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Biomedical subjects

Ahmed Hassanein

Publications and source records attributed to Ahmed Hassanein.

6 recordsLinked to original sources

Hemodynamic computation using multiphase flow dynamics in a right coronary artery.

Hemodynamic data on the roles of physiologically critical blood particulates are needed to better understand cardiovascular diseases. The blood flow patterns and particulate buildup were numerically simulated using the multiphase non-Newtonian theory of dense suspension hemodynamics in a realistic right coronary artery (RCA) having various cross sections. The local hemodynamic factors, such as wall shear stress (WSS), red blood cell (RBC) buildup, viscosity, and velocity, varied with the spatially nonuniform vessel structures and temporal cardiac cycles. The model generally predicted higher RBC buildup on the inside radius of curvature. A low WSS region was found in the high RBC buildup region, in particular, on the area of maximum curvature of a realistic human RCA. The complex recirculation patterns, the oscillatory flow with flow reversal, and vessel geometry resulted in RBC buildup due to the prolonged particulate residence time, specifically, at the end of the diastole cycle. The increase of the initial plasma viscosity caused the lower WSS. These predictions have significant implications for understanding the local hemodynamic phenomena that may contribute to the earliest stage of atherosclerosis, as clinically observed on the inside curvatures and torsion of coronary arteries.

Blood Viscosity↗

Nanopumping using carbon nanotubes.

A new "nanopumping" effect consisting of the activation of an axial gas flow inside a carbon nanotube by producing Rayleigh traveling waves on the nanotube surface is predicted. The driving force for the new effect is the friction between the gas particles and the nanotube walls. A molecular dynamics simulation of the new effect was carried out showing macroscopic flows of atomic and molecular hydrogen and helium gases in a carbon nanotube.

Capillary Action↗

Multiphase hemodynamic simulation of pulsatile flow in a coronary artery.

A multiphase transient non-Newtonian three-dimensional (3-D) computational fluid dynamics (CFD) simulation has been performed for pulsatile hemodynamics in an idealized curved section of a human coronary artery. We present the first prediction, to the authors' knowledge, of particulate buildup on the inside curvature using the multiphase theory of dense suspension hemodynamics. In this study, the particulates are red blood cells (RBCs). The location of RBC buildup on the inside curvature correlates with lower wall shear stress (WSS) relative to the outside curvature. These predictions provide insight into how blood-borne particulates interact with artery walls and hence, have relevance for understanding atherogenesis since clinical observations show that atherosclerotic plaques generally form on the inside curvatures of arteries. The buildup of RBCs on the inside curvature is driven by the secondary flow and higher residence times. The higher viscosity in the central portion of the curved vessel tends to block their flow, causing them to migrate preferentially through the boundary layer. The reason for this is the nearly neutrally buoyant nature of the dense two-phase hemodynamic flow. The two-phase non-Newtonian viscosity model predicts greater shear thinning than the single-phase non-Newtonian model. Consequently, the secondary flow induced in the curvature is weaker. The waveforms for computed hemodynamic parameters, such as hematocrit, WSS, and viscosity, follow the prescribed inlet velocity waveforms. The lower oscillatory WSS produced on the inside curvature has implications for understanding thickening of the intimal layer.

Biomechanical Phenomena↗

One or 2 Intacs segments for the correction of keratoconus.

PURPOSE: To evaluate the effect of implanting 1 or 2 intracorneal rings (Intacs, KeraVision) as a device to correct, stabilize, and/or improve the best corrected visual acuity in patients with clear cornea keratoconus oriented by the preoperative corneal topography pattern. SETTING: Vissum/Instituto Oftalmológico de Alicante, Miguel Hernandez University, Alicante, Spain. METHODS: In this prospective comparative consecutive study, Intacs segments were implanted in 26 keratoconic eyes with clear central corneas of 19 consecutive patients (9 women and 10 men). Corneas were divided into 2 groups according to the topographic pattern of the cone. Group I included keratoconus not crossing the 180 degrees meridian and Group II included keratoconus crossing the 180 degrees meridian. The Intacs were horizontally placed through a lateral clear corneal incision. According to the corneal topography 1 segment was implanted 0.45 mm inferior in Group I, and 2 segments were implanted, 1 0.25 mm superior and the other 0.45 mm inferior, in Group II. All cases completed a minimum follow-up of 1 year. Differences between preoperative and postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and keratometry were clinically and statistically evaluated. RESULTS: Spherical equivalent error and refractive astigmatism were significantly reduced. The mean keratometric values were reduced following Intacs insertion in both groups. At the end of the first year of the postoperative follow-up, Group I (1 segment) had an improvement in mean UCVA to 20/50 (0.4 +/- 0.22 decimal value), which was statistically significant when compared to the preoperative UCVA of 20/100 (0.2 +/- 0.13 decimal value) (P=.011). Mean BSCVA was 20/32 (0.62 +/- 0.24 decimal value), which was also statistically significant when compared to the preoperative BSCVA, which was 20/50 (0.4 +/- 0.21 decimal value) (P=.002). In Group II (2 segments), UCVA after 1 year was 20/63 (0.34 +/- 0.17 decimal value), which was statistically significant when compared to the preoperative UCVA of 20/400 (0.06 +/- 0.02 decimal value) (P=.001). Mean BSCVA was 20/32 (0.62 +/- 0.27 decimal value), which was significantly better than the preoperative UCVA of 20/50 (0.38 +/- 0.22 decimal value) (P=.001). In 4 eyes, the inferior segment was removed because of partial extrusion during the postoperative follow-up. CONCLUSIONS: Treatment of keratoconus with 1 or 2 Intacs segments oriented by the preoperative corneal topography used in this study proved to be effective in decreasing the corneal steepening and astigmatism and improving BSCVA. Further follow-up is needed to determine the final effect of Intacs on the progression of the corneal disease.

Adult↗

Hyaluronic acid combined with mannitol to improve protection against free-radical endothelial damage: experimental model.

PURPOSE: To evaluate the protective properties of combined sodium hyaluronate 2% and mannitol 0.5% (Visiol) on the corneal endothelium in the presence of oxidative stress induced by hydrogen peroxide (H(2)O(2)). SETTING: Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain. METHODS: This was an exploratory randomized controlled parallel-group, masked-assessor study of 3 sodium hyaluronate-based ophthalmic viscosurgical devices (OVDs): Visiol, Healon (sodium hyaluronate 1%), and Viscoat (sodium hyaluronate 3%-chondroitin sodium 4%). The OVDs were tested for protective effects on the endothelium following oxidative stress induced by H(2)O(2) at increased concentrations: control (lactated Ringer's solution), 1 mM, 10 mM, and 100 mM. Groups without OVD were used as controls at the same concentrations of peroxide. Each animal received the same treatment in both eyes (10 eyes per group). Endothelial cell lesion was assessed using the Janus green photometry absorbance technique. RESULTS: At 10 mM peroxide concentration, the value of endothelial cell lesion was significantly lower in the Visiol (16.8%, P=.0056), Healon (22.2%, P=.0302), and Viscoat (21.6%, P=.0336) groups than in the control group (29.4%, no OVD). There was a trend in favor of Visiol to more efficiently reduce cell lesions of the endothelium, than Healon (P=.055) and Viscoat (P=.1013). Values of endothelial cell lesion at peroxide concentrations of 1 mM and 100 mM showed the same trends than those observed at 10 mM. CONCLUSIONS: All of the OVDs tested efficiently reduced endothelial lesions against free radicals compared with the control group in which no OVD was used. The following sequence for the efficacy of endothelial cell protection was established: Visiol>Viscoat>Healon>no OVD.

Animals↗

Changes in keratoconic corneas after intracorneal ring segment explantation and reimplantation.

PURPOSE: To evaluate the outcome and potential reversibility of the changes induced in keratoconic eyes after intracorneal ring segment explantation. DESIGN: Retrospective, interventional case series. PARTICIPANTS: Five eyes of 4 patients who underwent uneventful implantation of one or two intracorneal ring segment segments for the correction of clear corneal keratoconus and who required explantation of one segment due to complications. MAIN OUTCOME MEASURES: Visual acuity, refraction, keratometric readings, and corneal topography. The follow-up was up to 1 year from the primary implantation procedure in all cases. RESULTS: Explantation was performed easily in all cases without intraoperative or postoperative complications. The segments were extracted due to migration and local melting. The visual, refractive, and topographic map findings regressed to approximate the original clinical situation before segment implantation. CONCLUSIONS: Intracorneal ring segments are safely and easily explanted from keratoconic eyes. Most of the visual, refractive, and topographic findings return to near the preimplantation levels.

Adult↗