類別:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/158
2024-03-06T02:49:07Z麻醉時脈波傳遞時間與心跳變異率相關性之研究
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/10668
標題: 麻醉時脈波傳遞時間與心跳變異率相關性之研究; A Study of the Correlation of Pulse Wave Transit Time and Heart Rate Variability during Anesthesia
作者: Wei Liu; 劉為
摘要: 在手術房中,麻醉是相當重要且不可缺少的一環,尤其是施打麻醉的劑量更是重要,但過多或過少的麻醉劑量均會帶給病患不好的影響。一般來說,全身性的藥物麻醉會透過阻斷自主神經系統來影響病患心血管狀況,常引發病人的心率改變、心臟收縮力下降、血管彈性改變以及周邊血管擴張等等現象,這種血行動力學的變化會造成受麻醉病人的血壓下降甚至產生休克的風險,尤其是對於本身患有糖尿病或心血管疾病等高危險性病人,更有導致併發症甚至死亡的危險。
心跳變異率(heart rate variability, HRV)在許多文獻中皆有探討到可以用來做為評估自主神經系統活性的工具。由於心跳速率的低頻部分是交感神經與副交感神經所共同作用;高頻部分則由副交感神經所單獨控制。因此,最常見的心跳變異率分析方法即為利用功率頻譜密度(power spectrum density)得到心跳間隔在頻域上的高低頻比值,推估目前心血管系統受到自主神經調控的程度。
本論文的研究內容即是針對手術中之麻醉安全,整合心電圖、光體積描述訊號等非侵入式相關生理資訊,並利用圖形化程式語言LabVIEW8.6軟體為平台開發一套監控程式,分析受測者接受麻醉藥物Bariburates前後心跳變異率以及脈波傳遞時間(PTT)的改變趨勢來推估目前接受麻醉的病人自主神經以及心血管系統變化的情況。最後建立一個評估方法,提供麻醉科醫師在手術時應變的參考,給予病人最適度的麻醉劑量,讓病人可以在手術過後能以最快的時間復原。; In an operation room, anesthetics plays an important role and are indispensable. Furthermore, the dosage of anesthetic given is much more important because it may have terrible influences on the patients if it’s not accurate. Generally, general anesthesia affect the patients' cardiovascular system by cutting off the autonomic nervous system, which causes the patients' rhythm of the heart and blood vessels' elasticity to change, weakens the strength of systole, makes the peripheral vascular to extend and so on. These changes of hemodynamic may cause the patients' blood pressure to drop and will probably result in shock. Moreover, those who suffer from diabetes and cardiovascular disease are even more likely to have complications or die.
According to many references, heart rate variability (HRV) is a way to estimate the activity of the autonomic nervous system. Since the sympathetic nervous system and parasympathetic nervous system mutually affect the low-frequency part of the heart rate, while the parasympathetic nervous system alone controls the high- frequency part, the most common way to analyze heart rate variability is to use power spectrum density to get the power ratio (LF/HF) between heartbeats and speculate about how much the cardiovascular system is controlled by the autonomic nervous system.
This study aims at the safety of anesthetic in operations, combining relevant, non- intrusive measuring devices : electrocardiograms and photoplethysmographic. The thesis also analyzes the changes of HRV and pulse wave transit time (PTT) during anesthesia by LabVIEW8.6 based application program to estimate the patients’ autonomic nervous system and cardiovascular system. Eventually, the method of assessment to offer doctors a reference during an operation was build so that the patients could recover in the shortest time by giving them the appropriate anesthetic dosage.2010-01-01T00:00:00Z高通量免標定光學繞射斷層掃描術於紅血球三維型態之分析
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/85833
標題: 高通量免標定光學繞射斷層掃描術於紅血球三維型態之分析; Label-free Characterization of Red Blood Cell 3D Morphology with High-Throughput Optical Diffraction Tomography
作者: Yu-Hsiang Chang; 張祐祥
摘要: 作為人體氣體與調控循環系統的核心,紅血球的三維圓盤形狀、兩側表面凹陷程度、血紅素狀態甚至細胞膜表面的黏彈性,都與其物質攜帶交換的能力息息相關。因此可以推論出當其中出現變化勢必會伴隨著相關疾病的存在,像是貧血、糖尿病等患者都有異常血球的出現。臨床上針對紅血球的型態檢驗方式主要是血液抹片,但此方式在判定上較為緩慢且主觀,而在黏彈性等資訊上則需利用滲透壓梯度細胞計數儀等專業器材獲得。因此需多相關研究都提出不同的三維血球分析方式,包含在更高通量下獲取資訊,或是以旋轉樣本或旋轉光源方式拍攝紅血球三維資訊。本文整合並提升這些方式中的技術,達到高通量又能定量分析的三維紅血球量測技術。 定量相位顯微術作為一種免標記技術,可以動態的將樣本厚度及內部物質折射率資訊定量的記錄在干涉影像中,而這樣的技術去除了人為觀察,並可將其中所有參數以數值方式定量記錄。在先前文獻中即提出利用此技術結合微流道建立出高通量斷層繞射顯微系統以提升拍攝通量,並實現三維影像的擷取。建立在此技術之上,本研究將其最佳化並建立高通量斷層繞射顯微系統。在拍攝通量上可達到每分鐘43顆紅血球的拍攝速度,而為使處理速度同樣提升,利用深度學習模型進行影像分割並以圖形處理器進行後續運算上的加速。在三維重建流程中,本實驗提升澤爾尼克多項式擬合角度的正確性,並修正三維重建中資訊缺失的問題。文中將此技術應用在加入不同濃度戊二醛,來模擬血球型態異常之紅血球與一般情況之對比分析。在結果上平均物質質量、光學體積、細胞膜表面黏彈性、大小、體積、血球表面凹陷程度、球型率等變化,皆符合假設與文獻結果且都具有顯著差異。由此可以預期此技術在紅血球相關疾病或是觀察藥物影響的應用上,能以定量且快速的優勢輔助臨床檢驗。; As the central cell of the gas and circulatory system regulation, the characteristic of red blood cells includes disk shape, biconcave geometry, hemoglobin concentration, or even membrane fluctuation all related to the ability to carry and exchange. Therefore, we can speculate that the variation of that property will accompany the disease. For instance, in anemia, diabetes patients have been found to have abnormal RBCs. In clinical, the analysis of RBCs 3D features mainly uses blood smear, but the process is slow and subjective and the viscoelasticity of red blood cells requires professional equipment to measure, such as osmotic gradient ektacytometry. Hence, many studies have proposed different methods to analyze RBC, including higher throughput or captured 3D information by rotating incident light or sample. In this article, we have incorporated some of these techniques to achieve higher throughput while quantitatively measuring RBC. Digital holographic microscopy is a label-free method that can dynamically and quantitatively encode sample thickness and inner substance into an interferogram. This method records all parameters in numerical values to eliminate subjective judgments. In this study, we combined a digital holographic microscope with a microfluidic device to construct optical diffraction tomography to improve capture throughput. The results show that with this setting, 43 RBCs can be captured per minute. As throughput increases, this article uses deep learning and GPU to accelerate processing. For 3D RBC reconstruction, this research optimizes the Zernike polynomial angle estimation algorithm and minimizes the problems caused by the missing angle problem. Finally, this setting was applied to observe red blood cells induced by different amounts of glutaraldehyde to simulate the comparison between abnormal red blood cells and normal red blood cells. The result shows that mean mass density, optical volume, membrane fluctuation, size, volume, sphericity, and concavity are all in agreement with the hypothesis and previous research significantly. From the result, this research is expected to use quantitative and rapid advantages to assist clinical testing on other RBC-related diseases or measure the impact of drugs.2022-01-01T00:00:00Z高解析掃描式表面電漿共振顯微鏡應用於大腸癌腫瘤標誌陣列晶片之檢測
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/57589
標題: 高解析掃描式表面電漿共振顯微鏡應用於大腸癌腫瘤標誌陣列晶片之檢測; High-resolution Scanning Surface Plasmon Resonance Microscopy for Imaging of Colorectal Cancer Sensor Array
作者: Pei-Tung Yang; 楊沛東
摘要: 近年藉由多種腫瘤標誌物表現量做為癌症預後評估因子已逐漸受到重視,以腸胃等消化系統來說,隨著生活及飲食方式的改變,大腸癌在世界各國的盛行率不斷的攀升,因超過半數的大腸癌患者大多於第二期或第三期才被診斷接受治療,其中部分患者易有轉移或復發的情形而降低了存活率,因此如何能協助臨床人員針對不同大腸癌的分期以及不同病灶發生的位置,做一個適當的預後評估為一個重要的課題,其中以在腫瘤標誌物檢測的研究領域上,如何能達到多功檢測以及降低檢測成本的情形下,可以有較高的靈敏度以及更快速的檢測,並提供較為直觀的檢測技術也被視為該領域當中主要探討的議題。
本研究以先前對於掃描式表面電漿共振顯微鏡的研究基礎,將此技術全新的應用在微奈米級的蛋白質陣列檢測上,以作為高解析、非標記且於低濃度下有高靈敏度的光學檢測技術之一,嘗試幫助解決目前在蛋白質檢測上所面臨到的問題。本論文在探討檢測應用前,先將過去對於掃描式表面電漿共振顯微鏡的系統研究加以延伸,探討到該顯微鏡之影像品質以及檢測品質,以了解該系統之空間解析度以及檢測極限,量測結果顯示目前所量測到最佳橫向解析度為1 μm左右,證實該技術可以解決因表面電漿共振波傳遞所造成過去影像中橫向解析度失真的問題,而表面電漿共振角解析度於低薄膜樣本量測時可至0.0045度左右,換算成可量測的等效折射率變化可至〖10〗^(-4)等級,其檢測極限與過去研究結果相符,顯示若將其作為檢測工具,因表面電漿共振技術具有極佳的靈敏度,高解析掃描式表面電漿共振顯微鏡可作為高檢測品質的影像式檢測技術之一。
本論文的另一主軸,即是將掃描式表面電漿共振顯微鏡應用於腫瘤標誌陣列檢測,以大腸癌預後標誌物之胎盤生長因子做為檢測標的,實驗結果顯示該顯微鏡系統搭配金微奈米陣列晶片的檢測相較於傳統平面金膜晶片的檢測,於低抗原濃度100 pg/mL以下有高出10倍的檢測靈敏度結果,並與陰性對照組比較後其檢測極限可至10 pg/mL,其檢測線性範圍包含胎盤生長因子作為預後評估的濃度閥值20.6 pg/mL,因此將掃描式表面電漿共振顯微鏡應用於微奈米級的胎盤生長因子陣列檢測,可以以金微奈米陣列晶片上修飾少量的檢測試劑的優點達到降低檢測成本外,搭配掃描式表面電漿共振顯微鏡可以於低濃度下,透過金微奈米結構將檢測訊號放大,達到較高的檢測靈敏度和檢測極限的效果,未來期望透過陣列多功檢測的優點,進行多種的大腸癌腫瘤標誌物陣列檢測,以多種腫瘤標誌物之濃度指標針對大腸癌患者進行適當的預後評估,提高大腸癌患者的生存率。; With the changes of living style and diet habit, the occurrence of colorectal cancer (CRC) has steadily increased in recent years. More than half of new CRC patients are initially diagnosed and received treatments beyond stage II or even III and thus have lower 5-years relative survival percentage due to metastasis or relapse. Thus, it is critical to develop a better tool to assist the clinician for appropriate prognosis of recurrence or prediction of survival rate in different cancer stage or in different tumor site or even to deliver a proper personalized treatment. Multiplex detection of prognostic cancer biomarkers has been an important trend in translational medicine and the grand challenge is to achieve higher detection sensitivity at lower sample volume.
In this thesis, our study was based on the foregoing researches of scanning surface plasmon resonance microscopy (sSPRM) and applied this technique to novel detection of submicron scale protein array. It is a label-free optical sensing method of high resolution and sensitivity. Based on the foregoing system researches on scanning surface plasmon resonance microscopy, we firstly characterized the quality of imaging system with fabricated nano-structure. According to measurement results, the lateral resolution of system was 1 μm and the resolution of surface plasmon resonance angle was 0.0045 degrees, which is equal to 〖10〗^(-4) of effective refractive index changes on thin film measurement. It revealed that this sSPRM can serve as a high sensitivity image-type sensing technique.
At the second part of this thesis, we applied this sSPRM system to cancer biomarker array detection. We used the placental growth factor (PlGF), one of colorectal cancer prognostic biomarkers, as the sensing target. According to the experimental results, compared to the conventional SPR senor chip (gold film), the sensitivity of detection improved 10 folds at low sample concentration (below the 100 pg/mL) by gold array senor chip in submicron scale. The limit of detection was down to the 10 pg/mL in reference to the negative control and the linear range of detection included the prognostic threshold 20.6 pg/mL of placental growth factor. In conclusion, the using of test cost of the sensor array was lower than ELISA method and our detection method can enhance the sensitivity and the detection limit without additional fluorescent label by Au array imaging of SPRM. In the future, we expect that the advantage of sensor array, detecting many prognostic biomarkers by SPRM system, can provide an appropriate prognosis and increase the survival rate of colorectal cancer.2014-01-01T00:00:00Z高解析度、對比增強的人腦磁化率權重造影
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/22954
標題: 高解析度、對比增強的人腦磁化率權重造影; High-Resolution, Contrast-Enhanced Susceptibility Weighted Imaging of Human Brain
作者: Hao-Chieng Liao; 廖浩謙
摘要: 磁化率權重造影是近期發展的T2*權重的梯度迴訊(gradient echo)序列,利用不同組織的磁化率差異會導致局部的非均勻性磁場。這項技術是起源於高解析度、血氧濃度依賴的靜脈造影(HRBV),相較於傳統的造影技術而言,可以提升以往看不見的微小靜脈血管的可見度。因為越來越多的發展和應用並不侷限在靜脈血管造影方面,所以現在被重新賦予了名稱『磁化率權重造影』。
磁化率權重造影的主要機制是利用不同組織的磁化率差異作為對比特性,特別是去氧紅血球在大腦靜脈結構中的磁化率特性。雖然現今,磁化率權重造影已經內建於許多核磁共振機台的序列中,但我們仍然要去了解磁化率權重造影的重建方法和參數,唯有如此,我們才能再進一步地對磁化率權重造影最佳化。
演算法的處理步驟1)對原始相位影像的濾波過程,移除背景造成的低頻雜訊部分2)製作負的相位遮罩,對已濾波的相位影像去做負相位的萃取和正規化3)將負相位遮罩去乘上振幅影像,將相位影像對磁化率敏感度的優勢,映射至磁化率權重的影像中4)最小強度投影,讓磁化率權重能進一步地被突顯出來。
最後,本研究會將磁化率權重造影的技術嘗試在臨床的疾病。許多文獻也證明在磁化率權重造影中,出血性的組織部位將會比用傳統照影方式更容易被偵測到;這項特性促成了磁化率權重造影在醫學上的貢獻,因而能有效地評估病理的症狀,越來越多臨床疾病的技術應用也陸續地被發現。; Susceptibility-weighted imaging (SWI) is the recently T2*-weighted gradient echo sequence, taking advantage of magnetic susceptibilities of tissues because of local in-homogeneities in mainly magnetic field. It originates from “High –Resolution Blood oxygen level dependent Venography (HRBV)”, helping visualization of the venous structure in the brain. In this way, minute vessels can be seen by HRBV, not by conventional imaging technique. Because more and more applications are not restricted to venography, it is recalled “Susceptibility-weighted imaging” for its contrast mechanism.
The essential theory of SWI is utilizing paramagnetic properties to enhance contrast and detection, especially deoxygenated hemoglobin in venous vasculature. Until now, SWI has become the scanner-derived image, but we should know post-processed reconstruction in order to improve SWI technique one day. The processing methods include filtering phase data, generating phase mask and multiplying magnitude image with phase mask.
The study also promotes the clinical applications of SWI. Literatures prove that hemorrhagic lesions are more detectable and visible in the SWI than in traditional sequences. This can contribute SWI to evaluate pathology effectively and efficient.2011-01-01T00:00:00Z