Helmut Reichenberger

Therapy apparatus for treating conditions of the heart and heart-proximate vessels

In a therapy apparatus and method for treating conditions of the heart and, particularly, of heart-proximate vessels with therapeutic ultrasound waves having a therapeutically effective region. The therapy apparatus generates therapeutic ultrasound waves with such an intensity that tissue modifications, particularly necrotization, are produced in the tissue located in the region of influence. The therapy apparatus preferably contains an ultrasound source that can be transesophageally applied.

Shock wave tube for the fragmentation of concrements

In a shock wave tube for concrement fragmentation in a patient the coil is formed as a plane flat coil. A tubular connecton leads from the region between the flat coil and a diaphragm disposed before it to the suction side of a vacuum pump. During operation of the shock wave tube, the diaphragm is sucked against the flat coil. The arrangement has the advantage that a pressure chamber for pressing the diaphragm from the outside is eliminated. Therefore the shock waves need not pass through any exit windows, owing to which malfunctions due to cracks in the exit window are obviated. The shock wave tube can be designed in a very compact form in conjunction with reflectors. The reflectors preferably have a parabolic form with a focus at which the concrement of the patient is positioned.

New Generation Shock Wave Lithotripsy

Extracorporeal shock wave lithotripsy has been clinically successful for more than 5 years. Currently, several devices commonly termed second generation lithotriptors are under experimental or clinical trials. We present a prototype multifunctional urological table that uses a new mode of shock wave generation along with local coupling to the patient. The results of the first 400 treatments are presented after a brief description of pre-clinical experiments. The prototype has been in operation since March 1986. Particular attention is paid to adjuvant endourological measures, which all have been performed on the same table.

Shockwave source having a centrally disposed ultrasound locating system

A shockwave source of the type wherein a shockwave is generated by rapid electromagnetic repulsion of a membrane by a rapidly energized coil has a central opening extending through the membrane and the coil. An ultrasound head of an ultrasound transmission and reception system is received in the opening. The ultrasound head is disposed in a mount which is rotatable around its longitudinal axis by a rotary drive. In one embodiment of the shockwave source, the shockwave source also has a focusing device disposed in front of the membrane, and in this embodiment the focusing device also has a central opening in which the ultrasound head is received. The ultrasound head has a distal end in contact with a liquid coupling agent for promoting transmission to, and reception from, a patient to which the shockwave source is coupled. The shockwave source is particularly suited for lithotripsy treatment of gallstones.

Method for providing a magnetic resonance image from respiration-gated image data

A method and a device for the composition of an MR image with respiration-controlled recording of the spin echoes. The phase coding gradient of an MR equipment is stepped as a function of a motion phase of the respiratory motion once per respiration cycle. With a constant phase coding gradient several scans, possibly EKG-triggered, are then recorded within the respiration cycle. The spin echo signals recorded for each scan are stored in a first memory. In a second memory, the amplitude of the respiratory motion at the respective scan moment is stored. Then a comparison of all stored amplitude of the respiratory motion with a reference value R is made. For the composition of the MR image only that scan per respiration cycle is used for which the respective amplitude of the respiratory motion fulfills a given criterion with respect to the reference value R.

Second generation shock wave lithotripsy: experience with the lithostar

SummaryExtracorporeal shock wave lithotripsy (ESWL) has been in clinical use for more than 5 years. Several devices commonly designated “second generation” lithotriptors are now under experimental or clinical trials. A multifunctional lithotriptor unit developed in cooperation with the Siemens Company in Germany is described, which utilizes an electromagnetic mode of shock wave generation along with local coupling to the patient. The results of 795 treatments are presented. The prototype has been in operation since March 1986. Adjuvant endourological measures, all of which have been performed on the same table, include insertion of double-J stents and ureteral catheters prior to ESWL in 27% of all treatments. Shock wave lithotripsy alone has been performed successfully under local anesthesia or a combination of parenteral analgesia and sedation. Results of treatment have been uniformly satisfying.

Apparatus for producing time-staggered shock waves

A shock wave tube generates a plane shock wave which is divided into two partial waves by means of a splitting device, such as a cone. Adjacent the cone are first and second reflectors. The reflectors have different parabolic curvatures and different distances from the cone. Their respective foci coincide at a common point, where a concrement is located. The partial waves require different transit times to reach the common focus point. Time-staggered shock waves are obtained in the concrement with the use of a single shock wave tube.

Lithotripter comprising locating apparatus

A lithotripter for treating calculi has a housing formed by a first sub-housing with an opening with a membrane for contacting the patient, a second sub-housing composed of two parts with the first of the two parts forming a cylindrical bearing with the first sub-housing to allow rotation around an axis, a second part being mounted for pivotal movement on an axis extending perpendicular to the axis of rotation. The second housing part supports the source of the shockwave to create a shockwave on a central axis and includes a focussing arrangement mounted on the second part for focussing the shockwave on the central axis. To locate the calculus or stone, two scanning heads having sector scanning planes are mounted at a predetermined angle on the focus arrangement. To locate the stone, the second housing part is rotated to locate the stone in one of the scan planes, and then the second housing part is pivoted to move the second scan plane onto the stone.

Extracorporeal shock wave source with a piezoelectric generator

An extracorporeal lithotripter with a piezoceramic pressure source which emits focused pressure waves focussed at a point within a patient at which a calculus to be disintegrated is located. A number of discrete piezoceramic elements are arranged along a curve forming an ultrasound resonator having a diameter of at least about 10 cm and a radius of curvature up to about 20 cm, and operated at an ultrasound frequency below about 500 kHz. The volume between the ultrasound resonator and a terminating membrane through which the pressure waves pass is filled with a A having an acoustic impedance higher than water, preferably greater than or equal to the acoustic impedance of ethylene glycol, so that the piezoceramic elements, forming the pressure source, can be disposed closer to the focus, thereby reducing losses due to non-linear attenuation. The overall efficiency of the lithotripter is thereby increased, and the load of acoustical energy on the patient is diminished. A coupling member may be disposed between the terminating membrane and the patient.

Ultra-sound sensor

The ultrasound sensor (2) of the invention comprises a polymer foil (4) which is supported in its outer region and is piezoelectrically activated at least in one portion (42). The portion (42) is coupled electrically to a first electrode (200) in the form of an adjacent, i.e., touching pin. A second electrode (8), in the form of a grid (214) connected to ground and/or a ring (216) connected to ground, is physically separated from the activated portion (42). The pin (200) is connected to the first input of an amplifier (210). The second input thereof is connected to ground. The metallic take-off at the activated zone (42) results in high sensitivity of the ultra-sound sensor (2) which is provided particularly for the measurement of shock waves with a high pressure amplitude and which finds application in lithotripsy.