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Lechtig A, Hanna P, Nagy JA, Wixted J, Nazarian A, Rutkove SB. Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model. Sci Rep 2023; 13:18252. [PMID: 37880267 PMCID: PMC10600169 DOI: 10.1038/s41598-023-45209-w] [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: 07/21/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023] Open
Abstract
Acute Compartment Syndrome (ACS) is one of the most devastating orthopedic conditions, affecting any of the body's many compartments, which, if sufficiently severe, may result in disability and amputation. Currently, intra-compartmental pressure measurements serve as the gold standard for diagnosing ACS. Diagnosing limbs at risk for ACS before irreversible damage to muscle and nerve is critical. Standard approaches for diagnosing impending compartment syndrome include clinical evaluation of the limb, such as assessment for "tightness" of the overlying skin, reduced pulses distally, and degree of pain, none of which are specific or sensitive. We have proposed a novel method to detect ACS via electrical impedance myography (EIM), where a weak, high-frequency alternating current is passed between one pair of electrodes through a region of tissue, and the resulting surface voltages are measured via a second pair. We evaluated the ability of EIM to detect early muscle ischemia in an established murine model of compression-induced muscle injury, where we collected resistance, reactance, and their dimensionless product, defined as Relative Injury Index (RII) during the study. Our model generated reproducible hypoxia, confirmed by Hypoxyprobe™ staining of endothelial regions within the muscle. Under conditions of ischemia, we demonstrated a reproducible, stable, and significant escalation in resistance, reactance, and RII values, compared to uninjured control limbs. These data make a reasonable argument for additional investigations into using EIM for the early recognition of muscle hypoperfusion and ischemia. However, these findings must be considered preliminary steps, requiring further pre-clinical and clinical validation.
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Affiliation(s)
- Aron Lechtig
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Philip Hanna
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Janice A Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - John Wixted
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
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Zhi JJ, Yan H, Sun LH. Establishment of an acute extraocular muscle injury model in cats. Int J Ophthalmol 2018; 11:1475-1481. [PMID: 30225221 PMCID: PMC6133886 DOI: 10.18240/ijo.2018.09.08] [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: 07/24/2017] [Accepted: 05/07/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To describe an acute extraocular muscle injury model in cats. METHODS Seventy-two cats were randomly divided into 6 groups (12 cats per group). Cats' left lateral recti were clamped using a surgical needle holder with a clamping strength of 2 (Groups A and D), 4 (Groups B and E) and 6 kg (Groups C and F). The right lateral recti were treated as controls. On the 4th and 7th days, hematoxylin eosin (HE) staining, immunohistochemical staining for proliferating cell nuclear antigen (PCNA), muscle force measurements and ocular alignment changes were performed to evaluate the extent of injuries. RESULTS The morphological changes were graded as mild, moderate or severe by HE staining in all experiment groups. PCNA immunohistochemical staining indicated repairment of muscle fibers in the damaged area. On the 4th and 7th days after clamping, the injured lateral muscle exhibited an elevated threshold for electric stimulation. The muscle forces among groups 2, 4 and 6 kg injury at 4d (Groups A, B and C) were statistically significant (P<0.05), but no significant differences were noted among groups 2, 4 and 6 kg injury at 7d (Groups D, E and F) (P>0.05), respectively. In addition, medial deviation in ocular alignment was also present to various degrees in all groups. CONCLUSION A cat model of acute extraocular muscle injury can be established by rectus clamping. Different clamping strengths can make different degrees of muscle injury. This model may help the future study in the acute extraocular muscle injury.
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Affiliation(s)
- Jun-Jie Zhi
- Department of Ophthalmology, Xi'an No. 4 Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
- Department of Ophthalmology, No. 422 Hospital of PLA, Zhanjiang 524009, Guangdong Province, China
| | - Hong Yan
- Department of Ophthalmology, Xi'an No. 4 Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi Province, China
| | - Li-Hua Sun
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi Province, China
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Lansink MO, Patyk V, de Groot H, Effenberger-Neidnicht K. Melatonin reduces changes to small intestinal microvasculature during systemic inflammation. J Surg Res 2017; 211:114-125. [DOI: 10.1016/j.jss.2016.11.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 10/26/2016] [Accepted: 11/30/2016] [Indexed: 12/15/2022]
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