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26. Houston JG, Gandy SJ, Milne W, Dick JB, Belch JJ, Stonebridge PA. Spiral laminar flow in the abdominal aorta: a predictor of renal impairment deterioration in patients with renal artery stenosis? Nephrol Dial Transplant. 2004 Jul;19(7):1786-91. Epub 2004 May 25. 27. Friedman MH, Krams R, Chandran KB. Flow interactions with cells and tissues: cardiovascular flows and fluid-structure interactions. Sixth International Bio- Fluid Mechanics Symposium and Workshop, March 28-30, 2008, Pasadena, California. Ann Biomed Eng. 2010 Mar;38(3):1178-87. 28. Caro CG, Fitz-Gerald JM, Schroter RC. Arterial wall shear and distribution of early atheroma in man. Nature. 1969 Sept 13;223(5211):1159-60. 29. Zarins CK, Giddens DP, Bharadvaj BK, Sottiurai vS, Mabon RF, Glagov S. Carotid bifurcation atherosclerosis. Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress. Circ Res. 1983 Oct;53(4):502-14. 30. Caro CG, Cheshire NJ, Watkins N. Preliminary comparative study of small amplitude helical and conventional ePTFE arteriovenous shunts in pigs. J R Soc Interface. 2005 Jun 22;2(3):261-6. 31. Stonebridge PA, Buckley C, Thompson A, Dick J, Hunter G, Chudek JA, Houston JG, Belch JJ. Non spiral and spiral (helical) flow patterns in stenoses. In vitro observations using spin and gradient echo magnetic resonance imaging (MRI) and computational fluid dynamic modeling. J Int Angiol. 2004 Sep;23(3):276-83. 32. Paul MC, Larman A. Investigation of spiral blood flow in a model of arterial stenosis. Med Eng Phys. 2009 Nov;31(9):1195-203. Epub 2009 Aug 11. 33. Morbiducci u, Ponzini R, Grigioni M, Redaelli A. Helical flow as fluid dynamic signature for atherogenesis risk in aortocoronary bypass. A numeric study. J Biomech. 2007;40(3):519-34. Epub 2006 Apr 19. 34. Teng X, Deng X. [Optimization of a helical flow inducer of endovascular stent based on the principle of swirling flow in arterial system][Article in Chinese]. Sheng Wu yi Xue Gong Cheng Xue Za Zhi. 2010 Apr;27(2):429-34. 35. Zhang Z, Fan y, Deng X, Wang G, Zhang H, Guidoin R. Simulation of blood flow in a small-diameter vascular graft model with a swirl (spiral) flow guider. Sci China C Life Sci. 2008 Oct;51(10):913-21. Epub 2008 Sept 26. 36. Chen Z, Fan y, Deng X, Xu Z. Swirling flow can suppress flow disturbances in endovascular stents: a numerical study. ASAIO J. 2009 Nov-Dec;55(6):543-9. 37. Sauvage LR, Walker MW, Berger K, Robel SB, Lischko MM, yates SG, Logan GA. Current arterial prostheses. Experimental evaluation by implantation in the carotid and circumflex coronary arteries of the dog. Arch Surg. 1979 Jun;114(6):687-91. 38. Zhan F, Fan y, Deng X. Swirling flow created in a glass tube suppressed platelet adhesion to the surface of the tube: its implication in the design of small-caliber arterial grafts. Thromb Res. 2010 May;125(5):413-8. Epub 2009 Mar 21. 26 vII (1) 2011 | MDCvJ
P.E. Sovelius Jr. Overview PLATO’S CAvE — KNOWLEDGE-BASED MEDICINE OR BLACK SWAN TECHNOLOGy? Paul E. Sovelius Jr. The Methodist Hospital, Houston, Texas Plato’s CAVE TM is a presurgical planning, multidimensional “life space situation room” designed, developed, and introduced to clinical practice by the Department of Radiation Oncology at The Methodist Hospital, located in Houston’s Texas Medical Center. At approximately 500 square feet, Plato’s CAVE was specifically designed to permit a team of physicians to review all available diagnostic images of the patient (Figures 1a, 1b). The initial clinical focus was for interventions within the domain of surgical oncology, including radiation therapy, reconstructive surgery, and organ transplantation. This advanced clinical visualization process, supported by a novel and creative assemblage of FDA-approved, commercially available diagnostic imaging components, is available for all relevant patient care services within The Methodist Hospital System. Figure 1a. Inside Plato’s CAVE with large screen and virtual surgical table visualized with TeraRecon, Inc. Figure 1b. Inside Plato’s CAVE with large screen and laptop integrated visualization by BodyViz, Inc. The underlying concept is that of a military flight simulator. As opposed to a commercial flight simulator, a fighter pilot environment is a multi-body simulation that records all of the plane’s internal instruments and the pilot’s actions with the digital fly-by-wire avionics system; its external position in relation to its global position; and, with GPS, the absolute spatial (X, Y, Z) position of the squadron and the aggressor(s) within its three-dimensional sphere of influence. This well-vetted process of recording input/output variables and resultant differences along the flight path of interaction is critical for pilots to learn from each other’s experience what works well and what should be improved, all within a real-time frame of reference for action and reaction. The knowledge gained is now being used by unmanned aerial vehicles that are remotely piloted, not unlike the da Vinci surgical robot. MDCvJ | vII (1) 2011 27
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