic Shock

    Directory of Open Access Journals (Sweden)

    Zhao-peng Zhong

    2016-01-01

    Full Text Available Heart failure (HF can be defined as cardiac structural or functional abnormality leading to a series of symptoms due to deficiency of oxygen delivery. In the clinical practice, acute heart failure (AHF is usually performed as cardiogenic shock (CS, pulmonary edema, and single or double ventricle congestive heart failure. CS refers to depressed or insufficient cardiac output (CO attributable to myocardial infarction, fulminant myocarditis, acute circulatory failure attributable to intractable arrhythmias or the exacerbation of chronic heart failure, postcardiotomy low CO syndrome, and so forth. Epidemiological studies have shown that CS has higher in-hospital mortality in patients with AHF. Besides, we call the induced, sustained circulatory failure even after administration of high doses of inotropes and vasopressors refractory cardiogenic shock. In handling these cases, mechanical circulatory support devices are usually needed. In this review, we discuss the current application status and clinical points in utilizing extracorporeal membrane oxygenation (ECMO.

  13. Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow.

    Science.gov (United States)

    Rompe, J D; Hope, C; Küllmer, K; Heine, J; Bürger, R

    1996-03-01

    We report a controlled, prospective study to investigate the effect of treatment by low-energy extracorporeal shock waves on pain in tennis elbow. We assigned at random 100 patients who had had symptoms for more than 12 months to two groups to receive low-energy shock-wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm2 and group II, the control group, 30 impulses. The patients were reviewed after 3, 6 and 24 weeks. There was significant alleviation of pain and improvement of function after treatment in group I in which there was a good or excellent outcome in 48% and an acceptable result in 42% at the final review, compared with 6% and 24%, respectively, in group II.

  14. Extracorporal shock wave therapy in patients with tennis elbow and painful heel.

    Science.gov (United States)

    Hammer, D S; Rupp, S; Ensslin, S; Kohn, D; Seil, R

    2000-01-01

    The aim of this study was to evaluate the effect of extracorporal shock wave therapy (ESWT) in tennis elbow and painful heel. Nineteen patients with tennis elbow and 44 patients with painful heel in which conservative treatment had failed underwent ESWT. Both groups received 3000 shock waves of 0.12 mJ/mm2 three times at weekly intervals. After a follow-up of 5 and 6 months respectively, pain measured on a visual analogue scale (VAS) decreased significantly in both groups. The success rate (excellent and good results) was 63% in tennis elbows and 70% in painful heels. ESWT seems to be a useful conservative alternative in the treatment of both conditions.

  15. The value of extracorporeal shock-wave lithotripsy in the management of bile duct stones.

    Science.gov (United States)

    Lee, S H; Fache, J S; Burhenne, H J

    1990-10-01

    We evaluated the role of biliary extracorporeal shock-wave lithotripsy in treating 70 symptomatic patients with bile duct stones in whom endoscopic or percutaneous radiologic attempts at basket extraction had failed. Forty-four patients had common bile and/or common hepatic duct stones, 21 patients had cystic duct stones, and five patients had intrahepatic duct stones. A total of 43 patients (61%) had complete elimination of stone fragments during the initial treatment period. If patients in whom stones were successfully fragmented yet not totally eliminated on initial hospital treatment but who were asymptomatic at follow-up times of 8-22 months are included, the overall successful treatment rate was 83%. Stones were cleared in 26 of 44 common bile/hepatic duct stone patients, spontaneously in seven patients and after endoscopic or percutaneous radiologic intervention in 19 patients. Fifteen (71%) of 21 patients had cystic duct stones successfully cleared. The fragments in two of five patients with intrahepatic duct stones also were cleared. Five patients (7%) had minor side effects. Seven (10%) of 70 patients went on to have surgery. Complications after 30 days occurred in five patients (7%); two required repeated endoscopy with fragment extraction, two required placement of an endoprosthesis, and one died. We conclude that biliary extracorporeal shock-wave lithotripsy is valuable as an adjuvant to standard interventional techniques for removing bile duct stones.

  16. The effects of extracorporeal shock wave therapy on pain, disability, and depression of chronic low back pain patients.

    Science.gov (United States)

    Han, Hyeonjee; Lee, Daehee; Lee, Sangyong; Jeon, Chunbae; Kim, Taehoon

    2015-02-01

    [Purpose] The purpose of this study was to examine the effects of extracorporeal shock wave therapy on pain, disability, and depression of chronic low back pain patients. [Subjects] In this study, 30 chronic low back pain patients were divided into an extracorporeal shock wave therapy group (ESWTG, n=15) and a conservative physical therapy group (CPTG, n=15). [Methods] The ESWTG received extracorporeal shock wave therapy and the CPTG received general conservative physical therapy two times per week for six weeks. Pain was measured using a visual analog scale (VAS), the degree of disability of the patients was assessed using the Oswestry Disability Index (ODI), and their degree of depression was measured using the Beck depression index (BDI). [Results] In intra-group comparisons, ESWTG and CPTG showed significant decreases in VAS, ODI, and BDI scores. Intergroup comparisons revealed that these decreases in VAS, ODI, and BDI scores were significantly larger in ESWTG than in CPTG. [Conclusion] Extracorporeal shock wave therapy is an effective intervention for the treatment of pain, disability, and depression in chronic low back pain patients.

  17. The effectiveness of extracorporeal shock wave therapy for the treatment of lower limb ulceration: a systematic review.

    Science.gov (United States)

    Butterworth, Paul A; Walsh, Tom P; Pennisi, Yvonne D; Chesne, Anna D; Schmitz, Christoph; Nancarrow, Susan A

    2015-01-01

    Extracorporeal shock wave therapy has been reported as an effective treatment for lower limb ulceration. The aim of this systematic review was to investigate the effectiveness of extracorporeal shock wave therapy for the treatment of lower limb ulceration. Five electronic databases (Ovid MEDLINE, CINAHL, Web of Knowledge, Scopus and Ovid AMED) and reference lists from relevant studies were searched in December 2013. All study designs, with the exception of case-reports, were eligible for inclusion in this review. Assessment of each study's methodological quality was performed using the Quality Index tool. The effectiveness of studies was measured by calculating effect sizes (Cohen's d) from means and standard deviations. Five studies, including; three randomised controlled trials, one quasi-experimental study and one case-series design met our inclusion criteria and were reviewed. Quality assessment scores ranged from 38 to 63% (mean 53%). Improvements in wound healing were identified in these studies following extracorporeal shock wave therapy. The majority of wounds assessed were associated with diabetes and the effectiveness of ESWT as an addition to standard care has only been assessed in one randomised controlled trial. Considering the limited evidence identified, further research is needed to support the use of extracorporeal shock wave therapy in the treatment of lower limb ulceration.

  18. Intérêt des ondes de choc (ESWT: extracorporeal shock wave therapy) dans le traitement des arthropathies calcifiantes

    OpenAIRE

    2006-01-01

    Extracorporeal Shock Wave Therapy (ESWT) regularly used in Urology finds at present an indication for the treatment of soft tissue calcifications. A literature review presents the physical characteristics, action mode and side effects; it also outlines some of the clinical indications. Peer reviewed

  19. Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite.

    Science.gov (United States)

    Schlaudraff, Kai-Uwe; Kiessling, Maren C; Császár, Nikolaus Bm; Schmitz, Christoph

    2014-01-01

    Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient's individual cellulite grade at baseline, individual patient age, body mass index (BMI), weight, and/or height. Fourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean) cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast(®) device (Electro Medical Systems, S.A., Nyon, Switzerland). Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right), totaling eight treatments on the selected side. Treatment was performed at 3.5-4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area). Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires. The mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades) and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades). Compared with baseline, no patient's condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, Pcellulite grade at baseline, BMI, weight, height, or age. Radial shock wave therapy is a safe and effective treatment option for cellulite. The individual clinical outcome cannot be predicted by the patient's individual cellulite grade at baseline, BMI, weight

  20. Primary cardiac lymphoma complicated by cardiogenic shock: successful treatment with chemotherapy delivered under extracorporeal membrane oxygenation support.

    Science.gov (United States)

    Allain, Géraldine; Hajj-Chahine, Jamil; Lacroix, Corentin; Jayle, Christophe

    2015-12-01

    Primary cardiac lymphomas (PCLs) are rare in immunocompetent patients. Their clinical presentation is highly variable and in case of cardiogenic shock, death is often inevitable with a diagnosis made post-mortem. We report the case of a 65-year old immunocompetent man with cardiogenic shock requiring emergent extracorporeal membrane oxygenation (ECMO). Soon after, a diagnosis of PCL was given and chemotherapy was delivered under ECMO support. The patient was progressively weaned from the mechanical support. Six months later, he had fully recovered.

  1. Development of Extracorporeal Shock Wave Therapy for the Treatment for Ischemic Cardiovascular Diseases

    Science.gov (United States)

    Shimokawa, Hiroaki

    Cardiovascular diseases, such as coronary artery disease and peripheral artery disease, are the major causes of death in developed countries, and the number of elderly patients has been rapidly increasing worldwide. Thus, it is crucial to develop new non-invasive therapeutic strategies for these patients. We found that a low-energy shock wave (SW) (about 10% of the energy density that is used for urolithiasis) effectively increases the expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. Subsequently, we demonstrated that extracorporeal cardiac SW therapy with low-energy SW up-regulates the expression of VEGF, enhances angiogenesis, and improves myocardial ischemia in a pig model of chronic myocardial ischemia without any adverse effects in vivo. Based on these promising results in animal studies, we have subsequently developed a new, non-invasive angiogenic therapy with low-energy SW for cardiovascular diseases. Our extracorporeal cardiac SW therapy improved symptoms and myocardial perfusion evaluated with stress-scintigraphy in patients with severe coronary artery disease without indication of percutaneous coronary intervention or coronary artery bypass surgery. Importantly, no procedural complications or adverse effects were noted. The SW therapy was also effective in ameliorating left ventricular remodeling after acute myocardial infarction in pigs and in enhancing angiogenesis in hindlimb ischemia in animals and patients with coronary artery disease. Furthermore, our recent experimental studies suggest that the SW therapy is also effective for indications other than cardiovascular diseases. Thus, our extracorporeal cardiac SW therapy is an effective, safe, and non-invasive angiogenic strategy for cardiovascular medicine.

  2. Ultrasound-Guided Extracorporeal Shock Wave Lithotripsy of Pancreatic Ductal Stones: Six Years’ Experience

    Directory of Open Access Journals (Sweden)

    Werner Johanns

    1996-01-01

    Full Text Available Extracorporeal shock wave lithotripsy (ESWL and endoscopic sphincterotomy (EST was performed in 35 patients suffering from pancreatic duct stones. Calculi disintegration and resolution of obstruction were achieved in all cases. Completely stone-free ducts were achieved in 16 patients (46% while some peripheral asymptomatic stone material remained in 19 (54%. Dilation of the main pancreatic duct was reduced in 29 patients (83%. Twelve patients (34% became completely asymptomatic and 17 (49% reported a marked reduction of pain. Pancreatogenic steatorrhea ceased and 18 patients (51% gained weight. Pathological glucose tolerance returned to normal in one patient. No major complications were observed. The combination of ESWL and EST is a successful, nonoperative, new treatment in pancreatic stone disease.

  3. Extracorporeal shock wave treatment for shoulder calcific tendonitis: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Mouzopoulos, G.; Tzurbakis, M. [Orthopaedic Department of Evangelismos Hospital, Athens (Greece); Stamatakos, M. [University of Athens, General Surgery Department of Laiko Hospital, Athens (Greece); Mouzopoulos, D. [Radiology Department of IKA Pentelis, Athens (Greece)

    2007-09-15

    The treatment of patients with calcific tendonitis is typically conservative, including physical therapy, iontophoresis, deep friction, local or systemic application of noninflammatory drugs, needle irrigation-aspiration of calcium deposit, and subacromial bursal steroid injection. If the pain becomes chronic or intermittent after several months of conservative treatment, arthroscopic and open procedures are available to curette the calcium deposit, and additional subacromial decompression can be performed if necessary. As an alternative, minimally invasive extracorporeal shock wave therapy (ESWT) has been postulated to be an effective treatment option for treating calcific tendinitis of the shoulder, before surgery. Herein we discuss the indications, mechanism of therapeutic effect, efficacy of treatment, and complications after ESWT application. (orig.)

  4. Patient exposure and radiation environment of an extracorporeal shock wave lithotriptor system

    Energy Technology Data Exchange (ETDEWEB)

    Lin, P.J.; Hrejsa, A.F.

    1987-10-01

    Radiation exposures to the patient undergoing extracorporeal shock wave lithotripsy were assessed along with the scattered radiation levels around the lithotriptor systems. The data gathered from 2 Dornier lithotriptor systems suggest that the lead shieldings required for this particular make and model are minimal. Owing to the physical size of the lithotriptor system, the treatment room housing it may not require additional lead shielding when the walls are constructed with appropriate materials. Typical radiation exposures to the patient have been assessed from the experimental data. The total amount of radiation exposures a patient is likely to receive has been estimated to be approximately 26 roentgens, for example 21 roentgens from 3 to 4 minutes of fluoroscopic exposure and 5 roentgens from 8 frames of video spot filming. The scattered radiation has been found to be approximately 0.5 mR. per hour at 3 feet or 91 cm. from the center of the lithotriptor water tank.

  5. Design of the Dual Stone Locating System on an Extracorporeal Shock Wave Lithotriptor

    Directory of Open Access Journals (Sweden)

    Chien-Chen Chang

    2013-01-01

    Full Text Available Extracorporeal Shock Wave Lithotriptors are very popular for the treatment of urinary stones all over the world. They depend basically upon either X-ray fluoroscopy or ultrasound scans to detect the stones before therapy begins. To increase the effectiveness of treatment this study took advantage of both X-ray and ultrasound to develop a dual stone locating system with image processing modules. Its functions include the initial stone locating mode with stone detection by fluorescent images and the follow-up automatic stone tracking mode made by constant ultrasound scanning. The authors have integrated both apparatus and present the operating principles for both modes. The system used two in vitro experiments to justify its abilities of stone location in all procedures.

  6. A Case of Septic Shock caused by Achromobacter xylosoxidans in an Immunocompetent Female Patient after Extracorporeal Shock Wave Lithotripsy for a Ureteral Stone.

    Science.gov (United States)

    Lee, Jae Hyuk; Lee, So Yon; Park, In Young; Park, So Yeon; Lee, Jin Seo; Kang, Goeun; Kim, Jae Seok; Eom, Joong Sik

    2016-03-01

    Achromobacter xylosoxidans can cause various types of infections, but its infection in humans is rare. A. xylosoxidans has been reported as a rare etiological agent of infections including primary bacteremia, catheter-related bloodstream infection, endocarditis, otitis, and pneumonia, particularly in immunocompromised hosts. We encountered a case of septic shock caused by A. xylosoxidans in a 52-year-old, immunocompetent woman with no underlying disease, who received extracorporeal shock wave lithotripsy to remove a left upper ureteral stone. She was treated with antibiotics to which the organism was susceptible but died as a result of septic shock.

  7. Multiple extracorporeal shock wave therapy degrades capsular fibrosis after insertion of silicone implants.

    Science.gov (United States)

    Fischer, Sebastian; Mueller, Wolf; Schulte, Matthias; Kiefer, Jurij; Hirche, Christoph; Heimer, Sina; Köllensperger, Eva; Germann, Günter; Reichenberger, Matthias A

    2015-03-01

    Capsular fibrosis is the most frequent long-term complication after insertion of silicone devices. Today, mainly direct immunostimulation and subclinical infection are held responsible for inducing and maintaining inflammatory reactions, which lead to overwhelming extracellular matrix formation. Extracorporeal shock waves (ESWs) are capable of inhibiting inflammatory processes and revealing antibacterial capacity. In our previous study, we observed decelerated capsule development after application of a single shock wave immediately after surgery. The purpose of this study was to evaluate the effects of multiple ESWT after insertion of silicone implants in the same rodent model. Therefore, silicone prostheses were inserted into a submuscular pocket in 12 additional male Lewis rats, and shock waves were administered over a 14-d interval. At 35 d (n = 6) and 100 d (n = 6) after insertion, silicone implants and surrounding capsule tissue were removed and prepared for histologic and immunohistochemical analysis, as well as polymerase chain reaction (Ccl2, CD68, transforming growth factor β1, matrix metalloproteinase 2). Compared with the control group, multiple ESWT had no effect on day 35, but resulted in a significantly thinner capsule on day 100 (825.8 ± 313.2 vs. 813.3 ± 47.9, p = 0.759, and 1062.3 ± 151.9 vs. 495.4 ± 220.4, p shock wave application, which had been found to result in thinner capsules at every time point in our previous study. This active degradation of the fibrous envelope caused by multiple ESWs was accompanied by synergistic alterations in pro- and anti-fibrotic proteins (transforming growth factor β1 and matrix metalloproteinase 2, respectively). In conclusion, after insertion of silicone devices, single ESWT is capable of decelerating capsule formation in contrast to multiple ESWT, which degrades fibrotic tissue. These findings seem to be associated with inhibition of inflammation and beneficial effects on pro- and anti-fibrotic proteins.

  8. Early Extracorporeal Membrane Oxygenation Support for 5-Fluorouracil-induced Acute Heart Failure with Cardiogenic Shock.

    Science.gov (United States)

    Höllriegel, Robert; Fischer, Julia; Schuler, Gerhard

    2014-01-01

    A 50-year-old man with no previous history of cardiovascular disease or risk factors was admitted for syncope and orthopnea. Importantly, he underwent recent chemotherapy with 5-fluorouracil (5-FU) until 1 day before his acute presentation. In the emergency room, patient developed asystole and was successfully resuscitated for 2 min. At coronary angiography, no signs of coronary artery disease were detectable, but transthoracic echocardiography showed a severely decreased left-ventricular systolic function. Due to the progressive cardiogenic shock, an extracorporeal membrane oxygenation (ECMO) support was used as bridge-to-recovery and to avoid the use of sympathomimetics with their known disadvantages. On ECMO support, hemodynamic stabilization was evident and medical heart failure treatment was commenced. Left-ventricular function recovered to normal values within a short period of time. Cardiac complications after chemotherapy with 5-FU are not rare and should be taken into consideration even in acute heart failure with cardiogenic shock. ECMO as the most potent form of acute cardiorespiratory support enables complete relief of cardiac workload and therefore recovery of cardiac function.

  9. Repair of articular cartilage in rabbit osteochondral defects promoted by extracorporeal shock wave therapy

    Science.gov (United States)

    Chu, C.-H.; Yen, Y.-S.; Chen, P.-L.; Wen, C.-Y.

    2015-03-01

    This study investigated the stimulative effect of extracorporeal shock wave therapy (ESWT) on the articular cartilage regeneration in the rabbit osteochondral defect model for the first time. An osteochondral defect, 3 mm in diameter and 3 mm in depth, was drilled in the patellar groove at the distal end of each femur in 24 mature New Zealand rabbits. The right patellar defects received 500 impulses of shock waves of (at 14 kV) at 1 week after surgery and were designated as the experimental samples; the left patellar defects served as control. At 4, 8, and 12 weeks after ESWT, cartilage repair was evaluated macroscopically and histologically using a semiquantitative grading scale. The total scores of the macroscopic evaluation at 4, 8, and 12 weeks in the experimental group were superior to those in the control group (statistical significance level ). As to the total scores of the histologic evaluation, the experimental group showed a tendency toward a better recovery than the control group at 4 weeks (). At 8 and 12 weeks the differences between the experimental and control groups became mild and had no significance on statistical analysis. These findings suggested that regeneration of articular cartilage defects might be promoted by ESWT, especially at the early stage. The easy and safe ESWT is potentially viable for clinical application.

  10. A novel cardiac extracorporeal shock wave for enhancing the efficacy of cell therapy

    Science.gov (United States)

    Khaled, Walaa; Assmus, Birgit; Lutz, Andreas; Walter, Dirk; Leistner, David; Dimmeler, Stefanie; Zeiher, Andreas

    2012-11-01

    Targeted therapy can maximize therapeutic efficiency and minimize the side effects of drug treatments, especially for cancer and cardiovascular disease. In previous in-vitro experiments, it was shown that shock wave (SW) application can change the permeability of cell membranes for tumor therapy. Similarly, in animal studies, extracorporeal SWs were proven to increase expression of growth and homing factors like SDF-1 and vascular endothelial growth factor (VEGF) within a targeted ischemic tissue. This pretreatment increased the homing and neovascularization following application of bone marrow-derived mononuclear cells (BMC). In a randomized, double blinded, placebo-controlled clinical trial, 103 patients were recruited with stable chronic post-infarction heart failure (CHF). The goal of this work was to demonstrate improved recovery of left ventricular contractile function (LVEF) by combining targeted SW application with subsequent BMC administration. Results showed that the shock wavefacilitated intracoronary BMC administration in patients with chronic post-infarction heart failure is associated with significant persistent improvements in LVEF contractile function, NYHA class, and reduction of major adverse clinical events during extended clinical follow-up. (clinicaltrials.gov: NCT00326989).

  11. Side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow.

    Science.gov (United States)

    Haake, M; Böddeker, I R; Decker, T; Buch, M; Vogel, M; Labek, G; Maier, M; Loew, M; Maier-Boerries, O; Fischer, J; Betthäuser, A; Rehack, H C; Kanovsky, W; Müller, I; Gerdesmeyer, L; Rompe, J D

    2002-05-01

    Apart from a few observational reports, there are no studies on the side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of insertion tendopathies. Within the framework of a randomised, placebo-controlled, single-blind, multicentre study to test the effectiveness of ESWT in the case of lateral epicondylitis (LE), side-effects were systematically recorded. A total of 272 patients from 15 centres was allocated at random to active ESWT (3 x 2000 pulses, energy flux density ED(+) 0.04 to 0.22 mJ/mm(2) under local anaesthesia) or placebo ESWT. In all, 399 ESWT and 402 placebo treatments were analysed. More side-effects were documented in the ESWT group (OR = 4.3, CI = [2.9; 6.3]) than in the placebo group. Most frequently, transitory reddening of the skin (21.1%), pain (4.8%) and small haematomas (3.0%) were found. Migraine was registered in four and syncopes in three instances after ESWT. ESWT for LE with an energy flux density of ED(+) 0.04 to 0.22 mJ/mm(2) is a treatment method which has very few side-effects. The possibility of migraine being triggered by ESWT and the risk of a syncope should be taken into account in the future. No physical shock wave parameters could be definitely identified as the cause of the side-effects observed.

  12. Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Nikos Malliaropoulos

    2016-01-01

    Full Text Available Background and Aims. The exploration of an individualised protocol of radial extracorporeal shock wave therapy (rESWT for plantar fasciopathy, assessing success rates and the recurrence rate over a 1-year period after treatment, is not yet identified in literature. Methods and Results. Between 2006 and 2013, 68 patients (78 heels were assessed for plantar fasciopathy. An individualised rESWT treatment protocol was applied and retrospectively analysed. Heels were analysed for mean number of shock wave impulses, mean pressure, and mean frequency applied. Significant mean pain reductions were assessed through Visual Analogue Scale (VAS after 1-month, 3-month, and 1-year follow-up. Success rates were estimated as the percentage of patients having more than 60% VAS pain decrease at each follow-up. 1-year recurrence rate was estimated. The mean VAS score before treatment at 6.9 reduced to 3.6, 1 month after the last session, and to 2.2 and 0.9, after 3 months and 1 year, respectively. Success rates were estimated at 19% (1 month, 70% (3 months, and 98% (1 year. The 1-year recurrence rate was 8%. Moderate positive Spearman’s rho correlation (r=0.462, p<0.001 was found between pretreatment pain duration and the total number of rESWT sessions applied. Conclusions. Individualised rESWT protocol constitutes a suitable treatment for patients undergoing rESWT for plantar fasciitis.

  13. Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones

    Directory of Open Access Journals (Sweden)

    Fábio César Miranda Torricelli

    2015-02-01

    Full Text Available The use of certain technical principles and the selection of favorable cases can optimize the results of extracorporeal shock wave lithotripsy (ESWL. The aim of this study is to review how ESWL works, its indications and contraindications, predictive factors for success, and its complications. A search was conducted on the Pubmed® database between January 1984 and October 2013 using "shock wave lithotripsy" and "stone" as key-words. Only articles with a high level of evidence, in English, and conducted in humans, such as clinical trials or review/meta-analysis, were included. To optimize the search for the ESWL results, several technical factors including type of lithotripsy device, energy and frequency of pulses, coupling of the patient to the lithotriptor, location of the calculus, and type of anesthesia should be taken into consideration. Other factors related to the patient, stone size and density, skin to stone distance, anatomy of the excretory path, and kidney anomalies are also important. Antibiotic prophylaxis is not necessary, and routine double J stent placement before the procedure is not routinely recommended. Alpha-blockers, particularly tamsulosin, are useful for stones >10mm. Minor complications may occur following ESWL, which generally respond well to clinical interventions. The relationship between ESWL and hypertension/diabetes is not well established.

  14. Treatment of cystine stones: combined approach using open pyelolithotomy, percutaneous pyelolithotripsy, extracorporeal shock wave lithotripsy and chemolysis

    DEFF Research Database (Denmark)

    Aabech, J; Andersen, J T

    1993-01-01

    Treatment of cystine stones in the urinary tract can be difficult because of a high frequency of recurrence, resistance to Extracorporeal Shock Wave Lithotripsy (ESWL), difficulty in localization and access to peripheral stones during Percutaneous Nephrolithotripsy (PCNL), and the insufficient...... effect of oral chemolysis. We present two cases of urinary cystine calculi treated with a combination of pyelolithotomy, PCNL, ESWL and percutaneous irrigation chemolysis, using N-acetylcysteine and Tromethamine-E....

  15. Experience of emplying extracorporal shock-wave therapy for treating limb enthesopathies in patients with articular hypermobility syndrome

    OpenAIRE

    2014-01-01

    Purpose: to study the efficiency of extracorporal shock-wave therapy and the affected area orthopedic relief for treating pain syndrome associated with enthesopathies in patients with articular hypermobility syndrome.75 patients with enthesopathies of various localizations and diagnosed articular hypermobility were observed in 2008-2011, their age varying from 35 to 55 years (median age: 37.5±0.4 years). The treatment mode was out-patient, with a shockwave device PIEZOSON-100 (manufacturer: R...

  16. Embolisation of pheochromocytoma to stabilise and wean a patient in cardiogenic shock from emergency extracorporeal life support.

    Science.gov (United States)

    Vagner, Helle; Hey, Thomas Morris; Elle, Bo; Jensen, Marianne Kjær

    2015-03-03

    Pheochromocytoma is a catecholamine-secreting tumour associated with varying symptoms ranging from episodic headache, sweating, paroxysmal hypertension and tachycardia to intractable cardiogenic shock. Cardiogenic shock is rare but well-described and the timing of correct management is crucial since mortality is high. Fifty per cent of pheochromocytomas are diagnosed on autopsy. We report on a case of embolisation of the adrenal artery during ongoing extracorporeal life support (ECLS) in order to stabilise and wean the patient from ECLS as a bridge to final surgery.

  17. Extracorporeal shock wave lithotripsy in the treatment of renal pelvicalyceal stones in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    V. A. Mezentsev

    2005-04-01

    Full Text Available INTRODUCTION: Management of urolithiasis in morbidly obese patients is usually associated with higher morbidity and mortality compared to non-obese patients. In morbidly obese patients, since the kidney and stone are at a considerable distance from the skin (compared to non-obese patients difficulty may be found in positioning the patient so that the stone is situated at the focal point of the lithotripter. OBJECTIVE: To evaluate the outcomes and cost-efficiency of extracorporeal shock wave lithotripsy (ESWL in the treatment of renal pelvicalyceal stones sized between 6 and 20 mm in morbidly obese patients. MATERIALS AND METHODS: Using various aids, such as mobile overtable module, extended shock pathway and abdominal compression 37 patients with body mass index more than 40 kg/m2 were treated using the Siemens Lithostar-plus third generation lithotripter. The size of renal pelvicalyceal stones was between 6 and 20 mm. Treatment costs for shock wave lithotripsy were calculated. RESULTS: The overall stone free rate at 3 months of 73% was achieved. The mean number of treatments per patient was 2.1. The post-lithotripsy secondary procedures rate was 5.4%. No complications, such as subcapsular haematoma or acute pyelonephritis were recorded. The most effective (87% success rate and cost-efficient treatment was in the patients with pelvic stones. The treatment of the patients with low caliceal stones was effective in 60% only. The cost of the treatment of the patients with low calyceal stones was in 1.8 times higher than in the patients with pelvic stones. CONCLUSION: We conclude that ESWL with the Siemens Lithostar-plus is the most effective and cost-efficient in morbidly obese patients with pelvic stones sized between 6 and 20 mm. 87% success rate was achieved. The increased distance from the skin surface to the stone in those patients does not decrease the success rate provided the stone is positioned in the focal point or within 3 cm of it on the

  18. Comparison of CME/Shock Propagation Models with Heliospheric Imaging and In Situ Observations

    Science.gov (United States)

    Zhao, Xinhua; Liu, Ying D.; Inhester, Bernd; Feng, Xueshang; Wiegelmann, Thomas; Lu, Lei

    2016-10-01

    The prediction of the arrival time for fast coronal mass ejections (CMEs) and their associated shocks is highly desirable in space weather studies. In this paper, we use two shock propagation models, i.e., Data Guided Shock Time Of Arrival (DGSTOA) and Data Guided Shock Propagation Model (DGSPM), to predict the kinematical evolution of interplanetary shocks associated with fast CMEs. DGSTOA is based on the similarity theory of shock waves in the solar wind reference frame, and DGSPM is based on the non-similarity theory in the stationary reference frame. The inputs are the kinematics of the CME front at the maximum speed moment obtained from the geometric triangulation method applied to STEREO imaging observations together with the Harmonic Mean approximation. The outputs provide the subsequent propagation of the associated shock. We apply these models to the CMEs on 2012 January 19, January 23, and March 7. We find that the shock models predict reasonably well the shock’s propagation after the impulsive acceleration. The shock’s arrival time and local propagation speed at Earth predicted by these models are consistent with in situ measurements of WIND. We also employ the Drag-Based Model (DBM) as a comparison, and find that it predicts a steeper deceleration than the shock models after the rapid deceleration phase. The predictions of DBM at 1 au agree with the following ICME or sheath structure, not the preceding shock. These results demonstrate the applicability of the shock models used here for future arrival time prediction of interplanetary shocks associated with fast CMEs.

  19. Quantification of Acoustic Cavitation Produced by a Clinical Extracorporeal Shock Wave Therapy System Using a Passive Cylindrical Detector

    Science.gov (United States)

    Choi, M. J.; Cho, S. C.; Kang, G. S.; Paeng, D. G.; Lee, K. I.; Hodnett, M.; Zeqiri, B.; Coleman, A. J.

    Acoustic cavitation is regarded to play an important role in extracorporeal shock wave therapy (ESWT). However it is not yet well characterized the cavitation in ESWT due to difficulty in its measurement. This study tests NPL cavitation sensor to discuss its potential to quantify cavitation activities produced by a clinical shock wave field. In the present experiment, the sensor was located at the focus of an electromagentic shock wave generator (HnT Medical System, Korea). Measurements were repeated 15 times as varying setting numbers. It was observed that the acoustic signals recorded by the sensor contain characteristic features of broadband spikes representing cavitation. Spectral band magnitude (SBM), used as a cavitation measure, rose with the setting number. There was a threshold above which SBM soared up and had its uncertainty greately increased. The results prove the potential of the sensor in characterizing the cavitation produced by shock wave fields.

  20. Extracorporeal shock wave therapy in pillar pain after carpal tunnel release: a preliminary study.

    Science.gov (United States)

    Romeo, Pietro; d'Agostino, M Cristina; Lazzerini, A; Sansone, Valerio C

    2011-10-01

    "Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this condition. Our results show that in all of the treated patients, there was a marked improvement: the mean visual analogue scale (VAS) score decreased from 6.18 (±1.02) to 0.44 (±0.63) 120 d after treatment, and redness and swelling of the surgical scar had also decreased significantly.

  1. Extracorporeal shock wave therapy in myofascial pain syndrome of upper trapezius.

    Science.gov (United States)

    Ji, Hye Min; Kim, Ho Jeong; Han, Soo Jeong

    2012-10-01

    To evaluate the effect of extracorporeal shock wave therapy (ESWT) in myofascial pain syndrome of upper trapezius with visual analogue scale (VAS) and pressure threshold by digital algometer. Twenty-two patients diagnosed with myofascial pain syndrome in upper trapezius were selected. They were assigned to treatment and standard care (control) groups balanced by age and sex, with eleven subjects in each group. The treated group had done four sessions of ESWT (0.056 mJ/mm(2), 1,000 impulses, semiweekly) while the control group was treated by the same protocol but with different energy levels applied, 0.001 mJ/mm(2). The VAS and pressure threshold were measured twice: before and after last therapy. We evaluated VAS of patients and measured the pressure threshold by using algometer. There were two withdrawals and the remaining 20 patients were three men and 17 women. Age was distributed with 11 patients in their twenties and 9 over 30 years old. There was no significant difference of age, sex, pre-VAS and pre-pressure threshold between 2 groups (p>0.05) found. The VAS significantly decreased from 4.91±1.76 to 2.27±1.27 in the treated group (pmyofascial pain syndrome of upper trapezius is effective to relieve pain after four times therapies in two weeks. But further study will be required with more patients, a broader age range and more males.

  2. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun [AMC, Seoul (Korea, Republic of); Kim, Seung Kook [Kwang-Ju Health College, Kwang-Ju (Korea, Republic of)

    2001-06-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously.

  3. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison.

    Science.gov (United States)

    Gündüz, Rukiye; Malas, Fevziye Ünsal; Borman, Pınar; Kocaoğlu, Seher; Özçakar, Levent

    2012-05-01

    The aim of this study was to compare--clinically and ultrasonographically--the therapeutic effects of physical therapy modalities (hot pack, ultrasound therapy, and friction massage), local corticosteroid injection, and extracorporeal shock wave treatment (ESWT) in lateral epicondylitis (LE). Fifty-nine elbows of 59 patients with LE were randomized into three treatment groups receiving either physical therapy, a single corticosteroid injection, or ESWT. Visual analogue scale (VAS) was used to assess pain intensity, Jamar hydraulic dynamometer for grip strength, finger dynamometer for pinch strength (before treatment, on the first, third, and sixth months of treatment). All subjects were also evaluated with ultrasonography before and 6 months after treatment. In all groups, VAS scores of the patients were found to decrease significantly on the first, third, and sixth months of treatment. With respect to grip strength evaluations, the increase after treatment was significant only on the first month in group II; on the first and third months in group I; and on the first, third, and sixth months of treatment in group III. Pinch strength and ultrasonographical findings did not change during follow-up in any group. We imply that physical therapy modalities, corticosteroid injection, and ESWT have favorable effects on pain and grip strength in the early period of LE treatment. The increase in grip strength lasts longer with ESWT. On the other hand, ultrasonographic findings do not change in the first six months of these treatment methods.

  4. Renal damage after extracorporeal shock-wave lithotripsy detected by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Torii, Shinichiro; Machida, Toyohei; Ooishi, Yukihiko; Tashiro, Kazuya; Mochizuki, Atsushi; Yoshigoe, Fukuo

    1988-08-01

    The acute effects of extracorporeal Shock-wave lithotripsy (ESWL) on morphology of the renal parenchyma were evaluated by Magnetic Resonance Imaging (MRI) in 15 kidneys, before and immediately after (within 24 hours) ESWL in 11 cases. The renal parenchymal damages were observed by MRI as the changes of signal itensity of renal cortex and medulla, perirenal fluid, loss of corticomedullar differentiation, and other renal traumas. Loss of corticomedullar differentiation was seen in 9/11 cases and peripheral fluid of the kidney was seen in 4/11 cases. Irregular and edematous changes of renal capsula were seen in 5/11 cases. Obvious abnormal findings indicated renal trauma were not observed in this study. Several MRI findings may transient and reversible changes and the morpholigic changes detected by MRI may attributed to renal parenchymal obstruction and edema and decreasing of renal capillary flow, such as in renal contusion. It is concluded that MRI is very sensitive and the best technique to detect the effects and clinical trouble of ESWL.

  5. Renal morphology and function immediately after extracorporeal shock-wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kaude, J.V.; Williams, C.M.; Millner, M.R.; Scott, K.N.; Finlayson, B.

    1985-08-01

    The acute effects of extracorporeal shock-wave lithotripsy (ESWL) on morphology and function of the kidney were evaluated by excretory urography, quantitative radionuclide renography (QRR), and magnetic resonance imaging (MRI) in 33 consecutive patients. Excretory urograms demonstrated an enlarged kidney in seven (18%) of 41 treatments and partial or complete obstruction of the ureter by stone fragments after 15 (37%) of 41 treatments. Total effective renal plasma flow (ERPF) was not changed after ESWL, but the percentage ERPF of the treated kidney was decreased by more than 5% in 10 (30%) of 33 cases. QRR images showed partial parenchymal obstruction in 10 (25%) of 41 teated kidneys and total parenchymal obstruction in 9 (22%). MRI disclosed one or more abnormalities in 24 (63%) of 38 treated kidneys. Treated kidneys were normal by all three imaging methods in 26% and abnormal by one or more tests in 74% of cases. The morphologic and functional changes are attributed to renal contusion resulting in edema and extravasation of urine and blood into the interstitial, subcapsular, and perirenal spaces.

  6. The Effects of Extracorporeal Shock Wave Therapy in Patients with Coccydynia: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Shih-Feng Lin

    Full Text Available Coccydynia is pain in the coccygeal region, and usually treated conservatively. Extracorporeal shock wave therapy (ESWT was incorporated as non-invasive treatment of many musculoskeletal conditions. However, the effects of ESWT on coccydynia are less discussed. The purpose of this study is to evaluate the effects of ESWT on the outcomes of coccydynia. Patients were allocated to ESWT (n = 20 or physical modality (SIT group (n = 21 randomly, and received total treatment duration of 4 weeks. The visual analog scale (VAS, Oswestry disability index (ODI, and self-reported satisfaction score were used to assess treatment effects. The VAS and ODI scores were significantly decreased after treatment in both groups, and the decrease in the VAS score was significantly greater in the ESWT group. The mean proportional changes in the ODI scores were greater in the ESWT group than in the SIT group, but the between-group difference was not statistically significant. The patients in the ESWT group had significantly higher subjective satisfaction scores than SIT group. We concluded that ESWT is more effective and satisfactory in reducing discomfort and disability caused by coccydynia than the use of physical modalities. Thus, ESWT is recommended as an alternative treatment option for patients with coccydynia.ClinicalTrials.gov NCT02313324.

  7. Utility of Ultrasonography in Assessing the Effectiveness of Extracorporeal Shock Wave Therapy in Insertional Achilles Tendinopathy

    Directory of Open Access Journals (Sweden)

    Yi Cheng

    2016-01-01

    Full Text Available Introduction. The aim of this study was to investigate the utility of ultrasonography (US for predicting and assessing the effectiveness of extracorporeal shock wave therapy (ESWT in insertional Achilles tendinopathy (IAT. Methods. A total of 42 patients with an established diagnosis of chronic IAT were examined by US before ESWT and at 4 weeks and 12 weeks after ESWT. The thickness and cross-sectional area (CSA of the Achilles tendon, size of calcific plaques, tendon structure score, and neovascularization score were measured at each time point. Results. After therapy, Victorian Institute of Sport Assessment-Achilles (VISA-A scores increased significantly, and the size of calcific plaques decreased (P<0.05. Neovascularization scores increased at the 4th week and then decreased at the 12th week (P<0.05. The thickness, CSA, and structure of the Achilles tendon did not change. Variables observed by US at baseline were not associated with changes in VISA-A scores at follow-up. However, the changes in calcific plaque size and neovascularization scores were related to the improvement of VISA-A scores between pre- and posttherapy (P<0.01. Conclusion. Ultrasonography can reveal some changes in the insertion of the Achilles tendon after ESWT, but the outcome of ESWT in IAT cannot be predicted by the variables observed by US.

  8. Extracorporeal Shock Wave Lithotripsy in the Management of Chronic Calcific Pancreatitis: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Freeman ML

    2005-01-01

    Full Text Available CONTEXT: Main pancreatic duct stones may contribute to pain in chronic pancreatitis. Extracorporeal shock wave lithotripsy (ESWL has been used alone or in combination with endoscopic therapy for fragmentation of stones. Published studies have shown mixed efficacy due to small sample size. OBJECTIVE: Systematic analysis of all published data evaluating ESWL with or without endoscopic therapy in pancreatic duct clearance and symptom relief. METHODS: Two investigators independently reviewed the computer databases. 31 potential studies were identified. Only studies using ESWL with or without endoscopic therapy were included. Completeness of the search was confirmed by an expert. Studies were independently coded by two investigators and differences rectified by mutual consent. MAIN OUTCOME MEASURES: Pain at follow-up and duct clearance. RESULTS: Seventeen studies published between 1989 and 2002 were included. Sixteen had a measure of pain at follow-up and duct clearance. All studies were case series with a total of 588 subjects, and included varying number of subjects undergoing endoscopic pancreatic sphincterotomy and stone extraction. The mean effect size (weighted correlation coefficient for pain was 0.6215 and for duct clearance was 0.7432; thus indicating a large effect. All studies showed homogeneity suggesting similar effect size irrespective of the combinations of therapy. CONCLUSIONS: ESWL is effective in clearance of stones from the pancreatic duct and in relief of pain. Published studies showed homogeneity of the effect size of ESWL both in pancreatic duct clearance and relief of pain.

  9. Extracorporeal Shock Wave Therapy could be a Potential Adjuvant Treatment for Orthopaedic Implant-associated Infections

    Directory of Open Access Journals (Sweden)

    Xiao-feng Chen

    2013-07-01

    Full Text Available Over the past half-century, biomaterials have been used in orthopaedic surgery world widely, but orthopaedic implant-associated infections (OIAIs are still a puzzle for orthopaedic surgeons, which may result in prolonged hospitalisation, poor functional status and high costs. The presence of implants increases the risk of microbial infection; moreover, the formation of bacterial biofilm leads to a higher resistance to antibiotics and local immune response. In such cases, conventional systemic delivery of drugs seems to be fairly inefficient and out-dated. Owing to this, debridement and/or removing the implant always become the only solution. Hence, it needs a simple, minimally invasive and effective therapy to eradicate the problem. There are abundant evidences showing that extracorporeal shock wave therapy (ESWT has favourable effects on stimulating callus formation, inducing angiogenesis, promoting osteogenesis and relieving pain. Studies also indicated that ESWs have a significant bactericidal effect on bacterial strains of bone- and implant-associated infections. Therefore, a hypothesis proposed herein is that ESWT may well be an effective adjuvant treatment for OIAI by controlling infection, inducing bone regeneration and promoting re-osseointegration.

  10. Utility of Ultrasonography in Assessing the Effectiveness of Extracorporeal Shock Wave Therapy in Insertional Achilles Tendinopathy

    Science.gov (United States)

    Zhang, Jian

    2016-01-01

    Introduction. The aim of this study was to investigate the utility of ultrasonography (US) for predicting and assessing the effectiveness of extracorporeal shock wave therapy (ESWT) in insertional Achilles tendinopathy (IAT). Methods. A total of 42 patients with an established diagnosis of chronic IAT were examined by US before ESWT and at 4 weeks and 12 weeks after ESWT. The thickness and cross-sectional area (CSA) of the Achilles tendon, size of calcific plaques, tendon structure score, and neovascularization score were measured at each time point. Results. After therapy, Victorian Institute of Sport Assessment-Achilles (VISA-A) scores increased significantly, and the size of calcific plaques decreased (P < 0.05). Neovascularization scores increased at the 4th week and then decreased at the 12th week (P < 0.05). The thickness, CSA, and structure of the Achilles tendon did not change. Variables observed by US at baseline were not associated with changes in VISA-A scores at follow-up. However, the changes in calcific plaque size and neovascularization scores were related to the improvement of VISA-A scores between pre- and posttherapy (P < 0.01). Conclusion. Ultrasonography can reveal some changes in the insertion of the Achilles tendon after ESWT, but the outcome of ESWT in IAT cannot be predicted by the variables observed by US. PMID:28004000

  11. Treatment of urinary lithiasis following kidney transplantation with extracorporeal shock-wave lithotripsy

    Institute of Scientific and Technical Information of China (English)

    LI Sha-dan; WANG Qing-tang; CHEN Wei-guo

    2011-01-01

    Background The incidence of urinary lithiasis following kidney transplantation is very low, and decision-supporting data are not available. The aim of this study was to review the diagnosis and treatment of urinary lithiasis following kidney transplantation, which is of realistic significance to reduce urinary lithiasis following kidney transplantation, prolong the survival of renal allografts.Methods The incidence, diagnosis and treatment of urinary lithiasis in ten patients following kidney transplantation were analyzed retrospectively. Seven out of these patients had stones sized approximately 0.4-1.1 cm, and they were treated with low-voltage, low-frequency extracorporeal shock-wave lithotripsy (ESWL). Two patients had stones sized <0.3 cm and they underwent cystoscopy and ureteroscopy. The ureteral catheter endoscopes were inserted in a retrograde manner to mobilize stones repeatedly. After elimination of obstruction, a ureteral double J stent was indwelt.One patient had a pelvic stone (1.2 cm), which was removed surgically.Results The major clinical manifestations were hematuria, oliguria or anuria. Some patients were asymptomatic and they were diagnosed through laboratory tests and imaging examinations, e.g., ultrasonography. After elimination of obstruction, subjective symptoms disappeared in all patients, and the function of renal allografts recovered. A six-month follow-up indicated no remnant stones or lithiasis relapse.Conclusions The diagnosis and treatment of renal allograft lithiasis are challenging. After prompt and appropriate treatment, the prognosis was satisfactory, and permanent renal functional impairment did not occur in most patients.

  12. Veno-arterial extracorporeal membrane oxygenation for Streptococcus pyogenes toxic shock syndrome in pregnancy.

    Science.gov (United States)

    Imaeda, Taro; Nakada, Taka-Aki; Abe, Ryuzo; Tateishi, Yoshihisa; Oda, Shigeto

    2016-06-01

    Streptococcal toxic shock syndrome (STSS), an invasive Streptococcus pyogenes (Group A streptococcus) infection with hypotension and multiple organ failure, is quite rare in pregnancy but is characterized by rapid disease progression and high fatality rates. We present a case of STSS with infection-induced cardiac dysfunction in a pregnant woman who was treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). A 24-year-old multiparous woman in the third trimester had early symptoms of high fever and diarrhea 1 day prior to admission to the hospital emergency department. On admission, she had multiple organ failure including circulatory failure. Due to fetal distress, emergency Cesarean section was carried out and transferred to intensive care units. She had refractory circulatory failure with depressed myocardial contractility with progressive multiple organ failure, despite receiving significant hemodynamic supports including high-dose catecholamine. Thus, VA-ECMO was initiated 18 h after intensive care unit admission. Consequently, ECMO provided extra time to recover from infection and myocardial depression. She was successfully weaned from VA-ECMO on day 7 and was discharged home on day 53. VA-ECMO can be a therapeutic option for refractory circulatory failure with significant myocardial depression in STSS.

  13. [Extracorporeal shock wave: An effective and safe therapy for the pain symptom of type IIIB prostatitis].

    Science.gov (United States)

    Zhang, Lan; Tong, Hua; Li, Yan-jun; Shan, Yu-xi

    2015-04-01

    To investigate the effect and safety of extracorporeal shock wave (ESW) in the treatment of pain symptom of type III B prostatitis. We treated 50 cases of type III B prostatitis by ESW once a week for 4 weeks. Then we evaluated the clinical effect and safety of the therapy based on the NIH-CPSI scores, visual analogue scale (VAS) scores, IIEF-5 scores, prostate volume and morphous, state of urination, color of urine, results of routine semen analysis, and changes of cytokines (IL-6, TNF-α and IL-1β) in expressed prostatic secretion (EPS). All the patients successfully accomplished the treatment. Compared with the baseline, decreases were observed after 4 weeks of cytokine treatment in the pain scores (14. 61 ± 1. 82 vs 9. 36 ± 1. 47, P 0. 05) , quality of life scores (6. 51 ± 1. 03 vs 4. 56 ± 1. 02, P 0. 05) or various sperm parameters before and after treatment (P >0. 05). And no significant changes were observed in the prostate volume, morphous or internal echoes. The ESW therapy is effective and safe for the pain symptom of type III B prostatitis.

  14. Quantitative evaluation of stone fragments in extracorporeal shock wave lithotripsy using a time reversal operator

    Science.gov (United States)

    Wang, Jen-Chieh; Zhou, Yufeng

    2017-03-01

    Extracorporeal shock wave lithotripsy (ESWL) has been used widely in the noninvasive treatment of kidney calculi. The fine fragments less than 2 mm in size can be discharged by urination, which determines the success of ESWL. Although ultrasonic and fluorescent imaging are used to localize the calculi, it's challenging to monitor the stone comminution progress, especially at the late stage of ESWL when fragments spread out as a cloud. The lack of real-time and quantitative evaluation makes this procedure semi-blind, resulting in either under- or over-treatment after the legal number of pulses required by FDA. The time reversal operator (TRO) method has the ability to detect point-like scatterers, and the number of non-zero eigenvalues of TRO is equal to that of the scatterers. In this study, the validation of TRO method to identify stones was illustrated from both numerical and experimental results for one to two stones with various sizes and locations. Furthermore, the parameters affecting the performance of TRO method has also been investigated. Overall, TRO method is effective in identifying the fragments in a stone cluster in real-time. Further development of a detection system and evaluation of its performance both in vitro and in vivo during ESWL is necessary for application.

  15. Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis.

    Science.gov (United States)

    Tourchi, Ali; Ebadi, Maryam; Hosseinzadeh, Alireza; Shabaninia, Mahsa

    2014-03-01

    Haematogenous dissemination of undiagnosed urinary tuberculosis after performing extracorporeal shock-wave lithotripsy (ESWL) is extremely rare. Herein, we report a 41-year-old male who presented with urosepsis to the emergency room; catheterization was performed and retention resolved. He had a tattoo on his left arm and a five-year history of intravenous drug use. Blood tests indicated anaemia, leukocytosis, elevated CRP and ESR and mild hyponatraemia; haematuria, moderate bacteriuria and 2+ proteinuria on urinanalysis were observed. Chest X-ray revealed lesions suggestive of miliary tuberculosis, which was confirmed by chest CT scan. Brain CT and MRI suggested brain involvement in the setting of tuberculosis. On further investigations, HIV infection and hepatitis C seropositivity were detected and the patient remained in a coma for five days with a Glasgow Coma Scale of 6/15. Finally, the diagnosis of haematogenous dissemination of tuberculosis following lithotripsy was established. Anti-tuberculosis and anti-retroviral therapy were prescribed and monthly follow-up visits were scheduled. In conclusion, in a patient diagnosed with ureterolithiasis, a thorough history and physical examination, with specific attention to HIV and tuberculosis predisposing factors, should be carried out and preoperative screening tests considering the possibility of urinary tuberculosis are required. Finally, if urinary tuberculosis is detected, ESWL must be postponed until after appropriate treatment of tuberculosis.

  16. Effect of Extracorporeal Shock Wave Therapy on Hamstring Tightness in Healthy Subjects: A Pilot Study.

    Science.gov (United States)

    Kim, Yong Wook; Chang, Won Hyuk; Kim, Na Young; Kwon, Jun Beom; Lee, Sang Chul

    2017-05-01

    To assess the effect of extracorporeal shock wave therapy (ESWT) for healthy participants with hamstring tightness. This study was performed at a university rehabilitation hospital. Twenty nine healthy adults with hamstring tightness were enrolled and randomly allocated into four groups (ESWT, stretching exercise, ESWT with stretching exercise, and control). The effects of individual treatments were compared by the finger-to-floor test and popliteal angle. The ESWT group, stretching exercise group and ESWT with stretching exercise group had decreased finger-to-floor distances and right popliteal angles immediately after intervention, compared with the control group (p<0.05). At 4 weeks after completion of the interventions, finger-to-floor distances and the right popliteal angle in only the ESWT with stretching exercise group showed a significant improvement, compared with the control group (p=0.008 and 0.023). While ESWT and stretching both reduced hamstring tightness immediately after interventions, only ESWT with stretching exercise maintained the significantly improved relief of hamstring tightness significantly after 4 weeks.

  17. Clinical outcomes of extracorporeal shock wave therapy in patients with secondary lymphedema: a pilot study.

    Science.gov (United States)

    Bae, Hasuk; Kim, Ho Jeong

    2013-04-01

    To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment. In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 secondary lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056-0.068 mJ/mm(2), 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment. ESWT is an effective modality in the treatment of stage 3 lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with lymphedema and satisfied almost all patients with lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancer-related lymphedema.

  18. Effect of extracorporeal shock wave therapy on the treatment of patients with carpal tunnel syndrome

    Science.gov (United States)

    Vahdatpour, Babak; Kiyani, Abolghasem; Dehghan, Farnaz

    2016-01-01

    Background: The carpal tunnel syndrome (CTS) is the most common neuropathy. The aim of this study was to evaluate the effect of a new and noninvasive treatment including extracorporeal shock wave therapy (ESWT) in the treatment of CTS. Materials and Methods: This study is a clinical trial conducted on 60 patients with moderate CTS in selected health centers of Isfahan Medical University from November 2014 to April 2015. Patients with CTS were randomly divided into two groups. Conservative treatment including wrist splint at night for 3 months, consumption of nonsteroidal anti-inflammatory drugs for 2 weeks, and oral consumption of Vitamin B1 for a month was recommended for both groups. The first group was treated with ESWT, one session per week for 4 weeks. Focus probe with 0.05, 0.07, 0.1, and 0.15 energy and shock numbers 800, 900, 1000, and 1100 were used from the first session to the fourth, respectively. The evaluated parameters were assessed before treatment and after 3 and 6 months. Data were analyzed using SPSS version 19, Student’s t-test, and Chi-square test. Results: All parameters were significantly decreased in the ESWT group after 3 months. These results remained almost constant after 6 months compared with 3 months after treatment. However, only two parameters considerably improved after 3 months of treatment in the control group. The entire indexes in the control group implicated the regression of results in long-term period. Conclusion: It is recommended to use ESWT as a conservative treatment in patients with CTS. PMID:27563630

  19. Experimental studies on the biological effects of extracorporeal shock wave therapy on tendon models. A review of the literature.

    Science.gov (United States)

    Visco, Vincenzo; Vulpiani, Maria Chiara; Torrisi, Maria Rosaria; Ferretti, Andrea; Pavan, Antonio; Vetrano, Mario

    2014-07-01

    Encouraging results using extracorporeal shock wave therapy (ESWT) for treating chronic tendinopathies were recently obtained, although the specific mechanisms by which it induces therapeutic effects remain largely unknown. In order to provide possible explications of such clinical efficacy, several reports have investigated the effects of ESWT on animal models and different kind of cultured cells. Our contribute in establishing the potential outcome of ESWT on human primary cultured tenocytes, derived from healthy compared to ruptured tendons, have supported the growing evidence that shock waves may supply faster post-injury recovery. The purpose of this review was to summarize and evaluate the available basic scientific evidences for using ESWT in tendon pathologies, suggesting possible shock waves-induced mechanisms of tissue repair.

  20. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie's disease and erectile dysfunction: results from a prospective randomized trial.

    Science.gov (United States)

    Palmieri, A; Imbimbo, C; Creta, M; Verze, P; Fusco, F; Mirone, V

    2012-04-01

    Extracorporeal shock wave therapy improves erectile function in patients with Peyronie's disease. However, erectile dysfunction still persists in many cases. We aimed to investigate the effects of extracorporeal shock wave therapy plus tadalafil 5 mg once daily in the management of patients with Peyronie's disease and erectile dysfunction not previously treated. One hundred patients were enrolled in a prospective, randomized, controlled study. Patients were randomly allocated to receive either extracorporeal shock wave therapy alone for 4 weeks (n = 50) or extracorporeal shock wave therapy plus tadalafil 5 mg once daily for 4 weeks (n = 50). Main outcome measures were: erectile function (evaluated through the shortened version of the International Index of Erectile Function), pain during erection (evaluated through a Visual Analog Scale), plaque size, penile curvature and quality of life (evaluated through an internal questionnaire). Follow-up evaluations were performed after 12 and 24 weeks. In both groups, at 12 weeks follow-up, mean Visual Analog Scale score, mean International Index of Erectile Function score and mean quality of life score ameliorated significantly while mean plaque size and mean curvature degree were unchanged. Intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and quality of life score in patients receiving the combination. After 24 weeks, intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and mean quality of life score in patients that received extracorporeal shock wave therapy plus tadalafil. In conclusion extracorporeal shock wave therapy plus tadalafil 5 mg once daily may represent a valid conservative strategy for the management of patients with Peyronie's disease and erectile dysfunction.

  1. Extracorporeal shock wave lithotripsy for pancreatic and large common bile duct stones

    Institute of Scientific and Technical Information of China (English)

    Manu Tandan; D Nageshwar Reddy

    2011-01-01

    Extraction of large pancreatic and common bile duct (CBD) calculi has always challenged the therapeutic endoscopist. Extracorporeal shockwave lithotripsy (ESWL) is an excellent tool for patients with large pancreatic and CBD calculi that are not amenable to routine endotherapy. Pancreatic calculi in the head and body are targeted by ESWL, with an aim to fragment them to < 3 mm diameter so that they can be extracted by subsequent endoscopic retrograde cholangiopancreatography (ERCP). In our experience, complete clearance of the pancreatic duct was achieved in 76% and partial clearance in 17% of 1006 patients. Short-term pain relief with reduction in the number of analgesics ingested was seen in 84% of these patients. For large CBD calculi, a nasobiliary tube is placed to help target the calculi, as well as bathe the calculi in saline - a simple maneuver which helps to facilitate fragmentation.The aim is to fragment calculi to < 5 mm size and clear the same during ERCP. Complete clearance of the CBD was achieved in 84.4% of and partial clearance in 12.3% of 283 patients. More than 90% of the patients with pancreatic and biliary calculi needed three or fewer sessions of ESWL with 5000 shocks being delivered at each session. The use of epidural anesthesia helped in reducing patient movement. This, together with the better focus achieved with newer third-generation generation lithotripters, prevents collateral tissue damage and minimizes the complications. Complications in our experience with nearly 1300 patients were minimal, and no extension of hospital stay was required. Similar rates of clearance of pancreatic and biliary calculi with minimal adverse effects have been reported from the centers where ESWL is performed regularly. In view of its high efficiency, non-invasive nature and low complication rates, ESWL can be offered as the first-line therapy for selected patients with large pancreatic and CBD calculi.

  2. "Awake Veno-arterial Extracorporeal Membrane Oxygenation" in Pediatric Cardiogenic Shock: A Single-Center Experience.

    Science.gov (United States)

    Schmidt, F; Jack, T; Sasse, M; Kaussen, T; Bertram, H; Horke, A; Seidemann, K; Beerbaum, P; Koeditz, H

    2015-12-01

    In pediatric patients with acute refractory cardiogenic shock (CS), extracorporeal membrane oxygenation (ECMO) remains an established procedure to maintain adequate organ perfusion. In this context, ECMO can be used as a bridging procedure to recovery, VAD or transplantation. While being supported by ECMO, most centers tend to keep their patients well sedated and supported by invasive ventilation. This may be associated with an increased risk of therapy-related morbidity and mortality. In order to optimize clinical management in pediatric patients with ECMO therapy, we report our strategy of veno-arterial ECMO (VA-ECMO) in extubated awake and conscious patients. We therefore present data of six of our patients with CS, who were treated by ECMO being awake without continuous analgosedation and invasive ventilation. Of these six patients, four were 14 years of age. Median time on ECMO was 17.4 days (range 6.9-94.2 days). Median time extubated, while receiving ECMO support was 9.5 days. Mean time extubated was 78 % of the total time on ECMO. Three patients reached full recovery of cardiac function on "Awake-VA-ECMO," whereas the other three were successfully bridged to destination therapy (VAD, heart transplantation, withdrawal). Four out of our six patients are still alive. Complications related to ECMO therapy (i.e., severe bleeding, site infection or dislocation of cannulas) were not observed. We conclude that "Awake-VA-ECMO" in extubated, spontaneously breathing conscious pediatric patients is feasible and safe for the treatment of acute CS and can be used as a "bridging therapy" to recovery, VAD implantation or transplantation.

  3. Effect of extracorporeal shock wave therapy on scar pain in burn patients

    Science.gov (United States)

    Cho, Yoon Soo; Joo, So Young; Cui, Huisong; Cho, Sung-Rae; Yim, Haejun; Seo, Cheong Hoon

    2016-01-01

    Abstract Background: Extracorporeal shock wave therapy (ESWT) has been used to reduce pain in patients with various musculoskeletal diseases and wounds. We investigated the effect of ESWT on scar pain after complete wound epithelialization in burn patients. Methods: A prospective, single-blind, placebo-controlled study was conducted from February 2014 to 2015. Forty patients with burn scar pain despite standard therapy (medication, physical therapy, and burn rehabilitation massage therapy) were randomized into ESWT or control (sham ESWT) groups. ESWT was administered at 100 impulses/cm2 (0.05–0.15 mJ/mm2) once per week for 3 weeks. The treatment effects were assessed using the numerical rating scale (NRS), pain threshold, Nirschl pain phase system, and Roles and Maudsley scores. Results: The characteristics of patients between the 2 study groups were balanced (P >0.05) for age, sex, and total burn surface area (%). In both groups, the NRS, pain threshold (Ib/cm2), and Nirschl pain phase system values significantly improved (P therapy, and there were significant differences between the 2 groups in terms of these 3 variables (P <0.001, P <0.001, P = 0.013, respectively). The Roles and Maudsley scores significantly improved; among 20 patients, 17 reported a score of poor (85%) and 3 reported fair (15%) before ESWT, whereas 3 reported poor (15%), 8 reported fair (40%), 5 reported good (25%), and 4 reported excellent (20%) after ESWT (P = 0.004). The scores did not improve in the control group (P = 0.128). Conclusion: ESWT significantly reduced scar pain in burn patients after wound recovery. PMID:27512886

  4. Outcome of Extracorporeal Shock Wave Therapy for Insertional Achilles Tendinopathy with and without Haglund's Deformity

    Science.gov (United States)

    Yao, Wei; Chen, Shiyi

    2016-01-01

    Purpose. To compare the results of extracorporeal shock wave therapy (ESWT) for insertional Achilles tendinopathy (IAT) with or without Haglund's deformity. Methods. Between September 2014 and May 2015, all patients who underwent ESWT were retrospectively enrolled in this study. A total of 67 patients were available for follow-up and assigned into nondeformtiy group (n = 37) and deformtiy group (n = 30). Clinical outcomes were evaluated by VISA-A Score and 6-point Likert scale. Results. The VISA-A score increased in both groups, from 49.57 ± 9.98 at baseline to 83.86 ± 8.59 at 14.5 ± 7.2 months after treatment in nondeformity group (P < 0.001) and from 48.70 ± 9.38 at baseline to 67.78 ± 11.35 at 15.3 ± 6.7 months after treatment in deformity group (P < 0.001). However, there was a greater improvement in VISA-A Score for the nondeformity group compared with deformity group (P = 0.005). For the 6-point Likert scale, there were decreases from 3.92 ± 0.80 at baseline to 1.57 ± 0.73 at the follow-up time point in nondeformity group (P < 0.001) and from 4.0 ± 0.76 at baseline to 2.37 ± 1.03 at the follow-up time point in deformity group (P < 0.001). There was no significant difference in improvement of the 6-point Likert scale between both groups (P = 0.062). Conclusions. ESWT resulted in greater clinical outcomes in patients without Haglund's deformity compared with patients with Haglund's deformity. PMID:28042570

  5. A meta-analysis of extracorporeal shock wave therapy for Peyronie's disease.

    Science.gov (United States)

    Gao, L; Qian, S; Tang, Z; Li, J; Yuan, J

    2016-09-01

    The efficiency of extracorporeal shock wave therapy (ESWT) for Peyronie's disease (PD) has been controversial for a very long time. We aimed to evaluate the efficiency of ESWT for PD and provide possible evidence on the basis of a meta-analysis of existing comparative studies. All controlled studies, including randomized controlled trials (RCTs), cohort studies and case-control studies, that focused on the efficiency of ESWT for PD, were prospectively identified through comprehensive searches of PubMed, the Cochrane Library and Embase databases. We conducted a meta-analysis of these studies. Six studies including 443 patients were selected for the meta-analysis. Pooling data of these studies showed that ESWT could significantly increase the percentage of men with lessening of penile plaques (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.11-3.85, P=0.02), relief of pain (OR 4.46, 95% CI 2.29-8.68, P<0.0001) and complete remission of pain (OR 5.86, 95% CI 2.66-12.92, P<0.0001). However, insignificant differences were found in improvement of penile curvature (OR 1.88, 95% CI 0.97-3.65, P=0.06) and sexual function (OR 2.22, 95% CI 0.69-7.11, P=0.18) between ESWT and placebo groups. Further, similar results were shown for sensitivity and publication bias analysis when only RCTs were included. However, sporadic complications caused by ESWT were reported, but no patient needed additional treatment aside from conservative observation. ESWT may be an effective and safe treatment for lessening of penile plaques and relieving pain for men with PD, but not for improving of penile curvature and sexual function.

  6. Extracorporeal shock wave therapy (ESWT) for the treatment of cellulite--A current metaanalysis.

    Science.gov (United States)

    Knobloch, Karsten; Kraemer, Robert

    2015-12-01

    The aim of this metaanalysis was to investigate the effectiveness of extracorporeal shock wave therapy (ESWT) in cellulite. Electronic databases (such as Ovid MEDLINE, Scopus and Ovid) as well as reference lists of the available studies were evaluated in June 2015 by two expert examiners. Assessment of each study's methodological quality was performed with the help of the published quality index tool by Downs and Black. This metanalysis included a total of eleven clinical trials on the effects of ESWT on cellulite with a total of 297 included females. Among the eleven clinical trials five randomized controlled trials on ESWT in cellulite with a total number of 123 females have been published so far. Both, focused as well as radial ESWT devices have been found effective in treating cellulite so far. Typically, one or two sessions per week and six to eight sessions overall were studied in the published clinical trials. Overall, outcome parameters mainly focused on digital standardized photographs, circumference measurements and specific ultrasound examinations. Reporting quality showed substantial heterogenity from 22 to 82 points with a mean of 57 points. This metanalysis identified eleven published clinical studies on ESWT in cellulite with five randomized-controlled trials among them. There is growing evidence that both, radial as well as focused ESWT and the combination of both are able to improve the degree of cellulite. Typically, six to eight treatments once or twice a week have been studied. Long-term follow-up data beyond one year are lacking as well as details on potential combination therapies in cellulite such as with low level laser therapy (LLLT), cryolipolysis and others. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  7. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue.

    Science.gov (United States)

    Notarnicola, Angela; Moretti, Biagio

    2012-01-01

    There is currently great interest in the use of Extracorporeal Shock Wave Therapy (ESWT) and in clarifying the mechanisms of action in tendon pathologies. The success rate ranges from 60% to 80% in epicondylitis, plantar fasciitis, cuff tendinitis, trocanteritis, Achilles tendinitis or jumper's knee. In contrast to urological treatments (lithotripsy), where shockwaves are used to disintegrate renal stones, in musculoskeletal treatments (orthotripsy), shockwaves are not being used to disintegrate tissues, but rather to microscopically cause interstitial and extracellular biological responses and tissue regeneration. The researchers are interesting to investigate the biological effects which support the clinical successes. Some authors speculated that shockwaves relieve pain in insertional tendinopathy by hyper-stimulation analgesia. Many recent studies demonstrated the modulations of shockwave treatment including neovascularization, differentiation of mesenchymal stem cells and local release of angiogenetic factors. The experimental findings confirm that ESWT decrease the expression of high levels of inflammatory mediators (matrix metalloproteinases and inter-leukins). Therefore, ESWT produces a regenerative and tissue-repairing effect in musculoskeletal tissues, not merely a mechanical disintegrative effect as generally before assumed. Based on the encouraging results of clinical and experimental studies, the potential of ESWT appears to be emerging. The promising outcome after this non-invasive treatment option in tendinitis care justifies the indication of shockwave therapy. Further studies have to be performed in order or determine optimum treatment parameters and will bring about an improvement in accordance with evidence-based medicine. Finally, meta-analysis studies are necessary to demonstrate the efficacy and safety of ESWT in treating tendinopathies.

  8. Clinical Features and outcomes in adults with cardiogenic shock supported by extracorporeal membrane oxygenation.

    Science.gov (United States)

    Carroll, Brett J; Shah, Ravi V; Murthy, Venkatesh; McCullough, Stephen A; Reza, Nosheen; Thomas, Sunu S; Song, Tae H; Newton-Cheh, Christopher H; Camuso, Janice M; MacGillivray, Thomas; Sundt, Thoralf M; Semigran, Marc J; Lewis, Gregory D; Baker, Joshua N; Garcia, José P

    2015-11-15

    Extracorporeal membrane oxygenation (ECMO) is an increasingly used supportive measure for patients with refractory cardiogenic shock (CS). Despite its increasing use, there remain minimal data regarding which patients with refractory CS are most likely to benefit from ECMO. We retrospectively studied all patients (n = 123) who underwent initiation of ECMO for CS from February 2009 to September 2014 at a single center. Baseline patient characteristics, including demographics, co-morbid illness, cause of CS, available laboratory values, and patient outcomes were analyzed. Overall, 69 patients (56%) were weaned from ECMO, with 48 patients (39%) surviving to discharge. Survivors were younger (50 vs 60 years; p ≤0.0001), had a lower rate of previous smoking (27 vs 56%; p = 0.01) and chronic kidney disease (2% vs 13%; p = 0.03), and had lower lactate measured soon after ECMO initiation (3.1 vs 10.2 mmol/l; p = 0.01). Patients with pulmonary embolism (odds ratio 8.0, 95% confidence interval 2.00 to 31.99; p = 0.01) and acute cardiomyopathy (odds ratio 7.5, 95% confidence interval 1.69 to 33.27; p = 0.01) had a higher rate of survival than acute myocardial infarction, chronic cardiomyopathy, and miscellaneous etiologies compared to postcardiotomy CS as a referent. In conclusion, survival after ECMO initiation differs based on underlying cause of CS. Survival may be lower in older patients and those with early evidence of persistent hypoperfusion after initiation of ECMO for CS.

  9. Noninvasive management of obstructing ureteral stones using electromagnetic extracorporeal shock wave lithotripsy.

    Science.gov (United States)

    Sighinolfi, M C; Chiara, S M; Micali, S; Salvatore, M; De Stefani, S; Stefano, D S; Saredi, G; Mofferdin, A; Grande, M; Bianchi, G; Giampaolo, B

    2008-05-01

    Extracorporeal shock wave lithotripsy (ESWL) represents noninvasive management of urolithiasis. Since the first HM3 model, technological progress has improved the efficacy and safety of this treatment. The current study aimed to evaluate the role of ESWL as a first-line emergency therapy of renal colic due to ureteral stone with impaired renal function. This prospective study enrolled all the patients admitted from the emergency room with acute renal colic meeting the following criteria: serum creatinine level ranging from 1.5 to 2.5 mg/dl, hydronephrosis, ureteral stones 6 to 15 mm in size, body mass index less than 30, normal renal function at baseline, and no evidence of urinary tract infection. The patients were submitted to a single-session emergency treatment using Dornier Litothripter S. Follow-up assessment, performed at 24 and 72 h, included radiologic and ultrasound examinations with renal function serum assessment. The end points were a decrease in creatinine level and a stone-free condition. A total of 40 patients were eligible for the study. The mean creatinine level at admission was 1.93 +/- 0.26 mg/dl. After the treatment, renal function recovery occurred for 34 subjects (85%), with a significant global decrease in creatinine levels (p = 0.00). The global stone-free rate 72 h after SWL was 67.5% (27/40). The patients with residual fragments were managed using re-SWL (n = 7) and endoscopic technique (n = 6). Emergency SWL represents an effective tool in the treatment of ureteral stones with hydronephrosis and slight renal impairment. Although complete stone clearance after one treatment still remains a difficult target, the actual role of SWL in the management of acute obstruction is to obtain ureteral canalization and renal function recovery.

  10. Extracorporeal Shock Wave Therapy for Digital Ulcers of Systemic Sclerosis: A Phase 2 Pilot Study.

    Science.gov (United States)

    Saito, Shinichiro; Ishii, Tomonori; Kamogawa, Yukiko; Watanabe, Ryu; Shirai, Tsuyoshi; Fujita, Yoko; Shirota, Yuko; Fujii, Hiroshi; Ito, Kenta; Shimokawa, Hiroaki; Yamaguchi, Takuhiro; Kawaguchi, Yasushi; Harigae, Hideo

    2016-01-01

    Patients with systemic sclerosis (SSc) often display Raynaud's phenomenon and digital skin ulcers. As these ulcers are not associated with autoimmune factors or abnormal coagulation, conventional immunosuppressive therapies, vasodilators, and anticoagulants are often ineffective. Here, we used extracorporeal shock wave therapy (ESWT) to treat these ulcers. Nine SSc patients with new digital ulcers, previously treated with at least one currently available vasodilator or anticoagulant were enrolled. One ESWT session consisted of 100 pulses at 0.08-0.25 mJ/mm(2) in 20 areas on both hands and 15 areas on both feet, totaling 7,000 pulses. Treatment was performed once per week for 9 weeks with observations over 20 weeks. Outcomes were evaluated according to the number and diameter of ulcers, Rodnan skin score, Health Assessment Questionnaire (HAQ), EuroQol 5 dimensions (EQ-5D), visual analog scale for pain, and the PainVision system. The surface skin temperature of all the fingers was measured using thermography. Ulcers showed signs of healing after one session, and their mean number decreased from 5.4 to 1.1 at 9 weeks. In particular, of the 18 large ulcers (> 5 mm) observed in 7 patients before the treatment, 10 disappeared and the rest became smaller; namely, the mean size decreased from 10.9 mm to 2.5 mm at 20 weeks. The average scores on the HAQ, EQ-5D, and PainVision system also improved. Treatment was minimally invasive and could be repeated without any adverse effects. ESWT may be added to standard treatments for indolent digital ulcers of SSc, as an effective and safe method.

  11. Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL Sonolith vision

    Directory of Open Access Journals (Sweden)

    Nakamura Kogenta

    2011-12-01

    Full Text Available Abstract Background The aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004. Methods The subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment. Results At 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]. Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each. Conclusions ESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.

  12. An in situ Comparison of Electron Acceleration at Collisionless Shocks under Differing Upstream Magnetic Field Orientations

    Science.gov (United States)

    Masters, A.; Sulaiman, A. H.; Stawarz, Ł.; Reville, B.; Sergis, N.; Fujimoto, M.; Burgess, D.; Coates, A. J.; Dougherty, M. K.

    2017-07-01

    A leading explanation for the origin of Galactic cosmic rays is acceleration at high-Mach number shock waves in the collisionless plasma surrounding young supernova remnants. Evidence for this is provided by multi-wavelength non-thermal emission thought to be associated with ultrarelativistic electrons at these shocks. However, the dependence of the electron acceleration process on the orientation of the upstream magnetic field with respect to the local normal to the shock front (quasi-parallel/quasi-perpendicular) is debated. Cassini spacecraft observations at Saturn’s bow shock have revealed examples of electron acceleration under quasi-perpendicular conditions, and the first in situ evidence of electron acceleration at a quasi-parallel shock. Here we use Cassini data to make the first comparison between energy spectra of locally accelerated electrons under these differing upstream magnetic field regimes. We present data taken during a quasi-perpendicular shock crossing on 2008 March 8 and during a quasi-parallel shock crossing on 2007 February 3, highlighting that both were associated with electron acceleration to at least MeV energies. The magnetic signature of the quasi-perpendicular crossing has a relatively sharp upstream-downstream transition, and energetic electrons were detected close to the transition and immediately downstream. The magnetic transition at the quasi-parallel crossing is less clear, energetic electrons were encountered upstream and downstream, and the electron energy spectrum is harder above ˜100 keV. We discuss whether the acceleration is consistent with diffusive shock acceleration theory in each case, and suggest that the quasi-parallel spectral break is due to an energy-dependent interaction between the electrons and short, large-amplitude magnetic structures.

  13. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  14. Extracorporeal Shock Wave Therapy for Breast Cancer-Related Lymphedema: A Pilot Study.

    Science.gov (United States)

    Cebicci, Mehtap Aykac; Sutbeyaz, Serap Tomruk; Goksu, Sema Sezgin; Hocaoglu, Sehriban; Oguz, Arzu; Atilabey, Ayse

    2016-09-01

    To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment. Prospective clinical pilot study. Education and research hospital. Women with a diagnosis of lymphedema secondary to breast cancer (N=11). Patients were treated for 12 sessions of ESWT with 2500 impulses each. The treatment frequency was 4Hz in multiple shock mode. The energy flow density during treatment was equal to a working pressure of 2 bar. The primary outcome measure was volumetric measurements. The secondary outcome measures were the short version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) and the brief version of the World Health Organization Quality of Life (WHOQOL-BREF). Assessments were conducted by the same investigator at baseline, posttreatment, and at 1, 3, and 6 months after treatment for all patients. Significant reduction was found in the amount of lymphedema with ESWT treatment in all patients, and this reduction was maintained for 6 months. A statistically significant reduction was observed in volumetric measurements for the follow-up period (P=.001). The mean volume displacement of the affected upper extremity before treatment was 870.45±384.19mL at 6 months, and after the treatment it was 604.54±381.74mL. In addition, improvements were observed in the QuickDASH functional assessment tool and in the physical health domain of the WHOQOL-BREF questionnaire (P=.002 and P=.007, respectively). ESWT was shown to provide a reduction in the amount of lymphedema in patients with lymphedema secondary to breast cancer. Also, a marked improvement was observed in the functional status and quality of life of study patients. Treatment efficacy was maintained in the long term. As a noninvasive, novel, and effective method, ESWT is a promising treatment modality for the treatment of lymphedema, which is a chronic, progressive, and refractory condition. Copyright © 2016 American

  15. In-Situ Magnetic Gauging Technique Used at LANL -- Method and Shock Information Obtained

    Science.gov (United States)

    Sheffield, Stephen A.

    1999-06-01

    Measuring techniques, including magnetic gauges, quartz gauges, manganin gauges, PVDF gauges, velocity interferometry (VISAR, Fabry-Perot, ORVIS, etc.), piezoelectric pins, shorting pins, flash gaps, etc., have been used over the years to measure shock properties and wave evolution in condensed phase materials. In general, each of these techniques has its own strengths and weaknesses. The use of a particular technique depends on the measured parameter and the sample material properties. This paper will concentrate on in-situ magnetic gauging which is particularly useful in high explosive shock initiation experiments. A short history of this technique will be given but the main discussion will concentrate on the multiple magnetic gauge technique developed at Los Alamos National Lab.(LANL). Vorthman and Wackerle (Vorthman, J.E., ``Facilities for the Study of Shock Induced Decomposition in High Explosive,'' in Shock Waves in Condensed Matter -- 1981, Eds. W. J. Nellis, L. Seaman, and R.A. Graham, AIP Conference Proceedings No. 78 (1982) p. 680.) started developing the technique in 1980, concentrating on particle velocity and ``impulse'' gauges so that Lagrange analysis could be used to map the entire reactive field. Over the years, changes to the gauge design, fabrication, and experimental focus have led to the present LANL capability. During the past two years measurements have tracked the reactive wave evolution resulting from a shock-to-detonation transition in several high explosive materials. The data from a single experiment provides: 1)particle velocity wave profiles from ten to twelve depths in the sample, 2) shock front tracking, 3) an unreacted Hugoniot point (in which both the shock velocity and particle velocity are measured), 4) a ``Pop-plot'' or distance-(time-)to-detonation point, and 5) a 3% measurement of the detonation velocity. Details of the experimental setup and information from several experiments will be discussed.

  16. Three-dimensional magnetohydrodynamic simulations of in situ shock formation in the coronal streamer belt

    CERN Document Server

    Zaliznyak, Yu A; Goedbloed, J P; Zaliznyak, Yu.

    2003-01-01

    We present a numerical study of an idealized magnetohydrodynamic (MHD) configuration consisting of a planar wake flow embedded into a three-dimensional (3D) sheared magnetic field. Our simulations investigate the possibility for in-situ development of large-scale compressive disturbances at cospatial current sheet -- velocity shear regions in the heliosphere. Using a linear MHD solver, we first systematically chart the destabilized wavenumbers, corresponding growth rates, and physical parameter ranges for dominant 3D sinuous-type instabilities in an equilibrium wake--current sheet system. Wakes bounded by sufficiently supersonic (Mach number $M_s > 2.6$) flow streams are found to support dominant fully 3D sinuous instabilities when the plasma beta is of order unity. Fully nonlinear, compressible 2.5D and 3D MHD simulations show the self-consistent formation of shock fronts of fast magnetosonic type. They carry density perturbations far away from the wake's center. Shock formation conditions are identified in ...

  17. Successful use of extracorporeal membrane oxygenation in an adult patient with toxic shock-induced heart failure.

    Science.gov (United States)

    Gabel, Eilon; Gudzenko, Vadim; Cruz, Daniel; Ardehali, Abbas; Fink, Mitchell P

    2015-02-01

    Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotropes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) was instituted as a bridge to recovery. After administration of antibiotics and intravenous immunoglobulin, the patient's condition improved and he was successfully weaned off ECMO after 6 days. The patient recovered from multiorgan failure, and left ventricular ejection fraction improved from <10% pre-ECMO to 65% 8 months after discharge. This case supports the view that VA ECMO can be used successfully to support vital organ perfusion in patients with profound but reversible cardiomyopathy attributed to TSS.

  18. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... anesthesia with 20 ml. 1% lidocaine with epinephrine. All patients received an intravenous dose of morphine just before ESWL. The patients were comparable with regard to age, sex, weight, morphine dosage, number of shock waves given and duration of treatment. Median pain score and the amount of supplementary...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  19. High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series

    Directory of Open Access Journals (Sweden)

    Fuqiang Gao

    2015-01-01

    Full Text Available Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score, P=0.00006; Harris hip score, P=0.00091. During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group. The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group, P=0.091; non-LPFH group, P=0.087. A significant reduction in bone marrow edema was observed after treatment (LPFH group, P=0.007; non-LPFH group, P=0.016. High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

  20. Mechanical Stimulation (Pulsed Electromagnetic Fields "PEMF" and Extracorporeal Shock Wave Therapy "ESWT") and Tendon Regeneration: A Possible Alternative.

    Science.gov (United States)

    Rosso, Federica; Bonasia, Davide E; Marmotti, Antonio; Cottino, Umberto; Rossi, Roberto

    2015-01-01

    The pathogenesis of tendon degeneration and tendinopathy is still partially unclear. However, an active role of metalloproteinases (MMP), growth factors, such as vascular endothelial growth factor (VEGF) and a crucial role of inflammatory elements and cytokines was demonstrated. Mechanical stimulation may play a role in regulation of inflammation. In vitro studies demonstrated that both pulsed electromagnetic fields (PEMF) and extracorporeal shock wave therapy (ESWT) increased the expression of pro-inflammatory cytokine such as interleukin (IL-6 and IL-10). Moreover, ESWT increases the expression of growth factors, such as transforming growth factor β(TGF-β), (VEGF), and insulin-like growth factor 1 (IGF1), as well as the synthesis of collagen I fibers. These pre-clinical results, in association with several clinical studies, suggest a potential effectiveness of ESWT for tendinopathy treatment. Recently PEMF gained popularity as adjuvant for fracture healing and bone regeneration. Similarly to ESWT, the mechanical stimulation obtained using PEMFs may play a role for treatment of tendinopathy and for tendon regeneration, increasing in vitro TGF-β production, as well as scleraxis and collagen I gene expression. In this manuscript the rational of mechanical stimulations and the clinical studies on the efficacy of extracorporeal shock wave (ESW) and PEMF will be discussed. However, no clear evidence of a clinical value of ESW and PEMF has been found in literature with regards to the treatment of tendinopathy in human, so further clinical trials are needed to confirm the promising hypotheses concerning the effectiveness of ESWT and PEMF mechanical stimulation.

  1. Impact of extracorporeal shock waves on the human skin with cellulite: A case study of an unique instance

    Directory of Open Access Journals (Sweden)

    Christoph Kuhn

    2008-03-01

    Full Text Available Christoph Kuhn1, Fiorenzo Angehrn1, Ortrud Sonnabend2, Axel Voss31Klinik Piano, Biel, Switzerland; 2Pathodiagnostics, Herisau, Switzerland; 3SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: In this case study of an unique instance, effects of medium-energy, high-focused extracorporeal generated shock waves (ESW onto the skin and the underlying fat tissue of acellulite afflicted, 50-year-old woman were investigated. The treatment consisted of four ESW applications within 21 days. Diagnostic high-resolution ultrasound (Collagenoson was performed before and after treatment. Directly after the last ESW application, skin samples were taken for histopathological analysis from the treated and from the contra-lateral untreated area of skin with cellulite. No damage to the treated skin tissue, in particular no mechanical destruction to the subcutaneous fat, could be demonstrated by histopathological analysis. However an astounding induction of neocollageno- and neoelastino-genesis within the scaffolding fabric of the dermis and subcutis was observed. The dermis increased in thickness as well as the scaffolding within the subcutaneous fat-tissue. Optimization of critical application parameters may turn ESW into a noninvasive cellulite therapy.Keywords: cellulite, extracellular matrix, fat tissue, high-resolution ultrasound of skin, extracorporeal shock wave, histopathology, scaffolding of subcutaneous connective tissue

  2. Contemporary Outcomes of Venoarterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock at a Large Tertiary Care Center.

    Science.gov (United States)

    Truby, Lauren; Mundy, Lily; Kalesan, Bindu; Kirtane, Ajay; Colombo, Paolo C; Takeda, Koji; Fukuhara, Shinichi; Naka, Yoshifumi; Takayama, Hiroo

    2015-01-01

    Refractory cardiogenic shock (RCS) is associated with significant morbidity and mortality, and current mainstays of medical therapy appear inadequate. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) represents an increasingly accepted therapy for RCS. Demographics, past medical history, preoperative characteristics, outcomes, and adverse events were collected for consecutive patients who received VA-ECMO support for RCS at our institution from March 2007 to December 2013. One hundred and seventy-nine patients with a mean age of 56.9 ± 16.1 years were included. Etiologies of RCS included postcardiotomy shock in 70 patients (39%), acute myocardial infarction in 46 patients (26%), primary graft failure in 17 patients (10%), and acute decompensated heart failure in 24 patients (13%). Mean arterial pressure before VA-ECMO support was 59.4 ± 22.8 mm Hg and 30.7% (n = 55) were undergoing active cardiopulmonary resuscitation at the time of cannulation. Overall, 38.6% of patients (n = 69) survived to discharge and 44.7% of patients (n = 80) survived to 30 days. Myocardial recovery was achieved in 79.7% of survivors (n = 55) and 39.1% were transitioned to a more durable device. Univariate analysis identified age (p = 0.002) and etiology of RCS (p = 0.041) as the most significant predictors of in-hospital mortality. Venoarterial extracorporeal membrane oxygenation for RCS appears successful as salvage therapy. Age and etiology should be considered when evaluating patients for VA-ECMO.

  3. Assessment of In Situ Time Resolved Shock Experiments at Synchrotron Light Sources*

    Science.gov (United States)

    Belak, J.; Ilavsky, J.; Hessler, J. P.

    2005-07-01

    Prior to fielding in situ time resolved experiments of shock wave loading at the Advanced Photon Source, we have performed feasibility experiments assessing a single photon bunch. Using single and poly-crystal Al, Ti, V and Cu shock to incipient spallation on the gas gun, samples were prepared from slices normal to the spall plane of thickness 100-500 microns. In addition, single crystal Al of thickness 500 microns was shocked to incipient spallation and soft recovered using the LLNL e-gun mini-flyer system. The e-gun mini-flyer impacts the sample target producing a 10's ns flat-top shock transient. Here, we present results for imaging, small-angle scattering (SAS), and diffraction. In particular, there is little SAS away from the spall plane and significant SAS at the spall plane, demonstrating the presence of sub-micron voids. * Use of the Advanced Photon Source was supported by the U. S. Department of Energy, Office of Science, Office of Basic Energy Sciences, under Contract No. W-31-109-Eng-38 and work performed under the auspices of the U.S. Department of Energy by University of California, Lawrence Livermore National Laboratory under Contract W-7405-Eng-48.

  4. Comparison of Extracorporeal Shock Wave Lithotripsy for Urolithiasis Between Children and Adults: A Single Centre Study

    Science.gov (United States)

    Assad, Salman; Rahat Aleman Bhatti, Joshua; Hasan, Aisha; Shabbir, Muhammad Usman; Akhter, Saeed

    2016-01-01

    Objective To retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) for urolithiasis and compare the results between children and adults. Materials and methods From January 2011 to January 2015 (four years), ESWL was performed in 104 children and 300 adults for urolithiasis. MODULITH® SLX-F2 lithotripter (Storz Medical AG, Tägerwilen, Switzerland) equipment was used for ESWL. The stone-free rates, the number of ESWL sessions required, complication rates and ancillary procedures used were evaluated in a comparative manner. Results The mean age ± standard deviation (SD) of children was 7.84±4.22 years and of adults was a 40.22±1.57 years. Mean ± SD of the stone size was 1.28±61 cm in the adults while 1.08 ± 0.59 cm in the children. In adults, the complications included steinstrasse in six (1.98%) patients, fever in 15 (4.95%), hematuria in 19 (6.28%) and sepsis in six (1.98%) patients. In children, steinstrasse was observed in two (1.9%), mild fever in two (1.9%), hematuria in six (5.7%) and sepsis was seen in four (3.8%) patients. The overall complication rate in the adults and in the children, it was found to be 46/300 (15%) and in the children, it was seen to be 14/104 (13%). No statistical difference was found in post-ESWL complications between children and adults (P>0.05). Ancillary procedures including double J (DJ) stent were used in 13 (12.5%) children and 87 (29%) adults. There was a better stone clearance rate in children i.e. 79% as compared to 68% in adults (X2: P=0.036). Conclusion Children can achieve high stone-free rates after ESWL with a lower need for repeat ancillary procedures as compared to adults. However, there is a difference in the post-ESWL complications between these groups. PMID:27800291

  5. The Effect of Extracorporeal Shock Wave Therapy on Myofascial Pain Syndrome

    Science.gov (United States)

    Jeon, Jong Hyun; Jung, Yun Jae; Lee, Ju Youn; Choi, Ji Soo; Mun, Jeong Hyeon; Park, Won Yong; Seo, Cheong Hoon

    2012-01-01

    Objective To investigate the effect of extracorporeal shock wave therapy (ESWT) on myofascial pain syndrome (MPS). Method Thirty patients with MPS in trapezius muscle were randomly divided into two groups, ESWT group (n=15), and trigger point injections (TPI)+transcutaneous electrical nerve stimulation (TENS) group (n=15). For a total of 3 weeks, ESWT was undertaken with 1,500 pulse each time at one week interval totaling 4,500 pulse, TPI for once a week totaling three times and TENS for five times a week totaling three weeks. Results The changes in pain threshold (lb/cm2) showed the values of 6.86±1.35 before first therapy, 11.43±0.27 after first therapy, and 12.57±0.72 after third therapy, while TPI+TENS group showed the values of 6.20±1.92 before first therapy, 8.80±0.48 after first therapy, and 9.60±2.19 after third therapy, and the changes between the groups were significantly different (p=0.045). The changes in visual analog scale were estimated to be 6.86±0.90 before first therapy, 2.86±0.90 after first therapy, and 1.86±0.69 after third therapy in case of ESWT group, whereas the figures were estimated to be 7.20±1.30 before first therapy, 4.60±0.55 after first therapy, and 2.80±0.84 after third therapy in case of TPI+TENS group, and the changes between the groups were significantly different (p=0.010). The changes in McGill pain questionnaire (p=0.816) and pain rating scale (p=0.644) between the groups were not significantly different. The changes in neck ROM were also not significantly different between the groups (p>0.05). Conclusion The ESWT in patients with MPS in trapezius muscle are as effective as TPI and TENS for the purpose of pain relief and improving cervical range of motion. PMID:23185731

  6. Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial

    NARCIS (Netherlands)

    Kolk, A. van der; Yang, K.G.; Tamminga, R.; Hoeven, H. van der

    2013-01-01

    The aim of this study was to determine the effect of radial extracorporeal shock-wave therapy (rESWT) on patients with chronic tendinitis of the rotator cuff. This was a randomised controlled trial in which 82 patients (mean age 47 years (24 to 67)) with chronic tendinitis diagnosed clinically were

  7. Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial

    NARCIS (Netherlands)

    Kolk, A. van der; Yang, K.G.; Tamminga, R.; Hoeven, H. van der

    2013-01-01

    The aim of this study was to determine the effect of radial extracorporeal shock-wave therapy (rESWT) on patients with chronic tendinitis of the rotator cuff. This was a randomised controlled trial in which 82 patients (mean age 47 years (24 to 67)) with chronic tendinitis diagnosed clinically were

  8. The effect of high-energy extracorporeal shock waves on hyaline cartilage of adult rats in vivo.

    Science.gov (United States)

    Mayer-Wagner, Susanne; Ernst, Judith; Maier, Markus; Chiquet, Matthias; Joos, Helga; Müller, Peter E; Jansson, Volkmar; Sievers, Birte; Hausdorf, Jörg

    2010-08-01

    The aim of this study was to determine if extracorporeal shock wave therapy (ESWT) in vivo affects the structural integrity of articular cartilage. A single bout of ESWT (1500 shock waves of 0.5 mJ/mm(2)) was applied to femoral heads of 18 adult Sprague-Dawley rats. Two sham-treated animals served as controls. Cartilage of each femoral head was harvested at 1, 4, or 10 weeks after ESWT (n = 6 per treatment group) and scored on safranin-O-stained sections. Expression of tenascin-C and chitinase 3-like protein 1 (Chi3L1) was analyzed by immunohistochemistry. Quantitative real-time polymerase chain reaction (PCR) was used to examine collagen (II)alpha(1) (COL2A1) expression and chondrocyte morphology was investigated by transmission electron microscopy no changes in Mankin scores were observed after ESWT. Positive immunostaining for tenascin-C and Chi3L1 was found up to 10 weeks after ESWT in experimental but not in control cartilage. COL2A1 mRNA was increased in samples 1 and 4 weeks after ESWT. Alterations found on the ultrastructural level showed expansion of the rough-surfaced endoplasmatic reticulum, detachment of the cell membrane and necrotic chondrocytes. Extracorporeal shock waves caused alterations of hyaline cartilage on a molecular and ultrastructural level that were distinctly different from control. Similar changes were described before in the very early phase of osteoarthritis (OA). High-energy ESWT might therefore cause degenerative changes in hyaline cartilage as they are found in initial OA. Copyright 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  9. A Case Report of Churg-Strauss Syndrome Presenting With Cardiogenic Shock Treated With Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Cui, Na; Su, Longxiang; Wang, Hao; Long, Yun; Pang, Cheng; Yang, Fei; Liu, Dawei

    2015-10-01

    Churg-Strauss Syndrome (CSS) complicated with cardiogenic shock is rare. Few case reports have described successful treatment of this rare disease. However, no one has reported on the application of mechanical life support with extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease.A 36-year-old female with limb numbness for >10 days, chest tightness for 2 days, and worsening dyspnea for 5 h presented in the emergency room. Vital signs showed a low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm). Laboratory tests revealed that eosinophil was significantly increased (WBC: 34.46 × 10/L, neutrophil: 7.56 × 10/L[21.9%], eosinophil: 23.84 × 10/L[69.2%]), and serum myocardial enzymes was abnormal (CK 1049U/L, CKMB-mass 145.1 μg/L, cTnI 16.24 μg/L). Myocardial injury (tachycardia with ST elevation) and poor heart function (LVEF 31%) were found by electrocardiogram and transthoracic echocardiography. On the next day, cardiogenic shock had been developed as demonstrated by deteriorating the perfusion index.Churg-Strauss Syndrome with cardiogenic shock.A series of conservative therapy with drugs such as corticosteroids, anticoagulant, antiplatelet, nitrates, calcium antagonists, inotrope, and vasopressors were initiated on the day of admission. The treatment was ineffective and a cardiogenic shock developed on the next day. Thus, ECMO was initiated immediately to stabilize circulation and perfusion. At the same time, high-dose corticosteroids combined with immunosuppressive therapy were continuously used.Symptoms of cardiogenic shock were gradually improved after ECMO treatment. Elevated values of cardiac enzymes were decreased and the dose of vasoactive drugs was reduced. Extracorporeal membrane oxygenation was discontinued after 8 days, and the patient was eventually weaned off the ventilator. The patient was discharged after 40 days treatment.Once a CSS develops into a

  10. NORMOTHERMIC EXTRACORPOREAL PERFUSION IN SITU IN DECEASED ORGAN DONORS WITH IRREVERSIBLE CARDIAC ARREST AND ONE HOUR OF ASYSTOLE. 5-YEAR OUTCOMES OF KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. E. Skvortsov

    2016-01-01

    Full Text Available Aim. The global shortage of deceased organ donors caused increasing interest to the transplant program based on the use of organs from the donors with sudden irreversible cardiac arrest, or asystolic donors (DCD. Ischemia-reperfusion injury as a result of cardiac arrest remains a key problem that limits the use of organs from DCD. Our clinical study was intended to determine the acceptability of renal transplants derived from the DCD using extracorporeal perfusion in situ after 60 minutes of asystole. Materials and methods. In 2009–2014, St. Petersburg Organ Procurement Organization (OPO obtained kidneys from 29 DCD with critically expanded warm ischemic time (WIT. The design of this study was approved by the Scientifi c Board and Ethics Committee of the State Research Institute for Emergency Medicine (Decision 7/0615/09. Initially, no one of died patients was considered as potential organ donors. In case of failed advanced CPR the death of a patient was declared initiating the protocol of subnormothermic extracorporeal abdominal perfusion with ECMO, thrombolytics (strepokinase 1.5 mln U, and LD. The procedures were established by the authorized OPO team which arrived with perfusion equipment in 30–40 minutes after declaration of donors’ death. Mean WIT was 58.1 (19.39 minutes (Mean (SD. Resuscitated grafts were transplanted into 58 recipients. The outcomes of transplantation of resuscitated kidneys were compared to those of 112 KTx from 115 brain death donors (BDDs. Results. Immediate functioning of kidney grafts was observed in 28 (48.3% of 58 recipients. There were 4 cases of primary graft non-function. By the end of the fi rst post-transplant year there was an acute rejection rate of 12.1% (9 episodes of rejection in the DCD group vs. 23.2% (26 episodes of rejection in the BDD group (p < 0.05. The actuarial 5-year graft survival rate was 82.8% (n = 48 in DCD group, and 87.5% (n = 98 in BDD group (p > 0.05. Creatinine levels at the end

  11. Shock Melting of Iron Silicide as Determined by In Situ X-ray Diffraction.

    Science.gov (United States)

    Newman, M.; Kraus, R. G.; Wicks, J. K.; Smith, R.; Duffy, T. S.

    2016-12-01

    The equation of state of core alloys at pressures and temperatures near the solid-liquid coexistence curve is important for understanding the dynamics at the inner core boundary of the Earth and super-Earths. Here, we present a series of laser driven shock experiments on textured polycrystalline Fe-15Si. These experiments were conducted at the Omega and Omega EP laser facilities. Particle velocities in the Fe-15Si samples were measured using a line VISAR and were used to infer the thermodynamic state of the shocked samples. In situ x-ray diffraction measurements were used to probe the melting transition and investigate the potential decomposition of Fe-15Si in to hcp and B2 structures. This work examines the kinetic effects of decomposition due to the short time scale of dynamic compression experiments. In addition, the thermodynamic data collected in these experiments adds to a limited body of information regarding the equation of state of Fe-15Si, which is a candidate for the composition in Earth's outer core. Our experimental results show a highly textured solid phase upon shock compression to pressures ranging from 170 to 300 GPa. Below 320 GPa, we observe diffraction peaks consistent with decomposition of the D03 starting material in to an hcp and a cubic (potentially B2) structure. Upon shock compression above 320 GPa, the intense and textured solid diffraction peaks give way to diffuse scattering and loss of texture, consistent with melting along the Hugoniot. When comparing these results to that of pure iron, we can ascertain that addition of 15 wt% silicon increases the equilibrium melting temperature significantly, or that the addition of silicon significantly increases the metastability of the solid phase, relative to the liquid. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  12. Extracorporeal membrane oxygenation support in refractory cardiogenic shock: treatment strategies and analysis of risk factors.

    Science.gov (United States)

    Loforte, Antonio; Marinelli, Giuseppe; Musumeci, Francesco; Folesani, Gianluca; Pilato, Emanuele; Martin Suarez, Sofia; Montalto, Andrea; Lilla Della Monica, Paola; Grigioni, Francesco; Frascaroli, Guido; Menichetti, Antonio; Di Bartolomeo, Roberto; Arpesella, Giorgio

    2014-07-01

    Two centrifugal pumps, the RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA), used in central or peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated, in terms of double-center experience, as treatment for patients with refractory cardiogenic shock (CS). Between January 2006 and December 2012, 228 consecutive adult patients were supported on RotaFlow (n=213) or CentriMag (n=15) ECMO, at our institutions (155 men; age 58.3±10.5 years, range: 19-84 years). Indications for support were: failure to wean from cardiopulmonary bypass in the setting of postcardiotomy (n=118) and primary donor graft failure (n=37); postacute myocardial infarction CS (n=27); acute myocarditis (n=6); and CS on chronic heart failure (n=40). A peripheral ECMO setting was established in 126 (55.2%) patients while it was established centrally in 102 (44.7%). Overall mean support time was 10.9±9.7 days (range: 1-43 days). Eighty-four (36.8%) patients died on ECMO. Overall success rate, in terms of survival on ECMO (n=144), weaning from mechanical support (n=107; 46.9%), bridge to mid-long-term ventricular assist device (n=6; 2.6%), and bridge to heart transplantation (n=31; 13.5%), was 63.1%. One hundred twenty-two (53.5%) patients were successfully discharged. Stepwise logistic regression identified blood lactate level and MB isoenzyme of creatine kinase (CK-MB) relative index at 72 h after ECMO initiation, and number of packed red blood cells (PRBCs) transfused on ECMO as significant predictors of mortality on ECMO (P=0.010, odds ratio [OR]=2.94; 95% confidence interval [CI]=1.10-3.14; P=0.010, OR=2.82, 95% CI=1.014-3.721; and P=0.011, OR=2.69; 95% CI=1.06-4.16, respectively). Central ECMO population had significantly higher rate of continuous veno-venous hemofiltration need and bleeding requiring surgery events compared with the peripheral ECMO setting population

  13. Extracorporeal shock wave therapy for painful chronic neurogenic heterotopic ossification after traumatic brain injury: a case report.

    Science.gov (United States)

    Choi, Yong Min; Hong, Seok Hyun; Lee, Chang Hyun; Kang, Jin Ho; Oh, Ju Sun

    2015-04-01

    Neurogenic heterotopic ossification (NHO) is a process of benign bone formation and growth in soft tissues surrounding major synovial joints and is associated with central nervous system (CNS) injuries. It is a common complication in major CNS injuries, such as traumatic brain injury, spinal cord injury, and stroke. Here, we report the case of a 72-year-old male, who experienced a traumatic brain injury and painful chronic NHO around the left hip joint. Three applications of extracorporeal shock wave therapy (ESWT) were administered to the area of NHO, which resulted in pain relief and an improvement in the loss of motion in the left hip joint. Improvements were also noted in walking performance and activities of daily living, although the size of NHO remained unchanged. Therapeutic effects of ESWT lasted for 12 weeks.

  14. Effects of extracorporeal shock wave therapy on functional and strength recovery of handgrip in patients affected by epicondylitis.

    Science.gov (United States)

    Notarnicola, Angela; Quagliarella, Livio; Sasanelli, Nicola; Maccagnano, Giuseppe; Fracella, Maria Rosaria; Forcignanò, Maria Immacolata; Moretti, Biagio

    2014-12-01

    Extracorporeal shock wave therapy (ESWT) is effective in the treatment of tendinopathy. We designed a prospective observational clinical study to assess the correlation between clinical and functional measures and recovery of strength after ESWT for epicondylitis. We analyzed 26 patients. We measured progressive improvement in visual analogue scale values (p 0.05). We found no correlation between degree of clinical function and muscle deficit during follow-up. After ESWT, there was a tendency toward a decrease in grip strength, especially in the dominant limb. This could be related to the effects of ESWT, which reduces spasticity in painful hypertonic muscles. These data may be useful in defining the expectations for function during ESWT for epicondylitis, particularly for elite athletes.

  15. Hypovolemic Shock Caused by Massive Renal Hematoma After a Third Consecutive Extracorporeal Shockwave Lithotripsy Session: A Case Report.

    Science.gov (United States)

    Sermeus, Loic; Vander Eeckt, Kathy; Ost, Dieter; Van Den Branden, Marcel

    2016-01-01

    Extracorporeal shockwave lithotripsy (SWL) is a commonly used technique for treating urinary calculi. Although noninvasive, highly effective, and widely accepted, SWL is not without complications. Next to fragmenting the calculi, the surrounding tissue is damaged, which can result in renal hematoma, a well-described complication. In most cases, the collateral tissue damage is mild and resolves with conservative treatment. However, rarely, severe complications may arise. Here we present a case of a 46-year-old male who developed a massive hematoma, both subcapsular and retroperitoneal, after a third consecutive SWL session, resulting in hypovolemic shock. Different probable causes are proposed, of which one cause, the length of the interval between SWL sessions, is not yet studied properly. Probably, short intervals keep the damaged tissue from healing sufficiently, as proposed in our case. Possibly, life-threatening situations can be avoided if more evidence-based guidelines are available.

  16. /sup 99m/Tc-DTPA renography before and after extracorporeal shock wave lithotripsy for renal calculi

    Energy Technology Data Exchange (ETDEWEB)

    Ohtake, Eiji; Murata, Hajime; Kanemura, Mikio; Yokoyama, Masao

    1988-09-01

    This study was undertaken to evaluate /sup 99m/Tc-DTPA renography before and after extracorporeal shock wave lithotripsy (ESWL). Twelve patients with renal calculi were examined in this study. In three patients, bilateral kidneys were treated with ESWL. Sequential renal images of the vascular phase, and the functional and excretory phases were taken using a gamma camera (ZLC 7500, Siemens), after intravenous injection of 555 MBq of /sup 99m/Tc-DTPA. Renograms were generated using data stored every 10 seconds for a period of 30 minutes by computer (Scintipac-2400, Shimadzu). Some treated kidneys were enlarged and/or showed uniform retention of radioactivity on sequential images, within a week after ESWL. Renogram patterns after ESWL were varied in each patient. The renogram findings after ESWL seemed to be affected by the presence or absence of stone fragments in the urinary tract.

  17. Shocked monazite chronometry: integrating microstructural and in situ isotopic age data for determining precise impact ages

    Science.gov (United States)

    Erickson, Timmons M.; Timms, Nicholas E.; Kirkland, Christopher L.; Tohver, Eric; Cavosie, Aaron J.; Pearce, Mark A.; Reddy, Steven M.

    2017-03-01

    Monazite is a robust geochronometer and occurs in a wide range of rock types. Monazite also records shock deformation from meteorite impact but the effects of impact-related microstructures on the U-Th-Pb systematics remain poorly constrained. We have, therefore, analyzed shock-deformed monazite grains from the central uplift of the Vredefort impact structure, South Africa, and impact melt from the Araguainha impact structure, Brazil, using electron backscatter diffraction, electron microprobe elemental mapping, and secondary ion mass spectrometry (SIMS). Crystallographic orientation mapping of monazite grains from both impact structures reveals a similar combination of crystal-plastic deformation features, including shock twins, planar deformation bands and neoblasts. Shock twins were documented in up to four different orientations within individual monazite grains, occurring as compound and/or type one twins in (001), (100), ( 10bar{1} ), {110}, { 212 }, and type two (irrational) twin planes with rational shear directions in [0bar{1}bar{1}] and [bar{1}bar{1}0]. SIMS U-Th-Pb analyses of the plastically deformed parent domains reveal discordant age arrays, where discordance scales with increasing plastic strain. The correlation between discordance and strain is likely a result of the formation of fast diffusion pathways during the shock event. Neoblasts in granular monazite domains are strain-free, having grown during the impact events via consumption of strained parent grains. Neoblastic monazite from the Inlandsee leucogranofels at Vredefort records a 207Pb/206Pb age of 2010 ± 15 Ma (2 σ, n = 9), consistent with previous impact age estimates of 2020 Ma. Neoblastic monazite from Araguainha impact melt yield a Concordia age of 259 ± 5 Ma (2 σ, n = 7), which is consistent with previous impact age estimates of 255 ± 3 Ma. Our results demonstrate that targeting discrete microstructural domains in shocked monazite, as identified through orientation mapping, for in

  18. Mechanical stimulation (pulsed electromagnetic fields "PEMF" and extracorporeal shock wave therapy "ESWT" and tendon regeneration: a possible alternative.

    Directory of Open Access Journals (Sweden)

    Federica eRosso

    2015-11-01

    Full Text Available The pathogenesis of tendon degeneration and tendinopathy is still partially unclear. However, an active role of metalloproteinases (MMP, growth factors, such as vascular endothelial growth factor (VEGF and a crucial role of inflammatory elements and cytokines was demonstrated. Mechanical stimulation may play a role in regulation of inflammation. In vitro studies demonstrated that both pulsed electromagnetic fields (PEMF and extracorporeal shock wave therapy (ESWT increased the expression of pro-inflammatory cytokine such as interleukin (IL-6 and IL-10. Moreover ESWT increases the expression of growth factors, such as transforming growth factor beta (TGF-beta, Vascular Endothelial Growth Factor (VEGF, and insulin-like growth factor 1 (IGF1, as well as the synthesis of collagen I fibers. These pre-clinical results, in association with several clinical studies, suggest a potential effectiveness of ESWT for tendinopathy treatment. Recently PEMF gained popularity as adjuvant for fracture healing and bone regeneration. Similarly to ESWT, the mechanical stimulation obtained using PEMFs may play a role for treatment of tendinopathy and for tendon regeneration, increasing in-vitro TGF-beta production, as well as scleraxis and collagen I gene expression. In this manuscript the rational of mechanical stimulations and the clinical studies on the efficacy of extracorporeal shock wave (ESW and PEMF will be discussed. However, no clear evidence of a clinical value of ESW and PEMF has been found in literature with regards to the treatment of tendinopathy in human, so further clinical trials are needed to confirm the promising hypotheses concerning the effectiveness of ESWT and PEMF mechanical stimulation.

  19. Myocardial protection of early extracorporeal membrane oxygenation (ECMO) support for acute myocardial infarction with cardiogenic shock in pigs.

    Science.gov (United States)

    Zhu, Gang-jie; Sun, Li-na; Li, Xing-hai; Wang, Ning-fu; Wu, Hong-hai; Yuan, Chen-xing; Li, Qiao-qiao; Xu, Peng; Ren, Ya-qi; Mao, Bao-gen

    2015-09-01

    The aim of this study was to explore myocardial protection of early extracorporeal membrane oxygenation (ECMO) support for acute myocardial infarction with cardiogenic shock in pigs. 24 male pigs (34.6 ± 1.3 kg) were randomly divided into three groups-control group, drug therapy group, and ECMO group. Myocardial infarction model was created in drug therapy group and ECMO group by ligating coronary artery. When cardiogenic shock occurred, drugs were given in drug therapy group and ECMO began to work in ECMO group. The pigs were killed 24 h after cardiogenic shock. Compared with in drug therapy group, left ventricular end-diastolic pressure in ECMO group decreased significantly 6 h after ligation (P myocardial infarct size of ECMO group did not reduce significantly, but myocardial enzyme and troponin-I decreased significantly. Compared with drug therapy, ECMO improves left ventricular diastolic function, and may improve systolic function. ECMO cannot reduce myocardial infarct size without revascularization, but may have positive effects on ischemic areas by avoiding further injuring.

  20. Shock Wave Response of Iron-based In Situ Metallic Glass Matrix Composites

    Science.gov (United States)

    Khanolkar, Gauri R.; Rauls, Michael B.; Kelly, James P.; Graeve, Olivia A.; Hodge, Andrea M.; Eliasson, Veronica

    2016-03-01

    The response of amorphous steels to shock wave compression has been explored for the first time. Further, the effect of partial devitrification on the shock response of bulk metallic glasses is examined by conducting experiments on two iron-based in situ metallic glass matrix composites, containing varying amounts of crystalline precipitates, both with initial composition Fe49.7Cr17.7Mn1.9Mo7.4W1.6B15.2C3.8Si2.4. The samples, designated SAM2X5-600 and SAM2X5-630, are X-ray amorphous and partially crystalline, respectively, due to differences in sintering parameters during sample preparation. Shock response is determined by making velocity measurements using interferometry techniques at the rear free surface of the samples, which have been subjected to impact from a high-velocity projectile launched from a powder gun. Experiments have yielded results indicating a Hugoniot Elastic Limit (HEL) to be 8.58 ± 0.53 GPa for SAM2X5-600 and 11.76 ± 1.26 GPa for SAM2X5-630. The latter HEL result is higher than elastic limits for any BMG reported in the literature thus far. SAM2X5-600 catastrophically loses post-yield strength whereas SAM2X5-630, while showing some strain-softening, retains strength beyond the HEL. The presence of crystallinity within the amorphous matrix is thus seen to significantly aid in strengthening the material as well as preserving material strength beyond yielding.

  1. Effects of Extracorporeal Shock Wave Therapy on Spasticity in Patients after Brain Injury: A Meta-analysis.

    Science.gov (United States)

    Lee, Jin-Youn; Kim, Soo-Nyung; Lee, In-Sik; Jung, Heeyoune; Lee, Kyeong-Soo; Koh, Seong-Eun

    2014-10-01

    [Purpose] The purpose of this meta-analysis was to assess the effects of extracorporeal shock wave therapy (ESWT) on reducing spasticity immediately and 4 weeks after application of ESWT. [Subjects and Methods] We searched PubMed, TCL, Embase, and Scopus from their inception dates through June 2013. The key words "muscle hypertonia OR spasticity" were used for spasticity, and the key words "shock wave OR ESWT" were used for ESWT. Five studies were ultimately included in the meta-analysis. [Results] The Modified Ashworth Scale (MAS) grade was significantly improved immediately after ESWT compared with the baseline values (standardized mean difference [SMD], -0.792; 95% confidence interval [CI], -1.001 to -0.583). The MAS grade at four weeks after ESWT was also significantly improved compared with the baseline values (SMD, -0.735; 95% CI, -0.951 to -0.519). [Conclusion] ESWT has a significant effect on improving spasticity. Further standardization of treatment protocols including treatment intervals and intensities needs to be established and long-term follow up studies are needed.

  2. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function [Retraction

    Directory of Open Access Journals (Sweden)

    Wang L

    2016-10-01

    Full Text Available Wang L, Jiang Y, Jiang Z, Han L. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function. Neuropsychiatr Dis Treat. 2016 Aug 31;12:2189–2198. doi: 10.2147/NDT.S82864.This article was found to have plagiarized the content of:Low-energy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal injury published in the Journal of Neurosurgery in 2014 (J Neurosurg. 121: 1514–1525, 2014.Accordingly, Dr Pinder, Editor-in-Chief of Neuropsychiatric Disease and Treatment has decided to issue a Retraction notice and advise the academic supervisors of Dr Wang et al of this matter. This Retraction relates to

  3. Treatment Outcomes of Corticosteroid Injection and Extracorporeal Shock Wave Therapy as Two Primary Therapeutic Methods for Acute Plantar Fasciitis: A Prospective Randomized Clinical Trial.

    Science.gov (United States)

    Mardani-Kivi, Mohsen; Karimi Mobarakeh, Mahmoud; Hassanzadeh, Zabihallah; Mirbolook, Ahmadreza; Asadi, Kamran; Ettehad, Hossein; Hashemi-Motlagh, Keyvan; Saheb-Ekhtiari, Khashayar; Fallah-Alipour, Keyvan

    2015-01-01

    The outcome of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of acute plantar fasciitis has been debated. The purpose of the present study was to evaluate and compare the therapeutic effects of CSI and ESWT in patients with acute ( .05). Both ESWT and CSI can be used as the primary and/or initial treatment option for treating patients with acute plantar fasciitis; however, the CSI technique had better therapeutic outcomes.

  4. Effect of a Single Administration of Focused Extracorporeal Shock Wave in the Relief of Delayed-Onset Muscle Soreness: Results of a Partially Blinded Randomized Controlled Trial.

    Science.gov (United States)

    Fleckenstein, Johannes; Friton, Mara; Himmelreich, Heiko; Banzer, Winfried

    2017-05-01

    To examine the effects of a single administration of focused extracorporeal shock wave therapy on eccentric exercise-induced delayed-onset muscle soreness (DOMS). Three-arm randomized controlled study. University research center. Participants (N=46; 23 women) had a mean age of 29.0±3.0 years and a mean body mass index of 23.8±2.8kg/m(2). Participants were randomly allocated to verum- (energy flux density, .06-.09mJ/mm(2); pulse ratio per point, 200) or sham-focused extracorporeal shock wave therapy (no energy) at 7 equidistant points along the biceps muscle or no intervention. The primary outcome was the difference in pain intensity. Secondary outcomes included maximum isometric voluntary force (MIVF), pressure pain threshold (PPT), and impairment in daily life. Despite descriptive clinically meaningful differences, mixed-effects analysis (group × time) of changes to baseline did not reveal significant differences in the reduction of pain intensity between groups (F2,42=2.5, P=.094). MIVF was not significantly different between groups (F2,43=1.9, P=.159). PTT (F2,43=0.2, P=.854) and daily life impairment (F2,42=1.4, P=.248) were not significantly decreased over time, and there were no differences between groups in the post hoc analysis. DOMS is a common symptom in people participating in exercise, sports, or recreational physical activities. A single treatment with focused extracorporeal shock wave therapy causes clinically relevant effects in the relief of pain, increase in force, and improvement of pain-associated impairments of daily living. Still, results need to be cautiously interpreted because of the pilot character of this study. Focused extracorporeal shock wave therapy might present an option in the midterm recovery from DOMS (72h) and be an approach to enhance the return to play in athletes. Copyright © 2017. Published by Elsevier Inc.

  5. Awake extracorporeal membrane oxygenation (ECMO) as bridge to recovery after left main coronary artery occlusion: a promising concept of haemodynamic support in cardiogenic shock.

    Science.gov (United States)

    Alozie, Anthony; Kische, Stephan; Birken, Thomas; Kaminski, Alexander; Westphal, Bernd; Nöldge-Schomburg, Gabriele; Ince, Hüseyin; Steinhoff, Gustav

    2014-10-01

    Cardiogenic shock following acute myocardial infarction is associated with high mortality rate. Different management concepts including fluid management, inotropic support, intra aortic balloon counterpulsation (IABP) and extracorporeal membrane oxygenation (ECMO) mainly in mechanically ventilated patients have been used as cornerstones of management. However, success rates have been disappointing. Few reports suggested that ECMO when performed under circumvention of mechanical ventilation, may offer some survival benefits. We herein present our experience with the use of veno-arterial ECMO as bridge to recovery in an awake and spontaneously breathing patient after left main coronary artery occlusion complicated by cardiogenic shock.

  6. Extracorporeal shock wave lithotripsy of urinary calculi. Results from the first 306 patients treated at the Copenhagen Municipal Stone Center with a second generation lithotriptor

    DEFF Research Database (Denmark)

    Andersen, J T; Mogensen, P

    1991-01-01

    The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments...... were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29...

  7. Medication-induced Takotsubo Cardiomyopathy presenting with cardiogenic shock-utility of extracorporeal membrane oxygenation (ECMO): case report and review of the literature.

    Science.gov (United States)

    Rojas-Marte, Geurys; John, Jinu; Sadiq, Adnan; Moskovits, Norbert; Saunders, Paul; Shani, Jacob

    2015-01-01

    Takotsubo cardiomyopathy (TTC) is a transient condition that affects the myocardium and is seen mostly in post-menopausal women secondary to an emotional or physical stressor; however, certain drugs have been described as cause of this syndrome. We report the case of a young female with medication--induced TTC, who presented with cardiogenic shock as initial manifestation, treated successfully with extracorporeal membrane oxygenation (ECMO). To our knowledge, this is the first case in the literature describing the use of ECMO in cardiogenic shock due to medication-induced TTC.

  8. Immediate Dose-Response Effect of High-Energy Versus Low-Energy Extracorporeal Shock Wave Therapy on Cutaneous Microcirculation.

    Science.gov (United States)

    Kraemer, Robert; Sorg, Heiko; Forstmeier, Vinzent; Knobloch, Karsten; Liodaki, Eirini; Stang, Felix Hagen; Mailaender, Peter; Kisch, Tobias

    2016-12-01

    Elucidation of the precise mechanisms and therapeutic options of extracorporeal shock wave therapy (ESWT) is only at the beginning. Although immediate real-time effects of ESWT on cutaneous hemodynamics have recently been described, the dose response to different ESWT energies in cutaneous microcirculation has never been examined. Thirty-nine Sprague-Dawley rats were randomly assigned to three groups that received either focused high-energy shock waves (group A: total of 1000 impulses, 10 J) to the lower leg of the hind limb, focused low-energy shock waves (group B: total of 300 impulses, 1 J) or placebo shock wave treatment (group C: 0 impulses, 0 J) using a multimodality shock wave delivery system (Duolith SD-1 T-Top, Storz Medical, Tägerwilen, Switzerland). Immediate microcirculatory effects were assessed with the O2C (oxygen to see) system (LEA Medizintechnik, Giessen, Germany) before and for 20 min after application of ESWT. Cutaneous tissue oxygen saturation increased significantly higher after high-energy ESWT than after low-energy and placebo ESWT (A: 29.4% vs. B: 17.3% vs. C: 3.3%; p = 0.003). Capillary blood velocity was significantly higher after high-energy ESWT and lower after low-energy ESWT versus placebo ESWT (group A: 17.8% vs. group B: -22.1% vs. group C: -5.0%, p = 0.045). Post-capillary venous filling pressure was significantly enhanced in the high-energy ESWT group in contrast to the low-energy ESWT and placebo groups (group A: 25% vs. group B: 2% vs. group C: -4%, p = 0.001). Both high-energy and low-energy ESWT affect cutaneous hemodynamics in a standard rat model. High-energy ESWT significantly increases parameters of cutaneous microcirculation immediately after application, resulting in higher tissue oxygen saturation, venous filling pressure and blood velocity, which suggests higher tissue perfusion with enhanced oxygen saturation, in contrast to low-energy as well as placebo ESWT. Low-energy ESWT also increased tissue oxygen

  9. Extracorporeal shock wave therapy in orthopedics, basic research, and clinical implications

    Science.gov (United States)

    Hausdorf, Joerg; Jansson, Volkmar; Maier, Markus; Delius, Michael

    2005-04-01

    The molecular events following shock wave treatment of bone are widely unknown. Nevertheless patients with osteonecrosis and non unions are already treated partly successful with shock waves. Concerning the first indication, the question of the permeation of the shock wave into the bone was addressed. Therefore shockwaves were applied to porcine femoral heads and the intraosseous pressure was measured. A linear correlation of the pressure to the intraosseous distance was found. Approximately 50% of the pressure are still measurable 10 mm inside the femoral head. These findings should encourage continued shock wave research on this indication. Concerning the second indication (non union), osteoblasts were subjected to 250 or 500 shock waves at 25 kV. After 24, 48, and 72 h the levels of the bone and vascular growth factors bFGF, TGFbeta1, and VEGF were examined. After 24 h there was a significant increase in bFGF levels (pshock wave treatment and may lead to a more specific application of shock waves in orthopedic surgery.

  10. Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum.

    Science.gov (United States)

    Oktaş, Birhan; Orhan, Zafer; Erbil, Barış; Değirmenci, Erdem; Ustündağ, Nil

    2014-01-01

    The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n=10) was identified as control group. In the second group (n=10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n=9), periosteum was left intact and ESWT was applied. In the forth group (n=8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically. In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums. According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.

  11. Extracorporeal Shock Wave Treatment (ESWT improves in vitro functional activities of ruptured human tendon-derived tenocytes.

    Directory of Open Access Journals (Sweden)

    Laura Leone

    Full Text Available In vitro models of human tenocytes derived from healthy as well as from ruptured tendons were established, characterized and used at very early passage (P1 to evaluate the effects of Extracorporeal Shock Wave Treatment (ESWT. The molecular analysis of traditional tenocytic markers, including Scleraxis (Scx, Tenomodulin (Tnm, Tenascin-C (Tn-C and Type I and III Collagens (Col I and Col III, permitted us to detect in our samples the simultaneous expression of all these genes and allowed us to compare their levels of expression in relationship to the source of the cells and treatments. In untreated conditions, higher molecular levels of Scx and Col I in tenocytes from pathological compared to healthy samples have been detected, suggesting--in the cells from injured tendon--the natural trigger of an early differentiation and repairing program, which depends by Scx and requires an increase in collagen expression. When ESWT (at the dose of 0.14 mJ/mm(2 was applied to cultured tenocytes explanted from injured source, Scx and Col I were significantly diminished compared to healthy counterpart, indicating that such natural trigger maybe delayed by the treatment, in order to promote cellular repair. Herein, we show for the first time that ESWT enhances in vitro functional activities of ruptured tendon-derived tenocytes, such as proliferation and migration, which could probably contributes to tendon healing in vivo.

  12. Extracorporeal Shock Wave Therapy Versus Trigger Point Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum.

    Science.gov (United States)

    Hong, Jin Oh; Park, Joon Sang; Jeon, Dae Geun; Yoon, Wang Hyeon; Park, Jung Hyun

    2017-08-01

    To compare the effectiveness of extracorporeal shock wave therapy (ESWT) and trigger point injection (TPI) for the treatment of myofascial pain syndrome in the quadratus lumborum. In a retrospective study at our institute, 30 patients with myofascial pain syndrome in the quadratus lumborum were assigned to ESWT or TPI groups. We assessed ESWT and TPI treatment according to their affects on pain relief and disability improvement. The outcome measures for the pain assessment were a visual analogue scale score and pain pressure threshold. The outcome measures for the disability assessment were Oswestry Disability Index, Roles and Maudsley, and Quebec Back Pain Disability Scale scores. Both groups demonstrated statistically significant improvements in pain and disability measures after treatment. However, in comparing the treatments, we found ESWT to be more effective than TPI for pain relief. There were no statistically significant differences between the groups with respect to disability. Compared to TPI, ESWT showed superior results for pain relief. Thus, we consider ESWT as an effective treatment for myofascial pain syndrome in the quadratus lumborum.

  13. Combined endoscopic and extracorporeal shock-wave treatment in difficult bile duct stones: early and long-term results.

    Science.gov (United States)

    Testoni, P A; Lella, F; Masci, E; Bagnolo, F; Colombo, E; Tittobello, A

    1994-01-01

    Endoscopic papillosphincterotomy (EPT) has become a well-established therapeutic procedure in the management of common bile duct stones; however, in difficult cases with large stones or anatomic conditions limiting the amplitude of the sphincteric section, the procedure may fail. In these cases, the association with extracorporeal shock-wave lithotripsy (ESWL) has proved to be helpful. Twenty out of 21 patients in whom the endoscopic approach failed because of the presence of large stones in the biliary tree (15 cases) or anatomic conditions (5 cases) underwent ESWL treatment. Stone fragmentation was achieved in 18 of the 20 treated patients (90%), with spontaneous clearing of the fragments in 10 patients after ESWL sessions and in another 2 patients within three months. In 6 cases the residual fragments were extracted by means of endoscopy. The combined procedures were therefore successful in all the 18 cases in which stone fragmentation was obtained. Complications occurred in two cases after ESWL treatment (asymptomatic pancreatic reaction and severe bleeding from the papillary area). Clinical, ultrasound and biochemical evaluations at 6 and 12 months documented a normal condition in all but two treated subjects.

  14. High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.

    Science.gov (United States)

    Bannuru, Raveendhara R; Flavin, Nina E; Vaysbrot, Elizaveta; Harvey, William; McAlindon, Timothy

    2014-04-15

    Calcific and noncalcific tendinitis of the shoulder can be unresponsive to conventional therapies. Extracorporeal shock-wave therapy (ESWT) has been suggested as an alternative treatment. To assess the efficacy of ESWT in patients with calcific and noncalcific tendinitis. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Google Scholar were searched up to 1 November 2013. Randomized, controlled trials (RCTs) comparing high-energy versus low-energy ESWT or placebo for treatment of calcific or noncalcific tendinitis of the shoulder. Outcome measures included pain (visual analogue scale score), functional assessment (Constant-Murley score), and resolution of calcifications. Three independent reviewers abstracted data and determined eligibility and quality by consensus. Twenty-eight RCTs met the inclusion criteria. Studies were heterogeneous. Twenty RCTs compared ESWT energy levels and placebo and consistently showed that high-energy ESWT was significantly better than placebo in decreasing pain and improving function and resorption of calcifications in calcific tendinitis. No significant difference was found between ESWT and placebo in treatment of noncalcific tendinitis. The number of RCTs was small, and the studies were heterogeneous. High-energy ESWT is effective for improving pain and shoulder function in chronic calcific shoulder tendinitis and can result in complete resolution of calcifications. This therapy may be underutilized for a condition that can be difficult to manage. None.

  15. A comparison of the effectiveness of extracorporeal shock wave and ultrasound therapy in the management of heel pain

    Science.gov (United States)

    Cheing, G. L. Y.; Chang, H.; Lo, S. K.

    2007-11-01

    The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and ultrasound therapy (US) for managing heel pain. Thirty-seven subjects received either: ESWT (once a week), US (three times a week), or CONTROL (no treatment) for 3 consecutive weeks and were followed-up for 3 more weeks. A visual analogue scale (VAS), the maximum tolerable duration for prolonged walking or standing, and the Mayo clinical scoring system (MCSS) were evaluated. Mixed models treating baseline measures as covariates were adopted for statistical analysis. By week 3, intensity of heel pain on palpation was reduced by 37% (VAS score from 7.5 to 4.6) in the ESWT group, 24% (from 5.3 to 4.2) in the US group, and increased by 3% (5.6-5.7) in the control group; this difference was significant after adjusting for baseline VAS scores ( p = 0.022). The improvements in the maximum tolerable duration of prolonged walking or standing was only significant in the ESWT group (157% increase, p = 0.043) but not the other two groups. Both active treatment groups maintained the treatment effect at the three-week follow-up. We conclude that ESWT is potentially more effective in reducing heel pain than ultrasound therapy but additional evidence is needed due to the various limitations of the study.

  16. Complications of Extracorporeal Shock Wave Lithotripsy for Urinary Stones: To Know and to Manage Them—A Review

    Directory of Open Access Journals (Sweden)

    Alessandro D’Addessi

    2012-01-01

    Full Text Available To identify the possible complications after extracorporeal shock wave lithotripsy (SWL and to suggest how to manage them, the significant literature concerning SWL treatment and complications was analyzed and reviewed. Complications after SWL are mainly connected to the formation and passage of fragments, infections, the effects on renal and nonrenal tissues, and the effects on kidney function. Each of these complications can be prevented adopting appropriate measures, such as the respect of the contraindications and the recognition and the correction of concomitant diseases or infection, and using the SWL in the most efficient and safe way, tailoring the treatment to the single case. In conclusion, SWL is an efficient and relatively noninvasive treatment for urinary stones. However, as with any other type of therapy, some contraindications and potential complications do exist. The strictness in following the first could really limit the onset and danger of the appearance of others, which however must be fully known so that every possible preventive measure be implemented.

  17. Extracorporeal Shock Wave Therapy reduces upper limb spasticity and improves motricity in patients with chronic hemiplegia: a case series.

    Science.gov (United States)

    Troncati, Franco; Paci, Matteo; Myftari, Tefta; Lombardi, Bruna

    2013-01-01

    Extracorporeal Shock Wave Therapy (ESWT) has been proposed for treatment of abnormal muscle tone only in the last years. The effects on motor impairment are unknown. To assess the long-term effects of ESWT on muscle tone and motricity in upper limb in patients with chronic hemiplegia. Twelve patients were selected and treated with two sessions of ESWT. Participants were assessed at baseline, after the treatment, and at 3 and 6 months. Muscle tone of shoulder adductors, elbow, wrist and finger flexors was evaluated at all assessment points using the Modified Ashworth Scale (MAS), while motricity, passive range of motion (PROM) and pain sub-scores of upper extremity part of the Fugl-Meyer scale were used to assess motor recovery. The degree of perceived benefit from treatment was assessed on a visual analogue scale. MAS showed a significant reduction of spasticity and Fugl-Meyer scores improved immediately after treatment. Persistent effects were observed at 3 and 6 months for MAS, and for motricity and PROM subscores of the Fugl-Meyer scale. Clinical improvement was not correlated to the patients' perceived benefit. Two sessions of ESWT seem to have long-term effects in reducing muscle tone and enhancing motor impairment.

  18. Treatment of Kidney Stones Using Extracorporeal Shock Wave Lithotripsy (ESWL and Double-J Stent in Infants

    Directory of Open Access Journals (Sweden)

    Mehdi Younesi Rostami

    2012-01-01

    Full Text Available Background. Extracorporeal shock wave lithotripsy (ESWL has progressively acquired popularity as being the gold standard treatment for upper urinary tract lithiasis in infants since 1980. Our aim was to evaluate the outcome of ESWL for kidney stones and the use of double-J stent in infants. Material and Methods. A prospective clinical trial study performed on 50 infants with renal calculi at pelvic admitted in the Urology ward of Shafa Hospital, Sari, Iran, between 2001 and 2010. Main outcome measure of our study was clearing stones after one or more consecutive sessions of ESWL. Results. The study included 50 patients with renal calculi at pelvic. Among them, there were 35 (70% boys and 15 (30% girls with the age ranging from 1 to 13 months (mean of 7 month ± 3 days. All of them were treated by standard ESWL using Simons Lithostor plus machine. The stone sizes ranged from 6 mm to 22 mm. Double-J stents were placed in 11 infants (22% with stones larger than 13 mm. Most of the patients required only one ESWL session. Conclusion. Since there were no complications following ESWL treatment, we can conclude that, in short term, ESWL is an effective and safe treatment modality for renal lithiasis in infants. In addition, we recommend double-J stent in infants with stones larger than 13 mm.

  19. Impact of extracorporeal shock waves on the human skin with cellulite: A case study of an unique instance

    Science.gov (United States)

    Kuhn, Christoph; Angehrn, Fiorenzo; Sonnabend, Ortrud; Voss, Axel

    2008-01-01

    In this case study of an unique instance, effects of medium-energy, high-focused extracorporeal generated shock waves (ESW) onto the skin and the underlying fat tissue of a cellulite afflicted, 50-year-old woman were investigated. The treatment consisted of four ESW applications within 21 days. Diagnostic high-resolution ultrasound (Collagenoson) was performed before and after treatment. Directly after the last ESW application, skin samples were taken for histopathological analysis from the treated and from the contra-lateral untreated area of skin with cellulite. No damage to the treated skin tissue, in particular no mechanical destruction to the subcutaneous fat, could be demonstrated by histopathological analysis. However an astounding induction of neocollageno- and neoelastino-genesis within the scaffolding fabric of the dermis and subcutis was observed. The dermis increased in thickness as well as the scaffolding within the subcutaneous fat-tissue. Optimization of critical application parameters may turn ESW into a noninvasive cellulite therapy. PMID:18488890

  20. [Experience of the use of extracorporeal shock wave therapy in the treatment of category III B chronic prostatitis].

    Science.gov (United States)

    Kernesiuk, M N; Prouza, Onrej

    2013-01-01

    The randomized controlled study was aimed to the evaluation of the efficacy of extracorporeal shock wave therapy (ESWT) compared with drug treatment in patients with chronic prostatitis category IIIB. The study included 30 patients with category IIIB chronic prostatitis (CP IIIB), divided into two groups of 15 subjects. In group 1, prostate ESWT was used as monotherapy, in the group 2--only drug treatment. The impact was carried on the perineal region using standard radial ESWT device. The procedure was performed 1 time per week for 4 weeks according to the accepted protocol. All patients completed the treatment at outpatient settings. Control examinations of 30 patients were performed at 1, 2, 4 and 12 weeks after treatment. Efficacy was evaluated using the NIH-CPSI score. All patients in group 1 had a statistically significant reduction in pain intensity and improvement of quality of life compared with group 2. The study showed that prostate ESWT is a simple and effective method of treatment of CP IIIB not accompanied by the development of side effects.

  1. Pheochromocytoma-Induced Inverted Takotsubo-Like Cardiomyopathy Leading to Cardiogenic Shock Successfully Treated With Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Flam, Benjamin; Broomé, Michael; Frenckner, Björn; Bränström, Robert; Bell, Max

    2015-09-01

    Pheochromocytoma classically displays a variety of rather benign symptoms, such as headache, palpitations, and sweating, although severe cardiac manifestations have been described. We report a case of pheochromocytoma-induced inverted takotsubo-like cardiomyopathy leading to shock and cardiac arrest successfully treated with extracorporeal membrane oxygenation (ECMO) as a bridge to pharmacological therapy and curative adrenalectomy. A previously healthy 46-year-old woman presented to the emergency department with abdominal pain, dyspnea, nausea, and vomiting. Clinical evaluation revealed cardiorespiratory failure with hypoxia and severe metabolic acidosis. Computed tomography (CT) scan showed pulmonary edema and a left adrenal mass. Transthoracic echocardiography (TTE) displayed severe left ventricular dysfunction with inverted takotsubo contractile pattern. Despite mechanical ventilation and inotropic and vasopressor support, asystolic cardiac arrest ensued. The patient was resuscitated using manual chest compressions followed by venoarterial ECMO. Repeated TTEs demonstrated resolution of the cardiomyopathy within a few days. Laboratory results indicated transient renal and hepatic dysfunction, and CT scan of the brain displayed occipital infarctions. Biochemical testing and radionuclide scintigraphy confirmed a pheochromocytoma. Pharmacological adrenergic blockade was instituted prior to delayed adrenalectomy after which the diagnosis was histopathologically verified. The patient recovered after rehabilitation. We conclude that pheochromocytoma should be considered in patients presenting with unexplained cardiovascular compromise, especially if they display (inverted) takotsubo contractile pattern. Timely, adequate management might involve ECMO as a bridge to pharmacological therapy and curative surgery.

  2. Effect of Extracorporeal Shock Wave Treatment on Deep Partial-Thickness Burn Injury in Rats: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gabriel Djedovic

    2014-01-01

    Full Text Available Extracorporeal shock wave therapy (ESWT enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N=15, but not to group 2 (N=15. On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P<0.05. The reepithelialization rate was improved significantly on day 15 (P<0.05. The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.

  3. Effect of extracorporeal shock wave treatment on deep partial-thickness burn injury in rats: a pilot study.

    Science.gov (United States)

    Djedovic, Gabriel; Kamelger, Florian Stefan; Jeschke, Johannes; Piza-Katzer, Hildegunde

    2014-01-01

    Extracorporeal shock wave therapy (ESWT) enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N = 15), but not to group 2 (N = 15). On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P < 0.05). The reepithelialization rate was improved significantly on day 15 (P < 0.05). The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.

  4. Early effects of extracorporeal shock wave treatment on osteoblast-like cells: a comparative study between electromagnetic and electrohydraulic devices.

    Science.gov (United States)

    Martini, Lucia; Giavaresi, Gianluca; Fini, Milena; Borsari, Veronica; Torricelli, Paola; Giardino, Roberto

    2006-11-01

    Extracorporeal shockwave therapy (ESWT) has been increasingly applied to treat orthopedic and musculoskeletal pathologies. ESWT involves mechanical perturbations that, as with other physical therapies, can result in mechanical stimuli to a large number of cells, including bone cells. The aim of this study was to evaluate the effects of shock waves on osteoblast-like cells (MG63) when using two different generators of shock waves (electrohydraulic and electromagnetic devices), in terms of cell damage, cell viability, osteogenic phenotype expression, and cytokine production. MG63 cells were suspended in 1.5 mL screw-cap cryotubes (1 x 10 cells/mL), containing phosphate buffer solution (PBS), which were maintained at 37 degrees C during all the experimental times. Two levels of energy flux density (EFD) were evaluated for each device: 0.15 to 0.18 mJ/mm2 and 0.40 mJ/mm2. Cells were then cultivated for 72 hours starting from a concentration of 1 x 10 cells/mL, and biological activity and viability were evaluated 24 and 72 hours after treatment. The results obtained demonstrate that the factors most affecting osteoblast activity involve both the device and the level of EFD selected, and they must be considered all together. The use of the electromagnetic device and a level of EFD lower than 0.40 mJ/mm2 would appear to induce fewer immediate cytodestructive effects and better stimulate subsequent proliferation and the synthetic activity of MG63.

  5. Does extracorporeal shock wave therapy enhance healing of osteochondritis dissecans of the rabbit knee?: a pilot study.

    Science.gov (United States)

    Lyon, Roger; Liu, Xue Cheng; Kubin, Martin; Schwab, Joseph

    2013-04-01

    Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the healing process in OCD lesions. We asked whether ESWT would enhance articular cartilage quality, bone and cartilage density, and histopathology of osteochondral lesions compared to nontreated controls in an OCD rabbit model. We harvested a 4-mm-diameter plug of the weightbearing osteochondral surface on the medial femoral condyle of each knee in 20 skeletally immature (8-week-old) female rabbits. We placed a piece of acellular collagen-glycosaminoglycan matrix into the cavity and then replaced the plug. Two weeks after surgery, we sedated each rabbit and treated the right knee in a single setting with shock waves: 4000 impulses at 4 Hz and 18 kV. The left knee was a sham control. Ten weeks after surgery, we assessed cartilage morphology of the lesion using a modified Outerbridge Grading System, bone and cartilage density using histologic imaging, bone and cartilage morphology using the histopathology assessment system, and radiographic bone density and union and compared these parameters between ESWT-treated and control knees. Histologically, we observed more mature bone formation and better healing (1.1 versus 3.4) and density of the cartilage (60 versus 49) on the treated side. Radiographically, we noted an increase in bony density (154 versus 138) after ESWT. ESWT accelerated the healing rate and improved cartilage and subchondral bone quality in the OCD rabbit model. This therapeutic modality may be applicable in OCD treatment in the pediatric population. Future research will be necessary to determine whether it may play a role in healing of human osteochondral defects.

  6. Extracorporeal shock-wave therapy for chronic lateral tennis elbow--prediction of outcome by imaging.

    Science.gov (United States)

    Maier, M; Steinborn, M; Schmitz, C; Stäbler, A; Köhler, S; Veihelmann, A; Pfahler, M; Refior, H J

    2001-07-01

    Today the clinical use of extracorporeal shockwave application (ESWA) for the treatment of lateral tennis elbow is hampered by the lack of results from randomized controlled trials and of predictive parameters of clinical outcome. The present prospective study aimed to provide the latter by means of magnetic resonance imaging (MRI). Twenty-three female and 19 male patients with unilateral chronic tennis elbow of the dominant site were clinically examined before and after repetitive low-energy ESWA. MRI was performed before ESWA to evaluate signal intensity changes or contrast enhancement of the common extensor tendon and the lateral epicondyle. After ESWA (mean follow-up period 18.6 months for all patients), clinical evaluation showed a significantly better mean clinical performance after ESWA than before treatment. Interestingly, male patients showed a significantly better mean clinical performance after ESWA than female patients, and male and female patients differed significantly in the signal intensity of the common extension tendon cross-section and tendon thickening on MRI. For female patients, MRI scans could be applied for predicting a positive clinical outcome of ESWA. This study reports the first indication of predictability of positive clinical outcome of the treatment of chronic lateral tennis elbow by ESWA using imaging prior to treatment. This may serve as an important step towards overcoming the therapeutic nihilism with respect to the non-operative management of this condition recently in the literature.

  7. Comparison of CME/shock propagation models with heliospheric imaging and in situ observations

    CERN Document Server

    Zhao, Xinhua; Inhester, Bernd; Feng, Xueshang; Wiegelmann, Thomas; Lu, Lei

    2016-01-01

    The prediction of the arrival time for fast coronal mass ejections (CMEs) and their associated shocks is highly desirable in space weather studies. In this paper, we use two shock propagation models, i.e. Data Guided Shock Time Of Arrival (DGSTOA) and Data Guided Shock Propagation Model (DGSPM), to predict the kinematical evolution of interplanetary shocks associated with fast CMEs. DGSTOA is based on the similarity theory of shock waves in the solar wind reference frame, and DGSPM on the non-similarity theory in the stationary reference frame. The inputs are the kinematics of the CME front at the maximum speed moment obtained from the geometric triangulation method applied to STEREO imaging observations together with the Harmonic Mean approximation. The outputs provide the subsequent propagation of the associated shock. We apply these models to the CMEs on 2012 January 19, January 23, and March 7. We find that the shock models predict reasonably well the shock's propagation after the impulsive acceleration. ...

  8. Extracorporeal Membrane Oxygenation as a Bridge for Heart Failure and Cardiogenic Shock

    OpenAIRE

    Zhao-peng Zhong; Hong Wang; Xiao-tong Hou

    2016-01-01

    Heart failure (HF) can be defined as cardiac structural or functional abnormality leading to a series of symptoms due to deficiency of oxygen delivery. In the clinical practice, acute heart failure (AHF) is usually performed as cardiogenic shock (CS), pulmonary edema, and single or double ventricle congestive heart failure. CS refers to depressed or insufficient cardiac output (CO) attributable to myocardial infarction, fulminant myocarditis, acute circulatory failure attributable to intracta...

  9. Effect of Diuretics on Ureteral Stone Therapy with Extracorporeal Shock Wave Lithotripsy

    Directory of Open Access Journals (Sweden)

    Zomorrodi A

    2008-01-01

    Full Text Available To evaluate the effect of diuretics on ureteral stone fragmentation and clearance during therapy with extra corporeal shock wave lithotripsy (ESWL, we studied 87 patients with ureteral stone at different levels and treated with ESWL. The patients were randomized into two groups treated by standard ESWL; the treatment protocol included 3500 shock wave per patient in each session, energy of the shock in two groups was 13 to 9 kv per patient, and the number of sessions was 3 per patient. The first group included 43 patients who received only ESWL, while the second group of 44 patients received as well 40 mg of furosemide. Stone fragmentation rate was 81% and 93.1% and stone clearance rate was 68.2% and 88.4% for the first and the second groups, respectively. With diuretics, fragmentation was18.8% more in the middle ureteral stones, 16.9% more in the upper tract stones, and 5.4% more in the distal stones. Moreover, clearance of fragmented stones was 38%, 28%, 15.4% more at middle and upper and distal ureteral stone, respectively. We conclude that the stone fragmentation and clearance were higher with ESWL and diuretics than without diuresis. Diuresis is safe and has some advantage at increasing the effect of ESWL on ureteral stones especially the middle ureteral calculi.

  10. Extracorporeal shock-wave lithotripsy: a comparative study of electrohydraulic and electromagnetic units.

    Science.gov (United States)

    Matin, S F; Yost, A; Streem, S B

    2001-12-01

    We determined the results of shock wave lithotripsy with a newer electromagnetic lithotriptor and compared them with those in a contemporary series of cases managed by an electrohydraulic lithotriptor using identical treatment and followup criteria at a single center. Between 1995 and 1999, 356 patients (375 renal units, 483 upper urinary tract stones) meeting study inclusion criteria were treated with an MFL 5000 electrohydraulic shock wave lithotripsy unit (Dornier Medical Systems, Inc., Marietta, Georgia). From 1999 to 2000, 173 patients (175 renal units; 218 upper urinary tract stones) meeting identical study inclusion criteria were treated using an electromagnetic Modulith SLX shock wave lithotripsy unit (Karl Storz Lithotripsy, Atlanta, Georgia). In each group stone-free results were determined by plain abdominal x-ray and renal ultrasound 1 month after lithotripsy and efficiency quotients were developed. Baseline patient and stone characteristics were compared by the Wilcoxon rank sum and Fisher exact tests. All variables significant at p electromagnetic lithotripsy units (0.45 and 0.42, respectively, p = 0.43). Electrohydraulic lithotripsy resulted in a higher stone-free rate at 1 month, although it was associated with a higher rate of auxiliary measures. Ultimately the efficiency quotients were equivalent, implying that these 2 contemporary energy sources are acceptable. According to single center treatment and followup criteria they are equally efficacious.

  11. A prospective, randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow.

    Science.gov (United States)

    Crowther, M A A; Bannister, G C; Huma, H; Rooker, G D

    2002-07-01

    We undertook a prospective, randomised study to compare the analgesic effect of injection of steroid and of extracorporeal shock-wave therapy (ESWT) for the treatment of tennis elbow. Group 1 received a single injection of 20 mg of triamcinolone with lignocaine while group 2 received 2000 shock waves in three sessions at weekly intervals. After six weeks there was a significant difference between the groups with the mean pain score for the injection group falling from 66 to 21 compared with a decrease from 61 to 35 in the shock-wave group (p = 0.05). After three months, 84% of patients in group 1 were considered to have had successful treatment compared with 60% in group 2. In the medium term local injection of steroid is more successful and 100 times less expensive than ESWT in the treatment of tennis elbow.

  12. Development of a novel miniature detonation-driven shock tube assembly that uses in situ generated oxyhydrogen mixture

    Science.gov (United States)

    Janardhanraj, S.; Jagadeesh, G.

    2016-08-01

    A novel concept to generate miniature shockwaves in a safe, repeatable, and controllable manner in laboratory confinements using an in situ oxyhydrogen generator has been proposed and demonstrated. This method proves to be more advantageous than existing methods because there is flexibility to vary strength of the shockwave, there is no need for storage of high pressure gases, and there is minimal waste disposal. The required amount of oxyhydrogen mixture is generated using alkaline electrolysis that produces hydrogen and oxygen gases in stoichiometric quantity. The rate of oxyhydrogen mixture production for the newly designed oxyhydrogen generator is found to be around 8 ml/s experimentally. The oxyhydrogen generator is connected to the driver section of a specially designed 10 mm square miniature shock tube assembly. A numerical code that uses CANTERA software package is used to predict the properties of the driver gas in the miniature shock tube. This prediction along with the 1-D shock tube theory is used to calculate the properties of the generated shockwave and matches reasonably well with the experimentally obtained values for oxyhydrogen mixture fill pressures less than 2.5 bars. The miniature shock tube employs a modified tri-clover clamp assembly to facilitate quick changing of diaphragm and replaces the more cumbersome nut and bolt system of fastening components. The versatile nature of oxyhydrogen detonation-driven miniature shock tube opens up new horizons for shockwave-assisted interdisciplinary applications.

  13. Extracorporeal shock wave therapy reverses ischemia-related left ventricular dysfunction and remodeling: molecular-cellular and functional assessment.

    Directory of Open Access Journals (Sweden)

    Morgan Fu

    Full Text Available An optimal treatment for patients with diffuse obstructive arterial disease unsuitable for catheter-based or surgical intervention is still pending. This study tested the hypothesis that extracorporeal shock wave (ECSW therapy may be a therapeutic alternative under such clinical situation. Myocardial ischemia was induced in male mini-pigs through applying an ameroid constrictor over mid-left anterior descending artery (LAD. Twelve mini-pigs were equally randomized into group 1 (Constrictor over LAD only and group 2 (Constrictor over LAD plus ECSW [800 impulses at 0.09 mJ/mm(2] once 3 months after the procedure. Results showed that the parameters measured by echocardiography did not differ between two groups on days 0 and 90. However, echocardiography and left ventricular (LV angiography showed higher LV ejection fraction and lower LV end-systolic dimension and volume in group 2 on day 180 (p<0.035. Besides, mRNA and protein expressions of CXCR4 and SDF-1α were increased in group 2 (p<0.04. Immunofluorescence staining also showed higher number of vWF-, CD31-, SDF-1α-, and CXCR4-positive cells in group 2 (all p<0.04. Moreover, immunohistochemical staining showed notably higher vessel density but lower mean fibrosis area, number of CD40-positive cells and apoptotic nuclei in group 2 (all p<0.045. Mitochondrial protein expression of oxidative stress was lower, whereas cytochrome-C was higher in group 2 (all p<0.03. Furthermore, mRNA expressions of MMP-9, Bax and caspase-3 were lower, whereas Bcl-2, eNOS, VEGF and PGC-1α were higher in group 2 (all p<0.01. In conclusion, ECSW therapy effectively reversed ischemia-elicited LV dysfunction and remodeling through enhancing angiogenesis and attenuating inflammation and oxidative stress.

  14. Outcome of Extracorporeal Shock Wave Therapy for Insertional Achilles Tendinopathy with and without Haglund’s Deformity

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    Ziying Wu

    2016-01-01

    Full Text Available Purpose. To compare the results of extracorporeal shock wave therapy (ESWT for insertional Achilles tendinopathy (IAT with or without Haglund’s deformity. Methods. Between September 2014 and May 2015, all patients who underwent ESWT were retrospectively enrolled in this study. A total of 67 patients were available for follow-up and assigned into nondeformtiy group (n=37 and deformtiy group (n=30. Clinical outcomes were evaluated by VISA-A Score and 6-point Likert scale. Results. The VISA-A score increased in both groups, from 49.57±9.98 at baseline to 83.86±8.59 at 14.5±7.2 months after treatment in nondeformity group (P<0.001 and from 48.70±9.38 at baseline to 67.78±11.35 at 15.3±6.7 months after treatment in deformity group (P<0.001. However, there was a greater improvement in VISA-A Score for the nondeformity group compared with deformity group (P=0.005. For the 6-point Likert scale, there were decreases from 3.92±0.80 at baseline to 1.57±0.73 at the follow-up time point in nondeformity group (P<0.001 and from 4.0±0.76 at baseline to 2.37±1.03 at the follow-up time point in deformity group (P<0.001. There was no significant difference in improvement of the 6-point Likert scale between both groups (P=0.062. Conclusions. ESWT resulted in greater clinical outcomes in patients without Haglund’s deformity compared with patients with Haglund’s deformity.

  15. What is the impact of extracorporeal shock wave lithotripsy on semen parameters? A systematic review and meta-analysis.

    Science.gov (United States)

    Radfar, Mohammad H; Simforoosh, Nasser; Sotoudeh, Mehdi; Ramezani, Mehdi H; Mollakoochakian, Mohammad J; Nikravesh, Maryam; Shemshaki, Hamidreza

    2017-02-03

    Extracorporeal shock wave lithotripsy (ESWL) is an important tool for the management of urolithiasis. The effects of shockwaves on tissues are established. The aim of this meta-analysis is to evaluate the microscopic semen characteristics of young men before and after ESWL treatment for lower ureteral calculi. Literature searches were performed following the Cochrane guidelines. We conducted a systematic review and meta-analysis that included six trials that investigated the effects of ESWL on semen parameters, including sperm concentration, motility, and hematospermia. Meta-analyses were performed using fixed and random-effects models with tests for publication bias and heterogeneity. Significant worsening was detected in sperm concentration and motility after ESWL between case and control groups (mean difference -17.23, 95% confidence interval -22.53 to -11.93, p<0.00001, mean difference -10.82, 95% confidence interval -18.56 to -3.07, p = 0.006). Rate of microscopic and macroscopic hematospermia was significantly higher after ESWL between case and control groups [risk ratio (RR) 40.00, 95% confidence interval 10.11-158.30, p<0.00001, RR 14.33, 95% confidence interval 2.82-72.90, p = 0.001]. All parameters recovered after 3 months. This study showed sperm concentration, motility, and rate of hematospermia (microscopic and macroscopic) were affected by ESWL that was used for the treatment of lower ureteral stone. Long-term studies with a focus on male fertility (i.e., pregnancy rates) after ESWL are warranted.

  16. Extracorporeal Shock Wave Treatment (ESWT) enhances the in vitro-induced differentiation of human tendon-derived stem/progenitor cells (hTSPCs).

    Science.gov (United States)

    Leone, Laura; Raffa, Salvatore; Vetrano, Mario; Ranieri, Danilo; Malisan, Florence; Scrofani, Cristina; Vulpiani, Maria Chiara; Ferretti, Andrea; Torrisi, Maria Rosaria; Visco, Vincenzo

    2016-02-09

    Extracorporeal shock wave therapy (ESWT) is a non-invasive and innovative technology for the management of specific tendinopathies. In order to elucidate the ESWT-mediated clinical benefits, human Tendon-derived Stem/Progenitor cells (hTSPCs) explanted from 5 healthy semitendinosus (ST) and 5 ruptured Achilles (AT) tendons were established. While hTSPCs from the two groups showed similar proliferation rates and stem cell surface marker profiles, we found that the clonogenic potential was maintained only in cells derived from healthy donors. Interestingly, ESWT significantly accelerated hTSPCs differentiation, suggesting that the clinical benefits of ESWT may be ascribed to increased efficiency of tendon repair after injury.

  17. Clinical Research of Extracorporeal Shock Wave Therapy for the Treatment of Bone Nonunion%体外冲击波治疗骨不连临床研究

    Institute of Scientific and Technical Information of China (English)

    李恩; 李平; 韩永斌; 刘宇强; 范晓洁; 赵爱玲

    2016-01-01

    Objective:To observe the clinical curative effect of extracorporeal shock wave treatment (ESWT)of different time points on bone nonunion.Method:21 patients with bone nonunion undergoing extracorporeal shock wave treatment in our hospital from 2010 to 2015 were selected as the research objects. 11 patients 3 to 6 months after operation were selected as group A,10 patients 7 to 10 months after operation were selected as group B.They were all treated by focused extracorporeal shock wave therapy with personalized treatment parameters.They were regularly reviewed X-ray.The treatment effects were compared between the two groups.Result:The differences in scores of callus and fracture line of different time points inner the two groups were statistically significant(P<0.001).The differences in scores of callus and fracture line of different time points between the two groups were statistically significant(P<0.05).Conclusion:Extracorporeal shock wave treatment for bone nonunion is safe and effective,the effect of early intervention is better.%目的:观察不同时间体外冲击波疗法(ESWT)治疗骨不连的临床疗效。方法:收集本院2010-2015年收治的采用ESWT治疗骨不连的患者21例作为研究对象,以术后3~6个月患者为A组,以术后7~10个月患者为B组,两组均采用聚焦式体外冲击波机治疗,个性化确定治疗参数。定期复查X片,分析比较两组治疗效果。结果:两组组内不同时间骨痂及骨折线评分比较,差异均有统计学意义(P<0.001);两组组间不同时间骨痂及骨折线评分比较,差异均有统计学意义(P<0.05);骨痂及骨折线评分估算边际均值A组较B组上升趋势更明显。结论:ESWT治疗骨不连安全、有效,早期进行干预效果更佳。

  18. Experience with extracorporeal shock wave therapy (ESWT) in the United States

    Science.gov (United States)

    Furia, John P.

    2005-04-01

    The purpose of this presentation is to summarize the literature and to report on single treatment, high-energy ESWT for the treatment of chronic plantar fasciitis and lateral epicondylitis. Fifty-three patients (60 heels) were treated with 3800 shock waves. Sixteen patients (19 heels) were active, 21 (22 heels), were moderately active, and 16 (19 heels) were sedentary. Twelve weeks post treatment, mean visual analog scores (VAS) for the entire group improved from 9.2 to 2.4 (pepicondylitis were treated with 3200 shock waves. There were 9 workers compensation and 27 non-workers compensation patients. Twelve weeks post treatment, the mean VAS for the entire group improved from 8.0 to 2.5 (pelbows (77.8%) were assigned an excellent or good result. In both trials, outcome was similar for each subgroup. There were no significant complications in either trial. Using the therapeutic parameters applied, ESWT is a safe and effective treatment for chronic plantar fasciitis and lateral epicondylitis.

  19. Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome: a prospective, randomized and sham-controlled study

    Institute of Scientific and Technical Information of China (English)

    ZENG Xiao-yong; LIANG Chen; YE Zhang-qun

    2012-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum,pelvis,suprapubic area,or external genitalia and variable degrees of voiding and ejaculatory disturbance.The analgesic effect of extracorporeal shock wave treatment (ESWT) was an interesting phenomenon with an unclear mechanism discovered by chance in the applications for urolithiasis,on which ESWT has become an increasingly popular therapeutic approach as an alternative option for the treatment of a number of soft tissue complaints.In this study,we aimed to evaluate the feasibility and efficacy of ESWT in non-inflammatory (ⅢB) CP/CPPS.Methods Men diagnosed with ⅢB CP/CPPS were randomized to either ESWT (group 1,n=40) or the control (group 2,n=40).Group 1 received 20 000 shock wave impulses in 10 sessions over a two-week period,whereas group 2 received only a sham procedure.The total scores and sub-domain scores of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for both groups were assessed at baseline,mid-treatment,end-point,and 4-week and 12-week follow-up visits.Results The mean total NIH-CPSI score of group 1 was significantly decreased from baseline at all post-treatment time points (P <0.01 for all).Decreases in pain domain and quality of life (QOL) scores were also significant.In group 2,no significant decreases of total NIH-CPSI score and pain domain score were found at all post-treatment time points.At the end-point of treatment,71.1% of group 1 exhibited perceptible improvement in total NIH-CPSI compared with 27.0% of group 2 (P <0.001); additionally,28.9% of group 1 exhibited clinically significant improvement compared with 10.8% of group 2 (P <0.01).Moreover,a greater number of patients in group 1 at 4-week and 12-week follow-up were rated as responders (perceptible and clinically significant response) compared with group 2.Conclusion ESWT exhibits a potentially therapeutic

  20. PROSPECTIVE STUDY TO COMPARE THE EFFICACY OF ANALGESIC AGENTS USED FOR THE PAIN MANAGEMENT DURING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

    Directory of Open Access Journals (Sweden)

    Abhirudra

    2016-05-01

    Full Text Available BACKGROUND Extracorporeal shock wave lithotripsy (ESWL is well known for its non-invasiveness, effectiveness and minimal morbidity for the management of renal stones. Some generation of lithotripters were associated with significant pain, needing anaesthesia. In modern lithotripters, pain is insignificant making lithotripsy an outpatient procedure (day care. AIMS The present study is aimed to compare the clinical efficacy between four drugs. METHODS AND MATERIALS This was a prospective study of 1000 patients with normal BMI (25-30 who underwent ESWL in the Year 2012-15 at our institute. All the patients with renal stones were randomly divided into 4 groups. Dornier Compact Sigma lithotripsy machine was used in all the patients. Group A was given IM diclofenac sodium (1 mg/kg, 60 minutes before the procedure. In group B, 10 g of EMLA cream; and in group C, 15 g of diclofenac diethylamine gel; in group D placebo (electrode gel was applied locally. STATISTICAL ANALYSIS Visual analogue scale (VAS was used to assess the severity of pain for initial 5-10 minutes and after the procedure. A P value of less than 0.05 was considered to be statistically significant. Statistical analysis was done using one way ANOVA and results were compared between four groups. RESULTS All four groups were having comparable age, weight, stone size, number of shock waves delivered and maximum voltage used. In group A total 250 patients (M/F: 177/73, group B 250 patients (M/F: 129/121, group C 250 patients (M/F: 158/92, group D 250 patients (M/F: 162/88. With regard to pain scores, the responses were better in group B. According to location of the stones, majority of the stones were located in pelvis (41.5%, followed by upper (30.5% and middle calyx (16.8% and least in the lower calyx (11.2%. Overall stone free rate in our study was 75.5%, with least clearance in lower calyceal stones. 112 patients were stented prior to the procedure. Ureteroscopy and RIRS (Retrograde

  1. Short-term mechanical circulatory support by veno-arterial extracorporeal membrane oxygenation in the management of cardiogenic shock and end-stage heart failure.

    Science.gov (United States)

    Brugts, Jasper J; Caliskan, Kadir

    2014-02-01

    Despite modern treatment modalities, cardiogenic shock is associated with a very high risk of mortality and morbidity. The short- and long-term survival in patients with cardiogenic shock or end-stage heart failure has improved considerably by recent technological advances in short and long-term mechanical circulatory support devices. For short-term mechanical support, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used as bridge-to-decision and bridge-to-recovery in cardiogenic shock patients. Long-term mechanical circulatory support devices such as left ventricular assist devices (LVADs) are widely available and play a central role in bridge-to-transplantation in those eligible for heart transplantation (HTX) and as destination therapy (DT) in those not eligible for heart transplantation. Nevertheless, patients with critical cardiogenic shock show a deleterious outcome after LVAD-implantation or HTX with higher mortality, more complications and higher burden on financial resources. These considerations underscore the importance of optimal timing and appropriate patient selection for eventual LVAD therapy. The current report will focus on the immediate management of patients with cardiogenic shock with inotropes, discuss the use of IABP and focus mainly on pivotal choices to be made in the period spanned by short term mechanical circulatory support in patients with refractory cardiogenic shock.

  2. A comparative study of artificial neural network and multivariate regression analysis to analyze optimum renal stone fragmentation by extracorporeal shock wave lithotripsy

    Directory of Open Access Journals (Sweden)

    Goyal Neeraj

    2010-01-01

    Full Text Available To compare the accuracy of artificial neural network (ANN analysis and multi-variate regression analysis (MVRA for renal stone fragmentation by extracorporeal shock wave lithotripsy (ESWL. A total of 276 patients with renal calculus were treated by ESWL during December 2001 to December 2006. Of them, the data of 196 patients were used for training the ANN. The predictability of trained ANN was tested on 80 subsequent patients. The input data include age of patient, stone size, stone burden, number of sittings and urinary pH. The output values (predicted values were number of shocks and shock power. Of these 80 patients, the input was analyzed and output was also calculated by MVRA. The output values (predicted values from both the methods were compared and the results were drawn. The predicted and observed values of shock power and number of shocks were compared using 1:1 slope line. The results were calculated as coefficient of correlation (COC (r2 . For prediction of power, the MVRA COC was 0.0195 and ANN COC was 0.8343. For prediction of number of shocks, the MVRA COC was 0.5726 and ANN COC was 0.9329. In conclusion, ANN gives better COC than MVRA, hence could be a better tool to analyze the optimum renal stone fragmentation by ESWL.

  3. Extracorporeal shock wave lithotripsy for cystine urolithiasis in children: outcome and complications.

    Science.gov (United States)

    Slavković, Andjelka; Radovanović, Miladin; Sirić, Zlatko; Vlajković, Marina; Stefanović, Vladisav

    2002-01-01

    The Siemens Lithostar Litotriptor was used to treat 6 children with cystine nephrolithiasis, previously treated by open surgery. Five children had renal calculi (3 multiple caliceal, 2 pelvis) and one had ureteral calculus. Stone size ranged from 0.2-2.5 cm in diameter, and stone burden was from 0.24 to 10.81 cm3 per kidney. From one to 4 ESWL sessions per unit were applied, with a total of 1,800 to 12,000 shock waves. The stone free rate at 3 months was 50%. A complete elimination was obtained with cystine stones in renal pelvis and ureter, however, up to 4 ESWL treatments failed in caliceal stones. Rather location of cystine calculi than previous surgery was associated with ESWL success rate. Two patients with positive urine cultures were successfully treated with appropriate antibiotics before ESWL was attempted. Perirenal hematoma was major complication demonstrated by radionuclide scintigraphy in one patient, and resolved spontaneously by 3 months. In the combined treatment of cystine urolithiasis in children ESWL, as auxillary procedure, was safe and effective in pelvis stone but failed in caliceal stones. Medical dissolution for retained fragments was found effective.

  4. A modified regimen of extracorporeal cardiac shock wave therapy for treatment of coronary artery disease

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    Wang Yu

    2012-08-01

    Full Text Available Abstract Background Cardiac shock wave therapy (CSWT improves cardiac function in patients with severe coronary artery disease (CAD. We aimed to evaluate the clinical outcomes of a new CSWT treatment regimen. Methods The 55 patients with severe CAD were randomly divided into 3 treatment groups. The control group (n = 14 received only medical therapy. In group A ( n = 20, CSWT was performed 3 times within 3 months. In group B ( n = 21, patients underwent 3 CSWT sessions/week, and 9 treatment sessions were completed within 1 month. Primary outcome measurement was 6-minute walk test (6MWT. Other measurements were also evaluated. Results The 6MWT, CCS grading of angina, dosage of nitroglycerin, NYHA classification, and SAQ scores were improved in group A and B compared to control group. Conclusions A CSWT protocol with 1 month treatment duration showed similar therapeutic efficacy compared to a protocol of 3 months duration. Clinical trial registry We have registered on ClinicalTrials.gov, the protocol ID is CSWT IN CHINA.

  5. Extracorporeal shock wave therapy for non-unions and delayed fracture healing

    Science.gov (United States)

    Schaden, Wolfgang; Fischer, Andreas; Sailler, Andreas; Karadas, Ender

    2005-04-01

    Although the primary management of fractures is highly developed in Central Europe 1% of fractures develop a non-union. After successful pilot studies the Traumacenter Meidling started in December 1998 to treat non-unions regularly with shock wave therapy. From December 1998 to August 2004, 1153 patients with non-union and delayed healing fractures were treated. The results of 755 patients are available up to September 2004. The patients consisted of 250 (33%) female and 505 (67%) male. The mean age was 44.1 years (10; 90). The mean age of the non-union was 15.5 months. In 74 (10%) osteomyelitis was present before shockwave therapy. Out of 755 non-unions 593 (79%) achieved bony healing. As expected, the subgroup of 284 delayed unions (shockwave therapy 3-6 months after the trauma or the last surgery concerning the bone) showed the best results. 245 (86%) healed. Out of 471 non-unions being older than 6 months 348 (72%) achieved bony healing. Because of the efficacy and the lack of complications as well as the economic advantage in comparison to surgery, shockwave therapy is considered as therapy of first choice in the treatment of non-union and delayed healing fractures.

  6. Comparison of tamsulosin with extracorporeal shock wave lithotripsy in treating distal ureteral stones

    Institute of Scientific and Technical Information of China (English)

    ZHANG Meng-yuan; DING Sen-tai; L(U) Jia-ju; LUE Yan-he; ZHANG Hui; XIA Qing-hua

    2009-01-01

    Background Tamsulosin,an alpha-1 receptor antagonist,has been demonstrated effective in promoting distal ureteral stone passage and in reducing pain associated with stone expulsion.This study aimed to evaluate the effect of tamsulosin in comparison with nifedipine and extracerporeal shock wave lithotripsy (ESWL) on the expulsion rate of distal ureteral stones at different sizes.Methods We assigned 314 patients to three categories:Ⅰ,the stone with maximal diameter of 4.0-5.9 mm;Ⅱ,6.0-7.9mm,and Ⅲ,8.0-9.9 mm.Patients in each category were randomly subdivided into three treatment subgroups:group A (nifedipine group),group B (tamsulosin group),and group C (ESWL group).Stone-free rate and the dose of analgesics were recorded weekly during the 4-week follow-up period.Results Three hundred and three patients completed the study.The results showed that nifedipine and tamsulosin treatments promoted a small (4-8 mm,categories Ⅰ and Ⅱ) stone expulsive rate that was comparable with ESWL treatment.Nonetheless,when the stone diameter was 8.0-9.9 mm,ESWL showed a greater stone free rate than nifedipine and tamsulosin treatments;no significant difference existed between the latter two therapies.Although the ESWL treatment group required the least analgesics,tamsulosin treatments required less pain medication than nifedipine (P <0.05).Conclusions Tamsulosin treatment is recommended for patients with the stone diameter smaller than 8 mm because of its feasibility,effectiveness and safety.ESWL is more appropriate than tamsulosin therapy for the patients whose stones are larger than 8 mm.

  7. On the interplanetary evolution of CME-driven shocks: a comparison between remote sensing observations and in-situ data

    Science.gov (United States)

    Volpes, Laura; Bothmer, Volker

    2015-08-01

    Fast coronal mass ejections (CMEs) are a prime driver of major space weather effects and strong geomagnetic storms. When the CME propagation speed is higher than the Alfvén speed a shock forms in front of the CME leading edge. CME-driven shocks are observed in in-situ data and, with the advent of increasingly sensitive imaging instruments, also in remote sensing observations in the form of bright fronts ahead of the CMEs.In this work we present the study of 4 Earth-directed CMEs which drove shocks detected in STEREO COR 2 and HI observations. For each event we identify the source region and the signatures of CME eruption such as waves, EUV dimmings, flare and prominence eruptions. The shock and CME interplanetary evolution is determined from COR2 and HI observations via an application of triangulation techniques. Furthermore, propagation speed and arrival times are inferred. The CME geometry is modelled in COR2 via the graduated cylindrical shell (GCS) model and the assumption on self-similar expansion is tested by expanding the flux rope to the HI1 field of view. A combination of these results with models for the shock location allows to infer the time evolution of the compression ratio ρd/ρu across the shock and of the upstream Mach number M at locations where no direct plasma measurements are available. These values, as well as the arrival time and speed, are compared to ACE in-situ measurements to validate the results. For the 03 April 2010 event, e.g., the values of the Mach number and the compression ratio extrapolated to the position of ACE are respectively 2.1 situ values found in literature, ρd/ρu = 2.84 and M = 2.2. This study is carried out in conjunction to simulations of CME initiation. Combined results from observations and simulations allow to connect the interplanetary and near-Earth properties of CMEs to those of their source regions, and to the mechanisms of CME onset.

  8. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study

    Institute of Scientific and Technical Information of China (English)

    Yong Wook Kim; Ji Cheol Shin; Jeong-Gyu Yoon; Yong-Kyun Kim; Sang Chul Lee

    2013-01-01

    Background There are not many studies about treatment of shoulder spasticity.Although botulinum toxin injection has been reported to be effective for shoulder spasticity,the effectiveness was judged by pain and limited motion change,but not the spasticity itself.Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder.However,the subscapularis muscle,unlike the pectoralis major muscle,is located deep beneath scapula,where conventional injection is difficult to perform.As extracorporeal shock wave therapy (ESWT) has been reported to be effective for spasticity relief,and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment.This study was to evaluate the beneficial effects of radial ESWT (rESWT) on spastic subscapularis muscle in stroke patients.Methods This is an uncontrolled,prospective,unicenter,clinical pilot study.Stroke patients (n=57; mean age 55.4years) with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital.rESWT was administered to each patient every two or three days for two weeks (five total treatments).Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks.Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale (MAS),and passive range of motion (ROM) of the shoulder in external rotation was recorded.Pain was measured using a visual analogue scale (VAS) during passive ROM of the shoulder in external rotation,and was additionally recorded for patients who preserved cognitive and communicative ability (Pain group).Results Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline.The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the

  9. Comparison of extracorporeal shock wave lithotripsy running models between outsourcing cooperation and rental cooperation conducted in Taiwan.

    Science.gov (United States)

    Liu, Chih-Kuang; Ko, Ming-Chung; Chen, Shiou-Sheng; Lee, Wen-Kai; Shia, Ben-Chang; Chiang, Han-Sun

    2015-02-01

    We conducted a retrospective study to compare the cost and effectiveness between two different running models for extracorporeal shock wave lithotripsy (SWL), including the outsourcing cooperation model (OC) and the rental cooperation model (RC). Between January 1999 and December 2005, we implemented OC for the SWL, and from January 2006 to October 2011, RC was utilized. With OC, the cooperative company provided a machine and shared a variable payment with the hospital, according to treatment sessions. With RC, the cooperative company provided a machine and received a fixed rent from the hospital. We calculated the cost of each treatment session, and evaluated the break-even point to estimate the lowest number of treatment sessions to make the balance between revenue and cost every month. Effectiveness parameters, including the stone-free rate, the retreatment rate, the rate of additional procedures and complications, were evaluated. Compared with OC there were significantly less treatment sessions for RC every month (42.6±7.8 vs. 36.8±6.5, p=0.01). The cost of each treatment session was significantly higher for OC than for RC (751.6±20.0 USD vs. 684.7±16.7 USD, p=0.01). The break-even point for the hospital was 27.5 treatment sessions/month for OC, when the hospital obtained 40% of the payment, and it could be reduced if the hospital got a greater percentage. The break-even point for the hospital was 27.3 treatment sessions/month for RC. No significant differences were noticed for the stone-free rate, the retreatment rate, the rate of additional procedures and complications. Our study revealed that RC had a lower cost for every treatment session, and fewer treatment sessions of SWL/month than OC. The study might provide a managerial implication for healthcare organization managers, when they face a situation of high price equipment investment. Copyright © 2012. Published by Elsevier B.V.

  10. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study.

    Science.gov (United States)

    Kim, Yong Wook; Shin, Ji Cheol; Yoon, Jeong-Gyu; Kim, Yong-Kyun; Lee, Sang Chul

    2013-01-01

    There are not many studies about treatment of shoulder spasticity. Although botulinum toxin injection has been reported to be effective for shoulder spasticity, the effectiveness was judged by pain and limited motion change, but not the spasticity itself. Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder. However, the subscapularis muscle, unlike the pectoralis major muscle, is located deep beneath scapula, where conventional injection is difficult to perform. As extracorporeal shock wave therapy (ESWT) has been reported to be effective for spasticity relief, and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment. This study was to evaluate the beneficial effects of radial ESWT (rESWT) on spastic subscapularis muscle in stroke patients. This is an uncontrolled, prospective, unicenter, clinical pilot study. Stroke patients (n = 57; mean age 55.4 years) with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital. rESWT was administered to each patient every two or three days for two weeks (five total treatments). Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks. Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale (MAS), and passive range of motion (ROM) of the shoulder in external rotation was recorded. Pain was measured using a visual analogue scale (VAS) during passive ROM of the shoulder in external rotation, and was additionally recorded for patients who preserved cognitive and communicative ability (Pain group). Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline. The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the

  11. In-situ Raman spectroscopy and high-speed photography of a shocked triaminotrinitrobenzene based explosive

    Science.gov (United States)

    Saint-Amans, C.; Hébert, P.; Doucet, M.; de Resseguier, T.

    2015-01-01

    We have developed a single-shot Raman spectroscopy experiment to study at the molecular level the initiation mechanisms that can lead to sustained detonation of a triaminotrinitrobenzene-based explosive. Shocks up to 30 GPa were generated using a two-stage laser-driven flyer plate generator. The samples were confined by an optical window and shock pressure was maintained for at least 30 ns. Photon Doppler Velocimetry measurements were performed at the explosive/window interface to determine the shock pressure profile. Raman spectra were recorded as a function of shock pressure and the shifts of the principal modes were compared to static high-pressure measurements performed in a diamond anvil cell. Our shock data indicate the role of temperature effects. Our Raman spectra also show a progressive extinction of the signal which disappears around 9 GPa. High-speed photography images reveal a simultaneous progressive darkening of the sample surface up to total opacity at 9 GPa. Reflectivity measurements under shock compression show that this opacity is due to a broadening of the absorption spectrum over the entire visible region.

  12. Extracorporeal shock wave therapy in patients with plantar fasciitis. A randomized, placebo-controlled trial with ultrasonographic and subjective outcome assessments

    Directory of Open Access Journals (Sweden)

    Babak Vahdatpour

    2012-01-01

    Full Text Available Background and Aim: Results of previous studies have been conflicting on the efficacy of extracorporeal shock wave therapy (ESWT in the treatment of plantar fasciitis. We evaluated the effects of ESWT on plantar fasciitis in terms of ultrasonographic and subjective evaluations. Materials and Methods: In this randomized placebo-controlled trial, patients with plantar fasciitis were assigned to receive ESWT (4000 shock waves/session of 0.2 mJ/mm 2 in 3 sessions at weekly intervals or sham therapy (n = 20 in each group. Outcomes were documented by the ultrasonographic appearance of the aponeurosis and by patients′ pain scores, performed at baseline and 12 weeks after completion of the therapy. Results : The two groups were similar in baseline characteristics. Over the study period, plantar fascia thickness significantly reduced in the ESWT group (4.1 ± 1.3 to 3.6 ± 1.2 mm, P < 0.001, but slightly increased in the sham group (4.1 ± 0.8 to 4.5 ± 0.9 mm, P = 0.03. Both groups showed significant pain improvement over the course of the study (P < 0.001, though pain scores were significantly more reduced in the ESWT than the sham group (-4.2 ± 2.9 vs. -2.7 ± 1.8, P = 0.049. Conclusions: Extracorporeal shock wave therapy contributes to healing and pain reduction in plantar fasciitis and ultrasound imaging is able to depict the morphologic changes related to plantar fasciitis as a result of this therapy.

  13. Extracorporeal Treatment for Metformin Poisoning

    DEFF Research Database (Denmark)

    Calello, Diane P; Liu, Kathleen D; Wiegand, Timothy J

    2015-01-01

    BACKGROUND: Metformin toxicity, a challenging clinical entity, is associated with a mortality of 30%. The role of extracorporeal treatments such as hemodialysis is poorly defined at present. Here, the Extracorporeal Treatments In Poisoning workgroup, comprising international experts representing...... diverse professions, presents its systematic review and clinical recommendations for extracorporeal treatment in metformin poisoning. METHODS: A systematic literature search was performed, data extracted, findings summarized, and structured voting statements developed. A two-round modified Delphi method......) and made the following recommendations: extracorporeal treatment is recommended in severe metformin poisoning (1D). Indications for extracorporeal treatment include lactate concentration greater than 20 mmol/L (1D), pH less than or equal to 7.0 (1D), shock (1D), failure of standard supportive measures (1D...

  14. Synchrotron radiation X-ray diffraction in situ study of fine-grained minerals in shock veins of Suizhou meteorite

    Institute of Scientific and Technical Information of China (English)

    XIE Xiande; SHU Jinfu; CHEN Ming

    2005-01-01

    The synchrotron radiation X-ray diffraction technique developed for in situ study at high pressure and temperature has also been used to investigate microscopic mineral inclusions in ultrahigh-pressure metamorphic rocks and deep-mantle samples. Present study added two more examples of successful utilization of synchrotron radiation X-ray diffraction technique for in situ investigations of fine-grained (0.5―30μm in size) minerals in very thin shock melt veins of the Suizhou meteorite: ( i ) X-ray diffraction measurement of extremely small-sized vein matrix minerals, and (ii) identification of the micron-sized new mineral tuite embedded in the vein matrix. It has been revealed that the fine-grained vein matrix consists of well crystallized garnet, kamacite and troilite, and the powder diffraction pattern consisting of 17 lines with d-values, intensities ( I ), relative intensities (I/Io) and Miller indices, as well as the cell parameters for the new mineral tuite has also been successfully obtained. The result of present investigations has enriched the content of dynamic high-pressure mineralogy and that of Earth's mantle geochemistry.

  15. Oldest biliary endoprosthesis in situ

    Science.gov (United States)

    Consolo, Pierluigi; Scalisi, Giuseppe; Crinò, Stefano F; Tortora, Andrea; Giacobbe, Giuseppa; Cintolo, Marcello; Familiari, Luigi; Pallio, Socrate

    2013-01-01

    The advantages of endoscopic retrograde cholangiopancreatography over open surgery have made it the predominant method of treating patients with choledocholithiasis. After sphincterotomy, however, 10%-15% of common bile duct stones cannot be removed with a basket or balloon. The methods for managing “irretrievable stones” include surgery, mechanical lithotripsy, intraductal or extracorporeal shock wave lithotripsy and biliary stenting. The case presented was a referred 82-year-old Caucasian woman with a 7-year-old plastic biliary endoprosthesis in situ. To the best of our knowledge the examined endoprosthesis is the oldest endoprosthesis in situ reported in the literature. Endoscopic biliary endoprosthesis placement remains a simple and safe procedure for patients with stones that are difficult to manage by conventional endoscopic methods and for patients who are unfit for surgery or who are high surgical risks. To date no consensus has been reached regarding how long a biliary prosthesis should remain in situ. Long-term biliary stenting may have a role in selected elderly patients if stones extraction has failed because the procedure may prevent stones impaction and cholangitis. PMID:23858381

  16. In situ plume radiance measurements from the bow shock ultraviolet 2 rocket flight

    Science.gov (United States)

    Erdman, Peter W.; Zipf, Edward C.; Espy, Patrick; Howlett, Carl; Christou, Carol; Levin, Deborah A.; Collins, Robert J.; Candler, Graham V.

    1993-10-01

    The ultraviolet spectrum (200-400 nm) of the plumes generated by the second- and third-stage engines of a Strypi XI rocket and of the Mach 17 re-entry bow shock were obtained by a sounding rocket experiment launched from the Barking Sands Research Range (Kauai, Hawaii) on February 18, 1991 at 14:30 GMT. The re-entry optical data were obtained as the payload descended from 120 to 65 km with a vehicle velocity of 5.1 km/s. The intensities of the vacuum ultraviolet resonance radiation emitted by atomic oxygen and hydrogen in the bow shock at 130.4 and 121.5 nm, respectively, were also measured. Complementary Langmuir probe measurements provided data on the total plasma density and electron temperature in the boundary layer.

  17. Cost-effectiveness of extracorporeal shock wave lithotripsy in a poor resource setting: The Okada, Nigeria experience

    Directory of Open Access Journals (Sweden)

    Kenneth C Eze

    2016-01-01

    Full Text Available Background: The first extracorporeal shock wave lithotripsy (ESWL used in Nigeria was at Igbinedion Hospital and Medical Research Centre (IHMRC, Okada in 1992 and it functioned for 6 consecutive years. The objectives of this study were to analyze the cost-effectiveness of the procedure and highlight the associated factors that led to its failure. Methods: A retrospective study of medical records and publications associated with the use of ESWL at IHMRC, Okada, for the period of 1992 to 1998. The study was conducted between January 2003 and November 2008. Unclassified authentic information relating to the use of ESWL and treatment of upper urinary tract stones was obtained from the IHMRC Okada and some government hospitals on hospital bills. Relevant documents in public domains related to the national and international wages and emoluments of medical workers and socioeconomic development of Nigeria within the time the ESWL functioned were studied. Result: A total of 32 patients were treated with 51 treatment sessions which is an average of nine patients per year and an average of two treatment sessions per patient were involved. The reasons for the low patronage were the extremely low stone formation rate of Nigerians, poverty, and out-of-pocket payment system. In addition, each treatment session of ESWL at Okada cost an average of $681.8 compared to $227.3 for open nephrolithotomy in a nearby high profile teaching hospital. The IHMRC, Okada, paid an average annual salary of ₦180,000 ($8,181.8 for each medical consultant compared to ₦120,000 ($5,454.5 paid by federal teaching hospitals in Nigeria within the period. Expatriate consultant doctors from Europe and USA who initially manned the lithotriptor at IHMRC, Okada, were paid much higher salaries. Average annual income of $5,909 for each of the 6 years amounting to a total of $34,771.7 for the six years was realized which could not maintain staff salaries in the hospital leading to staff

  18. 骨科体外冲击波疗法应用体会%Experience of application of orthopedic extracorporeal shock wave therapy

    Institute of Scientific and Technical Information of China (English)

    范晓洁; 李平; 李红; 张晋巧

    2011-01-01

    @@ 体外冲击波疗法(extracorporeal shock wave therapy,ESWT)是一种非侵入性治疗方法,用于治疗骨骼、肌肉系统疾病.该疗法具有病人不必住院、治疗后疼痛明显减低、无副反应、治疗风险低于外科手术、治愈率高等特点[1],被称为骨科疾病的绿色疗法.我科于2010年5月开展ESWT,共治疗病人229 例,临床效果满意.但在治疗过程中有一些问题需注意,现总结如下.

  19. Functional estimation of kidneys after extracorporeal shock wave therapy (ESWL) by clearance. Funktionsbeurteilung der Nieren nach extrakorporaler Stosswellenlithotripsie (ESWL) mittels Nieren-Clearance

    Energy Technology Data Exchange (ETDEWEB)

    Sydow, K.; Kirschner, P.; Brien, G.; Buchali, K.; Frenzel, R. (Humboldt-Universitaet, Berlin (Germany). Medizinische Fakultaet)

    1991-10-01

    35 patients were scintiscanned with 99m-Tc-DTPA to determine the effects of extracorporeal shock waves used to desintegrate renal concrements may have on the patients renal function. The therapy was conducted using a standard Lithostar unit (Siemens) (20 patients) and an additional overtable module (15 patients). Functional scintigraphy was performed using a gamma camera before lithotripsy, and on the first day after it. Further control investigations were performed one or two weeks later and two till six months later. In both groups most of the patients developed temporary restrictions in renal function, some of them irreversible restrictions. Functional losses were found to be less severe with the use of the overtable module than with the standard Lithostar unit. (orig.).

  20. Low Energy Extracorporeal Cardiac Shock Wave Therapy for Ischemic Heart Disease%低能量体外冲击波治疗缺血性心脏病

    Institute of Scientific and Technical Information of China (English)

    王蹿蹿; 谢华宁; 郭宏

    2009-01-01

    Ischemic heart disease is a leading cause of death. The low energy extracorporeal cardiac shock wave is a novel therapy which could improve symptoms and reduce nitroglycerin use for the patients of ischemia heart disease by upregulating mRNA expression of VEGF and its receptor Flt-1, improving myocardial perfusion and left ventricular remodeling.%缺血性心脏病是导致死亡的主要原因.低能量体外冲击波治疗可以通过增加血管内皮生长因子的mRNA的表达、增加心肌有效灌注和改善左室重塑,从而改善缺血性心脏病患者的症状,减少硝酸甘油的服用,达到治疗缺血性心脏病的目的.

  1. Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare

    Directory of Open Access Journals (Sweden)

    Darla K. Moser

    2017-05-01

    Full Text Available This report describes fibrous cyst lining injection and extracorporeal shock wave therapy (ESWT of a medial femoral condyle (MFC subchondral cystic lesion (SCL resulting in catastrophic MFC fracture in an Arabian mare. The mare was presented for evaluation of a severe hind limb lameness of approximately 4 months duration. On presentation, a non-weight bearing lameness of the left hind limb with severe effusion and soft tissue swelling of the stifle region was noted. Radiographic evaluation of the stifle revealed a large SCL of the MFC with associated osteoarthritis. Arthroscopic guided intra-lesional injection of the SCL with corticosteroids and autologous bone marrow concentrate was performed followed by ESWT of the MFC. The mare was discharged walking comfortably 48-hours post-operatively. An acute increase in lameness was noted 14 days post-operatively. Imaging revealed catastrophic fracture of the left MFC. Possible mechanisms leading to failure of the MFC secondary to the described treatment are discussed.

  2. The combination of extracorporeal shock wave therapy and noncontact apoptosis-inducing radiofrequency achieved significant waist circumferential reduction: a pilot study.

    Science.gov (United States)

    Kim, Hyeyeon

    2017-06-30

    A paradigm shift towards noninvasive body contouring has occurred over the past few years. Radiofrequency (RF) is one popular treatment method. Noncontact-type RF systems with frequencies in the tens of megahertz represent a novel approach. The current pilot study investigated the efficacy of an interesting combination of extracorporeal shock wave therapy (ESWT) and an apoptosis-inducing RF (AiRF) system for circumferential reduction. Twenty-seven females, ages ranging from 13-69 years, (mean age 37.96 years) participated in the study. They were assigned to two treatment-based groups: Group A (n=19) and Group B (n=8). A voluntary daily dietary restriction plan of 500 kcal was put in place for all subjects. A combination of two different devices was used; an extracorporeal shock wave therapy (ESWT) system and a 27.12 MHz AiRF system. Either 4 (n=28) or 6 sessions (n=19) were given, one week apart. In Group A, the ESWT was applied before the RF with the reverse order of application in Group B. Weight and waist circumference were noted at baseline, then one week after the 4(th) and the 6(th) treatment sessions at which points clinical photography was also obtained. All patients showed statistically significant waist circumferential loss in both the 4- and 6-week treated groups: Group A, 6.3 cm and 8.8 cm; Group B, 5.9 cm and 6.4 cm, respectively. Greater circumference loss tended to be seen in Group A in both groups, but without statistical significance. No patient complained of pain during or after the treatment sessions, and there were no adverse events. This pilot study showed that the combination of ESWT and AiRF was safe and effective for significant waist circumferential reduction. The results tended to be better when ESWT was applied before AiRF, although the difference was not significant.

  3. Embolisation of pheochromocytoma to stabilise and wean a patient in cardiogenic shock from emergency extracorporeal life support

    DEFF Research Database (Denmark)

    Vagner, Helle; Hey, Thomas Morris; Elle, Bo;

    2015-01-01

    Pheochromocytoma is a catecholamine-secreting tumour associated with varying symptoms ranging from episodic headache, sweating, paroxysmal hypertension and tachycardia to intractable cardiogenic shock. Cardiogenic shock is rare but well-described and the timing of correct management is crucial...

  4. Left anterior descending coronary artery blood flow and left ventricular unloading during extracorporeal membrane oxygenation support in a swine model of acute cardiogenic shock.

    Science.gov (United States)

    Brehm, Christoph; Schubert, Sarah; Carney, Elizabeth; Ghodsizad, Ali; Koerner, Michael; McCoach, Robert; El-Banayosy, Aly

    2015-02-01

    The impact of extracorporeal membrane oxygenation (ECMO) support on coronary blood flow and left ventricular unloading is still debated. This study aimed to further characterize the influence of ECMO on coronary artery blood flow and its ability to unload the left ventricle in a short-term model of acute cardiogenic shock. Seven anesthetized pigs were intubated and then underwent median sternotomy and cannulation for venoarterial (VA) ECMO. Flow in the left anterior descending (LAD) artery, left atrial pressure (LAP), left ventricular end-diastolic pressure (LVEDP), and mean arterial pressure (MAP) were measured before and after esmolol-induced cardiac dysfunction and after initiating VA-ECMO support. Induction of acute cardiogenic shock was associated with short-term increases in LAP from 8 ± 4 mm Hg to 18 ± 14 mm Hg (P = 0.9) and LVEDP from 5 ± 2 mm Hg to 13 ± 17 mm Hg (P = 0.9), and a decrease in MAP from 63 ± 16 mm Hg to 50 ± 24 mm Hg (P = 0.3). With VA-ECMO support, blood flow in the LAD increased from 28 ± 25 mL/min during acute unsupported cardiogenic shock to 67 ± 50 mL/min (P = 0.003), and LAP and LVEDP decreased to 8 + 5 mm Hg (P = 0.7) and 5 ± 3 mm Hg (P = 0.5), respectively. In this swine model of acute cardiogenic shock, VA-ECMO improved coronary blood flow and provided some degree of left ventricular unloading for the short duration of the study.

  5. Analysis of the safety profile of treatment with a large number of shock waves per session in extracorporeal lithotripsy.

    Science.gov (United States)

    Budía Alba, A; López Acón, J D; Polo-Rodrigo, A; Bahílo-Mateu, P; Trassierra-Villa, M; Boronat-Tormo, F

    2015-06-01

    To assess the safety of increasing the number of waves per session in the treatment of urolithiasis using extracorporeal lithotripsy. Prospective, comparative, nonrandomized parallel study of patients with renoureteral lithiasis and an indication for extracorporeal lithotripsy who were consecutively enrolled between 2009 and 2010. We compared group I (160 patients) treated on schedule with a standard number of waves/session (mean 2858,3±302,8) using a Dornier lithotripter U/15/50 against group II (172 patients) treated with an expanded number of waves/session (mean, 6728,9±889,6) using a Siemens Modularis lithotripter. The study variables were age, sex, location, stone size, number of waves/session and total number of waves to resolution, stone-free rate (SFR) and rate of complications (Clavien-Dindo classification). Student's t-test and the chi-squared test were employed for the statistical analysis. The total rate of complications was 11.9% and 10.46% for groups I and II, respectively (P=.39). All complications were minor (Clavien-Dindo grade I). The most common complications were colic pain and hematuria in groups I and II, respectively, with a similar treatment intolerance rate (P>.05). The total number of waves necessary was lower in group II than in group I (P=.001), with SFRs of 96.5% and 71.5%, respectively (P=.001). Treatment with an expanded number of waves per session in extracorporeal lithotripsy does not increase the rate of complications or their severity. However, it could increase the overall effectiveness of the treatment. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Effect of extracorporeal shock wave lithotripsy for the postoperative residual bilestone of choledocholithiasis%体外冲击波对胆总管术后残留结石的碎石效应

    Institute of Scientific and Technical Information of China (English)

    潘爱国; 张殿忠; 徐家宽; 宋东惠

    2002-01-01

    Objective To explore the effect of extracorporeal shock wave lithotripsy(ESWL) for the postoperative residual bilestone of choledocholithiasis.Method Inject contrast medium of biligrafin via T tube.After accurate apposition with X ray,take lithotripsy with extracorporeal shock wave. In some cases T tube washing and transcutaneous choledochoscope were used to take out bilestones.Results The lithotripsies were successful in all the 48 patients and the lithotriptic rate was 100% .The removing rate of bilestones was over 90% with washing method.Choledochoscope was used in 6 cases,and 48 patients were completely healed.In them 24 suffered from slight expanding pain in right upper abdomen or nausea and no any complications and sequelae in others.Conclusion ESWL is an effect method to heal patients with the postoperative residual bilestones of choledocholithiasis.

  7. Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis

    Directory of Open Access Journals (Sweden)

    Amir Moayednia

    2014-01-01

    Full Text Available Background: There is limited evidence about the chronic pelvic pain syndrome (CPPS treatment by shockwave therapy, and the aim of this study was to evaluate the effect of extracorporeal shockwave therapy on CPPS due to non bacterial prostatitis in a long-term period. Materials and Methods: In a follow-up survey, 40 patients with CPPS (that were randomly distributed into the treatment or sham groups were evaluated at 16, 20, and 24 weeks. In the treatment group, patients were treated by extracorporeal shock wave therapy (ESWT once a week for 4 weeks by a protocol of 3000 impulses, 0.25 mJ/m 2 and 3 Hz of frequency. 0.05 mJ/m 2 were added in each week. In the sham group, the same protocol was applied, but with the probe being turned off. The follow-up assessments were done by visual analog scale for pain and National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI. Data were compared using independent t-test or analysis of variences. Results: Three patients did not complete the study protocol, 37 patients were evlauated (19 patients in treatment and 18 patients in the sham group. At week 24, the mean of pain score, urinary score, quality-of-life and NIH-CPSI score between two groups were not statistically different. Conclusion: Although, ESWT therapy as a safe and effective therapy in CPPS in short-term follow-up has been established, its long-term efficacy was not supported by this study.

  8. Shock initiation sensitivity and Hugoniot-based equation of state of Composition-B obtained using in situ electromagnetic gauging

    Science.gov (United States)

    Gibson, L.; Dattelbaum, Dana; Bartram, Brian; Sheffield, Stephen; Gustavsen, Richard; Handley, Caroline; Shock and Detonation Physics Team; Explosives Modelling Team

    2013-06-01

    Composition-B (Comp-B) is a solid cast explosive comprised of 59.5 wt% cyclotrimethylene-trinitramine (RDX), 39.5 wt% 2,4,6-trinitrotoluene (TNT), and 1 wt% wax. Its initial density depends on formulation method and as a result, the detonation properties of Comp-B have generally been studied at densities of 1.69 g/cm3 and 1.72 g/cm3. The shock initiation sensitivity (Pop-plot) of Comp-B has been reported previously; obtained using both explosively-driven wedge tests and embedded manganin gauge techniques. We describe the results of a series of gas-gun-driven plate-impact initiation experiments on Comp-B (ρ0 = 1.72 g/cm3) using embedded electromagnetic gauges to obtain in situ particle velocity wave profiles at 10 Lagrangian positions in each experiment. From the wave profiles, an unreacted Hugoniot locus, the run-distance-to-detonation, and initiation waveforms are obtained in each experiment. The results indicate that Comp-B at ρ0 = 1.72 g/cm3 is more sensitive than reported previously. Comparisons are made of the new Hugoniot states with an earlier Hugoniot-based EOS. Measurements of the detonation wave profile using photonic Doppler velocimetry are also presented and discussed in the context of ZND detonation theory.

  9. Efficacy of Extracorporeal Shock Wave in the Treatment of Senile Knee Osteoarthritis%体外冲击波治疗老年膝关节骨性关节炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    王宏伟; 李宏儒; 梁丽荣

    2016-01-01

    目的:观察体外冲击波在老年膝关节骨性关节炎的临床应用疗效。方法选择2015年1~9月我院76例老年膝关节骨性关节炎患者行体外冲击波治疗。结果76例中有临床效果62例,其中2例痊愈、19例显效,41例有效,14例无效,有效率81.6%(62/76)。结论体外冲击波治疗膝关节骨性关节炎疗效确切。%Objective To observe the clinical application of extracorporeal shock wave in the elderly knee joint osteoarthritis.Methods Between January 2015 to September 2015,76 cases of extracorporeal shock wave therapy in elderly patients with knee osteoarthritis in our hospital.Results 76 cases with clinical effect of 62 cases,among them 2 cases,19 cases were cured,41 cases were effective,14 cases ineffective,the effective rate was 81.6%(62/76). Conclusion The curative effect is extracorporeal shock wave treatment of knee osteoarthritis.

  10. Is it possible to change of the duration of consolidation period in the distraction osteogenesis with the repetition of extracorporeal shock waves?

    Science.gov (United States)

    Bereket, Cihan; Sener, Ismail; Ozkan, Nilufer; Senel, Erman; Polat, Ahmet-Veysel

    2017-01-01

    Background In this study we examined the effects of two different repeated Extracorporeal Shock Waves (ESW) on the consolidation period of the distraction osteogenesis (DO) of the rabbit mandible using stereological, radiological and immunohistochemical methods. Material and Methods DO was performed unilaterally in the mandible of 18 New Zealand rabbits (six months old, weighing between 2.5-3 kg). In the consolidation period, rabbits were divided into three groups randomly after the distraction period. The distraction zone of the mandible was received no treatment as controls (E0*2). Group 2 (E 500*2) received ESWT (twice 500 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation. Group 3 (E1000*2) treated with ESWT (twice 1000 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation period. After the sacrification, radiologically bone mineral density, new bone formation, new fibrous tissue and new vessel formation were analyzed by stereological. Results It was found a statistically significant difference between the study groups and control group in the bone mineral density measurements and the highest value was in the E1000*2 group. In the stereological analysis, new bone formation was highest in the E1000*2 group and there was a significant difference compared to the other groups (E0*2 and E500*2) (p=0.000). The lowest connective tissue volume was found in the E500*2 and there was a significant difference compared to the other groups (E0*2 and E1000*2) (p=0.000). The volume of the new vessel was highest in the E500*2 and lowest in the E0*2 group. It was found statistically significant difference between the values of the study and control groups. Conclusions Interestingly, we found that repetition of the 1000 impulses ESWT accelerated the consolidation, 500 impulses ESWT extended consolidation period of the DO. Key words:Distraction osteogenesis, extracorporeal shock waves, stereology

  11. [Analgesic effect of low energy extracorporeal shock waves in tendinosis calcarea, epicondylitis humeri radialis and plantar fasciitis].

    Science.gov (United States)

    Maier, M; Dürr, H R; Köhler, S; Staupendahl, D; Pfahler, M; Refior, H J; Meier, M

    2000-01-01

    Is there a pain reduction at the application site after extracorporeal shockwave application for tendinitis calcarea, epicondylitis radialis and plantar fasziitis? In a prospective study 85 patients were observed. Shockwave application was performed three or five times using low energies (0.09-0.18 ml/mm2). Before and after shockwave application pain was evaluated using SF-36 score and Visual Analog Scale (VAS). After 5 months for all three indications a significant improvement of the pain situation could be reached. Patients with plantar fasziitis demonstrated the highest decrease of pain, followed by tendinosis calcarea and epicondylitis radialis. The number of applications had no influence to the clinical result of the ESWT. In the present study the analgetic effect of ESWT after repeated low-energy application was described for the standard indications.

  12. Extracorporeal shock wave therapy in the treatment of primary bone marrow edema syndrome of the knee: a prospective randomised controlled study.

    Science.gov (United States)

    Gao, Fuqiang; Sun, Wei; Li, Zirong; Guo, Wanshou; Wang, Weiguo; Cheng, Liming; Yue, Debo; Zhang, Nianfei; Savarin, Amanda

    2015-12-05

    The aim of this prospective study was to evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) in normalizing the symptoms and imaging features of primary bone marrow edema syndrome (BMES) of the knee. This study compared the outcomes of ESWT (Group A) (n = 20) and intravenously applied prostacyclin and bisphosphonate (Group B) (n = 20) in the treatment of BMES of the knee in our department between 2011 and 2013. The Visual Analog Scale for pain (VAS, 100 mm), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the SF-36 scores and MRI scans as well as plain radiographs were obtained before and after therapy between two groups. Compared with Group B, we found greater improvement in VAS, the WOMAC Osteoarthritis Index and SF-36 score at 1, 3 and 6 months post-treatment in Group A (P edema at 6 months in Group A (95 vs. 65 %; P = 0.018). The MRI at 1 year follow-up showed complete regression in all patients in Group A. However, two cases in Group B continued to normalize over the subsequent follow-up period. ESWT can produce rapid pain relief and functional improvement. It may be an effective, reliable, and non-invasive technique for rapid treatment of BMES of the knee. Research Registry UIN 528, September 03, 2015.

  13. Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial.

    Science.gov (United States)

    Kolk, A; Yang, K G Auw; Tamminga, R; van der Hoeven, H

    2013-11-01

    The aim of this study was to determine the effect of radial extracorporeal shock-wave therapy (rESWT) on patients with chronic tendinitis of the rotator cuff. This was a randomised controlled trial in which 82 patients (mean age 47 years (24 to 67)) with chronic tendinitis diagnosed clinically were randomly allocated to a treatment group who received low-dose rESWT (three sessions at an interval 10 to 14 days, 2000 pulses, 0.11 mJ/mm(2), 8 Hz) or to a placebo group, with a follow-up of six months. The patients and the treating orthopaedic surgeon, who were both blinded to the treatment, evaluated the results. A total of 44 patients were allocated to the rESWT group and 38 patients to the placebo group. A visual analogue scale (VAS) score for pain, a Constant-Murley (CMS) score and a simple shoulder test (SST) score significantly improved in both groups at three and six months compared with baseline (all p ≤ 0.012). The mean VAS was similar in both groups at three (p = 0.43) and six months (p = 0.262). Also, the mean CMS and SST scores were similar in both groups at six months (p = 0.815 and p = 0.834, respectively). It would thus seem that low-dose rESWT does not reduce pain or improve function in patients chronic rotator cuff tendinitis compared with placebo treatment.

  14. Extracorporeal shock wave therapy for non-calcific supraspinatus tendinitis - 10-year follow-up of a randomized placebo-controlled trial.

    Science.gov (United States)

    Efe, Turgay; Felgentreff, Markus; Heyse, Thomas J; Stein, Thomas; Timmesfeld, Nina; Schmitt, Jan; Roessler, Philip P

    2014-10-01

    Evidence for the efficacy of extracorporeal shock wave therapy (ESWT) in supraspinatus tendinopathy without calcification is sparse, and therefore this treatment option is often controversial. Patients of a randomized placebo-controlled study to analyze the effects of ESWT on function and pain were revisited 10 years after the initial consultation. The former verum group received 6000 impulses (energy flux density, 0.11 mJ/mm²) in three sessions after local anesthesia between 1999 and 2000. The placebo group had 6000 impulses of a sham ESWT after local anesthesia in the same period. Re-evaluation of the patients included a relative Constant score as well as pain measurements (visual analogue scale) during activity and at rest. No significant changes (p>0.05) in relative Constant scores, pain at rest, or pain during activity could be found after a 10-year follow-up between the placebo and verum groups after ESWT. The treatment of non-calcific supraspinatus tendinopathy with ESWT does not seem to have an effect on function or pain improvement in the long run. The results of the present study cannot advise the use of ESWT in cases of non-calcific supraspinatus tendinopathy.

  15. Effectiveness of oral litholysis therapy for improving glucose intolerance and malnutrition in patients with poor results following endoscopic therapy and extracorporeal shock wave lithotripsy for calcified pancreatic stones.

    Science.gov (United States)

    Ashizawa, Nobuo; Hamano, Koichi; Noda, Aiji

    2015-10-01

    We report a case of pancreatolithiasis in which glucose intolerance and malnutrition were significantly improved after starting oral litholysis therapy (OLT) with use of trimethadione. A 43-year-old female with multiple calcified stones in the main and peripheral pancreatic ducts had experienced recurrent and severe attacks of pain for 7 years (from 21 to28 years of age). Impaired glucose tolerance was first noted at the age of 32 years. We started OLT after interventional endoscopic therapy combined with extracorporeal shock wave lithotripsy failed because of kink and stenosis of the main pancreatic duct (MPD). Over the next 9 years, a significant decrease in total pancreatic calcified stone volume was shown by computer analysis of follow-up computed tomography images. Larger stones completely disappeared without attacks of pain. In addition, both glucose intolerance and insulin secretion were significantly ameliorated, followed by improvement of malnutrition. OLT may induce intraductal decompression by dissolving stones in the peripheral ducts as well as the MPD, with resulting preservation of endocrine function and improvement of malnutrition. Since the present results were obtained in a single case, further clinical trials are necessary to evaluate the value of performing OLT under various conditions to eliminate stones.

  16. Plain radiography, renography, and [sup 99m]Tc-DMSA renal scintigraphy before and after extracorporeal shock wave lithotripsy for urolithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Munck, O.; Gerquari, I.; Moeller, J.T.; Jensen, L.I.; Thomsen, H.S. (Dept. of Clinical Physiology, Dept. of Nuclear Medicine, Dept. of Diagnostic Radiology, Herlev Hospital, Copenhagen Univ. (Denmark))

    1992-11-01

    Eighteen patients were evaluated before and 5 weeks after the first treatment with extracorporeal shock wave lithotripsy (ESWL) using abdominal plain radiography, [sup 131]I-hippuran probe renography, and [sup 99m]Tc-dimercaptosuccinic acid scintigraphy. In 6 patients no urolithiasis was present on the post ESWL plain radiograph, in 7 the size had decreased, and in 5 the stone mass was unchanged. The renograms were within normal range in the 6 patients who were cured by ESWL, whereas this was the case for only 4 of the 12 who still had renal calculi. In 2 patients pelvic stones had descended into the ureter after ESWL, and the renograms indicated obstruction. Another 3 patients had ureteral stones, whereas in the remaining 7 patients only pelvic stones were found on the plain radiographs. In no patient did the scintigrams reveal scars. It is concluded that abdominal plain radiography of the urinary tract and probe renography are complementary and sufficient in the monitoring of patients with urolithiasis post ESWL. (orig.).

  17. 低能量体外冲击波用于痉挛治疗的研究%Advance in Extracorporeal Shock Wave Therapy for Hypertonia (review)

    Institute of Scientific and Technical Information of China (English)

    林歆; 丛芳; 李辰

    2012-01-01

    In recent 30 years, it was approved that extracorporeal shock wave (ESW) is effective on musculoskeletal disorders. Hyperto-nia is a common complication in patients suffered from central nervous system lesion. Recently, there were several literatures report hyperto-nia can be treated with ESW. This paper reviewed the research in basic principle of ESW and its use on hypertonia.%近30年来,大量研究证实体外冲击波在骨骼肌肉疾病治疗中的有效性.痉挛是中枢神经系统损伤的常见并发症.最近国外有研究报道低能量体外冲击波治疗可有效缓解痉挛.本文从体外冲击波的基本原理及其在治疗痉挛方面的研究进展做一综述.

  18. The Effect of Radial Extracorporeal Shock Wave Stimulation on Upper Limb Spasticity in Chronic Stroke Patients: A Single-Blind, Randomized, Placebo-Controlled Study.

    Science.gov (United States)

    Dymarek, Robert; Taradaj, Jakub; Rosińczuk, Joanna

    2016-08-01

    The main purpose of this study was to determine the clinical, electrophysiological and thermal effects of radial extracorporeal shock wave (rESW) stimulation on upper limb muscles affected by spasticity in patients with chronic stroke. Patients included in the study were randomly assigned into the following two groups: 30 patients stimulated with active rESW (A); and 30 patients stimulated with placebo rESW (B). All patients were analyzed using the Modified Ashworth Scale (MAS) to test the spasticity levels of the elbow (E), radio carpal (RC) and fingers (FF) joints; surface electromyography (sEMG) was performed for the resting bioelectrical activity registration of the flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) muscles; and infrared thermal imaging (IRT) was used to assess the temperature distributions of the carpal flexor muscles (CFM). All assessments were performed at baseline (t0), immediately after rESW (t1) as well as 1 and 24 h following its finalization (t2 and t3). Patients treated with active rESW showed a statistically significant reduction in the MAS score for the RC joint at t1 and for the FF joints at t1, t2 and t3 (p  0.05). Applications of rESW demonstrating positive effects at reducing the level of spastic hypertonia of the upper limb muscles in patients with chronic stroke. ESW treatments should be considered as a potential anti-spastic effect to regulate vasculature.

  19. Long-term incidence and risk factors for recurrent stones following percutaneous nephrostolithotomy or percutaneous nephrostolithotomy/extracorporeal shock wave lithotripsy for infection related calculi.

    Science.gov (United States)

    Streem, S B

    1995-03-01

    A study was done to determine the long-term incidence and cause of recurrent stones following percutaneous nephrostolithotomy alone (13 patients) or combined with extracorporeal shock wave lithotripsy (31) for management of documented infection related struvite renal calculi. The patients were followed for 12 to 111 months (mean 41.7) to censorship or time of new stone formation. Of these patients 12 (27%) had recurrent stones at 12 to 61 months (mean 32.3) after treatment. As determined by a Kaplan-Meier estimate, the risk of new stone formation 5 years after treatment was 36.8%. Potential risk factors for recurrence, including history of stones, associated anatomical abnormalities, procedure used, radiographic status at completion of treatment and recurrent infection during followup, were analyzed with Cox's proportional hazards model. Of these potential risk factors, only an associated anatomical abnormality was found to influence significantly the rate of recurrent stone formation (p = 0.005). We conclude that continued surveillance for recurrent stones is mandatory even for patients initially rendered stone-free and those who maintain sterile urine. In addition, because the presence of a significant anatomical or functional urinary tract abnormality places a patient at much higher risk for recurrence, we suggest that subsequent studies be stratified as to the presence or absence of these abnormalities.

  20. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review.

    Science.gov (United States)

    Huisstede, Bionka M A; Gebremariam, Lukas; van der Sande, Renske; Hay, Elaine M; Koes, Bart W

    2011-10-01

    Extracorporeal shock-wave therapy (ESWT) is suggested as a treatment alternative for calcific and non-calcific rotator cuff tendinosis (RC-tendinosis), which may decrease the need for surgery. In this study we assessed the evidence for effectiveness of ESWT for these disorders. The Cochrane Library, PubMed, Embase, Pedro, and Cinahl were searched for relevant systematic reviews and RCTs. Two reviewers independently extracted data and assessed the methodological quality. Seventeen RCTs (11 calcific, 6 non-calcific) were included. For calcific RC-tendinosis, strong evidence was found for effectiveness in favour of high-ESWT versus low-ESWT in short-term. Moderate evidence was found in favour of high-ESWT versus placebo in short-, mid- and long-term and versus low-ESWT in mid- and long-term. Moreover, high-ESWT was more effective (moderate evidence) with focus on calcific deposit versus focus on tuberculum major in short- and long-term. RSWT was more effective (moderate evidence) than placebo in mid-term. For non-calcific RC-tendinosis, no strong or moderate evidence was found in favour of low-, mid- or high-ESWT versus placebo, each other, or other treatments. This review shows that only high-ESWT is effective for treating calcific RC-tendinosis. No evidence was found for the effectiveness of ESWT to treat non-calcific RC-tendinosis. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  1. Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?

    Directory of Open Access Journals (Sweden)

    Catalin Pricop

    2014-10-01

    Full Text Available The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS and extracorporeal shock waves lithotripsy (ESWL for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm Siemens (produced in 2010 by Siemens AG, Germany was used for ureteroscopy. The radiological devices of the lithotripters used in this study in the two clinical centers had similar characteristics. We evaluated patient exposure to ionizing radiation by using a relevant parameter, the air kerma-area product (PKA; all values in cGy cm2, calculated from the radiation dose values recorded by the fluoroscopy device. PKA depends on technical parameters that change due to anatomical characteristics of each case examined, such as body mass index (BMI, waist circumference, and stone location. For the patients subjected to ESWL for lumbar ureteral lithiasis the mean of PKA (cGy cm2 was 509 (SD=180, while for those treated for pelvic ureteral lithiasis the mean of PKA was 342 (SD=201. In the URS group for lumbar ureteral lithiasis, the mean of PKA (cGy cm2 was 892 (SD=436, while for patients with pelvic ureteral lithiasis, the mean of PKA was 601 (SD=429. The patients treated by URS had higher exposure to ionizing radiation dose than patients treated by ESWL. The risk factors of higher radiation doses were obesity, exposure time, and localization of the stones.

  2. Treatment of lower urethral calculi with extracorporeal shock-wave lithotripsy and pneumatic ureteroscopic lithotripsy: a comparison of effectiveness and complications

    Institute of Scientific and Technical Information of China (English)

    钟惟德; 曾广翘; 蔡岳斌; 戴奇山; 胡建波; 魏鸿蔼

    2003-01-01

    Objective To determine the efficacy and incidence of complications of extracorporeal shock-wave lithotripsy (ESWL) compared with pneumatic ureteroscopic lithotripsy (URSL) in the treatment of lower uretheral calculi. Methods From August 1997 to June 1999, 210 patients with lower ureteric calculi were treated with ESWL and the other 180 with URSL. The stones were fragmented with pneumatic lithotripter. The outcome was assessed by evacuation, retreatment and complication rates.Results ESWL for lower ureteric calculi resulted in a stone evacuation rate of 78.1%, compared with 93.3% for URSL (P<0.05). ESWL had a retreatment rate of 11.9% and a perforation rate of 0, while URSL caused perforation of ureters in 3.3% of patients and a refreatment of 2.2%. Conclusion For the management of lower ureteric calculi, ESWL provides a non-invasive, simple and safe option, and URSL has a higher stone evacuation rate but causes ureter perforation more frequently than ESWL does. Both ESWL and URSL have their respective advantages. It is recommended, however, that URSL be extensively developed for better treatment efficacy, given that the operator has an adequate technical background.

  3. In situ measurement of the particle size distribution of the fragmentation product of laser-shock-melted aluminum using in-line picosecond holography

    Directory of Open Access Journals (Sweden)

    Ying-Hua Li

    2016-02-01

    Full Text Available The dynamic fragmentation of shock-melted metal is a topic of increasing interest in shock physics. However, high-quality experimental studies of the phenomenon are limited, and data that are essential for developing predictive models of the phenomenon, such as the mass and particle sizes distributions, are quite sparse. In-line holography is an effective non-contact technique for measuring particle size distribution, but critical technical requirements, in particular, particle density limits, complicate its application to the subject phenomenon. These challenges have been reasonably overcome in the present study, allowing for successful in situ measurements of the size distribution of the fragmentation product from laser-shock-melted aluminum. In this letter, we report on our experiments and present the measured data.

  4. [Value of exact focusing of extracorporeal shock waves (ESWT) in therapy of tendinitis calcarea. A prospective randomized study].

    Science.gov (United States)

    Haake, M; Deike, B; Thon, A; Schmitt, J

    2001-03-01

    A controlled randomized study was designed to analyse the effect of extracorporeal shockwave therapy (ESWT) focussed on either the calcified region or the insertion of the supraspinatus tendon. The study included 50 patients who were treated with a Storz Minilith SI-1 prototype shockwave generator. In the treated group, 4000 impulses (ED+ 0.78 ml/mm2) were applied, under local anaesthesia to the insertion of the supraspinatus in 2 treatment sessions. Control patients received ESWT focussed on the calcified region. Follow-up examinations were carried out 12 weeks after treatment by an independent observer. We found functional improvement and pain reduction in both groups. Statistical analyses showed significant superiority of ESWT focussed on the calcified region for the parameters constant-score (primary endpoint, p < 0.001) and pain intensity (p = 0.001). For the treatment of calcific tendinitis affecting the supraspinatus, we recommend accurate fluoroscopy-controlled focussing of ESWT on the calcification. Focussing on the calcification rather than on the insertion of the supraspinatus tendon is significantly more effective. On the basis of our results, ESWT requires the use of suitable shockwave generators that permit accurate focussing.

  5. [Effectiveness of low-intensity extracorporeal shock wave therapy on patients with Erectile Dysfunction (ED) who have failed to respond to PDE5i therapy. A pilot study].

    Science.gov (United States)

    Bechara, Amado; Casabé, Adolfo; De Bonis, Walter; Nazar, Julián

    2015-03-01

    Low-intensity extracorporeal shock wave therapy (LIESWT) of the penis has recently emerged as a promising modality in the treatment of ED. The objective of this paper is to assess the effectiveness and safety of LIESWT on patients with ED who have failed to respond to PDE5i treatment. Open label, prospective, longitudinal observational study. The study involved an uncontrolled population of 25 patients. The treatment consisted in applying 20,000 shock waves during a period of four weeks. In each session the patient received 5000 shock waves of 0.09 mJ/mm2: 1800 were applied on the penis (900 on each corpus cavernosum), and 3200 were applied on the perineum (1600 on each crus). During the active treatment and follow-up phases, all patients remained on their regular high on demand or once-a-day dose PDE5i schedules. Effectiveness was assessed by IIEF-6, SEP2, SEP3 and GAQ. Patients were considered to be responders whenever they improved on all three erection assessment parameters and respond positively to the GAQ at three months post-treatment. Adverse events were recorded. Statistical variables were applied and findings were considered to be statistically significant whenever the P value was<0.05. Eighty percent (median age 63) of the patients (20/25) completed the study. Five patients were lost to follow-up and were excluded from the analysis. Sixty percent (60%) of the patients responded to the treatment, improved the 3 efficacy evaluating parameters and responded positively to the GAQ. The increase in mean IIEF-6 score was of 9 points after the third post-treatment month. There were no patients reporting treatment-related adverse events. LIESWT for men with ED and that are PDE5i non-responders was safe and effective and restoring PDE5i response in more than 50% of patients.A large-scale multicenter study is required to determine the benefits of this treatment for ED.

  6. Speed evolution of fast CME/shocks with SOHO/LASCO, WIND/WAVES, IPS and in-situ WIND data: analysis of kilometric type-II emissions

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    A. Gonzalez-Esparza

    2009-10-01

    Full Text Available Fast CME/shocks propagating in the interplanetary medium can generate kilometric Type II (km-TII radio emissions at the local plasma frequency and/or its harmonic, so these radio emissions provide a means of remotely tracking CME/shocks. We apply a new analysis technique, using the frequency drift of km-TII spectrum obtained by the Thermal Noise Receiver (TNR of the WIND/WAVES experiment, to infer, at some adequate intervals, the propagation speed of six CME/shocks. We combine these results with previously reported speeds from coronagraph white light and interplanetary scintillation observations, and in-situ measurements, to study the temporal speed evolution of the six events. The speed values obtained by the km-TII analysis are in a reasonable agreement with the speed measurements obtained by other techniques at different heliocentric distance ranges. The combination of all the speed measurements show a gradual deceleration of the CME/shocks as they propagate to 1 AU. This new technique can be useful in studying the evolution of fast CME/shocks when adequate intervals of km-TII emissions are available.

  7. SBOTE study: extracorporeal shock wave therapy versus electrical stimulation after botulinum toxin type a injection for post-stroke spasticity-a prospective randomized trial.

    Science.gov (United States)

    Santamato, Andrea; Notarnicola, Angela; Panza, Francesco; Ranieri, Maurizio; Micello, Maria Francesca; Manganotti, Paolo; Moretti, Biagio; Fortunato, Francesca; Filoni, Serena; Fiore, Pietro

    2013-02-01

    Research is on-going to identify new methods of biostimulation to increase the effect of botulinum toxin type A (BTX-A) in the treatment of spasticity. The Spasticity treated by Botulinum Toxin and ESWT (SBOTE) study is a prospective, randomized controlled trial assessing the effectiveness of extracorporeal shock wave therapy (ESWT) given immediately after BTX-A injections compared with electrical stimulation (ES) given immediately after BTX-A therapy for the management of focal upper limb spasticity in stroke patients. ES was given for 30 min twice a day for 5 days starting at 5 Hz; ESWT was given once a day for 5 days. At study follow-up, patients treated with BTX-A injections and ESWT showed a statistically greater significance and continuous decrease of spasticity measure (modified Ashworth scale [MAS]: 1.37, 1.75 and 1.58 at 15, 30 and 90 days post-treatment, respectively), of spasms (spasm frequency scale [SFS]: 0.8 and 0.25 at 30 and 90 days post-treatment, respectively) and of pain (visual analogue scale [VAS]: 1.94 and 1.87 at 30 and 90 days, respectively) compared with patients treated with BTX-A injections and ES (MAS: 2.37, 2.18 and 2.18, respectively) (p < 0.05) (SFS: 1.5 and 1.06, respectively) (p < 0.05) (VAS: 2.44 and 2.69 respectively) (p < 0.05). ESWT enhances the effect of BTX-A to a greater extent than ES, probably by modulating rheology of the muscle and neurotransmission at the neuromuscular junction.

  8. Urinary stone characteristics of patients treated with extracorporeal shock wave lithotripsy in Cipto Mangunkusumo Hospital Jakarta, 2008–2014: a gender analysis

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    Endrika Noviandrini

    2015-12-01

    Full Text Available Background: The incidence of urinary stone patient in Indonesia has increased every year in both genders. Data showed that urolithiasis was higher in male rather than female. The aimed of this study was to describe the characteristics of urinary stone found in patient who underwent extracorporeal shock wave lithotripsy (ESWL at Cipto Mangunkusumo Hospital, Jakarta from 2008–2014. Methods: Data obtained from ESWL medical record Cipto Mangunkusumo Hospital, Jakarta from 2008–2014. We obtained 5,174 out of 6,020 data due to incompleteness data record. We sorted data records by gender, age, stone location, stone opacity, size of the stone, and history of ESWL, and analyzed by statistic tools (SPSS v 20 for Mac.Results: From 5,174 records, we found that the incidence of urinary stones was two times higher in male rather than female (66.3%:33.64%, occurred mostly in productive age (65.2% male, 65.9% female. Unilateral kidney stone was most common location found for both gender (50.2% male, 57.2% female, and most frequent site located in calyx inferior (24.8% male, 28.9% female. About 72.9% stone was radiopaque (73.7% male and 71.5% female. The mean size of the stone in male and female was 11.34±7.15 mm and 11.90±7.54 mm, respectively. This study also showed that 79.3% patients came for first ESWL.Conclusion: Urinary stone founds two times higher in male than female, and mostly occurs on their productive ages. Unilateral kidney stone in calyx inferior become the most common stone found in both gender. Most of the stone has radiopaque opacity.

  9. Comparison of Peritendinous Hyaluronan Injections Versus Extracorporeal Shock Wave Therapy in the Treatment of Painful Achilles' Tendinopathy: A Randomized Clinical Efficacy and Safety Study.

    Science.gov (United States)

    Lynen, Nils; De Vroey, Thierry; Spiegel, Imke; Van Ongeval, Frederik; Hendrickx, Niels-Jan; Stassijns, Gaëtane

    2017-01-01

    To compare the safety and efficacy of hyaluronan (HA) injections with standard extracorporeal shock wave therapy (ESWT) in the treatment of painful midportion Achilles' tendinopathy. Multinational, prospective, randomized controlled, blinded-observer trial. Ambulatory care. Adults (N=62) with Achilles' midportion tendinopathy for ≥6 weeks and a pain score of at least 40mm (Huskisson visual analog scale [VAS], 100mm) were randomized, and 59 were analyzed in the intention-to-treat data set. There were no withdrawals because of adverse effects. Two peritendinous HA injections versus 3 ESWT applications at weekly intervals. Primary efficacy criterion was changed from the Victorian Institute of Sports Assessment-Achilles' questionnaire (VISA-A) score to the percent change in pain (VAS) at 3 months posttreatment, compared with baseline values. Main secondary parameters were VISA-A, Clinical Global Impression (CGI), and clinical parameters. HA treatment provided a clinically relevant improvement in Achilles' midportion tendinopathy. A large superiority of the HA group, compared with ESWT application, was observed for percent change in pain (VAS), and this superiority was proven to be statistically significant (Mann-Whitney statistic [MW]=.7507 with P=.0030 lower than required α=.025 significance level 1-sided; Mann-Whitney U test) at 3 months posttreatment. Similar findings for HA were also observed at 4 weeks (MW=.6425, P=.0304) and 6 months (MW=.7172, P=.0018). Advantage of HA treatment was confirmed by VISA-A questionnaire, CGI, and clinical parameters. Ten adverse events, 4 in the HA group and 6 in the ESWT group, were reported, but none were classified as serious. Two peritendinous HA injections showed greater treatment success in Achilles' midportion tendinopathy compared with standard ESWT. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Which method is more effective in treatment of calcific tendinitis in the shoulder? Prospective randomized comparison between ultrasound-guided needling and extracorporeal shock wave therapy.

    Science.gov (United States)

    Kim, Yang-Soo; Lee, Hyo-Jin; Kim, Yoon-vin; Kong, Chae-Gwan

    2014-11-01

    Ultrasound (US)-guided needling with subacromial corticosteroid injection is more effective than extracorporeal shock wave therapy (ESWT) for function restoration and pain relief in patients with calcific tendinitis of the shoulder. Fifty-four patients diagnosed with unilateral painful calcific tendinitis were randomly allocated to a US needling or ESWT group. The US needling group underwent US-guided needling and received a subacromial corticosteroid injection. The ESWT group received ESWT 3 times a week. All patients were prospectively evaluated; American Shoulder and Elbow Surgeons, Simple Shoulder Test, and visual analog scale for pain scores were recorded before the procedure and at 6 weeks, 12 weeks, 6 months, 12 months, and the last follow-up. The size and morphology of the deposits were evaluated by radiography. The average follow-up period was 23.0 months. At last follow-up, the mean size of the deposits was significantly different between the 2 groups (P = .001); it decreased to 0.5 mm from 14.8 mm in the US needling group and to 5.6 mm from 11.0 mm in the ESWT group. There were also significant improvements in clinical outcomes in both groups after treatment (P .05). Both treatment modalities for calcific tendinitis improved clinical outcomes and eliminated calcium deposits. US-guided needling treatment, however, was more effective in function restoration and pain relief in the short term. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  11. CLINICAL STUDIES OF EXTRACORPOREAL SHOCK WAVE THERAPY IN TREATMENT OF TENNIS ELBOWS%体外冲击波治疗网球肘的临床研究

    Institute of Scientific and Technical Information of China (English)

    李玉成; 邢星

    2011-01-01

    [目的]观察体外冲击波对网球肘的疗效.[方法]应用国产ESWO冲击波骨科治疗机治疗网球肘68例,随机分为观察组32例和对照组36例.观察组以痛点为中心,行体外冲击波疗法;对照组行按摩、药物、功能锻炼治疗.[结果]治疗后第4周,视觉模拟评分(VAS)评分,两组间比较差异无统计学意义.治疗后第8周和第12周,观察组VAS评分明显低于对照组(P<0.05).[结论]ESWT对网球肘所致的疼痛疗效明显.%[Objective] In order to reveal the effect of ESWT for tennis elbow. [Methods] 68 cases tennis elbow were treated with ESWT, were randomly divided into study groups of 32 cases and the control groups of 36 cases. The study group received extracorporeal shock wave therapy around the pain point; the control group received massage, drugs treatment, functional exercise. [Results] 4 weeks after treatment, VAS showed no difference between the two groups. VAS improved in the study group 8 weeks and 12 weeks after the treatment compared to the control group (P< 0.05). [Conclusion] ESWT for tennis ellow pain has the obvious effect.

  12. Clinical study with extracorporeal shock wave therapy to treat tennis elbows%体外冲击波治疗网球肘的临床研究

    Institute of Scientific and Technical Information of China (English)

    李玉成; 郑连杰; 王鸿飞

    2011-01-01

    [ Objective] To evaluate the effect of ESWT on tennis elbow. [ Methods] Sixty -eight cases of tennis elbow that were treated with ESWT were randomly divided into study group of thirty - two cases and control group of thirty - six cases.The study group received extracorporeal shock wave therapy around the pain point and the control group received massage,drug and functional exercise. [ Results] Four weeks after treatment, VAS showed no significant difference between the two groups. However, VAS in the study group was improved and ESWT was effective in 86% of the patients comparing to 74% of them in control group in eight and twelve weeks (P <0.05). [ Conclusion] ESWT is a valuble treatment in pain caused by tennis elbow.%[目的]观察体外冲击波对网球肘的疗效.[方法]应用国产ESWO冲击波骨科治疗机治疗网球肘68例,随机分为观察组32例和对照组36例.观察组以痛点为中心,行体外冲击波疗法;对照组行按摩、药物、功能锻炼治疗.[结果]治疗后第4周,视觉模拟评分(VAS)评分,两组间比较差异无显著性意义.治疗后第8周和第12周,观察组有效率86%,对照组有效率74%,观察组VAS评分明显低于对照组(P<0.05).[结论]ESWT对网球肘所致的疼痛有一定疗效.

  13. Adjunctive medical therapy with α-blocker after extracorporeal shock wave lithotripsy of renal and ureteral stones: a meta-analysis.

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    Mingchao Li

    Full Text Available Although some trials assessed the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after extracorporeal shock wave lithotripsy (ESWL, the role of the α-blocker in facilitating upper urinary calculi expulsion after ESWL remain controversial.To determine the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after ESWL.A literature search was carried out using the PubMed database, EMBASE and the Cochrane Library database to identify relevant studies. Two reviewers independently extracted data and assessed methodological quality. Pooled effect estimates were obtained using a fixed- and random-effects meta-analysis.The meta-analysis included 23 RCTs, α-blocker significantly enhanced expulsion rate of upper urinary tract calculi after ESWL (P<0.00001; RR 1.21; 95% CI 1.12-1.31, significantly promoted steinstrasse expulsion (P=0.03; RR 1.25; 95% CI 1.03-1.53, significantly shortened the discharge time of upper urinary tract calculi (P=0.0001; MD -2.12; 95% CI -3.20--1.04, significantly reduced the patient's pain VAS score (P=0.001; RR -1.0; 95% CI -1.61--0.39. Compared with the control group, dizziness (P=0.002; RR 5.48; 95% CI 1.91-15.77, anejaculation (P=0.02; RR 12.17; 95% CI 1.61-91.99 and headache (P=0.04; RR 4.03; 95% CI 1.04-15.72 in the α-blocker group was associated with a higher incidence.Treatment with α-blocker after ESWL appears to be effective in enhancing expulsion rate of upper urinary tract calculi, shortening the discharge time of upper urinary tract calculi, reducing the patient's pain. The side effects of α-blocker were light and few.

  14. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function

    Science.gov (United States)

    Wang, Lei; Jiang, Yuquan; Jiang, Zheng; Han, Lizhang

    2016-01-01

    Background Latest studies show that low-energy extracorporeal shock wave therapy (ESWT) can upregulate levels of vascular endothelial growth factor (VEGF). VEGF can ease nervous tissue harm after spinal cord injury (SCI). This study aims to explore whether low-energy ESWT can promote expression of VEGF, protect nervous tissue after SCI, and improve motor function. Methods Ninety adult female rats were divided into the following groups: Group A (simple laminectomy), Group B (laminectomy and low-energy ESWT), Group C (spinal cord injury), and Group D (spinal cord injury and low-energy ESWT). Impinger was used to cause thoracic spinal cord injury. Low-energy ESWT was applied as treatment after injury three times a week, for 3 weeks. After SCI, the Basso, Beattie, and Bresnahan (BBB) scale was used to evaluate motor function over a period of 42 days at different time points. Hematoxylin and eosin (HE) staining was used to evaluate nerve tissue injury. Neuronal nuclear antigen (NeuN) staining was also used to evaluate loss of neurons. Polymerase chain reaction was used to detect messenger RNA (mRNA) expression of VEGF and its receptor fms-like tyrosine kinase 1 (Flt-1). Immunostaining was used to evaluate VEGF protein expression level in myeloid tissue. Results BBB scores of Groups A and B showed no significant result related to dyskinesia. HE and NeuN staining indicated that only using low-energy ESWT could not cause damage of nervous tissue in Group B. Recovery of motor function at 7, 35, and 42 days after SCI in Group D was better than that in Group C (Ptherapy for spinal injury. PMID:27621630

  15. Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach.

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    Kang Su Cho

    Full Text Available To investigate whether skin-to-stone distance (SSD, which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL in patients with upper ureter stones.We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4-20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU, and SSD were determined on pretreatment non-contrast computed tomography (NCCT. For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile.In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032. The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL.Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL.

  16. Investigating the Effect of Extracorporeal Shock Wave Therapy on reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial

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    Saeid Khosrawi

    2017-01-01

    Full Text Available Background: Knee pain, is one of the most common causes of patients' referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. Materials and Methods: This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics. The patients with chronic PAB (pain duration more than 3 months, who were refractory to conservative treatments, were randomly divided into two 20-member experimental groups (extracorporeal shock wave therapy [ESWT] and sham ESWT. Pain scores of all patients were measured using the Visual Analog Scale (VAS and McGill Pain Questionnaire (MPQ (total and present pain indexes [TPIs and PPIs] before intervention, immediately after intervention (3rd week, and after 8 weeks. The pain scores were then compared and statistically analyzed. Results: In the ESWT group, the mean patient pain score of the VAS and TPI in MPQ were significantly lower than in the sham ESWT group immediately after intervention (3rd week: P=0.02, P= 0.04 respectively; and 8 weeks after the end of treatment: P=0.01, P= 0.000. Moreover, the PPI in both groups had significantly decreased over time, although in ESWT group this decrement was significantly more than sham ESWT group (P < 0.001. Conclusion: The results showed that ESWT could be effective in reducing the pain and treating PAB.

  17. An Evaluation of Electroacupuncture at the Weizhong Acupoint (BL-40 as a Means of Relieving Pain Induced by Extracorporeal Shock Wave Lithotripsy

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    Wei-Ta Chen

    2014-01-01

    Full Text Available Background. Extracorporeal shock wave lithotripsy (ESWL is the preferred option for urolithiasis treatment. However, intensities of pain may be induced and the sedative anesthetic or analgesics were usually needed. The aim of this study was to develop an improved acupuncture-assisted anesthesia approach in pain relief. Methods. We conducted a single-blind, randomized controlled study in China Medical University Hospital. Patients treated by ESWL due to upper urolithiasis were randomly divided into control group, sham-EA group, and 100 Hz EA group. The high frequency electroacupuncture (EA was applied at the Weizhong acupoint (100 Hz EA group for 20 minutes prior to the ESWL. In the sham-EA group, the same procedures were performed as those of 100 Hz EA group but no electric current was given to stimulate the acupoints. In the control group, no action was taken before operation. The information including the numbers and dosage of analgesic requirements, pain score, vital signs, and the satisfaction of procedure was collected. Results. A total of 74 subjects were recruited and we found that the interval to the first request analgesic, the number/total dosage of additional analgesic, recovery time from anesthesia, and the satisfaction were all better in both the 100 Hz EA and the sham-EA group. The 100 Hz EA also showed better relief of painful sensations by delaying the onset of pain. Conclusions. The 100 Hz EA and the sham-EA can effectively relieve pain due to ESWL as well as reducing the dosage of opium analgesic used.

  18. 小针刀疗法与体外冲击波治疗网球肘疗效对比观察%Comparison of the Efficacy of Needle Knife Therapy with Extracorporeal Shock Wave Treatment of Tennis Elbow

    Institute of Scientific and Technical Information of China (English)

    程明; 王跃

    2016-01-01

    目的研究网球肘采用小针刀疗法和体外冲击波治疗的临床效果对比。方法临床纳入100例我院2014年1月~2015年9月收治的网球肘患者,根据采用的治疗方式不同分为两组。其中50例患者采用小针刀疗法治疗作为对照组,另50例患者采用冲击波治疗作为观察组。结果观察组患者治疗后第10d、第20d的疗效显著优于对照组,两组相比较,<0.05。结论小针刀疗法与体外冲击波治疗网球肘,疗效均显著,但在临床治疗时间和创伤方面,冲击波治疗略优于小针刀疗法。%Objective To compare the clinical effect of small-needle-knife therapy and extracorporeal shock wave in the treatment of tennis elbow. Methods 100 patients with tennis elbow treated from January 2014 to September 2015 in our hospital were selected.The patients were divided into two groups according to different therapies,50 cases each group.The control group adopted the small-needle-knife therapy and the observation group adopted the extracorporeal shock wave.Results In the tenth and twentieth day of treatment,the curative effect of observation group was better than that of control group ( <0.05).Conclusion The small-needle-knife therapy and extracorporeal shock wave has an obvious effect in the treatment of tennis elbow.The treatment time and trauma based on the extracorporeal shock wave is slightly better than that of small-needle-knife therapy.

  19. 体外冲击波联合舒筋活血汤治疗跟痛症60例疗效观察%Observation 60 cases efficacy of Extracorporeal shock wave therapy combined with Shujinhuoxue soap for calcaneodynia

    Institute of Scientific and Technical Information of China (English)

    陈立

    2015-01-01

    Objective:To observe the clinical curative effect of extracorporeal shock wave combined with Shujinhuoxue soap in the treatment of heel pain. Methods: 120 cases of painful heel syndrome were randomly divided into treatment group and control group, 60 cases in each group. The control group were treated with extracorporeal shock wave therapy, patients in the treatment group were treated with extracorporeal shock wave combined with Shujin Huoxue soap in the treatment of washing. Results: the effective rate of treatment group was % and control group efficiency %, the effective rate of the treatment group was better than that of the control group (P<0.05); compare the rate of recurrence in the two groups, the treatment group was significantly lower than that of the control group (P<0.05). Conclusion: extracorporeal shock wave combined with Shujinhuoxue and washing of clinical curative effect of the treatment of heel pain, precise, low recurrence rate.%目的:观察体外冲击波联合舒筋活血洗方治疗跟痛症的临床疗效。方法:将120例跟痛症患者随机分为对照组和治疗组,每组各60例。对照组给予体外冲击波治疗,治疗组予以体外冲击波联合舒筋活血洗方治疗。结果:治疗组有效率为96.7%,对照组有效率为93.3%,治疗组有效率优于对照组(P<0.05);两组复发率比较,治疗组明显低于对照组(P<0.05)。结论:体外冲击波联合舒筋活血洗方治疗跟痛症临床疗效确切,复发率低。

  20. 体外冲击波疗法促进创面愈合机制研究进展%Advances in the research of mechanism of enhancement of wound healing with extracorporeal shock wave therapy

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    赵景春; 薛岩; 于家傲; 石凯; 咸春静; 周鑫

    2015-01-01

    The vast majority of the published papers dealing with the treatment of wounds in the past few decades reported that extracorporeal shock wave therapy (ESWT) used in wound repair is easy in manipulation,noninvasive,safe,effective,and well tolerated by patients.However,little is known about the mechanism of ESWT in wound healing to date.In this article,we reviewed the literature to identify the potential cellular and molecular mechanisms of ESWT in the process of wound healing,and the results of the literature showed that the mechanism of ESWT in promoting wound healing is the result of heterogeneous biological effects.

  1. 体外冲击波联合矫形鞋垫治疗足底筋膜炎的疗效观察%Therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis

    Institute of Scientific and Technical Information of China (English)

    严文广; 孙绍丹; 李旭红

    2014-01-01

    目的:观察体外冲击波联合矫形鞋垫治疗足底筋膜炎的疗效。方法:将153例足底筋膜炎患者随机分成联合组(n=51)、冲击波组(n=53)和矫形组(n=49)。联合组采用体外冲击波联合矫形鞋垫治疗,冲击波组采用体外冲击波治疗,矫形组采用矫形鞋垫治疗。比较患者治疗前和治疗后2周、1个月、3个月视觉模拟评分法(visual analogue scale,VAS)评分和持续行走时间、疗效及足底筋膜厚度。结果:3组治疗后VAS评分均较治疗前降低(P<0.05);2周时冲击波组高于矫形组,2周和3个月时联合组低于矫形组(P<0.05);1个月、3个月时矫形组与联合组均低于冲击波组(P<0.05);3组治疗后行走时间较治疗前明显提高,足底筋膜明显变薄(P<0.05);联合组的治愈率、总有效率明显高于其它两组,矫形组的治愈率高于冲击波组(P<0.05)。结论:体外冲击波联合矫形鞋垫治疗足底筋膜炎疗效确切,值得在临床上推广应用。%Objective: To observe the therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis. Methods: A total of 153 plantar with plantar fasciitis were randomly divided into a combined group (n=51), an extracorporeal shock wave group (n=53) and an orthopaedic group (n=49). The combined group received treatment of both extracorporeal shock wave and orthopaedic insole while the extracorporeal shock wave or the orthopaedic group only received the treatment of extracorporeal shock wave or orthopaedic insole. The therapeutic parameters such as visual analogue scale (VAS) scores, continued walking time and thickness of the plantar fascia were monitored before and atf er the treatment for 2 weeks, 1 month and 3 months, respectively. Results: The VAS scores in the 3 groups were all reduced after the treatment compared with the corresponding scores before the therapy (P<0.05). hTe VAS score in the extracorporeal shock wave group

  2. A Prospective Case-Control Study of Radial Extracorporeal Shock Wave Therapy for Spastic Plantar Flexor Muscles in Very Young Children With Cerebral Palsy.

    Science.gov (United States)

    Wang, Tiantian; Du, Lin; Shan, Ling; Dong, Hanyu; Feng, Junyan; Kiessling, Maren C; Angstman, Nicholas B; Schmitz, Christoph; Jia, Feiyong

    2016-05-01

    To assess the effects of radial extracorporeal shock wave therapy (rESWT) on plantar flexor muscle spasticity and gross motor function in very young patients with cerebral palsy (CP).The design was case-control study (level of evidence 3).The setting was the Department of Pediatric Neurology and Neurorehabilitation, First Hospital of Jilin University, Changchun, China.Those with a diagnosis of CP and spastic plantar flexor muscles were recruited between April 2014 and April 2015.According to the parents' decision, patients received 1 ESWT session per week for 3 months, with 1500 radial shock waves per ESWT session and leg with positive energy flux density of 0.03 mJ/mm, combined with traditional conservative therapy (rESWT group) or traditional conservative therapy alone (control group).The Modified Ashworth Scale (MAS) (primary outcome measure) and passive range of motion (pROM) measurements were collected at baseline (BL), 1 month (M1), and 3 months (M3) after BL. The Gross Motor Function Measure (GMFM)-88 was collected at BL and M3.Sixty-six patients completed the final review at 3 months and were included in the study. Subjects ranged in age from 12 to 60 months (mean age 27.0 ± 13.6 months; median age 22.0 months; 33.3% female). For the rESWT group (n = 34), mean MAS grades at BL, M1, and M3 were 2.6, 1.9, and 1.5 on the left side and 1.9, 1.7, and 1.2 on the right side. For the control group (n = 32), mean MAS grades at BL, M1, and M3 were 2.5, 2.4, and 2.1 on the left side and 1.8, 1.8, and 1.5 on the right side. The within-subject effects time × side and time × treatment were statistically significant (P therapy is more effective than traditional conservative therapy alone in the treatment of spasticity in very young patients with CP.

  3. Effects of Roughly Focused Extracorporeal Shock Waves Therapy on the Expressions of Bone Morphogenetic Protein-2 and Osteoprotegerin in Osteoporotic Fracture in Rats

    Science.gov (United States)

    Huang, Hai-Ming; Li, Xiao-Lin; Tu, Shu-Qiang; Chen, Xiao-Feng; Lu, Chang-Chun; Jiang, Liang-Hua

    2016-01-01

    Background: Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area, a large therapy zone, easy positioning, and less pain during treatment. The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats. Methods: Seventy-two female Sprague-Dawley (SD) rats, 3 months old, were divided into sham-operated group (n = 6) and an ovariectomized (OVX) group (n = 66). Sixty OVX SD rats were used as a model of double proximal tibial osteotomy and inner fixation. The osteotomy site in the left tibia was treated with roughly focused ESWT once at an energy density of 0.26 mJ/mm2, 60 doses/min, and 2000 pact quantities. The contralateral right tibia was left untreated and served as a control. Expression of OPG and BMP-2 in the callus of the osteoporotic fracture area was assessed using immunohistochemistry, real-time polymerase chain reaction (PCR), and Western blotting analysis. Results: Bone mineral density (BMD) at the proximal tibia, femur, and L5 spine was significantly reduced after ovariectomy. BMD of proximal tibia was 12.9% less in the OVX group than that in the sham-operated group. Meanwhile, bilateral oophorectomy resulted in a lower trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-OVX animals. Three months after bilateral oophorectomy, BV/TV was 14.29% of baseline BV/TV in OVX legs versus 45.91% in the sham-OVX legs (P shock wave treatment, paired with a much earlier (at 4 weeks) increase of BMP-2, and declined close to normal at 8 weeks. Conclusions: Roughly focused ESWT may promote the expression of OPG and BMP-2 in the osteoporotic fracture area in rats. BMP-2 and OPG may act synergistically and may lead to a significant enhancement of bone formation and remodeling. PMID:27779163

  4. A Prospective Case-Control Study of Radial Extracorporeal Shock Wave Therapy for Spastic Plantar Flexor Muscles in Very Young Children With Cerebral Palsy

    Science.gov (United States)

    Wang, Tiantian; Du, Lin; Shan, Ling; Dong, Hanyu; Feng, Junyan; Kiessling, Maren C.; Angstman, Nicholas B.; Schmitz, Christoph; Jia, Feiyong

    2016-01-01

    Abstract To assess the effects of radial extracorporeal shock wave therapy (rESWT) on plantar flexor muscle spasticity and gross motor function in very young patients with cerebral palsy (CP). The design was case-control study (level of evidence 3). The setting was the Department of Pediatric Neurology and Neurorehabilitation, First Hospital of Jilin University, Changchun, China. Those with a diagnosis of CP and spastic plantar flexor muscles were recruited between April 2014 and April 2015. According to the parents’ decision, patients received 1 ESWT session per week for 3 months, with 1500 radial shock waves per ESWT session and leg with positive energy flux density of 0.03 mJ/mm2, combined with traditional conservative therapy (rESWT group) or traditional conservative therapy alone (control group). The Modified Ashworth Scale (MAS) (primary outcome measure) and passive range of motion (pROM) measurements were collected at baseline (BL), 1 month (M1), and 3 months (M3) after BL. The Gross Motor Function Measure (GMFM)-88 was collected at BL and M3. Sixty-six patients completed the final review at 3 months and were included in the study. Subjects ranged in age from 12 to 60 months (mean age 27.0 ± 13.6 months; median age 22.0 months; 33.3% female). For the rESWT group (n = 34), mean MAS grades at BL, M1, and M3 were 2.6, 1.9, and 1.5 on the left side and 1.9, 1.7, and 1.2 on the right side. For the control group (n = 32), mean MAS grades at BL, M1, and M3 were 2.5, 2.4, and 2.1 on the left side and 1.8, 1.8, and 1.5 on the right side. The within-subject effects time × side and time × treatment were statistically significant (P < 0.01). Similar results were found for the improvement of mean pROM. GMFM-88 improved from BL to M3, but showed no statistically significant difference between the groups. There were no significant complications. This study demonstrates that the combination of rESWT and traditional conservative therapy is more

  5. Extracorporeal shock wave therapy for the reduction of post stroke spasticity: review article and meta-analysis

    Directory of Open Access Journals (Sweden)

    Davood Azimpour

    2017-08-01

    Methods: All primary reports of spasticity indexed in PubMed, MEDLINE, Science Direct, Scopus and search engine of Google Scholar from January 2000 to December 2016 were searched. The following terms were used as keywords: Spasticity, muscle hypertonicity, ESWT, stroke and hemiplegia. Any report was included if it met the following criteria: involving clinical trials, full-version availability, and being written in english. Two reviewers selected articles independently and reviewed the studies considering quality and eligibility, and then they extracted general information on objectives, design, participants, and outcomes. The methodologic quality of each study was assessed using the Pedro Scale. In the statistical analyses, we considered two outcomes; Modified Ashworth scale (MAS grade and passive rang of movement (PROM. The meta-analysis was done using random effect model in Stata, version 11 (Stata Corp., TX, USA. Results: Eleven studies within a total of 261 patients were included in this review. In seven studies the shock waves were applied to the upper limb muscles, and in four other studies, the effects of ESWT on the spasticity of the lower limb muscles were assessed. Immediately after applying the ESW, MAS grade was significantly decreased in comparison to the baseline values. (Standardized mean difference [SMD], -1.62; 95% confidence interval [CI], -2.2 to -1.04. The PROM was significantly increased immediately after ESWT in comparison to the baseline values (SMD, 3.23; CI 95%, 1.35 to 5.12. Conclusion: The results of this study showed that ESWT can immediately improve the spasticity and increased PROM, but it seems that the mechanism of action of shock waves on spasticity is still unclear. Further clinical trial studies with higher methodological quality should be recommended.

  6. Experimentally Shocked and Altered Basalt: Laboratory Analogs for Calibration of Mars Remote Sensing and In Situ Data

    Science.gov (United States)

    Bell, M. S.

    2015-01-01

    Calcium phosphate (likely chloroapatite) is formed in the alteration experiments and is more abundant in the altered and shocked sample probably due to increased surface area exposed to alteration fluids resulting from shock damage in the form of both brittle and structural deformation to the starting material (Figs 1 & 3). Apatite forms in basic conditions so the closed system alteration experiment must be buffered by the basalt starting material to create a fluid chemistry environment evolving from neutral at the start to alkaline after 21 days at 160 degrees Centigrade. Plagioclase feldspar in the unshocked sample (Fig. 2) has undergone a solid-state transformation to maskelynite, a disordered phase that is not manifest in the X-ray diffraction pattern of the shocked sample (Fig.4). Olivine and ulvospinel that are present in the starting material can be detected by X-ray diffraction in the shocked and altered sample (Fig. 4). Tungsten from the sample holder used in the shock experiments dominates the X-ray diffraction pattern of the shocked and altered sample (Fig. 4). Samples were weighed after the alteration experiments to determine mass loss and predict the amount of material available for the planned analyses from the shock experiments. Within the constraints of these experiments, mass loss is negligible. The samples will next be characterized by Moessbauer and Vis-Near Infrared spectroscopy, the results of which will be compared to the Mars Exploration Rovers and Mars Reconnaissance Orbiter data sets respectively.

  7. Shock initiation sensitivity and Hugoniot-based equation of state of Composition B obtained using in situ electromagnetic gauging

    Science.gov (United States)

    Gibson, L. L.; Dattelbaum, D. M.; Bartram, B. D.; Sheffield, S. A.; Gustavsen, R. L.; Brown, G. W.; Sandstrom, M. M.; Giambra, A. M.; Handley, C. A.

    2014-05-01

    A series of gas gun-driven plate impact experiments were performed on vacuum melt-cast Composition B to obtain new Hugoniot states and shock sensitivity (run-distance-to-detonation) information. The Comp B (ρ0 = 1.713 g/cm3) consisted of 59.5% RDX, 39.5% TNT, and 1% wax, with ~ 6.5% HMX in the RDX. The measured Hugoniot states were found to be consistent with earlier reports, with the compressibility on the shock adiabat softer than that of a 63% RDX material reported by Marsh.[4] The shock sensitivity was found to be more sensitive (shorter run distance to detonation at a given shock input condition) than earlier reports for Comp B-3 and a lower density (1.68-1.69 g/cm3) Comp B formulation. The reactive flow during the shock-to-detonation transition was marked by heterogeneous, hot spot-driven growth both in and behind the leading shock front.

  8. 体外震波在股骨头坏死中的应用研究进展%Application of extracorporeal shock wave in the treatment of osteonecrosis of the femoral head

    Institute of Scientific and Technical Information of China (English)

    孙伟; 高福强; 李子荣

    2014-01-01

    Extracorporeal shock wave ( ESW ) is a special form of sound wave, which is also an effective mechanical stimulation. Through the communication of alternate media of decompression and compression ( density ), the mechanical stimulation of tissue cells can be achieved without damage by the cavitation effect, tensile strength and shear force of ESW. And then the self-healing mechanism of tissue cells will be activated. A great deal of research on the action mechanism of ESW by the scholars at home and abroad revealed that new application prospects for ESW has been viewed in the prevention and treatment of ischemic diseases. Osteonecrosis of the femoral head ( ONFH ), which is also called ischemic necrosis of the femoral head, is a common and refractory disease in the ifeld of orthopedics with the results of structural changes, collapse and functional disorders of the femoral head due to the death of bone tissues and marrow and the subsequent repair caused by the interrupted blood supply. The new non-invasive method of extracorporeal shock wave treatment ( ESWT ) rises in the ifeld of orthopedics, which is superior to the traditional surgical method in the treatment of some orthopedic and soft-tissue disorders. This new ESWT therapy for ONFH are carried out in many domestic and foreign medical institutions, and the basic and clinical progress is summarized in this paper.

  9. Extracorporeal shock waves alone or combined with raloxifene promote bone formation and suppress resorption in ovariectomized rats.

    Science.gov (United States)

    Lama, Adriano; Santoro, Anna; Corrado, Bruno; Pirozzi, Claudio; Paciello, Orlando; Pagano, Teresa Bruna; Russo, Sergio; Calignano, Antonio; Mattace Raso, Giuseppina; Meli, Rosaria

    2017-01-01

    Osteoporosis is a metabolic skeletal disease characterized by an imbalance between osteoclast-mediated bone resorption and osteoblast-mediated bone formation. We examined the beneficial effect of shock waves (SW) alone or in combination with raloxifene (RAL) on bone loss in ovariectomized rats (OVX). Sixteen weeks after surgery, OVX were treated for five weeks with SW at the antero-lateral side of the right hind leg, one session weekly, at 3 Hz (EFD of 0.33 mJ/mm2), or with RAL (5 mg/kg/die, per os) or with SW+RAL. Sera, femurs, tibiae and vertebrae were sampled for following biochemical and histological analysis. SW, alone or combined with RAL, prevented femur weight reduction and the deterioration of trabecular microarchitecture both in femur and vertebrae. All treatments increased Speed of Sound (SoS) values, improving bone mineral density, altered by OVX. Serum parameters involved in bone remodeling (alkaline phosphatase, receptor activator of nuclear factor kappa-B ligand, osteoprotegerin) and osteoblast proliferation (PTH), altered by ovariectomy, were restored by SW and RAL alone or in combination. In tibiae, SW+RAL significantly reduced cathepsin k and TNF-α levels, indicating the inhibition of osteoclast activity, while all treatments significantly increased runt-related transcription factor 2 and bone morphogenetic-2 expression, suggesting an increase in osteoblastogenic activity. Finally, in bone marrow from tibiae, SW or RAL reduced PPARγ and adiponectin transcription, indicating a shift of mesenchymal cells toward osteoblastogenesis, without showing a synergistic effect. Our data indicate SW therapy, alone and in combination with raloxifene, as an innovative strategy to limit the hypoestrogenic bone loss, restoring the balance between bone formation and resorption.

  10. Extracorporeal shock waves alone or combined with raloxifene promote bone formation and suppress resorption in ovariectomized rats

    Science.gov (United States)

    Corrado, Bruno; Pirozzi, Claudio; Paciello, Orlando; Pagano, Teresa Bruna; Russo, Sergio; Calignano, Antonio; Mattace Raso, Giuseppina; Meli, Rosaria

    2017-01-01

    Osteoporosis is a metabolic skeletal disease characterized by an imbalance between osteoclast-mediated bone resorption and osteoblast-mediated bone formation. We examined the beneficial effect of shock waves (SW) alone or in combination with raloxifene (RAL) on bone loss in ovariectomized rats (OVX). Sixteen weeks after surgery, OVX were treated for five weeks with SW at the antero-lateral side of the right hind leg, one session weekly, at 3 Hz (EFD of 0.33 mJ/mm2), or with RAL (5 mg/kg/die, per os) or with SW+RAL. Sera, femurs, tibiae and vertebrae were sampled for following biochemical and histological analysis. SW, alone or combined with RAL, prevented femur weight reduction and the deterioration of trabecular microarchitecture both in femur and vertebrae. All treatments increased Speed of Sound (SoS) values, improving bone mineral density, altered by OVX. Serum parameters involved in bone remodeling (alkaline phosphatase, receptor activator of nuclear factor kappa-B ligand, osteoprotegerin) and osteoblast proliferation (PTH), altered by ovariectomy, were restored by SW and RAL alone or in combination. In tibiae, SW+RAL significantly reduced cathepsin k and TNF-α levels, indicating the inhibition of osteoclast activity, while all treatments significantly increased runt-related transcription factor 2 and bone morphogenetic-2 expression, suggesting an increase in osteoblastogenic activity. Finally, in bone marrow from tibiae, SW or RAL reduced PPARγ and adiponectin transcription, indicating a shift of mesenchymal cells toward osteoblastogenesis, without showing a synergistic effect. Our data indicate SW therapy, alone and in combination with raloxifene, as an innovative strategy to limit the hypoestrogenic bone loss, restoring the balance between bone formation and resorption. PMID:28158228

  11. Litiasis única en vesícula doble tratada con ondas de choque extracorpórea Single lithiasis in double gallblader treated with extracorporeal shock waves

    Directory of Open Access Journals (Sweden)

    Domingo Pérez González

    2004-06-01

    Full Text Available La vesícula biliar doble es una anomalía congénita poco frecuente. Su diagnóstico puede realizarse con ultrasonido y colecistografía. Se presenta una paciente de 27 años de edad, con antecedentes de intolerancia a las grasas y cólicos biliares a repetición, con vesícula duplicada; exteriormente fundida y dos conductos císticos independientes que desembocan en el hepatocolécodo, con un cálculo único, de 12 mm de diámetro, retrotransparente y 0 unidades Houndfield, ubicado en el cuello de la vesícula más desarrollada. Se aplicaron 2 259 ondas de choque extracorpóreas de 20,4 kilovoltios, generadas por el principio electromagnético; en una sesión de litroticia. Se detuvo fragmentación completa del cálculo. El tratamiento fue ambulatorio. La paciente se reincorporó a su vida laboral a las 24 horas. Durante la expulsión de los fragmentos tuvo varias crisis de dolor que cedieron con analgésicos orales. A los 6 meses, la vesícula afectada se encontraba libre de fragmentos y funcional. No existió complicación y hasta el momento se mantiene asintomáticaDouble gall bladder is an uncommon congenital abnormality. It may be diagnosed by ultrasound and cholecystography. It is reported the case of a 27-year-old patient with history of intolerance to fats and repeated biliary cholics, with duplicated gallbladder externally fused, and two independent cystic ducts flowing to the hepatocholedoco with a single calculus of 12 mm of diameter, retrotransparent and 0 Houndfield units, located in the neck of the more developed gallbladder. 2 259 extracorporeal shock waves of 20.4 kilovolts generated by the electromagnetic principle were applied in a lithotripsy session. The complete fragmentation of the calculus was stopped. The treatment was ambulatory. The patient reincorporated to her working life at 24 hours. During the expulsion of the fragments, she had several pain crises that were resolved with oral analgesics. Six months later, the

  12. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function

    Directory of Open Access Journals (Sweden)

    Wang L

    2016-08-01

    Full Text Available Lei Wang, Yuquan Jiang, Zheng Jiang, Lizhang Han Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, People’s Republic of China Background: Latest studies show that low-energy extracorporeal shock wave therapy (ESWT can upregulate levels of vascular endothelial growth factor (VEGF. VEGF can ease nervous tissue harm after spinal cord injury (SCI. This study aims to explore whether low-energy ESWT can promote expression of VEGF, protect nervous tissue after SCI, and improve motor function.Methods: Ninety adult female rats were divided into the following groups: Group A (simple laminectomy, Group B (laminectomy and low-energy ESWT, Group C (spinal cord injury, and Group D (spinal cord injury and low-energy ESWT. Impinger was used to cause thoracic spinal cord injury. Low-energy ESWT was applied as treatment after injury three times a week, for 3 weeks. After SCI, the Basso, Beattie, and Bresnahan (BBB scale was used to evaluate motor function over a period of 42 days at different time points. Hematoxylin and eosin (HE staining was used to evaluate nerve tissue injury. Neuronal nuclear antigen (NeuN staining was also used to evaluate loss of neurons. Polymerase chain reaction was used to detect messenger RNA (mRNA expression of VEGF and its receptor fms-like tyrosine kinase 1 (Flt-1. Immunostaining was used to evaluate VEGF protein expression level in myeloid tissue.Results: BBB scores of Groups A and B showed no significant result related to dyskinesia. HE and NeuN staining indicated that only using low-energy ESWT could not cause damage of nervous tissue in Group B. Recovery of motor function at 7, 35, and 42 days after SCI in Group D was better than that in Group C (P<0.05. Compared with Group C, number of NeuN-positive cells at 42 days after SCI increased significantly (P<0.05. The mRNA levels of VEGF and Flt-1 and VEGF expression at 7 days after SCI in Group D were significantly higher than those in Group C (P<0

  13. Espinelização in-situ e seu efeito na resistência ao choque térmico de concretos refratários In-situ spinelization and thermal shock performance of refractory castables

    Directory of Open Access Journals (Sweden)

    G. B. Cintra

    2008-09-01

    -magnesia refractory castables, as the in-situ spinel formation leads to a better chemical performance. The steel ladles are also subjected to abrupt temperature changes, due to heating and cooling cycles. Therefore, the thermal shock evaluation is of utmost importance to a proper material selection. The objective of this paper is the analysis of the matrix components and its consequences on the thermal shock damage in order to attain the most suitable thermo mechanical solution coupled with a high corrosion resistance, resulting the increase of the life expectancy of a steel ladle. The results presented show that alumina-spinel castables had better performance than alumina-magnesia castables when there is no constraining. The presence of microssilica increased the thermal shock damage, and this may be related to the testing temperature range.

  14. Effects of Roughly Focused Extracorporeal Shock Waves Therapy on the Expressions of Bone Morphogenetic Protein-2 and Osteoprotegerin in Osteoporotic Fracture in Rats

    Institute of Scientific and Technical Information of China (English)

    Hai-Ming Huang; Xiao-Lin Li; Shu-Qiang Tu; Xiao-Feng Chen; Chang-Chun Lu; Liang-Hua Jiang

    2016-01-01

    Background:Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area,a large therapy zone,easy positioning,and less pain during treatment.The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats.Methods:Seventy-two female Sprague-Dawley (SD) rats,3 months old,were divided into sham-operated group (n =6) and an ovariectomized (OVX) group (n =66).Sixty OVX SD rats were used as a model of double proximal tibial osteotomy and inner fixation.The osteotomy site in the left tibia was treated with roughly focused ESWT once at an energy density of 0.26 mJ/mm2,60 doses/min,and 2000 pact quantities.The contralateral right tibia was left untreated and served as a control.Expression of OPG and BMP-2 in the callus of the osteoporotic fracture area was assessed using immunohistochemistry,real-time polymerase chain reaction (PCR),and Western blotting analysis.Results:Bone mineral density (BMD) at the proximal tibia,femur,and L5 spine was significantly reduced after ovariectomy.BMD of proximal tibia was 12.9% less in the OVX group than that in the sham-operated group.Meanwhile,bilateral oophorectomy resulted in a lower trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-OVX animals.Three months after bilateral oophorectomy,BV/TV was 14.29% of baseline BV/TV in OVX legs versus 45.91% in the sham-OVX legs (P < 0.001).These data showed that the SD rats became a suitable model of osteoporosis,3 months after they were OVX.Immunohistochemical analysis showed higher levels of BMP-2 and OPG expression in the treatment group than those in the control group.Compared with the contralateral controls,decreased expression of OPG and BMP-2 at 3 days after roughly focused ESWT,followed by a later increase at 7 days,was indicated by real-time PCR and Western blotting analysis.The OPG

  15. Clinical Research of the Therapy of Extracorporeal Shock Wave to Chronic Acalculous Cholecystitis%体外冲击波治疗慢性非结石性胆囊炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    唐海涛; 李春恒; 赵红燕

    2015-01-01

    Objective This article aims to conduct the clinical observation and clinical research of extracorporeal shock wave therapy to chronic acalculous cholecystitis .Methods Divide 80 cases of patients of chronic acalculous chole-cystitis into 2 groups, with 40 cases in each group; as for the treatment group , the JDPN -VB model extracorporeal shock wave lithotripter by Shanghai Jiao Tong University is adopted to take the right upper quadrant as the shock wave path, and in prone position , to conduct the extracorporeal shock wave therapy to the gallbladder with the therapy voltage of 8 -10kv and the times of shock wave of 1000, and with the intervals of 2 weeks between two times;2 times are taken as 1 course of treatment; as for the control group , the anti-inflammatory and cholagogic medicines are taken for four weeks.Four weeks after the start of therapy , the two groups of patients are evaluated about the changes of clinical index be-fore and after the chronic acalculous cholecystitis .Results After 4 weeks of therapy , it is found that the single index im-provement degree and comprehensive therapeutic effect such as the clinical symptoms and the change in gallbladder Color Doppler Ultrasound of the treatment group are all obviously superior to that of the control group .Conclusions The extra-corporeal shock wave is a new effective method for the therapy of chronic acalculous cholecystitis ;it has the advantages of rapid effectiveness , safe and reliable and with effective therapy;worthy of clinic popularization and application .%目的:体外冲击波治疗慢性非结石性胆囊炎的疗效观察及临床研究。方法对80例慢性非结石性胆囊炎患者随机分成2组,每组40例;治疗组采用上海交大JDPN-VB型体外冲击波碎石机,以右上腹部为冲击波路径,俯卧位,对病变胆囊进行体外冲击波治疗,每次治疗电压选择8~10 kV,冲击波次数为1000次,间隔2周治疗下一次,2次为1个疗程;对

  16. 体外心脏震波治疗改善心肌梗死后心室重塑研究进展%Research Progress of Extracorporeal Cardiac Shock Wave Therapy Improving Ventricular Remodeling after Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    陶四明; 王钰; 郭涛

    2009-01-01

    Ventricular remodeling after myocardial infarction is a pathophysiological process. It is one of the most important risk factors for long-term mortality. Some research has found that many factors participate in, and accelerate the occurance of, ventricular remodeling after myocardial infarction. It was discovered that low-energy extracorporeal shock wave therapy can improve and regulate the function of myocardium during necrosis and can reconstruct the collagen metabolic process. This article reviews the mechanism of ventricular remodeling after myocardial infarction, explains the biological effect of shock wave, and the status of clinical application of extracorporeal cardiac shock wave therapy with the intent of improving ventricular remodeling after myocardial infarction.%急性心肌梗死后左室重构是临床上常见的进行性发展的病理生理过程,是心肌梗死远期心脏性死亡最重要危险因素之一.研究发现有多重因素参与相互促进,共同维持心肌梗死后心室重塑的发生发展.研究发现低能量的体外震波治疗有多项机制调节参与改善和恢复坏死区休眠心肌细胞功能,重新建立胶原代谢平衡,终止和缓解心室重塑发展.现综述心肌梗死后心室重塑发生机制;阐述震波治疗的生物效应及体外心脏震波治疗改善心肌梗死后心室重塑的潜在机制及研究现状.

  17. Effects of Extracorporeal Shock Wave Therapy Combined with Hyperbaric Oxygen on Nonunion of Long Bone Fractures%冲击波联合高压氧治疗长骨骨折不愈合的疗效分析

    Institute of Scientific and Technical Information of China (English)

    王海东; 杨智权; 张平; 张庆民; 徐啸; 李贵忠; 黄广林; 满立波

    2014-01-01

    Objective To explore the effect of extracorporeal shock wave therapy (ESWT) combined with hyperbaric oxygen on non-union after surgery. Methods 83 patients with nonunion were treated with ESWT combined with hyperbaric oxygen (treatment group), and 32 cases served as control group. ESWT application was conducted using a protocol totaling 3000 shocks per treatment. The treatment group received 3~5 times of treatment, at the same time hyperbaric oxygen therapy was performed. The control group received no treatment and was followed up at least 3 months after treatment. Results The overall success rate was 78.31% in the treatment group, while only 12.50%recovered in the control group (P<0.01). The complications of treatment group were less and negligible. Conclusion Treatment of nonunion by extracorporeal shock wave combined with hyperbaric oxygen is safe and effective.%目的:探讨体外冲击波疗法(ESWT)联合高压氧对骨折不愈合的治疗效果。方法将115例骨折不愈合患者分为ESWT联合高压氧治疗组(治疗组,n=83)和对照组(n=32)。治疗组采用ESWT治疗3~5次,每次治疗冲击计量3000次,期间配合高压氧治疗。对照组继续观察,随访3个月以上。结果治疗组总治愈率为78.31%,对照组为12.50%(P<0.01)。治疗组并发症少且轻微。结论 ESWT联合高压氧治疗骨折不愈合安全有效。

  18. Effect of Music Therapy on Comfort of Patients with Extracorporeal Shock Wave Iithotripsy%音乐疗法对128例行体外冲击波碎石患者舒适度的影响

    Institute of Scientific and Technical Information of China (English)

    李美红; 梁雪英

    2016-01-01

    Objective To study music therapy on the effect of extracorporeal shock wave lithotripsy patient comfort.Methods Se-lecting 256 patients with extracorporeal shock wave lithotripsy,patients were randomly divided into observation group and control group,each group of patients 128 cases,control group patients adopt conventional nursing methods;Observation group of patients in the control group,nursing method based on combined with music therapy intervention,two groups of patients undergoing regular care after treatment,compared two groups of patient care.Results The observation group,after the above treatment for the patients with sys-tolic blood pressure,heart rate,breathing,such as steady,anxious state improvement,significantly lower pain degree,a clear differ-ence between groups,statistical significance,P <0.05).Conclusion Using music therapy can effectively improve clinical extracorpo-real shock wave lithotripsy patient comfort,to improve patient care effect and improve the quality of prognosis,obtain ideal therapeutic effect,is worth promoting.%目的:观察音乐疗法对行体外冲击波碎石患者舒适度的影响。方法:选取接受体外冲击波碎石患者共256例,将患者分为观察组与对照组各128例。对照组采取常规护理方法;观察组在对照组护理方法基础之上,再联合采用音乐疗法干预治疗,两组在接受定期护理治疗后,比较两组护理效果。结果:观察组实施上述治疗后,患者收缩压、心率、呼吸等趋于平稳,焦虑状态改善,疼痛度明显降低,组间比较差异有统计学意义(P <0.05)。结论:临床上采用音乐疗法可有效提升行体外冲击波碎石患者舒适度,改善患者护理效果,提高预后质量,获得理想治疗效果,值得推广。

  19. THE CLINICAL EFFECTS OF COMBINED THERAPY OF EXTRACORPOREAL SHOCK WAVE AND ULTRASHORT WAVE ON STENOSAL TENDOSYNOVITIS%体外冲击波联合超短波治疗狭窄性腱鞘炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王李丽; 张晓哲; 刘延青

    2012-01-01

    目的:探讨体外冲击波联合超短波治疗狭窄性腱鞘炎的疗效.方法:将40例狭窄性腱鞘炎患者随机分为联合组与对照组各20例.联合组采用体外冲击波联合超短波治疗,对照组仅用超短波治疗.观察并记录术前、后的视觉模拟评分(visual analogue scale,VAS),并进行疗效评估.结果:治疗后30 d两组患者的VAS评分均低于治疗前(P<0.01),但联合组较对照组降低更明显(P<0.01).联合组总有效率为95%,对照组总有效率为80%,联合组疗效明显高于对照组.结论:体外冲击波联合超短波治疗狭窄性腱鞘炎是一种有效的治疗方法,疗效优于单纯超短波治疗法.%Objective: To explore the clinical effects of combined therapy of extracorporeal shock wave and ultrashort wave for stenosal tendosynovitis. Methods: A total of 40 cases with stenosal tendosynovitis were randomly and evenly divided into 2 groups: combined group and control group. The combined treatment group was treated with the combined therapy of extracorporeal shock wave and ultrashort wave. The control group was treated with single ultrashort wave only. The visual analgue scale (VAS) score and clinical effects were recorded before and after treatmennt. Results: Compared with before treatment, the VAS scores decreased in both groups at 30 d after treatment (P < 0.01). The VAS scores in combined group were lower than that in control group at 30 d after treatment (P < 0.01). The total effective rate in combined group (95%) was significantly higher than that in the control group (80%). Conclusion: The combined therapy of extracorporeal shock wave and ultrashort wave is effective for stenosal tendosynovitis, and the therapeutic effect is better than single ultrashort wave treatment.

  20. Ultrafast, In Situ Probing of Shocked Solids at the Mesoscale and Beyond: A New Paradigm for Materials Dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Lorenzana, H; Belak, J; Campbell, G; King, W; Nikkel, D; Bradley, K; McNaney, J; Kinney, J; Becker, R; Kalantar, D; Yaakobi, B

    2007-02-15

    Understanding material response under dynamic conditions and extreme pressures at the lattice level is important for being able to generate predictive models of material response. Despite many decades of study, material behavior is primarily inferred from bulk measurements on dynamically loaded samples or the microstructure from recovery experiments and not determined from lattice level measurements made in-situ at the relevant length scale of the governing physics. In the work described here, we report on progress made in advancing this frontier with research conducted under LDRD 04-ERD-071. Specifically, we present advances in, and applications of, dynamic x-ray diffraction, Extended X-ray Absorption Fine Structure and dynamic transmission electron microscopy.

  1. Shock initiation and detonation study on high concentration H2O2/H2O solutions using in-situ magnetic gauges

    Energy Technology Data Exchange (ETDEWEB)

    Sheffield, Stephen A [Los Alamos National Laboratory; Dattelbaum, Dana M [Los Alamos National Laboratory; Stahl, David B [Los Alamos National Laboratory; Gibson, L Lee [Los Alamos National Laboratory; Bartram, Brian D [Los Alamos National Laboratory; Engelke, Ray [Los Alamos National Laboratory

    2010-01-01

    Concentrated hydrogen peroxide (H{sub 2}O{sub 2}) has been known to detonate for many years. However, because of its reactivity and the difficulty in handling and confining it, along with the large critical diameter, few studies providing basic information about the initiation and detonation properties have been published. We are conducting a study to understand and quantify the initiation and detonation properties of highly concentrated H{sub 2}O{sub 2} using a gas-driven two-stage gun to produce well defined shock inputs. Multiple magnetic gauges are used to make in-situ measurements of the growth of reaction and subsequent detonation in the liquid. These experiments are designed to be one-dimensional to eliminate any difficulties that might be encountered with large critical diameters. Because of the concern of the reactivity of the H{sub 2}O{sub 2} with the confining materials, a remote loading system has been developed. The gun is pressurized, then the cell is filled and the experiment shot within less than three minutes. Several experiments have been completed on {approx}98 wt % H{sub 2}O{sub 2}/H{sub 2}O mixtures; homogeneous shock initiation behavior has been observed in the experiments where reaction is observed. The initial shock pressurizes and heats the mixture. After an induction time, a thermal explosion type reaction produces an evolving reactive wave that strengthens and eventually overdrives the first wave producing a detonation. From these experiments, we have determined unreacted Hugoniot points, times-to-detonation points that indicate low sensitivity (an input of 13.5 GPa produces detonation in 1 {micro}s compared to 9.5 GPa for neat nitromethane), and detonation velocities of high concentration H{sub 2}O{sub 2}/H{sub 2}O solutions of over 6.6 km/s.

  2. Shock initiation and detonation study on high concentration H2O2/H2O solutions using in-situ magnetic gauges

    Energy Technology Data Exchange (ETDEWEB)

    Sheffield, Stephen A [Los Alamos National Laboratory; Dattelbaum, Dana M [Los Alamos National Laboratory; Stahl, David B [Los Alamos National Laboratory; Gibson, L Lee [Los Alamos National Laboratory; Bartram, Brian D [Los Alamos National Laboratory; Engelke, Ray [Los Alamos National Laboratory

    2010-01-01

    Concentrated hydrogen peroxide (H{sub 2}O{sub 2}) has been known to detonate for many years. However, because of its reactivity and the difficulty in handling and confining it, along with the large critical diameter, few studies providing basic information about the initiation and detonation properties have been published. We are conducting a study to understand and quantify the initiation and detonation properties of highly concentrated H{sub 2}O{sub 2} using a gas-driven two-stage gun to produce well defined shock inputs. Multiple magnetic gauges are used to make in-situ measurements of the growth of reaction and subsequent detonation in the liquid. These experiments are designed to be one-dimensional to eliminate any difficulties that might be encountered with large critical diameters. Because of the concern of the reactivity of the H{sub 2}O{sub 2} with the confining materials, a remote loading system has been developed. The gun is pressurized, then the cell is filled and the experiment shot within less than three minutes. Several experiments have been completed on {approx}98 wt % H{sub 2}O{sub 2}/H{sub 2}O mixtures; homogeneous shock initiation behavior has been observed in the experiments where reaction is observed. The initial shock pressurizes and heats the mixture. After an induction time, a thermal explosion type reaction produces an evolving reactive wave that strengthens and eventually overdrives the first wave producing a detonation. From these experiments, we have determined unreacted Hugoniot points, times-to-detonation points that indicate low sensitivity (an input of 13.5 GPa produces detonation in 1 {micro}s compared to 9.5 GPa for neat nitromethane), and detonation velocities of high concentration H{sub 2}O{sub 2}/H{sub 2}O solutions of over 6.6 km/s.

  3. Low-energy extracorporeal shock wave therapy for promotion of vascular endothelial growth factor expression and angiogenesis and improvement of locomotor and sensory functions after spinal cord injury.

    Science.gov (United States)

    Yahata, Kenichiro; Kanno, Haruo; Ozawa, Hiroshi; Yamaya, Seiji; Tateda, Satoshi; Ito, Kenta; Shimokawa, Hiroaki; Itoi, Eiji

    2016-12-01

    OBJECTIVE Extracorporeal shock wave therapy (ESWT) is widely used to treat various human diseases. Low-energy ESWT increases expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. The VEGF stimulates not only endothelial cells to promote angiogenesis but also neural cells to induce neuroprotective effects. A previous study by these authors demonstrated that low-energy ESWT promoted expression of VEGF in damaged neural tissue and improved locomotor function after spinal cord injury (SCI). However, the neuroprotective mechanisms in the injured spinal cord produced by low-energy ESWT are still unknown. In the present study, the authors investigated the cell specificity of VEGF expression in injured spinal cords and angiogenesis induced by low-energy ESWT. They also examined the neuroprotective effects of low-energy ESWT on cell death, axonal damage, and white matter sparing as well as the therapeutic effect for improvement of sensory function following SCI. METHODS Adult female Sprague-Dawley rats were divided into the SCI group (SCI only) and SCI-SW group (low-energy ESWT applied after SCI). Thoracic SCI was produced using a New York University Impactor. Low-energy ESWT was applied to the injured spinal cord 3 times a week for 3 weeks after SCI. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan open-field locomotor score for 42 days after SCI. Mechanical and thermal allodynia in the hindpaw were evaluated for 42 days. Double staining for VEGF and various cell-type markers (NeuN, GFAP, and Olig2) was performed at Day 7; TUNEL staining was also performed at Day 7. Immunohistochemical staining for CD31, α-SMA, and 5-HT was performed on spinal cord sections taken 42 days after SCI. Luxol fast blue staining was performed at Day 42. RESULTS Low-energy ESWT significantly improved not only locomotion but also mechanical and thermal allodynia following SCI. In the double staining, expression of VEGF was observed in Neu

  4. A preliminary application of extracorporeal shock wave therapy in children with spastic cerebral palsy%体外冲击波治疗对痉挛型脑瘫儿童足背屈角的影响

    Institute of Scientific and Technical Information of China (English)

    杜琳; 王冰; 王刚; 贾飞勇; 冯俊燕; 单玲

    2014-01-01

    目的:探讨体外冲击波治疗对痉挛型脑瘫儿童足背屈角的改善效果。方法将痉挛型脑瘫患儿随机分为综合康复对照组和体外冲击波治疗组,综合康复对照组只接受常规的综合康复训练进行治疗,体外冲击波治疗组则在综合康复训练的同时进行体外冲击波治疗,应用被动足背屈角对两组患儿进行评价,比较两组患儿治疗1个月和3个月后的被动足背屈角变化有无统计学差异,分别比较治疗组初始治疗时、治疗1个月和3个月后当次治疗前后的被动足背屈角变化有无统计学差异,以此观察体外冲击波治疗的治疗效果。结果治疗1个月后和3个月后,治疗组患儿被动足背屈角的缩小均优于对照组(P<0.05),治疗组患儿初始治疗、治疗后1个月和治疗后3个月的当次治疗后足背屈角的缩小均优于当次治疗前(P<0.05)。结论体外冲击波治疗可以有效缩小痉挛型脑瘫儿童的足背屈角,即时效果明确,并在3个月内持续出现。%Objective To investigate the effects of extracorporeal shock wave therapy on foot dorsiflexion angle of children with spastic cerebral palsy. Methods The children with spastic cerebral palsy were randomly divided into two groups, control group and treatment group. The control group only accepted conventional comprehensive rehabilitation and the treatment group accepted extracorporeal shock wave therapy during comprehensive rehabilitative training. Evaluating children with passive foot dorsiflexion angle after the first month and the third month, comparing the difference of improvement in passive foot dorsiflexion angle between two groups, respectively comparing the difference of improvement in passive foot dorsiflexion angle between pre-therapy and post-treatment every time in the beginning, the first month and the third month in treatment group, to observe the effects of extracorporeal shock wave therapy

  5. Research Progress of Extracorporeal Cardiac Shock Wave Therapy in Treating Coronary Artery Disease%体外心脏震波治疗冠心病的疗效研究进展

    Institute of Scientific and Technical Information of China (English)

    彭云珠; 杨萍

    2011-01-01

    Extracorporeal cardiac shock wave therapy (CSWT) is an effective and noninvasive therapeutic strategy for coronary artery disease. Additionally, it can enhance ischemic myocardium angiogenesis, improve ventricular remodeling after myocardial infarction, and it has been shown to relieve patient symptoms without side-effects. This article presents the history of CSWT in coronary artery disease, and reviews the development of the therapy and the assessment of the curative effects of CSWT.%体外心脏震波治疗是近年来治疗冠心病的一个安全无创的新方法.研究表明它能促进血管再生,改善心肌梗死后心室重构以及慢性心肌缺血患者症状,现对心脏震波治疗冠心病的疗效研究进展做一综述.

  6. Advance of low -intensity extracorporeal shock wave therapy of erectile dysfunction%低强度体外冲击波治疗勃起功能障碍的进展

    Institute of Scientific and Technical Information of China (English)

    李道云; 刘凯峰

    2014-01-01

    目的:探讨低强度体外冲击波治疗(low intensity of extracorporeal shock wave therapy ,LI-ES-WT)阴茎勃起功能障碍的效果及探索治疗勃起功能障碍新方法。方法:对近年来国内外各机构用LI-ES-WT治疗阴茎勃起功能障碍的相关文献进行总结。结果:LI-ESWT对于勃起功能障碍治疗的效果显著。结论:要对该病患者多方面的因素进行综合分析,并在此基础上选择合适的治疗方案,为患者的治疗提供更好的选择。%Objectives:To explore the effect of low-intensity of extracorporeal shock wave therapy (LI-ESWT)for penile erectile dysfunction and explore new treatment methods of erectile dysfunction.Methods:To summarize the mechanism of related literatures with LI-ESWT in the treatment of erectile dysfunction at home and abroad in recent years.Results:The effect of LI-ESWT for erectile dysfunction was significant.Conclusion:A comprehensive analysis should be conducted on various factors of the disease to select a suitable therapy and provide the best reference for patients.

  7. Comparative analysis between extracorporeal shock wave and surgical treatment of nonunion%体外冲击波疗法与手术治疗骨不连疗效对比分析

    Institute of Scientific and Technical Information of China (English)

    王志强; 赵栋; 谢鹏; 王景贵

    2012-01-01

    [Objective] To explore the effect of shock wave in the treatment of nonunion. [ Methods] Shock wave group, 50 nonunion patients, shock wave treatment was used for 2 to 4 times and the treatment interval was 7~10 days. Surgery group, 35 cases of nonunion, according to the patient's condition different surgical approach were applied. [ Results] Two groups of patients received an average 11 months follow-up. In the shock wave group 46 patients healed, and in the surgical group 32 patients healed. [Conclusion]In the case of similar efficacy, extracorporeal shock wave therapy of nonunion is non-invasive, low cost, without hospitalization, but forgetting satisfactory results, indications must be strictly followed.%[目的]探讨冲击波在治疗骨不连中的疗效.[方法]冲击波组50例骨不连患者,应用冲击波治疗2~4次,治疗间隔7~10d.手术组,35例骨不连患者,根据患者病情选择不同的手术方式.[结果]两组患者均获平均11个月随访,冲击波组46例愈合,手术组32例愈合.[结论]在疗效相近的情况下,体外冲击波治疗骨不连具有无创、费用低、无需住院等优点,但要获得满意的疗效,必须严格掌握适应证.

  8. Curative effect of extracorporeal shock wave lithotripsy in the treatment of urinary calculi%体外冲击波碎石术治疗泌尿系结石的效果

    Institute of Scientific and Technical Information of China (English)

    徐红亮

    2014-01-01

    Objective To observe the curative effect of extracorporeal shock wave lithotripsy in the treatment of urinary calculi. Methods The clinical data of 98 cases with urinary calculi admitted to People's Hospital of Yunyang County in Chongqing City from January 2012 to January 2014 were analyzed retrospectively. All patients were taken the therapy of extracorporeal shock wave lithotripsy, and the curative effect and conditions of complications were observed. Results Among patients of this study, 44 cases of patients egested calculi completely for once, accounting for 44.90%, 30 cases of patients egested calculi completely for twice, accounting for 30.61%, 21 cases of patients egested calculi completely for three times, accounting for 22.45%, 3 cases of patients were failed after extracorporeal shock wave lithotripsy and then took open surgery. The clinical curative effect showed that, there were 54 cases of cured, 41 cases of improved, 3 cases of failed, the total effective rate was 96.94%. Complications after extracorporeal shock wave lithotripsy, all pa-tients showed more or less gross hematuria or microscopic hematuria, 1-2 days later, they were disappeared;the skin of 5 cases of patients showed petechiae or ecchymosis, the symptoms were disappeared without any treatment; 4 cases of patients showed more or less ureteral colic, the symptoms were improved through symptomatic treatment;2 cases of pa-tients were formed ureteral “stone street”, the symptom was disappeared after another extracorporeal shock wave lithotripsy; 1 case was combined with slight ureteral stricture; 2 cases had fever, the symptom was improved through antifebrile precessing; there were no other serious complications. Conclusion Extracorporeal shock wave lithotripsy in the treatment of urinary calculi has advantages of simple handling, safe and fast, exact curative effect, less side effects, and so on, which is worthy of clinical promotion and application.%目的:观察体外冲击波碎石

  9. Extracorporeal treatment for theophylline poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Wiegand, Timothy J; Liu, Kathleen D

    2015-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Here, the workgroup presents its systematic review and recommendations for theophylline. METHODS: After a systematic...... theophylline poisoning (1C). Specific recommendations for ECTR include a theophylline concentration [theophylline] > 100 mg/L (555 μmol/L) in acute exposure (1C), the presence of seizures (1D), life-threatening dysrhythmias (1D) or shock (1D), a rising [theophylline] despite optimal therapy (1D), and clinical...... deterioration despite optimal care (1D). In chronic poisoning, ECTR is suggested if [theophylline] > 60 mg/L (333 μmol/L) (2D) or if the [theophylline] > 50 mg/L (278 μmol/L) and the patient is either less than 6 months of age or older than 60 years of age (2D). ECTR is also suggested if gastrointestinal...

  10. 体外膜肺氧合对心脏手术后心源性休克的辅助效果%Extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock

    Institute of Scientific and Technical Information of China (English)

    侯晓彤; 孟旭; 龚庆成; 尤斌; 张健群; 程沛; 王盛宇; 曹向戎; 毛斌

    2008-01-01

    Objective To report the experience on extracorporeal membrane oxygenation (ECMO) for cardiogenic shock after cardiac surgery. Methods From June 2004 to October 2005, 26 patients with cardiogenic shock after cardiac surgery were placed on venoarterial ECMO using a heparin-bonded circuit. Surgical procedures included 10 coronary bypass, 5 valve replacement, 5 congenital heart disease repair, 4 heart transplantation and 1 aortic procedure. Average of patient age was (44.6±19.7) years (range, 7 months to 76 years). Average body weight was (64.1 ± 18.6) kg (range, 6.5 to 90.0 kg). Results Average time on ECMO was ( 72.6 ± 74.9 ) hours (range, 8 to 336 hours). Sixteen patients ( 61.5 % ) were weaned from ECMO. Twelve patients (45.2 % ) were suceessfully discharged. Conclusion Extracorporeal membrane oxygenation can provide cardiac support in patients in cardiogenic shock after cardiac surgery. The hospital survival is rather good compared with relative reports.%目的 报道体外膜肺氧合器(ECMO)对心脏术后心源性休克进行辅助的初步结果并总结经验.方法 2004年6月至2006年10月,临床应用肝素涂层ECMO对心脏术后心源性休克进行辅助26例,其中冠心病10例,瓣膜病6例,心脏移植4例,先心病5例,大血管病变1例.年龄7个月~76岁,平均(44.6±19.7)岁;体重6.5~90.0 kg,平均(64.1±18.6)kg.结果 辅助8~336 h.16例脱机,脱机率为61.5%.4例脱机后死亡,12例生存出院(46.2%).结论 ECMO可以有效地进行心脏术后心源性休克的辅助,辅助效果较好.

  11. 放散状与聚焦状冲击波治疗肱骨内上髁炎的疗效比较%Effect of radial and focused extracorporeal shock waves in the treatment of humeral internal epicondylitis

    Institute of Scientific and Technical Information of China (English)

    张隆浩; 黄广林; 满立波

    2013-01-01

    目的 探讨放散状与聚焦状冲击波治疗肱骨内上髁炎的疗效及安全性.方法 35例肱骨内上髁炎患者随机被分为放散状冲击波治疗组(放散组)和聚焦状冲击波治疗组(聚焦组),分别为20例和15例.放散组患者治疗频率为10 Hz,治疗探头15 mm,治疗压力l~2 bar,冲击剂量2000/次,手持压力低-中.聚焦组患者治疗电压7~8 kV,冲击频率60次/min,冲击剂量1200次.所有患者均治疗3次,治疗间隔为7d,治疗部位为肱骨内上髁部.治疗前,末次治疗4周后和12周后采用视觉模拟评级(VAS)法评估患者治疗前后疼痛强度.结果 两组患者治疗前VAS评分相近,放散组VAS评分(6.53±2.40),聚焦组VAS评分(7.19±1.98);末次治疗4周后及12周后,VAS评分均显著低于治疗前,差异有统计学意义(P<0.05);末次治疗4周后放散组VAS评分(3.47±1.93)显著低于聚焦组VAS评分(4.89 ±0.12),两组之间差异有统计学意义(P<0.05);在12周时放散组VAS评分2.05±1.11,聚焦组VAS评分2.22±0.42,两组比较之间差异无明显意义(P>0.05).结论 放散状冲击波治疗肱骨内上髁炎显效快,但是远期疗效与聚焦状冲击波治疗无明显差异.%Objective To compare the effect of the radial and focused extracorporeal shock waves in the treatment of humeral internal epicondylitis.Methods Thirty-five patients were included in the study,20 received radial extracorporeal shock waves therapy (RSWT) and the others received focused extracorporeal shock waves therapy (FSWT).RSWT group impulses applied with the 15 mm applicator at frequency of 10 Hz,with 2 000 impulses per session,air pressure of the device set at 1-2 bar.FSWT group impulses applied at frequency of 1 Hz,with 1 200 impulses per session,the treatment voltage set at 7-8 kV.Each patient received 3 sessions of treatment with 7 days apart.Visual analog scale (VAS) score was used to evaluate the extent of pain before the therapy and 4 or 12 weeks after the last

  12. Extracorporeal shock wave combined with massage therapy in the treatment of Achilles tendon enthesitis%体外冲击波结合推拿治疗跟骨跟腱止点末端病的临床研究

    Institute of Scientific and Technical Information of China (English)

    周春龙; 蔡建浩; 许易

    2013-01-01

    Objective:To evaluate the clinical effects of the extracorporeal shock wave combined with massage therapy in the treatment of the Achilles tendon enthesitis. Methods:56 athletes majored in track and field,badminton or gymnastics with Achilles tendon enthesitis in our college were randomly divided into the treatment group and the control group with 28 cases in each group. The athletes in the treatment group received extracorporeal shock wave combined with massage therapy and those in the control group were treated with extracorporeal shock wave therapy alone. Each athlete received the treatment once every four days and the duration of the the treatment was forty days. The sports training was not terminated during the treatment with a support belt being used to protect the Achilles tendon. The triceps muscle of calf was passively stretched after the sports training. The soft tissue tension test and visual analogue scales (VAS) were used to access the clinical effects at the beginning and the end of the treatment and the last follow-up visit. Results:The improvement of VAS in the treatment group was both better than that in the control group at the end of the treatment and the last follow-up visit with statistical significance ( F = 59. 258 ,P <0. 001). The improvement of the soft tissue test in the treatment group was higher than that in the control group with statistical significance at the end of the treatment and the last follow-up visit ( F = 55. 615 , P < 0. 001) . Conclusion:The clinical improvement was gotten in both groups and the improvement in the treatment group was better than that in the control group. The extracorporeal shock wave combined with massage therapy was more effective than the extracorporeal shock wave therapy alone for Achilles tendon enthesitis.%目的:观察体外冲击波结合推拿治疗跟骨跟腱止点末端病的疗效.方法:将来自本学院田径、羽毛球和体操专业的56例跟骨跟腱止点末端病运动员随机分

  13. 放散状与聚焦状冲击波治疗足底筋膜炎疗效比较%Comparison of the Curative Effect of Radial and Focused Extracorporeal Shock Waves in Treating the Plantar Fasciitis

    Institute of Scientific and Technical Information of China (English)

    张隆浩; 满立波; 黄广林; 王海; 徐啸

    2012-01-01

    Objective To compare the curative effect of radial and focused extracorporeal shock waves in the treatment of plantar fasciitis. Methods Fifty two patients with plantar fasciitis were included in the study, 26 of them received radial extracorporeal shock waves therapy (group R) and the others received focused extracorporeal shock waves therapy (group F). 5 Hz impulses of radial extracorporeal shock waves was applied for group R for 15 mm,2,000 impulses per session,and 2-3 bar air pressure. 1 Hz impulses was applied for group F for 15 mm, 1,200 impulses per session,and at the voltage of 7-8 kV. Each patient received three sessions of treatment with an interval of 1 week. Visual Analog Scale (VAS) score was used to evaluate the extent of pain before the therapy and 4 or 12 weeks after the last therapy. Results Prior to the therapy,the VAS scores were similar for both groups. VAS scores of 4 and 12 weeks after the therapy were significantly lower than before therapy (P 0.05). Conclusion Radial extracorporeal shock waves therapy showed a better effectiveness for treating plantar fasciitis in short-term, while there was no significant long-term difference in therapeutic effect between the two groups.%目的:比较放散状与聚焦状冲击波治疗足底筋膜炎的疗效.方法:52例足底筋膜炎患者被分为放散状冲击波治疗组(放散组)与聚焦状冲击波治疗组(聚焦组),每组26例.放散组患者治疗频率为5 Hz,治疗探头15 mm,治疗压力2~3bar,冲击波次数2000,手持压力中-高.聚焦组患者治疗电压7~8 kV,冲击频率60次/min,冲击次数1200次.所有患者均治疗3次,每次治疗间隔7天,治疗部位均为患侧跟骨内侧结节.治疗前和末次治疗后4周后和12周后,采用视觉模拟评级法(VAS)评估患者治疗前后疼痛强度.结果:治疗前两组患者VAS评分相近,末次治疗4周后及12周后,VAS评分均显著低于治疗前,两组之间的差异有统计学意义(P<0.05);本次治疗4

  14. [Treatment of hydroxychloroquine poisoning with extracorporeal circulation].

    Science.gov (United States)

    Mongenot, F; Gonthier, Y Tessier; Derderian, F; Durand, M; Blin, D

    2007-02-01

    We report a case of massive overdose of hydroxychloroquine treated with circulatory assistance by peripheral extracorporeal circulation (ECC). We expose the case of a 39-year-old woman who ingested 12 g of hydroxychloroquine with bromazepam, paroxetine, and zolpidem, in a suicide attempt. Patient has developed central nervous system depression, hemodynamic failure, life-threatening ventricular arrhythmias, and serious hypokalemia. Initially the patient has received conventional treatment with gastric lavage and activated charcoal for gastrointestinal decontamination, blood volume expansion and vasopressive drugs, intubation and mechanical ventilation, high dose of diazepam, and potassium replacement. A ventricular fibrillation was treated with external cardiac massage. In spite of this treatment, cardiogenic shock was uncontrolled, and imposed circulatory assistance. After extracorporeal circulation, we observed a spectacular improvement of hemodynamic parameters and electrocardiographic normalization at day one. Extracorporeal circulation could be used as a rescue treatment of cardiotrope and hydroxychloroquine overdoses.

  15. 体外冲击波疗法治疗胫骨结节骨软骨炎的疗效观察%Therapeutic effect of extracorporeal shock wave therapy on Osgood-Schlatter disease

    Institute of Scientific and Technical Information of China (English)

    吴洪; 兰才生; 邓惠文; 郑夏茹

    2010-01-01

    目的 观察体外冲击波疗法对胫骨结节骨软骨炎患者的临床疗效.方法 将60例胫骨结节骨软骨炎患者采用随机数字表法分为试验组和对照组,每组各30例.试验组采用体外冲击波疗法;对照组采用微波治疗、减少运动量和充分休息局部制动.结果 试验组和对照组治疗后胫骨结节部疼痛目测类比评分较治疗前均明显降低(P<0.05),分别为(2.2±1.3)分比(7.9±2.4)分、(4.8±2.6)分比(8.2±2.5)分,且试验组明显优于对照组(P<0.05).试验组治愈率[83.33%(25/30)]明显高于对照组[63.33%(19/30)],差异有统计学意义(P<0.05).结论 体外冲击波疗法是胫骨结节骨软骨炎的一种有效治疗方法.%Objective To investigate the therapeutic effect of extracorporeal shock wave therapy on Osgood-Schlatter disease. Methods Sixty Osgood-Schlatter disease patients were evenly randomly divided into therapeutic group 30 cases and control group 30 cases. The therapeutic group was treated with extracorporeal shock wave therapy. The control group was treated with high frequency electro therapy and rest on knee joint Results The clinical symptom and pain with visual analogous score the tibial tubercle of therapeutic group and control group were obviously decreased after treatment compared with before treatment (P< 0.05), they were (2.2 ± 1.3) scores vs (7.9 ± 2.4) scores, (4.8 ± 2.6) scores vs (8.2 ± 2.5) scores,the therapeutic group in pain resume significantly better than the control group (P<0.05 ). The cured rate of the therapeutic group was 83.33% (25/30), the control group was 63.33% (19/30), there was significant difference between the two groups (P <0.05). Conclusion The rehabilitation therapeutic effect of extracorporeal shock wave therapy on the Osgood-Schlatter disease is remarkable.

  16. Clinical effect analysis of quality care for treatment of frozen shoulder with extracorporeal shock wave%体外冲击波治疗肩周炎应用优质护理的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    林丽景; 韦翠花; 吴爱花; 黄凯莉

    2016-01-01

    目的:探讨体外冲击波治疗肩周炎患者实施优质护理干预的临床效果。方法选择2013年6月~2015年6月158例患有肩周炎患者,采用体外冲击波进行治疗,将患者随机分成观察组90例,对照组68例,对照组采用常规护理,观察组采用优质护理。观察并分析两组患者的治疗效果情况。结果观察组在治疗后1周、1个月、3个月及半个月后疼痛缓解明显优于对照组,治疗6个月后肩关节活动度明显改善;差异具有统计学意义(P<0.05)。结论优质护理干预对于体外冲击波治疗肩周炎患者效果显著,解决患者疾患,促进医护患和谐,提高患者的满意度,此护理值得在临床上推广应用。%Objective To explore the clinical efficacy of quality care for treatment of frozen shoulder with extracorporeal shock wave.Methods From June 2013 to June 2015,158 patients suffering from frozen shoulder were selected,all the patients were treated with extracorporeal shock wave,and were randomly divided into observation group(90 cases) and control group(68 patients).The patients in control group were given usual care, the patients in observation group were given quality care.The therapeutic effect of patients in two groups were observed and analyzed. Results In the observation group,after one week,one month,three months and two weeks treatment,the pain relief of patients was significantly better than that of patients in control group,after 6 months of treatment,the patients’ joint activity were significantly improved in observation group,the difference was statistically significant.Conclusion Quality care intervention for extracorporeal shock wave therapy in patients with frozen shoulder have significant effect,can relieve symptoms,promote harmony between doctors,care and patients,improve patient satisfaction,the quality care worthy of clinical application.

  17. Extracorporeal Shock Wave Therapy for Sports Injuries of Shoulder%体外冲击波治疗肩关节肌腱软组织损伤35例报道

    Institute of Scientific and Technical Information of China (English)

    戈允申; 陈世益; 李云霞

    2011-01-01

    Objective To reveal the techniques and efficiency of extracorporeal shock wave therapy (ESWT) in shoulder injuries. Methods Thirty-five patients examined shoulder disorders had received extracorporeal shock wave therapy (ESWT) . The follow-up evaluation was at 2. 4 and 6 weeks after completion of treatment. Pain and functional were assessed by VAS and Fudan University Shoulder Score (FDSS) . If the symptom was not relieved or even worse in the course of follow-up, patients was allocated to take a surgical treatment. A dynamic VAS assessment was also used to adjust the output energy in treatment. Results Except 3 patients examined rotator cuff lesion intervened by arthroscopic surgery procedure, thirty-two cases were given a full cycle treatment. The mean FDSS score increased from 44.7±7.1 to 92.9±2.5, and VAS score decreased from 8.1 ±0.9 to 1.5±0.7. At 4 weeks follow-up, the symptoms improved significantly. Conclusion Extracorporeal shock wave therapy had satisfied effects in the treatment of most shoulder musculoskeletal injuries, but less effects in some structural avulsion disorders, such as rotator cuff tear.%目的:探讨体外冲击波治疗肩关节肌腱软组织损伤的技术及疗效.方法:使用放散状体外冲击波治疗机治疗35例肩关节损伤患者.治疗1个疗程后分别随访2、4、6周,使用复旦大学肩关节评分系统( FDSS)和VAS进行疗效评价.期间如有症状反复或疗效不佳者转为手术干预.治疗中采用动态VAS评价法调整能量输出.结果:32例肩伤患者完成冲击波治疗,3例肩袖撕裂患者因疗效不佳中转关节镜手术治疗.完成治疗患者的FDSS平均得分由治疗前的(44.7±7.1)分提高到治疗后6周的(92.9±2.5)分,VAS评分由治疗前的(8.1±0.9)分降到治疗后6周的(1.5±0.7)分.治疗后4周左右症状改善明显.结论;体外冲击波治疗肩关节肌腱软组织慢性损伤(如肩袖腱病、肩峰下滑囊炎、肱二头肌长头腱炎、钙化性

  18. 心理干预和音乐支持在体外冲击波碎石中的应用%The Application of Psychological Intervention and Music Support in Extracorporeal Shock Wave Lithotripsy

    Institute of Scientific and Technical Information of China (English)

    杨福敏

    2014-01-01

    Objective To investigate the psychological intervention and support for music urinary calculi in patients receiving ESWL process of psychological change. Method: Through close observation of 210 cases of urinary calculi in patients receiving extracorporeal shock wave lithotripsy psychological barriers exist in the process, analyze and give psychological intervention and play music. Results: received psychological intervention and support of music ESWL patients discharged ideological concerns, no sense of fear and anxiety, and actively cooperate with treatment, muscle relaxation, so B-positioning easy operation, the treatment process smooth, good gravel ef ect, row Stone quickly, and achieved satisfactory results. Conclusion: the psychological intervention and music support is an important guarantee of extracorporeal shock wave lithotripsy treatment smoothly, can improve the success rate of stone removal in a large extent, the clinical satisfactory treatment ef ect.%目的:探讨心理干预和音乐支持对于泌尿系结石患者在接受体外震波碎石过程中的心理变化的影响。方法通过对210例泌尿系结石患者在接受体外冲击波碎石术过程中存在的心理障碍密切观察、分析,给予心理干预并播放轻音乐。结果接受心理干预和音乐支持的体外震波碎石的患者,思想顾虑解除,无恐惧及忧虑感,积极配合治疗,肌肉放松,使B超定位操作轻松,治疗过程顺利,碎石效果好,排石快,取得满意效果。结论心理干预和音乐支持是体外冲击波碎石治疗顺利进行的重要保证,能在很大程度上提高排石的成功率,临床收到满意的治疗效果。

  19. Time-resolved in situ detection of CO in a shock tube using cavity-enhanced absorption spectroscopy with a quantum-cascade laser near 4.6 µm.

    Science.gov (United States)

    Sun, Kai; Wang, Shengkai; Sur, Ritobrata; Chao, Xing; Jeffries, Jay B; Hanson, Ronald K

    2014-10-06

    Cavity-enhanced absorption spectroscopy (CEAS) using a mid-infrared DFB quantum-cascade laser is reported for sensitive time-resolved (10 μs) in situ CO measurements in a shock tube. Off-axis alignment and fast scanning of the laser wavelength were used to minimize coupling noise in a low-finesse cavity. An absorption gain factor of 91 was demonstrated, which enabled sub-ppm detection sensitivity for gas temperatures of 1000-2100K in a 15 cm diameter shock tube. This substantial improvement in detection sensitivity compared to conventional single-pass absorption measurements, shows great potential for the study of reaction pathways of high-temperature combustion kinetics mechanisms in shock tubes.

  20. Shock

    Science.gov (United States)

    Shock can be caused by any condition that reduces blood flow, including: Heart problems (such as heart attack or heart failure ) Low blood volume (as with heavy bleeding or dehydration ) Changes in blood vessels (as with infection ...

  1. Therapeutic effects of extracorporeal shock waves for the treatment of tibia stress fractures%体外冲击波疗法治疗胫骨应力性骨折疗效分析

    Institute of Scientific and Technical Information of China (English)

    程俊华; 周忠; 王万明; 孙效棠; 李同涛; 陈振南; 易文彪

    2014-01-01

    目的:观察体外冲击波在胫骨应力性骨折患者的疗效,并观察体外冲击波治疗的安全性。方法对2011年1月至2012年9月在我院治疗的34例胫骨应力性骨折患者,随机分为试验组(19例)和对照组(15例)。试验组使用体外冲击波对骨折处进行干预。对照组采用石膏固定的方法治疗。治疗后每4周复查X片、CT,并检查全身状况、进行DOMS疲劳程度6级及股四头肌肌力评分、膝关节活动度测量。比较两组患者治疗后DOMS≤1级所需周数和患者的治疗-愈合时间(THT)。结果经治疗后患者均获得临床愈合。达到DOMS≤1级的时间:试验组为(12.21±1.62)周;对照组为(17.05±3.51)周,THT:试验组为(16.44±2.14)周;对照组为(20.20±2.19)周,试验组骨折DOMS≤1级的时间及愈合时间均优于对照组,差异有统计学意义(P<0.05)。结论体外冲击波对于应力性骨折的治疗在加速骨折愈合和缓解疼痛症状方面均明显优于传统治疗方法,并有效预防关节僵硬和肌力下降,疗效明确,具有确切的应用价值。%Objective To compare the effects of extracorporeal shock waves and conventional methods for the treatment of tibia stress fractures, and to observe the effectiveness and safety of extracorporeal shock wave therapy. Methods 34 male soldiers, diagnosed the tibia stress fractures, in our hospital from January 2011 to September 2012, were randomly divided into experimental group (19 cases) and the control group (15 cases). The experimental group used extracorporeal shock wave treatment to treat fractures. Control group was used the plaster immobilization methods. After treatment, reviewed X-rays, CT, checked the general condition, and DOMS fatigue level 6 ratings, assessing the quadriceps muscle strength and measuring the angle of the knee joint activities every 4 weeks. Comparing two groups of patient's time of recover to DOMS≤1

  2. The effect and mechanism of extracorporeal shock wave therapy on bone and bone diseases%体外震波对骨和骨疾病的作用及其机制

    Institute of Scientific and Technical Information of China (English)

    燕晓宇; 罗从风; 曾炳芳

    2007-01-01

    体外震波(extracorporeal shock wave,ESW)于20世纪80年代中期开始用于骨科领域,目前,它作为一种非侵入性治疗方法用于治疗多种骨相关疾病。为指导其进一步用于临床治疗并提高疗效,了解它对正常骨组织的影响和对骨疾病的治疗作用及其机制非常重要。现已有不少学者对这些方面进行了相关的基础与临床研究,取得了明显进展。本文就体外震波对骨和骨疾病的作用及其机制综述如下。

  3. Efficacy of Combined Endoscopic Lithotomy and Extracorporeal Shock Wave Lithotripsy, and Additional Electrohydraulic Lithotripsy Using the SpyGlass Direct Visualization System or X-Ray Guided EHL as Needed, for Pancreatic Lithiasis

    Directory of Open Access Journals (Sweden)

    Ken Ito

    2014-01-01

    Full Text Available Introduction. To evaluate the efficacy of combined endoscopic lithotomy and extracorporeal shock wave lithotripsy (ESWL, and additional electrohydraulic lithotripsy (EHL as needed, for the treatment of pancreatic duct stones, we retrospectively evaluated 98 patients with chronic pancreatitis and pancreatic lithiasis. Methods. For the management of main pancreatic duct (MPD stones in 98 patients, we performed combined endoscopic treatment (ET/ESWL therapy as the first treatment option. When combined ET/ESWL was unsuccessful, EHL with the SpyGlass Direct Visualization system or X-ray guided EHL was performed. Outpatient ESWL was reserved as one of the final treatment options. Results. Fragmentation was successful in 80 (81.6% patients as follows: combined ET/ESWL: 67 cases; SpyGlass EHL: 4 cases; X-ray guided EHL: 3 cases; and outpatient ESWL: 6 cases. Successful outcome was obtained by combined ET/ESWL in 67 of the 98 patients (74.5%, by EHL in 7 of 14 patients (7.1%, and by outpatient ESWL in 6 of 6 patients (6.1%. Negotiating the guidewire through a severe MPD stricture was significantly associated with a higher rate of stone fragmentation (P=0.0003. Conclusions. In cases where combined ET/ESWL was not successful for stone clearance, EHL using the SpyGlass system or X-ray guided EHL was effective in cases where the guidewire could be negotiated through the MPD stricture and it increased the fragmentation rate.

  4. Progress of extracorporeal shock wave therapy in clinical application of muscle spasticity after stroke%体外冲击波对脑卒中肌肉痉挛的临床研究进展

    Institute of Scientific and Technical Information of China (English)

    李若金; 张红; 李贺; 徐国兴; 李贞兰

    2016-01-01

    脑卒中后常遗留不同程度的功能障碍,影响着患者的日常生活活动能力,给家庭和社会带来了沉重负担.肌痉挛是导致功能障碍的主要原因之一,因此,安全、有效且持久地控制肌痉挛对于功能恢复非常有益.近年来体外冲击波治疗应用于脑卒中肌痉挛,疗效显著,现就其在脑卒中肌痉挛治疗中的临床应用进展进行综述.%Patients who have survived stroke always have some dysfunction, which not only affects the ability of daily living of the patients, but also brings a heavy burden for the family and the society. One of the factors for dysfunction is muscle spasticity, thus, maintaining spasticity in a safe, effective and durable way is useful for functional recovery. In recent years, extracorporeal shock wave therapy has been applied to treat spasticity in patients after stroke with a striking effect. This paper summarized the progress in clinical application in the treatment of spasticity.

  5. Extracorporal Shock Waves Activate Migration, Proliferation and Inflammatory Pathways in Fibroblasts and Keratinocytes, and Improve Wound Healing in an Open-Label, Single-Arm Study in Patients with Therapy-Refractory Chronic Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Ilknur Aschermann

    2017-02-01

    Full Text Available Background/Aims: Chronic leg ulcers (CLUs are globally a major cause of morbidity and mortality with increasing prevalence. Their treatment is highly challenging, and many conservative, surgical or advanced therapies have been suggested, but with little overall efficacy. Since the 1980s extracorporal shock wave therapy (ESWT has gained interest as treatment for specific indications. Here, we report that patients with CLU showed wound healing after ESWT and investigated the underlying molecular mechanisms. Methods: We performed cell proliferation and migration assays, FACS- and Western blot analyses, RT-PCR, and Affymetrix gene expression analyses on human keratinocytes and fibroblasts, and a tube formation assay on human microvascular endothelial cells to assess the impact of shock waves in vitro. In vivo, chronic therapy-refractory leg ulcers were treated with ESWT, and wound healing was assessed. Results: Upon ESWT, we observed morphological changes and increased cell migration of keratinocytes. Cell-cycle regulatory genes were upregulated, and proliferation induced in fibroblasts. This was accompanied by secretion of pro-inflammatory cytokines from keratinocytes, which are known to drive wound healing, and a pro-angiogenic activity of endothelial cells. These observations were transferred “from bench to bedside”, and 60 consecutive patients with 75 CLUs with different pathophysiologies (e.g. venous, mixed arterial-venous, arterial were treated with ESWT. In this setting, 41% of ESWT-treated CLUs showed complete healing, 16% significant improvement, 35% improvement, and 8% of the ulcers did not respond to ESWT. The induction of healing was independent of patient age, duration or size of the ulcer, and the underlying pathophysiology. Conclusions: The efficacy of ESWT needs to be confirmed in controlled trials to implement ESWT as an adjunct to standard therapy or as a stand-alone treatment. Our results suggest that EWST may advance the

  6. [Shock waves in orthopedics].

    Science.gov (United States)

    Haupt, G

    1997-05-01

    Extracorporeal shock waves have revolutionized urological stone treatment. Nowadays shock waves are widely used in orthopedics, too. This article reviews the applications of extracorporeal shock waves on bone and adjacent soft tissue. The osteoneogenetic effect of extracorporeal shock waves has been proven and can be used to treat pseudarthrosis with a success rate of around 75%. Shock waves have a positive effect in tennis and golfer's elbow, calcaneal spur, and the complex called "periarthritis humero-scapularis." The mechanism for this is not yet known, and results from large prospective and randomized studies are still lacking. However, the treatment has been performed many thousands of times. In patients in whom conservative treatment has failed surgery used to be the only choice, but its success rate barely exceeds that of shock wave therapy and surgery can still be done if shock wave therapy fails. Extracorporeal shock waves will have an impact on orthopedics comparable to its effect in urology. Scientific evaluations, professional certifications, quality assurance and reimbursement issues present great challenges.

  7. Extracorporeal shock wave and myocardial angiogenesis:effects on endogenous stem cells, cytokines and local microenvironment%体外震波与心肌血管新生:对内源性干细胞、细胞因子、局部微环境的影响

    Institute of Scientific and Technical Information of China (English)

    马一铭; 李丽; 蔡红雁; 郭涛

    2015-01-01

    背景:研究证明体外震波治疗是一种有效、安全和无创的治疗缺血性心脏病的方法,它能促进缺血心肌血管新生。目的:总结体外震波促进缺血心肌血管新生作用的研究进展。方法:运用计算机检索Pubmed和中国知网1998至2014年相关文献,英文检索词为“shock wave, ischemic heart disease, angiogenesis, cytokine, stem cel ”,中文检索词为“震波、缺血心肌、血管新生、细胞因子、干细胞”。纳入关于体外震波促进缺血性心血管病血管新生的相关文献,排除重复性研究,选取51篇文献进行综述。结果与结论:体外震波动员干细胞增殖、分化为血管内皮细胞,提高血管生长因子(如血管内皮生长因子和碱性成纤维细胞生长因子)高表达,并通过抑制炎症、氧化应激和凋亡以及调控血管外基质为血管新生创造一个有利的微环境,从而间接促进缺血心肌血管新生。体外震波治疗在缺血心肌血管新生中起重要作用,其治疗缺血性心脏病可能有很好的临床运用前景,但具体机制有待进一步研究。%BACKGROUND:Studies have shown that extracorporeal shock wave therapy is an effective, safe, and non-invasive treatment for ischemic heart disease, which can improve angiogenesis in the ischemic myocardium. OBJECTIVE:To summarize the research advances in promotion of angiogenesis for ischemic myocardium by extracorporeal shock wave therapy. METHODS:A computer-based online search of PubMed database and CNKI database was performed for relevant articles published between 1998 and 2014 with key words of “shock wave, ischemic heart disease, angiogenesis, cytokine, stem cel” in English and Chinese, respectively. Articles related to the promotion of angiogenesis for ischemic cardiovascular disease by extracorporeal shock wave were selected. Repetitive articles were excluded. According to inclusion criteria, 51 literatures were

  8. Therapeutic Effect of Extracorporeal Shock Wave Therapy According to Treatment Session on Gastrocnemius Muscle Spasticity in Children With Spastic Cerebral Palsy: A Pilot Study.

    Science.gov (United States)

    Park, Dong-Soon; Kwon, Dong Rak; Park, Gi-Young; Lee, Michael Y

    2015-12-01

    To investigate the therapeutic effect of extracorporeal shockwave therapy (ESWT) according to treatment session on gastrocnemius muscle spasticity in children with spastic cerebral palsy (CP). Twelve children with spastic CP underwent 1 ESWT and 2 sham ESWT sessions for gastrocnemius (group 1) or 3 ESWT sessions (group 2) once per week for 3 weeks. Modified Ashworth Scale (MAS) score, passive range of motion (PROM) of the ankle plantar-flexor muscles with knee extension, and median red pixel intensity (RPI) of color histogram of medial gastrocnemius on real-time sonoelastography (RTS) were measured before ESWT, immediately after the first and third ESWT, and at 4 weeks after the third ESWT. Mean ankle PROM was significantly increased whereas as mean ankle MAS and median gastrocnemius RPI were significantly decreased in both groups after the first ESWT. Clinical and RTS parameters before ESWT were not significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 1. However, they were significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 2. Mean ankle PROM, mean ankle MAS, and median gastrocnemius RPI in group 2 were significantly different from that in group 1 at 4 weeks or immediately after the third ESWT. The therapeutic effect of ESWT on spastic medial gastrocnemius in children with spastic CP is dependent on the number of ESWT sessions.

  9. [Ureterorenoscopy combined with extracorporeal shockwave lithotripsy].

    Science.gov (United States)

    González Cabrera, L A; Oro Ortiz, J

    1989-01-01

    In May 1986, extracorporeal shock wave lithotripsy and endourologic procedures became available in the treatment of lithiasis at the "Hermanos Ameijeiras" Hospital. The present study describes our experience and the results achieved during a 12-month period using endourologic procedures. During this period 65 URS procedures were performed to treat post-ESWL ureteral obstruction, and 22 to push the stone up to the kidney for subsequent ESWL treatment.

  10. 体外冲击波疗法治疗肌肉骨骼系统疾病研究的相关进展%The research progression on musculoskeletal disorders of extracorporeal shock wave therapy

    Institute of Scientific and Technical Information of China (English)

    杨军; 史展; 邢更彦

    2014-01-01

    体外冲击波疗法(extracorporeal shock wave therapy,ESWT)治疗肌肉骨骼系统疾病的应用已经有十多年历史,主要用于治疗过度运动造成的腱性组织损伤疾病,如:足底筋膜炎、肱骨外上髁炎、钙化性或非钙化性冈上肌腱炎和髌腱损伤等。治疗成功率从65%提高到91%,并且几乎无任何并发症。ESWT也用于治疗长期骨折不愈合、股骨头缺血坏死、距骨骨软骨损伤、慢性糖尿病或非糖尿病性溃疡和缺血性心脏病等疾病。绝大多数已发表的论文均指出其具有积极、有益的作用。ESWT是一种新型的无需手术、避免了手术风险、非侵入性的治疗方式。本文阐述了ESWT治疗肌肉骨骼系统疾病研究的进展及应用,并对本领域未来进行了展望。%The application of extracorporeal shockwave therapy (ESWT) in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calciifc or non-calciifc tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65%to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head,osteochondral lesions of the talus, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneifcial effects. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks. This article reviews the current status of ESWT in musculoskeletal disorders. This paper expounds the research progression and application on musculoskeletal disorders of ESWT, this ifeld and the future was prospected.

  11. Comparative Analysis of Angiogenic Gene Expression in Normal and Impaired Wound Healing in Diabetic Mice: Effects of Extracorporeal Shock Wave Therapy

    Science.gov (United States)

    2010-01-01

    proangiogenic factors following ischemic isograft skin transplantation [19]. Moreover, ESWT has been shown to facilitate the mobili- zation of endothelial...murine skin isografts . Angiogenesis 11(4):369-380 303 20. Aicher A, Heeschen C, Sasaki K, Urbich C, Zeiher AM, Dimmeler S (2006) Low-energy shock

  12. 体外冲击波治疗肩手综合征的疗效观察%Clinical observation of the extracorporeal shock wave in the treatment of shoulder-hand syndrome

    Institute of Scientific and Technical Information of China (English)

    李进福; 张杨; 岳寿伟

    2016-01-01

    Objective:To observe the effectiveness of extracorporeal shock wave in the treatment of shock patientswith shoulder-hand syndrome by comparing with ultrasonic treatment.Methods:Sixty shock patients with shoulderhandsyndrome were randomly divided into extracorporeal shock wave treatment group (experimental group,30 cases)and ultrasonic treatment group (control group,30 cases).In addition,the two groups were given conventionalrehabilitation training including therapeutic exercise,occupational therapy,non-modulated medium frequency electrotherapy,intermittent pneumatic compression therapy,and acupuncture treatment.Experimental group receivedconventional rehabilitation training on the basis of extracorporeal shock wave therapy,and the control group receivedultrasound treatment on the basis of these conventional rehabilitations.The visual analog scale (VAS)and Fugl-Meyer upper limb movement function (FAM)scores before and 1,2 and 4 weeks after treatment,and total effectiverate after treatment for 4 weeks were compared between two groups.Results:The VAS scores in the two groupsshowed no statistically significant differences before and 1 and 2 weeks after treatment,but after treatment for 4weeks,the VAS scores were significantly increased in the two groups,and those in the experimental group weresignificantly lower than those in control group (P <0.05).The FAM scores in the two groups showed no statisticallysignificant differences before and 1 and 2 weeks after treatment,while the FAM scores in the extracorporealshock wave treatment group were obviously higher than those in the ultrasonic treatment group after treatment for 4weeks (P <0.05).At the same time,the total efficacy in the experimental group was obviously higher than that inthe control group after treatment for 4 weeks (93.3% vs.76.7%,P <0.05).Conclusion:The extracorporealshock wave therapy can alleviate the symptoms in stroke patients with shoulder-hand syndrome,promote upper limbfunctional recovery,and the

  13. Extracorporeal membrane oxygenation circuitry.

    Science.gov (United States)

    Lequier, Laurance; Horton, Stephen B; McMullan, D Michael; Bartlett, Robert H

    2013-06-01

    The extracorporeal membrane oxygenation circuit is made of a number of components that have been customized to provide adequate tissue oxygen delivery in patients with severe cardiac and/or respiratory failure for a prolonged period of time (days to weeks). A standard extracorporeal membrane oxygenation circuit consists of a mechanical blood pump, gas-exchange device, and a heat exchanger all connected together with circuit tubing. Extracorporeal membrane oxygenation circuits can vary from simple to complex and may include a variety of blood flow and pressure monitors, continuous oxyhemoglobin saturation monitors, circuit access sites, and a bridge connecting the venous access and arterial infusion limbs of the circuit. Significant technical advancements have been made in the equipment available for short- and long-term extracorporeal membrane oxygenation applications. Contemporary extracorporeal membrane oxygenation circuits have greater biocompatibility and allow for more prolonged cardiopulmonary support time while minimizing the procedure-related complications of bleeding, thrombosis, and other physiologic derangements, which were so common with the early application of extracorporeal membrane oxygenation. Modern era extracorporeal membrane oxygenation circuitry and components are simpler, safer, more compact, and can be used across a wide variety of patient sizes from neonates to adults.

  14. 体外冲击波治疗ⅢB型前列腺炎疗效的Meta分析%Efficacy of extracorporeal shock wave therapy on chronic prostatitisⅢB:Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    葛劲超; 朱进

    2015-01-01

    Objective:To assess the effcacy of extracorporeal shock wave therapy (ESWT) on chronic prostatitisⅢB, and evaluate the quality of the literatures. Methods:We retrieved all the case-control studies on ESWT for chronic prostatitisⅢB between January 1996 to May 2015 in National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed, EMbase, and Cochrane database, screened the eligible literature according to the selection and exclusion criteria, and performed meta-analyses of the included studies with the software Revman 5.1. Results:Eight eligible reports were identiifed in this study, including 323 cases and 269 controls. Meta-analysis showed a signiifcant difference on overall effectiveness between the ESWT and control groups (OR=18.32, 95%CI:4.13~81.33, Z=3.82, P=0.0001). Also, there is a significant difference of symptom score between the two groups (WMD=–5.08, 95%CI:–6.89~–3.28, Z=5.52, P<0.00001). Conclusion:ESWT exhibited a deifnite effect for the treatment of chronic prostatitisⅢB.%目的:评价体外冲击波治疗(extracorporeal shock wave therapy,ESWT)治疗ⅢB型前列腺炎的临床有效性,并对临床文献进行质量评价。方法:检索1996年1月至2015年5月中国知网(National Knowledge Infrastructure,CNKI)、万方、PubMed、EMbase、Cochrane Library数据库中有ESWT治疗ⅢB型前列腺炎对照研究的RCT文献,根据纳入和排出标准,筛选合适文献,并用RevMan 5.1软件进行统计分析。结果:共有8篇文献符合纳入标准,共计592例患者,其中治疗组323例,对照组269例。ESWT治疗ⅢB型前列腺炎的总有效率显著高于对照组(OR=18.32,95% CI:4.13~81.33,Z=3.82, P=0.0001)。二者治疗后症状积分相比,差异有显著性,(WMD=–5.08,95% CI:–6.89~–3.28, Z=5.52,P<0.00001)。结论:ESWT治疗ⅢB型前列腺炎的疗效确切,是治疗ⅢB型前列腺炎的有效方法之一。

  15. Experiencia en Cuba del tratamiento de la litiasis renoureteral con litotricia extracorpórea por ondas de choque en niños Cuban experience in the treatment of renouretheral lithiasis in children by using extracorporeal shock wave lithotripsy

    Directory of Open Access Journals (Sweden)

    María Victoria Labrada Rodríguez

    2012-06-01

    Full Text Available Introducción: la litiasis urinaria en el niño resulta una enfermedad poco frecuente si se compara con su incidencia en el adulto. Objetivos: describir el resultado del tratamiento en Cuba de la litiasis del aparato urinario en niños, mediante la litotricia extracorpórea por ondas de choque, así como validar la eficacia del método. Métodos: la muestra corresponde a 227 niños, tratados en el Centro de Tratamiento de la Litiasis Urinaria del Hospital Clinicoquirúrgico "Hermanos Ameijeiras'' de La Habana, entre abril de 1986 y octubre de 2011, utilizando 3 tipos de litotritores: el HM3 (Dornier, Lithostar Plus (Siemens y Medical Modulith® SLX (Storz. Resultados: las edades límites fueron 2 y 18 años. De manera general resultó similar el total de pacientes tratados del sexo femenino que el masculino (51 %/49 %. El síntoma predominante fue el cólico nefrítico con cálculos renales (81,9 %, y en el uréter (18,1 %. La superficie media fue de 1,20 cm². Se utilizó anestesia general orotraqueal (34,4 % y general intravenosa (65,6 %. Los retratamientos fueron necesarios en 8 casos (3,52 %. Las complicaciones fueron la infección urinaria aguda (3,08 % y el hematoma subcapsular renal (0,88 %. Resultó libre de material litiásico el 96,04 %. Conclusiones: la terapéutica mediante la litotricia extracorpórea por ondas de choque resulta efectiva, con baja tasa de morbilidad y de complicaciones graves, por lo que creemos debe defenderse científicamente como la primera opción terapéutica en la resolución de la litiasis urinaria en estas edades. Debe recordarse que eliminar el cálculo no es suficiente, hay que identificar la enfermedad, su tratamiento de fondo, y evitar las recidivas.Introduction: urinary lithiasis is a rare disease in children if compared with its incidence on the adults. Objectives: to describe the results of the treatment of urinary lithiasis in children in Cuba, by using extracorporeal shock wave lithrotripsy, and to

  16. Clinical effect of radial extracorporeal shock wave in the treatment of calciifc supraspinatus tendinitis%发散式体外冲击波治疗钙化性冈上肌腱炎的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘; 吴坤; 杨军; 刘水涛; 赵; 闫君; 史展; 扈文海; 邢更彦

    2016-01-01

    目的:观察发散式体外冲击波(radial extracorporeal shock wave,RESW)治疗钙化性冈上肌腱炎的效果。方法回顾性分析本院2012年1月至2014年10月经RESW治疗的40例钙化性冈上肌腱炎患者的临床资料,患者肩部痛点及病灶区行RSWT治疗3个疗程,每疗程治疗4次,所有患者随访6个月,观察治疗前后视觉模拟评分法(VAS)评分、Constant-Murley肩关节功能评分,分析X线片变化情况。结果所有患者症状均得以缓解,VAS评分、Constant-Murley肩关节功能评分均较治疗前改善(P<0.05)。通过X线片对比,15例患者治疗后6个月钙化斑块完全消失,25例患者治疗后6个月仍有部分钙化斑块存在,但疼痛及功能障碍等临床症状均较治疗前改善。结论 RESW是一种可供选择的安全有效的治疗钙化性冈上肌腱炎的方法。%ObjectiveTo evaluate the effect of radial extracorporeal shock wave (RESW) in the treatment of calciifc supraspinatus tendinitis.MethodRetrospective analyzed the clinical data of 40 cases of calciifed supraspinatus tendinitis patients treated by RESW treatment in our hospital from January 2012 to October 2014, patients with shoulder pain points and lesion area lined RSWT 3 courses of treatment, 4 times per course of treatment. All patients were followed up for 6 months, visual analogue scale (VAS) and Constant-Murley score were observed before and after treatment, and the changes of X-ray iflm were analyzed.ResultThe shoulder function were improved and the symptoms were disappeared or partially disappeared after therapy. The Constant-Murley scores, VAS scores were signiifcantly improved (P<0.05). The calciifed plaque of 15 patients disappear entirely 6 months after treatment, 25 patients exists in some calciifed plaque 6 months after treatment, but its clinical symptoms and functional improvement than before treatment.ConclusionRESW therapy is a safe and effective treatment modality

  17. Low-energy extracorporeal shock wave therapy improves microcirculation blood flow of ischemic limbs in patients with peripheral arterial disease: pilot study.

    Science.gov (United States)

    Tara, Shuhei; Miyamoto, Masaaki; Takagi, Gen; Kirinoki-Ichikawa, Sonoko; Tezuka, Akito; Hada, Tomohito; Takagi, Ikuyo

    2014-01-01

    Because direct application of low-energy shock waves induces angiogenesis, we investigated the safety and efficacy of this new therapy to develop a noninvasive method of repeatable therapeutic angiogenesis for treating peripheral arterial disease (PAD). The subjects were 10 patients who had symptomatic PAD and limited ischemia in a below-the-knee artery. Low-energy shock waves were directly applied to the calf muscles 6 times every other day. Intracorporeal changes were evaluated with ultrasonography to determine adverse effects of therapy. To assess blood flow of the microcirculation, transcutaneous oxygen tension (TcPO2), skin perfusion pressure (SPP), and (99m)technetium-tetrofosmin ((99m)Tc-TF) scintigraphy were performed before and after therapy. The TcPO2 was measured while subjects inhaled pure oxygen (maximum TcPO2). The (99m)Tc-TF perfusion index was determined as a ratio of uptake in muscle to that in the brain (control) for quantitative analysis. No adverse effects were noted in any patient. Maximum TcPO2 values increased significantly on the calf (57.3±28.4 to 71.0±14.5 mm Hg, p=0.044) and the dorsum of the foot (52.2±21.8 to 76.1±17.9 mm Hg, p=0.012). The SPP tended to increase after therapy on the dorsum and plantar surfaces of the foot, but the differences were not significant. The (99m)Tc-TF perfusion index in the foot significantly increased (0.48±0.09 to 0.61±0.12, p=0.0013), but that in the leg did not change. We have demonstrated that low-energy shock wave therapy is safe and can restore blood flow in the microcirculation in patients with symptomatic PAD.

  18. Short-term outcomes of extracorporeal shock wave therapy for the treatment of chronic non-calcific tendinopathy of the supraspinatus: a double-blind, randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Galasso Olimpio

    2012-06-01

    Full Text Available Abstract Background There is evidence supporting the use of extracorporeal shock wave therapy (ESWT in calcific tendinopathy of the rotator cuff, but the best current evidence does not support its use in non-calcifying tendinopathy. We conducted a randomized placebo-controlled trial to investigate the efficacy and safety of low energy ESWT for non-calcifying tendinopathy of the rotator cuff. Methods 20 patients with non-calcifying supraspinatus tendinopathy (NCST were randomized to an active or a sham treatment group. Physical, blood, roentgenographic, and MRI examinations of the shoulder were conducted to verify that patients met the inclusion and exclusion criteria. These examinations were repeated six and twelve weeks after treatments. Effectiveness was determined by comparison of the mean improvement in the Constant and Murley score (CMS between the treatment and the placebo groups at three months. Safety was assessed by analyzing the number and severity of adverse events. Results All the patients completed the investigation protocol. At the final follow-up, significant improvement in the total CMS score and most of the CMS subscales was observed in the ESWT group when compared to the baseline values. Significantly higher total CMS, and significantly higher scores for CMS pain and ROM were observed in the ESWT group when compared to the placebo. No serious adverse events were noted after ESWT. Conclusions Patients suffering from NCST may benefit from low energy ESWT, at least in short-term. The application protocol of ESWT is likely to play a key-role in a successful treatment. Future investigations should be undertaken on the long-term effects of this technique for the treatment of NCST. Trial registration Current Controlled Trials ISRCTN41236511

  19. Study on the application of lavender therapy in extracorporeal shock wave lithotripsy%薰香疗法在体外冲击波碎石术的应用

    Institute of Scientific and Technical Information of China (English)

    黄小敏; 曾莹; 陈妙琛; 柯小燕; 苏丽娟

    2010-01-01

    Objective To observe the effect of lavender therapy on comfort level of patients undergoing extracorporeal shock wave lithotripsy(ESWL). Methods 80 cases of patients undergoing ESWL for the first time were divided into the observation group(n=40),and the control group(n=40),the observation group treated with lavender therapy and the control group with routine nursing. Results Compared with the control group, pain level was lowered, circulatory system was more stable, painful behaviors were less and adjuvant drugs were less used in the observation group (all P< 0.05). Conclusion Lavender therapy has the effect of improving comfort level of patients during ESWL.%目的 观察薰香疗法对体外冲击波碎石患者舒适度的作用.方法 将80例首次接受体外冲击波碎石患者分为观察组和对照组,各40例.观察组采用常规护理方法外辅以薰香疗法,对照组采用常规护理方法.结果 与对照组相比,观察组患者疼痛程度明显降低(P<0.01),循环系统较稳定,波动少(P<0.05),辅助用药的使用率也明显低于对照组(P<0.01).结论 薰香疗法有利于提高体外冲击波碎石患者舒适度.

  20. Extracorporeal Shock-Wave Therapy in Treating Chronic Pelvic Pain Syndrome in Males%体外冲击波治疗在男性慢性骨盆疼痛综合征中的应用进展

    Institute of Scientific and Technical Information of China (English)

    童亮; 吕军

    2012-01-01

    Category Ⅲ prostatitis is also called chronic pelvic pain syndrome ( CPPS ), accounting for about 90% of chronic prostatitis, and studies have suggested that its age range was from 20 to 83 years, and its incidence is between 4% to 16%. The clinical manifestations of CPPS include long - term and reduplicated pelvic region pain or discomfort, and it can last for more than 3 months. Furthermore, it may be associated with some degrees of micturition symptoms and sexual dysfunction, which seriously reduced the quality of life of the patients. At present, the etiology and pathogenesis of CPPS are unclear, and there has been no standard treatments. Extracorporeal shock - wave therapy has been used clinically in treating CPPS in males and has received good clinical effects.%Ⅲ型前列腺炎又称为慢性骨盆疼痛综合征(CPPS),约占慢性前列腺炎的90%,20~83岁男性均可发病,发病率为4%~16%.临床表现为长期、反复的骨盆区域疼痛或不适,持续时间超过3个月,可伴有不同程度的排尿症状和性功能障碍,严重影响患者的生活质量.目前,CPPS的发病机制和病因尚不明确,尚没有标准的治疗方法.临床运用体外冲击波治疗男性CPPS,收到良好的临床效果.

  1. Observation on the Clinical Effect of Extracorporeal Shock Wave Acupuncture in the Treatment of Knee Osteoarthritis%体外冲击波针灸治疗膝骨性关节炎的疗效观察﹡

    Institute of Scientific and Technical Information of China (English)

    张新国; 李建伟; 郑世江; 张景春; 黄建军; 刘小刚

    2016-01-01

    目的:观察体外冲击波针灸( extracorporeal shock wave acupuncture , ESWA )治疗膝关节骨性关节炎( knee osteoarthritis , KOA)的临床疗效。方法将80例膝关节骨性关节炎患者随机分为冲击波针灸(经络穴位+痛点)治疗组40例,冲击波(痛点)对照组40例,治疗组采用冲击波针灸治疗方法刺激足阳明胃经、足太阴脾经、足少阳胆经,肾俞、委中、环跳、关元、血海、梁丘、膝阳关、膝眼、阳陵泉及阿是穴;对照组采用冲击波刺激痛点阿是穴;均隔2日治疗1次,共治疗5次。根据视觉模拟评分法( Visual Analogue Score ,VAS)观察两组治疗前后患膝关节的疼痛症状改善情况,通过Lysholm评分标准对治疗前后的膝关节功能进行综合评价。结果治疗后两组患膝的疼痛和活动功能均较治疗前明显改善( P<0.05),2周治疗后及治疗后4周、12周随访,治疗组的VAS评分指数低于对照组(P<0.05),Lysholm膝关节评分高于对照组(P<0.05)。结论体外冲击波针灸治疗能够有效的减轻KOA患者的疼痛,明显改善关节功能,是一种疗效显著、安全、临床应用易于推广的治疗方法。%Objective To observe the clinical effect of extracorporeal shock wave acupuncture ( ESWA) in the treatment of knee osteoarthritis ( KOA) .Methods 75 cases of patients with KOA were randomly divided into shock wave acupuncture treatment ( Meridians points and pain spot) group of 38 cases and shock waves (pain point) control group of 37 cases.The treatment group was treated by shock wave acupuncture method to stimulate the meridian of yangming foot , foot lunar spleen , foot shaoyang gallbladder meridian , Shenshu ( BL23 ) , Weizhong (BL40), Huantiao (GB30), Guanyuan (RN4), Xuehai (SP10), Liangqiu (ST34), Xiyangguan (GB33), Xiyan (EX-LE5), Yanglingquan (GB34) and Ashi points.The control group used shock wave to stimulate Ashi points

  2. 体外冲击波治疗脑瘫肌痉挛的疗效观察%Curative effect of extracorporeal shock wave treatment for muscle spasticity in children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    贠国俊; 刘青; 杨雪; 王玉娟; 曹建国

    2015-01-01

    Objective:To investigate the curative effects and security of extracorporeal shock wave treatment for muscle spasticity in children with cerebral palsy .Methods:Fifty children with cerebral palsy of muscle spasticity were divided into the observation group (n=24) and control group (n=26) .Two groups received routine rehabilita‐tion .The observation group was given extracorporeal shock wave treatment additionally .Before and after treat‐ment ,muscle spasticity was evaluated by passive range of motion (PROM ) ,modified Ashworth scale (MAS) , Gross Motor Function Measure (GMFM) ,and foot contact area .Results:One week and 4 weeks after treatment , the MAS scores of triceps surae muscle were decreased in the observation group as compared with those before treat‐ment (P<0 .05) ,showing a gradually descent trend (P<0 .05) ,and the score of every item at any time point was significantly different as compared with that in the control group (P<0 .05) .One week after treatment ,the MAS scores of triceps surae muscle in the control group showed no statistically significant difference from those before treatment .Four weeks after treatment ,the scores of MAS in control group were decreased as compared with those pretreatment and one week after treatment (P<0 .05) .One week and 4 weeks after treatment ,the scores of ankle PROM ,Gross Motor Function Measure ,foot contact area ,and foot pressure were increased in the observation group as compared with those before treatment (P< 0 .05) ,showing a gradually descent trend (P< 0 .05) .The score of every item in the observation group was increased as compared with the control group at any time point (P<0 .05) .One week after treatment ,the scores of ankle PROM ,Gross Motor Function Measure ,foot contact ar‐ea ,and foot pressure showed no statistically significant difference in the control group as compared with those before treatment .Four weeks after treatment ,the scores of ankle PROM ,Gross Motor Function Measure ,foot

  3. Present Condition and Developments in Extracorporeal Cardiac Shock Wave Therapy in Treating Ischemic Heart Disease%体外心脏震波治疗缺血性心脏病进展——一种新的治疗性血管新生法

    Institute of Scientific and Technical Information of China (English)

    蔡红雁; 赵玲; 郭涛

    2009-01-01

    介绍心脏震波治疗技术在治疗终末期冠状动脉粥样硬化性心脏病的历史中运用的历史与现状以及进展,对其适应证、方法、疗效评估等方面进行综述.%Developed in the 90s extracorporeal cardiac shock wave therapy (CSWT) is typically used for musculoskeletal disorders and in kidney stones. Here we present the history of CSWT in coronary artery disease, and review the development of the therapy, and the assessment of the curative effects of CSWT.

  4. Computed tomography after extra-corporeal shock wave lithotripsy (ESWL) of the kidneys. Pt. 1. Acute findings with histopathological correlation in an animal model. Computertomographie nach extrakorporaler Stosswellen-Lithotripsie (ESWL) der Nieren. T. 1. Korrelation mit akuten histopathologischen Befunden im Tierexperiment

    Energy Technology Data Exchange (ETDEWEB)

    Schaub, T.; Kunisch, M.; Stadtbaeumer, M.; Schild, H.; Thelen, M. (Mainz Univ. (Germany, F.R.). Inst. fuer Klinische Strahlenkunde); Stoerkel, S. (Mainz Univ. (Germany, F.R.). Pathologisches Inst.); El-Damanhoury, H. (Mainz Univ. (Germany, F.R.). Urologische Klinik und Poliklinik); Hennes, H.J. (Mainz Univ. (Germany, F.R.). Anaesthesiologische Klinik)

    1991-03-01

    In an experimentel study on pigs, 28 stone-free kidneys were treated with a second generation lithotripter. Histologically, acute bleeding was seen after ESWL in 23 (82 %) of the 28 treated kidneys. CT studies before and after contrast were correct in 20/28 (74%) cases. It was shown that extracorporeal shock waves cause renal bleeding that is only partially detected by computed tomography. It can be concluded that the CT findings seen in a high percentage of renal stone patients after ESWL represent bleeding. The incidence of renal bleeding after ESWL and thus the possible risk of hypertension has obviously been underestimated so far in clinical studies. (orig.).

  5. 体外心脏震波对急性心肌梗死模型猪左心室重塑的影响%Effect of extracorporeal cardiac shock wave therapy on left ventricular remodeling in a porcine model of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    陶四明; 郭涛; 王钰; 李建美; 蔡红雁; 羊超

    2012-01-01

    BACKGROUND: Initial studies have confirmed that extracorporeal cardiac shock wave therapy can ameliorate metabolism of ischemia myocardium from the level of gene and cells. However, will the therapy improve the development of post-infarction ventricular remodeling in a morphology level?OBJECTIVE: To explore the effects of extracorporeal cardiac shockwave therapy on the function and morphology of the left ventricle after acute myocardial infarction.METHODS: A total of 25 pigs were randomly divided into three groups: shock wave group, sham shock wave group and sham operation group. Pigs in the shock wave group were treated with extracorporeal cardiac shock wave therapy on 3, 5 and 7 days after the model construction of myocardial infarction. Pigs in the sham shock wave group received the same therapy to the shock wave group except for the shock waves and energy. Sham operation group received the same treatment to the sham shock wave group without constructing the myocardial infarction model.RESULTS AND CONCLUSION: Compared with the sham shockwave group, shockwave therapy significantly reduced the left ventricular end-systolic volume, increased the end-diastolic volume and improved the global left ventricular function (P< 0.001); it significantly improved the ventricular wall motor function in the myocardium of the myocardial infarction border zone and the motion compatibleness of the left ventricular. These findings demonstrate that the early application of effective extracorporeal cardiac shock wave therapy can delay the development to some extent from reversible stage to irreversible stage in the left ventricular remodeling after myocardial infarction.%背景:初期实验已经证实体外心脏震波治疗可从基因和细胞水平改善缺血心肌代谢,但是否在形态学水平也可缓解梗死后心室重塑的发展?目的:观察体外心脏震波对急性心肌梗死后左心室心功能及形态学指标的影响.方法:将25只猪随机分为3组:震

  6. Extracorporeal Cardiac Shock Wave Therapy Ameliorates Clinical Symptoms and Improves Regional Myocardial Blood Flow in a Patient with Severe Coronary Artery Disease and Refractory Angina

    Directory of Open Access Journals (Sweden)

    Christian Prinz

    2009-01-01

    Full Text Available Different therapeutic options are being used for chronic coronary artery disease (CAD. We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI and coronary artery bypass grafting (CABG. The patient received cardiac shock wave therapy (CSWT over a period of 6 month. There was no arrhythmia during or after treatment; enzyme levels were normal at all times. PET imaging showed a substantial improvement of myocardial stress perfusion. Since the patient reported that she now was fully capable to deal with her everyday life, further treatment options were postponed. Our case report suggests that ultrasound-guided CSWT is able to improve symptoms and perfusion in ischemic myocardium.

  7. Clinical study on the treatment of chronic pelvic inflammatory disease byabdominal extracorporeal shock%体外冲击波经腹治疗慢性盆腔炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    贾桂英; 吕艺; 唐海涛; 胡欣姝

    2014-01-01

    extracorporeal shock wave is a new effective method for the treatment of chronic pelvic inflammatory disease, no radiation, no toxic side effect, short and long term effect is signiifcant, the appropriate choice of energy, without obvious complications, clinical curative effect.

  8. Extracorporeal treatment for valproic acid poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Laliberté, Martin; Nolin, Thomas D

    2015-01-01

    BACKGROUND: The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup presents its systematic review and clinical recommendations on the use of extracorporeal treatment (ECTR) in valproic acid (VPA) poisoning. METHODS: The lead authors reviewed all of the articles from a systematic literature....... The workgroup concluded that VPA is moderately dialyzable (level of evidence = B) and made the following recommendations: ECTR is recommended in severe VPA poisoning (1D); recommendations for ECTR include a VPA concentration > 1300 mg/L (9000 μmol/L)(1D), the presence of cerebral edema (1D) or shock (1D...... 50 and 100 mg/L (350-700 μmol/L)(2D). Intermittent hemodialysis is the preferred ECTR in VPA poisoning (1D). If hemodialysis is not available, then intermittent hemoperfusion (1D) or continuous renal replacement therapy (2D) is an acceptable alternative. CONCLUSIONS: VPA is moderately dialyzable...

  9. Extra-corporeal membrane oxygenation

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007234.htm Extracorporeal membrane oxygenation To use the sharing features on this page, please enable JavaScript. Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a ...

  10. Extracorporeal treatment for thallium poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S

    2012-01-01

    The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl).......The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl)....

  11. 体外冲击波治疗肱骨外上髁炎的疗效观察%Observating of the curative effects of extra-corporeal shock wave therapy on external hu-meral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    吴长青; 华英

    2015-01-01

    AIM: To investigate the curative effect of extracor⁃poreal shock wave therapy on lateral epicondylitis. METHODS:A total of 56 cases with lateral epicondylitis admitted to our hospi⁃tal from January 2013 to June 2014 were selected and randomly divided into observation group and control group. Thirty patients in observation group received extracorporeal shock wave therapy, while 26 cases in control group received corticosteroid injection. Complications were recorded; visual analogue scale ( VAS ) and disabilities of arm, shoulder, and hand ( DASH) was used to e⁃valuate the effect, before the treatment, after 6⁃week treatment, and after three⁃month treatment. RESULTS:All the patients had full follow⁃ups. Local swelling and subcutaneous blood stasis ap⁃peared in six patients, and symptoms relieved after treatment. All patients had VAS ( lifting a 5KG dumbbell) and DASH assess⁃ment for three times, with the VAS score being 7. 6 ± 1. 3 before the treatment, 3. 2 ± 0. 7 6 weeks after treatment, and 2. 1 ± 0. 3 three months after treatment in observation group, and those num⁃bers being 7. 5 ± 1. 2, 3. 1 ± 0. 6, and 1. 9 ± 0. 4 in control group. There was no statistical difference between the two groups (P>0. 05). The DASH score were 16. 1 ± 1. 5, 10. 2 ± 1. 1, and 6. 1 ± 0. 6 in observation group, while 15. 8 ± 1. 4, 9. 8 ± 0. 9, and 5. 9 ± 0. 5 in control group. There was no statistical difference between the two groups (P>0. 05). There was, how⁃ever, statistically significant difference between pre⁃treatment score and post⁃treatment score (P <0. 05). CONCLUSION:Curative effects of extracorporeal shock wave therapy on lateral epicondylitis are prominent, which is the same to corticosteroid injection. It can markedly improve the symptoms of external hu⁃meral epicondylitis and is worthy of further promotion in the clini⁃cal practice.%目的:观察体外冲击波治疗肱骨外上髁炎的疗效.方法:选择2013⁃01/2014⁃06

  12. 认知疗法在尿路结石体外冲击波碎石中的应用%Application of Cognitive Therapy to Extracorporeal Shock Wave Lithotripsy in Treatment of Urolithiasis

    Institute of Scientific and Technical Information of China (English)

    皮定坤; 宋东奎

    2015-01-01

    目的:探讨认知疗法对尿路结石体外冲击波碎石的影响及意义。方法选取2013年12月~2014年12月我院门诊行体外冲击波碎石患者768例,随机分为两组,各384例,对照组实施一般护理,实验组在一般常规护理的基础上,对患者实施认知干预,比较两组患者碎石时间、术中疼痛、碎石有效率及术后并发症的情况。结果实验组在碎石时间、碎石有效率、术后并发症及术中疼痛与对照组比较差异均有统计学意义。结论认知干预能够提高体外碎石效果,减少并发症的发生。%Objective To investigate the effect and signiifcance of cognitive therapy to ESWL (extracorporeal shock wave lithotripsy, ESWL) in treatment of urolithiasis.Methods 768 cases of urolithiasis patients for the study in our hospital from December 2013 to December 2014, ESWL lithotripsy were given, and patients were divided into the experimental group in 384 cases, and the control group in 384 cases. The control group was treated with routine care, and the experimental group was given cognitive intervention, basis on the routine care. The gravel time, intraoperative pain, the efficiency of ESWL and postoperative complications were compared.Results The experimental group was better than control group in gravel time, intraoperative pain, efifciency and postoperative complications.Conclusion The application of cognitive intervention can improve the efficiency and reduce the complications in ESWL.

  13. Effects of Extracorporeal Shock Wave on Spasticity of Biceps Brachii after Stroke%体外冲击波缓解脑卒中后肱二头肌痉挛的效果

    Institute of Scientific and Technical Information of China (English)

    徐思维; 缪芸; 郁嫣嫣; 瞿强; 陈文华

    2014-01-01

    目的:观察体外冲击波对脑卒中后肱二头肌痉挛的治疗效果。方法12例脑卒中后肱二头肌痉挛患者分成对照组(n=6)和治疗组(n=6)。治疗组予单次体外冲击波治疗,对照组予安慰性治疗。两组患者在治疗前、治疗后即刻采用改良Ashworth量表(MAS)、上肢肩肘部分Fugl-Meyer评分(FMA)进行评定,表面肌电图测定肘伸展最大等长收缩时肱二头肌、肱三头肌的积分肌电值及协同收缩率。结果治疗组治疗后MAS、FMA评分,肱二头肌积分肌电值及协同收缩率均较治疗前改善(P<0.05),并优于对照组(P<0.05)。结论体外冲击波可以即刻缓解脑卒中后肱二头肌痉挛,降低肘伸展时肱二头肌的协同激活水平及协同收缩率,改善上肢运动功能。%Objective To observe the effects of extracorporeal shock wave therapy (ESWT) on spasticity of biceps brachii after stroke. Methods 12 patients with spasticity of biceps brachii after stroke were divided into control group (n=6) and ESWT group (n=6). The ESWT group received a session of ESWT and the control group received placebo treatment. All patients were assessed before and immediately after treatment, including integrated electromyogram (iEMG) and co-contraction ratio during maximum isometric voluntary contraction (MIVC) of elbow extension with surface electromyography, the modified Ashworth Scale (MAS) and content of shoulder and elbow of Fugl-Meyer Assessment (FMA). Results The scores of MAS and FMA, the iEMG and the cocontraction ratio of biceps brachii improved in the ESWT group after the treatment (P<0.05), and improved more than those in the control group (P<0.05). Conclusion ESWT can immediately re-lieve the spasticity of biceps brachii, inhibit the cocontraction of biceps brachii during elbow extension and improve the motor function of upper limb in patients post stroke.

  14. 体外冲击波治疗股骨头缺血性坏死Ⅳ期患者的效果%Effect of Extracorporeal Shock Wave on Avascular Necrosis of Femoral Head of Stage IV

    Institute of Scientific and Technical Information of China (English)

    马跃文; 姜冬蕾; 于晓彤

    2015-01-01

    Objective To observe the effect of extracorporeal shock waves (ESW) therapy on avascular necrosis of femoral head (AN-FH) of stage IV. Methods 72 hips of 44 patients with ANFH of stage IV, according to Association Research Circulation Osseous, were ran-domly divided into treatment group (n=37) and control group (n=35). The control group received routine therapy, while the treatment group received ESW in addition, 2.0-4.0 bar, 10 Hz, 6000 times. They were evaluated with Harris Hip Score, Manual Muscle Test (MMT) and Short Form of health survey (SF-36) before and 1 month after treatment. Results The scores of Harris Hip Score and MMT improved more in the treatment group than in the control group (P<0.05) after treatment, as well as the scores of SF-36 except physical health and vitality (P<0.05). Conclusion The ESW can obviously improve the motor function and quality of life of patients with ANFH of stage IV.%目的:观察体外冲击波(ESW)治疗股骨头缺血性坏死(ANFH)Ⅳ期患者的临床疗效。方法44例ANFH患者(72髋)均为国际骨循环研究会(ARCO)分期Ⅳ期,随机分为治疗组(n=37)和对照组(n=35)。对照组予常规治疗,治疗组加用ESW,压力2.0~4.0 bar,频率10 Hz,脉冲6000次。于治疗前及治疗1个月时,采用Harris髋关节评分、徒手肌力评定(MMT)及健康调查简表(SF-36)进行评估。结果治疗后,治疗组Harris髋关节评分、肌力优于对照组(P<0.05);SF-36中除生理职能、活力外,余各项评分优于对照组(P<0.05)。结论 ESW能改善ANFHⅣ期患者的关节功能,提高生活质量。

  15. Technique report on the application and research of low energy and long-ditance shock wave by extracorporeal shock wave lithotripsy(Report of 380 cases)%低能量长间距体外冲击波碎石(附380例报告)

    Institute of Scientific and Technical Information of China (English)

    李航; 王连志

    2000-01-01

    目的:探讨低能量、长间距冲击波技术在体外冲击波碎石(ESWL)中的应用,以及X线、B超双定位技术在ESWL中的优势。方法:应用低能量、长间距冲击波及X线、B超双定位技术进行ESWL380例。结果:380例均获成功,结石排净或残石颗粒直径均<3 mm。所有患者术后都出现轻微血尿,肾结石者12 h内消失,输尿管结石者1~2次后消失。58例局部皮肤出现点状红斑。¨例形成输尿管石街,经再次ESWL治疗而消失。肾被膜下血肿1例,经对症处理2周后血肿被吸收。结论:低能量、长间距冲击波技术碎石率高,具有血尿时间短、无输尿管绞痛发作、肾被膜血肿发生率低等优点。X线、B超双定位技术值得推广。%Purpose:Through the application and research of the technique low energy and long-distanceshock wave by extracorporeal shock wave lithotripsy(ESWL)we intend to explore its application skills ,advantageof X-ray or B-mode ultrasonic examination in determining the location. Methods:We used the technique of lowenergy ,long-distance shock wave and X-ray or B-mode ultrasonic examination in determining the location to treat380 patients who suffered from calculus disease. Results :The 380 cases which we performed turned out to be verysuccessful. The technique of therapy with low energy,long-distance shock wave has greatly raised the cure rate ofcalculosis. It has a superiority with short time of hematuria,no ureteralgia and lower the occurrence rate of kidneyfilm hematoma. Conclusion :ESWL provides a new therapy to treat calculus disease. The technique of low energyand long-distance shock wave has great practical value, and the technique of X-ray or B-mode ultrasonicexamination in determining the location of calculus is well worth spreading.

  16. Clinical application of extracorporeal membrane oxygenation for treatment of adult refractory cardiogenic shock%体外膜肺氧合在成人心原性休克救治中的临床应用

    Institute of Scientific and Technical Information of China (English)

    侯六生; 谢钢; 李建伟; 蒋崇慧; 袁勇; 李斌飞; 姜海明; 宁晔; 吴桂深

    2013-01-01

    Objective To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment for adult refractory cardiogenic shock.Methods From January 2003 to January 2011,patients with refractory cardiogenic shock required veno-arterial ECMO by failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied.Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.Patients were divided into weaned group(n =31) and not weaned group(n =23) according to the ECMO weaning.Results The duration of ECMO was 24.16(14.12,56.75) hours.Twenty-two out of 31 patients in the weaned group survived and were discharged,9 patients died after successfully weaned from ECMO (5 due to multisystem organ failure,2 due to reoccurred cardiogenic shock,1 due to infectious shock and 1 due to disseminated or diffuse intravascular coagulation).Pre-ECMO mean arterial pressure,ejection fraction,the duration of ECMO were significantly higher while pre-ECMO blood lactate [(8.64 ± 3.17) vs.(14.44 ± 2.52),P <0.01],the duration of ROSC [(16.70 ± 5.29) vs.(35.64 ± 5.89),P <0.01] and multisystem organ failure [0 vs.17.4% (4/23),P <0.05] were lower in weaned group than in not wean group.Conclusions ECMO is an effective mechanical assistant therapy strategy for adult refractory cardiogenic shock patients.Timely applying this strategy on suitable patients is crucial for the success of ECMO.Cardiac function and reversibility of heart failure are key factors determine the fate of weaned or not weaned ECMO in adult refractory cardiogenic shock patients.%目的 总结体外膜肺氧合(ECMO)在成人心原性休克(CS)中的临床救治经验,探讨ECMO的临床应用价值及影响脱机的可能危险因素.方法 回顾性分析中山大学附属中山医院2003年1月至2011年1月因药物和(或)主动脉内球囊反搏(IABP)无效而行ECMO救治的成人CS患者的临床资料,

  17. Radial versus focusing extracorporeal shock waves in treatment of delayed union and nonunion of fractures%放散状与聚焦状冲击波治疗骨折延迟愈合或不愈合的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张隆浩; 满立波; 黄广林; 王海; 徐啸

    2012-01-01

    Objective To compare radial and focusing extracorporeal shock waves in terms of their effects on the treatment of delayed union and nonunion of fractures.Methods Forty-seven patients with delayed union or nonunion of hypertrophic stable type received extracorporeal shock wave therapy from April to August 2011.They were 38 men and 9 women,aged from 21 to 56 years (average,35.0 years).The lesions involved the femur in 24 cases,the humerus in 6 cases and the tibia in 17 cases.The primary fixations included plating in 37 cases,external fixator in 8 cases,and locking intramedullary nailing in 2 cases.Twenty-three patients received radial shock wave therapy and 24 focusing shock wave therapy.Therapies were conducted with suitable shock wave energy,frequency and dosage according to the specific fracture location.X-ray follow-ups were performed at monthly intervals to evaluate the callus growth.The 2 groups were compared in terms of the cure rate and effective rate.Results The mean follow-up was 9 months.Of the 23 patients receiving radial extracorporeal shock wave therapy,21 got complete bone union,one partial union,and one no obvious callus growth.The cure rate and effective rate were 91.3% and 95.7% respectively.The union time ranged from 8 to 24 weeks,averaging 12 weeks.Of the 24 patients receiving focusing treatment,17 got complete bone union and 7 no obvious callus growth.The cure rate and effective rate were both 70.8%.The union time ranged from 8 to 40 weeks,averaging 18 weeks.There was a significant difference in the effective rate between the 2 groups (P=0.048) but no regarding the cure rate (P =0.137).Radial shock wave treatment caused vascular injury in 4 cases and focusing shock wave in 9 cases.Conclusions Extracorporeal shock waves are effective treatment of delayed union and nonunion of fractures.The radial extracorporeal shock waves may be more effective than the focusing extracorporeal shock waves.%目的 比较放散状与聚焦状冲击波治疗

  18. Cavitation inception following shock wave passage

    NARCIS (Netherlands)

    Ohl, C.D.

    2002-01-01

    Cavitation bubble nucleation following the passage of an extracorporeal shock wave lithotripter pulse is investigated experimentally and numerically. In the experiments two configurations are considered: Free passage of the shock wave, and reflection of the shock wave from a rigid reflector. The nuc

  19. Cavitation inception following shock wave passage

    NARCIS (Netherlands)

    Ohl, C.D.

    2002-01-01

    Cavitation bubble nucleation following the passage of an extracorporeal shock wave lithotripter pulse is investigated experimentally and numerically. In the experiments two configurations are considered: Free passage of the shock wave, and reflection of the shock wave from a rigid reflector. The nuc

  20. Efficacy of eccentric exercise combined with extracorporeal shock wave therapy on lateral epicondylitis%离心收缩训练联合体外冲击波治疗肱骨外上髁炎的疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈建新; 刘光华; 林瑜玮; 吴一鸣; 刘邦忠

    2016-01-01

    Objective: To compare clinical efficacy of three different treatments , eccentric exercise (EE ) , extracorporeal shock wave therapy (ESWT ) ,and EE combined with ESWT on lateral epicondylitis (LE) .Methods:Sixty subjects with LE were selected and randomly assigned to EE group (n=20) ,ESWT group (n=20) and EE combined with ESWT group (n=20) .All of the subjects were evaluated through the visual analogue scale (VAS) and hand-grip strength test at baseline and 2 weeks after the end of treatment respectively .All data were analyzed by SPSS 17 .0 .Results:The VAS scores dramatically decreased from baseline to 2 weeks after the end of treatment in all three groups (P<0 .05);however ,there were no significant differences in VAS scores between any two groups 2 weeks after the end of treatment .As to hand-grip strength , there was significant increase from baseline to 2 weeks after the end of treatment in all three groups (P<0 .05);moreover ,the hand-grip strength of EE combined with ESWT group was significantly higher than that of EE group (P<0 .05) and ESWT group (P<0 .05) at 2 weeks after the end of treatment ;however ,no significant difference of the hand-grip strength emerged between EE group and ESWT group at the same time point .The overall response rate of EE combined with ESWT group was 100% ,which was significantly higher than that of EE group (64 .70% ,P<0 .05) and ESWT group (68 .42% ,P<0 .05);no statistically significant difference of overall response rate was found between EE group and ESWT group .Conclusions:EE and ESWT were both effective and showed similar efficacy in the treatment of LE .In addition ,the combination therapy of EE and ESWT was better than either single therapy .%目的:比较离心收缩训练(eccentric exercise ,EE)、体外冲击波疗法(extracorporeal shock wave therapy ,ESWT)及EE联合ESWT对肱骨外上髁炎(lateral epicondylitis ,LE)的疗效。方法:选择60例LE受试者,随机分为EE

  1. Improving the Thermal Shock Resistance of Thermal Barrier Coatings Through Formation of an In Situ YSZ/Al2O3 Composite via Laser Cladding

    Science.gov (United States)

    Soleimanipour, Zohre; Baghshahi, Saeid; Shoja-razavi, Reza

    2017-04-01

    In the present study, laser cladding of alumina on the top surface of YSZ thermal barrier coatings (TBC) was conducted via Nd:YAG pulsed laser. The thermal shock behavior of the TBC before and after laser cladding was modified by heating at 1000 °C for 15 min and quenching in cold water. Phase analysis, microstructural evaluation and elemental analysis were performed using x-ray diffractometry, scanning electron microscopy (SEM), and energy-dispersive spectroscopy. The results of thermal shock tests indicated that the failure in the conventional YSZ (not laser clad) and the laser clad coatings happened after 200 and 270 cycles, respectively. The SEM images of the samples showed that delamination and spallation occurred in both coatings as the main mechanism of failure. Formation of TGO was also observed in the fractured cross section of the samples, which is also a main reason for degradation. Thermal shock resistance in the laser clad coatings improved about 35% after cladding. The improvement is due to the presence of continuous network cracks perpendicular to the surface in the clad layer and also the thermal stability and high melting point of alumina in Al2O3/ZrO2 composite.

  2. SUCCESSFUL EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT IN A PATIENT WITH FULMINANT MYOCARDITIS

    Institute of Scientific and Technical Information of China (English)

    Yong Yuan; Jian-ting Dong; Xuan-sheng Huang; Li-ting Zhang; Bin-fei Li; Zhi-gang Zhang; Ying Han

    2006-01-01

    @@ FULMINANT myocarditis complicated with refractory cardiogenic shock carries a very high mortality(76%). Herein we report our experience in treating a 23-year-old Chinese woman with fulminant myocarditis complicated with cardiogenic shock, who was rescued by extracorporeal membrane oxygenation (ECMO).

  3. 关节镜下膝关节清理术联合体外冲击波治疗膝关节骨性关节炎的疗效分析%Efficacy of Arthroscopic Debridement Combined with Extracorporeal Shock Wave Treatment of Knee Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    何子微; 赵维彪

    2016-01-01

    Objective:To analyze the curative effect of arthroscopic debridement combined with extracorporeal shock wave therapy in the treatment of knee osteoarthritis. Methods:All cases were divided into 2 groups:the control group were treated with arthroscopic debridement,the treatment group were treated with arthroscopic debridement combined with extracorporeal shock wave therapy. The Lysholm score and VAS score was used to determine the changes in patients. Results:After 1 months and 3 months, Lysholm score in the two groups of patients was higher than that before operation (P0.05) . Conclusion:Arthroscopic debridement combined with extracorporeal shock wave therapy in early stage can achieve the functional recovery and pain-relief effect, can better improve the patient's joint function and quality of life.%目的:关节镜下膝关节清理术联合体外冲击波治疗膝关节骨性关节炎的疗效分析。方法:将纳入病例分为2组:对照组患者单纯行关节镜下膝关节清理术;治疗组患者行关节镜下膝关节清理术联合冲击波疗法。对2组患者分别进行膝关节功能Lysholm评分和视觉模拟(VAS)评分,判断患者自觉膝关节功能和疼痛症状的变化。结果:治疗后1个月和3个月两个时间点2组患者的Lysholm评分较治疗前均升高(P<0.05),治疗组Lysholm评分大于对照组;VAS疼痛评分小于对照组(P<0.05)。治疗后6个月,2组患者的Lysholm评分及VAS评分差异无统计学意义(P>0.05)。结论:关节镜下膝关节清理术联合体外冲击波治疗在早期即能达到恢复功能及缓解疼痛的效果,能够更好地改善患者的关节功能和生活质量。

  4. Effect observation and care of applying extracorporeal shock wave therapy to nonunion and delayed union of fractures%体外冲击波治疗骨不连与骨折延迟愈合的效果观察与护理

    Institute of Scientific and Technical Information of China (English)

    李丽娟; 邵凤娣; 李锦英; 马蓝; 邓带欢

    2016-01-01

    目的:探讨应用体外冲击波治疗骨折延迟愈合以及骨不连的作用效果及其护理方法。方法:选择我院收治的2012年10月~2015年10月40例术后骨不连以及骨折延迟愈合患者作为研究对象,均实施体外冲击波治疗并予以针对性护理,对结果进行观察分析。结果:所有患者完成两个疗程治疗及护理后,治愈34例,好转6例。发生局部水肿2例,且经针对性处理后均有效缓解。结论:应用体外冲击波治疗骨不连以及骨折延迟愈合,可以产生明显的效果,结合有效的综合性护理,有效控制了并发症发生率,对于促进患者康复具有积极意义。%Objective:To explore the effects and nursing methods of applying extracorporeal shock wave therapy to delayed union and nonunion of fractures. Methods:Selected 40 patients with postoperative nonunion and delayed union of fractures from October 2012 to October 2015 as research objects. Carried out extracorporeal shock wave therapy and targeted nursing to all of them,observed and analyzed the results. Result:After finishing two treatment courses and care,34 patients of them were cured and 6 patients got better. There were 2 patients having local edema and their symptoms were all effectively relieved af-ter the targeted handling. Conclusion:Applying extracorporeal shock wave therapy to nonunion and delayed union of fractures can have significant effects. Combining it with effective and comprehensive nursing method can effectively control incidence rate of complication,which is of positive significance to pro-pel patients’recovery.

  5. Regional thrombolysis with tenecteplase during extracorporeal membrane oxygenation: a new approach for left ventricular thrombosis.

    Science.gov (United States)

    Sangalli, Fabio; Greco, Gianluca; Galbiati, Lucia; Formica, Francesco; Calcinati, Serena; Avalli, Leonello

    2015-06-01

    We present the case of a woman assisted with veno-arterial extracorporeal membrane oxygenation (v-a ECMO) for postischemic cardiogenic shock, who developed left ventricular thrombosis despite systemic anticoagulation and left ventricular apical venting. We successfully achieved local thrombolysis with tenecteplase administered through the venting cannula to obtain local thrombolysis while reducing systemic effects to a minimum. The procedure was effective with mild systemic bleeding and the patient was successfully weaned off the extracorporeal support a few days thereafter.

  6. Extracorporeal shock wave lithotripsy (ESWL) in orthopaedics

    OpenAIRE

    TOSUN, Nihat; Yucel, Mustafa; Brenner, Horst

    2004-01-01

    ESWL gained interest in orthopedics recently, especially in the treatment of tendinitis. Three sessions of ESWL with 1 month intervals were performed to 34 patients including 28 shoulder impingement syndromes, 4 lateral humeral epicondilitis and 2 Achilles tendinitis. Twenty (77%) patients with shoulder impingement, 2 (50%) patients with lateral humeral epicondilitis got benefit. However, it was ineffective in 2 cases (100%) with Achilles tendinitis, 2 cases (50%) with lateral humeral epicond...

  7. 不同频率体外冲击波碎石术治疗输尿管单发结石疗效分析%Effect of extracorporeal shock wave lithotripsy with different shock wave frequency on solitary ureteral calculi

    Institute of Scientific and Technical Information of China (English)

    姚史武; 李汉莱; 何强

    2016-01-01

    目的 探讨不同频率体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)治疗输尿管单发结石的疗效和安全性.方法 行ESWL治疗的输尿管单发结石患者268例,根据ESWL冲击波频率分为低频组142例和高频组126例,分别应用频率60、90 Hz冲击波进行治疗.术后随访3个月,比较2组术后1、4周及3个月排石率、排净率及并发症发生率.结果 低频组术后4周、3个月结石排净率(69.0%、85.9%)高于高频组(56.3%、75.4%)(P<0.05),术后疼痛或肾绞痛发生率(2.8%)低于高频组(8.7%)(P<0.05).结论 60 Hz频率冲击波可提高ESWL治疗输尿管单发结石术后结石排净率,降低疼痛或肾绞痛发生率.

  8. 体外冲击波治疗兔缺血性股骨头坏死过程中血管内皮生长因子的表达%The expression of VEGF in the ischemic necrosis of femoral heads of rabbits after extracorporeal shock wave treatment

    Institute of Scientific and Technical Information of China (English)

    汪结; 彭昊; 刘世清; 李瑞西

    2009-01-01

    目的 观察体外冲击波对兔股骨头缺血坏死模型中血管内皮生长因子(VEGF)表达的影响.方法 30只新西兰大白兔用甲基强的松龙和脂多糖诱导成股骨头缺血坏死模型,右侧为实验侧接受冲击波治疗,左侧为对照侧,治疗后1、2、4、8、12周取材行苏木素-伊红(HE)染色,VEGF免疫组织化学法检测蛋白表达分布,Western blot法定量蛋白.结果 实验侧软骨下骨组织VEGF的表达较对照组明显增加,在4周时达到高峰,并持续至8周,软骨下骨新生血管和成骨明显.结论 体外冲击波治疗能够促进缺血坏死股骨头中新生血管和软骨下骨的形成,VEGF的表达上调可能是其治疗机制.%Objective To observe the effect of the extracorporeal shock wave treatment on vascu- lar endothelial growth factor (VEGF) expression in the necrotic femoral heads of rabbits, and provide theo-retical basis for clinical therapy. Methods The methylprednisolone and lipopolysaccharide were applied to induce avascular necrosis of femoral heads in 30 New Zealand rabbits. The tight limb (the study side) received shock wave therapy to the femoral head, and the lett limb (the control side) received no shock wave therapy. Biopsies of the femoral heads were performed at the 1 st ,2nd ,4th, 8th, and 12th week. Immu- nocytochemistry and Western blot were used to detect the expression of VEGF. Results The VEGF pro- tein expression levels on the study side was increased to a peak at the 4th week and remained high for 8 weeks after the shock wave treatment,the ingrowth of neovascularization and bone formation were obviously increased at the same time;but on the control side,the VEGF protein always presented low expression, and the bone formation was not evident. Conclusion Extracorporeal shock wave treatment obviously increased the ingrowth of neovascularization and bone formation in the ischemic necrosis of femoral heads of rabbit models. The up-regulation of VEGF may play an

  9. 液电式体外冲击波治疗偏瘫肩痛%Treatment of hemiplegic shoulder pain with liquid-electric extracorporeal shock wave combined with therapeutic exercises

    Institute of Scientific and Technical Information of China (English)

    魏智钧; 欧阳颀; 李华; 侯艳丽; 张秋芬

    2014-01-01

    观察液电式体外冲击波治疗偏瘫肩痛(HSP)的疗效。方法脑卒中患者70例随机分为对照组(n=35)和观察组(n=35),两组患者进行运动疗法治疗,观察组同时对 HSP 肩关节进行体外液电式冲击波治疗。结果治疗4周后,观察组的治愈率为60.0%(21/35),总有效率为91.4%(33/35),对照组的治愈率为34.3%(12/35),总有效率为71.4%(25/35),两组比较差异有统计学意义(P <0.05)。两组治疗后与治疗前比较疼痛视觉模拟(VAS)评分及上肢运动功能(Fugl-Meyer)评分均有显著改善,分别为(5.91±1.70)分 vs (3.49±1.99)分、(5.80±1.47)分 vs (4.69±1.67)分 vs (24.86±9.08)分 vs (46.47±9.91)分、(26.91±9.70)分 vs (31.09±10.07)分,且观察组明显优于对照组(均P<0.01)。结论液电式体外冲击波是一种可供选择的治疗 HSP的较好方法。%Objective To observe the clinical efficacy of liquid-electric extracorporeal shock wave (ESW) combined with therapeutic exercise in treating hemiplegic shoulder pain.Methods Seventy patients with stroke were randomly divided into control group and observation group,the control group received therapeutic exercise,the observation group was used by liquid-electric ESW combined with therapeutic exercise,then,the clinical efficiency of two groups were evaluated before and after treatment by effective rate,visual analogue scale (VAS),Fugl-Meyer Assessment(FMA).Results After treatment of four weeks,the cure rate and the effective rate in the observation group were 60.0%(21/35),91.4%(33/35),while those in the control group were 34.3%(12/35),71.4%(25/35) (both P <0.05 );Before and after treatment,the VAS and FMA of observation group and control group were respectively (5.91±1.70)marks vs (5.80±1.47)marks,(3.49±1.99)marks vs (4.69±1.67)marks;(24.86± 9.08)marks vs (26.91 ± 9.70)marks,(46.47 ± 9.91)marks vs (31.09 ± 10.07)marks.The two groups had significantly improved after treatment in the VAS and Fugl

  10. The analgesia effect of extracorporeal shock wave therapy for tennis elbow%体外冲击波治疗网球肘的镇痛效果研究

    Institute of Scientific and Technical Information of China (English)

    张盘德; 彭小文; 容小川; 尹杰

    2013-01-01

    Objective: To study the analgesia effect of extracorporeal shock wave therapy (ESWT) in tennis elbow. Method: Forty-five patients with persistent tennis elbow received 3 times ESWT with 5 days intervals. The analgesia effect was assessed by present pain intensity (PPI), visual analogue scale (VAS) and Mills sign at the same day before and after treatment, and 1 week later of the last time treatment.Result: The analgesia effect after each treatment was obviously excellent than that before each treatment(P < 0.001). At the intermission the pain increased, the PPI scores before next treatment were higher than that of former post-treatment (P < 0.001), but were lower than that of former pre-treatment (P < 0.001). At 1 week follow-up, the PPI scores and VAS scores decreased from (2.29 ± 0.76) to (0.74 ± 0.52) and (5.06 ±1.51) to (1.99 ± 1.82) respectively, the positive rate of Mills sign decreased from 95.6% to 33.3%.Conclusion: ESWT has significantly immediate analgesia effect and accumulation effect of repeated treatment for tennis elbow.%目的:探讨体外冲击波治疗网球肘的即刻镇痛效应及累积效应.方法:使用国产电磁式体外冲击波治疗机治疗45例网球肘患者,5日1次,共3次.分别在每次治疗前、治疗后、疗程结束后1周,采用现时疼痛状况(PPI)、视觉模拟量表(VAS)、Mills征评定进行疗效评价.结果:3次治疗后即刻均比治疗前疼痛程度显著降低,差异有显著性意义(P< 0.001).在治疗间歇期,疼痛较上次治疗后即刻增加,差异有显著性意义(P< 0.001),但均比上次治疗前的疼痛程度低(P< 0.001),疗程结束后疼痛程度显著减轻,由治疗前的(2.29±0.76)分降到治疗后的(0.74±0.52)分.治疗后VAS评分比上次评定均有显著改善,由治疗前的(5.06±1.51)分降到治疗后的(1.99±1.82)分.治疗前Mills征阳性率为95.6%,3次治疗后阳性率分别为86.7%、64.4%、33.3%,差异有显著性意义(P< 0.001).结论:体

  11. 体外冲击波联合电针治疗顽固性网球肘的临床研究%Clinical study on combined treatments with extracorporeal shock wave treatment and electroacupuncture for refractory tennis elbow

    Institute of Scientific and Technical Information of China (English)

    徐远红; 王俊华; 王刚; 李海峰; 朱小虎; 谢谨

    2012-01-01

    Objective It is to observe the clinical effects of combined treatments with extracorporeal shock wave treatment ( ESWT ) and electroacupuncture on refractory tennis elbow and further explore its treatment mechanism. Methods 60 cases of patients with refractory tennis elbow were randomly divided into electroacupuncture group, ESWT group and combined group with 20 cases in each group. Visual analog scale( VAS ) was used to evaluate the pain degree and activity daily life ( ADL ) was evaluated before and 2 weeks, 4 weeks, 3 months after treatment in all groups. Results The VAS and ADL were both obviously improved after treatment at all phases in the 3 groups( all P < 0.05 ), the improvement in combined group was more obviously than the other two groups( all P < 0.05 ). There was no significant difference in VAS and ADL between electroacupuncture group and ESWT group at 2 weeks after treatment, but they were better in ESWT group than that in electroacupuncture group at 4 weeks and 3 months after treatment( all P <0. 05 );VAS and ADL gradually improved in combined group and ESWT group with the treatment lasting, but worse at 3 months in electroacupuncture group than 4 weeks after treatment( P <0.05 ). Conclusion ESWT and electroacupuncture both have clinical curative effects on refractory tennis elbow, combined treatments can increase the short term and long term effects, and it can make up the insufficient on short term for electroacupuncture and improve the analgesia effects for ESWT.%目的 观察体外冲击波联合电针治疗顽固性网球肘的临床疗效,进一步探索体外冲击波治疗机制.方法 将60例顽固性网球肘患者随机分为电针组、冲击波组及联合治疗组,每组20例.3组患者在治疗前及治疗结束后2周、4周、3个月分别进行VAS疼痛评分及日常生活能力(ADL)评定.结果 3组患者治疗后各期VAS评分及ADL评分均较治疗前明显改善(P均<0.05),且联合治疗组改善程度优于单

  12. 特拉唑嗪联合体外冲击波碎石术治疗输尿管下段结石疗效观察%Treatment of lower ureteral stones by terazosin combined extracorporeal shock wave lithotripsy

    Institute of Scientific and Technical Information of China (English)

    沈寅洲; 田马宝; 温机灵; 陆佳荪; 仇广明

    2012-01-01

    目的 探讨特拉唑嗪联合体外冲击波碎石术(ESWL)治疗输尿管下段结石的有效性及安全性.方法 112例输尿管下段结石患者完全随机分成2组,对照组56例行ESWL后每天饮水2L;治疗组56例ESWL后口服盐酸特拉唑嗪片4 mg,1次/d.每例患者用药时间不超过2周.ESWL术后2周复查肾-输尿管-膀胱摄影(KUB)与B超,检查结石是否排出,并记录患者发生肾绞痛需要服用镇痛药物的次数.结果 ESWL后2周,对照组排石率为64.3% (36/56),治疗组为85.7% (48/56),2组比较差异有统计学意义(P<0.05).2组因发生肾绞痛而需要镇痛药治疗的比例分别为19.6%(11/56)和7.1% (4/56),2组比较差异有统计学意义(P<0.05).治疗组有4例发生头晕.结论 特拉唑嗪能提高输尿管下段结石ESWL后的结石排出率,减少发生肾绞痛的概率,且安全、有效.特拉唑嗪联合ESWL可作为输尿管下段结石的治疗方法之一.%Objective To evaluate the efficacy and safety of terazosin combined extracorporeal shock wave lithotripsy in the treatment of lower ureteral stone.Methods A total of 112 patients with lower ureter stone were randomly divided into 2 groups.Control group drank water 2 liters in two weeks after ESWL,and treatment group received terazosin (4 mg,once daily) after ESWL.All patients were observed for 2 weeks.After 2 weeks of ESWL,KUB and B ultrasound were checked to judge whether the stone is discharged,and the times of needing to taking the analgesic drugs because of renal colic were recorded.Results During 2 weeks,expulsion of stone was in 36 cases (64.3% ) of control group,in 48 cases(85.7% ) of treatment group.The difference in expulsion rates between two groups was statistically significant ( P < 0.05 ).Renal colic recurred within 2 weeks and analgesics were used in 11 cases ( 19.6% ) of control group and in 4 cases (7.1% ) of treatment group with statistically significant (P <0.05).Conclusions It is demonstrated

  13. 体外冲击波碎石致尿脓毒症的临床分析%Treatment of urosepsis induced by extracorporeal shock wave lithotripsy: analysis of 4 cases

    Institute of Scientific and Technical Information of China (English)

    齐桓; 罗超; 刘成山

    2012-01-01

    Objective To evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL). Methods The clinical data were analyzed in 4 cases of urosepsis caused by ESWL during the period from January, 2008 to October 2011. Results Two of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture revealed the presence of E, coli in 2 cases, Klebsiella pneumoniae in 1 case and Pseudomonas putida combined E. coli in 1 case. All the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and anti-inflammatory therapy. The vital signs of the patients became stable after 5-11 days (mean 6.75 days). Three patients underwent ureteroscopic lithotripsy; and 1 patient had emergency ureteral stent indwelling. All the 4 patients were cured and discharged. Conclusions ESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for which early nonsurgical interventions should be administered immediately after the diagnosis is established.%目的 提高体外冲击波碎石(ESWL)术后并发尿脓毒症的临床认识及诊疗水平.方法 对经ESWL后并发尿脓毒症的4例患者的临床资料进行回顾性分析.4例肾结石或输尿管结石患者在接受ESWL术后6~36 h内出现尿脓毒症的临床表现,尿细菌培养2例为大肠埃希菌感染,1例肺炎克雷伯杆菌,1例大肠埃希菌并恶臭假单胞菌.结果 4例患者经心电、血压及氧饱和度监测,吸氧、补液、抗炎、升压等治疗,分别在术后5~11 d(平均6.75 d)生命体征恢复平稳,3例行输尿管镜下气压弹道碎石,1例紧急行膀胱镜下DJ管置入引流肾盂液体,经保守治疗11d后结石排岀,4例病人均痊愈出院.结论 ESWL术前伴有泌尿系感染的患者更易发生尿脓毒症;临床发现尿脓毒症时需要及早诊断,积极治疗,以保守治疗为主.

  14. 体外冲击波与小针刀疗法治疗肱骨内上髁炎疗效比较%Comparative study of extracorporeal shock wave therapy and small-needle-knife therapy in treating medial epicondylitis

    Institute of Scientific and Technical Information of China (English)

    云文科; 葛茂林; 曹磊光; 王剑; 宝音; 白杰; 任喜存

    2015-01-01

    目的:比较体外冲击波疗法及小针刀疗法治疗肱骨内上髁炎的效果。方法肱骨内上髁炎80例被随机分成两组,每组40例,分别行体外冲击波治疗和小针刀治疗,计算并比较两组术前及术后的VAS疼痛评分、HSS肘关节功能评分。结果小针刀及体外冲击波疗法均能明显缓解肱骨内上髁炎患者肘关节的疼痛,两组治疗后VAS评分均低于治疗前,差异有统计学意义(P<0.01);体外冲击波组治疗后VAS评分低于小针刀组治疗后[(1.07±0.66) vs (2.24±0.75)],差异有统计学意义(P<0.01)。两组治疗后HSS评分均高于治疗前,差异有统计学意义(P<0.01);体外冲击波组治疗后HSS评分高于小针刀组治疗后[(92.06±8.07) vs (83.71±7.65)],差异有统计学意义(P<0.01)。结论在治疗肱骨内上髁炎疼痛和恢复功能方面,体外冲击波疗法比小针刀效果更明显。%Objective To discuss and compare the effect of extracorporeal shock wave therapy and small needle knife therapy in the treatment of medial epicondylitis .Methods Eighly patients with medial epicondylitis were divided into two groups randomly ,the extracorporeal shock wave therapy group (ESWT) and the small needle knife therapy group (SNKT).The visual analog scale ( VAS) score, function and overall rating were compared before and after the treatment between the two groups .Results Both therapy relieved pain significantly, the VAS scores in the two groups declined to (2.24 ±0.75) and (1.07 ±0.66)(P<0.01),respectively after treatment.The HSS scores recoverd to (83.71 ±7.65) and (92.06 ±8.07), respectively, the functions of both elbows recovered sig-nificantly(P<0.01) compared with the condition of pre-treatment.The the rapy in ESWT group was more effective than in the SNKT group(P<0.01)in pain and function.Conclusions Both extracorporeal shock wave and the small needle knife therapy can

  15. Effects of Extracorporeal Shock Wave Treatment on Three-Dimensional Spatiotemporal Gait Parameters in Patients with Knee Osteoarthritis%体外冲击波治疗对膝关节骨性关节炎三维步态时空参数的影响

    Institute of Scientific and Technical Information of China (English)

    申美平; 戴明成; 秦庆奎; 罗春燕; 蒲兰芳

    2016-01-01

    目的:观察体外冲击波治疗对膝关节骨性关节炎三维步态时空的影响。方法将61例膝关节骨性关节炎患者随机分为常规治疗组(A 组,n=30)和体外冲击波治疗组(B 组,n=31),分别采用常规方法治疗和体外冲击波治疗,比较2组治疗前后三维步态时空参数、Lysholm 膝关节评分和疼痛视觉模拟评分(VAS)。结果2组患者治疗后的三维步态时空参数的支撑相、步频、步速,Lysholm 膝关节评分和 VAS 评分与治疗前相比,均有不同程度改善(P <0.05或 P <0.01)。治疗后 B 组的步态周期和步幅与治疗前比较差异具有统计学意义(P <0.05);与治疗后的 A 组比较,治疗后 B 组三维步态时空参数中的支撑相、步态周期、步频、步幅、步速,Lysholm 膝关节评分和VAS 评分,均有不同程度改善(P <0.05或 P <0.01)。结论体外冲击波治疗膝关节骨性关节炎疗效确切。%Objective To observe the effects of extracorporeal shock wave treatment on three-dimensional spatiotemporal gait parameters in patients with knee osteoarthritis.Methods Sixty-one patients with knee osteoarthritis were randomly assigned to receive either conventional thera-py(group A,n=30)or extracorporeal shock wave treatment(group B,n=31).Three-dimensional spatiotemporal gait parameters,Lysholm knee rating score and visual analogue scale(VAS)score were measured before and after the treatment.Results The support phase,cadence,walking ve-locity,Lysholm knee rating score and VAS score were significantly improved after treatment in both groups(P <0.05 or P <0.01).Furthermore,the gait cycle and stride length were obviously improved after extracorporeal shock wave treatment(P <0.05).Compared with group A,the sup-port phase,gait cycle,cadence,stride length,walking velocity,Lysholm knee rating score and VAS score were significantly improved in group B after treatment(P <0.05 or P <0

  16. Clinical effect of extracorporeal shock wave lithotripsy combined with drug therapy in the treatment of lower ureteral calculi%体外冲击波碎石联合药物治疗输尿管下段结石的临床效果

    Institute of Scientific and Technical Information of China (English)

    王洪海; 谭琳

    2015-01-01

    Objective To explore the clinical effect of extracorporeal shock wave lithotripsy combined with terazosin hydrochloride in the treatment of lower ureteral calculi. Methods 184 patients with lower ureteral calculi in the urinary system in our hospital from November 2012 to November 2014 were selected and randomly divided into the control group and the experiment group,92 patients in each group.The control group was treated with extracorporeal shock wave lithotripsy alone,the experiment group was treated with extracorporeal shock wave lithotripsy combined with terazosin hydrochloride.The clinical effect in two groups was compared. Results The cure rate and the total effective rate in the experiment group was higher than that in the control group,with significant difference (P<0.05).The application rate of painkiller in the experiment group was lower than that in the control group,with significant difference (P<0.05). Con-clusion The effect of extracorporeal shock wave lithotripsy combined with terazosin hydrochloride in the treatment of lower ureteral calculi in the urinary system is significant,which can eliminate the stones inside patients’body,reduce patients’pain.%目的:探讨体外冲击波碎石联合盐酸特拉唑嗪治疗输尿管下段结石的临床效果。方法选取2012年11月~2014年11月本院收治的184例泌尿系统输尿管下段结石患者作为研究对象,随机分为对照组和试验组,各92例。对照组采用体外冲击波碎石治疗,试验组采用体外冲击波碎石联合盐酸特拉唑嗪治疗,比较两组的临床效果。结果试验组的治愈率与总有效率显著高于对照组,差异有统计学意义(P<0.05)。试验组的止痛药物使用率显著低于对照组,差异有统计学意义(P<0.05)。结论体外冲击波碎石联合盐酸特拉唑嗪治疗输尿管下段结石效果显著,能更好地清除患者体内的碎石,减少患者病痛。

  17. In situ localization of heat-shock and histone proteins in honey-bee (Apis mellifera l.) larvae infected with Paenibacillus larvae.

    Science.gov (United States)

    Gregorc, A; Bowen, I D

    1999-01-01

    The immunohistochemical localization of the heat shock proteins (Hsp70 and Hsp90) and histone protein in healthy and Paenibacillus larvae infected honeybee (Apis mellifera L.) larvae has been studied. Hsp70 was found in the nuclei and the cytoplasm of infected midgut, salivary gland cells and haemocytes, but not in uninfected larvae. Hsp90 was localized in both infected and uninfected cells. Exposed histone proteins were localized in the nuclei of dying uninfected cells undergoing programmed cell death. The distribution of histone protein in uninfected cells of midgut, salivary gland, and other tissues was nuclear and indicative of normal programmed cell death at levels between 1 and 5%. After applying histone protein antibodies to P. larvae infected honeybee larvae, the DAB based reaction product was located in the nuclei or immediate surroundings of all larval cells. The Hsp70, Hsp90 and histone protein distribution patterns are discussed in relation to the morphological, cytochemical and immunocytochemical characteristics of programmed cell death and pathological necrosis. Results produced by methyl green-pyronin staining confirm an elevation of RNA levels in normal programmed cell death and a reduced staining for RNA in necrotic infected cells. Copyright 1999 Academic Press.

  18. Extracorporeal Treatment for Lithium Poisoning

    DEFF Research Database (Denmark)

    Decker, Brian S; Goldfarb, David S; Dargan, Paul I

    2015-01-01

    The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxico......The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical...... extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li...... treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li(+)], kidney function, pattern of lithium toxicity...

  19. A preliminary trial of extracorporeal shock waves for the treatment of ⅢB chronic prostatitis%体外冲击波治疗ⅢB型前列腺炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    曾晓勇; 叶章群; 李平; 陈志强; 杜广辉; 周惜才

    2009-01-01

    Objective To assess the effect of extracorporeal shock waves(ESWs)as a treatment for ⅢB chronic prostatitis(CP).Methods Forty-six men with ⅢB CP were randomly divided into an experimental group (n=34)and a control group(n=12).The patients in experimental group received low energy ESW treatment,20000 impulses in 10 sessions over 2 weeks.The patients in control group received sham ESW treatment without shock waves energy under the same other conditions as in experimental group.Pain,urination and quality of life/impact were assessed with National Institutes of Health-chronic prostatitis symptom index(NIH-CPSI).Both groups were assessed at baseline,post-treatment and at a 4-week follow-up.Resuits The total NIH-CPSI scores,pain scores and quality of life/impact scores in experimental group decreased significantly post-treatment(P<0.01),but urination scores did not(P>0.05).Similar decreases of these scores were also found in control group post-treatment.The total NIH-CPSl scores and pain scores maintained at a lower level at the 4-week follow-up in experimental group,but the scores returned to the level as pre-treatment in control group.The effectiveness rates and prominent effectiveness rates in experimental group were significantly higher than those in control group post-treatment and at the 4-week follow-up(all P<0.05). Conclusions ESWs was effective in the treatment for ⅢB CP.After ESWs treatment pain alleviated,symptoms reducea and quality of life improved.%目的 初步评价体外冲击波(ESW)治疗慢性前列腺炎的可行性及临床疗效.方法 将46例ⅢB型慢性前列腺炎患者随机分为治疗组(34例)及对照组(12例).治疗组患者给予低能量级别ESW治疗,每次治疗时ESW冲击数量为2 000次,每周治疗5次,治疗2周为1个疗程(共治疗10次);对照组接受模拟ESW治疗,期间ESW治疗仪无能量输出.2组患者分别于治疗前、治疗1个疗程及治疗结束后4周时进行慢性前列腺

  20. Extracorporeal life support for refractory ventricular tachycardia

    Science.gov (United States)

    Joseph, Nicholas; Hofmann, James P.; Saranteas, Theodosios; Papadimos, Thomas J.

    2017-01-01

    Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored. Data base searches were done using key words such as ECLS, VT, cardiac arrest, VT ablation, venoarterial extra-corporeal membrane oxygenation (VA-ECMO). The use of ECLS has been described in a few case reports to facilitate VT ablation for incessant VT refractory to medical therapy. For patients with, out-of- hospital ventricular fibrillation (VF) and VT, Minnesota Resuscitation Consortium has implemented emergent advanced perfusion and reperfusion strategy, followed by coronary angiography and primary coronary intervention to improve outcome. The major indications for ECLS are cardiogenic shock related to acute myocardial infarction, myocarditis, post embolic acute cor pulmonale, drug intoxication and post cardiac arrest syndrome with the threat of multi-organ failure. ECLS permits the use of negative inotropic antiarrhythmic drug therapy, facilitates the weaning of catecholamine administration, thereby ending the vicious cycle of catecholamine driven electric storm. ECLS provides hemodynamic support during ablation procedure, while mapping and induction of VT is undertaken. ECLS provides early access to cardiac catheterization laboratory in patients with cardiac arrest due to shockable rhythm. The current evidence from literature, supports the use of ECLS to ensure adequate vital organ perfusion in patients with refractory VT. ECLS is a safe, feasible and effective therapeutic option when conventional therapies are insufficient to support

  1. In situ expression of heat-shock proteins and 3-nitrotyrosine in brains of young rats exposed to a WiFi signal in utero and in early life.

    Science.gov (United States)

    Aït-Aïssa, Saliha; de Gannes, Florence Poulletier; Taxile, Murielle; Billaudel, Bernard; Hurtier, Annabelle; Haro, Emmanuelle; Ruffié, Gilles; Athané, Axel; Veyret, Bernard; Lagroye, Isabelle

    2013-06-01

    The bioeffects of exposure to Wireless High-Fidelity (WiFi) signals on the developing nervous systems of young rodents was investigated by assessing the in vivo and in situ expression levels of three stress markers: 3-Nitrotyrosine (3-NT), an oxidative stress marker and two heat-shock proteins (Hsp25 and Hsp70). These biomarkers were measured in the brains of young rats exposed to a 2450 MHz WiFi signal by immunohistochemistry. Pregnant rats were first exposed or sham exposed to WiFi from day 6 to day 21 of gestation. In addition three newborns per litter were further exposed up to 5 weeks old. Daily 2-h exposures were performed blind in a reverberation chamber and whole-body specific absorption rate levels were 0, 0.08, 0.4 and 4 W/kg. 3-NT and stress protein expression was assayed in different areas of the hippocampus and cortex. No significant difference was observed among exposed and sham-exposed groups. These results suggest that repeated exposure to WiFi during gestation and early life has no deleterious effects on the brains of young rats.

  2. Experimental study on the treatment of bone nonunion of rabbit radius by extracorporeal shock wave com-bined with hyperbaric oxygen%体外冲击波联合高压氧治疗兔桡骨骨折骨不连的实验研究

    Institute of Scientific and Technical Information of China (English)

    郁少林; 李宏宇; 刘搏宇; 蔡敏; 杨勇; 来文兵

    2015-01-01

    目的:探讨体外冲击波联合高压氧治疗兔桡骨骨折骨不连的效果及作用原理。方法选用新西兰雄性健康标准实验大白兔48只(月龄及体重相当),无菌条件下制作兔双侧桡骨骨不连模型,采用随机数字表法随机分成四组,每组12只。其中A组为体外冲击波联合高压氧治疗组;B组为单纯高压氧治疗组;C组为单纯体外冲击波治疗组;D组为对照组,不做任何处理。分别在治疗前及治疗后第2、4、8、12周摄X线片并处死部分实验动物取活组织进行大体观察、骨折间隙变化、骨痂钙含量测定、光镜检查骨痂成骨细胞计数,最后进行统计学分析。结果 X线观察,A组与B、C、D组骨不连间隙4、8、12周差异有统计学意义( P<0.05)。 A、C两组骨痂钙元素含量2、4、8、12周差异有统计学意义( P<0.05),骨痂成骨细胞计数2、4、8周差异具有统计学意义( P<0.05)。结论体外冲击波联合高压氧对骨不连的治疗效果优于单纯体外冲击波治疗,单纯高压氧治疗对骨不连无明显帮助,高压氧可作为体外冲击波治疗骨不连的一种良好的协同方法。%Objective To explore the effect and action mechanism of extracorpoporeal shock wave combined with hyperbaric oxygen in the treatment of bone ununion .Methods Forty-eight health standard experiment New Zeal-and white rabbits were chosen ( months of age are consistent with weights ) , and divided into four groups by using the random number table after the models were made by osteotomy (12 in each group).The group A was extracorporeal shock wave combined with hyperbaric oxygen group; The group B was hyperbaric oxygen group; The group C was pure extracorporeal shock wave group;The group D was in control group , X-ray examination was made before treat-ment and at 2, 4, 8, 12 weeks after treatment;and part of the experimental animals were executed at each time point

  3. [Shock wave treatment for tennis elbow].

    Science.gov (United States)

    Rompe, J D; Theis, C; Maffulli, N

    2005-06-01

    Randomized controlled trials were evaluated to assess the effectiveness of extracorporeal shock wave treatment in the management of tennis elbow. Five trials had a mediocre methodology and four trials had a high-quality design. Well-designed randomized control trials have provided evidence of the effectiveness of shock wave intervention for tennis elbow.

  4. Extracorporeal piezoelectric lithotripsy for complicated bile duct stones.

    Science.gov (United States)

    Weber, J; Adamek, H E; Riemann, J F

    1991-02-01

    Today, common bile duct stones are extracted endoscopically. After endoscopic sphincterotomy, nearly 90% of all stones can be removed with a Dormia basket or a mechanical lithotripter. Problems are encountered if there are larger stones or a duct stenosis. New conservative therapies do serve as an alternative to surgical intervention for those few patients in whom endoscopic measures have failed. Stone fragmentation can be achieved by extracorporeal shock wave lithotripsy, and remaining fragments can be removed endoscopically. So far, authors of most reports on the successful disintegration of common bile duct stones used the Dornier lithotripter. Stone localization is thus achieved with x-rays, and the shock waves are generated by an underwater spark discharge. We report on our experiences and results with extracorporeal piezoelectric shock wave lithotripsy (EPL) in 19 patients with complicated bile duct stones. With this lithotripter, stones are visualized by ultrasound, and shock waves are produced by a piezoelectric acoustic generator. Fragmentation was achieved in 84.2%, and complete stone removal in 78.9%. These results show that piezoelectric lithotripsy is also a useful method for the treatment of complicated bile duct stones, as has already been proved for the electrohydraulic- and electromagnetic-generated shock waves systems. However, the renunciation of general anesthesia and the need for analgesia or sedation in only 25% of the treatments render this lithotripter system attractive, especially for elderly and frail patients.

  5. Extracorporeal shock wave therapy, joint mobilization and short wave therapy in treating scapulohumeral periarthritis%体外冲击波与关节松动术加短波透热治疗肩周炎的效果比较研究

    Institute of Scientific and Technical Information of China (English)

    周宁; 邵彬; 陈勇; 彭军; 岳翔

    2010-01-01

    目的 比较体外冲击波与关节松动术加短波透热疗法在治疗肩关节周围炎疗效上的差异,探讨体外冲击波治疗肩周炎的临床机制与应用前景.方法 选取47例肩周炎患者,将其分为治疗组26例和对照组21例.治疗组采用体外冲击波治疗,体外冲击波频率为60次/min,能流密度为0.12 mJ/mm~3,每次治疗共冲击2 000次,每5 d治疗1次,共治疗3次.对照组患者给予温热量短波治疗后行关节松动术,每天1次,共治疗10次,其间间隔2 d.采用简化McGill疼痛问卷(SF-MPQ)和关节活动度测定来评估患者肩关节功能的改善情况.结果 2组患者治疗后的肩关节功能与治疗前比较,均有明显改善(P<0.05),治疗组第1次治疗后的疗效明显优于对照组,差异有统计学意义(P<0.01).结论 体外冲击波作为一种安全、省时并且有效的治疗手段,可以用于肩周炎的治疗.%Objective To compare the immediate effects of extracorporeal shock wave therapy with that of joint mobilization plus short wave therapy in treating scapulohumeral periarthritis, and to elucidate the mechanism of extracorporeal shock wave therapy and how it should be used. Methods Forty-seven patients diagnosed with scapulohumeral periarthritis were selected and randomized into two groups, a treatment group (n = 26) treated with extracorporeal shock wave therapy, and a control group ( n = 21 ) treated with joint mobilization plus short wave therapy. The short form of the McGill pain questionnaire (SF-MPQ) and range of motion (ROM) measurements were used to evaluate shoulder function. Results Compared with baseline, both groups improved significantly af-ter treatment, but the immediate effect in the treatment group was superior to that in the control group. Concln-sions As a safe, time-saving and effective therapy, extracorpnreal shock waves could be used to treat scapulo-humeral periarthritis.

  6. Effects of extracorporeal cardiac shock wave therapy in patients with ischemic heart failure%体外心脏震波治疗缺血性心力衰竭的初步观察

    Institute of Scientific and Technical Information of China (English)

    彭云珠; 郭涛; 杨萍; 杨洪文; 周平; 王钰; 骆志玲; 顾云; 潘家华

    2012-01-01

    目的 探讨体外心脏震波(CSWT)治疗缺血性心力衰竭(心衰)的可行性、安全性及疗效.方法 选取2009年8月至2011年8月诊断为冠心病缺血性心衰、左室射血分数<50%的患者50例.随机将患者分人:试验组,予震波能量(0.09 mJ/mm2)治疗;对照组,相同程序不予震波能量治疗;各25例.治疗程序为:3个月一疗程,共9次震波治疗.治疗前后行99锝m-甲氧基异丁基异腈(99Tcm-MIBI)/18氟-脱氧葡萄糖(18 F-FDG)双核素单光子发射型计算机心肌断层显像或者99Tcm-MIBI-单核素单光子发射型计算机心肌断层显像定位并评价存活/缺血心肌,同时行彩色心脏超声、肌钙蛋白Ⅰ、6 min步行距离等检查,治疗前后评价西雅图心绞痛量表、加拿大心绞痛分级、纽约心脏功能分级,临床随访不少于4个月.结果 所有患者均依方案完成研究.两组患者均无心绞痛加剧、无心肌损伤、出血、栓塞、无恶性心律失常等并发症.试验组震波治疗后的纽约心脏功能分级、加拿大心绞痛分级、硝酸甘油用量、左室舒张末期内径、左室灌注总分和左室代谢总分较治疗前减低(均为P<0.05),西雅图心绞痛量表评分、左室射血分数以及6 min步行距离较治疗前增高(均为P<0.05);对照组上述指标差异均改变不明显(均为P >0.05).多重线性回归分析显示,CSWT是以上各临床指标、超声指标、左室灌注指标改变的影响因素(均为P <0.05).结论 CSWT治疗是对冠心病缺血性心衰的一项无创、安全、有效的新疗法,可缓解患者心绞痛、改善心功能,提高生活质量及运动耐量.%Objective To evaluate the feasibility,safety and efficiency of extracorporeal cardiac shock wave therapy (CSWT)in patients with ischemic heart failure.Methods Fifty patients with ischemic heart failure and left ventricular ejection fraction (LVEF) < 50% were randomized to CSWT (shots/spot at 0.09 mJ/mm2 for 9

  7. Extracorporeal Treatment for Salicylate Poisoning

    DEFF Research Database (Denmark)

    Juurlink, David N; Gosselin, Sophie; Kielstein, Jan T

    2015-01-01

    STUDY OBJECTIVE: Salicylate poisoning is a challenging clinical entity associated with substantial morbidity and mortality. The indications for extracorporeal treatments such as hemodialysis are poorly defined. We present a systematic review of the literature along with evidence- and consensus......-based recommendations on the use of extracorporeal treatment in salicylate poisoning. METHODS: The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup is a multidisciplinary group with international representation whose aim is to provide evidence-based recommendations on the use of extracorporeal treatments...... in poisoning. We conducted a systematic literature review followed by data extraction and summarized findings, following a predetermined format. The entire work group voted by a 2-round modified Delphi method to reach consensus on voting statements, using a RAND/UCLA Appropriateness Method to quantify...

  8. 体外冲击波与推拿理疗治疗腱末端病随机对照试验的系统评价和Meta分析%Extracorporeal Shock Wave Therapy and Massage and Physical Therapy for Treatment of Tendon Enthesiopathy : A Systematic Review of Randomized Controlled Trials

    Institute of Scientific and Technical Information of China (English)

    葛瑞; 陈威妮; 王清; 向文东; 代波

    2013-01-01

    Objective: To systematically review the efficacy and safety between extracorporeal shock wave therapy and massage and physical therapy in treatment of tendon enthesiopathy. Methods : Based on the principles and methods of Cochrane systematic reviews, we searched MEDLINE, the Cochrane Central Register of Controlled Trials, CBM, CNKI, VIP and WanFang database from inception to August 2012. We handsearched references and relevant journals. The risk of bias in the included RCTs were evaluated according to the Cochrane Handbook for Systematic Reviews. The Cochrane Collaboration's software RevMan5.0 was used for Meta-analysis. Results : Six RCTs involving 599 patients were identified, 325 patients in treatment group and 274 patients in control group. The methodological quality of all the studies were low. Perceived pain was relieved and function was significantly improved in extracorporeal shock wave group than that in massage and physical therapy group. Side effects were not reported in both groups. Conclusion : There is no adequate evidence to confirm whether extracorporeal shock wave is superior to massage and physical therapy. Therefore, more large-sample, multicentre, high quality RCTs to confirm this conclusion are needed.%目的:系统评价体外冲击波与推拿理疗治疗腱末端病的疗效和安全性.方法:计算机检索PUBMED、Cochrane图书馆、CNKI数据库、维普数据库、万方数据库,检索年限均从建库至2012年8月,无语种限制,选择随机对照试验(RCT).按Cochrane系统评价方法筛选试验、评价质量、提取资料,用RevMan5.0软件对数据进行统计分析.结果:总计纳入6篇文献,包括599例患者,其中治疗组325例,对照组274例,质量等级均为C级.在患者自觉疼痛改善及功能改善上,体外冲击波治疗优于推拿理疗组.上述文章均未描述不良反应,两组治疗的安全性均较高,无明显不良反应发生.结论:无论体外冲击波治疗还

  9. The history of extracorporeal oxygenators.

    Science.gov (United States)

    Lim, M W

    2006-10-01

    Extracorporeal oxygenators are artificial devices that substitute for anatomical lungs by delivering oxygen to, and extracting carbon dioxide from, blood. They were first conceptualised by the English scientist Robert Hooke (1635-1703) and developed into practical extracorporeal oxygenators by French and German experimental physiologists in the 19th century. Indeed, most of the extracorporeal oxygenators used until the late 1970s were derived from von Schroder's 1882 bubble oxygenator and Frey and Gruber's 1885 film oxygenator. As there is no intervening barrier between blood and oxygen, these are called 'direct contact' oxygenators; they contributed significantly to the development and practice of cardiac surgery till the 1980s. Membrane extracorporeal oxygenators introduce a gas-permeable interface between blood and oxygen. This greatly decreased the blood trauma of direct-contact extracorporeal oxygenators, and enabled extracorporeal oxygenators to be used in longer-term applications such as the intensive therapy of respiratory distress syndrome; this was demonstrably beneficial for neonates but less so for older patients. Much work since the 1960s focused on overcoming the gas exchange handicap of the membrane barrier, leading to the development of high-performance microporous hollow-fibre oxygenators that eventually replaced direct-contact oxygenators in cardiac theatres.

  10. Clinical observation of extracorporeal shock wave therapy for chronic non-calcific tendinopathy of the supraspinatus%体外冲击波治疗非钙化性冈上肌肌腱炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    谷玉静; 林松; 冯晓东

    2014-01-01

    Objective To observe the clinical effects of extracorporeal shock wave therapy ( ESWT ) for chronic non-calcific tendinopathy of the supraspinatus.Methods From April 2011 to April 2013, 53 patients with chronic non-calciifc tendinopathy of the supraspinatus were adopted, whose average age was ( 40.42±1.33 ) years old. They were randomly divided into treatment group (n=26 ) and control group (n=27 ). The patients in both groups received infrared ray therapy. Besides, the patients in the treatment group received low-dose ESWT and the patients in the control group accepted placebo therapy. The Constant-Murley score ( CMS ) was used to assess the improvement of the shoulder function in both groups before the treatment and at 1 and 3months after the treatment.Results The patients in both groups were followed up for at least 3 months, and no severe side effects were noticed during the treatment. In the treatment group, the scores of Visual Analogue Scale ( VAS ), activity of daily living ( ADL ) scale, range of motion ( ROM ) scale, muscle strength grading scale and CMS were ( 2.08±0.80 ) points, ( 8.65±1.65 ) points, ( 12.77±3.10 ) points, ( 10.38±1.13 ) points and ( 33.88±4.08 ) points before the treatment, which were increased to ( 8.00±0.89 ) points, ( 12.96±1.40 ) points, ( 20.58±5.68 ) points, ( 13.50±1.24 ) points and ( 54.04±5.17 ) points at 1 month after the treatment and ( 11.08±1.47 ) points, ( 17.96±1.11 ) points, ( 30.46±4.43 ) points, ( 15.92±2.47 ) points and ( 75.42±6.35 ) points at 3 months after the treatment. When all the scores stated above and the total CMS score before the treatment were compared with that at 1 and 3 months after the treatment respectively, statistically signiifcant differences existed (P0.05 ). At 1 month after the treatment, there were statistically signiifcant differences between the 2 groups in all the scores and the total CMS score except the muscle strength grading score (P<0.05 ). At 3 months after the

  11. 体外心脏震波系统治疗顽固性心绞痛的临床探讨%Clinical study on treatment of extracorporeal cardiac shocK wave therapy in refractory angina pectoris patients

    Institute of Scientific and Technical Information of China (English)

    刘保逸; 陈聪霞; 张瑞生; 李文婵; 姚稚明; 何青

    2015-01-01

    Objective To evaluate the efficacy and safety of extracorporeal cardiac shock wave system ( CSWT ) in treating refractory angina pectoris patients. Methods Fifteen patients with severe coronary artery disease which was documented by coronary angiogram present with refractory angina pectoris were selected. The ischemic area was determined by the 99m Technetium-MIBI single-photon emission computed tomography (SPECT). The CSWT were performed in 3 months, and totally 9 times. The clinical evaluations include Canadian Cardiovascular Society ( CCS) class scores, New York Heart Association class ( NYHA ) , Seattle angina questionnaire ( SAQ ) , 6-min walking distance and the use of dosage of nitroglycerin;left ventricular end diastolic diameter ( LVEDD ) and left ventricular ejection of fraction ( LVEF) were also evaluated by echocardiography. The amelioration of ischemic myocardial was analyzed by SPECT, through comparison of myocardial perfusion scores and ischemic area before and after treatment. The variation of segment myocardial dysfunction was assessed by wall motion and wall thickening. Results CSWT obviously ameliorated CCS, NYHA, SAQ score, improved 6-min walking distance and decreased the use of nitroglycerin dose, but there was no significant changes in LVEDD and LVEF. SPECT date showed that in the treated segment, the rest myocardial perfusion score decreased from 1. 89 ± 0. 94 to 1. 37 ± 1. 07 (p=0. 004) and stress perfusion score also decreased from 2. 56 ±1. 19 to 1. 70 ±1. 27 (p=0. 000). The rest ischemic area decreased from 30. 81% ± 36. 60% to 17. 19% ± 28. 34% ( p =0. 004 ) and stress ischemic area from 61. 85% ± 30. 89% to 46. 31% ± 35. 72% ( p=0. 001 ) . The ventricular wall motion was improved from (6. 48 ± 2. 71) mm to (7. 49 ± 2. 43) mm (p=0. 007) and thickening from 44. 00% ± 22. 66% to 50. 46% ± 19. 91% (p=0. 038) in the rest, but no significant changes in the stress. There was no significant changes in CK, CKMB, TNT and there was no

  12. Effects of extracorporeal shock waves on the healing of bone nonunion in animals%体外冲击波对动物骨不连愈合的影响

    Institute of Scientific and Technical Information of China (English)

    钟俊; 李家元; 明江华; 彭昊; 刘世清; 王以强; 夏良波

    2006-01-01

    BACKGROUND: The therapy of nonunion has been a difficult issue in orthopedics all the time. Part of nonunion can't heal even after many times of operations. The effects of non-surgical treatments are not satisfactory. Extracorporeal shock waves (ESW) is a new method that popular abroad in recent years.OBJECTIVE: To investigate the effect of ESW on nonunion, and preliminarily probe into its mechanism.DESIGN: Randomized group-division design, animal experiment.SETTING: Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: The experiment was conducted in the Medical Experimental Center of Animal, Wuhan University from September 1997 to March 1999. Forty healthy male rabbits were selected to establish model of nonunion. Thirty-two rabbits with hypertrophic nonunion were taken as materials and randomly divided into treatment group and control group with 16 rabbits in each group.METHODS: A multifunctional ESW apparatus of type HX902Ⅲ was adopted to treat the broken ends of nonunion in the treatment group with the energy, frequency, dose and focus range of 0.54 m J/mm2, 60 times/minute,2 000 times and 1.5 cm2 respectively. The second focus of shock wave was adjusted, aiming at corresponding parts in distal and proximal sites of nonunion, and acted 1 000 times. After that, rabbits were re-fixed with external apparatus and acted freely. Rabbits in the control group were fixed with external apparatus without any other treatments.MAIN OUTCOME MEASURES: Examination of the healing of nonunion with radiograph, transmission electron microscope (TEM) and in histology.RESULTS: A total of 32 enrolled animals were involved in the analysis of results.①X-ray photograph: During the treatment with ESW, the gaps of nonunion were more and more indistinct in X-rays, and the densities of two sclerotic ends were reduced, and the sclerotic marrow cavities became unobstructed. The X-rays of nonunion-gaps before ESW were significantly narrowed than those after the

  13. Salvage Extracorporeal Membrane Oxygenation Prior to "Bridge" Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Chiu, Peter; Fearon, William F; Raleigh, Lindsay A; Burdon, Grayson; Rao, Vidya; Boyd, Jack H; Yeung, Alan C; Miller, David Craig; Fischbein, Michael P

    2016-06-01

    We describe a patient who presented in profound cardiogenic shock due to bioprosthetic aortic valve stenosis requiring salvage Extracorporeal Membrane Oxygenation followed by a "bridge" valve-in-valve transcatheter aortic valve replacement. doi: 10.1111/jocs.12750 (J Card Surg 2016;31:403-405).

  14. Extracorporeal piezoelectric lithotripsy for retained bile duct stones.

    Science.gov (United States)

    Weber, J; Adamek, H E; Riemann, J F

    1992-05-01

    Extracorporeal piezoelectric shock wave lithotripsy (EPL) was performed in 35 patients with endoscopically non-extractable stones. With this lithotripter, stones are visualized by ultrasound and shock waves are produced by a piezoelectric acoustic generator. The stones could be localized in 32 out of 35 patients. Fragmentation was achieved in 91.4% and complete stone removal in 77.1%. These results show that piezoelectric lithotripsy is also a useful method for the treatment of complicated bile duct stones, as already demonstrated for the electrohydraulically and electromagnetically generated shock waves systems. The piezoelectric system is especially useful in elderly and frail patients because no general anesthesia is needed and only 14% of cases require analgesia or sedation.

  15. Evaluation of kidney function before and after extracorporeal shock wave therapy using CT perfusion imaging%双能量CT灌注成像对体外冲击波治疗肾结石前后肾功能变化的评估

    Institute of Scientific and Technical Information of China (English)

    李才林; 吴非; 于晶; 李桂娟; 姜书山

    2013-01-01

    Objective By use of dual energy CT perfusion imaging,to study the renal blood flow changes in the kidney stone patients who were subjected to different energy levels of extracorporeal shock wave therapy,and to find the best therapy energy,which could be used in clinic.Methods Twenty-nine renal stone patients were recruited into our study,they were divided into two groups,9~10 kV therapy energy (19 cases),10~11 kV therapy energy (10 cases).All the patients were accepted dual energy CT perfusion before and after (24~72 hours) extracorporeal shock wave therapy.And we monitored the perfusion parameters changes such as maximum intensity projection (MIP),blood flow (BF),blood volume (BV),time to peak (TTP),permeability surface (PS),mean transit time (MTT) changes,and also monitored the serum creatinine,blood urea nitrogen,and other parameters before and after treatment.Results The perfusion parameters such as MIP,BF,BV,TTP,PS and MTT in stone surrounding area (energy impact center area) were significant differences before and after therapy,P <0.05,far stone area,they showed no significant differences before and after treatment,P >0.05.The serum creatinine,blood urea nitrogen level showed no significant differences before and after therapy,P >0.05.Conclusion CT perfusion imaging can be used to evaluate renal function changes in the patients before and after with extracorporeal shock wave lithotripsy.And the the hemodynamic changes are earlier than the serum creati nine,blood urea nitrogen changes.And we also get the conclusion that 9~10 kV and 10~11 kV are the safety energy of the extracorporeal shock wave therapy.%目的 研究肾结石患者经不同能量的冲击波碎石治疗后,患者肾血流的近期变化,并探讨体外冲击波碎石治疗最优能量.方法 29例肾结石患者,分为两组,分别用9~10kV(19例)、10~11kV(10例)进行体外冲击波治疗,并在治疗前即时、后24~72h行双能量多层螺旋CT灌注扫描,监测患

  16. Advancement in the research of effect of extracorporeal shock wave therapy on wound angiogenesis%体外冲击波疗法对促进创面血管生成及愈合作用的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵景春; 咸春静; 于家傲; 石凯; 吴巍巍

    2014-01-01

    改善创面循环血量对创面的快速愈合具有重要意义.研究显示,体外冲击波疗法(extracorporeal shock wave therapy,ESWT)对创面血管生成及创面愈合具有促进作用.本文查阅关于ESWT对创面血管再生及促进创面愈合作用的实验及临床研究论文,并对检索结果进行整理、综合与分析.目前研究结果显示,ESWT照射可通过上调血管生成及组织再生因子,如血管内皮生长因子、内皮型一氧化氮合酶以及增值性细胞核抗原的表达,增加组织灌注,改善局部血液供应,促进组织再生.虽然ESWT可有效改善局部血液供应及促进组织再生,但ESWT应用时的能量、聚焦程度、频率及周期数的最佳设置还有待于进一步研究.

  17. Extracorporeal cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Steven A. Conrad

    2016-04-01

    Full Text Available ECPR is defined as the rapidly-deployed application of venoarterial extracorporeal membrane oxygenation, in patients with cardiac arrest, during cardiopulmonary resuscitation before the return of ROSC. ECPR is one of the most rapidly growing segments of ECLS, and is becoming more widespread. Consideration for institution of ECPR is given to patients with witnessed arrest, good quality CPR instituted within 5 min of arrest, in whom ROSC does not occur within 15 min, and who can complete cannulation within 30–60 min. Patients from both inpatient and out-of-hospital settings are candidates if they meet these criteria. Deep hypothermic cardiac arrest, such as cold-water drowning, should receive consideration for ECPR even after considerable duration of arrest. Available outcome data are based on retrospective observation studies, some with propensity matching, and suggests a higher chance for survival with ECPR. Published outcomes from ECPR, however, are difficult to interpret, since many centers classify their use of ECLS after ROSC, in addition to ECLS before ROSC, as ECPR. Both children and adults are candidates for ECPR, but the experience in children is weighted heavily toward those with a diagnosis of cardiac disease and arrest occurring within closely monitored units.

  18. Extracorporeal treatment for acetaminophen poisoning

    DEFF Research Database (Denmark)

    Gosselin, S; Juurlink, D N; Kielstein, J T

    2014-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTR) in poisoning and the results are presented here for acetaminophen (APAP). METHODS: After a systematic review...... cases of APAP poisoning. However, given that APAP is dialyzable, the workgroup agreed that ECTR is suggested in patients with excessively large overdoses who display features of mitochondrial dysfunction. This is reflected by early development of altered mental status and severe metabolic acidosis prior...... and an APAP concentration over 900 mg/L (5960 mmol/L) if NAC is administered (1D). Intermittent hemodialysis (HD) is the preferred ECTR modality in APAP poisoning (1D). CONCLUSION: APAP is amenable to extracorporeal removal. Due to the efficacy of NAC, ECTR is reserved for rare situations when the efficacy...

  19. The Efficacy of Medical Expulsive Therapy (MET) in Improving Stone-free Rate and Stone Expulsion Time, After Extracorporeal Shock Wave Lithotripsy (SWL) for Upper Urinary Stones: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Skolarikos, Andreas; Grivas, Nikolaos; Kallidonis, Panagiotis; Mourmouris, Panagiotis; Rountos, Thomas; Fiamegos, Alexandros; Stavrou, Sotirios; Venetis, Chris

    2015-12-01

    In this meta-analysis, we included randomized studies on medical expulsive therapy implemented following shock wave lithotripsy for renal and ureteral stones. Pooled results demonstrated the efficacy of α-blockers, nifedipine, Rowatinex, and Uriston in increasing stone clearance. In addition, the time to stone elimination, the intensity of pain, the formation of steinstrasse, and the need for auxiliary procedures were reduced mainly with α-blockers. Expulsion rate was not correlated with the type of α-blocker, the diameter, and the location of stone. Our results show that medical expulsive therapy for residual fragments after shock wave lithotripsy should be implemented in clinical practice.

  20. Extracorporeal treatment for digoxin poisoning

    DEFF Research Database (Denmark)

    Mowry, James B; Burdmann, Emmanuel A; Anseeuw, Kurt

    2016-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, we present our results for digoxin. METHODS: After a systematic literature search, clinical and toxicokinetic data were...... recommended against the use of ECTR in cases of severe digoxin poisoning when Fab was available (1D) and also suggested against the use of ECTR when Fab was unavailable (2D). CONCLUSION: ECTR, in any form, is not indicated for either suspected or proven digoxin toxicity, regardless of the clinical context...

  1. Preventing LVAD implantation by early short-term mechanical support and prolonged inodilator therapy: A case series with acute refractory cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation and optimised medical strategy

    NARCIS (Netherlands)

    J.J. Brugts (Jasper); O.C. Manintveld (Olivier); A.A. Constantinescu (Alina); D.W. Donker (Dirk); R.J. van Thiel (Robert); K. Nieman (Koen); L.S.D. Jewbali (Lucia); F. Zijlstra (Felix); K. Caliskan (Kadir)

    2014-01-01

    textabstractCardiogenic shock continues to be a lifethreatening condition carrying a high mortality and morbidity, where the prognosis remains poor despite intensive modern treatment modalities. In recent years, mainly technical improvements have led to a more widespread use of short- and long-term

  2. [The combination of extracorporeal lithotripsy and percutaneous nephrostomy in the treatment of obstructive ureteral urate calculi].

    Science.gov (United States)

    Del Boca, C; Ferrari, C; Dotti, E; Corsi, G; Guardamagna, A; Giuberti, A C; Colloi, D

    1994-04-01

    The authors report their experience with combined percutaneous nephrostomy and extracorporeal shock-wave lithotripsy to treat obstructive uratic ureteral stones. The role of nephrostomy is stressed as a diagnosis and treatment method before, during and after lithotripsy. Thus, the method proved especially useful to drain obstructed kidneys and restore peristalsis, to evacuate septic urine, to facilitate the elimination of lithiasic fragments, to perform anterograde pyelography before, during and after lithotripsy and finally to allow pharmacological litholysis. Fourteen patients were successfully treated with combined extracorporeal lithotripsy and percutaneous nephrostomy and the results compared with those obtained with other techniques--e.g., ureteroscopy, whose value appears lower because the method requires general anesthesia and is more traumatic to the ureter. The authors conclude that combined extracorporeal lithotripsy and percutaneous nephrostomy make the best technique to treat obstructive uric acid stones thanks to their positive results, low invasiveness and to patients compliance.

  3. Comparison of the effects of human mesenchymal stem cells cultured by autologous serum into osteoblasts by extracorporeal shock waves versus dexamethasone%冲击波与地塞米松对自体血清培养的骨髓间充质干细胞成骨分化的比较研究

    Institute of Scientific and Technical Information of China (English)

    安佰京; 邢更彦

    2011-01-01

    [目的]观察冲击波(shock waves)与地塞米松对自体血清培养的人骨髓间充质干细胞(human mesenchyreal stem cells,hMSCs)体外成骨分化的影响比较.[方法]选择10名健康志愿者,每名健康志愿者抽取骨髓60 ml,抽取外周静脉血100 ml,然后分离出自体血清.把每名志愿者的骨髓分别用10%AS和10%FBS对hMSCs进行体外培养,通过相差倒置显微镜观察细胞形态、检测24 h细胞贴壁率、细胞倍增时间、检测细胞表面标记物、细胞周期及免疫细胞化学染色检测比较两组hMSCs的增殖状况.然后把AS培养的hMSCs两组分别用体外冲击波疗法(extracorporeal shock waves therapy,ESWT)[0.36 mj/(mm·100次)]和传统的诱导成骨培养基(10 nmol/L地寒米松、50umol/L抗坏血酸、10 mmol/L β-甘油磷酸钠)分别对hMSCs进行成骨诱导,对诱导好的细胞进行ALP定量检测、ALP染色、茜素红染色及RT-PCR测成骨基因(碱性磷酸酶、骨钙素、骨桥蛋白、骨结合素、Ⅰ型胶原)表达比较两组成骨分化情况.[结果]在细胞增殖上,两组细胞各代在细胞形态、细胞贴壁率、细胞周期以及免疫细胞化学染色检测上无明显差异,但在细胞倍增时间、细胞增殖速率上,自体血清明显优于胎牛血清.在细胞分化方面,两组在ALP定量检测、ALP染色、茜素红染色及RT-PCR测成骨基因上,冲击波作用于人骨髓间充质干细胞的成骨效应明显优于地塞米松.[结论]冲击波与地塞米松相比较,具有更良好促hMSCs成骨分化作用.%[Objective]To compare effects on the osteoblasts of human mesenchymal stem cells (hMSCs) in autologous serum by extracorporeal shock waves versus dexamethasone.[Methods]60 ml iliac crest bone marrow and 100 ml peripheral blood from 10 healthy volunteers were collected and the autologous serum were from peripheral blood.The iliac crest bone marrow from each volunteer were cultured for hMSCs with 10% AS (the experiment group

  4. 计算机辅助步态分析评价体外冲击波疗法治疗膝骨关节炎的效果%Computer-aided gait analysis evaluate the extracorporeal shock wave therapy in the treatment of knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    刘水涛; 刘彧; 杨军; 赵斌; 邢更彦

    2016-01-01

    ObjectiveWith computer-aided gait analysis as the main evaluation tools to evaluate the effect of extracorporeal shock wave therapy for knee osteoarthritis (KOA).MethodFrom March 2015 to June 2015, 25 cases of KOA patients in our hospital were selected as study subjects, all the patients were given radial extracorporeal shock wave therapy, treatment frequency was 3 Hz, 1~2 energy bar, under the shock of 2000 per week, received treatment once per week, 8 times for a course of treatment. Patients gait analysis before and at 1 month, 3 months, 6 months, collected time indicator: stance (%), swing (%), stride length (cm), wailing speed (m/s), analysis by used statistical software.ResultAfter ESW treatment, patients’stride length (cm) compared with before treatment had no signiifcant improvement (P>0.05), and wailing speed (m/s) in the treatment of 1 momth [(0.92±0.11) m/s], 3 months [(1.09±0.11) m/s] and 6 months [(1.12±0.13) m/s] had significant improvement than before treatment [(1.13±0.12) m/s](P0.05).ConclusionESW can restore the patients' knee function of with KOA, especially at 1, 3 and 6 months after treatment, the wailing speed (m/s) is signiifcantly improved. Gait analysis relative to other indicators is objective, accurate and quantitative advantages, is a new method for evaluating functional changes.%目的:以计算机辅助步态分析为主要评价手段,探讨体外冲击波疗法治疗膝骨关节炎(knee osteoarthritis,KOA)的效果。方法选取2015年3月至2015年6月本院收治的25例KOA患者为研究对象,均接受发散式体外冲击波(extracorporeal shock wave,ESW)治疗,治疗频率为3 Hz,能量为1~2 bar,每次冲击2000频次,每周接受1次治疗,8次为一疗程。所有患者均于治疗前及治疗后1、3、6个月行计算机辅助步态分析,收集时间-距离指标:支撑期百分比(%)、摆动期百分比(%)、步长(cm)、步速(m/s)的变化,应用统计学软

  5. 体外冲击波疗法联合自体骨髓干细胞移植治疗股骨头坏死%Extracorporeal shock wave therapy combined with autologous bone marrow stem cells transplantation for osteonecrosis treatment of femoral head

    Institute of Scientific and Technical Information of China (English)

    邢更彦; 张鹏礼; 姜川; 刘水涛

    2011-01-01

    Objective To evaluate the therapeutic effects of extracorporeal shock wave therapy ( ESWT ) combined with autologous bone marrow stem cells transplantation for osteonecrosis of the femoral head (ONFH ), and to explore new treatment of saving the head. Methods 120 patients ( 180 hips ) with ONFH were inrolled in General Hospital of Chinese Armed Police Force from January 2006 to June 2009. All patients were divided into four groups: blank control group, ESWT group, stem cell transplantation group and combining group. Harris score was used to evaluate hip function during follow-up by telephone and mail. The collapse of femoral head was summarized. and the collapse rates in the third year were compared among the four groups. Results Harris score of extracorporeal shock wave therapy combined with autologous bone marrow stem cell transplantation group was significantly better than ESWT group ( P < 0. 05 ) and stem cell transplantation group. The head collapse rate of the combining group in the third year was lower than the other groups. Conclusions Based on these results, it is concluded that with the features such as effective, minimally invasive and easily accepted by patients. the therapy is an ideal method of saving the femoral head with osteonecrosis.%目的 应用体外冲击波疗法(ESWT)联合自体骨髓干细胞移植治疗股骨头坏死(ONFH),分析其治疗效果,探索该病新的保髋治疗方法.方法 收集2006年1月至2009年6月在武警总医院收治的股骨头缺血性坏死患者120例180髋,分为空白对照组,单纯ESWT组,单纯干细胞移植组以及联合治疗组,采用髋关节功能评分标准(Harris评分)对患者进行电话随访以及书信随访,对治疗前后髋关节功能进行评价;统计所收集患者的股骨头塌陷情况,比较随访3年时各组股骨头塌陷率.结果 ESWT联合自体骨髓干细胞移植治疗ONFH在harris评分明显优于单纯ESWT组(P<0.05),以及单纯骨髓干细胞移植术(P<0.05),

  6. 体外冲击波与传统方法治疗腰椎间盘突出症疗效比较%The Efficacy and Life Quality Assessment on the Radial Extracorporeal Shock Wave Therapy of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    苏文珍; 林永杰; 孙立民; 石恩东; 张凯

    2014-01-01

    比较放散式体外冲击波与传统保守治疗腰椎间盘突出症的临床疗效及生命质量评价。对2010年6月至2013年6月收治且获得随访的257例腰椎间盘突出症患者进行分析,其中男139例,女118例。根据治疗方式不同随机分为两组,并在治疗前后应用日本骨科学会(JOA)下腰痛评分法及视觉模拟评分(VAS)进行疗效评价,应用健康调查评分量表SF-36进行生活质量评价。对患者进行随访1周~12周,平均(10.0±3.4)周,治疗组治疗后2周和4周VAS评分低于对照组,治疗后1周、2周及4周JO A评分高于对照组,治疗后4周、8周和12周的生理机能、生理职能、总体健康、情感职能和躯体疼痛得分高于对照组,差异有统计学意义(P<0.05)。放散式体外冲击波治疗腰椎间盘突出症疗效较好,并能够较好地提高患者的生活质量。%This article compares the clinical efficacy and life quality assessment on the radial extracorporeal shock wave therapy and the traditional conservative solution of lumbar disc herniation .From June 2010 to June 2013 ,257 cases (males 139 ,females 118) with lumbar disc herniation which were followed and treated were retrospectively analyzed .According to the different treatments ,they were randomly divided into two groups .We marked with the Japanese orthopaedic association low back score (JOA) and visual analogue scale (VAS) ,then assessed life quality using the MOS item short from health survey (SF-36) .The patients were followed up for 1 week to 12 week ,averaged (10 .0 ± 3 .4) weeks .The VAS score of treatment group was less than that of control group in the time of 2 weeks and 4 weeks ,the JOA score of treatment group was higher in the time of 1 week ,2 weeks and 4 weeks , the SF-36 score (physiological function , physiological role ,general health ,role emotional and physical pain score) of the treatment group was higher in the time of 4 weeks

  7. Role of artificial neural network and logistic regression model in predicting effect of extracorporeal shock wave for upper urinary tract calculi%人工神经网络及Logistic回归模型对预测体外冲击波治疗上尿路结石的疗效分析

    Institute of Scientific and Technical Information of China (English)

    蒋杰宏; 姚聪; 陈健芬; 徐乐

    2016-01-01

    目的 探讨人工神经网络和Logistic回归模型对预测体外冲击波治疗上尿路结石的治疗效果预测.方法 从2010年1月至2015年1月,本院泌尿科共接受ESWL治疗的肾结石患者340例,将治疗前的病例资料10项(年龄大小、体重指数大小、病程时间长短、性别、尿路刺激症、血尿、肾绞痛、结石位置、患侧和大小)纳入预测参数,建立人工神经网络和Logistic回归模型,预测体外冲击波治疗上尿路结石的临床疗效.结果 人工神经网络得到预测参数重要性的前5位依次为结石大小、病程时间、血尿、结石位置、体重指数,进行显著性检验时,P< 0.05.Logistic回归模型中重要的参数分别为病程时间、血尿和结石位置,差异有统计学意义,P< 0.05.结论 人工神经网络和Logistic回归模型预测ESWL治疗上尿路结石成功率有较好的准确性,可以在临床上广泛推广.%Objective To explore the role of artificial neural network and logistic regression model in predicting the effect of extracorporeal shock wave for upper urinary tract calculi.Methods From January,2010 to January,2015,d 340 patients with renal calculus were treated by ESWL at our hospital.The predictive parameters were sex,symptoms induced by urethral irritation,blood urine,renal colic,stone position,stone of one side,age,BMI,disease course,and stone size.Artificial neural network and logistic regression model were built basing on these parameters to predict the clinical effect of ESWL for calculus of upper urinary tract.Results The most important five parameters in artificial neural network were stone size,disease course,blood urine,stone position,and BMI,with statistical differences (P<0.05).The most important parameters in logistic regression model were disease course,blood urine,and stone position,with statistical differences (P<0.05).Conclusions Artificial neural network and logistic regression model in predicting the effect of

  8. 中西医结合治疗对体外震波碎石后结石排出时间的影响%Effect on Stone Expulsion Time and Complications after Extracorporeal Shock Wave Lithotripsy Combined with Integrated Chinese -western Therapy

    Institute of Scientific and Technical Information of China (English)

    莫先红

    2015-01-01

    s:Objective To study the effect of stone elimination time and complications by using integrated Chinese -western therapy combined with extracorporeal shock wave lithotripsy (ESWL) after urinary.Methods 120 cases of urinary stone patients were divided into 3 groups.Western medicine group received progesterone injection and hydrochlorothiazide , Chinese medicine group received Chinese herbs , and Chinese -western group received western medicine and traditional Chinese medicine .Results The lithagogue time and the total time of expelling stones in Chinese -western group were shorter than that of single drug group (P <0.05).Conclusion Integrated Chinese -west-ern therapy combined with GC -MS in treatment of calculus has remarkable effect .%目的:观察中西医结合疗法应用于体外震波碎石术(ESWL)后泌尿系结石的临床疗效。方法120例泌尿系结石病人分为3组,西药组以黄体酮注射和双氢克尿噻治疗,中药组以排石验方加减治疗,中西联用组以西药联合中药治疗,观察治疗前后结石排出时间。结果中西联用组结石排净时间及排石总时间均少于单用西药和中药组(P<0.05)。结论中西药联用配合体外震波碎石治疗结石疗效显著。

  9. Effects of systematic holistic nursing care on patients undergoing extracorporeal shock wave therapy for pain in limbs%系统护理干预在体外冲击波治疗肢体疼痛中的应用效果

    Institute of Scientific and Technical Information of China (English)

    陈莹; 汪晓俊

    2016-01-01

    目的 观察系统护理干预在骨科体外冲击波(extracorporeal shock wave,ESW)治疗肢体疼痛中的应用效果.方法 2012-01至2014-01在骨科接受ESW治疗的肢体疼痛患者328例,按随机数字表方法分成系统组(n=164)和常规组(n=164).常规组行骨科常规护理,系统组行系统护理干预,分析两组临床疗效、疼痛指标评分及护理的满意度.结果 系统组患者临床治疗有效率(95.12%)比常规组(78.05%)高(P<0.05),且系统组患者肢体疼痛缓解效果好,疼痛评分比常规组低(P<0.05);系统组患者对护理的满意度(98.17%)与常规组(80.49%)相比,差异具有统计学意义(P<0.05).结论 对行ESW治疗骨科肢体疼痛患者行系统护理干预,疗效显著,具有一定临床意义.

  10. Treatment of sodium bicarbonate combined with extracorporeal shock wave lithotripsy for renal uric acid stone and review of the literature%碳酸氢钠联合ESWL治疗双J管末端尿酸结石1例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    李浩勇; 梁培育; 周治彦; 宋鹏; 彭晓晖; 颜毅; 刘继红

    2012-01-01

    目的:探讨采用1.5%碳酸氢钠溶液联合ESWL治疗尿酸结石的疗效.方法:采用ESWL联合输尿管导管逆行插管后持续灌注1.5%碳酸氢钠溶石治疗1例43岁双肾尿酸结石男性患者.结果:治疗1周后,尿酸结石完全消失,双J管顺利拔出,无逆行感染.结论:1.5%碳酸氢钠溶液联合ESWL治疗尿酸结石疗程短,费用低,疗效确切,是一种治疗尿酸结石快速、安全和有效的治疗方法.%Objective:To investigate the treatment effects of 1. 5% sodium bicarbonate combined with extracorporeal shock wave lithotripsy(ESWL) for renal uric acid stone. Method: A single case of renal uric acid stone was report, a 43-year-old male patients with bilateral renal uric acid stone, and extremity of bilateral double J tube formed uric stone. Patient was treated by ESWL and 1. 5% sodium bicarbonate dissolution therapy. Result: All uric acid stone disappeared without any retrograde infection, bilateral double J tube were extracted successfully after a week. Conclusion:This method is perfect for renal uric acid stone. It might also served as an optimal treat procedure of sodium bicarbonate combined with ESWL for renal uric acid stone.

  11. Extracorporeal shockwave therapy for chronic proximal plantar fasciitis.

    Science.gov (United States)

    Strash, Walter W; Perez, Richard R

    2002-10-01

    Although much enthusiasm surrounds applying extracorporeal shock wave therapy for various musculoskeletal conditions, its effects are not well understood and warrant continued study. Certain body tissues or organs may be damaged either acutely or chronically by ESWT; however, it is unequivocal that lung tissue may be damaged. It is theorized that neovascularization is responsible for improvement in symptoms of plantar fasciitis. Neovascularization is the direct effect of macrophage stimulation through cytokines. ESWT has effects at the cellular level--does it interfere with metabolic activity or enhance it? The noninvasive nature and minimal complications of appropriately applied ESWT are its primary advantages. Symptoms may continue to improve for three weeks to six months after treatment; the effects of shock wave therapy seem to be time dependent. ESWT is an effective form of treatment for proximal insertional plantar fasciitis after exhaustive, conservative forms of treatment have failed.

  12. In-Situ Simulation

    DEFF Research Database (Denmark)

    Bjerregaard, Anders Thais; Slot, Susanne; Paltved, Charlotte

    2015-01-01

    Introduction: In situ simulation offers on-site training to healthcare professionals. It refers to a training strategy where simulation technology is integrated into the clinical encounter. Training in the simulation laboratory does not easily tap into situational resources, e.g. individual, team......, and organisational characteristic. Therefore, it might fail to fully mimic real clinical team processes. Though research on in situ simulation in healthcare is in its infancy, literature is abundant on patient safety and team training1. Patient safety reporting systems that identify risks to patients can improve...... offered in situ simulation faculty with a model for integrating reported critical incidents and adverse events with contextual needs analysis and short-term observations. Furthermore the research group is working on detailing the barriers of in situ simulation such as resources for team training despite...

  13. Effects of extracorporeal shock wave therapy on interleukin-1beta and matrix metalloproteinase-13 expression in rabbits with knee osteoarthritis%体外冲击波治疗兔膝骨关节炎:白细胞介素1β及基质金属蛋白酶13的表达

    Institute of Scientific and Technical Information of China (English)

    侯晓东; 刘洪柏; 刘克敏

    2014-01-01

    背景:白细胞介素1β和基质金属蛋白13能促进软骨细胞的分解代谢,抑制软骨细胞的合成修复能力,引起细胞外基质的降解,在骨关节炎的发生中有十分重要的作用。  目的:观察体外冲击波对兔膝骨关节炎软骨细胞中白细胞介素1β和基质金属蛋白酶13表达的影响。  方法:将30只新西兰兔随机分为治疗组、模型组、对照组,每组10只。治疗组和模型组均采用改良伸直位固定6周,制备兔膝骨关节炎模型。治疗组造模后给予体外冲击波治疗1次,能流密度0.1 mJ/mm2,冲击次数1000次。对照组不作任何处理。各组兔于治疗后4周处死,取膝关节液和关节软骨。苏木精-伊红染色和甲苯胺蓝染色法检测各组膝关节病理学形态改变,采用酶联免疫吸附法测定关节液白细胞介素1β水平,免疫组化法检测白细胞介素1β和基质金属蛋白酶13的表达。  结果与结论:治疗组和模型组关节液白细胞介素1β水平较对照组明显增高(P OBJECTIVE:To observe the effects of extracorporeal shock wave therapy on the interleukin-1βand matrix metal oproteinase-13 expression in rabbits with experimental knee osteoarthritis. METHODS:Thirty New Zealand rabbits were randomly and equal y divided into treatment group, model group and control group, with 10 rabbits in each group. Model of knee osteoarthritis was established in both the treatment group and model group, using modified plaster cast in extension position for 6 weeks. Then the rabbits of treatment group were treated with extracorporeal shock wave therapy, each 1 000 impulse, at the energy flux density of 0.1 mJ/mm2. There were no treatments in the control group. The rabbits in each group were sacrificed at 4 weeks after treatment, the knee synovial fluid and articular cartilage were col ected from the rabbits. The pathological changes of knee joint were detected using hematoxylin

  14. 体外冲击波疗法治疗骨科慢性劳损性疾病的心血管系统安全性观察%Observation on Cardiovascular Safety of Extracorporeal Shock Wave Therapy in Orthopedic Chronic Overuse Syndrome

    Institute of Scientific and Technical Information of China (English)

    刘亚军; 蒋继乐; 田伟; 张隆浩; 张颖; 郭安忆

    2016-01-01

    目的:观察体外冲击波疗法治疗骨科慢性劳损性疾病过程中对于心血管系统安全性的影响及治疗效果。方法前瞻性纳入2015年8月~2016年3月间因骨科慢性劳损性疾病接受冲击波治疗的患者。选取其中初次治疗者,搜集术前诊断,分别测量治疗前中后的呼吸、心率、血压及氧饱和度等生理参数,记录疼痛视觉评分(Visual Analogue Score,VAS)评分变化,对不同时间点参数的变化进行统计分析,并对伴高血压病患者进行亚组分析。结果共治疗628例患者,年龄范围为13~89岁平均(45.3±14.6)岁,其中高血压患者94例。所有患者治疗过程中VAS评分均明显升高,但心率、呼吸、血压及氧饱和度没有明显差异(P>0.05);治疗前后VAS评分比较具有明显差异,由治疗前的6.34±1.98下降到治疗后的3.89(P=0.000);未发现治疗中和治疗后心率、呼吸、血压及氧饱和度异常变化的个例病例。高血压亚组患者情况与所有患者相同。结论体外冲击波疗法对包括高血压患者在内的所有患者均不会明显增加心血管系统压力,能够显著缓解骨科慢性劳损性疾病的疼痛症状。%Objective To observe the cardiovascular safety and efficacy of extracorporeal shock wave therapy in orthopedic chronic overuse syndrome.MethodsPatients with chronic overuse syndrome in Orthopedic Extracorporeal Shock Wave Therapy Center in Jishuitan Hospital between May 2015 and March 2016 were prospectively selected. Parameters including breath rate, heart rate, blood pressure and oxygen saturation during therapy were documented in the patients’ ifrst course of treatment. Visual Analogue Score (VAS) was also recorded. Data were collected and compared before, during and after treatment. Patients with hypertension were analyzed in a subgroup.Results A total of 628 patients were enrolled, with an average age of 45.3±14.6 years old (13~89), among

  15. Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy : A pilot study

    NARCIS (Netherlands)

    Zwerver, J.; Dekker, F.; Pepping, G.J.

    2010-01-01

    Background and purpose: Patellar tendinopathy is a common overuse injury for which no evidence-based treatment guidelines exist. Extracorporeal Shock Wave Therapy (ESWT) seems to be an effective treatment for patellar tendinopathy but the most beneficial treatment strategies still need to be ascerta

  16. Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy : A pilot study

    NARCIS (Netherlands)

    Zwerver, J.; Dekker, F.; Pepping, G.J.

    2010-01-01

    Background and purpose: Patellar tendinopathy is a common overuse injury for which no evidence-based treatment guidelines exist. Extracorporeal Shock Wave Therapy (ESWT) seems to be an effective treatment for patellar tendinopathy but the most beneficial treatment strategies still need to be

  17. Patient and personnel exposure during extracorporeal lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Glaze, S.; LeBlanc, A.D.; Bushong, S.C.; Griffith, D.P.

    1987-12-01

    Extracorporeal shock wave lithotripsy (ESWL) has provided a nonsurgical approach to treatment of renal stones. The Dornier lithotripter uses dual image intensified x-ray systems to center the stone before treatment. Three imaging modes are offered: a fluoroscopic mode and two video spot filming modes. The average entrance exposure to the stone side of the typical patient at our facility is 2.6 X 10(-3) C kg-1 (10 R) (range: 0.5-7.7 X 10(-3) C kg-1 (2-30 R)) which is comparable and often much less than that reported for percutaneous lithotripsy. Recommendations are made for minimizing patient exposure. Scattered radiation levels in the lithotripter room are presented. We have determined that Pb protective apparel is not required during this procedure provided x-ray operation is temporarily halted should personnel be required to lean directly over the tub to attend to the patient. If the walls of the ESWL room are greater than 1.83 m (6 feet) from the tub, shielding in addition to conventional construction is not required.

  18. Patient and personnel exposure during extracorporeal lithotripsy.

    Science.gov (United States)

    Glaze, S; LeBlanc, A D; Bushong, S C; Griffith, D P

    1987-12-01

    Extracorporeal shock wave lithotripsy (ESWL) has provided a nonsurgical approach to treatment of renal stones. The Dornier lithotripter uses dual image intensified x-ray systems to center the stone before treatment. Three imaging modes are offered: a fluoroscopic mode and two video spot filming modes. The average entrance exposure to the stone side of the typical patient at our facility is 2.6 X 10(-3) C kg-1 (10 R) [range: 0.5-7.7 X 10(-3) C kg-1 (2-30 R)] which is comparable and often much less than that reported for percutaneous lithotripsy. Recommendations are made for minimizing patient exposure. Scattered radiation levels in the lithotripter room are presented. We have determined that Pb protective apparel is not required during this procedure provided x-ray operation is temporarily halted should personnel be required to lean directly over the tub to attend to the patient. If the walls of the ESWL room are greater than 1.83 m (6 feet) from the tub, shielding in addition to conventional construction is not required.

  19. Extracorporeal treatment for barbiturate poisoning

    DEFF Research Database (Denmark)

    Mactier, Robert; Laliberté, Martin; Mardini, Joelle

    2014-01-01

    The EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup conducted a systematic review of barbiturate poisoning using a standardized evidence-based process to provide recommendations on the use of extracorporeal treatment (ECTR) in patients with barbiturate poisoning. The authors reviewed all......-acting barbiturates are dialyzable and short-acting barbiturates are moderately dialyzable. Four key recommendations were made. (1) The use of ECTR should be restricted to cases of severe long-acting barbiturate poisoning. (2) The indications for ECTR in this setting are the presence of prolonged coma, respiratory...... treatment should be continued during ECTR. (4) Cessation of ECTR is indicated when clinical improvement is apparent. This report provides detailed descriptions of the rationale for all recommendations. In summary, patients with long-acting barbiturate poisoning should be treated with ECTR provided at least...

  20. Extracorporeal Treatment in Phenytoin Poisoning

    DEFF Research Database (Denmark)

    Anseeuw, Kurt; Mowry, James B; Burdmann, Emmanuel A

    2016-01-01

    The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup conducted a systematic literature review using a standardized process to develop evidence-based recommendations on the use of extracorporeal treatment (ECTR) in patients with phenytoin poisoning. The authors reviewed all articles......) despite its high protein binding and made the following recommendations. ECTR would be reasonable in select cases of severe phenytoin poisoning (neutral recommendation, 3D). ECTR is suggested if prolonged coma is present or expected (graded 2D) and it would be reasonable if prolonged incapacitating ataxia...... is present or expected (graded 3D). If ECTR is used, it should be discontinued when clinical improvement is apparent (graded 1D). The preferred ECTR modality in phenytoin poisoning is intermittent hemodialysis (graded 1D), but hemoperfusion is an acceptable alternative if hemodialysis is not available...

  1. Extracorporeal treatment for carbamazepine poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Yates, Christopher; Galvao, Tais F

    2014-01-01

    CONTEXT: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence and consensus-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. OBJECTIVES: To perform a systematic review and provide clinical recommendations for ECTR...... in carbamazepine poisoning. METHODS: After a systematic literature search, the subgroup extracted the data and summarized the findings following a pre-determined format. The entire workgroup voted via a two-round modified Delphi method to reach a consensus on voting statements, using a RAND/UCLA Appropriateness...... is suggested in severe carbamazepine poisoning (2D). ECTR is recommended if multiple seizures occur and are refractory to treatment (1D), or if life-threatening dysrhythmias occur (1D). ECTR is suggested if prolonged coma or respiratory depression requiring mechanical ventilation are present (2D...

  2. [Extracorporeal shockwave therapy in orthopedics. Positive results in tennis elbow and tendinosis calcarea of the shoulder].

    Science.gov (United States)

    Rompe, J D; Eysel, P; Hopf, C; Krischek, O; Vogel, J; Bürger, R; Jage, J; Heine, J

    1997-06-30

    Since the beginning of the 1990s scientific investigations on the use of extracorporeal shock wave therapy (ESWT) in the field of orthopedics have been carried out at the Orthopedic Department of the University of Mainz. Prospective studies demonstrated beneficial effects in chronic lateral humeral epicondylitis (tennis elbow), and in calcifying tendinitis of the shoulder in more than 50% of the cases. Additional indications for which positive results of prospective studies have been published during the past 2 years are plantar calcaneodynea and pseudoarthrosis. On the basis of the results achieved, it may be concluded that, for specific indications, extracorporeal shock wave therapy may now be taken out of the clinical testing stage and introduced into routine practice.

  3. Shock wave treatment in medicine

    Indian Academy of Sciences (India)

    S K Shrivastava; Kailash

    2005-03-01

    Extracorporeal shock wave therapy in orthopedics and traumatology is still a young therapy method. Since the last few years the development of shock wave therapy has progressed rapidly. Shock waves have changed the treatment of urolithiasis substantially. Today shock waves are the first choice to treat kidney and urethral stones. Urology has long been the only medical field for shock waves in medicine. Meanwhile shock waves have been used in orthopedics and traumatology to treat insertion tendinitis, avascular necrosis of the head of femur and other necrotic bone alterations. Another field of shock wave application is the treatment of tendons, ligaments and bones on horses in veterinary medicine. In the present paper we discuss the basic theory and application of shock waves and its history in medicine. The idea behind using shock wave therapy for orthopedic diseases is the stimulation of healing in tendons, surrounding tissue and bones. This is a completely different approach compared to urology where shock waves are used for disintegration.

  4. Hospital Costs Of Extracorporeal Life Support Therapy

    NARCIS (Netherlands)

    Oude Lansink-Hartgring, Annemieke; van den Hengel, Berber; van der Bij, Wim; Erasmus, Michiel E.; Mariani, Massimo A.; Rienstra, Michiel; Cernak, Vladimir; Vermeulen, Karin M.; van den Bergh, Walter M.

    2016-01-01

    Objectives: To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but

  5. In situ groundwater bioremediation

    Energy Technology Data Exchange (ETDEWEB)

    Hazen, Terry C.

    2009-02-01

    In situ groundwater bioremediation of hydrocarbons has been used for more than 40 years. Most strategies involve biostimulation; however, recently bioaugmentation have been used for dehalorespiration. Aquifer and contaminant profiles are critical to determining the feasibility and strategy for in situ groundwater bioremediation. Hydraulic conductivity and redox conditions, including concentrations of terminal electron acceptors are critical to determine the feasibility and strategy for potential bioremediation applications. Conceptual models followed by characterization and subsequent numerical models are critical for efficient and cost effective bioremediation. Critical research needs in this area include better modeling and integration of remediation strategies with natural attenuation.

  6. Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions.

    Science.gov (United States)

    Mosier, Jarrod M; Kelsey, Melissa; Raz, Yuval; Gunnerson, Kyle J; Meyer, Robyn; Hypes, Cameron D; Malo, Josh; Whitmore, Sage P; Spaite, Daniel W

    2015-12-17

    Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal life support that augments oxygenation, ventilation and/or cardiac output via cannulae connected to a circuit that pumps blood through an oxygenator and back into the patient. ECMO has been used for decades to support cardiopulmonary disease refractory to conventional therapy. While not robust, there are promising data for the use of ECMO in acute hypoxemic respiratory failure, cardiac arrest, and cardiogenic shock and the potential indications for ECMO continue to increase. This review discusses the existing literature on the potential use of ECMO in critically ill patients within the emergency department.

  7. Effectjveness of radial extracorporeal shock wave to treat tenderness in soft tissue on the lateral of elbow%放射式体外冲击波治疗肘外侧软组织疼痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    孙建峰; 李红娟

    2012-01-01

    目的 观察放射式体外冲击渡对肘外侧软组织疼痛的治疗效果.方法 对26例患者应用统一的冲击波治疗方案进行压痛点治疗,观察治疗前后及随访半年的肘关节活动度、VAS及ADL评分情况.结果 23例完成治疗方案,参照自定治疗标准,治愈11例,显效6例,有效3例,无效3例,总显效率73.9%.结论 放射式体外冲击波治疗肘外侧软组织疼痛具有非侵入性、方法简单、安全有效、并发症少、患者痛苦小等优点,值得临床推广应用.%Objective To evaluate the effectiveness of radial extracoiporeal shock wave therapy(RESWT) for the management of tenderness in soft tissue on the lateral of elbow. Methods Twenty-six patients were given standard of RESWT in the tenderness. They were evaluated with rang of motion of elbow,visual analogue scale (VAS) and activities of daily living (ADL) before and after treatment and at a 6-month follow-up. Results Twenty-three patients were accomplished the therapy, 1 leases cured,6 cases apparent recovered,3 cases with effective recovered,3 cases with invalid treatment,the total apparent rate were 73.9%. Conclusion RESWT in the treatment of tenderness in soft tissue on the lateral of elbow is safe effective; the method is simple,less complications. It is worth to be clinical application.

  8. Thermal Shock Resistance of Cordierite in-situ Formed with Andalusite Thermal Storage Ceramics for Solar Thermal Power Generation%原位生成堇青石结合红柱石太阳能热发电储热陶瓷的抗热震性能

    Institute of Scientific and Technical Information of China (English)

    吴建锋; 冷光辉; 徐晓虹; 方斌正; 张亚祥; 李坤

    2012-01-01

    为提高储热陶瓷材料的抗热震性能,采用原位生成堇青石增强技术,以红柱石为主要原料,通过半干压成型,无压烧结研制了用于太阳能高温热发电红柱石储热陶瓷材料样品。研究了配方组成、烧成温度、相组成、微观结构对样品抗热震性能的影响。结果表明:红柱石添加量为 70%,经1 400 ℃烧成的样品抗热震性能最佳:30 次热震实验(热震条件:1 100 ℃~室温,风冷)的强度不仅没有损失,反而增加了 26.20%。相组成和微观结构分析表明样品的晶相为堇青石、莫来石、硅线石、α-方石英、α-石英等,原位生成的堇青石晶体均匀分布在由红柱石转化的莫来石晶体之间,赋予样品较好的抗热震性能%In order to improve the thermal shock resistance of the thermal storage ceramic, cordierite was formed in-situ with andalusite as a main raw material by a semi-dry pressing and pressureless firing method. The result showed that the cordierite sample with andalusite of 70% fired at 1 400 ℃ had a superior thermal shock resistance and optimum physical and chemical properties. This sample did not crack after thirty times thermal shock resistance tests (1 100 ℃-room temperature, air cooling). The bending strength was increased by 26.20%. It was indicated that the phase compositions of the sample were cordierite, mullite, sllimanite, cristobalite and a-quartz. The crystals of cordierite are distributed into the mullite crystals, showing a good thermal shock resistance. The ceramic of cordierite in-situ formed with andalusite could be used as a high temperature thermal storage ceramic for solar thermal power generation.

  9. [Musculoskeletal shock wave therapy--current database of clinical research].

    Science.gov (United States)

    Rompe, J D; Buch, M; Gerdesmeyer, L; Haake, M; Loew, M; Maier, M; Heine, J

    2002-01-01

    During the past decade application of extracorporal shock waves became an established procedure for the treatment of various musculoskeletal diseases in Germany. Up to now the positive results of prospective randomised controlled trials have been published for the treatment of plantar fasciitis, lateral elbow epicondylitis (tennis elbow), and of calcifying tendinitis of the rotator cuff. Most recently, contradicting results of prospective randomised placebo-controlled trials with adequate sample size calculation have been reported. The goal of this review is to present information about the current clinical database on extracorporeal shock wave treatment (ESWT).

  10. 体外冲击波疗法对激素性股骨头缺血坏死中血管内皮生长因子及骨形态发生蛋白的影响%Effects of extracorporeal shock wave therapy on the expression of VEGF and BMP in femoral head tissue of rabbits with steroid-induced avascular necrosis

    Institute of Scientific and Technical Information of China (English)

    李平; 郭小波; 刘宇强; 刘强; 范晓洁

    2014-01-01

    Objective To observe the VEGF and BMP in the glucocorticoid-induced ischemic necrosis of femoral head treated with extracorporeal shock wave therapy.Methods40 New Zealand rabbits were modeled in Yamamoto. Experimental group (group A): the left side of the rabbits, femoral head treated with extracorporeal shock wave therapy; contrast group (group B): the right side of the rabbits, femoral head without any treatment. After 1, 2, 4, 8, 12 weeks random eight rabbits to be put to death at a time.Both sides of all the rabbits, femoral head were observed in HE staining for cell count, the expression of VEGF and BMP immunohistochemical observation.Results HE dyeing observation after 4, 8, 12 weeks, group A blood capillary count average were 9.95±2.14, 14.70±3.08, 13.15±3.07, and group B were 4.85±1.67, 4.30±1.63, 4.40±1.79; Osteoblast count group A mean value of 33.35±3.39, 47.35±5.20, 53.40±5.09, while group B were 24.1±2.45, 21.70±4.08, 19.60±4.28, HE staining was similar between the two groups had statistical significance (P<0.05). Immunohistochemical staining after 2, 4, 8, 12 weeks of VEGF expression in group A mean value of 0.104±0.018, 0.177±0.020, 0.167±0.017, 0.144±0.031, while group B were 0.074±0.017, 0.078±0.021, 0.078±0.023, 0.070±0.019; And the expression of BMP group A mean value of 0.210±0.028, 0.304±0.039, 0.292±0.052, 0.268±0.053, while group B were 0.136±0.025, 0.140±0.033, 0.144±0.029, 0.118±0.028, immunohistochemical staining was similar between the two groups had statistical significance (P<0.05).Conclusion Extracorporeal shock wave therapy can promote rabbit VEGF and BMP in the glucocorticoid-induced ischemic necrosis of femoral head.%目的:观察体外冲击波疗法对激素性股骨头缺血坏死中血管内皮生长因子(VEGF)和骨形态发生蛋白(BMP)的影响。方法新西兰大白兔40只,Yamamoto法制造模成功后,左侧股骨头做冲击波治疗设为实验组(A组),右侧股骨头

  11. The experimental study of nonunion treatment with Extracorporeal Shock Wave Therapy and Autograft of 5-BrdU labled Bone Mesenchymal Stem Cells of Rabbits%体外冲击波结合自体5-BrdU标记骨髓间充质干细胞移植治疗骨不连的实验研究

    Institute of Scientific and Technical Information of China (English)

    王旭明; 邢更彦; 韩新明

    2010-01-01

    目的 在体外成功分离培养标记兔骨髓间充质干细胞(Bone mesenchymal stem cells,BMSCs)的基础上,观察体外冲击波疗法(Extracorporeal shock wave therapy,ESWT)结合自体BMSCs移植治疗骨不连的疗效.方法 制作兔骨不连模型并根据于预方式不同随机分为4个组:冲击波结合干细胞组,干细胞组,冲击波组,完全对照组.定期拍片测量骨折间隙宽度变化(2周、6周、10周)、免疫组化观察,10周后比较愈合率.结果 标记后的干细胞移植6周后,在冲击波结合干细胞组、干细胞组骨痂中可见(5-bromodeoxyuridine,BrdU)标记的阳性细胞聚集,冲击波组和对照组中未发现明显的聚集现象;冲击波结合干细胞组干预后6周、10周,与其它各组骨不连间隙差异有显著性;10周后冲击波结合干细胞组骨不连愈合效果好,与其他各组统计学上差异有意义.结论 移植的自体干细胞可能参与了骨不连的成骨,结合冲击波的微动力学刺激,有利于骨折的愈合,有望成为一种较好的骨不连治疗方法.

  12. The effect and factors associated with outcome of extracorporeal membrane oxygenation in refractory cardiogenic shock patients%体外膜肺氧合治疗难治性心原性休克的临床疗效及其影响因素

    Institute of Scientific and Technical Information of China (English)

    朱瑞秋; 刘长智; 卢剑海; 苏用鹏; 温树超; 聂广杰; 胡允兆; 左六二

    2016-01-01

    目的 观察体外膜肺氧合(ECMO)治疗难治性心原性休克的效果,并探讨其影响因素.方法 回顾性分析顺德第一人民医院自2013年5月至2015年11月经ECMO救治的难治性心原性休克患者.观察并记录入选患者ECMO前状态、应用ECMO时机,ECMO并发症及疗效,并收集入选患者ECMO 2 h前及2、6、24和48 h后的血液动力学数据及血管活性药物量.结果 共入选患者10例,女性6例、男性4例,年龄12 ~ 56岁,其中暴发性心肌炎5例、急性心肌梗死4例、心脏破裂1例.入选患者在使用ECMO前,左心室射血分数为(31.4±10.2)%,APACHEⅡ评分26.6±10.8.8例患者出现心跳骤停,心肺复苏时间10 ~ 300 min,3例植入主动脉内球囊反搏.ECMO支持2h后,入选患者的中心静脉压降低、血压升高、心率减慢、中心静脉血氧饱和度升高、多巴酚丁胺减量(P均<0.05).ECMO支持6h后,乳酸水平降低、去甲肾上腺素减量(P均<0.05).ECMO支持24、48 h后,血液动力学保持稳定,休克明显改善.并发症,3例患者出现置管部位或下肢感染,2例患者发生股动脉血栓,2例患者出现下肢缺血性损害,2例患者置管部位出血.10例患者ECMO辅助时间为2~ 220 h,撤机成功率90% (9/10),生存出院率60% (6/10),2例患者由于应用ECMO时机偏晚导致死亡,另外2例患者由于严重肢体并发症死亡.结论 ECMO能迅速改善心原性休克患者血液动力学稳定性,而准确把握应用ECMO时机、减少肢体并发症是提高ECMO疗效的关键.%Objective To observe the clinical efficacy and factors associated with outcome of extracorporeal membrane oxygenation (ECMO) in refractory cardiogenic shock patients.Methods Patients with refractory cardiogenic shock received ECMO treatment in our hospital from May 2013 to November 2015 were retrospectively analyzed.The clinical status before ECMO support,ECMO timing,complications and outcome were observed and analyzed.The hemodynamic data

  13. The microphysics of collisionless shock waves

    CERN Document Server

    Marcowith, A; Bykov, A; Dieckman, M E; Drury, L O C; Lembege, B; Lemoine, M; Morlino, G; Murphy, G; Pelletier, G; Plotnikov, I; Reville, B; Riquelme, M; Sironi, L; Novo, A Stockem

    2016-01-01

    Collisionless shocks, that is shocks mediated by electromagnetic processes, are customary in space physics and in astrophysics. They are to be found in a great variety of objects and environments: magnetospheric and heliospheric shocks, supernova remnants, pulsar winds and their nebul\\ae, active galactic nuclei, gamma-ray bursts and clusters of galaxies shock waves. Collisionless shock microphysics enters at different stages of shock formation, shock dynamics and particle energization and/or acceleration. It turns out that the shock phenomenon is a multi-scale non-linear problem in time and space. It is complexified by the impact due to high-energy cosmic rays in astrophysical environments. This review adresses the physics of shock formation, shock dynamics and particle acceleration based on a close examination of available multi-wavelength or in-situ observations, analytical and numerical developments. A particular emphasize is made on the different instabilities triggered during the shock formation and in a...

  14. Advances in Monitoring and Management of Shock

    Science.gov (United States)

    Mtaweh, Haifa; Trakas, Erin V.; Su, Erik; Carcillo, Joseph A.; Aneja, Rajesh K.

    2013-01-01

    Synopsis Shock continues to be the proximate cause of death for many childhood diseases and imposes a significant burden. Early recognition and treatment of pediatric shock, regardless of etiology, decreases mortality and improves outcome. In addition to the conventional parameters (e.g., heart rate (HR), systolic blood pressure (SBP), urine output (UOP), and central venous pressure (CVP)), biomarkers and non-invasive methods of measuring cardiac output are now available to monitor and treat shock. In this article, we emphasize how fluid resuscitation is the cornerstone of shock resuscitation although the choice and amount of fluid may vary based on the etiology of shock. Other emerging treatments for shock i.e., temperature control, extracorporeal membrane oxygenation (ECMO)/Ventricular Assist Devices (VAD) are also discussed briefly in this article. PMID:23639660

  15. In Situ Mass Spectrometer Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The In Situ Mass Spectrometer projects focuses on a specific subsystem to leverage advanced research for laser-based in situ mass spectrometer development...

  16. 中医电针联合体外冲击波治疗创伤性桡骨茎突狭窄性腱鞘炎的临床疗效%Clinical curative efficacy observation of electroacupuncture of traditional Chinese medicine with extracorporeal shock wave therapy in the treatment of traumatic stenosing tenosynovitis of radial styloid process

    Institute of Scientific and Technical Information of China (English)

    常宁

    2016-01-01

    Background Stenosing tenosynovitis of radial styloid process (de Quervain disease) is very common in athletes.The main pathological change is hypertrophy and inelasticity of the sheath which tightly surrounds the tendon.Mild adhesions may happen between tendon and sheath.In early cases,in addition to the roughness without brightness,the shape of tendon is approximately normal. Sometimes the thicken tendon may look like the spindle as it becomes thinner at the site of sheath stricture with long time edema at both ends.Biopsies of cases show chronic inflammation.Longer duration and treatment difficulties exert great influence on training at the onset of illness. Extracorporeal shock wave therapy (ESWT)may often be applied as the clinical treatment in the department of orthopedics and traumatology while electroacupuncture therapy may often be used in the department of traditional Chinese medicine.An attempt by combining two methods (combination therapy)is adopted in this experiment for treatment of stenosing tenosynovitis of radial styloid process.By collecting clinical data,comparisons of clinical curative efficacy are made among the electroacupuncture group, the ESWT group and the combination method group to explore the treatment mechanism of combination therapy and enhance the therapeutic effect of traumatic stenosing tenosynovitis of radial styloid process as much as possible.Methods General data:A total of 36 patients were admitted via the Outpatient Clinic of Xinjiang Institute of Physical Education from January 2013 to March 201 5 with confirmed diagnosis of stenosing tenosynovitis of radial styloid process.The diagnosis and symptoms:(1)pain,tenderness and local swelling on the radial styloid process;(2 )aggravated pain with the activity of thumb and wrist;(3 )positive Finkelstein test. Inclusive criteria:(1)the course of disease was over 30 days;(2)patients had received rehabilitation programs like physical therapy,functional exercise,etc.,but there was no

  17. Surgical myocardial revascularization without extracorporeal circulation

    Directory of Open Access Journals (Sweden)

    Salomón Soriano Ordinola Rojas

    2003-05-01

    Full Text Available OBJECTIVE: To assess the immediate postoperative period of patients undergoing myocardial revascularization without extracorporeal circulation with different types of grafts. METHODS: One hundred and twelve patients, 89 (79.5% of whom were males, were revascularized without extracorporeal circulation. Their ages ranged from 39 to 85 years. The criteria for indicating myocardial revascularization without extracorporeal circulation were as follows: revascularized coronary artery caliber > 1.5 mm, lack of intramyocardial trajectory on coronary angiography, noncalcified coronary arteries, and tolerance of the heart to the different rotation maneuvers. RESULTS: Myocardial revascularization without extracorporeal circulation was performed in 112 patients. Three were converted to extracorporeal circulation, which required a longer hospital stay but did not impact mortality. During the procedure, the following events were observed: atrial fibrillation in 10 patients, ventricular fibrillation in 4, total transient atrioventricular block in 2, ventricular extrasystoles in 58, use of a device to retrieve red blood cells in 53, blood transfusion in 8, and arterial hypotension in 89 patients. Coronary angiography was performed in 20 patients on the seventh postoperative day when the grafts were patent. CONCLUSION: Myocardial revascularization without extracorporeal circulation is a reproducible technique that is an alternative for treating ischemic heart disease.

  18. Development of a system of automatic gap-adjusted electrodes for shock wave generators

    Science.gov (United States)

    Manousakas, Ioannis; Liang, Shen-Min; Wan, Long-Ray; Wang, Chia-Hui

    2004-11-01

    In this study, a system of automatic gap-adjusted electrodes is developed for electrohydraulic shock wave generators that can be used both for extracorporeal shock wave lithotripsy (treatment of renal calculi) and for the extracorporeal shock wave therapy for musculo-skeletal disorders. This system is composed of three main components: (1) two electrodes and their bases; (2) servo motors and control software; (3) a high sensitivity CCD camera and image processing program. To verify system performance, in vitro fragmentation tests have been conducted using kidney stone phantoms. Results indicate that the efficiency of stone fragmentation using automatic gap adjustment can be increased up to 55.2%, which is twice more than without automatic gap adjustment (26.7%). This system can be applied to any commercial electrohydraulic extracorporeal shock wave lithotriptor or orthotriptor without difficulty.

  19. Inflammatory response and extracorporeal circulation.

    Science.gov (United States)

    Kraft, Florian; Schmidt, Christoph; Van Aken, Hugo; Zarbock, Alexander

    2015-06-01

    Patients undergoing cardiac surgery with extracorporeal circulation (EC) frequently develop a systemic inflammatory response syndrome. Surgical trauma, ischaemia-reperfusion injury, endotoxaemia and blood contact to nonendothelial circuit compounds promote the activation of coagulation pathways, complement factors and a cellular immune response. This review discusses the multiple pathways leading to endothelial cell activation, neutrophil recruitment and production of reactive oxygen species and nitric oxide. All these factors may induce cellular damage and subsequent organ injury. Multiple organ dysfunction after cardiac surgery with EC is associated with an increased morbidity and mortality. In addition to the pathogenesis of organ dysfunction after EC, this review deals with different therapeutic interventions aiming to alleviate the inflammatory response and consequently multiple organ dysfunction after cardiac surgery.

  20. Combined venoarterial extracorporeal membrane oxygenation and transcatheter aortic valve implantation for the treatment of acute aortic prosthesis dysfunction in a high-risk patient.

    Science.gov (United States)

    Pergolini, Amedeo; Zampi, Giordano; Tinti, Maria Denitza; Polizzi, Vincenzo; Pino, Paolo Giuseppe; Pontillo, Daniele; Musumeci, Francesco; Luzi, Giampaolo

    2016-01-01

    We describe the case of a patient with acute bioprosthesis dysfunction in cardiogenic shock, in whom hemodynamic support was provided by venoarterial extracorporeal membrane oxygenation, and successfully treated by transcatheter aortic valve implantation. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The microphysics of collisionless shock waves

    DEFF Research Database (Denmark)

    Marcowith, Alexandre; Bret, Antoine; Bykov, Andrei;

    2016-01-01

    Collisionless shocks, that is shocks mediated by electromagnetic processes, are customary in space physics and in astrophysics. They are to be found in a great variety of objects and environments: magnetospheric and heliospheric shocks, supernova remnants, pulsar winds and their nebulæ, active...... galactic nuclei, gamma-ray bursts and clusters of galaxies shock waves. Collisionless shock microphysics enters at different stages of shock formation, shock dynamics and particle energization and/or acceleration. It turns out that the shock phenomenon is a multi-scale non-linear problem in time and space....... It is complexified by the impact due to high-energy cosmic rays in astrophysical environments. This review adresses the physics of shock formation, shock dynamics and particle acceleration based on a close examination of available multi-wavelength or in situ observations, analytical and numerical developments...

  2. Impact of Extracorporeal Detoxification on the Serum Levels of Microbial Aromatic Acid Metabolites in Sepsis

    Directory of Open Access Journals (Sweden)

    S. E. Khoroshilov

    2015-01-01

    Full Text Available A search for low molecular weight biomarkers to objectively evaluate the efficiency of extracorporeal detoxification methods is extremely relevant. For this purpose, the investigation is to verify whether metabolites, the production of which from aromatic amino acids in the human body can be of microbial ori gin, may be used. Objective: to evaluate the efficiency of extracorporeal detoxification methods on the serum level of phenyl carboxylic acids in patients with sepsis associated renal failure. Subjects and methods. Ten patients with acute or chronic (end stage renal failure that had developed in the presence of severe sepsis, infective and toxic shock, long term extracorporeal circulation, postresuscitation disease, etc. were prospectively examined and treated. All the patients underwent extracorporeal detoxification; the choice of its technique was determined from their past medical history and intoxication patterns. The investigators eval uated organ dysfunctions using the Sequential Organ Failure Assessment (SOFA scale, estimated body tempera ture, leukocyte count, and leukocyte index of intoxication, and assessed the results of a procalcitonin test. Hemodiafiltration was done as extrarenally indicated to ameliorate a systemic inflammatory response in septic shock, by applying an EMiC2 superhigh permeability dialyzer. Low flux Diacap LO PS dialyzers were employed for hemodialysis. Blood samples were taken to estimate changes in the serum concentrations of phenylcarboxylic acid, benzoic acid, 3 phenylpropionic acid, phenyllactic acid, para hydroxyphenylacetic acid (p HPAA, and para hydroxyphenyllactic acid (p HPLA directly before and immediately after extracorporeal detoxification. Results. The severity of organ dysfunctions by SOFA score was 10—22 (mean 16 scores; 10 day mortality rates were 40%. In all the patients, the baseline serum levels of some phenylcarboxylic acids were considerably above normal. After hemodiafiltration, the

  3. Characterization and modification of cavitation pattern in shock wave lithotripsy

    NARCIS (Netherlands)

    Arora, Manish; Ohl, Claus-Dieter; Liebler, Marko

    2004-01-01

    The temporal and spatial dynamics of cavitation bubble cloud growth and collapse in extracorporeal shock wave lithotripsy (ESWL) is studied experimentally. The first objective is obtaining reproducible cloud patterns experimentally and comparing them with FDTD-calculations. Second, we describe a met

  4. Success of electromagnetic shock wave lithotripter as monotherapy ...

    African Journals Online (AJOL)

    K.S. Meitei

    The success rate of ESWL for both non-staghorn and staghorn calculi with size above 2 cm is low, so other treatment ..... Conflict of interest. None declared. ... Bazeed M. Prediction of success rate after extracorporeal shock-wave lithotripsy of ...

  5. Stenting and extracorporeal shock wave lithotripsy in chronic pancreatitis

    DEFF Research Database (Denmark)

    Holm, M; Matzen, Peter

    2003-01-01

    studies difficult, and little attention has been paid to the type and amount of analgesics used by patients before and after decompressive treatment. METHODS: We performed a retrospective study of all patients with chronic pancreatitis and large-duct disease and receiving decompressing treatment between 1...... November 1994 and 31 July 1999. Primary parameters were type and amount of analgesics used. RESULTS: Forty-nine patients with chronic pancreatitis and large-duct disease received stenting of the pancreatic duct (28 patients), ESWL (6 patients) or both (15 patients). After a median follow-up of 21 months...

  6. TREATMENT OF CYSTINE CALCULUS WITH EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To evaluate the effectiveness of ESWL for treating patients with cystine calculus.Methods Of 31 patients, 20 were subjected to ESWL only, 6 were subjected to combination therapy of PCNL and ESWL, 2 Pneumatic Lithotriptor-ESWL, 3 Laser lithotripsy-ESWL. Results For 14 renal stones, the fragmentation after ESWL monotherapy was 85. 7% and 14.3% after twice ESWL sessions. For 17 ureter calculus, the fragmentation after ESWL monotherapy was 82.3% and 11.7% after twice ESWL sessions. One patient (5. 8% ) failed and changed to open surgery. Conclusion ESWL is an effective and reliable method for treating patients with cystine calculus, however, better effects and shorter treatment time could be obtained by the combination of ESWL with other therapy options.

  7. 冲击波复合激痛点注射对颈肩肌筋膜疼痛综合征的治疗效果%The effects of extracorporeal shock wave therapy combined with trigger point injection on myofascial pain syndrome

    Institute of Scientific and Technical Information of China (English)

    刘思兰; 王丽娜; 金晓红

    2016-01-01

    目的 比较压痛点注射、体外冲击波疗法(extracorporeal shock wave therapy,ESWT)以及ESWT复合激痛点注射治疗颈肩肌筋膜疼痛综合征的安全性和有效性.方法 2013年5月至2015年2月在门诊诊治的颈肩肌筋膜疼痛综合征患者90例,男48例,女42例,年龄18~65岁,随机分为三组,每组30例.A组:每个压痛点注射复合镇痛液5 ml;B组:以压痛点定位冲击点,每次治疗一个或多个冲击点(疼痛区域),每个冲击点次数2 000次;C组:冲击波治疗后,在冲击波诱发的激痛点注射复合镇痛液5 ml.三组的治疗周期均为每周1次,连续治疗3次,治疗时间为5~10min,并随访记录首次治疗前(T0)、首次治疗后即刻(T1)、首次治疗后1周(T2)、2周(T3)、3周(T4)的VAS评分、颈椎的活动度(ROM)评分、症状改善优良率、总有效率.结果 90例患者中81例获得完全随访,B组有3例、C组有2例出现了皮下淤血,3d后消散,无其他不良事件发生.与T0时比较,T1~T4时三组VAS评分均明显降低(P<0.05);T2~T4时,三组的VAS评分随着时间的延长、治疗次数的增加逐渐降低;T1时B组和C组的VAS评分明显低于A组(P<0.05),T2、T3时C组VAS评分明显低于A组和B组(P<0.05),T4时C组VAS评分明显低于A组(P<0.05).与T0时比较,T3时三组ROM评分均明显降低(P<0.05),T3时B组和C组ROM评分明显低于A组(P<0.05).末次随访总有效率C组明显高于A组和B组(P<0.05),A、B两组差异无统计学意义.结论 ESWT复合激痛点注射治疗颈肩肌筋膜疼痛综合征无明显损伤、安全、简便、疗效显著、患者满意度高,可作为颈肩肌筋膜疼痛综合征综合治疗的选择.

  8. Clinical experience with adults receiving extracorporeal membrane oxygenation for cardiogeulc shock and quality of life in survivals%体外膜肺氧合治疗成人心脏术后心源性休克的临床经验及生命质量分析

    Institute of Scientific and Technical Information of China (English)

    王坚刚; 孟旭; 韩杰; 贾一新; 曾文; 许春雷; 张海波; 高峰; 侯晓彤

    2010-01-01

    Objective To review the experience with extracorporeal membrane oxygenation (ECMO) in adult postcardiotomy cadiogenic shock and evaluate quality of life (QOL) in survivals.Methods During 4 years 62 of 12,644 patients (0.49%) undergoing cardiac surgery (valve procedures,n=39; coronary artery bypass grafting, n=13; coronary artery bypass grafting plus valve procedures, n=4;heart transplantation, n=4, and total aortic arch replacement, n=2) required temporary postoperative ECMO support. At follow-up (mean 2.3±1.5 years, 100% complete), 32 were still alive and answered the Short-Form 36 Health Survey QOL questionnaire. Results Mean duration of ECMO support was 61±37 hors. Forty patients (64.5%) were successfully weaned from ECMO. Thirty-four patients (54.8%) were discharged from hospital after 44.3±17.6 days. The in-hospital mortality was 45.2%. The main cause of death was multiple organ failure. The postoperative peak lactate levels ≥ 12 mmol/L before ECMO initiation was a risk factor of in-hospital death. Mean QOL scores between the ECMO survivors and other patients after cardiac surgery without ECMO support showed no significant difference , except that the vitality and mental health were significant lower in the ECMO survivors (P<0.05). Both the ECMO survivors and the patients without ECMO support have significant lower QOL scores (except the vitality and mental health) relative to their respective Chinese population norms (P<0.05). Conclusion ECMO offers sufficient cardiopulmonary support in adults.Early indication, reduced complication could improve results with increasing experience. However, ECMO survivors had lower physical and mental health that need to be recovered.%目的 总结成人心脏术后心源性休克患者应用体外膜肺氧合(ECMO)治疗的临床经(ECMO)治疗的临床经验,对生存者进行生命质量分析.方法 2004年1月至2008年5月北京安贞医院心脏外科62例心用ECMO支持.其中男32例、女30例,年龄16~73(51

  9. Comparison of clinical efficacy on penile erectile dysfunction between extracorporeal shock wave and ;vacuum erectile device:a randomized controlled clinical trial%体外冲击波与真空负压吸引治疗阴茎勃起功能障碍随机临床对照试验

    Institute of Scientific and Technical Information of China (English)

    齐涛; 王博; 陈俊; 张滨

    2015-01-01

    目的:比较真空负压吸引(VED)与体外冲击波(ESW)治疗勃起功能障碍(ED)的疗效。方法选择60例 ED 患者,随机分为 ESW 组及 VED 组各30例。ESW 组患者在阴茎体近、中、远端以及双侧阴茎海绵体脚5个冲击区行频率2 Hz、强度为1 bar 共1500次冲击波治疗。VED组行 VED 治疗,治疗时真空压强设为16档、时间20 min。2组均每周治疗2次,疗程4周。分别在治疗前、治疗结束后1个月对患者进行勃起功能国际问卷-5(IIEF-5)、性活动日志、全球评估问卷及勃起硬度等级评分,比较2种物理方法治疗 ED 的效果。结果治疗后2组 ED 患者的 IIEF-5评分均明显高于治疗前(P 均<0.05),组间比较差异无统计学意义(P >0.05)。2组疗效比较差异亦无统计学意义(P >0.05)。结论ESW 与 VED 治疗 ED 的疗效相近,但 ESW 操作更为简单,适于临床推广。%Objective To compare the clinical efficacy of extracorporeal shock wave (ESW)and vacuum erectile device (VED)in treating erectile dysfunction (ED).Methods Sixty patients diagnosed with ED were randomly divided into the ESW (n =30)and VED groups (n =30).In the ESW group,ESW at a frequency of 2 Hz and an intensity of 1 bar was delivered at the proximal,intermediate and distal penis and bi-lateral crus of the penis for 1 500 times.In the VED group,patients received VED therapy with 16 grades of vacuum pressure for 20 min.Both therapies were delivered twice per week for four consecutive weeks.Interna-tional Index of Erectile Function-5 (IIEF-5),Sexual Encounter Profile diary,Global Assesment Questionnaric and Erection Hardness Score were employed to evaluate the clinical efficacy between two therapies before and at 1 month after corresponding treatment.Results The IIEF-5 scores were significantly increased after both ESW and VED therapies (both P 0.05).The clinical efficacy did not significantly differ between two groups (P >0

  10. Effect of Extracorporeal Shock Wave on Expression of Interleukin-1βand Tumour Necrosis Factor-αin Cartilage in Rabbits with Knee Osteoarthritis%体外冲击波对兔膝骨关节炎软骨白细胞介素-1β及肿瘤坏死因子-α表达的影响

    Institute of Scientific and Technical Information of China (English)

    侯晓东; 刘洪柏; 刘克敏

    2014-01-01

    Objective To explore the effect of extracorporeal shock wave (ESW) on expression of interleukin-1β(IL-1β) and tumor ne-crosis factor-α(TNF-α) in cartilage in rabbits with knee osteoarthritis. Methods 30 rabbits were randomly divided into control group, model group and treatment group, with 10 rabbits in each group. Model of knee osteoarthritis was established with modified plaster cast in exten-sion position for 6 weeks except the control group, and the treatment group was treated with ESW (each 1000 impulse, the energy flux densi-ty of 0.1 mJ/mm2). The rabbits were sacrificed respectively 4 weeks after ESW treatment, the general and histological changes of articular cartilage were examined and immunohistochemical staining was used to observe the expression of IL-1βand TNF-αin cartilage. Results The expression of IL-1βand TNF-αwere significantly lower in the treatment group than in the model group (P<0.01). Conclusion ESW can down-regulate the expression of IL-1βand TNF-αin chondrocytes with osteoarthritis.%目的:观察体外冲击波(ESW)对兔膝骨性关节炎软骨白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)水平的影响。方法将30只新西兰大白兔随机分为对照组、模型组和治疗组,每组各10只。模型组和治疗组采用改良伸直位固定6周,制备兔膝骨关节炎模型。治疗组造模后立即给予ESW治疗1次,能流密度0.1 mJ/mm2,冲击次数1000次。各组分别于治疗后4周处死,观察大体标本形态学变化,采用免疫组织化学法检测各组关节软骨中IL-1β和TNF-α的水平。结果治疗组IL-1β和TNF-α的表达较模型组明显下调(P<0.01)。结论 ESW能下调兔膝骨关节炎软骨细胞IL-1β、TNF-α的表达。

  11. The repeated extracorporeal shock waves and the renal parenchyma injury on normal and diabetic rats A repetição de ondas de choque extracorpóreas e a lesão do parênquima renal em ratos normais e diabéticos

    Directory of Open Access Journals (Sweden)

    Vicente Massaji Kira

    2007-08-01

    Full Text Available 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.RESUMO OBJETIVO: Avaliar o efeito de repetidas ondas de choque extracorpóreas (OCE sobre o parênquima renal de ratos normais e diabéticos. MÉTODOS: 40 ratos normais e 40 ratos diabéticos foram distribuídos para aplicação de OCE (Direx Tripter X1® - 14 KVA como segue: A1/B1 e A3/B3 sem OCE; A2/B2 uma sessão de OCE (2000 OC; A4/B4 duas sessões de OC (4000 OC num intervalo de 14 dias. Todos os animais foram sacrificados no 3º. dia após a aplicação da OCE e amostras de parênquima renal foram histologicamente preparados e corados em H&E. Para cada animal

  12. Quasiperpendicular high Mach number Shocks

    CERN Document Server

    Sulaiman, A H; Dougherty, M K; Burgess, D; Fujimoto, M; Hospodarsky, G B

    2015-01-01

    Shock waves exist throughout the universe and are fundamental to understanding the nature of collisionless plasmas. Reformation is a process, driven by microphysics, which typically occurs at high Mach number supercritical shocks. While ongoing studies have investigated this process extensively both theoretically and via simulations, their observations remain few and far between. In this letter we present a study of very high Mach number shocks in a parameter space that has been poorly explored and we identify reformation using in situ magnetic field observations from the Cassini spacecraft at 10 AU. This has given us an insight into quasi-perpendicular shocks across two orders of magnitude in Alfven Mach number (MA) which could potentially bridge the gap between modest terrestrial shocks and more exotic astrophysical shocks. For the first time, we show evidence for cyclic reformation controlled by specular ion reflection occurring at the predicted timescale of ~0.3 {\\tau}c, where {\\tau}c is the ion gyroperio...

  13. Use of extracorporeal membrane oxygenation in adults.

    Science.gov (United States)

    Lafç, Gökhan; Budak, Ali Baran; Yener, Ali Ümit; Cicek, Omer Faruk

    2014-01-01

    Since the first successful application of the heart-lung machine in 1953 by John Gibbon [1], great efforts have been made to modify the bypass techniques and devices in order to allow prolonged extracorporeal circulation in the intensive care unit (ICU), commonly referred to as extracorporeal membrane oxygenation (ECMO). ECMO uses classic cardiopulmonary bypass technology to support circulation. It provides continuous, non-pulsatile cardiac output and extracorporeal oxygenation [2]. Veno-venous ECMO (VV ECMO) provides respiratory support, while veno-arterial ECMO (VA ECMO) provides cardio-respiratory support to patients with severe but potentially reversible cardiac or respiratory deterioration refractory to standard therapeutic modalities. ECMO is a temporary form of life support providing a prolonged biventricular circulatory and pulmonary support for patients experiencing both pulmonary and cardiac failure unresponsive to conventional therapy. Despite the advent of newer ventricular assist devices that are more suitable for long term support, ECMO is simple to establish, cost-effective to operate.

  14. Climate Shocks and the Timing of Migration from Mexico.

    Science.gov (United States)

    Nawrotzki, Raphael J; DeWaard, Jack

    2016-09-01

    Although evidence is increasing that climate shocks influence human migration, it is unclear exactly when people migrate after a climate shock. A climate shock might be followed by an immediate migration response. Alternatively, migration, as an adaptive strategy of last resort, might be delayed and employed only after available in-situ (in-place) adaptive strategies are exhausted. In this paper, we explore the temporally lagged association between a climate shock and future migration. Using multilevel event-history models, we analyze the risk of Mexico-U.S. migration over a seven-year period after a climate shock. Consistent with a delayed response pattern, we find that the risk of migration is low immediately after a climate shock and increases as households pursue and cycle through in-situ adaptive strategies available to them. However, about three years after the climate shock, the risk of migration decreases, suggesting that households are eventually successful in adapting in-situ.

  15. In vivo biological response to extracorporeal shockwave therapy in human tendinopathy

    OpenAIRE

    CM Waugh; Morrissey, D.; E. Jones; GP Riley; H Langberg; HRC Screen

    2015-01-01

    Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment for chronic tendinopathies, however little is known about the in-vivo biological mechanisms of ESWT. Using microdialysis, we examined the real-time biological response of healthy and pathological tendons to ESWT. A single session of ESWT was administered to the mid-portion of the Achilles tendon in thirteen healthy individuals (aged 25.7 ± 7.0 years) and patellar or Achilles tendon of six patients with tendinopathies (aged 3...

  16. Severe hypoxemia during veno-venous extracorporeal membrane oxygenation: exploring the limits of extracorporeal respiratory support

    Directory of Open Access Journals (Sweden)

    Liane Brescovici Nunes

    2014-03-01

    Full Text Available OBJECTIVE: Veno-venous extracorporeal oxygenation for respiratory support has emerged as a rescue alternative for patients with hypoxemia. However, in some patients with more severe lung injury, extracorporeal support fails to restore arterial oxygenation. Based on four clinical vignettes, the aims of this article were to describe the pathophysiology of this concerning problem and to discuss possibilities for hypoxemia resolution. METHODS: Considering the main reasons and rationale for hypoxemia during veno-venous extracorporeal membrane oxygenation, some possible bedside solutions must be considered: 1 optimization of extracorporeal membrane oxygenation blood flow; 2 identification of recirculation and cannula repositioning if necessary; 3 optimization of residual lung function and consideration of blood transfusion; 4 diagnosis of oxygenator dysfunction and consideration of its replacement; and finally 5 optimization of the ratio of extracorporeal membrane oxygenation blood flow to cardiac output, based on the reduction of cardiac output. CONCLUSION: Therefore, based on the pathophysiology of hypoxemia during veno-venous extracorporeal oxygenation support, we propose a stepwise approach to help guide specific interventions.

  17. Medical and biomedical applications of shock waves

    CERN Document Server

    Loske, Achim M

    2017-01-01

    This book provides current, comprehensive, and clear explanations of the physics behind medical and biomedical applications of shock waves. Extracorporeal shock wave lithotripsy is one of the greatest medical advances of our time, and its techniques and clinical devices are continuously evolving. Further research continues to improve the understanding of calculi fragmentation and tissue-damaging mechanisms. Shock waves are also used in orthopedics and traumatology. Possible applications in oncology, cardiology, dentistry, gene therapy, cell transfection, transformation of fungi and bacteria, as well as the inactivation of microorganisms are promising approaches for clinical treatment, industrial applications and research. Medical and Biomedical Applications of Shock Waves is useful as a guide for students, technicians and researchers working in universities and laboratories. Chemists, biologists, physicians and veterinarians, involved in research or clinical practice will find useful advice, but also engineer...

  18. Extracorporeal total artificial heart as bailout surgery.

    Science.gov (United States)

    Perrodin, Stéphanie F; Muller, Olivier; Gronchi, Fabrizio; Liaudet, Lucas; Hullin, Roger; Kirsch, Matthias

    2017-03-01

    We report the use of a total extracorporeal heart for uncontrolled bleeding following a proximal left anterior descending artery perforation, using two centrifugal ventricular assist devices after heart explantation. The literature describing similar techniques and patient outcomes for this "bailout" technique are reviewed.

  19. Extracorporeal shockwave therapy in musculoskeletal disorders

    OpenAIRE

    Wang Ching-Jen

    2012-01-01

    Abstract The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave ...

  20. Guidelines on the use of extracorporeal photopheresis

    DEFF Research Database (Denmark)

    Knobler, R; Berlin, G; Calzavara-Pinton, P;

    2014-01-01

    BACKGROUND: After the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma was published in 1983 with its subsequent recognition by the FDA for its refractory forms, the technology has shown significant promise in the treatment...

  1. [Newborn life threatening respiratory failure treatment with extracorporeal membrane oxygenation].

    Science.gov (United States)

    Urbańska, Ewa; Grzybowski, Adam; Haponiuk, Ireneusz; Przybylski, Roman; Walas, Wojciech; Stempniewicz, Krzysztof; Szary, Tomasz; Włoczka, Grzegorz; Skalski, Janusz H; Zembala, Marian

    2006-01-01

    THE AIM of the study was to show first results of newborn life threatening respiratory failure treatment with extracorporeal membrane oxygenation (ECMO) in Poland. Nine newborns were treated with extracorporeal membrane oxygenation in Silesian Center for Heart Diseases. Newborns were born in 38 week of gestational age (36-41 weeks) with mean birth weight of 3490 g. Reasons for the referral were: meconium aspiration syndrome, infection, and pulmonary hypertension. Each newborn fulfilled an Extracorporeal Life Support Organization (ELSO) criteria for extracorporeal membrane oxygenation. seven out of nine of patients treated with extracorporeal membrane oxygenation survived. Full clinical stabilization was reached about 6th hour of treatment. Mean extracorporeal oxygenation time was 162 hours. For eight newborns veno-venous method was applied and for one newborn veno-arterial method. Roller pump was used in 7 cases and centrifugal pomp in one case. Five newborns had uneventful treatment. During extracorporeal membrane oxygenation therapy we have observed several complications: PDA, hemorrhagic complications, renal failure, arterial hypertension, septicemia, tubing rupture. extracorporeal oxygenation is an effective method of treatment for newborn life threatening respiratory failure. Obtained results do not differ much from Extracorporeal Life Support Organization register results. The most essential problem for extracorporeal membrane oxygenation therapy is correct qualification, early referral, safe transportation as well as the development of centers providing ECMO treatment.

  2. Cardiogenic shock

    Science.gov (United States)

    Shock - cardiogenic ... electrical system of the heart (heart block) Cardiogenic shock occurs when the heart is unable to pump ... orthostatic hypotension) Weak (thready) pulse To diagnose cardiogenic shock, a catheter (tube) may be placed in the ...

  3. INTERACTIONS BETWEEN CORONAL MASS EJECTIONS VIEWED IN COORDINATED IMAGING AND IN SITU OBSERVATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ying D.; Luhmann, Janet G.; Moestl, Christian; Martinez-Oliveros, Juan C.; Bale, Stuart D.; Lin, Robert P. [Space Sciences Laboratory, University of California, Berkeley, CA 94720 (United States); Harrison, Richard A. [Space Science and Technology Department, Rutherford Appleton Laboratory, Didcot (United Kingdom); Temmer, Manuela [Institute of Physics, University of Graz (Austria); Webb, David F. [Institute for Scientific Research, Boston College, Newton, MA 02459 (United States); Odstrcil, Dusan, E-mail: liuxying@ssl.berkeley.edu [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States)

    2012-02-20

    The successive coronal mass ejections (CMEs) from 2010 July 30 to August 1 present us the first opportunity to study CME-CME interactions with unprecedented heliospheric imaging and in situ observations from multiple vantage points. We describe two cases of CME interactions: merging of two CMEs launched close in time and overtaking of a preceding CME by a shock wave. The first two CMEs on August 1 interact close to the Sun and form a merged front, which then overtakes the July 30 CME near 1 AU, as revealed by wide-angle imaging observations. Connections between imaging observations and in situ signatures at 1 AU suggest that the merged front is a shock wave, followed by two ejecta observed at Wind which seem to have already merged. In situ measurements show that the CME from July 30 is being overtaken by the shock at 1 AU and is significantly compressed, accelerated, and heated. The interaction between the preceding ejecta and shock also results in variations in the shock strength and structure on a global scale, as shown by widely separated in situ measurements from Wind and STEREO B. These results indicate important implications of CME-CME interactions for shock propagation, particle acceleration, and space weather forecasting.

  4. Interactions between Coronal Mass Ejections Viewed in Coordinated Imaging and In Situ Observations

    Science.gov (United States)

    Liu, Ying D.; Luhmann, Janet G.; Moestl, Christian; Martinez-Oliveros, Juan C.; Bale, Stewart D.; Lin, Robert P.; Harrison, Richard A.; Temmer, Manuela; Webb, David F.; Odstrcil, Dusan

    2013-01-01

    The successive coronal mass ejections (CMEs) from 2010 July 30 - August 1 present us the first opportunity to study CME-CME interactions with unprecedented heliospheric imaging and in situ observations from multiple vantage points. We describe two cases of CME interactions: merging of two CMEs launched close in time and overtaking of a preceding CME by a shock wave. The first two CMEs on August 1 interact close to the Sun and form a merged front, which then overtakes the July 30 CME near 1 AU, as revealed by wide-angle imaging observations. Connections between imaging observations and in situ signatures at 1 AU suggest that the merged front is a shock wave, followed by two ejecta observed at Wind which seem to have already merged. In situ measurements show that the CME from July 30 is being overtaken by the shock at 1 AU and is significantly compressed, accelerated and heated. The interaction between the preceding ejecta and shock also results in variations in the shock strength and structure on a global scale, as shown by widely separated in situ measurements from Wind and STEREO B. These results indicate important implications of CME-CME interactions for shock propagation, particle acceleration and space weather forecasting.

  5. In Situ Aerosol Detector Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA is developing new platform systems that have the potential to benefit Earth science research activities, which include in situ instruments for atmospheric...

  6. A control study of the radial extracorporeal shock wave therapy for treatment of stenosing tenosynovitis at the radial styloid%放散状冲击波治疗桡骨茎突狭窄性腱鞘炎的对照研究

    Institute of Scientific and Technical Information of China (English)

    张隆浩; 满立波; 李贵忠; 黄广林

    2013-01-01

    Objective To investigate the effectiveness and safety of radial extracorporeal shock waves therapy (RSWT) in treating stenosing tenosynovitis at the radial styloid.Methods Forty-seven patients with stenosing tenosynovitis at the radial styloid were randomly divided into the treatment group(32 cases) and control group (15 cases).Patients in the treatment group received three sessions of RSWT,while those in the control group received conservative therapy with Votalin emulsion and local massage.Visual analog scale (VAS) was used to evaluate the extent of pain before the therapy and 1 or 4 weeks after the last therapy session.Results In the treatment group pain was alleviated and wrist function was improved.The VAS improved from (7.12 ±1.74) prior therapy to (2.16 ± 1.05) and (0.50 ± 0.71) 1 week and 4 weeks after the therapy,respectively.The difference before and after the treatment was significant (P < 0.05).The VAS improved from (6.60 ±1.72) prior therapy to (4.06± 1.83) and (3.46±2.23) 1 week and 4 weeks after the therapy respectively in the control group.The difference before and after the treatment was significant (P < 0.05),while the VAS scores at 1 week and 4 weeks after the therapy were not different(P > 0.05).Conclusion RSWT is a new treatment option for stenosing tenosynovitis at the radial styloid that has such advantages as being effective,simple,atraumatic and safe.%目的 探讨放散状冲击波治疗桡骨茎突狭窄性腱鞘炎的疗效及安全性.方法 对47例桡骨茎突狭窄性腱鞘炎患者随机分为治疗组(32例)和对照组(15例).治疗组采用放散状冲击波治疗,对照组采用外敷双氯芬酸二乙胺,配合局部按摩.采用视觉模拟评分法(visual analog scale,VAS)评估患者治疗前、末次治疗1周后及4周后的疼痛强度.结果 治疗组患者末次治疗1周后疼痛全部缓解,功能有明显改善,治疗前及末次治疗1周和4周后VAS评分分别为(7.12±1.74)、(2.16±1.05)和(0.50±0

  7. Highly selective α1 blocker tamsulosin as adjunctive medical expulsion therapy following extracorporeal shock wave lithotripsy of renal calculi%坦索罗辛对肾结石体外震波碎石术后辅助排石作用的研究

    Institute of Scientific and Technical Information of China (English)

    叶烈夫; 傅长德; 杨泽松; 何延瑜; 詹汉雄; 林玉琴; 许庆均; 张志刚; 黄水通

    2013-01-01

    目的 评估高选择性α1受体阻滞剂坦索罗辛对肾结石体外震波碎石(ESWL)术后辅助排石作用的有效性及安全性.方法 140例单发的非下盏部位的肾结石患者,结石大小6~20 mm,ESWL碎石成功后随机分为两组,每组70例.对照组给予标准治疗包括中成药尿石通丸及司帕沙星,试验组接受标准治疗基础上加用坦索罗辛,随访2个月.结果 试验组(坦索罗辛组)单次ESWL后结石排出率、结石排出时间、石街形成率、肾绞痛发生次数及哌替啶的使用次数等指标均优于对照组(P值分别为0.009,0.000,0.028,0.012,0.002),但两组之间的结石排净率差异无统计学意义(P =0.125).按结石大小进行分组分析,结石≥10 mm患者中,坦索罗辛组的结石排净率高于对照组,差异有统计学意义(P=0.044),且其余各项指标均优于对照组(P<0.05).结石< 10 mm者,坦索罗辛组仅结石排出时间与肾绞痛发生次数两项指标优于对照组(P=0.001,0.026).坦索罗辛组药物副作用发生率与对照组相比差别无统计学意义(P =0.085),且症状轻微,无一例患者因副作用停止治疗.结论 坦索罗辛能够促进并加快肾结石单次ESWL术后碎石排出,减少石街形成并降低肾绞痛发生频率及止痛针使用,对于≥10 mm肾结石患者还能够提高结石排净率,用于辅助排石安全有效.%Objective To define the efficacy and safety of the highly selective α1 blocker tamsulosin as adjunctive expulsion therapy after extracorporeal shock wave lithotripsy (ESWL)in patients with kidney stones.Methods 140 patients with single 6-20 mm non-lower-pole kidney stone were enrolled in this study from March 2009 to October 2011.After one session of successful ESWL,they were randomized into two groups of 70 patients each.Control group received a standard medical therapy which consisted of a traditional Chinese medicine (niaoshitong) and sparfloxacin,while study group was given tamsulosin in

  8. Extracorporeal membrane oxygenation after living-related liver transplant.

    Science.gov (United States)

    Gedik, Ender; Çelik, Muhammet Reha; Otan, Emrah; Dişli, Olcay Murat; Erdil, Nevzat; Bayındır, Yaşar; Kutlu, Ramazan; Yılmaz, Sezai

    2015-04-01

    Various types of extracorporeal membrane oxygenation methods have been used in liver transplant operations. The main indications are portopulmonary or hepatopulmonary syndromes and other cardiorespiratory failure syndromes that are refractory to conventional therapy. There is little literature available about extracorporeal membrane oxygenation, especially after liver transplant. We describe our experience with 2 patients who had living-related liver transplant. A 69-year-old woman had refractory aspergillosis pneumonia and underwent pumpless extracorporeal lung assist therapy 4 weeks after liver transplant. An 8-month-old boy with biliary atresia underwent urgent liver transplant; he received venoarterial extracorporeal membrane oxygenation therapy on postoperative day 1. Despite our unsuccessful experience with 2 patients, extracorporeal membrane oxygenation and pumpless extracorporeal lung assist therapy for liver transplant patients may improve prognosis in selected cases.

  9. Quasiperpendicular High Mach Number Shocks

    Science.gov (United States)

    Sulaiman, A. H.; Masters, A.; Dougherty, M. K.; Burgess, D.; Fujimoto, M.; Hospodarsky, G. B.

    2015-09-01

    Shock waves exist throughout the Universe and are fundamental to understanding the nature of collisionless plasmas. Reformation is a process, driven by microphysics, which typically occurs at high Mach number supercritical shocks. While ongoing studies have investigated this process extensively both theoretically and via simulations, their observations remain few and far between. In this Letter we present a study of very high Mach number shocks in a parameter space that has been poorly explored and we identify reformation using in situ magnetic field observations from the Cassini spacecraft at 10 AU. This has given us an insight into quasiperpendicular shocks across 2 orders of magnitude in Alfvén Mach number (MA ) which could potentially bridge the gap between modest terrestrial shocks and more exotic astrophysical shocks. For the first time, we show evidence for cyclic reformation controlled by specular ion reflection occurring at the predicted time scale of ˜0.3 τc , where τc is the ion gyroperiod. In addition, we experimentally reveal the relationship between reformation and MA and focus on the magnetic structure of such shocks to further show that for the same MA , a reforming shock exhibits stronger magnetic field amplification than a shock that is not reforming.

  10. In-situ magnetic gauge measurements in Kel-F

    Energy Technology Data Exchange (ETDEWEB)

    Sheffield, S.A.; Alcon, R.R.

    1991-01-01

    In-situ gauge measurements have been made in Kel-F using multiple, embedded Lagrangian particle velocity and impulse gauges to measure shock attributes. Shock stresses attained were between 0.9 and 11 GPa. At the lower stresses, we were looking for the effects of a subtle phase transformation to be manifested in the form of a multiple wave structure. Clear evidence of this transformation was not observed but the shape of the transmitted waves indicated the viscoplastic nature of this material. This effect was nearly gone at 2.6 GPa. At the highest stress condition (11 GPa), the waveforms suggest that the single-crystal sapphire impactor was starting to yield, indicating that sapphire is not elastic all the way to 12 GPa, as had been previously thought. Rarefaction speed measurements at shock conditions were obtained from each experiment but it was not possible to obtain accurate estimates of the Gruneisen parameter. 8 refs., 3 figs., 2 tabs.

  11. [Percutaneous nephrostomy associated with extracorporeal shockwave lithotripsy in the treatment of renoureteral lithiasis].

    Science.gov (United States)

    Larrea Masvidal, E; García Serrano, C; Hernández Silverio, D; Castillo Rodriguez, M; Valdes Gómez, A C; Báez Hernández, D; Ramirez Hernández, L

    1993-01-01

    From a series of 5000 cases that had undergone extracorporeal shock wave lithotripsy at the Hospital Clinico Quirúrgico "Hermanos Ameijeiras" from March, 1986 to April, 1988, 220 cases that required percutaneous nephrostomy due to obstructive hydronephrosis from stone fragments were studied. We analyzed the clinical, radiological and ultrasound features of these cases, as well as the criteria for performing percutaneous nephrostomy. We identified the risk factors that made the procedure necessary, particularly urinary tract infection. No important complications ascribable to the foregoing procedure were observed. Performing the procedure early improved patient clinical course and reduced cost of treatment. To eliminate stone fragments completely, percutaneous nephrostomy was combined with other procedures in 198 cases (90%). The stone fragments were passed spontaneously in 10 cases (4.5%) following diversion. At 2 months 190 cases (86%) were completely stone free, 18 (8%) had residual stones and 12 (6%) required open surgery. The foregoing results show that percutaneous nephrostomy is a very useful procedure in septic-obstructive complications following extracorporeal shock wave lithotripsy and acquiring the skill to perform it is essential.

  12. Combined treatment of gallbladder and common bile duct stones disease with endoscopy, laparoscopy and extracorporeal lithotripsy; Skojarzenie endoskopii z laparoskopia i litotrypsja pozaustrojowa w leczeniu kamicy pecherzyka i przewodu zolciowego wspolnego

    Energy Technology Data Exchange (ETDEWEB)

    Modrzejewski, A.; Butkiewicz, J.; Czernicki, K.; Borowski, M.; Sikorski, A. [Pomorska Akademia Medyczna, Szczecin (Poland)

    1993-12-31

    A case of cholecysto- and choledocholithiasis with common bile duct obstructed by multiple large stones is presented. Attempts to remove all stones via endoscopic papillotomy, were ineffective. Two sessions, each of 1 hour extracorporeal shock wave lithotrypsion, were successful. All fragments of crushed concrements were endoscopically evacuated. 4 days later laparoscopic cholecystectomy completed the treatment. (author). 5 refs, 2 figs.

  13. [Venoarterial extracorporeal membrane oxygenation in an awake patient : Use of the mobile ECMO team for fulminant pulmonary embolism].

    Science.gov (United States)

    Keller, D; Lotz, C; Kippnich, M; Adami, P; Kranke, P; Roewer, N; Kredel, M; Schimmer, C; Leyh, R; Muellenbach, R M

    2015-05-01

    The current report highlights the use of venoarterial extracorporeal membrane oxygenation (va-ECMO) in a case of pulmonary embolism complicated by right ventricular failure. A 38-year-old woman was admitted to a secondary care hospital with dyspnea and systemic hypotension. Diagnostic testing revealed a massive pulmonary embolism. Thrombolytic therapy was unsuccessful necessitating thromboendarterectomy in the presence of cardiogenic shock. To allow the necessary transport of the highly unstable patient to a tertiary care center a mobile ECMO team was called in. The team immediately initiated awake va-ECMO as a bridge to therapy. Extracorporeal support subsequently allowed a safe transportation and successful completion of the surgical procedure with complete recovery.

  14. Venovenous Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure.

    Science.gov (United States)

    Ham, P Benson; Hwang, Brice; Wise, Linda J; Walters, K Christian; Pipkin, Walter L; Howell, Charles G; Bhatia, Jatinder; Hatley, Robyn

    2016-09-01

    Conventional treatment of respiratory failure involves positive pressure ventilation that can worsen lung damage. Extrac