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1.
Cells ; 10(5)2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34065411

RESUMO

Three-dimensional (3D) bioprinting is a promising technology to establish a 3D in vitro hepatic model that holds great potential in toxicological evaluation. However, in current hepatic models, the central area suffers from hypoxic conditions, resulting in slow and weak metabolism of drugs and toxins. It remains challenging to predict accurate drug effects in current bioprinted hepatic models. Here, we constructed a hexagonal bioprinted hepatic construct and incorporated a spinning condition with continuous media stimuli. Under spinning conditions, HepG2 cells in the bioprinted hepatic construct exhibited enhanced proliferation capacity and functionality compared to those under static conditions. Additionally, the number of spheroids that play a role in boosting drug-induced signals and responses increased in the bioprinted hepatic constructs cultured under spinning conditions. Moreover, HepG2 cells under spinning conditions exhibited intensive TGFß-induced epithelial-to-mesenchymal transition (EMT) and increased susceptibility to acetaminophen (APAP)-induced hepatotoxicity as well as hepatotoxicity prevention by administration of N-acetylcysteine (NAC). Taken together, the results of our study demonstrate that the spinning condition employed during the generation of bioprinted hepatic constructs enables the recapitulation of liver injury and repair phenomena in particular. This simple but effective culture strategy facilitates bioprinted hepatic constructs to improve in vitro modeling for drug effect evaluation.


Assuntos
Biomimética , Bioimpressão/instrumentação , Proliferação de Células , Fígado/patologia , Modelos Biológicos , Impressão Tridimensional/estatística & dados numéricos , Engenharia Tecidual , Acetaminofen/toxicidade , Acetilcisteína/farmacologia , Analgésicos não Narcóticos/toxicidade , Sequestradores de Radicais Livres/farmacologia , Células Hep G2 , Humanos , Hidrogéis , Técnicas In Vitro , Fígado/efeitos dos fármacos , Alicerces Teciduais/química , Testes de Toxicidade
2.
Sci Rep ; 11(1): 7005, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33772092

RESUMO

The usefulness of 3-dimensional (3D)-printed disease models has been recognized in various medical fields. This study aims to introduce a production platform for patient-specific 3D-printed brain tumor model in clinical practice and evaluate its effectiveness. A full-cycle platform was created for the clinical application of a 3D-printed brain tumor model (3D-printed model) production system. Essential elements included automated segmentation software, cloud-based interactive communication tools, customized brain models with exquisite expression of brain anatomy in transparent material, adjunctive devices for surgical simulation, and swift process cycles to meet practical needs. A simulated clinical usefulness validation was conducted in which neurosurgeons assessed the usefulness of the 3D-printed models in 10 cases. We successfully produced clinically applicable patient-specific models within 4 days using the established platform. The simulated clinical usefulness validation results revealed the significant superiority of the 3D-printed models in surgical planning regarding surgical posture (p = 0.0147) and craniotomy design (p = 0.0072) compared to conventional magnetic resonance images. The benefit was more noticeable for neurosurgeons with less experience. We established a 3D-printed brain tumor model production system that is ready to use in daily clinical practice for neurosurgery.


Assuntos
Neoplasias Encefálicas/patologia , Simulação por Computador , Imageamento por Ressonância Magnética/métodos , Neurocirurgiões/estatística & dados numéricos , Neurocirurgia/métodos , Impressão Tridimensional/estatística & dados numéricos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Anatômicos , Prognóstico , Estudos Retrospectivos , Adulto Jovem
3.
Heart ; 106(21): 1631-1637, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32727918

RESUMO

OBJECTIVE: Three-dimensional printing (3DP) is a novel technology with applications in healthcare, particularly for congenital heart disease (CHD). We sought to explore the spectrum of use of 3D printed CHD models (3D-CM) and identify knowledge gaps within the published body of literature to guide future research. METHODS: We conducted a scoping review targeting published literature on the use of 3D-CMs. The databases of MEDLINE, EMBASE and Web of Science were searched from their inception until 19 July 2019. Inclusion criteria were primary research; studies reporting use of 3D-CMs; and human subjects. Exclusion criteria were studies where 3D-CMs were generated for proof of concept but not used; and studies focused on bioprinting or computational 3D-CMs. Studies were assessed for inclusion and data were extracted from eligible articles in duplicate. RESULTS: The search returned 648 results. Following assessment, 79 articles were included in the final qualitative synthesis. The majority (66%) of studies are case reports or series. 15% reported use of a control group. Three main areas of utilisation are for (1) surgical and interventional cardiology procedural planning (n=62), (2) simulation (n=25), and (3) education for medical personnel or patients and their families (n=17). Multiple studies used 3D-CMs for more than one of these areas. CONCLUSIONS: 3DP for CHD is a new technology with an evolving literature base. Most of the published literature are experiential reports as opposed to manuscripts on scientifically robust studies. Our study has identified gaps in the literature and addressed priority areas for future research.


Assuntos
Simulação por Computador , Cardiopatias Congênitas/cirurgia , Impressão Tridimensional/estatística & dados numéricos , Humanos
4.
J Am Coll Surg ; 229(6): 552-559.e3, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31493548

RESUMO

BACKGROUND: Lateral pelvic lymph node dissection for rectal cancer is a difficult technique due to the complex pelvic anatomy involved. Three-dimensional (3D) organ models have been introduced as education tools to study anatomy in some fields. In this study, we educated the participants about pelvic anatomy using a 3D model, and evaluated learning efficiency, comparing the outcomes with those using a traditional textbook. STUDY DESIGN: This study was a randomized, controlled, single-center trial conducted between July 2018 and July 2019. A total of 102 participants (34 medical students, 34 residents, and 34 surgeons) were enrolled. Participants were randomly assigned to the 3D model group or the textbook group. First, they completed a short test to confirm their basic knowledge before further education. After collocated education, they completed the same short test again and another long test to evaluate their learning outcomes. RESULTS: Before education, there was no significant difference in the short test scores between the 3D model group and the textbook group. After education, the short and long test scores of the 3D model group were significantly higher than those of the textbook group for students (short test; p = 0.05, long test; p = 0.03), residents (short test; p = 0.05, long test; p = 0.002), and surgeons (short test; p = 0.009, long test; p < 0.001). CONCLUSIONS: Using a 3D pelvic model is superior to using a textbook when learning pelvic anatomy required for lateral pelvic lymph node dissection.


Assuntos
Educação Médica/métodos , Cirurgia Geral/educação , Excisão de Linfonodo/educação , Linfonodos/diagnóstico por imagem , Modelos Anatômicos , Pelve/diagnóstico por imagem , Impressão Tridimensional/estatística & dados numéricos , Feminino , Humanos , Aprendizagem , Masculino , Estudos Retrospectivos , Estudantes de Medicina
5.
Comput Methods Programs Biomed ; 165: 225-233, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30337077

RESUMO

BACKGROUND AND OBJECTIVE: The purpose of the present paper is to pave the road to the systematic optimization of complex craniofacial surgical intervention and to validate a design methodology for the virtual surgery and the fabrication of cranium vault custom plates. Recent advances in the field of medical imaging, image processing and additive manufacturing (AM) have led to new insights in several medical applications. The engineered combination of medical actions and 3D processing steps, foster the optimization of the intervention in terms of operative time and number of sessions needed. Complex craniofacial surgical intervention, such as for instance severe hypertelorism accompanied by skull holes, traditionally requires a first surgery to correctly "resize" the patient cranium and a second surgical session to implant a customized 3D printed prosthesis. Between the two surgical interventions, medical imaging needs to be carried out to aid the design the skull plate. Instead, this paper proposes a CAD/AM-based one-in-all design methodology allowing the surgeons to perform, in a single surgical intervention, both skull correction and implantation. METHODS: A strategy envisaging a virtual/mock surgery on a CAD/AM model of the patient cranium so as to plan the surgery and to design the final shape of the cranium plaque is proposed. The procedure relies on patient imaging, 3D geometry reconstruction of the defective skull, virtual planning and mock surgery to determine the hypothetical anatomic 3D model and, finally, to skull plate design and 3D printing. RESULTS: The methodology has been tested on a complex case study. Results demonstrate the feasibility of the proposed approach and a consistent reduction of time and overall cost of the surgery, not to mention the huge benefits on the patient that is subjected to a single surgical operation. CONCLUSIONS: Despite a number of AM-based methodologies have been proposed for designing cranial implants or to correct orbital hypertelorism, to the best of the authors' knowledge, the present work is the first to simultaneously treat osteotomy and titanium cranium plaque.


Assuntos
Desenho Assistido por Computador , Anormalidades Craniofaciais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Impressão Tridimensional , Cirurgia Assistida por Computador/métodos , Desenho Assistido por Computador/estatística & dados numéricos , Anormalidades Craniofaciais/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Imageamento Tridimensional/estatística & dados numéricos , Modelos Anatômicos , Osteotomia/métodos , Osteotomia/estatística & dados numéricos , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Medicina de Precisão/estatística & dados numéricos , Impressão Tridimensional/estatística & dados numéricos , Desenho de Prótese/estatística & dados numéricos , Procedimentos de Cirurgia Plástica/estatística & dados numéricos , Crânio/diagnóstico por imagem , Crânio/cirurgia , Cirurgia Assistida por Computador/estatística & dados numéricos , Titânio , Interface Usuário-Computador
6.
J Orthop Surg Res ; 13(1): 130, 2018 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-29848357

RESUMO

BACKGROUND: The conventional method of core decompression combined with porous bioceramics rod is usually performed under C-arm fluoroscopy for the treatment of early osteonecrosis of the femoral head (ONFH). This study was to evaluate the clinical value and efficacy of three-dimensional (3D) printing guide plate in the process of core decompression plus porous bioceramics rod for the treatment of early ONFH. METHODS: Forty patients were enrolled, including 20 patients undergoing the surgery with 3D printing guide plate in the experiment group and 20 controls with C-arm fluoroscopy. The following parameters such as surgery time, blood loss, fluoroscopy times, and the accuracy of core decompression for necrosis area, function outcome according to Harris Hip Score (HHS), and any possible complications were recorded and compared between the two groups. All the patients were followed up at 6, 12, and 18 months postoperatively. RESULTS: The surgery time, fluoroscopy time, and intraoperative blood loss in the experiment group was significantly less (P < 0.05) than those in the control group. There was no statistical significance in the accuracy of core decompression and porous bioceramics rod placement between the two groups (P > 0.05). All patients were followed up for 18 months. There was a significant difference between the preoperative and final follow-up HSS scores in both groups (P < 0.05). In addition, there was also a significant difference between the groups in the last follow-up HSS scores (P < 0.05). CONCLUSIONS: Compared with the traditional method, 3D printing guide plate could shorten the surgery time and fluoroscopy times and decrease intraoperative blood loss. It seems to be an effective method in the combined core decompression with porous bioceramics rod placement for early ONFH.


Assuntos
Cerâmica , Descompressão Cirúrgica/métodos , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Impressão Tridimensional , Adulto , Cerâmica/uso terapêutico , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Porosidade , Impressão Tridimensional/estatística & dados numéricos , Resultado do Tratamento
7.
Pesqui. vet. bras ; 38(6): 1178-1183, jun. 2018. graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-955449

RESUMO

An 8 month-old, 10 kg male Azawakh dog was presented due to worsening forelimb gait and exercise intolerance. The right forelimb presented gross angular limb deformity with carpal valgus and radial procurvatum. Surgical planning based on radiographs allowed calculation of the centers of rotation and angularity (CORAs). The computer tomography data were used to generate 3D reconstructions of the antebrachium to aid the detection of the orthopaedic problems. With proper imaging software, the nature of the deformity and its degree were quantified using a previously unreported method based on the CORAs as a 3D printed model of anatomical area of interest. This 3D printed model was used by the surgeon to simulate the surgery with all orthopaedic steps, which included a partial ulna osteotomy and a double cuneiform osteotomy of the radius performed at the level of CORAs and stabilized with bone plates and screws. After 7 weeks, radiographs revealed bone union. At 8 months after surgery the animal presented a complete recovery of the involved forelimb. CORAs method combined with computed tomography and 3D model was useful to plan and simulate surgical procedures, including the corrective surgery of forelimb deformities in a dog which improved the surgical efficiency comparatively to the conventional pre-operative study.(AU)


Um cão com 8 meses de idade, 10kg de peso vivo, macho da raça Azawakh foi apresentado à clínica devido à intolerância ao exercício e agravamento da marcha do membro anterior. O membro anterior direito apresentou uma deformidade angular com valgus carpal e com um procarvatum radial. O planeamento cirúrgico inicialmente baseado em exames radiográficos possibilitou o cálculo dos centros de rotação e angulação articulares (CORAs). O exame de tomografia computadorizada foi utilizado juntamente com um software de imagiologia para obter o modelo 3D virtual da área anatómica de interesse que foi posteriormente impresso em 3D e que permitiu quantificar micrometricamente a deformação óssea presente. Este modelo 3D foi utilizado pelos cirurgiões para executar uma simulação cirúrgica completa que englobou todos os procedimentos cirúrgicos, que incluiu a realização de várias osteotomias e aplicação do material cirúrgico (placas e parafusos). Com base na simulação cirúrgica foi executada a cirurgia ao animal. Decorridas sete semanas, as radiografias demonstraram uma correta regeneração óssea. Oito meses após a cirurgia o animal apresentou uma recuperação completa. O método dos CORAs juntamente com a tomografia computadorizada e com a utilização do modelo 3D revelou-se útil no planeamento e na simulação dos vários procedimentos cirúrgicos, resultando numa melhoria significativa da eficiência cirúrgica.(AU)


Assuntos
Animais , Cães , Cães/anormalidades , Impressão Tridimensional/estatística & dados numéricos , Rádio (Anatomia)/cirurgia
8.
World Neurosurg ; 114: 37-42, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29530693

RESUMO

BACKGROUND: The polymalformative syndromes and craniofacial anomalies association is a well-known phenomenon in patients with Crouzon, Pfeiffer, Apert, or Muenke disease. Recently, other less frequent pathologies, such as Alagille syndrome, have shown an association with alterations in the development of cranial sutures, resulting in serious cosmetic defects and neurologic disorders. CASE DESCRIPTION: We report an exceptional case of a 30-month-old girl, a nephroblastoma survivor diagnosed with Alagille syndrome, who was referred to our department with progressive anterior plagiocephaly and premature left coronal suture closure associated with a large compensating right bossing. Despite the patient's age, we offered aggressive surgical treatment performing a new forehead harvested from the skull vertex with orbital rim reconstruction. CONCLUSIONS: Alagille syndrome is a complex multisystem pathology with a poor craniosynostosis association and only 3 cases have been described in the literature.


Assuntos
Síndrome de Alagille/diagnóstico por imagem , Síndrome de Alagille/cirurgia , Craniossinostoses/diagnóstico por imagem , Craniossinostoses/cirurgia , Plagiocefalia/diagnóstico por imagem , Plagiocefalia/cirurgia , Síndrome de Alagille/complicações , Pré-Escolar , Craniossinostoses/complicações , Feminino , Humanos , Plagiocefalia/complicações , Impressão Tridimensional/estatística & dados numéricos
9.
J Pediatr Surg ; 53(5): 937-941, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29506814

RESUMO

BACKGROUND: Hypertrophic pyloric stenosis (HPS) is a common neonatal condition treated with open or laparoscopic pyloromyotomy. 3D-printed organs offer realistic simulations to practice surgical techniques. The purpose of this study was to validate a 3D HPS stomach model and assess model reliability and surgical realism. METHODS: Medical students, general surgery residents, and adult and pediatric general surgeons were recruited from a single center. Participants were videotaped three times performing a laparoscopic pyloromyotomy using box trainers and 3D-printed stomachs. Attempts were graded independently by three reviewers using GOALS and Task Specific Assessments (TSA). Participants were surveyed using the Index of Agreement of Assertions on Model Accuracy (IAAMA). RESULTS: Participants reported their experience levels as novice (22%), inexperienced (26%), intermediate (19%), and experienced (33%). Interrater reliability was similar for overall average GOALS and TSA scores. There was a significant improvement in GOALS (p<0.0001) and TSA scores (p=0.03) between attempts and overall. Participants felt the model accurately simulated a laparoscopic pyloromyotomy (82%) and would be a useful tool for beginners (100%). CONCLUSION: A 3D-printed stomach model for simulated laparoscopic pyloromyotomy is a useful training tool for learners to improve laparoscopic skills. The GOALS and TSA provide reliable technical skills assessments. LEVEL OF EVIDENCE: II.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Cirurgia Geral/educação , Laparoscopia/educação , Impressão Tridimensional/estatística & dados numéricos , Estenose Pilórica Hipertrófica/cirurgia , Piloromiotomia/educação , Treinamento por Simulação , Feminino , Humanos , Internato e Residência , Masculino , Pediatria , Piloromiotomia/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários
10.
Ann Pharm Fr ; 76(2): 139-146, 2018 Mar.
Artigo em Francês | MEDLINE | ID: mdl-29277367

RESUMO

3D printing plays an increasingly important role in the medical sector and particularly in surgery. Nowadays, numerous manufacturers benefit from this technology to produce their medical devices and some hospitals have also purchased 3D printers. In this context, the aim of the present study was to study the distribution and the use of 3D printing in French hospitals in order to its main features in surgery. By conducting a national survey, we targeted hospitals equipped with 3D printers and those using external providers to benefit from this technology. Forty-seven hospitals were identified as using 3D printing including eight equipped with in-house 3D printers. This work gives us a first picture of 3D printing for hospital use in France and it raises questions about hospital pharmacists' involvement in 3D printed medical device production.


Assuntos
Modelos Anatômicos , Impressão Tridimensional/estatística & dados numéricos , França , Hospitais/estatística & dados numéricos , Humanos , Inquéritos e Questionários
11.
World Neurosurg ; 105: 1032.e13-1032.e17, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28578109

RESUMO

BACKGROUND: Neurosurgery and spine surgery have the potential to benefit from the use of 3-dimensional printing (3DP) technology due to complex anatomic considerations and the delicate nature of surrounding structures. We report a procedure that uses a 3D-printed titanium T9 vertebral body implant post T9 vertebrectomy for a primary bone tumor. CASE DESCRIPTION: A 14-year-old female presented with progressive kyphoscoliosis and a pathologic fracture of the T9 vertebra with sagittal and coronal deformity due to a destructive primary bone tumor. Surgical resection and reconstruction was performed in combination with a 3D-printed, patient-specific implant. Custom design features included porous titanium end plates, corrective angulation of the implant to restore sagittal balance, and pedicle screw holes in the 3D implant to assist with insertion of the device. In addition, attachment of the anterior column construct to the posterior pedicle screw construct was possible due to the customized features of the patient-specific implant. CONCLUSIONS: An advantage of 3DP is the ability to manufacture patient-specific implants, as in the current case example. Additionally, the use of 3DP has been able to reduce operative time significantly. Surgical procedures can be preplanned using 3DP patient-specific models. Surgeons can train before performing complex procedures, which enhances their presurgical planning in order to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomic fit for the patient, with the potential to improve restoration of anatomy.


Assuntos
Procedimentos de Cirurgia Plástica/métodos , Impressão Tridimensional/estatística & dados numéricos , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia , Adolescente , Feminino , Humanos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem
12.
Eur Arch Otorhinolaryngol ; 274(8): 3021-3028, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28540513

RESUMO

With the advent of single-sided hearing loss increasingly being treated with cochlear implantation, bone conduction implants are reserved for cases of conductive and mixed hearing loss with greater complexity. The BoneBridge (BB, MED-EL, Innsbruck, Austria) is an active fully implantable device with no attenuation of sound energy through soft tissue. However, the floating mass transducer (FMT) part of the device is very bulky, which limits insertion in complicated ears. In this study, 3D printed temporal bones of patients were used to study its utility in preoperative planning on complicated cases. Computed tomography (CT) scans of 16 ears were used to 3D print their temporal bones. Three otologists graded the use of routine preoperative planning provided by MED-EL and that of operating on the 3D printed bone of the patient. Data were collated to assess the advantage and disadvantage of the technology. There was a statistically significant benefit in using 3D printed temporal bones to plan surgery for difficult cases of BoneBridge surgery compared to the current standard. Surgeons preferred to have the printed bones in theatre to plan their drill sites and make the transition of the planning to the patient's operation more precise. 3D printing is an innovative use of technology in the use of preoperative planning for complex ear surgery. Surgical planning can be done on the patient's own anatomy which may help to decrease operating time, reduce cost, increase surgical precision and thus reduce complications.


Assuntos
Implante Coclear , Auxiliares de Audição , Perda Auditiva Condutiva/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Impressão Tridimensional/estatística & dados numéricos , Osso Temporal/diagnóstico por imagem , Adulto , Austrália , Implante Coclear/efeitos adversos , Implante Coclear/métodos , Feminino , Humanos , Masculino , Planejamento de Assistência ao Paciente/normas , Desenho de Prótese , Ajuste de Prótese/métodos , Melhoria de Qualidade , Tomografia Computadorizada por Raios X/métodos
13.
J Appl Clin Med Phys ; 18(1): 76-81, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28291910

RESUMO

This work describes the use of 3D printing technology to create individualized boluses for patients treated with electron beam therapy for skin lesions of the eye canthi. It aimed to demonstrate the effectiveness of 3D-printed over manually fabricated paraffin boluses. The study involved 11 patients for whom the construction of individual boluses were required. CT scans of the fabricated 3D-printed boluses and paraffin boluses were acquired and superimposed onto patient CT scans to compare their fitting, bolus homogeneity, and underlying dose distribution. To quantify the level of matching, multiple metrics were utilized. Matching Level Index (ML) values ranged from 0 to 100%, where 100% indicated a perfect fit between the reference bolus (planned in treatment planning system) and 3D-printed and paraffin bolus. The average ML (± 1 SD) of the 3D-printed boluses was 95.1 ± 2.1%, compared to 46.0 ± 10.1% for the manually fabricated paraffin bolus. Correspondingly, mean doses were closer to the prescribed doses, and dose spreads were less for the dose distributions from the 3D-printed boluses, as compared to those for the manually fabricated paraffin boluses. It was concluded that 3D-printing technology is a viable method for fabricating boluses for small eye lesions and provides boluses superior to our boluses manually fabricated from paraffin sheets.


Assuntos
Carcinoma Basocelular/radioterapia , Carcinoma de Células Escamosas/radioterapia , Elétrons/uso terapêutico , Oftalmopatias/radioterapia , Impressão Tridimensional/estatística & dados numéricos , Dermatopatias/radioterapia , Humanos , Impressão Tridimensional/instrumentação , Garantia da Qualidade dos Cuidados de Saúde , Dosagem Radioterapêutica
14.
J Neurointerv Surg ; 9(8): 0, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27405312

RESUMO

BACKGROUND: Computational modeling of intracranial aneurysms provides insights into the influence of hemodynamics on aneurysm growth, rupture, and treatment outcome. Standard modeling of coiled aneurysms simplifies the complex geometry of the coil mass into a homogeneous porous medium that fills the aneurysmal sac. We compare hemodynamics of coiled aneurysms modeled from high-resolution imaging with those from the same aneurysms modeled following the standard technique, in an effort to characterize sources of error from the simplified model. MATERIALS: Physical models of two unruptured aneurysms were created using three-dimensional printing. The models were treated with coil embolization using the same coils as those used in actual patient treatment and then scanned by synchrotron X-ray microtomography to obtain high-resolution imaging of the coil mass. Computational modeling of each aneurysm was performed using patient-specific boundary conditions. The coils were modeled using the simplified porous medium or by incorporating the X-ray imaged coil surface, and the differences in hemodynamic variables were assessed. RESULTS: X-ray microtomographic imaging of coils and incorporation into computational models were successful for both aneurysms. Porous medium calculations of coiled aneurysm hemodynamics overestimated intra-aneurysmal flow, underestimated oscillatory shear index and viscous dissipation, and over- or underpredicted wall shear stress (WSS) and WSS gradient compared with X-ray-based coiled computational fluid dynamics models. CONCLUSIONS: Computational modeling of coiled intracranial aneurysms using the porous medium approach may inaccurately estimate key hemodynamic variables compared with models incorporating high-resolution synchrotron X-ray microtomographic imaging of complex aneurysm coil geometry.


Assuntos
Simulação por Computador , Hidrodinâmica , Aneurisma Intracraniano/diagnóstico por imagem , Impressão Tridimensional , Síncrotrons , Microtomografia por Raio-X/métodos , Prótese Vascular/estatística & dados numéricos , Simulação por Computador/estatística & dados numéricos , Procedimentos Endovasculares/métodos , Procedimentos Endovasculares/estatística & dados numéricos , Hemodinâmica/fisiologia , Humanos , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/terapia , Porosidade , Impressão Tridimensional/estatística & dados numéricos , Síncrotrons/estatística & dados numéricos , Microtomografia por Raio-X/estatística & dados numéricos
15.
Cesk Slov Oftalmol ; 72(3): 80-84, 2016.
Artigo em Tcheco | MEDLINE | ID: mdl-27658975

RESUMO

Nowadays 3D printing allows us to create physical objects on the basis of digital data. Thanks to its rapid development the use enormously increased in medicine too. Its creations facilitate surgical planning processes, education and research in context of organ transplantation, individualization prostheses, breast forms, and others.Our article describes the wide range of applied 3D printing technology possibilities in ophthalmology. It is focusing on innovative implementation of eye tumors treatment planning in stereotactic radiosurgery irradiation.We analyze our first experience with 3D printing model of the eye in intraocular tumor planning stereotactic radiosurgery. KEY WORDS: 3D printing, model, Fused Deposition Modelling, stereotactic radiosurgery, prostheses, intraocular tumor.


Assuntos
Neoplasias Oculares/radioterapia , Impressão Tridimensional/estatística & dados numéricos , Radiocirurgia/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética , Modelos Biológicos , Oftalmologia , Planejamento da Radioterapia Assistida por Computador
16.
Biofabrication ; 8(2): 022001, 2016 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-27321137

RESUMO

Microfluidics is a flourishing field, enabling a wide range of biochemical and clinical applications such as cancer screening, micro-physiological system engineering, high-throughput drug testing, and point-of-care diagnostics. However, fabrication of microfluidic devices is often complicated, time consuming, and requires expensive equipment and sophisticated cleanroom facilities. Three-dimensional (3D) printing presents a promising alternative to traditional techniques such as lithography and PDMS-glass bonding, not only by enabling rapid design iterations in the development stage, but also by reducing the costs associated with institutional infrastructure, equipment installation, maintenance, and physical space. With the recent advancements in 3D printing technologies, highly complex microfluidic devices can be fabricated via single-step, rapid, and cost-effective protocols, making microfluidics more accessible to users. In this review, we discuss a broad range of approaches for the application of 3D printing technology to fabrication of micro-scale lab-on-a-chip devices.


Assuntos
Microfluídica/instrumentação , Impressão Tridimensional , Desenho de Equipamento , Dispositivos Lab-On-A-Chip , Impressão Tridimensional/instrumentação , Impressão Tridimensional/estatística & dados numéricos
17.
Biofabrication ; 8(2): 025003, 2016 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-27108484

RESUMO

Three dimensional (3D) printing has emerged as an efficient tool for tissue engineering and regenerative medicine, given its advantages for constructing custom-designed scaffolds with tunable microstructure/physical properties. Here we developed a micro-precise spatiotemporal delivery system embedded in 3D printed scaffolds. PLGA microspheres (µS) were encapsulated with growth factors (GFs) and then embedded inside PCL microfibers that constitute custom-designed 3D scaffolds. Given the substantial difference in the melting points between PLGA and PCL and their low heat conductivity, µS were able to maintain its original structure while protecting GF's bioactivities. Micro-precise spatial control of multiple GFs was achieved by interchanging dispensing cartridges during a single printing process. Spatially controlled delivery of GFs, with a prolonged release, guided formation of multi-tissue interfaces from bone marrow derived mesenchymal stem/progenitor cells (MSCs). To investigate efficacy of the micro-precise delivery system embedded in 3D printed scaffold, temporomandibular joint (TMJ) disc scaffolds were fabricated with micro-precise spatiotemporal delivery of CTGF and TGFß3, mimicking native-like multiphase fibrocartilage. In vitro, TMJ disc scaffolds spatially embedded with CTGF/TGFß3-µS resulted in formation of multiphase fibrocartilaginous tissues from MSCs. In vivo, TMJ disc perforation was performed in rabbits, followed by implantation of CTGF/TGFß3-µS-embedded scaffolds. After 4 wks, CTGF/TGFß3-µS embedded scaffolds significantly improved healing of the perforated TMJ disc as compared to the degenerated TMJ disc in the control group with scaffold embedded with empty µS. In addition, CTGF/TGFß3-µS embedded scaffolds significantly prevented arthritic changes on TMJ condyles. In conclusion, our micro-precise spatiotemporal delivery system embedded in 3D printing may serve as an efficient tool to regenerate complex and inhomogeneous tissues.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Células-Tronco Mesenquimais/citologia , Impressão Tridimensional/estatística & dados numéricos , Articulação Temporomandibular/fisiopatologia , Animais , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Fator de Crescimento do Tecido Conjuntivo/metabolismo , Fator de Crescimento do Tecido Conjuntivo/farmacologia , Sistemas de Liberação de Medicamentos/instrumentação , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/metabolismo , Coelhos , Regeneração , Articulação Temporomandibular/lesões , Articulação Temporomandibular/metabolismo , Engenharia Tecidual/instrumentação , Alicerces Teciduais/química , Fator de Crescimento Transformador beta3/metabolismo , Fator de Crescimento Transformador beta3/farmacologia
18.
Ned Tijdschr Tandheelkd ; 123(1): 19-23, 2016 Jan.
Artigo em Holandês | MEDLINE | ID: mdl-26780333

RESUMO

A 22-year old male was referred to the Department of Oral and Maxillofacial Surgery of a university clinic 2 months after he had sustained multiple traumatic injuries abroad because of an anterior malocclusion. The malocclusion was the sequel of an unrecognised, untreated, already consolidated paramedian mandibular fracture on the right and a fracture of the contralateral mandibular angle on the left. Preoperatively, a cobalt-chrome 3D-printed dental splint was prepared. Surgical correction of the malocclusion was carried out by segmental osteotomies of the mandible at the original fracture sites. This involved a vertical paramedian osteotomy on the right side and a unilateral sagittal split osteotomy on the left mandibular angle side. The mandibular segment was mobilised in the correct occlusion with the aid of the 3D-printed dental splint. The splint was fixed to the teeth with dental composite. The custom made 3D-printed dental splint is considered a promising procedural innovation in oral and maxillofacial surgery.


Assuntos
Má Oclusão/cirurgia , Fraturas Mandibulares/cirurgia , Placas Oclusais , Impressão Tridimensional/estatística & dados numéricos , Humanos , Masculino , Má Oclusão/etiologia , Fraturas Mandibulares/complicações , Adulto Jovem
20.
Integr Biol (Camb) ; 7(9): 1068-78, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26190039

RESUMO

While cancer cell invasion and metastasis are dependent on cancer cell-stroma, cancer cell-blood vessel, and cancer cell-lymphatic vessel interactions, our understanding of these interactions remain largely unknown. A need exists for physiologically-relevant models that more closely mimic the complexity of cancer cell dynamics in a real tissue environment. The objective of this study was to combine laser-based cell printing and tissue culture methods to create a novel ex vivo model in which cancer cell dynamics can be tracked during angiogenesis in an intact microvascular network. Laser direct-write (LDW) was utilized to reproducibly deposit breast cancer cells (MDA-MB-231 and MCF-7) and fibroblasts into spatially-defined patterns on cultured rat mesenteric tissues. In addition, heterogeneous patterns containing co-printed MDA-MB-231/fibroblasts or MDA-MB-231/MCF-7 cells were generated for fibroblast-directed and collective cell invasion models. Printed cells remained viable and the cells retained the ability to proliferate in serum-rich media conditions. Over a culture period of five days, time-lapse imaging confirmed fibroblast and MDA-MB-231 cell migration within the microvascular networks. Confocal microscopy indicated that printed MDA-MB-231 cells infiltrated the tissue thickness and were capable of interacting with endothelial cells. Angiogenic network growth in tissue areas containing printed cancer cells was characterized by significantly increased capillary sprouting compared to control tissue areas containing no printed cells. Our results establish an innovative ex vivo experimental platform that enables time-lapse evaluation of cancer cell dynamics during angiogenesis within a real microvascular network scenario.


Assuntos
Separação Celular/instrumentação , Microvasos/fisiopatologia , Neoplasias Experimentais/patologia , Neoplasias Experimentais/fisiopatologia , Neovascularização Patológica/patologia , Neovascularização Patológica/fisiopatologia , Animais , Movimento Celular , Separação Celular/métodos , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Células MCF-7 , Mesentério/fisiopatologia , Invasividade Neoplásica , Impressão Tridimensional/estatística & dados numéricos , Ratos
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