by Lo, Kin Yin Anthony. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 168-195). / Abstracts in English and Chinese. / Abstract --- p.i / Declaration --- p.V / Publications and Conference Presentations --- p.vi / Scholarships and Awards --- p.vii / Acknowledgements --- p.viii / Table of contents --- p.X / Abbreviations --- p.xiv / List of Figures --- p.xvi / List of Tables --- p.xvii / Chapter 1. --- General Introduction --- p.1 / Chapter 2. --- Literature Review --- p.7 / Chapter 2.1 --- Introduction of nephrolithasis and surgical management --- p.9 / Chapter 2.1.1 --- Epidemology and physiochemistry --- p.9 / Chapter 2.1.2 --- Surgical management of nephrolithasis parallel with stone factors --- p.15 / Chapter 2.2 --- Extracorpoeral Shock Wave Lithotripsy in present study --- p.17 / Chapter 2.2.1 --- The 4th generation - Sonolith Vision electroconductive lithotripter --- p.18 / Chapter 2.2.2 --- The role of shock wave delivery rate in treatment outcome and its prediction --- p.23 / Chapter 2.2.3 --- Patient-controlled analgesia during Shock Wave Lithotripsy treatment and its pain management --- p.29 / Chapter 2.2.4 --- Shock wave induced renal injury & the use of urinary biomarker --- p.35 / Chapter 3. --- Materials and Methods --- p.62 / Chapter 3.1 --- Study Design --- p.63 / Chapter 3.2 --- Patient Selection --- p.64 / Chapter 3.3 --- Treatment Protocol --- p.63 / Chapter 3.4 --- Sample size calculation --- p.68 / Chapter 3.5 --- Statistical analysis --- p.68 / Chapter 4. --- The effect of shock wave delivery rate on treatment outcome and its prediction --- p.69 / Chapter 4.1 --- Introduction --- p.70 / Chapter 4.2 --- Materials and Methods --- p.72 / Chapter 4.2.1 --- ESWL treatment protocol --- p.72 / Chapter 4.2.2 --- Outcome Assessment --- p.73 / Chapter 4.2.3 --- Mathematical model development --- p.75 / Chapter 4.2.4 --- Statistical analysis --- p.76 / Chapter 4.3 --- Results --- p.77 / Chapter 4.3.1 --- Baseline characteristics and treatment modalities --- p.78 / Chapter 4.3.2 --- ESWL treatment outcome --- p.79 / Chapter 4.3.3 --- Mathematical model --- p.81 / Chapter 4.4 --- Discussion --- p.82 / Chapter 4.4.1 --- Overall treatment outcome improved by the use of slower rate --- p.82 / Chapter 4.4.2 --- When should we use fast/slow rate? --- p.86 / Chapter 4.4.3 --- Mathematical model to predict ESWL outcome --- p.88 / Chapter 4.5 --- Conclusion --- p.91 / Chapter 5. --- The role of shock wave delivery rate and patient-controlled analgesia in pain --- p.101 / Chapter 5.1 --- Introduction --- p.102 / Chapter 5.2 --- Materials and Methods --- p.104 / Chapter 5.2.1 --- ESWL treatment protocol and PCA settings --- p.104 / Chapter 5.2.2 --- Outcome Assessment --- p.105 / Chapter 5.2.3 --- Statistical analysis --- p.107 / Chapter 5.3 --- Results --- p.108 / Chapter 5.3.1 --- Baseline characteristics and treatment modalities --- p.108 / Chapter 5.3.2 --- Pain experience and satisfaction with PCA at different shock wave delivery rates --- p.108 / Chapter 5.3.3 --- Correlation between rate pain --- p.110 / Chapter 5.3.4 --- Vital signs --- p.110 / Chapter 5.4 --- Discussion --- p.111 / Chapter 5.4.1 --- Adverse complication was mild with PCA using alfentanil --- p.111 / Chapter 5.4.2 --- Less pain experience with 60 SWs/min --- p.112 / Chapter 5.4.3 --- Why PCA usage was the same in both groups? --- p.112 / Chapter 5.4.4 --- No correlation with treatment outcome --- p.114 / Chapter 5.5 --- Conclusion --- p.115 / Chapter 6. --- "The relations among rate of shock wave delivery, induced renal injury and acute complications" --- p.128 / Chapter 6.1 --- Introduction --- p.129 / Chapter 6.2 --- Materials and Methods --- p.130 / Chapter 6.2.1 --- ESWL treatment protocol --- p.130 / Chapter 6.2.2 --- Outcome Assessment --- p.131 / Chapter 6.2.3 --- Statistical analysis --- p.136 / Chapter 6.3 --- Results --- p.137 / Chapter 6.3.1 --- Baseline characteristics and treatment modalities --- p.137 / Chapter 6.3.2 --- Quality control of creatinine and NAG --- p.137 / Chapter 6.3.3 --- Standard curves ofIL-18 and NGAL --- p.137 / Chapter 6.3.4 --- Higher levels of urinary NAG and IL-18 in 60 SWs/min group --- p.138 / Chapter 6.3.5 --- Similar levels of urinary NGAL in both groups --- p.138 / Chapter 6.3.6 --- Unplanned hospital visits were similar in both groups --- p.139 / Chapter 6.4 --- Discussion --- p.140 / Chapter 6.4.1 --- More tubular damages caused by slower rate --- p.140 / Chapter 6.4.2 --- Escalated inflammatory activities in 60 SWs/min --- p.141 / Chapter 6.4.3 --- Vascular damage and ischemic insults were the same in both groups? --- p.142 / Chapter 6.4.4 --- Post-operative complications are similar in both groups --- p.142 / Chapter 6.4.5 --- 60 SWs/min vs. 120 SWs/min - What makes the difference in renal injury? --- p.143 / Chapter 6.5 --- Conclusion --- p.145 / Chapter 7. --- Discussion --- p.154 / Chapter 7.1 --- General discussion --- p.155 / Chapter 8. --- Conclusion --- p.158 / Chapter 8.1 --- General conclusion --- p.159 / Appendix --- p.160 / Appendix I --- p.161 / Appendix II --- p.163 / References --- p.167

Hui, Fan Fong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 153-181). / Abstract also in Chinese. / Acknowledgements --- p.ii / Abstract --- p.iii / Abbreviations --- p.vii / Table of Contents --- p.ix / List of Tables --- p.xv / List of Tables --- p.xv / List of Figures --- p.xvi / Major Conference Presentations --- p.xix / Publications in Preparation --- p.xxii / Chapter Chapter 1 --- Study Background --- p.1 / Chapter 1. --- Introduction --- p.2 / Chapter 1.1. --- Spinal Deformities --- p.2 / Chapter 1.1.1. --- Treatment --- p.2 / Chapter 1.2. --- Spinal fusion --- p.4 / Chapter 1.2.1. --- Gold Standard of Spinal Fusion --- p.4 / Chapter 1.2.2. --- Decortication in Spinal Fusion --- p.4 / Chapter 1.2.3. --- Autograft in Spinal Fusion --- p.4 / Chapter 1.2.4. --- Local Factors Influencing Spinal Fusion --- p.5 / Chapter 1.2.5. --- Ultimate Goals of Spinal Fusion --- p.7 / Chapter 1.2.6. --- Limitations of Spinal fusion --- p.7 / Chapter 1.3. --- Alternatives of Different Components for Enhancing Spinal Fusion / Chapter 1.3.1. --- Bone Graft Substitute --- p.9 / Chapter 1.3.2. --- Bioactive Factors --- p.15 / Chapter 1.4. --- Limitations of the Alternative Methods in Spinal Fusion Enhancement --- p.19 / Chapter 1.4.1. --- BMPs --- p.19 / Chapter 1.4.2. --- Gene Therapy --- p.20 / Chapter 1.4.3. --- Biophysical Stimulation --- p.20 / Chapter 1.5. --- Recent Methods in Enhancing Spinal Fusion --- p.21 / Chapter 1.5.1. --- Low Intensity Pulsed Ultrasound --- p.21 / Chapter 1.5.2. --- Mesenchymal Stem Cells in Spinal Fusion --- p.24 / Chapter 1.6. --- Conclusion --- p.26 / Chapter Chapter 2 --- "Hypothesis, Objectives and Plan of Study" --- p.29 / Chapter 2. --- "Hypothesis, Objectives and Plan of Study" --- p.30 / Chapter 2.1 --- Study Hypothesis --- p.31 / Chapter 2.2 --- Study Objectives --- p.31 / Chapter 2.3 --- Plan of Study --- p.32 / Chapter 2.3.1 --- For First Objective --- p.32 / Chapter 2.3.2 --- For Second Objective --- p.32 / Chapter 2.3.3 --- For Third Objective --- p.33 / Chapter Chapter 3 --- In vitro Study of Effect of Low Intensity Pulsed Ultrasound on Mesenchymal Stem Cells --- p.34 / Chapter 3.1. --- Introduction --- p.35 / Chapter 3.2. --- Materials and Methods --- p.36 / Chapter 3.2.1. --- Experimental Animal --- p.36 / Chapter 3.2.2. --- Materials and Reagents --- p.36 / Chapter 3.2.2.1. --- Dulbecco，s Modified Eagle Medium (DMEM) --- p.36 / Chapter 3.2.2.2. --- Phosphate Buffered Saline (PBS) --- p.37 / Chapter 3.2.2.3. --- Osteogenic Medium (OS) --- p.37 / Chapter 3.2.2.4. --- Alkaline Phosphatase (ALP) Buffer --- p.37 / Chapter 3.2.2.5. --- ALP Substrate Buffer --- p.38 / Chapter 3.2.2.6. --- MTT Stock Solution --- p.38 / Chapter 3.2.2.7. --- MTT Working Solution --- p.38 / Chapter 3.2.2.8. --- Lysis buffer --- p.38 / Chapter 3.2.2.9. --- Alkaline Phosphatase (ALP) Working Reagents --- p.39 / Chapter 3.2.3. --- Isolation of Bone Marrow Derived Mesenchymal Stem Cells (BM derived MSCs) --- p.39 / Chapter 3.2.4. --- In vitro Low Intensity Pulsed Ultrasound Treatment --- p.40 / Chapter 3.2.4.1. --- In vitro LIPUS Devices --- p.40 / Chapter 3.2.4.2. --- Treatment Procedure and Experimantal Groupings --- p.40 / Chapter 3.2.5. --- Effect of LIPUS on Cell Viability and Osteogenesis in bone marrow derived-MSCs --- p.41 / Chapter 3.2.5.1. --- Cell Viability Assay --- p.41 / Chapter 3.2.5.2. --- Alkaline Phosphatase (ALP) Enzyme Activity --- p.42 / Chapter 3.2.5.3. --- Cell Morphology and Alkaline Phosphatase Cytochemistry --- p.42 / Chapter 3.2.6. --- Statistical Analysis --- p.43 / Chapter 3.3. --- Results --- p.43 / Chapter 3.3.1. --- Morphology --- p.43 / Chapter 3.3.2. --- Total Number of Viable Cells --- p.44 / Chapter 3.3.3. --- ALP Activity Absorbance --- p.44 / Chapter 3.3.4. --- ALP staining --- p.45 / Chapter 3.3.5. --- Qualitative Analysis --- p.45 / Chapter 3.3.6. --- Quantitative Analysis --- p.46 / Chapter 3.4. --- Discussion --- p.46 / Chapter 3.4.1. --- LIPUS have No Enhancing Effect on Proliferation of MSCs in Basal Medium Nor Osteogenic Medium --- p.47 / Chapter 3.4.2. --- LIPUS Stimulate Proliferation of MSCs in Early Period --- p.49 / Chapter 3.4.3. --- LIPUS Further Enhanced Osteogenesis of MSCs in Osteogenic Medium --- p.49 / Chapter 3.4.4. --- 10 mins LIPUS treatment for 7 days can positively enhance osteogenic differentiation --- p.50 / Chapter 3.4.5. --- Optimum Conditions of LIPUS was Cell Type Dependent --- p.51 / Chapter 3.4.6. --- LIPUS Promoted Osteogenesis in MSCs through Accelerated Mineralization --- p.52 / Chapter Chapter 4 --- Enhancement of Posterior Spinal Fusion The Effect of Tissue-Engineered MSC and Calcium Phosphate Ceramic composite treated with LIPUS in Vivo --- p.68 / Chapter 4.1. --- Introduction --- p.69 / Chapter 4.1.1. --- TCP Biomaterials --- p.70 / Chapter 4.2. --- Materials and Methods --- p.71 / Chapter 4.2.1. --- Materials and Reagents --- p.71 / Chapter 4.2.2. --- Preparation of MSC Derived Osteogenic Cells-tricalcium Phosphate Ceramics Composite --- p.73 / Chapter 4.2.3. --- Posterior Spinal Fusion Surgery --- p.74 / Chapter 4.2.4. --- In vivo LIPUS treatment --- p.75 / Chapter 4.2.5. --- Assessment of Fusion Mass --- p.76 / Chapter 4.2.6. --- Histology --- p.77 / Chapter 4.2.7. --- Statistical Analysis --- p.79 / Chapter 4.3. --- Results --- p.79 / Chapter 4.3.1. --- Fusion by Manual Palpation --- p.79 / Chapter 4.3.2. --- pQCT Analysis --- p.80 / Chapter 4.3.3. --- Histological Analysis --- p.81 / Chapter 4.4. --- Discussion --- p.85 / Chapter 4.4.1. --- Summary of the Findings from Different Assessment Methods --- p.85 / Chapter 4.4.2. --- Addition of MSCs to TCP ceramic in Spinal Fusion --- p.87 / Chapter 4.4.3. --- The Needs of Differentiated MSC in Spinal Fusion --- p.89 / Chapter 4.4.4. --- bFGF Masked the Effect of OS in MSC --- p.91 / Chapter 4.4.5. --- LIPUS Enhanced Bone Formation --- p.95 / Chapter 4.4.6. --- LIPUS Enhanced Bone Formation through Mineralization --- p.96 / Chapter 4.4.7. --- LIPUS Enhanced Spinal Fusion through Bone Remodeling-induced Fusion Mass --- p.97 / Chapter 4.4.8. --- LIPUS Enhanced Bone Formation through Endochondral Ossification --- p.99 / Chapter Chapter 5 --- In Vivo Monitoring of Spinal Fusion in Animal Model with High-resolution Peripheral Quantitative Computed Tomography-A New Pilot Study --- p.122 / Chapter 5.1. --- Introduction --- p.123 / Chapter 5.2. --- Materials and Methods --- p.124 / Chapter 5.2.1. --- Animal Groupings --- p.124 / Chapter 5.2.2. --- Preparation of MSC Derived Osteogenic Cells-tricalcium Phosphate Ceramics Composite --- p.124 / Chapter 5.2.3. --- Posterior Spinal Fusion Operation Procedures --- p.125 / Chapter 5.2.4. --- LIPUS treatment --- p.125 / Chapter 5.2.5. --- High-resolution Peripheral Quantitative Computed Tomography …- --- p.125 / Chapter 5.2.6. --- Analysis with HR-pQCT --- p.126 / Chapter 5.3. --- Result --- p.128 / Chapter 5.3.1. --- Qualitative Observations from HR-pQCT Images --- p.128 / Chapter 5.3.2. --- Quantitative Analysis --- p.129 / Chapter 5.4. --- Discussion --- p.130 / Chapter Chapter 6 --- "Overall Summary, Discussion and Conclusion" --- p.140 / Chapter 6.1. --- Overall Summary and Discussion --- p.141 / Chapter 6.2. --- Limitations and Further Studies --- p.145 / Chapter 6.3. --- Conclusions --- p.147 / Chapter 6.4. --- Summary Flowchart of the whole thesis --- p.148 / References --- p.153