Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1550

Search results for: Blood Pressure

1550 Improving the Design of Blood Pressure and Blood Saturation Monitors

Authors: L. Parisi

Abstract:

A blood pressure monitor or sphygmomanometer can be either manual or automatic, employing respectively either the auscultatory method or the oscillometric method. The manual version of the sphygmomanometer involves an inflatable cuff with a stethoscope adopted to detect the sounds generated by the arterial walls to measure blood pressure in an artery. An automatic sphygmomanometer can be effectively used to monitor blood pressure through a pressure sensor, which detects vibrations provoked by oscillations of the arterial walls. The pressure sensor implemented in this device improves the accuracy of the measurements taken.

Keywords: Blood pressure, blood saturation, sensors, actuators, design improvement.

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1549 Estimation of Systolic and Diastolic Pressure using the Pulse Transit Time

Authors: Soo-young Ye, Gi-Ryon Kim, Dong-Keun Jung, Seong-wan Baik, Gye-rok Jeon

Abstract:

In this paper, algorithm estimating the blood pressure was proposed using the pulse transit time (PTT) as a more convenient method of measuring the blood pressure. After measuring ECG and pressure pulse, and photoplethysmography, the PTT was calculated from the acquired signals. Thereafter, the system to indirectly measure the systolic pressure and the diastolic pressure was composed using the statistic method. In comparison between the blood pressure indirectly measured by proposed algorithm estimating the blood pressure and real blood pressure measured by conventional sphygmomanometer, the systolic pressure indicates the mean error of ±3.24mmHg and the standard deviation of 2.53mmHg, while the diastolic pressure indicates the satisfactory result, that is, the mean error of ±1.80mmHg and the standard deviation of 1.39mmHg. These results are satisfied with the regulation of ANSI/AAMI for certification of sphygmomanometer that real measurement error value should be within the mean error of ±5mmHg and the standard deviation of 8mmHg. These results are suggest the possibility of applying to portable and long time blood pressure monitoring system hereafter.

Keywords: Blood pressure, Systolic, Diastolic, Pulse transit time.

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1548 Monitoring Blood Pressure Using Regression Techniques

Authors: Qasem Qananwah, Ahmad Dagamseh, Hiam AlQuran, Khalid Shaker Ibrahim

Abstract:

Blood pressure helps the physicians greatly to have a deep insight into the cardiovascular system. The determination of individual blood pressure is a standard clinical procedure considered for cardiovascular system problems. The conventional techniques to measure blood pressure (e.g. cuff method) allows a limited number of readings for a certain period (e.g. every 5-10 minutes). Additionally, these systems cause turbulence to blood flow; impeding continuous blood pressure monitoring, especially in emergency cases or critically ill persons. In this paper, the most important statistical features in the photoplethysmogram (PPG) signals were extracted to estimate the blood pressure noninvasively. PPG signals from more than 40 subjects were measured and analyzed and 12 features were extracted. The features were fed to principal component analysis (PCA) to find the most important independent features that have the highest correlation with blood pressure. The results show that the stiffness index means and standard deviation for the beat-to-beat heart rate were the most important features. A model representing both features for Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) was obtained using a statistical regression technique. Surface fitting is used to best fit the series of data and the results show that the error value in estimating the SBP is 4.95% and in estimating the DBP is 3.99%.

Keywords: Blood pressure, noninvasive optical system, PCA, continuous monitoring.

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1547 Applying Similarity Theory and Hilbert Huang Transform for Estimating the Differences of Pig-s Blood Pressure Signals between Situations of Intestinal Artery Blocking and Unblocking

Authors: Jia-Rong Yeh, Tzu-Yu Lin, Jiann-Shing Shieh, Yun Chen

Abstract:

A mammal-s body can be seen as a blood vessel with complex tunnels. When heart pumps blood periodically, blood runs through blood vessels and rebounds from walls of blood vessels. Blood pressure signals can be measured with complex but periodic patterns. When an artery is clamped during a surgical operation, the spectrum of blood pressure signals will be different from that of normal situation. In this investigation, intestinal artery clamping operations were conducted to a pig for simulating the situation of intestinal blocking during a surgical operation. Similarity theory is a convenient and easy tool to prove that patterns of blood pressure signals of intestinal artery blocking and unblocking are surely different. And, the algorithm of Hilbert Huang Transform can be applied to extract the character parameters of blood pressure pattern. In conclusion, the patterns of blood pressure signals of two different situations, intestinal artery blocking and unblocking, can be distinguished by these character parameters defined in this paper.

Keywords: Blood pressure, spectrum, intestinal artery, similarity theory and Hilbert Huang Transform.

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1546 A Simulation for Estimation of the Blood Pressure using Arterial Pressure-volume Model

Authors: Gye-rok Jeon, Jae-hee Jung, In-cheol Kim, Ah-young Jeon, Sang-hwa Yoon, Jung-man Son, Jae-hyung Kim, Soo-young Ye, Jung-hoon Ro, Dong-hyun Kim, Chul-han Kim

Abstract:

A analysis on the conventional the blood pressure estimation method using an oscillometric sphygmomanometer was performed through a computer simulation using an arterial pressure-volume (APV) model. Traditionally, the maximum amplitude algorithm (MAP) was applied on the oscillation waveforms of the APV model to obtain the mean arterial pressure and the characteristic ratio. The estimation of mean arterial pressure and characteristic ratio was significantly affected with the shape of the blood pressure waveforms and the cutoff frequency of high-pass filter (HPL) circuitry. Experimental errors are due to these effects when estimating blood pressure. To find out an algorithm independent from the influence of waveform shapes and parameters of HPL, the volume oscillation of the APV model and the phase shift of the oscillation with fast fourier transform (FFT) were testified while increasing the cuff pressure from 1 mmHg to 200 mmHg (1 mmHg per second). The phase shift between the ranges of volume oscillation was then only observed between the systolic and the diastolic blood pressures. The same results were also obtained from the simulations performed on two different the arterial blood pressure waveforms and one hyperthermia waveform.

Keywords: Arterial blood pressure, oscillometric method

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1545 Evaluation of Carbon Dioxide Pressure through Radial Velocity Difference in Arterial Blood Modeled by Drift Flux Model

Authors: Aicha Rima Cheniti, Hatem Besbes, Joseph Haggege, Christophe Sintes

Abstract:

In this paper, we are interested to determine the carbon dioxide pressure in the arterial blood through radial velocity difference. The blood was modeled as a two phase mixture (an aqueous carbon dioxide solution with carbon dioxide gas) by Drift flux model and the Young-Laplace equation. The distributions of mixture velocities determined from the considered model permitted the calculation of the radial velocity distributions with different values of mean mixture pressure and the calculation of the mean carbon dioxide pressure knowing the mean mixture pressure. The radial velocity distributions are used to deduce a calculation method of the mean mixture pressure through the radial velocity difference between two positions which is measured by ultrasound. The mean carbon dioxide pressure is then deduced from the mean mixture pressure.

Keywords: Mean carbon dioxide pressure, mean mixture pressure, mixture velocity, radial velocity difference.

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1544 Resistance Training as a Powerful Tool in the Prevention and Treatment of Cardiovascular Diseases

Authors: I. Struhár, L. Dovrtělová, M. Kumstát

Abstract:

Regular exercise promotes reduction in blood pressure, reduction in body weight and it also helps to increase in insulin sensitivity. Participation in physical activity should always be linked to medical screening which can reveal serious medical problems. One of them is high blood pressure. Hypertension is risk factor for one billion people worldwide and the highest prevalence is found in Africa. Another component of hypertension is that people who suffer from hypertension have no symptoms. It is estimated that reduction of 3mm Hg in Systolic Blood Pressure decreases cardiac morbidity at least 5%. The most of the guidelines suggest aerobic exercise in a prevention of cardiovascular diseases. On the other hand, it is important to emphasize the impact of resistance training. Even, it was found higher effect for reduction on the level of systolic blood pressure than aerobic exercise.

Keywords: Coronary artery disease, physical activity, prevention, resistance training.

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1543 Hypertensive Response to Maximal Exercise Test in Young and Middle Age Hypertensive on Blood Pressure Lowering Medication: Monotherapy vs. Combination Therapy

Authors: James Patrick A. Diaz, Raul E. Ramboyong

Abstract:

Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: Antihypertensive, exercise test, hypertension, hypertensive response.

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1542 Intervention of Sambucus Nigra Polyphenolic Extract in Experimental Arterial Hypertension

Authors: Manuela Ciocoiu, Laur Badescu, Oana Badulescu, Magda Badescu

Abstract:

The research focuses on the effects of polyphenols extracted from Sambucus nigra fruit, using an experimental arterial hypertension pattern, as well as their influence on the oxidative stress. The results reveal the normalization of the reduced glutathion concentration, as well as a considerable reduction in the malondialdehide serum concentration by the polyphenolic protection. The rat blood pressure values were recorded using a CODATM system, which uses a non-invasive blood pressure measuring method. All the measured blood pressure components revealed a biostatistically significant (p<0.05) blood pressure drop between the AHT and the AHT+P groups. The results prove that oxidative stress is considerably lower, statistically speaking, in rats with hypertension but also provided with natural polyphenolic protection from Sambucus nigra fruits than in the rats belonging to the control group. In addition to the demonstrated antioxidant effects, natural polyphenols also have other biological properties that might contribute to the cardioprotective effects.

Keywords: Arterial hypertension, Oxidative stress, Sambucus nigra

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1541 Optimization of Breast Tumor Cells Isolation Efficiency and Purity by Membrane Filtration

Authors: Bhuvanendran Nair Gourikutty Sajay, Liu Yuxin, Chang Chia-Pin, Poenar Daniel Puiu, Abdur Rub Abdur Rahman

Abstract:

Size based filtration is one of the common methods employed to isolate circulating tumor cells (CTCs) from whole blood. It is well known that this method suffers from isolation efficiency to purity tradeoff. However, this tradeoff is poorly understood. In this paper, we present the design and manufacturing of a special rectangular slit filter. The filter was designed to retain maximal amounts of nucleated cells, while minimizing the pressure on cells, thereby preserving their morphology. The key parameter, namely, input pressure, was optimized to retain the maximal number of tumor cells, whilst maximizing the depletion of normal blood cells (red and white blood cells and platelets). Our results indicate that for a slit geometry of 5 × 40 μm on a 13 mm circular membrane with a fill factor of 21%, a pressure of 6.9 mBar yields the optimum for maximizing isolation of MCF-7 and depletion of normal blood cells.

Keywords: Circulating tumor cells, Parylene slit membrane, Retention, White Blood Cell depletion.

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1540 Effect of Twelve Weeks Brisk Walking on Blood Pressure, Body Mass Index, and Anthropometric Circumference of Obese Males

Authors: Kaukab Azeem

Abstract:

Introduction: Obesity is a major health risk issue in the present day of life for one and all globally. Obesity is one of the major concerns for public health according to recent increasing trends in obesity-related diseases such as Type 2 diabetes. ( Kazuya, 1994).and hyperlipidemia, (Sakata,1990) .which are more prevalent in Japanese adults with body mass index (BMI) values Z25 kg/m2.( Japanese Ministry of Health and Welfare,1997). The purpose of the study was to assess the effect of twelve weeks of brisk walking on blood pressure and body mass index, anthropometric measurements of obese males. Method: Thirty obese (BMI= above 30) males, aged 18 to 22 years, were selected from King Fahd University of Petroleum & Minerals, Saudi Arabia. The subject-s height (cm) was measured using a stadiometer and body mass (kg) was measured with a electronic weighing machine. BMI was subsequently calculated (kg/m2). The blood pressure was measured with standardized sphygmomanometer in mm of Hg. All the measurements were taken twice before and twice after the experimental period. The pre and post anthropometric measurements of waist and hip circumference were measured with the steel tape in cm. The subjects underwent walking schedule two times in a week for 12 weeks. The 45 minute sessions of brisk walking were undertaken at an average intensity of 65% to 85% of maximum HR (HRmax; calculated as 220-age). Results & Discussion: Statistical findings revealed significant changes from pre test to post test in case of both systolic blood pressure and diastolic blood pressure in the walking group. Results also showed significant decrease in their body mass index and anthropometric measurements i.e. (waist & hip circumference). Conclusion: It was concluded that twelve weeks brisk walking is beneficial for lowering of blood pressure, body mass index, and anthropometric circumference of obese males.

Keywords: Anthropometric, Blood pressure, Body mass index

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1539 Interaction between Respiration and Low-Frequency Cardiovascular Rhythms

Authors: Vladimir I. Ponomarenko, Mikhail D. Prokhorov, Anatoly S. Karavaev

Abstract:

The interaction between respiration and low-frequency rhythms of the cardiovascular system is studied. The obtained results count in favor of the hypothesis that low-frequency rhythms in blood pressure and R-R intervals are generated in different central neural structures involved in the autonomic control of the cardiovascular systems.

Keywords: Cardiovascular system, R-R intervals, blood pressure, synchronization.

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1538 The Role of Velocity Map Quality in Estimation of Intravascular Pressure Distribution

Authors: Ali Pashaee, Parisa Shooshtari, Gholamreza Atae, Nasser Fatouraee

Abstract:

Phase-Contrast MR imaging methods are widely used for measurement of blood flow velocity components. Also there are some other tools such as CT and Ultrasound for velocity map detection in intravascular studies. These data are used in deriving flow characteristics. Some clinical applications are investigated which use pressure distribution in diagnosis of intravascular disorders such as vascular stenosis. In this paper an approach to the problem of measurement of intravascular pressure field by using velocity field obtained from flow images is proposed. The method presented in this paper uses an algorithm to calculate nonlinear equations of Navier- Stokes, assuming blood as an incompressible and Newtonian fluid. Flow images usually suffer the lack of spatial resolution. Our attempt is to consider the effect of spatial resolution on the pressure distribution estimated from this method. In order to achieve this aim, velocity map of a numerical phantom is derived at six different spatial resolutions. To determine the effects of vascular stenoses on pressure distribution, a stenotic phantom geometry is considered. A comparison between the pressure distribution obtained from the phantom and the pressure resulted from the algorithm is presented. In this regard we also compared the effects of collocated and staggered computational grids on the pressure distribution resulted from this algorithm.

Keywords: Flow imaging, pressure distribution estimation, phantom, resolution.

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1537 Computational Study on Cardiac-Coronary Interaction in Terms of Coronary Flow-Pressure Waveforms in Presence of Drugs: Comparison Between Simulated and In Vivo Data

Authors: C. De Lazzari, E. Del Prete, I. Genuini, F. Fedele

Abstract:

Cardiovascular human simulator can be a useful tool in understanding complex physiopathological process in cardiocirculatory system. It can also be a useful tool in order to investigate the effects of different drugs on hemodynamic parameters. The aim of this work is to test the potentiality of our cardiovascular numerical simulator CARDIOSIM© in reproducing flow/pressure coronary waveforms in presence of two different drugs: Amlodipine (AMLO) and Adenosine (ADO). In particular a time-varying intramyocardial compression, assumed to be proportional to the left ventricular pressure, was related to the venous coronary compliances in order to study its effects on the coronary blood flow and the flow/pressure loop. Considering that coronary circulation dynamics is strongly interrelated with the mechanics of the left ventricular contraction, relaxation, and filling, the numerical model allowed to analyze the effects induced by the left ventricular pressure on the coronary flow.

Keywords: Cardiovascular system, Coronary blood flow, Hemodynamic, Numerical simulation.

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1536 Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City

Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

Abstract:

Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic Blood Pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2., and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: Hypertension, age, exercise, obesity, gender.

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1535 Gas Pressure Evaluation through Radial Velocity Measurement of Fluid Flow Modeled by Drift Flux Model

Authors: Aicha Rima Cheniti, Hatem Besbes, Joseph Haggege, Christophe Sintes

Abstract:

In this paper, we consider a drift flux mixture model of the blood flow. The mixture consists of gas phase which is carbon dioxide and liquid phase which is an aqueous carbon dioxide solution. This model was used to determine the distributions of the mixture velocity, the mixture pressure, and the carbon dioxide pressure. These theoretical data are used to determine a measurement method of mean gas pressure through the determination of radial velocity distribution. This method can be applicable in experimental domain.

Keywords: Mean carbon dioxide pressure, mean mixture pressure, mixture velocity, radial velocity.

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1534 Synchronization between the Slow Oscillations in the Human Cardiovascular System

Authors: M. D. Prokhorov, V. I. Ponomarenko, A. S. Karavaev, A. R. Kiselev, V. I. Gridnev

Abstract:

Synchronization between the slow oscillations of heart rate and blood pressure having in humans a basic frequency close to 0.1 Hz is investigated. A method is proposed for quantitative estimation of synchronization between these oscillating processes based on calculation of relative time of phase synchronization of oscillations. It is shown that healthy subjects exhibit in average substantially longer epochs of synchronization between the slow oscillations in heart rate and blood pressure than patients after acute myocardial infarction

Keywords: Cardiovascular system, slow oscillating processes, synchronization.

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1533 Identification of Regulatory Mechanism of Orthostatic Response

Authors: E. Hlavacova, J. Chrenova, Z. Rausova, M. Vlcek, A. Penesova, L. Dedik

Abstract:

En bloc assumes modeling all phases of the orthostatic test with the only one mathematical model, which allows the complex parametric view of orthostatic response. The work presents the implementation of a mathematical model for processing of the measurements of systolic, diastolic blood pressure and heart rate performed on volunteers during orthostatic test. The original assumption of model hypothesis that every postural change means only one Stressor, did not complying with the measurements of physiological circulation factor-time profiles. Results of the identification support the hypothesis that second postural change of orthostatic test causes induced Stressors, with the observation of a physiological regulation mechanism. Maximal demonstrations are on the heart rate and diastolic blood pressure-time profile, minimal are for the measurements of the systolic blood pressure. Presented study gives a new view on orthostatic test with impact on clinical practice.

Keywords: En bloc modeling, physiological circulatory factor, postural change, stressor

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1532 Modeling of Pulsatile Blood Flow in a Weak Magnetic Field

Authors: Chee Teck Phua, Gaëlle Lissorgues

Abstract:

Blood pulse is an important human physiological signal commonly used for the understanding of the individual physical health. Current methods of non-invasive blood pulse sensing require direct contact or access to the human skin. As such, the performances of these devices tend to vary with time and are subjective to human body fluids (e.g. blood, perspiration and skin-oil) and environmental contaminants (e.g. mud, water, etc). This paper proposes a simulation model for the novel method of non-invasive acquisition of blood pulse using the disturbance created by blood flowing through a localized magnetic field. The simulation model geometry represents a blood vessel, a permanent magnet, a magnetic sensor, surrounding tissues and air in 2-dimensional. In this model, the velocity and pressure fields in the blood stream are described based on Navier-Stroke equations and the walls of the blood vessel are assumed to have no-slip condition. The blood assumes a parabolic profile considering a laminar flow for blood in major artery near the skin. And the inlet velocity follows a sinusoidal equation. This will allow the computational software to compute the interactions between the magnetic vector potential generated by the permanent magnet and the magnetic nanoparticles in the blood. These interactions are simulated based on Maxwell equations at the location where the magnetic sensor is placed. The simulated magnetic field at the sensor location is found to assume similar sinusoidal waveform characteristics as the inlet velocity of the blood. The amplitude of the simulated waveforms at the sensor location are compared with physical measurements on human subjects and found to be highly correlated.

Keywords: Blood pulse, magnetic sensing, non-invasive measurement, magnetic disturbance.

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1531 CFD Simulation of Non-Newtonian Fluid Flow in Arterial Stenoses with Surface Irregularities

Authors: R. Manimaran

Abstract:

CFD simulations are carried out in arterial stenoses with 48 % areal occlusion. Non-newtonian fluid model is selected for the blood flow as the same problem has been solved before with Newtonian fluid model. Studies on flow resistance with the presence of surface irregularities are carried out. Investigations are also performed on the pressure drop at various Reynolds numbers. The present study revealed that the pressure drop across a stenosed artery is practically unaffected by surface irregularities at low Reynolds numbers, while flow features are observed and discussed at higher Reynolds numbers.

Keywords: Blood flow, Roughness, Computational fluid dynamics, Bio fluid mechanics.

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1530 Synchronization of 0.1 Hz Oscillations in Heart Rate and Blood Pressure: Application to Treatment of Myocardial Infarction Patients

Authors: M. D. Prokhorov, A. R. Kiselev, A. S. Karavaev, O. M. Posnenkova, V. I. Gridnev, V. I. Ponomarenko

Abstract:

Synchronization between 0.1 Hz oscillations in heart rate and blood pressure is studied and its change during vertical tilt is evaluated in 37 myocardial infarction patients. Two groups of patients are identified with decreased and increased, respectively, synchronization of the studied oscillations as a response to a tilt test. It is shown that assessment of synchronization of 0.1 Hz oscillations as a response to vertical tilt can be used as a guideline for selecting optimal dose of beta-blocker treatment in post-myocardial infarction patients.

Keywords: Cardiovascular system, heart rate variability, synchronization.

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1529 A Study of Cardio Pulmonary Changes during Upper Gastrointestinal Endoscopy

Authors: Sharan Badiger, Prema T. Akkasaligar, P. Amith Kumar

Abstract:

Upper gastrointestinal endoscopy is a commonly performed diagnostic and therapeutic procedure and has many adverse effects like cardiopulmonary complications, complications related to sedation, infectious complications, bleeding and perforation. So this study was undertaken to evaluate important variables like patient’s age, gender and stage of the procedure in relation to the cardiopulmonary changes during diagnostic upper gastrointestinal endoscopy by monitoring oxygen saturation, blood pressure, heart rate and electrocardiogram. This is a prospective longitudinal hospital based study involving a total of 140 consecutive patients, at Sri. B. M. Patil Medical College, Hospital and Research Centre. Cardiopulmonary changes during upper gastrointestinal endoscopy are more common in the age groups of 51-60 years, with equal frequency in both male and female. Oxygen saturation levels decreased by about 4% in both sexes during introduction of endoscopy. Mild to moderate hypoxia was found in 32% of the study group. Severe hypoxia was found in 5% of the patients, mostly in those patients who are above 50 years of age. Tachycardia was noted in 88% of the study group patients. Blood pressure increased to hypertension levels in 22 patients (15.7%) which returned to normal within few minutes after the procedure. S-T depression was noticed in 4% of patients and T wave inversion in 8% of patients during upper gastrointestinal endoscopy. All these changes disappeared after 10 minutes after the endoscopy. Cardiopulmonary changes are common during upper gastrointestinal endoscopy. Maximum changes in oxygen saturation, heart rate and blood pressure occurred immediately after the introduction of endoscope. The cardiopulmonary changes did not manifest into any identifiable clinical symptoms. The rate of recovery was faster in younger age groups and women.

Keywords: Blood Pressure, Cardio-Pulmonary, Heart Rate, Oxygen Saturation, Upper Gastrointestinal Endoscopy.

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1528 Determination of a Fair Price for Blood Transportation by Applying the Vehicle Routing Problem: A Case for National Blood Center, Thailand

Authors: S. Pathomsiri, P. Sukaboon

Abstract:

The National Blood Center, Thai Red Cross Society is responsible for providing blood to hospitals all over the country. When any hospital needs blood, it will have to send the vehicle to pick up at the NBC. There are a lot of vehicles to pick up blood at the NBC every day. Each vehicle is usually empty for inbound trip and a little loaded for outbound. The NBC realized such waste or loss and there have been the third party offered to distribute blood and charge for fee. This paper proposes to apply the vehicle routing problem (VRP) for estimating the fair price. The idea is tested with the real data during seven-day period of 6 – 12 July 2010 to estimate the fair price for transporting blood in Bangkok Metropolitan Region.

Keywords: Blood Supply Chain, Vehicle Routing Problem, Heuristic, Saving Algorithm, Fair Price.

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1527 Modeling of Normal and Atherosclerotic Blood Vessels using Finite Element Methods and Artificial Neural Networks

Authors: K. Kamalanand, S. Srinivasan

Abstract:

Analysis of blood vessel mechanics in normal and diseased conditions is essential for disease research, medical device design and treatment planning. In this work, 3D finite element models of normal vessel and atherosclerotic vessel with 50% plaque deposition were developed. The developed models were meshed using finite number of tetrahedral elements. The developed models were simulated using actual blood pressure signals. Based on the transient analysis performed on the developed models, the parameters such as total displacement, strain energy density and entropy per unit volume were obtained. Further, the obtained parameters were used to develop artificial neural network models for analyzing normal and atherosclerotic blood vessels. In this paper, the objectives of the study, methodology and significant observations are presented.

Keywords: Blood vessel, atherosclerosis, finite element model, artificial neural networks

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1526 Pressure Relief in Prosthetic Sockets through Hole Implementation Using Different Materials

Authors: Gabi N. Nehme

Abstract:

Below-knee amputees commonly experience asymmetrical gait patterns. It is generally believed that ischemia is related to the formation of pressure sores due to uneven distribution of forces. Micro-vascular responses can reveal local malnutrition. Changes in local skin blood supply under various external loading conditions have been studied for a number of years. Radionuclide clearance, photo-plethysmography, trans-cutaneous oxygen tension along with other studies showed that the blood supply would be influenced by the epidermal forces, and the rate and the amount of blood supply would decrease with increased epidermal loads being shear forces or normal forces. Several cases of socket designs were investigated using Finite Element Model (FEM) and Design of Experiment (DOE) to increase flexibility and minimize the pressure at the limb/socket interface using ultra high molecular weight polyethylene (UHMWPE) and polyamide 6 (PA6) or Duraform. The pressure reliefs at designated areas where reducing thickness is involved are seen to be critical in determination of amputees’ comfort and are very important to clinical applications. Implementing a hole between the Patellar Tendon (PT) and Distal Tibia (DT) would decrease stiffness and increase prosthesis range of motion where flexibility is needed. In addition, displacement and prosthetic energy storage increased without compromising mechanical efficiency and prosthetic design integrity.

Keywords: Patellar tendon, distal tibia, prosthetic socket, relief areas, hole implementation.

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1525 Computational Study of Blood Flow Analysis for Coronary Artery Disease

Authors: Radhe Tado, Ashish B. Deoghare, K. M. Pandey

Abstract:

The aim of this study is to estimate the effect of blood flow through the coronary artery in human heart so as to assess the coronary artery disease.Velocity, wall shear stress (WSS), strain rate and wall pressure distribution are some of the important hemodynamic parameters that are non-invasively assessed with computational fluid dynamics (CFD). These parameters are used to identify the mechanical factors responsible for the plaque progression and/or rupture in left coronary arteries (LCA) in coronary arteries.The initial step for CFD simulations was the construction of a geometrical model of the LCA. Patient specific artery model is constructed using computed tomography (CT) scan data with the help of MIMICS Research 19.0. For CFD analysis ANSYS FLUENT-14.5 is used.Hemodynamic parameters were quantified and flow patterns were visualized both in the absence and presence of coronary plaques. The wall pressure continuously decreased towards distal segments and showed pressure drops in stenotic segments. Areas of high WSS and high flow velocities were found adjacent to plaques deposition.

Keywords: Computational fluid dynamics, hemodynamics, velocity, strain rate, wall pressure, wall shear stress.

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1524 Warning about the Risk of Blood Flow Stagnation after Transcatheter Aortic Valve Implantation

Authors: Aymen Laadhari, Gábor Székely

Abstract:

In this work, the hemodynamics in the sinuses of Valsalva after Transcatheter Aortic Valve Implantation is numerically examined. We focus on the physical results in the two-dimensional case. We use a finite element methodology based on a Lagrange multiplier technique that enables to couple the dynamics of blood flow and the leaflets’ movement. A massively parallel implementation of a monolithic and fully implicit solver allows more accuracy and significant computational savings. The elastic properties of the aortic valve are disregarded, and the numerical computations are performed under physiologically correct pressure loads. Computational results depict that blood flow may be subject to stagnation in the lower domain of the sinuses of Valsalva after Transcatheter Aortic Valve Implantation.

Keywords: Hemodynamics, Transcatheter Aortic Valve Implantation, blood flow stagnation, numerical simulations.

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1523 Mathematical Modelling of Different Types of Body Support Surface for Pressure Ulcer Prevention

Authors: Mahbub C. Mishu, Venketesh N. Dubey, Tamas Hickish, Jonathan Cole

Abstract:

Pressure ulcer is a common problem for today’s healthcare industry. It occurs due to external load applied to the skin. Also when the subject is immobile for a longer period of time and there is continuous load applied to a particular area of human body, blood flow gets reduced and as a result pressure ulcer develops. Body support surface has a significant role in preventing ulceration so it is important to know the characteristics of support surface under loading conditions. In this paper we have presented mathematical models of different types of viscoelastic materials and also we have shown the validation of our simulation results with experiments.

Keywords: Pressure ulcer, viscoelastic material, mathematical model, experimental validation.

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1522 Three Dimensional Large Eddy Simulation of Blood Flow and Deformation in an Elastic Constricted Artery

Authors: Xi Gu, Guan Heng Yeoh, Victoria Timchenko

Abstract:

In the current work, a three-dimensional geometry of a 75% stenosed blood vessel is analyzed. Large eddy simulation (LES) with the help of a dynamic subgrid scale Smagorinsky model is applied to model the turbulent pulsatile flow. The geometry, the transmural pressure and the properties of the blood and the elastic boundary were based on clinical measurement data. For the flexible wall model, a thin solid region is constructed around the 75% stenosed blood vessel. The deformation of this solid region was modelled as a deforming boundary to reduce the computational cost of the solid model. Fluid-structure interaction is realized via a twoway coupling between the blood flow modelled via LES and the deforming vessel. The information of the flow pressure and the wall motion was exchanged continually during the cycle by an arbitrary Lagrangian-Eulerian method. The boundary condition of current time step depended on previous solutions. The fluctuation of the velocity in the post-stenotic region was analyzed in the study. The axial velocity at normalized position Z=0.5 shows a negative value near the vessel wall. The displacement of the elastic boundary was concerned in this study. In particular, the wall displacement at the systole and the diastole were compared. The negative displacement at the stenosis indicates a collapse at the maximum velocity and the deceleration phase.

Keywords: Large Eddy Simulation, Fluid Structural Interaction, Constricted Artery, Computational Fluid Dynamics.

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1521 Hypertension and Its Association with Oral Health Status in Adults: A Pilot Study in Padusunan Adults Community

Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

Abstract:

The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: Blood pressure, hypertension, DMFT, oral health status.

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