Minimally invasive in vivo human lung tissue bioimpedance measurements during the bronchoscopy procedure.

Respiratory diseases, which include diseases of the lung, pleura, bronchial tree, trachea, upper respiratory tract and of the respiratory muscles and nerves, are a common and important cause of illness and death among the population. Experimental evidences have shown that tissue lesions have different electrical properties compared with normal tissue. Therefore, lung tissues lesions may be differentiated from lung normal tissue by comparing the tissue passive electrical properties. The manuscript reports a feasibility study for minimally invasive in vivo human lung tissue tetrapolar bioimpedance measurements using a catheter during the bronchoscopy procedure based on multisine Electrical Impedance Spectroscopy (EIS) at 10 kHz - 1 MHz.

Tomografía de impedancia eléctrica en la lesión pulmonar aguda / Electrical impedance tomography in acute lung injury

La tomografía de impedancia eléctrica se ha descrito como un nuevo método de monitorización en el paciente crítico en ventilación mecánica. Recientemente ha cobrado especial interés, debido a su aplicabilidad para la monitorización de la ventilación y la perfusión pulmonar. Su implementación continua a pie de cama y el ser una técnica no ionizante y no invasiva son propiedades particulares que la convierten en un recurso extremadamente atractivo. Asimismo, por su capacidad de evaluar las características regionales de la estructura pulmonar, podría constituir una herramienta de monitorización ideal en el heterogéneo pulmón con lesión pulmonar aguda. En el presente artículo de revisión, se explica el concepto físico de la bioimpedancia y su aplicación clínica y se resume la evidencia científica publicada hasta la fecha en lo referido a la utilización de la tomografía de impedancia eléctrica como método de monitorización de la ventilación y de la perfusión, fundamentalmente en el enfermo con lesión pulmonar aguda, así como otras aplicaciones posibles de la técnica en el enfermo crítico. Asimismo, se resumen las limitaciones de la técnica y sus potenciales áreas de desarrollo en el futuro (AU)

Electrical impedance tomography has been described as a new method of monitoring critically ill patients on mechanical ventilation. It has recently gained special interest because of its applicability for monitoring ventilation and pulmonary perfusion. Its bedside and continuous implementation, and the fact that it is a non-ionizing and non-invasive technique, makes it an extremely attractive measurement tool. Likewise, given its ability to assess the regional characteristics of lung structure, it could be considered an ideal monitoring tool in the heterogeneous lung with acute lung injury This review explains the physical concept of bioimpedance and its clinical application, and summarizes the scientific evidence published to date with regard to the implementation of electrical impedance tomography as a method for monitoring ventilation and perfusion, mainly in the patient with acute lung injury, and other possible applications of the technique in the critically ill patient. The review also summarizes the limitations of the technique and its potential areas of future development (AU)

[Electrical impedance tomography in acute lung injury]. / Tomografía de impedancia eléctrica en la lesión pulmonar aguda.

Electrical impedance tomography has been described as a new method of monitoring critically ill patients on mechanical ventilation. It has recently gained special interest because of its applicability for monitoring ventilation and pulmonary perfusion. Its bedside and continuous implementation, and the fact that it is a non-ionizing and non-invasive technique, makes it an extremely attractive measurement tool. Likewise, given its ability to assess the regional characteristics of lung structure, it could be considered an ideal monitoring tool in the heterogeneous lung with acute lung injury. This review explains the physical concept of bioimpedance and its clinical application, and summarizes the scientific evidence published to date with regard to the implementation of electrical impedance tomography as a method for monitoring ventilation and perfusion, mainly in the patient with acute lung injury, and other possible applications of the technique in the critically ill patient. The review also summarizes the limitations of the technique and its potential areas of future development.

An elderly female patient with tardive oromandibular dystonia after prolonged use of the histamine analog betahistine.

Tardive oromandibular dystonia (OMD) is iatrogenic in origin and is characterised by orofacial and lingual stereotypes more frequently than the idiopathic form of OMD Tardive OMD is often associated with anti-dopaminergic treatment involving drugs such as anti-psychotics, anti-emetics, and anti-vertigo agents, although the syndrome can also be triggered by anti-epileptic or anti-depressant drugs that do not have anti-dopaminergic properties. We report an elderly female patient with OMD after prolonged, self-administered treatment with betahistine dihydrochloride, a histamine analogue.

Hypoglossal nucleus projections to the rat masseter muscle.

We investigated in the rat whether hypoglossal innervation extended to facial muscles other than the extrinsic musculature of the mystacial pad. Results showed that hypoglossal neurons also innervate the masseter muscle. Dil injected into the XII nucleus showed hypoglossal axons in the ipsilateral main trunk of the trigeminal nerve. After Gasser's ganglion crossing, the axons entered into the infraorbital division of the trigeminal nerve and targeted the extrinsic muscles of the mystacial pad. They also spread into the masseter branch of the trigeminal nerve to target the polar portions of the masseter muscle spindles. Retrograde double labelling, performed by injecting Dil into the pad and True Blue into the ipsilateral masseter muscle, showed labelled hypoglossal neurons in the medio-dorsal portion of the XII nucleus. The majority of these neurons were small (15-20 microm diameter), showed fluorescence for Dil and projected to the mystacial pad. Other medium-size neurons (25 microm diameter) were instead labelled with True Blue and projected to the masseter muscle. Finally, in the same area, other small hypoglossal neurons showed double labelling and projected to both structures. Functional hypotheses on the role of these hypoglossal projections have been discussed.

Indicator for hydration balance during haemodialysis based on anisotropic FEM.

The current paper proposes a new indicator for well-balanced dehydration of patients undergoing a haemodialysis. It is based on an estimator for the extra-cellular volume and the ultrafiltration rate. The extra-cellular fluid was computed from continuous tetrapolar bio-impedance measurements taken on the lower leg in a frequency range of several kilohertz up to 500 kHz. Finite element simulations on different leg models with anisotropic conductivities calculated with Cole models were carried out in order to incorporate the significant anisotropy of human tissue into the estimation process. The indicator was tested on measurement data gathered from 25 persons during 150 haemodialysis sessions. Its performance was determined by computing ROC curves. Results of the data analysis are reported.

Hypoglossal nuclei participation in rat mystacial pad control.

Recently, we showed that extra-trigeminal axons, originating from the hypoglossal nucleus, travel with the infraorbital division of the trigeminal nerve (ION), which is known to innervate the rat mystacial pad. Dil was monolaterally injected into the rat XII nucleus to analyse the peripheral distribution of hypoglossal axons to the mystacial pad, to evaluate their involvement in facial sensory-motor control. Electromyographic responses of mystacial pad motor units to electrical stimulation of the ION were recorded, along with the evoked responses to electrical stimulation of the ipsilateral XII nucleus. The results showed that hypoglossal axon terminals target the ipsilateral extrinsic musculature of the mystacial pad, but they do not have any contact with the intrinsic muscles. ION electrical stimulation increased electromyographic activity in the ipsilateral pad extrinsic muscles, even following VII nerve transection. Hypoglossal nucleus electrical stimulation induced field potentials and monosynaptic responses in the same motor units that persisted even following VII nerve transection, these disappearing after cooling the ION. We suggest that the small hypoglossal neurons projecting to the extrinsic musculature of the mystacial pad are part of a hypoglossal-trigeminal loop that participates in the sensory-motor control of the rat vibrissae system.

Monitoring Cole-Cole parameters during haemodialysis (HD).

UNLABELLED: The investigation of the hydration process during the haemodialysis treatment sessions is very important for the development of methods for predicting the unbalanced fluid shifts and hypotension crisis hence improving the quality of the haemodialysis procedure. Bioimpedance measurements can give valuable information about the tissue under measurement, therefore characterizing the tissue. In this work we propose a non-invasive method based on local multifrequency bioimpedance measurements that allow us to determine the fluid distribution and variations during haemodialysis. METHODS: Clinical measurements were done using 10 HD patients during 60 HD sessions. Bioimpedance data, ultrafiltration volume, blood volume and blood heamatocrit variations were recorded continuously during the HD sessions. Bioimpedance of the local tissue was measured with a 4-elctrode impedance system using surface electrodes with sampling rate of 1meas./4min. at 6 different frequencies. The measured impedances were fitted into Cole-Cole model and the Cole-Cole parameters were continuously determined for each measurement point during the HD session. ANALYSIS: The 4 Cole-Cole parameters (R 00, R 0, Fc,alpha) and their variations were evaluated. Impedance values at infinite and zero (R 00, R 0) frequencies were extrapolated from Cole-Cole mathematical model. These values are assumed to represent the impedance of total tissue fluid and the impedance of the extracellular space respectively.

Thermal diagnostics front-end electronics for LISA Pathfinder.

Precision temperature measurements are required in the LTP, the LISA technology package, for various diagnostics objectives. In this article, we describe in detail the front-end electronics design and the associated temperature sensors to achieve the LTP requirements: noise equivalent temperature of 10 microK Hz(-12) in the frequency range from 1 to 30 mHz at room temperature. We designed an ac Wheatstone bridge and a subsequent digital demodulation to minimize 1/f noise. We show experimental results where the required sensitivity in the measurement bandwidth is fulfilled.

Multiple automated minibioreactor system for multifunctional screening in biotechnology.

The current techniques applied in biotechnology allow to obtain many types of molecules that must be tested on cell cultures (high throughput screening HTS). Although such tests are usually carried out automatically on mini or microwell plates, the procedures in the preindustrial stage are performed almost manually on higher volume recipients known as bioreactors. The growth conditions in both stages are completely different. The screening system presented in this work is based on the multiwell test plates philosophy, a disposable multiple minibioreactor that allows reproduction of industrial bioreactor culture conditions: aeration, stirring, temperature, O2, pH and visible range optical absorbance measurements. It is possible to reproduce the growth conditions for both suspended and adherent animal cell types using 1 to 10 ml vol. bioreactors. In the case of bacteria or yeast, it is not possible to achieve a high biomass concentration, due to the reduced head volume air supply.

On-line monitoring of yeast cell growth by impedance spectroscopy.

The application of impedance spectroscopy to estimate on-line cell concentration was studied. The estimation was based on the relative variation between electrical impedance measured at low (10 kHz) and high frequencies (10 MHz). Studies were carried out to characterise the influence of changes in physical and chemical parameters on the impedance measurement. Two different possibilities to perform on-line measurements were tested: a simple set-up, based on an in situ probe, gave good results but was not suitable for high agitation and aeration rates. An ex situ flow-through on-line measuring cell was used to overcome these problems, showing a better performance. The use of this set-up for the growth monitorisation of a Saccharomyces cerevisiae culture showed an efficient performance, having the correlation between estimated and measured S. cerevisiae a Pearson coefficient of 0.999.

Tyrosinated alpha-tubulin changes following epileptogenic and non-epileptogenic lesions in rat brain cortex.

The expression of the tyrosinated isoform of alpha-tubulin was monitored in rat frontal cortex, in order to investigate the neuronal plasticity changes occurring either in a mirror focus or in a deafferented area. A mirror focus was triggered by epidural implantation of a cobalt gelatin disk in the contralateral left somatosensory area (group one). A deafferented area was obtained by surgical removal of the left frontal cortex (group two). All animals including controls underwent EcoG recordings immediately before killing (45, 60, 90 days post surgery). The right frontal cortex was removed from all the animals and processed with Western blot method. EcoG recordings revealed a paroxysmal activity in epileptic rats, whereas in rats with frontal deafferentation and controls, EcoG activity was normal. A significant increase in tyrosinated alpha-tubulin expression was detected both in the mirror focus (group one) and the "non-epileptic" deafferented frontal cortex (group two) in comparison with controls (group three). The transcallosal deafferentation, which is involved in both epileptogenic and non-epileptogenic lesions, is supposed to play a role in the mechanism responsible for the plasticity responses recorded in the cortical areas studied.

Epileptic seizures after treatment with thiocolchicoside.

PURPOSE: To report the occurrence of epileptic seizures in humans, closely related to the use of the centrally acting muscle relaxant thiocolchicoside. METHODS: Description of three case histories. RESULTS: Two patients, affected with complex-partial seizures, sometimes secondarily generalized, receiving antiepileptic therapy, were seizure free for 7 and 9 years, respectively. They had the reappearance of tonic-clonic seizures few days after the continued use of thiocolchicoside, at a cumulative dose of the drug of 52 mg and 76 mg, respectively. The third patient was brain damaged and without a history of seizures. He had a sudden, convulsive seizure a few minutes after 4 mg intramuscular thiocolchicoside. CONCLUSIONS: Our case histories indicate that thiocolchicoside has a powerful epileptogenic activity. This drug should be avoided in patients with epilepsy or acute brain injury and possible disruption of the blood-brain barrier.

Evaluation of the electrical impedance spectroscopy (EIS) equipment for ham meat quality selection.

The objective of this study was to evaluate the electrical impedance spectroscopy (EIS) prototype, to select the hams on the basis of meat quality characteristics in commercial conditions. Measurements of meat quality were made on 95 commercial hams (11.10±0.76 kg) to evaluate quality characteristics [ham weight, conformation (H), fat thickness in the rump (FTR), visual fatness (VF), pH(45), electrical conductivity (QM(45)) and ultimate pH (pH(24,) pH(36)) in the semimembranosus muscle]. The electrical parameters, Ro, Rinf, Ratio (Rinf/Ro), Fc and α, were obtained with the EIS equipment and was applied in five different regions of the ham (M, SM, M1, M2 and AD) at 36 h post-mortem. Principal component (PC) analysis has been used to describe the relationships between meat quality and electrical parameters in the ham meat. Two regions were selected, SM and M, showing the best correlations with pH(45) and fat characteristics in relation to electrical parameters Rinf and Ratio, respectively. Multiple regression analysis of the data confirmed that electrical variables, Ratio, α and Fc contributed to predict pH(45) (R(2)=0.50). In order to better predict visual fatness (VF), conformation and ham weight were included in the multiple regression. A R(2) of 0.59 was obtained with H, Rinf, ham weight and α. In conclusion, the results of this study have demonstrated that ratio in the SM region may classify with 88.46% accuracy the technologically normal meat (pH(45) > 6.10) from the PSE meat. In relation to visual fatness of the ham 84.21% of the samples with a Rinf in the M region > 56 had a score of > 2.5.

Disposition of propofol between red blood cells, plasma, brain and cerebrospinal fluid in rabbits.

The disposition of propofol in the blood and brain of New Zealand rabbits was studied in three groups of six rabbits. One group received a single anaesthetic dose; a second group received a 1-h infusion; and a third group was studied after the rabbits were judged to have recovered from a 1-h infusion. There was a high concentration of propofol in the red blood cell fraction and in the brain, however, the red blood cell concentration largely exceeded the one found in the brain in all groups of animals. This is consistent with the high fat solubility of diisopropylphenol. The possible effects of propofol sequestered in red blood cells is discussed.

Algorithms for parametric images in MEIT systems.

In this work we show the algorithms developed to extract the Cole parameters from multi-frequency EIT. With these parameters it is possible to obtain information about various different tissues and their pathologies. The algorithms developed obtain the Cole-model parameters from the real and imaginary parts of impedance, or using only the real part, without problems of convergence. A study of the influence of noise is performed with simulations. We find a correct solution in all cases with signal to noise ratio in the data higher than 40 dB. Finally, we show parametric images of the human abdomen obtained with these algorithms.

Heating of tissue by near-field exposure to a dipole: a model analysis.

We report a numerical study of the induced electric fields and specific absorption rate (SAR) produced by microwave radiation from a half-wavelength dipole near tissue models, and the resulting transient and steady-state temperature rises. Several models were explored, including a uniform semi-infinite plane of tissue, uniform sphere, a phantom model of the head filled with tissue-equivalent material, a numerical model of the head with uniform dielectric properties (obtained from a digitized computed tomography image), and a numerical model of the head with different dielectric properties corresponding to various tissues. The electromagnetic calculations were performed for half-wave dipoles radiating at 900 and 1900 MHz at various distances from the model, using the finite-difference-time-domain (FDTD) method. The resulting temperature rises were estimated by finite element solution of the bioheat equation. The calculated SAR values agree well with an empirical correlation due to Kuster. If the limiting hazard of such exposures is associated with excessive temperature increase, present exposure limits are very conservative and guidelines that are easier to implement might provide adequate protection.

In vivo and in situ ischemic tissue characterization using electrical impedance spectroscopy.

The investigation of processes of ischemia in different organ tissues is very important for the development of methods of protection and preservation during surgical procedures. Electrical impedance spectroscopy was used to distinguish between different tissues and their degree of ischemia. We describe mathematical methods used to adjust experimental data to Cole-Cole models for one-circle and two-circle impedance loci and a study of the main parameters for representing the behavior of ischemia in time. In vivo and in situ postmortem measurements of different tissues from pigs are shown in the 100 Hz to 1 MHz range. The Cole parameters that best characterize the ischemia are R0 and fc.

Biomass monitoring using impedance spectroscopy.

The biomass density in biotechnological processes is often determined by indirect and manual methods. Electrical impedance spectroscopy can provide online viable biomass density estimators. In this work, we present two linear estimators obtained with this technique. Four different microorganisms were measured. The detection threshold was approximately 1 g/L (dry weight) for bacteria and 0.5 g/L for yeast. Liposome suspensions were also used to validate the methods. The monitoring of the continuous growth of a yeast culture is also presented.

Epileptic discharge of cortical, subcortical and spinal neurons in penicillin induced experimental epilepsy.

The sensitivity and electrophysiological patterns of paroxysmal activity induced in different brain structures by topical application of penicillin-G were evaluated in the rat. Recordings were carried out in five groups of animals, in telencephalon, diencephalon, mesencephalon, rombencephalon and spinal cords. The following analysis were carried out: frequency distribution histograms, latency and time course duration of paroxysmal activity, duration and amplitude of epileptic bursts. The results obtained showed that the nervous structures tested with penicillin-G had a different epileptogenic sensitivity and response pattern which significantly changed along the cerebral cortex-spinal cord axis. The highest epileptic sensitivity was observed in somatosensory cortex (SI) at 500-600 microns depth; in the other cortical layers, a significant lenghtening in latency was observed. Among the other structures, the spinal cord seemed to be the most sensitive target to the epileptogenic action of penicillin-G, whereas in the remaining structures, sensitivity significantly decreased in rostro-caudal direction. As far as the features of the paroxysmal activity are concerned, significant differences among tested structures were observed. In particular, within the SI cortex, the main differences were represented by the gradual increase in burst frequency and voltage from the surface to the IVth layer and by their subsequent decrease in deeper layers (V-VI). In the diencephalon, the paroxysmal activity was similar to that observed in more superficial and deeper cortical layers even though epileptic bursts showed a lower amplitude. Mesencephalon and rombencephalon displayed a paroxysmal activity with a distinctive feature, characterized by long lasting bursts of low amplitude, although bulbar outbursts showed a shorter duration than the mesencephalic ones. In the spinal cord, the epileptiform activity displayed a different paroxysmal pattern, characterized by the longest duration and the highest amplitude. The different sensitivities of the investigated brain structures to penicillin-G and the characteristics of the induced paroxysmal activity have been extensively discussed.