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Ashbery D, Baez HC, Kanarr RE, Kunala K, Power D, Chu CJ, Schallek J, McGregor JE. In Vivo Visualization of Intravascular Patrolling Immune Cells in the Primate Eye. Invest Ophthalmol Vis Sci 2024; 65:23. [PMID: 39283618 PMCID: PMC11407476 DOI: 10.1167/iovs.65.11.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Purpose Insight into the immune status of the living eye is essential as we seek to understand ocular disease and develop new treatments. The nonhuman primate (NHP) is the gold standard preclinical model for therapeutic development in ophthalmology, owing to the similar visual system and immune landscape in the NHP relative to the human. Here, we demonstrate the utility of phase-contrast adaptive optics scanning light ophthalmoscope (AOSLO) to visualize immune cell dynamics on the cellular scale, label-free in the NHP. Methods Phase-contrast AOSLO was used to image preselected areas of retinal vasculature in five NHP eyes. Images were registered to correct for eye motion, temporally averaged, and analyzed for immune cell activity. Cell counts, dimensions, velocities, and frequency per vessel were determined manually and compared between retinal arterioles and venules. Based on cell appearance and circularity index, cells were divided into three morphologies: ovoid, semicircular, and flattened. Results Immune cells were observed migrating along vascular endothelium with and against blood flow. Cell velocity did not significantly differ between morphology or vessel type and was independent of blow flood. Venules had a significantly higher cell frequency than arterioles. A higher proportion of cells resembled "flattened" morphology in arterioles. Based on cell speeds, morphologies, and behaviors, we identified these cells as nonclassical patrolling monocytes (NCPMs). Conclusions Phase-contrast AOSLO has the potential to reveal the once hidden behaviors of single immune cells in retinal circulation and can do so without the requirement of added contrast agents that may disrupt immune cell behavior.
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Affiliation(s)
- Drew Ashbery
- University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
- Center for Visual Science, University of Rochester, Rochester, New York, United States
| | - Hector C Baez
- Center for Visual Science, University of Rochester, Rochester, New York, United States
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, United States
| | - Rye E Kanarr
- Center for Visual Science, University of Rochester, Rochester, New York, United States
| | - Karteek Kunala
- Byers Eye Institute, Stanford University, Palo Alto, California, United States
| | - Derek Power
- Center for Visual Science, University of Rochester, Rochester, New York, United States
| | - Colin J Chu
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Jesse Schallek
- Center for Visual Science, University of Rochester, Rochester, New York, United States
- Flaum Eye Institute, University of Rochester, Rochester, New York, United States
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, United States
- Department of Neuroscience, University of Rochester, Rochester, New York, United States
| | - Juliette E McGregor
- Center for Visual Science, University of Rochester, Rochester, New York, United States
- Flaum Eye Institute, University of Rochester, Rochester, New York, United States
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Rashidi M, Kalenkov G, Green DJ, Mclaughlin RA. Improved microvascular imaging with optical coherence tomography using 3D neural networks and a channel attention mechanism. Sci Rep 2024; 14:17809. [PMID: 39090263 PMCID: PMC11294560 DOI: 10.1038/s41598-024-68296-9] [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: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
Skin microvasculature is vital for human cardiovascular health and thermoregulation, but its imaging and analysis presents significant challenges. Statistical methods such as speckle decorrelation in optical coherence tomography angiography (OCTA) often require multiple co-located B-scans, leading to lengthy acquisitions prone to motion artefacts. Deep learning has shown promise in enhancing accuracy and reducing measurement time by leveraging local information. However, both statistical and deep learning methods typically focus solely on processing individual 2D B-scans, neglecting contextual information from neighbouring B-scans. This limitation compromises spatial context and disregards the 3D features within tissue, potentially affecting OCTA image accuracy. In this study, we propose a novel approach utilising 3D convolutional neural networks (CNNs) to address this limitation. By considering the 3D spatial context, these 3D CNNs mitigate information loss, preserving fine details and boundaries in OCTA images. Our method reduces the required number of B-scans while enhancing accuracy, thereby increasing clinical applicability. This advancement holds promise for improving clinical practices and understanding skin microvascular dynamics crucial for cardiovascular health and thermoregulation.
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Affiliation(s)
- Mohammad Rashidi
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Georgy Kalenkov
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, 6009, Australia
| | - Robert A Mclaughlin
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia
- School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
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3
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Chan AHP, Xu XS, Chin IL, Grant AJ, Lau K, Hu Y, Michael PL, Lam YT, Wise SG, Tan RP. Dapansutrile OLT1177 suppresses foreign body response inflammation while preserving vascularisation of implanted materials. J Mater Chem B 2024. [PMID: 38973614 DOI: 10.1039/d4tb00705k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Mitigating inflammation associated with the foreign body response (FBR) remains a significant challenge in enhancing the performance of implantable medical devices. Current anti-inflammatory approaches aim to suppress implant fibrosis, the major outcome of the FBR, but also inadvertently inhibit beneficial immune signalling necessary for tissue healing and vascularization. In a previous study, we demonstrated the feasibility of 'selective' immunosuppression targeting the NLRP3 inflammasome using the small molecule inhibitor MCC950, leading to reduced implant fibrosis without compromising healing and leading to enhanced vascularization. However, the clinical potential of MCC950 is severely limited due to its failure to pass Phase I clinical safety trials. This has triggered substantial efforts to develop safer analogues of NLRP3 inhibitors. Dapansutrile (OLT1177) is emerging as a leading candidate amongst current NLRP3 inhibitors, demonstrating both safety and effectiveness in a growing number of clinical indications and Phase 2 trials. While the anti-inflammatory effects of OLT1177 have been shown, validation of these effects in the context of implanted materials and the FBR have not yet been demonstrated. In this study, we show OLT1177 possesses beneficial effects on key cell types which drive FBR outcomes, including macrophages, fibroblasts, and smooth muscle cells. Evaluation of OLT1177 in a 28 day subcutaneous implantation model showed OLT1177 reduced fibrotic capsule formation while promoting implant vascularization. Mechanistic studies revealed that this occurred through activation of early pro-angiogenic markers while suppressing late-stage anti-angiogenic markers. These findings establish OLT1177 as a promising therapeutic approach for mitigating implant fibrosis while supporting vascularisation, suggesting a highly promising selective immunosuppressive strategy for the FBR warranting further research to explore its optimal integration into medical materials and devices.
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Affiliation(s)
- Alex H P Chan
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Xueying S Xu
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Ian L Chin
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Angus J Grant
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Kieran Lau
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Yunfei Hu
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Praveesuda L Michael
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Yuen Ting Lam
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Steven G Wise
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Richard P Tan
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
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Saijo Y, Akaishi S, Kuwahara H. High-frequency Power Doppler Ultrasonography in Predicting Burn Depth: A Preliminary Case Report. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5949. [PMID: 38957717 PMCID: PMC11219173 DOI: 10.1097/gox.0000000000005949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/01/2024] [Indexed: 07/04/2024]
Abstract
Accurate burn depth assessment is essential to decide an appropriate surgical procedure. However, most cases of burn depth are diagnosed with subjective judgment by an experienced plastic surgeon. There is a need for a simple, noninvasive, and accurate diagnostic method. Here, the authors present two burn cases in which burn depth was predicted using high-frequency power Doppler ultrasonography. In case 1, the patient showed partial deep burn area prediagnosed by clinical inspection in dorsal area. However, pulsatile microcirculation was detected in the deep dermal layer using high-frequency power Doppler ultrasonography, and we rediagnosed it as deep dermal burn. Tangential excision was performed to debride necrotic tissue, preventing excessive removal of viable dermal tissue. In case 2, the patient showed anterior chest burn covered eschar. Pulsatile microcirculation was detected in the dermis using high-frequency power Doppler ultrasonography. The authors diagnosed the area as superficial dermal burn and opted for conservative treatment. Dermal microvascular damage is a more sensitive indicator of tissue injury. Hence, the burn depth can be assessed using dermal microcirculation. To the best of the authors' knowledge, there are no reports on the evaluation of blood flow in burn wounds using high-frequency power Doppler ultrasonography. In this case report, the authors introduce the possibility of using high-frequency ultrasonography to assess burn depth.
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Affiliation(s)
- Yusaku Saijo
- From the Department of Plastic Surgery, Nippon Medical School, Musashikosugi Hospital, Kawasaki, Japan
| | - Satoshi Akaishi
- From the Department of Plastic Surgery, Nippon Medical School, Musashikosugi Hospital, Kawasaki, Japan
| | - Hiroaki Kuwahara
- From the Department of Plastic Surgery, Nippon Medical School, Musashikosugi Hospital, Kawasaki, Japan
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5
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Efendiev K, Alekseeva P, Linkov K, Shiryaev A, Pisareva T, Gilyadova A, Reshetov I, Voitova A, Loschenov V. Tumor fluorescence and oxygenation monitoring during photodynamic therapy with chlorin e6 photosensitizer. Photodiagnosis Photodyn Ther 2024; 45:103969. [PMID: 38211779 DOI: 10.1016/j.pdpdt.2024.103969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND The study is aimed at developing a method for monitoring photodynamic therapy (PDT) of a tumor using chlorin-type photosensitizers (PSs). Lack of monitoring of chlorin e6 (Cе6) photobleaching, hemoglobin oxygenation and blood flow during light exposure can limit the PDT effectiveness. MATERIALS AND METHODS Phototheranostics includes spectral-fluorescence diagnostics of Ce6 distribution in the NIR range and PDT with simultaneous assessment of hemoglobin oxygenation and tumor blood flow. Fluorescence diagnostics and PDT were performed using the single laser λexc=660 ± 5 nm. RESULTS Combined spectroscopic PDT monitoring method allowed simultaneous estimation of Ce6 photobleaching, hemoglobin oxygenation and tumor vascular thrombosis during PDT without interrupting the therapeutic light exposure. CONCLUSION The developed method of tumor phototheranostics using chlorin-type PSs may make it possible to personalize the duration of therapeutic light exposure during PDT.
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Affiliation(s)
- Kanamat Efendiev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia; National Research Nuclear University "MEPhI", Moscow, Russia.
| | - Polina Alekseeva
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
| | - Kirill Linkov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
| | - Artem Shiryaev
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Aida Gilyadova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Igor Reshetov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Victor Loschenov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia; National Research Nuclear University "MEPhI", Moscow, Russia
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6
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Liu B, Postnov D, Boas DA, Cheng X. Dynamic light scattering and laser speckle contrast imaging of the brain: theory of the spatial and temporal statistics of speckle pattern evolution. BIOMEDICAL OPTICS EXPRESS 2024; 15:579-593. [PMID: 38404305 PMCID: PMC10890898 DOI: 10.1364/boe.510333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 02/27/2024]
Abstract
Dynamic light scattering (DLS) and laser speckle contrast imaging (LSCI) are closely related techniques that exploit the statistics of speckle patterns, which can be utilized to measure cerebral blood flow (CBF). Conventionally, the temporal speckle intensity auto-correlation function g 2 t ( τ ) is calculated in DLS, while the spatial speckle contrast Ks is calculated in LSCI measurements. Due to the rapid development of CMOS detection technology with increased camera frame rates while still maintaining a large number of pixels, the ensemble or spatial average of g 2 s ( τ ) as well as the temporal contrast Kt can be easily calculated and utilized to quantify CBF. Although many models have been established, a proper summary is still lacking to fully characterize DLS and LSCI measurements for spatial and temporal statistics, laser coherence properties, various motion types, etc. As a result, there are many instances where theoretical models are misused. For instance, mathematical formulas derived in the diffusive regime or for ergodic systems are sometimes applied to small animal brain measurements, e.g., mice brains, where the assumptions are not valid. Therefore, we aim to provide a review of the speckle theory for both DLS and LSCI measurements with detailed derivations from first principles, taking into account non-ergodicity, spatial and temporal statistics of speckles, scatterer motion types, and laser coherence properties. From these calculations, we elaborate on the differences between spatial and temporal averaging for DLS and LSCI measurements that are typically ignored but can result in inaccurate measurements of blood flow, particularly the spatially varying nature of the static component in g 2 t ( τ ) and Kt. We also obtained g 2 s ( τ ) maps in in vivo mouse brain measurements using high frame rate CMOS cameras which have not been demonstrated before, and compared with g 2 t ( τ ) and Ks,t. This work provides a useful guide for choosing the correct model to analyze spatial and temporal speckle statistics in in-vivo DLS and LSCI measurements.
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Affiliation(s)
- Bingxue Liu
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Dmitry Postnov
- Aarhus University, CFIN Department of Clinical Medicine, Aarhus, 1710, Denmark
| | - David A. Boas
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Xiaojun Cheng
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
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7
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Ganier C, Mazin P, Herrera-Oropeza G, Du-Harpur X, Blakeley M, Gabriel J, Predeus AV, Cakir B, Prete M, Harun N, Darrigrand JF, Haiser A, Wyles S, Shaw T, Teichmann SA, Haniffa M, Watt FM, Lynch MD. Multiscale spatial mapping of cell populations across anatomical sites in healthy human skin and basal cell carcinoma. Proc Natl Acad Sci U S A 2024; 121:e2313326120. [PMID: 38165934 PMCID: PMC10786309 DOI: 10.1073/pnas.2313326120] [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: 08/06/2023] [Accepted: 11/13/2023] [Indexed: 01/04/2024] Open
Abstract
Our understanding of how human skin cells differ according to anatomical site and tumour formation is limited. To address this, we have created a multiscale spatial atlas of healthy skin and basal cell carcinoma (BCC), incorporating in vivo optical coherence tomography, single-cell RNA sequencing, spatial global transcriptional profiling, and in situ sequencing. Computational spatial deconvolution and projection revealed the localisation of distinct cell populations to specific tissue contexts. Although cell populations were conserved between healthy anatomical sites and in BCC, mesenchymal cell populations including fibroblasts and pericytes retained signatures of developmental origin. Spatial profiling and in silico lineage tracing support a hair follicle origin for BCC and demonstrate that cancer-associated fibroblasts are an expansion of a POSTN+ subpopulation associated with hair follicles in healthy skin. RGS5+ pericytes are also expanded in BCC suggesting a role in vascular remodelling. We propose that the identity of mesenchymal cell populations is regulated by signals emanating from adjacent structures and that these signals are repurposed to promote the expansion of skin cancer stroma. The resource we have created is publicly available in an interactive format for the research community.
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Affiliation(s)
- Clarisse Ganier
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
| | - Pavel Mazin
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CambridgeCB10 1SA, United Kingdom
| | - Gabriel Herrera-Oropeza
- Centre for Developmental Neurobiology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE1 1UL, United Kingdom
| | - Xinyi Du-Harpur
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
- The Francis Crick Institute, LondonNW1 1AT, United Kingdom
| | - Matthew Blakeley
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
| | - Jeyrroy Gabriel
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
| | - Alexander V. Predeus
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CambridgeCB10 1SA, United Kingdom
| | - Batuhan Cakir
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CambridgeCB10 1SA, United Kingdom
| | - Martin Prete
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CambridgeCB10 1SA, United Kingdom
| | - Nasrat Harun
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
| | - Jean-Francois Darrigrand
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
| | - Alexander Haiser
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
| | - Saranya Wyles
- Department of Dermatology, Mayo Clinic, Rochester, MN55905
| | - Tanya Shaw
- Centre for Inflammation Biology and Cancer Immunology, King’s College London, LondonSE1 1UL, United Kingdom
| | - Sarah A. Teichmann
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CambridgeCB10 1SA, United Kingdom
- Theory of Condensed Matter Group, Cavendish Laboratory, University of Cambridge, CambridgeCB3 0HE, United Kingdom
| | - Muzlifah Haniffa
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CambridgeCB10 1SA, United Kingdom
- Biosciences Institute, Newcastle University, Newcastle upon TyneNE2 4HH, United Kingdom
- National Institute for Health Research Newcastle Biomedical Research Centre, Newcastle Hospitals National Health Service Foundation Trust, Newcastle upon TyneNE1 4LP, United Kingdom
| | - Fiona M. Watt
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
- Directors’ Unit, European Molecular Biology Laboratory, Heidelberg69117, Germany
| | - Magnus D. Lynch
- Centre for Gene Therapy and Regenerative Medicine, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
- St. John’s Institute of Dermatology, King’s College London, Guy’s Hospital, LondonSE1 9RT, United Kingdom
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Gun Koplay T, Uysal E. Evaluation of nipple vascularity using superb microvascular imaging in patients with reduction mammoplasty. Medicine (Baltimore) 2023; 102:e35796. [PMID: 37904398 PMCID: PMC10615389 DOI: 10.1097/md.0000000000035796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/04/2023] [Indexed: 11/01/2023] Open
Abstract
We aimed to investigate the effect of the chosen pedicle on nipple vascularity by evaluating changes in the microvascular circulation of the nipples in patients undergoing reduction mammoplasty through superb microvascular imaging study (SMI). 70 nipples were included in this retrospective study. There were 15 patients (30 nipples) in Group A using the inferior pedicle and 20 patients (40 nipples) in Group B using the superomedial pedicle. The vascular index (VI) of each nipple were evaluated preoperatively and at the third postoperative month using SMI. The mean VI in Group A was 1.25 (0.5-3.6) preoperatively and 1.3 (0.4-3.2) at the third postoperative month (P > .05). The mean VI in Group B was 1.65 (0.7/2.9) preoperatively and 1.15 (0.2/1.9) at the third postoperative month (P < .05). While the VI increased by 11.3% in Group A, it decreased by 30.6% in Group B (P < .001). The changing of the VI was analyzed between comparable groups, and decreasing microvascular circulation of the nipple with use of the superomedial pedicle was detected by quantitative values, which can be useful in at-risk patient groups, the planning of surgical procedures, and early revisions at postoperative month 3.
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Affiliation(s)
- Tugba Gun Koplay
- University of Health Sciences, Konya City Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Konya, Turkey
| | - Emine Uysal
- Selcuk University, Medical Faculty, Department of Radiology, Konya, Turkey
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9
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Gün Koplay T, Uysal E, Köksal H, Babalıoğlu İ. Superb Microvascular Imaging at Evaluation of Nonvisible Buried De-epitelized Flap Vascularization in Breast Reconstruction. Eurasian J Med 2023; 55:213-217. [PMID: 37909195 PMCID: PMC10724750 DOI: 10.5152/eurasianjmed.2023.23063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/22/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE Superb microvascular imaging is a Doppler technique that increases the visibility of small vessels and gives quantitative information about tissue blood supply by measuring the vascular index. In this study, it is aimed to evaluate the long-term and postradiotherapy changes in blood flow of buried de-epitelized flaps in breast reconstruction by using the quantitative values obtained through superb microvascular imaging. MATERIALS AND METHODS Retrospective review of the 14 patients who underwent nipple-sparing breastconserving surgery and immediately breast reconstruction with a de-epitelized extended latissimus dorsi flap was done. In order to demonstrate the effect of radiotherapy on flaps microvascular circulation, patients were evaluated using superb microvascular imaging postoperative first week, first month, and postradiotherapy first week and sixth month. The normal distribution of the data was evaluated with the Shapiro-Wilk test. Paired samples t-test was used for comparisons. RESULTS According to the paired samples t-tests, postoperative first week mean vascular index was higher than postoperative first month and postradiotherapy first week (P < .05). Besides, postradiotherapy first week mean vascular index was higher than postoperative first month and also than postradiotherapy sixth month (P < .05). CONCLUSION Radiotherapy can affect the results of breast reconstruction by endothelial and fibrotic injury. In this study, the changes in the microvascular circulation of the latissimus dorsi flap were discussed and found to increase at postoperative and postradiotherapy early period related to inflammation and not decreased significantly at long-term follow-up after radiotherapy.
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Affiliation(s)
- Tuğba Gün Koplay
- Department of Plastic Reconstructive and Aesthetic Surgery, Konya City Hospital, Konya, Turkey
| | - Emine Uysal
- Department of Radiology, Selçuk University Medical Faculty, Konya, Turkey
| | - Hande Köksal
- Department of General Surgery, Selçuk University Faculty of Medicine, Konya, Turkey
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Ooms M, Winnand P, Heitzer M, Peters F, Bock A, Katz MS, Hölzle F, Modabber A. Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study. Sci Rep 2023; 13:15939. [PMID: 37743387 PMCID: PMC10518317 DOI: 10.1038/s41598-023-43151-5] [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: 06/11/2023] [Accepted: 09/20/2023] [Indexed: 09/26/2023] Open
Abstract
Unattached surface probes are commonly used with the O2C analysis system (LEA Medizintechnik, Germany) to monitor microvascular free flap perfusion. This study compared attached and unattached surface probes for extraoral free flaps. The study included 34 patients who underwent extraoral microvascular head and neck reconstruction between 2020 and 2022. Flap perfusion was monitored postoperatively using the O2C analysis system at 0, 12, 24, 36, and 48 h, with an attached surface probe at 3 mm tissue depth and an unattached surface probe at 2 mm and 8 mm tissue depths. Clinical complications, technical errors, and perfusion measurement values were compared. No clinical complications (attachment suture infections) or technical errors (probe detachment) occurred. Flap blood flow values of the probes were partially different (3 mm vs. 2 and 8 mm: p < 0.001; p = 0.308) and moderately correlated (3 mm with 2 and 8 mm: r = 0.670, p < 0.001; r = 0.638, p < 0.001). Hemoglobin concentration and oxygen saturation values were generally different (3 mm vs. 2 and 8 mm: all p < 0.001) and variably correlated (3 mm with 2 and 8 mm: r = 0.756, r = 0.645; r = 0.633, r = 0.307; all p < 0.001). Both probes are comparable in terms of technical feasibility and patient safety, with flap perfusion values dependent on tissue measurement depth.
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Affiliation(s)
- Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Florian Peters
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Anna Bock
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marie Sophie Katz
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Mauroux A, Joncour P, Brassard-Jollive N, Bacar H, Gillet B, Hughes S, Ardidie-Robouant C, Marchand L, Liabotis A, Mailly P, Monnot C, Germain S, Bordes S, Closs B, Ruggiero F, Muller L. Papillary and reticular fibroblasts generate distinct microenvironments that differentially impact angiogenesis. Acta Biomater 2023; 168:210-222. [PMID: 37406716 DOI: 10.1016/j.actbio.2023.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
Papillary and reticular dermis show distinct extracellular matrix (ECM) and vascularization corresponding to their specific functions. These characteristics are associated with gene expression patterns of fibroblasts freshly isolated from their native microenvironment. In order to assess the relevance of these fibroblast subpopulations in a tissue engineering context, we investigated their contribution to matrix production and vascularization using cell sheet culture conditions. We first performed RNA-seq differential expression analysis to determine whether several rounds of cell amplification and high-density culture affected their gene expression profile. Bioinformatics analysis revealed that expression of angiogenesis-related and matrisome gene signatures were maintained, resulting in papillary and reticular ECMs that differ in composition and structure. The impact of secreted or ECM-associated factors was then assessed using two independent 3D angiogenesis assays: -1/ a fibrin hydrogel-based assay allowing investigation of diffusible secreted factors, -2/ a scaffold-free cell-sheet based assay for investigation of fibroblast-produced microenvironment. These analyses revealed that papillary fibroblasts secrete highly angiogenic factors and produce a microenvironment characterised by ECM remodelling capacity and dense and branched microvascular network, whereas reticular fibroblasts produced more structural core components of the ECM associated with less branched and larger vessels. These features mimick the characteristics of both the ECM and the vasculature of dermis subcompartments. In addition to showing that skin fibroblast populations differentially regulate angiogenesis via both secreted and ECM factors, our work emphasizes the importance of papillary and reticular fibroblasts for engineering and modelling dermis microenvironment and vascularization. STATEMENT OF SIGNIFICANCE: Recent advances have brought to the forefront the central role of microenvironment and vascularization in tissue engineering for regenerative medicine and microtissue modelling. We have investigated the role of papillary and reticular fibroblast subpopulations using scaffold-free cell sheet culture. This approach provides differentiated cells conditions allowing the production of their own microenvironment. Analysis of gene expression profiles and characterisation of the matrix produced revealed strong and specific angiogenic properties that we functionally characterized using 3D angiogenesis models targeting the respective role of either secreted or matrix-bound factors. This study demonstrates the importance of cell-generated extracellular matrix and questions the importance of cell source and the relevance of hydrogels for developing physio-pathologically relevant tissue engineered substitutes.
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Affiliation(s)
- Adèle Mauroux
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France; Institut de Génomique Fonctionnelle de Lyon (IGFL), ENS de Lyon, CNRS, Univ Lyon 1, 32-34 Avenue Tony Garnier, Lyon 69007, France; R&D Department, SILAB, ZI de la Nau, Saint Viance 19240, France; Sorbonne Université, Collège Doctoral, 15 rue de l'Ecole de Médecine, Paris 75006, France
| | - Pauline Joncour
- Institut de Génomique Fonctionnelle de Lyon (IGFL), ENS de Lyon, CNRS, Univ Lyon 1, 32-34 Avenue Tony Garnier, Lyon 69007, France
| | - Noémie Brassard-Jollive
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France; Sorbonne Université, Collège Doctoral, 15 rue de l'Ecole de Médecine, Paris 75006, France
| | - Hisoilat Bacar
- Institut de Génomique Fonctionnelle de Lyon (IGFL), ENS de Lyon, CNRS, Univ Lyon 1, 32-34 Avenue Tony Garnier, Lyon 69007, France
| | - Benjamin Gillet
- Institut de Génomique Fonctionnelle de Lyon (IGFL), ENS de Lyon, CNRS, Univ Lyon 1, 32-34 Avenue Tony Garnier, Lyon 69007, France
| | - Sandrine Hughes
- Institut de Génomique Fonctionnelle de Lyon (IGFL), ENS de Lyon, CNRS, Univ Lyon 1, 32-34 Avenue Tony Garnier, Lyon 69007, France
| | - Corinne Ardidie-Robouant
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France
| | | | - Athanasia Liabotis
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France; Sorbonne Université, Collège Doctoral, 15 rue de l'Ecole de Médecine, Paris 75006, France
| | - Philippe Mailly
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France
| | - Catherine Monnot
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France
| | - Stéphane Germain
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France
| | - Sylvie Bordes
- R&D Department, SILAB, ZI de la Nau, Saint Viance 19240, France
| | - Brigitte Closs
- R&D Department, SILAB, ZI de la Nau, Saint Viance 19240, France
| | - Florence Ruggiero
- Institut de Génomique Fonctionnelle de Lyon (IGFL), ENS de Lyon, CNRS, Univ Lyon 1, 32-34 Avenue Tony Garnier, Lyon 69007, France.
| | - Laurent Muller
- Center for Interdisciplinary Research in Biology (CIRB), College de France - CNRS, INSERM, Université PSL, 11 Place Marcelin Berthelot, Paris 75005, France.
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Fasoula NA, Xie Y, Katsouli N, Reidl M, Kallmayer MA, Eckstein HH, Ntziachristos V, Hadjileontiadis L, Avgerinos DV, Briasoulis A, Siasos G, Hosseini K, Doulamis I, Kampaktsis PN, Karlas A. Clinical and Translational Imaging and Sensing of Diabetic Microangiopathy: A Narrative Review. J Cardiovasc Dev Dis 2023; 10:383. [PMID: 37754812 PMCID: PMC10531807 DOI: 10.3390/jcdd10090383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Microvascular changes in diabetes affect the function of several critical organs, such as the kidneys, heart, brain, eye, and skin, among others. The possibility of detecting such changes early enough in order to take appropriate actions renders the development of appropriate tools and techniques an imperative need. To this end, several sensing and imaging techniques have been developed or employed in the assessment of microangiopathy in patients with diabetes. Herein, we present such techniques; we provide insights into their principles of operation while discussing the characteristics that make them appropriate for such use. Finally, apart from already established techniques, we present novel ones with great translational potential, such as optoacoustic technologies, which are expected to enter clinical practice in the foreseeable future.
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Affiliation(s)
- Nikolina-Alexia Fasoula
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Yi Xie
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Nikoletta Katsouli
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Mario Reidl
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Michael A. Kallmayer
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
| | - Vasilis Ntziachristos
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Leontios Hadjileontiadis
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates;
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Alexandros Briasoulis
- Aleksandra Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;
| | - Gerasimos Siasos
- Sotiria Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;
| | - Kaveh Hosseini
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran;
| | - Ilias Doulamis
- Department of Surgery, The Johns Hopkins Hospital, School of Medicine, Baltimore, MD 21287, USA;
| | | | - Angelos Karlas
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
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Bajwa MS, Bashir MM, Bajwa MH, Iqbal Z, Salahuddin MA, Hussain A, Shahzad F. How long to wait after local infiltration anaesthesia: systematic review. BJS Open 2023; 7:zrad089. [PMID: 37768699 PMCID: PMC10538258 DOI: 10.1093/bjsopen/zrad089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/27/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Conflicting evidence exists regarding the optimal waiting time for stable analgesic and vasoconstrictive effects after local infiltration of lidocaine with epinephrine. An objective review is needed to dispel surgical dogma. METHODS This systematic review (PROSPERO ID: CRD42022362414) included RCTs and prospective cohort studies. Primary outcomes were (1) onset of analgesia and (2) onset of stable hypoperfusion, assessed directly, or measured indirectly using perfusion imaging. Other data extracted include waiting strategies, means of outcome assessment, anaesthetic concentrations, volume/endpoint of infiltration, and injection sites. Methodological quality was evaluated using the Cochrane risk-of-bias tool for randomized trials. Articles describing waiting strategies were critically appraised by the Joanna Briggs Institute tools. RESULTS Twenty-four articles were analysed, comprising 1013 participants. Ten investigated analgesia onset. Their pooled mean was 2.1 min (range 0.4-9.0 min). This varied with anatomic site and targeted nerve diameter. Fourteen articles investigated onset of stable hypoperfusion. Four observed bleeding intraoperatively, finding the minimum time to hypoperfusion at 7.0 min in the eyelid skin and 25.0 min in the upper limb. The ten remaining studies used perfusion imaging, reporting a wide range of results (0.0-30.0 min) due to differences in anatomic sites and depth, resolution and artefacts. Studies using near-infrared reflectance spectroscopy and hyperspectral imaging correlated with clinical observations. Thirteen articles discussed waiting strategies, seven relating to large-volume tumescent local infiltration anaesthesia. Different waiting strategies exist for emergency, arthroscopic and cosmetic surgeries, according to the degree of hypoperfusion required. In tumescent liposuction, waiting 10.0-60.0 min is the norm. CONCLUSION Current literature suggests that around 2 min are required for most patients to achieve complete analgesia in all sites and with all anaesthesia concentrations. Waiting around 7 min in eyelids and at least 25 min in other regions results in optimal hypoperfusion. The strategies discussed inform decisions of when and how long to wait.
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Affiliation(s)
- Mohammad Suleman Bajwa
- Department of Plastic & Reconstructive Surgery/Mayo Burn Centre, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
- Department of Surgery, Montefiore Medical Center, New York, USA
| | - Muhammad Mustehsan Bashir
- Department of Plastic & Reconstructive Surgery/Mayo Burn Centre, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | | | - Zafar Iqbal
- Department of Plastic & Reconstructive Surgery/Mayo Burn Centre, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Aizaz Salahuddin
- Department of Plastic & Reconstructive Surgery/Mayo Burn Centre, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Ahmad Hussain
- Department of Plastic & Reconstructive Surgery/Mayo Burn Centre, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Farooq Shahzad
- Plastic & Reconstructive Surgery Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
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14
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Ooms M, Winnand P, Heitzer M, Peters F, Bock A, Katz M, Hölzle F, Modabber A. Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity. Clin Oral Investig 2023; 27:5577-5585. [PMID: 37522990 PMCID: PMC10492739 DOI: 10.1007/s00784-023-05177-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES Postoperative flap monitoring is essential in oral microvascular reconstruction for timely detection of vascular compromise. This study investigated the use of attached surface probes for the oxygen-2-see (O2C) analysis system (LEA Medizintechnik, Germany) for intraoral flap perfusion monitoring. MATERIALS AND METHODS The study included 30 patients who underwent oral reconstruction with a microvascular radial-free forearm flap (RFFF) or anterolateral thigh flap (ALTF) between 2020 and 2022. Flap perfusion was measured with attached (3-mm measurement depth) and unattached surface probes (2- and 8-mm measurement depths) for the O2C analysis system at 0, 12, 24, 36, and 48 h postoperatively. Flap perfusion monitoring with attached surface probes was evaluated for cut-off values for flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation indicative of vascular compromise and for accuracy and concordance with unattached surface probes. RESULTS Three RFFFs were successfully revised, and one ALTF was unsuccessfully revised. The cut-off values indicative of vascular compromise for flap perfusion monitoring with attached surface probes were for RFFF and ALTF: blood flow < 60 arbitrary units (AU) and < 40AU, hemoglobin concentration > 100AU and > 80AU (both > 10% increase), and hemoglobin oxygen saturation < 40% and < 30%. Flap perfusion monitoring with attached surface probes yielded a 97.1% accuracy and a Cohen's kappa of 0.653 (p < 0.001). CONCLUSIONS Flap perfusion monitoring with attached surface probes for the O2C analysis system detected vascular compromise accurately and concordantly with unattached surface probes. CLINICAL RELEVANCE Attached surface probes for the O2C analysis system are a feasible option for intraoral flap perfusion monitoring.
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Affiliation(s)
- Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Florian Peters
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Anna Bock
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marie Katz
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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15
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Liu B, Shah S, Küreli G, Devor A, Boas DA, Cheng X. Measurements of slow tissue dynamics with short-separation speckle contrast optical spectroscopy. BIOMEDICAL OPTICS EXPRESS 2023; 14:4790-4799. [PMID: 37791271 PMCID: PMC10545176 DOI: 10.1364/boe.497604] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 10/05/2023]
Abstract
Laser speckle contrast imaging (LSCI) measures 2D maps of cerebral blood flow (CBF) in small animal brains such as mice. The contrast measured in LSCI also includes the static and slow-varying components that contain information about brain tissue dynamics. But these components are less studied as compared to the fast dynamics of CBF. In traditional wide-field LSCI, the contrast measured in the tissue is largely contaminated by neighboring blood vessels, which reduces the sensitivity to these static and slow components. Our goal is to enhance the sensitivity of the contrast to static and slow tissue dynamics and test models to quantify the characteristics of these components. To achieve this, we have developed a short-separation speckle contrast optical spectroscopy (ss-SCOS) system by implementing point illumination and point detection using multi-mode fiber arrays to enhance the static and slow components in speckle contrast measurements as compared to traditional wide-field LSCI (WF-LSCI). We observed larger fractions of the static and slow components when measured in the tissue using ss-SCOS than in traditional LSCI for the same animal and region of interest. We have also established models to obtain the fractions of the static and slow components and quantify the decorrelation time constants of the intensity auto-correlation function for both fast blood flow and slower tissue dynamics. Using ss-SCOS, we demonstrate the variations of fast and slow brain dynamics in animals before and post-stroke, as well as within an hour post-euthanasia. This technique establishes the foundation to measure brain tissue dynamics other than CBF, such as intracellular motility.
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Affiliation(s)
- Bingxue Liu
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Shashwat Shah
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Gülce Küreli
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
| | - Anna Devor
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - David A. Boas
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Xiaojun Cheng
- Neurophotonics Center, Boston University, Boston, Massachusetts 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
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Liao J, Yang S, Zhang T, Li C, Huang Z. A hand-held optical coherence tomography angiography scanner based on angiography reconstruction transformer networks. JOURNAL OF BIOPHOTONICS 2023; 16:e202300100. [PMID: 37264544 DOI: 10.1002/jbio.202300100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/18/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
Optical coherence tomography angiography (OCTA) has successfully demonstrated its viability for clinical applications in dermatology. Due to the high optical scattering property of skin, extracting high-quality OCTA images from skin tissues requires at least six-repeated scans. While the motion artifacts from the patient and the free hand-held probe can lead to a low-quality OCTA image. Our deep-learning-based scan pipeline enables fast and high-quality OCTA imaging with 0.3-s data acquisition. We utilize a fast scanning protocol with a 60 μm/pixel spatial interval rate and introduce angiography-reconstruction-transformer (ART) for 4× super-resolution of low transverse resolution OCTA images. The ART outperforms state-of-the-art networks in OCTA image super-resolution and provides a lighter network size. ART can restore microvessels while reducing the processing time by 85%, and maintaining improvements in structural similarity and peak-signal-to-noise ratio. This study represents that ART can achieve fast and flexible skin OCTA imaging while maintaining image quality.
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Affiliation(s)
- Jinpeng Liao
- School of Science and Engineering, University of Dundee, Scotland, UK
| | - Shufan Yang
- School of Computing, Engineering and Built Environment, Edinburgh Napier University, Edinburgh, UK
- Research Department of Orthopaedics and Musculoskeletal Science, University College London, UK
| | - Tianyu Zhang
- School of Science and Engineering, University of Dundee, Scotland, UK
| | - Chunhui Li
- School of Science and Engineering, University of Dundee, Scotland, UK
| | - Zhihong Huang
- School of Science and Engineering, University of Dundee, Scotland, UK
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Han D, Huang Z, Rahimi E, Ardekani AM. Solute Transport across the Lymphatic Vasculature in a Soft Skin Tissue. BIOLOGY 2023; 12:942. [PMID: 37508373 PMCID: PMC10375963 DOI: 10.3390/biology12070942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023]
Abstract
Convective transport of drug solutes in biological tissues is regulated by the interstitial fluid pressure, which plays a crucial role in drug absorption into the lymphatic system through the subcutaneous (SC) injection. In this paper, an approximate continuum poroelasticity model is developed to simulate the pressure evolution in the soft porous tissue during an SC injection. This poroelastic model mimics the deformation of the tissue by introducing the time variation of the interstitial fluid pressure. The advantage of this method lies in its computational time efficiency and simplicity, and it can accurately model the relaxation of pressure. The interstitial fluid pressure obtained using the proposed model is validated against both the analytical and the numerical solution of the poroelastic tissue model. The decreasing elasticity elongates the relaxation time of pressure, and the sensitivity of pressure relaxation to elasticity decreases with the hydraulic permeability, while the increasing porosity and permeability due to deformation alleviate the high pressure. An improved Kedem-Katchalsky model is developed to study solute transport across the lymphatic vessel network, including convection and diffusion in the multi-layered poroelastic tissue with a hybrid discrete-continuum vessel network embedded inside. At last, the effect of different structures of the lymphatic vessel network, such as fractal trees and Voronoi structure, on the lymphatic uptake is investigated. In this paper, we provide a novel and time-efficient computational model for solute transport across the lymphatic vasculature connecting the microscopic properties of the lymphatic vessel membrane to the macroscopic drug absorption.
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Affiliation(s)
- Dingding Han
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907, USA
| | - Ziyang Huang
- Mechanical Engineering Department, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ehsan Rahimi
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907, USA
| | - Arezoo M Ardekani
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907, USA
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Samils L, Henricson J, Strömberg T, Fredriksson I, Iredahl F. Workload and sex effects in comprehensive assessment of cutaneous microcirculation. Microvasc Res 2023; 148:104547. [PMID: 37192688 DOI: 10.1016/j.mvr.2023.104547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/25/2023] [Accepted: 05/11/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Workload and sex-related differences have been proposed as factors of importance when evaluating the microcirculation. Simultaneous assessments with diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) enable a comprehensive evaluation of the microcirculation. The aim of the study was to compare the response between sexes in the microcirculatory parameters red blood cell (RBC) tissue fraction, RBC oxygen saturation, average vessel diameter, and speed-resolved perfusion during baseline, cycling, and recovery, respectively. METHODS In 24 healthy participants (aged 20 to 30 years, 12 females), cutaneous microcirculation was assessed by LDF and DRS at baseline, during a workload generated by cycling at 75 to 80 % of maximal age-predicted heart rate, and recovery, respectively. RESULTS Females had significantly lower RBC tissue fraction and total perfusion in forearm skin microcirculation at all phases (baseline, workload, and recovery). All microvascular parameters increased significantly during cycling, most evident in RBC oxygen saturation (34 % increase on average) and perfusion (9-fold increase in total perfusion). For perfusion, the highest speeds (>10 mm/s) increased by a factor of 31, whereas the lowest speeds (<1 mm/s) increased by a factor of 2. CONCLUSION Compared to a resting state, all studied microcirculation measures increased during cycling. For perfusion, this was mainly due to increased speed, and only to a minor extent due to increased RBC tissue fraction. Skin microcirculatory differences between sexes were seen in RBC concentration and total perfusion.
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Affiliation(s)
- Linda Samils
- Department of Health, Medicine and Caring Sciences, Division of Community Medicine, Linköping University, Linköping, Sweden
| | - Joakim Henricson
- Department of Emergency Medicine in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Tomas Strömberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Ingemar Fredriksson
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Fredrik Iredahl
- Department of Health, Medicine and Caring Sciences, Division of Community Medicine, Linköping University, Linköping, Sweden.
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Dubin A. The relationship of postocclusive reactive hyperemia assessed by the plethysmographic perfusion index to lactate clearance: a new piece in the unsolved puzzle of tissue perfusion and oxygenation in septic shock. CRITICAL CARE SCIENCE 2023; 35:115-116. [PMID: 37712801 PMCID: PMC10406412 DOI: 10.5935/2965-2774.2023.edit-2.v35n2-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/10/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Arnaldo Dubin
- Servicio de Terapia Intensiva, Sanatorio Otamendi - Buenos Aires,
Argentina
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20
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Bhatti A, Ishii T, Kanno N, Ikeda H, Funamoto K, Saijo Y. Region-based SVD processing of high-frequency ultrafast ultrasound to visualize cutaneous vascular networks. ULTRASONICS 2023; 129:106907. [PMID: 36495767 DOI: 10.1016/j.ultras.2022.106907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/24/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Observing alterations in cutaneous vasculature in response to any disease or pathology is considered as a potential diagnostic marker in the progression and cure of a disease. To observe skin morphologies and tissue conditions, high-frequency ultrasound (HFUS) has been used in dermatology, although its ability to selectively visualize micro-vessels is limited due to insufficient Doppler sensitivity to peripheral slow-speed blood flow. In recent studies, this issue has been improved by increasing the sensitivity of Doppler imaging to slow flow, leveraging advanced cutter filtering approaches based on singular value decomposition (SVD) techniques that aid to effectively extract flow signals overlapped with tissue echo signals. Nevertheless, in skin imaging, variations in flow speed, diameter, and depth of the blood vessels at different skin layers can make clutter filtering challenging because these variations are problematic in selecting the optimal cut-off value for the SVD filtering. In this study, we aimed to devise a novel region-based SVD filtering approach for ultrafast HFUS data to visualize cutaneous vascular networks. The proposed method divides the acquired high-framerate data into two regions based on B-mode cutaneous morphological identification (dermis layer and subcutaneous tissue). Singular value decomposition processing was performed on each region to effectively extract the desired flow signal, and the processed regions were merged to generate a single power Doppler image, thereby highlighting the appearance of a complete cutaneous vascular network. Finally, top-hat transform was applied to the power Doppler image to further suppress the background noises and enhances the visibility of the micro-vessels. Experimental observations of the human cutaneous circulation showed that the image quality (contrast-to-noise ratio) through the region-based SVD filtering was measured to be 4.1 dB (before top-hat filtering) and 5.2 dB (after top-hat filtering), which were improved from 3.4 dB and 4.0 dB obtained using the global SVD approach with and without top-hat filtering, respectively. We envisioned that this approach would provide diverse applications in the diagnosis of cutaneous disorders.
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Affiliation(s)
- Anam Bhatti
- Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8579, Miyagi, Japan
| | - Takuro Ishii
- Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8579, Miyagi, Japan; Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-0845, Miyagi, Japan.
| | - Naoya Kanno
- Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8579, Miyagi, Japan
| | - Hayato Ikeda
- Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8579, Miyagi, Japan
| | - Kenichi Funamoto
- Institute of Fluid Science, Tohoku University, Sendai 980-8577, Miyagi, Japan
| | - Yoshifumi Saijo
- Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8579, Miyagi, Japan
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21
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Lymphatic uptake of biotherapeutics through a 3D hybrid discrete-continuum vessel network in the skin tissue. J Control Release 2023; 354:869-888. [PMID: 36634711 DOI: 10.1016/j.jconrel.2022.12.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023]
Abstract
Subcutaneous administration is a common approach for the delivery of biotherapeutics, which is achieved mainly through the absorption across lymphatic vessels. In this paper, the drug transport and lymphatic uptake through a three-dimensional hybrid discrete-continuum vessel network in the skin tissue are investigated through high-fidelity numerical simulations. We find that the local lymphatic uptake through the explicit vessels significantly affects macroscopic drug absorption. The diffusion of drug solute through the explicit vessel network affects the lymphatic uptake after the injection. This effect, however, cannot be captured using previously developed continuum models. The lymphatic uptake is dominated by the convection due to lymphatic drainage driven by the pressure difference, which is rarely studied in experiments and simulations. Furthermore, the effects of injection volume and depth on the lymphatic uptake are investigated in a multi-layered domain. We find that the injection volume significantly affects the rate of lymphatic uptake through the heterogeneous vessel network, while the injection depth has little influence, which is consistent with the experimental results. At last, the binding and metabolism of drug molecules are studied to bridge the simulations to the drug clearance experients. We provide a new approach to study the diffusion and convection of drug molecules into the lymphatic system through the hybrid vessel network.
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22
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Untracht GR, Dikaios N, Durrani AK, Bapir M, Sarunic MV, Sampson DD, Heiss C, Sampson DM. Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people. Sci Rep 2023; 13:1122. [PMID: 36670141 PMCID: PMC9853488 DOI: 10.1038/s41598-022-26871-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023] Open
Abstract
Optical coherence tomography angiography (OCTA) is a non-invasive, high-resolution imaging modality with growing application in dermatology and microvascular assessment. Accepted reference values for OCTA-derived microvascular parameters in skin do not yet exist but need to be established to drive OCTA into the clinic. In this pilot study, we assess a range of OCTA microvascular metrics at rest and after post-occlusive reactive hyperaemia (PORH) in the hands and feet of 52 healthy people and 11 people with well-controlled type 2 diabetes mellitus (T2DM). We calculate each metric, measure test-retest repeatability, and evaluate correlation with demographic risk factors. Our study delivers extremity-specific, age-dependent reference values and coefficients of repeatability of nine microvascular metrics at baseline and at the maximum of PORH. Significant differences are not seen for age-dependent microvascular metrics in hand, but they are present for several metrics in the foot. Significant differences are observed between hand and foot, both at baseline and maximum PORH, for most of the microvascular metrics with generally higher values in the hand. Despite a large variability over a range of individuals, as is expected based on heterogeneous ageing phenotypes of the population, the test-retest repeatability is 3.5% to 18% of the mean value for all metrics, which highlights the opportunities for OCTA-based studies in larger cohorts, for longitudinal monitoring, and for assessing the efficacy of interventions. Additionally, branchpoint density in the hand and foot and changes in vessel diameter in response to PORH stood out as good discriminators between healthy and T2DM groups, which indicates their potential value as biomarkers. This study, building on our previous work, represents a further step towards standardised OCTA in clinical practice and research.
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Affiliation(s)
- Gavrielle R Untracht
- Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, 6009, Australia
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
| | - Nikolaos Dikaios
- Mathematics Research Centre, Academy of Athens, Athens, 10679, Greece
| | - Abdullah K Durrani
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
- School of Physics, Advanced Technology Institute, The University of Surrey, Guildford, GU27XH, UK
| | - Mariam Bapir
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
| | - Marinko V Sarunic
- Institute of Ophthalmology, University College London, London, EC1V 2PD, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, WC1E 6BT, UK
| | - David D Sampson
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
- School of Physics, Advanced Technology Institute, The University of Surrey, Guildford, GU27XH, UK
| | - Christian Heiss
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
- East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, RH15RH, UK
| | - Danuta M Sampson
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK.
- Institute of Ophthalmology, University College London, London, EC1V 2PD, UK.
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23
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Fetzer DT. US Microvessel Imaging of Rat Liver Microcirculation: Opportunities and Challenges for Human Imaging. Radiology 2022; 307:e222735. [PMID: 36413135 DOI: 10.1148/radiol.222735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- David T. Fetzer
- From the Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316
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24
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Bhatti A, Kanno N, Ikeda H, Ishii T, Saijo Y. Development of an Imaging Framework for Visualization of Cutaneous Micro-Vasculature by using High Frequency Ultrafast Ultrasound Imaging. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:190-193. [PMID: 36086264 DOI: 10.1109/embc48229.2022.9871304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Visualization of cutaneous micro-vasculatures is a determined approach in the diagnosis of skin vascular disorders. Clinically, high frequency ultrasound (HFUS) modalities have been used for cutaneous morphological and structural imaging, but visualization of micro-vessels has always been remained a daunting task. These tiny structures might be visualized by devising a highly sensitive Doppler technique for HFUS systems. In this study, we proposed an imaging framework using HFUS (30 MHz) ultrafast Doppler imaging along with SVD clutter filtering that is proficient in detection of micro-scale circulation. The performance of the devised framework was examined on a 200-micron flow phantom made of poly-vinyl alcohol under four different flow rates (56 - 18 ul/min) and visualized the micro-structure with averaged detected diameter of 93 - 170 µm. The results indicated that the devised framework has sufficient sensitivity and resolvability to visualize the micro-vasculatures in dermis layer of skin (depth ≤ 4 mm). Clinical Relevance - This study brings an insight to visualize in-vivo cutaneous micro-vasculatures with ultrafast Doppler imaging in clinical applications for better assessment of cutaneous disorders.
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25
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Wang Q, Liu X, Li B, Yang X, Lu W, Li A, Li H, Zhang X, Han J. Sodium pentobarbital suppresses breast cancer cells growth partly via normalizing microcirculatory hemodynamics and oxygenation in tumors. J Pharmacol Exp Ther 2022; 382:11-20. [PMID: 35512800 DOI: 10.1124/jpet.121.001058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
Breast cancer remains the leading cause of cancer-related death among women worldwidely. Sodium pentobarbital was found to play an inhibitory role in glioma growth in rats. In this study, we aim to evaluate the effects of sodium pentobarbital on breast cancer growth both in vitro and in vivo, and its impacts on the microcirculatory changes both on skin and tumor surface in mice bearing subcutaneous xenograft. Cell counting assay was used to assess the anti-proliferative effect of sodium pentobarbital on MDA-MB-231 breast cancer cells. Subcutaneous xenograft model was established to study the role of sodium pentobarbital on in vivo tumor growth. Speed-resolved blood perfusion, hemoglobin oxygen saturation (SO2, %), total hemoglobin tissue concentration (THb, µM), and red blood cell (RBC) tissue fraction (%) were examined simultaneously by using EPOS system, to investigate the effects of sodium pentobarbital on microcirculatory hemodynamics and oxygenation. Sodium pentobarbital suppressed breast tumor growth both in vitro and in vivo Cutaneous blood flux in nutritive capillaries with low-speed flow was significantly increased in tumor-bearing mice, and high dose sodium pentobarbital treatment cause a reduction in this low-speed blood flux, whereas sodium pentobarbital therapy caused an elevated blood flux in larger microvessels with mid- and high-speed in a dose-dependent manner. Different doses of sodium pentobarbital exerted different actions on in SO2, ctTHb and RBC tissue fraction. Collectively, the inhibitory effect of sodium pentobarbital on breast tumor growth was at least partly associated with its ability to normalize microcirculatory hemodynamics and oxygenation in tumors. Significance Statement This study is the first to demonstrate the inhibiting effect of sodium pentobarbital on breast cancer growth both in vitro and in vivo, and such an inhibition was at least partly associated with its ability to normalize microcirculatory hemodynamics and oxygenation in tumors.
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Affiliation(s)
- Qin Wang
- Institute of Microcirculation, China
| | | | | | | | - Wenbao Lu
- Institute of Microcirculation, China
| | - Ailing Li
- Institute of Microcirculation, China
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26
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A time to heal: microRNA and circadian dynamics in cutaneous wound repair. Clin Sci (Lond) 2022; 136:579-597. [PMID: 35445708 PMCID: PMC9069467 DOI: 10.1042/cs20220011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/11/2022]
Abstract
Many biological systems have evolved circadian rhythms based on the daily cycles of daylight and darkness on Earth. Such rhythms are synchronised or entrained to 24-h cycles, predominantly by light, and disruption of the normal circadian rhythms has been linked to elevation of multiple health risks. The skin serves as a protective barrier to prevent microbial infection and maintain homoeostasis of the underlying tissue and the whole organism. However, in chronic non-healing wounds such as diabetic foot ulcers (DFUs), pressure sores, venous and arterial ulcers, a variety of factors conspire to prevent wound repair. On the other hand, keloids and hypertrophic scars arise from overactive repair mechanisms that fail to cease in a timely fashion, leading to excessive production of extracellular matrix (ECM) components such as such as collagen. Recent years have seen huge increases in our understanding of the functions of microRNAs (miRNAs) in wound repair. Concomitantly, there has been growing recognition of miRNA roles in circadian processes, either as regulators or targets of clock activity or direct responders to external circadian stimuli. In addition, miRNAs are now known to function as intercellular signalling mediators through extracellular vesicles (EVs). In this review, we explore the intersection of mechanisms by which circadian and miRNA responses interact with each other in relation to wound repair in the skin, using keratinocytes, macrophages and fibroblasts as exemplars. We highlight areas for further investigation to support the development of translational insights to support circadian medicine in the context of these cells.
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Moschetti L, Piantoni S, Vizzardi E, Sciatti E, Riccardi M, Franceschini F, Cavazzana I. Endothelial Dysfunction in Systemic Lupus Erythematosus and Systemic Sclerosis: A Common Trigger for Different Microvascular Diseases. Front Med (Lausanne) 2022; 9:849086. [PMID: 35462989 PMCID: PMC9023861 DOI: 10.3389/fmed.2022.849086] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
This review describes the complex interplay between inflammation, vasculopathy and fibrosis that involve the heart and peripheral small vessels, leading to endothelial stiffness, vascular damage, and early aging in patients with systemic lupus erythematosus and systemic sclerosis, which represents two different models of vascular dysfunction among systemic autoimmune diseases. In fact, despite the fact that diagnostic methods and therapies have been significantly improved in the last years, affected patients show an excess of cardiovascular mortality if compared with the general population. In addition, we provide a complete overview on the new techniques which are used for the evaluation of endothelial dysfunction in a preclinical phase, which could represent a new approach in the assessment of cardiovascular risk in these patients.
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Affiliation(s)
- Liala Moschetti
- Rheumatology and Clinical immunology Unit, ASST Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Silvia Piantoni
- Rheumatology and Clinical immunology Unit, ASST Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- *Correspondence: Silvia Piantoni,
| | - Enrico Vizzardi
- Cardiology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Mauro Riccardi
- Cardiology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Franco Franceschini
- Rheumatology and Clinical immunology Unit, ASST Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Ilaria Cavazzana
- Rheumatology and Clinical immunology Unit, ASST Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Khateeb K, Bloch J, Zhou J, Rahimi M, Griggs DJ, Kharazia VN, Le MN, Wang RK, Yazdan-Shahmorad A. A versatile toolbox for studying cortical physiology in primates. CELL REPORTS METHODS 2022; 2:100183. [PMID: 35445205 PMCID: PMC9017216 DOI: 10.1016/j.crmeth.2022.100183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/06/2022] [Accepted: 02/23/2022] [Indexed: 12/02/2022]
Abstract
Lesioning and neurophysiological studies have facilitated the elucidation of cortical functions and mechanisms of functional recovery following injury. Clinical translation of such studies is contingent on their employment in non-human primates (NHPs), yet tools for monitoring and modulating cortical physiology are incompatible with conventional lesioning techniques. To address these challenges, we developed a toolbox validated in seven macaques. We introduce the photothrombotic method for inducing focal cortical lesions, a quantitative model for designing experiment-specific lesion profiles and optical coherence tomography angiography (OCTA) for large-scale (~5 cm2) monitoring of vascular dynamics. We integrate these tools with our electrocorticographic array for large-scale monitoring of neural dynamics and testing stimulation-based interventions. Advantageously, this versatile toolbox can be incorporated into established chronic cranial windows. By combining optical and electrophysiological techniques in the NHP cortex, we can enhance our understanding of cortical functions, investigate functional recovery mechanisms, integrate physiological and behavioral findings, and develop neurorehabilitative treatments. MOTIVATION The primate neocortex encodes for complex functions and behaviors, the physiologies of which are yet to be fully understood. Such an understanding in both healthy and diseased states can be crucial for the development of effective neurorehabilitative strategies. However, there is a lack of a comprehensive and adaptable set of tools that enables the study of multiple physiological phenomena in healthy and injured brains. Therefore, we developed a toolbox with the capability to induce targeted cortical lesions, monitor dynamics of underlying cortical microvasculature, and record and stimulate neural activity. With this toolbox, we can enhance our understanding of cortical functions, investigate functional recovery mechanisms, test stimulation-based interventions, and integrate physiological and behavioral findings.
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Affiliation(s)
- Karam Khateeb
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Washington National Primate Research Center, Seattle, WA 98195, USA
| | - Julien Bloch
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Washington National Primate Research Center, Seattle, WA 98195, USA
| | - Jasmine Zhou
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Washington National Primate Research Center, Seattle, WA 98195, USA
| | - Mona Rahimi
- Washington National Primate Research Center, Seattle, WA 98195, USA
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195, USA
| | - Devon J. Griggs
- Washington National Primate Research Center, Seattle, WA 98195, USA
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195, USA
| | - Viktor N. Kharazia
- Department of Physiology and Center for Integrative Neuroscience, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Minh N. Le
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Ophthalmology, University of Washington Medicine, Seattle, WA 98195, USA
| | - Azadeh Yazdan-Shahmorad
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Washington National Primate Research Center, Seattle, WA 98195, USA
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195, USA
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29
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Dong LB, Wei YZ, Lan GP, Chen JT, Xu JJ, Qin J, An L, Tan HS, Huang YP. High resolution imaging and quantification of the nailfold microvasculature using optical coherence tomography angiography (OCTA) and capillaroscopy: a preliminary study in healthy subjects. Quant Imaging Med Surg 2022; 12:1844-1858. [PMID: 35284284 PMCID: PMC8899956 DOI: 10.21037/qims-21-672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/11/2021] [Indexed: 11/19/2023]
Abstract
BACKGROUND A wide range of diseases, such as systemic sclerosis, can be diagnosed by imaging the nailfold microcirculation, which is conventionally performed using capillaroscopy. This study applied optical coherence tomography angiography (OCTA) as a novel high resolution imaging method for the qualitative and quantitative assessment of the nailfold microvasculature, and compared OCTA imaging with capillaroscopy. METHODS For qualitative assessment, high resolution OCTA imaging was used to achieve images that contained a wide field of view of the nailfold microvasculature through mosaic scanning. OCTA imaging was also used to observe the characteristic changes in the microvasculature under external compression of the upper arm. For quantitative evaluation, the capillary density and the capillary diameter of the nailfold microvasculature were assessed with both OCTA and capillaroscopy by repeated measurements over 2 days in 13 normal subjects. The results were analyzed using the intraclass correlation coefficient (ICC). RESULTS OCTA imaging showed the typical nailfold microvasculature pattern, part of which was not directly seen with the capillaroscopy. OCTA imaging revealed significant changes in the nailfold microvasculature when a large external pressure was applied via arm compression, but no significant changes were observed using capillaroscopy. The capillary density measured by OCTA and capillaroscopy was 6.8±1.5 and 7.0±1.2 loops/mm, respectively, which was not significantly different (P=0.51). However, the capillary diameter measured by OCTA was significantly larger than that measured using capillaroscopy (19.1±2.5 vs. 13.3±2.3 µm, P<0.001). The capillary diameter measurements using OCTA and capillaroscopy were highly reproducible (ICC =0.926 and 0.973, respectively). While the capillary diameter measured with OCTA was significantly larger, it was rather consistent with the diameter measured using capillaroscopy (ICC =0.705). CONCLUSIONS This study demonstrated that OCTA is a potentially viable and reproducible tool for the imaging and quantification of the capillaries in the nailfold microvasculature. The results of this study provide a solid basis for future applications of OCTA in qualitative and quantitative assessment of nailfold microcirculation in vivo.
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Affiliation(s)
- Li-Bin Dong
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Ying-Zhao Wei
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Gong-Pu Lan
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Pearl River Talents Program, Guangdong Weiren Meditech Co., Ltd., Foshan, China
| | - Jia-Tao Chen
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Jing-Jiang Xu
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Pearl River Talents Program, Guangdong Weiren Meditech Co., Ltd., Foshan, China
| | - Jia Qin
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Pearl River Talents Program, Guangdong Weiren Meditech Co., Ltd., Foshan, China
| | - Lin An
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Pearl River Talents Program, Guangdong Weiren Meditech Co., Ltd., Foshan, China
| | - Hai-Shu Tan
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, Foshan University, Foshan, China
| | - Yan-Ping Huang
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Pearl River Talents Program, Guangdong Weiren Meditech Co., Ltd., Foshan, China
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30
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Riches-Suman K, Hussain A. Identifying and targeting the molecular signature of smooth muscle cells undergoing early vascular ageing. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166403. [DOI: 10.1016/j.bbadis.2022.166403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 10/18/2022]
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Microvascular Imaging as a Novel Tool for the Assessment of Blood Flow Velocity in Patients with Systemic Sclerosis: A Single-Center Feasibility Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Systemic sclerosis is an autoimmune disease characterized by organ fibrosis and vasculopathy. Almost all patients suffer from Raynaud’s phenomenon. Nailfold video capillaroscopy is the most widely imaging technique available, but flow quantification is impossible. Therefore, novel imaging techniques are of interest. We performed a single-center feasibility study using Microvascular Imaging (MVI) for flow quantification of small fingertip vessels. We compared 20 healthy controls (HCs) with 20 systemic sclerosis (SSc) patients. In HCs, measurements were, on average, statistically significantly higher when combined for all fingers (median 10.68 vs. 6 cm/s, Δ = 4.68 cm/s, p < 0.0001) and for individual fingers. An optimal cut-off value of peak systolic (PS) velocity of <6.13 cm/s and end-diastolic (ED) velocity of <2.13 cm/s discriminated HCs from SSc. Test characteristics for PS showed excellent sensitivity (0.90, 95% CI 0.70–0.98) and specificity (0.85, 95% CI 0.64–0.95; LR + 6.0). For ED velocity, sensitivity was 0.85 (95% CI 0.64–0.95) and specificity was 0.80 (95% CI 0.58–0.92, LR + 4.25). Here, we present the first study on the use of MVI to assess blood flow in the fingertips with high sensitivity and specificity in SSc. Future studies are needed to investigate correlations with the risk of organ complications, such as digital ulcers or pulmonary arterial hypertension.
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32
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Impaired Microvascular Function in Patients With Critical COVID-19. Crit Care Explor 2022; 4:e0643. [PMID: 35198986 PMCID: PMC8856124 DOI: 10.1097/cce.0000000000000643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES: Severe coronavirus disease 2019 is characterized by infected microvascular endothelial cells. The primary aim of this study was to investigate microvascular function in patients with critical coronavirus disease 2019. DESIGN: A prospective observational study was conducted in which patients with critical and severe COVID-19 were investigated during acute disease phase and at least 3 months after disease onset. SETTING: Single-center study at Danderyd University Hospital. PATIENTS: Twenty-three patients with critical coronavirus disease 2019 treated with noninvasive or invasive mechanical ventilation, seven patients with severe COVID-19 with dyspnea or need of oxygen supply up to 8 L/min, and 15 noncoronavirus disease controls. INTERVENTIONS: None. MEASUREMENTS: Skin perfusion was investigated through laser speckle contrast imaging before and after iontophoresis of acetylcholine and sodium nitroprusside for determination of the endothelial-dependent and the endothelial-independent vasodilation, respectively. MAIN RESULTS: Patients with critical COVID-19 had higher basal skin perfusion during both the acute (34 ± 9 perfusion unit; p = 0.0003) and the postinfectious phase (29 ± 8 perfusion unit; p = 0.04), compared with noncoronavirus disease controls (23 ± 7 perfusion unit). In addition, endothelial-dependent and endothelial-independent vasodilation were reduced in patients with critical COVID-19 during the acute disease phase (p < 0.001 for both), whereas no significant differences between patients and controls were found during the postinfectious phase. In patients with severe COVID-19, basal skin perfusion and endothelial-dependent vasodilatation were not significantly changed, whereas endothelial-independent vasodilatation was reduced (p = 0.02) compared with controls. CONCLUSIONS: Changes in skin microcirculation in patients with critical COVID-19 indicate that the infection induces a systemic microvascular impairment with persisting long-term effects on the microvascular function.
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Chaturvedi P, Worsley PR, Zanelli G, Kroon W, Bader DL. Quantifying skin sensitivity caused by mechanical insults: A review. Skin Res Technol 2022; 28:187-199. [PMID: 34708455 PMCID: PMC9298205 DOI: 10.1111/srt.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin sensitivity (SS) is a commonly occurring response to a range of stimuli, including environmental conditions (e.g., sun exposure), chemical irritants (e.g., soaps and cosmetics), and mechanical forces (e.g., while shaving). From both industry and academia, many efforts have been taken to quantify the characteristics of SS in a standardised manner, but the study is hindered by the lack of an objective definition. METHODS A review of the scientific literature regarding different parameters attributed to the loss of skin integrity and linked with exhibition of SS was conducted. Articles included were screened for mechanical stimulation of the skin, with objective quantification of tissue responses using biophysical or imaging techniques. Additionally, studies where cohorts of SS and non-SS individuals were reported have been critiqued. RESULTS The findings identified that the structure and function of the stratum corneum and its effective barrier properties are closely associated with SS. Thus, an array of skin tissue responses has been selected for characterization of SS due to mechanical stimuli, including: transepidermal water loss, hydration, redness, temperature, and sebum index. Additionally, certain imaging tools allow quantification of the superficial skin layers, providing structural characteristics underlying SS. CONCLUSION This review proposes a multimodal approach for identification of SS, providing a means to characterise skin tissue responses objectively. Optical coherence tomography (OCT) has been suggested as a suitable tool for dermatological research with clinical applications. Such an approach would enhance the knowledge underlying the multifactorial nature of SS and aid the development of personalised solutions in medical and consumer devices.
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Affiliation(s)
- Pakhi Chaturvedi
- Philips Consumer Lifestyle B.V.DrachtenThe Netherlands
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | | | | | - Wilco Kroon
- Philips Consumer Lifestyle B.V.DrachtenThe Netherlands
| | - Dan L. Bader
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
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Vanhaecke A, Debusschere C, Cutolo M, Smith V. Predictive value of laser speckle contrast analysis in systemic sclerosis. A systematic review and pilot study. Eur J Clin Invest 2022; 52:e13672. [PMID: 34424550 DOI: 10.1111/eci.13672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess whether tools to functionally examine the microcirculation, such as laser speckle contrast analysis (LASCA), are predictive of ischaemic digital trophic lesions ([i]DTL) in patients with systemic sclerosis (SSc). METHODS First, a systematic review (according to PRISMA) was conducted to identify studies describing a link between LASCA and SSc-related (i)DTL. In the additional pilot study, consecutive SSc patients underwent clinical and LASCA examinations (to assess the peripheral blood perfusion [PBP] of both hands) at enrolment. For one year, a monthly telephone survey was conducted to investigate (i)DTL occurrence. Logistic regression and ROC analysis were performed. RESULTS None of the three manuscripts retained through the systematic review examined the predictive value of LASCA for future (i)DTL. In our pilot study, 7/106 (6.6%) SSc patients developed at least one iDTL during follow-up, with PBP not found to be predictive (OR = 0.995, p = .418; ROC-AUC = 0.597). Post hoc, when only patients not taking vasodilators were analysed (n = 57), all three who developed iDTL had an average PBP ≤ 70 PU, while only 9/54 (16.7%) patients without iDTL occurrence had such values. CONCLUSION A predictive role of LASCA for (i)DTL has not yet been described in the literature and could also not be attested by our additional pilot study, due to a lower-than-expected iDTL incidence in our day-to-day SSc population in which patients were allowed to continue their vasodilator medication. However, the promising observations in the subgroup of vasodilator-naïve patients encourage further investigation of this potential added value of LASCA.
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Affiliation(s)
- Amber Vanhaecke
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Claire Debusschere
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - Vanessa Smith
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center, Ghent, Belgium
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35
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Le N, Cheng H, Subhash H, Kilpatrick-Liverman L, Wang RK. Gingivitis resolution followed by optical coherence tomography and fluorescence imaging: A case study. JOURNAL OF BIOPHOTONICS 2021; 14:e202100191. [PMID: 34453488 DOI: 10.1002/jbio.202100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 06/13/2023]
Abstract
Gingivitis is highly prevalent in adults, and if left untreated, can progress to periodontitis. In this article, we present an interesting case study where the resolution of gingivitis was followed over a period of 10 days using optical coherence tomography (OCT) and light-induced autofluorescence (LIAF). We demonstrate that OCT and its functional angiography can distinctively capture the changes during the resolution of gingivitis; while LIAF can detect red-fluorescent signals associated with mature plaque present at the inflamed site. The acute inflammatory region showed evidence of angiogenesis based on the quantification of vessel density and number; while no angiogenesis was detected within the less inflamed region. Gingival thickness showed a reduction of 140 ± 26 μm on average, measured between the peak gingivitis event and the period wherein the inflammation was resolved. Vessels in the angiogenesis site was found to reduce exponentially. The mildly inflamed site showed a decreasing trend in the vessel size, which however was within the error of the measurement.
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Affiliation(s)
- Nhan Le
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Harrison Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Hrebesh Subhash
- Clinical Method Development-Oral Care, Colgate-Palmolive Company, Piscataway, New Jersey, USA
| | | | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
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36
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Ajmal, Boonya-Ananta T, Rodriguez AJ, Du Le VN, Ramella-Roman JC. Monte Carlo analysis of optical heart rate sensors in commercial wearables: the effect of skin tone and obesity on the photoplethysmography (PPG) signal. BIOMEDICAL OPTICS EXPRESS 2021; 12:7445-7457. [PMID: 35003845 PMCID: PMC8713672 DOI: 10.1364/boe.439893] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/23/2021] [Accepted: 10/05/2021] [Indexed: 08/23/2023]
Abstract
Commercially available wearable devices have been used for fitness and health management and their demand has increased over the last ten years. These "general wellness" and heart-rate monitoring devices have been cleared by the Food and Drug Administration for over-the-counter use, yet anecdotal and more systematic reports seem to indicate that their error is higher when used by individuals with elevated skin tone and high body mass index (BMI). In this work, we used Monte Carlo modeling of a photoplethysmography (PPG) signal to study the theoretical limits of three different wearable devices (Apple Watch series 5, Fitbit Versa 2 and Polar M600) when used by individuals with a BMI range of 20 to 45 and a Fitzpatrick skin scale 1 to 6. Our work shows that increased BMI and skin tone can induce a relative loss of signal of up to 61.2% in Fitbit versa 2, 32% in Apple S5 and 32.9% in Polar M600 when considering the closest source-detector pair configuration in these devices.
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Affiliation(s)
- Ajmal
- Department of Biomedical Engineering,
Florida International University, 10555 W
Flagler St, Miami, FL 33174, USA
| | - Tananant Boonya-Ananta
- Department of Biomedical Engineering,
Florida International University, 10555 W
Flagler St, Miami, FL 33174, USA
| | - Andres J. Rodriguez
- Department of Biomedical Engineering,
Florida International University, 10555 W
Flagler St, Miami, FL 33174, USA
| | - V. N. Du Le
- Department of Biomedical Engineering,
Florida International University, 10555 W
Flagler St, Miami, FL 33174, USA
| | - Jessica C. Ramella-Roman
- Department of Biomedical Engineering,
Florida International University, 10555 W
Flagler St, Miami, FL 33174, USA
- Herbert Wertheim College of Medicine,
Florida International University, 11200 SW
8th St, Miami, FL 33199, USA
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37
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Zhu J, Liu X, Deng Y, Li D, Yu T, Zhu D. Tissue optical clearing for 3D visualization of vascular networks: A review. Vascul Pharmacol 2021; 141:106905. [PMID: 34506969 DOI: 10.1016/j.vph.2021.106905] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/01/2022]
Abstract
Reconstruction of the vasculature of intact tissues/organs down to the capillary level is essential for understanding the development and remodeling of vascular networks under physiological and pathological conditions. Optical imaging techniques can provide sufficient resolution to distinguish small vessels with several microns, but the imaging depth is somewhat limited due to the high light scattering of opaque tissue. Recently, various tissue optical clearing methods have been developed to overcome light attenuation and improve the imaging depth both for ex-vivo and in-vivo visualizations. Tissue clearing combined with vessel labeling techniques and advanced optical tomography enables successful mapping of the vasculature of different tissues/organs, as well as dynamically monitoring vessel function under normal and pathological conditions. Here, we briefly introduce the commonly-used labeling strategies for entire vascular networks, the current tissue optical clearing techniques available for various tissues, as well as the advanced optical imaging techniques for fast, high-resolution structural and functional imaging for blood vessels. We also discuss the applications of these techniques in the 3D visualization of vascular networks in normal tissues, and the vascular remodeling in several typical pathological models in clinical research. This review is expected to provide valuable insights for researchers to study the potential mechanisms of various vessel-associated diseases using tissue optical clearing pipeline.
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Affiliation(s)
- Jingtan Zhu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China; MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Xiaomei Liu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China; MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Yating Deng
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China; MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Dongyu Li
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China; MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Tingting Yu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China; MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China.
| | - Dan Zhu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China; MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
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Díaz-Flores L, Gutiérrez R, García MP, González-Gómez M, Rodríguez-Rodriguez R, Hernández-León N, Díaz-Flores L, Carrasco JL. Cd34+ Stromal Cells/Telocytes in Normal and Pathological Skin. Int J Mol Sci 2021; 22:ijms22147342. [PMID: 34298962 PMCID: PMC8307573 DOI: 10.3390/ijms22147342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
We studied CD34+ stromal cells/telocytes (CD34+SCs/TCs) in pathologic skin, after briefly examining them in normal conditions. We confirm previous studies by other authors in the normal dermis regarding CD34+SC/TC characteristics and distribution around vessels, nerves and cutaneous annexes, highlighting their practical absence in the papillary dermis and presence in the bulge region of perifollicular groups of very small CD34+ stromal cells. In non-tumoral skin pathology, we studied examples of the principal histologic patterns in which CD34+SCs/TCs have (1) a fundamental pathophysiological role, including (a) fibrosing/sclerosing diseases, such as systemic sclerosis, with loss of CD34+SCs/TCs and presence of stromal cells co-expressing CD34 and αSMA, and (b) metabolic degenerative processes, including basophilic degeneration of collagen, with stromal cells/telocytes in close association with degenerative fibrils, and cutaneous myxoid cysts with spindle-shaped, stellate and bulky vacuolated CD34+ stromal cells, and (2) a secondary reactive role, encompassing dermatitis—e.g., interface (erythema multiforme), acantholytic (pemphigus, Hailey–Hailey disease), lichenoid (lichen planus), subepidermal vesicular (bullous pemphigoid), psoriasiform (psoriasis), granulomatous (granuloma annulare)—vasculitis (leukocytoclastic and lymphocytic vasculitis), folliculitis, perifolliculitis and inflammation of the sweat and sebaceous glands (perifolliculitis and rosacea) and infectious dermatitis (verruca vulgaris). In skin tumor and tumor-like conditions, we studied examples of those in which CD34+ stromal cells are (1) the neoplastic component (dermatofibrosarcoma protuberans, sclerotic fibroma and solitary fibrous tumor), (2) a neoplastic component with varying presentation (fibroepithelial polyp and superficial myxofibrosarcoma) and (3) a reactive component in other tumor/tumor-like cell lines, such as those deriving from vessel periendothelial cells (myopericytoma), epithelial cells (trichoepithelioma, nevus sebaceous of Jadassohn and seborrheic keratosis), Merkel cells (Merkel cell carcinoma), melanocytes (dermal melanocytic nevi) and Schwann cells (neurofibroma and granular cell tumor).
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Affiliation(s)
- Lucio Díaz-Flores
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
- Correspondence: ; Tel.: +34-922-319-317; Fax: +34-922-319-279
| | - Ricardo Gutiérrez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
| | - Maria Pino García
- Department of Pathology, Eurofins Megalab–Hospiten Hospitals, 38100 Tenerife, Spain;
| | - Miriam González-Gómez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
| | - Rosa Rodríguez-Rodriguez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
| | - Nieves Hernández-León
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
| | - Lucio Díaz-Flores
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
| | - José Luís Carrasco
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (R.R.-R.); (N.H.-L.); (L.D.-F.J.); (J.L.C.)
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Wang-Evers M, Casper MJ, Glahn J, Luo T, Doyle AE, Karasik D, Kim AC, Phothong W, Nathan NR, Heesakker T, Kositratna G, Manstein D. Assessing the impact of aging and blood pressure on dermal microvasculature by reactive hyperemia optical coherence tomography angiography. Sci Rep 2021; 11:13411. [PMID: 34183707 PMCID: PMC8238964 DOI: 10.1038/s41598-021-92712-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/14/2021] [Indexed: 12/12/2022] Open
Abstract
Visualization and quantification of the skin microvasculature are important for studying the health of the human microcirculation. We correlated structural and pathophysiological changes of the dermal capillary-level microvasculature with age and blood pressure by using the reactive hyperemia optical coherence tomography angiography (RH-OCT-A) technique and evaluated both conventional OCT-A and the RH-OCT-A method as non-invasive imaging alternatives to histopathology. This observational pilot study acquired OCT-A and RH-OCT-A images of the dermal microvasculature of 13 young and 12 old healthy Caucasian female subjects. Two skin biopsies were collected per subject for histological analysis. The dermal microvasculature in OCT-A, RH-OCT-A, and histological images were automatically quantified and significant indications of vessel rarefaction in both old subjects and subjects with high blood pressure were observed by RH-OCT-A and histopathology. We showed that an increase in dermal microvasculature perfusion in response to reactive hyperemia was significantly lower in high blood pressure subjects compared to normal blood pressure subjects (117% vs. 229%). These results demonstrate that RH-OCT-A imaging holds functional information of the microvasculature with respect to physiological factors such as age and blood pressure that may help to monitor early disease progression and assess overall vascular health. Additionally, our results suggest that RH-OCT-A images may serve as a non-invasive alternative to histopathology for vascular analysis.
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Affiliation(s)
- Michael Wang-Evers
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Malte J Casper
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Laboratory for Functional Optical Imaging, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Joshua Glahn
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Yale School of Medicine, New Haven, CT, USA
| | - Tuanlian Luo
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Abigail E Doyle
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Karasik
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anne C Kim
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Weeranut Phothong
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Siriraj Hospital, Mahidol University, BKK, Thailand
| | - Neera R Nathan
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tammy Heesakker
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Garuna Kositratna
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dieter Manstein
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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40
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Lu J, Deegan AJ, Cheng Y, Liu T, Zheng Y, Mandell SP, Wang RK. Application of OCT-Derived Attenuation Coefficient in Acute Burn-Damaged Skin. Lasers Surg Med 2021; 53:1192-1200. [PMID: 33998012 DOI: 10.1002/lsm.23415] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/18/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES There remains a need to objectively monitor burn wound healing within a clinical setting, and optical coherence tomography (OCT) is proving itself one of the ideal modalities for just such a use. The aim of this study is to utilize the noninvasive and multipurpose capabilities of OCT, along with its cellular-level resolution, to demonstrate the application of optical attenuation coefficient (OAC), as derived from OCT data, to facilitate the automatic digital segmentation of the epidermis from scan images and to work as an objective indicator for burn wound healing assessment. STUDY DESIGN/MATERIALS AND METHODS A simple, yet efficient, method was used to estimate OAC from OCT images taken over multiple time points following acute burn injury. This method enhanced dermal-epidermal junction (DEJ) contrast, which facilitated the automatic segmentation of the epidermis for subsequent thickness measurements. In addition, we also measured and compared the average OAC of the dermis within said burns for correlative purposes. RESULTS Compared with unaltered OCT maps, enhanced DEJ contrast was shown in OAC maps, both from single A-lines and completed B-frames. En face epidermal thickness and dermal OAC maps both demonstrated significant changes between imaging sessions following burn injury, such as a loss of epidermal texture and decreased OAC. Quantitative analysis also showed that OAC of acute burned skin decreased below that of healthy skin following injury. CONCLUSIONS Our study has demonstrated that the OAC estimated from OCT data can be used to enhance imaging contrast to facilitate the automatic segmentation of the epidermal layer, as well as help elucidate our understanding of the pathological changes that occur in human skin when exposed to acute burn injury, which could serve as an objective indicator of skin injury and healing.
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Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Teng Liu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yujiao Zheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Samuel P Mandell
- Department of Surgery, Division of Trauma, Critical Care, and Burn, School of Medicine, University of Washington, Seattle, Washington, 98104
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195.,Department of Ophthalmology, School of Medicine, University of Washington, Seattle, Washington, 98104
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He Q, Sun Z, Li Y, Wang W, Wang RK. Spatiotemporal monitoring of changes in oxy/deoxy-hemoglobin concentration and blood pulsation on human skin using smartphone-enabled remote multispectral photoplethysmography. BIOMEDICAL OPTICS EXPRESS 2021; 12:2919-2937. [PMID: 34168907 PMCID: PMC8194624 DOI: 10.1364/boe.423160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 06/13/2023]
Abstract
We propose a smartphone-enabled remote multispectral photoplethysmography (SP-rmPPG) system and method to realize spatiotemporal monitoring of perfusion changes and pulsations of the oxyhemoglobin (HbO2) and deoxyhemoglobin (Hb) information of the effective blood volume within light interrogated skin tissue beds. The system is implemented on an unmodified smartphone utilizing its built-in camera and flashlight to acquire videos of the skin reflectance. The SP-rmPPG method converts the RGB video into multispectral cubes, upon which to decouple the dynamic changes in HbO2 and Hb information using a modified Beer-Lambert law and the selective wavelength bands of 500 nm and 650 nm. Blood pulsation amplitudes are then obtained by applying a window-based lock-in amplification on the derived spatiotemporal changes in HbO2 or Hb signals. To demonstrate the feasibility of proposed method, we conduct two experiments on the skin tissue beds that are conditioned by occlusive maneuver of supplying arteries: one using the popular blood cuff pressure maneuver on the upper arm, and another artificially inducing a transient ischemic condition on the facial skin tissue beds by finger pressing on the supplying external carotid artery. The cuff experiment shows that the measured dynamic information of HbO2 and Hb in the downstream agrees well with the parallel measurements of oxygenation saturation given by the standard pulse oximeter. We also observe the expected imbalance of spatiotemporal changes in the HbO2 and Hb between the right and left cheeks when the transient ischemic condition is induced in the one side of facial skin tissue beds. The results from the two experiments sufficiently demonstrate the feasibility of the proposed method to monitor the spatiotemporal changes in the skin hemodynamics, including blood oxygenation and pulsation amplitudes. Considering the ever-growing accessibility and affordability of the smartphone to the general public, the proposed strategy promises the early screening of vascular diseases and improving general public health particularly in rural areas with low resource settings.
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Affiliation(s)
- Qinghua He
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Zhiyuan Sun
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Yuandong Li
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Wendy Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
- Department of Ophthalmology, University of Washington, Seattle, WA98105, USA
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Deegan AJ, Lu J, Sharma R, Mandell SP, Wang RK. Imaging human skin autograft integration with optical coherence tomography. Quant Imaging Med Surg 2021; 11:784-796. [PMID: 33532277 DOI: 10.21037/qims-20-750] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Skin autografting is a common clinical procedure for reconstructive surgery. Despite its widespread use, very few studies have been conducted to non-invasively evaluate and monitor the vascular and structural features of skin grafts. This study, therefore, aims to demonstrate the potential of optical coherence tomography (OCT) alongside OCT-based angiography (OCTA) to non-invasively image and monitor human skin graft health and integration over time. Methods An in-house-built clinical prototype OCT system was used to acquire OCT/OCTA images from patients who underwent split-thickness skin graft surgery following severe burn damage to the skin. The OCT imaging was carried out at multiple locations over multiple time points with a field of view of ~9 mm × 9 mm and a penetration depth of ~1.5 mm. In addition to obtaining high-resolution qualitative images, we also quantitatively measured and compared specific structural and vascular parameters, such as identifiable layer thickness and corresponding vascular area density and diameter. Results Two patients (patient #1 and #2) were enrolled for this preliminary study. Vascular and structural features were successfully imaged and measured in the graft tissue and integration layer immediately beneath at different time points. Revascularization, healing, and integration were monitored with patient-specific details. Results of the quantitative image analysis from patient #1 indicated that integration layer thickness 16-day post-surgery was significantly less (~50%) than that of 7-day post-surgery. Additionally, with patient #2, significant growth (~20%) was seen with the vascular area density of both the graft and corresponding integration layer beneath between 6 and 14 days post-surgery. Conclusions Our preliminary studies show that OCT/OCTA has clinical potential to image and measure numerous features of human skin graft health and integration in the days and weeks following split-thickness surgery. For the first time, we demonstrate the applicability of non-invasive imaging technology for novel clinical uses that could eventually aid in the betterment of surgical practices and clinical outcomes.
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Affiliation(s)
- Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Jie Lu
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Rajendra Sharma
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Samuel P Mandell
- Division of Trauma, Critical Care, and Burn, University of Washington, Harborview Medical Center, Seattle, WA, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
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Lu J, Deegan AJ, Cheng Y, Mandell SP, Wang RK. OCT-Based Angiography and Surface Topography in Burn-Damaged Skin. Lasers Surg Med 2020; 53:849-860. [PMID: 33305835 DOI: 10.1002/lsm.23367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND OBJECTIVES There is a clinical need for an accurate, non-invasive imaging tool that can provide the objective assessment of burn wounds. The aims of this study are to demonstrate the potential of optical coherence tomography (OCT) in evaluating burn wound healing, as well as exploring the physiological basis of human wound healing. STUDY DESIGN/MATERIALS AND METHODS This was a retrospective study. Seven patients with severe burn wounds who were admitted to Harborview Medical Center were imaged using an in-house-built, clinical-prototype OCT system. OCT imaging was carried out at multiple scan sites on the burned skin across two time points (imaging session #1 and #2) with a field of view of ~9 × 9 mm. Due to pathological differences among burn zones, scan sites were classified into red sites (zone of hyperemia), white sites (zone of coagulation), and mixed sites. In addition to obtaining qualitative en face vascular and surface topography maps, we quantified vascular area density and surface roughness for comparative purposes. RESULTS En face vascular and surface topography maps demonstrated numerous morphological changes over both imaging sessions associated with burn injury, such as altered blood flow and loss of regular texture. Quantitative analyses revealed that during imaging session #1, vascular area density was significantly increased within the red sites compared with that of a healthy control (P = 0.0130), while vascular area density was significantly decreased within the white sites compared with that of a healthy control (P < 0.0001). During imaging session #2, vascular area density was significantly reduced to a more normal range within the red sites compared with imaging session #1 (P = 0.0215); however, vascular area density was still significantly lower within the white sites compared with that of a healthy control (P < 0.0001). Furthermore, vascular area density and surface roughness were significantly increased within the white sites during imaging session #2 compared with imaging session #1 (both P < 0.0001). CONCLUSIONS OCT is clinically feasible to monitor vascular changes and alterations in skin surface roughness during the process of burn wound healing. Variations in vascular area density and roughness measurements within the burn wounds revealed by OCT offer some key insights into the underlying pathophysiological mechanisms responsible for wound healing, which may become critical biological indicators in future clinical evaluation and monitoring of wound healing. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Samuel P Mandell
- Department of Surgery, Division of Trauma, Critical Care, and Burn, School of Medicine, University of Washington, Seattle, Washington, 98104
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195.,Department of Ophthalmology, School of Medicine, University of Washington, Seattle, Washington, 98104
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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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He Q, Liu T, Wang RK. Enhanced spatial resolution for snapshot hyperspectral imaging of blood perfusion and melanin information within human tissue. JOURNAL OF BIOPHOTONICS 2020; 13:e202000019. [PMID: 32141162 DOI: 10.1002/jbio.202000019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/29/2020] [Accepted: 03/04/2020] [Indexed: 06/10/2023]
Abstract
We report a reconstruction method to achieve high spatial resolution for hyperspectral imaging of chromophore features in skin in vivo. The method utilizes an established structure-adaptive normalized convolution algorithm to reconstruct high spatial resolution of hyperspectral images from snapshot low-resolution hyperspectral image sequences captured by a snapshot spectral camera. The reconstructed images at chromophore-sensitive wavebands are used to map the skin features of interest. We demonstrate the method experimentally by mapping the blood perfusion and melanin features (moles) on the facial skin. The method relaxes the constrains of the relatively low spatial resolution in the snapshot hyperspectral camera, making it more usable in imaging applications.
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Affiliation(s)
- Qinghua He
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Teng Liu
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
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Swanson EC, Friedly JL, Wang RK, Sanders JE. Optical coherence tomography for the investigation of skin adaptation to mechanical stress. Skin Res Technol 2020; 26:627-638. [PMID: 32227371 DOI: 10.1111/srt.12843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/23/2020] [Accepted: 02/29/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Skin breakdown due to limb-socket interface stress is a significant problem for lower limb prosthesis users. While it is known that skin can adapt to stress to become more resistant to breakdown, little is understood about skin adaptation and few methods exist to noninvasively investigate it. In this study, we present novel, noninvasive imaging methods using Optical Coherence Tomography (OCT) to assess key features of the cutaneous microvasculature that may be involved in skin adaptation. MATERIALS AND METHODS Eight able-bodied participants wore a modified below-knee prosthetic socket for two weeks to stress the skin of their lower limb. Two OCT-based imaging tests were used to assess the function and structure, respectively, of the cutaneous microvasculature at multiple time points throughout the socket wear protocol. RESULTS A measurable reactive hyperemia response was reliably induced in the skin of study participants in the vascular function assessment test. The vascular structure assessment demonstrated excellent field-of-view repeatability, providing rich data sets of vessel structure. No statistically significant differences were found in any of the measurements when compared between time points of the adaptation protocol. The participants' limbs were likely not stressed enough by the able-bodied socket to induce measurable skin adaptation. CONCLUSION This study introduced new techniques to investigate skin adaptation to mechanical stress. If the key limitations are addressed, these methods have the potential to provide insight into the function and structure of the cutaneous microvasculature that previously could not be attained noninvasively.
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Affiliation(s)
- Eric C Swanson
- Department of Bioengineering, University of Washington, Seattle, Washington
| | - Janna L Friedly
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington
| | - Joan E Sanders
- Department of Bioengineering, University of Washington, Seattle, Washington
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Protective Role of Nutritional Plants Containing Flavonoids in Hair Follicle Disruption: A Review. Int J Mol Sci 2020; 21:ijms21020523. [PMID: 31947635 PMCID: PMC7013965 DOI: 10.3390/ijms21020523] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 11/26/2022] Open
Abstract
Hair loss is a disorder in which the hair falls out from skin areas such as the scalp and the body. Several studies suggest the use of herbal medicine to treat related disorders, including alopecia. Dermal microcirculation is essential for hair maintenance, and an insufficient blood supply can lead to hair follicles (HF) diseases. This work aims to provide an insight into the ethnohistorical records of some nutritional compounds containing flavonoids for their potential beneficial features in repairing or recovering from hair follicle disruption. We started from a query for “alopecia” OR “hair loss” AND “Panaxginseng C.A. Mey.“ (or other six botanicals) terms included in Pubmed and Web of Sciences articles. The activities of seven common botanicals introduced with diet (Panaxginseng C.A. Mey., Malus pumila Mill cultivar Annurca, Coffea arabica, Allium sativum L., Camellia sinensis (L.) Kuntze, Rosmarinum officinalis L., Capsicum annum L.) are discussed, which are believed to reduce the rate of hair loss or stimulate new hair growth. In this review, we pay our attention on the molecular mechanisms underlying the bioactivity of the aforementioned nutritional compounds in vivo, ex vivo and in vitro studies. There is a need for systematic evaluation of the most commonly used plants to confirm their anti-hair loss power, identify possible mechanisms of action, and recommend their best adoption.
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He Q, Wang RK. Analysis of skin morphological features and real-time monitoring using snapshot hyperspectral imaging. BIOMEDICAL OPTICS EXPRESS 2019; 10:5625-5638. [PMID: 31799035 PMCID: PMC6865098 DOI: 10.1364/boe.10.005625] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/11/2019] [Accepted: 09/20/2019] [Indexed: 05/07/2023]
Abstract
We propose a snapshot hyperspectral imaging system and methods for skin morphological feature analysis and real-time monitoring of skin activities. The analysis method includes a strategy using weighted subtractions between sub-channel images to extract absorption information due to specific chromophores within skin tissue, for example hemoglobin and melanin. Based on morphological analysis results, we carry out real-time monitoring of the skin features to verify the ability of this method to provide temporal responses of the skin tissue activities, which is experimentally shown to be useful in the measurement of heartrate, monitoring of the tissue recovery after a body exercise, and studying of the tissue response due to a vascular occlusion. Compared to conventional multispectral imaging system, the proposed system improves the device simplicity and is immune to motion artifacts. Coupled with the extraction algorithms, the hyperspectral imaging promises a robust skin assessment tool with abilities for qualitative visualization and potentially quantitative analysis of skin features, useful in the applications of cosmetics and clinical dermatology.
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Affiliation(s)
- Qinghua He
- Department of Bioengineering, University of Washington, Seattle, Washington 98105, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, Washington 98105, USA
- Department of Ophthalmology, University of Washington, Seattle, Washington 98109, USA
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Deegan AJ, Mandell SP, Wang RK. Optical coherence tomography correlates multiple measures of tissue damage following acute burn injury. Quant Imaging Med Surg 2019; 9:731-741. [PMID: 31281770 DOI: 10.21037/qims.2019.04.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background The visual assessment of burned skin is inherently subjective, and whilst a number of imaging modalities have identified quantifiable parameters to characterize vascular and structural changes following burn damage, none have become common place in the assessment protocol. Here, we use optical coherence tomography (OCT)-based angiography (OCTA) to introduce novel correlations between vessel depth, i.e., the depth of functional blood vessels beneath the tissue surface, edema depth, i.e., the depth of interstitial fluid buildup beneath the tissue surface, and tissue injury depth, i.e., the depth of collagen denaturation beneath the tissue surface, following burn injury. Methods A clinical prototype OCT system was used to collect OCT images from various sites of burned skin in patients. Optical microangiography (OMAG) algorithm was used to derive OCTA information from the acquired OCT images, from which the presence of blood vessels and edema were detected. The optical attenuation mapping of structural OCT information was used to detect tissue injury depth. The depths of vessel, edema and tissue injury were measured using a semi-automatic segmentation algorithm. Correlation analysis was performed using a Pearson correlation coefficient using one-tailed analysis with significance being established by a P value ≤0.05. Results Four burn patients were recruited and scanned at multiple sites using the prototype system within 3-6 days of injury. Approximate measurements include a vessel depth range of 320-1,360 µm, an edema depth range of 0-400 µm, and a tissue injury depth range of 130-420 µm. Correlations were subsequently observed between vessel depth and edema depth (r=0.8521, P=0.0001), and vessel depth and tissue injury depth (r=0.6296, P=0.0106). Conclusions OCT is feasible to provide the critical information of vessel depth, edema depth, and tissue injury depth of skin burns, which may represent viable assessment criteria for the characterization of cutaneous burns in future.
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Affiliation(s)
- Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, WA 98104, USA
| | - Samuel P Mandell
- Division of Trauma, Critical Care, and Burn, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98104, USA.,Department of Ophthalmology, University of Washington, Seattle, WA 98104, USA
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