Abstract: Following recanalization of a stenotic blood vessel, a photosensitizer is administered by means of a vaso-absorbable stent to maintain the photosensitizer concentration level in the atheromatous plaque and smooth muscle cells in the vicinity of the lesion for a period of 5-18 days, the period in which cell proliferation can occur. The Vaso-Absorbable Stent (VAST) is described along with the method for its use in Photoatherolytic (PAL) Therapy. The VAST device is used post cardiovascular intervention to: a) deliver a series of drugs to prevent cell proliferation leading to restenosis; and, (b) maintain the patency of the treated vessel and prevent elastic recoil of the vessel by providing support for the vessel wall; and c) deliver and maintain a level of photosensitizer to the treatment site which inhibits smooth muscle cell proliferation and, when activated by light energy, induces cell lysis.

Abstract: An apparatus is described for the programmable iontophoretic or iontophoretic-ultrasonic (ionosonic) transdermal delivery of medication across the skin or other biological membrane. In one embodiment, the programmable apparatus controls the depth of penetration of a medicament into the skin. In another embodiment the programmed delivery of medicament is accompanied by an electrical stimulus for treating substance abuse. The apparatus can be adapted for large dermal area application or for a smaller area of application, depending on the choice of specific electrode employed. In a preferred embodiment the apparatus comprises a multichannel iontophoretic applicator electrode. Multiple piezoelectric elements are mounted on the iontophoretic electrode. The combination of ultrasonic vibration and iontophoresis improves the penetration of medicament in contact with the skin or mucous membrane underlying the electrode which can be programmably controlled by a CPU through the use of a EPROM.

Abstract: An apparatus and method for the non-surgical direct intubation of the duodenum or small bowel. The apparatus consists of an introducer tube comprising a double-lumen tubular member having a proximal end and a distal end. One of the lumens is dimensioned to permit the passage of a duodenal catheter therethrough. The other lumen is in fluid communication with the interior of an inflatable, anatomically-conforming balloon affixed asymmetrically near the distal end of the introducer tube. The anatomically-conforming balloon is stomach shaped when inflated. The introducer tube is advanced through the esophagus until the balloon is within the confines of the stomach. The introducer tube is then rotated so that the balloon is oriented toward (inflates toward) the greater curvature of the stomach. As the balloon is inflated, it expands into and conforms with the interior shape of the stomach.

Abstract: A tube securing device is described which is useful for fixing the position of a medical tubing, such as a thoracostomy tube, with respect to the skin of a patient. The anchoring device comprises a unitary strap resembling a cable tie having a free end, a body portion and a buckle end. The buckle end has two or more unidirectional locking mechanism thereon for enabling movement of the body portion of the strap in only one direction. In operation, the body portion of the device is wrapped around the invasive medical tubing at the point where it enters the skin and the free end of the strap is passed through the first unidirectional locking mechanism on the buckle portion to form a first loop which encircles and grasps the tubing. The loop may be taped to the body to secure the tubing in position. A special release loop is provided that enables removal of the anchoring device from the tubing without damaging the tubing.

Abstract: The present invention describes a catheter suitable for introduction into a tubular tissue for dissolving blockages in such tissue. The catheter is particularly useful for removing thrombi within blood vessels. In accordance with the preferred embodiments, a combination of vibrating motion and injection of a lysing agent is utilized to break up blockages in vessels. The vessels may be veins, arteries, ducts, intestines, or any lumen within the body that may become blocked from the material that flows through it. As a particular example, dissolution of vascular thrombi is facilitated by advancing a catheter through the occluded vessel, the catheter causing a vibrating, stirring action in and around the thrombus usually in combination with the dispensing of a thrombolytic agent such as urokinase into the thrombus. The catheter has an inflatable or expandable member near the distal tip which, when inflated or expanded, prevents the passage of dislodged thrombus around the catheter.

Abstract: An inexpensive adapter enabling the facile manual switching of the fluid uptake port of a standard manually-operated fluid dispensing pump fluid between a plurality of fluid reservoirs. The adapter, which has a low internal dead volume, has an adapter outlet port that is in fluid communication with the fluid uptake port of the fluid-dispensing pump and at least two adapter inlet ports. The adapter inlet ports are in fluid communication with respective fluid reservoirs. The adapter has concentric outer and inner housings. In a preferred embodiment, the outer housing is non-releasably affixed to a fluid dispenser head while the inner housing is releasably affixed to a plurality of fluid reservoirs. The position of the outer housing, which is manually rotated with respect to the inner housing, is determined by means of a spring-loaded detent.

Abstract: A device and method for the treatment of symptoms related to carpal tunnel syndrome is described. The device comprises an elastic member which removably attaches to the distal tips of the fingers and the thumb of the affected hand. The patient dons the device and with the fingers and thumb extended, repetitively forces the fingers and thumb outward away from one another against the elastic restoring force of the device. Brief, frequent, (preferably daily) use of this device relieves the symptoms of carpal tunnel syndrome.

Abstract: A diffuser tip for a fiber optic or array of fibers having a proximal end which abuts against the tip of the fiber optic or array of fibers. The diffuser tip has a cylindrical center core of transparent elastomer which contains scattering centers embedded therein. The scattering centers are distributed within the core so that the concentration of scatterers increases continuously in a direction from the proximal end of the diffuser tip to the distal end of the diffuser tip.

Abstract: An adjustable strap or band adapted to be circumferentially fitted around the forearm to alleviate the symptoms of tennis elbow. The strap is a generally band-shaped device having opposing inwardly protruding means on its forearm contacting surface to direct transaxial compression against the radial extensor, supinator complex and flexor muscles when the band is circumferentially tensioned and fastened in place around the forearm. In its preferred form, the band applies an adjustable pressure principally upon the extensor, supinator and flexor wads permitting unimpeded blood circulation along all other portions of the forearm. The two opposing means for applying transaxial compression are limited in their circumferential extent to those areas of the band immediately overlying the extensor and flexor muscle mass.

Abstract: A folding laminated map with an improved hinge and image retention is described. The map, or composite image, is separated into two or more discrete partial images or panels and printed on a single sheet of a suitable material. The discrete panels contain all the graphic information contained in the composite image, but the panels are spaced from adjacent panels in the composite image. The space between panels is a blank area on the printed sheet which will become the hinge. Slot-like portions are cut out of the blank area on the printed sheet in such a way as to leave connecting tabs between adjacent partial images or panels. The slots are very narrow enabling substantial juxtaposition of adjacent panels. After the slots are cut out of the hinge portion of the printed sheet, the single sheet containing the panels is passed through a laminating device with the hinge parallel to the direction of travel through the laminator.

Abstract: A cylindrical diffuser tip for use with an optical fiber is described. The diffuser tip comprises a silicone core abutted to the terminus of the conventional optical core of an optical fiber, an outer layer of silicone plus a suitable scatterer, and a final cladding of plastic tubing to provide controlled stiffness or rigidity to the silicone diffuser tip while maintaining a flexibility comparable to the optical fiber. The tip provides a substantially uniform distribution of radiance along its length and is particularly useful for laser radiation treatment of tumors. The stiffness of the diffuser tip can be varied by choosing an outer tubing of varying wall thickness and durometer. The diffuser tip is useful for providing uniform cylindrical illumination of target tissue in remote areas of the body and is particularly useful in such areas as Photodynamic Therapy of tumors and atheromas and hyperthermia.

Abstract: A flexible tip for a medical catheter suitable for the transmission of light and dimensioned to pass through extremely small tubular members is described. The flexible tip, preferably made of optically transparent silicone elastomer, is affixed to the terminal end of a conventional optical fiber. In a preferred embodiment, the flexible tip comprises a central silicone core surrounded by a cladding having an index of refraction less than that of the core, permitting internal reflection. The flexible tip is provided with an outer jacket which serves two purposes: a) it provides structural integrity for the tip, and b) it reinforces the union between the flexible tip and the optical fiber to which it is abutted. The tip enables the delivery of a comparable amount of light as a large glass fiber of equal core diameter but possesses much greater flexibility.

Abstract: An improved power meter for measuring the energy and wavelength of light emanating from an optical fiber. The meter is an integrating sphere having a source aperture for receiving the tip of an optical fiber and coupling the light from the tip into the sphere's central cavity. The source aperture is modified to include a sterilizable, liquid-fillable insert which mimics the optical environment within tissue. The sphere also has improved baffling and the sensitivity of wavelength verification is improved by means of a rotatable interference filter placed between an exit aperture and a light detector.

Abstract: An optical waveguide having a large diameter silicone core for transmission of visible and infrared light is described. The silicone-cored optical waveguide is generally useful for the conduction of light from a source to one or more remote distribution points for illumination. It is particularly useful for conducting light to areas of the body remote from the light source for medical application. The use of optically transparent silicone as the optical waveguide's core material enables the construction of an improved fiber having greater flexibility than a glass or plastic cored waeguide of the same diameter thereby enabling passage along a fortuous path. In the preferred embodiment, a silicone-cored waveguide is described which has large core diameter and a high degree of flexibility when compared to a glass fiber of similar core diameter.

Abstract: A microlens assembly for use with an optical fiber or fiber bundle that requires no crimping or mechanical distortion of the optical fiber. The microlens assembly has a front lens mounting portion and a rear portion. The rear portion is a cylindrical tube which is bonded to the sheath and cladding of the optical fiber or fiber bundle by means of suitable adhesive. The front lens mounting portion which houses the output lens is also tubular, having an inner diameter greater than the outer diameter of the rear portion. The front lens mounting portion is slid over the rear portion until the desired distribution of light emanating from the lens is achieved. The front lens mounting portion is then locked into position by bonding it to the rear portion by means of an appropriate adhesive. The adhesives are stable at high temperature and have an index of refractions suitable for preventing refractive loss of light from the lateral walls of the fiber core.

Abstract: A gastric band adapted for laparoscopic placement around the stomach and a method for deploying the band is described. The band is useful for creating a small pouch with a reinforced stoma in the stomach for the treatment of obesity. A first cannula is introduced into the abdominal cavity. Following gas insufflation, a camera for observing the placement of the band is introduced into the abdominal cavity by means of the first cannula. Two additional second and third cannulas are placed within the abdomen. The gastric band, which has a head end, a tail end and a body portion therebetween, is introduced into the abdomen by means of the second cannula. As the band emerges from the second cannula, an endoscopically-guided snare passed through the third cannula grasps one end of the band and pulls it into an encircling position around the stomach. The tail end of the band is adjustably attached to the head end to form a loop around the stomach. The band is tightened until the stoma has the desired size.

Abstract: A disposable aspirator assembly for use with an electrocautery handpiece is disclosed wherein the assembly removably attaches to the body of an electrocautery handpiece. The assembly is generally "T" shaped with the "base" of the T curved to extend in the general direction of the long axis of the handpiece to removably attach to vacuum tubing. In a preferred embodiment the hollow, tubular cross-member of the T is elastic and attaches by means of friction to the tip end of the electrocautery handpiece where it forms a substantially vacuum-tight fitting with the handpiece and protectively houses the electrocautery blade. Disposable vacuum tubing has a concave outer surface which mates with the convex outer surface of a cautery handpiece providing a cylindrical assembly which is easily grasped. The projection of the tip of the aspirator assembly along the electrocautery blade is adjustable.

Abstract: A device for applying therapeutic or analgesic pressure quantitatively which includes a sensor for continuously measuring the pressure on a patient's skin and underlying tissue. The instrument includes a hand-held force sensitive transducer having a blunt tip extending therefrom. When the blunt tip of the device is pressed against the skin thereby compressing the underlying tissue, the transducer yields an electrical signal proportional to the applied pressure. This signal is then fed to a resettable digital display. When the pressure applied to the skin reaches a threshold value, an actuator switch is actuated starting a timer which measures the elapsed time period during which the skin and underlying tissue is exposed to the measured pressure. An optional alarm indicates when the combination of pressure and elapsed time has reached a previously determined level.