2 resultados para 090304 Medical Devices

em ArchiMeD - Elektronische Publikationen der Universität Mainz - Alemanha


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Aseptic loosening of metal implants is mainly attributed to the formation of metal degradation products. These include particulate debris and corrosion products, such as metal ions (anodic half-reaction) and ROS (cathodic half-reaction). While numerous clinical studies describe various adverse effects of metal degradation products, detailed knowledge of metal-induced cellular reactions, which might be important for possible therapeutic intervention, is not comprehensive. Since endothelial cells are involved in inflammation and angiogenesis, two processes which are critical for wound healing and integration of metal implants, the effects of different metal alloys and their degradation products on these cells were investigated. Endothelial cells on Ti6Al4V alloy showed signs of oxidative stress, which was similar to the response of endothelial cells to cathodic partial reaction of corrosion induced directly on Ti6Al4V surfaces. Furthermore, oxidative stress on Ti6Al4V alloy reduced the pro-inflammatory stimulation of endothelial cells by TNF-α and LPS. Oxidative stress and other stress-related responses were observed in endothelial cells in contact with Co28Cr6Mo alloy. Importantly, these features could be reduced by coating Co28Cr6Mo with a TiO2 layer, thus favouring the use of such surface modification in the development of medical devices for orthopaedic surgery. The reaction of endothelial cells to Co28Cr6Mo alloy was partially similar to the effects exerted by Co2+, which is known to be released from metal implants. Co2+ also induced ROS formation and DNA damage in endothelial cells. This correlated with p53 and p21 up-regulation, indicating the possibility of cell cycle arrest. Since CoCl2 is used as an hypoxia-mimicking agent, HIF-1α-dependence of cellular responses to Co2+ was studied in comparison to anoxia-induced effects. Although important HIF-1α-dependent genes were identified, a more detailed analysis of microarray data will be required to provide additional information about the mechanisms of Co2+ action. All these reactions of endothelial cells to metal degradation products might play their role in the complex processes taking place in the body following metal device implantation. In the worst case this can lead to aseptic loosening of the implant and requirement for revision surgery. Knowledge of molecular mechanisms of metal-induced responses will hopefully provide the possibility to interfere with undesirable processes at the implant/tissue interface, thus extending the life-time of the implant and the overall success of metal implant applications.

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Im Rahmen meiner Dissertation habe ich gemäß dem Medizinproduktegesetz ein MR-kompatibles Verabreichungsgerät entwickelt, um Patienten hyperpolarisierte Gas Boli (He-3, Xe-129) als Kontrasgas zur MRT der Lunge zu applizieren. Das Gerät wurde dazu optimiert, die Gase oder Gasmischungen (z. B. HP Gas + N2) in definierten Mengen und zu definierten Zeitpunkten während der Inspiration mit hoher Reproduzierbarkeit und Zuverlässigkeit zu verabreichen, ohne dabei die MR-Qualität zu beeinträchtigen. Aus Sicherheitsgründen und zur späteren Datenanalyse werden die Atemflusskurven der Patienten kontinuierlich angezeigt und aufgezeichnet. Ein Kolbenkompressor ist integriert, um die gesamte gespeicherte He-3-Menge nutzen zu können. Weiterhin ist es möglich, die Polarisation vor Ort zu bestimmen und das abgeatmete He-3 zur späteren Rückgewinnung aufzufangen. Diese Auffangeffizienz konnte durch Untersuchungen mit He-4 (als He-3-Ersatz) gesteigert werden.rnDie ersten MR-Aufnahmen von 10 gesunden Probanden wurden mit diesem Aufbau imrnRahmen einer klinischen Studie durchgeführt. Die Analyse der bestimmten MR-Parameter Signal-Rausch-Verhältnis (SNR), Sauerstoffpartialdruck (pO2), Scheinbarer Diffusionskoeffizient (ADC=apparent diffusion coefficient) sowie die Signalanstiegszeit (rise-time) zeigt eine deutlich bessere Reproduzierbarkeit bei der Verabreichung des He-3 mit dem Applikators anstelle eines Tedlarbags (= kleine heliumdichte Plastiktüte).