Reference book is aimed at experts and students from different disciplines
A new standard work on neuroprostheses has been published by ENT professors Andrej Kral and Hannes Maier of Hannover Medical School together with Dr. Felix Aplin: "Prostheses for the Brain" is the title of the book, which is aimed equally at doctoral students and young scientists from technical and biological disciplines, as well as neuroscientists, engineers and physicians entering the field of neuroprosthetics.
Neuroprosthetics are used in the field of sensory prostheses (with cochlear implants, retinal implants and brainstem implants), but also in the field of motor (deep brain stimulation), in the spinal cord (in e.g. spinal stimulation for pain relief), in the experimental field of cerebral cortex implants (e.g. in paraplegia and in blindness). Neuroprosthetics has successfully mastered clinical translation in several areas, is a rapidly growing field of medicine. It is estimated that 1 million people worldwide already use neuroprostheses in their daily lives today.
The MHH authors provide a multidisciplinary introduction to artificial nerve stimulation. "Until now, no systematic introductory compilation of findings on principles and applications of neuroprostheses existed. Since many neuroprostheses are already in clinical use, such a synthesis is essential for the new generation of scientists and clinicians who are increasingly confronted with them in their field of work. The different fields of application can learn a lot from each other," reports Prof. Dr. Dr. Andrej Kral.
The authors review the technology of electrodes for registration and artificial stimulation of nerve tissue, safety limits and their determination, and describe the most clinically successful neuroprostheses such as the cochlear implant, brainstem implant, deep brain stimulation and spinal implants. The authors also present new developments in the field of retinal neuroprostheses, vestibular neuroprostheses, implants for control of extremities but also in stimulation of peripheral nerves. This gives the reader a comprehensive overview of the principles and applications of neuroprostheses. The book sets realistic expectations, both in terms of potentials and limitations for safety, design, and outcomes.
Prostheses for the Brain - Introduction to Neuroprosthetics
Authors: Andrej Kral, Felix Aplin, Hannes Maier
eBook ISBN: 9780128188934
Paperback ISBN: 9780128188927
Publisher: Academic Press
Published: April 3, 2021
414 pages
You can also find more information about the book online:
https://www.neuroprostheses.com/AK/Book.html
Background:
The ENT Clinic of the MHH is internationally known for the world's largest cochlear implant program for the care of hearing impaired patients. The first CI operation was performed here as early as 1984. In 2003, the German Hearing Center Hannover was opened. Other areas of focus include the provision of hearing aids and their further development, the early detection of childhood hearing loss, and the diagnosis and treatment of sensorineural hearing loss, including tinnitus. The treatment of patients is based on close cooperation between the ENT clinic, DHZ, acousticians, product manufacturers and scientists up to the development of new medical products.
For more information, please contact at www.dhz.clinic or from Daniela Beyer, Tel. 0511-532 3016, beyer.daniela@mh-hannover.de
At 11.11.2021 from 15:00 - 20:00 you can expect exciting lectures on the topic "Safety-integrated implants for the future". You will learn, for example, which materials are optimally suited for implants and how hearing implants enable brain maturation. Afterwards, you will gain insights into our various research laboratories and learn more exciting news about our research work. You can arrange this virtual tour individually in terms of time and content. You will also have the opportunity to ask our experts questions.
To ensure that your implant also lasts a lifetime and is characterized by a high level of safety, we are conducting research in the "Lower Saxony Center for Biomedical Engineering, Implant Research and Development" (NIFE) in interdisciplinary teams to develop new implants with increased compatibility and functionality - from A for aorta to Z for tooth, from the cellular level to the entire organ, using the body's own and artificial materials. Safety-relevant concepts from the engineering sciences, such as those used in aviation to increase safety, are being researched for the first time for medicine by the scientists in the "Safety-Integrated and Infection-Reactive Implants" (SIIRI) research network, which is funded by the German Research Foundation (DFG), in order to make your implants safer as well.
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Here you can register for the event log on.
Professor Dr. Andrea Hoffmann received the second teaching award in the category "Biosciences" on 20.10.2021 during the AStA summer party. This was awarded to her by the student body for her module "Adult Stem Cells in Regenerative Medicine". This lecture is offered for students of biochemistry of the MHH as well as for bachelor students of biology and life science of the LUH.
Twelve million euros for new Collaborative Research Center/Transregio led by MHH in cooperation with Leibniz Universität Hannover and other partners
A major success for medical research in Hannover: The German Research Foundation (DFG) is funding the new Transregional Collaborative Research Center TRR 298 on implants with around twelve million euros over the next four years. Under the leadership of Hannover Medical School (MHH), MHH physicians will work together with engineering and natural scientists from Leibniz Universität Hannover (LUH) to develop the implants of tomorrow. "On the one hand, this shows how powerful medical research is at the MHH," emphasizes MHH President Professor Dr. Michael Manns, "on the other hand, we have once again demonstrated how successfully the cooperations between the universities and research institutes of our metropolitan region are developing. Our already close cooperation with Leibniz Universität Hannover (LUH) is thus placed on an even firmer footing. I would like to thank all those involved for their commitment."
Intelligent implants of tomorrow
In the research network "Safety-integrated and infection-reactive implants" (SIIRI), which is headed by Professor Dr. Meike Stiesch, director of the MHH Clinic for Dental Prosthetics and Biomedical Materials Science, a completely new approach to implant research is being taken. "For the first time, we want to research safety-relevant concepts from the engineering sciences, such as those used in aviation to increase safety, for medicine," explains Professor Stiesch.
Researchers from a wide range of disciplines want to work together to develop intelligent implant systems for dentistry and orthopedics, as well as hearing implants, which for the first time will use state-of-the-art technology to allow continuous monitoring of implant function and thus early detection of complications such as infections. This will enable early therapeutic intervention to combat these infections, some of which can be life-threatening. However, the scientists want to go even further in this collaboration: "We are developing intelligent implant systems that can independently initiate early repair and thus healing via cell-based, chemical and physical so-called closed-loop systems," adds the professor.
Close cooperation of the different disciplines
The interdisciplinary and innovative concept has been made possible by the close cooperation of dentists, physicians, engineers, natural and social scientists. The nucleus for this interdisciplinary research is the NIFE (Lower Saxony Center for Implant Research and Development), which has been established in the Medical Park Hannover as an internationally visible research institute, achieving top results in experimental research and bringing them into clinical application for various organ systems.
In the Transregional Collaborative Research Center, more than 150 scientists from the MHH, Leibniz Universität Hannover, the Helmholtz Center for Infection Research in Braunschweig, the Technical University of Braunschweig and the University of Music, Drama and Media (HMTMH) will conduct joint research on the development of new implants to increase patient safety.
"This extremely challenging task can only be tackled jointly between the institutions involved. The engineering and medical expertise of the project partners complement each other perfectly for this purpose," emphasizes co-spokesman Professor Dr. Hans Jürgen Maier, head of the Institute of Materials Science at Leibniz University. Leibniz University scientists from the fields of mechanical engineering, chemistry and physics are involved, contributing expertise from materials science and sensor technology, among others.
Furthermore, another innovative approach in this research network is that not only the interfaces between technology and biology are explored, but also the patient perspective is included in all research and development steps from the very beginning. Research into the doctor-patient interaction will contribute significantly to a further increase in future implant and thus patient safety.
SERVICE:
More information please contact Professor Dr. Meike Stiesch, stiesch.meike@mh-hannover.de, telephone (0511) 532-4773.
DFG priority program funds four MHH projects with 1.6 million euros
For people with severe lung diseases, transplantation of a healthy organ is often the only chance of survival. But donor lungs are in short supply. A new artificial lung could provide a remedy. Since 2017, the German Research Foundation (DFG) has been supporting this scientific approach with its Priority Program SPP 2014 "Towards an implantable lung". The aim is to develop an artificial lung that can be permanently implanted as an alternative to a donor organ. Hannover Medical School (MHH), Europe's largest lung transplant center, is also involved in the nationwide research network. The DFG is now funding the work of the Hannover scientists for a further three years with more than 1.6 million euros.
ECMO support is not a permanent solution
At the MHH, research is being conducted on a so-called biohybrid lung. It is based on extracorporeal membrane oxygenation (ECMO), in which the blood is passed through hollow plastic fibers that act as "artificial alveoli" for gas exchange. This lung support system is already being used clinically - for example, to provide oxygen to patients in intensive care units who are severely ill with COVID-19. "So far, however, we have only been able to bridge lung function for a certain time with ECMO, because the blood forms clots when it comes into contact with the artificial surfaces and clogs the tubes," explains Dr. Bettina Wiegmann, who heads three of the four MHH projects at the Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE). The scientist wants to prevent this thrombus formation by populating the surfaces of the gas exchange membranes, the blood pump and the tubes with special, vessel-lining endothelial cells. "These endothelial cells, which are not endogenous to the body, are also genetically modified in such a way that they are virtually invisible to the patient's immune system and are therefore not recognized as foreign and fought against," explains the cardiac surgeon and emergency physician.
Large area with the smallest possible volume
The next step is to test whether the endothelial cells adhere firmly enough to the artificial surfaces and withstand the frictional stress caused by the blood flow. The membranes must also be further developed in such a way that, while providing the largest possible surface area for gas exchange, the volume of the artificial organ nevertheless remains as small and effective as possible, as is the case with the human lung. In the human lung, about 100 to 140 square meters of breathing surface are packed into 300 million alveoli to save space. Another requirement is the shape of the ECMO device, which must be modified during the development of the biohybrid lung so that it can be optimally implanted in the body. "We cannot insert a square box into a patient's chest," the scientist explains.
However, the scientist not only focuses on breathing, but also on kidney function. Because patients who have severe lung disease and require an ECMO machine usually also have an increased risk of acute kidney failure, they also require machine dialysis in addition to lung replacement therapy. Until now, these two procedures have been done with separate machines, which increases the risk of infection and thrombosis, among other things. The scientist is working to combine lung and kidney support in a single device. "This so-called lung-kidney crosstalk is another aspect for the development of an individualized implantable lung," Dr. Wiegmann emphasizes.
Develop different prototypes
Once all remaining problems have been solved, various prototypes of the biohybrid lung will first be tested under laboratory conditions using artificially generated blood circuits. In a next step, they will then be tested first as a respiratory acute aid and later as a permanent lung alternative in animal models. However, the researcher believes that it will be several years before the artificial lungs can be transplanted into the human body.
The DFG Priority Program SPP 2014 funds a total of ten projects nationwide. The Rhenish-Westphalian Technical University (RWTH) and the University Hospital Aachen are in charge. The MHH is involved with four projects. Three projects are headed by Dr. Bettina Wiegmann - one of them in cooperation with Professor Dr. Constanca Ferreira de Figueiredo from the Institute of Transfusion Medicine and Transplant Engineering. A fourth is located at the Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO) under the direction of Dr. Ruth Olmer.
SERVICE:
For further information, please contact Dr. Bettina Wiegmann, wiegmann.bettina@mh-hannover.de, telephone (0511) 532-1408.
A team consisting of students from LUH and MHH, who spent a year researching synthetic biology, implant research and modeling at the Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), was awarded a prize for their concept for a biosensor in this year's iGEM competition.
Every year, around 250 international student groups present their projects in the field of synthetic biology as part of the iGEM competition. 16 students* from LUH and MHH under the guidance of Prof. Dr. Heisterkamp and Dr. Kalies presented their project at the competition days in mid-November. The team was awarded a gold medal for their sensor concept and nominated for a special prize. All team members participated in the competition for the first time.
The team at NIFE has developed a cell-based sensor designed to detect inflammatory toxins. The origin of these toxins are bacterial colonies that settle on the implant surface after the insertion of medical implants. Such toxins can trigger serious diseases. With the sensor, the team enables a non-invasive detection of the bacterial colonies and thus increases the chance for a successful therapy.
The students also thought extensively about science communication and systems modeling in synthetic biology. As a result, a board game for students was created that teaches the basics of cell biology in a playful way. Other students developed a numerical model to simulate bacterial colonies.
The project is described in detail on the team's website (https://2020.igem.org/Team:Hannover) documented. For the first time, a project from Hannover was awarded a gold medal. Previously, LUH students* from Hannover took part in the competition in 2014 and 2016.
Below, the iGEM team from Hannover 2020.
From left to right Back row: Thorben Klamt, Timm Landes, Jan Mairose, Lara Gentemann, David Theidel, George Dati, Jonas Scholz.
From left to right front row: Anna- Charleen Wessel, Lisan Püttmann, Louise Schaar, Pia Peppermüller, Sören Donath, Celine Beckhausen, Fiene Daniel, Stefan Kalies.
Not pictured: Alexander Heisterkamp, Laura Wesche, Manmeet Singh.
The program includes a lecture on arteriosclerosis - from the outside in by Prof. Haverich as well as " Hands-on research":
Read the report at www.presse-club-hannover.de.Previous
Every hip counts
The central implant registry is intended to increase safety for patients.
It was a scandal: In 2010, it became known to the general public that the French manufacturer Poly Implant had been producing inferior breast implants for years. As a result, hundreds of women had to have the silicone-containing, often defective preparations removed.
Poly Implant revealed gaps in the control system of medical devices that are only gradually being closed. As recently as the end of 2018, a network of journalists discovered the "Implant Files": gaps in the approval of implants, without which modern high-performance medicine is inconceivable. Pacemakers, vascular prostheses, stents, cochlear and retinal implants: there is hardly an area in which medical devices cannot support or replace bodily functions.
"The legislator has now reacted to the abuses," says Prof. Henning Windhagen, Director of the Orthopedic Clinic of the Hannover Medical School (MHH) at the DIAKOVERE Annastift. He points to the significantly tightened approval procedure for medical devices at the EU level. Another advance is the current 16 voluntary implant registries for pacemakers and other implants maintained by medical societies more. "Products can remain in the patient's body for decades. Without registries, long-term effects are almost impossible to detect," says Windhagen.
A shining example is the Endoprostheses Register Germany (EPRD), established in 2012. According to Windhagen, almost 716 of 1,200 German hospitals that insert around 450,000 endoprostheses, i.e. artificial hip and knee joints, each year now report the data of patients - if they agree. "That's still 66.7 % of the implants inserted that are recorded in this way," says Windhagen.
The importance of data collection is shown by the more than 45,000 endoprosthetic operations performed each year in which, according to the EPRD, old implants are exchanged for new ones without the real reasons being known. Another example is thousands of hip replacements used until about 2010, in which the ball and joint alike were made of extremely hard cobalt chrome. "With the register, doctors would have been able to identify the problems with this design much earlier," Windhagen is certain.
His advice to patients: Only have operations performed in hospitals that report to the EPRD and are also part of the German Endoprosthetics Centers (EPC) network. Experts such as Windhagen believe that the statutory minimum volumes are not sufficient, not to mention the fact that hospitals tend to disregard them, as the German medical journal "Ärzteblatt" reported in June 2019.
"A single surgeon should be able to perform at least 50 operations a year, as specified in the EPCs, and at least 100 operations in the case of complicated procedures, for example due to congenital deformities," says Windhagen. Another advantage of the EPCs is the co-pilot concept: "A specialist must assist an experienced surgeon for two years before he or she can lead an operation," Windhagen explains.
In order to close the remaining gaps in the registration of implants, the establishment of a central registry based in Cologne is to start in 2020. It will merge the existing voluntary registries, cover additional implant groups and introduce a reporting requirement: Clinics will then have to report every "installation" of an implant and patients will have to agree to data transmission. "Ultimately, this is in the interest of patients," Windhagen says.
HAZ/NP Safety Weeks 07.11.2019
Dr. Manfred Elff was re-elected to the BVMed board for another 2 years at the BVMed general meeting in Berlin.
As a trade association, BVMed represents over 230 industrial and commercial companies in the medical technology sector. Among others, the 20 largest medical device manufacturers worldwide in the consumer goods sector are organized in BVMed. BVMed represents, among others, the areas of medical technology, implants, medical aids, homecare and dressings, as well as bio- and nanotechnologies.
On March 8, 2018, the Institute for Multiphase Processes at NIFE will organize the last event of the winter semester series HannoVersity under the title.
"Biomedical Engineering - What is that?"
With the new HannoVersity event series, Initiative Wissenschaft invites German and international students to "think outside the box".
The aim of the series is to gain insights into other research disciplines in a relaxed atmosphere at various locations in the city and at the universities, and to establish and expand international contacts and networks beyond one's own university life.
Advance registration for the event is mandatory and available by Feb. 28 at: rittinghaus@imp.uni-hannover.de
For more information on HannoVersity and the Initiative Wissenschaft, as well as on the program of the winter semester, please see here.
Bypasses from human cells could become an alternative to synthetic material in the future
It is a vision that may open up entirely new possibilities in the treatment of circulatory disorders: biologically compatible bypasses made from the patient's own cells. The bypasses grown in a bioreactor from blood and tissue cells are expected to be a significantly better tolerated alternative to conventional bypasses made from synthetic material.
An interdisciplinary team of researchers from Leibniz University is working on this at NIFE (Lower Saxony Center for Biomedical Engineering, Implant Research and Development) and has received the 2017 VDI Technology Award.
Circulatory disorders in the arteries can, in the worst case, lead to heart attack or stroke. In these cases, bypasses must be inserted urgently. In the case of vascular prostheses made of synthetic material such as Goretex, blood clotting must then be permanently reduced by medication, because otherwise there is a risk that the bypass will become clogged due to the material structure and there will be renewed vascular occlusion.
The anticoagulant drugs are not easy to use and can cause complications. Synthetic bypasses can also become infected. Venous autologous material that can be taken from patients elsewhere in the body and used is often not available in sufficient quantity and quality. There is therefore a great need for artificial vascular prostheses.
Research into bypasses made from animal material has been going on for a long time - but apart from ethical concerns, there have so far been problems with rejection and deposition processes. The scientists at Leibniz University are taking a different approach. They want to settle cells of the patient on a tubular scaffold structure made of synthetic material - a so-called scaffold. In a cultivation process in the bioreactor, a bypass develops from this, which can then be implanted. The scaffold is later degraded so that the vascular prosthesis consists only of the body's own material.
The scientists from the Institute of Technical Chemistry and the Institute of Microelectronic Systems jointly developed the technology for the cultivation. "Conditions in the bioreactor must mimic those in the human body," explains Prof. Cornelia Blume from the Institute of Technical Chemistry.
Heartbeat and blood pressure are simulated so that a bypass can be created in two to three weeks. "The further maturation process takes place in the body after implantation. The best bioreactor is the human being," she adds. The sensitive control and sensor technology as well as the monitoring via ultrasound - the bioreactor must hardly be opened during the process - were developed by Prof. Dr.-Ing. Holger Blume and his team from the Institute for Microelectronic Systems.
In the project, which is funded by the DFG, the researchers are working closely with Hannover Medical School and other partners. Applicability doesn't seem so far off: "We hope to be ready to test the bypasses in trials with sheep in about three years," says Prof. Cornelia Blume. This will be followed by the clinical phase with the approval process in humans.
Note to editors:
For further information, please contact Prof. Dr. med. Cornelia Blume from the Institute of Technical Chemistry by phone (+49 177 86 69 328) or E-mail gladly at your disposal.
Mechtild Freiin v. Münchhausen | idw - Science Information Service
More information:
http://www.uni-hannover.de