Titanium coatings plasma-sprayed with/without a shroud

Titanium coatings were deposited by plasma spraying with and without a shroud. The as-sprayed titanium coatings were then microstructurally examined. A comparison in microstructure between titanium coatings with and without the shroud was carried out. Based on the analytical results, it showed that the shroud played a critical role in protecting the titanium particles from oxidation. The presence of the shroud in the plasma spraying brought about better heating of the particles in the plasma jet due to mitigation of air entrainment with the shroud, thus a reduction in coating porosity was obtained. An enhanced microstructure in the shrouded titanium coatings was observed compared to the air plasma sprayed counterpart

Titanium coatings plasma-sprayed with/without a shroud

Titanium coatings were deposited by plasma spraying with and without a shroud. The as-sprayed titanium coatings were then microstructurally examined. A comparison in microstructure between titanium coatings with and without the shroud was carried out. Based on the analytical results, it showed that the shroud played a critical role in protecting the titanium particles from oxidation. The presence of the shroud in the plasma spraying brought about better heating of the particles in the plasma jet due to mitigation of air entrainment with the shroud, thus a reduction in coating porosity was obtained. An enhanced microstructure in the shrouded titanium coatings was observed compared to the air plasma sprayed counterpart

Identification of the NLS and NES motifs of VP2 from chicken anemia virus and the interaction of VP2 with mini-chromosome maintenance protein 3

<p>Abstract</p> <p>Background</p> <p>VP2 of chicken anemia virus (CAV) is a dual-specificity phosphatase required for virus infection, assembly and replication. The functions of the nuclear localization signal (NLS) and nuclear export signal (NES) of VP2 in the cell, however, are poorly understood. Our study identified the presence of a NLS in VP2 and showed that the protein interacted significantly with mini-chromosome maintenance protein 3 (MCM3) in the cell.</p> <p>Results</p> <p>An arginine-lysine rich NLS could be predicted by software and spanned from amino acids 133 to 138 of VP2. The critical amino acids residues between positions 136 and 138, and either residue 133 or 134 are important for nuclear import in mammalian cells based on systematic mutagenesis. A NES is also predicted in VP2; however the results suggest that no functional NES is present and that this protein is CRM1 independent. It was also shown that VP2 is a chromatin binding protein and, notably, using a co-immunoprecipitation assay, it was found that VP2 association with MCM3 and that this interaction does not require DSP activity.</p> <p>Conclusions</p> <p>VP2 contains a NLS that span from amino acids 133 to 138. VP2 is a CRM1 independent protein during nuclear export and associates with MCM3 in cells.</p

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

The Structural and Functional Characterization of the 3' Untranslated Region of Bamboo mosaic virus RNA in its replication cycle

竹嵌紋病毒 (Bamboo mosaic virus，簡稱 BaMV)，是以單一正股 RNA為基因體的植物病毒，在分類學上它是屬於馬鈴薯病毒屬 (Potexvirus)(見附錄圖一)。本篇論文中，我們成功的使用蔗糖密度梯度離心的方法(見附錄圖三、圖四)，從感染 BaMV或馬鈴薯病毒X (Potato virus X; PVX)的煙草葉片中，純化出含有 endogenous RNA，membrane-bound 的 BaMV或 PVX 的核醣核酸依賴型核醣核酸聚合酵素(RNA-dependent RNA polymerase complex; RdRp complex)。並且以此為基礎，建立 BaMV in vitro的複製分析系統。利用此分析系統的研究結果推知，BaMV正股 RNA的 3非轉譯區 (untranslated region，簡稱 UTR) 所形成的三級結構中，含有用來調控病毒合成負股RNA的啟動子區域 (promoter region)。除此之外，此區域中含有poly(A) tail的pseudoknot 結構對於負股RNA合成的效率上亦有重大的影響。接著在觀察 E. coli所表達的 BaMV RdRp的80 kDa截斷蛋白 Δ893(見附錄圖二)與 3UTR可以進行緊密的結合，再利用DEPC footprinting的實驗得知，Δ893會結合在pseudoknot 上。蛋白質結合的區域含蓋了部分的 poly(A) tail，大約是 20個腺苷酸 (adenylate)。進一步的經由 in vivo protoplast分析及 in vitro RdRp分析系統的實驗證明， BaMV RdRp complex合成負股 RNA的起始點，主要位於正股 3 UTR的 20個 adenylates之中第七個到第十個之間。在探討 BaMV in vitro RdRp複製分析系統中的酵素活性時，發現新合成的 endogenous RNA 3序列之後，具有放射性 adenylate的 poly(A) tail，因此我們發現 RdRp complex不只是含有複製 RNA的能力，也擁有 polyadenylation的酵素活性存在。Bamboo mosaic virus (BaMV), a member of the Potexvirus group, has a single-stranded plus-sense RNA molecule. The 3UTR of BaMV RNA was predicted to form a tertiary structure by computer simulation and confirmed by enzymatic and chemical structural mapping. The membrane-bound BaMV or Potato virus X (PVX) RNA-dependent RNA polymerase (RdRp) complex was purified by sucrose density gradient from Nicotiana benthamiana leaves infected with BaMV or PVX. Template-dependent and species-specific RdRp activity could be detected after removal of endogenous RNA templates. The 3UTR of BaMV was demonstrated to harbor the promoter sequences for minus-sense RNA synthesis by the in vitro exogenous RNA template activity assay using the purified RdRp complex. In the in vitro RdRp assay experiment, the pseudoknot in the 3UTR containing the poly (A) sequence was sufficient for minus-sense RNA synthesis. In the RNA-protein binding experiment, pseudoknot was bound with Escherichia coli-expressed RdRp core domain Δ893 specifically. Besides, we also demonstrated that there was about 20 adenylates of pseudoknot protected by Δ893(80kDa) in the DEPC footprinting experiment. Through the in vivo protoplast and in vitro RdRp replication assays, the highest frequency of initiation site of minus-sense RNA synthesis was located at the 7th to 10th adenylates counted from the 5¢-most adenylate of poly (A) tail. During the course of analyzing the endogenous RNA template activity, the newly synthesized RNA was identified to contain the poly (A) tail. These results indicated that the membrane-bound BaMV RdRp has both activities for viral RNA replicatieon and polyadenylation.目 錄(Content) 一、中文摘要(Chinese Abstract)…….………………………………………………1 二、英文摘要(English Abstract)….………………………………………………….2 三、前人研究(Previous Study)……….……………………...……………………….3 1.核醣核酸依賴型核醣核酸聚合酵素(RNA dependent RNA polymerase; RdRp)....3 2.竹嵌紋病毒(Bamboo mosaic virus; BaMV)………………………………………...5 四、內文(Content).…………………………………………………………………..9 Chapter 1 ...……………………………………………………………………………9 The partial purified RNA-dependent RNA polymerases from Bamboo mosaic virus and Potato virus X infected plants containing the template-dependent activities……..9 ABSTRACT…………………………………………………………………………...9 INTRODUCTION……………………………………………………………………10 METERIAILS AND METHODS……………………………………………………11 BaMV and PVX RdRp preparation………………………………………………..11 Preparation of RdRp templates................................................................................12 RdRp activity assay and analysis of products……………………………………..13 RESULTS…………………………………………………………………………….14 Preparation of BaMV and PVX RdRp…………………………………………….14 Template activities of various viral 3'RNA transcripts with BaMV and PVX RdRp.........................................................................................................................15 Complementary strand was synthesized using short transcript as template……….16 The 3'end minus-sense RNA can be an efficient template for plus-sense RNA synthesis…………………………………………………………………………...17 Structural elements in the 3'UTR of BaMV RNA are important for minus-sense RNA synthesis in vitro…………………………………………………………….17 DISSCUSSION………………………………………………………………………18 TABLES AND FIGURES…………………………………………………………...20 Chapter 2 ...…………………………………………………………………………..29 The Synthesis of Minus-Sense RNA of Bamboo mosaic virus Initiates from Multiples Sites within the Poly(A) Tail………………………………………………………....29 ABSTRACT……………………………………………………………………….…29 INTRODUCTION……………………………………………………………………30 METERIAILS AND METHODS……………………………………………………31 Mutant construction………………………………………………………………31 DEPC footprinting analysis………………………………………………………32 Double strand RNA preparation……………………………………………….…32 Progeny RNA analysis…………………………………………………………...34 RESULTS…………………………………………………………………………….34 Interaction between BaMV RdRp and the poly(A) sequence……………………34 A range of oligo(U) lengths at the 5'ends of BaMV minus-sense present in plants……………………………………………………………………………..35 5'ends of minus-senses RNA synthesized in vitro with RdRp preparation………35 Multiple putative initiation site were deduced from an in vitro replication assay.36 DISCUSSION………………………………………………………………………..38 TABLES AND FIGURES…………………………………………………………...41 Chapter 3 ...…………………………………………………………………………..46 The Activity of Polyadenylation of Bamboo mosaic virus……………………………………………………………………………..……46 ABSTRACT………………………………………………………………………….46 INTRODUCTION……………………………………………………………………47 METERIAILS AND METHODS……………………………………………………48 Preparation of RNA transcripts…………………………………………………..48 RdRp assay……………………………………………………………………….49 Analysis of reaction products of RdRp assay by RNase digestion………………49 In vitro polyadenylation assay……………………………………………………50 RESULTS…………………………………………………………………………….50 DISCUSSION………………………………………………………………………..52 TABLES AND FIGURES…………………………………………………………...55 五、結論與未來展望(Results and Future Work)……………….………………..60 六、參考文獻(Reference)…….……………………………………………………..61 七、附錄(Appendix)………………………………………………………………....73 八、縮寫(Abbreviation)……………………………………………………………..78 九、出版物(Publication)…………………………………………………………….7

New Frontiers of Extracorporeal Shock Wave Medicine in Urology from Bench to Clinical Studies

A shock wave (SW), which carries energy and propagates through a medium, is a type of continuous transmitted sonic wave that can achieve rapid energy transformations. SWs have been applied for many fields of medical science in various treatment settings. In urology, high-energy extracorporeal SWs have been used to disintegrate urolithiasis for 30 years. However, at lower energy levels, SWs enhance the expression of vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), proliferating cell nuclear antigen (PCNA), chemoattractant factors, and the recruitment of progenitor cells, and inhibit inflammatory molecules. Low energy extracorporeal shock wave (LESW) therapy has been used in urology for treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder, stress urinary incontinence, and erectile dysfunction through the mechanisms of anti-inflammation, neovascularization, and tissue regeneration. Additionally, LESW have been proven to temporarily increase tissue permeability and facilitate intravesical botulinum toxin delivery for treating overactive bladders in animal studies and in a human clinical trial. LESW assisted drug delivery was also suggested to have a synergistic effect in combination with cisplatin to improve the anti-cancer effect for treating urothelial cancer in an in vitro and in vivo study. LESW assisted drug delivery in uro-oncology is an interesting suggestion, but no comprehensive clinical trials have been conducted as of yet. Taken together, LESW is a promising method for the treatment of various diseases in urology. However, further investigation with a large scale of clinical studies is necessary to confirm the real role of LESW in clinical use. This article provides information on the basics of SW physics, mechanisms of action on biological systems, and new frontiers of SW medicine in urology