• Proceedings of the Acoustical Society of Korea Conference
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• spring
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• pp.379-384
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• 2004

체외 충격파 쇄석술 (ESWL)은 체외에서 발생된 충격파를 체내의 결석이 위치한 부위에 집속하여 결석을 분쇄하는 비 침습적인 치료술이다. 최근 충격파를 이용하여 근관절 질환을 치료하는 체외 충격 파 치료술 (ESWT)이 또한 임상적으로 주목을 받고 있다. 아직 ESWT를 위한 최적의 충격파 노출 조건은 알려져 있지 않지만, 일반적으로 ESWL에 비해 상대적으로 충격파장의 초점 영역이 넓고 낮은 강도의 충격파를 사용한다. 본 연구에서는 ESWT에 적합할 것으로 예상되는 테이퍼 원통형 충격파 발생 방식을 제안하고자 한다. 본 연구에서는 테이퍼 원통형 충격 파 발생 의 초점 부위의 파형을 수치 해석하여 평가하고, 기존 원통형의 경우와 비교하였다. 테이퍼 원통형 충격파 발생기의 시제품을 제작하고, 발생된 강도를 평가하기 위해, 모의 결석을 제작하여 분쇄 효율을 측정하였으며, 결과를 원통형 충격파 발생기와 비교하였다.

• Proceedings of the Acoustical Society of Korea Conference
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• spring
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• pp.389-392
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• 2002

체외 충격파 쇄석술 (ESWL)은 인체 외부에서 발생된 충격파를 인체 내부의 결석 부위에 집속하여 결석을 분쇄하고 치료 효과를 얻는 혁신적 치료술이다. 충격파의 압력 및 파형은 결석의 분쇄 효과 즉 치료 효과를 좌우한다. 체외에서 충격파의 압력은 고감도 하이드로폰을 이용하여 측정할 수 있지만, 인체 체내에서, 특히, 비침습적으로 충격파를 측정하기는 매우 어렵다. 본 논문에서는 ESWL 충격파에 의해 활성화된 체내의 기포군으로부터 방출된 음향 신호 (CIAE)를 측정하여 비침습적으로 충격파의 압력을 추정하는 방법을 실험하였다. 충격파 압력의 추정은 측정된 CIAE 신호에서 1차 기포군 파열음과 2차 파열음 간의 시간 지연은 충격파의 압력과 선형적인 관련성 가진다는 실험 결과 (Coleman et al 1996)에 근거하고 있다. 본 논문에서는 충격파 압력 측정 시스템을 구성하여 생체 외 실험을 수행하였고, 개발된 시스템의 임상적인 활용 가능성을 확인하였다.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.66-74
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• 2012

Purpose: To compare the outcome of two methods of chronic calcific tendinitis (CCT) treatment, Multiple drilling alone versus combined drilling and extracorporeal shock-wave therapy (ESWT). Furthermore, to analyze the clinical and radiologic results of different energy level configurations of ESWT. Materials and Methods: Among the patients complaining shoulder pain who visited the clinic from June 2010 to August 2011, 98 were diagnosed with CCT of the supraspinatus and were divided into the following three groups. Multiple drilling alone (n=31), Multiple drilling followed by high-energy ESWT (n=31), Multiple drilling followed by low-energy ESWT (n=36). The study was conducted only with patients with chronic pain persisting longer than six months despite prolonged conservative therapy. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using the ASES, KSS, CSS system reflecting performance and symptom improvement, and in radiologic terms by studying the change in size of the calcific nodules. Results: All of three groups showed effects for improvement of clinical function and decrease of calcification and clinical improvement was significantly high in comparison between the group fulfilled by only multiple needling (the third group) and the group fulfilled by additional ESWT (the first and second groups) and in the radiological evaluation, calcification size and the rate of calcification decrease showed significant improvement statistically. For the comparison among the groups, degree of clinical function improvement and rate of calcification decrease showed significant difference between high energy group (the first group) and multiple needling group (the third group) as well as low energy group (the second group) and multiple needling group (the third group). But, in comparison between high energy group (the first group) and low energy group (the second group), there was no significant difference for the degree of clinical function improvement and rate of calcification decrease. Conclusion: For the treatment of chronic calcific tendinitis, additional ESWT showed more superior effects on clinical function improvement and radiological improvement regardless of the energy standard rather than the exclusive fulfillment of needling. But, as the result of ESWT by the energy standard, there was no significant difference for the decrease of calcification and degree of clinical function improvement.

• The Journal of the Acoustical Society of Korea
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• v.24 no.5
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• pp.271-281
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• 2005

An electromagnetic type shock wave generator suitable for extracorporeal shock wave therapy has been constructed by employing a solenoid coil. The Property of the shock waves produced by the shock wave generator was evaluated using a needle hydrophone. It was shown that, as the capacitor discharging voltage increased from 8 to 18 kV, the Positive Peak Pressure (P+) of the shock wave increased non-linearly from 10 to 77 Wa. In contrast. the negative peak Pressure (f) varied between -3.2 and -6.8 MPa. had its absolute maximum of -6.9 ma at 14 kV The peak amplitudes P+ measured repeatedly under the same voltage setting varied within $5\;\%$ from mean values and this is very small compared to about $50\;\%$ for electrohydraulic type shock wave generators. It could be observed, from the hydrophone signal recorded over 1 ms. several sequential acoustic impulses representing bubble collapses. namely. acoustic cavitation. induced by the shock wave. A technique based on wavelet transformation was used to accurately measure the time delay between the 1st and 2nd collapse known to be closely related to the shock strength. It was observed that the measured time delay increased almost linearly from 120 to $700\;{\mu}s$ with the shock wave Pressure P+ increasing from 10 to 77 MPa.

• The Journal of the Acoustical Society of Korea
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• v.41 no.5
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• pp.570-588
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• 2022

We scrutinized the acoustic outputs from the 70 shock wave generators of the 15 product models whose technical documents were available, among the 46 ballistic extracorporeal shock wave therapeutic devices of 11 domestic and 6 foreign manufacturers, approved by the Minster of Food & Drug Safety (Rep. Korea). We found that the acoustic Energy Flux Density (EFD), the most popular exposure parameter, was different by up to 563.64 times among shock wave generators at their minimum output settings and by up to 74.62 times at their maximum settings. In the same product model, the EFD was shown to vary depending on shock wave transmitters by up to 81.82 times at its minimum output setting and by up to 46.15 times at its maximum setting. The lowest EFD 0.013 mJ/mm² at the maximum output settings was much lower (2.1 %) than the maximum value 0.62 mJ/mm² at the minimum settings. The Large acoustic output differences (tens to hundreds of times)from the therapeutic devices approved for the same clinical indications imply that their therapeutic efficacy & safety may not be assured. The findings suggest the regulatory authority to revise her guideline to give clearer criteria for clinical approval and equality in performance, and recommend the authority to initiate a post-approval surveillance as well as a test in conformance between the data in technical documents and the real acoustic outputs clinically used.

• The Journal of the Acoustical Society of Korea
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• v.39 no.4
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• pp.303-317
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• 2020

Extracorporeal Shock Wave Therapy (ESWT) is an innovative treatment in chronic musculoskeletal pain management and cardiovascular diseases. In this study, we surveyed the acoustic shock wave outputs from the domestically used focal type ESWT devices. The survey data were collected through 30 technical documents registered to the Ministry of Food and Drug Safety (MFDS), Rep. Korea. The results show that the focusing geometry varies largely, 5 mm to 65 mm in the focal length, 3 mm to 30 mm in focal width, and 4 mm to 108 mm in focal depth. The maximum positive pressure (P+) ranges from 7 MPa to 280 MPa, the focal Energy Flux Density (EFD) from 0.0035 mJ/㎟ to 35 mJ/㎟, and the energy per pulse (E) from 0.737 mJ to 80.86 mJ. All domestic PE-type (five) and one EM-type domestic devices included in the analysis of the correlation between P+ and EFD are shown to be far beyond the usual ranges and do not comply with expected correlation so that the reliability of their data was suspected. For the suspected, post-performance tests are required by a recognized testing agency. MFDS guidelines need to be revised so that the pass criteria for the shock wave acoustic outputs can be based on the clinical tests for indications.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.11a
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• pp.76-84
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• 2006

석회화 건염은 회전근 개중 극상근 건에 석회가 침착되는 질환으로서 진행 양상에 따라 Formative, Resting, Resorptive phases로 나눈다. 치료는 물리 치료, Puncture, 국소 steroid 주사, 체외 충격파 등 보존적 치료에 반응을 잘 하며, 특히 resorptive phases때의 극심한 통증은 석회 침착 부위에 puncture나 needling lavege를 실시하면 즉각적인 동통 감소 효과와 함께 석회 침착의 자연 소실을 기대할 수 있다. 이러한 보존적 치료에 효과가 없을 경우 수술적 처치를 고려할 수 있는데 최근에는 대부분 관절경을 이용한 석회 제거술을 시행한다. 수술전 견관절 충돌 징후가 있거나 수술 소견상 이를 의심할 만한 소견이 있을 경우 견봉하 성형술을 함께 실시하기도 한다.

• The Journal of the Acoustical Society of Korea
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• v.41 no.5
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• pp.589-600
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• 2022

In order to verify the reliability of Dry Test Bench (DTB) used for testing the output energy from ballistic extracorporeal shock wave therapeutic devices, the measurements with DTB were compared with the acoustic energy measured with a Laser Doppler Vibrometer (LDV) for a commercial ballistic ESWT device. It was shown that the mechanical energy detected with DTB had variability maintained within 5 % at the same output power setting and also had a linear correlation (adj. R² = 0.991) with the acoustic energy measured with the LDV for the entire output power settings. Using the correlation between the two methods and the correlation on the acoustic energy measured in between air and water with the LDV, the DTB measurement can be used to estimate the energy flux density in water with an average error of 7.85 % for the entire output power settings of the ballistic shock wave generator considered in the experiment. DTB provides information limited to the output mechanical energy and therefore it is not suitable for testing the various acoustic output parameters required in IEC61846 and IEC63045. However, DTB that is simple in measurement principles and easy to use is expected for manufacturers and clinical users to monitor the performance of ballistic Extracorporeal Shock Wave Therapy (ESWT) devices.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.13-19
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• 2014

Purpose: To evaluate the effectiveness of ultrasonography-guided combined multiple needling and high-energy extracorporeal shock wave therapy (ESWT) for calcific tendinitis of the shoulder. Materials and Methods: We included 42 calcific tendinitis patients who underwent ultrasonograpy-guided multiple needling followed by high-energy ESWT who visited the clinic from January 2010 to June 2013. The average follow up period was 45 weeks. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using pain visual analogue scale (P-VAS), ASES, UCLA scores reflecting performance and symptom improvement, and in sonographic terms by studying the changes in size of the calcific nodules. Results: A statistically significant improvement was seen in P-VAS, ASES, UCLA scores and decreased calcification size on sonographic evaluation. Conclusion: Ultrasonography-guided combined multiple needling and high-energy ESWT is considered as a useful method which could provide clinical function improvement and reduction of calcification deposit.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.60-66
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• 1997

Even though the urinary stones are rare in children, careful observation and monitoring are necessary because the incidence has been increasing. This study is aimed to document the characteristics of urinary stones in children including the symptoms, diagnosis, with or without urinary tract infection, other urinary tract anomaly and treatment. 45 patients under the age of 15 years with urinary stones hospitalized during Jan. 1986 to Jun. 1996 at Severance Hospital were reviewed retrospectively. Patients' mean age was 6.5 years and sex ratio (male : female) was 5.4:1. The most common symptom was gross hematuria. Stones accompanied with urinary tract infection was 46.7%, and stones associated with urinary tract anomaly was 35.6%. Extracorporeal shock wave lithotripsy, percutaneous nephrolithotorny, hydration and diuretics were the treatment modality used. Urinary stone were found to be a significant cause of urinary tract obstruction in children, requiring prompt diagnosis and treatment. Although KUB, IVP, and ultrasonography were commonly used to make the diagnosis, many cases were detected only by ultrasonographic study.