WO1996004957A1 - Electrotherapeutic system - Google Patents
Electrotherapeutic system Download PDFInfo
- Publication number
- WO1996004957A1 WO1996004957A1 PCT/US1995/000938 US9500938W WO9604957A1 WO 1996004957 A1 WO1996004957 A1 WO 1996004957A1 US 9500938 W US9500938 W US 9500938W WO 9604957 A1 WO9604957 A1 WO 9604957A1
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- WIPO (PCT)
- Prior art keywords
- prf
- recited
- plate
- capacitor
- applicator
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
Definitions
- This invention relates to an electro ⁇ mechanical system for the treatment of living tissues and/or cells by altering their interaction with their electrodynamic and electrostatic environments.
- the invention also relates to a system for the modification of cellular and tissue growth, repair, maintenance, and general behavior by the application of encoded electrical information. More particularly, this invention provides for the application, by surgically non-invasive direct reactive coupling, of one or more electrical voltage and corresponding current signals conforming to highly specific electromagnetic signal patterns.
- the instant invention accordingly, relates to the generalized area now known as electromagnetic medicine. That is, the use of electrical signals to modulate rates of in vivo biological growth and of repair processes.
- EMF millivolts per centimeter
- a second therapeutic EMF method to which the instant invention is more directly concerned involves the use of a shortwave pulsed radio frequency (PRF) signals having a microsecond burst of megahertz sinusoidal waves with such bursts repeating between 0.01 and 1000 Hertz, and inducing a maximum electrical field in the volts per centimeter range at tissue level.
- PRF radio frequency
- a PRF signal derived from a 27 MHz continuous sine wave used for deep tissue healing is known in the prior art of diathermy and its above referenced non-thermal successors thereto.
- a pulsed successor of the diathermy signal was originally reported as an electromagnetic field capable of eliciting a non-thermal biological effect in the treatment of infections by Ginzberg. Since that original work, PRF therapeutic applications have been reported for the reduction of post- traumatic and post-operative pain and edema in soft tissues, wound healing, burn treatment, and nerve regeneration. The application of EMF for the resolution of traumatic edema has become increasingly used in recent years. Results to date using PRF in animal and clinical studies suggest that edema may be measurably reduced from such electro-physical stimulus.
- EMF affects sympathetic outflow, including vasoconstriction, which restricts movement of blood constituents from vascular to extravascular compartments at the injury site.
- the within invention is based upon biophysical and animal studies which attribute the effect of cell-to-cell communication on the sensitivity of tissue structures to induced voltages and associated currents.
- a defining characteristic burst formed of such megahertz frequency pulses has been that of the configuration of the bi-polar amplitude envelope of the voltage of each pulse burst.
- This art is reflected in such clinical therapeutic devices as the SofPulse of Magnetic Resonance Therapeutics, Inc., Pompano Beach, Florida.
- a limitation in the art of record has been that efficient reactive coupling of the PRF signal to the tissue of interest has been difficult to accomplish.
- the instant invention addresses this problem by means of a system in which the impedance of the applicator head of the PRF apparatus is pre-set to an appropriate range of physiologic impedance and in which the power level of the PRF output of the pulse generating apparatus is continually monitored to thereby assure a closely regulated PRF signal input to the applicator head.
- This in combination with tunable reactive means in the applicator head, enables delivery of PRF signal within the appropriate range of physiologic impedance. With such efficient reactive coupling to the tissue to be treated, various advantages of system efficiency and effectiveness of delivered PRF signals are accomplished.
- the present invention sets forth a system for tissue-impedance matched pulsed radio frequency (PRF) electrotherapy in which said system includes a power supply; excitation means for generating PRF signals of a selectable frequency, said means having an input from said power supply; means for power amplification of signals from said excitation means; means for controlling pulse width duration, pulse burst repetition rate, and amplitude of said PRF signals, said controlling means having an input from said power supply.
- PRF radio frequency
- the system yet further includes a variable reactance athermapeutic applicator having, as a coaxial cable input thereto, said power and impedance compensated PRF signals outputted from said comparing means, said applicator including a treatment surface having an effective physiologic impedance in the range of 0.10 to 0.15 ohms.
- Fig. 1 is a perspective view showing the PRF generator and applicator head of the inventive system.
- Fig. 2 is a block diagrammatic view of the system.
- Figs. 3A and 3B are block diagrams showing the power supplies of the inventive system.
- Fig. 4 is a block diagram showing the power amplifier.
- Fig. 5 is a block diagram of the exciter assembly.
- Fig. 6 is a block diagram of the controller assembly shown in Fig. 2.
- Fig. 7 is a block diagram showing the automatic gain control (AGC) aspect of the system controller.
- AGC automatic gain control
- Fig. 8 is a block diagram of the standing wave ratio (SWR) detection assembly.
- Fig. 9A is an electrical schematic of the applicator of the instant invention.
- Fig. 9B is a schematic view of the power meter of said applicator.
- Fig. 10 is an axial cross-sectional view of the applicator.
- Fig. 11 is a top plan view of the RF coil shown in Figs. 9A and 10.
- Fig. 12 is a top plan view of the Faraday shield shown in Figs. 9A and 10. DETAILED DESCRIPTION OF THE INVENTION
- a PRF generator 10 for which PRF energy is applied to the patient.
- Said head 12 receives PRF energy from generator 10 through coaxial cable 14 while the alternating current (AC) input to the generator is obtained through electrical cord 16.
- AC alternating current
- PPS pulse repetition rate
- treatment duration dial 22 for example, the treatment duration dial 22.
- display counter 24 which provides, to the user, real time information respecting the time that the generator has been in operation during a given treatment session.
- start/stop momentary switch 26 for the back of generator 10 are cooling fins 28 as well as interfaces with said co ⁇ axial cable 14 and A/C power input cord 16.
- the primary subsystems of the inventive system may be seen to include a power supply 38, a PRF exciter 40, a system controller 42, a RF power amplifier 44, and a standing wave ratio SWR detector circuit 46.
- the function of power supply 38 is to provide a DC input 80 in the range of 12 to 15 volts to the exciter 40 and controller 42 and to provide a DC input 55 in the range of 50 to 60 volts to the power amplifier 44.
- the manner in which this is accomplished is more particularly shown in the views of Figs. 3A and 3B. More particularly, in Fig. 3A is shown rectifier and filter 48 which, together with regu ator 50 converts the A/C input 16 to the power supply 38 into the desired D/C output 80 in the range of 12 to 15 volts DC(Vdc).
- a combination of rectifier and filter 52 together with voltage limiter 54 is employed to obtain the DC output 55, for use by power amplifier 44, which is in the range of 48 to 60 Vdc.
- the power supply 38 uti izes a UL/CSA qualified low leakage transformer (not shown) to supply the power voltages to the internal circuitry.
- the primary of the transformer is protected with a fuse located inside the unit next to the transformer.
- the transformer's secondary voltages are, in said rectifier/filters 48/52, rectified and filtered by full space wave capacitor input filters.
- the two output voltages 80 and 55 shown in Figs. 3A and 3B respectively provide a current of about one ampere.
- the 12 Vdc output 80 of Fig. 3A is regulated by a three-terminal regulator that offers current and thermal protection, while the 50 Vdc output 80 of Fig. 3B is voltage upper limit-regulated at 60 volts using a discrete regulator, this being the function of voltage limiter 54.
- the instant inventive system may be seen to include said exciter 40, the function of which is to generate PRF signals of a selectable megahertz frequency, typically in the range of one-to-100 megahertz but, preferably, at the FCC approved biotherapeutic frequency of 27 megahertz.
- Pulse burst width control e.g., a pulse burst width of 65 microseconds is applied to exciter 40 through the digital logic of controller 42 (more fully described below).
- the power amplitude of the PRF output of exciter 40 is controlled by an automatic gain control (AGC) circuit in controller 42 in combination with the SWR detection circuit 46, as are more fully set forth below. That is, through the adjustment of said dials 18, 20 and 22, said controller 42 operates as a means for control of pulse width duration, pulse burst repetition rate, and power amplitude of the PRF signals produced by exciter 40 and furnished to said power amplifier 44.
- AGC automatic gain control
- Power amplifier 44 is more fully shown in the subsystem block diagram of Fig. 4 wherein it may be seen that the power amplifier comprises the combination of a Class C amplifier 56 and low pass filter 58. More particularly, power amplifier 44 employs two high voltage MRF-150 Mosfet's (FETs) in push- pull relationship at 60 Vdc maximum voltage. These FETs operate Class B thru C, depending upon the desired output power level. The gate voltage is controlled by a power output control loop. At higher output power levels a minimum amount of forward bias is applied to the FETs to maintain the desired pulse burst envelope shape and to increase the power gain at the power amplifier stage.
- Low pass filter 58 is a five pole Chebishev filter used for harmonic reduction. This filter operates to reduce harmonic energy to negligible levels.
- FIG. 4 Further shown in Fig. 4 is AGC input 74 and RF input 76 to the amplifier 56, as is RF output 84 to the SWR detector circuit.
- RF exciter 40 uses a fundamental frequency clap oscillator 60 which is controlled by crystal 62 that is located within exciter 40.
- the following stage shown in Fig. 5, is a Class AB keyed buffer 64 that isolates, amplifies and chops the oscillator pulses into a square envelope RF wave of approximately 65 micro ⁇ second duration. The output of this stage exhibits less than one microsecond of rise and fall time.
- Buffer 64 is switched on and off by a pulse shaping switch 66 (having pulse input 78 from controller 42) which may comprise a series NPN pass transistor which sources the voltage to the stage 64 while a shunt PNP transistor discharges the buffer 64 to supply voltages at the end of each pulse.
- a pulse shaping switch 66 having pulse input 78 from controller 42
- the signal output of buffer 64 is fed into a pre-driver 68 which operates from a variable voltage source that is a part of a e power output control loop.
- the pre-driver 68 obtains input 72 from controller 42 and provides AGC output 74 to RF amplifier 44 (see Fig. 2).
- Said pre-driver 68 is followed by a Class C driver stage 70 that operates at a constant 12 Vdc, and which provides RF output 76, of 27.12 MHz at a 5 watt maximum, to amplifier 44.
- controller 42 also alternately referred to below as control board 42.
- Controller 42 provides the necessary timing, user interface, and control signals to operate the present inventive system for tissue-impedance matched PRF electrotherapy.
- the controller 42 uses a 80C32 uC based micro ⁇ controller 81 running at 12 egaHertz. Further, a 150 nanosecond 8Kx 8 bit EPROM 83 is used. In view of the actual memory requirement of the system, that is, about one kilobyte, such memory sizing is adequate for future expansion.
- the power input 80 from power supply 38 is inputted to controller driver 85 for use by the rest of the controller 42.
- a regulator (not shown) down converts this voltage to the 5 volt Vdc required by the digital electronics thereof.
- the microcontroller 81 is supervised by a supervisory 86 of the 691 type. This provides a 200mS reset pulse 88 after a power-up operation has been initiated by actuating start switch button 26a.
- the various necessary operating parameters of this system are stored in an internal RAM of the microcontroller 81 or, alternatively, in a serial programmable EEPROM 90 of the 27C04 type.
- the second method is used. Therefore it is generally not necessary to use the UC RAM back-up of the micro- controller 81 or the battery fault signal 91 of supervisory 86.
- the memory of the EEPROM 90 is downloaded into the internal RAM of the microcontroller 81 , this including all the parameters of the machine set-up previously from the last power-down. This includes the time remaining from the time selected by treatment duration dial 22 (with a precision to the order of microseconds) and the pulse per second (PPS) setting accomplished by dial 22 (see Fig. 1). Other parameters may as well be stored in the internal RAM of the microcontroller 81.
- a serial IIC protocol is employed for communication to the EEPROM 90.
- the microcontroller 81 initiates a non-maskable interrupt subroutine storing the machine parameters.
- Information is preferably stored in tenths of milliseconds before the five volt power supply of the supervisory 86 reaches a critical level.
- Initial display blinking level on LED 24 on the face of the generator (see Fig. 1) is effected by enabling or disabling the output
- a multiplexer 100 selects either the PPS dial 20 and the start switch 26a, or the time setting 22 and the stop switch 26b, for input 102 to the micro ⁇ controller. Control of the multiplexer 100 is accomplished through a switch select signal 104 from port B 98.
- the positions of setting 22 and switch 26a are decoded in inverted binary logic to simplify programming.
- a power output 106 of port B 98 is enabled.
- transistor 108 is turned-on and inboard LED 110 and a timer counter within the micro ⁇ controller 81 are enabled.
- Two common anode displays 112 and 114, which are in communi ⁇ cation with the port A 96 indicate said timer status at counter 24. That is, port A controls the segment activation and selection of displays 112 and 114 and of complementary transistors 116 and 118. These displays are disabled by setting the display enable signal 120 at port B at a sufficiently high level.
- a piezoelectric buzzer and a 2.5 kilohertz oscillator 121 serve as an alert indicator. Said buzzer is enabled by a buzzer enable signal 122 from said port B 98.
- Power level rotary switch 18 (see Fig. 7) enables selection of any one of six pre- adjusted voltage references as an input 124 to comparator 142.
- Multi-turn reference potentiometers 126, 128, 130, 132, 134 and 136 are accessible from a test connector. Comparator 142 will trip (actuate) to a low value when the voltage at point 138 (see Fig. 7) indicates that the actual power level is larger than that of a selected reference.
- a driver 140 is used with phase lag (in order to stabilize the loop for any low power setting) which follows comparator 142 within the oscillator 121.
- Output 72 of driver 140 functions as an automatic gain control (AGC) input to the pre-driver 68 of the exciter 40 (see Fig. 5).
- AGC automatic gain control
- Driver 140 is activated only in the presence of pulses at point 138 (see Fig. 7). This is due to the to an open collector output
- comparator 142 that is, if no pulses are present the comparator remains low and a capacitor 144 (see Fig. 7) will initiate or continue until its discharge. The "on" transition of the generator is thereby smoothed since capacitor 144 is loaded gradually through a resistor within oscillator 121 as soon as the actuating 65 microsecond pulse train appears at input 138 to comparator 142. As the cadence set by the selected PPS of PPS dial 20 and while the power is on, the microcontroller 81 will become low for 65 microseconds. The driver 85 (see Fig. 6) then changes the polarity and the voltage level of the pulse. A transistor then causes the pulse fall time to become shorter. The pulse output 78 then becomes the pulse input of the pulse shaping circuit 66 of the exciter 40 (see Fig. 5).
- an expansion port 146 serves as an expansion port for the entire controller. Among the more important pin positions upon expansion port 146 are data bus 148, address bus 150 and 5Vdc power pin 154. As may be noted, expansion port 146 is also in communication with microcontroller 81 thru numerous additional pin locations which are shown at the upper left and upper right of the expansion port. As may be noted, there is provided a twelve megahertz system clock 152 which is common to both the microcontroller and the expansion port.
- Fig. 6 Further shown in the view of Fig. 6 is twelve megahertz crystal 62 which the time reference for system clock 152 and for the exciter 40 above described with reference to Fig. 5.
- Generation of the 65 microsecond pulse train is realized by using the Timer ZERO of the controller in Mode 2 and pre-setting the reference to be loaded into the micro ⁇ controller 81. This provides to the system a 100 microsecond unit of count. The number of interrupts is then compared to the value of the selected pulses per second from the PPS cadence and a pulse is thereupon generated if both match.
- a refreshing of a watchdog signal 156 is effected by subroutine that is included over the subroutine that manages the displays 112 and 114. This is recalled on the basis of every less than 100 microseconds than the 1.2 seconds required for the supervisory 86 to generate the reset pulse 88.
- the parameters of the micro-controller 81 are stored in EEPROM 90.
- Several subroutines perform a IIC two wire serial transmission protocol required for such memory to establish correct operation. During the uC initializa ⁇ tion these parameters are recalled.
- a power down transition generates a non-maskable interrupt that writes the current machine parameters into the EEPROM 90.
- SWR circuit detection circuit 46 With respect to the standing wave ratio (SWR) circuit detection circuit 46 (see Fig. 8), there is shown therein input 84 from power amplifier 44, as well as output 14 to applicator 12 and output 82 to controller 42.
- SWR standing wave ratio
- the function of the SWR circuit 46 is to compare current phase and ratios in the transmission cable 14 that feeds the applicator 12 to thereby provide a means for continually comparing the amplitude, and thereby impedance, of PRF signals outputted from amplifier 44 to a reference value therefor.
- Such means includes feedback means responsive to difference information between the compared PRF signals and said reference value. This difference information is inputted to the controller 42 at input 82 to continually effect adjustments of the amplitude of the PRF signals from exciter 40 and continually monitor the output of power amplifier 44 to thereby provide to co-axial cable 14 power and impedance compensated PRF signals to the applicator 12.
- the above comparing function is accomplished through a form of a non- directional voltage sampling (see Fig. 8) which is accomplished by a voltage divider including a 150 pF capacitor 158, a 150 pF capacitor 160, a 33 pF capacitor 162, and a 3- 12 pF variable capacitor 164.
- the current to cable 14 is sampled with a current transformer assembly which includes transformer 166, a 1000 uH inductor 167 and a resistor 168.
- Said current transformer provides two 180 degree directionally sensitive phase shifted outputs.
- One of said current transformer outputs namely, the output at diode 170 and capacitor 172, provides a vector subtraction of the capacitive voltage divider and the current transformer outputs.
- the other current transformer output provides a vector sum of the capacitive voltage divider and current transformer voltage outputs, this output occurring across diode 174 and capacitor 176.
- Variable capacitor 164 adjusts the capacitive voltage divider output until it matches the output voltage from the current transformer 166 with a zero phase shift 50 ohm resistive RF load, that is employed for calibration purposes, on the generator output.
- a resistive RF load By such matching to a resistive RF load, an effective matching, at a level of 0.10 to 0.151 ohms/sq.cm. of tissue, to the physiologic impedance of the tissue of the patient to be treated is accomplished. Thereby optimal reactive coupling between the PRF output of the present system and the tissue to be treated by the applicator 12 is accomplished.
- Fig. 9B power meter 32 which, thru the positioning of diode 181 and resistor 183 within the field of coil 180 enables delivered power of the applicator to be measured.
- the applicator 12 in accordance with the inventive system includes a housing having an upper surface 186 and a lower surface 188.
- lower surface 188 consists primarily of said patient treatment surface 36 (see also Fig. 1).
- Said housing is typically about nine inches in diameter (the horizonal axis of Fig. 10) and about six inches deep (the vertical axis of the schematic of Fig. 10).
- the upper and lower parts 186 and 188 of the applicator housing are secured to each other to enclose the operative components within.
- Said operative components are, starting at top housing surface 186, in succession a rectangular plate 188 which, is integrally fixed to bushing 190 which bushing and therefore plate 188 are externally controlled by said tuning means 30.
- the effect of rotation of tuning means 30 in a plane transverse to the plane of Fig. 10 is that of turning bushing 190 such that it will tilt moveable capacitor plate 192 relative to a fixed capacitor plate 194 to thereby define variable capacitor 182.
- a so-called spring plate 196 may be used to provide mechanical communication between the external part of tuning means 30 and said bushing 190.
- any one of a number of mechanical configurations may be employed to effect changes in orientation or attitude of moveable capacitor plate 192 relative to fixed capacitor plate 194 of the variable capacitor 182.
- a nylon support 198 upon which said RF coil 180 (see also Fig. 11) is secured. Accord ⁇ ingly, as above noted, it is at RF coil 180 that the PRF signal input 178 is received. Shown beneath RF coil 180 is said Faraday shield 184 and, therebeneath, said patient treatment surface 36 which exhibits an area of about 120 square centimeters.
- the RF coil 180 in combination with the variable capacitor 182 provides circulating resonant RLC tank RF currents which are confined to a closed path through the variable capacitor and the RF coil. Approximately half of the circulating current flows through the Faraday shield 184 to the inside of the housing of the applicator and, therefrom, will loop through the fixed capacitor plate 194. The focus of the RLC tank circuit is therefore that of focusing the PRF signals through Faraday shield 184 and, therefrom, through treatment surface 36.
- a further significant aspect of the RLC circuit that is defined by the combination of RF coil 180 and variable capacitor 182 is that of assuring constant power and impedance of the PRF RF current delivered through treatment surface 36 in order to, thereby, maintain an effective physiologic impedance match with the impedance of the tissue to be treated, this operating to maximize reactive coupling between the system and the operative dielectric cellular pathways and channels to be treated.
- the optimal impedance to accomplish this has been found to be in the range of 0.10 to 0.15 ohms per square centimeter of surface 36. At an output impedance of 50 ohms thru surface 36 having 120 sq. cm., this relationship is obtained.
- tap position 200 at which input 178 is provided may be adjusted as a further means of adjusting the impedance match from the applicator to tissue to be treated.
- meter 32 which is situated within upper housing 186 of the applicator 12 functions to read the electromagnetic field strength within the housing. It has been determined that a given level of field strength will assure performance with minimal distortion of the SWR current level inputted through coaxial cable 14 and, thereby, will provide further assurance of delivery of PRF signals through treatment surface 36 which is in the range of 0.10 to 0.15 ohm/sq. cm. or 25 to 75 ohms and, optimally it has been found at 50 ohms, this constituting the optimal physiologic impedance with which the inventors have been found to exist in human tissue given a treatment surface 36 having an area of about 120 sq. cm.
- a greater impedance will constitute the effective physiologic impedance.
- a preferred embodiment of the Faraday shield 184 which, it has been found, can be constructed through the use of 1,440 .025 inch wide foil copper traces. The same may be accomplished upon a printed circuit wafer having a diameter of about, eight inches.
- the above described applicator head structure provides a simple, relatively low cost design by which the level of PRF fields may be carefully adjusted and in which, through the use of Faraday shield 184, the applicator is rendered essentially free of stray electromagnetic field.
- variable capacitor 182 the range of capacitance achievable by variable capacitor 182 is that of 2.5 pF to 6.5 pF, this occurring as the applicator is used across a range of 25 to 30 megaHertz. While there has been shown and described the preferred embodiment of the instant invention it is to be appreciated that the invention may be embodied otherwise than is herein specifically shown and described and that, within said embodiment, certain changes may be made in the form and arrangement of the parts without departing from the underlying ideas or principles of this invention as set forth in the Claims appended herewith.
Abstract
Description
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Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP95912546A EP0776235A4 (en) | 1994-08-17 | 1995-01-30 | Electrotherapeutic system |
CA002197767A CA2197767C (en) | 1994-08-17 | 1995-01-30 | Electrotherapeutic system |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US29184394A | 1994-08-17 | 1994-08-17 | |
US08/291,843 | 1994-08-17 |
Publications (1)
Publication Number | Publication Date |
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WO1996004957A1 true WO1996004957A1 (en) | 1996-02-22 |
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Application Number | Title | Priority Date | Filing Date |
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PCT/US1995/000938 WO1996004957A1 (en) | 1994-08-17 | 1995-01-30 | Electrotherapeutic system |
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EP (1) | EP0776235A4 (en) |
CA (1) | CA2197767C (en) |
WO (1) | WO1996004957A1 (en) |
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Also Published As
Publication number | Publication date |
---|---|
EP0776235A4 (en) | 1999-08-25 |
CA2197767A1 (en) | 1996-02-22 |
CA2197767C (en) | 2001-01-02 |
EP0776235A1 (en) | 1997-06-04 |
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