In Vivo Hemodynamic Measurement - Light - Electric

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In Vivo Hemodynamic Measurement- Light -
Electric

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VO2, VCO2, RQ, RER MET
Aerobic, Non-aerobic
O2
VE f X Vt VE/VO2
ATP
()
Physical Performance
Respiration
Circulation
Metabolism
Heat etc.
(-)
Q P/R MBP C.O X TPR C.O. HR X SV SV
VO2/HR R 6Lh/pr4
Cutaneous Microcirculation Sweat
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Hemodynamic

• Resistance and Flow in Networks of Vessels
• Flow pressure difference/ resistance
• Q ?P/R
• R 8 Lh/pr4 Q ?P/8 Lh/pr4
• Laminar vs. Turbulence Flow
• Laminar Flow
• Shear stress ss 4 hQ /pr3
• h fluid viscosity
• Turbulence Flow
• Reynolds number (Re) gt2000
• Re 4 rQ /p h di
• r fluid density di inside diameter

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Hemodynamic

• Determinants of Arterial Pressure
• Mean Arterial Pressure
• PA CO X TPR
• CO HR X SV
• TPR 8 Lh/pr4
• Arterial Pulse Pressure
• Pp PS-PD
• Pp SV/CA

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Properties of Vessels

• Venous
• Compliance
• C ?V/?P
• Deep venous thrombosis
• Valve
• venous Insufficient

• Arteries
• Stiffness
• Arteriosclerosis
• Arterioles
• Active hyperemia
• Reactive hyperemia
• Intermittent claudication

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Arteriosclerosis
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Intermittent Claudication
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Control of Arteriolar Zone

• Local
• Metabolic
• ATP-senstive K channel, adenosine, CO2, H, O2
• Flow responses
• Endothelial cells
• EDRF, NO, EDHF, PGI2
• EDCF, endothelin (ET)
• Neural
• sympathetic vasoconstrictor fiber ? a1
• Hormonal
• circulating catecholamines, vasopressin,
  anigotensin II

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Venous Valve Insufficient
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Deep Venous Thrombosis
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Methodology

• Plethysmography
• Air, Water
• Strain gauge
• Impedance
• Doppler flowometry
• Laser
• Ultrasound
• Pulse wave analysis
• IR Rheography
• Spectrophometry
• Capillary Images

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Strain Gauge Plethysmography

• A change in the blood volume in an extremity will
  lead to a change in its circumference
• Elastic mercury tubes
• the change of the electrical resistance of the
  mercury corresponds with the change of the
  circumference of the extremity.
• 35 cm calf ? a change of about 1-3 cm
• Water or air plethysmophy.

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Impedance Plethymography

• The measurement of changes in the electrical
  resistance (impedance) caused by blood volume
  changes
• Very low amount of high frequency alternating
  current is passed through the selected measuring
  segment.
• Impedance changes is inverse proportional to the
  relative changes in blood volume.

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Impedance Plethymography
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Determine Resting and Hyperemic Arterial Inflow

• Application
• Testing of inflow at rest or of the arterial
  inflow during pharmaceutical or physical
  stimulation
• Testing of hyperemic inflow
• To diagnose arterial obliterative processes
• To evaluate the haemodynamic quality of
  collateral circulation
• Limitation
• A disturbed venous outflow (venous thrombosis)
• Mediasclerosis
• Adipose (fat)

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Reactive Hyperemia
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Venous Occlusion plethymography

• Application
• Diagnosis of deep venous thrombosis
• Testing the venous capacity and the venous
  compliance to quantify pathological changes of
  the veins
• Analysis of the circulation in the deep venous
  system before vascular surgery
• Limitation
• Disturbances of arterial inflow
• Adipose (fat)

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Venous Function

• Venous capacity
• Venous outflow
• Venous tone
• Flow resistance

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Venous Reflux Test

• Application
• Functional test of the venous valves
• Evaluation of the effectiveness of the muscle
  pump
• Early recognition of venous diseases
• Evaluation of a possible success of operation on
  varicose veins

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Venous Reflux Test

• Refilling time
• Refilling velocity
• Volume displacement

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Other Possible Applications

• Diagnosis of thoracic-outlet syndrome
• Patient with scalenus anticus syndrome
• Ankle-brachial index (ABI)
• PVD

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Pulse Wave Analysis

• IR Rheography

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Determination of Artery Stiffness and Arteriole
Reflection
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Artery Stiffness
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Arteriole Reflection
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Pulse Wave Analysis
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• Application of
• Wound Healing,
• Neuropathy,
• and Endothelial Function

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• This LDF is related to the average velocity and
  number of red cells within the tissue volume.
• The Periscan PIM-II uses a 670nm laser whereas
  the Moor instruments use a 633nm laser and a
  near-infrared 830 nm source for deeper
  penetration.

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Instrument
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Wound Healing
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Wound Healing
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Wound Healing
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Burn Levels
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Laser Doppler Imaging and Inotophoresis
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SNP ? smooth cell
ACh
? endothelial cell
EDRF
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Laser Doppler Imaging and Inotophoresis
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Aging, Exercise, Microcirculation
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Aging, Exercise, Microcirculation
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Aging, Exercise, Microcirculation
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In Vitro Cell Isolation and Function -
Centrifugation - Immunomagnetic Selection-
Fluorescence

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Hematopoiesis
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Blood Cells
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Cluster of Differentiation (CD)
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Isolation of Leukocytes
-Saline -1.077 g/ml -1.095 g/ml
-mononuclear cell -granulocytes -erythrocytes

RCF11.18(r)(rpm/1000) RCF???
r??(Rotor)?? rpm??
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Immunomagnetic Selection Technique
Positive
Negative
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Cell Motion
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Adhesion Molecules

• Adhesion molecules
• 1.Selectin
• 2.Mucin
• 3.Integrin
• 4.IgG-family CAM

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Stokes Law
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Fluorescence
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Thank You for Your Attention