WO2024218761A1 - Device for ultra-wideband micromechanical therapy and method of its operation - Google Patents
Device for ultra-wideband micromechanical therapy and method of its operation Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
- A61H23/008—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms using shock waves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
- A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
- A61H23/0245—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with ultrasonic transducers, e.g. piezoelectric
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
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- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04B—TRANSMISSION
- H04B17/00—Monitoring; Testing
- H04B17/0082—Monitoring; Testing using service channels; using auxiliary channels
- H04B17/0085—Monitoring; Testing using service channels; using auxiliary channels using test signal generators
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0073—Ultrasound therapy using multiple frequencies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0078—Ultrasound therapy with multiple treatment transducers
Definitions
- the present invention in some embodiments thereof, relates to a device and method for medical treatment using ultrasound waves and, more particularly, but not exclusively, to promoting tissue regeneration using pulsed ultrasound at relatively low intensities.
- Low intensity pulsed ultrasound is known for therapy.
- An example is Published U.S. Patent Application 2011/0178441 to Tyler.
- This application describes methods and devices for modulating the activity or activities of living cells. Methods comprise use of the application of ultrasound, such as low intensity, low frequency ultrasound to living cells to affect the cells and modulate the cells’ activities.
- the ultrasound waveforms shown in this publication generally consist of pulses 10 to 100 cycles long at frequencies of about 0.5 MHz, so their bandwidths are 1% to 10% of their frequency.
- An ultrasound therapy device includes waveform generator, one or more transducers, one or more sensors, and a controller.
- the waveform generator is configured to generate a first driving signal having a least a first waveform segment and a second waveform segment different from the first waveform segment.
- FIG. 3B is an exemplary multivariant waveform.
- cPLA2 cytosolic phospholipase A2
- U. S. Patent No. 6,231,528 to Kaufman et al describes non-invasive therapeutic treatment of bone in vivo using ultrasound in conjunction with application of a biochemical compound or bone growth factor, performed by subjecting bone to an ultrasound signal supplied to an ultrasound transducer placed on the skin of a bony member, and involving a repetitive finite duration signal consisting of plural frequencies that are in the ultrasonic range to 20 MHz.
- Concurrent with application of the ultrasound is the utilization of a bone growth factor applied to the skin of a bony member before stimulation with ultrasound.
- Ultrasonic stimulation is operative to transport the bone growth factor to the bone and then to synergistically enhance the interaction of the bone growth factor with the bone, whereby to induce healing, growth and ingrowth responses.
- FIGS. 2A and 2B are a set of acoustic ultrasonic signals used for stimulation of bone growth and healing for several of the currently preferred embodiments.
- U. S. Patent No. 4,530,360 to Duarte describes an apparatus and method for healing bone fractures, pseudoarthroses and the like with the use of ultrasound.
- An ultrasound transducer in contact with the skin of the patient, transmits ultrasound pulses to the site of the bone defect.
- the nominal frequency of the ultrasound is 1.5 MHz, the width of each pulse varies between 10 and 2000 microseconds, and the pulse repetitin rate varies between 100 and 1000 Hz.
- the power level of the ultrasound is maintained below 100 milliwatts per square centimeter. Treatments which last no more than 20 minutes per day have been found to heal defects in a wide variety of cases in less than 2 months.
- Extracorporeal shock wave therapy is used at high intensity to disintegrate kidney stones, and at lower intensity for a variety of other therapeutic purposes.
- Reviews of ESWT are given by Po-Yen Chen et al, “New Frontiers of Extracorporeal Shock Wave Medicine in Urology from Bench to Clinical Studies,” Biomedicines 2022, 10, 675, www(dot)(colon)(slash)(slash)doi(dot)org(slash) 10.3390(slash)biomedicines 1003675, and by M. C. d’Agostino et al, “Shock wave as biological therapeutic tool: from mechanical stimulation to recovery and healing, through mechanotransduction,” International Journal of Surgery 24 (2015), 147-153.
- MT Al microwave-induced thermoacoustic imaging
- An aspect of some embodiments of the invention concerns a device and method for performing ultrasound therapy using ultra- wideband ultrasound bursts with a spectrum that is fairly uniform and fairly filled-in over a fairly wide range of frequencies, for example covering at least a ratio of 3 in frequency, with ultrasound intensity integrated over frequencies between 1 and 20 MHz is not too high, and/or with ultrasound intensity integrated over frequencies between 40 and 200 MHz is not too high.
- a device for generating ultra-wideband bursts of ultrasound in a body tissue comprising: a) one or more ultrasound generating elements that together generate the bursts in the body tissue using an ultrasound generation method; and b) a signal generating module that generates signals used by each of the ultrasound generating elements to together generate bursts having a specified intensity and spectrum at a specified target location; wherein the device is configured for generating a train of bursts at the specified target location having the specified intensity and spectrum as a function of frequency, and wherein at least over a range of frequency covering a factor of 3 in frequency, at or above 1 MHz, an effective spectrum which is the specified spectrum adjusted for a response of resonators at each frequency in the range having a Q of 5, has 50% of its power in that range spread out over a highest power portion of the range covering at least 32% of the range; and wherein, the specified spectrum at the specified intensity has an ultrasound energy per area per bur
- the specified spectrum includes at least 2 consecutive such ranges of frequency where the effective spectrum has 50% of its power in that range spread out over a highest power portion of the range covering at least 32% of the range, and the specified spectrum averaged over the range of frequencies and over a duration of the train differs by less than a factor of 3 for the 2 consecutive ranges of frequency.
- the range of frequencies includes a factor of 7.
- the effective spectrum has 50% of its power in a range from 1 to 3 MHz spread out over a highest power portion of the range from 1 to 3 MHz, covering at least 32% of the range from 1 to 3 MHz.
- the specified spectrum has integrated energy per area per burst below 1 MHz that is at least a factor 2 lower than average energy per area per burst per MHz over the range of frequency covering a factor of 3.
- the power per area per MHz is at least 5 times a thermal noise level for the specified spectrum.
- the device is capable of generating the train of bursts at least a distance 10 cm inside the tank of distilled water.
- the one or more ultrasound generating elements comprise a first and a second ultrasound generating element, and a signal used by the first ultrasound generating element has a lower average frequency than a signal used by the second ultrasound generating element.
- the signal generating module is configured to generate at least one of the signals by: a) generating a first train of pulses; b) modifying a shape of the pulses in the first train by filtering them with a specified filter, to produce at least a first component of the signal; and c) using at least the first component of the signal to produce the signal.
- the pulses in the first train are at least approximately square pulses.
- the first train of pulses, after filtering is at least approximately a sine wave.
- the signal generating module is also configured to: a) generate one or more additional trains of pulses; and b) modify a shape of the pulses in each of the additional trains of pulses by filtering it with a specified filter, to produce respectively one or more additional components of the signal that are different in shape from the first component of the signal; wherein using at least the first signal component to produce the signal comprises combining the first and additional signal components to produce the signal.
- the pulse rate has a different frequency.
- the shapes of pulses in at least two of the trains of pulses are modified by filtering them with differently acting filters.
- the signal generating module is configured to generate at least one of the signals by synthesizing it digitally.
- the one or more ultrasound generating elements comprise one or more mechanical transducers that generate ultrasound.
- the mechanical transducers comprise one or more piezoelectric transducers.
- the device also comprises a controller that controls the signal module that generates signals used by each of the ultrasound generating elements, wherein the controller comprises a memory that stores data of a treatment protocol specifying the signals used by each of the ultrasound generating elements and their timing, for at least one patient receiving treatment according to the treatment protocol.
- the treatment protocol specifies generating a train of bursts having a specified intensity and a specified spectrum as a function of frequency, at least over a range of frequency at or above 1 MHz covering a factor of 3 in frequency, wherein an effective spectrum which is the specified spectrum adjusted for a response of resonators at each frequency in the range having a Q of 5, has 50% of its power in that range spread out over a highest power portion of the range covering at least 32% of the range.
- the device is a non-imaging device.
- the device is wearable, and comprises a positioning element for holding the device in a position on a body for generating the bursts in the body tissue.
- a device for generating ultra-wideband bursts of ultrasound in a body tissue comprising: a) one or more ultrasound generating elements that together generate the bursts in the body tissue using an ultrasound generation method; and b) a signal generating module that generates signals used by each of the ultrasound generating elements to together generate bursts having a specified intensity and spectrum at a specified target location; wherein the device is configured for generating a train of bursts at the target location, having the specified intensity and spectrum as a function of frequency, and wherein, at least over a range of frequency covering a factor of 3 in frequency, at or above 17 MHz, an effective spectrum which is the specified spectrum adjusted for a response of resonators at each frequency in the range having a Q of 5, has 50% of its power in that range spread out over a highest power portion of the range covering at least 32% of the range; and wherein, at the specified target location, the acoustic pressure,
- the specified spectrum of the bursts that the device is capable of generating has more of its power above 50 MHz than below 50 MHz.
- the one or more ultrasound generating elements comprise one or more nearinfrared lasers that generate ultrasound in body tissue using optoacoustics.
- the ultrasound generating elements comprise a black-coated thin film configured to generate ultrasound in the body tissue when it is heated by the one or more nearinfrared lasers.
- the one or more near-infrared lasers are configured to generate ultrasound in the body tissue by heating skin with one or more pulses of infrared light causing it to expand.
- a method of ultrasound medical treatment comprising: a) selecting a subject and target region to be treated; and b) generating bursts of ultra- wideband ultrasound in the target region of the subject, having a specified intensity and a specified spectrum as a function of frequency, wherein at least over a range of frequency at or above 1 MHz covering a factor of 3 in frequency, an effective spectrum which is the specified spectrum adjusted for a response of resonators at each frequency in the range having a Q of 5, has 50% of its power in that range spread out over a highest power portion of the range covering at least 32% of the range, and wherein the specified intensity integrated between 1 MHz and 20 MHz, is less than 5 x 10" 6 J/mm 2 per burst, and the specified intensity integrated between 1 MHz and 50 MHz is at least 10’ 11 J/mm 2 per burst.
- the method comprises: a) selecting a subject and target region to be treated; and b) generating bursts of ultra- wideband ultrasound in the target region of the subject, having a specified intensity and a specified spectrum as a function of frequency, wherein, at least over a range of frequency at or above 1 MHz covering a factor of 3 in frequency, an effective spectrum which is the specified spectrum adjusted for a response of resonators at each frequency in the range having a Q of 5, has 50% of its power in that range spread out over a highest power portion of the range covering at least 32% of the range, and wherein the acoustic pressure, due to frequency components between 50 MHz and 250 MHz, will be at least 2 kpa, and no more than 200 kpa.
- generating the train of ultrasound bursts at the target region comprises using a first transducer to launch first ultrasound waves to the target region, from a first location on an outer surface of the body, and using a second transducer to launch second ultrasound waves to the target region from a second location, different from the first location, on the surface of the body, the first ultrasound waves and the second ultrasound waves combining in the target region to produce the ultrasound bursts having the specified intensity and the specified spectrum as a function of frequency.
- the method comprises specifying a treatment protocol for the subject, before generating the bursts of ultrasound, wherein the treatment protocol includes the specified intensity and specified spectrum, as well as a burst rate and a duration of a treatment session, and wherein generating the bursts is done according to the treatment protocol.
- aspects of the present disclosure may be embodied as a system, method or computer program product. Accordingly, aspects of the present disclosure may take the form of an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, microcode, etc.) or an embodiment combining software and hardware aspects that may all generally be referred to herein as a “circuit,” “module” or “system” (e.g., a method may be implemented using “computer circuitry”). Furthermore, some embodiments of the present disclosure may take the form of a computer program product embodied in one or more computer readable medium(s) having computer readable program code embodied thereon.
- Implementation of the method and/or system of some embodiments of the present disclosure can involve performing and/or completing selected tasks manually, automatically, or a combination thereof.
- several selected tasks could be implemented by hardware, by software or by firmware and/or by a combination thereof, e.g., using an operating system.
- hardware for performing selected tasks according to some embodiments of the present disclosure could be implemented as a chip or a circuit.
- selected tasks according to some embodiments of the present disclosure could be implemented as a plurality of software instructions being executed by a computer using any suitable operating system.
- one or more tasks performed in method and/or by system are performed by a data processor (also referred to herein as a “digital processor”, in reference to data processors which operate using groups of digital bits), such as a computing platform for executing a plurality of instructions.
- the data processor includes a volatile memory for storing instructions and/or data and/or a non-volatile storage, for example, a magnetic hard-disk and/or removable media, for storing instructions and/or data.
- a network connection is provided as well.
- a display and/or a user input device such as a keyboard or mouse are optionally provided as well. Any of these implementations are referred to herein more generally as instances of computer circuitry.
- the computer readable medium may be a computer readable signal medium or a computer readable storage medium.
- a computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing.
- a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device.
- a computer readable storage medium may also contain or store information for use by such a program, for example, data structured in the way it is recorded by the computer readable storage medium so that a computer program can access it as, for example, one or more tables, lists, arrays, data trees, and/or another data structure.
- a computer readable storage medium which records data in a form retrievable as groups of digital bits is also referred to as a digital memory.
- a computer readable storage medium in some embodiments, is optionally also used as a computer writable storage medium, in the case of a computer readable storage medium which is not read-only in nature, and/or in a read-only state.
- a data processor is said to be “configured” to perform data processing actions insofar as it is coupled to a computer readable medium to receive instructions and/or data therefrom, process them, and/or store processing results in the same or another computer readable medium.
- the processing performed (optionally on the data) is specified by the instructions, with the effect that the processor operates according to the instructions.
- the act of processing may be referred to additionally or alternatively by one or more other terms; for example: comparing, estimating, determining, calculating, identifying, associating, storing, analyzing, selecting, and/or transforming.
- a digital processor receives instructions and data from a digital memory, processes the data according to the instructions, and/or stores processing results in the digital memory.
- “providing” processing results comprises one or more of transmitting, storing and/or presenting processing results. Presenting optionally comprises showing on a display, indicating by sound, printing on a printout, or otherwise giving results in a form accessible to human sensory capabilities.
- a computer readable signal medium may include a propagated data signal with computer readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated signal may take any of a variety of forms, including, but not limited to, electromagnetic, optical, or any suitable combination thereof.
- a computer readable signal medium may be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device.
- Program code embodied on a computer readable medium and/or data used thereby may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing.
- Computer program code for carrying out operations for some embodiments of the present disclosure may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, Smalltalk, C++ or the like and conventional procedural programming languages, such as the “C” programming language or similar programming languages.
- the program code may execute entirely on the user's computer, partly on the user's computer, as a stand-alone software package, partly on the user's computer and partly on a remote computer or entirely on the remote computer or server.
- the remote computer may be connected to the user's computer through any type of network, including a local area network (LAN) or a wide area network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet Service Provider).
- LAN local area network
- WAN wide area network
- Internet Service Provider for example, AT&T, MCI, Sprint, EarthLink, MSN, GTE, etc.
- These computer program instructions may also be stored in a computer readable medium that can direct a computer, other programmable data processing apparatus, or other devices to function in a particular manner, such that the instructions stored in the computer readable medium produce an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram block or blocks.
- the computer program instructions may also be loaded onto a computer, other programmable data processing apparatus, or other devices to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide processes for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.
- FIG. 1A schematically shows body tissue.
- FIG. IB schematically shows the interior of a cell, with resonant structures at a wide range of different distance scales and resonant frequencies, which potentially may be excited by ultra- wideband ultrasound bursts in some embodiments of the invention
- FIG. 2 schematically shows a system for generating ultra-wideband ultrasound bursts in body tissue, for therapy, according to an exemplary embodiment of the invention
- FIG. 3 is a flowchart showing a method of medical treatment using ultra-wideband ultrasound bursts, for example as generated by the system of FIG. 2, according to an exemplary embodiment of the invention
- FIG. 4A schematically shows a waveform of an ultra- wideband ultrasound burst, based on sine functions that would correspond to a flat spectrum of constant phase between 1 and 7 MHz, but with the waveform cut off at ⁇ 1 microsecond, so that the burst only lasts 2 microseconds, and
- FIG. 4B schematically shows the spectrum of the waveform shown in FIG. 4A;
- FIG. 5 schematically shows the spectrum of a long coherent train of bursts with the waveform shown in FIG. 4A;
- FIG. 6 schematically shows a spectrum of an ultra-wideband ultrasound burst to illustrate some of the claim limitations, according to an exemplary embodiment of the invention
- FIG. 7 schematically illustrates a prior art low intensity pulsed ultrasound (LIPUS) spectrum
- FIG. 8A schematically illustrates waveforms for 7 components, each consisting of a sine wave respectively at 1, 2, 3, 4, 5, 6 and 7 MHz and lasting for an interval of 1 microsecond, that can be generated by hardware, according to an exemplary embodiment of the invention
- FIG. 8B schematically illustrates a waveform that is the sum of the 7 components shown in FIG. 8A;
- FIG. 8C schematically illustrates the Fourier transforms of each of the components shown in FIG. 8A;
- FIG. 8D schematically shows the spectrum of the combined waveform shown in FIG. 8B.
- FIG. 9 is a graph schematically showing the results of a study of mouse wound-healing with and without exposure to ultra-wideband ultrasound bursts.
- FIG. 10 shows the block diagram that illustrates method of ultra-wideband micromechanical regenerative impact (UMI Burst Impact), according to an exemplary embodiment of the invention
- FIG. 11 shows the example of formation of a treating UMI Burst, with increasing shape of frequency spectrum by correcting the shape of spectrum of the main signal burst, according to an exemplary embodiment of the invention
- FIG. 12 shows the block diagram of a 3D system for measuring the spatial and spectral characteristics of UWB ultrasonic/micromechanical fields
- FIG. 13 Illustrates the dependence of the intensity averaged over space, time and frequency of ultra- wideband micromechanical impulses with a frequency range of 1.0 - 7.0 MHz on the distance to the transducer, in comparison with narrow-band ultrasonic signals of 1.0, 3.0 and 5.0 MHz frequencies, and also with ultra- wideband stochastic ultrasonic noise signal with a frequency band of 1.0 - 3.0 MHz.
- FIG. 14 Illustrates the differences in the impact of ultra-wideband micromechanical bursts (UMI Bursts) with a frequency spectrum range of 1.0 - 7.0 MHz on the proliferation rate of normal mouse fibroblast cells, in comparison with exposure to narrow-band ultrasound with frequencies of 1.0 MHz, 3.0 MHz and 7.0 MHz.
- UMI Bursts ultra-wideband micromechanical bursts
- FIG. 15 shows the differences in blast transformation (immune activity) of human T- lymphocytes in normal conditions, compared to LIPUS and UMI Burst exposures.
- FIG. 16 shows the differences in dynamics of healing of extensive linear wounds of mice in normal and under LIPUS and UMI Burst influences.
- FIG. 17 shows a variant of the implementation of a UMI Burst method for reducing an old, rough, extensive scar on the man’s face.
- FIG. 18 shows a variant of the implementation of a UMI Burst method for drastic reduction of long-term dermal hyperpigmentation (dermal melasma) on the on a woman's face and for reduction of deep forehead wrinkles.
- FIG. 19 A variant of the implementation of the UMI Burst method in cosmetology is shown. Reduction of deep creases of the skin on the face with quantitative control of the size of creases using the Altera 3D apparatus.
- FIG. 20 Illustrates the implementation of the proposed UMI Burst method for restoring blood microcirculation in the area of the lower limb with varicose veins.
- FIG. 21 is a general block diagram of the stationary device for ultra-wideband ultrasonic micromechanical regenerative spectral burst-therapy, according to an exemplary embodiment of the invention.
- FIG. 22 is a structural scheme of the personal mobile device for ultra- wideband ultrasonic micromechanical regenerative spectral burst-therapy, according to an exemplary embodiment of the invention.
- FIG. 23 are blocks and connections of the UWB volumetric piezoelectric transducer with generators, control and monitoring units;
- FIG. 24 is a sensor part of the volumetric UWB transducer for ultra-wideband ultrasonic micromechanical regenerative spectral burst-therapy with the units for monitoring the presence of acoustic contact;
- FIG. 25 are the variants of complementary spectra and time waveforms of the main and corrective signals and the variant of resulting signals for ultra-wideband micromechanical spectral burst regenerative therapy;
- FIG. 26 comparison of the spectra of own vibrations of biostructures with the spectra of known ultrasonic medical devices and the spectra of the proposed ultra- wideband micromechanical spectral devices.
- FIG. 27 schematically shows a block diagram of a system for generating ultra-wideband ultrasound bursts using a signal generator that synthesizes sine functions, according to an exemplary embodiment of the invention
- FIG. 28 schematically shows a plot of an exemplary ultra-wideband ultrasound burst spectrum generated by the system of FIG. 27;
- FIG. 29 shows a plot of the proliferation index of mouse fibroblast cells exposed to different power levels of the different ultra- wideband ultrasound burst generated by the system of FIG. 27, comparing how the different power levels and burst spectra affect the proliferation of fibroblasts;
- FIG. 30 schematically shows an optoacoustics system that uses a PDMS film and a laser to generate ultrasound in patient’ s body.
- the present invention in some embodiments thereof, relates to a device and method for medical treatment using ultrasound waves and, more particularly, but not exclusively, to promoting tissue regeneration using pulsed ultrasound at relatively low intensities.
- An aspect of some embodiments of the invention concerns a system and method for producing therapeutic ultrasound bursts in the body, with a spectrum that is relatively uniform over at least one relatively broad range of frequencies.
- These bursts are sometimes referred to herein as ultra-wideband bursts (UWB), or as Ultra-wideband Micromechanical Impact bursts (UMI). These terms are sometimes used interchangeably.
- UWB is a known term of the art that is often used when referring to ultrasound bursts used for ultrasound imaging.
- UMI is not a standard term, and is used here to emphasize the therapeutic impact that the bursts may have.
- the spectrum of the bursts covers a frequency range of at least a factor of 3, or at least a factor of 2, or at least a factor of 2.5, or at least a factor of 4, or at least a factor of 5, and its relative uniformity within this frequency range is defined as follows.
- the analysis is optionally done on an effective spectrum S e ff(co), which represents the response to the actual spectrum by resonant structures in body tissue that have a quality factor Q, as will be described below.
- the effective spectrum is given by
- Q may be taken as 4 or 3 or 2.5, for example, or any reasonably low value.
- different values of Q may be assumed for different frequencies or different frequency ranges.
- a potential advantage of analyzing the effective spectrum is that there may be many rather different-looking actual spectra that have the same or nearly the same effective spectrum, and all of them are expected to have nearly the same biological effect on body tissue. So in some embodiments of the invention, “relatively uniform over a relatively broad range of frequencies” is taken to depend only on characteristics of the effective spectrum.
- Another potential advantage of analyzing the effective spectrum is that the effective spectra tend to have a similar typical appearance even for actual spectra that look rather different, because the effective spectra are all fairly smooth. This may mean that if a certain criterion is developed for defining when an effective spectrum is “relatively uniform over a relatively broad range of frequencies,” and the criterion is found to work well for a few different spectra that might be used, then it is likely to work well for other spectra that might be used, because their effective spectra will not very different.
- “Relatively uniform over a relatively broad range of frequencies” may be defined in terms what fraction of the total power over the whole range of frequencies is found in the highest power portion of what range of frequencies. For example, if 50% of the power is found in a highest power portion of the range that only covers a small fraction of the whole range, much less than 50%, that means that the effective spectrum is not very uniform over the whole range. But if 50% of the power is spread out over a highest power portion of the range that covers a larger fraction of the range, that means that the effective spectrum is relatively uniform over the range.
- the criterion for “relatively uniform over a relatively broad range of frequencies” is that, for some range of frequencies coverting a factor of 3, 50% of the total power in the range is found in a highest power portion of the range that is at least 32% of the range.
- the criterion is that 50% of the total power is found in a highest power portion of the range that is at least 25% of the range, or at least 27%, or at least 30%, or at least 35%.
- the criterion is based on what fraction of the total power is found in the highest power portion of the range that covers 50% of the range. The higher the fraction of total power that is found in the highest power 50% of the range, the less uniformly distributed the effective spectrum is considered to be.
- the criterion for “relatively uniform over a relatively broad range of frequencies” is that, for at least one range of frequencies that covers a ratio of 3 in frequency, no more than 70% of the total power is found in the highest power portion of the range that covers 50% of the range.
- the criterion is that no more than 60% of the power is found in the highest power 50% of the range, or no more than 63%, or not more than 65%, or no more than 67%, or no more than 72%, or no more than 75%, or no more than 80%.
- the criterion for “relatively uniform over a relatively broad range of frequencies is based on the fraction of total power that is found in a different highest power fraction of the range, for example in 20% or 30% or 40% or 60% or 70% or 80% of the range, or it is based on the highest power portion of the range that has a different fraction of the total power, for example 20% or 30% or 40% or 60% or 70% or 80% of the total power.
- a convenient way to calculate these numbers is to calculate the effective spectrum in a spreadsheet such as Excel, at a set of equally spaced points over the range of frequencies, as a column of values.
- the column of values is then sorted from the highest to the lowest value, and another column is created showing the sum of the values from the top of the sorted column to each point in the middle of the sorted column.
- the sums of values are then normalized by the value at the bottom of the sorted column, which represents the total power integrated over the range of frequencies.
- the normalized value halfway down the column then represents the fraction of power found in the highest power 50% of the range of frequencies, and similarly for other fractions of the range of frequencies.
- the fraction of the range in which 50% of the value is found will be the fraction of the distance down the column at which 0.500 appears in the normalized sum of values, and similarly for other fractions of the total power.
- Another way to characterize the degree to which a spectrum is relatively uniform over a relatively broad range of frequencies is to compare the standard deviation of values of the effective spectrum over the range of frequencies, to the mean value of the effective spectrum over the range of frequencies.
- the mean value of the effective spectrum is given by where co min and ⁇ max are the minimum and maximum frequencies of the range, and the standard deviation of values of the effective spectrum is given by
- the ratio of standard deviation to mean value the more uniform the effective spectrum is over its range, according to this definition.
- the spectrum may be considered relatively uniform over a relatively broad range of frequencies if, for at least one range of frequencies covering a factor of 3, the ratio of the standard deviation to the mean is less than 0.50.
- the ratio is required to be less than 0.35, or less than 0.40, or less than 0.45, or less than 0.55, or less than 0.60, or less than 0.65.
- the bottom of the range of frequencies covering a factor of 3 is optionally required to be greater than some value, for example greater than 0.5 MHz, or greater than 1 MHz, or greater than 3 MHz, or greater than 10 MHz, or greater than 10% of the mean frequency or the burst, or 20% or 50% of the mean frequency of the burst.
- the spectrum is likely to be much lower at sufficiently low frequencies than at the frequencies that dominate the power, in the case of ultrasound bursts generated by types of transducers, such as PDVF transducers, that have a poor response at low frequencies, for example below 1 MHz.
- the spectrum shown in FIG. 28 for a PDVF transducer, the spectrum falls by about 10 dB, a factor of 10 in intensity, from 1 MHz to 0.5 MHz.
- ultra- wideband bursts of ultrasound are used together with narrowband ultrasound of much higher power at a very different frequency, then the total ultrasound spectrum is still considered to be “relatively uniform over a relatively broad range of frequencies.” It is possible that lower power ultra-wideband bursts, used together with higher power narrowband ultrasound at a very different frequency, will still provide the therapeutic benefits of ultra- wideband bursts, in spite of the presence of the narrowband ultrasound, so this case is not excluded from the definition of “relatively uniform over a relatively broad range of frequencies.” Alternatively, the range of frequencies has to include the highest power ultrasound frequencies present, and that case is excluded from the definition.
- Such an ultra-wideband ultrasound burst spectrum differs from the spectrum of prior art ultrasound bursts used for therapy, which are narrowband, for example having a characteristic bandwidth that is at least 3 times or 5 times of 10 times narrower than the peak frequency.
- the spectrum consists of a few narrowband frequencies that are well separated, for example at a fundamental frequency ®o and at harmonic frequencies such as 3®o and 5®o, each with a characteristic bandwidth that is well below coo, for example less than O.5coo or less than O.2coo. It should be noted that whether or not a given burst spectrum satisfies these conditions does not depend on fine details of the structure of the spectrum, but only on characteristics of the effective spectrum, which has these fine details smoothed out.
- these conditions on uniformity of the intensity over the range of frequencies apply not to the intensity of the ultrasound at the transducers producing the ultrasound at the outer surface of the body, but at a target region inside the body, where the therapy is being applied.
- the spectrum may differ at these locations, because higher frequency components of ultrasound tend to be more attenuated than lower frequency components when propagating through body tissue.
- the bursts are about as short as they can be, given the shape of their spectrum. For example, if most of the integrated intensity of the spectrum, or more than 75% of the integrated intensity of the spectrum, occurs at a frequency greater than co m in, then most of the power of the burst occurs within a duration of no more than no more than 5/®miii, or no more than 10/cOmin, or no more than 20/cDmin.
- the burst spectrum being ultra- wideband, includes significant contributions from frequencies well above the components at those widely different frequencies overlap substantially in time, so that the effective duration of the burst is not much more than, and may even be less than, a wave period at the lowest frequency that contributes significantly to the burst spectrum.
- bursts be about as short as they can be, given the shape of the spectrum, has the potential advantage that the ultrasound may have a greater biological effect on the tissue, and/or may produce less heating of the tissue, than if the bursts were longer. This may be true, for example, because shorter bursts may have a higher repetition rate, and/or may have a greater instantaneous power per area relative to the time-averaged power per area which determines the heating rate. Alternatively, the duration of the burst is much greater than the minimum it can be, given the shape of the spectrum.
- Exemplary characteristics of ultrasound burst amplitude Another way in which the ultrasound bursts used by the inventors may differ from some prior art ultrasound bursts concerns the total energy per area for each burst, or the total energy per area within a given range of frequencies, for example at the target region.
- Extracorporeal shock wave therapy (ESWT) bursts either low intensity or high intensity ESWT bursts, may also have broadband spectra, and may also be used for therapy, as described by Chen et al, by d’ Agostino et al, and by Lee et al, cited above.
- prior art ESWT bursts have relatively high energy per area per burst, in the frequency range between 1 and 20 MHz, much higher than the bursts used by the inventors.
- Chen et al in their Figure 2, show the ranges of ESWT energy per area per burst, in joules per square millimeter, at which the ESWT bursts can be used therapeutically to achieve various effects. Collectively, these ranges extend from 0.01 mJ/mm 2 to 0.25 mJ/mm 2 , and Chen et al say that higher energies, above 0.6 mJ/mm 2 , can be used for lithotripsy, breaking up kidney stones. Neither Chen et al, nor d’ Agostino et al, nor Lee et al, appear to describe any medical use for ESWT bursts at energies per area below 0.01 mJ/mm 2 .
- the instantaneous power per area would apparently be about 6 x 10 8 W/m 2 , and integrating this over the 2 x 10’ 7 second duration of the burst gives an energy per area per burst of 120 J/m 2 , or 0.12 mJ/mm 2 , similar in intensity to the bursts described by Chen et al.
- the spectra shown in Figures 2d, 2e and 2f of Chen et al are apparently greatest respectively in a frequency range of 0 to 7 MHz, 5 to 9 MHz, and 3 to 7 MHz, falling off at higher frequencies and (for Figures 2e and 2f) at lower frequencies.
- the spectra shown extend up to 20 MHz, where the energy per area has fallen to 20 dB, 6 dB and 8 dB, respectively for Figures 2d, 2e and 2f, below its peak value, and in all three cases it appears that most of the energy of the burst is found in the range from 1 to 20 MHz.
- Lee et al and d’ Agostino et al do not show spectra for their bursts
- the waveforms shown by Lee et al and by d’ Agostino et al look similar to the waveform shown in Fig. 2a of Chen et al, and the spectrum is probably similar to the spectrum shown in Fig. 2d of Chen et al, corresponding to the waveform in Fig.
- That energy per area may correspond approximately to the power per area per Hz at which acoustic receptor cells can detect sound at the threshold of hearing at a few tens of Hz, and it may be about 10 4 times greater than the thermal noise level of ultrasound integrated over 1 to 15 MHz, so it is plausible that cells may be affected by ultrasound bursts of that energy per area at approximately that frequency range.
- a useful ultra- wideband burst may be defined as one with an energy per area between 10’ 11 J/mm 2 and 5 x 10“ 6 J/mm 2 , between 1 and 20 MHz, at the target area.
- the minimum energy per area is 10“ 12 J/mm 2 or 3 x 10“ 12 J/mm 2 or 3 x 10 11 J/mm 2 or 10“ 10 J/mm 2 or 3 x 10“ 10 J/mm 2 , or a smaller, greater, or intermediate value.
- the maximum energy per area is 3 x 10“ 5 J/mm 2 or 10“ 5 J/mm 2 or 3 x 10 6 J/mm 2 or 10“ 6 J/mm 2 or 3 x 10 7 J/mm 2 or 10 7 J/mm 2 or 3 x 10“ 8 J/mm 2 , or a smaller, greater, or intermediate value.
- the bottom of the range of frequencies for this energy is 0.5 MHz or 2 MHz or 5 MHz or 10 MHz or 20 MHz, or a smaller, greater, or intermediate value.
- the top of the range of frequencies for this energy is 2 MHz or 5 MHz or 10 MHz or 50 MHz, or a smaller, greater, or intermediate value.
- a useful device for generating such ultra-wideband ultrasound bursts for therapy may be defined as one that, if it launches such ultrasound bursts into a tank of water that extends for at least 30 cm, there will be no location or almost no location in the water, less than 30 cm from the ultrasound generating element, where the energy per area per burst exceeds 5 x 10“ 6 J/mm 2 between 1 and 20 MHz, and there will be at least one location, within 30 cm of the ultrasound generating element, where the energy per area per burst is at least 10" 11 J/mm 2 .
- the energy per area per burst is at least 10“ 13 J/mm 2 or 3 x 10“ 13 J/mm 2 or 10“ 12 J/mm 2 or 3 x IO 2 J/mm 2 or 10’ 11 J/mm 2 or 3 x 10’ 11 J/mm 2 , or a smaller, greater, or intermediate value.
- the bottom of the range of frequencies for either of these energies is 0.5 MHz or 2 MHz, or 5 MHz or 10 MHz or 20 MHz, or a smaller, greater, or intermediate value.
- the top of the range of frequencies for either of these energies is 2 MHz or 5 MHz or 10 MHz or 50 MHz or 100 MHz, or a smaller, greater, or intermediate value.
- Pages 14-29 describe how to calculate the ultrasound burst waveform and acoustic pressure generated by a laser pulse of a given intensity and duration on the film, depending on characteristics of the film.
- Hou wishes to use such ultrasound bursts for ultrasound microscopy imaging, and for that purpose he apparently needs ultrasound with very short wavelengths, hence high frequencies, in order to obtain high resolution, and high acoustic pressure in order to obtain a high signal-to-noise ratio (SNR).
- Some of the ultrasound bursts that Hou produces may have spectra with shapes that are relatively uniform over a relative wide range of frequencies, by the definitions used above, although at frequencies between about 40 and 200 MHz, rather than between 1 and 20 MHz.
- the acoustic pressures of the ultrasound bursts that Hou describes generating in order to obtain a high SNR for ultrasound microscopy imaging may be higher than the range of acoustic pressures that are useful for therapeutic ultra-wideband ultrasound bursts.
- Hou describes using a near infrared laser pulse, 5 ns in duration and with an energy of 50 pJ, to illuminate a spot 25 pm in diameter on the surface of an 11 pm thick PDMS film coated with carbon black, with a tank of water on the other side of the film.
- such a laser pulse generates an ultrasound burst in the water with a wideband spectrum peaking at about 100 MHz, having an acoustic pressure of 500 Mpa at the film, and falling to about 800 kpa at 10 mm into the water, and Hou describes a measurement of acoustic pressure and ultrasound spectrum at that location that is apparently in good agreement with the model.
- Hou states, on page 29, that such ultrasound bursts should be high enough in acoustic amplitude to produce a good SNR for microscopy.
- ultra- wideband ultrasound bursts used for ultrasound therapy at a target region in body tissue have power components between 40 and 200 MHz with an acoustic pressure less than 800 kpa or less than 400 kpa, or less than 200 kpa, or less than 100 kpa, or less than 50 kpa, at the target region.
- the power components between 40 and 200 MHz have acoustic pressure greater than 0.2 kpa, or greater than 0.5 kpa, or greater than 1 kpa, or greater than 2 kpa, or greater than 5 kpa, or greater than 10 kpa, at the target region.
- ultrasound bursts at 40 to 200 MHz are expected to affect different cellular structures than ultrasound bursts at 1 to 7 MHz or 1 to 15 MHz, it would not be surprising if the acoustic pressure needed to produce therapeutic effects is comparable in the two frequency ranges.
- an optoacoustic device for producing ultra- wideband ultrasound bursts for therapy produces bursts in a tank of water at a distance of 10 mm from the transducer with power components between 40 and 200 MHz with an acoustic pressure less than 800 kpa or less than 400 kpa, or less than 200 kpa, or less than 100 kpa, or less than 50 kpa
- the ultrasound bursts produced by the device in water at a distance of 10 mm from the transducer have power components between 40 and 200 MHz with acoustic pressure greater than 0.2 kpa, or greater than 0.5 kpa, or greater than 1 kpa, or greater than 2 kpa, or greater than 5 kpa, or greater than 10 kpa, at the target region.
- Conventional ultrasound imaging devices such as B-mode imaging devices, operating at lower frequencies than Hou’s devices and not designed for microscopy, aside
- the energy per area per burst used for ultrasound imaginng is generally made as high as possible in the field of view being imaged, as long as it does not cause unwanted heating of tissue, in order to make the signal to noise ratio of the image as high as possible, and would generally be more than 5 x 10’ 6 J/mm 2 per burst between 1 and 20 MHz.
- Conventional imaging ultrasound bursts also do not generally extend to 50 MHz or above, since ultrasound of those frequencies would have a much shorter wavelength than the resolution needed for conventional ultrasound imaging, and would not penetrate far enough into body tissue to be useful for many ultrasound imaging purposes.
- imaging ultrasound bursts often have a spectrum that is approximately gaussian in shape, with a higher average energy per area per MHz below 1 MHz than at any higher frequency range, while the ultra- wideband ultrasound bursts used by the inventors often have lower average energy per area per MHz below 1 MHz than they do for some broad range of frequencies above 1 MHz, for example up to 3 MHz, or up to 5 MHz, or up to 7 MHz, or up to 10 MHz, or up to 20 MHz.
- ultra-wideband ultrasound bursts that satisfy these conditions can be therapeutically effective in certain situations, for example in promoting wound healing, or in promoting the proliferation of certain types of cells, such as fibroblasts or hematopoetic stem cells, that are associated with wound healing and other regenerative processes in the body. Without limiting our to any one theory of the reasons for these effects, the following model may have some validity. It is known that body tissue contains a large number of resonant micromechanical structures, that have a large range of different characteristic sizes, and a large range of resonant frequencies, for example ranging from about 1 MHz to about 100 MHz or even 250 MHz.
- resonant frequencies For example, at the largest distance scale and lowest resonant frequencies, roughly 1 to 10 MHz, there are macroscopic regions of tissue including cellular ensembles and the extracellular matrix. At smaller size scales and higher resonant frequencies, for example between 5 and 20 MHz, there are individual cells and cell membranes. At still smaller size scales and higher resonant frequencies, there are organelles, cytoskeletons, and other structures within the cell, and there is the cell nucleus, including the nuclear membrane, the structure of nuclear proteins and the chromatin. At still smaller sizes and higher resonant frequencies, up to 100 MHz or even 250 MHz, there are macromolecular condensates within the cell and within the nucleus, and DNA molecules.
- these mechanical structures may act as sensors, that respond to external stimuli, such as a force pushing the outside of a cell, and initiate a pathway of biochemical transformations, like an avalanche, for example ultimately activating certain genes, that allow the cell to respond to the stimuli in a way that promotes the survival of the organism.
- Ultrasound bursts with a given frequency component may excite structures that are resonant at that frequency, and initiate such a pathway of activity. Ultrasound bursts can also energize structures that are primarily chemical sensors.
- ultra-wideband ultrasound bursts applied to the right tissue, could be useful for producing any therapeutic regenerative effect that could be associated with stem cells, including wound-healing, healing of broken bones, treating stroke, myocardial infarction, atherosclerosis or ischemia, repairing spinal cord injury, repairing the optic nerve and the retina, treating glaucoma, treating diseases of the skeletomuscular system, treating diabetes, some types of cancer, skin conditions, and degenerative diseases of the brain.
- the ultrasound bursts might have such an effect even if the healing pathways normally activated by the body are not sufficiently activated by the trauma or other condition that is being treated.
- the ultrasound bursts might be able to initiate activation of such a pathway, which might continue to function properly on its own once it has been jump-started by the ultrasound bursts.
- these resonant mechanical structures are expected to have fairly low Q, for example less than 5, or less than 4, or less than 3, or less than 2.5, because body tissue, and the interior of cells, is generally soft and viscous. For that reason, the response of these resonant mechanical structures, and any consequent therapeutic effect, is expected not to depend on fine details of the spectrum of the ultrasound, but only on the effective spectrum, for which intensity values are averaged over ranges of frequency that differ by at least 20%.
- the ultra-wideband ultrasound bursts have spectra with significant contributions extending over much more than a factor of 3 in frequency.
- the spectrum has fairly uniform intensity, when averaged over frequency bands of factors of at least 1.2, over a range of frequencies covering a ratio of between 3 and 5, or between 5 and 10, or between 10 and 20, or between 20 and 50, or between 50 and 100, or more than 100.
- the range of frequency is about 1 MHz to 7 MHz, or about 3 MHz to 10 MHz, or about 7 MHz to 20 MHz, or about 1 MHz to 20 MHz, or about 1 MHz to 50 MHz, or about 1 MHz to 100 MHz, or about 1 MHz to 250 MHz.
- the intensity is optionally uniform (averaging within each of consecutive bands of factors of 1.2 in frequency) within 3 dB, or within 5 dB, or within 10 dB, or within 15 dB, or within 20 dB, optionally with the exception of a small number of bands of a frequency of a factor of 1.2 where the intensity is lower.
- the power per area per MHz during an ultrasound burst, at a given frequency or averaged over a given range of frequencies is at least 3 times the thermal noise level, or at least 5 times the thermal noise level, or at least 10 times the thermal noise level, or at least 20 times the thermal noise level, or at least 50 times the thermal noise level.
- the numerical factor of n 2 in the above expression may be different.
- the thermal noise level at 1 MHz, co 2z x 10 6 s’ 1 , is 6 x 10’ 8 W/cm 2 MHz, according to this expression, and increases in proportion to the square of the frequency at higher frequencies.
- a time-averaged intensity of 1 pW/cm 2 integrated over the spectrum of the burst, which might be uniformly distributed between 1 and 7 MHz, can have a strong therapeutic effect, when the duty cycle is less than 1%.
- the time-averaged power per area per MHz, integrated over the spectrum of the burst is between 1 pW/cm 2 and 10 pW/cm 2 , or between 10 pW/cm 2 and 0.1 mW/cm 2 , or between 0.1 mW/cm 2 and 1 mW/cm 2 , or between 1 mW/cm 2 and 10 mW/cm 2 , or between 10 mW/cm 2 and 0.1 W/cm 2 , or between 0.1 W/cm 2 and 1 W/cm 2 , or greater than 1 W/cm 2 .
- the duty cycle is greater than 10%, or between 1% and 10%, or between 10’ 3 and 1%, or between 10’ 4 and 10’ 3 , or less than 10’ 4 .
- the burst repetition rate is less than 100 Hz, or between 100 Hz and 1 kHz, or between 1 kHz and 10 kHz, or between 10 kHz and 100 kHz, or more than 100 kHz. For a burst spectrum that has a minimum frequency of 1 MHz that makes a substantial contribution to the spectrum, a burst of minimum duration will have a duration of about I ps.
- these powers per area refer to the power per area produced by a transducer at the surface of the body.
- these powers per area refer to the power per area produced at a target region some distance beneath the surface of the body.
- the target region is less than 5 mm deep, or between 5 mm and 1 cm deep, or between 1 and 2 cm deep, or between 2 and 4 cm deep, or between 4 and 6 cm deep, or between 6 and 10 cm deep, or more than 10 cm deep.
- these powers per area refer to the power per area produced for example in a phantom, or in a tank of water, or in a volume of raw meat, or in any other device used for calibrating and/or characterizing ultrasound systems.
- Such devices can also be used to calculate or estimate what ultrasound waveform and intensity should be used at the transducer, or at an optoacoustic ultrasound generator, to produce a specified waveform and intensity at a target region at a given location inside a patient’s body, and to determine whether a given ultrasound system is capable of generating ultrasound bursts of a specified intensity and waveform at a target region at a given location inside a patent’s body.
- Treating different medical conditions, and/or different patients, may require different treatment protocols. For example, ultrasound bursts of a specified waveform, spectrum, intensity and repetition rate may be applied to target region for a specified treatment duration. Treatment may be repeated periodically, for example once a day, for a specified number of treatment sessions, for example 5 or 10 or 20. The number of treatment sessions, and other aspects of the treatment protocol, may be adjusted during the course of treatment, in response to observed changes in the condition of the patient.
- the treatment protocol may be stored in the memory of the device, which may be particularly useful if the patient is being treated at home with a portable device.
- the ultrasound is generated at the surface of the body, by a mechanical transducer, for example a ceramic transducer or a PVDF transducer.
- the ultrasound is generated by a transducer introduced into the body by probe, for example through a natural orifice of the body, for example using a catheter, or may be used on an inside surface of the body during surgery.
- the ultrasound is generated inside the body, for example at or near the target region, by a laser beam, for example a near IR laser beam that can penetrate even several centimeters into body tissue, that is modulated at the desired ultrasound frequency or frequencies, and that generates the ultrasound by optoacoustics.
- a laser beam can also generate ultrasound at the surface of the body using optoacoustics, by using a pulse of laser light to heat a thin film transducer in acoustic contact with the surface of the body, making it expand, which generates a burst of ultrasound that propagates into the body, or by using a pulse of laser light to heat an area of skin at the surface of the body, causing the tissue to expand, generating a burst of ultrasound that propagates into the body.
- a near IR laser beam which can penetrate some distance into soft body tissue, can also produce ultrasound by heating tissue inside the body.
- the ultrasound burst has a wide frequency range
- two or more different transducers are used, each transducer covering a different frequency range that it is best suited for, or there are one or more mechanical transducers plus an optoacoustic laser beam, each generating ultrasound at a different range of frequencies.
- optoacoustics is especially suited for generating ultrasound at higher frequencies, for example above 20 MHz or above 50 MHz, because ultrasound of such high frequencies does not penetrate very far into body tissue.
- ceramic transducers generally work best at lower frequencies, below about 10 MHz, while PVDF transducers generally work best between about 1 MHz and 20 MHz or 50 MHz.
- the transducer uses a thin piezoelectric layer with electrodes placed in a housing, for example, a PVDF film 15 - 30 microns thick with acoustically transparent protection from mechanical damage.
- the thin film placed between the two electrodes represents a large capacitance, so the load impedance of the matching amplifier connected to the transducer is only a few ohms for the 1-20 MHz frequencies used in those experiments, and would have to be even lower at higher frequencies.
- Such PDVF transducers may not be practical to use for frequencies above 30 MHz.
- the ultrasound burst is generated by generating a voltage signal of the desired waveform, amplifying the voltage signal, and applying the amplified voltage signal to the transducer or to the optoacoustic ultrasound generator.
- more than one voltage signal is used, each covering a different range of frequencies and each applied to a different transducer, or optoacoustic ultrasound generator.
- Figure IB shows a single cell 102, such as one of the cells resident in the extracellular matrix shown in FIG. 1A, containing internal structures of a wide range of sizes, that may have resonant frequencies that are found in the spectra of ultra-wideband ultrasound bursts.
- the cell as a whole may also have a resonant frequency that responds to ultra- wideband ultrasound bursts.
- the internal structures shown in FIG. 1A may have resonant frequencies that are found in the spectra of ultra-wideband ultrasound bursts.
- the cell as a whole may also have a resonant frequency that responds to ultra- wideband ultrasound bursts.
- one or more of the ultrasound generating elements is an optoacoustic generating element, which generates ultrasound inside the body, for example directly in the target region or near the target region, by using a laser beam, such as a near infrared laser beam that can penetrate several centimeters into body tissue, that is modulated at the ultrasound frequency, and produces pressure perturbations in the body tissue at the modulation frequency by heating of the body tissue.
- a laser beam such as a near infrared laser beam that can penetrate several centimeters into body tissue, that is modulated at the ultrasound frequency, and produces pressure perturbations in the body tissue at the modulation frequency by heating of the body tissue.
- Optoacoustic generation of ultrasound may be especially suited for the highest ultrasound frequencies, for example above 20 MHz or above 50 MHz, because such high frequency ultrasound does not penetrate very far through body tissue, and may be best generated inside the body near the target region.
- the controller may select an ultrasound spectrum that is more enhanced in higher frequency components at the transducers, because the higher frequency components may suffer more attenuation than the lower frequency components, especially if there is a greater distance from the transducers to the target region.
- Figure 3 shows a flowchart 300 for a method of treatment using ultrasound, for example ultra- wideband ultrasound bursts, for example using the system of FIG. 2, once it has been decided that a particular patient should receive this treatment, and once a protocol for this treatment has been created, appropriate for the patient.
- a “method of treatment” may include a method of preventing a disease state, as well as a method of ameliorating a disease state.
- the controller generates a burst waveform voltage signal, optionally a different signal for different ultrasound generating elements, with a spectrum of frequencies suitable for that ultrasound generating element.
- the ultrasound generating elements are elements of a phased transducer array
- the voltage signals for different elements of the array may be identical except for phase differences that vary linearly across the array to control the direction of ultrasound waves that it produces, and/or quadratically across the array to control the focus of ultrasound waves that it produces.
- the controller generates the waveform voltage signals needed to generate ultrasound bursts of a specified intensity and waveform at a specified target region in a patient, for example calculated in advance, or calculated in real time by the controller, according to a model of ultrasound propagation in the patient’s body.
- the ultrasound generating elements use the voltage signals to produce ultrasound waves, for example a train of identical ultra-wideband ultrasound bursts, at the target region inside the body, of a specified waveform, spectrum, and intensity, including how these parameters vary spatially in the target region, and how they vary over time, to produce a therapeutic effect.
- ultrasound can be used therapeutically at high intensities for ablating tissue
- the emphasis in method 300 is on using very low intensity ultrasound, for example only 1 pW/cm 2 , to produce the kinds of therapeutic effects discussed above, involving inducing cells to undergo changes that improve regeneration of damaged tissue.
- Treatment of different medical conditions may have different protocols that specify different values of the ultrasound parameters, such as waveform, spectrum, intensity, burst repetition rate, duration of each treatment session, and location of the target region, which may be selected by changing the phases and intensities of different ultrasound generating elements.
- different values of the ultrasound parameters such as waveform, spectrum, intensity, burst repetition rate, duration of each treatment session, and location of the target region, which may be selected by changing the phases and intensities of different ultrasound generating elements.
- ultrasound bursts continue to be repeatedly generated, at least at the target region, by the ultrasound regenerating elements, for a duration of a treatment session.
- the duration is less than 1 minute, or between 1 and 2 minutes, or between 3 and 5 minutes, or between 5 and 10 minutes, or between 10 and 20 minutes, or more than 20 minutes.
- the treatment session is optionally repeated, for example once, or between 2 and 5 times, or between 5 and 10 times, or more than 10 times, for example at intervals of a day, or between 1 day and 1 week, or more than 1 week. In the studies done by the inventors, treatment duration has typically been between 5 and 10 minutes, and repeated once a day for between 5 and 10 days.
- a treatment session is provided once a day, for example for 5 to 10 days, a patient receiving the treatment comes into a doctor’s office, or a hospital out-patient clinic, each day to receive treatment, for example using non-portable equipment that normally stays at the doctor’s office or hospital.
- treatment is provided to the patient at home, for example using portable equipment that the patient keeps at home, and that is programmed to automatically provide the treatment protocol, and its associated parameters, that the patient is receiving.
- the equipment is wearable, and includes a strap or other element for attaching it to the body, and holding it firmly in position on a surface of the body when it is providing treatment.
- the equipment is programmed to automatically provide the treatment protocol for the patient, for example at a specified time each day, or when the patient initiates the treatment before each treatment session.
- Figure 4A shows a plot 400 of a waveform of an ultrasound burst that has an amplitude A as a function of time t given by
- This waveform was chosen because, if the equation at the top is extended to all values of t, then theoretically it will have a spectrum that is constant between ®o and 7®o, for example between 1 MHz and 7 MHz, and zero everywhere else.
- a spectrum is an example of a spectrum that is expected to be useful for therapeutic ultra-wideband ultrasound bursts, because it can excite a lot of different resonant frequencies of structures found in tissues and cells. In fact, it is impossible to generate a burst that lasts an infinite amount of time, and in practice it is necessary to cut the burst off at some finite time.
- Figure 4B shows a spectrum 402 calculated numerically, using the FFT function in Excel, for waveform 400 in FIG. 4A.
- Spectrum 402 is similar to the spectrum expected for an infinitely long burst of the form given by the equation above, constant between coo and 7®o, which may be thought of as between 1 MHz and 7MHz, and zero everywhere else.
- the waveform was cut off at
- spectrum 500 looks quite different from the appearance of spectrum 402, in fact the biological effects of the bursts are expected to be virtually identical in both cases, at least for many of the structures being excited. That is because the damping time of the resonant structures that the bursts could be exciting is expected to be much less than 4 microseconds, in fact less than about 5l2u microseconds, for any of the resonant structures, resonant at frequencies between 1 and 7 MHz, that the bursts might excite, because the structures are all expected to have Q ⁇ 5. So the resonant structures will respond to each burst independently, with no memory of the previous bursts, and it makes no difference if the train of bursts is coherent.
- the biological response to a burst will depend only on the burst spectrum smoothed over a frequency range of about 20% . That is why the spectrum of FIG. 6 is characterized by its average value over bands covering ranges of frequencies of a factor of 1.2, and not by the details of its structure at a finer scale. Physically, the 5-functions of spectrum 500 get smoothed out into the continuum of spectrum 402, by the low Q values of the resonant structures.
- Figure 6 shows a plot 600 of a burst spectrum 602 that barely satisfies the limitations of claim 1.
- spectrum 604 70% of the power in the range is found in the highest power portion that covers 50% of the range between 2 and 6 MHz, so by this alternative definition, spectrum 604 barely is “relatively uniform over a relatively broad range of frequencies.”
- the ratio of standard deviation to mean value for spectrum 604 is 46%, so by the definition that this ratio has to be less than 50%, spectrum 604 also is “relatively unifom over a relatively broad range of frequencies,” but not by very much.
- Figure 7 shows a plot 700 of a spectrum 702 consisting of 2 narrowband peaks of equal height and width, at 3 MHz and at 5 MHz, that might have been used in prior art ultrasound therapy. Narrowband spectra of only 2 or 3 frequencies are sometimes used in LIPUS therapy.
- spectrum 704 50% of the total power in the range between 2 and 6 MHz is found in a highest power portion of the range that covers only 27 % of the range, so claim 1 is not satisfied for this narrowband spectrum. Also, 73% of the power is found in a highest power portion of the range that covers 50% of the range, so by the alternative definition, that requires less than 70% of the power to be found in that range, effective spectrum 604 also is not “relatively uniform over a relatively broad range of frequencies.” And the ratio of standard deviation to mean value of spectrum 604 is 64%, so spectrum 604 also is not “relatively uniform over a relatively broad range of frequencies,” by the definition that requires this ratio to be less than 50%.
- results, and the results described for FIG. 6, provide a sense of the criteria that can be used to distinguish spectra that are suitable for ultra-wideband ultrasound bursts, and spectra that are used in narrowband ultrasound.
- FIGS. 8A-8D illustrate an ultra-wideband ultrasound burst waveform and spectrum, similar to that shown in FIGS. 4A and 4B, where the waveform signal can be generated by hardware, rather than synthesized digitally.
- Digitally synthesizing waveform signals may become impractical at frequencies of about 20 MHz and above, so it is useful to be able to generate waveform signals by hardware.
- Generating waveform signals at such high frequencies may start with the generation of bipolar square pulses, for example as described by Y. Onikienko et al, “High frequency Half-Bridge GaN-based pulse generator,” in 2019 IEEE 39 th International Conference on Electronics and Nanotechnology (ELN ANO), p. 700-703.
- the pulses are initially at least approximately square pulses, defined for example by their first few harmonics having amplitudes that are within 50% of the harmonic amplitudes, relative the amplitude of the fundamental frequency component, that an ideal square wave would have.
- a train of such square pulses may be converted into a segment of a sine wave by filtering out the higher harmonics.
- the filtered train of square pulses is at least approximately a sine wave, described for example in that their first few harmonics have amplitudes, relative to the amplitude of the fundamental frequency component, less than 50% of the amplitudes that an ideal square wave would have. This method can be used even to generate waveform signals at high power, and when energy efficiency is needed. At low power, a waveform signal that is a segment of a sine wave can be generated by using a sine wave generator, a selector, and a synchronizer.
- Figure 8A is a plot 800 of a set of 7 waveforms, labeled 802, 804, 806, 808, 810, 812, and 814, each consisting of a cosine function at a different frequency, all with the same constant amplitude for coot between -n and +x, and zero amplitude everywhere else.
- the plots of the different waveforms are displaced vertically from each other so they can be clearly seen.
- the 7 frequencies used are coo, 2coo, 3coo, 4coo, 5coo, 6coo, and 7coo.
- the frequencies are 1 MHz, 2 MHz, 3 MHz, 4 MHz, 5 MHz, 6 MHz, and 7 MHz, and each waveform lasts for 1 microsecond.
- the 7 waveforms respectively have 1, 2, 3, 4, 5, 6, and 7 full wave periods in that microsecond.
- Figure 8B shows a plot 816 of the sum S(t) of all the waveforms shown in FIG. 8A
- FIG. 8C shows overlapping plots of the Fourier transforms 818, 820, 822, 824, 826, 828, and 830 of the seven waveforms shown in FIG. 8A.
- the plots have been displaced vertically from each other so they can be clearly seen.
- Each Fourier transform consists of two sine functions centered at the positive and negative frequencies of the cosine function used to generate that waveform.
- Each sine function has a central peak that extends a distance coo to its first zero on either side.
- Figure 8D shows a plot 832 of the spectrum of waveform 816 in FIG. 8B.
- the spectrum is a reasonably good approximation to spectrum 402 of FIG. 4B, being roughly constant between +rao and +7 oo, and much smaller in magnitude everywhere else, but with somewhat larger wiggles and distortions than spectrum 402 in FIG. 4B. If, as the inventors believe, spectrum 402 in FIG. 4B is a useful spectrum for a therapeutic ultrasound burst to have, then we expect that spectrum 832 in FIG. 8D, which has the potential advantage that the burst can be generated by hardware, will also produce good results in ultrasound therapy.
- waveform 800 or FIG. 8A a good approximation to this waveform could probably be produced using somewhat fewer signal components that are generated by hardware, for example 4, 5 or 6 components.
- the higher frequency components could probably be spaced further apart in frequency, as long as adjacent frequency components are not more than 20% different in frequency, and the duration of each component could be made somewhat shorter than 1 microsecond, so that the sine functions for the different components would still overlap in frequency.
- Figure 9 shows the results of a study of wound-healing in mice, comparing a control group of mice with mice treated with LIPUS ultrasound, and mice treated with ultra-wideband ultrasound bursts. The study was done with a sample of 40 female BALB line mice. Standardized linear wounds were inflicted on their backs, 17 mm long and 1.2 mm deep. The control group of mice was not treated at all.
- the group treated with LIPUS were treated with 30 mW/cm 2 (at the peak intensity location along the length of the beam, averaged over the cross-section of the beam, and averaged over time during the duration of the treatment session) of 1.5 MHz ultrasound, in 200 ps long pulses with a 1 kHz repetition rate, for a duration of 5 minutes each day, for 9 days.
- the group treated with ultra-wideband ultrasound bursts were treated with 1 pW/cm 2 per MHz bursts with frequencies between 1 and 7 MHz (at the peak intensity location along the length of the beam, averaged over the beam cross-section, average over the duration of the treatment session, and averaged over the 1-7 MHz frequency range), with a 1 kHz burst repetition rate, for a duration of 5 minutes each day, for 9 days.
- the total power per area, integrated over the 1 to 7 MHz frequency range, would be 6 pW/cm 2 .
- a SigLent SDG 6052X DDS generator from SigLent Technologies Co. was used to generate the ultrasound.
- the head for emitting LIPUS and ultra-wideband bursts contained a multimode ultra-wideband transducer with a diameter of 20 mm.
- LIPUS and ultra-wideband bursts were delivered to the affected area on the back of the mouse through a layer of ultrasonic gel UBQ 5000 Ultragel.
- Figure 9 shows a plot 900 of the average length of the wound on each day of the study, for mice in each group.
- the vertical axis shows the average length of the wound in mm, and the horizontal axis shows the number of days.
- Curve 902 shows the results for the control group
- curve 904 shows the results for the group receiving LIPUS treatment
- curve 906 shows the results for the group receiving treatment with ultra-wideband bursts.
- inflammation and edema were observed in the wound area for the first two days, and thereafter the average wound length decreased by at most 2.1 mm per day.
- inflammation and edema were absent, but the average rate of healing thereafter was about the same as for the control group, a maximum of 2.1 mm per day.
- a SigLent SDG 6052X DDS generator was used, with a head containing a multimode ultra- wideband transducer with a diameter of 20 mm, for transmitting the LIPUS and the ultra- wideband ultrasound bursts.
- the LIPUS was at 1.5 MHz, at 30 mW/cm 2 , at the peak intensity location along the length of the beam, averaged over the beam cross-section, averaged over the beam cross-section and time averaged over the duration of the treatment session.
- the ultra-wideband bursts were used both at 30 mW/cm 2 per MHz and at 1 pW/cm 2 per MHz, with the bursts having frequencies between 1 and 7 MHz, at the peak intensity location along the length of the beam, averaged over the beam cross-section, time averaged over the duration of the treatment session, and averaged over the 1 to 7 MHz frequency range.
- the suspension of leukocytes with nutrient medium 199 (containing 200 IU of penicillin and 100 IU of streptomycin per ml) was diluted so that 1 ml contained 1 to 2 million leukocytes, in a medium that was 20% autologous plasma and 80% nutrient medium.
- the prepared leukocyte suspension was poured into sterile 1 ml vials and a gas mixture containing 5% carbon dioxide was passed through it to maintain sterility.
- the vials were placed in a thermostat at 37° C for 5 days. During each of the 5 days, the samples were exposed for 5 minutes to the LIPUS ultrasound, or to the ultra- wideband bursts at one of the two power levels, or in the case of the control samples were not exposed to ultrasound at all. At the end of the 5 days, the samples were examined in an optical microscope, and it was determined what percentage of T-lymphocytes had undergone blast transformation and were visibly different from normal cells.
- HPCs hematopoietic progenitor cells
- HSCs hematopoietic stem cells
- Ultra-wideband ultrasound bursts were used with an intensity of 1 pW/cm 2 per MHz, at the peak intensity location along the length of the beam, averaged over the cross-section of the beam, averaged over the duration of the treatment session, and averaged over frequency, with frequencies in a range between 1 and 20 MHz, and a pulse repetition rate of 100 kHz.
- the duration of the exposure in each session was 5 minutes, and the number of sessions was 10.
- the study was conducted on 45 sexually mature (3 months) female mice of the BALB/c line, with 15 animals each in the control and experimental groups. All work with experimental animals was carried out in compliance with the "European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes", as well as the principles of bioethics and biological safety standards.
- control samples of cells without introduction of antibodies (unstaining control), samples with each of the antibodies separately (single staining control) and samples with a combination of several antibodies without one (fluorescence minus one - FMO control) were used.
- HPCs haematopoietic progenitor cells
- HSCs hematopoietic stem cells
- the fibroblasts in a nutrient medium, were exposed to ultra- wideband ultrasound bursts with a spectrum having frequencies between 1 and 7 MHz, at an intensity of 30 mW/cm 2 per MHz, at the peak intensity location along the length of the beam, averaged over the cross-section of the beam, time averaged over the duration of the treatment session, and averaged over the 1 to 7 MHz frequency range; or to narrowband ultrasound waves at 1 MHz, 3 MHz, or 7 MHz, at an intensity of 30 mW/cm 2 , at the peak intensity location along the length of the beam, averaged of the cross-section of the beam, and time averaged over the duration of the treatment session.
- the duration of each treatment session was 5 minutes, with one treatment session performed per day for 5 consecutive days.
- a control sample of fibroblasts was not exposed to ultrasound at all. 24 hours after the last treatment session, the fibroblasts, dyed with Trypan blue dye from Hy Clone in the USA, were observed and photographed under an Aviostar Plus binocular microscope from Carl Zeiss of Germany.
- the number of live cells counted after each of the treatment methods was expressed as a percentage of the number of live cells counted in the control group sample, and error bars due to the finite numbers of cells were determined.
- the number of fibroblasts counted was 96% ⁇ 13% of the number in the control group, which was not a statistically significant difference, indicating a balance between any differences in apoptosis and proliferation of fibroblasts caused by the ultrasound.
- the number of fibroblasts counted was 120% + 14% of the number in the control group.
- the number of fibroblasts counted was 138% ⁇ 15% of the number in the control group, showing a clear net increase in proliferation over apoptosis caused by the ultra- wideband bursts at this intensity.
- Table 2 shows a similar study of the proliferation of fibroblasts, comparing the results of using narrowband LIPUS ultrasound bursts with various ultra- wideband ultrasound bursts.
- the LIPUS spectrum has its peak at 2.5 MHz and falls by 10 dB at 0.3 MHz on each side of the peak, with a time averaged power of 15 mW/cm 2 .
- Each LIPUS burst has a duration of 0.2 milliseconds, and there are 1000 bursts per second.
- Two different time-averaged powers of ultra-wideband ultrasound bursts were, 1 mW/cm 2 MHz and 1 pW/cm 2 MHz, averaged over the width of the spectrum, each with four different wideband waveforms, described below.
- 3T3-A31 cells (BALB/c mouse fibroblasts) were cultured in DMEM complete nutrient medium supplemented with 10% fetal calf serum (FCS) (Sigma, USA) and lx penicillin/streptomycin (Biowest, France).
- FCS fetal calf serum
- FCS fetal calf serum
- lx penicillin/streptomycin Biowest, France.
- the studied cells were cultured in plastic dishes in a humidified atmosphere with 5% CO2 at 37°C Changing the medium and reseeding cells was carried out according to standard methods. Cells in the exponential phase of growth were used for further research.
- the studied cells were planted in the wells of two 12-well plates for cell culture (TPP, Switzerland) in the amount of IxlO 4 cells/well in 3 ml of complete nutrient medium DMEM with 10% FST content and lx penicillin/streptomycin. Cells were cultivated in a humidified atmosphere with 5% CO2 at 37°C.
- the cells were treated with ultra-wideband ultrasound bursts in one of the 9 different modes listed in Table 2, except for the control group which was not treated with ultrasound.
- the cells were sonicated once a day for 5 days. Exposure was 5 minutes.
- the cells were placed in a CO2 incubator and cultured at 5% CO2 and 37°C.
- A/80x 2 X*10 6 cells in a milliliter of medium, where A is the number of cells , which was calculated in Goryaev's chamber (in 5 diagonal squares), x2 - dilution with trypan blue (1:1).
- FIG. 27 shows a block diagram of a system 1200 used to generate the ultrasound bursts.
- Signal generator 1202 synthesizes the sine signal.
- the generated signal is passed through a high pass filter 1204 that reduces frequency components below 1 MHz.
- the filtered signal is then passed through a balanced mixer 1206, and a matched amplifier 1210, which has an output that matches the load impedance of a piezoelectric transducer 1212 that generates the ultrasound.
- the matched amplifier can also compensate for any undesired filtering by the filter, the balanced mixer, and the transducer.
- the spectrum in each case fell rather steeply above the upper frequency, as expected for the spectrum of a sine function, with the fall-off being spread over about 0.5 MHz, possibly due to the truncation of the sine function by the signal generator. Below 1 MHz, the spectrum fell rather steeply due to a combination of the high pass filter, and the response of the amplifier and transducer below 1 MHz. Above 1 MHz, up to the upper frequency in each case, the spectrum of the generated ultrasound waves is in good agreement with the flat spectrum of the sine function.
- the measured ultrasound spectrum for the cases where the frequency extends from 1 to 7 MHz is shown in FIG. 28.
- the spectra for the other cases look similar, but with different maximum frequency where the spectrum falls off.
- For each of the 10 cases there were 6 wells of fibroblast cells prepared, and the number of cells from each well was recorded at the end of the ultrasound treatment period, and after culturing them in an incubator for 72 hours, as described above.
- the number of cells is listed for each well, for each case, per milliliter of culture medium, relative to 10 6 , in Table 2.
- the mean M and the standard deviation SD of the number of cells, over the 6 wells are listed, together with the percent increase (PI, or proliferation index) in mean number of cells compared to the number in the control group.
- the proliferation index is plotted in FIG.
- the proliferation index is very statistically significant, at p ⁇ 0.001, for MODE #7, corresponding to 1 pW/cm 2 MHz with spectrum extending from 1 to 7 MHz, and for MODE #8, corresponding to 1 pW/cm 2 MHz with spectrum extending from 1 to 15 MHz.
- Ultra- wide ultrasound bursts for therapy can be generated instead using a PDMS film in acoustic contact with body tissue, illuminated by short pulses of light from a near infrared laser, for example at a wavelength between about 1 pm and 1.5 pm, using pulses between 5 and 15 ns long.
- Figure 30 schematically shows an optoacoustics system 3000 that generates ultrasound bursts in a body 3002 of a patient.
- a near infrared laser 3004 produces a laser beam 3006 that is focused by a lens 3008 to a small spot on a PDMS film 3010 that is in contact with body 3002.
- a signal generator 3012 modulates laser 3004 to produce short pulses of the light, for example pulses about 5 ns long.
- Each pulse of laser light on the PDMS film, which is covered with black paint causes the film to abruptly heat and thermally expand, generating bursts of ultrasound 3014, which propagate into body 3002 to target zone 3016 in the body.
- a layer of acoustic gel 3018 between film 3010 and the skin of the patient keeps film 3010 in good acoustic contact with the body.
- the spectrum of the generated ultrasound waves depends on the duration of the pulses of laser light. For 5 ns pulses, the spectrum is typically ultra-wideband, which a peak around 100 MHz
- Ultra- wideband ultrasound bursts at high frequencies can also be generated directly in body tissue optoacoustically, without using a PDMS film, by focusing the laser light 3006 on the skin, or by focusing it inside body 3002, taking advantage of the fact that near infrared light can travel several mm or even 1 or 2 cm in soft body tissue.
- the short pulses of IR laser light heat the skin, or heat the internal body tissue that it is focused on, causing it to expand in response to each pulse of light, generating the ultrasound inside the body tissue, for example within or near target region 3016.
- the conversion efficiency of IR light energy into ultrasound energy in those cases will be lower than when the IR light is used to heat a black PDMS film in acoustic contact with the skin.
- the inventors estimate that the energy conversion efficiency of IR light, focused inside body tissue, to ultrasound, may be only about 10’ 5 . But even at that low efficiency, the acoustic pressure of the ultrasound bursts, near the small volume where the IR is focused, may be comparable to or greater than the acoustic pressure of the bursts that were found to have biological effects in the study of mouse fibroblast proliferation at 1 to 15 MHz, shown above in Table 2.
- ultrasound bursts of similar acoustic pressure at 40 to 200 MHz, also have biological effects, perhaps by mechanical excitation of the cell nucleus or of small structures inside the cell or the nucleus, then such optoacoustically generated ultrasound bursts could be therapeutically useful, probably for different purposes than ultrasound bursts at 1 to 15 MHz.
- the potential advantages of generating the ultrasound by direct heating of tissue inside the body are 1) that the ultrasound can be generated near the target area where it is needed, so it does not have to travel from the surface of the body over a distance where ultrasound of such high frequency would be greatly attenuated, and 2) by focusing the IR laser to a small volume inside the body, the therapeutic effect can be limited to a precisely defined target region, and if necessary the procedure can be repeated to precisely cover a larger target region of any shape, while avoiding surrounding tissue.
- Section 1, and Section 2 below provide some examples of structures and methods, some definitions that may also be used in some embodiments of the invention described elsewhere, and some references that are cited is Section 1 and Section 2. The numbering of the references starts over again in Section 2.
- the present invention for example as per the instant section, relates to micromechanical methods of impact, in particular to non-invasive ultra-wideband micromechanical impact burst used in research, technological, biological, medical and cosmetic equipment to affect diseased, damaged or altered, including aged or infected, biological tissues and somatic cells in order to enhance and speed up the processes their regeneration and recovery.
- the method comrpises applying ultra-wideband micromechanical impact bursts (UMI Bursts) to the tissue for acceleration of reparative and regenerative processes to multiple levels of cellular and tissue structures hierarchy of the tissues, for example having dimensions from about IO -4 mm to about 1.5 mm.
- UMI Bursts ultra-wideband micromechanical impact bursts
- Some embodiments of the invention include activation and transformation of specialized somatic cells into pluripotent and progenitor stem cells.
- the micromechanical energy of UMI Bursts non-invasively transferred to a great amount of mechanosensitive elements of pathologically altered and adjacent healthy tissues in the form of UMI Bursts is optionally formed by at least two signals - main and correcting.
- the frequency spectra of UMI Bursts contain a very large number of frequencies in one or several ultra-wideband ranges, and which have a broadband rate of 0.2 ⁇ q ⁇ 0.992, which corresponds to the spectral frequency range 1.0-250.0 MHz.
- Some embodiments of the present invention relate to ultra-wideband micromechanical methods of impact, in particular to non-invasive ultra-wideband micromechanical bursts used in research, technological, biological, medical and cosmetic equipment to affect diseased, damaged or altered, including aged or infected, somatic cells and biological tissues in order to enhance and speed up the processes their regeneration and recovery.
- Micro -energy modulation impact the impact in the treatment area of ultra- wideband micro-energy micromechanical signals with a maximum peak energy of 0.03-0.1 mJ / mm 2 , and a spatial-peak temporal average intensity of less than hundreds of microwatts per square millimeter [1].
- “Induced stem cells” undifferentiated pluripotent or progenitor stem cells obtained from somatic cells by their reprogramming
- Regenerative impact - restoration of diseased or damaged tissues and organs of a biological object using pluripotent and progenitor stem cells, activated, transplanted or transformed [2] ;
- Regenerative cosmetology - a technology for rejuvenating (revitalizing) aging skin by activation or transplantation of stem cells, or induced transformation of somatic and progenitor cells into stem cells [3];
- UWB Ultra-wideband
- b r the fractional bandwidth r
- UMI Burst Ultra-wideband Micromechanical Impact Burst propagating in medium detached ultra-wideband micro-mechanical disturbance of the medium, which differs in spectral and spatial characteristics from known narrowband and wideband ultrasound;
- Ispta - narrowband signal intensity - spatial-peak temporal-average intensity of narrowband signal or the sum of narrowband signals, averaged over the cross section of the ultrasonic beam, impulse rate and over time.
- Isptaf intensity of wideband and ultra-wideband signals intensity, in particular, ultra-wideband micro-mechanical impact bursts (UMI Bursts)" the intensity averaged over cross-section of the burst radiating beam, as well as over time, impulse rate and over burst spectrum.
- “Vibration modes of an electromechanical transducer” a set of natural or forced vibrations of a transducer with different physical characteristics, for example: resonance modes - radial R, edge E, angular A, volume V, as well as planar ultra- wideband P - mode - vibration of the surface layer of the transducer;
- Stem cells originate from two main “sources”: tissues of an adult organism and embryos. Scientists are also working on ways to obtain stem cells from other cells using reprogramming techniques.
- the sources of exogenous SC for transplantation are embryos, umbilical cord blood, bone marrow and adipose tissue. SC transplantation is widely used, despite the immunogenicity and oncogenicity of exogenous SC [14].
- SCs are found in many tissues of the body, including the brain, bone marrow, adipose tissue, blood and blood vessels, skeletal muscles, skin, and liver. It has been established that such and similar resident endogenous SCs, due to the home effect, can be accumulated in the treatment area and accelerate the regeneration process [15].
- autologous extracorporeal pluripotent SCs are often used, isolated, for example, from the adipose tissue of the body. They are propagated in an artificial nutrient medium and returned to the body . Disadvantages of the technology for extracorporeal cultivation of autologous SCs are their high cost, incomplete compatibility with resident cells, carcinogenicity arising from accumulated differences in the process of cell reproduction, and the presence of biochemical growth factors necessary for the growing process. It is safest to use your own non-multiplied SCs. They are obtained either from the-bones in the body marrow or with the help of drugs that displace SC into the blood. Using this technology, it is possible to obtain only a small amount of SC [16].
- Yamanaki Shinya and co-author showed [17-18] (John B. Gordon, Shinya Yamanaka. The Nobel Prize in Physiology or Medicine 2012) that in principle, an induced transformation (reprogramming) of any adult somatic cell into a pluripotent young stem cell is possible, and, in the future, its transformation into any specialized cell. Reprogramming took place in the cell culture due to the “cocktail” of Yamanaki - a set of four modified genes implanted into the genome of somatic cell generations of proliferating cells. The long-term consequences of such a transformation for the organism are still insufficiently understood. In addition, the extracorporeal production of modified cells using the Yamanaka technology is still very expensive.
- the cell nucleus including DNA and chromosomes, are sensitive mechanosensors.
- Mechanical informational signals come from the environment of cells into the intracellular cytoskeleton and along the filaments further into the nucleus. Deformation and conformal transformations of intranuclear structures are triggered, and changes in gene regulation and configuration of epigens are initiated.
- Mechanical signals in cells control numerous processes, including transformation of the epigenome and migration of methylating markers. Cells also exchange mechanical signals when their membranes are in contact [28]. It is obvious that external mechanical signals, similar to the signals of the cells themselves, can effectively influence the processes of their vital activity and transformation.
- the new type of ultrasound is needed, in which the mechanobiological effect prevails and are excluded the thermal, acoustochemical, acoustoelectric effects inherent in conventional impact-therapeutic ultrasound.
- Broadband rate q of LIPUS signals is q ⁇ 0.2.
- Duarte L.R. (US 5904659 [31]) significantly expanded the boundaries of the operating frequencies of signals.
- the carrier frequency is proposed in the range of 20,0 kHz - 10,0 MHz, the frequency of the modulating signal is from 5.0 Hz to 10.0 kHz, the Ispta intensity (spatial peak temporal average acoustic intensity) is less than 0.1 W/cm 2 (100 mW/cm 2 ).
- Broadband rate q is q ⁇ 0.2.
- LIPUS is a non-invasive method for stimulating tissue and cell bioactivity [32].
- Huckle J. et al in 2010 patented the use of LIPUS for the treatment of connective tissue pathologies, and hence diseases of the musculoskeletal system [40].
- EP Global Communications Inc. USA announced advanced technology and device for macular degeneration and retinitis pigmentosa by emitting low intensity ultrasound into the eye for the purpose of regeneration of damaged cells and to possibly stopping the degeneration of existing healthy cells within the macula and the entire retina [43].
- LIPUS in contrast to classical treatment ultrasound, is a non-invasive method of stem cell mechanotherapy in general and regenerative treatment in particular [25, 26, 28].
- LIPUS Low efficiency of the treatment of diseases.
- the main physical characteristics of LIPUS signals - vibration frequency, pulse duration, duty cycle and time of their exposure do not differ from classical treatment ultrasound. Only tens and hundreds of times the intensity of treatment signals were reduced, which, along with a large duty cycle, made it possible to avoid their power manifestations - heating, cavitation, acousto-chemical and acoustoelectric effects, which previously masked the manifestations of the effects of low-intensity signals.
- Vortman, K. in WO 2014135987 A2 [47] proposes to optimize the frequency of ultrasound depending on the type of tissue and the depth of the treatment effect.
- Barthe P. et al. in US 8460193 B2 [48] describe the system and method of ultra- high-frequency ultrasound treatment, considering it possible to increase the frequency of the treatment signal to 500 MHz to emit it deep into the tissues, the authors proposed a “semi-invasive” introduction using a needle emitter.
- Each impulse includes from 1 to 50,000 acoustic cycles, repeating with frequencies from 0.001 to 100 kHz, that is, it is emitted in the form of a comb spectrum.
- W. Tyler proposes a low-intensity ultrasound treatment using one modulated harmonic signal or using multiple signals or using multiple comb signals, or combinations thereof. It is obvious that any finite set of harmonic W. Tyler signals is always narrowband, and, therefore, the broadband ratio q ⁇ 0,2.
- W. Tylor uses a patented variety of signaling variants to modulate cellular activity, including nerves and other cells in the human body, namely for changes in:
- Change in cellular activity leads to a change in the physiological and pathological conditions of organs and tissues and treats the following, but not only: Parkinson's disease, Alzheimer's disease, coma, epilepsy, stroke, depression, schizophrenia, neurogenic pain, cognitive / memory dysfunction, diabetics, traumatic brain injury, spinal / cord injuries, migraine, epilepsy.
- LIPUS The physical reason for the low clinical efficiency of LIPUS is the discrepancy between the parameters of the ultrasound signal intended to affect cells with those signals that are adequate to the own micromechanical signals of the nuclei of cells, cells and tissues.
- the miniature radars began to be used in medicine for remote monitoring of respiration and heartbeat of patients (Me Ewan T., US5573012 [80]).
- Ultra-wideband equipment has appeared for monitoring vital functions of the human body, as well as equipment for cardiological, pneumological and obstetric remote visualization [81].
- Mahfouz M. et al. in 2011 described a surgical navigation ultra- wideband system for orthopedics [82].
- Ultra- wideband medical devices began to be developed since 1981 by the the present inventor, A. Marchenko, after the creation by him of broadband (later ultra- wideband) ultrasonic multimode transducers with a transducing efficiency comparable to mono frequency ones (Marchenko A. et al, [86-89], and see 1. Marchenko A. et al, Certificate of authorship (patent in USSR) No. 1323141 dated 21.04. 1981. Ultrasonic Broadband Transducer; 2. Ostrovsky I., Marchenko A. Variable Thickness Piezoelectric Transducers for Medical Applications. /35th Annual Convention of the AIUM, Georgia, USA, 1991, Abstract # 4012; 3. Ostrovsky I., Marchenko A.
- ultrasonic diagnostic devices An example of successful development of ultra-wideband devices for medical purposes is the creation of ultrasonic diagnostic devices in the last decades. Typical characteristics of the generators are low-cycle (four-cycle) pulses with an amplitude of 160 V, fed to an ultra- wideband multi-element converter with a frequency range of, for example, 3-7 MHz. An example is the ultrasound device is Phillips Clear Vue 350. Diagnostic and therapeutic signals of therapeutic ultrasound equipment and ultrasound devices do not match in all respects. Therefore, ultrasonic diagnostic devices may be unsuitable for therapy.
- a reason for using ultra-wideband bursts for treatment instead of using individual frequencies is that they may be closer to natural cell signals than individual frequencies to excite individual structures and cellular pathways.
- reliable transmission of micromechanical information in the form of weak signals from cell to cell and inside cells, as well as to exclude the cross influence of many neighboring cells on each other, that is, to exclude signal interference it is better to transmit information in an ultra-wideband pulsed form.
- this may apply to any levels of cellular activity, both intercellular and intracellular exchanges. Therefore, the previously used concept of “frequency” of oscillations may be replaced with the “band” of oscillations. And the vibrations of individual resonant structures of cells and tissues may be replaced with their spectral ultra-wideband response also. This is all are the more true because the oscillating structures of cells have a low-quality factor, that is, they are strongly damped, and information is transmitted by very weak signals.
- the method according to some embodiments of the present invention comprises applying ultra- wideband micromechanical impact bursts (UMI Bursts) for amplification and acceleration of regenerative processes in a human body to multiple levels of hierarchy of the tissue structures, having dimensions from about 10’ 4 mm to about 1.5 mm, for example.
- UMI Bursts ultra- wideband micromechanical impact bursts
- micromechanical energy is non-invasively transferred to mechanosensitive elements of pathologically altered tissues and adjacent healthy tissues located next to them, in the form of ultra- wideband micromechanical bursts each of which is formed by at least two signals with different complementary spectra.
- the method according to some embodiments of the present invention includes the use of UMI Bursts, the spectra of which contain a very large number of frequencies in at least one ultra-wideband frequency range, and have wideband rate of 0.2 ⁇ q ⁇ 0.992, which corresponds to the frequency range 1,0-250,0 MHz.
- the UMI Bursts may affect many mechanosensitive elements of cellular structures, intercellular and intracellular matrix, mechanosensitive receptors and elements of cell membranes, organelles, nuclei and DNA.
- the method of non-invasive regenerative ultra-wideband burst optionally includes one or more of:
- the main UMI Burst has a first frequency range with the first shape of the frequency spectrum and first intensity, which may mainly exert stress on tissues and intercellular matrix of the treatment area.
- at least one second UMI Burst has at least a second shape of the frequency spectrum and second intensity, that when exposed to cells and the intracellular media may mainly stimulate the processes of reprogramming, direct reprogramming, differentiation, proliferation, and cell replacement in the treatment area.
- the first UMI Burst is generated at least in the first frequency range, for example, 1,0-10,0 MHz, with a frequency, space and time-averaged intensity in the treatment area of 1,0-300,0 mW/cm 2 .
- This first UMI Burst has a repetition rate of 0.05 - 100,0 kHz.
- At least the second UMT Burst is generated in the second frequency range, for example, 10,0 - 50,0 MHz, with an intensity averaged over frequency, space and time in the treatment area is between 0.0001 -300,0 mW/cm 2 , for example.
- This at least the second impact UMI Burst is repeated at a frequency of 0.05- 10 3 kHz, for example.
- At least the third UMI Burst is formed in the third frequency range of 50,0- 250,0 MHz, and have a frequency, space and time averaged intensity of burst on the body surface of 0,0001-100,0 mW/cm 2 and into the treatment area of 0.0001-30,0 mW/cm 2 , for example.
- This at least the third UMI Burst has a repetition rate of 0.05- 10 3 kHz, for example.
- the burst frequency spectra shapes of the main generators are selected from shock signals, stress signals as well as from frequency spectra of rectangular, triangular, trapezoidal signals, or their differentials, and/or Frequency spectra of arbitrary signals or their combinations.
- the frequency spectra of the correction signals of the generators are selected from the differentials of the main signals and/or low-cycle sinusoidal signals, damped sinusoidal signals, damped Sine signals, as well as from Gaussian monocycles and from other known and arbitrary spectra of low-cycle signals or their combinations.
- the UMI Bursts have pulse durations of 5.0-100.0 ns or less.
- the sequence of the UMI Bursts is incoherent.
- the sequence of the UMI Bursts is coherent.
- the converting of electrical impulses into ultra-wideband micro-mechanical impact bursts are performed by more than one UWB transducer, coupled to the UWB acoustically transparent protector.
- the UMI Burst stimulation of the treatment area and surrounding tissues is performed by a multielement UWB transducer that generates the micromechanical field, which converging, diverging or dynamically changing in space and/or time.
- the UMI Bursts are applied to the body surface through acoustically transparent and acoustically coupled to each other intermediate medium, such as UWB protector, and UWB contact layer or an extended UWB medium placed between the protector and the body surface.
- each other intermediate medium such as UWB protector, and UWB contact layer or an extended UWB medium placed between the protector and the body surface.
- the UMI Bursts are introduced into the treatment area through eye conjunctival surface.
- the impact can be interventional and comprise inserting the UMI Bursts into body entity openings, such as nasal cavity, oral cavity, esophagus, rectum, vagina.
- the UMI Bursts are used in regenerative treatment to treat diseases selected from the group, including at least a stroke, myocardial infarction, ischemia, spinal cord injury, Alzheimer’s and Parkinson’s diseases, diabetes, some types of cancers, atherosclerosis, varicose, post- traumatic and post-bum scars and wounds.
- the UMI Bursts are used in regenerative ophthalmology to reduce vision loss, including vision loss due to degradation of the optic nerve or glaucoma.
- treating UMI Bursts are used in regenerative cosmetology to treat diseases and pathologically altered skin selected from the group, including the signs of skin aging, reduction of scars, acne, wrinkles, post- traumatic and post-surgical seals, melasma, swelling, ptosis.
- UMI Burst treatment can be used in combination with ultra- wideband electromagnetic signals, including gigahertz ultra-wideband pulsed radio signals.
- Cellular regeneration is characteristic for the hematopoietic system, skin epithelium, mucous membranes, connective tissue and bones. Such regeneration occurs due to division and subsequent maturation and renewal of cells. There are two phases of cell regeneration - cell proliferation and differentiation.
- the combination of cellular and intracellular regeneration may occur during the restoration of the lungs, liver, kidneys, pancreas, endocrine glands, central nervous system.
- Intracellular regeneration - renewal and restoration of cells - may prevail in the processes in the myocardium, skeletal muscles and nervous cells.
- the extracellular matrix is renewed, as well as disseminated resident and accumulated pluripotent, and progenitor somatic stem cells are attracted to the treatment area.
- the stem cells delivered by the blood flow (Homing effect) is involved in the regeneration process.
- New cells necessary for regeneration are located in cell niches that are freed from old, diseased and infected cells due to apoptosis - genetically programmed and regulated death by their self-separation into parts that are detected and eliminated by the immune system.
- biochemical regeneration that is, the renewal of the molecular composition of all organs and tissues of the body.
- regenerative processes are the activity of stem cells of different degrees of differentiation, which in the process of regeneration go through the stages of proliferation, differentiation (maturation), reprogramming (obtaining stem cells from any somatic cells), direct reprogramming (dedifferentiation and transformation into a specialized cell without passing through stage of young stem cells) [95].
- differentiation maturation
- reprogramming obtaining stem cells from any somatic cells
- direct reprogramming dedifferentiation and transformation into a specialized cell without passing through stage of young stem cells
- the present invention may solve the problem of creating micromechanical impact signals capable of stimulating and enhancing regenerative processes at the tissue, cellular and intracellular levels, and a synergistic increase in the effectiveness of non-invasive regenerative therapy.
- Some embodiments of the present invention may be implemented into practice with an apparatus having at least one UWB signals generator and at least one UWB signals corrector, as well as one UWB transducer of electrical signals into micromechanical bursts.
- some embodiments of the present invention can be implemented by an apparatus having two or more UWB generators, as well as UWB signal correctors and UWB transducers.
- the main events that occur when mechanical forces interact with tissues and cells are mechanosensitivity, or the ability of cells and tissues to perceive mechanical forces, and mechanotransduction, or the ability of tissues and cells to convert external mechanical signals into biochemical ones in order to stimulate certain tissue and cellular functions that can change their architecture and properties.
- Each resonant system may transmit mechanical signals to higher levels of tissue and cellular organization for their conversion into biochemical ones, to activate certain gene programs and trigger cellular responses.
- tissue cells through intercellular interactions, which are regulated by special protein complexes, including epithelial cells, endothelial cells, and non-epithelial cells. Their combination coordinates wound healing, tissue remodeling, and morphogenetic development [20-28].
- the matrix consists mainly of collagen, elastin, laminin and fibronectin.
- Transmembrane proteins - integrins - transmit mechanical signals into and out of cells and bind the extracellular matrix to the intracellular matrix through their cytoplasmic domains and nanoscale layers, mechanically connecting the domains and the cytoskeleton.
- the main components of the intracellular matrix are vinculin, paxillin, talin and kinase.
- the cytoskeleton regulates the propagation of mechanical signals within the cell. It is a dynamic multi resonant structure composed of microfilaments, microtubules and intermediate filaments. Through the cytoskeleton, mechanical signals affect many of the basic and specialized functions of cells. From the cytoskeletal fibers, mechanical signals collected by integrins are transmitted to the nuclear nucleoskeleton, causing changes in its structure and spatial organization.
- the structure of the nucleoskeleton is the main regulator of biochemical and physical connections between the nucleus and the cytoskeleton, through which the regulation of gene geometry and gene expression is carried out.
- the so-called LINC complex there are also other multi-resonance structures that connect the nuclear membrane to the cytoskeleton (the so-called LINC complex). Mechanical signals propagating through the LINC complex cause conformal changes in nuclear proteins and directly affect the structure of chromatin and the reprogramming of gene expression.
- LIPUS single-frequency or narrow-band mechanical/ultrasound signals
- Ultra- wideband low-intensity micromechanical perturbations of the elastic medium may be closer to the multi-resonant plurioscillations of cell and tissue structures and are proposed in some embodiments of the present invention for use in regenerative therapy.
- Narrowband and ultra- wideband signals differ significantly not only in the frequency band, but also in some other characteristics, for example, information capacity, noise immunity and energy loss (attenuation) during propagation in media.
- V F • T • D
- Bio tissues are complex structures, within which, when mechanical bursts propagate, there are absorption, scattering on various objects, reflection and re-reflection from internal boundaries and structures, interference of direct and reflected bursts.
- UMI Bursts One of the significant potential advantages of UMI Bursts is the absence of interference of directly propagating signals with their reflections from internal tissue structures.
- a short UMI Burst arrives at the structures of biological tissues in the minimum time, providing the necessary effect, and then leaves the area of influence. Many reflected signals, which are delayed in different ways in time, create some random noise weak signal lagging behind the curative. Thus, the short duration of treating bursts protects them from interference distortions.
- ultra-wideband ultrasonic low cycle short pulses can propagate in biological tissues with attenuation less than narrowband ones.
- FIG. 10 illustrates the method of ultra-wideband micromechanical impact Burst regenerative treatment (UMI Burst treatment), which is implemented using the device 10.
- the device contains an ultra- wideband main generator 12 and a corrective generator 13, which generate electrical frequency spectrum complementary to spectrum of main generator 12, that together satisfy the value of the (broad band rate) of 0.2 ⁇ q ⁇ 0.992 and the corresponding frequency band 1 - 250 MHz.
- Ultra- wideband signals can have one ultra-wide frequency range formed by generators 12 and 13 or at least two ultra-wide frequency ranges, formed by at least the second main generator 14 and the corrective generator 15.
- the outputs of generators 12 and 13, as well as generators 14 and 15, are connected to the inputs of ultra-wideband spectrum corrector 16.
- the coordinated operation of generators 12 - 15 by controller 18 is controlled, which also performs the functions of a programmer and interface.
- the corrector performs band-pass filtering of signals in each frequency range, normalization of their amplitudes and synchronous summation in order to obtain at the output frequency spectra with specified characteristics.
- the output of the spectrum corrector to the input of ultra- wideband amplifier 20 is connected, and the signals from which are fed to ultra-wideband head 21.
- Head 21 contains ultra-wideband transducer 22 of electrical pulses into detached bursts of low-intensity micromechanical energy that is ultra-wideband micromechanical impact bursts - UMI Bursts.
- Transducer 22 is equipped with rear 23 and front 24 electrodes connected to amplifier 20.
- UMI Bursts through ultra-wideband protector 26 of head 21 and, through the conductive UMI Bursts coupling medium, are delivered to the surface of body 28, and then non-invasively injected into treatment area 30 and adjacent tissues 31.
- controller 18 and functional blocks 12-15,16, 20, 21-26 of device 10 select the parameters of UMI Bursts and select the shape of the burst emission field of any shape, suitable to the geometrical form of the treatment area, for example, divergent, collinear, converging or a dynamically changing.
- UMI Bursts The energy of UMI Bursts is transmitted to a variety of mechano-sensitive resonant tissue structures, including cellular ensembles 31, extracellular matrix 33, somatic cells 34, progenitor cells 36, pluripotent cells 38, and cell nuclei 40.
- the UMI Bursts may stimulate and reinforce regenerative processes at various levels of mechano-sensitive tissue structures, including:
- UMI Bursts promotes accumulation of pluripotent and progenitor stem cells in and around treatment area by multi-day repetitions of UMI Bursts, thereby increasing the effectiveness of treatment.
- the electrical ultra- wideband frequency spectra of at least main generators 12 and 14 and - corresponding to the above electrical signals shapes of frequency spectra are selected from: shock signals, stress signals, as well as from the frequency spectra of rectangular, triangular, trapezoidal signals or their differentials, and / or from the spectra of arbitrary signals or their combinations.
- the electrical ultra-wideband frequency spectra of corrective signals at least of generators 13 and 15 are selected from the differentials of the signals of main generators 12 and 14, as well as from damped sinusoidal signals, damped Sine signals and from Gaussian monocycles and from all possible spectra of low-cycle signals.
- the treating UMI bursts are formed in one ultra- wide frequency range at least from the main and corrective signal, for example, for q>0.2, or are formed from several ultra-wideband frequency ranges, from several complementary signals, for example, for r
- 0.992.
- the intensity Isptaf of UMI bursts is selected from values within the range from 10’ 5 mW I cm 2 to 10 2 mW / cm 2, at a repetition rate of 0.05 - 5* 10 2 KHz.
- FIG. 11 shows an example of a complementary pair of spectra of treating signal.
- curve 42 after about 20 MHz, the amplitude of the frequency spectrum-decreases significantly with frequency.
- Corrective spectrum 46 FIG.l 1-c) is selected in the form of an exponentially damped sinusoid 48 (FIG.l l-d). Its frequency spectra increase with frequency after 20 MHz.
- FIG.l 1-e After spectrum corrector resulting spectrum 50 is shown in FIG.l 1-e. It has the necessary for UMI Bursts treatment frequency response.
- FIG. 11-f shows the complex shape of treatment time-domain pulse 52 after spectrum corrector 16.
- ultra-wideband micromechanical burst treatment which is implemented in device 10
- exposure to ultra-wideband micromechanical bursts may initiate and accelerate and intensify many processes that underlie the renewal and regeneration of cells and tissues, including:
- FIG. 12 shows a block diagram of an ultra-wideband experimental facilities based on the certified AIMS III Scanning System (ONDA Corporation, USA).
- the experimental facilities contain ultra-wideband generator 54 connected to ultra-wideband amplifier 56, the signal from which is fed to multimode ultra-wideband transducer 58.
- Calibrated needle hydrophone 60 and amplifier 62 from Precision Acoustic (UK) in the measurements were used.
- Experimental ultra- wideband transducer 58 emitted harmonic ultrasound at frequencies of 1.0, or 3.0 or 5.0 MHz (r
- FIG. 13 shows the changes in the intensity of ultrasound/micromechanical signals depending on the distance to transducer 58.
- the figure shows the curves: 70 - 1,0 MHz, 72 - 3,0 MHz, 74 - 5,0 MHz, 76 - stochastic noise having band 1,0 - 3,0 MHz, 78 - ultra- wideband UMI Burst with a frequency band of 1, 0-7,0 MHz.
- FIG. 14 shows the differences in the impact of ultra-wideband micromechanical bursts (UMI Bursts) with a frequency range of 1.0 - 7.0 MHz on the proliferation rate of normal mouse fibroblast cells, in comparison with exposure to ultrasound with frequencies of 1.0 MHz, 3.0 MHz and 7.0 MHz.
- UMI Bursts ultra-wideband micromechanical bursts
- the exposure time was 5 min daily for 5 days and beam-average intensity Isptaf of all signals was set at 30 mW / cm 2 , which was measured according to [106,107].
- Trypan blue dye was used (Hy Clone, USA).
- FIG. 15 shows the results of stimulation of cell bioactivity - blast transformation of T-lymphocytes - with LIPUS and UMI Burst exposures.
- the reaction of blast transformation of T-lymphocytes is an indicator of the of cellular immunity.
- the exposure time was 5 min daily for 5 days and beam-average intensity Isptaf of signals was set at 30 mW/cm 2 , which was measured according to [107].
- the intensity of UMI Bursts was set at 30 mW/cm 2 and 1.0 pW/cm 2 .
- the suspension of leukocytes with nutrient medium 199 (containing 200 ml of IU of penicillin and 100 IU of streptomycin in 1 ml) was diluted, so that 1 ml contained 1-2 mil of white blood cells, 20% autologous plasma and 80% of the nutrient medium.
- the prepared leukocyte suspension was poured into sterile 1 ml vials and there was passed some gas mixture containing 5% carbon dioxide. The vials were placed in a thermostat at 37 ° C for 5 days.
- FIG. 15 shows the results.
- BTLLIPUS 6.9 %.
- the UMI Bursts with an intensity of 30 mW I cm 2 increases the BTLUMT to 10.6 %, that is, almost one and a half times.
- UMI Bursts are an effective stimulator of the activity of immunocompetent cells.
- FIG. 16 compares wound healing in in control group of mice, that is, without exposure and, with ultrasonic LIPUS and micromechanical UMI Burst effects.
- mice - female BALB line were performed. Standardized linear wounds 17 mm long and 1.2 mm deep on their backs were inflicted.
- the animals were divided into 3 groups:
- Exposure was 5 minutes daily for 9 days until the wounds completely healed in one of the groups.
- a beam-average intensity of ultrasonic/micromechanical signals Ispta and Isptaf according to [107] were measured.
- the intensities of UMI bursts at 30 mW/cm 2 and 1.0 pW/cm 2 were set.
- the head for emitting LIPUS ultrasonic and ultra-wideband micromechanical UMI Bursts contained a multimode ultra-wideband transducer with a diameter of 20 mm. Ultrasonic oscillations and micromechanical bursts were delivered to the affected area on the back of the mouse through a layer of ultrasonic gel UBQ 5000 Ultragel.
- UMI Bursts may be more effective in promoting wound healing in compare with LIPUS.
- FIG. 17 shows a variant of the implementation of the UMI Burst method for reducing an old, rough, extensive scar on the face.
- the SigLent SDG 6052X DDS generator from SigLent Technologies Co was used.
- the head for emitting UMI Bursts contained a multimode ultra-wideband transducer with a diameter of 10 mm.
- the UMI Bursts to the scar and surrounding skin were delivered through a layer of ultrasonic gel UBQ 5000 Ultragel.
- the exposure was carried out daily for 9 days.
- the duration of each session was 10 min.
- FIG.17-a There is shown on the photo a pronounced scar with traces of surgical intervention before UMI Burst procedures.
- FIG.17-b there is a photo of the scar after 5 days of daily treatments.
- the traces of sutured wound are almost invisible.
- the depth of the scar has decreased significantly.
- FIG.17-c there is a photo of the scar after 9 days of applying UMI Bursts The scar has drastically decreased and become less noticeable. Its length by about 1 cm was also reduced.
- FIG. 18 shows a variant of the implementation of the UMI Burst method for drastic reduction of long-term dermal hyperpigmentation (dermal melasma) and reduction of deep forehead wrinkles on the face.
- a selected area of the skin with age-related changes with the UMI Bursts with a bandwidth of 1,0 - 7,0 MHz, with an intensity of Isptaf 30 mW/cm 2 and a repetition rate of 1 kHz were irradiated.
- the exposure was carried out daily for 40 days.
- the duration of each session was 10 minutes.
- the micromechanical transducer was moved slowly on the affected area.
- the head for emitting the UMI Bursts contained a multimode ultra-wideband transducer with a diameter of 10 mm.
- the UMI Bursts to the affected area through a layer of ultrasonic gel UBQ 5000 Ultragel were delivered.
- FIG. 19 the variant of the implementation of the UMI Burst method in cosmetology for correction of nasolabial folds is shown. Quantitative control of the size of creases by using Altera 3D apparatus was made. Testing subject R is a 49 years old woman.
- the UMI Burst exposure was used with a frequency band of 1,0 - 7,0 MHz, with an Isptaf intensity of 30 mW/cm 2 and a repetition rate of 1 kHz.
- the exposure daily for 14 days was performed.
- the duration of each session was 10 minutes.
- the micromechanical head was slowly moved on the affected area.
- the head for emitting the UMI Bursts contained a multimode ultra-wideband transducer having diameter of 10 mm.
- the UMI Bursts were delivered to the treatment area through a layer of ultrasonic gel UBQ 5000 Ultragel.
- FIG. 19 shows an example of the correction of the nasolabial folds of the woman R., age 59 years. Prior to the UMI Burst exposure, the crease volume measured by the Altera apparatus was 10.29 mm 3 .
- the volume of the crease decreased to 3.1 mm 3 , i.e., by 70%. No filling substances under the room were introduced.
- FIG. 20 Illustrates the implementation of the proposed method for restoring blood microcirculation in the area of the lower limb with varicose veins.
- the head for emitting of the UMI bursts contained a multimode ultra-wideband transducer with a diameter of 10 mm.
- the micromechanical bursts to the treatment area were delivered through a layer of ultrasonic gel UBQ 5000 Ultragel.
- FIG.20- a) and FIG.20- b) The appearance of the shin area with hematomas on the photographs of FIG .20- a) and FIG.20- b) before and after the UMI Burst treatment is shown. Note that by the time of treatment, hematomas were constantly present in the part of the limb shown in the photographs for more than 4 months, and were accompanied by microcirculatory disorders by periodic severe pain and night cramps of the calf muscles.
- ultra-wideband, micromechanical UMI burst regenerative treatment it is possible to treat skin diseases, injuries, degenerative and traumatic diseases of the musculoskeletal system and blood vessels circulation disorders. It is also possible to treat eye diseases, lesions of the heart to correct the state of the immune system, stimulate the defenses and general endurance, and on this basis, prevent premature aging.
- Embodiments of the invention can also be applied in field military and sports medicine, aesthetic medicine and cosmetology.
- Example 1 A method of ultra- wideband micromechanical modulating of cellular activity comprising: a) the generation of at least one pair of complementary electrical UWB signals, consisting of a main and correction signals with different distribution of frequency spectra, intended for at least one UWB frequency range of treating signals; b) the correction of UWB frequency spectra of the main signals in at least one frequency range by using bandpass filters as well as summation with the spectra of correcting signals, to obtain ultra-wideband electrical signals with constant, rising or arbitrary shape of the frequency spectrum; c) converting corrected UWB electrical signals by electromechanical transducer into Ultra- wideband Micromechanical Impact Bursts (UMI Bursts); d) delivery of impact UMI Bursts through an acoustically transparent UWB protector and a UWB coupling medium, which conduct UMI Bursts to the surface of object; e) non-invasive injection and delivery of impact UMI Bursts to the treatment area and adjacent to the treatment area of the biological tissues;
- Example 2 The method according to example 1, in which the first UMI Burst has a first frequency range with a first shape of frequency spectrum, which exerts stress on tissues and intercellular matrix of the treatment area, and wherein at least the second UMI Burst has at least a second frequency range with a second shape of frequency spectrum, that stimulates the processes of reprogramming, direct reprogramming, differentiation, proliferation and cell replacement in the treatment area of diseased or damaged cells with healthy ones.
- Example 3 The method according to example 2, wherein the first of said UMI Bursts is generated at least inside the first frequency range 1,0 - 10,0 MHz, with a frequency, space and time-averaged intensity in the treatment area of 1,0 - 300 ,0 mW/cm 2 .
- Example 4 The method according to example 3, wherein the first of said UMI Bursts has a repetition rate of 0.05 - 100,0 kHz.
- Example 5 The method according to example 3, wherein at least the second of said UMI Bursts is generated inside the second frequency range of 10,0 - 50,0 MHz, with an intensity averaged over frequency, space and time in the treatment area of 0.0001 - 30,0 mW/cm 2 .
- Example 6 The method according to example 5, in which at least the second of said UMI Bursts is repeated at a frequency of 0.05 - 10 3 kHz.
- Example 7 The method according to example 2, wherein, at least the third of several UMI Burst is formed inside the third frequency range of 50-250 MHz, and have a frequency, space and time averaged intensity of burst on the body surface of 0,0001- 100 MW/cm 2 and into the treatment area of 0.0001 - 30 mW/cm 2 .
- Example 8 The method according to example 7, wherein said at least the third UMI Burst has a repetition rate of 0.05 - 10 3 kHz.
- Example 9 The method according to example 1, in which the frequency spectra of the main signals of the generators are selected from shock signals, stress signals, as well as from the frequency spectra of rectangular, triangular, trapezoidal signals or their differentials, and/or from the frequency spectra of arbitrary signals, or their combinations.
- Example 10 The method according to example 1, in which the frequency spectra of the correction signals of the generators are selected from the differentials of the main signals, and/or from low-cycle sinusoidal signals, damped sinusoidal signals, damped Sine signals, as well as from Gaussian monocycles, and from other known and arbitrary spectra of low-cycle signals or their combinations.
- Example 11 The method according to example 1, in which UMI Burst has a pulses duration of 5.0 - 100.0 ns.
- Example 12 The method according to example 1, wherein the sequence of UMI Bursts is incoherent.
- Example 13 The method according to example 1, wherein the sequence of UMI Bursts is coherent.
- Example 14 The method according to example 1, in which the transducing of electrical impulses into UMI Bursts perform by more than one UWB transducer, acoustically coupled to the UWB acoustically transparent protector.
- Example 15 The method according to example 14, wherein the UMI Burst stimulation of the treatment area and surrounding tissues is performed by a multi-element UWB transducer that generates the UMI Burst field, converging, diverging or dynamically changing in space and time.
- Example 16 The method according to example 1, wherein said UMI Bursts are applied to the body surface through acoustically transparent and acoustically coupled to each other intermediate medium, such as UWB protector, and UWB contact layer or an extended UWB medium placed between the protector and object’s surface.
- each other intermediate medium such as UWB protector, and UWB contact layer or an extended UWB medium placed between the protector and object’s surface.
- Example 17 The method according of examples 1 - 16, wherein parameters of the spectra of impact UMI Bursts, as well as the treatment procedure, control remotely, including photo and video recording of the procedure, its Internet transmission and documentation.
- Example 18 The method according of examples 1 - 16, wherein said UMI Bursts are introduced into the treatment area through eye conjunctival surface.
- Example 19 The method according of examples 1 - 16, wherein the treatment can be interventional and comprise inserting the impact UMI Bursts into body entity openings, such as nasal cavity, oral cavity, esophagus, rectum, vagina.
- Example 20 The method according of examples 1 - 16, wherein said UMI Bursts are used in regenerative treatment to treat disease is selected from a group, including at least a stroke, myocardial infarction, ischemia, spinal cord injury, Alzheimer’s and Parkinson’s diseases, diabetes, some types of cancers, atherosclerosis, varicose, burns, post-traumatic and post-burn scars and wounds.
- Example 21 The method according of examples 1 - 16, in which the UMI Bursts are used in regenerative ophthalmology to reduce vision loss, including, at least vision loss due to degradation of the optic nerve including glaucoma.
- Example 22 The method according of examples 1 - 16, wherein said UMI Bursts are used in regenerative cosmetology to treat diseases and pathologically altered skin selected from the group, including the signs of skin aging, reduction of scars, acne, wrinkles, post-traumatic and post-surgical seals, melasma, swelling, ptosis.
- Example 23 The method according to example 1, additionally including the use of the UMI Bursts in combination with UWB radio frequency pulse signals of the gigahertz frequency range.
- the present invention for example per the instant section, in some embodiments, relates to medicine, particularly to non-invasive regenerative therapy, and more specifically, to devices and methods of their operation for the restoration of diseased or damaged tissues of the human body by ultra-wideband micromechanical spectral burst action on biological tissues and cells in order to enhance and accelerate the processes of their regeneration and repair.
- tissue and cellular activity including mechanosensitive structures of tissues and cells, including cellular ensembles, extracellular, intracellular, intranuclear matrices, blood vessels, blood cells, cells of nervous system , cells of the immune system, specialized somatic cells, stem cells, biochemical factors accompanying cellular activity, cell nuclei and DNA.
- Regenerative therapy considers means and methods of treatment, including cellular technologies, that promote regeneration or the formation of new tissues in damaged or pathologically altered tissues and organs.
- Regenerative restoration of tissue structure occurs at different levels of their organization - molecular, intracellular, cellular, tissue, organ. Recovery is carried out using cellular or intracellular hyperplastic processes.
- Organs and tissues in which the cellular form of regeneration predominates include bones, skin epithelium, mucous membranes, hematopoietic and loose connective tissue, etc.
- Cellular and intracellular forms of regeneration are observed in glandular organs (liver, pancreas, endocrine system), lungs, smooth muscles, autonomic nervous system.
- the organs and tissues where the intracellular form of regeneration predominates include the myocardium. In the central nervous system, this may be the only form of regeneration.
- Physiological regeneration is the restoration of cell and tissue elements after their natural death.
- the mechanisms of physiological regeneration in different tissues of the body are somewhat different, therefore, several groups are distinguished on this basis:
- tissue which combines cellular and intracellular regeneration - this group includes the epithelium of the liver, kidneys, lungs and endocrine glands, smooth muscle tissue. These tissues also contain stem cells, but they normally do not divide as often as in group I.
- - Ill group of tissues is characterized only by an intracellular form of physiological regeneration: striated tissue of the cardiac type, nervous tissue, epithelium of the pancreas and salivary glands.
- tissues of group III stem cells are practically absent; therefore, physiological regeneration proceeds by constant renewal of the organelles of mature cells.
- the fabrics of this group are sometimes called "eternal fabrics”. All 4 types of biological tissues of the body can regenerate - connective, epithelial, muscle and nervous.
- Reparative regeneration consists of two phases - proliferation and differentiation.
- the first phase is the reproduction of young undifferentiated stem cells. Each tissue is characterized by its own stem cells, which differ in the degree of proliferative activity and specialization.
- the second phase is differentiation: young stem cells mature, their structural and functional specialization takes place, and they compensate for the loss of highly differentiated cells.
- the same change of hyperplasia of ultrastructures by their differentiation underlies the mechanism of intracellular regeneration.
- the source of regeneration can be highly differentiated cells of the organ, which, under the conditions of a pathological process or external influence, can transform into stem cells, acquiring the ability for mitotic division with subsequent differentiation.
- regenerative histogenesis for example, cell reproduction or hyperplasia of intracellular structures
- the main role in regeneration processes belongs to the mitotic division, primarily of stem cells, including stem cells attracted to the pathology zone (Home effect).
- Regeneration histogenesis of growing tissues occurs both in the processes of cell proliferation and intracellular increase in structural components (organelles).
- the regeneration process includes a complex of interstitial and intercellular interactions of structures. Intercellular and intracellular matrices are formed. There are processes of interaction between the epithelium, connective and nervous tissues. To a large extent, the outcome of the recovery process is determined by inflammatory growths of the connective tissue. All regenerative processes take place in the interaction of the nervous, endocrine, vascular, immune systems with new tissues being formed. A system of blood supply and innervation of tissues is being created. Definitions
- Re generative therapy - restoration of diseased or damaged tissues and human organs - using pluripotent, multipotent and progenitor stem cells, activated, transplanted or transformed [ 1 ] ;
- Regenerative cosmetology a technology for rejuvenating (revitalizing) aging skin by activation or transplantation of stem cells and induced transformation of somatic cells into stem cells [2] ;
- Micro-energy regenerative therapy the impact in the treatment area of signals with a maximum peak energy less than 0.1 mJ / mm 2 , and a spatial-peak temporal average intensity of less than hundreds of microwatts per square millimeter [3].
- “Induced stem cells” pluripotent multipotent and progenitor stem cells obtained from somatic cells by epigenetic reprogramming
- Ultra-wideband Micro-mechanical Spectral Burst moving in medium detached ultra- wideband micro-mechanical spectral disturbance of the medium, which differs in spectral and spatial characteristics from narrowband and wideband ultrasound;
- Oscillatory modes of an electromechanical transduced’ - a set of natural or forced vibrations of a transducer which different by physical characteristics, for example: resonance modes - radial R, edge E, angular A, volume V, as well as planar ultra-wideband P - mode vibration of the surface layer of the transducer;
- Ispta - narrowband signal intensity - spatial-peak temporal-average intensity of narrowband signal or the sum of narrowband signals, averaged over the cross section of the ultrasonic beam, impulse rate and over time.
- Isptaf intensity of wideband and ultra-wideband signals in particular, ultra- wideband micro-mechanical spectral bursts (UMB)" - the spatial-peak temporalaverage intensity averaged over cross-section of the burst radiating beam, as well as over time, impulse rate and over burst spectrum.
- UMB ultra- wideband micro-mechanical spectral bursts
- Totipotent (omnipotent) stem cells which can originate a full-value viable organisms by differentiation up to formation of all embryonic and adnexa tissues in the form of three-dimensional mutually-connected structures (such stem cells include a zygote and several its descendants obtained during some first cycles of cell-division);
- Pluripotent stem cells which are direct or remote descendants of the totipotent cells, can originate almost all tissues and organs (with the exception of extra-embryonic tissues, e.g., placenta);
- Multipotent stem cells which are able to differentiate into some types of cells having near properties (e.g., lymphoid and myeloid cells that take part in hematogenesis); and
- Unipotent stem cells in other word precursor cells, blast cells
- blast cells which are specialized in repeated production of single-type cells-descendants (e.g., erythrogonium and some myelosatellitocytes that participate in formation of skeletal and muscular tissues).
- Multipotent and unipotent stem cells designate quite often by common generic term ‘progenitor cells' .
- the cell therapy was used only as alternative of bone marrow transplantation.
- injection of native liver cells of a human embryo having gestational age seven weeks had allowed at firstly restoration of hemopoiesis for woman suffering from aplastic anemia [12].
- J. I. Touraine had revealed possibility of the cell therapy in cases of serious combined immunodeficiencies that are caused by genetic defects. It was appeared that injections of genetically healthy pools of fetal hematopoietic stem cells into child organism (especially in case of early interference right up to antenatal period) allows compensating such immunodeficiencies [14].
- autologous pluripotent stem cells are successfully used for treatment of more than 100 diseases, for some of which the cell therapy is sole effective method.
- injections of stem cells serve more often as important addition to surgical treatment or to pharmacological therapy. Accordingly, demand on stem cells grows in leaps and bounds. It can seem that this demand can be satisfied by extracorporal reprogramming of mature somatic cells into so called induced pluripotent stem cells (further iPSC).
- That biological tissues can consider as media, in which interdependent cells can generate and perceive at the same time electrical, chemical and signals in the form of compression - distension (and, in other words, living cells can interchange information at mechanical level and perceive external force signals);
- That mechanical impact can invoke rapid mitosis of at least epithelial cells
- Those nuclei of living somatic cells are biological analogs of strain sensors
- That low-powered force signals have an influence on processes within cytoplasms and cells’ nuclei and, respectively, can enhance stem cells proliferation;
- That such force signals are able to reprogram mature specialized somatic cells at least into progenitor stem cells.
- LIPUS Low Intensity Pulsed Ultra Sound
- this LIPUS is amplitude-modulated narrowband ultrasound having average intensity up to 200 mW/cm 2 or even 1000 mW/cm 2 (but more often about 30 mW/cm 2 ), fixed frequency (usually 1.5 MHz and rarer up to 10 MHz), and duty cycle 0.2 [23-27].
- LIPUS Intensity of ultrasound 30 mW/cm 2 is considerably less than value allowed for medical purposes. Therefore, such LIPUS is not expected to cause injury to an organism even during long exposure, but shows local therapeutic or cosmetic action.
- the clinical use of LIPUS signals for the treatment of wounds and bone fractures is authorized by Food and Drug Administration (USA).
- a fundamentally important advantage of low-intensity ultrasound therapy is that the process of cell treatment involves one's own, and not transplanted foreign or chemically reprogrammed stem cells containing foreign reprogramming factors in genes. Therefore, mechanisms of tumor development are excluded due to the negative influence of foreign structures on the fate of cells (and the body). There is also no immune response to the rejection of the "alien" due to the fact that their own stem cells are activated.
- LIPUS Despite the attractiveness of LIPUS as a unique therapeutic factor, and for more than 30 years of research, so far it has been used to a limited extent, for example, to accelerate the healing of bones and soft tissues, as well as to accelerate the implantation of implants.
- the main reason for the limited use of LIPUS is the low efficiency of diseases treatment.
- Each impulse includes from 1 to 50,000 acoustic cycles, repeating with frequencies from 0.001 to 100 kHz, that is, it is emitted in the form of a comb spectrum.
- W. Tyler proposes a low-intensity ultrasound therapy using one modulated harmonic signal or using multiple harmonic signals or using multiple comb signals, or combinations thereof.
- the finite set of harmonic W. Tyler signals is generally narrowband, and, therefore, fractional bandwidth q ⁇ 0,2.
- a physical reason for the low clinical effectiveness of LIPUS may be the discrepancy between the parameters of narrow-band ultrasound signals intended to affect cells and cell genomes and those signals that are similar to the intrinsic micromechanical signals of cell nuclei, cells, cell ensembles and tissues.
- LIPUS Low clinical effectiveness
- Ultra- wideband medical devices began to be developed since 1981 by the the present inventor, A. Marchenko, after the creation by him and his team of broadband (later ultra- wideband) ultrasonic multimode transducers with a transducing efficiency comparable to mono frequency ones (Marchenko A. et al, [62-65]).
- the ultrasound therapeutic device includes a signal generator, one or more transducers, one or more sensors, and a controller.
- the generator generates one or more narrowband pulse signals with frequencies of 1-2.5 MHz. Signal intensity 30-100 mW/cm 2 .
- the signal generator is configured to generate a first ultrasonic signal having at least a first harmonic waveform segment and a second harmonic waveform segment of an ultrasonic waveform different from the first waveform segment.
- These low-intensity ultrasonic devices and methods of treating many diseases by changing cellular activity may be based on the use of one or many individual frequencies, which affect separate resonating structures of tissues and cells.
- Bio tissues, cells and intracellular structures - a that includes the generation of electrical and chemical signals, as well as the generation and receiving of mechanical signals.
- the intensity of such signals is very small, so we call them micromechanical. It was revealed that weak information signals by cells propagate among intense thermal micromechanical noise.
- Reliable reception and transmission of signals under such conditions may be possible only when encoding and subsequent decoding by cells of ultra-wideband signals.
- ultra-wideband systems that is, systems having a very large number of resonant frequencies of mechanical vibrations, may be able to have a conversion efficiency comparable to narrowband resonators [63-65].
- This is possible for multimode oscillatory systems, the modes of which overlap, and is implemented in many acoustic musical instruments (violin, guitar, piano).
- Reliable separation of wideband signals from noise may not require high quality factor (selectivity) of signal transmitters and receivers or their tuning to a specific frequencies, since the information signal is formed from a huge number of components inside the ultra-wide band.
- Transmission and reception in ultra-wide frequency bands are characteristic of biological tissues and cells that oscillate in highly damping and noisy media.
- tissue level tissues, blood vessels, blood, extracellular environment, cells of the immune system, nerve fibers, Characteristic dimensions of tissues - fractions - units of millimeters;
- Any living system consists of a spatially organized three-dimensional ensemble of cells, extra-and intra-cellular structures similar to each other, the spatial shape of which is maintained due to a three-dimensional framework of stretched threads of biomolecules, that is, “tensegrity” (tensional integrity) [75-76].
- tensegrity form extracellular, intracellular and intranuclear matrices. All living organisms use “tensegrity” to stabilize their form, as well as to detect and transmit micromechanical signals to multiple levels of the cellular hierarchy, including DNA. This is part of the structures that make it possible to generate, recognize and respond to mechanical forces.
- the generators of control signals may include the totality of all possible elastic (viscoelastic) structures of tissues and cells, which fluctuate in ultrawide bands at each of the possible levels of cellular organization, due to thermal vibrations of structures and elements.
- tissue structures oscillate with frequencies of 1-10 MHz, respectively, the dimensions of the “tensegrity” elements of tissues are units - fractions of millimeters.
- Cell membranes, their intracellular matrix and other elements of the micromechanical environment fluctuate in the frequency bands of 10-100 MHz and, accordingly, have characteristic dimensions of tenths - hundredths of millimeters.
- the intranuclear matrix and DNA strands have characteristic dimensions of the order of 1- 10 pm and resonant ultra- wide frequency bands in the frequency range of hundreds of MHz. It is clear that the frequency bands of the lowest level (a few megahertz) may also slightly affect the highest level of cellular activity, for example, gene expression and cell transformation, sequentially ascending to DNA along the transduction structures conducting ultra-wideband micromechanical oscillation spectra.
- each biological structure for example, a cell, constantly oscillates on a multitude of adjacent (merging) frequencies, that is, on ultrawide bands, and transmits this “oscillation symphony” to neighboring cells of the same (in the general case) that oscillate on the same ultra- wide bands.
- ultra-wideband micromechanical signals to the pathological site and surrounding healthy tissues, similar to those that are exchanged between cells and tissues.
- tissue, cellular, intracellular or intranuclear it may be necessary to select the correct ultra-wideband range (as shown above), or radiation in all ranges simultaneously.
- Such signals may provide additional micromechanical energy to all mechanosensitive levels of the tissue and cellular hierarchy, supplementing the energy of thermal vibrations. As a result, the reliability of the transmission of information signals within and between cells may increase.
- the number of cells simultaneously interacting with each other may also increase, that is, their coordination number and the number of ongoing processes per unit time may increase many times over.
- reparative and regenerative processes This is how natural reparative processes proceed normally.
- stem cells Due to micromechanical reprogramming, stem cells may multiply intensively, that is, proliferative processes may be induced. Due to the initiation of reprogramming some somatic cells may be transformed into progenitor and pluripotent stem cells. Deviant or diseased cells may undergo death on command - apoptosis. There is a cleansing of the pathology zone with its further filling with multiplied cells.
- the shells of cell nuclei and DNA molecules are not only mechanosensitive elements, but also sense space and environment.
- the nucleus in addition to its genetic functions, directly senses the physical environment of the cell and can control the movement of immunocompetent cells to the area of pathology.
- cell contractility may increase and the velocity of migration of lymphocytes and macrophages to the areas of regeneration and repair may increase and, consequently, the therapeutic effect may improve.
- ultra-wideband devices for UWB micromechanical action with spectral bursts of micro-energy having continuous constant, increasing or amplitude modulated power spectral density level is exerted on many levels of cellular, extracellular and intracellular organization of tissues and cells to enhance and accelerate the natural processes of repair and regeneration in them.
- the device contains at least one main generator of ultra-wideband (UWB) electrical spectrum, at least one generator of correcting UWB electrical spectrum, bandpass filters unit, UWB spectrum shape corrector, variable gain amplifier, UWB micromechanical transducer of electrical spectrum into micromechanical treating spectral bursts (UMB transducer), UWB protector, executive microcontroller, central processor unit and microprocessor for monitoring the presence of contact of the transducer with the patient's body.
- UWB ultra-wideband
- the at least one main generator of UWB electrical spectra is connected to the first input of the UWB spectrum shape corrector through a unit of bandpass filters.
- the at least one correcting generator of UWB electrical spectrum is connected through a unit of bandpass filters to the second input of the specified UWB spectrum shape corrector, and the output of this corrector is connected to the input of the UWB gain amplifier, and the output of the last is connected to the electrodes of the UMB transducer, acoustically attached to the UWB protector, in turn, acoustically connected through the contact medium to the surface of the patient's body.
- All these elements of the device are designed to form electrical spectra useful for the treatment using UWB, their subsequent conversion into UWB micromechanical spectral bursts, the shapes of the spectra of which may be different from those directed downwards, as well as to introduce these spectral bursts through the surface of the patient’s body into the treatment area and neighboring healthy tissues in order to influence all cellular structures with micromechanical UWB spectral bursts and cause their multiple own oscillations, thereby forming micromechanical therapeutic “images” identical to natural images that occur during the life of cells and tissues.
- the device also contains an executive microcontroller, central processing unit (CPU) and unit a microsignal monitoring of acoustical contact.
- the microcontroller is connected to the inputs of the main and corrective generators, and this controller is also a programmer and an indicator of the state of the claimed device, which in turn is controlled by the central processing unit (CPU).
- the mentioned UWB spectrum generators together with band-pass filters unit, the UWB spectrum shape corrector and the UMB transducer form treating UWB micromechanical spectral bursts having at least one continuous UWB frequency range inside the band of 1-250 MHz, which has spectrum shapes different from downward, while the mentioned band consist of one or more ultra-wideband spectral ranges, including 1-3, 3-10, 10-30, 30- 100, 100-250 MHz.
- the proposed device contains two or more UWB pulse generators, which, together with the band-pass filter unit, the UWB spectrum shape corrector and the UMB micromechanical spectral transducer, create therapeutic UWB micromechanical spectral bursts, forming a continuous band and this UWB band (spectrum) may consist of several UWB ranges.
- the executive microcontroller of the main, corrective and other generators also performs the functions of an indicator of the current state of this device and is connected to a detector of the presence and degree of acoustic contact between the UMB transducer and the patient's skin.
- the microsignal contact detector includes: a) a sensor for determining the parameters of the contact, formed by the front and lateral electrodes of the micromechanical volumetric UWB transducer and the sensing part of the transducer volume located between them; b) synchronous amplifier, c) hoarder of control signals, d) setter of values of parameters of signals of presence and degree of contact, e) signal processor of the contact detector.
- the executive microcontroller is connected to at least two UWB pulse signal generators main and correcting spectra, and to a narrowband low frequency LF pilot signal generator, to synchronous amplifier and to a contact signal microprocessor.
- the device contains a side electrode placed on the back surface of the UMB transducer, which is connected in series with the first input of the synchronous amplifier, the hoarder, the contact signal microprocessor, and with the second input of the executive microcontroller.
- the third output of the mentioned microcontroller is connected to the second input of the synchronous amplifier.
- the signal from the third output of the microcontroller is delayed relative to the signal of the first output by more than on 0.2 ps.
- the present device consists of a master part - a remote controller and an executive part - a mobile applicator for UWB non-invasive micromechanical spectral burst regenerative therapy with the electronics unit placed inside or outside the mobile applicator.
- the master part is CPU - central processing unit, connected to the executive microprocessor via Bluetooth, Wi-Fi or a radio module.
- CPU is an autonomous unit, performed as a mobile phone, tablet, mobile or desktop computer.
- the executive part also contains a Bluetooth or Wi-Fi or a radio module and a rechargeable power source with a charging microcontroller.
- the various amplitude distribution of the spectral power density and the shape of signals of spectrum of at least one main generator is selected from a variety of main spectra, including for example shock-wave, stress-wave, and from rectangular, triangular, trapezoidal form of spectra, or their differentials, or their combinations.
- the correcting spectra of at least one signal is selected from a variety of signals, for example, from the differentials of the main pulse signals, as well as low-cycle sinusoidal signal including, a Gaussian monocycle, a low-cycle sinusoid, a Sinus Cardinalis (Sine signal), or combinations thereof.
- the applicator is designed to introduce treating ultra-wideband micromechanical spectral bursts into the treatment area through the surface of the skin.
- the applicator may be designed to introduce ultra-wideband micromechanical bursts into conjunctival surface of the eye, as well as natural body entity openings, such as nasal cavity, oral cavity, esophagus, rectum, vagina.
- Another object of the invention is the method of operation of the device for UWB micromechanical regenerative spectral burst therapy.
- This method includes a series of successive steps. Firstly, it is generating at least one pair of complementary electrical UWB signals consisting of the main and corrective electrical signals with different amplitude distributions of the power spectral density, designed for at least one ultra- wideband frequency range of therapeutic signals within the band 1-250 MHz.
- the burst field is optionally configured so that in order to cause a variety of possible own micromechanical oscillations of cells and tissues, thus forming UWB micromechanical therapeutic "images" similar to natural images that arise in the process of life, that is, cause the radiation of own micromechanical therapeutic signals in the entire ultra-wide frequency range, for example 1-250 MHz.
- spectral micromechanical treatment responses in only one ultra- wide range or several ultra- wide ranges, for example: a) in the 1-5 MHz range - stimulation of regenerative processes in biological tissues, acceleration of growth of tissues, nerves and blood vessels, wound healing; b) in the 1- 10 MHz range - excitation of the activity of the extracellular matrix, increased apoptosis, increased local immunity, increased proliferative and migration processes and the activity of stem cells existing in tissues; c) in the 10-30 MHz range - stimulation of protein synthesis, stimulation of stem cell programming, direct reprogramming of progenitor cells, stem cell reproduction, a general increase in local cellular activity and repair processes; and d) in the 30-100 MHz range - an increase in the activity of processes caused by deformations of the nuclear membranes, processes of epigenetic reprogramming, gene expression, transformation of somatic cells into stem cells.
- UWB micromechanical spectral burst- stimulation or modulation of regenerative processes at various levels of the aforementioned mechanosensitive tissue structure, optionally including reprogramming of some somatic cells into multipotent, progenitor and pluripotent stem cells and, consequently, acceleration and enhancement of natural regenerative processes.
- UWB micromechanical spectral bursts there may be performed transfer of treating energy of UWB micromechanical spectral bursts to a variety of mechano-sensitive biological structures, including cellular ensembles, extracellular and intercellular matrices, blood vessels, blood cells, nervous system, immune and stem cells, cytokines, chemokines and other biologically active factors, cell nuclei and DNA.
- UWB micromechanical spectral burst-stimulation or modulation of regenerative processes at various levels of the aforementioned mechanosensitive tissue structure, including reprogramming of some somatic cells into multipotent, progenitor and pluripotent stem cells and, consequently, acceleration and enhancement of natural regenerative processes.
- At least one the first therapeutic UWB micromechanical spectral burst, formed by the first main and complementary to it first correcting spectrum has the first frequency range with the first shape of the spectrum, which may have a stressful effect on the tissues and on apoptosis processes in by changing the state of the extracellular matrix in the affected area and surrounding healthy tissues.
- the second therapeutic UWB micromechanical spectral burst formed by the second main and complementary second correcting spectra, has at least a second frequency range with a second shape of the spectrum.
- the proposed method stimulates in the somatic cells of the treatment area and surrounding healthy tissues the processes of reprogramming, direct reprogramming, differentiation, proliferation, tissue formation and replacement of diseased or damaged cells by healthy ones.
- the second treating UWB micro-mechanical spectral bursts are formed in frequency ranges of 10-30, 30-100 or 100-250 MHz, and have an intensity of spectral bursts averaged over the frequency of time and space on the body surface of 0,001-100 mW/cm 2 and in the treatment area of 0.0001-30 mW / cm 2 .
- first and second therapeutic UWB micromechanical spectral bursts form a common band of the therapeutic spectrum and are repeated during treatment in the frequency ranges 1-3, 3-10, 10-30 MHz with a frequency of 0.05 -1 kHz, and in the frequency ranges of 30-100, 100-250 MHz with a frequency of 0.05- 10 3 kHz.
- the UWB micromechanical spectral bursts, formed by this device may apply in regenerative medicine to treat diseases selected from the group, including: stroke, myocardial infarction, ischemia, spinal cord injury, degradation of the retina and optic nerve, glaucoma, diseases of the musculoskeletal system, diabetes, some types of cancer, atherosclerosis, varicose veins, post-traumatic, post-bum and postoperative wounds, rejuvenation of the skin and other structures of tissues and organs of the body.
- diseases selected from the group including: stroke, myocardial infarction, ischemia, spinal cord injury, degradation of the retina and optic nerve, glaucoma, diseases of the musculoskeletal system, diabetes, some types of cancer, atherosclerosis, varicose veins, post-traumatic, post-bum and postoperative wounds, rejuvenation of the skin and other structures of tissues and organs of the body.
- the treating ultra- wideband micro-mechanical spectral bursts, formed by the device may be applicable in regenerative cosmetology to treat diseases and pathological skin conditions including signs of skin aging, scars, acne, wrinkles, melasma, swelling, edema.
- the shapes of spectra of the main generators are selected from a variety of spectra, including shock wave, stress wave, as well as from the spectra of rectangular, triangular, trapezoidal pulses or combinations thereof.
- the shapes of the spectra of corrective generators are selected from a variety of main signals spectra and their differentials, as well as from a Gauss monocycle, a low-cycle sinusoid, a cardinal sinusoid (Sine signal), spectra of arbitrary waveforms, or combinations thereof.
- the sequence of therapeutic spectral bursts can be coherent, as well as incoherent.
- the transducing of electrical spectra into micromechanical treating spectral bursts is performed by more than one UMB transducer.
- An embodiment of the invention may be possible, in which the conversion of electrical spectra into micromechanical therapeutic spectral bursts is carried out by several ultra-wideband transducers, which are placed in a single housing, with the ability to move inside the latter in three planes (a system of “floating” transducers).
- the treating UWB micro-mechanical spectral bursts from the transducer to the surface of the body are fed to the body surface through acoustically transparent and acoustically coupled elements, such as ultra-wideband protector, acoustically transparent contact layer or an extended contact medium, placed between the protector and the body surface.
- acoustically transparent and acoustically coupled elements such as ultra-wideband protector, acoustically transparent contact layer or an extended contact medium, placed between the protector and the body surface.
- treating ultra-wideband micromechanical spectral bursts are introduced into the treatment area through the conjunctival surface of the eye, as well as directly into the orifices of the body, such as the nasal cavity, oral cavity, esophagus, rectum, vagina.
- the therapeutic impact on the pathological area and surrounding healthy tissues with ultra-wideband micromechanical spectral bursts is, for example, carried out daily for 5-40 minutes for 5 - 60 days.
- the ultra-wideband micromechanical devices 10 and 11 for regenerative spectral burst therapy may consist of three main units: (see FIG. 21 and FIG. 22):
- CPU central processor unit
- FIG. 21 is shown a general structural block diagram of stationary device 10 for ultra-wideband micromechanical regenerative spectral burst therapy.
- Electromechanical transducer unit 12 contains ultra-wideband transducer 28 or a set of piezoelectric transducers, which together provide operating frequency bands of micromechanical signals 1 - 10; 10 - 30; 30 - 100; 100 - 250 MHz or their combination.
- transmission/receiver (T/R) separator 30 is placed, which separates the signals of generators 18, 20 and signals to synchronous amplifier 32.
- CPU central processor unit
- Main signal generator 18 (see FIG. 21 and 22), which is located in the electronics unit, generates ultra-wideband spectra in a frequency band specified at - 6 dB.
- the signals from generator 18 are fed to the first input of band pass filter 22, which ensures the passage of the spectrum only in a given frequency band.
- At least one corrective signal generator 20 optionally generate spectrum to correct of the main generator spectrum.
- the pulses from the latter are fed to the second input of bandpass filter unit 22 and are limited in the required frequency band. From the first and second outputs of the bandpass filter unit, the filtered main and corrective ultra-wideband pulses are fed to the first and second inputs of spectrum corrector 24.
- the spectra from the UWB spectrum corrector output through T/R separator 30 are fed to UMI burst transducer 28.
- the latter converts the electrical spectra into UMB spectral bursts.
- Micromechanical spectral bursts from UMB transducer 28 through the gel contact layer come to the skin or other accessible areas of the patient's body and then reach the diseased or altered area and surrounding tissues.
- the micromechanical spectral beam can be configured to focus on a specific treatment area.
- the signals for contact control optionally have a much lower intensity than the treatment signals.
- the contact is determined by the microintensive circuit, in which the following is applied:
- contact detector 34 of coded microsignals which includes decoding and synchronous accumulation
- CPU central processing unit
- FIG. 22 shows a variant structural diagram of mobile device 11 for UMB spectral burst regenerative cosmetology. Due to the limited power of the rechargeable power supply in this device, it is advisable to use volumetric multimode UWB transducer 29 (see also FIG. 23 and FIG. 24). The electromechanical conversion factor of such transducers, if they are made of piezoelectric ceramics, is 6 times higher than the best polymer PVDF transducers. In device when using polymer UWB transducers, it is useful to install additional variable gain amplifier unit 26.
- the volumetric transducer is piezoceramic cone 29, on the front surface of which front electrode 44 is applied (see FIG. 3), and back electrode 46 is applied on the pointed back.
- the back part of transducer’s volume 48 is depolarized.
- the polarization is preserved.
- annular lateral electrode 52 is placed, which is used for supplying voltage from pilot signal generator 54 and excitation of one of the low-frequency oscillation modes of transducer 29, for example, the edge mode.
- the amplitude and decrement of the oscillation damping of the selected mode are sensitive to changes in the mechanical load when the acoustic contact changes.
- second ring side electrode 56 is placed, the electrical signals from which are fed to synchronous amplifier 32 of contact detector 34.
- Lateral electrodes 52 and side electrode 56 perform the functions of T/R separator 30.
- Volume 50 is a sensor 58 of contact (see FIG. 24).
- Micromechanical transducer 29 is fixed with back part 48 in case 60 (see. FIG. 3) by means of damper 62.
- the front surface of transducer 29 protected by UWB protector 64, which is transparent to UMB spectral bursts in the ultra-wide frequency band 1 - 250 MHz.
- contact pilot signal generator 44 was additionally used for the contact control circuit with volumetric UMB burst transducer 29.
- wireless data exchange unit 42 is additionally installed, which receives data from contact detector 34 and from which the data is transmitted to executive microcontroller 36.
- Remote central processor unit 16 communicates with unit 42 and controls the UMB spectral burst therapeutic device via Wi-Fi or Bluetooth.
- these UWB generators 18 and 20 form continuous UWB spectra and, together with bandpass filter unit 22 and UWB spectrum corrector 24 (see FIG. 2) and UMB transducer 28, create therapeutic micromechanical spectral bursts having continuous UWB frequency bands inside range 1-250 MHz.
- Each therapeutic UWB spectral band formed from one or more UWB bands including ranges 1-3, 3-10, 10-30, 30-100, 100-250 MHz.
- UMB transducer 28 is designed to introduce therapeutic ultra-wideband micromechanical spectral bursts into the treatment area through the conjunctival surface of the eye.
- UMB transducer 28 may be also designed to introduce ultra- wideband micromechanical spectral bursts into body entity openings, such as nasal cavity, oral cavity, esophagus, rectum, vagina.
- One of the preferred option of spectra and their corresponding time - domain waveforms of the UWB generators 18, 20 of the devices for UWB micromechanical regenerative spectral burst-therapy shown in FIG. 25 a) the main lobe of the shape of spectra of a rectangular video pulse. b) time - domain waveform a rectangular video pulse with a duration of 20 nanoseconds.
- the spectrum a) may be unsuitable for a medical device due to an unacceptably large change in the spectral amplitudes in the operating frequency band of 1-50 MHz.
- c) the increasing part of the spectrum of a four-cycle sinusoid with a frequency of 55 MHz is given. The descending part of the spectrum with frequencies above 50 MHz is limited by the bandpass filter and is not shown in the figure.
- e) is the result of summing the signals a) and c) by the spectrum corrector.
- the described device is applied as follows, in an exemplary embodiment of the invention.
- At least one pair of complementary electrical UWB spectra is generated, consisting of the main and corrective electrical signals.
- This pair of signals is intended for at least one ultra-wideband frequency range of treatment spectral burst
- the frequency bands of the main and corrective spectra are limited using bandpass filters unit 22 and the UWB spectra of the main and corrective electrical signals are corrected in at least one frequency range using the UWB corrector 24 of the signal spectrum shapes by summing them to obtain UWB bursts with a given spectrum shape.
- the obtained UWB electrical spectra are converted into therapeutic UWB micromechanical spectral bursts. These bursts are delivered through an acoustically transparent UWB transducer 28 and a UWB conductive medium to the surface of the body. Then, non-invasive introduction and delivery of UWB micromechanical spectral bursts to the treatment area and surrounding tissues adjacent to the mentioned area is carried out. In this case, there may be an energy transfer of therapeutic UWB micromechanical spectral bursts to a variety of mechanosensitive tissue structures, including cellular ensembles, intercellular matrix, cells and cell nuclei.
- This process may be accompanied by UWB micromechanical spectral burst- stimulation of regenerative processes at various levels of resonant mechanosensitive tissue structures, including reprogramming of some somatic cells into multipotent and pluripotent stem cells and, consequently, acceleration and enhancement of natural regenerative processes.
- UWB micromechanical spectral burst- stimulation of the processes of no accumulation of stem multipotent and pluripotent cells inside and around the treatment area may be carried out by repeating therapeutic micromechanical bursts for many days .
- the first therapeutic UWB micromechanical spectral burst formed by the first main and complementary to it first corrective spectra, has the first frequency band, which may have a stressful effect on the tissues and the extracellular matrix of the treatment area.
- the second therapeutic UWB micromechanical spectral burst formed by the second main and complementary second corrective spectrum, has at least a second frequency band.
- the proposed method may stimulate in the somatic cells of the treatment area processes of reprogramming, direct reprogramming, differentiation, proliferation, tissue formation and replacement of diseased or damaged cells with healthy cells.
- the first treating UWB micro-mechanical spectral bursts may be formed at least in the first frequency ranges 1-3, 3-10 MHz and have a frequency, space and time averaged intensity of bursts in the region treatment of 1-30 mW / cm 2 .
- the second treating UWB micro-mechanical spectral bursts may be formed in frequency ranges of 10-30, 30-100, 100-250 MHz, with a frequency, space and time averaged intensity of spectral bursts on the body surface of 0,001-100 MBT/CM 2 and in the treatment area of 0.0001-30 mW / cm 2 .
- the treating UWB micromechanical spectral bursts in the frequency ranges 1-3, 3-10, 10-30 MHz may repeat during the treatment with a frequency of 0.05- 1 KHz, and in the frequency ranges 30-100, 100-250 MHz may be repeated at a frequency of 0.05- 10 3 kHz.
- the UWB micro-mechanical spectral bursts, formed by proposed device may be used in regenerative medicine to treat diseases selected from the group, including: stroke, myocardial infarction, ischemia, spinal cord injury, degradation of the retina and optic nerve, glaucoma, diseases of the musculoskeletal system , diabetes, some types of cancer, atherosclerosis, varicose veins, post-traumatic, post-burn and postoperative wounds, rejuvenation of the skin and other structures of tissues and organs of the body.
- diseases selected from the group including: stroke, myocardial infarction, ischemia, spinal cord injury, degradation of the retina and optic nerve, glaucoma, diseases of the musculoskeletal system , diabetes, some types of cancer, atherosclerosis, varicose veins, post-traumatic, post-burn and postoperative wounds, rejuvenation of the skin and other structures of tissues and organs of the body.
- the treating ultra-wideband micro-mechanical spectral bursts, formed by the device may be used in regenerative cosmetology to treat diseases and skin conditions including signs of skin aging, scars, acne, wrinkles, melasma, swelling, edema.
- shapes of spectra of the generators are selected from a variety of signals (see FIG. 25), including for example shock-wave , stress- wave, and also from: rectangular, triangular, trapezoidal pulses, combinations, and the shapes of the spectra of corrective generators are selected for example from a variety of main spectra and their differentials, as well as from a Gauss monocycle, a low-cycle sinusoid, a cardinal sinusoid (Sine signal), non-periodic arbitrary waveforms, or combinations thereof.
- sequence of therapeutic spectral bursts can be coherent, as well as incoherent.
- the transducing of electrical spectra into micro-mechanical treating spectral bursts can be performed by more than one UWB transducers, acoustically coupled to the ultra-wideband acoustically transparent protector.
- the treating UWB micro-mechanical spectral bursts from transducer 29 are applied to the body surface through acoustically transparent and acoustically coupled to each other elements, such as thin ultra-wideband protector 64, a thin contact layer or an extended medium, for example water, placed between the protector and the body surface.
- the ultra-wideband electrical spectra arriving at transducer 29 (see FIGS. 23 and 24) excite the oscillations of thin piezoelectric layer of this transducer 29 adjacent to front electrode 44 on its radiating front surface.
- Micromechanical planar P-mode spectral bursts are input a protective ultra-wideband protector 64. Some shape of spectra of treatment spectral bursts are shown in FIG. 25.
- the micromechanical spectral bursts introduced into/through the patient's skin through an ultrasound gel such as UltraGel manufactured by many companies.
- FIG. 26 shows a comparison of the hypothetical spectra of natural oscillations of bioconstructions of biological tissue with the energy spectra of known pulses of ultrasonic medical devices and with the energy spectra of the proposed ultra- wideband micromechanical spectral devices.
- Broadband ultrasound signals are known in diagnostics, but their intensity is thousands of times greater than UMI Burst and LIPUS.
- W. Tylor in his patents [49, 50, 68, 71, 72, 77] suggests using known standard pulses, arbitrary waveform pulses, or combinations thereof for treatment. At the same time, the text of these patents always refers to the treatment with ultrasound of a certain frequency or group of frequencies. Therefore, we perceive the signals proposed by W. Tylor as a sequence of repetitive pulses, in which, due to coherence, the frequencies necessary for treatment or their sets in the form of line spectra or comb spectra are formed. Such spectra are not broadband, but narrowband.
- a single pulse of any shape has a power spectral density decreasing with frequency, sometimes, as for a cardinal sinusoid, falling very sharply.
- the pulse energy is always concentrated in the low-frequency part of the energy spectrum.
- it may be useful to transfer energy to biostructures in the across ultra-wideband frequency spectrum, within the range of 1-250 MHz.
- the energy spectrum of one basic, main known impulse may usefully be supplemented with the spectra of other impulses, which may be located on different parts of the spectral axis.
- the spectra of impulses may be united in amplitude and frequency, which means that before combining the pulse spectra, it may be useful to limit their frequency bands (that is, apply bandpass filtering) and select the amplitude characteristics of the spectral power densities of the spectra that complement the main spectrum to the desired one.
- ultra-wideband energy spectra with a distribution of spectral power densities that we have specified, which are configured to transfer ultra-wideband spectral energy to mechanosensitive elements of the biostructures.
- ultra-wideband continuous spectra with constant or increasing or arbitrary amplitudes of spectral power densities along the frequency axis.
- the therapeutic ultra-wideband micromechanical spectral bursts obtained by us and described above, are further used as follows.
- the treating ultra-wideband micro-mechanical spectral bursts are introduced into the treatment area through the conjunctival surface of the eye, as well as directly into the orifices of the body, such as the nasal cavity, oral cavity, esophagus, rectum, vagina.
- the impact on the treatment area with ultra- wideband micromechanical spectral bursts is carried out daily for 5-20 minutes for 5 - 60 days.
- bio tissues, cell ensembles, intercellular matrix, cells, cytoskeletons, microtubule system, filaments, nuclei and DNA are band oscillatory systems. Impact on the body ultra-wideband micromechanical spectral burst allows it to receive additional energy, which improves and enhances information exchange at various levels of cellular organization, increases the number (volume) of healthy cells involved in the process of influencing the sick and, thus, up to 3 times enhances and accelerates during treatment many of the natural indicators of regeneration and repair.
- An exemplary embodiment of the invention can be applied for the treatment of traumatic and degenerative pathological changes in organs and tissues, cardiovascular, endocrine and skin diseases, as well as pathologies of the musculoskeletal system and other diseases.
- the application of an exemplary embedment of the invention is promising for reducing hypoxic lesions of the heart and brain, restoring the immune system by stimulating the protective forces and general endurance, as well as for preventing premature aging.
- An exemplary embodiment of the invention can also be applied in military and sports medicine, aesthetic medicine and cosmetology.
- Example 1 A device for ultra-wideband (UWB) micromechanical regenerative spectral burst therapy, containing at least one main generator of UWB main electrical spectra, at least one correcting generator of UWB correcting electrical spectra, delayed along the frequency axis relative to the main spectra, and complementary to the main spectra, the band-pass filters unit, that serves to select the spectral bands of the main and corrective spectra, UWB spectrum shape corrector, UWB variable gain amplifier, ultra- wideband transducer of the electric spectrum into the micromechanical spectral bursts (UMB transducer), UWB protector and executive microcontroller, central processor unit and microprocessor for monitoring the presence of contact of the transducer with the patient's body, in which: a) at least one main generator of UWB main electrical spectra connected to the first input of the ultra-wideband spectrum shape corrector through the bandpass filter’s unit; b) at least one correcting generator of UWB correcting electrical spectra connected
- Example 2 The device according to example 1, in which the mentioned UWB spectrum generators together with band-pass filter unit and the UWB spectrum shape corrector and the UMB transducer form therapeutic UWB micromechanical spectral bursts with spectra within the frequency band of 1-250 MHz, which has spectrum shapes different from downward, while the mentioned band consist of one or more ultra-wideband spectral ranges, including 1-3, 3-10, 10-30, 30-100, 100-250 MHz.
- Example 3 The device according to example 2, which contains more than two generators of UWB spectra, which, together with band-pass filter unit the UWB spectrum shape corrector and the ultra-wideband micromechanical spectral burst transducer create UWB micromechanical spectral bursts, forming a continuous spectral band, and this UWB band (spectrum) may consist of several UWB ranges.
- Example 4 The device according to example 1, in which the said executive microcontroller also performs the functions of an indicator of the current state of this device and is connected to a detector of the presence and degree of acoustic contact between the said UMB transducer and the patient's skin, which in its queue contains:
- a sensor for determining the parameters of the contact formed by the frontal and lateral electrodes of the micromechanical volumetric UMB transducer and the sensing part of the UMB transducer volume located between the electrodes,
- Example 5 The device according to example 4, wherein said executive microcontroller is connected to at least two UWB spectrum generators of main and correcting spectra, and to a narrowband low frequency LF pilot signal generator, to synchronous amplifier, to hoarder and contact signal microprocessor.
- Example 6 The device according to example 1, which contains a side electrode placed on the back surface of the UMB transducer, which is connected in series with the first input of the synchronous amplifier, the said hoarder, the contact signal microprocessor, and with the second input of the executive microcontroller, and the third output of the mentioned microcontroller is connected to the second input of the synchronous amplifier, and the signal from the third output of the microcontroller is delayed relative to the signal of the first output by more than on 0.2 ps.
- Example 7 The device according to examples 1 - 6, which consists of a master part - a remote central processing unit and an executive part - a mobile applicator for non- invasive regenerative UWB micromechanical spectral burst therapy with the electronics unit placed inside or outside the mobile applicator, moreover, the master part is CPU - central processing unit, connected to the executive microprocessor via Bluetooth, Wi-Fi or a radio module, and is an autonomous unit, performed as a mobile phone, tablet, mobile or desktop computer, and the executive part also contains a Bluetooth or Wi-Fi or a radio module and a rechargeable power source -with a charging microcontroller.
- the master part is CPU - central processing unit, connected to the executive microprocessor via Bluetooth, Wi-Fi or a radio module, and is an autonomous unit, performed as a mobile phone, tablet, mobile or desktop computer, and the executive part also contains a Bluetooth or Wi-Fi or a radio module and a rechargeable power source -with a charging microcontroller.
- Example 8 The device according to example 1, in which the amplitude distribution of the spectral power density of spectrum of at least one main generator is selected from a variety of main signals, including shock-wave, stress-wave, and from rectangular, triangular, trapezoidal form of bursts or their differentials, or their combinations, and the various amplitude distribution of spectral power density of at least one correcting signal is selected from a variety of signals, namely, from the differentials of the main pulse signals, as well as low-cycle sinusoidal signal including, a Gaussian monocycle, a low-cycle sinusoid, a Sinus Cardinalis (Sine signal), or combinations thereof.
- a Gaussian monocycle a Gaussian monocycle
- a low-cycle sinusoid a Sinus Cardinalis (Sine signal)
- Example 9 The device according to example 7, in which the applicator is designed to introduce treating ultra-wideband micromechanical spectral bursts into the treatment area through the conjunctival surface of the eye.
- Example 10 The device according example 7, wherein the applicator is designed to introduce ultra-wideband micromechanical spectral bursts into body entity openings, such as nasal cavity, oral cavity, esophagus, rectum, vagina.
- Example 11 A method of operation of the device for UWB regenerative micromechanical spectral burst-therapy, comprising:
- the corrective spectra are delayed along the frequency axis relative to the main ones, and the total spectra differ from the descending ones.
- burst field is configured so that:
- Example 12 The method according to example 11, according to which at least one the first therapeutic UWB micromechanical spectral burst, formed by the first main and complementary to it first correcting spectrum, has the first frequency range with the first form of the spectrum, which has a stressful effect on the tissues and on apoptosis processes in by changing the state of the extracellular matrix in the affected area and surrounding healthy tissues, and at least one the second therapeutic UWB micromechanical spectral burst, formed by the second main and additional second correcting spectra, has at least a second frequency range with the second form of the spectrum, and stimulates reprogramming and direct reprogramming processes in the affected area and surrounding healthy tissues , and differentiation, proliferation and replacement of diseased or damaged cells by healthy ones.
- Example 13 The method according to example 11, in which the first therapeutic UWB micromechanical spectral bursts formed in the first frequency range of 1-3, 3-10 MHz, and have in the treatment area an intensity averaged over frequency, space and time in the range of about 1-500 mW / cm 2 .
- Example 14 The method according to example 11, in which the second treating UWB micro-mechanical spectral bursts are formed in frequency ranges of 10-30, 30-100, 100- 250 MHz, and have an intensity of spectral bursts averaged over the frequency of time and space on the body surface of 0,001-100 mW/cm 2 and in the treatment area of 0.0001-30 mW / cm 2 .
- Example 15 The method according to example 11, in which a plurality of these first and second therapeutic UWB micromechanical spectral bursts form a common band of the therapeutic spectrum and are repeated during treatment in the frequency ranges 1- 3, 3-10, 10-30 MHz with a frequency of 0.05 -1 kHz, and in the frequency ranges of 30-100, 100-250 MHz with a frequency of 0.05- 10 3 kHz.
- Example 16 The method according to example 11, whereby the UWB micromechanical spectral bursts, formed by said device are used in regenerative medicine to treat diseases selected from the group, including: stroke, myocardial infarction, ischemia, spinal cord injury, degradation of the retina and optic nerve, glaucoma, diseases of the musculoskeletal system , diabetes, some types of cancer, atherosclerosis, varicose veins, post-traumatic, post-burn and postoperative wounds, rejuvenation of the skin and other structures of tissues and organs of the body.
- diseases selected from the group, including: stroke, myocardial infarction, ischemia, spinal cord injury, degradation of the retina and optic nerve, glaucoma, diseases of the musculoskeletal system , diabetes, some types of cancer, atherosclerosis, varicose veins, post-traumatic, post-burn and postoperative wounds, rejuvenation of the skin and other structures of tissues and organs of the body.
- Example 17 The method according to example 11, whereby the treating ultra-wideband micro-mechanical spectral bursts, formed by the device are used in regenerative cosmetology to treat diseases and skin conditions including signs of skin aging, scars, acne, wrinkles, melasma, swelling, edema.
- Example 18 The method according to example 11, whereby the treating ultra-wideband micro-mechanical spectral bursts, formed by the device are used in regenerative cosmetology to treat diseases and skin conditions including signs of skin aging, scars, acne, wrinkles, melasma, swelling, edema.
- Example 18 The method according to example 11, whereby the treating ultra-wideband micro-mechanical spectral bursts, formed by the device are used in regenerative cosmetology to treat diseases and skin conditions including signs of skin aging, scars, acne, wrinkles, melasma, swelling, edema.
- Example 18 The method according to example 11, whereby the treating ultra-wideband micro-mechanical
- the shapes of burst spectra of the main generators are selected from a variety of spectra, including shock wave, stress wave, as well as from the spectra of rectangular, triangular, trapezoidal signals or combinations thereof, and the shapes of the spectra of corrective generators are selected from a variety of main signal spectra and their differentials, as well as from a Gauss monocycle, a low-cycle sinusoid, a cardinal sinusoid (Sine signal), arbitrary waveforms, or combinations thereof.
- Example 19 The method according to example 11, according to which the sequence of treating spectral bursts can be coherent, as well as incoherent.
- Example 20 The method according to example 11, whereby the transducing of electrical spectra into micromechanical treating spectral bursts is performed by more than one UMB transducers.
- Example 21 The method according to example claim 11, whereby the conversion of electrical impulses into micromechanical therapeutic spectral bursts is carried out by several ultra-wideband transducers, which are located in a single housing, with the ability to move inside the latter in three planes.
- Example 22 The method according to example 11, whereby the treating UWB micromechanical spectral bursts are applied to the body surface through acoustically transparent and acoustically coupled to each other elements, such as an ultra-wideband protector, a contact layer or an extended contact medium, placed between the protector and the body surface.
- elements such as an ultra-wideband protector, a contact layer or an extended contact medium
- Example 23 The method according to example 11, whereby treating ultra-wideband micro-mechanical spectral bursts are introduced into the treatment area through the conjunctival surface of the eye, as well as directly into the orifices of the body, such as the nasal cavity, oral cavity, esophagus, rectum, vagina.
- Example 24 The method according to example 11, whereby the therapeutic impact on the pathological area and surrounding healthy tissues with ultra- wideband micromechanical spectral bursts is carried out daily for 5-40 minutes for 5 - 60 days.
- Some embodiments of the invention relate to devices and methods of their operation for the restoration of diseased or damaged tissues of the human body by extracorporeal acceleration of natural reparative processes induced by micromechanical spectral burst at various levels of organization of tissue and cellular life, including the transformation of somatic cells into multipotent and pluripotent stem cells, accumulation of these cells and accelerated safe replacement of old cells with new cells.
- the proposed device for ultra- wideband (UWB) micromechanical regenerative spectral burst- therapy contains at least one main generator of the ultra- wideband (UWB) electrical signals, at least one generator of the corrective UWB electrical signals, bandpass filter unit, an UWB corrector of signals frequency spectra and amplitudes, an UWB amplifier, an UWB micromechanical transducer, an UWB protector and main controller. All these elements of the device are designed to generate UWB electrical impulse signals, convert them into UWB micromechanical spectral bursts signals with a constant or frequency-increasing amplitude in at least one UWB frequency range and input these bursts through the surface of the patient's body into the impact zone and adjacent healthy tissue.
- the main controller is connected to the outputs of the main and corrective generators, and it is also a programmer and an indicator of the current state of the entire device.
- a method and operating parameters of this device for UWB micromechanical regenerative spectral burst therapy are also proposed.
- ultrasound generator or ultrasound generating element
- compositions, method or structure may include additional ingredients, steps and/or parts, but only if the additional ingredients, steps and/or parts do not materially alter the basic and novel characteristics of the claimed composition, method or structure.
- a compound or “at least one compound” may include a plurality of compounds, including mixtures thereof.
- range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.
- a numerical range is indicated herein, it is meant to include any cited numeral (fractional or integral) within the indicated range.
- the phrases “ranging/ranges between” a first indicate number and a second indicate number and “ranging/ranges from” a first indicate number “to” a second indicate number are used herein interchangeably and are meant to include the first and second indicated numbers and all the fractional and integral numerals therebetween.
- method refers to manners, means, techniques and procedures for accomplishing a given task including, but not limited to, those manners, means, techniques and procedures either known to, or readily developed from known manners, means, techniques and procedures by practitioners of the chemical, pharmacological, biological, biochemical and medical arts.
- treating includes abrogating, substantially inhibiting, slowing or reversing the progression of a condition, substantially ameliorating clinical or aesthetical symptoms of a condition or substantially preventing the appearance of clinical or aesthetical symptoms of a condition.
- EMC Electromagnetic Compatibility
- EMP Electromagnetic Pulse
- ESD Electromagnetic Discharge
- Ultrasound Neuromodulation for Cognitive Enhancement US2014/0107533.Tyler W. Ultrasound Neuromodulation Treatment of Attention Deficit Hyperactivity Disorder US2014/0094720.Tyler W. Methods and Devices for Modulating Cellular Activity Using Ultrasound US2014/0094719.Tyler W. Ultrasound Neuromodulation Treatment of
- the nucleus acts as a ruler tailoring cell responses to spatial constraints. Science 2020 Oct 16; 370(6514): eaba 2894, doi: 10.1126/science.aba2894. Joseph T. Long and Jan Lammerding. Nuclear Deformation Lets Cells Gauge Their Physical Confinement/Development cell 56, January 25, 2021. Elsevier Inc. Steven Boeunaems et al. Phase separation in Biology and Disease; Current Perspectives and Open Questions//! Mol Biol. 2023 Mar 1; 435(5), 167971. DE102011115906A1. Kruglikov Hja. System for Generating Ultrasonic Waves and Procedures for Configuring an Ultrasonic System. 2013.
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