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Biomedical subjects

G Rau

Publications and source records attributed to G Rau.

At least 55 records · Page 3Linked to original sources
PubMed1999

Measuring system for in vivo recording of force systems in orthodontic treatment-concept and analysis of accuracy.

The aim of our developments is three-dimensional in vivo recording of those orthodontic force systems inducing tooth movements during treatment with fixed appliances. The concept presented here is the first to permit the forces and torques of these statically multiply undetermined systems to be recorded in vivo. For this purpose the force systems transmitted to the teeth from the archwire are isolated from the respective tooth by means of divisible special-design brackets and introduced into a 3D force torque sensor via a gripping appliance. The sensor is fixed with a purpose-developed device relative to the patient's dental arch. The patient's head is positioned relative to the system by means of a bite fork as well as a forehead and chin support. Electrical measurement of the mechanical quantities is carried out by a six-axis force torque sensor with semiconductor strain gauge elements, an electronical evaluator and a mobile measuring computer (PC). Extensive calibration of the sensor system has shown that the measuring uncertainty of the electrical measuring is less than 2%. Precise spatial fixing of bracket slot and archwire in the therapeutic position is crucial to the measuring accuracy of the system, as even minimum displacements affect the force system to be measured. Movements of the measuring system up to 0.04 mm result from a therapeutic force of 1.5 N. The results of extensive in vitro studies have already demonstrated that the system developed by us is suitable for the specified in vivo measuring function.

Biomechanical Phenomena↗
PubMed1999

A marker-based measurement procedure for unconstrained wrist and elbow motions.

A protocol is proposed to obtain the joint angles of wrist and elbow from tracked triads of surface markers on each limb segment. Cuffs placed on the limb support the rigidity of the triads. Additional markers are used to mark the approximate positions of joints. Corrections of surface marker data for skin motion are derived from a priori knowledge about plausible joint motions. In addition, ill-conditioned states are trapped when the elbow is nearly fully extended. The protocol is applied to sample motions which demonstrate the use and the effect of the corrections. The results show that the model assumptions are reasonable and that accurate joint rotations can be obtained. The correction steps prove to be an essential part of upper-extremity movement analysis.

Adult↗
PubMed1999

Non-invasive detection of the single motor unit action potential by averaging the spatial potential distribution triggered on a spatially filtered motor unit action potential.

For research as well as diagnostic applications the non-invasive detection of the activity of single motor units is of interest. The most direct information is expected to be found in monopolarly recorded data. But when an array of surface electrodes is used for the monopolar recordings of the potential distribution on the skin, in most cases an additional invasive needle electrode is utilized to detect the exact points in time when a certain motor unit is firing. With this supplementary information, an averaging of the monopolar EMG tracings can be performed. In this paper, a completely non-invasive methodology is presented which replaces the invasive needle by a spatial filtering procedure. The EMG signals from the m. biceps brachii are recorded monopolarly with an electrode array. Afterwards, a spatial filtering procedure, called normal double differentiating filter, is applied to the data. The EMG signals obtained are investigated by means of an amplitude threshold to distinguish the activity of different motor units. The point of the maximum amplitude of the selected peaks then is used as trigger point to average the monopolar EMG data. The time courses of the motor unit action potential signals found after applying the described procedure show similar shapes, while two different components are to be identified: corresponding to the spread of the excitation, one is referring to stationary, the other to travelling events. These results justify the possibility to replace the needle electrode to obtain a trigger event in the future by the non-invasive spatial filtering procedure.

Action Potentials↗
PubMed1999

Procedure for the semi-automatic detection of gastro-oesophageal reflux patterns in intraluminal impedance measurements in infants.

The diagnosis of gastro-oesophageal reflux (GOR) is of great interest for paediatric gastroenterologists. pH monitoring is the commonly used procedure for GOR diagnosis but a major amount of postprandial GOR is missed due to the mostly non-acidic gastric contents in infants. The multiple intraluminal impedance technique is based on the recording of the impedance changes during bolus transport inside the oesophagus. It is the first method which allows the pH-independent, long-term registration of GOR. The use of the impedance technology in clinical practice has been limited so far by the time-consuming, visual evaluation of the impedance traces. The new approach of a semi-automatic analysis of the impedance measurements allows the automated detection of reflux patterns. It is based on event marking and an optimised feature description of the impedance traces combined with a fuzzy system for pattern recognition. The classifier is developed and tested on 50 investigations in infants. Compared to the comprehensive, multiple visual evaluation the achieved precision is 75% sensitivity and 48% positive prediction. In comparison to a single visual evaluation the analysis of the automatically proposed patterns corresponds to a 96% reduction of the evaluation time with no loss of precision. Thus the applicability of the impedance technology is enhanced significantly. A combined measurement of pH and impedance gives evidence about the occurrence of GOR, its pH and the acidic exposure of the oesophagus.

Algorithms↗
PubMed1999

Ergonomic evaluation of an ecological interface and a profilogram display for hemodynamic monitoring.

OBJECTIVE: Comprehensive monitoring of the patient state and subsequent decision making is an essential part of the task of an anaesthetist. The physicians' decision making process is based upon a concept of partly abstract physiologic parameters such as depth of anaesthesia or contractility. This concept is derived from the measured parameters given on todays' trend displays in addition to context information available for the anaesthetist. We investigated two alternative approaches of display design for hemodynamic monitoring: 1) integrated displays based on ecological interface design, and 2) profilogram displays based on intelligent alarms. METHOD: To evaluate differences in decision making, the two displays and a trend display were compared in an experimental set-up with computer simulated vital parameter curves. From a start state with random parameter deviations from the ideal state, subjects had to achieve the ideal circulatory performance as fast as possible by manipulating vasomotor tone, heart rate, blood volume and contractility. To analyse subjects' decision making process, eye-tracking, event-logging, and the method of think aloud protocols were used. Twenty anaesthesiologists performed 113 experiments (approximately 2 with each display). RESULTS: The anaesthetists failed to achieve the task in 37% using the trend display, in 19% using the profilogram display, and in 13% using the ecological interface. Hence, a safer task solution was possible with the ecological interface and the profilogram display but at the expense of various performance parameters such as higher trial time, more interactions with the simulated system, and more frequent eye movements. In contrast to the trend display and the profilogram display, where anaesthetists were mainly focussed on controlling the left atrial pressure, such an behaviour was less observed with the ecological interface. CONCLUSION: Our results have shown that subjects came to more effective solutions with the traditional trend display. The main reason for this result may be their years of experience with this kind of display type. Regarding safe and goal-intended decision finding, the results are encouraging for further experiments with redesigned ecological displays. But these displays ought to have smoother changes with respect to the traditional trend displays. Furthermore, new experiments have to be performed under real or fairly real (e.g. together with an anaesthesia simulator) conditions to underline the positive results for ecological interfaces.

Adult↗
PubMed1999

CRIGOS: a compact robot for image-guided orthopedic surgery.

The CRIGOS (compact robot for image-guided orthopedic surgery) project was set up for the development of a compact surgical robot system for image-guided orthopedic surgery based on user requirements. The modular system comprises a compact parallel robot and a software system for planning of the surgical interventions and for supervision of the robotic device. Because it is not sufficient to consider only technical aspects in order to improve in clinical routine the therapeutic outcome of conventional interventions, a user-centered and task-oriented design process has been developed which also takes human factors into account. The design process for the CRIGOS system was started from requirement analysis of various orthopedic interventions using information gathered from literature, questionnaires, and workshops with domain experts. This resulted in identification of conventional interventions for which the robotic system would improve the medical and procedural quality. A system design concept has been elaborated which includes definitions of components, functionalities, and interfaces. Approaches to the acquisition of calibrated X-rays will be presented in the paper together with design and evaluation of a first human-computer interface. Finally, the first labtype parallel robot based on low-cost standard components is presented together with the first evaluation results concerning positioning accuracy.

Humans↗
PubMed1999

[Experimental MRI-controlled cryotherapy of the brain with almost real-time imaging by radial k-space scanning].

PURPOSE: To test radial k-space scanning by MR fluoroscopy to guide and control MR-guided interstitial cryotherapy of the healthy pig brain. METHODS: After MR tomographic planning of the approach, an MR-compatible experimental cryotherapy probe of 2.7 mm diameter was introduced through a 5 mm burr hole into the right frontal brain of five healthy pigs. The freeze-thaw cycles were imaged using a T1-weighted gradient echo sequence with radial k-Space scanning in coronal, sagittal, and axial directions. RESULTS: The high temporal resolution of the chosen sequence permits a continuous representation of the freezing process with good image quality and high contrast between ice and unfrozen brain parenchyma. Because of the interactive conception of the sequence the layer plane could be chosen as desired during the measurement. Ice formation was sharply demarcated, spherically configurated, and was free of signals. Its maximum diameter was 13 mm. CONCLUSIONS: With use of the novel, interactively controllable gradient echo sequence with radial k-space scanning, guidance of the intervention under fluoroscopic conditions with the advantages of MRT is possible. MR-guided cryotherapy allows a minimally-invasive, precisely dosable focal tissue ablation.

Animals↗
PubMed1999

Leakage flow at mechanical heart valve prostheses: improved washout or increased blood damage?

BACKGROUND AND AIMS OF THE STUDY: An essential problem of mechanical heart valve (MHV) prostheses is the risk of thromboembolic events and consequent need of lifetime anticoagulation due to unnatural hemodynamics that results in traumatization of red blood cells and platelets. The precise spatial and tidal localization of blood-damaging events within the flow is poorly understood. The present study addresses the question whether leakage flow at MHV, which is claimed to improve washout in the hinge areas of microthrombi and platelet-activating agents, is responsible for significant blood damage. METHODS: This study investigated leakage flow in vitro, primarily within turbulent leakage jets of currently used mechanical valves. St. Jude Medical, Sorin Bicarbon, Duromedics-Edwards and CarboMedics valves were analyzed in the mitral position of a circulatory mock loop. Jet configuration was determined by echocardiography; velocity and shear stress distributions within jets were measured using laser-Doppler anemometry (LDA). A blood damage index (BDI) was developed in terms of lactate dehydrogenase release by platelets and hemoglobin release by red blood cells (RBC), as a function of exposure time and shear stresses within the flow field. BDIs were validated by direct measurement of hemolysis caused by leakage flow, using porcine blood. RESULTS: All valves showed characteristic and reproducible jet patterns, mainly emerging from the hinge areas. Maximum velocities up to 1.7 m/s were measured. Maximum turbulent shear stresses > 80 Pa were found. The investigated MHV revealed significant differences in calculated BDIs. The Sorin Bicarbon had a significantly lower BDI for RBC damage, as well as for platelet damage; this was validated by direct hemolysis measurements. CONCLUSIONS: The relevance of the leakage-induced blood damage was demonstrated from a literature investigation of hemolysis as a function of valve type and implant position.

Echocardiography, Doppler↗
PubMed1999

Platelet function and hemolysis in centrifugal pumps: in vitro investigations.

The effects of centrifugal pumps on blood components other than erythrocytes, namely platelets and their interaction with the coagulation system, are not very well known. In a comparative study with three centrifugal pumps (BioMedicus BP-80, St. Jude Isoflow, and Sarns Delphin) and the Stockert roller pump hemolysis, platelet counts, thromboplastin and partial thromboplastin times, as well as resonance thrombography (RTG) parameters for the assessment of platelet and coagulation function were evaluated in vitro. Normalized indices of hemolysis (NIH) with ACD anticoagulation after 360 minutes were 0.008+/-0.004 (Isoflow), 0.018+/-0.017 (BP-80), 0.085+/-0.051 (Delphin), and 0.049+/-0.010 g/1001 (roller pump). Plasmatic coagulation was activated in all circuits. Platelet function was severely inhibited by the BP-80, indicated by increase in RTG platelet time to 358%+/-150% of initial values compared to 42%+/-29% (Isoflow), 40%+/-20% (Delphin), and 12%+/-10% (roller pump). Fibrin polymerization was affected similarly. The large surface area of the BP-80 leads to an extensive activation of platelets and plasminogen.

Blood Coagulation↗
PubMed1998

MR-guided interstitial cryotherapy of the liver with a novel, nitrogen-cooled cryoprobe.

The purpose of the study was to test a newly developed, MR-compatible, liquid nitrogen-cooled cryoprobe. The probe has an outer diameter of 3.5 mm and was specifically developed for percutaneous, MR-guided, interstitial cryotherapy. The probe was inserted percutaneously into the livers of 10 rabbits. The cryotherapy procedure was monitored with a surface coil in a 1.5 Tesla magnet using a gradient echo sequence. Follow-up examinations were performed 3 and 7 days after the freezing procedure using T1- and T2-weighted spin echo sequences. At 7 days the animals were sacrificed and the cryolesions were examined histologically. The cryoprobe enabled artifact-free MR imaging of the "iceball" formation during freezing of the rabbit liver. After 1 min of freezing, the iceball at the tip of the probe showed an average maximum diameter of 10.8 mm. No bleeding complications were observed during or after the freezing procedure. Histologic examination 7 days after cryotherapy confirmed that the liver lesions were the same size as had been predicted by the images of the acute iceball. This new, percutaneously inserted, MR-compatible, liquid-nitrogen cooled cryoprobe allows accurate, artifact-free MR imaging of interstitial cryotherapy.

Animals↗
PubMed1998

In vitro testing of a measuring system for in vivo recording of orthodontically applied forces and moments in the multiband technique. Part II.

The aim of this study was to measure in vivo the forces and moments acting therapeutically on the individual tooth in connection with the multiband technique. Securing and evaluating the planned in vivo measurements involves analysing the measuring accuracy of the system as a whole by means of corresponding in vitro investigations. Errors in determining the therapeutically effective force system may result from the electrical measurement of the mechanical quantities by the sensor system and from the fixing of the archwire in therapeutic position. The precision of this fixing is influenced by displacements induced by elasticities and mechanical tensions in the measuring system. Calibration test series have shown the sensor system to have a margin of error of less than 2%. The displacements influencing precision fixing of the archwire were determined by means of a laser position measuring system. For a maximum orthodontic force of 1.5 N, they are 0.06 mm in the least favourable case. The resulting measuring accuracy was determined analytically or graphically, depending on the key parameters. Successful in vivo studies of the therapeutically applied force systems are to be expected on the basis of these results.

Calibration↗
PubMed1998

Three-dimensional echocardiographic determination of left ventricular volumes and function by multiplane transesophageal transducer: dynamic in vitro validation and in vivo comparison with angiography and thermodilution.

The goal of this study was to validate 3-dimensional echocardiography by multiplane transesophageal transducer for the determination of left ventricular volumes and ejection fraction in an in vitro experiment and to compare the method in vivo with biplane angiography and the continuous thermodilution method. In the dynamic in vitro experiment, we scanned rubber balloons in a water tank by using a pulsatile flow model. Twenty-nine measurements of volumes and ejection fractions were performed at increasing heart rates. Three-dimensional echocardiography showed a very high accuracy for volume measurements and ejection fraction calculation (correlation coefficient, standard error of estimate, and mean difference for end-diastolic volume 0.998, 2.3 mL, and 0.1 mL; for end-systolic volume 0.996, 2.7 mL, and 0.5 mL; and for ejection fraction 0.995, 1.0%, and -0.4%, respectively). However, with increasing heart rate there was progressive underestimation of ejection fraction calculation (percent error for heart rate below and above 100 bpm 0.59% and -8.6%, P < .001). In the in vivo study, left ventricular volumes and ejection fraction of 24 patients with symmetric and distorted left ventricular shape were compared with angiography results. There was good agreement for the subgroup of patients with normal left ventricular shape (mean difference +/-95% confidence interval for end-diastolic volume 5.2+/-6.7 mL, P < .05; for end-systolic volume -0.5+/-8.4 mL, P = not significant; for ejection fraction 2.4%+/-7.2%, P = not significant) and significantly more variability in the patients with left ventricular aneurysms (end-diastolic volume 23.1+/-56.4 mL, P < .01; end-systolic volume 5.6+/-41.0 mL, P = not significant; ejection fraction 4.9%+/-16.0%, P < .05). Additionally, in 20 critically ill, ventilated patients, stroke volume and cardiac output measurements were compared with measurement from continuous thermodilution. Stroke volume as well as cardiac output correlated well to thermodilution (r = 0.89 and 0.84, respectively, P < .001), although both parameters were significantly underestimated by 3-dimensional echocardiography (mean difference +/-95% confidence interval = -6.4+/-16.0 mL and -0.6+/-1.6 L/min, respectively, P < .005).

Adult↗
PubMed1998

Miniaturized implantable rotary blood pump in atrial-aortic position supports and unloads the failing heart.

The purpose of this study was to test the pump performance of a miniaturized, newly developed, implantable rotary blood pump (the diagonal pump). In a series of six sheep, the pump was interposed in an atrial-aortic connection. Heart failure was induced by serial injection of glass beads into the left coronary artery. The assistance of the non-failing heart (with pump output up to 4.5 liter/min) did not change the total cardiac output or the blood pressure of the animal. The heart was significantly unloaded as demonstrated by a drop in first derivative of the left ventricular pressure (dP/dt) max (from 1645 to 1113 mmHg/s; P = 0.0003). Because of the specific interaction between heart function and rotary blood pump performance, the pump provided considerably more flow in the failing than in the non-failing heart. Cardiac output and perfusion pressures were restored to pre-assist values in the failing heart model. The heart-rotary blood pump interaction is an ideal substrate for long-term assistance. With this miniaturized rotary blood pump, hemodynamics in a severely failing heart can be restored. Atrial cannulation, which leaves the left ventricle untouched, provides similar results as apical cannulation in the failing heart.

Animals↗
PubMed1998

Estimation of the relationship between the noninvasively detected activity of single motor units and their characteristic pathological changes by modelling.

Neuromuscular disorders are often related to specific changes in the structure of single motor units (MUs). One approach for the detection of these changes is high-spatial-resolution EMG (HSR-EMG), which allows non-invasive recording of the activity of a single MU. Early investigations with patients suffering from various neuromuscular disorders have shown that there is a distinct difference between the HSR-EMG signals of healthy volunteers, patients with muscular disorders, and patients with neuronal disorders. In this study, the relationship between typical HSR-EMG patterns and characteristic pathological changes in the structure of the MUs is considered. Therefore, a muscle model has been developed which is adapted to the physiological properties of the m. abductor pollicis brevis. The effects of the loss of single muscle fibres (muscular disorders) and the loss of entire MUs (neuronal disorders) on the HSR-EMG pattern have been simulated. These simulations show the same HSR-EMG patterns as seen in patients and healthy volunteers. As a consequence, it can be assumed that the muscle model is an appropriate tool for the simulation of HSR-EMG signals. Furthermore, the simulation results support the hypothesis that the typical changes in the HSR-EMG pattern found in patients with neuromuscular disorders can be attributed to the characteristic changes in the structure of the MUs.

Action Potentials↗
PubMed1998

Implantable micropump system for augmented liver perfusion.

Liver cirrhosis, a worldwide health problem, decreases the blood flow through the liver. This in turn leads to dangerous portal hypertension and decreased metabolic function within the liver. To improve this situation, a new concept is proposed which involves introducing a microaxial blood pump into the portal vein. This device is intended to increase blood flow through the liver and to enhance hepatic function. Furthermore, high pressures will be reduced to physiological levels. The microaxial pump with its single stage impeller is powered by a proximally integrated microelectric motor. The pump unit is completely immersed within the blood vessel. Heat caused by electrical and mechanical losses will be transported into the blood. In vitro optimization of the pump design was accomplished using both hydraulic and hemolysis tests.

Biocompatible Materials↗
PubMed1998

Computer assisted orthopaedic surgery with image based individual templates.

Recent developments in computer assisted surgery offer promising solutions for the translation of the high accuracy of the preoperative imaging and planning into precise intraoperative surgery. Broad clinical application is hindered by high costs, additional time during intervention, problems of intraoperative man and machine interaction, and the spatially constrained arrangement of additional equipment within the operating theater. An alternative technique for computerized tomographic image based preoperative three-dimensional planning and precise surgery on bone structures using individual templates has been developed. For the preoperative customization of these mechanical tool guides, a desktop computer controlled milling device is used as a three-dimensional printer to mold the shape of small reference areas of the bone surface automatically into the body of the template. Thus, the planned position and orientation of the tool guide in spatial relation to bone is stored in a structural way and can be reproduced intraoperatively by adjusting the position of the customized contact faces of the template until the location of exact fit to the bone is found. No additional computerized equipment or time is needed during surgery. The feasibility of this approach has been shown in spine, hip, and knee surgery, and it has been applied clinically for pelvic repositioning osteotomies in acetabular dysplasia therapy.

Acetabulum↗