Cavitation bubbles are known to enhance the heating effect of high-intensity focused ultrasound (HIFU). In our previous study, the use of a “triggered HIFU” sequence consisting of a high-intensity pulse and a relatively low-intensity burst was proposed as an effective method to utilize the effect of cavitation bubbles. However, the duration of each component in the sequence has not been optimized. In this study, optical imaging was carried out to observe the behavior of cavitation bubbles in a gel phantom during the triggered HIFU exposure. Ultrasound imaging using the pulse inversion method was also conducted to detect the behavior of the bubbles. The results suggest that the oscillation of cavitation bubbles become inactive as the duration of HIFU burst exposure increases to the order of 10 ms. It was also suggested that ultrasonic imaging has potential use for detecting a change in the oscillation of cavitation bubbles for optimizing a triggered HIFU sequence.

High-intensity focused ultrasound (HIFU) is a noninvasive method for cancer treatment. One of the disadvantages of this method is that it has a long total treatment time because of the smallness of the treatment volume by a single exposure. To solve this problem, we have proposed a method of cavitation-enhanced heating, which utilized the heat generated by oscillating the cavitation bubbles, in combination with the method of lateral enlargement of a HIFU focal zone to minimize the surface volume ratio. In a previous study, focal spot scanning at multiple points was employed for the enlargement. This method involves nonlinear propagation and absorption due to the high spatial-peak temporal-peak (SPTP) intensity in addition to the cavitation-enhanced heating. However, it is difficult to predict the size and position of the coagulation volume because they are significantly affected by the nonlinear parameters of the tissue. In this study, a sector vortex method was employed to directly synthesize an annular focal pattern. Since this method can keep the SPTP intensity at a manageably low level, nonlinear propagation and absorption can be minimized. Experimental results demonstrate that the coagulation was generated only in the region where both the cavitation cloud and the heating ultrasound were matched. The proposed method will make the cavitation-enhanced HIFU treatment more accurate and predictable.

Acoustic cavitation bubbles can induce not only a thermal bioeffect but also a chemical bioeffect. When cavitation bubbles collapse and oscillate violently, they produce reactive oxygen species (ROS) that cause irreversible changes to the tissue. A sonosensitizer can promote such ROS generation. A treatment method using a sonosensitizer is called sonodynamic treatment. Rose bengal (RB) is one of the sonosensitizers whose in vivo and in vitro studies have been reported. In sonodynamic treatment, it is important to produce ROS at a high efficiency. For the efficient generation of ROS, a triggered high-intensity focused ultrasound (HIFU) sequence has been proposed. In this study, cavitation bubbles were generated in a chamber where RB solution was sealed, and a high-speed camera captured the behavior of these cavitation bubbles. The amount of ROS was also quantified by a potassium iodide (KI) method and compared with high-speed camera pictures to investigate the effectiveness of the triggered HIFU sequence. As a result, ROS could be obtained efficiently by this sequence.

No abstract

Background: Exercise therapy is occasionally considered as an initial treatment for temporomandibular disorders. However, pain can be exacerbated during exercise therapy.Objective: To investigate the immediate curative effects of exercise therapy in patients with masticatory muscle myalgia.Methods: Fifty-nine patients with masticatory muscle myalgia were included.Therapists performed exercise therapy (stretched the painful masseter and/or cervical muscles along the direction of muscle contraction) in 10 rounds of traction, each lasting 10 s. The patient's pain-free maximum mouth opening distance and degree of pain (VAS value) before and immediately after exercise therapy were compared using the Wilcoxon signed-rank test. The Mann-Whitney U test was used for the subgroup comparisons.Results: Mouth opening increased from 41 to 46 (IQR 43-48) mm and pain alleviation from 48 (IQR 31-56) to 21 (IQR 10-56) immediately following exercise therapy (p < .001 for both). None of the patients experienced pain exacerbation or reduction in mouth opening post-exercise. No difference in mouth opening distance changes according to sex, painful side, painful site and therapist were observed (p > .05 for all). Pain reduction was greater in patients with unilateral pain (26, IQR 12-39) than those with bilateral (13, IQR 5-25) (p = .019). There were no differences in the change in the degree of pain according to sex, painful site and therapist (p > .05 for all). Conclusion:Exercise therapy immediately enlarged the mouth opening distance and reduced myalgia; therefore, it could be helpful in managing masticatory muscle myalgia.