MECHANISMS OF SHOCK WAVE ACTION FOR IMPROVED SWL

项目2：冲击波作用改善SWL的机制 项目2的目标是找到改进碎石术的方法。为了实现这一目标，我们确定了三个主要目标。我们将：1）为肾结石治疗中SW率和功率的碎石机设置选择提供客观依据（目标1和2），2）确定空化气泡簇动力学在结石破碎中的作用，并为泌尿科医生找到增强空化在结石破碎中的积极作用的方法（目的3和4），3）评价新一代碎石机的有效性和安全性，包括有前途的双脉冲碎石机（目的5和6）。 项目2的实验将与本计划项目资助的其他项目高度互动。在与项目3和4的合作中，我们将利用高速摄影、双被动空化检测和B扫描超声来确定在低SW速率下改善结石破碎的机制，并将找到SW速率和功率之间的平衡，从而改善结石粉碎。在项目1的研究中，我们将使用一种新的动物模型在猪肾和输尿管中植入结石，以帮助评价碎石机设置对结石破碎的影响。我们将与项目3和项目4的同事一起分析体外空化气泡的活动，以确定结石的环境--也就是它的组织边界 以及浸泡结石的流体的成分影响结石破碎中涉及的空化气泡动力学。使用我们的体内结石植入模型和我们的项目1 SWL肾损伤动物模型，并与项目3和4合作，我们将评估和比较不同类型碎石机的有效性和安全性-包括电动液压Dornier HM 3、电磁Dornier Compact Delta（新一代紧聚焦区高功率机器）和Direx Duet双脉冲碎石机。 因此，项目2将找到改进使用传统碎石机进行碎石术的方法，评估更新的机器，以便我们能够学习更安全有效地使用它们，并测试有可能改善SWL的双脉冲SW输送的有前途的新概念。

Project 2: Mechanisms of Shock Wave Action for Improved SWL The goal of Project 2 is to find ways to improve lithotripsy. To reach this goal we have identified three main objectives. We will: 1) provide an objective basis for the choice of lithotripter settings for SW-rate and power used in treating kidney stones (Aims 1 and 2), 2) determine the role of cavitation bubble cluster dynamics in stone fragmentation and find ways for the urologist to enhance the positive action of cavitation in stone breakage (Aims 3 and 4), and 3) evaluate the efficacy and safety of newer generation lithotripters, including a promising dual pulse lithotripter (Aims 5 and 6). Project 2 experiments will be highly interactive with the other projects of this Program Project Grant. In collaboration with Projects 3 and 4 we will utilize high-speed photography, dual passive cavitation detection and B-scan ultrasound to determine the mechanism responsible for improved stone breakage at slow SW-rate, and will find the balance between SW-rate and power that gives improved stone comminution. In studies with Project 1 we will use a new animal model for stone implantation in the pig kidney and the ureter to help evaluate the effect of lithotfipter settings on stone breakage. With our colleagues in Projects 3 and 4 we will analyze cavitation bubble activity in vitro, to determine how the environment of a stone--that is, its tissue boundaries and the composition of the fluid that bathes the stoneminfluence cavitation bubble dynamics involved in stone fragmentation. Using our in vivo stone implantation model and our Project 1 animal model of renal injury in SWL, and in collaboration with projects 3 and 4, we will evaluate and compare the efficacy and safety of different types of lithotripters -- including the electrohydraulic Dornier HM3, the electromagnetic Dornier Compact Delta (a newer generation tight-focal-zone, high power machine), and the Direx Duet dual-pulse lithotripter. Thus, project 2 will find ways to improve how lithotripsy is performed using conventional lithotripters, evaluate newer machines so that we can learn to use them more safely and effectively, and test a promising new concept for dual pulse SW delivery that has the potential to improve SWL.