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abstract: Objective: Examine cardiovascular response to OMT via central and peripheral measurements. Methods: Central and peripheral cardiovascular signals of asymptomatic human subjects were monitored during a procedure with alternating rest and active phases. Active phases included systemic perturbations and application of controlled vertebral pressure (OMT) by an experienced osteopathic physician. Pulse plethysmograph and laser Doppler flow sensors measured peripheral flow from index and middle fingers bilaterally. A three-lead EKG monitored cardiac activity. The biosignals were recorded continuously, in real time, and analyzed in time and frequency domains. Results from the control group (n=11), without OMT, and active group (n=16), with OMT, were compared. Peripheral (n=5) and central responders (n=6), subsets of the active group showing stronger peripheral or central response, were examined. In an additional effort, a modified clinical device recorded spectral Doppler ultrasound signals of the radial and dorsalis pedis arteries of clinically asymptomatic human subjects. Controlled physiologic provocations (limb occlusion and elevation), were performed. Time domain and spectral analyses were completed. Results: In the human subject study, the time wave characteristics and spectral analysis resulted in similar trends. Peripheral blood flow attenuated in the control group over time, while it was maintained in the active group, and increased specifically during OMT in the responder groups. Heart rate remained around 65 BPM in the control group, fluctuated between 64-68 BPM in the active group, and dropped 4 and 3 BPM in the peripheral and central responder groups, respectively. The effect in the OMT group was statistically significant compared to no-OMT, however, was not statistically significant within-groups. For the preliminary spectral ultrasound Doppler study, segmental flow was successfully monitored. A prototype "Quick Assessment" tool was developed, providing instant post-processing results for clinical use. Conclusions: OMT along the vertebral column may influence autonomic processes that regulate heart rate and peripheral vascular flow. / Dissertation/Thesis / Masters Thesis Bioengineering 2014

Made available in DSpace on 2014-10-09T12:52:32Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:02:37Z (GMT). No. of bitstreams: 0 / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Les fluctuations du taux de dégagement de chaleur sont souvent responsables d’intensification des flux thermiques aux parois, de vibrations et d’émissions sonores qui peuvent éventuellement dégénérer en instabilités thermo-acoustiques auto-entretenues. Ces phénomènes instationnaires dégradent les performances des foyers, provoquent un vieillissement prématuré de certains éléments de la chambre de combustion, voire des dégâts plus importants sur l’installation. Ces perturbations sont cependant difficiles à mesurer dans les foyers car il n’existe pas de diagnostic qui permette d'accéder directement au taux de dégagement de chaleur. L’objectif de ce travail est d'explorer deux alternatives aux solutions existantes pour accéder aux fluctuations du taux de dégagement de chaleur avec une bonne résolution temporelle. Ces nouvelles méthodes sont testées dans des configurations génériques parfaitement prémélangées pour des écoulements laminaires. La première méthode est une technique acoustique, qui repose sur la détermination du temps de vol d’ondes ultrasonores qui traversent l’écoulement. Les fluctuations du temps de vol de ces ondes sont utilisées pour détecter des perturbations de la largeur des gaz brûlés le long du chemin acoustique. Cette information permet de reconstituer les fluctuations du taux de dégagement de chaleur dans des flammes prémélangées. Les premières validations de cette méthode sont présentées pour des flammes en l'absence de perturbation externe lorsqu'elles présentent une instabilité de type Kelvin-Helmholtz pilotée par les phénomènes de flottabilité du panache des gaz brûlés. Des mesures sont ensuite conduites pour des flammes soumises à des modulations harmoniques de l'écoulement. Les données obtenues dans ces configurations sont comparées à des mesures optiques ainsi qu'à des prévisions analytiques. La seconde méthode est une technique optique utilisant un système d’interférométrie laser Doppler permettant de déterminer les fluctuations de densité intégrées le long du chemin optique. On montre dans un premier temps que les perturbations de densité sont principalement causées par des fluctuations du taux de dégagement de chaleur lorsque les flammes sont confinées. Un lien est établi pour reconstituer les perturbations du taux de dégagement de chaleur exploitant le signal de l'interféromètre. La technique est validée pour des flammes pulsées pour différentes richesses et débits. Les données obtenues sont comparées à des mesures reposant sur la chimiluminescence de la flamme. Un bon accord est obtenu pour des modulations harmoniques de l'écoulement à différentes fréquences et niveaux de perturbation. Ce travail permet de valider le principe de ces deux techniques pour détecter les perturbations du taux de dégagement de chaleur lorsque l'accès optique à la zone de combustion est réduit et lorsque des informations quantitatives résolues temporellement sont nécessaires. / Heat release rate disturbances are the sources of additional thermal stresses, direct and indirect combustion noise and undesirable vibrations. In extreme cases, these perturbations may even cause destructive combustion instabilities. These quantities are difficult to measure in practical burners. The objective of this work is to develop two alternative diagnostics to measure heat release rate fluctuations in unsteady flames. These techniques are validated in generic configurations for perfectly premixed laminar flames. The first method is an acoustic technique, which is based on the measurement of the travel time of ultrasonic waves through the flames. Fluctuations of the sound propagation time transmission through unsteady flames are used to estimate perturbations in the burned gases width along the acoustic path. This information is then used to reconstruct heat release rate fluctuations. This technique is validated in the cases of unstable laminar premixed flames driven by buoyancy forces and for flames submitted to harmonic flow velocity modulations. Analytical expressions are derived linking fluctuations in heat release rate and disturbances of the sound travel time. Measurements made with this acoustic technique are compared with optical detections based on the flame chemiluminescence and with predictions from an analytical model. Good agreements are obtained between these different methods validating the proposed technique. The second method envisaged is an optical technique based on a Laser Interferometric Vibrometer used to measure integrated density perturbations along the optical path of a laser beam. It is shown that density disturbances along this path result mainly from heat release rate fluctuations when the flames are confined. A link is established to reconstruct heat release rate disturbances from the signal of the interferometer. The technique is validated in the case of pulsated laminar premixed flames. Measurements are compared to line-of-sight integrated chemiluminescence emission measurements. A good agreement is obtained for harmonic flow modulations at different forcing frequencies and perturbation levels for flames operating at different flow conditions. This work validates the principle of this alternative technique for detecting heat release rate perturbations.

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Made available in DSpace on 2014-10-09T12:52:32Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:02:37Z (GMT). No. of bitstreams: 0 / Queimaduras severas causam trauma às vítimas, pela perda de líquido corpóreo, injúria no sistema vascular cutâneo e demora na cicatrização das lesões. A irradiação com laser em baixa intensidade vem sendo estudada como tratamento alternativo, por ser uma terapia não-invasiva e capaz de acelerar o processo de cicatrização. O objetivo deste estudo foi avaliar os efeitos do laser de baixa potência (λ = 660 nm) em queimaduras de pele por histomorfometria e fluxometria laser Doppler utilizando duas condições de irradiação. Trinta e seis animais com duas queimaduras criadas por vapor foram divididos em três grupos: no grupo dose fracionada (GF), as lesões foram irradiadas com dose de 1 J/cm2 nos dias 1, 3, 8 e 10; no grupo dose única (GU), as lesões foram irradiadas com dose de 4 J/cm2 no dia 1. O grupo controle (GC) não foi irradiado. O fluxo sanguíneo foi monitorado nos dias 3, 8, 10, 15 e 21 e três animais por grupo foram sacrificados nestes momentos. Os grupos irradiados mostraram um pico de vasos neoformados no dia 15, enquanto que o pico do GC foi no dia 21. O número de vasos no GC foi significantemente maior que GF e GU no dia 21. Com relação ao fluxo sangüíneo, os grupos irradiados mostraram um valor mais alto que o controle no dia 8, porém, sem diferenças significantes entre os grupos. Estes achados sugerem que o laser acelera a cicatrização de queimaduras, porém, sem diferenças significativas entre as doses estudadas. / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Made available in DSpace on 2014-10-09T12:54:09Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:09:14Z (GMT). No. of bitstreams: 1 12700.pdf: 3254214 bytes, checksum: 3ca272c1fec4a2ef9d9cc0005e976dc4 (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP; Faculdade de Odontologia, Universidade de Sao Paulo , Sao Paulo

Alterações celulares e neurovasculares na polpa têm sido relacionadas a forças ortodónticas, usadas na movimentação dentária. As alterações observadas são geralmente relacionadas a alterações vasculares na polpa. Os primeiros estudos sobre alterações do fluxo sangüíneo pulpar (FSP) durante a movimentação dentária foram realizados usando técnicas qualitativas (e. g., cortes histológicos), e quantitativas (e. g., micro-esferas radioativas ou fluorescentes, radioespirometria). Tais técnicas são invasivas, destrutivas e não permitem o estudo de alterações dinâmicas do fluxo. Recentemente a fluxometria laser Doppler (FLD), uma técnica não invasiva, tem sido usada no estudo de alterações dinâmicas do FSP em humanos em condições próximas às reais. Mas os estudos disponíveis na literatura, usando a FLD, ainda são limitados a movimentos experimentais, pois ainda existem limitações práticas na FLD. O objetivo desta pesquisa foi, usando a FLD, estudar alterações do FSP de voluntários submetidos a duas fases de um tratamento ortodôntico corrente (nivelamento e retração), dentro de condições clinicas reais. Doze voluntários foram monitorados durante a fase de nivelamento e treze voluntários foram monitorados durante a fase de retração, antes da aplicação de forças, 20 minutos, 48h, 72h e 1 mês depois de aplicadas as forças. Analisando os resultados obtidos, durante as duas fases estudas foram encontradas evidências estatísticas suficientes para inferir que ocorrem alterações significativas no FSP, quando medidas via FLD, durante os movimentos e forças estudadas, nos seguintes momentos investigados: diminuição do FSP nos momentos 20 minutos, 48h e 72h. Durante o nivelamento, no dia 30 o FSP é próximo ou igual ao basal. Durante a retração, no dia 30 o fluxo ainda permanece diminuído. / Cellular and neurovascular changes in the pulp have been related to orthodontic forces, used to produce a dental movement. The observed alterations are generally related to pulpal vascular changes. Earlier studies on pulpal blood flow (PBF) changes during the dental movement were carried out by using qualitative techniques (e. g., histological slices), and quantitative (e. g., radioactive or fluorescent microspheres, radiospirometry). Such techniques are invasive, destructive, and do not allow dynamic flow changes to be studied. Recently the laser Doppler flowmetry (LDF), a non-invasive technique, has been used to study dynamic PBF alterations in humans into nearly real conditions. The available studies in the literature, by using the LDF, are limited to experimental studies, probably due to the LDF practical limitations. The aim of this work was, by using the FDF, to study PBF alterations from volunteers subjected to two phases of a current orthodontic treatment (leveling and retraction), into real clinical conditions. Twelve volunteers were monitored during the leveling phase and thirteen volunteers were monitored during the retraction phase, before the force to be applied, and 20 minutes, 48 hr, 72 hr and 1 month later. Analyzing the obtained results, during the two studied phases, it were found suffice statistical evidences to infer that significant PBF decrease occurs on the investigates moments: 20 minutes, 48 hr and 72 hr. During the leveling phase, on day 30, the PBF is near or equal to the basal level. During the retraction, on day 30, the flow is still decreased.

Abstract This thesis describes the laser Doppler technique based on a self-mixing effect in a diode laser to noninvasive cardiovascular pulse detection in a human wrist above the radial artery. The main applications of self-mixing interferometry described in this thesis in addition to pulse detection are arterial pulse shape and autonomic regulation measurements. The elastic properties of the arterial wall are evaluated and compared to pulse wave velocity variation at different pressure conditions inside the radial artery. The main advantages of self-mixing interferometry compared to conventional interferometers are that the measurement set up is simple, because basically only one optical component, the laser diode, is needed. The use of fewer components decreases the price of the device, thus making it inexpensive to use. Moreover, an interferometer can be implemented in a small size and it is easy to control because only one optical axis has to be adjusted. In addition, an accuracy, which corresponds to half of the wavelength of the light source, can be achieved. These benefits make this technique interesting for application to the measurement of different parameters of the cardiovascular pulse. In this thesis, measurement of three different parameters from cardiovascular pulsation in the wrist is studied. The first study considers arterial pulse shape measurement. It was found that an arterial pulse shape reconstructed from the Doppler signal correlates well to the pulse shape of a blood pressure pulse measured with a commercial photoplethysmograph. The second study considers measurement of autonomic regulation using the Doppler technique. It was found that the baroreflex part of autonomic regulation can be measured from the displacement of the arterial wall, which is affected by blood pressure variation inside the artery. In the third study, self-mixing interferometry is superimposed to evaluate the elastic properties of the arterial wall. It was found that the elastic modulus of the arterial wall increases as blood pressure increases. Correlations between measurements and theoretical values were found but deviation in measured values was large. It was noticed that the elastic modulus of the arterial wall and pulse wave velocity behave similarly as a function of blood pressure. When the arterial pressure increases, both the elastic modulus and pulse wave velocity reach higher values than in lower pressure.

The cerebral microcirculation consists of a complex network of small blood vessels that support nerve cells with oxygen and nutrition. The blood flow and oxygen delivery in the microcirculatory blood vessels are regulated through mechanisms which may be influenced or impaired by disease or brain damage resulting from conditions such as brain tumors, traumatic brain injury or subarachnoid hemorrhage (SAH). Monitoring of parameters relating to the microvascular circulation is therefore needed in the clinical setting. Optical techniques such as diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) are capable of estimating the oxygen saturation (SO2) and tracking the microvascular blood flow (perfusion) using a fiber optic probe. This thesis presents the work carried out to adapt DRS and LDF for monitoring cerebral microcirculation in the human brain. A method for real-time estimation of SO2 in brain tissue was developed based on the P3 approximation of diffuse light transport and quadratic polynomial fit to the measured DRS signal. A custom-made fiberoptic probe was constructed for measurements during tumor surgery and in neurointensive care. Software modules with specific user interface for LDF and DRS were programmed to process, record and present parameters such as perfusion, total backscattered light, heart rate, pulsatility index, blood fraction and SO2 from acquired signals. The systems were evaluated on skin, and experimentally by using optical phantoms with properties mimicking brain tissue. The oxygen pressure (pO2) in the phantoms was regulated to track spectroscopic changes coupled with the level of SO2. Clinical evaluation was performed during intraoperative measurements during tumor surgery (n = 10) and stereotactic deep brain stimulation implantations (n = 20). The LDF and DRS systems were also successfully assessed in the neurointensive care unit for a patient treated for SAH. The cerebral autoregulation was studied by relating the parameters from the optical systems to signals from the standard monitoring equipment in neurointensive care. In summary, the presented work takes DRS and LDF one step further toward clinical use for optical monitoring of cerebral microcirculation.