CA2565638A1 - Light diffuser and process for producing the same - Google Patents
Light diffuser and process for producing the same Download PDFInfo
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- CA2565638A1 CA2565638A1 CA002565638A CA2565638A CA2565638A1 CA 2565638 A1 CA2565638 A1 CA 2565638A1 CA 002565638 A CA002565638 A CA 002565638A CA 2565638 A CA2565638 A CA 2565638A CA 2565638 A1 CA2565638 A1 CA 2565638A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/062—Photodynamic therapy, i.e. excitation of an agent
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B2018/2255—Optical elements at the distal end of probe tips
- A61B2018/2261—Optical elements at the distal end of probe tips with scattering, diffusion or dispersion of light
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0601—Apparatus for use inside the body
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- Radiation-Therapy Devices (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
- Optical Fibers, Optical Fiber Cores, And Optical Fiber Bundles (AREA)
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Abstract
A light diffuser ( 10 ), which is particularly suitable for introducing diffuse light into a tissue, is produced by interpenetration of a diffuser material in a liquid state into a boundary layer ( 4 ) of a porous shaping material, by which process a diffuser surface is formed having a surface structure which represents essentially a negative of the pore structure of the shaping material and comprises undercut structures induced by a surface tension. The light diffuser ( 10 ) is, for example, produced by introducing a diffuser blank ( 1 ) comprising material which is liquefiable through mechanical vibration into the shaping material and simultaneously stimulating it with mechanical vibrations, such that the liquefiable material liquefies at least there where it is in contact with the shaping material and is pressed into the shaping material.
Description
35-125 CA/PCT CA 02565638 2006-11-03 Patent LIGHT DIFFUSER AND PROCESS FOR PRODUCING THE SAME
[001] The invention concerns a light diffuser suitable for the diffuse deflection of light delivered to the diffuser from a light source or through a light conductor in an essentially axial direction. The light diffuser according to the invention is e.g. suitable for application in endoscopic methods, e.g. for the targeted introduction of diffuse light into tissue structures, in particular into bone tissue, and for the consistent illumunation of hollow biological structures.
[001] The invention concerns a light diffuser suitable for the diffuse deflection of light delivered to the diffuser from a light source or through a light conductor in an essentially axial direction. The light diffuser according to the invention is e.g. suitable for application in endoscopic methods, e.g. for the targeted introduction of diffuse light into tissue structures, in particular into bone tissue, and for the consistent illumunation of hollow biological structures.
[002] Diffuse light is applied in tissue structures e.g. in the so-called photodynamic therapy methods known in particular for the treatment of tumorigenic diseases.
For this purpose a substance, which is sensitive to light and accumulates mainly in the tumorous tissue, is administered to a patient. Then the tumorous tissue is illuminated with light of a specific wavelength, which activates the photosensitive substance and triggers a chemical reaction, which in turn destroys the tumorous cells.
For this purpose a substance, which is sensitive to light and accumulates mainly in the tumorous tissue, is administered to a patient. Then the tumorous tissue is illuminated with light of a specific wavelength, which activates the photosensitive substance and triggers a chemical reaction, which in turn destroys the tumorous cells.
[003] Activating the photosensitive substance by light initiates the destruction of the tumorous cells. It is therefore important to be able to introduce a specific dose of light adjusted to the size of the tumour in a targeted manner and as homogenously as possible into the tumorous tissue, which is usually achieved by means of a light conductor, wherein the distal end of the light conductor is designed as a diffuser. The task of the diffuser is to scatter the light, which propagates essentially axially inside the light conductor, in as many different directions as possible and as evenly as possible.
The diffuser is brought to, or introduced into the tissue to be illuminated and is supplied by the light conductor with light of a given wavelength. The diffuser distributes the light introduced by the light conductor as homogenously as possible in a space whose shape is advantageously adapted to the circumstances.
The diffuser is brought to, or introduced into the tissue to be illuminated and is supplied by the light conductor with light of a given wavelength. The diffuser distributes the light introduced by the light conductor as homogenously as possible in a space whose shape is advantageously adapted to the circumstances.
[004] Such diffusers are known to be manufactured by corresponding modification of the distal end of a light conductor and/or by placing an appropriately equipped end-piece on or at the distal end of the light conductor. Thus e.g. the sleeve placed around the light conducting fibre is removed at the distal end of the light conductor and the surface of the light conducting fibre is roughened slightly, etched or treated with suitable tools to create a light scattering surface, as it is disclosed e.g.
in the publication 35-125 CA/PCT CA 02565638 2006-11-03 Patent FR-2782778. Light scattering end-pieces usually comprise a transparent material filled with particles (e.g. transparent plastics with particles of aluminium oxide or titanium oxide). In case the light scattering effect of the modified fibre surface and/or of the end piece does not suffice to deflect an adequate portion of the supplied light from the axial direction, it is also suggested that a mirror is positioned at the distal end of the light conductor or of the diffuser, reflecting non-deflected light back into the diffuser area (e.g. disclosed in US-5695583, US-2002/0094161 and US-5431647).
10051 Known light diffusers thus essentially represent the distal end of a light conductor and for medical purposes are brought to, or introduced into the tissue to be treated with minimally invasive methods and removed after the treatment. For the treatment, the proximal end of the light conductor is attached to a light source, wherein the light source is e.g. a laser but can also be the distal end of another light conductor.
[006] The known diffusers described above are manufactured by relatively elaborate methods and are therefore expensive. They nevertheless have to be treated as disposable items as they are difficult to clean and sterilize and the risk of infection is clinically often considered too high for a repeated application. For photodynamic therapy, the diffuser has to be brought into the immediate vicinity of, or even into the tissue to be treated and it has to be retracted from this tissue after the treatment, which is connected with the danger of diseased cells, e.g. metastasizing tumorous cells, being spread.
[007] The object of the invention is to create a light diffuser as well as a method for producing the same. The light diffuser according to the invention is to be suitable for most diverse applications, not only medical but also technical applications, in particular however for the aforementioned introduction of diffuse light into bone tissue (photodynamic therapy) and for the homogenous illumination of hollow biological structures (hollow organs). Compared to the production of known light diffusers, the method for producing the light diffuser according to the invention is to be simpler and it is to enable a simple adjustment to given circumstances, of the geometry of the space to be provided with diffuse light.
35-125 CA/PCT CA 02565638 2006-11-03 Patent [008] The method according to the invention serving for producing a light diffuser, or for supplying diffuse light to tissue, in particular to bone tissue respectively, is based on the following finding: When an implant consisting of a thermoplastic material is implanted in bone tissue by means of mechanical oscillation, in particular ultrasound, as described e.g. in the publication WO-02/069817, its surface changes in particular where this surface is, or is brought into contact with the bone tissue, and in particular when such locations are provided with energy directors. At these points the thermoplastic material liquefies and is pressed into uneven patches and pores (trabecular chambers) of the bone tissue; it interpenetrates the bone tissue.
Under normal implantation conditions this interpenetration e.g. in spongeous bone tissue reaches a depth equivalent to about two trabecular chambers. After re-solidification of the thermoplastic material, this material and the bone tissue are connected to each other in a positive fit connection, which is e.g. exploited as a primary stabilisation of the implant immediately after the implantation.
[009] It is found that the thermoplastic material penetrating the bone tissue also lends the implant a surface structure ideally suited to scatter light, which is coupled into a proximal face of a transparent implant in axial direction, from the implant into the bone tissue surrounding the implant. In its implanted condition the implant represents an excellent light diffuser. Prior to the implantation it is a kind of diffuser blank.
[0010] The change to the surface caused by the implantation in bone tissue by mechanical vibration, by which a corresponding implant (diffuser blank) becomes a diffuser, develops in the liquid condition of the diffuser material, so that the emerging structures have forms created in a flowing motion, therefore induced by a surface tension, and essentially representing a negative of the porous bone structure, i.e. in particular comprising undercuts.
[0011] When a laser beam of a 625mn wavelength is coupled from a light conductor (diameter 0,4 mm) to the proximal face of a pin-shaped implant of poly-LDL-lactide (length 25 mm, diameter 3,5 mm), ca. 75% of the coupled light intensity is measured at the distal end of the implant, which represents a very anisotrope light distribution. If the same implant is driven into "sawbone' (closed pore polyurethane foam reinforced by glass fibre), whose structure closely resembles bone, by ultrasound and without prior 35-125 CA/PCT CA 02565638 2006-11-03 Patent drilling, the implant surface changes and becomes light scattering. In this state of the implant, an essentially equal light intensity is measured (distal end: 0,22 W/mm2;
circumferential surface: 0,20 W/mm2) across the implant surface where altered by the implantation. These measurements show that the altered surface scatters the coupled light very homogenously, i.e. turns the implant into a very good light diffuser.
[0012] The finding described above does not only apply to bone tissue but can be transferred to other porous materials, in particular to artificial materials, wherein such artificial shaping materials are to comprise a porous structure like bone tissue. The pores of such shaping material are advantageously sized between 0.005 and 1.0 mm.
The properties of the shaping material furthermore must be such that its porous structure can offer sufficient resistance for enabling liquefaction and interpenetration of the thermoplastic material of the diffuser blank when the diffuser blank is introduced in the shaping material by mechanical vibration. If this is not the case, the porous structure collapses and the interpenetration of the porous shaping material necessary for the development of the desired surface structure does not take place.
[0013] Instead of liquefying by mechanical vibration a solid diffuser blank material in areas where the diffuser blank is in contact with the porous shaping material and by pressing the liquefied material into the porous shaping material through pressure applied to the diffuser blank, it is also possible to press or suck a liquid diffuser material into the porous shaping material (e.g. by capillary action or pressure difference). The liquid diffuser material is then hardened by cooling (e.g.
thermoplastic polylners, glasses), by a suitable chemical reaction (e.g. cross-linking resins such as epoxy resin or silicone) or by thickening (e.g. gels or hydrogels on the basis of polyethylene glycols, alginates, chitosanes, collagens and their copolymers or blends).
This method not only gives a greater choice of diffuser design than the õimplantation method" but it also makes it possible to create a gel-like, i.e. flexible diffuser in a flexible shaping material, which is then not removed from the diffuser and which is suitable e.g. for illumination of the walls of hollow spaces, as it can adapt to diverse shapes of hollow spaces, or e.g. can even be left in a corresponding space if a resorbable hydrogel is used. Such a light diffuser can e.g. in the case of tumour excision wounds not only assume the function of illumination but also the function of wound 35-125 CAIPCT CA 02565638 2006-11-03 Patent tamponing after irradiation, to which purpose it is advantageously modified in a known manner with active substances such as cytotoxins, anti-inflammatory substances, antibiotics or growth factors for the further treatment of the defect.
[0014] The properties of an artificial porous shaping material suitable for producing the diffuser according to the invention can be such that it can be removed from the diffuser produced therein e.g. by dissolution in an appropriate solvent, by etching, by melting or subliming. Providing the shaping material has at least locally suitable properties it can also remain on the diffuser surface and form a kind of diffuser cap, which, due to its porosity, can e.g. further scatter light deflected by the diffuser. Such a diffuser cap of the porous shaping material may already have the shape of a cap, i.e.
relatively thin walls, when the diffuser is produced, or it may be appropriately processed afterwards. The diffuser cap can also be fashioned for a specific non-optical additional function or can be shaped appropriately by a subsequent addition or removal of material or by re-forming. The porosity of the shaping material can be homogenous.
In particular if the diffuser cap has specific non-optical additional functions it may be advantageous to fashion the porosity inhomogeneous and to vary it depending on the function of each part of the diffuser cap. Thus a diffuser cap can be porous where it is to be interpenetrated by a diffuser material while the exterior surface of the cap is smooth and free from pores in order to minimize friction in the tissue and contamination e.g. in the endoscopic application.
[0015] Diffusers according to the invention produced by means of an artificial shaping material suit non-medical and medical applications, but in particular the introduction of diffuse light in soft tissue or in tissue voids (e.g. blood vessels, respiratory passages or digestive tract). In that case the same procedure is followed for the introduction of the diffuse light as with diffusers according to the state of the art, wherein the diffuser according to the invention is coupled with a light conductor or a light source and is positioned for the application. Then light of a desired wavelength is coupled from the light conductor into the diffuser, which scatters the light and thus brings it into the tissue. A particular advantage of flexible diffusers produced by the above mentioned method is the fact that due to its flexibility, the diffuser is optionally bent by the operator using per se known catheter techniques around a large solid angle, 35-125 CA/PCT CA 02565638 2006-11-03 Patent such enabling a corresponding control of the instrument on one hand and a targeted illumination on the other.
[0016] It is also possible to couple light to be scattered only into a part of the diffuser and to equip other areas thereof for other functions, wherein these other areas are e.g.
not transparent.
[0017] The use of vital tissue, in particular of bone tissue, as porous shaping material for producing the diffuser from a diffuser blank means that the diffuser blank is implanted and the light scattering surface structures develop during implantation (in situ). It is not imperative to create an opening (e.g. a bore) in the osseous material prior to the implantation. For example, the cortical layer of a bone is optionally drilled in advance and the implant positioned in the bore before it is driven by pressure force and simultaneous vibration into the spongiosa, without drilling the latter. With such a diffuser produced in situ, a tumour (or metastasis) located in the spongiosa can be illuminated. The diffuser implant optionally remains in the bone tissue for further illuminations, where with its intensive anchoring represents a beneficial further reinforcement of the osseous tissue debilitated by the tumour. The diffuser implant optionally consists of a biologically resorbable light conducting material so that it does not need to be removed after its use for the illumination of the tissue and is gradually replaced by regenerated bone tissue.
[00181 If the diffuser implant is to remain in the place of implantation after the illumination, it is suggested that care be taken that the proximal end of the diffuser implant does not protrude substantially from the bone and that its proximal end is primed for the connection with a light conductor which is advanced to this proximal end for the illumination as in known endoscopic methods.
[0019] The crucial advantage of the diffuser produced by implantation in vital bone tissue over known diffusers used for the same purpose, is the fact that precursory drilling is not necessarily needed and that the implant does not necessarily need to be removed, or to be removed immediately after the application of the diffuser for an illumination or activation. This means that no element needs to be removed from the 35-125 CA/PCT CA 02565638 2006-11-03 Patent tissue to be treated before or immediately after the treatment and therefore the danger of spreading diseased cells, e.g. metastasizing tumorous cells is considerably reduced.
[0020] The diffuser according to the invention and the method for its production are described in detail in connection with the following Figs., wherein:
100211 Figure 1 shows the method for producing the light diffuser according to the invention on the example of a diffuser, which is to have a more-or-less cylindrical active range;
[0022] Figure 2 shows a further exemplary diffuser blank and the light diffuser according to the invention produced therefrom, which diffuser comprises a more ball-shaped active range;
[0023] Figures 3 and 4 show intensity profiles of the light diffusers according to Figs. 1 and 2;
[0024] Figures 5 and 6 show further exemplary embodiments of diffuser blanks suitable for producing light diffusers with various active ranges;
[0025] Figure 7 shows a further light diffuser according to the invention comprising a diffuser core primed for additional functions;
[0026] Figures 8 and 9 show various ways of coupling light into a light diffuser according to Fig. 7;
[0027] Figure 10 shows a further light diffuser according to the invention with a hollow diffuser core primed for further functions;
[0028] Figures 11 and 12 show diffusers according to the invention with diffuser caps primed for further functions.
[0029] Figure 1 illustrates the method according to an embodiment of the invention for producing a light diffuser with the aid of a sequence of sections through the diffuser during production. It shows the production of an exemplary light diffuser, which is to have a relatively cylindrical active range. As described above, the diffuser can be produced in situ in a bone, or ex situ by means of an artificial shaping material, which 35-125 CA/PCT CA 02565638 2006-11-03 Patent is interpenetrated by the diffuser material in a contact layer, wherein for using the diffuser, the shaping material is optionally left as a diffuser cap on the diffuser or is removed therefrom.
[0030] The diffuser blank I consisting of a suitably transparent thermoplastic material in a solid state has , for example, an essentially cylindrical form with a distal end 1.1 and a proximal end 1.2, wherein the proximal end 1.2 is furnished with a means to couple an appropriately primed distal light conductor end 11, for example with a circumferential groove 1.4.
[0031] In the illustrated example essentially the whole circumferential surface of the diffuser blank 1, though not its distal face, is to be structured for the light scattering function. The surface to be structured thus consists of the thermoplastic material and may be additionally equipped with energy directors, e.g. with a pattern of humps or with axially extending ribs (not shown). The surfaces of the diffuser blank 1, which are not to be structured for a light scattering function, are advantageously polished, in particular the proximal face into which the light is to be coupled and the distal face which is to reflect light not scattered from the diffuser. On its distal face, the diffuser blank 1 optionally comprises an appropriate mirror-like coating.
[0032] For producing the light diffuser 10 from the diffuser blank 1, an opening 3, such as a bore, is provided in a porous shaping material 2, the opening being dimensioned thus that the diffuser blank 1 is at least locally slightly larger than the dimensions of the opening. The length of the bore is greater than the axial length of that part of the diffuser blank 1 to be positioned in the bore. To prevent the diffuser blank from being brought too far into the bore the blank comprises appropriate means, such as a proximal collar 1.5.
[00331 The diffuser blank 1 is positioned in the bore 3 of the porous shaping material 2 and then pressed into the bore 3, e.g. by means of a sonotrode 4 excited by ultrasonic oscillation. The thermoplastic material of the diffuser blank liquefies where it is in contact with the porous shaping material 2, and in particular where energy directors (not shown) of the thermoplastic material are in contact with the porous shaping material 2, which excited by the mechanical vibration cause stress concentrations in the 35-125 CA/PCT CA 02565638 2006-11-03 Patent diffuser material. The liquefied diffuser material is pressed into the pores of the porous shaping material 2 and interpenetrates the porous shaping material in a boundary layer 4 advantageously comprising a thickness of ca. 0.02 to 1.0 mm. Therein the light scattering surface structure 5 is fonned on re-solidification of the diffuser material, as illustrated in detail A, and therewith the diffuser blank 1 becomes a diffuser 10. The produced surface structure 4 corresponds essentially with the pore structure of the porous shaping material 2 or a cast negative thereof respectively. More specifically, it comprises undercut forms that are induced by a surface tension because they were formed in the liquid state of the diffuser material.
[0034] As illustrated on the right hand side of Fig. 1, for its use, the diffuser 10 is supplied with light L by coupling a distal light conductor end 11 to its proximal end, for example by securing an appropriate coupling piece 12 in the groove 1.4. Such couplings are part of the state-of-the-art technology and are therefore not further described here.
[00351 The diffuser 10 optionally remains in the porous shaping material 2 for its illuminative function and serves for introducing diffuse light into this shaping material, e.g. as a illuminative implant in bone tissue, as illustrated top right in Fig 1. The diffuser scatters the light in a very homogenous manner in a fairly cylindrical active area, as indicated by the chain line 13 (see also Fig. 3).
100361 The porous shaping material 2 (in this case inevitably transparent) forms a diffuser cap 14 (Fig. 1, centre right). Such a diffuser cap protects the diffuser and is optionally primed, for example for an additional scattering of the light it receives from the diffuser 10 or for further, non-optical functions. The diffuser cap is optionally furthennore primed for further light conducting, distracting, screening, focussing or filtering functions, as known from the state of the art. In addition to its optical functions the diffuser cap, if need be appropriately finished, optionally represents an instrument or part of an instrument (see Figs. 12 and 13).
[0037) The porous shaping material 2 is optionally removed from the diffuser 10 so that the light scattering surface structure 4 is the only light scattering means of the diffuser 10 (Fig. 1, bottom right).
in the publication 35-125 CA/PCT CA 02565638 2006-11-03 Patent FR-2782778. Light scattering end-pieces usually comprise a transparent material filled with particles (e.g. transparent plastics with particles of aluminium oxide or titanium oxide). In case the light scattering effect of the modified fibre surface and/or of the end piece does not suffice to deflect an adequate portion of the supplied light from the axial direction, it is also suggested that a mirror is positioned at the distal end of the light conductor or of the diffuser, reflecting non-deflected light back into the diffuser area (e.g. disclosed in US-5695583, US-2002/0094161 and US-5431647).
10051 Known light diffusers thus essentially represent the distal end of a light conductor and for medical purposes are brought to, or introduced into the tissue to be treated with minimally invasive methods and removed after the treatment. For the treatment, the proximal end of the light conductor is attached to a light source, wherein the light source is e.g. a laser but can also be the distal end of another light conductor.
[006] The known diffusers described above are manufactured by relatively elaborate methods and are therefore expensive. They nevertheless have to be treated as disposable items as they are difficult to clean and sterilize and the risk of infection is clinically often considered too high for a repeated application. For photodynamic therapy, the diffuser has to be brought into the immediate vicinity of, or even into the tissue to be treated and it has to be retracted from this tissue after the treatment, which is connected with the danger of diseased cells, e.g. metastasizing tumorous cells, being spread.
[007] The object of the invention is to create a light diffuser as well as a method for producing the same. The light diffuser according to the invention is to be suitable for most diverse applications, not only medical but also technical applications, in particular however for the aforementioned introduction of diffuse light into bone tissue (photodynamic therapy) and for the homogenous illumination of hollow biological structures (hollow organs). Compared to the production of known light diffusers, the method for producing the light diffuser according to the invention is to be simpler and it is to enable a simple adjustment to given circumstances, of the geometry of the space to be provided with diffuse light.
35-125 CA/PCT CA 02565638 2006-11-03 Patent [008] The method according to the invention serving for producing a light diffuser, or for supplying diffuse light to tissue, in particular to bone tissue respectively, is based on the following finding: When an implant consisting of a thermoplastic material is implanted in bone tissue by means of mechanical oscillation, in particular ultrasound, as described e.g. in the publication WO-02/069817, its surface changes in particular where this surface is, or is brought into contact with the bone tissue, and in particular when such locations are provided with energy directors. At these points the thermoplastic material liquefies and is pressed into uneven patches and pores (trabecular chambers) of the bone tissue; it interpenetrates the bone tissue.
Under normal implantation conditions this interpenetration e.g. in spongeous bone tissue reaches a depth equivalent to about two trabecular chambers. After re-solidification of the thermoplastic material, this material and the bone tissue are connected to each other in a positive fit connection, which is e.g. exploited as a primary stabilisation of the implant immediately after the implantation.
[009] It is found that the thermoplastic material penetrating the bone tissue also lends the implant a surface structure ideally suited to scatter light, which is coupled into a proximal face of a transparent implant in axial direction, from the implant into the bone tissue surrounding the implant. In its implanted condition the implant represents an excellent light diffuser. Prior to the implantation it is a kind of diffuser blank.
[0010] The change to the surface caused by the implantation in bone tissue by mechanical vibration, by which a corresponding implant (diffuser blank) becomes a diffuser, develops in the liquid condition of the diffuser material, so that the emerging structures have forms created in a flowing motion, therefore induced by a surface tension, and essentially representing a negative of the porous bone structure, i.e. in particular comprising undercuts.
[0011] When a laser beam of a 625mn wavelength is coupled from a light conductor (diameter 0,4 mm) to the proximal face of a pin-shaped implant of poly-LDL-lactide (length 25 mm, diameter 3,5 mm), ca. 75% of the coupled light intensity is measured at the distal end of the implant, which represents a very anisotrope light distribution. If the same implant is driven into "sawbone' (closed pore polyurethane foam reinforced by glass fibre), whose structure closely resembles bone, by ultrasound and without prior 35-125 CA/PCT CA 02565638 2006-11-03 Patent drilling, the implant surface changes and becomes light scattering. In this state of the implant, an essentially equal light intensity is measured (distal end: 0,22 W/mm2;
circumferential surface: 0,20 W/mm2) across the implant surface where altered by the implantation. These measurements show that the altered surface scatters the coupled light very homogenously, i.e. turns the implant into a very good light diffuser.
[0012] The finding described above does not only apply to bone tissue but can be transferred to other porous materials, in particular to artificial materials, wherein such artificial shaping materials are to comprise a porous structure like bone tissue. The pores of such shaping material are advantageously sized between 0.005 and 1.0 mm.
The properties of the shaping material furthermore must be such that its porous structure can offer sufficient resistance for enabling liquefaction and interpenetration of the thermoplastic material of the diffuser blank when the diffuser blank is introduced in the shaping material by mechanical vibration. If this is not the case, the porous structure collapses and the interpenetration of the porous shaping material necessary for the development of the desired surface structure does not take place.
[0013] Instead of liquefying by mechanical vibration a solid diffuser blank material in areas where the diffuser blank is in contact with the porous shaping material and by pressing the liquefied material into the porous shaping material through pressure applied to the diffuser blank, it is also possible to press or suck a liquid diffuser material into the porous shaping material (e.g. by capillary action or pressure difference). The liquid diffuser material is then hardened by cooling (e.g.
thermoplastic polylners, glasses), by a suitable chemical reaction (e.g. cross-linking resins such as epoxy resin or silicone) or by thickening (e.g. gels or hydrogels on the basis of polyethylene glycols, alginates, chitosanes, collagens and their copolymers or blends).
This method not only gives a greater choice of diffuser design than the õimplantation method" but it also makes it possible to create a gel-like, i.e. flexible diffuser in a flexible shaping material, which is then not removed from the diffuser and which is suitable e.g. for illumination of the walls of hollow spaces, as it can adapt to diverse shapes of hollow spaces, or e.g. can even be left in a corresponding space if a resorbable hydrogel is used. Such a light diffuser can e.g. in the case of tumour excision wounds not only assume the function of illumination but also the function of wound 35-125 CAIPCT CA 02565638 2006-11-03 Patent tamponing after irradiation, to which purpose it is advantageously modified in a known manner with active substances such as cytotoxins, anti-inflammatory substances, antibiotics or growth factors for the further treatment of the defect.
[0014] The properties of an artificial porous shaping material suitable for producing the diffuser according to the invention can be such that it can be removed from the diffuser produced therein e.g. by dissolution in an appropriate solvent, by etching, by melting or subliming. Providing the shaping material has at least locally suitable properties it can also remain on the diffuser surface and form a kind of diffuser cap, which, due to its porosity, can e.g. further scatter light deflected by the diffuser. Such a diffuser cap of the porous shaping material may already have the shape of a cap, i.e.
relatively thin walls, when the diffuser is produced, or it may be appropriately processed afterwards. The diffuser cap can also be fashioned for a specific non-optical additional function or can be shaped appropriately by a subsequent addition or removal of material or by re-forming. The porosity of the shaping material can be homogenous.
In particular if the diffuser cap has specific non-optical additional functions it may be advantageous to fashion the porosity inhomogeneous and to vary it depending on the function of each part of the diffuser cap. Thus a diffuser cap can be porous where it is to be interpenetrated by a diffuser material while the exterior surface of the cap is smooth and free from pores in order to minimize friction in the tissue and contamination e.g. in the endoscopic application.
[0015] Diffusers according to the invention produced by means of an artificial shaping material suit non-medical and medical applications, but in particular the introduction of diffuse light in soft tissue or in tissue voids (e.g. blood vessels, respiratory passages or digestive tract). In that case the same procedure is followed for the introduction of the diffuse light as with diffusers according to the state of the art, wherein the diffuser according to the invention is coupled with a light conductor or a light source and is positioned for the application. Then light of a desired wavelength is coupled from the light conductor into the diffuser, which scatters the light and thus brings it into the tissue. A particular advantage of flexible diffusers produced by the above mentioned method is the fact that due to its flexibility, the diffuser is optionally bent by the operator using per se known catheter techniques around a large solid angle, 35-125 CA/PCT CA 02565638 2006-11-03 Patent such enabling a corresponding control of the instrument on one hand and a targeted illumination on the other.
[0016] It is also possible to couple light to be scattered only into a part of the diffuser and to equip other areas thereof for other functions, wherein these other areas are e.g.
not transparent.
[0017] The use of vital tissue, in particular of bone tissue, as porous shaping material for producing the diffuser from a diffuser blank means that the diffuser blank is implanted and the light scattering surface structures develop during implantation (in situ). It is not imperative to create an opening (e.g. a bore) in the osseous material prior to the implantation. For example, the cortical layer of a bone is optionally drilled in advance and the implant positioned in the bore before it is driven by pressure force and simultaneous vibration into the spongiosa, without drilling the latter. With such a diffuser produced in situ, a tumour (or metastasis) located in the spongiosa can be illuminated. The diffuser implant optionally remains in the bone tissue for further illuminations, where with its intensive anchoring represents a beneficial further reinforcement of the osseous tissue debilitated by the tumour. The diffuser implant optionally consists of a biologically resorbable light conducting material so that it does not need to be removed after its use for the illumination of the tissue and is gradually replaced by regenerated bone tissue.
[00181 If the diffuser implant is to remain in the place of implantation after the illumination, it is suggested that care be taken that the proximal end of the diffuser implant does not protrude substantially from the bone and that its proximal end is primed for the connection with a light conductor which is advanced to this proximal end for the illumination as in known endoscopic methods.
[0019] The crucial advantage of the diffuser produced by implantation in vital bone tissue over known diffusers used for the same purpose, is the fact that precursory drilling is not necessarily needed and that the implant does not necessarily need to be removed, or to be removed immediately after the application of the diffuser for an illumination or activation. This means that no element needs to be removed from the 35-125 CA/PCT CA 02565638 2006-11-03 Patent tissue to be treated before or immediately after the treatment and therefore the danger of spreading diseased cells, e.g. metastasizing tumorous cells is considerably reduced.
[0020] The diffuser according to the invention and the method for its production are described in detail in connection with the following Figs., wherein:
100211 Figure 1 shows the method for producing the light diffuser according to the invention on the example of a diffuser, which is to have a more-or-less cylindrical active range;
[0022] Figure 2 shows a further exemplary diffuser blank and the light diffuser according to the invention produced therefrom, which diffuser comprises a more ball-shaped active range;
[0023] Figures 3 and 4 show intensity profiles of the light diffusers according to Figs. 1 and 2;
[0024] Figures 5 and 6 show further exemplary embodiments of diffuser blanks suitable for producing light diffusers with various active ranges;
[0025] Figure 7 shows a further light diffuser according to the invention comprising a diffuser core primed for additional functions;
[0026] Figures 8 and 9 show various ways of coupling light into a light diffuser according to Fig. 7;
[0027] Figure 10 shows a further light diffuser according to the invention with a hollow diffuser core primed for further functions;
[0028] Figures 11 and 12 show diffusers according to the invention with diffuser caps primed for further functions.
[0029] Figure 1 illustrates the method according to an embodiment of the invention for producing a light diffuser with the aid of a sequence of sections through the diffuser during production. It shows the production of an exemplary light diffuser, which is to have a relatively cylindrical active range. As described above, the diffuser can be produced in situ in a bone, or ex situ by means of an artificial shaping material, which 35-125 CA/PCT CA 02565638 2006-11-03 Patent is interpenetrated by the diffuser material in a contact layer, wherein for using the diffuser, the shaping material is optionally left as a diffuser cap on the diffuser or is removed therefrom.
[0030] The diffuser blank I consisting of a suitably transparent thermoplastic material in a solid state has , for example, an essentially cylindrical form with a distal end 1.1 and a proximal end 1.2, wherein the proximal end 1.2 is furnished with a means to couple an appropriately primed distal light conductor end 11, for example with a circumferential groove 1.4.
[0031] In the illustrated example essentially the whole circumferential surface of the diffuser blank 1, though not its distal face, is to be structured for the light scattering function. The surface to be structured thus consists of the thermoplastic material and may be additionally equipped with energy directors, e.g. with a pattern of humps or with axially extending ribs (not shown). The surfaces of the diffuser blank 1, which are not to be structured for a light scattering function, are advantageously polished, in particular the proximal face into which the light is to be coupled and the distal face which is to reflect light not scattered from the diffuser. On its distal face, the diffuser blank 1 optionally comprises an appropriate mirror-like coating.
[0032] For producing the light diffuser 10 from the diffuser blank 1, an opening 3, such as a bore, is provided in a porous shaping material 2, the opening being dimensioned thus that the diffuser blank 1 is at least locally slightly larger than the dimensions of the opening. The length of the bore is greater than the axial length of that part of the diffuser blank 1 to be positioned in the bore. To prevent the diffuser blank from being brought too far into the bore the blank comprises appropriate means, such as a proximal collar 1.5.
[00331 The diffuser blank 1 is positioned in the bore 3 of the porous shaping material 2 and then pressed into the bore 3, e.g. by means of a sonotrode 4 excited by ultrasonic oscillation. The thermoplastic material of the diffuser blank liquefies where it is in contact with the porous shaping material 2, and in particular where energy directors (not shown) of the thermoplastic material are in contact with the porous shaping material 2, which excited by the mechanical vibration cause stress concentrations in the 35-125 CA/PCT CA 02565638 2006-11-03 Patent diffuser material. The liquefied diffuser material is pressed into the pores of the porous shaping material 2 and interpenetrates the porous shaping material in a boundary layer 4 advantageously comprising a thickness of ca. 0.02 to 1.0 mm. Therein the light scattering surface structure 5 is fonned on re-solidification of the diffuser material, as illustrated in detail A, and therewith the diffuser blank 1 becomes a diffuser 10. The produced surface structure 4 corresponds essentially with the pore structure of the porous shaping material 2 or a cast negative thereof respectively. More specifically, it comprises undercut forms that are induced by a surface tension because they were formed in the liquid state of the diffuser material.
[0034] As illustrated on the right hand side of Fig. 1, for its use, the diffuser 10 is supplied with light L by coupling a distal light conductor end 11 to its proximal end, for example by securing an appropriate coupling piece 12 in the groove 1.4. Such couplings are part of the state-of-the-art technology and are therefore not further described here.
[00351 The diffuser 10 optionally remains in the porous shaping material 2 for its illuminative function and serves for introducing diffuse light into this shaping material, e.g. as a illuminative implant in bone tissue, as illustrated top right in Fig 1. The diffuser scatters the light in a very homogenous manner in a fairly cylindrical active area, as indicated by the chain line 13 (see also Fig. 3).
100361 The porous shaping material 2 (in this case inevitably transparent) forms a diffuser cap 14 (Fig. 1, centre right). Such a diffuser cap protects the diffuser and is optionally primed, for example for an additional scattering of the light it receives from the diffuser 10 or for further, non-optical functions. The diffuser cap is optionally furthennore primed for further light conducting, distracting, screening, focussing or filtering functions, as known from the state of the art. In addition to its optical functions the diffuser cap, if need be appropriately finished, optionally represents an instrument or part of an instrument (see Figs. 12 and 13).
[0037) The porous shaping material 2 is optionally removed from the diffuser 10 so that the light scattering surface structure 4 is the only light scattering means of the diffuser 10 (Fig. 1, bottom right).
35-125 CA/PCT CA 02565638 2006-11-03 Patent [0038] For the embodiment of the method according to Fig. 1, the diffuser material is selected with regard to the diffuser blank 1, i.e. comprising sufficient mechanical stability to be pressed into the bore 3. For being as energy-efficient as possible, which, in particular for an in situ production in viable bone tissue, is also protective, the diffuser material is selected for damping the mechanical vibration as little as possible.
In this application it is suggested that the elasticity modulus be greater than 0.5 GPa.
[0039] Transparent or sufficiently transparently processed thermoplastic diffuser materials suitable for diffuser blanks to be implanted in bone tissue are, for example, biologically resorbable polymers based on lactic and/or glycolic acid (PLA, PLLA, PGA, PLGA etc), in particular poly-LDL-lactide (e.g. available from Bohringer under the trade name Resomer LR708) or poly-DL-lactic acid (e.g. available from Bohringer under the trade name Resomer R208) or the likewise resorbable polyhydroxyalkanoates (PHA), polycaprolactones (PCL), polysaccharides, polydioxanons (PD), polyanhydrides, polypeptides or corresponding copolymers or the non-resorbable polyolefines (e.g. polyethylene), polyacrylates, polymethacrylates, polycarbonates, polyamides, polyesters, polyurethanes, polysulphones, polyphenylsulphides, liquid-crystal-polymers (LCPs), polyacetals, halogenated polymers, in particular halogenated polyolefines, polyphenylsulphides, polysulphones, polyether or corresponding copolymers and polymer mixtures.
[0040] The porous shaping material 2 is selected with regard to its pore structure remaining stable when in contact with the liquefied diffuser material but being interpenetrable by this material. An artificial porous shaping material is chosen based upon suitable porosity, wherein this is optionally open porosity or closed porosity with partitions perforable under the circumstances of the method. The pores are advantageously sized between 0,01 and 1.0 mm. Sizes and distribution of the pores optionally comprise gradients e.g. for the generation of fractal surface geometries or for the production of diffuser caps with a smooth pore-free surface.
[0041] Examples of artificial porous shaping materials to remain as diffuser caps on the diffuser and to assume further functions are, for example, glasses (sintered glass, foam glass), amorphous ceramics or cerainics with a high content of glass phases (oxidized ceramics such as aluminium oxide or titanium oxide or non-oxidized 35-125 CA/PCT CA 02565638 2006-11-03 Patent ceramics such as nitrides), doted ceramics (for further optical-physical functions such as filtering or stimulation of fluorescence) or amorphous or partly amorphous thennoplastic or cross-linked polymers. For producing porous forms of said materials, per se known methods are used such as foaming methods, vacuum-methods, leaching methods, sintering methods or segregation methods.
[0042] If the porous shaping material is to be removed from the diffuser after its production, it has, for example, a lower melting point than the diffuser material and is removed by heat or it is soluble in a solvent in which the diffuser material is not soluble and is removed by means of a solvent. Further suitable removing methods are etching procedures or sublimation or evaporation techniques. Thus, for example, foamed gypsum used as porous shaping material is removed from a diffuser of an amorphous polymer by means of a moderate acid (solvent) or a glass with a high content of sodium (e.g. waterglass) is removed with water.
[0043] The diffuser blanks and the diffusers shown in Fig. 1 are of a cylindrical shape. Of course this is not a condition for the invention. Similarly, diffuser blanks and diffusers optionally comprise any chosen cross section and optionally taper towards the distal end either continuously or in steps.
[0044] Figure 2 shows a further diffuser blank 1 and the light diffuser 10 produced thereof e.g. in situ in a bone 20 (porous shaping material). The diffuser blank 1 according to Fig. 2 has a distal end 1.1 which is pointed, and only a distal region 30 of its circumferential surface is provided with protruding energy directors 21 (e.g. axially extending ribs) for producing the light scattering surface structure 4. The proximal region 31 of the circumferential surface is, for example, polished or comprises a mirror-like coating.
[0045] For the implantation of the diffuser blank 1, a corresponding opening 3 is provided, for example, in the cortical layer 20.1 of the bone 20, where opening is advantageously slightly larger than the cross-section of the diffuser blank.
The diffuser blank 1 is then positioned in the opening with its distal end 1.1 facing forward. The pointed distal end 1.1 of the diffuser blank 1 is then driven into the spongeous bone 20.2 by means of pressure and mechanical vibration, and the diffuser material is 35-125 CA/PCT CA 02565638 2006-11-03 Patent liquefied in the region of the distal end 1.1 and of the circumferential surface 30 and is pressed into the porous structure of the spongiosa. Thereby, a diffuser 10 with a distal diffuser part 10.1 and a proximal light conductor part 10.2 is formed.
[00461 Obviously, the depth of the diffuser part in the bone is predetermined by the axial length of the diffuser blank 1 and the axial length of the circumferential surface region 31 not furnished with energy directors. The shape of the active region of the diffuser 10 according to Fig. 2 is spherical or spherical/cylindrical (chain line 13) depending on the axial length of the surface region 30 furnished with energy directors 21.
[0047] Due to its proximal light conducting part, the diffuser blank 1 according to Fig. 2 is suitable in particular as an illuminative implant for the photodynamic treatment of tumours or metastases inside the bone. Therein the length of the diffuser blank 1 is adjusted to the depth of the bone area to be treated, and the length of the surface range 30 furnished with energy directors 21 to the size of the bone area to be treated. The diffuser blank 1 is driven from the bone surface into the bone until its distal end is positioned in the bone area to be treated and the diffuser blank has thus become a diffuser. Then a distal light conductor end or a light source is attached to the proximal end of the diffuser and the bone area to be treated is illuminated.
[0048] Obviously, for the illumination there is no need to open up the bone area to be treated and to bring it into contact with any tool, which relevantly reduces the danger of diseased cells spreading from this area compared to illumination methods according to the state-of-the-art technology.
[0049] Depending on the diffuser material it is sometimes adequate not to furnish the distal area (surface range 30) of a diffuser blank 1' (in Fig. 2 illustrated below the diffuser blank 1) with energy directors 21 but instead to give it a slightly larger cross-section than the proximal surface range 31, so that the surface of the distal range 30 protrudes slightly from the surface of the proximal range 31 and thus comes into more intensive contact with the bone tissue 20 in a bore 3 than the further surface ranges 31, in which no light scattering surface structure is to be generated.
35-125 CA/PCT CA 02565638 2006-11-03 Patent [0050] As already described in connection with Fig. 1, it is of course also possible for the einbodiment of the method according to Fig. 2 to use an artificial shaping material and to either leave it on the diffuser as a diffuser cap or to remove it therefrom. The method according to Fig. 2 is particularly suitable for the use of a liquid diffuser material. The liquid diffuser material is pressed or drawn by a vacuum (pressure reduction on the outside of the form) into a mould, wherein the mould consists of the porous shaping material or comprises an interior coating of the porous shaping material. The diffuser material interpenetrates the porous shaping material in the range of a boundary layer. The liquid diffuser material within the form and the named boundary layer is then hardened by, for example, cooling, polymerisation or thickening, thus producing a light diffuser according to and embodiment of the invention, which is further used in the manner described above.
[0051] As castable diffuser materials cross-linkable polymers (e.g. cross-linked chemically, thermally or by radiation), such as e.g. silicones, polyurethanes, epoxy resins or polyester resins are optionally used. Likewise suitable are thermoplastic polymers, gels (e.g. PEG, PHEMA, acrylates, saccharides, alginates, chitosanes, or copolymers and mixtures of alginates and chitosanes), glasses, glass ceramics or oxidic and non-oxidic cerainics with a high content of amorphous phase. The castable material optionally comprises known scattering materials such as titanium oxide, mica, etc..
[0052] As a removable porous shaping material for producing a diffuser from a gelling diffuser material e.g. a Wood's alloy can be used. Such alloys are optionally sintered at very low temperatures and after the production of the diffuser they are optionally removed from the gel at temperatures just a little above ambient temperature.
Alternatively, the diffuser is removed from the mould by removing the solvent in the gel, i.e. by drying the gel, which reduces its volume.
[0053] Figure 3 shows an intensity profile measured for a diffuser according to Fig.
1. The diffuser was produced by implanting a pin-shaped diffuser blank (length 25mm, diameter 3,5mm) of poly-LDL-lactic acid by means of ultrasound (Branson hand tool, 20kHZ) in an appropriately predrilled spongeous bone (femur of a sheep). The depth of the bore exceeded 12 mm and the implant was driven into a depth of 12 mm, i.e.
not to the bottom of the bore. Then laser light of 625mn wavelength (power 0,5W) was 35-125 CA(PCT CA 02565638 2006-11-03 Patent coupled into the implant via a light conducting fibre (diameter 400 m) through the proximal face and the light intensity was measured by means of a silicone detector (diameter 7,9mm) at various points of the bone.
[0054] The diagram shown in Fig. 3 shows the measured light intensity [mW]
versus the distance from the diffuser surface [mm]. The fit with an exponentially descending curve results in an exponent of circa -2,2, which suggests a space illuminated by the diffuser with a more cylindrical (theoretical exponent = -2) than spherical (theoretical exponent = -3) form.
[0055] The measured light intensities show, that it is possible to supply a bone volume of ca. 1.5 cm diameter with an energy of 10J, which is sufficient for a cytotoxic photodynamic therapy treatment, with the aid of an implant of 3.5 mm diameter and a ca. 15 min. radiation time.
[0056] Figure 4 shows an intensity profile measured on a diffuser according to Fig.
2. The diffuser was produced by pressing a pin-shaped diffuser blank (length 25mm, diameter 3,5mm) of poly-LDL-lactic acid using ultrasound (Branson hand tool, 20kHZ) without pre-drilling into a piece of 'sawbone' (glass fibre reinforced polyurethane foam) to a depth of 12mm. Then, laser light of 625nm wavelength (power 0,5 W) was coupled from a light conducting fibre (diameter 400 m) through the proximal face into the implant and the light intensity was measured by means of a fibre-detector (diameter 200 m) at various points in the piece of sawbone.
[0057] The diagram shown in Fig. 4 shows the measured light intensity [counts]
versus the distance from the diffuser surface [mm]. The fit with an exponentially descending curve with an exponent of -3 is good (r = 0,89) and indicates an essentially spherical form of the space illuminated by the diffuser.
[0058] Figures 5 and 6 show two further exemplary diffuser blanks 1, from which diffusers for various applications are produced by the method according to the invention. The diffuser blank 1 according to Fig. 5 comprises a pointed distal end 1.1 and the distal region of its circumferential surface is furnished with energy directors 21 (e.g. axially extending ribs) around half the circumference, so that a light scattering 35-125 CA/PCT CA 02565638 2006-11-03 Patent structure is optionally generated only in this surface range. Such a diffuser blank results in a diffuser with an active area comprising roughly the shape of a hemisphere. The diffuser blank 1 according to Fig. 6 comprises a blunt distal end 1.1 and a middle region of its circumferential surface is furnished with energy directors 21 (e.g. humps) halfway around the circumference. Using the method illustrated in Fig. 1, this diffuser blank produces a diffuser with an active area roughly equivalent to half a circular cylinder.
[0059] Diffusers with active areas of most diverse shapes are optionally designed from diffuser blanks like those illustrated in the Figs. 5 and 6. Therein the diffuser blanks need not be pin-shaped and to comprise circular cross-sections as illustrated.
They optionally have a more compact form, be conically shaped and/or comprise polygon or irregular cross-sections.
[0060] Figure 7 is an axial section of another diffuser 10 according to an embodiment of the invention comprising a diffuser core 40, wherein the diffuser core 40 is equipped for further, e.g. non-optical functions. The diffuser material (e.g.
polymerpine) bearing the light scattering surface structure is arranged on the diffuser core 40 periphery and covers the surface of the diffuser core 40 completely or partially.
The diffuser core 40 consists of, for example titanium and in a diffuser implant assumes, for example, a load bearing function. The diffuser can be produced in situ or ex situ from a corresponding diffuser blank.
[0061] Light is to be coupled into the diffuser 10 according to Fig. 7, only through a part of the proximal face (outer ring). To this end e.g. a light conductor 11 is used as illustrated in cross-section in Fig. 8. This light conductor 11 comprises a conductor core 41 and light conducting fibres 42 arranged around it, wherein the cross-section of the conductor core 41 is adjusted to the proximal face of the diffuser core 40.
[0062] The diffuser core 40 optionally supports further functions instead of, or in addition to the already mentioned load bearing function and for such purposes consists of an appropriate material. If the diffuser is produced ex situ such an additional function serves e.g. for controlling the movement of the diffuser on positioning it at a location to be illuminated. If the diffuser or the diffuser cap is fashioned as an 35-125 CA/PCT CA 02565638 2006-11-03 Patent instrument (see Figs. 11 and 12), the additional function is optionally a rinsing or suction function for which the diffuser core is designed as a hollow light conduit.
Further light conductors optionally extend into such a hollow conduit of a diffuser produced e.g. in situ, wherein the further light conductors have e.g. a recording function and are connected to a micro-camera, which may serve e.g. the simultaneous analysis of an illumination effect or to detect and locate tumorous cells marked by fluorescence.
[0063] The diffuser core 40 of a diffuser produced in situ (diffuser implant) optionally supports a release function in order to administer a drug to the tissue surrounding the diffuser. If resorbable polymers or gels are used as diffuser material this release function can is optionally performed directly via the diffuser material. The diffuser core also is optionally fashioned as an optical element separated from the diffuser and designed for the coupling of light of another wavelength (e.g. in order to activate another photosensitive drug) or for the coupling of infra-red light in order to warm the tissue surrounding the diffuser. The arrangement of the diffuser material on the diffuser core 40 is to be adapted to the function of the diffuser core 40.
[0064] Figure 9 is an axial section through a further diffuser according to an embodiment of the invention, which is optionally produced in situ or ex situ and which comprises a diffuser core 40, upon which the diffuser material is arranged, for example, as a coating. For being coupled to the light conductor 11, the diffuser core 40 comprises a proximal region with a central opening 43, wherein, for example, at the bottom of the opening a conical mirror surface 50 is arranged and light emission apertures 51 are arranged above the mirror surface. A distal end of a light conductor 11, without cladding and with its front face advantageously adapted to the mirror surface 50, is introduced into this opening for coupling light into the central opening 43.
The light introduced by the light conductor 11 is reflected from the mirror surface 50 and reaches the diffuser material through the light emission apertures 51, as indicated in Fig. 9 by arrows.
[0065] Figure 10 is an axial section through a further diffuser 10 according to an embodiment of the invention comprising a diffuser core 40, which diffuser too is optionally produced either in situ or ex situ. The diffuser core 40 is sheath-shaped and comprises through openings. The diffuser material, e.g. a thermoplastic polyiner, gel or 35-125 CA/PCT CA 02565638 2006-11-03 Patent thennosetting polymer, is provided in the diffuser blank inside the sheath-shaped diffuser core 40. The diffuser 10 is produced by the diffuser material being pressed with the aid of mechanical vibrations deeper into the diffuser core, through the openings and into the surrounding bone tissue or artificial porous shaping material, and thereby gains the light scattering surface structure 5.
[0066] Figures 11 and 12 show diffusers 10 according to the invention, which are produced ex situ and comprise a diffuser cap 14 constituting an instrument or a part of an instrument. The instrument illustrated in Fig. 11 is a scalpel shown in axial section, whose blade is the diffuser cap 12, i.e. contains a diffuser 10 according to the invention.
The diffuser cap consists, for example, a transparent ceramic material, which is advantageously only relevantly porous in those areas where it is to serve as a porous shaping material, while it is, in particular in the area of the cutting edge, as compact as possible. A coupling point for a light conductor (not shown) is situated in the region of the handle 60. Due to the coupling of light into the diffuser 10 the scalpel blade becomes luminous and can illuminate hoinogenously its own working area.
[0067] The scalpel blade according to Fig. 11 is produced e.g. by a liquid diffuser material being sucked into an appropriate bore in the blade or being introduced by any of the other aforementioned methods. The blade can be further adapted after the diffuser 10 has been produced. To prevent the diffuser material from gaining a light scattering surface in the region of the handle 60, no porous shaping material but a compact shaping material is to be provided there.
[0068] It is also possible however, to provide a slightly larger bore in the region of the handle 60 than in the region of the blade and to introduce the diffuser material in the shape of a pin into the handle and to press it further into the blade with ultrasound and to transfer the light via the handle functioning as a light conductor into the blade.
[0069] Figure 12 shows, as a further example of a diffuser 10 according to the invention with a diffuser cap 14, an instrument similar to a pair of scissors or nippers, whose blades or legs 70 and 71 are each equipped with a diffuser (schematically indicated by broken line) in the manner described with regard to the scalpel blade of Fig. 11. When the instrument is in use, the blades or legs 70 and 71 serve 35-125 CA/PCT CA 02565638 2006-11-03 Patent simultaneously as a source of diffuse light, which illuminates the working area of the instrument.
[0070] Obviously, instruments or parts of an instrument equipped with a diffuser as illustrated in Figs. 11 and 12 are optionally be equipped with diffusers as known from the state of the art. In other words, it is not a condition for such instruments, that their diffusers have a light scattering surface, which is induced by surface tension and which comprises undercut forms. Other known light scattering surface structures are optionally created by casting in non-porous structures or by corresponding machining of a diffuser blank before it is positioned in the diffuser cap.
[0071] The described diffusers, which are optionally produced by the illustrated method from the described diffuser blanks, are used e.g. for photodynamic therapy methods, in particular for the treatment of tumorigenic diseases. For such application, in the method for introducing diffuse light into a tissue region as herein described and claimed, in which method one of the herein described and claimed, in particular pin-shaped diffuser blanks is implanted in the tissue, the tissue in question is, for example,.
a bone tissue and the bone tissue region to be treated is the region of a bone tumour or a metastasis.
[0072] The photodynamic therapy method thus comprises the steps of:
introducing a photosensitive substance into the tumorous tissue or the metastasis, producing a diffuser according to one of the embodiments of the method here described and claimed (in situ) or introducing a diffuser produced ex situ into the tumorous tissue or the metastasis, illuminating the tumorous tissue or the metastasis through the diffuser, in particular with a specific wavelength activating the photosensitive substance, and thus triggering a chemical reaction, by which the tumorous cells or the metastasis are destroyed. The method steps of'introducing the substance" and of "producing the diffuser" optionally take place in reverse order. The illumination need not be perforined with light in a visible range of wavelengths, the term "illuminate"
also incorporates radiation with electro-magnetic radiation of other wavelengths, in particular in the range of infrared or ultraviolet.
[0073] The step of introducing the photosensitive substance is optionally carried out by systemic administration of a substance which principally gathers in the tumorous 35-125 CA/PCT CA 02565638 2006-11-03 Patent tissue or the metastasis. The substance is optionally administered locally to the tumorous tissue or the metastasis. Furthermore, the substance is optionally released through the diffuser or the diffuser blank.
In this application it is suggested that the elasticity modulus be greater than 0.5 GPa.
[0039] Transparent or sufficiently transparently processed thermoplastic diffuser materials suitable for diffuser blanks to be implanted in bone tissue are, for example, biologically resorbable polymers based on lactic and/or glycolic acid (PLA, PLLA, PGA, PLGA etc), in particular poly-LDL-lactide (e.g. available from Bohringer under the trade name Resomer LR708) or poly-DL-lactic acid (e.g. available from Bohringer under the trade name Resomer R208) or the likewise resorbable polyhydroxyalkanoates (PHA), polycaprolactones (PCL), polysaccharides, polydioxanons (PD), polyanhydrides, polypeptides or corresponding copolymers or the non-resorbable polyolefines (e.g. polyethylene), polyacrylates, polymethacrylates, polycarbonates, polyamides, polyesters, polyurethanes, polysulphones, polyphenylsulphides, liquid-crystal-polymers (LCPs), polyacetals, halogenated polymers, in particular halogenated polyolefines, polyphenylsulphides, polysulphones, polyether or corresponding copolymers and polymer mixtures.
[0040] The porous shaping material 2 is selected with regard to its pore structure remaining stable when in contact with the liquefied diffuser material but being interpenetrable by this material. An artificial porous shaping material is chosen based upon suitable porosity, wherein this is optionally open porosity or closed porosity with partitions perforable under the circumstances of the method. The pores are advantageously sized between 0,01 and 1.0 mm. Sizes and distribution of the pores optionally comprise gradients e.g. for the generation of fractal surface geometries or for the production of diffuser caps with a smooth pore-free surface.
[0041] Examples of artificial porous shaping materials to remain as diffuser caps on the diffuser and to assume further functions are, for example, glasses (sintered glass, foam glass), amorphous ceramics or cerainics with a high content of glass phases (oxidized ceramics such as aluminium oxide or titanium oxide or non-oxidized 35-125 CA/PCT CA 02565638 2006-11-03 Patent ceramics such as nitrides), doted ceramics (for further optical-physical functions such as filtering or stimulation of fluorescence) or amorphous or partly amorphous thennoplastic or cross-linked polymers. For producing porous forms of said materials, per se known methods are used such as foaming methods, vacuum-methods, leaching methods, sintering methods or segregation methods.
[0042] If the porous shaping material is to be removed from the diffuser after its production, it has, for example, a lower melting point than the diffuser material and is removed by heat or it is soluble in a solvent in which the diffuser material is not soluble and is removed by means of a solvent. Further suitable removing methods are etching procedures or sublimation or evaporation techniques. Thus, for example, foamed gypsum used as porous shaping material is removed from a diffuser of an amorphous polymer by means of a moderate acid (solvent) or a glass with a high content of sodium (e.g. waterglass) is removed with water.
[0043] The diffuser blanks and the diffusers shown in Fig. 1 are of a cylindrical shape. Of course this is not a condition for the invention. Similarly, diffuser blanks and diffusers optionally comprise any chosen cross section and optionally taper towards the distal end either continuously or in steps.
[0044] Figure 2 shows a further diffuser blank 1 and the light diffuser 10 produced thereof e.g. in situ in a bone 20 (porous shaping material). The diffuser blank 1 according to Fig. 2 has a distal end 1.1 which is pointed, and only a distal region 30 of its circumferential surface is provided with protruding energy directors 21 (e.g. axially extending ribs) for producing the light scattering surface structure 4. The proximal region 31 of the circumferential surface is, for example, polished or comprises a mirror-like coating.
[0045] For the implantation of the diffuser blank 1, a corresponding opening 3 is provided, for example, in the cortical layer 20.1 of the bone 20, where opening is advantageously slightly larger than the cross-section of the diffuser blank.
The diffuser blank 1 is then positioned in the opening with its distal end 1.1 facing forward. The pointed distal end 1.1 of the diffuser blank 1 is then driven into the spongeous bone 20.2 by means of pressure and mechanical vibration, and the diffuser material is 35-125 CA/PCT CA 02565638 2006-11-03 Patent liquefied in the region of the distal end 1.1 and of the circumferential surface 30 and is pressed into the porous structure of the spongiosa. Thereby, a diffuser 10 with a distal diffuser part 10.1 and a proximal light conductor part 10.2 is formed.
[00461 Obviously, the depth of the diffuser part in the bone is predetermined by the axial length of the diffuser blank 1 and the axial length of the circumferential surface region 31 not furnished with energy directors. The shape of the active region of the diffuser 10 according to Fig. 2 is spherical or spherical/cylindrical (chain line 13) depending on the axial length of the surface region 30 furnished with energy directors 21.
[0047] Due to its proximal light conducting part, the diffuser blank 1 according to Fig. 2 is suitable in particular as an illuminative implant for the photodynamic treatment of tumours or metastases inside the bone. Therein the length of the diffuser blank 1 is adjusted to the depth of the bone area to be treated, and the length of the surface range 30 furnished with energy directors 21 to the size of the bone area to be treated. The diffuser blank 1 is driven from the bone surface into the bone until its distal end is positioned in the bone area to be treated and the diffuser blank has thus become a diffuser. Then a distal light conductor end or a light source is attached to the proximal end of the diffuser and the bone area to be treated is illuminated.
[0048] Obviously, for the illumination there is no need to open up the bone area to be treated and to bring it into contact with any tool, which relevantly reduces the danger of diseased cells spreading from this area compared to illumination methods according to the state-of-the-art technology.
[0049] Depending on the diffuser material it is sometimes adequate not to furnish the distal area (surface range 30) of a diffuser blank 1' (in Fig. 2 illustrated below the diffuser blank 1) with energy directors 21 but instead to give it a slightly larger cross-section than the proximal surface range 31, so that the surface of the distal range 30 protrudes slightly from the surface of the proximal range 31 and thus comes into more intensive contact with the bone tissue 20 in a bore 3 than the further surface ranges 31, in which no light scattering surface structure is to be generated.
35-125 CA/PCT CA 02565638 2006-11-03 Patent [0050] As already described in connection with Fig. 1, it is of course also possible for the einbodiment of the method according to Fig. 2 to use an artificial shaping material and to either leave it on the diffuser as a diffuser cap or to remove it therefrom. The method according to Fig. 2 is particularly suitable for the use of a liquid diffuser material. The liquid diffuser material is pressed or drawn by a vacuum (pressure reduction on the outside of the form) into a mould, wherein the mould consists of the porous shaping material or comprises an interior coating of the porous shaping material. The diffuser material interpenetrates the porous shaping material in the range of a boundary layer. The liquid diffuser material within the form and the named boundary layer is then hardened by, for example, cooling, polymerisation or thickening, thus producing a light diffuser according to and embodiment of the invention, which is further used in the manner described above.
[0051] As castable diffuser materials cross-linkable polymers (e.g. cross-linked chemically, thermally or by radiation), such as e.g. silicones, polyurethanes, epoxy resins or polyester resins are optionally used. Likewise suitable are thermoplastic polymers, gels (e.g. PEG, PHEMA, acrylates, saccharides, alginates, chitosanes, or copolymers and mixtures of alginates and chitosanes), glasses, glass ceramics or oxidic and non-oxidic cerainics with a high content of amorphous phase. The castable material optionally comprises known scattering materials such as titanium oxide, mica, etc..
[0052] As a removable porous shaping material for producing a diffuser from a gelling diffuser material e.g. a Wood's alloy can be used. Such alloys are optionally sintered at very low temperatures and after the production of the diffuser they are optionally removed from the gel at temperatures just a little above ambient temperature.
Alternatively, the diffuser is removed from the mould by removing the solvent in the gel, i.e. by drying the gel, which reduces its volume.
[0053] Figure 3 shows an intensity profile measured for a diffuser according to Fig.
1. The diffuser was produced by implanting a pin-shaped diffuser blank (length 25mm, diameter 3,5mm) of poly-LDL-lactic acid by means of ultrasound (Branson hand tool, 20kHZ) in an appropriately predrilled spongeous bone (femur of a sheep). The depth of the bore exceeded 12 mm and the implant was driven into a depth of 12 mm, i.e.
not to the bottom of the bore. Then laser light of 625mn wavelength (power 0,5W) was 35-125 CA(PCT CA 02565638 2006-11-03 Patent coupled into the implant via a light conducting fibre (diameter 400 m) through the proximal face and the light intensity was measured by means of a silicone detector (diameter 7,9mm) at various points of the bone.
[0054] The diagram shown in Fig. 3 shows the measured light intensity [mW]
versus the distance from the diffuser surface [mm]. The fit with an exponentially descending curve results in an exponent of circa -2,2, which suggests a space illuminated by the diffuser with a more cylindrical (theoretical exponent = -2) than spherical (theoretical exponent = -3) form.
[0055] The measured light intensities show, that it is possible to supply a bone volume of ca. 1.5 cm diameter with an energy of 10J, which is sufficient for a cytotoxic photodynamic therapy treatment, with the aid of an implant of 3.5 mm diameter and a ca. 15 min. radiation time.
[0056] Figure 4 shows an intensity profile measured on a diffuser according to Fig.
2. The diffuser was produced by pressing a pin-shaped diffuser blank (length 25mm, diameter 3,5mm) of poly-LDL-lactic acid using ultrasound (Branson hand tool, 20kHZ) without pre-drilling into a piece of 'sawbone' (glass fibre reinforced polyurethane foam) to a depth of 12mm. Then, laser light of 625nm wavelength (power 0,5 W) was coupled from a light conducting fibre (diameter 400 m) through the proximal face into the implant and the light intensity was measured by means of a fibre-detector (diameter 200 m) at various points in the piece of sawbone.
[0057] The diagram shown in Fig. 4 shows the measured light intensity [counts]
versus the distance from the diffuser surface [mm]. The fit with an exponentially descending curve with an exponent of -3 is good (r = 0,89) and indicates an essentially spherical form of the space illuminated by the diffuser.
[0058] Figures 5 and 6 show two further exemplary diffuser blanks 1, from which diffusers for various applications are produced by the method according to the invention. The diffuser blank 1 according to Fig. 5 comprises a pointed distal end 1.1 and the distal region of its circumferential surface is furnished with energy directors 21 (e.g. axially extending ribs) around half the circumference, so that a light scattering 35-125 CA/PCT CA 02565638 2006-11-03 Patent structure is optionally generated only in this surface range. Such a diffuser blank results in a diffuser with an active area comprising roughly the shape of a hemisphere. The diffuser blank 1 according to Fig. 6 comprises a blunt distal end 1.1 and a middle region of its circumferential surface is furnished with energy directors 21 (e.g. humps) halfway around the circumference. Using the method illustrated in Fig. 1, this diffuser blank produces a diffuser with an active area roughly equivalent to half a circular cylinder.
[0059] Diffusers with active areas of most diverse shapes are optionally designed from diffuser blanks like those illustrated in the Figs. 5 and 6. Therein the diffuser blanks need not be pin-shaped and to comprise circular cross-sections as illustrated.
They optionally have a more compact form, be conically shaped and/or comprise polygon or irregular cross-sections.
[0060] Figure 7 is an axial section of another diffuser 10 according to an embodiment of the invention comprising a diffuser core 40, wherein the diffuser core 40 is equipped for further, e.g. non-optical functions. The diffuser material (e.g.
polymerpine) bearing the light scattering surface structure is arranged on the diffuser core 40 periphery and covers the surface of the diffuser core 40 completely or partially.
The diffuser core 40 consists of, for example titanium and in a diffuser implant assumes, for example, a load bearing function. The diffuser can be produced in situ or ex situ from a corresponding diffuser blank.
[0061] Light is to be coupled into the diffuser 10 according to Fig. 7, only through a part of the proximal face (outer ring). To this end e.g. a light conductor 11 is used as illustrated in cross-section in Fig. 8. This light conductor 11 comprises a conductor core 41 and light conducting fibres 42 arranged around it, wherein the cross-section of the conductor core 41 is adjusted to the proximal face of the diffuser core 40.
[0062] The diffuser core 40 optionally supports further functions instead of, or in addition to the already mentioned load bearing function and for such purposes consists of an appropriate material. If the diffuser is produced ex situ such an additional function serves e.g. for controlling the movement of the diffuser on positioning it at a location to be illuminated. If the diffuser or the diffuser cap is fashioned as an 35-125 CA/PCT CA 02565638 2006-11-03 Patent instrument (see Figs. 11 and 12), the additional function is optionally a rinsing or suction function for which the diffuser core is designed as a hollow light conduit.
Further light conductors optionally extend into such a hollow conduit of a diffuser produced e.g. in situ, wherein the further light conductors have e.g. a recording function and are connected to a micro-camera, which may serve e.g. the simultaneous analysis of an illumination effect or to detect and locate tumorous cells marked by fluorescence.
[0063] The diffuser core 40 of a diffuser produced in situ (diffuser implant) optionally supports a release function in order to administer a drug to the tissue surrounding the diffuser. If resorbable polymers or gels are used as diffuser material this release function can is optionally performed directly via the diffuser material. The diffuser core also is optionally fashioned as an optical element separated from the diffuser and designed for the coupling of light of another wavelength (e.g. in order to activate another photosensitive drug) or for the coupling of infra-red light in order to warm the tissue surrounding the diffuser. The arrangement of the diffuser material on the diffuser core 40 is to be adapted to the function of the diffuser core 40.
[0064] Figure 9 is an axial section through a further diffuser according to an embodiment of the invention, which is optionally produced in situ or ex situ and which comprises a diffuser core 40, upon which the diffuser material is arranged, for example, as a coating. For being coupled to the light conductor 11, the diffuser core 40 comprises a proximal region with a central opening 43, wherein, for example, at the bottom of the opening a conical mirror surface 50 is arranged and light emission apertures 51 are arranged above the mirror surface. A distal end of a light conductor 11, without cladding and with its front face advantageously adapted to the mirror surface 50, is introduced into this opening for coupling light into the central opening 43.
The light introduced by the light conductor 11 is reflected from the mirror surface 50 and reaches the diffuser material through the light emission apertures 51, as indicated in Fig. 9 by arrows.
[0065] Figure 10 is an axial section through a further diffuser 10 according to an embodiment of the invention comprising a diffuser core 40, which diffuser too is optionally produced either in situ or ex situ. The diffuser core 40 is sheath-shaped and comprises through openings. The diffuser material, e.g. a thermoplastic polyiner, gel or 35-125 CA/PCT CA 02565638 2006-11-03 Patent thennosetting polymer, is provided in the diffuser blank inside the sheath-shaped diffuser core 40. The diffuser 10 is produced by the diffuser material being pressed with the aid of mechanical vibrations deeper into the diffuser core, through the openings and into the surrounding bone tissue or artificial porous shaping material, and thereby gains the light scattering surface structure 5.
[0066] Figures 11 and 12 show diffusers 10 according to the invention, which are produced ex situ and comprise a diffuser cap 14 constituting an instrument or a part of an instrument. The instrument illustrated in Fig. 11 is a scalpel shown in axial section, whose blade is the diffuser cap 12, i.e. contains a diffuser 10 according to the invention.
The diffuser cap consists, for example, a transparent ceramic material, which is advantageously only relevantly porous in those areas where it is to serve as a porous shaping material, while it is, in particular in the area of the cutting edge, as compact as possible. A coupling point for a light conductor (not shown) is situated in the region of the handle 60. Due to the coupling of light into the diffuser 10 the scalpel blade becomes luminous and can illuminate hoinogenously its own working area.
[0067] The scalpel blade according to Fig. 11 is produced e.g. by a liquid diffuser material being sucked into an appropriate bore in the blade or being introduced by any of the other aforementioned methods. The blade can be further adapted after the diffuser 10 has been produced. To prevent the diffuser material from gaining a light scattering surface in the region of the handle 60, no porous shaping material but a compact shaping material is to be provided there.
[0068] It is also possible however, to provide a slightly larger bore in the region of the handle 60 than in the region of the blade and to introduce the diffuser material in the shape of a pin into the handle and to press it further into the blade with ultrasound and to transfer the light via the handle functioning as a light conductor into the blade.
[0069] Figure 12 shows, as a further example of a diffuser 10 according to the invention with a diffuser cap 14, an instrument similar to a pair of scissors or nippers, whose blades or legs 70 and 71 are each equipped with a diffuser (schematically indicated by broken line) in the manner described with regard to the scalpel blade of Fig. 11. When the instrument is in use, the blades or legs 70 and 71 serve 35-125 CA/PCT CA 02565638 2006-11-03 Patent simultaneously as a source of diffuse light, which illuminates the working area of the instrument.
[0070] Obviously, instruments or parts of an instrument equipped with a diffuser as illustrated in Figs. 11 and 12 are optionally be equipped with diffusers as known from the state of the art. In other words, it is not a condition for such instruments, that their diffusers have a light scattering surface, which is induced by surface tension and which comprises undercut forms. Other known light scattering surface structures are optionally created by casting in non-porous structures or by corresponding machining of a diffuser blank before it is positioned in the diffuser cap.
[0071] The described diffusers, which are optionally produced by the illustrated method from the described diffuser blanks, are used e.g. for photodynamic therapy methods, in particular for the treatment of tumorigenic diseases. For such application, in the method for introducing diffuse light into a tissue region as herein described and claimed, in which method one of the herein described and claimed, in particular pin-shaped diffuser blanks is implanted in the tissue, the tissue in question is, for example,.
a bone tissue and the bone tissue region to be treated is the region of a bone tumour or a metastasis.
[0072] The photodynamic therapy method thus comprises the steps of:
introducing a photosensitive substance into the tumorous tissue or the metastasis, producing a diffuser according to one of the embodiments of the method here described and claimed (in situ) or introducing a diffuser produced ex situ into the tumorous tissue or the metastasis, illuminating the tumorous tissue or the metastasis through the diffuser, in particular with a specific wavelength activating the photosensitive substance, and thus triggering a chemical reaction, by which the tumorous cells or the metastasis are destroyed. The method steps of'introducing the substance" and of "producing the diffuser" optionally take place in reverse order. The illumination need not be perforined with light in a visible range of wavelengths, the term "illuminate"
also incorporates radiation with electro-magnetic radiation of other wavelengths, in particular in the range of infrared or ultraviolet.
[0073] The step of introducing the photosensitive substance is optionally carried out by systemic administration of a substance which principally gathers in the tumorous 35-125 CA/PCT CA 02565638 2006-11-03 Patent tissue or the metastasis. The substance is optionally administered locally to the tumorous tissue or the metastasis. Furthermore, the substance is optionally released through the diffuser or the diffuser blank.
Claims (30)
1. A light diffuser comprising an at least partly transparent diffuser material, the light diffuser comprising a proximal end suitable for coupling light supplied by a light conductor into the light diffuser; and light scattering surface areas through which light coupled into the light diffuser is deflected diffusely out of the light diffuser, characterized in that the light scattering surface areas comprise structures produced by interpenetration of the diffuser material in a liquid state in a boundary layer of a porous shaping material and which therefore comprise undercut forms induced by a surface tension.
2. A light diffuser according to claim 1 comprising a circumferential surface and a distal endcharacterized in that the light diffuser is pin-shaped and the light scattering surface areas are situated upon at least one of the circumferential surface and the distal end.
3. A light diffuser according to one of claims 1 or 2, characterized in that the diffuser material is one of a thermoplastic material, a material which is thermosetting through a chemical reaction, and a gel.
4. A light diffuser according to one of the claims 1 to 3, characterized in that it comprises a diffuser core.
5. A light diffuser according to claim 4, characterized in that the diffuser core comprisex a non-transparent material and is equipped for a non-optical function.
6. A light diffuser according to claim 4, characterized in that the diffuser core comprises an at least partly transparent material.
7. Al ight diffuser according to one of claims 1 to 6, characterized in that it is implanted in bone tissue and the bone tissue represents the shaping material.
8. A light diffuser according to one of claims 1 to 6, characterized in that it comprises a diffuser cap of the porous shaping material, wherein the porous shaping material of the diffuser cap is interpenetrated in a boundary layer by the diffuser material.
9. A light diffuser according to claim 8, characterized in that the diffuser cap is designed as an instrument or part of an instrument.
10. A light diffuser according to one of claims 8 and 9, characterized in that the diffuser cap has a non-homogenous porosity.
11. A method for producing a light diffuser according to one of claims 1 to 10, characterized in that the diffuser material in a liquid state is pressed in a boundary region into pores of the porous shaping material and is then brought into at least one of a solid and gel-like state.
12. A method according to claim 11, characterized in that the porous shaping material is left on the diffuser as a diffuser cap.
13. A method according to claim 11, characterized in that the porous shaping material is removed from the diffuser.
14. A method according to one of claims 11 to 13, characterized in that a diffuser blank consisting of a thermoplastic diffuser material comprises a distal end and a proximal end, which is equipped for coupling the supplied light into the light diffuser, is positioned one of in and on the porous shaping material and that mechanical vibration is applied to the proximal end, and the diffuser blank is simultaneously pressed against the porous shaping material, so that the thermoplastic diffuser material liquefies in those regions of the surface area in contact with the porous shaping material and is pressed into the porous shaping material.
15. A method according to one of claims 11 to 14, characterized in that the porous shaping material comprises a porosity with a pore size ranging between 0.005 and 1.0 mm.
16. A method according to one of claims 11 to 15, characterized in that an opening is provided in the porous shaping material and that the diffuser blank is positioned in the opening such that its distal end is not brought in contact with the bottom of the opening, neither when it is positioned nor when it is pressed and the mechanical vibration is applied.
17. A method according to one of claims 11 to 15, characterized in that at least one of an opening is provided in the porous shaping material and the diffuser blank is driven into a bottom of the opening, the distal end facing forward and no opening is provided in the porous shaping material and the diffuser blank is driven into the porous shaping material with the distal end facing forward.
18. A diffuser blank suitable for being used in the method according to one of claims 11 to 16, characterized in that it consists at least partly of a transparent, thermoplastic diffuser material and comprises a distal end and a proximal end, wherein the proximal end is suitable for coupling light into the diffuser blank and for mechanical vibrations to be applied to the diffuser blank, and the diffuser blankfurther comprises surface areas, where the diffuser material is suitable for being liquefied to provide a light scattering surface structure and suitable for being pressed into the porous shaping material, such that the diffuse blank at least one of protrudes beyond surface areas and comprises energy directors situated on the diffuser blank in such a manner that they are able to be brought into contact with the porous shaping material.
19. A diffuser blank according to claim 18, characterized in that it is pin-shaped and the surface areas, on which the light scattering structure is produced, are situated on it's a circumferential surface of the surface areas.
20. A diffuser blank according to any one of claims 18 and 19, characterized in that the further surface areas are at least one of polished and coated.
21. A diffuser blank according to one of claims 18 to 20, characterized in that it is suitable as an illuminative implant and comprises a clinically applicable, thermoplastic polymer.
22. A diffuser blank according to claim 21, characterized in that the polymer is biologically resorbable.
23. A diffuser blank according to one of claims 18 to 22, characterized in that it comprises a diffuser core , wherein at least one of the diffuser material is situated at a periphery of the diffuser core and the diffuser material is provided inside the diffuser core and the diffuser core comprises openings, through which the diffuser material is optionally pressed to the surface of the diffuser core.
24. A method to introduce diffuse light into an area in a tissue to be treated with light, wherein the light is supplied to the tissue area by means of a light conductor with a distal light conductor end, characterized in that a diffuser blank according to one of claims 21 to 23 is implanted in the tissue such that the proximal end remains accessible and the distal end reaches to, or into the tissue area to be treated, wherein, for implantation, mechanical vibrations are applied to the diffuser blank through its proximal end and the diffuser blank is pressed into the tissue such that the thermoplastic diffuser material is liquefied in the surface areas protruding or equipped with energy directors and is pressed into the tissue and that then the distal light conductor end is coupled to the proximal end and light is coupled into the diffuser.
25. A method according to claim 24, characterized in that the diffuser blank is pin-shaped and is implanted in bone tissue.
26. A method according to one of claims 24 and 25, characterized in that a cortical bone layer is opened for implantation of the diffuser blank and that the diffuser blank is driven into spongeous bone without providing an opening therein.
27. A method according to one of claims 24 to 26, characterized in that the diffuser blank (1) comprises at least one of a surface range without energy directors disposed proximate the proximal end and a surface range with a recessed surface such that the axial length of this surface range is adjusted to the depth of a bone region to be treated.
28. A method according to one of claims 26 and 27, characterized in that the diffuser blank comprises towards its distal end a surface range with energy directors and with a protruding surface and that the axial length of this surface range is adjusted to the size of abone tissue area to be treated.
29. A light diffuser with a light scattering surface, characterized in that a diffuser cap is situated around the light scattering surface and that the diffuser cap is designed as an instrument or part of an instrument.
30. A light diffuser according to claim 29, characterized in that the instrument is integrated into one of a scalpel blade, a blade of a scissor-like instrument and a leg of a nipper-like instrument.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CH7782004 | 2004-05-03 | ||
| CH778/04 | 2004-05-03 | ||
| PCT/CH2005/000246 WO2005105208A2 (en) | 2004-05-03 | 2005-05-03 | Light diffuser and process for producing the same |
Publications (1)
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|---|---|
| CA2565638A1 true CA2565638A1 (en) | 2005-11-10 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002565638A Abandoned CA2565638A1 (en) | 2004-05-03 | 2005-05-03 | Light diffuser and process for producing the same |
Country Status (9)
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| US (1) | US20070225695A1 (en) |
| EP (1) | EP1744812B2 (en) |
| JP (1) | JP4871267B2 (en) |
| CN (1) | CN100577237C (en) |
| AT (1) | ATE442186T1 (en) |
| CA (1) | CA2565638A1 (en) |
| DE (1) | DE502005008107D1 (en) |
| HK (1) | HK1105903A1 (en) |
| WO (1) | WO2005105208A2 (en) |
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- 2005-05-03 US US11/568,553 patent/US20070225695A1/en not_active Abandoned
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| EP1744812B2 (en) | 2014-06-04 |
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| CN100577237C (en) | 2010-01-06 |
| EP1744812B1 (en) | 2009-09-09 |
| HK1105903A1 (en) | 2008-02-29 |
| ATE442186T1 (en) | 2009-09-15 |
| JP4871267B2 (en) | 2012-02-08 |
| US20070225695A1 (en) | 2007-09-27 |
| JP2007536028A (en) | 2007-12-13 |
| EP1744812A2 (en) | 2007-01-24 |
| CN1953781A (en) | 2007-04-25 |
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