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In Vivo Hemodynamic Measurement - Light - Electric

In Vivo Hemodynamic Measurement - Light - Electric. 王鐘賢 長庚大學 長壽醫學研究中心　復健科學研究所　物理治療學系. VO 2 , VCO 2 , RQ, RER MET. Aerobic, Non-aerobic. O 2. VE = f X Vt VE/VO 2. ATP. (+). Physical Performance. Respiration. Circulation. Metabolism. Heat etc. (-). Q = P/R

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In Vivo Hemodynamic Measurement - Light - Electric

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  1. In Vivo Hemodynamic Measurement- Light - Electric 王鐘賢 長庚大學 長壽醫學研究中心　復健科學研究所　物理治療學系

  2. 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

  3. 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) >2000 • Re = 4 rQ/p h di • r = fluid density; di = inside diameter

  4. 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

  5. Venous Compliance C = V/P Deep venous thrombosis Valve venousInsufficient Arteries Stiffness Arteriosclerosis Arterioles Active hyperemia Reactive hyperemia Intermittent claudication Properties of Vessels

  6. Arteriosclerosis

  7. Intermittent Claudication

  8. 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

  9. Venous Valve Insufficient

  10. Deep Venous Thrombosis

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

  12. 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.

  13. 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.

  14. Impedance Plethymography

  15. 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)

  16. Reactive Hyperemia

  17. 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)

  18. Venous Function • Venous capacity • Venous outflow • Venous tone • Flow resistance

  19. 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

  20. Refilling time Refilling velocity Volume displacement Venous Reflux Test

  21. Other Possible Applications • Diagnosis of thoracic-outlet syndrome • Patient with scalenus anticus syndrome • Ankle-brachial index (ABI) • PVD

  22. Pulse Wave Analysis IR Rheography

  23. Determination of Artery Stiffness and Arteriole Reflection

  24. Artery Stiffness

  25. Arteriole Reflection

  26. Pulse Wave Analysis

  27. Application of Wound Healing, Neuropathy, and Endothelial Function

  28. 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.

  29. Instrument

  30. Wound Healing

  31. Wound Healing

  32. Wound Healing

  33. Burn Levels

  34. Laser Doppler Imaging and Inotophoresis

  35. SNP  smooth cell ACh  endothelial cell EDRF

  36. Laser Doppler Imaging and Inotophoresis

  37. Aging, Exercise, Microcirculation

  38. Aging, Exercise, Microcirculation

  39. Aging, Exercise, Microcirculation

  40. In Vitro Cell Isolation and Function - Centrifugation - Immunomagnetic Selection- Fluorescence 王鐘賢 長庚大學 長壽醫學研究中心　復健科學研究所　物理治療學系

  41. Hematopoiesis

  42. Blood Cells

  43. Cluster of Differentiation (CD)

  44. Isolation of Leukocytes -Saline -1.077 g/ml -1.095 g/ml -mononuclear cell -granulocytes -erythrocytes RCF=11.18(r)(rpm/1000) RCF：離心力 r：轉子(Rotor)半徑 rpm：轉速

  45. Immunomagnetic Selection Technique Positive Negative

  46. Cell Motion

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

  48. Stokes’ Law

  49. Fluorescence

  50. Thank You for Your Attention

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