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The present article describes a standard instrument for the continuous online determination of retinal vessel diameters, the commercially available retinal vessel analyzer. This report is intended to provide informed guidelines for measuring ocular blood flow with this system. The report describes the principles underlying the method and the instruments currently available, and discusses clinical protocol and the specific parameters measured by the system. Unresolved questions and the possible limitations of the technique are also discussed.
Patients after coarctation repair still have an increased risk of cardiovascular or cerebrovascular events. This has been explained by the persisting hypertension and alterations in the peripheral vessels. However, involvement of the central vessels such as the retinal arteries is virtually unknown. A total of 34 patients after coarctation repair (22 men and 12 women; 23 to 58 years old, age range 0 to 32 years at surgical repair) and 34 nonhypertensive controls underwent structural and functional retinal vessel analysis. Using structural analysis, the vessel diameters were measured. Using functional analysis, the endothelium-dependent vessel dilation in response to flicker light stimulation was assessed. In the patients after coarctation repair, the retinal arteriolar diameter was significantly reduced compared to that of the controls (median 182 μm, first to third quartile 171 to 197; vs 197 μm, first to third quartile 193 to 206; p <0.001). These findings were independent of the peripheral blood pressure and age at intervention. No differences were found for venules. The functional analysis findings were not different between the patients and controls (maximum dilation 3.5%, first to third quartile 2.1% to 4.5% vs 3.6%, first to third quartile 2.2% to 4.3%; p = 0.81), indicating preserved autoregulative mechanisms. In conclusion, the retinal artery diameter is reduced in patients after coarctation repair, independent of their current blood pressure level and age at intervention. As a structural marker of chronic vessel damage associated with past, current, or future hypertension, retinal arteriolar narrowing has been linked to stroke incidence. These results indicate an involvement of cerebral microcirculation in aortic coarctation, despite timely repair, and might contribute to explain the increased rate of cerebrovascular events in such patients.
Ein 34-jähriger männlicher Patient stellte sich zur Abklärung einer seit dem 9. Lebensjahr bestehenden und im letzten Jahr rasch progredienten Visusminderung beider Augen bei uns vor. Er beschrieb eine subjektiv zunehmende, im Spiegel für ihn selbst sichtbare, weißliche Trübung in der Pupille beidseits und eine starke Blendempfindlichkeit. Nebenbefundlich gab er rezidivierende Konjunktivitiden und morgens verklebte Lider an. Eine Allergie auf Gräserpollen und eine Unverträglichkeit auf Alkohol sowie mehrere Lebensmittel seien ebenfalls bekannt.
Zusätzlich leidet der Patient an stark ausgeprägtem atopischem Ekzem. Dieses wurde nie systemisch, sondern nur bei Bedarf mit kortisonhaltiger Salbe therapiert.
Bilaterale stromale Hornhauttrübungen sind für den Augenarzt eine differenzialdiagnostische Herausforderung. Im folgenden Beitrag werden 2 Patieninnen (30 und 36 Jahre) mit unterschiedlich stark ausgeprägter stromaler diffuser Hornhauttrübung vorgestellt. Patientin 1 war kleinwüchsig (114 cm) und Patientin 2 normal groß (172 cm). Beide Patientinnen wiesen veränderte Gelenkstrukturen an Hand und Fußgelenken sowie diffuse stromale Hornhauttrübungen auf. Des Weiteren lagen eine Mitral- und Aorteninsuffizienz (Patientin 1) bzw. eine Aorteninsuffizienz (Patientin 2) vor. Die stromalen diffusen Hornhauttrübungen ließen im Zusammenhang mit den Gelenkveränderungen ein Scheie-Syndrom vermuten. Therapeutisch ist bei Patienten mit Visusminderung eine (lamelläre) Keratoplastik sinnvoll.
Purpose: Image analysis by the retinal vessel analyzer (RVA) observes retinal vessels in their dynamic state online noninvasively along a chosen vessel segment. It has been found that high-frequency diameter changes in the retinal artery blood column along the vessel increase significantly in anamnestically healthy volunteers with increasing age and in patients with glaucoma during vascular dilation. This study was undertaken to investigate whether longitudinal sections of the retinal artery blood column are altered in systemic hypertension.
Methods: Retinal arteries of 15 untreated patients with essential arterial hypertension (age, 50.9 ± 11.9 years) and of 15 age-matched anamnestically healthy volunteers were examined by RVA. After baseline assessment, a monochromatic luminance flicker (530–600 nm; 12.5 Hz; 20 s) was applied to evoke retinal vasodilation. Differences in amplitude and frequency of spatial artery blood column diameter change along segments (longitudinal arterial profiles) of 1 mm in length were measured and analyzed using Fourier transformation.
Results: In the control group, average reduced power spectra (ARPS) of longitudinal arterial profiles did not differ when arteries changed from constriction to dilation. In the systemic hypertension group, ARPS during constriction, baseline, and restoration were identical and differed from ARPS during dilation (P < 0.05). Longitudinal arterial profiles in both groups showed significant dissimilitude at baseline and restoration (P < 0.05).
Conclusions: The retinal artery blood column demonstrates microstructural alterations in systemic hypertension and is less irregular along the vessel axis during vessel dilation. These microstructural changes may be an indication of alterations in vessel wall rigidity, vascular endothelial function, and smooth muscle cells in this disease, leading to impaired perfusion and regulation.
Autonomous robotic systems for penetrating thick ice shells with simultaneous collecting of scientific data are very promising devices in both terrestrial (glacier, climate research) and extra-terrestrial applications. Technical challenges in development of such systems are numerous and include 3D-navigation, an appropriate energy source, motion control, etc. Not less important is the problem of forward contamination of the pristine glacial environments with microorganisms and biomolecules from the surface of the probe. This study was devoted to establishing a laboratory model for microbial contamination of a newly constructed ice-melting probe called IceMole and to analyse the viability and amount of the contaminating microorganisms as a function of distance. The used bacterial strains were Bacillus subtilis (ATCC 6051) and Escherichia coli (ATCC 11775). The main objective was development of an efficient and reliable in-situ decontamination method of the melting probe. Therefore, several chemical substances were tested in respect of their efficacy to eliminate bacteria on the surface of the melting probe at low temperature (0 - 5 °C) and at continuous dilution by melted water. Our study has shown that at least 99.9% decontamination of the IceMole can be successfully achieved by the injection of 30% (v/v) hydrogen peroxide and 3% (v/v) sodium hypochlorite into the drilling site. We were able to reproduce this result in both time-dependent and depth-dependent experiments. The sufficient amount of 30% (v/v) H₂O₂ or 3% (v/v) NaClO has been found to be approximately 18 L per cm² of the probe’s surface.
Aims: Thrombotic complications due to activation of platelets and plasmatic clotting factors belong still to the most investigated topics in the field of study of patho-physiological mechanisms. Mathematical modeling of thrombotic reactions is established and validated in test cases. Aim of this study is to experimentally evaluate and computationally simulate platelets under the influence of well-defined shear flow conditions. Platelet behaviour and reactions are experimentally reproduced, measured and used for validation of the numerical simulation. Methods: A mathematical model of platelet activation, adhesion and aggregation has been implemented into a finite element CFD (Computational Fluid Dynamics) code. The approach is based on the advective and diffusive transport equations for resting platelets, activated platelets and platelet released agonists. Adhesion rates for the reactive surfaces depend on the hemocompatibility properties of the surface and the local shear rate. Experiments with citrate-anticoagulated freshly-drawn whole blood are performed in a perfusion flow chamber as well as in a system of rotating cylinders for Couette and Taylor-vortex flow. Different biomaterials are used. The activation, drop of platelet concentration, adhesion and aggregation are quantified using scanning electron microscopy (SEM) and flow cytometry. Results: Regions and flow conditions with a high potential for thrombus growth could be identified. The experiments clearly show the influence of the blood contacting material and flow properties. By means of SEM diverse platelet adhesion patterns are observed. Numerical analysis can explain the patterns and the degree of thrombus formation. Conclusion: The numerical method shows good agreement with experimental data indicating a possible prediction of initiation of activation and detection of the local adhesion areas in connection with the role of Von-Willebrand-Factor.
Purpose of Study: Thrombosis-related complications are among the leading causes for morbidity and mortality in patients who depend on artificial organs. For the prediction of platelet behavior both the flow conditions inside the device and the thrombogenic properties of the blood-contacting surfaces must be considered. Platelet reactions under the influence of well-defined shear rates are experimentally evaluated and numerically simulated. The approach is intended for the analysis of VAD and oxygenator design.
Methods Used: A mathematical model of platelet activation, adhesion and aggregation has been implemented into a finite element CFD (Computational Fluid Dynamics) code. The approach is based on the advective and diffusive transport equations for resting and activated platelets and platelet released agonists. Experiments with citrate-anticoagulated freshly-drawn whole blood are performed in a perfusion flow chamber as well as in a system of rotating cylinders for Couette and Taylor-vortex flow. Different biomaterials are used. The activation, adhesion and aggregation are quantified using scanning electron microscopy and flow cytometry.
Summary of Results: Regions and flow conditions with a high potential for thrombus growth could be identified. The experiments clearly show the influence of the blood contacting material and governing shear rates. Numerical analysis can explain observed adhesion patterns and the degree of thrombus formation
The MicroMed DeBakey ventricular assist device is an axial flow pump designed for providing long-term support to end-stage heartfailure patients. Previously, we presented computational analysis of the blood pump flow. From the analysis, we were able to identify regions of high shear and recirculating flow that may cause blood damage, for example, deformation and fragmentation of the red blood cell (RBC). This mechanical hemolysis can be predicted using a tensor-based blood damage model that is based on the physical properties of the RBCs, for example, the relaxation time of the RBC membrane. However, an extensive and detailed analysis was complicated by the fact that the previous method predicts hemolysis along a finite number of pathlines traversed by the RBCs, possibly omitting parts of the flow domain. Furthermore, it is computationally expensive and is not easily parallelizable.
Here, we propose a new method to estimate hemolysis. The method is based on treating the shape of droplet (tensor) as a field variable, like velocity in the Navier-Stokes system. The governing equation for the RBC shape is treated by least-squares finite element method and the volume conservation of the RBC is augmented by Lagrangian multiplier. Unlike the previous method, the proposed method can visualize areas of high RBC strain that is potentially dangerous for mechanical hemolysis. Also, the amount of plasma-free hemoglobin and, consequently, normalized index of hemolysis can be computed as a byproduct. The method is tested in a simple shear flow for validation and an artery graft flow is chosen to show its potential usefulness. Finally, the method is applied to the blood damage estimation for the pump.
In this paper, we will provide a feasible mission design for a multiple-rendezvous mission to Jupiter's Trojans. It is based on solar electric propulsion, as being currently used on the DAWN spacecraft, and other flight-proven technology. First, we have selected a set of mission objectives, the prime objective being the detection of water -especially subsurface water -to provide evidence for the Trojans' formation at large solar distances. Based on DAWN and other comparable missions, we have determined suitable payload instruments to achieve these objectives. Afterwards, we have designed a spacecraft that is able to carry the selected payload to the Trojan region and rendezvous successively with three target bodies within a maximum mission duration of 15 years. Accurate low-thrust trajectories have been obtained with a global low-thrust trajectory optimization program (InTrance). During the transfer from Earth to the first target, the spacecraft is propelled by two RIT-22 ion engines from EADS Astrium, whereas a single RIT-15 is used for transfers within the Trojan region to reduce the required power. For power generation, the spacecraft uses a multi-junction solar array that is supported by concentrators. To achieve moderate mission costs, we have restricted the launch mass to a maximum of 1600 kg, the maximum interplanetary injection capability of a Soyuz/Fregat launcher. Our final layout has a mass of 1400 kg, yielding a margin of about 14%. Nestor (a member of the L4-population) was determined as the first mission target. It can be reached within 4.6 years from launch. The fuel mass ratio for this transfer is about 35%. The stay time at Nestor is 1.2 years. Eurymedon was selected as the second target (transfer time 3.5 years, stay time 3.0 years) and Irus as the third target (transfer time 2.2 years). The transfers within the Trojan L4-population can be accomplished with fuel mass ratios of about 3% for each trajectory leg. Including the stay times in orbit around the targets, the mission can be accomplished within a total duration of about 14.5 years. According to our mission analysis, it is also feasible to fly to the L5-population with similar flight times. It has to be noted that -for a first analysis -we have taken only the named targets into account. Allowing also rendezvous with unnamed objects will very likely decrease the mission duration. Based on a scaling of DAWN's mission costs (due to comparable scientific instruments and mission objectives), and taking into account the longer mission duration and the potential re-use of already developed technology, we have estimated that these three rendezvous can be accomplished with a budget of about 250 Million Euros, i.e. about 25% of ROSETTA's budget.
The mission of the COMPASS-1 picosatellite is to take pictures of the earth, to validate a space-borne GPS receiver developed by the German Aerospace Center, and to verify the proper operation of the magnetic attitude control system in orbit. The spacecraft was launched on April 28, 2008 from the Indian space port Sriharikota, as part of the PSLV-C9 world record launch that simultaneously brought ten satellites into orbit. The mission operations were carried out from the ground stations in Aachen and Tainan. Arising difficulties in the communication link were overcome with the support of individuals from the amateur radio community. After several months of mission operation, abundant housekeeping and mission data has been commanded, received and analyzed and is presented in this paper.
Biomechanics studies biological soft tissue materials (growth, remodeling) in vivo. For this objective, the detailed information of material properties must be well defined to construct reliable constitutive models. In the paper, the bulge test is carried out with elastomers in order to develop a test method. Then, application of the test for soft tissue materials is straightforward due to the similarities between elastomers with soft tissue materials as proved in Holzapfel 2005, Ogden 2009. It means, after the preliminary experiments and parameter identification with rubber materials has been setup, experiments on soft tissue materials can be similarly carried out. Elastomers have a complex behavior which strongly depends on the largest previous load cycle. For simplicity we consider only the first loading.