Siemens Aktiengesellschaft

Georg Naser

Helmut Reichenberger

Siegfried Schneider

Erhard Schmidt

Hubert Schwark

Helmut Jahn

Bernd Granz

Dietrich Hassler

Dieter Hassler

Franz Grasser

Heinz Kresse

Franz Strahwald

Alfred Ulrich

Erich Szehi

Peter Reichelsdoerfer

Karl-Heinz Schlee

A multi-channel arrangement for measuring weak magnetic fields in living tissues, and for localizing the current sources which cause the magnetic fields by evaluating the topical magnetic values measured by individual sensors of the apparatus mounted in a vertically adjustable fashion to a patient support, the patient support being longitudinally and transversely adjustable, has a bicycle ergometer disposed at a foot end of the patient support, the bicycle ergometer consisting exclusively of components which are nonmagnetic and which do not generate a magnetic field. The bicycle ergometer is used by an examination subject so that signals can be obtained by the subject at rest and at a defined exertion level. The bicycle ergometer is mounted and constructed so that the examination subject can operate the ergometer after being positioned in a fixed position on the support.

Arrangement for measuring physiologically generated weak biomagnetic

An apparatus for extracorporeal lithotripsy has one or more shock wave sources for generating shock waves converging at a focus zone in which a calculus to be disintegrated is located in a patient, and additionally has a therapeutic ultrasound source for generating ultrasound waves focused at a focus zone substantially coinciding with the focus zone of the shock wave source. The ultrasound waves generated by the therapeutic ultrasound source have a sufficiently high energy to be effective for assiting in disintegrating the calculus, as contrasted with ultrasound waves used to obtain an ultrasound image. The shock wave source and the therapeutic ultrasound source can be driven from a generator stage connected both sources, which is capable of driving the sources simultaneously or in selected chronological succession, such as in alternation.

Apparatus for extracorporeal lithotripsy using shock waves and

A coupling member for transmission of shock waves from a shock wave device to a patient to be treated is composed of an elastic, shape-stable material having a moist outside surface, and is preferably formed of a hydro-gel, such as a polyacrylamide gel. The material is provided with an insert which contributes to its good stability and also enables manipulation of the member. The coupling member can also include, with or without the insert, a shock wave sensor which is embedded in the material and enables checking the power and the position or center of the shock wave source relative to a predetermined point.

Coupling member for a shock wave therapy device

A shock wave generator has a focusing stage wherein a number of different lenses having respectively different concentrating characteristics are accommodated, and which can be selectively introduced transversely into the path of the shock wave pulse, by linear displacement or by pivoting. The lenses can be alternatively introduced one at a time in one embodiment, or in a second embodiment more than one lens can be simultaneously introduced to achieve a concentrating characteristic resulting from a combination of lenses. For further adjustment and flexibility, the shock wave generator is provided with at least two capacitors for selectively varying the amount of discharge energy used to trigger the shock wave. The approach path between the membrane which generates the shock wave and the lens can also be varied. By combining variations in the discharge energy, the length of the approach path, and the type of lens, a wide range of operating conditions are available so that operation of the shock wave generator can be adapted from patient to patient in accord with the best suited treatment.

Shock wave generator for generating an acoustical shock wave pulse

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.

Shockwave source having a centrally disposed ultrasound locating system

A holding mechanism for vertically positioning a measuring cryostat relative to a patient includes a pair of spaced, vertically-extending columns, which are preferably connected at their upper ends by a cross member, each of said columns has a box vertically movable along the column. The two boxes are interconnected by a shackle which is mounted at each end for rotation on the boxes, and the shackle includes an arrangement for mounting the cryostat on the shackle which allows pivoting of the cryostat in a plane of the shackle. Thus, the structure allows for both rotating the cryostat around an axis around a point and pivoting in a plane extending perpendicular to the direction of rotation around the same point. In addition, the mechanism enables vertically positioning the point relative to a patient or other object.

Holding mechanism for a measuring cryostat

A shock wave tube has a coil carrier, an isolating foil, and a diaphragm. The diaphragm is made of a bronze alloy, preferably beryllium bronze. The diaphragm is silvered on the side facing the coil carrier. The coil carrier is made of an aluminum oxide ceramic. Advantages deriving from the use of the materials are long life, substantially constant technical parameters and good reproducability of the shock waves generated.

Shock wave tube with long service life

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.

Lithotripter comprising locating apparatus

A shock wave source, especially useful for a lithotriptor, has a pressure source for the generation of a pressure wave impulse, a focusing device for focusing the pressure wave pulse, and a seal diaphragm for coupling the pressure wave pulse into the body of a patient, perhaps via a coupling body placed between the seal diaphragm and the patient. The seal diaphragm and the focusing device of the pressure source form a space which serves as a prepassage. The prepassage space is filled with a liquid substance which has a high B/A ratio and an acoustic impedance less than or equal to that of water. The advantage of this configuration is that the pressure wave pulse can be built up very rapidly in its course through the space. At a given point in the space, with the selection of the above-mentioned substances, as compared to water, a given minimum value of the quotient amplitude/build-up time of the pressure wave pulse can be achieved inspite of a reduced output amplitude at the pressure source. Consequently, the life expectancy of the pressure source is higher and less stress is placed on the patient by the acoustic energy. Thus, the degree of effectiveness of the lithotriptor is increased.

Shock wave source with increased degree of effectiveness

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.

Extracorporeal shock wave source with a piezoelectric generator

A sensor for determining the position of shock wave pulses of a shock wave source comprises a device for holding a metal foil in the region of focus for the shock wave source. The metal foil is held to extend perpendicular to the main propagation direction of the pulses and the incidence of the pulses on the metal foil will cause a bulge-like deformation of the material to be formed at the point of incidence. The deformation in the foil can be optically measured, for example, by evaluation in terms of location, diameter, depth, profile and volume to obtain conclusions about the position of the center of the focussed shock waves and also the power or intensity of the shock waves.

Sensor for evaluation of shock wave pulses

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.

Ultra-sound sensor

In exemplary embodiments, an ultrasonic transducer serves as vibration generator. It is an object of the disclosure to construct such an apparatus which, with the simplest technical construction, is functionally reliable and can be operated in a very adaptable manner and which is simultaneously especially productive with regard to the desired destruction effect. In accordance with the disclosure this object is achieved in that an ultrasonic transducer to be focused on the calculus serves as a direct acoustic irradiator for the calculus, which irradiator has a surface area such that the sound energy per square unit along the transmission path is sufficiently small so as to avoid tissue damage on the one hand, but is sufficiently great at the focus point that is suffices for the destruction of the calculus disposed at the focus, on the other hand.

Apparatus for destroying calculi in body cavities

In the exemplary embodiments, a multiple electrode for interference current therapy includes individual contact parts for emplacement on the patient at the location of application, and from which connection lines lead to the operational apparatus, or the like. In order to guarantee as simple as possible an application of the electrode system, an extended area-flexible formed part of electrically insulating plastic has flexible, electrically conductive plastic parts, as electrode contact parts, embedded in a smooth fashion. A good adaptation of the electrode system to different contours of the application location on the patient's body thus results.

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Zirndorf, Germany

Georg Naser