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G Rau

Publications and source records attributed to G Rau.

At least 37 records · Page 2Linked to original sources

The presence of unknown layer of skin and fat is an obstacle to a correct estimation of the motor unit size from surface detected potentials.

To overcome problems with a strong distance-dependence of the motor unit potentials (MUPs), different methods to estimate the MU location and size have been proposed. Distance-independence of the exponent of the power function, that describes the MUP distance decline, and homogeneity of the volume conductor, are assumed in all methods. Some of them consider the exponent value as unique, irrespective of persons, muscles and their functional state. One method estimates the current exponent value. We evaluate this method by computer simulation of MUPs in infinite and semi-infinite volume conductor. Our results show that although the first assumption is not fulfilled, it does not affect considerably the estimate of the MU location and size obtained for infinite or semi-infinite homogeneous volume conductor. The errors of the MU location can be insignificant even in inhomogeneous volume conductor with a layer of lower conductivity (skin and fat) between the muscle tissue and electrode. The accurate location of the MU electrical axis is, however, not a sufficient condition for a correct MU size estimation that depends considerably on actual parameters of the layer. Thus, the surface EMG could hardly be considered as non-invasive alternative to macro EMG for detection of the enlarged MUs.

Action Potentials↗

Control of pore structure and size in freeze-dried collagen sponges.

Because of many suitable properties, collagen sponges are used as an acellular implant or a biomaterial in the field of tissue engineering. Generally, the inner three-dimensional structure of the sponges influences the behavior of cells. To investigate this influence, it is necessary to develop a process to produce sponges with a defined, adjustable, and homogeneous pore structure. Collagen sponges can be produced by freeze-drying of collagen suspensions. The pore structure of the freeze-dried sponges mirrors the ice-crystal morphology after freezing. In industrial production, the collagen suspensions are solidified under time- and space-dependent freezing conditions, resulting in an inhomogeneous pore structure. In this investigation, unidirectional solidification was applied during the freezing process to produce collagen sponges with a homogeneous pore structure. Using this technique the entire sample can be solidified under thermally constant freezing conditions. The ice-crystal morphology and size can be adjusted by varying the solute concentration in the collagen suspension. Collagen sponges with a very uniform and defined pore structure can be produced. Furthermore, the pore size can be adjusted between 20-40 microm. The thickness of the sponges prepared during this research was 10 mm.

Biocompatible Materials↗

An automatic camera-holding system for gynecologic laparoscopy.

Ergonomic analysis of conditions prevailing during laparoscopy show that static holding work causes considerable problems. The surgeon's assistant is particularly affected, for example, by holding the endoscope optical system. To minimize strain for the entire operating team and to increase the range of activities that can be performed by the assistant, an automatic surgical camera-holding system was developed. Its value in clinical practice was tested in gynecologic laparoscopy, where it enabled the surgical team to work more comfortably.

Equipment Design↗

Development of the MEDOS/HIA DeltaStream extracorporeal rotary blood pump.

The DeltaStream blood pump has been developed for extracorporeal circulation with one focus on potential integration into simplified bypass systems (SBS). Its small size and an embedded electric motor are the basic pump properties. A variation of the impeller design has been performed to optimize hydraulic and hematologic characteristics. A simple impeller design was developed which allows flow and pressure generation for cardiopulmonary bypass applications. The option of a pulsatile flow mode for ventricular assist device applications also was demonstrated in vitro. Impeller washout holes were implemented to improve nonthrombogenicity. The pump was investigated for potential thermal hazards for blood caused by the integrated electric motor. It could be demonstrated that there is no thermal risk associated with this design. Durability tests were performed to assess the lifetime of the pump especially with regard to the incorporated polymeric seal. Seal lifetimes of up to 28 days were achieved using different blood substitutes. In animal tests using either the pump as a single device or in an SBS setup, biocompatibility, low hemolysis, and nonthrombogenicity were demonstrated. In summary, the DeltaStream pump shows great potential for different extracorporeal perfusion applications. Besides heart-lung machine and SBS applications, ventricular assist and extracorporeal membrane oxygenation up to several days also appear promising as potential applications.

Animals↗

Metabolism of surfactant phosphatidylcholine molecular species in cftr(tm1HGU/tm1HGU) mice compared to MF-1 mice.

In cftr(tmIHGU/m1HGU) mice, an animal model designed to study pathophysiologic alterations due to the CFTR defect found in cysticfibrosis, surfactant phospholipids of bronchoalveolar lavage fluid (BALF) are increased. To study the metabolical basis of such increases, we intraperitoneally injected cft(tm1HGU/tm1HGU) mice [methyl-3H]choline and measured [methyl-3H]choline incorporation into phosphatidylcholine (PC) molecular species of lung tissue and BALF after 1.5 to 24 hours. MF1 and MF1 x cftr(tm1HGU/tm1HGU) hybrid mice served as controls. In tissue [methyl-3H]choline incorporation into total PC was constant for 24 hours and identical in control and cftr(tmIHGU/m1HGU) mice. However, from 7.5 to 24 hours there was a shift of [methyl-3H]choline incorporation from palmitoyloleoyl-PC and palmitoyllinoleoyl-PC towards PC species enriched in surfactant, dipalmitoyl-PC, palmitoylmyristoyl-PC, and palmitoylpalmitoleoyl-PC. The relative and absolute 3H-labels of PC species were identical for cftr(tmIHGU/m1HGU) compared to control mice. In BALF [methyl-3H]choline of total PC increased from 1.5 to 24 hours (R2 > .98), mainly due to [methyl-3H]choline-labelled dipalmitoyl-PC, in all experimental groups. In BALF from cftr(tmIHGU/m1HGU) mice, the [methyl-3H]choline label of total PC and individual PC species was significantly increased over control values after 24 hours, but not after 1.5 to 6 hours. Numbers and composition of BALF cells were not different between controls and cftr(tmIHGU/m1HGU) mice. We, conclude that increased alveolar phospholipid in cftr(tmIHGU/m1HGU) mice is likely due to decreased reuptake of surfactant.

Animals↗

Experimental MR imaging-guided interstitial cryotherapy of the brain.

BACKGROUND AND PURPOSE: Hyperthermal ablation techniques such as laser or RF ablation require dedicated heat-sensitive MR imaging sequences for monitoring MR imaging--guided interventions. Because cryotherapy does not have these limitations, the purpose of this study was to evaluate the feasibility of MR imaging--guided percutaneous cryotherapy of the brain. METHODS: An experimental cryoprobe with an outer diameter of 2.7 mm was inserted into the right frontal lobe of 11 healthy pigs under MR imaging control. Freezing procedures were monitored by using an interventional 1.5-T magnet and a gradient-echo sequence with radial k-space trajectories, a fast T2-weighted single-shot spin-echo sequence, and a T1-weighted single-shot gradient-echo sequence. In three animals, the procedure was also monitored by using dynamic CT. A freeze-thaw cycle with a duration of 3 minutes was repeated three times per animal. Follow-up MR images were obtained 3, 7, and 14 days after cryotherapy by using conventional MR sequences. Six animals were killed 7 days after intervention, and five animals were killed 14 days after intervention. The brains were sectioned, and the histologic findings of the lesions were compared with the MR imaging appearance. RESULTS: No artifacts due to the probe were observed on the MR images or CT scans. The ice formation (mean diameter, 12.5 mm) was very well delineated as a signal-free sphere. MR monitoring of the freezing procedure yielded a significantly higher ice:tissue contrast than did CT. The size of the ice ball as imaged by MR imaging and CT during the intervention correlated well with the MR imaging appearance of the lesions at the 14-day follow-up examination and with the histologic findings. Histologically, coagulation necrosis and gliosis were found, surrounded by a transition zone of edema and a disrupted blood-brain barrier, corresponding to a contrast-enhancing rim around the lesions on follow-up MR images. CONCLUSION: MR imaging-guided cryotherapy of the brain is possible and allows a precise prediction of the resulting necrosis. MR imaging of the freezing process does not require heat-sensitive sequences and is superior to CT for monitoring of cryoablation.

Animals↗

Variation of the HES concentration for the cryopreservation of keratinocytes in suspensions and in monolayers.

It has recently been shown that keratinocytes, both in suspension and in monolayers, can be successfully cryopreserved with hydroxyethyl starch (HES) (6, 9). HES is a nontoxic biodegradable macromolecule which is clinically approved as a plasma expander and which has already been used for the cryopreservation of red blood cells (10, 11). In this study we varied the HES concentration between 0 and 10 wt% in 2% steps for suspended cells and between 0, 4, 6, 8, and 10 wt% for monolayer cells in order to determine the effect on the survival rate and metabolic activity after cryopreservation. The experiments with the suspended cells were performed both with and without NCS. Cryopreserved keratinocytes can be transplanted onto patients for the treatment of deep dermal burns and leg ulcers. In this study, we achieved a survival rate of 80% for the suspended cells (10 wt% HES, 3 degrees C/min) and a survival rate of even 88% when the cells were cryopreserved as a monolayer using the same parameters. The addition of NCS did not improve the results for the suspended cells significantly.

Animals↗

[CRIGOS: development of a compact robot for image-guided orthopedic surgery].

In this paper, we present a medical robot system dedicated to support the surgeon during challenging tasks within orthopedic interventions. The main goal of this work is to develop a system as technically simple as the surgical requirements allow to keep its cost and complexity to a minimum. Therefore, we primarily focus on calibrated X-ray imaging for image acquisition, an easy registration procedure and robotic execution using a positioning device with simple parallel kinematics. Examples of different orthopedic interventions using the compact robot system for image-guided orthopedic surgery (CRIGOS) are presented, as well as various modes of execution of the device.

Arthroplasty, Replacement, Knee↗

Non-invasive approach of motor unit recording during muscle contractions in humans.

Information about the structural and functional characteristics of the motor unit (MU) is highly relevant for the diagnosis of neuromuscular disorders. Electromyography (EMG) is a suitable method for obtaining the information needed. The problem is the separation of the activity of one MU from others which are simultaneously active. Such investigations of single MU activity have commonly used invasive methods, e.g. employing a needle or a wire. Conventional surface-EMG methods have limited resolution and detect, at high contraction levels, multiple MU superimposed one on the other. The separation of the activity of a single MU can be achieved in a non-invasive way when highly specialised acquisition techniques are used. One approach, called high spatial resolution EMG (HSR-EMG), is based on the use of multi-electrode arrays in combination with a two-dimensional Laplace filter. The HSR-EMG permits the completely non-invasive detection of single MU activity even during maximal voluntary contractions. First applications have shown that the method provides a deeper insight into the functional and structural characteristics of the MU. In this paper the application of HSR-EMG to the diagnosis of neuromuscular disorders will be presented, and the latest results will be given of its application in the evaluation of treatment of patients with plexus lesion.

Electromyography↗

Movement biomechanics goes upwards: from the leg to the arm.

The analysis of lower limb movements has been well established in biomechanics research and clinical applications for a long time. For these studies, powerful and very advanced tools have been developed to measure movement parameters and reaction forces. The main focus of interest aims towards gait movements while the understanding of the basic concepts is supported by numerous models. Definitions of physiological ranges and detection of pathological changes in movements open an increasingly valuable clinical field of application. If, however, the primary function of the upper extremities as highly variable and adaptive organ for manipulating tasks is the subject of interest, the situation becomes considerably more complex. The nature of free arm movements is completely different from being restricted, repeatable or cyclic as compared to gait. Therefore, the transfer of the knowledge and experience gained in lower extremity movement analysis to the analysis of upper extremities turns out to be difficult. A proposal for how to proceed in measurements, e.g. where to place the markers and how to calculate movements and angles of segments involved, will be discussed which results in the description of the joint movements of wrist, elbow and shoulder joint. The definition of the motion is a specific step in upper extremity motion analysis which is important in terms of repeatability and significance of the results. An example of assessing movement disorders in children with plexus lesion will illustrate the implications and the potential of upper extremity movement analysis in clinical applications.

Arm↗

Development of recommendations for SEMG sensors and sensor placement procedures.

The knowledge of surface electromyography (SEMG) and the number of applications have increased considerably during the past ten years. However, most methodological developments have taken place locally, resulting in different methodologies among the different groups of users.A specific objective of the European concerted action SENIAM (surface EMG for a non-invasive assessment of muscles) was, besides creating more collaboration among the various European groups, to develop recommendations on sensors, sensor placement, signal processing and modeling. This paper will present the process and the results of the development of the recommendations for the SEMG sensors and sensor placement procedures. Execution of the SENIAM sensor tasks, in the period 1996-1999, has been handled in a number of partly parallel and partly sequential activities. A literature scan was carried out on the use of sensors and sensor placement procedures in European laboratories. In total, 144 peer-reviewed papers were scanned on the applied SEMG sensor properties and sensor placement procedures. This showed a large variability of methodology as well as a rather insufficient description. A special workshop provided an overview on the scientific and clinical knowledge of the effects of sensor properties and sensor placement procedures on the SEMG characteristics. Based on the inventory, the results of the topical workshop and generally accepted state-of-the-art knowledge, a first proposal for sensors and sensor placement procedures was defined. Besides containing a general procedure and recommendations for sensor placement, this was worked out in detail for 27 different muscles. This proposal was evaluated in several European laboratories with respect to technical and practical aspects and also sent to all members of the SENIAM club (>100 members) together with a questionnaire to obtain their comments. Based on this evaluation the final recommendations of SENIAM were made and published (SENIAM 8: European recommendations for surface electromyography, 1999), both as a booklet and as a CD-ROM. In this way a common body of knowledge has been created on SEMG sensors and sensor placement properties as well as practical guidelines for the proper use of SEMG.

Electrodes↗

A case study in designing speech interaction with a patient monitor.

OBJECTIVE: New developments in speech interaction technology warrant the assumption that some of the interaction problems at anesthesia workplaces can be solved using speech interaction. One application might be the documentation of the anesthetic procedure. METHOD: To investigate this hypothesis, a speech input system was developed for a commercially available patient monitor (Datex-Ohmeda AS/3 Anesthesia Monitor with Record-Keeper), which in addition to standard functions also facilitates the generation of the anesthesia record. The speech input system was based on the IBM ViaVoice speech recognition technology (version Millennium Pro). The speech input device was preliminarily tested by 5 anesthetists wearing surgical masks under laboratory conditions and through retrospectively documenting 4 to 5 anesthetic procedures (each 12 to 17 documentation entries) in a calm situation. The speech interactive documentation procedure was compared with the conventional keyboard documentation procedure. RESULTS: The test persons achieved an overall word recognition rate between 72% and 92.4%. Between 76.5% and 97.7% of the single word commands could be completed without any corrections. The same qualifier held for 58.5% to 86.3% of the two- and three-word commands. Despite high speech recognition error rates, almost all documentation entries (236 of 238) could be finished using speech interaction. Comparing both documentation techniques, speech interaction was said to be more intuitive and caused less frustration than the keyboard documentation procedure. However, speech interactive documentation was rated less controllable because of the high speech recognition error rates and bccause the auditive feedback dialogues took too long. CONCLUSIONS: Modern speech recognition tools are still not advanced enough to facilitate the design of applications with an almost natural speech interface and widespread user acceptance. Nevertheless, many tasks in anesthesia have the necessary characteristics to be optimally supported by speech interaction. In contrast to earlier approaches to speech-interactive anesthesia workplaces, successful application today depends on the question of design rather than solely on that of technology. Many of the constraints and drawbacks of current technology can be overcome through appropriate design measures. The goals must focus first on identifying task areas in intensive care where speech-interaction can yield real benefit in terms of work efficiency, and second on developing and evaluating an ergonomic design of speech interaction. The intended users seem to look forward to the incorporation of speech interaction at the workplace.

Anesthesiology↗

Evaluation of two new ecological interface approaches for the anesthesia workplace.

OBJECTIVE: Currently, vital parameters are commonly displayed as trends along a timeline. However, clinical decisions are more often based upon concepts, such as the depth of anesthesia, that are derived by combining parameter relationships and additional context information. The current displays do not visualize such concepts and therefore do not optimally support the decision process. A new display should present an ecological interface (EI). The principle of EI design is to visualize all of the information necessary for decision making in one single display. METHODS: In the first approach, we developed an EI that visualizes 35 relevant parameters for anesthesia monitoring. All of the parameters are generated by an anesthesia software simulator. Sixteen anesthetists had to administer two simulated general anesthetics: in one setting working only with the simulator's monitors ("Sim Only"), and in another setting working with the simulator's monitors in combination with the EI ("Combi1"). During each experiment, one unexpected critical incident (either blood loss or a cuff leakage) had to be identified. The control and monitoring behavior was analyzed by recording the subjects' eye movements and think-aloud protocol. With the help of the eye-tracking results, we re-designed the EI. The new EI was then tested with no eye tracking ("Combi2") on eight anesthetists under analogous conditions as in "Combi1." RESULTS: Cuff leakage was identified significantly quicker in "Combi1" (7 of 8 cases; time (T): 65 s +/- 73 s) than in "SimOnly" (6 of 8 cases; T: 222 s +/- 187 s). Blood loss was identified in 5 of 8 cases (T: 215 s +/- 76 s) in "Combi1" as quickly as in "SimOnly" (all cases; T: 217 s +/- 72 s). In "Combi1," the EI was used as the main source of information (in 43 +/- 19% of time) and was frequently favored when identifying an evolving critical incident. In "Combi2," cuff leakage was identified in 7 of 8 cases (T: 70 s +/- 111 s) as quickly as in "Combi1." Blood loss was identified significantly quicker in all cases (T: 147 s +/- 62 s) in "Combi2" than in "Combi1" and in "SimOnly." CONCLUSION: The results have shown that appropriately designed EIs may improve the anesthetist's decision making and focus attention on specific problems. Now, the findings have to be tested in future studies by widening the scope using other simulated scenarios and being closer to reality under real conditions in the OR. Eye tracking proved to be a useful method to analyze the anesthetists' decision making and appropriately re-design interfaces.

Anesthesia, General↗

A small pulsatile blood pump for ventricular support during end-stage heart failure.

A displacement blood pump to support the natural heart of patients for recovery from end-stage heart failure has been developed. This electromechanical pusher plate pump has a very compact and extremely flat design. The design goal was achieved by developing a novel gear system based on the principle of a swash plate. The blood pump and cannulae can be placed within the thoracic cavity between the lungs and ribcage. The first labtype model delivers an output of 3.1 L/min against an aortic pressure of 100 mm Hg at 120 bpm.

Biocompatible Materials↗

Freeze-drying of red blood cells at ultra-Low temperatures.

The hemolysis of human red blood cells (RBCs) after freeze-drying and resuspension depends on the vacuum-drying temperature. In an experimental study, RBCs were first solidified based on a modified high-yield cryopreservation protocol in the presence of hydroxyethyl starch and maltose. Afterward, they were vacuum-dried in a special low-temperature freeze-drying device at selected shelf temperatures between -5 and -65 degrees C. Subsequently, the dried samples were resuspended in an isotonic, phosphate-buffered saline solution. The hemolysis was determined according to a modified saline stability test. It decreases with a decreasing shelf temperature until a minimum is reached at -35 degrees C. A further decrease of the shelf temperature has no beneficial effect; the hemolysis even increases. To interpret these results, we assume that the hemolysis depends on two contrary damaging effects: (1) the higher the shelf temperature, the higher the probability of structural damages occurring during drying; (2) the lower the shelf temperature, the lower the driving force for water transport; this may lead to an incomplete intracellular dehydration which means that the cells are not in a glassy state at ambient temperature.

Blood Preservation↗

Imaging of interstitial cryotherapy--an in vitro comparison of ultrasound, computed tomography, and magnetic resonance imaging.

RATIONALE AND OBJECTIVES: To evaluate the imaging capabilities of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in monitoring interstitial cryotherapy and to compare them with visual control. METHODS: An experimental MR-compatible, vacuum-insulated and liquid nitrogen-cooled cryoprobe was inserted under in vitro conditions into a porcine liver, which was kept at a temperature of 37 +/- 1 degrees C, in a water bath with continuous stirring. The freezing procedure was controlled macroscopically, by US (Toshiba Sonolayer, 7.5-MHz linear array transducer), by CT (Siemens Somatom Plus, slice thickness 2-8 mm, 165-210 mA at 120 kV), and by MRI (Philips Gyroscan ACS-NT, FFE TR/TE/FA = 15/5.4/25 degrees, T1-SE 550/20, T2-TSE 1800/100) after the iceball reached its maximum size. RESULTS: The maximum iceball diameter around the probe tip was 12.0 mm by visual control, 12.4 mm by US, 12.7 mm by CT, and within 12.8 mm by spin echo sequences and 11 mm by gradient echo sequence. Due to the nearly signal-free appearance of the frozen tissue on MR images, the ice/tissue contrast on T1-weighted and gradient echo images was superior to T2-weighted images and CT images. Sonographically, the ice formation appeared as a hyperechoic sickle with nearly complete acoustic shadowing. CONCLUSION: Due to the better ice/tissue contrast, T1-weighted or gradient echo MR images were superior to CT and US in monitoring interstitial cryotherapy. Gradient echo sequences generally underestimated the ice diameter by 15%.

Animals↗

Cryopreservation of keratinocytes in a monolayer.

The cryopreservation of cells in tissues is one of the major challenges in current cryobiology, especially with regard to the progressively increasing field of tissue engineering. It is very questionable whether protocols which were developed for the cryopreservation of isolated cells are also applicable for cells in more complex structures, such as tissues. As a starting point toward cryopreservation of these three-dimensional structures, the aim of this study was to find an optimum cryopreservation protocol for keratinocytes in a monolayer (two-dimensional structure). These epidermal cells can be transplanted as a monolayer grown on an appropriate matrix for the treatment of deep-dermal burns and leg ulcers. The successful cryopreservation of such transplants would offer the advantage of long-term storage and immediate availability of the transplant. In our study, the variables investigated were the cryoprotective solution and the cooling rate. In order to find a nontoxic cryoprotective agent (CPA) which could be transplanted without an additional washing step, we included hydroxyethyl starch (HES) as a possible CPA in our experimental protocol with the commonly used CPAs Me(2)SO, glycerol, and ethylene glycol. For the evaluation, the cell survival rate was determined by dye exclusion (trypan blue) and the cell metabolism was investigated by cell activity assay (alamarBlue). In conclusion, the cryopreservation protocol with 10 wt.-% HES resulted not only in the highest survival rate (72%) but also in the highest metabolic activity of the cells after thawing; comparable values for the other CPAs were: Me(2)SO, 48%; glycerol, 8%; and ethylene glycol, 10%.

Cell Survival↗

Freeze-drying of red blood cells: how useful are freeze/thaw experiments for optimization of the cooling rate?

A red blood cell suspension, prepared according to a high-yield HES cryopreservation protocol, was frozen at selected cooling rates of 50, 220, 1250, 4200, and 13,500 K/min. After either thawing or vacuum-drying, the cell recovery was determined using a modified saline stability test. As expected, the recovery of thawed samples followed the theory of Mazur's two-factor hypothesis. The best result was found at a cooling rate of 220 K/min. In contrast, the recovery of freeze-dried and rehydrated samples was very poor at that rate, but maximal at 4200 K/min where thawing caused almost complete hemolysis. This discrepancy is attributed to different damaging mechanisms involved with the respective sample processing subsequent to freezing. While thawing leads to increased devitrification and recrystallization at supraoptimal cooling rates for cryopreservation, the resultant almost vitreous sample structure seems to be advantageous for vacuum-drying. It can be concluded that freeze/thaw experiments are not sufficient for optimization of the cooling rate for freeze-drying.

Adult↗