Conception of a Phantom in Agar-Agar Gel with the Same Bio-Impedance Properties as Human Quadriceps.

The physiology of the patient can be reflected by various data. Serious games, using an intelligent combination, could be based on this data to adjust to the specificities of the patient. Rehabilitation would therefore be personalized to the patient. This smart suit would use dry electrodes in order to be easily usable. Before performing dry electrode validation tests on a population, it is necessary to perform preliminary tests on a phantom. Agar-Agar (AA) gel, combined with NaCl and graphite which directly impact the resistivity and reactance values of the phantom, are generally used. Depending on the part of the body simulated by the phantom, it is necessary to adapt the concentrations of NaCl and graphite in order to obtain values of physiological reactance and resistance. The anisotropy of a muscle must also be considered. Different concentrations of NaCl and graphite have been tested in order to present charts linking the concentrations to the resistance and reactance values of the AA phantom. Electrical properties similar to those of human quadriceps are achieved at a concentration of 7 g/L of NaCl and 60 g/L of graphite. These values can be used as a conversion table to develop an AA phantom with electrical properties similar to different muscles. Furthermore, an AA phantom has an anisotropy of 0° and 90°. This anisotropy corresponds to a human quadriceps, where 0° is the direction of the muscle fiber. This will allow us to study and characterize the behavior of the electrodes on an anisotropic model. Thus it can be used as a first test phase for dry electrodes in order to propose the most suitable conditions for a connected garment application.

Ocular Phantom-Based Feasibility Study of an Early Diagnosis Device for Glaucoma.

Glaucoma causes total or partial loss of vision in 10% of people over the age of 70, increasing their fragility and isolation. It is characterised by the destruction of the optic nerve fibres, which may result from excessively high intraocular pressure as well as other phenomena. Diagnosis is currently reached through a combination of several checks, mainly of the eyes' fundus, tonometry and gonioscopy. Prior to validation for human subjects, the objective of this study is to validate whether ocular phantom-based models could be used to diagnose glaucoma using an onboard system, which could, even at home, prevent the early-stage development of the pathology. Eight phantoms modelling healthy eyes and eight phantoms modelling eyes with glaucoma due to excessive intraocular pressure were measured using an onboard system, including lens and electrophysiology electronics. We measured the actual average Zr (real part of impedance) impedance of 160.9 ± 24.3 ohms (glaucoma ocular phantom models) versus 211.9 ± 36.9 ohms (healthy ocular phantom models), and an average total water volume (Vt) of 3.02 ± 0.35 mL (glaucoma ocular phantom models) versus 2.45 ± 0.28 mL (healthy ocular Phantoms). On average, we obtained 51 ohms (-24.1%) less and 0.57 mL (22.9%) of total water volume more, respectively. Normality tests (Shapiro-Wilk) for Vt and Zr indicate p < 0.001 and p < 0.01, respectively. Since these variables do not respect normal laws, unmatched Mann-Whitney tests were performed indicating a significant difference between Vt and Zr in the healthy ocular phantom models and those modelling glaucoma. To conclude, this preliminary study indicates the possibility of discriminating between healthy eyes with those with glaucoma. However, further large-scale studies involving healthy eyes and those suffering from glaucoma are necessary to generate viable models.

Evaluation on Phantoms of the Feasibility of a Smart Bra to Detect Breast Cancer in Young Adults.

Breast cancer is the most common cancer observed in women. Although mammography is a recognized method, it remains ionizing and cannot be used routinely or in young adults, leaving up to two years between two diagnoses. Prior to validation on human subjects, this study aims to validate on phantoms the feasibility of quantifying breast density and detecting breast cancer tumors using a smart bra in young women. Six phantoms with various densities and seven phantoms with various volumes of modelized tumor were prepared and measured with a smart bra, including an electrophysiological module. There was a significant difference between the "healthy phantoms" and the "tumor phantoms" with P(Student) = 0.008 (Shapiro-Wilk p = 0.846, samples follow a normal distribution; Fisher variance test, p = 0.287). In addition, this study seems to indicate the possibility of discriminating various types of tumorous and healthy breast tissue using a smart bra, in high density breast. However, a new study on a large sample of human subjects will be required to generate new models, including resistive, capacitive, and other sensor parameters versus reference data collected from imaging.

Measurements of total body water with a foot-to-foot impedancemeter.

The objective was to set-up a method for measuring total body water volumes (TBW) using a Tefal foot-to-foot impedancemeter (FFI) by comparison with a multifrequency medical impedancemeter and to validate this method against deuterium dilution data. The investigation was carried out in 57 Caucasian adult subjects. Impedancemeters were a Tefal Bodymaster Vision (foot-to-foot) featuring a square wave signal and a Xitron Hydra 4200 (5-1000 kHz) using BIS method. TBW was measured by the Xitron using a new method that we have developed which applies the BIS method directly to extra and intracellular fluids combined. Although the high frequency impedance of the FFI (R(hf)) was higher than the Xitron infinite frequency resistance and corresponded to a frequency around 100 kHz, TBW differences between the FFI and Xitron were not significant, 0.17+/-2.17 L for men (P=0.694) and 0.04+/-1.88 L for women (P=0.902). Then, our method was tested on another Caucasian population in which R(hf) had been measured with the same FFI, together with TBW measurements by deuterium dilution. TBW differences between the FFI and dilution were -0.38+/-2.27 L for men (P=0.237) and -0.72+/-2.37 L for women (P=0.06). Our method permits, at least in a Caucasian healthy population, to measure TBW using this FFI with the same accuracy as a whole body multifrequency medical impedancemeter, and the measurement, made in upright position, is much quicker.

Assessment of body composition in adolescent subjects with anorexia nervosa by bioimpedance.

Our main goal was to test various impedance methods for measuring body composition in adolescents with anorexia nervosa (AN) during refeeding therapy. A specific objective was to compare the information provided by a foot-to-foot impedancemeter (FFI) with that supplied by a medical multifrequency impedancemeter and by dual X-ray absorptiometry (DXA). We have monitored 13 young AN subjects and 17 healthy controls of a similar age group using a Xitron 4200 multifrequency impedancemeter measuring extracellular (ECW) and total body water (TBW) volumes and a Tefal Bodymaster FFI measuring weight (W), fat-free-mass (FFM) and body fat mass (FM). This Tefal device has been modified to measure in addition ECW and TBW resistances permitting to calculate ECW and TBW volumes using appropriate algorithms. In addition FFM and FM were measured by DXA on AN subjects. FFM measured by the FFI and the Xitron in AN subjects were found to be respectively 7.8% and 4.5% lower than FFM measured by DXA. TBW measured by FFI was not significantly different from that measured by Xitron in AN subjects and in controls. ECW measured by the FFI was not significantly different from that measured by Xitron in controls, but was in AN subjects. The body cell mass to (height)2 ratio was found to be significantly different between AN subjects and controls. The modified FFI was found to be simpler and quicker to use than the Xitron, while giving similar information.

Total body water measurement by a modification of the bioimpedance spectroscopy method.

We propose a method for calculating directly total body water (TBW) volumes (V (t)) from whole body resistance extrapolated at infinite frequency (R (infinity)) using a XITRON 4200 impedance meter. Mean TBW resistivities for men and women were determined from measurements of R (infinity) and fat-free mass (FFM(d)) measured by DXA in 58 healthy subjects assuming an average hydration coefficient of 73.2%. Mean differences between V (t) measured by our new method and those deduced from DXA data were +0.11 +/- 1.61 L for women and +0.13 +/- 2.16 L for men. For validation, this method was tested with the same resistivities against a 2nd group of 16 volunteers and the mean difference between V (t) from impedance and DXA was -0.80 +/- 1.43 L. Since the resistance at 50 kHz (R (50)) was found to be equal, in average, to 1.230 R (infinity) for men and 1.223 R (infinity) for women, this method can also be applied at 50 kHz with a similar accuracy by estimating R (infinity) from R (50). When our new method was applied to the monitoring of water loss during 28 dialysis runs performed on 13 patients, it predicted a mean water loss equal to 94% of ultrafiltered volume.

Evaluation of a foot-to-foot impedance meter measuring extracellular fluid volume in addition to fat-free mass and fat tissue mass.

OBJECTIVES: The first objective was to compare the accuracy of a foot-to-foot impedance meter with a multifrequency bioimpedance for measurements of fat-free mass (FFM) and fat mass (FM) using dual energy X-ray absorptiometry (DXA) as reference. The second objective was to validate measurements of extracellular water resistance and volume by the foot-to-foot impedance meter, using multifrequency bioimpedance as reference. METHODS: This investigation was carried out in 60 volunteers 18 to 71 y of age. Impedance meters were a Tefal Bodymaster Vision (foot-to-foot) that featured a square wave signal and a Xitron Hydra 4200 (5 to 1000 kHz) by using the bioimpedance spectroscopic method. RESULTS: Bland-Altman tests showed that FFM differences between Tefal and DXA data were 1.98 +/- 3.09 kg in men and -0.08+/-2.98 kg in women. Total body water was measured by the Xitron, and FFM as measured with the Xitron was calculated as total body water divided by 0.732. Mean differences between Xitron-measured and DXA-measured FFM were 2.37+/-3.03 kg for men and 2.84+/-2.40 kg for women, indicating a systematic underestimation by the Xitron of intracellular volume. Extracellular water resistances measured by Tefal were in good agreement with those measured by Xitron with electrodes pasted under the subject's feet (mean difference 8.5+/-31 Omega). Extracellular water volumes were calculated from Tefal-measured extracellular water resistances by using a modified bioimpedance spectroscopic method and differed from those measured with Xitron by-0.03+/-0.66 L. CONCLUSION: Limits of agreement with DXA-measured FFM produced by the foot-to-foot impedance meter tested are too large for clinical measurements in individuals, but they are sufficient to assess FFM in groups of subjects and for home use. Our prototype was also capable of estimating extracellular water volume with a similar accuracy as multifrequency bioimpedance in normal subjects.