Progress in applied microcirculation ; Vol. 22
X, 186 s. : tab., fot., grafy ; 24 cm
- MeSH
- Dextrans therapeutic use MeSH
- Critical Illness MeSH
- Microcirculation MeSH
- Osmolar Concentration MeSH
- Perfusion MeSH
- Resuscitation methods MeSH
- Publication type
- Congress MeSH
- Collected Work MeSH
- Conspectus
- Lékařské vědy. Lékařství
- NML Fields
- anesteziologie a intenzivní lékařství
- kardiologie
- fyziologie
- angiologie
Hodnocení perfuze myokardu je důležité pro odhad prognózy nemocných především u akutního infarktu myokardu s reperfuzní léčbou. Myokardiální kontrastní echokardiografie (MCE) patří mezi nové a nadějné metody vhodné k opakovanému vyšetření u lůžka nemocného. K hlavním limitacím patří cena kontrastní látky a kvalita zobrazení při intravenózním podání u části nemocných.
Evaluation of myocardial perfusion is important for the estimation of patients‘ prognosis, particularly reperfusion therapy after an acute myocardial infarction. Myocardial contrast echocardiography (MCE) is one of new and promising methods suitable for repeated bed side patient examination. The main limitations are the cost of the contrast agent and the image quality during its intravenous application, which was suboptimal in several patients.
Cardiac arrest represents a leading cause of mortality and morbidity in developed countries. Extracorporeal cardiopulmonary resuscitation (ECPR) increases the chances for a beneficial outcome in victims of refractory cardiac arrest. However, ECPR and post-cardiac arrest care are affected by high mortality rates due to multi-organ failure syndrome, which is closely related to microcirculatory disorders. Therefore, microcirculation represents a key target for therapeutic interventions in post-cardiac arrest patients. However, the evaluation of tissue microcirculatory perfusion is still demanding to perform. Novel videomicroscopic technologies (Orthogonal polarization spectral, Sidestream dark field and Incident dark field imaging) might offer a promising way to perform bedside microcirculatory assessment and therapy monitoring. This review aims to summarise the recent body of knowledge on videomicroscopic imaging in a cardiac arrest setting and to discuss the impact of extracorporeal reperfusion and other therapeutic modalities on microcirculation.
- MeSH
- Diagnostic Imaging methods MeSH
- Humans MeSH
- Microcirculation physiology MeSH
- Perfusion MeSH
- Heart Arrest blood MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Tato práce si dává za cíl poskytnout základní seznámení s novou metodou k vyšetření mikrocirkulace pomocí laser Dopplerovy techniky a zároveň zahrnuje stručný přehled jejího využití v celé řadě oborů. Laser Doppler je citlivá moderní metoda k hodnocení funkce malých cév, která umožňuje zjištění a hodnocení časných patologických změn v mikrocirkulaci. V závislosti na typu přístrojového vybavení je možno ji provádět invazivně či neinvazivně, přičemž invazivní techniky jsou využívány zejména v plastické a transplantační chirurgii, gastroenterologii, neurochirurgii a řadě dalších oborů, a to i peroperačně. Časté je též použití v experimentálních modelech. Neinvazivně se nejčastěji vyšetřuje kožní mikrocirkulace. Tento postup je dostatečně jednoduchý a rychlý a také pohodlný pro pacienta i vyšetřující personál. Pomocí něj lze hodnotit přítomnost a závažnost časných mikroangiopatických změn u různých onemocnění a v případě detekce mikroangiopatie pak poskytuje možnost včasné intervence k prevenci závažnějších komplikací.
The aim of this review is to give a basic information on a new method for an examination of microcirculation by using laser Doppler techniques. It also provides a review of possible aplications in many branches of medicine and some practical implications as well. Laser Doppler is a sensitive, simple, and sophisticated method for detection and evaluation of early pathological changes in microcirculation and can be used either invasively or non-invasively. Invasive techniques are used in plastic surgery, transplantation medicine, and in many other branches such as gastroenterology, neurosurgery, and experimental studies. The non-invasive measurement of skin perfusion is simple and comfortable for both patients and staff. It can be used for the evaluation of capillary blood flow and early detection of microangiopathic changes in different diseases allowing thus the possibility of early intervention.
- MeSH
- Arteriosclerosis etiology prevention & control MeSH
- Adult MeSH
- Hormone Replacement Therapy MeSH
- Skin blood supply MeSH
- Middle Aged MeSH
- Humans MeSH
- Microcirculation physiopathology MeSH
- Risk Factors MeSH
- Growth Hormone deficiency therapeutic use MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
XII, 263 s. : obr., tab., grafy ; 24 cm
- MeSH
- Biological Transport MeSH
- Ischemia MeSH
- Oxygen MeSH
- Microcirculation MeSH
- Reperfusion Injury MeSH
- Conspectus
- Fyziologie člověka a srovnávací fyziologie
- NML Fields
- fyziologie
Východisko. Diabetická mikroangiopatie je častou komplikací onemocnění diabetes mellitus obou typů a její následky mohou být velice závažné. Odhalení přítomnosti časných cévních změn může vést k identifikaci pacientů s vysokým rizikem vzniku mikroangiopatie a má velký význam pro prevenci vážných komplikací. Cílem studie bylo vyšetření mikrocirkulace v kůži horních končetin u diabetiků 1. typu a kontrolní skupiny pomocí laser Dopplerové techniky a porovnání parametrů perfuze mezi oběma skupinami vyšetřených osob a dále s kompenzací diabetu vyjádřenou glykovaným hemoglobinem HbA1c, fruktosaminem a bazální glykémií. Rovněž byl analyzován vztah mezi cévními změnami, věkem pacienta a délkou trvání onemocnění. Metody a výsledky. Bylo vyšetřeno 38 diabetiků 1. typu (18 mužů, 20 žen) a 26 zdravých kontrol (16 mužů, 10 žen). Statisticky vysoce významné rozdíly perfuze mezi diabetiky a kontrolami byly nalezeny v řadě parametrů. Při porovnání perfuze s kompenzací diabetu byla nalezena statisticky významná negativní závislost procentového vzestupu perfuze při reaktivní hyperémii předloktí na HbA1c (r=0,52, p<0,001) a na fruktosaminu (r=-0,47, p<0,01), procentového vzestupu perfuze při hypertermii na HbA1c (r=-0,47, p<0,001) a maximální perfuze prstu při reaktivní hyperémii na fruktosaminu (r=-0,4, p<0,01). Mezi maximem perfuze při reaktivní hyperémii na předloktí a bazální glykémií byla rovněž zjištěna statisticky významná negativní korelace (r=-0,62, p<0,001). Nebyl nalezen žádný vztah mezi parametry kožní perfuze a věkem pacienta či trváním jeho onemocnění. Závěry. Tato studie nalezla významné rozdíly mezi diabetiky a zdravými kontrolami a odhalila závislost kožní perfuze na kompenzaci diabetu. Vyšetření mikrocirkulace u diabetiků pomocí laser Doppleru je neinvazivní, nenáročné pro pacienta a může být jednou z metod detekce mikroangiopatických změn.
Background. Diabetic microangiopathy is a very frequent complication of both types of diabetes mellitus. Detection of early microcirculation impairment may identify patients at high risk of severe complications and may have a great value for prevention of these complications. The aim of the study was to evaluate the skin microcircu- lation in upper extremities in Type 1 diabetic patients and in healthy volunteers with laser Doppler technique. Parameters of microcirculation were compared between these two groups and with diabetes control expressed by glycated hemoglobin, fructosamin and fasting glycaemia. Relationship between perfusion parameters, the age of patients and the duration of diabetes was analysed as well. Methods and Results. Thirty-eight Type 1 diabetic patients (18 men, 20 women) and twenty-six healthy persons (16 men, 10 women) were evaluated in this study. Differences of high statistical significance in many parameters of perfusion were found between these groups. A significant negative relationship was found between the percentage perfusion increase during postocclusive hyperaemia in forearm and HbA1c and fructosamine (r=-0,52, p<0,001 and r=-0,47, p<0,01, respectively), between percentage perfusion increase during local hypertermia and HbA1c (r=-0,47, p<0,001). Negative correlation was also found between maximal perfusion during postocclusive hyperaemia in finger and fructosamine (r=-0,4, p<0,01) and between the same parameter in forearm and fasting glycaemia (r=-0,62, p<0,001). Skin perfusion was independent on age and duration of diabetes. Conclusions. Significant differences between diabetic patients and healthy controls and a relationship between perfusion parameters and compensated diabetes status were described in the current study. Laser Doppler fluxmetry is a non-invasive method comfortable for patients and it can be used for detection of microangiopathy in diabetology.
A convenient geometrical description of the microvascular network is necessary for computationally efficient mathematical modelling of liver perfusion, metabolic and other physiological processes. The tissue models currently used are based on the generally accepted schematic structure of the parenchyma at the lobular level, assuming its perfect regular structure and geometrical symmetries. Hepatic lobule, portal lobule, or liver acinus are considered usually as autonomous functional units on which particular physiological problems are studied. We propose a new periodic unit-the liver representative periodic cell (LRPC) and establish its geometrical parametrization. The LRPC is constituted by two portal lobulae, such that it contains the liver acinus as a substructure. As a remarkable advantage over the classical phenomenological modelling approaches, the LRPC enables for multiscale modelling based on the periodic homogenization method. Derived macroscopic equations involve so called effective medium parameters, such as the tissue permeability, which reflect the LRPC geometry. In this way, mutual influences between the macroscopic phenomena, such as inhomogeneous perfusion, and the local processes relevant to the lobular (mesoscopic) level are respected. The LRPC based model is intended for its use within a complete hierarchical model of the whole liver. Using the Double-permeability Darcy model obtained by the homogenization, we illustrate the usefulness of the LRPC based modelling to describe the blood perfusion in the parenchyma.
The endothelium of different organs displays a remarkable heterogeneity, although it presents many common functional and morphological features. However, despite our knowledge of heterogeneity among endothelial cells from different sites, the differences between brain microvascular endothelial cells (BMEC) and coronary microvascular endothelial cells (CMEC) are poorly defined. The aim of this study was to investigate whether BMEC are distinct from CMEC at the protein level. Using the proteomic approach, we comparatively analyzed the proteome of cultured BMEC and CMEC. We reproducibly separated over 2000 polypeptides by using two-dimensional electrophoresis (2-DE) at pH range of 3-10. Using PDQuest software to process the 2-DE gel images, forty-seven protein spots were differentially expressed in the two-endothelial cells. Of these, thirty-five proteins are highly expressed in BMEC, whereas twelve proteins are highly expressed in CMEC. Fifteen proteins in BMEC and seven proteins in CMEC were identified with high confidence by matrix-associated laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF-MS). Our data suggested that BMEC and CMEC were different in several aspects including cytokine and growth-related molecules, stress-related proteins, metabolic enzymes, signal transduction proteins and others. The identification of a set of proteins preferentially expressed in BMEC and CMEC provided new data on the heterogeneity of the endothelium.
- MeSH
- Adaptor Proteins, Signal Transducing analysis chemistry MeSH
- Endothelium, Vascular cytology physiopathology pathology MeSH
- Research Support as Topic MeSH
- Cardiovascular Physiological Phenomena MeSH
- Microcirculation genetics physiology physiopathology MeSH
- Cerebrovascular Circulation physiology MeSH
- Rats, Wistar anatomy & histology MeSH
- Proteins analysis physiology chemistry MeSH
- Spectrum Analysis methods utilization MeSH
- Animals MeSH
- Check Tag
- Animals MeSH
