High density electrodes are a new frontier for biomedical implants. Increasing the density and the number of electrodes used for the stimulation of retinal ganglion cells is one possible strategy for enhancing the quality of vision experienced by patients using retinal prostheses. The present work presents an integration strategy for a diamond based, high density, stimulating electrode array with a purpose built application specific integrated circuit (ASIC). The strategy is centered on flip-chip bonding of indium bumps to create high count and density vertical interconnects between the stimulator ASIC and an array of diamond neural stimulating electrodes. The use of polydimethylsiloxane (PDMS) housing prevents cross-contamination of the biocompatible diamond electrode with non-biocompatible materials, such as indium, used in the microfabrication process. Micro-imprint lithography allowed edge-to-edge micro-scale pattering of the indium bumps on non-coplanar substrates that have a form factor that can conform to body organs and thus are ideally suited for biomedical applications. Furthermore, micro-imprint lithography ensures the compatibility of lithography with the silicon ASIC and aluminum contact pads. Although this work focuses on 256 stimulating diamond electrode arrays with a pitch of 150 μm, the use of indium bump bonding technology and vertical interconnects facilitates implants with tens of thousands electrodes with a pitch as low as 10 μm, thus ensuring validity of the strategy for future high acuity retinal prostheses, and bionic implants in general.
Successful visual prostheses require stable, long-term attachment. Epiretinal prostheses, in particular, require attachment methods to fix the prosthesis onto the retina. The most common method is fixation with a retinal tack; however, tacks cause retinal trauma, and surgical proficiency is important to ensure optimal placement of the prosthesis near the macula. Accordingly, alternate attachment methods are required. In this study, we detail a novel method of magnetic attachment for an epiretinal prosthesis using two prostheses components positioned on opposing sides of the retina. The magnetic attachment technique was piloted in a feline animal model (chronic, nonrecovery implantation). We also detail a new method to reliably control the magnet coupling force using heat. It was found that the force exerted upon the tissue that separates the two components could be minimized as the measured force is proportionately smaller at the working distance. We thus detail, for the first time, a surgical method using customized magnets to position and affix an epiretinal prosthesis on the retina. The position of the epiretinal prosthesis is reliable, and its location on the retina is accurately controlled by the placement of a secondary magnet in the suprachoroidal location. The electrode position above the retina is less than 50 microns at the center of the device, although there were pressure points seen at the two edges due to curvature misalignment. The degree of retinal compression found in this study was unacceptably high; nevertheless, the normal structure of the retina remained intact under the electrodes.
BACKGROUND: Many pediatric and neonatal ICU patients receive nitric oxide (NO), with some also requiring magnetic resonance imaging (MRI) scans. MRI-compatible NO delivery devices are not always available. We describe and bench test a method of delivering NO during MRI using standard equipment in which a NO delivery device was positioned in the MRI control room with the NO blender component connected to oxygen and set to 80 ppm and delivering flow via 12 m of tubing to a MRI-compatible ventilator, set up inside the MRI scanner magnet room. METHODS: For our bench test, the ventilator was set up normally and connected to an infant test lung to simulate several patients of differing weight (ie, 4 kg, 10 kg, 20 kg). The NO blender delivered flows of 2-10 L/min to the ventilator to achieve a range of NO and oxygen concentrations monitored via extended tubing. The measured values were compared to calculated values. RESULTS: A range of NO concentrations (12-41 ppm) and F IO 2 values (0.67-0.97) were achieved during the bench testing. The additional flow increased delivered peak inspiratory pressure and PEEP by 1-5 cm H 2 O. Calculated values were within acceptable ranges and were used to create a lookup table. CONCLUSIONS: In clinical use, this system can safely generate a range of NO flows of 15-42 ppm with an accompanying F IO 2 range of 0.34-0.98.
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