Design of a new pulse duplicator system for prosthetic heart valves

This paper discusses results of a computer simulation for designing a new pulse duplicator system for mechanical heart valves. The design objective of the system is to obtain a compact, efficient pulse duplicator system capable of accurately measuring the volume flow rate across a valve. The volume flow rate is determined as the derivative of the volume displacement of an actuator piston which directly drives the fluid. The system does not need any circulatory loop, since the piston is controlled on-line to follow command signals representing an aortic impedance. The results of the computer simulation show: the designed PI-controllers of the actuator can precisely control valve motion to follow given command signals, the eigenvalues of the controllers have to be carefully chosen to prevent unstable behaviors of a valve in diastole, and the dimensions of the actuator is optimized by minimizing a cost function of the total efficiency of the system.     

THE MECHANICAL HEART ON THE MEDICAL HORIZON

Progress in materials and design of a total artificial heart has lengthened survival times from 1(1/2) hours in 1958 to 3 months in 1974. During those years various limiting factors were found and analyzed. Remaining limitations encountered in a 3-month survivor were localized thrombosis within the blood chambers and infection along drive lines into the mediastinum.     

Resonant hopping of a robot controlled by an artificial neural oscillator

The bouncing gaits of terrestrial animals (hopping, running, trotting) can be modeled as a hybrid dynamic system, with spring-mass dynamics during stance and ballistic motion during the aerial phase. We used a simple hopping robot controlled by an artificial neural oscillator to test the ability of the neural oscillator to adaptively drive this hybrid dynamic system. The robot had a single joint, actuated by an artificial pneumatic muscle in series with a tendon spring. We examined how the oscillator-robot system responded to variation in two neural control parameters: descending neural drive and neuromuscular gain. We also tested the ability of the oscillator-robot system to adapt to variations in mechanical properties by changing the series and parallel spring stiffnesses. Across a 100-fold variation in both supraspinal gain and muscle gain, hopping frequency changed by less than 10%. The neural oscillator consistently drove the system at the resonant half-period for the stance phase, and adapted to a new resonant half-period when the muscle series and parallel stiffnesses were altered. Passive cycling of elastic energy in the tendon accounted for 70-79% of the mechanical work done during each hop cycle. Our results demonstrate that hopping dynamics were largely determined by the intrinsic properties of the mechanical system, not the specific choice of neural oscillator parameters. The findings provide the first evidence that an artificial neural oscillator will drive a hybrid dynamic system at partial resonance.     

An artificial muscle actuator for biomimetic underwater propulsors

In this paper, we introduce the analytical framework of the modeling dynamic characteristics of a soft artificial muscle actuator for aquatic propulsor applications. The artificial muscle used for this underwater application is an ionic polymer-metal composite (IPMC) which can generate bending motion in aquatic environments. The inputs of the model are the voltages applied to multiple IPMCs, and the output can be either the shape of the actuators or the thrust force generated from the interaction between dynamic actuator motions and surrounding water. In order to determine the relationship between the input voltages and the bending moments, the simplified RC model is used, and the mechanical beam theory is used for the bending motion of IPMC actuators. Also, the hydrodynamic forces exerted on an actuator as it moves relative to the surrounding medium or water are added to the equations of motion to study the effect of actuator bending on the thrust force generation. The proposed method can be used for modeling the general bending type artificial muscle actuator in a single or segmented form operating in the water. The segmented design has more flexibility in controlling the shape of the actuator when compared with the single form, especially in generating undulatory waves. Considering an inherent nature of large deformations in the IPMC actuator, a large deflection beam model has been developed and integrated with the electrical RC model and hydrodynamic forces to develop the state space model of the actuator system. The model was validated against existing experimental data.     

A linear motor and compact cylinder-piston driver for left ventricular bypass

A simple, portable, reliable and noise-free pneumatic driver has been developed. It consists of a linear motor attached to a cylinder piston, in one unit. The motor coil is directly wound on the cylinder, and the permanent magnet is fixed to the piston. As a continuous voltage square wave is applied to the coil, the cylinder reciprocates on the piston periodically, producing air pressure and vacuum alternately. In conjunction with a locally made diaphragm pump, the driver was tested in vitro and in vivo. Results demonstrated that the device could drive the diaphragm pump and so support the circulation of an experimental animal. The driver weighs 12 kg. For 200 mmHg air pressure and — 80 mmHg vacuum the power consumed is 30 W. Its noise is about 30 dB, less than that of an artificial valve and pump.     

Long-term predictable nipple projection following reconstruction.

The creation of the nipple-areola complex is often the final step in the surgical treatment of breast cancer patients, and it consequently has important symbolic and aesthetic implications. Patient expectations and the need for symmetry make nipple projection a crucial aesthetic determinant of nipple reconstruction. We hypothesize that long-term nipple projection and shape can be achieved in a predictable fashion using the modified star dermal fat flap technique. Prospectively, 93 nipples were reconstructed by a single surgeon using a modified star dermal fat flap technique in 44 implant and 49 TRAM flap breast reconstructions. Flap dimensions (base diameter and flap length) were designed according to patient desire or to the base diameter and projection of the opposite breast nipple. A standardized, 3-month postoperative care regimen was observed in all patients. Nipple projection was assessed by the same observer at each follow-up examination. The average length of follow-up was 730 days (745 for TRAM reconstructions and 713 for implants). Consistently, an average of 41 percent of the intraoperative projection remained intact in both groups at final evaluation (SD 12 percent). The total flap length was strongly predictive of intraoperative and long-term projection (r = 0.64 and 0.86, p < 0.0001). Flap lengths ranged from 5.5 to 9.0 cm, and in a linear correlation, resulted in intraoperative projection of 1.0 to 2.1 cm, respectively, and long-term projection of 0.4 to 0.83 cm, respectively. Based on the linear relationship, every 1-cm increase in flap length could be expected to result in a 0.16-cm increase in projection. When controlled for flap length and intraoperative projection, there was no difference between TRAM and implant nipple reconstruction in predicting postoperative nipple projection. Intraoperative planning and execution are critical to achieve predictable nipple shape, size, and projection. The dimensions of the star dermal fat flap can be strategically modified to allow the surgeon predictable projection with a consistent 41-percent preservation of intraoperative nipple projection in both TRAM and implant patients at 2 years.     

Mechanical performance of artificial pneumatic muscles to power an ankle-foot orthosis

We developed a powered ankle-foot orthosis that uses artificial pneumatic muscles to produce active plantar flexor torque. The purpose of this study was to quantify the mechanical performance of the orthosis during human walking. Three subjects walked at a range of speeds wearing ankle-foot orthoses with either one or two artificial muscles working in parallel. The orthosis produced similar total peak plantar flexor torque and network across speeds independent of the number of muscles used. The orthosis generated approximately 57% of the peak ankle plantar flexor torque during stance and performed approximately 70% of the positive plantar flexor work done during normal walking. Artificial muscle bandwidth and force-length properties were the two primary factors limiting torque production. The lack of peak force and work differences between single and double muscle conditions can be explained by force-length properties. Subjects altered their ankle kinematics between conditions resulting in changes in artificial muscle length. In the double muscle condition greater plantar flexion yielded shorter artificial muscles lengths and decreased muscle forces. This finding emphasizes the importance of human testing in the design and development of robotic exoskeleton devices for assisting human movement. The results of this study outline the mechanical performance limitations of an ankle-foot orthosis powered by artificial pneumatic muscles. This orthosis could be valuable for gait rehabilitation and for studies investigating neuromechanical control of human walking.     

A newly designed tensile tester for cells and its application to fibroblasts

A tensile test system for cells has been designed and applied to fibroblasts from the rabbit patellar tendon. It consists of a thermostatic test chamber, an inverted fluorescence microscope, micromanipulators, a direct drive linear actuator, a cantilever-type load cell, and a video dimension analyzer (VDA). The test chamber and the microscope are mounted on a vibration isolator. A cell floated in Hanks' balanced salt solution of 37 degrees C is gripped with a pair of micropipettes which have very fine tips (outer diameter = 20 approximately 30 microm, inner diameter = 3 approximately 5 microm) and are coated with a cell adhesive, Cell-Tak, at their ends. One of the micropipettes is fixed to the load cell; the other one is attached to the linear actuator which is used to stretch the cell. Load applied to the cell is measured with the load cell, while elongation of the cell is determined with the VDA using the images of the ends of the micropipettes as markers. The measurement accuracy of the load cell was +/-0.05 microN. All the fibroblasts tested were firmly attached to the micropipettes during tensile testing, and showed local non-uniform deformation. The maximum load and elongation to failure of the cells were 0.9+/-0.2 microN and 86+/-24 microm, respectively.     

Design and Experiments of a Robotic Fish Imitating Cow-Nosed Ray

<正> The cow-nosed ray is studied as natural sample of a flapping-foil robotic fish.Body structure, motion discipline, and dynamicfoil deformation of cow-nosed ray are analyzed.Based on the analysis results, a robotic fish imitating cow-nosed ray,named Robo-ray Ⅱ, mainly composed of soft body, flexible ribs and pneumatic artificial muscles, is developed.Structure andswimming morphology of the robotic prototype are as that of a normal cow-nosed ray in nature.Key propulsion parameters ofRobo-ray Ⅱ at normal conditions, including the St Number at linear swimming, thrust coefficient at towing are studied throughexperiments.The suitable driving parameters are confirmed considering the efficiency and swimming velocity.Swimmingvelocity of 0.16 m·s~(-1)'and thrust coefficient of 0.56 in maximum are achieved in experiments.     

Extensive enlargement of the maxillary sinus in Alouatta caraya (mammalia, primates, cebidae): an allometric approach to skull pneumatization in Atelinae

In contrast to the paranasal sinuses of Old World monkeys and hominoids, little information is available about the paranasal sinuses of New World monkeys. Because this information is crucial in order to draw further conclusions about the evolution and biological role of skull pneumatization, this study investigates the morphology of the paranasal sinuses in adult black-and-gold howler monkeys (Alouatta caraya). Volumes of the paranasal sinuses were calculated using computer software (SURFdriver or Allegro) from serial coronal CT scans of 20 skulls of both sexes. Skull pneumatization in A. caraya is more complex than in other higher primates. In both sexes, the maxillary sinus (MS) is the only pneumatic cavity and enlarges regularly into neighboring bones such as the frontal bone and the basisphenoid. The resulting pansinus is often partitioned by several vertical septa. As in most external cranial dimensions, mean MS volume of A. caraya (male 4.08 cm(3); female 2.00 cm(3)) shows significant sexual dimorphism. Reduced major axis regression analysis between MS volume and different cranial dimensions for A. caraya (and for available data from other platyrrhines) suggests a distinct association for this group, with Alouatta having one of the largest pneumatic cavities. The combination of this unusual expansion of the MS of Alouatta and the occurrence of distinct septa within the sinus may be a consequence of the distinct skull architecture of Alouatta.     

Inexpensive, semi-automated system for measuring mechanical properties of soft tissues.

Stiffness and strength are important properties of many tissues, but standard material-testing equipment is expensive, often ill-suited for testing soft tissues, and rarely accessible to biologists. We describe a system built around a microcomputer and an electronic balance which is particularly well-suited for measuring stress and strain in small samples of soft tissue. We use a discarded floppy disk drive as a linear actuator to strain the sample, while an electronic balance measures the tension (used to calculate stress). We give an algorithm for a program to drive a microcomputer which controls the floppy disk drive via its parallel port and records the balance measurements via its serial port. We used this system to obtain stress-strain curves from a sample of latex rubber and a sample of soft insect cuticle. Three tests of the rubber sample gave nearly identical results, with smooth, J-shaped stress-strain curves. The stress-strain curves gave a modulus elasticity value of 1.72 Mpa over the steep, straight region, well within the range for natural latex rubber. We also tested a sample of abdominal cuticle from a caterpillar (Manduca sexta). The caterpillar cuticle had a J-shaped stress-strain curve with a modulus of elasticity of 2.11 Mpa over the steep part of the curve. J. Exp. Zool. 284:374-378, 1999.     

Effect of an Artificial Caudal Fin on the Performance of a Biomimetic Fish Robot Propelled by Piezoelectric Actuators

This paper addresses the design of a biomimetic fish robot actuated by piezoeeramic actuators and the effect of artificial caudal fins on the fish robot＇s performance. The limited bending displacement produced by a lightweight piezocomposite actuator was amplified and transformed into a large tail beat motion by means of a linkage system. Caudal fins that mimic the shape of a mackerel fin were fabricated for the purpose of examining the effect of caudal fm characteristics on thrust production at an operating frequency range. The thickness distribution of a real mackerel＇s fin was measured and used to design artificial caudal fins. The thrust performance of the biomimetic fish robot propelled by fins of various thicknesses was examined in terms of the Strouhal number, the Froude number, the Reynolds number, and the power consumption. For the same fm area and aspect ratio, an artificial caudal fin with a distributed thickness shows the best forward speed and the least power consumption.     

Nitrogen removal from wastewater in vertical flow constructed wetlands containing LWA/gravel layers and reed vegetation

The influence of light weight aggregates made of fly ash from sewage sludge thermal treatment (FASSTT LWA) on the nitrogen removal efficiency from artificial wastewater in constructed wetlands (CW) with vertical flow reed bed was investigated. Thirty lysimeters with six different double-layer bed constructions (upper layer of FASSTT LWA with thicknesses of: 0 cm, 12 cm, 25 cm, 50 cm, and 100 cm of the total depth of the lysimeter, above a lower gravel layer), either with or without reed plants were operated with wastewater hydraulic loading rate of 4.67 mm/d. During a six-month experiment, high efficiency of ammonia removal was observed. The influence of FASSTT LWA as a bed material and the presence of reed on CW treatment efficiency was determined. The highest total nitrogen removal efficiency, 59.5%, was obtained in the CW with double-layer lysimeters consisting of 25% FASSTT LWA (upper layer), and 75% gravel (lower layer), and planted with reed.     

Experimental analysis of pulsatile flow through elastic collapsible tubes: application to cardiac assist device

This study presents a simulated analysis of Phased Compression Cardiac Assist Device (PCCAD) and evaluation of its applicability as a non-invasive temporary assist for a failing heart. The new technique is based on the chest pump mechanism for blood flow augmentation during external massage by phased compression of the abdominal and thoracic cavities. A semi-closed hydraulic system to simulate the systemic circulation was constructed; the system includes a left ventricle which functions according to the Starling principle and a pneumatic system which controls the pressures applied to the thoracic and abdominal cavities, in complete synchronization with the beating normal or failing heart. The possibility of manipulating the three pumps in series (venous, heart, and arterial) has been checked, and the principal parameters which effect the efficiency of the PCCAD were evaluated. This in vitro analysis shows the high potential of a non-invasive temporary cardiac assist device. It points to the necessary measures one has to take in order to achieve good synchronization and to interfere externally with the augmentation of cardiac output or with the augmentation of root aortic pressure.     

Sleeve Muscle Actuator: Concept and Prototype Demonstration

This paper presents the concept and prototype demonstration results of a new sleeve muscle actuator, which provides a significantly improved performance through a fundamental structural change to the traditional pneumatic muscle. Specifically, the sleeve muscle incorporates a cylindrical insert to the center of the pneumatic muscle, and thus eliminates the central portion of the internal volume. Through the analysis of the actuation mechanism, it is shown that the sleeve muscle is able to provide a consistent increase of force capacity over the entire range of motion. Furthermore, the sleeve muscle provides a significant energy saving effect, as a result of the reduced internal volume as well as the enhance force capacity. To demonstrate this new concept, a sleeve muscle prototype was designed and fabricated. Experiments conducted on the prototype verified the improvement in the force capacity and demonstrated a significant energy saving effect (20%–37%). Finally, as the future work on this new concept, the paper presents a new robotic elbow design actuated with the proposed sleeve muscle. This unique design is expected to provide a highly compact and powerful actuation approach for robotic systems.     

Measurement of blood flow from an assist ventricle by computation of pneumatic driving parameters

The measurement of blood flow from an assist ventricle is important but sometimes difficult in artificial heart experiments. Along with the development of a pneumatic cylinder-piston driver coupled with a ventricular assist device, a simplified method for measuring pump flow was established. From driving parameters such as the piston (or cylinder) displacement and air pressure, the pump flow could be calculated by the use of the equation of state for an ideal gas. The results of this method are broadly in agreement with electromagnetic and Doppler measurements.     

Hydraulic design of pine needles: one-dimensional optimization for single-vein leaves

Single-vein leaves have the simplest hydraulic design possible, yet even this linear water delivery system can be modulated to improve physiological performance. We determined the optimal distribution of transport capacity that minimizes pressure drop per given investment in xylem permeability along the needle for a given length without a change in total water delivery, or maximizes needle length for a given pressure difference between petiole and needle tip. This theory was tested by comparative analysis of the hydraulic design of three pine species that differ in the length of their needles [Pinus palustris (Engl.) Miller, approximately 50 cm; Pinus ponderosa Lawson & Lawson, approximately 20 cm and Pinus rigida Miller, approximately 5 cm]. In all three species, the distribution of hydraulic permeability was similar to that predicted by the optimum solution. The needles of P. palustris showed an almost perfect match between predicted and actual hydraulic optimum solution, providing evidence that vein design is a significant factor in the hydraulic design of pine leaves.     

Totally implantable robot to treat chronic atrial fibrillation

Chronic atrial fibrillation affects millions of people worldwide. Its surgical treatment often fails to restore the transport function of the atrium. This study first introduces the concept of an atrial assist device (AAD) to restore the pump function of the atrium. The AAD is developed to be totally implantable in the human body with a transcutaneous energy transfer system to recharge the implanted battery. The ADD consists of a motorless pump based on artificial muscle technology, positioned on the external surface of the atrium to compress it and restore its muscular activity. A bench model reproduces the function of a fibrillating atrium to assess the circulatory support that this pump can provide. Atripump (Nanopowers SA, Switzerland) is a dome-shaped silicone-coated nitinol actuator 5 mm high, sutured on the external surface of the atrium. A pacemaker-like control unit drives the actuator that compresses the atrium, providing the mechanical support to the blood circulation. Electrical characteristics: the system is composed of one actuator that needs a minimal tension of 15 V and has a maximum current of 1.5 A with a 50% duty cycle. The implantable rechargeable battery is made of a cell having the following specifications: nominal tension of a cell: 4.1 V, tension after 90% of discharge: 3.5 V, nominal capacity of a cell: 163 mA h. The bench model consists of an open circuit made of latex bladder 60 mm in diameter filled with water. The bladder is connected to a vertically positioned tube that is filled to different levels, reproducing changes in cardiac preload. The Atripump is placed on the outer surface of the bladder. Pressure, volume and temperature changes were recorded. The contraction rate was 1 Hz with a power supply of 12 V, 400 mA for 200 ms. Preload ranged from 15 to 21 cm H(2)O. Maximal silicone membrane temperature was 55 degrees C and maximal temperature of the liquid environment was 35 degrees C. The pump produced a maximal work of 16 x 10(-3) J. Maximal volume pumped was 492 ml min(-1). This artificial muscle pump is compact, follows the Starling law and reproduces the hemodynamic performances of a normal atrium. It could represent a new tool to restore the atrial kick in persistent atrial fibrillation.     

Pulsatile flow and oxygen transport past cylindrical fiber arrays for an artificial lung: computational and experimental studies

The influence of time-dependent flows on oxygen transport from hollow fibers was computationally and experimentally investigated. The fluid average pressure drop, a measure of resistance, and the work required by the heart to drive fluid past the hollow fibers were also computationally explored. This study has particular relevance to the development of an artificial lung, which is perfused by blood leaving the right ventricle and in some cases passing through a compliance chamber before entering the device. Computational studies modeled the fiber bundle using cylindrical fiber arrays arranged in in-line and staggered rectangular configurations. The flow leaving the compliance chamber was modeled as dampened pulsatile and consisted of a sinusoidal perturbation superimposed on a steady flow. The right ventricular flow was modeled to depict the period of rapid flow acceleration and then deceleration during systole followed by zero flow during diastole. Experimental studies examined oxygen transfer across a fiber bundle with either steady, dampened pulsatile, or right ventricular flow. It was observed that the dampened pulsatile flow yielded similar oxygen transport efficiency to the steady flow, while the right ventricular flow resulted in smaller oxygen transport efficiency, with the decrease increasing with Re. Both computations and experiments yielded qualitatively similar results. In the computational modeling, the average pressure drop was similar for steady and dampened pulsatile flows and larger for right ventricular flow while the pump work required of the heart was greatest for right ventricular flow followed by dampened pulsatile flow and then steady flow. In conclusion, dampening the artificial lung inlet flow would be expected to maximize oxygen transport, minimize work, and thus improve performance.     

Immediate breast reconstruction using biodimensional anatomical permanent expander implants: a prospective analysis of outcome and patient satisfaction

Immediate breast reconstruction is offered to the majority of women requiring a mastectomy for cancer treatment. Improvements in implant technology have seen the evolution of shaped, fixed-volume implants and permanent expanders. The theoretical benefits of biodimensional anatomical expander implants include better reconstructed breast form, the potential for achieving this at a single procedure, and the avoidance of a contralateral procedure as a result of improved ipsilateral cosmesis. The aim of the present study was to assess outcome after immediate breast reconstruction using the McGhan 150 permanent expander implant. A total of 107 consecutive patients (129 breast reconstructions) were studied over a 30-month period; 49 patients (68 reconstructions) had submuscular implant placement alone, and 58 patients (61 reconstructions) had an implant in conjunction with a latissimus dorsi flap. The mean patient age was 47 years (range, 22 to 72 years) and the mean follow-up was 18 months (range, 6 to 40 months). Outcome was assessed in the following four ways: geometric measurements, evaluation of photographs by four independent observers, linear numerical analogue scale, and a quality-of-life questionnaire. Geometric measurements after surgery showed median differences that were highly consistent with good symmetry. Transverse breast width difference between breasts was 0.35 cm, vertical breast height difference was 0.8 cm, sternal notch-to-nipple distance difference was 0.6 cm, midclavicular line-to-nipple distance difference was 0.5 cm, nipple-to-inframammary crease distance difference was 0.5 cm, midline-to-nipple distance difference was 0 cm, and projection difference was 0 cm. Photographic assessment by four observers who evaluated shape, cleavage, symmetry, and overall outcome produced correlation values of 0.73 to 0.81. More than 75 percent of each of these parameters was scored as good or excellent. A numerical analogue scale (from 1 to 10) assessing overall result by the surgeon and patient revealed good (7 to 8) or excellent (9 to 10) scores in 83 and 82 percent of respondents, respectively. Quality-of-life data showed that 81 and 88 percent of women felt "a little" or "not at all" less feminine, respectively, and 88 percent were satisfied with the appearance of their breasts. A total of 88 percent of women would also choose the same reconstructive procedure if faced with the same cancer diagnosis. Complication rates were low; infections occurred in 6.2 percent of reconstructions, hematoma occurred in 1.6 percent, and implant loss occurred in 3.9 percent. Only 24 of 107 patients (22 percent) elected to have a synchronous contralateral breast adjustment, and four of 107 (4 percent) chose to have a subsequent procedure for symmetry. Biodimensional expander implants used in immediate breast reconstruction are associated with high levels of patient and surgeon satisfaction. Optimum breast form can be achieved during a single operation with a low incidence of complications.