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  1. Damage mechanisms in shock wave lithotripsy (SWL)

    NASA Astrophysics Data System (ADS)

    Lokhandwalla, Murtuza

    Shock wave lithotripsy is a 'non-invasive' therapy for treating kidney stones. Focused shock waves fragment stones to a size that can be passed naturally. There is, however, considerable tissue injury, and the mechanisms of stone fragmentation and tissue injury are not well understood. This work investigates potential tissue damage mechanisms, with an aim towards enhancing stone fragmentation and minimizing tissue damage. Lysis of red blood cells (RBC's) due to in vitro exposure to shock waves was investigated. Fluid flow-fields induced by a non-uniform shock wave, as well as radial expansion/implosion of a bubble was hypothesized to cause cell lysis. Both the above flow-fields constitute an unsteady extensional flow, exerting inertial as well as viscous forces on the RBC membrane. The resultant membrane tension and the membrane areal strain due to the above flow-fields were estimated. Both were found to exert a significantly higher inertial force (50--100 mN/m) than the critical membrane tension (10 mN/m). Bubble-induced flow-field was estimated to last for a longer duration (˜1 microsec) compared to the shock-induced flow (˜1 ns) and hence, was predicted to be lytically more effective, in typical in vitro experimental conditions. However, in vivo conditions severely constrain bubble growth, and cell lysis due to shock-induced shear could be dominant. Hemolysis due to shock-induced shear, in absence of cavitation, was experimentally investigated. The lithotripter-generated shock wave was refocused by a parabolic reflector. This refocused wave-field had a tighter focus (smaller beam-width and a higher amplitude) than the lithotripter wave-field. Cavitation was eliminated by applying overpressure to the fluid. Acoustic emissions due to bubble activity were monitored by a novel passive cavitation detector (HP-PCD). Aluminum foils were also used to differentiate cavitational from non-cavitational mode of damage. RBC's were exposed to the reflected wave-field from the parabolic reflector and also from a flat reflector, the latter serving as a control experiment. Exposure to the wave-field from the parabolic reflector increased hemolysis four-fold compared to untreated controls and was twice that of cell lysis with the flat reflector. This result corroborated the hypothesis of shock-induced shear as a damage mechanism.

  2. A Pilot Study to Evaluate Haemostatic Function, following Shock Wave Lithotripsy (SWL) for the Treatment of Solitary Kidney Stones

    PubMed Central

    Hughes, Stephen Fôn; Thomas-Wright, Samantha Jayne; Banwell, Joseph; Williams, Rachel; Moyes, Alyson Jayne; Mushtaq, Sohail; Abdulmajed, Mohamed; Shergill, Iqbal

    2015-01-01

    Purpose The number of patients undergoing shock wave lithotripsy (SWL) in the UK for solitary unilateral kidney stones is increasing annually. The development of postoperative complications such as haematuria and sepsis following SWL is likely to increase. Comparing a range of biological markers with the aim of monitoring or predicting postoperative complications following SWL has not been extensively researched. The main purpose of this pilot-study was to test the hypothesis that SWL results in changes to haemostatic function. Subsequently, this pilot-study would form a sound basis to undertake future investigations involving larger cohorts. Methods Twelve patients undergoing SWL for solitary unilateral kidney stones were recruited. From patients (8 male and 4 females) aged between 31–72 years (median—43 years), venous blood samples were collected pre-operatively (baseline), at 30, 120 and 240 minutes postoperatively. Specific haemostatic biomarkers [platelet counts, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, von Willebrand Factor (vWF), sE-selectin and plasma viscosity (PV)] were measured. Results Platelet counts and fibrinogen concentration were significantly decreased following SWL (p = 0.027 and p = 0.014 respectively), while D-dimer and vWF levels significantly increased following SWL (p = 0.019 and p = 0.001 respectively). PT, APTT, sE-selectin and PV parameters were not significantly changed following SWL (p>0.05). Conclusions Changes to specific biomarkers such as plasma fibrinogen and vWF suggest that these represent a more clinically relevant assessment of the extent of haemostatic involvement following SWL. Analysis of such markers, in the future, may potentially provide valuable data on “normal” response after lithotripsy, and could be expanded to identify or predict those patients at risk of coagulopathy following SWL. The validation and reliability will be assessed through the assessment of larger cohorts. PMID:25938233

  3. Shock wave lithotripsy (SWL) induces significant structural and functional changes in the kidney

    NASA Astrophysics Data System (ADS)

    Evan, Andrew P.; Willis, Lynn R.; Lingeman, James E.

    2003-10-01

    The foundation for understanding SWL-injury has been well-controlled renal structural and functional studies in pigs, a model that closely mimics the human kidney. A clinical dose (2000 shocks at 24 kV) of SWL administered by the Dornier HM3 induces a predictable, unique vascular injury at F2 that is associated with transient renal vasoconstriction, seen as a reduction in renal plasma flow, in both treated and untreated kidneys. Unilateral renal denervation studies links the fall in blood flow in untreated kidneys to autonomic nerve activity in the treated kidney. SWL-induced trauma is associated with an acute inflammatory process, termed Lithotripsy Nephritis and tubular damage at the site of damage that leads to a focal region of scar. Lesion size increases with shock number and kV level. In addition, risk factors like kidney size and pre-existing renal disease (e.g., pyelonephritis), can exaggerate the predicted level of renal impairment. Our new protection data show that lesion size can be greatly reduced by a pretreatment session with low kV and shock number. The mechanisms of soft tissue injury probably involves shear stress followed by acoustic cavitation. Because of the perceived enhanced level of bioeffects from 3rd generation lithotripters, these observations are more relevant than ever.

  4. Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL)

    SciTech Connect

    Williams, James C. Jr.; Zarse, Chad A.; Jackson, Molly E.; McAteer, James A.; Lingeman, James E.

    2007-04-05

    Great variability exists in the response of urinary stones to SWL, and this is true even for stones composed of the same mineral. Efforts have been made to predict stone fragility to shock waves using computed tomography (CT) patient images, but most work to date has focused on the use of stone CT number (i.e., Hounsfield units). This is an easy number to measure on a patient stone, but its value depends on a number of factors, including the relationship of the size of the stone to me resolution (i.e., the slicewidth) of the CT scan. Studies that have shown a relationship between stone CT number and failure in SWL are reviewed, and all are shown to suffer from error due to stone size, which was not accounted for in the use of Hounsfield unit values. Preliminary data are then presented for a study of calcium oxalate monohydrate (COM) stones, in which stone structure-rather than simple CT number values-is shown to correlate with fragility to shock waves. COM stones that were observed to have structure by micro CT (e.g., voids, apatite regions, unusual shapes) broke to completion in about half the number of shock waves required for COM stones that were observed to be homogeneous in structure by CT. This result suggests another direction for the use of CT in predicting success of SWL: the use of CT to view stone structure, rather than simply measuring stone CT number. Viewing stone structure by CT requires the use of different viewing windows than those typically used for examining patient scans, but much research to date indicates that stone structure can be observed in the clinical setting. Future clinical studies will need to be done to verify the relationship between stone structure observed by CT and stone fragility in SWL.

  5. Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL)

    NASA Astrophysics Data System (ADS)

    Williams, James C.; Zarse, Chad A.; Jackson, Molly E.; Lingeman, James E.; McAteer, James A.

    2007-04-01

    Great variability exists in the response of urinary stones to SWL, and this is true even for stones composed of the same mineral. Efforts have been made to predict stone fragility to shock waves using computed tomography (CT) patient images, but most work to date has focused on the use of stone CT number (i.e., Hounsfield units). This is an easy number to measure on a patient stone, but its value depends on a number of factors, including the relationship of the size of the stone to me resolution (i.e., the slicewidth) of the CT scan. Studies that have shown a relationship between stone CT number and failure in SWL are reviewed, and all are shown to suffer from error due to stone size, which was not accounted for in the use of Hounsfield unit values. Preliminary data are then presented for a study of calcium oxalate monohydrate (COM) stones, in which stone structure—rather than simple CT number values—is shown to correlate with fragility to shock waves. COM stones that were observed to have structure by micro CT (e.g., voids, apatite regions, unusual shapes) broke to completion in about half the number of shock waves required for COM stones that were observed to be homogeneous in structure by CT. This result suggests another direction for the use of CT in predicting success of SWL: the use of CT to view stone structure, rather than simply measuring stone CT number. Viewing stone structure by CT requires the use of different viewing windows than those typically used for examining patient scans, but much research to date indicates that stone structure can be observed in the clinical setting. Future clinical studies will need to be done to verify the relationship between stone structure observed by CT and stone fragility in SWL.

  6. Complementary approaches to decreasing discomfort during shockwave lithotripsy (SWL).

    PubMed

    Ngee-Ming, Goh; Tamsin, Drake; Rai, B P; Somani, B K

    2014-06-01

    Shock wave lithotripsy (SWL) is an established treatment for renal stones. Although non-invasive, it can cause significant pain and anxiety during the procedure. Our purpose was to review the literature to look at the effect of complimentary therapy in patients undergoing SWL and whether it led to a reduction in the requirement of analgesics and anxiolytics. A systematic review was performed on the use of acupuncture, auricular acupressure, transcutaneous electrical nerve stimulation (TENS) and music during SWL. Only prospective randomized controlled trials were selected. Two reviewers independently extracted the data from each study. Outcomes relating to analgesia requirement, anxiety and stone-free rates (SFR) were compared. Seven papers were identified reporting on 591 patients (acupuncture-3, TENS-1 and music-3). Pain control/analgesia requirement was significantly better in four studies (music-2, acupuncture-1, TENS-1). Significantly lower anxiety was noted in one study with music and two using acupuncture. No difference in SFR was noted with the use of complementary therapy. No major or minor side effects were noted. Complementary therapy for SWL can help lower analgesia requirement and the anxiety associated with it. However, it does not have any effect on the SFR. PMID:24648110

  7. Uncovering the Secret of Shock Wave Lithotripsy

    NASA Astrophysics Data System (ADS)

    Zhong, P.

    Shock wave lithotripsy (SWL) is an engineering innovation that has revolutionized the treatment of kidney stone disease since the early 1980s [1] - [3]. Today, SWL is the first-line therapy for millions of patients worldwide with renal and upper urinary stones [3, 4].

  8. Rupture of undiagnosed embryonal rhabdomyosarcoma after shock wave lithotripsy in an 11-year-old girl

    PubMed Central

    Shin, Yu Seob; Kim, Young Gon; Jang, Kyu Yun; Choi, Hwang; Kim, Hyung Jin

    2014-01-01

    We present a case of a rupture of an undiagnosed embryonal rhabdomyosarcoma after shock wave lithotripsy (SWL) in an 11-year-old girl. Although SWL is generally regarded as safe, careful imaging before SWL is important to prevent life-threatening complications in children. PMID:25485021

  9. Novel instrumentation in urologic surgery: Shock wave lithotripsy

    PubMed Central

    Semins, Michelle J.; Matlaga, Brian R.

    2010-01-01

    Extracorporeal shock wave lithotripsy (SWL) was first introduced in 1980 and it rapidly revolutionized the treatment of stone disease. SWL is a non-invasive, outpatient procedure that now accounts for the majority of stone removal procedures. Since the introduction of first generation lithotripter, the Dornier HM3 machine, SWL devices have undergone many modifications secondary to limitations, in efforts to create a more effective and efficient way to treat stones and decrease possible morbidities. Herein, we review the evolution of the technology and advances in the instrumentation over the last three decades. PMID:21116366

  10. Extracorporeal shock wave lithotripsy today

    PubMed Central

    Tailly, Geert G

    2013-01-01

    Even 32 years after its first introduction shockwave lithotripsy (SWL) remains a matter of discussion and controversy. Since the first SWL in 1980, millions of treatments have been performed worldwide. To this day SWL remains the least invasive of all stone treatments and is considered the treatment modality of first choice for the majority of urinary stones. Despite the massive scale on which SWL is performed in a wide range of indications, complication rate has always remained very low and usually limited to minor side effects and complications. The introduction of affordable multifunctional lithotripters has made SWL available to more and more departments of urology worldwide. Still many centers are disappointed with the treatment results and concerned about the adverse tissue effects. In this SWL proves to be the victim of its uninvasiveness and its apparent ease of practice. Urologists need proper skill and experience; however, to adequately administer shockwaves in order to improve outcome. This aspect is too often minimized and neglected. Apart from this the power of shockwaves often is underestimated by operators of shockwave machines. Basic knowledge of the physics of shockwaves could further reduce the already minimal adverse tissue effects. Good training and coaching in the administration of shockwaves would no doubt lead to a renaissance of SWL with better treatment results and minimal adverse tissue effects. PMID:24082441

  11. Extracorporeal shock wave lithotripsy: An opinion on its future

    PubMed Central

    Rassweiler, Jens; Rassweiler, Marie-Claire; Frede, Thomas; Alken, Peter

    2014-01-01

    The development of miniaturized nephroscopes which allow one-stage stone clearance with minimal morbidity has brought the role of shock wave lithotripsy (SWL) in stone management into question. Design innovations in SWL machines over the last decade have attempted to address this problem. We reviewed the recent literature on SWL using a MEDLINE/PUBMED research. For commenting on the future of SWL, we took the subjective opinion of two senior urologists, one mid-level expert, and an upcoming junior fellow. There have been a number of recent changes in lithotripter design and techniques. This includes the use of multiple focus machines and improved coupling designs. Additional changes involve better localization real-time monitoring. The main goal of stone treatment today seems to be to get rid of the stone in one session rather than being treated multiple times non-invasively. Stone treatment in the future will be individualized by genetic screening of stone formers, using improved SWL devices for small stones only. However, there is still no consensus about the design of the ideal lithotripter. Innovative concepts such as emergency SWL for ureteric stones may be implemented in clinical routine. PMID:24497687

  12. Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

    PubMed Central

    Semins, Michelle Jo; Matlaga, Brian R

    2015-01-01

    Shock wave lithotripsy (SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient- and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate. PMID:25949936

  13. Shock Wave Injury to the Kidney in SWL: Review and Perspective

    NASA Astrophysics Data System (ADS)

    McAteer, James A.; Evan, Andrew P.; Willis, Lynn R.; Connors, Bret A.; Williams, James C.; Pishchalnikov, Yuri A.; Lingeman, James E.

    2007-04-01

    Shock wave lithotripsy (SWL) is a first-line option for treatment for urinary calculi—particularly effective for the removal of uncomplicated stones from the upper urinary tract. The success of lithotripsy is tempered, however, by the occurrence of acute injury that has been reported to progress to long-term complications. SW trauma to the kidney is a vascular lesion characterized by parenchymal and subcapsular bleeding. The acute lesion is dose-dependent, and typically localized to the focal volume of the lithotripter. Cavitation has been implicated in vessel rupture, but SW-shear has the potential to be a primary mechanism for damage as well. Possible chronic adverse effects of SWL may include new-onset hypertension, development of diabetes, and exacerbation of stone disease. If acute trauma could be reduced, it seems likely that serious long-term effects could be minimized, or even eliminated. Reducing the dose of SW's needed for stone breakage is one option. Improved coupling improves stone breakage, and slowing SW rate significantly improves stone-free outcomes. Experiments with animals now show that treatment protocols can be designed to protect against tissue injury. Initiating treatment with low energy SW's dramatically reduces lesion size, and reducing the rate of SW delivery virtually eliminates SW trauma altogether. SWL stands to gain from new advances in technology, as lithotripters become safer and more effective. Perhaps the greatest progress will be made when we have determined the physical mechanisms of SW action both for stone breakage and tissue damage, and have better characterized the biological response to SW's—as this will provide the principles needed to achieve the best combination of safety and efficiency with whatever lithotripter is at hand.

  14. The Future of SWL: A Global Perspective

    NASA Astrophysics Data System (ADS)

    Köhrmann, Kai Uwe

    2007-04-01

    The future relevance of shock wave lithotripsy (SWL) to the treatment of urinary stones has been questioned by some. This paper reviews recent developments with an aim to predict the level of usefulness of SWL for the future. The incidence of urolithiasis is increasing throughout the world, and existing metaphylaxis is not widely effective. This results in an increasing need for active stone removal. SWL was and is a well established treatment modality for urolithiasis in the upper urinary tract. For most stone situations there will remain a reasonable choice between SWL versus endoscopic procedures, and it is unlikely that endoscopic procedures will displace SWL completely in general practice. In conclusion, SWL will continue to play an established, if slightly reduced, role in stone treatment in the future.

  15. Observation of cavitation during shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Bailey, Michael R.; Crum, Lawrence A.; Pishchalnikov, Yuri A.; McAteer, James A.; Pishchalnikova, Irina V.; Evan, Andrew P.; Sapozhnikov, Oleg A.; Cleveland, Robin O.

    2005-04-01

    A system was built to detect cavitation in pig kidney during shock wave lithotripsy (SWL) with a Dornier HM3 lithotripter. Active detection, using echo on B-mode ultrasound, and passive cavitation detection (PCD), using coincident signals on confocal, orthogonal receivers, were equally sensitive and were used to interrogate the renal collecting system (urine) and the kidney parenchyma (tissue). Cavitation was detected in urine immediately upon SW administration in urine or urine plus X-ray contrast agent, but in tissue, cavitation required hundreds of SWs to initiate. Localization of cavitation was confirmed by fluoroscopy, sonography, and by thermally marking the kidney using the PCD receivers as high intensity focused ultrasound sources. Cavitation collapse times in tissue and native urine were about the same but less than in urine after injection of X-ray contrast agent. Cavitation, especially in the urine space, was observed to evolve from a sparse field to a dense field with strong acoustic collapse emissions to a very dense field that no longer produced detectable collapse. The finding that cavitation occurs in kidney tissue is a critical step toward determining the mechanisms of tissue injury in SWL. [Work sup ported by NIH (DK43881, DK55674, FIRCA), ONRIFO, CRDF and NSBRI SMS00203.

  16. Kidney stones - lithotripsy - discharge

    MedlinePLUS

    Extracorporeal shock wave lithotripsy - discharge; Shock wave lithotripsy - discharge; Laser lithotripsy - discharge; Percutaneous lithotripsy - discharge; Endoscopic lithotripsy - discharge; ESWL - discharge

  17. Retroperitoneal laparoscopic pyelolithotomy versus extra corporeal shock-wave lithotripsy for management of renal stones

    PubMed Central

    Chander, Jagdish; Gupta, Nikhil; Lal, Pawanindra; Lal, Pawan; Ramteke, Vinod K

    2010-01-01

    AIM: The purpose of this study was to evaluate the role of retroperitoneal laparoscopic pyelolithotomy (RPPL) and its comparison with extra corporeal shock wave lithotripsy in the management of renal calculi. MATERIALS AND METHODS: The study was carried out in the Department of surgery, Maulana Azad Medical College, New Delhi, India. The study included 86 cases of solitary renal calculi in the retroperitoneoscopic (RPPL) group and 82 cases in the shock wave lithotripsy (SWL) group. The parameters compared were stone clearance, hospital stay, number of postoperative visits, mean time to resume normal activities, number of man days lost, and analgesic requirement. RESULTS: The RPPL group showed better stone clearance, fewer hospital visits, low analgesic requirement, fewer number of man days lost, and early resumption of normal activities, as compared to the SWL group. CONCLUSIONS: Shock wave lithotripsy, being a noninvasive modality, is an established procedure all over the world. However RPPL achieves comparable or better results in high volume centers. PMID:21120067

  18. Electrohydraulic and extracorporeal shock-wave lithotripsy.

    PubMed

    Adams, L G; Senior, D F

    1999-01-01

    The literal meaning of lithotripsy is the "act of breaking stones." There are two forms of lithotripsy available for use in veterinary medicine: electrohydraulic shock-wave lithotripsy (EHL) and extracorporeal shock-wave lithotripsy (ESWL). With EHL, a shock-wave is generated immediately adjacent to a urolith within the urinary bladder. In dogs, nephroliths or ureteroliths can be successfully treated with ESWL. With ESWL, the shock-waves are generated outside the body and directed toward the urolith. PMID:10028164

  19. Modification of the edge wave in shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Zhou, Yufeng

    2012-10-01

    To reduce the bubble cavitation and the consequent vascular injury of shock wave lithotripsy (SWL), a new method was devised to modify the diffraction wave generated at the aperture of a Dornier HM-3 lithotripter. Subsequently, the duration of the tensile wave was shortened significantly (3.2±0.54 ?s vs. 5.83±0.56 ?s). However, the amplitude and duration of the compressive wave of LSW between these two groups as well as the -6 dB beam width and the amplitude of the tensile wave are almost unchanged. The suppression on bubble cavitation was confirmed using the passive cavitation technique. At the lithotripter focus, while 30 shocks can cause rupture of blood vessel phantom using the HM-3 lithotripter at 20 kV; no rupture could be found after 300 shocks with the edge extender. On the other hand, after 200 shocks the HM-3 lithotripter at 20 kV can achieve a stone fragmentation of 50.4±2.0% on plaster-of-Paris stone phantom, which is comparable to that of using the edge extender (46.8±4.1%, p=0.005). Altogether, the modification on the diffraction wave at the lithotripter aperture can significantly reduce the bubble cavitation activities. As a result, potential for vessel rupture in shock wave lithotripsy is expected.

  20. Shock wave lithotripsy: advances in technology and technique

    PubMed Central

    Lingeman, James E.; McAteer, James A.; Gnessin, Ehud; Evan, Andrew P.

    2010-01-01

    Shock wave lithotripsy (SWL) is the only noninvasive method for stone removal. Once considered as a primary option for the treatment of virtually all stones, SWL is now recognized to have important limitations that restrict its use. In particular, the effectiveness of SWL is severely limited by stone burden, and treatment with shock waves carries the risk of acute injury with the potential for long-term adverse effects. Research aiming to characterize the renal response to shock waves and to determine the mechanisms of shock wave action in stone breakage and renal injury has begun to suggest new treatment strategies to improve success rates and safety. Urologists can achieve better outcomes by treating at slower shock wave rate using a step-wise protocol. The aim is to achieve stone comminution using as few shock waves and at as low a power level as possible. Important challenges remain, including the need to improve acoustic coupling, enhance stone targeting, better determine when stone breakage is complete, and minimize the occurrence of residual stone fragments. New technologies have begun to address many of these issues, and hold considerable promise for the future. PMID:19956196

  1. A Rare Complication of Extracorporeal Shock Wave Lithotripsy: Intrarenal Hematoma Mimicking Pelvis Renalis Tumor

    PubMed Central

    Akbulut, Fatih; Kucuktopcu, Onur; Ucpinar, Burak; Savun, Metin; Ozgor, Faruk; Sonmezay, Erkan; Simsek, Abdulmuttalip; Gurbuz, Gokhan

    2015-01-01

    Extracorporeal shock wave lithotripsy (SWL) is a very commonly used treatment modality for appropriate sized stones. Even though it is a noninvasive treatment technique, major complications may occur following SWL sessions. Herein, we report a 17-year-old male patient, who received 2 sessions of SWL treatment for his left kidney stone, 4 months before his admission. Imaging methods showed an enhanced left renal pelvis mass with contrast-enhanced computerized tomography (CT) and this finding raised a suspicion of pelvis renalis tumor. Diagnostic ureterorenoscopy was planned for the patient and operation revealed a left intrarenal hematoma, which was drained percutaneously during the same operation. Careful history should be taken from patients with renal pelvis masses and intrarenal hematoma formation should be kept in mind, especially if the patient has a previous SWL history. PMID:26064767

  2. Shock Wave Lithotripsy and Renal Hemorrhage

    PubMed Central

    Silberstein, Jonathan; Lakin, Charles M; Kellogg Parsons, J

    2008-01-01

    Although shock wave lithotripsy is a safe and efficacious treatment for nephrolithiasis, the most common acute complication is renal hemorrhage. Shock wave-induced renal hemorrhage is a potentially devastating injury if not promptly recognized and treated appropriately. The authors report a large perirenal hematoma occurring after shock wave lithotripsy and review the causes, prevention, and treatment of shock wave-induced renal hemorrhage. PMID:18836562

  3. [Extra corporeal shock wave lithotripsy (ESWL) procedure in urology].

    PubMed

    Doré, B

    2005-01-01

    Since 1980, extra corporeal shock wave lithotripsy (ESWL) has become the first line treatment for most stones in adults and children. The indications are based on criteria depending on localization, chemical composition and size of the renal and ureteral calculi. Since the DORNIER HM 3 which remains the gold standard of first generation lithotripters, many devices of second and third generation have been built (electro hydrolic, piezo electric and electromagnetic) with fluoroscopic and ultrasound localization systems. SWL may now be performed on an out-patient basis without anaesthesia or under neuroleptic analgesia. Indications and evaluation criteria on 3 months plain abdominal X-ray are better defined since 1996. Nevertheless, comparison of reported results remains difficult due to the multiplicity of lithotripter types and the lack of consensus on efficacy criteria. Today, the third generation of mobile electromagnetic lithotripters give an average of 80% stone free rate of patients with kidney and ureteral calculi whatever the localization and size. PMID:16302706

  4. Is flexible ureterorenoscopy and laser lithotripsy the new gold standard for lower pole renal stones when compared to shock wave lithotripsy: Comparative outcomes from a University hospital over similar time period

    PubMed Central

    Burr, Jacob; Ishii, Hiro; Simmonds, Nick

    2015-01-01

    Introduction Renal lower pole stones pose difficulty in management due to anatomical variation, stone size, hardness and patient demographics. Flexible ureterorenoscopy and laser lithotripsy (FURSL) and shock wave lithotripsy (SWL) are preferred for stones 1-2 cm in size. We wanted to compare the outcomes of FURSL and SWL for lower pole stones during the same time period. Material and methods All patients who were treated for lower pole stones with FURSL and SWL during a 19-month period were included. The stone free rate (SFR) was defined as ?3 mm fragments on follow-up imaging or stone free endoscopically. Data was recorded in an excel spreadsheet with SPSS version 21 used for statistical analysis. Results A total of 161 lower pole procedures were done (93 SWL and 63 FURSL). The mean stone size for SWL (7.4 mm; range: 4-16 mm) was significantly smaller than for FURSL (13.4 mm; 4-53 mm). The mean operating time and hospital stay for FURSL was 65 minutes (range: 30-160 minutes) and 0.5 days (range: 0-7 days) respectively. The SFR was significantly better (p <0.001) for FURSL (n = 63, 93%) compared to SWL (n = 23, 25%). There were 4 (6%) complications (3 Clavien II and 1 Clavien I) in the FURSL group (2 urosepsis, 1 UTI and 1 stent pain). Three patients in the SWL group (Clavien I) were readmitted with renal colic but there were no other complications. Conclusions FURSL for lower pole stones seems to be a much better alternative than SWL with a high SFR even for larger stones and seems to be the new gold standard for lower pole stone management. PMID:26251738

  5. The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones

    PubMed Central

    Ozturk, M.D. Ufuk; ?ener, Nevzat Can; Goktug, H.N. Goksel; Gucuk, Adnan; Nalbant, Ismail; ?mamoglu, M. Abdurrahim

    2013-01-01

    Introduction In this study we compare the success rates and complication rates of shock wave lithotripsy (SWL), laparoscopic, and ureteroscopic approaches for large (between 1 and 2 cm) proximal ureteral stones. Methods: In total, 151 patients with ureteral stones between 1 and 2 cm in diameter were randomized into 3 groups (52 SWL, 51 laparoscopy and 48 retrograde intrarenal surgery [RIRS]). The groups were compared for stone size, success rates, and complication rates using the modified Clavien grading system. Results: Stone burden of the groups were similar (p = 0.36). The success rates were 96%, 81% and 79%, respectively in the laparoscopy, SWL, and ureteroscopy groups. The success rate in laparoscopy group was significantly higher (p < 0.05). When these groups were compared for complication rates, RIRS seemed to be the group with the lowest complication rates (4.11%) (p < 0.05). SWL and laparoscopy seem to have similar rates of complication (7.06% and 7.86%, respectively, p = 0.12). Interpretation: To our knowledge, this is the first study to compare the results of laparoscopy, SWL and RIRS in ureteral stones. Our results showed that in management of patients with upper ureteral stones between 1 and 2 cm, laparoscopy is the most successful method based on its stone-free rates and acceptable complication rates. However, the limitations of our study are lack of hospital stay and cost-effectiveness data. Also, studies conducted on larger populations should support our findings. When a less invasive method is the only choice, SWL and flexible ureterorenoscopy methods have similar success rates. RIRS, however, has a lower complication rate than the other approaches. PMID:24282455

  6. Acute pancreatitis and development of pancreatic pseudo cyst after extra corporeal shock wave lithotripsy to a left renal calculus: A rare case with review of literature

    PubMed Central

    Mylarappa, Prasad; Javali, Tarun; Prathvi; Ramesh, D.

    2014-01-01

    Extracorporeal shock wave lithotripsy (SWL) is considered the standard of care for the treatment of small upper ureteric and renal calculi. A few centers have extended its use to the treatment of bile duct calculi and pancreatic calculi. The complication rates with SWL are low, resulting in its wide spread acceptance and usage. However, some of the serious complications reported in 1% of patients include acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, rupture of aortic aneurysm and intracranial hemorrhage. To our knowledge, only six cases of acute pancreatitis or necrotizing pancreatitis following SWL have been documented in the literature. Herein, we report a rare case of acute pancreatitis and formation of a pseudo cyst following SWL for left renal pelvic calculus. PMID:24497695

  7. Innovations in Lithotripsy Technology

    NASA Astrophysics Data System (ADS)

    Zhong, Pei

    2007-04-01

    The introduction of shock wave lithotripsy (SWL) in the early 1980's revolutionized the surgical management for kidney stone disease. Since then, although numerous 2nd- and 3rd-generation lithotripters have been developed using various means for shock wave generation, focusing, patient coupling and stone localization, the technical improvements in these devices were largely made based on practical concerns for user convenience and multifunctionality of the system rather than a clear understanding of the working principles of SWL. In this paper, the fundamental mechanisms of stone comminution and tissue injury in SWL revealed by basic studies in the past two decades are first reviewed. This is followed by a summary of the innovations in SWL technology developed in recent years that have been demonstrated to provide improved stone comminution with concomitantly reduced tissue injury both in vitro using phantom systems and in vivo in animal models. Furthermore, the role of treatment strategy in determining the overall outcome of clinical lithotripsy is emphasized, and future prospects for lithotripsy research and technological innovations are discussed.

  8. The Effect of Terpene Combination on Ureter Calculus Expulsion After Extracorporeal Shock Wave Lithotripsy

    PubMed Central

    Kim, Dai Hee; Goh, Hyeok Jun; Lee, Ho Won; Kim, Kyu Shik; Kim, Yong Tae; Moon, Hong Sang; Lee, Seung Wook

    2014-01-01

    Purpose Terpene combination (Rowatinex) is known to help with the expulsion of urinary stones. The aim of this study was to determine how Rowatinex affects the expulsion of remnant stones after shock wave lithotripsy (SWL). Materials and Methods Clinical data were collected retrospectively from 499 patients with a diagnosis of ureteral stones who underwent SWL from January 2009 to August 2012. Ureteral stones were diagnosed in all patients by kidney, ureter, and bladder x-ray and abdominal computed tomography (CT). The progress of patients was documented every 2 weeks to confirm remnant stones after SWL. The patients with remnant stones underwent SWL again. Group 1 consisted of patients who were prescribed an analgesic, Tamsulosin 0.2 mg, and Rowatinex. Group 2 consisted of patients who were prescribed only an analgesic and Tamsulosin 0.2 mg. The expulsion rate of urinary stones was compared between groups. Results The expulsion rate of urinary stones was not significantly different between the two groups after 2 weeks. However, after 4 weeks, group 1 had a significantly higher expulsion rate (72.2% compared with 61.1%, p=0.022). Fifteen patients (10.2%) in group 1 and 40 (11.4%) in group 2 had to undergo ureteroscopic removal of the stone (p=0.756). Acute pyelonephritis occurred in one patient (0.7%) in group 1 and in one patient (0.3%) in group 2 (p=0.503). Conclusions The long-term administration of Rowatinex for 4 weeks increased the expulsion rate of urinary stones after SWL. PMID:24466395

  9. Shock Wave Lithotripsy: Effects on the Pancreas and Recurrent Stone Disease

    NASA Astrophysics Data System (ADS)

    Krambeck, Amy E.; Rohlinger, Audrey L.; Lohse, Christine M.; Patterson, David E.; Gettman, Matthew T.

    2007-04-01

    Long-term effects of shockwave lithotripsy (SWL) are unknown; however, we recently found an association between SWL and diabetes mellitus in a population based case control cohort. To further study the association between SWL and diabetes mellitus, we determined the immediate impact of SWL on the pancreas as well as the long-term natural history of stone disease following treatment. Chart review identified 630 patients treated with SWL at our institution in 1985. Questionnaires focusing on recurrent stone episodes after SWL were sent to 578 patients alive in 2004. To further assess impact of SWL on the pancreas, pancreatic enzyme measurements were performed on 24 symptomatic stone patients treated in 2006 with ureteroscopy (n=12) and SWL (n=12). Serum amylase and lipase were evaluated pre and post SWL. A⩾5 U/L increase in either lab value was considered significant. Among patients in the long-term SWL treatment group, the questionnaire response rate was 58.9% (288/489). Recurrent stone events were noted in 154 (53.5%) of the survey respondents. Characteristics associated with stone recurrences were: gender (p=0.004), age at SWL (p=0.022), BMI (p=0.007), SWL complications (p=0.009), and lower pole SWL (p=0.025). Recurrent stone disease was also associated with the development of diabetes mellitus (p=0.020). In the contemporary group of treated stone patients, pancreatic enzyme analysis demonstrated an increase in serum amylase and lipase in 3 (25.0%) SWL patients and 1 (8.3%) ureteroscopy patient (p=0.273). In conclusion, over half of the patients treated with SWL will develop recurrent stone events. We found a strong association between recurrent stone disease and the development of diabetes mellitus at long-term follow-up. Although not statistically significant due to small number, data in a contemporary treatment cohort suggest the possibility that the pancreas can be adversely affected by SWL.

  10. New-onset diabetes mellitus after shock wave lithotripsy for urinary stone: a systematic review and meta-analysis.

    PubMed

    Deng, Tuo; Liao, Banghua; Tian, Ye; Luo, Deyi; Liu, Jiaming; Jin, Tao; Wang, Kunjie

    2015-06-01

    The purpose of the study was to evaluate the association between shock wave lithotripsy (SWL) for urinary stone and new-onset diabetes mellitus (DM). A comprehensive data collection was performed in the Pubmed database, Embase database, Chinese Biomedical database, Chinese National Knowledge Infrastructure database and VIP database. Difference in incidence of new-onset DM after SWL between cases and controls was evaluated by odds ratio (OR) with its 95% confidence interval (CI). And summary adjusted risk ratios (RRs) and 95% CIs were calculated to assess the strength of association between SWL and new-onset DM, and then subgroup analyses were conducted. Five studies were included in this meta-analysis. The incidence of new-onset DM after SWL is not higher than that in the population who do not receive SWL [OR = 1.59, 95% CI (0.92, 2.74), P = 0.10]. And statistical association between SWL and new-onset DM could not be found significantly [RR = 1.33, 95% CI (0.83, 2.13), P = 0.24], either. However, body mass index (BMI) [RR = 1.09, 95% CI (1.04, 1.14), P < 0.001] and family history of DM (FHx DM) [RR = 0.35, 95% CI (0.15, 0.80), P = 0.013] were found significantly associated with the development of DM in subgroup analyses. Our data suggests that there is no association between SWL for urinary stone and new-onset DM. PMID:25753541

  11. Are Hounsfield densities of ureteral stones a predictive factor for effectiveness of extracorporeal shock wave lithotripsy?

    PubMed Central

    Cakiroglu, Basri; Eyyupoglu, S Erkan; Tas, Tuncay; Balci, MB Can; Hazar, Ismet; Aksoy, S Hilmi; Sinanoglu, Orhun

    2014-01-01

    Extracorporeal Shock Wave Lithotripsy (SWL) has long been used successfully to dissolve ureteral stones. We researched whether Hounsfield values of ureteral stones is a factor that affects the success of SWL. Methods: Data from 144 patients who had diagnoses of ureteral stones and underwent SWL, were retrospectively reviewed between January 2011 and December 2012. Urinary tomography of patients was processed and classified into 3 groups by Hounsfield units (Group 1, < 500 HU; Group 2, 500-1000 HU; and Group 3, > 1000 HU) and 2 groups by stone size (Group A; < 1 cm, Group B; > 1 cm). SWL success was analyzed for both of these group types. Failure was defined as any fragments of the stone that remained within the ureter. Results were analyzed by evaluating the predictive factors in both groups. Results: The study included 144 patients (100 men, 44 women) who fit the inclusion criteria. In Hounsfield unit Group 1 (12 women and 44 men), the mean age was 37.2 ± 13.2, stone size was 8.5 ± 2.5 mm, number of shocks was 3240 ± 1414 (1200-7500) and number of treatments was 1.4 ± 0.6. In Group 2 (26 women and 32 men), the mean age was 33.6 ± 7.6, stone size was 9.6 ± 3.1 mm, process number was 3375 ± 2103 (1200-8750) and shock amount was 1.6 ± 0.8. In Group 3 (6 women and 24 men), the mean age was 42.2 ± 13.6, stone size was 11.7 ± 3.0 mm, number of shocks was 4513 ± 2458 (1300-8700) and number of treatments was 2.1 ± 1.2. In size Group 1 (28 women and 74 men), the mean age was 35.8 ± 10.6, stone size was 8.1 ± 1.4 mm, process number was 3105 ± 1604, shock amount was 1.4 ± 0.5 and HU value was 580 ± 297. In Group 2 (16 women and 26 men), the mean age was 39.9 ± 14.2, stone size was 13.9 ± 2.4 mm, number of shocks was 4722 ± 2467, number of treatments was 2.3 ± 1.1 and HU value was 912 ± 270. Conclusion: Although stone density predicted the failure of SWL, size of the stone is more important criterion for successful lithotripsy of ureteral stones. PMID:24995083

  12. Bubble Proliferation in Shock Wave Lithotripsy Occurs during Inertial Collapse

    NASA Astrophysics Data System (ADS)

    Pishchalnikov, Yuri A.; McAteer, James A.; Pishchalnikova, Irina V.; Williams, James C.; Bailey, Michael R.; Sapozhnikov, Oleg A.

    2008-06-01

    In shock wave lithotripsy (SWL), firing shock pulses at slow pulse repetition frequency (0.5 Hz) is more effective at breaking kidney stones than firing shock waves (SWs) at fast rate (2 Hz). Since at fast rate the number of cavitation bubbles increases, it appears that bubble proliferation reduces the efficiency of SWL. The goal of this work was to determine the basis for bubble proliferation when SWs are delivered at fast rate. Bubbles were studied using a high-speed camera (Imacon 200). Experiments were conducted in a test tank filled with nondegassed tap water at room temperature. Acoustic pulses were generated with an electromagnetic lithotripter (DoLi-50). In the focus of the lithotripter the pulses consisted of a ˜60 MPa positive-pressure spike followed by up to -8 MPa negative-pressure tail, all with a total duration of about 7 ?s. Nonlinear propagation steepened the shock front of the pulses to become sufficiently thin (˜0.03 ?m) to impose differential pressure across even microscopic bubbles. High-speed camera movies showed that the SWs forced preexisting microbubbles to collapse, jet, and break up into daughter bubbles, which then grew rapidly under the negative-pressure phase of the pulse, but later coalesced to re-form a single bubble. Subsequent bubble growth was followed by inertial collapse and, usually, rebound. Most, if not all, cavitation bubbles emitted micro-jets during their first inertial collapse and re-growth. After jetting, these rebounding bubbles could regain a spherical shape before undergoing a second inertial collapse. However, either upon this second inertial collapse, or sometimes upon the first inertial collapse, the rebounding bubble emerged from the collapse as a cloud of smaller bubbles rather than a single bubble. These daughter bubbles could continue to rebound and collapse for a few cycles, but did not coalesce. These observations show that the positive-pressure phase of SWs fragments preexisting bubbles but this initial fragmentation does not yield bubble proliferation, as the daughter bubbles coalesce to reform a single bubble. Instead, bubble proliferation is the product of the subsequent inertial collapses.

  13. Ureteroscopy in proximal ureteral stones after shock wave lithotripsy failure: Is it safe and efficient or dangerous?

    PubMed Central

    Kilinc, Muhammet Fatih; Doluoglu, Omer Gokhan; Karakan, Tolga; Dalkilic, Ayhan; Sonmez, Nurettin Cem; Aydogmus, Yasin; Resorlu, Berkan

    2015-01-01

    Introduction: We assessed the effectiveness of ureteroscopy (URS) in proximal ureteral stones performed after shock wave lithotripsy (SWL) failure, and determined outcomes in terms of success rate, complications, and operation time. Methods: We analyzed data of patients with previous unsuccessful SWL (Group I) and the ones that did not have SWL or URS before (Group II) for proximal ureteral stones between December 2007 and August 2014. Group I included 346 patients who underwent complementary URS and Group II 209 patients who underwent primary URS. Success rates, operation time and complications were compared between groups. Results: Success rates of complementary and primary URS were 78.9% and 80.9%, respectively. The difference in success rates was not statistically significant between groups (p = 0.57). The complication rates of complementary URS was 12.1%, and 9.5% in primary URS (p = 0.49). No statistically significant differences were noted in terms of gender, age, stone size and side, or lithotripter type between groups. The mean operation time and need for balloon dilatation were higher in complementary URS group compared to the primary URS group, and the difference was statistically significant (p < 0.05). Conclusions: Complementary URS may be used safely after SWL failure in proximal ureteral stones. Its success rate and morbidities are similar to primary URS, except for longer operation time and an increased need for balloon dilatation. PMID:26664506

  14. Lithotripsy

    MedlinePLUS

    ... pass through your body until they hit the kidney stones. If you are awake, You may feel a ... Lithotripsy is used to remove kidney stones that are causing: Bleeding ... Not all kidney stones can be removed using lithotripsy. ...

  15. Ordnance gelatine as an in vitro tissue simulation scaffold for extracorporeal shock wave lithotripsy.

    PubMed

    Mendez-Probst, C E; Vanjecek, M; Razvi, H; Cadieux, P A

    2010-12-01

    In vitro shock wave lithotripsy (SWL) research is typically performed utilizing wet coupling lithotriptors with a mesh basket model. This model does not take into account shock wave energy attenuation through tissue. Models using dry coupling lithotriptors rely on immersion chambers and face similar limitations. Ordnance gelatin (OG) displays strength and viscous properties similar to human tissue and is therefore widely used for ballistic tissue injury research. We present our initial experience using an OG tissue simulating scaffold for dry coupling SWL research. Using 10% OG prepared in a disc-shaped mold (five stone wells/gel), we tested the model using a Modulith SLX-F2 lithotriptor and artificial stone phantoms. Following a test of concept run on an empty gel mold and a material integrity check for leakage, we shocked 60 stones (30 narrow focus [NF], 30 wide focus [WF]) in human pooled urine. Half were shocked using gels containing open-ended wells with the remainder closed-ended wells. Fragmentation coefficients (FC) were calculated across both foci and gel models. All gels successfully completed 5,000 shocks (1,000/well) without loss of gel integrity or fluid leakage. The mean FC using open-ended wells was 77.9 ± 7.6% NF and 74.4 ± 4.8% WF, and for closed wells 75.9 ± 8.0% NF and 67.1 ± 3.5% WF. The total model cost including the preparation of gels and begostones was assessed at approximately $1 per stone (Canadian). Ordnance gel serves as an excellent surrogate tissue shockwave scaffold providing an easily manufactured, reproducible and inexpensive model for dry coupling SWL research. PMID:20967432

  16. Clinical Nomograms to Predict Stone-Free Rates after Shock-Wave Lithotripsy: Development and Internal-Validation

    PubMed Central

    Kim, Jung Kwon; Ha, Seung Beom; Jeon, Chan Hoo; Oh, Jong Jin; Cho, Sung Yong; Oh, Seung-June; Kim, Hyeon Hoe; Jeong, Chang Wook

    2016-01-01

    Purpose Shock-wave lithotripsy (SWL) is accepted as the first line treatment modality for uncomplicated upper urinary tract stones; however, validated prediction models with regards to stone-free rates (SFRs) are still needed. We aimed to develop nomograms predicting SFRs after the first and within the third session of SWL. Computed tomography (CT) information was also modeled for constructing nomograms. Materials and Methods From March 2006 to December 2013, 3028 patients were treated with SWL for ureter and renal stones at our three tertiary institutions. Four cohorts were constructed: Total-development, Total-validation, CT-development, and CT-validation cohorts. The nomograms were developed using multivariate logistic regression models with selected significant variables in a univariate logistic regression model. A C-index was used to assess the discrimination accuracy of nomograms and calibration plots were used to analyze the consistency of prediction. Results The SFR, after the first and within the third session, was 48.3% and 68.8%, respectively. Significant variables were sex, stone location, stone number, and maximal stone diameter in the Total-development cohort, and mean Hounsfield unit (HU) and grade of hydronephrosis (HN) were additional parameters in the CT-development cohort. The C-indices were 0.712 and 0.723 for after the first and within the third session of SWL in the Total-development cohort, and 0.755 and 0.756, in the CT-development cohort, respectively. The calibration plots showed good correspondences. Conclusions We constructed and validated nomograms to predict SFR after SWL. To the best of our knowledge, these are the first graphical nomograms to be modeled with CT information. These may be useful for patient counseling and treatment decision-making. PMID:26890006

  17. Perspective on Lithotripsy Adverse Effects

    NASA Astrophysics Data System (ADS)

    Knoll, Thomas; Wendt-Nordahl, Gunnar

    2008-09-01

    Shock wave lithotripsy (SWL) is an effective and without any doubt the least invasive procedure to treat upper urinary tract calculi. Acute complications are rarely reported and do not require specific treatment in most cases. However, one should be aware that energy levels sufficient for stone breakage are capable of damaging tissue as well, and significant hematoma—not only in the kidney but as well in surrounding organs—has been observed. Furthermore, only little is known about the long-term effects of SWL. Some authors have reported an increased incidence of hypertension and possibly also diabetes mellitus. Such chronic diseases—if indeed related to prior SWL—may be a late result of acute SWL-related trauma but the discussion on the underlying pathogenesis is controversial. Many factors have to be considered, such as the natural history of recurrent stone formers, technical principles of SWL, and differences in treatment protocols. Promising studies are currently underway to optimize stone breakage while limiting potential collateral damage. With this progress, SWL remains a safe treatment option for most urinary calculi.

  18. Extracorporeal shock wave lithotripsy: What is new?

    PubMed Central

    Bach, Christian; Karaolides, Theocharis; Buchholz, Noor

    2012-01-01

    Objectives Thirty years after its introduction, extracorporeal shockwave lithotripsy (ESWL) is still first-line treatment for more than half of all urinary tract stones, but machines and treatment strategies have significantly developed over time. In this review, we summarise the latest knowledge about the clinically important aspects of ESWL. Methods We searched PubMed to identify relevant reports and the latest European Association of Urology guidelines, and standard urological textbooks were consulted. Results New technical developments include: Twin-head and tandem-pulse shock-wave generators; wide-focus, low-pressure systems; optimised coupling; and automated location and acoustic tracking systems. Indications have been refined, making possible the identification of patients in whom ESWL treatment is likely to fail. By lowering the shock-wave rate, improving coupling, applying abdominal compression, power ‘ramping’ and postoperative medical expulsion therapy, treatment protocols have been optimised. Conclusions Promising new technical developments are under development, with the potential to increase the stone-free rate after ESWL. For optimal results, the refined indications need to be respected and optimised treatment protocols should be applied. PMID:26558039

  19. Drugs for Pain Management in Shock Wave Lithotripsy

    PubMed Central

    Bach, Christian; Zaman, Faruquz; Kachrilas, Stefanos; Kumar, Priyadarshi; Buchholz, Noor; Masood, Junaid

    2011-01-01

    Objective. With this review, we provide a comprehensive overview of the main aspects and currently used drugs for analgesia in shockwave lithotripsy. Evidence Acquisition. We reviewed current literature, concentrating on newer articles and high-quality reviews in international journals. Results. No standardized protocols for pain control in SWL exist, although it is crucial for treatment outcome. General and spinal anaesthesia show excellent pain control but are only recommended for selected cases. The newer opioids and nonsteroidal anti-inflammatory drugs are able to deliver good analgesia. Interest in inhalation anaesthesia with nitrous oxide, local anaesthesia with deep infiltration of the tissue, and dermal anaesthesia with EMLA or DMSO has recently rekindled, showing good results in terms of pain control and a favourable side effect profile. Tamsulosin and paracetamol are further well-known drugs being currently investigated. Conclusion. Apart from classically used drugs like opioids and NSARs, medicaments like nitrous oxide, paracetamol, DMSA, or refined administration techniques for infiltration anaesthesia show a good effectiveness in pain control for SWL. PMID:22135735

  20. Diuresis and inversion therapy to improve clearance of lower caliceal stones after shock wave lithotripsy: A prospective, randomized, controlled, clinical study

    PubMed Central

    Ahmed, Abul-fotouh; Shalaby, Essam; Maarouf, Aref; Badran, Yasser; Eladl, Mahmoud; Ghobish, Ammar

    2015-01-01

    Objective: To improve the clearance of lower caliceal stones (LCSs) after shock wave lithotripsy (SWL) using a combination of intra-operative forced diuresis and inversion therapy. Materials and Methods: One hundred and fifty-seven consecutive patients with symptomatic, single LCSs of 5–20 mm size were prospectively randomized into two groups. The first (study group, SG) underwent SWL at the time of the maximum diuresis with the patient in the Trendelenburg position with an angle of 30 degree, while the second group (control group, CG) underwent standard SWL. After the last SWL session, patients were followed-up regularly using plain abdominal X-ray and renal ultrasound. The primary endpoint of the study was the stone-free rate (SFR) at 12 weeks. Results: A total of 141 patients completed the study treatment protocol and follow-up: 69 patients in SG and 72 patients in CG. Both groups were comparable in baseline data. SG showed significantly higher SFR at all follow-up time points. At week 12, 78.3% of SG were rendered stone free, whereas only 61.1% were stone free in CG (P = 0.030). Also, there was a significantly higher SFR for larger stones (>10 mm) and stones with higher attenuation value (>500 Hounsfield units) in SG than CG. Mild non-significant complications were reported in both groups. Conclusion: SWL with intraoperative forced diuresis and inversion seems to be an effective measure with minimal extra cost to improve LCS clearance post-SWL. PMID:25878414

  1. Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments.

    PubMed

    Schnabel, M J; Gierth, M; Chaussy, C G; Dötzer, K; Burger, M; Fritsche, H M

    2014-06-01

    Shock wave lithotripsy (SWL) is the gold standard for the treatment of upper urinary tract stones. Despite being relatively non-invasive, SWL can cause renal hematoma (RHT). The aim of this study was to determine incidence and risk factors for RHT following SWL. 857 patients were included in a prospectively maintained database. The observation period spans from 2007 to 2012. 1,324 procedures were performed due to kidney stones. Treatment protocol included power ramping and shock wave frequency of 60-90 per minute as well as an ultrasound check within 3 days of SWL for all patients. Patients with RHT were analyzed, and treatment characteristics were compared with the complete population in a non-statistical manner due to the low event count. RHTs after SWL, sized between 2.6 × 0.6 cm and 17 × 15 cm, were verified in seven patients (0.53%). In four patients, the RHT was asymptomatic. Three patients developed pain after SWL treatment due to a RHT. In one patient surgical intervention was necessary due to a symptomatic RHT, the kidney was preserved. The risk of RHT following SWL treatment of kidney stones is about 0.5%. Clinically relevant or symptomatic RHTs occur in 0.23%, RHTs requiring surgical intervention are extremely rare. Older age and vascular comorbidities appear to be risk factors for the development of RHT. The technical characteristics of SWL treatment and intake of low-dose acetylsalicylic acid due to an imperative cardiologic indication do not appear to influence the risk. Prospective studies are warranted. PMID:24419328

  2. Optimization of pressure waveform, distribution and sequence in shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Zhou, Yufeng

    This work aims to improve shock wave lithotripsy (SWL) technology by increasing stone comminution efficiency while reducing simultaneously the propensity of tissue injury. First, the mechanism of vascular injury in SWL was investigated. Based on in vitro vessel phantom experiment and theoretical calculation, it was found that SWL-induced large intraluminal bubble expansion may constitute a primary mechanism for the rupture of capillaries and small blood vessels. However, when the large intraluminal bubble expansion is suppressed by inversion of the pressure waveform of the lithotripter shock wave (LSW), rupture of a 200-mum cellulose hollow fiber vessel phantom can be avoided. Based on these experimental observations and theoretical assessment of bubble dynamics using the Gilmore model an in situ pulse superposition technique was developed to reduce tissue injury without compromising stone comminution in SWL. A thin shell ellipsoidal reflector insert was fabricated to fit snugly with the original HM-3 reflector. Using the Hamilton model, the effects of reflector geometry on the pulse profile and sequence of the shock waves were evaluated qualitatively. Guided by this analysis, the design of the reflector insert had been refined to suppress the intraluminal bubble expansion, which was confirmed by high-speed imaging of bubble dynamics both in free field and inside a vessel phantom. The pulse pressure, beam size and stone comminution efficiency of the upgraded reflector were all found to be comparable to those of the original reflector. However, the greatest difference lies in the propensity for tissue injury. At the lithotripter focus, about 30 shocks are needed to cause a rupture of the vessel phantom using the original reflector, but no rupture can be produced after 200 shocks by the upgraded reflector. Overall, the upgraded reflector could significantly reduce the propensity of vessel rupture while maintaining satisfactory stone comminution. Second, to improve stone comminution in SWL a new piezoelectric annular array (PEAA) generator made of 1--3 piezocomposite material was fabricated and retrofitted on a clinical HM-3 lithotripter. The operation of the integrated lithotripter system can be controlled by an automatic program. The shock wave produced by the PEAA generator was used to intensify the collapse of LSW-induced bubbles near the target stone. In vitro experiments have shown that combining the upgraded reflector with the PEAA generator could produce better stone comminution efficiency after 1,500 shock (95.25%) than that produced by the original reflector (81.58%). In animal experiments, a BegoStone phantom was implanted into the renal pelvis of right porcine kidney from the urinary tract and exposed up to 2,000 shocks produced by different lithotripter configurations. Better stone comminution efficiencies can be achieved by using the upgraded reflector and the combined system (91.6% and 93.2%, respectively) than the original HM-3 reflector (87.6%). Meanwhile, the volume percentages of gross injury produced by the upgraded reflector and the combined system (0.92% and 0.71%, respectively) are found to be less than that of the original reflector (1.69%). All together, it has been shown both in vitro and in vivo that optimization of lithotripter pressure waveform, distribution, and sequence can improve stone comminution efficiency and reduce simultaneously the propensity of tissue injury.

  3. Does ureteral stenting matter for stone size? A retrospectıve analyses of 1361 extracorporeal shock wave lithotripsy patients

    PubMed Central

    Dogan, Cagatay; Can, Gulce Ecem; Tansu, Nejat; Erozencı, Ahmet; Onal, Bulent

    2015-01-01

    Introduction The aim of our study was to determine the efficacy of ureteral stents for extracorporeal shock wave lithotripsy (SWL) treatment of pelvis renalis stones and to compare the results and complications in stented and non-stented patients. Material and methods Between 1995 and 2011, 1361 patients with pelvis renalis stones were treated with SWL. Patients were subdivided into three groups according to stone burden: ≤1 cm2 (group 1; n = 514), 1.1 to 2 cm2 (group 2; n = 530) and >2 cm2 (group 3; n = 317). Each group was divided into subgroups of patients who did and did not undergo ureteral stent implantation before SWL treatment. The efficacy of treatment was evaluated by determining the effectiveness quotient (EQ). Statistical analysis was performed by chi-square, Fisher's exact and Mann-Whitney U tests. Results Of the 514, 530 and 317 patients in groups 1, 2 and 3 respectively, 30 (6%), 44 (8%) and 104 (33%) patients underwent auxiliary stent implantation. Steinstrasse rates did not differ significantly between stented and non-stented patients in each group. The EQ was calculated as 62%, 33% and 70% respectively in non-stented, stented and totally for group 1. This ratio calculated as 58%, 25% and 63% for group 2 and 62%, 26% and 47% for group 3. Stone-free rates were significantly higher for non-stented than for stented patients in groups 2 and 3. Conclusions Stone free rates are significantly higher in non-stented than in stented patients with pelvis renalis stones >1 cm2, whereas steinstrasse rates are not affected. PMID:26568882

  4. One hundred cases of anaesthesia for extracorporeal shock wave lithotripsy.

    PubMed Central

    Frank, M.; McAteer, E. J.; Cohen, D. G.; Blair, I. J.

    1985-01-01

    One hundred cases of anaesthesia for Extracorporeal Shock Wave Lithotripsy (ESWL) are described. Epidural or general anaesthesia was used. Anaesthetic complications were mainly cardiovascular, namely hypotension and bradycardia. With increased experience, it was noted that the use of minimal concentrations of general anaesthetic agents, or epidural anaesthesia supplemented with ephedrine, decreased the incidence of these problems. There was a low incidence of nausea or vomiting or analgesic requirements postoperatively, and the average length of stay in hospital postoperatively was 3 days. PMID:4073761

  5. The effects of extracorporeal shock wave lithotripsy on pacemaker function.

    PubMed

    Langberg, J; Abber, J; Thuroff, J W; Griffin, J C

    1987-09-01

    Twenty-two pacemaker pulse generators were exposed to shock waves of an extracorporeal shock wave lithotripter to assess the effects of the extremely high pressure transients on pacemaker function. The pulse generator and distal aspect of the lead were positioned 5 cm from the focal point of the lithotripter and 10 cm from each other. Pulse generator function was analyzed during shock wave delivery synchronized with pulse generator output, during shock waves at a rate faster than the escape rate, and after exposure to lithotripsy. During shock waves delivered synchronously with pulse generator output, only one of 22 pulse generators malfunctioned by intermittently reverting to the magnet rate. When subjected to shock waves at a rate greater than the escape rate, 50% of the pulse generators were inhibited by electromechanical interference from the lithotripter. Both bipolar and unipolar devices were affected. However, analysis after exposure to shock waves showed that none of the pacemakers was damaged or spuriously reprogrammed. In conclusion, cardiac pacemakers do not appear to be damaged or reprogrammed by exposure to extracorporeal shock wave lithotripsy. The likelihood of false inhibition appears to be very low if shock waves are delivered synchronously with the QRS. PMID:2444938

  6. Tracking kidney stones with sound during shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Kracht, Jonathan M.

    The prevalence of kidney stones has increased significantly over the past decades. One of the primary treatments for kidney stones is shock wave lithotripsy which focuses acoustic shock waves onto the stone in order to fragment it into pieces that are small enough to pass naturally. This typically requires a few thousand shock waves delivered at a rate of about 2 Hz. Although lithotripsy is the only non-invasive treatment option for kidney stories, both acute and chronic complications have been identified which could be reduced if fewer shock waves were used. One factor that could be used to reduce the number of shock waves is accounting for the motion of the stone which causes a portion of the delivered shock waves to miss the stone, yielding no therapeutic benefit. Therefore identifying when the stone is not in focus would allow tissue to be spared without affecting fragmentation. The goal of this thesis is to investigate acoustic methods to track the stone in real-time during lithotripsy in order to minimize poorly-targeted shock waves. A relatively small number of low frequency ultrasound transducers were used in pulse-echo mode and a novel optimization routine based on time-of-flight triangulation is used to determine stone location. It was shown that the accuracy of the localization may be estimated without knowing the true stone location. This method performed well in preliminary experiments but the inclusion of tissue-like aberrating layers reduced the accuracy of the localization. Therefore a hybrid imaging technique employing DORT (Decomposition of the Time Reversal Operator) and the MUSIC (Multiple Signal Classification) algorithm was developed. This method was able to localize kidney stories to within a few millimeters even in the presence of an aberrating layer. This would be sufficient accuracy for targeting lithotripter shock waves. The conclusion of this work is that tracking kidney stones with low frequency ultrasound should be effective clinically.

  7. FRAGMENTATION OF URINARY CALCULI IN VITRO BY BURST WAVE LITHOTRIPSY

    PubMed Central

    Maxwell, Adam D.; Cunitz, Bryan W.; Kreider, Wayne; Sapozhnikov, Oleg A.; Hsi, Ryan S.; Harper, Jonathan D.; Bailey, Michael R.; Sorensen, Mathew D.

    2015-01-01

    Purpose We have developed a new method of lithotripsy that uses short, broadly focused bursts of ultrasound rather than shock waves to fragment stones. This study investigated the characteristics of stone comminution by burst wave lithotripsy in vitro. Materials and Methods Artificial and natural stones (mean 8.2±3.0 mm, range 5–15 mm) were treated with ultrasound bursts using a focused transducer in a water bath. Stones were exposed to bursts with focal pressure amplitude ?6.5 MPa at 200 Hz burst repetition rate until completely fragmented. Ultrasound frequencies of 170 kHz, 285 kHz, and 800 kHz were applied using 3 different transducers. The time to achieve fragmentation for each stone type was recorded, and fragment size distribution was measured by sieving. Results Stones exposed to ultrasound bursts were fragmented at focal pressure amplitudes ?2.8 MPa at 170 kHz. Fractures appeared along the stone surface, resulting in fragments separating at the surface nearest to the transducer until the stone was disintegrated. All natural and artificial stones were fragmented at the highest focal pressure of 6.5 MPa with treatment durations between a mean of 36 seconds for uric acid to 14.7 minutes for cystine stones. At a frequency of 170 kHz, the largest artificial stone fragments were <4 mm. Exposures at 285 kHz produced only fragments <2 mm, and 800 kHz produced only fragments <1 mm. Conclusions Stone comminution with burst wave lithotripsy is feasible as a potential noninvasive treatment method for nephrolithiasis. Adjusting the fundamental ultrasound frequency allows control of stone fragment size. PMID:25111910

  8. Controlled Cavitation to Augment SWL Stone Comminution: Mechanistic Insights In-Vitro

    PubMed Central

    Duryea, Alexander P.; Roberts, William W.; Cain, Charles A.; Hall, Timothy L.

    2013-01-01

    Stone comminution in shock wave lithotripsy (SWL) has been documented to result from mechanical stresses conferred directly to the stone, as well as the activity of cavitational microbubbles. Studies have demonstrated that the presence of this cavitation activity is crucial for stone subdivision; however, its exact role in the comminution process remains somewhat weakly defined, in part due to the fact that it is difficult to isolate the cavitational component from the shock waves themselves. In this study, we further explored the importance of cavitation in SWL stone comminution through the use of histotripsy ultrasound therapy. Histotripsy was utilized to target model stones designed to mimic the mid-range tensile fracture strength of naturally occurring cystine calculi with controlled cavitation at strategic time points in the SWL comminution process. All SWL was applied at a peak-positive pressure (p+) of 34 MPa and a peak-negative pressure (p?) of 8 MPa; a shock rate of 1 Hz was used. Histotripsy pulses had a p? of 33 MPa and were applied at a pulse repetition frequency (PRF) of 100 Hz. Ten model stones were sonicated in-vitro with each of five different treatment schemes: A. 10 minutes SWL (600 shocks) with 0.7 seconds of histotripsy interleaved between successive shocks (totaling to 42,000 pulses); B. 10 minutes SWL (600 shocks) followed by 10 minutes histotripsy applied in 0.7 second bursts (1 burst per second, totaling to 42,000 pulses); C. 10 minutes histotripsy applied in 0.7 second bursts (42,000 pulses) followed by 10 minutes SWL (600 shocks); D. 10 minutes SWL-only (600 shocks); E. 10 minutes histotripsy-only applied in 0.7 second bursts (42,000 pulses). Following sonication, debris was collected and sieved through 8, 6, 4, and 2 mm filters. It was found that SWL-only generated a broad range of fragment sizes, with an average of 14.9 ± 24.1% of the original stone mass remaining >8 mm. Histotripsy-only eroded the surface of stones to tiny particulate debris that was small enough to pass through the finest filter used in this study (<2 mm), leaving behind a single primary stone piece (>8 mm) with mass 85.1 ± 1.6% of the original following truncated sonication. The combination of SWL and histotripsy (schemes A, B, and C) resulted in a shift in the size distribution toward smaller fragments and complete elimination of debris >8 mm. When histotripsy controlled cavitation was applied following SWL (B), the increase in exposed stone surface area afforded by shock wave stone subdivision led to enhanced cavitation erosion. When histotripsy controlled cavitation was applied prior to SWL (C), it is likely that stone surface defects induced by cavitation erosion provided sights for crack nucleation and accelerated shock wave stone subdivision. Both these effects are likely at play in the interleaved therapy (A), although shielding of shock waves by remnant histotripsy microbubble nuclei may have limited the efficacy of this scheme. Nevertheless, these results demonstrate the important role played by cavitation in the stone comminution process, and suggest that the application of controlled cavitation at strategic time points can provide an adjunct to traditional SWL therapy. PMID:23357904

  9. Adverse effects of shock waves and strategies for improved treatment in shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    McAteer, James A.; Evan, Andrew P.; Connors, Bret A.; Williams, James C.; Willis, Lynn R.

    2005-04-01

    Lithotripter SWs rupture blood vessels in the kidney. This acute trauma, accompanied by a fall in renal function, can lead to significant long-term effects such as profound scarring of the kidney cortex and renal papillaea permanent loss of functional renal mass. SWL has been linked to new-onset hypertension in some patients, and recent studies suggest that multiple lithotripsies can actually alter a patient's stone disease leading to formation of stones (brushite) that are harder to break. Cavitation and shear appear to play a role in stone breakage and tissue damage. Progress in understanding these mechanisms, and the renal response to SWs, has led to practical strategies to improve treatment. Slowing the SW-rate, or initiating treatment at low kV/power both improve stone breakage and reduce the number of potentially tissue-damaging SWs needed to achieve comminution. The observation that SWs cause transient vasoconstriction in the kidney has led to studies in pigs showing that a pre-conditioning dose of low-energy SWs significantly reduces trauma from subsequent high-energy SWs. Thus, SWs can induce adverse effects in the kidney, but what we have learned about the mechanisms of SW action suggests strategies that could make lithotripsy safer and more effective. [Work supported by NIH-DK43881, DK55674.

  10. Turbulent Water Coupling in Shock Wave Lithotripsy

    PubMed Central

    Lautz, Jaclyn; Sankin, Georgy; Zhong, Pei

    2013-01-01

    Previous studies have demonstrated that stone comminution decreases with increased pulse repetition frequency as a result of bubble proliferation in the cavitation field of a shock wave lithotripter (Pishchalnikov et al., 2011). If cavitation nuclei remain in the propagation path of successive lithotripter pulses, especially in the acoustic coupling cushion of the shock wave source, they will consume part of the incident wave energy, leading to reduced tensile pressure in the focal region and thus lower stone comminution efficiency. We introduce a method to remove cavitation nuclei from the coupling cushion between successive shock exposures using a jet of degassed water. As a result, pre-focal bubble nuclei lifetime quantified by B-mode ultrasound imaging was reduced from 7 s to 0.3 s by a jet with an exit velocity of 62 cm/s. Stone fragmentation (percent mass < 2 mm) after 250 shocks delivered at 1 Hz was enhanced from 22 ± 6% to 33 ± 5% (p = 0.007) in water without interposing tissue mimicking materials. Stone fragmentation after 500 shocks delivered at 2 Hz was increased from 18 ± 6% to 28 ± 8% (p = 0.04) with an interposing tissue phantom of 8 cm thick. These results demonstrate the critical influence of cavitation bubbles in the coupling cushion on stone comminution and suggest a potential strategy to improve the efficacy of contemporary shock wave lithotripters. PMID:23322027

  11. Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy

    PubMed Central

    Tekinarslan, Erdem; Keskin, Suat; Buldu, İbrahim; Sönmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa Okan

    2015-01-01

    Introduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible. PMID:26568880

  12. Turbulent water coupling in shock wave lithotripsy.

    PubMed

    Lautz, Jaclyn; Sankin, Georgy; Zhong, Pei

    2013-02-01

    Previous studies have demonstrated that stone comminution decreases with increased pulse repetition frequency as a result of bubble proliferation in the cavitation field of a shock wave lithotripter (Pishchalnikov et al 2011 J. Acoust. Soc. Am. 130 EL87-93). If cavitation nuclei remain in the propagation path of successive lithotripter pulses, especially in the acoustic coupling cushion of the shock wave source, they will consume part of the incident wave energy, leading to reduced tensile pressure in the focal region and thus lower stone comminution efficiency. We introduce a method to remove cavitation nuclei from the coupling cushion between successive shock exposures using a jet of degassed water. As a result, pre-focal bubble nuclei lifetime quantified by B-mode ultrasound imaging was reduced from 7 to 0.3 s by a jet with an exit velocity of 62 cm s(-1). Stone fragmentation (percent mass <2 mm) after 250 shocks delivered at 1 Hz was enhanced from 22 ± 6% to 33 ± 5% (p = 0.007) in water without interposing tissue mimicking materials. Stone fragmentation after 500 shocks delivered at 2 Hz was increased from 18 ± 6% to 28 ± 8% (p = 0.04) with an interposing tissue phantom of 8 cm thick. These results demonstrate the critical influence of cavitation bubbles in the coupling cushion on stone comminution and suggest a potential strategy to improve the efficacy of contemporary shock wave lithotripters. PMID:23322027

  13. Transient cavitation produced by extracorporeal shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Cioanta, Iulian

    1998-12-01

    Two decades ago, a new medical procedure was introduced, allowing the fragmentation of kidney stones from outside the human body (noninvasively) using a shock wave device termed lithotripter ('stone crusher'). Considered as one of the most important medical inventions of this century, lithotripsy is currently used in more than 80% of urolithiasis cases. Experimental studies have shown that transient or inertial cavitation is generated by this procedure near the stones and in renal tissue. To find a correlation between the number of shocks delivered and the treatment efficiency, the acoustic emission (AE) generated by the oscillation of cavitation bubbles, and its relation with stone fragmentation and tissue damage during shock wave lithotripsy were studied. In vitro experiments were carried out to identify the correlation between the AE signals and the expansion and collapse of cavitation bubbles, which were captured by high-speed photography (20,000 frames per second). This correlation has been verified on four different electrohydraulic lithotripters, under multiple experimental conditions. The effects of tissue attenuation on AE and stone fragmentation were also studied. The in vitro results have further allowed the interpretation of AE signals from in vivo experiments with pigs. Although similar in general trend, in vivo AE signals are found to be shorter in expansion and longer in the total ringing times (including the rebound phenomenon) than for in vitro AE signals, indicating a tissue constraining effect on bubble oscillation. Based on this observation a new mechanism for renal vascular and tubular injury is proposed. In addition, changes in AE signals have been observed as the total number of shocks increases, and this dose dependence feature has allowed the determination of a threshold value for extended tissue injury at 20 kV. This result has been confirmed by histological analysis and by results of a theoretical model study of bubble oscillation in a tissue mimicking membrane structure. To improve the efficiency of stone fragmentation and to reduce tissue injury, a new design for lithotripters shock wave reflector has been proposed and tested in vitro.

  14. Treatment of large proximal ureteral stones: extra corporeal shock wave lithotripsy versus semi-rigid ureteroscope with lithoclast

    PubMed Central

    2010-01-01

    Purpose Assessment of safety and efficacy of extracorporeal shockwave lithotripsy versus semi-rigid ureteroscope with lithoclast for treatment of large proximal ureteral stones. Materials and methods The study included 147 patients with large upper ureteral stones. SWL and ureteroscopy were performed in 71 and 76 patients respectively. Patients in the SWL group were treated with Siemens: - Modularis lithovario under intravenous sedation on an out patient basis. Patients in the ureteroscopy group were treated with (7.5 Fr) semi-rigid ureteroscope and lithoclast under spinal anesthesia on a day care basis. Results Stone - free rate for in situ SWL was 58% (41 of 71) patients. For semi-rigid ureteroscope accessibility of the stones was 94% (72 of 76) and the stone free rate was 92% (70 of 76) No major complications were encountered in both groups. Mean stone size was 1.34 ± 0.03 cm in the SWL group and 1.51 ± 0.04 in the ureteroscopy group. Conclusions Our study demonstrates that ureteroscopy with lithoclast can be considered as acceptable treatment modality for large proximal ureteral calculi and can be considered as fist line for treatment of large proximal ureteral stones. PMID:20181036

  15. Ureteral stenting with extracorporeal shock-wave lithotripsy.

    PubMed

    Cass, A S

    1992-05-01

    We reviewed the results of ureteral stent use with extracorporeal shock-wave lithotripsy (ESWL) in 3,096 patients with renal calculi less than 3 cm in diameter. The 2,595 patients with indwelling ureteral stents required lower total power (shocks x voltage) and less radiation and had a lower secondary procedure rate but a higher retreatment rate than the 501 patients without stents. However, the only statistically significant difference was in the average radiation dose in patients with or without stents and single stones no larger than 10 mm (16 vs. 18 rad). The hospital stay was one day or less in 98 percent of the patients in both groups. With an 80 percent follow-up rate at three months indwelling ureteral stents were associated with a higher stone-free rate in patients with a single stone but a lower stone-free rate in patients with multiple stones, compared with those treated without a stent. An indwelling ureteral stent may result in urinary frequency and bladder discomfort in some patients, and with no statistical difference in the results with or without a ureteral stent it is questionable whether or not the high use of an indwelling ureteral stent is justified in patients admitted for one day or less. PMID:1580036

  16. Impact of Colic Pain as a Significant Factor for Predicting the Stone Free Rate of One-Session Shock Wave Lithotripsy for Treating Ureter Stones: A Bayesian Logistic Regression Model Analysis

    PubMed Central

    Chung, Doo Yong; Cho, Kang Su; Lee, Dae Hun; Han, Jang Hee; Kang, Dong Hyuk; Jung, Hae Do; Kown, Jong Kyou; Ham, Won Sik; Choi, Young Deuk; Lee, Joo Yong

    2015-01-01

    Purpose This study was conducted to evaluate colic pain as a prognostic pretreatment factor that can influence ureter stone clearance and to estimate the probability of stone-free status in shock wave lithotripsy (SWL) patients with a ureter stone. Materials and Methods We retrospectively reviewed the medical records of 1,418 patients who underwent their first SWL between 2005 and 2013. Among these patients, 551 had a ureter stone measuring 4–20 mm and were thus eligible for our analyses. The colic pain as the chief complaint was defined as either subjective flank pain during history taking and physical examination. Propensity-scores for established for colic pain was calculated for each patient using multivariate logistic regression based upon the following covariates: age, maximal stone length (MSL), and mean stone density (MSD). Each factor was evaluated as predictor for stone-free status by Bayesian and non-Bayesian logistic regression model. Results After propensity-score matching, 217 patients were extracted in each group from the total patient cohort. There were no statistical differences in variables used in propensity- score matching. One-session success and stone-free rate were also higher in the painful group (73.7% and 71.0%, respectively) than in the painless group (63.6% and 60.4%, respectively). In multivariate non-Bayesian and Bayesian logistic regression models, a painful stone, shorter MSL, and lower MSD were significant factors for one-session stone-free status in patients who underwent SWL. Conclusions Colic pain in patients with ureter calculi was one of the significant predicting factors including MSL and MSD for one-session stone-free status of SWL. PMID:25902059

  17. Fluoroscopically guided laser lithotripsy versus extracorporeal shock wave lithotripsy for retained bile duct stones: a prospective randomised study.

    PubMed Central

    Jakobs, R; Adamek, H E; Maier, M; Krömer, M; Benz, C; Martin, W R; Riemann, J F

    1997-01-01

    BACKGROUND AND AIMS: To compare extracorporeal shock wave lithotripsy (ESWL) and laser induced shock wave lithotripsy (LISL) of retained bile duct stones to stone free rate, number of therapeutic sessions, and costs. PATIENTS: Thirty four patients were randomly assigned to either ESWL or LISL therapy. The main reasons for failure of standard endoscopy were due to stone impaction (n = 12), biliary stricture (n = 8), or large stone diameter (n = 14). METHODS: An extracorporeal piezoelectic lithotripter with ultrasonic guidance and a rhodamine 6G laser with an integrated stone tissue detection system were used. LISL was performed exclusively under radiological control. RESULTS: Using the initial methods complete stone fragmentation was achieved in nine of 17 patients (52.4%) of the ESWL group and in 14 of 17 patients (82.4%) in the LISL group, or combined with additional fragmentation techniques 31 of the 34 patients (91.2%) were stone free at the end of treatment. In comparison LISL tended to be more efficient in clearing the bile ducts (p = 0.07, NS). Significantly less fragmentation sessions (1.29 v 2.82; p = 0.0001) and less additional endoscopic sessions (0.65 v 1.6; p = 0.002) were necessary in the LISL group. There were no major complications in either procedure. CONCLUSIONS: Compared with ESWL, fluoroscopically guided LISL achieves stone disintegration more rapidly and with significantly less treatment sessions, which leads to a significant reduction in cost. PMID:9203950

  18. Modeling elastic wave propagation in kidney stones with application to shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Cleveland, Robin O.; Sapozhnikov, Oleg A.

    2005-10-01

    A time-domain finite-difference solution to the equations of linear elasticity was used to model the propagation of lithotripsy waves in kidney stones. The model was used to determine the loading on the stone (principal stresses and strains and maximum shear stresses and strains) due to the impact of lithotripsy shock waves. The simulations show that the peak loading induced in kidney stones is generated by constructive interference from shear waves launched from the outer edge of the stone with other waves in the stone. Notably the shear wave induced loads were significantly larger than the loads generated by the classic Hopkinson or spall effect. For simulations where the diameter of the focal spot of the lithotripter was smaller than that of the stone the loading decreased by more than 50%. The constructive interference was also sensitive to shock rise time and it was found that the peak tensile stress reduced by 30% as rise time increased from 25 to 150 ns. These results demonstrate that shear waves likely play a critical role in stone comminution and that lithotripters with large focal widths and short rise times should be effective at generating high stresses inside kidney stones.

  19. Modeling elastic wave propagation in kidney stones with application to shock wave lithotripsy.

    PubMed

    Cleveland, Robin O; Sapozhnikov, Oleg A

    2005-10-01

    A time-domain finite-difference solution to the equations of linear elasticity was used to model the propagation of lithotripsy waves in kidney stones. The model was used to determine the loading on the stone (principal stresses and strains and maximum shear stresses and strains) due to the impact of lithotripsy shock waves. The simulations show that the peak loading induced in kidney stones is generated by constructive interference from shear waves launched from the outer edge of the stone with other waves in the stone. Notably the shear wave induced loads were significantly larger than the loads generated by the classic Hopkinson or spall effect. For simulations where the diameter of the focal spot of the lithotripter was smaller than that of the stone the loading decreased by more than 50%. The constructive interference was also sensitive to shock rise time and it was found that the peak tensile stress reduced by 30% as rise time increased from 25 to 150 ns. These results demonstrate that shear waves likely play a critical role in stone comminution and that lithotripters with large focal widths and short rise times should be effective at generating high stresses inside kidney stones. PMID:16266186

  20. Dynamics of bubble oscillation in constrained media and mechanisms of vessel rupture in SWL.

    PubMed

    Zhong, P; Zhou, Y; Zhu, S

    2001-01-01

    Rupture of small blood vessels is a primary feature of the vascular injury associated with shock-wave lithotripsy (SWL) and cavitation has been implicated as a potential mechanism. To understand more precisely the underlying mechanical cause of the injury, the dynamics of SWL-induced bubble dynamics in constrained media were investigated. Silicone tubing and regenerated cellulose hollow fibers of various inner diameters (0.2 to 1.5 mm) were used to fabricate vessel phantoms, which were placed in a test chamber filled with castor oil so that cavitation outside the phantom could be suppressed. Degassed water seeded with 0.2% Albunex contrast agent was circulated inside the vessel phantom, and intraluminal bubble dynamics during SWL were examined by high-speed shadowgraph imaging and passive cavitation detection via a 20-MHz focused transducer. It was observed that, in contrast to the typical large and prolonged expansion and violent inertial collapse of SWL-induced bubbles in a free field, the expansion of the bubbles inside the vessel phantom was significantly constrained, leading to asymmetric elongation of the bubbles along the vessel axis and, presumably, much weakened collapse. The severity of the constraint is vessel-size dependent, and increases dramatically when the inner diameter of the vessel becomes smaller than 300 microm. Conversely, the rapid, large intraluminal expansion of the bubbles causes a significant dilation of the vessel wall, leading to consistent rupture of the hollow fibers (i.d. = 200 microm) after less than 20 pulses of shock wave exposure in a XL-1 lithotripter. The rupture is dose-dependent, and varies with the spatial location of the vessel phantom in the lithotripter field. Further, when the large intraluminal bubble expansion was suppressed by inversion of the lithotripter pressure waveform, rupture of the hollow fiber could be avoided even after 100 shocks. Theoretical calculation of SWL-induced bubble dynamics in blood confirms that the propensity of vascular injury due to intraluminal bubble expansion increases with the tensile pressure of the lithotripter shock wave, and with the reduction of the inner diameter of the vessel. It is suggested that selective truncation of the tensile pressure of the shock wave may reduce tissue injury without compromising the fragmentation capability of the lithotripter pulse. PMID:11295278

  1. Extracorporeal shock wave lithotripsy of gallstones in different biles and water in vitro.

    PubMed

    Nitsche, R; Amelsberg, A; Berg, T; Fölsch, U R

    1994-01-01

    Twenty-four gallstones were fragmented by extracorporeal shock wave lithotripsy (ESWL) to compare the influence of three different biles (bovine bile, human bile, synthetic bile) and water on the rapidity of fragmentation. Four groups of comparable stones were used for lithotripsy in vitro. The stones were collected from 6 patients, four nearly identical 'sister' stones from each patient. The number of shock waves required for adequate fragmentation (fragments < or = 4 mm) was measured for comparison. Overall highly significant differences were found for the four different 'biles' with regard to the number of shock waves required for adequate fragmentation. Using synthetic bile, which was artificially composed according to a textbook on hepatology, significantly more shock waves were necessary for fragmentation compared to the use of water, bovine bile or human bile. On the other hand, no significant difference between water and human bile could be registered. We conclude that the number of shock waves required for adequate lithotripsy is influenced by the composition of bile in which the stone is fragmented. Possibly results of ESWL can be improved by manipulation of the bile. PMID:8174831

  2. Acoustic Bubble Removal to Enhance SWL Efficacy at High Shock Rate: An In Vitro Study

    PubMed Central

    Roberts, William W.; Cain, Charles A.; Tamaddoni, Hedieh A.; Hall, Timothy L.

    2014-01-01

    Abstract Rate-dependent efficacy has been extensively documented in shock wave lithotripsy (SWL) stone comminution, with shock waves (SWs) delivered at a low rate producing more efficient fragmentation in comparison to those delivered at high rates. Cavitation is postulated to be the primary source underlying this rate phenomenon. Residual bubble nuclei that persist along the axis of SW propagation can drastically attenuate the waveform's negative phase, decreasing the energy which is ultimately delivered to the stone and compromising comminution. The effect is more pronounced at high rates, as residual nuclei have less time to passively dissolve between successive shocks. In this study, we investigate a means of actively removing such nuclei from the field using a low-amplitude acoustic pulse designed to stimulate their aggregation and subsequent coalescence. To test the efficacy of this bubble removal scheme, model kidney stones were treated in vitro using a research electrohydraulic lithotripter. SWL was applied at rates of 120, 60, or 30?SW/min with or without the incorporation of bubble removal pulses. Optical images displaying the extent of cavitation in the vicinity of the stone were also collected for each treatment. Results show that bubble removal pulses drastically enhance the efficacy of stone comminution at the higher rates tested (120 and 60?SW/min), while optical images show a corresponding reduction in bubble excitation along the SW axis when bubble removal pulses are incorporated. At the lower rate of 30?SW/min, no difference in stone comminution or bubble excitation was detected with the addition of bubble removal pulses, suggesting that remnant nuclei had sufficient time for more complete dissolution. These results corroborate previous work regarding the role of cavitation in rate-dependent SWL efficacy, and suggest that the effect can be mitigated via appropriate control of the cavitation environment surrounding the stone. PMID:23957846

  3. The effect of renal cortical thickness on the treatment outcomes of kidney stones treated with shockwave lithotripsy

    PubMed Central

    Luke, Sylvia; Chiu, Peter K.F.; Teoh, Jeremy Y.C.; Wong, Ka-Tak; Hou, Simon S.M.

    2015-01-01

    Purpose Because the shock wave passes through various body tissues before reaching the stone, stone composition may affect the treatment efficacy of shock wave lithotripsy (SWL). We investigated the effect of various tissue components along the shock wave path on the success of SWL. Materials and Methods From October 2008 to August 2010, a total of 206 patients with kidney stones sized 5 to 20 mm were prospectively recruited for a study of the factors that affect the outcome of treatment with a Sonolith Vision lithotripter. Successful SWL was defined as either stone-free status or residual fragments <4 mm at 12 weeks. Logistic regression analysis was performed to assess the factors that predicted treatment outcomes. Potential predictors included the patient's age, shock wave delivery rate, stone volume (SV), mean stone density (MSD), skin-to-stone distance (SSD), and the mean thickness of the three main components along the shock wave path: renal cortical thickness (KT), muscle thickness (MT), and soft-tissue thickness (ST). Results The mean age of the patients was 53.8 years (range, 25-82 years). The overall treatment success rate after one session of SWL was 43.2%. The mean KT, MT, and ST were 26.9, 16.6, and 40.8 mm, respectively. The logistic regression results showed that a slower shock wave delivery rate, smaller SV, a lower MSD, and a thicker KT were found to be significant predictors for successful SWL. SSD, MT, and ST were not predictors of successful treatment. Conclusions Among the main tissue components along the shock wave path, a thicker KT was a favorable factor for successful SWL after adjustment for SV, MSD, and the shock wave delivery rate. PMID:25964839

  4. Blood pressure changes after extracorporeal shock wave lithotripsy in normotensive patients.

    PubMed

    Claro, J de A; Lima, M L; Ferreira, U; Rodrigues Netto, N

    1993-12-01

    To evaluate the blood pressure changes caused by extracorporeal shock wave lithotripsy 102 patients 5 to 81 years old (mean age 40 years) with normal blood pressure and kidney lithiasis were monitored during a mean period of 22 months. There were 61 male (group 1) and 41 female (group 2) patients. Patients were evaluated by measurement of the diastolic pressure and the average arterial pressure before and after lithotripsy. Hypertension was considered when the diastolic pressure was greater than 90 mm. Hg for 2 weeks. The amount of shock waves applied in each case ranged from 1,250 to 6,000, with a mean of 4,000 shock waves at a median intensity of 18.1 kv. The incidence of hypertension after extracorporeal shock wave lithotripsy was 3.92%, which is similar to that of a normal population, although the diastolic pressure was statistically higher after treatment in both groups. In the male patients the diastolic pressure increased from 79.26 (+/- 9.7) to 81.47 (+/- 10.1) mm. Hg and in female patients it ranged from 76.58 (+/- 8.3) to 79.26 (+/- 9.9) mm. Hg. Similarly, the average arterial pressure was equally higher in the female group, ranging from 89.88 to 91.75 mm. Hg. In the male group the difference was not statistically significant, despite an increase from 94.5 to 95.8 mm. Hg. PMID:8230498

  5. New Devices and Old Pitfalls in Shock Wave Therapy

    NASA Astrophysics Data System (ADS)

    Bailey, Michael R.; Matula, Thomas J.; Sapozhnikov, Oleg A.; Cleveland, Robin O.; Pishchalnikov, Yuri A.; McAteer, James A.

    2006-05-01

    Shock waves are now used to treat a variety of musculoskeletal indications and the worldwide demand for shock wave therapy (SWT) is growing rapidly. It is a concern that very little is known about the mechanisms of action of shock waves in SWT. The technology for SWT devices is little changed from that of shock wave lithotripters developed for the treatment of urinary stones. SWT devices are engineered on the same acoustics principles as lithotripters, but the targets of therapy for SWT and shock wave lithotripsy (SWL) are altogether different. For SWT to achieve its potential as a beneficial treatment modality it will be necessary to determine precisely how SWT shock waves interact with biological targets. In addition, for SWT to evolve, the future design of these devices should be approached with caution, and lithotripsy may serve as a useful model. Indeed, there is a great deal to be learned from the basic research that has guided the development of SWL.

  6. Extracorporeal shock wave lithotripsy: our experimental and clinical experience with the Direx machine.

    PubMed

    Servadio, C; Livne, P M; Simon, D

    1990-07-01

    The Direx Tripter X-1 is a modular extracorporeal shock wave system that uses underwater spark gaps as its source for lithotripsy. Experience with 712 treatments in 541 patients has given a fragmentation rate of 99%. Of these patients, 27% had stones larger than 2 cm or multiple stones. A stone free situation at 3 months follow-up was achieved in 75% of the cases. Seventeen percent had small fragments less than 4 mm and 8% had fragments greater than 4 mm. Auxiliary procedures following ESWL were required in 7%. No major complications were seen. The advantages of this system are: modularity, mobility, flexibility, and low cost. PMID:10148920

  7. More efficient focusing for extracorporeal shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Loske, Achim M.; Prieto, Fernando E.

    2001-10-01

    The purpose of this study was to generate alternative pressure waveforms in order to increase efficiency during non-invasive treatments of nephrolithiasis. Two new systems for electrohydraulic shock wave generators were tested. These devices generate two pressure pulses, instead of only one positive peak, followed by a trough, as in conventional systems. Pressure measurements and stone fragmentation efficiency were compared to that of conventional shock wave generators, using needle hydrophones and kidney-stone models.

  8. Effect of alkalinization on calcium oxalate monohydrate calculi during extracorporeal shock wave lithotripsy: in vivo experiments.

    PubMed

    Vandeursen, H; De Ridder, D; Demeulenaere, R; Pittomvils, G; Boving, R; Baert, L

    1992-01-01

    Previous in vitro experiments demonstrated the reduced microhardness of calcium oxalate monohydrate (COM) calculi, relative to dry values, when saturated with an alkaline solution (pH = 9.5). Nineteen patients with a COM calculus in the distal ureter which had been resistant to prior extracorporeal shock wave lithotripsy in situ, were treated when the stone was surrounded by alkaline urine. The urine of 14 patients was alkalinized orally by administration of acetazolamine and citrate solution; in 5 other patients direct percutaneous irrigation of sodium bicarbonate via a nephrostomy tube was carried out. The urinary pH just before lithotripsy was greater than or equal to 9 in 17/19 patients. 4,000 shock waves, averaging 18.1 kV generated by the Siemens Lithostar, were delivered onto the calculus. No significant increase of comminution rate was apparent at radiographic control immediately after the treatment and only in half of the cases was evacuation obtained within 3 months. PMID:1316663

  9. Laser-induced shock-wave lithotripsy of canine urocystoliths and nephroliths

    NASA Astrophysics Data System (ADS)

    Woods, J. P.; Bartels, Kenneth E.; Stair, Ernest L.; Schafer, Steven A.; Nordquist, Robert E.

    1997-05-01

    Urolithiasis is a common disease affecting dogs which can sometimes be treated with dietary and medical protocols. In many cases, however, medical management cannot be employed because the dietary restrictions are contraindicated, effective medical dissolution protocols for the calculi (uroliths) do not exist, or obstruction by the calculi may result in deterioration of renal function during the time required for medical dissolution. At present, the management of medically untreatable calculi has been surgical removal which may result in temporary but dramatic decrease in renal function, irreversible loss of damaged nephrons, and significant risk, particularly for bilateral or recurrent nephroliths. An innovative technique for the removal of these uroliths would involve laser lithotripsy which transforms light energy into acoustical energy generating a shock wave sufficient to fragment stones (photoacoustic ablation). The laser is transmitted via quartz fibers which are small and flexible and can be used under direct vision through endoscopes resulting in effective fragmentation with little surrounding tissue damage. Lasers are becoming increasingly more utilized in veterinary medicine, in contrast to the limited availability of other non-invasive methods of treatment of nephroliths (i.e. extracorporeal shock-wave lithotripsy).

  10. Scrotal hematoma resulting from extracorporeal shock wave lithotripsy for a renal calculus: a sign of retroperitoneal hemorrhage

    PubMed Central

    Katz, Darren J.; Dodds, Lachlan J.

    2011-01-01

    We report a rare case of a patient presenting with scrotal hematoma associated with retroperitoneal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). We propose a mechanism for the formation of scrotal hematoma and its importance as a sign of retroperitoneal hemorrhage. PMID:24578909

  11. Stone Comminution Correlates with the Average Peak Pressure Incident on a Stone during Shock Wave Lithotripsy

    PubMed Central

    Smith, N.; Zhong, P.

    2012-01-01

    To investigate the roles of lithotripter shock wave (LSW) parameters and cavitation in stone comminution, a series of in vitro fragmentation experiments have been conducted in water and 1,3-butanediol (a cavitation-suppressive fluid) at a variety of acoustic field positions of an electromagnetic shock wave lithotripter. Using field mapping data and integrated parameters averaged over a circular stone holder area (Rh = 7 mm), close logarithmic correlations between the average peak pressure (P+(avg)) incident on the stone (D = 10 mm BegoStone) and comminution efficiency after 500 and 1,000 shocks have been identified. Moreover, the correlations have demonstrated distinctive thresholds in P+(avg) (5.3 MPa and 7.6 MPa for soft and hard stones, respectively), that are required to initiate stone fragmentation independent of surrounding fluid medium and LSW dose. These observations, should they be confirmed using other shock wave lithotripters, may provide an important field parameter (i.e., P+(avg)) to guide appropriate application of SWL in clinics, and facilitate device comparison and design improvements in future lithotripters. PMID:22935690

  12. The adoption and use of extracorporeal shock wave lithotripsy by hospitals in the United States.

    PubMed

    Power, E J

    1987-01-01

    Extracorporeal shock wave lithotripsy (ESWL) for upper urinary stones has been in use in the United States since 1984. It was accepted immediately by hospitals and physicians, and its diffusion has been and continues to be rapid. Government payment and planning policies do not seem to have slowed this diffusion, although they have had some effect on the ownership of lithotripters and the manner in which ESWL is provided. An unintended but foreseeable result of ESWL's popularity with hospitals, physicians, and patients is that ESWL is not only rapidly replacing traditional surgery but is being used on many patients who would not have had surgery. It is likely that many more upper urinary stones are being treated aggressively now than before ESWL was introduced. PMID:10285325

  13. Extracorporeal shock wave lithotripsy: the first 50 patients treated in Britain.

    PubMed Central

    Wickham, J E; Webb, D R; Payne, S R; Kellet, M J; Watkinson, G; Whitfield, H N

    1985-01-01

    Fifty patients have been treated for upper tract urinary calculi by extracorporeal shock wave lithotripsy (ESWL) at the Devonshire Hospital lithotripter centre since November 1984. The average stay for an inpatient was 3 X 7 days. All patients suffered minimal postoperative discomfort and nearly all resumed normal activity within one day after discharge. Complications requiring auxiliary procedures were few. The procedure was found to be safe, cost effective, extremely well received by patients, and superior to all other methods of removing renal stones. This study confirms that treatment by ESWL is a specialised urological procedure that requires operators who are also trained in open, percutaneous, and ureteroscopic surgery and with a back up of a radiological team skilled in percutaneous renal puncture. Images FIG 1 FIG 2 PMID:3921147

  14. A case of hyperreninemic hypertension after extracorporeal shock-wave lithotripsy.

    PubMed

    Sasaguri, M; Noda, K; Matsumoto, T; Shirai, K; Tsuji, E; Tsuji, Y; Arakawa, K

    2000-11-01

    A 53-year-old male was found to have hypertension caused by the significant secretion of renin from an atrophic left kidney. He had undergone extracorporeal shock-wave lithotripsy (ESWL) for left renal lithiasis 11 years previously. A renal dynamic study with 99mTc-diethylenetriaminepentaacetic acid (DTPA) indicated that the rate of renal excretion and uptake was decreased in the left kidney and normal in the right kidney. Renal angiography demonstrated a normal right renal artery and a small but nonstenotic left renal artery. The ratio of PRA in the left renal vein to that in the right renal vein was 1.7. Blood pressure could be lowered to the range of 140-150/80-90 mmHg with imidapril, an ACE inhibitor. ESWL may cause hypertension via the well-known Page kidney effect. In this case, the kidney, atrophic probably due to ESWL, released a significant amount of renin. PMID:11131285

  15. An FDTD-based computer simulation platform for shock wave propagation in electrohydraulic lithotripsy.

    PubMed

    Y?lmaz, Bülent; Çiftçi, Emre

    2013-06-01

    Extracorporeal Shock Wave Lithotripsy (ESWL) is based on disintegration of the kidney stone by delivering high-energy shock waves that are created outside the body and transmitted through the skin and body tissues. Nowadays high-energy shock waves are also used in orthopedic operations and investigated to be used in the treatment of myocardial infarction and cancer. Because of these new application areas novel lithotriptor designs are needed for different kinds of treatment strategies. In this study our aim was to develop a versatile computer simulation environment which would give the device designers working on various medical applications that use shock wave principle a substantial amount of flexibility while testing the effects of new parameters such as reflector size, material properties of the medium, water temperature, and different clinical scenarios. For this purpose, we created a finite-difference time-domain (FDTD)-based computational model in which most of the physical system parameters were defined as an input and/or as a variable in the simulations. We constructed a realistic computational model of a commercial electrohydraulic lithotriptor and optimized our simulation program using the results that were obtained by the manufacturer in an experimental setup. We, then, compared the simulation results with the results from an experimental setup in which oxygen level in water was varied. Finally, we studied the effects of changing the input parameters like ellipsoid size and material, temperature change in the wave propagation media, and shock wave source point misalignment. The simulation results were consistent with the experimental results and expected effects of variation in physical parameters of the system. The results of this study encourage further investigation and provide adequate evidence that the numerical modeling of a shock wave therapy system is feasible and can provide a practical means to test novel ideas in new device design procedures. PMID:23261077

  16. Tissue damage in kidney, adrenal glands and diaphragm following extracorporeal shock wave lithotripsy.

    PubMed

    Gecit, Ilhan; Kavak, Servet; Oguz, Elif Kaval; Pirincci, Necip; Günes, Mustafa; Kara, Mikail; Ceylan, Kadir; Kaba, Mehmet; Tanık, Serhat

    2014-10-01

    This study was designed to investigate whether exposure to short-term extracorporeal shock wave lithotripsy (ESWL) produces histologic changes or induces apoptosis in the kidney, adrenal glands or diaphragm muscle in rats. The effect of shock waves on the kidney of male Wistar rats (n = 12) was investigated in an experimental setting using a special ESWL device. Animals were killed at 72 h after the last ESWL, and the tissues were stained with an in situ Cell Death Detection Kit, Fluorescein. Microscopic examination was performed by fluorescent microscopy. Apoptotic cell deaths in the renal tissue were not observed in the control group under fluorescent microscopy. In the ESWL group, local apoptotic changes were observed in the kidney in the area where the shock wave was focused. The apoptotic cell deaths observed in the adrenal gland of the control group were similar to those observed in the ESWL groups, and apoptosis was occasionally observed around the capsular structure. Apoptotic cell deaths in the diaphragm muscle were infrequently observed in the control group. Apoptosis in the ESWL group was limited to the mesothelial cells. This study demonstrated that serious kidney, adrenal gland and diaphragm muscles damage occurred following ESWL, which necessitated the removal of the organ in the rat model. It is recognized that the ESWL complications related to the kidney, adrenal gland and diaphragm muscles are rare and may be managed conservatively. PMID:23095486

  17. Suppressing bubble shielding effect in shock wave lithotripsy by low intensity pulsed ultrasound.

    PubMed

    Wang, Jen-Chieh; Zhou, Yufeng

    2015-01-01

    Extracorporeal shock wave lithotripsy (ESWL) has been used as an effective modality to fragment kidney calculi. Because of the bubble shielding effect in the pre-focal region, the acoustic energy delivered to the focus is reduced. Low pulse repetition frequency (PRF) will be applied to dissolve these bubbles for better stone comminution efficiency. In this study, low intensity pulsed ultrasound (LIPUS) beam was aligned perpendicular to the axis of a shock wave (SW) lithotripter at its focus. The light transmission was used to evaluate the compressive wave and cavitation induced by SWs without or with a combination of LIPUS for continuous sonication. It is found that bubble shielding effect becomes dominated with the SW exposure and has a greater significant effect on cavitation than compressive wave. Using the combined wave scheme, the improvement began at the 5th pulse and gradually increased. Suppression effect on bubble shielding is independent on the trigger delay, but increases with the acoustic intensity and pulse duration of LIPUS. The peak negative and integral area of light transmission signal, which present the compressive wave and cavitation respectively, using our strategy at PRF of 1 Hz are comparable to those using SW alone at PRF of 0.1 Hz. In addition, high-speed photography confirmed the bubble activities in both free field and close to a stone surface. Bubble motion in response to the acoustic radiation force by LIPUS was found to be the major mechanism of suppressing bubble shielding effect. There is a 2.6-fold increase in stone fragmentation efficiency after 1000 SWs at PRF of 1 Hz in combination with LIPUS. In summary, combination of SWs and LIPUS is an effective way of suppressing bubble shielding effect and, subsequently, improving cavitation at the focus for a better outcome. PMID:25173067

  18. Extracorporeal shock wave lithotripsy in the primary treatment of encrusted ureteral stents.

    PubMed

    Irkilata, Lokman; Ozgur, Berat Cem; Sancaktutar, Ahmet Ali; Akdeniz, Ekrem; Aydin, Mustafa; Demirel, Huseyin Cihan; Aydin, Hasan Riza; Doluoglu, Omer Gokhan; Resorlu, Berkan; Atilla, Mustafa Kemal

    2015-08-01

    Double pigtail (JJ) ureteral stents, are the most commonly used method of urinary diversion in the ureteral obstructions. Encrustations may occur as a result of prolonged exposure due to forgetting these stents in the body. Removing these materials might be an annoyance. Forty-four patients from three tertiary referral centres with forgotten JJ stents left in them between the years 2007 and 2014 were included in the study. Stents could not be removed by attempted cystoscopy. As an alternative approach, extracorporeal shock wave lithotripsy (ESWL) was the first choice since it is minimally invasive. The results of that treatment are presented along with the relevant demographic data. JJ stenting for urolithiasis was performed in 36 patients, after open surgery in five patients, and for oncological reasons in three patients. ESWL was applied to stents or to any suspicious region adjacent to the stent. In 29 of 44 patients, the stents were easily removed under cystoscopic procedures while in one patient the fragmented residual stent was spontaneously excreted. In eight patients, ureteroscopy was required; in five patients, percutaneous nephrolithotripsy was required; and in one patient, open surgery was required in order to remove stents. ESWL can be considered as a first-line treatment when a forgotten JJ stent is detected despite all precautions after any kind of urological intervention involving insertion of ureteral stents. PMID:25981234

  19. Reduction of tissue injury without compromising stone comminution in shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Zhou, Yufeng; Auge, Brian; Preminger, Glenn M.; Zhong, Pei

    2002-05-01

    To ameliorate vascular injury without compromising stone comminution in shock wave lithotripsy, we have recently developed an in situ pulse superposition technique to suppress large intraluminal bubble expansion [Zhong and Zhou, J. Acoust. Soc. Am. 110, 3283-3291 (2001)]. This strategy was implemented using a simple modification of a HM-3 lithotripter reflector. In this work, further optimization of the reflector geometry was carried out based on theoretical analysis and in vitro pressure waveform measurements using a fiber optical hydrophone. Using the upgraded reflector, no rupture of a cellulose hollow fiber (i.d.=0.2 mm) vessel phantom could be observed around the lithotripter beam focus even after 200 shocks at 24 kV. In comparison, less than 50 shocks were needed to cause a rupture of the vessel phantom using the original reflector at 20 kV. At corresponding output settings, stone comminution is comparable between the two reflector configurations, although the size of the fragments produced by the upgraded reflector is slightly larger. In addition, preliminary results from animal studies have demonstrated a significant reduction in tissue injury using the upgraded reflector, which confirms the validity of this approach in vivo. [Work supported by NIH.

  20. Assessment of Extracorporeal Shock Wave Lithotripsy (ESWL) Therapeutic Efficiency in Urolithiasis

    PubMed Central

    Tomescu, P.; P?nu?, A.; Mitroi, G.; Dr?goescu, O.; Stoica, L.; Dena, S.; Enache, E.

    2009-01-01

    Extracorporeal shock wave lithotripsy (ESWL) revolutionized the treatment of urolithiasis and gradually became the favorite treatment option so that today it is considered to be the first line of treatment for more than 75% of the patients with urolithiasis. The purpose of this study was the assessment of the therapeutic efficiency, complications and limitations of ESWL in urolithiasis in the initial experience using a third generation electromagnetic lithotripter.  Between 2007 and 2008 we performed ESWL for 167 patients with urolithiasis. We recorded 92 patients with single stone (55.1%) and 72 with multiple lithiasis (44.9%). Stone size varied between 7 and 24 mm with an average of 12.3±7.1 mm. Radioopac stones were found in 104 patients (62.3%) while radiolucent stones in 63 only (37.6%).    Complete stone disintegration and clearance was achieved in most cases (86.2%). Complications were mostly minor and rare (transitory haematuria, renal colic). Severe complications (renal hematoma, steinstrasse) were diagnosed for a limited number of patients (3.6%) and their management was mostly nonsurgical or minimally invasive (retrograde ureteroscopy). ESWL is therefore the first line of treatment for urolithiasis with stone size smaller than 2.5 cm. It has an efficiency rate above 85%, low procedure time, high safety and good tolerability (new generation lithotripters do not require anesthesia) and minimal complications. PMID:24778813

  1. [Effectiveness of flexible ureteroscopy versus extracorporeal shock wave lithotripsy for kidney stones treatment].

    PubMed

    Ravier, E; Abid, N; Ruffion, A; Fassi-Fehri, H; Buron, C; Ganne, C; Mallet, A; Martin, X

    2015-04-01

    Primary endpoint was to objective a better effectiveness of flexible ureteroscopy (fURS) compared to extracorporeal shock wave lithotripsy (ESWL) 3 months after treatment of a unique kidney stone from 5 to 20mm. Secondary endpoints were to evaluate effectiveness in subgroup and tolerance. We conducted a prospective comparative randomised trial between May 2012 and February 2014. A computerised tomography was done before treatment and another 3 months after treatment. Of the 30 randomised patients, 8 dropped out from the study and 4 were lost to follow-up. Median time of follow-up was 3.82 months. In per-protocol analysis, success rate was 60% for fURS group versus 28.6% for ESWL group (P=0.29). In intention to treat analysis, success rate was 77.8% in fURS group versus 53.8% in ESWL group (P=0.38). In ESWL group, 5 patients (41.7%) needed a second treatment versus none in fURS group but it was not significant. During follow-up, 1 patient in each group presented a complication. Results of this feasibility study did not allowed to conclude on superiority of a technic. A multicenter study with more important enrollment is necessary considering economic side and tolerance of these treatments. PMID:25640027

  2. Can a dual-energy computed tomography predict unsuitable stone components for extracorporeal shock wave lithotripsy?

    PubMed Central

    Ahn, Sung Hoon; Oh, Tae Hoon

    2015-01-01

    Purpose To assess the potential of dual-energy computed tomography (DECT) to identify urinary stone components, particularly uric acid and calcium oxalate monohydrate, which are unsuitable for extracorporeal shock wave lithotripsy (ESWL). Materials and Methods This clinical study included 246 patients who underwent removal of urinary stones and an analysis of stone components between November 2009 and August 2013. All patients received preoperative DECT using two energy values (80 kVp and 140 kVp). Hounsfield units (HU) were measured and matched to the stone component. Results Significant differences in HU values were observed between uric acid and nonuric acid stones at the 80 and 140 kVp energy values (p<0.001). All uric acid stones were red on color-coded DECT images, whereas 96.3% of the nonuric acid stones were blue. Patients with calcium oxalate stones were divided into two groups according to the amount of monohydrate (calcium oxalate monohydrate group: monohydrate?90%, calcium oxalate dihydrate group: monohydrate<90%). Significant differences in HU values were detected between the two groups at both energy values (p<0.001). Conclusions DECT improved the characterization of urinary stone components and was a useful method for identifying uric acid and calcium oxalate monohydrate stones, which are unsuitable for ESWL. PMID:26366277

  3. Extracorporeal shock wave lithotripsy: the use of chemical treatments for improved stone comminution.

    PubMed

    Akers, S R; Cocks, F H; Weinerth, J L

    1987-11-01

    Extracorporeal shock wave lithotripsy (ESWL) can require more than two thousand acoustic shocks to achieve an adequate degree of renal calculus comminution. A decrease in the number of shocks necessary for effective treatment offers both technical and clinical benefits. The results presented here demonstrate that it is possible in particular cases to increase substantially the degree of comminution produced using a fixed number of acoustic impulses by exposing the stones to solutions of controlled pH and chemical composition during acoustic shock treatment. The largest increase in comminution was observed for magnesium ammonium phosphate hexahydrate/apatite stones exposed to citrate solutions. The smaller particle sizes are shown to result not only from stone dissolution but also from an increase in the ease of stone fracture during acoustic shocking. The degree of comminution of the largest fragment sizes was also found to be slightly increased for calcium oxalate stones by exposure to synthetic urine of elevated pH. These chemical methods of increased stone comminution appear to be directly applicable to particular cases and may have general clinical utility if suitable conditions affecting all stones can be found. PMID:3669190

  4. Treatment Protocols to Reduce Injury and Improve Stone Breakage in SWL

    NASA Astrophysics Data System (ADS)

    McAteer, James A.; Evan, Andrew P.; Connors, Bret A.; Pishchalnikov, Yuri A.; Williams, James C.; Lingeman, James E.

    2008-09-01

    Here we provide a capsule summary of key observations showing that adverse effects can be reduced and stone breakage outcomes can be improved by the choice of the treatment protocol used in SWL. The take home message is—technique in lithotripsy can be used to significant advantage. SW-rate is key, and so is the sequence of SW delivery. Patient studies have shown that stone breakage is significantly improved at 60SW/min compared to a rate of 120SW/min, and laboratory experiments with pigs show that acute SWL injury to the kidney can be reduced dramatically by further slowing the SW firing rate to 30SW/min. The sequence of SW administration has a profound effect on the kidney, and renal injury is significantly reduced when the treatment protocol incorporates a priming dose of SW's followed by a brief pause before treatment is resumed. Continued developments in lithotripsy technology are welcome and will hopefully lead to improved SWL systems. Current experience suggests, however, that technology is not a substitute for expert technique, and attention to the fundamentals of SW delivery is essential to achieve the best possible outcomes regardless of the lithotripter at hand.

  5. Evaluation of contralateral kidney, liver and lung after extracorporeal shock wave lithotripsy in rabbits.

    PubMed

    Senyucel, M F; Boybeyi, O; Ayva, S; Aslan, M K; Soyer, T; Demet, A I; K?sa, U; Basar, M; Cakmak, M A

    2013-10-01

    An experimental study was carried out to evaluate the effects of extracorporeal shock wave lithotripsy (ESWL) on contralateral kidney, liver and lung by histopathological and biochemical methods. Twelve New Zealand rabbits were allocated to two groups (n = 6). Tissues of control group (CG, n = 6) were harvested without any intervention. In ESWL group (EG), right kidneys were exposed to 3,000 shock waves at 14 kV energy using electro-hydraulic type ESWL device three times every other day. Both kidneys, liver, and right lobe of lung tissues in EG were harvested on seventh day. Kidneys were examined histopathologically for presence of glomerular and tubular injury, interstitial edema, congestion, inflammation and fibrosis. Livers were examined for hepatocyte vacuolization, congestion, portal inflammation and fibrosis. Lung tissues were examined for loss of normal structure, emphysema, interstitial congestion-edema, prominent alveolar septal vessels, interstitial inflammation, intra-alveolar hemorrhage, intraluminal hemorrhage, peribronchial edema, congestion, inflammation in bronchial wall and epithelial desquamation. Biochemical analysis of tissue samples was performed for oxidative injury markers. Histopathological evaluations revealed that tubular injury was found in both shocked and contralateral kidneys (p < 0.05). EG showed higher grades of portal fibrosis in liver and higher grades of peribronchial congestion in lung when compared to CG (p < 0.05). Biochemical evaluations of both kidneys showed that malondialdehyde levels were higher in EG than in CG (p < 0.05). ESWL causes histopathologic alterations both in shocked and contralateral kidneys. Extrarenal tissues such as liver and lung can be affected by shock waves histopathologically and oxidative injury of contralateral kidney may occur acutely after ESWL. PMID:23728121

  6. Propagation of shock waves in elastic solids caused by cavitation microjet impact. II: Application in extracorporeal shock wave lithotripsy.

    PubMed

    Zhong, P; Chuong, C J; Preminger, G M

    1993-07-01

    To better understand the mechanism of stone fragmentation during extracorporeal shock wave lithotripsy (ESWL), the model developed in Part I [P. Zhong and C.J. Chuong, J. Acoust. Soc. Am. 94, 19-28 (1993)] is applied to study cavitation microjet impingement and its resultant shock wave propagation in renal calculi. Impact pressure at the stone boundary and stress, strain at the propagating shock fronts in the stone were calculated for typical ESWL loading conditions. At the anterior surface of the stone, the jet induced compressive stress can vary from 0.82 approximately 4 times that of the water hammer pressure depending on the contact angles; whereas the jet-induced shear stress can achieve its maximum, with a magnitude of 30% approximately 54% of the water hammer pressure, near the detachment of the longitudinal (or P) wave in the solid. Comparison of model predictions with material failure strengths of renal calculi suggests that jet impact can lead to stone surface erosion by combined compressive and shear loadings at the jet impacting surface, and spalling failure by tensile forces at the distal surface of the stone. Comparing responses from four different stone types suggests that cystine is the most difficult stone to fragment in ESWL, as observed from clinical experience. PMID:8354759

  7. A cumulative shear mechanism for tissue damage initiation in shock-wave lithotripsy

    PubMed Central

    Freund, Jonathan B.; Colonius, Tim; Evan, Andrew P.

    2007-01-01

    Evidence suggests that inertial cavitation plays an important role in the renal injury incurred during shock-wave lithotripsy. However, it is unclear how tissue damage is initiated, and significant injury typically occurs only after a sufficient dose of shock waves. While it has been suggested that shock-induced shearing might initiate injury, estimates indicate that individual shocks do not produce sufficient shear to do so. In this paper, we hypothesize that the cumulative shear of the many shocks is damaging. This mechanism depends upon whether there is sufficient time between shocks for tissue to relax to its unstrained state. We investigate the mechanism with a physics-based simulation model wherein the the basement membranes that define the tubules and vessels in the inner medulla are represented as elastic shells surrounded by viscous fluid. Material properties are estimated from in vitro tests of renal basement membranes and documented mechanical properties of cells and extracellular gels. Estimates for the net shear deformation from a typical lithotripter shock (~ 0.1%) are found from a separate dynamic shock simulation. The results suggest that the larger interstitial volume (~ 40%) near the papilla tip gives the tissue there a relaxation time comparable to clinical shock delivery rates (~ 1Hz), thus allowing shear to accumulate. Away from the papilla tip, where the interstitial volume is smaller (? 20%), the model tissue relaxes completely before the next shock would be delivered. Implications of the model are that slower delivery rates and broader focal zones should both decrease injury, consistent with some recent observations. PMID:17507147

  8. Impact of shock wave pattern and cavitation bubble size on tissue damage during ureteroscopic electrohydraulic lithotripsy.

    PubMed

    Vorreuther, R; Corleis, R; Klotz, T; Bernards, P; Engelmann, U

    1995-03-01

    It is known that electrohydraulic lithotripsy (EHL) during ureteroscopy may cause ureteral damage. To evaluate this trauma potential, find its mechanism and make it possible to avoid it, our research employed photographic evaluation, tissue studies, shock wave measurements and disintegration tests. The setup included a 3.3 F probe attached to an experimental generator with adjustable voltages and capacities providing energies from 25 mJ. to 1300 mJ. per pulse. In general, we distinguish between two traumatic mechanisms: (1) After placing the probe directly on the mucosa the rapid initial plasma penetrates the tissue resulting in a small, nonthermal, punched-like defect, whose depth depends on the energy applied. This trauma has minor clinical implications and is avoided by maintaining a minimum safety distance of 1 mm.; (2) According to physics, each plasma is followed by a cavitation bubble. The maximum size of this bubble depends on the energy applied and ranges from 3 mm. (25 mJ) to > 15 mm. (1300 mJ). In proportion to the bubble size, the ureteral wall may be distended or disrupted, even when the probe is not in direct contact with the mucosa. Therefore, the goal should be to obtain a low energy pressure pulse with high disintegration efficacy. Our evaluation of the pressure waves revealed that the selection of a high voltage and a low capacity leads to short and steep "laser-like" pulses. These pulses have a significant higher impact on stone disintegration than the broader pulses of the same energy provided by currently available generators. PMID:7861549

  9. Effect of the frequency of transcutaneous electrical nerve stimulation on analgesia during extracorporeal shock wave lithotripsy.

    PubMed

    Kararmaz, Alper; Kaya, Sedat; Karaman, Haktan; Turhanoglu, Selim

    2004-12-01

    In this prospective, randomised, sham controlled study, we set out to determine which transcutaneous electrical nerve stimulation (TENS) therapy modality (conventional vs acupuncture-like) is more effective as a supplementary analgesic regimen during extracorporeal shock wave lithotripsy (ESWL). Patients were prospectively randomised to one of three groups. In Group I (n=22), conventional TENS (impulse pattern: continuous at 80 Hz; intensity: 10-30 mA) was applied. In Group II (n=22) acupuncture-like TENS (impulse pattern: burst at 2 Hz; intensity: 15-50 mA) was applied. In Group III (n=22) (control group), stimulation was started at 1 mA and the intensity increased to no more than 10 mA until it produced a tickling sensation. Alfentanil was administered through a patient controlled analgesic device. Alfentanil consumption, hemodynamics and respiratory parameters, a 10-cm visual analogue pain scale, patient satisfaction, recovery and discharge times were evaluated. The consumption of alfentanil was significantly lower in Group I than in Groups II and III (P<0.0001). Pain scores were lower in Group I than in the other two groups (P<0.05). Patients in Group I were more satisfied with their analgesic medication than those in the other two groups (P<0.05). Both the time to an Aldrete score >8 and a modified post-anaesthetic discharge score >8 were significantly shorter in Group I (2.3+/-1.8, 49.1+/-14.6) than those of Groups II (4.6+/-2.2, 60.2+/-18.1) and III (4.9+/-2.8, 58.4+/-16.5) (P<0.0001 and P<0.05, respectively). We conclude that the use of conventional TENS is effective in decreasing the analgesic requirements and the incidence of alfentanil-related side effects during ESWL. PMID:15243722

  10. Extracorporeal Shock Wave Lithotripsy for Management of Residual Stones after Ureterolithotripsy versus Mini-Percutaneous Nephrolithotomy: A Retrospective Study

    PubMed Central

    Huang, Zhichao; Zhao, Xiaokun; Zhang, Lei; Zhong, Zhaohui; Xu, Ran; Zhang, Lianping

    2013-01-01

    Purpose To compare the efficacy of extracorporeal shock wave lithotripsy in managing residual stones after ureterolithotripsy and mini-percutaneous nephrolithotomy. Materials and Methods A retrospective study was carried out of 71 patients with proximal urinary tract stones (greater than 10 mm) who underwent ureterolithotripsy or mini-percutaneous nephrolithotomy at a single institution from 2009 to 2011. The 71 patients were divided into two groups: group I (n = 37) comprised patients who underwent ureterolithotripsy, and group II (n = 34) comprised patients who underwent mini-percutaneous nephrolithotomy. Clinical characteristics, stone-free rates, stone demographics, and complications were evaluated. Results The overall stone-free rate was 90.1%. The stone-free rates in groups I and II were 97.3% and 82.4%, respectively. There was a statistically significant difference in the stone-free rates between groups I and II (P = 0.035). Neither serious intraoperative nor postoperative complications were observed. No significant difference in complications was observed between the two groups (P = 0.472). Conclusions The results of our study suggest that extracorporeal shock wave lithotripsy is an effective and safe auxiliary procedure for managing residual stones after primary endoscopic surgery. This procedure is associated with a satisfactory stone-free rate and a low complication rate, particularly for residual stones after ureteroscopic procedures. PMID:23785516

  11. Advantage of a Broad Focal Zone in SWL: Synergism Between Squeezing and Shear

    NASA Astrophysics Data System (ADS)

    Sapozhnikov, Oleg A.; Bailey, Michael R.; Maxwell, Adam D.; MacConaghy, Brian; Cleveland, Robin O.; McAteer, James A.; Crum, Lawrence A.

    2007-04-01

    Objective: The focal zone width appears to be a critical factor in lithotripsy. Narrow focus machines have a higher occurrence of adverse effects, and arguably no greater comminution efficiency. Manufacturers have introduced new machines and upgrades to broaden the focus. Still, little data exists on how focal width plays a role in stone fracture. Thus, our aim was to determine if focal width interacts with established mechanisms known to contribute to stone fracture. Method: A series of experiments were undertaken with changes made to the stone in an effort to determine which is most important, the shock wave (SW) reflected from the back end of the stone (spallation), the SW ringing the stone (squeezing), the shear wave generated at surface of the stone and concentrated in the bulk of it (shear), or SWs generated from bubble collapse (cavitation). Shock waves were generated by a Dornier HM3-style lithotripter, and stones were made from U30 cement. Baffles were used to block specific waves that contribute to spallation, shear, or squeezing, and glycerol was used to suppress cavitation. Numerical simulation and high-speed imaging allowed for visualization of specific waves as they traveled within the stone. Results: For brevity, one result is explained. A reflective baffle was placed around the front edge of a cylindrical stone. The proximal baffle prevented squeezing by preventing the SW from traveling over the stone, but permitted the SW entering the stone through the proximal face and did not affect the other mechanisms. The distal baffle behaved the same as no baffle. The proximal baffle dramatically reduced the stress, and the stone did not break (stone broke after 45±10 SWs without the baffle and did not break after 400 SWs when the experiment stopped). The result implies that since removing squeezing halted comminution, squeezing is dominant. However, there is much more to the story. For example, if the cylindrical stone was pointed, it broke with the point on the distal end but not with the point on the proximal end. In both cases, squeezing was the same, so if squeezing were dominant, both stones should have broken. But the pointed front edge prevents the shear wave. The squeezing wave and its product — the shear wave — are both needed and work synergistically in a way explained by the model. Conclusions: A broad focus enhances the synergism of squeezing and shear waves without altering cavitation's effects, and thus accelerates stone fracture in SWL.

  12. Part I. Mechanisms of injury associated with extracorporeal shock wave lithotripsy; Part II. Exsolution of volatiles

    NASA Astrophysics Data System (ADS)

    Howard, Danny Dwayne

    Part I - Shock waves are focused in extracorporeal shock wave lithotripsy (ESWL) machines to strengths sufficient to fracture kidney stones. Substantial side effects-most of them acute-have resulted from this procedure, including injury to soft tissue. The focusing of shock waves through various layers of tissue is a complex process which stimulates many bio-mechano-chemical responses.This thesis presents results of an in vitro study of the initial mechanical stimulus. Planar nitrocellulose membranes of order 10 um thick were used as models of thin tissue structures. Two modes of failure were recorded: Failure due to cavitation collapsing on or near the membranes, and failure induced by altering the structure of shock waves. Tests were done in water at and around F2 to characterize the extent of cavitation damage, and was found to be confined within the focal region, 1.2 cm along the axis of focus.Scattering media were used to simulate the effects of acoustic nonuniformity of tissue and to alter the structure of focusing shock waves. 40 um diameter (average) hollow glass spheres were added to ethylene glycol, glycerine and castor oil to vary the properties of the scattering media. Multiple layer samples of various types of phantom tissue were tested in degassed castor oil to gauge the validity of the scattering media. The scattering media and tissue samples increased the rise time decreased strain rate in a similar fashion. Membranes were damaged by the decreased strain rate and accumulated effects of the altered structure: After about 20 or so shocks immersed in the scattering media and after about 100 shocks behind the tissue samples. The mode of failure was tearing with multiple tears in some cases from about .1 cm to about 3 cm depending of the number of shocks and membrane thickness.Part II - This work examines the exsolution of volatiles-carbon dioxide from water-in a cylindrical test cell under different pressure conditions. Water was supersaturated with carbon dioxide under various pressures (620 to 1062 kPa), and depressurized rapidly to investigate how carbon dioxide is undissolved, exsolution, and its effects on the surrounding environment. Cavities grow as a result of convective diffusion: They move before depleting carbon dioxide in a given region. The radius of a cavity in this environment grows at a faster rate [...] than that of a cavity at rest [...]. Bubble growth rates were inferred by measuring the bulk liquid using high speed motion pictures. Water in the test-cell is accelerated as a result of buoyancy induced by cavity growth. Cavities are elliptical in shape and grow until mutual interaction causes them to fragment. Accelerations range from 10 to 100 g were measured with velocities ranging from 7 to 13 m/s.

  13. High frequency jet ventilation through a supraglottic airway device: a case series of patients undergoing extra-corporeal shock wave lithotripsy.

    PubMed

    Canty, D J; Dhara, S S

    2009-12-01

    High frequency jet ventilation has been shown to be beneficial during extra-corporeal shock wave lithotripsy as it reduces urinary calculus movement which increases lithotripsy efficiency with better utilisation of shockwave energy and less patient exposure to tissue trauma. In all reports, sub-glottic high frequency jet ventilation was delivered through a tracheal tube or a jet catheter requiring paralysis and direct laryngoscopy. In this study, a simple method using supraglottic jet ventilation through a laryngeal mask attached to a circle absorber anaesthetic breathing system is described. The technique avoids the need for dense neuromuscular blockade for laryngoscopy and the potential complications associated with sub-glottic instrumentation and sub-glottic jet ventilation. The technique was successfully employed in a series of patients undergoing lithotripsy under general anaesthesia as an outpatient procedure. PMID:19712208

  14. How has extracorporeal shock-wave lithotripsy changed the treatment of urinary stones in Quebec?

    PubMed Central

    Levy, A R; McGregor, M

    1995-01-01

    OBJECTIVES: To determine the number of people who underwent treatment of urinary stones in Quebec before and after the introduction of extracorporeal shock-wave lithotripsy (ESWL) and to determine how the introduction of ESWL influenced resource utilization. DESIGN: Before-after study; data were obtained from administrative databases and hospital-based cost estimates. SETTING: The 68 acute care hospitals in Quebec in which treatment of urinary stones is undertaken. PATIENTS: Quebec residents admitted to hospital for treatment of urinary stones between the fiscal years 1984 and 1992. OUTCOME MEASURES: Number of people treated for urinary stones per year, total number of procedures per year (including open surgery, percutaneous procedures, retrograde procedures and ESWL), and annual resources (including number of hospital bed-days and direct costs) for treatment of urinary stones used overall and in hospitals with and without ESWL services. RESULTS: Over the study period the number of people treated for urinary stones increased by 59%. As well, the combined frequency of ESWL and surgery (the two main treatment methods) increased by 107%. These increases were largely due to rates of treatment that grew by 52% among women and by 34% among men. The total number of hospital bed-days decreased by 28%, which reflected shorter hospital stays for ESWL. However, despite this decrease, the total direct annual costs were 7% higher in 1992 than in 1984 because of the increased numbers of people treated and procedures performed. In the three hospitals that offered ESWL the number of hospital bed-days and the direct costs of treating urinary stones increased by 49% and $2.5 million respectively. In the 65 other hospitals these figures decreased by 41% and about $2.9 million respectively. CONCLUSIONS: Because of increased intervention rates the total cost of treating urinary stones has risen since the introduction of ESWL. The introduction of ESWL has also been associated with a shift in the use of resources for treating urinary stones to hospitals with a lithotriptor. The reasons for the increased intervention rates are unknown. However, given the possibility of negative health effects and the increased costs, studies to determine whether the increased rates improve health outcomes are warranted. PMID:8529187

  15. Shock wave-bubble interaction near soft and rigid boundaries during lithotripsy: numerical analysis by the improved ghost fluid method

    NASA Astrophysics Data System (ADS)

    Kobayashi, Kazumichi; Kodama, Tetsuya; Takahira, Hiroyuki

    2011-10-01

    In the case of extracorporeal shock wave lithotripsy (ESWL), a shock wave-bubble interaction inevitably occurs near the focusing point of stones, resulting in stone fragmentation and subsequent tissue damage. Because shock wave-bubble interactions are high-speed phenomena occurring in tissue consisting of various media with different acoustic impedance values, numerical analysis is an effective method for elucidating the mechanism of these interactions. However, the mechanism has not been examined in detail because, at present, numerical simulations capable of incorporating the acoustic impedance of various tissues do not exist. Here, we show that the improved ghost fluid method (IGFM) can treat shock wave-bubble interactions in various media. Nonspherical bubble collapse near a rigid or soft tissue boundary (stone, liver, gelatin and fat) was analyzed. The reflection wave of an incident shock wave at a tissue boundary was the primary cause for the acceleration or deceleration of bubble collapse. The impulse that was obtained from the temporal evolution of pressure created by the bubble collapse increased the downward velocity of the boundary and caused subsequent boundary deformation. Results of this study showed that the IGFM is a useful method for analyzing the shock wave-bubble interaction near various tissues with different acoustic impedance.

  16. Role of Vitamin C and E supplementation in reduction of serum level of renal injury marker following shock wave lithotripsy: Prospective single centre experience

    PubMed Central

    Modi, Jayesh; Modi, Pranjal; Pal, Bipinchandra; Bansal, Jyoti; Kumar, Suresh; Nagarajan, Ramya; Saifee, Yusuf

    2015-01-01

    Introduction: Shock wave lithotripsy has become first line treatment modality for renal calculi due to its noninvasiveness. However, the destructive forces like dispersion of cavitation bubbles can cause trauma to thin-walled vessels and renal parenchyma during fragmentation of the stones. Antioxidants are our first line of defense against oxidative stress. The aim of this study was to investigate whether oral administration of Vitamin C and E help in a reduction of the serum level of inflammatory mediator by serial measurement of high sensitivity C-reactive protein (hs-CRP) and by this reduction in the risk of renal damage. Patients and Methods: A total of 107 subjects were recruited in three groups. Group A served as a control group, and Group B and Group C received oral medication of Vitamin E 800 mg/day and Vitamin C 1000 mg/day respectively, start from 2 days prior the lithotripsy and continued for total 7 days. The level of hs-CRP was used as a mediator of the inflammatory response following lithotripsy and thus for long term renal injury. Serum level of hs-CRP was measured on 2 days prior the lithotripsy and day 2, 7 and 28 after the lithotripsy. Results: Patients who were given either Vitamin C or Vitamin E showed a significant reduction of serum level of hs-CRP when compared to control the group. Conclusion: Oral administration of Vitamin C and E helps in reduction of serum levels of the inflammatory marker for acute renal injury and thus they can be useful in minimizing the kidney injury following lithotripsy for renal stone disease. PMID:26229324

  17. EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY AND ENDOSCOPIC URETERAL STENT PLACEMENT IN AN ASIAN SMALL-CLAWED OTTER (AONYX CINEREA) WITH NEPHROLITHIASIS.

    PubMed

    Wojick, Kimberlee B; Berent, Allyson C; Weisse, Chick W; Gamble, Kathryn C

    2015-06-01

    Urolithiasis is a significant disease concern in Asian small-clawed otters (Aonyx cinerea), with over 60% of captive animals affected. Bilateral ureteral stent placement, using endoscopic and fluoroscopic guidance, and extracorporeal shock wave lithotripsy (ESWL) were performed as salvage procedures in a 13-yr-old intact female Asian small-clawed otter following a 7-yr history of nephrolithiasis and progressive renal insufficiency. Following the procedure, radiographs revealed a slight shifting of urolith position, although a decrease in urolith mass was not observed. As a result of declining quality of life related to severe osteoarthritis, the otter was euthanized 5 wk after the procedure. While this treatment approach was unsuccessful in this case, the technique was clinically feasible, so ESWL and ureteral stent placement may remain a consideration for other individuals of this species presented earlier in the course of this disease. PMID:26056891

  18. Shockwave lithotripsy with renoprotective pause is associated with renovascular vasoconstriction in humans

    PubMed Central

    Bailey, Michael; Lee, Franklin; Hsi, Ryan; Paun, Marla; Dunmire, Barbrina; Liu, Ziyue; Sorensen, Mathew; Harper, Jonathan

    2015-01-01

    Animal studies have shown that shock wave lithotripsy (SWL) delivered with an initial course of low-energy shocks followed by a pause reduces renal injury. The pause correlates with increased arterial resistive index (RI) during SWL as measured by ultrasound. This suggests that renal vasoconstriction is associated with protecting the kidney from injury. This study explored whether a similar increase in RI is observed in humans. Patients were prospectively recruited from two hospitals. All received an initial dose of 250 lowest energy shocks followed by a two-minute pause. Shock power was then ramped up at the discretion of the physician; shock rate was maintained at 1 Hz. Spectral Doppler velocity measurements were taken from an interlobar artery at baseline after induction, during the pause at 250 shocks, after 750 shocks, after 1500 shocks, and at the end of the procedure. RI was calculated from the peak systolic and end diastolic velocities and a linear mixed-effects model was used to compare RIs. The statistical model accounted for age, gender, laterality, and body mass index (BMI). Measurements were taken from 15 patients. Average RI ± standard deviation pretreatment, after 250 shocks, after 750 shocks, after 1500 shocks, and post treatment was 0.68 ± 0.06, 0.71 ± 0.07, 0.73 ± 0.06, 0.75 ± 0.07 and 0.75 ± 0.06, respectively. RI was found to be significantly higher after 250 shocks compared to pretreatment (p = 0.04). RI did not correlate with age, gender, BMI, or treatment side. This is suggestive that allowing a pause for renal vascular vasoconstriction to develop may be beneficial, and can be monitored for during SWL, providing real-time feedback as to when the kidney is protected. PMID:26203348

  19. Ulnar nerve neuropraxia after extracorporeal shock wave lithotripsy: a case report

    PubMed Central

    Konczak, Clark R

    2005-01-01

    A case is presented that illustrates and discusses the clinical presentation, diagnosis and chiropractic management of a 50-year-old male presenting with a case of ulnar neuropraxia following extracorporal shockwave lithotripsy. Onset is believed to be due to the patient’s arm position in full abduction and external rotation during the lithotripsy procedure. Motor abnormalities related to the ulnar nerve were noted in the absence of distinct sensory findings. Chiropractic treatment focused on relief of the patient’s pain during the course of the condition. Treatment may have helped in the rapid and complete resolution of his symptoms in this case. Poor patient positioning on hard surfaces, for extended periods may place pressure on superficial nerves resulting in nerve injury. In this case, the outcome was excellent, with complete resolution of symptoms less than one week later. The prognosis for this type of neuropraxia is usually good with conservative management. The patient history and chronological clinical course strongly suggest a causal association between the patient’s position during the procedure and the development of the ulnar neuropraxia. PMID:17549150

  20. Shock-induced bubble jetting into a viscous fluid with application to tissue injury in shock-wave lithotripsy

    PubMed Central

    Freund, J. B.; Shukla, R. K.; Evan, A. P.

    2009-01-01

    Shock waves in liquids are known to cause spherical gas bubbles to rapidly collapse and form strong re-entrant jets in the direction of the propagating shock. The interaction of these jets with an adjacent viscous liquid is investigated using finite-volume simulation methods. This configuration serves as a model for tissue injury during shock-wave lithotripsy, a medical procedure to remove kidney stones. In this case, the viscous fluid provides a crude model for the tissue. It is found that for viscosities comparable to what might be expected in tissue, the jet that forms upon collapse of a small bubble fails to penetrate deeply into the viscous fluid “tissue.” A simple model reproduces the penetration distance versus viscosity observed in the simulations and leads to a phenomenological model for the spreading of injury with multiple shocks. For a reasonable selection of a single efficiency parameter, this model is able to reproduce in vivo observations of an apparent 1000-shock threshold before wide-spread tissue injury occurs in targeted kidneys and the approximate extent of this injury after a typical clinical dose of 2000 shock waves. PMID:19894850

  1. Simulation of shock-induced bubble collapse with application to vascular injury in shockwave lithotripsy

    NASA Astrophysics Data System (ADS)

    Coralic, Vedran

    Shockwave lithotripsy is a noninvasive medical procedure wherein shockwaves are repeatedly focused at the location of kidney stones in order to pulverize them. Stone comminution is thought to be the product of two mechanisms: the propagation of stress waves within the stone and cavitation erosion. However, the latter mechanism has also been implicated in vascular injury. In the present work, shock-induced bubble collapse is studied in order to understand the role that it might play in inducing vascular injury. A high-order accurate, shock- and interface-capturing numerical scheme is developed to simulate the three-dimensional collapse of the bubble in both the free-field and inside a vessel phantom. The primary contributions of the numerical study are the characterization of the shock-bubble and shock-bubble-vessel interactions across a large parameter space that includes clinical shockwave lithotripsy pressure amplitudes, problem geometry and tissue viscoelasticity, and the subsequent correlation of these interactions to vascular injury. Specifically, measurements of the vessel wall pressures and displacements, as well as the finite strains in the fluid surrounding the bubble, are utilized with available experiments in tissue to evaluate damage potential. Estimates are made of the smallest injurious bubbles in the microvasculature during both the collapse and jetting phases of the bubble's life cycle. The present results suggest that bubbles larger than one micrometer in diameter could rupture blood vessels under clinical SWL conditions.

  2. Combined short and long-delay tandem shock waves to improve shock wave lithotripsy according to the Gilmore-Akulichev theory.

    PubMed

    de Icaza-Herrera, Miguel; Fernández, Francisco; Loske, Achim M

    2015-04-01

    Extracorporeal shock wave lithotripsy is a common non-invasive treatment for urinary stones whose fragmentation is achieved mainly by acoustic cavitation and mechanical stress. A few years ago, in vitro and in vivo experimentation demonstrated that such fragmentation can be improved, without increasing tissue damage, by sending a second shock wave hundreds of microseconds after the previous wave. Later, numerical simulations revealed that if the second pulse had a longer full width at half maximum than a standard shock wave, cavitation could be enhanced significantly. On the other side, a theoretical study showed that stress inside the stone can be increased if two lithotripter shock waves hit the stone with a delay of only 20 ?s. We used the Gilmore-Akulichev formulation to show that, in principle, both effects can be combined, that is, stress and cavitation could be increased using a pressure pulse with long full width at half maximum, which reaches the stone within hundreds of microseconds after two 20 ?s-delayed initial shock waves. Implementing the suggested pressure profile into clinical devices could be feasible, especially with piezoelectric shock wave sources. PMID:25553714

  3. The impact of the geometry of the lithotriptor aperture on fragmentation effect at extracorporeal shock wave lithotripsy treatment.

    PubMed

    Westermark, S; Nelson, E; Kinn, A C; Wiksell, H

    1999-08-01

    The aim of this study was to determine the impact of the aperture size of an electro-hydraulic lithotriptor on the fragmentation effect. We also wanted to investigate whether a potential change in the capacitance of the pulse forming network (PFN), at a certain energy level, might have an impact on fragmentation rate. Two different apertures with a diameter of 23 and 17 cm respectively were compared using two different values of total PFN capacitance: 50 nF and 80 nF. Model stones of similar size and weight were fragmented. The number of shots for complete fragmentation or the grade of fragmentation after a certain number of shots was measured. This study shows that for the shock wave system used, the 23-cm aperture seems to provide more effective fragmentation as function of the number of shots compared with the 17-cm aperture at the same energy level. Furthermore, a minor change in the PFN capacitance between reasonable limits does not affect the fragmentation efficiency. This article also highlights the fact that it is not relevant simply to compare the voltage level given in the shots in extracorporeal shock wave lithotripsy treatment between different lithotriptors. PMID:10460896

  4. Urinary Expression of Novel Tissue Markers of Kidney Injury After Ureteroscopy, Shockwave Lithotripsy, and in Normal Healthy Controls

    PubMed Central

    Fahmy, Nader; Sener, Alp; Sabbisetti, Venkata; Nott, Linda; Lang, R. Michael; Welk, Blayne K.; Méndez-Probst, Carlos E.; MacPhee, Roderick A.; VanEerdewijk, Susan; Cadieux, Peter A.; Bonventre, Joseph V.

    2013-01-01

    Abstract Background and Purpose: Shockwave lithotripsy (SWL) and ureteroscopy (URS) are minimally invasive treatment alternatives for kidney stones. Although less invasive, SWL subjects the renal parenchyma to a high level of energy and the potential to cause renal injury. The ability to detect renal injury post-SWL in a reliable and noninvasive way would be clinically beneficial. Kidney injury molecule 1 (KIM-1) and N-acetyl-?-D-glucosaminidase (NAG) are two proteins secreted by the kidney into the urine and have been found to be sensitive markers of acute kidney injury in transplant patients. The aim of this work was to measure urinary levels of KIM-1 and NAG in patients with kidney stone who were treated by SWL or URS and in nonstone volunteers. Patients and Methods: Patients with kidney stones who were treated by SWL (n=50) or URS (n=10) were recruited. Voided urine samples were collected before and 2 to 3 hours after URS and SWL. In addition, further urinary specimens were collected 2 days and 2 weeks post-SWL treatment. Voided urine samples from healthy volunteers were also collected. Results: Mean KIM-1 values were increased in patients with kidney stones when compared with volunteers. KIM-1 and NAG levels significantly increased post-SWL and returned to baseline within 2 weeks post-SWL. Poor kidney function was significantly associated with increased biomarker activity both in baseline and post-SWL measurements. There was no significant change in urinary KIM-1 and NAG concentrations before and after URS. Conclusions: Kim-1 and NAG levels significantly increased post-SWL treatment suggesting a potential role for these urinary markers in identifying patients at higher risk of tissue injury. PMID:24180435

  5. The effect of transcutaneous electrical nerve stimulation for pain relief during extracorporeal shock-wave lithotripsy procedure.

    PubMed

    Ozsaker, Esma; Diramali, Alev

    2014-03-01

    The purpose of this study was to investigate the effect of transcutaneous electrical nerve stimulation (TENS) for pain relief during extracorporeal shock-wave lithotripsy (ESWL) procedure. An experimental study with repeated measures design was used in this study. Fifty patients aged 20-65 years receiving ESWL treatment were used for this convenience sample. Two applications were used for each patient: one involving administration of TENS instrument for ESWL treatment and the other without TENS. For effective stimulation, 2 stimulator electrodes were placed paravertebrally at L1 and 2 near the lithotripter shock tube before ESWL. Blood pressure, heart rate, pain intensity, analgesic use, and side effects were measured every 10 minutes during the procedure and after the end of ESWL. Results showed that TENS application decreased patients' intensity of pain and amount of analgesic requests and, related to that, decreased the incidence of side effects and increased patients' satisfaction during ESWL. TENS application is recommended as a pain-relieving technique during ESWL. PMID:24602425

  6. A novel method to control P+/P- ratio of the shock wave pulses used in the extracorporeal piezoelectric lithotripsy (EPL).

    PubMed

    Lewin, P A; Chapelon, J Y; Mestas, J L; Birer, A; Cathignol, D

    1990-01-01

    There is growing evidence that acoustic cavitation plays an important role in stone fragmentation during extracorporeal shock wave lithotripsy (ESL) treatment. In addition, side effects of the treatment, such as the hemorrhage and destruction of the tissue in the vicinity of the stone are also ascribed to cavitation phenomenon. Since cavitation is associated with the maximum negative pressure in the shock pulse, it would thus appear that possibility of controlling this pressure would be desirable in ESL applications. This paper describes a novel technique developed to control the ratio of compressional peak (P+) to rarefactional peak pressure (P-) of the shock wave for use in lithotripsy treatment. The procedure is based on the finite amplitude wave generation by focused piezoelectric transducers and subsequent interaction of the shocked waves in the common focal region. The highly asymmetrical shock wave is produced in the focal region by providing an appropriate time delay to each of the high voltage electrical excitation signals which drive the transducers. The degree of relative reduction of negative halfcycles and the corresponding positive halfcycles amplification increases with the number of the acoustic sources used. The practical implementation of the shock wave generator was obtained by using 5 cm diameter, focused 1 MHz transmitter, and additional transducers of identical construction having frequencies corresponding to the harmonics and subharmonics of the 1 MHz frequency. The importance of the results for the future development of lithotripters, and stone treatment efficiency is pointed out. PMID:2238254

  7. Evaluation of a system for classification of stones and their sites in kidneys treated with extracorporeal shock wave lithotripsy.

    PubMed

    Pettersson, B; Tiselius, H G; Rahmqvist, M

    1990-01-01

    The results of treatment with extracorporeal shock wave lithotripsy (ESWL) were recorded in 1067 patients with renal calculi during their first admission to hospital. All treatments were performed in an unmodified Dornier HM3 lithotripter according to the original recommendations whereby the generator voltage was usually set between 18 and 23 kV. The stones in kidneys treated with ESWL alone were first classified into four different types (A. B. C. D) and after which a further subgrouping was carried out according to the number and sites of stones in the renal pelvis or calyces. The number of shock-waves. the energy index. the duration of treatment, and length of hospital stay as well as the therapeutic results after four weeks and six months were recorded for the different subgroups. An approximate estimate of the stone volume was calculated from measurements on a plain abdominal radiograph. The mean stone volume, number of shock waves, energy index, duration of treatment, and length of hospital stay increased progressively and significantly from group A to group D. The stone volumes and the energy indexes in the different subgroups within each type were distributed around levels that clearly differed between the types. Although minor variations were observed similar patterns also were recorded for the retreatment rate, the total duration of treatment, and the length of hospital stay. The therapeutic result, expressed as satisfactory disintegration, showed roughly similar results within each group but, as expected, the success rate decreased when more complicated stones were treated. Although stones located in the renal pelvis were often bigger than calyceal stones, the former seemed to disintegrate more easily.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2274754

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

    PubMed Central

    Tandan, Manu; Reddy, D Nageshwar

    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 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. PMID:22110261

  9. Arguments for choosing extracorporeal shockwave lithotripsy for removal of urinary tract stones.

    PubMed

    Tiselius, Hans-Göran; Chaussy, Christian G

    2015-10-01

    At a time when there is an almost unlimited enthusiasm and preference among urologists for endoscopic stone removal, we have found it essential to meet some of the frequently presented arguments on why extracorporeal shockwave lithotripsy (SWL) should not be used. We have based our considerations in this brief article on our 30-35 years' experience with the non-invasive or least invasive technique that SWL represents. Stone disintegration, requirement of repeated treatment sessions, the concern of residual fragments, complications and economic aspects are some points that are discussed. PMID:26315364

  10. Suppression of large intraluminal bubble expansion in shock wave lithotripsy without compromising stone comminution: methodology and in vitro experiments.

    PubMed

    Zhong, P; Zhou, Y

    2001-12-01

    To reduce the potential of vascular injury without compromising the stone comminution capability of a Dornier HM-3 lithotripter, we have devised a method to suppress intraluminal bubble expansion via in situ pulse superposition. A thin shell ellipsoidal reflector insert was designed and fabricated to fit snugly into the original reflector of an HM-3 lithotripter. The inner surface of the reflector insert shares the same first focus with the original HM-3 reflector, but has its second focus located 5 mm proximal to the generator than that of the HM-3 reflector. With this modification, the original lithotripter shock wave is partitioned into a leading lithotripter pulse (peak positive pressure of 46 MPa and positive pulse duration of 1 micros at 24 kV) and an ensuing second compressive wave of 10 MPa peak pressure and 2 micros pulse duration, separated from each other by about 4 micros. Superposition of the two waves leads to a selective truncation of the trailing tensile component of the lithotripter shock wave, and consequently, a reduction in the maximum bubble expansion up to 41% compared to that produced by the original reflector. The pulse amplitude and -6 dB beam width of the leading lithotripter shock wave from the upgraded reflector at 24 kV are comparable to that produced by the original HM-3 reflector at 20 kV. At the lithotripter focus, while only about 30 shocks are needed to cause a rupture of a blood vessel phantom made of cellulose hollow fiber (i.d.=0.2 mm) using the original HM-3 reflector at 20 kV, no rupture could be produced after 200 shocks using the upgraded reflector at 24 kV. On the other hand, after 100 shocks the upgraded reflector at 24 kV can achieve a stone comminution efficiency of 22%, which is better than the 18% efficiency produced by the original reflector at 20 kV (p = 0.043). All together, it has been shown in vitro that the upgraded reflector can produce satisfactory stone comminution while significantly reducing the potential for vessel rupture in shock wave lithotripsy. PMID:11785829

  11. [Electrohydraulic biliary lithotripsy. What approach?].

    PubMed

    Ponchon, T; Martin, X; Valette, P J; Ayela, P

    1987-10-31

    In 11 patients stones in the common bile duct or in intrahepatic bile ducts could not be extracted by the retrograde route after endoscopic sphincterotomy. Electro-hydraulic lithotripsy was then attempted, using the retrograde route in 4 cases, the transhepatic route in 3 cases and the extracorporeal shock wave technique in 7 cases. The stones could be divided into fragments small enough to be extracted in all patients. The respective indications of the 3 types of electro-hydraulic biliary lithotripsy are discussed. PMID:2962103

  12. Lithotripsy for refractory pediatric sialolithiasis.

    PubMed

    McJunkin, Jonathan; Milov, Simon; Jeyakumar, Anita

    2009-02-01

    Symptomatic salivary stones in the middle or proximal parotid duct have traditionally been treated by gland excision, which is associated with a 3% to 27% risk to the facial nerve in the pediatric population. Minimally invasive approaches to the management of salivary duct calculi have been introduced over the last several years. Fluoroscopically guided basket retrieval, lithotripsy, and intraoral stone removal under general anesthesia have found favor with many surgeons. Our patient had extracorporeal lithotripsy to his parotid gland with complete disintegration of the stone. He has had no evidence of stone recurrence or further bouts of parotitis. Extracorporeal shock wave lithotripsy with or without duct dilation is an efficient technique for the therapy of sialolithiasis in selected patients, especially patients who are at higher risk from a surgical standpoint. PMID:19172610

  13. Results of extracorporeal shock wave lithotripsy of gall bladder stones in 693 patients: a plea for restriction to solitary radiolucent stones.

    PubMed Central

    Elewaut, A; Crape, A; Afschrift, M; Pauwels, W; De Vos, M; Barbier, F

    1993-01-01

    During a period of 24 months 693 consecutive patients with symptomatic gall bladder stones (526 males, 167 females; mean age 51 years, range 18-89) were treated by extracorporeal shock wave lithotripsy with a Piezolith 2300. The procedure was carried out on an out-patient basis without analgesics or sedatives. Concomitant chemolitholytic treatment (ursodeoxycholic and chenodeoxycholic acid 7.5 mg/kg/day each) was administered until three months after total fragment clearance for a maximum therapy period of 1.5 years. In 601 patients with radiolucent stones complete clearance of all fragments was obtained after three, six, 12, and 18 months in respectively 20, 41, 64, and 78%. Actuarial analysis of the subgroups according to the stone mass (size and number) selected an ideal patient population with solitary stones less than 20 mm diameter (84% stone free after one year). The results are significantly less good when the greater the number of stones or their maximal diameter increases. Treatment was interrupted in 3.6% of the patients. In 90 sludge or fragments remain present. Twenty five patients were lost to follow up for non-biliary reasons. Stone recurrence was 5.7% at one year and was observed both in patients with solitary and multiple stones. A cost effectiveness analysis suggests that laparoscopic cholecystectomy is the most effective and economic solution, although extracorporeal shock wave lithotripsy for solitary radiolucent stones less than 2 cm is cheaper than conventional cholecystectomy. Extracorporeal shock wave lithotripsy for multiple stones is the most expensive and least effective option. PMID:8432485

  14. Effect of High Shock Number on Acute Complication Development After Extracorporeal Shockwave Lithotripsy

    PubMed Central

    Hadj-Moussa, Miriam

    2013-01-01

    Abstract Purpose We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). Patients and Methods A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24?kV using a Medstone STS-T lithotripter (Medstone International Inc., Aliso Viejo, CA) was conducted. Complications occurred within 4 weeks of SWL. Treatments were split into three cohorts based on shock number (<2400, 2401–4000, and >4000). Postoperative sequelae of patients who were stone free and those with residual stone were studied separately. Chi-square tests were used to evaluate the relationship between shock number cohort and postoperative complication development. Results SWL treatments recorded for each cohort were 158 (37.4%), 145 (34.4%), and 119 (28.2%), respectively. The short-term complication rate when SWL was successful was 8.3% overall. Complication rate for each cohort was 9.5% (11), 7.8% (5), and 7.2% (7), respectively. When SWL was successful, statistical analysis revealed no significant difference between complication rates and shock number cohort (P=0.63). Complications in patients with a residual stone occurred after 41.4% of treatments and trended upward with shock number cohort, but did not reach statistical significance (P=0.84). Conclusions At high voltage, high shock number was not shown to cause higher rates of short-term postoperative complications, as experienced by patients, when SWL was successful or resulted in a residual stone, yet complication rates associated with residual stone burden were approximately five times as common. Forgoing a higher shock number in the presence of a residual stone may therefore increase the risks of sequelae immediately after SWL. PMID:23537270

  15. Overview of shock waves in medicine

    NASA Astrophysics Data System (ADS)

    Cleveland, Robin O.

    2003-10-01

    A brief overview of three applications of shock waves is presented. Shock wave lithotripsy (SWL) has been in clinical use for more than 20 years. In the United States it is used to treat more than 80% of kidney stone cases and has wide acceptance with patients because it is a noninvasive procedure. Despite SWLs enormous success there is no agreement on how shock waves comminute stones. There is also a general acceptance that shock waves lead to trauma to the soft tissue of the kidney. Yet there has been little forward progress in developing lithotripters which provide comminution with less side-effects, indeed the original machine is still considered the gold standard. The last decade has seen the advent of new shock wave devices for treating principally musculoskeletal indications, such as plantar fasciitis, tennis elbow, and bone fractures that do not heal. This is referred to as shock wave therapy (SWT). The mechanisms by which SWT works are even less well understood than SWL and the consequences of bioeffects have also not been studied in detail. Shock waves have also been shown to be effective at enhancing drug delivery into cells and assisting with gene transfection. [Work partially supported by NIH.

  16. Modeling and experimental analysis of acoustic cavitation bubbles for Burst Wave Lithotripsy

    NASA Astrophysics Data System (ADS)

    Maeda, Kazuki; Kreider, Wayne; Maxwell, Adam; Cunitz, Bryan; Colonius, Tim; Bailey, Michael

    2015-12-01

    Cavitation bubbles initiated by focused ultrasound waves are investigated through experiments and modeling. Pulses of focused ultrasound with a frequency of 335 kHz and a peak negative pressure of 8 MPa is generated in a water tank by a piezoelectric transducer to initiate cavitation. The pressure field is modeled by solving the Euler equations and used to simulate single bubble oscillation. The characteristics of cavitation bubbles observed by highspeed photography qualitatively agree with the simulation results. Finally, bubble clouds are captured using acoustic B-mode imaging that works synchronized with high-speed photography.

  17. Proteus mirabilis viability after lithotripsy of struvite calculi

    NASA Astrophysics Data System (ADS)

    Prabakharan, Sabitha; Teichman, Joel M. H.; Spore, Scott S.; Sabanegh, Edmund; Glickman, Randolph D.; McLean, Robert J. C.

    2000-05-01

    Urinary calculi composed of struvite harbor urease-producing bacteria within the stone. The photothermal mechanism of holmium:YAG lithotripsy is uniquely different than other lithotripsy devices. We postulated that bacterial viability of struvite calculi would be less for calculi fragmented with holmium:YAG irradiation compared to other lithotripsy devices. Human calculi of known struvite composition (greater than 90% magnesium ammonium phosphate hexahydrate) were incubated with Proteus mirabilis. Calculi were fragmented with no lithotripsy (controls), or shock wave, intracorporeal ultrasonic, electrohydraulic, pneumatic, holmium:YAG or pulsed dye laser lithotripsy. After lithotripsy, stone fragments were sonicated and specimens were serially plated for 48 hours at 38 C. Bacterial counts and the rate of bacterial sterilization were compared. Median bacterial counts (colony forming units per ml) were 8 X 106 in controls and 3 X 106 in shock wave, 3 X 107 in ultrasonic, 4 X 105 in electrohydraulic, 8 X 106 in pneumatic, 5 X 104 in holmium:YAG and 1 X 106 in pulsed dye laser lithotripsy, p less than 0.001. The rate of bacterial sterilization was 50% for holmium:YAG lithotripsy treated stones versus 0% for each of the other cohorts, p less than 0.01. P. mirabilis viability is less after holmium:YAG irradiation compared to other lithotripsy devices.

  18. A comparative study to analyze the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy for residual calculi after percutaneous nephrolithotripsy

    PubMed Central

    Xu, Gang; Wen, Jiaming; Li, Zhongyi; Zhang, Zhewei; Gong, Xiuqing; Chen, Jimin; Du, Chuanjun

    2015-01-01

    A certain proportion of patients with initial Percutaneous nephrolithotripsy (PCNL) management require ancillary procedures to increase the stone-free rate. In this study, we aim to analyze the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy (F-UL) for treatment of residual calculi after PCNL by comparison with extracorporeal shockwave lithotripsy (SWL). Total of 96 patients with residual renal calculi (4 mm to 20 mm) after PCNL was enrolled from May 2010 to March 2013. They were randomly divided into two groups: US Group: patients were treated with F-UL; SWL Group: patients were treated with SWL. Follow-up was made one month and three months after treatment. The mean residual stone size after PCNL was 12.4 ± 4.3 mm in US group compared with 11.9 ± 4.5 in SWL group. The stone-free rate was 84.7% one month after surgical procedure in US group, this rate increased to 91.3% in the third months, while the stone-free rate in SWL group is 64.6% one month after treatment and 72.9% in the third month. For residual stone in lower calyx, the stone-free rate three month after treatment was 90.4% in US group compared to 65.2% in SWL group (P < 0.05). The overall complication rate was low in both groups, no severe complication was found. Both F-UL and SWL are safe and effective methods for residual calculi after PCNL, without severe complications. F-UL provided significantly higher stone-free rate compared with SWL, especially for low-pole calculi. PMID:26064375

  19. A comparative study to analyze the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy for residual calculi after percutaneous nephrolithotripsy.

    PubMed

    Xu, Gang; Wen, Jiaming; Li, Zhongyi; Zhang, Zhewei; Gong, Xiuqing; Chen, Jimin; Du, Chuanjun

    2015-01-01

    A certain proportion of patients with initial Percutaneous nephrolithotripsy (PCNL) management require ancillary procedures to increase the stone-free rate. In this study, we aim to analyze the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy (F-UL) for treatment of residual calculi after PCNL by comparison with extracorporeal shockwave lithotripsy (SWL). Total of 96 patients with residual renal calculi (4 mm to 20 mm) after PCNL was enrolled from May 2010 to March 2013. They were randomly divided into two groups: US Group: patients were treated with F-UL; SWL Group: patients were treated with SWL. Follow-up was made one month and three months after treatment. The mean residual stone size after PCNL was 12.4 ± 4.3 mm in US group compared with 11.9 ± 4.5 in SWL group. The stone-free rate was 84.7% one month after surgical procedure in US group, this rate increased to 91.3% in the third months, while the stone-free rate in SWL group is 64.6% one month after treatment and 72.9% in the third month. For residual stone in lower calyx, the stone-free rate three month after treatment was 90.4% in US group compared to 65.2% in SWL group (P < 0.05). The overall complication rate was low in both groups, no severe complication was found. Both F-UL and SWL are safe and effective methods for residual calculi after PCNL, without severe complications. F-UL provided significantly higher stone-free rate compared with SWL, especially for low-pole calculi. PMID:26064375

  20. Shock Wave Lithotripsy

    MedlinePLUS

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  1. Noncontrast computed tomography can predict the outcome of shockwave lithotripsy via accurate stone measurement and abdominal fat distribution determination.

    PubMed

    Geng, Jiun-Hung; Tu, Hung-Pin; Shih, Paul Ming-Chen; Shen, Jung-Tsung; Jang, Mei-Yu; Wu, Wen-Jen; Li, Ching-Chia; Chou, Yii-Her; Juan, Yung-Shun

    2015-01-01

    Urolithiasis is a common disease of the urinary system. Extracorporeal shockwave lithotripsy (SWL) has become one of the standard treatments for renal and ureteral stones; however, the success rates range widely and failure of stone disintegration may cause additional outlay, alternative procedures, and even complications. We used the data available from noncontrast abdominal computed tomography (NCCT) to evaluate the impact of stone parameters and abdominal fat distribution on calculus-free rates following SWL. We retrospectively reviewed 328 patients who had urinary stones and had undergone SWL from August 2012 to August 2013. All of them received pre-SWL NCCT; 1 month after SWL, radiography was arranged to evaluate the condition of the fragments. These patients were classified into stone-free group and residual stone group. Unenhanced computed tomography variables, including stone attenuation, abdominal fat area, and skin-to-stone distance (SSD) were analyzed. In all, 197 (60%) were classified as stone-free and 132 (40%) as having residual stone. The mean ages were 49.35 ± 13.22 years and 55.32 ± 13.52 years, respectively. On univariate analysis, age, stone size, stone surface area, stone attenuation, SSD, total fat area (TFA), abdominal circumference, serum creatinine, and the severity of hydronephrosis revealed statistical significance between these two groups. From multivariate logistic regression analysis, the independent parameters impacting SWL outcomes were stone size, stone attenuation, TFA, and serum creatinine. [Adjusted odds ratios and (95% confidence intervals): 9.49 (3.72-24.20), 2.25 (1.22-4.14), 2.20 (1.10-4.40), and 2.89 (1.35-6.21) respectively, all p < 0.05]. In the present study, stone size, stone attenuation, TFA and serum creatinine were four independent predictors for stone-free rates after SWL. These findings suggest that pretreatment NCCT may predict the outcomes after SWL. Consequently, we can use these predictors for selecting the optimal treatment for patients with urinary stones. PMID:25600918

  2. Acoustic cavitation bubbles in the kidney induced by focused shock waves in extracorporeal shock wave lithotripsy (ESWL)

    NASA Astrophysics Data System (ADS)

    Kuwahara, M.; Ioritani, N.; Kambe, K.; Taguchi, K.; Saito, T.; Igarashi, M.; Shirai, S.; Orikasa, S.; Takayama, K.

    1990-07-01

    On an ultrasonic imaging system a hyperechoic region was observed in a focal area of fucused shock waves in the dog kidney. This study was performed to learn whether cavitation bubbles are responsible for this hyperechoic region. The ultrasonic images in water of varying temperatures were not markedly different. In the flowing stream of distilled water, the stream was demonstrated as a hyperechoic region only with a mixture of air bubbles. Streams of 5%-50% glucose solutions were also demonstrated as a hyperechoic region. However, such concentration changes in living tissue, as well as thermal changes, are hardly thought to be induced. The holographic interferometry showed that the cavitation bubbles remained for more than 500 msec. in the focal area in water. This finding indicate that the bubble can remain for longer period than previously supposed. These results support the contentions that cavitation bubbles are responsible for the hyperechoic region in the kidney in situ.

  3. Focused Ultrasound and Lithotripsy.

    PubMed

    Ikeda, Teiichiro; Yoshizawa, Shin; Koizumi, Norihiro; Mitsuishi, Mamoru; Matsumoto, Yoichiro

    2016-01-01

    Shock wave lithotripsy has generally been a first choice for kidney stone removal. The shock wave lithotripter uses an order of microsecond pulse durations and up to a 100 MPa pressure spike triggered at approximately 0.5-2 Hz to fragment kidney stones through mechanical mechanisms. One important mechanism is cavitation. We proposed an alternative type of lithotripsy method that maximizes cavitation activity to disintegrate kidney stones using high-intensity focused ultrasound (HIFU). Here we outline the method according to the previously published literature (Matsumoto et al., Dynamics of bubble cloud in focused ultrasound. Proceedings of the second international symposium on therapeutic ultrasound, pp 290-299, 2002; Ikeda et al., Ultrasound Med Biol 32:1383-1397, 2006; Yoshizawa et al., Med Biol Eng Comput 47:851-860, 2009; Koizumi et al., A control framework for the non-invasive ultrasound the ragnostic system. Proceedings of 2009 IEEE/RSJ International Conference on Intelligent Robotics and Systems (IROS), pp 4511-4516, 2009; Koizumi et al., IEEE Trans Robot 25:522-538, 2009). Cavitation activity is highly unpredictable; thus, a precise control system is needed. The proposed method comprises three steps of control in kidney stone treatment. The first step is control of localized high pressure fluctuation on the stone. The second step is monitoring of cavitation activity and giving feedback on the optimized ultrasound conditions. The third step is stone tracking and precise ultrasound focusing on the stone. For the high pressure control we designed a two-frequency wave (cavitation control (C-C) waveform); a high frequency ultrasound pulse (1-4 MHz) to create a cavitation cloud, and a low frequency trailing pulse (0.5 MHz) following the high frequency pulse to force the cloud into collapse. High speed photography showed cavitation collapse on a kidney stone and shock wave emission from the cloud. We also conducted in-vitro erosion tests of model and natural kidney stones. For the model stones, the erosion rate of the C-C waveform showed a distinct advantage with the combined high and low frequency waves over either wave alone. For optimization of the high frequency ultrasound intensity, we investigated the relationship between subharmonic emission from cavitation bubbles and stone erosion volume. For stone tracking we have also developed a non-invasive ultrasound theragnostic system (NIUTS) that compensates for kidney motion. Natural stones were eroded and most of the resulting fragments were less than 1 mm in diameter. The small fragments were small enough to pass through the urethra. The results demonstrate that, with the precise control of cavitation activity, focused ultrasound has the potential to be used to develop a less invasive and more controllable lithotripsy system. PMID:26486335

  4. The feasibility of shockwave lithotripsy for treating solitary, lower calyceal stones over 1 cm in size

    PubMed Central

    Kim, Tae Beom; Lee, Sang Cheol; Kim, Khae Hawn; Jung, Han; Yoon, Sang Jin; Oh, Jin Kyu

    2013-01-01

    Introduction: Recently, few studies were reported about the treatment of large, solitary, renal calculi between shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PNL). We assess the feasibility of SWL for managing solitary, lower calyceal stones over 1 cm by comparing the results of lower pole calculi treatment between patients that underwent SWL or PNL. Methods: We retrospectively reviewed clinical data for patients who had undergone PNL or SWL due to lower calyceal stones over 1 cm. Group 1 consisted of patients who underwent SWL to treat lower pole renal calculi from 2010 to 2011. Group 2 included patients who underwent PNL to manage lower pole renal calculi from 2008 to 2009. We compared patient age, gender, stone size, comorbidities, postoperative complications, additional interventions and anatomical parameters between the two groups. Results: A total of 55 patients were enrolled in this study. The mean ages (±SD) of groups 1 (n = 33) and 2 (n = 22) were 55.1 (±13.0) and 50.0 (±10.6) years (p = 0.133) and mean stone sizes were 1.6 (±0.7) and 1.9 (±0.8) cm (p = 0.135), respectively. There were no significant differences in gender distribution, comorbidities or stone laterality between the two groups. No significant differences in various parameters were observed between patients with stones 1 to 2 cm and ones with stones 2 cm or larger. Conclusions: Our results demonstrated that SWL is a safe, feasible treatment for solitary, lower calyceal stones over 1 cm. PMID:23589749

  5. [Contact lithotripsy in treatment of choledocholithiasis].

    PubMed

    Razmakhnin, E V; Khyshiktuev, B S; Lobanov, S L

    2014-01-01

    It was suggested to use contact ultrasonic lithotripsy in lumen of common bile duct during laparoscopic surgery in order to preserve the sphincter apparatus of major duodenal papilla. Waveguide with original structure was used for lithotripsy performing. Waveguide's total length is 400 mm. It has a radially curved 40 degrees broken part with diameter of 6 mm cone rolling in working portion with diameter of 4 mm and length of 60 mm for introduction in common bile duct. There is concave lens on waveguide working portion end with diameter of 1 mm. A lens permits concentrating the waves beam in longitudinal direction avoiding its scattering and minimizing the impact on surrounding tissues. Lithotripsy efficiency was proved in the in vitro (n=68) and in vivo (n=20) experiments. Such structure of waveguide permits to penetrate in lumen of common bile duct through dilated cystic duct or choledochendysis for calculi fragmentation. PMID:25146540

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

    PubMed Central

    Pricop, Catalin; Maier, Adrian; Negru, Dragos; Malau, Ovidiu; Orsolya, Martha; Radavoi, Daniel; Serban, Dragomir R.

    2014-01-01

    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. PMID:25428680

  7. Intracorporeal laser lithotripsy

    PubMed Central

    Papatsoris, Athanasios G.; Skolarikos, Andreas; Buchholz, Noor

    2012-01-01

    Objectives To review the current literature on intracorporeal laser lithotripsy. Methods We searched PubMed for relevant reports up to January 2012, using the keywords ‘laser’, ‘lithotripsy’ and ‘intracorporeal’. Results We studied 125 relevant reports of studies with various levels of evidence. Efficient lithotripsy depends on the laser variables (wavelength, pulse duration and pulse energy) and the physical properties of the stones (optical, mechanical and chemical). The most efficient laser for stones in all locations and of all mineral compositions is the holmium yttrium–aluminium–garnet laser (Ho:YAG). The frequency-doubled double-pulse Nd:YAG laser functions through the generation of a plasma bubble. New laser systems, such as the erbium:YAG and the thulium laser, are under evaluation. Laser protection systems have also been developed for the novel digital flexible ureteroscopes. Although complications are rare, a high relevant clinical suspicion is necessary. Conclusions Laser lithotripsy technology is continuously developing, while the Ho:YAG laser remains the reference standard for intracorporeal lithotripsy. PMID:26558041

  8. Quantitative Assessment of Shockwave Lithotripsy Accuracy and the Effect of Respiratory Motion*

    PubMed Central

    Bailey, Michael R.; Shah, Anup R.; Hsi, Ryan S.; Paun, Marla; Harper, Jonathan D.

    2012-01-01

    Abstract Background and Purpose Effective stone comminution during shockwave lithotripsy (SWL) is dependent on precise three-dimensional targeting of the shockwave. Respiratory motion, imprecise targeting or shockwave alignment, and stone movement may compromise treatment efficacy. The purpose of this study was to evaluate the accuracy of shockwave targeting during SWL treatment and the effect of motion from respiration. Patients and Methods Ten patients underwent SWL for the treatment of 13 renal stones. Stones were targeted fluoroscopically using a Healthtronics Lithotron (five cases) or Dornier Compact Delta II (five cases) shockwave lithotripter. Shocks were delivered at a rate of 1 to 2?Hz with ramping shockwave energy settings of 14 to 26?kV or level 1 to 5. After the low energy pretreatment and protective pause, a commercial diagnostic ultrasound (US) imaging system was used to record images of the stone during active SWL treatment. Shockwave accuracy, defined as the proportion of shockwaves that resulted in stone motion with shockwave delivery, and respiratory stone motion were determined by two independent observers who reviewed the ultrasonographic videos. Results Mean age was 51±15 years with 60% men, and mean stone size was 10.5±3.7?mm (range 5–18?mm). A mean of 2675±303 shocks was delivered. Shockwave-induced stone motion was observed with every stone. Accurate targeting of the stone occurred in 60%±15% of shockwaves. Conclusions US imaging during SWL revealed that 40% of shockwaves miss the stone and contribute solely to tissue injury, primarily from movement with respiration. These data support the need for a device to deliver shockwaves only when the stone is in target. US imaging provides real-time assessment of stone targeting and accuracy of shockwave delivery. PMID:22471349

  9. 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

    PubMed Central

    Cho, Kang Su; Jung, Hae Do; Ham, Won Sik; Chung, Doo Yong; Kang, Yong Jin; Jang, Won Sik; Kwon, Jong Kyou; Choi, Young Deuk; Lee, Joo Yong

    2015-01-01

    Objectives 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. Patients and Methods 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. Results 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. Conclusions Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL. PMID:26659086

  10. Pain control using pethidine in combination with diazepam compared to diclofenac in combination with hyoscine-n-butyl bromide: in patients undergoing extracorporeal shock wave lithotripsy

    PubMed Central

    Cecen, Kursat; Karadag, Mert Ali; Uslu, Mehmet; Arslan, Omer Erkam

    2015-01-01

    Introduction Extracorporeal Shock Wave Lithotripsy (ESWL) remains the preferred least invasive treatment for urinary tract stones. The main purpose of this study was to compare two treatment modalities for pain control during the ESWL procedure. Material and methods From 2013 to 2014, 220 patients received ESWL for kidney stones. Before the procedure, the weight and height were measured to determine the body mass index (BMI); in addition, oxygen saturation and the pulse of the patients, as well as pain level were determined. The pain control provided included two different methods: diclofenac sodium plus hyoscine-N-butyl bromide in the first group and pethidine plus diazepam in the second group. The pain level of the patients was determined using two different scales: the Wong-Baker and the Visual Analogue scales (VAS). At the end of three sessions, all patients were evaluated for the stone fragmentation rate by plain abdominal X-ray, and the findings were recorded and analyzed. Results A total of 220 patients were enrolled in this study. There were 91 patients in the first group (diclofenac sodium + hyoscine-N-butyl bromide) (male/female: 63/28) and 129 (male/female: 83/46) patients in the second group (pethidine HCL +diazepam). The mean age with SD according to each group was 42.03 (±16.43) and 42.56 (±14.23), respectively (p = 0.8). With regard to pain scores (using the Wong-Baker and VAS scales), the responses were significantly lower in the second group (p <0.001). Conclusions Pethidine in combination with diazepam was superior to diclofenac and Hyoscine-N-butyl bromide for pain in patients undergoing ESWL. PMID:26251744

  11. Flexible Ureterorenoscopy versus Extracorporeal Shock Wave Lithotripsy for the treatment of upper/middle calyx kidney stones of 10-20?mm: a retrospective analysis of 174 patients.

    PubMed

    Cecen, Kursat; Karadag, Mert Ali; Demir, Aslan; Bagcioglu, Murat; Kocaaslan, Ramazan; Sofikerim, Mustafa

    2014-01-01

    To compare the outcomes of flexible ureterorenoscopy (F-URS) with extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper or mid calyx kidney stones of 10 to 20?mm. A total of 174 patients with radioopaque solitary upper or mid calyx stones who underwent ESWL or F-URS with holmium:YAG laser were enrolled in this study. Each group treated with ESWL and F-URS for upper or mid calyx kidney stones were retrospectively compared in terms of retreatment and stone free rates, and complications. 87% (n?=?94) of patients who underwent ESWL therapy was stone free at the end of 3rd month. This rate was 92% (n?=?61) for patients of F-URS group (p?=?0.270 p?>?0.05). Retreatment was required in 12.9% of patients (n?=?14) who underwent ESWL and these patients were referred to F-URS procedure after 3rd month radiologic investigations. The retreatment rate of cases who were operated with F-URS was 7.5% (n?=?5) (p?=?0.270 p?>?0.05). Ureteral perforation (Clavien grade 3B) was occured in 3 patients (4.5%) who underwent F-URS. Fever (Clavien grade 1) was noted in 7 and 5 patients from ESWL and F-URS group, respectively (6.4% vs 7.5%) (p?=?0.78 p?>?0.05). F-URS and ESWL have similar outcomes for the treatment of upper or mid calyx renal stones of 10-20?mm. ESWL has the superiority of minimal invasiveness and avoiding of general anethesia. F-URS should be kept as the second teratment alternative for patients with upper or mid caliceal stones of 10-20?mm and reserved for cases with failure in ESWL. PMID:25332859

  12. Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1-2 cm: a meta-analysis.

    PubMed

    Zheng, Changjian; Yang, Hongmei; Luo, Jun; Xiong, Bo; Wang, Hongzhi; Jiang, Qing

    2015-11-01

    This study is to evaluate the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) versus retrograde intrarenal surgery (RIRS) for the treatment for renal calculi 1-2 cm. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Literature Database were researched and hand-searched for relevant congress abstracts and journals about RIRS and ESWL for the treatment for 1- to 2-cm renal stones. The retrieval time ended in September 2014. The related trials met the inclusion criteria were included in the meta-analysis. Two reviewers independently assessed the quality of all included studies, and meta-analysis was performed with RevMan 5.2. Seven literatures were retrieved, including 983 patients. The meta-analysis results showed that, compared to RIRS group, the patients in ESWL group had the following features:(1) the stone-free rate [relative risk (RR) 0.86; 95% confidence interval (CI) 0.77-0.95, P = 0.005] was significantly different between two groups; (2) The retreatment rate of RIRS group was lower (RR 8.12; 95% CI 4.77-13.83, P < 0.00); (3) The complications were not significantly different between two groups (Grade I RR 1.06; 95% CI 0.67-1.69, P = 0.80; Grade II RR 0.75; 95% CI 0.29-1.91, P = 0.54; Grade III RR 0.86; 95% CI 0.26-2.86, P = 0.80). Compared to ESWL, our results showed that RIRS provided significantly higher stone-free rate and lower retreatment rate and without increase in the incidence of complications. However, further randomized trials are needed to confirm these findings. PMID:26211003

  13. The success of extracorporeal shock-wave lithotripsy based on the stone-attenuation value from non-contrast computed tomography

    PubMed Central

    Massoud, Amr M.; Abdelbary, Ahmed M.; Al-Dessoukey, Ahmad A.; Moussa, Ayman S.; Zayed, Ahmed S.; Mahmmoud, Osama

    2014-01-01

    Objective To determine the utility of the urinary stone-attenuation value (SAV, in Hounsfield units, HU) from non-contrast computed tomography (NCCT) for predicting the success of extracorporeal shock-wave lithotripsy (ESWL). Patients and methods The study included 305 patients with renal calculi of ?30 mm and upper ureteric calculi of ?20 mm. The SAV was measured using NCCT. Numerical variables were compared using a one-way analysis of variance with posthoc multiple two-group comparisons. Univariate and multivariate regression analysis models were used to test the preferential effect of the independent variable(s) on the success of ESWL. Results Patients were grouped according to the SAV as group 1 (?500 HU, 81 patients), group 2 (501–1000 HU, 141 patients) and group 3 (>1000 HU, 83 patients). ESWL was successful in 253 patients (83%). The rate of stone clearance was 100% in group 1, 95.7% (135/141) in group 2 and 44.6% (37/83) in group 3 (P = 0.001). Conclusions The SAV value is an independent predictor of the success of ESWL and a useful tool for planning stone treatment. Patients with a SAV ?956 HU are not ideal candidates for ESWL. The inclusion criteria for ESWL of stones with a SAV <500 HU can be expanded with regard to stone size, site, age, renal function and coagulation profile. In patients with a SAV of 500–1000 HU, factors like a body mass index of >30 kg/m2 and a lower calyceal location make them less ideal for ESWL. PMID:26019941

  14. Do Renal Cysts Affect the Success of Extracorporeal Shockwave Lithotripsy? A Retrospective Comparative Study

    PubMed Central

    Gücük, Adnan; Öztürk, Ufuk; Üyetürk, U?ur; Kemahl?, Eray; Ak?n, Güven; ?mamo?lu, M. Abdurrahim; Metin, Ahmet

    2013-01-01

    The aim of this study was to assess the effect of simple renal cysts on extracorporeal shockwave lithotripsy (SWL) in patients with calyceal renal calculi. Patients with simple renal cysts >35?mm and ipsilateral renal calculi <20?mm that were treated with SWL constituted group 1 (cyst + calculi). The control group included patients aged >40 years that had renal calculi <20?mm and no cysts that were treated with SWL. The 2 groups were compared according to age, gender, body mass index, calculi size, localization, and density, the calculi fragmentation rate, and the percentage of stone-free patients. Mean cyst size in group 1 was 44.04 ± 9.08?mm. Mean age in group 1 was 61.4 ± 10.2 years versus 56.9 ± 8.2 years in the control group; the difference was significant (P = 0.045). There were not any other significant differences between the 2 groups, except for the stone-free rate (P > 0.05), which was 33.3% in group 1 and 68.2% in the control group (P = 0.017). The presence of renal cysts in a patient with calculi requires that an individualized treatment plan be devised, so as to provide the patient with the most effective treatment. PMID:23840202

  15. Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter

    PubMed Central

    Neisius, Andreas; Smith, Nathan B.; Sankin, Georgy; Kuntz, Nicholas John; Madden, John Francis; Fovargue, Daniel E.; Mitran, Sorin; Lipkin, Michael Eric; Simmons, Walter Neal; Preminger, Glenn M.; Zhong, Pei

    2014-01-01

    The efficiency of shock wave lithotripsy (SWL), a noninvasive first-line therapy for millions of nephrolithiasis patients, has not improved substantially in the past two decades, especially in regard to stone clearance. Here, we report a new acoustic lens design for a contemporary electromagnetic (EM) shock wave lithotripter, based on recently acquired knowledge of the key lithotripter field characteristics that correlate with efficient and safe SWL. The new lens design addresses concomitantly three fundamental drawbacks in EM lithotripters, namely, narrow focal width, nonidealized pulse profile, and significant misalignment in acoustic focus and cavitation activities with the target stone at high output settings. Key design features and performance of the new lens were evaluated using model calculations and experimental measurements against the original lens under comparable acoustic pulse energy (E+) of 40 mJ. The ?6-dB focal width of the new lens was enhanced from 7.4 to 11 mm at this energy level, and peak pressure (41 MPa) and maximum cavitation activity were both realigned to be within 5 mm of the lithotripter focus. Stone comminution produced by the new lens was either statistically improved or similar to that of the original lens under various in vitro test conditions and was significantly improved in vivo in a swine model (89% vs. 54%, P = 0.01), and tissue injury was minimal using a clinical treatment protocol. The general principle and associated techniques described in this work can be applied to design improvement of all EM lithotripters. PMID:24639497

  16. Music does not reduce alfentanil requirement during patient-controlled analgesia (PCA) use in extracorporeal shock wave lithotripsy for renal stones.

    PubMed

    Cepeda, M S; Diaz, J E; Hernandez, V; Daza, E; Carr, D B

    1998-12-01

    To evaluate the impact of music on opioid requirements and pain levels during renal lithotripsy using alfentanil patient-controlled analgesia (PCA), we conducted a prospective, blinded, randomized controlled trial. Patients undergoing lithotripsy were instructed in PCA use and asked to rate their anxiety and select their preferred type of music. They were then premedicated with morphine and ketorolac and randomly allocated into two groups. Group 1 (n = 97) had music started 10 min before the procedure and maintained until 10 min after its conclusion. Group 2 (n = 96) had music begun at the conclusion of lithotripsy and continued for 10 min. Pain intensity, alfentanil requirement, side effects, quality of analgesia, patient satisfaction, and acceptance of the technique were evaluated. Demographics, alfentanil requirement, pain levels, side effects, quality of analgesia, and patient satisfaction were similar in both groups. The addition of music did not provide any benefit. This result raises the possibility that some nonpharmacologic therapies have minimal impact in settings where the painful stimulus is moderate to severe and adequate pharmacotherapy is available. PMID:9879163

  17. Kidney Stone Treatment with Lithotripsy

    MedlinePLUS Videos and Cool Tools

    Kidney Stone Treatment with Lithotripsy Broward Health Medical Center Fort Lauderdale, FL November 11, 2011 I'm ... got at least three stones in his left kidney. He's been having pain and blood in his ...

  18. Shock-Induced Bubble Collapse in a Vessel: Implications for Vascular Injury in Shockwave Lithotripsy

    NASA Astrophysics Data System (ADS)

    Coralic, Vedran; Colonius, Tim

    2013-11-01

    We numerically investigate the shock-induced collapse (SIC) of a preexisting bubble in a blood vessel and evaluate the potential of such an event to contribute to onset of vascular injury in shockwave lithotripsy (SWL). Previously, we utilized a 3D, high-order accurate, shock- and interface-capturing, multicomponent flow algorithm to carry out a large-scale parametric study of this problem [V. Coralic and T. Colonius, Eur. J. Mech. B-Fluid 40, 64-74 (2013)]. The results indicated that the influence of the blood vessel on the bubble dynamics was negligible and confirmed with experiments that the vessel would freely deform under the forcing imparted by the collapse. As a result, in this study, we perform simulations of the SIC of a preexisting bubble in a free field and couple them to a freely deforming Lagrangian mesh so to characterize the deformations in the fluid surrounding the bubble, which, as our previous results suggest, may be interpreted as the vessel and surrounding tissue. We report the fully 3D and time-dependent Green-Lagrange strains and compare them to the ultimate strains obtained in uniaxial compression/tension tests in tissue. Our findings suggest that the SIC of preexisting bubbles in blood vessels is a viable mechanism by which injury may be initiated in SWL. This research was supported by NIH grant no. 2PO1DK043881 and utilized XSEDE, which is supported by NSF grant no. OCI-1053575.

  19. Patient and personnel exposure during extracorporeal lithotripsy.

    PubMed

    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. PMID:3679826

  20. Electrohydraulic lithotripsy with peroral choledochoscopy.

    PubMed Central

    Leung, J. W.; Chung, S. S.

    1989-01-01

    OBJECTIVE--To determine the efficacy of peroral electrohydraulic lithotripsy performed with an extra large duodenoscope (outside diameter 14.8 mm) and a choledochoscope with a diameter of 4.1 mm (Olympus "mother and baby" endoscope system) in the removal of very large stones from the common bile duct. DESIGN--Prospective study of patients with giant stones in the common bile duct that were resistant to extraction by conventional means. SETTING--Endoscopy unit at a university hospital. PATIENTS--Four women and one man aged 48-82 (mean 66.4 years) with a total of nine stones in their common bile ducts ranging from 2.2 to 3.6 cm in diameter. INTERVENTIONS--Peroral electrohydraulic lithotripsy was performed after intravenous sedation and under antibiotic cover. Two endoscopists took part in each procedure, coordination being achieved by means of a video monitor. The procedures were performed with a Lithotron EL-23 lithotripter and a 3 French lithotripsy probe inserted through the choledochoscope under direct vision. MAIN OUTCOME MEASURE--Complete clearance of the common bile duct confirmed by occlusion cholangiography. RESULTS--All nine stones (mean minimal diameter 2.6 cm; mean maximal diameter 3.1 cm) were successfully fragmented by electrohydraulic lithotripsy, allowing subsequent extraction with the aid of endoscopy and clearance of the common bile duct. A median of three (range two to five) sessions of endoscopic retrograde cholangiopancreatography were required to achieve complete clearance of the ducts. Patients stayed a median of eight days in hospital after lithotripsy (range eight to 14). There were no complications. CONCLUSION--Peroral electrohydraulic lithotripsy offers a safe and effective alternative for the management of patients with large stones in the common bile duct. Images FIG 1 FIG 2 PMID:2508816

  1. Thulium fiber laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Scott, Nicholas J.; Cilip, Christopher M.; Fried, Nathaniel M.

    2009-02-01

    Complications during laser lithotripsy include optical fiber bending failure resulting in endoscope damage and low irrigation rates leading to poor visibility. Both problems are related to fiber diameter and limited by the Holmium:YAG laser (? = 2120 nm) multimode beam profile. This study exploits the Thulium fiber laser (? = 1908 nm) beam profile for higher power transmission through smaller fibers. Thulium fiber laser radiation with 1-ms pulse duration, pulse rates of 10-30 Hz, and 70-?m-diameter spot was coupled into silica fibers with 100, 150, and 200 ?m core diameters. Fiber transmission, bending, and endoscope irrigation tests were performed. Damage thresholds for 100, 150, 200 ?m fibers averaged 40 W, 60 W, and > 80 W. Irrigation rates measured 35, 26, and 15 ml/min for no fiber, 100, and 200 ?m fibers. Thulium fiber laser energy of 70-mJ delivered at 20 Hz through a 100 ?m fiber resulted in vaporization and fragmentation rates of 10 and 60 mg/min for uric acid stones. The Thulium fiber laser beam profile provides higher laser power through smaller fibers than the Ho:YAG laser, potentially reducing fiber failure and endoscope damage and allowing greater irrigation rates for improved visibility.

  2. Optically triggered solid state driver for shock wave therapy

    NASA Astrophysics Data System (ADS)

    Duryea, Alexander P.; Roberts, William W.; Cain, Charles A.; Hall, Timothy L.

    2012-10-01

    Shock wave lithotripsy (SWL) represents one of several first-line therapies for the treatment of stones located in the kidneys and ureters. Additional applications for shock wave therapy are also under exploration, including non-urinary calculi, orthopedics, and neovascularization. Except for the elimination of a large water bath in which the treatment is performed, current procedures remain largely unchanged, with one of the original commercial devices (the Dornier HM3) still considered a gold standard for comparison. To accelerate research in this area, Coleman, et al. published an experimental electrohydraulic shock wave generator capable of simulating the acoustic field generated by the HM3. We propose a further update of this system, replacing the triggered spark gap with an optically triggered solid state switch. The new system has better reliability, a wider operating range, and reduced timing jitter allowing synchronization with additional acoustic sources under exploration for improving efficacy and reducing injury. Originally designed for exciting electrohydraulic spark electrodes, the system can also be adapted for driving piezoelectric and electromagnetic sources.

  3. Mechanisms of action in dual-pulse lithotripsy

    NASA Astrophysics Data System (ADS)

    Sokolov, Dahlia L.; Bailey, Michael R.; Crum, Lawrence A.

    2003-10-01

    Dual-pulse lithotripsy has emerged as a promising technique for a safer and more effective shock wave lithotripsy treatment. A single source and confocal sources of various design have been used to produce either synchronous or asynchronous dual pulses. It has been shown that dual pulses enhance stone comminution and reduce tissue injury in vivo and in vitro. Pressure doubling at the focus of synchronous confocal sources contributes to increased fragmentation by a combination of direct shock-wave effects and increased cavitation, while decreased cell damage near the focus is largely a result of cavitation mitigation by the second, delayed shock wave. It follows that weaker pulses may be used to achieve complete stone fragmentation while further protecting surrounding tissue. Twin sources may also be fired asynchronously to enhance or mitigate cavitation as well as to minimize tissue damage by dividing the impact over two tissue paths. Numerical calculations using the Gilmore model and primary radiation force model as well as high speed camera images show little evidence that bubble translation contributes to the observed bioeffects. These results and the history and mechanisms of dual-pulse lithotripsy will be reported. [Work supported by NIH PO1 DK43881 and RO1 DK55674.

  4. Extracorporeal Shockwave Lithotripsy of Primary Intrahepatic Stones

    PubMed Central

    Kim, Myung Hwan; Lee, Sung Koo; Min, Young Il; Lee, Mun Gyu; Sung, Kyu Bo; Cho, Kyung Sik; Lee, Sung Gyu; Min, Pyung Chul

    1992-01-01

    Extracorporeal shockwave lithothripsy (ESWL) was performed in intrahepatic stone patients (n = 18) by Dornier MPL 9,000 with ultrasound guidance. The patients had T-tube (n = 9) or percutaneous transhepatic biliary drainge tube (n = 9). Average treatment session was four and shock-wave numbers were in the range of 3,064 to 12,000 (average 6,288 shocks). Intrahepatic stones were removed completely in 16 patients over a 3 month period by ESWL and combined stone extraction maneuver such as cholangioscopic or interventional radiologic method. Extracorporeal shockwave lithothripsy was very helpful in facilitating extraction of stones in unfavorable locations or located above the severe stricture. In summary, extracorporeal Shockwave lithotripsy, followed by percutaneous stone extraction, will provide an improvement in the success rate and duration of treatment required for complete removal of primary hepatolithiasis. PMID:1477027

  5. Bubble Dynamics in Laser Lithotripsy

    NASA Astrophysics Data System (ADS)

    Mohammadzadeh, Milad; Martinez Mercado, Julian; Ohl, Claus-Dieter

    2015-12-01

    Laser lithotripsy is a medical procedure for fragmentation of urinary stones with a fiber guided laser pulse of several hundred microseconds long. Using high-speed photography, we present an in-vitro study of bubble dynamics and stone motion induced by Ho:YAG laser lithotripsy. The experiments reveal that detectable stone motion starts only after the bubble collapse, which we relate with the collapse-induced liquid flow. Additionally, we model the bubble formation and dynamics using a set of 2D Rayleigh-Plesset equations with the measured laser pulse profile as an input. The aim is to reduce stone motion through modification of the temporal laser pulse profile, which affects the collapse scenario and consequently the remnant liquid motion.

  6. High intensity focused ultrasound lithotripsy with cavitating microbubbles.

    PubMed

    Yoshizawa, Shin; Ikeda, Teiichiro; Ito, Akira; Ota, Ryuhei; Takagi, Shu; Matsumoto, Yoichiro

    2009-08-01

    In the medical ultrasound field, microbubbles have recently been the subject of much interest. Controlling actively the effect of the microbubbles, a novel therapeutic method has been investigated. In this paper, our works on high intensity focused ultrasound (HIFU) lithotripsy with cavitating microbubbles are reviewed and the cavitation detection method to optimize the HIFU intensity is investigated. In the HIFU lithotripsy, collapse of the cloud cavitation is used to fragment kidney stones. Cloud cavitation is potentially the most destructive form of cavitation. When the cloud cavitation is acoustically forced into a collapse, it has the potential to concentrate a very high pressure. For the control of the cloud cavitation collapse, a novel two-frequency wave (cavitation control [C-C] waveform) is designed; a high-frequency ultrasound pulse (1-4 MHz) to create the cloud cavitation and a low-frequency trailing pulse (500 kHz) following the high-frequency pulse to force the cloud into collapse. High-speed photography showed the cavitation collapse on the stone and the shock-wave emission from the cloud. In vitro erosion tests of model and natural stones were also conducted. In the case of model stones, the erosion rate of the C-C waveform showed a distinct advantage with the combined high- and low-frequency waves over either wave alone. For the optimization of the high-frequency ultrasound intensity, the subharmonic acoustic pressure was examined. The results showed relationship between the subharmonic pressure from cavitating bubbles induced by the high-frequency ultrasound and eroded volume of the model stones. Natural stones were eroded and most of the resulting fragments were less than 1 mm in diameter. The method has the potential to provide a novel lithotripsy system with small fragments and localized cavitating bubbles on a stone. PMID:19360448

  7. Endoscopically controlled laser lithotripsy of sialoliths

    NASA Astrophysics Data System (ADS)

    Gundlach, Peter; Hopf, Juergen U. G.; Linnarz, Marietta; Leege, Nils; Scherer, Hans H.; Tschepe, Johannes; Mueller, Gerhard J.

    1992-08-01

    Among the diseases of the major salivary glands, sialolithiasis is a frequent clinical picture. Until now the condition has nearly always had to be treated surgically. In rare cases, discharge can be achieved by acid stimulation of secretion. If located distally in the excretory duct, concrements may be removed by enoral lancing. If it is close to glands, e.g., in the knee of Wharton's duct or in the ductal part of the submandibular gland, extirpation of the gland including the stone is unavoidable. Besides wound healing problems and the occurrence of salivary fistulas, the main risk of surgery is injury to the nerves around the major salivary glands, e.g., the n. facialis or one of its branches, the n. hypoglossus, or the n. lingualis with consecutive paresis. Based on the clinical results of lithotripsy by laser-induced shock waves (LIL) applied to renal stones and ureteroliths as well as bilary duct and pancreas stones, we investigated the suitability of endoscopically controlled laser therapy for sialolithiasis.

  8. [Clinical application of extracorporeal microexplosive lithotripsy].

    PubMed

    Honda, M; Maeda, S; Takasaki, E

    1989-03-01

    A total of 46 cases underwent 66 treatments with extracorporeal microexplosive lithotripsy (EML) for upper urinary tract calculi between March 10, 1987 and May 28, 1987. The efficacy of EML therapy was investigated in all cases over 3 months. The lithotripter of EML made by the Yachiyoda Co. Ltd (SZ-1) was adapted to a microexplosion (10 mg silver azide) as the source of energy for underwater shock wave generation. Fifteen cases (32.6%) had a history of previous open lithotomy of the same upper urinary tract as being treated by EML. Pre-treatments with ureteral catheters and ureteral stents were performed in 4 and 4 cases (8.7% and 8.7%), respectively. The microexplosions were conducted in syncronization with patient exhalation from 100 to 400 times during 1 session, depending upon the size of the stone. The patients felt pressure only on their back at the pulse of explosion and complained occasionally a dull pain, but this pain was mild and tolerable, and no patients required anesthesia. When stone disintegration was judged to be unsatisfactory, that is the stone remained unfragment or the size of the residual stone fragments was greater than 5 mm., an additional session was performed, usually 1 week after the previous session. On the X-ray film obtained three months after EML treatment, 26 cases (57%) were completely free from stone concerments, 17 cases (37%) had stone fragments of equal to or less than 5 mm and 3 cases (6%) had ones of greater than 5 mm. Treatment of EML alone was performed in 44 cases (96%), while 2 cases (4%) required transurethral stone manipulation following EML.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2735248

  9. Urinothorax: A path, less travelled: Case report and review of literature

    PubMed Central

    Ranjan, Vikrant; Agrawal, Santosh; Chipde, Saurabh Sudhir; Dosi, Ravi

    2015-01-01

    Urinothorax is a very rare occurrence of urine in the pleural space. Urinothorax can occur as a consequence to percutaneous nephrolithotomy (PCNL), ureterorenoscopic lithotripsy (URSL) or shock wave lithotripsy (SWL). We herewith report a rare case of Urinothorax in a 35 years old male patient and discuss its current knowhow and clinical management. PMID:25810665

  10. Ureteroscopy and laser lithotripsy: technologic advancements.

    PubMed

    Alexander, B; Fishman, A I; Grasso, M

    2015-02-01

    Ureteroscopic lithotripsy has evolved since the first reported cases employing rigid rod-lens endoscopes and stiff ultrasonic lithotrites. Fiber optics facilitated rigid endoscope miniaturization and the development of a steerable, deflectable flexible ureteroscopes. Over 30 years of technical innovations culminating in digital imagers and powerful, precise laser lithotrites, complimented by progressive endoscopic techniques have produced efficient endoscopic therapies with minimal morbidity and commonly performed in an outpatient setting. PMID:25266163

  11. Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones?

    PubMed Central

    Lim, Ki Hong; Jung, Jin-Hee; Kwon, Jae Hyun; Lee, Yong Seok; Bae, Jungbum; Cho, Min Chul; Lee, Kwang Soo

    2015-01-01

    Purpose The objective was to determine whether stone density on plain radiography (kidney-ureter-bladder, KUB) could predict the outcome of extracorporeal shockwave lithotripsy (ESWL) for ureteral stones. Materials and Methods A total of 223 patients treated by ESWL for radio-opaque ureteral stones of 5 to 20 mm were included in this retrospective study. All patients underwent routine blood and urine analyses, plain radiography (KUB), and noncontrast computed tomography (NCCT) before ESWL. Demographic, stone, and radiological characteristics on KUB and NCCT were analyzed. The patients were categorized into two groups: lower-density (LD) group (radiodensity less than or equal to that of the 12th rib, n=163) and higher-density (HD) group (radiodensity greater than that of the 12th rib, n=60). Stone-free status was assessed by KUB every week after ESWL. A successful outcome was defined as stone free within 1 month after ESWL. Results Mean stone size in the LD group was significantly smaller than that in the HD group (7.5±1.4 mm compared with 9.9±2.9 mm, p=0.002). The overall success rates in the LD and HD groups were 82.1% and 60.0%, respectively (p=0.007). The mean duration of stone-free status and average number of SWL sessions required for success in the two groups were 21.7 compared with 39.2 days and 1.8 compared with 2.3, respectively (p<0.05). On multivariate logistic analysis, stone size and time to ESWL since colic and radiodensity of the stone on KUB were independent predictors of successful ESWL. Conclusions Our data suggest that larger stone size, longer time to ESWL, and ureteral stones with a radiodensity greater than that of the 12th rib may be at a relatively higher risk of ESWL failure 1 month after the procedure. PMID:25598937

  12. Efficacy of extracorporeal shockwave lithotripsy using Dornier SII in different levels of ureteral stones

    PubMed Central

    Elkholy, Mohamed M.; Ismail, Hassan; Abdelkhalek, Mohamed A.; Badr, Mohamad M.; Elfeky, Mohamed M.

    2014-01-01

    Objective: The objective of this study was to evaluate the efficacy and safety of the Dornier lithotripter S II system in the treatment of ureteral calculi. Patients and Methods: A total of 97 cases which consists of 54 males and 43 females with ureteral stones were treated by extracorporeal shock wave lithotripsy (ESWL). Mean age was 42.6 years. Inclusion criteria were solitary radiopaque ureteral stones of radiological stone size of ?1 cm. The stones were not impacted, with normal kidney functions. Procedure time, number of shocks, energy used, number of sessions and complications were reported. The outcome of ESWL was also recorded. Results: Stones were in the abdominal (upper ureter) in 50% of patients, in pelvic (middle ureter) in 47% of patients. All patients had unilateral stones and the mean stone size in maximum length was) 10 mm). Good dye excretion passing the stone was noted in all patients. Mild hydronephrosis was found in 85% of cases. A total of 49 cases were treated by a single session, while in 35% of cases two sessions were enough and 16% received three sessions. The average number of shocks per session was 3125. The average number of shocks per patient was 5962.5 shocks and average energy was 204.3 Joules. The overall stone-free rate 3 months after lithotripsy was 94%. After a single session of lithotripsy, 49 patients (49%) became stone-free. Stone free rates after ESWL for upper, middle ureteral stones were 94%, 95.7% respectively. Additional procedures were needed in only 6 cases (6%) to render patients stone-free after lithotripsy. No serious complications occurred. Conclusion: The Dornier lithotripter S II is very effective in the treatment of ureteral calculi with no major complications. PMID:25371614

  13. Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy

    PubMed Central

    Cho, C one; Yu, Ji Hyeong; Sung, Luck Hee; Chung, Jae Yong

    2010-01-01

    Purpose Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast®) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated the efficacy and safety of PCNL via Lithoclast® alone or combined with ultrasonic lithotripsy. Materials and Methods Thirty-five (group A) and 39 (group B) patients underwent Lithoclast® PCNL and combination therapy, respectively, from May 2001 to March 2010, and the two groups were compared in terms of stone size, location, and composition; operative time; average number of treatments; hospital days; hemoglobin loss; ancillary procedures; rate of device failure; and initial and total stone-free rates. Results The two groups did not differ significantly in preoperative stone size, location, or composition; the average number of treatments; or the initial and overall stone-free rates. However, combination therapy was associated with a significantly lower operative time (181±50 vs. 221±65 min, respectively, p=0.004), number of hospital days (11.6±3.8 vs. 14.2±4.4 days, respectively, p=0.009), and average hemoglobin loss (1.12±0.61 vs. 1.39±1.02 g/dl, respectively, p=0.013). Transfusions were required in 6 patients (4 and 2 in each group, respectively), but there were no significant complications related to percutaneous access. There were 2 (5.7%) mechanical failures (Lithoclast® probe fracture) in the group A and 5 (12.8%) in the group B (2 cases of suction tube obstruction, 3 cases of overheating). Conclusions The combination of ultrasonic lithotripter and Lithoclast® is more effective than Lithoclast® alone because it significantly decreases operative time, hemoglobin loss, and the hospital stay. This may reflect the superior power of Lithoclast® and the ability to aspirate the debris during ultrasonic lithotripsy. PMID:21165200

  14. [Use of high frequency jet ventilation in extracorporeal shockwave lithotripsy].

    PubMed

    Schulte am Esch, J; Kochs, E; Meyer, W H

    1985-06-01

    High frequency jet ventilation (HFJV) was used in 68 patients which were treated with extracorporal shock wave lithotripsy (ESWL) because of stone diseases in the upper urinary tract. The question was whether HFJV in combination with a semiclosed conventional circle system offered a practicable and safe technique to minimize the oscillations which are proportional to the applied tidal volume and to the diaphragmatic movements. With IPPV the mean distance of the stone movement was 32 mm, whereas with the application of HFJV the stones oscillated around their resting position within limits of 2 to 3 mm (ventilation frequency: 200-300/min, driving pressure: 0.6-1.1 bar, tidal volume: 3-8 1/min). The effectiveness of HFJV was monitored by the end-tidal carbon dioxide tension (PeCO2) during intermittently conventional ventilation with "adequate" tidal volumes (TV 15 ml/kg bw). The correlation between PeCO2 and simultaneous measured PaCO2 was r = 0,91. The application of HFJV enhances the efficiency of ESWL. So the treatment of stones of the upper urinary tract can be varied by more subtle dosage of the incoming shock wave energy and by stabilisation of the stones in the underlying ellipsoid of the energy focus. PMID:3904519

  15. Superior Mesenteric Artery Dissection after Extracorporeal Shockwave Lithotripsy

    PubMed Central

    Bakoyiannis, Christos; Anastasiou, Ioannis; Koutsoumpelis, Andreas; Fragiadis, Evangelos; Felesaki, Eleni; Kafeza, Marina; Georgopoulos, Sotirios; Tsigris, Christos

    2012-01-01

    The use of shockwave lithotripsy is currently the mainstay of treatment in renal calculosis. Several complications including vessel injuries have been implied to extracorporeal shockwave lithotripsy. We report an isolated dissection of the superior mesenteric artery in a 60-year-old male presenting with abdominal pain which occurred three days after extracorporeal shockwave lithotripsy. The patient was treated conservatively and the abdominal pain subsided 24 hours later. The patient's history, the course of his disease, and the timing may suggest a correlation between the dissection and the ESWL. PMID:23304627

  16. Extra corporeal shockwave lithotripsy resulting in skin burns--a report of two cases.

    PubMed

    Rao, Sandhya R; Ballesteros, Natalia; Short, Kerry L; Gathani, Krishna K; Ankem, Murali K

    2014-01-01

    Severe skin injury after extracorporeal shock wave lithotripsy (ESWL) is rare. We describe two patients who suffered full thickness skin burns following ESWL for renal calculi. One patient was treated conservatively and the other underwent debridement with skin grafting. We speculate that failure of the thermostatic mechanism of the lithotripter, leading to overheating of the water-filled cushion, resulted in this very rare adverse event. Proper preoperative patient counseling regarding the risk of serious burn injuries will help to avoid potential litigation. PMID:25615256

  17. Calcium Phosphate Composition Affects Ureteroscopic Laser Lithotripsy.

    PubMed

    Otsuki, Hideo; Yoshioka, Takashi; Shimizu, Toshihiro; Nakanishi, Yusuke; Fujio, Kei; Murao, Wataru; Uehara, Shinya; Kikuchi, Hirosato; Fujio, Koji

    2016-02-01

    The effects of stone composition on transurethral lithotripsy (TUL) have not been sufficiently elucidated. The purpose of this study was to identify how calcium phosphate stone composition impacts TUL. Two hundred eighty-nine cases of semi-rigid and/or flexible TUL for upper urinary tract calculi were reviewed retrospectively. Inclusion criteria were a preoperative assessment by noncontrast computed tomography (NCCT) and a stone composition analysis. Small stones and those without calcium composition were excluded. Stone core radiodensity (SCR) was measured by taking the average of the upper 3 of 5 points in the proximity of the center of the stone on NCCT. Fifty-three patients with calcium phosphate composition (CaP) and 118 patients with calcium oxalate and without phosphate composition were eligible for analysis. SCR was significantly higher in the CaP group (p<0.01). The CaP patient group needed a significantly longer operation time (p=0.014) and more laser energy (p=0.085), and tended to have a lower rate of complete lithotripsy (p=0.096) and higher incidence of postoperative pyelonephritis (p=0.181). Stones containing calcium phosphate are harder, demand more laser energy, and require a longer operating time. NCCT evaluation can estimate stone composition preoperatively, and may be a useful tool for predicting operative outcomes. PMID:26899606

  18. Experimental Study of the Richtmyer-Meshkov Instability Induced by Cylindrical Converging Shock Waves

    NASA Astrophysics Data System (ADS)

    Si, Ting; Zhai, Zhigang; Luo, Xisheng; Yang, Jiming

    The Richtmyer-Meshkov (RM) instability induced by converging shock waves becomes more and more attractive because of its physical applications in shock-wave lithotripsy, inertial confinement fusion, turbulent mixing in scramjet and collapse in supernova.

  19. [TRANSURETHRAL CONTACT URETERAL LITHOTRIPSY IN A GASEOUS (CO2) MEDIUM].

    PubMed

    Glybochko, P V; Aljaev, Ju G; Rapoport, L M; Carichenko, D G; Arzumanjan, E G

    2015-01-01

    The paper describes for the first time the method of contact ureteral lithotripsy in gaseous (CO2) medium. It presents the results of a comparative study of urolithiasis patients treated with this treatment modality (study group, n=30) and with traditional contact ureteral lithotripsy in liquid medium (control group, n=30). The incidence of retrograde migration of calculus in the kidney in the study group was 0%, while it was 16.6% in the control group. Acute or exacerbation of chronic pyelonephritis was diagnosed in only 3 (10%) patients in the control group. The suggested method of contact ureteral lithotripsy is safe and provides several advantages over traditional contact ureteral lithotripsy in a fluid medium, such as: physiologic validity, absence of calculus hypermobility (increased mobility), improved visualization during surgery and high cost effectiveness. PMID:26237808

  20. Long-term effects of pediatric extracorporeal shockwave lithotripsy on renal function

    PubMed Central

    Akin, Yigit; Yucel, Selcuk

    2014-01-01

    Introduction Extracorporeal shock wave lithotripsy (ESWL) is a well-known and successful treatment modality. In addition, it can be used in premature infants. ESWL is used to treat kidney and ureter stones in children. However, although it is a preferred noninvasive treatment in that setting, there is debate about its long-term effects on growing kidneys in children. Objectives To investigate the long-term effects of pediatric ESWL on renal function in light of updated literature. Methods PubMed and Medline were searched for studies on ESWL in a pediatric population with keywords including efficacy, child, kidney calculi, ureter calculi, lithotripsy, injury, vascular trauma, and shock waves. The research was limited to the English literature during a period from 1980 to 2014. In total, 3,000 articles were evaluated, but only 151 papers were considered. Only the manuscripts directly related to the reviewed subjects were included in the current study. Results However, the acute effects of ESWL in kidney are well-described. Although there are limited studies on the long-term effects of ESWL in children, there is a widespread opinion that ESWL is not affecting renal functions in the long-term. Conclusion ESWL is a safe, effective, and noninvasive treatment option in children. Although ESWL can cause some acute effects in the kidney, there is no long-term effect on the growing kidneys of children. PMID:24892029

  1. Report from the 29th World Congress of Endourology and SWL (November 30-December 3, 2011 - Kyoto, Japan).

    PubMed

    Rabasseda, X

    2012-02-01

    Kyoto is a city of surprises: from the most beautiful castles and temples known far and wide across the world, to the humblest temples, as beautiful as those appearing in all tourist guides, just hidden away in small lanes among busy traffic of bicycles and pedestrians shopping in markets or attending to their daily business. Add the innumerable tourists busily exploring the city's attractions, although this was not the reason for visiting Kyoto, which was the site of this year's World Congress of Endourology and SWL. Nevertheless, maybe as a compensation, the meeting was held in Kokusaikaikan, literally the International Conference Centre, which is a modern facility in the city outskirts, actually adjoining the Takaragaike park, with a beautiful lake and the mountains, brightly led by the trees' red leaves, just visible through the main hall windows. PMID:22384455

  2. Biological consequences of fiber fragmentation with pulsed laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Bruhn, Erich W.; Go, Peter M. N. Y. H.; McClane, Robert W.; Hunter, John G.; Straight, Richard C.

    1990-06-01

    Fiber tip breakage during urinary and biliary laser lithotripsy has been recognized to occur with several laser types. This phenomenon has also been seen with Q-switched Nd:YAG laser lithotripsy. Our aim was to determine the biological consequences of this event in the canine ureter and bile duct. In an excised tissue preparation, urinary and biliary stones were impacted in a canine ureter and common bile duct. Three and four hundred micron quartz laser fibers were placed in direct contact with the stone. Normal saline coaxial irrigation was initiated at 75 xal/min. A Q-switched Nd:YAG laser was activated at repetition rates from 1O-30 Hz. and pulse energies from 10-30 mJ. The tissue was sectioned and microscopic examination of the fragmentation site was performed. Histological exam revealed the persistence of large numbers of fiber fragments in the lumen and imnbedded in the epithelium at the lithotripsy site. Fragments varied greatly in size and appeared to have angular, sharp edges We conclude that irrigation can not be relied upon to remove the fiber fragments from the lithotripsy sites and that the biological consequences of fiber fragmentation may be greater than previously believed. Glass fragments "blown" into the epitheliumu will often result in glass granulomas, which may eventually cause obstruction of closed lumninal structures. This raises serious concern for the presence of any fiber breakage during laser lithotripsy.

  3. Massive Pulmonary Calculi Embolism: A Novel Complication of Pneumatic Lithotripsy

    PubMed Central

    Zhang, Lin; Zhou, Yiwu

    2015-01-01

    Abstract Pneumatic lithotripsy is a minimally invasive technique mainly for the treatment of urinary staghorn stones. Previous literatures have reported some therapeutic complications during or after this procedure, but calculi embolism has not been mentioned before. We report here a fatal case of calculi-induced pulmonary embolism in an adult woman who underwent pneumatic lithotripsy. An autopsy did not reveal any evidence of pulmonary embolism. However, light microscopy revealed noticeable presence of calculi in pulmonary arterioles and capillaries, as evidenced by environmental scanning electron microscope and energy dispersive X-ray analysis. The primary determinants of calculi embolism include intrarenal pressure, and volume and viscosity of the calculi fragments formation. Vascular intravasation of smashed calculi might increase pulmonary vascular resistance and hypoxemia and decrease cardiac output. This case report intends to provide information for clinicians to consider the probability of intraoperative calculi embolism during lithotripsies when patients develop typical symptoms of acute pulmonary embolism. PMID:26222867

  4. Adaptable Design Improvements for Electromagnetic Shock Wave Lithotripters and Techniques for Controlling Cavitation

    NASA Astrophysics Data System (ADS)

    Smith, Nathan Birchard

    In this dissertation work, the aim was to garner better mechanistic understanding of how shock wave lithotripsy (SWL) breaks stones in order to guide design improvements to modern electromagnetic (EM) shock wave lithotripters. To accomplish this goal, experimental studies were carefully designed to isolate mechanisms of fragmentation, and models for wave propagation, fragmentation, and stone motion were developed. In the initial study, a representative EM lithotripter was characterized and tested for in vitro stone comminution efficiency at a variety of field positions and doses using phantom kidney stones of variable physical properties, and in different fluid mediums to isolate the contribution of cavitation. Through parametric analysis of the acoustic field measurements alongside comminution results, a logarithmic correlation was determined between average peak pressure incident on the stone surface and comminution efficiency. It was also noted that for a given stone type, the correlations converged to an average peak pressure threshold for fragmentation, independent of fluid medium in use. The correlation of average peak pressure to efficacy supports the rationale for the acoustic lens modifications, which were pursued to simultaneously enhance beam width and optimize the pulse profile of the lithotripter shock wave (LSW) via in situ pulse superposition for improved stone fragmentation by stress waves and cavitation, respectively. In parallel, a numerical model for wave propagation was used to investigate the variations of critical parameters with changes in lens geometry. A consensus was reached on a new lens design based on high-speed imaging and stone comminution experiments against the original lens at a fixed acoustic energy setting. The results have demonstrated that the new lens has improved efficacy away from the focus, where stones may move due to respiration, fragmentation, acoustic radiation forces, or voluntary patient movements. Using the traditional theory of brittle fragmentation and newfound understanding of average peak pressure correlation to stone comminution, the entire set of stone comminution data for lens comparison was heuristically modeled using a Weibull-style distribution function. This model linked both the average peak pressure and shock wave dose to efficacy, including their respective threshold parameters, and demonstrated correlation of coefficients to cavitation activity. Subsequently, this model was used in prediction of stone comminution efficiency from mimicked respiratory motions in vitro, which compared favorably to actual simulated motion studies using both the new and original lenses. Under a variety of mimicked respiratory motions, the new lens produced statistically higher stone comminution efficiency than the original lens. These results were confirmed in vivo in a swine model, where the new lens produced statistically higher stone comminution after 1,000 and 2,000 shocks. Finally, a mechanistic investigation into the effects of cavitation with the original lens was conducted using an integrated, self-focusing annular ring transducer specially designed for tandem pulse lithotripsy. It was found that cavitation and stone comminution efficiency are progressively enhanced by tandem pulsing as source energies of both the primary LSW and trailing pressure pulse increase, which suggests that cavitation and stress waves act synergistically to enhance the efficacy in kidney stone fragmentation.

  5. Renal rupture following extracorporeal shockwave lithotripsy.

    PubMed

    Torbati, Sam S; Niku, Michelle; Vos, Elaine; Hogan, Shomari

    2014-09-01

    A 41-year-old woman presented to the emergency department with a chief complaint of hematuria three days status post extracorporeal shockwave lithotripsy. The patient described a three-day history of worsening left-sided abdominal pain immediately following the procedure. She denied any fever, chills, changes in bowel habits, hematochezia, increased urinary frequency, urinary urgency, or dysuria. Physical exam revealed tenderness to palpation in the left upper quadrant, left flank and periumbilical region with mild guarding. Laboratory studies revealed an anemic patient with downward trending hematocrit (red blood cell count of 3.41 10(6)/?L, hemoglobin of 10.6 g/dL, and a hematocrit of 31.3% down from 43% a week and a half prior). Urinalysis revealed red and cloudy urine with 3+ leukocytes. A chest radiograph was unremarkable. A computed tomography of the chest, abdomen, and pelvis showed a laceration to the lateral aspect of the mid left kidney with a hematoma measuring 3.2 cm in thickness (Figure). The patient was subsequently admitted to the hospital for monitoring and discharged on day nine. PMID:25247048

  6. Renal Rupture Following Extracorporeal Shockwave Lithotripsy

    PubMed Central

    Torbati, Sam S.; Niku, Michelle; Vos, Elaine; Hogan, Shomari

    2014-01-01

    A 41-year-old woman presented to the emergency department with a chief complaint of hematuria three days status post extracorporeal shockwave lithotripsy. The patient described a three-day history of worsening left-sided abdominal pain immediately following the procedure. She denied any fever, chills, changes in bowel habits, hematochezia, increased urinary frequency, urinary urgency, or dysuria. Physical exam revealed tenderness to palpation in the left upper quadrant, left flank and periumbilical region with mild guarding. Laboratory studies revealed an anemic patient with downward trending hematocrit (red blood cell count of 3.41 106/?L, hemoglobin of 10.6 g/dL, and a hematocrit of 31.3% down from 43% a week and a half prior). Urinalysis revealed red and cloudy urine with 3+ leukocytes. A chest radiograph was unremarkable. A computed tomography of the chest, abdomen, and pelvis showed a laceration to the lateral aspect of the mid left kidney with a hematoma measuring 3.2 cm in thickness (Figure). The patient was subsequently admitted to the hospital for monitoring and discharged on day nine. PMID:25247048

  7. [A fundamental study on expansive splitter lithotripsy].

    PubMed

    Kawauchi, A

    1989-07-01

    The application of expansive splitter for industrial use to lithotripsy was studied. A natural rubber latex catheter 350 mm in length, 3.5 mm in diameter and 0.1 mm in thickness was newly developed for prevention from alkalization by expansive splitter. Expansive pressure generated by expansive splitter was measured to calculate the fragmentation time of urinary stones. Urinary stones 20, 30 or 40 mm in diameter were expected to be fragmented in 7.5, 9 and 11 minutes. Human bladder stone 55 x 54 x 33 mm in size was divided into two parts in 24 minutes using expansive splitter. The fragmentation test of model calculi was performed to decide the boring length necessary for the fragmentation of urinary stones. The necessary boring length was a half of the stone diameter in stones smaller than 20 mm in diameter and was 3/4 of it in stones larger than 30 mm in diameter. A tolerance test of the catheter was performed. When the used catheters for splitting were immersed in water, no change was observed in pH, in spite of the elevation of pH from 6.6 to 12.3 when the splitter itself was immersed in water. No leakage of water from the catheter was observed in this tolerance test. Histological change on the epithelium of the bladder and the renal pelvis by expansive splitter was examined. The mucosa of the dog; bladder and the pig renal pelvis, to which expansive splitter was made contact, showed no histological change after 30, 45 or 60 minutes after the contact. In conclusion, expansive splitter enclosed in the natural rubber latex catheter can be employed for clinical use to fragment urinary calculi in endourological procedures. PMID:2801401

  8. Clearance of refractory bile duct stones with extracorporeal shockwave lithotripsy

    PubMed Central

    Ellis, R; Jenkins, A; Thompson, R; Ede, R

    2000-01-01

    BACKGROUND—Extracorporeal shockwave lithotripsy (ESWL) has been used since the mid-1980s to fragment bile duct stones which cannot be removed endoscopically. Early machines required general anaesthesia and immersion in a waterbath.?AIMS—To investigate the effectiveness of the third generation Storz Modulith SL20 lithotriptor in fragmenting bile duct stones that could not be cleared by mechanical lithotripsy.?METHODS—Eighty three patients with retained bile duct stones were treated. All patients received intravenous benzodiazepine sedation and pethidine analgesia. Stones were targeted by fluoroscopy following injection of contrast via a nasobiliary drain or T tube. Residual fragments were cleared at endoscopic retrograde cholangiopancreatography.?RESULTS—Complete stone clearance was achieved in 69 (83%) patients and in 18 of 24 patients (75%) who required more than one ESWL treatment. Stone clearance was achieved in all nine patients (100%) with intrahepatic stones and also in nine patients (100%) referred following surgical exploration of the bile duct. Complications included six cases of cholangitis and one perinephric haematoma which resolved spontaneously.?CONCLUSION—Using the Storz Modulith, 83% of refractory bile duct calculi were cleared with a low rate of complications. These results confirm that ESWL is an excellent alternative to surgery in those patients in whom endoscopic techniques have failed.???Keywords: lithotripsy; bile duct calculi; extracorporeal lithotripsy PMID:11034593

  9. Sound field prediction of ultrasonic lithotripsy in water with spheroidal beam equations

    NASA Astrophysics Data System (ADS)

    Zhang, Lue; Wang, Xiang-Da; Liu, Xiao-Zhou; Gong, Xiu-Fen

    2015-01-01

    With converged shock wave, extracorporeal shock wave lithotripsy (ESWL) has become a preferable way to crush human calculi because of its advantages of efficiency and non-intrusion. Nonlinear spheroidal beam equations (SBE) are employed to illustrate the acoustic wave propagation for transducers with a wide aperture angle. To predict the acoustic field distribution precisely, boundary conditions are obtained for the SBE model of the monochromatic wave when the source is located on the focus of an ESWL transducer. Numerical results of the monochromatic wave propagation in water are analyzed and the influences of half-angle, fundamental frequency, and initial pressure are investigated. According to our results, with optimization of these factors, the pressure focal gain of ESWL can be enhanced and the effectiveness of treatment can be improved. Project supported by the National Basic Research Program of China (Grant Nos. 2012CB921504 and 2011CB707902), the National Natural Science Foundation of China (Grant No. 11274166), the State Key Laboratory of Acoustics, Chinese Academy of Sciences (Grant No. SKLA201401), and the China Postdoctoral Science Foundation (Grant No. 2013M531313).

  10. Hazardous sound levels produced by extracorporeal shock wave lithotripsy

    SciTech Connect

    Lusk, R.P.; Tyler, R.S.

    1987-06-01

    Sound emitted from the Dornier system GmbH lithotriptor was found to be of sufficient intensity to warrant concern about noise-induced sensorineural hearing loss. The patients were exposed to impulses of 112 dB. peak sound pressure level. Operating room personnel were exposed to sounds of less intensity, although the number of impulses they were exposed to was much greater, thereby increasing the risk of hearing loss. Hearing protection is recommended for patients and operating room personnel.

  11. Laser and acoustic lens for lithotripsy

    DOEpatents

    Visuri, Steven R. (Livermore, CA); Makarewicz, Anthony J. (San Ramon, CA); London, Richard A. (Orinda, CA); Benett, William J. (Livermore, CA); Krulevitch, Peter (Pleasanton, CA); Da Silva, Luiz B. (Pleasanton, CA)

    2002-01-01

    An acoustic focusing device whose acoustic waves are generated by laser radiation through an optical fiber. The acoustic energy is capable of efficient destruction of renal and biliary calculi and deliverable to the site of the calculi via an endoscopic procedure. The device includes a transducer tip attached to the distal end of an optical fiber through which laser energy is directed. The transducer tip encapsulates an exogenous absorbing dye. Under proper irradiation conditions (high absorbed energy density, short pulse duration) a stress wave is produced via thermoelastic expansion of the absorber for the destruction of the calculi. The transducer tip can be configured into an acoustic lens such that the transmitted acoustic wave is shaped or focused. Also, compressive stress waves can be reflected off a high density/low density interface to invert the compressive wave into a tensile stress wave, and tensile stresses may be more effective in some instances in disrupting material as most materials are weaker in tension than compression. Estimations indicate that stress amplitudes provided by this device can be magnified more than 100 times, greatly improving the efficiency of optical energy for targeted material destruction.

  12. Influence of Saline on Temperature Profile of Laser Lithotripsy Activation

    PubMed Central

    Silva, Igor N.; Donalisio da Silva, Rodrigo; Gustafson, Diedra; Sehrt, David; Kim, Fernando J.

    2015-01-01

    Abstract Purpose: We established an ex vivo model to evaluate the temperature profile of the ureter during laser lithotripsy, the influence of irrigation on temperature, and thermal spread during lithotripsy with the holmium:yttrium-aluminum-garnet (Ho:YAG) laser. Materials and Methods: Two ex vivo models of Ovis aries urinary tract and human calcium oxalate calculi were used. The Open Ureteral Model was opened longitudinally to measure the thermal profile of the urothelium. On the Clinical Model, anterograde ureteroscopy was performed in an intact urinary system. Temperatures were measured on the external portion of the ureter and the urothelium during lithotripsy and intentional perforation. The lithotripsy group (n=20) was divided into irrigated (n=10) and nonirrigated (n=10), which were compared for thermal spread length and values during laser activation. The intentional perforation group (n=10) was evaluated under saline flow. The Ho:YAG laser with a 365 μm laser fiber and power at 10W was used (1J/Pulse at 10 Hz). Infrared Fluke Ti55 Thermal Imager was used for evaluation. Maximum temperature values were recorded and compared. Results: On the Clinical Model, the external ureteral wall obtained a temperature of 37.4°C±2.5° and 49.5°C±2.3° (P=0.003) and in the Open Ureteral Model, 49.7°C and 112.4°C with and without irrigation, respectively (P<0.05). The thermal spread along the external ureter wall was not statically significant with or without irrigation (P=0.065). During intentional perforation, differences in temperatures were found between groups (opened with and without irrigation): 81.8°±8.8° and 145.0°±15.0°, respectively (P<0.005). Conclusion: There is an increase in the external ureteral temperature during laser activation, but ureteral thermal values decreased when saline flow was applied. Ureter thermal spread showed no difference between irrigated and nonirrigated subgroups. This is the first laser lithotripsy thermography study establishing the framework to evaluate the temperature profile in the future. PMID:25154455

  13. Minimally invasive percutaneous cystostomy with ureteroscopic pneumatic lithotripsy for calculus in bladder diverticula

    PubMed Central

    GU, SI-PING; YOU, ZHI-YUAN; HUANG, YUNTENG; LU, YI-JIN; HE, CAOHUI; CAI, XIAO-DONG; ZHOU, XIAO-MING

    2013-01-01

    The aim of this study was to investigate the effectiveness of minimally invasive percutaneous cystostomy with ureteroscopic pneumatic lithotripsy for treating calculus in bladder diverticula. Percutaneous cystostomy with ureteroscopic pneumatic lithotripsy was performed on six elderly male patients with calculi in bladder diverticula, who could not be treated with transurethral ureteroscopic lithotripsy. The stones were successfully removed from all patients, with no complications such as bladder perforation, rupture, urethritis or cystitis. The surgery time was 15–60 min, with an average time of 32 min. Postoperative ultrasound or X-ray examination showed no stone residues and the bladder stoma healed well. No recurrent stones were detected in the follow-up of 3–24 months (average, 16 months). Minimally invasive percutaneous cystostomy with ureteroscopic pneumatic lithotripsy is a safe, efficient and easy treatment for calculus in bladder diverticula. This method provides a new clinical approach for lithotripsy and we suggest that it is worthy of wider use. PMID:23837044

  14. Extracorporeal shockwave lithotripsy: first 1000 cases at the London Stone Clinic.

    PubMed Central

    Das, G; Dick, J; Bailey, M J; Fletcher, M S; Webb, D R; Kellett, M J; Whitfield, H N; Wickham, J E

    1987-01-01

    One thousand patients underwent extracorporeal shockwave lithotripsy for renal and ureteric calculi at this clinic. An overall success rate of 91.8% was achieved (stone free or less than 2 mm fragments at three months) and for stones measuring 1 cm 96.3%. Lithotripsy produced extremely low morbidity, and no deaths have occurred at the clinic. Patients who had lithotripsy alone had a mean hospital stay of three days and in most instances were able to perform their full range of activities on discharge. Planned combination of lithotripsy with minimally invasive endourological procedures such as percutaneous nephrolithotomy and ureterorenoscopy has allowed us to extend the range of treatable cases to include large stones. Prophylactic use of Double-J ureteric stents in selected cases has reduced the incidence of obstruction by stone fragments after lithotripsy, thereby decreasing morbidity and hospital stay. PMID:3119090

  15. Paravertebral block is a proper alternative anesthesia for outpatient lithotripsy

    PubMed Central

    Hanoura, Samy; Elsayed, Mahmoud; Eldegwy, Magdy; Elsayed, Ahmed; Ewieda, Tamer; Shehab, Mohammad

    2013-01-01

    Context: This study evaluated the effectiveness of paravertebral block as an alternative anesthetic technique for extracorporeal shock wave lithotripsy (ESWL) procedure. A total of 50 patients with renal stones, aged 20-60 years, were randomly allocated into two groups; 25 patients in group P; received unilateral paravertebral block from T8 through L1 with injection of 5 mL 0.5% bupivacaine and 25 patients in group L; received local infiltration by bupivacaine 0.25% (2 mg/kg) into the 30 cm2 area after localizing the stones site, 10 min before the session. A total of 10 mm visual analogue scale (VAS) was used to evaluate pain every 10 min during the session. At the end of the procedure, total doses of rescue analgesia, the number of shockwaves, their power, and the total duration of shockwave treatment were recorded. After completion of the procedure, the patient was assessed for pain and nausea in the postanesthesia care unit (PACU) using the VAS. Patient's satisfaction and time needed to discharge patients to home also were recorded. Time to do the anesthetic technique was significantly higher (P < 0.001) in group-P than group-L, it was 12.7 ± 2.3 min versus 6.9 ± 1.9 min, respectively; intraoperative rescue analgesia by fentanyl was lesser (P < 0.001) in group-P than group-L, 26.7 ± 6.32 mcg versus 78.6 ± 5.41 mcg, respectively, also time interval between ends of the procedure till discharge to home was significantly higher (P < 0.001) in group-P than group-L, it was 99 ± 17 min versus 133 ± 31 min, respectively. VAS was not significant difference between both groups either intraoperative or postoperative in first hour. Patient's satisfaction was significantly higher (P < 0.05) in group-P than group-L, it was 8.8 ± 1.1 versus 6.1 ± 0.6, respectively. Adverse events were lesser, but not significant in group-P than in group-L. Two patients (8%) in group-L and one patient (4%) in the group-P experienced episodes of postoperative nausea and vomiting (PONV). Paravertebral block is an effective alternative anesthesia for outpatient lithotripsy; multiple level paravertebral blocks provide an optimal anesthetic condition, with acceptable adverse events for ESWL. And, providing proper analgesia during the procedure and in first hour after finishing of the procedure, early discharge to home and providing better patient's satisfactions. Aims: This study evaluated the effectiveness of paravertebral block as an alternative anesthetic technique for ESWL procedure. Settings and Design: Prospective open label study. Subject and Methods: A total of 50 patients with renal stones, aged 20-60 years, were randomly allocated into two groups; 25 patients in group P; received unilateral paravertebral block from T8 through L1 with injection of 5mL 0.5% bupivacaine and 25 patients in group L; received local infiltration by bupivacaine 0.25% (2 mg/kg) into the 30 cm2 area after localizing the stones site, 10 min before the session. A total of 10 mm VAS was used to evaluate pain every 10 min during the session. At the end of the procedure, total doses of rescue analgesia, the number of shockwaves, their power, and the total duration of shockwave treatment were recorded. After completion of the procedure, the patient was assessed for pain and nausea in the PACU using the VAS. Patient's satisfaction and time needed to discharge patients to home also were recorded. Statistical Analysis: The findings of the two groups were statistically compared using SPSS version 12 (SPSS Inc., Chicago, IL). Data were expressed as mean ± standard deviation, number, and percentage. Nominal nonparametric data were analyzed using Chi-square test. Parametric data were compared using unpaired t-test. Ordinal nonparametric data were analyzed using Mann-Whitney U-test. Results: Time to do the anesthetic technique was significantly higher (P < 0.001) in group-P than group-L, it was 12.7 ± 2.3 min versus 6.9 ± 1.9 min, respectively; intraoperative rescue analgesia by fentanyl was lesser (P < 0.001) in

  16. Acoustic field distribution of sawtooth wave with nonlinear SBE model

    NASA Astrophysics Data System (ADS)

    Liu, Xiaozhou; Zhang, Lue; Wang, Xiangda; Gong, Xiufen

    2015-10-01

    For precise prediction of the acoustic field distribution of extracorporeal shock wave lithotripsy with an ellipsoid transducer, the nonlinear spheroidal beam equations (SBE) are employed to model acoustic wave propagation in medium. To solve the SBE model with frequency domain algorithm, boundary conditions are obtained for monochromatic and sawtooth waves based on the phase compensation. In numerical analysis, the influence of sinusoidal wave and sawtooth wave on axial pressure distributions are investigated.

  17. Factors Influencing Urologist Treatment Preference in Surgical Management of Stone Disease

    PubMed Central

    Childs, M. Adam; Rangel, Laureano J.; Lingeman, James E.; Krambeck, Amy E.

    2015-01-01

    Objective To assess the surgeon factors influencing the surgical treatment decisions for symptomatic stone disease. The factors influencing the selection of shock wave lithotripsy (SWL), ureteroscopy, or percutaneous nephrolithotomy to treat symptomatic stone disease are not well studied. Methods Electronic surveys were sent to urologists with American Medical Association membership. Information on training, practice, and ideal treatment of common stone scenarios was obtained and statistically analyzed. Results In November 2009, 600 surveys were sent and 180 were completed. High-volume SWL practices (>100 cases annually) were more common in community practice (P < .01), and high-volume ureteroscopy and percutaneous nephrolithotomy practices were more common in academic practice (P = .03). Community practice was associated with SWL selection for proximal urolithiasis and upper pole nephrolithiasis (P < .005). An increasing time since urologic training was associated with SWL selection for proximal urolithiasis and upper pole nephrolithiasis (P < .01). Urologists reporting shock wave lithotriptor ownership were 3-4 times more likely to select SWL for urolithiasis or nephrolithiasis compared with urologists who did not own a lithotripter (P < .01). Routine concern for stent pain and rigid ureteroscope preference (vs flexible) were associated with SWL selection (P < .03). Conclusion Surgeon factors significantly affected urolithiasis treatment selection. SWL was associated with community urology practice, increasing time since training, shock wave lithotriptor ownership, concern for stent pain, and ureteroscope preference. PMID:22245295

  18. Thulium fiber laser lithotripsy in an in vitro ureter model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2014-12-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (?=2120 nm) was operated with standard parameters of 600 mJ, 350 ?s, 6 Hz, and 270-?m-core optical fiber. The TFL (?=1908 nm) was operated with 35 mJ, 500 ?s, 150 to 500 Hz, and a 100-?m-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.

  19. Intracorporeal lithotripsy with the holmium:YAG laser

    NASA Astrophysics Data System (ADS)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

    1995-05-01

    A variety of devices are currently available for intracorporeal stone fragmentation. Recently a new wavelength of laser, the Holmium:YAG, has demonstrated a variety of potential urologic applications including ablation of soft tissue lesions as well as stone fragmentation. This laser has a wavelength of 2100 nm and operates in a pulsed mode. Energy is delivered through a 400 um quartz end-firing fiber. In this presentation we review our clinical experience with the Holmium:YAG laser for the treatment of renal and ureteral calculi. Over a 23 month period, 63 patients underwent 67 procedures. Seven procedures consisted of percutaneous nephrolithotripsy for large or staghorn renal calculi. Sixty procedures were performed for ureteral stones. Procedures for proximal ureteral stones (6) employed a retrograde approach using flexible ureteroscopes (8.5 or 9.8). Stones in the mid ureter (12) and distal ureter (42) were approached transurethrally using a 6.9 rigid ureteroscope. Complete stone fragmentation without the need for additional procedures was achieved in 82% of cases. Treatment failures included 1 stone migration into the renal pelvis during laser activation, 6 patients who had incomplete fragmentation and 3 patients in which laser malfunction precluded complete fragmentation. Stone analysis available in 23 patients revealed calcium oxalate monohydrate (15), calcium oxalate dihydrate (2), cystine (2), uric acid (3) and calcium phosphate (1). A single complication of ureteral perforation occurred when the laser was fired without direct visual guidance. Radiographic follow-up at an average of 16 weeks is available in 22 patients and has identified 2 patients with ureteral strictures that are not believed to be related to laser lithotripsy. In summary, we have found the Holmium:YAG laser to be a reliable and versatile device for intracorporeal lithotripsy. Its safety and efficacy make it a suitable alternative for performing intracorporeal lithotripsy of urinary calculi.

  20. Electrohydraulic lithotripsy of gall stones--in vitro and animal studies.

    PubMed Central

    Harrison, J; Morris, D L; Haynes, J; Hitchcock, A; Womack, C; Wherry, D C

    1987-01-01

    Electrohydraulic lithotripsy of human gall stones was investigated in vitro in a bath of saline and in a saline perfused bile duct. The technique was effective--only two stones could not be shattered. Electrohydraulic lithotripsy power requirement correlated with mechanical strength of stones, but not with biochemical composition. A trend toward higher power requirement was recorded with larger stones and stones over 2 cm in diameter could not be fragmented. Safety studies indicated that electrohydraulic lithotripsy was safe, provided the probe tip was not in contact with the bile duct wall. In vivo studies did not show any late effects after 10 days. Electrohydraulic lithotripsy is likely to be useful in the management of biliary calculi. Images Figs 1(a)-1(b) PMID:3570031

  1. Holmium: YAG laser lithotripsy versus pneumatic lithotripsy for treatment of distal ureteral calculi: a meta-analysis.

    PubMed

    Yin, Xiangrui; Tang, Ziwei; Yu, Bei; Wang, Yarong; Li, Yuehua; Yang, Qi; Tang, Wei

    2013-04-01

    The objective of this study was to estimate the treatment effect of Pneumatic Lithotripsy (PL) versus holmium: YAG laser lithotripsy (LL) in the treatment of distal ureteric calculi. A bibliographic search covering the period from 1990 to April 2012 was conducted using search engines such as MEDLINE, EMBASE, and Cochrane library. Data were extracted and analyzed with RevMan5.1 software. A total of 47 studies were scant, and 4 independent studies were finally recruited. Holmium: YAG LL conveyed significant benefits compared with PL in terms of early stone-free rate [odds ratio (OR)=4.42, 95% confidence interval (CI) (1.14, 17.16), p=0.03], delayed stone-free rate [OR=4.42, 95%CI (1.58, 12.37), p=0.005], mean operative time [WMD=-16.86, 95%CI (-21.33, -12.39), p<0.00001], retaining double-J catheter rate [OR=0.44, 95%CI (0.25, 0.78), p=0.004], and stone migration incidence [OR=0.26, 95%CI (0.11, 0.62), p=0.003], but not yet in the postoperative hematuria rate and the ureteral perforation rate according to this meta-analysis. Precise estimates on larger sample size and trials of high quality may provide more uncovered outcomes in the future. PMID:23016622

  2. Shock-induced collapse of a gas bubble in shockwave lithotripsy.

    PubMed

    Johnsen, Eric; Colonius, Tim

    2008-10-01

    The shock-induced collapse of a pre-existing nucleus near a solid surface in the focal region of a lithotripter is investigated. The entire flow field of the collapse of a single gas bubble subjected to a lithotripter pulse is simulated using a high-order accurate shock- and interface-capturing scheme, and the wall pressure is considered as an indication of potential damage. Results from the computations show the same qualitative behavior as that observed in experiments: a re-entrant jet forms in the direction of propagation of the pulse and penetrates the bubble during collapse, ultimately hitting the distal side and generating a water-hammer shock. As a result of the propagation of this wave, wall pressures on the order of 1 GPa may be achieved for bubbles collapsing close to the wall. The wall pressure decreases with initial stand-off distance and pulse width and increases with pulse amplitude. For the stand-off distances considered in the present work, the wall pressure due to bubble collapse is larger than that due to the incoming shockwave; the region over which this holds may extend to ten initial radii. The present results indicate that shock-induced collapse is a mechanism with high potential for damage in shockwave lithotripsy. PMID:19062841

  3. Shock-induced collapse of a gas bubble in shockwave lithotripsy

    PubMed Central

    Johnsen, Eric; Colonius, Tim

    2008-01-01

    The shock-induced collapse of a pre-existing nucleus near a solid surface in the focal region of a lithotripter is investigated. The entire flow field of the collapse of a single gas bubble subjected to a lithotripter pulse is simulated using a high-order accurate shock- and interface-capturing scheme, and the wall pressure is considered as an indication of potential damage. Results from the computations show the same qualitative behavior as that observed in experiments: a re-entrant jet forms in the direction of propagation of the pulse and penetrates the bubble during collapse, ultimately hitting the distal side and generating a water-hammer shock. As a result of the propagation of this wave, wall pressures on the order of 1 GPa may be achieved for bubbles collapsing close to the wall. The wall pressure decreases with initial stand-off distance and pulse width and increases with pulse amplitude. For the stand-off distances considered in the present work, the wall pressure due to bubble collapse is larger than that due to the incoming shockwave; the region over which this holds may extend to ten initial radii. The present results indicate that shock-induced collapse is a mechanism with high potential for damage in shockwave lithotripsy. PMID:19062841

  4. Safety and efficacy of holmium:YAG laser lithotripsy in patients with bleeding diatheses

    NASA Astrophysics Data System (ADS)

    Watterson, James D.; Girvan, Andrew R.; Cook, Anthony J.; Beiko, Darren T.; Nott, Linda; Auge, Brian K.; Preminger, Glenn M.; Denstedt, John D.

    2003-06-01

    Purpose: To assess the safety and efficacy of ureteroscopy and holmium:YAG (yttrium-aluminum-garnet) laser lithotripsy in the treatment of upper urinary tract calculi in patients with known and uncorrected bleeding diatheses. Materials and Methods: A retrospective chart review from 2 tertiary stone centers was performed to identify patients with known bleeding diatheses who were treated with holmium:YAG laser lithotripsy for upper urinary tract calculi. Twenty-five patients with 29 upper urinary tract calculi were treated with ureteroscopic holmium laser lithotripsy. Bleeding diatheses identified were coumadin administration for various conditions (17), liver dysfunction (3), thrombocytopenia (4), and von Willebrand's disease (1). Mean international normalized ratio (INR), platelet count and bleeding time were 2.3, 50 x 109/L, and > 16 minutes, for patients receiving coumadin or with liver dysfunction, thrombocytopenia, or von Willebrand's disease, respectively. Results: Overall, the stone-free rate was 96% (27/28) and 29 of 30 procedures were completed successfully without significant complication. One patient who was treated concomitantly with electrohydraulic lithotripsy (EHL) had a significant retroperitoneal hemorrhage that required blood transfusion. Conclusions: Treatment of upper tract urinary calculi in patients with uncorrected bleeding diatheses can be safely performed using contemporary small caliber ureteroscopes and holmium laser as the sole modality of lithotripsy. Ureteroscopic holmium laser lithotripsy without preoperative correction of hemostatic parameters limits the risk of thromboembolic complications and costs associated with an extended hospital stay. Avoidance of the use of EHL is crucial in reducing bleeding complications in this cohort of patients.

  5. Extracorporeal shockwave lithotripsy of gallstones. Possibilities and limitations.

    PubMed Central

    Vergunst, H; Terpstra, O T; Brakel, K; Laméris, J S; van Blankenstein, M; Schröder, F H

    1989-01-01

    Recently extracorporeal shockwave lithotripsy (ESWL) has been introduced as a nonoperative treatment for gallstone disease. Except for lung damage, no significant adverse effects of ESWL of gallbladder stones have been observed in animals. In clinical use ESWL of gallbladder stones is now confined to 15% to 30% of symptomatic patients. To achieve complete stone clearance, ESWL of gallbladder stones must be supplemented by an adjuvant therapy. ESWL of bile duct stones is highly effective and can be considered in patients in whom primary endoscopic or surgical stone removal fails. Second generation lithotriptors allow anesthesia-free (outpatient) treatments, but the clinical experience with most of these ESWL devices is still limited. The likelihood of gallbladder stone recurrence is a major disadvantage of ESWL treatment, which raises the issue of cost-effectiveness. ESWL for cholelithiasis is a promising treatment modality with good short-term and unknown long-term results. PMID:2684058

  6. Stress wave focusing transducers

    SciTech Connect

    Visuri, S.R., LLNL

    1998-05-15

    Conversion of laser radiation to mechanical energy is the fundamental process behind many medical laser procedures, particularly those involving tissue destruction and removal. Stress waves can be generated with laser radiation in several ways: creation of a plasma and subsequent launch of a shock wave, thermoelastic expansion of the target tissue, vapor bubble collapse, and ablation recoil. Thermoelastic generation of stress waves generally requires short laser pulse durations and high energy density. Thermoelastic stress waves can be formed when the laser pulse duration is shorter than the acoustic transit time of the material: {tau}{sub c} = d/c{sub s} where d = absorption depth or spot diameter, whichever is smaller, and c{sub s} = sound speed in the material. The stress wave due to thermoelastic expansion travels at the sound speed (approximately 1500 m/s in tissue) and leaves the site of irradiation well before subsequent thermal events can be initiated. These stress waves, often evolving into shock waves, can be used to disrupt tissue. Shock waves are used in ophthalmology to perform intraocular microsurgery and photodisruptive procedures as well as in lithotripsy to fragment stones. We have explored a variety of transducers that can efficiently convert optical to mechanical energy. One such class of transducers allows a shock wave to be focused within a material such that the stress magnitude can be greatly increased compared to conventional geometries. Some transducer tips could be made to operate regardless of the absorption properties of the ambient media. The size and nature of the devices enable easy delivery, potentially minimally-invasive procedures, and precise tissue- targeting while limiting thermal loading. The transducer tips may have applications in lithotripsy, ophthalmology, drug delivery, and cardiology.

  7. Large Bowel Obstruction Due to a Big Gallstone Successfully Treated with Endoscopic Mechanical Lithotripsy

    PubMed Central

    Balzarini, Marco; Broglia, Laura; Comi, Giovanni; Calcara, Calcedonio

    2015-01-01

    Colonic gallstone ileus in an uncommon mechanical bowel obstruction caused by intraluminal impaction of one or more gallstones. The surgical management of gallstone ileus is complex and is potentially of high risk. There have been reports of gallstone extractions using various endoscopic modalities to relieve the obstruction. In this report we present the technique employed to successfully perform a mechanical lithotripsy and extraction of a large gallstone embedded in a sigmoid colon affected by diverticular stenosis. We passed through the stenosis with a 11.3 mm videoscope with 3.7 mm channel. A large lithotripsy extraction basket was used to catch and break up the stone and fragments were removed using the same basket. The patient was discharged asymptomatic three days after the procedure. Using appropriate devices mechanical lithotripsy is a safe and effective method to treat colonic obstruction and avoid surgery in the setting of gallstone ileus even in case of big stones. PMID:26137329

  8. Predictive Factors of the Outcome of Extracorporeal Shockwave Lithotripsy for Ureteral Stones

    PubMed Central

    Choi, Ji Woong; Song, Phil Hyun

    2012-01-01

    Purpose Extracorporeal Shock Wave Lithotripsy (ESWL) has shown successful outcomes for ureteral stones. We investigated predictive factors for failure of ESWL for treating ureteral stones. Materials and Methods A total of 153 patients who underwent ESWL between July 2006 and July 2009 for ureteral stones diagnosed by non-enhanced spiral computed tomography were divided into two groups: (group A, stone size ?10 mm; and group B, stone size >10 mm). The failure was defined as remnant stones >4 mm. We assessed age, sex, body mass index, stone size, laterality, location, skin-to-stone distance (SSD), Hounsfield unit, and the presence of secondary signs (hydronephrosis, renal enlargement, perinephric fat stranding, and tissue rim sign). We analyzed predictive factors by using logistic regression in each group. Results The success rates were 90.2% and 68.6% in group A and B, respectively. In the univariate analysis of each group, stone size, SSD, and all secondary signs showed statistically significant differences in terms of the outcome of ESWL (p<0.05). In the multivariate logistic regression, stone size (odds ratio [OR], 50.005; 95% confidence interval [CI], 6.207 to 402.852) was an independent predictive factor in group A. The presence of perinephric fat standing (OR, 77.634; 95% CI, 1.349 to 446.558) and stone size (OR, 19.718; 95% CI, 1.600 to 243.005) were independent predictive factors in group B. Conclusions Stone size is an independent predictive factor influencing failure of ESWL for treating ureteral stones. In larger ureteral stones (>10 mm), the presence of perinephric fat stranding is also an independent predictive factor. PMID:22741053

  9. Impact of Residual Fragments following Endourological Treatments in Renal Stones

    PubMed Central

    Acar, Cenk; Cal, Cag

    2012-01-01

    Today, shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureterorenoscopy (URS) are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelography which are less sensitive than CT that leads to be diversity of study results in reporting outcome. Residual fragments (RFs) after interventional therapies may cause pain, infection, or obstruction. The size and location of RFs following SWL and PCNL are the major predictors for clinical significant symptoms and stone events requiring intervention. There is no consensus regarding schedule for followup of SWL, PCNL, and flexible URS. Active monitoring can be recommended when the stones become symptomatic, increase in size, or need intervention. RFs <4?mm after SWL and <2?mm after PCNL and flexible URS could be actively monitored on an annual basis with CT. Early repeat SWL and second-look endoscopy are recommended after primary SWL and PCNL, respectively. There is insufficient data for flexible URS, but RFs can be easily treated with repeat URS. Finally, medical therapy should be tailored based on the stone analysis and metabolic workup that may be helpful to prevent regrowth of the RFs. PMID:22829812

  10. A tapered distal fiber tip for thulium fiber laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Irby, Pierce B.; Fried, Nathaniel M.

    2010-02-01

    The Thulium fiber laser has recently been tested as a potential alternative to the Holmium:YAG laser for lithotripsy. This study explores use of a short taper for expanding the Thulium fiber laser beam at the distal tip of a small-core fiber. Thulium fiber laser radiation with a wavelength of 1908 nm, 10 Hz pulse rate, 70 mJ pulse energy, and 1-ms pulse duration was delivered through a 2-m-length fiber with 150-?m-input-end, 300-?m-output-end, and 5-mmlength taper, in contact with human uric acid (UA) and calcium oxalate monohydrate (COM) stones, ex vivo (n=10 each). Stone mass loss, stone crater depths, fiber transmission losses, fiber burn-back, irrigation rates, and deflection through a flexible ureteroscope were measured for the above tapered fiber and compared with conventional fibers. After delivery of 1800 pulses through the tapered fiber, mass loss measured 12.7 +/- 2.6 mg for UA and 7.2 +/- 0.8 mg COM stones, comparable to conventional 100-?m-core fibers (12.6 +/- 2.5 mg for UA and 6.8 +/- 1.7 mg for COM stones). No transmission losses or burn-back occurred for the tapered fiber after 36,000 pulses, while a conventional 150-?m fiber experienced significant tip degradation after only 1800 pulses. High irrigation rates were measured with the tapered fiber inserted through the working port of an ureteroscope, without hindering ureteroscope deflection, mimicking that of conventional 150 ìm fibers. The short tapered distal fiber tip allows expansion of the laser beam, resulting in decreased fiber tip damage compared to conventional small-core fibers, without compromising fiber bending, stone vaporization efficiency, or irrigation rates.

  11. Predicting Difficulty Score for Spinal Anesthesia in Transurethral Lithotripsy Surgery

    PubMed Central

    Khoshrang, Hossein; Falahatkar, Siavash; Heidarzadeh, Abtin; Abad, Mohsen; Rastjou Herfeh, Nadia; Naderi Nabi, Bahram

    2014-01-01

    Background: Spinal anesthesia (SA) is the most common regional anesthesia (RA) conducted for many surgical procedures. Objectives: The current study aimed to predict the difficulty score of SA, by which to reduce the complications and ultimately improve the anesthesia quality. Materials and Methods: Transurethral Lithotripsy (TUL) surgery candidates were enrolled in this observational study from 2010 to 2011. Before SA, the patient`s demographic information along with the Body Mass Index (BMI), lumbar spinous process status, spinal deformity, radiological signs of lumbar vertebrae, and a history of spinal surgery or difficult SA were recorded, then the patients underwent SA in L3-L4 interspinous process space. Information about Cerebrospinal Fluid (CSF) visibility at the first attempt (easy SA) and the times of trying with shifting in that space or trying the second space (moderate SA) and the third space (difficult SA) were recorded. Multinominal regression and relative operating characteristic (ROC) curve were used for statistical analysis. Results: Hundred and one patients were enrolled. Of these patients, 50 (49.5%) underwent SA by the first attempt of the first space, in 36 patients (35.6%) it was moderate and in 15 patients (14.9%) it was difficult. There was no significant relationship between difficulty score of SA and gender, age, height, and history of previous difficult SA. But there was a significant relationship between difficulty score of SA and lumbar spinous process status (P =0.0001), radiological profile of the lumbar spine (P = 0.0001), the status of lumbar deformity (P = 0.007), and BMI (P = 0.006). Then using the ROC curve to predict the difficult SA, the cutoff point was 8.5 with 86.7% and 86% sensitivity and specificity, respectively. Conclusions: It seems that considering the clinical examination of patients before SA focusing on lumbar spinous process status, presence of lumbar deformity, calculation of BMI and radiological signs of lumbar vertebrae can be helpful in predicting SA difficulty. PMID:25337470

  12. [Contribution of surgical endoscopy and extrahydraulic lithotripsy in complex biliopancreatic lithiasis].

    PubMed

    Kestens, P J; Gigot, J F; Mathurin, P; Goffette, P

    1992-01-01

    Surgical endoscopy combined with electro-hydraulic lithotripsy was done on 17 patients selected for complex multiple bilio-pancreatic lithiasis. In the biliary tract (7 patients), per operatory lithotripsy was performed on 3 patients (impacted main duct stones n = 2, impacted left hepatic stones n = 1); it was done through a T-tube in 1 young patient with an impacted stone in the ampulla and percutaneously in 3 patients (1 gall bladder and 2 intra hepatic lithiasis, one of them with biliary cirrhosis and portal hypertension). Four of this patients had had iterative surgery, extracorporeal lithotripsy or retrograde endoscopy. Complete desobstruction was obtained in all patients with minimal morbidity (minor hemobilia n = 2, hemorrhage from oesophageal varicose n = 1). In the pancreas, the technique was performed on 10 patients with impacted stones in the Wirsung duct and cephalic obstruction. Mean duct diameter was 7 mm. Complete desobstruction was obtained in 9 cases and endoscopic maneuvers were associated with "double stream" operation: sphincterotomy and cephalic desobstruction plus latero-lateral wirsungo-jejunostomy. Morbidity was small (minor hemorrhage n = 3). To conclude, endoluminal electro-hydraulic lithotripsy is an interesting adjuvant technique for the treatment of obstruction from stones in complex bilio-pancreatic lithiasis, either during open surgery or trans-cutaneously. PMID:1341281

  13. Ureteropyeloscopy and homium: YAG laser lithotripsy for treatment of ureteral calculi (report of 356 cases)

    NASA Astrophysics Data System (ADS)

    Wu, Zhong; Din, Qiang; Jiang, Hao-wen; Zen, Jing-cun; Yu, Jiang; Zhang, Yuanfang

    2005-07-01

    Objective: To evaluate the efficacy and safety of holmium YAG laser lithotripsy for the treatment of ureteral calculi. Methods: A total of 356 patients underwent ureteropyeloscopic lithotripsy using holmium YAG laser with a semirigid uretesopyeloscope, 93 upper, 135 middle, and 128 lower ureteral stones were treated. Results: The overall successful fragmentation rate for all ureteral stones in a single session achieved 98% (349/356). The successful fragmentation rate stratified by stone location was 95% 88/93 in the upper ureter, 99% (134/135) in the mid ureter , and 99%(127/128) in the distal ureter. 12 cases with bilateral ureteral stones which caused acute renal failure and anuria were treated rapidly and effectively by the holmium YAG laser lithotripsy. No complications such as perforation and severe trauma were encountered during the operations. 2 weeks 17months (with an average of 6.8 month ) follow up postoperatively revealed that the overall stone-free rate was 98%(343/349) and no ureteral stenosis was found. Conclusions Holmium YAG laser lithotripsy is a highly effective, minimally invasive and safe therapy for ureteral calculi. It is indicated as a first choice of treatment for patients with ureteral calculi, especially for the ones with mid- lower levels of ureteral calculi.

  14. History of Ureteral Stenting Negatively Affects the Outcomes of Extracorporeal Shockwave Lithotripsy. Results of a Matched-pair Analysis.

    PubMed

    Sfoungaristos, Stavros; Gofrit, Ofer N; Pode, Dov; Landau, Ezekiel H; Yutkin, Vladimir; Latke, Arie; Duvdevani, Mordechai

    2015-01-01

    To evaluate the impact of ureteral stenting history to the outcomes of extracorporeal shockwave lithotripsy, we retrospectively analysed patients who underwent shockwave lithotripsy with Dornier Gemini lithotripter between September 2010 and August 2012. Forty seven patients (group A) who had a double J stent which was removed just before the procedure were matched-paired with another 47 patients (group B) who underwent shockwave lithotripsy having no stent history. The correlation between ureteral stenting history and stone-free rates was assessed. Stone-free rates were 68.1% and 87.2% for patients of group A and B, respectively (p=0.026). Postoperative complications were not different between groups. Multivariate analysis revealed that stone size (p=0.007), stone location (p=0.044) and history of ureteral stenting (p=0.046) were independent predictors for stone clearance after shockwave lithotripsy. Ureteral stents adversely affect shockwave lithotripsy outcome, even if they are removed before the procedure. Stenting history should divert treatment plan towards intracorporeal lithotripsy. PMID:26445394

  15. Optimal Management of Lower Polar Calyceal Stone 15 to 20 mm

    PubMed Central

    Haroon, Naveed; Nazim, Syed M

    2013-01-01

    Purpose To compare the stone clearance rate, efficiency quotient (EQ), and early complications of shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) for solitary lower-pole renal stones measuring 15 to 20 mm. Materials and Methods This was a retrospective matched-pair analysis of 142 patients (78 in the SWL and 64 in the PCNL group). Preoperative imaging was done by use of noncontrast computed tomography (CT kidney, ureter, and bladder [KUB]), intravenous urogram, or plain X-ray and ultrasound KUB to assess the largest dimension of the stones. Only patients with radiopaque stones were included. The stone-free rates were assessed with plain X-ray and ultrasound at 4 weeks. Data were analyzed by use of SPSS ver. 19. Results The patients' demographic profiles (age, body mass index) and the stone sizes were comparable in the two groups. The mean stone size was 17.4±2.12 in the PCNL group compared with 17.67±2.04 in the SWL group (p=0.45). At 4 weeks, 83% of patients undergoing PCNL were stone-free compared with 51% in the SWL group (p<0.001). The EQ for the PCNL group was 76% compared with 44% for the SWL group (p<0.001). Ancillary procedures were required by 9% of patients in the PCNL group compared with 15% in the SWL group. The complication rate was 19% in both groups. The SWL complications were minor. Conclusions Stone clearance from the lower pole of solitary stones sized 15 to 20 mm at the greatest diameter following SWL is poorer. These calculi can be better managed with percutaneous surgery owing to its higher efficacy and acceptably low morbidity. PMID:23614064

  16. Use of a nasogastric tube to evacuate stone debris after ureteroscopic holmium lithotripsy.

    PubMed

    Cadeddu, J A; Jarrett, T

    1998-11-01

    We report a case of bilateral struvite and matrix staghorn calculi in a quadriplegic man with severe upper and lower extremity contractures that prevented percutaneous nephrolithotomy. Bilateral ureteroscopic lithotripsy was performed but the "snowstorm" of particles and viscous matrix material prevented complete stone clearance with the ureteroscope alone. Irrigation and aspiration through a fluoroscopically positioned nasogastric tube allowed evacuation of stone debris, mucinous matrix, and completion of the procedure. PMID:9801120

  17. Renal arteriovenous fistula: a rare complication of electro-hydraulic lithotripsy.

    PubMed

    Abogunrin, Funso Ayowale

    2012-11-01

    Renal arteriovenous fistula (rAVF) is an uncommon condition, usually iatrogenic and in most cases caused by percutaneous renal needle biopsy. This is a report of rAVF following flexible ureteroscopic electro-hydraulic lithotripsy of a lower pole renal calculus and its subsequent management. A high index of suspicion is required for the diagnosis of this rare complication, which is easily treated by radiological intervention. PMID:23217556

  18. Photothermal ablation is the primary mechanism in holmium:YAG laser lithotripsy of urinary calculi

    NASA Astrophysics Data System (ADS)

    Glickman, Randolph D.; Teichman, Joel M. H.; Corbin, Nicole S.; Vassar, George J.; Weintraub, Susan T.; Chan, Kin Foong; Welch, Ashley J.

    1999-09-01

    Because of the >= 250 microsecond(s) pulsewidth emitted by the Ho:YAG laser used in clinical lithotripsy, it is unlikely that stress confinement occurs within the irradiated stones. Experimental data supports a thermal mechanism for Ho:YAG laser stone ablation. Previous work has shown that stone fragmentation occurs soon after the onset of the laser pulse, is uncorrelated to cavitation bubble formation or collapse, and is associated with low pressures. Moreover, lithotripsy proceeds fastest with desiccated stones in air (data based on laser ablation of calcium oxalate monohydrate stones), indicating that direct absorption of the laser radiation by the stone material is required for the most efficient ablation. Lowering the initial temperature of calculi reduces the stone mass-loss following 20 J of delivered laser energy: 2.2 +/- 1.1 mg vs 5.2 +/- 1.6 mg for calcium oxalate monohydrate (COM) stones (-80 vs 23 degree(s)C), and 0.8 +/- 0.4 mg vs 2.2 +/- 1.1 mg for cystine stones (-80 vs 23 degree(s)C), p lithotripsy.

  19. Comparison of different pulsed and Q-switched solid state laser systems for endoscopic laser-induced shockwave lithotripsy: performance and laser/stone interactions

    NASA Astrophysics Data System (ADS)

    Steiger, Erwin

    1990-06-01

    At present the laser induced shock wave lithotripsy (LISL) of urinary and biliary stones via fiber optic beam delivery is governed by two competing' laser systems: The flashlamp-pumped pulsed dye laser and the Q-switched Nd:YAG laser. The pulsed radiation of the dye system with pulse durations in the 1-2 .tsec region can be easily transmitted through extremely flexible fused silica fibers with core diameters of only 200 im whilst the Q-switched Nd:YAG laser with pulselengths of 5-25 nsec needs fibers with more than 400 tm core diameter. The dye laser releases acoustic shock waves for fragmentation simply by stone contact, the Q-switched Nd:YAG produces these waves in the surrounding aqueous medium by laser induced optical breakdown (LIB) when refocused by optical means or through additional metal absorbers, i.e. opto - mechanical couplers. We report on the system performances and laser/stone interactions of two alternative solid-state laser systems with variable pulselengths in the range of 1.7 - 30 sec and 30 - 1000 nsec, respectively: The pulsed psec-Nd:YAG laser and the Q-switched alexandrite laser. Regarding the endoscopic laser lithotripsy of urinary and biliary stones in the ureter or common bile duct, respectively, the laser energy delivery system, i.e. the optical fiber; is the most stressed part. Therefore we used long-pulse solid-state laser systems like the pulsed Nd:YAG laser with a pulse-slicing unit and a pulselength-tunable Q-switched alexandrite laser and studied fragmentation of synthetic plaster samples as well as urinary and biliary stones. The radiation of both laser systems can be effectively transmitted via standard 200 im core diameter optical quartz fibers what is absolutely necessary when used in conjunction with small caliber rigid or flexible endoscopes. As a compact and reliable solid-state system the alexandrite laser lithotripter is much less expensive than an extracorporeal shock wave lithotripter with the same fragmentation results and may become the laser of choice for LISL.

  20. Shock Wave Technology and Application: An Update☆

    PubMed Central

    Rassweiler, Jens J.; Knoll, Thomas; Köhrmann, Kai-Uwe; McAteer, James A.; Lingeman, James E.; Cleveland, Robin O.; Bailey, Michael R.; Chaussy, Christian

    2012-01-01

    Context The introduction of new lithotripters has increased problems associated with shock wave application. Recent studies concerning mechanisms of stone disintegration, shock wave focusing, coupling, and application have appeared that may address some of these problems. Objective To present a consensus with respect to the physics and techniques used by urologists, physicists, and representatives of European lithotripter companies. Evidence acquisition We reviewed recent literature (PubMed, Embase, Medline) that focused on the physics of shock waves, theories of stone disintegration, and studies on optimising shock wave application. In addition, we used relevant information from a consensus meeting of the German Society of Shock Wave Lithotripsy. Evidence synthesis Besides established mechanisms describing initial fragmentation (tear and shear forces, spallation, cavitation, quasi-static squeezing), the model of dynamic squeezing offers new insight in stone comminution. Manufacturers have modified sources to either enlarge the focal zone or offer different focal sizes. The efficacy of extracorporeal shock wave lithotripsy (ESWL) can be increased by lowering the pulse rate to 60–80 shock waves/min and by ramping the shock wave energy. With the water cushion, the quality of coupling has become a critical factor that depends on the amount, viscosity, and temperature of the gel. Fluoroscopy time can be reduced by automated localisation or the use of optical and acoustic tracking systems. There is a trend towards larger focal zones and lower shock wave pressures. Conclusions New theories for stone disintegration favour the use of shock wave sources with larger focal zones. Use of slower pulse rates, ramping strategies, and adequate coupling of the shock wave head can significantly increase the efficacy and safety of ESWL. PMID:21354696

  1. Evaluation of Extracorporeal Shock Wave Lithotripsy (ESWL): Efficacy in Treatment of Urinary System Stones

    PubMed Central

    Junuzovic, Dzelaludin; Prstojevic, Jelena Kovacevic; Hasanbegovic, Munira; Lepara, Zahid

    2014-01-01

    ABSTRACT Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (x2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter. PMID:25568579

  2. Effect of lithotripter focal width on stone comminution in shock wave lithotripsy

    PubMed Central

    Qin, Jun; Simmons, W. Neal; Sankin, Georgy; Zhong, Pei

    2010-01-01

    Using a reflector insert, the original HM-3 lithotripter field at 20 kV was altered significantly with the peak positive pressure (p+) in the focal plane increased from 49 to 87 MPa while the ?6 dB focal width decreased concomitantly from 11 to 4 mm. Using the original reflector, p+ of 33 MPa with a ?6 dB focal width of 18 mm were measured in a pre-focal plane 15-mm proximal to the lithotripter focus. However, the acoustic pulse energy delivered to a 28-mm diameter area around the lithotripter axis was comparable (?120 mJ). For all three exposure conditions, similar stone comminution (?70%) was produced in a mesh holder of 15 mm after 250 shocks. In contrast, stone comminution produced by the modified reflector either in a 15-mm finger cot (45%) or in a 30-mm membrane holder (14%) was significantly reduced from the corresponding values (56% and 26%) produced by the original reflector (no statistically significant differences were observed between the focal and pre-focal planes). These observations suggest that a low-pressure?broad focal width lithotripter field will produce better stone comminution than its counterpart with high-pressure?narrow focal width under clinically relevant in vitro comminution conditions. PMID:20370044

  3. Extracorporeal shock wave lithotripsy for urinary stone disease: clinical experience with the electromagnetic lithotriptor 'Lithostar'.

    PubMed

    Simon, J; Corbusier, A; Mendes Leal, A; Van den Bossche, M; Wespes, E; Van Regemorter, G; Schulman, C C

    1989-01-01

    400 urinary stone patients were treated with the electromagnetic lithotriptor Siemens 'Lithostar': 66.3% had renal stones and 33.7% had ureteral stones. Ninety percent of the treatments were performed under intravenous sedation only: 14.5% of the patients had more than one session. After 3 months more than 80% of the patients with a single stone smaller than 1.5 cm and 46% of the patients with stones larger than 2.5 cm were 'stone-free'. PMID:2714323

  4. [Application of rowatinex in the perioperative period in the extracorporeal shock wave lithotripsy].

    PubMed

    Popkov, V M; Bliumberg, B I; Osnovin, O V; Shatylko, T V

    2014-01-01

    Despite the high efficacy and safety of ESWL used to disintegrate stones in pyelocaliceal system and upper ureter, the issue of further reduction of the risk of complications of this procedure remains unresolved. The inclusion ofphytopreparations with anti-inflammatory and lithokinetic properties in the scheme of perioperative treatment is one of the ways for prevent complications of ESWL. The effect of the drug Rowatinex on the process of discharge of calculi fragments after ESWL is evaluated. The frequency and intensity of qualitative changes of urine after appointment this drug were assessed. It is concluded that Rowatinex has positive impact on the final result of ESWL in the case of its inclusion in the complex medical treatment, which manifests in terms of reducing the time of discharge of fragments, mitigation of subjective symptoms, as well as reducing the frequency of subclinical bacteriuria and severe complications. PMID:24956667

  5. Percutaneous Endoscopic Holmium Laser Lithotripsy for Management of Complicated Biliary Calculi

    PubMed Central

    Healy, Kelly; Chamsuddin, Abbas; Spivey, James; Martin, Louis; Nieh, Peter

    2009-01-01

    Background and Objectives: Advances in endoscopic techniques have transformed the management of urolithiasis. We sought to evaluate the role of such urological interventions for the treatment of complex biliary calculi. Methods: We conducted a retrospective review of all patients (n=9) undergoing percutaneous holmium laser lithotripsy for complicated biliary calculi over a 4-year period (12/2003 to 12/2007). All previously failed standard techniques include ERCP with sphincterotomy (n=6), PTHC (n=7), or both of these. Access to the biliary system was obtained via an existing percutaneous transhepatic catheter or T-tube tracts. Endoscopic holmium laser lithotripsy was performed via a flexible cystoscope or ureteroscope. Stone clearance was confirmed intra- and postoperatively. A percutaneous transhepatic drain was left indwelling for follow-up imaging. Results: Mean patient age was 65.6 years (range, 38 to 92). Total stone burden ranged from 1.7 cm to 5 cm. All 9 patients had stones located in the CBD, with 2 patients also having additional stones within the hepatic ducts. All 9 patients (100%) were visually stone-free after one endoscopic procedure. No major perioperative complications occurred. Mean length of stay was 2.4 days. At a mean radiological follow-up of 5.4 months (range, 0.5 to 21), no stone recurrence was noted. Conclusions: Percutaneous endoscopic holmium laser lithotripsy is a minimally invasive alternative to open salvage surgery for complex biliary calculi refractory to standard approaches. This treatment is both safe and efficacious. Success depends on a multidisciplinary approach. PMID:19660213

  6. Electrohydraulic lithotripsy: experimental study and case reports with the stone disintegrator.

    PubMed

    Raney, A M

    1975-03-01

    Electrohydraulic lithotripsy with the SD-1 for crushing bladder stones was performed experimentally, in vitro and in vivo. The results of this experiment in laboratory animals and in 19 patients revealed that the procedure is safe and superior to the conventional methods with blind or optical lithotriptors. The methods is easy to learn and application of the technique may be combined in the same session with other urological operations. This procedure was done more than 50 times in toto without any complication. PMID:1117502

  7. Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy

    NASA Astrophysics Data System (ADS)

    Watterson, James D.; Girvan, Andrew R.; Beiko, Darren T.; Nott, Linda; Wollin, Timothy A.; Razvi, Hassan A.; Denstedt, John D.

    2003-06-01

    Objectives: Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy (PCN). Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy. The purpose of this study was to review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Methods: A retrospective analysis was conducted at 2 tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and 2 encrusted ureteral stents were treated. Mean gestational age at presentation was 22 weeks. Mean stone size was 8.1 mm. Stones were located in the proximal ureter/ureteropelvic junction (UPJ) (3), mid ureter (1), and distal ureter (6). Results: Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetrical or urological complications were encountered. Conclusions: Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.

  8. Holmium:YAG laser lithotripsy for the management of urolithiasis in small ruminants and pot-bellied pigs

    NASA Astrophysics Data System (ADS)

    Halland, Spring K.; House, John K.; George, Lisle

    2001-05-01

    Obstructive urolithiasis is a common problem in small ruminants and pot-bellied pigs. The most common site of urinary tract obstruction in these species is the urethra. Surgical procedures developed to relieve obstructions, in our experience have been effective in approximately 75% of cases. Urethral stricture is a common complication if the mucosa of the urethra is disrupted. The objective of this project was to evaluate endoscopy guided laser lithotripsy as a therapeutic modality to relieve urethral obstructions in small ruminants and pot-bellied pigs. The study population consisted of patients presented to the Veterinary Medical Teaching Hospital at the University of California Davis with obstructive urolithiasis. Lithotripsy was performed using a Holmium:YAG laser via a 200-micron low water quartz fiber passed through a flexible mini-endoscope. Two types of urinary calculi were managed with this technique, calcium carbonate and calcium hydroxyphosphate. Laser lithotripsy was effective at relieving obstructions caused by both types of calculi when conventional methods had failed. Laser lithotripsy performed via urethral endoscopy is a safe and effective therapeutic modality for management of obstructive urolithiasis in small ruminants and pot-bellied pigs and reduces the risk of post procedural urethral stricture.

  9. Variation of slow-wave frequency and locking during the migrating myoelectric complex in dogs.

    PubMed

    Caenepeel, P; Janssens, W; Accarino, A; Janssens, J; Vantrappen, G; Eyssen, H

    1991-12-01

    Slow waves determine rhythm and polarity of spike bursts. We measured the variation of slow-wave frequency (swf) and locking (swl) in the canine jejunum during the various phases of the migrating myoelectric complex (MMC) and during induced phase III (erythromycin 125 micrograms/kg iv bolus or somatostatin 2.5 micrograms.kg-1.h-1 iv infusion), blocked phase III (atropine 20 micrograms/kg iv bolus), and so-called stationary phase III activity (cisapride 150 micrograms/kg iv bolus). The EMG of 4 dogs, implanted with 10 bipolar electrodes, was recorded on a polygraph. Our results indicate that swf and swl change during the MMC from a stepwise swf gradient with slow waves locked in plateaus during phase I to a continuous swf gradient without or with significantly reduced phase locking during phase III. The length of the first swf plateau decreases significantly from 42 +/- 12 cm post Treitz during phase I to 11 +/- 4 cm during spontaneous phase III. Atropine block of phase III activity prevents phase unlocking and development of a continuous swf gradient. Our hypothesis is that phase unlocking may be one of the induction mechanisms of spike-burst activity. PMID:1685071

  10. [Extracorporeal lithotripsy and our future approach in lithiasis].

    PubMed

    Schmidt, A; Geist, E; Eisenberger, E G

    1994-01-01

    It can be claimed that ESWL is an optimal alternative for ablation of calculi by external shock waves. The new developments in ESWL focus more on the economic aspects of treatment rather than enhancing its efficacy or reducing the side effects. The routine indications of ESWL are well known and widely accepted. Similarly, its limitations are well defined: silent caliceal calculi, diverticular caliceal calculi, nephrolithiasis in horseshoe kidney, medullary sponge kidney and residual fragments after ESWL. Although endourology offers new, less invasive and less traumatic ways for stone ablation, such as lasertripsy, mini flexible ureteroscopes and ureteropyeloscopes, the indication for a more aggressive approach in the cases mentioned above is limited to the symptomatic cases. For calculi in the distal ureter, only the ureteroscope and intraureteral laser open new and interesting possibilities in the near future. PMID:7944603

  11. Percutaneous yttrium aluminum garnet-laser lithotripsy of intrahepatic stones and casts after liver transplantation.

    PubMed

    Schlesinger, Nis Hallundbaek; Svenningsen, Peter; Frevert, Susanne; Wettergren, André; Hillingsø, Jens

    2015-06-01

    Bile duct stones and casts (BDSs) contribute importantly to morbidity after liver transplantation (LT). The purpose of this study was to estimate the clinical efficacy, safety, and long-term results of percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) in transplant recipients and to discuss underlying factors affecting the outcome. A retrospective chart review revealed 18 recipients with BDSs treated by PTCSL laser lithotripsy with a holmium-yttrium aluminum garnet laser probe at 365 to 550 µm. They were analyzed in a median follow-up time of 55 months. In all but 1 patient (17/18 or 94%), it was technically feasible to clear all BDSs with a mean of 1.3 sessions. PTCSL was unsuccessful in 1 patient because of multiple stones impacting the bile ducts bilaterally; 17% had early complications (Clavien II). All biliary casts were successfully cleared; 39% had total remission; 61% needed additional interventions in the form of percutaneous transhepatic cholangiography and dilation (17%), re-PTCSL (11%), self-expandable metallic stents (22%), or hepaticojejunostomy (6%); and 22% eventually underwent retransplantation. The overall liver graft survival rate was 78%. Two patients died during follow-up for reasons not related to their BDS. Nonanastomotic strictures (NASs) were significantly associated with treatment failure. We conclude that PTCSL in LT patients is safe and feasible. NASs significantly increased the risk of relapse. Repeated minimally invasive treatments, however, prevented graft failure in 78% of the cases. PMID:25821134

  12. Bifunctional irrigation liquid as an ideal energy converter for laser lithotripsy with nanosecond laser pulses

    NASA Astrophysics Data System (ADS)

    Reichel, Erich; Schmidt-Kloiber, Heinz; Paltauf, Guenther; Groke, Karl

    1991-07-01

    The intracorporal lithotripsy of ureter stones using laser pulses with a duration of 8 to 20 ns is carried out by means of energy converters. These devices have the purpose to transform the optical energy of the laserlight into mechanical energy of shockwaves, which cause the intended stone fragmentation. Therefore this method is independent of any optical property of the stone. For the endoscopic lithotripsy a continuous flow of irrigation liquid must be supplied to ensure a clear field of view and to transport the small stone fragments out of the body. In the case of the method developed by us, a second function is appointed to this liquid: the energy conversion. In transparent liquids, conversion of the optical energy is done by the laser-induced breakdown (LIB), which produces mechanical shockwaves. To release such a LIB, the laserpulse intensity must exceed a certain threshold. To achieve a LIB in the liquid at the fiber exit there are two possibilities. First, the fiber exit is spherically shaped, which leads to a kind of focus between fiber and stone. Second, the threshold intensity of the liquid is lowered. This is performed by addition of minimal amounts of Fe+++-ions. To obtain a stable and physiologically applicable irrigation solution the Fe+++-ions were added to isotonic saline solution in form of a dextran complex.

  13. Engineering Better Lithotripters.

    PubMed

    Chaussy, Christian G; Tiselius, Hans-Göran

    2015-08-01

    Although shock wave lithotripsy (SWL) remains an excellent non-invasive method for active removal of stones from the ureter and kidney, its popularity has decreased during recent years and the arguments for choosing endoscopic procedures rather than the only non-invasive surgical procedure are usually based on the opinion that SWL results are inferior to those obtained with endoscopic methods. It is considered that slow technical progress has not sufficiently met the requirements of disintegration, reduced need of repeated treatments, shorter treatment duration and less negative effects on tissues. This article summarises some recently published articles that address these problems and have the aim of improving the function of lithotripters. Modification of the shock wave geometry, elimination or control of cavitation bubbles, and different techniques of disintegration studied in in vitro and in animal experiments suggest several possible future directions that might provide a basis for development of a new "gold standard" lithotripter. PMID:26077353

  14. Comparative evaluation of general, epidural and spinal anaesthesia for extracorporeal shockwave lithotripsy.

    PubMed Central

    Rickford, J. K.; Speedy, H. M.; Tytler, J. A.; Lim, M.

    1988-01-01

    The results of a prospective randomised evaluation of general anaesthesia (GA), epidural anaesthesia (EA) and spinal anaesthesia (SA) for extracorporeal shockwave lithotripsy are presented. GA provided speed and reliability but resulted in a high incidence of postoperative nausea, vomiting and sore throat. Both regional techniques conferred the advantages of an awake, cooperative patient, but EA required a longer preparation time than SA and more supplementary treatment with fentanyl or midazolam. A major drawback associated with the use of SA was a 42% incidence of postspinal headache. All three techniques were associated with hypotension on placement in the hoisl; bath immersion resulted in significant rises in blood pressure in the EA and SA groups and a more variable (overall non-significant) response in the GA group. PMID:3044238

  15. Comparison of treatment of renal calculi by open surgery, percutaneous nephrolithotomy, and extracorporeal shockwave lithotripsy.

    PubMed Central

    Charig, C R; Webb, D R; Payne, S R; Wickham, J E

    1986-01-01

    This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) patients after open surgery, 289 (83%) after percutaneous nephrolithotomy, 301 (92%) after ESWL, and 15 (62%) after percutaneous nephrolithotomy and ESWL. Comparative total costs to the NHS were estimated as 3500 pounds for open surgery, 1861 pounds for percutaneous nephrolithotomy, 1789 pounds for ESWL, and 3210 pounds for both ESWL and nephrolithotomy. ESWL caused no blood loss and little morbidity and is the cheapest and quickest way of returning patients to normal life. PMID:3083922

  16. AB093. Treatment of upper ureteral calculi with trans-ureteroscopic holmium laser lithotripsy

    PubMed Central

    Liu, Wei-Guang

    2015-01-01

    Objective To study the clinical effects of using ureteroscopic holmium laser lithotripsy to treat patients with upper urinary tract calculi. Methods We analysis the clinical materials of 260 cases patients in our hospital using ureteroscopic holmium laser lithotripsy to treat patients with upper ureteral stones in 2014. Results The overall successful rate of fragmentation for all ureteral stones in a single procedure achieved 93.1% (242/260). Ten cases were fragmented successfully by ESWL, four cases were fragmented successfully by flexible ureteroscope, two cases were fragmented successfully by mPCNL, two cases were fragmented successfully by laparoscopic. Operation time ranged 36 min (mean 36.±47.9 min), and duration of hospitalization after operation was 3-7 d, with an average 4.5 d. There were 15 patients with urinary tract infection and suffered fever. One patient with ureteral perforation, and no one with ureteral avulsion or long term complications such as ureteral stricture. The stone-free rate was 98.3% (238/242) in a month postoperation. Conclusions Trauma patients are small, quick recovery and fewer complications. It is an ideal methods treatment of urinary calculi, especially in some complex upper urinary tract stones, such as patients failed from ESWL or with stone wrapped by hyperplasia tissues. Correct and skilled ureteroscopic holmium laser management may decrease the complication. Breaking the stones gradually, and using small power and slow lavage can prevent stones from translocating efficiently. To treat stones which combined with polyps or wrapped by hyperplasia tissues, it is not necessary to clear the polyps or hyperplasia tissues absolutely, but the stones must be removed absolutely.

  17. Comparison of holmium:YAG and thulium fiber lasers for lithotripsy

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Irby, Pierce B.; Fried, Nathaniel M.

    2010-02-01

    The Holmium:YAG laser is currently the most common laser lithotripter. However, recent experimental studies have demonstrated that the Thulium fiber laser is also capable of vaporizing urinary stones. The high-temperature water absorption coefficient for the Thulium wavelength (?a = 160 cm-1 at ? = 1908 nm) is significantly greater than for the Holmium wavelength (?a = 28 cm-1 at ? = 2120 nm). We hypothesize that this should translate into more efficient laser lithotripsy using the Thulium fiber laser. This study directly compares stone vaporization rates for Holmium and Thulium fiber lasers. Holmium laser radiation pulsed at 3 Hz with 70 mJ pulse energy and 220 ?s pulse duration was delivered through a 100-?m-core silica fiber to human uric acid (UA) and calcium oxalate monohydrate (COM) stones, ex vivo (n = 10 each). Thulium fiber laser radiation pulsed at 10 Hz with 70 mJ pulse energy and 1 ms pulse duration was also delivered through a 100-?m fiber for the same sets of 10 stones. For same number of pulses and total energy (126 J) delivered to each stone, mass loss averaged 2.4 +/- 0.6 mg (UA) and 0.7 +/- 0.2 mg (COM) for Holmium laser and 12.6 +/- 2.5 mg (UA) and 6.8 +/- 1.7 (COM) for Thulium fiber laser. UA and COM stone vaporization rates for Thulium fiber laser averaged 5-10 times higher than for Holmium laser at 70 mJ pulse energies. With further development, the Thulium fiber laser may represent an alternative to the conventional Holmium laser for more efficient laser lithotripsy.

  18. Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury.

    PubMed

    Tepeler, Abdulkadir; Sninsky, Brian C; Nakada, Stephen Y

    2015-11-01

    The objective of this study is to present the outcomes of flexible ureteroscopic laser lithotripsy (URS) for upper urinary tract stone disease in spinal cord injury (SCI) patients performed by a single surgeon. A retrospective analysis was performed for SCI patients treated with flexible URS for proximal ureter and kidney stone disease by a single surgeon between 2003 and 2013. Patient characteristics, operative outcomes, metabolic evaluation, and stone analyses were assessed in detail. A total of 27 URS procedures were performed for urolithiasis in 21 renal units of 19 patients. The mean age was 52.1 ± 15.6 years (16-72) and mean BMI was 29.2 ± 7.3 kg/m(2) (20-45.7). Etiology of SCI was trauma (n: 10), multiple sclerosis (n: 6), cerebrovascular accident (n: 1), or undetermined (n: 2). The mean stone size was 15.9 ± 8.6 (6-40) mm. In the 27 URS procedures, stones were located in the ureter (n: 5), the kidney (n: 14), and both areas (n: 8). Mean hospitalization time was 2.0 ± 2.4 (0-10) days. Postoperative complications were observed in 6 cases (22.2%). Three major complications included urosepsis (n: 1) and respiratory failure (n: 2), that were observed postoperatively and required admission to the intensive care unit. The 2 minor complications were hypotension, fever and UTI, and required medical treatment. Fourteen (66.6%) of the 21 renal units were stone free. Calcium phosphate carbonate (n: 9) and struvite (n: 5) were the primary stone compositions detected. Hypocitraturia (n: 6), hypercalciuria (n: 5), hypernaturia (n: 5), hyperoxaluria (n: 4), and hyperuricosuria (n: 1) were common abnormalities in 24-h urine analysis. Ureteroscopic laser lithotripsy can be an effective treatment modality for SCI patients with upper urinary tract calculi. PMID:25987450

  19. The economic burden of gallstone lithotripsy. Will cost determine its fate?

    PubMed Central

    Nealon, W H; Urrutia, F; Fleming, D; Thompson, J C

    1991-01-01

    Gallstone lithotripsy (LITHO) was performed on 52 patients who underwent 107 procedures. Two hundred sixty-seven gallstone patients were screened and 215 (81%) were excluded. Excessive stone burden and nonvisualization by oral cholecystogram (OCG) were the most common reasons for exclusion. The hospital course of 100 excluded patients who later underwent elective cholecystectomy was evaluated for length of hospital stay (2.3 days) and total cost of treatment ($3685.00). Successful fragmentation to less than 5 mm was achieved in 43 LITHO patients (83%). Five LITHO patients (10%) required conversion to operative management. Complications of LITHO included acute cholecystitis (1 of 52 patients) and biliary colic (17 of 52 patients, or 33%). Multiple procedures in one patient were common. Costs for LITHO were calculated in two ways: first the individual cost for each of the 52 candidates; second the cost for successful LITHO was calculated by excluding five patients who required operation as well as five patients (10%) who are predicted failures of LITHO. Including the preoperative evaluation, treatment, recovery room, and follow-up, the individual LITHO cost for 52 patients was $8275.00. If the same total expenditure is calculated after excluding patients who required operation and those predicted to fail, the cost per 'successful' LITHO procedure was $10,245. The cost of 1 year of bile acid therapy is $1949.00 or $2413.00 per 'successful' procedure. Follow-up costs were $1232.00 per patient or $1525.00 per 'successful' procedure. The added LITHO cost incurred by screening eventual noncandidates was $904.00 per successful procedure. The sum of these individual costs was $15,087.00 per success, as compared to $3685.00 for cholecystectomy. No allowance was made for cost of stone recurrence. Lithotripsy costs appear to be sufficiently high to render the procedure unlikely to emerge as the treatment of choice. PMID:2039296

  20. Safety and efficacy of using the stone cone and an entrapment and extraction device in ureteroscopic lithotripsy for ureteric stones

    PubMed Central

    Shabana, Waleed; Teleb, Mohamed; Dawod, Tamer

    2015-01-01

    Objective To assess the safety and efficacy of using a stone cone and an entrapment and extraction device (N-Trap®, Cook Urological, Bloomington, IN, USA) to avoid stone retropulsion during ureteroscopic lithotripsy for ureteric stones. Patients and methods This retrospective comparative study included 436 patients treated with ureteroscopic lithotripsy for a single ureteric stone from February 2011 to January 2014. The diagnosis of a stone was confirmed by plain spiral computed tomography in all cases. Patients were divided according to the ureteric occlusion device applied to avoid stone retropulsion during pneumatic lithotripsy into three groups; group 1 (156) had no instruments used, group 2 (140) in whom the stone cone was applied, and group 3 (140) in whom the N-Trap was used. Patient demographics, stone criteria, operative duration and complications, and success rates (complete stone disintegration with no upward migration) were reported and analysed statistically. Results The stone was in the lower ureter in >55% of patients in all groups. The mean (SD) of maximum stone length was 9.8 (2.5), 10.4 (2.8) and 9.7 (2.9) in groups 1–3, respectively. The use of the stone cone or N-Trap did not significantly increase the operative duration (P = 0.13) or complication rates (P = 0.67). There was a statistically significant difference (P < 0.001) favouring groups 2 and 3 for retropulsion and success rates, being 83.3% in group 1, 97.1% in group 2 and 95.7% in group 3. Conclusion The stone cone and N-Trap gave high success rates in preventing stone retropulsion during ureteric pneumatic lithotripsy. Both devices caused no increase in operative duration or complications when used cautiously. PMID:26413324

  1. A comparison of efficacies of holmium YAG laser, and pneumatic lithotripsy in the endoscopic treatment of ureteral stones

    PubMed Central

    Akdeniz, Ekrem; ?rk?lata, Lokman; Demirel, Hüseyin Cihan; Sayl?k, Acun; Bolat, Mustafa Suat; ?ahinkaya, Necmettin; Zengin, Mehmet; Atilla, Mustafa Kemal

    2014-01-01

    Objective: We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones. Material and methods: A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients’ files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography. Results: Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p=0.00). Conclusion: Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL. PMID:26328167

  2. The evolution of the endourologic management of pediatric stone disease

    PubMed Central

    Smaldone, Marc C.; Gayed, Bishoy A.; Ost, Michael C.

    2009-01-01

    In the 1980s, the advent of shock wave lithotripsy (SWL) revolutionized pediatric stone management and is currently the procedure of choice in treating most upper tract calculi <1.5 cm in children. However, with miniaturization of instruments and refinement of surgical technique the management of pediatric stone disease has undergone a dramatic evolution over the past twenty years. In a growing number of centers, ureteroscopy (URS) is now being performed in cases that previously would have been treated with SWL or percutaneous nephrolithotomy (PCNL). PCNL has replaced open surgical techniques for the treatment of large stone burdens >2 cm with efficacy and complication rates similar to the adult population. Recent results of retrospective reviews of large single institution series demonstrate stone free and complication rates with URS comparable to PCNL and SWL but concerns remain with these techniques regarding renal development and damage to the pediatric urinary tract. Randomized controlled trials comparing the efficacy of SWL and URS for upper tract stone burden are needed to reach consensus regarding the most effective primary treatment modality in children. This report provides a comprehensive review of the literature evaluating the indications, techniques, complications, and efficacy of endourologic stone management in children. PMID:19881120

  3. Bilateral stones as a cause of acute renal failure in the emergency department

    PubMed Central

    Alonso, Joaquín V.; cachinero, Pedro L.; Ubeda, Fran R.; Ruiz, Daniel J. L.; Blanco, Alfredo

    2014-01-01

    BACKGROUND: Acute renal failure (ARF) due to obstructive uropathy is a urological emergency. The standard radiological investigations in the emergency setting include X-ray, ultrasonography and computed tomography. But occasionally the cause of obstruction may be elusive. METHODS: We present a case of obstructive uropathy due to bilateral stones presenting as acute renal failure. The patient underwent successful shock wave lithotripsy (SWL) for dissolution of calculi. RESULTS: The patient was successfully treated, and reported asymptomatic in a follow-up. CONCLUSION: Close collaboration between nephrological, urological, and radiological services is required. PMID:25215151

  4. Moderate high power 1 to 20?s and kHz Ho:YAG thin disk laser pulses for laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Renz, Günther

    2015-02-01

    An acousto-optically or self-oscillation pulsed thin disk Ho:YAG laser system at 2.1 ?m with an average power in the 10 W range will be presented for laser lithotripsy. In the case of cw operation the thin disk Ho:YAG is either pumped with InP diode stacks or with a thulium fiber laser which leads to a laser output power of 20 W at an optical-to-optical efficiency of 30%. For the gain switched mode of operation a modulated Tm-fiber laser is used to produce self-oscillation pulses. A favored pulse lengths for uric acid stone ablation is known to be at a few ?s pulse duration which can be delivered by the thin disk laser technology. In the state of the art laser lithotripter, stone material is typically ablated with 250 to 750 ?s pulses at 5 to 10 Hz and with pulse energies up to a few Joule. The ablation mechanism is performed in this case by vaporization into stone dust and fragmentation. With the thin disk laser technology, 1 to 20 ?s-laser pulses with a repetition rate of a few kHz and with pulse energies in the mJ-range are available. The ablation mechanism is in this case due to a local heating of the stone material with a decomposition of the crystalline structure into calcium carbonate powder which can be handled by the human body. As a joint process to this thermal effect, imploding water vapor bubbles between the fiber end and the stone material produce sporadic shock waves which help clear out the stone dust and biological material.

  5. Acoustical And Optical Feedback Guidance For Pulsed Laser Lithotripsy And Angioplasty

    NASA Astrophysics Data System (ADS)

    Rosen, David I.; Bhatta, Krishna M.; Dretler, Stephen P.

    1989-09-01

    The feasibility of using acoustic and plasma optical feedback emissions for guidance during pulsed laser lithotripsy and angioplasty procedures was studied in-vitro. A flash-lamp pumped tunable dye laser operating at a wavelength of 504 nm (coumarin green) was used as the laser source. Acoustic signals were recorded with a hydrophone which has a useful frequency response of up to 350 KHz. Plasma optical emissions were transmitted retrograde along the laser fiber and reflected through a beam splitter to an optical detection system consisting of a series of spectral filters (to transmit plasma radiation from 380 to 440 nm and block any 504 nm laser light) and a photomultiplier tube. Measurements of the laser-induced acoustic and the plasma optical emission signals were obtained from urinary and biliary calculi, ex-vivo bovine ureters, blood, blood clots, bile, atheromatous plaque and normal arterial wall. Results of monitoring show that it is possible to know without direct vision whether the laser energy is being discharged in the lumen, on healthy soft tissue, or on calculus or atheromatous plaque. Blood, blood clots, bile produced strong acoustic signals but no plasma signals; calculi and plaque produced strong plasma and strong acoustic signals. Neither plasma nor significant acoustic signals were produced by normal ureteral or arterial wall. These distinctions may allow clinical laser fragmentation of calculi or ablation of plaque to be performed with fewer complications.

  6. Intracorporeal electrohydraulic lithotripsy for intrahepatic bile duct stone formation after choledochal cyst excision.

    PubMed

    Shima, Hideki; Yamataka, Atsuyuki; Yanai, Toshihiro; Kobayashi, Hiroyuki; Miyano, Takeshi

    2004-01-01

    An 18-year-old girl who had undergone excision of a choledochal cyst and Roux-en-Y hepatico-jejunostomy at another hospital when 23 months old was referred to our department because of recurrent cholangitis. Radiological investigations showed stones lying in minimally dilated, right posterior intrahepatic bile ducts (IHBD). At laparotomy, the hepatico-jejunostomy site was incised, and a flexible endoscope inserted into the IHBD. Multiple stones packed in the IHBD were easily fragmented using an electro-hydraulic lithotripsy (EHL) device inserted through the endoscope, and removed. There were no EHL-related complications, and her postoperative progress was uneventful. She is currently well with no episodes of cholangitis after a follow-up period of 3 years. EHL is a simple, effective alternative method for removing IHBD stones after choledochal cyst excision. To the best of our knowledge, this is the first report of EHL being used to remove stones that developed in the IHBD after choledochal cyst excision. PMID:14758497

  7. Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones

    PubMed Central

    Knoll, Thomas; Buchholz, Noor; Wendt-Nordahl, Gunnar

    2012-01-01

    Objectives To review previous reports and discuss current trends in extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and ureterorenoscopy (URS). ESWL was recommended as the first-line treatment for small and intermediate-sized stones in the lower pole, while it is the standard treatment for large stones. However, the stone clearance rate after ESWL seems to be lower than that of stones in other locations. This seems to result from a lower rate of fragment passage, due to anatomical factors. Methods Reports on urinary stone disease were reviewed, assessing only publications in peer-reviewed, Medline-listed journals in the English language (publication years 1990–2011). Results Recent experience with flexible URS (fURS) for intrarenal stones showed that excellent stone-free rates can be achieved. With increasing experience and technically improved equipment, fURS has become an alternative to ESWL for small and intermediate-sized renal stones. Furthermore, several authors reported successful retrograde treatment for large renal stones, proposing fURS as an alternative to PCNL. However, the major drawbacks are long operating times and commonly, staged procedures, which is why PCNL remains the method of choice for such stones. Conclusions Considering the currents trends and evidence, the 2012 update of the European Association of Urology Guidelines on Urolithiasis has upgraded the endourological treatment of kidney stones. Individual factors such as body habitus, renal anatomy, costs and patient preference must be considered. PMID:26558046

  8. Investigation on the impact of pulse duration for laser induced lithotripsy

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Kiris, Tugba; Fiedler, Sebastian; Scheib, Gabriel; Kuznetsova, Julia; Pongratz, Thomas

    2014-03-01

    Objective: In-vitro investigation of Ho:YAG-laser induced stone fragmentation was performed to identify potential impacts of different pulse durations on stone fragmentation characteristics. Materials and Methods: An innovative Ho:YAG laser system (Swiss LaserClast, EMS S.A., Nyon, Switzerland) with selectable long- or short pulse mode was tested with regard to its fragmentation properties. The pulse duration depends on the specific laser parameter used. Fragmentation tests (hand held, hands free, single pulse induced crater) on artificial BEGO-Stones and fiber burn back tests were performed under reproducible experimental conditions. Additionally, the repulsion of long versus short laser pulses was compared using the pendulum set-up. Results: Differences in fragmentation rates between the two pulse duration regimes were seen. The difference was, however, not statistically significant. Using long pulse mode, the fiber burn back is nearly negligible while in short pulse mode an increased burn back was seen. The results of the pendulum test showed that the deviation induced by the momentum of shorter pulses is increased compared to longer pulses. Conclusion: Long pulse-mode showed reduced side effects like repulsion and fiber burn back in comparison to short pulse-mode while fragmentation rates remained at a comparable level. Lower push back and reduced burn back of longer laser pulses may results in better clinical outcome of laser lithotripsy and more convenient handling during clinical use.

  9. Efficacy and safety of Ho:YAG Laser Lithotripsy for ureteroscopic removal of proximal and distal ureteral calculi

    PubMed Central

    2014-01-01

    Background Laser lithotripsy is an established endourological modality. Ho:YAG laser have broadened the indications for ureteroscopic stone managements to include larger stone sizes throughout the whole upper urinary tract. Aim of current work is to assess efficacy and safety of Ho:YAG laser lithotripsy during retrograde ureteroscopic management of ureteral calculi in different locations. Methods 88 patients were treated with ureteroscopic Ho:YAG laser lithotripsy in our institute. Study endpoint was the number of treatments until the patient was stone-free. Patients were classified according to the location of their stones as Group I (distal ureteric stones, 51 patients) and group II (proximal ureteral stones, 37). Group I patients have larger stones as Group II (10.70 mm vs. 8.24 mm, respectively, P = 0.020). Results Overall stone free rate for both groups was 95.8%. The mean number of procedures for proximal calculi was 1.1 ± 0.1 (1–3) and for distal calculi was 1.0 ± 0.0. The initial treatment was more successful in patients with distal ureteral calculi (100% vs. 82.40%, respectively, P = 0.008). No significant difference in the stone free rate was noticed after the second laser procedure for stones smaller versus larger than 10 mm (100% versus 94.1%, P = 0.13). Overall complication rate was 7.9% (Clavien II und IIIb). Overall and grade-adjusted complication rates were not dependant on the stone location. No laser induced complications were noticed. Conclusions The use of the Ho:YAG laser appears to be an adequate tool to disintegrate ureteral calculi independent of primary location. Combination of the semirigid and flexible ureteroscopes as well as the appropriate endourologic tools could likely improve the stone clearance rates for proximal calculi regardless of stone-size. PMID:25107528

  10. An integrated fiber and stone basket device for use in Thulium fiber laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hutchens, Thomas C.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2014-03-01

    The Thulium fiber laser (TFL) is being explored as an alternative laser lithotripter to the Holmium:YAG laser. The TFL's superior near-single mode beam profile enables higher power transmission through smaller fibers with reduced proximal fiber tip damage. Recent studies have also reported that attaching hollow steel tubing to the distal fiber tip decreases fiber degradation and burn-back without compromising stone ablation rates. However, significant stone retropulsion was observed, which increased with pulse rate. In this study, the hollow steel tip fiber design was integrated with a stone basket to minimize stone retropulsion during ablation. A device was constructed consisting of a 100-?m-core, 140-?m-OD silica fiber outfitted with 5-mm-long stainless steel tubing at the distal tip, and integrated with a 1.3-Fr (0.433-mm-OD) disposable nitinol wire basket, to form an overall 1.9-Fr (0.633-mm- OD) integrated device. This compact design may provide several potential advantages including increased flexibility, higher saline irrigation rates through the ureteroscope working channel, and reduced fiber tip degradation compared to separate fiber and stone basket manipulation. TFL pulse energy of 31.5 mJ with 500 ?s pulse duration and pulse rate of 500 Hz was delivered through the integrated fiber/basket device in contact with human uric acid stones, ex vivo. TFL stone ablation rates measured 1.5 +/- 0.2 mg/s, comparable to 1.7 +/- 0.3 mg/s (P > 0.05) using standard bare fiber tips separately with a stone basket. With further development, this device may be useful for minimizing stone retropulsion, thus enabling more efficient TFL lithotripsy at higher pulse rates.

  11. Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

    PubMed Central

    Bozkurt, Ibrahim Halil; Yonguc, Tarik; Arslan, Burak; Degirmenci, Tansu; Gunlusoy, Bulent; Aydogdu, Ozgu; Koras, Omer

    2015-01-01

    Introduction: The management of patients with large impacted upper ureteral stones is difficult; there is no standard treatment. We compared the outcomes of percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (UL) to treat large (?1.5 cm), impacted, upper ureteral stones. Methods: In total, 86 patients with large impacted upper ureteral stones were included in this study. Of these patients 41 underwent UL and 45 underwent PCNL. The inclusion criteria were: longest diameter of stone ?1.5 cm, the localization of stone between the lower border of L4 spine and ureteropelvic junction and impacted stone. Results: In the UL group, we were unable to reach the stone in 3 patients because of ureteral stricture and edema despite balloon dilation. Of these 3 patients, we were unable to optimally visualize the stone in 2 patients due to bleeding and mucosal injury following balloon dilation. The stricture was too firm and could not be passed in the third patient. Also in the UL group, 15 patients had stones or big fragments which migrated into the renal collecting system. In the PCNL group, 21 patients had concurrent renal stones <1 cm and stones were successfully removed in all patients. No statistically significant difference was found between groups in terms of operation time. Mean hospital stay was significantly shorter in the UL group. Success rates were 82.3% in the UL group and 97.6% in the PCNL group (p = 0.001). Conclusion: The recent study confirms that PCNL is a safe and effective minimally invasive procedure with acceptable complication rates in the treatment of patients with large, impacted upper ureteral stones. PMID:25844097

  12. Differentiation of tissue and kidney stones for laser lithotripsy using different spectroscopic approaches

    NASA Astrophysics Data System (ADS)

    Lange, Birgit; Cordes, Jens; Brinkmann, Ralf

    2015-07-01

    Holmium lasers are nowadays the gold standard for endoscopic laser lithotripsy. However, there is a risk of damaging or perforating the ureter or kidney tissue when the vision is poor. An automatic tissue/stone differentiation would improve the handling and safety of the procedure. To achieve this objective, an easy and robust real-time discrimination method has to be found which can be used to realize a feedback loop to control the laser system. Two possible approaches have been evaluated: White light reflectance and fluorescence spectroscopy. In both cases, we use the treatment fiber for detection and evaluate the possibility to decide whether the fiber is placed in front of tissue or calculus by the signal that is delivered by the surface in front of it. White light reflectance spectroscopy uses the standard light source for endourologic surgeries: Radiation of a Xenon light source is coupled to the ureteroscope via a liquid light guide. The part of the white light that is reflected back into the fiber is spectroscopically analyzed. In a clinical proof of concept study reflection signals were measured in vivo in 8 patients. For differentiation of stone and tissue via autofluorescence, excitation as well as detection was done via the treatment fiber. A suitable excitation wavelength was chosen with in vitro measurements (UV / visible) on several human renal calculi and porcine tissues. For verification of the positive results with green excitation in a clinical proof of concept study, a measurement set-up was realized which allows the recording of fluorescence signals during an endourological intervention.

  13. In vitro investigations of repulsion during laser lithotripsy using a pendulum set-up.

    PubMed

    Sroka, Ronald; Haseke, Nicolas; Pongratz, Thomas; Hecht, Volkmar; Tilki, Derya; Stief, Christian G; Bader, Markus Jürgen

    2012-05-01

    Ureteroscopic laser lithotripsy is a commonly used technique to treat ureteral calculi.The type of energy source used is one of the main influences of retrograd calculi propulsion. Using a momentum pendulum under-water set-up the induced momentum and the initial velocity were investigated. Pulsed laser light from three different clinically available laser systems, including a Ho:YAG laser, a frequency-doubled double-pulse (second harmonic generation, SHG) Nd:YAG laser and a flash-lamp pumped dye (FLPD) laser, were transmitted via flexible fibres of different core diameter to the front of the pendulum sinker. Single pulses at variable pulse energy, according to the clinical laser parameter settings, were applied to the target sinker, thus causing a repulsion-induced deflection which was documented by video recording. The maximum deflection was determined. Solving the differential equation of a pendulum gives the initial velocity, the laser-induced momentum and the efficiency of momentum transfer. The induced deflection as well as the starting velocity of the two short-duration pulsed laser systems (SHG Nd:YAG, FLPD) were similar (s (max)?=?2-3.6 cm and v (0)?=?150-200 mm/s, respectively), whereas both values were lower using the Ho:YAG laser with a long pulse duration (s (max)?=?0.9--1.6 cm and v (0)?=?60-105 mm/s, respectively). The momentum I induced by the Ho:YAG laser was only 50% and its transfer efficacy ? (Repuls) was reduced to less than 5% of the values of the two short-pulsed laser systems. This investigation clearly showed the variable parts and amounts of repulsion using different pulsed lasers in an objective and reproducible manner. The momentum transfer efficiency could be determined without any physical friction problems. Further investigations are needed to compare stone fragmentation techniques with respect to laser repulsion and its clinical impact. PMID:22011742

  14. Percutaneous Transhepatic Endoscopic Holmium Laser Lithotripsy for Intrahepatic and Choledochal Biliary Stones

    SciTech Connect

    Rimon, Uri; Kleinmann, Nir; Bensaid, Paul; Golan, Gil; Garniek, Alexander; Khaitovich, Boris; Winkler, Harry

    2011-12-15

    Purpose: To report our approach for treating complicated biliary calculi by percutaneous transhepatic endoscopic biliary holmium laser lithotripsy (PTBL). Patients and Methods: Twenty-two symptomatic patients (11 men and 11 women, age range 51 to 88 years) with intrahepatic or common bile duct calculi underwent PTBL. Nine patients had undergone previous gastrectomy and small-bowel anastomosis, thus precluding endoscopic retrograde cholangiopancreatography. In the other 13 patients, stone removal attempts by ERCP failed due to failed access or very large calculi. We used a 7.5F flexible ureteroscope and a 200-{mu}m holmium laser fiber by way of a percutaneous transhepatic tract, with graded fluoroscopy, to fragment the calculi with direct vision. Balloon dilatation was added when a stricture was seen. The procedure was performed with the patient under general anaesthesia. A biliary drainage tube was left at the end of the procedure. Results: All stones were completely fragmented and flushed into the small bowel under direct vision except for one patient in whom the procedure was aborted. In 18 patients, 1 session sufficed, and in 3 patients, 2 sessions were needed. In 7 patients, balloon dilatation was performed for benign stricture after Whipple operation (n = 3), for choledochalenteric anastomosis (n = 3), and for recurrent cholangitis (n = 1). Adjunctive 'balloon push' (n = 4) and 'rendezvous' (n = 1) procedures were needed to completely clean the biliary tree. None of these patients needed surgery. Conclusion: Complicated or large biliary calculi can be treated successfully using PTBL. We suggest that this approach should become the first choice of treatment before laparoscopic or open surgery is considered.

  15. Treatment of ureteral calculus obstruction with laser lithotripsy in an Atlantic bottlenose dolphin (Tursiops truncatus).

    PubMed

    Schmitt, Todd L; Sur, Roger L

    2012-03-01

    An adult female bottlenose dolphin (Tursiops truncatus) presented with acute anorexia secondary to progressive azotemia (blood urea nitrogen = 213 mg/dl, creatinine [Cr] = 9.5 mg/dl) and electrolyte abnormalities (K = 7.4 mEq/L). It was later diagnosed with postrenal obstruction secondary to bilaterally obstructing ureteral calculi seen on ultrasound. Treatment of the obstruction required two endoscopic procedures, cystoscopy for ureteral stent placement and ureteroscopy to perform intracorporeal lithotripsy on the obstructing calculi. Before the first procedure, the dolphin's azotemia was stabilized with aggressive fluid therapy, peritoneal dialysis, and treatment for acidosis. Diuresis subsequent to the fluid therapy enabled passage of the right obstructing urolith. For both endoscopic procedures, the dolphin was placed in left lateral recumbency due to the peritoneal dialysis catheter in the right retroperitoneal region. For the first procedure, a 12-French (Fr) flexible cystoscope was inserted retrograde into the bladder via the urethra, whereupon a calculus was seen obstructing the left ureteral orifice. A 4.8-Fr, 26-cm double-pigtail ureteral stent was placed up the left ureter to relieve the postrenal obstruction. Inadvertent proximal migration of the left ureteral stent occurred during the procedure. However, renal parameters (serum Cr = 5.8, K = 5.4) improved significantly by the next day. For the second procedure, 28 hr later, ureteroscopy was performed to treat the calculus and replace the existing stent with a longer stent. The left ureteral calculus was pulverized into tiny fragments by using a holmium:yttrium-aluminum-garnet laser inserted through a 6.9-Fr semirigid ureteroscope. The migrated stent was visualized in the distal left ureter and replaced with a 90-cm single-pigtail ureteral stent that was sutured exterior to the urogenital slit and removed 3 days later. Renal function normalized over the next several days, and the dolphin recovered over the next 2 mo. PMID:22448516

  16. Chemical decomposition of urinary stones during holmium-laser lithotripsy: II. Evidence for photothermal breakdown

    NASA Astrophysics Data System (ADS)

    Glickman, Randolph D.; Teichman, Joel M. H.; Vassar, George J.; Weintraub, Susan T.; Chan, Kin Foong; Pfefer, T. Joshua; Welch, Ashley J.

    1999-06-01

    Because of the greater than or equal to 250 microsecond pulsewidth emitted by the Ho:YAG laser used in clinical lithotripsy, it is unlikely that stress confinement occurs within the irradiated stones. Experimental data supports a thermal mechanism for Ho:YAG laser stone ablation. Stone fragmentation occurs soon after the onset of the laser pulse, is uncorrelated to cavitation bubble formation or collapse, and is associated with low pressures (cf. part I). The mass- loss of desiccated calcium oxalate monohydrate (COM) stones exposed to 150 J from the Ho:YAG laser in air was 40 plus or minus 12 mg (mean plus or minus 1 s.d.); for hydrated stones in air was 25 plus or minus 9 mg; and for hydrated stones in water was 17 plus or minus 3 mg, p less than .001. These differences indicate that direct absorption of the laser radiation by the stone is required for the most efficient ablation. Lowering the initial temperature of COM or cystine stones also reduced the stone mass-loss following 20 J of delivered laser energy: 2.2 plus or minus 1.1 mg vs 5.2 plus or minus 1.6 mg for COM stones (-80 vs 23 degrees Celsius), and 0.8 plus or minus 0.4 mg vs 2.2 plus or minus 1.1 mg for cystine stones (-80 vs 23 degrees Celsius), p less than or equal to .05. Finally, chemical analysis of the laser-induced stone fragments revealed the presence of thermal breakdown products: CaCO3 from COM; free sulfur and cysteine from cystine; Ca2O7P2 from calcium hydorgen phosphate dihydrate, and cyanide from uric acid.

  17. Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

    PubMed Central

    Song, Hyeong Cheol; Jung, Ha Bum; Lee, Yong Seong; Lee, Young Goo; Kim, Ki Kyung

    2012-01-01

    Purpose We evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones. Materials and Methods Patients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST). Results A total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1±8.2 minutes and the mean stone size was 1.15±0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6±8.3 minutes) than in the COM group (24.0±7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size. Conclusions The results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component. PMID:23301129

  18. Comparison Between Percutaneous Transhepatic Rigid Cholangioscopic Lithotripsy and Conventional Percutaneous Transhepatic Cholangioscopic Surgery for Hepatolithiasis Treatment

    PubMed Central

    Sun, Beiwang; Huang, Binyuan; Xie, Jiafen; Liu, Yanmin; Zhu, Canhua; Ye, Chen; Zhou, Zixuan

    2016-01-01

    Background: Percutaneous transhepatic cholangioscopy (PTCS) is one option for treating hepatolithiasis without surgical resection. This approach can use conventional biliary drainage methods over a long period, but a shorter procedure needs to be evolved. Objective: To evaluate the short-term and the long-term therapeutic outcomes of percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) in comparison with conventional PTCS. Methods: In this retrospective study, 118 patients with hepatolithiasis were enrolled who underwent treatment in our hospital between March 2007 and July 2014. About 67 of them received PTCSL and the remaining 51 patients received conventional PTCS. Preoperative data, surgical operation-related records, the postoperative therapeutic effect, and the long-term hepatolithiasis recurrence rate were collected for comparison between the 2 groups. Results: The age, sex, and surgical history were similar between the 2 groups, but there was a significant difference in the Child-Pugh score, with more grade 3 patients in the PTCS group (P=0.002). However, the operation time, intraoperative blood infusion, and the blood loss were similar between the 2 groups. The final clearance ratio of calculus in the PTCSL group was significantly better than in the PTCS group after multivariate analysis (P=0.021; OR=0.201; 95% CI, 0.051-0.785). Calculus recurrence was 9% (PTCSL) and 22% (PTCS). The postoperative hospital stay was significantly shorter in the PTCSL group (P=0.001; OR=1.337; 95% CI, 1.132-1.58). Conclusions: PTCSL was a satisfactory therapeutic option for hepatolithiasis treatment, with less operation time and a superior long-term therapeutic effect compared with conventional PTCS. PMID:26679679

  19. Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter

    PubMed Central

    Chaussy, Christian; Bergsdorf, Thorsten

    2008-01-01

    Extracorporeal shockwave lithotripsy (ESWL) has revolutionized the treatment of urinary calculi and became the accepted standard therapy for the majority of stone patients. Only for stones located in the lower calix, ESWL displayed a limited efficacy. Since the stone-free rate seemed to be preferential, endoscopic maneuvers like percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) have been proposed as the primary approach for this stone localization. Stone size seems to be the most important parameter in regard to the stone-free rate, whereas anatomical characteristics of the lower pole collecting system are discussed controversial. Various studies show a good stone clearance between 70-84% for stones up to 1 cm in diameter. Additional physical and medical measures are suitable to improve treatment results. Stone remnants after ESWL, defined as clinical insignificant residual fragments (CIRF) will not cause problems in every case and will pass until up to 24 months after treatment; in total 80-90% of all patients will become stone-free or at least symptom-free. When complete stone-free status is the primary goal, follow-up examinations with new radiological technologies like spiral CT show that the stone-free rate of ESWL and endoscopically treated patients (RIRS) does not differ significantly. However, in comparison to endoscopic stone removal, shockwave therapy is noninvasive, anesthesia-free and can be performed in an outpatient setup. Therefore, ESWL remains the first choice option for the treatment of lower caliceal stones up to 1 cm. The patient will definitely favour this procedure. PMID:19468510

  20. Subcapsular renal hematoma after ureteroscopy with holmium:yttrium-aluminum-garnet laser lithotripsy.

    PubMed

    Tao, Wei; Cai, Chun Jie; Sun, Chuan Yang; Xue, Bo Xin; Shan, Yu Xi

    2015-07-01

    Subcapsular renal hematoma (SRH) after ureteroscopic lithotripsy (URSL) using holmium:yttrium-aluminum-garnet (Ho:YAG) laser to treat ureteric stones is a rare complication. We aimed to review our unit's experience of post-URSL subcapsular renal hematoma. From 2006 to 2012, 2059 URSLs using F9.5 rigid ureteroscope were performed in our unit. Patients with post-URSL symptomatic renal hematoma were reviewed. Perioperative information on patients' renal function, stone characteristics, and degree of renal hydronephrosis were reviewed. Operative data, postoperative information such as clinical manifestation, changes in blood parameters, CT findings, and subsequent treatment were documented. Of the 2059 patients treated with URSL and Ho:YAG laser, three patients were diagnosed as subcapsular renal hematoma after surgery; the age is 57, 61, and 63 years old, respectively. Preoperative imaging examination showed that two patients and one patient had obstructing middle and proximal ureteral stones ranging in size from 0.8 to 1.6 cm, and three patients had thin renal cortices. The double-J ureteral stents were inserted in all cases regularly. All three subcapsular renal hematoma patients had the loin pain of the operation side and fever, and one patient had significant hemoglobin drop (from 111 to 61 g/L) who need to transfusion. Two patients presented within 24 h of URSL, and one patient presented on day 10. One patient was treated conservatively for 3 weeks and recovered with bed rest, antibiotics, hemostasis, and analgesia with no intervention or drain. The other two patients underwent ultrasonography-guided drainage of the hematoma. Two-month follow-up CT scans or ultrasonography confirmed the resolution of the hematoma in all three cases. Renal subcapsular hematoma after URSL is a rare and one of serious complications. Subcapsular renal hematoma should be considered when patients have the symptoms of significant loin pain after URSL for obstructing ureteral stones with thin renal cortices. The treatment of post-URSL renal subcapsular hematomas needs to be customized for each patient. PMID:25943289

  1. Sudden onset of a huge subcapsular renal hematoma following minimally invasive ureteroscopic holmium laser lithotripsy: A case report

    PubMed Central

    ZHANG, PENG; HU, WAN-LI

    2015-01-01

    The postoperative complication rate of ureteroscopic lithotripsy (URSL) is low, and the most frequent complication is fever. Thus, urological surgeons often neglect or are unaware of subcapsular renal hematoma (SRH) as a rare complication following URSL. Although a SRH after undergoing URSL is uncommon, the occurrence may be fatal. The current study reports on a rare life-threatening case that occurred recently at Zhongnan Hospital (Wuhan, China). A 24-year-old male patient presented with a large SRH (11×14×11 cm) after undergoing a failed, but minimally invasive URSL with a holmium laser. The presence of the large SRH was confirmed by computerized tomography imaging. The patient underwent conservative management, which prevented hematoma enlargement, and no further treatment was conducted. In conclusion, SRH, although rare following URSL, should be noted by the urological surgeon. PMID:26170958

  2. Characterization of calculus migration during Ho:YAG laser lithotripsy by high speed camera using suspended pendulum method

    NASA Astrophysics Data System (ADS)

    Zhang, Jian James; Rajabhandharaks, Danop; Xuan, Jason Rongwei; Chia, Ray W. J.; Hasenberg, Tom

    2014-03-01

    Calculus migration is a common problem during ureteroscopic laser lithotripsy procedure to treat urolithiasis. A conventional experimental method to characterize calculus migration utilized a hosting container (e.g. a "V" grove or a test tube). These methods, however, demonstrated large variation and poor detectability, possibly attributing to friction between the calculus and the container on which the calculus was situated. In this study, calculus migration was investigated using a pendulum model suspended under water to eliminate the aforementioned friction. A high speed camera was used to study the movement of the calculus which covered zero order (displacement), 1st order (speed) and 2nd order (acceleration). A commercialized, pulsed Ho:YAG laser at 2.1 um, 365-um core fiber, and calculus phantom (Plaster of Paris, 10×10×10mm cube) were utilized to mimic laser lithotripsy procedure. The phantom was hung on a stainless steel bar and irradiated by the laser at 0.5, 1.0 and 1.5J energy per pulse at 10Hz for 1 second (i.e., 5, 10, and 15W). Movement of the phantom was recorded by a high-speed camera with a frame rate of 10,000 FPS. Maximum displacement was 1.25+/-0.10, 3.01+/-0.52, and 4.37+/-0.58 mm for 0.5, 1, and 1.5J energy per pulse, respectively. Using the same laser power, the conventional method showed <0.5 mm total displacement. When reducing the phantom size to 5×5×5mm (1/8 in volume), the displacement was very inconsistent. The results suggested that using the pendulum model to eliminate the friction improved sensitivity and repeatability of the experiment. Detailed investigation on calculus movement and other causes of experimental variation will be conducted as a future study.

  3. Surgical Management of Stones: New Technology

    PubMed Central

    Matlaga, Brian R.; Lingeman, James E.

    2011-01-01

    In recent years, the surgical treatment of kidney stone disease has undergone tremendous advances, many of which were possible only as a result of improvements in surgical technology. Rigid intracorporeal lithotrites, the mainstay of percutaneous nephrolithotomy, are now available as combination ultrasonic and ballistic devices. These combination devices have been reported to clear a stone burden with much greater efficiency than devices that operate by either ultrasonic or ballistic energy alone. The laser is the most commonly used flexible lithotrite; advances in laser lithotripsy have led to improvements in the currently utilized Holmium laser platform, as well as the development of novel laser platforms such as Thulium and Erbium devices. Our understanding of shock wave lithotripsy (SWL)has been improved over recent years as a consequence of basic science investigations. It is now recognized that there are certain maneuvers with SWL that the treating physician can do that will increase the likelihood of a successful outcome while minimizing the likelihood of adverse treatment-related events. PMID:19095207

  4. Medical therapy for calculus disease.

    PubMed

    Singh, Shrawan K; Agarwal, Mayank Mohan; Sharma, Sumit

    2011-02-01

    Urolithiasis is a common problem with a high recurrence rate. Medical therapy directed to relieve agonizing pain, expulsion of stone, dissolution of uric acid and cystine stone and prevention of recurrence. NSAIDs are superior to opioids for renoureteral colic because their use doesn't induce vomiting and there is lesser requirement of rescue analgesia. In randomized trials, anticholinergics were not found to be beneficial. Alpha blockers, particularly tamsulosin, reduce pain and facilitate expulsion of stone and fragments of stone following extracorporeal shock wave lithotripsy (SWL) and ureterorenoscopic lithotripsy. Potassium citrate helps in chemodissolution of uric acid and cystine stones and is useful in prevention of stone recurrence in general and in those who have undergone SWL or percutaneious nephrolithotomy. Other measures for prevention of stone recurrence include fluid and dietary therapy, counteracting underlying metabolic abnormalities using suitable medications, phytotheurapeutic agents and probiotics. Once the role of nanobacteria is established in genesis of urinary stones, anti-nanobacteria therapy holds the promise of opening new horizons for prevention of urinary stones. PMID:21244607

  5. Clinical effectiveness of the PolyScope™ endoscope system combined with holmium laser lithotripsy in the treatment of upper urinary calculi with a diameter of less than 2 cm

    PubMed Central

    GU, SI-PING; HUANG, YUN-TENG; YOU, ZHI-YUAN; ZHOU, XIAOMING; LU, YI-JIN; HE, CAO-HUI; QI, JUAN

    2013-01-01

    The aim of this study was to evaluate the clinical value of the PolyScope™ endoscope system in the treatment of upper urinary calculi with a diameter of <2 cm. A total of 86 patients hospitalized with upper urinary tract calculi were included. The patients were placed under general or spinal anesthesia and in a lithotomy position. Following the dilation of the ureter, a guide wire was inserted under the direct vision of an F8/9.8 rigid ureteroscope, and an F12/14 flexible ureteral access sheath was positioned along the guide wire. Holmium laser lithotripsy was subsequently performed, using an F8.0 ‘PolyScope’ modular flexible ureteroscope. Plain film of the kidney-ureter-bladder (KUB) was performed 1 day subsequent to the surgery, in order to determine the result of the lithotripsy and the position of the double-J stent which was inserted after after holmium laser lithotripsy. In addition, in certain patients, KUB radiography was performed 2–4 weeks subsequent to the surgery, and extracorporeal shockwave lithotripsy (ESWL) was performed if the diameter of the residual stones was >6 mm. Lithotripsy was successful in 77 patients and the duration of the surgery ranged between 25 and 80 min (mean duration, 42 min). Little bleeding was observed. Three patients presented with a slight fever following the surgery; however, no ureteral perforation, high fever or septicemia was observed among the patients following anti-inflammatory treatment. The stone-free rate (SFR) of the single-pass lithotripsy was 89.5% (77/86) and the SFR with ESWL was 96.5% (83/86). The study demonstrated that the F8 modular flexible ureteroscope was safe, convenient and effective for the lithotripsy of upper-tract calculi. PMID:24137232

  6. Surgical management of pediatric urolithiasis

    PubMed Central

    Mishra, Shashi K.; Ganpule, A.; Manohar, T.; Desai, Mahesh R.

    2007-01-01

    Pediatric urolithiasis poses a technical challenge to the urologist. A review of the recent literature on the subject was performed to highlight the various treatment modalities in the management of pediatric stones. A Medline search was used to identify manuscripts dealing with management options such as percutaneous nephrolithotomy, shock wave lithotripsy, ureteroscopy and cystolithotripsy in pediatric stone diseases. We also share our experience on the subject. Shock wave lithotripsy should be the treatment modality for renal stone less than 1cm or < 150 mm2 and proximal non-impacted ureteric stone less than 1 cm with normal renal function, no infection and favorable anatomy. Indications for PCNL in children are large burden stone more than 2cm or more than 150mm2 with or without hydronephrosis, urosepsis and renal insufficiency, more than 1cm impacted upper ureteric stone, failure of SWL and significant volume of residual stones after open surgery. Shock wave lithotripsy can be offered for more soft (< 900 HU on CT scan) renal stones between 1-2cm. Primary vesical stone more than 1cm can be tackled with percutaneous cystolithomy or open cystolithotomy. Open renal stone surgery can be done for renal stones with associated structural abnormalities, large burden infective and staghorn stones, large impacted proximal ureteric stone. The role of laparoscopic surgery for stone disease in children still needs to be explored. PMID:19718300

  7. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction.

    PubMed

    d'Agostino, M C; Craig, K; Tibalt, E; Respizzi, S

    2015-12-01

    Extracorporeal Shock Wave Therapy (ESWT) is a form of "mechanotherapy", that, from its original applications as urological lithotripsy, gained the field of musculo-skeletal diseases as Orthotripsy (mainly tendinopaties and bone regenerative disorders) and Regenerative Medicine as well. The mechanisms of action of Shock Waves (SW), when applied in non-urological indications, are not related to the direct mechanical effect, but to the different pathways of biological reactions, that derive from that acoustic stimulations, through "mechano-transduction". So, the "mechanical model" of urological lithotripsy has been substituted by a "biological model", also supported by current knowledge in "mechanobiology", the emerging multidisciplinary field of science that investigates how physical forces and changes in cell/tissue mechanics can influence the tissue development, physiology and diseases. Although some details are still under study, it is known that SW are able to relief pain, as well to positively regulate inflammation (probably as immunomodulator), to induce neoangiogenesis and stem cells activities, thus improving tissue regeneration and healing. ESWT can be nowadays considered an effective, safe, versatile, repeatable, noninvasive therapy for the treatment of many musculo-skeletal diseases, and for some pathological conditions where regenerative effects are desirable, especially when some other noninvasive/conservative therapies have failed. Moreover, based on the current knowledge in SW mechanobiology, it seems possible to foresee new interesting and promising applications in the fields of Regenerative Medicine, tissue engineering and cell therapies. PMID:26612525

  8. A Miniaturized, 1.9F Integrated Optical Fiber and Stone Basket for Use in Thulium Fiber Laser Lithotripsy.

    PubMed

    Wilson, Christopher R; Hutchens, Thomas C; Hardy, Luke A; Irby, Pierce B; Fried, Nathaniel M

    2015-10-01

    The thulium fiber laser (TFL) is being explored as an alternative laser lithotripter to the standard holmium:yttrium-aluminum-garnet laser. The more uniform beam profile of the TFL enables higher power transmission through smaller fibers. In this study, a 100-?m core, 140-?m outer-diameter (OD) silica fiber with 5-mm length hollow steel tip was integrated with 1.3F (0.433-mm OD) nitinol wire basket to form a 1.9F (0.633-mm OD) device. TFL energy of 30?mJ, 500??s pulse duration, and 500?Hz pulse rate was delivered to human uric acid stones, ex vivo. Stone ablation rates measured 1.5 ± 0.2?mg/s, comparable to 1.7 ± 0.3?mg/s using bare fiber tips separately with stone basket. With further development, this device may minimize stone retropulsion, allowing more efficient TFL lithotripsy at higher pulse rates. It may also provide increased flexibility, higher saline irrigation rates through the ureteroscope working channel, reduce fiber degradation compared with separate fiber and basket manipulation, and reduce laser-induced nitinol wire damage. PMID:26167738

  9. Extracorporeal shockwave lithotripsy, endourology and open surgery: the management and follow-up of 200 patients with urinary calculi.

    PubMed Central

    Webb, D. R.; McNicholas, T. A.; Whitfield, H. N.; Wickham, J. E.

    1985-01-01

    The management and follow up of 200 consecutive patients with renal and ureteric calculi are presented. The primary treatment of 185 (92.5%) was by extracorporeal shockwave lithotripsy (ESWL), of whom three (1.6)%) with large calculi underwent percutaneous nephrolithotripsy (PCNL) prior to ESWL as a planned combined procedure. Twelve (6%) were treated by PCNL or ureterorenoscopy (URS) as their definitive treatment and three (1.5%) by conventional open renal and ureteric surgery. The average in-patient stay was 3.8 days and most returned to normal activity within one day of discharge. Of the 185 patients 102 (55%) required no analgesia after treatment by ESWL, 29 (15.6%) required parenteral analgesia and the rest were comfortable with oral non-narcotic medication. Thirty (16%) required auxillary treatment by percutaneous nephrostomy (PCN), PCNL and URS following ESWL for obstructive complications from stone particles. Two required further ESWL and one PCNL at three months for large fragments. Overall, open surgery was required for only 1% of renal calculi and 13% of ureteric stones. These results are consistant with the extensive West German experience confirming that most urinary calculi are now best managed by ESWL and endoscopic techniques. Where these facilities are available open surgery should only be necessary for less than 5% of upper urinary tract stones. PMID:4073760

  10. Kidney stone ablation times and peak saline temperatures during Holmium:YAG and Thulium fiber laser lithotripsy, in vitro, in a ureteral model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-02-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental Thulium fiber laser (TFL) was studied and compared to clinical gold standard Holmium:YAG laser. The Holmium laser (? = 2120 nm) was operated with standard parameters of 600 mJ, 350 ?s, 6 Hz, and 270-?m-core optical fiber. TFL (? = 1908 nm) was operated with 35 mJ, 500 ?s, 150-500 Hz, and 100-?m-core fiber. Urinary stones (60% calcium oxalate monohydrate / 40% calcium phosphate), of uniform mass and diameter (4-5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 ml/min and 13.7 ml/min for the TFL and Holmium laser, respectively. The temperature 3 mm from tube's center and 1 mm above mesh sieve was measured by a thermocouple and recorded during experiments. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. Holmium laser time measured 167 +/- 41 s (n = 12). TFL times measured 111 +/- 49 s, 39 +/- 11 s, and 23 +/- 4 s, for pulse rates of 150, 300, and 500 Hz (n = 12 each). Mean peak saline irrigation temperatures reached 24 +/- 1 °C for Holmium, and 33 +/- 3 °C, 33 +/- 7 °C, and 39 +/- 6 °C, for TFL at pulse rates of 150, 300, and 500 Hz. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and reduced stone retropulsion, and may provide a clinical alternative to the conventional Holmium laser for lithotripsy.

  11. Obtaining patient feedback in an outpatient lithotripsy service is facilitated by use of a touch-screen tablet (iPad™) survey.

    PubMed

    Turney, B W; Reynard, J M

    2014-08-01

    There is now a requirement for every doctor in the UK to obtain patient feedback for revalidation. This can be an onerous and time-consuming task. The objective of this study was to evaluate a novel electronic patient feedback method in an outpatient lithotripsy service setting. Between September 2013 and January 2014, 100 patients attending an outpatient lithotripsy service in Oxford were asked to complete a selection of pre-approved NHS questions about the service they had received. Questions were presented on a tablet device (iPad™) and answered using the touch screen. Departmental staff were unaware of the questions in the survey. Patients were asked to complete the survey by an independent research nurse. Questions were created online in a free-to-use web-based survey application and presented on the tablet device in a user-friendly format via an application. Data were uploaded via wifi™ to the online system. Data were viewed, automatically analysed and displayed graphically. The age range of the patients surveyed was 20-80 years of age. All 100 patients completed the survey without difficulty. All patients answered every question. Data could be automatically viewed, analysed and presented graphically. This method of collecting patient feedback proved to be rapid and efficient. The feedback highlighted a high patient satisfaction with the lithotripsy service. A touch screen tablet device is an efficient and effective method of collecting truly objective patient feedback. This method of patient feedback could be employed in other clinical environments to collect data for revalidation purposes. PMID:24747981

  12. Water content contribution in calculus phantom ablation during Q-switched Tm:YAG laser lithotripsy.

    PubMed

    Zhang, Jian J; Rajabhandharaks, Danop; Xuan, Jason Rongwei; Wang, Hui; Chia, Ray W J; Hasenberg, Tom; Kang, Hyun Wook

    2015-12-01

    Q-switched (QS) Tm:YAG laser ablation mechanisms on urinary calculi are still unclear to researchers. Here, dependence of water content in calculus phantom on calculus ablation performance was investigated. White gypsum cement was used as a calculus phantom model. The calculus phantoms were ablated by a total 3-J laser pulse exposure (20 mJ, 100 Hz, 1.5 s) and contact mode with N=15 sample size. Ablation volume was obtained on average 0.079, 0.122, and 0.391  mm3 in dry calculus in air, wet calculus in air, and wet calculus in-water groups, respectively. There were three proposed ablation mechanisms that could explain the effect of water content in calculus phantom on calculus ablation performance, including shock wave due to laser pulse injection and bubble collapse, spallation, and microexplosion. Increased absorption coefficient of wet calculus can cause stronger spallation process compared with that caused by dry calculus; as a result, higher calculus ablation was observed in both wet calculus in air and wet calculus in water. The test result also indicates that the shock waves generated by short laser pulse under the in-water condition have great impact on the ablation volume by Tm:YAG QS laser. PMID:26662067

  13. Water content contribution in calculus phantom ablation during Q-switched Tm:YAG laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Zhang, Jian J.; Rajabhandharaks, Danop; Xuan, Jason Rongwei; Wang, Hui; Chia, Ray W. J.; Hasenberg, Tom; Kang, Hyun Wook

    2015-12-01

    Q-switched (QS) Tm:YAG laser ablation mechanisms on urinary calculi are still unclear to researchers. Here, dependence of water content in calculus phantom on calculus ablation performance was investigated. White gypsum cement was used as a calculus phantom model. The calculus phantoms were ablated by a total 3-J laser pulse exposure (20 mJ, 100 Hz, 1.5 s) and contact mode with N=15 sample size. Ablation volume was obtained on average 0.079, 0.122, and 0.391 mm3 in dry calculus in air, wet calculus in air, and wet calculus in-water groups, respectively. There were three proposed ablation mechanisms that could explain the effect of water content in calculus phantom on calculus ablation performance, including shock wave due to laser pulse injection and bubble collapse, spallation, and microexplosion. Increased absorption coefficient of wet calculus can cause stronger spallation process compared with that caused by dry calculus; as a result, higher calculus ablation was observed in both wet calculus in air and wet calculus in water. The test result also indicates that the shock waves generated by short laser pulse under the in-water condition have great impact on the ablation volume by Tm:YAG QS laser.

  14. Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

    PubMed Central

    Dede, Onur; ?ener, Nevzat Can; Ba?, Okan; Dede, Gülay; Ba?banc?, Muhammet ?ahin

    2015-01-01

    Objective: The aim of the current study was to investigate whether obesity influences the outcome of extra-corporeal shockwave lithotripsy (ESWL) treatment for upper ureteral stones. Material and methods: This is a retrospective study of 134 patients who underwent ESWL between June 2011 and May 2014. Patients were divided into 2 groups. Group 1 comprised 94 patients of normal weight, and group 2 comprised 40 morbidly obese patients. Patients in both groups had upper ureteral stones. Results: The mean age of groups 1 and 2 was 45.6±12.1 and 45.3±15.5 years, respectively (p=0.98). There was no significant difference in demographic variables between the groups. The mean stone size in groups 1 and 2 was 81.7±25.7 mm2 and 86.3±22.4 mm2, respectively (p=0.51), the mean body mass index (BMI) was 27.4±2.9 and 42.9±2.1, respectively (p<0.01), the mean number of ESWL sessions was 2.4±0.6 and 2.4±0.7, respectively (p=0.97), and the mean follow-up time was 7.1±3.4 and 6.6±2.8 weeks, respectively (p=0.67). The overall stone-free rate was 82% in group 1 and 67% in group 2 (p=0.01). Conclusion: It is well-known that morbidly obese patients have higher rates of anesthesia-related problems due to the comorbidities commonly observed in this population. In the current study, we found that ESWL is a safe and acceptable treatment option for morbidly obese patients with upper ureteral stones. PMID:26328193

  15. Percutaneous nephrolithotomy vs. extracorporeal shockwave lithotripsy for treating a 20–30 mm single renal pelvic stone

    PubMed Central

    Hassan, Mohammed; El-Nahas, Ahmed R.; Sheir, Khaled Z.; El-Tabey, Nasr A.; El-Assmy, Ahmed M.; Elshal, Ahmed M.; Shokeir, Ahmed A.

    2015-01-01

    Objective To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) for treating a 20–30 mm single renal pelvic stone. Patients and methods The computerised records of patients who underwent PNL or ESWL for a 20–30 mm single renal pelvic stone between January 2006 and December 2012 were reviewed retrospectively. Patients aged <18 years who had a branched stone, advanced hydronephrosis, a solitary kidney, anatomical renal abnormality, or had a surgical intervention within the past 6 months were excluded. The study included 337 patients with a mean (SD, range) age of 49.3 (12.2, 20–81) years. The patients’ criteria (age, sex, body mass index) and the stone characteristics (side, stone length, surface area, attenuation value and skin-to-stone distance) were compared between the groups. The re-treatment rate, the need for secondary procedures, success rate, complications and the total costs were calculated and compared. Results In all, 167 patients were treated by ESWL and 170 by PNL. The re-treatment rate (75% vs. 5%), the need for secondary procedures (25% vs. 4.7%) and total number of procedures (three vs. one) were significantly higher in the ESWL group (P < 0.001). The success rate was significantly higher in the PNL group (95% vs. 75%, P < 0.001), as was the complication rate (13% vs. 6.6%, P = 0.050). The total costs of primary and secondary procedures were significantly higher for PNL (US$ 1120 vs. 490; P < 0.001). Conclusions PNL was more effective than ESWL for treating a single renal pelvic stone of 20–30 mm. However, ESWL was associated with fewer complications and a lower cost. PMID:26413350

  16. Percutaneous papillary large balloon dilation during percutaneous cholangioscopic lithotripsy for the treatment of large bile-duct stones: a feasibility study.

    PubMed

    Han, Jee Young; Jeong, Seok; Lee, Don Haeng

    2015-03-01

    When access to a major duodenal papilla or endoscopic retrograde cholangiopancreatography has failed, percutaneous transhepatic cholangioscopic lithotripsy (PTCS-L) may be useful for removing common bile duct (CBD) stones. However, the feasibility and usefulness of percutaneous transhepatic papillary large-balloon dilation (PPLBD) during PTCS-L for the removal of large CBD stones has not been established. We aimed to determine the safety and efficacy of PPLBD for the treatment of large CBD stones. Eleven patients with large CBD stones in whom the access to the major papilla or bile duct had failed were enrolled prospectively. Papillary dilation was performed using a large (12-20 mm) dilation balloon catheter via the percutaneous transhepatic route. Post-procedure adverse events and efficacy of the stone retrieval were measured. The initial success rate of PPLBD was 100%. No patient required a basket to remove a stone after PPLBD. Electrohydraulic lithotripsy was required in 2 (18.2%) patients. The median time to complete stone removal after PPLBD was 17.8 min and no adverse events occurred after PPLBD. Asymptomatic hyperamylasemia was not encountered in any patients. This study indicates that PPLBD is safe and effective for removal of large CBD stones. PMID:25729250

  17. Effects of shock waves on growth of endothelial cells in vitro

    NASA Astrophysics Data System (ADS)

    Tamagawa, Masaaki; Kitayama, Masanobu; Iwakura, Seiya

    2005-04-01

    Recently shock wave phenomena in living tissues are being widely applied in the fields of medical and chemical engineering, such as extracorporeal shock wave lithotripsy, bioprocess for environmental protection and tissue engineering. In the field of tissue engineering, the bone therapy to regenerate the bone by extracorporeal shock waves shows the possibility for new therapy. In this paper, to investigate the effects of shock waves on the endothelial cells in vitro, the cells by plane shock waves are observed by microscope and the growth rate and others are measured by image processing. The peak pressure works on the endothelial cells in water at the test case is 0.4 MPa. After working shock waves on suspended cells and fixed cells, the disintegration, shape and growth are investigated. It is found that the younger generation cells have small differences of shape index, and the growth rate of the shock-worked cells from 0 to 4 h are clearly high compared with control ones. It is concluded that once shock waves worked, some of them are disintegrated, but the other has capacity to increase growth rate of cell culture in vitro.

  18. Assessment of shock wave lithotripters via cavitation potential

    PubMed Central

    Iloreta, Jonathan I.; Zhou, Yufeng; Sankin, Georgy N.; Zhong, Pei; Szeri, Andrew J.

    2008-01-01

    A method to characterize shock wave lithotripters by examining the potential for cavitation associated with the lithotripter shock wave (LSW) has been developed. The method uses the maximum radius achieved by a bubble subjected to a LSW as a representation of the cavitation potential for that region in the lithotripter. It is found that the maximum radius is determined by the work done on a bubble by the LSW. The method is used to characterize two reflectors: an ellipsoidal reflector and an ellipsoidal reflector with an insert. The results show that the use of an insert reduced the ?6 dB volume (with respect to peak positive pressure) from 1.6 to 0.4 cm3, the ?6 dB volume (with respect to peak negative pressure) from 14.5 to 8.3 cm3, and reduced the volume characterized by high cavitation potential (i.e., regions characterized by bubbles with radii larger than 429 µm) from 103 to 26 cm3. Thus, the insert is an effective way to localize the potentially damaging effects of shock wave lithotripsy, and suggests an approach to optimize the shape of the reflector. PMID:19865493

  19. Modeling of shock wave propagation in large amplitude ultrasound.

    PubMed

    Pinton, Gianmarco F; Trahey, Gregg E

    2008-01-01

    The Rankine-Hugoniot relation for shock wave propagation describes the shock speed of a nonlinear wave. This paper investigates time-domain numerical methods that solve the nonlinear parabolic wave equation, or the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation, and the conditions they require to satisfy the Rankine-Hugoniot relation. Two numerical methods commonly used in hyperbolic conservation laws are adapted to solve the KZK equation: Godunov's method and the monotonic upwind scheme for conservation laws (MUSCL). It is shown that they satisfy the Rankine-Hugoniot relation regardless of attenuation. These two methods are compared with the current implicit solution based method. When the attenuation is small, such as in water, the current method requires a degree of grid refinement that is computationally impractical. All three numerical methods are compared in simulations for lithotripters and high intensity focused ultrasound (HIFU) where the attenuation is small compared to the nonlinearity because much of the propagation occurs in water. The simulations are performed on grid sizes that are consistent with present-day computational resources but are not sufficiently refined for the current method to satisfy the Rankine-Hugoniot condition. It is shown that satisfying the Rankine-Hugoniot conditions has a significant impact on metrics relevant to lithotripsy (such as peak pressures) and HIFU (intensity). Because the Godunov and MUSCL schemes satisfy the Rankine-Hugoniot conditions on coarse grids, they are particularly advantageous for three-dimensional simulations. PMID:18564596

  20. Lower pole calculi larger than one centimeter: Retrograde intrarenal surgery

    PubMed Central

    Gross, Andreas J.; Bach, Thorsten

    2008-01-01

    Controversy remains on how to treat lower pole calculi between 1 and 2 cm of size. Treatment options like shock wave lithotripsy (SWL) or percutaneous stone treatment (PCNL) are associated with poor stone-free rates or high morbidity. Due to the ongoing development in endourologic technology, especially in flexible renoscopy, laser technique and grasping devices (tipless Nitinol baskets) retrograde intrarenal surgery (RIRS) has become an option in treating these patients. Based on personal experience and an overview of the published literature we discuss RIRS as a valuable alternative to PCNL in treating patients with larger calculi of the lower pole. The technical developments in laser technology as well as significant improvement in flexible renoscopes have made RIRS for larger lower pole stones possible. The low complication rate gives RIRS for lower pole stones superiority over the invasive percutaneous approach, which is associated with significant morbidity, even in experienced hands. PMID:19468516

  1. Modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi: A single-surgeon experience of 382 cases

    PubMed Central

    YAN, ZEJUN; XIE, GUOHAI; YUAN, HESHENG; CHENG, YUE

    2015-01-01

    To determine the safety and efficacy of modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi, a retrospective chart review of a single surgeon's 3-year modular flexible ureteroscopy experience was performed. All of the patients were treated with modular flexible ureteroscopy and holmium laser lithotripsy by a single surgeon. Stone-free status was defined as no fragments or a single fragment ?4 mm in diameter at the 3-month follow-up. The procedure number, operative time, stone-free rates, repeat usage of the multilumen catheter, and perioperative complications were documented. The present study included 215 male patients and 167 female patients, with an average age of 48.5±13.7 years (range, 17–84 years). The mean stone size was 11.5±4.1 mm (range, 4–28 mm), and the mean total stone burden was 17.5±5.7 mm (range 15–46 mm). A total of 305 patients (79.8%) had a stone burden ?20 mm, and 77 patients (20.2%) had a stone burden >20 mm. The mean number of primary procedures was 1.3±0.2 (range, 1–3). The stone-free rate following the first and the second procedure was 73.4 and 86.9%, respectively. The mean postoperative hospital stay was 3.1±1.2 days (range, 2–6 days). The highest clearance rates were observed for proximal ureteral stones (100%) and renal pelvic stones (88.7%), whereas the lowest clearance rates were observed for lower calyx stones (76.7%) and multiple calyx stones (77.8%). The higher the initial stone burden, the lower the postoperative stone-free rate (?20 vs. >20 mm; 89.8 vs. 75.3%). The overall complication rate was 8.1%. The results of the present study suggest that modular flexible ureteroscopy with holmium laser lithotripsy may be considered the primary method for the treatment of renal and proximal ureteral calculi in select patients, due to its acceptable efficacy, low morbidity, and relatively low maintenance costs. PMID:26622508

  2. Sonographic imaging of extracorporeal shock wave effects in the liver and gallbladder of dogs.

    PubMed

    Delius, M; Gambihler, S

    1992-01-01

    During extracorporeal shock wave lithotripsy, changes in tissue echogenicity are observed by ultrasound. Their significance is not known. An experiment was performed in which 3,000 extracorporeal shock waves were applied under sonographic observation to the gallbladder wall of 6 dogs. No stones had been implanted, but transient shadows appeared simulating jumping stone fragments in the bladder. Echoes within the bladder lumen occurred in 3 dogs and were associated with hemorrhage into the lumen; in an additional ex vivo experiment, shock waves generated echoes in bile only after injection of a small amount of blood. In the liver, a transient increase in echogenicity was noted after a few shocks; it coincided with the region of tissue damage. Intense focal echoes occurred in the liver of 2 dogs at sites where a hematoma was found at autopsy. It is concluded that an increased focal echogenicity is an indicator of tissue damage by shock waves. The sonographic changes are thought to be caused by the transient generation of gas bubbles. The interaction of shock waves with gas bubbles is an established powerful mechanism which could explain the generation of tissue damage by shock waves. PMID:1426698

  3. Heat Waves

    MedlinePLUS

    Heat Waves Dangers we face during periods of very high temperatures include: Heat cramps: These are muscular pains and spasms due ... that the body is having trouble with the heat. If a heat wave is predicted or happening… - ...

  4. Gravity Waves

    Atmospheric Science Data Center

    2013-04-19

    article title:  Gravity Waves Ripple over Marine Stratocumulus Clouds ... Imaging SpectroRadiometer (MISR), a fingerprint-like gravity wave feature occurs over a deck of marine stratocumulus clouds. Similar ... that occur when a pebble is thrown into a still pond, such "gravity waves" sometimes appear when the relatively stable and stratified air ...

  5. A comparative study of cystolithotripsy and extracorporeal shock wave therapy for bladder stones.

    PubMed

    Bhatia, V; Biyani, C S

    1994-01-01

    This study compares the safety and efficacy of mechanical cystolithotripsy (MCLT) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of vesical stones. In the last four years we have treated 144 bladder lithiasis patients with MCLT (86; group A) and ESWL (58; group B). All patients in group A were treated under spinal anaesthesia while 47 patients in group B needed intravenous sedation. The early complication rates in groups A and B were 19.7 and 6.8%, respectively. The corresponding mean hospital stay was 60 and 18 hours. ESWL should be considered as an effective, safe and least invasive alternative to MCLT in the therapeutic options for vesical lithiasis. PMID:8026920

  6. Numerical Simulation of Bubble Dynamics in Deformable Vessels

    NASA Astrophysics Data System (ADS)

    Coralic, Vedran; Colonius, Tim

    2011-11-01

    The growth and collapse of cavitation bubbles has been implicated as a potential damage mechanism leading to the rupture of blood vessels in shock wave lithotripsy (SWL). While this phenomenon has been investigated numerically, the resulting simulations have often assumed some degree of symmetry and have often failed to include a large number of influential physics, such as viscosity, compressibility, surface tension, phase change and fluid-structure interactions. We present here our efforts to explore the role that cavitation bubbles play in the rupture of blood vessels in SWL and to improve upon the current state of the numerical approach. We have developed a three-dimensional, high-order accurate, shock- and interface-capturing, multicomponent flow algorithm that accounts for the effects of viscosity and surface tension. At this time, we omit any effects due to elasticity and instead, as a first step, model tissue as a viscous and stiffened gas. We discuss preliminary results for the Rayleigh and shock-induced collapse of a gas bubble within a blood vessel and characterize the increase in vessel deformation with increasing bubble confinement and proximity to the vessel wall. This research was supported by the National Institutes of Health grant No. 2PO1DK43881.

  7. Perioperative cultures and the role of antibiotics during stone surgery

    PubMed Central

    Motamedinia, Piruz; Korets, Ruslan; Badalato, Gina

    2014-01-01

    Urinary tract infection and urosepsis are the most common complications associated with the procedures urologists employ to manage stone disease. Recommendations regarding antibiotic prophylaxis and utilization of perioperative urine and stone culture prior to shockwave lithotripsy (SWL) or endoscopic intervention have evolved overtime. We sought to provide readers with a comprehensive consensus regarding these most recent recommendations. PMID:26816781

  8. Shock wave permeabilization with ribosome inactivating proteins: a new approach to tumor therapy.

    PubMed

    Delius, M; Adams, G

    1999-10-15

    Extracorporeal shock waves are high-pressure pulses of microsecond duration clinically used for lithotripsy. Recently, shock waves been shown to cause a transient increase of the permeability of the cell membrane. We therefore hypothesized that shock waves might be able to transfer tumoricidal agents into tumor cells and examined this in vitro and in vivo. In vitro, the ribosome inactivating proteins gelonin and saporin were transferred into L1210, SSK2, and HeLa cells, and dose-response curves were established. The drug concentration that reduced the cell proliferation by 50% (IC50) was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and the enhancement factors from shock wave application were calculated. It was found that shock waves enhanced the action of gelonin from 900-fold in L1210 cells to 40,000-fold in HeLa cells and the action of saporin from 300-fold in L1210 cells to 15,000-fold in HeLa cells. In vivo, the effect of gelonin and saporin was assessed in a murine tumor model. SSK2 fibrosarcoma tumors locally grown in C3H mice were treated with shock waves after i.p. administration of gelonin or saporin. Shock wave application delayed the tumor growth, and long-term remissions lasting >180 days were induced in 40% of the animals. In conclusion, shock waves enhanced the action of ribosome inactivating proteins and led to complete tumor remissions. The local transfer of toxic substances by shock waves into tumors constitutes a new approach to a local tumor therapy. PMID:10537301

  9. Third Wave.

    ERIC Educational Resources Information Center

    Reed, Chris

    2000-01-01

    Third Wave is a Christian charity based in Derby (England) that offers training in vocational skills, preindustrial crafts, horticultural and agricultural skills, environmental education, and woodland survival skills to disadvantaged people at city and farm locations. Third Wave employs a holistic approach to personal development in a community…

  10. Development of Laser-induced Grating Spectroscopy for Underwater Temperature Measurement in Shock Wave Focusing Regions

    NASA Technical Reports Server (NTRS)

    Gojani, Ardian B.; Danehy, Paul M.; Alderfer, David W.; Saito, Tsutomu; Takayama, Kazuyoshi

    2003-01-01

    In Extracorporeal Shock Wave Lithotripsy (ESWL) underwater shock wave focusing generates high pressures at very short duration of time inside human body. However, it is not yet clear how high temperatures are enhanced at the spot where a shock wave is focused. The estimation of such dynamic temperature enhancements is critical for the evaluation of tissue damages upon shock loading. For this purpose in the Interdisciplinary Shock Wave Research Center a technique is developed which employs laser induced thermal acoustics or Laser Induced Grating Spectroscopy. Unlike most of gasdynamic methods of measuring physical quantities this provides a non-invasive one having spatial and temporal resolutions of the order of magnitude of 1.0 mm3 and 400 ns, respectively. Preliminary experiments in still water demonstrated that this method detected sound speed and hence temperature in water ranging 283 K to 333 K with errors of 0.5%. These results may be used to empirically establish the equation of states of water, gelatin or agar cells which will work as alternatives of human tissues.

  11. Tkachenko waves

    NASA Astrophysics Data System (ADS)

    Andereck, C. David; Glaberson, W. I.

    1982-08-01

    The existence of Tkachenko waves in rotating superfluid4He has been confirmed experimentally. Tkachenko waves are displacement waves in the vortex line array that exists in a rotating superfluid. The waves were excited and detected in resonant cavities formed by a stack of closely spaced parallel plates. The dispersion relation, studied as a function of rotation speed, disk spacing (which fixed one component of the wave vector), and temperature, is compared with existing theories and found to be in good agreement at low temperatures. The theories predict peaks in the density of states associated with a lattice of vortices; the resonant responses observed are found to correspond to these peaks. The need for a more complete theory is presented in the light of the behavior of the vortex resonances at elevated temperatures.

  12. Role of steroidal anti-inflammatory agent prior to intracorporeal lithotripsy under local anesthesia for ureterovesical junction calculus: A prospective randomized controlled study

    PubMed Central

    Lodh, Bijit; Singh, Kaku Akoijam; Sinam, Rajendra Singh

    2015-01-01

    Objective: The objective of the following study is to assess the effect of steroidal anti-inflammatory agent on the outcome of ureterorenoscopic lithotripsy (URSL) for ureterovesical junction (UVJ) calculus. Settings and Design: This was a prospective randomized controlled study conducted at the Department of Urology, Regional Institute of Medical Sciences, Imphal. Subjects and Methods: One hundred and twenty-six patients requiring ureteroscopic lithotripsy for UVJ calculus were randomly assigned into two groups. The study group received tablet deflazacort 30 mg once a day for 10 days prior to the procedure, whereas the control group did not receive such treatment. Parameters with respect to the outcome of the procedure were recorded for all patients in both groups. Statistical Analysis Used: Fisher's exact and independent t-test was used to compare the outcome between the groups where P < 0.05 was considered to be statistically significant. Results: There was significant statistical difference (P - 0.016) on the endoscopic appearance of the region of ureteric orifice in patients receiving steroidal anti-inflammatory agent compared with control. Severe procedure related pain and mean operative time was less in the study group compared to control (P - 0.020 and 0.031, respectively). Re-treatment rates in the study group were lower than the control group (4.76% vs. 17.46%) and found to be statistically significant (P - 0.044). It is found that computed tomography (CT) appearance (r - 0.399) and stone size (r - 0.410) strongly correlate with the endoscopic findings of the region of UVJ (P - 0.001). Conclusions: Inflamed and or obliterated ureteric orifice is the major constraints for stone clearance at ureterovesical junction. The present study showed the administration of tablet deflazacort (a steroidal anti-inflammatory agent) significantly improves the outcome of URSL under local anesthesia. We strongly recommend its use prior to URSL for UVJ calculus, especially for stone size ≥10.24 mm and on CT evidence of prominent soft tissue swelling at the UVJ. PMID:25835035

  13. Atmospheric Waves

    NASA Technical Reports Server (NTRS)

    2007-01-01

    With its Multispectral Visible Imaging Camera (MVIC), half of the Ralph instrument, New Horizons captured several pictures of mesoscale gravity waves in Jupiter's equatorial atmosphere. Buoyancy waves of this type are seen frequently on Earth - for example, they can be caused when air flows over a mountain and a regular cloud pattern forms downstream. In Jupiter's case there are no mountains, but if conditions in the atmosphere are just right, it is possible to form long trains of these small waves. The source of the wave excitation seems to lie deep in Jupiter's atmosphere, below the visible cloud layers at depths corresponding to pressures 10 times that at Earth's surface. The New Horizons measurements showed that the waves move about 100 meters per second faster than surrounding clouds; this is about 25% of the speed of sound on Earth and is much greater than current models of these waves predict. Scientists can 'read' the speed and patterns these waves to learn more about activity and stability in the atmospheric layers below.

  14. Characterization of the HIFU-induced cloud cavitation for the optimization of high pressure concentration for lithotripsy

    NASA Astrophysics Data System (ADS)

    Ikeda, Teiichiro; Yoshizawa, Shin; Kaneko, Yukio; Matsumoto, Yoichiro

    2006-05-01

    The bubble cloud is a highly scattering object; to the contrary, it is also a strong pressure wave enhancer, if the wavelength and amplitude of the wave is appropriate ones. We've been investigated the stone erosion enhancement in the existence of bubble cloud on the stone surface by using high frequency waveform that immediately followed by low frequency trailing pulse (C-C waveform; Cavitation Control waveform). For the optimization of the high pressure concentration it is needed to know, "how the enhancement of the pressure wave through the bubble cloud" and "how we can estimate the efficiency thorough the passive detection of the reflected signal from the bubble cloud". We measured the "Transmittance" and "Reflection" by two types of acoustic emission sensors, PCD (Passive Cavitation Detector) and DCD (Direct Collapse Detector). The results well depict the characteristics of the HIFU-induced bubble cloud responses. The response curves reveal that the local maxima of the "Transmittance" and "Reflection" occur at the different bubble cloud volume. The PCD signal is higher in the larger bubble cloud band. The DCD signal is larger in the smaller bubble cloud band. These tendencies imply the therapeutic effect through the bubble cloud is optimized in the small bubble cloud region and too much bubbles scatter the incoming ultrasound wave and the ultrasound wave does not efficiently propagates inward the bubble cloud. Thus, for the optimization of the bubble cloud collapse, the cavitation threshold can be the lower limit and the large scattering amplitude from bubble cloud can be the upper limit of the ultrasound conditions.

  15. Tkachenko waves

    NASA Astrophysics Data System (ADS)

    Sonin, E. B.

    2014-02-01

    This is a short review of theoretical and experimental studies of Tkachenko waves starting from their theoretical prediction by Tkachenko about 50 years ago up to their unambiguous experimental observation in the Bose-Einstein condensate of cold atoms.

  16. Laser lithotripsy of gallstones: alexandrite and rhodamine-6G versus coumarin dye laser: fragmentation and fiber burn-off in vitro

    NASA Astrophysics Data System (ADS)

    Hochberger, Juergen; Bredt, Marion; Mueller, Gudrun; Hahn, Eckhart G.; Ell, Christian

    1993-05-01

    In the following study three different pulsed laser lithotripsy systems were compared for the fine fragmentation of identical sets of natural and synthetic gallstones `in vitro.' Using a pulsed coumarin dye laser (504 nm), a pulsed rhodamine 6G dye laser (595 nm), and a pulsed Alexandrite laser (755 nm) a total of 184 concrements of known chemical composition, size, and weight were disintegrated to a fragment size of

  17. Wave records and freak waves

    NASA Astrophysics Data System (ADS)

    Lechuga, Antonio

    2010-05-01

    Recently some evidences of freak waves have been found all over the world. 25-30 accidents have been reported to happen yearly due to them (Pelinovsky et al.). However direct measurements of freak or rogue waves is not easy .The main reason for it comes from its elusive quality as pointed out by researches and observers. Therefore to approach the problem we have to use whatever tool is available for us. One of them are wave records from buoys deployed near the presumed location. Thus we have to look for freak waves using data that have not got, in general, any anomalous wave (from the usual definition) but they present some characteristics that make it probable to induce its formation. We are going to carry out the analysis of the wave records close to locations where some accident has taken place, assuming nonlinear focussing as the framework of the involved theory. According to Janssen and Onorato et al. the main parameter to consider is kurtosis and through it the related BF index (BFI). This procedure, uniting statistical properties of random seas and a powerful theory, could in a near future to help us to foretell the appearance of rogue waves.

  18. Plasma waves

    SciTech Connect

    Vandenplas, P.E.

    1996-03-01

    This paper presents a summary of important parts of `Plasma waves` by J.F. Denisse and J.L.Delcroix, Interscience-Wiley, 1963, itself a translation of `Theorie des Ondes dans les Plasmas`, Dunod, 1959. We shall, however, use S.I. units instead of cgs ones and adopt where necessary more modern notations. A rather complete overview of the complexity of waves in a hot magnetized plasma is given. The effects of collisions have been mostly neglected. 1 fig.

  19. Reorganization of pathological control functions of memory-A neural model for tissue healing by shock waves

    NASA Astrophysics Data System (ADS)

    Wess, Othmar

    2005-04-01

    Since 1980 shock waves have proven effective in the field of extracorporeal lithotripsy. More than 10 years ago shock waves were successfully applied for various indications such as chronic pain, non-unions and, recently, for angina pectoris. These fields do not profit from the disintegration power but from stimulating and healing effects of shock waves. Increased metabolism and neo-vascularization are reported after shock wave application. According to C. J. Wang, a biological cascade is initiated, starting with a stimulating effect of physical energy resulting in increased circulation and metabolism. Pathological memory of neural control patterns is considered the reason for different pathologies characterized by insufficient metabolism. This paper presents a neural model for reorganization of pathological reflex patterns. The model acts on associative memory functions of the brain based on modification of synaptic junctions. Accordingly, pathological memory effects of the autonomous nervous system are reorganized by repeated application of shock waves followed by development of normal reflex patterns. Physiologic control of muscle and vascular tone is followed by increased metabolism and tissue repair. The memory model may explain hyper-stimulation effects in pain therapy.

  20. Devices That May Interfere with Pacemakers

    MedlinePLUS

    ... wave lithotripsy (ESWL) : a noninvasive treatment that uses hydraulic shocks to dissolve kidney stones. This procedure may ... wave lithotripsy (ESWL) : a noninvasive treatment that uses hydraulic shocks to dissolve kidney stones. This procedure may ...

  1. A Review of Computational Methods in Materials Science: Examples from Shock-Wave and Polymer Physics

    PubMed Central

    Steinhauser, Martin O.; Hiermaier, Stefan

    2009-01-01

    This review discusses several computational methods used on different length and time scales for the simulation of material behavior. First, the importance of physical modeling and its relation to computer simulation on multiscales is discussed. Then, computational methods used on different scales are shortly reviewed, before we focus on the molecular dynamics (MD) method. Here we survey in a tutorial-like fashion some key issues including several MD optimization techniques. Thereafter, computational examples for the capabilities of numerical simulations in materials research are discussed. We focus on recent results of shock wave simulations of a solid which are based on two different modeling approaches and we discuss their respective assets and drawbacks with a view to their application on multiscales. Then, the prospects of computer simulations on the molecular length scale using coarse-grained MD methods are covered by means of examples pertaining to complex topological polymer structures including star-polymers, biomacromolecules such as polyelectrolytes and polymers with intrinsic stiffness. This review ends by highlighting new emerging interdisciplinary applications of computational methods in the field of medical engineering where the application of concepts of polymer physics and of shock waves to biological systems holds a lot of promise for improving medical applications such as extracorporeal shock wave lithotripsy or tumor treatment. PMID:20054467

  2. Experimentally validated multiphysics computational model of focusing and shock wave formation in an electromagnetic lithotripter

    PubMed Central

    Fovargue, Daniel E.; Mitran, Sorin; Smith, Nathan B.; Sankin, Georgy N.; Simmons, Walter N.; Zhong, Pei

    2013-01-01

    A multiphysics computational model of the focusing of an acoustic pulse and subsequent shock wave formation that occurs during extracorporeal shock wave lithotripsy is presented. In the electromagnetic lithotripter modeled in this work the focusing is achieved via a polystyrene acoustic lens. The transition of the acoustic pulse through the solid lens is modeled by the linear elasticity equations and the subsequent shock wave formation in water is modeled by the Euler equations with a Tait equation of state. Both sets of equations are solved simultaneously in subsets of a single computational domain within the BEARCLAW framework which uses a finite-volume Riemann solver approach. This model is first validated against experimental measurements with a standard (or original) lens design. The model is then used to successfully predict the effects of a lens modification in the form of an annular ring cut. A second model which includes a kidney stone simulant in the domain is also presented. Within the stone the linear elasticity equations incorporate a simple damage model. PMID:23927200

  3. A review of computational methods in materials science: examples from shock-wave and polymer physics.

    PubMed

    Steinhauser, Martin O; Hiermaier, Stefan

    2009-12-01

    This review discusses several computational methods used on different length and time scales for the simulation of material behavior. First, the importance of physical modeling and its relation to computer simulation on multiscales is discussed. Then, computational methods used on different scales are shortly reviewed, before we focus on the molecular dynamics (MD) method. Here we survey in a tutorial-like fashion some key issues including several MD optimization techniques. Thereafter, computational examples for the capabilities of numerical simulations in materials research are discussed. We focus on recent results of shock wave simulations of a solid which are based on two different modeling approaches and we discuss their respective assets and drawbacks with a view to their application on multiscales. Then, the prospects of computer simulations on the molecular length scale using coarse-grained MD methods are covered by means of examples pertaining to complex topological polymer structures including star-polymers, biomacromolecules such as polyelectrolytes and polymers with intrinsic stiffness. This review ends by highlighting new emerging interdisciplinary applications of computational methods in the field of medical engineering where the application of concepts of polymer physics and of shock waves to biological systems holds a lot of promise for improving medical applications such as extracorporeal shock wave lithotripsy or tumor treatment. PMID:20054467

  4. Making WAVES.

    ERIC Educational Resources Information Center

    Hindes, Victoria A.; Hom, Keri; Brookshaw, Keith

    About 46% of high school graduates enrolled in California State Universities need remedial courses in both math and English to prepare them for college level. These students typically earned B averages in their high school math and English classes. In order to address this issue, Shasta College launched Operation WAVES (Win by Achieving Valuable…

  5. Wave Turbulence

    NASA Astrophysics Data System (ADS)

    Newell, Alan C.; Rumpf, Benno

    2011-01-01

    In this article, we state and review the premises on which a successful asymptotic closure of the moment equations of wave turbulence is based, describe how and why this closure obtains, and examine the nature of solutions of the kinetic equation. We discuss obstacles that limit the theory's validity and suggest how the theory might then be modified. We also compare the experimental evidence with the theory's predictions in a range of applications. Finally, and most importantly, we suggest open challenges and encourage the reader to apply and explore wave turbulence with confidence. The narrative is terse but, we hope, delivered at a speed more akin to the crisp pace of a Hemingway story than the wordjumblingtumbling rate of a Joycean novel.

  6. On neutron surface waves

    SciTech Connect

    Ignatovich, V. K.

    2009-01-15

    It is shown that neutron surface waves do not exist. The difference between the neutron wave mechanics and the wave physics of electromagnetic and acoustic processes, which allows the existence of surface waves, is analyzed.

  7. Whip waves

    NASA Astrophysics Data System (ADS)

    McMillen, Tyler; Goriely, Alain

    2003-10-01

    The sound created by a whip as it cracks is produced by a mini-sonic boom created by a supersonic motion of the end of the whip. To create such a motion, one sends an impulse to the handle of the whip that travels to the end and accelerates the tip to supersonic speed. The impulse which creates a whip crack is studied as a wave travelling along an elastic rod. The whip is modeled as an inextensible, unshearable, inhomogeneous planar elastic rod. A crack is produced when a section of the whip breaks the sound barrier. We show by asymptotic analysis that a wave travelling along the whip increases its speed as the radius decreases-as the whip tapers. A numerical scheme adapted to account for the varying cross-section and realistic boundary conditions is presented, and results of several numerical experiments are reported and compared to theoretical predictions. Finally, we describe the shape of the shock waves emitted by a material point on the whip travelling faster than the speed of sound.

  8. Full-wave modeling of therapeutic ultrasound: Nonlinear ultrasound propagation in ideal fluids

    NASA Astrophysics Data System (ADS)

    Ginter, Siegfried; Liebler, Marko; Steiger, Eckard; Dreyer, Thomas; Riedlinger, Rainer E.

    2002-05-01

    The number of applications of high-intense, focused ultrasound for therapeutic purposes is growing. Besides established applications like lithotripsy, new applications like ultrasound in orthopedics or for the treatment of tumors arise. Therefore, new devices have to be developed which provide pressure waveforms and distributions in the focal zone specifically for the application. In this paper, a nonlinear full-wave simulation model is presented which predicts the therapeutically important characteristics of the generated ultrasound field for a given transducer and initial pressure signal. A nonlinear acoustic approximation in conservation form of the original hydrodynamic equations for ideal fluids rather than a wave equation provides the base for the nonlinear model. The equations are implemented with an explicit high-order finite-difference time-domain algorithm. The necessary coefficients are derived according to the dispersion relation preserving method. Simulation results are presented for two different therapeutic transducers: a self-focusing piezoelectric and one with reflector focusing. The computational results are validated by comparison with analytical solutions and measurements. An agreement of about 10% is observed between the simulation and experimental results.

  9. Effects of an acoustic diode on lithotripter shock wave, cavitation, and stone fragmentation

    NASA Astrophysics Data System (ADS)

    Zhu, Songlin; Dreyer, Thomas; Liebler, Marko; Zhong, Pei

    2002-05-01

    Recent studies suggest that reducing the large intraluminal bubble expansion in small blood vessels may ameliorate the potential for vascular injury in shock wave lithotripsy. To achieve this objective without compromising stone comminution, a selective truncation of the tensile component of lithotripter shock wave (LSW) is needed. In this work, an acoustic diode (AD) of Riedlinger's design was constructed and evaluated. The AD consists of two peripherally secured membranes having opposite surfaces held in direct contact under partial vacuum. The AD permits transmission of the leading compressive component of a LSW; yet the membranes may separate under tension, thus blocking the transmission of the trailing tensile component of the LSW. Following each LSW, the membranes will again establish direct contact due to the partial vacuum between them. Using the AD at a vacuum level of 10.75 in.Hg, the collapse time of the LSW-induced bubble cluster at the beam focus of a HM-3 lithotripter at 20 kV was found to be reduced by 29%, whereas the compressive pressure and stone comminution were only reduced slightly by 4% and 5%, respectively. Thus the AD may be used to reduce tissue injury produced by LSW. [Work supported by Whitaker Foundation and NIH.

  10. Making Waves: Seismic Waves Activities and Demonstrations

    NASA Astrophysics Data System (ADS)

    Braile, S. J.; Braile, L. W.

    2011-12-01

    The nature and propagation of seismic waves are fundamental concepts necessary for understanding the exploration of Earth's interior structure and properties, plate tectonics, earthquakes, and seismic hazards. Investigating seismic waves is also an engaging approach to learning basic principles of the physics of waves and wave propagation. Several effective educational activities and demonstrations are available for teaching about seismic waves, including the stretching of a spring to demonstrate elasticity; slinky wave propagation activities for compressional, shear, Rayleigh and Love waves; the human wave activity to demonstrate P- and S- waves in solids and liquids; waves in water in a simple wave tank; seismic wave computer animations; simple shake table demonstrations of model building responses to seismic waves to illustrate earthquake damage to structures; processing and analysis of seismograms using free and easy to use software; and seismic wave simulation software for viewing wave propagation in a spherical Earth. The use of multiple methods for teaching about seismic waves is useful because it provides reinforcement of the fundamental concepts, is adaptable to variable classroom situations and diverse learning styles, and allows one or more methods to be used for authentic assessment. The methods described here have been used effectively with a broad range of audiences, including K-12 students and teachers, undergraduate students in introductory geosciences courses, and geosciences majors.

  11. Symmetric irrotational water waves are traveling waves

    NASA Astrophysics Data System (ADS)

    Kogelbauer, Florian

    2015-11-01

    We show that a spatially periodic solution to the irrotational two-dimensional gravity water wave problem, with the property that the horizontal velocity component at the surface, as well as the wave profile is symmetric, necessarily defines a traveling wave. The proof makes use of maximum principles for harmonic functions and structural properties of the governing equations for nonlinear water waves.

  12. ASTER Waves

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The pattern on the right half of this image of the Bay of Bengal is the result of two opposing wave trains colliding. This ASTER sub-scene, acquired on March 29, 2000, covers an area 18 kilometers (13 miles) wide and 15 kilometers (9 miles) long in three bands of the reflected visible and infrared wavelength region. The visible and near-infrared bands highlight surface waves due to specular reflection of sunlight off of the wave faces.

    Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of International Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. Dr. Anne Kahle at NASA's Jet Propulsion Laboratory, Pasadena, California, is the U.S. science team leader; Moshe Pniel of JPL is the project manager. ASTER is the only high-resolution imaging sensor on Terra. The primary goal of the ASTER mission is to obtain high-resolution image data in 14 channels over the entire land surface, as well as black and white stereo images. With revisit time of between 4 and 16 days, ASTER will provide the capability for repeat coverage of changing areas on Earth's surface. Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of International Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. Dr. Anne Kahle at NASA's Jet Propulsion Laboratory, Pasadena, California, is the U.S. science team leader; Moshe Pniel of JPL is the project manager. ASTER is the only high-resolution imaging sensor on Terra. The primary goal of the ASTER mission is to obtain high-resolution image data in 14 channels over the entire land surface, as well as black and white stereo images. With revisit time of between 4 and 16 days, ASTER will provide the capability for repeat coverage of changing areas on Earth's surface.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping and monitoring dynamic conditions and temporal change. Examples of applications include monitoring glacial advances and retreats, potentially active volcanoes, thermal pollution, and coral reef degradation; identifying crop stress; determining cloud morphology and physical properties; evaluating wetlands; mapping surface temperature of soils and geology; and measuring surface heat balance.

  13. Waves and Tsunami Project

    ERIC Educational Resources Information Center

    Frashure, K. M.; Chen, R. F.; Stephen, R. A.; Bolmer, T.; Lavin, M.; Strohschneider, D.; Maichle, R.; Micozzi, N.; Cramer, C.

    2007-01-01

    Demonstrating wave processes quantitatively in the classroom using standard classroom tools (such as Slinkys and wave tanks) can be difficult. For example, waves often travel too fast for students to actually measure amplitude or wavelength. Also, when teaching propagating waves, reflections from the ends set up standing waves, which can confuse…

  14. Waves and Tsunami Project

    ERIC Educational Resources Information Center

    Frashure, K. M.; Chen, R. F.; Stephen, R. A.; Bolmer, T.; Lavin, M.; Strohschneider, D.; Maichle, R.; Micozzi, N.; Cramer, C.

    2007-01-01

    Demonstrating wave processes quantitatively in the classroom using standard classroom tools (such as Slinkys and wave tanks) can be difficult. For example, waves often travel too fast for students to actually measure amplitude or wavelength. Also, when teaching propagating waves, reflections from the ends set up standing waves, which can confuse…

  15. Gravitational research. Gravitational waves

    NASA Astrophysics Data System (ADS)

    Amaldi, E.; Pizzella, G.

    1985-04-01

    Gravitational wave research is reviewed. Gravitational theory, relativity theory, experiments in general relativity, sources of gravitational waves, the Rome gravitational experiment, quantic limits of gravitational waves measurements and how to avoid those limits are discussed.

  16. Lasers in the management of calcified urinary tract stents

    NASA Astrophysics Data System (ADS)

    Nseyo, Unyime O.; Tunuguntla, Hari S. G. R.; Crone, Michael

    2003-06-01

    Indwelling double J ureteral stents are used for internal urinary diversion for ureteral obstruction and post-surgical drainage of the upper urinary tract. Stent calcification is a serious complication especially in those with forgotten stents. In a retrospective review of 16 patients (10 male and 6 female) we found holmium laser to be highly effective in the management of calcified stents. Encrustations/calcifications were noted on the distal end of the sent in 6 patiens (37.5%), middle and distal portions in 2 patients (12.5%), along the entire length of the stent in 3 patients (18.75%), lower portion of the stent in 4 patients (25%) and at the upper and lower ends of the stent in one patient (6.25%). Cystolitholapaxy, retrograde ureteroscopy (URS) with holmium: YAG (yttrium-aluminum-garnet) laser intracorporeal lithotripsy, percutaneous nephrostolithotomy (PNL) and antegrade URS with holmium: YAG laser intracorporeal lithotripsy were effectively performed without intraoperative complications. Lithotripsy became necessary before stent removal in 11 patients (68.75%). Holmium laser lithotripsy was useful in managing 7 patients (43.75%), and shockwave lithotripsy (SWL) in 6 patients (37.5%). In two patients (12.5%) both holmium and SWL were used before the stent can be removed.

  17. Geometrical versus wave optics under gravitational waves

    NASA Astrophysics Data System (ADS)

    Angélil, Raymond; Saha, Prasenjit

    2015-06-01

    We present some new derivations of the effect of a plane gravitational wave on a light ray. A simple interpretation of the results is that a gravitational wave causes a phase modulation of electromagnetic waves. We arrive at this picture from two contrasting directions, namely, null geodesics and Maxwell's equations, or geometric and wave optics. Under geometric optics, we express the geodesic equations in Hamiltonian form and solve perturbatively for the effect of gravitational waves. We find that the well-known time-delay formula for light generalizes trivially to massive particles. We also recover, by way of a Hamilton-Jacobi equation, the phase modulation obtained under wave optics. Turning then to wave optics—rather than solving Maxwell's equations directly for the fields, as in most previous approaches—we derive a perturbed wave equation (perturbed by the gravitational wave) for the electromagnetic four-potential. From this wave equation it follows that the four-potential and the electric and magnetic fields all experience the same phase modulation. Applying such a phase modulation to a superposition of plane waves corresponding to a Gaussian wave packet leads to time delays.

  18. Auroral plasma waves

    NASA Technical Reports Server (NTRS)

    Gurnett, Donald A.

    1989-01-01

    A review is given of auroral plasma wave phenomena, starting with the earliest ground-based observations and ending with the most recent satellite observations. Two types of waves are considered, electromagnetic and electrostatic. Electromagnetic waves include auroral kilometric radiation, auroral hiss, ELF noise bands, and low-frequency electric and magnetic noise. Electrostatic waves include upper hybrid resonance emissions, electron cyclotron waves, lower hybrid waves, ion cyclotron waves and broadband electrostatic noise. In each case, a brief overview is given describing the observations, the origin of the instability, and the role of the waves in the physics of the auroral acceleration region.

  19. Robotic partial nephrectomy for caliceal diverticulum: a single-center case series.

    PubMed

    Akca, Oktay; Zargar, Homayoun; Autorino, Riccardo; Brandao, Luis Felipe; Laydner, Humberto; Samarasekera, Dinesh; Krishnan, Jayram; Noble, Mark; Haber, George-Pascal; Kaouk, Jihad H; Stein, Robert J

    2014-08-01

    The aim of this study is to examine the role of robotic partial nephrectomy (RPN) in the management of caliceal diverticula by assessing our single-center outcomes. Between July 2007 and July 2013, 7 of 670 patients underwent RPN procedures as a reason of caliceal diverticula. The indications for RPN in all cases were recurrent urinary tract infection and pain attributed to the diverticulum in addition to failed management by endourologic or extracorporeal shockwave lithotripsy (SWL) treatments. One patient with a calcified diverticulum and another with an unsuccessful SWL treatment underwent RPN without further endourologic intervention. The other five patients had a history of unsuccessful percutaneous nephrolithotomy (one case), ureteroscopy (URS) (two cases), and a combination of SWL+URS (two cases). No intraoperative or postoperative complications were observed. No patient was readmitted postoperatively. Unique features of the robotic platform facilitate the excision of diverticulum and subsequent kidney reconstruction for this benign, but complex pathology. PMID:24720868

  20. Bubble Proliferation or Dissolution of Cavitation Nuclei in the Beam Path of a Shock-Wave Lithotripter

    NASA Astrophysics Data System (ADS)

    Frank, Spencer; Lautz, Jaclyn; Sankin, Georgy N.; Szeri, Andrew J.; Zhong, Pei

    2015-03-01

    It is hypothesized that the decreased treatment efficiency in contemporary shock-wave lithotripters is related to tensile wave attenuation due to cavitation in the prefocal beam path. Utilizing high-speed imaging of the beam path and focal pressure waveform measurements, tensile attenuation is associated with bubble proliferation. By systematically testing different combinations of pulse-repetition frequency and gas concentration, we modulate the bubble-dissolution time to identify which conditions lead to bubble proliferation and show that reducing bubble proliferation in the beam path significantly improves acoustic transmission and stone comminution efficiency in vitro. In addition to experiments, a bubble-proliferation model is developed that takes gas diffusion across the bubble wall and bubble fragmentation into account. By aligning the model with experimental observations, the number of daughter bubbles produced after a single lithotripter bubble collapse is estimated to be in the range of 253 ˜510 . This finding is on the same order of magnitude with previous measurements of an isolated bubble collapse in a lithotripter field by Pishchalnikov, McAteer, and Williams [BJU Int. 102, 1681 (2008), 10.1111/j.1464-410X.2008.07896.x], and this estimate improves the general understanding of lithotripsy bubble dynamics in the beam path.

  1. Calyceal diverticula: a comprehensive review.

    PubMed

    Waingankar, Nikhil; Hayek, Samih; Smith, Arthur D; Okeke, Zeph

    2014-01-01

    Calyceal diverticula are rare outpouchings of the upper collecting system that likely have a congenital origin. Stones can be found in up to 50% of calyceal diverticula, although, over the combined reported series, 96% of patients presented with stones. Diagnosis is best made by intravenous urography or computed tomography urogram. Shock wave lithotripsy (SWL) is an option for first-line therapy in patients with stone-bearing diverticula that have radiologically patent necks in mid- to upper-pole diverticula and small stone burdens. Stone-free rates are the lowest with SWL, although patients report being asymptomatic following therapy in up to 75% of cases with extended follow-up. Ureteroscopy (URS) is best suited for management of anteriorly located mid- to upperpole diverticular stones. Drawbacks to URS include difficulty in identifying the ostium and low rate of obliteration. Percutaneous management is best used in posteriorly located mid- to lower-pole stones, and offers the ability to directly ablate the diverticulum. Percutaneous nephrolithotomy remains effective in the management of upperpole diverticula, but carries the risk of pulmonary complications unless subcostal access strategies such as triangulation or renal displacement are used. Laparoscopic surgery provides definitive management, but should be reserved for cases with large stones in anteriorly located diverticula with thin overlying parenchyma, and cases that are refractory to other treatment. This article reviews the current theories on the pathogenesis of calyceal diverticula. The current classification is examined in addition to the current diagnostic methods. Here we summarize an extensive review of the literature on the outcomes of the different treatment approaches. PMID:24791153

  2. The change in upper tract urolithiasis composition, surgical treatments and outcomes of para and quadriplegic patients over time.

    PubMed

    Clifton, Marisa M; Gettman, Matthew T; Patterson, David E; Rangel, Laureano; Krambeck, Amy E

    2014-10-01

    Stone disease in patients with spinal cord injury is a source of morbidity and mortality. Previous studies have indicated a decrease in infection-based urolithiasis in recent decades. We aimed to identify changes in stone composition and surgical outcomes in patients with para and quadriplegia over time. A retrospective review of para and quadriplegic patients from 1986 to 2011 who underwent surgical intervention for urolithiasis was performed, identifying 95 patients. The Mantel-Haenszel Chi square test was used to compare change in stone composition over time. The mean patient age was 44.0 years (range 18-88) and treatment included percutaneous nephrolithotomy (PCNL) 40 (42.1 %), ureteroscopy 28 (29.5 %), shock wave lithotripsy (SWL) 26 (27.4 %), and nephrectomy 1 (1 %). Overall stone-free status was found in 47.4 % with 19.0 % requiring a repeat procedure. The median hospital stay for patients undergoing SWL was 2.5 days, ureteroscopy 5 days, and PCNL 6 days. Infection-based stone composition was identified in 23 patients (36.5 %). We evaluated the linear change in percent of each stone component over time and identified increasing components of calcium oxalate dihydrate (p = 0.002) and calcium carbonate (p = 0.009). However, over a period of 25 years, the incidence of infection-based stone did not change (p = 0.57). Para and quadriplegic patients with urolithiasis can be difficult to treat surgically with prolonged hospitalizations, low stone-free status, and often require additional procedures. Despite improvements in antibiotic agents and management of neurogenic bladders, infection-based calculi continue to be a significant source of morbidity to this patient population. PMID:25015593

  3. Calyceal Diverticula: A Comprehensive Review

    PubMed Central

    Waingankar, Nikhil; Hayek, Samih; Smith, Arthur D; Okeke, Zeph

    2014-01-01

    Calyceal diverticula are rare outpouchings of the upper collecting system that likely have a congenital origin. Stones can be found in up to 50% of calyceal diverticula, although, over the combined reported series, 96% of patients presented with stones. Diagnosis is best made by intravenous urography or computed tomography urogram. Shock wave lithotripsy (SWL) is an option for first-line therapy in patients with stone-bearing diverticula that have radiologically patent necks in mid- to upper-pole diverticula and small stone burdens. Stone-free rates are the lowest with SWL, although patients report being asymptomatic following therapy in up to 75% of cases with extended follow-up. Ureteroscopy (URS) is best suited for management of anteriorly located mid- to upperpole diverticular stones. Drawbacks to URS include difficulty in identifying the ostium and low rate of obliteration. Percutaneous management is best used in posteriorly located mid- to lower-pole stones, and offers the ability to directly ablate the diverticulum. Percutaneous nephrolithotomy remains effective in the management of upperpole diverticula, but carries the risk of pulmonary complications unless subcostal access strategies such as triangulation or renal displacement are used. Laparoscopic surgery provides definitive management, but should be reserved for cases with large stones in anteriorly located diverticula with thin overlying parenchyma, and cases that are refractory to other treatment. This article reviews the current theories on the pathogenesis of calyceal diverticula. The current classification is examined in addition to the current diagnostic methods. Here we summarize an extensive review of the literature on the outcomes of the different treatment approaches. PMID:24791153

  4. Phonons, Atoms, and Waves

    ERIC Educational Resources Information Center

    Reid, John S.

    1977-01-01

    Discussed are how the thermal vibrations of a solid are described in terms of lattice waves, how these waves interact with other waves, or with themselves, and how one is led from such a description in terms of waves to the concept of a phonon. (Author/MA)

  5. A Simple Wave Driver

    ERIC Educational Resources Information Center

    Temiz, Burak Kagan; Yavuz, Ahmet

    2015-01-01

    This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the…

  6. Financial Rogue Waves

    NASA Astrophysics Data System (ADS)

    Yan, Zhen-Ya

    2010-11-01

    We analytically give the financial rogue waves in the nonlinear option pricing model due to Ivancevic, which is nonlinear wave alternative of the Black—Scholes model. These rogue wave solutions may he used to describe the possible physical mechanisms for rogue wave phenomenon in financial markets and related fields.

  7. A Simple Wave Driver

    ERIC Educational Resources Information Center

    Temiz, Burak Kagan; Yavuz, Ahmet

    2015-01-01

    This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the…

  8. Plasma waves at Venus

    NASA Technical Reports Server (NTRS)

    Strangeway, R. J.

    1991-01-01

    Many significant wave phenomena have been discovered at Venus with the plasma wave instrument on the Pioneer Venus Orbiter. It has been shown that whistler-mode waves in the magnetosheath of the planet may be an important source of energy for the topside ionosphere. Plasma waves are also associated with thickening of the ionopause current layer. Current-generated waves in plasma clouds may also provide anomalous resistance resulting in electron acceleration, possibly producing aurora. Ion-acoustic waves are observed in the bow shock, and appear to be a feature of the magnetotail boundary. Lastly, plasma waves have been cited as evidence for lightning on Venus.

  9. Photoelectron wave function in photoionization: plane wave or Coulomb wave?

    PubMed

    Gozem, Samer; Gunina, Anastasia O; Ichino, Takatoshi; Osborn, David L; Stanton, John F; Krylov, Anna I

    2015-11-19

    The calculation of absolute total cross sections requires accurate wave functions of the photoelectron and of the initial and final states of the system. The essential information contained in the latter two can be condensed into a Dyson orbital. We employ correlated Dyson orbitals and test approximate treatments of the photoelectron wave function, that is, plane and Coulomb waves, by comparing computed and experimental photoionization and photodetachment spectra. We find that in anions, a plane wave treatment of the photoelectron provides a good description of photodetachment spectra. For photoionization of neutral atoms or molecules with one heavy atom, the photoelectron wave function must be treated as a Coulomb wave to account for the interaction of the photoelectron with the +1 charge of the ionized core. For larger molecules, the best agreement with experiment is often achieved by using a Coulomb wave with a partial (effective) charge smaller than unity. This likely derives from the fact that the effective charge at the centroid of the Dyson orbital, which serves as the origin of the spherical wave expansion, is smaller than the total charge of a polyatomic cation. The results suggest that accurate molecular photoionization cross sections can be computed with a modified central potential model that accounts for the nonspherical charge distribution of the core by adjusting the charge in the center of the expansion. PMID:26509428

  10. Cutting Head for Ultrasonic Lithotripsy

    NASA Technical Reports Server (NTRS)

    Angulo, Earl D. (Inventor); Goodfriend, Roger (Inventor)

    1989-01-01

    A cutting head for attachment to the end of the wire probe of an ultrasonic kidney stone disintegration instrument. The cutting head has a plurality of circumferentially arranged teeth formed at one end thereof to provide a cup-shaped receptacle for kidney stones encountered during the disintegration procedure. An integral reduced diameter collar diminishes stress points in the wire and reduces breakage thereof.

  11. Cutting Head for Ultrasonic Lithotripsy

    NASA Technical Reports Server (NTRS)

    Angulo, E. D.; Goodfriend, R.

    1987-01-01

    Kidney stones lodged in urinary tract disintegrated with increased safety and efficiency by cutting head attached to end of vibrated wire probe. Aligns probe with stone and enables probe to vibrate long enough to disintegrate stone. Design of cutting head reduces risk of metal-fatigue-induced breakage of probe tip leaving metal fragments in urinary tract. Teeth of cutting head both seat and fragment kidney stone, while extension of collar into catheter lessens mechanical strain in probe wire, increasing probe life and lessening danger of in situ probe breakage.

  12. PROPAGATING WAVES ALONG SPICULES

    SciTech Connect

    Okamoto, Takenori J.; De Pontieu, Bart

    2011-08-01

    Alfvenic waves are thought to play an important role in coronal heating and acceleration of solar wind. Here we investigate the statistical properties of Alfvenic waves along spicules (jets that protrude into the corona) in a polar coronal hole using high-cadence observations of the Solar Optical Telescope on board Hinode. We developed a technique for the automated detection of spicules and high-frequency waves. We detected 89 spicules and found (1) a mix of upward propagating, downward propagating, as well as standing waves (occurrence rates of 59%, 21%, and 20%, respectively); (2) the phase speed gradually increases with height; (3) upward waves dominant at lower altitudes, standing waves at higher altitudes; (4) standing waves dominant in the early and late phases of each spicule, while upward waves were dominant in the middle phase; (5) in some spicules, we find waves propagating upward (from the bottom) and downward (from the top) to form a standing wave in the middle of the spicule; and (6) the medians of the amplitude, period, and velocity amplitude were 55 km, 45 s, and 7.4 km s{sup -1}, respectively. We speculate that upward propagating waves are produced near the solar surface (below the spicule) and downward propagating waves are caused by reflection of (initially) upward propagating waves off the transition region at the spicule top. The mix of upward and downward propagating waves implies that exploiting these waves to perform seismology of the spicular environment requires careful analysis and may be problematic.

  13. Generalized viscoelastic wave equation

    NASA Astrophysics Data System (ADS)

    Wang, Yanghua

    2016-02-01

    This paper presents a generalized wave equation which unifies viscoelastic and pure elastic cases into a single wave equation. In the generalized wave equation, the degree of viscoelasticity varies between zero and unity, and is defined by a controlling parameter. When this viscoelastic controlling parameter equals to 0, the viscous property vanishes and the generalized wave equation becomes a pure elastic wave equation. When this viscoelastic controlling parameter equals to 1, it is the Stokes equation made up of a stack of pure elastic and Newtonian viscous models. Given this generalized wave equation, an analytical solution is derived explicitly in terms of the attenuation and the velocity dispersion. It is proved that, for any given value of the viscoelastic controlling parameter, the attenuation component of this generalized wave equation perfectly satisfies the power laws of frequency. Since the power laws are the fundamental characteristics in physical observations, this generalized wave equation can well represent seismic wave propagation through subsurface media.

  14. Global Coronal Waves

    NASA Astrophysics Data System (ADS)

    Chen, P. F.

    This paper uses "Extreme Ultraviolet (EUV) waves" for any kind of wavelike phenomena observed in EUV and 'Extreme Imaging Telescope (EIT) waves" for the phenomenon discovered by Thompson. The discovery and the ensuing interpretation of the globally propagating waves in the solar corona, that is, "EIT waves", are an excellent example to illustrate how complicated a propagating pattern would be. The chapter reviews the progress on this global coronal wave in the past 18 years. The authors argued that the faster wave corresponds to the coronal Moreton wave, therefore, it is of fast mode; the slower one corresponds to the diffuse "EIT wave" as discovered by Thompson. In principle, the authors might adjust the coronal magnetic field in order to make the derived velocity of the slower type of EUV wave best match the observation, and then consider the corresponding three-dimensional magnetic field to represent the real corona.

  15. ULF Waves at Mercury

    NASA Astrophysics Data System (ADS)

    Kim, E.-H.; Boardsen, S. A.; Johnson, J. R.; Slavin, J. A.

    This chapter provides a brief overview of the observed characteristics of ultra-low-frequency (ULF) waves at Mercury. It shows how field-aligned propagating ULF waves at Mercury can be generated by externally driven fast compressional waves (FWs) via mode conversion at the ion-ion hybrid resonance. Then, the chapter reviews the interpretation that the strong magnetic compressional waves near and its harmonics observed with 20 of Mercury's magnetic equator could be the ion Bernstein wave (IBW) mode. A recent statistical study of ULF waves at Mercury based on MESSENGER data reported the occurrence and polarization of the detected waves. The chapter further introduces the field line resonance and the electromagnetic ion Bernstein waves to explain such waves, and shows that both theories can partially explain the observations.

  16. Fracture channel waves

    SciTech Connect

    Nihei, K.T.; Yi, W.; Myer, L.R.; Cook, N.G.; Schoenberg, M.

    1999-03-01

    The properties of guided waves which propagate between two parallel fractures are examined. Plane wave analysis is used to obtain a dispersion equation for the velocities of fracture channel waves. Analysis of this equation demonstrates that parallel fractures form an elastic waveguide that supports two symmetric and two antisymmetric dispersive Rayleigh channel waves, each with particle motions and velocities that are sensitive to the normal and tangential stiffnesses of the fractures. These fracture channel waves degenerate to shear waves when the fracture stiffnesses are large, to Rayleigh waves and Rayleigh-Lamb plate waves when the fracture stiffnesses are low, and to fracture interface waves when the fractures are either very closely spaced or widely separated. For intermediate fracture stiffnesses typical of fractured rock masses, fracture channel waves are dispersive and exhibit moderate to strong localization of guided wave energy between the fractures. The existence of these waves is examined using laboratory acoustic measurements on a fractured marble plate. This experiment confirms the distinct particle motion of the fundamental antisymmetric fracture channel wave (A{sub 0} mode) and demonstrates the ease with which a fracture channel wave can be generated and detected. {copyright} 1999 American Geophysical Union

  17. Guided solitary waves

    PubMed Central

    Miles, John

    1980-01-01

    Transversely periodic solitary-wave solutions of the Boussinesq equations (which govern wave propagation in a weakly dispersive, weakly nonlinear physical system) are determined. The solutions for negative dispersion (e.g., gravity waves) are singular and therefore physically unacceptable. The solutions for positive dispersion (e.g., capillary waves or magnetosonic waves in a plasma) are physically acceptable except in a limited parametric interval, in which they are complex. The two end points of this interval are associated with (two different) resonant interactions among three basic solitary waves, two of which are two-dimensional complex conjugates and the third of which is one-dimensional and real. PMID:16592789

  18. Gravity wave transmission diagram

    NASA Astrophysics Data System (ADS)

    Tomikawa, Y.

    2015-12-01

    A new method of obtaining power spectral distribution of gravity waves as a function of ground-based horizontal phase speed and propagation direction from airglow observations has recently been proposed. To explain gravity wave power spectrum anisotropy, a new gravity wave transmission diagram was developed in this study. Gravity wave transmissivity depends on the existence of critical and turning levels for waves that are determined by background horizontal wind distributions. Gravity wave transmission diagrams for different horizontal wavelengths in simple background horizontal winds with constant vertical shear indicate that the effects of the turning level reflection are significant and strongly dependent on the horizontal wavelength.

  19. Gravity waves from thunderstorms

    NASA Technical Reports Server (NTRS)

    Balachandran, N. K.

    1980-01-01

    Gravity waves generated by severe thunderstorms in the eastern Ohio-Pennsylvania area were recorded by an array of microbarovariographs at Palisades, New York and by standard microbarographs across northeastern United States. The waves were associated with the cold mesohigh from the outflow of the thunderstorms. Along their path the waves apparently triggered new thunderstorms. The waves were observed to propagate with the velocity of the wind just below the tropopause. The long-distance propagation of the waves is explained by the presence of a dust associated with the critical level (steering level), in agreement with the derivations given by Lindzen and Tung (1976). The dust was directional and waves were absent to the west of the generating area. In the generating area wave-CISK might have been operating. Sharp vertical temperature gradients associated with the passage of the waves were observed by temperature sensors on a tower.

  20. Detonation Wave Profile

    SciTech Connect

    Menikoff, Ralph

    2015-12-14

    The Zel’dovich-von Neumann-Doering (ZND) profile of a detonation wave is derived. Two basic assumptions are required: i. An equation of state (EOS) for a partly burned explosive; P(V, e, λ). ii. A burn rate for the reaction progress variable; d/dt λ = R(V, e, λ). For a steady planar detonation wave the reactive flow PDEs can be reduced to ODEs. The detonation wave profile can be determined from an ODE plus algebraic equations for points on the partly burned detonation loci with a specified wave speed. Furthermore, for the CJ detonation speed the end of the reaction zone is sonic. A solution to the reactive flow equations can be constructed with a rarefaction wave following the detonation wave profile. This corresponds to an underdriven detonation wave, and the rarefaction is know as a Taylor wave.

  1. Wave Meteorology and Soaring

    NASA Technical Reports Server (NTRS)

    Wiley, Scott

    2008-01-01

    This viewgraph document reviews some mountain wave turbulence and operational hazards while soaring. Maps, photographs, and satellite images of the meteorological phenomena are included. Additionally, photographs of aircraft that sustained mountain wave damage are provided.

  2. Traveling Wave Demonstration.

    ERIC Educational Resources Information Center

    Kluger-Bell, Barry

    1995-01-01

    Describes a traveling-wave demonstration that uses inexpensive materials (crepe-paper streamers) and is simple to assemble and perform. Explains how the properties of light waves are illustrated using the demonstration apparatus. (LZ)

  3. Oceanic wave measurement system

    NASA Technical Reports Server (NTRS)

    Holmes, J. F.; Miles, R. T. (inventors)

    1980-01-01

    An oceanic wave measured system is disclosed wherein wave height is sensed by a barometer mounted on a buoy. The distance between the trough and crest of a wave is monitored by sequentially detecting positive and negative peaks of the output of the barometer and by combining (adding) each set of two successive half cycle peaks. The timing of this measurement is achieved by detecting the period of a half cycle of wave motion.

  4. Waves of Hanta

    NASA Astrophysics Data System (ADS)

    Abramson, Guillermo

    2003-03-01

    A spatially extended model of the hantavirus infection in deer mice is analyzed. Traveling waves solutions of the infected and susceptible populations are studied in different regimes, controlled by an environmental parameter. The wave of infection is shown to lag behind the wave of susceptible population, and the delay between the two is analyzed numerically and through a piecewise linearization.

  5. Paper terahertz wave plates.

    PubMed

    Scherger, Benedikt; Scheller, Maik; Vieweg, Nico; Cundiff, Steven T; Koch, Martin

    2011-12-01

    We present a low-cost terahertz wave plate based on form birefringence fabricated using ordinary paper. Measurements of the transfer function of the wave plate between polarizers closely agree with predictions based on the measured complex indices of refraction of the effective medium. For the design frequency, the dependence on wave plate angle also agrees with theory. PMID:22273881

  6. Wave turbulence in annular wave tank

    NASA Astrophysics Data System (ADS)

    Onorato, Miguel; Stramignoni, Ettore

    2014-05-01

    We perform experiments in an annular wind wave tank at the Dipartimento di Fisica, Universita' di Torino. The external diameter of the tank is 5 meters while the internal one is 1 meter. The tank is equipped by two air fans which can lead to a wind of maximum 5 m/s. The present set up is capable of studying the generation of waves and the development of wind wave spectra for large duration. We have performed different tests including different wind speeds. For large wind speed we observe the formation of spectra consistent with Kolmogorv-Zakharov predictions.

  7. Gravitational-wave astronomy.

    NASA Technical Reports Server (NTRS)

    Press, W. H.; Thorne, K. S.

    1972-01-01

    Discussion of the nature and origin of gravitational waves in the light of current theories and data, stating the concept of gravitational waves as a field of relative gravitational forces that propagate with the speed of light. The topics include the generation of gravitational waves, their astrophysical sources, pulsars, supernovae, the birth of neutron stars, explosions in quasars and nuclei of galaxies, and atomic and molecular processes. Also considered are gravitational wave reception techniques, covering free-mass antennas, nonmechanical displacement sensors, almost free antennas, mechanical displacement sensors, acoustic systems, resonant antennas, Weber's detectors, and natural antennas. Future developments in gravitational wave astronomy are considered.

  8. Fast wave current drive

    SciTech Connect

    Goree, J.; Ono, M.; Colestock, P.; Horton, R.; McNeill, D.; Park, H.

    1985-07-01

    Fast wave current drive is demonstrated in the Princeton ACT-I toroidal device. The fast Alfven wave, in the range of high ion-cyclotron harmonics, produced 40 A of current from 1 kW of rf power coupled into the plasma by fast wave loop antenna. This wave excites a steady current by damping on the energetic tail of the electron distribution function in the same way as lower-hybrid current drive, except that fast wave current drive is appropriate for higher plasma densities.

  9. Martian atmospheric lee waves

    NASA Technical Reports Server (NTRS)

    Pirraglia, J. A.

    1975-01-01

    Mariner 9 television pictures of Mars extensive mountain lee wave phenomenon in the northern mid-latitudes during winter were evaluated. The characteristic wave length of the lee waves is readily observable, and in a few cases the boundaries of the wave patterns, as well as the wave length, are observed. The cloud patterns resulting from the waves generated by the flow across a mountain or crater are shown to be dependent upon the velocity profile of the air stream and the vertical stability of the atmosphere. Using the stability as inferred by the temperature structure obtained from the infrared spectrometer data, a two layer velocity model of the air stream is used in calculations based on the theory of mountain lee waves. Results yield magnitudes generally in agreement with various other circulation models.

  10. Computational modelling of the interaction of shock waves with multiple gas-filled bubbles in a liquid

    NASA Astrophysics Data System (ADS)

    Betney, M. R.; Tully, B.; Hawker, N. A.; Ventikos, Y.

    2015-03-01

    This study presents a computational investigation of the interactions of a single shock wave with multiple gas-filled bubbles in a liquid medium. This work illustrates how multiple bubbles may be used in shock-bubble interactions to intensify the process on a local level. A high resolution front-tracking approach is used, which enables explicit tracking of the gas-liquid interface. The collapse of two identical bubbles, one placed behind the other is investigated in detail, demonstrating that peak pressures in a two bubble arrangement can exceed those seen in single bubble collapse. Additionally, a parametric investigation into the effect of bubble separation is presented. It is found that the separation distance has a significant effect on both the shape and velocity of the main transverse jet of the second bubble. Extending this analysis to effects of relative bubble size, we show that if the first bubble is sufficiently small relative to the second, it may become entirely entrained in the second bubble main transverse jet. In contrast, if the first bubble is substantially larger than the second, it may offer it significant protection from the incident shock. This protection is utilised in the study of a triangular array of three bubbles, with the central bubble being significantly smaller than the outer bubbles. It is demonstrated that, through shielding of bubbles until later in the collapse process, pressures over five times higher than the maximum pressure observed in the single bubble case may be achieved. This corresponds to a peak pressure that is approximately 40 times more intense than the incident shock wave. This work has applications in a number of different fields, including cavitation erosion, explosives, targeted drug delivery/intensification, and shock wave lithotripsy.

  11. Cycloidal Wave Energy Converter

    SciTech Connect

    Stefan G. Siegel, Ph.D.

    2012-11-30

    This program allowed further advancing the development of a novel type of wave energy converter, a Cycloidal Wave Energy Converter or CycWEC. A CycWEC consists of one or more hydrofoils rotating around a central shaft, and operates fully submerged beneath the water surface. It operates under feedback control sensing the incoming waves, and converts wave power to shaft power directly without any intermediate power take off system. Previous research consisting of numerical simulations and two dimensional small 1:300 scale wave flume experiments had indicated wave cancellation efficiencies beyond 95%. The present work was centered on construction and testing of a 1:10 scale model and conducting two testing campaigns in a three dimensional wave basin. These experiments allowed for the first time for direct measurement of electrical power generated as well as the interaction of the CycWEC in a three dimensional environment. The Atargis team successfully conducted two testing campaigns at the Texas A&M Offshore Technology Research Center and was able to demonstrate electricity generation. In addition, three dimensional wave diffraction results show the ability to achieve wave focusing, thus increasing the amount of wave power that can be extracted beyond what was expected from earlier two dimensional investigations. Numerical results showed wave cancellation efficiencies for irregular waves to be on par with results for regular waves over a wide range of wave lengths. Using the results from previous simulations and experiments a full scale prototype was designed and its performance in a North Atlantic wave climate of average 30kW/m of wave crest was estimated. A full scale WEC with a blade span of 150m will deliver a design power of 5MW at an estimated levelized cost of energy (LCOE) in the range of 10-17 US cents per kWh. Based on the new results achieved in the 1:10 scale experiments these estimates appear conservative and the likely performance at full scale will exceed this initial performance estimates. In advancing the Technology Readiness Level (TRL) of this type of wave energy converter from 3 to 4, we find the CycWEC to exceed our initial estimates in terms of hydrodynamic performance. Once fully developed and optimized, it has the potential to not just outperform all other WEC technologies, but to also deliver power at a lower LCOE than competing conventional renewables like wind and solar. Given the large wave power resource both domestically and internationally, this technology has the potential to lead to a large improvement in our ability to produce clean electricity at affordable cost.

  12. Water wave metamaterials

    NASA Astrophysics Data System (ADS)

    Petitjeans, Philippe; Palacios, Carmen; Maurel, Agnès; Pagneux, Vincent

    2012-11-01

    The phenomenon of water wave deviation in a bended wave-guide has been studied experimentally. We propose a theoretical analogy to electromagnetism, from which we derive the mathematical tools to design a water wave-deviator. To obtain the effect of metamaterial in the case of surface waves, one has to design a water-bed consisting of periodic layers of two different heights inclined with a specific angle with respect to the direction of propagation of waves. We designed and built (using rapid prototyping) deviators with progressively increasing angles of bending, and their homologue wave-guides with a flat bottom. The wave elevation was measured with good accuracy in time and in space by an optical method. Results show a good efficiency of the wave-deviator. The wavefront maintains its original inclination once the wave crosses the bend (in contrary to the wave-guide with a flat bottom), however departs from the predicted behavior as the wavefront advances. The analysis of harmonics shows a reduction of backwards reflection and a strong decrease in higher modes excitation after the bend. The results are optimistic and might open new possibilities; ultimately those regarding the cloaking of floating structures which could, in the future, be used for coastal protection.

  13. Trapped rossby waves

    PubMed

    Muller

    2000-02-01

    The possibility of tidal dynamics at strictly imaginary Lamb parameters has been known for more than three decades. The present paper explores the prevailing physics in this parameter regime. To this end, basic features of the global circulation such as baroclinicity and geostrophy have to be incorporated into tidal dynamics. The tidal equations of the thermal wind are readily obtained in the framework of spherical bishallow water theory. Density surfaces of a circulation with available potential energy alter the spatial inhomogenities of the generic tidal problem. Wave dynamics in an inhomogeneous medium are characterized not only by a dispersion relation but also by a wave guide geography: significant wave amplitudes are trapped in specific regions of frequency-dependent width. As an inherently global issue, evaluation of the Rossby wave guide geography for a given circulation cannot rely on the familiar regional filters of tidal theory. On the global domain, the Rossby wave specification is given by the Margules filter. A thermal wind is stable against nondivergent Rossby wave disturbances. Rossby waves propagating with a geostrophic wind are governed by prolate dynamics (real Lamb parameters) while imaginary Lamb parameters emerge for the oblate dynamics of Rossby waves running against a geostrophic wind. Oblate Rossby wave dynamics include pole-centered wave guides and very low-frequency disturbances propagating eastward against a westward wind. PMID:11046427

  14. A reduced-order, single-bubble cavitation model with applications to therapeutic ultrasound

    PubMed Central

    Kreider, Wayne; Crum, Lawrence A.; Bailey, Michael R.; Sapozhnikov, Oleg A.

    2011-01-01

    Cavitation often occurs in therapeutic applications of medical ultrasound such as shock-wave lithotripsy (SWL) and high-intensity focused ultrasound (HIFU). Because cavitation bubbles can affect an intended treatment, it is important to understand the dynamics of bubbles in this context. The relevant context includes very high acoustic pressures and frequencies as well as elevated temperatures. Relative to much of the prior research on cavitation and bubble dynamics, such conditions are unique. To address the relevant physics, a reduced-order model of a single, spherical bubble is proposed that incorporates phase change at the liquid-gas interface as well as heat and mass transport in both phases. Based on the energy lost during the inertial collapse and rebound of a millimeter-sized bubble, experimental observations were used to tune and test model predictions. In addition, benchmarks from the published literature were used to assess various aspects of model performance. Benchmark comparisons demonstrate that the model captures the basic physics of phase change and diffusive transport, while it is quantitatively sensitive to specific model assumptions and implementation details. Given its performance and numerical stability, the model can be used to explore bubble behaviors across a broad parameter space relevant to therapeutic ultrasound. PMID:22088026

  15. A model for damage of microheterogeneous kidney stones

    NASA Astrophysics Data System (ADS)

    Szeri, Andrew J.; Zohdi, Tarek I.; Blake, John R.

    2005-04-01

    In this paper, a theoretical framework is developed for the mechanics of kidney stones with an isotropic, random microstructure-such as those comprised of cystine or struvite. The approach is based on a micromechanical description of kidney stones comprised of crystals in a binding matrix. Stress concentration functions are developed to determine load sharing of the particle phase and the binding matrix phase. As an illustration of the theory, the fatigue of kidney stones subject to shock wave lithotripsy is considered. Stress concentration functions are used to construct fatigue life estimates for each phase, as a function of the volume fraction and of the mechanical properties of the constituents, as well as the loading from SWL. The failure of the binding matrix is determined explicitly in a model for the accumulation of distributed damage. Also considered is the amount of material damaged in a representative non-spherical collapse of a cavitation bubble near the stone surface. The theory can be used to assess the importance of microscale heterogeneity on the comminution of renal calculi and to estimate the number of cycles to failure in terms of measurable material properties.

  16. Waves in Space Plasmas

    SciTech Connect

    Kim, Eun-Hwa; Johnson, Jay R.; Cairns, Iver H.; Lee, Dong-Hun

    2009-11-26

    Applications of linear mode conversion at Alfven/ion-ion hybrid resonances and at electron plasma frequency have been discussed. Alfven resonances play an important role on energy transport the outer to inner regions of magnetospheres. At Earth's magnetopause, the mode-converted kinetic Alfven waves also lead to solar wind particle entry and transverse ion heating. IIH resonant waves can explain of the generation of linearly polarized EMIC waves at Earth. Compressional waves can also interact with Mercury's magnetosphere exciting IIH resonances as global eigenmodes. Linear mode conversion (LMC) from Langmuir to electromagnetic waves is relevant to explain type II and III radio bursts. Through the LMC, both right- and left-hand polarized wave modes are produced and it provides the solutions for linear/partial polarized type II and III problems.

  17. RADIATION WAVE DETECTION

    DOEpatents

    Wouters, L.F.

    1960-08-30

    Radiation waves can be detected by simultaneously measuring radiation- wave intensities at a plurality of space-distributed points and producing therefrom a plot of the wave intensity as a function of time. To this end. a detector system is provided which includes a plurality of nuclear radiation intensity detectors spaced at equal radial increments of distance from a source of nuclear radiation. Means are provided to simultaneously sensitize the detectors at the instant a wave of radiation traverses their positions. the detectors producing electrical pulses indicative of wave intensity. The system further includes means for delaying the pulses from the detectors by amounts proportional to the distance of the detectors from the source to provide an indication of radiation-wave intensity as a function of time.

  18. Power from water waves

    NASA Astrophysics Data System (ADS)

    Evans, D. V.

    A review is presented of wave-energy devices and hydrodynamic properties of idealized equipment for extracting power from waves. The governing equations involve the fluid hydrodynamic theory applied to machines with zero forward speed which can absorb energy from the neighboring wave field. A mixture of waves of different amplitudes, periods, wavelengths, and directions with randomly distributed phases coexist at a given time; a mathematical model of the sea surface assumes it to be an infinite superposition of wave trains of various amplitudes and frequencies. A theory was developed for the oscillation of two-dimensional energy-absorbing cylindrical sections which can be utilized for estimating hydrodynamic characteristics of fully three-dimensional ship hulls. Finally, three-dimensional wave-energy absorbers are represented by expressions in terms of the force amplitude, direction of motion, and the damping coefficient.

  19. Waves in Space Plasmas

    NASA Astrophysics Data System (ADS)

    Kim, Eun-Hwa; Johnson, Jay R.; Cairns, Iver H.; Lee, Dong-Hun

    2009-11-01

    Applications of linear mode conversion at Alfven/ion-ion hybrid resonances and at electron plasma frequency have been discussed. Alfven resonances play an important role on energy transport the outer to inner regions of magnetospheres. At Earth's magnetopause, the mode-converted kinetic Alfven waves also lead to solar wind particle entry and transverse ion heating. IIH resonant waves can explain of the generation of linearly polarized EMIC waves at Earth. Compressional waves can also interact with Mercury's magnetosphere exciting IIH resonances as global eigenmodes. Linear mode conversion (LMC) from Langmuir to electromagnetic waves is relevant to explain type II and III radio bursts. Through the LMC, both right- and left-hand polarized wave modes are produced and it provides the solutions for linear/partial polarized type II and III problems.

  20. "Hearing" Electromagnetic Waves

    NASA Astrophysics Data System (ADS)

    Rojo, Marta; Muñoz, Juan

    2014-12-01

    In this work, an educational experience is described in which a microwave communication link is used to make students aware that all electromagnetic waves have the same physical nature and properties. Experimental demonstrations are linked to theoretical concepts to increase comprehension of the physical principles underlying electromagnetic waves. Moreover, students learn about the importance and historical development of communication systems, the basic principles of communication links, and the procedure to send information through an electromagnetic wave.1,2

  1. Cloaking of Matter Waves

    SciTech Connect

    Zhang Shuang; Genov, Dentcho A.; Sun Cheng; Zhang Xiang

    2008-03-28

    Invariant transformation for quantum mechanical systems is proposed. A cloaking of matter wave can be realized at given energy by designing the potential and effective mass of the matter waves in the cloaking region. The general conditions required for such a cloaking are determined and confirmed by both the wave and particle (classical) approaches. We show that it may be possible to construct such a cloaking system for cold atoms using optical lattices.

  2. Hysteresis of ionization waves

    SciTech Connect

    Dinklage, A.; Bruhn, B.; Testrich, H.; Wilke, C.

    2008-06-15

    A quasi-logistic, nonlinear model for ionization wave modes is introduced. Modes are due to finite size of the discharge and current feedback. The model consists of competing coupled modes and it incorporates spatial wave amplitude saturation. The hysteresis of wave mode transitions under current variation is reproduced. Sidebands are predicted by the model and found in experimental data. The ad hoc model is equivalent to a general--so-called universal--approach from bifurcation theory.

  3. Nonlinear Internal Waves Generation

    NASA Astrophysics Data System (ADS)

    Kanarska, Y.; McWilliams, J. C.; Shchepetkin, A.

    2006-12-01

    We present several studies of the generation of internal waves to explain the occurrence and properties of nonlinear waves in the South China Sea region. According to the fundamental work of Bell (1975), for linear generation of internal waves over topography (height h and length L) in medium with buoyancy frequency N by oscillatory flow with frequency ω 0 and amplitude U, two limiting case are possible: (a) a slowly varying version of lee waves in a steady stratified fluid if ω 0 / N → 0 (or some times replaced on more general condition U / ω 0 L >>1); (b) wave beams with wave slope √{{ω_02}-f2} / √ {N2 - ω 0 2} if U / ω 0 L → 0. Liner theory requires that wave slope be greater than topographic slope for both limits (i.e., subcritical topography). In realistic conditions of nonuniform stratification and finite depth the definition of characteristic regimes is more problematic e.g. ω 0 / N < < 0 in the pycnocline and, at the same time, U / ω 0 L is small. Moreover, in the case of finite depth topography (e.g. for the Luzon strait (h/H~ 0.9)) and a supercritical slope the generation of internal waves by the barotropic tide can be characterized by nonlinear processes such as flow separation, hydraulic jumps, and associated mixing that affect the bottom drag, wave generation and energy conversion and dissipation. We systematically study the impact of these nonlinearities on the wave field structure for mentioned conditions using idealized Gaussian ridge configuration and non-hydrostatic numerical model. Finally, the generation of tidal internal waves is investigated in a realistic regional configuration for the South China Sea, where the Kuroshio and other subtidal currents affect the generation and propagation of internal waves.

  4. Reverse Quantum Waves

    NASA Astrophysics Data System (ADS)

    Boyd, Jeffrey

    2010-02-01

    As preposterous as it might sound, if quantum waves travel in the reverse direction from subatomic particles, then most of quantum physics can be explained without quantum weirdness or Schr"odinger's cat. Quantum mathematics is unchanged. The diffraction pattern on the screen of the double slit experiment is the same. This proposal is not refuted by the Innsbruck experiments; this is NOT a hidden local variable theory. Research evidence will be presented that is consistent with the idea waves travel in the opposite direction as neutrons. If one's thinking shifts from forwards to backwards quantum waves, the world changes so drastically it is almost unimaginable. Quantum waves move from the mathematical to the real world, multiply in number, and reverse in direction. Wave-particle duality is undone. In the double slit experiment every part of the target screen is emitting such quantum waves in all directions. Some pass through the two slits. Interference occurs on the opposite side of the barrier than is usually imagined. They impinge on ``S'' and an electron is released at random. Because of the interference it is more likely to follow some waves than others. It follows one and only one wave backward; hitting the screen where it's wave originated. )

  5. Nondispersing wave packets

    SciTech Connect

    Maeda, H.; Gallagher, T. F.

    2007-03-15

    A nondispersing Rydberg wave packet can be made by applying a weak, linearly polarized field at the Kepler frequency of a Rydberg atom. The field phase locks the electron's motion to the microwave field, and the wave packet retains its spatial localization for times in excess of a microsecond. The electron's orbital oscillation leads to an oscillating dipole, which can either oscillate in phase or out of phase with the applied microwave field, creating wave packets analogous to Trojan and anti-Trojan wave packets described theoretically. Our observations can be described in both quantum mechanical and classical terms.

  6. Caustics of atmospheric waves

    NASA Astrophysics Data System (ADS)

    Godin, Oleg A.

    2015-04-01

    Much like light and sound, acoustic-gravity waves in inhomogeneous atmosphere often have a caustic or caustics, where the ray theory predicts unphysical, divergent values of the wave amplitude and needs to be modified. Increase of the wave magnitude in the vicinity of a caustic makes such vicinities of primary interest in a number of problems, where a signal needs to be separated from a background noise. The value of wave focusing near caustics should be carefully quantified in order to evaluate possible nonlinearities promoted by the focusing. Physical understanding of the wave field in the vicinity of a caustic is also important for understanding of the wave reflection from and transmission (tunneling) through the caustic. To our knowledge, in contrast to caustics of acoustic, electromagnetic, and seismic waves as well as gravity waves in incompressible fluids, asymptotics of acoustic-gravity waves in the vicinity of a caustic have never been studied systematically. In this paper, we fill this gap. Atmospheric waves are considered as linear acoustic-gravity waves in a neutral, horizontally stratified, moving ideal gas of variable composition. Air temperature and wind velocity are assumed to be gradually varying functions of height, and slowness of these variations determines the large parameter of the problem. The scale height of the atmosphere can be large or small compared to the vertical wavelength. It is found that the uniform asymptotics of the wave field in the presence of a simple caustic can be expressed in terms of the Airy function and its derivative. As for the acoustic waves, the argument of the Airy function is expressed in terms of the eikonal calculated in the ray, or WKB, approximation. The geometrical, or Berry, phase, which arises in the consistent WKB approximation for acoustic-gravity waves, plays an important role in the caustic asymptotics. In the uniform asymptotics, the terms with the Airy function and its derivative are weighted by cosine and sine of the Berry phase, respectively. Explicit expressions are found for the amplitude factors in the dominant term of the uniform asymptotics. The amplitude factors can be expressed in terms of the Berry phase and the divergent wave amplitudes, which are found in the first WKB approximation, but remain finite at the caustic and in its vicinity. The uniform asymptotic expansion of acoustic-gravity waves in the presence of a caustic reduces to known results in the acoustic limit. Physical meaning and corollaries of the newly derived caustic asymptotics will be discussed.

  7. Thermal-Wave Microscope

    NASA Technical Reports Server (NTRS)

    Jones, Robert E.; Kramarchuk, Ihor; Williams, Wallace D.; Pouch, John J.; Gilbert, Percy

    1989-01-01

    Computer-controlled thermal-wave microscope developed to investigate III-V compound semiconductor devices and materials. Is nondestructive technique providing information on subsurface thermal features of solid samples. Furthermore, because this is subsurface technique, three-dimensional imaging also possible. Microscope uses intensity-modulated electron beam of modified scanning electron microscope to generate thermal waves in sample. Acoustic waves generated by thermal waves received by transducer and processed in computer to form images displayed on video display of microscope or recorded on magnetic disk.

  8. Extracorporeal shock waves stimulate frog sciatic nerves indirectly via a cavitation-mediated mechanism.

    PubMed Central

    Schelling, G.; Delius, M.; Gschwender, M.; Grafe, P.; Gambihler, S.

    1994-01-01

    Shock waves (SWs) are single pressure pulses with amplitudes up to over 100 MPa, a rise time of only a few nanoseconds, and a short duration of approximately 2 microseconds. Their clinical application for stone destruction causes pain, indicating nerve stimulation by SWs. To examine this phenomenon, sciatic nerves of frogs were exposed to SWs in an organ bath. The SWs were generated with an experimental Dornier lithotripter model XL1 at an operating voltage of 15 kV. The nerves were mounted in a chamber which allowed electrical nerve stimulation and the registration of electrically and SW-induced compound action potentials (SWCAPs). The chamber was filled with frog Ringer's solution. In a standardized protocol. The first experiment established that 95.0 +/- 4.7% of administered SWs induced action potentials which were lower in amplitude (1.45 +/- 1.14 versus 1.95 +/- 0.95 mV, p = 0.004) but similar in shape to electrically induced compound action potentials. In a second experiment, it was shown that the site of origin of the SWCAPs could be correctly determined by simultaneous recording of action potentials at both ends of the nerve. The mechanism of shock wave stimulation was examined by experiments 3 and 4. In experiment 3, in contrast to the previous experiments, SW exposure of the nerves was performed 6 cm outside the shock wave focus. This resulted in a mean probability of inducing a SWCAP of only 4%. After gas bubble administration, this probability increased to 86% for the first SW released immediately after bubble application and declined to 56% for the second, 21% for the third, to 0 for the 10th SW after fluid injection. This indicates that cavitation, the interaction between shock waves and gas bubbles in fluid or tissues, was involved in SWCAP generation. In experiment 4, nerves were again exposed in the focus, however, the Ringer's solution surrounding the nerve was replaced by polyvinyl alcohol (PVA). PVA is a solution with low cavitation activity.In PVA, the excitability was markedly diminished to 11.0 +/- 5.1% compared with 96.0 +/- 4.4% in control nerves exposed in Ringer's solution. In conclusion, bioeffects of SWs on nervous tissue appear to result from cavitation. It is suggested that cavitation is also the underlying mechanism of SW-related pain during extracorporeal SW lithotripsy in clinical medicine. Images FIGURE 1 PMID:8130332

  9. Stream breakup by waves

    NASA Astrophysics Data System (ADS)

    Samuelsen, G. S.; Ateshkadi, Arash

    1995-04-01

    An imaging technique is used to investigate the fluid dynamics associated with the breakup of a liquid jet by a passing transverse shock wave. This mechanism is believed to be a potential source of combustion instability in liquid propellant rocket engines. Combustion instability is caused by the release of heat in phase with a passing pressure disturbance. The jet/wave interaction causes rapid atomization and propellant redistribution, and enhances mixing, vaporization, and reaction rates. Knowledge of the breakup process aids in prediction of local heat release with respect to the passing wave and provides insight on its viability as a potential instability mechanism. The present shock tube study applies high-speed, high-resolution photography to explore the jet/wave interaction that might be experienced in a large scale liquid oxygen/hydrogen (LOX/H2) engine similar to the Space Shuttle Main Engine (SSME) or other such engines being considered for the next generation of launch systems. Fluid parameters deemed important were simulated as well as possible. Two types of wave induced breakup were examined: a constant velocity flow field (square wave) and an exponentially decaying velocity field (N-wave). Time resolved images of the jet/wave interaction indicate very rapid and fire atomization within 500 microns of impingement. Shock interaction with the primary atomization process produces a substantial change to the breakup mechanism and serves as a principal candidate for the promotion and acceleration of rocket engine instability. Results of the qualitative and quantitative study reveal that the step wave produces a long duration tangential and normal stress on the liquid column as compared to the N-wave. As a result, N-waves decelerate jet displacement and extend the jet breakup time.

  10. Oceanic-wave-measurement system

    NASA Technical Reports Server (NTRS)

    Holmes, J. F.; Miles, R. T.

    1980-01-01

    Barometer mounted on bouy senses wave heights. As wave motion raises and lowers barometer, pressure differential is proportional to wave height. Monitoring circuit samples barometer output every half cycle of wave motion and adds magnitudes of adjacent positive and negative peaks. Resulting output signals, proportional to wave height, are transmitted to central monitoring station.

  11. Attosecond Shock Waves

    NASA Astrophysics Data System (ADS)

    Zhokhov, P. A.; Zheltikov, A. M.

    2013-05-01

    Shock-wave formation is a generic scenario of wave dynamics known in nonlinear acoustics, fluid dynamics, astrophysics, seismology, and detonation physics. Here, we show that, in nonlinear optics, remarkably short, attosecond shock transients can be generated through a strongly coupled spatial and temporal dynamics of ultrashort light pulses, suggesting a pulse self-compression scenario whereby multigigawatt attosecond optical waveforms can be synthesized.

  12. The Relativistic Wave Vector

    ERIC Educational Resources Information Center

    Houlrik, Jens Madsen

    2009-01-01

    The Lorentz transformation applies directly to the kinematics of moving particles viewed as geometric points. Wave propagation, on the other hand, involves moving planes which are extended objects defined by simultaneity. By treating a plane wave as a geometric object moving at the phase velocity, novel results are obtained that illustrate the…

  13. Wave action generator

    SciTech Connect

    Trepl, J.A.

    1983-04-05

    A wave motion motor is disclosed with an impeller moved by a float. The float is coupled to a swivel arrangement to turn in the direction of wave current and has an inclined underside. Also disclosed are means to adjust to tide level and triangular coupling means between the float and a flywheel.

  14. The Relativistic Wave Vector

    ERIC Educational Resources Information Center

    Houlrik, Jens Madsen

    2009-01-01

    The Lorentz transformation applies directly to the kinematics of moving particles viewed as geometric points. Wave propagation, on the other hand, involves moving planes which are extended objects defined by simultaneity. By treating a plane wave as a geometric object moving at the phase velocity, novel results are obtained that illustrate the…

  15. Thermal-Wave Imaging.

    ERIC Educational Resources Information Center

    Rosencwaig, Allan

    1982-01-01

    Thermal features of and beneath the surface of a sample can be detected and imaged with a thermal-wave microscope. Various methodologies for the excitation and detection of thermal waves are discussed, and several applications, primarily in microelectronics, are presented. (Author)

  16. Power from Ocean Waves.

    ERIC Educational Resources Information Center

    Newman, J. N.

    1979-01-01

    Discussed is the utilization of surface ocean waves as a potential source of power. Simple and large-scale wave power devices and conversion systems are described. Alternative utilizations, environmental impacts, and future prospects of this alternative energy source are detailed. (BT)

  17. Spin Wave Directional Coupler

    NASA Astrophysics Data System (ADS)

    Nanayakkara, Kasuni; Kozhanov, Alexander

    2015-03-01

    Spin wave based logic devices are evolved as promising candidates for information processing due to potential in scaling and low power consumption. An element performing directional energy transfer between spin waveguides is required in order to implement existing proposed spin wave logic devices. Optical waveguide couplers are well studied and widely utilized in integrated and fiber optics applications. In this work we apply the concept of optical directional coupler to design and investigate the spin wave directional coupler comprised of the two ferromagnetic stripes separated by a nanometer scale air gap. Micromagnetic simulations and experimental spin wave energy transfer investigations using propagating spin wave spectroscopy were carried out. Spin waves are generated at one of the ends of the input waveguide while detected at remaining three ends of both spin waveguides. Spin wave coupling is investigated as the coupler geometry, biasing magnetic field amplitude and orientation and the spin wavelength are varied. Results are modeled as coupled backward volume magnetostatic spin wave modes. This work was supported in part by Georgia State University.

  18. Phononic plate waves.

    PubMed

    Wu, Tsung-Tsong; Hsu, Jin-Chen; Sun, Jia-Hong

    2011-10-01

    In the past two decades, phononic crystals (PCs) which consist of periodically arranged media have attracted considerable interest because of the existence of complete frequency band gaps and maneuverable band structures. Recently, Lamb waves in thin plates with PC structures have started to receive increasing attention for their potential applications in filters, resonators, and waveguides. This paper presents a review of recent works related to phononic plate waves which have recently been published by the authors and coworkers. Theoretical and experimental studies of Lamb waves in 2-D PC plate structures are covered. On the theoretical side, analyses of Lamb waves in 2-D PC plates using the plane wave expansion (PWE) method, finite-difference time-domain (FDTD) method, and finite-element (FE) method are addressed. These methods were applied to study the complete band gaps of Lamb waves, characteristics of the propagating and localized wave modes, and behavior of anomalous refraction, called negative refraction, in the PC plates. The theoretical analyses demonstrated the effects of PC-based negative refraction, lens, waveguides, and resonant cavities. We also discuss the influences of geometrical parameters on the guiding and resonance efficiency and on the frequencies of waveguide and cavity modes. On the experimental side, the design and fabrication of a silicon-based Lamb wave resonator which utilizes PC plates as reflective gratings to form the resonant cavity are discussed. The measured results showed significant improvement of the insertion losses and quality factors of the resonators when the PCs were applied. PMID:21989878

  19. Advanced Gravitational Wave Detectors

    NASA Astrophysics Data System (ADS)

    Blair, D. G.; Howell, E. J.; Ju, L.; Zhao, C.

    2012-02-01

    Part I. An Introduction to Gravitational Wave Astronomy and Detectors: 1. Gravitational waves D. G. Blair, L. Ju, C. Zhao and E. J. Howell; 2. Sources of gravitational waves D. G. Blair and E. J. Howell; 3. Gravitational wave detectors D. G. Blair, L. Ju, C. Zhao, H. Miao, E. J. Howell, and P. Barriga; 4. Gravitational wave data analysis B. S. Sathyaprakash and B. F. Schutz; 5. Network analysis L. Wen and B. F. Schutz; Part II. Current Laser Interferometer Detectors: Three Case Studies: 6. The Laser Interferometer Gravitational-Wave Observatory P. Fritschel; 7. The VIRGO detector S. Braccini; 8. GEO 600 H. Lück and H. Grote; Part III. Technology for Advanced Gravitational Wave Detectors: 9. Lasers for high optical power interferometers B. Willke and M. Frede; 10. Thermal noise, suspensions and test masses L. Ju, G. Harry and B. Lee; 11. Vibration isolation: Part 1. Seismic isolation for advanced LIGO B. Lantz; Part 2. Passive isolation J-C. Dumas; 12. Interferometer sensing and control P. Barriga; 13. Stabilizing interferometers against high optical power effects C. Zhao, L. Ju, S. Gras and D. G. Blair; Part IV. Technology for Third Generation Gravitational Wave Detectors: 14. Cryogenic interferometers J. Degallaix; 15. Quantum theory of laser-interferometer GW detectors H. Miao and Y. Chen; 16. ET. A third generation observatory M. Punturo and H. Lück; Index.

  20. Those Elusive Gravitational Waves

    ERIC Educational Resources Information Center

    MOSAIC, 1976

    1976-01-01

    The presence of gravitational waves was predicted by Einstein in his theory of General Relativity. Since then, scientists have been attempting to develop a detector sensitive enough to measure these cosmic signals. Once the presence of gravitational waves is confirmed, scientists can directly study star interiors, galaxy cores, or quasars. (MA)

  1. SQUARE WAVE AMPLIFIER

    DOEpatents

    Leavitt, M.A.; Lutz, I.C.

    1958-08-01

    An amplifier circuit is described for amplifying sigmals having an alternating current component superimposed upon a direct current component, without loss of any segnnent of the alternating current component. The general circuit arrangement includes a vibrator, two square wave amplifiers, and recombination means. The amplifier input is connected to the vibrating element of the vibrator and is thereby alternately applied to the input of each square wave amplifier. The detailed circuitry of the recombination means constitutes the novelty of the annplifier and consists of a separate, dual triode amplifier coupled to the output of each square wave amplifier with a recombination connection from the plate of one amplifier section to a grid of one section of the other amplifier. The recombination circuit has provisions for correcting distortion caused by overlapping of the two square wave voltages from the square wave amplifiers.

  2. Vector financial rogue waves

    NASA Astrophysics Data System (ADS)

    Yan, Zhenya

    2011-11-01

    The coupled nonlinear volatility and option pricing model presented recently by Ivancevic is investigated, which generates a leverage effect, i.e., stock volatility is (negatively) correlated to stock returns, and can be regarded as a coupled nonlinear wave alternative of the Black-Scholes option pricing model. In this Letter, we analytically propose vector financial rogue waves of the coupled nonlinear volatility and option pricing model without an embedded w-learning. Moreover, we exhibit their dynamical behaviors for chosen different parameters. The vector financial rogue wave (rogon) solutions may be used to describe the possible physical mechanisms for the rogue wave phenomena and to further excite the possibility of relative researches and potential applications of vector rogue waves in the financial markets and other related fields.

  3. Spin-Wave Diode

    NASA Astrophysics Data System (ADS)

    Lan, Jin; Yu, Weichao; Wu, Ruqian; Xiao, Jiang

    2015-10-01

    A diode, a device allowing unidirectional signal transmission, is a fundamental element of logic structures, and it lies at the heart of modern information systems. The spin wave or magnon, representing a collective quasiparticle excitation of the magnetic order in magnetic materials, is a promising candidate for an information carrier for the next-generation energy-saving technologies. Here, we propose a scalable and reprogrammable pure spin-wave logic hardware architecture using domain walls and surface anisotropy stripes as waveguides on a single magnetic wafer. We demonstrate theoretically the design principle of the simplest logic component, a spin-wave diode, utilizing the chiral bound states in a magnetic domain wall with a Dzyaloshinskii-Moriya interaction, and confirm its performance through micromagnetic simulations. Our findings open a new vista for realizing different types of pure spin-wave logic components and finally achieving an energy-efficient and hardware-reprogrammable spin-wave computer.

  4. Holographic tunneling wave function

    NASA Astrophysics Data System (ADS)

    Conti, Gabriele; Hertog, Thomas; van der Woerd, Ellen

    2015-12-01

    The Hartle-Hawking wave function in cosmology can be viewed as a decaying wave function with anti-de Sitter (AdS) boundary conditions. We show that the growing wave function in AdS familiar from Euclidean AdS/CFT is equivalent, semiclassically and up to surface terms, to the tunneling wave function in cosmology. The cosmological measure in the tunneling state is given by the partition function of certain relevant deformations of CFTs on a locally AdS boundary. We compute the partition function of finite constant mass deformations of the O( N ) vector model on the round three sphere and show this qualitatively reproduces the behaviour of the tunneling wave function in Einstein gravity coupled to a positive cosmological constant and a massive scalar. We find the amplitudes of inhomogeneities are not damped in the holographic tunneling state.

  5. Sculpting Waves (Presentation Recording)

    NASA Astrophysics Data System (ADS)

    Engheta, Nader

    2015-09-01

    In electronics controlling and manipulating flow of charged carriers has led to design of numerous functional devices. In photonics, by analogy, this is done through controlling photons and optical waves. However, the challenges and opportunities are different in these two fields. Materials control waves, and as such they can tailor, manipulate, redirect, and scatter electromagnetic waves and photons at will. Recent development in condensed matter physics, nanoscience, and nanotechnology has made it possible to tailor materials with unusual parameters and extreme characteristics and with atomic precision and thickness. One can now construct structures much smaller than the wavelengths of visible light, thus ushering in unprecedented possibilities and novel opportunities for molding fields and waves at the nanoscale with desired functionalities. At such subwavelength scales, sculpting optical fields and waves provides a fertile ground for innovation and discovery. I will discuss some of the exciting opportunities in this area, and forecast some future directions and possibilities.

  6. Electromagnetic wave energy converter

    NASA Technical Reports Server (NTRS)

    Bailey, R. L. (Inventor)

    1973-01-01

    Electromagnetic wave energy is converted into electric power with an array of mutually insulated electromagnetic wave absorber elements each responsive to an electric field component of the wave as it impinges thereon. Each element includes a portion tapered in the direction of wave propagation to provide a relatively wideband response spectrum. Each element includes an output for deriving a voltage replica of the electric field variations intercepted by it. Adjacent elements are positioned relative to each other so that an electric field subsists between adjacent elements in response to the impinging wave. The electric field results in a voltage difference between adjacent elements that is fed to a rectifier to derive dc output power.

  7. Project GlobWave

    NASA Astrophysics Data System (ADS)

    Busswell, Geoff; Ash, Ellis; Piolle, Jean-Francois; Poulter, David J. S.; Snaith, Helen; Collard, Fabrice; Sheera, Harjit; Pinnock, Simon

    2010-12-01

    The ESA GlobWave project is a three year initiative, funded by ESA and CNES, to service the needs of satellite wave product users across the globe. Led by Logica UK, with support from CLS, IFREMER, SatOC and NOCS, the project will provide free access to satellite wave data and products in a common format, both historical and in near real time, from various European and American SAR and altimeter missions. Building on the successes of similar projects for Sea Surface Temperature and ocean colour, the project aims to stimulate increased use and analysis of satellite wave products. In addition to common-format satellite data the project will provide comparisons with in situ measurements, interactive data analysis tools and a pilot spatial wave forecast verification scheme for operational forecast production centres. The project will begin operations in January 2010, with direction from regular structured user consultation.

  8. Observations of freak waves in random wave field in 2D experimental wave flume

    NASA Astrophysics Data System (ADS)

    Li, Jin-xuan; Li, Peng-fei; Liu, Shu-xue

    2013-10-01

    Long time series of wave field are experimentally simulated by JONSWAP spectra with random phases in a 2D wave flume. Statistic properties of wave surface, such as significant wave height, skewness and kurtosis, are analyzed, and the freak wave occurrence probability and its relations with Benjamin-Feir index (BFI) are also investigated. The results show that the skewness and the kurtosis are significantly dependent on the wave steepness, and the kurtosis increases along the flume when BFI is large. The freak waves are observed in random wave groups. They occur more frequently than expected, especially for the wave groups with large BFI.

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

    PubMed Central

    Notarnicola, Angela; Moretti, Biagio

    2012-01-01

    Summary 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. PMID:23738271

  10. Secondary dust density waves excited by nonlinear dust acoustic waves

    SciTech Connect

    Heinrich, J. R.; Kim, S.-H.; Meyer, J. K.; Merlino, R. L.; Rosenberg, M.

    2012-08-15

    Secondary dust density waves were observed in conjunction with high amplitude (n{sub d}/n{sub d0}>2) dust acoustic waves (DAW) that were spontaneously excited in a dc glow discharge dusty plasma in the moderately coupled, {Gamma}{approx}1, state. The high amplitude dust acoustic waves produced large dust particle oscillations, displacements, and trapping. Secondary dust density waves were excited in the wave troughs of the high amplitude DAWs. The waveforms, amplitudes, wavelengths, and wave speeds of the primary DAWs and the secondary waves were measured. A dust-dust streaming instability is discussed as a possible mechanism for the production of the secondary waves.

  11. Periodic Wave, Solitary Wave and Compacton Solutions of a Nonlinear Wave Equation with Degenerate Dispersion

    NASA Astrophysics Data System (ADS)

    Zhu, Wen-Jing; Chen, Ai-Yong; Liu, Qi-Huai

    2015-01-01

    In this letter, we investigate traveling wave solutions of a nonlinear wave equation with degenerate dispersion. The phase portraits of corresponding traveling wave system are given under different parametric conditions. Some periodic wave and smooth solitary wave solutions of the equation are obtained. Moreover, we find some new hyperbolic function compactons instead of well-known trigonometric function compactons by analyzing nilpotent points.

  12. Undamped electrostatic plasma waves

    SciTech Connect

    Valentini, F.; Perrone, D.; Veltri, P.; Califano, F.; Pegoraro, F.; Morrison, P. J.; O'Neil, T. M.

    2012-09-15

    Electrostatic waves in a collision-free unmagnetized plasma of electrons with fixed ions are investigated for electron equilibrium velocity distribution functions that deviate slightly from Maxwellian. Of interest are undamped waves that are the small amplitude limit of nonlinear excitations, such as electron acoustic waves (EAWs). A deviation consisting of a small plateau, a region with zero velocity derivative over a width that is a very small fraction of the electron thermal speed, is shown to give rise to new undamped modes, which here are named corner modes. The presence of the plateau turns off Landau damping and allows oscillations with phase speeds within the plateau. These undamped waves are obtained in a wide region of the (k,{omega}{sub R}) plane ({omega}{sub R} being the real part of the wave frequency and k the wavenumber), away from the well-known 'thumb curve' for Langmuir waves and EAWs based on the Maxwellian. Results of nonlinear Vlasov-Poisson simulations that corroborate the existence of these modes are described. It is also shown that deviations caused by fattening the tail of the distribution shift roots off of the thumb curve toward lower k-values and chopping the tail shifts them toward higher k-values. In addition, a rule of thumb is obtained for assessing how the existence of a plateau shifts roots off of the thumb curve. Suggestions are made for interpreting experimental observations of electrostatic waves, such as recent ones in nonneutral plasmas.

  13. Jovian Planetary Waves

    NASA Astrophysics Data System (ADS)

    Harrington, Joseph

    1997-07-01

    The detection of slowly-moving, wave-like features in infrared {IR} observations of Jupiter {by us and others} has generated excitement. If these features are Rossby waves, they may probe the atmosphere down to the boundary with the planetary interior. Rossby waves cause zonal flows to oscillate about their characteristic latitude. We will search for such undulations in all available HST images of Jupiter's atmosphere, applying the automated searching techniques already successful in our infrared work. The amplitude of meridional oscillations would be 2,000 km, or 0decarcsec6 as seen from Earth. Detecting oscillations consistent with the wavenumbers and phases seen in IR data will establish that these features are indeed Rossby waves. Wave speeds, dispersion relations, longevity, vertical extent, and population statistics will all constrain models of planetary atmospheres, which have direct application to terrestrial meteorology. If, as we suspect, the waves have a large vertical extent, they may reflect the boundary conditions between the troposphere and planetary interior. Planetary interior modeling predicts convection organized into ``banana- cells'', which extend from pole to pole but are constrained in longitude. The number of cells strongly constrains the convection and is of interest to interior modelers. Detecting similar waves in both visible and IR data that maintain speed and wavenumber over a large range of latitudes would constitute a major step forward in measuring the conditions in the planetary interior.

  14. Wave action power plant

    SciTech Connect

    Lucia, L.V.

    1982-03-16

    A wave action power plant powered by the action of water waves has a drive shaft rotated by a plurality of drive units, each having a lever pivotally mounted on and extending from said shaft and carrying a weight, in the form of a float, which floats on the waves and rocks the lever up and down on the shaft. A ratchet mechanism causes said shaft to be rotated in one direction by the weight of said float after it has been raised by wave and the wave has passed, leaving said float free to move downwardly by gravity and apply its full weight to pull down on the lever and rotate the drive shaft. There being a large number of said drive units so that there are always some of the weights pulling down on their respective levers while other weights are being lifted by waves and thereby causing continuous rotation of the drive shaft in one direction. The said levers are so mounted that they may be easily raised to bring the weights into a position wherein they are readily accessible for cleaning the bottoms thereof to remove any accumulation of barnacles, mollusks and the like. There is also provided means for preventing the weights from colliding with each other as they independently move up and down on the waves.

  15. Wave-wave interactions in solar type III radio bursts

    SciTech Connect

    Thejappa, G.; MacDowall, R. J.

    2014-02-11

    The high time resolution observations from the STEREO/WAVES experiment show that in type III radio bursts, the Langmuir waves often occur as localized magnetic field aligned coherent wave packets with durations of a few ms and with peak intensities well exceeding the strong turbulence thresholds. Some of these wave packets show spectral signatures of beam-resonant Langmuir waves, down- and up-shifted sidebands, and ion sound waves, with frequencies, wave numbers, and tricoherences satisfying the resonance conditions of the oscillating two stream instability (four wave interaction). The spectra of a few of these wave packets also contain peaks at f{sub pe}, 2f{sub pe} and 3 f{sub pe} (f{sub pe} is the electron plasma frequency), with frequencies, wave numbers and bicoherences (computed using the wavelet based bispectral analysis techniques) satisfying the resonance conditions of three wave interactions: (1) excitation of second harmonic electromagnetic waves as a result of coalescence of two oppositely propagating Langmuir waves, and (2) excitation of third harmonic electromagnetic waves as a result of coalescence of Langmuir waves with second harmonic electromagnetic waves. The implication of these findings is that the strong turbulence processes play major roles in beam stabilization as well as conversion of Langmuir waves into escaping radiation in type III radio bursts.

  16. The pendulum wave machine

    NASA Astrophysics Data System (ADS)

    Zetie, K. P.

    2015-05-01

    There are many examples on the internet of videos of ‘pendulum wave machines’ and how to make them (for example, www.instructables.com/id/Wave-Pendulum/). The machine is simply a set of pendula of different lengths which, when viewed end on, produce wave-like patterns from the positions of the bobs. These patterns change with time, with new patterns emerging as the bobs change phase. In this article, the physics of the machine is explored and explained, along with tips on how to build such a device.

  17. Demonstration of Shear Waves, Lamb Waves, and Rayleigh Waves by Mode Conversion.

    ERIC Educational Resources Information Center

    Leung, W. P.

    1980-01-01

    Introduces an experiment that can be demonstrated in the classroom to show that shear waves, Rayleigh waves, and Lamb waves can be easily generated and observed by means of mode conversion. (Author/CS)

  18. Lattice Waves, Spin Waves, and Neutron Scattering

    DOE R&D Accomplishments Database

    Brockhouse, Bertram N.

    1962-03-01

    Use of neutron inelastic scattering to study the forces between atoms in solids is treated. One-phonon processes and lattice vibrations are discussed, and experiments that verified the existence of the quantum of lattice vibrations, the phonon, are reviewed. Dispersion curves, phonon frequencies and absorption, and models for dispersion calculations are discussed. Experiments on the crystal dynamics of metals are examined. Dispersion curves are presented and analyzed; theory of lattice dynamics is considered; effects of Fermi surfaces on dispersion curves; electron-phonon interactions, electronic structure influence on lattice vibrations, and phonon lifetimes are explored. The dispersion relation of spin waves in crystals and experiments in which dispersion curves for spin waves in Co-Fe alloy and magnons in magnetite were obtained and the reality of the magnon was demonstrated are discussed. (D.C.W)

  19. Perfect Surface Wave Cloaks

    NASA Astrophysics Data System (ADS)

    Mitchell-Thomas, R. C.; McManus, T. M.; Quevedo-Teruel, O.; Horsley, S. A. R.; Hao, Y.

    2013-11-01

    This Letter presents a method for making an uneven surface behave as a flat surface. This allows an object to be concealed (cloaked) under an uneven portion of the surface, without disturbing the wave propagation on the surface. The cloaks proposed in this Letter achieve perfect cloaking that only relies upon isotropic radially dependent refractive index profiles, contrary to those previously published. In addition, these cloaks are very thin, just a fraction of a wavelength in thickness, yet can conceal electrically large objects. While this paper focuses on cloaking electromagnetic surface waves, the theory is also valid for other types of surface waves. The performance of these cloaks is simulated using dielectric filled waveguide geometries, and the curvature of the surface is shown to be rendered invisible, hiding any object positioned underneath. Finally, a transformation of the required dielectric slab permittivity was performed for surface wave propagation, demonstrating the practical applicability of this technique.

  20. Traveling-wave photodetector

    DOEpatents

    Hietala, V.M.; Vawter, G.A.

    1993-12-14

    The traveling-wave photodetector of the present invention combines an absorptive optical waveguide and an electrical transmission line, in which optical absorption in the waveguide results in a photocurrent at the electrodes of the electrical transmission line. The optical waveguide and electrical transmission line of the electrically distributed traveling-wave photodetector are designed to achieve matched velocities between the light in the optical waveguide and electrical signal generated on the transmission line. This velocity synchronization provides the traveling-wave photodetector with a large electrical bandwidth and a high quantum efficiency, because of the effective extended volume for optical absorption. The traveling-wave photodetector also provides large power dissipation, because of its large physical size. 4 figures.

  1. Traveling-wave photodetector

    DOEpatents

    Hietala, Vincent M. (Placitas, NM); Vawter, Gregory A. (Albuquerque, NM)

    1993-01-01

    The traveling-wave photodetector of the present invention combines an absorptive optical waveguide and an electrical transmission line, in which optical absorption in the waveguide results in a photocurrent at the electrodes of the electrical transmission line. The optical waveguide and electrical transmission line of the electrically distributed traveling-wave photodetector are designed to achieve matched velocities between the light in the optical waveguide and electrical signal generated on the transmission line. This velocity synchronization provides the traveling-wave photodetector with a large electrical bandwidth and a high quantum efficiency, because of the effective extended volume for optical absorption. The traveling-wave photodetector also provides large power dissipation, because of its large physical size.

  2. Traveling-wave photodetector

    SciTech Connect

    Hietala, V.M.; Vawter, G.A.

    1992-12-31

    The traveling-wave photodetector of the present invention combines an absorptive optical waveguide and an electrical transmission line, in which optical absorption in the waveguide results in a photocurrent at the electrodes of the electrical transmission line. The optical waveguide and electrical transmission line of the electrically distributed traveling-wave photodetector are designed to achieve matched velocities between the light in the optical waveguide and electrical signal generated on the transmission line. This velocity synchronization provides the traveling-wave photodetector with a large electrical bandwidth and a high quantum efficiency, because of the effective extended volume for optical absorption. The traveling-wave photodetector also provides large power dissipation, because of its large physical size.

  3. Coupled wedge waves.

    PubMed

    Abell, Bradley C; Pyrak-Nolte, Laura J

    2013-11-01

    The interface between two wedges can be treated as a displacement discontinuity characterized by elastic stiffnesses. By representing the boundary between the two quarter-spaces as a displacement discontinuity, coupled wedge waves were determined theoretically to be dispersive and to depend on the specific stiffness of the non-welded contact between the two wedges. Laboratory experiments on isotropic and anisotropic aluminum confirmed the theoretical prediction that the velocity of coupled wedge waves, for a non-welded interface, ranged continuously from the single wedge wave velocity at low stress to the Rayleigh velocity as the load applied normal to the interface was increased. Elastic waves propagating along the coupled wedges of two quarter-spaces in non-welded contact are found to exist theoretically even when the material properties of the two quarter-spaces are the same. PMID:24180766

  4. Heat Wave Safety Checklist

    MedlinePLUS

    ... heat has caused more deaths than all other weather events, including floods. A heat wave is a ... care for heat- related emergencies … ❏ Listen to local weather forecasts and stay aware of upcoming temperature changes. ❏ ...

  5. Nonspreading Wave Packets.

    ERIC Educational Resources Information Center

    Berry, M. V.; Balazs, N. L.

    1979-01-01

    Explains properties of the Airy packet that show that quantum wave functions correspond to a family of orbits and not to a single particle. Introducing the Airy packet into elementary quantum mechanics courses is recommended. (HM)

  6. Perfect surface wave cloaks.

    PubMed

    Mitchell-Thomas, R C; McManus, T M; Quevedo-Teruel, O; Horsley, S A R; Hao, Y

    2013-11-22

    This Letter presents a method for making an uneven surface behave as a flat surface. This allows an object to be concealed (cloaked) under an uneven portion of the surface, without disturbing the wave propagation on the surface. The cloaks proposed in this Letter achieve perfect cloaking that only relies upon isotropic radially dependent refractive index profiles, contrary to those previously published. In addition, these cloaks are very thin, just a fraction of a wavelength in thickness, yet can conceal electrically large objects. While this paper focuses on cloaking electromagnetic surface waves, the theory is also valid for other types of surface waves. The performance of these cloaks is simulated using dielectric filled waveguide geometries, and the curvature of the surface is shown to be rendered invisible, hiding any object positioned underneath. Finally, a transformation of the required dielectric slab permittivity was performed for surface wave propagation, demonstrating the practical applicability of this technique. PMID:24313489

  7. Cold waves in Serbia

    NASA Astrophysics Data System (ADS)

    Unkasevic, Miroslava; Tosic, Ivana

    2013-04-01

    Climate extreme indices allow the assessment of changes in extreme climate events. The cold Spell Duration Indice (CSDI), from which the duration and severity of the cold waves are estimated, was applied to the seasonal series of the daily minimum temperatures at 15 meteorological stations in Serbia during the period 1949 to 2012. An analysis of the daily minimum temperatures during the winter season revealed that the longest (up to 20-22 days) and most severe cold waves were recorded in 1954, 1956, 1963 and 1983. In the transient seasons, the cooling episodes were observed in 1983 and 1988 (autumn season) and in 1987 (spring season) followed with a great reduction in duration and severity of cold waves. During the summer season, only in 1962, the longest (from 6 to 8 days) and most intense cold wave was registered almost over the whole territory of Serbia.

  8. Inventing the Wave Catchers.

    ERIC Educational Resources Information Center

    Fisher, Arthur

    1983-01-01

    Physicists and engineers advance the state of several arts in the design of gravitational-wave detection equipment. Provides background information and discusses the equipment (including laser interferometer), its use, and results of several experimental studies. (JN)

  9. Sound wave transmission (image)

    MedlinePLUS

    When sounds waves reach the ear, they are translated into nerve impulses. These impulses then travel to the brain where they are interpreted by the brain as sound. The hearing mechanisms within the inner ear, can ...

  10. WindWaveFloat

    SciTech Connect

    Weinstein, Alla

    2011-11-01

    Presentation from the 2011 Water Peer Review includes in which principal investigator Alla Weinstein discusses project progress in development of a floating offshore wind structure - the WindFloat - and incorporation therin of a Spherical Wave Energy Device.

  11. Dark- and bright-rogue-wave solutions for media with long-wave-short-wave resonance.

    PubMed

    Chen, Shihua; Grelu, Philippe; Soto-Crespo, J M

    2014-01-01

    Exact explicit rogue-wave solutions of intricate structures are presented for the long-wave-short-wave resonance equation. These vector parametric solutions feature coupled dark- and bright-field counterparts of the Peregrine soliton. Numerical simulations show the robustness of dark and bright rogue waves in spite of the onset of modulational instability. Dark fields originate from the complex interplay between anomalous dispersion and the nonlinearity driven by the coupled long wave. This unusual mechanism, not available in scalar nonlinear wave equation models, can provide a route to the experimental realization of dark rogue waves in, for instance, negative index media or with capillary-gravity waves. PMID:24580164

  12. Generating gravity waves with matter and electromagnetic waves

    SciTech Connect

    Barrabes, C.; Hogan, P A.

    2008-05-15

    If a homogeneous plane lightlike shell collides head on with a homogeneous plane electromagnetic shock wave having a step-function profile then no backscattered gravitational waves are produced. We demonstrate, by explicit calculation, that if the matter is accompanied by a homogeneous plane electromagnetic shock wave with a step-function profile then backscattered gravitational waves appear after the collision.

  13. Measurement of high frequency waves using a wave follower

    NASA Technical Reports Server (NTRS)

    Tang, S.; Shemdin, O. H.

    1983-01-01

    High frequency waves were measured using a laser-optical sensor mounted on a wave follower. Measured down-wind wave slope spectra are shown to be wind speed dependent; the mean square wave-slopes are generally larger than those measured by Cox and Munk (1954) using the sun glitter method.

  14. Wave Separation, Wave Intensity, the Reservoir-Wave Concept, and the Instantaneous Wave-Free Ratio: Presumptions and Principles.

    PubMed

    Westerhof, Nico; Segers, Patrick; Westerhof, Berend E

    2015-07-01

    Wave separation analysis and wave intensity analysis (WIA) use (aortic) pressure and flow to separate them in their forward and backward (reflected) waves. While wave separation analysis uses measured pressure and flow, WIA uses their derivatives. Because differentiation emphasizes rapid changes, WIA suppresses slow (diastolic) fluctuations of the waves and renders diastole a seemingly wave-free period. However, integration of the WIA-obtained forward and backward waves is equal to the wave separation analysis-obtained waves. Both the methods thus give similar results including backward waves spanning systole and diastole. Nevertheless, this seemingly wave-free period in diastole formed the basis of both the reservoir-wave concept and the Instantaneous wave-Free Ratio of (iFR) pressure and flow. The reservoir-wave concept introduces a reservoir pressure, Pres, (Frank Windkessel) as a wave-less phenomenon. Because this Windkessel model falls short in systole an excess pressure, Pexc, is introduced, which is assumed to have wave properties. The reservoir-wave concept, however, is internally inconsistent. The presumed wave-less Pres equals twice the backward pressure wave and travels, arriving later in the distal aorta. Hence, in contrast, Pexc is minimally affected by wave reflections. Taken together, Pres seems to behave as a wave, rather than Pexc. The iFR is also not without flaws, as easily demonstrated when applied to the aorta. The ratio of diastolic aortic pressure and flow implies division by zero giving nonsensical results. In conclusion, presumptions based on WIA have led to misconceptions that violate physical principles, and reservoir-wave concept and iFR should be abandoned. PMID:26015448

  15. Wave Propagation Program

    Energy Science and Technology Software Center (ESTSC)

    2007-01-08

    WPP is a massively parallel, 3D, C++, finite-difference elastodynamic wave propagation code. Typical applications for wave propagation with WPP include: evaluation of seismic event scenarios and damage from earthquakes, non-destructive evaluation of materials, underground facility detection, oil and gas exploration, predicting the electro-magnetic fields in accelerators, and acoustic noise generation. For more information, see User’s Manual [1].

  16. Edge wave visualization

    NASA Technical Reports Server (NTRS)

    Dominek, Allen K.; Nguyen, Truong X.

    1991-01-01

    Scattering mechanisms that involve edge waves are addressed. The behavior of edge waves and their interaction with flat, perfectly conducting plates are depicted in the time domain through a visualization of surface currents that flow on the surface, as an incident Gaussian pulse of energy washes over the surface. Viewing these surface currents allows a very clear physical interpretation and appreciation of the scattering process.

  17. Imploding conical shock waves

    NASA Astrophysics Data System (ADS)

    Paton, R. T.; Skews, B. W.; Rubidge, S.; Snow, J.

    2013-07-01

    The behaviour of conical shock waves imploding axisymmetrically was first studied numerically by Hornung (J Fluid Mech 409:1-12, 2000) and this prompted a limited experimental investigation into these complex flow patterns by Skews et al. (Shock Waves 11:323-326, 2002). Modification of the simulation boundary conditions, resulting in the loss of self-similarity, was necessary to image the flow experimentally. The current tests examine the temporal evolution of these flows utilising a converging conical gap of fixed width fed by a shock wave impinging at its entrance, supported by CFD simulations. The effects of gap thickness, angle and incident shock strength were investigated. The wave initially diffracts around the outer lip of the gap shedding a vortex which, for strong incident shock cases, can contain embedded shocks. The converging shock at exit reflects on the axis of symmetry with the reflected wave propagating outwards resulting in a triple point developing on the incident wave together with the associated shear layer. This axisymmetric shear layer rolls up into a mushroom-shaped toroidal vortex ring and forward-facing jet. For strong shocks, this deforms the Mach disk to the extent of forming a second triple point with the primary shock exhibiting a double bulge. Separate features resembling the Richtmeyer-Meshkov and Kelvin-Helmholtz instabilities were noted in some tests. Aside from the incident wave curvature, the reflection patterns demonstrated correspond well with the V- and DV-types identified by Hornung although type S was not clearly seen, possibly due to the occlusion of the reflection region by the outer diffraction vortex at these early times. Some additional computational work explicitly exploring the limits of the parameter space for such systems has demonstrated the existence of a possible further reflection type, called vN-type, which is similar to the von Neumann reflection for plane waves. It is recommended that the parameter space be more thoroughly explored experimentally.

  18. Wave Propagation Program

    SciTech Connect

    2007-01-08

    WPP is a massively parallel, 3D, C++, finite-difference elastodynamic wave propagation code. Typical applications for wave propagation with WPP include: evaluation of seismic event scenarios and damage from earthquakes, non-destructive evaluation of materials, underground facility detection, oil and gas exploration, predicting the electro-magnetic fields in accelerators, and acoustic noise generation. For more information, see User?s Manual [1].

  19. Attosecond shock waves.

    PubMed

    Zhokhov, P A; Zheltikov, A M

    2013-05-01

    Shock-wave formation is a generic scenario of wave dynamics known in nonlinear acoustics, fluid dynamics, astrophysics, seismology, and detonation physics. Here, we show that, in nonlinear optics, remarkably short, attosecond shock transients can be generated through a strongly coupled spatial and temporal dynamics of ultrashort light pulses, suggesting a pulse self-compression scenario whereby multigigawatt attosecond optical waveforms can be synthesized. PMID:23683197

  20. Sound Waves Levitate Substrates

    NASA Technical Reports Server (NTRS)

    Lee, M. C.; Wang, T. G.

    1982-01-01

    System recently tested uses acoustic waves to levitate liquid drops, millimeter-sized glass microballoons, and other objects for coating by vapor deposition or capillary attraction. Cylindrical contactless coating/handling facility employs a cylindrical acoustic focusing radiator and a tapered reflector to generate a specially-shaped standing wave pattern. Article to be processed is captured by the acoustic force field under the reflector and moves as reflector is moved to different work stations.

  1. Continuous wave nanowire lasing.

    PubMed

    Röder, Robert; Wille, Marcel; Geburt, Sebastian; Rensberg, Jura; Zhang, Mengyao; Lu, Jia Grace; Capasso, Federico; Buschlinger, Robert; Peschel, Ulf; Ronning, Carsten

    2013-08-14

    Tin-doped cadmium sulfide nanowires reveal donor-acceptor pair transitions at low-temperature photoluminescence and furthermore exhibit ideal resonator morphology appropriate for lasing at continuous wave pumping. The continuous wave lasing mode is proven by the evolution of the emitted power and spectrum with increasing pump intensity. The high temperature stability up to 120 K at given pumping power is determined by the decreasing optical gain necessary for lasing in an electron-hole plasma. PMID:23862660

  2. The wave of the future - Searching for gravity waves

    SciTech Connect

    Goldsmith, D.

    1991-04-01

    Research on gravity waves conducted by such scientists as Gamov, Wheeler, Weber and Zel'dovich is discussed. Particular attention is given to current trends in the theoretical analysis of gravity waves carried out by theorists Kip Thorne and Leonid Grishchuk. The problems discussed include the search for gravity waves; calculation of the types of gravity waves; the possibility of detecting gravity waves from localized sources, e.g., from the collision of two black holes in a distant galaxy or the collapse of a star, through the Laser Interferometer Gravitational Wave Observatory; and detection primordial gravity waves from the big bang.

  3. Traveling-Wave Tubes

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.

    1998-01-01

    The traveling-wave tube (TWT) is a vacuum device invented in the early 1940's used for amplification at microwave frequencies. Amplification is attained by surrendering kinetic energy from an electron beam to a radio frequency (RF) electromagnetic wave. The demand for vacuum devices has been decreased largely by the advent of solid-state devices. However, although solid state devices have replaced vacuum devices in many areas, there are still many applications such as radar, electronic countermeasures and satellite communications, that require operating characteristics such as high power (Watts to Megawatts), high frequency (below 1 GHz to over 100 GHz) and large bandwidth that only vacuum devices can provide. Vacuum devices are also deemed irreplaceable in the music industry where musicians treasure their tube-based amplifiers claiming that the solid-state and digital counterparts could never provide the same "warmth" (3). The term traveling-wave tube includes both fast-wave and slow-wave devices. This article will concentrate on slow-wave devices as the vast majority of TWTs in operation fall into this category.

  4. A simple wave driver

    NASA Astrophysics Data System (ADS)

    Kağan Temiz, Burak; Yavuz, Ahmet

    2015-08-01

    This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the wheel starts to turn at a constant angular speed. A rod that is fixed on the wheel turns at the same constant angular speed, too. A tight string that the wave will be created on is placed at a distance where the rod can touch the string. During each rotation of the wheel, the rod vibrates the string up and down. The vibration frequency of this rod equals the wheel’s rotation frequency, and this frequency value can be measured easily with a small magnet and a bicycle speedometer. In this way, the frequency of the waves formed in the rope can also be measured.

  5. Ocean wave electric generators

    SciTech Connect

    Rosenberg, H.R.

    1986-02-04

    This patent describes an apparatus for generating electricity from ocean waves. It consists of: 1.) a hollow buoyant duck positioned in the path of waves including a core about the center axis of which the duck rotates, a lower chamber portion having liquid therein and an upper chamber portion having air therein. The air is alternately compressed and expanded by the liquid in the chamber during the rotational motion of the duck caused by waves. A turbine mounted in the upper portion of the duck is driven by the compressed and expanded air. A generator is coupled to the turbine and operated to produce electrical energy and an air bulb; 2.) a spine having a transverse axial shaft anchoring the spine to the ocean floor. The upper portion of the spine engages the duck to maintain the duck in position. The spine has a curved configuration to concentrate and direct wave energy. The spine configuration acts as a scoop to increase the height of wave peaks and as a foil to increase the depth of wave troughs.

  6. Lamb wave diffraction tomography

    NASA Astrophysics Data System (ADS)

    Malyarenko, Eugene Valentinovich

    As the worldwide aviation fleet continues to age, methods for accurately predicting the presence of structural flaws, such as hidden corrosion and disbonds, that compromise air worthiness become increasingly necessary. Ultrasonic guided waves, Lamb waves, allow large sections of aircraft structures to be rapidly inspected. However, extracting quantitative information from Lamb wave data has always involved highly trained personnel with a detailed knowledge of mechanical waveguide physics. In addition, human inspection process tends to be highly subjective, slow and prone to errors. The only practical alternative to traditional inspection routine is a software expert system capable of interpreting data with minimum error and maximum speed and reliability. Such a system would use the laws of guided wave propagation and material parameters to help signal processing algorithms automatically extract information from digitized waveforms. This work discusses several practical approaches to building such an expert system. The next step in the inspection process is data interpretation, and imaging is the most natural way to represent two-dimensional structures. Unlike conventional ultrasonic C-scan imaging that requires access to the whole inspected area, tomographic algorithms work with data collected over the perimeter of the sample. Combined with the ability of Lamb waves to travel over large distances, tomography becomes the method of choice for solving NDE problems. This work explores different tomographic reconstruction techniques to graphically represent the Lamb wave data in quantitative maps that can be easily interpreted by technicians. Because the velocity of Lamb waves depends on the thickness, the traveltimes of the fundamental modes can be converted into a thickness map of the inspected region. Lamb waves cannot penetrate through holes and other strongly scattering defects and the assumption of straight wave paths, essential for many tomographic algorithms, fails. Diffraction tomography is a way to incorporate scattering effects into tomographic algorithms in order to improve image quality and resolution. This work describes the iterative reconstruction procedure developed for the Lamb Wave tomography and allowing for ray bending correction for imaging of moderately scattering objects.

  7. Kinetic Alfvén waves in aurora.

    NASA Astrophysics Data System (ADS)

    Wang, Deyu

    1996-06-01

    On the basis of the differences between ideal MHD Alfvén waves and kinetic Alfvén waves, the nonlinear kinetic Alfvén wave with Poisson equation correction and the evolution of kinetic wave have been presented. These results have been used to explain the observation data from Freja satellite and CRIT II rocket in aurora.

  8. Near Shore Wave Modeling and applications to wave energy estimation

    NASA Astrophysics Data System (ADS)

    Zodiatis, G.; Galanis, G.; Hayes, D.; Nikolaidis, A.; Kalogeri, C.; Adam, A.; Kallos, G.; Georgiou, G.

    2012-04-01

    The estimation of the wave energy potential at the European coastline is receiving increased attention the last years as a result of the adaptation of novel policies in the energy market, the concernsfor global warming and the nuclear energy security problems. Within this framework, numerical wave modeling systems keep a primary role in the accurate description of wave climate and microclimate that is a prerequisite for any wave energy assessment study. In the present work two of the most popular wave models are used for the estimation of the wave parameters at the coastline of Cyprus: The latest parallel version of the wave model WAM (ECMWF version), which employs new parameterization of shallow water effects, and the SWAN model, classically used for near shore wave simulations. The results obtained from the wave models near shores are studied by an energy estimation point of view: The wave parameters that mainly affect the energy temporal and spatial distribution, that is the significant wave height and the mean wave period, are statistically analyzed,focusing onpossible different aspects captured by the two models. Moreover, the wave spectrum distribution prevailing in different areas are discussed contributing, in this way, to the wave energy assessmentin the area. This work is a part of two European projects focusing on the estimation of the wave energy distribution around Europe: The MARINA platform (http://www.marina-platform.info/ index.aspx) and the Ewave (http://www.oceanography.ucy.ac.cy/ewave/) projects.

  9. Various Boussinesq solitary wave solutions

    SciTech Connect

    Yates, G.T.

    1995-12-31

    The generalized Boussinesq (gB) equations have been used to model nonlinear wave evolution over variable topography and wave interactions with structures. Like the KdV equation, the gB equations support a solitary wave solution which propagates without changing shape, and this solitary wave is often used as a primary test case for numerical studies of nonlinear waves using either the gB or other model equations. Nine different approximate solutions of the generalized Boussinesq equations are presented with simple closed form expressions for the wave elevation and wave speed. Each approximates the free propagation of a single solitary wave, and eight of these solutions are newly obtained. The author compares these solutions with the well known KdV solution, Rayleigh`s solution, Laitone`s higher order solution, and ``exact`` numerical integration of the gB equations. Existing experimental data on solitary wave shape and wave speed are compared with these models.

  10. Waves Within Magnetic Clouds

    NASA Astrophysics Data System (ADS)

    Siu Tapia, A. L.; Blanco-Cano, X.; Kajdic, P.; Aguilar-Rodriguez, E.; Russell, C. T.; Jian, L. K.; Luhmann, J. G.

    2013-05-01

    Complex events are formed by two or more large-scale structures which interact in the solar wind. Typical cases are interactions of: (i) a magnetic cloud/interplanetary coronal mass ejection (MC/ICME) with another MC/ICME transient; (ii) a MC/ICME embedded within a stream interaction region (SIR); and (iii) a MC/ICME followed by a fast stream. Using data from the STEREO mission during the years 2007-2011 we found 17 ICMEs forming complex events with an associated shock wave. All the ICMEs included in this study showed a smooth rotation of the magnetic field and low proton beta plasma, and were classified as MCs. We use magnetic field and plasma data to study the waves observed within these MCs. To determine wave characteristics we perform Power Spectra and Minimum Variance Analysis. We also analyze 10 MCs driving shocks which were not associated with complex events. We compare wave characteristics within the Magnetic Clouds forming Complex Events (MCCE), with those waves observed within the Magnetic Clouds that were isolated (IMC), i. e., not associated with complex events. Transverse and almost parallel propagating ion cyclotron waves were observed within both, MCCE and IMC. Compressive mirror mode waves were observed only within MCCE. Both modes can grow due to temperature anisotropy. Most of the mirror mode events found within MCCE are observed in regions with enhanced plasma beta. This is in agreement with kinetic theory, which predicts that mirror mode growth is favored by high plasma beta values. It is possible that the observed enhancements in plasma beta are due to compressions inside MCCE.

  11. O Wave-Wave Interactions on the Ocean Surface.

    NASA Astrophysics Data System (ADS)

    Naciri, Mamoun

    Part 1: Bragg scattering of sound from a line source by surface waves. The strong scattering of plane sound waves from a line source in a waveguide is analysed for a hard bottom and a soft undulatory surface representing one or two uniform surface waves. In the presence of one surface wave, sound is radiated and scattered in the same two directions. When two surface waves are present, each outgoing sound wave is scattered in two new directions in the horizontal plane. If the two surface waves satisfy one of two geometrical criteria, multiple scattering occurs and sound is resonantly scattered in a third new direction. Evolution equations are deduced for the sound wave envelopes, and the corresponding far field is asymptotically matched with the near field of the source. These envelopes are strongly dispersive and propagate in many directions. Part 2: Interactions of short and long waves on the sea surface. The evolution of a weakly nonlinear short wave interacting with a long gravity wave is investigated using a formulation based on Lagrangian variables. In Chapter I, the long wave is a weakly nonlinear irrotational Stokes wave. In Chapter II, we allow the long wave to assume a finite amplitude. Analytical results on the modulation of short waves agree fairly well with existing theories which rely on numerically obtained long waves. The evolution of short waves is described by a nonlinear Schrodinger equation with explicit time-periodic coefficients. Analysis of the stability of uniform short waves to sideband disturbances shows the appearance of additional bands of instability. Numerical results from both the nonlinear evolution and a lower order dynamical system suggest that the evolution of a uniform short wave disturbed by its most unstable sideband can become chaotic when the short wave slope increases and (or) when the long to short wave frequency ratio decreases. In Chapter III, the short waves are incident at an angle theta relative to the steep Gerstner wave. For small theta, the nonlinear evolution of the short wave envelope is described by a two-dimensional Schrodinger equation with explicit time-periodic coefficients. The Benjamin-Feir stability of uniform short waves to two-dimensional sidebands shows the proliferation of instability bands in addition to the single instability strip found in the absence of long waves. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253 -1690.) (Abstract shortened with permission of school.).

  12. Gravitational Wave Astronomy

    NASA Astrophysics Data System (ADS)

    Finn, Lee Samuel

    2012-03-01

    If two black holes collide in a vacuum, can they be observed? Until recently, the answer would have to be "no." After all, how would we observe them? Black holes are "naked" mass: pure mass, simple mass, mass devoid of any matter whose interactions might lead to the emission of photons or neutrinos, or any electromagnetic fields that might accelerate cosmic rays or leave some other signature that we could observe in our most sensitive astronomical instruments. Still, black holes do have mass. As such, they interact—like all mass—gravitationally. And the influence of gravity, like all influences, propagates no faster than that universal speed we first came to know as the speed of light. The effort to detect that propagating influence, which we term as gravitational radiation or gravitational waves, was initiated just over 50 years ago with the pioneering work of Joe Weber [1] and has been the object of increasingly intense experimental effort ever since. Have we, as yet, detected gravitational waves? The answer is still "no." Nevertheless, the accumulation of the experimental efforts begun fifty years ago has brought us to the point where we can confidently say that gravitational waves will soon be detected and, with that first detection, the era of gravitational wave astronomy—the observational use of gravitational waves, emitted by heavenly bodies—will begin. Data analysis for gravitational wave astronomy is, today, in its infancy and its practitioners have much to learn from allied fields, including machine learning. Machine learning tools and techniques have not yet been applied in any extensive or substantial way to the study or analysis of gravitational wave data. It is fair to say that this owes principally to the fields relative youth and not to any intrinsic unsuitability of machine learning tools to the analysis problems the field faces. Indeed, the nature of many of the analysis problems faced by the field today cry-out for the application of machine learning techniques. My principal goal in this chapter is to (i) describe the gravitational wave astronomy problem domain and associated analysis challenges, and (ii) identify some specific problem areas where the application of machine learning techniques may be employed to particular advantage. In Section 19.2, I describe what gravitational waves are, how they are generated and propagated, and the several different observational technologies through which we expect, over the next decade or so, gravitational wave astronomy will exploit. I have written this section for the non astronomer; however, I think that even the gravitational wave astronomer may find the viewpoint taken here to be of interest. In Section 19.3, I deconstruct the work involved in the analysis of gravitational wave data and describe (briefly!) the techniques currently used for data analysis. The focus of Section 19.4 is on the application of machine learning tools and techniques in gravitational wave data analysis. I conclude with some closing remarks in Section 19.5.

  13. Longitudinal shear wave and transverse dilatational wave in solids.

    PubMed

    Catheline, S; Benech, N

    2015-02-01

    Dilatation wave involves compression and extension and is known as the curl-free solution of the elastodynamic equation. Shear wave on the contrary does not involve any change in volume and is the divergence-free solution. This letter seeks to examine the elastodynamic Green's function through this definition. By separating the Green's function in divergence-free and curl-free terms, it appears first that, strictly speaking, the longitudinal wave is not a pure dilatation wave and the transverse wave is neither a pure shear wave. Second, not only a longitudinal shear wave but also a transverse dilatational wave exists. These waves are shown to be a part of the solution known as coupling terms. Their special motion is carefully described and illustrated. PMID:25698051

  14. Pilot-Wave Hydrodynamics

    NASA Astrophysics Data System (ADS)

    Bush, John W. M.

    2015-01-01

    Yves Couder, Emmanuel Fort, and coworkers recently discovered that a millimetric droplet sustained on the surface of a vibrating fluid bath may self-propel through a resonant interaction with its own wave field. This article reviews experimental evidence indicating that the walking droplets exhibit certain features previously thought to be exclusive to the microscopic, quantum realm. It then reviews theoretical descriptions of this hydrodynamic pilot-wave system that yield insight into the origins of its quantum-like behavior. Quantization arises from the dynamic constraint imposed on the droplet by its pilot-wave field, and multimodal statistics appear to be a feature of chaotic pilot-wave dynamics. I attempt to assess the potential and limitations of this hydrodynamic system as a quantum analog. This fluid system is compared to quantum pilot-wave theories, shown to be markedly different from Bohmian mechanics and more closely related to de Broglie's original conception of quantum dynamics, his double-solution theory, and its relatively recent extensions through researchers in stochastic electrodynamics.

  15. Noise Driven Evolutionary Waves

    PubMed Central

    Hallatschek, Oskar

    2011-01-01

    Adaptation in spatially extended populations entails the propagation of evolutionary novelties across habitat ranges. Driven by natural selection, beneficial mutations sweep through the population in a “wave of advance”. The standard model for these traveling waves, due to R. Fisher and A. Kolmogorov, plays an important role in many scientific areas besides evolution, such as ecology, epidemiology, chemical kinetics, and recently even in particle physics. Here, we extend the Fisher–Kolmogorov model to account for mutations that confer an increase in the density of the population, for instance as a result of an improved metabolic efficiency. We show that these mutations invade by the action of random genetic drift, even if the mutations are slightly deleterious. The ensuing class of noise-driven waves are characterized by a wave speed that decreases with increasing population sizes, contrary to conventional Fisher–Kolmogorov waves. When a trade-off exists between density and growth rate, an evolutionary optimal population density can be predicted. Our simulations and analytical results show that genetic drift in conjunction with spatial structure promotes the economical use of limited resources. The simplicity of our model, which lacks any complex interactions between individuals, suggests that noise-induced pattern formation may arise in many complex biological systems including evolution. PMID:21423714

  16. Waves in Motion

    NASA Astrophysics Data System (ADS)

    McGourty, L.; Rideout, K.

    2005-12-01

    "Waves in Motion" This teaching unit was created by Leslie McGourty and Ken Rideout under the Research Experience for Teachers (RET) program at MIT Haystack Observatory during the summer of 2005. The RET program is funded by a grant from the National Science Foundation. The goals of this teaching unit are to deepen students' understanding about waves, wave motion, and the electromagnetic spectrum as a whole. Specifically students will comprehend the role radio waves play in our daily lives and in the investigation of the universe. The lessons can be used in a high school physics, earth science or astronomy curriculum. The unit consists of a series of interlocking lectures, activities, and investigations that can be used as stand alone units to supplement a teacher's existing curriculum, as an independent investigation for a student, or as a long exploration into radio astronomy with a theme of waves in space: how and where they carry their information. Special emphasis is given to the Relativity theories in honor of the "World Year of Physics" to celebrate Einstein's 1905 contributions. The lessons are currently being implemented at the high school level, the preliminary results of which will be presented. At the end of the academic year, the units will be evaluated and updated, reflecting student input and peer review after which they will be posted on the internet for teachers to use in their classrooms.

  17. Optical Dark Rogue Wave

    NASA Astrophysics Data System (ADS)

    Frisquet, Benoit; Kibler, Bertrand; Morin, Philippe; Baronio, Fabio; Conforti, Matteo; Millot, Guy; Wabnitz, Stefan

    2016-02-01

    Photonics enables to develop simple lab experiments that mimic water rogue wave generation phenomena, as well as relativistic gravitational effects such as event horizons, gravitational lensing and Hawking radiation. The basis for analog gravity experiments is light propagation through an effective moving medium obtained via the nonlinear response of the material. So far, analogue gravity kinematics was reproduced in scalar optical wave propagation test models. Multimode and spatiotemporal nonlinear interactions exhibit a rich spectrum of excitations, which may substantially expand the range of rogue wave phenomena, and lead to novel space-time analogies, for example with multi-particle interactions. By injecting two colliding and modulated pumps with orthogonal states of polarization in a randomly birefringent telecommunication optical fiber, we provide the first experimental demonstration of an optical dark rogue wave. We also introduce the concept of multi-component analog gravity, whereby localized spatiotemporal horizons are associated with the dark rogue wave solution of the two-component nonlinear Schrödinger system.

  18. Vacuum Kundt waves

    NASA Astrophysics Data System (ADS)

    McNutt, David; Milson, Robert; Coley, Alan

    2013-03-01

    We discuss the invariant classification of vacuum Kundt waves using the Cartan-Karlhede algorithm and determine the upper bound on the number of iterations of the Karlhede algorithm to classify the vacuum Kundt waves (Collins (1991 Class. Quantum Grav. 8 1859-69), Machado Ramos (1996 Class. Quantum Grav. 13 1589)). By choosing a particular coordinate system we partially construct the canonical coframe used in the classification to study the functional dependence of the invariants arising at each iteration of the algorithm. We provide a new upper bound, q ? 4, and show that this bound is sharp by analyzing the subclass of Kundt waves with invariant count beginning with (0, 1,…) to show that the class with invariant count (0, 1, 3, 4, 4) exists. This class of vacuum Kundt waves is shown to be unique as the only set of metrics requiring the fourth covariant derivatives of the curvature. We conclude with an invariant classification of the vacuum Kundt waves using a suite of invariants.

  19. Optical Dark Rogue Wave

    PubMed Central

    Frisquet, Benoit; Kibler, Bertrand; Morin, Philippe; Baronio, Fabio; Conforti, Matteo; Millot, Guy; Wabnitz, Stefan

    2016-01-01

    Photonics enables to develop simple lab experiments that mimic water rogue wave generation phenomena, as well as relativistic gravitational effects such as event horizons, gravitational lensing and Hawking radiation. The basis for analog gravity experiments is light propagation through an effective moving medium obtained via the nonlinear response of the material. So far, analogue gravity kinematics was reproduced in scalar optical wave propagation test models. Multimode and spatiotemporal nonlinear interactions exhibit a rich spectrum of excitations, which may substantially expand the range of rogue wave phenomena, and lead to novel space-time analogies, for example with multi-particle interactions. By injecting two colliding and modulated pumps with orthogonal states of polarization in a randomly birefringent telecommunication optical fiber, we provide the first experimental demonstration of an optical dark rogue wave. We also introduce the concept of multi-component analog gravity, whereby localized spatiotemporal horizons are associated with the dark rogue wave solution of the two-component nonlinear Schrödinger system. PMID:26864099

  20. Optical Dark Rogue Wave.

    PubMed

    Frisquet, Benoit; Kibler, Bertrand; Morin, Philippe; Baronio, Fabio; Conforti, Matteo; Millot, Guy; Wabnitz, Stefan

    2016-01-01

    Photonics enables to develop simple lab experiments that mimic water rogue wave generation phenomena, as well as relativistic gravitational effects such as event horizons, gravitational lensing and Hawking radiation. The basis for analog gravity experiments is light propagation through an effective moving medium obtained via the nonlinear response of the material. So far, analogue gravity kinematics was reproduced in scalar optical wave propagation test models. Multimode and spatiotemporal nonlinear interactions exhibit a rich spectrum of excitations, which may substantially expand the range of rogue wave phenomena, and lead to novel space-time analogies, for example with multi-particle interactions. By injecting two colliding and modulated pumps with orthogonal states of polarization in a randomly birefringent telecommunication optical fiber, we provide the first experimental demonstration of an optical dark rogue wave. We also introduce the concept of multi-component analog gravity, whereby localized spatiotemporal horizons are associated with the dark rogue wave solution of the two-component nonlinear Schrödinger system. PMID:26864099

  1. Reflection and Refraction of Acoustic Waves by a Shock Wave

    NASA Technical Reports Server (NTRS)

    Brillouin, J.

    1957-01-01

    The presence of sound waves in one or the other of the fluid regions on either side of a shock wave is made apparent, in the region under superpressure, by acoustic waves (reflected or refracted according to whether the incident waves lie in the region of superpressure or of subpressure) and by thermal waves. The characteristics of these waves are calculated for a plane, progressive, and uniform incident wave. In the case of refraction, the refracted acoustic wave can, according to the incidence, be plane, progressive, and uniform or take the form of an 'accompanying wave' which remains attached to the front of the shock while sliding parallel to it. In all cases, geometrical constructions permit determination of the kinematic characteristics of the reflected or refractive acoustic waves. The dynamic relationships show that the amplitude of the reflected wave is always less than that of the incident wave. The amplitude of the refracted wave, whatever its type, may in certain cases be greater than that of the incident wave.

  2. Potential changes of wave steepness and occurrence of rogue waves

    NASA Astrophysics Data System (ADS)

    Bitner-Gregersen, Elzbieta M.; Toffoli, Alessandro

    2015-04-01

    Wave steepness is an important characteristic of a sea state. It is also well established that wave steepness is one of the parameter responsible for generation of abnormal waves called also freak or rogue waves. The study investigates changes of wave steepness in the past and future wave climate in the North Atlantic. The fifth assessment report IPCC (2013) uses four scenarios for future greenhouse gas concentrations in the atmosphere called Representative Concentration Pathways (RCP). Two of these scenarios RCP 4.5 and RCP 8.5 have been selected to project future wave conditions in the North Atlantic. RCP 4.5 is believed to achieve the political target of a maximum global mean temperature increase of 2° C while RPC 8.5 is close to 'business as usual' and expected to give a temperature increase of 4° C or more. The analysis includes total sea, wind sea and swell. Potential changes of wave steepness for these wave systems are shown and compared with wave steepness derived from historical data. Three historical data sets with different wave model resolutions are used. The investigations show also changes in the mean wind direction as well as in the relative direction between wind sea and swell. Consequences of wave steepness changes for statistics of surface elevation and generation of rogue waves are demonstrated. Uncertainties associated with wave steepness projections are discussed.

  3. A new approximation for nonlinear wave-wave interactions

    NASA Astrophysics Data System (ADS)

    Perrie, William; Susilo, Adhi; Toulany, Bechara

    Modern wave models require an accurate computation of the nonlinear wave-wave interactions. This is because nonlinear wave-wave interactions play an important role in the evolution of wind waves, accounting for nonlinear transfer of wave energy to lower and higher frequencies within the spectrum. Presently, in almost all operational state-of-the-art wave models, nonlinear transfer due to wave-wave interactions are evaluated by the discrete interaction approximation (DIA), which was developed by pioneering studies led by Hasselmann more than two decades ago. Although many efforts have tried to develop new methodologies to improve DIA, its basic formulation has not changed. In this study, we present a new computational method by evaluating the dominant nonlinear wave transfer along the wavenumber and the wave directional axes, and by approximating the contributions along the resonance loci. The new method is denoted the Advanced Dominant Interaction (AvDI) method. We show that AvDI is sufficiently efficient that it can be implemented within an operational wave model. As a validation of the approach, we compare simulations of hurricane Juan with observed wave data.

  4. Tango waves in a bidomain model of fertilization calcium waves

    NASA Astrophysics Data System (ADS)

    Li, Yue-Xian

    2003-12-01

    Fertilization of an egg cell is marked by one or several Ca 2+ waves that travel across the intra-cellular space, called fertilization Ca 2+ waves. Patterns of Ca 2+ waves observed in mature or immature oocytes include traveling fronts and pulses as well as concentric and spiral waves. These patterns have been studied in other excitable media in physical, chemical, and biological systems. Here, we report the discovery of a new wave phenomenon in the numerical study of a bidomain model of fertilization Ca 2+ waves. This wave is a front that propagates in a back-and-forth manner that resembles the movement of tango dancers, thus is called a tango wave. When the medium is excitable, a forward-moving tango wave can generate traveling pulses that propagate down the space without reversal. The study shows that the occurrence of tango waves is related to spatial inhomogeneity in the local dynamics. This is tested and confirmed by simulating similar waves in a medium with stationary spatial inhomogeneity. Similar waves are also obtained in a FitzHugh-Nagumo system with a linear spatial ramp. In both the bidomain model of Ca 2+ waves and the FitzHugh-Nagumo system, the front is stable when the slope of a linear ramp is large. As the slope decreases beyond a critical value, front oscillations occur. The study shows that tango waves facilitate the dispersion of localized Ca 2+. Key features of the bidomain model underlying the occurrence of tango waves are revealed. These features are commonly found in egg cells of a variety of species. Thus, we predict that tango waves can occur in real egg cells provided that a slowly varying inhomogeneity does occur following the sperm entry. The observation of tango wave-like waves in nemertean worm and ascidian eggs seems to support such a prediction.

  5. Neural field theory of nonlinear wave-wave and wave-neuron processes

    NASA Astrophysics Data System (ADS)

    Robinson, P. A.; Roy, N.

    2015-06-01

    Systematic expansion of neural field theory equations in terms of nonlinear response functions is carried out to enable a wide variety of nonlinear wave-wave and wave-neuron processes to be treated systematically in systems involving multiple neural populations. The results are illustrated by analyzing second-harmonic generation, and they can also be applied to wave-wave coalescence, multiharmonic generation, facilitation, depression, refractoriness, and other nonlinear processes.

  6. Piezoelectric wave motor

    DOEpatents

    Yerganian, Simon Scott (Lee's Summit, MO)

    2003-02-11

    A piezoelectric motor having a stator in which piezoelectric elements are contained in slots formed in the stator transverse to the desired wave motion. When an electric field is imposed on the elements, deformation of the elements imposes a force perpendicular to the sides of the slot, deforming the stator. Appropriate frequency and phase-shifting of the electric field will produce a wave in the stator and motion in a rotor. In a preferred aspect, the piezoelectric elements are configured so that deformation of the elements in the direction of an imposed electric field, generally referred to as the d.sub.33 direction, is utilized to produce wave motion in the stator. In a further aspect, the elements are compressed into the slots so as to minimize tensile stresses on the elements in use.

  7. Piezoelectric wave motor

    DOEpatents

    Yerganian, Simon Scott (Lee's Summit, MO)

    2001-07-17

    A piezoelectric motor having a stator in which piezoelectric elements are contained in slots formed in the stator transverse to the desired wave motion. When an electric field is imposed on the elements, deformation of the elements imposes a force perpendicular to the sides of the slot, deforming the stator. Appropriate frequency and phase shifting of the electric field will produce a wave in the stator and motion in a rotor. In a preferred aspect, the piezoelectric elements are configured so that deformation of the elements in direction of an imposed electric field, generally referred to as the d.sub.33 direction, is utilized to produce wave motion in the stator. In a further aspect, the elements are compressed into the slots so as to minimize tensile stresses on the elements in use.

  8. Traveling wave tube circuit

    NASA Technical Reports Server (NTRS)

    Connolly, D. J. (Inventor)

    1978-01-01

    A traveling wave tube (TWT) has a slow wave structure (SWS) which is severed into two or more sections. A signal path, connects the end of an SWS section to the beginning of the following SWS section. The signal path comprises an impedance matching coupler (IMC), followed by an isolator, a variable phase shifter, and a second IMC. The aggregate band pass characteristic of the components in the signal path is chosen to reject, or strongly attenuate, all frequencies outside the desired operating frequency range of the TWT and yet pass, with minimal attenuation in the forward direction, all frequencies within the desired operating frequency range. The isolator is chosen to reject, or strongly attenuate, waves, of all frequencies, which propagate in the backward direction. The aggregate phase shift characteristic of the components in the signal path is chosen to apply signal power to the beginning of the following SWS section with the phase angle yielding maximum efficiency.

  9. Solar system plasma waves

    NASA Technical Reports Server (NTRS)

    Gurnett, Donald A.

    1995-01-01

    An overview is given of spacecraft observations of plasma waves in the solar system. In situ measurements of plasma phenomena have now been obtained at all of the planets except Mercury and Pluto, and in the interplanetary medium at heliocentric radial distances ranging from 0.29 to 58 AU. To illustrate the range of phenomena involved, we discuss plasma waves in three regions of physical interest: (1) planetary radiation belts, (2) planetary auroral acceleration regions and (3) the solar wind. In each region we describe examples of plasma waves that are of some importance, either due to the role they play in determining the physical properties of the plasma, or to the unique mechanism involved in their generation.

  10. Upstream waves at Mars

    NASA Technical Reports Server (NTRS)

    Russell, C. T.; Luhmann, J. G.; Schwingenschuh, K.; Riedler, W.; Eroshenko, E.

    1992-01-01

    Weak, about 0.15 nT, narrow band emissions at the proton gyro frequency are observed by the Phobos magnetometer MAGMA, upstream from the bow shock of Mars. These waves are left-hand elliptically polarized. They may be associated with the pick up of protons from the Martian hydrogen exosphere. Strong turbulence, similar to that observed at the terrestrial bow shock, is found on occasion in the upstream region when the IMF connects to the bow shock. On two occasions this turbulence occurred when the spacecraft crossed the orbit of Phobos. This coincidence raises the possibility that material in the orbits of Phobos interacts with the solar wind in such a way to either affect the direction of the IMF or to cause instabilities in the solar wind plasma. However, since on a third occasion these waves did not occur, these waves may be shock associated rather than Phobos associated.

  11. Planetary radio waves

    NASA Technical Reports Server (NTRS)

    Goertz, C. K.

    1986-01-01

    Three planets, the earth, Jupiter and Saturn are known to emit nonthermal radio waves which require coherent radiation processes. The characteristic features (frequency spectrum, polarization, occurrence probability, radiation pattern) are discussed. Radiation which is externally controlled by the solar wind is distinguished from internally controlled radiation which only originates from Jupiter. The efficiency of the externally controlled radiation is roughly the same at all three planets (5 x 10 to the -6th) suggesting that similar processes are active there. The maser radiation mechanism for the generation of the radio waves and general requirements for the mechanism which couples the power generator to the region where the radio waves are generated are briefly discussed.

  12. Standing wave compressor

    DOEpatents

    Lucas, Timothy S. (4614 River Mill Ct., Glen Allen, VA 23060)

    1991-01-01

    A compressor for compression-evaporation cooling systems, which requires no moving parts. A gaseous refrigerant inside a chamber is acoustically compressed and conveyed by means of a standing acoustic wave which is set up in the gaseous refrigerant. This standing acoustic wave can be driven either by a transducer, or by direct exposure of the gas to microwave and infrared sources, including solar energy. Input and output ports arranged along the chamber provide for the intake and discharge of the gaseous refrigerant. These ports can be provided with optional valve arrangements, so as to increase the compressor's pressure differential. The performance of the compressor in either of its transducer or electromagnetically driven configurations, can be optimized by a controlling circuit. This controlling circuit holds the wavelength of the standing acoustical wave constant, by changing the driving frequency in response to varying operating conditions.

  13. Electromagnetic wave test

    NASA Astrophysics Data System (ADS)

    Matthews, R. K.; Stepanek, S. A.

    Electromagnetic wave testing, which represents a relatively new test technique that involves the union of several disciplines (aerothermodynamics, electromagnetics, materials/structures, and advanced diagnostics) is introduced. The essence of this new technique deals with the transmission and possible distortion of electromagnetic waves (RF or IR) as they pass through the bow shock, flow field, and electromagnetic window of a missile flying at hypersonic speeds. Variations in gas density along the optical path can cause significant distortion of the electromagnetic waves and, therefore the missile seeker system may not effectively track the target. Two specific test techniques are described. The first example deals with the combining of a wind tunnel and an RF range while the second example discusses the complexities of evaluating IR seeker system performance.

  14. The gravitational wave experiment

    NASA Technical Reports Server (NTRS)

    Bertotti, B.; Ambrosini, R.; Asmar, S. W.; Brenkle, J. P.; Comoretto, G.; Giampieri, G.; Less, L.; Messeri, A.; Wahlquist, H. D.

    1992-01-01

    Since the optimum size of a gravitational wave detector is the wave length, interplanetary dimensions are needed for the mHz band of interest. Doppler tracking of Ulysses will provide the most sensitive attempt to date at the detection of gravitational waves in the low frequency band. The driving noise source is the fluctuations in the refractive index of interplanetary plasma. This dictates the timing of the experiment to be near solar opposition and sets the target accuracy for the fractional frequency change at 3.0 x 10 exp -14 for integration times of the order of 1000 sec. The instrumentation utilized by the experiment is distributed between the radio systems on the spacecraft and the seven participating ground stations of the Deep Space Network and Medicina. Preliminary analysis is available of the measurements taken during the Ulysses first opposition test.

  15. IR Hot Wave

    SciTech Connect

    Graham, T. B.

    2010-04-01

    The IR Hot Wave{trademark} furnace is a breakthrough heat treatment system for manufacturing metal components. Near-infrared (IR) radiant energy combines with IR convective heating for heat treating. Heat treatment is an essential process in the manufacture of most components. The controlled heating and cooling of a metal or metal alloy alters its physical, mechanical, and sometimes chemical properties without changing the object's shape. The IR Hot Wave{trademark} furnace offers the simplest, quickest, most efficient, and cost-effective heat treatment option for metals and metal alloys. Compared with other heat treatment alternatives, the IR Hot Wave{trademark} system: (1) is 3 to 15 times faster; (2) is 2 to 3 times more energy efficient; (3) is 20% to 50% more cost-effective; (4) has a {+-}1 C thermal profile compared to a {+-}10 C thermal profile for conventional gas furnaces; and (5) has a 25% to 50% smaller footprint.

  16. Drift Wave Turbulence

    SciTech Connect

    Horton, W.; Kim, J.-H.; Asp, E.; Hoang, T.

    2008-05-14

    Drift waves occur universally in magnetized plasmas producing the dominant mechanism for transport of particles, energy and momentum across magnetic field lines. A wealth of information obtained from laboratory experiments for plasma confinement is reviewed for drift waves driven unstable by density gradients, temperature gradients and trapped particle effects. The modern understanding of origin of the scaling laws for Bohm and gyro-Bohm transport fluxes is discussed. The role of sheared flows and magnetic shear in reducing the transport fluxes is discussed and illustrated with large scale computer simulations. Plasmas turbulence models are derived with reduced magnetized fluid descriptions. The types of theoretical descriptions reviewed include weak turbulence theory and anisotropic Kolmogorov-like spectral indices, and the mixing length. A number of standard turbulent diffusivity formulas are given for the various space-time scales of the drift-wave turbulent mixing.

  17. Adaptive multiconfigurational wave functions

    SciTech Connect

    Evangelista, Francesco A.

    2014-03-28

    A method is suggested to build simple multiconfigurational wave functions specified uniquely by an energy cutoff Λ. These are constructed from a model space containing determinants with energy relative to that of the most stable determinant no greater than Λ. The resulting Λ-CI wave function is adaptive, being able to represent both single-reference and multireference electronic states. We also consider a more compact wave function parameterization (Λ+SD-CI), which is based on a small Λ-CI reference and adds a selection of all the singly and doubly excited determinants generated from it. We report two heuristic algorithms to build Λ-CI wave functions. The first is based on an approximate prescreening of the full configuration interaction space, while the second performs a breadth-first search coupled with pruning. The Λ-CI and Λ+SD-CI approaches are used to compute the dissociation curve of N{sub 2} and the potential energy curves for the first three singlet states of C{sub 2}. Special attention is paid to the issue of energy discontinuities caused by changes in the size of the Λ-CI wave function along the potential energy curve. This problem is shown to be solvable by smoothing the matrix elements of the Hamiltonian. Our last example, involving the Cu{sub 2}O{sub 2}{sup 2+} core, illustrates an alternative use of the Λ-CI method: as a tool to both estimate the multireference character of a wave function and to create a compact model space to be used in subsequent high-level multireference coupled cluster computations.

  18. Quantum wave turbulence

    NASA Astrophysics Data System (ADS)

    Haeri, M. B.; Putterman, S. J.; Garcia, A.; Roberts, P. H.

    1993-01-01

    The nonlinear quantum kinetic equation for the interaction of sound waves is solved via analytic and numerical techniques. In the classical regime energy cascades to higher frequency (?) according to the steady-state power law ?-3/2. In the quantum limit, the system prefers a reverse cascade of energy which follows the power law ?-6. Above a critical flux, a new type of spectrum appears which is neither self-similar nor close to equilibrium. This state of nonlinear quantum wave turbulence represents a flow of energy directly from the classical source to the quantum degrees of freedom.

  19. Internal Waves in CVX

    NASA Technical Reports Server (NTRS)

    Berg, Robert F.

    1996-01-01

    Near the liquid-vapor critical point, density stratification supports internal gravity waves which affect 1-g viscosity measurements in the CVX (Critical Viscosity of Xenon) experiment. Two internal-wave modes were seen in the horizontal viscometer. The frequencies of the two modes had different temperature dependences: with decreasing temperature, the higher frequency increased monotonically from 0.7 to 2.8 Hz, but the lower frequency varied non-monotonically, with a maximum of 1.0 Hz at 20 mK above the critical temperature. The measured frequencies agree with independently calculated frequencies to within 15%.

  20. Ultrasonic shear wave couplant

    DOEpatents

    Kupperman, David S.; Lanham, Ronald N.

    1985-01-01

    Ultrasonically testing of an article at high temperatures is accomplished by the use of a compact layer of a dry ceramic powder as a couplant in a method which involves providing an ultrasonic transducer as a probe capable of transmitting shear waves, coupling the probe to the article through a thin compact layer of a dry ceramic powder, propagating a shear wave from the probe through the ceramic powder and into the article to develop echo signals, and analyzing the echo signals to determine at least one physical characteristic of the article.

  1. Ultrasonic shear wave couplant

    DOEpatents

    Kupperman, D.S.; Lanham, R.N.

    1984-04-11

    Ultrasonically testing of an article at high temperatures is accomplished by the use of a compact layer of a dry ceramic powder as a couplant in a method which involves providing an ultrasonic transducer as a probe capable of transmitting shear waves, coupling the probe to the article through a thin compact layer of a dry ceramic powder, propagating a shear wave from the probe through the ceramic powder and into the article to develop echo signals, and analyzing the echo signals to determine at least one physical characteristic of the article.

  2. Nondispersing Bohr Wave Packets

    SciTech Connect

    Maeda, H.; Gurian, J. H.; Gallagher, T. F.

    2009-03-13

    Long-lived, nondispersing circular, or Bohr, wave packets are produced starting from Li Rydberg atoms by exposing them first to a linearly polarized microwave field at the orbital frequency, 17.6 GHz at principal quantum number n=72, which locks the electron's motion into an approximately linear orbit in which the electron oscillates in phase with the microwave field. The microwave polarization is changed to circular polarization slowly compared to the orbital frequency, and the electron's motion follows, resulting in a nondispersing Bohr wave packet.

  3. Nondispersing Bohr Wave Packets

    NASA Astrophysics Data System (ADS)

    Maeda, H.; Gurian, J. H.; Gallagher, T. F.

    2009-03-01

    Long-lived, nondispersing circular, or Bohr, wave packets are produced starting from Li Rydberg atoms by exposing them first to a linearly polarized microwave field at the orbital frequency, 17.6 GHz at principal quantum number n=72, which locks the electron’s motion into an approximately linear orbit in which the electron oscillates in phase with the microwave field. The microwave polarization is changed to circular polarization slowly compared to the orbital frequency, and the electron’s motion follows, resulting in a nondispersing Bohr wave packet.

  4. Offshore wave energy experiment

    SciTech Connect

    Nielsen, K.; Scholten, N.C.; Soerensen, K.A.

    1995-12-31

    This article describes the second phase of the off-shore wave energy experiment, taking place in the Danish part of the North Sea near Hanstholm. The wave power converter is a scale model consisting of a float 2.5 meter in diameter connected by rope to a seabed mounted piston pump installed on 25 meter deep water 2,5 km offshore. The structure, installation procedure results and experience gained during the test period will be presented and compared to calculations based on a computer model.

  5. THERMOPLASTIC WAVES IN MAGNETARS

    SciTech Connect

    Beloborodov, Andrei M.; Levin, Yuri E-mail: yuri.levin@monash.edu.au

    2014-10-20

    Magnetar activity is generated by shear motions of the neutron star surface, which relieve internal magnetic stresses. An analogy with earthquakes and faults is problematic, as the crust is permeated by strong magnetic fields which greatly constrain crustal displacements. We describe a new deformation mechanism that is specific to strongly magnetized neutron stars. The magnetically stressed crust begins to move because of a thermoplastic instability, which launches a wave that shears the crust and burns its magnetic energy. The propagating wave front resembles the deflagration front in combustion physics. We describe the conditions for the instability, the front structure, and velocity, and discuss implications for observed magnetar activity.

  6. Quantum positron acoustic waves

    SciTech Connect

    Metref, Hassina; Tribeche, Mouloud

    2014-12-15

    Nonlinear quantum positron-acoustic (QPA) waves are investigated for the first time, within the theoretical framework of the quantum hydrodynamic model. In the small but finite amplitude limit, both deformed Korteweg-de Vries and generalized Korteweg-de Vries equations governing, respectively, the dynamics of QPA solitary waves and double-layers are derived. Moreover, a full finite amplitude analysis is undertaken, and a numerical integration of the obtained highly nonlinear equations is carried out. The results complement our previously published results on this problem.

  7. Rogue Waves in the Ocean

    NASA Astrophysics Data System (ADS)

    Waseda, Takuji

    2010-03-01

    Giant episodic ocean waves that suddenly soar like a wall of water out of an otherwise calm sea are not just a legend. Such waves—which in the past have been called “abnormal,” “exceptional,” “extreme,” and even “vicious killer” waves—are now commonly known as “rogue waves” or “freak waves.” These waves have sunk or severely damaged 22 supercarriers in the world and caused the loss of more than 500 lives in the past 40 years. The largest wave registered by reliable instruments reached 30 meters in height, and the largest wave recorded by visual observation reached about 34 meters, equivalent to the height of an eight-story building. Tales of seafarers from Christopher Columbus to the passengers of luxury cruise ships had long been undervalued by scientists, but in the past 10 or so years, those historical notes and modern testimonies have been scientifically dissected to reveal the nature of these monster waves.

  8. Explosive plane-wave lens

    DOEpatents

    Marsh, Stanley P. (Los Alamos, NM)

    1988-01-01

    An explosive plane-wave air lens which enables a spherical wave form to be converted to a planar wave without the need to specially machine or shape explosive materials is described. A disc-shaped impactor having a greater thickness at its center than around its periphery is used to convert the spherical wave into a plane wave. When the wave reaches the impactor, the center of the impactor moves first because the spherical wave reaches the center of the impactor first. The wave strikes the impactor later in time as one moves radially along the impactor. Because the impactor is thinner as one moves radially outward, the velocity of the impactor is greater at the periphery than at the center. An acceptor explosive is positioned so that the impactor strikes the acceptor simultaneously. Consequently, a plane detonation wave is propagated through the acceptor explosive.

  9. The Virtual Wave Observatory (VWO)

    NASA Technical Reports Server (NTRS)

    Fung, Shing F.

    2008-01-01

    Heliophysics wave data are currently not easily searchable by computers, making identifying pertinent wave data features for analyses and cross comparisons difficult and laborious. Since wave data analysis requires specialized knowledge about waves, which spans the spectrum of microphysics to macrophysics, researchers having varied expertise cannot easily use wave data. To resolve these difficulties and to allow wave data to contribute more fully to Heliophysics research, we are developing a Virtual Wave Observatory (VWO) whose goal is to enable all Heliophysics wave data to become searchable, understandable and usable by the Heliophysics community. The VWO objective is to enable search of multiple and distributed wave data (from both active and passive measurements). This presentation provides and overview of the VWO, a new VxO component within the emerging distributed Heliophysics data and model environment.

  10. Explosive plane-wave lens

    DOEpatents

    Marsh, S.P.

    1988-03-08

    An explosive plane-wave air lens which enables a spherical wave form to be converted to a planar wave without the need to specially machine or shape explosive materials is described. A disc-shaped impactor having a greater thickness at its center than around its periphery is used to convert the spherical wave into a plane wave. When the wave reaches the impactor, the center of the impactor moves first because the spherical wave reaches the center of the impactor first. The wave strikes the impactor later in time as one moves radially along the impactor. Because the impactor is thinner as one moves radially outward, the velocity of the impactor is greater at the periphery than at the center. An acceptor explosive is positioned so that the impactor strikes the acceptor simultaneously. Consequently, a plane detonation wave is propagated through the acceptor explosive. 4 figs.

  11. Explosive plane-wave lens

    DOEpatents

    Marsh, S.P.

    1987-03-12

    An explosive plane-wave air lens which enables a spherical wave form to be converted to a planar wave without the need to specially machine or shape explosive materials is described. A disc-shaped impactor having a greater thickness at its center than around its periphery is used to convert the spherical wave into a plane wave. When the wave reaches the impactor, the center of the impactor moves first because the spherical wave reaches the center of the impactor first. The wave strikes the impactor later in time as one moves radially along the impactor. Because the impactor is thinner as one moves radially outward, the velocity of the impactor is greater at the periphery than at the center. An acceptor explosive is positioned so that the impactor strikes the acceptor simultaneously. Consequently, a plane detonation wave is propagated through the acceptor explosive. 3 figs., 3 tabs.

  12. Wave Tank Studies of Phase Velocities of Short Wind Waves

    NASA Astrophysics Data System (ADS)

    Ermakov, S.; Sergievskaya, I.; Shchegolkov, Yu.

    Wave tank studies of phase velocities of short wind waves have been carried out using Ka-band radar and an Optical Spectrum Analyser. The phase velocities were retrieved from measured radar and optical Doppler shifts, taking into account measurements of surface drift velocities. The dispersion relationship was studied in centimetre (cm)- and millimetre(mm)-scale wavelength ranges at different fetches and wind speeds, both for a clean water surface and for water covered with surfactant films. It is ob- tained that the phase velocities do not follow the dispersion relation of linear capillary- gravity waves, increasing with fetch and, therefore, depending on phase velocities of dominant decimetre (dm)-centimetre-scale wind waves. One thus can conclude that nonlinear cm-mm-scale harmonics bound to the dominant wind waves and propagat- ing with the phase velocities of the decimetric waves are present in the wind wave spectrum. The resulting phase velocities of short wind waves are determined by re- lation between free and bound waves. The relative intensity of the bound waves in the spectrum of short wind waves is estimated. It is shown that this relation depends strongly on the surfactant concentration, because the damping effect due to films is different for free and bound waves; this results to changes of phase velocities of wind waves in the presence of surfactant films. This work was supported by MOD, UK via DERA Winfrith (Project ISTC 1774P) and by RFBR (Project 02-05-65102).

  13. Oscilloscope Traveling Wave Experiment.

    ERIC Educational Resources Information Center

    Cloud, S. D.

    1985-01-01

    The moving pattern that appears on an oscilloscope screen is used to illustrate two kinds of wave motion and the relationship between them. Suggestions are presented for measuring wavelength, frequency, phase shift, and phase velocity in this college-level laboratory exercise. (DH)

  14. Search for Gravitational Waves

    NASA Astrophysics Data System (ADS)

    Pizzella, G.

    2002-06-01

    Gravitational waves and their possible astrophysical sources are reviewed. The experiments in the data taking stage or in preparation, with resonant and non resonant detectors, are briefly outlined. Results obtained with the resonant detectors ALLEGRO, AURIGA, EXPLORER, NAUTILUS and NIOBE are given at a sensitivity level of h ~ 4 10-19. Perspectives are indicated.

  15. Submillimeter wave heterodyne receiver

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Goutam (Inventor); Manohara, Harish (Inventor); Siegel, Peter H. (Inventor); Ward, John (Inventor)

    2011-01-01

    In an embodiment, a submillimeter wave heterodyne receiver includes a finline ortho-mode transducer comprising thin tapered metallic fins deposited on a thin dielectric substrate to separate a vertically polarized electromagnetic mode from a horizontally polarized electromagnetic mode. Other embodiments are described and claimed.

  16. Atoms riding Rayleigh waves.

    PubMed

    Benedek, G; Echenique, P M; Toennies, J P; Traeger, F

    2010-08-01

    Under special kinematic conditions helium atoms impinging upon a crystal surface can be inelastically trapped into a surface bound state and ride the created Rayleigh wave. This special case of phonon-assisted selective adsorption, leading to an atom-phonon bound state (atomic polaron), can explain previously unassigned resonant features observed in published helium atom scattering distributions. PMID:21399348

  17. Oblique detonation wave ramjet

    NASA Technical Reports Server (NTRS)

    Morrison, R. B.

    1980-01-01

    Two conceptual designs of the oblique detonation wave ramjet are presented. The performance is evaluated for stoichiometric hydrogen-air equivalence ratios of phi = 1/3, 2/3 and 1 for a range of flight Mach numbers from 6 to 10.

  18. Waves and Water Beetles

    ERIC Educational Resources Information Center

    Tucker, Vance A.

    1971-01-01

    Capillary and gravity water waves are related to the position, wavelength, and velocity of an object in flowing water. Water patterns are presented for ships and the whirling beetle with an explanation of how the design affects the objects velocity and the observed water wavelengths. (DS)

  19. Waves: Internal Tides

    NASA Technical Reports Server (NTRS)

    Ray, Richard D.

    1999-01-01

    Oceanic internal tides are internal waves with tidal periodicities. They are ubiquitous throughout the ocean, although generally more pronounced near large bathymetric features such as mid-ocean ridges and continental slopes. The internal vertical displacements associated with these waves can be extraordinarily large. Near some shelf breaks where the surface tides are strong, internal displacements (e.g., of an isothermal surface) can exceed 200 meters. Displacements of 10 meters in the open ocean are not uncommon. The associated current velocities are usually comparable to or larger than the currents of the surface tide. On continental shelves internal tides can occasionally generate packets of internal solitons, which are detectable in remote sensing imagery. Other common nonlinear features are generation of higher harmonics (e.g., 6-hr waves) and wave breaking. Internal tides are known to be an important energy source for mixing of shelf waters. Recent research suggests that they may also be a significant energy source for deep-ocean mixing.

  20. Waves and Crops

    ERIC Educational Resources Information Center

    Bennett, J.

    1973-01-01

    Discusses wave patterns on the surfaces of ripening wheat and barley crops when the wind is moderately strong. Examines the structure of the turbulence over such natural surfaces and conditions under which the crop may be damaged by the wind. (JR)

  1. Gravitational waves from technicolor

    SciTech Connect

    Jaervinen, Matti; Sannino, Francesco; Kouvaris, Chris

    2010-03-15

    We investigate the production and possible detection of gravitational waves stemming from the electroweak phase transition in the early universe in models of minimal walking technicolor. In particular we discuss the two possible scenarios in which one has only one electroweak phase transition and the case in which the technicolor dynamics allows for multiple phase transitions.

  2. "Hearing" Electromagnetic Waves

    ERIC Educational Resources Information Center

    Rojo, Marta; Munoz, Juan

    2014-01-01

    In this work, an educational experience is described in which a microwave communication link is used to make students aware that all electromagnetic waves have the same physical nature and properties. Experimental demonstrations are linked to theoretical concepts to increase comprehension of the physical principles underlying electromagnetic…

  3. "Hearing" Electromagnetic Waves

    ERIC Educational Resources Information Center

    Rojo, Marta; Munoz, Juan

    2014-01-01

    In this work, an educational experience is described in which a microwave communication link is used to make students aware that all electromagnetic waves have the same physical nature and properties. Experimental demonstrations are linked to theoretical concepts to increase comprehension of the physical principles underlying electromagnetic…

  4. Deflagration Wave Profiles

    SciTech Connect

    Menikoff, Ralph

    2012-04-03

    Shock initiation in a plastic-bonded explosives (PBX) is due to hot spots. Current reactive burn models are based, at least heuristically, on the ignition and growth concept. The ignition phase occurs when a small localized region of high temperature (or hot spot) burns on a fast time scale. This is followed by a growth phase in which a reactive front spreads out from the hot spot. Propagating reactive fronts are deflagration waves. A key question is the deflagration speed in a PBX compressed and heated by a shock wave that generated the hot spot. Here, the ODEs for a steady deflagration wave profile in a compressible fluid are derived, along with the needed thermodynamic quantities of realistic equations of state corresponding to the reactants and products of a PBX. The properties of the wave profile equations are analyzed and an algorithm is derived for computing the deflagration speed. As an illustrative example, the algorithm is applied to compute the deflagration speed in shock compressed PBX 9501 as a function of shock pressure. The calculated deflagration speed, even at the CJ pressure, is low compared to the detonation speed. The implication of this are briefly discussed.

  5. Generating electromagnetic waves from gravity waves in cosmology

    SciTech Connect

    Hogan, P. A.; O'Farrell, S.

    2009-05-15

    Examples of test electromagnetic waves on a Friedmann-Lemaitre-Robertson-Walker (FLRW) background are constructed from explicit perturbations of the FLRW space-times describing gravitational waves propagating in the isotropic universes. A possible physical mechanism for the production of the test electromagnetic waves is shown to be the coupling of the gravitational waves with a test magnetic field, confirming the observation of Marklund, Dunsby and Brodin [Phys. Rev. D 62, 101501(R) (2000)].

  6. Freak waves under typhoon conditions

    NASA Astrophysics Data System (ADS)

    Mori, Nobuhito

    2012-11-01

    Benjamin-Feir Index (BFI) and directional spread are measures of nonlinear four-wave interactions and resultant indices of possible conditions for freak waves. Temporal-spatial distributions of BFI and directional spread are examined with numerical simulations of a spectral wave model using typhoon conditions. The spatial distributions of wave characteristics such as significant wave height, wave period, BFI and directional spread are different from each other around the eye of the typhoon. BFI is significantly large in the fourth quadrant of the typhoon, while waves are steep and have narrow frequencies and directional spectra. Freak waves resulting from nonlinear four-wave-wave interactions have a greater potential of occurring in the fourth quadrant of the typhoon than in the other quadrants. Furthermore, crossing sea states from two-wind-wave systems can be observed behind the eye of the typhoon. The crossing, two-wind systems are also dangerous sea states, although as observed, they are closer to linear wave conditions. Finally, the characteristics of possible freak wave conditions during typhoons are verified with field data.

  7. Surface gravity-wave lensing.

    PubMed

    Elandt, Ryan B; Shakeri, Mostafa; Alam, Mohammad-Reza

    2014-02-01

    Here we show that a nonlinear resonance between oceanic surface waves caused by small seabed features (the so-called Bragg resonance) can be utilized to create the equivalent of lenses and curved mirrors for surface gravity waves. Such gravity wave lenses, which are merely small changes to the seafloor topography and therefore are surface noninvasive, can focus or defocus the energy of incident waves toward or away from any desired focal point. We further show that for a broadband incident wave spectrum (i.e., a wave group composed of a multitude of different-frequency waves), a polychromatic topography (occupying no more than the area required for a monochromatic lens) can achieve a broadband lensing effect. Gravity wave lenses can be utilized to create localized high-energy wave zones (e.g., for wave energy harvesting or creating artificial surf zones) as well as to disperse waves in order to create protected areas (e.g., harbors or areas near important offshore facilities). In reverse, lensing of oceanic waves may be caused by natural seabed features and may explain the frequent appearance of very high amplitude waves in certain bodies of water. PMID:25353576

  8. Management of 1-2 cm renal stones

    PubMed Central

    Srivastava, Aneesh; Chipde, Saurabh S

    2013-01-01

    Introduction: The preferred treatment of >1cm stone is shockwave lithotripsy (SWL), while that of stone <2 cm is percutaneous nephrolithotomy (PCNL), but treatment of 1-2 cm renal stones is a controversial issue. We searched the literature to present a comprehensive review on this group. Material and Methods: Pubmed search of literature was done using the appropriate key words. We separately discussed the literature in lower polar and non lower polar stone groups. Results: For non lower polar renal stones of 1-2 cm, SWL is preferred approach, while for the lower polar stones; literature favors the use of PCNL. Retrograde intrarenal surgery (RIRS) is emerging as a promising technique for these calculi. Conclusions: Treatment of renal stone disease depends on stone and patient related, as well as on renal anatomical factors. Treatment should be individualized according to site of stone and available expertise. PMID:24082440

  9. Percutaneous Nephrolithotomy in Children

    PubMed Central

    DeMarco, Romano T.

    2011-01-01

    The surgical management of pediatric stone disease has evolved significantly over the last three decades. Prior to the introduction of shockwave lithotripsy (SWL) in the 1980s, open lithotomy was the lone therapy for children with upper tract calculi. Since then, SWL has been the procedure of choice in most pediatric centers for children with large renal calculi. While other therapies such as percutaneous nephrolithotomy (PNL) were also being advanced around the same time, PNL was generally seen as a suitable therapy in adults because of the concerns for damage in the developing kidney. However, recent advances in endoscopic instrumentation and renal access techniques have led to an increase in its use in the pediatric population, particularly in those children with large upper tract stones. This paper is a review of the literature focusing on the indications, techniques, results, and complications of PNL in children with renal calculi. PMID:22013438

  10. [Heat waves: health impacts].

    PubMed

    Marto, Natália

    2005-01-01

    During the summer of 2003, record high temperatures were reported across Europe, causing thousands of casualties. Heat waves are sporadic recurrent events, characterised by intense and prolonged heat, associated with excess mortality and morbidity. The most frequent cause of death directly attributable to heat is heat stroke but heat waves are known to cause increases in all-cause mortality, specially circulatory and respiratory mortality. Epidemiological studies demonstrate excess casualties cluster in specific risk groups. The elderly, those with chronic medical conditions and the socially isolated are particularly vulnerable. Air conditioning is the strongest protective factor against heat-related disorders. Heat waves cause disease indirectly, by aggravating chronic disorders, and directly, by causing heat-related illnesses (HRI). Classic HRI include skin eruptions, heat cramps, heat syncope, heat exhaustion and heat stroke. Heat stroke is a medical emergency characterised by hyperthermia and central nervous system dysfunction. Treatment includes immediate cooling and support of organ-system function. Despite aggressive treatment, heat stroke is often fatal and permanent neurological damage is frequent in those who survive. Heat related illness and death are preventable through behavioural adaptations, such as use of air conditioning and increased fluid intake. Other adaptation measures include heat emergency warning systems and intervention plans and environmental heat stress reduction. Heat related mortality is expected to rise as a consequence of the increasing proportion of elderly persons, the growing urban population, and the anticipated increase in number and intensity of heat waves associated with global warming. Improvements in surveillance and response capability may limit the adverse health conditions of future heat waves. It is crucial that health professionals are prepared to recognise, prevent and treat HRI and learn to cooperate with local health agencies. PMID:16684487

  11. Gravitational-Wave Detection (ii). Current Gravitational Wave Detector Results

    NASA Astrophysics Data System (ADS)

    Kanda, Nobuyuki

    2005-11-01

    The workshop session C1ii was focused on the results of recent operating detectors. 10 speakers presented the latest results of each experiments: ALLEGRO, GEO, LIGO, TAMA and VIRGO experiments. There were reports about searches for gravitational waves in analysis of observation data. The results are of no detection of gravitational waves, but observational upper-limits of gravitational waves are improved.

  12. A nonlocal wave-wave interaction among Alfven waves in an intermediate-{beta} plasma

    SciTech Connect

    Zhao, J. S.; Wu, D. J.; Lu, J. Y.

    2011-03-15

    A nonlocal coupling mechanism to directly transfer the energy from large-scale magnetohydrodynamic (MHD) Alfven waves to small-scale kinetic Alfven waves is presented. It is shown that the interaction between a MHD Alfven wave and a reversely propagating kinetic Alfven wave can generate another kinetic Alfven wave, and this interaction exists in the plasmas where the thermal to magnetic pressure ratio is larger than the electron to ion mass ratio. The proposed nonlocal interaction may have a potential application to account for the observed electron scale kinetic Alfven waves in the solar wind and solar corona plasmas.

  13. Curved characteristics behind blast waves.

    NASA Technical Reports Server (NTRS)

    Laporte, O.; Chang, T. S.

    1972-01-01

    The behavior of nonisentropic flow behind a propagating blast wave is theoretically studied. Exact solutions, expressed in closed form in terms of elementary functions, are presented for three sets of curved characteristicseind a self-similar, strong blast wave.

  14. MHD Waves in Coronal Holes

    NASA Astrophysics Data System (ADS)

    Banerjee, D.; Krishna Prasad, S.

    This chapter reviews the observations of magnetohydrodynamic (MHD) waves in coronal holes focusing primarily on progress made in the past few years. It also discusses on the new evidences of wave damping and highlights how such observations can be used to probe coronal conditions through seismology. Numerous observations, using imaging and spectroscopic techniques, have revealed the presence of different MHD waves in these structures that can be categorized into compressive and incompressive waves. One of the most desirable characteristics of MHD wave observations in the solar atmosphere, is their dissipation. The energy carried by these waves has to be deposited at appropriate heights to facilitate coronal heating and solar wind acceleration. It turned out that the compressive waves are easy to dissipate with the conventional physical mechanisms whereas the incompressive waves require some special conditions.

  15. Gravitational Waves: The Evidence Mounts

    ERIC Educational Resources Information Center

    Wick, Gerald L.

    1970-01-01

    Reviews the work of Weber and his colleagues in their attempts at detecting extraterrestial gravitational waves. Coincidence events recorded by special detectors provide the evidence for the existence of gravitational waves. Bibliography. (LC)

  16. Ion Bernstein wave heating research

    SciTech Connect

    Ono, M. )

    1993-02-01

    Ion Bernstein wave heating (IBWH) utilizes the ion Bernstein wave (IBW), a hot plasma wave, to carry the radio frequency (rf) power to heat the tokamak reactor core. Earlier wave accessibility studies have shown that this finite-Larmor-radius (FLR) mode should penetrate into a hot dense reactor plasma core without significant attenuation. Moreover, the IBW's low perpendicular phase velocity ([omega]/[ital k][sub [perpendicular

  17. Observations of running penumbral waves.

    NASA Technical Reports Server (NTRS)

    Zirin, H.; Stein, A.

    1972-01-01

    Quiet sunspots with well-developed penumbrae show running intensity waves with period running around 300 sec. The waves appear connected with umbral flashes of exactly half the period. Waves are concentric, regular, with velocity constant around 10 km/sec. They are probably sound waves and show intensity fluctuation in H alpha centerline or wing of 10 to 20%. The energy is tiny compared to the heat deficit of the umbra.

  18. ULF waves in the magnetosphere

    SciTech Connect

    Takahashi, Kazue )

    1991-01-01

    Research efforts in the area of magnetospheric ULF waves in the 1987-1990 period are reviewed. Attention is given to externally excited hydromagnetic waves including field line resonance, the global cavity mode, bow-shock-associated upstream waves, and Kelvin-Helmholtz waves. Consideration is given to internally excited Pc 4-5 pulsations and the role of these pulsations in the diffusion of ring-current ions based on the observed properties of the pulsations. 154 refs.

  19. Modeling Seismic Noise Body Waves

    NASA Astrophysics Data System (ADS)

    Stutzmann, E.; Farra, V.; Gualtieri, L.; Schimmel, M.; Ardhuin, F.

    2014-12-01

    Secondary microseismic noise is generated by non-linear interactions between ocean waves at the ocean surface. The sources correspond to pressure fluctuations close to the ocean surface. They generate acoustic waves in the ocean, which are then converted into P, SV, and Rayleigh waves in the deeper Earth layers. Rayleigh waves are the most energetic noise signal but body wave amplitude can be extracted using beamforming analysis. We analyze several typhoons recorded by the Southern California Seismic Network and we show that the detected P-wave amplitudes are frequency dependent. In order to understand the body wave generation mechanism, we model the P-wave amplitude. The sources are the power spectral density of the pressure derived from the ocean wave interaction model. They are distributed along the ocean surface and they are frequency dependent. We then compute the site effect of the ocean layer upon body waves generated by the noise sources. The site effect can be described as the constructive interference of multiply reflected P waves in the ocean that are then converted to P waves at the ocean-crust interface. It varies with frequency and ocean depth. Finally we compute the propagation from the source area to the network by taking into account seismic attenuation and geometrical spreading. We show that the modeled P-wave amplitude reproduce well the frequency dependent variations of the measured P-wave. This frequency dependent effect is due to both the source and site effect. We define the effective source as the product of the power spectral density of the pressure close to the surface and the site effect. We show that its maximum is consistent with the source location obtained by back projecting the slowness derived from the beamforming analysis. Finally, we show that body wave analysis enable to efficiently constrain the amount of sources generated by ocean wave reflected at the coast.

  20. Stationary waves in the wintertime mesosphere: Evidence for gravity wave filtering by stratospheric planetary waves

    NASA Astrophysics Data System (ADS)

    Lieberman, R. S.; Riggin, D. M.; Siskind, D. E.

    2013-04-01

    Quasi-stationary planetary-scale waves in the wintertime mesosphere and lower thermosphere (MLT) are thought to be forced in part by drag imparted by gravity waves that have been modulated by underlying stratospheric waves. Although this mechanism has been demonstrated numerically, there have been very few observational studies that examine wave driving as a source of planetary waves in the MLT. This study uses data from EOS Aura and TIMED between 2005 and 2011 to examine the momentum budget of MLT wintertime planetary waves. Monthly averages for January indicate that the dynamics of zonal wave number 1 are determined from a three-way balance among the Coriolis acceleration, the pressure gradient force, and a momentum residual term that reflects wave drag. The MLT circulations in January 2005, 2006, 2009, and 2011 are qualitatively consistent with a simple model of wave forcing by drag from gravity waves that have been modulated by stratospheric planetary waves. MLT winds during these years are also consistent with analyses from a high-altitude operational prediction model that includes parameterized nonorographic gravity wave drag. The importance of wave drag for the MLT momentum budget suggests that the gradient wind approximation is inadequate for deriving planetary-scale winds from global temperature measurements. Our results underscore the need for direct global wind measurements in the MLT.

  1. ULTRASONIC MEASUREMENT MODELS FOR SURFACE WAVE AND PLATE WAVE INSPECTIONS

    SciTech Connect

    Schmerr, Lester W. Jr.; Sedov, Alexander

    2010-02-22

    A complete ultrasonic measurement model for surface and plate wave inspections is obtained, where all the electrical, electromechanical, and acoustic/elastic elements are explicitly described. Reciprocity principles are used to describe the acoustic/elastic elements specifically in terms of an integral of the incident and scattered wave fields over the surface of the flaw. As with the case of bulk waves, if one assumes the incident surface waves or plate waves are locally planar at the flaw surface, the overall measurement model reduces to a very modular form where the far-field scattering amplitude of the flaw appears explicitly.

  2. Wave/current interaction model

    NASA Technical Reports Server (NTRS)

    Liu, A. K.

    1988-01-01

    The wave-current interaction for the application to remote sensing data via numerical simulations and data comparison is modelled. Using the field data of surface current shear, wind condition and ambient wave spectrum, the numerical simulations of directional wave spectrum evolution were used to interpret and to compare with the aircraft data from Radar Ocean Wave Spectrometer (ROWS) and Surface Contour Radar (SCR) across the front during Frontal Air Sea Interaction Experiment (FASINEX). The wave-ice interaction was inspired by the observation of large amplitude waves hundreds of kms inside the ice pack in the Weddell Sea, resulting in breakup of the ice pack. The developed analysis of processes includes the refraction of waves at the pack edge, the effects of pack compression on wave propagation, wave train stability and buckling stability in the ice pack. Sources of pack compression and interaction between wave momentum and pack compression are investigated. Viscous camping of propagating waves in the marginal ice zone are also studied. The analysis suggests an explanation for the change in wave dispersion observed from the ship and the sequence of processes that cause ice pack breakup, pressure ridge formation and the formation of open bands of water.

  3. Energy in a String Wave

    ERIC Educational Resources Information Center

    Ng, Chiu-king

    2010-01-01

    When one end of a taut horizontal elastic string is shaken repeatedly up and down, a transverse wave (assume sine waveform) will be produced and travel along it. College students know this type of wave motion well. They know when the wave passes by, each element of the string will perform an oscillating up-down motion, which in mechanics is termed…

  4. Energy from the sea waves

    SciTech Connect

    Blandino, A.; Brighenti, A.; Vielmo, P.

    1980-01-01

    The main results relevant to certain themes are shown and discussed together with the computerized procedures by which they have been obtained. These themes include the following: (a) Evaluation of the sea wave energy content; (b) Interaction between the incident wave field and the absorbing device; and (c) Economic assessment of the wave power generator.

  5. Energy in a String Wave

    ERIC Educational Resources Information Center

    Ng, Chiu-king

    2010-01-01

    When one end of a taut horizontal elastic string is shaken repeatedly up and down, a transverse wave (assume sine waveform) will be produced and travel along it. College students know this type of wave motion well. They know when the wave passes by, each element of the string will perform an oscillating up-down motion, which in mechanics is termed…

  6. The Detection of Gravitational Waves

    NASA Astrophysics Data System (ADS)

    Blair, David G.

    2005-10-01

    Part I. An Introduction to Gravitational Waves and Methods for their Detection: 1. Gravitational waves in general relativity D. G. Blair; 2. Sources of gravitational waves D. G. Blair; 3. Gravitational wave detectors D. G. Blair; Part II. Gravitational Wave Detectors: 4. Resonant-bar detectors D. G. Blair; 5. Gravity wave dewars W. O. Hamilton; 6. Internal friction in high Q materials J. Ferreirinko; 7. Motion amplifiers and passive transducers J. P. Richard; 8. Parametric transducers P. J. Veitch; 9. Detection of continuous waves K. Tsubono; 10. Data analysis and algorithms for gravitational wave-antennas G. V. Paalottino; Part III. Laser Interferometer Antennas: 11. A Michelson interferometer using delay lines W. Winkler; 12. Fabry-Perot cavity gravity-wave detectors R. W. P. Drever; 13. The stabilisation of lasers for interferometric gravitational wave detectors J. Hough; 14. Vibration isolation for the test masses in interferometric gravitational wave detectors N. A. Robertson; 15. Advanced techniques A. Brillet; 16. Data processing, analysis and storage for interferometric antennas B. F. Schutz; 17. Gravitational wave detection at low and very low frequencies R. W. Hellings.

  7. Determination of wave speed and wave separation in the arteries.

    PubMed

    Khir, A W; O'Brien, A; Gibbs, J S; Parker, K H

    2001-09-01

    Considering waves in the arteries as infinitesimal wave fronts rather than sinusoidal wavetrains, the change in pressure across the wave front, dP, is related to the change in velocity, dU, that it induces by the "water hammer" equation, dP=+/-rhocdU, where rho is the density of blood and c is the local wave speed. When only unidirectional waves are present, this relationship corresponds to a straight line when P is plotted against U with slope rhoc. When both forward and backward waves are present, the PU-loop is no longer linear. Measurements in latex tubes and systemic and pulmonary arteries exhibit a linear range during early systole and this provides a way of determining the local wave speed from the slope of the linear portion of the loop. Once the wave speed is known, it is also possible to separate the measured P and U into their forward and backward components. In cases where reflected waves are prominent, this separation of waves can help clarify the pattern of waves in the arteries throughout the cardiac cycle. PMID:11506785

  8. The wave and wave forecasting in the China Seas

    SciTech Connect

    Xu Fuxiang

    1993-12-31

    The China Seas located at the Southeastern part of the large Eurasia continent, and beside the largest ocean, the Pacific. They are greatly influenced by continent and the ocean. Due to it across the tropical zone, the subtropical zone and the extropical zone, the cold and warm air circulation in Northsouth is a very active exchange. In the summer, the South China Sea and the East China Sea are frequently hit by typhoon waves. In spring and autumn, the bohai sea, the Yellow sea and the East China Seas had series disasters caused by the extropical cyclone wave and the cold air wave. In this paper the time-space distribution and formative cases of wave disaster in the China Seas, and the wave monitoring and prediction system, the wave prediction method, and two automatic systems of numerical wave forecasting are briefly introduced.

  9. Dynamical behaviors of nonlinear dust acoustic waves: From plane waves to dust acoustic wave turbulence

    NASA Astrophysics Data System (ADS)

    Tsai, Ya-Yi; Chang, Mei-Chu; I., Lin; I.

    2014-12-01

    The dust acoustic wave (DAW), associated with longitudinal dust oscillations in dusty plasmas, can be self-excited from the free energy of ion streaming. It is not only a fundamental plasma wave but also a paradigm to understand the generic dynamical behaviors of self-excited nonlinear longitudinal density waves through optically monitoring particle motion and dust density evolutions over a large area. In this paper, the dynamical behaviors of the wave-particle interaction and wave breaking in ordered self-excited DAW with straight wave fronts, and the defect-mediated wave turbulence with fluctuating defects and chaotic low amplitude hole filaments along defect trajectories in the 2+1D space-time space, are briefly reviewed. The first experimental observation of acoustic vortices with helical waveforms in self-excited acoustic-type defect-mediated wave turbulence, and the dynamics of spontaneous pair generation, propagation, and pair annihilation of acoustic vortices, is demonstrated and discussed.

  10. Wave-Particle Dynamics of Wave Breaking in the Self-Excited Dust Acoustic Wave

    SciTech Connect

    Teng, L.-W.; Chang, M.-C.; Tseng, Y.-P.; I Lin

    2009-12-11

    The wave-particle microdynamics in the breaking of the self-excited dust acoustic wave growing in a dusty plasma liquid is investigated through directly tracking dust micromotion. It is found that the nonlinear wave growth and steepening stop as the mean oscillating amplitude of dust displacement reaches about 1/k (k is the wave number), where the vertical neighboring dust trajectories start to crossover and the resonant wave heating with uncertain crest trapping onsets. The dephased dust oscillations cause the abrupt dropping and broadening of the wave crest after breaking, accompanied by the transition from the liquid phase with coherent dust oscillation to the gas phase with chaotic dust oscillation. Corkscrew-shaped phase-space distributions measured at the fixed phases of the wave oscillation cycle clearly indicate how dusts move in and constitute the evolving waveform through dust-wave interaction.

  11. Three-wave and four-wave interactions of harmonic nonlinear surface waves on deep water

    NASA Astrophysics Data System (ADS)

    Efimov, Viktor; Ilic, Suzana; Luxmoore, James; McClintock, Peter; Nygaard, Ivar; Pakodzi, Csaba; Stansberg, Carl; Stefanovska, Aneta

    2014-05-01

    The dispersion law for deep-water gravitational surface waves of small amplitude, ? ~k-, allows only for four-wave interactions, with three-wave processes being forbidden by energy and momentum conservation. The situation changes slightly if the amplitude of waves increases and they become nonlinear. Under these conditions, the three-wave interaction is possible and, in the quasi-one-dimensional case, it leads to the formation of multiple harmonics. We have studied experimentally the propagation of quasi-one-dimensional harmonic waves in the 50x70m Marintek Ocean Basin. The water depth was 3m. Sensors were positioned in different groups along the central axis of the basin in the direction of wave propagation. Waves were investigated within the frequency range 0.4 - 2.5 Hz, for amplitudes 0.068 - 0.2 m. The signal recording time for each set of measurements was typically 300s, corresponding to approximately 200-500 wave crests. The time dependence of the wave shape at each sensor was investigated both by Fourier analysis and in terms of amplitude statistics as functions of time and distance from the wave generator. All of the harmonic waves studied in our experiments (A=0.068m and higher) were nonlinear, and the three-wave interaction was the dominant process in creating surface turbulence. The effect of four-wave interactions was seen only for waves of much smaller amplitude, reflected back from the remote wave absorber. An increase in wave amplitude up to h/? ~ 0.2 led to the formation of multiple harmonics within the first ten wavelengths, but their Fourier spectrum smeared as the waves propagated along the basin. For high amplitude waves we observed the formation of an inverse energy flux from the pumping frequency towards the lower energy edge of the spectrum. We will discuss the Fourier spectrum and amplitude, the analysis of the initial harmonic waves and their evolution with time and distance, and the effects of wave interactions for both two and three co-linear harmonic waves.

  12. Dimensions and Gravitational Waves

    NASA Astrophysics Data System (ADS)

    van Haasteren, Rutger

    2014-10-01

    High-precision timing of Galactic millisecond pulsars with radio telescopes holds great promise for the detection of astrophysical gravitational-waves in frequency range 10--100 nHz. Modern Bayesian data analysis methods rely mostly on Markov Chain Monte Carlo (MCMC) to explore the model parameter space when searching for signals in the pulsar timing data. Current challenges involve parameter spaces with large dimensionality, and linear algebra of high-dimensional systems. I will present sampling methods (taken from the Planck analysis team), and rank-reduction methods for large linear systems, that have enabled us to decrease the dimensionality of such problems. These methods are now being used to search for gravitational-waves in pulsar timing array projects. Especially our rank-reduction techniques are useful for any data analysis problem that involve large linear least-squares systems.

  13. Nonlinear Hysteretic Torsional Waves.

    PubMed

    Cabaret, J; Béquin, P; Theocharis, G; Andreev, V; Gusev, V E; Tournat, V

    2015-07-31

    We theoretically study and experimentally report the propagation of nonlinear hysteretic torsional pulses in a vertical granular chain made of cm-scale, self-hanged magnetic beads. As predicted by contact mechanics, the torsional coupling between two beads is found to be nonlinear hysteretic. This results in a nonlinear pulse distortion essentially different from the distortion predicted by classical nonlinearities and in a complex dynamic response depending on the history of the wave particle angular velocity. Both are consistent with the predictions of purely hysteretic nonlinear elasticity and the Preisach-Mayergoyz hysteresis model, providing the opportunity to study the phenomenon of nonlinear dynamic hysteresis in the absence of other types of material nonlinearities. The proposed configuration reveals a plethora of interesting phenomena including giant amplitude-dependent attenuation, short-term memory, as well as dispersive properties. Thus, it could find interesting applications in nonlinear wave control devices such as strong amplitude-dependent filters. PMID:26274421

  14. Holographic p -wave superfluid

    NASA Astrophysics Data System (ADS)

    Wu, Ya-Bo; Lu, Jun-Wang; Zhang, Wen-Xin; Zhang, Cheng-Yuan; Lu, Jian-Bo; Yu, Fang

    2014-12-01

    In the probe limit, we numerically construct a holographic p -wave superfluid model in the four-dimensional (4D) and five-dimensional (5D) anti-de Sitter black holes coupled to a Maxwell-complex vector field. We find that, for the condensate with the fixed superfluid velocity, the results are similar to the s -wave cases in both 4D and 5D spacetimes. In particular, the Cave of Winds and the phase transition, always being of second order, take place in the 5D case. Moreover, we find that the translating superfluid velocity from second order to first order S/y? increases with the mass squared. Furthermore, for the supercurrent with fixed temperature, the results agree with the Ginzburg-Landau prediction near the critical temperature. In addition, this complex vector superfluid model is still a generalization of the SU(2) superfluid model, and it also provides a holographic realization of the H e3 superfluid system.

  15. Supersymmetric string waves

    SciTech Connect

    Bergshoeff, E.A. ); Kallosh, R.; Ortin, T. )

    1993-06-15

    We present plane-wave-type solutions of the lowest-order superstring effective action which have unbroken space-time supersymmetries. They are given by a stringy generalization of the Brinkmann metric, dialton, axion, and gauge fields. Some conspiracy between the metric and the axion field is required. The [alpha][prime] stringy corrections to the effective on-shell action, to the equations of motion (and therefore to the solutions themselves), and to the supersymmetry transformations are shown to vanish for a special class of these solutions that we call supersymmetric string waves (SSW's). In the SSW solutions, there exists a conspiracy not only between the metric and the axion field, but also between the gauge fields and the metric, since the embedding of the spin connection in the gauge group is required.

  16. Plasma wave accelerator. II

    SciTech Connect

    Mori, W.; Joshi, C.; Dawson, J.M.

    1982-01-01

    It was shown that the insertion of a cross magnetic field prevents the particles from getting out of phase with the electric field of the plasma wave in the beat wave accelerator scheme. Thus, using a CO/sub 2/ laser, n/sub c//n/sub e/ = (..omega../sub 0//..omega../sub p/)/sup 2/ approx. 35, and a 300 kG magnetic field, electrons can be (in principle) accelerated to 100 GeV in 2 meters. For comparison without the magnetic field, the same energies may be obtained in a n/sub c//n/sub e/ approx. 10/sup 5/ plasma over a distance of 100 meters.

  17. Nonlinear Hysteretic Torsional Waves

    NASA Astrophysics Data System (ADS)

    Cabaret, J.; Béquin, P.; Theocharis, G.; Andreev, V.; Gusev, V. E.; Tournat, V.

    2015-07-01

    We theoretically study and experimentally report the propagation of nonlinear hysteretic torsional pulses in a vertical granular chain made of cm-scale, self-hanged magnetic beads. As predicted by contact mechanics, the torsional coupling between two beads is found to be nonlinear hysteretic. This results in a nonlinear pulse distortion essentially different from the distortion predicted by classical nonlinearities and in a complex dynamic response depending on the history of the wave particle angular velocity. Both are consistent with the predictions of purely hysteretic nonlinear elasticity and the Preisach-Mayergoyz hysteresis model, providing the opportunity to study the phenomenon of nonlinear dynamic hysteresis in the absence of other types of material nonlinearities. The proposed configuration reveals a plethora of interesting phenomena including giant amplitude-dependent attenuation, short-term memory, as well as dispersive properties. Thus, it could find interesting applications in nonlinear wave control devices such as strong amplitude-dependent filters.

  18. Gravity wave initiated convection

    NASA Technical Reports Server (NTRS)

    Hung, R. J.

    1990-01-01

    The vertical velocity of convection initiated by gravity waves was investigated. In one particular case, the convective motion-initiated and supported by the gravity wave-induced activity (excluding contributions made by other mechanisms) reached its maximum value about one hour before the production of the funnel clouds. In another case, both rawinsonde and geosynchronous satellite imagery were used to study the life cycles of severe convective storms. Cloud modelling with input sounding data and rapid-scan imagery from GOES were used to investigate storm cloud formation, development and dissipation in terms of growth and collapse of cloud tops, as well as, the life cycles of the penetration of overshooting turrets above the tropopause. The results based on these two approaches are presented and discussed.

  19. On gravitational waves

    NASA Astrophysics Data System (ADS)

    Chiba, J.

    1984-11-01

    Gravitational wave is produced whenever massive bodies accelerate under gravitational or nongravitational driving forces. The equations of Einstein's general theory of relativity have solutions in the weak field approximations which are very similar to those of electrodynamics. Analogies may be made between gravitational radiation and the electromagnetic radiation from accelerated charges although care has to be taken to recognize the limitations of such analogies. Because of the weakness of the Einstein's qravitational constant, the rate of energy radiated is normally very small. It is very desirable to be able to generate dynamic Newtonian gravitational field with sufficient intensity to be detected in the small laboratory. Experimental techniques used in generation and detection of dynamic Newtonian gravitational fields are reviewed and their application to Morse code communication in very near zone, as one approach to the gravitational wave technology.

  20. Sources of gravitational waves

    NASA Technical Reports Server (NTRS)

    Schutz, Bernard F.

    1989-01-01

    Sources of low frequency gravitational radiation are reviewed from an astrophysical point of view. Cosmological sources include the formation of massive black holes in galactic nuclei, the capture by such holes of neutron stars, the coalescence of orbiting pairs of giant black holes, and various means of producing a stochastic background of gravitational waves in the early universe. Sources local to our Galaxy include various kinds of close binaries and coalescing binaries. Gravitational wave astronomy can provide information that no other form of observing can supply; in particular, the positive identification of a cosmological background originating in the early universe would be an event as significant as was the detection of the cosmic microwave background.