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Biodegradable polymer scaffolds with well-defined interconnected spherical pore network.

Scaffolding plays pivotal role in tissue engineering. In this work, a novel processing technique has been developed to create three-dimensional biodegradable polymer scaffolds with well-controlled interconnected spherical pores. Paraffin spheres were fabricated with a dispersion method, and were bonded together through a heat treatment to form a three-dimensional assembly in a mold. Biodegradable polymers such as PLLA and PLGA were dissolved in a solvent and cast onto the paraffin sphere assembly. After dissolving the paraffin, a porous polymer scaffold was formed. The fabrication parameters were studied in relation to the pore shape, interpore connectivity, pore wall morphology, and mechanical properties of the polymer scaffolds. The compressive modulus of the scaffolds decreased with increasing porosity. Longer heat treatment time of the paraffin spheres resulted in larger openings between the pores of the scaffolds. Foams of smaller pore size (100-200 microm) resulted in significantly lower compressive modulus than that of larger pore sizes (250-350 or 420-500 microm). The PLLA foams had a skeletal structure consisting of small platelets, whereas PLGA foams had homogeneous skeletal structure. The new processing technique can tailor the polymer scaffolds for a variety of potential tissue engineering applications because of the well-controlled architecture, interpore connectivity, and mechanical properties.

Absorbable Implants↗

Clinical engineering internships: a regional hospital-based approach.

Clinical engineering has been defined as that branch of applied science that is concerned with solving problems associated with the clinical aspects of health care delivery and patient care using principles, methods and approaches drawn from engineering science and technology. To prepare individuals for this type of activity requires that they be exposed to the clinical environment during their academic programs. Such an experience permits the student to observe not only the operation of specific medical instruments, but also the environment in which they are used and the people who use them. The nature of this clinical experience may vary in terms of its duration and specificity, but it must occur. Consequently, all clinical engineering programs must contain, as an integral part of their activity, a significant internship experience. This article presents the activities of a regional, hospital-based clinical engineering internship program that has been in operation during the past decade, and highlights the major arguments for the internship approach.

Biomedical Engineering↗

Microengineering of cellular interactions.

Tissue function is modulated by an intricate architecture of cells and biomolecules on a micrometer scale. Until now, in vitro cellular interactions were mainly studied by random seeding over homogeneous substrates. Although this strategy has led to important discoveries, it is clearly a nonoptimal analog of the in vivo scenario. With the incorporation--and adaptation--of microfabrication technology into biology, it is now possible to design surfaces that reproduce some of the aspects of that architecture. This article reviews past research on the engineering of cell-substrate, cell-cell, and cell-medium interactions on the micrometer scale.

Animals↗

Evaluation of infusion pumps and controllers: fourth report.

The evaluation of pumps and controllers is being undertaken for the DHSS within the Bath District Health Authority. Technical performance assessments are made at the Bath Institute of Medical Engineering; user assessments in various local hospitals; and equipment is tested to BS 5724 at the British Standards Institution Test House. A recent issue of 'Health Equipment Information' ('HEI') (No. 125), published in September 1984, contains evaluation reports on a further four infusion devices. This is the fourth report in the series: the first three were devoted to groups of instruments of broadly similar types. In this report, a mixed batch of syringe pumps, volumetric pumps and controllers is reviewed--the aim being to evaluate new instruments as soon as possible after they appear on the market. Edited versions of earlier reports have appeared in 'Journal of Medical Engineering & Technology' [1 and 2]. For full details of the evaluation findings readers should consult 'HEI' 125--the following are extracts from the report.

Biomedical Engineering↗

[Standardization and certification of medical devices].

The paper deals with the problems associated with the absence of a well-defined standard basis of the standardization, licensing, etc. of medical engineering articles, which the public corporation "Izhevsk Motor Plant Axion-Holding", one of the largest manufacturers of medical equipment comes up against.

Biomedical Engineering↗

Knowledge management system for benchmarking performance indicators using statistical process control (SPC) and Virtual Instrumentation (VI).

Healthcare is ever changing environment and with the Joint Commission for the Accreditation of Hospital Organization (JCAHO) emphasis on quality improvement during the past several years, and the cost-focused healthcare reforms of the 1990s, benchmarking with peer comparison, and more recently benchmarking against competitors, has taken on a new emphasis. All acute healthcare organizations accredited by JCAHO now require participation in a program titled ORYX, which is designed to use comparisons with other organizations and promote national benchmarks. The knowledge management system designed assists clinical engineering department to convert vast amounts of available data into information, which is ultimately transformed into knowledge to enable better decision-making. The systems assist in using the data as a comparison tool, to compare the performance internally and also compare performance with peer organizations using the same measures within the same measurement system. Collectively, these applications support better, faster data-driven decisions. This tool provides fast and easy access to financial and quality metrics to clinical engineering department managers, which increases their ability to perform sophisticated analysis to develop accurate models and forecasts, and make timely, data driven decisions. The project also provides a platform by means of which clinical engineering departmental procedures, data, and methods can be assessed and shared among institutions.

Artificial Intelligence↗

Matching technical jobs with needs.

Selecting a suitable mix of engineers and technicians who can respond to changing technological needs can be a formidable task for the administrator.

Biomedical Engineering↗

Group processes of decision making for hospital-based technology assessment committees.

There are a variety of group-judgment methods to resolve controversial issues in health care. Meta-analysis and group judgment methods such as consensus conferences are attempts to bring diverse elements of information together for synthesis. Leape notes that a significant body of literature exists regarding the techniques used to elicit opinions from groups. Organizational structures and functions of groups vary in terms of the natures of interactions among group members and the manners in which final conclusions are reached and expressed. The introduction of the process of technology assessment into the hospital setting introduces a problem inherent in the introduction of somewhat academic processes into the operational real world of interpersonal relations, administrative and medical staff interactions, staff costs, and institutional priorities. Hospital administrative processes are based on the committee approach. Medical staff credentialing, drug formularies, and administrative policies are all developed, approved, and implemented through committees. It would seem logical that if technology assessment is to be effective in the hospital setting, then those same group decision processes inherent in committees should be used in technology assessment. Relatedly, if technology assessment is to be successful in the hospital setting, then how can the limited resources of hospital-based staff be best utilized to carry through the assessment of elected technologies? This paper discusses group decision processes, particularly as they relate to technology assessment. The processes of particular interest are those that focus on group interactions rather than theory-based decision processes. The purpose for the paper is to provide to clinical engineering management and senior hospital management background information to use in the formulation of the operating parameters of a hospital-based technology assessment committee.

Biomedical Engineering↗

The role of clinical engineers in hospitals: essential or expedient?

This article explores the capabilities of those technicians and clinical engineers who manage biomedical equipment. Equipment technicians maintain the equipment in hospitals and may participate in some basic equipment management. Clinical engineers, on the other hand, may augment this management effort in equipment-intensive hospitals by designing the specifications and procedures needed to integrate equipments into properly working systems and to maintain them under local conditions. In addition, clinical engineers can improve equipment management by providing an engineering viewpoint to such areas as technology assessment, computer applications, quality improvement, and in-service education.

Biomedical Engineering↗

Engineering of molecular and cellular biocatalysts: selected contributions by James E. Bailey.

James (Jay) E. Bailey was a pioneer in biotechnology and biochemical engineering. During his 30 years in academia he made seminal contributions to many fields of chemical engineering science, including catalysis and reaction engineering, bioprocess engineering, mathematical modeling of cellular processes, recombinant DNA technology, enzyme engineering, and metabolic engineering. This article celebrates some of his contributions to the engineering of molecular and cellular biocatalysts, and identifies the influence he had on current and future research in biotechnology.

Biochemistry↗

Bioreactor cultivation conditions modulate the composition and mechanical properties of tissue-engineered cartilage.

Cartilaginous constructs have been grown in vitro with use of isolated cells, biodegradable polymer scaffolds, and bioreactors. In the present work, the relationships between the composition and mechanical properties of engineered cartilage constructs were studied by culturing bovine calf articular chondrocytes on fibrous polyglycolic acid scaffolds (5 mm in diameter, 2-mm thick, and 97% porous) in three different environments: static flasks, mixed flasks, and rotating vessels. After 6 weeks of cultivation, the composition, morphology, and mechanical function of the constructs in radially confined static and dynamic compression all depended on the conditions of in vitro cultivation. Static culture yielded small and fragile constructs, while turbulent flow in mixed flasks yielded constructs with fibrous outer capsules; both environments resulted in constructs with poor mechanical properties. The constructs that were cultured freely suspended in a dynamic laminar flow field in rotating vessels were the largest, contained continuous cartilage-like extracellular matrices with the highest fractions of glycosaminoglycan and collagen, and had the best mechanical properties. The equilibrium modulus, hydraulic permeability, dynamic stiffness, and streaming potential correlated with the wet-weight fractions of glycosaminoglycan, collagen, and water. These findings suggest that the hydrodynamic conditions in tissue-culture bioreactors can modulate the composition, morphology, mechanical properties, and electromechanical function of engineered cartilage.

Animals↗

Large-scale animal cell cultures: design and operational considerations.

The manufacture of biologicals, especially proteins, using large-scale culture of animal cells is becoming popular. There is a need for a rational approach to the design and scale-up of bioreactors for these applications. The ultimate requirement of any scale-up strategy should be to preserve the biological activity of these high-value molecules. With this as the central theme, the design and operation of animal cell processes has been discussed. Equal importance has been given to both the biological and the engineering aspects which need to be considered for a successful scale-up. An integrated systems approach has been stressed.

Animals↗

Biomaterials in Canada: the first four decades.

Biomaterials research in Canada began in the 1960s. Over the past four decades significant contributions have been made across a broad spectrum covering dental, orthopaedic, cardiovascular, neuro, and ocular biomaterials. Canadians have also been active in the derivative area of tissue engineering. Biomaterials laboratories are now established in universities and research institutes from coast to coast, supported mainly by funding from the Federal and Provincial Governments. The Canadian Biomaterials Society was formed in 1971 and has played an important role in the development of the field. The Society played host to the 5th World Biomaterials Congress in Toronto in 1996. The work of Canadian researchers over the past four decades is summarized briefly. It is concluded that biomaterials and tissue engineering is a mature, strong area of research in Canada and appears set to continue as such into the future.

Biocompatible Materials↗

Tissue engineering: a 21st century solution to surgical reconstruction.

Tissue engineering has emerged as a rapidly expanding approach to address the organ shortage problem. It is an "interdisciplinary field that applies the principles and methods of engineering and the life sciences toward the development of biological substitutes that can restore, maintain, or improve tissue function." Much progress has been made in the tissue engineering of structures relevant to cardiothoracic surgery, including heart valves, blood vessels, myocardium, esophagus, and trachea.

Biomedical Engineering↗

Biomaterials in drug delivery and tissue engineering: one laboratory's experience.

This Account reviews our laboratory's research in biomaterials. In one area, drug delivery, we discuss the development of materials that are capable of releasing macromolecules such as proteins and peptides, intelligent delivery systems based on magnetism or microchip technology, new degradable materials such as polyanhydrides, and noninvasive approaches for delivering molecules through the skin and lungs. A second area, tissue engineering, is also discussed. New polymer systems for creating cartilage, blood vessels, nerves, and other tissues are examined.

Animals↗

Controlled growth factor release from synthetic extracellular matrices.

Polymeric matrices can be used to grow new tissues and organs, and the delivery of growth factors from these matrices is one method to regenerate tissues. A problem with engineering tissues that exist in a mechanically dynamic environment, such as bone, muscle and blood vessels, is that most drug delivery systems have been designed to operate under static conditions. We thought that polymeric matrices, which release growth factors in response to mechanical signals, might provide a new approach to guide tissue formation in mechanically stressed environments. Critical design features for this type of system include the ability to undergo repeated deformation, and a reversible binding of the protein growth factors to polymeric matrices to allow for responses to repeated stimuli. Here we report a model delivery system that can respond to mechanical signalling and upregulate the release of a growth factor to promote blood vessel formation. This approach may find a number of applications, including regeneration and engineering of new tissues and more general drug-delivery applications.

Alginates↗

Tissue engineering research in oral implant surgery.

In this article, we introduce some of the more extensively evaluated technologies using concepts of tissue engineering. We report on hard tissue engineering and soft tissue engineering and their utility for dental implant therapy. For hard tissue engineering, we evaluated human recombinant bone morphogenetic protein-2 and marrow mesenchymal stem cells using a model of sinus augmentation procedure in rabbit. We also describe distraction osteogenesis as another category for hard tissue engineering. In addition, we evaluate soft tissue management using cultured epithelial grafting for soft tissue engineering. The results of our tissue regeneration materials and methods in this study are positive. When the tissue engineering materials are used in clinics in the future, implant surgery could be the leading field.

Absorbable Implants↗