Air or gas filled microballons for preparation of suspensions in liquid mediafor ultrasonic echography and method of obtaining them
Abstract
Air or gas filled microballoons bounded by an interfacially deposited polymer membrane which can be dispersed in aqueous carrier liquids to be injected into living organisms or administered orally, rectally and urethrally for therapeutic or diagnostic purposes (echography). The properties of the polymeric membrane of the microballoons (elasticity, permeability, biodegradability) can be controlled at will depending on the selected polymer, the interfacial deposition conditions, and the polymer additives.
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Expired 16 May 2006, 20.4 years ago.
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21 claims: 1 independent, 20 dependent
- 1Zastrzeżenia patentowe 1. Sposób wytwarzania wypełnionych powietrzem lub gazem mikrobalonów do sporządzania zawiesin w ciekłych nośnikach do echografii, ultrasonograficznej,nadających się do podawania doustnie, doodbytniczo i do przewodu moczowego lub do wstrzyknięć żywym organizmom, znamienny tym, że (1) emulguje się hydrofobową fazę organiczną w wodzie otrzymując w fazie wodnej kropelki fazy hydrofobowej jako emulsję typu olej w wodzie, (2) dodaje się do tej emulsji roztwór co najmniej jednego polimeru w nierozpuszczalnym w fazie wodnej, lotnym rozpuszczalniku, przy czym wokół kropelek tworzy się warstwa polimeru, (3) odparowuje się lotny rozpuszczalnik, przy czym polimer ulega wytrącaniu na granicy faz wokół kropelek, które następnie tworzą perełki z rdzeniem z fazy hydrofobowej zamkniętej membraną polimerową, przy czym perełki te są w zawiesinie w fazie wodnej, (4) poddaje się zawiesinę działaniu obniżonego ciśnienie w takich warunkach, żeby zakapsułkowana faza hydrofobowa była usuwana przez odparowanie, przy czym tak dobiera się fazę hydrofobową, żeby odparowała ona praktycznie równocześnie z fazą wodną i żeby była zastępowana przez powietrze lub gaz.
- 2Sposób według zastrz. 1, znamienny tym, że polimer rozpuszcza się w fazie hydrofobowej i wtedy etapy (2) i (3) mogą być pominięte, a membranę polimerową tworzy się przez wytrącanie na granicy faz w etapie (4).
- 3Sposób według zastrz. 1, znamienny tym, że odparowanie fazy hydrofobowej w etapie (4) się w temperaturze, przy której ciśnienie cząstkowe par fazy hydrofobowej jest tego samego rzędu co ciśnienie pary wodnej.
- 4Sposób według zastrz. 1, znamienny tym, że odparowanie w etapie (4) przeprowadza się w warunkach odpowiadających suszeniu przez wymrażanie.
- 5Sposób według zastrz. 4, znamienny tym, że odparowanie przeprowadza się w zakresie temperatur od -40°C do 0°C.
- 6Sposób według zastrz. 1 albo 3, znamienny tym, że stosuje się fazę hydrofobową wybraną spośród związków organicznych, o prężności pary około 0,98· 10* Pa w temperaturze mieszającej się w przedziale od około -40°C do 0°C.
- 7Sposób według zastrz. 1 albo 2, znamienny tym, że stosuje się fazę wodną zawierającą rozpuszczone stabilizatory w ilościach od około 1 do 20% wagowych obejmujące związki hydrofilowe wybrane spośród cukrów polialkoholu winylu (PVA),poliwinylopirolidonu (PVP) żelatyny, skrobi, polidekstrozy i albuminy.
- 8Sposób według zastrz. 2, znamienny tym, że dodatki regulujące stopień przepuszczalności membrany polimeru dodaje się do fazy hydrofobowej, a szybkość biodegradacji polimeru po wstrzyknięciu mikrobalonów do żywego organizmu jest funkcją stopnia przepuszczalności.
- 9Sposób według zastrz. 8, znamienny tym, że stosuje się dodatki obejmujące hydrofobowe tłuszcze, woski i węglowodory lub fosfolipidy o dużym ciężarze cząsteczkowym i węglowodory o niskim ciężarze cząsteczkowym.
- 10Sposób według zastrz. 8, znamienny tym, że jako plastyfikatory stosuje się mirystynian izopropylu, jednostearynian gliceryny, substancje amfipatyczne obejmujące surfaktanty i fosfolipidy, takie jak lecytyna i związki hydrofobowe obejmujące węglowodory o wysokim ciężarze cząteczkowym, takie jak wosk parafinowy
- 11Sposób według zastrz. 9, znamienny tym, że miękkość i sprężystość membrany polimerycznej reguluje się dodawaniem polimerów zawierających węglowodory o niskim ciężarze cząsteczkowym, przy czym ciężar cząsteczkowy polimerów zawiera się w zakresie 1000 do 15000. 166 827
- 12Sposób według zastrz. 8, znamienny tym, że stosuje się dodatki wybrane spośród polilaktydów, poliglikolidów, glikoli polialkilenowych, takich jak glikol polietylenowy i glikol polipropylenowy i poliole, jak poligliceryna.
- 13Sposób według zastrz. 2, znamienny tym, że stosuje się fazę hydrofobową poddawaną emulgowaniu fazie wodnej zawierającą również rozpuszczalnik rozpuszczalny w wodzie, który po rozcieńczeniu w fazie wodnej podczas emulgowania będzie zmniejszał wielkość kropli wywoływał wytrącanie polimeru na granicy faz przed przeprowadzeniem etapu (4).
- 14Sposób według zastrz. 1 albo 2, znamienny tym, że wytwarza się membranę elastyczną o grubości 50 - 500 nm, która wytrzymuje zmiany ciśnienia towarzyszące uderzeniom serca w strumieniu krwi.
- 15Sposób według zastrz. 1 albo 2, znamienny tym, że wytwarza się membranę polimeryczną o grubości od kilku do kilku tysięcy nanometrów, korzystnie 50 - 2000 nm.
- 16Sposób według zastrz. 1 albo 2, znamienny tym, że jako polimer tworzący membranę stosuje się polimer ulegający biodegradacji wybrany spośród polisacharydów, poliaminokwasów, polilaktydów i poliglikolidów i ich kopolimerów, kopolimerów laktydów i laktonów, polipeptydów, poli/orto/estrów, polidioksanonu, poli-p-aminoketonów, polfosfazenów, polibezwodników i poli/alkilo-cyjanoakrylanów/.
- 17Sposób według zastrz. 1 albo 2, znamienny tym, że jako polimer membrany stosuje się polimer wybrany spośród pochodnych kwasów poliglutaminowego i poliasparaginowego i ich kopolimerów z innymi aminokwasami.
- 18Sposób według zastrz. 17, znamienny tym, że stosuje się pochodne kwasów poliasparginowego i poliglutaminowego wybrane spośród estrów i amidów z łańcuchami bocznymi zawierającymi grupy karboksylowe o wzorach -/CH2/nCOO-OHR l COOR lub -/CH^nCOOCR κ-O-COR lub -/CH2/nCO/NH-CHX-CO/ m NHCH/COOH/-/CH2/pCOOH, w których to wzorach R oznacza metyl, etyl,propyl, izopropyl, izobutyl, IIIn-butyl i benzyl, R 1 oznacza, r2 oznacza atom wodoru lub R i R 1 połączone są przez podstawiony lub niepodstawiony człon łączący tworząc 5- lub 6-członowy pierścień, n jest 1 lub 2, pjest 1,2 lub 3, mjest liczbą całkowitą od 1 do 5, a X oznacza łańcuch boczny reszty aminokwasu.
- 19Sposób według zastrz. 1 albo 2, znamienny tym, że wytwarza się membranę polimerową nie ulegającą biodegradacji w przewodzie pokarmowym metyl lub podstawiony metylen, a i nieprzepuszczalną dla cieczy biologicznych.
- 20Sposób według zastrz. 19, znamienny tym, że stosuje się polimer wybrany z poliolefin, poliakrylanów, poliakrylonitrylu, poliestrów nie ulegających hydrolizie, poliuretanów i polimoczników.
- 21Sposób według zastrz. 1, znamienny tym, że w przypadku wytwarzania zawiesin do wstrzykiwania użytecznych jako kontrastowe czynniki do echografii ultrasonograficznej, suche, sypkie i nadające się do łatwego dyspergowania, wypełnione powietrzem mikrobalony otrzymuje się w wodzie lub w buforowanym albo niebuforowanym roztworze solanki.
Independent claims21
78 paragraphs, as filed
The present invention relates to a method for producing air or gas-filled microbaloons for suspending in liquid ultrasound echography carriers.
Microballoons with an organic polymer coating filled with gas or air in dispersed form or as a suspension in an aqueous medium are administered orally, rectally or introduced into the ureter and can also be used in the form of injections into living organisms for, for example, ultrasound and other medical applications .
The production method also includes the production of microbaloons in dry form, which, when spread in an aqueous medium, immediately gives a suspension with improved properties over known products. Therefore, microbaloon suspensions ready for administration are also part of the invention. It is known that air or gas micro-bodies or micro-spheres, e.g. microspheres such as microbubbles or microballoons containing
166 827 sewn in liquids are extremely effective ultrasound reflectors for echography purposes. As used herein, the term microbubble refers in particular to air or gas microspheres suspended in a liquid carrier into which gas or air is introduced separately. Preferably surfactants (surfactants) or tensides are introduced into the liquid to regulate the surface properties and stability of the micro bubbles. The gas-liquid interface in the micro-spheres essentially contains loosely bound liquid carrier particles. The term microcapsule or microballon means, preferably, a gaseous medium or air together with particles constituting a coating material having a composition different from the chemical composition of the liquid carrier, i.e. it may be a polymer membrane constituting the wall of the microcapsule. Both microbubbles and microballoons are very useful as contrasting agents in ultrasonic technology. For example, injection of a suspension of gas or microballoons (with a diameter in the range of 0.5 to 10 gm /) in a liquid vehicle into the bloodstream of living organisms causes a significant strengthening of the ultrasound image and thus allows the visualization of internal organs. Visualization of vessels and internal organs can significantly help in medical diagnosis.
Suspensions of microbubbles in an injectable liquid carrier, useful in echography, can be accomplished by releasing gas dissolved under pressure in this liquid or by a chemical reaction leading to the formation of gaseous products, or by introducing into the liquid carrier soluble or insoluble solids containing occluded or adsorbed gas or air.
For example, from the patent specification Ser. 4,446,442 a number of different techniques are known for making suspensions of gas microbubbles in a sterile injectable liquid carrier. These suspensions are prepared using (a) a solution of tenside (surfactant) in a liquid carrier (aqueous solution) and (b) a solution that increases viscosity and acts as a stabilizer. The method of producing bubbles given in the aforementioned description is based on the forced flow of the mixture (a), (b) and air at a high speed through a small-diameter hole or, before use, the mixture (a) is injected into the mixture (b) together with a physiologically acceptable gas. According to another method, the acid is introduced into the mixture (a) and carbonate into the mixture (b) and the two components are mixed before use, as a result of which the acid reacts with carbonate, forming CO2 bubbles, or pressurized gas is introduced into the stored mixtures ( a) and (b), which, when the injection mixture is used, is released in the form of microbubbles.
One of the problems with microbubbles is that they generally have a short life span even in the presence of stabilizers.
Hence, EP-A-131.540 describes a method of preparing a microbubble suspension, according to which a stabilized liquid injection vehicle, e.g. an aqueous saline solution or a sugar solution such as maltose, dextrose, lactose or galactose, is mixed with solids microparticles (diameter ranging from 0.1 gm to 1 gm) of the same sugars containing occluded air. To make a suspension of microbubbles in a liquid carrier, both the liquid and solid components are mixed together for several seconds under sterile conditions. After mixing, the suspension obtained must be used immediately, i.e. for echographic measurements, the injection should be given within 5-10 minutes. This procedure is necessary due to the disappearance of bubbles as a result of which their concentration becomes too low to be of practical importance after this period.
Another problem associated with microbubbles for echography is their size. It is widely accepted that the useful size of microbubbles that allows them to easily move through narrow blood vessels is in the range of about 0.5 gm to 10 gm. In the case of larger bubbles, there is a risk of clots forming, which results in blockages. For example, the bubble suspension described in US Pat. Ser. No. 4,446,442, in the manufacture of which aqueous surfactant solutions such as lecithin, fatty acid esters and ethers with polyoxyethylene and polyoxyethylene polyols, such as sorbitol, glycols and glycerin, cholesterol or polyoxyethylene-polyoxypropylene polymers, are vigorously mixed with solutions viscosity-increasing and stabilizing compounds, such as mono and polysaccharides (glucose, lactose, sugar, dextran, sorbitol), polyalcohols e.g. glycerol, polyglycols and polypeptides, such as proteins, gelatin, polyoxy gelatine and plasma protein, only 50% of vesicles then have sizes below 40-50 pm, which in turn makes this suspension unsuitable for many applications in echography.
An attempt to eliminate some of the above-mentioned disadvantages was to develop methods for producing microcapsules and microbaloons. As mentioned previously, while the microbubbles have only an intangible or disappearing coating, i.e. they are surrounded only by a wall of liquid whose surface tension is modified by the introduction of surfactants, then microballoons and microcapsules have a tangible coating made of a material other than the material of the carrier, for example. it can be a polymer membrane having a certain mechanical strength. In other words, they are microspheres made of solid material in which the gas or air is more or less tightly closed.
For example, U.S. Patent No. Ser. No. 4,276,885 describes the use of gas-filled microcapsules with a membrane coating used to amplify ultrasound images. The membrane consists of organic molecules that do not have toxic and antigenic properties.
It is stated in the description that these microbubbles have a non-coalescence gelatinous membrane and their dimensions are 5-10 μm. It is believed that the said microbubbles are sufficiently stable to perform echographic measurements, however it was also mentioned that after some time the gas occluded in they dissolve in the bloodstream and the bubbles gradually disappear. This effect is caused by the slow dissolution of gelatin. Before use, said microcapsules are stored in a gelatin solution where they remain stable, but the gelatin must be warmed and melted to obtain the liquid suspension needed at the time of injection.
Microspheres with increased storage stability, although not containing gelatin, are described in US Pat. Ser. No. 4,718,433. These microspheres were made by sonication (5-10 KHz frequency), viscous protein solutions, such as 5% serum albumin, and had a diameter in the range of 2-20 Jim and mainly 2-4 μm. After sonication, the microspheres are stabilized by denaturing the proteins that make up the membrane. The denaturation process is carried out by heating or by a chemical reaction, for example with formaldehyde or glutaraldehyde. The concentration of stable microspheres obtained by this method is considered to be about 8x10<sup>6</sup> / ml for diameters in the range of 2-4 μm, about 10<sup>6</sup> / ml in the diameter range of 4-5 μm and below 5x10<sup>5</sup> / ml in the diameter range of 5-6 μm. The shelf life of such microspheres is 48 hours and more, but after intravenous injection they allow for effective visualization of the left ventricle. For example, after injection into an external vein, supersonic microbubbles of albumin have the ability to pass through lung tissue. This results in a loss of transparency of the left ventricular cavity and myocardial tissue.
Recent reports speak of further improvements in the production of injectable microbaloons for ultrasound purposes. In EP-A324,938, air-filled protein-coated microcapsules are described whose concentration exceeds 10<sup>8</sup> with a diameter of 10 μm and their lifetime is of the order of several months and more. Aqueous suspensions of these microbaloons are produced by ultrasonic cavitation of denatured protein solutions, e.g. human serum albumin. This process also partially foams the membrane-forming proteins and subsequently cures them as a result of heat. Also other proteins such as hemoglobin and collagen are considered useful for these applications.
Recently, MAWheatley et al. In the journal Biomaterials, 11, 1990, 713-717, described the production of polymer coated microspheres by ionotropic alginate gelatinization. The publication mentions a number of techniques used to make such microspheres. According to one of them, the alginate solution is forced through the air nozzle needle, resulting in a mist consisting of air-filled capsules, which
166 322 cure in a bath containing a 1.2% aqueous CaCl2 solution. According to a second method involving coextrusion of gas and liquid, gas bubbles are introduced into the forming capsules by means of a triple sleeve head. This is done in such a way that the air is injected into the middle capillary (sleeve) while the alginate solution is forced through a second, larger capillary located concentrically in relation to the first, around which sterile air flows inside the mantle surrounding the second capillary. Also according to the third method, the gas is captured in sodium alginate solution before extrusion and capsule formation (by spraying) and further processing of the solution using a tissue homogenizer or bath or sonication probe. The microballons obtained in this way had a diameter in the range of 30-100 gm, but they were too large to be able to easily move in the pulmonary tubules.
The high storage stability of the microballoons suspensions described in Patent No. EP-A-324.922 allows their commercial distribution in this form, i.e. together with a liquid carrier. This fact is a very strong commercial advantage as it is no longer necessary to make the suspension just before use. However, the protein material described in this specification can cause allergic reactions in sensitive patients, and in addition the exceptional strength and durability of the membrane material has several disadvantages. For example, due to the stiffness of the membrane, it cannot withstand the sudden pressure changes that microspheres may undergo during movement in the bloodstream. These pressure changes are caused by heart pulsations. Thus, during practical ultrasonic tests, some of the microspheres are damaged, which results in disruption of the obtained images. Also, the mentioned microballoons are not suitable for oral administration because they show a lack of resistance to the digestive effects of enzymes present in the gastrointestinal tract. In addition, it is known that microspheres with flexible walls give a better acoustic echo than balls whose walls are rigid.
In the case of injections, the excessive durability of the walls of the material from which the microsphere is made causes that the processes of biodegradation of the wall occurring in the tested body will be slowed down, which in turn may cause problems associated with metabolism. Therefore, solutions aimed at developing microbaloons with soft and flexible walls, which under the influence of momentary pressure changes may be deformed but are characterized by increased ability to reflect acoustic waves, are preferred. In addition, microballoons with controlled biodegradability, made for example of semi-permeable polymer coatings, biodegradable and with controlled microporosity allow slow penetration of biological liquids which would be highly desirable.
The above-mentioned preferred features have been obtained with microballoons prepared according to the invention. In addition, although these microballoons have a relatively short lifetime, i.e. they are susceptible to biodegradation, which allows to deal with the mentioned metabolic problems by using selected types of polymers, nevertheless this feature (controlled by technological parameters) is not a commercial disadvantage. Microbalones can be stored and transported in dry form, because under these conditions they remain stable indefinitely, or a membrane completely impermeable to the liquid carrier can be made, and then degradation begins only after injection. In the first case, the microballoons in the form of a dry powder are properly combined with the aqueous phase of the carrier before use, depending on the needs. It should be noted that this procedure is an additional advantage over the products known in the art, because the concentration of the suspension can be chosen freely, and the initial concentration values (i.e. after preparation of the suspension) significantly exceed the above-mentioned value of 2 2 / ml and are within easily achievable concentration range from 10<sup>5</sup> to 10 6. It is worth noting that the method according to the invention allows the regulation of porosity in a wide range. Hence, microballoons with a permanently impermeable membrane can be easily manufactured, while maintaining stability in the form of a suspension in a liquid aqueous carrier and in this form they can be placed on the market.
Liquid-filled membrane microspheres with membranes filled with liquid are well known. Usually they can be formed by emulsifying droplets (whose size
166 827 depends on the parameters of the emulsification process) of the first aqueous phase in the organic polymer solution and then the dispersion of the resulting emulsion in the second aqueous phase and subsequent evaporation of the organic solvent. During evaporation of the volatile solvent, interfacial polymer deposition occurs at the droplet boundary to form a microporous membrane that effectively delimits the closed first aqueous phase from the surrounding second aqueous phase. Although this technique is feasible, it is not preferred in the method according to the invention.
Otherwise, the emulsion can be made using the hydrophobic phase of the aqueous phase emulsifier (usually containing a viscosity enhancer and acting as an emulsion stabilizer, thereby obtaining a droplet emulsion, an oil-in-water hydrophobic phase, and then introducing into it a membrane-forming polymer dissolved in a volatile organic solvent, immiscible with the aqueous phase.
If this polymer is insoluble in the hydrophobic phase, then it will deposit on the interface between the droplets and said aqueous phase. In addition, evaporation of the volatile solvent causes the formation of an interfacial membrane around the droplets of the emulsified hydrophobic phase. Further evaporation of the closed, volatile hydrophobic phase leads to the formation of water-filled microcapsules surrounded by a membrane of interphase-deposited polymer. This technique has been successfully used in the method of the invention and has been described by K. Uno et al in J. Microencapsulation 1 (198), 3-8 and K. Makino et al in Chem. Pharm. Bull. 33 (1984), 1195-1201. As mentioned, the droplet size can be adjusted by changing the emulsion production parameters, i.e. the type of emulsifier used (more effective surfactant, i.e. the greater the ratio of the hydrophilic phase to the lyophilic phase, the smaller the droplets are formed) and by the mixing conditions (the faster and more vigorous the mixing, the smaller the droplets formed).
According to another variant, the interface-forming polymer dissolves in the initial hydrophobic phase, which emulsifies as droplets in the aqueous phase, and the formation of a membrane around said droplets occurs as a result of evaporation of the closed hydrophobic phase. As an example, the publication in Powder Technology 22 (1978) 11-16 of JR Farnand and others. These authors emulsified the polymer solution (e.g. polyethylene) in naphthalene, using water at reflux, after cooling, they recovered naphthalene in the form of a suspension of polymer beads in cold water and finally removed the naphthalene, subjecting the micro beads to sublimation, resulting in microballoons with a diameter of 25 gm. There are also other examples according to which the polymer dissolves in a mixed hydrophobic phase containing a hydrophobic, volatile organic solvent and a water-soluble organic solvent. The polymer solution thus obtained is emulsified in the aqueous phase containing the emulsifiers, as a result of which the water-soluble solvent is dispersed in the aqueous phase, thereby facilitating the formation of hydrophobic phase microsphere emulsions and causing polymer precipitation at the interface. This method is described in EP-A-274,961.
The techniques described above can be adapted to produce gas or air-filled microbalones useful for ultrasonic visualization, provided that the appropriate possibilities of adjusting the size of the balls in the desired ranges, controlling permeable or impermeability at the cell-wall interface and developing the closed liquid phase with air or selected gas are developed . The ability to control the overall size of the ball is obviously important when adapting the microballoons for accepted applications, i.e. injection or oral administration. Requirements for the size of the injectable beads (about 0.5-10 gm medium size) have been discussed previously. In the case of oral administration, the range may be wider if it is taken into account that the reflectivity of sound waves increases with increasing ball size. Hence, you can use microballons with diameters in various size ranges, say between 1 and 1000 gm, depending on your needs and provided that the membrane is flexible enough to not break when moving in the stomach and intestines. The ability to regulate the permeability of the wall is important to ensure that there is no infiltration (soaking) of the aqueous phase of the injected carrier or that it is free enough,
166 827 that it does not impede echographic measurements but, in some cases, ensures that the permeation occurs to such an extent that it provides relatively rapid biodegradation after the test, that is, the easy metabolism of the suspension by the body. Also, the microporous structure of the microballon coating (pores of the order of several nm to several hundred nm or more in the case of microballoon coatings in the thickness range 50-500 nm) is a factor determining the shape retention, i.e. microspheres can easily respond to pressure changes without causing cracks. The preferred pore size range is about 50,000 nm (nanometers).
The conditions to achieve these results are met using the method of the invention, which consists in (1) emulsifying the hydrophobic organic phase in water to obtain droplets of the hydrophobic phase in the aqueous phase as an oil in water emulsion, (2) is added to this emulsion, a solution of at least one polymer in a volatile solvent insoluble in the aqueous phase, with a polymer layer forming around the droplets, (3) the volatile solvent is evaporated, wherein the polymer precipitates at the interface around the droplets, which then form beads with a core of a hydrophobic phase closed with a polymer membrane, the beads being suspended in the aqueous phase, (4) the suspension is subjected to reduced pressure under conditions such that it is encapsulated the hydrophobic phase was removed by evaporation, in which way the hydrophobic phase is selected, that it evaporates virtually simultaneously with the aqueous phase and that it is replaced by air or gas.
The polymer is preferably dissolved in the hydrophobic phase and then steps (2) and (3) can be omitted and the polymer membrane is formed by precipitation at the interface in step (4). Evaporation of the hydrophobic phase in step (4) is preferably carried out at a temperature at which the partial vapor pressure of the hydrophobic phase is in the same order as the steam pressure, especially under conditions corresponding to freeze drying, e.g. in the temperature range from -40 ° C to 0 ° C.
The process of the invention uses a hydrophobic phase selected from organic compounds with a vapor pressure of about 0.98 · 10<sup>4</sup> Pa at a temperature in the range of about -40 ° C to 0 ° C and an aqueous phase containing dissolved stabilizers in amounts of about 1 to 20% by weight including hydrophilic compounds selected from sugars, PVA, PVP, gelatin, starch, polydextrose and albumin . Additives controlling the degree of permeability of the polymer membrane are added to the hydrophobic phase, and the rate of polymer biodegradation after injection of microballoons into a living organism is a function of the degree of permeability. Additives including hydrophobic fats, waxes and hydrocarbons or high molecular weight phospholipids and low molecular weight hydrocarbons are used. Plasticizers include isopropyl myristate, glycerol monostearate, amphipathic substances including surfactants and phospholipids such as lecithin and hydrophobic compounds including high molecular weight hydrocarbons such as paraffin wax. The softness and elasticity of the polymeric membrane is controlled by the addition of polymers containing low molecular weight hydrocarbons, the molecular weight of the polymers being in the range of 1000 to 15,000.
In addition, additives selected from polylactides, polyglycolides, polyalkylene glycols such as polyethylene glycol and polypropylene glycol and polyalcohols such as polyglycerol are used.
The process of the invention preferably uses a hydrophobic phase which is emulsified in the aqueous phase, which also contains a water-soluble solvent which, when diluted in the aqueous phase during emulsification, will reduce the droplet size and cause polymer precipitation at the interface before performing step (4), and it produces a 50-500 nm thick membrane that withstands pressure changes associated with heartbeats in the blood stream.
> The polymeric membrane produced has a thickness of several to several thousand nanometers, preferably 50 - 2000 nm. The membrane-forming polymer used is a biodegradable polymer selected from polysaccharides, polyamino acids, polylactides and polyglycolides and their copolymers, copolymers of lactides and lactones, polypeptides, poly / ortho / esters,
166 827 polydioxanone, poly-p-amino-ketones, polyphosphazenes, polyanhydrides and poly (alkyl-cyanoacrylates), preferably the polymer of the membrane is a polymer selected from derivatives of polyglutamic and polyaspartic acids and their copolymers with other amino acids.
Also used are derivatives of polyaspartic and polyglutamic acids selected from esters and amides together with side chains containing carboxyl groups with the formulas - / CWnCOO-OHRCOOR or - / CH2nCOQCR'R<sup>2</sup>-O-COR or - / CH<sub>2</sub>/ "CO / NH-CHXCO /<sub>m</sub>NHCH / COOH / - / CH2 / pCOOH, in which formulas R is methyl, ethyl, propyl, isopropyl, isobutyl and benzyl, R<sup>1</sup> is methylene or substituted methylene and R<sup>2</sup> is hydrogen or R and R<sup>1</sup> are joined by a substituted or unsubstituted linking member to form a 5- or 6-membered ring, n is 1 or 2, p is 1 2 or 3, m is an integer from 1 to 5, and X is the side chain of the amino acid residue.
According to the invention, a polymer membrane is produced which is not biodegradable in the gastrointestinal tract and impermeable to biological liquids.
Preferably a polymer selected from polyolefins, polyacrylates, polyacrylonitrile, non-hydrolyzable polyesters, polyurethanes and polyureas is used.
Preferably, for the preparation of injectable suspensions useful as contrast agents for ultrasound echography, dry, free-flowing and easily dispersed, air-filled microbaloons are obtained in water or in a buffered or unbuffered saline solution.
One of the factors that allows regulating the permeability of the microballon membrane is the degree of evaporation of the hydrophobic phase relative to the degree of evaporation of the aqueous phase in step (4) of the method according to the invention, e.g. under freeze-drying conditions, which is the case described in claim 4. For example, if the evaporation is carried out in the temperature range -40 ° to 0 ° C, and hexane is used as the hydrophobic phase, then polystyrene is a polymer that settles on the interface and results in beads with relatively large pores. This is because the hydrocarbon vapor pressure in the selected temperature range is much greater than the water vapor pressure, and this means that the pressure difference between the inside and the outer area of the balls will increase the pore size of the membrane, through which the material inside the microsphere will evaporate . On the contrary, using cycloacetate as the hydrophobic phase (at -17 ° C the cycloacetate vapor pressure is equal to the water vapor pressure) beads with small pores are obtained, because under these conditions the pressure difference between the inside and the outer coating of the beads is minimized.
Depending on the degree of porosity of the microballoons obtained by the process of the invention, they can be stable in a liquid carrier for a period of several hours to several months and at the same time echographic signals are obtained for a long period of time. Indeed, depending on the polymer chosen, the membrane can be obtained completely impermeable on contact with a liquid carrier having appropriate osmotic properties, i.e. one containing the appropriate amount of insoluble matter. It should be noted that the presence of micropores in the coating of the microballoons also appears to be associated with the reflected echographic signal, i.e., while maintaining all other factors unchanged, the microporous vesicles ensure a more effective echographic signal than non-porous vesicles. The reason is not exactly known, but it can be argued that when the gas is in resonance, being in a closed structure, then its damping properties may be different depending on whether it is porous or not.
Other water-insoluble organic solvents whose vapor pressure in the range of -40 ° C to 0 ° C are of the same order can be used as the hydrophobic solvents according to the invention. These include hydrocarbons such as, for example, n-octane, cyclooctane, dimethylcyclohexane, ethylcyclohexane 2-, 3-, and 4-methylheptane, 3-ethylhexane, toluene, xylene, 2-methyl-2-heptane, 2,2,3 , 3-tetramethylbutane and the like. Esters such as propyl and isopropylbutyrate and isobutyrate, butyl formate and the like are also suitable. Another advantage of freeze-drying (evaporation from a frozen state) is that this process can be carried out under reduced gas pressure instead of air, resulting in a micro-balanced filling.
166 827 gas. Physiologically acceptable gases such as CO2, N2O, methane, freon, helium and other rare gases can also be used. You may also consider using gases that contain radioactive indicators.
As volatile water-insoluble solvents used to dissolve the polymer to be deposited on the interface, there may be mentioned halogen compounds such as CCl, CHaBr, CH2Cl2, chloroform, low boiling esters such as methyl, ethyl and propyl acetate as well as lower ethers and ketones with low water solubility. When using solvents that do not completely dissolve in water, e.g. ethyl ether, it is preferred to use as an aqueous phase an aqueous solution saturated with said solvents.
The aqueous phase in which the hydrophobic phase is emulsified, as an oil-in-water emulsion, preferably contains 1-20% by weight of water-soluble hydrophilic compounds, such as sugars and polymers, which act as stabilizers, e.g. polyvinyl alcohol (PVA), polyvinylpyrrolidone (PVP), polyethylene glycol (PEG), gelatin, polyglutaric acid, albumin and polysaccharides such as starch, dextran, agar, xanthate, and the like. As the liquid carrier in which the microballoons are suspended before use, aqueous phases similar to those mentioned can be used.
Part of the water-soluble polymer may remain in the shell of the microballoons or may be removed by washing the beads before subjecting them to final evaporation of the encapsulated hydrophobic phase of the core.
Emulsifiers that can be used (0.1-5% by weight) for the production of an oil-in-water hydrophobic phase emulsion include most physiologically acceptable emulsifiers, for example, egg or soy lecithin, or synthetic lecithins, such as saturated synthetic lecithins , for example D-phosphatidylcholine dipalmitoil, DL-α-phosphatidylcholine dimiristoyl or phosphatidylcholine distearoyl or unsaturated synthetic lecithins, such as dioleoyl La-phosphatidylcholine or dilinoleoyl, La-phosphatidylcholine. The group of emulsifiers also includes surfactants, such as free fatty acids, fatty acid esters with polyalkyl compounds, such as polyoxypropylene glycol and polyoxyethylene glycol, fatty alcohol ethers with polyoxyalkyl glycols, fatty acid esters with polyoxyalkylated sorbitols, soaps, stearates, polyglyceryl glycerides glyceryl polyoxyethylene, mono- and copolymers of polyalkylene glycols, polyoxyethylene soybean and castor oils, as well as hydrogenated derivatives, ethers and esters of sucrose or carbohydrate fatty acids optionally polyoxyalkylated, mono-, di- and triglycerides of saturated and unsaturated fatty acids, soybean oil and sucrose glycerides.
The polymer that is the coating or membrane of the injection microbalons can be selected from most polymers with hydrophilic, biodegradable and physiologically compatible polymers. Among these polymers, mention may be made of polysaccharides with low water solubility, polylactides and polyglycolides and their copolymers, copolymers of lactides and lactones such as ε-caprolactone, δ-valerolactone and polypeptides.
The great advantage of the invention is the universality in the choice of polymer, because, as is the case with patients sensitive to allergies, the use of microbaloons made of natural proteins (albumin, gelatin) described in patents US-A-4,276,885 or EP-A- 324.938. Other suitable polymers that can be used are poly / ortho / esters (see for example US-A-4,093,709; US-A-4 131,648; US-A4,138,344; US-A-4,180,646), polylactic and polyglycolic acids and their copolymers for example DEXON (see J. Heller, Biomaterials 1 (1980), 51; poly / DL-lactide ^ caprolactone), poly / DL-lactide ^ valerolactone / copolymer, poly / DL-lactide-y-butyrolactone / copolymer, polyacrylic cyanoakiylay; polyamides, polyhydroxybutyrate, polydioxanone; poly-P-amino ketones / Polymer 23 - 1982/1693; polyphosphazenes (Science 193/1976 /, 1214); and polyanhydrides. References for biodegradable polymers can be found in R. Langer et al., Macromol, Chem. Phys. C23 (1983) 61-126. Polyamino acids such as polyglutamic and polyaspargic acids and their derivatives, that is, partially from 166 827 esterified with lower alcohols or glycols. A practical example of this kind of polymers is poly (tertiary butylglutamine). Copolymers with other amino acids such as methionine, leucine, valine, proline, glycine, alamine and the like can also be used. New derivatives of polyaspargic and polyglutamic acids with controlled biodegradability have recently been described (see Patent Nos. W087 / 03891; US-4,888,398 and EP-130,935). These polymers (and copolymers with other amino acids) can be written by the formula: - / NH-CHA-CO / x / NH-CHX-CO /<sub>s</sub>in which X is the side chain of the amino acid residue, while A is the group of formula - / C ^ nnĆOOR ^ -OCOR, in which R<sup>1</sup> is methylene or substituted methylene and R<sup>2</sup> is hydrogen and R is methyl, ethyl, propyl, isopropyl, isobutyl IIIrz - butyl and benzyl or R and R<sup>1</sup> are joined by a substituted or unsubstituted linking group to form 5- or 6-membered rings.
A can also be a group of formula: - / CH ^ nCOO-CHR ^ OOR and of formula - / CH2 / nCO / NH-CHX-CO /<sub>m</sub>NH-CH / CÓOH / - / CH2 / pCOOH or an anhydride group suitable for them. In all these formulas, n and mip represent small integers (not exceeding 5), while x and y also have integers chosen so that the molecular weight is not lower than 5000.
The polymers mentioned above are suitable for the production of microballoons by the process of the invention. Depending on the types of R, R substituents used<sup>1</sup>, R2 and X can affect membrane properties such as strength, flexibility and biodegradability. For example, X may be methyl / alanine, isopropyl / valine, isobutyl / leucine or isoleucine /, benzyl / phenylalanine /.
Various additives can be added to modify the physical properties of the polymer wall of the microballon, such as dispersibility, flexibility and water solubility. To introduce these substances into the polymer, they can be dissolved in the polymer dispersion phase. For example, by emulsifying the hydrophobic phase in the aqueous phase, the precipitation of additives with the polymer occurs during membrane formation at the interface.
Among the useful additives can be mentioned compounds that have the ability to hydrophobize the membrane of microballoons to reduce its ability to pass water. Compounds such as high molecular weight hydrocarbons, fats and waxes can be used as additional substances. Additives that improve the ability to disperse microballoons in a liquid carrier belong to the group of amphipathic compounds, such as phospholipids, in addition, they also increase water permeability through the membrane and the rate of biodegradation.
Non-biodegradable polymers used to produce microbaloons introduced into the gastrointestinal tract can be selected from most water-insoluble, physiologically acceptable and biologically resistant polymers, such as polyolefins (polystyrene), acrylic resins (polyacrylates, polyacrylonitriles), polyesters (polycarbonates), polyurethanes, polyurea and their copolymers, ABS (acrylic butadiene styrene) is the preferred copolymer.
Additives that increase membrane flexibility are plasticizers such as isopropyl myristate and the like. Also very useful additives can be found among related polymers, those of which the membrane itself is made, but with a relatively low molecular weight. For example, if the membrane is made of a polylactide / polyglycolide type copolymer, then the membrane properties can be modified (increased softness and biodegradability) by incorporating, as additives, polyglycolide or low molecular weight polylactide (1000 to 15,000). An additive with membrane softening properties is polyethylene glycol with moderate to low molecular weight M<sub>in</sub>(e.g. PEG 2000).
Depending on the needs, the amount of additives added to the polymer forming the membrane of the microballon, produced by the method of the invention can vary within very wide limits. In some cases no additives are added, while in others this amount can reach a value of about 20% by weight relative to the polymer.
166 827
In order to maintain and prevent coalescence, injectable microbaloons are stored dry with or without additives. As additives, from 0.1 to 25% by weight of water-soluble, physiologically acceptable compounds such as mannitol, galactose, lactose or sucrose or hydrophilic polymers such as dextran, xanthan, agar, starch, PVP, polyglutamic acid, polyvinyl alcohol ( PVA), albumin and gelatin. The useful life time of microbaloons in a liquid carrier, i.e. the period of time during which useful echographic signals can be obtained, can be adjusted from a few minutes up to several months, depending on the needs. This can be achieved by controlling the degree of porosity of the membrane, ranging from total impermeability towards the liquid carrier, to porosity where the pore size is from a few to several hundred nanometers. This degree of porosity can be obtained in a controlled manner by, in addition to the choice of the type of membrane-forming polymer and polymer additives, such as the selection of evaporation rate and temperature in step (4) of the method of the invention and the appropriate selection of the type of compound (or mixture of compounds) contained in the hydrophobic phase , i.e. the greater the difference in its vapor pressure compared to the vapor pressure of the aqueous phase, the larger the pores of the microballon membrane will be. Of course, the described method of regulation through the selection of the hydrophobic phase can be further improved by the choice of stabilizers and their concentration which will allow control of the water evaporation rate during the formation of microbaloons. All these operations can easily be carried out by someone with dexterity without showing creativity.
It should be noted that although the microballons of the invention may be placed on the market in dry form, in special cases, especially when their lifetime after injection is short, it may be necessary to sell them in ready form, i.e. suspensions of microbaloons in an aqueous carrier, intended for injection or oral administration. In such applications it is required that the microballon membrane is completely impermeable (at least for a period of several months or more) to the liquid carrier. It has been shown in the description that such requirements can be easily met in accordance with the invention by proper selection of the type of polymer and the parameters of the polymer interface at the interface. In fact, such parameters have been selected (for example, using a polyglutamine polymer / in which A is a group of the formula - / CHt / hCOoRk-O-COR), in which R is methyl, .propyl, isopropyl, isobutyl, Il.butyl and benzyl , R<sup>1</sup> means methylene or substituted methylene, and R2 is hydrogen or R and R1 are connected via a substituted or unsubstituted linking member to form a 5- or 6-membered ring, n is 1 or 2, and cyclooctane as the hydrophobic phase) so that the porosity of the membrane evaporation of the hydrophobic phase is so insignificant that the microballoons are completely ni ^ pr: zi ^^ and ^ '^: ^ (^: depending on the phase of the liquid carrier in which they are suspended. The recommended method of preparation of the preparation for administration for diagnostic purposes includes suspension in a buffered or unbuffered saline solution (0.9% aqueous NaCl solution, 10 nM HCl buffer) containing 108-10 microbubbles / ml. Such a preparation can be prepared by following the directions contained in the examples given below, and in particular, Examples III and IV are recommended illustrating the use of poly- / DL-lactide / polymer from the Boehringer Company, Ingelheim, Germany. The following examples provide a pictorial illustration of the invention.
Example 1. One gram of polystyrene is dissolved in 19 g of liquid naphthalene at 100 ° C. The naphthalene solution obtained is emulsified at a temperature of 90-95 ° C with 200 ml of an aqueous solution of polyvinyl alcohol (PVA) (4% by weight) containing 0.1% Tween-40 emulsifier, i.e. 0.1% polyoxyethylene sorbitan monopalmitate. For emulsification, a Polytron PT-3000 head was used at approximately 10,000 revolutions per minute. The resulting emulsion is then diluted with continuous stirring in 500 ml of the same aqueous phase at 15 ° C, as a result of which the naphthalene droplets solidify in the form of beads with a diameter below 50 μm as evidenced by a screening test through a 50 μm sieve. The resulting suspension is centrifuged using 1000 g acceleration, then the beads are washed with water and centrifuged again. This procedure is repeated twice.
666 227
The resulting beads are re-suspended in 100 ml of water containing 0.8 g of dissolved lactose, and then the suspension is frozen in block form at -30 ° C. The frozen block is subsequently evaporated under reduced pressure of about 0.49-1.96-10<sup>4</sup> Pa in a temperature range of -20 ° to -10 ° C. The result is air-filled microballoons with a size of about 5-10 gm and controlled porosity, which, when dispersed in water (3% dispersion) gave an echographic signal at 2.25 and 7.5 MHz. Microbaloons in dry form are stable for an indefinite period of time. When the suspension was prepared in the liquid carrier, its lifetime for echography was about 30 minutes or more. Polystyrene is not biodegradable and is therefore not recommended for echographic injections but is useful for gastrointestinal examination. This example clearly demonstrates the suitability of the method according to the invention.
Example II A mixed copolymer (0.3 g) of the 50:50 DL-lactide and glycol type (Du Pont Medisorb) and 16 mg of chicken egg lecithin are dissolved in 7.5 ml CHCh to give a solution (1).
Solution (2) contains 20 mg paraffin wax (melting point 54 ° -56 ° C) dissolved in 10 ml cyclooctane (melting point 10<sup>ABOUT</sup>-13 ° C). This solution is emulsified in 150 ml of an aqueous solution (0.13% by weight) of the preparation under the trade name Pluronic F-102 (block copolymer of ethylene oxide and propylene oxide) also containing 1.2 g of CHCl3. Emulsification is carried out at room temperature for 1 minute using a Polytron head at 7000 rpm (7000 rpm). Then, while stirring, the solution (1) is added and after about 30-60 seconds, the head is replaced with a screw stirrer (500 rpm) and stirring is continued for about 3 hours at room temperature (22 ° C). The resulting suspension is passed through a 50 gm sieve and then frozen in the form of a block, which in turn is evaporated under reduced pressure in the temperature range from -20 ° C to 0 ° C (cold trap -60 ° to -20 ° C) . The result is 0.264 g (88%) of solid, air-filled microbaloons in dry form.
Suspensions of said microbaloons in water (without the addition of stabilizers) gave a strong echographic signal for at least 1 hour. After being injected into the body, they are biodegradable within a few days.
Example III. A solution is prepared, which in 200 ml tetrahydrofuran (THF) contains 0.2 g of 50:50 DL-lactide and glycolide copolymer (Boehrunger AG), 20 mg of chicken egg lecithin, 64 mg of paraffin wax and 4 ml of octane. The resulting solution is emulsified by placing it slowly and with continuous stirring with a screw stirrer (500 rpm) into 400 ml of a 0.1% aqueous solution of Pluronic F-102. After stirring for 15 minutes, the obtained milky dispersion is evaporated under reduced pressure 9.2 -11.76-1010 at 25 ° C in a rotary evaporator until the volume is reduced to about 400 ml. The resulting dispersion is passed through a 50 gm mesh screen, then cooled to -40 ° C and freeze-dried under reduced pressure of about 0.92.10<sup>4</sup> Pa. The obtained residue, in an amount of 1.32 g of dry, very fine powder is mixed with 40 ml of distilled water. As a result, after 3 minutes of manual mixing, a very homogeneous dispersion of microballoons is obtained, the average size of which is measured with a particle analyzer (Malvern Mastersizer ), is 4.5 gm. The concentration of microbaloons (measured with a Coulter counter) was about 2 · 10<sup>9</sup>/ Ml. The resulting suspension gave a strong echographic signal that lasted for about 1 hour.
If in this example no additives included in the polymer membrane are introduced, i.e. only 200 mg of lactide / glycolide copolymer in THF / octane solution is used, then a drastic reduction in wall permeability is observed, but after three days no significant level of signal attenuation is observed echography derived from dispersion in a liquid carrier.
By using intermediate amounts of added additives, a controlled intermediate porosity and dispersion life are obtained.
166 827
Example IV In this example, a polymer of the formula of claim 8 is used wherein the side group has the formula - / CH2 /<sub>n</sub>COOR<sup>L</sup>R<sup>2</sup>-O-COR in which R<sup>1</sup> and R<sup>2 </sup>are hydrogen and R is a tertiary butyl radical. The preparation of this polymer (referred to as poly / POMEG) is described in US Pat. Ser. No. 4,888,398.
The procedure is similar to that described in Example III using 0.1 g poly-POMEG, 70 ml THF, 1 ml cyclooctane and 100 ml 0.1% aqueous solution of the preparation under the trade name Pluronic F-108. No lecithin or high molecular weight hydrocarbons are added. The milky emulsion is evaporated at 27 ° C under 9.8 pressure<sup>4</sup> Pa until about 100 ml of solution remain, which is then passed through a 50 gm sieve and frozen. Evaporation of the frozen block is carried out (0.49-1.96-104 P<sub>and</sub>) until dry. Due to the presence of surfactants, the obtained yield is 0.18 g. The obtained substance was dispersed in 10 ml of distilled water, after which the particle size distribution was evaluated using a Coulter counter. As a result of the measurement, the concentration was found to be 1.43x10<sup>9 </sup>microcapsules / ml, the average size measured with particle analyzer (Mastersizer from Malvern) is 5.21 gm. The dispersion was diluted 100-fold to obtain a concentration of 1.5x10<sup>7 </sup>microspheres / ml and the ability to reflect sound waves was measured. The amplitude of the reflected signal was 5 times higher at 7.5 MHz than at 2.25 MHz. These signals were reproducible for a long time.
The echogenicity measurements were carried out using an echo pulse system consisting of a Plexiglas sample holder (300 nm diameter) equipped with an 29 gm thick mylar acoustic window, a transducer mounted in the handle and immersed in a constant temperature water bath, Accutron M3010JS pulse receiver (equipped with a preamplifier with a constant gain of 40 dB and an external amplifier with adjustable gain from -40 to +40 dB and interchangeable 13 mm unfocused transducers. To improve the signal-to-interference ratio, a narrow band 10 MHz filter was placed in the receiving part of the system. The A / D A / D converter board in the IBM PC was of the Sonotek STR 832 type. The measurements were carried out at the frequencies 2,25,3,5 and 7.5 MHz.
If the polymer used in this example is replaced with lactide-lactone copolymers, one of the lactones may be γ-butyrolactone, δ-valerolactone or ε-caprolactone (see Fukuzaki et al., J. Biomedical Mater. Res. 25/1991 / 315-328), then similar results are obtained. Satisfactory results, also in a similar sense, were obtained using polyalkyl cyanoacrylates, in particular a mixed copolymer type 90:10 poly / DL-lactide glycolide, however the preferred polymer is poly / DL lactide / The Company Boehringer Ingelheim sold under the trade name Resomer R-206 or Resomer R-207.
Example V. After injection into the peripheral vein of a test dog, 0.1-2 ml of the dispersion prepared according to example IV (1.43x10<sup>9</sup>/ ml) two-dimensional echoradiography was performed using the Acuson-128 apparatus. After obtaining the expected enhanced contrast of the image of the right ventricle, an intense and persistent amplified signal of the left ventricle with a clear outline of endocardium could be observed. This confirms that microbaloons made with the use of poly-POMEG (or at least a significant part of them) were able to get into the pulmonary pulmonary circulation and remain in the bloodstream for a period of time sufficient to carry out effective echographic analysis.
In other series of experiments, non-disappearing, amplified Doppler signal from systemic arteries and portal vein was obtained. These experiments were carried out on a rabbit and a rat, which was injected with 0.5-2 ml of a preparation containing microballoons prepared according to example IV, but poly / dL lactic acid was used as the polymer phase. This composition contained 1, 9x10<sup>8</sup> bubbles.
Another composition was prepared, also according to the directions given in Example 4, using IIIrz poly / glutamate this time. -butyl as a polymer phase. This composition (0.5 ml) diluted to a concentration of 3.4x10<sup>8</sup> microballoons / ml were injected into the portal vein of the rat which allowed for permanent enhanced contrast of the liver parenchyma.
166 827
Example VI. A suspension of microballoons (1.1x10<sup>9</sup> bubbles / ml) according to the instructions in Example 1 (resin = polystyrene). One ml of this suspension was diluted with 100 ml of a 300 nM mannitol solution. Then 7 ml of this solution was introduced into the stomach of a laboratory rat. The animal was examined using an Acuson-128 device designed to obtain two-dimensional echographic images of the gastrointestinal tract. Single small intestine and colon loops were clearly observed.
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Numbers
- Application
- 29027191
Titles
- English
- AIR OR GAS FILLED MICROBALLONS FOR PREPARATION OF SUSPENSIONS IN LIQUID MEDIAFOR ULTRASONIC ECHOGRAPHY AND METHOD OF OBTAINING THEM
Classification
- CPC, 3
- A61K49/223
- A61K49/00
- A61B8/00
- IPC, 13
- A61B
- A61K
- A61B8 00
- A61K9 107
- A61K9 127
- A61K9 16
- A61K9 50
- A61K47 30
- A61K49 00
- A61K49 22
- B01J13 02
- B01J13 04
- B01J13 06