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[Functional state of the vascular wall in patients with coronary arteriosclerosis and different types of reactions to psycho- emotional stress].

With changes in psychoemotional stress, antithrombogenic properties of the vascular wall and hemostatic parameters were evaluated in 25 healthy subjects and 46 patients with coronary heart disease (CHD) who differently performed a leader function when intrapersonal interaction was simulated by using a bioengineering "Gomeostat" device. There was a significant increase in the functional activity of the hemostatic system involving enhanced platelet functional activity and diminished blood procoagulative fibrinolytic activity and decreased antithrombogenic activity of the vascular wall in patients with CHD who showed a managerial tactics during simulated intrapersonal interaction in a minor group as compared to a group of followers among CHD patients.

Adult↗

ITI-system. Basic and clinical procedures.

Future development in implant prosthodontics should be based on the fundamentals of sound research and reliable clinical implementation. The goals should be to research the safety and efficacy of implants with regard to materials, host receptor site and interfacial zone; to develop acceptable uniform standards of evaluation; and to submit findings to scientific methods of analysis in determining benefit-to-risk factors. This presentation will offer a glimpse at some current developments in basic and clinical research focusing on studies in biocompatibility and host acceptance; the implant-tissue interface; processes in osteogenesis related to vascularization of host sites; and bioengineering studies related to stress analysis and dimensional accuracy of impression systems for implants. The presentation will further describe future directions in research, training and implementation of services through development of an interdisciplinary team. A center is proposed to address the need for combined efforts in clinical++ and basic science research, the broad scope of implant utilization, and the teaching of implant procedures within an academic setting and to our colleagues.

Biocompatible Materials↗

Future directions in the use of dental implants.

Future development in implant prosthodontics should be based on the fundamentals of sound research and reliable clinical implementation. The goals should be to research the safety and efficacy of implants with regard to materials, host receptor site and interfacial zone; to develop acceptable uniform standards of evaluation; and to submit findings to scientific methods of analysis in determining benefit-to-risk factors. This presentation will offer a glimpse at some current developments in basic and clinical research focusing on studies in biocompatability and host acceptance; the implant-tissue interface; processes in osteogenesis related to vascularization of host sites; and bioengineering studies related to stress analysis and dimensional accuracy of impression systems for implants. The presentation will further describe future direction in research, training and implementation of services through development of an interdisciplinary team. A center is proposed to address the need for combined efforts in clinical and basic science research, the broad scope of implant utilization, and the teaching of implant procedures within an academic setting and to our colleagues.

Dental Implantation↗

Dielectric properties of tissues and biological materials: a critical review.

We critically review bulk electrical properties of tissues and other biological materials, from DC to 20 GHz, with emphasis on the underlying mechanisms responsible for the properties. We summarize the classical principles behind dielectric relaxation and critically review recent developments in this field. Special topics include a summary of the significant recent advances in theories of counterion polarization effects, dielectric properties of cancer vs. normal tissues, properties of low-water-content tissues, and macroscopic field-coupling considerations. Finally, the dielectric properties of tissues are summarized as empirical correlations with tissue water content in other compositional variables; in addition, a comprehensive table is presented of dielectric properties. The bulk electrical properties of tissues are needed for many bioengineering applications of electric fields or currents, and they provide insight into the basic mechanisms that govern the interaction of electric fields with tissue.

Adipose Tissue↗

[Physiology of the skin of the vulva: new aspects].

Using noninvasive bioengineering skin technology, the vulvar skin has been partially characterized as having unique properties. The reduction in stratum corneum barrier function and the increase in basal blood flow in the vulvar skin may explain the high rate of percutaneous absorption and the increased reactivity to irritants. The vulvar microbial flora represents a unique combination of contaminants from the vagina and the perianal area and a resident flora that is typical for intertriginous skin, together with a high carrier rate of Staphylococcus aureus. The long-term goal of vulvar physiology is to understand better how this more specialized skin differs from less specialized areas in the hope of using this information clinically.

Bacterial Infections↗

Biostability of polyurethanes.

Aside from the medical requirements a material has to fulfill to qualify as biocompatible, for the bioengineer, who is involved in the design, construction and fabrication of prosthetic devices, the mechanical, physical and chemical properties of the material as well as its possible manufacturing procedures and, last but not least, its biostability are of the same importance. In the very aggressive biological environment, the material should behave inertly, showing no surface erosions, molecular chain disruptions, uptake of low molecular weight biological materials, local chemical imbalances, tendency to calcification or negative changes of mechanical properties. With regard to this aspect, different polyurethanes have been evaluated in-vitro and in-vivo as basic materials and already fabricated devices (blood pumps and heart valves). The comparison of the results stresses the necessity of further efforts to achieve a standardized test protocol for the prove of the biostability of polymers, containing appropriate, well-defined in-vitro and in-vivo test methods to establish the necessary data basa for the materials' clinical approval.

Animals↗

Approach to rheumatic diseases.

Rheumatic diseases are the most prevalent of the chronic painful disorders in the world today. The specialty of rheumatology is one of the most clinically orientated. Hence the approach to rheumatic diseases must be clinical. Proper history taking and physical examination including that of the musculoskeletal system cannot be overemphasized. Special attention must be paid to the skin, mucous membrane, the eyes, the gastrointestinal and genitourinary systems. Laboratory tests are meant to supplement a thorough history and physical examination and never in place of them. Because there is so much overlap in the clinical manifestations of the different rheumatic diseases, a precise diagnosis may be difficult in the early stages. Management goals must therefore be bipartite. Short term goal is aimed at symptomatic relief, gaining the patient's confidence and preventing disability. Long term goal requires the physician's attention to diagnosis and prognosis, drug toxicity, negotiating with the patient regarding an acceptable life-style and degree of relief and finally prolonging or protecting life. In fact the modern approach to health care delivery in rheumatic diseases must be based on the team concept. The team should consist of the physician/rheumatologist, the orthopaedic surgeon and a spectrum of arthritis health professionals composed of physical therapists, occupational therapists, nurses, psychologists, social workers, dietitians, bioengineers and administrators.

Health Services Needs and Demand↗

Biomaterials: selection and complications.

Basic concepts of bioengineering and biomechanics are presented. The application of these various terms explain the mechanical and physical properties of biomaterials widely used in implanted devices. An explanation and literature review explains the possible biocompatibility reactions to these implants.

Biocompatible Materials↗

Heart valve replacement with the pivoting disc prosthesis: appraisal of results and description of a new all-carbon model.

The Lillehei-Kaster pivoting disc (LKPD) valve has a free-floating pyrolite carbon disc suspended within a unibody titanium housing. A brief history of its development beginning in 1964 illustrates the origin of the concepts of central flow, lifetime durability, laminar flow, and low profile with lightness of weight. Clinical evidence indicating that this prosthesis has lifetime wearability is confirmed by complete freedom from mechanical failure in widespread clinical usage. Postoperative studies for abnormal hemolysis disclosed a striking improvement over lateral flow prostheses. The hemodynamic performance has been evaluated in both early and late postoperative studies and showed excellent results in all but the smallest sizes in the aortic position. The incidence of thromboembolism was found to be very low. In a total of 1610 patients at risk, the overall incidence of embolism was only 1.1 percent, and fatal embolism occurred in only one patient. These results with use of the LKPD valve have confirmed substantial progress in resolving the problems of prosthesis-related complications. Performance parameters still in need of improvement have also been identified, and these considerations have been incorporated into the design of a new all-carbon prosthesis with bioengineering refinements to meet these needs.

Aortic Valve↗

Progress in hemodialysis.

Bioengineering research over the past 16 years has provided clear definition of the design parameters controlling solute transport in dialyzers and resulted in the present dialysis systems which have a broad range of solute transport and ultrafiltration properties with predictable performance. Research into the pathophysiology of uremia has further established the role of protein catabolism in pathogenesis and resulted in information indicating that endocrine metabolic, drug toxicity and immunologic pathogenetic mechanisms may also be operative in this complex syndrome. Average dialysis treatment time has decreased more than 50 percent over the last ten years, but to a considerable extent remains empirically determined. Progress in elucidation of the solute kinetic parameters controlling solute concentration during regular dialysis therapy (RDT) is reviewed and the critical role of mass balance in evaluation of this therapy is discussed. Progress in kinetic modeling to quantify RDT is reviewed, the limitations of current kinetic models are considered and anticipated requirements to develop improved model parameters outlined.

History, 20th Century↗

ITI endosteal hollow cylinder implant systems.

The endosteal hollow cylinder implant systems have been in clinical use for over 10 years. These systems incorporate advanced sophisticated biomaterials and bioengineering design concepts such as the titanium plasma spray (TPS) surface coating as well as the cylindric shape. This shape has now introduced the third dimension to dental implantology. In previous systems, such as the blade-vent, only height and width were present. Therefore, these previous systems could not be used as single-tooth replacements; also, they were not able to withstand lateral forces or torquing. In a series of cases reported from Switzerland, Sweden, Germany, and the United States, 580 hollow cylinder implants were placed for up to 10 years with an overall rate of success of 95.3 per cent.

Crowns↗

Biodynamics--the key to flight.

Biodynamics measures the effects of mechanical force on living tissues. The quantitative relations of mechanical stress factors and biological strain responses of the living body provide criteria for limits of injury threshold, reversible injury, permanently disabling injury, and fatal injury. These criteria are guidelines for aerospace design and performance standards involving human survival in the environment of flight. Below these limits, the effects of mechanical force factors on human performance while acutely or chronically exposed to them in aerial or space flight are crucial. Some can be accumulatively disabling; others can be adapted to over a period of time. Extremes of low-frequency vibration cannot be long endured, while sustained zero gravity in space flight produces mild, transient malaise followed by adaptation in several hours. Aerospace flight biodynamics deals with human reactions to absence of gravity; sustained curvilinear acceleration; sustained acceleration and deceleration (launch and reentry in space flight); single impact force (collisions); low-frequency vibration in the whole human body resonance response range; whole-body tumbling and spinning, as in high-altitude free-fall; acoustical range vibrations; explosive blast in air or water; abrupt decompression, as in cabin pressure failure; static forces in tension, compression, torsion and shear. Biodynamic stress analysis takes into account whole-body responses, particular responses of rigid bone, viscous elastic soft tissues, pneumatic and hydraulic effects of gas and fluids in hollow organs, and displacements of solid organs suspended in body cavities. Accurate and comprehensive results require physical measurements, clinical and laboratory studies before and after exposure, subjective reports of trained volunteer subjects, and objective medical and bioengineering evaluation of results.(ABSTRACT TRUNCATED AT 250 WORDS)

Aviation↗

Contributions of aerospace medicine to clinical medicine.

The contributions of aerospace medicine to clinical medicine far exceed the aggregate of the clinical applications of individual technologies which originated in aerospace medicine, important though these be. Contributions of aerospace medicine to clinical medicine will be discussed in seven categories: The raising of issues, questions, and need for systems for protection or support for man before such issues and needs were recognized by clinicians to be important or feasible; Contributing to the manpower pool of able clinical investigators through recruitment and special training in research; Providing fundamental insights into specific biologic processes of clinical significance; The recruitment of disciplines not previously involved extensively in addressing biologic problems and the creation or strengthening of hybrid disciplines such as bionics and bioengineering; Pioneering emphasis on safety, prevention and environmental health now being incorporated into clinical medicine; The development of specific research technologies which have been used to address an array of clinical problems; Specific technologies of clinical significance to which aerospace medicine has contributed, including systems for air transport of patients, many components of modern systems for patient monitoring, components of circulatory and ventillatory support systems, hypoxia warning systems, prevention of toxic exposure and treatment of toxic injury, prevention and treatment of burns, restraint systems, artificial organs, the application of models to clinical practice, and the ordering and automating of information processing.

Aerospace Medicine↗

Biomechanics of the hip joint.

A great deal of biomechanical research remains to be done in the area of hip joint trauma so that bioengineers and other medical scientists can work with accurate bone failure data, which are essential to the design of sports equipment, vehicles, workplace situations, and prostheses. The application of biomechanical data, in addition to being essential in prosthesis design and ergonomics, also can be useful in such diverse problems as pathogenesis of degenerative joint disease, management of the postfracture patient, bracing in Perthes' disease, and in many other pathologic conditions.

Adult↗

Preventive surgery for congenital deformities of the hand.

Science is on the verge of major changes in the treatment of congenital deformities of the hand. The first changes will be technical and will involve the increasing use of microsurgery, laser surgery, electricity, and fiber optics. Improved imaging techniques will permit earlier and more precise diagnosis of tissue abnormalities. The second phase will be antenatal preventive surgery, first on the fetus and later on the embryo. The third phase will be the prevention of congenital deformities by bioengineering.

Abnormalities, Drug-Induced↗

Human red blood cells with normal or improved oxygen transport function prepared and frozen in the primary polyvinyl chloride plastic blood collection container.

This is a report a a new system for freezing human red blood cells in the same polyvinyl chloride plastic container in which the blood is collected and separated into components. This polyvinyl chloride plastic collection bag with integrally attached transfer packs for blood collection, component separation, red blood cell biochemical modification, freezing, storage, and post-thaw dilution before washing, represents a major advancement in the freeze-preservation process. The label with the donor's blood type and identification number affixed to the bag at the time of collection remains in place throughout the freezing and thawing process. The transfused red blood cells are of superior quality, and the processing cost is less than with other methods of freeze-preservation. There is a lower risk of contamination with these red blood cells because manipulation of the product is kept at a minimum. "Rejuvenation", a bioengineering process by which outdated red blood cells can be salvaged, can be incorporated into the preservation process using one of the attached transfer packs of the primary collection bag. This process has been introduced as a possible means of alleviating the dramatic blood shortages which occur periodically. Red blood cells may also be "rejuvenated" after storage in the liquid state to increase their 2,3 DPG and ATP levels to 150 to 200% of normal, and these red blood cells with improved oxygen transport function have been administered to anemic patients with and without cardiopulmonary insufficiency, patients undergoing cardiopulmonary bypass and treatment with hypothermia during cardiac surgery, and in instances where nonhemolytic transfusion reactions might be expected.

Adenosine Triphosphate↗

Sensory feedback in a myoelectric upper limb prosthesis: a preliminary report.

Upper limb prostheses are often rejected because they do not provide the sensory feedback available from a normal hand. A system for providing sensory feedback has been developed at the University of New Brunswick for use with the three-state myoelectric controls prepared in the Bioengineering Institute there. Strain gauges mounted on the forefinger of an electric hand provide information which is processed electronically to cause a tingling sensation in the patient's stump, proportional in its intensity to the pinch force in the finger. This system has been used by a patient at the Ontario Crippled Children's Centre in Toronto, since June 1976. She uses it consistently with great satisfaction and enthusiasm. It gives her a sense of competence and confidence she does not have without it.

Arm↗

[Studies on the modification of sexual and breeding maturity in swine using gonadotrophic hormone preparations].

Injection of low doses of PMSG-HCG gonadotrophin mixes to intensively raised prepuberal gilts, aged six months, stimulated sexual juvenile development prior to breeding use, the average being 255 days. First insemination of the test animals, following synchronisation of oestrus or ovulation, increased live births by 0.5 piglets per litter over the untreated controls. More controlled production experiments to test the new bioengineering approach are in preparation.

Animals↗