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At least 19 records

Risk of decompression sickness in the presence of circulating microbubbles

In this study, we examined the association between microbubbles formed in the circulation from a free gas phase and symptoms of altitude decompression sickness (DCS). In a subgroup of 59 males of mean (S.D) age 31.2 (5.8) years who developed microbubbles during exposure to 26.59 kPa (4.3 psi) under simulated extravehicular activities (EVA), symptoms of DCS occurred in 24 (41 percent) individuals. Spencer grade 1 microbubbles occurred in 4 (7 percent), grade 2 in 9 (15 percent), grade 3 in 15 (25 percent), and grade 4 in 31 (53 percent) of subjects. Survival analysis using Cox proportional hazards regression showed that individuals with less than grade 3 CMB showed 2.46 times (95 percent confidence interval = 1.26 to 5.34) higher risk of symptoms. This information is crucial for defining the risk of DCS for inflight Doppler monitoring under space EVA. Altitude decompression sickness (DCS) occurs when there is acute reduction in ambient pressure. The symptoms of DCS are due to the formation of a free gas phase (in the form of gas microbubbles) in tissues during decompression. Musculo-skeletal pain of bends is the commonest form of DCS in altitude exposures. In the space flight environment, there is a risk of DCS when astronauts decompress from the normobaric shuttle pressure into the hypobaric space suit pressure (currently about 29.65 kPa (4.3 psi) for extra-vehicular activities (EVA). This risk is counterbalanced by a judicious combination of prior denitrogenation and staged decompression. Studies of DCS are limited by the duration of the test at reduced pressure. Since only a proportion of subjects tested develop symptoms, the information on DCS is generally incomplete or 'censored'. Many studies employ Doppler ultrasound monitoring of the precordial area for detecting circulating microbubbles (CMB). Although the association between CMB and bends pain is not causal, CMB are frequently monitored during decompression. In this paper, we examine the association between CMB and symptoms of DCS under simulated EVA profiles.

Kumar, K. Vasantha↗

Time to detection of circulating microbubbles as a risk factor for symptoms of altitude decompression sickness

This study investigated the association between time at onset of circulating microbubbles (CMB) and symptoms of altitude decompression sickness (DCS), using Cox proportional hazard regression models. The study population consisted of 125 individuals who participated in direct ascent, simulated extravehicular activities profiles. Using individual CMB status as a time-dependent variable, we found that the hazard for symptoms increased significantly (at the end of 180 min at altitude) in the presence of CMB (Hazard Ratio = 29.59; 95 percent confidence interval (95 percent CI) = 7.66-114.27), compared to no CMB. Further examination was conducted on the subgroup of individuals who developed microbubbles during the test (n = 49), by using Cox regression. Individuals with late onset of CMB (greater than 60 min at altitude) showed a significantly reduced risk of symptoms (hazard ratio = 0.92; 95 percent CI = 0.89-0.95), compared to those with early onset (equal to or less than 60 min), while controlling for other risk factors. We conclude that time to detection of circulating microbubbles is an independent determinant of symptoms of DCS.

Kumar, K. V.↗

Aromatic proteinaceous surfactants stabilize long-lived gas microbubbles from natural sources

Three different types of protein-specific chemical tests were performed on long-lived gas microbubbles derived from aqueous solutions of agarose powder and from filtered aqueous extracts of Hawaiian forest soil. The separate protein-specific tests involved use of either 0.3% (w/v) ninhydrin, 100 microM methylene blue dye, or 0.7-1.0 M 2-hydroxy-5-nitrobenzyl bromide. The chemical test results obtained with each of the two natural substances, i.e., agarose powder and Hawaiian forest soil, were very similar and indicate that the biological surfactants which surround and stabilize long-lived gas microbubbles are proteinaceous compounds that contain, and whose surface activity depends upon, aromatic amino acid residues, particularly tryptophan.

Darrigo, J. S.↗

Microbubble dynamics and heat transfer in boiling droplets

Dissipating large heat fluxes from a surface is critically important in numerous industrial and natural applications. Boiling based spray cooling and surface texturing are two of the most promising methods being investigated to address this problem. Although our understanding on these topics has significantly improved over past decades, critical gaps remain in the knowledgebase stymieing the realization of their full potential. As an example, while bubble growth in pool boiling have been investigated in detail, comparatively little is known about how the bubbles evolve inside boiling drops. In the present work, we have investigated for the first time, the microbubble dynamics inside water droplets boiling on superhydrophilic textured substrates using high-speed X-ray phase contrast imaging (XRPCI). Our observations show that the transient bubble density variation follows similar characteristics irrespective of the texture spacing at a given surface temperature. For an example microstructure, we found that the number of discrete bubbles on the surface decreases as temperature is increased although their growth rate increases. Here, we observe that bubble growth is highly non-uniform during the lifetime of a drop on the surface. Initially, bubbles grow under diffusion-limited regime, but at later times they grow as ~t 1.45 due to combined effects of coalescence and evaporation. In some conditions, we found that bubbles shrink dramatically af- ter the initial growth spurt presumably due to severe quenching of the surface, and migration of bubbles on the surface. Using the bubble sizes, for the first time we analyzed the heat flux removed by a single bubble and also by all the bubbles at a given time. We find that the highest dissipation through latent- heat component (~600 W/cm 2 ) occurs just in the beginning and thereafter it decreases. We expect that our findings and the analysis would guide further work on the topic and will aid in the overarching goal of engineering surfaces that are more efficient in boiling heat transfer.

42 ENGINEERING↗

The effect of differences in time to detection of circulating microbubbles on the risk of decompression sickness

Circulating microbubbles (CMB) are frequently detected prior to the appearance of symptoms of Decompression Sickness (DCS). It is difficult to analyze the effect of CMB on symptoms due to differences in the time to detection of CMB. This paper uses survival analysis models to evaluate the risk of symptoms in the presence of CMB. Methods: Information on 81 exposures to an altitude of 6,400 m (6.5 psi) for a period of three hours, with simulated extravehicular activities, was examined. The presence or absence of CMB was included as a time dependent covariate of the Cox proportional hazards regression model. Using this technique, the subgroup of exposures with CMB was analyzed further. Mean (S.D.) time in minutes to onset of CMB and symptoms were 125 (63) and 165 (33) respectively, following the three hours exposure. The risk of symptoms (17/81) increased 14 times in the presence of CMB, after controlling for variations in time to detection of CMB. Further, the risk was lower when time to detection of CMB was greater than 60 minutes (risk ratio = 0.96; 95 percent confidence intervals = 0.94 - 0.99 0.99 P less than 0.01) compared to CMB before 60 minutes at altitude. Conclusions: Survival analysis showed that individual risk of DCS changes significantly due to variations in time to detection of CMB. This information is important in evaluating the risk of DCS in the presence of CMB.

Kumar, K. V.↗

Laboratory comparisons of acoustic and optical sensors for microbubble measurement

This paper presents the results of a recent comparison between three microbubble size spectrum measurement systems. These systems are the light-scattering bubble counter, the photographic bubble-imaging system, and the acoustic resonator array. Good agreement was formed among these three systems over the bubble size range appropriate for each system.

Su, Ming Yang↗

Quantitative phase imaging around water vapor microbubbles under pulsed laser illumination

We measured water temperature around a self-oscillating water vapor-rich bubble using diffraction phase microscopy equipped with a pulsed laser. The water vapor-rich bubble, which causes a strong water flow around it, was generated by locally heating degassed water through the photothermal conversion properties of an FeSi2 thin film. The generation of the flow is related to the self-oscillation of the bubble at sub-MHz frequencies and the temperature distribution around it. Here, the refractive index of the surrounding water was measured using a pulsed laser with a 3.5-ns pulse duration, which guarantees a time resolution of less than 1/200 of the oscillation cycle of the bubble. The temperature distribution around the bubble was calculated from the measured refractive index.

Narihira, Kyoshiro [Kyoto University, Japan]↗

Vessel Rupture Thresholds for Vessel–Bubble Interactions Using an Earthworm Vasculature Model

Intravenous microbubble oscillation in the presence of ultrasound has the potential to yield a wide range of therapeutic benefits. However, the likelihood of vessel damage caused by mechanical effects has not been quantified as a function of the numerous important parameters in therapeutic ultrasound procedures. In this study, we examined the effects of microbubbles injected into the vasculature of the earthworm. It was found that the elastic properties of earthworm blood vessels are similar to those of arteries in older humans, and that earthworms are well suited to the large number of experiments necessary to investigate safety of procedures involving microbubble oscillation in sonicated vessels. Microbubbles were infused into earthworm vessels, and the rupture time during sonication was recorded as a function of ultrasound frequency, pulse repetition frequency and acoustic pressure. A modified mechanical index (MMI) was defined that successfully captured the trends in rupture probability and rupture time for the different parameter values, creating a database of vessel rupture thresholds. In the absence of bubbles, the product of MMI squared and rupture time was approximately constant, indicating a possible radiation-force effect. Here, the MMI was an effective correlating parameter in the presence of bubbles, though the mathematical dependence is not yet apparent. The results of the study are expected to be valuable in designing more refined studies in vertebrate models, as well as informing computational models.

59 BASIC BIOLOGICAL SCIENCES↗

Patent Foramen Ovale: Association between the Degree of Shunt by Contrast Transesophageal Echocardiography and the Risk of Future Ischemic Neurologic Events

This study investigated whether there is an association between the degree of interatrial shunting across a patent foramen ovale, as determined by saline contrast transesophageal echocardiography, and the risk of subsequent systemic embolic events, including stroke. Thirty-four patients found to have patent foramen ovale during transesophageal echocardiography were divided into two groups on the basis of the maximum number of microbubbles in the left heart in any single frame after intravenous saline contrast injection: group 1 (n = 16) with a "large" degree of shunt (220 microbubbles) and group 2 (n = 18) with a "small" degree of shunt (23 but <20 microbubbles). Patients were followed up over a mean period of 21 months for subsequent systemic embolic events, including transient ischemic attack and stroke. Five (31%) of the patients with large shunts had subsequent ischemic neurologic events, whereas none of the patients with small shunts had embolic events (p= 0.03). These events occurred in spite of antiplatelet or anticoagulant therapy. We conclude that patients with a large degree of shunt across a patent foramen ovale, as determined by contrast transesophageal echocardiography, are at a significantly higher risk for subsequent adverse neurologic events compared with patients with a small degree of shunt.

Stone, David A.↗

Characterizing how size distribution and concentration affect echogenicity of ultrasound contrast agents

Here, we investigated the effects of UCA gas bubble size distribution and concentration on the generated ultrasound echogenicity signal. Gas bubble size characterization using Coulter Counter and cryogenic-SEM revealed the hollow structure and rare presence of microbubbles >10 µm in a commercial UCA product, Lumason™. Volume-weighed size and concentration were observed to be more sensitive to changes in UCA bubble stability than number-weighted size and concentration. Size distribution measurements showed that the force (e.g., shaking/agitation energy) used to redisperse the sample did not affect the size distribution, concentration, or echogenicity of the UCA sample. The ultrasound backscattering coefficient (BSC) of size fractionated and serial diluted microbubbles showed that the echogenicity signal correlates most with UCA bubble concentration, especially volume-weighted concentration. Findings from this study may be used to support demonstrating the equivalence of a generic UCA product to the reference listed drug.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Scoping Thermal Response Calculations of RNS Waste During Transport to and Disposal at the WIPP

Sandia National Laboratories (SNL) was contracted by the United States Department of Energy Environmental Management (DOE-EM), Los Alamos Field Office to perform mechanical and thermal scoping calculations as part of a study seeking to understand the ignitability risk of the Remediated Nitrate Salts (RNS) waste drums during transportation from the Waste Control Specialists (WCS) facility to Waste Isolation Pilot Plant (WIPP) and permanent disposal of the waste at WIPP. The scoping thermal simulations described in this report pertain to thermal calculations performed with a packaging system consisting of one Standard Waste Box (SWB) loaded with drums placed inside a Standard Large Box 2 (SLB2). During transportation, the SLB2 is inside Transuranic Package Transporter Model III (TRUPACT-III), which provides the third layer of the packaging. Once at the WIPP, it is assumed the SLB2 is extracted from the TRUPACT-III and maintained above ground, and then subsequently placed underground for permanent disposal. In these proposed configurations, the space between the SLB2 and the SWB is always filled by a layer of insulation consisting of air-filled glass microbubbles except for the bottom which rests directly on the SLB2. The thermal scoping calculations described in this report specifically address whether the introduction of external heat inputs, combined with the contributions from the internally generated radiolytic decay heat and chemical reactions, lead to an unstable thermal state during the time of its movement and placement in the permanent disposal location. The external heat inputs are of two forms: 1) ambient thermal irradiation (e.g., solar and ambient storage/disposal temperatures) and 2) accident-induced fire. Three scoping calculation scenarios were derived as representative, conservative scenarios: 1A) TRUPACT-III transient transportation, 1B) SLB2 48-hour outdoor storage with solar radiation, and 2) fully-engulfing fire during SLB2 handling or emplacement following a steady-state analysis in a 38 °C environment. All the simulated scenarios are conservative relative to the operational conditions expected for handling the waste package during transportation and placement in the WIPP underground disposal unit. The predictions obtained from simulating the three exposure scenarios revealed that adding the SLB2 and the air-filled glass microbubbles to the transport and storage/disposal configurations provides additional thermal protection of the drums beyond what the SWB provides alone, both during long-term above ground insolation and underground during a fire accident. Under the current transportation/storage/disposal concepts, the degree of protection provided by the packaging concept is sufficient to prevent the waste from being ignitable. The simulation results demonstrate that there is adequate margin to safely transport and place the RNS waste from WCS to the WIPP under the current operational concept.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Characteristics of Patent Foramen Ovale Associated with Cryptogenic Stroke: A Biplane Transesophageal Echocardiography Study

Patent foramen ovale is associated with ischemic stroke in patients without a clearly identifiable etiology for stroke (cryptogenic stroke). Paradoxical embolization is thought to be a potential mechanism. However, patent foramen ovale is also found in patients with known cause of stroke. Therefore, using contrast transesophageal echocardiography, we characterized the patent foramen ovale in cryptogenic stroke patients to assess morphological factors that may contribute to paradoxical embolization. Methods: Contrast transesophageal echocardiographic studies of 74 consecutive patients referred for ischemic stroke were reviewed. Twenty-three patients with patent foramen ovale were identified. These patients were classified as having strokes of determined origin or cryptogenic strokes according to criteria developed for the Stroke Data Bank of the National Institute of Neurological Disorders and Stroke. Separation of septum primum from secundum and the number of microbubbles appearing in left atrium were then quantitated. These parameters were compared between patients with cryptogenic stroke and those with known cause of stroke. Results: The patent foramen ovale dimension was significantly larger in patients with cryptogenic stroke compared with patients with an identifiable cause of stroke (2.1+/-1.7 mm versus 057+/-0.78 mm [mean+/-SD]; P<.01). The number of microbubbles was also greater in patients with cryptogenic stroke compared with patients with an identifiable cause of stroke (13.9+/-10.7 versus 1.62+/-0.8 [mean+/-SD]; P<.0005). Conclusions: Patients with cryptogenic stroke have larger patent foramen ovale with more extensive right-to-left inter-atrial shunting than patients with stroke of determined cause. Transesophageal echocardiographically identifiable characteristics of patent foramen ovale may be important in defining the clinical significance of individual patent foramina.

Homma, S.↗

Temperature controlled transformations of giant unilamellar vesicles of amphiphilic triblock copolymers synthesized via microfluidic mixing

We report on a simple approach for synthesis of temperature-responsive giant unilamellar vesicles (GUVs) from poly(N-vinylcaprolactam) 15 -block-poly(dimethylsiloxane) 65 -block-poly(N-vinylcaprolactam) 15 (PVCL 15 -PDMS65-PVCL 15 ) triblock copolymer and non-temperature responsive small and giant vesicles from novel poly(N-vinylpyrrolidone)-block-poly(dimethylsiloxane)-block-poly(N-vinylpyrrolidone) (PVPON 15 -PDMS 65 -PVPON 15 and PVPON 6- PDMS 30- PVPON 6 ) triblock copolymers using microfluidic mixing at 25 °C. We show that temperature-responsive PVCL 15 -PDMS 65- PVCL 15 GUVs with the average diameter of 1.4 ± 0.2 µm while being stable at room temperature for at least 14 days, transformed irreversibly into small vesicles of 168 ± 40 nm after incubation of their aqueous solution at 42 °C for 24 h. We hypothesized that this transformation is induced by local compressive stresses of the vesicle membrane due to the collapse of PVCL blocks above the copolymer lower critical solution temperature (LCST) leading to the decrease of the vesicle membrane thickness. Consequently, we found that the temperature-induced size transformation of the PVCL-based GUVs at 42°C can be suppressed by substituting PVCL with its hydrophilic homologue PVPON, or by suppressing the PVCL's LCST behavior through hydrogen-bonding with tannic acid molecules. In the former case, novel PVPON n -PDMS m -PVPON n triblock copolymers (n = 15, m = 65 and n = 6, m = 30) assemble into vesicles stable from 25 °C to 55 °C as confirmed by optical and electron microscopy, dynamic light scattering (DLS) and small-angle neutron scattering (SANS). In the latter, hydrogen bonding interactions of PVCL with the polyphenol tannic acid (TA) at room temperature resulted in stable PVCL-based GUVs at 42°C as confirmed by optical, electron, and atomic force microscopies. We also found that physical crosslinking of the PVCL corona through hydrogen bonding with TA in PVCL 15- PDMS 65- PVCL 15 GUVs will delay their low pH-induced degradation at 37°C by 48 h compared to non-modified GUVs. Our findings open opportunities for the development of temperature-regulated stable micro-vehicles that would change their structural characteristics in the physiologically relevant temperature range from 25 to 42°C and can be utilized for cell mimicking studies. The developed GUVs also have potential in theranostic drug delivery as substitutes for polymer microcapsules and lipid microbubbles as well as for stimuli-triggered sensing, protection, and rapid response in an aqueous environment.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Ultrasound-Mediated Gemcitabine Delivery Reduces the Normal-Tissue Toxicity of Chemoradiation Therapy in a Muscle-Invasive Bladder Cancer Model

Chemoradiation therapy is the standard of care in muscle-invasive bladder cancer (MIBC). Although agents such as gemcitabine can enhance tumor radiosensitivity, their side effects can limit patient eligibility and treatment efficacy. This study investigates ultrasound and microbubbles for targeting gemcitabine delivery to reduce normal-tissue toxicity in a murine orthotopic MIBC model.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Density Measurements of Various Molten Sodium, Magnesium, Potassium, and Uranium Chloride Salt Compositions Using Neutron Imaging

With an increased interest in the use of molten salts for energy generation, obtaining thermophysical properties of salt mixtures becomes critical for the understanding of salt performance and behavior. Density is one of the significant thermophysical properties of salt systems. This work presents the density measurement of molten chloride salt mixtures using neutron imaging. This work was performed at the Oak Ridge National Laboratory High-Flux Isotope Reactor. Here, resulting densities as a function of temperature for different molten chloride salts from this work were compared with calculated values using Redlich–Kister modeling. Agreement between the calculated and measured values was within 1–10%, with the exception of the ternary UCl 3 –NaCl–KCl salt that showed a 32% discrepancy between several literature reports; however, the results did align well with another neutron radiography article. Analysis of the radiographs suggests that microbubbles in the ternary mixture might have biased the density measurements.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

risingMicrobubbleLattice

This code is a simulation case to be run with OpenFOAM, an open-source computational fluid dynamics software. A gmsh mesh file is also included. Specifically, this simulation demonstrates the transport of a single microbubble rising through an ordered lattice due to an applied flow. The bubble deforms as it squeezes through the pores of the lattice. Is

Guo, Jack [Lawrence Livermore National Laboratory ↗

Intravascular bubbles associated with intravenous injections and altitude

Ultrasonically detected microbubbles were more abundant in the pulmonary artery of dogs intravenously injected with 10 ml of saline than in the same noninjected control during 10,000 ft (3,048 m), 20,000 ft (6,096 m), and 40,000 ft (12,121 m) exposures. Continuous intravenous (i.v.) drip infusions also introduced many small bubbles. Since they may serve as 'nuclei' for visible intravascular bubble formation, are sometimes associated with decompression sickness, and are additionally considered undesirable, it would appear prudent to minimize i.v. injections immediately before flights. However, a 10-min delay before ascent wil reduce their number and a 60-min delay will insure their almost complete absence. Also, slow ascent, a 1-h denitrogenation time, or use of a degassed solution will help reduce their total number.

Cooke, J. P.↗