1. A method of achieving wound hemostasis and closure for soft body tissue, comprising the steps of:
applying a bolt, wherein the bolt comprises a single axially elongate shaft having a distal, pointed end and a proximal end, through tissue surrounding a wound, wherein the distal end and the proximal end of the bolt are exposed outside the tissue;
applying a first pressure plates to the distal, pointed end of said shaft, wherein the distal, pointed end extends beyond the first pressure plate;
applying a second pressure plate to the proximal end of said shaft, wherein the second end extends beyond the second pressure plate;
applying a first lock to the distal, pointed end of the shaft;
applying a second lock to the proximal end of the shaft, wherein said second lock comprises an adjustment mechanism; and
adjusting the position of the second pressure plate and lock with the adjustment mechanism on the proximal end of the bolt to maintain said first and second pressure plates in compression against said tissue as constrained by said bolt to achieve wound closure and hemostasis.
2. The method of claim 1 further comprising the step of removing or retracting the distal, pointed end of the bolt.
3. The method of claim 1 wherein the placement of said bolt is accomplished through an axially elongate hollow introduction device.
4. The method of claim 3 further comprising the step of directly visualizing the placement of the bolt.
5. The method of claim 1 wherein removal of said bolt is accomplished through an axially elongate hollow introduction device.
6. The method of claim 1 further comprising the step of removing the bolt at from the tissue.
7. The method of claim 1 further comprising the step of implanting the bolt in body tissue for a long period of time.
8. The method of claim 1 further comprising the step of allowing the bolt to resorb.
9. The method of claim 1 further comprising the step of bending the bolt into an arcuate shape prior to applying the bolt through the tissue.
10. The method of claim 1 further comprising the step of visualizing the bolt using fluoroscopy or X-rays.
11. A method of manufacturing a medical device for approximating wounded soft body tissue comprising:
providing a malleable bolt comprising a single, axially elongate shaft and having first and second ends, wherein the first end of the bolt comprises a tapered point;
providing first and second pressure plates adapted to slide over each of the first and second ends of the bolt;
providing first and second locking mechanisms adapted to longitudinally fix the first and second pressure plates, respectively, along the length of the bolt;
forcing the first end of the bolt through body tissue until the first and second ends of the bolt extend from the tissue;
affixing the first pressure plate on the first end of the bolt;
placing the second pressure plate on the second end of the bolt;
affixing the first locking mechanism on the first end of the bolt, to maintain the position of the first pressure plate;
placing the second locking mechanism on the second end of the bolt;
forcing the first and second pressure plates into contact with the body tissue; and
adjusting the position of the second pressure plate and second lock, relative to the second end of the axially elongate shaft, to achieve a desired amount of tissue compression.
12. The method of claim 11 further comprising the steps of bending the malleable bolt, and forcing the bolt through body tissue so that both ends of the bolt protrude from an accessible surface of the body tissue.
13. The method of claim 11 further comprising the step of removing the bolt.
14. The method of claim 11 wherein the first lock and the first pressure plate are integral to each other and the second lock and the second pressure plate are integral to each other.
15. The method of claim 11 further comprising the step of advancing the tapered point to pierce the tissue as the bolt is being forced through the body tissue and retracting the tapered point once the forcing step is completed.
16. the method of claim 11 further comprising the steps of applying a plurality of bolts to the body tissue.
17. the method of claim 11 comprising the step of forcing the bolt through solid organ tissue.
18. The method of claim 11 comprising the step of forcing the bolt through muscle tissue.
19. A method of achieving wound closure for soft body tissue, comprising the steps of:
applying a bolt, comprising a single, axially elongate shaft with a first, sharpened end and a second, blunt end, through a region of tissue surrounding a wound so that the first, sharpened end and the second, blunt end of the bolt are exposed outside the tissue;
applying a pressure plate and a lock at each end of the shaft;
adjusting the position of the pressure plate on the second blunt end of the bolt, relative to the axially elongate shaft, to achieve a desired amount of wound closure; and
activating the locks to keep said pressure plates in compression against said tissue as constrained by said bolt to achieve wound closure.
20. The method of claim 11 wherein the adjustment step comprises actuating a ratchet mechanism.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. A copolycarbonate of the formula
wherein
5 to 50 mole percent of the total number of R1 groups is derived from a monomer of formula (2)
wherein each Rf is independently at each occurrence a halogen atom, a hydrocarbon group having 1 to 10 carbons, or a halogen substituted hydrocarbon group having 1 to 10 carbons, and n is 0 to 4; and
50 to 95 mole percent of the R1 groups are derived from a dihydroxy compound of formula (7)
wherein Ra and Rb are each independently a halogen atom or a monovalent C1-6 alkyl group; p and q are each independently integers of 0 to 4; and Xa is one of the following groups:
wherein Rc and Rd are each independently a hydrogen atom or a C1-29 alkyl group, or Rc, C, and Rd taken together are a divalent C3-10 cycloalkyl group that is optionally substituted with one or more C1-10 alkyl groups, and Re is a divalent hydrocarbon group; or R1 can be derived from arylene-containing compounds selected from 4,4\u2032-dihydroxybiphenyl, 1,6-dihydroxynaphthalene, and 2,6-dihydroxynaphthalene, and the dihydroxy compound of formula (7) is not a compound of formula (2), and wherein
the copolycarbonate comprises at least 10% fewer carbonate linkages of formula (4)
than would be theoretically obtained in a random copolymer made from the same ratio of the monomer of formula (2) and the dihydroxy compound of formula (7) or the arylene-containing compounds.
2. The copolycarbonate of claim 1, wherein n is zero.
3. The copolycarbonate of claim 1, wherein the monomer of formula (2) is hydroquinone.
4. The copolycarbonate of claim 1, wherein the dihydroxy compound is of the formula (7)
wherein Ra and R b are each independently a halogen atom or a monovalent C1-6 alkyl group; p and q are each independently integers of 0 to 4; and Xa is one of the following groups:
wherein Rc and Rd are each independently a hydrogen atom or a C1-29 alkyl group, or Rc , C, and Rd taken together are a divalent C3-10 cycloalkyl group that is optionally substituted with one or more C1-10 alkyl groups, and Re is a divalent hydrocarbon group.
5. The copolycarbonate of claim 4, wherein each p and q are each zero and Xa is 2,2-propylene.
6. The copolycarbonate of claim 5, wherein n is zero.
7. The copolycarbonate of claim 5, wherein the monomer of formula (2) is hydroquinone.
8. The copolycarbonate of claim 1, wherein 10 to 40 mole % of the R1 groups in the copolycarbonate are derived from a monomer of formula (2), and 60 to 90 mole % of the R1 units are derived from another dihydroxy compound of formula (7) or the arylene-containing compounds.
9. The copolycarbonate of claim 1, comprising 15 to 98% fewer carbonate linkages of formula (4) than would theoretically be obtained in a random copolymer made from the same ratio of the monomer of formula (2) and the dihydroxy compound of formula (7) or the arylene-containing compounds.
10. A method of preparing a copolycarbonate comprising 5 to 50 mole percent of units derived from a monomer of formula (2)
wherein each Rf is independently at each occurrence a halogen atom, a hydrocarbon group having 1 to 10 carbons, or a halogen substituted hydrocarbon group having 1 to 10 carbons, and n is 0 to 4, the method comprising
forming a bischloroformate from a dihydroxy compound of formula (3)
HO\u2014R5\u2014OH\u2003\u2003(3)
wherein at least 60% of the R5 groups are aromatic, the dihydroxy compound of formula (3) is not a compound of formula (2), and the average number of units in the bischloroformate is 1 to 2, wherein the forming is performed by contacting the dihydroxy compound(s) in a substantially inert, substantially water-immiscible solvent with an aqueous alkali or alkaline earth metal solution and phosgene; and
reacting the monomer of formula (2) with the bischloroformate to produce a condensate, in a reaction system comprising water, a substantially inert, substantially water-insoluble organic liquid, base, and a phase transfer agent to form the copolycarbonate.
11. The method of claim 10, further comprising contacting the condensate with an organic base to hydrolyze and condense residual bischloroformates in the condensate.
12. The method of claim 10, wherein n is zero.
13. The method of claim 10, wherein the monomer of formula (2) is hydroquinone.
14. The method of claim 10 wherein the reaction system has a pH of 7 to 10.
15. A copolycarbonate prepared by the method of claim 10.
16. An article comprising the copolycarbonate of claim 1.
17. An article comprising the copolycarbonate manufactured by the method of claim 10.
18. A method of preparing a copolycarbonate comprising 5 to 50 mole percent of units derived from a monomer of formula (2)
wherein each Rf is independently at each occurrence a halogen atom, a hydrocarbon group having 1 to 10 carbons, or a halogen substituted hydrocarbon group having 1 to 10 carbons, and n is 0 to 4, the method comprising
forming a bischloroformate from a dihydroxy compound of formula (7)
wherein Ra and Rb are each independently a halogen atom or a monovalent C1-6 alkyl group; p and q are each independently integers of 0 to 4; and Xa is one of the following groups:
wherein Rc and Rd are each independently a hydrogen atom or a C1-29 alkyl group, or Rc, C, and Rd taken together are a divalent C3-10 cycloalkyl group that is optionally substituted with one or more C1-10 alkyl groups, and Re is a divalent hydrocarbon group; or R1 can be derived from arylene-containing compounds selected from 4,4\u2032-dihydroxybiphenyl, 1,6-dihydroxynaphthalene, and 2,6-dihydroxynaphthalene;
wherein the dihydroxy compound of formula (7) is not a compound of formula (2), and the average number of units in the bischloroformate is less than 19; and
reacting the monomer of formula (2) with the bischloroformate, in a reaction system comprising water, a substantially inert, substantially water-insoluble organic liquid, base, and a phase transfer agent to form the copolycarbonate.
19. The method of claim 18, wherein the average number of units in the bischloroformate is 1 to 3.
20. The method of claim 18, wherein the average number of units in the bischloroformate is 1 to 2.