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A Poll

Publications and source records attributed to A Poll.

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Correlation between LDA and ultrasound heart catheter measurements in a stenosed arterial model.

Ultrasound heart catheters are used to measure the velocity in coronary arteries. However, the act of introducing a catheter into the vessel disturbs the very flow being measured. We used laser Doppler anemometry to measure the velocity distribution in an axially symmetric model, both with and without a catheter inserted. The catheter reduced the center-line velocity by as much as 60 percent at a distance of 2 mm downstream from the catheter, and by as much as 25 percent at a distance of 10 mm. This means the velocity measured with an ultrasound catheter does not show the maximum velocity of the undisturbed flow in the tube center. In the constriction, however, the measured velocities with the LDA and ultrasound catheter are almost the same. Thus, catheter measurements in the stenosis achieve accurate results. The velocity profile in the stenosed areas is flattened over nearly the whole cross section. The velocity is extremely reduced only close to the wall. The measurements outside of the stenosis lead to large differences which need to be studied carefully in the future. The disturbed flow finally disappeared 15 mm downstream of the catheter. The measurements were done at steady flow using a glycerine water solution with a dynamic viscosity of 4.35 mPas. In future studies, these experiments will be repeated for pulsatile flow conditions using non-Newtonian blood-like fluids.

Blood Flow Velocity↗

Echo contrast agents improve flow display of color Doppler: in vitro studies.

Flow detection by color Doppler is impaired by low velocity of flow and increasing attenuation and depth of ultrasound penetration. The effects of increased echogenicity on flow detection (Toshiba SSH 65A) were thus studied in a flow model, which yielded similar strengths of Doppler signals as seen in the clinical routine, by adding microbubble solutions to the blood analog fluid (45% aqueous glycerin) and comparing signal strength (score 0-5) prior to and after contrast. The flow within the plexiglass tube with less than 3 degrees angle of coincidence for Doppler interrogation was laminar with a parabolic velocity profile at physiological velocities and pressures. In comparison with various contrast agents at a flow velocity of 18 cm/sec and 19 dB attenuation, flow was not detectable in control color Doppler, after 4 mL of the blood analog fluid, and after 4 mL of an agitated saline solution 9 mg/mL, but visible after 4 mL of Echovist, a polysaccharide solution with reproducible bubble size and concentration and after 4 mL of an agitated polygelatin solution. Increasing concentration of Echovist (50-400 mg/mL) improved flow detection. Echovist 200 mg/mL enhanced the score by 1.1 + -0.6 for velocities 5-20 cm/sec (P less than 0.01), by 1.6 + -0.8 for 40-100 cm/sec (P less than 0.001), and by 1.1 + -0.6 for velocities greater than 150 cm/sec (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗

Limitations of flow detection by color Doppler: in vitro comparison to conventional Doppler.

There is little awareness of the limitations of flow detection with the commercially available color Doppler flow mapping system. The influence of flow velocity, ultrasound attenuation, and penetration depth on flow detection in color Doppler (Toshiba SSH 65A) were therefore studied in vitro and compared with conventional Doppler. The flow model had physiological flow volumes and laminar flow with parabolic velocity profile in a horizontal tube of Lucite with less than 3 degrees of coincidence. Conventional Doppler flow velocity measurements correlated highly with laser Doppler anemometry results (r = 0.99, SEE = 3 cm/sec). Signal strength of color Doppler and pulsed Doppler was semi-quantitatively graded using a scale from 0 to 5. Scale 1 (sparse signals) was useless for any assessment in color Doppler but just allowed velocity measurement in pulsed Doppler. Using 19-dB attenuation, flow velocities greater than 100 cm/sec had good scores with moderate gain, 60-100 cm/sec needed increasing gain, and velocities less than 40 cm/sec were not detectable with color Doppler but readily so with pulsed Doppler. With increasing attenuation (1-29 dB) and also with increasing penetration depth, flow detection was reduced significantly (P less than 0.001) more in color Doppler than in the pulsed technique (P less than 0.01). In conclusion, low flow velocities, high attenuation, and greater than 8 cm penetration depth may hamper flow detection in color Doppler and, thus, diagnostic accuracy. Conventional Doppler with its superior accuracy and sensitivity should therefore consolidate diagnostic ultrasound assessment.

Blood Flow Velocity↗

[Accuracy of various Doppler technics in recording blood flow velocity. Studies in vitro].

Conventional and color-coded Doppler techniques were studied as to their accuracy in displaying flow and velocity using an in vitro model and a Laser-Doppler-anemometer. Furthermore, the estimation of pressure gradients as determined by Doppler ultrasound was compared to measurements by manometers under a variety of hemodynamic conditions. Pulsed and continuous wave Doppler had good reproducibility. There was an excellent correlation for measurements of flow velocity as determined by Doppler ultrasound and by Laser-Doppler anemometer (r = 0.98, SEE = 3 cm/s). The well-known underestimation of flow velocity due to an increasing angle of incidence (greater than 25 degrees) was confirmed in vitro. However this error was smaller than the actual overestimation resulting from angle correction for the apparent cosine. Doppler gradients correlated strongly with manometer gradients for orifice areas 12-80 mm2 and flow volumes 0.9-12.8 l/min (r = 0.98, SEE = 7 mm Hg) using continuous as well as pulsatile flow. Some overestimation of the Doppler gradient occurred with increasing flow rates (r = 0.66). Color-Doppler has poor spatial resolution. Display of velocities was therefore assessed using a qualitative score (0-5), the variability of which was 13 +/- 30% of the initial value. Display of faintest quality (score 1) was useless for clinical assessment in color-Doppler technique, but allowed quantitative measurement of velocity in conventional Doppler. Reduction of flow velocities limited display in color-Doppler (5-20 cm/s) but not in pulsed-Doppler technique. Thus, conventional Doppler has better sensitivity and accuracy of displaying flow when compared to color-Doppler, particularly in conditions of poor imaging. As reproducibility and accuracy of velocity determination are excellent, this technique should be used in all diagnostic procedures involving ultrasound. The Doppler gradient as derived from the modified Bernoulli equation provides accurate results in vitro which may also be concluded for use in the clinical situation.

Blood Flow Velocity↗

Flow visualization studies in a mold of the normal human aorta and renal arteries.

To study the flow behavior in regions where hemodynamic effects have been suggested to participate in atherogenesis, we evaluated flow in a mold of the aorta and renal arteries of a previously healthy 27-year-old woman who died of trauma. A birefringent solution (vanadium-pentoxide) was used. When diluted, this material behaves like a Newtonian fluid. This method gives a complete picture of the entire flow field. Zones of flow separation and disturbed flow can be seen and the location and size of disturbed areas observed. Unseparated flow regions downstream from disturbed zones can be properly visualized and the method can be used for pulsatile flow as well as steady flow. During steady flow (only at branch to-trunk flow ratios greater than 0.20), zones of flow separation were observed in the aorta distal to the renal arteries. During pulsatile flow, disturbances were found at nearly all branch-to-trunk flow ratios.

Aorta↗

Haemodynamic stress in terminal aneurysms.

The flow velocities in glass and silastic aneurysm models located at bifurcations were quantitatively determined using the non-invasive laser-Doppler method. The geometrical relation between aneurysm and parent vessels was found to be the primary factor governing the intra-aneurysmal flow pattern. Flow was stagnant in straight terminal models, with the aneurysm forming an extension of the afferent vessel, as long as the outflow through the branches of the bifurcation was balanced. Average flow velocities in the fundus were small but turbulent flow fluctuations of high amplitudes were observed. Asymmetric outflow through the branches of the bifurcation induced a rotatory intra-aneurysmal circulation from the dominant to the subordinate branch. The circulation in angled terminal aneurysms with the aneurysmal axis at a 45 degree angle to the plane of the bifurcation was a vortex, which was a natural consequence of the excentric inflow from the afferent vessel. Maximum flow velocities measured in the centre plane of the angled terminal aneurysms were in the range of 50 to 80% of the axial velocity in the afferent vessel. The elasticity of the models did not affect the global turnover rates but it damped the intra-aneurysmal pulse wave. On the basis of the measured velocity gradients near the walls maximum shear stresses on the wall of human terminal aneurysms were estimated to be in the order of 50 dynes/cm2 (5 Pascal), a value that is similar to the maximum wall shear stresses estimated for lateral aneurysms.

Brain↗

Hemodynamic stress in terminal saccular aneurysms: a laser-Doppler study.

The flow conditions and the related stresses in glass and silastic model aneurysms located at bifurcations were quantitatively determined by means of laser-Doppler-anemometry. The flow velocities in straight terminal models with the aneurysm forming an extension of the afferent vessel were unstable if the outflow through the branches of the bifurcation was balanced. Average flow velocities in the fundus were small, but irregular flow fluctuations of high amplitudes were observed. Asymmetrical outflow through the branches of the bifurcation induced a rotatory intra-aneurysmal circulation from the dominant to the subordinate branch. The circulation in angled terminal aneurysms with the aneurysmal axis at a 45 degree angle to the plane of the bifurcation was a vortex caused by the eccentric inflow from the afferent vessel. Maximum flow velocities measured in the center plane of the angled terminal aneurysms were in the range 50%-80% of the axial velocity in the afferent vessel. The present results indicate that the geometrical relation between aneurysm and parent vessels is the primary factor governing the intra-aneurysmal flow pattern. The elasticity of the models did not affect the average flow velocities, but the intra-aneurysmal pulse wave was damped in elastic models. On the basis of the measured velocity gradients near the walls, maximum shear stresses on the wall of a typical human terminal aneurysm were estimated to be in the order of 50 dyne/cm2 (5 Pascal), a value that is similar to the shear stresses that occur at the flow divider of a cerebral artery bifurcation. This is based on absolute flow velocity measurements in patients [8, 13].

Blood Flow Velocity↗

Haemodynamic stress in lateral saccular aneurysms. An experimental study.

The flow velocities in lateral glass and silastic aneurysm models were quantitatively measured with the non-invasive laser Doppler method. The influences of the elasticity of the wall, the pulse wave and the properties of the perfusion medium on the intra-aneurysmal circulation were investigated. As shown previously, the inflow into the aneurysm arose from the downstream lip and was directed toward the centre of the fundus. Backflow to the parent vessel took place along the walls of the fundus. With non-pulsatile perfusion, flow velocities in the centre of the standardized aneurysms varied between 0.4 and 2% of the maximum velocity in the parent vessel. With pulsatile perfusion, flow velocities in the centre of the fundus ranged between 8 and 13% of the flow velocity in the axis of the parent vessel. Flow velocities in the aneurysms were slower with a macromolecular perfusion medium with blood like properties compared to a glycerol/water solution. Flow velocity measurements near the aneurysmal wall allowed the estimation of the shear stresses at critical locations. The maximum shear stresses at the downstream lip of the aneurysm were in the range of the stresses measured at the flow divider of an arterial bifurcation. The present results suggest that in human saccular aneurysms intra-aneurysmal flow and shear stress on the wall are directly related to the pulsatility of perfusion, i.e. the systolic/diastolic pressure difference and that the tendency to spontaneous thrombosis depends on the viscoelastic properties of the blood, namely the haematocrit.

Blood Flow Velocity↗

Basic flow structure in saccular aneurysms: a flow visualization study.

Basic flow patterns were investigated in a set of glass aneurysm models by means of flow visualization methods. Dye injection and streaming double refraction were used to visualize flow. The circulation inside lateral aneurysms arising at a 90 degree angle from a straight parent conduit could not be visualized by the dye-injection technique but could be demonstrated by streaming double refraction. The inflow was seen to arise from the downstream lip of the orifice and to project to the dome of the aneurysm. Backflow to the parent conduit took place along the walls of the aneurysm. In aneurysms located at bifurcations, flow characteristics depended on the geometry of the bifurcation and the flow ratio between the branches. Relatively little intra-aneurysmal flow was demonstrated in side branch-related aneurysms arising distal to an asymmetric 90 degrees bifurcation of the type encountered at the junction of the internal carotid and posterior communicating arteries. Stagnation of flow at the neck and little intra-aneurysmal circulation were found with terminal aneurysms of the basilar bifurcation type if the outflow through the branches was symmetric. With asymmetric outflow, however, or if the axis of the aneurysm did not coincide with that of the afferent vessel, an active rotation developed in these aneurysms. The size of the aneurysm had no influence on the basic pattern of intra-aneurysmal circulation. The use of pulsatile perfusion did not significantly alter the basic flow patterns observed with steady flow. Locally disturbed laminar flow was observed in certain models at physiological Reynold's numbers, but there were no signs of fully developed turbulence.

Coloring Agents↗

Hemodynamic stress in lateral saccular aneurysms.

The flow velocities in glass and silastic lateral aneurysm models were quantitatively measured with the non-invasive laser Doppler method. The influences of the elasticity of the wall, the pulse wave and the properties of the perfusion medium on the intra-aneurysmal circulation were investigated. As shown previously, the inflow into the aneurysm arose from the downstream lip and was directed toward the center of the fundus. Backflow to the parent vessel took place along the walls of the fundus. With non-pulsatile perfusion, flow velocities in the center of the standardized aneurysms varied between 0.4 and 2% of the maximum velocity in the parent vessel. With pulsatile perfusion, flow velocities in the center of the fundus ranged between 8 and 13% of the flow velocity in the axis of the parent vessel. Flow velocities in the aneurysms were slower with a polymer suspension with blood-like properties compared to a glycerol/water solution. Flow velocity measurements near the aneurysmal wall allowed the estimation of the shear stresses at critical locations. The maximum shear stresses at the downstream lip of the aneurysm were in the range of the stresses measured at the flow divider of an arterial bifurcation. The present results suggest that in human saccular aneurysms intra-aneurysmal flow and shear stress on the wall are directly related to the pulsatility of perfusion, i.e. the systolic/diastolic pressure difference and that the tendency to spontaneous thrombosis depends on the viscoelastic properties of the blood, namely the hematocrit.

Blood Flow Velocity↗

[Spontaneous intra-antral rhinolith. A case study].

Rhinoliths of the paranasal sinuses have often been reported and are generally due to trauma and surgery of these cavities and to retained foreign bodies. In the present case, an unilateral chronic rhinosinusitis had been treated by antiinflammatory agents only, but never underwent surgery or trauma. Tomography revealed a high density concretion. A solid rhinolith was removed by a Caldwell-Luc procedure and was then submitted to spectrographic and electron microscopic investigations.

Calcium Phosphates↗

Recording of unexpectedly high frequency vibrations of blood vessel walls in experimental arteriovenous fistulae of rabbits using a laser vibrometer.

Because arteriovenous fistulae are associated with a palpable thrill and an audible murmur, the vibrational activity of the blood vessel walls about experimental arteriovenous fistulae in rabbits was investigated using, for the first time, a high-resolution laser vibrometer. Frequencies of mural vibrations up to 2200 Hz were recorded at different sites about the fistulae. The relationship of this vibratory activity of blood vessel walls to physiological and pathological conditions warrants further investigation.

Animals↗