The recognition that supportive mechanical ventilation can also damage the lung, the so called ventilation induced lung injury (VILI), has revived the more than 40 year long debate on the optimal level of PEEP to be used. It is established that the prevention of VILI improves patient outcome and that PEEP exerts protective effects by preventing unstable diseased alveoli from collapsing. Therefore, the term “open lung PEEP” (OL-PEEP) has been introduced as the end-expiratory pressure that keeps the lung open after its collapse has been eliminated by an active lung recruitment manoeuvre. The determination of such an optimal level of PEEP under clinical circumstances is difficult and remains to be investigated. The aim of this study was to investigate the usefulness of breath by breath monitoring of dynamic compliance (Cdyn) as a clinical means to identify OL-PEEP at the bedside and to demonstrate the improvement in lung function resulting from its application. In a porcine lung lavage model of acute lung injury PEEP at maximum Cdyn during a decremental PEEP trial after full lung recruitment was related to the onset of lung collapse and OL-PEEP could be found 2 cmH2O above this level Ventilation at OL-PEEP was associated with improved gas exchange, efficiency of ventilation, lung mechanics and less than 5% collapse on CT scans. In addition, dead space, especially its portion related to alveolar gas changed characteristically during recruitment, PEEP titration and collapse thereby helping to identify OL-PEEP. The beneficial effects of OL-PEEP on lung function and mechanics was demonstrated in a porcine model of VILI. OL-PEEP improved lung function and mechanics when compared to lower or higher levels prior to or after lung recruitment. By using electrical impedance tomography it could be shown that PEEPs within the range of 14 to 22 cmH2O resulted in a similar redistribution of both ventilation and perfusion to the dorsal regions of the lung. OL-PEEP resulted in the best regional and global matching of ventilation and perfusion explaining the drastic improvements in gas exchange. Also regional compliance was greatly improved in the lower half of the lung as compared to all other situations. In ARDS patients OL-PEEP could be identified applying the same protocol. The physiological changes described could now be reproduced and maintained during a four hours study ventilation period in real patients at four study centres. In conclusion, the usefulness of dynamic compliance for identifying open lung PEEP during a decremental PEEP trial was demonstrated under experimental and clinical conditions. This PEEP should then be used as an essential part of any lung protective ventilation strategy. The impact of ventilating ARDS patients according to the principles described in these studies on outcome are currently being evaluated in an international randomized controlled trial.

Magnetic Resonance Electrical Impedance Tomography (MREIT) reconstructs images of electrical conductivity distribution based on magnetic flux density (B) measurements. Magnetic flux density is generated by an externally applied current on the object and measured by a Magnetic Resonance Imaging (MRI) scanner. With the measured data and peripheral voltage measurements, the conductivity distribution of the object can be reconstructed. There are two types of reconstruction algorithms. First type uses current density distributions to reconstruct conductivity distribution. Object must be rotated in MRI scanner to measure three components of magnetic flux density. These types of algorithms are called J-based reconstruction algorithms. The second type of reconstruction algorithms uses only one component of magnetic flux density which is parallel to the main magnetic field of MRI scanner. This eliminates the need of subject rotation. These types of algorithms are called B-based reconstruction algorithms. In this study four of the B-based reconstruction algorithms, proposed by several research groups, are examined. The algorithms are tested by different computer models for noise-free and noisy data. For noise-free data, the algorithms work successfully. System SNR 30, 20 and 13 are used for noisy data. For noisy data the performance of algorithm is not as satisfactory as noise-free data. Twice differentiation of z component of B (Bz) is used for two of the algorithms. These algorithms are very sensitive to noise. One of the algorithms uses only one differentiation of Bz so it is immune to noise. The other algorithm uses sensitivity matrix to reconstruct conductivity distribution.

Magnetic Resonance Electrical Impedance Tomography (MREIT) reconstructs conductivity distribution with internal current density (MRCDI) and boundary voltage measurements. There are many algorithms proposed for the solution of MREIT inverse problem which can be divided into two groups: Current density (J) and magnetic flux density (B) based reconstruction algorithms. In this thesis, J-based MREIT reconstruction algorithms are implemented and optimized with modifications. These algorithms are simulated with five conductivity models which have different geometries and conductivity values. Results of simulation are discussed and reconstruction algorithms are compared according to their performances. Equipotential-Projection algorithm has lower error percentages than other algorithms for noise-free case whereas Hybrid algorithm has the best performance for noisy cases. Although J-substitution and Hybrid algorithms have relatively long reconstruction times, they produced the best images perceptually. v Integration along Cartesian Grid Lines and Integration along Equipotential Lines algorithms diverge as noise level increases. Equipotential-Projection algorithm has erroneous lines starting from corners of FOV especially for noisy cases whereas Solution as a Linear Equation System has a typical grid artifact. When performance with data of experiment 1 is considered, only Solution as a Linear Equation System algorithm partially reconstructed all elements which show that it is robust to noise. Equipotential-Projection algorithm reconstructed resistive element partially and other algorithms failed in reconstruction of conductivity distribution. Experimental results obtained with a higher conductivity contrast show that Solution as a Linear Equation System, J-Substitution and Hybrid algorithms reconstructed both phantom elements and Hybrid algorithm is superior to other algorithms in percentage error comparison.

Electrical conductivity of biological tissues is a distinctive property which differs among tissues. It also varies according to the physiological and pathological state of tissues. Furthermore, in order to solve the bioelectric field problems accurately, electrical conductivity information is essential. Magnetic Resonance Electrical Impedance Tomography (MREIT) technique is proposed to image this information with high spatial resolution. However, almost all MREIT algorithms proposed to date assumes isotropic conductivity in order to simplify the underlying mathematics. But it is known that most of the tissues in human body have anisotropic conductivity values. The aim of this study is to reconstruct anisotropic conductivity images with MREIT. In the study, five novel anisotropic conductivity reconstruction algorithms are developed and implemented. Proposed algorithms are grouped into two: current density based reconstruction algorithms (Type-I) and magnetic flux density based algorithms (Type-II). Performances of the algorithms are evaluated in several aspects and compared with each other. The technique is experimentally realized using 0.15T METU &ndash / EE MRI System and anisotropic conductivity images of test phantoms are reconstructed using all proposed algorithms.

Breast cancer is the most crucial cancer type among all other cancer types. There are many imaging techniques used to screen breast carcinoma. These are mammography, ultrasound, computed tomography, magnetic resonance imaging, infrared imaging, positron emission tomography and electrical impedance tomography. However, there is no gold standard in breast carcinoma diagnosis. The object of this study is to create a hybrid system that uses thermal and electrical imaging methods together for breast cancer diagnosis. Body tissues have different electrical conductivity values depending on their state of health and types. Consequently, one can get information about the anatomy of the human body and tissue&rsquo / s health by imaging tissue conductivity distribution. Due to metabolic heat generation values and thermal characteristics that differ from tissue to tissue, thermal imaging has started to play an important role in medical diagnosis. To increase the temperature contrast in thermal images, the characteristics of the two imaging modalities can be combined. This is achieved by implementing thermal imaging applying electrical currents from the body surface within safety limits (i.e., thermal imaging in active mode). Electrical conductivity of tissues changes with frequency, so it is possible to obtain more than one thermal image for the same body. Combining these images, more detailed information about the tumor tissue can be acquired. This may increase the accuracy in diagnosis while tumor can be detected at deeper locations. Feasibility of the proposed technique is investigated with analytical and numerical simulations and experimental studies. 2-D and 3-D numerical models of the female breast are developed and feasibility work is implemented in the frequency range of 10 kHz and 800 MHz. Temporal and spatial temperature distributions are obtained at desired depths. Thermal body-phantoms are developed to simulate the healthy breast and tumor tissues in experimental studies. Thermograms of these phantoms are obtained using two different infrared cameras (microbolometer uncooled and cooled Quantum Well Infrared Photodetectors). Single and dual tumor tissues are determined using the ratio of uniform (healthy) and inhomogeneous (tumor) images. Single tumor (1 cm away from boundary) causes 55 &deg / mC temperature increase and dual tumor (2 cm away from boundary) leads to 50 &deg / mC temperature contrast. With multi-frequency current application (in the range of 10 kHz-800 MHz), the temperature contrast generated by 3.4 mm3 tumor at 9 mm depth can be detected with the state-of-the-art thermal imagers.

This dissertation focuses on the application of tomography in the sugar milling process, specifically within the vacuum pan. The research aims to improve the efficiency and throughput of a sugar mill by producing real-time images of the boiling dynamic in the pan and hence can be used as a diagnostic tool. The real-time tomography system is a combination of ruggedized data collecting hardware, a switching circuit and software algorithms. The system described in this dissertation uses 16 electrodes and estimates images based on the distinct differences in conductivities to be found in the vacuum pan, i.e. a conductive syrup-like fluid (massecuite) and bubbles. There is a direct correlation between the bubbles produced during the boiling process and heat transfer in the pan. From this correlation one can determine how well the pan is operating. The system has been developed in order to monitor specific parts of a pan for optimal boiling. A binary reconstructed image identifies either massecuite or water vapour. Each image is reconstructed using a modified neighbourhood data collection method and a back projection algorithm. The data collection and image reconstruction take place simultaneously, making it possible to generate images in real-time. Each image frame is reconstructed at approximately 1.1 frames per second. Most of the system was developed in LabVIEW, with some added external drive electronics, and functions seamlessly. The tomography system is LAN enabled hence measurements are initiated through a remote PC on the same network and the reconstructed images are streamed to the user. The laboratory results demonstrate that it is possible to generate tomographic images from bubbles vs massecuite, tap water and deionized water in real-time. / Thesis (M.Sc.Eng.)-University of KwaZulu-Natal, Durban, 2012.

Magnetic resonance imaging (MRI) is a high resolution medical imaging technique based on distinguishing tissues according to their nuclear magnetic properties. Magnetic resonance electrical impedance tomography (MREIT) is a conductivity imaging technique which reconstructs images of electrical properties, based on their effect on induced magnetic flux density due to externally applied current flow. Both of these techniques are of interest for novel research and development. Simulators help researchers observe the accuracy and the results of the study. In this study a user friendly complete MRI/MREIT simulator is designed. This simulator is the combination of improved version of MRI simulator (implemented by V. E. Arpinar, H. Yigitler), a forward solver, to observe the current injection effect, the improved version of user interface that is designed on LabVIEW graphical programming environment (designed by M. Ozsut), and equi-potential projection (EPP) reconstruction algorithm (proposed by M. S. Ozdemir, M. Eyuboglu, O. Ozbek). All of these individual parts are improved and gathered in LabVIEW environment in order to work in synchrony. In addition to that, regional image reconstruction technique (proposed by H. Altunel, M. Eyuboglu) is also included in the simulator. The simulator is run for various inputs and system specifications. It is observed that the simulation results are consistent with the expected results for MRI, MREIT and conventional/regional MREIT reconstruction. Four different models are designed and results are obtained using these models. The accuracy of the results usually differs with the input parameters and model geometry. Validating numerically the accuracy of the forward solution part using Biot-Savart and Ampere&#039 / s laws, the consistency of the forward problem solution part is obtained at a percentage of 95%. In the MREIT part, magnetic flux density distribution taken from forward solver part is added to the main magnetic flux density used in the MRI part. Consistency of the magnetic flux density distribution given to the simulator as input and the output taken from the MREIT part of the simulator is found as 99%. In addition to conventional EPP algorithm, regional MREIT reconstruction algorithm is applied for various noise levels. It is observed that, as the noise level increases, regional MREIT reconstruction algorithm gives relatively much better results compared to conventional MREIT reconstruction algorithm. Errors obtained by applying conventional reconstruction and regional reconstruction are compared for each inhomogeneity individually. Therefore, accuracies of the different current patterns depending on the inhomogeneities are observed as well.

A multi-frequency data acquisition system is realized for subsurface conductivity imaging of biological tissues. The measurement procedures of the system at different frequencies are same. The only difference between the single frequency experiments and the multi-frequency experiments is the hardware, i.e. the sensor and the power amplifier used in the single frequency experiments was different than that were used in the multi-frequency experiments. To avoid confusion the measurement system with which the single frequency experiments were performed is named as prototype system and the measurement system with which the multi-frequency experiments were performed is named as multi-frequency system. This system uses magnetic excitation (primary field) to induce eddy currents inside the conductive object and measures the resulting magnetic field due to eddy currents (secondary field). For this purpose, two differential-coil sensors are constructed / one is for the single frequency measurements and the other is for the multi-frequency measurements. Geometrically the coils are same, the only difference between them is the radius of the wires wound on them. The sensor consists of two differentially connected identical receiver coils employed to measure secondary field and in between the receiver coils is placed a transmitter coil, which creates the primary field. The coils are coaxial. In the prototype system the transmitter coil is driven by a sinusoidal current of 300 mA (peak) at 50 kHz. In the multi-frequency system the transmitter coil is driven by a sinusoidal current of 217 mA (peak), 318 mA (peak), 219 mA (peak) and 211 mA (peak) at 30 kHz, 50 kHz, 60 kHz and 90 kHz, respectively. A data acquisition card (DAcC) is designed and constructed on a printed circuit board (PCB) for phase sensitive detection (PSD). The equivalent input noise voltage of the card was found as $146.80 hspace{0.1 cm}nV$. User interface programs (UIP) are prepared to control the scanning experiments via PC (HP VEE based UIP, LabVIEW based UIP) and to analyze the acquired data (MATLAB based UIP). A novel sensitivity test method employing resistive ring phantoms is developed. A relation between the classical saline solution filled vessel (45mm radius, 10 mm depth) phantoms and the resistive ring phantoms is established. The sensitivity of the prototype system to saline solutions filled vessels is 13.2 $mV/(S/m)$ and to resistive rings is 155.02 mV/Mho while the linearity is 3.96$%$ of the full scale for the saline solution filled vessels and 0.12$%$ of the full scale for the resistive rings. Also the sensitivity of the multi-frequency system is determined at each operation frequency by using resistive ring phantoms. The results are in consistence with the theory stating that the measured signals are linearly proportional with the square of the frequency. The signal to noise ration (SNR) of the prototype system is calculated as 35.44 dB. Also the SNR of the multi-frequency system is calculated at each operation frequency. As expected, the SNR of the system increases as the frequency increases. The system performance is also tested with agar phantoms. Spatial resolution of the prototype system is found 9.36 mm in the point spread function (PSF) sense and 14.4 mm in the line spread function (LSF) sense. Spatial resolution of the multi-frequency system is also found at each operation frequency. The results show that the resolving power of the system to distinguish image details increases as the frequency increases, as expected. Conductivity distributions of the objects are reconstructed using Steepest-Descent algorithm. The geometries and the locations of the reconstructed images match with those of the real images. The image of a living tissue, a leech, is acquired for the first time in the literature. Magnetic conductivity spectroscopy of a biological tissue is shown for the first time in electrical conductivity imaging via contactless measurements. The results show the potential of the methodology for clinical applications.

Introdução: O ângulo de fase (AF), derivado da análise de bioimpedância elétrica (BIA), tem sido interpretado como indicador de integridade da membrana celular; e a dinamometria manual têm sido usados como indicadores de prognóstico em algumas situações clínicas. Objetivos: avaliar o comportamento do AF e da dinamometria manual em pacientes submetidos à cirurgia cardíaca e associá-los com EuroSCORE e desfechos clínicos. Métodos: Estudo de coorte prospectivo com 50 pacientes submetidos à cirurgia cardíaca, com idade ≥18 anos, entre janeiro de 2015 e outubro de 2015. O AF e a dinamometria manual foram aferidos em três momentos: pré-operatório, pré-alta hospitalar e três meses após à cirurgia. Também foram coletadas as seguintes variáveis: tempo de circulação extracorpórea (CEC), isquemia, ventilação mecânica (VM), tempo de internação na Unidade de Terapia Intensiva (UTI) e tempo de internação hospitalar após à cirurgia e foi calculado o EuroSCORE. Resultados: Os pacientes foram de predominância do sexo masculino 32 (64%) com idade média de 62,8 ± 10,2 anos, tempo de estadia na UTI de 3 dias (2 – 23), tempo de internação pré-operatória de 7 (5 – 61) dias e EuroSCORE 4 (0 – 10) dias. Houve redução do AF, com diferença entre o período pré-operatório e os dois momentos de avaliação no pós-operatório (p<0,001). Quando a dinamometria manual foi avaliada ao longo do tempo foi observada uma redução entre o préoperatório e a pré-alta hospitalar (p<0,001) e recuperação dessa nos três meses após à cirurgia (p<0,001). A VM e o EuroSCORE tiveram correlação inversa com o AF e a dinamometria manual nos três momentos. A correlação do AF no período pré-operatório do EuroScore p=0,007 e o segundo e o terceiro momento p<0,001, e para os três momentos da VM (p<0,001), respectivamente. Já a correlação da dinamometria manual no primeiro e no segundo momento com o EuroSCORE e a VM p <0,001 e no terceiro momento p=0,010 e p=0,018, respectivamente. Conclusões: O AF e a dinamometria manual parecem estar associados ao tempo de VM, tempo de internação na UTI e tempo de internação no pós-operatório em pacientes submetidos à cirurgia cardíaca. / Background and aims: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), have been interpreted as cell membrane integrity indicator; and the handgrip strength (HGS) have been used as prognostic indicators in some clinical situations. This study aims to evaluate the PA and HGS behavior in patients undergoing cardiac surgery and associate these with clinical outcomes and prognostic. Methods: Cohort prospective study of consecutive recruited patients undergoing cardiac surgery aged ≥18 years. The PA and HGS were measured at three set points: preoperatively, hospital predischarge and three months after surgery. Were also collected: time of cardiopulmonary bypass (CPB), ischemia, mechanical ventilation (MV), length of stay (LOS) in Intensive Care Unit (ICU) and LOS after surgery and calculated the EuroSCORE. Results: A decrease in PA was observed between the preoperative and the two postoperative stages (p<0.001). When the HGS was evaluated over time was seen a reduction between preoperative and predischarge (p<0.001) and a recovery in three months after surgery (p<0.001). The MV and EuroSCORE had an inverse association with PA and HGS in three stages. PA correlation in the first stage of the EuroSCORE p=0.007 and the second and third stage p<0.001, and for the three stages of MV (p<0.001), respectively. In HGS correlation in the first and second stage of the EuroSCORE and MV p<0,001 and in the third stage p=0.010 and p=0.018, respectively. Conclusion: PA and HGS appears to be related to MV time, LOS in ICU and LOS after surgery in patients undergoing cardiac surgery.

Orientador: Carlos Frederico de Oliveira Graeff / Banca: Ivo Alexandre Hummelgen / Banca: Luis Vicente de Andrade Scalvi / O Programa de Pós Graduação em Ciência e Tecnologia de Materiais, POSMAT, tem caráter institucional e integra as atividades de pesquisa em materiais em diversos campi / Resumo: Efeitos de campo magnético em materiais e dispositivos orgânicos não-magnéticos vêm sendo foco de grande destaque na comunidade científica. De maneira a melhor compreender tais fenômenos, este trabalho propôs-se à implementação das técnicas de Espectroscopia de impedância elétrica em correntes alternadad (EIE-AC) na Presença de Campo Magnético e de Ressonância Magnética Detectada Eletricamente (RMDE). Para a montagem dessas técnicas foram utilizados instrumentos convencionais disponiveis no laboratório e as suas arquiteturas foram planejadas para permitir a utilização desses instrumentos em outros sistemas de medida. Programas na plataforma Agilent Vee Pro 9.2 foram desenvolvidos para o controle e aquisição dos dados das medições. A validação do sistema de EIE-AC na Presença de Campo Magnético foi efetuada a partir de medidas em circuitos básicos e num diodo orgânico emissor de luz (OLED) à base da molécula de Alq3, o qual era sabido que este apresentava o efeito de magnetoresistência. A influência do campo magnético sobre o comportamento das impedâncias do OLED de medida só foi percebida significativamente a partir da aplicação de tensões contínuas acima de 4 V, as quais condicionavam o OLED em seu estado emissivo. O fenômeno de Magneto-Impedância foi verificado nessa amostra, sendo que os efeitos mais expressivos ocorreram nas impedâncias imaginárias e para a frequencia em torno de 20Hz. Um segundo efeito de campo magnético de longo prazo de ação sobre o comportamento da impedância da amostra também foi verificado e discutido. Dentre os mecanismos físicos que podem explicar os efeitos observados no OLED, destacam-se os processos de recombinação de carga, o aprisionamento de cargas em defeitos e a ocorrência de polarização magnética das moléculas constituintes do OLED / Abstract: Magnetic Field Effects on non-magnetic organic materials and device have attracted the attention of the scientific community. In order to elucidate those phenomena, this work proposes the implantation of two advanced characterization techniques: Electrical Impedance Spectroscopy in Alternating Current (EIS-AC) in the presence of magnetic field; and electrically detected magnetic resonance (EDMR). Both techniques were implemented using conventional laboratory instruments. Computational routiness were developed with Agilent Vee Pro 9.2 in order to control and acquire data from the measuring instruments. the validation f eIS-AC system was performed by using basic electrical circuits and an Organic Light Emiting Diode (OLED) based in Alq3 molecule, which has the magnetoresistance effect. The magnetic field effects over impedances were only detected when the applied continuous voltage was above 4 V, from which the OLED is in its emiting state. The Magneto-Impedance phenomenon was evidenced in this sample mainly in the imaginary impedances and for frequencies around 20 Hz. A second magnetic field effect, with long time term action over the impedance behavior, was also verified and discussed. Among the possible physical mechanisms behind the magnetic effects, charge recombination process, charge trapping by deffects, and the magnetic polarization of the OLED active molecules are discussed / Mestre