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J Vanderschoot

Publications and source records attributed to J Vanderschoot.

At least 19 recordsLinked to original sources

A compartmental model of an external urethral sphincter motoneuron of Onuf's nucleus.

This article discusses a model of the electrical behavior of an external urethral sphincter motoneuron, based on morphological parameters like soma size, dendritic diameters and spatial dendritic configuration, and several electrical parameters. Because experimental data about the exact ion conductance mix of external urethral sphincter neurons is scarce, the gaps in knowledge about external urethral sphincter motoneurons were filled in with known data of alpha-motoneurons. The constructed compartmental model of motoneurons of Onuf's nucleus contains six voltage-dependent ionic conductances: a fast sodium and potassium conductance and an anomalous rectifier in the soma; a fast delayed rectifier type potassium conductance and a fast sodium conductance in the initial axon segment; an L-type calcium channel in the dendritic compartments. This paper considers the simulation of external urethral sphincter motoneuron responses to current injections that evoke bistable behavior. Simulations show self-sustained discharge following a depolarizing pulse through the microelectrode; the firing was subsequently terminated by a short hyperpolarizing pulse. This behavior is highly functional for neurons that have to exhibit prolonged activation during sphincter closure. In addition to these 'on' and 'off ' responses, we also observed a particular firing behavior in response to long-lasting triangular current pulses. When the depolarizing current was slowly increased and then decreased (triangular pulse) the firing frequency was higher during the descending phase than during the initial ascending phase.

Animals↗

Modelling the biomechanics and control of sphincters.

This paper reviews current mathematical models of sphincters and compares them with a new spatial neuromuscular control model based on known physiological properties. Almost all the sphincter models reviewed were constructed as a component of a more extensive model designed to mirror the overall behaviour of a larger system such as the lower urinary tract. This implied less detailed modelling of the sphincter component. It is concluded that current sphincter models are not suitable for mimicking detailed interactions between a neural controller and a sphincter. We therefore outline a new integrated model of the biomechanics and neural control of a sphincter. The muscle is represented as a lumped-mass model, providing the possibility of applying two- or three-dimensional modelling strategies. The neural network is a multi-compartment model that provides neural control signals at the level of action potentials. The integrated model was used to simulate a uniformly activated sphincter and a partially deficient innervation of the sphincter, resulting in a non-uniformly activated sphincter muscle. During the simulation, the pressure in the sphincter lumen was prescribed to increase sinusoidally to a value of 60 kPa. In the uniformly activated situation, the sphincter muscle remains closed, whereas the partially denervated sphincter is stretched open, although the muscle is intact.

Animals↗

Vessel diameter measurements in gadolinium contrast-enhanced three-dimensional MRA of peripheral arteries.

In this study, the possibilities for quantification of vessel diameters of peripheral arteries in gadolinium contrast-enhanced magnetic resonance angiography (Gd CE MRA) were evaluated. Absolute vessel diameter measurements were assessed objectively and semi-automatically in maximum intensity projections (MIPs) of contrast-enhanced T1-weighted 3D spoiled gradient-echo datasets, studied with digital subtraction techniques. In vivo, the complete peripheral arterial bed of six patients was studied, from the aorto-iliac bifurcation down to the distal run-off. By measuring the signal intensity (SI) over the lumen of a vessel in the MIP, an SI-plot was obtained. Next, the vessel boundaries were determined using a threshold algorithm; from these boundary points individual diameter values could be obtained along the trajectory of the vessel. In an in vitro study, an optimal threshold value of 30% of the range of SI-values between the background and the maximal SI in the vessel was obtained for accurate diameter measurement in Gd CE MRA (i.e., full-width 30%-maximum). Furthermore, the relationship between the accuracy of these measurements and the scan resolution was investigated. Accuracy was found to be acceptable (i.e., less than 10% over/underestimation) for vessel sizes covering at least 3 pixels. In six patients, diameters were measured in MIPs of the total datasets (i.e., D(T)) as well as in selective MIPs of the clipped datasets (i.e., D(S)) (n = 209). D(T) and D(S) were statistically significantly correlated (p < 0.01) with a Pearson correlation coefficient rP = 0.98. Measurements in the total MIPs yielded statistically significant (p < 0.01) smaller diameter values compared with measurements in selective MIPs, with a mean difference of 0.15 mm. Diameter values from the selective MIPs of the aorto-iliac arteries were also compared with diameter values measured at corresponding anatomic positions in X-ray angiograms of these patients (i.e., D(x)) (n = 70). D(X) and D(S) were statistically significantly correlated (p < 0.01) with a Pearson correlation coefficient rP = 0.92. Diameters measured in the selective MIPs were smaller than those measured in the X-ray angiograms (mean difference 0.49 mm) and this difference was statistically significant (p < 0.01). In conclusion, diameter values can be evaluated accurately in MIPs of vessels with at least 3 pixels in diameter, using the full-width 30%-maximum criterion.

Adult↗

Scan optimization of gadolinium contrast-enhanced three-dimensional MRA of peripheral arteries with multiple bolus injections and in vitro validation of stenosis quantification.

In this study, a T1-weighted three-dimensional (3D) spoiled gradient-echo scanning protocol was developed to image the complete arterial system of the pelvis and both legs along their entire length in patients with peripheral arterial disease. Three adjacent stations were to be acquired consecutively, with some overlap, to image the entire area of interest; per station one gadolinium (Gd) contrast bolus would be administered. In an in vitro phantom study, the scanning protocol was optimized. The optimal flip angle was found to be 50 degrees. Also, the optimal scan delay was chosen to be equal to the arrival time of the contrast bolus, thereby minimizing artifacts. Three contrast bolus injections showed sufficient enhancement of the vessels after image subtraction. Finally, stenosis quantification by manual caliper was performed by five observers in the magnetic resonance angiography (MRA) images and correlated with the percent diameter reduction determined by quantitative angiography from corresponding X-ray images. The MRA measurements were reproducible, and intra- and interobserver variabilities were statistically non-significant (p=0.54 and p=0.12, respectively). Stenosis quantification performed by four observers showed a good correlation with the X-ray-derived values (rp > 0.90, p < 0.02); the results from one observer were not significantly correlated. Five patients with proven peripheral disease were investigated with this new MRA scanning protocol, using standard hardware and software. The images were of good quality, which allowed adequate clinical evaluation; the original diagnoses obtained from X-ray examinations, were confirmed with MRA. In conclusion, peripheral arterial disease can be evaluated adequately with this magnetic resonance scanning protocol.

Adult↗

Gadolinium contrast-enhanced three-dimensional MRA of peripheral arteries with multiple bolus injection: scan optimization in vitro and in vivo.

In this study, a scanning protocol was developed to image the arterial bed of the pelvis and both legs along their entire length in patients with peripheral arterial disease, using standard hard- and software. Three adjacent stations are acquired consecutively, with some small overlap; per station; one Gadolinium contrast bolus is administered. The scanning protocol was optimized in an in vitro phantom study. The optimal flip angle was found to be 50 degrees. Also, the optimal scan delay was chosen to be equal to the arrival time of the contrast bolus thereby minimizing artifacts. Three contrast bolus injections showed sufficient enhancement of the vessels after image subtraction. Finally, stenosis quantification by manual caliper was performed by five observers in the MRA images and correlated with the percent diameter reduction determined by quantitative angiography from corresponding X-ray images. The results of the MRA measurements were reproducible and intra- and inter-observer variabilities were statistically non-significant (p = 0.54 and p = 0.12, respectively). Stenosis quantification performed by four observers showed a good correlation with the X-ray derived values (rp > 0.90, p < 0.02); the results from one observer were not significantly correlated. Five patients with proven peripheral disease were investigated with this new MRA scanning protocol. The images were of good quality which allowed adequate clinical evaluation; the original diagnoses obtained from X-ray examinations, were confirmed with MRA. In conclusion, peripheral arterial disease can be evaluated adequately with this MR scanning protocol.

Adult↗

Stenosis quantification from post-stenotic signal loss in phase-contrast MRA datasets of flow phantoms and renal arteries.

In this study a semi-automated and observer-independent algorithm for quantifying post-stenotic signal loss (PSL) in 3D phase-contrast (PC) magnetic resonance angiography (MRA) of patients with renal artery stenosis is presented. This algorithm was developed on MRA datasets of stenotic phantoms, which were included in a flow circuit with stationary flows. The length and the severity of the PSL (incorporating both length and degree of PSL) in the maximum intensity projections (MIPs) of MRA datasets were proposed for quantifying stenoses. The algorithm was tested in renal arteries of ten patients with renal artery stenosis and seven healthy volunteers. Digital subtraction angiography (DSA) was performed in the patients and served as the gold standard. Stenosis severity showed better correlation with the severity of the PSL than with the length, both for in vitro as in vivo. Spearman correlation coefficients (rS) showed statistically significant correlations between the severity of the PSL and parameters determined by DSA, i.e. percent diameter stenosis (rS = 0.90). The length of the PSL showed no correlation with the diameter stenosis (rS = 0.37).

Adult↗

Objective stenosis quantification from post-stenotic signal loss in phase-contrast magnetic resonance angiographic datasets of flow phantoms and renal arteries.

In this study a semi-automated and observer-independent algorithm for quantifying post-stenotic signal loss (PSL) in three-dimensional phase-contrast (PC) magnetic resonance angiography (MRA) of patients with renal artery stenosis is presented. This algorithm was developed on MRA datasets of stenotic phantoms, included in a flow circuit with stationary flows. The length and the severity of the PSL (incorporating both the length and the degree of PSL) in the MRA datasets were proposed for quantifying the stenoses. The algorithm was tested in renal arteries; ten patients with renal artery stenosis and seven healthy volunteers were investigated. Digital subtraction angiography was performed in the patients and served as the gold standard. Stenosis severity showed better correlation with the severity of the PSL than with the length, both for in vitro and in vivo measurements. Spearman correlation coefficients (rs) showed statistically significant correlations between the severity of the PSL and parameters determined by digital subtraction angiography, i.e., percent diameter stenosis (rs = 0.90). The length of the PSL showed no correlation with the diameter stenosis (rs = 0.37). In conclusion, this study presents a semi-automated and observer-independent way of quantifying signal loss, and the severity of the PSL is proposed for quantifying stenoses, rather than the length of PSL.

Aged↗

Distribution of crackles on the flow-volume plane in different pulmonary diseases.

A new method to represent and evaluate crackles on the flow-volume plane is described. Characteristic crackle patterns were found in patients with pneumonia, bronchiectasis, chronic obstructive pulmonary disease, heart failure and cryptogenic fibrosing alveolitis. In addition to visual assessment, simple statistical parameters were used to describe the observed pathological phenomena.

Adult↗

State-space analysis of a myocybernetic model of the lower urinary tract.

To study the control of the lower urinary tract, the state space of the myocybernetic model by Bastiaanssen et al. (1996) is analysed. This model is able to respond to input signals from a neural network and includes descriptions of the muscle dynamics of both the detrusor in the bladder wall and the urethral sphincter. The equilibrium states of the model for constant input signals were found by evaluation of the roots of calculated flow curves. Two types of equilibrium states could be distinguished: (i) the inflow and the outflow of the bladder are both equal to zero and (ii) the bladder in- and outflow are both equal to a prescribed small constant flow from the ureters into the bladder. The first type of equilibrium features a very high bladder pressure, which in vivo could result in a reflux of urine into the ureters. The second type shows a constant loss of urine. For different combinations of constant input signals, several stable equilibrium states of both types were found. The neural controller should avoid these states so that the lower urinary tract fulfils either its storage or its voiding function. Therefore, the trajectory through the state space of a simulated normal filling and micturition event was evaluated here. It appeared that equilibrium states were avoided by rapid changes of the input signals. The behaviour of the model outside the normal trajectory is compared with neurologic urinary tract disorders. Several pathological behaviours are in qualitative agreement with the model predictions.

Computer Simulation↗

A myocybernetic model of the lower urinary tract.

A biomechanical model of the lower urinary tract which is able to respond to input signals from a neural network is presented. The neural input is the starting point in the description of the relationships between the various physical parameters in the mechanical model of the bladder and the urethra. The cybernetics of the lower urinary tract are described on the basis of the muscle dynamics of simple models of both the detrusor in the bladder wall and the urethral sphincter. The urethral sphincter is not described as a variable resistance, like in other biomechanical models of the lower urinary tract, but is described on the basis of striated muscle dynamics. The forces produced by the detrusor and the urethral sphincter give rise to the bladder pressure and the urethral pressure. Using quasi-steady assumptions, the flow rate of urine is calculated as a result of the pressure difference between the bladder and the urethra. Parameters like the bladder volume, the flow rate and the pressure in the bladder can be compared with clinical data of urodynamic measurements. Simulation results show that the model is able to mimic both a filling and an emptying behaviour which resembles the behaviour of the lower urinary tract. By increasing the resistance of the urethra, a behaviour model of the lower urinary tract appears which is comparable with the pathology of urethral obstruction. A sensitivity analysis of various parameters in the model leads to a better understanding of the biomechanics of the lower urinary tract.

Biomechanical Phenomena↗

Lung sounds during allergen-induced asthmatic responses in patients with asthma.

We postulated that the distinct pathophysiologic mechanisms of airway narrowing during the early (EAR) and the late (LAR) asthmatic responses to inhaled allergens are reflected by the generation or transmission of lung sounds in asthma. Therefore, we measured FEV1 and recorded lung sounds in eight mildly asthmatic subjects before a standardized allergen challenge (PRE), during the EAR, during the recovery phase at 2 h (MID), during the LAR at 7 h, and after inhalation of a bronchodilator (POST). The recordings were made during flow- and volume-standardized quiet breathing, and during maximal forced breathing maneuvers. Airflow-dependent power spectra were analyzed for lung sound intensity (LSI), quartile power points (Q25, Q50, Q75), and extent of wheezing (W). These sound characteristics were compared among the various stages of the challenge in the presence (EAR, LAR) and absence (PRE, MID, POST) of acute airway obstruction using ANOVA. LSI, Q25 - Q75, and W were all elevated during airway obstruction. When matched for percent fall in FEV1, during the EAR and the LAR (mean +/- SD: 26.7 +/- 4.0, and 28.9 +/- 5.7, respectively; p = 0.385), the increase in Q25, and Q50 with airflow during quiet expiration, as well as the extent of wheezing, were higher during the LAR than during the EAR (p < or = 0.042 and p < or = 0.012, respectively). At similar levels of FEV1 (p > or = 0.156), LSI on expiration was higher at POST than at PRE or MID (p < or = 0.067), whereas Q25 (p < or = 0.047) and Q50 (p < or = 0.064) were lower at POST than at PRE. During forced expiration W was higher at MID and POST than at PRE (p < or = 0.014). We conclude that LSI, frequency content, and the extent of wheezing vary during the subsequent stages of allergen-induced bronchoconstriction in asthma despite matched values of FEV1. This suggests that airflow-standardized phonopneumography is a sensitive method for detecting differences in the pathophysiology of airway narrowing in asthma.

Acoustics↗

The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects.

The association between lung sound alterations and airways obstruction has long been recognized in clinical practice, but the precise pathophysiological mechanisms of this relationship have not been determined. Therefore, we examined the changes in lung sounds at well-defined levels of methacholine-induced airway narrowing in eight normal and nine asthmatic subjects with normal baseline lung function. All subjects underwent phonopneumography at baseline condition and at > or = 20% fall in forced expiratory volume in one second (FEV1), and in asthmatic subjects also at > or = 40% fall in FEV1. Lung sounds were recorded at three locations on the chest wall during standardized quiet breathing, and during maximal forced breathing. Airflow-dependent power spectra were computed using fast Fourier transform. For each spectrum, we determined the intensity and frequency content of lung sounds, together with the extent of wheezing. The results were analysed using analysis of variance (ANOVA). During acute airway narrowing, the intensity and frequency content of the recorded sounds, as well as the extent of wheezing, were higher than at baseline in both groups of subjects. At similar levels of obstruction, both the pitch and the change in sound intensity with airflow were higher in asthmatics than in normal subjects. Wheezing, being nondiscriminative between the subject groups at baseline, was more prominent in asthmatics than in normal subjects at 20% fall in FEV1. We conclude that, at given levels of acute airway narrowing, lung sounds differ between asthmatics and normal subjects. This suggests that airflow-standardized phonopneumography is a sensitive method for detecting abnormalities in airway dynamics in asthma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Abnormal lung sounds in patients with asthma during episodes with normal lung function.

Even in patients with clinically stable asthma with normal lung function, the airways are characterized by inflammatory changes, including mucosal swelling. In order to investigate whether lung sounds can distinguish these subjects from normal subjects, we compared lung sound characteristics between eight normal and nine symptom-free subjects with mild asthma. All subjects underwent simultaneous recordings of airflow, lung volume changes, and lung sounds during standardized quiet breathing, and during forced maneuvers. Flow-dependent power spectra were computed using fast Fourier transform. For each spectrum we determined lung sound intensity (LSI), frequencies (Q25%, Q50%, Q75%) wheezing (W), and W%. The results were analyzed by ANOVA. During expiration, LSI was lower in patients with asthma than in healthy controls, in particular at relatively low airflow values. During quiet expiration, Q25% to Q75% were higher in asthmatics than in healthy controls, while the change of Q25% to Q75% with flow was greater in asthmatic than in normal subjects. The W and W% were not different between the subject groups. The results indicate that at given airflows, lung sounds are lower in intensity and higher in pitch in asthmatics as compared with controls. This suggests that the generation and/or transmission of lung sounds in symptom-free patients with stable asthma differ from that in normal subjects, even when lung function is within the normal range. Therefore, airflow standardized phonopneumography might reflect morphologic changes in airways of patients with asthma.

Adult↗

AR (q, v) modeling of normal lung sounds.

A model for the dependence of normal lung sounds upon airflow and air volume recorded at the mouth, is proposed and investigated. Data from 8 healthy subjects and 2 sessions have been analysed. Test statistics give very strong support for the adequacy of the model. This opens possibilities for diagnostic application of the model to normal lung sounds. Several suggestions are given for still further improvement of the model.

Analysis of Variance↗

Learning procedure in a neural control model for the urinary bladder.

A continuous neural network coupled to a dynamical model of the urinary bladder is defined. The neural network is trained to control the bladder model to track a prescribed volume fluctuation, by adjusting weights and time constants. The gradients of the error in the output neurons of the neural network are unknown. Therefore, the learning procedure discussed here minimizes the error functional without using gradient descent.

Animals↗

Lung sound intensity in patients with emphysema and in normal subjects at standardised airflows.

BACKGROUND: A common auscultatory finding in pulmonary emphysema is a reduction of lung sounds. This might be due to a reduction in the generation of sounds due to the accompanying airflow limitation or to poor transmission of sounds due to destruction of parenchyma. Lung sound intensity was investigated in normal and emphysematous subjects in relation to airflow. METHODS: Eight normal men (45-63 years, FEV1 79-126% predicted) and nine men with severe emphysema (50-70 years, FEV1 14-63% predicted) participated in the study. Emphysema was diagnosed according to pulmonary history, results of lung function tests, and radiographic criteria. All subjects underwent phonopneumography during standardised breathing manoeuvres between 0.5 and 2 1 below total lung capacity with inspiratory and expiratory target airflows of 2 and 1 l/s respectively during 50 seconds. The synchronous measurements included airflow at the mouth and lung volume changes, and lung sounds at four locations on the right chest wall. For each microphone airflow dependent power spectra were computed by using fast Fourier transformation. Lung sound intensity was expressed as log power (in dB) at 200 Hz at inspiratory flow rates of 1 and 2 l/s and at an expiratory flow rate of 1 l/s. RESULTS: Lung sound intensity was well repeatable on two separate days, the intraclass correlation coefficient ranging from 0.77 to 0.94 between the four microphones. The intensity was strongly influenced by microphone location and airflow. There was, however, no significant difference in lung sound intensity at any flow rate between the normal and the emphysema group. CONCLUSION: Airflow standardised lung sound intensity does not differ between normal and emphysematous subjects. This suggests that the auscultatory finding of diminished breath sounds during the regular physical examination in patients with emphysema is due predominantly to airflow limitation.

Aged↗

An adaptive on-line method for the extraction of the complete fetal electrocardiogram from cutaneous multilead recordings.

The detection of a fetal electrocardiogram (FECG) is described to be a so-called inverse problem. A geometric interpretation of such a problem is presented. It can be solved by determining the weights to be used in one or more weighted sums of measurement signals. A novel method is presented to determine these weights. Theoretical and experimental evidence is given that this method has the following attractive properties. Application of the method results in one or more FECG signals, free of maternal ECG (MECG) which are at the same time maximal with respect to noise. It is shown that one FECG signal does not always suffice to describe the observed electrical heart activity in a set of cutaneous electrodes, equivalently to the adult ECG (see figure 7). It is explained and experimentally verified that the application of three thoracic signals is useful to guarantee the suppression of the MECG. The positions of the abdominal electrodes then determine the obtained FECG to noise ratio, and will have no influence on the degree of MECG suppression (see figure 6). It is expected that a total of about eight measurement signals are sufficient in most cases. The method is simple to apply by medical personnel, and after a transient of about 1 s the signals with the mentioned properties are obtained (see figure 5). Further on, the weights are allowed to change in order to adapt automatically to sudden changes in the measurement signal properties (see figure 6). These may occur e. g. due to fetal movement. Application of the method requires no human interpretation or decision in order to obtain the claimed properties.

Electrocardiography↗