Breast implant

Summary

A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery. Complications of implants may include breast pain, rashes, skin changes, infection, rupture, cosmetic changes to the breasts such as asymmetry and hardness, and a fluid collection around the breast. A rare complication associated with textured surfaced implants is a type of lymphoma (cancer of the immune system) known as breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). There are four general types of breast implants, defined by their filler material: saline solution, silicone gel, structured and composite filler. The saline implant has an elastomer silicone shell filled with sterile s

Official source

https://en.wikipedia.org/wiki/Breast_implant

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Une université des métiers au coeur de la ville. Requalification de l'espace de la gare de Sion (VS)

Ce travail de diplôme se propose de requalifier l'ensemble de l'espace de la gare de Sion (VS). Cet espace revêt une grande importance tant sur le plan régional, puisqu'il offre l'une des plus grandes gares routières de Suisse, que sur le plan urbain de par sa position centrale. Actuellement, cet espace souffre de la difficile cohabitation entre les véhicules et les piétons, et du manque d'intégration au tissu environnant. Ce travail se propose donc d'améliorer cette interface urbaine et de lui donner le statut d'espace public. Ceci passe par une clarification et une redistribution des différents modes de transports présents sur le site. Dans ce sens, une interface de transport, regroupant la gare CFF et la gare routière, est créée au sud du site, le long des rails. Cet espace ne se limite pas seulement à une interface de divers moyens de transports, mais il a le potentiel de devenir un véritable vide urbain. Dans ce but, le projet propose la création d'un nouveau pôle urbain à l'est du site, sur des terrains à l'abandon. La création de ce nouveau pôle proposant une mixité d'affectations, tant publiques que privées, permet de mieux insérer le site dans son contexte immédiat et de créer une façade de la ville. Cette partie est définie par l'implantation de différents volumes, dont un nouveau bâtiment pour la haute école valaisanne regroupant deux domaines de formation. L'implantation des différents volumes définit des «vides urbains», dont une grande place qui est mise en relation avec les autres espaces publics par un axe existant, mais inexploité.

2005

Diamond-like carbon (DLC) coatings can improve the wear resistance of articulating implants. However despite successful in-vitro testing, some DLC coated joint replacements had to be revised prematurely, mainly due to coating delamination induced by corrosion at the substrate/DLC interface. Body fluid will enter defective coating sites and if the reactively formed interface or interlayer materials are instable in the confined fluid, they with dissolve, resulting in delamination of the DLC and ultimate failure of the implant. The aim of this thesis is therefore to investigate the corrosion mechanisms responsible for delamination at a substrate/DLC interface in body-like media. This is achieved by developing and implementing experimental methodologies addressing/simulating aggravating factors such as confinements/crevices, galvanic coupling, stress and fatigue on the interface to investigate corrosion initiation, propagation, and failure. Firstly, corrosion initiation and galvanic coupling risk are addressed with a methodology for accessing and characterizing the reactivity of buried interlayers. The interlayer is revealed by ion beam polishing, forming a wedge-like profile of the substrate/interlayer/DLC. The composition and chemical state of the interlayer/interface is determined by Auger electron spectroscopy. Reactive interlayers/interfaces, Si, titanium (Ti) and chromium (Cr), formed new phases (carbides and oxides). These new materials are then characterized with a local-electrochemical microcapillary technique. Cr and Si-DLC based interlayers presented good passive behavior, while a Si interlayer corroded in bovine-based wear test fluid (HyClone® WTF). The influence of coating defects on the current response of DLC surfaces was also investigated by varying the exposed working area (cm2 to µm2 range). To address the failure case of a TiAlV/Si/DLC implant, the influence of confinements/crevices on corrosion propagation is investigated. It is shown that Si is highly vulnerable to corrosion in confined conditions. Pitting corrosion susceptibility is found in a crevice, whereas a Si dissolution rate of ca. 3.6 nm/h at 37 °C occurs within a confined area. The corrosion rates increased at elevated temperatures and yielded linear Arrhenius relations, with activation energies of 106 KJ/mol in phosphate buffered saline (PBS) and 109 KJ/mol in HyClone® WTF. Phosphorous species enhanced Si dissolution, while chlorides were not so influential. Galvanic coupling with Ti and applied stress further accelerated the Si dissolution. Finally, corrosion related fracture of a CoCrMo/DLC interface is investigated by applying static and cyclic load. A reciprocating sliding rig is utilized to determine the number of sliding cycles required for interface delamination to occur at a critical load, in PBS at 37 °C. The results followed a Wöhler curve relation. Small O2 contaminations (0.5 and 1.0%) at the interface adversely affected the CF behaviour by lowering the critical load and endurance limit. The fitted Wöhler curves could be extrapolated and were found to be in good agreement with long-term experimental results previously obtained on an implant in a spinal disk simulator.

EPFL2019

Intra-aneurysmal hemodynamics: evaluation of pCONus and pCANvas bifurcation aneurysm devices using DSA optical flow imaging

Pierre Bouillot

Background Implantation of self-expanding stents from the parent artery into the sac of a bifurcation aneurysm is regularly used to facilitate endovascular coil occlusion with the so-called waffle cone technique (WCT). Self-expanding aneurysm bridging stents like Solitaire AB, can be used; however, bifurcation devices like pCONus and pCANvas are especially designed for WCT. These devices provide additional support for coil implantation owing to intraluminal nylon fibers (pCONus) or membranes (pCANvas) covering the intracranial aneurysm neck. Objective Assessment of the intra-aneurysmal hemodynamic impact of these three devices: a regular intracranial stent (Solitaire AB) and two bifurcation devices (pCONus and pCANvas). Material and methods An in vitro experiment was set up using a silicone model of a basilar tip aneurysm filled with blood mimicking fluid under a pulsatile circulation. Solitaire AB, pCONus, and pCANvas were successively implanted in the model for hemodynamic evaluation. High frame rate DSA series were acquired under various conditions. Intra-aneurysmal flow changes, including mean aneurysm flow amplitude ratio (R), were subsequently assessed by the optical flow method, measuring the detector velocity field before and after device implantations. Results pCONus and Solitaire minimally reduced the intra-aneurysmal flow (R=0.96, p=0.17 and R=0.91, p=0.01, respectively), whereas pCANvas strongly diminished the intra-aneurysmal flow (R=0.41, p=5x10(-12)). Conclusions Waffle cone deployment of stents and technique-specific devices had no undesirable effect on the intra-aneurysmal flow. In particular, no increased flow was redirected into the aneurysm sac. The intraluminal membrane of the pCANvas strongly reduced the intra-aneurysmal flow, potentially preventing recanalization problems.

BMJ2015

EPFL2019