Oscillations, Waves, and Interactions - GWDG

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200 W. Eisenmenger and U. Kaatze The successful extracorporeal disintegration of stones in the seventies of the last century, using acoustical waves or shock waves in Saarbrücken [1] and Friedrichshafen [2], has revolutionized the treatment of urinary lithiasis. Extracorporeal shock wave lithotripsy (ESWL) has received rapid acceptance, because of its noninvasive nature, high efficiency, and ease of use. Lithotripsy is the most effective non-surgical procedure for the disintegration of kidney stones ever developed. It is an alternative to surgery for seventy to eighty per cent of patients with kidney stones. Therefore, within a very few years, ESWL became the standard treatment for stones in the kidney and ureter worldwide. Stones are comminuted into small fragments which are passed with the urine during the weeks after treatment. The risk for patients to suffer major complications is distinctly lower than with surgical stone removal. The unique development of ESWL has been described in various review articles and textbooks [3–8]. Despite increasing perfection in the lithotripter generations that followed the first Dornier HM3 device, there is currently only limited agreement on the relevant stone breaking mechanisms. Some authors consider cavitation, besides shear and spalling, as the most important force for the ultimate stone fragmentation in applications of conventional lithotripters [8,9]. Cavitation is believed to cause trauma to thin-walled vessels in the kidney and in adjacent tissue as side effects, leading to short-term complications and to scar and chronic loss of tissue function [8]. Alternatively, in experiments with focal diameters on the order of the stone diameter, evidence for a squeezing mechanism has been found [10]. In addition to the question of the stone fragmentation mechanism, it has become obvious that, since the promising introduction of the Dornier HM3, progress in ESWL techniques has been unexpectedly slow [11]. The further optimization of the physical parameters of the pressure shock waves with respect to fragmentation efficiency and avoidance of side effects has been scarce and is still matter of a lively scientific debate [7,12]. In this article we summarize the results on the efficient mechanism of stone fragmentation by wide-focus and low-pressure shock waves, which one of us has obtained at the University of Stuttgart [10]. We also review clinical studies [13,14] demonstrating successful treatment of a large group of patients with kidney stones, without necessity for preventive measures, using an advanced ESWL conception. It involves a wide-focus low-pressure lithotripter that had been developed in cooperation between the Erstes Physikalisches Institut of the University of Stuttgart and the Xixin Medical Instruments Co. Ltd., Suzhou, China. 2 Lithotripter shock wave generation Shock wave lithotripters are currently produced by more than ten companies. As an example, Fig. 1 shows the Xixin instrument, meanwhile named XX-ES lithotripter [15], as it has been used in the clinical studies which we report here. During treatment the patient rests on an examination couch which is provided with X-ray equipment and/or ultrasonic B-scan facilities for the optimum positioning. For the treatment of the patient in either dorsal or face-down position the lithotripter is equipped with a shock wave generator in an overcouch or undercouch arrangement. The shock wave
Wide-focus low-pressure ESWL 201 Figure 1. Lithotripter of Xixin Medical Instruments Co. Ltd., China, equipped with self-focussing electromagnetic shock wave generator from the University of Stuttgart. is normally coupled to the patient’s body via a water-filled cushion and a gel coat. Various principles of shock wave generation are used [4]. In the electrohydraulic, or spark-gap, technology the wave is created under water by generation of an electrical discharge between two tips of an electrode (Fig. 2). The discharge produces a vaporization bubble which expands and immediately collapses, generating a highenergy pressure wave thereby. The electrode tips are located in the first focus of an ellipsoidal reflector made of suitable metal. Hence the high-energy pressure waves created in this point converge at the second focal point of the ellipse where pressure is sufficiently high for fragmentation of stones. In the piezoelectric method a shock wave is generated by an array of some tens to thousands of piezoelectric elements stimulated with high-energy electrical pulses Figure 2. Sketch of electromagnetic shock wave generation with a high-voltage electrical current passing across a spark-gap electrode system that is located within a water-filled container.
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Thomas Kurz, Ulrich Parlitz, and Ud
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erschienen im Universitätsverlag G
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Bibliographische Information der De
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iv Contents Laser speckle metrology
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Oscillations, Waves and Interaction
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Applied physics at the “Dritte”
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noise component [GNE] 5 4 3 2 1 can
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3.4 Transfer to running speech Spee
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3.4.2 Analysis of running speech Sp
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Speech research 33 Area [Pixels] 60
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Speech research 35 [13] D. Michaeli
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Specific signal types in hearing re
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74 D. Ronneberger et al. Mechel fou
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76 D. Ronneberger et al. (flow velo
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78 D. Ronneberger et al. |t + acous
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80 D. Ronneberger et al. Figure 6.
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82 D. Ronneberger et al. Figure 8.
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84 D. Ronneberger et al. (flow velo
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96 D. Ronneberger et al. powers of
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100 D. Ronneberger et al. The term
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102 D. Ronneberger et al. Neverthel
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104 D. Ronneberger et al. [4] J. Br
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106 D. Ronneberger et al. strömung
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108 D. Guicking synchronised tuning
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110 D. Guicking primary noise micro
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112 D. Guicking primary sensor desi
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114 D. Guicking by an antiphase sou
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116 D. Guicking R L C C + + 1 1−C
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118 D. Guicking More involved than
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120 D. Guicking In the 1980s, longi
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122 D. Guicking with electrodynamic
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124 D. Guicking 3.6 Noise reduction
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126 D. Guicking the turbulence of a
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128 D. Guicking References [1] Lord
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130 D. Guicking [44] Falcke, H.,
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132 D. Guicking [84] J. Melcher,
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134 D. Guicking [125] D. Heyland et
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136 D. Guicking [166] S. Zommer et
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138 D. Guicking [212] M. L. Post an
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140 W. Lauterborn et al. liquid κ
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142 W. Lauterborn et al. Figure 2.
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144 W. Lauterborn et al. nator, and
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146 W. Lauterborn et al. by types a
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148 W. Lauterborn et al. bubble rad
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250 A. Vogel, I. Apitz, V. Venugopa
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260 K. D. Hinsch Generally, any of
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262 K. D. Hinsch Figure 1. Monitori
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264 K. D. Hinsch Figure 3. ESPI stu
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266 K. D. Hinsch Figure 4. Deterior
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268 K. D. Hinsch Often, in-plane mo
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270 K. D. Hinsch Figure 7. Optical
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272 K. D. Hinsch Figure 9. Humidity
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276 K. D. Hinsch Figure 13. Map of
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278 K. D. Hinsch References [1] D.
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280 Schreiber not moving along with
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282 Schreiber These properties made
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284 Schreiber Figure 3. The G ring
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286 Schreiber Rotation Rate [rad/s]
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288 Schreiber and it is currently b
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290 Schreiber n1 D A B n Figure 8.
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292 Schreiber Beamwalk [µm] 80.0 7
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294 Schreiber ∆ Perimeter [*10e12
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296 Schreiber and the last term acc
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298 Schreiber Δf [µHz] 100 50 0 -
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300 Schreiber formation of a new wo
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302 Schreiber PSD [*10 16 (rad/s) 2
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304 Schreiber 7.2 The ring laser co
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306 Schreiber Demodulator Signal [V
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308 Schreiber Est. Phase Vel. (m/s)
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310 Schreiber [18] V. Frede and V.
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312 Martin Dressel tice is reduced
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314 Martin Dressel Metallic whisker
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316 Martin Dressel (a) (b) (c) CH 3
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318 Martin Dressel 3.1 Charge densi
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320 Martin Dressel Absorptivity σ
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322 Martin Dressel brought a confir
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324 Martin Dressel a charge disprop
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326 Martin Dressel Conductivity 70
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328 Martin Dressel Reflectivity Con
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330 Martin Dressel References [1] M
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332 Martin Dressel and L. Montgomer
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334 R. Pottel, J. Haller and U. Kaa
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368 U. Kaatze and R. Behrends with
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386 U. Kaatze and R. Behrends of th
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398 U. Kaatze and R. Behrends [6] M
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400 U. Kaatze and R. Behrends [49]
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402 U. Kaatze and R. Behrends (2002
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404 U. Kaatze and R. Behrends Copyr
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406 U. Parlitz here chaos control m
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410 U. Parlitz 4 10 5 5 (a) (b) (c)
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418 U. Parlitz Figure 9. Correlatio
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420 U. Parlitz series” where for
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422 U. Parlitz current state future
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424 U. Parlitz tion [69] of two uni
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426 U. Parlitz LD1 LD2 M BS1 BS2 OD
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428 U. Parlitz with a clear tendenc
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430 U. Parlitz (a) y (c) y 40 20 È
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432 U. Parlitz [29] P. Grassberger,
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434 U. Parlitz [76] H. D. I. Abarba
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436 S. Lakämper and C. F. Schmidt
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462 Index basin of attraction, 144
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464 Index cone bubble structure, 19
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466 Index turbulent, 111, 126 fluct
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468 Index LPC, 29 luminescence of b
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470 Index peak factor, 38, 43 Peier
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472 Index laser-induced bubble, 152
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474 Index ultraharmonic resonance,
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