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Olsen AA, Burgdorf S, Bigler DR, Siemsen M, Aasvang EK, Goetze JP, Svendsen MBS, Svendsen LB, Achiam MP. Digital thermography complements Laser Speckle Contrast Imaging for the diagnosis of quantified severe mesenteric traction syndrome - A prospective cohort study. Microvasc Res 2024; 154:104690. [PMID: 38670452 DOI: 10.1016/j.mvr.2024.104690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/09/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Affiliation(s)
- August A Olsen
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Denmark.
| | - Stefan Burgdorf
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Dennis Richard Bigler
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Mette Siemsen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Eske K Aasvang
- Department of Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Denmark; Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Denmark
| | | | - Lars Bo Svendsen
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Michael Patrick Achiam
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Denmark
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Tang Y, Xu F, Lei P, Li G, Tan Z. Spectral analysis of laser speckle contrast imaging and infrared thermography to assess skin microvascular reactive hyperemia. Skin Res Technol 2023; 29:e13308. [PMID: 37113098 PMCID: PMC10234160 DOI: 10.1111/srt.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/25/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Post-occlusive reactive hyperemia (PORH) test with signal spectral analysis coupled provides potential indicators for the assessment of microvascular functions. OBJECTIVE The objective of this study is to investigate the variations of skin blood flow and temperature spectra in the PORH test. Furthermore, to quantify the oscillation amplitude response to occlusion within different frequency ranges. MATERIALS AND METHODS Ten healthy volunteers participated in the PORH test and their hand skin temperature and blood flow images were captured by infrared thermography (IRT) and laser speckle contrast imaging (LSCI) system, respectively. Extracted signals from selected areas were then transformed into the time-frequency space by continuous wavelet transform for cross-correlation analysis and oscillation amplitude response comparisons. RESULTS The LSCI and IRT signals extracted from fingertips showed stronger hyperemia response and larger oscillation amplitude compared with other areas, and their spectral cross-correlations decreased with frequency. According to statistical analysis, their oscillation amplitudes in the PORH stage were obviously larger than the baseline stage within endothelial, neurogenic, and myogenic frequency ranges (p < 0.05), and their quantitative indicators of oscillation amplitude response had high linear correlations within endothelial and neurogenic frequency ranges. CONCLUSION Comparisons of IRT and LSCI techniques in recording the reaction to the PORH test were made in both temporal and spectral domains. The larger oscillation amplitudes suggested enhanced endothelial, neurogenic, and myogenic activities in the PORH test. We hope this study is also significant for investigations of response to the PORH test by other non-invasive techniques.
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Affiliation(s)
- Yuanliang Tang
- Institute of Biological and Medical EngineeringGuangdong Academy of SciencesGuangzhouChina
- National Engineering Research Center for Healthcare DevicesGuangzhouChina
| | - Fei Xu
- Institute of Biological and Medical EngineeringGuangdong Academy of SciencesGuangzhouChina
- National Engineering Research Center for Healthcare DevicesGuangzhouChina
| | - Peng Lei
- Institute of Biological and Medical EngineeringGuangdong Academy of SciencesGuangzhouChina
- National Engineering Research Center for Healthcare DevicesGuangzhouChina
| | - Guixiang Li
- Institute of Biological and Medical EngineeringGuangdong Academy of SciencesGuangzhouChina
- National Engineering Research Center for Healthcare DevicesGuangzhouChina
| | - Zhongwei Tan
- Institute of Biological and Medical EngineeringGuangdong Academy of SciencesGuangzhouChina
- National Engineering Research Center for Healthcare DevicesGuangzhouChina
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D’Oria M, Gandin I, Riccardo P, Hughes M, Lepidi S, Salton F, Confalonieri P, Confalonieri M, Tavano S, Ruaro B. Correlation between Microvascular Damage and Internal Organ Involvement in Scleroderma: Focus on Lung Damage and Endothelial Dysfunction. Diagnostics (Basel) 2022; 13:diagnostics13010055. [PMID: 36611347 PMCID: PMC9818898 DOI: 10.3390/diagnostics13010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/11/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Systemic sclerosis (SSc) is an incurable connective tissue disease characterized by decreased peripheral blood perfusion due to microvascular damage and skin thickening/hardening. The microcirculation deficit is typically secondary to structural vessel damage, which can be assessed morphologically and functionally in a variety of ways, exploiting different technologies. OBJECTIVE This paper focuses on reviewing new studies regarding the correlation between microvascular damage, endothelial dysfunction, and internal organ involvement, particularly pulmonary changes in SSc. METHODS We critically reviewed the most recent literature on the correlation between blood perfusion and organ involvement. RESULTS Many papers have demonstrated the link between structural microcirculatory damage and pulmonary involvement; however, studies that have investigated correlations between microvascular functional impairment and internal organ damage are scarce. Overall, the literature supports the correlation between organ involvement and functional microcirculatory impairment in SSc patients. CONCLUSIONS Morphological and functional techniques appear to be emerging biomarkers in SSc, but obviously need further investigation.
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Affiliation(s)
- Mario D’Oria
- Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Ilaria Gandin
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy
| | - Pozzan Riccardo
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Michael Hughes
- Northern Care Alliance NHS Foundation Trust, Salford Care Organisation and Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M6 8HD, UK
| | - Sandro Lepidi
- Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Francesco Salton
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Paola Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Marco Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Stefano Tavano
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Barbara Ruaro
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
- Correspondence: ; Tel.: +39-040-399-4871
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Abstract
PURPOSE OF REVIEW Vascular assessment in systemic sclerosis (SSc) is included in classification criteria for this disease, thus routinely used in the evaluation of patients in which this diagnosis is being considered. In this review, imaging techniques for assessment of vascular involvement in SSc hands and skin are discussed. RECENT FINDINGS Longitudinal use of imaging techniques has important implications for understanding the progressive vasculopathy and fibrotic transition in SSc. Nailfold and oral capillaroscopy as well as laser speckle contrast analysis are established techniques for vascular functional assessment, but longitudinal use is challenged by equipment costs and clinical time constraints. Ultrasound techniques are well described but require technical training. Advances in mobile infrared thermography and optical coherence tomography could potentially provide a point-of-care, quantitative outcome measure in clinical trials and practice. SUMMARY The equipment cost, technical training, data standardization, and invasiveness of vascular assessment techniques that quantify morphological (microangiopathy) and functional (blood flow reduction) are critical for implementation into SSc clinical trials and practice to understand progressive vasculopathy, such as wound development.
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Affiliation(s)
- Tracy M. Frech
- Vanderbilt University Medical Center, Department of Medicine, Division of Rheumatology and Immunology, Nashville, Tennessee, USA
- Veterans Affair Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
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Laser speckle contrast imaging and laser Doppler flowmetry reproducibly assess reflex cutaneous vasoconstriction. Microvasc Res 2022; 142:104363. [DOI: 10.1016/j.mvr.2022.104363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022]
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Ruaro B, Bruni C, Wade B, Baratella E, Confalonieri P, Antonaglia C, Geri P, Biolo M, Confalonieri M, Salton F. Laser Speckle Contrast Analysis: Functional Evaluation of Microvascular Damage in Connective Tissue Diseases. Is There Evidence of Correlations With Organ Involvement, Such as Pulmonary Damage? Front Physiol 2021; 12:710298. [PMID: 34707506 PMCID: PMC8542764 DOI: 10.3389/fphys.2021.710298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Laser speckle contrast analysis (LASCA) is a non-contact technique able to quantify peripheral blood perfusion (PBP) over large skin areas. LASCA has been used to study hand PBP in several clinical conditions. These include systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) and LASCA showed that PBP was significantly lower in these conditions than in healthy subjects (HS). Moreover, it has been demonstrated that LASCA is a safe technique also able to monitor digital ulcer perfusion and their evolution in SSc patients, during systemic and local treatment. The use of LASCA, coupled with reactivity tests is commonplace in the field of microvascular function research. Post-occlusive hyperemia reactivity (POHR) and local thermal hyperemia, associated with laser techniques are reliable tests in the evaluation of perfusion in SSc patients. Other studies used laser speckled techniques, together with acetylcholine and sodium nitroprusside iontophoresis, as specific tests of endothelium function. In conclusion, LASCA is a safe, non-contact reliable instrument for the quantification of PBP at skin level and can also be associated with reactivity tests to monitor disease progression and response to treatment in different connective tissue diseases.
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Affiliation(s)
- Barbara Ruaro
- Unit of Pulmonology, University Hospital of Trieste, Trieste, Italy
| | - Cosimo Bruni
- Department of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of Florence, Florence, Italy
| | - Barbara Wade
- AOU City of Health and Science of Turin, Department of Science of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Elisa Baratella
- Department of Radiology, Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy
| | | | | | - Pietro Geri
- Unit of Pulmonology, University Hospital of Trieste, Trieste, Italy
| | - Marco Biolo
- Unit of Pulmonology, University Hospital of Trieste, Trieste, Italy
| | | | - Francesco Salton
- Unit of Pulmonology, University Hospital of Trieste, Trieste, Italy
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New mechanism-based approaches to treating and evaluating the vasculopathy of scleroderma. Curr Opin Rheumatol 2021; 33:471-479. [PMID: 34402454 DOI: 10.1097/bor.0000000000000830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Utilizing recent insight into the vasculopathy of scleroderma (SSc), the review will highlight new opportunities for evaluating and treating the disease by promoting stabilization and protection of the microvasculature. RECENT FINDINGS Endothelial junctional signaling initiated by vascular endothelial-cadherin (VE-cadherin) and Tie2 receptors, which are fundamental to promoting vascular health and stability, are disrupted in SSc. This would be expected to not only diminish their protective activity, but also increase pathological processes that are normally restrained by these signaling mediators, resulting in pathological changes in vascular function and structure. Indeed, key features of SSc vasculopathy, from the earliest signs of edema and puffy fingers to pathological disruption of hemodynamics, nutritional blood flow, capillary structure and angiogenesis are all consistent with this altered endothelial signaling. It also likely contributes to further progression of the disease including tissue fibrosis, and organ and tissue injury. SUMMARY Restoring protective endothelial junctional signaling should combat the vasculopathy of SSc and prevent further deterioration in vascular and organ function. Indeed, this type of targeted approach has achieved remarkable results in preclinical models for other diseases. Furthermore, tracking this endothelial junctional signaling, for example by assessing vascular permeability, should facilitate insight into disease progression and its response to therapy.
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Herrick AL, Dinsdale G, Murray A. New perspectives in the imaging of Raynaud's phenomenon. Eur J Rheumatol 2020; 7:S212-S221. [PMID: 33164735 PMCID: PMC7647685 DOI: 10.5152/eurjrheum.2020.19124] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 03/05/2020] [Indexed: 12/15/2022] Open
Abstract
The last 10-20 years have seen huge strides in imaging science. The aim of this review article is to share with the reader the key recent advances in non-invasive imaging of the digital (finger) vasculature in patients with Raynaud's phenomenon (RP), including in systemic sclerosis (SSc)-related digital vasculopathy. For the rheumatologist, seeing a patient with RP is an opportunity for early diagnosis of an underlying SSc-spectrum disorder or (conversely) for reassuring the patient with primary (idiopathic) RP. Non-invasive imaging techniques can help to provide diagnostic certainty. In addition, they can provide new insights into pathophysiology and have the potential to facilitate the development of much needed effective treatments by providing primary and secondary endpoints for randomized controlled trials: validation studies are ongoing. This review article focuses on nailfold capillaroscopy, thermography, and laser Doppler methods but also discusses (briefly) other technologies, including optical coherence tomography, multispectral imaging, and photoacoustic imaging. Key recent advances are the increasing use/availability of nailfold capillaroscopy (and better understanding of the role of low-cost hand-held devices), increased accessibility of thermography (including mobile phone thermography), and increased application of laser Doppler methods to the study of RP/digital vasculopathy (in particular of laser Doppler imaging and laser speckle contrast imaging, both of which measure blood flow over an area rather than at a single site). In an era of precision medicine, non-invasive imaging techniques can help stratify risk of (a) SSc in the patient with RP and (b) digital vascular disease progression in the patient with an SSc-spectrum disorder.
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Affiliation(s)
- Ariane L. Herrick
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Graham Dinsdale
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Andrea Murray
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
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Ruaro B, Nallino MG, Casabella A, Salton F, Confalonieri P, De Tanti A, Bruni C. Monitoring the microcirculation in the diagnosis and follow-up of systemic sclerosis patients: Focus on pulmonary and peripheral vascular manifestations. Microcirculation 2020; 27:e12647. [PMID: 32603500 DOI: 10.1111/micc.12647] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/26/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
Systemic sclerosis (SSc) is a connective tissue disease, characterized by vascular damage and progressive fibrosis, affecting the skin and internal organs. The vascular changes include functional and structural abnormalities in the microcirculation, which play a central role not only in diagnosis but also in the prognosis and follow-up of systemic sclerosis patients. Nailfold videocapillaroscopy (NVC) is a safe, validated, noninvasive, inexpensive, reliable, and reproducible method that allows for the evaluation of structural changes in scleroderma microangiopathy. However, capillary blood flow/perfusion cannot be measured by NVC under standard conditions and, consequently, must rely on various laser techniques and thermography for the assessment and quantification of cutaneous blood perfusion. Other emerging technologies, such as optical Doppler tomography and spectroscopy, may be used to evaluate the skin flow. This review updates current knowledge on the use of microvascular evaluation techniques in SSc, including complications such as digital ulcers and pulmonary arterial hypertension.
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Affiliation(s)
| | | | - Andrea Casabella
- Department of Internal Medicine (Di.M.I.), Research Laboratory and Academic Division of Clinical Rheumatology, San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | | | | | - Antonio De Tanti
- Cardinal Ferrari Center, S. Stefano Rehabilitation, Fontanellato (Parma), Italy
| | - Cosimo Bruni
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
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11
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WUWHS 2020 Global Healing Changing Lives, Abu Dhabi, UAE March 8-12. J Wound Care 2020; 29:1-314. [PMID: 32686975 DOI: 10.12968/jowc.2020.29.sup7b.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The abstract book contains the abstracts of keynote lectures, global gelebration, focus sessions, symposia, regional view, workshops, sponsored symposia, oral presentations, posters and the index.
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Joseph V, Yang X, Gao SS, Elstrott J, Weimer RM, Theess W, Thrasher C, Singh N, Lin J, Bauer RN. Development of AITC-induced dermal blood flow as a translational in vivo biomarker of TRPA1 activity in human and rodent skin. Br J Clin Pharmacol 2020; 87:129-139. [PMID: 32415670 DOI: 10.1111/bcp.14370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/27/2020] [Accepted: 05/01/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND PURPOSE Develop a translational assay of Transient Receptor Potential Ankyrin 1 (TRPA1) activity for use as a preclinical and clinical biomarker. EXPERIMENTAL APPROACH Allyl isothiocyanate (AITC), capsaicin or citric acid were applied to ears of wildtype and Trpa1-knock out (Trpa1 KO) rats, and changes in dermal blood flow (DBF) were measured by laser speckle contrast imaging. In humans, the DBF, pain and itch responses to 5-20% AITC applied to the forearm were measured and safety was evaluated. Reproducibility of the DBF, pain and itch responses to topically applied 10% and 15% AITC were assessed at two visits separated by 13-15 days. DBF changes were summarized at 5-minute intervals as areas under the curve (AUC) and maxima. Intraclass correlation coefficient (ICC) was calculated to assess arm-arm and period-period reproducibility. KEY RESULTS AITC- and citric acid-induced DBF were significantly reduced in Trpa1 KO rats compared to wildtype (90 ± 2% and 65 ± 11% reduction, respectively), whereas capsaicin response did not differ. In humans, each AITC concentration significantly increased DBF compared to vehicle with the maximal increase occurring 5 minutes post application. Ten percent and 15% AITC were selected as safe and effective stimuli. AUC from 0 to 5 minutes was the most reproducible metric of AITC-induced DBF across arms (ICC = 0.92) and periods (ICC = 0.85). Subject-reported pain was more reproducible than itch across visits (ICC = 0.76 vs 0.17, respectively). CONCLUSION AND IMPLICATIONS AITC-induced DBF is a suitable target engagement biomarker of TRPA1 activity for preclinical and clinical studies of TRPA1 antagonists.
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Affiliation(s)
- Victory Joseph
- Biomedical Imaging, Genentech, Inc., South San Francisco, CA, USA
| | - Xiaoying Yang
- Biostatistics, Genentech, Inc., South San Francisco, CA, USA
| | - Simon S Gao
- Clinical Imaging, Genentech, Inc., South San Francisco, CA, USA
| | - Justin Elstrott
- Biomedical Imaging, Genentech, Inc., South San Francisco, CA, USA
| | - Robby M Weimer
- Biomedical Imaging, Genentech, Inc., South San Francisco, CA, USA
| | - Wiebke Theess
- Early Clinical Development, Genentech, Inc., South San Francisco, CA, USA
| | - Cory Thrasher
- Environmental Health and Safety, Genentech, Inc., South San Francisco, CA, USA
| | | | - Joseph Lin
- Early Clinical Development, Genentech, Inc., South San Francisco, CA, USA
| | - Rebecca N Bauer
- OMNI Biomarker Development, Genentech, Inc., South San Francisco, CA, USA
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Abstract
Raynaud's phenomenon (RP) is common, affecting approximately 5% of the population, and is important to the rheumatologist because it is often the presenting symptom of connective tissue disease, especially of systemic sclerosis (SSc)-spectrum disorders. RP therefore provides a window of opportunity for early diagnosis. When RP is associated with SSc it is particularly challenging to treat. This review begins with a discussion of some of the recent advances in our understanding of the pathogenesis of RP: it is through increased understanding of the complex pathophysiology of RP that we are most likely to develop new therapies. The following questions are then addressed (with three clinical scenarios demonstrating key principles of assessment and management): 1. How can we predict underlying connective tissue disease in the patient presenting with Raynaud's? 2. How can we measure severity of Raynaud's? 3. What are the latest advances in treatment of connective tissue disease-related digital vasculopathy?
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Affiliation(s)
- Ariane L Herrick
- Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Fredrick M Wigley
- Department of Medicine, Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, USA.
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Balasubramanian G, Vas P, Chockalingam N, Naemi R. A Synoptic Overview of Neurovascular Interactions in the Foot. Front Endocrinol (Lausanne) 2020; 11:308. [PMID: 32528410 PMCID: PMC7256167 DOI: 10.3389/fendo.2020.00308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
Diabetes is a worldwide public health concern as it is associated with various complications. One of the major complications of diabetes is diabetic foot syndrome that results in catastrophic events such as ulceration and amputation. Therefore, the main four strategies of diabetic foot care involve risk prediction, prevention, and early diagnosis and prompt intervention. The drivers of ulceration are multifactorial, and importantly, include microcirculatory changes in the diabetic skin. Cutaneous microcirculation on the foot is greatly influenced by the small fibers which mediate thermal sensation and pain perception in addition to sympathetic activities such as thermoregulation and vasodilation. The interdependence between the neurovascular elements means with the loss of small fiber functions, the corresponding microcirculatory responses may be compromised. Thus, it can be hypothesized that the impairment of the microcirculation may follow the order of the corresponding small fiber nerve dysfunction or vice versa. In this review, select neurovascular investigations that inform the cutaneous microcirculatory and small fiber nerve function in response to pain, cold, and heat and pressure stimuli are reviewed and discussed in this order of sensory loss: the loss of pain, cold, warmth, touch and deep pressure sensation. We also discuss the neurological and vascular characteristics of each of these neurovascular responses. This review highlights the influence of small fibers on cutaneous microcirculation and the need for prospective studies that can determine the course of microcirculatory impairment over time. This, in turn, may help clarify the exact role of microcirculatory changes in the pathway of ulceration. The insights from this review can be pertinent to understand key microcirculatory disturbances and given that the microcirculatory impairment develops at an early stage, relevant interventions can be implemented to possibly reverse or regress the course of the disease. Therefore, knowledge of the neurovascular interactions aids to map the disease progression for early diagnosis and prevention of adverse complications.
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Affiliation(s)
- Gayathri Balasubramanian
- Centre for Biomechanics and Rehabilitation Technologies, Science Centre, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Prashanth Vas
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Science Centre, Staffordshire University, Stoke-on-Trent, United Kingdom
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Roozbeh Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Science Centre, Staffordshire University, Stoke-on-Trent, United Kingdom
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Ruaro B, Smith V, Sulli A, Pizzorni C, Tardito S, Patané M, Paolino S, Cutolo M. Innovations in the Assessment of Primary and Secondary Raynaud's Phenomenon. Front Pharmacol 2019; 10:360. [PMID: 31073287 PMCID: PMC6495407 DOI: 10.3389/fphar.2019.00360] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/22/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives: Raynaud's phenomenon (RP) is characterized by intense vasospasm of the digital arteries that causes characteristic color changes in fingers. There are two main types of RP: Primary RP (PRP) and Secondary RP (SRP). PRP is a benign condition. Whilst SRP is associated with several connective tissue diseases (CTD), in particular systemic sclerosis (SSc). The objectives of this report were: to present a short review on morphological (nailfold videocapillaroscopy, NVC) and functional techniques (laser tools and thermography) that allow for a correct diagnosis and treatment of RP and to investigate blood perfusion (BP) by laser speckle contrast analysis (LASCA) in different skin areas of hands and face in PRP, SRP to SSc, and healthy subjects (CNT). Methods: 31 PRP patients (LeRoy criteria), 70 SRP to SSc (ACR/EULAR criteria) and 68 CNT were enrolled. BP was assessed by LASCA at the level different areas of hands and face. NVC was performed to distinguish between PRP and SRP, and to detect the proper pattern of nailfold microangiopathy in SSc patients. Results: Both PRP and SRP showed a statistically significant lower BP than CNT at the level of fingertips (p < 0.0001), periungual (p < 0.0001), palmar aspect of 3rd finger (p < 0.0001), and palm areas (p < 0.0001). Moreover, BP was significantly lower in PRP than in SRP to SSc with the "Early" pattern of microangiopathy in the same areas as above (p < 0.04). Conclusion: By considering a small cohort of patients, BP of hands was found lower in PRP than in SSc patients with the "Early" NVC pattern of microangiopathy.
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Affiliation(s)
- Barbara Ruaro
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - Alberto Sulli
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | - Carmen Pizzorni
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | - Samuele Tardito
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | - Massimo Patané
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | - Sabrina Paolino
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
| | - Maurizio Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), San Martino Polyclinic Hospital, University of Genova, Genova, Italy
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Kojima S, Sakamoto T, Nagai Y, Matsui Y, Nambu K, Masamune K. Laser Speckle Contrast Imaging for Intraoperative Quantitative Assessment of Intestinal Blood Perfusion During Colorectal Surgery: A Prospective Pilot Study. Surg Innov 2019; 26:293-301. [PMID: 30638132 DOI: 10.1177/1553350618823426] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The main limitation of perfusion assessment with indocyanine green fluorescence angiography during colorectal surgery is that the surgeon assesses the quality of perfusion subjectively. The ideal intestinal viability test must be minimally invasive, objective, and reproducible. We evaluated the quantitativity and reproducibility of laser speckle contrast imaging for perfusion assessment during colorectal surgery. METHODS This was a prospective, nonrandomized, pilot study of 8 consecutive patients who underwent elective left-sided colorectal resection. Laser speckle perfusion images at the site of proximal transection of the bowel were obtained intraoperatively. We tested the hypothesis that laser speckle contrast imaging was able to quantitatively identify areas of diminished intestinal perfusion after devascularization and assessed the reproducibility of this method. RESULTS All surgical procedures were uneventful and blood flow measurements were successfully made in all patients. None of the patients developed postoperative complications related to the anastomosis and stoma. Data analyses were successfully optimized to perform quantitative regional perfusion assessments in all cases. The bowel tissue blood flows of the anal side region adjacent to the transection line were significantly lower than those of the oral side region adjacent to the transection line after ligation of marginal vessels ( P = .012). Interrater reliability was high (intraclass correlation coefficients = 0.989), and a Bland-Altman plot showed few differences of mean flux data between 2 investigators. CONCLUSION Laser speckle contrast imaging is feasible for real-time assessment of bowel perfusion with quantitativity and excellent reproducibility during colorectal surgery without administration of any contrast agents.
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Affiliation(s)
- Shigehiro Kojima
- 1 Sainokuni Higashiomiya Medical Center, Saitama, Japan.,2 Joint Graduate School of Tokyo Women's Medical University and Waseda University, Tokyo, Japan
| | | | - Yuko Nagai
- 1 Sainokuni Higashiomiya Medical Center, Saitama, Japan
| | - Yutaka Matsui
- 3 Tokyo Women's Medical University, Tokyo, Japan.,4 Pioneer Corporation, Tokyo, Japan
| | - Kyojiro Nambu
- 2 Joint Graduate School of Tokyo Women's Medical University and Waseda University, Tokyo, Japan
| | - Ken Masamune
- 2 Joint Graduate School of Tokyo Women's Medical University and Waseda University, Tokyo, Japan
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17
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Jansen SM, de Bruin DM, van Berge Henegouwen MI, Bloemen PR, Strackee SD, Veelo DP, van Leeuwen TG, Gisbertz SS. Effect of ephedrine on gastric conduit perfusion measured by laser speckle contrast imaging after esophagectomy: a prospective in vivo cohort study. Dis Esophagus 2018; 31:4969976. [PMID: 29668909 DOI: 10.1093/dote/doy031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/13/2018] [Indexed: 12/11/2022]
Abstract
Compromised perfusion due to ligation of arteries and veins in esophagectomy with gastric tube reconstruction often (5-20%) results in necrosis and anastomotic leakage, which relate to high morbidity and mortality (3-4%). Ephedrine is used widely in anesthesia to treat intraoperative hypotension and may improve perfusion by the increase of cardiac output and mean arterial pressure (MAP). This study tests the effect of ephedrine on perfusion of the future anastomotic site of the gastric conduit, measured by laser speckle contrast imaging (LSCI). This prospective, observational, in vivo pilot study includes 26 patients undergoing esophagectomy with gastric tube reconstruction from October 2015 to June 2016 in the Academic Medical Center (Amsterdam). Perfusion of the gastric conduit was measured with LSCI directly after reconstruction and after an increase of MAP by ephedrine 5 mg. Perfusion was quantified in flux (laser speckle perfusion units, LSPU) in four perfusion locations, from good perfusion (base of the gastric tube) toward decreased perfusion (fundus). Intrapatient differences before and after ephedrine in terms flux were statistically tested for significance with a paired t-test. LSCI was feasible to image gastric microcirculation in all patients. Flux (LSPU) was significantly higher in the base of the gastric tube (791 ± 442) compared to the fundus (328 ± 187) (P < 0.001). After administration of ephedrine, flux increased significantly in the fundus (P < 0.05) measured intrapatients. Three patients developed anastomotic leakage. In these patients, the difference between measured flux in the fundus compared to the base of the gastric tube was high. This study presents the effect of ephedrine on perfusion of the gastric tissue measured with LSCI in terms of flux (LSPU) after esophagectomy with gastric tube reconstruction. We show a small but significant difference between flux measured before and after administration of ephedrine in the future anastomotic tissue (313 ± 178 vs. 397 ± 290). We also show a significant decrease of flux toward the fundus.
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Affiliation(s)
- S M Jansen
- Departments of Biomedical Engineering and Physics.,Plastic, Reconstructive and Hand Surgery.,Surgery
| | - D M de Bruin
- Departments of Biomedical Engineering and Physics
| | | | - P R Bloemen
- Departments of Biomedical Engineering and Physics
| | | | - D P Veelo
- Anesthesiology, Academic Medical Center, Amsterdam, The Netherlands
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Maki KA, Griza DS, Phillips SA, Wolska BM, Vidovich MI. Altered Hand Temperatures Following Transradial Cardiac Catheterization: A Thermography Study. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 20:496-502. [PMID: 30078631 DOI: 10.1016/j.carrev.2018.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/24/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND There is concern about potential detrimental effects of transradial access (TRA) on radial artery structure, endothelial and hand function. This thermography study evaluated TRA impact on hand microvascular perfusion. METHODS AND RESULTS We prospectively measured hand thermography, radial and ulnar artery size and blood flow velocities in both catheterization and non-catheterization hands at baseline and 30-days after TRA in 158 patients. There were no differences in radial or ulnar arterial diameters or velocities pre- and post-TRA in catheterization and non-catheterization hands (p = NS). The absolute total hand thermography values post-TRA were increased in both catheterization and non-catheterization hand (pre-TRA 30.4 ± 2.9 vs. post-TRA 31.6 ± 2.6 p < 0.01; pre-TRA 30.2 ± 2.9, post-TRA 31.6 ± 2.6 p < 0.01, respectively). After ulnar artery occlusion, hand temperatures decreased in both catheterization and non-catheterization hands, both pre- and post-TRA and were similar in the catheterization and non-catheterization hands (p = NS). Total hand temperature decreased with ulnar artery occlusion and was significantly attenuated post-TRA (p < 0.001 both catheterization and non-catheterization hands). CONCLUSIONS TRA is associated with temperature changes in both catheterization and non-catheterization hands at one month after the index procedure. These changes likely represent a systemic response to local TRA stimulus.
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Affiliation(s)
- Katherine A Maki
- Jesse Brown VA Medical Center, Chicago, IL, United States of America; College of Nursing, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Decebal S Griza
- Jesse Brown VA Medical Center, Chicago, IL, United States of America
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Beata M Wolska
- Department of Physiology and Biophysics, Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, United States of America; Division of Cardiology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Mladen I Vidovich
- Jesse Brown VA Medical Center, Chicago, IL, United States of America; Division of Cardiology, University of Illinois at Chicago, Chicago, IL, United States of America.
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Orbegozo D, Mongkolpun W, Stringari G, Markou N, Creteur J, Vincent JL, De Backer D. Skin microcirculatory reactivity assessed using a thermal challenge is decreased in patients with circulatory shock and associated with outcome. Ann Intensive Care 2018; 8:60. [PMID: 29725778 PMCID: PMC5934288 DOI: 10.1186/s13613-018-0393-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background Shock states are characterized by impaired tissue perfusion and microcirculatory alterations, which are directly related to outcome. Skin perfusion can be noninvasively evaluated using skin laser Doppler (SLD), which, when coupled with a local thermal challenge, may provide a measure of microcirculatory reactivity. We hypothesized that this microvascular reactivity would be impaired in patients with circulatory shock and would be a marker of severity. Methods We first evaluated skin blood flow (SBF) using SLD on the forearm and on the palm in 18 healthy volunteers to select the site with maximal response. Measurements were taken at 37 °C (baseline) and repeated at 43 °C. The 43 °C/37 °C SBF ratio was calculated as a measure of microvascular reactivity. We then evaluated the SBF in 29 patients with circulatory shock admitted to a 35-bed department of intensive care and in a confirmatory cohort of 35 patients with circulatory shock. Results In the volunteers, baseline SBF was higher in the hand than in the forearm, but the SBF ratio was lower (11.2 [9.4–13.4] vs. 2.0 [1.7–2.6], p < 0.01) so we used the forearm for our patients. Baseline forearm SBF was similar in patients with shock and healthy volunteers, but the SBF ratio was markedly lower in the patients (2.6 [2.0–3.6] vs. 11.2 [9.4–13.4], p < 0.01). Shock survivors had a higher SBF ratio than non-survivors (3.2 [2.2–6.2] vs. 2.3 [1.7–2.8], p < 0.01). These results were confirmed in the second cohort of 35 patients. In multivariable analysis, the APACHE II score and the SBF ratio were independently associated with mortality. Conclusions Microcirculatory reactivity is decreased in patients with circulatory shock and has prognostic value. This simple, noninvasive test could help in monitoring the peripheral microcirculation in acutely ill patients. Electronic supplementary material The online version of this article (10.1186/s13613-018-0393-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Diego Orbegozo
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium
| | - Wasineenart Mongkolpun
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium
| | - Gianni Stringari
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium
| | - Nikolaos Markou
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium
| | - Jacques Creteur
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium
| | - Jean-Louis Vincent
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.
| | - Daniel De Backer
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.
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Jansen SM, Almasian M, Wilk LS, de Bruin DM, van Berge Henegouwen MI, Strackee SD, Bloemen PR, Meijer SL, Gisbertz SS, van Leeuwen TG. Feasibility of Optical Coherence Tomography (OCT) for Intra-Operative Detection of Blood Flow during Gastric Tube Reconstruction. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1331. [PMID: 29693606 PMCID: PMC5982600 DOI: 10.3390/s18051331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/15/2018] [Accepted: 04/21/2018] [Indexed: 01/09/2023]
Abstract
In this study; an OCT-based intra-operative imaging method for blood flow detection during esophagectomy with gastric tube reconstruction is investigated. Change in perfusion of the gastric tube tissue can lead to ischemia; with a high morbidity and mortality as a result. Anastomotic leakage (incidence 5⁻20%) is one of the most severe complications after esophagectomy with gastric tube reconstruction. Optical imaging techniques provide for minimal-invasive and real-time visualization tools that can be used in intraoperative settings. By implementing an optical technique for blood flow detection during surgery; perfusion can be imaged and quantified and; if needed; perfusion can be improved by either a surgical intervention or the administration of medication. The feasibility of imaging gastric microcirculation in vivo using optical coherence tomography (OCT) during surgery of patients with esophageal cancer by visualizing blood flow based on the speckle contrast from M-mode OCT images is studied. The percentage of pixels exhibiting a speckle contrast value indicative of flow was quantified to serve as an objective parameter to assess blood flow at 4 locations on the reconstructed gastric tube. Here; it was shown that OCT can be used for direct blood flow imaging during surgery and may therefore aid in improving surgical outcomes for patients.
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Affiliation(s)
- Sanne M Jansen
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
- Department of Plastic, Reconstructive & Hand Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Mitra Almasian
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Leah S Wilk
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Daniel M de Bruin
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Mark I van Berge Henegouwen
- Department of Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Simon D Strackee
- Department of Plastic, Reconstructive & Hand Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Paul R Bloemen
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Sybren L Meijer
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Suzanne S Gisbertz
- Department of Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Ton G van Leeuwen
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
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Wilkinson JD, Leggett SA, Marjanovic EJ, Moore TL, Allen J, Anderson ME, Britton J, Buch MH, Del Galdo F, Denton CP, Dinsdale G, Griffiths B, Hall F, Howell K, MacDonald A, McHugh NJ, Manning JB, Pauling JD, Roberts C, Shipley JA, Herrick AL, Murray AK. A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography: Outcome Measures for Systemic Sclerosis-Related Raynaud's Phenomenon. Arthritis Rheumatol 2018; 70:903-911. [PMID: 29457381 PMCID: PMC6001804 DOI: 10.1002/art.40457] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/13/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Reliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)-related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low-cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc-related RP. METHODS Patients with RP secondary to SSc were recruited from 6 UK tertiary care centers. The patients underwent cold challenge on 2 consecutive days. Changes in cutaneous blood flow/skin temperature at each visit were imaged simultaneously using LSCI, standard thermography, and mobile thermography. Measurements included area under the curve (AUC) for reperfusion/rewarming and maximum blood flow rate/skin temperature after rewarming (MAX). Test-retest reliability was assessed using intraclass correlation coefficients (ICCs). Estimated latent correlations (estimated from multilevel models, taking values between -1 and 1; denoted as rho values) were used to assess the convergent validity of LSCI and thermography. RESULTS In total, 159 patients (77% with limited cutaneous SSc) were recruited (84% female, median age 63.3 years). LSCI and standard thermography both had substantial reliability, with ICCs for the reperfusion/rewarming AUC of 0.67 (95% confidence interval [95% CI] 0.54, 0.76) and 0.68 (95% CI 0.58, 0.80), respectively, and ICCs for the MAX of 0.64 (95% CI 0.52, 0.75) and 0.72 (95% CI 0.64, 0.81), respectively. Very high latent correlations were present for the AUCs of LSCI and thermography (ρ = 0.94; 95% CI 0.87, 1.00) and for the AUCs of standard and mobile thermography (ρ = 0.98; 95% CI 0.94, 1.00). CONCLUSION This is the first multicenter study to examine the reliability and validity of cold challenge using LSCI and thermography in patients with SSc-related RP. LSCI and thermography both demonstrated good potential as outcome measures. LSCI, standard thermography, and mobile thermography had very high convergent validity.
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Affiliation(s)
- Jack D Wilkinson
- University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah A Leggett
- University of Manchester, Manchester, UK, and Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Elizabeth J Marjanovic
- University of Manchester, Manchester, UK, and Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Tonia L Moore
- University of Manchester, Manchester, UK, and Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
| | - John Allen
- Freeman Hospital and Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Maya H Buch
- NIHR Leeds Musculoskeletal Biomedical Research Unit and Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, Leeds, UK
| | - Francesco Del Galdo
- NIHR Leeds Musculoskeletal Biomedical Research Unit and Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, Leeds, UK
| | | | - Graham Dinsdale
- University of Manchester, Manchester, UK, and Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Bridgett Griffiths
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Frances Hall
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kevin Howell
- University College London Medical School, London, UK
| | - Audrey MacDonald
- Freeman Hospital and Newcastle University, Newcastle upon Tyne, UK
| | - Neil J McHugh
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Foundation Trust, Bath, UK
| | - Joanne B Manning
- University of Manchester, Manchester, UK, and Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
| | - John D Pauling
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Foundation Trust and University of Bath, Bath, UK
| | - Christopher Roberts
- University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Jacqueline A Shipley
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Foundation Trust, Bath, UK
| | - Ariane L Herrick
- University of Manchester and NIHR Manchester Musculoskeletal Biomedical Research Centre, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Andrea K Murray
- University of Manchester, Manchester, UK, and Salford Royal Foundation, NHS Trust, Manchester Academic Health Science Centre, Salford, UK
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Unal-Cevik I. Temporal and Spatial Quantification of Pain- Related Small Fiber Functionality Assessed Using Laser Speckle Contrast Analysis. Pain Pract 2018; 18:824-838. [PMID: 29350880 DOI: 10.1111/papr.12679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/11/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study aimed to establish a practical method for assessing pain symptomatology and develop criteria for quantifying small fiber functions using laser speckle contrast analysis (LASCA). METHODS Axon flare responses, which reflect small fiber functions, were induced either by histamine or capsaicin applied to the volar surface of the skin of the left forearm. To inhibit small fiber function, local anesthetic cream was applied to the skin of right forearm. The effects on pain symptomatology (severity/timing) and axon flare responses (temporal/spatial characteristics) were measured using LASCA. To highlight the clinical relevance, this method was applied to 3 different types of patients with small fiber dysfunction. RESULTS Forty-four forearms of 22 healthy volunteers were tested. Eutectic mixture local anesthetic cream reduced the severity and duration of pain, abolishing or prolonging the latency to reach 3-fold higher levels of basal skin microcirculation levels, and decreasing the area and intensity of flare responses. There were positive correlations between pain symptomatology and flare response characteristics in the control forearm. Similar results were confirmed in neuropathic pain patients. CONCLUSIONS Pain-related small fiber functions and symptomatology (two-in-one method) can be assessed via histamine- or capsaicin-evoked axon flare responses in as little as 15 minutes. The reduction of small fiber functions are characterized by decrease in flare size/intensity at 5 minutes after stimulation and prolongation/abolishment of the latency to reach 3-fold higher levels of baseline skin microcirculation. LASCA may be applied in the clinic to aid early diagnosis, monitor disease progression, and objectively assess treatment efficacy in patients with neuropathic pain.
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Affiliation(s)
- Isin Unal-Cevik
- Department of Neurology, Faculty of Medicine, Pain Unit, Hacettepe University, Ankara, Turkey
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24
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Internal Mammary Vessels' Impact on Abdominal Skin Perfusion in Free Abdominal Flap Breast Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1601. [PMID: 29632780 PMCID: PMC5889442 DOI: 10.1097/gox.0000000000001601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 10/20/2017] [Indexed: 11/26/2022]
Abstract
Background Wound healing problems at the donor site in free abdominal flap breast reconstruction cause significant morbidity to patients. No studies have investigated what impact the use of the internal mammary artery in free abdominal flap breast reconstruction has on abdominal skin perfusion. We hypothesized that harvesting the internal mammary vessels (IMV) has a negative effect on abdominal skin perfusion. Methods The abdomen and anterior thoracic wall of 17 patients scheduled for secondary free abdominal flap breast reconstruction using IMV was pre-, intra-, and postoperatively examined with dynamic infrared thermography. Qualitative and quantitative analyses of the rate and pattern of recovery in Huger's vascular zones were made with each patient being its own control. Zone III on the side where IMV were used was numbered zone IV. The contralateral zone III was used as reference. Results Postoperative abdominal skin perfusion in zone IV was always significantly reduced compared with zone III (1-tailed t test, P < 0.05). The difference between zones II and III was statistically significant for day 1 and 3, but not for day 6 (2-tailed t test, P < 0.05). Skin perfusion in zones II and IV increased during consecutive postoperative days with an increase of hot spots in these areas. Conclusions Using the IMV in free abdominal flap breast reconstruction had a significant effect on abdominal skin perfusion and may contribute to abdominal wound healing problems. The reperfusion of the abdominal skin was a dynamic process showing an increase in perfusion in the affected areas during the postoperative days.
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Dual-Wavelength Laser Speckle Contrast Imaging (dwLSCI) Improves Chronic Measurement of Superficial Blood Flow in Hands. SENSORS 2017; 17:s17122811. [PMID: 29206145 PMCID: PMC5751676 DOI: 10.3390/s17122811] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/03/2017] [Accepted: 11/28/2017] [Indexed: 12/30/2022]
Abstract
Laser speckle contrast imaging (LSCI) has been widely used to determine blood flow and perfusion in biological tissues. The physical model of traditional LSCI ignores the effects of scattering property distribution in relation to speckle correlation time τc and blood flow v, which further results in biased estimation. In this study, we developed a dual-wavelength laser speckle contrast imaging (dwLSCI) method and a portable device for imaging the blood flow and tissue perfusion in human hands. Experimental data showed that dwLSCI could retrieve the vein vasculatures under the surface skin, and it further provided accurate measurements of vein blood flow signals, tissue perfusion signals, and fingertip perfusion signals, which assist with assessments of rehabilitation therapy for stroke patients. Fingertip perfusion signals demonstrated better performance in early assessments, while vein blood flow signals assisted the Fugl-Meyer Assessment Scale (FMA) and the Wolf Motor Function Test (WMFT) behavior assessments. As a general noninvasive imaging method, dwLSCI can be applied in clinical studies related to hand functions combined with behavior assessments.
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Katsui S, Inoue Y, Igari K, Toyofuku T, Kudo T, Uetake H. Novel assessment tool based on laser speckle contrast imaging to diagnose severe ischemia in the lower limb for patients with peripheral arterial disease. Lasers Surg Med 2017; 49:645-651. [PMID: 28370223 PMCID: PMC5573943 DOI: 10.1002/lsm.22669] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/31/2022]
Abstract
Objective We propose a new assessment tool to diagnose severe ischemia of the lower limb in peripheral arterial disease, using laser speckle contrast imaging to evaluate heating‐induced microcirculatory fluctuations in the proximal and distal sites of the dorsal foot. Study Design A cross‐sectional study. Methods We recorded the slope describing the behavior of perfusion values (decrease or plateau) following the initial, heating‐induced increase in perfusion in 63 feet of patients with clinical signs of peripheral arterial disease. Results The plateau and decrease groups were defined as having perfusion slopes of <0.20 and ≥0.20 PU/min, respectively. Transcutaneous oxygen tension was significantly lower (P < 0.001) in the plateau than in the decrease group (8 vs. 45 mmHg), indicating more severe ischemia. The laser speckle contrast imaging thermal load test discriminated transcutaneous oxygen tension <30 mmHg with good sensitivity (78.7%) and specificity (96.2%), and an area under the curve of 0.908. Conclusions Both transcutaneous oxygen tension and the laser speckle contrast imaging thermal load test are useful in diagnosing severe ischemia in the foot. Lasers Surg. Med. 49:645–651, 2017. © 2017. The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Sotaro Katsui
- Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinori Inoue
- Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kimihiro Igari
- Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Toyofuku
- Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshifumi Kudo
- Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Uetake
- Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan
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Vainer BG. Lasers and infrared thermography: advantageous cooperation. APPLIED OPTICS 2016; 55:D95-D100. [PMID: 27958431 DOI: 10.1364/ao.55.000d95] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In a brief review, the beneficial outcomes that have arisen from simultaneous use of laser- and infrared thermography (IRT)-based techniques are demonstrated. The most recent literary and original experimental results collected from different research and practical areas are presented. It is shown that modern IRT acts as an indispensable laser partner in various biomedical and many other applications and technologies. And vice versa, the laser-based methods and techniques often serve as an appropriate research instrument enriching IRT measurement data with independently obtained information.
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Burkes SA, Patel M, Adams DM, Hammill AM, Eaton KP, Randall Wickett R, Visscher MO. Infantile hemangioma status by dynamic infrared thermography: A preliminary study. Int J Dermatol 2016; 55:e522-32. [PMID: 27062495 PMCID: PMC5026852 DOI: 10.1111/ijd.13298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 09/29/2015] [Accepted: 12/28/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Infantile hemangiomas (IH) are initially warm due to increased proliferation and perfusion then involute with apoptosis and reduced perfusion. Objective quantitative evaluation of IH treatment response is essential for improving outcomes. We applied a functional imaging method, dynamic infrared (IR) thermography, to investigate IH status versus control skin and over time. MATERIALS AND METHODS A preliminary prospective observational study was conducted among 25 subjects with superficial or mixed IHs (< 19 months) over 59 clinic visits. Infrared images of IHs and control sites, standardized color images, and three-dimensional images were obtained. Tissue responses following application and removal of a cold stress were recorded with video IR thermography. Outcomes included areas under the curve during cooling (AUCcool ) and rewarming (AUCrw ) and thermal intensity distribution maps. RESULTS AUCcool and AUCrw were significantly higher and cooling rate slower for IHs versus uninvolved tissue indicating greater heat, presumably due to greater perfusion and metabolism for the IH. IR distribution maps showed specific areas of high and low temperature. Significant changes in IH thermal activity were reflected in the difference (AUCcool - AUCrw ), with 6.2 at 2.2 months increasing to 37.6 at 12.8 months. IH cooling rate increased with age, indicating slower recovery, and interpreted as reduced proliferation and/or involution. CONCLUSIONS Dynamic IR thermography was a well-tolerated, quantitative functional imaging modality appropriate for the clinic, particularly when structural changes, i.e., height, volume, color, were not readily observed. It may assist in monitoring progress, individualizing treatment, and evaluating therapies. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov (Identifier NCT02061735).
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Affiliation(s)
- Shoná A Burkes
- Skin Sciences Program, University of Cincinnati, Cincinnati, OH, USA
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Manish Patel
- Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Denise M Adams
- Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Adrienne M Hammill
- Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kenneth P Eaton
- Imaging Research Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Randall Wickett
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - Marty O Visscher
- Skin Sciences Program, University of Cincinnati, Cincinnati, OH, USA.
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Cracowski JL, Roustit M. Current Methods to Assess Human Cutaneous Blood Flow: An Updated Focus on Laser-Based-Techniques. Microcirculation 2016; 23:337-44. [DOI: 10.1111/micc.12257] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 11/20/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Jean-Luc Cracowski
- Université Grenoble Alpes; Grenoble France
- INSERM; Grenoble France
- Clinical Pharmacology Unit; INSERM CIC1406; Grenoble University Hospital; Grenoble France
| | - Matthieu Roustit
- Université Grenoble Alpes; Grenoble France
- INSERM; Grenoble France
- Clinical Pharmacology Unit; INSERM CIC1406; Grenoble University Hospital; Grenoble France
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Riquet D, Houel N, Bodnar JL. Stimulated infrared thermography applied to differentiate scar tissue from peri-scar tissue: a preliminary study. J Med Eng Technol 2016; 40:307-14. [PMID: 27270169 DOI: 10.1080/03091902.2016.1193239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Every human injury leads to a scar formation. The healing process leads to the formation of new tissue: the scar, which is different from the original tissue. This process is influenced by mechanical strength and the local vasculature is modified. The purpose of this study is to show that there are various temperatures between the scar and the peri-scar area associated with the healing process that can be estimated using the thermal infrared camera. In the study, 12 scars were stimulated by cold. Several changes of temperature were observed between scar and peri-scar area for 10 min. Scars appeared significantly colder with a Wilcoxon test (p = 0.01). Results showed that stimulated infrared thermography can be used to monitor the temperature difference between the scar and peri-scar tissue.
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Affiliation(s)
- Damien Riquet
- a ESO Paris Research, Ecole Supérieure D'Ostéopathie , Cité Descartes , Champs-sur-Marne , France ;,b GRESPI/ECATHERM UFR Sciences Exactes Et Naturelles Campus Du Moulin De La Housse , Reims , France
| | - Nicolas Houel
- a ESO Paris Research, Ecole Supérieure D'Ostéopathie , Cité Descartes , Champs-sur-Marne , France
| | - Jean-Luc Bodnar
- b GRESPI/ECATHERM UFR Sciences Exactes Et Naturelles Campus Du Moulin De La Housse , Reims , France
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Dei A, Miyamoto JJ, Takada JI, Ono T, Moriyama K. Evaluation of blood flow and electromyographic activity in the perioral muscles. Eur J Orthod 2015; 38:525-31. [PMID: 26584843 DOI: 10.1093/ejo/cjv079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES Although the electromyographic (EMG) activity of the perioral muscles, including the orbicularis oris and mentalis muscles, has been described in individuals with lip incompetence during lip sealing, blood flow through these muscles remains to be elucidated. The purpose of this study was to examine the blood flow associated with EMG activity in the perioral muscles using laser speckle imaging in individuals with lip incompetence. SUBJECTS/METHODS Blood flow and EMG activity of the superior and inferior orbicularis oris and mentalis muscles were measured with the lips in contact (C condition) and apart (O condition) in lip incompetence (experimental) and control subjects (n = 15 in each group; mean age: 29.5 years). The change ratios of blood flow and EMG activity in the C condition versus O condition (C/O ratios) were calculated and plotted in a scattergram. The Mann-Whitney U-test, Wilcoxon signed-rank test, discriminant analysis using the Mahalanobis generalized distance, and Spearman correlation were used for statistical analysis. RESULTS In the experimental group, blood flow and EMG activity in all muscles were significantly greater in the C condition than in the O condition. The plots of C/O ratios in the experimental group showed a distinct and wide distribution and were significantly different than those in the control group. In both groups, a significant positive correlation was observed between blood flow and EMG activity in the mentalis muscle. CONCLUSIONS/IMPLICATIONS The present findings suggest that observing blood flow in the mentalis muscle is an effective and easily performed method of evaluating lip incompetence.
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Affiliation(s)
- Ayano Dei
- *Department of Maxillofacial Orthognathics
| | | | | | - Takashi Ono
- **Department of Orthodontic Science,Tokyo Medical and Dental University (TMDU), Japan
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Hellmann M, Roustit M, Cracowski JL. Skin microvascular endothelial function as a biomarker in cardiovascular diseases? Pharmacol Rep 2015; 67:803-10. [DOI: 10.1016/j.pharep.2015.05.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/13/2015] [Accepted: 05/13/2015] [Indexed: 11/17/2022]
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Pauling JD, Shipley JA, Hart DJ, McGrogan A, McHugh NJ. Use of Laser Speckle Contrast Imaging to Assess Digital Microvascular Function in Primary Raynaud Phenomenon and Systemic Sclerosis: A Comparison Using the Raynaud Condition Score Diary. J Rheumatol 2015; 42:1163-8. [PMID: 26034146 DOI: 10.3899/jrheum.141437] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Evaluate objective assessment of digital microvascular function using laser speckle contrast imaging (LSCI) in a cross-sectional study of patients with primary Raynaud phenomenon (RP) and systemic sclerosis (SSc), comparing LSCI with both infrared thermography (IRT) and subjective assessment using the Raynaud Condition Score (RCS) diary. METHODS Patients with SSc (n = 25) and primary RP (n = 18) underwent simultaneous assessment of digital perfusion using LSCI and IRT with a cold challenge on 2 occasions, 2 weeks apart. The RCS diary was completed between assessments. The relationship between objective and subjective assessments of RP was evaluated. Reproducibility of LSCI/IRT was assessed, along with differences between primary RP and SSc, and the effect of sex. RESULTS There was moderate-to-good correlation between LSCI and IRT (Spearman rho 0.58-0.84, p < 0.01), but poor correlation between objective assessments and the RCS diary (p > 0.05 for all analyses). Reproducibility of IRT and LSCI was moderate at baseline (ICC 0.51-0.63) and immediately following cold challenge (ICC 0.56-0.86), but lower during reperfusion (ICC 0.3-0.7). Neither subjective nor objective assessments differentiated between primary RP and SSc. Men reported lower median daily frequency of RP attacks (0.82 vs 1.93, p = 0.03). Perfusion using LSCI/IRT was higher in men for the majority of assessments. CONCLUSION Objective and subjective methods provide differing information on microvascular function in RP. There is good convergent validity of LSCI with IRT and acceptable reproducibility of both modalities. Neither subjective nor objective assessments could differentiate between primary RP and SSc. Influence of sex on subjective and objective assessment of RP warrants further evaluation.
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Affiliation(s)
- John D Pauling
- From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath.
| | - Jacqueline A Shipley
- From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath
| | - Darren J Hart
- From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath
| | - Anita McGrogan
- From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath
| | - Neil J McHugh
- From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath
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Chevalier G, Melvin G, Barsotti T. One-Hour Contact with the Earth’s Surface (Grounding) Improves Inflammation and Blood Flow—A Randomized, Double-Blind, Pilot Study. Health (London) 2015. [DOI: 10.4236/health.2015.78119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Omarjee L, Signolet I, Humeau-Heutier A, Martin L, Henrion D, Abraham P. Optimisation of movement detection and artifact removal during laser speckle contrast imaging. Microvasc Res 2015; 97:75-80. [DOI: 10.1016/j.mvr.2014.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
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Allen J, Howell K. Microvascular imaging: techniques and opportunities for clinical physiological measurements. Physiol Meas 2014; 35:R91-R141. [DOI: 10.1088/0967-3334/35/7/r91] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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37
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Gaillard-Bigot F, Roustit M, Blaise S, Gabin M, Cracowski C, Seinturier C, Imbert B, Carpentier P, Cracowski JL. Abnormal amplitude and kinetics of digital postocclusive reactive hyperemia in systemic sclerosis. Microvasc Res 2014; 94:90-5. [PMID: 24990822 DOI: 10.1016/j.mvr.2014.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Postocclusive reactive hyperemia is mediated by two major mediators: sensory nerves and endothelium-derived hyperpolarizing factors. We hypothesized that the skin microvascular response to 5 min ischemia would differ depending upon the hand location in patients with systemic sclerosis (SSc), primary Raynaud's phenomenon (PRP) and healthy controls. METHODS Fifteen patients with SSc, 15 sex- and age-matched patients with PRP and healthy controls were enrolled. Their right hands were subjected to 5 min ischemia followed by a postocclusive hyperemia test, with local microcirculation monitoring by laser speckle contrast imaging on the dorsal face of the hand. RESULTS Postocclusive reactive hyperemia was abnormal in terms of peak and area under the curve (AUC) on all fingers except the thumb in patients with SSc and PRP compared with controls. In contrast, the kinetics of the response was longer only in SSc patients, with mean (SD) time to peak on the index, middle and ring finger were respectively 72 (58), 73 (51) and 67 (47) s for SSc; 40 (20), 40 (20) and 36 (19) s for PRP; and 34 (30), 34 (30) and 29 (24) s for controls (P=0.009 for interaction). CONCLUSIONS We observed decreased distal digital microvascular perfusion following 5 min of ischemia in patients presenting with PRP or SSc, while the kinetics was prolonged only in SSc. A dynamic assessment of digital skin blood flow using laser speckle contrast imaging following 5 min ischemia could be used as a tool to assess microvascular abnormalities in patients with Raynaud's phenomenon secondary to SSc.
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Affiliation(s)
- F Gaillard-Bigot
- Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France
| | - M Roustit
- Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France
| | - S Blaise
- Univ. Grenoble Alpes, HP2, 38000, France; Vascular Medicine Department, Grenoble University Hospital, 38043, France
| | - M Gabin
- Univ. Grenoble Alpes, HP2, 38000, France
| | - C Cracowski
- Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France
| | - C Seinturier
- Vascular Medicine Department, Grenoble University Hospital, 38043, France
| | - B Imbert
- Vascular Medicine Department, Grenoble University Hospital, 38043, France
| | - P Carpentier
- Vascular Medicine Department, Grenoble University Hospital, 38043, France
| | - J L Cracowski
- Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France.
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Norheim AJ, Mercer J, Weerd LD, Borud EK, Sagen T, Hjelle D. Termografi ved frostskader i Forsvaret. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2014; 134:1645. [DOI: 10.4045/tidsskr.14.0634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Meknas K, Al Hassoni TN, Odden-Miland Å, Castillejo M, Kartus J. Medium-Term Results After Treatment of Recalcitrant Lateral Epicondylitis: A Prospective, Randomized Study Comparing Open Release and Radiofrequency Microtenotomy. Orthop J Sports Med 2013; 1:2325967113505433. [PMID: 26535247 PMCID: PMC4555492 DOI: 10.1177/2325967113505433] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Recalcitrant lateral epicondylitis (elbow extensor-origin tendinosis) is a common cause of elbow pain with many treatment options. In the present study, the medium-term results after open release and radiofrequency microtenotomy are reported. HYPOTHESIS Microtenotomy would provide long-term pain relief that was as good as the open release method. STUDY DESIGN Prospective, randomized trial. METHODS Twenty-four patients randomized to either open release or microtenotomy were assessed after 5 to 7 years. Clinical examination and dynamic infrared thermography (DIRT) of both elbows were performed preoperatively and at the medium-term follow-up. Magnetic resonance imaging (MRI) of both elbows was performed at the medium-term follow-up. RESULTS Significant pain reduction was found using a visual analog scale (VAS) at the medium-term follow-up in both groups compared with the preoperative assessment (P < .005). The Mayo Elbow Performance Score (MEPS) increased significantly in both groups (P < .01). The improvement in grip strength was not significant in either group. There was no significant difference between the groups in terms of VAS, strength, and the MEPS. On the DIRT examinations, there were significantly fewer hot spots at the medium-term follow-up than preoperatively (P = .0067, both study groups together). The MRI examinations revealed grade II changes in the operated elbow in 1 patient in each group at the medium-term follow-up, while all the other MRI examinations revealed a normal tendon. CONCLUSION In this prospective, randomized trial with a medium-term follow-up, the results were similar after surgical release and microtenotomy in patients with recalcitrant lateral epicondylitis. The hypothesis was thus verified.
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Affiliation(s)
- Khaled Meknas
- Department of Orthopedics, University Hospital North Norway, Tromsø, Norway
- Bone and Joint Research Group, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | | | - Åshild Odden-Miland
- Cardiovascular Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Norway
| | - Miguel Castillejo
- Department of Radiology, University Hospital North Norway, Tromsø, Norway
| | - Jüri Kartus
- Department of Orthopedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden
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Nakamoto T, Kanao M, Kondo Y, Kajiwara N, Masaki C, Takahashi T, Hosokawa R. Two-Dimensional Real-Time Blood Flow and Temperature of Soft Tissue Around Maxillary Anterior Implants. IMPLANT DENT 2012; 21:522-7. [DOI: 10.1097/id.0b013e318272fe81] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kanao M, Nakamoto T, Kajiwara N, Kondo Y, Masaki C, Hosokawa R. Comparison of plaque accumulation and soft-tissue blood flow with the use of full-arch implant-supported fixed prostheses with mucosal surfaces of different materials: a randomized clinical study. Clin Oral Implants Res 2012; 24:1137-43. [DOI: 10.1111/j.1600-0501.2012.02523.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Masato Kanao
- Department of Oral Reconstruction and Rehabilitation; Kyushu dental College; Kitakyushu City; Fukuoka; Japan
| | - Tetsuji Nakamoto
- Department of Oral Reconstruction and Rehabilitation; Kyushu dental College; Kitakyushu City; Fukuoka; Japan
| | - Norihiro Kajiwara
- Department of Oral Reconstruction and Rehabilitation; Kyushu dental College; Kitakyushu City; Fukuoka; Japan
| | - Yusuke Kondo
- Department of Oral Reconstruction and Rehabilitation; Kyushu dental College; Kitakyushu City; Fukuoka; Japan
| | - Chihiro Masaki
- Department of Oral Reconstruction and Rehabilitation; Kyushu dental College; Kitakyushu City; Fukuoka; Japan
| | - Ryuji Hosokawa
- Department of Oral Reconstruction and Rehabilitation; Kyushu dental College; Kitakyushu City; Fukuoka; Japan
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