Abstract: Provided are disposable dosage units for use in iontophoresis-facilitated transdermal delivery which have hydrophilic polymer first and second layers, the first layer having ionic resin particles dispersed therein and the second layer having an ionized pharmaceutical contained. The second layer having on its surface a thin fabric layer bearing an adhesive layer. The polymer first and second layers are separated by a permselective membrane. Also provided are related devices and processes using the novel disposable dosage units.

Abstract: A surgical instrument for removing a cataract from a patient's eye including a hollow vibrating needle surrounded by two hollow infusion sleeves. The outer sleeve conforms to the incision in the eye and the inner sleeve prevents the outer sleeve from collapsing onto the hollow, vibrating needle.

Abstract: A drug delivery device is described which utilizes gas pressure from free oxygen and hydrogen derived from the electrolysis of water at the electrodes in negatively charged polymeric hydrogels by electro-osmosis. The gas pressure forces the infusion of the drugs through appropriate means into the body. The rate of electrolysis which produces the oxygen and hydrogen is controlled by an electric current. Therefore the rate of drug delivery can be predetermined and precisely controlled. The current is activated and controlled by an electronic timer or a biomedical control system. The negatively charged hydrogel polymers have mechanical strength and rigidity and allow water to flow through the polymer network toward the cathode ensuring a continuous water supply to the electrodes inside the hydrogel system by electro-osmosis. The hydrogels may be recharged (reswollen) with water or simply replaced.

Abstract: A medical device for invasive positioning in the body comprises a liquid flow passage extending between an entry orifice (24) for admitting liquid into the device and an exit orifice from which liquid may pass from the device into the body, and means for establishing a positive electric field at a point (28) within the device. Negatively-charged bacteria are attracted by the positive field towards that point and away from the operative end of the device.

Abstract: A method for determining the concentration of a constituent of blood employing a sensor in or near a catheter in a blood vessel for producing a signal related to the concentration of the constituent of blood is disclosed. The improvement comprises obtaining the signal while at least one of the following is present in the blood vessel: (1) an added vasodilator component and/or vasodilation promotor in an amount effective to reduce the vasoconstriction caused by the presence of the catheter in the blood vessel and (2) an added platelet/white cell inhibitor component and/or a platelet/white cell deactivation promotor in an amount effective to reduce the platelet and/or white cell activation caused by the presence of the catheter in the blood vessel.

Abstract: An apparatus is provided for use with a contrast media injector. The injector is of the type including a gas source and a liquid source. The apparatus includes a gas delivery channel connected to the gas source and a liquid delivery channel connected to the liquid source. Two normally closed valves are provided to control flow from the gas and liquid channel. The valves insure that gas and liquid do not simultaneously exit from the channel. The valves minimize inadvertent mixing of the gas and saline downstream of the valves. The gas channel is connected to a gas source using a fitting which also connects electro-conductive wires in the apparatus to a power source. The liquid channel connects to a source of liquid.

Abstract: A two phase adhesive matrix for use in an electrically powered iontophoretic delivery device is provided. The adhesive matrix comprises an adhesive hydrophobic polymer phase and about 15 to 60 wt. % on a dry weight basis of a hydrophilic polymer phase distributed through the hydrophobic polymer phase. The hydrophilic phase forms upon hydration an interconnecting network of aqueous pathways for passage of the agent through the adhesive. The adhesive can be used to adhere an electrode assembly of an iontophoretic delivery device to a body surface such as skin or a mucosal membrane. Alternatively, the adhesive can be used to adhere together two or more elements of an iontophoretic delivery device.

Abstract: A method useful in a process for cataractous lens removal for operating phacoemulsifier apparatus having a vacuum pump and a fluid irrigation pump in order to simultaneously control vacuum, for aspiration, and fluid flow, for irrigation, to a phacoemulsifier handpiece. The method includes selecting a vacuum limit for aspiration; selecting a fluid flow limit for irrigation; assigning a linear relationship between a remotely disposed control lever and vacuum provided to the handpiece by the vacuum pump between zero and the vacuum limit; supplying vacuum to the handpiece by actuating the control lever; and controlling the fluid flow to the handpiece in response to the level of vacuum provided to the handpiece so that as more vacuum is provided, less fluid flow than the fluid flow limit is provided to the handpiece.

Abstract: An ultrasonic ablation device for effecting ultrasonic ablation of intravascular obstructions such as plaque or thrombi. The ultrasonic ablation device has a) an elongate catheter body, b) a wave guide or ultrasound transmission wire extending through the elongate catheter body, and c) a distal head or probe member positioned at the distal end of the catheter body. A guidewire lumen or passageway extends longitudinally through the catheter body and a guidewire aperture or passageway extends through the distal head or probe such that a guidewire may be passed through the distal head or probe and through the catheter body. Also disclosed is an improved distal head or probe which may be incorporated in any elongate ultrasonic ablation device, the improvement comprising the formation of a concavity or indentation in the distal or frontal face of the distal head or probe to improve the cavitation created thereby.

Abstract: Disclosed is an improved ultrasonic knife of the type for surgical incision in various types of tissue and/or for the removal of cement within the body. The knife has a reduced thermal footprint to minimize thermally induced tissue damage. Tooth configuration on the knife cooperates with the stroke of the ultrasonic drive to produce efficient cutting, as well as tactile feedback to the surgeon with respect to the rate of cutting, and changes in tissue density. Ultrasonic knife tip extenders are also disclosed for advancing the ultrasonic knife tip through the working channel of an endoscope. Methods utilizing the foregoing apparatus are also disclosed.

Abstract: One of the aspects of the present invention relates to a method for the treatment of retinal detachments utilizing a transparent liquid or gel retina reattachment enhancing material preferably perfluorotri-n-propylamine for long-term but not permanent replacement in the eye for effecting a retinal reattachment of a retinal tear. A sufficient amount of a gas is first injected into the vitreous cavity of a patient's eye having a first gel or liquid material therein and a retinal tear so that the gas expands, compresses, and displaces an amount of the first gel or liquid to provide a space for receipt of a sufficient amount of the retina reattachment enhancing material. Once sufficient space is provided in the vitreous cavity, the retina reattachment enhancing material is injected into the eye. Once the retinal tear is visible and lies flat upon the underlying tissue, the retina is tacked down around the retinal tear so as to form a retinal scar.

Abstract: An electrophoretic/electro-osmotic transdermal drug delivery system for passing at least one drug, or therapeutic compound, through the skin membrane of a patient by way of a drug reservoir or gel for delivery to the systemic blood of a patient in selected, periodic pulsations. The system can be varied to accommodate various types of therapeutic compounds having varied characteristics and purposes. The system includes a current oscillator that applies periodic electrical variations to the system in order to trigger rhythmical variations of the potential and resistance of the skin membrane so as to cause oscillatory electro-osmotic streaming of the liquid with the therapeutic compound across the skin membrane in synchronization with the oscillator to the systemic blood of the patient in response to the rhythmical variations.

Abstract: The invention discloses methods and compositions for enhanced skin concentration of iontophoretic delivered active agents. The compositions are pharmaceutically acceptable compositions for iontophoretic delivery which comprise a skin concentration enhancing amount of a vasoconstrictor and active agent. Methods comprise adding a skin concentration enhancing amount of a vasoconstrictor to an active agent and delivering by iontophoresis.

Abstract: A single use needleless hypodermic injector includes an elongate housing with a proximal end, a distal end, an axis and a hollow bore therethrough. The housing has a reservoir at the distal end with a generally cylindrical chamber for containing an injectable liquid. The chamber has a axis aligned with the housing longitudinal axis. The chamber has a first open end adjacent the housing with a resilient stopper mounted therein. The reservoir has a distal second end with an orifice in fluid communication with the chamber. The resilient stopper seals the chamber and ejects the liquid from the chamber, forming a stream at the orifice when the stopper is moved distally in the chamber. The injector has an piston mounted for axial movement within the housing bore and elements to axially bias the piston distally within the bore. The piston has an armed position wherein it is positioned proximally within the bore.

Abstract: An electrophoretic/electro-osmotic transdermal drug delivery system for passing at least one drug, or therapeutic compound, through the skin membrane of a patient by way of a drug reservoir or gel for delivery to the systemic blood of a patient in selected, periodic pulsations. The system can be varied to accommodate various types of therapeutic compounds having varied characteristics and purposes. The system includes a current oscillator that applies periodic electrical variations to the system in order to trigger rhythmical variations of the potential and resistance of the skin membrane so as to cause oscillatory electro-osmotic streaming of the liquid with the therapeutic compound across the skin membrane in synchronization with the oscillator to the systemic blood of the patient in response to the rhythmical variations.

Abstract: A needle tip protecting device is provided for catheters having an insertion needle. The device is small enough to be stored at the base of the catheter needle prior to and during use. After use it may be slip to cover the needle tip where it automatically self-attaches and becomes non-removable. Various embodiments of mechanisms to achieve this effect are described.

Abstract: An irrigation and aspiration apparatus for cataract surgery or the like, which is particularly suitable for aspiration and removal of the cortex lentis during the surgical operation. As for the structure, the irrigation and aspiration apparatus of the present application includes a selector coupling to which ends of a plurality of aspiration tubes are connected, while the other ends of the aspiration tubes are respectively connected to handpieces which can perform aspiration, so that one of the handpieces for aspirating irrigating fluid and the like from a diseased eye of a patient can be chosen by switching the selector coupling. With this structure, aspiration and removal of the residual cortex after removal of the lens nucleus in the surgery of the crystalline lens can be accomplished easily and reliably, thereby relieving the doctor and the patient from the stress and load of the surgical operation.

Abstract: A hydratable iontophoretic bioelectrode including a plurality of layers of material capable of absorbing and holding an ionized fluid when placed in contact with the fluid. In one embodiment, a layer of a highly crosslinked dry hydrogel is used with a second layer of a more lightly crosslinked dry hydrogel. When the lightly crosslinked hydrogel layer is located so as to be in contact with the skin during iontophoresis, the medicament ions will be concentrated next to the skin. When the more highly crosslinked layer is located next to the conductive member, the undesirable effects of hydrolysis or corrosion of the conductive member are lessened. In another embodiment, adjacent layers are maintained at least partially out of contact from one another so as to improve the rate of hydration by disposition between the layers of spacing elements such as sugar or other dissolvable particles or cellulose or by forming a three dimensional pattern thereon.

Abstract: An ultrasonic angioplasty device comprising an elongate ultrasound transmission member having a proximal end attachable to an ultrasound generating device and a bulbous distal head or probe formed on the distal end thereof for effecting ablative treatment of an occluding lesion. The ultrasound transmission member may be formed of one or more superelastic metal alloys such as NiTi (50 at. % Ni). A guidewire lumen may be formed in the distal head or probe to permit passage of a guidewire therethrough. Portions of the ultrasound transmission member may be curved or bent. Portions of the ultrasound transmission member may be tapered or narrowed. One or more surface disruptions may be formed on the distal head or probe to improve treatment efficacy. An increased hardness coating or outer skin may be formed on the ultrasound transmission member. The device of the present invention may be incorporated into an angioscopic device.

Abstract: A catheter device incorporating combined ultrasound ablation and balloon dilation components. The catheter device generally comprises an elongate catheter body having proximal and distal ends and an outer surface. Disposed on the outer surface of the catheter body is a dilation balloon. At least one balloon inflation lumen fluidly connects the proximal end of the catheter body to the dilation balloon to permit injection of inflation fluid into the dilation balloon. Extending longitudinally through the catheter body is an ultrasound transmission member having a proximal end and a distal end, with the proximal end being connectable to an ultrasound transducer such that ultrasonic energy will pass through the ultrasound transmission member to the distal end thereof. In alternative embodiments of the present invention, there are provided catheter devices incorporating combined ultrasound ablation and laser ablation components as well as combined ultrasound ablation and atherectomy ablation components.