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At least 559 records · Page 31Linked to original sources
PubMed2007

Stereolithographic reproduction of complex cardiac morphology based on high spatial resolution imaging.

BACKGROUND: Precise knowledge of cardiac anatomy is mandatory for diagnosis and treatment of congenital heart disease. Modern imaging techniques allow high resolution three-dimensional (3D) imaging of the heart and great vessels. In this study stereolithography was evaluated for 3D reconstructions of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) data. METHODS: A plastinated heart specimen was scanned with MDCT and after segmentation a stereolithographic (STL) model was produced with laser sinter technique. After scanning the STL model with MDCT these data were compared with those of the original specimen after rigid registration using the iterative closest points algorithm (ICP). The two surfaces of the original specimen and STL model were matched and the symmetric mean distance was calculated. Additionally, the heart and great vessels of patients (age range 41 days-21 years) with congenital heart anomalies were imaged with MDCT (n=2) or free breathing steady, state free-precession MRI (n=3). STL models were produced from these datasets and the cardiac segments were analyzed by two independent observers. RESULTS: All cardiac structures of the heart specimen were reconstructed as a STL model within sub-millimeter resolution (mean surface distance 0.27+/-0.76 mm). Cardiac segments of the STL patient models were correctly analyzed by two independent observers compared to the original 3D datasets, echocardiography (n=5), x-ray angiography (n=5), and surgery (n=4). CONCLUSIONS: High resolution MDCT or MRI 3D datasets can be accurately reconstructed using laser sinter technique. Teaching, research and preoperative planning may be facilitated in the future using this technique.

Adolescent↗
PubMed2004

Voxel-based computational models of real human anatomy: a review.

Computational models of human anatomy are mathematical representations of human anatomy designed to be used in dosimetry calculations. They have been used in dosimetry calculations for radiography, radiotherapy, nuclear medicine, radiation protection and to investigate the effects of low frequency electromagnetic fields. Tomographic medical imaging techniques have allowed the construction of digital three-dimensional computational models based on the actual anatomy of individual humans. These are called voxel models, tomographic models or phantoms. Their usefulness lies in their faithful representation of human anatomy and the flexibility they afford by being able to be scaled in size to match the required human dimensions. Segmenting medical images in order to make voxel models is very time-consuming so semi-automatic segmentation techniques are being developed. Some 21 whole or partial body models currently exist and more are being prepared. These models are listed and discussed.

Adult↗
PubMed2007

Correction of compliance and resistance altered by endotracheal tube leaks and non-linear pressure/volume-relationships.

Measurements of lung compliance (C) and resistance (R) are influenced by endotracheal tube leaks (ETTL) as well as non-linear pressure/volume relationships (P/V relationship). To keep C and R reliable, we developed an algorithm to mathematically correct inspiratory and expiratory volume (V) and flow. In this study, a ventilated lung model for non-linear P/V relationship with adjustment of an increasing ETTL was studied. In addition, the recordings (airway pressure, flow, and volume) of 21 infants (median weight: 1,220 g, range: 640-2,160 g, with a median leak size of 32%, range: 24-56%) were investigated. C and R were calculated continuously from the recordings of flow, volume, and airway pressure over time according to the changing volume. A method especially developed for the analysis of non-linear pressure-volume-relationship (APVNL) was employed. C and R affected by leaks were corrected applying the newly developed mathematical algorithm and compared with measurements without leakage. C could be corrected up to a leak of 80% and R up to 55% leak at half tidal V for the model with non-linear P/V-R. C and R without leak and after leak correction did not differ significantly in all infants where the APVNL method was applied (P > 0.05).

Airway Resistance↗
PubMed2000

The inverse dynamics problem of neuromuscular control.

The myoskeletal inverse dynamics problem and the myocybernetic control inverse problem were investigated with respect to their ill-posedness. The first problem consists of finding from observed experimental motion and reaction force data the resultant muscle moments that generated the observed motion, while the second aims at finding the corresponding neural controls. It is shown that both problems belong to the class of incorrectly posed (ill-posed) problems that, by definition, do not possess unique solutions. To illustrate this point, results of a forward dynamics simulation of a comprehensive neuromusculoskeletal model of the human body are presented. These results demonstrate that fairly chaotic neural control perturbations have very little influence on the resulting motion trajectory, at least in the present example. While a regularization procedure may be applied to solve successfully the myoskeletal inverse dynamics problem, the myocybernetic control inverse problem is unsolvable. The latter fact has the important implication that, based on the somatosensory inputs it receives, the pars intermedia in the cerebellum is not able to control individual motor unit stimulation rates and recruitment patterns but only whole muscles by means of a single compound signal. The latter signal is identified as the "common drive." Presumably at the spinal level, special neural circuits are used to decompose the common drive signal into motor unit recruitment patterns and stimulation rates that are specific for a given mode of contraction and probably obey certain optimality principles.

Computer Simulation↗
PubMed2004

Laparoscopic virtual reality and box trainers: is one superior to the other?

BACKGROUND: Virtual reality (VR) simulators now have the potential to replace traditional methods of laparoscopic training. The aim of this study was to compare the VR simulator with the classical box trainer and determine whether one has advantages over the other. METHODS: Twenty four novices were tested to determine their baseline laparoscopic skills and then randomized into the following three group: LapSim, box trainer, and no training (control). After 3 weekly training sessions lasting 30-min each, all subjects were reassessed. Assessment included motion analysis and error scores. Nonparametric tests were applied, and p < 0.05 was deemed significant. RESULTS: Both trained groups made significant improvements in all parameters measured ( p < 0.05). Compared to the controls, the box trainer group performed significantly better on most of the parameters, whereas the LapSim group performed significantly better on some parameters. There were no significant differences between the LapSim and box trainer groups. CONCLUSIONS: LapSim is effective in teaching skills that are transferable to a real laparoscopic task. However, there appear to be no substantial advantages of one system over the other.

Adult↗
PubMed2006

Comparison of different training models for laparoscopic surgery in neonates and small infants.

BACKGROUND: Minimally invasive surgery in small children and infants requires special skills and training. This experimental study compares the efficiency of an in vitro pelvic trainer (PT) and an a in vivo animal model (AM). METHODS: For this study, 12 residents were prospectively randomized into two groups. Initially, all had to pass a basic skill assessment (3 tasks). Then endoscopic small bowel biopsy was performed (8 times) either with the in vitro PT (group A) or the in vivo AM (group B). Finally, all had to demonstrate this procedure in the in vivo AM and repeat the basic skill assessment. A quality index (complications, suture, biopsy) was evaluated. RESULTS: Initially, there was no difference between the two groups. Interestingly, the mean regression gradient of the index for the in vitro PT (group A) was significantly better than for the in vivo AM (group B). In the final in vivo operation, however, the mean index for the in vitro PT (group A) worsened significantly, whereas it increased for the in vivo AM (group B) (p = 0.037). CONCLUSION: Adequate training for an isolated mechanical task such as gut biopsy can be supplied using a pelvic trainer or animal model with similar effects. However in vivo performance of the same task requires secondary surgical skills, which are conveyed during live training with greater success. Consequently, stepwise teaching with both modules seems reasonable before these procedures are approached in neonates or small children.

Adult↗
PubMed1997

The sensitivity of new color systems in blood-flow diagnosis. The maximum entropy method and angio-color-comparative in vitro flow measurements to determine sensitivity.

BACKGROUND: Two new blood-flow-diagnosis techniques have recently been developed as supplements to the established color techniques: the MEM (maximum entropy method) technique and color flow amplitude (power Doppler). These are capable of representing blood flow in distinctly more slowly flowing areas than is possible with the conventional Doppler technique. METHODS: Both methods make use of the Doppler technique in part, yet analyze the reflected signal in a different manner, in so doing optimizing the relation between the noise and the signal. Measurements were obtained on two anatomic flow models to test the sensitivity of both techniques under slow flow conditions. RESULTS: The slowest flow the MEM technique was capable of recording was 0.5 mm/s, albeit utilizing a 5-MHz transducer for the MEM technique and a 10-MHz transducer for the angio technique. One may thus assume that the MEM technique would be still more sensitive when utilizing a 10-MHz transducer. The advantage of the MEM technique is its real-time flow representation: The angio technique requires a few seconds of acquisition time. This could have serious consequences during clinical utilization. Doppler sonography was merely capable of detecting a minimum flow velocity of 15 mm/s. The angio technique is less dependent on the angle during flow representation than the MEM technique. CONCLUSIONS: The distinctly higher sensitivity of these two new color techniques offers new possibilities in the clinical sector as far as the perfusion diagnosis of organs and tumors is concerned.

Angiography↗
PubMed2005

Role of facet curvature for accurate vertebral facet load analysis.

The curvature of vertebral facet joints may play an important role in the study of load-bearing characteristics and clinical interventions such as graded facetectomy. In previously-published finite element simulations of this procedure, the curvature was either neglected or approximated with a varying degree of accuracy. Here we study the effect of the curvature in three different load situations by using a numerical model which is able to represent the actual curvature without any loss of accuracy. The results show that previously-used approximations of the curvature lead to good results in the analysis of sagittal moment/rotation. However, for sagittal shear-force/displacement and for the contact stress distribution, previous results deviate significantly from our results. These findings are supported through related convergence studies. Hence we can conclude that in order to obtain reliable results for the analysis of sagittal shear-force/displacement and the contact stress distribution in the facet joint, the curvature must not be neglected. This is of particular importance for the numerical simulation of the spine, which may lead to improved diagnostics, effective surgical planning and intervention. The proposed method may represent a more reliable basis for optimizing the biomedical engineering design for tissue engineering or, for example, for spinal implants.

Biomechanical Phenomena↗
PubMed2006

Three dimensional finite element analysis of the pediatric lumbar spine. Part II: biomechanical change as the initiating factor for pediatric isthmic spondylolisthesis at the growth plate.

A non-linear 3-dimensional finite element pediatric lumbar spine model with vertebral growth plate and apophyseal bony ring was developed. Lumbar spondylolysis was simulated in the model. The Von Mises stresses in the structures surrounding the vertebral growth plate, including apophyseal bony ring and osseous endplate were calculated in various loading modes. Instantaneous axis of rotation (IAR) path from flexion to extension was also analyzed. The results were compared with those of the intact model and the literature. The IAR path was at the posterior disc-endplate space of the lower vertebra in the intact spine, and moved cranially towards the upper-posterior disc space in the lytic spine. This was in agreement with in vivo radiological data by Sakamaki et al. [19]. During various loading modes, stresses in the spondylolytic pediatric model were higher than that of the intact model; ranging from 1.1 to 6.0 times, with the highest value in extension at the growth plate. In conclusion, FE models indicate that stress concentrations in the lytic model increase at the growth plate which may lead to physis stress fracture leading to spondylolisthesis.

Biomechanical Phenomena↗
PubMed2007

Biomechanical study of anterior spinal instrumentation configurations.

The biomechanical impact of the surgical instrumentation configuration for spine surgery is hard to evaluate by the surgeons in pre-operative situation. This study was performed to evaluate different configurations of the anterior instrumentation of the spine, with simulated post-operative conditions, to recommend configurations to the surgeons. Four biomechanical parameters of the anterior instrumentation with simulated post-operative conditions have been studied. They were the screw diameter (5.5-7.5 mm) and its angle (0 degrees - 22.5 degrees), the bone grip of the screw (mono-bi cortical) and the amount of instrumented levels (5-8). Eight configurations were tested using an experimental plan with instrumented synthetic spinal models. A follower load was applied and the models were loaded in flexion, torsion and lateral bending. At 5 Nm, average final stiffness was greater in flexion (0.92 Nm/degrees) than in lateral bending (0.56 Nm/degrees) and than in torsion (0.26 Nm/degrees). The screw angle was the parameter influencing the most the final stiffness and the coupling behaviors. It has a significant effect (p < or = 0.05) on increasing the final stiffness for a 22.5 degrees screw angle in flexion and for a coronal screw angle (0 degrees) in lateral bending. The bi-cortical bone grip of the screw significantly increased the initial stiffness in flexion and lateral bending. Mathematical models representing the behavior of an instrumented spinal model have been used to identify optimal instrumentation configurations. A variation of the angle of the screw from 22.5 degrees to 0 degrees gave a global final stiffness diminution of 13% and a global coupling diminution of 40%. The screw angle was the most important parameter affecting the stiffness and the coupling of the instrumented spine with simulated post-operative conditions. Information about the effect of four different biomechanical parameters will be helpful in preoperative situations to guide surgeons in their clinical choices.

Biomechanical Phenomena↗
PubMed2004

Towards in vivo aorta material identification and stress estimation.

This paper addresses the problem of constructing a mechanical model for the abdominal aorta and calibrating its parameters to in vivo measurable data. The aorta is modeled as a pseudoelastic, thick-walled, orthotropic, residually stressed cylindrical tube, subjected to an internal pressure. The model parameters are determined by stating a minimization problem for the model pressure and computing the optimal solution by a minimization algorithm. The data used in this study is in vivo pressure-diameter data for the abdominal aorta of a 24-year-old man. The results show that the axial, circumferential and radial stresses have magnitudes in the span 0 to 180 kPa. Furthermore, the results show that it is possible to determine model parameters directly from in vivo measurable data. In particular, the parameters describing the residual stress distribution can be obtained without interventional procedures.

Adult↗
PubMed2004

Hemodynamics and wall mechanics in human carotid bifurcation and its consequences for atherogenesis: investigation of inter-individual variation.

Finite element simulations of fluid-solid interactions were used to investigate inter-individual variations in flow dynamics and wall mechanics at the carotid artery bifurcation, and its effects on atherogenesis, in three healthy humans (normal volunteers: NV1, NV2, NV4). Subject-specific calculations were based on MR images of structural anatomy and ultrasound measurements of flow at domain boundaries. For all subjects, the largest contiguous region of low wall shear stress (WSS) occurred at the carotid bulb, WSS was high (6-10 Pa) at the apex, and a small localized region of WSS > 10 Pa occurred close to the inner wall of the external carotid artery (ECA). NV2 and NV4 had a "spot" of low WSS distal to the bifurcation at the inner wall of the ECA. Low WSS patches in the common carotid artery (CCA) were contiguous with the carotid bulb low WSS region in NV1 and NV2, but not in NV4. In all three subjects, areas of high oscillatory shear index (OSI) were confined to regions of low WSS. Only NV4 exhibited high levels of OSI on the external adjoining wall of the ECA and CCA. For all subjects, the maximum wall shear stress temporal gradient (WSSTG) was highest at the flow divider (reaching 1,000 Pa/s), exceeding 300 Pa/s at the walls connecting the ECA and CCA, but remaining below 250 Pa/s outside of the ECA. In all subjects, (maximum principle) cyclic strain (CS) was greatest at the apex (NV1: 14%; NV2: 11%; NV4: 6%), and a second high CS region occurred at the ECA-CCA adjoining wall (NV1: 11%, NV2: 9%, NV4: 5%). Wall deformability was included in one simulation (NV2) to verify that it had little influence on the parameters studied. Location and magnitude of low WSS were similar, except for the apex (differences of up to 25%). Wall distensibility also influenced OSI, doubling it in most of the CCA, separating the single high OSI region of the carotid bulb into two smaller regions, and shrinking the ECA internal and external walls' high OSI regions. These observations provide further evidence that significant intra-subject variability exists in those factors thought to impact atherosclerosis.

Adult↗
PubMed2005

Buckling of adaptive elastic bone-plate: theoretical and numerical investigation.

During day-to-day activities, many bones in the axial and appendicular skeleton are subjected to repetitive, cyclic loading that often results directly in an increased risk of bone fracture. In clinical orthopedics, trabecular fatigue fractures are observed as compressive stress fractures in the proximal femur, vertebrae, calcaneus and tibia, that are often preceded by buckling and bending of microstructural elements (Müller et al. in J Biomechanics 31:150 1998; Gibson in J Biomechanics 18:317-328 1985; Gibson and Ashby in Cellular solids 1997; Lotz et al. in Osteoporos Int 5:252-261 1995; Carter and Hayes in Science 194:1174-1176 1976). However, the relative importance of bone density and architecture in the etiology of these fractures are poorly understood and consequently not investigated from a biomechanical point of view. In the present contribution, an attempt is made to formulate a bone-plate buckling theory using Cowin's concepts of adaptive elasticity (Cowin and Hegedus in J Elast 6:313-325 1976; Hegedus and Cowin J Elast 6:337-352 1976). In particular, the buckling problem of a Kirchhoff-Love bone plate is investigated numerically by using the finite difference method and an iterative solving approach (Chen in Comput Methods Appl Mech Eng 167:91-99 1998; Hildebland in Introduction to numerical analysis 1974; Richtmyer and Morton in Difference methods for initial-value problems 1967).

Biomechanical Phenomena↗
PubMed2005

Aorta in vivo parameter identification using an axial force constraint.

It was shown in a previous study by Stålhand et al. (2004) that both material and residual strain parameters for an artery can be identified noninvasively from an in vivo clinical pressure-diameter measurement. The only constraints placed on the model parameters in this previous study was a set of simple box constraints. More advanced constraints can also be utilized, however. These constraints restrict the model parameters implicitly by demanding the state of the artery to behave in a specified way. It has been observed in vitro that the axial force is nearly invariant to the pressure at the physiological operation point. In this paper, we study the possibility to include this behaviour as a constraint in the parameter optimization. The method is tested on an in vivo obtained pressure-diameter cycle for a 24-year-old human. Presented results show that the constrained parameter identification procedure proposed here can be used to obtain good results, and we believe that it may be applied to account for other observed behaviours as well.

Adult↗
PubMed2005

A polyconvex anisotropic strain-energy function for soft collagenous tissues.

Polyconvexity of a strain-energy function is a very important mathematical condition, especially in the context of a boundary-value problem. In the present paper, we propose an exponential polyconvex anisotropic strain-energy function. It is given by a series with an arbitrary number of terms and associated material constants. Each term of this series a priori satisfies the condition of the energy- and stress-free natural state so that no additional restrictions have to be imposed. Due to the exponential form, the proposed hyperelastic model is suitable for soft biological tissues. Thus, a good agreement with experimental data on different types of tissues is achieved.

Animals↗
PubMed2005

Modeling initial strain distribution in soft tissues with application to arteries.

A general theory for computing and identifying the stress field in a residually stressed tissue is presented in this paper. The theory is based on the assumption that a stress free state is obtained by letting each point deform independently of its adjacent points. This local unloading represents an initial strain, and can be described by a tangent map. When experimental data is at hand in a specific situation, the initial strain field may be identified by stating a nonlinear minimization problem where this data is fitted to its corresponding model response. To illustrate the potential of such a method for identifying initial strain fields, the application to an in vivo pressure-radius measurement for a human aorta is presented. The result shows that the initial strain is inconsistent with the strain obtained with the opening-angle-method. This indicates that the opening-angle-method has a too restrictive residual strain parameterization, in this case.

Algorithms↗
PubMed2005

Computational modeling of vascular anastomoses.

Recent development of computational technology allows a level of knowledge of biomechanical factors in the healthy or pathological cardiovascular system that was unthinkable a few years ago. In particular, computational fluid dynamics (CFD) and computational structural (CS) analyses have been used to evaluate specific quantities, such as fluid and wall stresses and strains, which are very difficult to measure in vivo. Indeed, CFD and CS offer much more variability and resolution than in vitro and in vivo methods, yet computations must be validated by careful comparison with experimental and clinical data. The enormous parallel development of clinical imaging such as magnetic resonance or computed tomography opens a new way toward a detailed patient-specific description of the actual hemodynamics and structural behavior of living tissues. Coupling of CFD/CS and clinical images is becoming a standard evaluation that is expected to become part of the clinical practice in the diagnosis and in the surgical planning in advanced medical centers. This review focuses on computational studies of fluid and structural dynamics of a number of vascular anastomoses: the coronary bypass graft anastomoses, the arterial peripheral anastomoses, the arterio-venous graft anastomoses and the vascular anastomoses performed in the correction of congenital heart diseases.

Anastomosis, Surgical↗