Yos S. Morsi

Error analysis of FDM fabricated medical replicas

Purpose – Recent advancement in fused deposition modelling (FDM) rapid prototyping technology has made it a viable technology for application in reconstructive surgery. The purpose of this paper is to investigate the errors generated during the fabrication stage of complex anatomical replicas derived from computed tomography coupled with the technique of FDM.Design/methodology/approach – An evaluation on the errors generated during the fabrication process of two anatomical parts (skull or mandible) for different human sizes (infant, female or male) is carried out. A comparison between the linear measurements of 11 landmarks on the virtual model of a skull and nine for the mandible of patient specific and its replica is conducted. Furthermore, eight landmarks are chosen to evaluate the bone thickness variation over the fabricated replicas.Findings – Although the FDM technology proved the ability to manufacture and to fit prosthesis to a patients unique proportions quickly and with relatively low cost, the...

Numerical analysis of coronary artery bypass grafts: An over view

Arterial bypass grafts tend to fail after some years due to the development of intimal thickening (restenosis). Non-uniform hemodynamics following a bypass operation contributes to restenosis and bypass failure can occur due to the focal development of anastomotic intimal hyperplasia. Additionally, surgical injury aggravated by compliance mismatch between the graft and artery has been suggested as an initiating factor for progress of wall thickening along the suture line Vascular grafts that are small in diameter tend to occlude rapidly. Computational fluid dynamics (CFD) methods have been effectively used to simulate the physical and geometrical parameters characterizing the hemodynamics of various arteries and bypass configurations. The effects of such changes on the pressure and flow characteristics as well as the wall shear stress during a cardiac cycle can be simulated. Recently, utilization of fluid and structure interactions have been used to determine fluid flow parameters and structure forces including stress and strains relationships under steady and transient conditions. In parallel to this, experimental diagnostics techniques such as Laser Doppler Anemometry, Particle Image Velocimetry, Doppler Guide wire and Magnetic Resonance Imaging have been used to provide essential information and to validate the numerical results. Moreover, clinical imaging techniques such as magnetic resonance or computed tomography have assisted considerably in gaining a detailed patient-specific picture of the blood flow and structure dynamics. This paper gives a review of recent numerical investigations of various configurations of coronary artery bypass grafts (CABG). In addition, the paper ends with a summary of the findings and the future directions.

Transient fluid–structure coupling for simulation of a trileaflet heart valve using weak coupling

In this article, a three-dimensional transient numerical approach coupled with fluid–structure interaction for the modeling of an aortic trileaflet heart valve at the initial opening stage is presented. An arbitrary Lagrangian–Eulerian kinematical description together with an appropriate fluid grid was used for the coupling strategy with the structural domain. The fluid dynamics and the structure aspects of the problem were analyzed for various Reynolds numbers and times. The fluid flow predictions indicated that at the initial leaflet opening stage a circulation zone was formed immediately downstream of the leaflet tip and propagated outward as time increased. Moreover, the maximum wall shear stress in the vertical direction of the leaflet was found to be located near the bottom of the leaflet, and its value decreased sharply toward the tip. In the horizontal cross section of the leaflet, the maximum wall shear stresses were found to be located near the sides of the leaflet.

Improved properties of incorporated chitosan film with ethyl cellulose microspheres for controlled release

In this article, to discover an innovative drug release system, ciprofloxacin hydrochloride-loaded blending films of chitosan (CS)/ethyl cellulose (EC) microspheres were prepared. Two steps were adopted in the film forming process. The first was formation of the drug-loaded EC microspheres in CS solution by solvent remove/solvent evaporation methods; then, the composite films were made by casting and solvent evaporation. The results were that the drug-loaded round EC microspheres dispersed asymmetrically in the CS films and largely improved the release time. Moreover, the drug-loaded blending film containing 0.5 g EC microspheres prepared at 90 degrees C showed highlighted extended release property. The drug was stable in the blending films, which expressed good cytocompatibility proved by MTT test. The film should be a promising carrier for controlled and extended drug release system in pharmaceutical applications.

Artery vessel fabrication using the combined fused deposition modeling and electrospinning techniques

Purpose – The purpose of this paper is to prepare a new combined method of rapid prototyping, fused deposition modeling (FDM) and electrospinning for the fabrication of coronary artery bypass graft (CABG).Design/methodology/approach – A dynamically optimum design of blood vessel graft was constructed using FDM and electrospinning. Fabrication of 3‐D CABG model was constructed using pro‐engineer based on the optimum hemodynamic analysis and was converted to an stereolithography file format which was imported to the Magic software where it was edited to a high‐resolution contour. The model was then created from acrylonitrile butadiene styrene which was used as a collector for electrospinning fabrication. For the electrospinning thermoplastic polyurethane was dissolved with hexafluoroisopropanol. The voltage applied for electrospinning was 15 kV where the solid FDM model was used to collect nanofibers at fixed distance.Findings – The properties of the fabricated vessel agreed well with those of human artery....

Breast-Cancer identification using HMM-fuzzy approach

This paper presents an ensemble of feature selection and classification technique for classifying two types of breast lesion, benign and malignant. Features are selected based on their area under the ROC curves (AUC) which are then classified using a hybrid hidden Markov model (HMM)-fuzzy approach. HMM generated log-likelihood values are used to generate minimized fuzzy rules which are further optimized using gradient descent algorithms in order to enhance classification performance. The developed model is applied to Wisconsin breast cancer dataset to test its performance. The results indicate that a combination of selected features and the HMM-fuzzy approach can classify effectively the lesion types using only two fuzzy rules. Our experimental results also indicate that the proposed model can produce better classification accuracy when compared to most other computational tools.

Gentamicin-impregnated chitosan/nanohydroxyapatite/ethyl cellulose microspheres granules for chronic osteomyelitis therapy.

In this article gentamicin (GM) impregnated microspheres were used to extend the drug release time for the treatment of chronic osteomyelitis. The granules were prepared in solution and consisted of nanohydroxyapatite (nHA), chitosan (CS) and GM loaded ethyl cellulose (EC) microspheres. A rabbit model with chronic osteomyelitis was made by using staphylococcus aureus and morrhuate sodium and special inspection methods were used to test the curative effects of the granules, such as microbiological investigations, tissue, and X-ray observations. The granules were provided with excellent drug release properties, 49 days in vitro and 45 days in vivo, moreover, they showed almost no cytotoxic for fibroblast and osteoblast. The findings indicated that the GM-impregnated CS/nHA/EC microspheres granules showed outstanding curative effect. Generally, it can be concluded that the granules containing GM impregnated microspheres may be used effectively in the treatment of the chronic osteomyelitis.

Haemodynamic analysis of coronary artery bypass grafting in a non-linear deformable artery and Newtonian pulsatile blood flow.

A three-dimensional (3D) computational model of stenotic coronary artery bypass grafting (CABG) system with fluid—structure interaction (FSI) using realistic physiological conditions is introduced. Unsteady pulsatile blood flow is applied to the wall of non-linear deformable arteries over the systolic period. In the analysis, the arbitrarily Lagrangian—Eulerian (ALE) formulation is used to couple the fluid region and solid domain. The method couples the equations of the deformation of the artery wall and applies them as the fluid domain boundary condition. The flow distribution and haemodynamic forces are presented in terms of velocity profiles and temporal and spatial wall shear stresses (WSSs) at the distal area. Rapid changes in the flow fields are observed in the early stages of the cardiac cycle, which alters the location of the recirculation zone from the toe to the host bed and then to the heel. The migration of the recirculation zone, considering the effect of deformability of the artery wall, indicates the same trend as the rigid wall model according to the location of low and high WSSs. However, the WSSs in the critical areas such as toe, heel, and suture lines are found to have dramatic drops in magnitudes in comparison with those of the rigid wall model. This could initiate the promotion of intimal hyperplasia (IH) and may cause an early graft failure in CABG.

A New Sterilization Technique of Bovine Pericardial Biomaterial Using Microwave Radiation

Bioprosthetic valves created from chemically treated natural tissues such as bovine pericardial biomaterial are used as heart valve scaffolds. Methods currently available for sterilization of biomaterial for transplantation include the application of gamma radiation and chemical sterilants. These techniques, however, can be problematic because they can be expensive and lead to a reduction in tissue integrity. Therefore, improved techniques are needed that are cost effective and do not disrupt the physical properties, functionality, and lifespan of the valvular leaflets. This study examined a novel technique using nonthermal microwave radiation that could lead to the inactivation of bacteria in bovine pericardial biomaterial without compromising valve durability. Two common pathogenic species of bacteria, Escherichia coli and Staphylococcus aureus, were used as test microorganisms. Optimized microwave parameters were used to determine whether inactivation of pathogenic bacteria from bovine pericardium could be achieved. In addition, the effect of microwave sterilization on tissue integrity was examined. The mechanical properties (assessed using dynamic mechanical analysis) and tensile strength testing (using a Universal Tensile Tester) as well as thermal analysis (using thermogravimetric analysis and differential scanning calorimetry) indicated that microwave sterilization did not compromise the functionality of bovine pericardial biomaterial. Scanning electron microscopy imaging and cytotoxicity testing also confirmed that the structure and biocompatibility of transplant biomaterial remained unaltered after the sterilization process. Results from the application of this new microwave (MW) sterilization technique to bovine pericardium showed that near-complete inactivation of the contaminant bacteria was achieved. It is concluded that nonthermal inactivation of pathogenic bacteria from bovine pericardial biomaterial could be achieved using microwave radiation.

PIV measurements and numerical validation of end-to-side anastomosis

In this article, particle image velocimetry (PIV) technique was used to determine the instantaneous velocity fields inside a model of end-to-side anastomosis under various physiological flow conditions. Using ANSYS software, a three-dimensional (3D) computational model at the peak systolic blood flow was simulated. The numerical and experimental results were presented and discussed in terms of velocity fields at various locations along the graft and the host artery. The numerical results were then compared with the experimental data and a large difference was found, which was attributed to the imperfection of manufacturing the glass model and measurements error associated with PIV. The findings indicated in general that the analysis at peak systole, steady flow could help in providing essential quantitative information of the hemodynamics in anastomotic artery.