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Flow Changes (flow + change)
Kinds of Flow Changes Selected AbstractsA Broad Diagnostic Battery for Bedside Transcranial Doppler to Detect Flow Changes With Internal Carotid Artery Stenosis or OcclusionJOURNAL OF NEUROIMAGING, Issue 3 2001Ioannis Christou MD ABSTRACT Background and Purpose. The authors establish accuracy parameters of a broad diagnostic battery for bedside transcranial Doppler (TCD) to detect flow changes due to internal carotid artery (ICA) stenosis or occlusion. Methods. The authors prospectively studied consecutive patients with stroke or transient ischemic attack referred for TCD. TCD was performed and interpreted at bedside using a standard insonation protocol. A broad diagnostic battery included major criteria: collateral flow signals, abnormal siphon or terminal carotid signals, and delayed systolic flow acceleration in the middle cerebral artery. Minor criteria included a unilateral decrease in pulsatility index (, 0.6 or , 70% of contralateral side), flow diversion signs, and compensatory velocity increase. Angiography or carotid duplex ultrasound (CDU) was used to grade the degree of carotid stenosis using North American criteria. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TCD findings were determined. Results. Seven hundred and twenty patients underwent TCD, of whom 517 (256 men and 261 women) had angiography and/or CDU within 8.8 ± 0.9 days. Age was 63.1 ± 15.7 years. For a 70% to 99% carotid stenosis or occlusion, TCD had sensitivity of 79.4%, specificity of 86.2%, PPV of 57.0%, NPV of 94.8%, and accuracy of 84.7%. For a 50% to 99% carotid stenosis or occlusion, TCD had sensitivity of 67.5%, specificity of 83.9%, PPV of 54.5%, NPV of 90.0%, and accuracy of 81.6%. TCD detected intracranial carotid lesions with 84.9% accuracy and extracranial carotid lesions with 84.4% accuracy (sensitivity of 88% and 79%, specificity of 85% and 86%, PPV of 24% and 54%, and NPV of 99% and 95%, respectively). The prevalence of the ophthalmic artery flow reversal was 36.4% in patients with , 70% stenosis or occlusion. If present, this finding indicated a proximal ICA lesion location in 97% of these patients. Conclusions. In symptomatic patients, bedside TCD can accurately detect flow changes consistent with hemodynamically significant ICA obstruction; however, TCD should not be a substitute for direct carotid evaluation. Because TCD is sensitive and specific for , 70% carotid stenosis or occlusion in both extracranial and intracranial carotid segments, it can be used as a complementary test to refine other imaging findings and detect tandem lesions. [source] Noninvasive Activity-based Control of an Implantable Rotary Blood Pump: Comparative Software Simulation StudyARTIFICIAL ORGANS, Issue 2 2010Dean M. Karantonis Abstract A control algorithm for an implantable centrifugal rotary blood pump (RBP) based on a noninvasive indicator of the implant recipient's activity level has been proposed and evaluated in a software simulation environment. An activity level index (ALI),derived from a noninvasive estimate of heart rate and the output of a triaxial accelerometer,forms the noninvasive indicator of metabolic energy expenditure. Pump speed is then varied linearly according to the ALI within a defined range. This ALI-based control module operates within a hierarchical multiobjective framework, which imposes several constraints on the operating region, such as minimum flow and minimum speed amplitude thresholds. Three class IV heart failure (HF) cases of varying severity were simulated under rest and exercise conditions, and a comparison with other popular RBP control strategies was performed. Pump flow increases of 2.54, 1.94, and 1.15 L/min were achieved for the three HF cases, from rest to exercise. Compared with constant speed control, this represents a relative flow change of 30.3, 19.8, and ,15.4%, respectively. Simulations of the proposed control algorithm exhibited the effective intervention of each constraint, resulting in an improved flow response and the maintenance of a safe operating condition, compared with other control modes. [source] Functional map and age-related differences in the human face: nonimmunologic contact urticaria induced by hexyl nicotinateCONTACT DERMATITIS, Issue 1 2006Slaheddine Marrakchi Variation in human skin reactivity to various irritants in association with age and body region has been reported. Hexyl nicotinate (HN), a lipophilic nicotinate ester, was used to induce nonimmunologic contact urticaria in human volunteers of 2 age groups: 10 young subjects [24,34 years, mean ± standard deviation (SD) 29.8 ± 3.9 years] and 10 older volunteers (66,83 years, mean ± SD 73.6 ± 17.4 years); and to define skin function and potential age-related differences in various facial areas. About 5 mM of HN in ethanol was applied to 8 locations on the face, neck, and volar forearm. A laser Doppler flowmeter was used to determine baseline blood flow and to monitor the skin blood flow changes after HN application. In the contralateral areas, stratum corneum turnover was determined using 5% dansyl chloride in petrolatum. In the young group, the perioral area exhibited the strongest reaction to HN. In the older group, the chin was the most sensitive site. In both the groups, the forearm was the least responsive. The older group demonstrated a stronger reaction than the younger group in 3 sites (forehead, cheek, and nasolabial area). Stratum corneum turnover was slower in the nasolabial area and in the forearm in both age groups, whereas the fastest was in the perioral area and the chin in the younger group and in the chin and the forehead in the older group. Compared to the older group, the younger group showed a slower stratum corneum turnover in the nose and the neck. This study demonstrates the regional and the age-related variability of the stratum corneum turnover and the skin reactions to HN. These observations may help explain some aspects of the cutaneous intolerance in skin care of the face. [source] Released nucleotides amplify the cilium-dependent, flow-induced [Ca2+]i response in MDCK cellsACTA PHYSIOLOGICA, Issue 3 2009H. A. Praetorius Abstract Aim:, Changes in perfusate flow produce increases in [Ca2+]i in renal epithelial cells. Cultured renal epithelia require primary cilia to sense subtle changes in flow. In perfused kidney tubules this flow response is caused by nucleotide signalling via P2Y2 receptors. It is, however, not known whether nucleotides are released by mechanical stress applied to renal primary cilia. Here we investigate whether nucleotides are released during the cilium-dependent flow response and contribute to the flow-induced, cilium-dependent [Ca2+]i signal. Methods:, MDCK cells loaded with Fluo-4-AM were observed at 37 °C in semi-open single or closed-double perfusion chambers. Results:, Our data suggest a purinergic component of the cilium-dependent flow-response: (1) ATP scavengers and P2 receptor antagonists reduced (55%) the cilium-dependent flow-response; (2) ATP added at subthreshold concentration sensitized the renal epithelia to flow changes; (3) increases in fluid flow transiently enhanced the ATP concentration in the superfusate (measured by biosensor-cells). To test if nucleotides were released in sufficient quantities to stimulate renal epithelia we used non-confluent MDCK cells without cilia as reporter cells. We confirmed that non-confluent cells do not respond to changes in fluid flow. Placing confluent, ciliated cells upstream in the in-flow path of the non-confluent cells made them responsive to fluid flow changes. This phenomenon was not observed if either non-confluent or de-ciliated confluent cells were placed upstream. The [Ca2+]i -response in the non-confluent cells with ciliated cells upstream was abolished by apyrase and suramin. Conclusion:, This suggests that subtle flow changes sensed by the primary cilium induces nucleotide release, which amplifies the epithelial [Ca2+]i -response. [source] Doppler Superior Vena Cava Flow Evolution and Respiratory Variation in Superior Vena Cava SyndromeECHOCARDIOGRAPHY, Issue 4 2008Fa Qin Lv M.D. Background: Superior vena cava syndrome (SVCS) is a clinical expression of obstruction of blood flow through the superior vena cava. The patterns of the Doppler flow changes of superior vena cava (SVC), especially the respiratory effects on them have not yet been fully elucidated. This study was to examine SVC Doppler flow patterns and the respiratory effects on them in healthy subjects and patients with SVCS. Methods: The SVC Doppler flow patterns of 18 normal human subjects and 22 patients with SVCS were analyzed at initial diagnosis and were followed up every 2 months for at least 11 months. Results: Among the 22 patients, 5 patients with the tumor near the right atrium oppressing the inferior segment of the SVC had clear VR- and AR-waves, while in the other 17 patients the VR- and AR-waves disappeared or their outlines were vague. The respiratory variations of the S- and D-waves as a percentage change in inspiration compared to expiration in patient group were much lower than those in control group (S-wave: 1.67 ± 3.32% vs. 15.65 ± 16.15%, P = 0.0003; D-wave: 1.80 ± 1.12% vs. 23.55 ± 37%, P = 0.0087), which gradually became larger with treatment and showed no significant difference with those in control group after 7 months. Conclusions: The Doppler flows of the patients with SVCS correlate well with the images of CT scan of them. The respiratory variation of the S- and D-velocities could be used to evaluate the severity of SVC obstruction and its therapeutic effect. [source] Analysis of Steady Ground Water Flow Toward Wells in a Confined-Unconfined AquiferGROUND WATER, Issue 4 2006Chen Chong-Xi A confined aquifer may become unconfined near the pumping wells when the water level falls below the confining unit in the case where the pumping rate is great and the excess hydraulic head over the top of the aquifer is small. Girinskii's potential function is applied to analyze the steady ground water flow induced by pumping wells with a constant-head boundary in a mixed confined-unconfined aquifer. The solution of the single-well problem is derived, and the critical radial distance at which the flow changes from confined to unconfined condition is obtained. Using image wells and the superposition method, an analytic solution is presented to study steady ground water flow induced by a group of pumping wells in an aquifer bounded by a river with constant head. A dimensionless function is introduced to determine whether a water table condition exists or not near the pumping wells. An example with three pumping wells is used to demonstrate the patterns of potentiometric surface and development of water table around the wells. [source] Gingival blood flow changes following periodontal access flap surgery using laser Doppler flowmetryJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2007M. Retzepi Abstract Aim: To investigate the pattern of gingival blood flow changes following periodontal access flap surgery by laser Doppler flowmetry (LDF). Material and methods: Fourteen patients with chronic periodontitis presenting upper anterior sites with pocket depth 5 mm after initial treatment were included in the study. Periodontal access flap surgery was performed on the experimental areas and LDF recordings were taken at baseline, following anaesthesia, immediately postoperatively and on days 1, 2, 3, 4, 7, 15, 30 and 60 of healing, at nine predetermined sites per flap. Results: Significant ischaemia was observed at all flap sites following anaesthesia and immediately postoperatively. At the alveolar mucosal sites, a peak increase of the gingival blood flow was observed on postoperative day 1 (p<0.001), which persisted until day 7 (p=0.012) and resolved by day 15. The mucosal sites close to the flap periphery presented higher blood perfusion compared with the sites located centrally in the flap. The microcirculatory perfusion of the buccal and palatal papillae was maximum on postoperative day 7 (p=0.013 and <0.001, respectively) and returned to baseline by day 15. Conclusion: Topographically distinct areas of the periodontal access flap consistently present different patterns of microvascular blood flow alterations during the wound-healing period. [source] Orbital blood flow velocities in patients with rheumatoid arthritisJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2007Besir Erdogmus MD Abstract Purpose. To assess orbital blood flow changes in patients with rheumatoid arthritis using Doppler sonography. Patients and Methods. The study comprised 35 patients who were diagnosed with RA and were treated at the Department of Physical Therapy and Rehabilitation at Duzce Medical School. A control group consisted of 35 healthy volunteers. Color Doppler imaging was used to measure peak systolic velocity (PSV) and end diastolic velocity (EDV), from which the resistance index (RI) was calculated in the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). Results. In the OA, PSV, EDV, and RI were, respectively, 36.7 ± 0.6 cm/sec, 9.7 ± 0.2 cm/sec, and 0.73 in the control group versus 34.7 ± 3.0 cm/sec, 9.1 ± 1.1 cm/sec, and 0.74 in the patient group. In the CRA, they were, respectively, 11.8 ± 1.7 cm/sec, 3.6 ± 0.7 cm/sec, and 0.66 in the control group versus 11.1 ± 1.7 cm/sec, 3.4 ± 0.7 cm/sec, and 0.68 in the patient group. In the PCAs, they were, respectively, 13.2 ± 1.2 cm/sec, 4.7 ± 0.6 cm/sec, and 0.65 in the control group versus 12.4 ± 1.2 cm/sec, 4.2 ± 0.6 cm/sec, and 0.66 in the PCAs. PSV, EDV, and RI of the PCAs and OA and RI of the CRA were significantly different between patients and controls, whereas there was no difference in the serum levels of glucose, triglyceride, low-density lipoprotein cholesterol, and total cholesterol. In the patient group, there was a significant correlation between orbital blood flow and duration of disease. Conclusion. Ocular blood flow appears to be slightly lower in RA patients than in healthy controls, suggesting that RA is a systemic inflammatory disease that may also involve ocular vessels. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007 [source] Assessment of regional myocardial oxygenation changes in the presence of coronary artery stenosis with balanced SSFP imaging at 3.0T: Theory and experimental evaluation in caninesJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2008Rohan Dharmakumar PhD Abstract Purpose To examine the dependence of steady-state free-precession (SSFP) -based myocardial blood-oxygen-level-dependent (BOLD) contrast on field strength using theoretical and experimental models. Materials and Methods Numerical simulations using a two-pool exchange model and a surgically prepared dog model were used to assess the SSFP-based myocardial BOLD signal changes at 1.5T and 3.0T. Experimental studies were performed in eight canines with pharmacological vasodilation under various levels of left circumflex coronary artery stenosis. Experimentally obtained BOLD signal changes were correlated against microsphere-based true flow changes. Results Theoretical results showed that, at 3.0T, relative to 1.5T, a threefold increase in oxygen sensitivity can be expected. Experimental studies in canines showed near similar results,a 2.5 ± 0.2-fold increase in BOLD sensitivity at 3.0T relative to 1.5T (P < 0.05). Based on the scatter gram of BOLD data and microsphere data, it was found that the minimum regional flow difference that can be detected with SSFP-based myocardial BOLD imaging at 1.5T and 3.0T were 2.9 and 1.6, respectively (P < 0.05). Conclusion This study demonstrated that SSFP-based myocardial BOLD sensitivity is substantially greater at 3.0T compared with 1.5T. The findings here suggest that SSFP-based myocardial BOLD imaging at 3.0T may have the necessary sensitivity to detect the clinically required minimum flow difference of 2.0. J. Magn. Reson. Imaging 2008;27:1037,1045. © 2008 Wiley-Liss, Inc. [source] A Broad Diagnostic Battery for Bedside Transcranial Doppler to Detect Flow Changes With Internal Carotid Artery Stenosis or OcclusionJOURNAL OF NEUROIMAGING, Issue 3 2001Ioannis Christou MD ABSTRACT Background and Purpose. The authors establish accuracy parameters of a broad diagnostic battery for bedside transcranial Doppler (TCD) to detect flow changes due to internal carotid artery (ICA) stenosis or occlusion. Methods. The authors prospectively studied consecutive patients with stroke or transient ischemic attack referred for TCD. TCD was performed and interpreted at bedside using a standard insonation protocol. A broad diagnostic battery included major criteria: collateral flow signals, abnormal siphon or terminal carotid signals, and delayed systolic flow acceleration in the middle cerebral artery. Minor criteria included a unilateral decrease in pulsatility index (, 0.6 or , 70% of contralateral side), flow diversion signs, and compensatory velocity increase. Angiography or carotid duplex ultrasound (CDU) was used to grade the degree of carotid stenosis using North American criteria. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TCD findings were determined. Results. Seven hundred and twenty patients underwent TCD, of whom 517 (256 men and 261 women) had angiography and/or CDU within 8.8 ± 0.9 days. Age was 63.1 ± 15.7 years. For a 70% to 99% carotid stenosis or occlusion, TCD had sensitivity of 79.4%, specificity of 86.2%, PPV of 57.0%, NPV of 94.8%, and accuracy of 84.7%. For a 50% to 99% carotid stenosis or occlusion, TCD had sensitivity of 67.5%, specificity of 83.9%, PPV of 54.5%, NPV of 90.0%, and accuracy of 81.6%. TCD detected intracranial carotid lesions with 84.9% accuracy and extracranial carotid lesions with 84.4% accuracy (sensitivity of 88% and 79%, specificity of 85% and 86%, PPV of 24% and 54%, and NPV of 99% and 95%, respectively). The prevalence of the ophthalmic artery flow reversal was 36.4% in patients with , 70% stenosis or occlusion. If present, this finding indicated a proximal ICA lesion location in 97% of these patients. Conclusions. In symptomatic patients, bedside TCD can accurately detect flow changes consistent with hemodynamically significant ICA obstruction; however, TCD should not be a substitute for direct carotid evaluation. Because TCD is sensitive and specific for , 70% carotid stenosis or occlusion in both extracranial and intracranial carotid segments, it can be used as a complementary test to refine other imaging findings and detect tandem lesions. [source] CLIMATE CHHANGE SENSITIVITY ASSESSMENT ON UPPER MISSISSIPPI RIVER BASIN STREAMFLOWS USING SWAT,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 4 2006Manoj Jha ABSTRACT: The Soil and Water Assessment Tool (SWAT) model was used to assess the effects of potential future climate change on the hydrology of the Upper Mississippi River Basin (UMRB). Calibration and validation of SWAT were performed using monthly stream flows for 1968,1987 and 1988,1997, respectively. The R2 and Nash-Sutcliffe simulation efficiency values computed for the monthly comparisons were 0.74 and 0.69 for the calibration period and 0.82 and 0.81 for the validation period. The effects of nine 30-year (1968 to 1997) sensitivity runs and six climate change scenarios were then analyzed, relative to a scenario baseline. A doubling of atmospheric CO2 to 660 ppmv (while holding other climate variables constant) resulted in a 36 percent increase in average annual streamflow while average annual flow changes of ,49, ,26, 28, and 58 percent were predicted for precipitation change scenarios of ,20, ,10, 10, and 20 percent, respectively. Mean annual streamflow changes of 51,10, 2, ,6, 38, and 27 percent were predicted by SWAT in response to climate change projections generated from the CISRO-RegCM2, CCC, CCSR, CISRO-Mk2, GFDL, and HadCMS general circulation model scenarios. High seasonal variability was also predicted within individual climate change scenarios and large variability was indicated between scenarios within specific months. Overall, the climate change scenarios reveal a large degree of uncertainty in current climate change forecasts for the region. The results also indicate that the simulated UMRB hydrology is very sensitive to current forecasted future climate changes. [source] On the timing characteristics of the apparent diffusion coefficient contrast in fMRIMAGNETIC RESONANCE IN MEDICINE, Issue 2 2002Stacey L. Gangstead Abstract For the past 10 years, functional MRI (fMRI) has seen rapid progress in both clinical and basic science research. Most of the imaging techniques are based on the blood oxygenation level-dependent (BOLD) contrast which arises from the field perturbation of the paramagnetic deoxyhemoglobin due to the mismatch between the local oxygen demand and delivery. Because the changes of oxygenation level take place mostly in the veins, the dominant signal sources of the BOLD signal are intra- and extravascular proton pools of the veins. Perfusion imaging methods, developed parallel to the BOLD technique, seek to quantify the blood flow and perfusion. Recently, perfusion imaging using arterial spin tagging methods have been used to study brain function by investigating the changes of the blood flow and perfusion during brain activation, thereby generating an alternative contrast mechanism to the functional brain imaging. Since most of these methods require tagging pulse and wait time for blood to be delivered to the imaged slice, the temporal resolution may not be optimal. Dynamic intravoxel incoherent motion (IVIM) weighting schemes using apparent diffusion coefficient (ADC) contrast were suggested to image the relative changes of the in-plane blood flow during brain function. In this report, it was demonstrated that, in addition to the spatial discrepancies of the activated areas, the time course based on the ADC contrast consistently precedes that from the BOLD contrast with timing offset on the order of 1 sec. Since arterial networks would have different spatial locations and preceding temporal characters, the findings in this report are indicative that the ADC contrast is sensitive to the arterial blood flow changes. Magn Reson Med 48:385,388, 2002. © 2002 Wiley-Liss, Inc. [source] Blood Flow in Snake Infrared Organs: Response-Induced Changes in Individual VesselsMICROCIRCULATION, Issue 2 2007RICHARD C. GORIS ABSTRACT Objective: In the past the microkinetics of blood flow in the infrared pit organs of pit vipers has been studied with Doppler flowmetry using various infrared stimuli such as a human hand or soldering iron at various distances, lasers of various wavelengths, etc. Quick-acting variations in blood flow were recorded, and interpreted as a cooling mechanism for avoiding afterimage in the infrared receptors. However, the Doppler measurements provided only the summation of blood flow in a number of vessels covered by the sensing probe, but did not give data on flow in individual vessels. Methods: In the present work the authors introduced into the bloodstream of Gloydius and Trimeresurus pit vipers fluorescent microspheres labeled with fluorescein isothiocyanate (FITC) contained in a solution of FITC-dextran in physiological saline. They observed the passage of the microspheres through individual pit organ vessels with a fluorescent microscope to which was attached a high-speed video camera and image intensifier. Output of the camera was recorded before, during, and after stimulus with a 810-nm diode laser. Recording was done at 250 frames/s on high-speed video apparatus and downloaded to a hard disk. Disk files were loaded into proprietary software and particles were tracked and average velocities calculated. The data were then tested for significance by ANOVA with post hoc tests. Results: A significant (p < .05) increase in blood velocity was found at the focal point of the stimulus laser, but not anywhere removed from this point. Proximal severing of the pit sensory nerves caused degeneration of the pit receptor terminals and abolished stimulus-induced blood flow changes, but did not affect normal blood flow. Conclusions: The authors conclude that the receptors themselves are directly and locally controlling the smooth muscle elements of the blood vessels, in response to heating of the receptors by infrared radiation. They speculate that the heavy vascularization constitutes a cooling system for the radiation-encoding receptors, and further that the agent of control may be a volatile neuromediator such as nitric oxide. [source] Assessment of spinal cord pathology following trauma using early changes in the spinal cord evoked potentials: A pharmacological and morphological study in the ratMUSCLE AND NERVE, Issue S11 2002Hari Shanker Sharma PhD Abstract The possibility that spinal cord pathology following trauma can be assessed with early changes in the spinal cord evoked potentials (SCEPs) was examined in a rat model. Spinal cord injury (SCI) was produced in Equithesin-anesthetized (3 ml/kg, i.p.) rats through a longitudinal incision into the right dorsal horn at the T10,11 segments. The SCEPs were recorded with epidural electrodes placed over the T9 (rostral) segment of the cord. The SCEPs consisted of a small positive amplitude and a broad and high negative amplitude (NA). SCI resulted in an instant depression of the rostral NA that lasted for 1 h. However, the latency of NA continued to increase over time. At 5 h, spinal cord blood flow declined by 30% in the T9 segment, whereas the spinal cord water content and the permeability of the blood,spinal cord barrier (BSCB) were markedly increased. Damage to the nerve cells, glial cells, and myelin was quite common in the spinal cord, as seen by light and electron microscopy. Pretreatment with p -chlorophenylalanine, indomethacin, ibuprofen, and nimodipine attenuated the SCEP changes immediately after trauma and resulted in a marked reduction in edema formation, BSCB permeability, and blood flow changes at 5 h. However, pretreatment with cyproheptadine, dexamethasone, phentolamine, and propranolol failed to attenuate the SCEP changes after SCI and did not reduce the cord pathology. These observations suggest that early changes in SCEP reflect secondary injury-induced alterations in the cord microenvironment. Obviously, these changes are crucial in determining the ultimate magnitude and severity of cord pathology. © 2002 Wiley Periodicals, Inc. Muscle Nerve Supplement 11: S83,S91, 2002 [source] Evaluation of the anti-vascular effects of combretastatin in rodent tumours by dynamic contrast enhanced MRINMR IN BIOMEDICINE, Issue 2 2002Ross J. Maxwell The anti-vascular effects of the tubulin binding agent, disodium combretastatin A-4 3- O -phosphate (CA-4-P), have been investigated in the rat P22 carcinosarcoma by measurements of radiolabelled iodoantipyrine uptake and dynamic contrast-enhanced MRI. The iodoantipyrine estimates of absolute tumour blood flow showed a reduction from 0.35 to 0.04,ml g,1 min,1 6,h after 10,mg kg,1 CA-4-P and to <0.01,ml g,1 min,1 after 100,mg kg,1. Tumour blood flow recovered to control values 24,h after 10,mg kg,1 CA-4-P, but there was no recovery by 24,h after the higher dose. Dynamic contrast-enhanced MR images were obtained at 4.7 T, following injection of 0.1,mmol kg,1 Gd-DTPA and analysed assuming a model arterial input function. A parameter, Ktrans, which is related to blood flow rate and permeability of the tumour vasculature to Gd-DTPA, was calculated from the uptake data. Ktrans showed a reduction from 0.34 to 0.11 min,1 6,h after 10,mg kg,1 CA-4-P and to 0.07 min,1 after 100,mg kg,1. Although the magnitude of changes in Ktrans was smaller than that in tumour blood flow, the time course and dose-dependency patterns were very similar. The apparent extravascular extracellular volume fraction, ,e, showed a four-fold reduction 6,h after 100,mg kg,1 CA-4-P, possibly associated with vascular shutdown within large regions of the tumour. These results suggest that Ktrans values for Gd-DTPA uptake into tumours could be a useful non-invasive indicator of blood flow changes induced by anti-vascular agents such as combretastatin. Copyright © 2002 John Wiley & Sons, Ltd. [source] Simultaneous Automatic Control of Oxygen and Carbon Dioxide Blood Gases During Cardiopulmonary BypassARTIFICIAL ORGANS, Issue 6 2010Berno J.E. Misgeld Abstract In this work an automatic control strategy is presented for the simultaneous control of oxygen and carbon dioxide blood gas partial pressures to be used during cardiopulmonary bypass surgery with heart,lung machine support. As the exchange of blood gases in the artificial extracorporeal lung is a highly nonlinear process comprising varying time delays, uncertainties, and time-varying parameters, it is currently being controlled manually by specially trained perfusionist staff. The new control strategy includes a feedback linearization routine with augmented time-delay compensation and two external linear gain-scheduled controllers, for partial oxygen and carbon dioxide pressures. The controllers were robustly tuned and tested in simulations with a detailed artificial lung (oxygenator) model in cardiopulmonary bypass conditions. Furthermore, the controllers were implemented in an ex vivo experiment using fresh porcine blood as a substitute fluid and a special deoxygenation technique to simulate a patient undergoing cardiopulmonary bypass. Both controllers showed robust stability during the experiments and a good disturbance rejection to extracorporeal blood flow changes. This automatic control strategy is proposed to improve patient's safety by fast control reference tracking and good disturbance rejection under varying conditions. [source] Coronary Hemodynamics and Myocardial Oxygen Consumption During Support With Rotary Blood PumpsARTIFICIAL ORGANS, Issue 1 2009Peter Voitl Abstract Mechanical support offered by rotary pumps is increasingly used to assist the failing heart, although several questions concerning physiology remain. In this study, we sought to evaluate the effect of left-ventricular assist device (VAD) therapy on coronary hemodynamics, myocardial oxygen consumption, and pulmonary blood flow in sheep. We performed an acute experiment in 10 sheep to obtain invasively measured coronary perfusion data, as well as pressure and flow conditions under cardiovascular assistance. A DeBakey VAD (MicroMed Cardiovascular, Inc., Houston, TX, USA) was implanted, and systemic and coronary hemodynamic measurements were performed at defined baseline conditions and at five levels of assistance. Data were measured when the pump was clamped, as well as under minimum, maximum, and moderate levels of assistance, and in a pump-off condition where backflow occurs. Coronary flow at the different levels of support showed no significant impact of pump activity. The change from baseline ranged from ,10.8% to +4.6% (not significant [n.s.]). In the pulmonary artery, we observed a consistent increase in flow up to +4.5% (n.s.) and a decrease in the pulmonary artery pressure down to ,14.4% (P = 0.004). Myocardial oxygen consumption fell with increasing pump support down to ,34.6% (P = 0.008). Left-ventricular pressure fell about 52.2% (P = 0.016) as support was increased. These results show that blood flow in the coronary arteries is not affected by flow changes imposed by rotary blood pumps. An undiminished coronary perfusion at falling oxygen consumption might contribute to cardiac recovery. [source] External cephalic version induced fetal cerebral and umbilical blood flow changes are related to the amount of pressure exertedBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2004Tak Yeung Leung Objective To correlate the applied pressure during external cephalic version with the changes in fetal middle cerebral arterial and umbilical arterial flow before and after the procedure. Design A prospective observational study over a two-year period. Setting External cephalic version was performed in a university hospital. Population Sixty-nine women with singleton breech-presenting pregnancy at or above 36 weeks of gestation undergoing external cephalic version. Methods During external cephalic version, the operator wore a pair of pressure-sensing gloves which had thin piezo-resistive sensors positioned on the palmar surface. During each version procedure, real-time pressure readings were recorded from all sensors, and then analysed with a computer program. The amount of pressure applied over time was presented by pressure,time integral. The pulsatility indices of both fetal middle cerebral artery and umbilical artery before and after external cephalic version were measured. The changes of pulsatility indices of both middle cerebral artery and umbilical artery were presented as a ratio of the post-external cephalic version pulsatility indices to pre-external cephalic version pulsatility indices, denoted by middle cerebral artery pulsatility index ratio and umbilical artery pulsatility index ratio, respectively. The statistical correlation between pressure,time integral and middle cerebral artery pulsatility index ratio and umbilical artery pulsatility index ratio are analysed using Pearson's correlation test. Main outcome measures Changes in pulsatility indices of fetal middle cerebral and umbilical arteries and fetal heart rate after external cephalic version. Results The overall success rate of external cephalic version was 77%. There was a significant negative correlation between pressure,time integral and both middle cerebral artery pulsatility index ratio (P= 0.001) and umbilical artery pulsatility index ratio (P= 0.012). When women were categorised according to placental site, pressure,time integral was negatively correlated with middle cerebral artery pulsatility index ratio only when the placenta was posteriorly located (P= 0.003), and with umbilical artery pulsatility index ratio only when the placenta was laterally located (P= 0.03). Conclusions The greater the force applied during external cephalic version, the greater the reduction in pulsatility indices of middle cerebral artery and umbilical artery, indicating an increase in blood flow through these arteries. The increase in cerebral blood flow after external cephalic version is more prominent when the placenta is lying posteriorly, while the increase in umbilical flow is more prominent when the placenta is lying laterally. These findings suggest that the vascular changes probably represent a direct effect of force exerted on the fetal head and the placenta. [source] 3251: From elementary concept in animal models to new frontiers in humans: neurovascular coupling in the ocular circulationACTA OPHTHALMOLOGICA, Issue 2010C RIVA Purpose The retina and optic nerve, both optically accessible components of the central nervous system, are ideally suited for the investigation of the intrinsic physiological process by which blood ,ow, metabolism and neural activity are tightly coupled (Roy and Sherrington. 1890). Methods Using various techniques in the cat and human eye, the changes in blood flow in the retina and optic nerve in response to increased neural activity by flicker stimulation have been determined. The effect of varying the stimulus parameters, such as flicker modulation depth, frequency, luminance and red-green color ratio, on the blood flow response was investigated. Putative mediators of the activity-induced flow changes and the relationship between activity, blood flow and metabolic changes were assessed. Results Visual stimulation with flicker increases rapidly and markedly both retinal and optic nerve blood ,ows (functional hyperemia). Moreover, the data reveal unequivocally the presence, under specific conditions of flicker, of a neurovascular/neurometabolic coupling in these tissues, partly mediated by local potassium ions and nitric oxide production. Furthermore, the activity-induced hyperemia is altered during a number of physiological and pharmacological interventions and in some pathologic conditions. Conclusion Flicker stimulation of the retina offers a new and powerful means to modulate blood flow and investigate the neurovascular coupling in the neural eye tissues. Exploration of this activity-induced hyperemia and the mechanism(s) underlying the neurovascular coupling will lead to an increased understanding of the pathophysiology of various ocular diseases. [source] | |||||||||||||||||||||||||