• The Journal of Korean Physical Therapy
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• v.21 no.4
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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.

• Journal of Biomedical Engineering Research
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• v.36 no.5
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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.

• Physical Therapy Korea
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• v.9 no.1
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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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• v.33 no.6
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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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• v.40 no.6
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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.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.101-106
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• 2014

In this study, we investigated the proliferative and adhesional effect of human osteoblast like MG-63 cell treated with low intensity pulsed ultrasound (LIPUS). We tested the effectiveness of LIPUS in human osteoblast like MG-63 cells. Cell proliferation was measured using a water soluble tetrazolium salts-1 assay. The mRNA expression of alkaline phosphate, vascular endothelial growth factor (VEGF), integrin alpha 2, colla 1A1 were performed by reverse transcription-polymerase chain reaction. LIPUS was no cytotoxicity in human osteoblast like MG-63 cells. In addition, the data show that treatment with 1 MHz and 3 MHz LIPUS on increased proliferation 7 days after. There were significant increased in mRNA expression of alkaline phosphatase, osteocalcin, VEGF, integrin alpha 2 and colla 1A1 (p<0.05). Therefore, the LIPUS significantly increased differential expression of mRNA levels in osteoblast like MG-63 cell and new possibilities in dental clinical practice.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.5
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• pp.1262-1269
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• 2008

Low intensity pulsed ultrasound(LIPUS) is known to accelerate bone regeneration, but the precise cellular signaling mechanism is still unclear. The purpose if this study was to determine the effect of LIPUS on the signaling mechanism of rat chondrocyte. In the explant culture condition, there was inhibition effect of 1 $W/cm^2$ intensity LIPUS on chondrocytes proliferation but chondrocytes proliferation was increased at 0.25 $W/cm^2$ intensity. In addition, western blot analysis of MAPKs showed that LIPUS increased ERK1/2 activity from the 10 min treatment of LIPUS. Hydrogen peroxide($H_2O_2$), resulted in a time- and dose-dependent cell proliferation, which was largely attributed to apoptosis. $H_2O_2$ treatment caused marked sustained nucleus condensation in Hoechst stain. LIPUS and $H_2O_2$ activates phosphorylation of p-ERK1/2 and PD 98059($10^{-5}M$) blocked the effect of LIPUS and $H_2O_2$. Moreover, the synergistic phosphorylation of p44/42 MAPK by $H_2O_2$, LIPUS was selectively inhibited by PD 98059, ERK1/2 inhibitor. In order to determine whether the increase in cell proliferation caused by $H_2O_2$ and LIPUS could be explained by changes in the level of the prostaglandin $E_2$. Our study demonstrated that LIPUS stimulate the cell proliferation via activated phosphorylation of ERK1/2 in condrocyte. LIPUS has anabolic effects on rat cartilage in explant cultures, indicating a potential important method for the treatment of osteoarthritic cartilarge.

• Physical Therapy Korea
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• v.12 no.1
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• pp.80-90
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• 2005

The purpose of this study was to evaluate the effects of pulsed ultrasound on wound healing and observe during the wound healing process the distribution of mast cells according to histopathologic findings. Eighty Sprague Dawley rats which were divided into 4 groups received full thickness skin wounds on the back. Each of the 5 animals was sacrificed immediately and then sacrificed again 1, 3, 6, and 12 days after injury. Specimens from the wounds were removed during healing and routinely processed with a hematoxylin-eosin stain and a toluidine blue stain. The authors then observed the distribution of mast cells under a light microscope. The results of this study were as follows: The rate of wound healing and the length of the wounds of the pulsed ultrasound group II was significantly faster than group I on day 6 and day 12 (p<.001). Group III showed the most significant effect after12 days (p<.001). Group IV also showed a significant effect at 12 days (p<.01). A low-intensity ultrasound .5 $W/cm^2$ resulted in a fast healing rate. During the wound healing process mast cells had a tendency to decrease in the acute inflammatory phase. During the wound healing process mast cells were thought to contribute to the healing of the wound.

• Korean Chemical Engineering Research
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• v.46 no.2
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• pp.217-221
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• 2008

To investigate the enhancing effects in transdermal permeation of drug using newly designed ultrasound apparatus of 500 kHz, the transdermal permeation studies through the hairless mouse skin were conducted with lidocaine. The ultrasound apparatus of 500 kHz frequency and transducer were newly developed. The drug permeation studies were performed according to the ultrasound frequencies such as 1 MHz and 500 kHz at $1W/cm^2$ in intensity in continuous mode or pulsed mode, respectively. The results on transdermal permeation of lidocaine according to ultrasound intensity showed that the drug permeation increased as the intensity was higher.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.33-37
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• 2014

Objective: Low intensity pulsed ultrasound (LIPUS) has been shown to accelerate cell proliferation and tissue healing in both animal models and clinical trials. However, details of the clinical effects of LIPUS have not been well characterized. The aim of this study was to investigate the effect of LIPUS on mitogen-activated protein kinase (MAPK) activation in rat articular chondrocytes. Design: Cross-sectional study. Methods: Chondrocyte were cultured in six well cell culture plates for 72 hours at $37^{\circ}C$ with 5% $CO_2$, and then exposed to LIPUS at 1.5 MHz frequency and $30-mW/cm^2$ power. Changes in chondrocyte activities were evaluated in response to oxydative stress in dose-dependent (0 and 300 uM) and time-dependent (0-24 hr) manner. The cell viability were analyzed using MTT [3-(4.5-dimethylthiazol-2-yl)-2.5 diphenyltetrazolium bromide]. The expression of p38 MAPK was measured using western blotting. Results: Oxidative stress was induced in rat chondrocytes using hydrogen peroxide ($H_2O_2$). The cell viability was decreased in chondrocytes after the $H_2O_2$ dose and time-dependent treatment. The p38 MAPK phosphorylation occurred at a significantly increased rate after $H_2O_2$ treated (p<0.05). Expression of p38 MAPK was decreased in the p38 inhibitor groups compared with the oxidative stress-induced chondrocyte damage via the p38 MAPK signaling pathways (p<0.05). Conclusions: It could be concluded that LIPUS can inhibit oxidative stress-induced chondrocyte damage via the p38 MAPK signaling pathways.