Viability of the random pattern dorsal skin flap in mice submitted to photobiomodulation and therapeutic ultrasound / Viabilidade do retalho cutâneo randômico dorsal em camundongos submetidos à fotobiomodulação e ultrassom terapêutico

INTRODUCTION: The skin flap is a surgical technique widely used in clinical practice and generally presents postoperative complications. Therefore, elucidating interventions that assist in tissue conservation is essential. Photobiomodulation (PBM) and therapeutic ultrasound (TUS) are non-invasive alternatives for assisting tissue repair, however, there is no consensus on the parameters used. OBJECTIVE: To describe the effectiveness of the different parameters of PBM and TUS in the viability of the dorsal random pattern skin flap in mice. METHODS: Fifty-five Swiss mice were used, distributed in eleven groups. The animals were submitted to surgical technique including revascularization of the area limited through a plastic barrier (polyester/polyethylene) with the same dimension as the flap. PBM or TUS was applied for five consecutive days. Photographic and thermographic recordings were performed with Cyber-Shot DSC-P72 and FlirC2 cameras and analyzed using the ImageJ® and FLIR Tools software, respectively. In the statistical analysis, the data were submitted to the GraphPad Prism® 8.0 software. Analysis of variance (ANOVA Two-way) and Tukey's post-test was performed, considering 5% significance level. RESULTS: Groups 5 (PBM830 nm; 10 J/cm²) and 6 (TUS 3 MHz; 0.4 W/cm²) showed percentages of viable tissue significantly higher on the third and fifth day of the experiment, when compared to the other groups. The temperature decreased significantly in group 1 when compared to the others in the postoperative period. CONCLUSION: The continuous TUS at 3 MHz and PBM 830 nm were more effective in improving the viability of the dorsal random pattern skin flap in mice.

INTRODUÇÃO: O retalho cutâneo é uma técnica cirúrgica amplamente empregada na prática clínica e comumente apresenta complicações pós-operatórias. Portanto, elucidar intervenções que auxiliem na conservação do tecido são fundamentais. A fotobiomodulação (FBM) e o ultrassom terapêutico (UST) são alternativas não invasivas que auxiliam no reparo tecidual, contudo, ainda não há consenso sobre os parâmetros a serem utilizados. OBJETIVO: Descrever a efetividade dos diferentes parâmetros da FBM e do UST na viabilidade do retalho cutâneo randômico dorsal em camundongos. MÉTODOS: Utilizou-se 55 camundongos Swiss, distribuídos em onze grupos. Os animais foram submetidos à técnica cirúrgica com a revascularização da área limitada através de uma barreira plástica (poliéster/polietileno) da mesma dimensão do retalho. Aplicou-se a FBM ou UST durante cinco dias consecutivos. O registro fotográfico e termográfico foi realizado com as câmeras Cyber-Shot DSC-P72 e FlirC2, sendo posteriormente analisados nos softwares ImageJ® e FLIR Tools, respectivamente. Na análise estatística, os dados foram submetidos ao software GraphPad Prism® 8.0 e ao teste Shapiro-Wilk para a análise da normalidade. Realizou-se a análise de variância (ANOVA Two-way) e pós-teste de Tukey, com nível de significância de 5%. RESULTADOS: Os grupos 5 (FBM 830 nm; 10 J/cm²) e 6 (UST 3 MHz; 0,4W/cm²) apresentaram porcentagens de tecido viável significativamente maiores no terceiro e quinto dia do experimento. A temperatura reduziu significativamente no grupo-1 quando comparado aos demais no pós-operatório. CONCLUSÃO: O UST contínuo a 3 MHz e FBM 830 nm, foram mais eficazes melhorando a viabilidade a do retalho cutâneo randômico dorsal em camundongos.

Preliminary study on the efficacy of ultrasound therapy in the rat model of sepsis / 中华危重病急救医学

Objective:To investigate the possible mechanism of ultrasound therapy in the rat model of sepsis.Methods:Seventy-eight male Sprague-Dawley (SD) rats were randomly divided into Sham group ( n = 12), septic model group ( n = 22), ultrasound treatment group ( n = 22), methyllycaconitine citrate (MLA) combined with ultrasound treatment group ( n = 22). In the Sham group, only the abdomen was opened, the cecum was found to be free, without cecal ligation and puncture (CLP). In the septic model group, CLP was used to replicate the septic rat model. After operation, each group of rats were subcutaneously injected with preheated 37 ℃ normal saline. The rats in the ultrasound treatment group were treated with ultrasound [Philips IU22 L9-3 ultrasound instrument and 9 MHz probe were used to break the sequence in the spleen area once every 6 seconds, with 1 second for each time, the mechanical index (MI) was 0.72, and the treatment time was 10 minutes]. In the MLA combined with ultrasound treatment group, α7 nicotinic acetylcholine receptor (α7nAChR) specific blocker MLA 4 mg/kg was injected intraperitoneally 30 minutes before operation, and ultrasound treatment was performed 2 hours after operation. The levels of tumor necrosis factor-α (TNF-α) and interleukin (IL-1β, IL-6) in serum of each group were measured by enzyme-linked immunosorbent assay (ELISA) at 24 hours after operation. The 10-day survival rate of each group was recorded, and the symptoms of each group were evaluated by clinical disease score (CDS). The histopathological changes of lung and colon were observed under light microscope. Results:Compared with the Sham group, the 10-day survival rate of rats in the septic model group was decreased significantly [40% (4/10) vs. 100% (6/6)], the CDS was (10.73±2.19 vs. 6.17±0.58) and the levels of TNF-α, IL-6, and IL-1β were increased significantly at 24 hours after operation [TNF-α (ng/L): 42.00±8.92 vs. 13.16±3.19, IL-6 (ng/L): 129.37±25.04 vs. 63.99±12.92, IL-1β(ng/L): 254.98±67.27 vs. 76.83±25.39, all P < 0.01]. Compared with the septic model group, the survival rate in the ultrasound treatment group was improved [70% (7/10) vs. 40% (4/10)], but there was no significant difference ( P > 0.05). The CDS (7.64±2.68 vs. 10.73±2.19) and the expressions of TNF-α, IL-6, and IL-1β were significantly reduced at 24 hours after operation [TNF-α(ng/L): 16.93±6.02 vs. 42.00±8.92, IL-6 (ng/L): 73.65±24.38 vs. 129.37±25.04, IL-1β(ng/L): 111.86±14.08 vs. 254.98±67.27, all P < 0.01]. Compared with the ultrasound treatment group, the survival rate in the MLA combined with ultrasound treatment group was reduced [60% (6/10) vs. 70% (7/10)], but the difference was not statistically significant ( P > 0.05). CDS was significantly increased (9.55±2.72 vs. 7.64±2.68), and the levels of TNF-α, IL-6 and IL-1β were significantly increased at 24 hours after operation [TNF-α(ng/L): 34.61±7.89 vs. 16.93±6.02, IL-6 (ng/L): 112.92±10.42 vs. 73.65±24.38, IL-1β(ng/L): 212.57±32.16 vs. 111.86±14.08, all P < 0.01]. Microscopically, in the septic model group, the alveolar septum was thickened, a large number of inflammatory cells infiltrated, normal pulmonary reticular structure disappeared, and pulmonary interstitium showed obvious hemorrhage and edema, meanwhile, the structure of colonic villi was obviously abnormal, with cells were edema and inflammatory cell infiltration, and the arrangement was disordered, so that the subepithelial space and the top of it fell off. After ultrasound treatment, the thickness of the alveolar interval in rats was similar to that in Sham group, without obvious inflammatory cell infiltration, and the pulmonary reticular structure was relatively intact. At the same time, the morphology of colonic villi was basically normal and orderly, the edema of cell was not obvious, and subcutaneous space and tip fall off were not obvious. After being antagonized by MLA, the rat lung tissue showed thickened alveolar septum, inflammatory cell infiltration, incomplete pulmonary network structure, hemorrhage and edema in the interstitium. The villi structure of the colon was faintly visible, with obvious cell edema and inflammatory cell infiltration, and the arrangement was abnormal. Conclusion:Ultrasound treatment improves the prognosis of septic rats, MLA can reverse the anti-inflammatory effect of ultrasound therapy by antagonizing α7nAChR, suggesting that the protective mechanism of ultrasound in sepsis may be related to activating the cholinergic anti-inflammatory pathway mediated by α7nAChR.

Short And Long-Term Effects Of Pulsed Wave And Continuous Wave Ultrasound For The Treatment Of Carpal Tunnel Syndrome: A Randomized Clinical Trial

Background: Sonotherapy is used in carpal tunnel syndrome (CTS) treatment; continuous or pulsed ultrasound waves are commonly used. The aim was to assess the short and long-term effects of CTS treatment using continuous and pulsed ultrasound waves. Methods: This study was a randomized clinical trial. Forty-eight patients with mild and moderate CTS (20 unilateral and 28 bilateral) were subjected to complex physiotherapy. Complex physiotherapy included whirlpool massage, neuromobilization, and sonotherapy (continuous wave and pulsed wave ultrasound). The patients were randomly placed in two treatment groups and were subjected to sonotherapy with continuous or pulsed ultrasound waves. Seventy-six hands were assessed before, immediately after, and one year after treatment. Outcome measures included the Boston Carpal Tunnel Questionnaire (CTS SSS & FSS), computer-measured global handgrip force, provocative and functional tests, assessments of vegetative disorders, and sensation disorders. Results: Significant improvements in symptoms and parameters were observed after sonotherapy in both groups immediately after and one year after treatment. Long–term effects of CTS SSS & FSS for pulsed-wave amounted to p=0.0018, p=0.0001 while p=0.0003, p=0.0021 for continuous wave, respectively. Between the groups, a statistically significant difference was found in the change of muscle strength (p=0.0374) and Luthy's sign result (p=0.0262) between examination one and examination 3. Conclusions: Short and long-term effects of continuous and pulsed ultrasound wave in CTS treatment is comparable. Effects are influenced by energy density transmitted to tissues. Pulsed wave appears more effective in the long-term in improving the condition of hand muscles.

Percepção das pacientes sobre a atuação profissional e os procedimentos realizados no pré, no intra e no pós-operatório de abdominoplastia / Perception of patients about professional performance and procedures performed in the pre, intra, and postoperative period of abdominoplasty

Introdução: A abdominoplastia é a terceira cirurgia estética mais realizada no Brasil, sendo que o planejamento cirúrgico envolve os momentos pré, intra e pós-operatórios com a atuação de diversos profissionais especializados. Portanto, o objetivo deste estudo foi analisar a percepção das pacientes sobre a atuação profissional e os procedimentos realizados no pré, no intra e no pós-operatório de abdominoplastia. Métodos: Trata-se de um estudo transversal e observacional. A coleta de dados foi feita através de um questionário online, disponibilizado por meios digitais para mulheres com idade entre 18 e 60 anos, que realizaram a abdominoplastia nos últimos 12 meses. Resultados: Um total de 376 pacientes respondeu ao questionário; porém, 22 foram excluídos, totalizando 354 questionários respondidos. Observouse que 63.5% relataram que realizou a abdominoplastia por flacidez de pele, 53.3% realizaram a abdominoplastia associada à lipoaspiração, 61% relataram que não realizaram procedimentos pré-operatórios, 59.9% relataram não saber se havia fisioterapeuta no centro cirúrgico durante o intraoperatório, 70.6% das pacientes realizaram procedimentos pós-operatórios, sendo 37.4% com fisioterapeuta, a complicação mais comum foi edema representando 84.2%. Conclusão: A principal indicação para a abdominoplastia foi por flacidez de pele, sendo mais frequentemente associada à lipoaspiração. A maior parte das pacientes não realizou procedimentos pré-operatórios e realizou pós-operatório iniciado após 1 a 3 dias, com fisioterapeuta, por indicação de um conhecido, com frequência de três vezes na semana, pela queixa de edema, sendo que os procedimentos mais realizados foram a drenagem linfática manual e o ultrassom terapêutico.

Introduction: abdominoplasty is the third most performed cosmetic surgery in Brazil. Its surgical planning involves the pre, intra, and postoperative moments with the performance of several specialized professionals. Therefore, the objective of this study was to analyze the patients' perception of their professional performance and the procedures performed before, during, and after the abdominoplasty. Methods: This is a cross-sectional and observational study. Data collection was done through an online questionnaire made available digitally to women aged between 18 and 60 years, who underwent abdominoplasty in the last 12 months. Results: A total of 376 patients answered the questionnaire; however, 22 were excluded, totaling 354 questionnaires answered. It was observed that 63.5% reported having undergone abdominoplasty due to skin flaccidity, 53.3% had undergone abdominoplasty associated with liposuction, 61% reported that they had not undergone preoperative procedures, 59.9% reported not knowing whether there was a physiotherapist in the operating room during the intraoperative period. , 70.6% of the patients underwent postoperative procedures, 37.4% of whom were physiotherapists, the most common complication being edema representing 84.2%. Conclusion: The main indication for abdominoplasty was sagging skin, which is most often associated with liposuction. Most of the patients did not undergo preoperative procedures. They were performed after 1 to 3 days after the operation, with a physiotherapist, on the advice of an acquaintance, often three times a week, due to the complaint of edema. The most performed procedures were manual lymphatic drainage and therapeutic ultrasound.

Comparative Analysis of the Effect of Two Therapeutic Ultrasound Protocols for Regeneration of a Critical Bone Defect / Análise comparativa do efeito de dois protocolos de ultrassom terapêutico para regeneração de defeito ósseo crítico

Abstract Objective To compare the effect of two therapeutic ultrasound protocols, with different times of exposure in the regeneration of critical bone defect. Methods Forty-five male rats were distributed among three experimental groups: therapeutic ultrasound group 5 minutes (TUG 5); therapeutic ultrasound group 10 minutes (TUG 10); and control group (CG). In all groups, a critical bone defect of 8.5 mm diameter was made in the calvaria region. The protocol was initiated on the 1st postoperative day in TUGs 5 and 10, with therapeutic ultrasound at the frequency of 1.0 MHz, pulsed mode, five times a week, at periods of 15, 30, and 60 days. Results Among the experimental groups, the highest volume of neoformation of osteoid matrix took place in the TUG 10 group followed by TUG 5, when compared with the CG group, in which the neoformation was restricted to the border region. The use of ultrasound promoted an increase in the thickness of the conjunctive matrix, proliferation of capillaries, alignment of the collagen fibers, reduction of edema and inflammatory process, being more significant in the 10-minutes time period. Conclusion Therapeutic ultrasound stimulated the repair of a critical bone defect, and the longer exposure time promoted greater osteogenic stimulation.

Resumo Objetivo Comparar o efeito de dois protocolos de ultrassom terapêutico com diferentes tempos de exposição para regeneração de defeito ósseo crítico. Métodos Foram utilizados 45 ratos, machos, distribuídos em três grupos: grupo ultrassom terapêutico 5 minutos (GUS 5); grupo ultrassom terapêutico 10 minutos (GUS 10); e grupo controle (GC). Em todos os grupos, confeccionou-se um defeito ósseo crítico, com 8,5 mm de diâmetro, na região da calvária. O protocolo foi iniciado no 1º dia do pós-operatório, no GUS 5 e no GUS 10, com ultrassom terapêutico na frequência de 1,0 MHz, modo pulsado, 5 vezes por semana, nos períodos de 15, 30, e 60 dias. Resultados Dentre os grupos experimentais, houve maior neoformação de matriz osteoide no GUS 10, seguido do GUS 5 quando comparados ao GC, no qual a neoformação foi restrita à região de borda. O uso do ultrassom promoveu aumento na espessura da matriz conjuntiva, proliferação de capilares, alinhamento das fibras colágenas, redução do edema e do processo inflamatório, tendo sido mais significativo no tempo de 10 minutos. Conclusão O ultrassom terapêutico estimulou o reparo do defeito ósseo crítico, e o maior tempo de exposição promoveu maior estímulo osteogênico.

Bioprinted HepG2 cells for studying sonodynamic anticancer activity of chlorine e6 / 药学学报

This paper showed bioprinted HepG2 tumor tissues used for studying the sonodynamic anticancer activity of chlorine e6 (Ce6). HepG2 cells were printed by using alginate/gelatin/hydroxyethyl cellulose composite biomaterial as bio ink and cell viability was detected with Live-Dead assay and MTT proliferation. The ultrasonic intensities of self-built micro ultrasonic device under different powers were estimated by using the temperature change caused by the conversion of acoustic energy to heat energy. Ce6 of 14.3 and 28.6 μg·mL-1 were acted on two-dimensional cultured and three-dimensional printed HepG2 cells, and the antitumor activity of Ce6 was detected by MTT method with ultrasound intensity of 0.15 W·cm2 for 60 s. The results showed that the activities of bioprinted HepG2 cells were as high as 95%, and tumor microspheres were formed after 7 days of culture. The ultrasound intensity was lower than 3 W·cm2, which belonged to low ultrasound intensity and had no damage to normal hepatocyte LO2 cells. By comparing the antitumor activity of Ce6 on 2D cultured and printed HepG2 cells, it was found that the anticancer activity of Ce6 on bioprinted HepG2 cells was 63.4% lower than that on 2D culture cells, indicating the acoustic drug resistance of three-dimensional tumor model. Bioprinted tumor tissues show the potential in the application of in vitro activity evaluation models for sonodynamic therapy.

In vitro recognition of HIFU-induced biological tissue degeneration based on ultrasound / 中国医学影像技术

Objective: To explore a method to improve the identification rate of tissue degeneration caused by high intensity focused ultrasound (HIFU) based on ultrasound combining with generalized regression neural network (GRNN). Methods: Totally 300 fresh isolated pork tissue samples were selected and irradiated at different HIFU doses, then 150 denatured and 150 undenatured samples were obtained. Ultrasonic images of the samples were collected before and after irradiation, then ultrasonic subtraction images were obtained. A total of 18 characteristic parameters of ultrasonic subtractive images were extracted using gray-gradient co-occurrence matrix and gray difference statistical methods, and the best characteristic vectors were obtained with P-value significance detection method and Euclidean distance method. Among 300 samples, 198 were taken as training samples and 102 as test samples. After recognition of training samples, the feature vectors eliminated with P-value significance detection method and 2 feature vectors with the smallest Euclidean distance were taken as control group of the best feature vectors, and then were input into GRNN respectively for recognition of tissue denaturation. Correct recognition rate and total recognition rate of test samples were calculated using combining feature vectors with GRNN. Results: The best feature vectors were non-uniformity of gray distribution and non-uniformity of gradient distribution, and the total recognition rate was 90.20% and 91.18% combining with GRNN, respectively, which increased to 98.04% when both 2 best characteristic parameters combined GRNN. The feature vectors eliminated using P-value significance detection method were average value and contrast, and the total recognition rate combining with GRNN was 48.04% and 75.49%, respectively, which became 79.41% when both 2 best characteristic parameters combined GRNN. The feature vectors with the smallest euclide distance were energy and small gradient, and the total recognition rate combining with GRNN was 88.24% and 89.22%, respectively, which remained 89.22% when both 2 of them combined with GRNN. The recognition rate of the optimal feature vectors combined with GRNN for tissue denaturation was significantly higher than that of control group. Conclusion: Based on ultrasonic subtraction images, of pork tissue irradiated with HIFU, non-uniformity of gray distribution and non-uniformity of gradient distribution combined with GRNN can both improve the recognition rate of tissue denaturation, while the combination of them and GRNN is more effective in identifying tissue denaturation induced by HIFU.

A Comparative Study On The Effect Of Paraffin Wax Therapy With Manual Mobilization Versus Ultrasound Therapy With Manual Mobilization On Pain, Range Of Motion And Functional Status Of Shoulder In Diabetic Subjects With Adhesive Capsulitis

Background: The shoulder is a complex joint that plays a crucial role in many activities of daily living. Adhesive capsulitis is defined as a painful and disabling condition in which the capsule and the connective tissue surrounding the glenohumeral (GH) joint becomes inflamed, leading to restriction of range of motion in the joint. A wide range of physical therapy interventions are used to improve the joint range of motion in subjects with adhesive capsulitis. Earlier, isolated studies were done on the effectiveness of paraffin wax therapy and ultrasound therapy in subjects with adhesive capsulitis. The need of the present study was to compare the effect of paraffin wax therapy with manual mobilization and ultrasound therapy with manual mobilization on pain, shoulder ROM and functional status in diabetic subjects with adhesive capsulitis. Methods: Subjects for the study were recruited from the outpatient department of endocrinology and physiotherapy. The size of the sample is 80 (eighty subjects) 40 in each group, and study design is an experimental study design (Non-randomized open-label study). The pretreatment values of pain and functional status of the shoulder were assessed using Shoulder Pain and Disability Index (SPADI) scale and ROM was assessed using a universal goniometer. The subjects in the paraffin wax therapy group received wax therapy for 10 minutes and undergone manual mobilization. The subjects in the ultrasound therapy group received ultrasound therapy (3MHz) for 10 minutes and undergone manual mobilization. The treatment was given for 3 sessions per week for 6 weeks and post-treatment values were noted for the subjects of both the groups. Results: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group (p< 0.05). Conclusion: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group.

Validación de la evaluación por ultrasonido de la vaina del nervio óptico para la cuantificación de la presión intracraneana en grandes altitudes / Validation of the ultrasound evaluation of the optic nerve sheath for the quantification of intracranial pressure at high altitudes

INTRODUCCIÓN. La medición del diámetro de la vaina del nervio óptico a través de la ventana ocular puede ser un método no invasivo para la detección de hipertensión endocraneana. OBJETIVO. De este trabajo fue validar una fórmula de cuantificación de la presión intracraneana a partir de la evaluación por ultrasonido de la vaina del nervio óptico en una ciudad de gran altitud. MATERIALES Y MÉTODOS. Estudio prospectivo de 27 pacientes con trauma craneoencefalico grave en quienes se les colocó un sensor de presión intracraneana intraventricular y se realizó el cálculo de la PIC no invasiva mediante correlación utilizando la evaluación de la vaina del nervio óptico a través de ultrasonido y aplicando una fórmula de cálculo. RESULTADOS. Correlación positiva débil con significancia estadística. CONCLUSIÓN. La cuantificación de la presión intracraneana no invasiva a través de la evaluación de la vaina del nervio óptico por ultrasonido podría ser una herramienta útil en ciudades de gran altitud sobre el nivel del mar.

INTRODUCTION. Measuring the diameter of the optic nerve sheath through the eye window can be a non-invasive method for the detection of endocranial hypertension. OBJECTIVE. This work was to validate a formula for quantifying intracranial pressure from the ultrasound evaluation of the optic nerve sheath in a high-altitude city. MATERIALS AND METHODS. Prospective study of 27 patients with severe cranioencephalic trauma in whom an intraventricular intracranial pressure sensor was placed and the calculation of non-invasive ICP was performed by correlation using the evaluation of the optic nerve sheath through ultrasound and applying a formula of calculation. RESULTS. Weak positive correlation with statistical significance. CONCLUSION. Quantification of non-invasive intracranial pressure through the evaluation of the optic nerve sheath by ultrasound could be a useful tool in high altitude cities above sea level.

Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic nonspecific low back pain: a randomized controlled clinical trial

Abstract Objective: To compare the short-term effects of pulsed laser and pulsed and continuous ultrasound on pain and functional disability in women with chronic non-specific low back pain. Methods: The sample was composed of 100 volunteers randomly allocated into four groups: The Pulsed Laser Group (n = 26) was treated with 3 J/cm2; the Pulsed Ultrasound Group (n = 24; 3 MHz) was treated with 1 W/cm2; the Continuous Ultrasound Group (n = 26; 1 MHz) was treated with 1 W/cm2; and a Control Group (n = 24), where the patients were still waiting for treatment. Before and after 10 sessions of treatment, the intensity of pain was assessed using the visual analogue scale (VAS), the quality of pain was evaluated using the McGill pain questionnaire and functional disability was investigated using the Roland-Morris questionnaire. Results: The three treated groups exhibited a decrease in pain (p < 0.001); the Pulsed Laser Group showed the greater relative gain (91.2%), Meanwhile, the Control Group exhibited a worsening of - 5.8%. The three treated groups demonstrated improvement in the quality of pain (McGill) in the total, sensory and affective dimensions (p < 0.005; p < 0.002; p < 0.013, respectively). All treated groups showed a decrease in functional disability (p < 0.001), but the Pulsed Ultrasound Group showed the highest relative gain (83.3%). Conclusions: The three modalities have significant effects to decreasing low back pain and improving functional disability in women with non-specific chronic low back pain, but the pulsed low-level laser had the best results on pain while the pulsed ultrasound had the best results on improve the functional disability. Trial registration:ClinicalTrials.gov: NCT02150096.

Impact of focused ultrasound on expression of hypoxia inducible factor-1α, vascular endothelial growth factor and mutant type p53 in vulvar skin of rat models with low grade squamous intraepithelial lesion / 中国介入影像与治疗学

Objective: To explore the impact of focused ultrasound on expression of hypoxia inducible factor-1α (HIF-1α),vascular endothelial growth factor (VEGF) and mutant type p53 (mtp53) in vulvar skin of rat models with low grade squamous intraepithelial lesion (LSIL). Methods: A total of 28 rat models with LSIL were established and randomly divided into treatment group and control group (each n=14). The rat models in treatment group were treated with focused ultrasound, while in control group only received sham irradiation (no power output from ultrasonic therapeutic instrument). Histological changes of vulvar skin in SD rats were observed 4 weeks later. The expression of HIF-1α, VEGF and mtp53 protein were detected using immunohistochemistry. Results: After 4 weeks of focused ultrasound irradiation/sham irradiation, there were 92.86% (13/14) rats return to normal in treatment group and 71.43% (10/14) rats progressed into high grade squamous intraepithelial lesion (HSIL) in control group. Compared with control group, HIF-1α, VEGF and mtp53 protein levels significantly decreased in treatment group (all P<0.05). Conclusion: Focused ultrasound treatment can improve the microenvironment of local vulvar tissue by decreasing the expression of HIF-1α, VEGF and mtp53 in vulvar skin, therefore can be used to treat LSIL safely and effectively in rat models.

The application of the energy-based photoelectric and ultrasonic technology in facial rejuvenation / 中华整形外科杂志

Photoelectric and ultrasonic technology rapid development has brought more choices for facial rejuvenation, but its prosperous clinical application forms a sharp contrast with its weak theoretical based research. Moreover, there is still no consensus on how to standardize the short-term and long-term effects of skin rejuvenation for different energy sources. This paper summarizes the application and progress of photoelectric and ultrasonic technology in facial rejuvenation in recent years, with emphasis on its characteristics and combination with other non-surgical treatments. Combining a variety of non-surgical treatments to maximize efficacy and balance the related risks is the direction of future development.

Focused ultrasound therapy for reducing recurrence of vulvar lichen simplex chronicus in rats: efficacy and mechanism / 南方医科大学学报

OBJECTIVE@#To explore the changes of collagen fibrosis in the vulva skin of SD rats with lichen simplex chronicus (LSC) after focused ultrasound therapy and explore the mechanism by which focused ultrasound reduces the recurrence of vulvar LSC.@*METHODS@#Fifty female SD rat models of vulvar LSC were established and randomly divided into the treatment group and the control group (=25) for treatment with focused ultrasound and sham treatment, respectively. Before and after the treatment, vulvar skin tissues were sampled to observe the pathological changes with HE staining and assess the density of collagen fibers using Masson staining. The ultrastructure of the collagen fibers in the superficial dermis was observed using transmission electron microscopy. The expressions of notch1 and c-fos in the vulvar tissue were detected by immunohistochemistry and Western blotting.@*RESULTS@#After 4 weeks of focused ultrasound therapy, 16% (4/25) of the rats in the treatment group showed lesion progression to LSIL, 4% (1/25) still had LSC, and 80% (20/25) showed normal vulvar skin. In the control group, progression to LSIL occurred in 19 (76%) rats, 3 (12%) rats still showed LSC, and only 3 (12%) had normal vulvar skin. The difference in the cure rate differed significantly between the two groups ( < 0.05). The density of collagen fibers in the superficial dermis and the expressions of notch1 and c-fos in the vulvar skin were significantly lower in the treatment group than in the control group ( < 0.05).@*CONCLUSIONS@#Focused ultrasound therapy can inhibit superficial collagen fibrosis of the dermis by lowering the expressions of notch1 and c-fos in the vulvar skin to reduce the recurrence of vulvar LSC in rats.

Utilization Characteristics and User Satisfaction by Type of Physical Therapy Service in Senior Centers

PURPOSE: This study was conducted to identify the characteristics of physical therapy service utilization and user satisfaction depending on the experience with therapeutic exercise or ultrasound intervention among elderly persons using senior centers. METHODS: The subjects were adults aged over 60 years (total 215) recruited in 40 senior centers located in each province in South Korea. Subjects responded to questions concerning overall demographics factors, utilized characteristics of physical therapy service and 12 variety user satisfactions with effectiveness, facilities, and therapist using a survey instrument. The collected data were analyzed by Fishers' exact tests and t-tests using the SPSS 21.0 program to compare the results of elderly persons who had or had not experienced exercise therapy or ultrasound therapy. RESULTS: The participants that experienced ultrasound therapy or therapeutic exercise reported significantly higher overall results pertaining to effectiveness of physical therapy and a clear explanation from physical therapist's satisfaction than those who were non-experienced. Satisfaction with pain relief was significantly higher among elderly who experienced therapeutic exercise than those who did not. Those who underwent ultrasound therapy showed significantly higher satisfaction with facilities and location than those who did not. CONCLUSION: The results of this study suggest that satisfaction among users differs by type of physical therapy. In the future, physiotherapy services provided in senior centers needs to be designed to improve the effectiveness of physical therapy, professionalism of physical therapists and comfort of facility.

Effect of Ultrasound Therapy on Radiation-induced Dysphagia for Nasopharyngeal Carcinoma / 中国康复理论与实践

@#Objective To explore the effect of ultrasound therapy on dysphagia caused by radiotherapy for nasopharyngeal carcinoma. Methods From February to December, 2017, 60 patients with radiation-induced dysphagia for nasopharyngeal carcinoma were randomly divided into control group (n = 30) and treatment group (n = 30). All the patients accepted routine rehabilitation and balloon dilatation. The treatment group received ultrasound therapy, and the control group received placebo ultrasound. They were evaluated with Kubota Drinking Water Test (KDWT) and Videofluoroscopic Swallowing Study (VFSS), and the interincisor distance were measured to determine the clinical effect, before and six weeks after treatment. Results The score of KDWT (Z = -2.253, P < 0.05) and the pass time in VFSS (t > 2.4265, P < 0.05) improved more in the treatment group than in the control group after treatment, as well as the incidence of effect (Z = -4.113, P < 0.001). Conclusion Ultrasound therapy can further improve the function of swallowing based on the balloon dilatation.

Effects of Transcranial Ultrasound Therapy on Balance and Walking in Children with Dyskinetic Cerebral Palsy / 中国康复理论与实践

Objective To observe the effects of transcranial ultrasound (TU) therapy on balance function and walking ability in children with dyskinetic cerebral palsy (CP). Methods From June, 2015 to February, 2016, 51 children with dyskinetic CP were randomly divided in-to control group (n=25) and TU group (n=26). All the children accepted routine rehabilitation, while TU group accepted TU in addition, 1.2 W/cm2 for 20 minutes per day, 5 times a week, for three weeks. They were evaluated with Pediatric Balance Scale (PBS), walking speed, step length and step width with footprint analysis before and after intervention. Results The PBS score, step length and walking speed im-proved in both groups after intervention (Z>4.112, t>3.338, P2.038, P<0.05). Conclusion TU therapy can improve balance function and walking ability in children with dyskinetic CP.

Morphometric and fractal analysis of injured skeletal muscle tissue subjected to a combination of treatments; cryotherapy and therapeutic ultrasound / Análisis de la morfometría y de la dimensión fractal en la lesión del tejido muscular esquelético expuesto en la combinación de los tratamientos de crioterapia y ultrasonido

The aim of this study was to analyze the effects of an association of cryotherapy and therapeutic ultrasound on the treatment of muscle injured by impact. Fifty-five Wistar rats were divided into five groups (n = 11), Acute Injury (AI), Injury (I), Cryotherapy (CR), Therapeutic Ultrasound (TU) and Association of Cryotherapy and Therapeutic Ultrasound (CRTU). The CR and CRTU groups received applications of Cryotherapy three times (immediately, 24 and 48 h after injury) of 20 minutes duration. The TU and CRTU groups received applications of Therapeutic Ultrasound for seven days, for five minutes, in pulsed mode, 0.5 w/cm intensity, frequency 1 MHz. Body mass and gastrocnemius mass were analyzed. In addition to histological slides stained with hematoxylin and eosin used for morphometric analysis, picrosirius dye was used for quantification of collagen by Fractal Dimension (FD). The results of the intra-group analysis showed lower body mass and gastrocnemius in the CRTU group in relation to the AI (p = 0.001), I (p = 0.001), CR (p = 0.001) and TU groups (p = 0.001), and lower values of FD to quantify collagen in the CRTU group in relation to the AI (p = 0.007) and CR groups (p = 0.014). In summary, the present study showed that the association of Cryotherapy with Therapeutic Ultrasound promoted better results in the aspects analyzed compared to application of the therapies in isolation.

El objetivo del estudio fue evaluar los efectos de la asociación de las técnicas de crioterapia y ultrasonido terapéutico en el tratamiento de la lesión muscular por impacto. Fueron utilizadas 55 ratas Wistar, expuestas a lesión y separadas en grupos (n = 11): Lesión aguda (LA), Lesión (L), Crioterapia (CR), Ultrasonido Terapéutico (UT) y Crioterapia + Ultrasonido Terapéutico (CRUT). Los grupos CR y CRUT recibieron la aplicación, durante 20 minutos, en tres momentos (inmediatamente, 24 y 48 horas, después de la lesión). Los grupos UT y CRUT, recibieron UT por siete días, con una duración de cinco minutos, en modo pulsado, con una intensidad de 0,5 W/cm2 y frecuencia de 1 MHz. Fueran medidos el peso corporal y el peso de los músculos gastrocnemios y se realizaron cortes histológicos del músculo gastrocnemio, los cuales fueron teñidos con hematoxilina-eosina (HE) para el análisis morfométrico y con picrosirius para el análisis del colágeno por dimensión fractal (DF). Los resultados de los análisis intragrupo demostraron una menor disminución de la masa coporal y muscular en el grupo CRUT. Además, fue observado un valor inferior en la morfometría en el grupo CRUT en comparación a los grupos LA (p = 0,001), L (p = 0,001), CR (p = 0,001) y UT (p = 0,001), y un menor valor de la DF con respecto al colágeno en el grupo CRUT en comparación a los grupos LA (p = 0,007) y CR (p = 0,014). En síntesis, el presente estudio demostró que el protocolo de asociación de las técnicas de CR y UT causaron mayores respuestas benéficas en los aspectos analizados en comparación a los protocolos con los tratamientos aplicados de forma aislada.

Uso del ultrasonido terapéutico pulsado en el tratamiento de personas con osteoartritis de rodilla / Pulsed therapeutic ultrasound in the treatment of persons with knee osteoarthritis

La osteoartritis de rodilla es una patología crónica y degenerativa caracterizada por la destrucción del cartílago articular, para la cual en la actualidad no existen intervenciones terapéuticas que detengan el deterioro. Una de las modalidades utilizadas en fisioterapia para el tratamiento de la osteoartritis es el ultrasonido terapéutico, sin embargo los resultados reportados en la literatura sobre el efecto del ultrasonido terapéutico en pacientes con osteoartritis de rodilla son contradictorios y limitan la toma de decisiones en el ámbito clínico. En este sentido, en esta revisión se realizó el análisis crítico de la evidencia científica que evalúa el efecto del ultrasonido en pacientes con OA de rodilla. Fue realizado un acercamiento a los parámetros adecuados para alcanzar efectos terapéuticos, además se analizaron los posibles mecanismos por los cuales el ultrasonido terapéutico puede favorecer dichos efectos.

Knee osteoarthritis is a chronic, degenerative disease without therapeutic interventions toward prevent the articular cartilage deterioration, thus pain and functionality limitation are the main goals of the physical therapy treatment. The therapeutic ultrasound is a common physical modality used for the treatment of osteoarthritis, however, the results reported in the literature about the therapeutic effect of this physical modality in patients with knee osteoarthritis are contradictory and limits clinical decision making. Therefore, we made a critical analysis of scientific evidence about this matter, we made an approached to the appropriate parameters to achieve therapeutic effects and we analyzed the possible mechanisms by which these effects can occur.

USO DE PONTA DIAMANTADA CVDENTUS® EM PACIENTES COM FISSURA LABIOPALATINA / THE USE OF CVDENTUS® DIAMOND BURS IN PATIENTS WITH CLEFT LIP AND PALATE

O objetivo deste estudo foi relatar o uso do sistema CVDentus® em dois casos clínicos de crianças com fissuras labiopalatinas e cárie dentária. Demonstração da técnica de utilização do sistema CVDentus®, associada à cureta para remover a cárie dentária das paredes circundantes. Os dentes foram restaurados com Cimento de Ionômero de Vidro modificado por Resina. O acabamento e o polimento foram realizados com pontas diamantadas douradas, pedra Arkansas branca e pontas de silicone. A vantagem oferecida pelo sistema CVDentus® está diretamente relacionada a um maior conforto ao profissional e paciente, pois promove menor ruído, vibração e sensibilidade dolorosa, superando, assim, um dos maiores desafios da odontopediatria. O sistema CVDentus® parece ser uma alternativa promissora, sobretudo para pacientes com fissura labiopalatina mais agitados, ansiosos, cujos efeitos negativos dos instrumentos rotatórios convencionais podem tornar mais difícil o controle de suas condutas durante o atendimento odontológico.

The aim of this study was report the use of the system CVDentus® in two clinical cases of children with cleft lip and palate and dental caries. Technique demonstration of using the system CVDentus®, combined with a curette to remove caries of the cavity walls. The teeth were restored with glass-ionomer cement modified by resin. The finishing and polishing were performed (were done or were conducted) with diamond gold, white Arkansas stone and silicone tips. New technologies have emerged in the dental market, in order to facilitate the removal of carie tissue preserving the most of tooth structure. The system CVDentus® promotes reduced noise, vibration and pain sensitivity and consequently increased comfort to the patient and professional. The comfort provided is directly related to good behavior, thus overcoming one of the biggest challenges of pediatric dentistry. The CVDentus ® system seems to be a promissory alternative, especially for patients with cleft lip and palate more agitated, anxious, whose negative effects of conventional rotary instruments may make it harder to control their behavior during dental treatment.

Effect of Low Frequency Ultrasound on Carotid Plaque / 中国康复理论与实践

@#Objective To observe the effects of low frequency ultrasound on carotid artery plaque and artery stenosis. Methods 156 patients with carotid atherosclerosis were divided into treatment group (n=80) and control group (n=76). The control group was administered routine medicine, while the treatment group accepted low frequency ultrasound therapy in addition. The size and shape of carotid artery plaque, severity of stenosis and the level of lipid were observed before and after treatment, and the side-effects were recorded. Results The intima-media thickness (IMT), diameter of plaque, plaque score decreased after treatment in both groups, and decreased more in the treatment group than in the control group (P<0.05); while the frequence of moderate stenosis and severe stenosis was less (P<0.05). The levels of low density lipoprotein- cholesterol and total cholesterol decreased in both groups after treatment (P<0.05), and decreased more in the treatment group than in the control group (P<0.05). No serious side-effect was observed. Conclusion Low frequency ultrasound can reduce the atherosclerotic plaques in carotid artery and relieve the stenosis.