Centres of Competence for Medical Technology

Transcription

Centres of Competence for
Medical Technology
BMBF PUBLIK
Innovation and Research Potential
BMBF PUBLIK
Impressum
Photos
Published by
Federal Ministry of Education and Research
Public relation
53170 Bonn
E-Mail: [email protected]
Internet: http://www.bmbf.de
Title:
AKM Aachen Competence Centre for Medcial
Engineering
TELTRA Competence and Service Centre for
Traumatology
The Center of Competences is a project of several
departments within the Federal Ministry for
Education and Research. The main contact
address is the German Aerospace Center (DLR) Project Management Health Research.
Edited by
focon GmbH, Aachen
Layout by
focon GmbH, Aachen
Printed by
medienfabrik, Aachen
Date
November 2000
Centres of Competence for
Medical Technology
Innovation and Research Potential
Table of Contents
Preface
4
Introduction
6
Miniature technology for faster healing - Miniaturised components for cardio
vascular and tissue therapy, Aachen Competence Centre for Medical Engineering
(AKM), Aachen
8
Blood purification in new fields of treatment - Centre for Apheresis Technology
reg. ass., (C.A.T.), Rostock
12
The intelligent hifi hearing ais of the future - Competence Centre for Hearing-,
Aid System Technology (HörTech), Oldenburg
16
Development, Promotion, Application - New Approaches in Medical Device
technology - innovative medical technology centre Hamburg GmbH
20
Modern Prothesis for Improved Quality of Life - Centre of Competence for
Intelligent Implants and Protheses (INPRO), Duisburg
24
Reasonable Dentistry for Everybody - Competence Centre for Innovative
Technologies to reduce costs in dentistry (KITZ), Frankfurt
28
2
Table of Contents
3
Gentle waves instead of harsh X-rays - Medical Technology Centre of
Competence Ruhr (KMR), Bochum
32
Cell Monitoring Systems - Medical Microsensoric Centre of Competence
Microelectronic Meets Medicine (m hoch drei), Rostock
36
High tech for the heart - Centre of Competence Cardiovascular Implants
(MEDIMPLANT), Hannover
40
Large operations with small cuts - Minimally Invasive Medicine &
Technology (MITT), Tübingen-Tuttlingen
44
Protection and aid with modern technology - Miniaturized Monitoring- and
Intervention Systems (MOTIV), St. Ingbert/Berlin
48
Modern Medical Technology improves visual acuity - OphthalmoInnovation
Thüringen (OIT), Jena
52
Telemedicine for Accident Victims - Competence and Service Centre for
Traumatology (TELTRA), Karlsruhe
56
A strong community - Competence Centre for Innovative Technology use
in Medicine (ZENIT), Erlangen
60
Glossary
64
Contact addresses
67
Technological progress shall
serve the welfare of people. Medical technology is devoted to this
demand in a particular manner.
The great progress of medicine in the past century is not
conceivable without the developments in medical technology. At
the beginning of the 20th century there was the revolutionary
invention by Röntgen, and today
the everyday medical routine cannot be imagined without sophisticated procedures and devices from pacemakers to hi-fi hearing
aids, from keyhole surgery to
laser treatment of the eye, from
magnetic resonance tomography
to ultrasound shots of the unborn.
4
Preface
By this I do not want to advocate a medicine
that sees medical progress one-sidedly in the
development of new technologies. But as an aid
in the doctor's hand, modern technical apparatus
is indispensable today for the diagnosis and cure
of diseases.
The development and manufacture of medical technological products has high standards in
Germany. Here a high level of the health care of
the population, by which an important home
market for medical technological products is
already assured, combines with a wide knowhow in basic technologies important for medical
technological products. To be mentioned are
microsystem technology and material science,
among others. Increasingly important is, above
all, information technology. In today's Germany
medical technology industry is an important
economic factor, which contributes, not least by
its growing export part, to economic power and
employment.
The increase of innovation velocity means a
great challenge of the future. New products are
out-dated soon, the competition on the international market calls for a fast transformation of
new ideas into products. The medical technology industry invests about ten per cent of its
turn-over into research and development, and by
this it is an outrider of innovation. However still
further innovation potentials can be opened by
improved cooperation: improved cooperation
between industrial companies themselves, for
competition does not rule out cooperation,
intensified and early coordination between industry and users, and, above all, increased co-operation between science and economy. The
Federal Government wants to give incentives
and support to that.
Networking the competence in a certain field
of technology and focusing it in a centre can
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exploit synergies and surmount obstacles of
innovation.
Therefore I invited for a competition about
forming Centres of competence for medical
technology in March 1999. Syndicates with university institutes, non-academic research institutions and industrial companies took part in this
competition. The 14 winners of the first round
of qualification are described in this brochure.
In an additional second round eight of the 14
Centres of competence qualified for federal funding over five years.
I wish all Centres of competence good success with their future work.
Edelgard Bulmahn
Federal Minister for Education and Research
By the action "Centres of Competence for
Medical Technology" the Federal Ministry for
Education and Research (BMBF) targets its support to initiatives for concentrating this competence and for applying innovative medical technology in Germany.
The selection of qualified centres of competence was performed as a competition in two
rounds. After a public invitation to bid end of
March 1999, 56 applications were submitted. In
mid-September 1999 the 14 winners of the first
round were determined. They were invited to
work out their concepts in detail, and took part
in the second round of selection. The result of
this round at the end of March 2000 was that all
of the 14 centres of competence comply with
the aims of the competition; eight of them
receive financial support from the BMBF.
Medical technology is a multi-disciplinary and
thematically wide-stretched field of research and
application. It still has a substantial growth
potential related to the international market.
Therefore it is of great importance not only for
the healthcare system, but also for the industrial
development. Increasing technological standards, demands on valid clinical studies, and preconditions by legal healthcare regulations increasingly move the importance of cooperation
to the foreground.
In the field of medical technology, Germany
is characterised by an internationally recognised
high potential of innovation and by high-quality
developments. The high industrial density and
the specialisation of companies as well as universities are further good conditions for bringing the existing competence together.
The BMBF's funding firstly refers to the
foundation of the centres of competence: it
supports measures that are suited to combine
competence in medical technology thematically
and organisationally, i.e. erecting and extending
an effective structure. Secondly, the funds are
also employed for R&D projects that make use
of the combined competence in an optimal and
exemplary way. And not least the relevant funding programmes published by the BMBF are
open to all centres of competence of course. In
this case the specific funding needs of the centres are taken into account.
The funding of the centres of competence is
limited to five years as a start-up financing. After
that the centres are supposed to be continued in
an independent structure open for supplements. Each centre has worked out a concept
about how it can be continued after the expiration of the BMBF funding.
6
Introduction
The centres of competence mostly have a
regional design and show a thematic profile of
their own in a field of medical technology relevant for marketing and care. They combine the
best and most competent institutions of academic and non-academic research, including research-oriented healthcare providers and industry. Their responsible bodies are institutions
from the areas of science, economy, health
system and finance. The centres are characterised by an intense multilateral communication
between the participants, by the installation and
utilisation of common forums and services, by
the utilisation of common resources as well as
the division of labour in solving problems.
Furthermore health-economic expertise is embodied in all important processes of decision.
The centres bundle up competence horizontally, i.e. trans-technologically and interdisciplinarily, as well as vertically, i.e. by covering the
chain of value addition from the idea over research up to development, production, and marketing. They initiate and accompany innovations for medical applications in selected areas
of technology with a high potential of value
addition. In the area of their technological specialisation they possess scientific-technological
competence on an excellent level and, as knowhow carriers of innovation transfer, they are
capable of passing on this knowledge. This is
combined with their organisational experience
and their positive self-understanding as service
enterprises. They also serve as the BMBF's
information desk for political and technological
questions concerning medical technology, and as
knowledge carriers for third-party inquiries.
The work of the centres of competence is
targeted to the optimal transformation of medical technological ideas into corresponding pro-
7
ducts and services in the healthcare system,
while early including healthcare providers and
cost payers. Thus it is secured that by the development of technological innovations the
expenditure of healthcare is lowered, or the quality of healthcare is improved visibly. A comprehensive strategy of implementation will improve
the acceptance and the access to medical application.
The centres of competence contribute to
secure Germany as a location of medical technology on the present high level, to strengthen
its competitiveness on an international scale, and
thus to increase its attractivity for national and
international enterprises. By their attraction they
help to maintain jobs and to create new ones.
Miniature technology for faster healing
Miniaturised components for cardiovascular and tissue therapy,
Aachen Competence Centre for Medical Engineering
The Aachen region has a great potential of medical and technical innovative power with its University
Clinic, the RWTH Aachen, numerous research institutions which are either affiliated to university institutes or are independent of these as well as over 150 medical engineering companies, some of whom
have great competence in microengineering.
Outstanding work is being performed in Aachen in particular in the field of cardiovascular and tissue therapy. Close co-operation with the engineering sciences guarantees a high application-orientation
of the research.
The Aachen Competence Centre for Medical Engineering (AKM) concentrates the local skills and
capacities so that products and processes can be brought to market maturity more quickly in co-operation with industry through optimised sequences. An important aspect is the interdisciplinary co-operation between doctors,
engineers and natural
Competence mediation
• Organisation, co-ordination
Function of the Competence Center
scientists in the fields of
• Acquisition, marketing
• Evaluation
cardiovascular and tis• Project management
Supra-regional partners
sue therapy. The chosen
• Quality management
Regional partners
• Financing
focus concentrates on
• Patenting
Service provider
Clinic
• Certification
fields of indications
AGIT, ECM, IHK,
Surgery, cardiosurgery,
• Foundation management
MeTNet, 3i, Atlas,
cardiology, pathology,
which are important for
S-Vc, SUBG, GIMV, tbg
radiology, urology,
medical care and sociohealth economy etc.
animal testing,
economics. In these
orthopaedics
Products
Ideas
fields, a therapy using
„Turntable
Solutions
Requirements
competence mediation"“
miniaturised compoProcesses
Problems
Engineering
nents and systems leads
Companies / Industry
Helmholtz-Institute;
RWTH-Institutes: aerodynamics,
Impella, Medos, Mecora,
to methods of treatplastics, ceramics;
ADIAM, Bytec, CWA,
Fraunhofer Institutes: laser
ment with a great marCook Europe, Vygon,
technology, production technoket potential which are
Triflo, Hüttinger etc.
logy; Special Research Project
microassembly, etc..
more gentle on the
patient, improve the
quality of results and
are more cost-efficient.
Contact address:
Dr. Dieter Westphal
Aachener Kompetenzzentrum Medizintechnik
Technologiezentrum am Europaplatz
D-52068 Aachen
Tel: + 49 (0)241/963-242-0,
Fax: + 49 (0)241/963-242-1
email: [email protected]
http://www.akm-aachen.de
http://www.kompetenznetze.de
The medical goal of the AKM is to cut the time which
patients have to spend in hospitals after operations and
reduce complications through the miniaturisation of medical engineering components and systems.
The AKM was launched with 5 projects from the fields
of cardiovascular and tissue therapy.
8
Cardiovascular therapy
Diseases of the cardiovascular system are the
most common cause of death in western industrialised countries. Apart from strokes, cardiac
insufficiency is a further health problem. A heart
transplant is not an option for the majority of
patients on account of the limited availability of
donor organs. The further development of miniaturised systems for cardiovascular therapy is thus
an important step in improving the therapy and
sense from an socio-economic point of view.
Self-expanding axial blood pump which
can be inserted through the skin as temporary support system for the left ventricle
(Flow > 1 l /min at 60 mm Hg)
The goal of this project is to develop a special
implantable blood pump with an extremely small
insertion diameter of less than 3 mm. Such a minimal-invasive device could be an important factor
for saving lives after an acute cardiac infarct.
Project manager
ä Prof. Dr. med. Dipl.-Ing. Thomas SchmitzRode, University Clinic for Diagnostic
Radiology
Self-expanding axial blood pump
Co-operation Partners
ä Helmholtz Institute for Biomedical
Engineering
äFraunhofer Institute for Production
Technology (IPT)
äMedical Clinic I
äAerodynamics Institute
äInstitute for Animal Testing
äImpella Cardiotechnik AG
äMecora Medizintechnik GmbH
Minimal-invasive approach to intraoperative mapping and radiofrequency ablation of
ventricular tachycardia
Ventricular arrhythmias from the left heart
chamber are a major healthcare problem in
Western industrial countries. The implantable
defibrillator, albeit being very effective in terminating sustained ventricular tachyarrhythmias, does
not aim to treat the underlying cause. Therefore,
a surgical, minimal-invasive tool for introduction
into the left heart chamber will be developed
which can be used for mapping and ablation of
9
ventricular tachycardia.
Project manager
ä Privatdozent Dr. med. Christoph Stellbrink
Medical Clinik I
ä University Clinic for Thorax, Cardiac and
Vascular Surgery
ä CWA-Biotronik
Cardiovascular therapy
Micro-diagonal pump
Blood pumps for the temporary and permanent replacement
of the cardiac function
A mechanical support can restore the cardiac function after an acute
or chronic cardiac failure. However, different types of blood pumps for
the specific indications in order to guarantee an optimum supply. The
goal of this project is to investigate and evaluate six different types of
blood pump right through to an artificial heart as a complete heart replacement.
Project manager
ä Prof. Dr. med. Dipl.-Phys. Friedrich A. Schöndube, University Clinic
for Thorax, Cardiac and Vascular Surgery
ä Helmholtz Institute for Biomedical Engineering (HIA)
ä Fraunhofer Institute for Production Technology (IPT)
ä Institute for Materials in Electrical Engineering
ä Medical Clinic I and Children's Cardiology Clinic
ä Institute for Animal Testing
ä Impella Cardiotechnik AG
ä MEDOS Medizintechnik AG
Encapsulated, fully implantable blood pump
with motor and rotor
borne in the blood
stream
ä Mecora Medizintechnik GmbH
Microaxial pump
Perfusion of 60 ml blood/min against a load of 60 mm Hg
Concept for the electro-mechanical artificial heart
ACor
1. Pump unit
2. Buffer battery
3. Transcutaneous energy transmission
4. External power supply
10
Miniature technology for faster healing
Miniaturised components for cardiovascular and tissue therapy,
Aachen Competence Centre for Medical Engineering
Tissue therapy
In the field of tissue therapy, the very widespread integration of various functions (mechanical, electrical, fluidic and optical) enables the optimisation and minimisation of invasive interventions. The results are new operation techniques and therapies with reduction of pain,
lower complication rates and shorter periods of rest, so
that the strain on the patient is lower and the consequential costs drop.
Microsurgical anastomosis of micro-vessels by
laser-assisted tissue fusion
Very small hollow structures such as blood vessels and
spermatic cords display a high rate of secondary occlusion following conventional surgical anastomosis. This
often leads to complications such as a later knotty scaring
and inflammatory reaction due to the suture material.
This problem can be solved with the aid of new, laserassisted technologies. The internal patency of micro-vessels following their operative anastomosis is increased by
suture material-free tissue adaptations by means of laserassisted tissue fusion.
Project mnager
ä Prof. Dr. med. Gerhard Jakse, Urology University
Clinic
Development of a microsensor to measure the
suture and tissue tension for the closure of an
abdominal wall
The primary closure of the abdominal wall fails in 1015% of all abdominal operations so that a repeat operative intervention is unavoidable. Around 15,000 patients
every year in Germany thus have to undergo a subsequent operation.
A reduction of this complication through the miniaturised control of surgical suturing techniques can relieve
the patient and significantly lower costs. The optimum
tension for the specific tissue when closing the abdominal wall can be determined using implantable microsensors. This type of sensor is integrated in manual and
mechanical suture instruments.
Project manager
ä Dr. med. Jörg Höer, Surgical University Clinic
ä Fraunhofer Institute for Production Technology
(IPT)
ä Surgical University Clinic
ä Institute for Pathology
ä Fraunhofer Institute for Laser Technology (ILT)
ä Institute for Plastics Processing (IKV)
ä Institute of Animal Testing
ä Institute for Pathology
ä Institute for Macromolecular Chemistry
Example of a tissue pressure sensor
11
Blood purification in new fields of treatment
C.A.T. - Centre for Apheresis Technology (registered association)
Apheresis (separation, extraction) is a method of blood purification. The patient's blood is extracted
from the body (extra corporeal) by filters, adsorbers or other systems specifically designed for the illness.
During the apheresis treatment, materials, which play an important role in the illness, are either removed from the blood or their volume is reduced.
The Centre for Apheresis Technology is a network of start-up technology companies, universities and
other public research institutes and clinical users. The goal is to establish apheresis as an innovative
blood purification process with considerable weight in the politics of health care and to sustain
Germany's technological advance in the field. Hence, the centre's work concentrates on research, development, production, validation and use of apheresis in treatment and other specific blood purification
processes, with the exception of renal replacement therapy.
Apheresis is specifically used in the treatment of illnesses, which even today cannot be adequately treated. These are, for example: autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis,
vascular diseases such as atherosclerosis and cardiac infarction, circulatory disturbances such as diabetic
foot and hearing impairments as well as liver failure.
In the Centre for Apheresis Technology there are 3 working groups, the main focuses of which are:
ä To explain the effective mechanisms of apheresis
ä To develop adsorbers and extra corporeal systems
ä To create effective treatment and care structures / quality assurance.
Center of Competence
Organization / Board
Network:
C.A.T.-Reference Lab
Topic:
Basic Research about Apheresis and Matrix
This cooperation is of
Center of Apheresis service to the patient on
Technologies e.V. the one hand, as knowAdvisory Board
Teterow / Rostock ledge is specifically
bundled here, allowing
C.A.T.-Center of Apheresis
new and innovative straPartner:
tegies to be developed
for previously untreataUniversity: Rostock, Greifswald,
Berlin (Charite, FU);
ble illnesses.
Development of new Adsorbentien
Design of a new extracorporal System
In vitro Tests
Helmholtzgesellschaft: GKSS Teltow;
TITK Rudolstadt
Technology Enterprises from Teterow,
Rostock und Berlin
Inst. Diabetes Karlsburg
Animal Model
Pilotproduction
Clinical Study
Clinical Application
Ideal Apheresis
Licence New Enterprises Settlement Production Expert Opinion
Biomedizintechnikum Teterow, AFFINA
Center of Apheresis: Rostock, Berlin, Klink
Reimbursement ( AOK, LVA )
Additionally, important impetus is given to
advances in technology.
On top of that the
C.A.T. also facilitates the
formation of profitable
start-up companies.
The Patient
Industry, Venture Capital., Bank
12
Explanation of the effective mechanisms
of apheresis
The explanation of the effective mechanisms of
apheresis in treatment is an essential requirement
for the development of more effective and illnessspecific apheresis technology. Understanding the
effective mechanisms is of great importance for the
acceptance of the technology and its implementation in clinical use.
Goals
Members
You will find the directory of the members of
the Centre for Apheresis Technology on the
homepage
www.apherese-technologie.de/mitglieder
Current projects
at
You can also find out about current projects
ww.apherese-technologie.de/projekte
ä The identification of the substances to be
extracted (toxic substances, certain immunoglobulins, immunocomplexes, antigens,
antibodies, cytokine)
ä The creation of effective systems for the
extraction of these substances (illnessspecific, capacity, bio-compatibility, no
leakage)
ä Definition of the areas of use
ä Development of economical strategies.
Contact address:
Centrum für Apherese-Technologien e.V.
Dr. Hagen Pommerenke
Dr. Wolfgang Ramlow
Friedrich-Barnewitz-Str. 4
D - 18119 Rostock
Tel.: + 49 (0)381/4050219
Fax: + 49 (0)381/4050234
Email:
[email protected]
http://www.apherese-technologie.de
13
Treatment of DCM: High-spezific adsorber for elimination of Beta-1 Andrenozeptor Antigens
Development of the adsorber matrix and
the extra corporeal system
The matrix that filters the material sought out of the
blood and the extracorporeal system play important roles
in the development of apheresis technology. In the
Centre for Apheresis Technology technically optimised
systems are developed, which are distinguished by their
ease of use and higher level of efficiency, as a replacement for today's relatively complex systems.
ä
ä
ä
ä
Goals
Improvement of adsorption kinetics in the matrix
Optimisation of the flow conditions in the extra
corporeal system and the adsorber
Reduction in the treatment time
Simplicity and safety of the system
Optimisation of the system
ä AdsorberPorosity
matrix:
Diffusion times
Mechanical stability of the
materials used
ä Column design:
Flow rates
Flow conditions
Recyclability
Blood and plasma loss
ä Machine:
Technology
Ergonomics
Computersimulation of flow- and
pressure conditions and AdsorberDesign (ASD-GmbH) as modern
developing aid
14
Blood purification in new fields of treatment
C.A.T. - Centre for Apheresis Technology (registered association)
Effective treatment and care structures
When using modern technology in the area
of extra corporeal blood purification, it is
necessary to create quality standards and
appropriate care structures. The Centre for
Apheresis Technology is cooperating in the
setting up of modern network structures in
the area of clinical studies and medical care.
Goals
ä Definition Definition of treatment
strategies (guidelines)
ä Internationally coordinated use of
apheresis systems
ä Objective approach to successful treatment
ä
ä
ä
ä
ä
Patienten
Hospital days / a
in the first year
after beginning
of apheresis
Hospital days /a
in three years
before beginning
of apheresis
Project
International data and research management
Setting up of a national apheresis register
incooperation with those bearing the
costs
Implementation of defined clinical studies
Validation of the apheresis process as
regards costs and health care
Setting up of interdisciplinary treatment
institutions
Reduction of hospital days as a result of apheresis
Network Structure
Implementation
The implementation is via the initiation
and establishment of modern structures in the
field of clinical studies and of medical care
with the participation of all groups concerned.
Paying Authority
Medical bureau
of the health
insurance
Reference Laboratory
Project
Treatment Centre
Project
Scientifical Data
Analysis
Apheresis Register
Project
Scientifical Clinical
Studies
15
The intelligent hifi hearing aid of the future
HörTech - Competence Centre for Hearing-Aid System Technology
Optimised supply of hearing aids, rehabilitation of hearing impaired patients
The goal of the Competence Centre HörTech is to comprehensively and effectively improve the
system technology of hearing aids in order to enable patients to hear better and more comfortably. New
findings regarding the audiology of hearing impairments, digital signal processing techniques for hearing
aids (software), and technological innovations of the hardware are developed in the Centre and result in
improved products and optimised fitting and rehabilitation strategies.
About 15% of the German population (i.e. approximately 12 million people) suffer from a hearing
impairment requiring medical treatment. However, only about half a million hearing aids are sold in Germany per year. Despite the great number of hearing-impaired people and the drastic consequences of
such communication impairments, the acceptance of hearing aids and the success that can be achieved
using them is still very low. In many cases the sold and fitted hearing aids are hardly or not at all used
(disappear in a drawer).
Since the digital technology has been introduced into hearing aids on a large scale, the latest developments in the field of audiology and digital signal processing are principally applicable, but have not
been realised consequently mainly because of the high degree of specialisation among the individual
research and production institutions, respectively. For example, the performance of microchips for commercial in-the-ear hearing aids have been considerably improved due to an increasing miniaturisation.
The software (algorithms) for an optimal application of these resources, however, needs to be improved
just as well as the fitting to an individual patient. There is no sufficient feedback from the users of hearing aids to the system designers because of structural and methodological deficits. A concerted action
of all institutions involved in this process - from the fundamental research via the production to the fitting of hearing aids - is required to remove this obstruction
to innovation.
This is the goal which the Competence Centre HörTech
will achieve in cooperation with the leading representatives
from all fields of specialisation and institutions nation-wide.
Contact address:
Prof. Dr. Dr. Birger Kollmeier
Medizinische Physik
Universität Oldenburg
Stephan Albani
Hörzentum Oldenburg
Carl-von-Ossietzky Str. 9-11, D - 26111 Oldenburg
Tel.: + 49 (0)441/973 8997, Fax: + 49 (0)441/973 8998
Email: [email protected]
16
Additionally, the Centre will evaluate the strategies for the supply of and rehabilitation with hearing aids from a socioeconomic point of view
(cost/benefit analyses) in order to optimise and
eventually implement these strategies.
The research aims are pursued via six projects
concerned with all areas of hardware and software of hearing aids as well as with the methods
and structures in supplying patients with hearing
aids.
Until its foundation as an independent company, the Competence Centre HörTech will be
coordinated by the Hörzentrum (Audiological
Centre) Oldenburg. As an institute between
Oldenburg University, hospital, and industrial
customers the Hörzentrum is destined for mediatorship and has model character as a unique
institution of this kind nation-wide.
Profits/surplus from industrial projects as
well as from the marketing/licensing of products will be directly invested in the expansion/consolidation of the Centre itself such that
an effective economic establishment of the
Centre will be ensured.
Oldenburg is the local centre which nearly all
partners are related to in some way. The primary
structural perspective is a centre unique in
Germany and Europe which - owing to a wellaimed cooperation and on the basis of the
know-how available at leading institutions - deals
with urgent problems impeding innovation in
the supply of hearing aids and serves the entire
branch as an information and transfer centre of
system technology.
The Competence Centre HörTech will be
founded as a public welfare institution of limited
liability ("gGmbH"). This legal form agrees perfectly with the concept of a joint platform for
pre-competitive R&D projects funded by the
industry. The managing partners are Oldenburg
University and the Hörzentrum Oldenburg.
17
Hearing-aid systems interior view
Project I: "Hardware"
In this project hardware-related approaches are made
to optimise the transmission quality of hearing aids.
Among other things, the bandwidth, frequency range,
distortions, and feedback reduction are to be improved.
The integration of an active output signal control and the
enhancement of critical system components (e.g. sound
channel, receiver, microphone, amplifier, otoplastic) are
additional subjects to be treated.
Envisaged results and products
ä New hardware components to improve the sound
quality, comfort, and acceptance
ä Prototypes for hifi hearing aids as well as general
specifications for hifi hearing aids
ä Quantification of users' benefit
Results and products
ä Providing an optimised set of audiological methods
for efficiently characterising an individual patient
ä "Patient performance prediction" for an objective
assessment of the benefit that patients derive from
an optimal hearing-aid fitting
Project III: "Algorithms"
This project focuses on the development of suitable
algorithms (computer programs) for dynamic compression, interfering noise reduction, support of binaural hearing and situation-dependent signal processing in digital
hearing aids.
Hearing-aid-algorithm: processing model
ä Improved field-tested algorithms for recruitment
compensation (model-based), interfering noise reduction with situation-dependent control (classification of the acoustics and optimised combination of
algorithms)
ä Adjustment strategies for new algorithms
ä Implementation in prototypes as well as test results
in the laboratory and in the field.
Research hearing-aid
Project II: "Models"
By means of an optimised set of audiological
methods appropriate models are developed to predict
speech intelligibility without and with hearing aids. Their
implementation and evaluation then yield a basis allowing
a model for normal and pathological hearing to be formulated.
Project IV: "Efficiency"
The emphasis of this project is on methods to determine the cost/benefit relation of hearing-aid components and on the resulting implementations of an expert
system for supporting developments.
ä Inventory for evaluating system components in hearing-aid technology
18
The intelligent hifi hearing aid of the future
HörTech - Competence Centre for Hearing-Aid System Technology
Optimised supply of hearing aids, rehabilitation of hearing impaired patients
Project VI: "Services"
In this project the elements of hearing-aid fitting are
investigated, from which the quality of the hearing-aid
supply for a patient is derived. In addition, flexible strategies for treatment of patients with different forms and
degrees of defective hearing are developed, in order to
optimally employ the limited resources in the Public
Health Service.
ä Quality standard for hearing aid fitting
ä Cost/benefit functions for different fitting strategies
and for the elements of after-care and rehabilitation
ä Flexible concepts for fitting/rehabilitation
Adaptation or check-up of a hearing-aid
ä Expert system for a development scheme and develop-
ment control of hearing-aid system technology
Project V: "Fitting"
The purpose of this project is to advance and optimise audiological methods of testing as
components for fitting and verification
procedures on the one hand and the
investigation of factors influencing
those tests such as auditory training or
the acclimatisation of patients on the
other hand.
ä Optimised fitting of hearing aids
oriented by the current state of
hearing-aid technology
ä Procedures/methods for verifying
the success of fittings
ä Implementation in fitting software
Expert system as a basic for development
of hearing-aids
19
Development, Promotion, Application - New
Approaches in Medical Device Technology
imtc - INNOVATIVE MEDICAL TECHNOLOGY CENTER
HAMBURG
OUR OBJECTIVE
imtc GmbH (innovative medical technology center Hamburg) aims at enhancing the competitiveness
of the Hamburg economic area and its medical device industry. We are strengthening development and
marketing of innovative medical technology products. Thus, we
ä preserve and create jobs
ä promote business start-ups and spin-offs, and
ä enhance quality and efficiency of health care.
OUR APPROACH
Innovative are the ideas we support, innovative is also the way we go about organising our work. We
tend to arrange our thinking following the logic of medical device technology and hence transcend traditional boundaries between different medical fields. We ask questions like, "How may micro systems
technology contribute to improvements in orthopedics, gastroenterology, cardiology etc.?", and look for
cross-over insights. A second unique feature of imtc is our emphasis not only on technical but also on
economic viability of product ideas from their very inception. Thus, we try to provide solutions for a
demand felt by the patient rather than offer supplier-driven devices to be marketed with extreme effort.
OUR SERVICES
imtc GmbH seeks and supports people who come up with innovative solutions to medical engineering problems. Along the chain of value creation we offer a series of highly qualified services for researchers, developers, entrepreneurs and users, particularly in small and medium sized industries. Among
others we
ä
ä
ä
ä
assess product ideas
study both technical and economic feasibility, investigate market potential
procure development and implementation partners
provide advice on applications (e.g. how to draw up a business plan) and inform on financial aid
programs
ä establish investor contacts, consult on project planning and management, promote contacts for
clinical trials
ä assist in comprehensive quality management, as well as in patent application and property rights
protection
20
INNOVATIVE MEDICAL TECHNOLOGY CENTER
HAMBURG
A business start-up initiative vigorously supports the creation
of new companies in medical device technology.
OUR NETWORK
It is neither intention nor mandate of imtc GmbH to provide those services all on its own. Rather, we are building an
ever increasing network of cooperative partners and function as
an information clearing house for demand and supply.
In seminars, in workshops, and on information platforms we
promote the development of market oriented and economically attractive solutions in medical device technology.
We facilitate the encounter of cooperative partners and promote or co-host idea contests. The winners of the first contest
receive their awards in November 2000.
Contact address:
imtc GmbH
Dr. Georg H. Thiessen
Steckelhörn 9, 20457 Hamburg
Tel. + 49 (0)40/300 698-0,
Fax + 49 (0)40/300 698-77
http://www.imtc-hamburg.de
21
Kompetenzzentren Medizintechnik
Gemeinsam für Medizintechnik
im Wirtschaftsraum Hamburg
UNSERE GESELLSCHAFTER HEUTE:
Industrielle Investoren Finanzinvestoren
Freie und Hansestadt Hamburg
Innovation für marktfähige
Produkte anstoßen
PLATO-Gesellschaft für Planung in
Technologie und Organisation
BTG
Beteiligungsgesellschaft Hamburg GmbH
Gottlieb Weinmann - Geräte für Medizin
und Arbeitsschutz GmbH & Co
Joh. Berenberg, Gossler & Co. Berenberg Bank
Dienstleistungen anbieten wie
Qualitätssicherung und Markterschließung
Eppendorf - Netheler - Hinz GmbH
Implantcast Feinguss GmbH
Bauer und Häselbarth - Chirurg GmbH
Nutzen für Patienten, Arzt, Krankenhaus
und Kostenträger bewerten
Olympus Optical Co. (Europa) GmbH
Dräger Medizintechnik GmbH
GeroMed - Pflege- und
Medizintechnik Handelsgesellschaft mbH
M.M. Warburg & Co KgaA
Lithos GmbH & Co. KG
Techno Nord VC GmbH
Philips Medizin Systeme
BHF Bank AG
MABAG - Medizinische Apparate Bau AG
Pricap Venture Partners AG
Devon Medical GmbH
Handelsgesellschaft für Medizinprodukte mbH
Existenzgründung fördern Risikokapital bereitstellen
Waldemar Link GmbH & Co.
Fabrik chirurgischer Instrumente und Implantate
Beiersdorf AG
UEG - Unabhängige Entwicklungsgesellschaft
für Seed- und Startunternehmen mbH
DIE NETZWERKPARTNER
! AOK Hamburg
! Arbeitsgemeinschaft Medizintechnik in
Schleswig-Holstein
! Ärztekammer Hamburg
! Bernhard-Nocht-Institut für
Tropenmedizin
! Berufsgenossenschaftliches Unfallkrankenhaus Hamburg
! Deutscher Gewerkschaftsbund DGB
! Deutsches Elektronen-Synchrotron DESY
! Fachhochschule Hamburg
! GKSS Forschungszentrum Geest-hacht
GmbH
! Hamburger ExistenzgründungsProgramm hep
! Hamburger Initiative für Existenzgründungen und Innovationen H.E.I.
! Hamburger Verbund zur Verwertung
von Forschungs- und Entwicklungsergebnissen aus Hochschulen und
Forschungseinrichtungen
! Hamburgische Krankenhausgesellschaft
e.V.
Ideen in
Ideenwerkstatt
finden
! Handelskammer Hamburg
! HANSE-OFFICE
! Hochschule für Wirtschaft und Politik
HWP
! Industrieverband Hamburg ihv
! Innovationsstiftung Hamburg
! Institut für klinische Forschung und
Entwicklung ikfe
! Institut für Medizintechnik an der
Medizinischen Universität zu Lübeck
! Labor für Biomedizintechnik an der
Fachhochschule Lübeck
! Landesbetrieb Krankenhäuser (LBK
Hamburg) mit den Krankenhäusern AK
Altona, AK Barmbek, AK Eilbek, AK
Bergedorf, AK Harburg, Klinikum Nord,
AK St. Georg, AK Wandsbek
! MEDCERT Zertifizierungs- und Prüfungsgesellschaft für die MedizinGmbH
! Med-Netconsult
wirtschaftlichtechnische
Machbarkeit
prüfen
! Technische Universität HamburgHarburg
! TUHH Technologie GmbH
! Universität der Bundeswehr Hamburg
! Universität Hamburg
! Universitäts-Krankenhaus Eppendorf
UKE
! Verband der AngestelltenKrankenkassen VdAK
! Verband freier gemeinnütziger
Krankenhäuser in Hamburg e.V.
! ZVEI Zentralverband Elektrotechnik und
Elektronikindustrie e.V.
Markt
erschließen
und
Produkte
verwerten
Projekte
entwickeln
und
fördern
imtc GmbH
Geschäftsstelle: Steckelhörn 9, 20457 Hamburg
Tel. 040/300698-0 , Fax 040/300698-77
Geschäftsführer: Dr. Georg H.Thiessen
Internet: http://www.imtc-hamburg.de
22
Development, Promotion, Application - New
Approaches in Medical Device Technology
imtc - INNOVATIVE MEDICAL TECHNOLOGY CENTER
HAMBURG
OUR
ENVIRONMENT
Medical device technology is one of the leading sectors in the Hamburg economic area. Universities, hospitals and industries each provide excellent know-how and
competence in their respective fields. imtc serves as catalyst for an ever closer joining of forces within the
Hamburg economic area making use of the comparative
advantage of short geographic distance.
OUR
FINANCING
In the first five years of its existence imtc GmbH is
being financed by a grant from the Free and Hanseatic
City of Hamburg after which time enough revenue has to
supply the means for economic sustainability. A sufficient
number of high quality innovative medical devices will
provide an adequate return on investment. We will secure income by way of selling shares of start-ups and spinoffs, by disposing of patents and licenses, and by transferring the rights of marketable products. Only in very
rare cases we will provide credits and earn on rebates.
OUR FIRST
INVESTMENT
An interesting example of our mode of operation
during the pre-seed stage of a product is Vasa-Inject, a
project by VASATECH GmbH, a start-up company supported by imtc GmbH. Vasa-Inject is a device that allows
an appropriate vessel to bei identified for drawing blood
and to program the determination of adequate location,
angle and depth of punctuation and selection of an
appropriate cannula.
23
OUR
SHAREHOLDERS
imtc GmbH was formally constituted in January 2000,
having been conceptualised by a steering committee composed of representatives from the Departments of
Labour, Health and Social Welfare, of Science and
Investigation, and of Finance of the Free and Hanseatic
City of Hamburg, and from industry and finance. Three
syndicates each hold approximately a third of the shares:
medical device industries, financial institutions, and the
Free and Hanseatic City of Hamburg. The board of imtc
GmbH is composed of six persons, two representatives
from each consortium. A consultative committee staffed
by renowned specialists provides medical, technical, economic and financial advice.
Shareholders are shown in the illustration on the previous page.
OUR NETWORK
PARTNERS
Partners in our network are mostly hospitals and
scientific institutions, as well as a variety of associations
and federations, such as the Chamber of Commerce and
the Federation of Industries. Thus we are able to procure
for our clients partners in research and development, to
mediate in clinical trials, to provide business angles, and
offer many other services.
Our network of partners is also represented in the
illustration on the previous page.
Modern Prostheses for Improved Quality of Life
INPRO - Centre of Competence for Intelligent
Implants and Prostheses
Hundreds of thousands of paraplegics are living in Germany. Two hundred thousand people per year
suffer a stroke. Hundreds of thousands of people become victim of cranial injuries needing medical
treatments. For 3-4 million age and metabolism related diseases result in urinary and intestinal incontinence. Apart from neurological diseases especially cardiovascular diseases contribute to an increase in
the number of patients with physical disorder. The situation for the visual and hearing impaired is similar.
For all these people modern medical implants and prostheses - e.g. cardiac pacemaker, auditory
implants and cranial stimulators - can mean a significant increase in quality of life. In addition, the new
developments reduce cost in treatment and promote an earlier vocational rehabilitation.
Intelligent medical implants and prostheses are suitable for diagnostic, therapy, rehabilitation and substitution of disordered physical functions. The Centre of Competence for Intelligent Implants and
Prostheses "INPRO" takes advantage of the huge potential in the microsystem technology in order to
realise the second generation of implants. These can be defined as implantable microsystems with telemetric power and data transmission. Examples are
ä implantable intraocular pressure sensing systems,
ä fully implantable cochlear implants,
ä implantable bladder stimulators,
ä implantable cerebral pressure sensing systems and cranial stimulators.
INPRO focuses the potential in medicine, microsystem and information technology for the realization of intelligent implants and prostheses in order to significantly improve the possibilities in therapy
and diagnostics, to improve the quality of life of the afflicted and to reduce the consequential cost of
nursing and rehabilitation.
The core of the technical partners are departments of the
University of Duisburg and the Fraunhofer Institute of
Microelectronic Circuits and Systems (IMS). As an integral
part of the centre noted research oriented clinics in Germany
are responsible for the manifold medical applications.
Innovative companies accompany the products from the very
first idea to their commercialisation. Several experts assist the
centre in health economical aspects.
The cooperation of all of these different competences
guarantees product developments which will meet the requirements of the market and the users as well as the regulatory
affairs and health economics.
Miniaturised pressure sensors with integrated
electronics for medical use
24
INPRO
INPRO will promote synergies between the partners and
additionally works as an interface for engineers, users and
afflicted. The centre will supply implants and prostheses for
the following areas:
ä ophthalmology,
ä otorhinolaryngology,
ä cardiology,
ä urology,
ä neurology/neurosurgery.
The second greneration implants will be realised by new
developments as well as by further miniaturisation of existing electronics, sensor and actuator components. Telemetric power and data transmission will be an integral part
of these developments.
Cochlear implant with receiver unit
Resulting from projects which either have their focus on
product development or on research purpose, the centre creates specific technical and medical knowhow as well as innovative multidisciplinary technologies. Apart from the final products as a specific goal
of each project partial results will be generated for the use in a unit construction system. Modules of
this system can either be commercialised or used to create new intelligent implants. By this way timeto-market can be significantly reduced and the advantage in competition is guaranteed.
The final products are ideally suitable for small and medium size companies looking for business
fields in the hightech area. Partners from the "venture capital" field will be involved in time in order to
professionally promote company start-up.
In order to guarantee the quality and the goal of INPRO all projects and decision procedures are
subject to design and process control according to ISO9001. The acceptance of the products is ensured by involving the users and patient groups early during the development.
Contact address:
Coordinator:
Prof. Dr. G. Zimmer
Correspondence:
Dr. H.K. Trieu
Fraunhofer Institute of Microelectronic Circuits and
Systems (IMS)
Finkenstr. 61, 47057 Duisburg
Tel: + 49 (0)203/3783-0, Fax: + 49 (0)203/3783-266
25
INPRO offers the appropriate platform for interested users, engineers and entrepreneurs looking for
solutions in the field of intelligent implants and prostheses.
INPRO
Existing conservative treatments of physical disorders are from the medical
point of view unsatisfactory. Considering this status quo novel medical implants and prostheses will widely extend the possibilities of diagnostics, therapy and rehabilitation. In particular the quality of life can be improved and cost
in public health will be reduced due to lower cost of treatment and earlier vocational rehabilitation. Cardiac pacemakers, cochlear implants and cranial stimulators are already in successful clinical use. For the treatment of cranial injuries
and nervous diseases concepts and very first prototypes are existing. However
the clinical results are in these cases still unsatisfactory.
Implants of the second generation which are enabled by the rapid development in microelectronics and microsystem technology will allow to improve the
therapy significantly. In this context implantable microchips capable for measurement and control play a major role. Furthermore miniaturisation, telemetric
data and power transmission, new sensors and actuators as well as the integration of implantable adaptive closed loop control structures are characteristic
features of intelligent implants and prostheses.
The application field is manifold. For example implantable stimulators will
help a certain group of blind people to recover part of their vision, implantable
systems will continously monitor the intraocular pressure for patients with glaucoma and the cerebral pressure of patients with hydrocephalus. Implantable drug
delivery systems will help diabetes patients to apply their insulin correctly.
Improvements will be achieved for patients with nervous diseases by use of
implantable systems with sensory and motor functions. Furthermore these new
developments will have a stimulating effect on the clinical research.
Intelligent implants and prostheses will be of great aid for the home care.
By the use of these technical innovations the expenditure for nursing and the
cost for ambulatory and stationary treatments will be reduced in the future.
From the technical point of view the requirements of intelligent implants
and prostheses are comparable, despite their different application fields.
In working groups dealing with the topics sensors/actuators, signal conditioning/power and data transmission, biocompatibility/system stability, health
economics, marketing/spin offs/technology transfer, assembly/test/quality
management as well as interdisciplinary aspects of system integration knowhow will be generated and transfered. As an essential part of INPRO these
working groups ensure the transfer of information between the project groups
and hence support the R&D works. Their activities guarantee in a long term the
specific know-how for INPRO.
The working groups consist of members from the medical field as well as
from the technical field. This specific configuration helps to reduce the existing
communication barriers between scientists/engineers and physicians.
26
Modern Prostheses for Improved Quality of Life
INPRO - Centre of Competence for Intelligent
Implants and Prostheses
Apart from the R&D activities the supply of information and its transfer will play an important role for the
success of the centre. It's known that engineers in some
cases don't have the appropriate insight into the daily
situation of the users and that is why they run the risk of
failing the development goal. In addition many physicians
are not aware of what is already practicable from the
technological point of view in order to solve their medical problems.
Examples of such amazing technological achievements
are for instance microchips with 0.5mm x 5mm in size with
integrated electronics and miniaturised pressure sensors for
the measurement of the cerebral pressure or for intracorporal temperature detection. Microchips for flow measurement or for the detection of acceleration are existing. By
means of microsystem technology and micro electroplating
even three-dimensional microelctrodes for the stimulation
of nerves or for the recording of action potentials can be
fabricated. Implantable microcoils for use in transponders
are also available. The combination of microsensors/ actuators and transponder technology will open up totally new
application fields for intelligent implants.
The goal of INPRO is, hand in hand with users, engineers and patient groups, to focus the existing cutting
edge technological potential in Germany for the benefit
of public health.
Retina implant with encapsulation
27
Array of 3D microelectrodes for stimulation of nerves
Microcoil for transponder use
Reasonable Dentistry for Everybody
KITZ - Competence Centre for Innovative Technologies
to reduce costs in dentistry
A high-quality and therewith a high-price denture is no more affordable for everybody in future.
Manufacture of dental restorations needs many manual design steps by qualified staff. The costs to
manufacture crowns and bridges at the time can be reduced decisively by the use of CAD/CAM technology and by industrial production methods. At the same time the materials quality, precision of fit,
and the prognosis of lifetime will be enhanced. New methods such as caries prevention or the therapy
of craniomandibular disorders will lower costs and minimise the frequency of medical treatment.
Scientists from the "Zentrum der Zahn-, Mund- und Kieferheilkunde (ZZMK)" of the clinic of university Frankfurt will implement computer aided systems together with selected partners from industry
to reduce costs and save time.This will relieve dentists and dental technicans and will lead to better
results.
Dentists and dental labs are confronted with many new product developments each year. These new
product developments did not lead to a lowering of costs in the public health system. On the contrary,
the costs in dental labs to manufacture dentures were doubled nearly in recent years. In Germany there
does not exist an infrastructure with close interlocking of research institutes and partners from industry
for developing lower-cost products.
Therefore the "Zentrum der Zahn-, Mund- und Kieferheilkunde" of the clinic of university Frankfurt strives with partners from research institutes and industry for a public utility of a Competence
Centre for Innovative Technologies to reduce costs in dentistry.
The statutory health insurance expended 23.3 billions DM in 1997 for dentistry. This is more than
10% of the total expenses. Therefore there is a high interest for an infrastructure with close interlocking
of research institutes and partners from industry for developing lower-cost products. According to the
distribution of the expenses the competence centre will turn its attention to project, that lead to a pricereduction for dentures, followed by projects changing concepts in therapy in order to prevent consequential loss.
The partners of the competence centre decided to build up the centre even if the BMBF does not
sponsor the centre. The BMBF favoured this decision. The primary conception
ä to develop marketable products and
ä to search for concepts and materials that were concentrated primarily on a therapeutic long-term effect in the sense of Evidencebased dentistry
Contact address:
Universitäts Prof. Dr. Hans-Christoph Lauer
J. W. Goethe-Universität Frankfurt
Zentrum der Zahn-, Mund- und Kieferheilkunde (ZZMK)
Poliklinik für Zahnärztliche Prothetik
Theodor-Stern-Kai 7, 60590 Frankfurt a. Main
Tel.: + 49 (0)69/6301-5640, E-Mail: [email protected]
Topics of Centre
28
will be retained. But in consequence of the
lacking BMBF funding other ways are required.
Examples are advisory activities for industrial
research and development, information about
grants and issue of proposals, to compilate qualified partners. These activities will not be sufficient to finance the structure of the centre. The
partners try to get an initial financing from
public funds.
The partners of the competence centre come
from the clinic, research, dental industry and
mechanical engineering industry. They possess a
high competence in different subject areas and
are adept at interdisciplinary collaboration. The
partners coming from the dental industry have
excellent sales and marketing structures available
to dentists and dental labs. The quality management of the centre will induce external partners,
as health insurance, to enforce the premise of
cost reduction in dentistry.
Long-term the competence centre will place
at the disposal as contact and developer in nearly all problems implementing innovative technologies in dentistry. The product development
will give in addition to cost reduction, will contribute to preservation and creation of new jobs.
29
The projects will be financed by suited grants.
The projects are partitioned in three thematic
groups:
ädigital dentistry,
ätechnical innovation and
äprevention.
There will be built up a process chain for the
fully automatic manufacture of crowns and
bridges having a biofunctional occlusal surface.
Optimising the dentures geometry will lead to a
considerable enhancement in lifetime of the
denture. Caries and other dental damages will be
detected by a new method of intra oral scanning.
The improvement in therapy of craniomandibular disorder will help to reduce headache and
facial pain. New concepts for lingual attachments of brackets will lead to a wide acceptance
by adults for orthodontic treatment. A novel
thermal chemical method will give shelter to the
enamel and so lead to a minimisation of caries.
Digital Dentistry
Project 1: CAD/CAM-assisted manufacture of
dental restorations
Costs in dental medicine have risen dramatically in
recent years. Whilst the cost of the treatment carried out
by the dentist has risen only slightly, laboratory costs have
doubled. The main costs are incurred by the labour-intensive operations performed by the dental technician.
Because of the manual nature of the work, the quality of
the inlay fillings, crowns and bridges, is not uniform.
Over the past three decades, various approaches to rationalising and optimising manual, dental single part production with the help of industrial processes have been
developed. To date, these have all focused on CAD-assisted design and forming operations based on CAM technology.
The dental CAD/CAM systems currently used are not
capable of designing or manufacturing dental restorations fully automatically. Some systems have, however,
been able to establish themselves on the market purely on
the strength of the fact that they reduce the problem.
These systems are restricted to inlays or crown or semifinished goods (copings), which must be completed in a
conventional, manual operation. This additional time
required of qualified personnel has until now prevented
any real cost savings from being made.
The objective of this project is to achieve a substantial reduction in the current manufacturing costs of
crowns and bridges and, at the same time, to increase the
material quality and precision of fit in order to enhance
the service life expectancy. The process chain to be developed consists of the components measurement system,
design, material development and manufacture. The
development tasks will be concentrated within the project
on achieving fully automatic mass production of single,
unique parts - crowns and bridges.
An extra-oral measuring device reproduces the surfaces of jaw and tooth models precisely and fully automatically. CAD software accepts the measuring data and
designs the dental prostheses without interaction. The
latter is made possible by the simulation of the procedure
carried out by the dental technician - iteration and functional adaptation. A bio-compatible, tooth-coloured
material will be developed on the basis of innovative dental material, in order to ensure rational and economical
machining processes. Optimised machining strategies
with multi-axial milling machines will be developed
accordingly. To conclude the project, the machine-produced dental prostheses will undergo clinical trials.
The fully automatic process chain envisaged has the
potential to emerge as an innovative product with a very
high level of socio-economic relevance. In the year 1997
alone, the obligatory health insurance companies paid for
approx. 6 million crowns and partial crowns.
Technical Innovation
Project 2: Computer-assisted techniques for analysing failure probability and the life time distribution of all-ceramic crowns
The aim of the project is to develop and to validate a
computer-assisted analysis procedure for the lifetime
assessment of all-ceramic crowns. The numerical simulation technique to be developed is based on a combination
of engineering and medical expertise. It is envisaged that
the option of a straightforward, selective change in parameters should be used for the identification of influence
factors due to material characteristics, crown geometry
and the type of attachment used. This will reduce cost
and the frequency of medical treatment.
Project 3: Optical characterisation of dental hard
tissue and dental restoration materials
Virtual Crown
The project will deliver a database of the optical properties of natural teeth in a parametric form, based upon
absorption and scattering coefficients and the anisotropy factor. The project will open the door for a deeper under-
30
Reasonable Dentistry for Everybody
KITZ - Competence Centre for Innovative Technologies
to reduce costs in dentistry
Fluorescence picture of a tooth
standing of the
optics of dental
hard tissue for diagnostic procedures. Mathematical tools will be
optimised to describe and predict
the optical properties of dental restoration material
i.e. ceramic. This is
the basis for any
automatic shading
and colour adaptation process
Project 6: Caries prevention by laser assisted
heating and fluoridation
The basic idea is to combine thermally induced superficial enamel modification with fluoridation. Laboratory
research has shown that a reduction of the acid solubility of
dental enamel can be achieved by heating (Er:YAG-laser).
There are indications of a synergistic effect of heat and fluorides on enamel solubility. That could lead to an acid resistance not reached so far.
Project 4: Intra-oral scanner system for threedimensional measurement of the oral cavity
A high-precision intra-oral scanner presents the
option of producing a data record directly from the original. This eliminates the errors of an extra-oral scanning.
This improves the input data for dentures which are produced using a CAD/CAM system. This enhances the
precision of the denture.
Prevention
Project 5: Early detection and initial treatment
of craniomandibular disorders
In the United States for each 100 million workers, 17.8
million working days are lost because of craniomandibular disorders of the masticatory systems (CMD). Current
studies representative of the whole population have
shown that the CMD-related treatment need amounts to
3.2% of the adult population in Germany and 3.6-7.0%
of the adult population in the U.S. The therapy of CMD
patients who often suffer from headaches or facial pain
symptoms usually requires a multidisciplinary therapeutic
approach requiring the cooperation of various specialisations in medicine and dentistry. Occlusal splint therapy is
minimally invasive and may help avoid TMJ surgery or
reduce the use of analgesics which are expensive and have
a potential for abuse. The objectives of this project are
the further improvement of a diagnostic concept for
early detection of CMD and the improvement, streamlining and cost reduction of the process and material
used in occlusal splint therapy.
31
Reduction of acid solubility of dental enamel as a result of Laser
assisted heating (corrosive picture)
Project 7: Reducing the cost of lingual orthodontic treatment techniques by using innovative,
pre-fabricated attachments
The objective of this development program is to facilitate the lingual treatment by constructing and manufacturing innovative brackets and tubes. The anticipated
time and cost reduction for the orthodontist should be
the factor 5. At the same time specific shaping of these
brackets can enhance the patient's comfort and the tongue motion and speech function is less hindered. The
cost for lingual orthodontic treatment will be lowered
considerably.
Gentle waves instead of harsh X-rays
KMR - Kompetenzzentrum Medizintechnik Ruhr
Medical ultrasound is indispensable in many clinical applications. In the region of Bochum
(Germany), new applications for ultrasound are under investigation.
The "Kompetenzzentrum Medizintechnik Ruhr" (KMR), a centre of competence for Medical
Engineering located in Bochum, is established by the Ruhr University Bochum and the
"Technologiezentrum Ruhr", residing on the university campus. Other existing medical companies, institutes, service and health care providers of the region also participate in this centre. The main focus of
this centre is medical ultrasound.
In this field there are three main topics:
The first topic 'tissue' deals with the non-invasive, image-based diagnosis of biological tissue. Special
signal processing and pattern recognition methods will be applied and combined with new non-ionizing
imaging methods. New methods and medical equipment will contribute to the improved, non-invasive
early detection of cancer diseases, such as skin or prostate cancer.
Those subjects are of great medical and socioeconomic interest.
32
This also applies to the second topic, 'vessels'.
Here, improved methods for vessel imaging and
diagnosis in the fields of cardiology, angiology
and neurology will be developed. The main
focus is on the early detection of atherosclerosis,
therapeutic intervention (stents) and stroke diagnosis.
In the third topic 'navigation', further applications of ultrasound for interventional neurosurgery as well as spinal and traumatologic surgery
will be investigated. The planned concepts will
further reduce the grade of invasion and the
intraoperative radiation exposure for patients
and physicians.
Besides high frequency ultrasound, real time
elastography will play an important role in all of
these fields. This method, developed in Bochum,
visualises the 'hardness' of tissue (nodules,
plaques) in addition to conventional ultrasound.
First clinical trials of this method showed
encouraging results.
Contact address:
Prof. Dr.-Ing. Helmut Ermert
Ruhr-Universität Bochum
Institut für Hochfrequenztechnik
Gebäude IC 6/132, D-44780 Bochum
Tel.: +49 (0)234/3222842,
Fax: +49 (0)234/3214167
http://www.kmr-bochum.de
33
Furthermore, the existing competence of
KMR partners in computer vision will be utilised
for new concepts of ultrasound imaging, especially with objects that move or alter in shape.
The cooperating partners of KMR come
from research institutes, businesses and health
care institutions. Besides research activities, the
centre will also deal with other aspects, such as
consulting and financing of startup companies.
Using the potentials of quality management the
centre will consider the distinctive features of
the ultrasound realm, the market and legislation.
Thus the complete spectrum from teaching and
research to marketing and application of
methods in the field of medical engineering will
be taken into consideration.
The main purpose of the projects are the
improvement of image quality, the 'intelligent'
processing of unused ultrasonic signal information, development of new imaging modalities,
the combination with other methods and the
investigation of new applications. The innovative approaches and methods are shown in the
following figure, which also illustrates technical
progress and the assignment of methods to different applications.
Topic 'Tissue':
In early detection of prostate cancer the determination of the prostate specific antigen (PSA) and palpation
are only an imperfect gold standard. Ultrasound in conjunction with elastography is a promising approach for
this application. With skin cancers, especially the malignant melanome, high frequency ultrasound forming a
sensor fusion with optic imaging can be a powerful
screening concept for early cancer detection. High fre-
quency ultrasound was already tested in differential diagnosis and surgery planning. Endoscopic application of
high frequency ultrasound offers new ways of tumor diagnosis of the mucous membranes in the oesophagus, stomach and intestines. High frequency ultrasound can also
be used for the validation of new imaging modalities,
such as optical coherence tomography (OCT).
34
Gentle waves instead of harsh X-rays
KMR - The Projects
Morphologic ultrasound image (100 MHz) of a malignant melanome with histology (right)
Topic 'Vessels':
Recent results show the potential of high resolution
ultrasound as a method for the early detection of atherosclerosis. With vascular diseases it can also be applied for
diagnosis, therapy preparation and control and for the
validation of therapy methods. Therefore, ultrasound is
also an important tool in the development and optimisation of vessel implants (stents). As with the topic 'Tissues',
ultrasound can also be used for the assessment of new
imaging modalities. In this case intravascular ultrasound
(IVUS) can be used for characterisation of soft and calcified plaques and for the validation of multislice cardio
CT imaging. New signal processing methods for imaging
with ultrasound contrast agents permit a more detailed
visualization of brain perfusion and aid in improving transcranial sonography for stroke diagnosis.
Topic 'Navigation':
Brain perfusion image. Image depth 10 cm
35
In combination with interventional measures (surgery,
minimal invasive technologies) there is a high demand
for ultrasound as a supplemental image modality for
intraoperative diagnosis and navigation. Technical potentials in this field are not fully investigated yet and are a
motivation for the activities planned by this centre.
Besides that, both patients and surgeons will benefit
from this approach and health care costs can be decreased. The use of ultrasound as a navigation modality will
also greatly reduce the grade of invasivity and the intraoperative radiation exposure.
Cell Monitoring Systems (CMS)
Medical Microsensoric Centre of Competence
- Microelectronics Meet Medicine Cells are full of life they produce proteins and energy, and they communicate vividly with neighbouring cells and their environment. Many diseases are based on malfunctions of the cells metabolism.
With the help of todays state-of-the-art microelectronic devices and miniature sensors a variety of
important metabolic processes can be measured.
In a collaboration with the technical University of Munich, the University of Rostock succeeded in
the development of a new monitoring system for cells (called CMS), which effectively analyses numerous
metabolic processes, electrical activity as well as the morphology of cells and cell cultures. Application
areas for this combination of semiconductor technology and cell physiology are e.g. tumor diagnostics
and therapy, as well as metabolic diseases or the proof of bacterial contaminations.
The main objective
of the centre of competence is to demonstrate the considerable improvement of clinical diagnostics and therapy possible in
many areas in case microsensor-arrays will be used for monitoring
of complex clinical states.
The theme
of the consortium is within the promising field of analytic chip
technologies and biosystems technology.
Biosystems technology applies itself to the contact zone between
Tumor cell on microsensor
ä cell biology (biomolecules, cells, and tissue) and
ämicrosystems technology (semiconductor technologies, nanotechnologies, microelectronics, sensorics).
Contact address:
Dr. Werner Baumann
Prof. Dr. Bernhard Wolf
Prof. Dr. Dieter Weiss
Institut für Zelltechnologie e.V.
an der Universität Rostock
Friedrich Barnewitz Str. 4, 18119 Rostock
Tel.: +49 (0)381/498 1970
Fax: +49 (0)381/498 1975
Email:
[email protected]
Prof. Dr. Bernhard Wolf
Heinz-Nixdorf-Lehrstuhl für
Medizinische Elektronik
Technische Universität München
Arcisstr. 21, D-80290 München
Tel.: +49 (0)89/289-229447
Fax: +49 (0)89/289-229450
http://www.cell-meets-silicon.com
36
Partners:
Rostock and Munich are in Germany leading
locations in the area of biosystem technique. This is
documented by
ä local companies
ä the Research Centre for Biosystems Technology
at Rostock
ä the "Rostock Innovationskolleg" Complex and
Cellular Sensor Systems
ä the special dedication of professorships (e.g.
Heinz-Nixdorf-Lehrstuhl für Medizinische
Elektronik at the TUM) and
ä the new branch of study "biosystem technique"
at the University of Rostock.
In cooperation with a producer of semiconductors considerably experienced in mixed signal
CMOS systems microsensor chips in standard process-techniques are being developed and evaluated,
and can therefore be provided in good quality to a
broad number of applicants in research and economics.
Multisensor microchip in standard IC ceramic carrier.
On the right hand side with cell culture trough and flow head
37
Under the introduction of innovative processes based
on semiconductor chip technologies a new quality level
can be achieved in critical areas of clinical diagnostics and
therapy (tumor diagnostics and tumor therapy, sepsis,
hepatic coma, diabetes, and other metabolic diseases) and
clinical hygiene.
The multiparametric online monitoring in cells and tissue under the use of multiparametric semiconductor
chips is here of particular importance.
The application of semiconductor technologies can
realise inexpensively and with large reliability microphysiological sensors for the work with living cells, allowing
for the first time a non-invasive, multiparametric longterm registration of functionally specific signals with high
precision and opens perfect new possibilities in cell research by that.
Neuron network on semiconductor multielectrode array
The establishment of innovative and cost-saving technologies in the health service becomes possible through
the synergy effects in the Medical Microsensoric Centre
of Competence (connecting partners of the entire valuecreating chain beginning from the development over production up to the clinical application).
The desired close team cooperation between the branches with the regional and interregional industry is guaranted by the selection of partners and by supporting activities at the biosystems technology location Rostock.
The appropriate competency (patents, certifications,
legal questions, validations) is excellently covered by the
wide range of working areas of the centre members.
Neuron network on semiconductor multisensor chip
38
Cell Monitoring Systems
Medical Microsensoric Centre of Competence
- Microelectronics Meet Medicine The Centre of Competence concentrates on three
central projects at the moment, which - according to
international evaluation - are characterised on the one
hand as having a high socio-economical importance in
health service and on the other hand as expecting due to
already realised preliminary work of project partners of
the consortium a full development up to the distribution
of products within the next years.
Emphasis projects:
1. Tumor diagnostics and tumor therapy
2. Hybrid cell-silicon-monitoring system for
metabolic encephalopathies
3. Detection and prevention of biofilm and
bacterial contamination
Following projects:
Middle or longer term following projects based on
parts of developments of emphasis projects guarantee an
innovative further development of the centre.
The competence in the centre which has grown over
a long period of years based on the preliminary projects
as well as the co-operating partners guarantee a lasting
dynamic further development. Already today there is a
large demand for the different systems and product
groups, so that also further companies will be founded
around the centre. Appropriate patent applications secured already early the distribution rights of the hitherto
existing innovative systems.
1. Micro-drug-delivery systems for tumor therapy
2. Telematic systems for decentral patient
monitoring
3. Multiwell tester for functional pharmascreening
The single components of the respective systems are
modularly fitted in the next highest systems based on
these components. The semiconductor structures for
instance were developed to be of use in the area of diagnostic products as well as in micro-drug-delivery
systems.
Layout of multiwell plate with microsensor chips integrated
39
High-tech for the heart
Centre of Competence Cardiovascular Implants
MEDIMPLANT
The Centre of Competence Medimplant bundles regionally existing inter-facultative scientific and
technical competence in the field of therapeutical effective cardiovascular implants. Thus the organisational, scientific and technological requirements for a quick, innovative, demand-orientated development
of implants are improved.
In the phase of set-up, the Centre of Competence concentrates on therapeutically effective implants
with an extended functional duration, a lower relapse rate and new claims to compatibility and effectiveness. At this analytical aspects play a role, e.g. the evaluation of long-term demand, social, ethical and
legal aspects and potential impacts of new medical technologies with regard to safety, effectiveness and
risk-benefit-relationship.
The regionally existing inter-facultative know-how is applied to the following topics:
ä
ä
ä
ä
ä
ä
inclusion of existing technological potential
fullfilment of requirements for preclinical trials and validity tests appropriate for approval
timely patent application
an early risk-cost-benefit assessment
focussing the available and future capacities of personnel and materials
the primary involvement of qualified high-performance industrial partners.
The Centre of Competence Medimplant is not only organizer and coordinator of these tasks, but
should also create the groundwork for the projects themselves by setting up functionally independent
units e.g. a cardiovascular animal laboratory or a laboratory for biocompatibility assessments. In addition
it should install a system of independent future work units as well as an organizational and functional
structure. The Centre of Competence should be developed long-term, e.g. beyond the funding period,
to a centre of science and technology in the field of medical implants.
The most important points are:
ä use of the ideas derived from clinical
application and activity
ä expansion of the financial basis
through start up companies and
licencing.
The bioreactor is used for storage of vessels and heart valves,
for decellularization, for reseedimg and for transport
40
Institutions involved in the period of foundation:
ä Hanover Medical School, University of
Hanover, Veterinarian School Hanover
ä German Research Centre for Biotechnology
Cooperating academic institutions:
ä Institute for Biomedical Engineering
(University Erlangen/Nuremberg)
ä Institute for Biomedical Engineering
(University Rostock)
ä Institute for Macromolecular Chemistry
and Franz Patat Institute for PolymerChemistry (Brunswick)
Biodegradable stents based on magnesium alloys. Modification of
tissue reaction by coating with bioactive substances.
ä Harvard Medical School and Massachusetts
General Hospital Boston, USA
Industrial partners in the period of foundation are
ä Institute of Experimental Audiology
(University Münster)
ä
ä
ä
ä
ä
ä
ä Institute for Medical Informatics, Biometry
und Epidemiology (University Munich)
Contact address:
Prof. Dr. Bernd Heublein
Leibniz Research Laboratories for Biotechnology and
Artificial Organs;
Cardio-Thoracic Division
Hannover Medical School
Podbielskistraße 380, D - 30569 Hannover
Tel.: +49 (0)511/906 3553, Fax: +49 (0)511/906 3569
41
Jostra, Hirrlingen
Biotronik, Berlin
Devon-Medical, Hamburg
Laser Centre, Hanover
Nitinol Medical Technologie, Boston, USA
Ethicon, Norderstedt
The concrete product-oriented research and developmental projects of the Centre of Competence Medimplant Hanover are assigned to three main topics:
ä the development of partial or complete degradable
implants for arterial and venous vessels
ä the development of partial or complete cardiovascu-
lar implants consisting of organic components with
methods of tissue engineering
ä the comprehensive focus on the innovation-oriented
evaluation of the technology of cardiovascular
implants.
reaction not interfering with growth. Since the process of
degradation is controllable through the suitable selection
of implant components, these implants facilitate possibilities to release one or more drugs (or cells with suitable
information) locally and over the limited period of degradation. Thereby, the implant is only the degradable
mechanical carrier of a likewise degradable drug containing polymer or is simultaneously a drug, as inherent implant-components can be released during degradation
and be locally active.
Based on extensive preliminary investigations, therefore, the development of temporary implants on the
basis of metallic alloys is supported in the Centre of
Biocorrosion
Stent
Biocompatibility of Mg-stents:Complete
endothelialisation after 4 days
Occlusion system
Electron microscopy, 200- and 1000 x magnification:
confluent endothelialisation of degradable stents
Coating
Cell Seeding
HE-histology (4 weeks after coronary implantation without HAcoating (left) and with HA-coating (right)
Permanent implants
Permanent implants in the therapy of common vascular diseases are linked with some disadvantages for the
patient. For example the lack of adaptation to growth
(e.g. diseases at infancy), the permanent irritation of the
vessel wall and linked unwanted tissue reactions, the
inadequate mechanical adaptability to the surrounding
tissue particular in moving organs and the limitations of
potential necessary for newer diagnostic possibilities (e. g.
in neuroradiology).
Degradable implants with a sufficient biocompatibility could represent a substantial improvement. They fulfill
their function as long as it is required and induce during
the process of degradation a local endogenous tissue
Tissuecoating of a normal ( left) and with autologous cells preseeded system (right) after 30 days in vivo.
Competence. Due to the varying requirements on the
alloys e.g. mechanical qualities, degradation rate, technology of production but also on the intended operational
area (stents or occluders) two different groups of alloys
based on magnesium and iron are used.
The objectives are innovative, degradable stents for
use in coronary and peripheral arterial and venous vessels,
implantable systems for induced vessel-occlusions and
completely degradable implants or implant-hybrids as
occluders for inborn septum defects of the heart.
42
High-tech for the heart
Centre of Competence Cardiovascular Implants
MEDIMPLANT
Implants composed of organic components by methods of tissue engineering
The optimal substitution of diseased or destructed
tissue and parts of organs (e.g. heart valves, vessels, vessel valves) results from autologous cells. If form and function of the reproduced tissue can be obtained in the laboratory or in the living organism by suitable methods with
the necessary functional stability, the implant efficiency
will be expected to be much higher by this "borrow from
nature" concept. Besides especially developed reactors
for cell and tissue growth (bioreactors), novel degradable
polymers or natural matrixes are substantial requirements
for being successful.
Based on extensive experiences in the field of cardiovascular "tissue engineering", four (preliminary) project
lines are promoted in the Centre of Competence. They
are methodically closely linked and they can, already in
the process of development, use important practical
know-how from direct clinical contact (application, animal experimental evaluation of the concept, long-term
examination with appropriate methods, etc.).
One main focus of the Centre of Competence in the
phase of foundation is the improvement of key technologies. The development of a bioreactor adapted to the
special requirements of the future operational area is one
main point (cardiovascular bioreactor).
Product-oriented projects are the development (and
pre-clinical testing phase) of small calibre arterial vessels
based on a xenogeneic starter matrix, the development of
valved venous conduits for the therapy of patients suffering from chronic venous insufficiency and the development and pre-clinical test of a biodegradable heart valve.
Autologous cell-seeded vein valve for surgical implantation in
the v.femoralis
Innovation-related evaluation of the
technology for cardiovascular implants
In another, separate oriented focus, implant technologies are analysed and evaluated. This innovation-related
evaluation of technology (health technology assessment)
considers questions of safety, efficiency, cost-benefit ratio
and includes social, ethical and juridical aspects. This proMethod
Expert contact
Case study / paralleling
Analysis of epidemiological
and other data
Survey
Literature review / systematic
review
Delphi study and related
designs
Modelling / decision analysis
Type of problem to be addressed
Needs
safety / risk efficacy
indication costs / costassessment
effectiveness
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Methods available for innovation-related evaluation of technology
43
Biopolymer heart valve device after seeding with myofibroblasts and
endothelial cells.
ject accompanies the above-mentioned projects of the
Centre of Competence, and furthermore develops independently general guide lines for an evaluation of the
technology of cardiovascular implants based on scientific
data and knowledge as a support for decision making in
public health policy, self-administration, for the advisory
boards of the government, for institutions and, of course, for the developing biomedical industry.
Large Operations with Small Cuts
Minimally Invasive Medicine & Technology Tübingen - Tuttlingen
A network of sience and economy to allow further development of technology
for minimally invasive surgery and to secure international competitiveness
Instrument Systems
Manipulator
Systems
System
Integration
NeuroEndoscopy
Applications in
MR-Tomographs
Minimally invasive medicine
Minimally invasive medicine which is being
applied in all operative disciplines today has undergone a rapid progress and has revolutionised the
entire healthcare system in no more than 15 years.
Less straining ambulant operations reduced,
for example, the patients' times of stay in the clinic, thus leading to a considerable saving of
money. In connection with the high acceptance of
this technique from the patients' side, a high
potential of growth for the next 10 years can be
expected for products such as instrument and
camera systems, imaging techniques, specially created implants and components for microsystem
technology.
Industry
A worldwide unique concentration of 400
companies from industry and trade which
manufacture surgical instruments has developed
in the Tuttlingen area during the past 130 years.
During the recent 15 years, these mostly small
and medium-sized enterprises have developed
new products for applications in minimally invasive medicine, among others. This process was
strongly supported by workgroups from the
Tübingen university clinic and the Stuttgart university. However, there was no systematic interconnection of medical, technically scientific, and
industrial partners.
44
The centre of competence
These facts became the foundation on which
the centre of competence "Minimally Invasive
Medicine & Technology Tübingen-Tuttlingen"
was built up by
ä the Tübingen university clinic (UKT)
ä the German institute for textile and fibre
research Stuttgart
ä the Stuttgart university
ä the Karlsruhe Research Centre
ä the Chamber of Industry and Commerce
Schwarzwald-Baar-Heuberg (IHK) and
ä representatives of industry and trade from
the Tuttlingen area together with various
institutes of technology and materials
science.
The aim of this centre of competence is to
combine the existing experience and ability in
the area of Minimally Invasive Medicine to form
an interdisciplinary network. The common target is both to overcome the handicaps resulting
from the size of small and medium-sized firms,
and to create the prerequisites for mutual, precompetitive research and development.
The selection of research and development
projects, e.g. based on economic criteria in
healthcare, contributes to the fact that especially
export oriented enterprises of medical technology will ensure their international competitiveness. Bearing this fact in mind, the centre of
competence makes a contribution to secure existing and to create new jobs in a branch which is
characterised by a constant technological change.
The centre will also support the foundation
of new enterprises. The basis for this effort are
the corresponding supportive measures of state,
45
municipalities, chambers as well as special university programmes on the one hand, and risk
capital funds of regional financial institutions on
the other. Outsourcing is supported by the cities
of Tübingen and Tuttlingen which make areas
available which can be bought or rented for a
favourable price.
Realisation and orientation
For definite realisation of the plan, permanent service points will be set up in Tübingen
and Tuttlingen, which will give advice to all participants but which are also open to enterprises
outside the core area of Tübingen-Tuttlingen.
An internet application tailored to the specific
needs of the partners will serve as information
pool and discussion forum.
The service points accompany and optimise
the development processes for medical instruments or procedures from the innovative idea up
to clinical evaluation, quality assurance and training of the users.
During the start-up phase, the subjects are
focussed on development via application research up to clinical evaluation; examples are
multifunctional systems, micro-endoscopy,
manipulator systems and visualising instruments.
Contact address:
Prof. Dr. H.D. Becker
Universitätsklinikum Tübingen
Hoppe-Seyler-Str. 3
72076 Tübingen
Tel. + 49 (0)7071/29-86620
Fax: + 49 (0)7071/29-5588
www.kompetenznetze.de
Minimally invasive surgery is a widespread technique
in the area of standard surgical interventions. For complex surgical operations, minimally invasive surgery is not
so often the technique of choice because of the technical
drawbacks of today's instruments. Special problems are:
ä
ä
ä
ä
ä
Restricted vision
Limited mobility of instruments
Missing tactile feedback from the tissue
Insufficient intraoperative imaging
Insufficient integration and combination of various
technologies in the modern operating theatre.
Areas of development
Visualising instrument systems
Many different medical operations are planned exactly and carried through by the aid of imaging procedures
such as computer tomography, ultrasonic diagnostics, and
nuclear spin tomography. During these procedures the
success can be observed by a direct feedback of information.
Based on the good (3-dimensional) representation of
soft tissue, without the exposure to radiation, nuclear spin
tomography has the best chance for the development of
relevant therapy methods.
For example, the performance and success of a thermal therapy for the healing and pain-relieving treatment
of tumours in the liver or the pelvic area can be controlled in a much better way. Nuclear spin tomography can
also make a valuable contribution to microsurgical interventions or the insertion of stents.
Instruments which neither disturb the imaging in the
tomograph nor are subject to the strong, safety affecting
magnetic forces, must still be developed.
Instruments
which neither disturb the imaging in
the tomograph nor
are subject to the
strong, safety affecting magnetic forces,
must still be developed.
MR-Monitoring of a HF induced
thermal therapy of liver metastasis
Manipulator systems for minimally invasive surgery
Minimally invasive methods which, concerning the
use for the patient, are superior to the traditional open
surgery were developed in many areas. This is especially
true for standard operations such as the resection of the
gall bladder (cholecystectomy). The major weak point of the
existing endoscopic instruments is the restricted mobility
inside the human body. This makes complex operations
difficult or impossible, especially in microsurgery.
First prototype of a surgical manipulator
New instrument systems which allow a better access
to the patient because of a higher number of degrees of
freedom will promote the development of the minimally
invasive surgery also for more complex operations.
Instrument systems for the minimally invasive
surgery in the area of head and neck
Minimally invasive, endoscopically-assisted surgical
procedures have replaced open surgery in many areas.
The prerequisite for using these procedures is normally
the access through existing cavities in the body (e.g. abdomen, hollow organs, joints).
So far, this means a considerable restriction of potential areas of application. Consequently, the development
of an instrument system which gives access to the human
body where there are no preformed cavities has top priority.
46
Large Operations with Small Cuts
Minimally Invasive Medicine & Technology Tübingen - Tuttlingen
Innovations for neuro-endoscopy
Minimally invasive, neuro-endoscopic methods have
been increasingly applied for special diseases of the central nervous system during the past years. They partly
replaced or at least supplemented microsurgical operative
techniques. In order to promote the application of these
techniques, the equipment for realisation (neuro-endoscopes) and planning (virtual endoscopy) must be improved. Moreover, it is necessary to develop special instruments, e.g. for spinal therapy.
ä
ä
Multi-functionality and system integration in
minimally invasive surgery
The available concepts for a central control and monitoring of the numerous individual systems which are
required in an operating theatre are not complete and,
most of all, not prepared for a modular expansion. For
example, neither a digital image documentation nor corresponding possibilities of computer-assisted diagnosis
are integrated. The development of new materials and
components aim at a better multi-functionality and integration of systems, especially in the area of endoscopic
imaging and instruments.
ä
ä
ä
ä
The Founders
University Clinic Tübingen:
Surgical Clinic [Prof. H. D. Becker] with Section of
Minimally Invasive Surgery [Prof. Dr. G. Bueß]
Gynaecological Clinic [Prof. D. Wallwiener]
Department for Radiological Diagnostics
[Prof. C. Claussen]
Clinic for Oral, Jaw, and Face Surgery
[Prof. S. Reinert]
Department of Neuro-Surgery [Prof. E. Grothe]
Institute for Medical Information Processing
[Prof. H. K. Selbmann]
Chamber of Industry and Commerce
Schwarzwald-Baar-Heuberg:
ä For industry and trade in the Tuttlingen area, repre-
sentative of the interests of the Chamber of
Handicraft Konstanz and the Chamber of Industry
and Commerce (IHK) Reutlingen.
Stuttgart University:
ä German Institute for Textile and Process Engineer-
ing Denkendorf (ITV) and BMOZ
[Prof. H. Planck]
ä Institute for control engineering for machine tools
and production equipment, robotics, and sensorics
[Dr. K.-H. Wurst]
ä Institute for Machine and Transmission Construction
[Prof. H. Seeger]
Research Centre Karlsruhe:
ä Institute for Microstructure Engineering (IMT)
Model system of an integrated OP including the components to
be cross-linked
47
[Prof. V. Saile]
ä Institute for Medical Engineering and Biophysics
(IMB) [Director of Medical Engineering
Dr. H. Fischer]
Protection and aid with modern technology
Miniaturised Monitoring and Intervention Systems MOTIV
The Fraunhofer Institute for Biomedical Engineering (IBMT) in St.
Ingbert and the Laser- und Medizin-Technologie GmbH (LMTB) in Berlin
have established the nationwide Competence Centre for Miniaturised
Monitoring and Intervention Systems (MOTIV).
Both institutions have gained long term experience in the field of biomedical technology covering a spectrum from research and development
to device prototyping and services. IBMT and LMTB combine in MOTIV
the following structures and expertise:
Berlin
St. Ingbert
ä
Ultrasound technology (IBMT) and laser technology
(LMTB) in the fields of therapy / therapy control as
well as in endosystems
ä
Clinical therapy, diagnostics and monitoring
methods (LMTB), combined with communication
structures and networks in ambulatory and homecare environments (IBMT)
ä
Complementation of accredited laboratory for
medical devices (LMTB) with standardized processes after ISO 10993 for the examination of
cytotoxicity of materials and active implants (IBMT)
leading to a better quality assurance
ä
Access to a wide network of clinical partners with
outstanding competence in the regions Berlin/
Brandenburg (LMTB), Mannheim/Heidelberg
(IBMT) and Saarland (IBMT)
Contact address:
Prof. Dr. Jörg-Uwe Meyer
Fraunhofer-Institut für Biomedizinische Technik
Ensheimer Straße 48
D-66386 St. Ingbert
Tel. + 49 (0)6894/980-150
Fax: + 49 (0)6894/980-400
e-mail: [email protected]
http:///www.kompetenznetze.de
Prof. Dr.-Ing. Gerhard Müller
Laser- und Medizin-Technologie GmbH, Berlin
Fabeckstr. 60-62
D-14195 Berlin
Tel: + 49 (0)30/844923-0
Fax: + 49 (0)30/844923-99
e-mail: [email protected]
48
The Competence Centre MOTIV combines
its dual regional technical infrastructure and
competence with nationwide cooperation structures for identifying innovative medical projects
with great market potential and for sustained
support of these projects. MOTIV supports
research and development efforts in the following biomedical areas:
ä Therapy/Therapy Control
ä Ambulatory Care and Homecare
ä Microimplants and Endosystems
Application areas in which MOTIV brings in its technological background
Common in all areas is the use of microtechnologies and information technologies. At the
moment, MOTIV coordinates projects comprising ultrasound-based therapy control for monitoring thermal therapies, intelligent microimplants
for the brain, and telematic healthcare environments for patients outside the hospital. In general, MOTIV supports potential projects in the
initiation phase, attends the projects during the
actual project period, and assists in the commercialization and continuation of the endeavour.
49
Telecolposcopy
Colposcopy represents together with the cervical cytology
one of the most substantial diagnostic measures for the
detection of diseases in women. Previous disadvantages
of colposcopy are the low specificity (while high sensitivity) and the great inter observer and intra observer variability, which can only be improved through intensive
training. The combination of conventional binocular colposcopy with digital image processing and archiving
systems hold the promise to improve the objectivity of
the diagnosis using second opinions. In this project, an
image-based communication network will be established
that allow the integration of a colposcopy expert into
routine diagnostic examinations.
Ultrasound-guided thermotherapy
The interstitial thermotherapy is a minimal-invasive
method for the treatment of pathologic tissue alterations,
e.g. liver tumors or prostate tissue alterations. Local temperatures of 50 - 100° C are generated through laser light
and high-frequency applicators which can lead to thermal
tissue destruction.
There is concern that destructive tissue temperatures
extend to areas with healthy tissue. Intraoperational control is not existing on how temperature is distributed in
the tissue area of interest. Therefore, we investigate a
new and favourable temperature monitoring method based
on ultrasound technology. In addition, a photometric tool
will be developed to analyse scattered laser light for functional diagnosis. To improve the spatial resolution of
Devices for interstitial laser therapy
biophotonic diagnosis by one order of magnitude, the
photon-phonon interaction will be studied using modulated laser light combined with focused ultrasound. This
method will provide online information on temperature
profiles and tissue conditions as well as imaging data in
the target region with high precision and resolution. An
instrumental platform will be delivered, suitable for clinical studies in the areas of prostate tumor and liver metastases treatment.
Ultrasound-based images on temperature distribution in tissue
50
Protection and aid with modern technology
Miniaturised Monitoring and Intervention Systems MOTIV
TeleMOM
It is the objective of this project to develop a generic
telematic homecare platform that enables patients and
users at home to be integrated into a secure telecommunication healthcare provider network. The modular tele-
Patient oriented telematic healthcare network
matic homecare system backbone will be suited to meet
the home healthcare requirement of different healthcare
scenarios suited for the requirements of the German
public health system. The modular design of the system
will allow the telehomecare systems to be tailored according to the regional configuration of health care providers and networks. Technical developments comprise a
communication server-based telematic homecare system,
virtual drivers for receiving monitored vital sign and
patient data, and an electronic home-based patient
record with gateways to various health system standards
including secure data exchange. One field trial will be
initially prepared concomitant with the technical
developments. The field trial will be conducted in Berlin.
The initial field trial concerns the treatment, rehabilitation and secondary prophylaxis of patients after stroke
and congestive heart failure. Measures include ambulatory, continuous monitoring of blood pressure and body
weight. In particular, telematic control of blood coagulation will be investigated in patients, when treated with
anti-coagulant agents. Medication intake adherence (compliance) will be studied.
51
Brain Shunt
The brain of the human being is surrounded by the
cerebrospinal fluid (CSF). CSF is produced and absorbed
into the bloodstream in a fashion that keeps pressures in
the brain controlled in a fairly narrow range. If this
balance is disturbed, e.g. in patients with hydrocephalus,
artificial valve systems are implanted to shunt the excess
fluid. Conventional valve systems work in a predefined
pressure range. If there is a shift of physiological pressure conditions during the patient's life time (due to age
or other conditions) uncontrolled shunting may occur.
Uncontrolled shunting may lead to over-drainage or
under-drainage which poses a high risk on the patient.
The proposed project is aiming to develop an electronically controlled shunt systems which adapts to various
physiological states of the patient. The new concept
includes the development of a compliance-controlled intelligent valve system based on in-built microsensors and
actuated valve systems. Development efforts include
modeling of compliance-controlled fluid regulation in the
brain, integration of microsensors, and devising a fluidic,
electromechanical valve system. Neurosurgeons in
Homburg and Berlin will advise during the technical
development phase and will test the shunt systems once
they are built.
Valve system for regulation of fluids in the ventricles of the brain
Modern Medical Technology improves visual acuity
The Competence Centre OPTHALMOINNOVATION THÜRINGEN
The high-tech region centered around the German cities Jena and
Erfurt, and the town of Ilmenau has a long tradition of optics and precision mechanics which has allowed a unique synthesis of scientific, technological and industrial expertise. The research and development of
systems for the diagnosis and therapy of eye disorders occupies a special
position here.
The Competence Centre OPHTHALMOINNOVATION THÜRINGEN is
engaged in the full spectrum of medical and medical technology research
- from clinical testing to the industrial implementation of systems for
objective functional diagnostics and laser therapy to correct vision.
Carl Zeiss Jena GmbH and Asclepion Meditec AG are partners of the
Competence Centre and are international leaders in the field of eye care
technology, offering high-tech products and enabling revolutionary treatment concepts. Small and medium sized enterprises make use of synergistic effects to allow the high threshold for successful market launch or the
"return on investment" to be attained more easily. The eye
clinic of the Friedrich-Schiller University in Jena provides
outstanding clinical competence.
Modern medical technology allows the fundus of the
eye to be visualized
Contact address:
Prof. Dr.-Ing. habil. Günter Henning
Spokesperson for the Competence Centre
Volker Wiechmann
Competence Center Office
Wildenbruchstraße 15, 07745 JENA
Tel. + 49 (0)3641/675690
Fax: + 49 (0)3641/675693
http://www.ophthalmoinnovation.de
52
The Technical University of Ilmenau, the
Frauenhofer Institute and the IOF in Jena work
closely with manufacturers of technical equipment and physicians to attain a level of innovation which can be directly utilized in training and
research and thus make an important contribution to the work of the Competence Center.
OPHTALMOINNOVATION THÜRINGEN, with its
interdisciplinary approach and its broad technological expertise, is the ideal partner for clinicians, scientists and representatives of industry.
The development of the latest medical technology for
ophthalmology
53
The work of the Competence Center focuses on the
development and optimization of the following innovative products and services for ophthalmological use:
ä Diagnostic systems for objective investigation of the
underlying functions of the visual process, metabolic
pathways and microcirculation within the eye
ä Therapeutic systems based on laser treatment for eye
disorders
The use of the latest medical technology in clinics and
private ophthalmology centers is of considerable importance in combating the main causes of blindness in industrial nations:
ä Age-related macular degeneration (AMD)
ä Glaucoma
ä Diabetic retinopathy
ä Arterial and venal occlusion disorders
Unique imaging of the fundus of the eye
The main causes of reduced visual acuity are errors of
refraction and cataracts (grey cataract). Over 2 billion people
around the world are affected by poor vision (200 million
alone in the EU). Some 400,000 patients need to undergo cataract surgery - one of the most expensive surgical
procedures - in Germany every year.
The ever-increasing requirements placed on visual
acuity, both in the workplace and outside it, make it
necessary to have improved diagnostic and therapeutic
procedures available in Ophthalmology.
Attention is focused on the following main areas by
the Competence Center OPHTHALMOINNOVATION
THÜRINGEN.
The eye and loss of vision - diagnostic methods
It is known that there is a causal relationship between
impaired vision and disorders of microcirculation and
metabolism within the eye. New methods to simulate and
record retinal circulation should allow an improved
understanding of its functions. Such methods will allow
the functional interrelationships involved in retinal circulation, either unknown or not verifiable at present, to be
elucidated in greater detail. As a consequence, it is expected that there will be considerable advances in our understanding of retinal circulation, allowing early recognition
of disease and screening for it, as well as an evaluation of
ageing processes and individual vasoactive therapy modalities.
Photodynamic therapy brings hope for AMD patients
54
Modern Medical Technology improves visual acuity
The Competence Centre OPTHALMOINNOVATION THÜRINGEN
The unique optical capture of retinal circulation for
"microangiology" of the eye expands the angiology of the
macrovascular system by representative non-invasive
methods. This in particular allows the diagnosis of glaucoma, as well as the sequelae of diabetes mellitus.
The eye and loss of vision - therapy options
Age-related macular degeneration (AMD) affects
around 2.5 million people in the industrial nations. This
condition has been treated to date by laser photocoagulation
which is limited in what can be achieved. The method is
based on the use of laser radiation to heat and thus kill
the protein components of diseased tissue at the point of
highest visual acuity of the eye. The method brings considerable risks for the patient.
Photodynamic therapy - based on the use of innovative laser technology and dyes - opens up entirely new treatment possibilities. Laser intensities can be generated
with precision and spot sizes of 0.5 to 6.4 millimeters
allow treatment of the drug-sensitized target area of the
yellow spot without damage to surrounding tissue.
Treatment can be performed on an outpatient basis and
will allow the older members of society to keep their
vision.
The patient can be shown the likely results of the laser
surgery before the operation is carried out. The quality of
treatment is substantially increased and the pre-operative
demonstration of the anticipated outcome of treatment
significantly improves the acceptance of the therapy.
Seeing is critical for quality of life
The ability to deliver energy to tissue in a precise and
non-contact manner has opened up new possibilities in
ophthalmology.
Refractive laser surgery using an excimer laser is now
a recognized procedure for the correction of such common forms of ametropia as myopia, hyperopia and astigmatism. The standardized procedures in current use do
not yet allow more severe aberrations to be treated since
they are more difficult to record.
The Competence Centre studies and evaluates
methods for recording corrections to the status of the
eye. Once a method for establishing more severe aberrations has been chosen, the reproducibility of the procedures for correcting vision using the excimer laser can be
analyzed.
55
Laser treatment with minimal impact
Telemedicine for Accident Victims
Competence and Service Centre for Traumatology - TELTRA
The TELTRA Competence Centre for Traumatology links information technology know-how with
medical know-how in order to provide more efficient knowledge management, structural organisation
and work processes and to develop innovative products and services. At the same time TELTRA will
maintain a service centre which implements the service concepts and is available to all concerned with
accident care.
TELTRA cooperates with:
ä
ä
ä
ä
ä
ä
ä
Renowned clinics
The German Society of Traumatology
The Ruhr University Bochum
The Universtity of Karlsruhe - Institute for Biomedical Technology
The Research Centre for Information Technology in Karlsruhe
The trade cooperatives
The leading providers of medical technology
TELTRA is a service provider for
ä
ä
ä
ä
ä
ä
ä
Teltra Ltd
Teltra AED-T
Teltra ROUNDS
Teltra WOUND HEALING
Teltra IMAGE
Teltra KNOWLEDGE
Teltra TQM
Competence network / Call Centre
Data transfer with pictures for lay defibrillation
Telemedical supervision of outpatients
Teleobservation via web camera
Implementation of digital picture transfer systems
Set-up and operation of multimedia databases
Project evaluation and activities for the Teltra Ltd competence
network
The TELTRA competence network implements the results from research
and model projects. The society's aim is to bundle traumatological knowledge,
the latest results from biomedical research, and practical experience in the organisation of treatment in legal accident insurance.
56
TELTRA creates a technical logistical and
administrative infrastructure. The society contributes to the realisation of demands for quality,
more cooperation and economy in the health
sector.
For the patient this means:
ä Plannable, cost-efficient, high quality
health services
ä Less visits and examinations, more time,
more information, more comfort
Rehabilitation providers and doctors have
extensive facilities at hand:
ä
ä
ä
ä
ä
ä
ä
ä
ä
Individual medical advice and care
Patient monitoring
Easy access to all patient data
Medical information worldwide
Teleconferences, second opinions
Consequent use of the internet
Online service billing
Quality management
Economy
The cost-bearers also benefit from:
ä
ä
ä
ä
ä
ä
ä
Optimal treatment organisation
Digital picture and data transfer
Closer contact to the patient
Quality management
Data base management
Online service billing
Economy
TELTRA is breaking new ground. The society is taking the politicians by their word:
"I hereby expressly declare that I am willing,
if necessary, to become legislatively active - but
only when it becomes evident that the health
sector has met its limits in self-regulation....."
Contact address:
Prof. Dr. A Bolz
Institute for Biomedical Technology
University of Karlsruhe
Kaiserstr. 12, D - 76128 Karlsruhe
Tel. + 49 (0)721/608-2650
Fax + 49 (0)721/608-2789
57
(Federal Health Minister Andrea Fischer on the occasion of the first meeting of the Telematic Action Forum
in the Health Sector on 19th August 1999 in Bonn)
Dr. med. B. Clasbrummel
Klaus-Dieter Pöhl
First Aid
The development of a fully automatic external
defibrillator with integrated telemetrics (AED-T)
About 100,000 people die every year in Germany from
sudden heart failure. The proven rescue measure - defibrilla-
Diagnosis
Teleradiology for surgery
Quick and precise diagnosis is a necessity for optimal
therapy. Precisely these experts are often not at hand for
the victims at the scene of an accident. This dilemma
could be resolved technically using remote evaluation of
X-ray or other pictures and subsequent remote advice for
the doctor at the scene. These solutions are already being
tested in local projects. ISDN-based devices which require 10 minutes for uncompressed picture transfer are
state-of-the-art technology in teleradiology.
It is TELTRA's aim to offer remote evaluation as a
service throughout the country and to link it with remote consultation. To enable this, technical requirements
must be fulfilled, in particular the means for data transfer
and viewing stations with adequate speed and safety must
be developed to provide data communication.
tion - is often implemented too late. A fully automatic external defibrillator (AED) widely available and accessible to all
would lower the death rate considerably. This has been proven in clinical studies. A bill of law allowing access to AEDs
in public buildings and companies is currently being drafted.
Telemetrical remote advice for the person giving first
aid and an automatic alarm at the rescue services sent by
the TELTRA service centre could increase the effectivity
of first aid.
Project partners:
ä Metrax GmbH
ä University of Karlsruhe (IBT)
ä Research Centre for Information Technology (FZI)
Project partners:
ä Medical Communications GmbH (Coop. mit Philips)
ä Research Centre for Information Technology (FZI)
ä BG Clinic Bergmannsheil
58
Telemedicine for Accident Victims
Competence and Service Centre for Traumatology - TELTRA
Aftercare
Rehabilitation
Differentiated wound diagnostics to shorten
inpatients stay
Tele-rehabilitation in the case of neurological
defects
The length of inpatient stay, which is not only a burden for the patient but also linked with high daily care
costs of about 500 to 700 DM, can be reduced considerably through telemetrical healing observation. The
patients can return to their familiar surroundings earlier
and only have to go to hospital for treatment where
necessary.
The technical solution necessitates the transfer of
large amounts of data and the development of a diagnos-tic process which can reliably record an inflammative process in a wound.
TELTRA is developing the necessary equipment, doing
clinical tests and will organise communication between doctor and patient in the service centre.
Project partners:
ä MCC Ltd.
ä Research Centre for Information Technology
ä BG Clinic Bergmannsheil
ä University of Karlsruhe (IBT, IPR, ITIV, IHE)
59
Rehabilitation is the restoration of impaired functionality through exercise. An important factor for its success
lies in the continuity of the training. Often when the
patients are discharged there is a so-called rehab-hole as
they do not continue with the exercises properly and
sometimes not at all. It is not possible to provide life-long
medical supervision. However the problem can be remedied by remote supervision of the training results. This
way trends can be recognised and analysed and patients
correspondingly selected for further rehabilitation treatment or a refresher course.
TELTRA will offer remote supervision as a service
and give patients advice. It will also take care of pension
claims. In this way disabled people will have a better quality of live and costs will be cut.
Project partners:
ä Siemens AG(GT 2)
ä evosoft Telecare Ltd.
ä Park Clinic Bad Rothenfelde
ä Clinic am Lindenplatz Bad Sassendorf
A strong community
Imaging for Minimising the Trauma at Treatment Competence Centre for Innovative Technology Usage in Medicine - ZENIT
Initial situation and problem posed
The plan of the centre is based on the research associations FORBILD and MITI - founded 1998 of the medical faculty of the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), and the
Technical University of Munich (TUM), emphasising imaging and picture processing as well as pictureassisted minimal-invasive therapeutic action, being supported by the partners of both these institutions.
Both associations are embedded in an active surrounding of large industrial, SMEs and research institutions.
The regional co-operation is benefited by long-existing research contacts and the tele-communicative
infrastructure (Gigabit-Testbed).
The foundation of a competence centre for medical technology is aiming to organise all already available partial competencies and thus the existing development potential in one common structure for two
clearly outlined fields of activities
ä medical imaging and
ä minimising the trauma at treatment by precision-actions assisted by monitor images and navigation
to co-ordinate activities in respect to their innovative medical technology and to evaluate the economic consequences of the new technologies.
Due to the technology-oriented ventures, a special market potential results for the medical technology. Regional companies will benefit in a special way by the foundation of a centre.
The existing need for coordination and adjusting between clinics, participating research institutions
and industrial partners requires a central post for coordination of the thematic centre about the level of
projects and the anchoring in the existing infrastructure of the Forum MedizinTechnik und Pharma in
Bayern e.V. (Forum). Only in this way is a suitable and coordinated communication on county, national
and European level possible.
The thematic concentration of partial competencies into medical, technological, scientific and especially economic know-how is presented with its background of the scientific and economic competitiveness of the location Bavaria and Germany.
Contact address:
Dr. Thomas Feigl
Forum MedizinTechnik und Pharma
in Bayern e.V.
c/o Bayern Innovativ GmbH
Gewerbemuseumsplatz 2, D-90403 Nürnberg
Tel. +49 (0)911/206 71-15
Fax +49 (0)911/206 71-88
[email protected]
http://www.forum-medtech-pharma.de
60
Contents of the Centre's Conception
ä Model of a Disease-oriented Information
System only for the Hospital
was established. Consequently, this is completed by a concept for an
The Medical-clinical Aspect of the Centre
The interventional medical disciplines all aim
at minimising the trauma at treatment, whereas
the therapeutic efficiency should not only be
maintained, but at the same time even increased.
By the opinion of the applicants, this set aim can
be reached by combination and usage of
modern imaging technologies, integration of
instruments for intervening into the diagnostictherapeutic process and the mechatronics.
ä Integrated Interdisciplinary Combined
Workstation.
The Industrial Centre's Aspect
The post for coordination has another central
task. It is obliged to adjust commercial interests
of the participating partners from industry and
at the same time force the product development.
The integration of imaging and mechatronics
Developing and providing of technological
comprises the aspects of the direct therapeutic
components resulting from applications and
action as well as
their integration
the work-flow
Health Economy /Health Management
into system's soluIHK
which characterNuremberg
LGA
tions requires coHealth Insurances
ises the proceAOK
operation of suitIndustry
IZMP
Techniker
dures at work staable SMEs and
Krankenkasse
Research
TÜV
IHK
tions defined as
FAU
industrial compaMunich
Nürnberger
Versicherung
inter ventional.
BPW
nies,
because
MITI
North Bavaria
Industry
Choosing four
SBK
covering the comTUM
thematic areas for
Research
plex and very difprocessing will
ferent
medical
BPW
consider
both
Munich
Erlangen
product areas can
Nuremberg
aspects. The proonly be guarjects
anteed by an indu-
strial consortium.
At this point furtBeginning for
Project Partners (dark) and supporting institutions (bright) of the centre (IHK =
her
required
Prevention
Chamber of Commerce; BPW = Business Plan Competition)
action for instituand Therapy
tionalising a centre in the form of the Forum is
of the Gonarthrosis and
evident. The Forum as an institution for coordiä Highly Precise Minimal-invasive Interstitial
nation offers a large advantage, because it alreaTumour Therapy
dy fulfils current existing infrastructural condiwere chosen as examples for the therapeutic
tions and at the same time shows high acceptconsequences. However, since each direct theraance in industry (ca. 160 companies in memberpeutic application of the integrative model imagship) and this way can become effective in this
ing - mechatronics will also have essential impact
function.
on the work-flow, the
ä Integrated
61
Munich
ä Acquisition of new partners from science and
industry for the topics of the centre
ä Acquisition, initiation and management of further
projects in the context of the centre
ä Information management: acquisition, processing
and diffusion of specific information about the
centre in the sense of a common know-how basis
intranet- internet
ä Assistance for foundation of companies
Setting Goals and Setting Tasks of the Centre
Basic tasks and direct goals of the office to be established in this centre are:
ä coordination of topics and time concerning the
single projects
ä Repetitive internal reviews in the sense of quality
management
ä Assistance in marketing, especially for small and
middle-sized companies, for counselling, public
work, matching co-operation partners, transfer of
know-how and other
ä Contact persons for external - national and interna-
tional - interested parties, especially connecting link
to other German competence centres, also on the
level of projects
Idea
Technological R&D
Centres
Clinical
Application
Centres
Insurances
Industry
Prototype
Development
Validation
Applicationoriented
Products+
Systems
Product
Development
Marketing
Marketing
ä Active presentation of the fostered regional com-
bined research for public relations
ä Health-economic aspects as a functional link of the
centre with its projects
ä Diffusion of new developments into the broad
medical care
Structural Conception of the Centre
The centre's organ will be affiliated to the Forum
Medical Technology and Pharma in Bayern e.V. , founded
in 1998, with the location and the head office at Bayern
Innovativ, Gesellschaft für Innovation und Wissenstransfer mbH. The Forum and Bayern Innovativ guarantee the infrastructural conditions for establishing a
centre management.
The connection of the sectors technological basic
research, clinical research and product development is
asserted by the partners and appropriate communication
structures. This fixed circle of partners from clinics,
scientific institutions and industry with the commitment
for the superior leading subject guarantees continuity in
information and know-how transfer and therefore creates the conditions for efficient usage of any new gain of
experience.
In addition, new projects corresponding to the required competencies are performed in changing combinations, case-wise by integrating partners from other cen-
Aims and strategies of the centre
62
A strong community
Imaging for Minimising the Trauma at Treatment Competency Centre for Innovative Technology Usage in Medicine - ZENIT
tres. So the basics for further development into a metacentre are set. For this active, interdisciplinary and national network a post for coordination is founded, enriched
with the necessary cross-sectional competence, which
functions as a catalyst, which accompanies the real transfer of the co-operation, and which supports the entering
of new projects from the pool of information.
Furthermore, an improvement of the reasearch and
technology transfer is given by the development of continuous communication structures, by using the newest
communication media and by integrating the centre into
the Forum with its about 300 members from science,
industry and the entire health care system.
This centre is to be seen complementary to the complete measures of the Bavarian State Government. The
access to the relevant financial support schemes on
county, national and European level by the management
of the Forum and the Innovation Relay Centre (IRC
Bavaria) by the Bayern Innovativ GmbH is most important for a long-term continuation of the competence
centre.
Structure and embedding of the centre in the network of Forum MedTech-Pharma e.V. and the Bayern Innovativ GmbH.
63
Glossary
Abdomen
Ablation
Absorption
AMD
Analgesic
Anastomosis
Angiology
Anisotropy
Apheresis
Audiology
Autologous
Binaural
Cataract
Cervix cytology
Cholecystectomy
Cochlea
Colposcopy
Compliance
Conduit
Craniomandibular disfunction
Cytotoxicity
DCM
Defibrillation
Diabetic retinopathy
Lower part of the stomach
Operative removal
The partial or complete "swallowing" of an electromagnetic wave
or particle radiation on passage through material
Age-related macular degeneration (disorder of the retina in older
persons, accompanied by an advancing loss of vision)
Pain-relieving preparation
Operatively created artificial link between hollow organs
Area of medical science focussed on the blood vessels and their
diseases
The direction-dependence of the different physical properties of
a substance, e.g. optical properties
Removal, separation (e.g. of certain substances from the blood)
Partial area of medicine focussed on the functions and diseases of
the human hearing organs.
Coming from the same body
Relating to both ears, for both ears
Clouding of the eye lens with differing impairment of the vision,
depending on the size and location, Eye disease "grey cataract"
Examination of smears from the cervix (neck of the uterus)
Removal of the gall bladder
Part of the inner ear (helix)
Examination of the vaginal mucosa by means of a vaginoscopy
Expandability
Channel
Function disturbances of the masticatory system
Ability of certain [chemical] substances to damage tissue cells
Dilatative cardiomyopathy (ventricular enlargement, (ventricle =
heart chamber); a possible consequence is cardiac insufficiency)
Heart muscle disorder which is treated with a defibrillator (defibrillator: device which remedies heart muscle disorders with an
electric shock or a given strength); Remedying of a cardiovascular
standstill
Disorder of the retina caused by diabetes mellitus (diabetes
mellitus = "sugar sickness")
64
Glossary
Dosimetry
Encephalopathy
Endothelial cells
Glaucoma
Gonarthrosis
Hydrocephalus
Interventional
Interstitial
Intravascular
Laser photocoagulation
Mechatronics
Micro-drug delivery system
Monitoring
Myofibroblast
Occlusal surface
Optical coherence tomography
Ophthalmology
Otoplastic
Perfusion
Prostatic hyperplasia
Refraction fault
Sepsis
65
Measurement of the energy in radiation (e.g. of X-rays)
Non-inflammatory illness of the brain, brain disease, brain damage
Single-layer lining of vessels
Cataract disease, eye disease accommpanied by an impairment of
the vision. An increase in the aqueous humopur results in an
increase in pressure in the eye referred to as green cataract; it
results in damage to the retina and the optic nerve
Arthrosis of the knee joint
"Water on the brain"; abnormally enlarged skull due to an
exceesive collection of fluid in the cerebral sinuses
Taking of intermediate action
Lying in the intermediate tissue
In the vessels
Projection of a laser beam onto the retina, e.g. for reattachment
of separating tissue
Interdisciplinary area of mechanics and electronics
A system implanted in the body for uniform dosing of medication
Supervision
Formative or embryonic cell of the fibrous muscle connective
tissue
Masticatory surface
Method for structural analysis of tissue. The tissue is irradiated
with a light source; the reflected light is measured with a sensor
and subsequently.
Eye medicine
Earpiece of a hearing aid
The [artificial] circulation through a hollow organ or vessel to
feed and clean the tissue
Prostate enlargement
Fault in the eye caused by different refraction of the light (short
or long sightedness)
Blood poisoning; general infection with continuous or periodic
infiltration of pathogens into the blood stream (generally pusforming organisms) from an initial focus
Glossary
Shunt
Stent
Tissue engineering
Transcranial
Transcutaneous
Traumatology
Vasoactive
Ventricular tachycardia
Xenogenic
Operatively created artificial link between vessel systems
Tissue support
Tissue development
Through the skull
Through the skin
Science of wound treatment and healing
Influencing vessels
Cardiac irregularity, abnormal acceleration of the heart beat
Deriving from individuals of different species
66
Contact addresses
AKM
Dr. Dieter Westphal, Aachener Kompetenzzentrum
Medizintechnik
Technologiezentrum am Europaplatz, D-52068 Aachen
Tel: + 49 (0)241/963-242-0, Fax: + 49 (0)241/963-242-1
email: [email protected], www.akm-aachen.de
C.A.T.
Centrum für Apherese-Technologien e.V.
Dr. Hagen Pommerenke, Dr. Wolfgang Ramlow
Friedrich-Barnewitz-Str. 4, D - 18119 Rostock
Tel.: + 49 (0)381/4050219, Fax: + 49 (0)381/4050234
www.apherese-technologie.de
HörTech
Prof. Dr. Dr. Birger Kollmeier
Medizinische Physik, Universität Oldenburg
Stephan Albani, Hörzentum Oldenburg
Carl-von-Ossietzky Str. 9-11, D - 26111 Oldenburg
Tel.: + 49 (0)441/973 8997, Fax: + 49 (0)441/973 8998
imtc
imtc GmbH, Dr. Georg H. Thiessen
Steckelhörn 9, 20457 Hamburg
Tel. + 49 (0)40/300 698-0, Fax + 49 (0)40/300 698-77
Email: [email protected], www.imtc-hamburg.de
INPRO
Coordinator:Prof. Dr. G. Zimmer,
Correspondence: Dr. H.K. Trieu
Fraunhofer Institute of Microelectronic Circuits and Systems
(IMS), Finkenstr. 61, 47057 Duisburg
Tel: + 49 (0)203/3783-0, Fax: + 49 (0)203/3783-266
KITZ
Universitäts Prof. Dr. Hans-Christoph Lauer
J. W. Goethe-Universität Frankfurt, Zentrum der Zahn-,
Mund- und Kieferheilkunde (ZZMK)
Theodor-Stern-Kai 7, 60590 Frankfurt a. Main
Tel.: + 49 (0)69/6301-5640, E-Mail: [email protected]
KMR
Prof. Dr.-Ing. Helmut Ermert, Ruhr-Universität Bochum
Institut für Hochfrequenztechnik
Gebäude IC 6/132, D-44780 Bochum
Tel.: +49 (0)234/3222842, Fax: +49 (0)234/3214167
www.kmr-bochum.de, www.kompetenznetze.de
67
Microelectronic meets Medicine
Dr. W. Baumann, Prof. Dr. B. Wolf, Prof. Dr. D. Weiss
Institut für Zelltechnologie e.V. an der Universität Rostock
Friedrich Barnewitz Str. 4, 18119 Rostock
Tel.: +49 (0)381/498 1970, Fax: +49 (0)381/498 1975
MEDIMPLANT
Prof. Dr. Bernd Heublein, Leibniz Research Laboratories for
Biotechnology and Artificial Organs; Cardio-Thoracic
Division Hannover Medical School
Podbielskistraße 380, D - 30569 Hannover
Tel.: +49 (0)511/906 3553, Fax: +49 (0)511/906 3569
Email: [email protected], www.kompetenznetze.de
MITT
Prof. Dr. H.D. Becker, Universitätsklinikum Tübingen
Hoppe-Seyler-Str. 3, 72076 Tübingen
Tel. + 49 (0)7071/29-86620, Fax: + 49 (0)7071/29-5588
MOTIV
Prof. Dr. Jörg-Uwe Meyer
Fraunhofer-Institut für Biomedizinische Technik
Ensheimer Straße 48, D-66386 St. Ingbert
Tel. + 49 (0)6894/980-150, Fax: + 49 (0)6894/980-400
e-mail: [email protected], www.kompetenznetze.de
OIT
Prof. Dr.-Ing. habil. Günter Henning
Spokesperson for the Competence Center
Volker Wiechmann, Competence Center Office
Wildenbruchstraße 15, 07745 Jena
Tel. + 49 (0)3641/675690, Fax: + 49 (0)3641/675693
Email: [email protected], www.ophthalmoinnovation.de
TELTRA
Prof. Dr. A Bolz
Institute for Biomedical Technology, University of Karlsruhe
Kaiserstr. 12, D - 76128 Karlsruhe
Tel. + 49 (0)721/608-2650, Fax + 49 (0)721/608-2789
Email: [email protected], www.kompetenznetze.de
ZENIT
Dr. Thomas Feigl
Forum MedizinTechnik und Pharma in Bayern e.V.
c/o Bayern Innovativ GmbH
Gewerbemuseumsplatz 2, D-90403 Nürnberg
Tel. +49 (0)911/206 71-15, Fax +49 (0)911/206 71-88
[email protected]
www.forum-medtech-pharma.de
68
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Centres of Competence for Medical Technology

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