Physiological Modeling of Concentration-Effect Relationship for Nondepolarizing Neuromuscular Blocking Drugs.

This paper reports modeling of physiological processes of neuromuscular transmission considering effects of nondepolarizing neuromuscualr blocking drugs (NDNBs) used during general anesthesia. NDNBs are considered to act by interacting with acetylcohine receptors located at pre- and post-junctional sites. This paper proposes an extension of the standard model of synaptic depression used in the field of neuroscience to describe the pre-junctional effect of NDNBs.

Nonlinear model predictive glycemic control of critically ill patients using online identification of insulin sensitivity.

In critically ill patients suffering from hyperglycemia, it has been recently shown that mortality and morbidity can be reduced by keeping blood glucose within the range of 80-110 mg/dL. However, maintaining glycemia within such range is difficult due to the time variability in insulin sensitivity in critically ill patients. In this paper, we propose a novel glycometabolism model of critically ill patients with an insulin sensitivity parameter and develop a nonlinear model predictive glycemic control system with online identification of insulin sensitivity at one-hour intervals.

Mixed model of dietary fat effect on postprandial glucose-insulin metabolism from carbohydrates in type 1 diabetes.

In this study we introduce an extension of a previously developed model of glucose-insulin metabolism in type 1 diabetes (T1D) from carbohydrates that includes the effect of dietary fat on postprandial glycemia. We include two compartments that represent plasma triglyceride and nonesterified fatty acid (NEFA) concentration, in addition to a mathematical representation of delayed gastric emptying and insulin resistance, which are the most well-known effects of dietary fat metabolism. Simulation results show that postprandial glucose as well as lipid levels in our model approximates clinical data from T1D patients.

Postprandial blood glucose control in type 1 diabetes for carbohydrates with varying glycemic index foods.

Treatment of type 1 diabetes consists of maintaining postprandial normoglycemia using the correct prandial insulin dose according to food intake. Nonetheless, it is hardly achieved in practice, which results in several diabetes-related complications. In this study we present a feedforward plus feedback blood glucose control system that considers the glycemic index of foods.

Hypnosis control based on the minimum concentration of anesthetic drug for maintaining appropriate hypnosis.

This paper proposes a novel hypnosis control method using Auditory Evoked Potential Index (aepEX) as a hypnosis index. In order to avoid side effects of an anesthetic drug, it is desirable to reduce the amount of an anesthetic drug during surgery. For this purpose many studies of hypnosis control systems have been done.

A model-predictive hypnosis control system under total intravenous anesthesia.

In ambulatory surgery, anesthetic drugs must be administered at a suitable rate to prevent adverse reactions after discharge from the hospital. To realize more appropriate anesthesia, we have developed a hypnosis control system, which administers propofol as an anesthetic drug to regulate the bispectral index (BIS), an electroencephalography (EEG)-derived index reflecting the hypnosis of a patient. This system consists of three functions: 1) a feedback controller using a model-predictive control method, which can adequately accommodate the effects of time delays; 2) a parameter estimation function of individual differences; and 3) a risk control function for preventing undesirable states such as drug overinfusion or intraoperative arousal.

How to control blood glucose under continuous glucose challenge.

A newly improved method for controlling blood glucose was compared with the standard model predictive controller under continuous glucose infusion. Continuous intravenous glucose infusion at rates of 50 or 100 mg/kg/hour was conducted on pancreatectomized dogs. An improved blood glucose control method using a combination of the proportional controller in the initial stage and the model predictive controller in the later stage was compared with the simple model predictive controller.