Part I. Mechanisms of injury associated with extracorporeal shock wave lithotripsy; Part II. Exsolution of volatiles

Citation

Howard, Danny Dwayne (1996) Part I. Mechanisms of injury associated with extracorporeal shock wave lithotripsy; Part II. Exsolution of volatiles. Dissertation (Ph.D.), California Institute of Technology. doi:10.7907/995X-8517. https://resolver.caltech.edu/CaltechETD:etd-10242005-083544

Abstract

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Part I - Shock waves are focused in extracorporeal shock wave lithotripsy (ESWL) machines to strengths sufficient to fracture kidney stones. Substantial side effects-most of them acute-have resulted from this procedure, including injury to soft tissue. The focusing of shock waves through various layers of tissue is a complex process which stimulates many bio-mechano-chemical responses.

This thesis presents results of an in vitro study of the initial mechanical stimulus. Planar nitrocellulose membranes of order 10 um thick were used as models of thin tissue structures. Two modes of failure were recorded: Failure due to cavitation collapsing on or near the membranes, and failure induced by altering the structure of shock waves. Tests were done in water at and around F2 to characterize the extent of cavitation damage, and was found to be confined within the focal region, 1.2 cm along the axis of focus.

Scattering media were used to simulate the effects of acoustic nonuniformity of tissue and to alter the structure of focusing shock waves. 40 um diameter (average) hollow glass spheres were added to ethylene glycol, glycerine and castor oil to vary the properties of the scattering media. Multiple layer samples of various types of phantom tissue were tested in degassed castor oil to gauge the validity of the scattering media. The scattering media and tissue samples increased the rise time decreased strain rate in a similar fashion. Membranes were damaged by the decreased strain rate and accumulated effects of the altered structure: After about 20 or so shocks immersed in the scattering media and after about 100 shocks behind the tissue samples. The mode of failure was tearing with multiple tears in some cases from about .1 cm to about 3 cm depending of the number of shocks and membrane thickness.

Part II - This work examines the exsolution of volatiles-carbon dioxide from water-in a cylindrical test cell under different pressure conditions. Water was supersaturated with carbon dioxide under various pressures (620 to 1062 kPa), and depressurized rapidly to investigate how carbon dioxide is undissolved, exsolution, and its effects on the surrounding environment. Cavities grow as a result of convective diffusion: They move before depleting carbon dioxide in a given region. The radius of a cavity in this environment grows at a faster rate [...] than that of a cavity at rest [...]. Bubble growth rates were inferred by measuring the bulk liquid using high speed motion pictures. Water in the test-cell is accelerated as a result of buoyancy induced by cavity growth. Cavities are elliptical in shape and grow until mutual interaction causes them to fragment. Accelerations range from 10 to 100 g were measured with velocities ranging from 7 to 13 m/s.

Thesis Files