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Contact scrotal thermography: application to problems of infertility.

Traditionally, studies on the relationship between scrotal or testicular temperature and infertility have concerned patients with varicoceles. However, some varicoceles are difficult to palpate and, in fact, there now appears to be an entity called subclinical varicocele. These data have led to the development of a new diagnostic tool, a contact thermography camera, which is inexpensive in comparison to infrared thermography units, is portable and provides consistent permanent recordings of scrotal temperature. The initial use of this camera in 30 patients seen in an infertility clinic is reported.

Body Temperature↗

The combination of liquid crystal thermography and duplex scanning in the diagnosis of deep vein thrombosis.

One hundred patients with clinically suspected deep vein thrombosis (DVT) were studied by liquid crystal thermography (LCT), duplex scanning and venography. Liquid crystal thermography was found to have a negative predictive value of 97% if performed within 1 week of the onset of symptoms. Duplex scanning had a sensitivity of 93% and specificity of 91% for all thrombi (proximal and calf). On the basis of these results a plan of investigation has been formulated that would avoid duplex scanning and venography in 39 of the 100 patients. Duplex scanning alone would be appropriate in 56 of the remaining 61 patients. Only six patients would be unsuitable for duplex scanning because of a very tense tender leg and require venography. The plan would miss one calf thrombus and result in treating three patients unnecessarily. This policy would be not only effective but also cost-effective.

Female↗

Electronic thermography for the assessment of inferior alveolar nerve deficit.

Neurosensory deficit is one of the major complications encountered in oral and maxillofacial surgery. OBJECTIVES. To determine the efficacy of electronic thermography in objectively assessing neurosensory deficits of the inferior alveolar nerve. STUDY DESIGN. Three studies were conducted measuring skin temperature over the chin region of the face at 0.1 degree C accuracy. RESULTS. (1) Thermal symmetry of the chin region in normal subjects (delta T = 0.2 degree C, SD = 0.02 degree C); (2) Induction of transient thermal asymmetry by local anesthetic injection (delta T = +0.4 degree C, SD = 0.2 degree C); (3) nine subjects with neurologic alterations of the inferior alveolar nerve (delta T = +0.5 degree C, SD = 0.2 degree C). Statistically significant differences were found between control group and experimental groups at p < 0.001 with the use of the Student's t test. CONCLUSIONS. These studies indicate that electronic thermography is capable of detecting sensory changes caused by inferior alveolar nerve injury or by pharmacologic nerve block.

Adult↗

The assessment of trapezius muscle symptoms of patients with temporomandibular disorders by the use of liquid crystal thermography.

OBJECTIVE: To test the hypothesis that neuromuscular symptoms of patients with temporomandibular disorders that occur in the upper back and neck can be evaluated by recording the temperature patterns in the skin overlying the muscles. STUDY DESIGN: Liquid crystal contact thermography was evaluated on patients with temporomandibular disorders to demonstrate temperature changes in the muscles of the neck and upper back. The study consisted of 22 patients with temporomandibular disorders and 22 normal controls. RESULTS: The mean right-versus-left-side temperature difference of the control group was 0.13 degree C whereas the patient group showed a difference of 0.78 degree C. Of the 22 patients with temporomandibular disorders, 21 (95.5%) showed an increased temperature over the trapezius muscle on the symptomatic side. CONCLUSIONS: These findings indicate that thermography may be useful in the diagnosis of myofascial symptoms that may be associated with temporomandibular disorders.

Adult↗

Computerized thermography. The emergence of a new diagnostic imaging modality.

Medical thermology is a relatively new diagnostic imaging modality that is based on thermography and has just recently gained acceptance by the medical community at large. In fact, the first comprehensive book on thermology appeared in press just a few months ago (2). Thermography is the recording and displaying of images that depict the distribution of temperature on the skin surface of patients. Thermology is the systematic interpretation of clinical thermograms. The leading thermographic technique is now based on remote infrared sensing. using digitizing techniques and microcomputers, the images can be processed to facilitate better thermological interpretation. This paper presents a brief account of the evolvement of this imaging modality, its current technology and medical uses, and its potential to become a major diagnostic tool in a large number of clinical situations. Finally, we will attempt to assess the overall role and place of thermology in medicine while also pointing out the need for fundamental thermological research to support the current empirical diagnostic applications.

Computers↗

Arterial wall thermography.

An atherosclerotic plaque is considered vulnerable when it is at higher risk of inducing acute cardiac events. The early detection and follow-up of the vulnerable plaque are crucial to prevent these events from happening. To date there are no proven techniques to detect such a plaque. Arterial wall thermography, tracing the heat signature of the activated macrophages, is a new and promising method in this direction. However, the difficulties of applying such a method in vivo should not be neglected. Current science proposes several potential thermographic methods. They can be generally categorized as noninvasive and invasive. Magnetic resonance thermometry (MRT) is the most important noninvasive method. It is novel, accurate, and reproducible, but is unfortunately hampered by resolution limitations due to the size and motion of the target vessels. The "infrared" and the "contact-sensor" are the most important invasive thermographic methods. Mainly due to the difficulties of infrared radiation in penetrating the flowing blood, the contact thermographic methods seem to be the most feasible at present. The superiority of thermal mapping of the arterial wall versus the localized temperature measurements is clear. The use of multiple thermal sensors arranged around the vessel's circumference and the application of motorized catheter pullback, not only ensure a large area of coverage, but also enable us to build thermal maps and vascular thermoanatomical reconstructions by using modern computer technology. It is expected that arterial thermography will undoubtedly initiate debate, mainly concerning the most appropriate therapy for the vulnerable plaque. Data collection and correct interpretation are expected to lead us into making wise decisions.

Arteries↗

Role of thermography in the assessment of infraorbital nerve injury after malar fractures.

We studied 45 patients with malar fractures who had some degree of infraorbital nerve deficit. Thermographic facial images failed to show any substantial changes in the temperature profiles of the affected and the normal control sides in relation to reco very of their facial sensation. Although some patients who had thermography on the day of injury showed significant temperature differences between the affected and the normal sides, these differences were probably the result of the acute inflammatory ch anges caused by the injury. We suggest that infrared thermography has little place in the assessment of infraorbital nerve deficits.

Adolescent↗

Thermography in the diagnosis of headache.

We reviewed thermograms of 993 suitable patients with migraine with and without aura, chronic daily headache, cluster headache, posttraumatic headache, and a variety of other headache types. Eight hundred fifty-five (86.1%) had abnormal thermograms usually characterized by decreased supraorbital thermal emission. Six hundred ninety-four (69.9%) of 993 had migraine without aura of whom 593 (85.4%) had abnormal thermograms. Two hundred two (20.3%) of 993 had migraine with aura, of whom 180 (89.1%) had abnormal thermograms. Thirty of 35 (85.7%) patients with cluster headache, and 28 of 33 (84.8%) with posttraumatic headache had abnormal thermograms. Twenty-four of 29 (82.8%) of patients with various less common headaches and head pain syndromes had abnormal thermography. Previous studies have indicated that about 67 to 84% of patients with migraine have abnormal thermograms. Some reports have indicated fewer have thermal asymmetries in migraine without aura, and even fewer with "mixed or muscle contraction" headaches. Our study indicates a somewhat greater number of headache patients have abnormal thermograms than has generally been reported. We conclude digital infrared thermography is a useful diagnostic test in the management of headaches.

Adolescent↗

[Thermography in osteosyntheses and total endoprostheses of the knee joint with and without infection (author's transl)].

Thermography supplies information on the radiation temperature and hence on the blood supply in the body surface area. Together with the clinical findings this can contribute towards the recognition and recording of infections. During the normal course of a cure following osteosynthesis, the radiation temperature rose moderately up to +2 C degrees and returned to normal after 4 to 6 weeks. In case of infections, however, hyperthermia was very pronounced. Hyperthermia did not rise above +2 degrees C in case of mechanical loosening of an alloarthroplastic knee joint substitute. However, in infections temperature rises up to +44 degrees C were seen. Hence, thermography can supply additional pointers for further therapeutic approach.

Fracture Fixation, Internal↗

Thermography in a child with varicocele.

A 12-year-old boy with a left-sided varicocele (Grade 3) was assessed preoperatively and followed postoperatively by computer-assisted infrared thermography. The temperature of the left scrotum was 35.4 degrees C before surgery which was 4 degrees C higher than that of the right scrotum. After ligation of the left internal spermatic vein and removal of the varicocele, scrotal thermograms 39 days and 12 months after operation were normal. Therefore, it seems that thermography is very valuable in the evaluation of testicular function in children with varicocele, in whom semen analysis is impossible.

Child↗

MR imaging and thermography of facial angioedema: a case report.

Magnetic resonance imaging and thermography were performed in a 67-year-old man with idiopathic facial angioedema. Thermography suggested decreased heat emission in the region of the angioedema. Magnetic resonance imaging revealed diffuse high intensity in the subcutaneous interstitial tissue and dilated veins on T2-weighted images. Marked contrast enhancement was noted in the subcutaneous tissue on postcontrast T1-weighted images.

Aged↗

Computerized breast thermography: study of image segmentation and temperature cyclic variations.

Breast cancer is a common and dreadful disease in women. The surface temperature and the vascularization pattern of the breast could indicate breast diseases. Establishing the surface isotherm pattern of the breast and the normal range of cyclic variations of temperature distribution can assist in identifying the abnormal infrared images of diseased breasts. This paper investigates the cyclic variation of temperature and vascularization of the normal breast thermograms under a controlled environment. More than 50 Asian women, were examined and some of them have been examined continuously for two month. All together, not less than 800 thermograms were obtained. Before these thermograms can be analysed objectively via a computer algorithm, they must be digitized and segmented. The authors present a method to segment thermograms and extract the useful region from the background. After the image processing, these thermograms can be analysed and then the best time to perform an examination can be chosen. All these results are important for establishing a data bank of normal breast thermography, to choose the best time for an examination and as a systematic methodology for evaluating and analysing the abnormal breast thermography in the future.

Adult↗

Statistical analysis of healthy and malignant breast thermography.

Analysis of thermograms has often been subjective and has resulted in inconsistency in the diagnosis of breast diseases by thermography. The aim of this paper is to study the problem of subjective interpretation of breast thermograms and hence using thermography as an adjunct tool for breast cancer diagnosis. It ws proposed that the thermograms should be taken within the recommended screening period, classified and analysed in conjunction with an artificial neural network (ANN). Qualitative interpretation of thermal images can be carried out using an active contours algorithm. The 256 x 200 pixel image can be segmented as one of the inputs to the ANN. To achieve quantitative analysis of the breast thermograms, firstly the inputs of the ANN should be determined, so that the thermograms could be successfuly classified and based on the suggested inputs.

Body Temperature↗

FPA-based infrared thermography as applied to the study of cutaneous perspiration and stimulated vascular response in humans.

This review gives an overview of focal plane array (FPA)-based infrared (IR) thermography as a powerful research method in the field of physiology and medicine. Comparison of the gained results with the data previously obtained by other authors with other research tools is given. Outer thermoregulatory manifestations displayed by the human organism subjected to whole-body heating (sauna bath) and physical loads (exercise bicycling) are quantitatively analysed. Some details of human body emotional sweating (psycho-physiological effect) are reported. Particular attention is paid to studying active sweat glands as individual objects. All experimental data were obtained with the help of a high-sensitivity (0.03 degrees C) fast 128 x 128 InAs IR detector-based thermal imaging system operating in the short-wave spectral region (2.5 to 3 microm) and perfectly suiting medical purposes. It is shown that IR thermography makes it possible to overcome limitations inherent to contact measuring means that were traditionally used before in thermal studies. It is also shown that heterogeneous thermograms displayed by organisms with disturbed inner equilibrium can be quantitatively analysed in terms of statistical parameters of related surface-temperature histograms, such as the mean temperature and the standard deviation of temperature (SDT). The increase and the decrease in SDT turned out to be typical of prolonged physical load and subsequent relaxation, and of external whole-body heating, respectively. Explanation of this result based on a hypothesis advanced within the context of the doctrine of human-organism evolution is given. Skin-temperature distribution function accompanying the relaxed organism in normality was found to closely resemble normal-distribution function. Symmetry break down and variation of the shape of this characteristic may serve as an indicator of homeostasis shift and can be used as a quantitative criterion for the latter. A new phenomenon, stable punctate hidrosis, is discovered and described. The term sweatology is introduced to refer to the discussed specific research area in biomedical science.

Body Temperature↗

Estimation of coronary blood flow by ECG gated cardiac thermography in open-chest conditions.

Thermography is suggested as a tool to estimate myocardial and coronary epicardial flow in open-chest heart surgery. To test the feasibility and compare various methods for coronary flow estimation in open-chest surgery, thermographic imaging was applied to eight open-chest dogs which were injected with cold saline into the aortic root. Blood flow in the left arterial descending (LAD) coronary vessel was measured by a transit-time flowmeter. ECG gated images were acquired for 20-30 s, while the cold saline (20 ml) was injected into the aortic root. Several flow levels were achieved during repeated hyperaemic response to transient occlusions of the LAD. A temperature response curve for each flow level was obtained by averaging over an edge-detected arterial segment for each image frame. Several indices were calculated from the temperature curve and correlated with the measured coronary flow. These include: an index based on a corrective heat transfer model (r = 0.69, p < 0.001), the slope of the descending part of the response curve (r = 0.76, p < 0.001), the peak temperature difference (r = 0.66, p < 0.001), and the area above the temperature response curve (r = 0.61, p < 0.01). As shown, coronary flow can be estimated quantitatively by intraoperative epicardial thermography, and may therefore provide important on-line information regarding blood flow during open-chest surgical procedures. Further studies are required for optimal application of this technique so as to increase its potential as a valid clinical tool.

Animals↗

Thermography used for analysis and comparison of different cataract surgery procedures based on phacoemulsification.

Thermography has been employed to analyze and compare three cataract surgery procedures performed in vivo with phacoemulsification, namely, the Sovereign phacoemulsification system with a traditional technique, the Sovereign WhiteStar phacoemulsification system with a traditional technique and the Sovereign WhiteStar phacoemulsification system with a bimanual technique. During the entire surgical procedure, the temperature of the ocular surface was monitored. The temperature values in the area where the phaco probe was inserted in the eye were measured, and the quantities of heat transmitted to the eye in the different procedures were assessed through suitable indices. In this study the highest temperature measured for each procedure during the surgical operation was 44.9 degrees C for the Sovereign phacoemulsification system with a traditional technique, 41 degrees C for the Sovereign WhiteStar phacoemulsification system with a traditional technique and 39.5 degrees C for the Sovereign WhiteStar phacoemulsification system with a bimanual technique, which is also the surgical procedure having the lowest thermal impact on the eye, i.e., the one in which the temperature peaks are lowest in amplitude and the least amount of heat is transmitted to the eye. Thermography, used in this study as a temperature monitoring instrument, has allowed analysis to be effected through a useful and advantageous methodology, totally non-invasive as regards both surgeon and patient, and has been applied in vivo without requiring any change in the surgical procedure.

Algorithms↗

Thermography as a predictor of sacral pressure sores.

Ninety-one patients admitted to a geriatric unit with apparently undamaged sacral skin were examined by thermography. Nineteen per cent showed a thermal pattern consistent with occult skin damage, and 35% of these developed an overt pressure sore at the thermographically abnormal site within 10 days of admission. None of the remaining patients developed a sore within this time. Thermography can provide a more precise indication of the risk of early development of a sacral pressure sore than the Norton score.

Aged↗