临床低温外科装置

低温冷冻在临床上可用来杀死各类肿瘤组织,冷冻治疗具有许多优越性,如手术过程出血少、痛苦小.文中介绍低温外科装置的工作过程及装置结构,分析冷冻探头的传热过程.最后根据临床应用,对装置的工作压力、冷冻速率、复温速率等重要参数进行讨论.     

前列腺低温微创治疗及器件的研究

利用低温冷冻破坏前列腺增生或肿瘤组织治疗疾病具有许多的优点,如出血少、痛苦小,有时甚至不需要麻醉。前列腺冷冻术可采用两种方法,即穿刺式和接触式。穿刺式就是将探针直接插入病灶组织中心,予以冷冻,主要用于较小的病灶;接触式就是将探针冷冻区接触病灶组织表面予以冷冻,主要用于较小的前列腺增生或不规则的肿瘤等,有时也可将二者结合使用。冷冻术最大的优点还在于可防止肿瘤细胞的扩散。文中详细介绍前列腺冷冻治疗的机理、冷冻探针的结构特点及临床应用效果。     

基于液氮低温冷刀系统的冻结组织温度场分布研究

设计了基于液氮的低温冷冻治疗系统,并进行动物组织实验研究,得到组织关键测温点的温度变化;并对冷冻过程进行数值模拟,将实验结果与模拟冷冻结果进行对比,根据二者的差异对数值模拟中采用的组织热物性参数进行修正,使模拟结果更接近于实际冷冻过程.     

低温冷冻刀降温方法综述及展望

介绍了冷冻治疗和它的发展历程,对低温冷冻刀的降温方法作了全面的综述和分类,并进行了降温方法机理分析和优缺点比较,结合冷冻外科的应用现状对低温冷冻刀的应用前景做出展望,为新型低温冷冻刀的设计提供了参考。     

医用低温温度标定方法

低温冷冻手术是以杀死病变细胞、组织,达到治愈疾病的目的,在-40℃以下的低温特别适合实体肿瘤的治疗,其治疗效果主要取决于冷冻温度和冻结界面范围,所以对温度的监测和控制十分重要。介绍了常用医用低温温度计的特点及分度,并提出了(77K-273K)温区的温度标定方法和标定装置控制逻辑系统。该标定装置可实现低温温度的标定,标定温度误差为0.1K。     

外科冷冻探针周围组织温度场的焓法求解

本文通过用焓模型求解非线性生物传热方程,研究了低温外科中冷冻探针周围组织的瞬态温度场,使生物组织的“冷冻损伤”形状、成长速率及最终稳态冷冻区域大小得以确定.本文旨在一方面为低温外科提供必要的理论依据,另一方面使一般相变导热问题的焓法求解得以进一步深入及推广.     

模拟生物组织冻结过程实验与分析

冷冻外科中组织冻结过程的分析对手术实施十分重要。本文建立了低温冷刀实验台,在模拟生物组织中进行冷冻实验,测量了冰球内某点的温度变化;并用有限元方法求解了建立在治法基础上的模拟生物组织冻结过程多维数学模型,计算结果与实验值符合较好;用该模型和方法计算了实验条件下冰球内的温度梯度变化和冷刀所需理论冷量;分析了不同的冷刀直径对冻结过程的影响。     

生物材料低温保存过程中的温度场模拟

低温保存是生物材料进行长时间保存的一种有效方法,但在0℃~-60℃的温区范围,极容易发生低温损伤,如何减小低温损伤是细胞进行成功的低温保存的关键。文中建立了生物组织在低温保存过程中的数学模型,通过ANSYS分析软件,对样品在降温过程中的温度场进行了计算分析和数值模拟,为冷冻造成细胞损伤的研究提供了理论依据。     

双冷针冷冻手术中冻结相变传热的数值模拟

建立了生物组织(含正常组织与肿瘤)冻结过程相变传热的数学模型.模型中采用树状分形方法模拟血管的结构形态,同时考虑了组织在冻结过程中存在冻结区、糊状区和未冻结区三个区域.对生物组织在同时插入两根探针时冻结过程中温度场分布及冰晶生长规律进行了模拟.模拟结果表明:在冷冻初期,冰晶的生长速度较快,到了后期冰晶生长速度明显减慢;探针间距在冷冻初期对冰晶生长产生较大影响,随着冷冻时间的增加这种差别会逐渐减少.     

激光诱导间质热疗的深低温流体冷却方法

为防止激光诱导间质内热疗治疗肿瘤时激光光纤加热段周围组织的炭化,本文提出了一种采用深低温流体对激光光纤及其临近组织进行降温冷却的方法.为验证该方法的可行性,本文对采用该方法后激光间质内热疗过程中组织的传热问题进行了深入的数值研究.结果表明,深低温流体冷却方法可避免局部高温对组织的炭化,并显著扩展有效加热范围,从而对肿瘤实施高效的热凝固.     

Time-dependent speckle in holographic optical coherence imaging and the health of tumor tissue

Holographic optical coherence imaging acquires en face images from successive depths inside scattering tissue. In a study of multicellular tumor spheroids the holographic features recorded from a fixed depth are observed to be time dependent, and they may be classified as variable or persistent. The ratio of variable to persistent features, as well as speckle correlation times, provides quantitative measures of the health of the tissue. Studies of rat osteogenic sarcoma tumor spheroids that have been subjected to metabolic and cross-polymerizing poisons provide quantitative differentiation among healthy, necrotic, and poisoned tissue. Organelle motility in healthy tissue appears as super-Brownian laser speckle, whereas chemically fixed tissue exhibits static speckle.     

The structure of the fibrous tissue on the articular surface of the temporal bone in the monkey (Macaca mulatta)

The articulating surface of bones which ossify in mesenchyme, like the mandible, is covered by a layer of dense, fibrous tissue. The purpose of the present study was to examine the structure of the fibrous tissue on the surface of the articular surface of the temporal bone in the monkey. Young Rhesus monkeys (Macaca mulatta) were perfused with glutaraldehyde-paraformaldehyde. The specimens were demineralized in 0.5M EDTA. Small pieces of fibrous tissue and underlying bone were dissected out and processed for light and electron microscopy. The mandibular fossa is shallower and the articular eminence flatter in the monkeys as compared to humans. The articular part of the temporal bone is covered by a layer of avascular, soft tissue extending from the surface to the underlying bone. The tissue can be divided into three zones which gradually merge into one another. The zone facing the articular cavity consists of dense, fibrous tissue with layers of collagen fibers, oriented parallel to the articular surface, but at angles to each other. Fibers thought to be elastic fibers oriented parallel with the collagen fibers are also observed, particularly close to the surface, and their function is probably to impart resilience to the fibrous articular tissue. Between the fibers scattered cells with an ample rough endoplasmic reticulum are present. A thin layer of granular appearance is often observed on the surface. This layer may be of importance in joint lubrication. The second zone is more cell rich and the cells have long slender cellular processes and are surrounded by a dense collagenous matrix with an irregular orientation. These cells are probably precursor for the underlying cartilage but, not for the cells in the outer articular layer. In the third zone next to the bone the fibrous tissue gradually turns into cartilage. The cartilagenous zone is narrow, sometimes absent and is replaced by bone tissue. In some areas chondroclasts are observed, with forming osteons with osteoid seams. These observations indicate that remodeling is taking place and that cartilage is replaced by bone. The three zones observed correspond to findings in the mandibular condyle, but the zones are not as constant and distinct as in the condyle, and this reflects the adaptive role of the temporal bone in the growth of the temporomandibular joint.     

接触压力作用下皮肤形变对于漫反射光谱测量影响研究

人体成分无创光谱检测过程中,测量条件特别是探头压力造成的组织形变在一定程度上影响光谱测量结果。利用物理模型与仿真方法,定量分析了探头接触压力作用下皮肤组织应变,及光学参数与漫反射光谱变化。首先,在多层皮肤组织物理复合模型基础上,结合生物组织固液两相组成特性,定量分析了压力作用下各层皮肤组织形变大小以及成分变化。该模型将皮肤力学模型简化为固态弹性结构及包含于其中的牛顿流体,利用有限元方法,分别模拟不同压力作用下多层皮肤组织应变大小及时间特性,并根据各层组织体积及水含量变化,定量计算其散射系数及吸收系数改变。然后,利用Monte Carlo方法模拟压力作用前后光在组织中传输过程,定量分析了探头压力对漫反射光谱中所包含人体成分检测有效信息的影响。实验结果表明,在光纤探头接触压力作用下,人体皮肤组织中真皮层厚度变小,自由水体积减小,引起散射特性及光子传输路径改变,使得漫反射光谱中所包含的有效光谱信息下降。该研究结果为优化人体漫反射光谱测量策略,提高测量准确性以及重复性提供了参考。     

Quantitative multivoxel proton chemical shift imaging of the breast

The study of focal pathology by single-voxel magnetic resonance spectroscopy (MRS) is hampered by the impossibility to study tissue heterogeneity or compare the metabolite signals in breast lesion directly to those in unaffected tissue. Multivoxel MRS studies, while potentially allowing for truly quantitative tissue characterization, have up to now also been far from quantitative with, for example, the signal-to-noise ratio of the choline (Cho) signal serving as measure of tumor activity. Shown in this study is that in a standard clinical setting with a regular 1.5-T magnetic resonance scanner, it is possible to perform quantitative multivoxel MRS. With the use of literature values for the T1 and T2 relaxation times of Cho and water in fibroglandular breast tissue and tumors, one can determine the concentrations of Cho in different tumor compartments and surrounding tissues in two brief multivoxel MRS measurements. This opens excellent perspectives to quantitative diagnostic and follow-up studies of focal pathology such as lesions suspected of breast cancer.     

Autofluorescence endoscopy for the gastrointestinal tract

This review focuses on our basic study results and clinical experience of fluorescence endoscopy for the gastrointestinal (GI) tract. Collagen, which fluoresces in the green wavelength range, is one of the major sources of tissue autofluorescence (AF) and AF imaging systems are now available. With their use, however, it is important to take into account tissue changes other than, or in addition to, changes in gross tissue morphology. These may include alterations in the local blood volume, tissue metabolic activity, and relative fluorophore concentrations. New AF imaging systems are very easy to use, because white light endoscopy can be changed to AF at the push of a button, and hold great promise for diagnosis of early carcinomas and premalignant lesions in the GI tract. In particular, AF endoscopy has potential for identification of small or flat tumors, tumor margins and premalignant lesions in Barrett’s esophagus, as well as for assessing tumor grade and response to therapy. However, large-scale studies are needed to clarify the clinical impact of this new diagnostic approach.     

Compatibility of Gd-DTPA perfusion and histologic studies of the brain

Histology, including immunohistochemistry, and magnetic resonance imaging microscopy (microMRI) are complementary techniques for the analysis of brain structure. Therefore, microMRI analysis, often of formalin-fixed tissue, precedes histologic evaluation of the same experimental animal in many studies. However, the application of gadopentetate dimeglumine (Gd-DTPA), while of value for MRI studies, has an unknown effect on subsequent histology. We demonstrate here that for the mouse brain, histology with Nissl staining and immunostaining for microtubule-associated protein 2, using standard techniques for tissue preparation, are unaffected by prior perfusion of the tissue with Gd-DTPA. This conclusion was based on qualitative morphologic comparisons of stained sections, as well as quantification of mean immunofluorescence pixel intensities from Gd-treated (mean+/-S.D.=131.2+/-28.4; n=3) as compared to nontreated specimens (116.2+/-34.7; n=3, P=.7). Therefore, Gd-DTPA may be applied as a microMRI contrast agent in formalin-fixed brain tissue prior to histologic studies.     

基于漫反射光谱法下层组织信息的最佳探测位置的研究

由于人体组织结构的复杂性和个体差异性,采用光谱分析技术实现组织内部信息的检测方法中,仍存在着检测位置不明确的问题。采用多位置空间分辨漫反射光谱法对脂肪肌肉组织中内部信息的最佳探测位置进行了研究。由于目标组织为肌肉组织,为了消除由于不同人体皮下脂肪层厚度的差异以及目标层中多次后向散射光对测量结果引起的较大误差,并根据光在复杂生物组织中的传输模型,通过增加约束条件——两条理想的“香蕉型”路径—来定义有效光子比SNR,并以SNR作为评价最佳探测位置SDS_best的标准,对优化后的Monte Carlo仿真结果进行统计分析,分别研究了脂肪层厚度h_f、脂肪层吸收系数μ_af和肌肉层吸收系数μ_am与光源探测器间距SDS之间的关系,并以h_f为自变量与SDS_best建立线性回归模型。研究表明,(1)当0<h_f<0.6 cm时,μ_af和μ_am对SDS_best几乎没有影响,而h_f与SDS_best的建模相关系数R2为0.991 8;(2)任取脂肪层厚度值0.12与0.22 cm作预测,得到预测误差分别为0.030 14和0.020 16,预测误差均能控制在5%以内。该方法能更方便、快速地为测量组织内部信息确定最佳检测位置,并有效削弱浅表组织以及目标层中多次背向散射光的干扰。     

Simulation of ultrasonic pulse propagation, distortion, and attenuation in the human chest wall

A finite-difference time-domain model for ultrasonic pulse propagation through soft tissue has been extended to incorporate absorption effects as well as longitudinal-wave propagation in cartilage and bone. This extended model has been used to simulate ultrasonic propagation through anatomically detailed representations of chest wall structure. The inhomogeneous chest wall tissue is represented by two-dimensional maps determined by staining chest wall cross sections to distinguish between tissue types, digitally scanning the stained cross sections, and mapping each pixel of the scanned images to fat, muscle, connective tissue, cartilage, or bone. Each pixel of the tissue map is then assigned a sound speed, density, and absorption value determined from published measurements and assumed to be representative of the local tissue type. Computational results for energy level fluctuations and arrival time fluctuations show qualitative agreement with measurements performed on the same specimens, but show significantly less waveform distortion than measurements. Visualization of simulated tissue-ultrasound interactions in the chest wall shows possible mechanisms for image aberration in echocardiography, including effects associated with reflection and diffraction caused by rib structures. A comparison of distortion effects for varying pulse center frequencies shows that, for soft tissue paths through the chest wall, energy level and waveform distortion increase markedly with rising ultrasonic frequency and that arrival-time fluctuations increase to a lesser degree.     

A theoretical study of the effects of various laryngeal configurations on the acoustics of phonation.

Simulation of glottal volume flow and vocal fold tissue movement was accomplished by numerical solution of a time-dependent boundary value problem, in which nonuniform, orthotropic, linear, incompressible vocal fold tissue media were surrounded by irregularly shaped boundaries, which were either fixed or subject to aerodynamic stresses. Spatial nonuniformity of the tissues was of the layered type, including a mucosal layer, a ligamental layer, and muscular layers. Orthotropy was required to stabilized the vocal folds longitudinally and to accomodate large variations in muscular stress. Incompressibility and vertical motions at the golttis played an important role in producing and sustaining phonation. A nominal configuration for male fundamental speaking pitches was selected, and the regulation of fundamental frequency, intensity, average volume flow, and vocal efficiency was investigated in terms of variations around this nominal configuration. Parameters which were varied consisted of geometrical factors such as length, thickness, and depth, factors for shaping the glottis, as well as tissue elasticities, tissue viscosities, and subglottal pressure. Since nonlinear stress-strain properties were not included, subglottal pressure did not produce a pronounced effect upon fundamental frequency under these somewhat edealized conditions F0 rasing correlated strongly with increased tension in the ligament, and somewhat with increasing tension in the vocalis. F0 lowering correlated with increase in vocal fold length when the tensions were held constant, but not with increase in vocal fold thickness. Vocal intensity and efficiency are shown to have local maxima as the configurational parameters are varied one at a time. It appears that oral acoustic power output and vocal efficiency can be maximized by proper adjustments of longitudinal tension of nonmuscular (mucosal and ligamental) tissue layers in relation to muscular layers. Quantitative verification of the "body-cover" theory is therefore suggested, and several further implications with regard to control of the human larynx are considered.