@phdthesis{Ruecker2019,
  author    = {R{\"u}cker, Christoph},
  title     = {Development of a prevascularized bone implant},
  doi       = {10.25972/OPUS-17886},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-178869},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {The skeletal system forms the mechanical structure of the body and consists of bone, which is hard connective tissue. The tasks the skeleton and bones take over are of mechanical, metabolic and synthetic nature. Lastly, bones enable the production of blood cells by housing the bone marrow. Bone has a scarless self-healing capacity to a certain degree. Injuries exceeding this capacity caused by trauma, surgical removal of infected or tumoral bone or as a result from treatment-related osteonecrosis, will not heal. Critical size bone defects that will not heal by themselves are still object of comprehensive clinical investigation. The conventional treatments often result in therapies including burdening methods as for example the harvesting of autologous bone material. The aim of this thesis was the creation of a prevascularized bone implant employing minimally invasive methods in order to minimize inconvenience for patients and surgical site morbidity. The basis for the implant was a decellularized, naturally derived vascular scaffold (BioVaSc-TERM®) providing functional vessel structures after reseeding with autologous endothelial cells. The bone compartment was built by the combination of the aforementioned scaffold with synthetic β-tricalcium phosphate. In vitro culture for tissue maturation was performed using bioreactor technology before the testing of the regenerative potential of the implant in large animal experiments in sheep. A tibia defect was treated without the anastomosis of the implant's innate vasculature to the host's circulatory system and in a second study, with anastomosis of the vessel system in a mandibular defect. While the non-anastomosed implant revealed a mostly osteoconductive effect, the implants that were anastomosed achieved formation of bony islands evenly distributed over the defect. In order to prepare preconditions for a rapid approval of an implant making use of this vascularization strategy, the manufacturing of the BioVaSc-TERM® as vascularizing scaffold was adjusted to GMP requirements.},
  subject      = {Tissue Engineering},
  language  = {en}
}
@phdthesis{Meininger2022,
  author    = {Meininger, Markus},
  title     = {Calcium hydroxide as antibacterial implant coating},
  doi       = {10.25972/OPUS-26112},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261122},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {In modern medicine hip and knee joint replacement are common surgical procedures. However, about 11 \% of hip implants and about 7 \% of knee implants need re-operations. The comparison of implant registers revealed two major indications for re-operations: aseptic loosening and implant infections, that both severely impact the patients' health and are an economic burden for the health care system. To address these problems, a calcium hydroxide coating on titanium was investigated in this thesis. Calcium hydroxide is a well-known antibacterial agent and used with success in dentistry. The coatings were applied with electrochemically assisted deposition, a versatile tool that combines easiness of process with the ability to coat complex geometries homogeneously. The pH-gradient during coating was investigated and showed the surface confinement of the coating process. Surface pre-treatment altered the surface morphology and chemistry of the titanium substrates and was shown to affect the morphology of the calcium hydroxide coatings. The influence of the coating parameters stirring speed and current pulsing were examined in various configurations and combinations and could also affect the surface morphology. A change in surface morphology results in a changed adhesion and behavior of cells and bacteria. Thus, the parameters surface pre-treatment, stirring speed and current pulsing presented a toolset for tailoring cellular response and antibacterial properties. Microbiological tests with S. aureus and S. epidermidis were performed to test the time-dependent antibacterial activity of the calcium hydroxide coatings. A reduction of both strains could be achieved for 13 h, which makes calcium hydroxide a promising antibacterial coating. To give insight into biofilm growth, a protocol for biofilm staining was investigated on titanium disks with S. aureus and S. epidermidis. Biofilm growth could be detected after 5 days of bacterial incubation, which was much earlier than the 3 weeks that are currently assumed in medical treatment. Thus, it should be considered to treat infections as if a biofilm were present from day 5 on. The ephemeral antibacterial properties of calcium hydroxide were further enhanced and prolonged with the addition of silver and copper ions. Both ionic modifications significantly enhanced the bactericidal potential. The copper modification showed higher antibacterial effects than the silver modification and had a higher cytocompatibility which was comparable to the pure calcium hydroxide coating. Thus, copper ions are an auspicious option to enhance the antibacterial properties. Calcium hydroxide coatings presented in this thesis have promising antibacterial properties and can easily be applied to complex geometries, thus they are a step in fighting aseptic loosening and implant infections.},
  subject      = {Calciumhydroxid},
  language  = {en}
}
@phdthesis{Kress2019,
  author    = {Kreß, Sebastian},
  title     = {Development and proof of concept of a biological vascularized cell-based drug delivery system},
  doi       = {10.25972/OPUS-17865},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-178650},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {A major therapeutic challenge is the increasing incidence of chronic disorders. The persistent impairment or loss of tissue function requires constitutive on-demand drug availability optimally achieved by a drug delivery system ideally directly connected to the blood circulation of the patient. However, despite the efforts and achievements in cell-based therapies and the generation of complex and customized cell-specific microenvironments, the generation of functional tissue is still unaccomplished. This study demonstrates the capability to generate a vascularized platform technology to potentially overcome the supply restraints for graft development and clinical application with immediate anastomosis to the blood circulation. The ability to decellularize segments of the rat intestine while preserving the ECM for subsequent reendothelialization was proven. The reestablishment of a functional arteriovenous perfusion circuit enabled the supply of co-cultured cells capable to replace the function of damaged tissue or to serve as a drug delivery system. During in vitro studies, the applicability of the developed miniaturized biological vascularized scaffold (mBioVaSc-TERM®) was demonstrated. While indicating promising results in short term in vivo studies, long term implantations revealed current limitations for the translation into clinical application. The gained insights will impact further improvements of quality and performance of this promising platform technology for future regenerative therapies.},
  subject      = {Vaskularisation},
  language  = {en}
}
@phdthesis{Bachschmidt2015,
  author    = {Bachschmidt, Theresa},
  title     = {Magnetic Resonance Imaging in Proximity to Metal Implants at 3 Tesla},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135690},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Magnetic resonance imaging is derogated by the presence of metal implants and image quality is impaired. Artifacts are categorized according to their sources, the differences in susceptibility between metal and tissue and the modulation of the magnetic radiofrequency (RF) transmit field. Generally, these artifacts are intensified at higher field strength. The purpose of this work is to analyze the efficiency of current methods used for metal artifact reduction at 3T and to investigate improvements. The impact of high-bandwidth RF pulses on susceptibility-induced artifacts is tested. In addition, the benefit of a two-channel transmit system with respect to shading close to total hip replacements and other elongated metal structures in parallel to the magnetic field is analyzed. Local transmit/receive coils feature a higher peak B1 amplitude than conventional body coils and thus enable high-bandwidth RF pulses. Susceptibility-induced through-plane distortion relates reciprocally to the RF bandwidth, which is evaluated in vitro for a total knee arthroplasty. Clinically relevant sequences (TSE and SEMAC) with conventional and high RF pulse bandwidths and different contrasts are tested on eight patients with different types of knee implants. Distortion is rated by two radiologists. An additional analysis assesses the capability of a local spine transmit coil. Furthermore, B1 effects close to elongated metal structures are described by an analytical model comprising a water cylinder and a metal rod, which is verified numerically and experimentally. The dependence of the optimal polarization of the transmit B1 field, creating minimum shading, on the position of the metal is analyzed. In addition, the optimal polarization is determined for two patients; its benefit compared to circular polarization is assessed. Phantom experiments confirm the relation of the RF bandwidth and the through-plane distortion, which can be reduced by up to 79\% by exploitation of a commercial local transmit/receive knee coil at 3T. On average, artifacts are rated "hardly visible" for patients with joint arthroplasties, when high-bandwidth RF pulses and SEMAC are used, and for patients with titanium fixtures, when high-bandwidth RF pulses are used in combination with TSE. The benefits of the local spine transmit coil are less compared to the knee coil, but enable a bandwidth 3.9 times as high as the body coil. The modulation of B1 due to metal is approximated well by the model presented and the position of the metal has strong influence on this effect. The optimal polarization can mitigate shading substantially. In conclusion, through-plane distortion and related artifacts can be reduced significantly by the application of high-bandwidth RF pulses by local transmit coils at 3T. Parallel transmission offers an option to substantially reduce shading close to long metal structures aligned with the magnetic field. Effective techniques dedicated for metal implant imaging at 3T are introduced in this work.},
  subject      = {Kernspintomografie},
  language  = {en}
}