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In Vivo Hemodynamic Measurement - Light - Electric. 王鐘賢 長庚大學 長壽醫學研究中心 復健科學研究所 物理治療學系. VO 2 , VCO 2 , RQ, RER MET. Aerobic, Non-aerobic. O 2. VE = f X Vt VE/VO 2. ATP. (+). Physical Performance. Respiration. Circulation. Metabolism. Heat etc. (-). Q = P/R - PowerPoint PPT Presentation
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In VivoIn Vivo Hemodynamic Measurement Hemodynamic Measurement
- - LightLight - Electric - Electric
王鐘賢王鐘賢長庚大學長庚大學
長壽醫學研究中心 復健科學研究所 物理治療學系長壽醫學研究中心 復健科學研究所 物理治療學系
Respiration Circulation Metabolism
ATP
O2
(+)
Heat
etc.
(-)
VE = f X Vt VE/VO2
Q = P/R
MBP = C.O X TPR
C.O. = HR X SV
SV= VO2/HR
R = 6L/r4
VO2, VCO2,
RQ, RER
MET
Aerobic,
Non-aerobic
Cutaneous Microcirculation
Sweat
Physical
Performance
Hemodynamic Hemodynamic Resistance and Flow in Networks of VesselsResistance and Flow in Networks of Vessels
Flow = pressure difference/ resistanceFlow = pressure difference/ resistance Q = Q = P/RP/R R = 8 LR = 8 L//rr44; Q = ; Q = P/8 LP/8 L//rr44
Laminar vs. Turbulence FlowLaminar vs. Turbulence Flow Laminar FlowLaminar Flow
Shear stress; Shear stress; ss = 4 = 4 QQ//rr33
== fluid viscosityfluid viscosity Turbulence FlowTurbulence Flow
Reynolds number (Reynolds number (RRee) >2000) >2000 RRee = 4 = 4 QQ//ddii
= fluid density; = fluid density; ddii = inside diameter = inside diameter
HemodynamicHemodynamic Determinants of Arterial PressureDeterminants of Arterial Pressure
Mean Arterial PressureMean Arterial Pressure PPAA = CO X TPR = CO X TPR
CO = HR X SVCO = HR X SV TPR = 8 LTPR = 8 L//rr44
Arterial Pulse PressureArterial Pulse Pressure PPpp = P = PSS-P-PDD
PPpp ~~ SV/C SV/CAA
Properties of VesselsProperties of Vessels
VenousVenous ComplianceCompliance
C = C = V/V/P P Deep venous throDeep venous thro
mbosismbosis
ValveValve venous Insufficientvenous Insufficient
ArteriesArteries StiffnessStiffness
ArteriosclerosisArteriosclerosis
ArteriolesArterioles Active hyperemiaActive hyperemia Reactive hyperemiaReactive hyperemia
Intermittent claudicaIntermittent claudicationtion
ArteriosclerosisArteriosclerosis
Intermittent ClaudicationIntermittent Claudication
Control of Arteriolar ZoneControl of Arteriolar Zone LocalLocal
MetabolicMetabolic ATP-senstive KATP-senstive K++ channel, adenosine, CO channel, adenosine, CO22, H, H++, O, O22
Flow responsesFlow responses Endothelial cellsEndothelial cells
EDRF, NO, EDHF, PGIEDRF, NO, EDHF, PGI22
EDCF, endothelin (ET)EDCF, endothelin (ET)
NeuralNeural sympathetic vasoconstrictor fiber sympathetic vasoconstrictor fiber 11
HormonalHormonal circulating catecholamines, vasopressin, anigotensin IIcirculating catecholamines, vasopressin, anigotensin II
Venous Valve InsufficientVenous Valve Insufficient
Deep Venous ThrombosisDeep Venous Thrombosis
MethodologyMethodology PlethysmographyPlethysmography
Air, WaterAir, Water Strain gaugeStrain gauge ImpedanceImpedance
Doppler flowometryDoppler flowometry LaserLaser UltrasoundUltrasound
Pulse wave analysisPulse wave analysis IR RheographyIR Rheography
SpectrophometrySpectrophometry Capillary ImagesCapillary Images
Strain Gauge PlethysmographyStrain Gauge Plethysmography
A change in the blood volume in an extremitA change in the blood volume in an extremity will lead to a change in its circumference y will lead to a change in its circumference
Elastic mercury tubesElastic mercury tubes the change of the electrical resistance of the the change of the electrical resistance of the
mercury corresponds with the change of the mercury corresponds with the change of the circumference of the extremity. circumference of the extremity.
35 cm calf 35 cm calf + a change of about 1-3 cm + a change of about 1-3 cm Water or air plethysmophy.Water or air plethysmophy.
Impedance Impedance PlethymographyPlethymography
The measurement of changes in the The measurement of changes in the electrical resistance (impedance) caused by electrical resistance (impedance) caused by blood volume changesblood volume changes
Very low amount of high frequency Very low amount of high frequency alternating current is passed through the alternating current is passed through the selected measuring segment.selected measuring segment.
Impedance changes is inverse proportional Impedance changes is inverse proportional to the relative changes in blood volume.to the relative changes in blood volume.
Impedance Impedance PlethymographyPlethymography
Determine Resting and Hyperemic Determine Resting and Hyperemic Arterial InflowArterial Inflow
ApplicationApplication Testing of inflow at rest or of the arterial inflow durinTesting of inflow at rest or of the arterial inflow durin
g pharmaceutical or physical stimulationg pharmaceutical or physical stimulation Testing of hyperemic inflowTesting of hyperemic inflow
To diagnose arterial obliterative processesTo diagnose arterial obliterative processes To evaluate the haemodynamic quality of collateral circulatiTo evaluate the haemodynamic quality of collateral circulati
on on
LimitationLimitation A disturbed venous outflow (venous thrombosis)A disturbed venous outflow (venous thrombosis) MediasclerosisMediasclerosis Adipose (fat)Adipose (fat)
Reactive HyperemiaReactive Hyperemia
Venous Occlusion plethymographyVenous Occlusion plethymography
ApplicationApplication Diagnosis of deep venous thrombosisDiagnosis of deep venous thrombosis Testing the venous capacity and the venous Testing the venous capacity and the venous
compliance to quantify pathological changes of the compliance to quantify pathological changes of the veinsveins
Analysis of the circulation in the deep venous Analysis of the circulation in the deep venous system before vascular surgerysystem before vascular surgery
LimitationLimitation Disturbances of arterial inflowDisturbances of arterial inflow Adipose (fat)Adipose (fat)
Venous Function Venous Function
Venous capacityVenous capacity Venous outflowVenous outflow Venous toneVenous tone Flow resistanceFlow resistance
VenousVenous Reflux Test Reflux Test
ApplicationApplication Functional test of the venous valvesFunctional test of the venous valves Evaluation of the effectiveness of the muscle Evaluation of the effectiveness of the muscle
pumppump Early recognition of venous diseasesEarly recognition of venous diseases Evaluation of a possible success of Evaluation of a possible success of
operation on varicose veinsoperation on varicose veins
VenousVenous Reflux Test Reflux Test
Refilling timeRefilling time Refilling velocityRefilling velocity Volume displacementVolume displacement
Other Possible ApplicationsOther Possible Applications
Diagnosis of thoracic-outlet syndromeDiagnosis of thoracic-outlet syndrome Patient with scalenus anticus syndromePatient with scalenus anticus syndrome
Ankle-brachial index (ABI)Ankle-brachial index (ABI) PVDPVD
Pulse Wave AnalysisPulse Wave Analysis
IR RheographyIR Rheography
Determination of Determination of Artery Stiffness and Arteriole ReflectionArtery Stiffness and Arteriole Reflection
Artery StiffnessArtery Stiffness
Arteriole ReflectionArteriole Reflection
Pulse Wave AnalysisPulse Wave Analysis
Application of Application of Wound Healing, Wound Healing, Neuropathy, Neuropathy, and Endothelial Functionand Endothelial Function
This LDF is related to the average velocity and This LDF is related to the average velocity and number of red cells within the tissue volume.number of red cells within the tissue volume.
The Periscan PIM-II uses a 670nm laser whereThe Periscan PIM-II uses a 670nm laser whereas the Moor instruments use a 633nm laser anas the Moor instruments use a 633nm laser and a near-infrared 830 nm source for deeper ped a near-infrared 830 nm source for deeper penetration.netration.
InstrumentInstrument
Wound HealingWound Healing
Wound HealingWound Healing
Wound HealingWound Healing
Burn LevelsBurn Levels
Laser Doppler Imaging and InotophoresiLaser Doppler Imaging and Inotophoresiss
ACh
EDRF
SNP smooth cell
endothelial cell
Laser Doppler Imaging and InotophoresiLaser Doppler Imaging and Inotophoresiss
Aging, Exercise, MicrocirculationAging, Exercise, Microcirculation
Aging, Exercise, MicrocirculationAging, Exercise, Microcirculation
Aging, Exercise, MicrocirculationAging, Exercise, Microcirculation
In VitroIn Vitro Cell Isolation and Function Cell Isolation and Function
- - Centrifugation Centrifugation - Immunomagnetic Selection- Immunomagnetic Selection
- - FluorescenceFluorescence
王鐘賢王鐘賢長庚大學長庚大學
長壽醫學研究中心 復健科學研究所 物理治療學系長壽醫學研究中心 復健科學研究所 物理治療學系
HematopoiesisHematopoiesis
Blood CellsBlood Cells
Cluster of Differentiation (CD)
-Saline
-1.077 g/ml
-1.095 g/ml
-mononuclear cell
-granulocytes
-erythrocytes
Isolation of LeukocytesIsolation of Leukocytes
RCF=11.18(r)(rpm/1000) RCF :離心力 r :轉子 (Rotor) 半徑 rpm :轉速
Immunomagnetic Selection TechniqueImmunomagnetic Selection Technique
Positive Negative
Cell MotionCell Motion
Adhesion Molecules
Adhesion molecules
1.Selectin 2.Mucin 3.Integrin 4.IgG-family CAM
Stokes’ LawStokes’ Law
FluorescenceFluorescence
Thank You forThank You for Your Attention Your Attention