176 results on '"Pekkan K"'
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2. Production of opaque frits with low ZrO2 and ZnO contents and their industrial uses for fast single-fired wall tile glazes
- Author
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Pekkan, K. and Karasu, B.
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- 2009
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3. Real-World Variability in the Prediction of Intracranial Aneurysm Wall Shear Stress: The 2015 International Aneurysm CFD Challenge
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Universitat Rovira i Virgili, Valen-Sendstad K; Bergersen AW; Shimogonya Y; Goubergrits L; Bruening J; Pallares J; Cito S; Piskin S; Pekkan K; Geers AJ; Larrabide I; Rapaka S; Mihalef V; Fu W; Qiao A; Jain K; Roller S; Mardal KA; Kamakoti R; Spirka T; Ashton N; Revell A; Aristokleous N; Houston JG; Tsuji M; Ishida F; Menon PG; Browne LD; Broderick S; Shojima M; Koizumi S; Barbour M; Aliseda A; Morales HG; Lefèvre T; Hodis S; Al-Smadi YM; Tran JS; Marsden AL; Vaippummadhom S; Valen-Sendstad K; Bergersen AW; Shimogonya Y; Goubergrits L; Bruening J; Pallares J; Cito S; Piskin S; Pekkan K; Geers AJ; Larrabide I; Rapaka S; Mihalef V; Fu W; Qiao A, Universitat Rovira i Virgili, and Valen-Sendstad K; Bergersen AW; Shimogonya Y; Goubergrits L; Bruening J; Pallares J; Cito S; Piskin S; Pekkan K; Geers AJ; Larrabide I; Rapaka S; Mihalef V; Fu W; Qiao A; Jain K; Roller S; Mardal KA; Kamakoti R; Spirka T; Ashton N; Revell A; Aristokleous N; Houston JG; Tsuji M; Ishida F; Menon PG; Browne LD; Broderick S; Shojima M; Koizumi S; Barbour M; Aliseda A; Morales HG; Lefèvre T; Hodis S; Al-Smadi YM; Tran JS; Marsden AL; Vaippummadhom S; Valen-Sendstad K; Bergersen AW; Shimogonya Y; Goubergrits L; Bruening J; Pallares J; Cito S; Piskin S; Pekkan K; Geers AJ; Larrabide I; Rapaka S; Mihalef V; Fu W; Qiao A
- Abstract
© 2018, The Author(s). Purpose: Image-based computational fluid dynamics (CFD) is widely used to predict intracranial aneurysm wall shear stress (WSS), particularly with the goal of improving rupture risk assessment. Nevertheless, concern has been expressed over the variability of predicted WSS and inconsistent associations with rupture. Previous challenges, and studies from individual groups, have focused on individual aspects of the image-based CFD pipeline. The aim of this Challenge was to quantify the total variability of the whole pipeline. Methods: 3D rotational angiography image volumes of five middle cerebral artery aneurysms were provided to participants, who were free to choose their segmentation methods, boundary conditions, and CFD solver and settings. Participants were asked to fill out a questionnaire about their solution strategies and experience with aneurysm CFD, and provide surface distributions of WSS magnitude, from which we objectively derived a variety of hemodynamic parameters. Results: A total of 28 datasets were submitted, from 26 teams with varying levels of self-assessed experience. Wide variability of segmentations, CFD model extents, and inflow rates resulted in interquartile ranges of sac average WSS up to 56%, which reduced to < 30% after normalizing by parent artery WSS. Sac-maximum WSS and low shear area were more variable, while rank-ordering of cases by low or high shear showed only modest consensus among teams. Experience was not a significant predictor of variability. Conclusions: Wide variability exists in the prediction of intracranial aneurysm WSS. While segmentation and CFD solver techniques may be difficult to standardize across groups, our findings suggest that some of the variability in image-based CFD could be reduced by esta
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- 2018
4. Endothelial shear stress and vascular remodeling in bioresorbable scaffold and metallic stent
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Tenekecioglu, E, Katagiri, Y. (Yuki), Takahashi, K. (Kuniaki), Tomaniak, M., Dudek, D. (Dariusz), Cequier, A. (Angel), Carrié, D., Iñiguez, A., van der Schaaf, R, Dominici, M, Boven, A.J. (Ad) van, Helqvist, S. (Steffen), Sabaté, M., Baumbach, A. (Andreas), Piek, J.J. (Jan), Wykrzykowska, J.J. (Joanna), Kitslaar, P, Dijkstra, J. (Jouke), Reiber, JHC, Chevalier, B. (Bernard), Ural, D., Pekkan, K., Bourantas, CV, Gijsen, F.J.H. (Frank), Onuma, Y. (Yoshinobu), Torii, K. (Kan), Serruys, P.W.J.C. (Patrick), Tenekecioglu, E, Katagiri, Y. (Yuki), Takahashi, K. (Kuniaki), Tomaniak, M., Dudek, D. (Dariusz), Cequier, A. (Angel), Carrié, D., Iñiguez, A., van der Schaaf, R, Dominici, M, Boven, A.J. (Ad) van, Helqvist, S. (Steffen), Sabaté, M., Baumbach, A. (Andreas), Piek, J.J. (Jan), Wykrzykowska, J.J. (Joanna), Kitslaar, P, Dijkstra, J. (Jouke), Reiber, JHC, Chevalier, B. (Bernard), Ural, D., Pekkan, K., Bourantas, CV, Gijsen, F.J.H. (Frank), Onuma, Y. (Yoshinobu), Torii, K. (Kan), and Serruys, P.W.J.C. (Patrick)
- Abstract
Background and aims: The impact of endothelial shear stress (ESS) on vessel remodeling in vessels implanted with bioresorbable scaffold (BRS) as compared to metallic drug-eluting stent (DES) remains elusive. The aim of this study was to determine whether the relationship between ESS and remodeling patterns differs in BRS from those seen in metallic DES at 3-year follow-up. Methods: In the ABSORB II randomized trial, lesions were investigated by serial coronary angiography and intravascular ultrasound (IVUS). Three-dimensional reconstructions of coronary arteries post-procedure and at 3 years were performed. ESS was quantified using non-Newtonian steady flow simulation. IVUS cross-sections in device segment were matched using identical landmarks. Results: Paired ESS calculations post-procedure and at 3 years were feasible in 57 lesions in 56 patients. Postprocedure, median ESS at frame level was higher in BRS than in DES, with marginal statistical significance (0.97 ± 0.48 vs. 0.75 ± 0.39 Pa, p = 0.063). In the BRS arm, vessel area and lumen area showed larger increases in the highest tercile of median ESS post-procedure as compared to the lowest tercile. In contrast, in DES, no significant relationship between median ESS post-procedure and remodeling was observed. In multivariate analysis, smaller vessel area, larger lumen area, higher plaque burden post-procedure, and higher median ESS post-procedure were independently associated with expansive remodeling in matched frames. Only in BRS, younger age was an additional significant predictor of expansive remodeling. Conclusions: In a subset of lesions with large plaque burden, shear stress could be associated with expansive remodeling and late lumen enlargement in BRS, while ESS had no impact on vessel dimension in metallic DES.
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- 2020
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5. The impact of plaque type on strut embedment/protrusion and shear stress distribution in bioresorbable scaffold
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Torii, K. (Kan), Tenekecioglu, E. (Erhan), Katagiri, Y. (Yuki), Chichareon, P. (Ply), Sotomi, Y. (Yohei), Dijkstra, J. (Jouke), Asano, T. (Taku), Modolo, R. (Rodrigo), Takahashi, K. (Kuniaki), Jonker, H. (Hans), Geuns, R.J.M. (Robert Jan) van, Onuma, Y. (Yoshinobu), Pekkan, K. (Kerem), Bourantas, C.V. (Christos), Serruys, P.W.J.C. (Patrick), Torii, K. (Kan), Tenekecioglu, E. (Erhan), Katagiri, Y. (Yuki), Chichareon, P. (Ply), Sotomi, Y. (Yohei), Dijkstra, J. (Jouke), Asano, T. (Taku), Modolo, R. (Rodrigo), Takahashi, K. (Kuniaki), Jonker, H. (Hans), Geuns, R.J.M. (Robert Jan) van, Onuma, Y. (Yoshinobu), Pekkan, K. (Kerem), Bourantas, C.V. (Christos), and Serruys, P.W.J.C. (Patrick)
- Abstract
AIMS: Scaffold design and plaque characteristics influence implantation outcomes and local flow dynamics in treated coronary segments. Our aim is to assess the impact of strut embedment/protrusion of bioresorbable scaffold on local shear stress distribution in different atherosclerotic plaque types. METHODS AND RESULTS: Fifteen Absorb everolimus-eluting Bioresorbable Vascular Scaffolds were implanted in human epicardial coronary arteries. Optical coherence tomography (OCT) was performed post-scaffold implantation and strut embedment/protrusion were analysed using a dedicated software. OCT data were fused with angiography to reconstruct 3D coronary anatomy. Blood flow simulation was performed and wall shear stress (WSS) was estimated in each scaffolded surface and the relationship between strut embedment/protrusion and WSS was evaluated. There were 9083 struts analysed. Ninety-seven percent of the struts (n = 8840) were well-apposed and 243 (3%) were malapposed. At cross-section level (n = 1289), strut embedment was significantly increased in fibroatheromatous plaques (76 ± 48 µm) and decreased in fibrocalcific plaques (35 ± 52 µm). Compatible with strut embedment, WSS was significantly higher in lipid-rich fibroatheromatous plaques (1.50 ± 0.81 Pa), whereas significantly decreased in fibrocalcified plaques (1.05 ± 0.91 Pa). After categorization of WSS as low (<1.0 Pa) and normal/high WSS (≥1.0 Pa), the percent of low WSS in the plaque subgroups were 30.1%, 31.1%, 25.4%, and 36.2% for non-diseased vessel wall, fibrous plaque, fibroatheromatous plaque, and fibrocalcific plaque, respectively (P-overall < 0.001). CONCLUSION: The composition of the underlying plaque influences strut embedment which seems to have effect on WSS. The struts deeply embedded in lipid-rich fibroatheromas plaques resulted in higher WSS compared with the other plaque types.
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- 2020
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6. The impact of plaque type on strut embedment/protrusion and shear stress distribution in bioresorbable scaffold
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Torii, R, Tenekecioglu, E, Katagiri, Y, Chichareon, P, Sotomi, Y, Dijkstra, J (Jouke), Asano, T, Modolo, R, Takahashi, K, Jonker, H, Jan van Geuns, R, Onuma, Yoshinobu, Pekkan, K, Bourantas, Christos, Serruys, PWJC (Patrick), Torii, R, Tenekecioglu, E, Katagiri, Y, Chichareon, P, Sotomi, Y, Dijkstra, J (Jouke), Asano, T, Modolo, R, Takahashi, K, Jonker, H, Jan van Geuns, R, Onuma, Yoshinobu, Pekkan, K, Bourantas, Christos, and Serruys, PWJC (Patrick)
- Published
- 2020
7. Two-dimensional flow and [NO.sub.x] emissions in deflagrative internal combustion wave rotor configurations
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Pekkan, K. and Nalim, M.R.
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Rotors -- Research ,Engineering and manufacturing industries ,Science and technology - Abstract
A wave rotor is proposed for use as a constant volume combustor. A novel design feature is investigated as a remedy for hot gas leakage, premature ignition, and pollutant emissions that are possible in this class of unsteady machines. The base geometry involves fuel injection partitions that allow stratification of fuel/oxidizer mixtures in the wave rotor channel radially, enabling pilot ignition of overall lean mixture for low [NO.sub.x] combustion. In this study, available turbulent combustion models are applied to simulate approximately constant volume combustion of propane and resulting transient compressible flow. Thermal NO production histories are predicted by simulations of the STAR-CD code. Passage inlet/outlet/wall boundary conditions are time-dependent, enabling the representation of a typical deflagrative internal combustor wave rotor cycle. Some practical design improvements are anticipated from the computational results. For a large number of derivative design configurations, fuel burn rate, two-dimensional flow and emission levels are evaluated. The sensitivity of channel combustion to initial turbulence levels is evaluated. [DOI: 10.1115/1.1586315]
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- 2003
8. VAD STRATEGIES FOR FONTAN CIRCULATION: IN VITRO EVALUATION: P9
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Dur, O., Lara, M., Vandenberghe, S., Keller, B., Arnold, D., and Pekkan, K.
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- 2009
9. P5631The impact of plaque type on strut embedment/protrusion and shear stress distribution in bioresorbable scaffold
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Tenekecioglu, E, primary, Torii, R, additional, Katagiri, Y, additional, Dijkstra, J, additional, Modolo, R, additional, Pekkan, K, additional, Bourantas, C, additional, and Serruys, P W, additional
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- 2019
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10. P5629The effect of strut protrusion on local shear stress and neointimal hyperplasia
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Tenekecioglu, E, primary, Katagiri, Y, additional, Torii, R, additional, Pekkan, K, additional, Onuma, Y, additional, and Serruys, P W, additional
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- 2019
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11. Post-implantation shear stress assessment: an emerging tool for differentiation of bioresorbable scaffolds
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Tenekecioglu, E. (Erhan), Torii, K. (Kan), Katagiri, Y. (Yuki), Chichareon, P. (Ply), Asano, T. (Taku), Miyazaki, Y. (Yosuke), Takahashi, K. (Kuniaki), Modolo, R. (Rodrigo), Al-Lamee, R. (Rasha), Al-Lamee, K. (Kadem), Colet, C. (Carlos), Reiber, J.H.C. (Johan), Pekkan, K. (Kerem), Geuns, R.J.M. (Robert Jan) van, Bourantas, C.V. (Christos), Onuma, Y. (Yoshinobu), Serruys, P.W.J.C. (Patrick), Tenekecioglu, E. (Erhan), Torii, K. (Kan), Katagiri, Y. (Yuki), Chichareon, P. (Ply), Asano, T. (Taku), Miyazaki, Y. (Yosuke), Takahashi, K. (Kuniaki), Modolo, R. (Rodrigo), Al-Lamee, R. (Rasha), Al-Lamee, K. (Kadem), Colet, C. (Carlos), Reiber, J.H.C. (Johan), Pekkan, K. (Kerem), Geuns, R.J.M. (Robert Jan) van, Bourantas, C.V. (Christos), Onuma, Y. (Yoshinobu), and Serruys, P.W.J.C. (Patrick)
- Abstract
Optical coherence tomography based computational flow dynamic (CFD) modeling provides detailed information about the local flow behavior in stented/scaffolded vessel segments. Our aim is to investigate the in-vivo effect of strut thickness and strut protrusion on endothelial wall shear stress (ESS) distribution in ArterioSorb Absorbable Drug-Eluting Scaffold (ArterioSorb) and Absorb everolimus-eluting Bioresorbable Vascular Scaffold (Absorb) devices that struts with similar morphology (quadratic structure) but different thickness. In three animals, six coronary arteries were treated with ArterioSorb. At different six animals, six coronary arteries were treated with Absorb. Following three-dimensional(3D) reconstruction of the coronary arteries, Newtonian steady flow simulation was performed and the ESS were estimated. Mixed effects models were used to compare ESS distribution in the two devices. There were 4591 struts in the analyzed 477 cross-sections in Absorb (strut thickness = 157 µm) and 3105 struts in 429 cross-sections in ArterioSorb (strut thickness = 95 µm) for the protrusion analysis. In cross-section level analysis, there was significant difference between the scaffolds in the protrusion distances. The protrusion was higher in Absorb (97% of the strut thickness) than in ArterioSorb (88% of the strut thickness). ESS was significantly higher in ArterioSorb (1.52 ± 0.34 Pa) than in Absorb (0.73 ± 2.19 Pa) (p = 0.001). Low- and very-low ESS data were seen more often in Absorb than in ArterioSorb. ArterioSorb is associated with a more favorable ESS distribution compared to the Absorb. These differences should be attributed to different strut thickness/strut protrusion that has significant effect on shear stress distribution.
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- 2018
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12. 419 A Patient-Specific Lumped Parameter Model of Human Penile Erection
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Pekkan, K., primary, Erturk, H., additional, Culha, M.G., additional, and Serefoglu, E.C., additional
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- 2017
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13. The effect of ZnO on development of crystals in crystal glaze applications [Kristal sir uygulamalarinda ZnO'in kristal sir gelişimine etkisi]
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Pekkan K., Taşçi E., and Gün Y.
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Frit ,ZnO ,Crystalline glaze - Abstract
Crystalline glaze is one of the most important artistic glaze types to have visual effect in art ceramic field. It has micro or macro crystals inside or on the surface of glass phases where macro crystals occur being embedded inside the glaze and micro ones form as bunches on the glaze surface. The smallest element forming these bunches is called core, coming together in melted glaze and forming macro crystals. The glaze has the elements to improve crystallization in the primary mixture. After the development of the mixture, glaze crystallized slowly. Crystals can be formed in the same or different colours. This study is intended to investigate the effect of ZnO addition on crystalline formation and development inside the frit mixtures prepared in various ratios. The crystalline developments were inspected and defined with characterization techniques in the best crystal mixture. XRD phase analysis method was used to analyze the phase development of frit compositions and glaze applications. Crystals were visualized by polarized optical microscope, and microstructural analyses were done with SEM-EDX. Willemite crystals are formed during glaze firing cycles instead of frit preparation step. Successful crystal glaze surfaces are obtained by fritted recipes of ZnO-Na2O-SiO2 (ZNS) and ZnO-Na2O-SiO2-Al2O3 (ZNSA) glaze systems.
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- 2015
14. Outcomes of the ninth international conference on pediatric mechanical circulatory support systems and pediatric cardiopulmonary perfusion
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Ündar, A, Wang, S, Palanzo, D, Weaver, B, Pekkan, K, Agirbasli, M, Zahn, Jd, Luciani, GIOVANNI BATTISTA, Clark, Jb, Wilson, Rp, Kunselman, Ar, Sano, S, Belli, E, Pierce, Ws, and Myers, J. L.
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Extracorporeal life support ,pediatric cardiac surgery ,90399 Biomedical Engineering not elsewhere classified ,FOS: Medical engineering - Abstract
The overall objective of this annual conference remains to bring together internationally known clinicians, bioengineers, and basic scientists involved in research on pediatric mechanical circulatory support (MCS) systems and pediatric cardiopulmonary bypass (CPB) procedures.The main focus is to explicitly describe the problems with current pediatric MCS systems, methods, and techniques during acute and chronic support, and to suggest solutions and future directions for research. During the past 9 years, the main focus has not changed but has given the highest possible educational opportunities to the diverse participants. More hands-on wet labs and simulations with the newest devices and techniques have been added (1,2).
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- 2014
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15. Characterizaton of the vessel geometry, flow mechanics and wall shear stress in the great arteries of wildtype prenatal mouse
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Yap, CH, Liu, X, Pekkan, K, Yap, CH, Liu, X, and Pekkan, K
- Abstract
Introduction: Abnormal fluid mechanical environment in the pre-natal cardiovascular system is hypothesized to play a significant role in causing structural heart malformations. It is thus important to improve our understanding of the prenatal cardiovascular fluid mechanical environment at multiple developmental time-points and vascular morphologies. We present such a study on fetal great arteries on the wildtype mouse from embryonic day 14.5 (E14.5) to near-term (E18.5). Methods: Ultrasound bio-microscopy (UBM) was used to measure blood velocity of the great arteries. Subsequently, specimens were cryo-embedded and sectioned using episcopic fluorescent image capture (EFIC) to obtain high-resolution 2D serial image stacks, which were used for 3D reconstructions and quantitative measurement of great artery and aortic arch dimensions. EFIC and UBM data were input into subject-specific computational fluid dynamics (CFD) for modeling hemodynamics. Results: In normal mouse fetuses between E14.5-18.5, ultrasound imaging showed gradual but statistically significant increase in blood velocity in the aorta, pulmonary trunk (with the ductus arteriosus ), and descending aorta. Measurement by EFIC imaging displayed a similar increase in cross sectional area of these vessels. However, CFD modeling showed great artery average wall shear stress and wall shear rate remain relatively constant with age and with vessel size, indicating that hemodynamic shear had a relative constancy over gestational period considered here. Conclusion: Our EFIC-UBM-CFD method allowed reasonably detailed characterization of fetal mouse vascular geometry and fluid mechanics. Our results suggest that a homeostatic mechanism for restoring vascular wall shear magnitudes may exist during normal embryonic development. We speculate that this mechanism regulates the growth of the great vessels. © 2014 Yap et al.
- Published
- 2014
16. Production and industrial adaptation of fast single firing wall tile opaque glass-ceramic glazes containing borax solid wastes
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Pekkan, K. K., Karasu, Bekir, Küçük, A., Anadolu Üniversitesi, Mühendislik Fakültesi, Malzeme Bilimi ve Mühendisliği Bölümü, and Karasu, Bekir
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Wall Tiles ,Borax Solid Wastes ,Industrial Adaptation ,Glass-Ceramic Glazes ,Evaluation - Abstract
2008 Global Symposium on Recycling, Waste Treatment and Clean Technology, REWAS 2008 -- 12 October 2008 through 15 October 2008 -- Cancun -- 75513, Zircon (zirconium silicate) is the main opacifier of glossy, opaque, white colored, frit-based wall tile glazes. However, zirconia containing frits employed in the preparation of these glazes increase the production cost and therefore, limit zircon usage as a raw material at industrial scale. With the present study, it was searched whether borax solid wastes could be evaluated as a component in the starting relevant frit recipes. The wastes were obtained from Eti Maden Kirka Boron Company of Turkiye. Frit production, glaze preparation, application, and fast single-firing of glazed wall tiles were conducted under laboratory working conditions in Anadolu University, Department of Materials Science and Engineering laboratories. Beside standard tests applied to the final glazed wall tiles, color and gloss analyses of the fired glazes were conducted with a spectrophoto-meter and a gloss-meter. Characterization of these newly produced glass-ceramic glazes was made by X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) techniques.
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- 2008
17. Experimental and computational investigation of the patient-specific abdominal aortic aneurysm pressure field
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Antón, R., primary, Chen, C.-Y., additional, Hung, M.-Y., additional, Finol, E.A., additional, and Pekkan, K., additional
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- 2014
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18. Zircon-free frits suitable for single fast-firing opaque wall tile glazes and their industrial productions
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Pekkan, K., primary and Karasu, B., additional
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- 2009
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19. A New Method for Registration-Based Medical Image Interpolation
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Frakes, D.H., primary, Dasi, L.P., additional, Pekkan, K., additional, Kitajima, H.D., additional, Sundareswaran, K., additional, Yoganathan, A.P., additional, and Smith, M.J.T., additional
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- 2008
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20. Experimental and computational investigation of the patient-specific abdominal aortic aneurysm pressure field.
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Antón, R., Chen, C.-Y., Hung, M.-Y., Finol, E.A., and Pekkan, K.
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AORTIC aneurysms ,ANEURYSMS ,VASCULAR diseases ,CARDIAC aneurysms ,DISSECTING aneurysms ,PRESSURE regulators - Abstract
The objective of the present manuscript is three-fold: (i) to study the detailed pressure field inside a patient-specific abdominal aortic aneurysm (AAA) model experimentally and numerically and discuss its clinical relevance, (ii) to validate a number of possible numerical model options and their ability to predict the experimental pressure field and (iii) to compare the spatial pressure drop in the AAA before and after the formation of intraluminal thrombus (ILT) for a late disease development timeline. A finite volume method was used to solve the governing equations of fluid flow to simulate the flow dynamics in a numerical model of the AAA. Following our patient-specific anatomical rapid prototyping technique, physical models of the aneurysm were created with seven ports for pressure measurement along the blood flow path. A flow loop operating with a blood analogue fluid was used to replicate the patient-specific flow conditions, acquired with phase-contrast magnetic resonance imaging, and measure pressure in the flow model. The Navier–Stokes equations and two turbulent models were implemented numerically to compare the pressure estimations with experimental measurements. The relative pressure difference from experiments obtained with the best performing model (unsteady laminar simulation) was ∼1.1% for the AAA model without ILT and ∼15.4% for the AAA model with ILT (using Reynolds Stress Model). Future investigations should include validation of the 3D velocity field and wall shear stresses within the AAA sac predicted by the three numerical models. [ABSTRACT FROM AUTHOR]
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- 2015
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21. 3-D Stereo-particle image velocimetry in the total cavopulmonary connection
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Kitajima, H.D., primary, Sundareswaran, K.S., additional, Teisseyre, T.Z., additional, Pekkan, K., additional, de Zelicourt, D., additional, Fogel, M.A., additional, and Yoganathan, A.P., additional
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- 2006
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22. Importance of respiration and graft compliance in Fontan circulations: Experimental and computational studies
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Lucas, C., primary, Ketner, M., additional, Steele, B., additional, Mill, M.R., additional, Sheridan, B., additional, Lucas, W.J., additional, Pekkan, K., additional, and Yoganathan, A., additional
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- 2006
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23. Progress towards surgical planning of the total cavopulmonary connection
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de Zélicourt, D., primary, Pekkan, K., additional, Sundareswaran, K., additional, Kitajima, H., additional, Rossignac, J., additional, Parks, J., additional, Sharma, S., additional, Kanter, K., additional, Fogel, M., additional, and Yoganathan, A.P., additional
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- 2006
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24. Hemodynamic assessment of virtual surgery options for a failing Fontan using lumped parameter simulation.
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Haggerty, C.M., de Zelicourt, D.A., Sundareswaran, K.S., Pekkan, K., Whited, B., Rossignac, J.R., Fogel, M.A., and Yoganathan, A.P.
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- 2009
25. Anatomically Realistic Patient-Specific Surgical Planning of Complex Congenital Heart Defects Using MRI and CFD.
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Sundareswaran, K.S., de Zelicourt, D., Pekkan, K., Jayaprakash, G., Kim, D., Whited, B., Rossignac, J., Fogel, M.A., Kanter, K.R., and Yoganathan, A.P.
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- 2007
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26. New power loss optimized Fontan connection evaluated by calculation of power loss using high resolution PC-MRI and CFD.
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Soerensen, D.D., Pekkan, K., Sundareswaran, K.S., and Yoganathan, A.P.
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- 2004
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27. Pulsatile venous waveform quality affects the conduit performance in functional and 'failing' Fontan circulations.
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Dur O, Kocyildirim E, Soran O, Wearden PD, Morell VO, Degroff CG, and Pekkan K
- Published
- 2012
28. Production of opaque frits with low ZrO2 and ZnO contents and their industrial uses for fast single-fired wall tile glazes.
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Pekkan, K. and Karasu, B.
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ZIRCONIUM oxide , *ZINC oxide , *GLAZES , *CERAMIC tile manufacturing , *INDUSTRIAL costs , *OPACITY (Optics) , *NUCLEATION , *ZIRCON - Abstract
The amounts of zirconium and zinc oxides, which raise the production costs of ceramic glazes, were decreased in fast single-fired wall tile frit compositions and an industrial frit production was conducted. Opacity of the fired frit-based glazes was accomplished by compositional modifications of frits with no other nucleating agent. It was determined that the ratios of Al2O3/ΣR2O, Al2O3/ΣRO, and Al2O3/B2O3 have significant effects on decreasing ZrO2 and ZnO levels in the frit composition. A reduction of 25% in both zirconia and zinc oxide contents of frit batches, with respect to the reference frit ( R) containing 6–10% ZrO2 and 6–10% ZnO for a glossy white opaque wall tile glaze, was achieved in the ZD glaze consisting of 4.5–7.5% zirconia and 4.5–7.5% ZnO in its frit composition. It was concluded that zircon was the main crystalline phase of the glaze contributing the opacity. The ZD frit-based glaze has a thermal expansion coefficient value of 61.13 ± 0.32 × 10−7 °C−1 at 400 °C which well matches to that of the wall tile body. TS EN ISO 10545 standard tests were also applied to the final ZD glaze. It is confirmed that the production cost of a fast single-fired wall tile glaze can be decreased by 15–20% with the successful new frit developed. [ABSTRACT FROM AUTHOR]
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- 2009
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29. Total cavopulmonary connection flow with functional left pulmonary artery stenosis: angioplasty and fenestration in vitro.
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Pekkan K, Kitajima HD, de Zelicourt D, Forbess JM, Parks WJ, Fogel MA, Sharma S, Kanter KR, Frakes D, and Yoganathan AP
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- 2005
30. Mitral Web - A New Concept for Mitral Valve Repair: Improved Engineering Design and In-Vitro Studies
- Author
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Erek, E., Padala, M., Pekkan, K., Jimenez, J., Yalçinba, Y. K., Ece Salihoglu, Sanoǧlu, T., and Yoganathan, A. P.
31. New power loss optimized Fontan connection evaluated by calculation of power loss using high resolution PC-MRI and CFD
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Soerensen, D.D., primary, Pekkan, K., additional, Sundareswaran, K.S., additional, and Yoganathan, A.P., additional
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32. Bicuspid-valved PTFE conduit optimization for pediatric RVOT reconstruction.
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Bernstein, D., Dur, O., Yoshida, M., and Pekkan, K.
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- 2011
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33. Nonlinear power loss during exercise in single-ventricle patients after the Fontan: insights from computational fluid dynamics.
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Whitehead KK, Pekkan K, Kitajima HD, Paridon SM, Yoganathan AP, and Fogel MA
- Published
- 2007
34. Framework for Fluid-Structure Interaction Analysis of Aortic Coarctation Resulting From Proximal Protusion of Thoracic Aortic Stent Graft Into the Arch
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David A. Vorp, Jae Sung Cho, Onur Dur, Salvatore Pasta, Kerem Pekkan, Pasta S., Dur O., Cho J.-S., Pekkan K., and Vorp D.A.
- Subjects
Aortic arch ,medicine.medical_specialty ,Aorta ,business.industry ,medicine.medical_treatment ,aorti failure ,Settore ING-IND/34 - Bioingegneria Industriale ,Hemodynamics ,Stent ,Curvatures of the stomach ,Surgery ,Apposition ,surgical procedures, operative ,medicine.artery ,Internal medicine ,Occlusion ,cardiovascular system ,Cardiology ,Medicine ,business ,Complication - Abstract
Thoracic aortic stent grafts (TASG) are commonly used to repair aortic anomalies or diseases in a minimally-invasive fashion. One complication of TASG is collapse, whereby blood is unable to completely flow through the graft as intended. Most TASG collapses occur in the setting of endovascular repair of traumatic thoracic aortic transection, where a typically smaller diameter aorta of pediatric patients is repaired with a relatively larger diameter endograft designed to treat aneurysmal disease [1]. It is hypothesized that the poor apposition of the leading edge of the proximal stent graft to the lesser curvature of the aortic arch can result increased hemodynamic force at the leading side of the graft can reach sufficient magnitude to cause collapse and gradual occlusion of the tubular graft. The incidence rates of stent graft collapse in endovascular aortic transection repairs have been reported to range from 0.03% to 10% [2].Copyright © 2011 by ASME
- Published
- 2011
35. Computer Modeling for the Prediction of Thoracic Aortic Stent Graft Collapse
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Jae Sung Cho, David A. Vorp, Kerem Pekkan, Onur Dur, Salvatore Pasta, Pasta S., Cho J.-S., Dur O., Pekkan K., and Vorp D.A.
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Aortic arch ,Male ,medicine.medical_specialty ,Aortography ,medicine.medical_treatment ,Hemodynamics ,Aorta, Thoracic ,FOS: Medical engineering ,Prosthesis Design ,Blood Vessel Prosthesis Implantation ,Imaging, Three-Dimensional ,Blood vessel prosthesis ,medicine.artery ,Materials Testing ,medicine ,Humans ,Computer Simulation ,thoracic aortic stent graft (TASG) ,Aorta ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Models, Cardiovascular ,Stent ,Settore ING-IND/34 - Bioingegneria Industriale ,nutritional and metabolic diseases ,90399 Biomedical Engineering not elsewhere classified ,Curvatures of the stomach ,Surgery ,Biomechanical Phenomena ,Blood Vessel Prosthesis ,Prosthesis Failure ,Equipment Failure Analysis ,Regional Blood Flow ,Radiographic Image Interpretation, Computer-Assisted ,Stents ,lipids (amino acids, peptides, and proteins) ,Stress, Mechanical ,biological phenomena, cell phenomena, and immunity ,business ,Nuclear medicine ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,Perfusion ,Algorithms - Abstract
OBJECTIVE: To assess the biomechanical implications of excessive stent protrusion into the aortic arch in relation to thoracic aortic stent graft (TASG) collapse by simulating the structural load and quantifying the fluid dynamics on the TASG wall protrusion extended into a model arch. METHODS: One-way coupled fluid-solid interaction analyses were performed to investigate the flow-induced hemodynamic and structural loads exerted on the proximal protrusion of the TASG and aortic wall reconstructed from a patient who underwent traumatic thoracic aortic injury repair. Mechanical properties of a Gore TAG thoracic endoprosthesis (W. L. Gore and Assoc, Flagstaff, Ariz) were assessed via experimental radial compression testing and incorporated into the computational modeling. The TASG wall protrusion geometry was characterized by the protrusion extension (PE) and by the angle (θ) between the TASG and the lesser curvature of the aorta. The effect of θ was explored with the following four models with PE fixed at 1.1 cm: θ = 10 degrees, 20 degrees, 30 degrees, and 40 degrees. The effect of PE was evaluated with the following four models with θ fixed at 10 degrees: PE = 1.1 cm, 1.4 cm, 1.7 cm and 2.0 cm. RESULTS: The presence of TASG wall protrusion into the aortic arch resulted in the formation of swirling, complex flow regions in the proximal luminal surface of the endograft. High PE values (PE = 2.0 cm) led to a markedly reduced left subclavian flow rate (0.27 L/min), low systolic perfusion pressure (98 mm Hg), and peak systolic TASG diameter reduction (2 mm). The transmural pressure load across the TASG was maximum for the model with the highest PE and θ, 15.2 mm Hg for the model with PE = 2.0 cm and θ = 10 degrees, and 11.6 mm Hg for PE = 1.1 cm and θ = 40 degrees. CONCLUSIONS: The findings of this study suggest that increased PE imparts an apparent risk of distal end-organ malperfusion and proximal hypertension and that both increased PE and θ lead to a markedly increased transmural pressure across the TASG wall, a load that would portend TASG collapse. Patient-specific computational modeling may allow for identification of patients with high risk of TASG collapse and guide preventive intervention. CLINICAL RELEVANCE: A potentially devastating complication that may occur after endovascular repair of traumatic thoracicaortic injuries is stent graft collapse. Although usually asymptomatic, stent graft collapse may be accompanied by adverse hemodynamic consequences. Numerous anatomic and device-related factors contribute to the development of collapse, but predictive factors have not yet been clearly defined. In the present study, we assessed the relevant hemodynamics and solid mechanics underlying stent graft collapse using a computational fluid-structure interaction framework of stent graft malapposition. Our findings suggest that both increased stent graft angle and extension into the aortic arch lead to a markedly increased transmural pressure across the stent graft wall, portending collapse. Patient-specific computational modeling may allow for identification of patients at high risk for collapse and aid in planning for an additional, prophylactic intervention to avert its occurrence.
- Published
- 2011
36. Effect of impeller rotational phase on the FDA blood pump velocity fields.
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Ucak K, Karatas F, and Pekkan K
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- Humans, United States, Rotation, Rheology, Equipment Design, Blood Flow Velocity physiology, Prosthesis Design, Heart-Assist Devices, United States Food and Drug Administration
- Abstract
Background: The Food and Drug Administration (FDA) blood pump is an open-source benchmark cardiovascular device introduced for validating computational and experimental performance analysis tools. The time-resolved velocity field for the whole impeller has not been established, as is undertaken in this particle image velocimetry (PIV) study. The level of instantaneous velocity fluctuations is important, to assess the flow-induced rotor vibrations which may contribute to the total blood damage., Methods: To document these factors, time-resolved two-dimensional PIV experiments were performed that were precisely phase-locked with the impeller rotation angle. The velocity fields in the impeller and in the volute conformed with the previous single blade passage experiments of literature., Results: Depending on the impeller orientation, present experiments showed that volute outlet nozzle flow can fluctuate up to 34% during impeller rotation, with a maximum standard experimental uncertainty of 2.2%. Likewise, the flow fields in each impeller passage also altered in average 33.5%. Considerably different vortex patterns were observed for different blade passages, with the largest vortical structures reaching an average core radii of 7 mm. The constant volute area employed in the FDA pump design contributes to the observed velocity imbalance, as illustrated in our velocity measurements., Conclusions: By introducing the impeller orientation parameter for the nozzle flow, this study considers the possible uncertainties influencing pump flow. Expanding the available literature data, analysis of inter-blade relative velocity fields is provided here for the first-time to the best of our knowledge. Consequently, our research fills a critical knowledge gap in the understanding of the flow dynamics of an important benchmark cardiovascular device. This study prompts the need for improved hydrodynamic designs and optimized devices to be used as benchmark test devices, to build more confidence and safety in future ventricular assist device performance assessment studies., (© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
- Published
- 2024
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37. Review of Machine Learning Techniques in Soft Tissue Biomechanics and Biomaterials.
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Donmazov S, Saruhan EN, Pekkan K, and Piskin S
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- Humans, Biomechanical Phenomena, Animals, Models, Cardiovascular, Tissue Engineering methods, Prosthesis Design, Materials Testing, Finite Element Analysis, Machine Learning, Biocompatible Materials
- Abstract
Background and Objective: Advanced material models and material characterization of soft biological tissues play an essential role in pre-surgical planning for vascular surgeries and transcatheter interventions. Recent advances in heart valve engineering, medical device and patch design are built upon these models. Furthermore, understanding vascular growth and remodeling in native and tissue-engineered vascular biomaterials, as well as designing and testing drugs on soft tissue, are crucial aspects of predictive regenerative medicine. Traditional nonlinear optimization methods and finite element (FE) simulations have served as biomaterial characterization tools combined with soft tissue mechanics and tensile testing for decades. However, results obtained through nonlinear optimization methods are reliable only to a certain extent due to mathematical limitations, and FE simulations may require substantial computing time and resources, which might not be justified for patient-specific simulations. To a significant extent, machine learning (ML) techniques have gained increasing prominence in the field of soft tissue mechanics in recent years, offering notable advantages over conventional methods. This review article presents an in-depth examination of emerging ML algorithms utilized for estimating the mechanical characteristics of soft biological tissues and biomaterials. These algorithms are employed to analyze crucial properties such as stress-strain curves and pressure-volume loops. The focus of the review is on applications in cardiovascular engineering, and the fundamental mathematical basis of each approach is also discussed., Methods: The review effort employed two strategies. First, the recent studies of major research groups actively engaged in cardiovascular soft tissue mechanics are compiled, and research papers utilizing ML and deep learning (DL) techniques were included in our review. The second strategy involved a standard keyword search across major databases. This approach provided 11 relevant ML articles, meticulously selected from reputable sources including ScienceDirect, Springer, PubMed, and Google Scholar. The selection process involved using specific keywords such as "machine learning" or "deep learning" in conjunction with "soft biological tissues", "cardiovascular", "patient-specific," "strain energy", "vascular" or "biomaterials". Initially, a total of 25 articles were selected. However, 14 of these articles were excluded as they did not align with the criteria of focusing on biomaterials specifically employed for soft tissue repair and regeneration. As a result, the remaining 11 articles were categorized based on the ML techniques employed and the training data utilized., Results: ML techniques utilized for assessing the mechanical characteristics of soft biological tissues and biomaterials are broadly classified into two categories: standard ML algorithms and physics-informed ML algorithms. The standard ML models are then organized based on their tasks, being grouped into Regression and Classification subcategories. Within these categories, studies employ various supervised learning models, including support vector machines (SVMs), bagged decision trees (BDTs), artificial neural networks (ANNs) or deep neural networks (DNNs), and convolutional neural networks (CNNs). Additionally, the utilization of unsupervised learning approaches, such as autoencoders incorporating principal component analysis (PCA) and/or low-rank approximation (LRA), is based on the specific characteristics of the training data. The training data predominantly consists of three types: experimental mechanical data, including uniaxial or biaxial stress-strain data; synthetic mechanical data generated through non-linear fitting and/or FE simulations; and image data such as 3D second harmonic generation (SHG) images or computed tomography (CT) images. The evaluation of performance for physics-informed ML models primarily relies on the coefficient of determination R 2 . In contrast, various metrics and error measures are utilized to assess the performance of standard ML models. Furthermore, our review includes an extensive examination of prevalent biomaterial models that can serve as physical laws for physics-informed ML models., Conclusion: ML models offer an accurate, fast, and reliable approach for evaluating the mechanical characteristics of diseased soft tissue segments and selecting optimal biomaterials for time-critical soft tissue surgeries. Among the various ML models examined in this review, physics-informed neural network models exhibit the capability to forecast the mechanical response of soft biological tissues accurately, even with limited training samples. These models achieve high R 2 values ranging from 0.90 to 1.00. This is particularly significant considering the challenges associated with obtaining a large number of living tissue samples for experimental purposes, which can be time-consuming and impractical. Additionally, the review not only discusses the advantages identified in the current literature but also sheds light on the limitations and offers insights into future perspectives., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.)
- Published
- 2024
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38. Synchronous PIV measurements of a self-powered blood turbine and pump couple for right ventricle support.
- Author
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Ucak K, Karatas F, Cetinkaya E, and Pekkan K
- Abstract
A blood turbine-pump system (iATVA), resembling a turbocharger was proposed as a mechanical right-heart assist device without external drive power. In this study, the iATVA system is investigated with particular emphasis on the blood turbine flow dynamics. A time-resolved 2D particle image velocimetry (PIV) set-up equipped with a beam splitter and two high speed cameras, allowed simultaneous recordings from both the turbine and pump impellers at 7 different phased-locked instances. The iATVA prototype is 3D printed using an optically clear resin following our earlier PIV protocols. Results showed that magnetically coupled impellers operated synchronously. As the turbine flow rate increased from 1.6 to 2.4 LPM, the rotational speed and relative inlet flow angle increase from 630 to 900 rpm, and 38 to 55% respectively. At the trailing edges, backflow region spanned 3/5 of the total passage outlet flow, and an extra leakage flow was observed at the leading edge. For this early turbine design, approximately, 75% of the turbine blade passage was not contributing to the impulse operation mode. The maximum non-wall shear rate was ~ 2288 s
-1 near to the inlet exit, which is significantly lower than the commercial blood pumps, encouraging further research and blood experiments of this novel concept. Experimental results will improve the hydrodynamic design of the turbine impeller and volute regions and will be useful in computational fluid dynamics validation studies of similar passive devices., (© 2024. The Author(s).)- Published
- 2024
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39. Modulation of mechanosensitive genes during embryonic aortic arch development.
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Siddiqui HB, Golcez T, Çelik M, Sevgin B, Çoban M, Süder İ, Kaya Ö, Özören N, and Pekkan K
- Abstract
Background: Early embryonic aortic arches (AA) are a dynamic vascular structures that are in the process of shaping into the great arteries of cardiovascular system. Previously, a time-lapsed mechanosensitive gene expression map was established for AA subject to altered mechanical loads in the avian embryo. To validate this map, we investigated effects on vascular microstructure and material properties following the perturbation of key genes using an in-house microvascular gene knockdown system., Results: All siRNA vectors show a decrease in the expression intensity of desired genes with no significant differences between vectors. In TGFβ3 knockdowns, we found a reduction in expression intensities of TGFβ3 (≤76%) and its downstream targets such as ELN (≤99.6%), Fbn1 (≤60%), COL1 (≤52%) and COL3 (≤86%) and an increase of diameter in the left AA (23%). MMP2 knockdown also reduced expression levels in MMP2 (≤30%) and a 6-fold increase in its downstream target COL3 with a decrease in stiffness of the AA wall and an increase in the diameter of the AA (55%). These in vivo measurements were confirmed using immunohistochemistry, western blotting and a computational growth model of the vascular extracellular matrix (ECM)., Conclusions: Localized spatial genetic modification of the aortic arch region governs the vascular phenotype and ECM composition of the embryo and can be integrated with mechanically-induced congenital heart disease models., (© 2024 The Author(s). Developmental Dynamics published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)
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- 2024
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40. Mechanical characterization and torsional buckling of pediatric cardiovascular materials.
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Donmazov S, Piskin S, Gölcez T, Kul D, Arnaz A, and Pekkan K
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- Animals, Cattle, Stress, Mechanical, Polytetrafluoroethylene chemistry, Swine, Pressure, Child, Humans, Biomechanical Phenomena, Blood Vessel Prosthesis, Torque, Pericardium physiology, Materials Testing
- Abstract
In complex cardiovascular surgical reconstructions, conduit materials that avoid possible large-scale structural deformations should be considered. A fundamental mode of mechanical complication is torsional buckling which occurs at the anastomosis site due to the mechanical instability, leading surgical conduit/patch surface deformation. The objective of this study is to investigate the torsional buckling behavior of commonly used materials and to develop a practical method for estimating the critical buckling rotation angle under physiological intramural vessel pressures. For this task, mechanical tests of four clinically approved materials, expanded polytetrafluoroethylene (ePTFE), Dacron, porcine and bovine pericardia, commonly used in pediatric cardiovascular surgeries, are conducted (n = 6). Torsional buckling initiation tests with n = 4 for the baseline case (L = 7.5 cm) and n = 3 for the validation of ePTFE (L = 15 cm) and Dacron (L = 15 cm and L = 25 cm) for each are also conducted at low venous pressures. A practical predictive formulation for the buckling potential is proposed using experimental observations and available theory. The relationship between the critical buckling rotation angle and the lumen pressure is determined by balancing the circumferential component of the compressive principal stress with the shear stress generated by the modified critical buckling torque, where the modified critical buckling torque depends linearly on the lumen pressure. While the proposed technique successfully predicted the critical rotation angle values lying within two standard deviations of the mean in the baseline case for all four materials at all lumen pressures, it could reliably predict the critical buckling rotation angles for ePTFE and Dacron samples of length 15 cm with maximum relative errors of 31% and 38%, respectively, in the validation phase. However, the validation of the performance of the technique demonstrated lower accuracy for Dacron samples of length 25 cm at higher pressure levels of 12 mmHg and 15 mmHg. Applicable to all surgical materials, this formulation enables surgeons to assess the torsional buckling potential of vascular conduits noninvasively. Bovine pericardium has been found to exhibit the highest stability, while Dacron (the lowest) and porcine pericardium have been identified as the least stable with the (unitless) torsional buckling resistance constants, 43,800, 12,300 and 14,000, respectively. There was no significant difference between ePTFE and Dacron, and between porcine and bovine pericardia. However, both porcine and bovine pericardia were found to be statistically different from ePTFE and Dacron individually (p < 0.0001). ePTFE exhibited highly nonlinear behavior across the entire strain range [0, 0.1] (or 10% elongation). The significant differences among the surgical materials reported here require special care in conduit construction and anastomosis design., (© 2024. The Author(s).)
- Published
- 2024
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41. Evaluation of the total hydrodynamic energy loss using 4D flow MRI in a case with Fontan failure.
- Author
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Odemis E, Gumus T, Aka İB, Ozkok S, and Pekkan K
- Abstract
Fontan Failure (FF) is a common problem for single-ventricle patients as they reach adulthood. Although several mechanisms may cause FF, an optimized blood flow stream through the surgical conduits is essential to avoid excessive energy loss (EL). Recent clinical studies showed EL is related to the quality of life, exercise capacity, and hepatic function since the single-ventricle feeds pulmonary and systemic circulation serially. 4D flow MRI effectively estimates EL in Fontan circulation and allows clinicians to compare the effectiveness of the treatment strategy concerning pre-intervention. Here, we present 26-year-old women with FF who had normal cardiac catheterization findings and were treated according to high EL definitions that are measured through 4D flow MRI., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)
- Published
- 2024
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42. Interstitial flow, pressure and residual stress in the aging carotid artery model in FEBio.
- Author
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Altundemir S, Lashkarinia SS, Pekkan K, and Uğuz AK
- Subjects
- Humans, Aged, Biomechanical Phenomena, Carotid Artery, Common physiology, Tunica Media physiology, Stress, Mechanical, Cardiovascular Diseases
- Abstract
Vascular smooth muscle cells (VSMCs) are subject to interstitial flow-induced shear stress, which is a critical parameter in cardiovascular disease progression. Transmural pressure loading and residual stresses alter the hydraulic conductivity of the arterial layers and modulate the interstitial fluid flux through the arterial wall. In this paper, a biphasic multilayer model of a common carotid artery (CCA) with anisotropic fiber-reinforced soft tissue and strain-dependent permeability is developed in FEBio software. After the verification of the numerical predictions, age-related arterial thickening and stiffening effects on arterial deformation and interstitial flow are computed under physiological geometry and physical parameters. We found that circumferential residual stress shifts outward in each layer and its gradient increases up to 6 times with aging. Internally pressurized CCA displays nonlinear deformation. In the aged artery, the circumferential stress becomes greater on the media layer (82-158 kPa) and lower on the intima and adventitia (19-23 kPa and 25-28 kPa, respectively). The radial compression of the intima reduces the total hydraulic conductivity by 48% in the young and 16% in the aged arterial walls. Consequently, the average radial interstitial flux increases with pressure by 14% in the young and 91% in the aged arteries. Accordingly, the flow shear stress experienced by the VSMCs becomes more significant for aged arteries, which may accelerate cardiovascular disease progression compared to young arteries., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2024
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43. Optimizing percutaneous pulmonary valve implantation with patient-specific 3D-printed pulmonary artery models and hemodynamic assessment.
- Author
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Odemis E, Aka İB, Ali MHA, Gumus T, and Pekkan K
- Abstract
Background: Percutaneous pulmonary valve implantation (PPVI) has emerged as a less invasive alternative for treating severe pulmonary regurgitation after tetralogy of Fallot (TOF) repair in patients with a native right ventricular outflow tract (RVOT). However, the success of PPVI depends on precise patient-specific valve sizing, the avoidance of oversizing complications, and optimal valve performance. In recent years, innovative adaptations of commercially available cardiovascular mock loops have been used to test conduits in the pulmonary position. These models are instrumental in facilitating accurate pulmonic valve sizing, mitigating the risk of oversizing, and providing insight into the valve performance before implantation. This study explored the utilization of custom-modified mock loops to implant patient-specific 3D-printed pulmonary artery geometries, thereby advancing PPVI planning and execution., Material and Methods: Patient-specific 3D-printed pulmonary artery geometries of five patients who underwent PPVI using Pulsta transcatheter heart valve (THV) ® were tested in a modified ViVitro pulse duplicator system®. Various valve sizes were subjected to 10 cycles of testing at different cardiac output levels. The transpulmonary systolic and regurgitation fractions of the valves were also recorded and compared., Results: A total of 39 experiments were conducted using five different patient geometries and several different valve sizes (26, 28, 30, and 32 mm) at 3, 4, and 5 L/min cardiac output at heart rates of 70 beats per minute (bpm) and 60/40 systolic/diastolic ratios. The pressure gradients and regurgitation fractions of the tested valve sizes in the models were found to be similar to the pressure gradients and regurgitation fractions of valves used in real procedures. However, in two patients, different valve sizes showed better hemodynamic values than the actual implanted valves., Discussion: The use of 3D printing technology, electromagnetic flow meters, and the custom-modified ViVitro pulse duplicator system® in conjunction with patient-specific pulmonary artery models has enabled a comprehensive assessment of percutaneous pulmonic valve implantation performance. This approach allows for accurate valve sizing, minimization of oversizing risks, and valuable insights into hemodynamic behavior before implantation. The data obtained from this experimental setup will contribute to advancing PPVI procedures and offer potential benefits in improving patient outcomes and safety., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Odemis, AKA, Ali, Gumus and Pekkan.)
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- 2024
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44. Switching the Left and the Right Hearts: A Novel Bi-ventricle Mechanical Support Strategy with Spared Native Single-Ventricle.
- Author
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Şişli E, Yıldırım C, Aka İB, Tuncer ON, Atay Y, Özbaran M, and Pekkan K
- Subjects
- Animals, Humans, Adolescent, Heart Ventricles, Hemodynamics physiology, Heart, Vascular Resistance, Models, Cardiovascular, Fontan Procedure, Heart-Assist Devices
- Abstract
End-stage Fontan patients with single-ventricle (SV) circulation are often bridged-to-heart transplantation via mechanical circulatory support (MCS). Donor shortage and complexity of the SV physiology demand innovative MCS. In this paper, an out-of-the-box circulation concept, in which the left and right ventricles are switched with each other is introduced as a novel bi-ventricle MCS configuration for the "failing" Fontan patients. In the proposed configuration, the systemic circulation is maintained through a conventional mechanical ventricle assist device (VAD) while the venous circulation is delegated to the native SV. This approach spares the SV and puts it to a new use at the right-side providing the most-needed venous flow pulsatility to the failed Fontan circulation. To analyze its feasibility and performance, eight SV failure modes have been studied via an established multi-compartmental lumped parameter cardiovascular model (LPM). Here the LPM model is experimentally validated against the corresponding pulsatile mock-up flow loop measurements of a representative 15-year-old Fontan patient employing a clinically-approved VAD (Medtronic-HeartWare). The proposed surgical configuration maintained the healthy cardiac index (3-3.5 l/min/m
2 ) and the normal mean systemic arterial pressure levels. For a failed SV with low ejection fraction (EF = 26%), representing a typical systemic Fontan failure, the proposed configuration enabled a ~ 28 mmHg amplitude in the venous/pulmonary waveforms and a 2 mmHg decrease in the central venous pressure (CVP) together with acceptable mean pulmonary artery pressures (17.5 mmHg). The pulmonary vascular resistance (PVR)-SV failure case provided a ~ 5 mmHg drop in the CVP, with venous/pulmonary pulsatility reaching to ~ 22 mmHg. For the high PVR failure case with a healthy SV (EF = 44%) pulmonary hypertension is likely to occur as expected. While this condition is routinely encountered during the heart transplantation and managed through pulmonary vasodilators a need for precise functional assessment of the spared failed-ventricle is recommended if utilized in the PVR failure mode. Comprehensive in vitro and in silico results encourage this novel concept as a low-cost, more physiological alternative to the conventional bi-ventricle MCS pending animal experiments., (© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society.)- Published
- 2023
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45. Surgical and transcatheter pulmonary valve replacement in patients with repaired tetralogy of Fallot: cardiac magnetic resonance imaging characteristics and morphology of right ventricular outflow tract.
- Author
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Ozkok S, Ciftci HO, Kose KB, Yucel IK, Sasmazel A, Celebi A, and Pekkan K
- Subjects
- Humans, Heart Ventricles diagnostic imaging, Heart Ventricles surgery, Magnetic Resonance Imaging, Treatment Outcome, Retrospective Studies, Pulmonary Valve diagnostic imaging, Pulmonary Valve surgery, Tetralogy of Fallot diagnostic imaging, Tetralogy of Fallot surgery, Pulmonary Valve Insufficiency diagnostic imaging, Pulmonary Valve Insufficiency surgery
- Abstract
Background: Pulmonary valve replacement is recommended in patients with repaired tetralogy of Fallot based on cardiac magnetic resonance imaging (MRI) criteria. This procedure is performed by surgical or transcatheter approaches., Objective: We aimed to investigate the differences in preprocedural MRI characteristics (volume, function, strain) and morphology of the right ventricular outflow tract and branch pulmonary arteries in patients for whom surgical or transcatheter pulmonary valve replacement was planned., Materials and Methods: Cardiac MRI of 166 patients with tetralogy of Fallot were analyzed. Of these, 36 patients for whom pulmonary valve replacement was planned were included. Magnetic resonance imaging characteristics, right ventricular outflow tract morphology, branch pulmonary artery flow distribution and diameter were compared between surgical and transcatheter groups. Spearman correlation and Kruskal-Wallis tests were performed., Results: Circumferential and radial MRI strain for the right ventricle were lower in the surgical group (P=0.045 and P=0.046, respectively). The diameter of the left pulmonary artery was significantly lower (P=0.021) and branch pulmonary artery flow and diameter ratio were higher (P=0.044 and P = 0.002, respectively) in the transcatheter group. There was a significant correlation between right ventricular outflow tract morphology and right ventricular end-diastolic volume index and global circumferential and radial MRI strain (P=0.046, P=0.046 and P= 0.049, respectively)., Conclusion: Preprocedural MRI strain, right-to-left pulmonary artery flow, diameter ratio and morphological features of the right ventricular outflow tract were significantly different between the two groups. A transcatheter approach may be recommended for patients with branch pulmonary artery stenosis, since both pulmonary valve replacement and branch pulmonary artery stenting can be performed in the same session., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2023
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46. Left Atrial Ligation in the Avian Embryo as a Model for Altered Hemodynamic Loading During Early Vascular Development.
- Author
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Sevgin B, Coban MN, Karatas F, and Pekkan K
- Subjects
- Infant, Newborn, Animals, Humans, Heart Atria surgery, Heart Ventricles, Hemodynamics, Atrial Fibrillation, Heart Defects, Congenital pathology
- Abstract
Due to its four-chambered mature ventricular configuration, ease of culture, imaging access, and efficiency, the avian embryo is a preferred vertebrate animal model for studying cardiovascular development. Studies aiming to understand the normal development and congenital heart defect prognosis widely adopt this model. Microscopic surgical techniques are introduced to alter the normal mechanical loading patterns at a specific embryonic time point and track the downstream molecular and genetic cascade. The most common mechanical interventions are left vitelline vein ligation, conotruncal banding, and left atrial ligation (LAL), modulating the intramural vascular pressure and wall shear stress due to blood flow. LAL, particularly if performed in ovo, is the most challenging intervention, with very small sample yields due to the extremely fine sequential microsurgical operations. Despite its high risk, in ovo LAL is very valuable scientifically as it mimics hypoplastic left heart syndrome (HLHS) pathogenesis. HLHS is a clinically relevant, complex congenital heart disease observed in human newborns. A detailed protocol for in ovo LAL is documented in this paper. Briefly, fertilized avian embryos were incubated at 37.5 °C and 60% constant humidity typically until they reached Hamburger-Hamilton (HH) stages 20 to 21. The egg shells were cracked open, and the outer and inner membranes were removed. The embryo was gently rotated to expose the left atrial bulb of the common atrium. Pre-assembled micro-knots from 10-0 nylon sutures were gently positioned and tied around the left atrial bud. Finally, the embryo was returned to its original position, and LAL was completed. Normal and LAL-instrumented ventricles demonstrated statistically significant differences in tissue compaction. An efficient LAL model generation pipeline would contribute to studies focusing on synchronized mechanical and genetic manipulation during the embryonic development of cardiovascular components. Likewise, this model will provide a perturbed cell source for tissue culture research and vascular biology.
- Published
- 2023
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47. Tension controlled hollow-fiber winding machine for blood oxygenator prototypes.
- Author
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AliAbbasi E, Akseki A, Ullah A, and Pekkan K
- Abstract
Blood oxygenators involve a complex network of hollow fibers for efficient gas exchange with blood. The optimal microstructural arrangement of these fibers is an ongoing research interest. While the fiber systems of commercial oxygenators are manufactured to address mass production, the research oxygenator prototypes demand more flexibility so that different design parameters can be tested. Here a hollow-fiber assembly system is designed and built for winding research grade extracorporeal blood oxygenator mandrels at different layout dimensions so that these different configurations can be evaluated for mass transfer capacity and blood damage. The hardware design and manufacturing details of this system presented together with its impact on the prototype oxygenator device assembly process. This in-house built system can wind thin fibers, having outer diameters ranging from 100 μm to 1 mm, at any specified winding angle continuously. A control system for fiber stress is also incorporated to eliminate fiber damage. Our system consists of three main units: (1) unwinding, (2) accumulator, and (3) winding systems, integrated together via the control software. The unwinding unit has a PID controller to maintain the position of the accumulator motor on the reference point by tuning the velocity of feeding fibers to the accumulator unit. Another PID controller preserves the desired tension value of the fibers by adjusting the position of the accumulator motor. Desired tension value is defined by the user and typically obtained through uniaxial testing of fibers. The control unit employs a "cascaded" PID controller since the PID controller in the accumulator unit maintains the tension and the PID controller in the unwinding unit controls the position of the accumulator motor. Finally, the winding unit utilizes two motors to wind the fibers over the outer diameter of a mandrel at the desired winding angle. The first motor drives the translational movement, and the second one provides mandrel rotation. The desired angles are achieved by tuning the synchronous movement of the winding motors. While the system is designed to produce assembled blood oxygenator mandrel prototypes, this concept is also applicable for producing cylindrical fiber-reinforced composite materials with specified fiber angles and stents winded on jigs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)
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- 2023
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48. Myocardial Biomechanics and the Consequent Differentially Expressed Genes of the Left Atrial Ligation Chick Embryonic Model of Hypoplastic Left Heart Syndrome.
- Author
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Lashkarinia SS, Chan WX, Motakis E, Ho S, Siddiqui HB, Coban M, Sevgin B, Pekkan K, and Yap CH
- Subjects
- Humans, Biomechanical Phenomena, Myocardium metabolism, Heart Atria diagnostic imaging, Heart Ventricles, Hypoplastic Left Heart Syndrome diagnostic imaging, Hypoplastic Left Heart Syndrome genetics, Atrial Fibrillation
- Abstract
Left atrial ligation (LAL) of the chick embryonic heart is a model of the hypoplastic left heart syndrome (HLHS) where a purely mechanical intervention without genetic or pharmacological manipulation is employed to initiate cardiac malformation. It is thus a key model for understanding the biomechanical origins of HLHS. However, its myocardial mechanics and subsequent gene expressions are not well-understood. We performed finite element (FE) modeling and single-cell RNA sequencing to address this. 4D high-frequency ultrasound imaging of chick embryonic hearts at HH25 (ED 4.5) were obtained for both LAL and control. Motion tracking was performed to quantify strains. Image-based FE modeling was conducted, using the direction of the smallest strain eigenvector as the orientations of contractions, the Guccione active tension model and a Fung-type transversely isotropic passive stiffness model that was determined via micro-pipette aspiration. Single-cell RNA sequencing of left ventricle (LV) heart tissues was performed for normal and LAL embryos at HH30 (ED 6.5) and differentially expressed genes (DEG) were identified.After LAL, LV thickness increased by 33%, strains in the myofiber direction increased by 42%, while stresses in the myofiber direction decreased by 50%. These were likely related to the reduction in ventricular preload and underloading of the LV due to LAL. RNA-seq data revealed potentially related DEG in myocytes, including mechano-sensing genes (Cadherins, NOTCH1, etc.), myosin contractility genes (MLCK, MLCP, etc.), calcium signaling genes (PI3K, PMCA, etc.), and genes related to fibrosis and fibroelastosis (TGF-β, BMP, etc.). We elucidated the changes to the myocardial biomechanics brought by LAL and the corresponding changes to myocyte gene expressions. These data may be useful in identifying the mechanobiological pathways of HLHS., (© 2023. The Author(s).)
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- 2023
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49. Cardiac magnetic resonance T2* mapping in patients with COVID-19 pneumonia is associated with serum ferritin level?
- Author
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Ozkok S, Ciftci HO, Keles N, Karatas M, Parsova KE, Kahraman E, Durak F, Pekkan K, Kocogulları CU, and Yiyit N
- Subjects
- Humans, Predictive Value of Tests, Magnetic Resonance Imaging methods, Myocardium pathology, Magnetic Resonance Spectroscopy, Ferritins, Magnetic Resonance Imaging, Cine methods, Contrast Media, COVID-19 complications
- Abstract
The coronavirus disease of 2019 (COVID-19)-related myocardial injury is an increasingly recognized complication and cardiac magnetic resonance imaging (MRI) has become the most commonly used non-invasive imaging technique for myocardial involvement. This study aims to assess myocardial structure by T2*-mapping which is a non-invasive gold-standard imaging tool for the assessment of cardiac iron deposition in patients with COVID-19 pneumonia without significant cardiac symptoms. Twenty-five patients with COVID-19 pneumonia and 20 healthy subjects were prospectively enrolled.Cardiac volume and function parameters, myocardial native-T1, and T2*-mapping were measured. The association of serum ferritin level and myocardial mapping was analyzed. There was no difference in terms of cardiac volume and function parameters. The T2*-mapping values were lower in patients with COVID-19 compared to controls (35.37 [IQR 31.67-41.20] ms vs. 43.98 [IQR 41.97-46.88] ms; p < 0.0001), while no significant difference was found in terms of native-T1 mapping value(p = 0.701). There was a positive correlation with T2*mapping and native-T1 mapping values (r = 0.522, p = 0.007) and negative correlation with serum ferritin values (r = - 0.653, p = 0.000), while no correlation between cardiac native-T1 mapping and serum ferritin level. Negative correlation between serum ferritin level and T2*-mapping values in COVID-19 patients may provide a non-contrast-enhanced alternative to assess tissue structural changes in patients with COVID-19. T2*-mapping may provide a non-contrast-enhanced alternative to assess tissue alterations in patients with COVID-19. Adding T2*-mapping cardiac MRI in patients with myocardial pathologies would improve the revealing of underlying mechanisms. Further in vivo and ex vivo animal or human studies designed with larger patient cohorts should be planned., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2023
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50. Embryonic aortic arch material properties obtained by optical coherence tomography-guided micropipette aspiration.
- Author
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Lashkarinia SS, Coban G, Banu Siddiqui H, Hwai Yap C, and Pekkan K
- Subjects
- Collagen, Heart, Stress, Mechanical, Chick Embryo, Aorta, Thoracic diagnostic imaging, Tomography, Optical Coherence, Branchial Region blood supply, Branchial Region diagnostic imaging
- Abstract
It is challenging to determine the in vivo material properties of a very soft, mesoscale arterial vesselsof size ∼ 80 to 120 μm diameter. This information is essential to understand the early embryonic cardiovascular development featuring rapidly evolving dynamic microstructure. Previous research efforts to describe the properties of the embryonic great vessels are very limited. Our objective is to measure the local material properties of pharyngeal aortic arch tissue of the chick-embryo during the early Hamburger-Hamilton (HH) stages, HH18 and HH24. Integrating the micropipette aspiration technique with optical coherence tomography (OCT) imaging, a clear vision of the aspirated arch geometry is achieved for an inner pipette radius of Rp = 25 μm. The aspiration of this region is performed through a calibrated negatively pressurized micro-pipette. A computational finite element model is developed to model the nonlinear behaviour of the arch structure by considering the geometry-dependent constraints. Numerical estimations of the nonlinear material parameters for aortic arch samples are presented. The exponential material nonlinearity parameter (a) of aortic arch tissue increases statistically significantly from a = 0.068 ± 0.013 at HH18 to a = 0.260 ± 0.014 at HH24 (p = 0.0286). As such, the aspirated tissue length decreases from 53 μm at HH18 to 34 μm at HH24. The calculated NeoHookean shear modulus increases from 51 Pa at HH18 to 93 Pa at HH24 which indicates a statistically significant stiffness increase. These changes are due to the dynamic changes of collagen and elastin content in the media layer of the vessel during development., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
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