ULTRASONIC THERAPY—Physiological Basis and Clinical Application

Ultrasound is a relatively new but fairly well accepted physical modality. Therapeutically, ultrasonic energy is employed empirically, but the present trend is to utilize low and medium intensities, 0.5 to 2.0 watts per square centimeter, rather than high intensities, over 2.0 watts per square centimeter, for medical purposes.The important physiological effects of ultrasonic energy on living tissue are thermal, mechanical, chemical and biological. Which one of these effects is dominant is not clearly understood. However, the intensity of the ultrasound field and the duration of application determines the extent to which the thermal or the mechanical effect prevails.From a clinical point of view ultrasonic energy has been most effective in the treatment of painful conditions involving the musculoskeletal and neuromuscular structures. More recently, studies have been directed toward the use of ultrasound as a neurosurgical tool.     

Development of Enzymes Involved in Photosynthetic Carbon Assimilation in Greening Seedlings of Maize (Zea mays)

Upon illumination of dark-grown maize seedlings (5 days old) with incandescent light, there occurred a nearly simultaneous increase, after a certain lag period, in the activities of enzymes engaged in the C₄ pathway and the Calvin-Benson cycle. The light-induced biosynthesis of chlorophyll (a and b) precedes the increase in enzyme activities and proceeds without lag phase. A diphasic feature in the elevation of enzyme activities as a function of the intensities of light provided was observed; the increase in enzyme activities was enhanced by light intensities greater than 10³ ergs per square centimeter per second in comparison with light of lower intensities. Under light intensities greater than 10³ ergs per square centimeter per second, the simultaneous addition of levulinic acid, which inhibited chlorophyll formation, markedly reduced the increase of enzyme activities. However, neither the diphasic light effect nor the inhibitory effect of levulinic acid was observed with ribulose-1,5-bisphosphate carboxylase. The enzyme activities in the dark-grown maize seedlings were enhanced by a brief irradiation with the red light and the red light effect was reversed by the following far red light treatment. The red light-induced increase in the enzyme activities did not accompany chlorophyll synthesis, and was completely inhibited by cycloheximide, indicating that enzyme synthesis rather than activation might be involved. Light may play a dual role in enzyme induction; one is as an energy source through the photosystems at high intensities and the other is presumably as a signal mediated by phytochrome at low intensities.     

Bio-effects and safety of low-intensity, low-frequency ultrasonic exposure

Low-frequency (LF) ultrasound (20-100 kHz) has a diverse set of industrial and medical applications. In fact, high power industrial applications of ultrasound mainly occupy this frequency range. This range is also used for various therapeutic medical applications including sonophoresis (ultrasonic transdermal drug delivery), dentistry, eye surgery, body contouring, the breaking of kidney stones and eliminating blood clots. While emerging LF applications such as ultrasonic drug delivery continue to be developed and undergo translation for human use, significant gaps exist in the coverage of safety standards for this frequency range. Accordingly, the need to understand the biological effects of LF ultrasound is becoming more important. This paper presents a broad overview of bio-effects and safety of LF ultrasound as an aid to minimize and control the risk of these effects. Its particular focus is at low intensities where bio-effects are initially observed. To generate a clear perspective of hazards in LF exposure, the mechanisms of bio-effects and the main differences in action at low and high frequencies are investigated and a survey of harmful effects of LF ultrasound at low intensities is presented. Mechanical and thermal indices are widely used in high frequency diagnostic applications as a means of indicating safety of ultrasonic exposure. The direct application of these indices at low frequencies needs careful investigation. In this work, using numerical simulations based on the mathematical and physical rationale behind the indices at high frequencies, it is observed that while thermal index (TI) can be used directly in the LF range, mechanical index (MI) seems to become less reliable at lower frequencies. Accordingly, an improved formulation for the MI is proposed for frequencies below 500 kHz.     

Influence of the Irradiance on Carbohydrate Content and Rooting of Cuttings of Pine Seedlings (Pinus sylvestris L.)

Seedlings of Pinus sylvestris L. were grown for 6 weeks at an irradiance of either 8 or 40 watts per square meter in a controlled environment room. Cuttings from these plants were rooted in tap water for 75 days at either 8 or 40 watts per square meter. The photoperiod was 17 hours.

During the first 30 days of the rooting period quantitative changes in carbohydrates were recorded in cuttings from the different treatments. The carbohydrate contents of the cuttings were mainly regulated by the irradiance during the stock plant stage and generally a higher carbohydrate level was found in cuttings from stock plants grown at 40 watts per square meter.

The irradiance during the rooting period had only minor effects on the time course of root formation, whereas the irradiance during the stock plant stage did influence the subsequent root formation. Cuttings from stock plants grown at 8 watts per square meter rooted faster and with higher frequency than those from stock plants grown at 40 watts per square meter. These results are discussed in relation to the mentioned irradiance effects on carbohydrate content.

     

Bioeffect of ultrasound on endothelial cells in vitro

The effects of low-intensity ultrasound (US) on biological systems have been investigated extensively; however, the effects of ultrasound stimulation on endothelial cells were rarely studied. In this study, 1 MHz, pulsed 1:4, and four different spatial-average temporal-peak intensities (0.5, 1.0, 1.6, and 2W/cm2) of ultrasound were used to stimulate endothelial cells for 10 min per day. The results showed that ultrasound (intensity 1.6-2.0W/cm2) treatment after 6 days enhanced the nitric oxide (NO) and Ca2+ release from the endothelial cells but did not promote cell growth. In addition, ultrasound stimulation changed the cellular morphology and orientation, and increased extracellular matrix secretion from endothelial cells.     

Measurement of CO(2) and H(2)O Vapor Exchange in Spinach Leaf Discs : Effects of Orthophosphate

A leaf chamber has been designed which allows the measurement of both CO₂ and water vapor exchange in Spinacia oleracea leaf discs. The center of the disc lies within a cylindrical gas chamber and its margins are enclosed within a cavity through which water or various metabolites can be pumped. In saturating light and normal atmospheres, the leaf discs have a relatively low resistance to H₂O vapor transfer (r_w = 1.87 seconds per centimeter) and can support high rates of photosynthesis for several hours. The abaxial surface of a disc had a higher resistance to water vapor transfer (r_w = 3.22 seconds per centimeter) than the adaxial (r_w = 2.45 seconds per centimeter) despite having a higher stomatal frequency (abaxial, 105/square millimeter; adaxial, 58/square millimeter). In 2% O₂, the discs required an internal concentration of CO₂ of 115 microliters per liter to support one-half of the maximal velocity of apparent photosynthesis (average value, 66 milligrams CO₂ per square decimeter per hour). In 20% O₂, the comparable values are 156 microliters per liter and 56 milligrams CO₂ per square decimeter per hour. In air, apparent photosynthesis saturated at intensities (750 microeinsteins per square meter per second) well below that of daylight but, when the internal CO₂ was raised to 700 to 900 microliters per liter, photosynthesis was not saturated even at daylight intensities (2025 microeinsteins per square meter per second). The distribution of Prussian blue crystals, formed after ferrocyanide feeding, showed that water entered the disc via the vasculature. When 25-minute pulses of orthophosphate were provided in the feeding solution, there were concentration-dependent increases in both r_w and r_m leading to inhibition of photosynthesis. The orthophosphate-dependent inhibitions were reversible.     

Ultrasound-biophysics mechanisms

Ultrasonic biophysics is the study of mechanisms responsible for how ultrasound and biological materials interact. Ultrasound-induced bioeffect or risk studies focus on issues related to the effects of ultrasound on biological materials. On the other hand, when biological materials affect the ultrasonic wave, this can be viewed as the basis for diagnostic ultrasound. Thus, an understanding of the interaction of ultrasound with tissue provides the scientific basis for image production and risk assessment. Relative to the bioeffect or risk studies, that is, the biophysical mechanisms by which ultrasound affects biological materials, ultrasound-induced bioeffects are generally separated into thermal and non-thermal mechanisms. Ultrasonic dosimetry is concerned with the quantitative determination of ultrasonic energy interaction with biological materials.

Whenever ultrasonic energy is propagated into an attenuating material such as tissue, the amplitude of the wave decreases with distance. This attenuation is due to either absorption or scattering. Absorption is a mechanism that represents that portion of ultrasonic wave that is converted into heat, and scattering can be thought of as that portion of the wave, which changes direction. Because the medium can absorb energy to produce heat, a temperature rise may occur as long as the rate of heat production is greater than the rate of heat removal. Current interest with thermally mediated ultrasound-induced bioeffects has focused on the thermal isoeffect concept. The non-thermal mechanism that has received the most attention is acoustically generated cavitation wherein ultrasonic energy by cavitation bubbles is concentrated. Acoustic cavitation, in a broad sense, refers to ultrasonically induced bubble activity occurring in a biological material that contains pre-existing gaseous inclusions. Cavitation-related mechanisms include radiation force, microstreaming, shock waves, free radicals, microjets and strain. It is more challenging to deduce the causes of mechanical effects in tissues that do not contain gas bodies. These ultrasonic biophysics mechanisms will be discussed in the context of diagnostic ultrasound exposure risk concerns.     

Light- and sugar-mediated control of direct de novo flower differentiation from tobacco thin cell layers

The nature of organs neoformed from tobacco (Nicotiana tabacum cv Samsun) thin cell layers is influenced by the quantity of light supplied and on the sequence of this supply. It is observed that glucose exhibits similar effects. In the presence of glucose at 167 millimolar, continuous light of 50 watts per square meter is required for optimal flower differentiation in vitro. However, 50 watts per square meter irradiance limited to 6 days is sufficient to trigger flower formation in 80% of the explants provided that light is applied from day 6 to day 11 of culture. This critical phase may correspond to the initiation phase during which soluble sugars are mainly needed as carbon energy source rather than as osmoregulators. Under continuous or precise sequential sugar deprivations, either no organogenesis occurs, or abnormal structures or buds are formed. Therefore, light per se is not sufficient to induce flower differentiation. Conversely, a specific quantitative combination of glucose and sucrose almost substitutes for the light requirement for differentiation of anthers and pistils. These observations suggest that, during the sequence of events leading to flower differentiation, light acts on energy-dependent sugar uptake and metabolism and on the increase of reducing potential of chloroplasts.     

The temperature dependence of receptor structures and temperature-related reception]

In acute experiments on rats, studies have been made on impulse activity of single fibres of n. ischiadicus evoked by stimulation of the receptive fields of the sole by focused ultrasound. Mechanical effects were produced by rectangular ultrasonic stimuli, thermal ones--by trapezoid ones. With respect to the magnitude of a threshold response to a rectangular stimuli, the receptor structures were divided into three groups, i.e. low, mean and high threshold ones. Low and mean threshold receptor units responded to local thermal stimulation. Mean threshold units exhibited an increase of the threshold to mechanical stimulation after local thermal one. In human subjects, the structures which are functionally similar to mean threshold units, evoke thermal sensations, and may be classified not only as temperature dependent, but also as temperature sensitive.     

Phytochrome control of two low-irradiance responses in etiolated oat seedlings

Light-induced coleoptile stimulation and mesocotyl suppression in etiolated Avena sativa (cv. Lodi) has been quantitated. Etiolated seedlings showed the greatest response to light when they were illuminated 48 to 56 hours after imbibition. Two low-irradiance photoresponses for each tissue have been described. Red light was 10 times more effective than green and 1,000 times more effective than far red light in evoking these responses. The first response, which resulted in a 45% mesocotyl suppression and 30% coleoptile stimulation, had a threshold at 10⁻¹⁴ einsteins per square centimeter and was saturated at 3.0 × 10⁻¹² einsteins per square centimeter of red light. This very low-irradiance response could be induced by red, green, or far red light and was not photoreversible. Reciprocity failed if the duration of the red illumination exceeded 10 minutes. The low-irradiance response which resulted in 80% mesocotyl suppression and 60% coleoptile stimulation, had a threshold at 10⁻¹⁰ einsteins per square centimeter and was saturated at 3.0 × 10⁻⁸ einsteins per square centimeter of red light. A complete low-irradiance response could be induced by either red or green light but not by far red light. This response could be reversed by a far red dose 30 times greater than that of the initial red dose for both coleoptiles and mesocotyls. Reciprocity failed if the duration of the red illumination exceeded 170 minutes. Both of these responses can be explained by the action of phytochrome.     

生物热应变成像技术的研究进展

热应变成像(thermal strain imaging,TSI)是一种利用超声回波时移的温度相关性进行成像的超声应用.它既具有超声安全、无创和实时成像的优点,又能够显示与其他超声成像方式不同的组织特征,具有良好的应用前景.热应变成像目前在生物医学领域主要应用于组织表征和温度监测两个方面.本综述介绍了热应变成像的基本原理,讨论了适用于临床的主要能量源,并通过回顾近几年热应变成像的研究成果和分析目前面临的局限与挑战,对热应变成像技术的发展进行了探讨和展望.     

Red Light-inhibited Mesocotyl Elongation in Maize Seedlings: II. Kinetic and Spectral Studies

Red light induces two distinct inhibition responses in mesocotyls of etiolated corn seedlings. A light dose of 10 nanoeinsteins per square centimeter is saturating for the more sensitive response, whereas doses above 1,000 nanoeinsteins per square centimeter are required to exceed the threshold sensitivity of the less sensitive one. The sensitive response can be detected within 20 minutes of the onset of illumination whereas the other response does not become apparent until more than 4 hours after the beginning of irradiation. The reciprocity law is valid for the first response, but probably not for the second. An action spectrum for the first response shows two maxima, one at 640 nanometers and the other between 660 and 670 nanometers, with a pronounced minimum near 650 nanometers. The effects both of 640 and 665 nanometers of light were reversible by far red light, but doses of far red required for full reversibility were almost three orders of magnitude greater than the doses of red required either to saturate the initial inhibition or to reverse the effect of far red light. The results suggest that corn may contain a red-absorbing pigment other than phytochrome which in some way interacts with phytochrome in the inhibition of mesocotyl elongation by red light.     

Interaction between Green and Far-Red Light on the Low Fluence Rate Chloroplast Orientation in Mougeotia

Continuous irradiation of Mougeotia with linearly polarized green light (550 nanometers, 0.2 watt per square meter) induces a change in the orientation of its chloroplast from profile to face position, if the electrical vector of the green light is vibrating normal to the cell axis. This change is complete within 25 minutes of the onset of irradiation. In contrast, if the electrical vector of the green light is parallel to the cell axis, no chloroplast reorientation is induced, even with a fluence rate as high as 3 watts per square meter. Furthermore, unpolarized far-red light (727 nanometers, 2 watts per square meter) given alone has no effect on chloroplast reorientation. Simultaneous and continuous irradiation with polarized green light, regardless of its plane of polarization, together with unpolarized far-red light, however, does lead to chloroplast reorientation. These data indicate that, in addition to the red-absorbing form of phytochrome, there exists in Mougeotia another sensory pigment absorbing green light.     

Maintenance of High Photosynthetic Rates during the Accumulation of High Leaf Starch Levels in Sunflower and Soybean

Sunflower (cv. “Mammoth Greystripe”) and soybean (Merr. cv. “Amsoy 71”) leaves were exposed to continuous light for at least 52 hours in an attempt to determine the relationship between leaf starch levels and photosynthetic rates. Immature rapidly expanding and relatively mature slowly expanding sunflower leaves were studied. After 52 hours continuous light, the rapidly expanding leaves accumulated high starch levels (3.3 milligrams per square centimeter, 43% of dry weight) with only about a 10% decline from the initial photosynthetic rate of 42 milligrams CO₂ per square decimeter per hour. Under the same conditions, the slowly expanding leaves accumulated less starch, but the photosynthetic rate declined 30%. Soybean leaves, which were slowly expanding, accumulated less starch than sunflower leaves (2.1 milligrams per square centimeter, 34% of dry weight), and their photosynthetic rates declined only about 10% after 54 hours continuous light.     

Ultrasound induced strain cytoskeleton rearrangement: An experimental and simulation study

Cytoskeleton and specially actin filaments are responsible for mechanical modulation of cellular behavior. These structures could be fluidized in response to transient mechanical cues. Ultrasound devices have been widely used in medicine which their generated ultrasonic waves could disrupt/fluidize actin filaments in cytoskeleton and thus could affect cellular organization. Present research aims at revealing the mechanism of fluidization caused by ultrasound induced strains. First, a numerical simulation was performed to reveal the effect of oscillating ultrasonic pressure on induced deformation in the cell with respect to different cell geometries and exposure conditions. The model revealed that higher pressure and frequencies induce higher levels of strain in the cell. The results also showed that spread cells are more exposed to cytomechanical remodeling due to higher level of ultrasound induced deformations but also the effect of harmonic excitation decreases with spreading. Furthermore, strain values found to be less in the nucleus comparing the value in the cytoplasm, but still these strains can affect the behavior of the cell through mechanotransduction mechanisms. Then, different experimental ultrasound protocols were used to evaluate their effects on cell viability and actin cytoskeleton distribution. Results of Live/Dead assay indicated that high pressure and duration of the exposure had negative effects on the viability of C2C12 cells, while the viability ratio still remained above 85%. In addition, actin fluorescent staining showed that high levels of filament disruption could occur with increasing the pressure. The results of this study shed light on cellular response to mechanical stimuli applied by ultrasonic waves.     

Free radical formation induced by ultrasound and its biological implications.

The chemical effects of ultrasound in aqueous solutions are due to acoustic cavitation, which refers to the formation, growth, and collapse of small gas bubbles in liquids. The very high temperatures (several thousand K) and pressures (several hundred atmospheres) of collapsing gas bubbles lead to the thermal dissociation of water vapor into .OH radicals and .H atoms. Their formation has been confirmed by electron spin resonance (ESR) and spin trapping. The sonochemistry of aqueous solutions of gases and of volatile and nonvolatile solutes is reviewed. The similarities and differences between sonochemistry and radiation chemistry of aqueous solutions are explained. Some unusual characteristics of aqueous sonochemistry can be understood by considering the properties of supercritical water. By the use of rare gases with different thermal conductivities, it is possible to distinguish between temperature-dependent processes such as redox reactions initiated by .OH radicals and .H atoms and pressure-dependent processes which lead to polymer degradation and cell lysis. The evidence for free radical formation in aqueous solutions by pulsed ultrasound is discussed. This subject is of interest because it is related to the possible deleterious effects of ultrasonic diagnostic devices. The role of free radicals and of mechanical effects induced by ultrasound in DNA degradation, inactivation of enzymes, lipid peroxidation, and cell killing is reviewed.     

Effects of red, far red, and blue light on enhancement of nitrate reductase activity and on nitrate uptake in etiolated rice seedlings

The effects of red (R), far red (FR), or blue light (B) on the enhancement of nitrate reductase (NR) activity and on nitrate uptake in etiolated rice seedlings were examined. On 5-minute illumination followed by 12-hour dark, R caused marked increase of NR activity, but FR and B caused only slight increase. Illumination with 560 ergs per square centimeter per second of R for 5 minutes caused maximal increase. The effect of R was almost completely counteracted by subsequent illumination with 2,000 ergs per square centimeter per second of FR for 10 minutes, indicating that NR induction was mediated by phytochrome. Exogenous supply of inducer nitrate was not required during the 5-minute illumination and the R-FR cycles, if the seedlings were transferred to nitrate solution at the beginning of the dark incubation. NR activity in the shoots was found high when shoots were illuminated but was low when only roots were illuminated. On continuous illumination for 12 hours, B had more effect on NR increase than R.     

Assessment of fibroblast cells submitted to ultrasonic irradiation

Physiotherapists consider ultrasound an indispensable tool, which is commonly employed in clinical practice as a treatment aid for musculoskeletal dysfunctions. The aim of our study has been to analyze fibroblast cell structures following low-intensity pulsed ultrasonic irradiation. Fibroblast cell cultures irradiated with ultrasound were analyzed through electron microscopy to determine an ideal irradiation beam that preserved cell morphology and integrity. Analysis by fluorescence microscopy and transmission electron microscopy was used to follow morphological changes of the nucleus and cytoskeleton following different ultrasound irradiation intensities. According to the parameters used in the pulsed irradiation of fibroblast cultures, control over the intensity employed is fundamental to the optimal use of therapeutic ultrasound. Cell cultures submitted to low-intensity pulsed ultrasonic irradiation (0.2-0.6 W/cm2) at 10% (1:9 duty cycle) and 20% (2:8 duty cycle) maintained shape and cellular integrity, with little damage. In the group irradiated with an intensity of 0.8 W/cm2, a loss of adhesion was observed along with an alteration in the morphology of some cells at an intensity of 1.0 W/cm2, which resulted in the presence of cellular fragments and a decrease of adhering cells. In cells irradiated at 2.0 W/cm2, there was a complete loss of adhesion and aggregation of cellular fragments. The present study confirms that biophysical properties of pulsed ultrasound may accelerate proliferation processes in different biological tissues.     

Syringomycin, a bacterial phytotoxin, closes stomata

The effects of the bacterial phytotoxin, syringomycin, on stomata were investigated using detached leaves of Xanthium strumarium and isolated epidermes of Vicia faba. Syringomycin is known to cause K⁺ efflux in fungal and higher plant cells. Doses of syringomycin as low as 0.3 unit per square centimeter (about 0.88 pmole per square centimeter) resulted in measurable stomatal closure when applied through the transpiration stream of detached leaves; higher doses produced larger reductions in stomatal conductance. Stomatal apertures of isolated epidermes were also reduced by low concentrations (3.2 units per milliliter; 10⁻⁸ molar) of syringomycin. The effects of syringomycin were similar to those of ABA. Both compounds closed stomata at a similar rate and at similar concentrations. In addition, neither compound significantly affected the relationship between photosynthesis and intercellular CO₂ based on data taken after stomatal conductance had stabilized following the treatment. It is possible that syringomycin and ABA activate the same K⁺ export system in guard cells, and syringomycin may be a valuable tool for studying the molecular basis of ABA effects on guard cells.