Laser Doppler anemometer measurements of pulsatile flow in a model carotid bifurcation

Hemodynamics at the human carotid bifurcation is important to the understanding of atherosclerotic plaque initiation and progression as well as to the diagnosis of clinically important disease. Laser Doppler anemometry was performed in a large scale model of an average human carotid. Pulsatile waveforms and physiologic flow divisions were incorporated. Disturbance levels and shear stresses were computed from ensemble averages of the velocity waveform measurements. Flow in the common carotid was laminar and symmetric. Flow patterns in the sinus, however, were complex and varied considerably during the cycle. Strong helical patterns and outer wall flow separation waxed and waned during each systole. The changing flow patterns resulted in an oscillatory shear stress at the outer wall ranging from -13 to 9 dyn cm-2 during systole with a time-averaged mean of only -0.5 dyn cm-2. This contrasts markedly with an inner wall shear stress range of 17-50, (mean 26) dyn cm-2. The region of transient separation was confined to the carotid sinus outer wall with no reverse velocities detected in the distal internal carotid. Notable disturbance velocities were also time-dependent, occurring only during the deceleration phase of systole and the beginning of diastole. The present pulsatile flow studies have aided in identifying hemodynamic conditions which correlate with early intimal thickening and predict the physiologic level of flow disturbances in the bulb of undiseased internal carotid arteries.     

Evaluation of mammary blood flow measurements in lactating goats using the ultrasound Doppler principle

1. Non-invasive methods were developed for measuring mammary blood flow in lactating goats. 2. A Doppler principle ultrasound device was equipped with an external detector measuring maximal blood velocity (Vmax) and average blood velocity (Vav) was calculated as Vmax/2. Volume flow then depended on determination of the angle of insonation and the cross-sectional area of the milk vein (the caudal superficial epigastric or subcutaneous abdominal vein). 3. Blood velocities were measured on the milk vein of either side of the animal while clamping the pudendal veins manually. Blood velocities ranged from 7-34 cm/sec. 4. The milk vein diameter was measured by means of a slide gauge which, for clearly protruding veins, gave similar results to that measured by ultrasound scanning. In protruding veins the cross-section was circular. In non-protruding veins the cross-section was elliptical and the slide gauge significantly (P less than 0.01) overestimated the cross-sectional area. The milk vein diameter of either side measured in 10 lactating goats was 8.8 +/- 1.1 mm (means +/- SD). 5. Blood flow ranged from 90-675 ml/min in a dry and a high-yielding (3.4 l milk daily) goat, respectively. The reproducibility of the blood flow measurements was 12-16%. 6. It is concluded that the present method may be used for quantitative measurements of mammary blood flow in goats.     

Calf blood flow and posture: Doppler ultrasound measurements during and after exercise.

To investigate the joint effects of body posture and calf muscle pump, the calf blood flow of eight healthy volunteers was measured with pulsed Doppler equipment during and after 3 min of rhythmic exercise on a calf ergometer in the supine, sitting, and standing postures. Muscle contractions seriously impeded calf blood flow. Consequently, blood flow occurred mainly between contractions and reached a plateau that lasted at least the final 100 s of each exercise series. After exercise the blood flow decreased much faster in the sitting and standing postures than in the supine posture. There was no difference in blood flow between various postures during the same submaximal exercise. However, subjects in the standing posture were able to perform exercise with a higher load than in the supine posture, and blood flow in the standing posture could become twice as high as in the supine posture. We conclude that calf blood flow is regulated according to needs; available perfusion pressure determined maximal blood flow and exercise; and compared with the supine posture, the standing posture and calf muscle pump increase the perfusion pressure.     

Laser Doppler flowmeter monitoring of free-tissue transfers: blood flow in normal and complicated cases

In this article, laser Doppler flowmeter (LDF) monitoring of blood flow in 94 free flaps is summarized. Seventy-six patients had uneventful postoperative courses, and 18 patients developed postoperative complications, with a salvage rate of 88 percent. Except for one case, the flowmeter identified developing complications before clear clinical indices appeared, and in two cases it was the only indication of vascular compromise of the flap. On the basis of the data obtained, the ranges of absolute flow values in different types of uncomplicated flaps are reported, along with their temporal pattern of flow. Decrease inflow pattern may be an early indicator of a developing perfusion disturbance. On the basis of LDF readings, the following classifications of free-flap blood flow are suggested. (1) If the flow is within or slightly above the established range, then normal diligence in observation is justified. If the flow is well above the normal range, artifacts that could falsely elevate readings should be investigated. (2) If the flow is somewhat below the established range, then a modest increase in observation is warranted (alert level 1). (3) If the relative flow falls to 50 percent of the initial flow of that flap and remains at that level for 30 minutes or longer, then more aggressive flap observation is indicated (alert level 2). (4) If the flow is below 0.4 LDF units for 30 minutes, then aggressive clinical observation should be performed (alert level 3, or "red alert") and exploration should be strongly considered.Falsely elevated measurements can be caused by vibration, motion of the probe or tissue, or location of the probe over a macroscopic blood vessel. False low readings are quite rare but can result from partial probe detachment from the flap or coagulum accumulating on the probe. Once artifacts are ruled out, LDF readings have a high level of credibility and, in the authors' experience, significantly improve salvage rates.     

The resolution of the ultrasound pulsed Doppler for blood velocity measurements

Pulsed ultrasound Doppler velocity meters (PUDVM) permit noninvasive blood velocity measurements. The emitted ultrasound beam characteristics primarily determine the resolution of the instrument when recording velocity profiles. The sample volume, the small region over which velocity information data are detected, was found to be > 2·3 mm³ depending on the transducer disk dia., distance in front of the disk, sampling time increment, and pulse length. The shape of the sample volume approximates a cylinder in the near field and a frustrum of a cone in the far field. The end surfaces of the sample volume were affected by the emitted pulse shape. Ultrasonic beam cross-sections were found to be smaller than predicted by theory due to the finite threshold levels of the PUDVM. The variation of the sample volume with range was illustrated by steady laminar flow velocity profile measurements in rigid tubes. The accuracy of velocity measurements was within 5 per cent with slightly larger deviations occurring near the walls due to the finite sample volume.     

Transrectal Doppler sonography of uterine blood flow

Transrectal Doppler ultrasound was used for the noninvasive investigation of uterine blood flow in cows. Both the left and right Aa. uterinae were scanned to obtain blood flow velocity waveforms over 2 consecutive estrous cycles. Blood flow was reflected by the resistance index (RI) and the time-averaged maximum velocity (TAMV). Intra-observer reproducibility of Doppler measurements was evaluated. The intra-class correlation coefficient (Intra-CC) was 0.97 for the RI and 0.95 for TAMV. While RI values did not differ between the left and right A. uterina (P > 0.05), differences in TAMV occurred between both vessels in 2 cows. These differences were not related to the ovary bearing the dominant follicle or to the corpus luteum (P < 0.001). As in all cows, changes of RI and TAMV values between the left and right artery during the estrous cycle were correlated (correlation coefficient r > 0.72; P < 0.0001); the mean values of both sides were used for subsequent analyses. Variance component estimates for the effect of cow on RI and TAMV were 8 and 13% and for the influence of day of estrous cycle they were 70 and 47%, respectively (P <0.0001). Between estrous cycles no significant differences could be measured within cows (P > 0.05). The highest RI and lowest TAMV values occurred on Day 0 (= day of ovulation) and Day 1, while the lowest RI and highest TAMV values were measured between Days -3 and -1 of the estrous cycle, respectively. There was a positive correlation between TAMV and estrogen concentrations and a negative correlation between RI and plasma estrogen levels. Plasma progesterone levels and TAMV were negatively correlated, but no correlation could be measured (P > 0.05) between RI values and plasma progesterone concentrations. While there were no differences in plasma concentrations of estrogens and progesterone between estrous cycles within cows, the levels of these hormones differed between cows. The results show that transrectal Doppler sonography is a useful, noninvasive method for examining uterine blood flows in cows. If there is an influence of uterine perfusion on fertility in cows its role needs further investigation.     

Localized real time blood flow measurements

A novel method for real time, localized, flow measurements is applied to blood flow in human fingers. Results for arterial and venous flow in normal subjects and patients with abnormal blood circulation are presented. Effects of blood flow regulation by the autonomic nervous system have been observed. Stricture of the digital arteries could be clearly demonstrated in a patient with Raynaud's phenomenon. Experimental signals due to pulsatile flow in a model system can be simulated in a quantitative way. The calibration, however, depends on the actual spin-spin relaxation time and the shape of the pulsatile flow vs. time curve. Due to these limitations, the volume flow rate can be measured with a relative error of approximately +/- 25%.     

De novo adipogenesis for reconstructive surgery

Autografting of lost soft tissue is an important subject of the plastic and reconstructive surgery and autograft of fat pads has been only technique for this goal. However, the results are disappointing because of absorption of the grafts with time. Adipoblasts or adipocyte precursor cells distribute widely in connective tissues and they can proliferate and mature into adipocytes even in the adult body. In experiments using mice, we found that de novo adipogenesis of endogenous precursor cells can be induced by injecting reconstituted basement membrane, Matrigel, supplemented with more than 1 ng/ml of bFGF. This adipogenesis was reproducibly induced by subcutaneous injection over the chest, lateral abdomen or head. Adipogenesis was induced even in ear cartilage or in muscle. To evaluate the possibility of future application of this de novo adipogenesis to plastic and reconstructive surgery, we have reviewed updated knowledge of the adipogenesis. This revised version was published online in August 2006 with corrections to the Cover Date.     

Reduction of cutaneous blood flow in cold fingers

Blood flow to fingers is reduced during cold exposure. This is generally attributed to vasoconstriction. We tested the hypothesis that increased blood viscosity, not vasoconstriction, accounts for reductions of cutaneous flow after fingers cool. Blood viscosity was higher at 10 degree C than at 27 degree C and independent of hematocrit at low shear rates. The increase of finger vascular resistance may be due to increased vascular hindrance early in cold exposure (< 15 min) and is more likely due to increased viscosity after 20-30 min, a factor that may dominate the peripheral microcirculaton during prolonged cold exposure.     

A laser Doppler scanner for imaging blood flow in skin

This paper describes a novel medical instrument that produces an image of blood flow in the capillaries under the skin surface. A laser beam is used to detect blood cell motion from the Doppler broadening of the laser light scattered from the skin. The image is generated by scanning the laser beam in a raster. The design of a practical clinical instrument is outlined and some preliminary results are presented.     

Laser anemometry measurements of pulsatile flow past aortic valve prostheses

Experimental results are presented on physiological pulsatile flow past caged ball and tilting disc aortic valve prostheses mounted in an axisymmetric chamber incorporated in a mock circulatory system. The measurements of velocity profiles and turbulent normal stresses during several times in a cardiac cycle were obtained using laser-Doppler anemometry. Our results show that with increased angle of opening for the tilting disc valves, a large but locally confined vortex is observed along the wall in the minor flow region throughout most of the cardiac cycle. The turbulent normal stresses measured downstream to the tilting disc in the minor flow region parallel to the tilt axis were found to be larger than those measured downstream to the caged ball valves. Comparison of measurements with steady flow at flow rates comparable to peak pulsatile flow rate show that the turbulent normal stresses are larger by a factor of two in pulsatile flow with a frequency of 1.2 Hz.     

Influence of blood flow on cutaneous permeability to inert gas

A thermally regulated Plexiglas chamber was designed for investigation of transcutaneous diffusion of N2 and helium (He) in the human hand. Influence of cutaneous blood flow in this process was studied simultaneously with gas diffusion measurements. Changes in cutaneous blood flow (Q, in ml X min-1 X 100 ml tissue-1) were effected by altering ambient temperature (T) from 20 to 40 degrees C (Q = 0.08 X 100.07T). We found that the rate of inert gas diffusion through human skin, expressed as conductance (G, in ml STPD X h-1 X m-2 X atm-1), increases exponentially as a function of blood flow, and was indistinguishable between He and N2 (G = 21.19 X 100.0124Q). The permeability, diffusion coefficient per unit diffusion distance (D/h, in cm/h), also rose exponentially as a function of blood flow. But permeability for He (D/h = 0.1748 X 100.0203Q) was greater than that for N2 (D/h = 0.1678 X 100.0114Q). As cutaneous blood flow rises, because of increased temperature, the apparent diffusion distance falls linearly for both N2 and He. The change is more prominent for He than for N2 diffusion. Estimated replacement time for the body stores of N2 by transcutaneous diffusion alone was shortened from 26.8 h at 31 degrees C to 15.1 h at 37 degrees C. It is suggested from this study that beneficial results may be derived during decompression procedure 1) by maintaining an appropriate transcutaneous pressure gradient of inert gases, and 2) by elevating ambient temperature.