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A micro-pillar-based silicone rubber adhesive coated with a thin silicone oil layer is investigated in this paper for developing friction-based clamping mechanisms for robotic endoscopic microcapsules. These adhesives are shown to enhance the frictional force between the capsule and the intestinal wall by a factor of about seven over a non-patterned flat elastomer material. In this study, tests performed on fresh samples of pig small intestine are used to optimize the diameter of the micro-pillars to maximize the frictional forces. In addition, the effects of other factors such as the oil viscosity and applied normal forces are investigated. It is demonstrated that the proposed micro-pillar pattern based elastomer adhesive exhibits a maximal frictional force when the pillar diameter is 140 microm and coated silicon oil has a very high viscosity (10,000 cSt). It is also found that the frictional force of the micro-patterned adhesive increases nonlinearly in proportion to the applied normal force. These adhesives would be used as a robust attachment material for developing robotic capsule endoscopes inside intestines with clamping capability.

This paper presents a stopping and a locomotion mechanism to be used with an endoscopic microcapsule robot. In the diagnosis of gastrointestinal diseases, microcapsules have been developed recently as alternatives to conventional endoscopy. However, they have less accuracy and functionality in diagnosis as they lack the ability to control their position. We propose mechanisms to be used with such microcapsules that would enable them to anchor and crawl in any position inside the small intestines. The stopping mechanism, actuated by coil type shape memory alloys, makes use of dry and wet elastomer (PDMS) micro-patterned adhesives inspired by beetles to attach to the intestinal tract. The locomotion mechanism, inspired by the locomotion principles of inchworms, is a modular expansion of the stopping mechanism. Both the stopping and the crawling locomotion mechanisms have been built and successfully tested inside a flexible vinyl tube. Results showed stopping with high repeatability and 0.5 mm/sec locomotion speed. The stopping mechanism was also integrated to a tethered camera for testing.

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Blast-induced traumatic brain injury (bTBI) has received increasing attention in recent years due to ongoing military operations in Iraq and Afghanistan. Sudden impacts or explosive blasts generate stress and pressure waves that propagate at high velocities and affect sensitive neurological tissues. The immediate soft tissue response to these stress waves is difficult to assess using current in vivo imaging technologies. However, these stress waves and resultant stretching and shearing of tissue within the nano- to microsecond time scale of blast and impact are likely to cause initial injury. To visualize the effects of stress wave loading, we have developed a new ex vivo model in which living tissue slices from rat brain, attached to a ballistic gelatin substrate, were subjected to high-strain-rate loads using a polymer split Hopkinson pressure bar (PSHPB) with real-time high-speed imaging. In this study, average peak fluid pressure within the test chamber reached a value of 1584±63.3 psi. Cavitation due to a trailing underpressure wave was also observed. Time-resolved images of tissue deformation were collected and large maximum eigenstrains (0.03-0.42), minimum eigenstrains (-0.33 to -0.03), maximum shear strains (0.09-0.45), and strain rates (8.4×10³/sec) were estimated using digital image correlation (DIC). Injury at 4 and 6 h was quantified using Fluoro-Jade C. Neuronal injury due to PSHPB testing was found to be significantly greater than injury associated with the tissue slice paradigm alone. While large pressures and strains were encountered for these tests, this system provides a controllable test environment to study injury to submerged brain slices over a range of strain rate, pressure, and strain loads.

Background:The risk of excessive bleeding prompts physicians to stop multiple antiplatelet agents before minor surgery, which puts coronary stenting patients at risk for adverse thrombotic events.Hypothesis:We hypothesized that most dental extractions can be carried out safely without stopping multiple antiplatelet agents.Methods:All dental extraction patients who had undergone coronary stenting and who were also on oral multiple antiplatelet agents therapy were enrolled. One hundred patients underwent dental procedures without stopping antiplatelet agents. All wounds were sutured and followed up at 24 hours, 1 week, and 1 month after the procedure. There were 2233 patients who had not taken oral antiplatelet agents from a health promotion center and had teeth extracted by the same method. After performing propensity‐score matching for the entire population, a total of 100 matched pairs of patients were created. The primary outcome was a composite of excessive intraextraction blood loss, transfusion, and rehospitalization for bleeding, and the secondary outcome was a composite of death, nonfatal myocardial infarction, target lesion revascularization, and stent thrombosis within 1 month after the procedure.Results:There were 2 excessive intraextraction bleeding cases that continued at the extraction site for 4 and 5 hours, respectively, in the coronary stenting patients, and 1 excessive intraextraction bleeding case that continued for 3 hours in the control patients. There were no cases of transfusion, rehospitalization for bleeding, or major cardiovascular events for the 2 propensity‐matched groups.Conclusions:We found that most dental extractions in coronary stenting patients can be carried out safely without stopping multiple antiplatelet agents.The authors have no conflicts of interest to disclose.This study was supported in part by a grant from Yuhan Corporation, Ltd., Seoul, The Republic of Korea.

BackgroundReexpansion pulmonary edema (REPE) is known as a rare and fatal complication after tube thoracostomy.ObjectivesWe investigated the risk factors for the development of REPE in patients with spontaneous pneumothorax.MethodsWe selected patients who were diagnosed with spontaneous pneumothorax and were initially treated with tube thoracostomy between August 1, 2003 and December 31, 2011. The patients’ electronic medical records, including operative notes and chest x-ray and computed tomography scans, were reviewed.ResultsREPE developed in 49 of the 306 patients (16.0%). REPE was more common in patients with diabetes (14.3% vs 3.9%, P = 0.004) or tension pneumothorax (46.8% vs 16.2%, P = 0.000). The pneumothorax was larger in patients with REPE than without REPE (57.0 ± 16.0% vs 34.2 ± 17.6%, P = 0.000), and the incidence of REPE increased with the size of pneumothorax. On multivariate analysis, diabetes mellitus [(odds ratio (OR) = 9.93, P = 0.003), and the size of pneumothorax (OR = 1.07, P = 0.000) were independent risk factors of REPE.ConclusionsThe presence of diabetes increases the risk of REPE development in patients with spontaneous pneumothorax. The risk of REPE also increases significantly with the size of pneumothorax.

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