• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.33-37
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• 2014

Objective: Low intensity pulsed ultrasound (LIPUS) has been shown to accelerate cell proliferation and tissue healing in both animal models and clinical trials. However, details of the clinical effects of LIPUS have not been well characterized. The aim of this study was to investigate the effect of LIPUS on mitogen-activated protein kinase (MAPK) activation in rat articular chondrocytes. Design: Cross-sectional study. Methods: Chondrocyte were cultured in six well cell culture plates for 72 hours at $37^{\circ}C$ with 5% $CO_2$, and then exposed to LIPUS at 1.5 MHz frequency and $30-mW/cm^2$ power. Changes in chondrocyte activities were evaluated in response to oxydative stress in dose-dependent (0 and 300 uM) and time-dependent (0-24 hr) manner. The cell viability were analyzed using MTT [3-(4.5-dimethylthiazol-2-yl)-2.5 diphenyltetrazolium bromide]. The expression of p38 MAPK was measured using western blotting. Results: Oxidative stress was induced in rat chondrocytes using hydrogen peroxide ($H_2O_2$). The cell viability was decreased in chondrocytes after the $H_2O_2$ dose and time-dependent treatment. The p38 MAPK phosphorylation occurred at a significantly increased rate after $H_2O_2$ treated (p<0.05). Expression of p38 MAPK was decreased in the p38 inhibitor groups compared with the oxidative stress-induced chondrocyte damage via the p38 MAPK signaling pathways (p<0.05). Conclusions: It could be concluded that LIPUS can inhibit oxidative stress-induced chondrocyte damage via the p38 MAPK signaling pathways.

• Physical Therapy Rehabilitation Science
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• 제2권1호
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• pp.21-26
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• 2013

Objective: The aim of this study was to investigate the effect of therapeutic ultrasound (US) of cell viability and inflammatory cytokine in rat articular chondrocyte cultures stimulated with lipopolysaccharide (LPS). Design: One group pretest-posttest design. Methods: Cultured chondrocytes were treated with US and/or LPS and assessed for viability, Tumor necrosis factor $(TNF)-{\alpha}$ and Interleukin (IL)-1 production. Results: Oxidative stress was induced in rat chondrocytes with LPS. The cell viability was decreased in chondrocytes after treatment with LPS. The viability revealed that low-intensity pulsed ultrasound (LIPUS) exerted no significant cytotoxicity in the rat chondrocyte. LIPUS inhibited decreased cell viability in the presence of LPS ($30{\mu}g/ml$) in a intensity dependent pattern at LIPUS (p<0.05). $TNF-{\alpha}$ production in the presence of LPS was also inhibited in a dose dependent manner (p<0.05 from $30mW/cm^2$). IL-1 production in the presence of LPS was inhibited as well (p<0.05 from $7.5mW/cm^2$). Conclusions: Our results demonstrate that US was the anti-inflammatory effect of chondrocytes. LIPUS may exert its anti inflammatory effects through inhibition of $TNF-{\alpha}$ and IL-1 synthesis. These results suggest that US have potential for use as a pain relief and reduce the articular destruction.

• Medical Lasers
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• 제10권1호
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• pp.15-21
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• 2021

As technology advances at a rapid rate, innovations in regenerative medicine will eventually include the use of energy-based therapeutics, such as low intensity-pulsed ultrasound stimulation (LIPUs), pulsed electromagnetic field stimulation (PMFs), and low-level laser/light therapy (LLLt) or photobiomodulation therapy (PBMt). Among these treatments, LLLt/PBMt attracted significant attention by the turn of the century, as evidenced by the numerous publications compared to LIPUs and PMFs, particularly for augmented bone regeneration (ABR). This is a testament of how the maturation of technology and scientific knowledge leads to latent compounded applications, even when the value of a technique is reliant on empirical data. This article reviews some of the notable investigations using LLLt/PBMt for bone regeneration published in the past decade, focusing on how this type of therapy has been utilized together with the existing regenerative medicine landscape.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.199-209
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• 2011

Purpose: Osteoporosis, is a major health problem for the elderly and post-menopausal women and shown to alter the properties of bone as well as impair bone healing around titanium implants in both human and animals. The objective of this study was to examine the effect of LIPUS with adipose-derived stem cells on the healing process around a titanium implant in rats with osteoporosis. Methods: Sixteen osteoporosis-induced rats were divided into two groups: an adipose-derived stem cell injected with Low Intensity Pulsed Ultrasound (LIPUS) application group and a control group. Titanium screw implants (diameter, 2.0 mm: length, 3.5 mm, Cowell Medi, Korea) were placed into both tibia of 16 rats, on 8 rats as the control group and the other 8 rats as the experimental group. Rats were sacrificed at different intervals from 1, 2, 4 and 8 weeks after implantation for histopathologic and immunohistochemical analyses. Results: Histopathological analysis revealed newly formed bone in experimental group earlier than that in control group. Especially at 1 week after implantation, more amounts of new bone matrix and collagen around the implant in the experimental group were seen compared with the control group. Immunohistochemical analysis showed that the levels of osteoprotegerin (OPG) expression in the experimental group were increased at early stages compared with that of control group until 2 weeks after implantation. But after 2 weeks, the expression level of OPG similar in both groups. The expression levels of receptor activator of nuclear factor kB ligand (RANKL) were stronger in the experimental group than the control group until 2 weeks after implantation. After 4 weeks, expression of RANKL in experimental group was similar to the control group. Conclusion: The results of this study suggest that LIPUS with Adipose-Derived Stem Cells in implantation could promote bone healing around titanium implants in rats with osteoporosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권5호
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• pp.386-395
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• 2011

Introduction: Osteoporosis is a major health problem in the elderly that involves changes in the properties of bone as well as impaired bone healing around a titanium implant in both humans and animals. This study examined effect of low intensity pulsed ultrasound (LIPUS) on the bone healing process around a titanium implant in osteoporosis-induced rats. Materials and Methods: Sixteen rats were divided into two groups. A control group with osteoporosis induced by removing both ovaries and an experimental group of rats that were applied with LIPUS after osteoporosis had been induced. A screw type titanium implant (diameter, 2.0 mm: length, 3.5 mm, Cowell-Medi, KOREA) was placed into the tibias of 16 rats. The control and experimental group contained 8 rats each. The rats were sacrificed at 1, 2, 4, and 8 weeks after implantation to examine the histopathology and immunochemistry. Results: The histopathology examination revealed earlier new bone formation in the experimental group than the control group. In particular, at 1 week after implantation, more new bone matrix and collagen were observed around the implant of the experimental group compared to the control group. Immunochemistry analysis showed that the level of OPG expression of the experimental group was higher in the early stages than in the control group. After 8 weeks, the levels of OPG expression were similar in both groups. The expression level of receptor activator of nuclear factor kB ligand (RANKL) was stronger in the experimental group than the control group. After 4 weeks, the level of RANKL expression was similar in both groups. Conclusion: These results suggest that the application of LIPUS to implantation can promote bone healing around titanium in osteoporosis animals.

• The Journal of Korean Physical Therapy
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• 제18권1호
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• pp.75-82
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• 2006

Purpose: This study conducted the following experiment to examine transdermal permeation effects or 500 KHz ultrasound with lidocaine HCl. Methods; First, to experiment skin permeation enhancement effects of 500 KHz ultrasound frequency, it produced apparatus and transducer of 500 KHz ultrasound and Franz diffusion cell for skim permenation experiment suitable to purposes of the experiment. Transdermal permeation experiment applied Lidocaine HCL gel to skin of hairless mouse depending on ultrasound frequency and duty cycle and analyzed permeation ratio with HPLC. Results: As a result of fixing lidocaine HCl gel at the same intensity with pulsed mode and continuous mode and comparing transdermal permeation ratio by frequency, transdermal permeation ratio was increased at 500 KHz ultrasound and remarkably increased at continuous ultrasound. It was found that 1 MHz and 500 KHz ultrasound in transdermal permeation experiment enhanced transdermal permeation of lidocaine HCl. In particular, transdermal permeation of 500 KHz using lidocaine HCl gel was highest. Conclusion: However, researches considering various frequencies, intensities and application hours in low frequency areas including 500 KHz ultrasound are needed to increase deep permeation or drugs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.301-311
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• 2011

Introduction: This study examined the effect of the application of low intensity pulsed ultrasound on bone healing after an injection of adipose tissue-derived stem cells (ADSCs) during the implantation of a titanium implant in the tibia of diabetes-induced rats. Materials and Methods: Twelve Sprague-Dawely rats were used. After inducing diabetes, the ADSCs were injected into the hole for the implant. Customized screw type implants, 2.0 mm in diameter and 3.5 mm in length, were implanted in both the tibia of the diabetes-induced rats. After implantation, LIPUS was applied with parameters of 3 MHz, 40 mW/$cm^2$, and 10 minutes for 7 days to the left tibiae (experimental group) of the diabetesinduced rats. The right tibiae in each rat were used in the control group. At 1, 2 and 4 week rats were sacrificed, and the bone tissues of both tibia were harvested. The bone tissues of the three rats in each week were used for bone-to-implant contact (BIC) and bone area (BA) analyses and the bone tissues of one rat were used to make sagittal serial sections. Results: In histomorphometric analyses, the BIC in the experimental and control group were respectively, $39.00{\pm}18.17%$ and $42.87{\pm}9.27%$ at 1 week, $43.74{\pm}6.83%$ and $32.27{\pm}6.00%$ at 2 weeks, and $32.62{\pm}11.02%$ and $47.10{\pm}9.77%$ at 4 weeks. The BA in experimental and control group were respectively, $37.28{\pm}3.68%$ and $31.90{\pm}2.84%$ at 1 week, $20.62{\pm}2.47%$ and $15.64{\pm}2.69%$ at 2 weeks, and $11.37{\pm}4.54%$ and $17.69{\pm}8.77%$ at 4 weeks. In immunohistochemistry analyses, Osteoprotegerin expression was strong at 1 and 2 weeks in the experimental group than the control group. Receptor activator of nuclear factor kB ligand expression showed similar staining at each week in the experimental and control group. Conclusion: These results suggest that the application of low intensity pulsed ultrasound after an injection of adipose tissue-derived stem cells during the implantation of titanium implants in the tibia of diabetes-induced rats provided some positive effect on bone regeneration at the early stage after implantation. On the other hand, this method is unable to increase the level of osseointegration and bone regeneration of the implant in an uncontrolled diabetic patient.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권4호
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• pp.195-203
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• 2012

Dental implants using titanium have greatly advanced through the improvement of designs and surface treatments. Nonetheless, the anatomical limits and physiological changes of the patient are still regarded as obstacles in increasing the success rate of implants further, even with the enhancement of implant products. So there have been many efforts to overcome these limits. The intrinsic potential for bone regeneration can be stimulated through adjuvant treatments with the continuous improvement of implant properties, and this can play an important role in achieving optimum osseointegration toward peripheral bone tissue and securing ultimate long-term implant stability in standard surgical procedures. For this purpose, various chemical, biological, or biophysical measures were developed such as bone grafts, materials, pharmacological agents, growth factors, and bone formation proteins. The biophysical stimulation of bone union includes non-invasive and safe methods. In the beginning, it was developed as a method to enhance the healing of fractures, but later evolved into Pulsed Electromagnetic Field, Low-Intensity Pulsed Ultrasound, and Low-Level Laser Therapy. Their beneficial effects were confirmed in many studies. This study sought to examine bone-implant union and its latest trend as well as the biophysical stimulation method to enhance the union. In particular, this study suggested the enhancement of the function of cells and tissues under a disadvantageous bone metabolism environment through such adjunctive stimulation. This study is expected to serve as a treatment guideline for implant-bone union under unfavorable circumstances caused by systemic diseases hampering bone metabolism or the host environment.

• 대한의용생체공학회:의공학회지
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• 제40권2호
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• pp.39-47
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• 2019

Ultrasound sonication along with microbubble (MB) could enhance drug delivery to promote the absorption of anticancer drugs into cancers in a noninvasive and targeted manners. In this study, we verify the acute drug delivery enhancement (within an hour) of two representative focused ultrasound driven drug delivery enhancement methods (MB and Doxorubicin-coated Nanoparticle complex (MB-NP) based). Experiments were conducted using in vivo mouse model with MDA-MB-231 breast cancer cell line. Ultrasound generated by single-element 1 MHz focused ultrasound transducer was delivered in pulsed sonication consisted of 0.125 msec bursts at a pulse repetition frequency of 2 Hz for 20 seconds without a significant increase in local temperature (less than $0.1^{\circ}C$) or hemorrhage. Doxorubicin concentrations in tumors were improved by 1.97 times in the case of MB-NP, and 1.98 times by using Doxorubicin and MB separately. These results indicate anticancer drug delivery based on MB and MB-NP can significantly improve the effect of anticancer drugs delivered to tumors in a short time period by using low-intensity focused ultrasound.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권3호
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• pp.163-172
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• 2012

Purpose: Diabetes mellitus (DM) has been shown to alter the properties of the bone and impair bone healing around a titanium implant. The aim of this study is to investigate whether the low-intensity pulsed ultrasound (LIPUS), which has been known to stimulate the bone healing, improve the osseointegration of the titanium implant in tibia of DM-induced rats. Methods: 16 rats were received streptozotocin (60 mg/kg) for inducing diabetes. A total number of 32 titanium implants were placed bilaterally into both tibiae of these rats. The right tibia of each rat received LIPUS application (10 min/day) during 7 days post-operation, while the left side received no treatment. The study was carried on for six weeks and the rats were sacrificed at 1, 2, 4, and 6 weaks postoperatively (4 rats for each week) for histomorphometric and histologic analysis. Bone-implant contact and bone area were measured. Comparisons between the groups were made using statistical analysis on histomorphometric analysis. Results: The histomorphometry parameters showed that the bone-implant contact and the bone area values have decreased in the late osseointegration periods (4, 6 weeks) compared to the early osseointegration periods (1, 2 weeks) in both two groups. The bone-implant contact values of the LIPUS group were somewhat higher than those of controls at 1, 2 weeks, but the difference was not statistically significant. The bone area values of the LIPUS group were also higher than those of controls at 1, 2 weeks, but the difference was not statistically significant as well. Conclusion: Results of this study indicate that LIPUS may have positive effects on early osseointegration but could not improve the long term stability of dental implants.