Variations In Blood Flow Research Articles

Assessment of Tumor Blood Flow Distribution by Dynamic Contrast-Enhanced CT

A distinct feature of the tumor vasculature is its tortuosity and irregular branching of vessels, which can translate to a wider dispersion and higher variability of blood flow in the tumor. To enable tumor blood flow variability to be assessed in vivo by imaging, a tracer kinetic model that accounts for flow dispersion is developed for use with dynamic contrast-enhanced (DCE) CT. The proposed model adopts a multiple-pathway approach and allows for the quantification of relative dispersion in the blood flow distribution, which reflects flow variability in the tumor vasculature. Monte Carlo simulation experiments were performed to study the possibility of reducing the number of model parameters based on the Akaike information criterion approach and to explore possible noise and tissue conditions in which the model might be applicable. The model was used for region-of-interest analysis and to generate perfusion parameter maps for three patient DCE CT cases with cerebral tumors, to illustrate clinical applicability.

Transjugular intrahepatic portosystemic shunt induced short- and long-term cerebral blood flow variations in cirrhotic patients: an arterial spin labeling MRI study

Short- and long-term effects of transjugular intrahepatic portosystemic shunt (TIPS) on cerebral blood flow (CBF) in patients with cirrhosis are still unclear. The purpose of this longitudinal study was to explore CBF alteration patterns in cirrhotic patients after TIPS. Thirteen cirrhotic patients (7 male, 6 female, mean age 50.0 ± 9.3 years) underwent arterial-spin labeling (ASL) MRI 1-9 days (median 1 days) before TIPS. Follow-up MR examinations were performed about 1 week (median 6 days), 3 months (n = 6), 6-9 months (n = 5) and 12-18 months (n = 5) after TIPS. CBF, ammonia level, Child-Pugh score, number connection test type A (NCT-A) and digit symbol test (DST) scores were converted into relative values by dividing by his/her pre-TIPS values, and then, compared via one-way analysis of variance (ANOVA). Correlations between the pre- and post-TIPS changes of relative CBF (rCBF) and the changes of relative ammonia (rAmmonia), Child-Pugh (rChild-Pugh), and NCT-A/DST (rNCT-A/rDST) scores were calculated by crossing subjects. Compared with the pre-TIPS level, the global rCBF slightly increased by 10.9 % about 1 week later, then rapidly decreased by 14.2 % 3 months later, and flatly decreased by 17.2 % in 6-9 months and 18.0 % in 12-18 months following TIPS. The changes of 3-month rDST score were slightly correlated with 3-month rCBF rather than 1-week rCBF, (P < 0.1, FDR-corrected) No difference was found between the pre- and post-TIPS rAmmonia levels, rChild-Pugh and rNCT-A/rDST scores (Post-hoc P > 0.05). CBF measured at different time points after TIPS insertion showed different patterns, indicating varying longitudinal effects of TIPS on CBF. A sharp decline of rCBF was found in the 1 week to 3 months period after insertion, indicating that high event rate of hepatic encephalopathy might relate with the unadaptable CBF in patients undergoing TIPS insertion.

Multi Frequency Phase Fluorimetry (MFPF) for Oxygen Partial Pressure Measurement: Ex Vivo Validation by Polarographic Clark-Type Electrode

BackgroundMeasurement of partial pressure of oxygen (PO2) at high temporal resolution remains a technological challenge. This study introduces a novel PO2 sensing technology based on Multi-Frequency Phase Fluorimetry (MFPF). The aim was to validate MFPF against polarographic Clark-type electrode (CTE) PO2 measurements.Methodology/Principal FindingsMFPF technology was first investigated in N = 8 anaesthetised pigs at FIO2 of 0.21, 0.4, 0.6, 0.8 and 1.0. At each FIO2 level, blood samples were withdrawn and PO2 was measured in vitro with MFPF using two FOXY-AL300 probes immediately followed by CTE measurement. Secondly, MFPF-PO2 readings were compared to CTE in an artificial circulatory setup (human packed red blood cells, haematocrit of 30%). The impacts of temperature (20, 30, 40°C) and blood flow (0.8, 1.6, 2.4, 3.2, 4.0 L min−1) on MFPF-PO2 measurements were assessed. MFPF response time in the gas- and blood-phase was determined. Porcine MFPF-PO2 ranged from 63 to 749 mmHg; the corresponding CTE samples from 43 to 712 mmHg. Linear regression: CTE = 15.59+1.18*MFPF (R2 = 0.93; P<0.0001). Bland Altman analysis: meandiff 69.2 mmHg, rangediff -50.1/215.6 mmHg, 1.96-SD limits -56.3/194.8 mmHg. In artificial circulatory setup, MFPF-PO2 ranged from 20 to 567 mmHg and CTE samples from 11 to 575 mmHg. Linear regression: CTE = −8.73+1.05*MFPF (R2 = 0.99; P<0.0001). Bland-Altman analysis: meandiff 6.6 mmHg, rangediff -9.7/20.5 mmHg, 1.96-SD limits -12.7/25.8 mmHg. Differences between MFPF and CTE-PO2 due to variations of temperature were less than 6 mmHg (range 0–140 mmHg) and less than 35 mmHg (range 140–750 mmHg); differences due to variations in blood flow were less than 15 mmHg (all P-values>0.05). MFPF response-time (monoexponential) was 1.48±0.26 s for the gas-phase and 1.51±0.20 s for the blood-phase.Conclusions/SignificanceMFPF-derived PO2 readings were reproducible and showed excellent correlation and good agreement with Clark-type electrode-based PO2 measurements. There was no relevant impact of temperature and blood flow upon MFPF-PO2 measurements. The response time of the MFPF FOXY-AL300 probe was adequate for real-time sensing in the blood phase.

Vasoconstriction in horses caused by endophyte-infected tall fescue seed is detected with Doppler ultrasonography1

The hypotheses that endophyte (Neotyphodium coenophialum)-infected tall fescue (TF) seed causes vasoconstriction in horses in vivo and that ground seed would cause more pronounced vasoconstriction than whole seed were tested. Ten horses each received 1 of 3 treatments: endophyte-free ground (E-G; n = 4 horses) seed, endophyte-positive whole (E+W; n = 3) seed, or endophyte-positive ground (E+G; n = 3) seed. There were two 14-d periods, P1 and P2. During P1, animals were adapted to a concentrate (0.2% BW, as fed, twice daily) and alfalfa cubes. During P2, the seed was mixed into the concentrate portion of the diet and alfalfa cubes were offered ad libitum. Fescue seed was fed in increasing amounts ranging from 0.02% BW on d 1 (averaging 76 ug/kg ergovaline + ergovalinine) to 0.22% BW on d 11 to 14 (averaging 713 ug/kg ergovaline + ergovalinine). The distal palmar artery of the left foreleg of each horse was scanned via Doppler ultrasonography for 4 d during each period, with 5 replicate scans performed on each scanning day. The measurements taken at each scan included artery luminal diameter, area, and circumference, peak systolic velocity, end diastolic velocity and blood flow variables. Animal temperature, heart rate, and respiration rate and ambient temperature and humidity were also recorded. Blood samples were taken on each scanning day to measure inflammatory cytokine mRNA abundances, and blood samples were collected on d 0, 4, 8, and 14 of P2 to measure prolactin concentrations. Consumption of E+G TF seed caused decreased artery lumen diameter (P = 0.0033), area (P = 0.0406), and circumference (P = 0.0480) compared with E-G seed, and E+W seed produced an intermediate response. Blood flow volume was reduced (P < 0.05) during P2 in horses receiving E+G seed compared with horses receiving E-G seed. Other ultrasound variables were not different (P > 0.05) among treatment groups, and neither were cytokine mRNA or prolactin concentrations. Treatment did not alter (P > 0.05) animal temperature, heart rate, or respiration rate, and neither ambient temperature nor relative humidity was consistently correlated with any response variable measured. Taken together, these data confirm that consumption of E+G fescue seed caused vasoconstriction in horses, which could be readily measured by Doppler ultrasonography. Use of Doppler ultrasound to monitor the diameter of the palmar artery of horses grazing endophyte-infected (E+) fescue pastures may provide a convenient and satisfactory biomarker to determine premonitory signs of fescue toxicosis.

General Anesthesia with Sevoflurane Decreases Myocardial Blood Volume and Hyperemic Blood Flow in Healthy Humans

Preservation of myocardial perfusion during general anesthesia is likely important in patients at risk for perioperative cardiac complications. Data related to the influence of general anesthesia on the normal myocardial circulation are limited. In this study, we investigated myocardial microcirculatory responses to pharmacological vasodilation and sympathetic stimulation during general anesthesia with sevoflurane in healthy humans immediately before surgical stimulation. Six female and 7 male subjects (mean age 43 years, range 28-61) were studied at baseline while awake and during the administration of 1 minimum alveolar concentration sevoflurane. Using myocardial contrast echocardiography, myocardial blood flow (MBF) and microcirculatory variables were assessed at rest, during adenosine-induced hyperemia, and after cold pressor test-induced sympathetic stimulation. MBF was calculated from the relative myocardial blood volume multiplied by its exchange frequency (β) divided by myocardial tissue density (ρT), which was set at 1.05 g·mL(-1). During sevoflurane anesthesia, MBF at rest was similar to baseline values (1.05 ± 0.28 vs 1.05 ± 0.32 mL·min(-1)·g(-1); P = 0.98; 95% confidence interval [CI], -0.18 to 0.18). Myocardial blood volume decreased (P = 0.0044; 95% CI, 0.01-0.04) while its exchange frequency (β) increased under sevoflurane anesthesia when compared with baseline. In contrast, hyperemic MBF was reduced during anesthesia compared with baseline (2.25 ± 0.5 vs 3.53 ± 0.7 mL·min(-1)·g(-1); P = 0.0003; 95% CI, 0.72-1.84). Sympathetic stimulation during sevoflurane anesthesia resulted in a similar MBF compared to baseline (1.53 ± 0.53 and 1.55 ± 0.49 mL·min(-1)·g(-1); P = 0.74; 95% CI, -0.47 to 0.35). In otherwise healthy subjects who are not subjected to surgical stimulation, MBF at rest and after sympathetic stimulation is preserved during sevoflurane anesthesia despite a decrease in myocardial blood volume. However, sevoflurane anesthesia reduces hyperemic MBF, and thus MBF reserve, in these subjects.

Interindividual relationships between blood pressure and cerebral blood flow variability with intact and blunted cerebrovascular control

The relationships between blood pressure variability (BPV) and cerebral blood flow variability (CFV) across individuals in the presence of intact and blunted cerebrovascular control are poorly understood. This study sought to characterize the interindividual associations between spontaneous BPV and CFV under conditions of normal and blunted [calcium channel blockade (CCB)] cerebrovascular control in healthy humans. We analyzed blood pressure and flow velocity data from 12 subjects treated with CCB (60 mg oral nimodipine) and 11 subjects treated with a placebo pill. Spontaneously occurring fluctuations in mean arterial blood pressure (MAP) and middle cerebral artery flow velocity (MCAv(mean); transcranial Doppler) were characterized using power spectral and transfer function analysis in the very-low- (0.02-0.07 Hz), low- (0.07-0.20 Hz), and high-frequency (0.20-0.40 Hz) ranges. Across our study sample, MAP and MCAv(mean) power were positively correlated in all three frequency ranges, both before (R(2) = 0.34-0.67, all P < 0.01) and after CCB (R(2) = 0.53-0.61, all P < 0.02). Compared with placebo, CCB reduced very-low-frequency MAP (P < 0.05) and MCAv(mean) power (P < 0.01) and the low-frequency cross-spectral phase angle (P < 0.05). The magnitude of change in MAP and MCAv(mean) power with CCB (i.e., change scores) was positively related in the very-low-frequency range. Collectively, these findings indicate that CFV may be an explanatory factor in the association between elevated BPV and adverse cerebrovascular outcomes and support the possibility of using CCB to improve hemodynamic stability under resting conditions.

Integration of exercise response and allometric scaling in endotherms

The relationship between heart beat frequency and the rate of oxygen consumption for different species of birds and mammals is influenced by body size, the type of exercise being undertaken and its intensity. Here a model is presented combining allometric scaling and exercise-induced variations in oxygen consumption and blood flow, when birds and mammals undergo their primary mode of locomotion. Novel relationships, common to the regulatory systems of all endotherms, are found to relate the rate of oxygen consumption, heart-rate, body and heart mass in 24 species of endotherms spanning 5 orders of body mass. We show that these relationships can be derived from linearity between heart-rate and the arteriovenous oxygen difference, present in data from exercise-attuned humans. We find that the metabolic rate of endotherms undergoing their primary mode of locomotion across a range of exercise intensities is quadratically related to heart-rate and that body mass is inferior to heart mass as a predictive scaling variable. The model facilitates graphical comparisons between species, and enables metabolic costs to be extrapolated from heart-rate data whenever direct measurements of oxygen consumption prove prohibitively challenging.

Effect of Variation of Portal Venous Blood Flow on Radiofrequency and Microwave Ablations in a Blood-perfused Bovine Liver Model

To assess whether there is a significant difference in the effect of incremental changes of portal venous blood flow rates on the size of radiofrequency (RF) versus microwave (MW) ablation lesions in an ex vivo blood-perfused bovine liver model. This study was exempt from approval by the Institutional Animal Care and Use Committee. Sixty ablations (30 MW and 30 RF ablations) were performed ex vivo in 15 bovine livers perfused with autologous blood via the portal vein at 60, 70, 80, 90, and 100 mL/min per 100 g of liver tissue (three livers were used for each flow rate). Long-axis diameter (LAD), short-axis diameter (SAD), and volume were measured for each ablation lesion. A general linear mixed model was used to examine the effect of location, ablation device, and flow rate on LAD, SAD, and volume. Results were considered to indicate a significant difference at P less than .05. Location was not a significant predictor of LAD, SAD, or volume (P ≥ .4). The slope of the relationship between flow rate and LAD, SAD, and volume was significantly different according to ablation device (P < .0001). For RF ablation lesions, the mean LAD, SAD, and volume demonstrated a significant inverse relationship with flow rate, while the measurements for MW ablation did not change with variation in flow rates. The size of RF ablation lesions is highly variable, with a significant inverse relationship to the rate of portal venous blood flow. Conversely, the size of MW ablation lesions is unaffected by changes in portal venous blood flow. The consistency of the size of MW ablation lesions could translate into a higher local tumor eradication rate than that reported with RF ablation.

Transrectal Doppler sonography of uterine blood flow during the first two weeks after parturition in Simmenthal heifers

Transrectal Doppler sonography was used to evaluate uterine blood flow during the first two weeks after parturition in six primiparous Simmental cows. The uterine blood flow was evaluated on the day of parturition (Day 0), once daily from Days 1 to 8 and then every other day until Day 14. Blood flow was quantified by determining the diameter (D), the time-averaged maximum velocity (TAMV), the pulsatility index (PI) and the blood flow volume (BFV) of the uterine arteries ipsilateral and contralateral to the formerly pregnant uterine horn. During the first four days after calving D, TAMV and BFV declined (ipsilateral: TAMV 70%, BFV 87%, contralateral: D 47%, BFV 84%; p < 0.05), while PI increased (ipsilateral 158%, contralateral 100%; p < 0.05) distinctly. Between Days 4 and 14 only the ipsilateral D (12%) and the BFV of both arteries (ipsilateral 5%, contralateral 8%) decreased (p < 0.05). Blood flow variables were very strongly correlated with each other (r > ±0.75, p < 0.05), with negative correlations with PI and positive correlations with all other investigated factors. Overall, this study revealed characteristic changes in uterine perfusion during the first two weeks after parturition in cows that were pronounced during the first four days postpartum.

The effect of irrigation of intracisternal papaverine on cerebral blood flow in subarachnoid hemorrhage

Background:Despite different treatments, cerebral vasospasm is still the most important cause of death in patients after subarachnoid hemorrhage. This study was conducted to explore the effect of intracisternal washing with papaverine on cerebral blood flow.Materials and Methods:This study was performed on 40 patients and totally 120 arteries in 2010. Then, variations in cerebral blood flow before and after washing with papaverine were measured and analyzed.Results:Twenty (20) patients with aneurysm of the anterior communicating artery (ACOM) and 20 patients with aneurysm of the middle cerebral artery (MCA) were assessed. Mean blood flow before aneurysm and before washing in ACOM and MCA was 70.68 ± 14.8 cm/s and 65.66 ± 9.3 cm/s, respectively, which reached 23.25 ± 5.17 cm/s and 34.1 ± 4.7 cm/s, respectively after washing (P value = 0.016 and 0.024). Mean blood flow after aneurysm and before washing in ACOM and MCA was 95.12 ± 13.9 cm/s and 67.44 ± 15.16 cm/s, respectively, which reached 35.69 ± 6.2 cm/s and 38.01 ± 8.28 cm/s, respectively after washing (P value = 0.001 and 0.01).Conclusion:Washing with papaverine significantly reduces cerebral blood flow and relieves vasospasm.

Regional variation in myocardial blood flow in patients with left bundle branch block evaluated with quantitative perfusion CMR

Background This study is the first to use quantitative perfusion CMR to evaluate regional differences in myocardial blood flow (MBF) in patients with left bundle branch block (LBBB). LBBB is often associated with underlying CAD but its presence can limit the diagnostic accuracy of non-invasive imaging tests. In particular, there is a high incidence of false-positive results with exercise SPECT due to apparent septal perfusion defects. The use of vasodilator stress has reduced but not eliminated this problem. Several hypotheses have been postulated to explain the cause of such perfusion defects, and these include early activation of the septum, leading to shortened diastole and reduced blood flow; partial volume effects caused by impaired septal thickening; and increased septal intra-myocardial pressure during diastole, resulting in reduced flow reserve. A number of small studies using PET or early quantitative SPECT techniques have evaluated regional differences in MBF in patients with LBBB, but the results have been conflicting and have shown either no regional differences or a relative but not absolute reduction in septal perfusion. This study re-evaluates the unresolved question of septal perfusion in LBBB using quantitative perfusion CMR.

3D respiratory resolved phase contrast imaging of the aorta

Background Respiratory motion compensation is essential for reproducible and robust cardiovascular MRI. Traditionally, breathholds or prospective gating by bellows or navigator signals limit data acquisition to the quiescent phase of respiration [1]. These approaches do not capture any variations of blood flow over the respiratory cycle, yet respiration has been shown to significantly affect flow in the great vessels [2]. The purpose of this pilot study was to adapt a 3D radially undersampled PC MR sequence (PC VIPR [3,4]) for use with our retrospective dual-gated (cardiac and respiratory) reconstruction to evaluate respiratory effects on net flow and cardiac flow waveforms.

Oscillator Suppression in the Blood Flow Regulation of Interacting, Non- Identical Nephrons

Background: Regulation of the blood flow to the individual functional unit (nephron) of the kidney involves a feedback mechanism that produces large-amplitude oscillations in the blood flow itself as well as in the intra-nephron pressures and flows. Neighboring nephrons adjust their blood flow variations relative to one another via signals that propagate along the interconnecting blood vessels. Purpose and method: Using a detailed physiological-based model of a pair of vascular coupled, non-identical nephrons, the paper examines the effect that their relative oscillatory strength has on the behavior of the coupled system. This is of direct interest in connection with ongoing work attempting to study the synchronization behavior for larger groups of superficial nephrons by means of laser speckle contrast imaging. Results: Our analysis demonstrates that a region of so-called “broadband Synchronization” may develop between those coupling strengths at which the stronger oscillating nephron starts to suppress the autonomous oscillations of the weaker nephron and those coupling strengths at which the two nephrons mutually inhibit each other’s oscillations. We suggest that the transition be-tween synchronized and suppressed dynamics may have a physiological significance comparable to the transition from ergodic to synchronized periodic dynamics.

Assessment of voluntary rhythmic muscle contraction-induced exercising blood flow variability measured by Doppler ultrasound

Given recent technological developments, ultrasound Doppler can provide valuable measurements of blood velocity/flow in the conduit artery with high temporal resolution. In human-applied science such as exercise physiology, hemodynamic measurements in the conduit artery is commonly performed by blood flow feeding the exercising muscle, as the increase in oxygen uptake (calculated as a product of arterial blood flow to the exercising limb and the arterio-venous oxygen difference) is directly proportional to the work performed. The increased oxygen demand with physical activity is met through a central mechanism, an increase in cardiac output and blood pressure, as well as a peripheral mechanism, an increase in vascular conductance and oxygen extraction (a major part of the whole exercising muscles) from the blood. The increase in exercising muscle blood flow in relation to the target workload (quantitative response) may be one indicator in circulatory adjustment for the ac- tivity of muscle metabolism. Therefore, the determination of local blood flow dynamics (potential oxygen supply) feeding repeated (rhythmic) muscle contractions can contribute to the understanding of the factors limiting work capacity including, for instance, muscle metabolism, substance utilization and magnitude of vasodilatation in the exercising muscle. Using non-invasive measures of pulsed Doppler ultrasound, the validity of blood velocity/flow in the forearm or lower limb conduit artery feeding to the muscle has been previously demonstrated during rhythmic muscle exercise. For the evaluation of exercising blood flow, not only muscle contraction induced internal physiological variability, or fluctuations in the magnitude of blood velocity due to spontaneous muscle contraction and relaxation induced changes in force curve intensity, superimposed in cardiac beat-by-beat, but also the alterations in the blood velocity (external variability) due to a temporary sudden change in the achieved workload, compared to the target workload, should be considered. Furthermore, a small amount of inconsistency in the voluntary muscle contraction force at each kick seems to be unavoidable, and may influence exercising muscle blood flow, although subjects attempt to perform precisely similar repeated voluntary muscle contractions at target workload (muscle contraction force). This review presents the methodological considerations for the variability of exercising blood velocity/flow in the limb conduit artery during dynamic leg exercise assessed by pulsed Doppler ultrasound in relation to data previously reported in original research.

Increasing temperature speeds intracellular Po2kinetics during contractions in singleXenopusskeletal muscle fibers

Precise determination of the effect of muscle temperature (T(m)) on mitochondrial oxygen consumption kinetics has proven difficult in humans, in part due to the complexities in controlling for T(m)-related variations in blood flow, fiber recruitment, muscle metabolism, and contractile properties. To address this issue, intracellular Po(2) (P(i)(O(2))) was measured continuously by phosphorescence quenching following the onset of contractions in single Xenopus myofibers (n = 24) while controlling extracellular temperature. Fibers were subjected to two identical contraction bouts, in random order, at 15°C (cold, C) and 20°C (normal, N; n = 12), or at N and 25°C (hot, H; n = 12). Contractile properties were determined for every contraction. The time delay of the P(i)(O(2)) response was significantly greater in C (59 ± 35 s) compared with N (35 ± 26 s, P = 0.01) and H (27 ± 14 s, P = 0.01). The time constant for the decline in P(i)(O(2)) was significantly greater in C (89 ± 34 s) compared with N (52 ± 15 s; P < 0.01) and H (37 ± 10 s; P < 0.01). There was a linear relationship between the rate constant for P(i)(O(2)) kinetics and T(m) (r = 0.322, P = 0.03). Estimated ATP turnover was significantly greater in H than in C (P < 0.01), but this increased energy requirement alone with increased T(m) could not account for the differences observed in P(i)(O(2)) kinetics among conditions. These results demonstrate that P(i)(O(2)) kinetics in single contracting myofibers are dependent on T(m), likely caused by temperature-induced differences in metabolic demand and by temperature-dependent processes underlying mitochondrial activation at the start of muscle contractions.

Motion Artifact Compensation for Wristwatch Type Photoplethysmography Sensor

Heart beat measurement is useful not just for medical use but also for daily healthcare monitoring and for sports. Photoplethysmography is an optical pulse measurement method that measures the variation of light absorption of the blood flow in capillary. Fingertip and earlobe, which are suitable places for this method, are not suitable for wearing sensors in daily life. Measurement at wrist will be more favorable. Technical difficulties of applying photoplethysmography measurement on wrist are: a) blood flow variation and change of sensor orientation caused by body motions, and b) low sensitivity compared to measurement at fingertips or earlobes because of the low capillary density in the tissue. We derived a transfer function that expresses the relationship between body acceleration and change in capillary blood flow based on a simple fluid dynamics model of artery and capillary. Preliminary experiments have shown that motion the artifacts can be reduced by subtracting the change of blood flow estimated from body acceleration. This method is different from conventional frequency filtering methods that do not consider the relationship between the body motion and the changes in the capillary blood flow. Furthermore, sensor head suspension mechanism has been employed in order to stabilize the sensor orientation with respect to the skin as well as the applied force on the skin.

Self-mixing microprobe for monitoring microvascular perfusion in rat brain

Measuring functional activity in brain in connection with neural stimulation faces technological challenges. Our goal is to evaluate, in relative terms, the real-time variations of local cerebral blood flow in rat brain, with a convenient spatial resolution. The use of laser Doppler flowmetry (LDF) probes is a promising approach but commercially available LDF probes are still too large (450 μm) to allow insertion in brain tissue without causing damage in an extension that may negatively impact local measurements. The self-mixing technique coupled to LDF is herein proposed to overcome limitations of the minimal diameter of the probe imposed by non-self-mixing probes (commercial available probes). Our Monte Carlo simulations show that laser photons have a mean penetration depth of 0.15 mm, on the rat brain with the 785 nm laser light microprobe. Moreover, three self-mixing signal processing methods are tested: counting method, autocorrelation method, power spectrum method. The perfusion signal computed shows a good linearity with the scatterers velocity, for the three methods (a determination coefficient close to one is obtained), for the in vitro measurements. Furthermore, we believe that these indicators can be used to monitor local blood flow changes in the rat brain.

Riparian ecosystems in human cancers

Intratumoral evolution produces extensive genetic heterogeneity in clinical cancers. This is generally attributed to an increased mutation rate that continually produces new genetically defined clonal lineages. Equally important are the interactions between the heritable traits of cancer cells and their microenvironment that produces natural selection favoring some clonal ‘species’ over others. That is, while mutations produce the heritable variation, environmental selection and cellular adaptation govern the strategies (and genotypes) that can proliferate within the tumor ecosystem. Here we ask: What are the dominant evolutionary forces in the cancer ecosystem? We propose that the tumor vascular network is a common and primary cause of intratumoral heterogeneity. Specifically, variations in blood flow result in variability in substrate, such as oxygen, and metabolites, such as acid, that serve as critical, but predictable, environmental selection forces. We examine the evolutionary and ecological consequences of variable blood flow by drawing an analogy to riparian habitats within desert landscapes. We propose that the phenotypic properties of cancer cells will exhibit predictable spatial variation within tumor phenotypes as a result of proximity to blood flow. Just as rivers in the desert create an abrupt shift from the lush, mesic riparian vegetation along the banks to sparser, xeric and dry-adapted plant species in the adjacent drylands, we expect blood vessels within tumors to promote similarly distinct communities of cancer cells that change abruptly with distance from the blood vessel. We propose vascular density and blood flow within a tumor as a primary evolutionary force governing variations in the phenotypic properties of cancer cells thus providing a unifying ecological framework for understanding intratumoral heterogeneity.

Correlations Between CPR Quality Metrics and End-Tidal CO2 in Out-of-Hospital Cardiac ArrestStatus: PendingCategory: CPR Quality

Background: Limited data from human CPR studies indicate a possible relationship between chest compression (CC) quality and End-Tidal CO2 (ETCO2) due to associated variations in blood flow. We evaluated the correlations between CC metrics and ETCO2 during out-of-hospital cardiac arrest (OHCA).

793 Management of Acute Circulatory Failure in Children Based on the Evaluation by Echocardiography in Pediatric Intensive Care Unit (PICU)

Background and AimsEchocardiography has an important role to perform in the PICU, as it is an efficient, accurate, non invasive diagnostic modality that can aid the intensivist in the management...