Electrical impedance tomography (EIT) has been used for functional lung imaging of regional air distributions during mechanical ventilation in intensive care units (ICU). From numerous clinical and animal studies focusing on specific lung functions, a consensus about how to use the EIT technique has been formed lately. We present an integrated EIT system implementing the functions proposed in the consensus. The integrated EIT system could improve the usefulness when monitoring of mechanical ventilation for lung protection so that it could facilitate the clinical acceptance of this new technique. Using a custom-designed 16-channel EIT system with 50 frames/s temporal resolution, the integrated EIT system software was developed to implement five functional images and six EIT measures that can be observed in real-time screen view and analysis screen view mode, respectively. We evaluated the performance of the integrated EIT system with ten mechanically ventilated porcine subjects in normal and disease models. Quantitative and simultaneous imaging of tidal volume (TV), end-expiratory lung volume change ($$\triangle$$EELV), compliance, ventilation delay, and overdistension/collapse images were performed. Clinically useful parameters were successfully extracted including anterior/posterior ventilation ratio (A/P ratio), center of ventilation ($${\mathrm{CoV}}_{{x}}$$, $${\mathrm{CoV}}_{{y}}$$), global inhomogeneity (GI), coefficient of variation (CV), ventilation delay and percentile of overdistension/collapse. The integrated EIT system was demonstrated to suggest an optimal positive end-expiratory pressure (PEEP) for lung protective ventilation in normal and in the disease model of an acute injury. Optimal PEEP for normal and disease model was 2.3 and $$7.9 \, {\mathrm{cmH}}_{2}\mathrm{O}$$, respectively. The proposed integrated approach for functional lung ventilation imaging could facilitate clinical acceptance of the bedside EIT imaging method in ICU. Future clinical studies of applying the proposed methods to human subjects are needed to show the clinical significance of the method for lung protective mechanical ventilation and mechanical ventilator weaning in ICU.

When we use a conductive fabric as a pressure sensor, it is necessary to quantitatively understand its electromechanical property related with the applied pressure. We investigated electromechanical properties of three different conductive fabrics using the electrical impedance spectroscopy (EIS). We found that their electrical impedance spectra depend not only on the electrical properties of the conductive yarns, but also on their weaving structures. When we apply a mechanical tension or compression, there occur structural deformations in the conductive fabrics altering their apparent electrical impedance spectra. For a stretchable conductive fabric, the impedance magnitude increased or decreased under tension or compression, respectively. For an almost non-stretchable conductive fabric, both tension and compression resulted in decreased impedance values since the applied tension failed to elongate the fabric. To measure both tension and compression separately, it is desirable to use a stretchable conductive fabric. For any conductive fabric chosen as a pressure-sensing material, its resistivity under no loading conditions must be carefully chosen since it determines a measurable range of the impedance values subject to different amounts of loadings. We suggest the EIS method to characterize the electromechanical property of a conductive fabric in designing a thin and flexible fabric pressure sensor.

We developed a multilayer fabric pressure distribution sensor, sensor interface, and electrical impedance imaging system for real-time pressure distribution imaging. The new pressure distribution sensor consists of conductive elastic fabrics and layered polyurethane (PU) nanoweb containing air shells to increase its pressure sensitivity. The sensitivity and hysteresis of three fabric sensors with different layer structures were measured to compare their electromechanical properties as a pressure sensor. The sensor with one PU nanoweb layer sandwiched by two conductive elastic fabrics showed the best performance and was chosen for real-time pressure distribution imaging experiments. The imaging system acquired the electrical impedance data along the boundary of the sensor by injecting ac currents and measuring induced voltages on its boundary. This enabled the system to detect both piezo-resistance and piezo-capacitance changes in the sensing area of the sensor subject to a vertically applied pressure distribution on the top surface of the sensor. Applying an impedance image reconstruction algorithm to the collected boundary data, impedance images of the sensing area were reconstructed in real time, which corresponded to the applied pressure distribution. Quantitative analyses of reconstructed impedance images were performed to evaluate the overall performance of the developed multilayer fabric pressure distribution sensor. The fabric sensor and the imaging system provide a new way of quantitatively visualizing pressure distributions in real time.

Otitis media is mainly caused by upper respiratory tract infection and eustachian tube dysfunction. If external upper respiratory tract infection is not detected early in the middle ear, or an appropriate immune response does not occur, otitis media can become a chronic state or complications may occur. Therefore, given the important role of Toll-like receptors (TLRs) in the early response to external antigens, we surveyed the role of TLRs in otitis media. To summarize the role of TLR in otitis media, we reviewed articles on the expression of TLRs in acute otitis media (AOM), otitis media with effusion (OME), chronic otitis media (COM) with cholesteatoma, and COM without cholesteatoma. Many studies showed that TLRs 1–10 are expressed in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. TLR expression in the normal middle ear mucosa is absent or weak, but is increased in inflammatory fluid of AOM, effusion of OME, and granulation tissue and cholesteatoma of COM. In addition, TLRs show increased or decreased expression depending on the presence or absence of bacteria, recurrence of disease, tissue type, and repeated surgery. In conclusion, expression of TLRs is associated with otitis media. Inappropriate TLR expression, or delayed or absent induction, are associated with the occurrence, recurrence, chronicization, and complications of otitis media. Therefore, TLRs are very important in otitis media and closely related to its etiology.

Non-destructive continuous monitoring of regenerative tissue is required throughout the entire period of in vitro tissue culture. Microscopic electrical impedance tomography (micro-EIT) has the potential to monitor the physiological state of tissues by forming three-dimensional images of impedance changes in a non-destructive and label-free manner. We developed a new micro-EIT system and report on simulation and experimental results of its macroscopic model. We propose a new micro-EIT system design using a cuboid sample container with separate current-driving and voltage sensing electrodes. The top is open for sample manipulations. We used nine gold-coated solid electrodes on each of two opposing sides of the container to produce multiple linearly independent internal current density distributions. The 360 voltage sensing electrodes were placed on the other sides and base to measure induced voltages. Instead of using an inverse solver with the least squares method, we used a projected image reconstruction algorithm based on a logarithm formulation to produce projected images. We intended to improve the quality and spatial resolution of the images by increasing the number of voltage measurements subject to a few injected current patterns. We evaluated the performance of the micro-EIT system with a macroscopic physical phantom. The signal-to-noise ratio of the developed micro-EIT system was 66 dB. Crosstalk was in the range of -110.8 to -90.04 dB. Three-dimensional images with consistent quality were reconstructed from physical phantom data over the entire domain. From numerical and experimental results, we estimate that at least 20 × 40 electrodes with 120 μ m spacing are required to monitor the complex shape of ingrowth neotissue inside a scaffold with 300 μ m pore. The experimental results showed that the new micro-EIT system with a reduced set of injection current patterns and a large number of voltage sensing electrodes can be potentially used for tissue culture monitoring. Numerical simulations demonstrated that the spatial resolution could be improved to the scale required for tissue culture monitoring. Future challenges include manufacturing a bioreactor-compatible container with a dense array of electrodes and a larger number of measurement channels that are sensitive to the reduced voltage gradients expected at a smaller scale.