scholarly journals Mucosal blood flow in the remaining rectal stump is more affected by total than partial mesorectal excision in patients undergoing anterior resection: a key to understanding differing rates of anastomotic leakage?

2021 ◽  
Author(s):  
Erik Back ◽  
Fredrik Brännström ◽  
Johan Svensson ◽  
Jörgen Rutegård ◽  
Peter Matthiessen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Repeated Measures ◽  
Surgical Techniques ◽  
Rectal Stump ◽  
Blood Perfusion ◽  
Mucosal Blood Flow ◽  
Mesorectal Excision ◽  
Doppler Flowmetry

Abstract Purpose Anterior resection is the procedure of choice for tumours in the mid and upper rectum. Depending on tumour height, a total mesorectal excision (TME) or partial mesorectal excision (PME) can be performed. Low anastomoses in particular have a high risk of developing anastomotic leakage, which might be explained by blood perfusion compromise. A pilot study indicated a worse blood flow in TME patients in an open setting. The aim of this study was to further evaluate perianastomotic blood perfusion changes in relation to TME and PME in a predominantly laparoscopic context. Method In this prospective cohort study, laser Doppler flowmetry was used to evaluate the perianastomotic colonic and rectal perfusion before and after surgery. The two surgical techniques were compared in terms of mean differences of perfusion units using a repeated measures ANOVA design, which also enabled interaction analyses between type of mesorectal excision and location of measurement. Anastomotic leakage until 90 days after surgery was reported for descriptive purposes. Results Some 28 patients were available for analysis: 17 TME and 11 PME patients. TME patients had a reduced blood perfusion postoperatively compared to PME patients in the aboral posterior area (mean difference: −57 vs 18 perfusion units; p = 0.010). An interaction between mesorectal excision type and anterior/posterior location was detected at the aboral level (p = 0.007). Two patients developed a minor leakage, diagnosed after discharge. Conclusion Patients operated on using TME have a decreased blood flow in the aboral posterior quadrant of the rectum postoperatively compared to patients operated on using PME. This might explain differing rates of anastomotic leakage. Trial registration ClinicalTrials.gov Identifier: NCT02401100

Effect of a Gel Formulation of Sucralfate on Gastric Microcirculation

1993 ◽  
Vol 21 (1) ◽  
pp. 47-50 ◽  
Author(s):  
M Guslandi ◽  
M Sorghi ◽  
A Foppa ◽  
PC Braga ◽  
A Tittobello
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Chronic Gastritis ◽  
Blood Perfusion ◽  
Mucosal Blood Flow ◽  
Gastric Blood Flow ◽  
Doppler Flowmetry ◽  
Before And After ◽  
Therapeutic Properties ◽  
Gastric Microcirculation

Dyspeptic patients ( n = 12) with endoscopic signs of chronic gastritis were treated orally for 28 days with a new gel formulation of sucralfate at a dose of 1 g twice daily. Before and after treatment, gastric blood flow was assessed during endoscopy by means of laser Doppler flowmetry. The sucralfate gel promoted a significant increase ( P < 0.001) in blood perfusion in all patients, restoring normal levels of gastric microcirculation. The results are consistent with observations in animals, suggesting that the mechanisms responsible for the gastroprotective and therapeutic properties of sucralfate include enhancement of mucosal blood flow.

Using reactive hyperemia to investigate the effect of cupping sizes of cupping therapy on skin blood flow responses

2021 ◽  
pp. 1-7
Author(s):  
Xiangfeng He ◽  
Xueyan Zhang ◽  
Fuyuan Liao ◽  
Li He ◽  
Xin Xu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Skin Blood Flow ◽  
Repeated Measures ◽  
Recovery Time ◽  
Reactive Hyperemia ◽  
Cupping Therapy ◽  
Doppler Flowmetry ◽  
Healthy Participants ◽  
Hyperemic Response

BACKGROUND: Various cupping sizes of cupping therapy have been used in managing musculoskeletal conditions; however, the effect of cupping sizes on skin blood flow (SBF) responses is largely unknown. OBJECTIVE: The objective of this study was to compare the effect of three cupping sizes of cupping therapy on SBF responses. METHODS: Laser Doppler flowmetry (LDF) was used to measure SBF on the triceps in 12 healthy participants in this repeated measures study. Three cup sizes (35, 40 and 45 mm in diameter) were blinded to the participants and were tested at -300 mmHg for 5 minutes. Reactive hyperemic response to cupping therapy was expressed as a ratio of baseline SBF. RESULTS: All three sizes of cupping cups resulted in a significant increase in peak SBF (p< 0.001). Peak SBF of the 45 mm cup (9.41 ± 1.32 times) was significantly higher than the 35 mm cup (5.62 ± 1.42 times, p< 0.05). Total SBF of the 45 mm cup ((24.33 ± 8.72) × 103 times) was significantly higher than the 35 mm cup ((8.05 ± 1.63) × 103 times, p< 0.05). Recovery time of the 45 mm cup (287.46 ± 39.54 seconds) was significantly longer than the 35 mm cup (180.12 ± 1.42 seconds, p< 0.05). CONCLUSIONS: Our results show that all three cup sizes can significantly increase SBF. The 45 mm cup is more effective in increasing SBF compared to the 35 mm cup.

Effect of Oxymetazoline on Nasal and Sinus Mucosal Blood Flow in the Rabbit as Measured with Laser-Doppler Flowmetry

1993 ◽  
Vol 102 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Anders Åkerlund ◽  
Karl-E. Arfors ◽  
Mats Bende ◽  
Marcos Intaglietta
Keyword(s):  
Blood Flow ◽  
Maxillary Sinus ◽  
Laser Doppler Flowmetry ◽  
Mucosal Blood Flow ◽  
Laser Doppler ◽  
Negative Consequences ◽  
Doppler Flowmetry ◽  
Dose Dependent Decrease ◽  
Dose Dependent ◽  
Sinus Ostium

The effect of topical oxymetazoline hydrochloride on the blood flow of the nasal and sinus mucosa of the rabbit was measured by laser-Doppler flowmetry. Oxymetazoline, the active component in clinically used nose drops, induced a dose-dependent decrease of the nasal mucosal blood flow. This effect has previously been shown in humans and suggests the presence of α2–adrenoceptors in the nasal mucosa of the rabbit. Doses of oxymetazoline used clinically in humans induced a 50% reduction of blood flow in rabbits. Rhythmic variations in blood flow were seen in 30% of the rabbits after administration of oxymetazoline. Additionally, oxymetazoline induced a dose-dependent decrease of the mucosal blood flow in the maxillary sinus when the drug was applied in the nose. A vasoconstricting effect of oxymetazoline on the arteries penetrating the maxillary sinus ostium is a possible explanation. This can have positive as well as negative consequences on acute sinus infections.

scholarly journals Oscillation intervals of cutaneous blood perfusion as indicators of aging

2021 ◽  
Author(s):  
Guangjun Wang ◽  
Shuyong Jia ◽  
Xiaojing Song ◽  
Shuyou Wang ◽  
Weibo Zhang
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Upper Limb ◽  
Blood Perfusion ◽  
Limb Blood Flow ◽  
Doppler Flowmetry ◽  
Age Related ◽  
Healthy Participants ◽  
Cutaneous Blood ◽  
Age Related Changes

Abstract A total of 30 healthy participants (Old, aged >40 years, n=12; Young, age<40, n=18) were recruited, and their bilateral upper limb blood flow was recorded. The results showed that on either the left or right side, the average oscillation intervals of the lower age were significantly higher than those of the older age and that on the left or right side, the average interval was negatively and weakly correlated with age. The current study provides a window to access age-related changes on the oscillation interval of cutaneous laser Doppler flowmetry.

scholarly journals Laser doppler flowmetry for human blood microcirculation assessment

2014 ◽  
Vol 95 (1) ◽  
pp. 63-69 ◽  
Author(s):  
I V Barhatov
Keyword(s):  
Blood Flow ◽  
Frequency Analysis ◽  
Laser Doppler Flowmetry ◽  
Maximum Amplitude ◽  
Blood Perfusion ◽  
Laser Doppler ◽  
Doppler Flowmetry ◽  
Functional Changes ◽  
Microcirculatory Disorders ◽  
The Impact

The prevention and treatment of various microcirculation disorders are one of the most important problems of medical practice. The difficulties of studying the microcirculation are related to the blood vessels small size and extensive branching within organ tissues. At present, various methods of microcirculation assessment using the laser Doppler flowmetry are applied in active clinical practice in our country. The review covers the main methods of laser Doppler flowmetry used for the diagnosis of various microcirculation disorders. The method is based on the determination of tissue blood perfusion by measuring the Doppler frequency shift while tissue is illuminated by a laser beam, followed by the registration of the reflected radiation from moving and stationary tissue components. Microcirculatory oscillation rhythm plays an important role, especially in early diagnosis of many diseases. The loss of certain types of oscillations at laser Doppler flowmetry is interpreted as «spectral narrowing» and serves as a diagnostic criterion for microcirculation deregulation, which is directly related to decreased blood perfusion and tissue hypotrophy. The use of amplitude-frequency analysis of blood flow oscillations can non-invasively evaluate the impact of the various components of microvascular tone, allowing to calculate an index of neurogenic and myogenic tone and bypass index. The amplitude-frequency analysis of the laser Doppler flowmetry spectrum uses normalized parameters determining the maximum amplitude of the blood flow oscillation in different bands, as well as their ratio - microcirculation effectiveness index. Hyperemic, spastic, spastic-atonic, structural and degenerative, congestive and stasic forms of various microcirculation disorders are marked out. Each of these microcirculatory disorders is characterized by a certain ratio of structural and functional changes and changes in blood velocity, as well as impaired barrier function. The main principles of the microcirculatory disorders are described.

Cutaneous microvascular flow in the foot during simulated variable gravities

1996 ◽  
Vol 271 (4) ◽  
pp. R961-R966
Author(s):  
D. S. Chang ◽  
G. A. Breit ◽  
J. R. Styf ◽  
A. R. Hargens
Keyword(s):  
Blood Flow ◽  
Human Subjects ◽  
Weight Bearing ◽  
Blood Perfusion ◽  
Whole Body ◽  
External Compression ◽  
Doppler Flowmetry ◽  
Gravitational Fields ◽  
Plantar Surface ◽  
Opening Load

Our objective was to understand how weight bearing with varying gravitational fields affects blood perfusion in the sole of the foot. Human subjects underwent whole body tilting at four angles: upright [1 gravitational vector from head to foot (Gz)], 22 degrees (0.38 Gz), 10 degrees (0.17 Gz), and supine (0 Gz), simulating the gravitational fields of Earth, Mars, Moon, and microgravity, respectively. Cutaneous capillary blood flow was monitored on the plantar surface of the heel by laser Doppler flowmetry while weight-bearing load was measured. At each tilt angle, subjects increased weight bearing on one foot in graded load increments of 1 kg beginning with zero. The weight bearing at which null flow first occurred was determined as the closing load. Subsequently, the weight bearing was reduced in reverse steps until blood flow returned (opening load). Mean closing loads for simulated Earth gravity, Mars gravity, Moon gravity, and microgravity were 9.1, 4.6, 4.4, and 3.6 kg, respectively. Mean opening loads were 7.9, 4.1, 3.5, and 3.1 kg, respectively. Mean arterial pressures in the foot (MAP(foot)) calculated for each simulated gravitational field were 192, 127, 106, and 87 mmHg, respectively. Closing load and opening load were significantly correlated with MAP(foot) (r =0.70, 0.72, respectively) and were significantly different (P < 0.001) from each other. The data suggest that decreased local arterial pressure in the foot lowers tolerance to external compression. Consequently, the human foot sole may be more prone to cutaneous ischemia during load bearing in microgravity than on Earth.

Role of prostaglandins in regulation of gastric mucosal blood flow and acid secretion

1992 ◽  
Vol 263 (4) ◽  
pp. G446-G451 ◽  
Author(s):  
L. Holm ◽  
A. Jagare
Keyword(s):  
Blood Flow ◽  
Acid Secretion ◽  
Acid Output ◽  
Mucosal Blood Flow ◽  
Gastric Mucosal Blood Flow ◽  
Doppler Flowmetry ◽  
Blood Flow Reduction ◽  
Red Blood Cell Velocity ◽  
Blood Flow Increase

The role of prostaglandins in the rat gastric mucosal vascular response to acid stimulation was studied. Blood flow was measured with laser-Doppler flowmetry (LDF) and with red blood cell velocity measurements in the superficial mucosa; acid secretion was determined by titration. Baseline acid output was calculated to be 0.026 +/- 0.011 mueq/min. Pentagastrin (20 and 40 micrograms.kg-1.h-1 iv) significantly increased acid output to 0.387 +/- 0.104 and 0.546 +/- 0.220 mueq/min and LDF to 119 +/- 10 and 132 +/- 13% of control, respectively. LDF was significantly reduced by 15% after indomethacin (3 mg/kg iv) and was not changed by pentagastrin, whereas acid secretion increased to similar levels as without indomethacin pretreatment. The H2-agonist impromidine (100 and 500 micrograms.kg-1.h-1 iv) induced a dose-dependent increase in acid secretion (0.178 +/- 0.068 and 0.330 +/- 0.072 mueq/min, respectively) while blood flow was unchanged. Despite a substantial blood flow reduction (-38%) by indomethacin, impromidine did not alter blood flow, and acid secretion was dose dependently increased to similar values as without indomethacin pretreatment. These results provide further evidence that there is not necessarily any correlation between blood flow and acid secretion and that the pentagastrin-induced blood flow increase depends on prostaglandin release.

scholarly journals Oxygen Tension and Blood Flow in Relation to Revascularization in Transplanted Adult and Fetal Rat Pancreatic Islets

2002 ◽  
Vol 11 (8) ◽  
pp. 813-820 ◽  
Author(s):  
Per-Ola Carlsson ◽  
Göran Mattsson
Keyword(s):  
Blood Flow ◽  
Pancreatic Islets ◽  
Oxygen Tension ◽  
Blood Perfusion ◽  
Vascular Density ◽  
Low Oxygen ◽  
Doppler Flowmetry ◽  
Rat Pancreatic Islets ◽  
Low Oxygen Tension ◽  
Fetal Islets

We have previously recorded a decreased oxygen tension and blood flow in syngeneically transplanted rat pancreatic islets. The present study related measurements of oxygen tension and blood flow to the vascular density in such grafts implanted beneath the renal capsule. We also evaluated whether transplanted fetal islets are better revascularized than adult islets, and if the degree of revascularization is directly related to the islet vascular endothelial growth factor (VEGF) production. Tissue pO2 was measured using Clark microelectrodes, whereas islet graft blood flow was measured with laser-Doppler flowmetry. The vascular density of endogenous and transplanted islets was quantified in histological specimens stained with the lectin Bandeiraea simplicifolia (BS-1). Tissue pO2 in the transplanted adult and fetal islet grafts was similar and markedly lower than in the endogenous islets. The blood perfusion of both the adult and fetal islet grafts was 60–65% of that in the renal cortex. Administration of d-glucose did not affect tissue pO2 in either the endogenous or transplanted islets, nor graft blood perfusion. The number of capillaries found in the transplanted adult and fetal islets was similar and markedly lower than in endogenous islets. However, in the connective tissue stroma, which constituted ~20% of all islet grafts, the vascular density was higher than in the corresponding endocrine parts of these grafts. Incubated adult islets released higher amounts of VEGF than fetal islets. In conclusion, the previously described low oxygen tension of syngeneically transplanted adult rat islets is related to a low vascular density. Similar low oxygen tension and vascular density are seen in grafted fetal islets. The amount of VEGF production does not correlate to the degree of revascularization of the grafts.

Laser-Doppler measurement of tracheal mucosal blood flow: comparison with tracheal arterial flow

1991 ◽  
Vol 70 (1) ◽  
pp. 274-281 ◽  
Author(s):  
D. R. Corfield ◽  
M. E. Deffebach ◽  
I. Erjefalt ◽  
R. O. Salonen ◽  
S. E. Webber ◽  
...  
Keyword(s):  
Blood Flow ◽  
Mucosal Blood Flow ◽  
Laser Doppler ◽  
Doppler Measurement ◽  
Tracheal Mucosa ◽  
Doppler Flowmetry ◽  
Arterial Perfusion ◽  
Arterial Inflow ◽  
Electromagnetic Flow Probe ◽  
Tracheal Mucosal Blood Flow

Blood flow in the tracheal mucosa (Qm) has been measured by laser-Doppler flowmetry in anesthetized sheep and dogs. The values have been compared with tracheal arterial inflow (Qtr) by use of an electromagnetic flow probe and with tracheal arterial perfusion pressure (Ptr) produced by mechanical perfusion. Changes in blood flow were caused by injections of methacholine, phenylephrine, and histamine into the perfusion circuit. These interventions produced a range of measurements for each animal. Correlations of Qm against Qtr were significant in two of five animals (R = 0.03–0.93); correlations of Qm against Ptr were significant in two of four animals (R = 0.56–0.96). Percent changes in Qtr were generally much larger than those of Qm, and there was considerable variability between Qm and either Qtr or Ptr. Qm reflected the same vascular changes as Ptr or Qtr in 28 interventions and showed an opposing change in 4 cases. In 11 interventions, changes measured by Ptr or Qtr were not reflected by any changes in Qm. Thus qualitative changes in tracheal perfusion measured with these methods were usually the same; quantitatively the three methods showed great differences. These differences may reflect different regulatory mechanisms in various components of the tracheal vasculature or different technical aspects of the methods used.

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