nfrared thermography as a complementary method when diagnosing birth-related brachial plexus injury.

OBJECTIVES: The main objective of this study was to determine whether infrared thermography could be used as an efficient technique to evaluate the impact of a birth-related brachial plexus injury on the temperature of the injured arm and whether it could be used as a complementary method when diagnosing this injury in clinical praxis. BACKGROUND: Clinically, the brachial plexus injury is a peripheral paresis, which occurs when nerves that send signals from the spinal cord to the shoulder, arm, and hand are stretched or compressed. In principle, the brachial plexus injury, as a long-lasting injury, should be causing hypothermia of the injured arm. METHODS: The usage of contactless infrared thermography could offer a "new view" of the diagnostic process in this case. The present study, therefore, describes a process of clinical infrared thermography examination of three patients of different age and presents results from those examinations. RESULTS AND CONCLUSION: From our results, it can be confirmed that the birth-related brachial plexus injury affects the temperature of the affected arm, especially in the area of the cubital fossa, to an extent that the thermal camera is capable of detecting significant temperature differences between the healthy and injured arms (Tab. 3, Fig. 7, Ref. 13). Text in PDF www.elis.sk Keywords: birth brachial plexus injury, upper type palsy, peripheral palsy, infrared thermography.

Infrared thermography as option for evaluating the treatment effect of percutaneous transluminal angioplasty by patients with peripheral arterial disease.

Aim of this study was to evaluate the possible use of infrared thermography as a supplementary method to the ankle-brachial index used in assessing the treatment effect of percutaneous transluminal angioplasty. The study included 21 patients, mean age was 60.22 years. Healthy control group included 20 persons, mean age was 55.60 years. Patients with symptomatic peripheral arterial disease (Fontaine stages I-III) were admitted for endovascular treatment by percutaneous transluminal angioplasty. Thermal images and ankle-brachial index values were obtained before and after treatment by percutaneous transluminal angioplasty. Median temperature change in the treated limb was 0.4℃, for non-treated limb was -0.5℃. The median value of ankle-brachial index in the treated limb increased by 0.17 from 0.81 after the procedure. The median value of ankle-brachial index in the non-treated limb decreased by 0.03 from the value of 1.01. Significant difference between treated limb and non-treated limb in change of ankle-brachial index was found with p value = .0035. The surface temperature obtained by the infrared thermography correlates with ankle-brachial index. We present data showing that the increase of ankle-brachial index is associated with increase of skin temperature in the case of limbs treated by percutaneous transluminal angioplasty. Our results also suggest potential of the use of infrared thermography for monitoring foot temperature as a means of early detection of onset of foot ischemic disorders.

[Alternative healing methods around us]. / Alternativní lécebné metody kolem nás.

This article gives information on selected alternative medicine methods (AMM) under conditions of the Czech health care system. They can be defined as contemporaneous diagnostic and therapeutic methods which differ in their theoretical fundaments as well as practices from the evidence based medicine. This definition is controversial because these methods are an intrinsically incompatible aggregate of modalities acting as a placebo above all. We can encounter many "therapeutic" and "examination" methods which are practiced namely by healers without formal medical education, and connected closely with esotericism. A general feature of the alternative methods is a void usage of scientific concepts and theories, e.g. the concept of energy.Motivations of patients and doctors are briefly introduced here. However, AMM is also an ethical problem because the doctor should help the patient with maximum efficiency hence excluding the methods with a questionable, small or negligible efficiency. The opinions how to find the way out from this situation are divergent. It could be a refusal or a very reserved attitude to AMM plus maximisation of the placebo effect enhancing the efficiency of a rational therapy. Furthermore, the methods most spread in the Czech Republic are subjected to elementary critics - the homoeopathy, acupuncture, the so-called "bioresonance" instrumental methods, psychic healing, and also some refused methods in cancer treatment. In our opinion medicine disposes of sufficient knowledge and experience to assess the efficiency of AMM and refuse them in causal therapy, eventually. Their use as a placebo should be carefully considered.Key words: alternative medicine, placebo, homeopathy, acupuncture.

Effect of near field ultrasound on carboplatin treatment of ovarian carcinoma cells.

It has long been shown that therapeutic ultrasound has the potential to affect cells surfaces and membranes. In this study, the effects of ultrasound in near field mode, the anti-cancer drug carboplatin and their combined application were studied on human carcinoma cells A2780. Four modes of treatment were used: exposure to ultrasonic field, application of carboplatin, exposure to ultrasound followed by carboplatin and carboplatin treatment followed by exposure to near field ultrasound. The value of viability was measured by standard MTT test. The value of ultrasound intensity was set 1 W x cm(-2) and 1 MHz frequency was used. The real value of acoustic pressure during in vitro experiments was assessed by hydrophone. The results showed that a combined effect of ultrasound and carboplatin influenced the viability of human carcinoma cells A2780 more than the application of ultrasound or carboplatin alone. It could be assumed that exposure of cells to ultrasonic field had an immediate effect on the structure of cell surface and consequently on the entry of carboplatin into the cell. The results of our experiments demonstrated possibility of using therapeutic ultrasound in potentiating the cytostatic treatment of human carcinoma cells.

Determination of free cisplatin in medium by differential pulse polarography after ultrasound and cisplatin treatment of a cancer cell culture.

The in vitro study was carried out for detection of the cisplatin in free form and in culture medium, depending on various conditions of sonodynamic human ovarian cancer cells A2780 treatment by differential pulse polarography (DPP). For sonodynamic treatment, we used cisplatin alone and combined cisplatin/ultrasound treatments. The ultrasound exposure intensity of 1.0 and 2.0 W x cm(-2) in far field for incubation periods 1, 24 and 48 h was used. The parameters of DPP measurements were--1 s drop time, 5 mV x s(-1) voltage scan rate, 50 mV modulation amplitude and negative scanning direction; platinum wire served as counter electrode and Ag/AgCl/3 M KCl as reference electrode. The results showed the dependence of free platinum quantities in culture medium on incubation time and treatment protocol. We found difference in concentration of free cisplatin between conventional application of cisplatin and sonodynamic treatment. The sonodynamic combined treatment of cisplatin and ultrasound field showed a higher cisplatin content in the culture medium than cisplatin treatment alone; a difference of 20% was observed for incubation time 48 h. The results also showed the influence of a time sequence of ultrasound and cytostatics in the sonodynamic treatment. The highest amount of free cisplatin in the solution was found for primary application of cisplatin and the subsequent ultrasound exposure. The quantity of free cisplatin increased with time, namely for time intervals 1-24 h. There was no difference between the DPP signal of cisplatin in reaction mixture containing cells in small quantities and micro-filtered mixture without cells. Thus, the DPP method is suitable for the detection and quantification of free cisplatin in the culture medium of cell suspension. Ultrasound field can be important factor during cytostatic therapy.

Infrared thermal imaging: a potential tool used in open colorectal surgery.

Aim of this pilot study was to assess blood perfusion of bowel in resection lines by means of the infrared thermal imaging in order to choose the best place for anastomosis. The paper brings a first experience with infrared thermal imaging used in colorectal surgery operation from initial observation of the patient with T3 adenomatous carcinoma with no lymph node metastasis. The obtained infrared images show a clear boundary between parts of the intestine with blood perfusion and without it. The proposed position of resection of colon identified by infrared camera is in accordance with routinely designated position. Infrared thermal imaging seems to be a complimentary diagnostic method to see the perfusion in colorectal surgery.

Photochemical properties of a potential photosensitiser indocyanine green in vitro.

The present study investigates the photochemical properties of a potential photosensitiser, indocyanine green (ICG), in an in vitro HeLa cell system. Cell proliferation was studied after a combined effect of ICG, at a concentration range of 24-94 microM, and therapeutic laser irradiation at several different energy densities. In addition, ICG cytotoxicity was evaluated in HeLa cells and V79 Chinese hamster by the MTT assay. Phototoxicity was evaluated at 1, 24, and 48 h after irradiation. No phototoxic effect was detected 1h after irradiation. The maximum phototoxic effect of ICG on HeLa cells was detected for an ICG concentration of 94 microM, a laser output of 360 mW, and an energy density of 99 J/cm(2) at 24h after irradiation. Potentiation of the ICG phototoxic effect was achieved by adding 20 microM H(2)O(2), which was a non-toxic concentration for HeLa cells in this experimental design. At 48 h after laser irradiation a statistically significant difference was found between the toxicity of ICG plus peroxide, as compared to ICG alone. The addition of H(2)O(2) at a concentration of 20 microM caused a significant increase in phototoxicity of ICG for HeLa cells. Our results confirm that ICG could be a perspective agent for use in photodynamic therapy and that its phototoxic effect can be potentiated by addition of an oxidative agent.

Using Noncontact Infrared Thermography for Long-term Monitoring of Foot Temperatures in a Patient with Diabetes Mellitus.

Foot complications in persons with diabetes mellitus (DM) are associated with substantial costs and loss of quality of life. Increasing evidence suggests changes in skin temperature, measured using an infrared thermographic system (IRT), may be a predictor of foot ulcer development in patients with DM. The purpose of this case study is to describe the long-term IRT findings and overall clinical outcomes of a patient with DM and peripheral vascular disease. Foot temperature measurements using IRT were obtained slightly more than 1 year before and immediately following endovascular treatment of a 76-year-old man, a nonsmoker with type 2 DM, hypertension, and ischemic heart disease with cardiac arrhythmia. Although he was otherwise asymptomatic, the infrared measurement showed an average temperature difference of 2.3˚ C between the left and right foot until he developed a small, trauma-induced wound on the left foot, at which time left foot temperature increased. He was diagnosed with rectosigmoid adenocarcinoma, underwent surgery and chemotherapy, and subsequently was evaluated for peripheral vascular disease. Before undergoing peripheral angiography and percutaneous transluminal angioplasty, IRT evaluation showed a hot spot on the left heel. Immediately following endovascular treatment, the mean temperature difference between the right and left foot was low (0.2˚ C), but a Stage I pressure ulcer was visible on the left heel. Skin breakdown in that area was observed 2 months later, and the wound continued to increase in size and depth. The patient died shortly thereafter due to complications of cancer. In this case study, a series of infrared images of foot skin temperatures appeared to show a relationship with blood circulation and wound/ulcer development and presentation. IRT has the ability to instantaneously measure the absolute temperature of the skin surface over a large area without direct skin contact. However, the devices are very sensitive and prospective clinical studies to determine the validity, reliability, sensitivity, and specificity of these measurements for routine use in patients who are at risk for vascular disease and/or foot ulcers are needed.

Discrete Fourier transform-based analysis of HeLa cell microtubules after ultrasonic exposure.

Cytoskeletal structures can be affected by external factors including ultrasound. Our task was to develop a structure analysis method to evaluate these changes quantitatively. We exposed HeLa cells to continuous ultrasound (1 MHz, 1 and 2 W/cm2, 10 min at 37 degrees C). The microtubules were detected by the monoclonal antibody TU-01/SwAM/FITC, observed in a fluorescence microscope and photographed digitally. The images were processed by "FFT magic" software. The structure analysis is based on frequency domain filtering using discrete Fourier transform. The basic idea is to design filters to extract information describing best the structural changes. The properties of the filter can be enhanced by direction filtering, i.e., extraction of a symmetric angular segment in the frequency domain centered on a zero frequency. The final image is a normalized sum of inverse FFT's of such segmented spectra. We needed a method yielding a single number assigned to the structure, e.g., the ratio of the area of microtubules to the total cell area. Assuming that the image background intensity is constant, we can use thresholding to detect areas occupied by the cells. The information about the area of the microtubules is contained in a wide range of higher intensities. Therefore, we use a gamma correction. The area occupied by microtubules is then considered an area with intensities above the selected threshold. There were tested three different filters to extract information about microtubules. The mathematical method chosen seems sensitive enough for quantitative assessment of changes of the microtubular network.

Effects of low-power laser irradiation on cell locomotion in protozoa.

Low-power lasers are commonly used in human medicine for treatment of various pathological conditions, but mechanisms of their healing effects are still poorly understood. The results of this study provide information related to these effects at the cellular level. Two different protozoan species, Euglena gracilis and Tetrahymena thermophila, were used to study changes in locomotion behavior in response to low-power lasers. The cells were irradiated at 830 and 650 nm generated by a semiconductor laser (99 J/cm2, 360 mW) and a laser pointer (0.75 J/cm2, 5 mW), respectively, and their locomotion was recorded by a TV camera and analyzed using computer software. Exposure to laser light, regardless of the wavelength, resulted in increased cell velocity in both species (P <0.001). Exposure to 650 nm produced an equal increase in median cell velocity in both E. gracilis (19.0%) and T. thermophila (18.2%), and some increase persisted in the postirradiation 30 s period. Irradiation by the 830 nm laser resulted in a markedly higher response in Tetrahymena (29.4%) than in Euglena (15.2%), and the two median values remained increased after irradiation was discontinued. Different reactions found in the species studied and some mechanisms underlying the response of cells to radiation are discussed.

Ultrasound and cisplatin combined treatment of human melanoma cells A375--the study of sonodynamic therapy.

Sonodynamic therapy, an effect of low-power ultrasound field and the anticancer drug cisplatin, was studied in vitro on human melanoma cells A375. The viability of cells has been studied by standard 3-(4,5-dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide viability assay according to different modes of treatment: application of cisplatin alone, exposure of ultrasound field alone, exposure to ultrasound followed by cisplatin and application of cisplatin followed by exposure to ultrasound. Ultrasound was used at a therapeutic intensity of 1 W∙cm(-2) for 10 min. Concentration of cisplatin in the cell suspension was always 2.3 µM. The results show that sonodynamic therapy is one of the possibilities of how to intensify standard cytostatic therapy. This conclusion is supported by reducing the viability of studied cells, especially 72 h after the treatment. The time sequence of application of ultrasonic field and cytostatics appears to be a significant factor affecting the changes in cell viability. Maximum suppression of viability has been found when applying the experimental design involving application of cisplatin followed by exposure to ultrasound; the final value of viability of combined affected cells was more than 10% lower than for cisplatin treatment alone.

Biological effects of combined ultrasound and cisplatin treatment on ovarian carcinoma cells.

The effects of low-power ultrasound, the anti-cancer drug cisplatin, and their combined application were studied in two lines of human ovarian carcinoma cells, A2780 and A2780cis. Four modes of treatment were used: exposure to ultrasonic field, application of cisplatin, exposure to ultrasound followed by cisplatin, and presence of cisplatin followed by exposure to application ultrasound. Ultrasound was used at intensities of 0.5 W/cm(2) and 1.0 W/cm(2) for 10 min, cisplatin was applied at concentrations of 1 microM and 6 microM per cell suspension treated in A2780 and cisplatin-resistant A2780cis cells, respectively. The results of each experimental treatment were assessed by the resultant cell viability related to the viability of control cells, using a standard MTT test. It was shown that a combined effect of ultrasound and cisplatin was more effective than that of ultrasound or cisplatin alone. It also appeared that the order of application played a role, with the cisplatin-ultrasound treatment lowering cell viability more than the ultrasound-cisplatin treatment. It can be assumed that the exposure of cells to a low-power ultrasonic field has an immediate effect on the structure of cell surfaces and, consequently, on entry of cisplatin into the cell. The study also included observations on changes in the cell cycle associated with the treatments used in both cell lines and their evaluation by flow cytometry.