이 작품은 국립 심장, 폐, 및 혈액 연구소에서 부여 보너스 번호 R01HL096593과 K23HL72825에 의해 지원되었다. 내용은 전적으로 토마스 제퍼슨 대학의 책임이며, 반드시 국립 심장, 폐, 및 혈액 연구소 또는 건강의 국립 연구소의 공식 전망을 대표하지 않습니다.

사례 발표 (필수, 해당되는 경우) : NA,이 여전히 실험적인 연구 절차입니다, 아직 임상 적으로 사용되지 않습니다. 진단, 평가 및 계획 (필수, 해당되는 경우) : NA,이는 아직 실험 연구 절차입니다는 아직 임상 적으로 사용되지 않습니다. 절차 (필수) :이 부분은 ​​아래의 가이드 라인을 충족, 관련 절차의 단계별로 설명을 포함해야합니다. 1. 모세관 현미경 (그림 1) <ol><li> 우리 capillaroscopy 기술은 Serne와 그의 동료 1 일부터 조정되었습니다. 콜라겐 혈관 질환이 알려진 모세관 변경 2를 생산하고 있기 때문에이 절차에 대한 제외 기준은, 콜라겐 혈관 질환입니다. </li><li> 최소 10 시간 하루 아침에 신속하고 앉아 나머지 20 분 후, microvascular 측정은 7 사이에 반 시간 동안 실시하고 있습니다호와 11 호는 심장 수준에서 앉은 자세와 왼쪽 손에 제목과 함께 조용한, 온도 제어 룸 (21.5-22.5 ° C 사이의 유지)에,입니다. </li><li> 세 번째 손가락의 등 피부에 Nailfold 모세 혈관은 (올림푸스, 센터 밸리, PA) stereomicroscope를 사용하여 시각화 있으며, 디지털 카메라를 (모델 번호-1400 : 진단 기기, 스털링 하이츠, MI) 흑백 4 메가​​ 픽셀 SPOT 통찰력에 연결, 와 노트북 컴퓨터 (델 위도 D600 : 델, 오스틴, TX). 움직임을 제한하려면 왼쪽 손과 팔은 느슨하게 접힌 담요로 덮여 있으며, 현미경의 기본에 위치 다른 접힌 담요 위에 안식합니다. </li><li> Nailbed 조명은 250 W의 할로겐 광섬유 램프 (KL 2500LCD :; Elmsford, NY SCHOTT-Fostec)로 이루어집니다 보충 150W의 광섬유 할로겐 광원 (B &amp; B 현미경 (주), Warrendale, PA)에서 추가 조명 사용 어둡게 색소 개인 인치 </li><li> 모세 혈관,를 시각화하려면3.2x 목적 (올림푸스 3.2/0.07)가 38.4x의 전체 시스템 배율과 함께 사용됩니다. </li><li> 카메라와 함께 제공 SPOT 이미징 소프트웨어, 모세관 사진의 어두운 / 밝은 명암을 사용하면 모든 과목에서 모세 혈관의 노출을 극대화하기 위해 동일한 표준 SPOT 소프트웨어 기능 (밝고 어두운 수준의 스트레칭)를 사용하여 향상됩니다. </li><li> 모세관 밀도를 수량화하기 위해, 디지털 photomicrographs는 postocclusive 반응 충혈 동안 휴식 기준선에서 세 단계의 각 기간 동안 모든 3-5 초 촬영하고, 정맥 폐색 동안 수 있습니다. (A) 휴식 기준에 photomicrographs는 모세 혈관은 휴식 perfused 감지 할 수있는 3 분에 걸쳐 이동합니다. 다음과 같이 (B) postocclusive 반응 충혈 동안, photomicrographs는 기능적으로 perfused 모세 혈관을 (기본 플러스 예약 모세 혈관) 수량화로 이동합니다. 먼저, 왼쪽 팔 위쪽에 가림 커프는 10 분에 수축기 혈압 위 40mm의 HG로 증가하고 있습니다. Photomicrographs 그 다음 일 중에 찍은전자 첫번째 분은 즉시 모든 기능 perfused 모세 혈관을 시각화, 동맥 폐색의 출시에 따라. 반응 충혈에 따라 낮은 모세 혈관 밀도는 장애인 기능 모세관 바뀐다는 것을 의미하고, 따라서 기능 희박. (C) 정맥 가림 photomicrographs 동안 모두 perfused (활성 적혈구 (RBC) 모션)과 다음과 같이 모세 혈관 3 (정체, 비 이동 적혈구가 가득) nonperfused을 포함 최대 모세관 밀도를 수량화로 이동합니다. postocclusive 반응 충혈 절차 후 나머지 십분 후, 팔 커프는 수동적으로 모든 특허 모세 혈관의 존재에 피를 강요하고 photomicrographs이 기간 동안 찍은 60 초에 60mm HG로 증가하고 있습니다. 최대 모세관 밀도는 포함되어 있기 때문에 구조적으로 존재하는 모든 모세 혈관, 최대 모세관 밀도의 감소는 구조 희박를 나타냅니다. </li><li> 모세관 밀도는 평방 밀리미터 당 모세 혈관의 수로 정의됩니다nailfold 피부의 limeter, 그리고는 최소 움직임에 의해 왜곡 네 개의 가장 명확하게 초점을 맞춘 이미지에서 얻은 네 측정의 평균으로 계산됩니다. 우리의 연구에서, 모세관 카운트에 대한 전형적인 값 (모세 혈관 / mm 2) 정맥 폐색에 대한 후 허혈성 및 90-105에 대한 기준, 65-90에 55-80했습니다. %의 모세관 채용에 대한 값은 5 %와 25 % (~ 10-15 % 평균) 사이에 70 %와 normotensives보다 hypertensives 중 낮은 것 값 95 % (~ 80~90%을 의미) 사이에 모세 혈관 perfused %를 일반적입니다. 계산 절차의 재현성은 10 개 과목의 사진과는 독립적 수동 평가 (그림 2)를 수행 셋 관계자와 확인되었습니다. 관찰은 이러한 과목의 정체성과 혈액 압력에 둔감했다. 교육 후, 독립적으로 수행 이후의 계산은 계약의 높은 수준을 보여 주었다. 평균 간 평가자 및 내부 평가자 불일치가 orde였다2-3 모세 혈관 / mm 2의 R 및 intraclass 상관 계수가 0.90보다 모두 더 있었다. capillaroscopy 조치의 단기 변화가 상호 평가자 및 내부 평가자 차이 (약 2 모세 혈관 / mm 2)와 같은 크기의 동일한 순서 있었지만, 2-3년 동안 관찰 장기적인 변화는 큰 규모의 순서였다 (약 15 모세 혈관 / mm 2), 세로 변경 사항은 즉시 평가자 변화 구별 될 수 있다는 의미. 두 모세관 기능 측정의 신뢰성은 (intraclass 상관 %의 모세관 모집에 대한 계수 = 0.84와 %를 perfused 모세 혈관에 대한 0.82)도 높은했습니다. </li><li> 조사는 이제 이미지 - 프로 플러스 이미징 소프트웨어 (: 그림 3 버전 6.2, 미디어 인공 이식, 주식회사, 베데스다, MD)를 사용하여 모세관 밀도를 정량화에 대한 컴퓨터 기반의 방법을 사용합니다. 기준, 후 허혈성 및 veno 사이의 피어슨 상관 관계10 과목에서 소프트웨어 및 해당 설명서 카운트 짓을 우리가 혼잡 계산은 두 가지 방법 사이의 합리적인 계약을 나타냅니다 (모든 P &lt;0.05) 각각 0.78, 0.78 및 0.71이었다. 컴퓨터 기반 계산의 신뢰성 수동 카운트보다 약간 낮은하지만 (정맥 폐색에 대한 기준에 대한 intraclass 상관 계수 = 0.91, 후 허혈성를위한 0.86 및 0.84) 여전히 높다. 우리는 또한 우리가 현재 발행을 준비하고 고혈압, 등 다양한 심혈관 위험 요인이있는 자동 계산의 연결을 보여주는되지 않은 데이터가 있습니다. </li><li> 표 1은 모세 혈관 밀도 측정 및 계산을 요약 한 것입니다. 비율 모세관 모집은 최대 모세관 밀도에 의해 postocclusive 반응 충혈 (postocclusive 반응 충혈 모세 혈관 밀도가 마이너스 기준 모세 혈관 밀도)에 의해 유도 모세관 밀도의 증가를 (수동 veno 동안 관찰 나누어 평가된다우리 가림). 퍼센트는 모세 혈관은 (기능적으로 활성) perfused 모든 모세 혈관 존재하는 비율을 나타냅니다, 그리고 최대 모세관 밀도에 의해 postocclusive 반응 충혈 모세 혈관 밀도를 나누어 계산합니다 perfused. %의 모세관 회원 모집 및 퍼센트는 모두 모세 혈관은 모세 혈관 기능의 숫자를 반영 perfused. 이러한 조치에 대한 낮은 값은 기능 모세관 희박를 나타냅니다. </li></ol> 2. 내피 기능 평가 <ol><li> 내피 기능은 vasodilation을 유발하는 반응성 충혈의 내피에 의존 자극을 활용 Sivertsson, (4)의 방법에 따라, 팔 혈액 흐름의 비 침습적 plethysmography 측정을 사용하여 postocclusive 반응성 충혈 이전과 이후 평가된다. </li><li> 의 휴식 길이가 aroun를 조작 해 놓았 너머 나태한 나머지 10 분 후 앉은 자세에서 대상으로 수은에 고무 스트레인 게이지는 10 %로 늘어antecubital fossa 아래 D 피사체의 팔 5cm. </li><li> 결과적으로 도플러 레코더 (, DE Hokanson, Inc의, Belleveue, WA CW-1)에 연결되어,; 스트레인 게이지는 plethysmograph (벨뷰, WA DE Hokanson, Inc의 EC-4)에 연결되어 있습니다. </li><li> 상부 암 가림 커프가 적용되고, 팔이 조절 정맥 주사 극에 연결된 슬링 붕대를 사용하여 심장 수준에서 편안하게 일시 중지되었습니다. 수축기 및 이완기 혈액 압력과 심장 박동을 반대 팔에 위치 Dinamap ProCare 100 자동 BP의 커프 (GE 의료, Piscataway, NJ)를 얻을 수 있습니다. </li><li> 손목 주위 소아 커프는 손에 흐름을 막다 할 수 HG 200mm로 증가하고 있습니다. 위쪽 팔 커프는 50mm의 HG로 증가 1.5 초에 deflated 한 다음, 팔 주변에 스트레인 게이지의 확장을 통해 얻은 각 팔 혈액의 흐름 측정에 빠르게 이전에 다시 증가 할 수 있습니다. </li><li> 팔 혈액의 흐름 (FBF)가 다시 안식 기준 (FBF 기지)에서 측정되어t postocclusive 충혈 유발 최대 vasodilation (FBF 최대). 기본 혈액 흐름 측정, 연속 4 FBF 곡선은 30 초 (FBF베이스)에서 얻을 수 있습니다. </li><li> 가림 커프 그 다음 10 분에 수축기 혈압 위 40mm의 HG로 증가하고 있습니다. 동맥 폐색 (postocclusive 반응 충혈)의 출시에 이어, 연속 4 FBF 곡선은 흐름의 첫 번째 30 초 (FBF 최대)에서 얻을 수 있습니다. </li><li> 비율 FBF 최대 / FBF 기지는 네 개의 FBF 기본 값의 평균으로 네 가지 FBF 최대 값의 평균을 나누어, vasodilation의 추정치로 계산됩니다. 최대 vasodilation (FVR 최대)에서 5 팔 혈관 저항은으로 계산됩니다 FBF 최대로 나누어 동맥 압력을 (MAP) 의미합니다. 반응 충혈 동안 FBF 최대 직접 간 동맥 아세틸 콜린의 최대 주입, 내피에 의존 vasodilator 후 FBF와 관련이 있습니다. 6 </저녁을 먹다&gt; 따라서, FBF 맥스와 비율 FBF 최대 / FBF베이스가 내피 기능의 비 침습적 조치. 6-8 또한 허용되며, FBF 맥스와 FVR 최대 모두 저항 동맥 구조적 변화 (증가 벽 / 루멘 비율) 반영합니다. 9 </li></ol>

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A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rarefaction+of+skin+capillaries+in+borderline+essential+hypertension+suggests+an+early+structural+abnormality.">Rarefaction of skin capillaries in borderline essential hypertension suggests an early structural abnormality.</a> Hypertension. 34, 655-658 (1999).</li><li>Noon, J. P., Walker, B. R., Webb, D. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impaired+microvascular+dilatation+and+capillary+rarefaction+in+young+adults+with+a+predisposition+to+high+blood+pressure.">Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure.</a> J. Clin. Invest. 99, 1873-1879 (1997).</li><li>Antonios, T. F., Rattray, F. M., Singer, D. R., Markandu, N. D., Mortimer, P. S., MacGregor, G. 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D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Free+fatty+acid+levels+modulate+microvascular+function:+relevance+for+obesity-associated+insulin+resistance,+hypertension,+and+microangiopathy.">Free fatty acid levels modulate microvascular function: relevance for obesity-associated insulin resistance, hypertension, and microangiopathy.</a> Diabetes. 53, 2873-2882 (2004).</li><li>de Jongh, R. T., Serne, E. H., RG, I. J., Stehouwer, C. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microvascular+function:+a+potential+link+betweensalt+sensitivity,+insulin+resistance+and+hypertension.">Microvascular function: a potential link betweensalt sensitivity, insulin resistance and hypertension.</a> J. Hypertens. 25, 1887-1893 (2007).</li><li>Ijzerman, R. G., Voordouw, J. J., Van Weissenbruch, M. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=TNF-alpha+levels+are+associated+withskin+capillary+recruitment+in+humans:+a+potential+explanation+for+the+relationship+between+TNF-alpha+and+insulin+resistance.">TNF-alpha levels are associated withskin capillary recruitment in humans: a potential explanation for the relationship between TNF-alpha and insulin resistance.</a> Clin. Sci. (Lond). 110, 361-368 (2006).</li><li>Yvonne-Tee, G. B., Rasool, A. H., Halim, A. S., Rahman, A. 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C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+aging+and+hypertension+on+the+microcirculation.">Effects of aging and hypertension on the microcirculation.</a> Hypertension. 47, 968-9674 (2006).</li><li>Debbabi, H., Uzan, L., Mourad, J. J., Safar, M., Levy, B. I., Tibirica, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+skin+capillary+density+in+treated+essential+hypertensive+patients.">Increased skin capillary density in treated essential hypertensive patients.</a> Am. J. Hypertens. 19, 477-483 (2006).</li><li>Serne, E. H., Gans, R. O., ter Maaten, J. C., Tangelder, G. J., Donker, A. J., Stehouwer, C. 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C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Capillaroscopy+and+the+measurement+of+capillary+pressure.">Capillaroscopy and the measurement of capillary pressure.</a> Br. J. Clin. Pharmacol. 50, 501-513 (2000).</li></ol>

저자는 공개 할이 작품의 행위 또는 출판에 관한 관심의 금융 충돌이 없습니다.

Capillaroscopy (모세관 현미경)는 모세관 구조의 표준이 아닌 측정하기위한 한 방법입니다. 그러나, 현재 모세관 structure.Furthermore 직접 평가를위한 표준 방법이 없습니다, 모세 혈관 현미경 널리 출판 작품 12, 13, 10, 11, 14-18의 큰 성장 본문에 capillarydensity의 직접적인 평가에 사용 된 . 또한 팔 혈액 흐름, 혈관 기능의 잘 알려진 측정, 10, 11 및 UAE, 선박 부상을 잘 구축 조치 (게시되지 않?...

non-invasive assessment of microvascular and endothelial function

저자는 심장 혈관 질환의 pathogenesis에 microvascular 장애의 역할을 조사하기 위해 capillaroscopy과 팔 혈액의 흐름 기법을 활용하고 있습니다. Capillaroscopy 직접 microcirculation을 시각화를위한 비 침습적 상대적으로 저렴한 방법입니다. 비율 모세관 모집은 최대 모세관 밀도 (수동 정맥 폐색 동안 휴일)에 의해 postocclusive 반응성 충혈 (postocclusive 반응 충혈 모세 혈관 밀도가 마이너스 기준 모세 혈관 밀도)에 의해 유도 모세관 밀도의 증가 나누어 평가된다. 퍼센트는 모세 혈관은 (기능적으로 활성) perfused 모든 모세 혈관 존재하는 비율을 나타냅니다, 그리고 최대 모세관 밀도에 의해 postocclusive 반응 충혈 모세 혈관 밀도를 나누어 계산합니다 perfused. %의 모세관 회원 모집 및 퍼센트는 모두 모세 혈관은 모세 혈관 기능의 숫자를 반영 perfused. 팔 혈액의 흐름 (FBF) 기술 홍보ovides은 내피 기능의 비 침습적 조치를 수락 : 비율 FBF 최대 / FBF 기지는 네 개의 FBF 기본 값의 평균으로 네 개의 FBF 최대 값의 평균을 나누어, vasodilation의 추정치로 계산됩니다. 최대 vasodilation (FVR 최대)의 팔 혈관 저항은 FBF 최대로 나눈 평균 동맥 압력 (MAP)로 계산됩니다. capillaroscopy와 팔 기술을 모두 환자에게 쉽게 허용하고 신속하게 배울 수 있습니다. microvascular 및 내피 기능이 논문에 설명 된 방법을 사용하여 얻은 임상 환자 심혈관 위험 감소 전략의 미래 유틸리티가있을 수 있습니다 측정합니다. 우리가 게시 한 바와 같이 그 microvascular 및 내피 기능 장애를 보여주는 보고서가 prehypertension 포함 고혈압의 초기 단계에서 발견되며, microvascular 및 내피 기능 조치는 결국 초기 식별에 도움이 될 수그 잠재적으로 치명적인 결과와 위험 층별 및 최종 단계 혈관 병리의 예방.

normotensive와 고혈압 개인 사이의 microvasculature의 모양의 차이는 그림 4 대와 5를 비교하여 쉽게 명백 있습니다. 그림 4 normotensive 개인의 잘 조직 된 행에 연속 모세 혈관의 전형적인 네트워크를 보여줍니다. 대조적으로, 그림 5는 축소, 코일 모세 혈관의 더 disarranged 패턴을 보여줍니다. 저자는 심장 혈관 질환의 pathogenesis에 microvascular 장애?...

Watch this Scientific Journal Video about Non-invasive Assessment of Microvascular and Endothelial Function at JoVE.com

Non-invasive Assessment of Microvascular and Endothelial Function

Capillaroscopy 직접 microcirculation을 시각화를위한 비 침습적 상대적으로 저렴한 방법입니다. 팔 혈액의 흐름 기술은 내피 기능의 인정 비 침습적 조치를 제공합니다.

Microvascular 및 내피 기능의 비 침습적 평가

The authors have utilized capillaroscopy and forearm blood flow techniques to investigate the role of microvascular dysfunction in pathogenesis of ...

non-invasive-assessment-of-microvascular-and-endothelial-function

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

16.1K 조회수.  Thomas Jefferson University. Capillaroscopy 직접 microcirculation을 시각화를위한 비 침습적 상대적으로 저렴한 방법입니다. 팔 혈액의 흐름 기술은 내피 기능의 인정 비 침습적 조치를 제공합니다.

비디오: Non-invasive Assessment of Microvascular and Endothelial Function

An in vivo Rodent Model of Contraction-induced Injury and Non-invasive Monitoring of Recovery

Muscle strains are one of the most common complaints treated by physicians. A muscle injury is typically diagnosed from the patient history and physical exam alone, however the clinical presentation can vary greatly depending on the extent of injury, the patient's pain tolerance, etc. In patients with muscle injury or muscle disease, assessment of muscle damage is typically limited to clinical signs, such as tenderness, strength, range of motion, and more recently, imaging studies. Biological markers, such as serum creatine kinase levels, are typically elevated with muscle injury, but their levels do not always correlate with the loss of force production. This is even true of histological findings from animals, which provide a "direct measure" of damage, but do not account for all the loss of function. Some have argued that the most comprehensive measure of the overall health of the muscle in contractile force. Because muscle injury is a random event that occurs under a variety of biomechanical conditions, it is difficult to study. Here, we describe an in vivo animal model to measure torque and to produce a reliable muscle injury. We also describe our model for measurement of force from an isolated muscle in situ. Furthermore, we describe our small animal MRI procedure.

An in vivo Rodent Model of Contraction-induced Injury and Non-invasive Monitoring of Recovery

An in vivo animal model of injury is described. The method takes advantage of the subcutaneous position of the fibular nerve. Velocity, timing of muscle activation, and arc of motion are all pre-determined and synchronized using commercial software. Post injury changes are monitored in vivo using MR imaging/spectroscopy.

생체내에</em수축 유도 부상 및 복구의 비침습 모니터링> 쥐 모델

Muscle strains are one of the most  common complaints treated by physicians. A muscle injury is typically diagnosed from the patient history and  physical ...

연구

의학

Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants

Perinatal brain injury remains a significant cause of infant mortality and morbidity, but there is not yet an effective bedside tool that can accurately screen for brain injury, monitor injury evolution, or assess response to therapy. The energy used by neurons is derived largely from tissue oxidative metabolism, and neural hyperactivity and cell death are reflected by corresponding changes in cerebral oxygen metabolism (CMRO2). Thus, measures of CMRO2 are reflective of neuronal viability and provide critical diagnostic information, making CMRO2 an ideal target for bedside measurement of brain health.
Brain-imaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) yield measures of cerebral glucose and oxygen metabolism, but these techniques require the administration of radionucleotides, so they are used in only the most acute cases.
Continuous-wave near-infrared spectroscopy (CWNIRS) provides non-invasive and non-ionizing radiation measures of hemoglobin oxygen saturation (SO2) as a surrogate for cerebral oxygen consumption. However, SO2 is less than ideal as a surrogate for cerebral oxygen metabolism as it is influenced by both oxygen delivery and consumption. Furthermore, measurements of SO2 are not sensitive enough to detect brain injury hours after the insult 1,2, because oxygen consumption and delivery reach equilibrium after acute transients 3. We investigated the possibility of using more sophisticated NIRS optical methods to quantify cerebral oxygen metabolism at the bedside in healthy and brain-injured newborns. More specifically, we combined the frequency-domain NIRS (FDNIRS) measure of SO2 with the diffuse correlation spectroscopy (DCS) measure of blood flow index (CBFi) to yield an index of CMRO2 (CMRO2i) 4,5.
With the combined FDNIRS/DCS system we are able to quantify cerebral metabolism and hemodynamics. This represents an improvement over CWNIRS for detecting brain health, brain development, and response to therapy in neonates. Moreover, this method adheres to all neonatal intensive care unit (NICU) policies on infection control and institutional policies on laser safety. Future work will seek to integrate the two instruments to reduce acquisition time at the bedside and to implement real-time feedback on data quality to reduce the rate of data rejection.

We combined frequency-domain near-infrared spectroscopy measures of cerebral hemoglobin oxygenation with diffuse correlation spectroscopy measures of cerebral blood flow index to estimate an index of oxygen metabolism. We tested the utility of this measure as a bedside screening tool to evaluate the health and development of the newborn brain.

유아의 뇌 신진 대사와 혈류 역학의 비 침습적 광학 측정

Perinatal brain injury remains a significant cause of infant mortality  and morbidity, but there is not yet an effective bedside tool that can  accurately ...

Murine Spinotrapezius Model to Assess the Impact of Arteriolar Ligation on Microvascular Function and Remodeling

The murine spinotrapezius is a thin, superficial skeletal support muscle that extends from T3 to L4, and is easily accessible via dorsal skin incision. Its unique anatomy makes the spinotrapezius useful for investigation of ischemic injury and subsequent microvascular remodeling. Here, we demonstrate an arteriolar ligation model in the murine spinotrapezius muscle that was developed by our research team and previously published1-3. For certain vulnerable mouse strains, such as the Balb/c mouse, this ligation surgery reliably creates skeletal muscle ischemia and serves as a platform for investigating therapies that stimulate revascularization. Methods of assessment are also demonstrated, including the use of intravital and confocal microscopy. The spinotrapezius is well suited to such imaging studies due to its accessibility (superficial dorsal anatomy) and relative thinness (60-200 &mu;m). The spinotrapezius muscle can be mounted en face, facilitating imaging of whole-muscle microvascular networks without histological sectioning. We describe the use of intravital microscopy to acquire metrics following a functional vasodilation procedure; specifically, the increase in arterilar diameter as a result of muscle contraction. We also demonstrate the procedures for harvesting and fixing the tissues, a necessary precursor to immunostaining studies and the use of confocal microscopy.

We demonstrate a novel arterial ligation model in murine spinotrapezius muscle, including a step-by-step procedure and description of required instrumentation. We describe the surgery and relevant outcome measurements relating to vascular network remodeling and functional vasodilation using intravital and confocal microscopy.

Microvascular 기능 및 리모델링에 Arteriolar 결합의 영향을 평가하기 위해 손쥐 Spinotrapezius 모델

The murine spinotrapezius is a thin, superficial skeletal support muscle that extends from T3 to L4, and is easily accessible via dorsal skin incision. ...

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

The endothelium is the innermost lining of the vasculature and is involved in the maintenance of vascular homeostasis. Damage to the endothelium may predispose the vessel to atherosclerosis and increase the risk for cardiovascular disease. Assessments of peripheral endothelial function are good indicators of early abnormalities in the vascular wall and correlate well with assessments of coronary endothelial function. The present manuscript details the important methodological steps necessary for the assessment of microvascular endothelial function using laser Doppler imaging with iontophoresis, large vessel endothelial function using flow-mediated dilatation, and carotid atherosclerosis using carotid artery ultrasound. A discussion on the methodological considerations for each of the techniques is also presented, and recommendations are made for future research.

The present article describes the methodological considerations for several non-invasive assessments of vascular function and morphology that are commonly used in medical research to assess different stages of atherosclerosis.

혈관 기능 및 형태의 비 침습적 평가에 대한 방법 론적 접근

The endothelium is the innermost lining of the vasculature and is involved in the maintenance of vascular homeostasis.  Damage to the endothelium may ...

Non-invasive Assessment of the Efficacy of New Therapeutics for Intestinal Pathologies Using Serial Endoscopic Imaging of Live Mice

Animal models of inflammatory bowel disease (IBD) and colorectal cancer (CRC) have provided significant insight into the cell intrinsic and extrinsic mechanisms that contribute to the onset and progression of intestinal diseases. The identification of new molecules that promote these pathologies has led to a flurry of activity focused on the development of potential new therapies to inhibit their function. As a result, various pre-clinical mouse models with an intact immune system and stromal microenvironment are now heavily used. Here we describe three experimental protocols to test the efficacy of new therapeutics in pre-clinical models of (1) acute mucosal damage, (2) chronic colitis and/or colitis-associated colon cancer, and (3) sporadic colorectal cancer. We also outline procedures for serial endoscopic examination that can be used to document the therapeutic response of an individual tumor and to monitor the health of individual mice. These protocols provide complementary experimental platforms to test the effectiveness of therapeutic compounds shown to be well tolerated by mice.

We describe methods for longitudinal monitoring of the efficacy of therapeutics for the treatment of colonic pathologies in mice using a rigid endoscope. This protocol can be readily used for the characterization of the therapeutic response of an individual tumor in live mice and also for monitoring potential disease relapse.

라이브 마우스의 직렬 내시경 이미징을 사용하여 소장 병변에 대한 새로운 치료제의 효능의 비 침습적 평가

Animal models of inflammatory bowel disease (IBD) and colorectal cancer (CRC) have provided significant insight into the cell intrinsic and extrinsic ...

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies.
Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events.
Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.

The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered.

내피 기능의 초음파 평가 : 흐름 중재 팽창 시험의 기술 가이드 라인

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a ...

Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy

While obesity is closely linked to the development of metabolic and cardiovascular disease, little is known about mechanisms that govern these processes. It is hypothesized that pro-atherogenic mediators released from fat tissues particularly in association with central/visceral adiposity may promote pathogenic vascular changes locally and systemically, and the notion that cardiovascular disease may be the consequence of adipose tissue dysfunction continues to evolve. Here, we describe a unique method of videomicroscopy that involves analysis of vasodilator and vasoconstrictor responses of intact small human arterioles removed from the adipose depot of living human subjects. Videomicroscopy is used to examine functional properties of isolated microvessels in response to pharmacological or physiological stimuli using a pressured system that mimics in vivo conditions. The technique is a useful approach to gain understanding of the pathophysiology and molecular mechanisms that contribute to vascular dysfunction locally within the adipose tissue milieu. Moreover, abnormalities in the adipose tissue microvasculature have also been linked with systemic diseases. We applied this technique to examine depot-specific vascular responses in obese subjects. We assessed endothelium-dependent vasodilation to both increased flow and acetylcholine in adipose arterioles (50 - 350 &#181;m internal diameter, 2 - 3 mm in length) isolated from two different adipose depots during bariatric surgery from the same individual. We demonstrated that arterioles from visceral fat exhibit impaired endothelium-dependent vasodilation compared to vessels isolated from the subcutaneous depot. The findings suggest that the visceral microenvironment is associated with vascular endothelial dysfunction which may be relevant to clinical observation linking increased visceral adiposity to systemic disease mechanisms. The videomicroscopy technique can be used to examine vascular phenotypes from different fat depots as well as compare findings across individuals with different degrees of obesity and metabolic dysfunction. The method can also be used to examine vascular responses longitudinally in response to clinical interventions.

Videomicroscopy systems are used to examine functional properties of isolated adipose tissue arterioles in response to physiological and pharmacological stimuli. This technique can be used to examine microvascular phenotypes in different adipose tissue domains in obese humans.

인간 지방 조직 Microvascular 함수 Videomicroscopy를 사용 하 여 평가

While obesity is closely linked to the development of metabolic and cardiovascular disease, little is known about mechanisms that govern these processes. ...

Assessment of Kidney Function in Mouse Models of Glomerular Disease

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function in diabetic nephropathy and podocyte-specific VEGF-A knock-out mice; therefore, this protocol describes the full kidney work-up used in our lab to assess these mouse models of glomerular disease, enabling a vast amount of information regarding kidney and glomerular function to be obtained from a single mouse. In comparison to alternative methods presented in the literature to assess glomerular function, the use of the method outlined in this paper enables the glomerular phenotype to be fully evaluated from multiple aspects. By using this method, the researcher can determine the kidney phenotype of the model and assess the mechanism as to why the phenotype develops. This vital information on the mechanism of disease is required when examining potential therapeutic avenues in these models. The methods allow for detailed functional assessment of the glomerular filtration barrier through measurement of the urinary albumin creatinine ratio and individual glomerular water permeability, as well as both structural and ultra-structural examination using the Periodic Acid Schiff stain and electron microscopy. Furthermore, analysis of the genes dysregulated at the mRNA and protein level enables mechanistic analysis of glomerular function. This protocol outlines the generic but adaptable methods that can be applied to all mouse models of glomerular disease.

This protocol describes a full kidney work-up that should be carried out in mouse models of glomerular disease. The methods allow for detailed functional, structural, and mechanistic analysis of glomerular function, which can be applied to all mouse models of glomerular disease.

신장 기능 사 질병 마우스 모델에서의 평가

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function ...

Non-invasive Assessment of Dorsiflexor Muscle Function in Mice

Assessment of skeletal muscle contractile function is an important measurement for both clinical and research purposes. Numerous conditions can negatively affect skeletal muscle. This can result in a loss of muscle mass (atrophy) and/or loss of muscle quality (reduced force per unit of muscle mass), both of which are prevalent in chronic disease, muscle-specific disease, immobilization, and aging (sarcopenia). Skeletal muscle function in animals can be evaluated by a range of different tests. All tests have limitations related to the physiological testing environment, and the selection of a specific test often depends on the nature of the experiments. Here, we describe an in vivo, non-invasive technique involving a helpful and easy assessment of force frequency-curve (FFC) in mice that can be performed on the same animal over time. This permits monitoring of disease progression and/or efficacy&#160;of a potential therapeutic treatment.

Measurement of rodent skeletal muscle contractile function is a useful tool that can be used to track disease progression as well as efficacy of therapeutic intervention. We describe here the non-invasive, in vivo assessment of the dorsiflexor muscles that can be repeated over time in the same mouse.

비-침략 적 쥐에서 Dorsiflexor 근육 기능 평가

Assessment of skeletal muscle contractile function is an important measurement for both clinical and research purposes. Numerous conditions can negatively ...

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.

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