• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.162-168
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• 2015

In this study, we suggested the performance and safety testing guideline for low intensity pulsed ultrasound (LIPUS) represented by the ultrasound fracture treatment device and cartilage treatment device and low intensity focused ultrasound (LIFU) represented by ultrasonic face lifting device. For these study, the international standards and management regulations of Korea, Japan and United State were analyzed. And the usefulness and applicability were evaluated by testing with commercial equipment and reflecting the views of the industry and experts. As a result of this study, the safety and performance test guidelines for low intensity therapeutic ultrasound device were proposed by presenting the 10 items for LIPUS and 12 items for LIFU. The suggested guidelines are considered a high utilization in the domestic testing and approval authorities. And they are also thought to be useful to new technology development.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.97-102
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• 2009

Purpose: The purpose of this study was to investigate the effects of low intensity pulsed ultrasound on TGF-$\beta$1 expression and healing of rat femur penetrating fractures. Methods: Rats were anesthetized with ketamine and xylazine. Using aseptic technique, we exposed the lateral right femoral diaphysis with removal of the periosteum. We made one hole along its long axis with an electrically-driven 1.8 mm diameter drill bit. Postoperatively, rats were divided into two groups (a control group, n=15; an experimental group, n=15). The experimental group was treated with low intensity pulsed ultrasound (pulse rate: 1:4, 0.5 W/$cm^2$, 10 minutes, 1 time per day) for 3 weeks. The control group was treated with sham ultrasound (with the US unit turned off). Results: The experimental group achieved more callus formation and TGF-$\beta$1 expression than the control group at the $7^{th}$, $14^{th}$ and $21^{st}$ days after low intensity pulsed ultrasound treatment. Conclusion: This study suggests that low intensity pulsed ultrasound facilitates bone fracture repair, possibly via increased TGF-$\beta$1 expression.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.97-105
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• 2002

The purpose of this study was to investigate the effectiveness of the low-intensity ultrasound (noblelife) treatment on the pain points of upper trapezius muscle. The study recruited 20 patients who had trigger points in one side of the upper trapezius. The effectiveness of the low-intensity ultrasound treatment was assessed with subjective pain intensity using visual analog scale (VAS) and pressure pain threshold (PPT). The PPT was measured by pressure threshold algometer. Before and after the treatment, changes of pain were evaluated. Wilcoxon test for VAS data and paired t-test for PPT data were used for statistical significance. Compared to the pain intensity before the treatment, the pain intensity after treatment was significantly decreased (p<.05). Low-intensity ultrasound could be safely used in clinical application and at home for the treatment of patients with pain in upper trapezius muscle.

• 한국전문물리치료학회지
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• 제5권3호
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• pp.34-41
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• 1998

Noninvasive low intensity ultrasound has been shown to be an effective means of accelerating bone fracture repair in both animal and clinical studies. The effects of ultrasound stimulation on bone repair after fibular osteotomy were assessed in a rabbit fibular fracture model. Bilateral closed fibular fractures were made in skeletally mature male White Japanese rabbits. In this study, 24 subjects were randomly divided into 2 groups: experimental group 1 (n=12), and experimental group 2 (n=12). Experimental group 1 received 0.875 MHz continuous ultrasound and Experimental group 2 was treated with 3 MHz continuous u1trasound. The ultrasound intensity was 50 $mW/cm^2$ and treatment time was 10 minutes for every session in both groups. In each rabbit, one fibula served as a control and the other was subjected to ultrasound treatment 5 times per week for 3 weeks. After 3 weeks, rabbits were sacrificed and the ratios of the area between the trabeculae and bone marrow of the fibulae were calculated. At the end of the experimental period, 14 of the 24 rabbits were excluded due to complications from surgery or inadequate fracture status for this study. There was no statistically significant difference in the trabeculae area between experimental leg and control leg in experimental group 1 and experimental group 2 (p>0.05). And there was also no statistic-statistically significant difference between experimental group 1 and experimental group 2 according to ultrasound treatment frequencies, 0.875 MHz and 3 MHz (p>0.05). These data suggest that in Japanese white rabbits, low intensity ultrasound stimulation does not facilitate fracture repair nor is there any difference in fracture repair results between ultrasound frequencies, 0.875 MHz and 3 MHz.

• Journal of Pharmaceutical Investigation
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• 제37권6호
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• pp.365-368
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• 2007

The primary aim of this study was to investigate the enhancement effect of low-frequency ultrasound on skin permeation. In vitro permeation experiments were performed using Franz modified diffusion cells with ketoprofen as model drug. The effect of various ultrasound factors-ultrasound application mode (continuous mode and discontinuous mode), ultrasound intensity (0.26 $W/cm^2$, and 0.29 $W/cm^2$) and duty cycle (3%, 16%, 50%, and 83%) were studied. The highest permeation was observed at 0.29 $W/cm^2$ intensity, 50% duty cycle, and discontinuous mode. The result suggested the feasibility of low frequency ultrasound application for the phonophoretic transdermal drug delivery system.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.81-96
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• 2002

The purpose of this research was to determine the effects on the healing of fibular fractures in rabbits of low-intensity pulsed ultrasound (50 $mW/cm^2$ and 500 $mW/cm^2$) applied for periods of 4, 14 and 24 days following fibular osteotomy. Thirty-six male Japanese white rabbits were randomly divided into three groups of twelve for three treatment protocols: (1) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 4th day following fibular osteotomy, (2) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 14th day following fibular osteotomy, and (3) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 24th day following fibular osteotomy. The low-intensity pulsed ultrasound was applied to only one fibula of each rabbit (these served as the experimental group). The other fibula of each rabbit served as the control group. The selection of which fibula was to be treated was made randomly. The animals were sacrificed on the 4th, 14th and 24th day after the start of ultrasound treatments. Percent of trabecular bone area and fibular radiography were carried out to compare the degree of fibular bone healing. A microscope was also used to determine any histologic changes. For statistical differences in radiological changes due to length of treatment period (4, 14 and 24 days respectively), the Wilcoxon signed-ranks test was used to compare the experimental and control groups. For statistical differences in fracture healing due to differences in ultrasound intensity, radiological studies were compared using the Mann-Whitney Test. And, to compute percentage differences in areas of trabecular bone, Two-way analysis of variance (ultrasound intensity x each group) was used. Experiment results were as follows: 1. In animals sacrificed on the 4th day, no difference was found in the radiological studies of the fibulae in the experimental and control groups (p>.05). However, experimental groups showed more rapid bone repair than control group. 2. Both radiographic and percent of trabecular bone area studies showed significant differences in rabbits sacrificed after 14 days. Fracture healing was significantly increased in the experimental group (p<.05) 3. In the animals sacrificed on the 24th day, histologic study showed rapid bone repair but fibular radiologic studies did not show statistical differences between the two groups (p>.05). 4. On the 14th day, bone union on radiograph was significantly more rapid in the treatment group with pulsed ultrasound of 50 $mW/cm^2$ than the group with 500 $mW/cm^2$ (p<.05). Histologic studies showed that both the 14 and 24 days groups had more rapid bone repair in animals treated with 50 $mW/cm^2$ ultrasound intensity than those treated with 500 $mW/cm^2$ intensity. In conclusion, it has been shown that the low-intensity pulsed ultrasound has a positive effect on bone fracture healing in the early stage and the range of pulse ultrasound from 50 $mW/cm^2$ to 500 $mW/cm^2$ is effective for fracture healing. Further study is needed to investigate the influence of pulsed ultrasound on delayed union and non-union in bone fractures and also for the clinical use of low-intensity pulsed ultrasound for bone healing in humans.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권6호
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• pp.467-477
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• 2011

Purpose: The objective of this study was to examine the affected period and the amount of bone formation during osteogenesis of intramembranous bone using low-intensity pulsed ultrasound (LPUS) $in$ $vivo$. Methods: Xeno-bone (Bio-oss) and autogenous bone were grafted bilaterally into mini-pig mandibles. The left mandible served as the control and the other mandible was treated with 3 MHz, 160 mW (output, 0.8 mW) ultrasound stimulation for 7 days 15 minutes per day. The mini-pigs were sacrificed at 1, 2, 4, and 8 weeks, and micro computed tomography (${\mu}CT$), a microscopic examination, and a statistical analysis were performed on the specimens. Results: Based on a computerized image analysis of the ${\mu}CT$ scans, the experimental group had an average 150% more new bone formation than that in the control group. The effect of LPUS continued during the post operative 2 weeks. The histomorphological microscopic examination showed similar results. Conclusion: Our results suggest the LPUS had an effect on early intramembranous bone formation in vivo.

• Journal of Periodontal and Implant Science
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• 제40권6호
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• pp.271-275
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• 2010

Purpose: Many techniques have been described for achieving vertical augmentation of the maxillary sinus. The aim of this study is to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) to enhance bone regeneration after sinus floor elevation. Methods: The sinus lifting technique was performed through a lateral approach on 8 different sites of 5 patients (3 males and 2 females) and their mean age was 45.7 years old. The sites were randomly assigned to the control or test groups. The control group had 4 sites that received lateral sinus lifting procedure only, while the test group had 4 sites that received LIPUS application after the lateral sinus lifting procedure. 24-32 weeks (an average of 29 weeks) postoperatively, new bone formation in the augmented sinus sites was evaluated through histologic and histomorphometric analyses of the biopsy specimens obtained during implant placement. Results: In the test group, the mean percentage of newly formed bone was $19.0{\pm}2.8$%. In the control group, the mean percentage of newly formed bone was $15.2{\pm}3.1$%. The percentage of newly formed bone was approximately 4% higher in those cases where the sinus was treated by LIPUS than the percentage in those cases where it was not used. The difference was statistically significant. Conclusions: Within the scope of this study, low-intensity pulsed ultrasound application after sinus lifting appeared to have a significant effect on the development of new bone formation.

• 치위생과학회지
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• 제14권2호
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• pp.101-106
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• 2014

본 연구는 저 출력 초음파 장치를 이용하여 osteoblastlike MG-63 세포에 1 MHz, 3 Mz 강도의 초음파 처리 후 조골세포의 변화를 관찰하였다. 3 MHz 강도의 주파수를 osteoblast-like MG-63 세포에 처리한 결과 7일 후 성장률이 대조군보다 증가하였다. 저 출력 초음파가 골의 치유에 영향을 미치는 인자를 확인하였을 때 ALP, osteocalcin, VEGF, colla 1A1의 증가를 확인하였으며, 1 MHz 주파수 처리시 integrin alpha 2의 발현이 대조군과 유사하게 발현되는 것을 확인하였다. 반면에, osteonectin, osteopontin, fibronectin, MMP 2 등은 변화가 없음을 확인하였다. 그러므로 본 연구는 저 출력 초음파 장치는 뼈 치유 촉진 단백질들의 발현을 증가시켜 구강 내 외과적 수술 시 골 치유 촉진 효과에 대한 가능성을 제시하였으며 임상에서 골 치유 촉진을 위한 장비로서의 사용 가능성을 제시하였다고 생각된다.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.10-26
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• 2019

Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging new technology with considerable potential to treat various neurological diseases. With refinement of ultrasound transducer technology and integration with magnetic resonance imaging guidance, transcranial sonication of precise cerebral targets has become a therapeutic option. Intensity is a key determinant of ultrasound effects. High-intensity focused ultrasound can produce targeted lesions via thermal ablation of tissue. MRgFUS-mediated stereotactic ablation is non-invasive, incision-free, and confers immediate therapeutic effects. Since the US Food and Drug Administration approval of MRgFUS in 2016 for unilateral thalamotomy in medication-refractory essential tremor, studies on novel indications such as Parkinson's disease, psychiatric disease, and brain tumors are underway. MRgFUS is also used in the context of blood-brain barrier (BBB) opening at low intensities, in combination with intravenously-administered microbubbles. Preclinical studies show that MRgFUS-mediated BBB opening safely enhances the delivery of targeted chemotherapeutic agents to the brain and improves tumor control as well as survival. In addition, BBB opening has been shown to activate the innate immune system in animal models of Alzheimer's disease. Amyloid plaque clearance and promotion of neurogenesis in these studies suggest that MRgFUS-mediated BBB opening may be a new paradigm for neurodegenerative disease treatment in the future. Here, we review the current status of preclinical and clinical trials of MRgFUS-mediated thermal ablation and BBB opening, described their mechanisms of action, and discuss future prospects.