cavitáéció előadás

8/6/2019 cavitci elads

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PROSLIMELTPROSLIMELT


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LowLow frequencyfrequency ultra soundultra sound

technologytechnology forforlocalisedlocalised fatfat reductionreduction


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First developed in World War II to locate submergedFirst developed in World War II to locate submergedobjects, the technique is now widely used in virtuallyobjects, the technique is now widely used in virtually

every branch of medicine.every branch of medicine.

In obstetrics, to study the age, sex, and level ofIn obstetrics, to study the age, sex, and level ofdevelopment of the foetus and to determine the presencedevelopment of the foetus and to determine the presence

of birth defects or other potential problems.of birth defects or other potential problems.In cardiology to detect heart damage.In cardiology to detect heart damage.

In ophthalmology to detect retinal problems.In ophthalmology to detect retinal problems.

Also used to heat joints, relieving arthritic joint pain, andAlso used to heat joints, relieving arthritic joint pain, andfor procedures such asfor procedures such as lithotripsylithotripsy ..

HISTORYHISTORY


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High-frequency therapeutic ultrasounds(1 to 3 MHz) have long been used for their analgesic,

coagulating, de-fibrotic properties.

However high-frequency ultrasounds do notproduce desired results on subcutaneous fat.

Hence, the use of low-frequency ultrasounds forthe treatment of lipodystrophies.

Ultrasound technology is non invasive, involves noradiation, and avoids possible hazards such asbleeding, infection, or reactions to chemicals.

RATIONALERATIONALE


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TARGET = FATTARGET = FATUltra SoundUltra Sound TransducerTransducer

EpidermisEpidermis

DermisDermis

HypodermisHypodermis &&

SubcutaneousSubcutaneous

fatfat

ParallelParallel fatfat

MuscleMuscle

TargetedTargeted AreaArea


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AESTHETIC APPLICATIONAESTHETIC APPLICATION

ImproveImprove shapeshape

Reduce volumeReduce volume


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FUNCTIONFUNCTION

LowLow --frequencyfrequency ultrasonicsultrasonics waveswaves havehave threethree principalprincipal effectseffects

DepolymerizationDepolymerization or the molecular dislocation of triglyceridesor the molecular dislocation of triglyceridesand the increase of their fluidity.and the increase of their fluidity.

LipolysisLipolysis or the ejection of fatty acids fromor the ejection of fatty acids from adipocyteadipocyte cellscells

due to stabledue to stable cavitationcavitation s and an increase ins and an increase in adipocyteadipocyte cellularcellularpermeability.permeability.

AdipocteAdipocte lysislysis ( disruption )( disruption )

DefibrosisDefibrosis through thethrough the defibrinolyticdefibrinolytic mechanical action on bulkmechanical action on bulktissue present in the hypoderm.tissue present in the hypoderm.


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LipolysisLipolysis && FatFat reductionreduction

TGTG

TGTG

TGTG

LPL

LPLLPL

TG with LPL FFA +

Glycerol ( water soluble)FFA binds to Albumin ( 2 3molecules of FFA binds to 1 ofalbumin ) transported away

FFA is metabolised by Liver

AdipocytesAdipocytes


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CAVITATIONCAVITATION

AcousticAcoustic cavitationcavitation occurs whenever a liquid is subjected tooccurs whenever a liquid is subjected to

sufficiently intense sound or ultrasound (frequencies of 20 kHzsufficiently intense sound or ultrasound (frequencies of 20 kHz upupto10 MHz).to10 MHz).

When sound passes through a liquid, it consists ofWhen sound passes through a liquid, it consists of expansionexpansionwaveswaves (negative(negative --pressure) andpressure) and compression wavescompression waves (positive(positive --pressure). If the intensity of the sound field is high enough, ipressure). If the intensity of the sound field is high enough, i t cant cancause the formation, growth, and rapid recompression of vapourcause the formation, growth, and rapid recompression of vapourbubbles in the liquid.bubbles in the liquid.

The implosive bubble collapse generatesThe implosive bubble collapse generates localized heatinglocalized heating , a, apressure pulse, and associated highpressure pulse, and associated high --energy chemistry.energy chemistry.


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CAVITATION PHENOMENONCAVITATION PHENOMENON

BubbleBubble

isis bornborn

andand

growsgrows

inin

negativenegative

pressurepressure

toto

maximummaximum

sizesize

BubbleBubble collapsescollapses inin compressioncompression

A newA new bubblebubble isis bornborn && cyclecycle repeatsrepeats itselfitself


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SPECIFICITIESSPECIFICITIES

FocusedFocused UltrasoundUltrasoundTwinTwin TransducersTransducers TechnologyTechnology

45 mm45 mm diameterdiameter eacheach withwith spotspot surfacesurface = 16 cm= 16 cm22


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SPECIFICITIESSPECIFICITIES

Power : 5Power : 5 wattswatts / cm2/ cm28080 wattswatts perper treatedtreated spotspot

FrequencyFrequency : 30: 30 khzkhz 7070 khzkhzSweepSweep Time: 3Time: 3 3030 ChangeableChangeable parametersparameters

Treatment timeTreatment timePowerPower

SweepSweep timetime


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PRONEPRONE

SESSION TREATMENT TIMESESSION TREATMENT TIME

AREA AREA PER AREA PER AREA TOTAL / ST / P TOTAL / ST / P

BACK BACK 4X154X15 6060 / 15/ 15 / 55/ 55

LOWER BACK &LOWER BACK &BOTTOMBOTTOM 4X154X15 6060 / 30/ 30 / 65/ 65

LATERAL EXTERNALLATERAL EXTERNALPOSTERIOR THIGHPOSTERIOR THIGH 3030 6060 / 30/ 30 / 65/ 65

CALVESCALVES 2020 4040/ 5/ 5 / 45/ 45

PROTOCOLSPROTOCOLS

Interval between treatment sessions 15 - 21 days (related to patient basal metabolism and lifestyle)

ST = ST = Sweep Sweep or or Scan Scan Time Time P = Power P = Power


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SUPINESUPINE SESSION TREATMENT TIMESESSION TREATMENT TIME

AREA AREA PER AREA PER AREA TOTAL / ST / P TOTAL / ST / P

EXTERNAL ARMSEXTERNAL ARMS 2020--3030 4040--6060 / 5/ 5 / 45/ 45EXTERNAL PARTEXTERNAL PART

BREAST/ PECTORALBREAST/ PECTORAL 2020 4040 / 15/ 15 / 55/ 55

ABDOMEN 4 ABDOMEN 4

SEGMENTSEGMENT 4X154X15 6060 / 30/ 30 / 60/ 60INNER, MEDIUMINNER, MEDIUM

THIGH THIGHINNER KNEEINNER KNEE

1010 --1515X3X3=30=30 --4545X2X2 6060--9090 / 20/ 20 /50/50

EXTERNAL THIGHEXTERNAL THIGH 3030 6060 / 30/ 30 / 70/ 70

PROTOCOLSPROTOCOLS

ST = ST = Sweep Sweep or or Scan Scan Time Time

P = Power P = Power


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CLINICAL RESULTSCLINICAL RESULTS


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CAMERA PICTURESCAMERA PICTURESRESULTSRESULTS

AFTER ONE SESSIONAFTER ONE SESSION


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Before After


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Before After


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Before After


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Before After


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Before After


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ProSlimPrKn0307 24Before After


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Before After


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0

10

20

30

40

50

60

70

80

90

100

1 2 3 4

Before

After

80

85

90

95

100

105

1 2

Before

After

AbdomenAbdomen after 4after 4 sessionssessions

ThighThigh after 6after 6 sessionssessions

PERIMETRIC EVALUATIONPERIMETRIC EVALUATION


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EchographicEchographic evaluationevaluation

AbdominalAbdominal area.area.

InitialInitial : 1.5 mm Post : 1.3mm: 1.5 mm Post : 1.3mm

PerimetricPerimetric reductionreduction : 3 cm: 3 cm

MeasurementMeasurement of theof the subcutaneoussubcutaneous fatfat layerlayer


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UpperUpper flankflank area.area.

InitialInitial : 0.9 mm Post : 0.8mm: 0.9 mm Post : 0.8mm

PerimetricPerimetric reductionreduction : 1 cm: 1 cm

TheThe amountamount ofof fatfat lossloss isis relatedrelated toto layerlayer thicknessthickness


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MidMid flankflank area.area.

InitialInitial : 1.2 mm Post : 1.1mm: 1.2 mm Post : 1.1mmPerimetricPerimetric reductionreduction : 2 cm: 2 cm

DensityDensity lossloss duedue toto adipocytesadipocytes disruptiondisruption withwith nono damagedamage toto surroundingsurrounding tissuestissues


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0

10

20

30

40

50

60

70

80

90

100

1 2 3 4

Before

After

80

85

90

95

100

105

1 2

Before

After

AbdomenAbdomen after 4after 4 sessionssessions

ThighThigh after 6after 6 sessionssessions

PERIMETRIC EVALUATIONPERIMETRIC EVALUATION


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CONTRAINDICATIONSCONTRAINDICATIONS

ABSOLUTEABSOLUTE

PregnancyPregnancy

BreastBreast feedingfeeding SeriousSerious LiverLiver disfunctiondisfunction

((HepatitisHepatitis ,, CyrhosisCyrhosis ))

SeriousSerious kydneykydney disfunctiondisfunction

EvolutiveEvolutive diseasedisease

MetalMetal implantimplant Pace makerPace maker


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CONCLUSIONCONCLUSIONTimeTime efficientefficient & non invasive procedure& non invasive procedure

EfficientEfficient && SafeSafe bodybody contouringcontouring treatmenttreatment

VisibleVisible reductionreduction of bodyof body circumferencecircumference afterafter eacheachtreatmenttreatment

AdiposeAdipose tissuetissue lysedlysed andand clearedcleared throughthrough naturalnaturalmechanismmechanism

No down time / No down time / WalkWalk in procedurein procedureOffice base treatment / noOffice base treatment / no surgicalsurgical theatertheater

NoNo anesthesiaanesthesia / / comfortablecomfortable procedureprocedure

PossibilityPossibility toto treattreat 22 areasareas at theat the samesame timetime


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REFERENCESREFERENCES1.1. Kenneth S.Kenneth S. SuslickSuslick . The Chemistry of. The Chemistry of cavitationcavitation . The Yearbook of. The Yearbook of

Science & the Future 1994; Encyclopaedia Britannica: Chicago, 19Science & the Future 1994; Encyclopaedia Britannica: Chicago, 19 94; pp94; pp138138 --155.155.

2.2. Gann N. Ultrasound: current concepts.Gann N. Ultrasound: current concepts. ClinClin Manage 1991;11:64Manage 1991;11:64 9.9.3.3. ZiskinZiskin M,M, McDiarmidMcDiarmid T,T, MichlovitzMichlovitz S. Therapeutic ultrasound. In:S. Therapeutic ultrasound. In:

MichlovitzMichlovitz S, ed. Thermal agents in rehabilitation. Philadelphia: F. A.S, ed. Thermal agents in rehabilitation. Philadelphia: F. A.Davis, 1990. .Davis, 1990. .

4.4. ChapelonChapelon J.Y.,J.Y., PichardoPichardo S.,S., ChavrierChavrier F.,F., CurielCuriel L., Angel Y.C. Effect ofL., Angel Y.C. Effect ofCavitationCavitation on Ultrasound Absorption in Biological Tissue.on Ultrasound Absorption in Biological Tissue. INSERM U556,INSERM U556,LyonLyon , FRANCE., FRANCE.

5.5. Bailey M.R.,Bailey M.R., HalaasHalaas D.J., Martin R. (D.J., Martin R. ( CenterCenter for Industrial and Medicalfor Industrial and Medical

Ultrasound, Applied Physics Laboratory, University of WashingtonUltrasound, Applied Physics Laboratory, University of Washington ,,Seattle, WA, USA);Seattle, WA, USA); CavitationCavitation Control by Dual FrequencyControl by Dual Frequency HinghHingh IntensityIntensityFocused Ultrasound.Focused Ultrasound. ChulichkovChulichkov A.A.,A.A., KhokhlovaKhokhlova V.A. (Department ofV.A. (Department ofAcoustics, Faculty of Physics, Moscow State University, Moscow,Acoustics, Faculty of Physics, Moscow State University, Moscow,

RUSSIA)RUSSIA)


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8.8. VykhodtsevaVykhodtseva N.,N., McdannoldMcdannold N.,N., SheikovSheikov N., Martin H.,N., Martin H., HynynenHynynen K.K.Effects ofEffects of cavitationcavitation induced by Low power Focused Ultrasound in theinduced by Low power Focused Ultrasound in thepresence of an US Contrast Agent: Study on Rabbit Brain in Vivo.presence of an US Contrast Agent: Study on Rabbit Brain in Vivo.

Focused Ultrasound Laboratory, Department of radiology, BrighamFocused Ultrasound Laboratory, Department of radiology, Brigham andandWomenWomen s Hospital, Harvard Medical school, Boston USA)s Hospital, Harvard Medical school, Boston USA)9. Ceccarelli M., Varlaro V. Idrolipoclasia Ultrasonica 1 ., 1996, Edizioni

Trimograf, Spezzano Albanese (CS).10. Silberg BN. The use of external ultrasound assist with liposuction :

Aesth Surg J 1998,16:284-511. Webster DF , Harvey W , Dyson M , Pond JB . The role of ultrasound-induced cavitation in the in vitro stimulation of collagen synthesisin human fibroblasts . Ultrasonics. 1980 Jan;18(1):33-7. PMID: 7350723[PubMed - indexed for MEDLINE]

12. Doan N , Reher P , Meghji S , Harris M . In vitro effects of therapeuticultrasound on cell proliferation, protein synthesis, and cytokineproduction by human fibroblasts, osteoblasts, and monocytes . JOral Maxillofac Surg. 1999 Apr;57(4):409-19; discussion 420.PMID:10199493 [PubMed - indexed for MEDLINE]

REFERENCESREFERENCES
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Webster+DF%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Harvey+W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Dyson+M%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Pond+JB%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Reher+P%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Meghji+S%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Harris+M%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Harris+M%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Meghji+S%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Reher+P%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Pond+JB%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Dyson+M%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Harvey+W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term=%22Webster+DF%22%5BAuthor%5D

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