Transport lattice models of heat transport in skin with spatially heterogeneous, temperature-dependent perfusion

Modeling for neurosurgical laser interstitial thermal therapy with and without intracranial recording electrodes

Laser thermal ablation has become a prominent neurosurgical treatment approach, but in epilepsy patients it cannot currently be safely implemented with intracranial recording electrodes that are used to study interictal or epileptiform activity. There is a pressing need for computational models of laser interstitial thermal therapy (LITT) with and without intracranial electrodes to enhance the efficacy and safety of optical neurotherapies. In this paper, we aimed to build a biophysical bioheat and ray optics model to study the effects of laser heating in the brain, with and without intracranial electrodes in the vicinity of the ablation zone during the LITT procedure. COMSOL Multiphysics finite element method (FEM) solver software was used to create a bioheat thermal model of brain tissue, with and without blood flow incorporation via Penne's model, to model neural tissue response to laser heating. We report that the close placement of intracranial electrodes can increase the maximum temperature of the brain tissue volume as well as impact the necrosis region volume if the electrodes are placed too closely to the laser coupled diffuse fiber tip. The model shows that an electrode displacement of 4 mm could be considered a safe distance of intracranial electrode placement away from the LITT probe treatment area. This work, for the first time, models the impact of intracranially implanted recording electrodes during LITT, which could improve the understanding of the LITT treatment procedure on the brain's neural networks a sufficient safe distance to the implanted intracranial recording electrodes. We recommend modeling safe distances for placing the electrodes with respect to the infrared laser coupled diffuse fiber tip.

Thermal Cues Composed of Sequences of Pulses for Transferring Data via a Haptic Thermal Interface

This research study is the preliminary phase of an effort to develop a generic data transfer method via human haptic thermal sensation (i.e., a coded language such as Morse or Braille). For the method to be effective, it must include a large variety of short, recognizable cues. Hence, we propose the concept of cues based on sequences of thermal pulses: combinations of warm and cool pulses with several levels of intensity. The objective of this study was to determine the feasibility of basing a generic data transfer method on haptic thermal cues using sequences of short pulses. The research included defining the basic characteristics of the stimuli parameters and developing practical methods for generating and measuring them. Several patterns of different sequences were designed considering the relevant data known to date and improved by implementing new insights acquired throughout the tests that were conducted. The final thermal cues presented to the participants were sensed by touch and clearly recognized. The results of this study indicate that developing this new method is feasible and that it could be applicable in various scenarios. In addition, the low impact measured on the user's skin temperature represents an inherent advantage for future implementation. This report presents promising findings and offers insights for further investigations.

Uncertainty analysis and optimization of laser thermal pain treatment

Uncertainty in operating parameters during laser thermal pain treatment can yield unreliable results. To ensure reliability and effectiveness, we performed uncertainty analysis and optimization on these parameters. Firstly, we conducted univariate analysis to identify significant operational parameters. Next, an agent model using RBNN regression determined the relationship between these parameters, the constraint function, and the target function. Using interval uncertainty analysis, we obtained confidence distributions and established a nonlinear interval optimization model. Introducing RPDI transformed the model into a deterministic optimization approach. Solving this with a genetic algorithm yielded an optimal solution. The results demonstrate that this solution significantly enhances treatment efficacy while ensuring temperature control stability and reliability. Accounting for parameter uncertainties is crucial for achieving dependable and effective laser thermal pain treatment. These findings have important implications for advancing the clinical application of this treatment and enhancing patient outcomes.

Skin Temperature: The Impact of Perfusion, Epidermis Thickness, and Skin Wetness

This work aimed to elucidate the primary factors which affect skin temperature. A simple thermophysical model of the skin, which accounts for radiative, convective, and evaporative heat losses, has been developed to address it. The model is based on the skin’s morphology and consists of passive (nonviable tissue) and active (viable tissue) layers. The bioheat equation was solved for these layers using realistic assumptions. It was found that other than the ambient temperature, blood perfusion and epidermis thickness are the primary factors responsible for the skin temperature variations. The main temperature drop in the skin is attributed to the cooling of the blood in the venous plexus. The temperature drop in the epidermis is on the scale of 0.1 °C for the normal epidermis but can be 1.5–2 °C or higher in calluses. Thus, local skin temperature variations can indicate the epidermis thickness variations, particularly in callus-prone areas. The effects of relative air humidity and skin wetness on skin temperature were also quantified. The presence of free moisture on the skin (e.g., wet wound) significantly increases the heat transfer, resulting in a skin temperature drop, which can be on the scale of several degrees Celsius. The relative air humidity significantly contributes (by slowing heat dissipation) only in the case of evaporative heat loss from wet skin. Therefore, wet skin is undesirable and should be avoided during a thermographic assessment.

Simulation of thermal field distribution in biological tissue and cell culture media irradiated with infrared wavelengths

In recent years, there has been a growing interest in the singlet form of oxygen as a regulator of the physiological functions of cells. One of the ways to generate singlet oxygen is direct optical excitation of the triplet oxygen form. Since molecular oxygen weakly absorbs light, high power is required to obtain sufficient concentrations of singlet oxygen. However, the increase in the radiation power of laser can induce a local temperature increase around the laser spot. This may be critical considering the temperature governs every biological reaction within living cells, in particular. Here, the interaction of laser radiation of infrared wavelengths, generating singlet oxygen, with biological tissues and cell culture media was simulated. Using the COMSOL Multiphysics software, the thermal field distribution in the volume of skin, brain tissue and cell culture media was obtained depending on the wavelength, power and exposure time. The results demonstrate the importance of taking temperature into account when conducting experimental studies at the cellular and organismal levels.

Intra-epidermal evoked potentials: A promising tool for spinal disorders?

OBJECTIVES

To test the robustness and signal-to-noise ratio of pain-related evoked potentials following intra-epidermal electrical stimulation (IES) compared to contact heat stimulation in healthy controls, and to explore the feasibility and potential added value of IES in the diagnosis of spinal disorders.

METHODS

Pain-related evoked potentials induced by IES (custom-made, non-invasive, concentric triple pin electrode with steel pins protruding 1 mm from the anode, triangularly separated by 7-10 mm respectively) and contact heat stimulation were compared in 30 healthy subjects. Stimuli were applied to four different body sites. Two IES intensities, i.e., high (individually adapted to contact heat painfulness) and low (1.5 times pain threshold), were used. Additionally, a 40-year-old patient with unilateral dissociated sensory loss due to a multi-segmental syringohydromyelia was assessed comparing IES and contact heat stimulation.

RESULTS

Both IES and contact heat stimulation led to robust pain-related evoked potentials recorded in all healthy subjects. Low intensity IES evoked potentials (14.1-38.0 µV) had similar amplitudes as contact heat evoked potentials (11.8-32.3 µV), while pain ratings on the numeric rating scale were lower for IES (0.8-2.5, compared to 1.5-3.9 for contact heat stimulation). High intensity IES led to evoked potentials with higher signal-to-noise ratio than low intensity IES and contact heat stimulation. The patient case showed impaired pain-related evoked potentials in segments with hypoalgesia for both IES modes. IES evoked potentials were preserved, with delayed latencies, while contact heat evoked potentials were abolished.

CONCLUSION

IES evoked robust pain-related cortical potentials, while being less painful in healthy controls. The improved signal-to-noise ratio supports the use of IES for objective segmental testing of nociceptive processing. This was highlighted in a spinal syndrome case, where IES as well as contact heat stimulation reliably detected impaired segmental nociception.

Wearable Personal Core Body Temperature Measurement Considering Individual Differences and Dynamic Tissue Blood Perfusion

Accurate and continuous measurement of the human core body temperature by a wearable device is of great significance for human health care and disease monitoring. The current wearable thermometers ignore the physiological differences between individuals and the role of blood perfusion in thermoregulation, resulting in insufficient accuracy and limitations in terms of the measurement sites. This study proposed a novel personal model for measuring core body temperature by taking dynamic tissue blood perfusion and individual differences into consideration. The technique facilitates possible accurate core body temperature measurements from the skin surface of the wrist and forehead. First, the personal core body temperature model was established based on the thermal equilibrium between the human body and the measurement device, in which the tissue blood perfusion changes dynamically with tissue temperature. Then, the parameters of the personal model that imply individual physiological differences were obtained based on personal data collected daily. The results show that with the developed personal model, the accuracy of the measured body temperature from the wrist is close to that of the forehead model. The wrist model and the forehead model have a mean absolute error of 0.297 (SD=0.078) C and 0.224 (SD=0.071) C, respectively, which meets the accuracy and robustness requirements of practical applications. The personal models significantly improve the accuracy compared with that of the group model, especially for the wrist model.

Modeling Focused-Ultrasound Response for Non-Invasive Treatment Using Machine Learning

The interactions between body tissues and a focused ultrasound beam can be evaluated using various numerical models. Among these, the Rayleigh-Sommerfeld and angular spectrum methods are considered to be the most effective in terms of accuracy. However, they are computationally expensive, which is one of the underlying issues of most computational models. Typically, evaluations using these models require a significant amount of time (hours to days) if realistic scenarios such as tissue inhomogeneity or non-linearity are considered. This study aims to address this issue by developing a rapid estimation model for ultrasound therapy using a machine learning algorithm. Several machine learning models were trained on a very-large dataset (19,227 simulations), and the performance of these models were evaluated with metrics such as Root Mean Squared Error (RMSE), R-squared (R²), Akaike Information Criterion (AIC), and Bayesian Information Criterion (BIC). The resulted random forest provides superior accuracy with an R² value of 0.997, an RMSE of 0.0123, an AIC of -82.56, and a BIC of -81.65 on an external test dataset. The results indicate the efficacy of the random forest-based model for the focused ultrasound response, and practical adoption of this approach will improve the therapeutic planning process by minimizing simulation time.

The interplay of blood flow and temperature in regional hyperthermia: a mathematical approach

In recent decades, hyperthermia has been used to raise oxygenation levels in tumours undergoing other therapeutic modalities, of which radiotherapy is the most prominent one. It has been hypothesized that oxygenation increases would come from improved blood flow associated with vasodilation. However, no test has determined whether this is a relevant assumption or other mechanisms might be acting. Additionally, since hyperthermia and radiotherapy are not usually co-administered, the crucial question arises as to how temperature and perfusion in tumours will change during and after hyperthermia. Overall, it would seem necessary to find a research framework that clarifies the current knowledge, delimits the scope of the different effects and guides future research. Here, we propose a simple mathematical model to account for temperature and perfusion dynamics in brain tumours subjected to regional hyperthermia. Our results indicate that tumours in well-perfused organs like the brain might only reach therapeutic temperatures if their vasculature is highly disrupted. Furthermore, the characteristic times of return to normal temperature levels are markedly shorter than those required to deliver adjuvant radiotherapy. According to this, a mechanistic coupling of perfusion and temperature would not explain any major oxygenation boost in brain tumours immediately after hyperthermia.

Thermal sensitivity in humans at the depth of thermal receptor endings beneath the skin: validation of a heat transfer model of the skin using high-temporal resolution stimuli

PURPOSE

The bioheat transfer equation predicts temperature distribution in living tissues such as the skin. This study aimed at psychophysically validating this model in humans.

METHODS

Three experiments were performed. In the first, participants were asked to judge the thermal intensity of stimuli with combinations of intensity and duration that yielded, according to the model, identical temperatures at the thermoreceptor's depth. In experiment 2, participants' thermal detection thresholds for stimuli of different durations were measured to verify whether these thresholds correspond, according to the model, to equivalent temperatures at the thermoreceptor's location. In experiment 3, an alternative forced choice method was used, in which subjects indicated which of the two consecutive thermal stimulations was more intense.

RESULTS

The model predicted results that agreed with subjects' perceptions. Participants judged stimuli of different combinations of intensities and durations yielding identical temperature at the receptor level as having equivalent intensity. Moreover, although cold detection thresholds for stimuli of different durations differed for temperatures of the stimulating probe, stimulations using the model's parameters showed equivalence at the depth of the thermal receptors. Furthermore, stimuli with temperature/duration combinations for which the model predicts temperature equivalence at the depth of the receptors corresponded to subjective equalization.

CONCLUSION

These findings indicate that heat transfer models provide good estimates of temperatures at the thermal receptors. Use of these models may facilitate comparisons among studies using different stimulation devices and may facilitate the establishment of standards involving all stimulation parameters.

Prediction of Gold Nanoparticle and Microwave-Induced Hyperthermia Effects on Tumor Control via a Simulation Approach

Hyperthermia acts as a powerful adjuvant to radiation therapy and chemotherapy. Recent advances show that gold nanoparticles (Au-NPs) can mediate highly localized thermal effects upon interaction with laser radiation. The purpose of the present study was to investigate via in silico simulations the mechanisms of Au-NPs and microwave-induced hyperthermia, in correlation to predictions of tumor control (biological endpoints: tumor shrinkage and cell death) after hyperthermia treatment. We also study in detail the dependence of the size, shape and structure of the gold nanoparticles on their absorption efficiency, and provide general guidelines on how one could modify the absorption spectrum of the nanoparticles in order to meet the needs of specific applications. We calculated the hyperthermia effect using two types of Au-NPs and two types of spherical tumors (prostate and melanoma) with a radius of 3 mm. The plasmon peak for the 30 nm Si-core Au-coated NPs and the 20 nm Au-NPs was found at 590 nm and 540 nm, respectively. Considering the plasmon peaks and the distribution of NPs in the tumor tissue, the induced thermal profile was estimated for different intervals of time. Predictions of hyperthermic cell death were performed by adopting a three-state mathematical model, where “three-state” includes (i) alive, (ii) vulnerable, and (iii) dead states of the cell, and it was coupled with a tumor growth model. Our proposed methodology and preliminary results could be considered as a proof-of-principle for the significance of simulating accurately the hyperthermia-based tumor control involving the immune system. We also propose a method for the optimization of treatment by overcoming thermoresistance by biological means and specifically through the targeting of the heat shock protein 90 (HSP90), which plays a critical role in the thermotolerance of cells and tissues.

EXACT ANALYTICAL SOLUTION OF BIOHEAT EQUATION SUBJECTED TO INTENSIVE MOVING HEAT SOURCE

Presented is the analytical solution of Pennes bio-heat equation, under localized moving heat source. The thermal behavior of one-dimensional (1D) nonhomogeneous layer of biological tissue is considered with blood perfusion term and modeled under the effect of concentric moving line heat source. The procedure of the solution is Eigen function expansion. The temperature profiles are calculated for three tissues of liver, kidney, and skin. Behavior of temperature profiles are studied parametrically due to the different moving speeds. The analytical solution can be used as a verification branch for studying the practical operations such as scanning laser treatment and other numerical solutions.

Influence of Initial Moisture Content on Heat and Moisture Transfer in Firefighters' Protective Clothing

This paper presents a model for heat and moisture transfer through firefighters' protective clothing (FPC) during radiation exposure. The model, which accounts for air gaps in the FPC as well as heat transfer through human skin, investigates the effect of different initial moisture contents on the thermal insulation performance of FPC. Temperature, water vapor density, and the volume fraction of liquid water profiles were monitored during the simulation, and the heat quantity absorbed by water evaporation was calculated. Then the maximum durations of heat before the wearer acquires first- and second-degree burns were calculated based on the bioheat transfer equation and the Henriques equation. The results show that both the moisture weight in each layer and the total moisture weight increase linearly within a given environmental humidity level. The initial moisture content in FPC samples significantly influenced the maximum water vapor density. The first- and second-degree burn injury time increase 16 sec and 18 sec when the RH increases from 0% to 90%. The total quantity of heat accounted for by water evaporation was about 10% when the relative humidity (RH) is 80%. Finally, a linear relationship was identified between initial moisture content and the human skin burn injury time before suffering first- and second-degree burn injuries.

Thermographic assessment of skin prick tests in comparison with the routine evaluation methods

INTRODUCTION

The skin prick test is still the first and basic procedure in the diagnosis of allergic diseases. The possibility of using a sensitive thermographic method supported by the mathematical model for the assessment of skin test results will be highlighted in the studies.

AIM

To compare the proposed approach with routine planimetric and thermographic methods.

MATERIAL AND METHODS

A mathematical model of allergic reaction was developed. Simplifying assumptions of the IgE-mediated skin reaction is the essence of the model. Investigations were performed in a group of 40 patients.

RESULTS

Using the spatio-temporal evolution of temperature distributions, the ratios of the histamine released from mast cells to the control histamine were determined. The obtained values very well correlate with the standard evaluation of skin prick tests (correlation coefficient = 0.98).

CONCLUSIONS

The proposed method of skin test evaluation presents several advantages. The continuous acquisition of data provides the monitoring of time course of the allergic response. The transport of mediator and its concentration were distinctly discriminated, which may be diagnostically useful, especially for abnormal cases. The high sensitivity of the method enables studying patients regardless of age and skin sensitivity.

Feasibility of a biomechatronic EPP Upper Limb Prosthesis Controller

In this paper, we examine the feasibility of an implantable topology of a Biomechatronic Extended Physiological Proprioception (EPP) Upper Limb Prosthesis Controller. Initial findings support the hypothesis that the topology is safe and feasible. This novel controller topology can maintain the advantages of EPP, but without its inherent disadvantages i.e. of the existence of unaesthetic cables, or mechanical linkages.

Dynamics of modulated waves in a lossy modified Noguchi electrical transmission line

We study analytically the dynamics of modulated waves in a dissipative modified Noguchi nonlinear electrical network. In the continuum limit, we use the reductive perturbation method in the semidiscrete limit to establish that the propagation of modulated waves in the network is governed by a dissipative nonlinear Schrödinger (NLS) equation. Motivated with a solitary wave type of solution to the NLS equation, we use both the direct method and the Weierstrass's elliptic function method to present classes of bright, kink, and dark solitary wavelike solutions to the dissipative NLS equation of the network. Through the exact solitary wavelike solutions to the dissipative NLS equation, we investigate the effects of the dissipative elements of the network on wave propagation. We show that the wave amplitude decreases and its width increases when the dissipative element of the network increases. It has been also found that the dissipative element of the network can be used to manipulate the motion of solitary waves through the network. This work presents a good analytical approach of investigating the propagation of solitary waves through discrete electrical transmission lines and is very important for studying modulational instability.

Prediction methods of skin burn for performance evaluation of thermal protective clothing

Most test methods use skin burn prediction to evaluate the thermal protective performance of clothing. In this paper, we reviewed different burn prediction methods used in clothing evaluation. The empirical criterion and the mathematical model were analyzed in detail as well as their relationship and limitations. Using an empirical criterion, the onset of skin burn is determined by the accumulated skin surface energy in certain periods. On the other hand, the mathematical model, which indicates denatured collagen, is more complex, which involves a heat transfer model and a burn model. Further studies should be conducted to examine the situations where the prediction methods are derived. New technologies may be used in the future to explore precise or suitable prediction methods for both flash fire tests and increasingly lower-intensity tests.

A novel artificial anal sphincter system in an in vitro and in vivo experiment

This paper presents some of the latest progress in the development of a novel artificial anal sphincter system (AASS) to treat severe fecal incontinence. We have redesigned and integrated an intelligent, remote-controlled artificial anal sphincter based on biological signal feedback mechanisms. The device consists of an external telemetry unit, an internal artificial anal sphincter (IAAS), and a transcutaneous energy transfer system (TETS). The mechanical medical micropump of the IAAS can realize bidirectional flow with a maximum flow rate of 8.5 ml/min and can build backpressure up to 170 kPa. The design of the prosthesis reduces occlusion pressure and allows for low inflation volumes (9 mL-10.5 mL); operating pressures between 4.05 kPa and 7.16 kPa indicate that the risk of ischemic injury to the bowel is minimal. Furthermore, the rechargeable battery based on TETS puts the operation time at an estimated 2 days. The performance characteristics of the AASS and its efficiency in achieving continence and sensing the stool inside the anorectum were evaluated in vitro and in vivo in a pig model. Experimental results confirm that the system can maintain continence and build the sense of defecation successfully. Moreover, this innovation can be integrated into not only severe fecal incontinence, erectile dysfunction, and therapy-resistant reflux disease, but also morbid adiposity therapeutic AASS applications.

INFLUENCE OF INFRARED RADIATION ON THE HUMAN SKIN TEMPERATURE — EXPERIMENTAL DATA AND MODELING

The temperature rise of the hand palm has been measured with infrared thermography under the influence of an external infrared radiation source. The temperature rises could be very well fitted to exponential function, so that the experimental data could be summarized with just two parameters: amplitude and time constant. A simple mathematical model has been set up to explain the experimentally observed phenomena. It was found that the blood perfusion is essential to explain the results. From our measurements, which is essentially a noninvasive technique, several parameters could be found, the numerical values of which, agree with data found in the literature.

An implantable thermoresponsive drug delivery system based on Peltier device

Locally dropping the temperature in vivo is the main obstacle to the clinical use of a thermoresponsive drug delivery system. In this paper, a Peltier electronic element is incorporated with a thermoresponsive thin film based drug delivery system to form a new drug delivery device which can regulate the release of rhodamine B in a water environment at 37 °C. Various current signals are used to control the temperature of the cold side of the Peltier device and the volume of water on top of the Peltier device affects the change in temperature. The pulsatile on-demand release profile of the model drug is obtained by turning the current signal on and off. The work has shown that the 2600 mAh power source is enough to power this device for 1.3 h. Furthermore, the excessive heat will not cause thermal damage in the body as it will be dissipated by the thermoregulation of the human body. Therefore, this simple novel device can be implanted and should work well in vivo.

Medical thermal imaging of electrically stimulated woman breast: a simulation study

Tissues have different electrical conductivity and metabolic energy consumption values depending on their state of health and species. Since metabolic heat generation values show differences from tissue to tissue, thermal imaging has started to play an important role in medical diagnoses. Temperature differences of healthy and cancerous tissue may be changed by means of frequency dependent current stimulation within medical safety limits, and thus, depth dependent imaging performance can be increased. In this study, a three-dimensional realistic model of a woman breast and malignant tissue is generated and frequency dependent feasibility work for the proposed method is implemented. Temperature distributions are obtained by solving Pennes Bio Heat Equation (using finite element method). Temporal and spatial temperature distribution images are obtained at desired depths for two cases; with and without current application. Different temperature distributions are imaged by altering the frequency of the applied current and the corresponding conductivity value. Improvement in the imaging performance can be provided by current stimulation, and the temperature difference generated by 40 mm(3) tumor at 1.5 cm depth can be detected on breast surface with the state-of-the-art thermal imagers.

Spatial temperature distribution in human hairy and glabrous skin after infrared CO2 laser radiation

BACKGROUND

CO2 lasers have been used for several decades as an experimental non-touching pain stimulator. The laser energy is absorbed by the water content in the most superficial layers of the skin. The deeper located nociceptors are activated by passive conduction of heat from superficial to deeper skin layers.

METHODS

In the current study, a 2D axial finite element model was developed and validated to describe the spatial temperature distribution in the skin after infrared CO2 laser stimulation. The geometry of the model was based on high resolution ultrasound scans. The simulations were compared to the subjective pain intensity ratings from 16 subjects and to the surface skin temperature distributions measured by an infrared camera.

RESULTS

The stimulations were sensed significantly slower and less intense in glabrous skin than they were in hairy skin (MANOVA, p < 0.001). The model simulations of superficial temperature correlated with the measured skin surface temperature (r > 0.90, p < 0.001). Of the 16 subjects tested; eight subjects reported pricking pain in the hairy skin following a stimulus of 0.6 J/cm2 (5 W, 0.12 s, d1/e2 = 11.4 mm) only two reported pain to glabrous skin stimulation using the same stimulus intensity. The temperature at the epidermal-dermal junction (depth 50 μm in hairy and depth 133 μm in glabrous skin) was estimated to 46°C for hairy skin stimulation and 39°C for glabrous skin stimulation.

CONCLUSIONS

As compared to previous one dimensional heat distribution models, the current two dimensional model provides new possibilities for detailed studies regarding CO2 laser stimulation intensity, temperature levels and nociceptor activation.

Relationships of skin depths and temperatures when varying pulse repetition frequencies from 2.0-microm laser light incident on pig skin

Human perception of 2.0-microm infrared laser irradiation has become significant in such disparate fields as law enforcement, neuroscience, and pain research. Several recent studies have found damage thresholds for single-pulse and continuous wave irradiations at this wavelength. However, the only publication using multiple-pulse irradiations was investigating the cornea rather than skin. Literature has claimed that the 2.0-microm light characteristic thermal diffusion time was as long as 300-ms. Irradiating the skin with 2.0-microm lasers to produce sensation should follow published recommendations to use pulses on the order of 10 to 100 ms, which approach the theoretical thermal diffusion time. Therefore, investigation of the heating of skin for a variety of laser pulse combinations was undertaken. Temperatures of ex vivo pig skin were measured at the surface and at three depths from pulse sequences of six different duty factors. Differences were found in temperature rise per unit exposure that did not follow a linear relation to duty factor. The differences can be explained by significant heat conduction during the pulses. Therefore, the common heat modeling assumption of thermal confinement during a pulse may need to be experimentally verified if the pulse approaches the theoretical thermal confinement time.

Distributed self-regulation of living tissue: beyond the ideal limit

The present paper is devoted to mathematical description of the vascular network response to local perturbations in the cellular tissue state, being one of the basic mechanisms controlling the inner environment of human body. Keeping in mind individual organs we propose a model for distributed self-regulation of living tissue, which is regarded as an active hierarchical system without any controlling center. This model is based on the self-processing of information about the cellular tissue state and cooperative interaction of blood vessels governing redistribution of blood flow over the vascular network. The information self-processing is implemented via mass conservation, i.e., conservation of blood flow as well as special biochemical compounds called activators transported by blood. The cooperative interaction of blood vessels stems from the response of individual vessels to activators in blood flowing through them. The general regularities are used to specify the vessel behavior. The arterial and venous beds are considered to be individually of the tree form. The constructed governing equations are analyzed numerically. In particular, first, we show that the blood perfusion rate approximately (in the analyzed case within 10% accuracy) depends only on the local concentration of activators in the cellular tissue. It is due to the hierarchical structure of the vascular network rather than the ideal behavior of individual vessels accepted previously. Second, we demonstrate the distinction between the reaction thresholds of individual vessels and that of the vascular network as a whole. The latter effect is the cause for introducing the notion of activators instead of using such quantities as temperature in describing the living tissue self-regulation.

Experimental Study of a TET System for Implantable Biomedical Devices

Time-varying magnetic fields can be used to transfer power across the skin to drive implantable biomedical devices without the use of percutaneous wires. However, the main challenges of a transcutanoues energy transfer (TET) system are the temperature rise caused by power loss in the implanted circuitry and the changes in positioning between the external and internal coils due to fitting and changes in posture. This study presents a TET system with a closed-loop frequency-based power regulation method to deliver the right amount of power to the load under variable coil coupling conditions. After implanting a TET system into adult sheep, the temperature rise in the internal and external coils of a TET system was measured for power delivery in the range of 5 W to 15 W. The sheep was housed in a temperature controlled (16 plusmn1degC, humidity 50plusmn10%) room, in accordance with the standard protocols implemented at the University of Auckland for sheep studies. A power-loss analysis for the overall system was performed. The system was capable of regulating power for axially aligned separations of up to 16 mm. The maximum power efficiency of the overall system was 82.1% and a maximum temperature rise of 2.7degC was observed on the implanted secondary coil.

Towards Solid Tumor Treatment by Nanosecond Pulsed Electric Fields

Local and drug-free solid tumor ablation by large nanosecond pulsed electric fields leads to supra-electroporation of all cellular membranes and has been observed to trigger nonthermal cell death by apoptosis. To establish pore-based effects as the underlying mechanism inducing apoptosis, we use a multicellular system model (spatial scale 100 μm) that has irregularly shaped liver cells and a multiscale liver tissue model (spatial scale 200 mm). Pore histograms for the multicellular model demonstrate the presence of only nanometer-sized pores due to nanosecond electric field pulses. The number of pores in the plasma membrane is such that the average tissue conductance during nanosecond electric field pulses is even higher than for longer irreversible electroporation pulses. It is shown, however, that these nanometer-sized pores, although numerous, only significantly change the permeability of the cellular membranes to small ions, but not to larger molecules. Tumor ablation by nanosecond pulsed electric fields causes small to moderate temperature increases. Thus, the underlying mechanism(s) that trigger cell death by apoptosis must be non-thermal electrical interactions, presumably leading to different ionic and molecular transport than for much longer irreversible electroporation pulses.

Heat transfer analysis for peripheral blood flow measurement system

Some disorders such as circulatory disease and metabolic abnormality cause many problems to peripheral blood flow condition. Therefore, frequent measurement of the blood flow condition is bound to contribute to precaution against those disorders and to control of conditions of the diseases. We propose a convenient means of blood flow volume measurement at peripheral part, such as fingertips. Principle of this measurement is based on heat transfer characteristics of peripheral part containing the blood flow. Transition response analysis of skin surface temperature has provided measurement model of the peripheral blood flow volume. We developed the blood flow measurement system based on that model and evaluated it by using artificial finger under various temperature conditions of ambience and internal fluid. The evaluation results indicated that proposed method could estimate the volume of the fluid regardless of temperature condition of them. Finally we applied our system to real finger testing and have obtained results correlated well with laser Doppler blood flow meter values.

Preliminary optimization of non-destructive high intensity focused ultrasound exposures for hyperthermia applications

Due to its high degree of accuracy and non-invasive implementation, pulsed-high intensity focused ultrasound (HIFU) is a promising modality for hyperthermia applications as adjuvant therapy for cancer treatment. However, the relatively small focal region of the HIFU beam could result in prohibitively long treatment times for large targets requiring multiple exposures. In this work, finite element analysis modeling was used to simulate focused ultrasound propagation and the consequent induction of hyperthermia. The accuracy of the simulations was first validated with thermocouple measurements in hydrogel phantoms. More advanced simulations of in vivo applications using single HIFU exposures were then done incorporating complex, multi-layered tissue composition and variable perfusion for an in vivo murine xenograft tumor model. The results of this study describe the development of a preliminary methodology for optimizing spatial application of hyperthermia, through the evaluation of different HIFU exposures. These types of simulations, and their validations in vivo, may help minimize treatment durations for pulsed-HIFU induced hyperthermia and facilitate the translation of these exposures into the clinic.

Sequential activation of a segmented ground pad reduces skin heating during radiofrequency tumor ablation: optimization via computational models

Radiofrequency (RF) ablation has become an accepted treatment modality for unresectable tumors. The need for larger ablation zones has resulted in increased RF generator power. Skin burns due to ground pad heating are increasingly limiting further increases in generator power, and thus, ablation zone size. We investigated a method for reducing ground pad heating in which a commercial ground pad is segmented into multiple ground electrodes, with sequential activation of ground electrode subsets. We created finite-element method computer models of a commercial ground pad (14 x 23 cm) and compared normal operation of a standard pad to sequential activation of a segmented pad (two to five separate ground electrode segments). A constant current of 1 A was applied for 12 min in all simulations. Time periods during sequential activation simulations were adjusted to keep the leading edge temperatures at each ground electrode equal. The maximum temperature using standard activation of the commercial pad was 41.7 degrees C. For sequential activation of a segmented pad, the maximum temperature ranged from 39.3 degrees C (five segments) to 40.9 degrees C (two segments). Sequential activation of a segmented ground pad resulted in lower tissue temperatures. This method may reduce the incidence of ground pad burns and enable the use of higher power generators during RF tumor ablation.

Active mechanisms are needed to describe cell responses to submicrosecond, megavolt-per-meter pulses: cell models for ultrashort pulses

Intracellular effects of submicrosecond, megavolt-per-meter pulses imply changes in a cell's plasma membrane (PM) and organelle membranes. The maximum reported PM transmembrane voltage is only 1.6 V and phosphatidylserine is translocated to the outer membrane leaflet of the PM. Passive membrane models involve only displacement currents and predict excessive PM voltages (approximately 25 V). Here we use a cell system model with nonconcentric circular PM and organelle membranes to demonstrate fundamental differences between active (nonlinear) and passive (linear) models. We assign active or passive interactions to local membrane regions. The resulting cell system model involves a large number of interconnected local models that individually represent the 1), passive conductive and dielectric properties of aqueous electrolytes and membranes; 2), resting potential source; and 3), asymptotic membrane electroporation model. Systems with passive interactions cannot account for key experimental observations. Our active models exhibit supra-electroporation of the PM and organelle membranes, some key features of the transmembrane voltage, high densities of small pores in the PM and organelle membranes, and a global postpulse perturbation in which cell membranes are depolarized on the timescale of pore lifetimes.

Sequential activation of multiple grounding pads reduces skin heating during radiofrequency tumor ablation

PURPOSE

Radiofrequency (RF) tumor ablation has become an accepted treatment modality for tumors not amenable to surgery. Skin burns due to ground pad heating may become a limiting factor for further increase in ablation zone dimensions and generator power. We investigated a method were groups of ground pads are sequentially activated to reduce skin heating.

METHODS

We compared conventional operation (i.e. simultaneous connection of all pads) to sequentially switched activation of the pads where different pad combinations are active for periods of approximately 0.3 - 8 s. The timing during sequential activation was adjusted to keep the leading edge temperature equal between the pads. We created Finite Element Method computer models of three pads (5 x 5 cm, 1 cm apart) placed in line with the RF electrode on a human thigh to determine differences in tissue heating during simultaneous and sequential ground pad activation. We performed experiments with three ground pads (5 x 10 cm, 4 cm apart) placed on a tissue phantom (1.5 A, 12 min) and measured pad surface and leading edge temperatures.

RESULTS

Temperature rise below the leading edge for proximal, middle and distal ground pad in relation to active electrode location was 5.9 degrees C +/- 0.1 degrees C, 0.8 degrees C +/- 0.1 degrees C and 0.3 degrees C +/- 0.1 degrees C for conventional operation, and 3.3 degrees C +/- 0.1 degrees C, 3.4 degrees C +/- 0.2 degrees C and 3.4 degrees C +/- 0.2 degrees C for sequentially activated operation in the experiments (p < 0.001).

CONCLUSION

Sequential activation of multiple ground pads resulted in reduced maximum tissue temperature. This may reduce the incidence of ground pad burns and may allow higher power RF generators.

Towards solid tumor treatment by irreversible electroporation: intrinsic redistribution of fields and currents in tissue

Local and drug-free tissue treatment by irreversible electroporation (IRE) involves the creation of aqueous pores in a cell's plasma membrane (PM) and leads to non-thermal cell death by necrosis. To investigate explicit pore-based effects we use two-dimensional system models with different spatial scales. The first is a multicellular system model (spatial scale 100 mum) that has irregularly shaped cells, and quantitatively describes dynamic (creation and destruction, evolution in pore size) pore behavior at the PM. The second is a tissue model (spatial scale 200 mm) that is constructed from a unit cell and uses the asymptotic (fixed pore size) electroporation model. Both system models show that significant redistribution of fields and currents occurs through transient PM pores. Pore histograms for the multicellular model demonstrate the simultaneous presence of small and large pores during IRE pulses. The associated significant increase of PM permeability may prove to be essential to understanding how cell death by necrosis occurs. The averaged tissue conductivity in both models increases during IRE pulses because of electroporation. This leads to greater electrical dissipation (heating) and, thus, to larger temperature increases than suggested by tissue models with passive and static electrical properties.

Electrical behavior and pore accumulation in a multicellular model for conventional and supra-electroporation

Extremely large but very short (20 kV/cm, 300 ns) electric field pulses were reported recently to non-thermally destroy melanoma tumors. The stated mechanism for field penetration into cells is pulse characteristic times faster than charge redistribution (displacement currents). Here we use a multicellular model with irregularly shaped, closely spaced cells to show that instead overwhelming pore creation (supra-electroporation) is dominant, with field penetration due to pores (ionic conduction currents) during most of the pulse. Moreover, the model's maximum membrane potential (about 1.2 V) is consistent with recent experimental observations on isolated cells. We also use the model to show that conventional electroporation resulting from 100 microsecond, 1 kV/cm pulses yields a spatially heterogeneous electroporation distribution. In contrast, the melanoma-destroying pulses cause nearly homogeneous electroporation of cells and their nuclear membranes. Electropores can persist for times much longer than the pulses, and are likely to be an important mechanism contributing to cell death.

Finite volume analysis of temperature effects induced by active MRI implants: 2. Defects on active MRI implants causing hot spots

BACKGROUND

Active magnetic resonance imaging implants, for example stents, stent grafts or vena cava filters, are constructed as wireless inductively coupled transmit and receive coils. They are built as a resonator tuned to the Larmor frequency of a magnetic resonance system. The resonator can be added to or incorporated within the implant. This technology can counteract the shielding caused by eddy currents inside the metallic implant structure. This may allow getting diagnostic information of the implant lumen (in stent stenosis or thrombosis for example). The electro magnetic rf-pulses during magnetic resonance imaging induce a current in the circuit path of the resonator. A by material fatigue provoked partial rupture of the circuit path or a broken wire with touching surfaces can set up a relatively high resistance on a very short distance, which may behave as a point-like power source, a hot spot, inside the body part the resonator is implanted to. This local power loss inside a small volume can reach (1/4) of the total power loss of the intact resonating circuit, which itself is proportional to the product of the resonator volume and the quality factor and depends as well from the orientation of the resonator with respect to the main magnetic field and the imaging sequence the resonator is exposed to.

METHODS

First an analytical solution of a hot spot for thermal equilibrium is described. This analytical solution with a definite hot spot power loss represents the worst case scenario for thermal equilibrium inside a homogeneous medium without cooling effects. Starting with this worst case assumptions additional conditions are considered in a numerical simulation, which are more realistic and may make the results less critical. The analytical solution as well as the numerical simulations use the experimental experience of the maximum hot spot power loss of implanted resonators with a definite volume during magnetic resonance imaging investigations. The finite volume analysis calculates the time developing temperature maps for the model of a broken linear metallic wire embedded in tissue. Half of the total hot spot power loss is assumed to diffuse into both wire parts at the location of a defect. The energy is distributed from there by heat conduction. Additionally the effect of blood perfusion and blood flow is respected in some simulations because the simultaneous appearance of all worst case conditions, especially the absence of blood perfusion and blood flow near the hot spot, is very unlikely for vessel implants.

RESULTS

The analytical solution as worst case scenario as well as the finite volume analysis for near worst case situations show not negligible volumes with critical temperature increases for part of the modeled hot spot situations. MR investigations with a high rf-pulse density lasting below a minute can establish volumes of several cubic millimeters with temperature increases high enough to start cell destruction. Longer exposure times can involve volumes larger than 100 mm3. Even temperature increases in the range of thermal ablation are reached for substantial volumes. MR sequence exposure time and hot spot power loss are the primary factors influencing the volume with critical temperature increases. Wire radius, wire material as well as the physiological parameters blood perfusion and blood flow inside larger vessels reduce the volume with critical temperature increases, but do not exclude a volume with critical tissue heating for resonators with a large product of resonator volume and quality factor.

CONCLUSION

The worst case scenario assumes thermal equilibrium for a hot spot embedded in homogeneous tissue without any cooling due to blood perfusion or flow. The finite volume analysis can calculate the results for near and not close to worst case conditions. For both cases a substantial volume can reach a critical temperature increase in a short time. The analytical solution, as absolute worst case, points out that resonators with a small product of inductance volume and quality factor (Q V(ind) < 2 cm3) are definitely save. Stents for coronary vessels or resonators used as tracking devices for interventional procedures therefore have no risk of high temperature increases. The finite volume analysis shows for sure that also conditions not close to the worst case reach physiologically critical temperature increases for implants with a large product of inductance volume and quality factor (Q V(ind) > 10 cm3). Such resonators exclude patients from exactly the MRI investigation these devices are made for.

Model of a confined spherical cell in uniform and heterogeneous applied electric fields

Cells exposed to electric fields are often confined to a small volume within a solid tissue or within or near a device. Here we report on an approach to describing the frequency and time domain electrical responses of a spatially confined spherical cell by using a transport lattice system model. Two cases are considered: (1) a uniform applied field created by parallel plane electrodes, and (2) a heterogeneous applied field created by a planar electrode and a sharp microelectrode. Here fixed conductivities and dielectric permittivities of the extra- and intracellular media and of the membrane are used to create local transport models that are interconnected to create the system model. Consistent with traditional analytical solutions for spherical cells in an electrolyte of infinite extent, in the frequency domain the field amplification, G(m) (f) is large at low frequencies, f<1 MHz. G(m) (f) gradually decreases above 1 MHz and reaches a lower plateau at about 300 MHz, with the cell becoming almost "electrically invisible". In the time domain the application of a field pulse can result in altered localized transmembrane voltage changes due to a single microelectrode. The transport lattice approach provides modular, multiscale modeling capability that here ranges from cell membranes (5 nm scale) to the cell confinement volume ( approximately 40 microm scale).

Microdosimetry for conventional and supra-electroporation in cells with organelles

Conventional electroporation (EP) by 0.1 to 1 kV/cm pulses longer than 100 micros, and supra-electroporation by 10 to 300 kV/cm pulses shorter than 1 micros cause different cellular effects. Conventional EP delivers DNA, proteins, small drugs, and fluorescent indicators across the plasma membrane (PM) and causes moderate levels of phosphatidylserine (PS) translocation at the PM. We hypothesize that supra-EP is central to intracellular effects such as apoptosis induction and higher levels of PS translocation. Our cell system model has 20,000 interconnected local models for small areas of the PM and organelle membranes, small regions of aqueous media, appropriate resting potentials, and the asymptotic EP model. Conventional EP primarily affects the PM, but with a hint of endoplasmic reticulum involvement. Supra-EP can involve all of a cell's membrane at the largest fields. Conventional EP fields tend to go around cells, but supra-EP fields go through cells, extensively penetrating organelles.

The kinetics of transdermal ethanol exchange

The kinetics of ethanol transport from the blood to the skin surface are incompletely understood. We present a mathematical model to predict the transient exchange of ethanol across the skin while it is being absorbed from the gut and eliminated from the body. The model simulates the behavior of a commercial device that is used to estimate the blood alcohol concentration (BAC). During the elimination phase, the stratum corneum of the skin has a higher ethanol concentration than the blood. We studied the effect of varying the maximum BAC and the absorption rate from the gut on the relationship between BAC and equivalent concentration in the gas phase above the skin. The results showed that the ethanol concentration in the gas compartment always took longer to reach its maximum, had a lower maximum, and had a slower apparent elimination rate than the BAC. These effects increased as the maximum BAC increased. Our model's predictions are consistent with experimental data from the literature. We performed a sensitivity analysis (using Latin hypercube sampling) to identify and rank the importance of parameters. The analysis showed that outputs were sensitive to solubility and diffusivity within the stratum corneum, to stratum corneum thickness, and to the volume of gas in the sampling chamber above the skin. We conclude that ethanol transport through the skin is primarily governed by the washin and washout of ethanol through the stratum corneum. The dynamics can be highly variable from subject to subject because of variability in the physical properties of the stratum corneum.

Functional infrared imaging for skin-cancer screening

Annually 133.000 people world-wide get sick on malign melanoma, tendency increasing. The purpose of this study is the early diagnosis of malignant skin cancer. At the moment the dermatologists are screening for anomalies at the relevant lesion by examining the skin area with a microscope. To determine changes, another scan has to be taken in a follow-up session after a time period of about 15-20 weeks. Today's visual diagnostic decision is based on the pragmatic ABCD approach (Asymmetry, Border, Colour, and Diameter). However, there is no adequate and sound non-invasive way to find out, if a skin spot is either malign or benign. If the visual approach corroborates a suspicion of skin cancer, histology is needed to make explicit diagnosis. To avoid unnecessary surgeries (on false positive alarm) and to initiate necessary surgeries in early stages a new diagnostic screening approach is presented here. Based on the fact that malign melanoma have higher metabolism as well as increased blood flow, it has been conjectured that malign melanoma have slightly higher temperature compared to the healthy skin that can be measured by high resolution functional infrared imaging.

Cylindrical cell membranes in uniform applied electric fields: validation of a transport lattice method

The frequency and time domain transmembrane voltage responses of a cylindrical cell in an external electric field are calculated using a transport lattice, which allows solution of a variety of biologically relevant transport problems with complex cell geometry and field interactions. Here we demonstrate the method for a cylindrical membrane geometry and compare results with known analytical solutions. Results of transport lattice simulations on a Cartesian lattice are found to have discrepancies with the analytical solutions due to the limited volume of the system model and approximations for the local membrane model on the Cartesian lattice. Better agreement is attained when using a triangular mesh to represent the geometry rather than a Cartesian lattice. The transport lattice method can be readily extended to more sophisticated cell, organelle, and tissue configurations. Local membrane models within a system lattice can also include nonlinear responses such as electroporation and ion-channel gating.