Newly prepared titanium alloy (Ti-13Zr-13Nb (TZN)) using powder metallurgy is considered in this investigation. Titanium alloys (TZN) are used in hip and knee replacement for orthopedic implants. Conventional machining, TZN alloys produce higher tool wear rate and poor surface quality, but this can be reduced by Electrical Discharge Machining (EDM) method. Moreover, EDM produce good biological and corrosion resistant surface. In this research, experiments were conducted by considering the influential process factors such as pulse on time, pulse off time, voltage, and current. The experiments were designed based on Response Surface Methodology (RSM) of face centered central composite design. Analysis of Variance (ANOVA) was conducted to identify the significance process factors and their relation to output responses such as Electrode Wear Rate (EWR), Surface Roughness (SR) and Material Removal Rate (MRR). Further, an empirical model was developed by RSM in order to predict the output responses.
We conducted a prospective study in order to audit our experience of repairing cranial defects using Methyl methacrylate. This included a total of 49 patients undergoing cranioplasty using methyl methacrylate, of which 45 were males and 4 females. The age of patients at the time of surgery ranged from 16 to 40 years old, with an average of 24 years. Malays were the majority (67%), followed by Chinese (23%) and Indian (10%). Cranial defects were mainly caused by motor vehicle accident (94%), while gunshot wounds, industrial accidents and tumours, each contribute 2%. Bone flaps were commonly removed during previous surgery related to traumatic subdural haemorrhage (33%), contusion (21%) and intracerebral haemorrhage (14%). The size of cranial defects ranged from 28 cm2 to 440 cm2, with an average of 201 cm2. Most had right sided (55%) and lateral defects [temporoparietal (52%) followed by temporal (16%), frontal (16%), frontotemporal (14%) and occipital (2%)]. Duration of surgery ranged from 70 to 275 minutes, with an average of 135 minutes. Nine of 12 patients (75%) with neurological disability had some improvement while 85% of symptomatic patients had symptoms improvement after cranioplasty. The infection rate in this series was 4%.
Additive Manufacturing is noted for ease of product customization and short production run cost-effectiveness. As our global population approaches 8 billion, additive manufacturing has a future in maintaining and improving average human life expectancy for the same reasons that it has advantaged general manufacturing. In recent years, additive manufacturing has been applied to tissue engineering, regenerative medicine, and drug delivery. Additive Manufacturing combined with tissue engineering and biocompatibility studies offers future opportunities for various complex cardiovascular implants and surgeries. This paper is a comprehensive overview of current technological advancements in additive manufacturing with potential for cardiovascular application. The current limitations and prospects of the technology for cardiovascular applications are explored and evaluated.
Hydroxyapatite is the main component of the bone which is a potential biomaterial substance that can be applied in orthopaedics. In this study, the biocompatibility of this biomaterial was assessed using an in vitro technique. The cytotoxicity and genotoxicity effect of HA2 and HA3 against L929 fibroblast cell was evaluated using the MTT Assay and Alkaline Comet Assay respectively. Both HA2 and HA3 compound showed low cytotoxicity effect as determined using MTT Assay. Cells viability following 72 hours incubation at maximum concentration of both HA2 and HA3 (200 mg/ml) were 75.3 +/- 8.8% and 86.7 +/- 13.1% respectively. However, the cytotoxicity effect of ZnSO4.7H2O as a positive control showed an IC50 values of 46 mg/ml (160 microM). On the other hand, both HA2 and HA3 compound showed a slight genotoxicity effect as determined using the Alkaline Comet Assay following incubation at the concentration 200 mg/ml for 72 hours. This assay has been widely used in genetic toxicology to detect DNA strand breaks and alkali-labile site. The percentage of the cells with DNA damage for both substance was 27.7 +/- 1.3% and 15.6 +/- 1.0% for HA2 and HA3 respectively. Incubation of the cells for 24 hours with 38 microg/ml (IC25) of positive control showed an increase in percentage of cells with DNA damage (67.5 +/- 0.7%). In conclusion, our study indicated that both hydroxyapatite compounds showed a good biocompatibility in fibroblast cells.
The present paper reports on the influence of sintering temperature on the porosity and strength of porous hydroxyapatite (HA). HA powder was first prepared by the sol-gel precipitation method using calcium hydroxide and ortho-phosporic acid. The fine HA powder, measuring <50 microm was then mixed into a slurry with the addition of binder agent, being a mixture of sago and PVA. A small amount of sodium dodecyl sulphate was also used as a foaming agent. Porous HA samples were then prepared via slip casting technique. The surface morphology of the sintered samples was observed under scanning electron microscopy at 20 kV and the compositions were determined via SEM-EDX. A universal testing machine was used to determine the compaction strength of the sintered samples.
With the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil's mutual displacement and coupling coefficients. This paper provides a comprehensive survey on various power amplifier classes and their characteristics, efficiency and controller techniques that have been used in bio-implants. The automatic frequency controller used in biomedical implants such as gate drive switching control, closed loop power control, voltage controlled oscillator, capacitor control and microcontroller frequency control have been explained. Most of these techniques keep the resonance frequency stable in transcutaneous power transfer between the external coil and the coil implanted inside the body. Detailed information including carrier frequency, power efficiency, coils displacement, power consumption, supplied voltage and CMOS chip for the controllers techniques are investigated and summarized in the provided tables. From the rigorous review, it is observed that the existing automatic frequency controller technologies are more or less can capable of performing well in the implant devices; however, the systems are still not up to the mark. Accordingly, current challenges and problems of the typical automatic frequency controller techniques for power amplifiers are illustrated, with a brief suggestions and discussion section concerning the progress of implanted device research in the future. This review will hopefully lead to increasing efforts towards the development of low powered, highly efficient, high data rate and reliable automatic frequency controllers for implanted devices.
The use of wireless communication using inductive links to transfer data and power to implantable microsystems to stimulate and monitor nerves and muscles is increasing. This paper deals with the development of the theoretical analysis and optimization of an inductive link based on coupling and on spiral circular coil geometry. The coil dimensions offer 22 mm of mutual distance in air. However, at 6 mm of distance, the coils offer a power transmission efficiency of 80% in the optimum case and 73% in the worst case via low input impedance, whereas, transmission efficiency is 45% and 32%, respectively, via high input impedance. The simulations were performed in air and with two types of simulated human biological tissues such as dry and wet-skin using a depth of 6 mm. The performance results expound that the combined magnitude of the electric field components surrounding the external coil is approximately 98% of that in air, and for an internal coil, it is approximately 50%, respectively. It can be seen that the gain surrounding coils is almost constant and confirms the omnidirectional pattern associated with such loop antennas which reduces the effect of non-alignment between the two coils. The results also show that the specific absorption rate (SAR) and power loss within the tissue are lower than that of the standard level. Thus, the tissue will not be damaged anymore.
The development of implanted devices is essential because of their direct effect on the lives and safety of humanity. This paper presents the current issues and challenges related to all methods used to harvest energy for implantable biomedical devices. The advantages, disadvantages, and future trends of each method are discussed. The concept of harvesting energy from environmental sources and human body motion for implantable devices has gained a new relevance. In this review, the harvesting kinetic, electromagnetic, thermal and infrared radiant energies are discussed. Current issues and challenges related to the typical applications of these methods for energy harvesting are illustrated. Suggestions and discussion of the progress of research on implantable devices are also provided. This review is expected to increase research efforts to develop the battery-less implantable devices with reduced over hole size, low power, high efficiency, high data rate, and improved reliability and feasibility. Based on current literature, we believe that the inductive coupling link is the suitable method to be used to power the battery-less devices. Therefore, in this study, the power efficiency of the inductive coupling method is validated by MATLAB based on suggested values. By further researching and improvements, in the future the implantable and portable medical devices are expected to be free of batteries.
Implanted medical devices are very important electronic devices because of their usefulness in monitoring and diagnosis, safety and comfort for patients. Since 1950s, remarkable efforts have been undertaken for the development of bio-medical implanted and wireless telemetry bio-devices. Issues such as design of suitable modulation methods, use of power and monitoring devices, transfer energy from external to internal parts with high efficiency and high data rates and low power consumption all play an important role in the development of implantable devices. This paper provides a comprehensive survey on various modulation and demodulation techniques such as amplitude shift keying (ASK), frequency shift keying (FSK) and phase shift keying (PSK) of the existing wireless implanted devices. The details of specifications, including carrier frequency, CMOS size, data rate, power consumption and supply, chip area and application of the various modulation schemes of the implanted devices are investigated and summarized in the tables along with the corresponding key references. Current challenges and problems of the typical modulation applications of these technologies are illustrated with a brief suggestions and discussion for the progress of implanted device research in the future. It is observed that the prime requisites for the good quality of the implanted devices and their reliability are the energy transformation, data rate, CMOS size, power consumption and operation frequency. This review will hopefully lead to increasing efforts towards the development of low powered, high efficient, high data rate and reliable implanted devices.
Iron and its alloy have been proposed as biodegradable metals for temporary medical implants. However, the formation of iron oxide and iron phosphate on their surface slows down their degradation kinetics in both in vitro and in vivo scenarios. This work presents new approach to tailor degradation behavior of iron by incorporating biodegradable polymers into the metal. Porous pure iron (PPI) was vacuum infiltrated by poly(lactic-co-glycolic acid) (PLGA) to form fully dense PLGA-infiltrated porous iron (PIPI) and dip coated into the PLGA to form partially dense PLGA-coated porous iron (PCPI). Results showed that compressive strength and toughness of the PIPI and PCPI were higher compared to PPI. A strong interfacial interaction was developed between the PLGA layer and the iron surface. Degradation rate of PIPI and PCPI was higher than that of PPI due to the effect of PLGA hydrolysis. The fast degradation of PIPI did not affect the viability of human fibroblast cells. Finally, this work discusses a degradation mechanism for PIPI and the effect of PLGA incorporation in accelerating the degradation of iron.
Since the establishment of implant in dentistry, the use of removable partial denture in replacing missing teeth apparently becomes less popular. The situation is made worse by the renowned limitations of removable partial denture. One of the obvious limitations of removable partial denture, especially in replacing missing anterior teeth is the unsightly view of metal used for retentive clasp. This case report describes the use of spring loaded plunger attachments as an alternative way to achieve retention and at the same time improving the aesthetic of the prosthesis.
There has been, and is still, concern about the high elastic modulus of Ti alloys compared to bone. Any reduction in the Young's modulus value of the implant is expected to enhance stress redistribution to the adjacent bone tissues, minimize stress shielding and eventually prolong device lifetime. Dynamic Monte Carlo simulation is used to predict the gradual reduction in Young's modulus values between the bulk of Ti alloys and the modified surface layers due to Ca ion implantation. The simulation can be used as a screening step when applying new alloys and/or coatings.
A study was conducted to investigate the effectiveness of freeze-dried bovine pericardium (FDBP) as a biomaterial in diaphragmatic herniorrhapy in dogs. Eight adult dogs were randomly selected and divided into two equal groups. In FDBP group, a diaphragmatic defect was induced and repaired with an identical size of FDBP. In the control group, a diaphragmatic wall was incised at three-side border creating a flap and sutured. Grossly, only mild intrathoracic adhesion was observed for most of the animals, and no herniation occured. Microscopically, the biomaterial incorporated into the host's tissue by ingrowth of young muscle fiber and massive new blood vessel formation in between the fibrous tissue.
Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.
A mixture with different compositions of HA and TCP were synthesize in this work by precipitation method using Ca(NO3)2 4H2 and (NH4)2HPO4 as the starting materials. A mixture with HA and TCP phases in different ratios were produced. The powders were sintered from 1000 degrees C to 1250 degrees C. The phase compositions of the mixtures were then studied via XRD. This work shows that the pH value determines the different phase compositions of the HA-TCP mixture. Chemical analyses were carried out by FTIR. The microstructure was observed under SEM.
The PROSTALAC (PROSThesis Antibiotic Loaded Acrylic Cement) functional spacer is made with antibiotic-loaded acrylic cement. We use it as an interim spacer in two-stage exchange arthroplasty in cases of infected total knee or total hip replacement. PROSTALAC allows continuous rehabilitation between stages as it maintains good alignment and stability of the joint with a reasonable range of movement. It also helps to maintain the soft-tissue planes, thereby facilitating the second-stage procedure. We report here early outcomes of the use of PROSTALAC in 5 patients - 3 in total knee replacements, 1 in a total hip replacement and 1 in a bipolar hemiarthroplasty.
Hip arthroplasty is an extremely satisfying treatment method for coxarthrosis which is in increasing use throughout the world. However, loosening of the prosthesis is a significant complication and to overcome this, ceramic liners are increasingly being selected. If the survival of ceramic surfaces is prolonged, there is a risk of fracture of the ceramic materials. New ceramic materials developed to overcome this problem are more resistant. The case presented here is of a patient in whom liner fracture developed following ceramic-ceramic hip arthroplasty. The ceramic femoral head was observed to have protruded into the defect created in the acetabular component. Acetabular revision was applied to the patient.
Priapism is a urological emergency. The treatment for ischaemic priapism is usually cavernosal aspiration with or without cavernosal irrigation. Some patients may need surgical intervention -the various shunt procedures. We report a 21-year-old man with priapism secondary to chronic myeloid leukemia who needed a combined medical and surgical management. He underwent a spongiocavernosal shunt as well as cytoreductive chemotherapy to achieve complete detumescence. Therefore, cytoreductive chemotherapy is an adjunct in difficult cult to treat priapism associated with chronic myeloid leukemia.
Magnesium (Mg) alloys present great potential for the development of orthopedic implants, whereas, their high degradation rate and poor antibacterial performance have restricted orthopedic applications. In this work, PLLA/GO-AgNP (poly-L-lactic acid/graphene oxide- silver nanoparticle) with different concentration of GO-AgNPs were deposited on Mg alloy via electrospinning method for enhancement of corrosion resistance and antibacterial performance. The result revealed that incorporation of GO into PLLA fibrous considerably slowed down the degradation rate of Mg alloy substrate and reduced the H2 release rate from the substrate. Also, co-incorporation of GO and AgNPs into PLLA fibrous resulted in substantial escalate in compressive strength after immersion in simulated body fluid (SBF). Antibacterial activity test exhibited that Mg alloy and neat PLLA fibrous presented minimal inhibition area toward Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). In contrast, using PLLA/GO-AgNPs fibrous improved antibacterial performance against both bacteria. Cytocompatibility results indicated that PLLA/GO-AgNPs fibrous with a low amount of GO-AgNPs enhanced cell proliferation and growth while high co-incorporation of GO-AgNPs showed a negative effect on cell proliferation. Taken together, PLLA/1GO-AgNPs fibrous coating shows suitable corrosion resistance, cytocompatibility, and antibacterial function for use in orthopedic applications.
Mid-facial defect is one of the most disfiguring and impairing defects. A design of prosthesis that is aesthetic and stable can be precious to a patient who has lost part of his face due to surgical excision. Prosthesis can restore the patients' self-esteem and confidence, which affects the patients and their life style. The aim of this case report is to describe a technique of mid-facial silicone prosthesis fabrication.