1
|
Pieruzzi L, Napoli V, Goretti C, Adami D, Iacopi E, Cicorelli A, Piaggesi A. Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit. INT J LOW EXTR WOUND 2020; 19:315-333. [PMID: 32820699 DOI: 10.1177/1534734620948351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ultrasound (US) is a noninvasive and versatile technology that in recent years found acceptance in almost all the medical specialties, with diagnostic and interventional applications. In the diabetic foot syndrome (DFS), US found specific indications mainly in the screening, quantification, and follow-up of the vascular component of the pathology, but also in the study of the deformities and structural modifications induced by neuropathy and in the diagnosis and surgical management of infections, especially those that induce anatomical changes, like abscesses and fasciitis. This review will summarize all these application of US, giving special attention to the vascular aspects, and on the predominant role that US gained in recent times to guide the indication to revascularization, on the new standardized approach to the study of the arterial tree of the limb and the foot, the so-called duplex ultrasound arterial mapping, which significantly increased the utilization of US to plan the revascularizations in this complex pathology. Outside the vascular fields, the diagnosis of neuropathy and infection and the intraoperative use of US in the surgical management of abscesses and fasciitis will be discussed, leaving the last part to the new and interesting applications of US in the management of DFU, a field that is still in evolution, offering new possibilities to the health care professionals involved in the management of these chronic wounds. The variety of applications both in diagnostic and operative fields makes US a rather versatile technology-a toolkit-that should have a special place among those at reach of the specialists of DFS care.
Collapse
|
2
|
Xu C, Gao F, Wu J, Niu S, Li F, Jin L, Shi Q, Du L. Biodegradable nanotheranostics with hyperthermia-induced bubble ability for ultrasound imaging-guided chemo-photothermal therapy. Int J Nanomedicine 2019; 14:7141-7153. [PMID: 31564870 PMCID: PMC6731980 DOI: 10.2147/ijn.s213518] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/15/2019] [Indexed: 12/24/2022] Open
Abstract
Background Theranostics, elaborately integrating both therapeutic and diagnostic functions into a nanoplatform holds great potential for precision cancer medicine. Methods Herein, a biodegradable theranostic nanoplatform with hyperthermia-induced bubble ability for highly efficient ultrasound (US) imaging-guided chemo-photothermal therapy of breast tumors was developed. The prepared nanoparticles consisted of polydopamine (PDA)-modified hollow mesoporous organosilica nanoparticles (HMONs) with approximately 75 nm in diameter for doxorubicin (DOX) loading and perfluoropentane (PFP) filling. In addition, the pH-sensitive PDA coating served as both gatekeeper controlling DOX release and photothermal agent for inducing hyperthermia. Results Such nanoplatform (PDA@HMONs-DOX/PFP, PHDP) provides efficient loading (328 mg/g) and controllable stimuli-responsive release of DOX for chemotherapy. The incorporated disulfide bonds in the framework of HMONs endowed nanoparticles with intrinsic glutathione-responsive biodegradability and improved biocompatibility. Benefiting from the hyperthermia upon an 808-nm laser irradiation of PDA, the liquid-gas phase transition of the loaded PFP was induced, resulting in the generation of the nanobubbles, followed by the coalescence into microbubbles. This conversation could enhance the tumor cell uptake of nanoparticles, as well as intensify the US imaging signals. In addition, a synergistic therapeutic effect of our fabricated nanoplatform on cells/tumor growth effect has been systematically evaluated both in vitro and in vivo. Conclusion Therefore, such "all-in-one" PHDP nanoparticles with satisfactory biocompatibility and biodegradability, hyperthermia-induced bubble ability and simultaneous US imaging performance hold great potential for cancer nanotheranostics.
Collapse
Affiliation(s)
- Changsong Xu
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai 201600, People's Republic of China.,Department of Ultrasound, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huai'an City, Jiangsu 223300, People's Republic of China
| | - Feng Gao
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201600, People's Republic of China
| | - Jianrong Wu
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, People's Republic of China
| | - Shiwei Niu
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, People's Republic of China
| | - Fan Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201600, People's Republic of China
| | - Lifang Jin
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201600, People's Republic of China
| | - Qiusheng Shi
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201600, People's Republic of China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai 201600, People's Republic of China.,Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201600, People's Republic of China
| |
Collapse
|
3
|
Wu J, Williams GR, Niu S, Gao F, Tang R, Zhu L. A Multifunctional Biodegradable Nanocomposite for Cancer Theranostics. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1802001. [PMID: 31380200 PMCID: PMC6661946 DOI: 10.1002/advs.201802001] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/21/2019] [Indexed: 05/02/2023]
Abstract
Theranostic formulations, integrating both diagnostic and therapeutic functions into a single platform, hold great potential for precision medicines. In this work, a biodegradable theranostic based on hollow mesoporous organosilica nanoparticles (HMONs) is reported and explored for ultrasound/photoacoustic dual-modality imaging guided chemo-photothermal therapy of cancer. The HMONs prepared are endowed with glutathione-responsive biodegradation behavior by incorporating disulfide bonds into their framework. The nanoparticles are loaded with indocyanine green (ICG) and perfluoropentane (PFP). The former acts as a photothermal agent and the latter can generate bubbles for ultrasound imaging. A paclitaxel prodrug is developed to both serve as a redox-sensitive gatekeeper controlling ICG release from the HMON pores and a chemotherapeutic. ICG generates mild hyperthermia upon exposure to an 808 nm laser, and this in turn leads to a liquid-gas phase transition of PFP, resulting in the generation of bubbles which can be used for ultrasound imaging. The platform is found to have excellent properties for both ultrasound and photoacoustic imaging. In addition, both in vitro and in vivo results show that the nanoparticles provide potent synergistic chemo-photothermal therapy. The material developed in this work thus has great potential for exploitation in advanced cancer therapies.
Collapse
Affiliation(s)
- Jianrong Wu
- College of Chemistry, Chemical Engineering and BiotechnologyDonghua UniversityShanghai201620P. R. China
| | - Gareth R. Williams
- UCL School of PharmacyUniversity College London29‐39 Brunswick SquareLondonWC1N 1AXUK
| | - Shiwei Niu
- College of Chemistry, Chemical Engineering and BiotechnologyDonghua UniversityShanghai201620P. R. China
| | - Feng Gao
- Department of UltrasoundShanghai General HospitalShanghai Jiaotong University School of MedicineShanghai200080P. R. China
| | - Ranran Tang
- Women's Hospital of Nanjing Medical UniversityNanjing Maternity and Child Health Care HospitalNanjing210004China
| | - Li‐Min Zhu
- College of Chemistry, Chemical Engineering and BiotechnologyDonghua UniversityShanghai201620P. R. China
| |
Collapse
|
4
|
Chen J, Wang CL, Wu S, He S, Ren J. The feasibility of using high-resolution ultrasonography to assess ulnar nerve in patients with diabetes mellitus. J Ultrason 2017; 17:160-166. [PMID: 29075520 PMCID: PMC5647610 DOI: 10.15557/jou.2017.0024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/16/2017] [Accepted: 07/20/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the usefulness of high-resolution ultrasonography for the diagnosis of polyneuropathy in diabetes mellitus patients by the examination of the ulnar nerves. METHOD We recruited 100 healthy age-matched volunteers (50 women and 50 men) with 200 arms without diabetes or cubital tunnel syndrome as the control group. We assessed the upper limbs of 100 diabetes mellitus patients (45 women and 55 men), 40 of whom had electrophysiologically confirmed diabetic peripheral neuropathy and 60 had no diabetic peripheral neuropathy in the upper limbs. Age, sex, height and weight were recorded and the cross-sectional area of the ulnar nerve was measured at every predetermined site. RESULTS The cross-sectional area of the ulnar nerve was measured at six sites (mid-humerus, inlet of the cubital tunnel, outlet of the cubital tunnel, upon the medial epicondyle, 6 cm upon the wrist crease and Guyon tunnel). The ulnar nerve in two measuring sites (mid-humerus, upon the medial epicondyle) in the control group showed a statistical difference between men and women (p < 0.05). There was no statistical difference in the cross-sectional area in the control group when dominant and non-dominant arms were compared. The cross-sectional area was larger in the diabetic peripheral neuropathy group in three sites (inlet of the cubital tunnel, outlet of the cubital tunnel, Guyon tunnel) compared with those in the control group. CONCLUSION High-resolution ultrasonography may be helpful in the early diagnosis of peripheral neuropathy in diabetic patients.
Collapse
Affiliation(s)
- Jun Chen
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P. R. China 550004.,Lianshui County People's Hospital of Jiangsu Province, Huaian 223400, Jiangsu Province, China
| | - Chun-Lei Wang
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P. R. China 550004
| | - Shan Wu
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P. R. China 550004
| | - Shan He
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P. R. China 550004
| | - Jun Ren
- University of Wyoming College of Health Sciences; Wyoming INBRE Program, Laramie, WY, USA
| |
Collapse
|
5
|
Tang H, Zheng Y, Chen Y. Materials Chemistry of Nanoultrasonic Biomedicine. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2017; 29:1604105. [PMID: 27991697 DOI: 10.1002/adma.201604105] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/12/2016] [Indexed: 06/06/2023]
Abstract
As a special cross-disciplinary research frontier, nanoultrasonic biomedicine refers to the design and synthesis of nanomaterials to solve some critical issues of ultrasound (US)-based biomedicine. The concept of nanoultrasonic biomedicine can also overcome the drawbacks of traditional microbubbles and promote the generation of novel US-based contrast agents or synergistic agents for US theranostics. Here, we discuss the recent developments of material chemistry in advancing the nanoultrasonic biomedicine for diverse US-based bio-applications. We initially introduce the design principles of novel nanoplatforms for serving the nanoultrasonic biomedicine, from the viewpoint of synthetic material chemistry. Based on these principles and diverse US-based bio-application backgrounds, the representative proof-of-concept paradigms on this topic are clarified in detail, including nanodroplet vaporization for intelligent/responsive US imaging, multifunctional nano-contrast agents for US-based multi-modality imaging, activatable synergistic agents for US-based therapy, US-triggered on-demand drug releasing, US-enhanced gene transfection, US-based synergistic therapy on combating the cancer and potential toxicity issue of screening various nanosystems suitable for nanoultrasonic biomedicine. It is highly expected that this novel nanoultrasonic biomedicine and corresponding high performance in US imaging and therapy can significantly promote the generation of new sub-discipline of US-based biomedicine by rationally integrating material chemistry and theranostic nanomedicine with clinical US-based biomedicine.
Collapse
Affiliation(s)
- Hailin Tang
- Department of Diagnostic Ultrasound, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, P. R. China
| | - Yuanyi Zheng
- Shanghai Institute of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated, Shanghai Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Yu Chen
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, P. R. China
| |
Collapse
|
6
|
Study on the use of quantitative ultrasound evaluation of diabetic neuropathy in the rat sciatic nerve. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2016; 39:997-1005. [DOI: 10.1007/s13246-016-0448-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/26/2016] [Indexed: 01/19/2023]
|
7
|
Pitarokoili K, Kerasnoudis A, Behrendt V, Labedi A, Ayzenberg I, Gold R, Yoon MS. Facing the diagnostic challenge: Nerve ultrasound in diabetic patients with neuropathic symptoms. Muscle Nerve 2016; 54:18-24. [DOI: 10.1002/mus.24981] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 11/10/2015] [Accepted: 11/16/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Kalliopi Pitarokoili
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| | - Antonios Kerasnoudis
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| | - Volker Behrendt
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| | - Adnan Labedi
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| | - Ilya Ayzenberg
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| | - Ralf Gold
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| | - Min-Suk Yoon
- Department of Neurology; Ruhr University, St. Josef-Hospital; Gudrunstr. 56 44791 Bochum Germany
| |
Collapse
|
8
|
Gallardo E, Noto YI, Simon NG. Ultrasound in the diagnosis of peripheral neuropathy: structure meets function in the neuromuscular clinic. J Neurol Neurosurg Psychiatry 2015; 86:1066-74. [PMID: 25653385 DOI: 10.1136/jnnp-2014-309599] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/08/2015] [Indexed: 02/06/2023]
Abstract
Peripheral nerve ultrasound (US) has emerged as a promising technique for the diagnosis of peripheral nerve disorders. While most experience with US has been reported in the context of nerve entrapment syndromes, the role of US in the diagnosis of peripheral neuropathy (PN) has recently been explored. Distinctive US findings have been reported in patients with hereditary, immune-mediated, infectious and axonal PN; US may add complementary information to neurophysiological studies in the diagnostic work-up of PN. This review describes the characteristic US findings in PN reported to date and a classification of abnormal nerve US patterns in PN is proposed. Closer scrutiny of nerve abnormalities beyond assessment of nerve calibre may allow for more accurate diagnostic classification of PN, as well as contribute to the understanding of the intersection of structure and function in PN.
Collapse
Affiliation(s)
- Elena Gallardo
- Service of Radiology, University Hospital Marqués de Valdecilla; Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain University of Cantabria (UC); and Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Santander, Spain
| | - Yu-Ichi Noto
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
| | - Neil G Simon
- Prince of Wales Clinical School, University of New South Wales, Australia Central Clinical School, The University of Sydney, Australia
| |
Collapse
|
9
|
Prado-Olivarez J, Arellano-Olivares F, Padilla-Medina A, Diaz-Carmona J, Ramirez-Agundis A, Espinosa-Calderon A, Garcia-Mesita M, Aguilar-Diaz T. Bioimpedance phase angle analysis of foot skin in diabetic patients: An experimental case study. Ing Rech Biomed 2015. [DOI: 10.1016/j.irbm.2015.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
10
|
Upadhyay RK. Emerging risk biomarkers in cardiovascular diseases and disorders. J Lipids 2015; 2015:971453. [PMID: 25949827 PMCID: PMC4407625 DOI: 10.1155/2015/971453] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 12/16/2022] Open
Abstract
Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future.
Collapse
Affiliation(s)
- Ravi Kant Upadhyay
- Department of Zoology, DDU Gorakhpur University, Gorakhpur 273009, India
| |
Collapse
|
11
|
Kerasnoudis A. Intranerve cross sectional area variability of tibial nerve in diabetic neuropathy. Eur J Radiol 2013; 82:1590-1. [DOI: 10.1016/j.ejrad.2013.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 02/28/2013] [Indexed: 11/29/2022]
|