Tethered capsule endomicroscopy (TCE) is an emerging screening technology that comprehensively obtains microstructural OCT images of the gastrointestinal (GI) tract in unsedated patients. To advance clinical adoption of this imaging technique, it will be important to validate TCE images with co-localized histology, the current diagnostic gold standard. One method for co-localizing OCT images with histology is image-targeted laser marking, which has previously been implemented using a driveshaft-based, balloon OCT catheter, deployed during endoscopy. In this paper, we present a TCE device that scans and targets the imaging beam using a low-cost stepper motor that is integrated inside the capsule. In combination with a 4-laser-diode, high power 1430/1450 nm marking laser system (800 mW on the sample and 1s pulse duration), this technology generated clearly visible marks, with a spatial targeting accuracy of better than 0.5 mm. A laser safety study was done on swine esophagus ex vivo, showing that these exposure parameters did not alter the submucosa, with a large, 4-5x safety margin. The technology was demonstrated in living human subjects and shown to be effective for co-localizing OCT TCE images to biopsies obtained during subsequent endoscopy.
Abstract:Total knee arthroplasty is a common orthopaedic procedure conducted in the United States with approximately 700,000 surgeries performed annually. A common complication following total knee arthroplasty is anterior knee pain which affects tens to hundreds of thousands of people each year. The exact mechanism that leads to anterior knee pain remains unknown, but improper component selection may cause pathologic loading of the knee which leads to pain. Measuring loads in the knee to elucidate the mechanisms underlying anterior knee pain remains a challenge because the joints are so small. Using novel wireless sensor technology, we have developed and validated the first "smart" patellar implant capable of measuring force magnitude and force distribution in the knee. Implantable force sensors were calibrated and tested through the range of physiologic loading. Three sensors were then interfaced with a Zimmer patellar implant and placed into a custom loading apparatus. The smart patellar implant was then incrementally loaded from 0-500 N. Sensor signals were all recorded simultaneously in real time to measure the load across the patellofemoral joint. Results demonstrated that the smart patellar implant was able to accurately measure the load being transmitted across the simulated patellofemoral joint.
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