Circulating microRNAs as promising testicular translatable safety biomarkers: current state and future perspectives.

Drug-induced testicular injury (DITI) is one of the often-observed and challenging safety issues seen during drug development. Semen analysis and circulating hormones currently utilized have significant gaps in their ability to detect testicular damage accurately. In addition, no biomarkers enable a mechanistic understanding of the damage to the different regions of the testis, such as seminiferous tubules, Sertoli, and Leydig cells. MicroRNAs (miRNAs) are a class of non-coding RNAs that modulate gene expression post-transcriptionally and have been indicated to regulate a wide range of biological pathways. Circulating miRNAs can be measured in the body fluids due to tissue-specific cell injury/damage or toxicant exposure. Therefore, these circulating miRNAs have become attractive and promising non-invasive biomarkers for assessing drug-induced testicular injury, with several reports on their use as safety biomarkers for monitoring testicular damage in preclinical species. Leveraging emerging tools such as 'organs-on-chips' that can emulate the human organ's physiological environment and function is starting to enable biomarker discovery, validation, and clinical translation for regulatory qualification and implementation in drug development.

Dataset of breast thermography images for the detection of benign and malignant masses.

Thermographic image analysis is a subfield of diagnostic image processing aimed at detecting breast abnormalities in women at an early stage. It is a developing field of research and its effectiveness and scope require scientific assessment to be determined. An open-access dataset has been created for the scientific community to test and develop techniques for computational detection of normal and abnormal breast conditions from thermograms. This dataset is a valuable resource for researchers due to the scarcity of publicly available datasets of breast thermographic images. It includes thermographic images of the female chest area in three capture positions: anterior, left oblique and right oblique. The data set comes from 119 women ranging from 18 to 81 years of age. A table is attached to the dataset with the diagnosis of breast pathology, showing that 84 patients had benign pathology and 35 patients had malignant pathology. The diagnoses of women with healthy breast pathology are not included.

Medical thermography (digital infrared thermal imaging - DITI) in paediatric forearm fractures - A pilot study.

Trauma is the most common cause of hospitalisation in children, and forearm fractures comprise 35% of all paediatric fractures. One-third of forearm fractures are distal forearm fractures, which are the most common fractures in the paediatric population. This type of fracture represents an everyday problem for the paediatric surgeon. The three phases of fracture healing in paediatric trauma are associated with skin temperature changes that can be measured and then compared with standard plain radiographs of visible callus formation, and eventually these methods can be used in everyday practice. Thermographic assessment of temperature distribution within the examined tissues enables a quick, non-contact, non-invasive measurement of their temperature. Medical thermography is used as a screening method in other parts of medicine, but the use of this method in traumatology has still not been researched.

Infrared Imaging Tools for Diagnostic Applications in Dermatology.

Infrared (IR) imaging is a collection of non-invasive imaging techniques that utilize the IR domain of the electromagnetic spectrum for tissue assessment. A subset of these techniques construct images using back-reflected light, while other techniques rely on detection of IR radiation emitted by the tissue as a result of its temperature. Modern IR detectors sense thermal emissions and produce a heat map of surface temperature distribution in tissues. Thus, the IR spectrum offers a variety of imaging applications particularly useful in clinical diagnostic area, ranging from high-resolution, depth-resolved visualization of tissue to temperature variation assessment. These techniques have been helpful in the diagnosis of many medical conditions including skin/breast cancer, arthritis, allergy, burns, and others. In this review, we discuss current roles of IR-imaging techniques for diagnostic applications in dermatology with an emphasis on skin cancer, allergies, blisters, burns and wounds.

Evaluation of digital infra-red thermal imaging as an adjunctive screening method for breast carcinoma: a pilot study.

BACKGROUND: Early screening plays a pivotal role in management of breast cancer. Given the socio-economic situation in India, there is a strong felt need for a screening tool which reaches the masses rather than waiting for the masses to reach tertiary centers to be screened. Digital infra-red thermal imaging (DITI) or breast thermography as a screening test offers this possibility and needs to be carefully assessed in Indian scenario. METHODS: The study involved 1008 female patients of age 20-60 years that had not been diagnosed of cancer of breast earlier. All the subjects in this population were screened for both the breasts using DITI. Based on the measured temperature gradients (ΔT) in thermograms, the subjects were classified in one of the three groups, normal (ΔT ≤ 2.5), abnormal (ΔT > 2.5, <3) and potentially having breast cancer (ΔT ≥ 3). All those having (ΔT > 2.5) underwent triple assessment that consisted of clinical examination, radiological and histopathological examination. Those with normal thermograms were subjected to only clinical examination. RESULTS: Forty nine female breasts had thermograms with temperature gradients exceeding 2.5 and were subjected to triple assessment. Forty one of these which had ΔT ≥ 3 were proven to be having cancer of breast and were offered suitable treatment. Eight thermograms had temperature gradients exceeding 2.5 but less than 3. Most of these were lactating mothers or had fibrocystic breast diseases. As a screening modality, DITI showed sensitivity of 97.6%, specificity of 99.17%, positive predictive value 83.67% and negative predictive value 99.89%. CONCLUSION: Based on the results of this study involving 1008 subjects for screening of breast cancer, thermography turns out to be a very useful tool for screening. Because it is non-contact, pain-free, radiation free and comparatively portable it can be used in as a proactive technique for detection of breast carcinoma.

Single and triple moxibustion with large, indirect moxa induced differential effects on skin temperature and blood perfusion in healthy human subjects: Counterevidence to a previous report.

OBJECTIVES: This study aims to investigate the possible differences in skin temperature and blood perfusion changes between single and triple moxibustion. DESIGN AND SETTING: Thirty healthy volunteers were randomly divided into two groups: a triple moxibustion group (n=15) received indirect moxibustion on CV12 for 30min and a single moxibustion group (n=15) for 10min. After 10min of bed rest, skin temperature and blood perfusion were measured by digital infrared thermal imaging and laser Doppler perfusion imaging eight times in total, pre-moxibustion and 0, 5, 10, 15, 20, 25 and 30min post moxibustion. MAIN OUTCOME MEASUREMENT: The changes in the skin temperature and blood perfusion in an area 5cm in diameter around CV12 at 0min post treatment compared to baseline was the main outcome measurement. RESULTS: The difference of changes in skin temperature and blood perfusion on CV12 between the two groups remained statistically significant for 30min in an area 5cm in diameter around CV12 and for 25min in a 15-cm-diameter area. No adverse events were reported. CONCLUSION: Triple moxibustion with large, indirect moxa appeared to induce greater increases in skin temperature and blood perfusion than single moxibustion.

Application of Digital Infrared Thermographic Imaging (DITI) in the Monitoring of Change of Skin Temperature about Vascular Supply of Lower Abdominal Axial Flap in the Rabbit / 고신대학교의과대학학술지

OBJECTIVES: Monitoring viability of flap is important. The flap survival depends on the vascularity of the flap, on which the skin temperature depends. The authors applied digital infrared thermographic imaging (DITI) for monitoring the vascular supply of the flap and for the prediction of the prognosis of the flap survival. METHODS: Eight male New Zealand white rabbits with average weight of 3kg were used. A 10 x 10 cm unipedicled fasciocutaneous island flap was elevated based on the left superficial inferior epigastric vessel. The surface temperatures on designed flap were checked with DITI for 24 hours after the operation. On 14th day after the operation, the surviving area was measured and compared with DITI image which was taken on 24 hours after the operation using digital analysis software ImageJ. Statistical analysis was evaluated by paired T-test. RESULTS: On DITI image 24 hours after the flap elevation, distal portion of the flap showed remarkable color change. The average percentage and the standard deviation of the survival area of the flap which is predicted by DITI and the average percentage and the standard deviation of the survival area of the flap which was actually measured 2 weeks after flap elevation were 55.3 (16.6), 56.2 (18.0), respectively. This shows no significant difference between the two. CONCLUSIONS: This study shows that DITI system could be used in evaluation of flap vascularity with ease, quickness and safety for patient and flap. Thus, it could be used clinically for the prediction of flap survival.

Is the use of Digital Infrared Thermal Imaging Useful in Whiplash Injury?

OBJECTIVE: The name of whiplash Injury derives from the etiopathogenic description of the sudden sharp whipping movement of the head and neck, symptoms are varied, manifesting as neck pain, occipital pain, dysesthesia, and weakness of arm, and so on. But there is no objective diagnostic tool for the evaluation of its symptoms. The purpose of the study is to visualize the symptomatic region before and after treatment and comparing the images obtained by infrared study. METHODS: From march 2006 to June 2008, 20 patients diagnosed as whiplash injuries were examined by digital infrared thermographic imaging system (DITI, DOREX, USA). The male-to-female ratio was 14:6 and their ages were ranging in age from 20 to 67 years, with mean age of 38.5 years. We evaluated thermal change (deltaT) in lesion area(neck and shoulder) and also compared thermal difference (deltaT (2wk-I)) after pre- & post- treatment. RESULTS: Initial DITI was 34.28 +/- 2.90 on anterior neck, 34.29 +/- 2.98 on posterior neck, 33.42 +/- 2.93 on right shoulder shoulder (Lt), and 33.59 +/- 2.81 on left shoulder. DITI after 2weeks treatment was 33.60 +/- 2.88 on anterior neck, 33.78 +/- 2.99 on posterior neck, 32.79 +/- 2.78 on right shoulder, and 33.05 +/- 2.74 on left shoulder. The thermal difference of lesional area on the initial treatment and after treatment (deltaT (2wk-I)) was 0.68 +/- 0.45 on anterior neck, 0.51 +/- 0.36 on posterior neck, 0.63 +/- 0.32 on right shoulder, and 0.54 +/- 0.64 on left shoulder, and these result were statistically significant (p < 0.05). Thermal difference (deltaT) was neck 0.34 and shoulder 0.33 on initial injury, and 0.39, 0.31 after 2 weeks respectively. This finding was symmetrical and below deltaT 0.5 based on pathologic body temperature. Initial VAS (Visual Analogue Scale) of Neck was 7.9 +/- 0.78 and after 2 weeks was 3.6 +/- 1.21 the initial VAS of shoulder was 7.4 +/- 0.52 and after 2 weeks was 3.2 +/- 0.97. There was statistically significant (p=0.001). CONCLUSION: Therefore DITI was perceived as a reliable tool in the objective assessment of treatment effect after sustaining whiplash injuries, in clinical practice.

Multi-access for the Diagnosis of Missed Upper Lumbar Disc Herniation

Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging(DITI), and repeated magnetic resonance(MR) image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.

Application of Digital Infrared Thermographic Imaging(DITI) to the Evaluation of Blood Supply of Lower Abdominal Flap in Rabbit

The monitoring method of the flap for detecting the compromise of vascular circulation has been developed in order to prevent flap loss in the microsurgery. The ideal flap monitor for the flaps would show the vascularity and circulation state of the flap, any time, any place easily. The concept that the skin temperature is up to the vascularity under the skin, rendered to apply IR(infrared) thermometer as quantitative analysis and IRIS-2000 (digital infrared thermographic imaging: DITI) as geographic analysis to the several kinds of flap in 15 New Zealand white rabbits. The IR thermometer showed that the nearer to the pedicle, the higher temperature quantitatively. The DITI scan showed to us like below. The nearer to the pedicle, the higher temperature color in DITI scan image. The DITI scan image of myocutaneous flap had higher temperature color than that of fasciocutaneous flap. In case of cut down of one side vascular pedicle, the DITI scan image of the pedicle-cut-down side showed lower temperature color than the opposite side. So, the better blood supply in the area of the flap, the higher temperature as color image in DITI scan. We supposed that the DITI would help to estimate the circulation of the flap as its color image, based on skin temperature.

Sympathetic Vasomotor Response with Stress Digital Infrared Thermal Imaging in Normal Healthy Subjects

OBJECTIVE: To investigate sympathetic vasomotor response of the hands to cold and warm stress on the foot with Digital Infrared Thermal Imaging (DITI) in normal healthy subjects. METHOD: Fifteen healthy subjects were participated in this study. The DITI was taken during immersing right foot in cold and warm water bath. The thermal images of the dorsal hands were captured at the starting point and then every 5-minute up to 30 minutes. The ratio of temperature between the ending point (30T) and the starting point (0T) was calculated. RESULTS: In cold stress test, the mean 30T/0T ratio were 92.8+/-2.4% and 92.2+/-2.7% in the right and left hands, respectively. There were no statistically significant side to side differences. The temperature of the each hand was significantly lowered at every 5 minutes interval (p<0.05). In warm stress test, the mean 30T/0T ratio were 104.5+/-1.8% and 104.4+/-2.0% in the right and left hands, respectively. The temperature of each hand was significantly increased at the first 5 minutes (p<0.05), and tended to increase until 10 minutes. After then, the temperature was not significantly changed until 30 miniutes. CONCLUSION: We could identify the normal sympathetic vasomotor response to the cold and warm stress with DITI. It might be served as an useful baseline data for the identification of sympathetic dysfunction.

The New Diagnostic Method for Hyperhidrosis: Digital Infrared Thermographic Imaging

Essential palmar hyperhidrosis is a disease characterized by excessive sweating on palms and hands due to hyperaction of sympathetic nervous discharge. It develops severe hypothermia on both hands because of loss of surface heat by evaporation of the sweating. Numerous tests including starch-iodine test were used to detect sweating status. But they were complicated and unpleasant to patients. Digital infrared Thermographic Imaging(DITI) can show a thermal difference very clearly. We have used DITI not only for the diagnosis, but for planning of the operation and operative follow up of the disease since 1990. 343 cases of bilateral upper thoracic(T2 & T3) sympathetic ganglionectomy were performed from Mar. 1989 to Dec. 1996 in our spine center. Among them, open surgery with posterior midline approach were initially carried out in 54 cases and recently percutaneous endoscopic sympathectomy were carried out in 289 additional cases. Digital Infrared Thermographic Imaging has been taken pre and postoperatively in 339 cases. Preoperatively, severe hypothermia is noted in 96.2% in both hands and feet. Immediately after operation, the sweating ceased in all cases and marked hyperthermia was noted in both hands compared to preoperative status due to sympathetic denervation. DITI is more accurate and easier than any other method for diagnosis and evaluation of treatment effect in hyperhidrosis. DITI is simple, accurate, comfortable and objective diagnostic tool for hyperhidrosis patient.

Diagnostic Efficacy of Digital Infrared Thermographic Imaging in Carpal Tunnel Syndrome

OBJECTIVE: Electromyography(EMG) has been very helpful in establishing the diagnosis of carpal tunnel syndrome(CTS). But invasive procedure of EMG makes patients discomfort, who are suffering from consistent numbness. The authors investigate the diagnostic efficacy of Digital Infrared Thermographic Imaging(DITI) in CTS by comparing thermal changes between normal control group and patients group. METHODS: Among 31 patients who had operated due to CTS from march 1984 to February 2002 at the Spine Center, both EMG & DITI were used for diagnostic method in 24 patients. Authors have measured thermal differences(deltaT, degrees C) of symptomatic site between forearm and palm in 20 patients, and 30 normal controls. Authors have analyzed thermal differences(deltaT, degrees C) statistically using T-test. RESULTS: Average thermal difference(deltaT, degrees C) in symptomatic site was statistically higher than that of normal control group. Average thermal difference(deltaT, degrees C) is+0.984+/-0.342 degrees C in symptomatic site, +0.323+/-0.296 degrees C in normal control group, respectively. Significant thermal difference(deltaT, degrees C) was seen between two groups(p<0.005). Average thermal difference(deltaT, degrees C) in CT S was statistically higher than normal group, significantly. Average thermal difference(deltaT, degrees C) greater than 1 degrees C can be suspicious of CTS. CONCLUSION: Diagnostic usefulness of DITI in CTS is very high especially for the screening purpose.