Wir danken den Dialysemitarbeitern und Mitgliedern der Abteilung für Nephrologie im Saitama Medical Center der Jichi Medical University. Wir danken Editage (www.editage.com) für die englischsprachige Bearbeitung.

Alle Teilnehmer gaben eine schriftliche Einverständniserklärung. Die Studie wurde vom Institutional Review Board des Saitama Medical Center, Jichi Medical University, Japan genehmigt (RIN 15–104).
1. Gerät zur Überwachung von rSO2
<ol><li>Bereiten Sie ein NIRS-Gerät zur Messung der Sauerstoffversorgung des Gewebes vor. Dieses Gerät verfügt über vier Kanäle und kann Messungen in bis zu vier Organen gleichzeitig durchführen.</li>
	<li>Bereiten Sie einen Messsensor für die NIRS-Überwachung vor, um dierSO-2-Werte in jedem Organ durch Übertragung von Nahinfrarotlicht bei zwei Wellenlängen der Befestigung zu bewerten.</li>
</ol>2. Anbringen des Messsensors
<ol><li>Lassen Sie jeden Patienten mindestens 5 Minuten vor der Huntington-Krankheit in Rückenlage ruhen.</li>
	<li>Befestigen Sie Messsensoren an der Stirn, dem rechten Hypochondrium und den Unterschenkeln, um rSO2 im Gehirn, in der Leber bzw. in der Unterschenkelmuskulatur zu bewerten.</li>
	<li>Überwachung der zerebralen Sauerstoffversorgung<ol><li>Befestigen Sie Messsensoren an der Stirn der dominanten Hemisphäre.</li>
	</ol></li>
	<li>Überwachung der hepatischen Oxygenierung<ol><li>Bereiten Sie die Echographie vor, um die Tiefe der Leber des Patienten von der Körperoberfläche aus zu messen. Vergewissern Sie sich, dass diese Messung innerhalb von 20–30 mm von der Körperoberfläche entfernt ist. Als nächstes befestigen Sie die Messsensoren am rechten Hypochondrium. HINWEIS: In diesem Gerät solltenrSO2-Werte in tiefem Gewebe 20–30 mm von der Körperoberfläche entfernt erhalten werden. In einigen Fällen kann sich die Leber aufgrund des Vorhandenseins von dickem Unterhautfett mehr als 30 mm von der Körperoberfläche entfernt befinden.</li>
	</ol></li>
	<li>Überwachung der Sauerstoffversorgung der Muskeln<ol><li>Befestigen Sie Messsensoren an den rechten oder beidseitigen Unterschenkeln.</li>
	</ol></li>
	<li>Sensoranschluss und Stromversorgung des Geräts<ol><li>Verbinden Sie jeden Sensor mit den Leitungen des Geräts. Schalten Sie anschließend das Gerät ein und beginnen Sie mit der Messung der Sauerstoffversorgung.</li>
	</ol></li>
</ol>3. Durchstechen des Dialyse-Shunts und Beginn der Überwachung
<ol><li>Punktion des Dialyse-Shunts<ol><li>Punktieren Sie den Dialyse-Shunt der Patienten, um die Huntington-Therapie zu beginnen. Messen Sie zu diesem Zeitpunkt den Blutdruck mit einem digitalen Blutdruckmessgerät, das mit dem Dialysegerät ausgestattet ist, und entnehmen Sie Blutproben mit Spritzen.</li>
	</ol></li>
	<li>Überwachung starten<ol><li>Nach Beginn der Huntington-Therapie beginnen Sie mit der Überwachung der Sauerstoffversorgung des Gewebes der drei Organe: Gehirn, Leber und Unterschenkelmuskulatur.</li>
	</ol></li>
	<li>Überwachung von rSO2 während der HD<ol><li>Beobachten Sie Veränderungen derrSO2-Werte jedes Organs und messen Sie den Blutdruck regelmäßig zusätzlich zu der üblichen Überwachung während der Huntington-Therapie, einschließlich Herzfrequenz, Venendruck und Blutvolumen. Bestätigen Sie den Befestigungsbereich und die Verbindung zwischen den Sensoren und Leitungen.</li>
	</ol></li>
</ol>

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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=Central+venous+oxygen+saturation+and+thoracic+admittance+during+dialysis:+new+approaches+to+hemodynamic+monitoring.">Central venous oxygen saturation and thoracic admittance during dialysis: new approaches to hemodynamic monitoring.</a> Hemodialysis International. 12 (3), 369-377 (2008).</li><li>Kamijo, Y., 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=Continuous+monitoring+of+blood+pressure+by+analyzing+the+blood+flow+sound+of+arteriovenous+fistula+in+hemodialysis+patients.">Continuous monitoring of blood pressure by analyzing the blood flow sound of arteriovenous fistula in hemodialysis patients.</a> Clinical and Experimental Nephrology. 22 (3), 677-683 (2018).</li><li>Ito, K., 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=Factors+affecting+cerebral+oxygenation+in+hemodialysis+patients:+cerebral+oxygenation+associates+with+pH,+hemodialysis+duration,+serum+albumin+concentration,+and+diabetes+mellitus.">Factors affecting cerebral oxygenation in hemodialysis patients: cerebral oxygenation associates with pH, hemodialysis duration, serum albumin concentration, and diabetes mellitus.</a> PLoS One. 10 (2), 0117474 (2015).</li><li>Imai, S., 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=Deterioration+of+Hepatic+Oxygenation+Precedes+an+Onset+of+Intradialytic+Hypotension+with+Little+Change+in+Blood+Volume+during+Hemodialysis.">Deterioration of Hepatic Oxygenation Precedes an Onset of Intradialytic Hypotension with Little Change in Blood Volume during Hemodialysis.</a> Blood Purification. 45 (4), 345-346 (2018).</li><li>Cho, A. R., Kwon, J. Y., Kim, C., Hong, J. M., Kang, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+sensor+location+on+regional+cerebral+oxygen+saturation+measured+by+INVOS+5100+in+on-pump+cardiac+surgery.">Effect of sensor location on regional cerebral oxygen saturation measured by INVOS 5100 in on-pump cardiac surgery.</a> Journal of Anesthesia. 31 (2), 178-184 (2017).</li><li>Ito, K., 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=Deterioration+of+cerebral+oxygenation+by+aortic+arch+calcification+progression+in+patients+undergoing+hemodialysis:+A+cross-sectional+study.">Deterioration of cerebral oxygenation by aortic arch calcification progression in patients undergoing hemodialysis: A cross-sectional study.</a> BioMed Research International. , 2852514 (2017).</li><li>Ito, K., 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=Blood+transfusion+during+haemodialysis+improves+systemic+tissue+oxygenation:+A+case+report.">Blood transfusion during haemodialysis improves systemic tissue oxygenation: A case report.</a> Nefrologia. 37 (4), 435-437 (2017).</li><li>Ito, K., 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=Improvement+of+bilateral+lower-limb+muscle+oxygenation+by+low-density+lipoprotein+apheresis+in+a+patient+with+peripheral+artery+disease+undergoing+hemodialysis.">Improvement of bilateral lower-limb muscle oxygenation by low-density lipoprotein apheresis in a patient with peripheral artery disease undergoing hemodialysis.</a> Nefrologia. 39 (1), 90-92 (2019).</li><li>Kitano, T., 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=Changes+in+tissue+oxygenation+in+response+to+sudden+intradialytic+hypotension.">Changes in tissue oxygenation in response to sudden intradialytic hypotension.</a> Journal of Artificial Organs. 23 (2), 187-190 (2020).</li><li>Lemmers, P. 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Keine Interessenkonflikte.

Die NIRS-Überwachung wurde hauptsächlich zur Beurteilung von zerebralem rSO2 eingesetzt, insbesondere bei kardiovaskulären oder zerebrovaskulären Operationen, die eine extrakorporale Zirkulation erfordern. Während der extrakorporalen Zirkulation einschließlich der Huntington-Therapie konnten einige Organe eine relative Ischämiezeigen 7,17,18; Es bleibt jedoch unklar, ob die Sauerstoffversorgung des Gewebes nied...

Nahinfrarotspektroskopie (NIRS) wurde verwendet, um die regionale Sauerstoffsättigung (rSO 2), einen Marker für die Oxygenierung des Gewebes, insbesondere die zerebrale Sauerstoffversorgung, in verschiedenen klinischen Umgebungen zu bewerten 1,2,3 und wurde kürzlich bei Patienten angewendet, die sich einer Hämodialyse (HD) unterziehen4,5,6,7,8,9,10, 11. Zerebrale rSO2 ist Berichten zufolge mit kognitiver Funktion bei Patienten assoziiert, die sich der Huntington-Krankheit unterziehen oder solche mit nicht-dialysierter chronischer Nierenerkrankung (CKD)11,12. Bisher war der Einsatz der NIRS-Überwachung bei Patienten mit CNE jedoch begrenzt.
Da die NIRS-Überwachung in Echtzeit und nichtinvasiv ist, haben wir ihre Nützlichkeit als Überwachungsgerät bei Patienten mit der Huntington-Krankheit bewertet. Obwohl NIRS hauptsächlich zur Messung von zerebralem rSO 2 verwendet wird, untersuchten wir auch rSO 2-Werte in anderen Organen während der Huntington-Krankheit. Konkret wurden die rSO2-Messsensoren an der Stirn, dem rechten Hypochondrium und den Unterschenkeln angebracht, um rSO2 im Gehirn, in der Leber bzw. in den unteren Muskeln zu bewerten. Die Ergebnisse zeigten, dass die NIRS-Überwachung ein neuer Ansatz sein könnte, um Veränderungen der Organoxygenierung während der Huntington-Krankheit oder Faktoren, die die Gewebeoxygenierung bei CNE-Patienten beeinflussen, zu klären.
Bisher wurde eine kontinuierliche Überwachung während der Huntington-Krankheit, Blutvolumenüberwachung, zentralvenöse Sauerstoffsättigung, Thoraxaufnahme und elektronisch stethoskopgesteuerter geschätzter Blutdruck (BP) in klinischen Umgebungen durchgeführt13,14,15; Es gibt jedoch Einschränkungen für die Vorhersage von Hypotonie oder die breite Verwendung von Geräten. Im Gegensatz dazu könnte der neue nichtinvasive Ansatz hier Echtzeitinformationen über die intradialytische Sauerstoffdynamik in einzelnen Organen liefern. Daher kann diese Überwachungsmethode den Nachweis einer vorübergehenden Organischämie in den frühen Phasen der intradialytischen Hypotonie ermöglichen und auch die sichere Durchführung der Huntington-Krankheit ermöglichen. Dieser Artikel beschreibt ein Protokoll zur Messung der Gewebeoxygenierung, dargestellt durch rSO2, wie es bei Patienten mit der Huntington-Krankheit angewendet wird.

<table>
	<tbody>
		<tr>
			<td>DBB-100NX</td>
			<td>Nikkiso</td>
			<td>DBB-100NX</td>
			<td>Dialysis machine</td>
		</tr>
		<tr>
			<td>INVOS 5100c</td>
			<td>Covidien Japan</td>
			<td>INVOSTM 5100c</td>
			<td>tissue oxygenation device</td>
		</tr>
		<tr>
			<td>SOMASENSER</td>
			<td>Covidien Japan</td>
			<td>CV-SAFB-SM/INTL</td>
			<td>NIRS sensor</td>
		</tr>
	</tbody>
</table>

measurement of tissue oxygenation using near-infrared spectroscopy in patients undergoing hemodialysis

Die Nahinfrarotspektroskopie (NIRS) wurde kürzlich als Werkzeug zur Messung der regionalen Sauerstoffsättigung (rSO2), einem Marker für die Sauerstoffversorgung des Gewebes, in klinischen Umgebungen wie Herz-Kreislauf- und Gehirnchirurgie, Neugeborenenüberwachung und präklinischer Medizin eingesetzt. Die NIRS-Überwachungsgeräte sind echtzeitfähig und nichtinvasiv und wurden hauptsächlich zur Beurteilung der zerebralen Sauerstoffversorgung bei kritisch kranken Patienten während einer Operation oder Intensivpflege eingesetzt. Bisher war der Einsatz der NIRS-Überwachung bei Patienten mit chronischer Nierenerkrankung (CKD) einschließlich Hämodialyse (HD) begrenzt; Daher untersuchten wirrSO-2-Werte in einigen Organen während der Huntington-Krankheit. Wir überwachtenrSO2-Werte mit einem NIRS-Gerät, das Nahinfrarotlicht bei 2 Wellenlängen der Befestigung übertrug. Die Huntington-Patienten wurden in Rückenlage gebracht, wobei rSO 2-Messsensoren an der Stirn, dem rechten Hypochondrium und den Unterschenkeln angebracht waren, um rSO2 im Gehirn, in der Leber bzw. in der Unterschenkelmuskulatur zu bewerten. Die NIRS-Überwachung könnte ein neuer Ansatz sein, um Veränderungen der Organoxygenierung während der Huntington-Krankheit oder Faktoren, die die Sauerstoffversorgung des Gewebes bei CNE-Patienten beeinflussen, zu klären. Dieser Artikel beschreibt ein Protokoll zur Messung der Gewebeoxygenierung, dargestellt durch rSO2, wie es bei Huntington-Patienten angewendet wird.

Zerebrale rSO 2-Werte vor der Huntington-Krankheit waren niedriger als bei gesunden Probanden und zerebrale rSO2 bei Huntington-Patienten mit Diabetes mellitus (DM) waren niedriger als bei Huntington-Patienten ohne DM (Abbildung 1)16. Obwohl die Sauerstoffversorgung des Gewebes ohne eine Abnahme des Blutdrucks während der Huntington-Krankheit fortgesetzt wird, beobachteten wir zufällig Veränderungen des zerebralen und hepatischen rSO 2 aufgrun...

Watch this Scientific Journal Video about Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis at JoVE.com

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Wir präsentieren ein Protokoll zur Messung der regionalen Sauerstoffsättigung (rSO2) bei Hämodialysepatienten (HD) unter Verwendung eines Nahinfrarotspektroskopie-Monitors. DerrSO-2-Wert ist ein Index der Gewebeoxygenierung. Diese nichtinvasive und Echtzeitüberwachung könnte nützlich sein, um Veränderungen der Organoxygenierung während der Huntington-Krankheit zu bestätigen.

Messung der Gewebeoxygenierung mittels Nahinfrarotspektroskopie bei Patienten, die sich einer Hämodialyse unterziehen

Near-infrared spectroscopy (NIRS) has recently been applied as a tool to measure regional oxygen saturation (rSO2), a marker of tissue oxygenation, in ...

measurement-tissue-oxygenation-using-near-infrared-spectroscopy

Research

JoVE Journal

Medicine

2.0K Aufrufe.  Jichi Medical University. Wir präsentieren ein Protokoll zur Messung der regionalen Sauerstoffsättigung (rSO2) bei Hämodialysepatienten (HD) unter Verwendung eines Nahinfrarotspektroskopie-Monitors. DerrSO-2-Wert ist ein Index der Gewebeoxygenierung. Diese nichtinvasive und Echtzeitüberwachung könnte nützlich sein, um Veränderungen der Organoxygenierung während der Huntington-Krankheit zu bestätigen.

Serie: Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Dual-mode Imaging of Cutaneous Tissue Oxygenation and Vascular Function

Accurate assessment of cutaneous tissue oxygenation and vascular function is important for appropriate detection, staging, and treatment of many health disorders such as chronic wounds. We report the development of a dual-mode imaging system for non-invasive and non-contact imaging of cutaneous tissue oxygenation and vascular function. The imaging system integrated an infrared camera, a CCD camera, a liquid crystal tunable filter and a high intensity fiber light source. A Labview interface was programmed for equipment control, synchronization, image acquisition, processing, and visualization. Multispectral images captured by the CCD camera were used to reconstruct the tissue oxygenation map. Dynamic thermographic images captured by the infrared camera were used to reconstruct the vascular function map. Cutaneous tissue oxygenation and vascular function images were co-registered through fiduciary markers. The performance characteristics of the dual-mode image system were tested in humans.

A dual-mode imaging system was developed for non-contact assessment of cutaneous tissue oxygenation and vascular function.

Dual-Mode-Imaging von Hautgewebe Oxygenation und Gefäßfunktion

Accurate assessment of cutaneous tissue oxygenation and vascular function is important for appropriate detection, staging, and treatment of many health ...

Forschung

Medizin

Near Infrared Optical Projection Tomography for Assessments of &beta;-cell Mass Distribution in Diabetes Research

By adapting OPT to include the capability of imaging in the near infrared (NIR) spectrum, we here illustrate the possibility to image larger bodies of pancreatic tissue, such as the rat pancreas, and to increase the number of channels (cell types) that may be studied in a single specimen. We further describe the implementation of a number of computational tools that provide: 1/ accurate positioning of a specimen's (in our case the pancreas) centre of mass (COM) at the axis of rotation (AR)2; 2/ improved algorithms for post-alignment tuning which prevents geometric distortions during the tomographic reconstruction2 and 3/ a protocol for intensity equalization to increase signal to noise ratios in OPT-based BCM determinations3. In addition, we describe a sample holder that minimizes the risk for unintentional movements of the specimen during image acquisition. Together, these protocols enable assessments of BCM distribution and other features, to be performed throughout the volume of intact pancreata or other organs (e.g. in studies of islet transplantation), with a resolution down to the level of individual islets of Langerhans.

Near Infrared Optical Projection Tomography for Assessments of &amp;#946;-cell Mass Distribution in Diabetes Research

We describe the adaptation of optical projection tomography (OPT)1 to imaging in the near infrared spectrum, and the implementation of a number of computational tools. These protocols enable assessments of pancreatic &beta;-cell mass (BCM) in larger specimens, increase the multichannel capacity of the technique and increase the quality of OPT data.

Near Infrared Optical Projection Tomography für Assessments von β-Zellen Massenverteilung im Diabetes Research

By adapting OPT to include the capability of imaging in the near infrared (NIR) spectrum, we here illustrate the possibility to image larger bodies of ...

Tissue-simulating Phantoms for Assessing Potential Near-infrared Fluorescence Imaging Applications in Breast Cancer Surgery

Inaccuracies in intraoperative tumor localization and evaluation of surgical margin status result in suboptimal outcome of breast-conserving surgery (BCS). Optical imaging, in particular near-infrared fluorescence (NIRF) imaging, might reduce the frequency of positive surgical margins following BCS by providing the surgeon with a tool for pre- and intraoperative tumor localization in real-time. In the current study, the potential of NIRF-guided BCS is evaluated using tissue-simulating breast phantoms for reasons of standardization and training purposes.
Breast phantoms with optical characteristics comparable to those of normal breast tissue were used to simulate breast conserving surgery. Tumor-simulating inclusions containing the fluorescent dye indocyanine green (ICG) were incorporated in the phantoms at predefined locations and imaged for pre- and intraoperative tumor localization, real-time NIRF-guided tumor resection, NIRF-guided evaluation on the extent of surgery, and postoperative assessment of surgical margins. A customized NIRF camera was used as a clinical prototype for imaging purposes.
Breast phantoms containing tumor-simulating inclusions offer a simple, inexpensive, and versatile tool to simulate and evaluate intraoperative tumor imaging. The gelatinous phantoms have elastic properties similar to human tissue and can be cut using conventional surgical instruments. Moreover, the phantoms contain hemoglobin and intralipid for mimicking absorption and scattering of photons, respectively, creating uniform optical properties similar to human breast tissue. The main drawback of NIRF imaging is the limited penetration depth of photons when propagating through tissue, which hinders (noninvasive) imaging of deep-seated tumors with epi-illumination strategies.

Near-infrared fluorescence (NIRF) imaging may improve therapeutic outcome of breast cancer surgery by enabling intraoperative tumor localization and evaluation of surgical margin status. Using tissue-simulating breast phantoms containing fluorescent tumor-simulating inclusions, potential clinical applications of NIRF imaging in breast cancer patients can be assessed for standardization and training purposes.

Gewebe-Simulation Phantoms zur Bestimmung der potentiellen Near-Infrarot-Fluoreszenz-Imaging-Anwendungen in Brustkrebschirurgie

Inaccuracies in intraoperative tumor localization and evaluation of surgical margin status result in suboptimal outcome of breast-conserving surgery ...

Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli

Direct thrombus imaging visualizes the root cause of thromboembolic infarction. Being able to image thrombus directly allows far better investigation of stroke than relying on indirect measurements, and will be a potent and robust vascular research tool. We use an optical imaging approach that labels thrombi with a molecular imaging thrombus marker&#160;&#8212; a Cy5.5 near-infrared fluorescent (NIRF) probe that is covalently linked to the fibrin strands of the thrombus by the fibrin-crosslinking enzymatic action of activated coagulation factor XIIIa during the process of clot maturation. A micro-computed tomography (microCT)-based approach uses thrombus-seeking gold nanoparticles (AuNPs) functionalized to target the major component of the clot: fibrin. This paper describes a detailed protocol for the combined in vivo microCT and ex vivo NIRF imaging of thromboemboli in a mouse model of embolic stroke. We show that in vivo microCT and fibrin-targeted glycol-chitosan AuNPs (fib-GC-AuNPs) can be used for visualizing both in situ thrombi and cerebral embolic thrombi. We also describe the use of in vivo microCT-based direct thrombus imaging to serially monitor the therapeutic effects of tissue plasminogen activator-mediated thrombolysis. After the last imaging session, we demonstrate by ex vivo NIRF imaging the extent and the distribution of residual thromboemboli in the brain. Finally, we describe quantitative image analyses of microCT and NIRF imaging data. The combined technique of direct thrombus imaging allows two independent methods of thrombus visualization to be compared: the area of thrombus-related fluorescent signal on ex vivo NIRF imaging vs. the volume of hyperdense microCT thrombi in vivo.

This protocol describes the application of combined near-infrared fluorescent (NIRF) imaging and micro-computed tomography (microCT) for visualizing cerebral thromboemboli. This technique allows the quantification of thrombus burden and evolution. The NIRF imaging technique visualizes fluorescently labeled thrombus in excised brain, while the microCT technique visualizes thrombus inside living animals using gold-nanoparticles.

Kombinierte Near-Infrarot-Fluoreszenz-Bildgebung und Mikrocomputertomographie für Direkt Visualizing Cerebral Thromboembolie

Direct thrombus imaging visualizes the root cause of thromboembolic infarction. Being able to image thrombus directly allows far better investigation of ...

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and lower quality of life. Persistent postsurgical pain is relatively refractory to treatment hence generating a high need for preventive strategies and treatments. Therefore, the identification of patients at risk of developing persistent pain is an area of active ongoing research. Recently it was demonstrated that peri-operative disruptions in central pain processing may be able to predict persistent postsurgical pain at long term follow-up in breast cancer patients. The aim of the current report is to present a short protocol to obtain pain thresholds to different stimuli at multiple sites and a measure of endogenous analgesia in breast cancer patients. We have used this method successfully in a clinical context and detail some representative results from a clinical study.

Persistent postsurgical pain may be related to changes in pain processing. By assessing pain in response to standardized stimuli, changes in pain processing can be elucidated. We present methods to obtain pain thresholds to different stimuli and a measure of endogenous analgesia in patients undergoing breast cancer surgery.

Eine Quantitative sensorische Tests Paradigma zu Maßnahmen der Schmerzen bei Patienten mit Brustkrebschirurgie Verarbeitung

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and ...

Skeletal Muscle Neurovascular Coupling, Oxidative Capacity, and Microvascular Function with 'One Stop Shop' Near-infrared Spectroscopy

Exercise represents a major hemodynamic stress that demands a highly coordinated neurovascular response in order to match oxygen delivery to metabolic demand. Reactive hyperemia (in response to a brief period of tissue ischemia) is an independent predictor of cardiovascular events and provides important insight into vascular health and vasodilatory capacity. Skeletal muscle oxidative capacity is equally important in health and disease, as it determines the energy supply for myocellular processes. Here, we describe a simple, non-invasive approach using near-infrared spectroscopy to assess each of these major clinical endpoints (reactive hyperemia, neurovascular coupling, and muscle oxidative capacity) during a single clinic or laboratory visit. Unlike Doppler ultrasound, magnetic resonance images/spectroscopy, or invasive catheter-based flow measurements or muscle biopsies, our approach is less operator-dependent, low-cost, and completely non-invasive. Representative data from our lab taken together with summary data from previously published literature illustrate the utility of each of these end-points. Once this technique is mastered, application to clinical populations will provide important mechanistic insight into exercise intolerance and cardiovascular dysfunction.

Skeletal Muscle Neurovascular Coupling, Oxidative Capacity, and Microvascular Function with &#039;One Stop Shop&#039; Near-infrared Spectroscopy

Here, we describe a simple, non-invasive approach using near-infrared spectroscopy to assess reactive hyperemia, neurovascular coupling and skeletal muscle oxidative capacity in a single clinic or laboratory visit.

Skelettmuskulatur neurovaskuläre Kopplung, Oxidative Kapazität und mikrovaskuläre Funktion mit "One Stop Shop" Nah-Infrarot-Spektroskopie

Exercise represents a major hemodynamic stress that demands a highly coordinated neurovascular response in order to match oxygen delivery to metabolic ...

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

Near infrared spectroscopy (NIRS) calculates regional tissue oxygenation (rSO2) using the different absorption spectra of oxygenated and deoxygenated hemoglobin molecules. A probe placed on the skin emits light that is absorbed, scattered, and reflected by the underlying tissue. Detectors in the probe sense the amount of reflected light: this reflects the organ-specific ratio of oxygen supply and consumption - independent of pulsatile flow. Modern devices enable the simultaneous monitoring at different body sites. A rise or dip in the rSO2 curve visualizes changes in oxygen supply or demand before vital signs indicate them. The evolution of rSO2 values in relation to the starting point is more important for interpretation than are absolute values.
A routine clinical application of NIRS is the surveillance of somatic and cerebral oxygenation during and after cardiac surgery. It is also administered in preterm infants at risk for necrotizing enterocolitis, newborns with hypoxic ischemic encephalopathy and a potential risk of impaired tissue oxygenation. In the future, NIRS could be increasingly used in multimodal neuromonitoring, or applied to monitor patients with other conditions (e.g., after resuscitation or traumatic brain injury).

This protocol is designed to assist clinicians to measure regional tissue oxygenation at different body sites in infants and children. It can be used in situations where tissue oxygenation is potentially compromised, particularly during cardiopulmonary bypass, when using non-pulsatile cardiac-assist devices, and in critically ill neonates, infants and children.

Wie man Nahinfrarot-Spektroskopie bei kritisch kranken Neugeborenen, Säuglingen und Kindern verabreicht

Near infrared spectroscopy (NIRS) calculates regional tissue oxygenation (rSO2) using the different absorption spectra of oxygenated and deoxygenated ...

Near Infrared Photoimmunotherapy for Mouse Models of Pleural Dissemination

The efficacy of photoimmunotherapy can be evaluated more accurately with an orthotopic mouse model than with a subcutaneous one. A pleural dissemination model can be used for the evaluation of treatment methods for intrathoracic diseases such as lung cancer or malignant pleural mesothelioma.
Near-infrared photoimmunotherapy (NIR-PIT) is a recently developed cancer treatment strategy that combines the specificity of tumor-targeting antibodies with toxicity caused by a photoabsorber (IR700Dye) after exposure to NIR light. The efficacy of NIR-PIT has been reported using various antibodies; however, only a few reports have shown the therapeutic effect of this strategy in an orthotopic model. In the present study, we demonstrate an example of efficacy evaluation of the pleural disseminated lung cancer model, which was treated using NIR-PIT.

Near-infrared photoimmunotherapy (NIR-PIT) is an emerging cancer therapeutic strategy that utilizes an antibody-photoabsorber (IR700Dye) conjugate and NIR light to destroy cancer cells. Here, we present a method to evaluate the antitumor effect of NIR-PIT in a mouse model of pleural disseminated lung cancer and malignant pleural mesothelioma using bioluminescence imaging.

Nahinfrarot-Photoimmuntherapie für Mausmodelle der Pleuraverbreitung

The efficacy of photoimmunotherapy can be evaluated more accurately with an orthotopic mouse model than with a subcutaneous one. A pleural dissemination ...

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

Ischemic heart disease (IHD) represents a group of clinical syndromes characterized by myocardial ischemia, leading to an impairment in the myocardial blood supply and compromised perfusion. Several clinical variables assessed through a stress test, such as oxygen uptake (VO2) and heart rate oxygen pulse (HR/O2), have been attributed as cardiopulmonary prognostic factors in patients with IHD. However, other factors like hydration status (HS), potentially affecting the cardiopulmonary response, have been barely addressed. Unbalanced HS has a short-term effect on plasma volume and the sympathetic nervous system, which impacts blood volume, and lowers VO2 and HR/O2. Recently, bioelectrical impedance analysis (BIA), a method based on the opposition of body tissues (including fluid volume) to a low electrical current, has been widely used to assess HS by obtaining two components: resistance (R) and reactance (Xc) and using prediction formulas. However, several limitations as chronic illness or abnormal fluid status, may affect the results. In this sense, alternative BIA methods, such as bioelectrical impedance vector analysis (BIVA), have become relevant. R and Xc (adjusted by height) result in a vector plotted on the R/Xc graph, which allows interpreting the HS as normal or abnormal according to the distance of the mean vector. This study aims to describe how to determine HS by BIVA using a single-frequency device and compare the results with the cardiopulmonary response in patients with IHD.

Hydration status imbalances can have a short-term effect on direct and indirect determinants of oxygen uptake and pulse, and morbidity and mortality prognostic factors in ischemic heart disease. This protocol describes the technique for assessment of hydration status through bioelectrical impedance vector analysis and cardiopulmonary response during exercise stress test.

Bewertung des Hydratationsstatus durch bioelektrische Impedanzvektoranalyse bei Patienten mit ischämischer Herzkrankheit, die sich einem Belastungstest unterziehen

Ischemic heart disease (IHD) represents a group of clinical syndromes characterized by myocardial ischemia, leading to an impairment in the myocardial ...

Funktionelle OT- und Nah-IR-Spektroskopie zur Untersuchung des Umbaus der Gehirnfunktion

Investigating the Effect of Different Types of Exercise on Upper Limb Functional Recovery in Patients with Right Hemisphere Damage Based on fNIRS

To investigate the effects of functional occupational therapy (FOT) combined with different types of exercise on upper limb motor function recovery and brain function remodeling in patients with right hemisphere damage (RHD) by analyzing functional near-infrared spectroscopy (fNIRS). Patients (n = 32) with RHD at Beijing Bo'ai Hospital were recruited and randomly allocated to receive either FOT combined with passive motion (N=16) or FOT combined with assisted active movement (N=16). The passive motion group (FOT-PM) received functional occupational therapy for 20 min and passive exercise for 10 min in each session, while the assisted active movement group (FOT-AAM) received functional occupational therapy for 20 min and assisted active exercise for 10 min. Both groups received conventional drug therapy and other rehabilitation therapy. Treatment was performed once a day, 5 times a week for 4 weeks. The recovery of motor function and activities of daily living (ADL) was assessed using Fugl-Meyer Assessment upper extremity (FMA-UE) and modified Barthel index (MBI) before and after treatment, and brain activation of the bilateral motor area was analyzed with fNIRS. The findings suggested that FOT combined with AAM was more effective than FOT combined with PM in improving the motor function of RHD patients' upper limbs and fingers, improving their ability to perform activities of daily living, and facilitating brain function remodeling of the motor area.

Autor im Rampenlicht: Förderung der Rehabilitation der oberen Gliedmaßen bei Patienten mit Schäden an der rechten Hemisphäre durch assistiertes aktives Training

Here, we investigate the effect of functional occupational therapy combined with assisted active or passive motion on the upper limb function of patients with right hemisphere damage and explore the effect of functional near-infrared spectroscopy on brain function remodeling.

Untersuchung der Wirkung verschiedener Arten von Bewegung auf die funktionelle Wiederherstellung der oberen Gliedmaßen bei Patienten mit Schädigung der rechten Hemisphäre auf der Grundlage von fNIRS

To investigate the effects of functional occupational therapy (FOT) combined with different types of exercise on upper limb motor function recovery and ...