Advances in Assistive Electronic Device Solutions for Urology

Recent technology advances have led urology to become one of the leading specialities to utilise novel electronic systems to manage urological ailments. Contemporary bladder management strategies such as urinary catheters can provide a solution but leave the user mentally and physically debilitated. The unique properties of modern electronic devices, i.e., flexibility, stretchability, and biocompatibility, have allowed a plethora of new technologies to emerge. Many novel electronic device solutions in urology have been developed for treating impaired bladder disorders. These disorders include overactive bladder (OAB), underactive bladder (UAB) and other-urinary-affecting disorders (OUAD). This paper reviews common causes and conservative treatment strategies for OAB, UAB and OUAD, discussing the challenges and drawbacks of such treatments. Subsequently, this paper gives insight into clinically approved and research-based electronic advances in urology. Advances in this area cover bladder-stimulation and -monitoring devices, robot-assistive surgery, and bladder and sphincter prosthesis. This study aims to introduce the latest advances in electronic solutions for urology, comparing their advantages and disadvantages, and concluding with open problems for future urological device solutions

Miniaturized wireless electronic device for application on rodents thermal neuromodulation

Dissertação de mestrado em Biomedical Engineering, Medical Electronics BranchA epilepsia é uma doença neurológica que afeta muitas pessoas em todo o mundo, e cerca de 30% dos pacientes epiléticos são resistentes aos medicamentos. Normalmente, estes são obrigados a ficar em casa, uma vez que a opção é uma cirurgia de ressecção focal, o que nem sempre é possível ou aceite. Portanto, e como em muitas patologias onde é possível o desenvolvimento de dispositivos médicos capazes de melhorar a qualidade de vida dos pacientes, a tecnologia pode-se associar à medicina e fornecer uma solução alternativa para tais pacientes. Dos vários estudos já realizados neste campo, a neuromodulação térmica é uma técnica promissora, uma vez que reduz ou possivelmente interrompe as crises epiléticas. Assim, a fim de potencializar uma solução futura para estes pacientes, é necessário primeiro realizar vários testes experimentais com modelos animais. Com o intuito de melhor compreender o funcionamento dos testes in vivo, foram realizados testes em GAERS no Grenoble Institute of Neuroscience com um dispositivo previamente desenvolvido, a fim de recolher dados sobre o efeito de arrefecimento nos neurónios. Isso permitiu alargar o conhecimento sobre o arrefecimento focal, mas também permitiu encontrar limitações no dispositivo utilizado, dado que era necessário que este estivesse conectado por fios para ser possível aplicar frio e gravar o EEG. Assim, o objetivo desta dissertação foi melhorar a comunicação sem fios de um dispositivo eletrónico capaz de controlar um Peltier e registar a atividade elétrica cerebral de um roedor. O sistema possui dois módulos, um que maioritariamente transmite dados e outro que os recebe. Nesse sentido, o transmissor possui toda a eletrónica associada à comunicação sem fios, à aquisição de sinais eletrofisiológicos e ao controlo do Peltier. Já o recetor possui a eletrónica para a comunicação sem fios e um conector USB para se conectar ao computador. Com o intuito de aumentar o débito binário da transação de dados, os dois módulos foram programados com o protocolo proprietário da Nordic Semiconductor, denominado Enhanced ShockBurst que opera na banda 2.4 GHz. Após a implementação do software, obteve-se um débito binário de 368640 bps, o que é 17 vezes superior ao protocolo usado anteriormente. Assim, é possível adquirir biossinais com frequências mais elevadas, ou então, com frequências mais baixas, mas com mais resolução e, ainda a visualização de mais do que um canal. De forma a validar todo o sistema, realizaram-se vários testes. Um dos testes foi colocar nos elétrodos uma onda sinusoidal e observar no computador se a onda recebida era igual à onda de entrada. O outro foi determinar a taxa de erros associada à comunicação e o tempo de vida da bateria.Epilepsy is a neurological disorder that affects numerous people worldwide, and around 30% of epileptic patients are drug resistant. Usually, they are restrained at home, since the option is a focal resection surgery, which is not always possible or accepted. Therefore, and as in many pathologies, where it allows the development of medical devices capable of improving patients’ quality of life, technology may be used here to help medicine providing an alternative solution for such patients. Of the many studies already conducted in this field, thermal neuromodulation is a promising technique as it reduces or possibly interrupts epileptic seizures. Thus, in order to leverage a future solution for these patients, it’s first necessary to run several experimental tests with animal models. To better understand how in vivo tests work, tests were initially performed on GAERS at the Grenoble Institute of Neuroscience with a previously developed device in order to collect data on the cooling effect on neurons. This allowed to extend the knowledge about focal cooling, but also allowed to find limitations in the device used, as it was required to be wired in order to be able to apply cold and record the EEG. Therefore, the aim of this dissertation was to improve the wireless communication of an electronic device capable of controlling a Peltier module and recording the electrical brain activity of a rodent. The system has two modules, one that mostly transmits data and another that receives them. In this sense, the transmitter has all the electronics associated with wireless communication, electrophysiological signal acquisition, and Peltier control. The receiver, on the other hand, has the electronics for wireless communication and a USB connector to connect to the computer. In order to increase the binary throughput of the data transaction, the two modules were programmed with the 2.4 GHz proprietary protocol from Nordic Semiconductor, called Enhanced ShockBurst. After implementation of the software, a binary throughput of 368640 bps was obtained, which is 17 times higher than the previously used protocol. Thus, it is possible to acquire biosignals at higher frequencies, or at lower frequencies but with more resolution, and to visualize more than one channel. In order to validate the whole system, several tests were performed. One of the tests was to place a sine wave on the electrodes and observe in the computer if the signal received was equal to the input wave. The other, on the other hand, was to determine the error rate associated with communication and battery life

소형동물의 뇌신경 자극을 위한 완전 이식형 신경자극기

학위논문(박사)--서울대학교 대학원 :공과대학 전기·정보공학부,2020. 2. 김성준.In this study, a fully implantable neural stimulator that is designed to stimulate the brain in the small animal is described. Electrical stimulation of the small animal is applicable to pre-clinical study, and behavior study for neuroscience research, etc. Especially, behavior study of the freely moving animal is useful to observe the modulation of sensory and motor functions by the stimulation. It involves conditioning animal's movement response through directional neural stimulation on the region of interest. The main technique that enables such applications is the development of an implantable neural stimulator. Implantable neural stimulator is used to modulate the behavior of the animal, while it ensures the free movement of the animals. Therefore, stable operation in vivo and device size are important issues in the design of implantable neural stimulators. Conventional neural stimulators for brain stimulation of small animal are comprised of electrodes implanted in the brain and a pulse generation circuit mounted on the back of the animal. The electrical stimulation generated from the circuit is conveyed to the target region by the electrodes wire-connected with the circuit. The devices are powered by a large battery, and controlled by a microcontroller unit. While it represents a simple approach, it is subject to various potential risks including short operation time, infection at the wound, mechanical failure of the device, and animals being hindered to move naturally, etc. A neural stimulator that is miniaturized, fully implantable, low-powered, and capable of wireless communication is required. In this dissertation, a fully implantable stimulator with remote controllability, compact size, and minimal power consumption is suggested for freely moving animal application. The stimulator consists of modular units of surface-type and depth-type arrays for accessing target brain area, package for accommodating the stimulating electronics all of which are assembled after independent fabrication and implantation using customized flat cables and connectors. The electronics in the package contains ZigBee telemetry for low-power wireless communication, inductive link for recharging lithium battery, and an ASIC that generates biphasic pulse for neural stimulation. A dual-mode power-saving scheme with a duty cycling was applied to minimize the power consumption. All modules were packaged using liquid crystal polymer (LCP) to avoid any chemical reaction after implantation. To evaluate the fabricated stimulator, wireless operation test was conducted. Signal-to-Noise Ratio (SNR) of the ZigBee telemetry were measured, and its communication range and data streaming capacity were tested. The amount of power delivered during the charging session depending on the coil distance was measured. After the evaluation of the device functionality, the stimulator was implanted into rats to train the animals to turn to the left (or right) following a directional cue applied to the barrel cortex. Functionality of the device was also demonstrated in a three-dimensional maze structure, by guiding the rats to navigate better in the maze. Finally, several aspects of the fabricated device were discussed further.본 연구에서는 소형 동물의 두뇌를 자극하기 위한 완전 이식형 신경자극기가 개발되었다. 소형 동물의 전기자극은 전임상 연구, 신경과학 연구를 위한 행동연구 등에 활용된다. 특히, 자유롭게 움직이는 동물을 대상으로 한 행동 연구는 자극에 의한 감각 및 운동 기능의 조절을 관찰하는 데 유용하게 활용된다. 행동 연구는 두뇌의 특정 관심 영역을 직접적으로 자극하여 동물의 행동반응을 조건화하는 방식으로 수행된다. 이러한 적용을 가능케 하는 핵심기술은 이식형 신경자극기의 개발이다. 이식형 신경자극기는 동물의 움직임을 방해하지 않으면서도 그 행동을 조절하기 위해 사용된다. 따라서 동물 내에서의 안정적인 동작과 장치의 크기가 이식형 신경자극기를 설계함에 있어 중요한 문제이다. 기존의 신경자극기는 두뇌에 이식되는 전극 부분과, 동물의 등 부분에 위치한 회로부분으로 구성된다. 회로에서 생산된 전기자극은 회로와 전선으로 연결된 전극을 통해 목표 지점으로 전달된다. 장치는 배터리에 의해 구동되며, 내장된 마이크로 컨트롤러에 의해 제어된다. 이는 쉽고 간단한 접근방식이지만, 짧은 동작시간, 이식부위의 감염이나 장치의 기계적 결함, 그리고 동물의 자연스러운 움직임 방해 등 여러 문제점을 야기할 수 있다. 이러한 문제의 개선을 위해 무선통신이 가능하고, 저전력, 소형화된 완전 이식형 신경자극기의 설계가 필요하다. 본 연구에서는 자유롭게 움직이는 동물에 적용하기 위하여 원격 제어가 가능하며, 크기가 작고, 소모전력이 최소화된 완전이식형 자극기를 제시한다. 설계된 신경자극기는 목표로 하는 두뇌 영역에 접근할 수 있는 표면형 전극과 탐침형 전극, 그리고 자극 펄스 생성 회로를 포함하는 패키지 등의 모듈들로 구성되며, 각각의 모듈은 독립적으로 제작되어 동물에 이식된 뒤 케이블과 커넥터로 연결된다. 패키지 내부의 회로는 저전력 무선통신을 위한 지그비 트랜시버, 리튬 배터리의 재충전을 위한 인덕티브 링크, 그리고 신경자극을 위한 이상성 자극파형을 생성하는 ASIC으로 구성된다. 전력 절감을 위해 두 개의 모드를 통해 사용률을 조절하는 방식이 장치에 적용된다. 모든 모듈들은 이식 후의 생물학적, 화학적 안정성을 위해 액정 폴리머로 패키징되었다. 제작된 신경자극기를 평가하기 위해 무선 동작 테스트가 수행되었다. 지그비 통신의 신호 대 잡음비가 측정되었으며, 해당 통신의 동작거리 및 데이터 스트리밍 성능이 검사되었고, 장치의 충전이 수행될 때 코일간의 거리에 따라 전송되는 전력의 크기가 측정되었다. 장치의 평가 이후, 신경자극기는 쥐에 이식되었으며, 해당 동물은 이식된 장치를 이용해 방향 신호에 따라 좌우로 이동하도록 훈련되었다. 또한, 3차원 미로 구조에서 쥐의 이동방향을 유도하는 실험을 통하여 장치의 기능성을 추가적으로 검증하였다. 마지막으로, 제작된 장치의 특징이 여러 측면에서 심층적으로 논의되었다.Chapter 1 : Introduction 1 1.1. Neural Interface 2 1.1.1. Concept 2 1.1.2. Major Approaches 3 1.2. Neural Stimulator for Animal Brain Stimulation 5 1.2.1. Concept 5 1.2.2. Neural Stimulator for Freely Moving Small Animal 7 1.3. Suggested Approaches 8 1.3.1. Wireless Communication 8 1.3.2. Power Management 9 1.3.2.1. Wireless Power Transmission 10 1.3.2.2. Energy Harvesting 11 1.3.3. Full implantation 14 1.3.3.1. Polymer Packaging 14 1.3.3.2. Modular Configuration 16 1.4. Objectives of This Dissertation 16 Chapter 2 : Methods 18 2.1. Overview 19 2.1.1. Circuit Description 20 2.1.1.1. Pulse Generator ASIC 21 2.1.1.2. ZigBee Transceiver 23 2.1.1.3. Inductive Link 24 2.1.1.4. Energy Harvester 25 2.1.1.5. Surrounding Circuitries 26 2.1.2. Software Description 27 2.2. Antenna Design 29 2.2.1. RF Antenna 30 2.2.1.1. Design of Monopole Antenna 31 2.2.1.2. FEM Simulation 31 2.2.2. Inductive Link 36 2.2.2.1. Design of Coil Antenna 36 2.2.2.2. FEM Simulation 38 2.3. Device Fabrication 41 2.3.1. Circuit Assembly 41 2.3.2. Packaging 42 2.3.3. Electrode, Feedthrough, Cable, and Connector 43 2.4. Evaluations 45 2.4.1. Wireless Operation Test 46 2.4.1.1. Signal-to-Noise Ratio (SNR) Measurement 46 2.4.1.2. Communication Range Test 47 2.4.1.3. Device Operation Monitoring Test 48 2.4.2. Wireless Power Transmission 49 2.4.3. Electrochemical Measurements In Vitro 50 2.4.4. Animal Testing In Vivo 52 Chapter 3 : Results 57 3.1. Fabricated System 58 3.2. Wireless Operation Test 59 3.2.1. Signal-to-Noise Ratio Measurement 59 3.2.2. Communication Range Test 61 3.2.3. Device Operation Monitoring Test 62 3.3. Wireless Power Transmission 64 3.4. Electrochemical Measurements In Vitro 65 3.5. Animal Testing In Vivo 67 Chapter 4 : Discussion 73 4.1. Comparison with Conventional Devices 74 4.2. Safety of Device Operation 76 4.2.1. Safe Electrical Stimulation 76 4.2.2. Safe Wireless Power Transmission 80 4.3. Potential Applications 84 4.4. Opportunities for Further Improvements 86 4.4.1. Weight and Size 86 4.4.2. Long-Term Reliability 93 Chapter 5 : Conclusion 96 Reference 98 Appendix - Liquid Crystal Polymer (LCP) -Based Spinal Cord Stimulator 107 국문 초록 138 감사의 글 140Docto

Development of a Dual-Mode CMOS Microelectrode Array for the Simultaneous Study of Electrochemical and Electrophysiological Activities of the Brain

Medical diagnostic devices are in high demand due to increasing cases of neurodegenerative diseases in the aging population and pandemic outbreaks in our increasingly connected global community. Devices capable of detecting the presence of a disease in its early stages can have dramatic impacts on how it can be treated or eliminated. High cost and limited accessibility to diagnostic tools are the main barriers preventing potential patients from receiving a timely disease diagnosis. This dissertation presents several devices that are aimed at providing higher quality medical diagnostics at a low cost. Brain function is commonly studied with systems detecting the action potentials that are formed when neurons fire. CMOS technology enables extremely high-density electrode arrays to be produced with integrated amplifiers for high-throughput action potential measurement systems while greatly reducing the cost per measurement compared to traditional tools. Recently, CMOS technology has also been used to develop high-throughput electrochemical measurement systems. While action potentials are important, communication between neurons occurs by the flow of neurotransmitters at the synapses, so measurement of action potentials alone is incapable of fully studying neurotransmission. In many neurodegenerative diseases the breakdown in neurotransmission begins well before the disease manifests itself. The development of a dual-mode CMOS device that is capable of simultaneous high-throughput measurement of both action potentials and neurotransmitter flow via an on-chip electrode array is presented in this dissertation. This dual-mode technology is useful to those studying the dynamic decay of the neurotransmission process seen in many neurodegenerative diseases using a low-cost CMOS chip. This dissertation also discusses the development of more traditional diagnostic devices relying on PCR, a method commonly used only in centralized laboratories and not readily available at the point-of-care. These technologies will enable faster, cheaper, more accurate, and more accessible diagnostics to be performed closer to the patient

The Hand-Held Force Magnifier: Surgical Tools to Augment the Sense of Touch

Modern surgeons routinely perform procedures with noisy, sub-threshold, or obscured visual and haptic feedback,either due to the necessary approach, or because the systems on which they are operating are exceeding delicate. For example, in cataract extraction, ophthalmic surgeons must peel away thin membranes in order to access and replace the lens of the eye. Elsewhere, dissection is now commonly performed with energy-delivering tools – rather than sharp blades – and damage to deep structures is possible if tissue contact is not well controlled. Surgeons compensate for their lack of tactile sensibility by relying solely on visual feedback, observing tissue deformation and other visual cues through surgical microscopes or cameras. Using visual information alone can make a procedure more difficult, because cognitive mediation is required to convert visual feedback into motor action. We call this the “haptic problem” in surgery because the human sensorimotor loop is deprived of critical tactile afferent information, increasing the chance for intraoperative injury and requiring extensive training before clinicians reach independent proficiency. Tools that enhance the surgeon’s direct perception of tool-tissue forces can therefore potentially reduce the risk of iatrogenic complications and improve patient outcomes. Towards this end, we have developed and characterized a new robotic surgical tool, the Hand-Held Force Magnifier (HHFM), which amplifies forces at the tool tip so they may be readily perceived by the user, a paradigm we call “in-situ” force feedback. In this dissertation, we describe the development of successive generations of HHFM prototypes, and the evaluation of a proposed human-in-the-loop control framework using the methods of psychophysics. Using these techniques, we have verified that our tool can reduce sensory perception thresholds, augmenting the user’s abilities beyond what is normally possible. Further, we have created models of human motor control in surgically relevant tasks such as membrane puncture, which have shown to be sensitive to push-pull direction and handedness effects. Force augmentation has also demonstrated improvements to force control in isometric force generation tasks. Finally, in support of future psychophysics work, we have developed an inexpensive, high-bandwidth, single axis haptic renderer using a commercial audio speaker

Lab-on-a-Chip Fabrication and Application

The necessity of on-site, fast, sensitive, and cheap complex laboratory analysis, associated with the advances in the microfabrication technologies and the microfluidics, made it possible for the creation of the innovative device lab-on-a-chip (LOC), by which we would be able to scale a single or multiple laboratory processes down to a chip format. The present book is dedicated to the LOC devices from two points of view: LOC fabrication and LOC application

Stem Cell Therapy for Spinal Cord Injuries

Stem cell-based therapies are an emerging branch of medicine with the purpose of restoring tissue function for patients with serious injuries, such as a spinal cord injury. As a result, scientists and engineers are increasing research efforts in the field of regenerative medicine. Due to the delicate nature of stem cells, producing the large quantity required for a successful therapy has proved challenging. In recent years, research has shown the potential of stem cell-based therapies, and thus there is a need for the commercialization of these treatments. The proposed facility targets the demand for spinal cord injury treatments and can support production for both clinical trials and a commercial release. Bioreactors designed specifically for the culture and growth of stem cells have flexibility in their ability to support different stem cell lines for various therapies. Small reactors in parallel can easily adapt to changes in production size. This process also takes advantage of the best options currently available for purification and preservation to maximize the product yield. Due to the strict regulations set in place by the FDA and lack of adequate funding, there is an untapped market for stem cell therapies for spinal cord injuries. Approximately 250,000 people in the United States suffer from spinal cord injuries, varying in severity, and this patient base increases at a rate of 12,000 new injuries every year (“Spinal Cord Injury Facts and Figures”, 2009). Future markets include expansion into Europe and Asia. There are two steps to this proposal: the upstream process and the downstream process. The upstream process includes the scale-up, differentiation, and purification of human embryonic stem cells; the downstream process consists of the scale-up of neurons for injection. The upstream process will be built initially and yield enough cells for clinical trials, without incurring the capital costs of building the entire plant. Upon success of the clinical trials, the downstream process will be built for maximum production. The profitability of this proposal is based on running 26 batches a year at 1.02x1010 cells per batch or 2.66x1011 cells per year. By targeting 5,000 patients, two percent of the current market, and charging $45,000 per dose, a profitable profile can be created. Assuming 50$961,892,600, and 242.81% respectively. Using a 50% production capacity allows for higher profit margins upon expansion. The proposed plan will meet the need of this growing market

Computed fingertip touch for the instrumental control of musical sound with an excursion on the computed retinal afterimage

In this thesis, we present an articulated, empirical view on what human music making is, and on how this fundamentally relates to computation. The experimental evidence which we obtained seems to indicate that this view can be used as a tool, to systematically generate models, hypotheses and new technologies that enable an ever more complete answer to the fundamental question as to what forms of instrumental control of musical sound are possible to implement. This also entails the development of two novel transducer technologies for computed fingertip touch: The cyclotactor (CT) system, which provides fingerpad-orthogonal force output while tracking surface-orthogonal fingertip movement; and the kinetic surface friction transducer (KSFT) system, which provides fingerpad-parallel force output while tracking surface-parallel fingertip movement. In addition to the main research, the thesis also contains two research excursions, which are due to the nature of the Ph.D. position. The first excursion shows how repeated and varying pressing movements on the already held-down key of a computer keyboard can be used both to simplify existing user interactions and to implement new ones, that allow the rapid yet detailed navigation of multiple possible interaction outcomes. The second excursion shows that automated computational techniques can display shape specifically in the retinal afterimage, a well-known effect in the human visual system.Computer Systems, Imagery and Medi

Brain Injury

The present two volume book "Brain Injury" is distinctive in its presentation and includes a wealth of updated information on many aspects in the field of brain injury. The Book is devoted to the pathogenesis of brain injury, concepts in cerebral blood flow and metabolism, investigative approaches and monitoring of brain injured, different protective mechanisms and recovery and management approach to these individuals, functional and endocrine aspects of brain injuries, approaches to rehabilitation of brain injured and preventive aspects of traumatic brain injuries. The collective contribution from experts in brain injury research area would be successfully conveyed to the readers and readers will find this book to be a valuable guide to further develop their understanding about brain injury