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1.
Radiol Oncol ; 58(3): 326-334, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-39287164

RESUMEN

BACKGROUND: Laser speckle coherence imaging (LSCI) is an emerging imaging modality that enables noninvasive visualization and assessment of tissue perfusion and microcirculation. In this article, we evaluated LSCI in imaging perfusion in clinical oncology through a systematic review of the literature. METHODS: The inclusion criterion for the literature search in PubMed, Web of Science and Scopus electronic databases was the use of LSCI in clinical oncology, meaning that all animal, phantom, ex vivo, experimental, research and development, and purely methodological studies were excluded. RESULTS: Thirty-six articles met the inclusion criteria. The anatomic locations of the neoplasms in the selected articles were brain (5 articles), breasts (2 articles), endocrine glands (4 articles), skin (12 articles), and the gastrointestinal tract (13 articles). CONCLUSIONS: While LSCI is emerging as an appealing imaging modality, it is crucial for more clinical sites to initiate clinical trials. A lack of standardized protocols and interpretation guidelines are posing the most significant challenge.


Asunto(s)
Imágenes de Contraste de Punto Láser , Neoplasias , Humanos , Neoplasias/diagnóstico por imagen , Imágenes de Contraste de Punto Láser/métodos , Microcirculación
2.
Front Immunol ; 15: 1419005, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39247187

RESUMEN

Background: Rosacea has a high incidence, significantly impacts quality of life, and lacks sufficient diagnostic techniques. This study aimed to investigate the feasibility of laser speckle contrast imaging (LSCI) for measuring facial blood perfusion in patients with rosacea and to identify differences in blood flow among various facial regions associated with different rosacea subtypes. Methods: From June to December 2023, 45 patients were recruited, with 9 excluded, leaving 36 subjects: 12 with erythematotelangiectatic rosacea (ETR), 12 with papulopustular rosacea (PPR), and 12 healthy controls. The Think View multispectral imaging analyzer assessed inflammation via gray reading values across the full face and five facial areas: forehead, nose, cheeks, and chin. LSCI measured and analyzed blood perfusion in the same areas. Plasma biomarkers interleukin-6 (IL-6), IL-1ß, and tumor necrosis factor-α (TNF-α) were tested in different groups. Results: Both ETR and PPR groups showed increased average blood perfusion and facial inflammation intensity by gray values compared to controls, with statistically significant differences. Average blood perfusion of ETR and PPR groups showed increased values in the forehead, cheeks, and nose, compared to controls, and the values in the cheeks were statistically different between ETR and PPR. The facial inflammation intensity of the ETR group showed increased values in the forehead and cheeks, and the PPR group showed increased gray values in the forehead, cheeks, nose, and chin compared to controls, and the values for the cheeks, nose, and chin were statistically significantly different between ETR and PPR. Plasma biomarkers IL-6, IL-1ß, and TNF-α were significantly elevated in both ETR and PPR groups compared to controls. Conclusion: LSCI is a valuable, non-invasive tool for assessing blood flow dynamics in rosacea, providing a data foundation for clinical research. Different rosacea subtypes exhibit distinct lesion distribution and blood flow patterns, and both ETR and PPR could affect all facial areas, particularly the cheeks in ETR and the forehead, nose, and chin in PPR.


Asunto(s)
Cara , Imágenes de Contraste de Punto Láser , Rosácea , Humanos , Rosácea/diagnóstico , Rosácea/sangre , Femenino , Masculino , Adulto , Persona de Mediana Edad , Cara/irrigación sanguínea , Flujo Sanguíneo Regional , Biomarcadores/sangre
3.
Surg Endosc ; 38(9): 5292-5303, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39020119

RESUMEN

BACKGROUND: Anastomotic leakage (AL) is a dreaded complication following colorectal cancer surgery, impacting patient outcome and leads to increasing healthcare consumption as well as economic burden. Bowel perfusion is a significant modifiable factor for anastomotic healing and thus crucial for reducing AL. AIMS: The study aimed to calculate a cut-off value for quantified laser speckle perfusion units (LSPUs) in order to differentiate between ischemic and well-perfused tissue and to assess inter-observer reliability. METHODS: LSCI was performed using a porcine ischemic small bowel loop model with the PerfusiX-Imaging® system. An ischemic area, a well-perfused area, and watershed areas, were selected based on the LSCI colormap. Subsequently, local capillary lactate (LCL) levels were measured. A logarithmic curve estimation tested the correlation between LSPU and LCL levels. A cut-off value for LSPU and lactate was calculated, based on anatomically ischemic and well-perfused tissue. Inter-observer variability analysis was performed with 10 observers. RESULTS: Directly after ligation of the mesenteric arteries, differences in LSPU values between ischemic and well-perfused tissue were significant (p < 0.001) and increased significantly throughout all following measurements. LCL levels were significantly different (p < 0.001) at both 60 and 120 min. Logarithmic curve estimation showed an R2 value of 0.56 between LSPU and LCL values. A LSPU cut-off value was determined at 69, with a sensitivity of 0.94 and specificity of 0.87. A LCL cut-off value of 3.8 mmol/L was found, with a sensitivity and specificity of 0.97 and 1.0, respectively. There was no difference in assessment between experienced and unexperienced observers. Cohen's Kappa values were moderate to good (0.52-0.66). CONCLUSION: Real-time quantification of LSPUs may be a feasible intraoperative method to assess tissue perfusion and a cut-off value could be determined with high sensitivity and specificity. Inter-observer variability was moderate to good, irrespective of prior experience with the technique.


Asunto(s)
Isquemia , Laparoscopía , Imágenes de Contraste de Punto Láser , Animales , Laparoscopía/métodos , Porcinos , Isquemia/etiología , Isquemia/diagnóstico por imagen , Imágenes de Contraste de Punto Láser/métodos , Fuga Anastomótica/diagnóstico por imagen , Fuga Anastomótica/etiología , Modelos Animales de Enfermedad , Intestino Delgado/irrigación sanguínea , Intestino Delgado/cirugía , Intestino Delgado/diagnóstico por imagen , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Ácido Láctico/metabolismo
4.
Int J Mol Sci ; 25(14)2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-39062800

RESUMEN

Transient ischemic attack (TIA) is an early warning sign of stroke and death, necessitating suitable animal models due to the associated clinical diagnostic challenges. In this study, we developed a TIA model using flexible spatially targeted photothrombosis combined with real-time blood flow imaging feedback. By modulating the excitation light using wavefront technology, we precisely created a square light spot (50 × 250 µm), targeted at the distal middle cerebral artery (dMCA). The use of laser speckle contrast imaging (LSCI) provided real-time feedback on the ischemia, while the excitation light was ceased upon reaching complete occlusion. Our results demonstrated that the photothrombus formed in the dMCA and spontaneously recanalized within 10 min (416.8 ± 96.4 s), with no sensorimotor deficits or infarction 24 h post-TIA. During the acute phase, ischemic spreading depression occurred in the ipsilateral dorsal cortex, leading to more severe ischemia and collateral circulation establishment synchronized with the onset of dMCA narrowing. Post-reperfusion, the thrombi were primarily in the sensorimotor and visual cortex, disappearing within 24 h. The blood flow changes in the dMCA were more indicative of cortical ischemic conditions than diameter changes. Our method successfully establishes a photochemical TIA model based on the dMCA, allowing for the dynamic observation and control of thrombus formation and recanalization and enabling real-time monitoring of the impacts on cerebral blood flow during the acute phase of TIA.


Asunto(s)
Circulación Cerebrovascular , Modelos Animales de Enfermedad , Ataque Isquémico Transitorio , Ataque Isquémico Transitorio/diagnóstico por imagen , Ataque Isquémico Transitorio/fisiopatología , Animales , Masculino , Trombosis/diagnóstico por imagen , Ratones , Imágenes de Contraste de Punto Láser/métodos , Arteria Cerebral Media/diagnóstico por imagen
5.
J Biomed Opt ; 29(6): 067001, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38826808

RESUMEN

Significance: In the realm of cerebrovascular monitoring, primary metrics typically include blood pressure, which influences cerebral blood flow (CBF) and is contingent upon vessel radius. Measuring CBF noninvasively poses a persistent challenge, primarily attributed to the difficulty of accessing and obtaining signal from the brain. Aim: Our study aims to introduce a compact speckle contrast optical spectroscopy device for noninvasive CBF measurements at long source-to-detector distances, offering cost-effectiveness, and scalability while tracking blood flow (BF) with remarkable sensitivity and temporal resolution. Approach: The wearable sensor module consists solely of a laser diode and a board camera. It can be easily placed on a subject's head to measure BF at a sampling rate of 80 Hz. Results: Compared to the single-fiber-based version, the proposed device achieved a signal gain of about 70 times, showed superior stability, reproducibility, and signal-to-noise ratio for measuring BF at long source-to-detector distances. The device can be distributed in multiple configurations around the head. Conclusions: Given its cost-effectiveness, scalability, and simplicity, this laser-centric tool offers significant potential in advancing noninvasive cerebral monitoring technologies.


Asunto(s)
Circulación Cerebrovascular , Diseño de Equipo , Análisis Espectral , Humanos , Circulación Cerebrovascular/fisiología , Análisis Espectral/instrumentación , Análisis Costo-Beneficio , Reproducibilidad de los Resultados , Dispositivos Electrónicos Vestibles , Relación Señal-Ruido , Rayos Láser , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Imágenes de Contraste de Punto Láser/instrumentación
6.
Lasers Surg Med ; 56(6): 564-573, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-38890796

RESUMEN

OBJECTIVES: Under optimal conditions, afferent and efferent human skin graft microcirculation can be restored 8-12 days postgrafting. Still, the evidence about the reperfusion dynamics beyond this period in a dermato-oncologic setting is scant. We aimed to characterise the reperfusion of human skin grafts over 4 weeks according to the necrosis extension (less than 20%, or 20%-50%) and anatomic location using laser speckle contrast imaging (LSCI). METHODS: Over 16 months, all eligible adults undergoing skin grafts following skin cancer removal on the scalp, face and lower limb were enroled. Perfusion was assessed with LSCI on the wound margin (control skin) on day 0 and on the graft surface on days 7, 14, 21 and 28. Graft necrosis extension was determined on day 28. RESULTS: Forty-seven grafts of 47 participants were analysed. Regardless of necrosis extension, graft perfusion equalled the control skin by day 7, surpassed it by day 21, and stabilised onwards. Grafts with less than 20% necrosis on the scalp and lower limb shared this reperfusion pattern and had a consistently better-perfused centre than the periphery for the first 21 days. On the face, the graft perfusion did not differ from the control skin from day 7 onwards, and there were no differences in reperfusion within the graft during the study. CONCLUSION: Skin graft reperfusion is a protracted process that evolves differently in the graft centre and periphery, influenced by postoperative time and anatomic location. A better knowledge of this process can potentially enhance the development of strategies to induce vessel ingrowth into tissue-engineered skin substitutes.


Asunto(s)
Imágenes de Contraste de Punto Láser , Reperfusión , Trasplante de Piel , Humanos , Masculino , Femenino , Trasplante de Piel/métodos , Persona de Mediana Edad , Anciano , Reperfusión/métodos , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Necrosis , Cuero Cabelludo/irrigación sanguínea , Factores de Tiempo , Adulto , Anciano de 80 o más Años , Piel/irrigación sanguínea , Piel/diagnóstico por imagen , Piel/patología , Microcirculación , Estudios Prospectivos , Periodo Posoperatorio
7.
J Biophotonics ; 17(7): e202400017, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38714530

RESUMEN

We utilize Laser Speckle Contrast Imaging (LSCI) for visualizing cerebral blood flow in mice during and post-cardiac arrest. Analyzing LSCI images, we noted temporal blood flow variations across the brain surface for hours postmortem. Fast Fourier Transform (FFT) analysis depicted blood flow and microcirculation decay post-death. Continuous Wavelet Transform (CWT) identified potential cerebral hemodynamic synchronization patterns. Additionally, non-negative matrix factorization (NMF) with four components segmented LSCI images, revealing structural subcomponent alterations over time. This integrated approach of LSCI, FFT, CWT, and NMF offers a comprehensive tool for studying cerebral blood flow dynamics, metaphorically capturing the 'end of the tunnel' experience. Results showed primary postmortem hemodynamic activity in the olfactory bulbs, followed by blood microflow relocations between somatosensory and visual cortical regions via the superior sagittal sinus. This method opens new avenues for exploring these phenomena, potentially linking neuroscientific insights with mysteries surrounding consciousness and perception at life's end.


Asunto(s)
Encéfalo , Hemodinámica , Animales , Ratones , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Circulación Cerebrovascular , Imágenes de Contraste de Punto Láser , Masculino , Autopsia
8.
Langenbecks Arch Surg ; 409(1): 147, 2024 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-38695955

RESUMEN

PURPOSE: To investigate the accuracy of laser speckle flowgraphy (LSFG), a noninvasive method for the quantitative evaluation of blood flow using mean blur rate (MBR) as a blood flow parameter in the assessment of bowel blood perfusion compared to indocyanine green fluorescence angiography (ICG-FA). METHODS: We enrolled 46 patients who underwent left-sided colorectal surgery. LSFG and ICG-FA were applied to assess blood bowel perfusion, with MBR and luminance as parameters, respectively. In both measurement methods, the position where the parameter suddenly decreased was defined as the blood flow boundary line. Subsequently, the blood flow boundaries created after processing the blood vessels flowing into the intestinal tract were determined using LSFG and ICG-FA, and concordance between the two was examined. Blood flow boundaries were visually identified using color tone changes on a color map created based on MBR in LSFG and using differences in luminance in ICG-FA. The distances between the transection line and blood flow boundaries determined using each method were compared. RESULTS: The location of blood flow boundaries matched in 65% (30/46) of cases. Although locations differed in the remaining 35% (16/46), all were located on the anal side near the transection line, and the difference was not clinically significant. The average distances between the transection line and blood flow boundary were 2.76 (SD = 3.25) and 3.71 (SD = 4.26) mm, respectively. There was no statistically significant difference between the two groups (p = 0.38). CONCLUSION: LSFG was shown to have comparable accuracy to ICG-FA, and may be useful for evaluating bowel perfusion.


Asunto(s)
Colorantes , Angiografía con Fluoresceína , Verde de Indocianina , Humanos , Femenino , Angiografía con Fluoresceína/métodos , Masculino , Anciano , Persona de Mediana Edad , Imágenes de Contraste de Punto Láser , Anciano de 80 o más Años , Flujo Sanguíneo Regional/fisiología , Adulto , Intestinos/irrigación sanguínea , Velocidad del Flujo Sanguíneo/fisiología , Neoplasias Colorrectales/cirugía
9.
Orbit ; 43(4): 464-470, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38687914

RESUMEN

PURPOSE: In oculoplastic surgery the eyelid tissue is frequently stretched in order to repair defects after tumor surgery. However, there is a paucity of research regarding how stretching affects eyelids. The purpose of this study was to gain insight into how traction force affects eyelid stretch as well as tissue perfusion, using a laser-based in vivo monitoring technique. METHOD: Lower-lid pentagonal resections were performed in eight patients and a total of nine eyelids. The medial section of the eyelid was then stretched using a dynamometer up to a force of 2.3 Newtons (N), and eyelid stretching and blood perfusion were continuously measured using laser speckle contrast imaging. RESULTS: Tissue perfusion decreased exponentially when eyelid tissue was stretched, with an initial sharp decline followed by a more gradual reduction. Perfusion approached zero at a force of approximately 2.0 N. The length of the eyelid increased with increasing force up to 1.5 N, after which there was only a very slight increase in length. CONCLUSIONS: Eyelid tissue seems to respond to traction in a non-linear fashion, where the initial force results in the greatest eyelid stretching and reduction in blood perfusion. The results provide information on the effects of a large force for direct closure of large eyelid defects. Considering how quickly perfusion approaches zero, the high success rate of eyelid reconstruction surgery is likely a testament to the extensive vascularization of the periocular region.


Asunto(s)
Párpados , Flujo Sanguíneo Regional , Humanos , Párpados/cirugía , Párpados/irrigación sanguínea , Femenino , Masculino , Anciano , Flujo Sanguíneo Regional/fisiología , Persona de Mediana Edad , Tracción , Imágenes de Contraste de Punto Láser , Neoplasias de los Párpados/cirugía , Neoplasias de los Párpados/fisiopatología , Anciano de 80 o más Años , Procedimientos de Cirugía Plástica/métodos , Blefaroplastia/métodos
11.
Opt Express ; 32(5): 6887-6902, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38439384

RESUMEN

Laser speckle contrast imaging (LSCI) has gained significant attention in the biomedical field for its ability to map the spatio-temporal dynamics of blood perfusion in vivo. However, LSCI faces difficulties in accurately resolving blood perfusion in microvessels. Although the transmissive detecting geometry can improve the spatial resolution of tissue imaging, ballistic photons directly transmitting forward through tissue without scattering will cause misestimating in the flow speed by LSCI because of the lack of a quantitative theoretical model of transmissvie LSCI. Here, we develop a model of temporal LSCI which accounts for the effect of nonscattered light on estimating decorrelation time. Based on this model, we further propose a dual-exposure temporal laser speckle imaging method (dEtLSCI) to correct the overestimation of background speed when performing traditional transmissive LSCI, and reconstruct microvascular angiography using the scattered component extracted from total transmitted light. Experimental results demonstrated that our new method opens an opportunity for LSCI to simultaneously resolve the blood vessels morphology and blood flow speed at microvascular level in various contexts, ranging from the drug-induced vascular response to angiogenesis and the blood perfusion monitoring during tumor growth.


Asunto(s)
Angiografía , Imágenes de Contraste de Punto Láser , Microvasos/diagnóstico por imagen , Perfusión , Rayos Láser
12.
Dis Colon Rectum ; 67(6): 850-859, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38408871

RESUMEN

BACKGROUND: Left-sided colorectal surgery demonstrates high anastomotic leak rates, with tissue ischemia thought to influence outcomes. Indocyanine green is commonly used for perfusion assessment, but evidence remains mixed for whether it reduces colorectal anastomotic leaks. Laser speckle contrast imaging provides dye-free perfusion assessment in real-time through perfusion heat maps and quantification. OBJECTIVE: This study investigates the efficacy of advanced visualization (indocyanine green versus laser speckle contrast imaging), perfusion assessment, and utility of laser speckle perfusion quantification in determining ischemic margins. DESIGN: Prospective intervention group using advanced visualization with case-matched, retrospective control group. SETTINGS: Single academic medical center. PATIENTS: Forty adult patients undergoing elective, minimally invasive, left-sided colorectal surgery. INTERVENTIONS: Intraoperative perfusion assessment using white light imaging and advanced visualization at 3 time points: T1-proximal colon after devascularization, before transection, T2-proximal/distal colon before anastomosis, and T3-completed anastomosis. MAIN OUTCOME MEASURES: Intraoperative indication of ischemic line of demarcation before resection under each visualization method, surgical decision change using advanced visualization, post hoc laser speckle perfusion quantification of colorectal tissue, and 30-day postoperative outcomes. RESULTS: Advanced visualization changed surgical decision-making in 17.5% of cases. For cases in which surgeons changed a decision, the average discordance between the line of demarcation in white light imaging and advanced visualization was 3.7 cm, compared to 0.41 cm ( p = 0.01) for cases without decision changes. There was no statistical difference between the line of ischemic demarcation using laser speckle versus indocyanine green ( p = 0.16). Laser speckle quantified lower perfusion values for tissues beyond the line of ischemic demarcation while suggesting an additional 1 cm of perfused tissue beyond this line. One (2.5%) anastomotic leak occurred in the intervention group. LIMITATIONS: This study was not powered to detect differences in anastomotic leak rates. CONCLUSIONS: Advanced visualization using laser speckle and indocyanine green provides valuable perfusion information that impacts surgical decision-making in minimally invasive left-sided colorectal surgeries. See Video Abstract . UTILIDAD CLNICA DE LAS IMGENES DE CONTRASTE MOTEADO CON LSER Y LA CUANTIFICACIN EN TIEMPO REAL DE LA PERFUSIN INTESTINAL EN RESECCIONES COLORRECTALES DEL LADO IZQUIERDO MNIMAMENTE INVASIVAS: ANTECEDENTES:La cirugía colorrectal del lado izquierdo demuestra altas tasas de fuga anastomótica, y se cree que la isquemia tisular influye en los resultados. El verde de indocianina se utiliza habitualmente para evaluar la perfusión, pero la evidencia sobre si reduce las fugas anastomóticas colorrectales sigue siendo contradictoria. Las imágenes de contraste moteado con láser proporcionan una evaluación de la perfusión sin colorantes en tiempo real a través de mapas de calor de perfusión y cuantificación.OBJETIVO:Este estudio investiga la eficacia de la evaluación de la perfusión mediante visualización avanzada (verde de indocianina versus imágenes de contraste moteado con láser) y la utilidad de la cuantificación de la perfusión con moteado láser para determinar los márgenes isquémicos.DISEÑO:Grupo de intervención prospectivo que utiliza visualización avanzada con un grupo de control retrospectivo de casos emparejados.LUGARES:Centro médico académico único.PACIENTES:Cuarenta pacientes adultos sometidos a cirugía colorrectal electiva, mínimamente invasiva, del lado izquierdo.INTERVENCIONES:Evaluación de la perfusión intraoperatoria mediante imágenes con luz blanca y visualización avanzada en tres puntos temporales: T1-colon proximal después de la devascularización, antes de la transección; T2-colon proximal/distal antes de la anastomosis; y T3-anastomosis completa.PRINCIPALES MEDIDAS DE VALORACIÓN:Indicación intraoperatoria de la línea de demarcación isquémica antes de la resección bajo cada método de visualización, cambio de decisión quirúrgica mediante visualización avanzada, cuantificación post-hoc de la perfusión con láser moteado del tejido colorrectal y resultados posoperatorios a los 30 días.RESULTADOS:La visualización avanzada cambió la toma de decisiones quirúrgicas en el 17,5% de los casos. Para los casos en los que los cirujanos cambiaron una decisión, la discordancia promedio entre la línea de demarcación en las imágenes con luz blanca y la visualización avanzada fue de 3,7 cm, en comparación con 0,41 cm (p = 0,01) para los casos sin cambios de decisión. No hubo diferencias estadísticas entre la línea de demarcación isquémica utilizando láser moteado versus verde de indocianina (p = 0,16). El moteado con láser cuantificó valores de perfusión más bajos para los tejidos más allá de la línea de demarcación isquémica y al mismo tiempo sugirió 1 cm adicional de tejido perfundido más allá de esta línea. Se produjo una fuga anastomótica (2,5%) en el grupo de intervención.LIMITACIONES:Este estudio no tuvo el poder estadístico suficiente para detectar diferencias en las tasas de fuga anastomótica.CONCLUSIONES:La visualización avanzada utilizando moteado láser y verde de indocianina proporciona información valiosa sobre la perfusión que impacta la toma de decisiones quirúrgicas en cirugías colorrectales mínimamente invasivas del lado izquierdo. (Traducción-Dr. Ingrid Melo).


Asunto(s)
Fuga Anastomótica , Verde de Indocianina , Imágenes de Contraste de Punto Láser , Humanos , Femenino , Masculino , Verde de Indocianina/administración & dosificación , Persona de Mediana Edad , Fuga Anastomótica/prevención & control , Fuga Anastomótica/diagnóstico , Anciano , Imágenes de Contraste de Punto Láser/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Colorantes/administración & dosificación , Colon/irrigación sanguínea , Colon/cirugía , Colon/diagnóstico por imagen , Estudios Retrospectivos , Colectomía/métodos , Estudios Prospectivos , Anastomosis Quirúrgica/métodos , Isquemia/prevención & control , Isquemia/diagnóstico , Estudios de Casos y Controles
13.
J Endocrinol Invest ; 47(8): 1903-1909, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38329608

RESUMEN

AIM: Acromegaly is a rare chronic disease, caused by the over-secretion of growth hormone (GH), that creates a pro-inflammatory state, but the exact mechanisms by which GH or insulin-like growth factor 1 (IGF-1) act on inflammatory cells are not fully understood. Aim of the study was to evaluate Interleukin-33 (IL33) and the skin perfusion of hands in patients with acromegaly (AP) and healthy controls (HC). METHODS: IL33 have been assessed in 40 AP and 40 HC. IL 33 was determined and skin perfusion of hands was assessed by laser speckle contrast analysis (LASCA) in both populations. RESULTS: IL33 was significantly higher in AP compared to HC [45.72 pg/ml (IQR 28.74-60.86) vs 14 pg/ml (IQR 6.5535); p < 0.05]. At LASCA, peripheral blood perfusion (PBP) was significantly lower in AP compared to HC [53.39 pU (IQR 40.94-65.44) vs 87 pU (IQR 80-98) p < 0.001]. The median values of ROI1, ROI2 and ROI3 were significantly lower in AP compared to HC [97.32 pU (IQR 50.89-121.69) vs 131 pU (IQR 108-135); p < 0.001], [58.68 pU (IQR 37.72-84.92) vs 83 pU (IQR 70-89), p < 0.05] and HC [52.16 (34.47-73.78) vs 85 (78-98), p < 0.001], respectively. The proximal-distal gradient (PDG) was observed in 18 of 40 (45%) AP. CONCLUSION: Serum IL33 is higher in AP compared to HC; conversely a reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction, strictly dependent on acromegaly and are not influenced by the choice of treatment.


Asunto(s)
Acromegalia , Inflamación , Interleucina-33 , Humanos , Acromegalia/metabolismo , Acromegalia/sangre , Acromegalia/complicaciones , Acromegalia/patología , Masculino , Femenino , Persona de Mediana Edad , Interleucina-33/sangre , Interleucina-33/metabolismo , Inflamación/metabolismo , Adulto , Estudios de Casos y Controles , Microvasos/patología , Microvasos/metabolismo , Piel/irrigación sanguínea , Piel/patología , Piel/metabolismo , Biomarcadores/sangre , Enfermedad Crónica , Hormona de Crecimiento Humana/sangre , Hormona de Crecimiento Humana/metabolismo , Imágenes de Contraste de Punto Láser/métodos , Estudios de Cohortes , Mano , Factor I del Crecimiento Similar a la Insulina/metabolismo , Factor I del Crecimiento Similar a la Insulina/análisis
14.
J Tissue Viability ; 33(2): 292-297, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38378352

RESUMEN

AIM OF THE STUDY: This study investigated how the air-bladder offloading mode of the Orbiter by Kalogon wheelchair cushion (Orbiter) affected blood flow in the gluteal region of non-disabled subjects. The hypothesis was that the cushion's offloading mode would improve blood flow, resulting in reduced reactive hyperemia when compared to the static setting, or Loaded Control (LC). Furthermore, the study proposed a technique using a high-resolution image laser speckle contrast system to measure blood flow in the gluteal area. METHODS: Two procedures were carried out, one with the participant sitting on a cushion in LC, and the second, the cushion was set to offloading mode. Blood flow was measured through data imaging after each procedure. Three trials were performed, starting and ending in different cushion bladders. Customized algorithms were used to select regions of interest on the images for calculations. The Wilcoxon Signed-Rank Test was conducted to compare the offloads and loaded control values of each region of interest. Results were considered significant at α = 0.05. RESULTS: Ten healthy, non-disabled adults participated in the study, seven females and three males. There were no significant differences among the participants. However, results showed that seven subjects tended to decrease reactive hyperemia in the offload sequence of trial when the last two bladders offloaded were the sacrum followed by the right ischial tuberosity. CONCLUSIONS: The high-resolution imager showed that the Orbiter Offloads helped reduce reactive hyperemia in seven subjects, potentially improving blood flow. More research is necessary to comprehend the mechanisms of these effects fully.


Asunto(s)
Silla de Ruedas , Humanos , Nalgas/irrigación sanguínea , Nalgas/fisiología , Silla de Ruedas/normas , Masculino , Femenino , Adulto , Diseño de Equipo/normas , Diseño de Equipo/métodos , Flujo Sanguíneo Regional/fisiología , Imágenes de Contraste de Punto Láser/métodos , Imágenes de Contraste de Punto Láser/normas
15.
Sci Robot ; 9(87): eadh1978, 2024 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-38381838

RESUMEN

Micro/nanorobotic swarms consisting of numerous tiny building blocks show great potential in biomedical applications because of their collective active delivery ability, enhanced imaging contrast, and environment-adaptive capability. However, in vivo real-time imaging and tracking of micro/nanorobotic swarms remain a challenge, considering the limited imaging size and spatial-temporal resolution of current imaging modalities. Here, we propose a strategy that enables real-time tracking and navigation of a microswarm in stagnant and flowing blood environments by using laser speckle contrast imaging (LSCI), featuring full-field imaging, high temporal-spatial resolution, and noninvasiveness. The change in dynamic convection induced by the microswarm can be quantitatively investigated by analyzing the perfusion unit (PU) distribution, offering an alternative approach to investigate the swarm behavior and its interaction with various blood environments. Both the microswarm and surrounding environment were monitored and imaged by LSCI in real time, and the images were further analyzed for simultaneous swarm tracking and navigation in the complex vascular system. Moreover, our strategy realized real-time tracking and delivery of a microswarm in vivo, showing promising potential for LSCI-guided active delivery of microswarm in the vascular system.


Asunto(s)
Imágenes de Contraste de Punto Láser , Robótica , Flujometría por Láser-Doppler/métodos , Flujo Sanguíneo Regional
16.
J Cereb Blood Flow Metab ; 44(7): 1163-1173, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38233750

RESUMEN

Cerebral hyperperfusion (CHP) occurred frequently after direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery for moyamoya disease (MMD). We analyzed cortical microvascular density (CMD) and the change of cerebral blood flow (LΔCBF) using intraoperative laser speckle contrast imaging (LSCI) on 130 hemispheres of 95 consecutive adult patients with MMD. The demographic characteristics, cortical hemodynamic sources, bypass methods, intraoperative blood flow data, and relative CBF changes on single-photon emission computed tomography (SPECT) examination (SΔrCBF) were compared between the groups with and without CHP. The median values for CMD, LΔCBF, and SΔrCBF were significantly higher in the CHP group than in the non-CHP group (CMD 0.240 vs 0.206, P = 0.004; LΔCBF 2.285 vs 1.870, P < 0.001; SΔCBF 1.535 vs 1.260, P < 0.001). Multivariate analysis revealed that hemodynamic sources of recipient parasylvian cortical arteries from MCA (M-PSCAs), end-to-side (E-S) bypass method, CMD ≥ 0.217, and LΔCBF ≥ 1.985 were the risk factors for CHP. Intraoperative LSCI was useful for evaluating hemodynamics and predicting CHP in patients with MMD.


Asunto(s)
Revascularización Cerebral , Circulación Cerebrovascular , Hemodinámica , Imágenes de Contraste de Punto Láser , Arteria Cerebral Media , Enfermedad de Moyamoya , Arterias Temporales , Humanos , Enfermedad de Moyamoya/cirugía , Enfermedad de Moyamoya/diagnóstico por imagen , Enfermedad de Moyamoya/fisiopatología , Adulto , Masculino , Circulación Cerebrovascular/fisiología , Femenino , Revascularización Cerebral/métodos , Persona de Mediana Edad , Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/cirugía , Arteria Cerebral Media/fisiopatología , Arterias Temporales/cirugía , Arterias Temporales/diagnóstico por imagen , Imágenes de Contraste de Punto Láser/métodos , Hemodinámica/fisiología , Tomografía Computarizada de Emisión de Fotón Único/métodos , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Adulto Joven
17.
Acta Neurochir (Wien) ; 166(1): 27, 2024 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-38261093

RESUMEN

Adenosine induced cardiac arrest (AiCA) is one of the methods used to facilitate microsurgical aneurysm clipping by providing more visibility and less pressure in the aneurysmal sac and neighboring vessels. We report the use of laser speckle contrast imaging (LSCI) during AiCA to monitor the changes in pulsation and perfusion on the cortical surface during adenosine induced cardiac arrest for aneurysm clipping surgery. Application of this technology for perfusion monitoring may improve workflow and surgical guidance and provide valuable feedback continuously throughout the procedure. ClinicalTrials.gov identifier: NCT0502840.


Asunto(s)
Aneurisma , Imágenes de Contraste de Punto Láser , Humanos , Perfusión , Adenosina , Paro Cardíaco Inducido
18.
Sci Rep ; 14(1): 1735, 2024 01 19.
Artículo en Inglés | MEDLINE | ID: mdl-38242903

RESUMEN

The use of various blood flow control methods in neurovascular interventions is crucial for reducing postoperative complications. Neurosurgeons worldwide use different methods, such as contact Dopplerography, intraoperative indocyanine videoangiography (ICG) video angiography, fluorescein angiography, flowmetry, intraoperative angiography, and direct angiography. However, there is no noninvasive method that can assess the presence of blood flow in the vessels of the brain without the introduction of fluorescent substances throughout the intervention. The real-time laser-speckle contrast imaging (LSCI) method was studied for its effectiveness in controlling blood flow in standard cerebrovascular surgery cases in rat common carotid arteries, such as proximal occlusion, trapping, reperfusion, anastomosis, and intraoperative vessel thrombosis. The real-time LSCI method is a promising method for use in neurosurgical practice. This approach allows timely diagnosis of intraoperative disturbance of blood flow in vessels in cases of clip occlusion or thrombosis. Additionally, LSCI allows us to reliably confirm the functioning of the anastomosis and reperfusion after removal of the clips and thrombolysis in real time. An unresolved limitation of the method is noise from movements, but this does not reduce the value of the method. Additional research is required to improve the quality of the data obtained.


Asunto(s)
Verde de Indocianina , Trombosis , Ratas , Animales , Imágenes de Contraste de Punto Láser , Colorantes , Angiografía con Fluoresceína
19.
J Biophotonics ; 17(3): e202300394, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38169143

RESUMEN

The early detection and pathological classification of brain edema are very important for symptomatic treatment. The dual-optical imaging system (DOIS) consists of intrinsic optical signal imaging (IOSI) and laser speckle contrast imaging (LSCI), which can acquire cerebral hemodynamic parameters of mice in real-time, including changes of oxygenated hemoglobin concentration ( Δ C HbO 2 ), deoxyhemoglobin concentration (ΔCHbR) and relative cerebral blood flow (rCBF) within the field of view. The slope sum of Δ C HbO 2 , ΔCHbR and rCBF was proposed to classify vasogenic edema (VE) and cytotoxic edema (CE). The slope sum values in the VE and CE group remain statistically different and the classification results provide higher accuracy of more than 93% for early brain edema detection. In conclusion, the differences of hemodynamic parameters between VE and CE in the early stage were revealed and the method helps in the classification of early brain edema.


Asunto(s)
Edema Encefálico , Imágenes de Contraste de Punto Láser , Ratones , Animales , Edema Encefálico/diagnóstico por imagen , Imagen Óptica/métodos , Hemodinámica , Circulación Cerebrovascular , Edema/diagnóstico por imagen
20.
J Biomed Opt ; 29(1): 016009, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-38283936

RESUMEN

Significance: Laser speckle contrast imaging (LSCI) is a real-time wide-field technique that is applied to visualize blood flow in biomedical applications. However, there is currently a lack of relevant research to demonstrate that it can measure velocities over a wide dynamic range (WDR), which is critical for monitoring much higher and more pulsatile blood flow in larger size myocardial vessels, such as the coronary artery bypass graft, and visualizing the spatio-temporal evolution of myocardial blood flow perfusion in cardiac surgery. Aim: We aim to demonstrate that the LSCI technique enables measuring velocities over a WDR from phantom experiments to animal experiments. In addition, LSCI is preliminarily applied to imaging myocardial blood flow distribution in vivo on rabbits. Approach: Phantom and animal experiments are performed to verify that the LSCI method has the ability to measure blood velocities over a wide range. Our method is also validated by transit time flow measurement, which is the gold standard for blood flow measurement in cardiac surgery. Results: Our method is demonstrated to measure the blood flow over a wide range from 0.2 to 635 mm/s. To validate the phantom results, the varying blood flow rate from 0 to 320 mm/s is detected in the rat carotid artery. Additionally, our technique also obtains blood flow maps of different myocardial vessels, such as superficial large/small veins, veins surrounded by fat, and myocardial deeper arteriole. Conclusions: Our study has the potential to visualize the spatio-temporal evolution of myocardial perfusion in coronary artery bypass grafting, which would be of great benefit for future research in the life sciences and clinical medicine.


Asunto(s)
Hemodinámica , Imágenes de Contraste de Punto Láser , Ratas , Animales , Conejos , Velocidad del Flujo Sanguíneo , Flujo Sanguíneo Regional/fisiología , Venas , Flujometría por Láser-Doppler/métodos
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