Clinical evaluation of a high-fidelity wireless intravaginal pressure sensor.

INTRODUCTION AND HYPOTHESIS: A wireless intravaginal pressure sensor (IVPS) has been developed to quantify abdominal pressure (P(abd)) changes during exercise and activities of daily living to guide post-operative advice given to women. In this pilot study, we aimed to compare IVPS performance, comfort, retention, and acceptability to a standard fluid-filled intrarectal pressure catheter currently used to measure P(abd) during routine urodynamics. METHODS: A Life-Tech 3-mm urodynamic intrarectal catheter and IVPS were inserted concurrently in volunteers attending a urodynamics clinic. The IVPS was positioned above the levator plate and the intrarectal catheter positioned in routine fashion well above the anal sphincter. Routine urodynamics was undertaken, with women asked to perform star jumps if coughing or Valsalva did not invoke leakage. Subjects rated device comfort using a visual analogue scale (0-10). Repeated measures Bland-Altman analysis determined level of agreement (LOA) between the two devices for peak pressures for each activity. RESULTS: Twenty-seven women were recruited, 67% of the participants preferred the IVPS, 18% the intrarectal catheter, while 15% had no preference. Mean comfort score was 0.9 ± 1.7 and 2.1 ± 2.6 (p = 0.049) for the IVPS and intrarectal catheter respectively. Bland-Altman analysis demonstrated minimal bias for cough and Valsalva, however LOA were wide. Differences were more prominent during star jumps where rapid dynamic pressure changes occurred. CONCLUSIONS: The IVPS had a higher comfort score and was well retained. The LOA between the two systems was moderate, but the high sampling rate and lower susceptibility to motion artefacts of the IVPS may provide more accurate information that will be important clinically.

Generalized spatiotemporal myocardial strain analysis for DENSE and SPAMM imaging.

Displacement encoding using stimulated echoes (DENSE) and spatial modulation of magnetization (SPAMM) are MRI techniques for quantifying myocardial displacement and strain. However, DENSE has not been compared against SPAMM in phantoms exhibiting nonhomogeneous strain, and interobserver variability has not been compared between DENSE and SPAMM. To perform these comparisons, there is a need for a generalized analysis framework for the evaluation of myocardial strain. A spatiotemporal mathematical model was used to represent myocardial geometry and motion. The model was warped to each frame using tissue displacement maps calculated from either automated phase unwrapping (DENSE) or nonrigid registration (SPAMM). Strain and motion were then calculated from the model using standard methods. DENSE and SPAMM results were compared in a deformable gel phantom exhibiting known nonhomogeneous strain, and interobserver errors were determined in 19 healthy human volunteers. Nonhomogeneous strain in the phantom was accurately quantified using both DENSE and SPAMM. In the healthy volunteers, DENSE produced better interobserver errors than SPAMM for radial strain (-0.009 ± 0.069 vs. 0.029 ± 0.152, respectively, bias ± 95% confidence interval). In conclusion, generalized spatiotemporal modeling enables robust myocardial strain analysis for DENSE or SPAMM.

Radius-dependent decline of performance in isolated cardiac muscle does not reflect inadequacy of diffusive oxygen supply.

The study of cardiac energetics commonly involves the use of isolated muscle preparations (papillary muscles or trabeculae carneae). Their contractile performance has been observed to vary inversely with thickness. This inverse dependence has been attributed, almost without exception, to inadequate diffusion of oxygen into the centers of muscles of large diameter. It is thus commonly hypothesized that the radius-dependent diminution of performance reflects the development of an anoxic core. We tested this hypothesis theoretically by solving a modification of the diffusion equation, in which the rate of oxygen consumption is a sigmoidal function of the partial pressure of oxygen. The model demonstrates that sufficiently thick muscles, operating at sufficiently high rates of oxygen demand or sufficiently low ambient partial pressures of oxygen, will indeed show diminished energetic performance, whether indirectly indexed as stress (force per cross-sectional area) development or as the rate of heat production. However, such simulated behavior requires the adoption of extreme parameter values, often differing by an order of magnitude from their experimental equivalents. We thus conclude that the radius-dependent diminution of muscle performance in vitro cannot be attributed entirely to an insufficient supply of oxygen via diffusion.

Energetics of stress production in isolated cardiac trabeculae from the rat.

The heat liberated upon stress production in isolated cardiac muscle provides insights into the complex thermodynamic processes underlying mechanical contraction. To that end, we simultaneously measured the heat and stress (force per cross-sectional area) production of cardiac trabeculae from rats using a flow-through micromechanocalorimeter. In a flowing stream of O(2)-equilibrated Tyrode solution (∼22°C), the stress and heat production of actively contracting trabeculae were varied by 1) altering stimulus frequency (0.2-4 Hz) at optimal muscle length (L(o)), 2) reducing muscle length below L(o) at 0.2 and 2 Hz, and 3) changing extracellular Ca(2+) concentrations ([Ca(2+)](o); 1 and 2 mM). Linear regression lines were adequate to fit the active heat-stress data. The active heat-stress relationships were independent of stimulus frequency and muscle length but were dependent on [Ca(2+)](o), having greater intercepts at 2 mM [Ca(2+)](o) than at 1 mM [Ca(2+)](o) (3.5 and 2.0 kJ·m(-3)·twitch(-1), respectively). The slopes among the heat-stress relationships did not differ. At the highest experimental stimulus frequency, pronounced elevation of diastolic Ca(2+) resulted in incomplete twitch relaxation. The resulting increase of diastolic stress, which occurred with negligible metabolic energy expenditure, subsequently diminished due to the time-dependent loss of myofilament Ca(2+)-sensitivity.

A unique micromechanocalorimeter for simultaneous measurement of heat rate and force production of cardiac trabeculae carneae.

To study cardiac muscle energetics quantitatively, it is of paramount importance to measure, simultaneously, mechanical and thermal performance. Ideally, this should be achieved under conditions that minimize the risk of tissue anoxia, especially under high rates of energy expenditure. In vitro, this consideration necessitates the use of preparations of small radial dimensions. To that end, we have constructed a unique micromechanocalorimeter, consisting of an open-ended flow-through microcalorimeter, a force transducer, and a pair of muscle-length actuators. The device enables the metabolic and mechanical performance of cardiac trabeculae carneae to be investigated for prolonged periods in a continuously replenished oxygen- and nutrient-rich environment.

Inexpensive optical system for microarray ELISA.

The use of antibody-based diagnostic testing has increased significantly over the past decade, giving rise to a wide range of diagnostic devices. At one end of the cost-range are rapid inexpensive point-of-care tests based on immunochromatographic strips which provide a qualitative positive or negative test outcome. On the other hand, quantitative tests generally require the use of dedicated and expensive laboratory instruments. There remains a need for diagnostic instruments and tests that can provide quantitative assessment of disease markers at low cost. This paper describes the development of a novel low cost optical device for reading colorimetric and fluorescent immunodiagnostic test results. This portable instrument uses a webcam to capture test results from a specially designed 16-well slide containing a miniaturized array of test spots. Arrays are illuminated with either LEDs or lasers, while transmitted or emitted light is captured through a long-pass filter, allowing two different types of optical measurement to be performed within the same device. This device was used to read results from an array of antibodies conjugated with either an enzymatic or fluorescent tag resulting in a colored or fluorescent readout.

Stress development, heat production and dynamic modulus of rat isolated cardiac trabeculae revealed in a flow-through micro-mechano-calorimeter.

Progress toward understanding the thermo-mechanical behavior of isolated cardiac muscle, excised from either healthy or diseased heart, is contingent on being able to measure simultaneously the stress (force per cross-sectional area) and heat production. Determination of dynamic modulus (dynamic stiffness times muscle length per cross-sectional area) sheds further light on the behavior of the force-and heat-generating actin-myosin cross-bridges. We are in a unique position to perform such measurements, given the recent completion of a micro-mechano-calorimeter. In this paper, we characterize the micro-mechano-calorimeter and present experimental results of twitch stress, heat per twitch and dynamic modulus measured in rat right-ventricular trabeculae at varied stimulus frequencies and muscle lengths. The minute radial dimensions of cardiac trabeculae (which approximate those of a human hair) ensure adequate provision of oxygen and nutrients via diffusion from the continuously replenished superfusate flowing through the measurement chamber. This enables investigation of the thermo-mechanical performance of cardiac trabeculae for many hours.