Skin trauma rapidly induces thermoregulatory plexus hyperemia, while an increased nutritive papillary capillary function can be detected after 24 h
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Clinical assessments and laser Doppler perfusion measurements (LDPM) of skin microcirculation have limited value, as they fail to capture events regulated by local metabolic needs at a papillary capillary level. This study aimed to examine the ability of computer-assisted video microscopy (CAVM) and diffuse reflectance spectroscopy (DRS) to assess skin nutritive perfusion-compared to LDPM.Keywords:
Reactive hyperemia
Capillary refill
textabstractIn the first part of this thesis, describing clinical and experimental studies, laser
Doppler flowmetry is evaluated as diagnostic tool to assess tissue microcirculation
after various microvascular operations. The second part concerns the application of
laser Doppler flowmetry to investigate and to objectivate the negative effects of
cigarette smoking upon the microcirculation under normal circumstances as well as
after microvascular operative procedures.
Success of plastic and reconstructive operations, especially of microvascular
surgery, is determined to a great extent by circulation of the tissues. Reliable
assessment of blood flow and more specifically of microcirculation, which
determines tissue viability is of great clinical importance.
Microvascular surgery
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Reactive hyperemia
SIGNAL (programming language)
Velocimetry
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Microcirculation was studied with laser doppler flowmetry in 226 patients with acute destructive pancreatitis treated with standard detoxication, antiinflammatory, antibacterial and surgical methods. The examination was performed on the unit LAKK-01 (NPP 'Lazma', Russia) by original methods based on the study of microcirculation in biologically active points. Based on analysis of 2500 dopplerograms, criteria of assessment of organic and systemic capillary circulation and also laser doppler flowmetric characteristics of 4 degree microcirculation's insufficiency were developed. The proposed scheme was effectively applied for assessment of each medical procedure and of all curative complex in general.
Detoxication
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We assessed the cutaneous microcirculatory reactivity of a clinically unaffected skin region in patients with systemic sclerosis (SSc) compared to healthy controls by measuring transcutaneous oxygen saturation (TcPO2) and Laser Doppler flowmetry (LDF).Twelve consecutive patients with SSc and twelve healthy controls were subjected to TcPO2 monitoring and LDF during cuff-induced ischemia and reactive hyperemia in order to measure the skin oxygen tension and the microcirculatory blood flow. Mean minimal and maximal values of oxygen tension and blood flow, time to peak (TTP), and declining slopes after peaking (slope) were compared between patients with SSc and controls.Compared to the controls, TcPO2 values in SSc were similar during ischemia and diminished during reactive hyperemia, with longer TTP, and a slower return to baseline (-60% vs. -58% , p = 1.000, +76% vs. +210% , p = 0.047, 137 s vs. 108 s, p = 0.028, -0.009% /s vs. -0.019% /s, p = 0.021, respectively). LDF values, however, did not differ significantly between patients with SSc and controls.Unaffected skin regions of SSc patients showed a significantly diminished postischemic vasodilatory reactivity when assessed by TcPO2 monitoring, but not by LDF, indicating that vasculopathy may represent an early mechanism in the onset of skin sclerosis. TcPO2 measurement may help to detect changes in the microcirculation in SSc with no skin affection.
Oxygen Saturation
Saturation (graph theory)
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Skin Temperature
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The experimental research included the study of the functional state of blood microcirculation by means of laser Doppler flowmetry (LDF). It is allowed to assess the condition of tissue blood flow and to detect the early signs of changes in the microcirculation under the influence on breath-holding test. The obtained results showed that at most of students high-amplitude LDF with the expressed vasomotors` waves of the second order mainly was registered
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The human cutaneous microcirculation has so ar been studied by rather crude methods, such as plethsmography and l33Xn clearance. New sophisticated and noninvasive techniques are now available, with which the microcirculation of the skin can be continuously studied and measured for hours. With two such methods, i.e.,Laser-Doppler flowmetry and dynamic capillaroscopy, fast dynamic fluctuations of the microcirculation can be allowed. Under resting conditions, the total skin flow of small area (1–2 mm2) varies consistently with time, These variations are caused by the arterial pulse, but also by active vasomotion with a frequency of about 4–8 cy-les/min. These fluctuations can also be seen in single kin capillaries, but with a somewhat faster frequency: −10 cycles/min. The reaction of the cutaneous micro-circulation to provocation tests, such as postocclusive reactive hyperemia response and venous occlusion (50 mm Hg), can also be studied. The time to peak during postocclusive reactive hyperemia is very consistent. In response to venous congestion, capillary flow rate falls drastically, whereas Laser-Doppler flow is much less dramatically reduced. These discrepancies suggest that the Laser-Doppler flowmeter records blood flow in skin vessels in addition to the superficial, nutritional capillaries. The dynamic pattern of the skin microcirculation is altered in patients with hypertension, diabetes, and obstructive arterial disease.
Reactive hyperemia
Vasomotion
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Reactive hyperemia
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Laser Doppler flowmetry signals give information about many physiological activities of the cardiovascular system. The activities manifest themselves in rhythmic cycles. In order to explore these activities during the reactive hyperemia phenomenon, a novel time-frequency method, called the S-transform, based on a scalable Gaussian wavelet, is applied. The goal is to have a deeper understanding of reactive hyperemia. This paper focuses on the evaluation of the different activities between a rest signal and an hyperemia signal, both acquired simultaneously on the two forearms of healthy subjects. The results show that after the release of the occlusion, the myogenic, neurogenic, and endothelial related activities clearly increase on the forearm where the occlusion took place. Then, they return progressively to their basal level. However, on the rest forearm, no increase is noted for the three activities. The mechanisms that take place during reactive hyperemia are, therefore, local. The S-transform proves to be a suited time-frequency method, in order to analyze laser Doppler signal underlying mechanisms.
Reactive hyperemia
SIGNAL (programming language)
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В статье анализируются преимущества и недостатки методов лазерной допплеровской флоуметрии и биомикроскопии при изучении микроциркуляции в кровеносных и лимфатических микрососудах кожи и др. органов. На конкретных примерах показаны широкие недостаточно используемые возможности биомикроскопии. The article analyzed merits and demerits of laser Doppler flowmetry and biomicroscopy in studying microcirculation in blood and lymphatic microvessels of the skin and other organs. Specific examples show wide, underutilized potentialities of biomicroscopy.
Ultrasound biomicroscopy
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