Gd Added Mg Alloy for Biodegradable Implant Applications

Microstructure, mechanical, in vitro and in vivo behavior of extruded Mg alloys with varying Zn/Gd ratios, Mg-2Gd-2Zn-0.5Zr (Zn/Gd = 1), Mg-2Gd-6Zn-0.5Zr (Zn/Gd = 3), and Mg-10Gd-1Zn-0.5Zr (Zn/Gd = 0.1) were investigated. The results revealed that the major secondary phases such as W (Mg3Zn3Gd2), (Mg,Zn)3Gd, LPSO (Long period stacking order) and I (Mg3Zn6Gd) phase in alloys depended on Zn/Gd ratio. These second phases influenced the mechanical as well as biological characteristics of the alloys. Among studied alloys, Mg-10Gd-1Zn-0.5Zr alloy showed the highest yield strength and tensile strength of 270 (±9.29) and 330 MPa (±15.8), respectively, with a reasonably good elongation of 12% (±2.36). The presence of Gd2O3 in the degradation film of Mg-10Gd-1Zn-0.5Zr enhanced the resistance offered by the film, which resulted in its lowest biodegradation, better viability, and cell proliferation under in vitro condition. The short term (subcutaneous implantation in rats for 1 month) in vivo studies showed that the alloy Mg-10Gd-1Zn-0.5Zr degraded at a rate of 0.35 mm/y (±0.02) and did not induce any toxicity to the vital organs.

Use of bioresorbable fibers for short-wave infrared spectroscopy using time-domain diffuse optics

We demonstrate the usability of bioresorbable phosphate glass fibers for time-domain diffuse optical spectroscopy (TD-DOS) in the short-wave infrared (SWIR) region of 950-1600 nm, with the use of an InGaAs detector. Bioresorbable fibers for diffuse optics present an exciting prospect due to their ability to be left implanted while retrieving optical properties from deeper regions (few cm) for monitoring treatments. Extending TD-DOS to the SWIR region could be useful to better identify biomarkers such as water, lipids and collagen, given their increase in absorption in this range. We attempt to use the bioresorbable fibers to spectrally identify these biomarkers by measuring a series of biological samples known to contain them, such as porcine muscle, porcine fat and bone. We further validate our measurements by comparing the optical properties of high-scattering solid silicone phantoms retrieved with these bioresorbable fibers with those by a standard Si fiber.

Implantable antennas for biomedical applications: a systematic review

This review presents an in-depth examination of implantable antennas for various biomedical purposes. The development of implantable antennas, including their designs, materials, and operating principles, are introduced at the beginning of the discussion. An overview of the many kinds of implantable antennas utilized in implantable medical devices (IMDs) are presented in this study. The article then discusses the important factors to consider when developing implantable antennas for biomedical purposes, including implant placement, frequency range, and power needs. This investigation additionally examines the challenges and limitations encountered with implantable antennas, including the limited space available within the human body, the requirement for biocompatible materials, the impact of surrounding tissue on antenna performance, tissue attenuation, and signal interference. This review also emphasizes the most recent advances in implanted antenna technology, such as wireless power transmission, multiband operation, and miniaturization. Furthermore, it offers illustrations of several biomedical uses for implantable antennas, including pacemaker, capsule endoscopy, intracranial pressure monitoring, retinal prostheses, and bone implants. This paper concludes with a discussion of the future of implantable antennas and their possible use in bioelectronic medicine and novel medical implants. Overall, this survey offers a thorough analysis of implantable antennas in biomedical applications, emphasizing their importance in the development of implantable medical technology.

Development of reduced volume endosseous cuspid tooth implant using topology optimization by SIMP technique for improved osseointegration

The article aims to design and develop a topology-optimized endosseous cuspid tooth implant of the maxilla region. The manuscript presents a numerical analysis of the resulting von Mises stresses and effective strain resulting in the topology-optimized implant with occlusal loading of 110 N. Solid Isotropic Material with Penalization (SIMP) method is employed for topology optimization and four different models, namely model-1, model-2, model-3, and model-4, are developed based on volume reduction rates of 8%, 16%, 24%, and 32%, respectively. FEA results highlight that the maximum stress and strain in the screw increases with volume reduction rates. The comparative analyses of the resulting stresses in the compact and cancellous bone along with the strain in the screw led to the conclusion that model-1, model-2, and model-3 resulted in moderate stresses on compact and cancellous bone compared to the original model of the implant. However, the screw and bones are subjected to maximum stress and strain in the model-4. The study concludes that model-2, with 16% reduced volume and 14.2% reduced mass as compared to the original implant, may be considered as the optimized design of the model. The resulting model offers a significant reduction in the weight and volume with a minor increase in effective stress and strain without negatively impacting the functionality and bio-mechanical performance of the implant. The optimized dental implant prototype is also fabricated as a proof of concept by the Fused Deposition Modelling process.

Investigation of toxicity and performance deterioration of parylene-C packaged copper coils using accelerated test

OBJECTIVES

In this paper, to figure out the reliability of copper wire wound coil in an in vitro environment, performance deterioration and copper ion elution of coil was investigated using accelerated tests.

METHODS

Bare coils with enamel coating and parylene-C coated coils were immersed into the 75-degree Celsius phosphate-buffered saline for accelerated tests. Performance and elution of the copper ion were investigated using proper equipment.

RESULTS

The parylene-C coating with a thickness of several um effectively depress the performance degradation and the elution of the copper ion. However, it has not reached a perfect level and research on additional packaging methods is needed.

SIGNIFICANCE

Coil for wireless power and data transfer is an important element in the design of implantable devices. Copper is the most widely used material for the design of coils in general. However, because of its cytotoxicity and high reactivity with water, the packaging capabilities should be investigated closely. In this paper, a method for evaluating the packaging performance when the coil is coated with parylene-C and the results are presented.

The history of cardiac pacing in the young and a look to the future

PURPOSE OF REVIEW

The purpose of this review is to explore the historical and serendipitous events that led to the creation of modern-day pacemakers. In addition, this review will explore how contemporary conduction site-specific pacing has overcome some of the deleterious effects from historical chronic right ventricular apical pacing.

RECENT FINDINGS

Recently, there have been tremendous advances in not just the lead design but the tools required to promote more physiologic pacing. Although cardiac resynchronization pacing has been around for nearly 2 decades, this review also introduces and discusses the early results of His-bundle pacing and left bundle branch pacing and some of the potential applicability of this technology for our children.

SUMMARY

Pacemakers have evolved significantly in the last 30 years through collaborative partnerships between physicians and engineers. The future of cardiac pacing is bright compared to the field of electrotherapy 50 years ago. Future iterations of pacemakers must consider unusual anatomy and growing children. Pediatric patients contribute to a small percentage of the overall device volume, but the majority of these patients will have a pacemaker for life. We need to be proactive and consider what are the best short and long-term solutions for this cohort.

Experimental investigation on effect of accelerated speed and rotor material on life of implantable micro-infusion pump tubing

Peristaltic pumps have been put to use in various biomedical applications like devices for the transfer of body fluids as well as devices for controlled release of medication, including implantable infusion pumps. Out of the various components of a peristaltic pump, tubing is considered the most vulnerable part. This study focuses on the performance of Silicone micro-pump tubing used in such an implantable drug delivery device. Long-term implantable medical devices are expected to be operational for about 10 years. But experimental testing of the reliability of components under normal working speeds are time-consuming and thus delays the product development cycle. While simulating the conditions in the laboratory under accelerated speeds, the effect of increasing the speed must be accounted. In this study, the effect of accelerated speed and rotor material on pump tubing life is investigated. A test jig is developed which simulates the running conditions of the infusion pump for long-duration operation. Different rotor speeds and material configurations are investigated to obtain their effect on long-duration performance. Thermal effects on the roller junctions are studied and found that the Delrin silicone combination has twice the rise in junction temperature than the titanium silicone combination. The failure modes are inspected using microstructure analysis and the best configuration is identified.

A Ceramic-Electrolyte Glucose Fuel Cell for Implantable Electronics

Next-generation implantable devices such as sensors, drug-delivery systems, and electroceuticals require efficient, reliable, and highly miniaturized power sources. Existing power sources such as the Li-I₂ pacemaker battery exhibit limited scale-down potential without sacrificing capacity, and therefore, alternatives are needed to power miniaturized implants. This work shows that ceramic electrolytes can be used in potentially implantable glucose fuel cells with unprecedented miniaturization. Specifically, a ceramic glucose fuel cell-based on the proton-conducting electrolyte ceria-that is composed of a freestanding membrane of thickness below 400 nm and fully integrated into silicon for easy integration into bioelectronics is demonstrated. In contrast to polymeric membranes, all materials used are highly temperature stable, making thermal sterilization for implantation trivial. A peak power density of 43 µW cm^-2 , and an unusually high statistical verification of successful fabrication and electrochemical function across 150 devices for open-circuit voltage and 12 devices for power density, enabled by a specifically designed testing apparatus and protocol, is demonstrated. The findings demonstrate that ceramic-based micro-glucose-fuel-cells constitute the smallest potentially implantable power sources to date and are viable options to power the next generation of highly miniaturized implantable medical devices.

Electrical Brain Stimulation for Epilepsy and Emerging Applications

SUMMARY

Electrical brain stimulation is an established therapy for movement disorders, epilepsy, obsessive compulsive disorder, and a potential therapy for many other neurologic and psychiatric disorders. Despite significant progress and FDA approvals, there remain significant clinical gaps that can be addressed with next generation systems. Integrating wearable sensors and implantable brain devices with off-the-body computing resources (smart phones and cloud resources) opens a new vista for dense behavioral and physiological signal tracking coupled with adaptive stimulation therapy that should have applications for a range of brain and mind disorders. Here, we briefly review some history and current electrical brain stimulation applications for epilepsy, deep brain stimulation and responsive neurostimulation, and emerging applications for next generation devices and systems.

Powering Implantable and Ingestible Electronics

Implantable and ingestible biomedical electronic devices can be useful tools for detecting physiological and pathophysiological signals, and providing treatments that cannot be done externally. However, one major challenge in the development of these devices is the limited lifetime of their power sources. The state-of-the-art of powering technologies for implantable and ingestible electronics is reviewed here. The structure and power requirements of implantable and ingestible biomedical electronics are described to guide the development of powering technologies. These powering technologies include novel batteries that can be used as both power sources and for energy storage, devices that can harvest energy from the human body, and devices that can receive and operate with energy transferred from exogenous sources. Furthermore, potential sources of mechanical, chemical, and electromagnetic energy present around common target locations of implantable and ingestible electronics are thoroughly analyzed; energy harvesting and transfer methods befitting each energy source are also discussed. Developing power sources that are safe, compact, and have high volumetric energy densities is essential for realizing long-term in-body biomedical electronics and for enabling a new era of personalized healthcare.

Recent Advances of Energy Solutions for Implantable Bioelectronics

The emerging field of implantable bioelectronics has attracted widespread attention in modern society because it can improve treatment outcomes, reduce healthcare costs, and lead to an improvement in the quality of life. However, their continuous operation is often limited by conventional bulky and rigid batteries with a limited lifespan, which must be surgically removed after completing their missions and/or replaced after being exhausted. Herein, this paper gives a comprehensive review of recent advances in nonconventional energy solutions for implantable bioelectronics, emphasizing the miniaturized, flexible, biocompatible, and biodegradable power devices. According to their source of energy, the promising alternative energy solutions are sorted into three main categories, including energy storage devices (batteries and supercapacitors), internal energy-harvesting devices (including biofuel cells, piezoelectric/triboelectric energy harvesters, thermoelectric and biopotential power generators), and external wireless power transmission technologies (including inductive coupling/radiofrequency, ultrasound-induced, and photovoltaic devices). Their fundamentals, materials strategies, structural design, output performances, animal experiments, and typical biomedical applications are also discussed. It is expected to offer complementary power sources to extend the battery lifetime of bioelectronics while acting as an independent power supply. Thereafter, the existing challenges and perspectives associated with these powering devices are also outlined, with a focus on implantable bioelectronics.

A Review of Power Management Integrated Circuits for Ultrasound-Based Energy Harvesting in Implantable Medical Devices

This paper aims to review the recent architectures of power management units for ultrasound-based energy harvesting, while focusing on battery-less implantable medical devices. In such systems, energy sustainability is based on piezoelectric devices and a power management circuit, which represents a key building block since it maximizes the power extracted from the piezoelectric devices and delivers it to the other building blocks of the implanted device. Since the power budget is strongly constrained by the dimension of the piezoelectric energy harvester, complexity of topologies have been increased bit by bit in order to achieve improved power efficiency also in difficult operative conditions. With this in mind, the introduced work consists of a comprehensive presentation of the main blocks of a generic power management unit for ultrasound-based energy harvesting and its operative principles, a review of the prior art and a comparative study of the performance achieved by the considered solutions. Finally, design guidelines are provided, allowing the designer to choose the best topology according to the given design specifications and technology adopted.

Allergy Considerations in Implanted Neuromodulation Devices

OBJECTIVES

Allergic reactions are rare and poorly understood complications of neuromodulation device implantation. There are currently no guidelines for management of allergic reactions to these devices and their components. Here we review the published cases of allergic reactions to implanted neuromodulatory devices and leverage the experiences of other specialties that deal with similar complications to formulate recommendations for prevention and management.

MATERIALS AND METHODS

A review and assessment of the literature.

RESULTS

Allergic reactions to a number of implantable devices have been observed and published. In dentistry and orthopedics, metals such as nickel are the most frequent cause of allergic reactions. In interventional cardiology, where devices closely resemble neuromodulatory devices, titanium, silicone, and polyurethanes are the most common causes of allergic reactions. In neurosurgery, allergic reactions to implantable neuromodulatory devices are rare, and we summarize 13 cases published to date. Such allergic reactions generally present as local dermatitis, erythema, and pruritus, which can be difficult to distinguish from surgical site infection. In one published case, symptoms resolved with corticosteroid treatment, but all other cases required explantation. The successful reimplantation with a modified device was reported in some cases.

CONCLUSIONS

Patients should be screened for a personal history of contact allergy before implantation procedures. A multidisciplinary approach to suspected cases of postoperative allergic reactions involving collaboration between neurosurgeons and other implanting physicians, dermatologists or allergists, and device manufacturers is recommended. In cases where an allergic reaction is suspected, an infectious etiology should be ruled out first. Clinical suspicion can then be supported with the use of patch testing, interpreted by an experienced dermatologist or allergist. If patch testing supports an allergic etiology, the implanting physician and the device manufacturer can work together to modify the device for safe reimplantation.

Materials Strategies and Device Architectures of Emerging Power Supply Devices for Implantable Bioelectronics

Implantable bioelectronics represent an emerging technology that can be integrated into the human body for diagnostic and therapeutic functions. Power supply devices are an essential component of bioelectronics to ensure their robust performance. However, conventional power sources are usually bulky, rigid, and potentially contain hazardous constituent materials. The fact that biological organisms are soft, curvilinear, and have limited accommodation space poses new challenges for power supply systems to minimize the interface mismatch and still offer sufficient power to meet clinical-grade applications. Here, recent advances in state-of-the-art nonconventional power options for implantable electronics, specifically, miniaturized, flexible, or biodegradable power systems are reviewed. Material strategies and architectural design of a broad array of power devices are discussed, including energy storage systems (batteries and supercapacitors), power devices which harvest sources from the human body (biofuel cells, devices utilizing biopotentials, piezoelectric harvesters, triboelectric devices, and thermoelectric devices), and energy transfer devices which utilize sources in the surrounding environment (ultrasonic energy harvesters, inductive coupling/radiofrequency energy harvesters, and photovoltaic devices). Finally, future challenges and perspectives are given.

A Novel Approach for Responsive Neural Stimulator Implantation With Infraclavicular Placement of the Internal Pulse Generator

INTRODUCTION

The Responsive Neurostimulation System (RNS, Neuropace, Mountain View, California) has been proven to be effective at reducing seizures in patients with partial-onset epilepsy. The system incorporates a skull-mounted neurostimulator that requires a cranial incision for replacement. Although integral to the functioning of the system, in some circumstances, such as in the setting of infection, this can be disadvantageous. At present, there are no alternatives to cranial implantation of the RNS System.

METHODS

We describe a novel procedure enabling implantation of the neurostimulator within the chest wall, using components from a peripheral nerve stimulator. In a patient who achieved complete seizure freedom with the use of the RNS System, distant site implantation provided a viable means of continuing therapy in a setting where device explantation would have otherwise been inevitable as a result of cranial infection. We present continuous electrocorticographic data recorded from the device documenting the performance of the system with the subclavicular neurostimulator.

RESULTS

Band pass detection rates increased by 50%, while line length detection rates decreased by 50%. The number of detections decreased from 1046 to 846, with a resultant decrease in stimulations. Although there was some compromise of function due to the elevated noise floor, more than 2 yr following the procedure the patient remains free of seizures and infection.

CONCLUSION

The salvage procedure we describe offered an alternative therapeutic option in a patient with a complicated cranial wound issue, using heterogeneous components with marginal compromises in device functionality and no sacrifice in patient outcome.

Micro/Nano Technologies for High-Density Retinal Implant

During the past decades, there have been leaps in the development of micro/nano retinal implant technologies, which is one of the emerging applications in neural interfaces to restore vision. However, higher feedthroughs within a limited space are needed for more complex electronic systems and precise neural modulations. Active implantable medical electronics are required to have good electrical and mechanical properties, such as being small, light, and biocompatible, and with low power consumption and minimal immunological reactions during long-term implantation. For this purpose, high-density implantable packaging and flexible microelectrode arrays (fMEAs) as well as high-performance coating materials for retinal stimulation are crucial to achieve high resolution. In this review, we mainly focus on the considerations of the high-feedthrough encapsulation of implantable biomedical components to prolong working life, and fMEAs for different implant sites to deliver electrical stimulation to targeted retinal neuron cells. In addition, the functional electrode materials to achieve superior stimulation efficiency are also reviewed. The existing challenge and future research directions of micro/nano technologies for retinal implant are briefly discussed at the end of the review.

A Compact Broadband Antenna with Dual-Resonance for Implantable Devices

A compact broadband implantable patch antenna is designed for the field of biotelemetry and experimentally demonstrated using the Medical Device Radiocommunications Service (MedRadio) band (401⁻406 MHz). The proposed antenna can obtain a broad impedance bandwidth by exciting dual-resonant frequencies, and has a compact structure using bent metal radiating strips and a short strategy. The total volume of the proposed antenna, including substrate and superstrate, is about 479 mm³ (23 × 16.4 × 1.27 mm³). The measured bandwidth is 52 MHz (382⁻434 MHz) at a return loss of -10 dB. The resonance, radiation and specific absorption rate (SAR) performance of the antenna are examined and characterized.

A Novel Approach for Assessing the Fatigue Behavior of PEEK in a Physiologically Relevant Environment

In recent years, the need of surgical procedures has continuously increased and, therefore, researchers and clinicians are broadly focusing on the development of new biocompatible materials. Among them, polyetheretherketone (PEEK) has gained wide interest in load-bearing applications due to its yielding behaviour and its superior corrosion resistance. To assure its reliability in these applications where notches and other stress concentrators weaken implants resistance, a design tool for assessing its tensile and fatigue behaviour in the presence of geometrical discontinuities is highly claimed. Herein, a new fatigue design method based on a local approach is proposed for PEEK implant, and the results are compared with those obtained using the two main biomaterial design approaches available in literature, i.e., the theory of critical distances (TCD) and the notch stress intensity factor (NSIF) approach. To this aim, previously published datasets of PEEK-notched specimens are used, and the proposed method is reported to provide more accurate results and to be robust for different notch geometries.

Practical Inductive Link Design for Biomedical Wireless Power Transfer: A Tutorial

Wireless power transfer systems, particularly those based on inductive coupling, provide an increasingly attractive method to safely deliver power to biomedical implants. Although there exists a large body of literature describing the design of inductive links, it generally focuses on single aspects of the design process. There is a variety of approaches, some analytic, some numerical, each with benefits and drawbacks. As a result, undertaking a link design can be a difficult task, particularly for a newcomer to the subject. This tutorial paper reviews and collects the methods and equations that are required to design an inductive link for biomedical wireless power transfer, with a focus on practicality. It introduces and explains the published methods and principles relevant to all aspects of inductive link design, such that no specific prior knowledge of inductive link design is required. These methods are also combined into a software package (the Coupled Coil Configurator), to further simplify the design process. This software is demonstrated with a design example, to serve as a practical illustration.

Neural Monitoring With CMOS Image Sensors

Implantable image sensors have several biomedical applications due to their miniature size, light weight, and low power consumption achieved through sub-micron standard CMOS (Complementary Metal Oxide Semiconductor) technologies. The main applications are in specific cell labeling, neural activity detection, and biomedical imaging. In this paper the recent research studies on implantable CMOS image sensors for neural activity monitoring of brain are being quantified and reviewed. Based on the results, the suitable implantable image sensors for brain neural monitoring should have high signal to noise ratio of above 60 dB, high dynamic range of near 88 dB and low power consumption than the safety threshold of 4W/cm². Moreover, it is found out that the next generation of implantable imaging device trend should reduce the pixel size and power consumption of CMOS image sensors to increase spatial resolution of sample images.

Extending the Limits of Wireless Power Transfer to Miniaturized Implantable Electronic Devices

Implantable electronic devices have been evolving at an astonishing pace, due to the development of fabrication techniques and consequent miniaturization, and a higher efficiency of sensors, actuators, processors and packaging. Implantable devices, with sensing, communication, actuation, and wireless power are of high demand, as they pave the way for new applications and therapies. Long-term and reliable powering of such devices has been a challenge since they were first introduced. This paper presents a review of representative state of the art implantable electronic devices, with wireless power capabilities, ranging from inductive coupling to ultrasounds. The different power transmission mechanisms are compared, to show that, without new methodologies, the power that can be safely transmitted to an implant is reaching its limit. Consequently, a new approach, capable of multiplying the available power inside a brain phantom for the same specific absorption rate (SAR) value, is proposed. In this paper, a setup was implemented to quadruple the power available in the implant, without breaking the SAR limits. A brain phantom was used for concept verification, with both simulation and measurement data.

Implanted Cardiac Pacemaker Mathematical Modeling and Research based on the Volume Conduction

The research of the communication between implanted Cardiac Pacemaker and external devices is a focus. In this paper, a data communications model based Volume Conduction is creatively presented, in this way the human body conductive ability will been utilized to transmit current, which is more effective and decrease for harm of the human body than the other ways, such as: RF, Optical Transcutaneous, etc. As the frequency increases the KHz level, the effect of background biological noise is considered negligible, the channel is thus modeled as AWGN channel in these frequencies. From Shannon information theory, in two-dimensional modulation, the volume conduction channel capacity formula was derived, further derivation: with extremely low SNR using in the two-level modulation can be very effective use of channel capacity, with high SNR a multi-level modulation is used in order to make full use of the channel capacity. Matlab software is used to the channel simulation, the input and output signal waveforms and eye diagram comparison, the curves of the BER and SNR.

Electrical stimulation of the brain and the development of cortical visual prostheses: An historical perspective

Rapid advances are occurring in neural engineering, bionics and the brain-computer interface. These milestones have been underpinned by staggering advances in micro-electronics, computing, and wireless technology in the last three decades. Several cortically-based visual prosthetic devices are currently being developed, but pioneering advances with early implants were achieved by Brindley followed by Dobelle in the 1960s and 1970s. We have reviewed these discoveries within the historical context of the medical uses of electricity including attempts to cure blindness, the discovery of the visual cortex, and opportunities for cortex stimulation experiments during neurosurgery. Further advances were made possible with improvements in electrode design, greater understanding of cortical electrophysiology and miniaturisation of electronic components. Human trials of a new generation of prototype cortical visual prostheses for the blind are imminent. This article is part of a Special Issue entitled Hold Item.

Fully Integrated On-Chip Coil in 0.13 μm CMOS for Wireless Power Transfer Through Biological Media

Delivering milliwatts of wireless power at centimeter distances is advantageous to many existing and emerging biomedical applications. It is highly desirable to fully integrate the receiver on a single chip in standard CMOS with no additional post-processing steps or external components. This paper presents a 2 × 2.18 mm(2) on-chip wireless power transfer (WPT) receiver (Rx) coil fabricated in 0.13 μm CMOS. The WPT system utilizes a 14.5 × 14.5 mm(2) transmitter (Tx) coil that is fabricated on a standard FR4 substrate. The on-chip power harvester demonstrates a peak WPT efficiency of -18.47 dB , -20.96 dB and -20.15 dB at 10 mm of separation through air, bovine muscle and 0.2 molar NaCl, respectively. The achieved efficiency enables the delivery of milliwatts of power to application circuits while staying below safe power density and electromagnetic (EM) exposure limits.

Immunologic and tissue biocompatibility of flexible/stretchable electronics and optoelectronics

Recent development of flexible/stretchable integrated electronic sensors and stimulation systems has the potential to establish an important paradigm for implantable electronic devices, where shapes and mechanical properties are matched to those of biological tissues and organs. Demonstrations of tissue and immune biocompatibility are fundamental requirements for application of such kinds of electronics for long-term use in the body. Here, a comprehensive set of experiments studies biocompatibility on four representative flexible/stretchable device platforms, selected on the basis of their versatility and relevance in clinical usage. The devices include flexible silicon field effect transistors (FETs) on polyimide and stretchable silicon FETs, InGaN light-emitting diodes (LEDs), and AlInGaPAs LEDs, each on low modulus silicone substrates. Direct cytotoxicity measured by exposure of a surrogate fibroblast line and leachable toxicity by minimum essential medium extraction testing reveal that all of these devices are non-cytotoxic. In vivo immunologic and tissue biocompatibility testing in mice indicate no local inflammation or systemic immunologic responses after four weeks of subcutaneous implantation. The results show that these new classes of flexible implantable devices are suitable for introduction into clinical studies as long-term implantable electronics.

Development of implantable medical devices: from an engineering perspective

From the first pacemaker implant in 1958, numerous engineering and medical activities for implantable medical device development have faced challenges in materials, battery power, functionality, electrical power consumption, size shrinkage, system delivery, and wireless communication. With explosive advances in scientific and engineering technology, many implantable medical devices such as the pacemaker, cochlear implant, and real-time blood pressure sensors have been developed and improved. This trend of progress in medical devices will continue because of the coming super-aged society, which will result in more consumers for the devices. The inner body is a special space filled with electrical, chemical, mechanical, and marine-salted reactions. Therefore, electrical connectivity and communication, corrosion, robustness, and hermeticity are key factors to be considered during the development stage. The main participants in the development stage are the user, the medical staff, and the engineer or technician. Thus, there are three different viewpoints in the development of implantable devices. In this review paper, considerations in the development of implantable medical devices will be presented from the viewpoint of an engineering mind.

Nanoporous inorganic membranes or coatings for sustained drug delivery in implantable devices

The characteristics of nanoporous inorganic coatings on implants or on implantable devices are reviewed. The commonly used nanoporous materials, such as aluminum oxide (Al(2)O(3)), titanium oxide (TiO(2)) and porous silicon are highlighted with illustrative examples. The critical issues for sustained release systems are examined and the elution profiles of nanoporous coatings are discussed. The available data shows that these systems can be used effectively for sustained release applications. They satisfy the basic biocompatibility tests, meet the requirements of drug loading and sustained release profiles extending to several weeks and also are compatible with current implant technologies. Nanoporous inorganic coatings are well suited to provide improved efficacy and integration of implants in a variety of therapeutic situations.

Implantable Microimagers

Implantable devices such as cardiac pacemakers, drug-delivery systems, and defibrillators have had a tremendous impact on the quality of live for many disabled people. To date, many devices have been developed for implantation into various parts of the human body. In this paper, we focus on devices implanted in the head. In particular, we describe the technologies necessary to create implantable microimagers. Design, fabrication, and implementation issues are discussed vis-à-vis two examples of implantable microimagers; the retinal prosthesis and in vivo neuro-microimager. Testing of these devices in animals verify the use of the microimagers in the implanted state. We believe that further advancement of these devices will lead to the development of a new method for medical and scientific applications.

Transcutaneous battery recharging by volume conduction and its circuit modeling

Many implantable devices require large capacity batteries implanted in the body. Transcutaneous battery recharging can effectively maintain the longevity of these implants. Based on this consideration we have developed a transcutaneous battery recharging circuit unit which takes advantages of skin volume conduction. This unit is able to pass 2.8 mA from the outside to the inside of pig skin with a current transmitting efficiency of 27%. Theoretical analysis and experiments have validated that this battery recharging technology is an effective approach. In this research we have constructed an x-type equivalent circuit model of skin volume conduction for battery recharging. The parameters of the x-type equivalent circuit can be easily measured and used to evaluate the battery charging system characteristics, such as the rechargeable prerequisite and the current transmitting efficiency limitation. We have analyzed the transcutaneous current transmitting efficiency by applying the x-type equivalent circuit model and discussed approaches for enhancing current transmitting efficiency.

Controlled-release microchips

Efficient drug delivery remains an important challenge in medicine: continuous release of therapeutic agents over extended time periods in accordance with a predetermined temporal profile; local delivery at a constant rate to the tumour microenvironment to overcome much of the systemic toxicity and to improve antitumour efficacy; improved ease of administration, and increasing patient compliance required are some of the unmet needs of the present drug delivery technology. Microfabrication technology has enabled the development of novel controlled-release microchips with capabilities not present in the current treatment modalities. In this review, the current status and future prospects of different types of controlled-release microchips are summarised and analysed with reference to microneedle-based microchips, as well as providing an in-depth focus on microreservoir-based and nanoporous microchips.

A genetic algorithm–based area coverage approach for controlled drug delivery using microrobots

BACKGROUND

The use of microrobots for controlled drug delivery shows great potential to achieve precise targeting with controllable side effects. One of the major challenges for controlled drug delivery is robot path planning for area coverage.

METHODS

This article proposes a genetic algorithm (GA)-based area coverage approach for robot path planning. The GA-based area coverage approach is characterized by (1) online path planning combined with offline path planning to cope with environmental uncertainties and (2) optimal path planning for selecting an optimal path by evaluating path lengths and turning angles. The expandable chromosome concept is proposed and implemented for the area coverage.

RESULTS

Simulation results from 5 different map environments show that the proposed approach achieved significant improvement in path effectiveness compared with the fixed-path approach.

CONCLUSION

The proposed GA approach has advantages over traditional path planning approaches in terms of computational costs and has advantages over existing online path planning approaches (eg, fixed-path plan approaches or path-length optimization approaches) in terms of path optimality.

Implantable stimulation system dedicated for neural selective stimulation

A functional electrical stimulation system is presented, which is dedicated for the selective neural stimulation of the bladder. The proposed system is composed of an internal stimulator (implant) and an external controller. The system is used to produce low-pressure voiding of the bladder in spinal cord injured patients. The implant is powered and operated by the external controller via radio-frequency electromagnetic coupling. All stimulation parameters are chosen externally using the controller and are sent to the implant, which produces the desired stimuli. These stimuli are applied directly to the S2 nerve which is linked to the sphincter and bladder muscles. A high-frequency signal is used to inhibit the contraction of the sphincter muscle, and low-frequency pulses stimulate the bladder muscle (the detrusor). Dedicated computer software is used by the physician to select the optimal parameters for each patient and to activate the implant through a parallel port interface with built-in transmitter. The parameters are then transferred to a hand-held controller which is used by the technical staff and by the patients themselves. Acute studies have been performed to validate the selective stimulation strategy, and chronic experimentation is currently underway in dogs.

Stimulator design and subsequent stimulation parameter optimization for controlling micturition and reducing urethral resistance

An implantable computerized electrical stimulation system designed to induce bladder evacuation in animal models (dogs) after spinal cord transection has been realized and evaluated. This fully programmable system is based on a handheld device and generates a wide range of stimuli through multichannel implantable miniaturized stimulator. Using the new bladder stimulator and inducing reversible fatigue to the external sphincter via the pudendal nerve enables us to reduce the bladder outlet resistance, resulting in the proper emptying of the bladder during stimulation without the need for sacral nerve rhizotomies and the pudendal nerve neurectomies. Four chronically affected dogs were studied to determine the optimal stimulation parameters for inducing a sphincter fatigue that would reliably empty the bladder for the duration of the experiment. These parameters were: maximum amplitude of 1.5 mA +/- 0.5 SD, stimuli composed of a high frequency signal of 200 Hz +/- 50 SD modulated by a low frequency signal of 10 Hz +/- 5 SD, pulse width controlled by a duty-cycle of 20% +/- 10 SD, sacral nerve stimulation of 50 s +/- 25 SD and fatiguing duration of 20 s +/- 5 SD.