Improving lithotripsy.The National Institute of Diabetes and Digestive and Kidney Diseases About NIDDK The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), of the U.S. National Institutes of Health, conducts and supports research on many of the most serious diseases affecting public health. has renewed a major grant which will allow Indiana University School of Medicine The Indiana University School of Medicine is the medical school of Indiana University, part of the Indiana University Purdue University at Indianapolis (IUPUI) campus located in Indianapolis, Indiana. Established in 1903, the school had an initial class of 25 students. researchers to continue scrutinizing the long-term effects of shock wave lithotripsy Lithotripsy Definition Lithotripsy is the use of high-energy shock waves to fragment and disintegrate kidney stones. The shock wave, created by using a high-voltage spark or an electromagnetic impulse, is focused on the stone. in the treatment of kidney stones. "In our previous grants, we were looking for mechanisms that cause shock waves to break stones and injure tissue," said Dr. Andrew Evan, professor of anatomy and the principal investigator of the $6.5 million grant. "We have spent nine years on that and have made very good progress in answering those questions. Now, we're reviewing the data to develop protocols to make lithotripsy safer for all patients." For example, earlier studies show that low doses of shock waves cause blood vessels in the kidney to narrow or constrict--protecting the kidney and reducing internal bleeding before strong shock waves are administered to break up a stone. Now, the research team will try to determine the physiological mechanisms causing the blood vessel constriction constriction /con·stric·tion/ (kon-strik´shun) 1. a narrowing or compression of a part; a stricture.constric´tive 2. a diminution in range of thinking or feeling, associated with diminished spontaneity. . That information will help launch a clinical trial, which may revamp standard shock wave lithotripsy protocols or lead to the development of drugs that can enhance the constriction to reduce the number of shocks administered. Another part of the project included in the grant funding is under the direction of Tim Colonius, Ph.D., a professor of aeronautics at California Institute of Technology California Institute of Technology, at Pasadena, Calif.; originally for men, became coeducational in 1970; founded 1891 as Throop Polytechnic Institute; called Throop College of Technology, 1913–20. . Dr. Colonius and his team have developed a sophisticated computer model of air bubbles generated when shock waves travel through the water to the kidney. "As a group, we think these bubbles, called acoustic cavitation cavitation Formation of vapour bubbles within a liquid at low-pressure regions that occur in places where the liquid has been accelerated to high velocities, as in the operation of centrifugal pumps, water turbines, and marine propellers. , are important in stone breakage and kidney damage," said Dr. Evan. The Caltech team members will attempt to build a virtual lithotriptor lithotriptor /litho·trip·tor/ (lith´o-trip?tor) lithotripter. to simulate what happens to the kidney in a shock wave path. "There is a consistent theme to all of our research and that is to reduce the kidney's exposure to shock waves, improving the effectiveness of lithotripsy and safeguarding the patient's health," said Dr. Evan. |
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