Mucosal reactivity of the intestinal allograft during acute rejection.
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Acute Disease↗
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Results for “Laser-Doppler Flowmetry”
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Comparative effects of exposure to different light sources (He-Ne laser, InGaAl diode laser, a specific type of noncoherent LED) on skin blood flow for the head.
BACKGROUND AND OBJECTIVE: This study assessed the effects of optic stimuli emitted by three different light sources on head skin blood flow. MATERIALS AND METHODS: The irradiation effects of the He-Ne laser (632.8 nm, 10 mW, total energy appr. 9.4 J), the InGaAl diode laser (670 nm, 60 mW, appr. 108 J) and monochromatic light (635 nm, 112.5 mW, appr. 202.5 J) were measured using laser Doppler technology. The corresponding fluences (energy densities) varied from 0.01 J/cm2 (He-Ne) to a range of 0.12-0.72 J/cm2 (InGaAl) and 0.22-1.36 J/cm2 (LED). The investigation was completed under single-blind, placebo-controlled conditions where the subjects (10 male healthy volunteers) were exposed on two occasions to the placebo (LED)-device against the laser (He-Ne or InGaAl). RESULTS: A short lasting vasodilation, a 54 per cent increase (p < 0.05) in skin blood flow was seen after the InGaAl irradiation (fluences between 0.12-0.36 J/cm2) whereas the non-coherent monochromatic irradiation (0.68-1.36 J/cm2) used in this particular study decreased blood flow by 36 per cent (p < 0.05). The He-Ne irradiation (0.01 J/cm2) had no effect. Skin temperature changes were insignificant. CONCLUSIONS: Skin blood flow changes seemed to be related more on radiant exposures then coherency.
Adult↗
The effect of aminophylline on pharmacological stress with intravenous adenosine.
Myocardial perfusion imaging with adenosine pharmacological stress may be useful in patients with obstructive lung disease who are unable to exercise. However, these patients are often treated with medications containing theophylline, which is an adenosine antagonist. This study assessed the effect of aminophylline on coronary vasodilation produced by intravenous adenosine as commonly used during cardiac imaging. Changes in coronary flow velocity (measured by intracoronary Doppler catheter) heart rate, arterial pressure and changes in coronary resistance were measured during intravenous infusion of adenosine at 140 micrograms/kg/min before and after aminophylline, 6 mg/kg intravenously in 12 patients. After aminophylline infusion, the theophylline level averaged 14 +/- 1 microgram/mL. The coronary hemodynamic effects of adenosine were markedly attenuated by aminophylline. Adenosine increased coronary blood flow velocity by 192 +/- 39% at control and 78 +/- 16% after aminophylline (P < .05 v control). Adenosine produced a 63 +/- 5% decrease in coronary vascular resistance at control and 40 +/- 6% (P < .05) after aminophylline. The utility of myocardial imaging techniques using coronary vasodilation with intravenous adenosine may be reduced in patients treated with theophylline-containing preparations.
Adenosine↗
Left ventricular cavitary geometry and dynamic intracavitary left ventricular obstruction during dobutamine stress echocardiography.
To investigate the relationship between left ventricular cavity geometry and dynamic intracavitary left ventricular obstruction occurring during dobutamine stress echocardiography, we evaluated 44 patients who underwent dobutamine stress echocardiography. Dynamic intracavitary left ventricular obstruction appeared in 10 (23%) patients (Group 1), and was absent in the remaining 34 patients (Group 2), during dobutamine stress echocardiography. The ratio of the apicalto-narrowest mid-left ventricular minor-axis dimension (D1/D2), as an index of the left ventricular cavitary geometry, was measured in the baseline two dimensional apical long-axis view. The left ventricular out-flow blood Doppler velocity was measured in the apical long-axis or five-chamber view at each stage during dobutamine infusion. Left ventricular end-systolic dimension was smaller (21 +/- 4 mm v 29 +/- 6 mm; p< .01), percent fractional shortening of the left ventricle was greater (51 +/- 4% v 39 +/- 8%, P>.01), and D1/D2 was greater (1.13 +/- 0.08 v.0.96 +/- 0.09; p < .0001) in Group 1 than in Group 2 in the baseline echocardiogram. Maximal out flow blood Doppler velocity during dobutamine infusion correlated moderately with percent fractional shortening of the left ventricle (r = .53; P < .01) and D1/D2 (r = .60; P < .0001). Dynamic intracavitary left ventricular obstruction, defined as an elevated intracavitary Doppler flow velocity with late-systolic peaking, was not related to the presence of left ventricular hypertrophy or the development of hypotension during dobutamine infusion. We conclude that dynamic left ventricular intracavitary obstruction during dobutamine infusion is associated with a characteristic (narrower-waisted) left ventricular cavitary geometry and increased contractility.
Adult↗
Laser Doppler vibrometer (LDV)--a new clinical tool for the otologist.
We describe a laser Doppler system (LDS) that can be used clinically for the measurement of tympanic membrane (TM), malleus and prosthesis head displacement in response to sound inputs of 80-to 100-dB sound-pressure level (SPL). It also has the potential for use in the operating room to perform measurements of prosthesis and stapes displacement. The information provided by such testing gives the otologist knowledge of TM and ossicular function that is unique in evaluating middle ear function; it should help select the best type of reconstruction in a given case and direct us toward new and better methods of TM and ossicular reconstruction. The results of umbo displacement measurements in 95 human ears are reported. Examples are provided of LDS measurements in representative ears and how they can be of help to the clinician. The potential of multisite TM-displacement testing is demonstrated in two temporal bones, including before and after partial ossicular replacement prosthesis (PORP) insertion.
Audiometry, Pure-Tone↗
[Effects of beta-adrenergic blockers on retinal circulation].
We evaluated the effects of 0.5% betaxolol hydrochloride and 0.5% timolol maleate on retinal blood flow. We measured the diameter of the retinal artery (Da) and vein (Dv), and retinal venous blood flow rate (V) in 8 healthy young volunteers by laser speckle velocimetry before and after the application of betaxolol or timolol topically to both eyes daily for one week. There were no any significant changes. Da before and after the application of betaxolol was 114.2 +/- 6.3 (mean +/- standard deviation) microns and 115.6 +/- 6.7 microns and before and after the application of timolol, 117.5 +/- 12.7 microns and 101.3 +/- 9.5 microns. Dv before and after the application of betaxolol was 149.5 +/- 11.1 microns and 148.4 +/- 13.3 microns, and before and after the application of timolol 148.5 +/- 9.2 microns and 146.2 +/- 10.3 microns. V before and after the application of timolol was 12.3 +/- 2.6 mm/s and 12.6 +/- 2.4 mm/s, and before and after the application of betaxolol, 11.6 +/- 1.5 mm/s and 11.4 +/- 2.1 mm/s. Thus one-week application of the beta-blockers, betaxolol and timolol did not change the retinal arterial or venous blood flow.
Adolescent↗
Age-related changes in gastric blood flow in rats.
The present study was designed to examine the influence of aging on the gastric blood flow, a major mucosal protective mechanism against experimental gastric mucosal injury, basally and after treatment with acid, a known stimulant of gastric blood flow. Our data demonstrated that aging was associated with a significant decline in basal gastric blood flow (both mucosal and serosal). However, there were no significant differences in acid-induced increases in gastric blood flow between the young and aged animals. These findings suggest that aging is associated with selective and specific reductions in mucosal protective mechanisms that may predispose aged animals to gastric mucosal injury.
Aging↗
The accuracy of magnetic resonance phase velocity measurements in stenotic flow.
Nuclear magnetic resonance (MR) can be used to measure velocities in fluid flow using the technique of phase velocity mapping. Advantages of MR velocimetry include the simultaneous mapping of the entire flow field through a non-contacting, magnetic window. The phase velocity mapping technique assumes that velocity is constant over the measurement time (typically around 10 ms). For many fluid flows, this assumption is not valid. The current study showed that MR phase velocity measurements of velocity through stenotic flow can be in error by over 100% immediately upstream and downstream of the stenosis throat and by 20% far downstream of the throat in comparison with laser Doppler anemometer measurements taken at the same location. Highly turbulent flow also led to significant errors in velocity measurement. These errors can be attributed to several sources including low signal-to-noise ratio, additional phase shifts due to non-constant velocities, and non-stationary transit-time effects. Velocity measurement errors could be reduced to under 30% at all measurement locations through the use of MR sequences with high signal-to-noise ratios, low echo times, and thick slices.
Arterial Occlusive Diseases↗
Lasers in dentistry: a review. Part 2: Diagnosis, treatment and research.
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Dental Caries↗
A microstructural flow analysis within a bileaflet mechanical heart valve hinge.
BACKGROUND AND AIMS OF THE STUDY: During recent clinical trials, the Medtronic Parallel bileaflet heart valve was found to have an unacceptable thrombosis complication rate. As patient- and material-related factors proved negative causes for this outcome, it was hypothesized that the flow fields within the valve's hinge pocket contributed to the thrombus formation. METHODS: A microstructural flow analysis within the hinge pocket is presented which uses the techniques of flow visualization, computational fluid dynamics (CFD), and laser Doppler velocimetry (LDV). The application of these techniques towards solving this problem has become possible through (i) the ability to manufacture dimensionally correct 1-X transparent heart valve housings, (ii) advances in CFD technology, and (iii) advances in LDV measurement techniques. RESULTS: This analysis showed that a vortex was present at the hinge pocket's inflow channel during forward flow and degenerated to a disturbed three-dimensional structure during reverse flow with zones of turbulent shear stress large enough to cause blood cell damage. In addition, multiple zones of flow stagnation and disturbed flow existed along the leaflet's pivot throughout the entire cardiac cycle. It was felt that these complex fluid structures created conditions which resulted in the formation of thrombus within the hinges of the Medtronic Parallel valve. These findings were supported by limited clinical explant data which illustrated early thrombus formation within the Parallel valve's hinge pocket at sites predicted by the analysis. CONCLUSIONS: This study provides, for the first time, an understanding of the detailed flow structures within the hinges of a mechanical heart valve and demonstrates an analysis technique by which future mechanical heart valve designs may be assessed for the potential of thrombus formation within the valve's hinge regions.
Computer Simulation↗
Influence of healing on the disturbed blood flow regulation in venous ulcers.
Cutaneous blood flow regulation is disturbed in severe chronic venous insufficiency (CVI). The feedback system between the transmural pressure in the postcapillary venules and the precapillary resistance regulating arterioles has gone awry. The upregulated control system causes "luxus"-hyperperfusion. In this study laser Doppler fluxmetry was performed in 6 patients' florid venous ulcers (U) and later in the former ulcer area after healing (H) and in the inner ankle area of 12 healthy volunteers (C). Laser Doppler flux (LDF) changes were measured with the leg elevated and lowered as well as after arterial and during venous occlusion. The results proved a diminished (p < 0.01) flux increase with the leg elevated (U: LDF = -9%, H: LDF = 3.1%, C: LDF = 80%) and after arterial occlusion (U: LDF = 1.3%, H: LDF = 0%; C: 189.6%) in severe CVI both in florid ulcers and after healing. The ability to reduce flux when transmural pressures were increased remained. Leg lowering reduced flux by 46.4% in ulcers and by 36.8% after healing. This postural response to high transmural pressures, however, seemed weakened compared to controls, where LDF decreased by 65.8%. Our findings suggest that the postural feedback system remains disturbed and upregulated even after a venous ulcer has healed.
Adult↗
[Influence of hemodialysis on changes in cerebral artery blood flow velocity in patients with chronic renal failure].
The effect of hemodialysis on the cerebral circulation have been inadequately studied. Because of repeatability, safety and non-invasiveness transcranial Doppler sonography is well suited for evaluation of cerebral circulation and for estimation of cerebral blood flow during hemodialysis as well. The aim of our study was to find out whether hemodialysis affects the velocity of blood flow in extra- and intracranial arteries and in what way. 41 patients aged 18-71 (mean 43.9 +/- 13) years suffering from chronic renal failure made up the investigation group. We investigated 17 men and 24 women. Doppler examination was done to each dialized patient immediately before and then 120 and 240 minutes after the onset of hemodialysis. We used pulsed wave Doppler (TC2-64B, EME). Mean blood flow velocities were obtained from extracranial (CCA, ICA, ECA) and intracranial vessels (MCA, ACA, PCA). Simultaneously the series of biochemical blood parameters and arterial blood pressure were monitored. On the basis of investigation results the following conclusion have been drawn: Hemodialysis significantly affects on changes of blood flow velocities in extra-an intracranial arteries. Above mentioned changes consist in decrease of blood flow velocity in both CCA, left ICA, both MCA and PCA and right ACA.
Adolescent↗
Multimodal monitoring and assessment of cerebral haemodynamic reserve after severe head injury.
This article contains an overview of selected clinical techniques employed for neurointensive care monitoring and testing of cerebral autoregulation of patients following severe head injury. Multiple modalities are used for monitoring of cerebral haemodynamic reserve, including intracranial pressure, cerebral perfusion pressure (CPP), blood flow velocity (FV) in the middle cerebral artery (MCA), jugular bulb oxygen saturation, laser-Doppler cortical flowmetry, near infrared spectroscopy of cerebral cortex, tissue oxygenation, and microdialysis. Large volumes of information demand specialised computer support for sensible interpretation and filtration of artifacts. Methods of testing of cerebral autoregulatory reserve based on transcranial Doppler ultrasonography are reviewed. Repetitive or continuous assessment is important in practice as autoregulatory reserve may fluctuate in time. Static and dynamic rates of autoregulation show sensitivity to carbon dioxide-induced vasodilatation, but fail to correlate with outcome following head injury. The carotid artery compression test, useful for assessment of patients after subarachnoid haemorrhage, has yet to prove its usefulness in head injury. Continuous waveform analysis of MCA FV and CPP correlates with coma score after resuscitation and outcome and hence may be considered as a robust method for the assessment of autoregulation in ventilated head trauma patients.
Cerebrovascular Circulation↗
Laser Doppler perfusion imaging of proximal interphalangeal joints in patients with rheumatoid arthritis.
OBJECTIVE: A non-invasive imaging technique (laser Doppler perfusion imaging-LDI) based on measurement of backscattered Doppler-broadened near infra-red laser radiation was used to provide two-dimensional images of perfusion over the proximal interphalangeal (PIP) joints of a group of normal subjects compared to a group of patients with rheumatoid arthritis (RA). RESULTS: Some PIP joints of the RA group showed areas of increased perfusion whereas normal subjects showed much less variation in perfusion between joints. These hyperaemic areas arose from the underlying joint, as scans taken with a less penetrating red laser did not show such areas. CONCLUSION: Apart from its obvious dermatological uses, LDI could be employed to image hyperaemia associated with a variety of inflammatory conditions affecting subcutaneous structures.
Adult↗
Measurement of optic nerve head circulation: comparison of laser speckle and hydrogen clearance methods.
Microcirculation in the optic nerve head (ONH) in the ocular fundus was measured noninvasively using the recently developed laser speckle circulation analyzer. Results were compared with capillary blood flow (CBF) measurements made by the hydrogen clearance method. The ONH blood flow of six normal rabbits was measured simultaneously by both methods. Inhalation of 10% carbon dioxide (CO2) increased the CBF by 22% (hydrogen clearance method). Intravenous injection of endothelin-1 (ET-1) (10(-10) mol/kg) decreased the CBF by 19%. Significant correlations were found between the NB (normalized blur) value by the laser speckle method and CBF (r = 0.38, P < 0.05, n = 30) and also between the relative change of NB and CBF (r = 0.92, P < 0.01, n = 30) in the ONH. This indicates that evaluation of the NB change in the ONH is as accurate with the laser speckle method as with the hydrogen clearance method, giving a basis for the clinical application of the laser speckle method of measuring ONH circulation.
Administration, Inhalation↗
[Comparative hydrodynamic evaluation of variants of the cavopulmonary anastomosis].
An analysis of the range of postoperative complications following cavapulmonary anastomosis reveals a number of medical engineering problems in surgery techniques. The severity of the surgery due to the nonphysiological rearrangement of blood circulation makes it necessary to search for the most optimal types of anastomosis in terms of the hemo- and hydrodynamics of circulation. To optimize the performance of cavapulmonary anastomosis, namely to define the mutual localization and orientation of the implanted anastomoses against the axes of inflow and outflow, hemo- and hydrodynamic studies were made by Doppler laser anemometry. From the hydrodynamic point of view, the findings indicate the most optimal type of cavapulmonary anastomosis-cruciform anastomosis by displacing 0.5 d from the outflow axis at an angle of 60ë5 degrees.
Anastomosis, Surgical↗
Role of AT1 receptors in the central control of sympathetic vasomotor function.
1. In a number of species, high concentrations of angiotensin II (AngII) receptors have been found in the rostral ventrolateral medulla (RVLM) in the hindbrain, which is an important region involved in the modulation of sympathetic vasomotor tone. The present review describes studies in which the contribution of angiotensin receptors in the brainstem to cardiovascular regulation, in particular sympathetic vasomotor reflexes, has been examined in conscious and anaesthetized rabbits. 2. In conscious rabbits, fourth ventricular infusions of AngII produced dose-dependent pressor responses as does 400 times less than equipressor intravenous doses. Chronic baroreceptor denervation increased the sensitivity to AngII by 1000-fold. Administration of prazosin i.v. blocked the pressor response, suggesting that the mechanism involved sympathetic vasoconstriction. 3. The pattern of haemodynamic changes in response to AngII injected into the fourth ventricle (4V) involved decreased total peripheral conductance and mesenteric conductance, but a rise in hindlimb conductance. Sinoaortic denervation changed the hindlimb fall in conductance to an increase, suggesting that muscle vasomotor pathways were particularly inhibited by baroreceptor feedback mechanisms. 4. In anaesthetized rabbits, infusion of AngII into the RVLM increased blood pressure and transiently increased resting renal sympathetic nerve activity. The renal sympathetic baroreflex curves were shifted to the right and the upper plateau of the sympathetic reflex increase was markedly increased. 5. The pressor actions of 4V AngII were blocked by administration of a peptide antagonist injected into the RVLM or by the angiotensin AT1 antagonist losartan injected into the 4V. These results suggest that mainly AT1 receptors are involved and that the RVLM is a likely candidate site for the modulation of the renal sympathetic baroreflex. 6. Losartan administration into the 4V in conscious rabbits increased resting renal sympathetic tone and enhanced renal sympathetic baroreflex and chemoreflexes. 7. Our studies suggest that there are sympathoexcitatory AT1 receptors in the RVLM accessible to AngII from the cerebrospinal fluid. In addition, an AT1 receptor pathway normally inhibits the sympathoexcitation produced by baroreceptor unloading or chemoreceptor activation. The effect of losartan suggests that there is greater tonic activity within the sympathoinhibitory pathways. These two actions suggest that angiotensin receptors in the brainstem modulate sympathetic responses to specific afferent inputs, thus forming part of a potentially important mechanism for the integration of characteristic autonomic response patterns.
Analysis of Variance↗
[Microcirculatory changes in mitral prolapse as an expression of a systemic change in the connective tissue].
Many authors hypothesize that mitral valve prolapse (MVP) can be, in most cases, only a clinical sign of a primitive and systemic disorder of the connective tissue, like in Marfan Syndrome (MS). In our previous works we supported the presence of morphological and functional alterations of the microcirculation in patients affected by MS. In order to characterize a possible common denominator between these pathologies we have studied the cutaneous microcirculation in a group of patients affected by MVP, divided into 2 groups: anatomic MVP (MVP) and MVP syndrome (MVPS). The morphologic parameters have been investigated by nailfold capillaroscopy while digital laser-Doppler was used to study skin flowmetry. The results have been compared with a control group. Capillaroscopic remarkers showed an architecturally disorganized microvasculature with aspects related to a reduced compactness of the microvasculature unit with a significatively higher score compared with controls (7.3 +/- 2.9 vs 3.6 +/- 1 p less than 0.0005). Laser-Doppler flowmetry showed a significatively reduced rest flow; ischemic test showed: spike time 48.9 +/- 36.9 vs 15.3 +/- 7.7 s (p less than 0.0005), hyperemic acme 6.6 +/- 2.7 vs 12.5 +/- 8.4 UP (p less than 0.002); % increase 32.1 +/- 20.2 vs 51.5 +/- 15.4 (p less than 0.002). Thermic test showed a significatively higher thermic acme 8.7 +/- 4.2 vs 12.6 +/- 9.11 UP (p less than 0.05). These results appeared to be correlated with stage pathology as it was observed a severe microvasculature disorders in MVPS. Therefore we suppose that a phenotypic continuum may exist between MS and MVP.
Adult↗