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A Noordergraaf

Publications and source records attributed to A Noordergraaf.

98 records · Page 6Linked to original sources
PubMedDate not supplied

Signal analysis of noninvasive Xenon-133 cerebral blood flow measurements.

An anatomical model in conjunction with experimentally determined absorption data provides a framework to simulate signals as obtained from the noninvasive Xenon-133 cerebral blood flow technique. The contribution of individual tissue compartments to the total signal as well as the effect on the computed results were investigated under normal conditions. The introduction of physiological abnormalities into the model allowed the determination of sensitivity of the technique with respect to size, position, and perfusion level of the lesion. In addition, effects of cross-talk between hemispheres and signal overlap of adjacent detectors were quantified. It was found that the change of externally measured blood flow is proportional to the decrement/increment of flow in the lesion. Contrary to earlier reports, the effects of cross-talk and signal overlap were not found to be serious limitations in identifying lesions.

Animals↗
PubMedDate not supplied

Wave transmission and input impedance of a model of skeletal muscle microvasculature.

We analyzed wave transmission properties and input impedance of a microvascular network model. The model, derived from rat spinotrapezius muscle and previously described and validated by other investigators for steady pressure-flow relations, was expanded to include pulsatile phenomena. Microvessels are considered purely elastic, with compliances a function of vessel type; viscous dissipation follows Poiseuille's law. Linear and nonlinear results are presented. In the nonlinear case, shear rate-dependent viscosity of blood and transmural pressure-dependent vascular diameters were calculated and small signal perturbations were imposed around several working points. We investigated effects on input impedance of physiological variability of network parameters and structure: distribution of capillary diameters, capillary segment length, and presence or absence of cross-connecting capillaries. Results show that although wave transmission properties are complex, input impedance is simple. Apparent wave speeds differ substantially from phase velocities and change markedly from branch to branch; pressure and flow waves appear to travel at different speeds. These features result from the mesh-like structure of the network and the prominence of reflection at branchpoints. Input impedance displays a similar form under all conditions: Magnitude is a monotonically decreasing function of frequency, and phase decreases from 0 to approximately -45 degrees. Consideration of the characteristic impedance of a microvessel leads to modification of the three-element Windkessel as a reduced model of the observed input impedance.

Animals↗
PubMedDate not supplied

Arterial wave propagation phenomena, ventricular work, and power dissipation.

The effects of wave propagation phenomena, namely global reflection coefficient (gamma G[omega]) and pulse wave velocity (Cph), are studied in a model of the coupled left ventricle/arterial system. The left ventricle consists of a time-varying elastance, while the arterial system is modeled as a single, uniform, elastic tube terminating in a complex load. Manipulation of model parameters allowed for the precise control of gamma G(omega) and Cph independent of each other, peripheral resistance, and characteristic impedance. Reduction of gamma G(omega) and Cph were achieved through increases in load compliance and tube compliance, respectively. The equations describing the system were solved for left ventricular and aortic pressures and aortic flow. From these, stroke volume (SV), left ventricular stroke work (SW), and steady (Ws), oscillatory (Wo), and total power dissipation (Wt) in the arterial system were calculated. An index of arterial system efficiency was the ratio Wo/Wt (%Wo), with lower values indicating higher efficiency. Reduction of gamma G(omega) yielded initial increases in Ws, while Wo increased for the entire range of gamma G(omega), resulting in increased %Wo. This reduced efficiency is imposed on the ventricle, resulting in increased SW without increased SV. On the other hand, decreased Cph yielded in a steady increase in Ws and a biphasic response in Wo, resulting in reduced %Wo for most of the range of reduced Cph. These results suggest that differential effects on arterial system efficiency can result from reductions of gamma G(omega) and Cph. In terms of compliance, changes in arterial compliance can have different effects on efficiency, depending on where the compliance change takes place. Reasons for these results are suggested, and the role of distributed compliances is raised as a new problem.

Arteries↗
PubMedDate not supplied

Training needs and qualifications of anaesthesiologists not exposed to ALS.

OBJECTIVES: To establish which needs exist for specific training in Advanced Cardiac Life Support (ALS) in anaesthesiology residents and interns not exposed to structured ALS courses. METHODS: 48 residents, and seven interns accepted for training in anaesthesiology, were tested in a spontaneous, blind, cross-sectional, prospective assessment using a recording manikin with validated scoring system, a questionnaire, and 35 multiple-choice questions. RESULTS: 65% admitted not having had any CPR training within the last 2 years. The answers were correct in 55 +/- 14% of the cases, increasing significantly with the length of training (P = 0.001). One-rescuer CPR skills were inadequate: only 13% (n = 7) of participants scored within acceptable limits when using the Berden Scoring system (Berden et al., Resuscitation 1992;13:31-41), which assigned weighted error points to BLS skills. No correlation with skill was noted with increased length of residency, confidence, ER or ICU experience, or participation in CPR-incidents. CONCLUSIONS: Anaesthesiology residents and interns were not able to demonstrate BLS skills properly even while in training and did not recognize this themselves. CPR-related knowledge is poor and increases only incidentally over the years of residency even though participants were frequently confronted with seminars and resuscitation situations, and see protocols daily. The use of multiple-choice questions and the Berden scoring system avoids difficulties in evaluating case-scenario type of tests. We suggest that trainees are motivated to take part in standardized, intensive, recognised ALS courses which emphasize BLS skills and require (re)certification.

Adult↗