Synchronous twin-pulse technique to improve efficacy of SWL: preliminary results of an experimental study.

BACKGROUND AND PURPOSE: Extracorporeal shockwave lithotripsy (SWL) is the treatment of choice for the majority of renal and ureteral stones. The Dornier HM3 lithotripter has good results but with some limitations and complications. A number of second- and third-generation machines have been developed employing different energy sources, focusing devices, and coupling media. These devices overcome some of the limitations and lessen the complications but at the expense of the success rate. Use of the consecutive double-pulse technique (as in the MFL 5000) and of combined under-table and over-table modules consecutively (as in the Siemens Lithostar Plus) improves the efficacy of fragmentation. The aim of this study was to study the effects of the use of synchronous twin pulses generated by under-table and over-table identical shockwave reflectors for stone fragmentation. MATERIALS AND METHODS: We designed a lithotripter with two identical shockwave generators and identical reflectors (twin heads). One reflector was under the table and fixed, while the second reflector was over the table and hangs on a C-arm so that the angle between the axes of the two reflectors could be changed. The second focal points (F2) of the two reflectors lay in the same position. A lucent lightweight acrylic water tank with one side sealed by a silicon rubber membrane was fixed to the SWL table so that the membrane coupled with the water cushions of both reflectors. The tank was filled with degassed water and the targeted material was fixed on a holder and immersed in the water so as to be at F2. Comparison of the use of one shockwave source and two shockwave sources simultaneously was done relative to: (1) cavitation effect on aluminum foil; (2) quality of disintegration, shape of the focal zone, and ideal position of F2 using ceramic blocks; and (3) disintegrative efficacy using dental bone cement. RESULTS: The cavitation effect became more localized with the use of two reflectors. Also, the volume and rate of stone disintegration increased with the use of the two reflectors, with production of fine (<2-mm) fragments. The focal zone became smaller and conical with no propagation of shockwaves beyond F2. These results were more evident if the angle between the axes of the reflectors was 90 degrees. CONCLUSION: This new technique of SWL may improve the efficacy of treatment of urinary tract stones. It also may be less harmful to the renal tissues, but animal experiments must be carried out to prove this.

Effects of superstructure type and design on force transmission via implant-stabilised mandibular prostheses.

Forces to which individual implant units are subjected when an implant-stabilised mandibular over-denture is loaded have been measured using a carbon-fibre reinforced epoxy resin replica of an edentulous mandible mounted in a loading rig which simulated physiological conditions. Three different retentive designs were used; ball attachments, a fixed-fixed bar cranked anteriorly, and a similar design with posterior cantilevers. Forces exerted on the implants were measured using resistance strain gauges mounted on their trans-mucosal abutments and the dentures were loaded at individual tooth positions with a strain gauge beam. Ball attachments were associated with the lowest detected forces on the abutments. It is concluded that variations in superstructure design affect the forces transmitted by implants stabilising a complete mandibular over-denture, when the mandible is suspended and loaded in a physiological manner.

Sodium absorption by intact sugar beet plants.

Sodium absorption by intact sugar beet plants (Beta vulgaris) was found to be mediated by at least two distinct mechanisms when uptake was studied over a wide range of Na and K concentrations. The first mechanism operates at low Na concentrations (<1 milliequivalent per liter); presence of K completely blocks this mechanism for Na. The second mechanism operates at high Na concentrations (>1 milliequivalent per liter), transporting Na as well as K; but apparently this mechanism is not active for Na absorption in young sugar beet plants up to the 10-leaf stage.

Interaction of rubidium or sodium with potassium in absorption by intact sugar beet plants.

This study concerns the selective absorption of K and Rb or of K and Na by intact sugar beet (Beta vulgaris) plants from modified conventional nutrient solutions over an extended period of plant growth. Long term results agreed with those of short term experiments by other investigators using excised root systems and simple salt solutions. Potassium and Rb were mutually competitive in their absorption. High selectivity of K relative to Na absorption was observed. Sodium was excluded during the early growth period of sugar beets.

Interactions of rubidium, sodium, and potassium on the nutrition of sugar beet plants.

The effect of Rb on the growth and the development of sugar beet plants (Beta vulgaris, var. MS NB1 x NB4) depends on the Rb concentration, the K supply, and the relative abundance of Na. Rubidium added either to a low or high K solution with or without added Na increased leaf blade size greatly, possibly through an effect on phytohormones or through a "partitioning effect" on the distribution of carbohydrates, with top growth favored over storage roots.Sodium increased the growth of sugar beet plants when they were either K-deficient or adequately supplied with K. Sodium or Rb added to a high K solution increased the sucrose percentage and total sucrose of the storage roots significantly. Sodium and Rb supplied simultaneously to the nutrient solution resulted in synergetic effects only at low K supply.Potassium was translocated in mature leaves from the petiole to the blade when Na was added to a low K solution, or when Rb was added either to a low or a high K solution. Rb + K had little to no effect on Na redistribution.

Sodium and rubidium as possible nutrients for sugar beet plants.

This study concerned the degree to which Na or Rb could substitute for K in the growth of sugar beet plants when K in the culture solution was low (1 meq/liter) or high (12 meq/liter).Sodium at high concentrations increased the growth of plants in a basal nutrient medium when either deficient in K or when adequately supplied with K alone. Redistribution of K from petioles to blades could not fully explain these results. Therefore, the essentiality of Na per se for growth of sugar beet plants may be inferred.Rubidium increased the growth of plants significantly when supplied in small doses to a nutrient medium deficient or adequately supplied with K. The amount of K added and the mode of Rb addition to solution cultures should be carefully considered when studying the effect of Rb on growth. High Rb concentrations were toxic, especially to the growth of fibrous roots.Sodium or Rb have been shown to enhance the growth of sugar beet plants under either low or high K conditions. Essentiality of either Na and/or Rb per se for growth of sugar beets may be inferred, but other criteria should be fulfilled also for conclusive proof.