No description available.

No description available.

No description available.

Respiration rate is one of the main indicators of an individual's health and therefore it requires accurate quantification. Its value can be used to predict life threatening conditions such as the child death syndrome and heart attacks. The current respiration rate monitoring methods are contact based, i.e. a sensing device needs to be attached to the person's body. Physically constraining infants and young children by a sensing device can be stressful to the individuals which in turn affects their respiration rate. Therefore, measuring respiration rate in a non-contact manner (i.e. without attaching the sensing device to the subject) has distinct benefits. Currently there is not any non-contact respiration rate monitoring available for use in medical field. The aim of this study was to investigate thermal imaging as a means for non-contact respiration rate monitoring. Thermal imaging is safe and easy to deploy. Twenty children were enrolled for the study at Sheffield Children Hospital; the children were from 6 month to 17 years old. They slept comfortably in a bed during the recordings. A high resolution high sensitivity (0.08 degree Kelvin) thermal camera (Flir A40) was used for the recordings. The image capture rate was 50 frames per second and its recording duration per subject was two minutes (i.e. 6000 image frames)A median digital lowpass filter was used to remove unwanted frequency spectrum of the images. An important issue was to localize and track the area centered on the tip of the nose (i.e. respiration region of interest, ROI). A number of approaches were developed for this purpose. The most effective approach was to identify use the warmest facial point (i.e. the point where the bridge of the nose meets the corner of one of the eyes). A novel method to analyse the selected ROI was devised. This involved segmenting the ROI into eight equal segments centred on the tip of nose. A respiration signal was produced for each segment across the 6000 recorded images from each subject. The study demonstrated that the process of dividing the ROI into eight segments improves determination of respiration rate. The respiration signals were processed both in the time and frequency domains to determine respiration rates for the 20 subjects included in the study. The respiration values obtained from the two domains were close. During each recording respiration rate was monitored using conventional contact methods (e.g. nostril thermistor, abdomen and chest movement sensor etc). There was a close correlation (correlation value 0.99) between respiration values obtained by thermal imaging and those obtained using conventional contact method. The novel aspects of the study relate to the development of techniques that facilitated thermal imaging as an effective non-contact respiration rate monitoring in both normal and patient subject groups.

No description available.

A novel in vitro membrane oxygenator circuit was developed to test gas exchange where particular elements could be examined whilst keeping other variables constant. The circuit comprises two membrane oxygenators connected to form a continuous blood circuit resembling venous and arterial blood conditions. The effects of Isoflurane, a volatile anaesthetic, on oxygen transfer were investigated. RBC resistance to nitric oxide diffusion (DNO) was tested in this circuit by haemolysis and addition of the haemoglobin-based-oxygen-carrier (HBOC) Oxyglobin. The circuit was primed with equine blood flowing at 2.5 l/min. The oxygenator was ventilated with 5 l/min air/oxygen/N2 mix providing a range of FiO2. The deoxygenator received 5 l/min 5% CO2 in N2 with 0.2-0.3 l/min CO2. Isoflurane 1%, NO 4000-16000 ppb and CO 0.03% were added to the oxygenator gas. Uptake of O2, CO2, CO and NO were calculated by gas inlet and outlet concentrations and flow rates. Arterial and venous oxygen dissociation curve (aODC and vODC) comparisons were made. Isoflurane uptake by the circuit blood was evident and 1% Isoflurane did not affect oxygen uptake (p=0.981), aODC or vODC (p=0.311 and p=0.751). Haemolysis did not affect O2 or CO2 transfer but increased DNO (p<0.001). 250ml free Hb solution addition to the circuit increased DNO by 91% (p<0.0001). Addition of 250ml Oxyglobin increased DNO by 143% from 7.41±2.77 to 17.97±1.83 ml/min/mmHg. Oxyglobin caused a right shift of aODC and vODC (p<0.0001) but NO-bound Oxyglobin caused a left vODC shift (p<0.0001). Conclusion: Isoflurane administered via a membrane oxygenator does not affect O2 uptake or carriage in the blood. RBC surroundings provide significant resistance to DNO in circuit tests. Significant uptake of NO by Oxyglobin supports the potential of HBOCs to scavenge endothelial NO in vivo, causing vasoconstriction.

By undertaking a number of different experimental approaches at the genetic, cellular/ molecular and integrative physiology levels, I investigated functional variation in the Hypoxia-Inducible Factor (HIF) transcription pathway in humans. My studies focused on Tibetan natives. Tibetan highlanders are adapted to life in a hypoxic environment and exhibit distinct physiological traits at high altitude. Recent studies identified positive selection at two genetic loci, EPAS1 (HIF2α) and EGLN1 (PHD2), in Tibetan highlanders and demonstrated an association of EGLN1/EPAS1 genotype with haemoglobin concentration. Both are genes of the HIF pathway, which coordinates an organism’s response to hypoxia. Patients living at sea level with genetic diseases of the HIF pathway have characteristic phenotypes at both the integrative physiology and cellular levels. I investigated whether Tibetans living at sea level also possess distinct phenotypic characteristics, and whether these may be related to underlying variation within the HIF pathway. I compared Tibetans living at sea level with Han Chinese, their most closely-related major ethnic group, and found that Tibetans possess a significantly different integrative physiology phenotype. Tibetans had a lower haemoglobin concentration and haematocrit, a higher pulmonary ventilation relative to metabolism, and blunted pulmonary vascular responses to both acute (minutes) and sustained (8 hours) hypoxia. Regarding genotype- phenotype relationships within the Tibetans, I found a significant correlation between both EPAS1 and EGLN1 genotype and the induction of erythropoietin by systemic hypoxia. At an intermediate cellular level, the relative expression and the hypoxic induction of HIF- regulated genes were significantly lower in peripheral blood lymphocytes from Tibetans compared with Han Chinese. I also investigated whether the genetic variation in EPAS1 selected for in Tibetans may be functional at the molecular level by affecting transcription of EPAS1 in cells and whether certain coding variants in <e,>EGLN1 found in Tibetans affect protein (PHD2) activity in cells and in vitro. A small supplementary study was undertaken in patients with idiopathic erythrocytosis, who have elevated or inappropriately normal erythropoietin levels, to investigate if they have genetic alterations in the HIF system.

The work presented in this thesis is concerned with development of spectroscopic detection methods based on absorption spectroscopy using semiconductor lasers, with particular ref- erence to the field of medical diagnostics through breath analysis. The first part of this thesis deals with the design and testing of a prototype analyser for simultaneous monitoring of the exchange gases O₂ , CO₂ and H₂O in breath. The aim of this analyser is to provide information required to monitor respiration, with potential use in intensive care monitoring or during anaesthesia. The relatively high concentrations of these gases in breath and read- ily available diode laser sources make detection in the near-infrared (NIR) ideal. However, the relatively weakly absorbing A-band O₂ transitions at 760 nm require the application of a sensitive spectroscopic method, cavity enhanced absorption spectroscopy (CEAS). In contrast, CO₂ and H₂O are monitored using direct single pass absorption spectroscopy, with transitions arising from the 2&nu;₁ + &nu;₃ band at 2 &mu;m and &nu;₁ + &nu;₃ band at 1.3 &mu;m, respectively. It has been demonstrated that these gases can be detected simultaneously over a short pathlength (2.74 - 4 cm) in the respiratory flow by combining various spectroscopic methodologies and real-time data analysis. This analyser is shown to offer a viable alter- native for monitoring respiration, exhibiting absolute detection limits of changes of 0.26 % O₂ , 0.02 % CO₂ and 0.003 % H₂O with a 10 ms time resolution, which are comparable to current mass spectrometry based methods, but without their inherent delays. Following this, investigations into the detection of the main gas constituents in breath in the NIR employing noise-reduction modulation based spectroscopic techniques, namely wavelength and frequency modulation (WMS and FMS respectively) are also reported. The described WMS studies on water at 1.37 &mu;m provide a demonstration of conventional WMS detection, as well as a “proof-of-principle” example of a relatively new approach to calibrating the non-absolute information obtained from a WMS absorption signal. Typically WMS spectra are calibrated using mixtures of known gas concentrations or an absolute direct absorption spectrum where possible. In this work however, a self-calibrating method, the phasor decomposition method (PDM), is employed and the returned concentration from this calibration is compared to direct absorption measurement. From this, the calculated concentration using the PDM is found to differ by 9 % from the concentration value obtained by direct absorption, providing an alternative method of calibration for when direct absorption measurements are not possible. The use of FMS in the NIR is also demonstrated as a potential alternative to CEAS for monitoring O₂ at 760 nm. FMS detection is performed on atmospherically broadened O₂ and a time-normalised &alpha;_min(t) of 2.45 ×10⁻⁶ cm⁻¹ s^1/2 is obtained, which is two orders of magnitude less sensitive than the value of &alpha;_min(t) = 2.35 ×10⁻⁸ cm⁻¹ s^1/2 obtained with CEAS. This combined with the experimental requirements of an FMS system, make its use for detection of O₂ a less practicable option compared to CEAS for real-time breath analysis. The latter work in this thesis involves a change in focus to detection of trace gases in breath in the mid-infrared (MIR). The move of spectroscopic detection to the MIR exploits the larger absorption cross-sections available in this region, and to achieve this, a relatively new form of semiconductor laser, the quantum cascade laser (QCL) is used. The design of a continuous wave QCL spectrometer at 8 &mu;m and its operating characteristics are demon- strated and improvements in its performances are also discussed. This QCL system is then utilised to demonstrate the potential of monitoring species in breath, namely the narrow- band absorber methane and the broadband absorber acetone, taking into consideration the potential interference from other absorbing species in breath and the different spectroscopic characteristics exhibited by these molecules. Finally, the potential to further improve the sensitive detection of trace gases in breath in the MIR is also investigated with studies on the use of CEAS and multipass cells. In this work, the molecule of interest is the biomarker OCS, using transitions of the 2&nu;₂ band at 1031 cm⁻¹ , that are probed using a 10 &mu;m QCL. The application of CEAS in the MIR is not as well developed as in the NIR, and the experimental consequences of using optical cavities at these wavelengths, where equipment tends to be more limited, are investigated and sensitivities discussed in the context of other literature. The experimental procedure of optimising a cavity for CEAS using the off-axis alignment method is also studied in detail, as well as the addition of WMS to further improve the signal quality. An effective absorption pathlength of &sim; 100 m was achieved in the cavity, with a bandwidth reduced &alpha;_min(BW) of 1.7 ×10⁻⁷ cm⁻¹ Hz^−1/2 using WMS CEAS achieved. With the poorer quality optics and limitations in equipment in the MIR for CEAS experiments, the use of a multipass cell, a 238 m Herriott cell, is also investigated as an alternative to the use of an optical cavity at 10 &mu;m. Detection of OCS using direct absorption and WMS is demonstrated in the Herriott cell, achieving &alpha;_min(BW) = 2.03×10⁻⁸ cm⁻¹ Hz^−1/2 using WMS. This shows an improvement in sensitivity compared to WMS CEAS, and also shows the potential for future work on biomarker detection, as it approaches the &sim; ppb levels required for breath analysis.