1
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Jochims F, Lippmann N, Simon JC. [Painful ulcers in a young male refugee]. Dermatologie (Heidelb) 2024; 75:340-342. [PMID: 38172280 DOI: 10.1007/s00105-023-05285-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Affiliation(s)
- F Jochims
- , Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
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2
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Khandare S, Smallcomb M, Elliott J, Vidt ME, Simon JC. Focused ultrasound as an alternative to dry needling for the treatment of tendinopathies: A murine model. J Orthop Res 2024; 42:598-606. [PMID: 37804211 DOI: 10.1002/jor.25700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 05/26/2023] [Accepted: 10/05/2023] [Indexed: 10/09/2023]
Abstract
Tendinopathies account for 30% of 102 million annual musculoskeletal injuries occurring annually in the United States. Current treatments, like dry needling, induce microdamage to promote healing but produce mixed success rates. Previously, we showed focused ultrasound can noninvasively create microdamage while preserving mechanical properties in ex vivo murine tendons. This present study compared growth factor, histological, and mechanical effects after focused ultrasound or dry needling treatments in an in vivo murine tendon injury model. Partial Achilles tenotomy was performed in 26 rats. One-week postsurgery, tendons were treated with focused ultrasound (1.5 MHz, 1-ms pulses at 10 Hz for 106 s, p+ = 49 MPa, p- = 19 MPa) or dry needling (30 G needle, 5 fenestrations over 20 s) and survived for 1 additional week. Blood was collected immediately before and after treatment and before euthanasia; plasma was assayed for growth factors. Treated tendons and contralateral controls were harvested for histology or mechanical testing. No differences were found between treatments in release of insulin growth factor 1 and transforming growth factor beta; vascular endothelial growth factor A concentrations were too low for detection. Histologically, focused ultrasound and dry needling tendons displayed localized fibroblast infiltration without collagen proliferation with no detectable differences between treatments. Mechanically, stiffness and percent relaxation of dry needling tendons were lower than controls (p = 0.0041, p = 0.0441, respectively), whereas stiffness and percent relaxation of focused ultrasound tendons were not different from controls. These results suggest focused ultrasound should be studied further to determine how this modality can be leveraged as a therapy for tendinopathies.
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Affiliation(s)
- Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Molly Smallcomb
- Graduate Program in Acoustics, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jacob Elliott
- Graduate Program in Acoustics, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
- Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Julianna C Simon
- Biomedical Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
- Graduate Program in Acoustics, Pennsylvania State University, University Park, Pennsylvania, USA
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3
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Rokni E, Simon JC. Effect of ambient gas and crystal features on Doppler ultrasound twinkling of pathological mineralizations. J Acoust Soc Am 2023; 154:3397-3402. [PMID: 37991465 DOI: 10.1121/10.0022511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023]
Abstract
Color Doppler twinkling on kidney stones and other pathological mineralizations is theorized to arise from stable microbubbles, which suggests twinkling will be sensitive to ambient gas. Here, lab-grown cholesterol, calcium phosphate, and uric acid crystals were imaged with ultrasound in water while varying oxygen, carbon dioxide, and nitrogen levels. Twinkling was found to increase on cholesterol in elevated oxygen, cholesterol and calcium phosphate in elevated carbon dioxide, and no crystals in elevated nitrogen. These results support the crevice microbubble theory of twinkling and suggest gases may be varied to enhance twinkling on some mineralizations.
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Affiliation(s)
- Eric Rokni
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
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4
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Kim I, Elliott JC, Lawanprasert A, Wood GM, Simon JC, Medina SH. Real-Time, In Situ Imaging of Macrophages via Phase-Change Peptide Nanoemulsions. Small 2023; 19:e2301673. [PMID: 37452514 PMCID: PMC10787802 DOI: 10.1002/smll.202301673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/22/2023] [Indexed: 07/18/2023]
Abstract
Macrophages are specialized phagocytes that play central roles in immunity and tissue repair. Their diverse functionalities have led to an evolution of new allogenic and autologous macrophage products. However, realizing the full therapeutic potential of these cell-based therapies requires development of imaging technologies that can track immune cell migration within tissues in real-time. Such innovations will not only inform treatment regimens and empower interpretation of therapeutic outcomes but also enable prediction and early intervention during adverse events. Here, phase-changing nanoemulsion contrast agents are reported that permit real-time, continuous, and high-fidelity ultrasound imaging of macrophages in situ. Using a de novo designed peptide emulsifier, liquid perfluorocarbon nanoemulsions are prepared and show that rational control over interfacial peptide assembly affords formulations with tunable acoustic sensitivity, macrophage internalization, and in cellulo stability. Imaging experiments demonstrate that emulsion-loaded macrophages can be readily visualized using standard diagnostic B-mode and Doppler ultrasound modalities. This allows on-demand and long-term tracking of macrophages within porcine coronary arteries, as an exemplary model. The results demonstrate that this platform is poised to open new opportunities for non-invasive, contrast-enhanced imaging of cell-based immunotherapies in tissues, while leveraging the low-cost, portable, and safe nature of diagnostic ultrasound.
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Affiliation(s)
- Inhye Kim
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802-4400, USA
| | - Jacob C Elliott
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, 16802-4400, USA
| | - Atip Lawanprasert
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802-4400, USA
| | - Grace M Wood
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, 16802-4400, USA
| | - Julianna C Simon
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802-4400, USA
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, 16802-4400, USA
| | - Scott H Medina
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802-4400, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802-4400, USA
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5
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Yeingst TJ, Arrizabalaga JH, Rawnaque FS, Stone LP, Yeware A, Helton AM, Dhawan A, Simon JC, Hayes DJ. Controlled Degradation of Polycaprolactone Polymers through Ultrasound Stimulation. ACS Appl Mater Interfaces 2023; 15:34607-34616. [PMID: 37432796 PMCID: PMC10496768 DOI: 10.1021/acsami.3c06873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
This study describes the development of an ultrasound-responsive polymer system that provides on-demand degradation when exposed to high-intensity focused ultrasound (HIFU). Diels-Alder cycloadducts were used to crosslink polycaprolactone (PCL) polymers and underwent a retro Diels-Alder reaction when stimulated with HIFU. Two Diels-Alder polymer compositions were explored to evaluate the link between reverse reaction energy barriers and polymer degradation rates. PCL crosslinked with isosorbide was also used as a non-Diels-Alder-based control polymer. An increase of HIFU exposure time and amplitude correlated with an increase of PCL degradation for Diels-Alder-based polymers. Ultrasound imaging during HIFU allowed for real-time visualization of the on-demand degradation through cavitation-based mechanisms. The temperature surrounding the sample was monitored with a thermocouple during HIFU stimulation; a minimal increase in temperature was observed. PCL polymers were characterized using Fourier transform infrared (FTIR) spectroscopy, nuclear magnetic resonance (NMR), differential scanning calorimetry (DSC), optical profilometry, and mechanical testing. PCL degradation byproducts were identified by mass spectrometry, and their cytocompatibility was evaluated in vitro. Overall, this study demonstrated that HIFU is an effective image-guided, external stimulus to control the degradation of Diels-Alder-based PCL polymers on-demand.
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Affiliation(s)
- Tyus J Yeingst
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Julien H Arrizabalaga
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Ferdousi S Rawnaque
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Lindsay P Stone
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Amar Yeware
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Angelica M Helton
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Aman Dhawan
- Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, United States
| | - Julianna C Simon
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Daniel J Hayes
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- Materials Research Institute, Millennium Science Complex, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- The Huck Institute of Life Sciences, Millennium Science Complex, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
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Smallcomb M, Simon JC. Dual-frequency boiling histotripsy in an ex vivo bovine tendinopathy model. J Acoust Soc Am 2023; 153:3182. [PMID: 37279386 PMCID: PMC10247224 DOI: 10.1121/10.0019630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/19/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023]
Abstract
Histotripsy fractionates most soft tissues; however, healthy tendons have shown resistance to histotripsy fractionation. Prior work has shown that pre-heating tendons increases susceptibility to histotripsy fractionation; combining multiple driving frequencies may also allow successful fractionation of tendons. Here, we evaluate single- and dual-frequency histotripsy in four healthy and eight tendinopathic ex vivo bovine tendons. First, we evaluated single-frequency (1.07, 1.5, and 3.68 MHz) and dual-frequency (1.07 and 1.5 MHz or 1.5 and 3.68 MHz) bubble dynamics with high-speed photography in a tissue-mimicking phantom. Then, tendons were treated with histotripsy. Cavitation activity was monitored with a passive cavitation detector (PCD) and targeted areas were evaluated grossly and histologically. Results in tendinopathic tendons showed 1.5 MHz or 3.68 MHz single-frequency exposure caused focal disruption, whereas 1.5 and 3.68 MHz dual-frequency exposures caused fractionated holes; all treatments caused some thermal denaturation. Exposure to 1.07 MHz alone or combined with 1.5 MHz did not show fractionation in tendinopathic tendons. In healthy tendons, only thermal necrosis was observed for all tested exposures. PCD showed some differences in cavitation activity in tendinopathic tendons but did not predict successful fractionation. These results suggest that full histotripsy fractionation is possible using dual-frequency exposures in tendinopathic tendons.
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Affiliation(s)
- Molly Smallcomb
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
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Elliott J, Simon JC. Histotripsy Bubble Dynamics in Elastic, Anisotropic Tissue-Mimicking Phantoms. Ultrasound Med Biol 2023; 49:853-865. [PMID: 36577567 PMCID: PMC9908827 DOI: 10.1016/j.ultrasmedbio.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Elastic, anisotropic tissue such as tendon has proven resistant to mechanical fractionation by histotripsy, a subset of focused ultrasound that uses the creation, oscillation and collapse of cavitation bubbles to fractionate tissue. Our objective was to fabricate an optically transparent hydrogel that mimics tendon for evaluation of histotripsy bubble dynamics. Ex vivo bovine deep digital flexor tendons were obtained (n = 4), and varying formulations of polyacrylamide (PA), collagen and fibrin hydrogels (n = 3 each) were fabricated. Axial sound speeds were measured at 1 MHz for calculation of anisotropy. All samples were treated with a 1.5-MHz focused ultrasound transducer with 10-ms pulses repeated at 1 Hz (p+ = 127 MPa, p- = 35 MPa); treatments were monitored with passive cavitation imaging and high-speed photography. Dehydrated fibrin gels were found to be the most similar to tendon in cavitation emission energy (fibrin = 0.69 ± 0.24, tendon = 0.64 ± 0.19 [× 1010 V2]) and anisotropy (fibrin = 3.16 ± 1.12, tendon = 19.4). Bubble cloud area in dehydrated fibrin (0.79 ± 0.14 mm2) was significantly smaller than most other tested hydrogels. Finally, anisotropy was found to have moderately strong linear relationships with cavitation energy and bubble cloud size (r = -0.65 and -0.80, respectively). Dehydrated fibrin shows potential as a repeatable, transparent, tissue-mimicking hydrogel for evaluation of histotripsy bubble dynamics in elastic, anisotropic tissues.
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Affiliation(s)
- Jake Elliott
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania, USA.
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania, USA
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8
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Rokni E, Simon JC. The effect of crystal composition and environment on the color Doppler ultrasound twinkling artifact. Phys Med Biol 2023; 68. [PMID: 36634375 DOI: 10.1088/1361-6560/acb2ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 01/12/2023] [Indexed: 01/14/2023]
Abstract
Objective.Pathological mineralizations form throughout the body and can be difficult to detect using conventional imaging methods. Color Doppler ultrasound twinkling highlights ∼60% of kidney stones with a rapid color shift and is theorized to arise from crevice microbubbles as twinkling disappears on kidney stones at elevated pressures and scratched acrylic balls in ethanol. Twinkling also sometimes appears on other pathological mineralizations; however, it is unclear whether the etiology of twinkling is the same as for kidney stones.Approach.In this study, five cholesterol, calcium phosphate, and uric acid crystals were grownin vitroand imaged in Doppler mode with a research ultrasound system and L7-4 transducer in water. To evaluate the influence of pressure on twinkling, the same crystals were imaged in a high-pressure chamber. Then, the effect of surface tension on twinkling was evaluated by imaging crystals in different concentrations of surfactant (1%, 2%, 3%, 4%) and ethanol (10%, 30%, 50%, 70%), artificial urine, bovine blood, and a tissue-mimicking phantom.Main results. Results showed that all crystals twinkled in water, with cholesterol twinkling significantly more than calcium phosphate and uric acid. When the ambient pressure was increased, twinkling disappeared for all tested crystals when pressures reached 7 MPa (absolute) and reappeared when returned to ambient pressure (0.1 MPa). Similarly, twinkling across all crystals decreased with surface tension when imaged in the surfactant and ethanol (statistically significant when surface tension <22 mN m-1) and decreased in blood (surface tension = 52.7 mN m-1) but was unaffected by artificial urine (similar surface tension to water). In the tissue-mimicking phantom, twinkling increased for cholesterol and calcium phosphate crystals with no change observed in uric acid crystals.Significance.Overall, these results support the theory that bubbles are present on crystals and cause twinkling, which could be leveraged to improve twinkling for the detection of other pathological mineralizations.
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Affiliation(s)
- Eric Rokni
- Graduate Program in Acoustics, The Pennsylvania State University, 201E Applied Science Building, University Park, PA 16802, United States of America
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, 201E Applied Science Building, University Park, PA 16802, United States of America
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Smallcomb M, Simon JC. High intensity focused ultrasound atomization and erosion in healthy and tendinopathic tendons. Phys Med Biol 2023; 68:10.1088/1361-6560/aca9b7. [PMID: 36595243 PMCID: PMC10122516 DOI: 10.1088/1361-6560/aca9b7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/07/2022] [Indexed: 12/12/2022]
Abstract
Objective.High-intensity focused ultrasound (HIFU) can induce thermal and mechanical mechanisms in a well-defined focal volume of tissues. Histotripsy is a form of mechanical HIFU that can initiate and interact with bubble(s) to cause shock scattering and perhaps atomization within the bubble(s) to fractionate most soft tissues. Ultrasonic atomization, or the ejection of fine droplets from an acoustically-excited liquid exposed to air, has been shown to erode planar soft tissue surfaces, which has led to theories that atomization is a mechanism in histotripsy. However, healthy tendons show resistance to conventional histotripsy; pre-treatment of tendons with heat increases susceptibility to histotripsy fractionation. This study investigates ultrasonic atomization and erosion from planar healthy and tendinopathic tendon surfaces as we evaluate HIFU parameters for histotripsy in tendons.Approach.Forty-sixex vivobovine tendon-air interfaces were pre-conditioned to surface wetting, heat baths of 20 °C (unaltered), 37 °C (body temperature), and 58 °C (collagen degradation), collagenase soaks for 1, 3, 5, and 24 h (mimicking tendinopathic tendons), and phosphate buffered saline soaks for 24 h. Ejected fragments, histology, and gross analysis determined erosion success. Tissue displacement from the HIFU radiation force was monitored with high-speed photography, and tissue relaxation was pixel-tracked and fit to a Kelvin-Voigt model to evaluate changes in viscoelastic properties.Main results.Results showed that atomization produced holes in 24 h collagenase tendons and surface pitting in 58 °C, 3 h, and 5 h collagenase tendons. Increased mound heights and viscoelastic constants in pre-heated (to 58 °C) and collagenase-soaking (3+ hours) tendinopathic models caused a decrease in elasticity and/or increase in viscosity, increasing susceptibility to erosion by HIFU atomization.Significance.Therefore, tendons with chronic tendinopathies may be more susceptible than healthy tendons to histotripsy fractionation.
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Affiliation(s)
- Molly Smallcomb
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, PA, United States of America
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, PA, United States of America
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Williams RP, Simon JC, Khokhlova VA, Sapozhnikov OA, Khokhlova TD. The histotripsy spectrum: differences and similarities in techniques and instrumentation. Int J Hyperthermia 2023; 40:2233720. [PMID: 37460101 PMCID: PMC10479943 DOI: 10.1080/02656736.2023.2233720] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/15/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
Since its inception about two decades ago, histotripsy - a non-thermal mechanical tissue ablation technique - has evolved into a spectrum of methods, each with distinct potentiating physical mechanisms: intrinsic threshold histotripsy, shock-scattering histotripsy, hybrid histotripsy, and boiling histotripsy. All methods utilize short, high-amplitude pulses of focused ultrasound delivered at a low duty cycle, and all involve excitation of violent bubble activity and acoustic streaming at the focus to fractionate tissue down to the subcellular level. The main differences are in pulse duration, which spans microseconds to milliseconds, and ultrasound waveform shape and corresponding peak acoustic pressures required to achieve the desired type of bubble activity. In addition, most types of histotripsy rely on the presence of high-amplitude shocks that develop in the pressure profile at the focus due to nonlinear propagation effects. Those requirements, in turn, dictate aspects of the instrument design, both in terms of driving electronics, transducer dimensions and intensity limitations at surface, shape (primarily, the F-number) and frequency. The combination of the optimized instrumentation and the bio-effects from bubble activity and streaming on different tissues, lead to target clinical applications for each histotripsy method. Here, the differences and similarities in the physical mechanisms and resulting bioeffects of each method are reviewed and tied to optimal instrumentation and clinical applications.
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Affiliation(s)
- Randall P Williams
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, PA, USA
| | - Vera A Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
- Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia
| | - Oleg A Sapozhnikov
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
- Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia
| | - Tatiana D Khokhlova
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
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Rawnaque FS, Simon JC. The effects of elastic modulus and impurities on bubble nuclei available for acoustic cavitation in polyacrylamide hydrogels. J Acoust Soc Am 2022; 152:3502. [PMID: 36586847 DOI: 10.1121/10.0016445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Safety of biomedical ultrasound largely depends on controlling cavitation bubbles in vivo, yet bubble nuclei in biological tissues remain unexplored compared to water. This study evaluates the effects of elastic modulus (E) and impurities on bubble nuclei available for cavitation in tissue-mimicking polyacrylamide (PA) hydrogels. A 1.5 MHz focused ultrasound transducer with f# = 0.7 was used to induce cavitation in 17.5%, 20%, and 22.5% v/v PA hydrogels using 10-ms pulses with pressures up to peak negative pressure (p-) = 35 MPa. Cavitation was monitored at 0.075 ms through high-speed photography at 40 000 fps. At p- = 29 MPa for all hydrogels, cavitation occurred at random locations within the -6 dB focal area [9.4 × 1.2 mm (p-)]. Increasing p- to 35 MPa increased bubble location consistency and caused shock scattering in the E = 282 MPa hydrogels; as the E increased to 300 MPa, bubble location consistency decreased (p = 0.045). Adding calcium phosphate or cholesterol at 0.25% w/v or bovine serum albumin at 5% or 10% w/v in separate 17.5% PA as impurities decreased the cavitation threshold from p- = 13.2 MPa for unaltered PA to p- = 11.6 MPa, p- = 7.3 MPa, p- = 9.7 MPa, and p- = 7.5 MPa, respectively. These results suggest that both E and impurities affect the bubble nuclei available for cavitation in tissue-mimicking hydrogels.
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Affiliation(s)
- Ferdousi Sabera Rawnaque
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
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12
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Abstract
ABSTRACT Tendon injury is prevalent and costly in the United States, comprising 45% of the 66 million musculoskeletal injuries and costing $114 billion annually. Surgical and therapeutic methods, such as arthroscopic surgery, dry needling, and physical therapy, produce mixed success in reintroducing a healing response in tendinopathy due in part to inconsistent dosing and monitoring. Ultrasound is one therapeutic modality that has been shown to noninvasively induce bioeffects in tendon that may help promote healing. However, results from this modality have also been mixed. This review compares the current state of the field in therapeutic ultrasound and shockwave therapy, including low-intensity therapeutic ultrasound, extracorporeal shockwave therapy, and radial shockwave therapy, and evaluates the efficacy in treating tendinopathies with ultrasound. We found that the mixed successes may be attributed to the wide variety of achievable parameters within each broader treatment type and the lack of standardization in measurements and reporting. Despite mixed outcomes, all three therapies show potential as an alternative therapy with lower-risk adverse effects than more invasive methods like surgery. There is currently insufficient evidence to conclude which ultrasound modality or settings are most effective. More research is needed to understand the healing effects of these different therapeutic ultrasound and shockwave modalities.
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Affiliation(s)
- Molly Smallcomb
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, PA, USA
| | - Sujata Khandare
- Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
| | - Meghan E. Vidt
- Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
- Physical Medicine & Rehabilitation, Pennsylvania State College of Medicine, Hershey, PA, USA
| | - Julianna C. Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, PA, USA
- Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
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13
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Arrizabalaga JH, Smallcomb M, Abu-Laban M, Liu Y, Yeingst TJ, Dhawan A, Simon JC, Hayes DJ. Ultrasound-Responsive Hydrogels for On-Demand Protein Release. ACS Appl Bio Mater 2022; 5:3212-3218. [PMID: 35700312 PMCID: PMC10496416 DOI: 10.1021/acsabm.2c00192] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of tunable, ultrasound-responsive hydrogels that can deliver protein payload on-demand when exposed to focused ultrasound is described in this study. Reversible Diels-Alder linkers, which undergo a retro reaction when stimulated with ultrasound, were used to cross-link chitosan hydrogels with entrapped FITC-BSA as a model protein therapeutic payload. Two Diels-Alder linkage compositions with large differences in the reverse reaction energy barriers were compared to explore the influence of linker composition on ultrasound response. Selected physicochemical properties of the hydrogel construct, its basic degradation kinetics, and its cytocompatibility were measured with respect to Diels-Alder linkage composition. Focused ultrasound initiated the retro Diels-Alder reaction, controlling the release of the entrapped payload while also allowing for real-time visualization of the ongoing process. Additionally, increasing the focused ultrasound amplitude and time correlated with an increased rate of protein release, indicating stimuli responsive control.
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Affiliation(s)
- Julien H Arrizabalaga
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Molly Smallcomb
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Mohammad Abu-Laban
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Yiming Liu
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Tyus J Yeingst
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Aman Dhawan
- Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, United States
| | - Julianna C Simon
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Daniel J Hayes
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- Materials Research Institute, Millennium Science Complex, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- The Huck Institute of the Life Sciences, Millennium Science Complex, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
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14
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Elliott J, Khandare S, Butt AA, Smallcomb M, Vidt ME, Simon JC. Automated Tissue Strain Calculations Using Harris Corner Detection. Ann Biomed Eng 2022; 50:564-574. [PMID: 35334018 DOI: 10.1007/s10439-022-02946-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Abstract
The elastic modulus, or slope of the stress-strain curve, is an important metric for evaluating tissue functionality, particularly for load-bearing tissues such as tendon. The applied force can be tracked directly from a mechanical testing system and converted to stress using the tissue cross-sectional area; however, strain can only be calculated in post-processing by tracking tissue displacement from video collected during mechanical testing. Manual tracking of Verhoeff stain lines pre-marked on the tissue is time-consuming and highly dependent upon the user. This paper details the development and testing of an automated processing method for strain calculations using Harris corner detection. The automated and manual methods were compared in a dataset consisting of 97 rat tendons (48 Achilles tendons, 49 supraspinatus tendons), divided into ten subgroups for evaluating the effects of different therapies on tendon mechanical properties. The comparison showed that average percent differences between the approaches were 0.89% and -2.10% for Achilles and supraspinatus tendons, respectively. The automated approach reduced processing time by 83% and produced similar results to the manual method when comparing the different subgroups. This automated approach to track tissue displacements and calculate elastic modulus improves post-processing time while simultaneously minimizing user dependency.
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Affiliation(s)
- Jake Elliott
- Graduate Program in Acoustics, Pennsylvania State University, 201E Applied Science Building, University Park, PA, 16802, USA.
| | - Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Ali A Butt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Molly Smallcomb
- Graduate Program in Acoustics, Pennsylvania State University, 201E Applied Science Building, University Park, PA, 16802, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA.,Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Julianna C Simon
- Graduate Program in Acoustics, Pennsylvania State University, 201E Applied Science Building, University Park, PA, 16802, USA.,Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
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15
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Mentzel J, Anderegg U, Paasch U, Simon JC, Grupp M, Grunewald S. 'Retraction artefacts' in basal cell carcinomas do not result from fixation but likely arise by degradation of extracellular matrix during tumour growth. J Eur Acad Dermatol Venereol 2021; 36:e244-e247. [PMID: 34704294 DOI: 10.1111/jdv.17776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- J Mentzel
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - U Anderegg
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - U Paasch
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - M Grupp
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - S Grunewald
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
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16
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Smallcomb M, Elliott J, Khandare S, Butt AA, Vidt ME, Simon JC. Focused Ultrasound Mechanical Disruption of Ex Vivo Rat Tendon. IEEE Trans Ultrason Ferroelectr Freq Control 2021; 68:2981-2986. [PMID: 33891552 PMCID: PMC8547257 DOI: 10.1109/tuffc.2021.3075375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Around 30 million tendon injuries occur annually in the U.S. costing $ 114 billion. Conservative therapies, like dry needling, promote healing in chronically injured tendons by inducing microdamage but have mixed success rates. Focused ultrasound (fUS) therapy can noninvasively fractionate tissues through the creation, oscillation, and collapse of bubbles in a process termed histotripsy; however, highly collagenous tissues, like tendon, have shown resistance to mechanical fractionation. This study histologically evaluates whether fUS mechanical disruption is achievable in tendons. Ex vivo rat tendons (45 Achilles and 44 supraspinatus) were exposed to 1.5-MHz fUS operating with 0.1-10 ms pulses repeated at 1-100 Hz for 15-60 s with peak positive pressures <89 MPa and peak negative pressures <26 MPa; other tendons were exposed to dry needling or sham. Immediately after treatment, tendons were flash-frozen and stained with hematoxylin and eosin (H&E) or alpha-nicotinamide adenine dinucleotide diaphorase ( α -NADH-d) and evaluated by two reviewers blinded to the exposure conditions. Results showed successful creation of bubbles for all fUS-treated samples; however, not all samples showed histological injury. When the injury was detected, parameter sets with shorter pulses (0.1-1 ms), lower acoustic pressures, or reduced treatment times showed mechanical disruption in the form of fiber separation and fraying with little to no thermal injury. Longer pulses or treatment times showed a combination of mechanical and thermal injury. These findings suggest that mechanical disruption is achievable in tendons within a small window of acoustic parameters, supporting the potential of fUS therapy in tendon treatment.
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17
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Sloand JN, Rokni E, Watson CT, Miller MA, Manning KB, Simon JC, Medina SH. Ultrasound‐Responsive Nanopeptisomes Enable Synchronous Spatial Imaging and Inhibition of Clot Growth in Deep Vein Thrombosis (Adv. Healthcare Mater. 16/2021). Adv Healthc Mater 2021. [DOI: 10.1002/adhm.202170072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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18
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Sloand JN, Rokni E, Watson CT, Miller MA, Manning KB, Simon JC, Medina SH. Ultrasound-Responsive Nanopeptisomes Enable Synchronous Spatial Imaging and Inhibition of Clot Growth in Deep Vein Thrombosis. Adv Healthc Mater 2021; 10:e2100520. [PMID: 34137205 DOI: 10.1002/adhm.202100520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/25/2021] [Indexed: 01/22/2023]
Abstract
Deep vein thrombosis (DVT) is a life-threatening blood clotting condition that, if undetected, can cause deadly pulmonary embolisms. Critical to its clinical management is the ability to rapidly detect, monitor, and treat thrombosis. However, current diagnostic imaging modalities lack the resolution required to precisely localize vessel occlusions and enable clot monitoring in real time. Here, we rationally design fibrinogen-mimicking fluoropeptide nanoemulsions, or nanopeptisomes (NPeps), that allow contrast-enhanced ultrasound imaging of thrombi and synchronous inhibition of clot growth. The theranostic duality of NPeps is imparted via their intrinsic binding to integrins overexpressed on platelets activated during coagulation. The platelet-bound nanoemulsions can be vaporized and oscillate in an applied acoustic field to enable contrast-enhanced Doppler ultrasound detection of thrombi. Concurrently, nanoemulsions bound to platelets competitively inhibit secondary platelet-fibrinogen binding to disrupt further clot growth. Continued development of this synchronous theranostic platform may open new opportunities for image-guided, non-invasive, interventions for DVT and other vascular diseases.
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Affiliation(s)
- Janna N. Sloand
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Eric Rokni
- Graduate Program in Acoustics The Pennsylvania State University University Park PA 16802 USA
| | - Connor T. Watson
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Michael A. Miller
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Keefe B. Manning
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Julianna C. Simon
- Graduate Program in Acoustics The Pennsylvania State University University Park PA 16802 USA
| | - Scott H. Medina
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
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19
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Khandare S, Smallcomb M, Klein B, Geary C, Simon JC, Vidt ME. Comparison between dry needling and focused ultrasound on the mechanical properties of the rat Achilles tendon: A pilot study. J Biomech 2021; 120:110384. [PMID: 33773298 PMCID: PMC8089046 DOI: 10.1016/j.jbiomech.2021.110384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/18/2021] [Accepted: 03/10/2021] [Indexed: 11/25/2022]
Abstract
In the U.S., approximately 14 million tendon and ligament injuries are reported each year. Dry needling (DN) is a conservative treatment introduced to alleviate pain and restore function; however, it is invasive and has mixed success. Focused ultrasound (fUS) is a non-invasive technology that directs ultrasound energy into a well-defined focal volume. fUS induces thermal and/or mechanical bioeffects which can be controlled by the choice of ultrasound parameters. fUS could be an alternative to DN for treatment of tendon injuries, but the bioeffects must be established. Thus, the purpose of this pilot study was to compare the effect of DN and fUS on the mechanical properties and cell morphology of 30 ex vivo rat Achilles tendons. Tendons were randomly assigned to sham, DN, or fUS, with 10 tendons per group. Within each group, 5 tendons were evaluated mechanically, and 5 tendons were analyzed histologically. Elastic modulus in the DN (74.05 ± 15.0 MPa) group was significantly lower than sham (149.84 ± 59.1 MPa; p = 0.0094) and fUS (128.84 ± 28.3 MPa; p = 0.0453) groups. Stiffness in DN (329.05 ± 236.8 N/mm; p = 0.0034) and fUS (315.26 ± 68.9 N/mm; p = 0.0027) groups were significantly lower than sham (786.10 ± 238.7 N/mm) group. Histologically, localized necrosis was observed in 3 out of 5 tendons exposed to fUS, with surrounding tissue unharmed; no evidence of cellular injury was observed in DN or sham groups. These results suggest that fUS preserves the mechanical properties of tendon better than DN. Further studies are needed to evaluate fUS as an alternative, noninvasive treatment modality for tendon injuries.
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Affiliation(s)
- Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Molly Smallcomb
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, USA
| | - Bailey Klein
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Colby Geary
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Julianna C Simon
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA; Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA; Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
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20
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Rokni E, Zinck S, Simon JC. Evaluation of Stone Features That Cause the Color Doppler Ultrasound Twinkling Artifact. Ultrasound Med Biol 2021; 47:1310-1318. [PMID: 33602553 DOI: 10.1016/j.ultrasmedbio.2021.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The color Doppler ultrasound twinkling artifact is a rapid color shift that appears on 43%-96% of kidney stones. Surface microbubbles on kidney stones are theorized to cause twinkling as exposure to elevated static pressures of 0.41-1.13 MPa (approximately 0.5-1 times diagnostic ultrasound pressure and 5-10 times ambient pressure) reduced twinkling. However, it is unclear what external and internal stone features support bubbles. Thirteen ex vivo kidney stones were scanned with color Doppler ultrasound at 2.5, 5 and 18.5 MHz. Select stones were imaged with environmental scanning electron microscopy or underwater micro-computed tomography to evaluate features that may cause twinkling. Results revealed that the lower frequencies produced larger volumes of twinkling. Condensation first occurred in the smallest (∼1 µm diameter) surface pores and may be indicative of where bubbles form. Gas pockets were seen inside two of three tested stones that may contribute to twinkling. Overall, these results provide evidence of cavity structures both externally and internally and their correlation to the twinkling artifact. This indicates that microbubbles may be present on and within kidney stones and may contribute to the twinkling artifact.
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Affiliation(s)
- Eric Rokni
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania, USA.
| | - Scott Zinck
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania, USA
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21
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Mentzel J, Stecher MM, Paasch U, Simon JC, Grunewald S. Ex vivo confocal laser scanning microscopy with digital staining is able to map characteristic histopathological features and tissue reaction patterns of inflammatory skin diseases. J Eur Acad Dermatol Venereol 2020; 35:e263-e265. [PMID: 33085808 DOI: 10.1111/jdv.17006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- J Mentzel
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - M-M Stecher
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - U Paasch
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - S Grunewald
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
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22
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Abstract
Improved methods are needed to assess the structure and activity of lesions on root surfaces in order to improve clinical decision making. Conventional visual and tactile methods for assessing lesion activity are not reliable, and the clinician is often unable to evaluate if the lesion is progressing or has remineralized. An important marker of an arrested lesion is a highly mineralized surface zone that forms when mineral is deposited in the outer layer of the lesion. In vitro studies have shown that a mineralized surface zone influences the kinetics of water evaporation and the surface temperature while drying. Temperature changes can be monitored by measuring the thermal emission with thermal imaging. Studies have also shown that the depth and severity of demineralization and the thickness of the highly mineralized transparent surface zone on arrested lesions can be measured nondestructively with optical coherence tomography (OCT). Thermal imaging at 8-µm to 13-µm wavelengths was completed on 30 test subjects with a suspected active root caries lesion by monitoring thermal emission from the tooth surfaces during 30 s of air drying. Lesions were also evaluated using cross-polarization OCT (CP-OCT) during lesion dehydration to identify transparent surface zones indicative of arrested lesions and determine if shrinkage occurred during drying. The overall thermal emission recorded during drying was significantly different (P < 0.001) when comparing sound tooth surfaces, lesion areas identified as arrested, and lesion areas identified as active, demonstrating that thermal imaging is a promising approach for the clinical assessment of lesion activity on root surfaces. Ten of the lesions in this study had distinct areas with transparent surface zones that were visible in CP-OCT images. Shrinkage was detected with CP-OCT during drying for 12 lesions. This study confirms that these novel approaches for assessing lesion activity on root surfaces can be implemented in vivo.
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Affiliation(s)
- V Yang
- University of California, San Francisco, San Francisco, CA, USA
| | - Y Zhu
- University of California, San Francisco, San Francisco, CA, USA
| | - D Curtis
- University of California, San Francisco, San Francisco, CA, USA
| | - O Le
- University of California, San Francisco, San Francisco, CA, USA
| | - N Y N Chang
- University of California, San Francisco, San Francisco, CA, USA
| | - W A Fried
- University of California, San Francisco, San Francisco, CA, USA
| | - J C Simon
- University of California, San Francisco, San Francisco, CA, USA
| | - P Banan
- University of California, San Francisco, San Francisco, CA, USA
| | - C L Darling
- University of California, San Francisco, San Francisco, CA, USA
| | - D Fried
- University of California, San Francisco, San Francisco, CA, USA
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23
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Simon JC, Holm JR, Thiel J, Dunmire B, Cunitz BW, Bailey MR. Evidence of Microbubbles on Kidney Stones in Humans. Ultrasound Med Biol 2020; 46:1802-1807. [PMID: 32245546 PMCID: PMC7293935 DOI: 10.1016/j.ultrasmedbio.2020.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/17/2020] [Accepted: 02/16/2020] [Indexed: 06/11/2023]
Abstract
The color Doppler ultrasound twinkling artifact has been found to improve detection of kidney stones with ultrasound; however, it appears on only ∼60% of stones. Evidence from ex vivo kidney stones suggests twinkling arises from microbubbles stabilized in crevices on the stone surface. Yet it is unknown whether these bubbles are present on stones in humans. Here, we used a research ultrasound system to quantify twinkling in humans with kidney stones in a hyperbaric chamber. Eight human patients with non-obstructive kidney stones previously observed to twinkle were exposed to a maximum pressure of 4 atmospheres absolute (ATA) while breathing air, except during the 10-min pause at 1.6 ATA and while the pressure decreased to 1 ATA, during which patients breathed oxygen to minimize the risk of decompression sickness. A paired one-way t-test was used to compare the mean twinkle power at each pressure pause with baseline twinkling, with p < 0.05 considered to indicate significance. Results revealed that exposure to 3 and 4 ATA of pressure significantly reduced twinkle power by averages of 35% and 39%, respectively, in 7 patients (p = 0.04); data from the eighth patient were excluded because of corruption. This study supports the theory that microbubbles are present on kidney stones in humans.
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Affiliation(s)
- Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA; Graduate Program in Acoustics, Pennsylvania State University, University Park, Pennsylvania, USA.
| | - James R Holm
- Center for Hyperbaric Medicine, Virginia Mason Medical Center, Seattle, Washington, USA
| | - Jeffrey Thiel
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Barbrina Dunmire
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Bryan W Cunitz
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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24
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Sloand JN, Nguyen TT, Zinck SA, Cook EC, Zimudzi TJ, Showalter SA, Glick AB, Simon JC, Medina SH. Ultrasound-Guided Cytosolic Protein Delivery via Transient Fluorous Masks. ACS Nano 2020; 14:4061-4073. [PMID: 32134630 DOI: 10.1021/acsnano.9b08745] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The inability to spatiotemporally guide proteins in tissues and efficiently deliver them into cells remains a key barrier to realizing their full potential in precision medicine. Here, we report ultrasound-sensitive fluoro-protein nanoemulsions which can be acoustically tracked, guided, and activated for on-demand cytosolic delivery of proteins, including antibodies, using clinically relevant diagnostic ultrasound. This advance is accessed through the discovery of a family of fluorous tags, or FTags, that transiently mask proteins to mediate their efficient dispersion into ultrasound-sensitive liquid perfluorocarbons, a phenomenon akin to dissolving an egg in liquid Teflon. We identify the biochemical basis for protein fluorous masking and confirm FTag coatings are shed during delivery, without disrupting the protein structure or function. Harnessing the ultrasound sensitivity of fluorous emulsions, real-time imaging is used to simultaneously monitor and activate FTag-protein complexes to enable controlled cytosolic antibody delivery in vitro and in vivo. These findings may advance the development of image-guided, protein-based biosensing and therapeutic modalities.
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Affiliation(s)
- Janna N Sloand
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Theodore T Nguyen
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Scott A Zinck
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Erik C Cook
- Department of Chemistry, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Tawanda J Zimudzi
- Materials Research Institute, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Scott A Showalter
- Department of Chemistry, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Adam B Glick
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Julianna C Simon
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Scott H Medina
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
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25
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Schüürmann M, Stecher MM, Paasch U, Simon JC, Grunewald S. Evaluation of digital staining for ex vivo confocal laser scanning microscopy. J Eur Acad Dermatol Venereol 2020; 34:1496-1499. [PMID: 31732988 DOI: 10.1111/jdv.16085] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/17/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ex vivo confocal laser scanning microscopy (CLSM) is a novel diagnostic tool for the fast examination of native tissue. However, CLSM produces black/white/green images, depending on the refraction indices of the tissue structures, complemented by nuclear fluorescence staining, which the vast majority of Mohs surgeons and dermatopathologists are not trained to interpret. Digital staining is applicable to ex vivo CLSM investigations to simulate the images of conventional slides stained with haematoxylin and eosin (H&E). OBJECTIVES The aim of our study was to evaluate in detail the appearance of human skin structures using digitally stained ex vivo CLSM images and compare the results to that of conventional H&E slides of the same specimen. METHODS After providing informed consent, 26 patients donated their Burow's triangles (healthy skin) that resulted from plastic reconstruction after the R0 excision of skin tumours. After being investigated by ex vivo CLSM, including automated digital staining (VivaScope 2500M-4G, MAVIG GmbH), the specimens were fixed in formalin, embedded in paraffin and stained with H&E. RESULTS Almost all skin structures in the digitally stained ex vivo CLSM images morphologically resembled the structures in the histopathological images acquired from H&E slides. Due to the high refraction index of melanin, the hair shafts appeared bright pink, and the melanocytes and melanophages were poorly imaged, resulting in a strong pink appearance that vastly differed from the appearance of conventional H&E-stained histopathology. CONCLUSIONS Digital staining of ex vivo CLSM images is an easy and highly useful tool to facilitate the interpretation of black-field images generated by confocal laser scanning microscopy for dermatopathologists and Mohs surgeons who are familiar with H&E staining. Unlike the pigmented structures, the cutaneous and subcutaneous structures had excellent visualization with only minimal differences from their appearance on H&E slides.
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Affiliation(s)
- M Schüürmann
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - M M Stecher
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - U Paasch
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - S Grunewald
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
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26
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Treudler R, Zeynalova S, Riedel-Heller SG, Zuelke AE, Roehr S, Hinz A, Glaesmer H, Kage P, Loeffler M, Simon JC. Depression, anxiety and quality of life in subjects with atopic eczema in a population-based cross-sectional study in Germany. J Eur Acad Dermatol Venereol 2020; 34:810-816. [PMID: 31838777 DOI: 10.1111/jdv.16148] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Atopic eczema (AE) may be associated with several mental health problems. In Germany, existing data from selected patient cohorts may lead to misestimation of the problem. OBJECTIVES We aimed to cross-sectionally determine associations of AE with depression, anxiety, quality of life (QoL) and social interactions in subjects from the population-based LIFE-Adult-Study. METHODS Subjects underwent standardized interviews (medical history) and answered standardized questionnaires [Centre of Epidemiologic studies-Depression scale (CES-D), Generalized Anxiety Disorder (GAD-7), Lubben Social Network Scale (LSNS), Short Form Health Survey (SF-8)]. We compared data from subjects with AE with those from subjects with selected other chronic/disabling diseases (cardiovascular, diabetes, cancer) and adjusted for selected sociodemographic parameters. Multivariate binary logistic regression was used for categorical variables, linear regression for continuous variables. RESULTS Out of 9104 adults included (57% female, median age 54 years), 372 (4.1%) had a history of AE. Compared with controls, subjects with AE showed higher scores for depressive symptoms (9.3% vs. 6.3%; P < 0.001) and anxiety (8.4% vs. 5.6%, P < 0.001). Odds ratio (OR) was 1.5 [CI 1.0; 2.3] (P = 0.031) for depression, which was comparable to OR in patients with a history of cancer (OR 1.6 [1-2.3], P = 0.001. OR for anxiety in AE was 1.5 [1.0; 2.2], P < 0.049, which was slightly higher than in diabetes mellitus (OR 1.2) and stroke (OR 1.4). Other than in diabetes and/or stroke, we did not find a significant association between AE and social isolation. QoL scores were lower in AE than in controls (mean 46.9 vs. 48.0, P < 0.001 for physical and 50.6 vs. 52.5, P < 0.001 for mental components). CONCLUSIONS Subjects with AE showed higher values for depression and anxiety as well as lower QoL scores compared to controls. With regard to depression, odds in AE and cancer were hardly different. Medical care of AE patients should therefore include mental health evaluation and treatment if indicated.
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Affiliation(s)
- R Treudler
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - S Zeynalova
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - A E Zuelke
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - S Roehr
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - A Hinz
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - H Glaesmer
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - P Kage
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany
| | - M Loeffler
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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27
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Khokhlova TD, Schade GR, Wang YN, Buravkov SV, Chernikov VP, Simon JC, Starr F, Maxwell AD, Bailey MR, Kreider W, Khokhlova VA. Pilot in vivo studies on transcutaneous boiling histotripsy in porcine liver and kidney. Sci Rep 2019; 9:20176. [PMID: 31882870 PMCID: PMC6934604 DOI: 10.1038/s41598-019-56658-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
Boiling histotripsy (BH) is a High Intensity Focused Ultrasound (HIFU) method for precise mechanical disintegration of target tissue using millisecond-long pulses containing shocks. BH treatments with real-time ultrasound (US) guidance allowed by BH-generated bubbles were previously demonstrated ex vivo and in vivo in exposed porcine liver and small animals. Here, the feasibility of US-guided transabdominal and partially transcostal BH ablation of kidney and liver in an acute in vivo swine model was evaluated for 6 animals. BH parameters were: 1.5 MHz frequency, 5–30 pulses of 1–10 ms duration per focus, 1% duty cycle, peak acoustic powers 0.9–3.8 kW, sonication foci spaced 1–1.5 mm apart in a rectangular grid with 5–15 mm linear dimensions. In kidneys, well-demarcated volumetric BH lesions were generated without respiratory gating and renal medulla and collecting system were more resistant to BH than cortex. The treatment was accelerated 10-fold by using shorter BH pulses of larger peak power without affecting the quality of tissue fractionation. In liver, respiratory motion and aberrations from subcutaneous fat affected the treatment but increasing the peak power provided successful lesion generation. These data indicate BH is a promising technology for transabdominal and transcostal mechanical ablation of tumors in kidney and liver.
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Affiliation(s)
- Tatiana D Khokhlova
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA. .,Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA.
| | - George R Schade
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Sergey V Buravkov
- Faculty of Fundamental Medicine, M.V. Lomonosov Moscow State University, Moscow, Russia
| | | | - Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Frank Starr
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA.,Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Wayne Kreider
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Vera A Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA.,Physics Faculty, M.V. Lomonosov Moscow State University, Moscow, Russia
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28
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Abstract
This article presents the case of a patient with newly developed skin erosions and ulcerations following an exanthematous drug eruption due to sultamicillin therapy. The skin lesions were treated topically with clobetasol and prednicarbate and orally with methylprednisolone. A skin smear revealed massive growth of Escherichia coli bacteria. Blood cultures were negative. The cause for developing ecthyma gangrenosum in our patient were iatrogenic immunosuppression and transient bacteremia.
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Affiliation(s)
- A Markovic
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - J C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - R Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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29
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Abstract
Tinea barbae is a rare dermatomycocis, by definition follicular bound in the beard area of adult men. Manifestation usually starts with erythema accompanied by desquamation. Deeper distribution along terminal hairs leads to folliculitis with formation of pustules and nodes as well as abscesses; fixed adherent yellowish crusts may appear. Frequently there is locoregional swelling of the lymph nodes and occasionally a deterioration of general condition with (sub)febrile temperatures. Often this leads to the initial suspected diagnosis of a bacterial folliculitis barbae or impetigo contagiosa. Tinea barbae is mostly induced by species of the genus Trichophyton (T.). The pathogens are diverse and are mostly zoophilic, sometimes anthropophilic and rarely geophilic dermatophytes. With the help of a specific anamnesis and diagnostic procedure, including mycological examinations, histology and molecular detection of dermatophytes via polymerase chain reaction (PCR), tinea barbae-in our patient induced by T. mentagrophytes-can be rapidly diagnosed. Early initiation and adequate treatment duration lead to restitutio ad integrum.
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Affiliation(s)
- H Kirsten
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - J Haiduk
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - P Nenoff
- Labor für medizinische Mikrobiologie, Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Rötha OT Mölbis, Deutschland
| | - S Uhrlaß
- Labor für medizinische Mikrobiologie, Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Rötha OT Mölbis, Deutschland
| | - M Ziemer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - J C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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30
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Aurich S, Spiric J, Engin A, Simon JC, Mahler V, Treudler R. Report of a Case of IgE-Mediated Anaphylaxis to Fenugreek. J Investig Allergol Clin Immunol 2019; 29:56-58. [DOI: 10.18176/jiaci.0328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Al-Saddik H, Laybros A, Simon JC, Cointault F. Protocol for the Definition of a Multi-Spectral Sensor for Specific Foliar Disease Detection: Case of "Flavescence Dorée". Methods Mol Biol 2019; 1875:213-238. [PMID: 30362007 DOI: 10.1007/978-1-4939-8837-2_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Flavescence Dorée (FD) is a contagious and incurable grapevine disease that can be perceived on leaves. In order to contain its spread, the regulations obligate winegrowers to control each plant and to remove the suspected ones. Nevertheless, this monitoring is performed during the harvest and mobilizes many people during a strategic period for viticulture. To solve this problem, we aim to develop a Multi-Spectral (MS) imaging device ensuring an automated grapevine disease detection solution. If embedded on a UAV, the tool can provide disease outbreaks locations in a geographical information system allowing localized and direct treatment of infected vines. The high-resolution MS camera aims to allow the identification of potential FD occurrence, but the procedure can, more generally, be used to detect any type of foliar diseases on any type of vegetation.Our work consists on defining the spectral bands of the multispectral camera, responsible for identifying the desired symptoms of the disease. In fact, the FD diseased samples were selected after establishing a Polymerase Chain Reaction (PCR) confirmation test and then a feature selection technique was applied to identify the best subset of wavelengths capable of detecting FD samples. An example of a preliminary version of the MS sensor was also presented along with the geometric and radiometric required corrections. An image analysis based on texture and neural networks was also detailed for an enhanced disease classification.
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Affiliation(s)
- H Al-Saddik
- Agroecology, Agrosup Dijon, INRA, Univ. Bourgogne Franche-Comté, Dijon, France.
| | - A Laybros
- Agroecology, Agrosup Dijon, INRA, Univ. Bourgogne Franche-Comté, Dijon, France
| | - J C Simon
- Agroecology, Agrosup Dijon, INRA, Univ. Bourgogne Franche-Comté, Dijon, France
| | - F Cointault
- Agroecology, Agrosup Dijon, INRA, Univ. Bourgogne Franche-Comté, Dijon, France
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32
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Abstract
Tendon injuries comprise 45% of the 66 million musculoskeletal injuries each year with annual costs of $114 billion. Conservative therapies to treat injured tendon produce mixed success rates. Histotripsy is a high intensity focused ultrasound modality that creates and oscillates bubbles to fractionate soft tissues in a well-defined focal volume; however, highly collagenous tissues like tendon have proven resistant to histotripsy. The goal here is to explore acoustic parameters for mechanical fractionation of tendons. Large animal Achilles tendons were exposed to HIFU at 1.07-3.68 MHz with 0.005-20 ms pulses repeated at 1-1000 Hz for 15-60 s with acoustic pressures up to p+ = 97 MPa, p- = 27 MPa. A Verasonics research ultrasound imaging system and ATL L7-4 transducer was used to monitor bubble activity during exposure. Tendon samples were fixated and stained with Hematoxylin and Eosin (H&E) for cellular morphology analysis and alpha-nicotinamide dinucleotide diaphorase (αNADH-d) for enzymatic activity analysis. Results showed successful bubble creation in the focal region; however, only 1/90 samples showed focal coagulative necrosis histologically. Future work involves an evaluation of whether bubbles are of insufficient size or collapse strength to mechanically fractionate tendon. [Work supported by Penn State Seed Grant, NIH EB027886, and NSF DGE1255832].
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Affiliation(s)
- Molly Smallcomb
- Department of Acoustics, Pennsylvania State University, University Park, PA, 16802
| | - Julianna C Simon
- Department of Acoustics, Pennsylvania State University, University Park, PA, 16802
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33
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Simon JC, Bailey MR. Summary of "Biomedical Acoustics and Physical Acoustics: Shock Waves and Ultrasound for Calculus Fragmentation". Proc Meet Acoust 2018; 35:002001. [PMID: 32148645 PMCID: PMC7059322 DOI: 10.1121/2.0000948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This paper summarizes the special session, "Shock Waves and Ultrasound for Calculus Fragmentation," that took place during the 176th Meeting of the Acoustical Society of America and 2018 Acoustics Week in Canada. The sessions were cosponsored by the Biomedical Acoustics and Physical Acoustics Technical Committees and consisted of ten talks by industry and academic researchers from institutions in the United States, France, and the Russian Federation. The sessions described basic and applied acoustic research to manage urinary stones.
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Affiliation(s)
- Julianna C Simon
- Graduate Program in Acoustics, Pennsylvania State University, Penn State 201E Applied Sciences Building, University Park, Pennsylvania, 16802
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th St., Seattle, Washington, 98105
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34
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Haiduk J, Brockstedt LA, Mitter D, Hiemisch A, Merkenschlager A, Simon JC, Kunz M. [Disseminated linear and irregular pigmentation of the skin]. Hautarzt 2018; 69:870-873. [PMID: 29992407 DOI: 10.1007/s00105-018-4231-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J Haiduk
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - L A Brockstedt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - D Mitter
- Institut für Humangenetik, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland
| | - A Hiemisch
- Klinik für Kinder und Jugendliche, Neuropädiatrie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland
| | - A Merkenschlager
- Klinik für Kinder und Jugendliche, Neuropädiatrie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland
| | - J C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - M Kunz
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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35
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Simon JC, Sapozhnikov OA, Kreider W, Breshock M, Williams JC, Bailey MR. The role of trapped bubbles in kidney stone detection with the color Doppler ultrasound twinkling artifact. Phys Med Biol 2018; 63:025011. [PMID: 29131810 DOI: 10.1088/1361-6560/aa9a2f] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The color Doppler ultrasound twinkling artifact, which highlights kidney stones with rapidly changing color, has the potential to improve stone detection; however, its inconsistent appearance has limited its clinical utility. Recently, it was proposed stable crevice bubbles on the kidney stone surface cause twinkling; however, the hypothesis is not fully accepted because the bubbles have not been directly observed. In this paper, the micron or submicron-sized bubbles predicted by the crevice bubble hypothesis are enlarged in kidney stones of five primary compositions by exposure to acoustic rarefaction pulses or hypobaric static pressures in order to simultaneously capture their appearance by high-speed photography and ultrasound imaging. On filming stones that twinkle, consecutive rarefaction pulses from a lithotripter caused some bubbles to reproducibly grow from specific locations on the stone surface, suggesting the presence of pre-existing crevice bubbles. Hyperbaric and hypobaric static pressures were found to modify the twinkling artifact; however, the simple expectation that hyperbaric exposures reduce and hypobaric pressures increase twinkling by shrinking and enlarging bubbles, respectively, largely held for rough-surfaced stones but was inadequate for smoother stones. Twinkling was found to increase or decrease in response to elevated static pressure on smooth stones, perhaps because of the compression of internal voids. These results support the crevice bubble hypothesis of twinkling and suggest the kidney stone crevices that give rise to the twinkling phenomenon may be internal as well as external.
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Affiliation(s)
- Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th St., Seattle, WA 98105, United States of America. Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195, United States of America. Current address: Graduate Program in Acoustics, The Pennsylvania State University, 201E Applied Science Building, University Park, PA 16802, United States of America. Author to whom any correspondence should be addressed
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36
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Abstract
Bone demineralization, dehydration, and stasis put astronauts at an increased risk of forming kidney stones in space. The incidence of kidney stones and the potential for a mission-critical event are expected to rise as expeditions become longer and immediate transport to Earth becomes more problematic. At the University of Washington, we are developing an ultrasound-based stone management system to detect stones with S-mode™ ultrasound imaging, break stones with burst wave lithotripsy (BWL™), and reposition stones with ultrasonic propulsion (UP™) on Earth and in space. This review discusses the development and current state of these technologies, as well as integration on the flexible ultrasound system sponsored by NASA and the National Space Biomedical Research Institute.
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Affiliation(s)
- Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40 St., Seattle, WA 98105 USA.,Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195 USA
| | - Barbrina Dunmire
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40 St., Seattle, WA 98105 USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40 St., Seattle, WA 98105 USA.,Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195 USA.,Department of Urology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356510, Seattle, WA 98195 USA
| | - Mathew D Sorensen
- Department of Urology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356510, Seattle, WA 98195 USA.,Division of Urology, Department of Veteran Affairs Medical Center, 1660 S Columbian Way, Seattle, WA 98108 USA
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37
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Treudler R, Zeynalova S, Walther F, Engel C, Simon JC. Atopic dermatitis is associated with autoimmune but not with cardiovascular comorbidities in a random sample of the general population in Leipzig, Germany. J Eur Acad Dermatol Venereol 2017; 32:e44-e46. [PMID: 28758257 DOI: 10.1111/jdv.14495] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- R Treudler
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany.,Leipzig Interdisciplinary Allergy Center (LICA) - Comprehensive Allergy Center, Leipzig, Germany.,Leipzig Research Center for Civilization Disease - LIFE, Universität Leipzig, Germany
| | - S Zeynalova
- Leipzig Research Center for Civilization Disease - LIFE, Universität Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE) Leipzig, Universität Leipzig, Germany
| | - F Walther
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany.,Leipzig Research Center for Civilization Disease - LIFE, Universität Leipzig, Germany
| | - C Engel
- Leipzig Research Center for Civilization Disease - LIFE, Universität Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE) Leipzig, Universität Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany.,Leipzig Interdisciplinary Allergy Center (LICA) - Comprehensive Allergy Center, Leipzig, Germany.,Leipzig Research Center for Civilization Disease - LIFE, Universität Leipzig, Germany
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38
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Nenoff P, Kleine-Tebbe J, Simon JC. [Laudation of Professor Dr. med. Uwe-Frithjof Haustein on the occasion of his 80th birthday]. Hautarzt 2017; 68:172-176. [PMID: 28108779 DOI: 10.1007/s00105-017-3934-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P Nenoff
- Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Labor für medizinische Mikrobiologie, Mölbiser Hauptstr. 8, 04571, Rötha/OT Mölbis, Deutschland.
| | - J Kleine-Tebbe
- Praxis Hanf, Ackermann & Kleine-Tebbe, Allergie- u. Asthma-Zentrum Westend, Spandauer Damm 130, Haus 9, 14050, Berlin, Deutschland
| | - J C Simon
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Anstalt öffentlichen Rechts, Philipp-Rosenthal-Str. 23, Haus 10, 04103, Leipzig, Deutschland
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39
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Schüürmann M, Kutzner H, Simon JC, Ziemer M. [Smooth muscle hamartoma in volar skin]. Hautarzt 2017; 68:916-918. [PMID: 28812115 DOI: 10.1007/s00105-017-4030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report the case of a 12-year-old girl with a smooth muscle hamartoma of the right index finger. Smooth muscle hamartoma (SMH) is a congenital, relatively common disorder typically with predominance of autochthonal arrector pili muscles. An SMH can also rarely originate from smooth muscles of vessels in palmoplantar skin with the absence of pilosebaceous units. Because of overlapping histological features, the possibility of Becker's nevus being identical or associated with SMH has often been suspected by some authors.
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Affiliation(s)
- M Schüürmann
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - H Kutzner
- Dermatopathologie, Friedrichshafen/Bodensee, Deutschland
| | - J C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - M Ziemer
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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40
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Treudler R, Franke A, Schmiedeknecht A, Ballmer-Weber B, Worm M, Werfel T, Jappe U, Biedermann T, Schmitt J, Brehler R, Kleinheinz A, Kleine-Tebbe J, Brüning H, Ruëff F, Ring J, Saloga J, Schäkel K, Holzhauser T, Vieths S, Simon JC. BASALIT trial: double-blind placebo-controlled allergen immunotherapy with rBet v 1-FV in birch-related soya allergy. Allergy 2017; 72:1243-1253. [PMID: 27998002 DOI: 10.1111/all.13112] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Conflicting results exist on the effect of allergen immunotherapy (AIT) on pollen-related food allergy. We aimed to investigate the efficacy of one-year AIT with the folding variant (FV) of recombinant (r) Bet v 1 on birch-related soya allergy. METHODS Of 138 subjects with Bet v 1 sensitization, 82 were positive at double-blind placebo-controlled food challenge (DBPCFC) with soya. A total of 56 of 82 were randomized in the ratio of 2:1 (active: placebo). Per-protocol population (PPP) had received ≥150 μg of allergen or placebo preparation. OUTCOME MEASURES lowest observed adverse effect levels (LOAEL), postinterventional occurrence of objective signs (objS) at any dose level, sIgE/IgG4 against Bet v 1 and Gly m 4. Between-group changes were investigated (ancova, Mann-Whitney U-test, Fisher exact test). RESULTS Baseline characteristics including LOAELs were comparable in both groups with objS and subjS occurring in 82% and 95% of active (n = 38) vs 78% and 83% of placebo group (n = 18). After AIT, objS occurred in 24% and 47%, respectively. LOAEL group differences showed a beneficial tendency (P = 0.081) for LOAELobjective in PPP (30 active, 15 placebo). sIgG4 raised only in active group (Bet v 1: P = 0.054, Gly m 4: P = 0.037), and no relevant changes occurred for sIgE. Only 56% of the intended sample size was recruited. CONCLUSION For the first time, we present data on the effect of rBet v 1-FV on birch-related soya allergy. rBet v 1-FV AIT induced significant immunogenic effects. Clinical assessment showed a tendency in favour of the active group but did not reach statistical significance.
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Affiliation(s)
- R Treudler
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany
| | - A Franke
- Clinical Trial Centre Leipzig (ZKS), Universität Leipzig, Leipzig, Germany
| | - A Schmiedeknecht
- Clinical Trial Centre Leipzig (ZKS), Universität Leipzig, Leipzig, Germany
| | - B Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital Zürich and Centre of Dermatology and Allergology, Luzerner Kantonsspital, Luzern, Germany
| | - M Worm
- Allergy Center Charité, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Werfel
- Department of Dermatology and Allergology, MH Hannover, Hannover, Germany
| | - U Jappe
- Division of Clinical & Molecular Allergology Research Center Borstel, Airway Research Center North (ARCN) and Member of the German Center for Lung Research (DZL), Borstel, Germany
- Interdisciplinary Allergy Outpatient Clinic, Department of Internal Medicine, University of Lübeck, Lübeck, Germany
| | - T Biedermann
- Department of Dermatology, Universität Tübingen, Tübingen, Germany
- Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - J Schmitt
- Department of Dermatology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Center for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - R Brehler
- Department of Dermatology, Universität Münster, Münster, Germany
| | - A Kleinheinz
- Department of Dermatology, Elbekliniken Buxtehude, Buxtehude, Germany
| | | | - H Brüning
- Day care clinic for Allergy and Dermatology, Kiel, Germany
| | - F Ruëff
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - J Ring
- Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - J Saloga
- Department of Dermatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - T Holzhauser
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - S Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany
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Janssen KM, Brand TC, Cunitz BW, Wang YN, Simon JC, Starr F, Liggitt HD, Thiel J, Sorensen MD, Harper JD, Bailey MR, Dunmire B. Safety and Effectiveness of a Longer Focal Beam and Burst Duration in Ultrasonic Propulsion for Repositioning Urinary Stones and Fragments. J Endourol 2017; 31:793-799. [PMID: 28537452 DOI: 10.1089/end.2017.0167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE In the first-in-human trial of ultrasonic propulsion, subjects passed collections of residual stone fragments repositioned with a C5-2 probe. Here, effectiveness and safety in moving multiple fragments are compared between the C5-2 and a custom (SC-50) probe that produces a longer focal beam and burst duration. MATERIALS AND METHODS Effectiveness was quantified by the number of stones expelled from a calyx phantom consisting of a 30-mm deep, water-filled well in a block of tissue mimicking material. Each probe was positioned below the phantom to move stones against gravity. Single propulsion bursts of 50 ms or 3 s duration were applied to three separate targets: 10 fragments of 2 different sizes (1-2 and 2-3 mm) and a single 4 × 7 mm human stone. Safety studies consisted of porcine kidneys exposed to an extreme dose of 10-minute burst duration, including a 7-day survival study and acute studies with surgically implanted stones. RESULTS Although successful in the clinical trial, the shorter focal beam and maximum 50 ms burst duration of the C5-2 probe moved stones, but did not expel any stones from the phantom's 30-mm deep calyx. The results were similar with the SC-50 probe under the same 50 ms burst duration. Longer (3 s) bursts available with the SC-50 probe expelled all stones at both 4.5 and 9.5 cm "skin-to-stone" depths with lower probe heating compared to the C5-2. No abnormal behavior, urine chemistry, serum chemistry, or histological findings were observed within the kidney or surrounding tissues for the 10 min burst duration used in the animal studies. CONCLUSIONS A longer focal beam and burst duration improved expulsion of a stone and multiple stone fragments from a phantom over a broad range of clinically relevant penetration depths and did not cause kidney injury in animal studies.
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Affiliation(s)
- Karmon M Janssen
- 1 Department of Urology, Madigan Army Medical Center , Tacoma, Washington
| | - Timothy C Brand
- 1 Department of Urology, Madigan Army Medical Center , Tacoma, Washington
| | - Bryan W Cunitz
- 2 Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington , Seattle, Washington
| | - Yak-Nam Wang
- 2 Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington , Seattle, Washington
| | - Julianna C Simon
- 2 Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington , Seattle, Washington
| | - Frank Starr
- 2 Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington , Seattle, Washington
| | - H Denny Liggitt
- 3 Department of Comparative Medicine, University of Washington , Seattle, Washington
| | - Jeff Thiel
- 4 Department of Radiology, University of Washington , Seattle, Washington
| | - Mathew D Sorensen
- 5 Department of Urology, University of Washington School of Medicine , Seattle, Washington.,6 Division of Urology, Department of Veteran Affairs Medical Center , Seattle, Washington
| | - Jonathan D Harper
- 5 Department of Urology, University of Washington School of Medicine , Seattle, Washington
| | - Michael R Bailey
- 2 Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington , Seattle, Washington
| | - Barbrina Dunmire
- 2 Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington , Seattle, Washington
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Simon JC, Wang YN, Cunitz BW, Thiel J, Starr F, Liu Z, Bailey MR. Effect of Carbon Dioxide on the Twinkling Artifact in Ultrasound Imaging of Kidney Stones: A Pilot Study. Ultrasound Med Biol 2017; 43:877-883. [PMID: 28190622 PMCID: PMC5385287 DOI: 10.1016/j.ultrasmedbio.2016.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 12/09/2016] [Accepted: 12/14/2016] [Indexed: 06/06/2023]
Abstract
Bone demineralization, dehydration and stasis put astronauts at increased risk of forming kidney stones in space. The color-Doppler ultrasound "twinkling artifact," which highlights kidney stones with color, can make stones readily detectable with ultrasound; however, our previous results suggest twinkling is caused by microbubbles on the stone surface which could be affected by the elevated levels of carbon dioxide found on space vehicles. Four pigs were implanted with kidney stones and imaged with ultrasound while the anesthetic carrier gas oscillated between oxygen and air containing 0.8% carbon dioxide. On exposure of the pigs to 0.8% carbon dioxide, twinkling was significantly reduced after 9-25 min and recovered when the carrier gas returned to oxygen. These trends repeated when pigs were again exposed to 0.8% carbon dioxide followed by oxygen. The reduction of twinkling caused by exposure to elevated carbon dioxide may make kidney stone detection with twinkling difficult in current space vehicles.
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Affiliation(s)
- Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA.
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Bryan W Cunitz
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Jeffrey Thiel
- Department of Radiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Frank Starr
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Ziyue Liu
- Department of Biostatistics, Indiana University Schools of Public Health and Medicine, Indianapolis, Indiana, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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43
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Aurich S, Simon JC, Treudler R. Omalizumab does not improve skin lesions in a patient with hypocomplementemic urticarial vasculitis syndrome. J Eur Acad Dermatol Venereol 2017; 31:e395-e397. [PMID: 28273376 DOI: 10.1111/jdv.14202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Aurich
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, 04103, Leipzig, Germany.,LICA-Leipziger Interdisziplinäres Centrum für Allergologie, 04103, Leipzig, Germany
| | - J C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, 04103, Leipzig, Germany.,LICA-Leipziger Interdisziplinäres Centrum für Allergologie, 04103, Leipzig, Germany
| | - R Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, 04103, Leipzig, Germany.,LICA-Leipziger Interdisziplinäres Centrum für Allergologie, 04103, Leipzig, Germany
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44
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Simon JC, Maxwell AD, Bailey MR. Some Work on the Diagnosis and Management of Kidney Stones with Ultrasound. Acoust Today 2017; 13:52-59. [PMID: 30271311 PMCID: PMC6162072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ultrasound is currently the only noninvasive technology able to completely diagnose and manage kidney stones.
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Affiliation(s)
- Julianna C Simon
- Graduate Program in Acoustics, Pennsylvania State University, 201E Applied Science Building, University Park, Pennsylvania 16802, USA
| | - Adam D Maxwell
- Center for Industrial and Medical, Ultrasound, Applied Physics Laboratory and Department of Urology, University of Washington, 1013 NE 40th Street, Seattle, Washington 98105, USA
| | - Michael R Bailey
- Center for Industrial and Medical, Ultrasound, Applied Physics Laboratory;, Department of Mechanical Engineering; and Department of Urology, University of Washington, 1013 NE 40th Street, Seattle, Washington 98105, USA
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Treudler R, Franke A, Schmiedeknecht A, Ballmer-Weber BK, Worm M, Werfel T, Jappe U, Biedermann T, Schmitt J, Brehler R, Kleinheinz A, Kleine-Tebbe J, Brüning H, Ruëff F, Ring J, Saloga J, Schäkel K, Holzhauser T, Vieths S, Simon JC. Standardization of double blind placebo controlled food challenge with soy within a multicentre trial. Clin Transl Allergy 2016; 6:39. [PMID: 27826414 PMCID: PMC5098282 DOI: 10.1186/s13601-016-0129-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/14/2016] [Indexed: 11/17/2022] Open
Abstract
Background Multicentre trials investigating food allergies by double blind placebo controlled food challenges (DBPCFC) need standardized procedures, challenge meals and evaluation criteria. We aimed at developing a standardized approach for identifying patients with birch related soy allergy by means of DBPCFC to soy, including determination of threshold levels, in a multicentre setting. Methods Microbiologically stable soy challenge meals were composed of protein isolate with consistent Gly m 4 levels. Patients sensitized to main birch allergen Bet v 1 and concomitant sensitization to its soy homologue Gly m 4 underwent DBPCFC. Outcome was defined according to presence and/or absence of ten objective signs and intensity of eight subjective symptoms as measured by visual analogue scale (VAS). Results 138 adult subjects (63.8% female, mean age 38 years) underwent DBPCFC. Challenge meals and defined evaluation criteria showed good applicability in all centres involved. 45.7% presented with objective signs and 65.2% with subjective symptoms at soy challenge. Placebo challenge meals elicited non-cardiovascular objective signs in 11.6%. In 82 (59.4%) subjects DBPCFC was judged as positive. 70.7% of DPBCFC+ showed objective signs and 85.4% subjective symptoms at soy challenge. Subjective symptoms to soy challenge meal in DBPCFC+ subjects started at significantly lower dose levels than objective signs (p < 0.001). Median cumulative eliciting doses for first objective signs in DBPCFC+ subjects were 4.7 g [0.7–24.7] and 0.7 g [0.2–4.7] total soy protein for first subjective symptoms (p = 0.01). Conclusions We present the hitherto largest group of adults with Bet v 1 and Gly m 4 sensitization being investigated by DBPCFC. In this type of food allergy evaluation of DBPCFC outcome should not only include monitoring of objective signs but also scoring of subjective symptoms. Our data may contribute to standardize DBPCFC in pollen-related food allergy in multicentre settings. Trial registration EudraCT: 2009-011737-27.
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Affiliation(s)
- R Treudler
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany ; Leipziger Interdisziplinäres Centrum für Allergologie (LICA) - Comprehensive Allergy Centre (CAC), Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 23, 04103 Leipzig, Germany
| | - A Franke
- Clinical Trial Centre Leipzig (ZKS), Universität Leipzig, Leipzig, Germany
| | - A Schmiedeknecht
- Clinical Trial Centre Leipzig (ZKS), Universität Leipzig, Leipzig, Germany
| | - B K Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - M Worm
- Allergy Center Charité, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Werfel
- Department of Dermatology and Allergology, MH Hannover, Hannover, Germany
| | - U Jappe
- Division of Clinical and Molecular Allergology Research Center Borstel, Airway Research Center North (ARCN), Borstel, Germany ; Department of Internal Medicine, University of Lübeck, Lübeck, Germany
| | - T Biedermann
- Department of Dermatology, Universität Tübingen, Tübingen, Germany ; Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - J Schmitt
- Department of Dermatology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany ; Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - R Brehler
- Department of Dermatology, Universität Münster, Münster, Germany
| | - A Kleinheinz
- Department of Dermatology, Elbekliniken Buxtehude, Buxtehude, Germany
| | | | - H Brüning
- Day Care Clinic for Allergy and Dermatology, Kiel, Germany
| | - F Ruëff
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - J Ring
- Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - J Saloga
- Department of Dermatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - T Holzhauser
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - St Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, Universität Leipzig, Leipzig, Germany ; Leipziger Interdisziplinäres Centrum für Allergologie (LICA) - Comprehensive Allergy Centre (CAC), Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 23, 04103 Leipzig, Germany
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Annenkova EA, Sapozhnikov OA, Kreider W, Simon JC. Acoustic Nonlinearity as a Mechanism for Liquid Drop Explosions in Drop-chain Fountains Generated by a Focused Ultrasound Beam. IEEE Int Ultrason Symp 2016; 2016:10.1109/ultsym.2016.7728535. [PMID: 34650778 PMCID: PMC8514128 DOI: 10.1109/ultsym.2016.7728535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ultrasonic atomization has been used in air humidifiers and is also involved in therapeutic applications of intense ultrasound such as boiling histotripsy. An as-yet unexplained phenomenon occurs when a focused ultrasound beam in water creates an acoustic fountain in the form of a drop chain, which explodes in less than a millisecond. In the present paper, we seek to develop a nonlinear theory to explain this phenomenon. We hypothesize that standing wave harmonics are generated inside the water drops due to acoustic nonlinearities, which, along with localized heat deposition in the drop center, may generate a superheated vapor bubble that causes the explosion.
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Affiliation(s)
- Elena A Annenkova
- Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia
| | - Oleg A Sapozhnikov
- Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia
| | - Wayne Kreider
- CIMU, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Julianna C Simon
- CIMU, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
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Nitzsche G, Ziemer M, Simon JC, Kendler M. A tumourous mass on the toe. J Eur Acad Dermatol Venereol 2015; 30:1434-5. [PMID: 26387780 DOI: 10.1111/jdv.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G Nitzsche
- Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig AöR, Ph.-Rosenthal-Str. 23, Leipzig, D-04103, Germany
| | - M Ziemer
- Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig AöR, Ph.-Rosenthal-Str. 23, Leipzig, D-04103, Germany
| | - J C Simon
- Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig AöR, Ph.-Rosenthal-Str. 23, Leipzig, D-04103, Germany
| | - M Kendler
- Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig AöR, Ph.-Rosenthal-Str. 23, Leipzig, D-04103, Germany
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Nitzsche GR, Ziemer M, Simon JC, Kendler M. Dicke Zehe – ein operativer Fall. Akt Dermatol 2015. [DOI: 10.1055/s-0035-1558577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bodendorf MO, Willenberg A, Anderegg U, Grunewald S, Simon JC, Paasch U. Connective tissue response to fractionated thermo-ablative Erbium: YAG skin laser treatment. Int J Cosmet Sci 2015; 32:435-45. [PMID: 20384901 DOI: 10.1111/j.1468-2494.2009.00567.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Indications for and prevalence of laser therapies with a fractionated laser beam have risen significantly. However, as of yet, little is known about the underlying molecular changes, especially with respect to dermal extracellular-matrix remodelling, wound healing and inflammation. This study aimed at the investigation of the connective tissue response of sun-damaged skin following fractionated laser treatment. Seven patients received a laser therapy on the lateral side of the neck of wrinkles grade III-IV (Glogau scale) using a fractionated thermo-ablative erbium yttrium aluminium garnet (Er:YAG) laser (2940 nm, BURANE XL; Quantel Derma, Erlangen, Germany). Skin biopsies were taken at baseline from untreated skin, 1 and 6 weeks after laser intervention to investigate hyaluronan (HA), collagen-I (Coll-I) and collagen-III (Coll-III) remodelling as well as alteration of matrix metalloproteinase 1 expression (MMP-1). To address this issue, HA synthesizing (HA synthetases, HAS) and degrading (hyaluronidases, HYAL) enzymes were measured at mRNA-level using a real-time PCR. Furthermore, immunohistochemical staining for HA was performed by using the HA binding protein (HAbP) and for Coll-I, Coll-III and MMP-1 by using monoclonal antibodies. The degree of inflammation was correlated descriptively. Our findings were that at the two examined read out points, HAS and HYAL showed a slight response alluding to HA synthesis under minimal signs of inflammatory reaction. Concordantly, although to a varying degree, an increase in the HA content of the skin after laser treatment could be detected by immunhistochemistry. During remodelling, Coll-I, Coll-III and MMP-1 showed a cyclic course with a peak after 1 week. Conclusively, our results indicate a light alteration of the HA metabolism towards synthesis and a transient collagen neogenesis caused by a single fractionated thermo-ablative laser skin intervention. Clinical improvement might be attributed to synergistic effects between collagen neogenesis and the water binding capacities of HA and its influence on skin contraction and remodelling.
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Affiliation(s)
- M O Bodendorf
- Department of Dermatology, Medical Faculty, University of Leipzig, Philipp-Rosenthalstr. 23, 04103 Leipzig, Germany
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50
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Simon JC, Sapozhnikov OA, Wang YN, Khokhlova VA, Crum LA, Bailey MR. Investigation into the mechanisms of tissue atomization by high-intensity focused ultrasound. Ultrasound Med Biol 2015; 41:1372-85. [PMID: 25662182 PMCID: PMC4398613 DOI: 10.1016/j.ultrasmedbio.2014.12.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/29/2014] [Accepted: 12/10/2014] [Indexed: 05/20/2023]
Abstract
Ultrasonic atomization, or the emission of a fog of droplets, was recently proposed to explain tissue fractionation in boiling histotripsy. However, even though liquid atomization has been studied extensively, the mechanisms underlying tissue atomization remain unclear. In the work described here, high-speed photography and overpressure were used to evaluate the role of bubbles in tissue atomization. As static pressure increased, the degree of fractionation decreased, and the ex vivo tissue became thermally denatured. The effect of surface wetness on atomization was also evaluated in vivo and in tissue-mimicking gels, where surface wetness was found to enhance atomization by forming surface instabilities that augment cavitation. In addition, experimental results indicated that wetting collagenous tissues, such as the liver capsule, allowed atomization to breach such barriers. These results highlight the importance of bubbles and surface instabilities in atomization and could be used to enhance boiling histotripsy for transition to clinical use.
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Affiliation(s)
- Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA.
| | - Oleg A Sapozhnikov
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA; Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Vera A Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA; Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia
| | - Lawrence A Crum
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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