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Biomedical subjects

P A Wieringa

Publications and source records attributed to P A Wieringa.

16 recordsLinked to original sources
PubMed2007

Violations and errors during simulation-based driver training.

The effectiveness of virtual driving instruction can increase when techniques that automatically distinguish between violations and errors are available, two behaviours requiring different types of remediation. This study reports the analysis of the objectively measured performance of 520 participants completing a simulation-based training programme. Factor analysis of failure reasons showed that violations and errors were the primary underlying factors. Men committed more violations and women made more errors; the magnitude of sex differences corresponded to the factor loadings. Factor analysis of the mean task completion times yielded a factor that can be described as the extent to which motivation for speed resulted in quicker task execution. Quicker participants completed more tasks, committed more violations, but made fewer errors. Participants reduced errors during forced-paced driving and increased speed during self-paced driving. The authors would recommend exploiting the distinction between violations and errors by developing interfaces and feedback for both types of aberration.

Accidents, Traffic↗
PubMed2002

A clearly visible endoscopic instrument shaft on the monitor facilitates hand-eye coordination.

BACKGROUND: Passing an instrument through a small incision alters the kinematics of the instrument, thus hampering hand-eye coordination. Nevertheless, the incision provides a stable, nearly invariant, point of rotation for instrument movements. Therefore, we set out to evaluate the effects of the altered kinematics on hand-eye coordination. In addition, we assessed the hypothesis that the hand-eye coordination of laparoscopic surgeons incorporates the incision as a point of reference. METHODS: Eight surgeons with experience in laparoscopy repeatedly performed a positioning task on a two-dimensional endoscopic manipulation simulator. Task time was measured. In the first experiment, normal endoscopic manipulation was compared to a condition in which the kinematic effects of the incision were compensated for. In the second experiment, the instrument shaft on the monitor was not visible during half of the trials, so that all visual information about the location of the incision was obscured. RESULTS: Task performance improved significantly when the kinematic effects of the incision were compensated for (p = 0.001). Task performance improved when the instrument shaft was clearly visible on the monitor (p <0.05). CONCLUSIONS: Compensating for the kinematic effects introduced by the incision improves hand-eye coordination. The results of this study indicate that the incision provides a point of reference for hand-eye coordination during endoscopic manipulation.

Computer Simulation↗
PubMed2002

Quantitative evaluation of three advanced laparoscopic viewing technologies: a stereo endoscope, an image projection display, and a TFT display.

BACKGROUND: Compared to open surgery, minimally invasive surgery (MIS) relies heavily on advanced technology, such as endoscopic viewing systems and innovative instruments. The aim of the study was to objectively compare three technologically advanced laparoscopic viewing systems with the standard viewing system currently used in most Dutch hospitals. METHODS: We evaluated the following advanced laparoscopic viewing systems: a Thin Film Transistor (TFT) display, a stereo endoscope, and an image projection display. The standard viewing system was comprised of a monocular endoscope and a high-resolution monitor. Task completion time served as the measure of performance. Eight surgeons with laparoscopic experience participated in the experiment. RESULTS: The average task time was significantly greater (p <0.05) with the stereo viewing system than with the standard viewing system. The average task times with the TFT display and the image projection display did not differ significantly from the standard viewing system. CONCLUSION: Although the stereo viewing system promises improved depth perception and the TFT and image projection displays are supposed to improve hand-eye coordination, none of these systems provided better task performance than the standard viewing system in this pelvi-trainer experiment.

Analysis of Variance↗
PubMed2002

The perspective effect of wide-angle lenses in laparoscopes.

PURPOSE: To evaluate the effect of perspective distortion of wide-angle lenses in laparoscopes on hand-eye coordination during endoscopic manipulation. METHODS: Sixteen subjects repeatedly performed a standardized positioning task in a pelvi-trainer under two conditions. The subjects had no prior experience with endoscopic manipulation. In one condition, a wide-angle lens with considerable perspective distortion was used; in the other, a telephoto lens without perspective distortion was used. Task time and number of errors were measured. RESULTS: Task time and the number of errors did not significantly increase in the condition with a wide-angle lens. CONCLUSIONS: The perspective effect did not influence task performance in endoscopic manipulation in this experiment. Subjects indicated that they even preferred the wide-angle lens because its extreme perspective improved their perception of depth.

Adult↗
PubMed1998

A quantitative measure for degree of automation and its relation to system performance and mental load.

In this paper we quantitatively model degree of automation (DofA) in supervisory control as a function of the number and nature of tasks to be performed by the operator and automation. This model uses a task weighting scheme in which weighting factors are obtained from task demand load, task mental load, and task effect on system performance. The computation of DofA is demonstrated using an experimental system. Based on controlled experiments using operators, analyses of the task effect on system performance, the prediction and assessment of task demand load, and the prediction of mental load were performed. Each experiment had a different DofA. The effect of a change in DofA on system performance and mental load was investigated. It was found that system performance became less sensitive to changes in DofA at higher levels of DofA. The experimental data showed that when the operator controlled a partly automated system, perceived mental load could be predicted from the task mental load for each task component, as calculated by analyzing a situation in which all tasks were manually controlled. Actual or potential applications of this research include a methodology to balance and optimize the automation of complex industrial systems.

Adult↗
PubMed1995

Evidence that cell surface charge reduction modifes capillary red cell velocity-flux relationships in hamster cremaster muscle.

1. From capillary red cell velocity (V)-flux (F) relationships of hamster cremaster muscle a yield velocity (VF = 0) can be derived at which red cell flux is zero. Red cell velocity becomes intermittent and/or red blood cells come to a complete standstill for velocities close to this yield velocity, and, at the same time, capillary tube haematocrit becomes very low. 2. We have tested whether the net negative charge of red blood cells (RBCs) contributes to the magnitude of VF = 0. Velocity-flux relationships were measured for normal cells, normal cells labelled with the fluorescent dye calcein (LRBCs), and red cells treated with hexadimethrine to mask negative charge and labelled with calcein as well (HDM-LRBCs). Measurements were done in a hamster cremaster muscle preparation applying video in vivo microscopy. 3. Hexadimethrine treatment reduced the net negative surface charge of red cells to 20% of control as estimated from transmission electron microscopy using a ferritin tagging technique. The values of VF = 0 found for normal red cells and HDM-LRBCs were 86 +/- 15 and 31 +/- 17 microns s-1, +/- S.E.M., n = 12, respectively, which were significantly different (P < 0.05). For normal cells and cells labelled with calcein only, VF = 0 values were 63 +/- 14 and 65 +/- 13 microns s-1, n = 8, respectively, which were not significantly different. The effect of HDM treatment did not alter filterability of the red cells as estimated from transit times through 5 microns pores. 4. The present findings demonstrate that the net negative charge of RBCs contributes significantly to the yield velocity for red blood cells entering capillaries and flowing through them. HDM treatment reduced the net negative charge of red blood cells and may have caused cells to enter capillaries more easily owing to reduced electrostatic repulsion at the capillary entrance. In addition, HDM treatment may have lowered intracapillary flow resistance by a reduction in electrostatic repulsive forces between red blood cells and negatively charged (macromolecules on) capillary endothelial cells at sites of irregular capillary cross-sectional shape, without significantly affecting the lubricating properties of the capillary endothelial glycocalyx and/or associated plasma macromolecules.

Animals↗
PubMed1995

Method to create small photo-bleached volumes to monitor blood plasma flow in capillaries.

A method has been developed to examine the movement of plasma in capillaries using intravital microscopy. Spatial transients in fluorescence properties are instantaneously induced by laser photo-bleach pulses after which the convective recovery can be monitored. The plasma is tagged with fluorescent dyes coupled to bovine serum albumin, which is injected well before the measurements and circulates with the blood stream. A laser beam from an argon laser source, set to emit light with a wavelength of 488 nm, is focused on the illumination field diaphragm and creates a spot in the object plane of the microscope. At low laser power, the laser spot is aimed at a blood plasma gap between red blood cells in a capillary segment, using a steerable mirror. Light sensors, coupled to photo-multipliers in the secondary image plane of the microscope, record the light intensity of the moving plasma/dye while the preparation is continuously illuminated with a xenon epi-illuminating set-up. The laser photo-bleach spot is then used to bleach the dye complex within a 5.4 microns segment of the capillary for less than 20 ms. The movement of the bleached plasma bolus is tracked by the photo-sensors, placed sequentially along the capillary. Both dye and red blood cell passage can be detected in the photo-multiplier signals, and the relative velocities of the two blood components can be measured. Measurements reveal that the ratio of transit times between blood plasma and red blood cells is 1.23 (SD = 0.22, N = 18), which is in good agreement with measurements by other techniques.

Animals↗
PubMed1993

A technique for the estimation of plasma flow in single capillaries using photobleached dyes.

In order to estimate plasma flow in single capillaries, an "indicator bolus" was optically inserted into individual microvessels of the hamster cremaster muscle. This was accomplished using short-duration (200 msec), argon laser pulses to photobleach a 5-microns segment of fluorochrome circulating with the plasma. The subsequent motion of the bleached plasma bolus was then tracked using photomultipliers positioned at three sites along the capillary. The transient passage of the dye appeared as a steep fall in light intensity as the downstream edge of the bleached area entered the sensor field, followed by a steep rise in light intensity as trailing unbleached plasma flowed under the sensor. The behavior of light intensity as the photobleached bolus flowed past a sensor was analyzed using a theoretical model developed to predict the behavior of this type of plasma flow indicator in single capillaries. The characteristic time, tau, which equals the capillary segment volume divided by the plasma flow, was taken as an estimate of plasma flow. The model predicts that, for this system, tau of the capillary corresponds closely to the time at which 50% of the full sensor response to the bolus is attained, that is, the t50. The ratio between the t50 and the characteristic time is found to be a function of the relative sensor width and the flow velocity profile. A procedure is also described to assess the flow velocity profile from in vivo measurements. Using this technique, the ratio of the velocity of the red cell compared to that of plasma is found to be about 1.3.

Animals↗
PubMed1993

Heterogeneity of the hypoxic state in rat heart is determined at capillary level.

Heterogeneity in the hypoxic state of Tyrode-perfused rat hearts was studied using NADH and Pd-porphine videofluorometry. Ischemic as well as high-flow anoxia resulted in a homogeneous rise of tissue NADH fluorescence, whereas normoxic recovery from both types of anoxia caused transiently persisting patchy fluorescent areas. Patterns were always the same for a given heart. PO2 distribution in the vasculature measured by Pd-porphine phosphorescence showed patterns similar to the NADH fluorescence patterns. Microsphere embolization of the capillaries, but not of arterioles, elicited identical NADH fluorescence patterns as seen during recovery from anoxia without microspheres. High heartbeat rates also caused patchy fluorescent areas but not in the presence of adenosine. Patterns corresponded to those seen during normoxic recovery from anoxia under low beat rates. It is concluded that there are circulatory units in the rat heart at the capillary level that result in the temporary persistence of anoxic areas during recovery from anoxia. These vulnerable areas are the first to be compromised during high heartbeat rates.

Animals↗
PubMed1993

Oxygen diffusion in a network model of the myocardial microcirculation.

Oxygen supply was studied in a three-dimensional capillary network model of the myocardial microcirculation. Capillary networks were generated using one common strategy to locate the capillary branchings and segments, arterioles and venules. Flow paths developed with different capillary flow velocities. All pressure-flow relationships were linear. The model includes free diffusion of oxygen within tissue slices that are perpendicular to the main capillary orientation. Oxygen pressure distributions were calculated and correlated to oxygen delivery by small capillary segments. It was shown that intercapillary diffusion is important for reducing PO2 heterogeneity. The absence of this feature leads to an oxygen distribution that has similar heterogeneity characteristics as the capillary flow heterogeneity. Such situations may also occur during simulated, elevated metabolic activity in a network model that allows intercapillary diffusion. On the basis of our simulations of metabolic vasoactivity we concluded that the venous PO2 is a misleading quantity to indicate tissue oxygenation. The venous PO2 in our model was not a good measure for the mean tissue or capillary PO2, and for the low oxygen pressures that exist at some locations in the network model. Moreover, the venous PO2 may remain constant despite considerable changes on the tissue PO2 distribution induced by metabolic activity.

Blood Flow Velocity↗
PubMed1990

Heterogeneous NADH fluorescence during post-anoxic reactive hyperemia in saline perfused rat heart.

In the present study epicardial NADH fluorescence photographs were taken of rat hearts during dynamic transitions of oxygen content of the myocardium. Hearts were perfused in a Langendorff set-up where it was possible to switch between low and high-pO2 perfusates. NADH fluorescence photographs were taken with a suitable fluorescence set-up and photo negatives digitized and analyzed by use of a computer. Restoration of perfusion with a high-pO2 solution resulted in a reactive hyperemic flow being established. Prior to the occlusion being lifted high NADH fluorescence was observed. Reactive hyperemic flow was associated with heterogenic NADH fluorescence patterns which diminished as control flow was restored. The patterns observed during reactive hyperemia were identical to those observed when tissue oxygen was restored by high-pO2 perfusion following high flow hypoxia achieved by low-pO2 perfusion. This study shows that heterogenic epicardial flow patterns are associated with reactive hyperemia.

Animals↗
PubMed1988

Quantification of arteriolar density and embolization by microspheres in rat myocardium.

We developed a technique for in vitro determination of arteriolar densities. Hearts, obtained from anesthetized rats and perfused by the Langendorff method, were fully dilated with adenosine and were arrested with an elevated potassium concentration. After a stabilization period, the hearts were perfused with a buffered fixative for some minutes to obtain a nonvital vasculature. After fixation, perfusion was switched back to control for some minutes. The hearts were then perfused with a medium containing a low concentration of microspheres: either pollen grains [Urtica dioica (15.4 microns), Betula (23.5 microns), or Phleum pratense (36.5 microns)] or polystyrene microspheres (15 microns). The perfusion was switched back to the standard medium after flow had been reduced to between 83 and 57% of control flow. Microscopic observations of microsections revealed that the percentages of arterioles embolized by one microsphere were 64% for the 15.4-microns, 74% for the 15-microns, 78% for the 23.5-microns, and 72% for the 36.5-microns microspheres. The percentages of arterioles embolized with two microspheres were 20, 15, 15, and 16%, respectively. The arteriolar densities were calculated from the total fractional reduction in coronary flow, the amount of microspheres injected, the wet heart weight, and the degree of occupancy, which corrects for the multiple embolization of the arterioles. The arteriolar densities in the rat hearts were 162.4 +/- 54.9 mg-1 (N = 6) for polystyrene microspheres of 15 microns, 161.5 +/- 81.1 mg-1 (N = 15) for 15.4-microns microspheres, 31.6 +/- 7.8 mg-1 (N = 9) for 23.5-microns microspheres, and 13.0 +/- 2.4 mg-1 (N = 8) for 36.5-microns microspheres.

Animals↗
PubMed1987

Quantification of O2 consumption and arterial pressure as independent determinants of coronary flow.

The steady-state relationship between coronary arterial blood flow (CBF) and both myocardial O2 consumption (MVO2) and coronary arterial pressure (P) was explored in anesthetized dogs and goats. Both species were subjected to constant pressure perfusion of the left main coronary artery by an external pressure-controlling circuit. In addition a group of goats was studied with normal aortic perfusion using an occluder around the left main coronary artery to vary coronary arterial pressure. The statistical analysis revealed that despite the direct effect of P on MVO2 (the Gregg effect) the effects of both variables on CBF were independent and linear over a wide range of P and MVO2 so that multiple regression analysis with a linear equation (CBF = a X P + b X MVO2 + c) gave an excellent fit which was not improved by the introduction of an addition interactive term b3MVO2 X P. The mean correlation coefficient for all animals was greater than 0.9. From these data we conclude that any factor regulating coronary arterial flow would be influenced by both MVO2 and perfusion pressure in an independent way. This study characterizes the stationary behavior of local coronary flow control. Hence, it specifies quantitatively the relations to be predicted by hypotheses aiming to explain this control mechanism.

Analysis of Variance↗
PubMed1984

Mechanics of resting isolated single vascular smooth muscle cells from bovine coronary artery.

The viscoelastic behavior of single resting vascular smooth muscle cells from bovine coronary artery was studied. No maintained passive force could be recorded, even when the cells were stretched to two to four times their initial length; this finding suggests that the smooth muscle cells do not contribute to the parallel elastic component in arterial smooth muscle tissue. The force during stretch of resting arterial cells was proportional to the rate of stretch (which varied between 20 and 60% of the initial length per second). This linear viscous resistance was also found for toad stomach cells when similar stretches were applied. The stress-relaxation curves of the arterial cells could be fitted to the sum of two exponential components (with half-lives of 13.1 and 0.5 s, respectively). As a result of the above findings, a model consisting of two viscoelastic elements in parallel was proposed for a single resting arterial smooth muscle cell. The viscous resistance to stretch of resting cells in a Ca2+-containing solution was not significantly (P greater than 0.01) different from that in a Ca2+-free solution. The same result was obtained for bovine coronary arterial rings. It is concluded that an adequate model for resting arterial smooth muscle should include an intracellular viscous element.

Animals↗