| 1. |
- Barbu, Andreea, et al.
(författare)
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The use of hydrogen gas clearance for blood flow measurements in single endogenous and transplanted pancreatic islets
- 2015
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Ingår i: Microvascular Research. - : Elsevier BV. - 0026-2862 .- 1095-9319. ; 97, s. 124-129
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Tidskriftsartikel (refereegranskat)abstract
- The blood perfusion of pancreatic islets is regulated independently from that of the exocrine pancreas, and is of importance for multiple aspects of normal islet function, and probably also during impaired glucose tolerance. Single islet blood flow has been difficult to evaluate due to technical limitations. We therefore adapted a hydrogen gas washout technique using microelectrodes to allow such measurements. Platinum micro-electrodes monitored hydrogen gas clearance from individual endogenous and transplanted islets in the pancreas of male Lewis rats and in human and mouse islets implanted under the renal capsule of male athymic mice. Both in the rat endogenous pancreatic islets as well as in the intra-pancreatically transplanted islets, the vascular conductance and blood flow values displayed a highly heterogeneous distribution, varying by factors 6-10 within the same pancreas. The blood flow of human and mouse islet grafts transplanted in athymic mice was approximately 30% lower than that in the surrounding renal parenchyma. The present technique provides unique opportunities to study the islet vascular dysfunction seen after transplantation, but also allows for investigating the effects of genetic and environmental perturbations on islet blood flow at the single islet level in vivo. (C) 2014 The Authors. Published by Elsevier Inc.
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| 2. |
- Bergkvist, Max, et al.
(författare)
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Assessment of microcirculation of the skin using Tissue Viability Imaging: A promising technique for detecting venous stasis in the skin
- 2015
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Ingår i: Microvascular Research. - : Elsevier. - 0026-2862 .- 1095-9319. ; 101, s. 20-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: : Venous occlusion in the skin is difficult to detect by existing measurement techniques. Our aim was to find out whether Tissue Viability Imaging (TiVi) was better at detecting venous occlusion by comparing it with results of laser Doppler flowmetry (LDF) during graded arterial and venous stasis in human forearm skin. Methods: : Arterial and venous occlusions were simulated in 10 healthy volunteers by inflating a blood pressure cuff around the upper right arm. Changes in the concentration of red blood cells (RBC) were measured using TiVi, while skin perfusion and concentration of moving red blood cells (CMBC) were measured using static indices of LDF during exsanguination and subsequent arterial occlusion, postocclusive reactive hyperaemia, and graded increasing and decreasing venous stasis. Results: : During arterial occlusion there was a significant reduction in the mean concentration of RBC from baseline, as well as in perfusion and CMBC (p less than 0.008). Venous occlusion resulted in a significant 28% increase in the concentration of RBC (p = 0.002), but no significant change in perfusion (mean change -14%) while CMBC decreased significantly by 24% (p = 0.02). With stepwise increasing occlusion pressures there was a significant rise in the TiVi index and reduction in perfusion (p = 0.008), while the reverse was seen when venous flow was gradually restored. Conclusion: : The concentration of RBC measured with TiVi changes rapidly and consistently during both total and partial arterial and venous occlusions, while the changes in perfusion, measured by LDF, were less consistent This suggests that TiVi could be a more useful, non-invasive clinical monitoring tool for detecting venous stasis in the skin than LDF.
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| 3. |
- Bunke, Josefine, et al.
(författare)
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Extended-wavelength diffuse reflectance spectroscopy for a comprehensive view of blood perfusion and tissue response in human forearm skin
- 2019
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Ingår i: Microvascular Research. - : Elsevier BV. - 1095-9319 .- 0026-2862. ; 124, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this study was to investigate the possibility of using extended-wavelength diffuse reflectance spectroscopy (EW-DRS) to measure tissue response related to blood perfusion. The study was performed on a model that we have previously found to be useful for studying techniques for perfusion monitoring following the injection of epinephrine in a local anesthetic in the human forearm.METHODS: Nine healthy subjects were included in the study. Spectroscopy was performed with an EW-DRS system using a combination of two spectrometers to resolve light in the visible (350 nm to 1100 nm) and the near-infrared regions (900 nm to 1700 nm). The change in signal upon the injection of lidocaine (20 mg/ml) + epinephrine (12.5 μg/ml) (LIDO +EPI), compared to a control injection with saline (9 mg/ml), was investigated.RESULTS: Injection of lidocaine + epinephrine (12.5 μg/ml) caused a change in the EW-DRS signal in the wavelength intervals 510 to 610 nm, known to change upon deoxygenation of hemoglobin. When examining the full wavelength range (450 to 1550 nm) a decrease in reflectance upon LIDO +EPI injection was observed, suggesting that the broader spectrum provides more detailed information on the tissue response. The time to stable hypoperfusion was found to be 2.6 min.CONCLUSIONS: EW-DRS appears to be a promising technique for monitoring perfusion, and could provide a useful tool in plastic and reconstructive surgery. The broad spectrum provides detailed information on the molecular changes taking place in the tissue. However, the technique must be thoroughly validated before it can be implemented in clinical practice.
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| 4. |
- Dinsdale, Graham, et al.
(författare)
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Intra-and inter-observer reliability of nailfold videocapillaroscopy - A possible outcome measure for systemic sclerosis-related microangiopathy
- 2017
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Ingår i: Microvascular Research. - : Elsevier BV. - 1095-9319 .- 0026-2862. ; 112, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Our aim was to assess the reliability of nailfold capillary assessment in terms of image evaluability, image severity grade ('normal', 'early', 'active', 'late'), capillary density, capillary (apex) width, and presence of giant capillaries, and also to gain further insight into differences in these parameters between patients with systemic sclerosis (SSc), patients with primary Raynaud's phenomenon (PRP) and healthy control subjects.METHODS: Videocapillaroscopy images (magnification 300×) were acquired from all 10 digits from 173 participants: 101 patients with SSc, 22 with PRP and 50 healthy controls. Ten capillaroscopy experts from 7 European centres evaluated the images. Custom image mark-up software allowed extraction of the following outcome measures: overall grade ('normal', 'early', 'active', 'late', 'non-specific', or 'ungradeable'), capillary density (vessels/mm), mean vessel apical width, and presence of giant capillaries.RESULTS: Observers analysed a median of 129 images each. Evaluability (i.e. the availability of measures) varied across outcome measures (e.g. 73.0% for density and 46.2% for overall grade in patients with SSc). Intra-observer reliability for evaluability was consistently higher than inter- (e.g. for density, intra-class correlation coefficient [ICC] was 0.71 within and 0.14 between observers). Conditional on evaluability, both intra- and inter-observer reliability were high for grade (ICC 0.93 and 0.78 respectively), density (0.91 and 0.64) and width (0.91 and 0.85).CONCLUSIONS: Evaluability is one of the major challenges in assessing nailfold capillaries. However, when images are evaluable, the high intra- and inter-reliabilities suggest that overall image grade, capillary density and apex width have potential as outcome measures in longitudinal studies.
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| 5. |
- Dinsdale, Graham, et al.
(författare)
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Quantitative outcome measures for systemic sclerosis-related Microangiopathy – Reliability of image acquisition in Nailfold Capillaroscopy
- 2017
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Ingår i: Microvascular Research. - : Elsevier BV. - 0026-2862. ; 113, s. 56-59
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Tidskriftsartikel (refereegranskat)abstract
- Background Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. Method 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300 ×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4 outcome measures extracted: (1) overall image grade and then (where possible) distal vessel locations were marked, allowing (2) vessel density (across the whole nailfold) to be calculated (3) apex width measurement and (4) giant vessel count. Intra-rater, intra-visit and intra-rater inter-visit (baseline vs. 1 week) reliability were examined in 475 and 392 images respectively. A linear, mixed-effects model was used to estimate variance components, from which intra-class correlation coefficients (ICCs) were determined. Results Intra-visit and inter-visit reliability estimates (ICCs) were (respectively): overall image grade, 0.97 and 0.90; vessel density, 0.92 and 0.65; mean vessel width, 0.91 and 0.79; presence of giant capillary, 0.68 and 0.56. These estimates were conditional on each parameter being measurable. Conclusion Within-operator image analysis and acquisition are reproducible. Quantitative nailfold capillaroscopy, at least with a single observer, provides reliable outcome measures for clinical studies including randomised controlled trials.
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| 6. |
- Elawa, Sherif, et al.
(författare)
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The microvascular response in the skin to topical application of methyl nicotinate : Effect of concentration and variation between skin sites
- 2019
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Ingår i: Microvascular Research. - : Academic Press. - 0026-2862 .- 1095-9319. ; 124, s. 54-60
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMethyl nicotinate (MN) induces a local cutaneous erythema in the skin and may be used as a local provocation in the assessment of microcirculation and skin viability. The aims were to measure the effects of increasing doses of MN, to find the concentration that yields the most reproducible effect from day to day and between sites, and to study the variation between skin sites.MethodsMicrovascular responses to topically applied MN at different concentrations were measured in 12 subjects on separate days and on contralateral sides, using laserspeckle contrast imaging (LSCI). MN effects were measured in four different body sites.ResultsAt 20 mmol/L, the response to MN was most reproducible day-to-day and site-to-site, and resulted in a plateau response between 5 and 20 min after application.The skin region of the lower back had a lower perfusion value compared to the epigastric region (p = 0.007). When responses were compared to nearby, unprovoked areas, a significantly larger increase in perfusion was seen in the forearm, compared to all other anatomical sites (p < 0.03).ConclusionA concentration of 20 mmol/L MN generated the most reproducible microvascular response in the skin. The response varies between different body sites.
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| 7. |
- Emrani, Zahra, et al.
(författare)
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Capillary density : An important parameter in nailfold capillaroscopy
- 2017
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Ingår i: Microvascular Research. - Netherland : Elsevier. - 0026-2862 .- 1095-9319. ; 109, s. 7-18
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Tidskriftsartikel (refereegranskat)abstract
- Nailfold capillaroscopy is one of the various noninvasive bioengineering methods used to investigate skin microcirculation. It is an effective examination for assessing microvascular changes in the peripheral circulation; hence it has a significant role for the diagnosis of Systemic sclerosis with the classic changes of giant capillaries as well as the decline in capillary density with capillary dropout. The decline in capillary density is one of microangiopathic features existing in connective tissue disease. It is detectable with nailfold capillaroscopy. This parameter is assessed by applying quantitative measurement. In this article, we reviewed a common method for calculating the capillary density and the relation between the number of capillaries as well as the existence of digital ulcers, pulmonary arterial hypertension, autoantibodies, scleroderma patterns and different scoring system.
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| 8. |
- Fatemi, Alimohammad, et al.
(författare)
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Nailfold microvascular changes in patients with systemic lupus erythematosus and their associative factors
- 2019
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 126
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to determine capillaroscopic changes in patients with systemic lupus erythematosus (SLE) and their predictors. Methods: Fifty-nine SLE patients and 31 controls were enrolled in a cross-sectional study. Nailfold capillaroscopy examinations were performed, and qualitative semi-quantitative and quantitative parameters were evaluated in all fingers. Demographic features and lupus characteristics, such as renal involvement, medications, laboratory data, disease activity (SLEDAI) and damage, were recorded. The predictors of capillaroscopic abnormalities were obtained by backward stepwise regression analysis. Results: Capillary numbers of right hands were significantly lower in patients than in controls [8.74 (1.66) vs. 9.63 (1.80), P = 0.0001]. Capillaries were wider in patients than in controls in right [56.32 pm (16.76) vs. 50.43 mu m (10.16), P = 0.002] and left hands [54.40 (15.02) vs. 49.71 (9.77), P = 0.005]. Capillaries were shorter in SLE patients than in controls. Multivariate analysis revealed that the main associative factors of microvascular abnormalities were gender, drinking tea and hydroxychloroquine use for giant capillaries, SLEDAI and low C3 for avascularity and age, lupus nephritis and corticosteroid use for ramification. Conclusion: Most nailfold capillaroscopic abnormalities were more common in SLE patients than in controls. Hydroxychloroquine, corticosteroids, SLEDAI, low complement and lupus nephritis may be the major prognostic factors for microvascular changes in SLE patients.
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| 9. |
- Hultborn, Ragnar, 1946
(författare)
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Blood flow, volume and arterio-venous passages in induced mammary tumours of the rat
- 2018
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Ingår i: Microvascular Research. - : Elsevier BV. - 0026-2862. ; 116, s. 45-49
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study blood flow, vascular volume and arterio-venous passages in induced mammary tumours of the rat to characterize parameters possibly responsible for tumour hyponutrition. Method Dimethylbenzanthracene-induced mammary tumours in Sprague-Dawley rats were studied. Regional blood flow was studied by use of the radioactive microsphere tracer technique using 141Cerium-labelled 15 μm spheres coinjected into the left cardiac ventricle with 125Iodine-labelled 25 μm spheres. Blood volume was studied by use of 125Iodine- or 99mTechnetium-labelled human serum albumin, the latter allowing autoradiography of tumour sections for visualization of flow and volume. Results Twenty-seven rats with 170 tumours had a mean tumour blood flow of 48 and 67 mL × min− 1 × 100 g− 1 using 15 and 25 μm sphere data, respectively, indicating a significant passage through vessels between 15 and 25 μm. The lungs showed a “nominal bronchial” blood flow of 260 and 135 mL × min− 1 × 100 g− 1 for the 15 and 25 μm spheres, respectively, indicating pulmonary trapping, particularly of small spheres passing the systemic circulation in vessels larger than 15 μm. There was a positive correlation between the total tumour blood flow within individual rats and trapped spheres of both dimensions in the lungs, indicating shunts also larger than 25 μm. Normal tissues disclosed only small differences in regional blood flow as measured by the two spheres. Blood volume was studied in 20 rats with 120 tumours, with a vascular volume of 3.6 mL × 100 g− 1 representing a blood turnover > 15 times/min. Blood volume co-localized with perfusion as seen in autoradiographs. Conclusion In induced rat mammary tumours, a high fraction of blood, 28%, passes arterio-venous vessels between 15 and 25 μm and there also exist passages > 25 μm. These findings indicate that the functional capacity of the tumour vascular bed might be impaired, adding to the abnormal microenvironment of tumours. © 2017 Elsevier Inc.
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| 10. |
- Ingegnoli, Francesca, et al.
(författare)
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A comparison between nailfold capillaroscopy patterns in adulthood in juvenile and adult-onset systemic sclerosis: A EUSTAR exploratory study
- 2015
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Ingår i: Microvascular Research. - : Elsevier BV. - 1095-9319 .- 0026-2862. ; 102, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database. Methods: Data collected between June 2004 and April 2013 were examined with focus on capillaroscopy. In this retrospective exploratory study, series of patients with juvenile-onset SSc were matched with series of adult-onset SSc having the same gender and autoantibody profile. Results: 30 of 123 patients with juvenile-onset and 2108 of 7133 with adult-onset SSc had data on capillaroscopy. Juvenile-onset SSc showed scleroderma pattern more frequently than adult-onset SSc (93.3% and 88%). The OR was 2.44 and 95% Cl 0.57-10.41. An active scleroderma pattern was present in 58% of juvenile- and 61% of adult-onset SSc. The OR was 0.91 and 95% Cl 0.28-2.93. The late scleroderma pattern was present in 61% of juvenile- and 55.5% of adult-onset SSc. The OR was 1.06 and 95% Cl 0.34-3.56. Conclusion: This is the first exploratory study on the comparison of capillaroscopy between juvenile- and adult-onset SSc in adulthood. Juvenile-onset SSc had an increase prevalence of sderoderma pattern, but a similar distribution of the three patterns was suggested. Further studies are needed to define this issue. (C) 2015 Elsevier Inc. All rights reserved.
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| 11. |
- Jia, Min, et al.
(författare)
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Tetrahydroxystilbene glucoside-induced relaxation of the superior mesenteric artery via both endothelium-dependent and endothelium-independent mechanisms
- 2019
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Ingår i: Microvascular Research. - : Elsevier BV. - 0026-2862. ; 123, s. 42-49
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Tidskriftsartikel (refereegranskat)abstract
- Tetrahydroxystilbene glucoside (TSG) is the main water-soluble component in Polygonum multiflorum Thunb, and it has many cardioprotective effects. Although TSG is able to relax blood vessels, its relaxation of rat superior mesenteric arteries and the underlying mechanism of this process are not clearly understood. The aim of the present study was to use in vivo and in vitro models to investigate the arterial relaxation effect of TSG on rat superior mesenteric arteries and the mechanisms involved. We found that TSG concentration-dependently relaxed the superior mesenteric artery with or without endothelium. The vasorelaxation induced by TSG is not related to the vasodilator derived factor NO but is rather by the inhibition of COX-2 activity and decreased TXA2. We also found that the vasorelaxation induced by TSG was attenuated by 4‑AP. Moreover, TSG also inhibited the contraction induced by an increase in external calcium concentration in Ca2+-free medium plus KCl (60 mM). These results suggest that TSG induces relaxation in mesenteric arterial rings through an endothelium-dependent pathway that involves the inhibition of COX-2 activity and decreased in TXA2 and through an endothelium-independent pathway via opening of a voltage-dependent K+ channel, blockade of Ca2+ influx and release of intracellular Ca2+.
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| 12. |
- Jonasson, Hanna, et al.
(författare)
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Oxygen saturation, red blood cell tissue fraction and speed resolved perfusion — A new optical method for microcirculatory assessment
- 2015
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Ingår i: Microvascular Research. - : Academic Press. - 0026-2862 .- 1095-9319. ; 102, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- We have developed a new fiber-optic system that combines diffuse reflectance spectroscopy (DRS) and laser Doppler Flowmetry (LDF) for a multi-modal assessment of the microcirculation. Quantitative data is achieved with an inverse Monte Carlo algorithm based on an individually adaptive skin model. The output parameters are calculated from the model and given in absolute units: hemoglobin oxygen saturation (%), red blood cell (RBC) tissue fraction (%), and the speed resolved RBC perfusion separated into three speed regions; 0–1 mm/s, 1–10 mm/s and above 10 mm/s (% mm/s). The aim was to explore microcirculatory parameters using the new optical method, integrating DRS and LDF in a joint skin model, during local heating of the dorsal foot and venous and arterial occlusion of the forearm in 23 healthy subjects (age 20–28 years). There were differences in the three speed regions in regard to blood flow changes due to local heating, where perfusion for high speeds increased the most. There was also a high correlation between changes in oxygenation and changes in perfusion for higher speeds. Oxygen saturation at baseline was 44% on foot, increasing to 83% at plateau after heating. The larger increase in perfusion for higher speeds than for lower speeds together with the oxygenation increase during thermal provocation, shows a local thermoregulatory blood flow in presumably arteriolar dermal vessels. In conclusion, there are improved possibilities to assess microcirculation using integrated DRS and LDF in a joint skin model by enabling both oxygenation and speed resolved blood flow assessment simultaneously and in the same skin site. Output parameters in absolute units may also yield new insights about the microcirculatory system.
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| 13. |
- Karbalaie, Abdolamir, 1970-, et al.
(författare)
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Elliptical broken line method for calculating capillary density in nailfold capillaroscopy : Proposal and evaluation
- 2017
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Ingår i: Microvascular Research. - : Academic Press. - 0026-2862 .- 1095-9319. ; 113, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Nailfold capillaroscopy is a practical method for identifying and obtaining morphological changes in capillaries which might reveal relevant information about diseases and health. Capillaroscopy is harmless, and seems simple and repeatable. However, there is lack of established guidelines and instructions for acquisition as well as the interpretation of the obtained images; which might lead to various ambiguities. In addition, assessment and interpretation of the acquired images are very subjective. In an attempt to overcome some of these problems, in this study a new modified technique for assessment of nailfold capillary density is introduced. The new method is named elliptic broken line (EBL) which is an extension of the two previously known methods by defining clear criteria for finding the apex of capillaries in different scenarios by using a fitted elliptic. A graphical user interface (GUI) is developed for pre-processing, manual assessment of capillary apexes and automatic correction of selected apexes based on 90° rule. Intra- and inter-observer reliability of EBL and corrected EBL is evaluated in this study. Four independent observers familiar with capillaroscopy performed the assessment for 200 nailfold videocapillaroscopy images, form healthy subject and systemic lupus erythematosus patients, in two different sessions. The results show elevation from moderate (ICC = 0.691) and good (ICC = 0.753) agreements to good (ICC = 0.750) and good (ICC = 0.801) for intra- and inter-observer reliability after automatic correction of EBL. This clearly shows the potential of this method to improve the reliability and repeatability of assessment which motivates us for further development of automatic tool for EBL method.
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| 14. |
- Karbalaie, Abdolamir, 1975-, et al.
(författare)
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Image Enhancement Effect on Inter and Intra-observer Reliability of Nailfold Capillary Assessment
- 2018
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Ingår i: Microvascular Research. - : Elsevier. - 0026-2862 .- 1095-9319.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nailfold capillaroscopy (NC) is a diagnostic imaging technique that is used to assess the blood capillary network in the nailfold area. NC is routinely used for patients with microcirculation problems, such as systemic sclerosis and other connective tissue diseases. Experts commonly use subjective evaluation as a reference point in images of nailfold video capillaroscopy, so it is important to reduce the inherent ambiguities in human judgment and diagnosis. Image quality is an important factor that affects measurement error and assessment time of NC images.Objective: In this study, a new image enhancement technique was introduced and evaluated subjectively.Methods: In total, 475 nailfold video capillaroscopy images from 18 healthy subjects and 41 systemic lupus erythematosus patients were used. The images were randomly divided into two sets, one each with 275 and 200. Eight independent observers who were familiar with the capillaroscopy technique participated in this study. The set of 275 images was evaluated by three observers with the forced–choice pairwise comparison method. Elliptic broken line (EBL) was used to count the number of capillaries. The intra- and inter-observer reliability of the original and enhanced images was evaluated on 200 images by five observers.Result: Except for eight images, all observers preferred the enhanced images in the visual quality comparison method. The intra-class correlation coefficient (ICC) of intra- and inter-observer reliability increased from 0.76-0.84 to 0.82-0.89, respectively, when using the enhancement method.Conclusion: By improving the image quality, more capillary details will be visible, and an observer can document more details that may not be visible in the original image and can do so more efficiently.
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| 15. |
- Mirdell, Robin, et al.
(författare)
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The presence of synchronized perfusion dips in the microcirculation of the resting nail bed
- 2019
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 121, s. 71-81
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Laser speckle contrast imaging (LSCI) has seen limited use in the study of perfusion dynamics such as vasomotion. The aim of this study was to investigate the effects of a prolonged seated position on perfusion dynamics in the nail bed using LSCI. Methods: Perfusion was recorded in digits II to IV bilaterally for 20 min during two separate sessions in ten healthy volunteers. The acclimatization period was 5 min for the 1st session and 20 min for the 2nd. Perfusion variability and the presence of recurring perfusion dips were analyzed. A digital nerve block was done to verify suspected nervous origin of phenomenon. Results: Synchronized phases of vasoconstriction were observed in all subjects with perfusion dips in all digits bilaterally and simultaneously. Application of a digital nerve block abolished perfusion dips. The frequency of this phenomenon increased by 25.0% (95% CI: 1.6 to 49.2%) in the left-hand digits after a prolonged seated position. Perfusion variability increased by 11.6% (95% CI: 2.6 to 20.3%) in the digits of the left hand. Perfusion changes in right-hand digits did not significantly increase. During the 1st session, temperature increased by 2.7 degrees C (1.1 to 4.2) while it decreased by 1.3 degrees C (0.2 to 2.4) during the 2nd session. Conclusion: The observed perfusion dips are of a centrally mediated nervous origin but are also affected by local factors. They are affected by seating duration and differ between left and right hands, likely because of local micro perfusion dips. This phenomenon seems related to digital thermoregulation.
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| 16. |
- Sheikh, Rafi, et al.
(författare)
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Hypoperfusion following the injection of epinephrine in human forearm skin can be measured by RGB analysis but not with laser speckle contrast imaging
- 2019
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Ingår i: Microvascular Research. - : Elsevier BV. - 0026-2862. ; 121, s. 7-13
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe time taken for epinephrine to achieve its optimal effect during local anesthesia has recently become the subject of debate. The time from injection to commencement of surgery is traditionally quoted to be 7 to 10 min, while recent reports claim that it may take 30 min to achieve maximum hypoperfusion, which would prolong the time required for surgical procedures. The discrepancy may be related to difficulties associated with the techniques used to measure blood perfusion. The aim of this study was to test two methods of determining the time to maximum hypoperfusion.MethodsLaser speckle contrast imaging (LSCI) and red, green, blue (RGB) analysis of images obtained with a commercial digital camera, were used to monitor the effect of infiltration with commonly used local anesthetic preparations: lidocaine (20 mg/ml) + epinephrine (12.5 μg/ml), lidocaine (10 mg/ml) + epinephrine (5 μg/ml), and lidocaine (20 mg/ml) alone, in healthy subjects.ResultsLSCI showed a paradoxical increase in signal after the injection of local anesthetics containing epinephrine, probably due to a change in the laser penetration depth resulting from blanching of the skin. However, RGB analysis of digital photographs gave more reliable results, showing skin blanching that corresponded to the expected effect of epinephrine in local anesthetics. The time to maximum effect was found to be 7 (range 5–10) minutes for 12.5 μg/ml epinephrine, and 9 (range 7–13) minutes for 5 μg/ml epinephrine in lidocaine.ConclusionsRGB analysis of digital images proved to be a valid technique for monitoring the effect of local anesthetics with epinephrine in human skin. The technique requires only a commercial digital camera and constitutes a cheap, simple method. The optimal delay between epinephrine injection and incision, to minimize bleeding, was found to be 7 to 9 min, which is in good agreement with common surgical practice.
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| 17. |
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| 18. |
- Strömberg, Tomas, et al.
(författare)
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Temporal and spatiotemporal variability in comprehensive forearm skin microcirculation assessment during occlusion protocols
- 2017
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 113, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Forearm skin hyperemia during release after brachial occlusion has been proposed for evaluating peripheral arterial disease and endothelial dysfunction. We used a novel fiberoptic system integrating Laser Doppler Flowmetry and Diffuse Reflectance Spectroscopy for a comprehensive pointwise model based microcirculation characterization. The aim was to evaluate and compare the temporal and the spatiotemporal variabilities in forearm skin microcirculation parameters (speed resolved perfusion; low speed amp;lt; 1 mm/s, Perf(SR),(amp;lt; 1); mid-speed 1-10 mm/s, high speed amp;gt; 10 mm/s, and total perfusion (Perf(SR),(tot)); the concentration and oxygenation of red blood cells, C-RBC and S-O2). Ten healthy subjects underwent arterial and venous forearm occlusions (AO, VO), repeated within one week. The repeatability was calculated as the coefficient of variation (CV) and the agreement as the intra-class correlation co-efficient (ICC). The temporal CVs for conventional perfusion, Perf(conv), Perf(SR),(tot), C-RBC and S-O2 were 14%, 12%, 9% and 9%, respectively, while the ICC were amp;gt; 0.75 (excellent). The perfusion measures generally had a higher spatiotemporal than temporal variability, which was not the case for S-O2 and C-RBC. The corresponding spatiotemporal CVs were 33%, 32%, 18% and 15%, respectively. During VO, C-RBC had a CV amp;lt; 35% and ICC amp;gt; 0.40 (fair-good), and after release this was the case for C-RBC (AO and VO), S-O2 (VO) and Perf(SR), (amp;lt; 1) (VO). In conclusion, the skin microcirculation parameters showed excellent temporal repeatability, while the spatiotemporal repeatability especially for perfusion was poorer. The parameters with acceptable repeatability and fair-good agreement were: C-RBC during and after release of VO, the Perf(SR), (amp;lt; 1) after release of VO, the S-O2 and the C-RBC after release of AO. However, the value of these parameters in discriminating endothelial function remains to be studied. (C) 2017 Elsevier Inc. All rights reserved.
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| 19. |
- Tesselaar, Erik, 1977-, et al.
(författare)
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Acute effects of coffee on skin blood flow and microvascular function
- 2017
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Ingår i: Microvascular Research. - : Academic Press. - 0026-2862 .- 1095-9319. ; 114, s. 58-64
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveStudies on the acute effects of coffee on the microcirculation have shown contradicting results. This study aimed to investigate if intake of caffeine-containing coffee changes blood flow and microvascular reactivity in the skin.MethodsWe measured acute changes in cutaneous vascular conductance (CVC) in the forearm and the tip of the finger, the microvascular response to transdermaliontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) and post-occlusive reactive hyperemia (PORH) in the skin, after intake of caffeinated or decaffeinated coffee.ResultsVasodilatation during iontophoresis of ACh was significantly stronger after intake of caffeinated coffee compared to after intake of decaffeinated coffee (1.26 ± 0.20 PU/mm Hg vs. 1.13 ± 0.38 PU/mm Hg, P < 0.001). Forearm CVC before and after PORH were not affected by caffeinated and decaffeinated coffee. After intake of caffeinated coffee, a more pronounced decrease in CVC in the fingertip was observed compared to after intake of decaffeinated coffee (− 1.36 PU/mm Hg vs. − 0.52 PU/mm Hg, P = 0.002).ConclusionsCaffeine, as ingested by drinking caffeinated coffee acutely improves endothelium-dependent microvascular responses in the forearm skin, while endothelium-independent responses to PORH and SNP iontophoresis are not affected. Blood flow in the fingertip decreases markedly during the first hour after drinking caffeinated coffee compared to decaffeinated coffee.
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