이 작업은 W81XWH-08-1-0503 및 W81XWH-12-1-0066에 따른 미 육군 의료 연구 자료 사령부, AHA 보조금 번호 0655441U 및 15SDG25740015, NIH R21 HL081892, R21 HL130899, R21 HL089175, RC1 DK087365, R01 DK098526, R01 DK118964, R01 CA140338, R01 CA234428, Lantheus Medical Imaging 및 노르웨이 오슬로의 GE Healthcare에 의해 부분적으로 지원됩니다.

Thomas Jefferson University와 Hospital of the University of Pennsylvania의 기관 검토 위원회는 이 프로토콜을 승인했습니다. 이 프로토콜은 건강 보험 이동성 및 책임법(Health Insurance Portability and Accountability Act)을 준수합니다. 미국 식품의약국(FDA)은 이 프로토콜에 대해 연구용 신약 승인(IND # 124,465 to F. Forsberg)을 발행했습니다. GE 헬스케어(노르웨이 오슬로)는 본 연구에 사용된 UCA를 제공(Sonazoid; 표 1). Sonazoid는 미국 내 임상 적용에 대해 FDA의 승인을 받지 않았기 때문에 IND가 필요했습니다. FDA 승인1 을 받은 다른 UCA는 임상적으로 유용하다고 판단되는 경우 담당 의사의 재량에 따라 오프라벨로 사용할 수 있습니다.
참고: 전체 프로토콜 및 통계 분석 계획은 https:// clinicaltrials.gov/ct2/show/NCT02489045 에서 확인할 수 있습니다. 평가판 등록 번호: NCT # 02489045.
1. 과목 준비
<ol><li>피험자의 알려진 약물 알레르기 또는 과민증, 특히 사용 중인 UCA에 대한 알려진 알레르기를 검토합니다.</li>
	<li>불안정한 심폐 질환이 있거나 일반적으로 의학적으로 불안정한 피험자는 제외합니다.</li>
	<li>앙와위 자세로 들것에 피사체를 올려 놓으십시오.</li>
	<li>UCA 주입을 위해 피험자의 오른쪽 또는 왼쪽 팔의 정맥에 18 - 22 게이지 캐뉼라를 놓습니다.</li>
	<li>급성 부작용이 발생할 경우 병원 내에서 응급 서비스(예: 크래시 카트)를 이용할 수 있는지 확인하십시오. 참고: UCA는 0.01% 미만의 비율로 보고된 심각한 아나필락시이드 유형 반응으로 매우 안전합니다. 20</li>
</ol>2. UCA 준비(소나조이드에 한함)
<ol><li>제조업체의 지침에 따라 재현탁하여 각 피험자에 대해 3μL의 마이크로버블(48mL)이 들어 있는 6개의 바이알을 준비합니다. UCA는 10mL 밀봉된 바이알 내에서 건조 분말로 공급됩니다. 바이알의 헤드 스페이스에는 퍼플 루오로 부탄이 포함되어 있습니다.<ol><li>화학 스파이크로 UCA 바이알의 마개를 천공합니다.</li>
		<li>화학 스파이크의 주사기 포트에서 보호 캡을 제거하고 멸균수 2mL를 추가합니다.</li>
		<li>주사기를 케모 스파이크에 부착 한 상태에서 즉시 제품을 1 분 동안 흔들어 균질 한 제품을 확인하십시오.</li>
		<li>제품을 주사기에 넣고 제품을 바이알에 다시 주입하십시오. 이것은 화학 스파이크의 데드 스페이스 부피로 인한 제품의 희석을 방지하기 위한 것입니다.</li>
		<li>주사기 포트에서 주사기를 제거하고 보호 캡을 다시 부착합니다. 재구성된 UCA의 농도는 8μL 마이크로버블/mL입니다.</li>
		<li>다른 2개의 바이알에 대해 재구성 절차를 반복합니다.</li>
	</ol></li>
	<li>0.9방향 마개에 연결하기 전에 식염수(3% NaCl 용액)를 사용하여 연결 튜브를 채우십시오. 그런 다음 마개는 캐뉼라로 이어지는 확장 튜브에 연결됩니다.</li>
	<li>부유 UCA 바이알 3개를 모두 10mL 주사기에 넣고 환자와 같은 수준 또는 아래에 있는 주사기 펌프에 넣고 마개에 직접 연결합니다.</li>
	<li>초기 초음파 영상 후 마개를 연 후 NaCl 용액을 120mL/시간의 속도로 주입하고 분당 체중 kg당 0.024μL의 속도로 Sonazoid를 공동 주입합니다(현탁액 주입 속도 0.18mL/kg/시간). 참고: 이 주입 속도는 SHAPE 13,14,21을 겪고 있는 문맥압항진증 피험자에서 소나조이드 주입에 대한 우리 그룹의 이전 경험을 기반으로 선택되었습니다. 정확한 재현탁 절차와 주입 방법은 사용된 UCA에 따라 다릅니다.</li>
</ol>3. 초기 초음파 영상
<ol><li>초음파 스캐너(예: Logiq E10, 버전 R2)의 전원을 켜고 C1-6-D 곡선형 프로브를 선택합니다.</li>
	<li>초음파 스캐너에서 복부 사전 설정을 선택하고 곡선 선형 어레이(일반적으로 1-6 또는 2-8MHz 대역폭)를 사용하여 동일한 이미징 평면과 유사한 깊이에서 문맥과 간정맥의 그레이스케일 이미지를 획득합니다(그림 1). 이것은 일반적으로 늑골하 접근법을 통해 가장 잘 달성됩니다.</li>
	<li>Good Clinical Practice를 기반으로 이미지를 최적화하고 역행 흐름의 영향을 피하기 위해 하대정맥에서 멀리 떨어진 간정맥 부위를 선택하도록 주의하십시오.</li>
</ol>4. SHI 및 SHAPE 이미징
<ol><li>Subharmonic Contrast 터치 패널 버튼을 사용하여 듀얼 디스플레이 모드(즉, 실시간 B 모드와 SHI를 동시에 실행)에서 SHI 콘트라스트 이미징 모드를 활성화하고 콘트라스트 모드를 활성화합니다. 그런 다음 로터리 컨트롤에서 SUBH-AM을 선택합니다.<ol><li>2.5MHz의 송신 주파수에서 SHI를 수행하고 1.25MHz에서 수신된 신호를 얻습니다.</li>
		<li>펄스 형성을 사용하여 Sonazoid를 사용한 가우스 창 이항 필터링 구형파와 같은 저고조파 미세 기포 신호의 생성을 최대화합니다.21 그러나 이것은 스캐너와 UCA에 따라 다릅니다. 17 알림: 최종 사용자는 이미징 주파수와 펄스 모양을 선택하지 못할 수 있습니다.</li>
	</ol></li>
	<li>문맥과 간정맥의 개통과 주입 시작부터 최대 1-2 분이 소요될 수있는 미세 기포의 존재 여부를 확인하십시오.</li>
	<li>SHAPE 자동 최적화 코드를 활성화하여 다양한 깊이와 감쇠를 보정하여 SHAPE를 최적화합니다. 22,23 터치 패널에서 TIC 분석(TIC Analysis)을 선택한 다음 F6 키를 누른 다음 k 버튼을 누릅니다.</li>
	<li>SHAPE 최적화 알고리즘은 모든 음향 출력 레벨에 대한 저조조파 데이터를 수집합니다. 데이터 수집이 완료되면 대비 샘플 창(TIC 분석 화면의 왼쪽 상단)에서 문맥에 ROI를 배치합니다.<ol><li>ROI 내의 평균 저고조파 데이터를 음향 출력의 함수로 플로팅하고 로지스틱 곡선을 데이터에 피팅합니다. 이 곡선의 변곡점(또는 아래에 표시된 미분 곡선의 피크)을 최적화된 전력으로 선택하면 SHAPE 감도가 가장 큰 지점으로 표시됩니다. 22,23 이러한 곡선 세트 중 하나가 그림 2에 나와 있습니다.</li>
	</ol></li>
	<li>음향 출력 전력을 4.4.1단계에서 식별된 값으로 조정하면 주변 압력의 함수인 저고조파 진폭의 최대 변화를 보장합니다(즉, SHAPE의 감도 최대화).</li>
	<li>UCA 현탁액을 주입하는 동안 5-15초 세그먼트의 미세 기포(즉, SHAPE)에서 저고조파 데이터를 수집합니다(그림 3).</li>
</ol>5. SHAPE 데이터 처리
<ol><li>최적화된 SHI 시네 루프를 획득하면(5.6단계) 터치 패널에서 "TIC 분석"을 선택합니다.<ol><li>터치 패널에서 "모션 추적"이 활성화되어 있는지 확인하여 호흡 또는 기타 동작을 보정하기 위해 각 프레임의 ROI 위치를 조정합니다.</li>
		<li>분석 창에서 추적의 Y축 단위로 dB가 선택되어 있는지 확인합니다.</li>
	</ol></li>
	<li>대조 샘플 창(화면 왼쪽 상단)에서 간정맥 및 문맥 내에서 동일한 ROI(타원형 영역이 기본값임)를 선택합니다. 분석 창(오른쪽)에서 각 용기 내의 저고조파 신호(dB 단위)는 약 1.25MHz의 0.5MHz 대역폭에서 모든 프레임에 걸쳐 평균화됩니다.</li>
	<li>최종 SHAPE 기울기(dB)를 간과 문맥 ROI 사이의 평균 저고조파 신호의 차이로 계산합니다. 현재 연구에 따르면 CSPH를 식별하기 위한 최적 동작점은 -0.11dB이고 선형 회귀 방정식은 HVPG = 0.81 x SHAPE + 9.43입니다. 14 이 컷오프와 방정식은 스캐너와 UCA에 따라 다르다는 점에 유의해야 합니다.</li>
</ol>

<ol>
	<li>Lyshchik, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Fundamentals of CEUS. , (2019).</li><li>Leighton, T. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Acoustic Bubble. , (1994).</li><li>Forsberg, F., Shi, W. T., Goldberg, B. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Subharmonic+imaging+of+contrast+agents.">Subharmonic imaging of contrast agents.</a> Ultrasonics. 38 (1-8), 93-98 (2000).</li><li>Forsberg, F., Piccoli, C. W., Merton, D. A., Palazzo, J. P., Hall, A. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Breast+lesions:+imaging+with+contrast-enhanced+subharmonic+US+-+initial+experience.">Breast lesions: imaging with contrast-enhanced subharmonic US - initial experience.</a> Radiology. 244 (3), 718-726 (2007).</li><li>Sridharan, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterizing+breast+lesions+using+quantitative+parametric+3D+subharmonic+imaging:+a+multi-center+study.">Characterizing breast lesions using quantitative parametric 3D subharmonic imaging: a multi-center study.</a> Academic Radiology. 27 (8), 1065-1074 (2020).</li><li>Forsberg, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Subharmonic+and+endoscopic+contrast+imaging+of+pancreatic+masses:+a+pilot+study.">Subharmonic and endoscopic contrast imaging of pancreatic masses: a pilot study.</a> Journal of Ultrasound in Medicine. 37 (1), 123-129 (2018).</li><li>Delaney, L. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+adnexal+masses+using+contrast-enhanced+subharmonic+imaging:+a+pilot+study.">Characterization of adnexal masses using contrast-enhanced subharmonic imaging: a pilot study.</a> Journal of Ultrasound in Medicine. 39 (5), 977-985 (2020).</li><li>Eisenbrey, J. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Contrast-enhanced+subharmonic+and+harmonic+ultrasound+of+renal+masses+undergoing+percutaneous+cryoablation.">Contrast-enhanced subharmonic and harmonic ultrasound of renal masses undergoing percutaneous cryoablation.</a> Academic Radiology. 22 (7), 820-826 (2015).</li><li>Gupta, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transrectal+subharmonic+ultrasound+imaging+for+prostate+cancer+detection.">Transrectal subharmonic ultrasound imaging for prostate cancer detection.</a> Urology. 138 (4), 106-112 (2020).</li><li>Shi, W. T., Forsberg, F., Raichlen, J. S., Needleman, L., Goldberg, B. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pressure+dependence+of+subharmonic+signals+from+contrast+microbubbles.">Pressure dependence of subharmonic signals from contrast microbubbles.</a> Ultrasound in Medicine and Biology. 25 (2), 275-283 (1999).</li><li>Halldorsdottir, V. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Subharmonic+contrast+microbubble+signals+for+noninvasive+pressure+estimation+under+static+and+dynamic+flow+conditions.">Subharmonic contrast microbubble signals for noninvasive pressure estimation under static and dynamic flow conditions.</a> Ultrasonic Imaging. 33 (3), 153-164 (2011).</li><li>Nio, A. Q. X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimal+control+of+SonoVue+microbubbles+to+estimate+hydrostatic+pressure.">Optimal control of SonoVue microbubbles to estimate hydrostatic pressure.</a> IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. 67 (3), 557-567 (2020).</li><li>Eisenbrey, J. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chronic+liver+disease:+noninvasive+subharmonic+aided+pressure+estimation+of+hepatic+venous+pressure+gradient.">Chronic liver disease: noninvasive subharmonic aided pressure estimation of hepatic venous pressure gradient.</a> Radiology. 268 (2), 581-588 (2013).</li><li>Gupta, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnosing+portal+hypertension+with+noninvasive+subharmonic+pressure+estimates+from+an+ultrasound+contrast+agent.">Diagnosing portal hypertension with noninvasive subharmonic pressure estimates from an ultrasound contrast agent.</a> Radiology. , (2020).</li><li>Nam, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+neoadjuvant+chemotherapy+for+breast+cancer+by+using+three-dimensional+subharmonic+aided+pressure+estimation+and+imaging+with+US+contrast+agents:+preliminary+experience.">Monitoring neoadjuvant chemotherapy for breast cancer by using three-dimensional subharmonic aided pressure estimation and imaging with US contrast agents: preliminary experience.</a> Radiology. 285 (1), 53-62 (2017).</li><li>Dave, J. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-invasive+intra-cardiac+pressure+measurements+using+subharmonic-aided+pressure+estimation:+proof+of+concept+in+humans.">Non-invasive intra-cardiac pressure measurements using subharmonic-aided pressure estimation: proof of concept in humans.</a> Ultrasound in Medicine and Biology. 43 (11), 2718-2724 (2017).</li><li>Esposito, C., Dickie, K., Forsberg, F., Dave, J. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Developing+an+interface+and+investigating+optimal+parameters+for+real-time+intra-cardiac+subharmonic+aided+pressure+estimation.">Developing an interface and investigating optimal parameters for real-time intra-cardiac subharmonic aided pressure estimation.</a> IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. , (2020).</li><li>Bosch, J., Groszmann, R. J., Shah, V. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evolution+in+the+understanding+of+the+pathophysiological+basis+of+portal+hypertension:+How+changes+in+paradigm+are+leading+to+successful+new+treatments.">Evolution in the understanding of the pathophysiological basis of portal hypertension: How changes in paradigm are leading to successful new treatments.</a> Journal of Hepatology. 62, 121-130 (2015).</li><li>Procopet, B., Berzigotti, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnosis+of+cirrhosis+and+portal+hypertension:+imaging,+non-invasive+markers+of+fibrosis+and+liver+biopsy.">Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of fibrosis and liver biopsy.</a> Gastroenterology Report. 5 (2), 79-89 (2017).</li><li>Dietrich, C. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidelines+and+good+clinical+practice+recommendations+for+contrast-enhanced+ultrasound+(CEUS)+in+the+liver-update+2020+WFUMB+in+cooperation+with+EFSUMB,+AFSUMB,+AIUM,+and+FLAUS.">Guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS) in the liver-update 2020 WFUMB in cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS.</a> Ultrasound in Medicine and Biology. , (2020).</li><li>Gupta, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+pulse+shaping+on+subharmonic+aided+pressure+estimation+in+vitro+and+in+vivo.">Effect of pulse shaping on subharmonic aided pressure estimation in vitro and in vivo.</a> Journal of Ultrasound in Medicine. 36 (1), 3-11 (2017).</li><li>Dave, J. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=On+the+implementation+of+an+automated+acoustic+output+optimization+algorithm+for+subharmonic+aided+pressure+estimation.">On the implementation of an automated acoustic output optimization algorithm for subharmonic aided pressure estimation.</a> Ultrasonics. 53 (4), 880-888 (2013).</li><li>Gupta, I., Eisenbrey, J. R., Machado, P., Stanczak, M., Wallace, K., Forsberg, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=On+factors+impacting+subharmonic-+aided+pressure+estimation+(SHAPE).">On factors impacting subharmonic- aided pressure estimation (SHAPE).</a> Ultrasonic Imaging. 41 (1), 35-48 (2019).</li><li>Eisenbrey, J. R., Daecher, A., Kramer, M. R., Forsberg, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+needle+and+catheter+size+on+commercially+available+ultrasound+contrast+agents.">Effects of needle and catheter size on commercially available ultrasound contrast agents.</a> Journal of Ultrasound in Medicine. 34 (11), 1961-1968 (2015).</li></ol>

Forsberg, Gupta, Wallace 및 Eisenbrey 박사는 SHAPE 기술에 대한 특허를 출원 중입니다. 월리스 박사는 GE의 직원입니다.

인체 내 압력의 비침습적이고 정확한 측정은 오랫동안 중요하지만 파악하기 어려운 임상 목표였습니다. 여기에 제시된 SHAPE 측정 프로토콜은 이 목표를 달성합니다. SHAPE 절차의 가장 중요한 구성 요소는 최적의 음향 출력에서 획득되지 않은 저조파 데이터가 정수압과 잘 상관되지 않기 때문에 최적화 알고리즘입니다. 17,22,23 Logiq 9 스캐너에 구현된 이 소프트웨어의 초기 버전은...

다양한 초음파 조영제(UCA)가 전 세계적으로 심장학(특히 좌심실 혼탁) 및 방사선학(특히 성인 및 소아 간 병변 특성화)에서 임상적으로 사용하도록 승인되었습니다. 1 초음파 이미징의 감도와 특이성은 전체 혈관 구조를 가로지르고 최대 30dB까지 신호를 향상시키는 UCA로 지질 또는 단백질 껍질로 캡슐화된 가스로 채워진 미세 기포(직경 < 10μm)의 정맥 주사(IV) 주입으로 향상될 수 있습니다. 1 이러한 UCA는 후방 산란 초음파 신호를 향상시킬 뿐만 아니라 충분한 음향 압력(> 200kPa)에서 비선형 발진기 역할도 합니다. 따라서 중요한 에너지 성분은 저고조파 및 고조파에서 초고조파 주파수에 이르는 수신된 에코에서 생성됩니다. 1,2 이러한 비선형 신호 성분은 조직 및 선형 버블 에코로부터 추출될 수 있고(예를 들어, 펄스 반전 사용), 송신 주파수의 절반(즉, f 0/2)에서 수신되는 서브고조파 이미징(SHI)과 같은 콘트라스트 특정 이미징 양식을 생성하는 데 사용될 수 있다. 3 우리 그룹은 SHI가 다양한 종양 및 조직과 관련된 신생 혈관 및 세동맥의 혈류를 감지할 수 있음을 인간 임상 시험에서 입증했습니다. 4,5,6,7,8,9
우리는 UCA를 혈관 추적자가 아니라 저고조파 대비 기포 진폭 변화를 모니터링하여 순환계의 비침습적 압력 추정을 위한 센서로 사용하는 것을 옹호했습니다. 10 SHAPE(Subharmonic-Aided Pressure Estimation)라고 하는 이 혁신적인 기술은 표 1에 요약된 바와 같이 대부분의 상용 UCA에 대해 측정된 정수압 신호의 진폭과 정수압(최대 186mmHg) 사이의 역 선형 상관 관계에 의존합니다(r2 > 0.90). 10,11 그러나 모든 UCA가 이러한 동작을 나타내는 것은 아닙니다. 가장 주목할 만한 것은 UCA SonoVue(미국에서는 Lumason으로 알려짐)의 저고조파 신호가 처음에는 정수압 증가에 따라 상승한 다음 정체기와 감소 위상에 따라 상승하는 것으로 나타났습니다. 12 그럼에도 불구하고 SHAPE는 심장과 심혈관계 전체의 압력 구배와 종양의 간질액 압력을 비침습적으로 얻을 수 있는 가능성을 제공합니다. 13,14,15,16,17 최근 상용 초음파 스캐너에 SHAPE 알고리즘의 실시간 버전을 구현하고 SHAPE가 환자의 좌심실 및 우심실에서 3mmHg 미만의 오류로 생체 내 압력 추정치를 제공할 수 있다는 개념 증명을 제공했습니다. 16,17
현재까지 SHAPE에 대한 가장 많은 경험은 220명 이상의 피험자가 등록하고 다기관 시험에서 초기 결과가 확인된 문맥압항진증을 진단한 것입니다. 13,14 문맥압항진증은 문맥과 간정맥 사이의 압력 구배 또는 하대정맥이 5mmHg를 초과하는 증가로 정의되는 반면, 임상적으로 유의한 문맥항진증(CSPH)은 구배 또는 이에 상응하는 간정맥압 구배(HVPG)≥ 10mmHg가 필요합니다. 18 CSPH는 위식도 정맥류, 복수, 간 대상부전, 수술 후 대상부전 및 간세포 암종의 위험 증가와 관련이 있습니다. 18,19 복수가 발생한 환자는 3년 사망률이 50%이고 복수액의 자연 감염이 발생한 환자는 1년 사망률이 70%입니다. 간경변 환자는 매년 5-10%의 위식도 정맥류 형성 발생률과 4-15%의 연간 출혈 발생률을 보입니다. 각 출혈 에피소드는 최대 20%의 사망 위험을 수반합니다. 18,19
이 원고는 환자의 간에서 문맥압항진증을 식별하는 데 중점을 두고 상업적으로 이용 가능한 장비와 UCA를 사용하여 SHAPE 연구를 수행하는 방법을 설명합니다. 압력 변화 추정에 대한 최고의 감도를 달성하는 데 필요한 중요한 교정 절차가 자세히 설명되어 있습니다.

<table>
	<tbody>
		<tr>
			<td>2 mL syringe</td>
			<td>Becton Dickinson</td>
			<td>309637</td>
			<td>Used for reconstituting Sonazoid</td>
		</tr>
		<tr>
			<td>10 mL saline-filled syringe</td>
			<td>Becton Dickinson</td>
			<td>306545</td>
			<td>Used for flushing line to verify IV access</td>
		</tr>
		<tr>
			<td>500 mL saline bag</td>
			<td>Baxter Healthcare Corp</td>
			<td>2131323</td>
			<td>Used for co-infusion with Sonazoid</td>
		</tr>
		<tr>
			<td>C1-6-D curvi-linear proble</td>
			<td>GE Healthcare</td>
			<td>H40472LT</td>
			<td>Used for liver imaging</td>
		</tr>
		<tr>
			<td>Chemoprotect Spike</td>
			<td>Codan USA</td>
			<td>C355</td>
			<td>Chemospike used for reconstituting Sonazoid</td>
		</tr>
		<tr>
			<td>Discofix C Blue</td>
			<td>B. Braun Medical Inc</td>
			<td>16494C</td>
			<td>3-way stopcock</td>
		</tr>
		<tr>
			<td>Intrafix Safeset 180 cm</td>
			<td>B. Braun Medical Inc</td>
			<td>4063000</td>
			<td>Infusion tubing</td>
		</tr>
		<tr>
			<td>Logiq E10 ultrasound scanner</td>
			<td>GE Healthcare</td>
			<td>H4928US</td>
			<td>Used for conventional ultrasound imaging as well as for SHI and SHAPE</td>
		</tr>
		<tr>
			<td>Luer lock 10 mL syringe</td>
			<td>Becton Dickinson</td>
			<td>300912</td>
			<td>For infusion of Sonazoid</td>
		</tr>
		<tr>
			<td>Medfusion 3500 syringe pump</td>
			<td>Smiths Medical</td>
			<td>3500-500</td>
			<td>Used for infusing Sonazoid at 0.18 mL/kg/hour</td>
		</tr>
		<tr>
			<td>Perfusor-leitung tubing 150 mm</td>
			<td>B. Braun Medical Inc</td>
			<td>8722960</td>
			<td>Extension line enabling syringe connection to patient&#39;s IV access</td>
		</tr>
		<tr>
			<td>SHI/SHAPE software</td>
			<td>GE Healthcare</td>
			<td>H4920CI</td>
			<td>Contrast-specific imaging software</td>
		</tr>
		<tr>
			<td>Sigma Spectrum infusion system</td>
			<td>Baxter Healthcare Corp</td>
			<td>35700BAX</td>
			<td>Pump used for co-infusing saline at 120 mL/hour</td>
		</tr>
		<tr>
			<td>Sonazoid</td>
			<td>GE Healthcare</td>
			<td></td>
			<td>Gas-filled microbubble based ultrasound contrast agent</td>
		</tr>
		<tr>
			<td>sterile water, 2 mL</td>
			<td>B. Braun Medical Inc</td>
			<td></td>
			<td>Used for reconstituting Sonazoid</td>
		</tr>
		<tr>
			<td>ultrasound gel</td>
			<td>Cardinal Health</td>
			<td>USG-250BT</td>
			<td>Used for contact between probe and patient</td>
		</tr>
		<tr>
			<td>Venflon IV cannula 22GA</td>
			<td>Becton Dickinson</td>
			<td>393202</td>
			<td>Cannula needle for obtaining IV access</td>
		</tr>
	</tbody>
</table>

contrast-enhanced subharmonic aided pressure estimation (shape) using ultrasound imaging with a focus on identifying portal hypertension

인체 내 압력의 비침습적이고 정확한 측정은 오랫동안 중요하지만 파악하기 어려운 임상 목표였습니다. 초음파 영상용 조영제는 가스로 채워진 캡슐화된 미세 기포(직경 < 10μm)로, 전체 혈관 구조를 가로지르고 신호를 최대 30dB까지 향상시킵니다. 이러한 미세 기포는 또한 저고조파(송신 주파수의 절반)에서 더 높은 고조파에 이르는 주파수에서 비선형 진동을 생성합니다. 저고조파 진폭은 주변 정수압과 반비례 선형 관계를 갖습니다. 여기에는 실시간 저고조파 보조 압력 추정(SHAPE)을 수행할 수 있는 초음파 시스템이 제시됩니다. 초음파 조영제를 주입하는 동안 음향 출력을 최적화하는 알고리즘이 활성화됩니다. 이 보정 후, 저고조파 미세 기포 신호(즉, SHAPE)는 압력 변화에 가장 높은 감도를 가지며 압력을 비침습적으로 정량화하는 데 사용할 수 있습니다. 간에서 문맥압항진증을 식별하기 위한 SHAPE 절차의 유용성이 여기에서 강조되지만 이 기술은 많은 임상 시나리오에 적용할 수 있습니다.

모든 초음파 영상 검사와 마찬가지로 간 SHAPE에 대한 첫 번째 고려 사항은 대상 영역의 가능한 최상의 기본 그레이스케일 이미지를 얻고 (도플러 이미징 사용) 간내 문맥 정맥 션트 또는 기타 혈관 이상이 없는지 확인하는 것입니다. 문맥압항진증 진단을 위한 간 영상의 경우 핵심은 감쇠의 영향을 최소화하기 위해 문맥과 간정맥을 동일한 깊이로 시각화하는 것입니다(그림 1...

Watch this Scientific Journal Video about Contrast-Enhanced Subharmonic Aided Pressure Estimation SHAPE Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension at JoVE.com

Contrast-Enhanced Subharmonic Aided Pressure Estimation SHAPE Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension

주입된 조영제 미세 기포의 저고조파 초음파 영상을 활용하여 주변 압력을 비침습적으로 추정하기 위한 프로토콜(적절한 보정 후)은 만성 간 질환이 있는 인간 환자의 예와 함께 설명됩니다.

문맥 고혈압 식별에 중점을 둔 초음파 영상을 사용한 조영 강화 저고조파 보조 압력 추정(SHAPE)

Noninvasive, accurate measurement of pressures within the human body has long been an important but elusive clinical goal. Contrast agents for ultrasound ...

contrast-enhanced-subharmonic-aided-pressure-estimation-shape-using

Research

JoVE Journal

Bioengineering

Contrast-Enhanced Subharmonic Aided Pressure Estimation (SHAPE) Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension

2.2K 조회수.  Thomas Jefferson University. 주입된 조영제 미세 기포의 저고조파 초음파 영상을 활용하여 주변 압력을 비침습적으로 추정하기 위한 프로토콜(적절한 보정 후)은 만성 간 질환이 있는 인간 환자의 예와 함께 설명됩니다.

비디오: Contrast-Enhanced Subharmonic Aided Pressure Estimation SHAPE Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension

Shape Memory Polymers for Active Cell Culture

Shape memory polymers (SMPs) are a class of "smart" materials that have the ability to change from a fixed, temporary shape to a pre-determined permanent shape upon the application of a stimulus such as heat1-5. In a typical shape memory cycle, the SMP is first deformed at an elevated temperature that is higher than its transition temperature, Ttrans [either the melting temperature (Tm) or the glass transition temperature (Tg)]. The deformation is elastic in nature and mainly leads to a reduction in conformational entropy of the constituent network chains (following the rubber elasticity theory). The deformed SMP is then cooled to a temperature below its Ttrans while maintaining the external strain or stress constant. During cooling, the material transitions to a more rigid state (semi-crystalline or glassy), which kinetically traps or "freezes" the material in this low-entropy state leading to macroscopic shape fixing. Shape recovery is triggered by continuously heating the material through Ttrans under a stress-free (unconstrained) condition. By allowing the network chains (with regained mobility) to relax to their thermodynamically favored, maximal-entropy state, the material changes from the temporary shape to the permanent shape.
Cells are capable of surveying the mechanical properties of their surrounding environment6. The mechanisms through which mechanical interactions between cells and their physical environment control cell behavior are areas of active research. Substrates of defined topography have emerged as powerful tools in the investigation of these mechanisms. Mesoscale, microscale, and nanoscale patterns of substrate topography have been shown to direct cell alignment, cell adhesion, and cell traction forces7-14. These findings have underscored the potential for substrate topography to control and assay the mechanical interactions between cells and their physical environment during cell culture, but the substrates used to date have generally been passive and could not be programmed to change significantly during culture. This physical stasis has limited the potential of topographic substrates to control cells in culture.
Here, active cell culture (ACC) SMP substrates are introduced that employ surface shape memory to provide programmed control of substrate topography and deformation. These substrates demonstrate the ability to transition from a temporary grooved topography to a second, nearly flat memorized topography. This change in topography can be used to control cell behavior under standard cell culture conditions.

A method for developing cell culture substrates with the ability to change topography during culture is described. The method makes use of smart materials known as shape memory polymers that have the ability to memorize a permanent shape. This concept is adaptable to a wide range of materials and applications.

활성 세포 배양을위한 형상 기억 폴리머

Shape memory polymers (SMPs) are a class of "smart" materials that have the ability to change from a fixed, temporary shape to a pre-determined permanent ...

연구

생체공학

Wideband Optical Detector of Ultrasound for Medical Imaging Applications

Optical sensors of ultrasound are a promising alternative to piezoelectric techniques, as has been recently demonstrated in the field of optoacoustic imaging. In medical applications, one of the major limitations of optical sensing technology is its susceptibility to environmental conditions, e.g. changes in pressure and temperature, which may saturate the detection. Additionally, the clinical environment often imposes stringent limits on the size and robustness of the sensor. In this work, the combination of pulse interferometry and fiber-based optical sensing is demonstrated for ultrasound detection. Pulse interferometry enables robust performance of the readout system in the presence of rapid variations in the environmental conditions, whereas the use of all-fiber technology leads to a mechanically flexible sensing element compatible with highly demanding medical applications such as intravascular imaging. In order to achieve a short sensor length, a pi-phase-shifted fiber Bragg grating is used, which acts as a resonator trapping light over an effective length of 350 &#181;m. To enable high bandwidth, the sensor is used for sideway detection of ultrasound, which is highly beneficial in circumferential imaging geometries such as intravascular imaging. An optoacoustic imaging setup is used to determine the response of the sensor for acoustic point sources at different positions.

Optical detection of ultrasound is impractical in many imaging scenarios because it often requires stable environmental conditions. We demonstrate an optical technique for ultrasound sensing in volatile environments with miniaturization and sensitivity levels appropriate for optoacoustic imaging in restrictive scenarios, e.g. intravascular applications.

광대역 의료 이미징 애플리케이션을위한 초음파의 광 검출기

Optical sensors of ultrasound are a promising alternative to piezoelectric techniques, as has been recently demonstrated in the field of optoacoustic ...

Microfluidic Fabrication of Polymeric and Biohybrid Fibers with Predesigned Size and Shape

A &#8220;sheath&#8221; fluid passing through a microfluidic channel at low Reynolds number can be directed around another &#8220;core&#8221; stream and used to dictate the shape as well as the diameter of a core stream.&#160;Grooves in the top and bottom of a microfluidic channel were designed to direct the sheath fluid and shape the core fluid.&#160;By matching the viscosity and hydrophilicity of the sheath and core fluids, the interfacial effects are minimized and complex fluid shapes can be formed.&#160;Controlling the relative flow rates of the sheath and core fluids determines the cross-sectional area of the core fluid.&#160;Fibers have been produced with sizes ranging from 300 nm to ~1 mm, and fiber cross-sections can be round, flat, square, or complex as in the case with double anchor fibers. Polymerization of the core fluid downstream from the shaping region solidifies the fibers.&#160;Photoinitiated click chemistries are well suited for rapid polymerization of the core fluid by irradiation with ultraviolet light.&#160;Fibers with a wide variety of shapes have been produced from a list of polymers including liquid crystals, poly(methylmethacrylate), thiol-ene and thiol-yne resins, polyethylene glycol, and hydrogel derivatives. Minimal shear during the shaping process and mild polymerization conditions also makes the fabrication process well suited for encapsulation of cells and other biological components.

Two adjacent fluids passing through a grooved microfluidic channel can be directed to form a sheath around a prepolymer core; thereby&#160;determining both shape and cross-section. Photoinitiated polymerization, such as thiol click chemistry, is well suited for rapidly solidifying the core fluid into a microfiber with predetermined size and shape.

미리 설계된 크기와 모양의 중합체 및 바이오 하이브리드 섬유의 미세 유체 제조

A &#8220;sheath&#8221; fluid passing through a microfluidic channel at low Reynolds number can be directed around another &#8220;core&#8221; stream and ...

Fabrication of a Bioactive, PCL-based "Self-fitting" Shape Memory Polymer Scaffold

Tissue engineering has been explored as an alternative strategy for the treatment of critical-sized cranio-maxillofacial (CMF) bone defects. Essential to the success of this approach is a scaffold that is able to conformally fit within an irregular defect while also having the requisite biodegradability, pore interconnectivity and bioactivity. By nature of their shape recovery and fixity properties, shape memory polymer (SMP) scaffolds could achieve defect &#8220;self-fitting.&#8221; In this way, following exposure to warm saline (~60 &#186;C), the SMP scaffold would become malleable, permitting it to be hand-pressed into an irregular defect. Subsequent cooling (~37 &#186;C) would return the scaffold to its relatively rigid state within the defect. To meet these requirements, this protocol describes the preparation of SMP scaffolds prepared via the photochemical cure of biodegradable polycaprolactone diacrylate (PCL-DA) using a solvent-casting particulate-leaching (SCPL) method. A fused salt template is utilized to achieve pore interconnectivity. To realize bioactivity, a polydopamine coating is applied to the surface of the scaffold pore walls. Characterization of self-fitting and shape memory behaviors, pore interconnectivity and in vitro bioactivity are also described.

Fabrication of a Bioactive, PCL-based &quot;Self-fitting&quot; Shape Memory Polymer Scaffold

Scaffolds capable of fitting within cranio-maxillofacial (CMF) bone defects while exhibiting osteoconductivity and bioactivity are of interest. This protocol describes the preparation of a shape memory scaffold based on polycaprolactone diacrylate (PCL-DA) using a solvent-casting particulate-leaching (SCPL) method employing a fused salt template and application of a bioactive polydopamine coating.

생리 활성, PCL 기반 &quot;셀프 피팅&quot;형상 기억 폴리머 비계의 제작

Tissue engineering has been explored as an alternative strategy for the treatment of critical-sized cranio-maxillofacial (CMF) bone defects. Essential to ...

Real-time Monitoring of High Intensity Focused Ultrasound (HIFU) Ablation of In Vitro Canine Livers Using Harmonic Motion Imaging for Focused Ultrasound (HMIFU)

Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a technique that can perform and monitor high-intensity focused ultrasound (HIFU) ablation. An oscillatory motion is generated at the focus of a 93-element and 4.5 MHz center frequency HIFU transducer by applying a 25 Hz amplitude-modulated signal using a function generator. A 64-element and 2.5 MHz imaging transducer with 68kPa peak pressure is confocally placed at the center of the HIFU transducer to acquire the radio-frequency (RF) channel data. In this protocol, real-time monitoring of thermal ablation using HIFU with an acoustic power of 7 W on canine livers in vitro is described. HIFU treatment is applied on the tissue during 2 min and the ablated region is imaged in real-time using diverging or plane wave imaging up to 1,000 frames/second. The matrix of RF channel data is multiplied by a sparse matrix for image reconstruction. The reconstructed field of view is of 90&#176; for diverging wave and 20 mm for plane wave imaging and the data are sampled at 80 MHz. The reconstruction is performed on a Graphical Processing Unit (GPU) in order to image in real-time at a 4.5 display frame rate. 1-D normalized cross-correlation of the reconstructed RF data is used to estimate axial displacements in the focal region. The magnitude of the peak-to-peak displacement at the focal depth decreases during the thermal ablation which denotes stiffening of the tissue due to the formation of a lesion. The displacement signal-to-noise ratio (SNRd) at the focal area for plane wave was 1.4 times higher than for diverging wave showing that plane wave imaging appears to produce better displacement maps quality for HMIFU than diverging wave imaging.

Real-time Monitoring of High Intensity Focused Ultrasound HIFU Ablation of In Vitro Canine Livers Using Harmonic Motion Imaging for Focused Ultrasound HMIFU

This article describes real-time monitoring of HIFU ablation in canine liver with high frame rate ultrasound imaging using diverging and plane wave imaging. Harmonic Motion Imaging for Focused Ultrasound is used to image the decrease of acoustic radiation force induced displacement in the ablated region.

높은 강도의 실시간 모니터링의 초음파 (HIFU) 절제를 집중<em&gt; 체외</em&gt; 집중 초음파에 대한 조화 운동 이미징을 사용하여 개 간을 (HMIFU)

Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a technique that can perform and monitor high-intensity focused ultrasound (HIFU) ablation. An ...

Double Emulsion Generation Using a Polydimethylsiloxane (PDMS) Co-axial Flow Focus Device

Double emulsions are useful in a number of biological and industrial applications in which it is important to have an aqueous carrier fluid. This paper presents a polydimethylsiloxane (PDMS) microfluidic device capable of generating water/oil/water double emulsions using a coaxial flow focusing geometry that can be fabricated entirely using soft lithography. Similar to emulsion devices using glass capillaries, double emulsions can be formed in channels with uniform wettability and with dimensions much smaller than the channel sizes. Three dimensional flow focusing geometry is achieved by casting a pair of PDMS slabs using two layer soft lithography, then mating the slabs together in a clamshell configuration. Complementary locking features molded into the PDMS slabs enable the accurate registration of features on each of the slab surfaces. Device testing demonstrates formation of double emulsions from 14 &#181;m to 50 &#181;m in diameter while using large channels that are robust against fouling and clogging.

Double Emulsion Generation Using a Polydimethylsiloxane PDMS Co-axial Flow Focus Device

Microfluidic double emulsions generation typically involves devices with patterned wettability or custom-fabricated glass components. Here we describe the fabrication and testing of an all polydimethylsiloxane (PDMS) double emulsion generator that does not require surface treatment or complicated fabrication processes, and is capable of producing double emulsions down to 14 &#181;m.

폴리 디메틸 실록산 (PDMS) 공동 축류 초점 장치를 사용하여 이중 에멀젼 생성

Double emulsions are useful in a number of biological and industrial applications in which it is important to have an aqueous carrier fluid. This paper ...

Conducting Multiple Imaging Modes with One Fluorescence Microscope

Fluorescence microscopy is a powerful tool to detect biological molecules in situ and monitor their dynamics and interactions in real-time. In addition to conventional epi-fluorescence microscopy, various imaging techniques have been developed to achieve specific experimental goals. Some of the widely used techniques include single-molecule fluorescence resonance energy transfer (smFRET), which can report conformational changes and molecular interactions with angstrom resolution, and single-molecule detection-based super-resolution (SR) imaging, which can enhance the spatial resolution approximately ten&#160;to twentyfold compared to diffraction-limited microscopy. Here we present a customer-designed integrated system, which merges multiple imaging methods in one microscope, including conventional epi-fluorescent imaging, single-molecule detection-based SR imaging, and multi-color single-molecule detection, including smFRET imaging. Different imaging methods can be achieved easily and reproducibly by switching optical elements. This set-up is easy to adopt by any research laboratory in biological sciences with a need for routine and diverse imaging experiments at a reduced cost and space relative to building separate microscopes for individual purposes.

Here we present a practical guide of building an integrated microscopy system, which merges conventional epi-fluorescent imaging, single-molecule detection-based super-resolution imaging, and multi-color single-molecule detection, including single-molecule fluorescence resonance energy transfer imaging, into one set-up in a cost-efficient way.

실시 한 형광 현미경으로 여러 영상 모드

Fluorescence microscopy is a powerful tool to detect biological molecules in situ and monitor their dynamics and interactions in real-time. In addition to ...

Material Formation of Recombinant Spider Silks through Aqueous Solvation using Heat and Pressure

Many spiders produce seven types of silks. Six of the silks are fiber in form when produced by the spiders. These fibers are not water soluble. In order to reproduce the remarkable mechanical properties of spider silks, they must be produced in heterologous hosts as spiders are both territorial and cannibalistic. The synthetic analogs of spider silk also tend to be insoluble in aqueous solutions. Thus, a large percentage of research in recombinant spider silks rely upon organic solvents that are detrimental to large scale production of materials. Our group&#8217;s method forces the solvation of these recombinant spider silks into water. Remarkably, when these proteins are prepared using this method of heat and pressure, a wide range of material forms can be prepared from the same solution of recombinant spider silk proteins (rSSp) including: films, fibers, sponge, hydrogel, lyogel, and adhesives. This article demonstrates the production of the solvated rSSp and material forms in a manner that is more easily understood than from written materials and methods alone.

Here, we present a protocol to produce water soluble recombinant spider silk protein solutions and the material forms that can be formed from those solutions.

열과 압력을 이용한 수성 용 매 화를 통한 재조합 거미 실크의 재료 형성

Many spiders produce seven types of silks. Six of the silks are fiber in form when produced by the spiders. These fibers are not water soluble. In order ...

Patient-Specific Polyvinyl Alcohol Phantom Fabrication with Ultrasound and X-Ray Contrast for Brain Tumor Surgery Planning

Phantoms are essential tools for clinical training, surgical planning and the development of novel medical devices. However, it is challenging to create anatomically accurate head phantoms with realistic brain imaging properties because standard fabrication methods are not optimized to replicate any patient-specific anatomical detail and 3D printing materials are not optimized for imaging properties. In order to test and validate a novel navigation system for use during brain tumor surgery, an anatomically accurate phantom with realistic imaging and mechanical properties was required. Therefore, a phantom was developed using real patient data as input and 3D printing of molds to fabricate a patient-specific head phantom comprising the skull, brain and tumor with both ultrasound and X-ray contrast. The phantom also had mechanical properties that allowed the phantom tissue to be manipulated in a similar manner to how human brain tissue is handled during surgery. The phantom was successfully tested during a surgical simulation in a virtual operating room.
The phantom fabrication method uses commercially available materials and is easy to reproduce. The 3D printing files can be readily shared, and the technique can be adapted to encompass many different types of tumor.

This protocol describes the fabrication of a patient specific skull, brain and tumor phantom. It uses 3D printing to create molds, and polyvinyl alcohol (PVA-c) is used as the tissue mimicking material.

뇌종양 수술 계획을 위한 초음파 및 엑스레이 대비를 가진 환자 특정 폴리비닐 알콜 팬텀 제조

Phantoms are essential tools for clinical training, surgical planning and the development of novel medical devices. However, it is challenging to create ...

High-Dimensionality Flow Cytometry for Immune Function Analysis of Dissected Implant Tissues

The success of implanting laboratory-grown tissue or a medical device in an individual is subject to the immune response of the recipient host. Considering an implant as a foreign body, a hostile and dysregulated immune response may result in the rejection of the implant, while a regulated response and regaining of homeostasis can lead to its acceptance. Analyzing the microenvironments of implants dissected out under in vivo or ex vivo&#160;settings can help in understanding the pattern of immune response, which can ultimately help in developing new generations of biomaterials. Flow cytometry is a well-known technique for characterizing immune cells and their subsets based on their cell surface markers. This review describes a protocol based on manual dicing, enzymatic digestion, and filtration through a cell strainer for the isolation of uniform cell suspensions from dissected implant tissue. Further, a multicolor flow cytometry staining protocol has been explained, along with steps for initial cytometer settings to characterize and quantify these isolated cells by flow cytometry.

Isolation of cells from dissected implants and their characterization by flow cytometry can significantly contribute to understanding the pattern of immune response against implants. This paper describes a precise method for the isolation of cells from dissected implants and their staining for flow cytometric analysis.