205 research outputs found

    The Mechanical Impedance of the Human Skull via Direct Bone Conduction Implants

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    Purpose: The mechanical skull impedance is used in the design of direct bone drive hearing systems. This impedance is also important for the design of skull simulators used in manufacturing, service, and fitting procedures of such devices. Patients and Methods: The skull impedance was measured in 45 patients (25 female and 20 male) who were using percutaneous bone conduction implants (Ponto system or Baha system). Patients were recruited as a consecutive prospective case series and having an average age of 55.4 years (range 18-80 years). Seven patients were treated in Gothenburg, Sweden, and 38 patients in Edmonton, Canada. An impedance head (B&K 8001), driven by an excitation transducer with emphasized low-frequency response, was used to measure the mechanical point impedance with a swept sine from 100 to 10k Hz. Results and Discussion: The skull impedance was found to have an anti-resonance of approximately 150 Hz, with a median maximum magnitude of 4500 mechanical ohms. Below this anti-resonance, the mechanical impedance was mainly mass-controlled corresponding to an effective skull mass of 2.5 kg at 100 Hz with substantial damping from neck and shoulder. Above the anti-resonance and up to 4 kHz, the impedance was stiffness-controlled, with a total compliance of approximately 450n m/N with a small amount of damping. At frequencies above 4 kHz, the skull impedance becomes gradually mass-controlled originating from the mass of the osseointegrated implant and adjacent bone. No significant differences related to gender or skull abnormalities were seen, just a slight dependence on age and major ear surgeries. The variability of the mechanical impedance among patients was not found to have any clinical importance. Conclusion: The mechanical skull impedance of percutaneous implants was found to confirm previous studies and can be used for optimizing the design and test procedures of direct bone drive hearing implants

    Chronic skull-anchored percutaneous implants in non-human primates

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    Three groups of chronic, skull-anchored, percutaneous implants differing in materials, design and surgical procedures used for implantation, were tested in macaque monkeys in conjunction with studies of an inner ear stimulation device. Implants from the first two groups in which high-speed drilling methods and stainless steel materials were used, showed a high percentage of failures during the first 3 months after implantation of the percutaneous connector. Implants in the third group, in which measures were taken to preserve living bone tissue, all survived for greater than 7 months. Probable factors relating to implant survival are care of the bone during surgery, postsurgical mechanical trauma, materials and other details of the surgical procedure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27773/1/0000167.pd

    The SPINK gene family and celiac disease susceptibility

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    The gene family of serine protease inhibitors of the Kazal type (SPINK) are functional and positional candidate genes for celiac disease (CD). Our aim was to assess the gut mucosal gene expression and genetic association of SPINK1, -2, -4, and -5 in the Dutch CD population. Gene expression was determined for all four SPINK genes by quantitative reverse-transcription polymerase chain reaction in duodenal biopsy samples from untreated (n = 15) and diet-treated patients (n = 31) and controls (n = 16). Genetic association of the four SPINK genes was tested within a total of 18 haplotype tagging SNPs, one coding SNP, 310 patients, and 180 controls. The SPINK4 study cohort was further expanded to include 479 CD cases and 540 controls. SPINK4 DNA sequence analysis was performed on six members of a multigeneration CD family to detect possible point mutations or deletions. SPINK4 showed differential gene expression, which was at its highest in untreated patients and dropped sharply upon commencement of a gluten-free diet. Genetic association tests for all four SPINK genes were negative, including SPINK4 in the extended case/control cohort. No SPINK4 mutations or deletions were observed in the multigeneration CD family with linkage to chromosome 9p21-13 nor was the coding SNP disease-specific. SPINK4 exhibits CD pathology-related differential gene expression, likely derived from altered goblet cell activity. All of the four SPINK genes tested do not contribute to the genetic risk for CD in the Dutch population

    Oral Passive Immunization With Plasma-Derived Polyreactive Secretory-Like IgA/M Partially Protects Mice Against Experimental Salmonellosis.

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    Secretory immunoglobulins have a critical role in defense of the gastrointestinal tract and are known to act by preventing bacterial acquisition. A stringent murine model of bacterial infection with Salmonella enterica Typhimurium was used to examine protection mediated by oral passive immunization with human plasma-derived polyreactive IgA and IgM antibodies (Abs) reconstituted as secretory-like immunoglobulins (SCIgA/M). This reagent has been shown to trigger Salmonella agglutination and to limit the entry of bacterium into intestinal Peyer's patches via immune exclusion. We now demonstrate that upon administration into ligated intestinal loops, SCIgA/M properly anchors in the mucus and is protected from degradation to a better extent that IgA/M or IgG. Moreover, prophylactic oral administration of SCIgA/M before intragastric infection of mice with a virulent strain of S. enterica Typhimurium allows to protect infected animals, as reflected by reduced colonization of both mucosal and systemic compartments, and conserved integrity of intestinal tissues. In comparison with IgA/M or IgG administration, SCIgA/M provided the highest degree of protection. Moreover, such protective efficacy is also observed after therapeutic oral delivery of SCIgA/M. Either prophylactic or therapeutic treatment with passively delivered SCIgA/M ensured survival of up to 50% of infected mice, while untreated animals all died. Our findings unravel the potential of oral passive immunization with plasma-derived polyreactive SCIgA/M Abs to fight gastrointestinal infections
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