Medical & Biological Engineering & Computing

The paper reports on the effects of multiple whole-body infra-red-A irradiational (IRA) on 13 male patients known to have stage I or stage II essential arterial hypertension (WHO definition). The peripheral blood pressure was decreased significantly by IRA exposures. The lowered diastolic blood pressure lasted into post-treatment time. This effect is regarded as a consequence of an improvement in peripheral haemodynamics. A measure of this improvement is the different shape of the blood pressure pulse waves. Calculation and comparison of the spectral components of the recorded pulse signals show that these components are useful for a prediction of the blood pressure lowering effect.

A mathematical model is developed for the measurement of respiratory air flow, based on the phase shift of ultrasonic pulse trains. A correction is made for the velocity of found as a function of gas composition, moisture, temperature and pressure. Error estimates and calibration procedures as they relate to clinical application are discussed.

Intraoperative fluoroscopic images, as one of the most important input data for computer-assisted orthopedic surgery (CAOS) systems, have a significant influence on the positioning accuracy of CAOS system. In this study, we proposed to use multi-angle intraoperative fluoroscopy images as input based on real clinical scenario, and the aim was to analyze the positioning accuracy and the error propagation rules with multi-angle input images compared with traditional two input images. In the experiment, the positioning accuracy of the C-arm calibration-based algorithm was studied, respectively, using two, three, four, five, and six intraoperative fluoroscopic images as input data. Moreover, the error propagation rules of the positioning error were analyzed by the Monte Carlo method. The experiment result showed that increasing the number of multi-angle input fluoroscopic images could reduce the positioning error of CAOS system, which has dropped from 1.01 to 0.61 mm. The Monte Carlo simulation analysis showed that for random input errors subject to normal distribution (μ = 0, σ = 1), the image positioning error dropped from 0.29 to 0.23 mm, and the staff gauge positioning error dropped from 1.36 to 1.19 mm, while the tracking device positioning error dropped from 3.41 to 2.13 mm. In addition, the results showed that image positioning error and staff gauge positioning error were all nonlinear error for the whole system, but tracker device positioning error was a strictly linear error. In conclusion, using multi-angle fluoroscopy images was helpful for clinic, which could improve the positioning accuracy of the CAOS system by nearly 30%.

Cardiac resynchronization therapy (CRT) is an effective treatment for those patients with severe heart failure. Regrettably, there are about one third of CRT “non-responders”, i.e. patients who have undergone this form of device therapy but do not respond to it, which adversely affects the utility and cost-effectiveness of CRT. In this paper, we assess the ability of a novel surface ECG marker to predict CRT response. We performed a retrospective exploratory study of the ECG previous to CRT implantation in 43 consecutive patients with ischemic (17) or non-ischemic (26) cardiomyopathy. We extracted the QRST complexes (consisting of the QRS complex, the S-T segment, and the T wave) and obtained a measure of their energy by means of spectral analysis. This ECG marker showed statistically significant lower values for non-responder patients and, joint with the duration of QRS complexes (the current gold-standard to predict CRT response), the following performances: 86% accuracy, 88% sensitivity, and 80% specificity. In this manner, the proposed ECG marker may help clinicians to predict positive response to CRT in a non-invasive way, in order to minimize unsuccessful procedures.

The clotting time (CT) of fibrinogen mixed with thrombin decreased, then increased with increasing fibrinogen levels. By contrast, log CT decreased monotonically with respect to the log level of activating enzyme (thrombin or reptilase). Here, the CT was determined over a large range of fibrinogen concentration (to 100 mg ml−1) at a fixed level of enzyme. A new parameter, [Fib]min, the minimal fibrinogen concentration required for thrombin or reptilase-instigated phase change (coagulation), was determined as [Fib]min=0.2±0.05 μM fibrinogen. A dynamic simulation program (Stella) was employed to organize simulations based on simple and complex coagulation mechanisms, which generated CT values. The successful simulation aimed at forming [Fib]min and “recognized” the binding of unreacted fibrinogen with intermediate fibrin protofibrils. The “virtual data” mimicked the biphasic experimental CT values over a wide range of concentrations. Fibrinogen appeared to act in three modalities: as a thrombin substrate; as a precursor of fibrin; and as a competitor for fibrin protofibrils. The optimized simulation may provide a basis for predicting CT in more complex systems, such as pathological plasmas or whole blood or at high concentrations encountered with fibrin sealant.

SAR distributions were measured in the CDRH phanton, a 1 cm fatequivalent shell filled with an abdomen-equivalent liquid (σ=0.4−1.0 S m−1; dimensions 22×32×57 cm) to demonstrate the feasibility of the ring applicator to obtain deep heating. The ring electrodes were fixed in a PVC tube; diameter 48 cm, ring width 20 cm and gap width between both rings 31.6 cm. Radio-frequency energy was fed to the electrodes at eight points. The medium between the electrodes and the phantom was deionised water. The SAR distribution in the liquid tissue volume was obtained by a scanning E-field probe measuring the E-field in all three directions. With equal amplitude and phase applied to all feeding points, a uniform SAR distribution was measured in the central cross-section at 30 MHz. With RF energy supplied to only four adjacent feeding points (others were connected to a 50 ω load), the feasibility to perform amplitude steering was demonstrated; SAR values above 50% of the maximum SAR were measured in one quadrant only. SAR distributions obtained at 70 MHz showed an improved focusing ability; a maximum at the centre exists for an electric conductivity of the abdomen-equivalent tissue of 0.6 and 0.4 S m−1.