基于冠状动脉血管分支流量分配方法的血流储备分数数值模拟研究

目的在个性化无创计算血流储备分数(fractional flow reverse,FFR CT )中,流量边界条件的分配准确性往往是一个问题。本文基于种内标度律,提出了一种体积-流量关系的冠脉血流量分配方法进行血流量分配。方法对16例患者冠状动脉血管造影(CT angiography,CTA)图像进行重建,测量出各分支的体积,再经过标度律的方法将冠脉总流量以体积分配比分配到各分支出口。以临床FFR值和最终计算的血流动力学模拟值作分类对比,比较以往的管径流量模型分配方法和体积流量分配方法的准确性。结果基于体积法计算的FFR CT 误差为10.47%,基于管径法计算的FFR CT 为11.76%,并且体积分配方法与管径分配方法具有较好的一致性(80%)。结论本文结果可为临床无创检测FFR提出新的计算方法,并推动FFR CT 的临床应用研究。     

Comprehensive assessment of coronary fractional flow reserve

Fractional flow reserve (FFR) is considered nowadays as the gold standard for invasive assessment of physiologic stenosis significance and an indispensable tool for decision-making in coronary revascularization. Robust studies have shown that FFR is more effective in accurately identifying which lesions should be stented, and revascularization guided by FFR improves the outcome of coronary artery disease in patients. Therefore, FFR has been upgraded to a class A recommendation in current guidelines when the ischemic potential for specific target lesions is controversial. This article reviews the laboratory practice, functional evaluation of FFR as a gold standard and its emerging clinical application. In addition, novel noninvasive technologies of FFR measurement are discussed in depth.     

The theory of velocity selective neural recording: a study based on simulation

This paper describes the improvements to the theory of velocity selective recording and some simulation results. In this method, activity in different groups of axons is discriminated by their propagation velocity. A multi-electrode cuff and an array of amplifiers produce multiple neural signals; if artificial delays are inserted and the signals are added, the activity in axons of the matched velocity are emphasized. We call this intrinsic velocity selective recording. However, simulation shows that interpreting the time signals is then not straight-forward and the selectivity Q _v is low. New theory shows that bandpass filters improve the selectivity and explains why this is true in the time domain. A simulation study investigates the limits on the available velocity selectivity both with and without additive noise and with reasonable sampling rates and analogue-to-digital conversion parameters. Bandpass filters can improve the selectivity by factors up to 7 but this depends on the speed of the action potential and the signal-to-noise ratio.     

Axillary arch (of Langer): A large-scale dissection and simulation study based on unembalmed cadavers of body donors

Connective or muscular tissue crossing the axilla is named axillary arch (of Langer). It is known to complicate axillary surgery and to compress nerves and vessels transiting from the axilla to the arm. Our study aims at systematically researching the frequency, insertions, tissue composition and dimension of axillary arches in a large cohort of individuals with regard to gender and bilaterality. In addition, it aims at evaluating the ability of axillary arches to cause compression of the axillary neurovascular bundle. Four hundred axillae from 200 unembalmed and previously unharmed cadavers were investigated by careful anatomical dissection. Identified axillary arches were examined for tissue composition and insertion. Length, width and thickness were measured. The relation of the axillary arch and the neurovascular axillary bundle was recorded after passive arm movements. Twenty-seven axillae of 18 cadavers featured axillary arches. Macroscopically, 15 solely comprised muscular tissue, six connective tissue and six both. Their average length was 79.56 mm, width 7.44 mm and thickness 2.30 mm. One to three distinct insertions were observed. After passive abduction and external rotation of the arm, 17 arches (63%) touched the neurovascular axillary bundle. According to our results, 9% of the Central European population feature an axillary arch. Approximately 50% of it bilaterally. A total of 40.74% of the arches have a thickness of 3 mm or more and 63% bear the potential of touching or compressing the neuromuscular axillary bundle upon arm movement.     

Determination of flow resistance (vascular tone) by a perfusion pump method

Summary A pump was designed for measurement of the resistance (tone) of vessels by the method of perfusion, by way of the stable minute blood volume, taken from the animal undergoing the measurement (autoperfusion), or from a donor. The pump maintains a stable output.The pump provides the pulsation of perfusion pressure with the frequency of 90, 120, 150, 180, 240 and 300 per minute. When perfusion pressure is more than 300 Hg the pump automatically stops.The apparatus consists of three separate units; the drive, the removable working head and the resistering mercury manometer.This is attained by: a) ensuting rigidity of the hydraulic drive, and b) using distantly controlled external electromagnetic valves with a range of output regulation of from 3 to 120 ml per minute. The volume of blood contained in the pump is 6 to 8 ml.Presented by Active Member of the Acad. Med. Sci. USSR V. N. Chemigovskii     

心室辅助泵-罗叶血泵流场的数值模拟

目的 研究心室辅助泵-罗叶血泵(L-Y泵)的流场,并与Berlin Heart血泵(B-H泵)进行比较.方法 本研究运用计算流体力学(CFD)的方法,研究L-Y泵(80ml)和B-H泵(80ml)的流场,并从两种血泵的流线图和压力分布图中选择典型截面进行比较分析.结果 流线图显示,舒张早期,L-Y泵内流体呈现切线,舒张中期以高度连续流线状顺序在泵体内旋转形成旋涡;B-H泵在舒张早期泵内流体也呈切线状,但舒张中期末见旋涡形成.收缩期,两血泵内血流均以射流形式流出,由于L-Y泵的交叉设计特点,L-Y泵的流线分布较均匀;而B-H泵出入口呈平行状,其流线分布不太均匀.压力分布图显示,舒张期B-H泵局部低压区较多,L-Y泵只有1个局部低压区,收缩期B-H泵压力分布与L-Y泵类似.L-Y泵和B-H泵舒张期早期最高速度分别为0.472 m/s和0.486 m/s;收缩期中期最高速度分别为1.33 m/s和1.34 m/s.结论 L-Y泵能保持较好的线性流场,流线和压力分布较合理.B-H泵出入口区较易形成湍流,压力分布不够均匀,小旋涡和湍流较多.     

心室辅助泵-罗叶血泵流场的数值模拟

目的 研究心室辅助泵-罗叶血泵(L-Y泵)的流场,并与Berlin Heart血泵(B-H泵)进行比较.方法 本研究运用计算流体力学(CFD)的方法,研究L-Y泵(80ml)和B-H泵(80ml)的流场,并从两种血泵的流线图和压力分布图中选择典型截面进行比较分析.结果 流线图显示,舒张早期,L-Y泵内流体呈现切线,舒张中期以高度连续流线状顺序在泵体内旋转形成旋涡;B-H泵在舒张早期泵内流体也呈切线状,但舒张中期末见旋涡形成.收缩期,两血泵内血流均以射流形式流出,由于L-Y泵的交叉设计特点,L-Y泵的流线分布较均匀;而B-H泵出入口呈平行状,其流线分布不太均匀.压力分布图显示,舒张期B-H泵局部低压区较多,L-Y泵只有1个局部低压区,收缩期B-H泵压力分布与L-Y泵类似.L-Y泵和B-H泵舒张期早期最高速度分别为0.472 m/s和0.486 m/s;收缩期中期最高速度分别为1.33 m/s和1.34 m/s.结论 L-Y泵能保持较好的线性流场,流线和压力分布较合理.B-H泵出入口区较易形成湍流,压力分布不够均匀,小旋涡和湍流较多.     

介入器械放置与血流影响的仿真分析

心血管介入器械的使用越来越广泛,而综合考虑血流、器械和血管的作用情况,研究器械的放置和设计问题,有助于减少器械诱发的并发症,提高其使用的效果.本文以腔静脉滤器为例,采用计算机建模,有限体积法生成网格,通过计算流场来分析器械与血流的相互作用.结果表明介入器械的结构(如器械的支腿类型、附着方式)和放置对血管及血流有显著的影响,而器械的放置位置也可依据血管流场的情况来进行优化选择.     

Diagnostic accuracy of pattern differentiation algorithm based on Chinese medicine theory: a stochastic simulation study

Background  

Clinical practice of Chinese medicine requires little information for differentiation of Zang-fu patterns. This study is to test the impact of information amount on the diagnostic accuracy of pattern differentiation algorithm (PDA) using stochastic simulation of cases.     

Physiological interactions between Na(v)1.7 and Na(v)1.8 sodium channels: a computer simulation study

We have examined the question of how the level of expression of sodium channel Na(v)1.8 affects the function of dorsal root ganglion (DRG) neurons that also express Na(v)1.7 channels and, conversely, how the level of expression of sodium channel Na(v)1.7 affects the function of DRG neurons that also express Na(v)1.8, using computer simulations. Our results demonstrate several previously undescribed effects of expression of Na(v)1.7: 1) at potentials more negative than -50 mV, increasing Na(v)1.7 expression reduces current threshold. 2) Na(v)1.7 reduces, but does not eliminate, the dependence of action potential (AP) threshold on membrane potential. 3) In cells that express Na(v)1.8, the presence of Na(v)1.7 results in larger amplitude subthreshold oscillations and increases the frequency of repetitive firing. Our results also demonstrate multiple effects of expression of Na(v)1.8: 1) dependence of current threshold on membrane potential is eliminated or reversed by expression of Na(v)1.8 at ≥50% of normal values. 2) Expression of Na(v)1.8 alone, in the absence of Na(v)1.7, can support subthreshold oscillation. 3) Na(v)1.8 is required for generation of overshooting APs, and its expression results in a prolonged AP with an inflection of the falling phase. 4) Increasing levels of expression of Na(v)1.8 result in a reduction in the voltage threshold for AP generation. 5) Increasing levels of expression of Na(v)1.8 result in an attenuation of Na(v)1.7 current during activity evoked by sustained depolarization due, at least in part, to accumulation of fast inactivation by Na(v)1.7 following the first AP. These results indicate that changes in the level of expression of Na(v)1.7 and Na(v)1.8 may provide a regulatory mechanism that tunes the excitability of small DRG neurons.     

Tomographic bioluminescence imaging by use of a combined optical-PET (OPET) system: a computer simulation feasibility study

The feasibility and limits in performing tomographic bioluminescence imaging with a combined optical-PET (OPET) system were explored by simulating its image formation process. A micro-MRI based virtual mouse phantom was assigned appropriate tissue optical properties to each of its segmented internal organs at wavelengths spanning the emission spectrum of the firefly luciferase at 37 degrees C. The TOAST finite-element code was employed to simulate the diffuse transport of photons emitted from bioluminescence sources in the mouse. OPET measurements were simulated for single-point, two-point and distributed bioluminescence sources located in different organs such as the liver, the kidneys and the gut. An expectation maximization code was employed to recover the intensity and location of these simulated sources. It was found that spectrally resolved measurements were necessary in order to perform tomographic bioluminescence imaging. The true location of emission sources could be recovered if the mouse background optical properties were known a priori. The assumption of a homogeneous optical property background proved inadequate for describing photon transport in optically heterogeneous tissues and led to inaccurate source localization in the reconstructed images. The simulation results pointed out specific methodological challenges that need to be addressed before a practical implementation of OPET-based bioluminescence tomography is achieved.     

Rapid dual-tracer PTSM+ATSM PET imaging of tumour blood flow and hypoxia: a simulation study

Blood flow and hypoxia are interrelated aspects of physiology that affect cancer treatment and response. Cu-PTSM and Cu-ATSM are related PET tracers for blood flow and hypoxia, and the ability to rapidly image both tracers in a single scan would bring several advantages over conventional single-tracer techniques. Using dynamic imaging with staggered injections, overlapping signals for multiple PET tracers may be recovered utilizing information from kinetics and radioactive decay. In this work, rapid dual-tracer PTSM+ATSM PET was simulated and tested as a function of injection delay, order and relative dose for several copper isotopes, and the results were compared relative to separate single-tracer data. Time-activity curves representing a broad range of tumour blood flow and hypoxia levels were simulated, and parallel dual-tracer compartment modelling was used to recover the signals for each tracer. The main results were tested further using a torso phantom simulation of PET tumour imaging. Using scans as short as 30 minutes, the dual-tracer method provided measures of blood flow and hypoxia similar to single-tracer imaging. The best performance was obtained by injecting PTSM first and using a somewhat higher dose for ATSM. Comparable results for different copper isotopes suggest that tracer kinetics with staggered injections play a more important role than radioactive decay in the signal separation process. Rapid PTSM+ATSM PET has excellent potential for characterizing both tumour blood flow and hypoxia in a single, fast scan, provided that technological hurdles related to algorithm development and routine use can be overcome.     

Strain distribution on a finger link: a static simulation study

Functional prosthetics hands which have the ability to help amputees perform tasks in daily life have been developed over many years. These hands need a control system which is fed information from sensors mounted on a prosthetic hand and human–machine interface. A variety of sensors therefore been developed for the prosthetic hand to measure fingertip force, joint angle (position), object slip, texture and temperature. However, most of the strain/stress sensors are attached to the fingertip. In this paper, the potential positions for strain sensors on the side of the finger link of the prosthetic hand are investigated that, in the future, will allow for force control in a lateral or key grip. With modified links of a Southampton Hand, some promising positions for strain sensors have been determined. On some of the links, the strain sensor can be used as an indicator to show the angle of the finger during a curling operation.     

Dance movement psychotherapy for couples (DMP-C): systematic treatment guidelines based on a wide-ranging study

ABSTRACT

A new body of knowledge, growing out of the clinical and research fields, has been developing in recent years in the area of dance-movement psychotherapy for couples (DMP-C). Formulation of an intervention protocol based on a systematic review of theories and research is crucial to scientifically establishing the field and to implementing research findings in clinical practice. The present article reviews the results of a comprehensive qualitative research study in DMP-C, which addresses the following topics: couple intake, expectations of couples seeking therapy, a projective identification mechanism in the couple relationship, desires and expectations in the sexual relationship, synchrony in the non-verbal relationship, somatic mirroring, and kinaesthetic empathy in the couple relationship. Based on the findings of the research, a systematic intervention protocol for couples psychotherapy through movement and dance has been developed; its unique contribution will be examined alongside other interventions in couples therapy.     

Prevalidation of a rat liver foci bioassay (RLFB) based on results from 1600 rats: a study report

A rat liver foci bioassay (RLFB) based on an initiation-promotion protocol employing preneoplastic foci of altered hepatocytes (FAH) as an endpoint, was prevalidated in 5 different laboratories. FAH were identified by immunohistochemical demonstration of glutathione-S-transferase (placental form, GSTP) and by staining with hematoxilin/eosin (H&E), and their area fraction was quantified morphometrically. The four model hepatocarcinogens N-nitrosomorpholine, 2-acetylaminofluoren, phenobarbital, and clofibrate were selected according to characteristic differences in their presumed mode of action, and tested in a total of 1,600 male and female rats at 2 different dose levels. The chemicals were found to differ characteristically in their potency and dose-response relationship to induce FAH when given alone or when administered following initiation with diethylnitrosamine. The interlaboratory variation was small for results obtained with the GSTP-stain and somewhat larger with respect to H&E. The assessment of the carcinogenic potential of the four chemicals by the different laboratories was in the same range and the nature of their dose-response relationships did not differ essentially between laboratories. Our results suggest that this RLFB is a sensitive bioassay, providing potentially valuable information for risk assessment including the classification of carcinogenic chemicals according to their mode of action.     

Model‐based estimation of microscopic anisotropy using diffusion MRI: a simulation study

Non‐invasive estimation of cell size and shape is a key challenge in diffusion MRI. This article presents a model‐based approach that provides independent estimates of pore size and eccentricity from diffusion MRI data. The technique uses a geometric model of finite cylinders with gamma‐distributed radii to represent pores of various sizes and elongations. We consider both macroscopically isotropic substrates and substrates of semi‐coherently oriented anisotropic pores and we use Monte Carlo simulations to generate synthetic data. We compare the sensitivity of single and double diffusion encoding (SDE and DDE) sequences to the size distribution and eccentricity, and further analyse different protocols of DDE sequences with parallel and/or perpendicular pairs of gradients. We show that explicitly accounting for size distribution is necessary for accurate microstructural parameter estimates, and a model that assumes a single size yields biased eccentricity values. We also find that SDE sequences support estimates, although DDE sequences with mixed parallel and perpendicular gradients enhance accuracy. In the case of macroscopically anisotropic substrates, this model‐based approach can be extended to a rotationally invariant framework to provide features of pore shape (specifically eccentricity) in the presence of size distribution and orientation dispersion. Copyright © 2016 John Wiley & Sons, Ltd.