Search

Tiemeier, Henning/0000-0002-4395-1397 WOS: 000434304300098 PubMed: 29461364 Aim: The purpose of this study was to evaluate the effect of the unfocused extracorporeal shock wave therapy (ESWT) on healing of mandible ramus defects in diabetic rats. Material and method: Forty male Wistar albino rats were used in the experiment. All animals were randomly divided into 2 main groups, nondiabetic and diabetic. Critical-sized defects were created on ramus in all rats. ESWT was performed to half of rats in each group at 3 sessions after surgery. Animals were euthanized at either fourth or eighth week. Stereological and radiologic examination was performed. Data were statistically analyzed by one-way variance analysis and Tukey post-hoc test. Results: Hounsfield Unit values were higher in D-E+ group than D-E- group in both 8-week and 4-week groups (P>0.05). In both 4-week and 8-week diabetic groups, higher value was observed when compared with nondiabetic groups (P>0.05). According to stereological results, in 4-week groups, there was a higher new bone, connective tissue, and neovascularization volume in D-E- group than D-E+ group and in D+E- group than D+E+ group. These results are similar for the 8-week groups except NV volume. Conclusion: It was found that ESWT application has no positive effect on the healing of critical-sized bone defects in nondiabetics whereas promising effects in diabetics were observed. Project Management Office Coordinatorship of Ondokuz Mayis UniversityOndokuz Mayis University [PYO.-DIS.1904.12.006] This experimental study was supported by Project Management Office Coordinatorship of Ondokuz Mayis University with PYO.-DIS.1904.12.006 project code.

We evaluated the possible effects of noise created by high energy shock waves on the hearing function of children treated with extracorporeal shock wave lithotripsy.A total of 65 children with normal hearing function were included in the study. Patients were divided into 3 groups, ie those becoming stone-free after 1 session of shock wave lithotripsy (group 1, 22 children), those requiring 3 sessions to achieve stone-free status (group 2, 21) and healthy children/controls (group 3, 22). Extracorporeal shock wave lithotripsy was applied with patients in the supine position with a 90-minute frequency and a total of 2,000 shock waves in each session (Compact Sigma, Dornier MedTech, Wessling, Germany). Second energy level was used with a maximum energy value of 58 joules per session in all patients. Hearing function and possible cochlear impairment were evaluated by transient evoked otoacoustic emissions test at 1.0, 1.4, 2.0, 2.8 and 4.0 kHz frequencies before the procedure, 2 hours later, and 1 month after completion of the first shock wave lithotripsy session in groups 1 and 2. In controls the same evaluation procedures were performed at the beginning of the study and 7 weeks later.Regarding transient evoked otoacoustic emissions data, in groups 1 and 2 there was no significant alteration in values obtained after shock wave lithotripsy compared to values obtained at the beginning of the study, similar to controls.A well planned shock wave lithotripsy procedure is a safe and effective treatment in children with urinary stones and causes no detectable harmful effect on hearing function.

Animal experimental study.To present experimental evidence for cell therapy for spinal cord injury (SCI).In chronic SCI, the efficacy of cell engraftment has been known to be low due to its distinct pathology. Alteration of microenvironment was tried using extracorporeal shock waves (ESW) for chronic SCI, and the efficacy of cell therapy was investigated.A chronic contusive SCI model was made in 36 Sprague-Dawley rats. The rats were allocated into (1) control group (SCI only), (2) ESW control group (SCI + ESW), (3) IV group (SCI + intravenous transplantation of mesenchymal stem cells; MSCs), and (4) ESW + IV group (SCI + MSCs IV transplantation after ESW). ESW were applied at the energy determined by our preliminary trials. Engraftment of the cells and expressions of growth factors (brain-derived neurotrophic factor, neuronal growth factor) and cytokines (SDF-1, CXCR4, VEGF) at the epicenter were assessed. The Basso, Beattie, and Bresnahan locomotor scale was used for the clinical assessment.The mean numbers of engrafted cells were higher in the ESW+ IV than that in the IV with a statistical significance. The expression of SDF-1 was higher in the ESW groups than that in the control or IV group. CXCR4 was highly expressed in the transplanted groups. The expressions of growth factors in the treated group were higher in the treated group than those in the control group. However, various statistical significances were noted. The improvement of locomotor was higher in the transplanted groups than that in the control and ESW only group.At a given energy level, ESW presented more engraftment of the transplanted MSCs without any clinical deterioration in a chronic SCI. Based on this promising result and possible explanations, ESW may cause an alteration of the microenvironment for the cell therapy in chronic SCI.N/A.

Slipped capital femoral epiphysis (SCFE) is rare in nonambulatory patients, as mechanical factors play important roles in the development of the disease. We report a case of SCFE, which occurred in a 12-year-old girl with a nonambulatory status after cerebral infarction. SCFE occurred after she received passive range of motion exercise and extracorporeal shock wave treatment for neurogenic heterotopic ossification around the hip joint. The patient was successfully managed by a stepwise approach, with radiological and clinical improvements.

Background: Previous clinical studies have reported that extracorporeal shock wave (EPSW) is an effective treatment for patients with tennis elbow (TE). However, no systematic review has assessed its effectiveness and safety for the treatment of TE. Methods: In this systematic review, we will search the potential eligible literature from the following electronic databases: Central, Embase, MEDLINE, CINAHL, and CNKI from inception to the present. All literatures of randomized controlled trials of EPSW for TE will be considered without language restrictions. Two reviewers will independently select the studies, extract the data, and evaluate the methodology quality. All disagreements between those 2 reviewers will be resolved by a third reviewer involved through discussion. Outcome data will be pooled by RevMan 5.3 software if the heterogeneity is reasonable. Reporting bias will also be conducted if more than 10 included studies can be reached. Results: This systematic review will evaluate the clinical effectiveness and safety of EPSW for TE. Conclusion: The findings of this study will summarize the current evidence of EPSW on TE outcomes and may provide guidance for both clinical practice and further studies. Dissemination and ethics: This systematic review does not need ethical approval, because it does not utilize the individual patient data. Its findings are expected to publish in peer-reviewed journals. Systematic review registration: PROSPERO CRD42019119687.

This retrospective study investigated the efficacy and safety of extracorporeal shock wave (EPSW) combined with hyaluronic acid (HA) for patients with knee osteoarthritis (KOA). This retrospective study included 70 patients with KOA. Of those subjects, 35 of them received EPSW combined HA, and were allocated to a treatment group, while the other 35 participants received HA alone and were allocated to a control group. Patients in both groups were treated for a total of 8 weeks. The primary outcome was measured by visual analog scale (VAS). The secondary outcomes were measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee injury and osteoarthritis outcome score (KOOS). In addition, adverse events (AEs) were also evaluated. All outcomes were measured before and after the treatment. After the treatment, patients in the treatment group exhibited better efficacy in VAS (P

One of major limitations of applying distraction osteogenesis for craniofacial skeleton hypoplasia is the long duration for bony consolidation. This study investigated whether extracorporeal shock wave therapy (ESWT) could accelerate bony consolidation in distraction osteogenesis of the rat mandible.An L-shape osteotomy was performed unilaterally in the hemimandible of Sprague-Dawley rats. An internal distracter was employed to create a 7-mm distraction gap in the mandible. One hundred twenty rats were divided into three groups. The distraction zone of the mandible was received no treatment as controls (group I). Group II received ESWT (500 impulses at 14 kV) at 2 weeks postoperatively. Group III treated with 500 ESW impulses at 21 kV at 2 weeks postoperatively.Dual-energy X-ray absorptiometry and material testing showed that optimal dosage of ESWT in group II significantly increased mineral density and enhanced biomechanical strength of the bone tissue. In histomorphological analysis, the mandibular tissue in group II showed intense osteoblastic cell recruitment, new bone formation, and vascularization. The osteoblasts in the distracted zone in group II indicated significantly strong immunoreactivities for proliferating cell nuclear antigen, vascular endothelial growth factor, and bone morphogenetic protein-2, when compared with other groups.Optimal dosage of ESWT was beneficial for accelerating facial skeleton consolidation and bone regeneration in the distracted rat mandible tissue. The mechanism was presumably associated with the up-regulation of neovascularization, cell proliferation, and osteogenic growth factor expression in bone microenvironment.

Purpose: We evaluated the attenuation value of renal cal-culi on unenhanced axial computerized tomography (CT) as a predictor of calculus fragmentation by extracorporeal shock wave

This study highlights the emerging use of extracorporeal shock waves to treat nonunions and delayed unions. An overview of previous work performed in this area is presented. A feasibility study conducted by OssaTron (HealthTronics) is also reviewed, showing the results of high-energy extracorporeal shock wave for the treatment of nonunions in the proximal fifth metatarsal. Preliminary results support its effectiveness as a safe and less invasive means of treating difficult cases of nonunions or delayed unions. More research is needed to demonstrate the physiology of bone-healing induced by the use of shock wave therapy.

We compared the impact of intravenous sedation versus general anesthesia on the efficacy of extracorporeal shock wave lithotripsy.From November 1997 to May 1998, 295 patients with a single renal or upper ureteral radioopaque stone of less than 2 cm. were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia). The treating anesthesiologist and patient together elected intravenous sedation or general anesthesia. Of the 92 patients 60 (65%) treated under intravenous sedation and 126 of the 203 (62%) treated under general anesthesia had 3-month followup records available for review. Extracorporeal shockwave lithotripsy was considered a failure if residual stone fragments remained after 3 months, or an auxiliary procedure or re-treatment was required.At 3 months the stone-free rate in patients treated under intravenous sedation was 55% compared with 87% in those treated under general anesthesia (p0.001). There was no statistically significant difference in treatment time or the power index in the 2 groups. Stone size (1 to 10 versus 11 to 20 mm.) did not significantly affect the anesthesia specific stone-free rate.For single renal or upper ureteral stones less than 2 cm. a significantly better 3-month stone-free rate is achieved with the Doli 50 lithotriptor when general anesthesia is used instead of intravenous sedation.

Extracorporeal shock wave lithotripsy (ESWL) has become the preferred treatment modality for the majority of urinary tract calculi. This form of treatment boasts excellent patient acceptance and has significantly reduced the need for surgical intervention. An evaluation of our first 646 patients undergoing 722 ESWL treatments at Walter Reed Army Medical Center revealed an overall stone-free rate at 1 and 3 months of 52% and 79%, respectively. The exact location of each stone within the kidney and ureter further determined the stone-free rates at 1 and 3 months. Stone-free rates at 3 months ranged from 89% for renal pelvic stones to 64% for lower pole caliceal stones. Upper third ureteral stones treated in situ without stenting resulted in a 74% stone-free rate at 3 months. This rate increased to 85% when these patients were stented and treated in situ. Although statistically insignificant, when the upper third ureteral stones were manipulated into and treated in the renal pelvis (31% of our patient population) the 3-month stone-free rate increased to 87%. Attempts were made to stent all ureteral stones before treatment. The stone-free rate at 3 months was 86% for mid third ureteral stones and 81% for lower third ureteral stones. The overall retreatment rate was 11.8% with a complication rate of 7.6% and a 6.3% post-ESWL intervention rate (open or percutaneous surgery, stent or percutaneous nephrostomy placement).

Concerns about the safety of extracorporeal shock wave lithotripsy include the risk of vascular damage and the genesis of hypertension. We evaluated gross specimens and barium microangiograms of the right kidneys of 14 rabbits exposed to shock waves; the untreated left kidneys served as controls. Six rabbits were assessed immediately after shock wave treatment, whereas the other eight rabbits had the same procedure 3 months later. All six acute phase animals showed microangiographic changes indicative of shock wave trauma, including cortical, subcapsular, and medullary extravasation of barium and patchy loss of efferent vessels. No significant vascular abnormalities were seen in the control kidneys. All kidneys treated from the animals that had delayed microangiography showed macroscopic evidence of fibrotic capsular thickening and parenchymal scarring. Microscopically, there was crowding of glomeruli and areas of avascularity. In this model, shock waves damaged the cortical circulation and resulted in persistent alterations of the microvasculature that potentially could be responsible for the abnormal secretion of renin.

We present the initial results of a ureteral stone brush used in conjunction with extracorporeal shock wave lithotripsy for impacted ureteral stones. We studied 31 cases of ureteral calculi that could not be manipulated back into the renal collecting system. In 18 cases a ureteral catheter was placed past the calculus, while in 13 a catheter could not be passed. With the stone brush unbypassed stones yielded a success rate similar to that for bypassed stones (84.6 versus 88.9%, respectively). We believe that this result is due to the ability of the stone brush to remove circumferential fragments from around the stone, allowing more shock energy to reach the core of the stone. (J. Urol., 143: 261–262, 1990).

The initial United States cooperative experience with the EDAP LT-01 second generation piezoelectric extracorporeal shock wave lithotriptor using ultrasonic guidance is presented. Particular to the machine are lack of radiation exposure, no need for anesthesia, a purely outpatient procedure, no electrocardiographic problems, a high degree of safety and a paucity of complications. The equipment is described briefly. The same machine currently is being used to destroy renal and biliary stones. The results are encouraging and highly comparable to the initial experience with the earlier machines. Fragmentation rates are approximately 86%, with destruction rates of 63.4% over-all. Ultrasound localization and monitoring proved surprisingly easy to learn and were increasingly less of a problem as experience was gained. No serious complications were observed, and there were no renal losses and no deaths. Only 3 cases of steinstrasse were noted among 461 with 633 stones targeted during 595 treatments.