Biomedical subjects

T E Milner

Publications and source records attributed to T E Milner.

At least 37 records · Page 2Linked to original sources

PubMed2000

The effect of eccentric exercise on intrinsic and reflex stiffness in the human hand.

OBJECTIVE: The purpose of this work was to determine the effect of strenuous eccentric exercise on joint stiffness and to separate joint stiffness into components due to intrinsic muscle mechanics and delayed reflex muscle activation. DESIGN: Subjects performed 100 maximal eccentric contractions, using the first dorsal interosseus muscle to abduct the index finger while undergoing a 20 degrees displacement of the metacarpophalangeal joint. Joint stiffness was measured 24 h later during 15% and 65% maximal voluntary contraction and during electrical muscle stimulation at 15% of maximal voluntary contraction torque. BACKGROUND: Joint stiffness can be varied by changing voluntary muscle activation and thereby serves an important role in joint stabilization. Eccentric exercise has been shown to result in muscle fiber injury, reducing maximal muscle force. However, it is not known whether intrinsic muscle stiffness or reflex stiffness is also affected. METHODS: Displacements of 3 degrees amplitude were used to estimate joint stiffness about the neutral angle of the index finger. The difference between measurements made during voluntary muscle activation and electrical muscle stimulation was used to obtain reflex stiffness. RESULTS: There was no change in the passive joint stiffness nor was there any change in either the intrinsic or reflex stiffness at 15% maximal voluntary contraction. However, intrinsic stiffness for the electrically stimulated muscle was higher post-exercise than pre-exercise, while active joint stiffness at 65% maximal voluntary contraction (comprising intrinsic and reflex stiffness) was lower. CONCLUSION: The observed mechanical changes are compatible with the hypothesis that type II muscle fibers are more susceptible to injury than type I muscle fibers, which have higher intrinsic stiffness. RELEVANCE: Muscle stiffness is important for maintaining mechanical stability of a joint. The effects of eccentric exercise on muscle stiffness are likely analogous to the effects of muscle injury, making this a good model for biomechanical changes associated with muscle injury.

Adult↗

PubMed2000

Combining two excitation wavelengths for pulsed photothermal profiling of hypervascular lesions in human skin.

When pulsed photothermal radiometry (PPTR) is used for depth profiling of hypervascular lesions in human skin, melanin absorption also heats the most superficial skin layer (epidermis). Determination of lesion depth may be difficult when it lies close to the epidermal dermal junction, due to PPTR's limited spatial resolution. To overcome this problem, we have developed an approximation technique, which uses two excitation wavelengths (585 and 600 nm) to separate the vascular and epidermal components of the PPTR signal. This technique permits a noninvasive determination of lesion depth and epidermal thickness in vivo, even when the two layers are in close physical proximity to each other. Such information provides the physician with guidance in selecting the optimal parameters for laser therapy on an individual patient basis.

Blood↗

PubMed2000

Proteoglycan synthesis in porcine nasal cartilage grafts following Nd:YAG (lambda = 1.32 microns) laser-mediated reshaping.

Mechanically deformed morphologic cartilage grafts undergo temperature-dependent stress relaxation during sustained laser irradiation resulting in stable shape changes. In this study, porcine nasal septal cartilage specimens were evaluated for viability by measuring the incorporation of Na2(35)SO4 into proteoglycan (PTG) macromolecules in whole tissue culture following laser-mediated reshaping. Synthesis rates of PTG were determined by scintillation counting lyophilized specimens and normalizing these values by total protein content. Positive controls were established by inducing chondrocyte apoptosis using prolonged exposure to nitric oxide (NO). In chondrocytes, apoptosis induced using NO resulted in significantly lower PTG synthesis rates compared to untreated native specimens. Cartilage specimens were irradiated with light emitted from a Nd:YAG laser (25 W/cm2, lambda = 1.32 microns) while recording simultaneously radiometric surface temperature, internal stress and back-scattered light intensity from a probe laser. Each specimen received one, two or three sequential laser exposures. The duration of each exposure was determined from real-time measurements of characteristic changes in back-scattered light intensity that correlate with accelerated stress relaxation. A 5 min time interval between each laser exposures allowed the cartilage specimen to return to thermal equilibrium. Average PTG synthesis rates decreased with successive laser exposures, though these were always higher than baseline rates established for NO-treated tissues, suggesting that laser-mediated cartilage reshaping acutely does not eliminate the entire population of viable chondrocytes. The reduction in PTG synthesis is correlated with the time-temperature-dependent heating profile created during laser irradiation, supporting our hypothesis that careful monitoring of laser dosimetry is required to ensure chondrocyte viability.

Animals↗

PubMed1999

Modeling laser treatment of port wine stains with a computer-reconstructed biopsy.

BACKGROUND AND OBJECTIVE: The efficacy of laser treatment of port wine stains (PWS) has been shown to be highly dependent on patient-specific vasculature. The effect of tissue structure on optical and thermal mechanisms was investigated for different pulse durations by using a novel theoretical model that incorporates tissue morphology reconstructed tomographically from a PWS biopsy. STUDY DESIGN/MATERIALS AND METHODS: An optical-thermal numerical model capable of simulating arbitrarily complex, three-dimensional tissue geometries was developed. The model is comprised of (1) a voxel-based Monte Carlo optical model, (2) a finite difference thermal model, and (3) an Arrhenius rate process calculation to predict the distribution of thermal damage. Simulations based on previous computer-based reconstruction of a series of 6 microm sections from a PWS biopsy were performed for laser pulse durations (taup) of 0.5, 5.0, and 10.0 ms at a wavelength of 585 nm. RESULTS: Energy deposition rate in the blood vessels was primarily a function of vessel depth in skin, although shading effects were evident. Thermal confinement and selectivity of damage were seen to be inversely proportional to pulse duration. The model predicted blood-specific damage for taup = 0.5 ms, vascular and perivascular damage for taup = 5 ms, and widespread damage in superficial regions for taup = 10 ms. The effect of energy deposition in the epidermis was most pronounced for longer pulse durations, resulting in increased temperature and extent of damage. CONCLUSION: Pulse durations between 0.5 and 5 ms are likely optimal for the PWS analyzed. The incorporation of a tomographically reconstructed PWS biopsy into an optical-thermal model represents a significant advance in numerical modeling of laser-tissue interaction.

Adult↗

PubMed1998

Damping of the wrist joint during voluntary movement.

Damping characteristics of the musculoskeletal system were investigated during rapid voluntary wrist flexion movements. Oscillations about the final position were induced by introducing a load with the characteristics of negative damping, which artificially reduced the damping of the wrist. Subjects responded to increases in the negatively damped load by stronger cocontraction of wrist flexor and extensor muscles during the stabilization phase of the movement. However, their ability to counteract the effects of the negatively damped load diminished as the negative damping increased. Consequently, the number and frequency of oscillations increased. The oscillations were accompanied by phase-locked muscle activity superimposed on underlying tonic muscle activation. The wrist stiffness and damping coefficient increased with the increased cocontraction that accompanied more negatively damped loads, although changes in the damping coefficient were less systematic than the stiffness. Analysis of successive half-cycles of the oscillation revealed that the wrist stiffness and damping coefficient increased, despite decreasing muscle activation, as oscillation amplitude and velocity declined. This indicates that the inverse dependence of the damping coefficient on oscillation velocity contributes significantly to damping of joint motion. It is suggested that this property helps to offset a negative contribution to damping from the stretch reflex.

Adult↗

PubMed1998

Quantization of human motions and learning of accurate movements.

This paper presents a mathematical model for the learning of accurate human arm movements. Its main features are that the movement is the superposition of smooth submovements, the intrinsic deviation of arm movements is considered, visual and kinesthetic feed-back are integrated in the motion control, and the movement duration and accuracy are optimized with practice. This model is consistent with the jerky arm movements of infants, and may explain how the adult motion behavior emerges from the infant behavior. Comparison with measurements of adult movements shows that the kinematics of accurate movements are well predicted by the model.

Adult↗

PubMed1998

Signal attenuation and localization in optical coherence tomography studied by Monte Carlo simulation.

A Monte Carlo model has been developed for optical coherence tomography (OCT). A geometrical optics implementation of the OCT probe with low-coherence interferometric detection was combined with three-dimensional stochastic Monte Carlo modelling of photon propagation in the homogeneous sample medium. Optical properties of the sample were selected to simulate intralipid and blood, representing moderately (g = 0.7) and highly (g = 0.99) anisotropic scattering respectively. For shallow optical depths in simulated intralipid (<3 scattering mean free path (mfp) units), the number of detected backscattered photons followed the extinction-single-backscatter model, and OCT was found to detect only minimally scattered photons. Within this depth range the backscatter positions of detected photons corresponded well with the nominal focus position of the probe. For propagation to deeper positions in intralipid, localization of backscattering was quickly lost due to detection of stray photons, and the number of detected photons remained constant with increasing depth in the non-absorbing medium. For strongly forward-directed scattering in simulated blood, the number of detected photons approached the extinction-single-backscatter model only for very shallow depths (<2 mfp units). However, backscattering positions for detected photons correlated well with the nominal focus position of the probe even for optical depths greater than 40 mfp units.

Blood↗

PubMed1998

Accuracy and noise in optical Doppler tomography studied by Monte Carlo simulation.

A Monte Carlo model has been developed for optical Doppler tomography (ODT) within the framework of a model for optical coherence tomography (OCT). A phantom situation represented by blood flowing in a horizontal 100 microm diameter vessel placed at 250 microm axial depth in 2% intralipid solution was implemented for the Monte Carlo simulation, and a similar configuration used for experimental ODT measurements in the laboratory. Simulated depth profiles through the centre of the vessel of average Doppler frequency demonstrated an accuracy of 3-4% deviation in frequency values and position localization of flow borders, compared with true values. Stochastic Doppler frequency noise was experimentally observed as a shadowing in regions underneath the vessel and also seen in simulated Doppler frequency depth profiles. By Monte Carlo simulation, this Doppler noise was shown to represent a nearly constant level over an investigated 100 microm interval of depth underneath the vessel. The noise level was essentially independent of the numerical aperture of the detector and angle between the flow velocity and the direction of observation, as long as this angle was larger than 60 degrees. Since this angle determines the magnitude of the Doppler frequency for backscattering from the flow region, this means that the signal-to-noise ratio between Doppler signal from the flow region to Doppler noise from regions underneath the flow is improved by decreasing the angle between the flow direction and direction of observation. Doppler noise values from Monte Carlo simulations were compared with values from statistical analysis.

Diagnostic Imaging↗

PubMed1998

Accuracy of subsurface temperature distributions computed from pulsed photothermal radiometry.

Pulsed photothermal radiometry (PPTR) is a non-contact method for determining the temperature increase in subsurface chromophore layers immediately following pulsed laser irradiation. In this paper the inherent limitations of PPTR are identified. A time record of infrared emission from a test material due to laser heating of a subsurface chromophore layer is calculated and used as input data for a non-negatively constrained conjugate gradient algorithm. Position and magnitude of temperature increase in a model chromophore layer immediately following pulsed laser irradiation are computed. Differences between simulated and computed temperature increase are reported as a function of thickness, depth and signal-to-noise ratio (SNR). The average depth of the chromophore layer and integral of temperature increase in the test material are accurately predicted by the algorithm. When the thickness/depth ratio is less than 25%, the computed peak temperature increase is always significantly less than the true value. Moreover, the computed thickness of the chromophore layer is much larger than the true value. The accuracy of the computed subsurface temperature distribution is investigated with the singular value decomposition of the kernel matrix. The relatively small number of right singular vectors that may be used (8% of the rank of the kernel matrix) to represent the simulated temperature increase in the test material limits the accuracy of PPTR. We show that relative error between simulated and computed temperature increase is essentially constant for a particular thickness/depth ratio.

Algorithms↗

PubMed1998

A comparative study of human skin thermal response to sapphire contact and cryogen spray cooling.

Surface cooling, in conjunction with various thermally mediated therapeutic procedures, can provide a means to protect superficial tissues from injury while achieving destruction of deeper targeted structures. We have investigated the thermal response of in-vivo human skin to: 1) contact cooling with a sapphire window (6-12 degrees C); and 2) spray cooling with a freon substitute cryogen [tetrafluoroethane; boiling point approximately -26 degrees C at 1 atmospheric pressure (atm)]. Measurements utilizing infrared radiometry show surface temperature reductions from 30 degrees C to 14-19 degrees C are obtained within approximately 1 s in response to sapphire contact cooling. Surface temperature reductions to values between 5 degrees C and -9 degrees C are obtained in response to 20-100-ms cryogen spurts. Computational results, based on fitting the measured radiometric surface temperature to estimate heat transfer parameters, show: 1) temperature reductions remain localized to approximately 200 microns of superficial tissue; and 2) values of heat flux and total energy removed per unit skin surface area at least doubled when using cryogen spray cooling.

Aerosol Propellants↗

PubMed1998

Characterization of multijoint finger stiffness: dependence on finger posture and force direction.

The two-dimensional static stiffness of the index finger was measured with the interphalangeal joints in flexed and extended postures. The stiffness of the relaxed finger was compared with the stiffness when voluntary force was exerted in different directions. The finger stiffness was found to be anisotropic, with the direction of greatest stiffness being approximately parallel to the proximal phalange of the finger. This direction was relatively unaffected by finger posture or direction of finger force. Finger stiffness was more anisotropic when the interphalangeal joints were extended than flexed. The stiffness was most anisotropic when the interphalangeal joints were extended and force was being exerted in the direction of pointing, while it was least anisotropic when the interphalangeal joints were flexed and force was being exerted in directions normally associated with pinching and tapping actions. The stiffness of the individual finger joints was computed and the relation between stiffness and joint torque was examined. Previous studies, which examined single finger joints in isolation, had found that joint stiffness varied in a linear fashion with net joint torque. In contrast, we did not find a monotonic relation between joint stiffness and net joint torque, which we attributed to the need to vary the amount of cocontraction of antagonistic muscles when controlling the direction of finger force.

Adult↗

PubMed1998

Optical Doppler tomography: imaging in vivo blood flow dynamics following pharmacological intervention and photodynamic therapy.

A noninvasive optical technique has been developed for imaging in vivo blood flow dynamics and vessel structure with high spatial resolution. The technique is based on optical Doppler tomography, which combines Doppler velocimetry with optical coherence tomography to measure blood flow velocity at discrete spatial locations in turbid biological tissue. Applications of this technique for monitoring changes in blood flow dynamics and vessel structure following pharmacological intervention and photodynamic therapy are demonstrated.

Allantois↗

PubMed1998

Optical absorption of blood depends on temperature during a 0.5 ms laser pulse at 586 nm.

Optical properties are important parameters in port wine stain laser treatment models. In this study we investigated whether changes in blood optical properties occur during a 0.5 ms laser pulse. Blood from three volunteers was irradiated in vitro with laser pulses (radiant exposure 2-12 J cm-2, wavelength 586 nm, pulse length 0.5 ms). Reflection and transmission coefficients, measured using double integrating spheres, decreased slightly during the first part of the pulse. At 2.9 J cm-2 radiant exposure, the reflectance increased, independent of total radiant exposure of the pulse. This was caused by blood coagulation. A second sudden increase in reflection and a significant increase in transmission occurred near 6.3 J cm-2 and was accompanied by a "popping" sound, indicating rapid expansion of bubbles due to blood vaporization. A multilayered model of blood was used to fit calculated transmission coefficient curves to the measurements and determine temperature-dependent optical blood absorption. Heat diffusion was shown to be of minor importance. A 2.5-fold increase in absorption for temperatures increasing from 20 to 100 degrees C, accurately describes transmission coefficients measured up to 2.9 J cm-2.

Absorption↗

PubMed1997

Wavelengths for port wine stain laser treatment: influence of vessel radius and skin anatomy.

Recent Monte Carlo computations in realistic port wine stain (PWS) models containing numerous uniformly distributed vessels suggest equal depth of vascular injury at wavelengths of 577 and 585 nm. This finding contradicts clinical experience and previous theory. From a skin model containing normal and PWS vessels in separate dermal layers, we estimate analytically the average volumetric heat production in the deepest targeted PWS vessel. The fluence rate distribution is approximated by Beer's law, which depends upon the tissue's effective attenuation coefficient, and includes a homogeneous fractional volumetric blood concentration corrected for finite-size blood vessels. The model predicts 585-587 nm wavelengths are optimal in adult PWSs containing at least one layer of small-radius blood vessels. In superficial PWSs, typically in young children with small-radius vessels, 577-580 nm wavelengths are optimal. Wavelength-independent results similar to those from Monte Carlo models are valid in single-layered PWSs of large-radius vessels. In conclusion, the volumetric heat production in the deepest targeted PWS blood vessel can be maximized on an individual patient basis. However, absorption of 585-587 nm wavelengths is sufficiently high in superficial lesions, so we hypothesize that these wavelengths may be considered adequate for the treatment of any PWS.

Adult↗

PubMed1997

Nd:YAG laser irradiation in conjunction with cryogen spray cooling induces deep and spatially selective photocoagulation in animal models.

Successful laser treatment of haemangiomas requires selective photocoagulation of subsurface targeted blood vessels without thermal damage to the overlying epidermis. We present an in vivo experimental procedure, using a chicken comb animal model, and an infrared feedback system to deliver repetitive cryogen spurts (of the order of milliseconds) during continuous Nd:YAG laser irradiation. Gross and histologic observations show deep-tissue photocoagulation is achieved, while superficial structures are protected from thermal injury due to cryogen spray cooling. Experimental observation of epidermis protection in chicken comb animal models suggests selective photocoagulation of subsurface targeted blood vessels for successful treatment of haemangiomas can be achieved by repetitive applications of a cryogen spurt during continuous Nd:YAG laser irradiation.

Animals↗

PubMed1997

Non-invasive determination of port wine stain anatomy and physiology for optimal laser treatment strategies.

The treatment of port wine stains (PWSs) using a flashlamp-pumped pulsed dye laser is often performed using virtually identical irradiation parameters. Although encouraging clinical results have been reported, we propose that lasers will only reach their full potential provided treatment parameters match individual PWS anatomy and physiology. The purpose of this paper is to review the progress made on the technical development and clinical implementation of (i) infrared tomography (IRT), optical reflectance spectroscopy (ORS) and optical low-coherence reflectometry (OLCR) to obtain in vivo diagnostic data on individual PWS anatomy and physiology and (ii) models of light and heat propagation, predicting irreversible vascular injury in human skin, to select optimal laser wavelength, pulse duration, spot size and radiant exposure for complete PWS blanching in the fewest possible treatment sessions. Although non-invasive optical sensing techniques may provide significant diagnostic data, development of a realistic model will require a better understanding of relevant mechanisms for irreversible vascular injury.

Blood Vessels↗

PubMed1997

Three-dimensional reconstruction of port wine stain vascular anatomy from serial histological sections.

Port wine stains (PWSs) treated with a flashlamp-pumped pulsed dye laser show a variability in clinical response that is incompletely understood. To identify any vascular structure that might adversely affect treatment response, we obtained a three-dimensional reconstruction of the vascular anatomy of a non-responsive, light-purple superficial PWS on the forearm. The reconstructed PWS consisted of multiple clusters of small diameter (10-50 microns) blood vessels. We propose that this and similar structures, which have not been identified in the literature, have limited the efficacy of laser therapy. Further study is required to clarify the role of vessel clusters for laser treatment of PWSs, and the corresponding dosimetry necessary to clear non-responsive lesions. We expect that three-dimensional reconstruction of PWS vascular anatomy will provide the basis for (i) accurate PWS classification, (ii) guidance for selection of more effective laser dosimetry, and (iii) a standard against which to assess non-invasive diagnostic imaging techniques.

Adult↗

PubMed1996

Dynamic heat capacity changes of laser-irradiated type I collagen films.

BACKGROUND AND OBJECTIVE: A common assumption made in the thermal response of biological materials due to laser irradiation is the constancy of the specific heat capacity at constant pressure, CP. In this investigation, CP of pure hydrated Type I collagen films is measured in time during laser irradiation. STUDY DESIGN/MATERIALS AND METHODS: A Nd:YAG laser scanning calorimeter is developed and used to test the constant heat capacity assumption by monitoring transient, laser-induced thermal transitions in the collagen films. RESULTS: Results of preliminary studies on the irreversible, laser induced thermal denaturation of collagen with heating rates of up to 110 K/sec show a broad CP transition that can attain large values (20 J/g K). CONCLUSION: The magnitude of the CP change that occurs in response to laser irradiation shows that the assumption of a constant CP when modeling heat transport in tissues is not always valid.

Algorithms↗