Search results for: Surgical thread.

Authors: P. Paengkoum, T. Phonmun, S. Paengkoum

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Twenty four male Thai native × Anglo-Nubian crossbred goats were randomly allocated to receive four treatments. The experiment was conducted for four months and slaughtered that the Longissimus dorsi muscle was collected for fatty acid analysis. The results conclude that either castrated method or ages had no significantly different on monounsaturated fatty acid (MUFA) (P>0.05) except erucic acid (C22:1n9). Interaction between castrated method and ages had significantly different in MUFA (P<0.01). Although the effect of castration method and age are not difference on fatty acid composition, it contributed to known that difference castration method and age (surgical and budizzo) no effect on accumulation fatty acid in meat goats.

Keywords: Castration, goat, CLA, meat.

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Authors: Xiang Zhang, Daohong Yang, Ziyuan Wu, Lei Li, Wanting Zhou

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Visual Simultaneous Localization and Mapping (VSLAM) uses cameras to gather information in unknown environments to achieve simultaneous localization and mapping of the environment. This technology has a wide range of applications in autonomous driving, virtual reality, and other related fields. Currently, the research advancements related to VSLAM can maintain high accuracy in static environments. But in dynamic environments, the presence of moving objects in the scene can reduce the stability of the VSLAM system, leading to inaccurate localization and mapping, or even system failure. In this paper, a robust VSLAM method was proposed to effectively address the challenges in dynamic environments. We proposed a dynamic region removal scheme based on a semantic segmentation neural network and geometric constraints. Firstly, a semantic segmentation neural network is used to extract the prior active motion region, prior static region, and prior passive motion region in the environment. Then, the lightweight frame tracking module initializes the transform pose between the previous frame and the current frame on the prior static region. A motion consistency detection module based on multi-view geometry and scene flow is used to divide the environment into static regions and dynamic regions. Thus, the dynamic object region was successfully eliminated. Finally, only the static region is used for tracking thread. Our research is based on the ORBSLAM3 system, which is one of the most effective VSLAM systems available. We evaluated our method on the TUM RGB-D benchmark and the results demonstrate that the proposed VSLAM method improves the accuracy of the original ORBSLAM3 by 70%˜98.5% under a high dynamic environment.

Keywords: Dynamic scene, dynamic visual SLAM, semantic segmentation, scene flow, VSLAM.

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Authors: Qiuyu Dai, Haochong Zhang, Xiangrong Liu

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Efficient matrix-vector multiplication with diagonal sparse matrices is pivotal in a multitude of computational domains, ranging from scientific simulations to machine learning workloads. When encoded in the conventional Diagonal (DIA) format, these matrices often induce computational overheads due to extensive zero-padding and non-linear memory accesses, which can hamper the computational throughput, and elevate the usage of precious compute and memory resources beyond necessity. The ’DIA-Adaptive’ approach, a methodological enhancement introduced in this paper, confronts these challenges head-on by leveraging the advanced parallel instruction sets embedded within Machine Learning Units (MLUs). This research presents a thorough analysis of the DIA-Adaptive scheme’s efficacy in optimizing Sparse Matrix-Vector Multiplication (SpMV) operations. The scope of the evaluation extends to a variety of hardware architectures, examining the repercussions of distinct thread allocation strategies and cluster configurations across multiple storage formats. A dedicated computational kernel, intrinsic to the DIA-Adaptive approach, has been meticulously developed to synchronize with the nuanced performance characteristics of MLUs. Empirical results, derived from rigorous experimentation, reveal that the DIA-Adaptive methodology not only diminishes the performance bottlenecks associated with the DIA format but also exhibits pronounced enhancements in execution speed and resource utilization. The analysis delineates a marked improvement in parallelism, showcasing the DIA-Adaptive scheme’s ability to adeptly manage the interplay between storage formats, hardware capabilities, and algorithmic design. The findings suggest that this approach could set a precedent for accelerating SpMV tasks, thereby contributing significantly to the broader domain of high-performance computing and data-intensive applications.

Keywords: Adaptive method, DIA, diagonal sparse matrices, MLU, sparse matrix-vector multiplication.

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Authors: A. Mathieu, B. Aubry, E. Chhim, M. Jobe, M. Arnaud

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Present project consists in a study and a development of piezoelectric devices for supplying power to new generation pacemakers. They are miniaturized leadless implants without battery placed directly in right ventricle. Amongst different acceptable energy sources in cardiac environment, we choose the solution of a device based on conversion of the energy produced by pressure variation inside the heart into electrical energy. The proposed energy harvesters can meet the power requirements of pacemakers, and can be a good solution to solve the problem of regular surgical operation. With further development, proposed device should provide enough energy to allow pacemakers autonomy, and could be good candidate for next pacemaker generation.

Keywords: Energy harvester, heart, leadless pacemaker, piezoelectric cells, pressure variation.

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Authors: Fatahian Dehkordi R.F, Parchami A.

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Steroidal hormones with the efficient changes on the epiphyseal growth plate may influence tissue structure properties. Presents paper to investigate the effects of gonadectomy in the pattern distribution of the epiphyseal structure. Fifteen adult female New Zealand white rabbits were separated into three groups. One group was intact and others groups were selected for surgical operation. From these two groups, one group carried out steroidal administration. The results obtained showed that there is no statistically difference in the mean diameter of the growth plate cells between all three groups. The maximum value of the cartilage cells were allocated to the gonadectomized group and the minimum number were observed in Hormonal induced group significantly. Growth plate height was significantly greater in gonadectomized group than in two other groups.

Keywords: Steroidal hormones, Ovariectomy, Rabbit, Epiphyseal structure

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Authors: Fernando Pérez, Humberto Sossa, Rigoberto Martínez, Daniel Lorias, Arturo Minor

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This paper presents a system for tracking the movement of laparoscopic instruments which is based on an orthogonal system of webcams and video image processing. The movements are captured with two webcams placed orthogonally inside of the physical trainer. On the image, the instruments were detected by using color markers placed on the distal tip of each instrument. The 3D position of the tip of the instrument within the work space was obtained by linear triangulation method. Preliminary results showed linearity and repeatability in the motion tracking with a resolution of 0.616 mm in each axis; the accuracy of the system showed a 3D instrument positioning error of 1.009 ± 0.101 mm. This tool is a portable and low-cost alternative to traditional tracking devices and a trustable method for the objective evaluation of the surgeon’s surgical skills.

Keywords: Laparoscopic Surgery, Orthogonal Vision, Tracking Instruments, Triangulation.

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Authors: Dara Singh, Keikhosrow Firouzbakhsh, Mohammad Taghi Ahmadian

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In this paper, conventional laser Keratoplasty surgeries in the human eye are studied. For this purpose, a validated 3D finite volume model of the human eye is introduced. In this model the fluid flow has also been considered. The discretized domain of the human eye incorporates a bio-heat transfer equation coupled with a Boussinesq equation. Both continuous and pulsed lasers have been modeled and the results are compared. Moreover, two different conventional surgical positions that are upright and recumbent are compared for these laser therapies. The simulation results show that in these conventional surgeries, the temperature rises above the critical values at the laser insertion areas. However, due to the short duration and the localized nature, the potential damages are restricted to very small regions and can be ignored. The conclusion is that the present day lasers are acceptably safe to the human eye.

Keywords: Eye, heat-transfer, keratoplasty laser, surgery.

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Authors: Abdulrahim Shamayleh, John Fowler, Muhong Zhang

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Operating rooms are important assets for hospitals as they generate the largest revenue and, at the same time, produce the largest cost for hospitals. The model presented in this paper helps make capacity planning decisions on the combination of open operating rooms (ORs) and estimated overtime to satisfy the allocated OR time to each specialty. The model combines both decisions on determining the amount of OR time to open and to allocate to different surgical specialties. The decisions made are based on OR costs, overutilization and underutilization costs, and contribution margins from allocating OR time. The results show the importance of having a good estimate of specialty usage of OR time to determine the amount of needed capacity and highlighted the tradeoff that the OR manager faces between opening more ORs versus extending the working time of the ORs already in use.

Keywords: capacity planning, contribution margins, operating room, overutilization

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Authors: Katarzyna Mleczko

Abstract:

Processes of production of innovative medical tools have interdisciplinary character. They consist of direct and indirect close cooperation of specialists of different scientific branches. The Knowledge they have seems to be important for undertaken design, construction and manufacturing processes. The Knowledge exchange between participants of these processes is therefore crucial for the final result, which are innovative medical products. The paper draws attention to the necessity of feedback from the end user to the designer / manufacturer of medical tools which will allow for more accurate understanding of user needs. The study describes prerequisites of production processes of innovative medical (surgical) tools including participants and category of knowledge resources occurring in these processes. They are the result of research in selected Polish organizations involved in the production of medical instruments and are the basis for further work on the development of knowledge sharing model in interdisciplinary teams geographically dispersed.

Keywords: Interdisciplinary production processes, knowledge exchange, knowledge sharing, medical tools, user-centered design.

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Authors: Elina Ligere, Valts Ozolins, Lauris Smits, Normunds Sikora, Ivars Melderis, Laila Feldmane, Aris Lacis, Vladimir Kasyanov

Abstract:

Biomechanical properties of infantile aorta in vitro in cases of different standard anastomoses: end-to-end (ETE), extended anastomosis end-to-end (EETE) and subclavian flap aortoplasty (SFA) used for surgical correction of coarctation were analyzed to detect the influence of the method on the biomechanics of infantile aorta and possible changes in haemodinamics. 10 specimens of native aorta, 3 specimens with ETE, 4 EEET and 3 SFA were investigated. The experiments showed a non-linear relationship between stress and strain in the infantile aorta, the modulus of elasticity of the aortic wall increased with the increase of inner pressure. In the case of anastomosis end-to-end the modulus was almost constant, relevant to the modulus of elasticity of the aorta with the inner pressure 100-120 mmHg. The anastomoses EETE and SFA showed elastic properties closer to native aorta, the stiffness of ETE did not change with the changes in inner pressure.

Keywords: biomechanics, coarctation, mechanical properties, neonatal aorta

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Authors: Neila Mezghani, Philippe Phan, Hubert Labelle, Carl Eric Aubin, Jacques de Guise

Abstract:

The identification and classification of the spine deformity play an important role when considering surgical planning for adolescent patients with idiopathic scoliosis. The subject of this article is the Lenke classification of scoliotic spines using Cobb angle measurements. The purpose is two-fold: (1) design a rulebased diagram to assist clinicians in the classification process and (2) investigate a computer classifier which improves the classification time and accuracy. The rule-based diagram efficiency was evaluated in a series of scoliotic classifications by 10 clinicians. The computer classifier was tested on a radiographic measurement database of 603 patients. Classification accuracy was 93% using the rule-based diagram and 99% for the computer classifier. Both the computer classifier and the rule based diagram can efficiently assist clinicians in their Lenke classification of spine scoliosis.

Keywords: Scoliosis, Lenke model, decision-rules, computer aided classifier.

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Authors: M. Mottaghi, F. Ghalichi, H. Badri Ghavifekr, H. Niroomand Oskui

Abstract:

This paper presents design and characterization of a microaccelerometer designated for integration into cataract surgical probe to detect hardness of different eye tissues during cataract surgery. Soft posterior lens capsule of eye can be easily damaged in comparison with hard opaque lens since the surgeon can not see directly behind cutting needle during the surgery. Presence of microsensor helps the surgeon to avoid rupturing posterior lens capsule which if occurs leads to severe complications such as glaucoma, infection, or even blindness. The microsensor having overall dimensions of 480 μm x 395 μm is able to deliver significant capacitance variations during encountered vibration situations which makes it capable to distinguish between different types of tissue. Integration of electronic components on chip ensures high level of reliability and noise immunity while minimizes space and power requirements. Physical characteristics and results on performance testing, proves integration of microsensor as an effective tool to aid the surgeon during this procedure.

Keywords: Cataract surgery, MEMS, Microsensor, Phacoemulsification.

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Authors: Ramya Rathan, Miral N. F. Salama

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The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: Brachial artery, high termination, radial artery, ulnar artery.

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Authors: Siamak Najarian, Meysam Esmaeili, Mohsen Towliat Kashani

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In this article, we propose a new surgical device for circumferentially excision of high anal fistulas in a minimally invasive manner. The new apparatus works on the basis of axially rotating and moving a tubular blade along a fistulous tract straightened using a rigid straight guidewire. As the blade moves along the tract, its sharp circular cutting edge circumferentially separates approximately 2.25 mm thickness of tract encircling the rigid guidewire. We used the new set to excise two anal fistulas in a 62-year-old male patient, an extrasphincteric type and a long tract with no internal opening. With regard to the results of this test, the new device can be considered as a sphincter preserving mechanism for treatment of high anal fistulas. Consequently, a major reduction in the risk of fecal incontinence, recurrence rate, convalescence period and patient morbidity may be achieved using the new device for treatment of fistula-in-ano.

Keywords: Fecal Incontinence, Fistulectomy, High Anal Fistula, Minimally Invasive.

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Authors: M. Sadeghi, A.H. Jafari, S.M.P. Firoozabadi

Abstract:

Deep Brain Stimulation or DBS is a surgical treatment for Parkinson-s Disease with three stimulation parameters: frequency, pulse width, and voltage. The parameters should be selected appropriately to achieve effective treatment. This selection now, performs clinically. The aim of this research is to study chaotic behavior of recorded tremor of patients under DBS in order to present a computational method to recognize stimulation optimum voltage. We obtained some chaotic features of tremor signal, and discovered embedding space of it has an attractor, and its largest Lyapunov exponent is positive, which show tremor signal has chaotic behavior, also we found out, in optimal voltage, entropy and embedding space variance of tremor signal have minimum values in comparison with other voltages. These differences can help neurologists recognize optimal voltage numerically, which leads to reduce patients' role and discomfort in optimizing stimulation parameters and to do treatment with high accuracy.

Keywords: Chaos, Deep Brain Stimulation, Parkinson's Disease, Stimulation Parameters, tremor.

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Authors: Kasra Afsahi, Maryam Soheilifar, Noureddin Nakhostin Ansari

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COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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Authors: P. Sanzo

Abstract:

Ten percent of the population will develop plantar fasciitis (PF) during their lifetime. Two million people are treated yearly accounting for 11-15% of visits to medical professionals. Treatment ranges from conservative to surgical intervention. The purpose of this study was to assess the effects of extracorporeal shockwave therapy (ECSWT) on heel pain, function, range of motion (ROM), and strength in patients with PF. One hundred subjects were treated with ECSWT and measures were taken before and three months after treatment. There was significant differences in visual analog scale scores for pain at rest (p=0.0001); after activity (p= 0.0001) and; overall improvement (p=0.0001). There was also significant improvement in Lower Extremity Functional Scale scores (p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001), and eversion (p=0.017),and first metatarsophalangeal joint flexion (p=0.002) and extension (p=0.003) ROM. ECSWT is an effective treatment improving heel pain, function and ROM in patients with PF.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, plantar fasciitis, heel pain, function, range of motion, strength.

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Authors: Chang Soo Chon, Cheol Woong Ko, Han Sung Kim

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The aim of this study is to develop an anterior lumbar interbody fusion (ALIF) PEEK cage suitable for Korean people. In this study, CT images were obtained from Korean male (173cm, 71kg) and 3D Korean lumbar models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of anterior lumbar interbody fusion (ALIF) PEEK Cage were selected using the morphological measurement information of the Korean Lumbar models. Through finite element analysis and mechanical tests, the developed ALIFPEEK Cage prototype was compared with the Fidji Cage (Zimmer. Inc, USA) and it was found that the ALIF prototype showed similar and/or superior mechanical performance compared to the FidJi Cage. Also, clinical validation for the ALIF PEEK Cage prototype was carried out to check predictable troubles in surgical operations. Finally, it is considered that the convenience and stability of the prototype was clinically verified.

Keywords: Interbody fusion, PEEK, implant, finite element analysis, lumbar, spine.

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Authors: M R Asadi, G Torkaman, M Hedayati

Abstract:

We evaluated the effect of sensory (direct current (DC), 600μA) and motor (monophasic current, pulse duration 300μs, 100 Hz, 2.5-3mA) intensities of cathodal electrical stimulation (ES) current to release VEGF and biomechanical properties of wound. 54 male Sprague-dawley rats were randomly assigned into one control and two experimental groups. A full thickness skin incision was made on animals- dorsal region. The experimental groups received ES for 1h/day and every other day. VEGF expression was measured in skin on the 7th day after surgical incision and tensile strength was measured on 21st day. On the 7th day, the values of skin VEGF in the sensory group were significantly greater than those of the other groups (p < 0.05). Sensory and Motor intensity stimulation, can not improve the biomechanical properties of the repaired wounds. It seems the mechanical environment induced by sensory and motor intensity of electrical stimulation, could not simulate the role of normal daily stress and strain to maturation of collagen fibers and their cross links. Further work is needed to determine the relationship between VEGF expression after ES and its effect on tensile strength of healed wound.

Keywords: Biomechanical properties Direct current, Monophasic current, Skin, VEGF

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Authors: Beibei Han, Yong-Jin Yoon, Muhammad Hamidullah, Angel Tsu-Hui Lin, Woo-Tae Park

Abstract:

This paper presents the design of a ring-shaped tri-axial fore sensor that can be incorporated into the tip of a guidewire for use in minimally invasive surgery (MIS). The designed sensor comprises a ring-shaped structure located at the center of four cantilever beams. The ringdesign allows surgical tools to be easily passed through which largely simplified the integration process. Silicon nanowires (SiNWs) are used aspiezoresistive sensing elementsembeddedon the four cantilevers of the sensor to detect the resistance change caused by the applied load.An integration scheme with new designed guidewire tip structure having two coils at the distal end is presented. Finite element modeling has been employed in the sensor design to find the maximum stress location in order to put the SiNWs at the high stress regions to obtain maximum output. A maximum applicable force of 5 mN is found from modeling. The interaction mechanism between the designed sensor and a steel wire has been modeled by FEM. A linear relationship between the applied load on the steel wire and the induced stress on the SiNWs were observed.

Keywords: Triaxial MEMS force sensor, Ring shape, Silicon Nanowire, Minimally invasive surgery.

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Authors: Taqi Zahid Butt, Tanveer Ahmad Tabish

Abstract:

Martensitic stainless steels have been extensively used for their good corrosion resistance and better mechanical properties. Heat treatment was suggested as one of the most excellent ways to this regard; hence, it affects the microstructure, mechanical and corrosion properties of the steel. In the current research work the microstructural changes and corrosion behavior in an AISI 420A stainless steel exposed to temperatures in the 980-1035oC range were investigated. The heat treatment is carried out in vacuum furnace within the said temperature range. The quenching of the samples was carried out in oil, brine and water media. The formation and stability of passive film was studied by Open Circuit Potential, Potentiodynamic polarization and Electrochemical Scratch Tests. The Electrochemical Impedance Spectroscopy results simulated with Equivalent Electrical Circuit suggested bilayer structure of outer porous and inner barrier oxide films. The quantitative data showed thick inner barrier oxide film retarded electrochemical reactions. Micrographs of the quenched samples showed sigma and chromium carbide phases which prove the corrosion resistance of steel alloy.

Keywords: Martensitic stainless steel corrosion, microstructure, vacuum furnace.

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Authors: Shaila Ahmed, Raghu Prasad Rao Metpally, Sreedhara Sangadala, Boojala Vijay B Reddy

Abstract:

Bone growth factors, such as Bone Morphogenic Protein-2 (BMP-2) have been approved by the FDA to replace grafting for some surgical interventions, but the high dose requirement limits its use in patients. Noggin, an extracellular protein, blocks the effect of BMP-2 by binding to BMP. Preventing the BMP-2/noggin interaction will help increase the free concentration of BMP-2 and therefore should enhance its efficacy to induce bone formation. The work presented here involves computational design of novel small molecule inhibitory agents of BMP-2/noggin interaction, based on our current understanding of BMP-2, and its known putative ligands (receptors and antagonists). A successful acquisition of such an inhibitory agent of BMP-2/noggin interaction would allow clinicians to reduce the dose required of BMP-2 protein in clinical applications to promote osteogenesis. The available crystal structures of the BMPs, its receptors, and the binding partner noggin were analyzed to identify the critical residues involved in their interaction. In presenting this study, LUDI de novo design method was utilized to perform virtual screening of a large number of compounds from a commercially available library against the binding sites of noggin to identify the lead chemical compounds that could potentially block BMP-noggin interaction with a high specificity.

Keywords: Transforming growth factor-beta, Bone morphogenic proteins, Noggin, LUDI de novo design method, CAP small molecules.

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Authors: K. Chethana, A. S. Guru Prasad, S. N. Omkar, B. Vadiraj, S. Asokan

Abstract:

This paper describes an ab-initio design, development and calibration results of an Optical Sensor Ground Reaction Force Measurement Platform (OSGRFP) for gait and geriatric studies. The developed system employs an array of FBG sensors to measure the respective ground reaction forces from all three axes (X, Y and Z), which are perpendicular to each other. The novelty of this work is two folded. One is in its uniqueness to resolve the tri axial resultant forces during the stance in to the respective pure axis loads and the other is the applicability of inherently advantageous FBG sensors which are most suitable for biomechanical instrumentation. To validate the response of the FBG sensors installed in OSGRFP and to measure the cross sensitivity of the force applied in other directions, load sensors with indicators are used. Further in this work, relevant mathematical formulations are presented for extracting respective ground reaction forces from wavelength shifts/strain of FBG sensors on the OSGRFP. The result of this device has implications in understanding the foot function, identifying issues in gait cycle and measuring discrepancies between left and right foot. The device also provides a method to quantify and compare relative postural stability of different subjects under test, which has implications in post-surgical rehabilitation, geriatrics and optimizing training protocols for sports personnel.

Keywords: Balance, stability, Gait analysis, FBG applications, optical sensor ground reaction force platform.

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Authors: K. T. Huynh, I. Gibson, W. F. Lu, B. N. Jagdish

Abstract:

In this paper, the construction of a detailed spine model is presented using the LifeMOD Biomechanics Modeler. The detailed spine model is obtained by refining spine segments in cervical, thoracic and lumbar regions into individual vertebra segments, using bushing elements representing the intervertebral discs, and building various ligamentous soft tissues between vertebrae. In the sagittal plane of the spine, constant force will be applied from the posterior to anterior during simulation to determine dynamic characteristics of the spine. The force magnitude is gradually increased in subsequent simulations. Based on these recorded dynamic properties, graphs of displacement-force relationships will be established in terms of polynomial functions by using the least-squares method and imported into a haptic integrated graphic environment. A thoracolumbar spine model with complex geometry of vertebrae, which is digitized from a resin spine prototype, will be utilized in this environment. By using the haptic technique, surgeons can touch as well as apply forces to the spine model through haptic devices to observe the locomotion of the spine which is computed from the displacement-force relationship graphs. This current study provides a preliminary picture of our ongoing work towards building and simulating bio-fidelity scoliotic spine models in a haptic integrated graphic environment whose dynamic properties are obtained from LifeMOD. These models can be helpful for surgeons to examine kinematic behaviors of scoliotic spines and to propose possible surgical plans before spine correction operations.

Keywords: Haptic interface, LifeMOD, spine modeling.

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

Abstract:

Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of living tissues to mechanical loads is necessary for a wide range of developing fields such as prosthetics design or computerassisted surgical interventions. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically, growth is one of the main sources. Extracting body organ’s shapes from medical imaging does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is gravity since an organ grows under its influence from birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. This paper presents an original computational framework based on gradual growth to determine the residual stresses due to growth. To illustrate the method, we apply it to a finite element model of a healthy human face reconstructed from medical images. The distribution of residual stress in facial tissues is computed, which can overcome the effect of gravity and maintain tissues firmness. Our assumption is that tissue wrinkles caused by aging could be a consequence of decreasing residual stress and thus not counteracting gravity. Taking into account these stresses seems therefore extremely important in maxillofacial surgery. It would indeed help surgeons to estimate tissues changes after surgery.

Keywords: Finite element method, growth, residual stress, soft tissue.

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Authors: S. Jaramillo, Y. Montoya, W. Agudelo, J. Bustamante

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Cardiovascular diseases (CVD) are related to affectations of the heart and blood vessels, within these are pathologies such as coronary or peripheral heart disease, caused by the narrowing of the vessel wall (atherosclerosis), which is related to the accumulation of Low-Density Lipoproteins (LDL) in the arterial walls that leads to a progressive reduction of the lumen of the vessel and alterations in blood perfusion. Currently, the main therapeutic strategy for this type of alteration is drug treatment with statins, which inhibit the enzyme 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), responsible for modulating the rate of cholesterol production and other isoprenoids in the mevalonate pathway. This enzyme induces the expression of LDL receptors in the liver, increasing their number on the surface of liver cells, reducing the plasma concentration of cholesterol. On the other hand, when the blood vessel presents stenosis, a surgical procedure with vascular implants is indicated, which are used to restore circulation in the arterial or venous bed. Among the materials used for the development of vascular implants are Dacron® and Teflon®, which perform the function of re-waterproofing the circulatory circuit, but due to their low biocompatibility, they do not have the ability to promote remodeling and tissue regeneration processes. Based on this, the present research proposes the development of a hydrolyzed collagen and polyethylene oxide electrospun membrane reinforced with medium and high-intensity statins, so that in future research it can favor tissue remodeling processes from its microarchitecture.

Keywords: atherosclerosis, medium and high-intensity statins, microarchitecture, electrospun membrane

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Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb

Abstract:

Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.

Keywords: Stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback.

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Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

Abstract:

Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: Endometrial cancer, FIGO grade, lymphadenectomy, tumor size.

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