Perioperative Monitoring of Tissue Perfusion: New Developments

2013 ◽  
pp. 291-300 ◽  
Author(s):  
C. Boer
Keyword(s):  
Tissue Perfusion ◽  
New Developments ◽  
Perioperative Monitoring

Outcome Prediction in Microsurgery by Quantitative Evaluation of Perfusion Using ICG Fluorescence Angiography

2009 ◽  
Vol 34 (2) ◽  
pp. 238-246 ◽  
Author(s):  
H. MOTHES ◽  
T. DINKELAKER ◽  
T. DÖNICKE ◽  
R. FRIEDEL ◽  
G. O. HOFMANN ◽  
...  
Keyword(s):  
Hand Surgery ◽  
Tissue Perfusion ◽  
Clinical Results ◽  
Good Prognosis ◽  
Fluorescence Angiography ◽  
Clinical Parameters ◽  
Surgical Decision ◽  
Quantitative Parameters ◽  
Perioperative Monitoring ◽  
Surgical Decision Making

The purpose of this prospective study was to evaluate the clinical efficacy of laser-induced fluorescence angiography with indocyanine green (ICG-FA) for perioperative monitoring of tissue perfusion in hand surgery. Different quantitative parameters of the uptake, distribution and clearance of dye-marked blood were evaluated for their sensitivity and prognostic value in comparison to each other and to clinical parameters. One hundred and fifty-five measurements were performed prior to, or following, surgery for severe hand injuries. All quantitative parameters of ICG-FA detected intraoperatively were found to be of significant predictive value for outcome, but clinical parameters were not. For the dye uptake, a minimum slope value of 0.01 was significantly related to sufficient perfusion and good prognosis. There was no correlation between the quantitative ICG-FA results or any of the clinical parameters. Since clinical evaluation of perfusion in this surgery remains difficult, the additional use of ICG-FA may improve surgical decision making and, thereby, lead to better clinical results.

scholarly journals SBP Is Superior to MAP to Reflect Tissue Perfusion and Hemodynamic Abnormality Perioperatively

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Sun ◽  
Jing Yuan ◽  
Bin Li
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Systolic Function ◽  
Tissue Perfusion ◽  
Pulse Contour ◽  
Arterial Pulse ◽  
Hemodynamic Changes ◽  
Mathematical Formula ◽  
Output Change ◽  
Perioperative Monitoring

Many articles have reported that intraoperative low mean artery pressure (MAP) or low systolic blood pressure (SBP) impacts on organs’ function and patients’ outcomes perioperatively. On the contrary, what type of blood pressure should be obtained still needs to be clarified. In our paper, we compared the influencing factors of MAP and SBP, and mathematical formula, arterial pulse contour calculation, and cardiovascular physiological knowledge were adopted to discuss how blood pressure can effectively reflect tissue perfusion and hemodynamic abnormality perioperatively. We concluded that MAP can reflect cardiac output change sensitively and SBP can reflect stroke volume change sensitively. Moreover, SBP can reflect the early hemodynamic changes, organs’ perfusion, and heart systolic function. Compared with MAP, perioperative monitoring of SBP and timely detection and treatment of abnormal SBP are very important for the early detection of hemodynamic abnormalities.

Quantitative nano-characterization of heterogeneous catalysts

1995 ◽  
Vol 53 ◽  
pp. 398-399
Author(s):  
P.A. Crozier ◽  
M. Pan
Keyword(s):  
Heterogeneous Catalysts ◽  
Low Dose ◽  
Imaging Techniques ◽  
Structural Features ◽  
Catalyst Characterization ◽  
New Developments ◽  
Double Phase ◽  
Phase Systems ◽  
Dose Imaging

Heterogeneous catalysts can be of varying complexity ranging from single or double phase systems to complicated mixtures of metals and oxides with additives to help promote chemical reactions, extend the life of the catalysts, prevent poisoning etc. Although catalysis occurs on the surface of most systems, detailed descriptions of the microstructure and chemistry of catalysts can be helpful for developing an understanding of the mechanism by which a catalyst facilitates a reaction. Recent years have seen continued development and improvement of various TEM, STEM and AEM techniques for yielding information on the structure and chemistry of catalysts on the nanometer scale. Here we review some quantitative approaches to catalyst characterization that have resulted from new developments in instrumentation.HREM has been used to examine structural features of catalysts often by employing profile imaging techniques to study atomic details on the surface. Digital recording techniques employing slow-scan CCD cameras have facilitated the use of low-dose imaging in zeolite structure analysis and electron crystallography. Fig. la shows a low-dose image from SSZ-33 zeolite revealing the presence of a stacking fault.

Instrumental Assessment in Cleft Palate Care

2013 ◽  
Vol 23 (2) ◽  
pp. 49-61 ◽  
Author(s):  
Jamie Perry ◽  
Graham Schenck
Keyword(s):  
Cleft Palate ◽  
New Developments ◽  
Perceptual Evaluation ◽  
Advantages And Disadvantages ◽  
Instrumental Assessment ◽  
Speech Language Pathologist ◽  
Hypernasal Speech ◽  
Perceptual Assessment ◽  
Velopharyngeal Function ◽  
And Function

Despite advances in surgical management, it is estimated that 20–30% of children with repaired cleft palate will continue to have hypernasal speech and require a second surgery to create normal velopharyngeal function (Bricknell, McFadden, & Curran, 2002; Härtel, Karsten, & Gundlach, 1994; McWilliams, 1990). A qualitative perceptual assessment by a speech-language pathologist is considered the most important step of the evaluation for children with resonance disorders (Peterson-Falzone, Hardin-Jones, & Karnell, 2010). Direct and indirect instrumental analyses should be used to confirm or validate the perceptual evaluation of an experienced speech-language pathologist (Paal, Reulbach, Strobel-Schwarthoff, Nkenke, & Schuster, 2005). The purpose of this article is to provide an overview of current instrumental assessment methods used in cleft palate care. Both direct and indirect instrumental procedures will be reviewed with descriptions of the advantages and disadvantages of each. Lastly, new developments for evaluating velopharyngeal structures and function will be provided.

New developments in hematopoetic stem cell transplantation

2002 ◽  
Vol 59 (11) ◽  
pp. 571-576 ◽  
Author(s):  
Gratwohl
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Ältere Patienten ◽  
Solide Tumoren ◽  
Aplastische Anämie ◽  
New Developments ◽  
Lymphoproliferative Erkrankungen ◽  
Hematopoetic Stem Cell ◽  
Angeborene Erkrankungen ◽  
Hematopoetic Stem Cell Transplantation

Die Transplantation hämatopoietischer Stammzellen umfasst heute Stammzellen aus Knochenmark, peripherem Blut oder Nabelschnurblut. Leukämien, Lymphoproliferative Erkrankungen, aplastische Anämie und schwere angeborene Erkrankungen des Knochenmarkes sind Hauptindikationen für allogene, lymphoproliferative Erkrankungen, Leukämien, solide Tumoren und schwere Autoimmunkrankheiten Hauptindikationen für autologe Transplantationen. Neue Verfahren wie reduzierte Konditionierung und selektive Gabe von Spenderlymphozyten eröffnen die Stammzelltransplantation auch für ältere Patienten und für solche mit vorbestehender Komorbidität. Wenn immer möglich, wird die Transplantation ab Diagnose in den Behandlungsplan integriert. Die Wahl des Verfahrens und des geeigneten Zeitpunktes wird nach individuellem Risikoprofil erstellt. Alter oder Diagnose sind nicht mehr alleinige Entscheidungskriterien. Als etablierte Therapieform dürfte die hämatopoietische Stammzelltransplantation als Modell dienen für Stammzelltransplantationen auch anderer Organe.

Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

VASA ◽  
2017 ◽  
Vol 46 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Henrik Christian Rieß ◽  
Anna Duprée ◽  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Eike Sebastian Debus ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Quantitative Assessment ◽  
Tissue Perfusion ◽  
Fluorescent Imaging ◽  
Peripheral Artery ◽  
Peripheral Bypass ◽  
Before And After ◽  
Artery Disease ◽  
Green Fluorescent ◽  
Peripheral Bypass Grafting

Abstract. Background: Perioperative evaluation in peripheral artery disease (PAD) by common vascular diagnostic tools is limited by open wounds, medial calcinosis or an altered collateral supply of the foot. Indocyanine green fluorescent imaging (ICG-FI) has recently been introduced as an alternative tool, but so far a standardized quantitative assessment of tissue perfusion in vascular surgery has not been performed for this purpose. The aim of this feasibility study was to investigate a new software for quantitative assessment of tissue perfusion in patients with PAD using indocyanine green fluorescent imaging (ICG-FI) before and after peripheral bypass grafting. Patients and methods: Indocyanine green fluorescent imaging was performed in seven patients using the SPY Elite system before and after peripheral bypass grafting for PAD (Rutherford III-VI). Visual and quantitative evaluation of tissue perfusion was assessed in an area of low perfusion (ALP) and high perfusion (AHP), each by three independent investigators. Data assessment was performed offline using a specially customized software package (Institute for Laser Technology, University Ulm, GmbH). Slope of fluorescent intensity (SFI) was measured as time-intensity curves. Values were compared to ankle-brachial index (ABI), slope of oscillation (SOO), and time to peak (TTP) obtained from photoplethysmography (PPG). Results: All measurements before and after surgery were successfully performed, showing that ABI, TTP, and SOO increased significantly compared to preoperative values, all being statistically significant (P < 0.05), except for TTP (p = 0.061). Further, SFI increased significantly in both ALP and AHP (P < 0.05) and correlated considerably with ABI, TTP, and SOO (P < 0.05). Conclusions: In addition to ABI and slope of oscillation (SOO), the ICG-FI technique allows visual assessment in combination with quantitative assessment of tissue perfusion in patients with PAD. Ratios related to different perfusion patterns and SFI seem to be useful tools to reduce factors disturbing ICG-FI measurements.

What’s Next?

2011 ◽  
Vol 23 (1) ◽  
pp. 60-63 ◽  
Author(s):  
Peter Vorderer
Keyword(s):  
Cultural Differences ◽  
Factor Model ◽  
New Developments ◽  
Theoretical Concepts ◽  
Open Questions ◽  
Entertainment Products ◽  
Entertainment Theory

This paper points to new developments in the context of entertainment theory. Starting from a background of well-established theories that have been proposed and elaborated mainly by Zillmann and his collaborators since the 1980s, a new two-factor model of entertainment is introduced. This model encompasses “enjoyment” and “appreciation” as two independent factors. In addition, several open questions regarding cultural differences in humans’ responses to entertainment products or the usefulness of various theoretical concepts like “presence,” “identification,” or “transportation” are also discussed. Finally, the question of why media users are seeking entertainment is brought to the forefront, and a possibly relevant need such as the “search for meaningfulness” is mentioned as a possible major candidate for such an explanation.

Behavioral Testing of Mice Concerning Anxiety and Depression

2015 ◽  
Vol 223 (3) ◽  
pp. 151-156 ◽  
Author(s):  
Nina Schweinfurth ◽  
Undine E. Lang
Keyword(s):  
Environmental Influences ◽  
Sickness Behavior ◽  
Laboratory Research ◽  
Anxiety And Depression ◽  
Housing Conditions ◽  
Human Beings ◽  
Behavioral Testing ◽  
New Developments ◽  
Animal Trials ◽  
Resilience Factors

Abstract. In the development of new psychiatric drugs and the exploration of their efficacy, behavioral testing in mice has always shown to be an inevitable procedure. By studying the behavior of mice, diverse pathophysiological processes leading to depression, anxiety, and sickness behavior have been revealed. Moreover, laboratory research in animals increased at least the knowledge about the involvement of a multitude of genes in anxiety and depression. However, multiple new possibilities to study human behavior have been developed recently and improved and enable a direct acquisition of human epigenetic, imaging, and neurotransmission data on psychiatric pathologies. In human beings, the high influence of environmental and resilience factors gained scientific importance during the last years as the search for key genes in the development of affective and anxiety disorders has not been successful. However, environmental influences in human beings themselves might be better understood and controllable than in mice, where environmental influences might be as complex and subtle. The increasing possibilities in clinical research and the knowledge about the complexity of environmental influences and interferences in animal trials, which had been underestimated yet, question more and more to what extent findings from laboratory animal research translate to human conditions. However, new developments in behavioral testing of mice involve the animals’ welfare and show that housing conditions of laboratory mice can be markedly improved without affecting the standardization of results.

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