We propose a coordinated, highly interactive multidisciplinary collaboration between four Projects and two Cores with the main goal of making shock wave lithotripsy (SWL) safe and effective for all patients. In this work we will: * Determine the chronic effects of SWL on the kidney-the long-term effects on renal structure and function that follow induction of acute damage during a treatment session * Determine if lithotripsy induces new-onset diabetes Develop treatment protocols that protect patients from SWL adverse effects * Determine the properties of SWs at their site of action in the kidney and proximal ureter * Increase the efficiency of SWL by improving the acoustic coupling between the lithotripter and the patient * Devise treatment protocols that improve SWL outcomes for obese patients * Determine the treatment threshold for SWL injury and develop a method to monitor onset of conditions that are damaging to the kidney * Evaluate the efficacy and safety of a new trend-low-pressure wide-focal-zone-in clinical lithotripter technology * Develop acoustic monitoring and feedback techniques to improve the targeting and firing of lithotripters to eliminate the delivery of SWs that miss the stone, and to determine when the stone has broken to completion and the session can be ended * Determine the mechanism by which cavitation within a vessel causes hemorrhage * Develop numerical models to understand the role of cavitation and non-cavitational mechanisms in causing tissue damage

Public Health Relevance

Shock wave lithotripsy (SWL) is the most common treatment used to remove renal stones. However, SWL has been found to cause acute trauma to the kidney and surrounding organs that is linked to potentially very serious chronic adverse effects. The proposed research will find ways to make SWL safer and more effective.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Program Projects (P01)
Project #
5P01DK043881-18
Application #
8291366
Study Section
Special Emphasis Panel (ZDK1-GRB-R (M2))
Program Officer
Kirkali, Ziya
Project Start
1994-05-10
Project End
2014-06-30
Budget Start
2012-07-01
Budget End
2013-06-30
Support Year
18
Fiscal Year
2012
Total Cost
$1,462,673
Indirect Cost
$340,775
Name
Indiana University-Purdue University at Indianapolis
Department
Anatomy/Cell Biology
Type
Schools of Medicine
DUNS #
603007902
City
Indianapolis
State
IN
Country
United States
Zip Code
46202
Harper, Jonathan D; Dunmire, Barbrina; Wang, Yak-Nam et al. (2014) Preclinical safety and effectiveness studies of ultrasonic propulsion of kidney stones. Urology 84:484-9
Li, Guangyan; McAteer, James A; Williams Jr, James C et al. (2014) Effect of the body wall on lithotripter shock waves. J Endourol 28:446-52
Connors, Bret A; Evan, Andrew P; Blomgren, Philip M et al. (2014) Comparison of tissue injury from focused ultrasonic propulsion of kidney stones versus extracorporeal shock wave lithotripsy. J Urol 191:235-41
Coralic, Vedran; Colonius, Tim (2014) Finite-volume WENO scheme for viscous compressible multicomponent flows. J Comput Phys 274:95-121
Handa, Rajash K; Evan, Andrew P; Connors, Bret A et al. (2014) Shock wave lithotripsy targeting of the kidney and pancreas does not increase the severity of metabolic syndrome in a porcine model. J Urol 192:1257-65
Hsi, Ryan S; Dunmire, Barbrina; Cunitz, Bryan W et al. (2014) Content and face validation of a curriculum for ultrasonic propulsion of calculi in a human renal model. J Endourol 28:459-63
Alibakhshi, Mohammad A; Kracht, Jonathan M; Cleveland, Robin O et al. (2013) Single-shot measurements of the acoustic field of an electrohydraulic lithotripter using a hydrophone array. J Acoust Soc Am 133:3176-85
Tiwari, Arpit; Freund, Jonathan B; Pantano, Carlos (2013) A Diffuse Interface Model with Immiscibility Preservation. J Comput Phys 252:290-309
Lu, Wei; Sapozhnikov, Oleg A; Bailey, Michael R et al. (2013) Evidence for trapped surface bubbles as the cause for the twinkling artifact in ultrasound imaging. Ultrasound Med Biol 39:1026-38
Coralic, Vedran; Colonius, Tim (2013) Shock-induced collapse of a bubble inside a deformable vessel. Eur J Mech B Fluids 40:64-74

Showing the most recent 10 out of 137 publications