Peristaltic transport of a solid bolus

An analysis of the peristaltic propulsion of a solid spherical bolus enclosed in a contractile membrane is presented. The model is based on in vitro preparations of intestinal segments, and utilizes a simplified representation of the mechanical properties of the muscular coats of the wall. The sequence of deformed configurations of the membrane and the displacement of the bolus are obtained by numerical solution of the model equations. The analysis presented in this paper could be useful for other studies in biomechanics (e.g. uterine contraction and motion of red blood cells in narrow capillaries).     

Intestinal propulsion of a solid non-deformable bolus

A mathematical model of a segment of the gut with an enclosed pellet is constructed. The gut is represented as a thin deformable soft biological shell with the pellet modeled as a non-deformable solid. Mechanical properties of the gut wall were represented as longitudinal and circular smooth muscle layers embedded in stroma that satisfies the general type of nonlinear orthotropy. Deformations of the wall are finite. Bolus propulsion is numerically simulated by generation and propagation of an electromechanical wave along the syncytia. Pharmacological manipulation is applied to model 5-HT type 3 antagonist (Lotronex, GlaxoSmithKline) and 5-HT type 4 agonist (Zelnorm, Novartis, AB) drugs on the dynamics of bolus progression. The results lead to new quantitative insights into the complex spatio-temporal patterns of gastrointestinal transit. It is demonstrated that the reciprocal relationship in contraction of the longitudinal and circular smooth muscle syncytia is necessary to provide the "mixing" type of movements during the preparatory phase of propulsion. Strong simultaneous contractions of the both smooth muscle layers are required to expel the "mixed" pellet from the segment. The model is implemented as an interactive software system, Gut Discovery(www.aincompany.com), and accurately predicts the effects of drugs on gut motility.     

Cytochalasin B: preparation, analysis in tissue extracts, and pharmacokinetics after intraperitoneal bolus administration in mice

Cytochalasin B (CB) was prepared by methanol extraction of dehydrated mold (Drechslera dematioidea) matte, reverse-phase C18 silica gel batch adsorption, selective elution with 1:1 (v/v) hexane:tetrahydrofuran (THF), crystallization, preparative TLC, and recrystallization. Unit gravity silica gel normal phase chromatography afforded additional CB. Yield per liter of medium was 300 mg of CB greater than 95% pure by NMR, HPLC (60:40 hexane:THF, Lichrosorb Si60 silica gel, 230 nm), and TLC. CB added exogenously to mouse organs at 1 and 5 micrograms/organ was recovered 70 to 100% by methanol extraction, adsorption to C18 silica gel Sep-Pak cartridges, elution with ethyl acetate, and analysis by TLC and/or HPLC. Limiting sensitivity (micrograms/extract) was 0.5 TLC; 1.0 HPLC. Quantitative extraction was confirmed with 3H-labeled CB. CB ip in mice at 50 mg/kg (LD10) distributed rapidly into liver, renal fat, kidney, intestines, mesentery, pancreas, spleen, and blood cells and was cleared from all but liver within 24 h. CB was below detectable levels in thymus, lymph nodes, heart, brain, bone marrow, and lungs. Cytochalasin A is fixed to tissues and not extractable. This work affords a source of CB in quantities permitting in vivo study, provides methods for extraction and analysis, and reveals the pharmacokinetics of ip bolus CB.     

Efficient double-scattering proton therapy with a patient-specific bolus

PurposePassive scattering proton radiotherapy utilizes beam-specific compensators to shape the dose to the distal end of the tumor target. These compensators typically require therapists to enter the treatment room to mount between beams. This study investigates a novel approach that utilizes a single patient-specific bolus to accomplish the role of multi-field compensators to improve the efficiency of the treatment delivery.MethodsRay-tracing from the proton virtual source was used to convert the beam-specific compensators (mounted on the gantry nozzle) into an equivalent bolus thickness on the patient surface. The field bolus contours were combined to create a single bolus. A 3D acrylic bolus was milled for a head phantom. The dose distribution of the compensator plan was compared to the bolus plan using 3D Gamma analysis and film measurements. Boluses for two clinical patients were also designed.ResultsThe calculated phantom dose distribution of the original proton compensator plan was shown to be equivalent to the plan with the surface bolus. Film irradiations with the proton bolus also confirmed the dosimetric equivalence of the two techniques. The dose distribution equivalency of the bolus plans for the clinical patients were demonstrated.ConclusionsWe presented a novel approach that uses a single patient-specific bolus to replace patient compensators during passive scattering proton delivery. This approach has the potential to reduce the treatment time, the compensator manufacturing costs, the risk of potential collision between the compensator and the patient/couch, and the waste of compensator material.     

Coronary flow. Method of returning coronary bolus

This paper presents a mathematical procedure in order to obtain the coronary flow. The analysis is accomplished by considering an intravascular tracer and its detection in the right ventricle at the beginning and end of the ventricular phase of expulsion.     

Respiratory deposition model of an inhaled aerosol bolus

The bolus delivery method is designed to deliver a dose to the desired location in the lung, and it has the advantage of fewer side effects and a more efficient way of delivery. Based upon the lung deposition model developed for continuously inhaling aerosols of constant concentration, a mathematical model of aerosol bolus deposition is proposed. The calculated results show that the recovery depends on the bolus penetration depth, flow rate, particle size, breath holding time and bolus volume. Three sets of published experimental data with different controlling factors (particle size, flow rate and breath holding time) are adopted to make the quantitative comparisons with the calculated results. The predictions and data for the low intrinsic motion particles (～1 μm) have good agreement, as do the coarse particles in the shallow airways region. For females, the recovery was found to be consistently lower than that for males.     

Respiratory deposition model of an inhaled aerosol bolus

The bolus delivery method is designed to deliver a dose to the desired location in the lung, and it has the advantage of fewer side effects and a more efficient way of delivery. Based upon the lung deposition model developed for continuously inhaling aerosols of constant concentration, a mathematical model of aerosol bolus deposition is proposed. The calculated results show that the recovery depends on the bolus penetration depth, flow rate, particle size, breath holding time and bolus volume. Three sets of published experimental data with different controlling factors (particle size, flow rate and breath holding time) are adopted to make the quantitative comparisons with the calculated results. The predictions and data for the low intrinsic motion particles (～1 μm) have good agreement, as do the coarse particles in the shallow airways region. For females, the recovery was found to be consistently lower than that for males.     

Time analysis of hard and soft bolus processing

Objective: Clinical observations and mathematical models show that dental implants are influenced by the magnitude of loading. Therefore, the knowledge of mandible movement during mastication is important to assess occlusal and masticatory force vectors. The purpose of this study was to detect the path of movement of the lower jaw and to distinguish stages of mastication, duration of bolus processing and peak amplitude of mastication. Method: Motion analysis was used to record three-dimensional mandible movements. Individualized sensors were rigidly attached to the mandible of 51 study participants. At the beginning of the measurement, all subjects were asked to move the mandible in extreme positions (maximal opening and maximal lateral movements). Then, each subject masticated a bite of hard and soft food. Duration of bolus mastication and peak amplitude of mastication movement in mesio-distal, cranio-caudal and vestibulo-oral axes related to peak amplitude of marginal movements were evaluated for each subject. The chewing record of each subject was divided into three phases (chopping, grinding and swallowing), and the duration of mastication and number of closing movements were evaluated. Results: The findings of this pilot study suggest that masticatory movements vary in individuals. Bolus character influences the process duration, but not the frequency of closing movements. Neither gender nor age had any influence on either the time or frequency of bolus processing. Conclusion: Relationships to directions and magnitudes of acting chewing force should be more precisely examined since transversally acted forces during grinding are important factors in tooth/implant overloading.     

乌鸡白凤丸巩固治疗复发性外阴阴道念珠菌病的临床研究

目的 应用乌鸡白凤丸巩固治疗复发性外阴阴道念珠菌病（Recurrent Vulvovaginal Candidiasis,RVVC）,通过观察其疗效及安全性,探讨其有无降低RVVC复发率的作用.方法 486名处于VVC急性发作且以往有RVVC史的非孕育龄妇女,急性期阴道给予克霉唑栓强化治疗.达到临床及真菌治愈标准后,随机分为3组采取不同方案进行巩固治疗或临床观察.A组：每月月经净后3～7 d,继续单次阴道给予克霉唑栓500 mg,为期3个月;B组：每月月经净后口服乌鸡白凤丸每次1丸,1次/d,3周为1个疗程,连用3个月.对照组：仅作随访观察.各组在巩固治疗期间及巩固治疗结束后6个月内进行随访,观察疗效及不良反应发生情况.结果 巩固治疗期间,A组和B组分别累计有17人（10.12％）和23人（13.61％）出现复发,显著低于对照组（P＜0.001）.巩固治疗结束后,随访第3个月A组和B组分别累计有31人（21.83％）和37人（26.62％）出现复发;随访第6个月A组和B组分别累计有73人（51.41％）和79人（56.83％）出现复发,均显著低于对照组（P ＜0.001）,A、B组间各阶段复发率无显著差异（P＞0.05）,不良反应轻微.结论 RVVC近期治愈后采用乌鸡白凤丸巩固治疗,能够抑制念珠菌生长,增强免疫功能,控制阴道局部炎症反应,有效预防复发,效果满意且相对安全,值得临床应用与推广.     

Respiration during feeding on solid food: alterations in breathing during mastication, pharyngeal bolus aggregation, and swallowing.

During feeding, solid food is chewed and propelled to the oropharynx, where the bolus gradually aggregates while the larynx remains open and breathing continues. The aggregated bolus in the valleculae is exposed to respiratory airflow, yet aspiration is rare in healthy individuals. The mechanism for preventing aspiration during bolus aggregation is unclear. One possibility is that alterations in the pattern of respiration during feeding could help prevent inhalation of food from the pharynx. We hypothesized that respiration was inhibited during bolus aggregation in the valleculae. Videofluorography was performed on 10 healthy volunteers eating solid foods with barium. Respiration was monitored concurrently with plethysmography and nasal air pressure. The timing of events during mastication, food transport, pharyngeal bolus aggregation, and swallowing were measured in relation to respiration. Respiratory cycle duration decreased during chewing (P < 0.001) but increased with swallowing (P < 0.001). During 66 recordings of vallecular bolus aggregation, there was inspiration in 8%, expiration in 41%, a pause in breathing in 17%, and multiple phases (including inspiration) in 35%. Out of 98 swallows, 47% started in the expiratory phase and 50% started during a pause in breathing, irrespective of bolus aggregation in the valleculae. Plethysmography was better than nasal manometry for determining the end of active expiration during feeding and swallowing with solid food. The hypothesis is rejected in that respiration was not inhibited during bolus aggregation. These findings suggest that airflow through the pharynx does not have a role in preventing aspiration during bolus aggregation in the oropharynx.     

Clearance, metabolic fate and tissue distribution of an injected bolus of photoaffinity-labeled rat androgen binding protein

An injected bolus of tritiated photolabeled rat androgen binding protein (ABP) is cleared from the circulation in a biphasic manner. The rapid component of the clearance curve indicates a clearance half time (t1/2) of 4.24 +/- 0.20 h and the slow component indicates a t1/2 of 13.27 +/- 2.92 h. After injection, photolabeled ABP is rapidly degraded as determined by electrophoresis on polyacrylamide gels containing sodium dodecyl sulfate. This method dissociates ABP into subunits of approximately 48,000 daltons. One-half hour after injection of photolabeled ABP, 90% of the radioactivity migrates as a 20,000- rather than as a 48,000-dalton moiety; at the 24-h point only 20,000- and 16,000-dalton species were detectable. Chromatography of plasma on Sephadex G-150 indicated that, under nondenaturing conditions, radioactivity was still associated with proteins having a molecular weight similar to the native ABP dimer. These results suggest that the dimer is substrate for the proteolytic processes affecting ABP. Small (congruent to 7000 dalton) fragments of ABP could be detected in urine by G-150 chromatography 2 h after injection. The control protein [3H] bovine serum albumin (BSA) was cleared from the blood with a time course identical to that of photolabeled ABP (t1/2's 4.69 +/- 0.09 h and 13.56 +/- 1.03 h). [3H] BSA was degraded to peptides that were similar in size to those formed from photolabeled ABP. The uptake of photolabeled ABP and [3H] BSA by potential target tissues (testis, epididymis and ventral prostate) was equivalent, suggesting that the uptake of ABP was a nonspecific phenomenon rather than a receptor-mediated event. The liver and kidneys contained more radioactivity that did the other tissues and there was a differential uptake and clearance of photolabeled ABP and [3H] BSA by these organs. Whether this difference is related to specific uptake processes or to differences in the size and/or structure of the proteins or other factors remains to be determined.     

Effect of ventilation distribution on aerosol bolus dispersion and recovery

It has beenspeculated that convective ventilatory inhomogeneities are an importantfactor influencing aerosol bolus behavior in the compromisedlung. Multiple-breath¹³³Xe washout(MBW_Xe) is a commonly acceptedtest of ventilation distribution. By comparing aerosol bolus parametersto MBW_Xe in 9 healthy subjects and14 cystic fibrosis patients with mild-to-moderate airway obstruction,we have attempted to discern the effect of altered ventilationdistribution on aerosol bolus dispersion and recovery. Aerosol boluses(150-ml width) were delivered to the volumetric penetrations of 250 and500 ml. Similar tidal volumes (~1.25 liters) and flow rates (0.4 l/s)were used for aerosol bolus andMBW_Xe maneuvers. Associationsbetween bolus parameters and ventilation distribution were onlyobserved in the cystic fibrosis patients. We conclude that aerosolbolus dispersion and recovery are both influenced by convectiveventilatory inhomogeneities induced by airway obstruction in these patients.

     

Utilizing intraluminal pressure differences to predict esophageal bolus flow dynamics

Successful esophageal emptying depends on the generation of a sustained intrabolus pressure (IBP) sufficient to overcome esophagogastric junction (EGJ) obstruction. Our aim was to develop a manometric analysis paradigm that describes the bolus driving pressure difference and the flow permissive time for esophageal bolus transit. Twenty normal subjects were studied with a 36-channel manometry assembly (1-cm spacing) during two 5- and one 10-ml barium swallows and concurrent fluoroscopy. Bolus domain pressure plots were generated by plotting bolus domain pressure (BDP) and EGJ relaxation pressure. BDP was defined as the pressure midway between the peristaltic ramp-up and the proximal margin of the EGJ. The flow permissive time was defined as the period where the BDP was > or = EGJ relaxation pressure. The mean BDP was 11.7 +/- 1.0 mmHg (SE), and the mean flow permissive time was 3.9 +/- 0.4 s for 5-ml swallows in normal controls. The mean BDP difference during flow was 4.0 +/- 1.0 mmHg. There was no significant difference in the fluoroscopic transit time and the flow permissive time calculated from the BDP plots (5 ml: fluoroscopy 3.4 +/- 0.2 s; BDP 3.9 +/- 0.4 s, P > 0.05). BDP plots provide a reliable measurement of IBP and its relationship with EGJ relaxation. The time available for flow can be readily delineated from this analysis, and the driving pressure responsible for flow can be accurately described and quantified. This may help predict abnormal bolus transit and the underlying mechanical properties of the EGJ.