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Biomedical subjects

B H Brown

Publications and source records attributed to B H Brown.

At least 37 records · Page 2Linked to original sources

Assessing the conditions for in vivo electrical virtual biopsies in Barrett's oesophagus.

It has previously been shown that it is possible to differentiate between squamous and columnar epithelia in rat and resected human tissues using an impedance probe to make in vitro measurements. This probe can be passed down an endoscope allowing measurements to be made in patients. However, the probe emerges parallel to the oesophageal wall, with little room to manoeuvre. The conditions of control required to give reliable readings have been investigated. The importance of pressure applied and the angle of approach to the oesophagus was assessed. Pressures in the range 26.6 Pa to 46.3 kPa and angles in the range 15-90 degrees were considered. In in vitro studies it was observed that it was possible to obtain consistent readings with pressures greater than 2.9 kPa and with angles greater than 15 degrees between the probe and the oesophagus. These conditions can be achieved in vivo, and readings obtained from twelve patients are shown (45 readings on normal squamous, 34 on Barrett's oesophagus and 22 on stomach). At low frequencies (9.6-153.2 kHz), a Mann-Whitney test shows a significant difference (p < 0.001) when comparing the means from squamous and columnar, and also when readings from Barrett's and normal gastric epithelia are compared (p < 0.001).

Animals↗

A comparison of modified Howland circuits as current generators with current mirror type circuits.

Multi-frequency electrical impedance tomography (EIT) systems require stable voltage controlled current generators that will work over a wide frequency range and with a large variation in load impedance. In this paper we compare the performance of two commonly used designs: the first is a modified Howland circuit whilst the second is based on a current mirror. The output current and the output impedance of both circuits were determined through PSPICE simulation and through measurement. Both circuits were stable over the frequency ranges 1 kHz to 1 MHz. The maximum variation of output current with frequency for the modified Howland circuit was 2.0% and for the circuit based on a current mirror 1.6%. The output impedance for both circuits was greater than 100 kohms for frequencies up to 100 kHz. However, neither circuit achieved this output impedance at 1 MHz. Comparing the results from the two circuits suggests that there is little to choose between them in terms of a practical implementation.

Biomedical Engineering↗

Movement artefact rejection in impedance pneumography using six strategically placed electrodes.

In this paper, we have proposed a technique for reducing movement artefacts in impedance pneumography by placing six electrodes at appropriate locations and suitably combining the measurements obtained. The strategy for electrode placement was based on the observation that the electrodes appeared to slide over the rib cage along with the skin, during movement. A volume conductor model of the thoracic cavity was developed and movement artefacts were simulated by shifting the electrodes to a different location on the surface. The impedance changes due to movement in one of the measurements of a 'symmetrical pair' were 180 degrees out of phase with respect to those observed in the other measurement of that pair. However, the impedance changes due to breathing were in phase in both these measurements. Thus, it was possible to reduce movement artefacts by taking a mean of these measurements without affecting the breathing related changes. The six electrodes could be configured into two such symmetrical pairs. The same observation was made in experimental data recorded from human subjects. This indicated that movement artefacts were caused by sliding of electrodes along with the skin and could be reduced by using the six-electrode configuration.

Cardiography, Impedance↗

Cole equation modelling to measurements made using an impulse driven transfer impedance system.

Electrical impedance measurements are used to obtain information about a subject, tissue sample or tissue model under test. There are several ways of obtaining these impedance data and thereafter analysing the data to obtain relevant parameters. This paper shows how a completely isolated drive and receive system using current pulses, as opposed to sine waves, achieves good fitted results with resistor-capacitor Cole phantoms.

Data Interpretation, Statistical↗

Diuretic induced change in lung water assessed by electrical impedance tomography.

Monitoring patients with left ventricular failure can be difficult. Electrical impedance tomography (EIT) produces cross-sectional images of changes in the impedance of the thorax. We measured changes in the electrical impedance of the lung in nine volunteers following a diuretic challenge. The hypothesis was that lung impedance would increase with diuretic induced fluid loss. Heart rate, blood pressure and urine output were also recorded. After diuretic the mean urine output was 1220 ml compared with 187 ml after placebo. Following diuretic administration, mean thoracic impedance increased by 13.6% (p < 0.01) and lung impedance increased by 7.8% (p < 0.05). Taken as a group there was a correlation between overall impedance change and total urine output. However, for each individual, the time course of change in impedance and urine output did not correlate significantly. Our findings show that EIT may offer a better guide to the response of the lung to diuretic treatment than simply measuring urine output. The urine output is neither specific nor sensitive in the assessment of lung water. Mean lung impedance, however, is largely determined by lung water. The study showed that lung impedance can be recorded at supra-normal values. EIT may help in the management of patients with excess lung water.

Adolescent↗

An in vivo comparative study of the pregnant and nonpregnant cervix using electrical impedance measurements.

Electrical impedance may be measured using electrodes on the surface of the cervix and recording the potential that results when an electrical current is passed. Increased hydration of the cervix has been described throughout pregnancy and occurs most dramatically before labour. This study compared tissue impedance measurements of the pregnant and non-pregnant cervix and found a statistically significant lower value (P < 0.001) in pregnancy. Further work may show that such measurements alter in relation to labour onset.

Cervix Uteri↗

Virtual biopsies in Barrett's esophagus using an impedance probe.

Preliminary results of electrical impedance measurements in squamous and columnar epithelia in rat and human tissues are presented. The aim of this work is to show the possibility of differentiating these two types of epithelia in terms of their electrical characteristics. For the measurements, we employed a 1.95-m-long, 3.2-mm-diameter, four-electrode probe designed to be used transendoscopically in the diagnosis of Barrett's esophagus (BE). BE is a condition in which the normal squamous epithelium of the esophagus is replaced by columnar epithelium of the intestinal type. This metaplasia is considered as a premalignant condition that puts patients at a 30-125-fold risk of developing adenocarcinoma of the esophagus. The diagnosis and surveillance of BE involve taking multiple biopsies, an expensive and time-consuming procedure. This study constitutes the first stage in the replacement of tissue biopsy by "virtual biopsies".

Animals↗

Monitoring patients with left ventricular failure by electrical impedance tomography.

Acute left ventricular failure (LVF) is a common medical emergency but detection and monitoring of pulmonary oedema remains problematic. Fluid is an important determinant of tissue impedance. Electrical impedance tomography (EIT) is a non-invasive technique allowing localisation of impedance changes within tissue. We have investigated the relationship between LVF and the electrical impedance of lung tissue. Twenty patients with a clinical diagnosis of acute left ventricular failure were compared with 30 normal subjects. Patients were monitored using serial chest radiographs and electrical impedance tomography measurements of lung impedance during hospital admission. Radiographs were graded according to the severity of pulmonary oedema by two independent radiologists. Lung impedance was significantly (P<0.0001) lower than normal in patients with left ventricular failure. Values returned towards the normal range as LVF resolved. There was a similar improvement in the score of the chest radiographs. The electrical impedance of the lung is low in left ventricular failure and increases following treatment.

Acute Disease↗

A comparison of neonatal and adult lung impedances derived from EIT images.

An objective method of extracting respiratory data from lung images is presented, together with a technique for automatically generating regions of interest delineating the anterior and posterior regions of the lungs. The method is used to extract data on the change in lung impedance with frequency, and on calculated Cole parameters, from 19 normal neonates (gestational age 32 to 42 weeks) and 8 normal adults (age 21 to 82 years). A comparison of the impedance properties of neonatal and adult lungs was made. The variation of lung impedance with frequency in neonates, as derived from EIT images, is significantly different from that found for adults. The implications for a model of the electrical impedance of lung tissue are discussed.

Adult↗

Anatomical and physiological models for surgical simulation.

A considerable amount of effort has been aimed towards developing real-time deformable objects for surgical simulation, but very little work has been aimed towards including physiology within the soft tissue models. A simulator that links the structural and functional aspects of the human body would allow the user to develop a better understanding of the intrinsic link between anatomy and physiology. This positional paper discusses the challenges facing the creation of and the development of an integrated physiological and anatomical soft tissue model for use in surgical simulators. It explores the artificial dichotomy between anatomy and physiology and the issues it raises, by considering a suturing simulator capable of modelling ischaemia.

Animals↗

Model for the dielectric properties of human lung tissue against frequency and air content.

Electrical impedance tomographic spectroscopy measurements of the lungs are taken from nine normal subjects, in the frequency range 9.6 kHz-1.2 MHz. The results show that resistivity rho'FRC relative to functional residual capacity increases almost linearly with inspiration volume V, with the slope of the curve increasing with frequency f. Resistivity rho'9.6 kHz relative to 9.6 kHz decreases with f. rho'9.6 kHz increases with V, at any given frequency. Curves for rho'9.6 kHz show a roughly linear trend with log10(f). Based on a discussion of the measurement results, a mathematical lung tissue model is designed that involves extra-capillary blood vessels and alveoli, the walls of which consist of blood-filled capillaries, epithelial cells and intercellular liquid. Using this model, the increase in rho'FRC with V is explained by the thinning of alveolar walls with increasing air content. The almost linear shape of curves for rho'9.6 kHz is attributed to four partly overlapping main dispersions caused by extra-capillary blood vessels, epithelial cells, blood and the capillary network.

Adult↗

Information from time-varying vibrotactile stimuli.

Experiments have been carried out to investigate the information transfer available via a single vibrator on the fingertip. In a first experiment, for stimuli with durations 80 to 320 ms, discrimination of a one-octave step change in frequency at the halfway point was investigated. Results were similar for three stimulus types--sinewave, monophasic pulse and tetraphasic pulse--suggesting temporal cues are more important than spectral cues in this task. In a second experiment, subjects were required to perceive changes in a sequence of stimulus elements. A presentation rate of 6.25 elements s-1 was found to give better results than a rate of 12.5 elements s-1. In the former case, the potential information transfer per element was estimated to be approximately 1.0 bits, corresponding to an information transfer rate of around 6 bits s-1. Implications for the design of a tactile aid to lipreading are discussed.

Adult↗

Three-dimensional electrical impedance tomography.

The electrical resistivity of mammalian tissues varies widely and is correlated with physiological function. Electrical impedance tomography (EIT) can be used to probe such variations in vivo, and offers a non-invasive means of imaging the internal conductivity distribution of the human body. But the computational complexity of EIT has severe practical limitations, and previous work has been restricted to considering image reconstruction as an essentially two-dimensional problem. This simplification can limit significantly the imaging capabilities of EIT, as the electric currents used to determine the conductivity variations will not in general be confined to a two-dimensional plane. A few studies have attempted three-dimensional EIT image reconstruction, but have not yet succeeded in generating images of a quality suitable for clinical applications. Here we report the development of a three-dimensional EIT system with greatly improved imaging capabilities, which combines our 64-electrode data-collection apparatus with customized matrix inversion techniques. Our results demonstrate the practical potential of EIT for clinical applications, such as lung or brain imaging and diagnostic screening.

Algorithms↗

Parametric modelling for electrical impedance spectroscopy system.

Three parametric modelling approaches based on the Cole-Cole model are introduced. Comparison between modelling only the real part and modelling both the real and imaginary parts is carried out by simulations, in which random and systematic noise are considered, respectively. The results of modelling the in vitro data collected from sheep are given to reach the conclusions.

Animals↗

Determination of the relationship between the pH and conductivity of gastric juice.

Studies of gastric secretion were carried out on 14 subjects, some of whom had taken acid secretion inhibitors. In vitro studies were performed in an attempt to ascertain the effect of H+ and Na+ ions on conductivity. There is a strong correlation between intragastric pH and conductivity for pH < 2, but none of the gastric samples were isotonic. The measured conductivity of the samples was therefore considerably lower than predicted for isotonic gastric juice.

Adult↗

EITS changes following oleic acid induced lung water.

We present the results of using electrical impedance tomographic spectroscopy (EITS) to follow the changes in lung water induced by oleic acid. Measurements were made on three goats before and after the injection of oleic acid. In addition to the EITs measurements, lung water was also measured using a double-indicator technique. Large falls in lung electrical impedance were seen as a result of the increase in lung water but the size of the fall was a function of the frequency at which the measurements were made. These changes have been modelled using the Cole equation. Four-electrode measurements were also made on two extracted porcine lungs and Cole equation modelling carried out following the introduction of saline into the lungs. Results were similar in the two sets of animal experiments.

Animals↗

Can electrical impedance tomography be used to detect gastro-oesophageal reflux?

A number of experiments have been carried out to investigate the feasibility of using electrical impedance tomography as an alternative method for identifying gastro-oesophageal reflux. Five subjects have been studied using simultaneous EIT and intraoesophageal pH measurements. A refluxogenic meal was given during the course of the recording to induce reflux in the subjects. Results show that there is some change in conductivity in the stomach region during some of the reflux episodes, but EIT is not able to detect all of the pH changes associated with the reflux. Other large conductivity changes, relating to gastric motility can be detected at times when no reflux is occurring.

Adult↗

Reproducibility of electrical impedance tomographic spectroscopy (EITS) parametric images of neonatal lungs.

The reproducibility of electrical impedance tomographic spectroscopy (EITS) images of neonatal lungs have been investigated in 11 clinically stable babies. We have used the Sheffield Mark IIIa EITS system. An average inspiration frame was generated from the data frames associated with maximum inspiration. Frequency images were reconstructed from these frames. The frequency images were analysed to locate the pixel with the maximum change in the right lung field. The change was defined as the 614 kHz measurement relative to 9.6 kHz. A 3 x 3 pixel region of interest was centred at this point. The changes in impedance with frequency for this region of interest show good overall reproducibility between electrode applications for eight frequencies (95% limits of agreement +/- 28%). This reproducibility is improved (95% limits of agreement +/- 13%) by omitting the highest frequency (1.2 MHz) which is most subject to system noise. The parameters for the Cole model derived from data with the highest frequency omitted are less reproducible between electrode applications (95% limits of agreement, R/S +/- 0.83, fc +/- 81.6, RC +/- 0.52, SC +/- 0.39). We suspect that the parametric model used may have an effect on this. The signals recorded at the highest frequency (1.2 MHz) are a major source of variability. The reproducibility results are improved by omitting this frequency from the analysis.

Body Water↗