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[Report]
Advanced Polymers for Medical Applications: Materials, Product Development, and
Market Opportunities
Pub Time: 2002/02
Chapter One: Introduction To Polymers For Medical Applications
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Some Fundamental Concepts
o Polymers
o Polymeric Properties
o Naturally Occurring Polymers
o Biopolymers and Biomaterials
o Biodegradable Polymers
o Biocompatible Polymers
o Medical Polymers
o Tissue Engineering
o The Market
Properties of Polymers
o Physical and Chemical Properties
o Molecular Weight
Synthesis
o Addition Polymerization
o Condensation Polymerization
Physical Properties of Solid Polymers
o Tacticity
o Crystallinity
Mechanical Properties
o Tensile Properties
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Fatigue Behavior
Thermal Properties
o Glass Transition Temperature
Classes of Polymers Used in Medicine
o Homopolymers
o Copolymers
o Polyurethanes
Medical Polymers Come of Age
o Introduction
o Biodegradable Polymers
o From Tissues to Organs
o Degradable Inorganic Compounds
o Wound Closing
o Biomaterials are Advancing Oral Medicine
Legislation can Reduce the Risks of Innovation
o Legal Worries Now Impede Innovation
o Major Players are getting out of the Business
o Biomaterials Access Assurance Act
Merging Polymer Science and Biology
o Only a Limited Number of Building Blocks
o New Molecular Architectures Allow Control on the Nanoscale
Exciting Research: Biopolymer Optics and Electronics
o Medical Applications of Conducting Polymers
Synthesizing Active Polymers with Potential Bio-Interfaces
o Well-Defined Polymer Structures
o Future Polymers-Active Biomedical Processes
Chapter Two: Biodegradable Polymers And Medical Applications
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Biocompatibility
o Moving from Inert to Reactive
Biodegradable Polymers
o Definitions
o Advantages
o Design Criteria
Medical Applications of Biodegradable Polymers
o The Temporary Scaffold
o Degradable Sutures
o The Temporary Barrier
o The Drug Delivery Device
o Multifunctional Devices
o Tissue Engineering
o Bioactive Matrices
o Removing Blood Clots from Circulation
o New Chemistry Techniques
o Other New Formulations
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Chemistry and Physics of Biodegradable Polymers
Processing of Biodegradable Polymers
Mechanisms of Chemical Degradation
Packaging and Sterilization of Biodegradable Polymers
Degradation
New Biomaterial Shows Promise for Medical Applications
Biodegradable Polymers in Tissue Engineering
Researchers Create First "Designer" Biomaterial for Growing Mammalian
Nerve Cells
Hydrogels
o Classification and Basic Structure
o Preparation
o Hydrogel Swelling Behavior
o Properties of Some Biomedically and Pharmaceutically Important
Hydrogels
o Applications
Currently Available Degradable Polymers
o First, Nondestructible Polymers, Now You Want What?
o Polyhydroxybutyrate (PHB), Polyhydroxyvalerate (PHV), and
Copolymers
o Polycaprolactone
o Polyanhydrides
o Poly(ortho Esters)
o Poly(amino Acids) and "Pseudo" -poly(amino Acids)
o Polycyanoacrylates
o Polyphosphazenes
o Poly(lactic Acid) and Poly(glycolic Acid)
Chapter Three: Bone And Cartilage Replacement
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Bone Morphogenic Proteins
o Bone Cement
o The Bone Growth Factor
Starting the Bone Growth Process
Tissue Engineers Build New Bone
o Biomaterials Laced with Molecular Signals
o Expanding Bone Growth Techniques to other Tissues
Gene Therapy
o The Genetics Dimension
o Plasmids
o New Polymer System for the Delivery of Plasmids
New Stem Cell Sources
o Bone Marrow Stem Cells
o Mesenchymal Stem Cell Trials Await Food and Drug Administration
Action
o Competitive Pressures Limit Research
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Artery/Cartilage Replacement Biomaterial
Production of Human-Like Finger Joint
Protein Delivery System May Help Fight Osteoporosis
Inorganic Materials and Enzymes Disperse into Biodegradable Composites
Cell-Loaded Matrix Can Repair Bones
Chapter Four: Dressings For Burns And Chronic Wounds
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Bioreactive Fabrics
o Wound Dressings
o Hydrogel Drug Delivery System
o Imbedded Polymer Fabrics
o A Nontoxic Sterilization Process for Biomaterials
o Wound Care After Laser Resurfacing
o Artificial Cell Membranes for Medical Use
o Artificial Skin and other Biotech Devices Aid Wound Repair
o Wound-Healing Products
o Antiadhesive Products
Chapter Five: Molecular Imprinted Polymers
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Process Overview
History
Making an Imprint
Advantages and Limitations
Examples of Molecular Imprinted Polymers
Future Directions
Pros and Cons
Plastics with Molecular Memory
o Host-Guest Chemistry
o Biomimetic Recognition Systems
o Recognition Sites
Chemical Sensors
o Sensor Design Criteria
o Evolving Biosensor Technology
o Future Sensor Prospects
Molecular Imprinted Polymers for Chromatographic Separation
o Separation Technology
o Producing Molecular-Imprinted Polymers
Preparation and Optimization
o Molecular Recognition
o Specific Examples for Chromatographic Separations
o Chiral Separations with Molecular Imprinted Polymer Stationary Phases
Cutting Edge Research and the Future
o Making Polymer Coats for Molecules
o Plastic Pharmaceuticals
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Stretching Polymers May Effect Molecular Recognition
Chapter Six: Polymer Coatings And Surfaces For Medical Applications
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Polymer Coatings for Medical Products
o Increased Functionality and Versatility
o Coating Adhesion-Resistant Devices
o Conductive Coatings
o Implant Coatings
o Increasing Heat Resistance
o Special Cases
o Antibacterial Coatings
Polymer Coatings And Substrates For Drug Delivery Applications
o Drug-Delivery Coatings
o Getting Drugs to Hard-to-reach Places
o Engineering a New Drug Delivery Profile
o New Gel Could Mean Fewer Pills
o Star Polymer Has Drug Delivery Potential
Coating Process May Prevent Body From Rejecting Medical Implants
Surfaces Provide Key to Design of Clinically Useful Materials
o Self-Assembled Monolayers and RhoA
o Oligomers Of Ethylene Glycol (OEG)
Chapter Seven: Tissue Engineering
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Overview
An Emerging Industry
o Skin Engineering
o Bone Regeneration
Factors Driving Tissue Engineering Development
o Escalating Costs of Health Care
o Aging of the Population
o Organ Failure and Transplantation
o Challenges
o Future Outlook
o A Promising Multidiscipline Approach
o Microfabrication
Dog Bladders and Human Hearts
o The Bladder is Almost Here
o On to the Kidney and the Heart
Mass-Producing Polymer Scaffolds
o Standards for Organ Builders
o Building a Liver in Tubes and Layers
Cell Culture in Three Dimensions
o From Cell Layers to Organs
o Cartilage Engineering
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Animal Rights
Preserving and Shipping Artificial Tissues and Organs
Photopolymers
Chapter Eight: Product Development, Approval, And Regulations
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Overview
o Time is Money
o Testing the Biomaterial or the Medical Device?
Historical Overview of Medical Materials and Device Regulation
o Food, Drug, and Cosmetic Act of 1938
o Medical Device Amendments
o What Is a Medical Device?
o Safe Medical Devices Act of 1990
o Device Classification (21 CFR 860.3)
The Review and Approval Processes: Step by Step
o Premarket Approval Application
o Investigational Device Exemption (IDE)
o Alternative Product Development Protocols
Device Testing
o Nonclinical Testing
o Clinical Testing
Factors in Biocompatibility Evaluations
o Biocompatibility of Medical Materials
Who Writes Standards?
o The Standards Organizations
o Good Laboratory Practices
o Center for Devices and Radiological Health Premarket Review Staff
o Types of Standards
Who Uses Standards?
The American Society For Testing And Materials System
Committees
o Biocompatibility Standards
Chapter Nine: Market Perspective
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The Healthcare Marketplace
The Evolution of Medical Polymers
Tissue Engineering: Spare Parts
Medical Coatings Market Segment
Diagnostic Testing Segment
Biomaterials
o Commercial Biodegradable Devices
o Spinal Bone Graft
o New Directions in Coronary Stenting
Barriers to Progress
Chapter Ten: Company Profiles
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ABIOMED, Inc.
Acordis BV
Alexion Pharmaceuticals, Inc.
Allergan, Inc.
Alza Corporation (Johnson & Johnson)
Apogent Technologies Inc.
Arrow International, Inc.
Ballard Medical Products (Kimberly-Clark Health Care)
C. R. Bard, Inc.
Bausch & Lomb Inc.
Baxter International Inc.
Becton, Dickinson and Co.
Biocompatibles International Plc
Biomet, Inc.
Bionx Implants, Inc.
Boston Scientific Corporation
Carrington Laboratories, Inc.
Ciba Specialty Chemicals Holding Inc.
Clontech Laboratories, Inc.
ConvaTec
CryoLife, Inc.
Curative Health Services, Inc.
DePuy Inc.
Guidant Corporation
Haemonetics Corporation
Imagyn Medical Technologies, Inc.
Imperial Chemical Industries Plc
Implant Sciences Corporation
INAMED Corporation
Integra LifeSciences Holdings Corporation
Interpore International, Inc.
LifeCell Corporation
Medtronic Sofamor Danek, Inc.
Mentor Corporation
Nobel Biocare AB
Organogenesis Inc.
Ortec International, Inc.
Orthofix International N.V.
OrthoLogic Corp.
Osteotech, Inc.
Planet Polymer Technologies, Inc.
Polymer Group, Inc.
ProCyte Corporation
Protein Polymer Technologies, Inc.
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Smith & Nephew Plc
Stryker Corporation
Sulzer Medica Ltd
Synthetech, Inc.
Tutogen Medical Inc.
Wright Medical Group, Inc.
Zimmer Holdings, Inc.
Appendix A: Standard Terminology For Abbreviated Terms Relating to Plastics
ASTM D 1600-92
Appendix B: Plaspec Materials Selection Database
[Report]
Advanced Polymers for Medical Applications: Materials, Product Development, and
Market Opportunities
Pub Time: 2002/02
Published by : Kalorama Information
Distributed by : Global Information, Inc.
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NCUTE MODEL CURRICULUM
Pilot Programme
Extension Programme
4 Year Degree Program in Textile Technology
Curriculum
Workshops/Seminars/Industry
Meets
Programme Structure
Forthcoming Programmes
Semester - I
Semester - II
Semester - III
Textile Colleges
Semester - IV
Textile Polytechnics
Semester - V
Indian Institutes of Handloom
Technology
Semester - VI
Textile Research Associations
Semester - VIII
Semester -VII
4 Years Degree Program in
Textile Technology
3 Years Diploma Program in
Textile Technology
Technical Textiles
Human Resource Management
Operation Research and Inventory Control
TECHNICAL TEXTILES
High Technology Fibres
Glass Fibres
Manufacture of glass filaments and staple fibre manufacture of staple fibre yarn - properties and
application of filament and staple fibre yarns.
Asbestos Fibres
Manufacturing process - properties and applications of
asbestos yarn.
Carbon Fibres
Aramid and related fibres.
Tyre Cords and Fabrics
Requirements of tyre cord - suitability of various fibres polyester and Nylon tyre cords - manufacture of tyre cords
- Physical and mechanical property requirements for tyre
cord fabrics - Fabrics Design - Specifications. Rubberised
textiles.
Belts
Conveyor belts - physical and mechanical properties construction of belts - manufacture of conveyor belts power transmission belts.
Hoses
Weaving of Hose pipes. Different types and their
applications. Construction and applications.
Filter Fabrics
General consideration of filtration of solids from liquids,
solids from gases, solids from solids, liquid from liquids,
liquids from gases and gases from gases and the
respective types of filter fabrics used.
Non-Woven Textiles
Various uses of non-woven fabrics and their applications.
Manufacture of non-woven fabrics-adhesive bonding and
needle punching techniques.
Functional Fabrics
Fire protection, thermal and electrical insulation, base
cloth commonly used materials, coating techniques,
Waterproof fabrics, Gauze fabrics.
Medical Textiles
Surgical textiles, Suture threads. Cardio vascular textiles,
Knitted cardiac biological valves. Dialyste textiles, Hollow
fibres as dialysis membrane. Hospital textile. Operating
and post operating clothing, Disposable drapes. Sanitary
applications.
Geo Textiles
Geo Textile functions - raw material, woven, non-woven
and knitted geo textile - Application of geo textiles for
drainage application, separation application, soil
reinforcement and filtration and erosion control.
Suggested Text Books & References
1. R.W. Moncrieff, " Man-made Fibre", NewnesButterworths, London, 1975.
2. P.Bajaj and A.K. Sengupta, "High Performance Fibres",
The Textile Institute, Manchester.
3. M.McDonald, " Non-Woven Fabric Technology", Noyes
Data Corporation, New Jersey, 1971.
4. M.L. Gulrajani, "Non-Wovens", North India Textile
Institute, New York 1992.
5. "Medical Textiles - International Conference on Medical
Textiles", Bolton, Woodhed Publication, Cambridge, 1997.
6. H. Planck, "Medical Textiles for Implantation International ITV Conference on Bio materials - 3rd
Stuttgart 1989", Springer Verlag Publication, Berlin 1990.
7. N.W.M. John, "Geotextile", Blackie Publication,
Glasgow, 1987.
Top
HUMAN RESOURCE MANAGEMENT
Evolution in Human Resource Management
Influences on the approach of management of human
resources, line and staff components of human resource
management.
Importance and need of Human Resource
Management
Role of human resource management in a competitive
business environment, interpersonal dynamics, building a
task-person fit, determining humane resource
requirements, recruitment and selection process, training
and development, team building, leadership, appraising
employees performance, wage and salary administration,
collective bargaining and industrial relations, quality of
worklife.
Cost- benefit analysis of HR functions
Safety, health and employee assistance programmes,
global reference points of human resources management.
Suggested Text Books & References
1. H.J. Arnold and D.C. Fieldman, "Organisational
Behaviour", Mc Graw Hill, New York, 1986.
2. W.F. Cascio, "Managing Human Resources: Productivity,
Quality of Work Life, Profits," Mc Graw Hill, New York,
1995.
3. G. Dessler, "Personnel Management", Reston Publishing
Company, Reston, VA, 1984.
4. Monappa and M.S. Saiyadain, "Personnel Management",
Tata Mc Graw Hill, New Delhi, 1979.
5. Fomburn, N.M.Tichy and M.A. Devanna, "Strategic
Human Resource Management", Wiley, New Delhi, 1984.
6. U. Parikh and T.V. Rao, "Designing and Managing
Human Resource Systems", Oxford and IBN, New Delhi,
1992.
Top
OPERATION RESEARCH AND INVENTORY CONTROL
Linear Programming Techniques
Operations research and decision making, types of
mathematical models and constructing the model, role of
computers in operations research, formulation of linear
programming problem, applications and limitations,
simplex method (analytical and graphical).
Distribution Methods
Vogel's approximation method, modified distribution
method, optimisation models, unbalance and degeneracy
is transportation model.
Assignment Models
Hungarian algorithm, travelling salesman problem, routing
problems, processing 'n' jobs through two machines and
three machines, processing two jobs through 'm'
machines. Network Analysis
PERT and CPM. Total slack, free slack, probability of
achieving completion date, cost analysis, updating
resource smoothing - role of computers in network
analysis. Inventory Method
Variables in an inventory problem, inventory problem,
inventory models with penalty, storage and quantity
discount, safety stock, inventory models with probability,
demand, multi item deterministic model.
Queuing Theory
Poisson arrivals and exponential service times, waiting
time and idle time cost, single channel multichannel
problem, Monte Carlo technique applied to queuing
problems, Poisson arrivals and service time.
Decision Theory Game
Examples on the application of theory of games 2 x M and
M x 2 problems, graphic dominance and linear
programming method for different problems, decision
trees. Replacement Model
Replacement of items that deteriorate, gradually, fail
suddenly. Group replacement policy. Concept of system
reliability.
Suggested Text Books & References
1. H.A. Taha, "Operations Research", Mc Millan Publication
Co. Inc, New York.
2. F.S. Hiller, G.J. Liberman, "Introduction to Operations
Research 2nd Edition", Holden - Day Inc, San Francisco,
1974.
3. S.S. Rao, "Optimization - Theory and Applications",
Wiley Eastern, New Delhi, 1978.
4. K.V. Rao, "Management Science", Mc Graw Hill
Singapore, 1986.
5. M.A. Sesieni A. Yaspan and L. Friedman, "Operations
Research : Methods and Problems", John Wiley and Sons,
New York, 1959.
6. N.B. Wagner, "Principles of Operation Research", NJ
Prentice Hall, 1975.
7. C.D. Lewis, "Scientific Inventory Control", Butterworths,
London, 1970.
8. S. Love, "Inventory Control", Mc Graw Hill, 1979.
9. E. Naddor, , "Inventory System", Wiley New York,
1996.
Top
Home
Profile
News
What's New
Articles
Equipment
Fibers
Employment Maps
TISSUS DE BARRIÈRE DES FIBRES DE SPUNBOND SPECIALTY
POUR MÉDICALES DES APPLICATIONS
L'utilisation d'abord enregistrée des fibres étant utilisées dans la médecine a été
mentionnée dans "le Papyrus Chirurgical" il y a presque 4000 ans. La description est
utile des points de réparer des blessures. Naturellement, il est tout à fait probable
que des toiles main-tissées de tissu ou d'araignée aient été employées encore plus
tôt pour cesser de saigner. Dans "l'Susanta Sambita" de la littérature indienne, écrit
il y a approximativement 2500 ans, une variété de matériaux de suture sont
mentionnées comprenant le crin, les bandes de cuir, le coton, les tendons animaux,
et l'écorce fibreuse d'arbre.
Aujourd'hui il est peu probable que des fibres synthétiques existent qui à un moment
donné n'ont pas été considérées pour l'usage dans le domaine médical. Des salles
d'hôpital sont parquetées, curtained, et meublé avec les matériaux semblables à
ceux dans nos maisons. Le personnel a besoin d'uniformes et les patients ont besoin
vêtir. Ainsi, la plus grande utilisation des fibres dans l'industrie médicale est pour les
éléments qui ne diffèrent pas de manière significative dans le type chimique ou les
caractéristiques physiques pour ceux dans nos environnements domestiques. Pour
plusieurs de ces applications, des tissus de spunbond sont préférés en raison de leur
bas coût qui permet une utilisation de temps et réduit au minimum ainsi des
procédures de stérilisation.
Des Non-Wovens
Quand j'ai commencé la première fois à parler à cette conférence il y a
approximativement sept ans, j'ai su de l'activité très petite orientée sur le
développement des fibres spéciales pour les zones des textiles médicaux où le
spunbond et les tissus non-tissés sont largement répandus. Puisque ces textiles ne
sont pas ont généralement pensé pour entrer en contact avec des fluides de corps et
sont généralement peu coûteux, il n'ont pas semblé probablement que la recherche
dans cette zone semblerait raisonnable économique. Aujourd'hui cela a certainement
changé dans la zone des tissus de barrière. Avec l'augmentation rapide des maladies
soutenues par sang telles que l'hépatite C, la nécessité de fournir aux ouvriers
médicaux les vêtements protecteurs peu coûteux qui fournissent une barrière aux
fluides tels que l'eau, le sang, et l'alcool est devenue critique.
Pour répondre à ces besoins, le travail est effectué dans beaucoup de zones. Dans
certains cas des enduits spéciaux et/ou les films sont ajoutés aux fibres et aux
tissus. Dans d'autres cas, des ingrédients sont ajoutés directement dans le polymère
étant utilisé pour faire les fibres. Fondez le dénégateur enflé et bas que des fibres
sont posées au milieu des spunbonds. Des fibres de Bicomponent également sont
utilisées dans la production des spunbonds et d'autres non-wovens. Dans d'autres
non-wovens, on utilise des fibres splittable qui a comme conséquence les fibres de
0,2 dpf après s'être dédoublé dans un processus de hydroentanglement. Avec la
technologie bicomponent il est également faisable pour mettre les additifs
extrêmement chers dans une gaine de polymère sur une fibre de sheath/core pour
donner les propriétés extérieures désirées exigées sans coût élevé qui serait encouru
si l'additif était inclus dans toute la fibre.
TLes technologies principales fabriquaient les matériaux non-tissés de tissu
sont:
Cardée thermique métallisation
Hydroentangling ou needling
Spunbonding
Meltblowing
Tous ces processus sont employés pour faire les tissus non-tissés qui concurrencent
dans le marché médical.
Tous ces processus sont employés pour faire les tissus non-tissés qui concurrencent
dans le marché médical.
Des tissus collés thermiques sont généralement faits en cardant la fibre d'agrafe
dans un Web large qui est alors comprimé et collé avec la chaleur (fig. 1). La fibre de
base peut être faite à partir du polypropylène, du polyester, ou d'autres fibres
comprenant les fibres bicomponent. Quand des fibres de homopolymère sont
utilisées, la métallisation thermique peut être réalisée en ajoutant un bas matériel de
fonte dans le web qui favorise les liens ou par la fonte sélective de petites zones de
la feuille qui peut être seenon la configuration résultante dans le matériel. Si
bicomponent des fibres sont utilisées, seulement le polymère de fonte inférieur est
employé pour faire les liens. Les fibres bicomponent les plus communes utilisées
aujourd'hui pour cette application sont 50/50 des fibres de sheath/core PP/PET.
Processus de Spunbond (Fig. 3) sont directement du polymère au processus de
feuille avec la production en série élevée par unité de production cette des résultats
en coûts commerciaux très bas. Ils sont souvent combinés avec le soufflement de
fonte (Fig. 4) pour donner la barrière améliorée et pour couvrir des propriétés de
poids très bas de tissu. Des enduits, les fibres, et d'autres additifs peuvent être
appliqués dans des processus secondaires. La fibre produite dans la rotation peut
être homopolymère ou bicomponent. Les diamètres de fibre sont souvent aussi bas
que 20 microns pour l e processus de spunbond et aussi bas que 2 microns pour le
processus de meltblown.
Techniques pour améliorer des propriétés de barrière
"Le Holy Grail" des tissus de barrière pour des applications médicales serait un
matériel non-tissé à prix réduit qui est breathable, stérilisable, flexible, et
extrêmement résistant au sang et à la pénétration virale. Ce qui suit est une
discussion des techniques étant considérées comme pour produire un tel tissu.
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Les enduits de poids de base
Enduits et films
Abaissez les fibres de dénégateur
Meltblown pose
Fibres de Bicomponent
Additifs
Splittable
La voie la plus facile d'augmenter les propriétés de barrière d'un tissu non-tissé doit
augmenter le poids de base. En réalité ceci peut avoir peu d'effet sur les propriétés
de barrière mais aura certainement un effet principal sur le coût et le confort du tissu
ou du vêtement. Une meilleure approche est d'employer une fibre plus hydrophobe
pour faire le tissu. Une autre approche est d'augmenter la métallisation; cependant,
ceci réduira la flexibilité du tissu et peut donner au vêtement un raide, sensation
"boardy". Par exemple, Tyvek a d'excellentes propriétés de barrière mais est
extrêmement inflexible même en feuilles minces.
Une approche semblable est ajouter des enduits ou même de coller un film sur le
tissu non-tissé. Un film continu ou une volonté enduisante donnent évidemment
d'excellentes propriétés de barrière, mais comme un tissu fortement collé, sera raide
et boardy. D'une façon générale, un tissu enduit ne respirera pas puisque les films
normaux ne sont pas breathable, mais des films breathable sont développés. Une
meilleure approche est d'utiliser un enduit qui est hydrophobe pour changer la
tension superficielle du tissu pour résister à la pénétration de l'eau et pour remplir
également pores du tissu pour diminuer la taille des ouvertures disponibles pour la
pénétration.
Une autre approche est d'abaisser le dénégateur ou la taille des fibres employées
pour faire le tissu non-tissé. Ceci diminue la taille des ouvertures dans le tissu
assumant le même poids de base et augmente également la superficie des fibres. Si
la fibre ou l'enduit sur elles est hydrophobe, ceci peut avoir comme conséquence une
grande amélioration des propriétés de barrière. Bien qu'il y ait une certaine
augmentation en coût avec l'utilisation de plus petites fibres de diamètre, l'obstacle
principal à aller abaisser des fibres de dénégateur dans les non-wovens collés
thermiques a généralement été leur indisponibilité due aux complications de rotation
de fibre et aux difficultés accrues sous le cardage ou la formation de Web de basses
fibres de dénégateur.
Kimberly-Clark a eu le bon succès commercial avec le développement des tissus de
SMS (F25ig. 5). Ces tissus ont une couche de fibres de meltblown serrées entre deux
couches de tissu de spunbond. Les fibres de meltblown ont un diamètre de fibre
d'approximativement 2 microns et fournissent une excellente couche-barrière tout en
laissant toujours le tissu breathable. L'inconvénient principal à l'approche est le coût
du matériel exigé pour produire le tissu et en raison de la basse limitation de débit
du processus de meltblown.
La dernière approche à faire le bas dénégateur, de hauts non-wovens de barrière est
le processus de spunbond (fig. 6). Dans ce processus, un gicleur à haute pression
d'aspiration est utilisé accélèrent les filaments de fibre directement du polymère
fondu, voyageant de la filière aux vitesses de 4000 à 7000 mètres par minute dans
la distance de moins d'un mètre. Les fibres résultantes (généralement de PP ou de
PE) peuvent avoir un dénégateur entre 0,5 et 1,0 (des diamètres de fibre de moins
de 10 microns). Quand cette technologie est combinée avec la rotation bicomponent,
bien plus de propriétés mises en valeur peuvent être obtenues. Par exemple, une
fibre de 30/70 sheath/core PE/PP (fig. 7) peut être tournée avec le bas dénégateur à
la douceur améliorée par élasticité aussi bien que de bonnes propriétés et couverture
de barrière dans les tissus très bas de poids de base. En raison de la basse quantité
de polymères dans la gaine, des additifs tels que des produits de polytetrafluoride
peuvent être employés pour améliorer des propriétés de pénétration de l'eau sans
augmentation importante en coût. Également parce que le PE a une basse
température de fonte, le processus peut être exécuté aux vitesses de traitement
élevées même avec une cadence de masse élevée de produit par unité de longueur.
Des structures de Bicomponent des polymères stables de rayonnement (tels que PP
et le PE dans la gaine d'une structure de core/sheath) sont développées en tissus
médicaux.
Dans une autre approche bicomponent, une fibre splittable telle qu'un pâté en croûte
segmenté (fig. 8) peut être fournie comme fibre d'agrafe, cardée, et puis
hydroentangled. Les fibres dédoublées à part pendant l'élasticité de processus
hydroentangling un doux, tissu fortement flexible avec d'excellentes propriétés de
barrière. Dans un proche avenir on s'attend à ce que ce processus également soit
combiné avec des tissus de spunbond pour améliorer le coût encore autre pour les
tissus jetables et légers avec d'excellentes propriétés de barrière.
by
John Hagewood, Ph.D., P.E.
HILLS, Inc.
7785 Ellis Road
W. Melbourne, FL 32904
Telephone: (321) 724-2370
FAX:(321) 676-7635
Information and Sales: mailto:jhagewood@hillsinc.net
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Products
Coated fabrics
Industrial materials
Materials for a wide range of application possibilities
Our media-resistant composites made of fabrics or textile carrier materials and elastomer coatings
give an infinite number of combinations and a wide range of application possibilities. The huge range
of products stretches from medical articles via functional components for cars through to materials for
the protection of individuals and their environment.
As a partner to our customers in the development of new products, we respond flexibly and quickly to
changing assignments while employing our vast know-how in materials and processing technology,
and complying with defined quality principles.
New application fields for technical
fabrics
In a collaborative project with Hannover
Technical University students on the
Industrial Design course used the wide
range of potential applications for ContiTech
materials to develop innovative products.
Industrial materials
Highly resistant composite materials from
more than 100 substrates and 300 elastomer
coatings.
Boat and liferaft materials
Hard-wearing and tear-resistant materials for
use in extreme conditions.
Weaving beam coverings
Materials with strong fabric underlay for
covering all kinds of rollers.
Materials for airships and balloons
The fabrics must withstand the most extreme
conditions and meet the most rigorous
requirements.
Materials for temporary builings
Transparent composite material made of synthetic rubber and
fiber glass fabric.
A New Implantable Investigational Device under US FDA
for Patients with Urinary Incontinence or Retention.
Possible Applications of TBC Technology
Figure 1.
Potential Prosthetic Urethra
A.
B.
Demonstrates an extralumenal implant coated on key external surfaces with a highly porous alloplast to effect
Demonstrates placement of the "inner tube" within the permanent implant. An electromagnetic valve--like that
to provide volitional voiding.
Figure 2.
Electromagnetic valve/pump.
The photo demonstrates a 5/32 inch [4mm] dia. by 1-3/8 inch [19.5mm] long electromagnetic valve or pump and the re
Montgomery, # 845, San Francisco, CA. Such a pump might be used with the TBC by quadriplegics and could also be
Figure 3.
Modular prostheses
Modular prostheses consisting of a bioengineered urinary reservoir--placed either subcutaneously or in the pelvis--and
via a TBC.
Photographs of UroPort-TBC Components
Figure 1.
Components of the UroPort-TBC tissue
bonding cystostomy.
A = anchor implant.
B = temporary implant with occlusive cap.
.
C = transcutaneous, intravesical
drainage tube with right angle
cap and injection port
.
D = elongation obturator
*Note: Tubes 'B' and 'C' are made
considerably longer than shown.
They are custom cut during
implantation to fit each individual
patient.
Figure 2.
UroPort-TBC Complete Assembly.
A = anchor implant.
B temporary implant, not shown - see
= Figure 1.
C = transcutaneous, intravesical
drainage tube with right angle cap.
elongation obturator which is
D=
passing through the 'injection port'.
E = extracorporeal drainage assembly
with mechanical valve.
*Note: Tube 'C' is made considerably
longer than shown. It is custom cut
during implantation to fit the
individual patient.
UroPort-TBC Implantation Procedure
Stage I
Figure
1.
Anchor implant with temporary cap sandwiched between detrusor and rectus
abdominis muscles.
Stage I
Figure 2.
Fibroblasts and collagen penetrate into the pores of the polytetrafluoroethylene [PTFE]
material of the anchor implant to make a robust water-tight tissue-alloplast union in the
interim beween the implantation of the anchor implant and Stage 2 procedure.
Stage II
Figure 1.
A 7mm diameter circle of skin is excised directly over the palpable capped temporary
tube. The tube and cap are removed and replaced by a longer temporary tube that
extends above the skin. This temporary tube is impregnated with leachable
antimicrobials and capped or fitted with a right-angle drainage cap. The device is not
activated.
Stage II
Figure 2.
The temporary tube impregnated with leachable antimicrobials and capped or fitted with
a right-angle drainage cap. The device is not activated.
Stage III
Figure 1.
The device is activated by removal of the injection port and insertion of an 18 gauge
needle through the device into the bladder lumen. A stiff 0.038 inch guide wire is
passed into the bladder and out the urethra with the aid of a flexible endoscope.
Stage III
Figure 2.
The opening in the bladder wall is dilated with a balloon placed over the
guidewire.
Stage III
Figure 3.
The intravesical component is stretched with the obturator and is inserted through the
anchor implant and into the bladder.
Completed
Assembly
Figure 1.
The completed assemby in situ. The transcutaneous and intravesical components are
impregnated with antimicrobials. Periodic exchange or replacement of all components
except the anchor implant are anticipated in the clinic 2-4 times per year.
Completed
Assembly
Figure 2.
The completed assemby in situ. The injection port can be used to administer
drugs intravesically.
Donald P. Griffith, M.D.
Principal Investigator
A skilled surgeon and
respected clinician, Dr.
Donald P. Griffith is also a
dedicated academician and
accomplished scientist who
has devoted his professional
life to the advancement of
medicine in the field of
urology. The UroPortTBC is
the fruit of his efforts of almost
30 years of research and
development.
Since 1972 Dr. Griffith has been responsible for
numerous research projects either as the principal
investigator or study chairman. A prolific writer, he has
authored numerous scientific and medical publications,
including 129 articles in medical journals and
periodicals, and 48 medical textbook chapters.
Throughout his busy career in the field of urology he
has also made 265 scientific and medical
presentations to medical gatherings, symposia, and
congresses around the world.
In July 1971, Dr. Griffith joined the teaching faculty of
Baylor College of Medicine, Houston, Texas as
Assistant Professor of Urology. He has remained
continuously on the faculty at Baylor College of
Medicine, and has been Clinical Professor of Urology
since March 1996. He was also professor of
Surgery/Urology at the Texas Institute for Rehabilitation
and Research from July 1973 to February 1976.
Dr. Griffith's private medical practice is in Houston,
Texas, where he is affiliated with major hospitals and
is Director of the Urolithiasis Laboratory. He attended
The University of Texas at Austin, Texas, where he
graduated with a B. Sc. in Chemical Engineering in
1959. He then attended Baylor College of Medicine,
Houston, Texas, from 1959 to 1963, and received the
Doctor of Medicine degree from there. He did his
Surgical Internship at Harvard University/Massachusetts
General Hospital, Boston, Massachusetts. On
completing his internship, he served in the U.S. Navy
Medical Corps, where he did a fellowship in Aerospace
Medicine at the U.S. Navy Institute of Aerospace
Medicine. He was then Flight Surgeon aboard the
U.S.S. America, C.V.A. Following his military service, he
completed the urology residency at Baylor College of
Medicine affiliated hospitals.
Donald P. Griffith, M.D. has received numerous awards
and recognition for his civic, research, and teaching
activities. He is certified by the American Board of
Urology, and is licensed in the states of Texas, Florida,
and Massachusetts. He is on the Editorial Board of
and is a reviewer for several prestigious urology
journals, as well as a Reviewer for Grant Proposals
for the U.S. Food and Drug Administration and the
National Institute of Health. He is also member of
numerous medical professional societies, and is on
various committees and boards of various societies
and of the Methodist Hospital, Houston, Texas.
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Applications
Conveying
Conveying
Conveyor belt systems
Steel cord conveyor belts
Textile conveyor belts for open
cast mining operations,
machinery
and equipment manufacturers
Textile conveyor belts for
underground mining operations
Special conveyor
belts and products
Flexible containers
We manufacture a complete range for all conveying tasks
using one of the most advanced production technologies in
the world. As the leading manufacturer of textile and steel
cord conveyor belts, special products and conveyor belt
service material in Europe we develop “intelligent” belt
conveyor systems for controlling, monitoring and labeling.
Our comprehensive range covers the needs of mining
operations, machinery and equipment manufacturers and
many other industries for both original equipment and
spares requirements.
Containers for transport and
storage
Containers for tank inspection
Patients suffering from a lack of urinary control resulting from neuropathic bladder
dysfunction may benefit from a new investigational device currently being evaluated under
US FDA guidelines. The UroPort-TBC® utilizes latest Tissue Bonding Cystostomy (TBC)
technology to address the problems associated with traditional tube drainage.
FOR PATIENTS
FOR PHYSICIANS
THE RESEARCHERS
Principal Investigator
Information for Patients
Information for
Physicians
How the Urinary Bladder Works
Goals of TBC
Normal Voiding
Institutional Review Board for
Human Research
Inability to Void
Incomplete Voiding (Retention)
Urine Leakage ([ncontience)
Neurological Voiding Problems
Tube Drainage (Traditional)
Bibliographic Links to Experimental
Data
Donald P. Griffith, M.D.
Biographical sketch
Curriculum Vitae
Selected bibliography
e-mail Dr. Griffith
Photographs of TBC Components
Pictorial Depiction of UroPort-TBC
Implantation
Possible Future Applications of TBC
Technology
Tel: 713-790-0557
Fax: 713-790-0592
Co-Investigators
Alternative Treatments
e-mail Dr. Griffith
TBC-Tissue Bonding Cystostomy
Goal of UroPort-TBC
FDA-Monitored Research
How to Participate in Trialslor
Using UroPort-TBC
Use of Drugs with TBC
Follow-up Clinic Visits & Tests
T. B. Boone, M.D.
Curriculum Vitae
Selected bibliography
e-mail Dr. Boone
Potential Complicatons of the TBC
R. Darouiche, M.D.
Inactivation of TBC
Removal of TBC
Patient Costs
Evaluation and Treatment Info
e-mail Dr. Griffith
Curriculum Vitae
Selected bibliography
e-mail Dr. Darouiche
Web Site Design © 2000 by:
Martín Rubio & Associates
Houston, Texas USA
713 665-2335
RESEARCH
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Whether used in a wipe, a surgical gown or as substrates for artificial leather, spunlaced
nonwoven materials are finding application in a broad range of end uses, which has helped
propel the process into what some say is the fastest growing technology in the nonwovens
spectrum. Also known as hydroentangling, the spunlacing process involves mechanically
wrapping and knotting fibers in a web through the use of high velocity jets of water.
Currently, 110 spunlace plants are in production worldwide and additional lines are
scheduled to start up around the world. Industry experts estimate that approximately 12%
of nonwovens produced in the world are made through a spunlaced process.
“In the last two years, we have doubled our spunlacing output,” said David Ferrar, general
manager, BFF Nonwovens, Somerset, U.K. “This has been completely driven by demand
and we are always able to fill the added capacity.”
The growth in spunlaced materials has been led largely by the increased interest in
disposable wiping products for household, personal care and industrial applications. While
other applications certainly exist for spunlaced nonwoven fabrics, their textile-like feel,
softness, durability and absence of chemical additives make them ideal for wiping
applications. These benefits also make spunlaced nonwovens well suited for the medical
market where barrier protection benefits need to be combined with softness and
drapability.
While spunlaced nonwovens are ripe with benefits, manufacturers are still facing several
challenges. For one, spunlacing lines use a great deal of energy so it is important to
produce them in large volumes. As overcapacity continues to be somewhat of a problem in
the spunlacing market, producers have had to lower the costs of these roll goods. “It has
been turning from a sellers’ market to a buyers’ market despite the big growth of the wipes
market,” said Walter Hofmann, sales director, Jacob Holm, Soultz, France. “I think it should
stay this way for the next two years and a lot of this will depend on what happens in the
U.S. market.”
Spunlacing equipment supplier Rieter Perfojet, Montbonnot, France, has tried to cut the
cost of producing these materials with the introduction of its new machine, “Jetlace 3000.”
The machine was designed to reduce the energy required to entangle the fibers making it
less expensive to operate than other spunlacing machines. “Producers want low costs
because spunlacing technology is now huge in terms of volume compared to demand,”
said Bruno Roche, area sales manager. “This has driven down the costs of the finished
material; therefore the costs of making the web needs to be reduced.”
Furthermore, for the segment to continue its strong growth rate, manufacturers must
develop innovative technologies to help spunlaced materials find a place in new application
areas. One such market is the apparel market, which the nonwovens industry as a whole
has coveted for decades. Because spunlaced nonwovens so closely resemble textiles,
many manufacturers believe it will be the nonwoven technology most likely to take share
from woven and knitted fabrics.
“The apparel market is definitely a possibility,” said Carl Lukach, global business manager,
“Sontara” for DuPont, Wilmington, DE. “That’s the big dream of the next decade.”
Spunlacing Wipes Up
For a long time, baby wipes were the main focus
of producers targeting the wipes market. While
baby wipes remain the largest category in the
wipes market, they are being joined by new
applications including personal care wipes,
household cleaning wipes and industrial wipes.
Every day it seems another new wiping product is
hitting store shelves. In the U.S., all of the major
consumer product giants—Procter & Gamble,
Cincinnati, OH; Lever Brothers, London, U.K.;
Reckitt Benckiser, Windsor Berkshire, U.K. and
S.C. Johnson, Racine, WI—have launched wiping
products and this trend does not appear to be
letting up any time soon. Industry watchdogs claim
the proliferation of the U.S. wipes market mimics
activity already seen in Europe and Japan.
“In Japan, there is a wipe product for practically any application you can think of,” said
BFF’s Mr. Ferrar. “It’s to the point where there is practically one product to wipe your left
shoe and another to wipe your right shoe. Europe also has a lot of wiping applications and
so does the U.S., but I think it’s still in its infancy.”
While some wiping applications such as personal care products are more suited to air laid
materials because they offer a great deal of softness, spunlaced materials are often the
fabric of choice because of their durability. Still, industry insiders interviewed by
Nonwovens Industry feel that air laid materials pose little threat to spunlacing. “Both the
use of air laid and spunlaced fabrics in wiping applications will continue to increase,” said
Philippe Wigns, business director, BBA Nonwovens. “There will be a market for both
strategies and differentiation in product concept and marketing strategies will further help
develop certain consumer markets for nonwoven fabrics.”
Currently, the U.S. imports a great deal of spunlaced material from Europe but industry
experts expect to see additional spunlacing lines coming onstream here in coming years.
The challenge for these roll goods producers will be to convince Americans that spunlacebased wipes are worth the few pennies more they cost. Of course a big driver in the growth
of the wipes market is convenience. Consumers have limited time and a premoistened
wipe saves them time whether it is in cleaning the bathroom, removing make up or
washing their cars. These wipes, however, must be effective and strong because
consumers want to get their money’s worth.
“Spunlaced nonwovens work well for wipes because they are soft, strong, easy to handle
and feature good absorption,” said Jacob Holm’s Mr. Hofmann. “It has a more textile feel,
like a towel, that consumers prefer.” Mr. Hofmann predicted that companies will soon begin
differentiating the structure of their wipes to stand apart from the competition. While now
most wipe products are constructed into a plain white cloth material and differentiated only
by their outer packaging, in the future companies will use different colors, printing options,
embossing patterns and other design capabilities to make their wipes stand out. “It will
follow the diaper market,” he said. “In the beginning, everyone made the same product and
later began adding bells and whistles like leg cuffs and design patterns. Wipe producers
will do the same to differentiate their products from the others.”
DuPont has focused its Sontara brand of spunlaced material more on the industrial area
than the consumer segment. Credited with developing the spunlacing process more than
30 years ago, the company dabbles in baby, personal care and household cleaning wipes
but has focused more on high tech areas such as wipes for the aerospace, cleanroom,
automotive, automotive refinishing and printing industries. For instance, the company
recently combined knowledge from its automotive surface coatings unit with its nonwovens
technology to create an automotive surface preparation system containing five wipes. “We
applied the science from an area the company knows a lot about—the surface coatings
segment—to benefit our Sontara brand,” said the company’s Mr. Lukach.
Like DuPont, IMP Group, Padova, Italy, has been content to focus its spunlacing business
on niche applications. Nearly 90% of the company’s spunlaced output finds application in
the artificial leather substrate market, according to Marcello Bozzo, product manager. The
company entered this market because it saw great opportunity for spunlaced materials in
the Italian shoe market and is now the European leader in artificial leather substrates. “We
mainly produce viscose-based spunlaced nonwovens because they are able to absorb
moisture and simulate real leather,” he added.
Tech Craze
Many of the same features—good drapability, the absence of additives, effective barrier
protection—that make spunlaced materials ideal for the wipes market also make them
ideal for other areas including the medical and protective apparel markets. These features
have also led some nonwovens manufacturers to envision a place for spunlaced
nonwovens in the future of the garment industry, which could mean great things for the
nonwovens industry as a whole.
Spunlace technology is being driven by a desire among manufacturers to compete with
woven and knitted fabrics. One company making great strides in this area is Freudenberg
Nonwovens, Weinheim, Germany, which launched “Evolon” last year. Boasting a versatile
product range and vast end use capabilities, Evolon, which is being dubbed the first
continuous microfiber spunlaced fabric, competes favorably with woven and knitted fabrics
as well as with staple fiber nonwovens by offering higher strength to weight ratios.
Manufactured through a proprietary process that combines filament spinning and web
formation, Evolon offers good drapability, soft hand, high tensile strength, comfort
properties and good launderability. Applications range from apparel, interlinings, rental
laundry workware and automotive to carpet backing, sound insulation, footwear, luggage
and home furnishings.
Industry experts expect to see more innovations similar to Evolon appearing to reshape the
spunlace market and, in effect, the nonwovens industry as a whole. “The ability to split
fibers with high pressure to make subdenier fibers is receiving a lot of interest,” said Don
Gillespie, vice president of spunlacing machinery supplier Fleissner, Charlotte, NC. “This
process gives materials a fine and soft texture.”
Additionally, the formation of composite structures containing a spunlaced layer with a
second layer made with another woven or nonwoven process is expected to boost the
category into new application areas. “Spunlaced materials on their own can’t really make a
great deal of inroads into the clothing market unless they are part of a composite,” BFF’s
Mr. Ferrar said. “We will be going after a share of the woven market by combining a woven
with a spunlaced nonwoven.” While Mr. Ferrar declined to comment on his company’s
specific plans for the apparel market, he did say the company would be making major
announcements in upcoming months.
Besides coupling spunlaced materials with woven materials, manufacturers are examining
the possibility of layering them with nonwovens made with other processes such as air laid
and spunbond. “Spunlacing in combination with other technologies is the future of this
market,” Rieter Perfojet’s Mr. Roche said. “Adding another technology can make spunlaced
materials easier to produce while improving the qualities of the end product.” Reiter
Perfojet has already developed a combination spunbond, spunlace and air laid line that
runs at extremely high speed.
In addition to composite structures, spunlaced manufacturers are seeking ways to develop
a higher weight fabric through the spunlaced process. Created through the use of higher
pressure water jets, these thicker fabrics compete directly with needlepunched nonwovens,
according to Fleissner’s Mr. Gillespie. Fleissner has already been able to process
spunlaced fabrics with weights as high as 600 gpsm. Two reasons spunlacing is
preferential to needlepunching are its quicker line speeds and its ability to keep the fibers
from damage, Mr. Gillespie added.
While grabbing share away from competing nonwovens technologies as well as knitted and
woven applications is necessary for growth to continue in the spunlaced market, the future
in this category depends largely on the efforts of big name nonwoven end users which are,
in turn, dictated by consumer demand. “The spunlace category should grow for a while,”
BFF’s Mr. Ferrar said. “The challenge will be for the big national brands to create more
innovative products.” For instance, last year, P&G launched its “Swiffer” brand of antistatic
dust clothes made of a scrim-reinforced spunlace material. This product opened up a
whole new category for nonwovens in the household cleaning market.
What other categories spunlaced nonwovens find their way into remains to be seen.
Whether it be the above mentioned apparel industry or another application that no one has
yet dreamed up, there is no doubt that this textile-like application has the power to help the
nonwovens industry move into previously untapped markets, take share from woven and
knitted materials and continue the growth it has seen in recent years.
A. ANATOMY & PHYSIOLOGY
1. Anatomical and Physiological studies in Urology occupy a large space in Prof.
Shafik's research objectives. They include "A Study of the Arterial Pattern of the
normal Ureters": (J Urol, 1972), "The Mechanism of Micturition and Urinary
Continence: New Concepts" (Int Urogynecol J, 1992), "Levator Ani Muscle-New
Physioanatomical Aspects and Role in Micturition Mechanism" (World J Urol,
1999), "The Role of the Trigone in Micturition" (J Endourol, 1998), and
"Ureteropelvic Junction" (Eur Urol, 1999).
It was through his discovery of reflexes, like the "Recto-Urethral Reflex"
(Urollnt,1992), "Levator- Urethral Reflex" (Urology,1990), "Vesico-Levator reflex"
(Urology, 1993), "Straining-Urethral Reflex" (Acta Anat, 1991), "VesicoPuborectalis Reflex" (Urologia,1996), "Cutaneo-Urethral Reflex" (Urologia, 1992),
"Dilatation and Closing Urethral Reflexes" (World J Urol, 1991), "VesicoCavernosus Reflex" (Int Urogynecol J, 1993), "Ano-Vesical Reflex" (Paraplegia,
1994), and "Olfactory-Micturition Reflex" (Biol Signals,1994), that Prof. Shafik
could demonstrate and explain important interrelations in urinary continence and
evacuation.
The discovery of the "Ureterovesical Junction Inhibitory Reflex and the
Vesicoureteral Junction Excitatory Reflex" (Urol Res, 1996), as well as of "The
Pelvi-Ureteral Inhibitory Reflex and the Uretero-Pelvic Excitatory Reflex"
(Neurourol Urodyn, 1997) and the "Renal Pelvi-Vesical Reflex" (World J Urol,
1998) clarified more interrelations.
The descriptions of the "Filling-and Meato-Vesico-Ureteral Reflexes" (Int J Urol,
1998), of the "Calyceo-Pelvic Sphincter and Reflex" (Amer J Nephrol, 1998), the
"Sphinctero-Ureterovesical Reflex" (Urology, 1997), the "Reno-Renal Pelvic
Reflex" (World J Urol, 1998), the "Reno-Vesicosphincteric Reflex" (Urol Res,
1998), and of the very important "Voluntary Urinary Inhibition Reflex" (J Urol,
1999), as well as the "Reno-Gastric Reflex" ( Urology, 1999) added fresh knowledge
to the functional aspects of the Urinary System.
2. Likewise in Andrology, Prof. Shafik has introduced numerous Anatomical and
Physiological entities which have helped to improve the understanding of essential
issues in Human Reproduction and Sexual Intercourse in both sexes. He studied
"The Fasciomuscular Tube of the Spermatic Cord" (Br J Urol, 1972), "Venous
Plexuses of the Spermatic Cord" (Urologia, 1973), "The Cremasteric Muscle"
(Invest Urol, 1973), "The Dartos Muscle" (Invest Urol, 1973), 'Thermoregulatory
Apparatus of the Testicle" (Urologia, 1974), "The Cremasteric Intemus Muscle"
(Urologia, 1976), "Anatomy and Function of Scrotal Ligament" (Urology, 1977),
"Venous Tension Patterns in Cord Veins" (J Urol,1980), 'Epididymal Ligaments"
(Inn J Fertil, 1987), "Testicular Veins" (Urology, 1990), and "The Physiology of
Testicular Thermoregulation in the Light of New Anatomical and Pathological
Aspects" (Adv Exper Med Biol, 1991).
Lately, Prof. Shafik has looked into the "Response of the Urethral and
Intracorporeal Pressure to Cavernosus Muscles Stimulation" (Urology, 1995), as
well as reported his "Study of the Venous Anatomy of the Penis" (Egypt J Surg,
1995), and his findings on the "Pelvic Floor Muscles and Sphincters During
Erection and Ejaculation" (Arch Androl,1997), and "The Physioanatomic Entirety
of the External Anal Sphincter with the Bulbocavernosus muscle" (Arch Androl,
1999).
As already mentioned, many of his aforementioned and likewise the following
investigations deal with the Physiology of Reproduction, such as "Vaginal and
Uterine Response to Semen Deposition", ( Mol Androl, 1996 ), "Etiology of Uterine
Pressure Rise on Semen Deposition in the Vagina or Uterus" (Mol Androl, 1996),
"Substance "S" (Mol Androl, 1996), and "Anatomy of Corpora Cavernosa, Tunica
Albuginea and Superficial Perineal Muscles and their Relation to the Physiology of
Penile Reaction" (Egypt J Surg, 1995).
His minute studies of the male and female genital area brought to light the vital role
of Reflexes in Sexual Function and Performance, as he could define the "CavernosoUrethral Reflex" (Mol Androl,1993), "The Cervico-Cavernosus Reflex" (Int
Urogynecol J,1993), "Vagino-Cavernosus Reflex" (Gynecol Obst Invest, 1993),
"Cavernoso-Anal Reflex" (Urologia,1996), "Peno-Motor Reflex" (Int J lmpot Res,
1995), and "The Mechanism of Ejaculation: the Glans-Vasal and Urethromuscular
Reflexes" (Arch Androl, 1998). "Thelio-Cavernosus Reflex" (Mol Androl, 1995),
"Utero-Cervical Reflex" (Int J Gynecol Obst, 1994), "Study of the Response of the
Urinary Bladder to Stimulation of the Cervix Uteri and Clitoris: the Genito Vesical
Reflex" (Inn Urogynecol J, 1 995), "Utero-Cervical Inhibitory Reflex" ( Human
Reprod, 1 994 ), "Vaginolevator Reflex" (Eur J Obst Gynecol Reprod
Biol,1994),"Clitoromotor Reflex" (Gynecol Obst Invest, 1994), "VaginoPuborectalis Reflex" (Int J Gynecol Obst, 1995), "Cervico-Motor Reflex"' (J Sex
Res, 1996), and "Study of the Electromechanical Activity of the Uterus" (Clin Exper
Obst, 1996), "Study of the Intramural Oviduct Response to Tubal and Uterine
Distension: Identification of Tubo-Uterine Sphincter and Reflex" (Human Reprod,
1996), and "Study of the Uterine Response to Vaginal Distension: the VaginoUterine Reflex" (Gynecol Obst Invest, 1997).
3. Prof. Shafik is also active in the field of Proctology, where his discovery that the
Anal Sphincter Mechanism differs basically from the descriptions in the medical
literature stimulated a series of investigations, which gave rise to major changes in
the knowledge of the Anorectal region.
Under the title "A new Concept of the Anatomy of the Anal Sphincter Mechanism
and the Physiology of Defecation", Prof. Shafik published the results of a great
amount of basic research, such as "The external Anal Sphincter, a Triple Loop
System"' (Invest Urol, 1975), "Anatomy of the Levator Ani Muscle with special
reference to Puborectalis" (Invest Urol, 1975), ''The Longitudinal Anal Muscle"
(Invest Urol, 1976), "Anatomy of the Perianal Spaces" (Invest Urol, 1976), "The
Rectal Neck" (Chir Gastroenterol, 1977), "Levator Hiatus and Tunnel"
(DisColonRectum- 1979), "Single Loop Continenc"' (DisColonRectum, 1980),
"Anoretal Sinus and Band" (DisColonRectum, 1980), "Anal Canal: A Fallacious
Anatomical and Embryological Entity" (Amer J Proctol /Gastroenterol- ColRect
Surg, 1982), "Mechanism of Defecation'' (Coloproctology, 1982), "Pelvic Double
Sphincter Control Complex" (Urology, 1984), "Hemorrhoidal Venous Plexuses"
(Coloproc-tology, 1985), "The Involuntary Action of the External Anal Sphincter,
Histologic Study" (Acta Anat, 1990), and "Manometric and Electro-Myographic
Studies" (Eur Surg Res, 1992).
Prof. Shafik's studies "Surgical Anatomy of the Pudendal Nerve and its Clinical
Implications" (Clin Anat,1995) and "Pudendal Canal" (Amer Surg, 1999) are seen
as essential contributions, which have enabled the treatment of Idiopathic Pelvic
Pain, if it is caused by Pudendal Nerve Entrapment.
Other extensive Research into the Physio-Anatomical aspects of Coloproctology has
resulted in the following publications: "Mass Contraction of the Pelvic Floor
Muscles" (Inn Urogynecol J, 1998), "Study of the Effect of Colonic Mass Movement
on the Rectosigmoid Junction..." (J Invest Surg, 2000), "Dynamic Study of the
Rectal Detrusor Activity at Defecation" (Digestion, 1991), "Study of the Rectal
Detrusor Motility in Normal and Constipated Subjects" (Proc 2nd Int Mtg
Coloproctol, lvrea, Italy, 1992), "Study on the Origin of the External Anal, Urethral,
Vaginal and Prostatic Sphincters" (Inn Urogynecol J, 1997), "Rectosigmoid
Pacemaker" (Dig. Surg, 1993), "Study of the Electrical and Mechanical Activity of
the Rectum" (exper: Eur Surg Res,1994; Human: Coloproctology,
1993), "Functional Activity of the Sigmoid Colon and Rectum" (Coloproctology,
1997), "Rectosigmoid Junction" (Coloproctology, 1998), "'Is the Rectum a Conduit
or Storage Organ?" (lnt Surg,1997; Mature Med Canada,1998) ), "Arterial Pattern
of the Rectum and its Clinical Application" (Acta Anat, 1996), "Is the Origin of the
Electric Activity of the Rectum Neurogenic or Myogenic?" (Spinal Cord, 1998),
"Surgical Anatomy of the Somatic Terminal Innervation to the Anal and Urethral
Sphincters" ( J Urol, 1999), "On the Origin of the Rectal Electric
Waves" (DisColonRectum, 1999) "'Rectosigmoid Junction: Anatomic, Histologic
and Radiologic Studies with Special Reference to a Sphincteric Function" (Int J
Colorect Dis, 2000), "Rectal Pacing: Pacing Parameters Required for Rectal
Evacuation of Normal and Constipated Subjects" (J Surg Res, 2000), "Role of
Rectosigmoid Junction in Fecal Continence" (Front Biosci,1999).
Like in the Urinary Tract, Prof. Shafik discovered Reflexes of great functional
importance in this area also, including the "Levator-Sphincter Reflex"
(Coloproctology, 1992), the "Recto-Levator Reflex" (Clin Physiol Biochem, 1993),
"Ano-Urethral Reflex" (Paraplegia, 1992), "Recto-Puborectalis Reflex"
(Coloproctology, 1990), "Levator-Puborectalis Reflex" (Pract Gastroenterol, 1991),
"Straining Puborectalis Reflex"' ( The Anat Record, 1991 ), "Straining-Levator
Reflex" (Coloproctology, 1991), "Dilatation and Closing Anal Reflexes" (Acta Anal,
1991), "Recto-Colic Reflex" (Int Surg, 1996), "Esophago-Rectal Reflex" (Int Surg,
1993), "Anorectal Tightening Reflex" (Eur Surg Res,1993), "The ThermoSphincteric Reflex" (J Clin Gastroenterol, 1993), "Sigmoido-Rectal Junction
Reflex" (Clin Anat, 1996).
Other important findings in this area are: "Deflation Reflex" (Anat Record, 1997),
the "Reno-Anal Reflex" (Front Biosci, 1998 ), "Vesico-Anorectal Reflex"
(Neurogastroenterol & Motil, 1999), the Recctosigmoid-Rectal Reflex" (J Surg Res,
1999), the "Recto-Enteric Reflex" (Hepato-Gastroenterol, 2000), "ColoRectosigmoid Junction Reflex" (J Invest Surg, 2000), 'The Reflex effects of Rectal
Distension on Heart Rate, Arterial Blood pressure and electrocardiogram"
(Coloproctology, 1998), and "Recto-Enteric Reflex" (Hepato- Gastroenterol 2000).
4. Reflexes are of great significance also in Gastroenterology because they govern
actions such as deglutition, bile flow, gastric motility, and others. Prof. Shafik deals
with these concepts in his articles "Recognition of a Pharyngo-Esophageal Sphincter
Inhibitory Reflex in Dogs and its Role in Deglutition" (Exper Physiol,1995),
"Esophago- Sphincter Inhibitory Reflex" (J Invest Surg, 1996), "EsophagoPharyngeal Reflex" (J Thorax Cardiovasc Surg, 1997), 'Gastro-Esophageal Reflex
in Dogs" (Eur Surg Res, 1998), "The Duodeno-Pyloric Reflex" (World J Surg,
1998), 'Pharyngo-Esophago-Gastric Reflex in Dogs" (Digestion, 1999),
"Choledocho-Sphincter Inhibitory Reflex, in Dogs" (J Surg Res, 1998), and
"Cholecysto-Sphincter Inhibitory Reflex, in Dogs" (J Invest Surg, 1998).
Hence, Reflexology, as defined above, not only provides important functional keys
for the various body functions, but is potentially suitable to serve as Natural
Diagnostic Tools.
B. PATHOLOGY
C. CLINICAL APPLICATION
D. DIAGNOSTICS
Back to Professional Achievements of Prof. Dr. Ahmed Shafik
C. CLINICAL APPLICATION
The deepened understanding of pathologic conditions and their etiologies challenged
Prof. Shafik to develop Clinical Applications and New Surgical Approaches in light
of his Physioanatomic findings, advocating, as usual, explicit simplicity in
performance and addressing, again as usual, the pathologic cause before the
symptoms.
1. A great deal of Prof. Shafik's interest and effort is directed towards the creation
of new Surgical Treatment Modalities in the Colorectal and Anal Region, such as
"Anal Incontinence. A Technique for Repair" (Am J Proctol Gastroenterol Colon
Rect Surg.1981), "Complete Rectal Prolapse" (Coloproctology, 1987), "Partial
Rectal Resection" (Proc 2nd Int Mtg Coloproctol, lvrea ltaly, 1992), "The Posterior
Approach in the Treatment of Pudendal Canal Syndrome" (Coloproctology, 1992),
"Electrocauterization in the Treatment of Pilonidal Sinus" (Int Surg, 1996),
"Pectinatoplasty, A Technique for Treatment of Sensory Fecal Incontinence" (J Ped
Surg, 1996), and "Perirectal Graciloplasty, for Treatment of Neurogenic Rectum
and Rectal Inertial (Neurogastroenterol Mot, 1998), "Rectal Pacing in Patients with
Constipation due to Rectal Inertia (Int J Colorectal Dis, 2000), "Endoscopic
Pudendal Canal Decompression for the Treatment of Fecal Incontinence due to
Pudendal Canal Syndrome" (J Laparoendosc Adv Surg Techn, 199?), "Pudendal
Canal Decompression for the Treatment of Idiopathic Fecal Incontinence" (Dig
Surg, 1992) and Fecal Incontinence in complete Rectal Prolapse" (Amer Surg,
1996), "Lleal Reservoir Anal Anastomosis... for Pouch Construction using
Myectomy" (Coloproctology, 1997), "Reinnervation of the Rectum with a Somatic
Nerve" (Spinal Cord, 1997).
2. The field of Gastroenterology also benefited from Prof. Shafik's tireless efforts to
simplify procedures and improve their results when he developed "A new
Technique of Gastro-Jejunal Anastomosis after Partial Gastrectomy" (Am J Surg,
1981) and "A new Technique for the Surgical Treatment of Dumping Syndrome"
(Am J Proctol Gastroenterol Colon Rectal Surgery, 1984).
3. In Surgical Urology, Prof. Shafik has published "Subpubic Prostat-Ectomy" (J
Urol, 1972), "Cystomyotomy" (J Urol, 1973), "Invagination of Hernia Sac Stump"
(Am J Surg, 1980),"Obturator Foramen Approach for Vas Deferens
Reconstruction" (Am J Surg, 1982), Obturator Froamen Approach for
Undescended Testicle" (Am J Surg, 1982), "Prostatic Commissurotomy" (Br J Urol,
1986), "Closed Prostatic Commissurotomy" (Br J Urol, 1988), "Role of Warm
Water Bath in Inducing Micturition in Postoperative Urinary Retention after
Anorectal Operations" (Urol Int, 1993), and 'Pudendal Canal Decompression in the
Treatment of Urinary Stress Incontinence" (Int Urogynecol J, 1994).
4. Likewise, in Andrology Prof. Shafik has designed new Surgical procedures, such
as "Plication Operation" (Br J Urology, 1972), "Tunical Sling Operation"
(Urologia, 1974), and "Mobile Eepididymis and its Treatment by Epididymopexy'
(Urology, 1991).
5. Surgical Gynecology, too, received some attention by a contribution like
"Pudendal Canal Syndrome as a cause of Vulvodynia and its Treatment by
Pudendal Nerve Decompression" (Eur J Obst Gyn Reprod Biol 1998j 80: 215-220)
6. Multidisciplinary Oncological Surgery deserves a speclal mention here as there
are numerous procedures attesting to Prof. Shafik's undeterred battle against
Cancer. To start with, the continuous challenge by the relatively high incidence of
Bilharzial Cancer in Egypt stimulated him to develop several new techniques for
Urinary Diversion, such as "Perineal Ileo-Urethral Bladder" (Br J Urol, 1968),
"Stomal Stenosis after Cutaneous Ureterostomy" (J Urol, 1971), and
"Ureterosigmoidostomy with Cola-Colostomy" (J Urol, 1971), in Urology.
On the other hand, in Coloproctology, Prof. Shafik has devised "Tube-and
Marsupialization Colostomy" (Am J Proctol Gastroenterol Colon Rectal Surg,
1982) as a supporting procedure in drastic Colorectal Surgical measures, while in
his series entitled "A new Concept of the Anatomy of the Anal Sphincter
Mechanism and the Physiology of Defecation", he has presented original techniques
for the approach and the treatment of Anorectal Cancer, such as "Anorectal
Mobilization in the Treatment of Rectal Lesions" (Am J Surg, 1981;
Coloproctology, 1985), "Reversion to Normal Defecation after Combined Excision
Operation and End Colostomy for Rectal Cancer" (Am J Surg, 1986), "Pelvic
Adenectomy in the Local Treatment of Rectal Cancer" (Coloproctology, 1989), and
"Local Excision in the Treatment of Rectal Cancer" (Eur J Surg Oncol, 1992) .
7. By his determined effort to deal with Pathological conditions in the easiest and
simplest way, the Surgeon Prof. Shafik has also developed a numerous amount of
highy effective Non-Surgical Altemative Methods for a diversity of applications.
a. The outcome of Progressive Biophysical Investigations led Prof. Shafik to propose
scientifically tested methods for Reversible Male Contraception through controlled
Spermatogenesis. He developed "Testicular Suspension" (Andrologia,1991),
'Testicular Suspension as a Method of Male Contraception" (Adv Contracept Deliv
Syst, 1991), "Prolactin Injection" (Contraception, 1994), and "Intratesticular
Testosterone Concentration following Intratunical Administration in the
Hypogonadal animal" (J Androl, 1995).
A step further in this direction took Prof. Shafik to prove an absolutely deleterious
"Effect of different types of Textile Fabric on Spermatogenesis" (Andrologia, 1992;
Arch Androl, 1992; Urol Res, 1993; Mol Androl, 1994), and "The Effect of Different
Types of Textiles on Sexual Activity" (Eur Urol, 1993; Arch Androl, 1996), "Effect
of Different Types of Textiles on Pregnancy" (Adv Contracept Deliv Syst, 1994), and
also "Effect of Different Types of Textiles on Conception" (Ad Contracept Deliv
Syst, 1995).
Prof. Shafik used the results of this work to lock into "Contraceptive Efficacy of
Polyester Induced Azoospermia in Normal Men" (Contraception, 1992) and
developed another very efficient procedure for male Contraception. Like on the
male and female genital tract, the injurious influence of Polyester could also be
demonstrated in other body areas by studies such as
'Polyester but not Cotton or Wool Textiles Inhibit Hair Growth"
(Dermatology,1993) and "Electrostatic Potentials Generated on the Head and Chest
Wall by Wearing Different Types of Fabric" (Egypt J Biomed Engng, 1993).
b. Another branch of Non.Surgical Treatment, Nerve Stimulation, has received
much attention in Prof. Shafik's recent research and proved to be a promising
Multidisciplinary Approach in different Pathological conditions. He developed
"Perineal Nerve Stimulation for Urinary Sphincter Control" (Urol Res,1994),
"Pudendal Nerve Stimulation for Anal and Urethral Sphincter Control" (Eur J
Gastroenterol Hepatol, (1994), "Inferior Rectal Nerve Stimulation for Anal
Sphincteric Control" (J Surg Res,1995), "Sacral Root Stimulation for Controlled
Defecation" (Eur Surg Res, 1995), and "Perineal Nerve Stimulation: Role in Penile
Erection" (lnt J lmpot, 1997), among others.
c. Also in an attempt to avoid or reduce Surgical Intervention whenever feasible,
Prof. Shafik has devised a variety of other Non-Surgical and Mini-Invasive
Treatment Modalities. They range from Injection Techniques not only for various
Gastroenterological and Proctological Disorders, such as"lntraesophageal Polytef
Injection for the Treatment of Reflux Esophagitis" (Surg Endosc, 1995), "An
Injection Technique for the Treatment of Idiopathic Pruritus Ani" (Int Surg,1993),
"Perianal Injection of Autologous Fat for the Treatment of Sphincteric
Incontinence" (Dis ColonRectum, 1995), "Botulin Toxin in the Treatment of
Nonrelaxing Puborectalis Syndrome" (Dig Surg, 1998), "Treatment of Chronic
Anal Fissure using Formalin Injection (Minim Invas Ther, 1996).
The Injection Techniques also include a therapy for Gynecological Derangements
like "Vaginismus: Results of Treatment with Botulin Toxin" (J Obst Gynaecol,
2000), and then the most intriguing Injection Method of all: Submucosal Anal
Injection. This latter technique exploits, diagnostically and therapeutically, Prof.
Shafik's earlier detected unidirectional Venous Communications betveen the
Rectum and all Pelvic Organs.
Based on experimental studies, entitled "Anal Submuco-Sal Injection: A New Route
for Drug Administration in Pelvic Malignancies, Misonidazole distribution in
Serum and Tissues with Special Reference to Urinary Bladder" (Invest Radial,
1986) and "Misonidazole Distribution in Serum, Uterus and Vagina" (Gynecol Obst
Invest,1990), the new Mini-Invasive Approach proved suitable for Multidisciplinary
Applications in the Pelvic area, such as for Diagnostic purposes, "Anal
Cystography" (Urology, 1984) and "Pelvic Organ Venous Communications,
Cystovaginohystero-graphy" (Am J Obst Gynecol, 1988), and likewise for
Therapeutical administrations, e.g. the "Role of Hemorrhoids in the Pathogenesis of
Recurrent Bacteriuria with a New Approach for Treatment" (Eur Urol, 1985),
"Chronic Prostatitis" (Urology, 1991 and "Role of Hemorrhoids in Urinary Tract
Infection" (Pract Gastroenterol, 1989).
The efficacy of this direct approach in Oncological conditions of the Pelvic organs
was described in "Anal Submucosal Injection: A New Route for Drug
Administration in Pelvic Malignancies: Methotrexate Anal Injection in the
Treatment of Advanced Bladder Cancer (J Urol, 1988), Submucosal Anal Injection
in the Treatment of Cancer of Uterine Cervix" (Am J Obstetric Gynecol, 1989),
Advanced Prostatic Cancer" (Eur Urol, 1990), and Advanced Rectal Cancer" (Eur
J Surg Oncol, 1999).
Pro. Shafik validated the advantages of his simple Technique against the commonly
used parenteral injection of Chemotherapeutic agents in a publication reflecting his
long-time experience with this method: "Methotrexate concentration in Rectal
Tumor Tissue and Serum after Anal compared to Parenteral Injection" (AntiCancer Drugs, 1994). Other Injection procedures with a direct approach were
introduced for the treatment of Testicular Diseases: "Intratunical Versus
Parenteral Administration of Methotrexate in Testicular Tumors" (Anti-Cancer
Drugs, 1992), "Intratunical Injection of Methotrexate for the Treatment of
Seminoma of the Testicle" (Anti-Cancer Drugs, 1993), and "Treatment of
Tuberculous Epididymitis by Intratunical Injection of Rifampicin" (Arch Androl,
1996).
d. In another effort to replace conventional Surgery by Non-Surgical measures if at
all possible, Prof. Shafik created a Polyeffective Immuno-Stimulating (Antiviral)
drug which finished its precinical test run successfully. A number of publications on
this issue have reported on the effects of the drug, such as: "The Antioncogenic
Effect of, a Drug RACA 85" (Egypt Med J, 1985), "The Anti-Rheumatoid Effect of
CID 85 (J Drug Res Egypt, 1987), "Study on Anti-Inflammatory Potential of CID
85" (J Drug Res Egypt, 1987), "Subchroinic, Acute, Chronic Toxicity Study of CID
85" (J Drug Res Egypt, 1987), "The Anti-Inflammatory Effect of CID 85 by Paw
Edema Test" (J Drug Res Egypt, 1987), "Antinociceptive Studies of CID 85" (J
Drug Res Egypt, 1985), "A Contribution to the Effect of CID 85 on Humoral
Immunity" (J Drug Res Egypt, 1987), "Preclinical Antiviral and Immunological
Studies of MM-1 (5th Int Conf AIDS Africa,Kinshasa), "The Hemopoietic
Immunomodulating Effect of CID 85" (J Drug Res Egypt, 1987), "Preclinical
Toxicity Studies of MM-1 (5th Int Conf AIDS, Kinshasa), "The Effect of CID 85 on
Proteins (J Drug Res Egypt, 1991), and "Antileprotic effect of the
Immunostimulating Drug RACA 854 in Experimentally Infected Armadillos (Int J
Leprosy, 1992).
Clinical tests have been published under, "The Anti-Rheumatoid Effect of a Drug
Coded RACA 85" (Egypt Med J, 1985), "Role of MM-I, an Antivira Agent, in the
Treatment of Patients with AIDS" (Egypt Med J, 1987), "The Result of Treatment
of AIDS Patients with MM-1" (6th Int Forum Androl, Paris, 1988), "MM-I in the
Treatment of AIDS; Report on 172 Treated Patients" (5th Int Conf on AIDS,
Montreal, 1989), and "Effet du MM-I sur les (2105) Malades Attaints du SIDA"
(5th Int Conf AIDS, Montreal, 1989).
e. Again in an attempt to spare the patient surgery as far as possible, Prof. Shafik
created and further developed a Polyeffective Drug which has been 85' (Egypt Med
J, 1985), "The Anti-Rheumatoid Effect of CID 85" (J Drug Res Egypt, 1987),
"Study of Anti-Inflammatory Potential of CID 85" (J Drug Res Egypt,1987),
"Subchroinic, Acute, Chronic Toxicity Study of CID 85" (J Drug Res Egypt,1987),
"The Anti-Inflammatory Effect of CID 85 by Paw Edema Test" (J Drug Res
Egypt,1987), "'Antinociceptive Studies of CID 85" (J Drug Res Egypt, 1987), "A
Contribution to the Effect of CID 85 on Humoral Immunity" (J Druj Res Egypt,
1987), "Preclinical Antiviral and Immunological Studies of MM-1 (5 Int Conf AIDS
Africa, Kinshasa), "The Hemopoietic Immunomodulating Effect of CID 85" (J Drug
Res Egypt, 1987), "Preclinical Toxicity Studies of MM-1" (5th Int Conf AIDS,
Kinshasa), "The Effect of CID 85 on Proteins" (J Drug Res Egypt, 1991), and
"Antileprotic Effect of the Immunostimulating Drug RACA 854 in Experimentally
Infected Armadillos" (Int J Leprosy, 1992).
Clinical tests have been published under, "The Anti-Rheumatoid Effect of a Drug
Coded RACA 85" (Egypt Med J, 1985), 'Role of MM-I, an Antiviral Agent, in the
Treatment of Patients with AIDS" (Egypt Med J, 1987), "The Result of Treatment
of AIDS Patients with MM-1" (6th Int Forum Androl, Paris, 1988), "MM-1 in the
Treatment of AIDS; Report on 172 Treated Patients" (5th Int Conf on AIDS,
Montreal, 1989), and "Effet du MM-I sur les (2105) Malades Attaints du SIDA"
(5th Int Conf AIDS, Montreal, 1989).
A. ANATOMY, PHYSIOLOGY
B. PATHOLOGY
D. DIAGNOSTICS
Back to Professional Achievements of Prof. Dr. Ahmed Shafik
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Coated fabrics
Industrial materials
Materials for a wide range of application possibilities
Our media-resistant composites made of fabrics or textile carrier materials and elastomer coating
infinite number of combinations and a wide range of application possibilities. The huge range of p
stretches from medical articles via functional components for cars through to materials for the pro
individuals and their environment.
As a partner to our customers in the development of new products, we respond flexibly and quick
assignments while employing our vast know-how in materials and processing technology, and co
defined quality principles.
New application fields for technical
fabrics
In a collaborative project with Hannover
Technical University students on the
Industrial Design course used the wide
range of potential applications for ContiTech
materials to develop innovative products.
For professiona
Adhesives and
cements...
We optimise the
properties of ou
the particular ap
combining a var
materials...
Industrial materials
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more than 100 substrates and 300 elastomer
coatings.
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Weaving beam coverings
Materials with strong fabric underlay for
covering all kinds of rollers.
Materials for airships and balloons
The fabrics must withstand the most extreme
conditions and meet the most rigorous
requirements.
Materials for temporary builings
Transparent composite material made of
synthetic rubber and fiber glass fabric.
Nonwovens are found nearly everywhere when it comes to the medical market. With the
rise of infectious diseases and standards enforced in hospitals and healthcare facilities, it
is no wonder roll good manufacturers are seeing high consumer demand for nonwovens
with better protection in the medical market. Currently, nonwovens can be found in a wide
variety of medical-related areas, including facial masks, surgical packs, gowns and drapes,
sterilization packaging, gloves, surgical accessories and even protective footwear and
hoods. Hospital rooms are also no stranger to nonwovens, as they can be found in
bedding, pillows, towels and linens. Considering the number of hospitals, healthcare
facilities and medical employees, it is not surprising nonwovens manufacturers cannot
even begin to guess how big the medical market really is.
According to research conducted by INDA, Association of the Nonwoven Fabrics Industry,
Cary, NC, it is estimated that medical and surgical applications consume slightly more than
three billion square yards of nonwoven fabric in the U.S. and Canada alone each year. The
result: nonwovens manufacturers have their work cut out for them as they try to find a
balance between catering to high consumer demands and producing nonwovens that offer
the best protection and comfort.
One key trend being seen in this category is the push for hospitals to use disposables.
While disposables are safer for hospital use, there is a question about the amount of
infectious waste created once they are thrown away.
Charlie Granger, business development manager for Johns Manville’s Filtration Division,
Denver, CO, sees safety as the biggest reason why nonwovens are preferred in the
medical market. “Disposable nonwovens are strerilized, packaged, opened and then
disposed of, so there is less risk of contamination before or after use than would be the
case with a reusable product,” Mr. Granger said. Although Johns Manville’s medical
business comprises well less than 10% of its roll goods sales, the company is still
witnessing strong consumer demands and concerns regarding safety. “Everyone is coming
up with something new they would like to see. Right now we are working to develop our
surgical face mask media and we are upgrading products we already sell,” he said.
Mario Saldarini, commercial director of Orlandi SpA, Varese, Italy, believes that medical
nonwovens are growing most quickly in European markets, particularly France, Germany
and the U.K., but are stagnant elsewhere. “Nonwoven material is commonly being found in
swabs, gauze and plaster substrates,” Mr. Saldarini added. “We are finding more
nonwovens in the medical area, but in my opinion, they are seeing very slow growth.”
Orlandi’s medical production makes up 20% of its business whereas 70% of the company
is dedicated to the hygienic and cosmetic industry, which is seeing more rapid growth. Mr.
Saldarini said that hospitals need to change their mindsets for nonwovens to gain greater
marketshare in the medical market. “Hospitals have to get rid of their mentality that
disposables are luxuries. Reusable cotton gauze can then be replaced with disposables.
Disposable nonwovens give customers more security and peace of mind,” explained Mr.
Saldarini.
Guan Tao, an import and export executive at Hangzhou Advanced Nonwovens,
Hangzhou, China, credited new fiber developments for the drive for nonwovens. “Along
with developments of new manufacturing, compound and finishing processes in the
nonwovens industry and the development and application of new fiber and auxiliaries,
nonwoven medical products have been endowed with superior functions. They have more
advantages than traditional materials,” he said.
On A Wider Scale
Consumers are among the major influences on nonwovens
production. Whatever consumers demand, manufacturers try to
match. JM’s Mr. Granger said he noticed the highest consumer
demand in more protective medical nonwovens. The rise of
infectious diseases, such as AIDS, HIV and Hepatitis, and, more
importantly, an increased awareness of these diseases has
medical consumers requesting protective apparel.
“There is an increased awareness in the importance of barrier properties in nonwovens.
The quality of disposable nonwovens has created a whole new tier of products,” said Mr.
Granger. Some common advantages most manufacturers agree on is that they are
cheaper, disposable and more flexible to customers’ needs. “Possibilities are really
endless,” noted Mr. Granger.
Ray Dunleavy, business manager of BBA Nonwovens, Simpsonville, SC, said that in the
U.S. medical market, nonwovens have more or less fully penetrated most apparel and
packaging applications. These include products for the operating room such as surgical
gowns and drapes, head and shoe covers, face masks, sponges, towels, wipes and
sterilization wraps. In other parts of hospitals and healthcare facilities, nonwovens,
including pulp-based fabrics, are found in isolation gowns, exam and patient gowns, lab
coats, wipes, towels and bed linens.
“Nonwovens performance in the areas of protection, comfort and cost are the key drivers
for the change in this market, and this fosters competition between different nonwoven
fabric technologies. For example, the high levels of protection and low cost offered by SMS
technology are propelling it to marketshare gains in the surgical gown and drape market at
the expense of spunlaced technology,” Mr. Dunleavy explained. “However, further gains
versus reusable fabrics that are not nonwoven will occur very slowly.”
Cost remains a huge factor when it comes to developing nonwovens and with the
implementation of OSHA (Occupational Safety and Health Administration) laws, came
many new standards for hospitals. “Basically what we saw was a spike in demand while all
the facilities took steps to fill their cupboards with disposables, and then sales returned to a
more normal level,” said JM’s Mr. Granger, regarding the action many medical and dental
facilities took in response to OSHA’s standards. OSHA regulations called for employers to
provide protective equipment for their workers, mandating that nonwovens used is hospital
and healthcare facilities have better barrier protection while still offering comfort.
“Air flow and moisture vapor transmission are what makes a garment comfortable, but with
air flow also comes bacteria. Wherever air molecules can flow through the fabric means
that there is a risk that bacteria can also penetrate the fabric. There continues to be growth
in the use of composites, especially nonwovens matched with specialty films, to provide
comfort and barrier protection, but there is always a cost-price pressure,” said Mr.
Granger.
Carolyn Green, vice president of sales and marketing at Precision Fabrics Group, (PFG)
Greensboro, NC, believes nonwovens are growing in the international medical market but
cost will be factor. “There is always a pressure with cost. Manufacturers are always trying
to find better properties with a lower cost,” Ms. Green said. PFG, which is mostly involved
in the composite market, is developing several new products for its medical division and is
currently a leading innovator of value-added nonwoven fabrics for the global medical
products market, according to company executives. PFG targets a wide range of end uses
encompassing products such as surgical gowns, drapes, masks, wound dressings and
table covers. Orlandi’s Mr. Saldarini added, “Synthetic nonwovens are lint-free, pure and
have more stable prices when compared to cotton, which usually sees prices jumping up
and down. Synthetics tend to be more stable.”
It is clear nonwovens have advantages for use in areas of the world where consumers can
afford them. However, in developing countries where health standards are not as strongly
enforced as they are in the U.S., the future of medical nonwovens is questionable. Serkan
Gogus commercial director for Mogul Nonwovens, Baspinar, Gaziantep, Turkey, forsees a
strong and quick growth for nonwovens in the medical market. “Nonwoven material is
found nearly everywhere, in emergency, surgery and patient care,” Mr. Gogus said.
Mogul is currently trying to develop its market outside of Turkey. “We expect to see growth
in developing regions, such as the Far East, Eastern Europe and South America,” Mr.
Gogus projected. “We are also introducing our new SMS fabrics, aside from our
spunbonded fabrics.”
The use of nonwovens in the medical markets of developing countries is expected to be
much lower than the U.S. and other economically advantaged countries due to significantly
less household income. “As countries move from third world status to second world, they
begin to focus on medical issues,” said JM’s Mr. Granger “Health and sanitary issues are a
big problem in these countries, but so are financial constraints. People in third world
countries are making $200 a year so they are going to have trouble affording one sanitary
product that costs four dollars.”
“Western Europe and Japan have higher growth rates than the U.S. market (in the 5-10%
range) while Asia, Eastern Europe, South America and the Middle East are growing even
more rapidly. Education on the clinical and economic benefits of nonwovens directed at
health officials and practitioners in these regions result in increasing demand,” said BBA’s
Mr. Dunleavy.
The medical nonwovens industry in the U.S. has remained relatively mature, according to
Mr. Dunleavy. “The U.S. market is growing at 1-2% annually. Growth is driven by
increases in surgical procedures stemming from our aging population, which is offset by a
reduction in nonwovens used per procedure resulting from advances in surgical
technology and less invasive techniques,” Mr. Dunleavy explained.
Hangzhou’s Mr. Tao believes that nonwovens are growing very quickly in China. “Along
with the continuous growth of the national economy, China is going to establish an
integrated system of medical treatment and healthcare step by step to upgrade people’s
health and improve the instruments used in medical treatments continuously,” said
Hangzhou’s Mr. Tao.
Spunlace Comes In First
Manufacturers all seem to agree that one of the most preferred nonwovens technologies
used in the medical market is spunlaced. “Spunlaced is really used most often, especially
in surgical rooms or anything that involves direct contact with the skin,” said Mr. Saldarini.
Additionally, the absence of chemical treatment in spunlaced material makes it a fabric
often favored in the medical market. JM’s Mr. Granger agreed. “Spunlaced and SMS are
most commonly used because they are the most fabric-like. It’s a combination of barrier
protection and comfort,” he said.
Spunlaced nonwovens are made by entangling polyester fibers with a layer of wood pulp,
whereas SMS materials feature a composite of three layers—spunlace, meltblown and
spunbonded—normally using a polypropylene resin and then being stacked together.
BBA’s Mr. Dunleavy said that nonwovens are suitable in protective medical devices for a
variety of reasons. “Suitability depends on end use application, as nonwovens can be
designed to be absorbent or repellent, breathable or impervious, with film lamination or soft
and stiff,” Mr. Dunleavy said.
“Spunlace is most suitable because there are no chemicals used during the
hydroentanglement production process and it makes it very hygienic and sanitary.
Spunlace is soft and the surface will not become damaged,” Hangzhou’s Mr. Tao said.
“Spunlaced nonwovens can produce both light and heavy weight products with different
degrees of softness,” commented David Farrar, managing director of BFF Nonwovens,
Bridgwater, Somerset, U.K.
BFF fabrics go into swabs, fixation tapes, non-adherent dressings, disposable drapes,
surgical gowns, ostomy bag components and wipes.
But spunlace is not the only nonwoven technology finding application in the medical
market. For instance, BBA Nonwovens uses several different technologies to manufacture
fabrics for the medical market, including high barrier SMS fabrics for surgical gowns,
drapes and CSR wrap applications.
Additionally, spunbonded fabrics are used more for non-sterile apparel and laminate
structures and wetlaid fabrics are used more for disposable linens. Johns Manville uses
spunbonded polyester, meltblown polypropylene and polyester to produce its nonwovens
for the medical market.
Innovations Underway
Bacteria control must also be considered when producing a
nonwoven, especially one that is going to be used in the
medical market. Foss Manufacturing, Hampton, NH, has
recently introduced a new antimicrobial line to assist in
preventing bacteria from growing. “Fosshield Antimicrobial
Technologies” effectively guards against the growth of a broad
spectrum of odor-causing destructive bacteria, mold and
mildew. With its added level of product protection, Fosshield
fiber allows for applications across a wide range of products that
are vulnerable to the effects of bacterial degradation, including bed linens, towels and
wound care. The new antimicrobial technology is derived from an all-natural, silver-based
inorganic composition. Silver, one of the oldest known antimicrobial agents, has been
proven effective in protecting fibers and fabrics from a broad spectrum of destructive and
odor-causing bacteria, mold and mildew, according to company executives.
Fosshield uses a proprietary patented process developed by Foss for incorporating the
advanced silver-based agent into the bicomponent (two polymers/additives) and binder
(adhesive) fibers of fabrics. A continual delivery system ensures the slow release of silver.
The result is a fabric that maintains efficiency of its antimicrobial protection for the
longevity of the product and can withstand multiple launderings. There are several other
new Fosshield products currently under development that are intended for use in the
medical industry for mattress pads, pillows and hospital scrubs.
Among the latest developments from Hangzhou are improved plaster substrates. “We
have plaster nonwoven substrates that have high blood-absorbency and are soft,” Mr Tao
said. “Our new plaster substrates offer a different spunlaced fabric structure that offers
more comfort.”
Nonwovens sometimes need to receive a chemical treatment to prevent water, blood or
bacteria from seeping through the fabric. Chemical treatments applied to nonwovens can
range from a water repellent substance to a film. According to INDA surface treatments
adapted or borrowed directly from traditional textile, paper or plastic finishing technologies
are used to enhance fabric performance or aesthetic properties. Examples of performance
properties are moisture transport, absorbency or repellency, flame retardancy and
abrasion resistance. Fabric finishing is either chemical, mechanical or thermal-mechanical;
chemical finishing allows for dyestuffs, pigments or chemical coating applications on fibers.
Disposables Forecast Bright
Manufacturers agree that the future of nonwovens looks promising, if certain obstacles are
addressed during production. “The future of nonwovens looks bright as markets move
more toward disposable products. As new treatments and methods of care are developed,
the possibilities for the use of nonwovens can only improve,” said BFF’s Mr. Farrar.
However, Mr. Farrar also noted that people may be unwilling to switch products if
something they use already works well. Additionally, many medical products have a long
development time, which can be difficult to overcome.
The flexibility of nonwovens remains a key characteristic as the future of nonwovens in the
medical market is speculated. “Nonwovens will continue to adapt to meeting the changing
needs of the medical market, be it in the structure or composition of the nonwoven itself or
in combination with other materials or with post treatments,” BBA’s Mr. Dunleavy
projected. “Flexibility and adaptability at low costs will contribute to its success. The wide
variety of technologies and fibers enables nonwovens to be engineered to meet the
specific needs of each different end use application.”
Nonwovens manufacturers agree that nonwovens will see success in the future with the
development of newer and hi-tech materials in the medical market. “Factors that will bring
success to nonwovens in the medical market also involve medicine, new-type and highertech materials, which will support their development,” said Mr. Tao. To achieve this growth,
nonwovens have several obstacles to overcome. “The low-speed development of the fiber
industry may limit the developing speed of nonwovens for medical products. Also, the
degree of acknowledgement and understanding about nonwovens for medical products in
different countries will limit their popularization and applications as well as development of
nonwoven medical products in such countries,” Mr. Tao said.
Most manufacturers agree that nonwovens are key when it comes to the medical market.
The main cloud that still lingers overhead is the question of what becomes of the
disposable after it is thrown away.
“The waste treatment after usage will bring certain pressure to society and the
environment due to the increased use of disposable nonwovens,” offered Mr. Tao. With
manufacturers busy developing new products, they just might discover a solu-tion with
disposables