Impedance spectroscopy measurements as a tool for distinguishing different luminal content during bolus transit studies.

BACKGROUND: Intraluminal electrical impedance is a well-known diagnostic tool used to study bolus movement in the human esophagus. However, it is use in the human colon it is hindered by the fact that the content cannot be controlled and may include liquid, gas, solid, or a mixture of these at any one time. This article investigates the use of complex impedance spectroscopy to study different luminal content (liquid and gas). METHODS: An excised section of guinea pig proximal colon was placed in an organ bath with Krebs solution at 37°C and a custom built bioimpedance catheter was placed in the lumen. Liquid (Krebs) and gas (air) content was pumped through the lumen and the intraluminal impedance was measured at five different frequencies (1, 5.6, 31.6, 177.18 kHz and 1 MHz) at 10 samples per second. A numerical model was created to model the passage of bolus with different content and compared to the experimental data. KEY RESULTS: Differences in mean impedance magnitude and phase angle were found (from 1 to 177.18 kHz) for different contents. The numerical results qualitatively agreed with those in the experimental study. Conductivities of bolus had an effect on detecting its passage. CONCLUSIONS & INFERENCES: Complex impedance spectroscopy can distinguish between different luminal content within a range of measuring frequencies. The numerical model showed the importance of bolus conductivities for bolus transit studies in those where the bolus is controlled.

Long-term effectiveness of irreversible electroporation in a murine model of colorectal liver metastasis.

Irreversible electroporation (IRE) has recently gained in popularity as an ablative technique, however little is known about its oncological long-term outcomes. To determine the long-time survival of animals treated with a high dose of IRE and which histological changes it induces in tumoral tissue, IRE ablation was performed in forty-six athymic-nude mice with KM12C tumors implanted in the liver by applying electric current with different voltages (2000 V/cm, 1000 V/cm). The tumors were allowed to continue to grow until the animals reached the end-point criteria. Histology was harvested and the extent of tumor necrosis was semi-quantitatively assessed. IRE treatment with the 2000 V/cm protocol significantly prolonged median mouse survival from 74.3 ± 6.9 days in the sham group to 112.5 ± 15.2 days in the 2000 V/cm group. No differences were observed between the mean survival of the 1000 V/cm and the sham group (83.2 ± 16.4 days, p = 0.62). Histology revealed 63.05% ± 23.12 of tumor necrosis in animals of the 2000 V/cm group as compared to 17.50% ± 2.50 in the 1000 V/cm group and 25.6% ± 22.1 in the Sham group (p = 0.001). IRE prolonged the survival of animals treated with the highest electric field (2000 V/cm). The animals in this group showed significantly higher rate of tumoral necrosis.

Irreversible electroporation of the liver: is there a safe limit to the ablation volume?

Irreversible electroporation is a fast-growing liver ablation technique. Although safety has been well documented in small ablations, our aim is to assess its safety and feasibility when a large portion of liver is ablated. Eighty-seven mice were subjected to high voltage pulses directly delivered across parallel plate electrodes comprising around 40% of mouse liver. One group consisted in 55 athymic-nude, in which a tumor from the KM12C cell line was grown and the other thirty-two C57-Bl6 non-tumoral mice. Both groups were subsequently divided into subsets according to the delivered field strength (1000 V/cm, 2000 V/cm) and whether or not they received anti-hyperkalemia therapy. Early mortality (less than 24 hours post-IRE) in the 2000 V/cm group was observed and revealed considerably higher mean potassium levels. In contrast, the animals subjected to a 2000 V/cm field treated with the anti-hyperkalemia therapy had higher survival rates (OR = 0.1, 95%CI = 0.02-0.32, p < 0.001). Early mortality also depended on the electric field magnitude of the IRE protocol, as mice given 1000 V/cm survived longer than those given 2000 V/cm (OR = 4.7, 95%CI = 1.8-11.8, p = 0.001). Our findings suggest that ionic disturbances, mainly due to potassium alterations, should be warned and envisioned when large volume ablations are performed by IRE.

Comparison of the effects of the repetition rate between microsecond and nanosecond pulses: electropermeabilization-induced electro-desensitization?

BACKGROUND: Applications of cell electropermeabilization are rapidly growing but basic concepts are still unclear. In particular, the impact of electric pulse repetition rate in the efficiency of permeabilization has not yet been understood. METHODS: The impact of electric pulse repetition rate in the efficiency of permeabilization was analyzed in experiments performed on potato tissue and partially transposed on mice liver. On potato tissue, pulses with durations of 100µs or 10ns are applied. The intensity of permeabilization was quantified by means of bioimpedance changes and electric current measurements and a new index was defined. RESULTS: For the two pulse durations tested, very low repetition rates (below 0.1Hz) are much more efficient to achieve cell permeabilization in potato tissue. In mice liver, using 100µs pulses, the influence of the repetition rate is more complex. Indeed, repetition rates of 1Hz and 10Hz are more efficient than 100Hz or 1kHz, but not the repetition rate of 0.1Hz for which there is an impact of the living mice organism response. CONCLUSIONS: We propose that the effects reported here might be caused by an electroporation-induced cell membrane 'electro-desensitization' which requires seconds to dissipate due to membrane resealing. GENERAL SIGNIFICANCE: This study not only reinforces previous observations, but moreover it sustains a new concept of 'electro-desensitization' which is the first unifying mechanism enabling to explain all the results obtained until now both in vitro and in vivo, with long and short pulses.

Towards addressable wireless microstimulators based on electronic rectification of epidermically applied currents.

Electrical stimulation has been explored to restore the capabilities of the nervous system in paralysis patients. This area of research and of clinical practice, known as Functional Electrical Stimulation, would greatly benefit from further miniaturization of implantable stimulators. To that end, we recently proposed and demonstrated an innovative electrical stimulation method in which implanted microstimulators operate as rectifiers of bursts of innocuous high frequency current supplied by skin electrodes, thus generating low frequency currents capable of stimulating excitable tissues. A diode could suffice in some applications but, in order to broaden the method's clinical applicability, we envision rectifiers with advanced capabilities such as current control and addressability. We plan flexible thread-like implants (diameters < 300 µm) containing ASICs. As an intermediate stage, we are developing macroscopic implants (diameters ~ 2 mm) made of off-the-shelf components. Here we present a circuit which responds to commands modulated within the high frequency bursts and which is able to deliver charge-balanced currents. We show that a number of these circuits can perform independent stimulation of segments of an anesthetized earthworm following commands from a computer.

Non-invasive assessment of corneal endothelial permeability by means of electrical impedance measurements.

The permeability of the corneal endothelial layer has an important role in the correct function of the cornea. Since ionic permeability has a fundamental impact on the passive electrical properties of living tissues, here it is hypothesized that impedance methods can be employed for assessing the permeability of the endothelial layer in a minimally invasive fashion. Precisely, the main objective of the present study is to develop and to analyze a minimally invasive method for assessing the electrical properties of the corneal endothelium, as a possible diagnostic tool for the evaluation of patients with endothelial dysfunction. A bidimensional model consisting of the main corneal layers and a four-electrode impedance measurement setup placed on the epithelium has been implemented and analyzed by means of the finite elements method (FEM). In order to obtain a robust indicator of the permeability of the endothelium layer, the effect of the endothelium electrical properties on the measured impedance has been studied together with reasonable variations of the other model layers. Simulation results show that the impedance measurements by means of external electrodes are indeed sufficiently sensitive to the changes in the electrical properties of the endothelial layer. It is concluded that the method presented here can be employed as non-invasive method for assessing endothelial layer function.

Minimally invasive silicon probe for electrical impedance measurements in small animals.

It is commonly accepted that electrical impedance provides relevant information about the physiological condition of living tissues. Currently, impedance measurements are performed with relatively large electrodes not suitable for studies in small animals due to their poor spatial resolution and to the damage that they cause to the tissue. A minimally invasive needle shaped probe for electrical impedance measurements of living tissues is presented in this paper. This micro-probe consists of four square platinum electrodes (300 microm x 300 microm) on a silicon substrate (9 mm x 0.6 mm x 0.5 mm) and has been fabricated by using standard Si microelectronic techniques. The electrodes are not equally spaced in order to optimise the signal strength and the spatial resolution. Characterisation data obtained indicate that these probes provide high spatial resolution (measurement radius <4 mm) with a useful wide frequency band going from 100 Hz to 100 kHz. A series of in vivo experiments in rat kidneys subjected to ischemia was performed to demonstrate the feasibility of the probes and the measurement system. The impedance modulus and phase were measured at 1 kHz since this frequency is sufficiently low to permit the study of the extracellular medium. The extracellular pH and K+ were also simultaneously measured by using commercial miniaturised Ion Selective Electrodes. The induced ischemia period (45 min) resulted in significant changes of all measured parameters (Delta/Z/ approximately 65%; DeltapH approximately 0.8; DeltaK+ approximately 30 mM).

Multiparametric monitoring of ischemia-reperfusion in rat kidney: effect of ischemic preconditioning.

BACKGROUND: Microelectrode technology is a promising tool for monitoring kidney ischemia and the changes induced by its therapeutic management. Ischemic preconditioning, that is, brief ischemic periods before sustained ischemia, has been shown to protect several organs, including the kidney, from ischemia-reperfusion injury. We tested whether the effect of preconditioning could be appraised by real-time measurement of parameters representative of tissue hypoxia. METHODS: In a sample of pentobarbital-anesthetized and mechanically ventilated rats, we studied the effect of renal ischemic preconditioning (10-min ischemia and 10-min reflow interval) on subsequent ischemia-reperfusion (45 min and 60 min). Renal tissue electrical impedance, extracellular pH, and potassium concentration [K+] were measured continuously by implanted microelectrodes. RESULTS: Ischemia induced an early, rapid rise in extracellular potassium and impedance module, followed by a phase of slower increase, whereas pH decreased rapidly, reaching a plateau. Preconditioning treatment did not cause significant changes in interstitial pH and [K+] but increased ischemic tissue impedance. During reperfusion, the three variables recovered progressively; however, after a decline, electrical impedance showed a clear postischemic increase. This rise was suppressed by preconditioning. CONCLUSIONS: Real-time measurement of any of the three parameters showed capability for early detection of ischemia. In contrast with findings in myocardial tissue, preconditioning in the kidney did not increase potassium cell loss during ischemia or improve ischemic acidosis or tissue impedance. Electrical impedance increased for a second time during reperfusion, indicating the presence of a postischemic cellular edema; concealing this episode was the most noticeable effect of the preconditioning treatment.