Academic Journal
The interaction of shock waves with biological tissue - momentum transfer, the key for tissue stimulation and fragmentation.
| Τίτλος: | The interaction of shock waves with biological tissue - momentum transfer, the key for tissue stimulation and fragmentation. |
|---|---|
| Συγγραφείς: | Wess O; Department Applied Research, Storz Medical AG, Taegerwilen, Thurgau, Switzerland., Mayer J |
| Πηγή: | International journal of surgery (London, England) [Int J Surg] 2025 Apr 01; Vol. 111 (4), pp. 2810-2818. Date of Electronic Publication: 2025 Apr 01. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc. Original Publication: London : Surgical Associates Ltd., c2004- |
| Ιατρικοί όροι (MeSH): | High-Energy Shock Waves*/therapeutic use , Lithotripsy*/methods , Models, Biological*, Humans |
| Περίληψη: | Background: Shock waves in medicine have gained enormous importance and have spread since 1980, and the first kidney stone was successfully fragmented in a patient in Munich. Meanwhile, the spectrum of medical applications of shock waves ranges from powerful fragmentation of kidney stones to diverse indications such as wound healing, chronic pelvic pain, spasticity, erectile dysfunction, and others, to neuro-stimulation in the context of Alzheimer's disease. A comprehensive working mechanism for this diverse field of medical indications is still missing. Objective: Investigation of the physical basis of the working mechanism of shock waves in medical applications. Methods: We developed a model based on the mechanical forces generated by the momentum transfer at the acoustic interfaces of different layers of biological tissue. The generated forces are strong enough to crash brittle material and provide an adequate mechanical stimulus to activate mechano-transduction and mechano-sensory-transduction with nerve stimulation, thereby affecting the neural memory function of the central nervous system. Results: The key to generating appropriate forces in the millisecond range is the mechanism of momentum transfer at the interfaces between tissue layers with different acoustic impedances. According to Newton's laws of motion, a change in momentum (momentum transfer) generates force F = d P /d t . The inherent shear forces can stretch biological membranes to release biomolecules such as vascular endothelial growth factor and nitric oxide. A most favorable feature of this mechanism is the selective effect on soft tissue interfaces and small tissue inhomogeneities to generate small forces in the range of few (≤10) Newton to stimulate tissue and nerve cells, while the same shock wave can generate forces ≥200 Newton and more on hard tissue interfaces such as bones or stones. Conclusion: The mechanism of momentum transfer is the basis for mechano-transduction and mechano-sensory transduction. It offers the opportunity to stimulate peripheral nerves and modify the motor reflex patterns of "pathologic" reflexes by hyper stimulation. The new technique of transcranial pulse stimulation may be based on direct stimulation and reactivation of neurons in the brain. Momentum transfer is the basic physical mechanism and the initiator for successive biological processes in medical shock wave therapy. (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.) |
| References: | Chaussy C, Brendel W, Schmiedt E. Extracorporeally induced destruction of kidney stones by shock waves. Lancet 1980;316:1265. Chaussy C, Schmiedt E, Jocham D, et al. Berührungsfreie Nierensteinzertrümmerung durch Stoßwellen. Erste klinische Erfahrungen. Dt Ärzteblatt, Ärztliche Mitteilungen 1981;18:881–86. Chaussy C, Schmiedt E, Jocham D. Extracorporeal shock wave lithotripsy (ESWL) for treatment of urolithiasis. Urology 1984;23:59–66. Chaussy C, Schmiedt E, Jocham D, et al. First clinical experiences with extracorporeally induced destruction of kidney stones by shock waves. J Urol 1982;127:417–20. Wess O, Überle F, Dührßen RN, et al. Working group technical developments – consensus report. In: Chaussy Ch, Eisenberger F, Jocham D, Wilbert DM, eds. High energy shock waves in medicine. Georg Thieme Verlag; 1997:63. Sauerbruch T, Delius M, Paumgartner G, et al. Fragmentation of gallstones by extracorporeal shock waves. N Engl J Med 1986;314:818–22. Sauerbruch T, Stern M. Fragmentation of bile duct stones by extracorporeal shock waves. A new approach to biliary calculi after failure of routine endoscopic measures. Gastroenterology 1989;96:146–52. Sauerbruch T, Holl J, Sackmann M, et al. Disintegration of a pancreatic duct stone with extracorporeal shock waves in a patient with chronic pancreatitis. Endoscopy 1987;19:207. Marmary Y. A novel and non-invasive method for the removal of salivary gland stones. Int J Oral Maxillofac Surg 1986;15:585–87. Iro H, Nitsche N, Schneider H. Extracorporeal shockwave lithotripsy of salivary gland stones. Lancet 1989;334:115. Rassweiler J, Knoll T, Köhrmann KU, et al. Shock wave technology and application: an update. Europ Urol 2011;59:784–96. Zimmermann R, Cumpanas A, Hoeltl L, et al. Extracorporeal shock-wave therapy for treating chronic pelvic pain syndrome: a feasibility study and the first clinical results. BJU Int 2008;102:976–80. Zimmermann R, Cumpanas A, Miclea F, et al. Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. Eur Urol 2009;56:418–24. Hauck EW, Mueller UO, Bschleipfer T, et al. Extracorporeal shock wave therapy for Peyronie’s disease: exploratory meta-analysis of clinical trials. J Urol 2004;171:740–45. Olsen AB, Persiani M, Boie S, et al. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol 2015;49:329–33. Moya D, Ramon S, Schaden W, et al. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg 2018;100:251–63. Notarnicola A, Maccagnano G, Gallone MF, et al. Extracorporeal shockwave therapy versus exercise program in patients with low back pain: short-term results of a randomised controlled trial. J Biol Regul Homeost Agents 2018;32:385–89. Gleitz M, Hornig K. Trigger points – diagnosis and treatment concepts with special reference to extracorporeal shockwaves (article in German). Orthopade 2012;41:113–25. Gollwitzer H, Diehl P, von Korff A, et al. Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device. J Foot Ankle Surg 2007;46:348–57. Nicolaides AN, Marlinghaus EH, Cesarone MR, et al. Shock waves in vascular diseases: an in-vitro study. Angiology 1998;49:777–88. Ciampa AR, de Prati AC, Amelio E, Cavalieri E, et al. Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves. FEBS Lett 2005;579:6839–45. Ito K, Fukumoto Y, Shimokawa H. Extracorporeal shock wave therapy as a new and non-invasive angiogenic strategy. Tohoku J Exp Med 2009;219:1–9. Schmid JP, Capoferri M, Wahl A, et al. Cardiac shock wave therapy for chronic refractory angina pectoris. A prospective placebo-controlled randomized trial. Cardiovasc Ther 2013;31:e1–6. Beisteiner R, Matt E, Fan C, et al. Transcranial pulse stimulation with ultrasound in Alzheimer’s disease – a new navigated focal brain therapy. Adv Sci (Weinh) 2020;7:1902583. Beisteiner R, Lozano A. Treating the brain at the speed of sound. Brain Stimul 2020;13:1087–88. Matt E, Kaindl L, Tenk S, et al. First evidence of long-term effects of transcranial pulse stimulation (TPS) on the human brain. J Transl Med 2022;20:26. Matt E, Dörl G, Beisteiner R. Transcranial pulse stimulation (TPS) improves depression in AD patients on state-of-the-art treatment. Alzheimers Dement (N Y) 2022;8:e12245. Slezak C, Flatscher J, Slezak P. A comparative feasibility study for transcranial extracorporeal shock wave therapy. Biomedicines 2022;10:1457. Wess O, Mayer J. Fragmentation of brittle material by shock wave lithotripsy. Momentum transfer and inertia: a novel view on fragmentation mechanisms. Urolithiasis 2020;48:137–49. https://en.wikipedia.org/wiki/Mechanotransduction. d’Agostino MC, Craig K, Tibalt E, et al. Shock wave as biological therapeutic tool: from mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg 2015;24:147–53. Gillespie P, Walker R. Molecular basis of mechanosensory transduction. Nature 2001;413:194–202. Wess O. A neural model for chronic pain and pain relief by extracorporeal shock wave treatment. Urol Res 2008;36:327–34. Wess O, Röder U. A holographic model for associative memory chains. Biol Cybern 1977;27:89–98. Raegener K. Basic treatment principles. In: Dreisilker U, ed. Enthesiopathies, Ulrich Dreisilker. Leveho Buchverlag Daniela Bamberg; Vol 55; 2010:55. |
| Contributed Indexing: | Keywords: fragmentation; momentum transfer; neurostimulation; shock wave therapy; shock waves |
| Entry Date(s): | Date Created: 20250226 Date Completed: 20250416 Latest Revision: 20250923 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12175785 |
| DOI: | 10.1097/JS9.0000000000002261 |
| PMID: | 40009555 |
| Βάση Δεδομένων: | MEDLINE |
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