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ケースプレゼンテーション （必要に応じて、該当する場合）：NA、これはまだ実験的な研究の手順ですが、まだ臨床的に使用されていません。 診断、評価、及び計画 （該当する場合は、必須）：NAは、これはまだ、まだ臨床的に使用されていない実験的な研究の手順です。 手順 （必須）：この部分は、以下のガイドラインを満たし、関連手順のステップバイステップの説明を含めてください。 1。毛細管顕微鏡（ 図1） <ol><li>当社capillaroscopy技術はSerneと彼の同僚は1から適応されました。膠原病が知られている2キャピラリー変更を生成するので、この手順の除外基準は、膠原病である。 </li><li>最低10時間一晩絶食させ、着座残りの20分後に、微小血管の測定は7の間に1時間半のために行われている静かで、温度制御された部屋の中で時から11時、（21.5から22.5℃の間に維持さ）、心臓レベルで着座位置と左手で被写体と。 </li><li>第三指の背側皮膚のNailfold毛細血管が（オリンパス;センターバレー、ペンシルバニア州）実体顕微鏡を用いて可視化され、デジタルカメラ（型番IN-1400：診断機器、スターリングハイツ、ミシガン州）モノクロ4メガピクセルのSPOT Insightにリンクされている、とラップトップコンピュータ（Dellの緯度D600：デル、テキサス州オースティン）。動きを制限するには、左の手と前腕は緩く折り畳んだ毛布で覆われており、顕微鏡のベースにある別の折り畳んだ毛布に休まれています。 </li><li> Nailbed照明は250 Wのハロゲン光ファイバーランプ​​（KL 2500LCD：;エルムズフォード、ニューヨーク州ショット-Fostec）;を用いて達成される補足150W光ファイバーハロゲン光源（B＆B、顕微鏡、株式会社Warrendaleの、PA）から追加の照明が使用され暗く着色された個人インチ</li><li>毛細血管、視覚化するために3.2倍対物レンズ（オリンパス3.2/0.07）は38.4xの総システム倍率で使用されます。 </li><li>カメラに付属のSPOTのイメージングソフトウェアを使用して、キャピラリー写真の明/暗コントラストはすべての被験者の毛細血管の可視性を最大化するために同じ標準SPOTのソフトウェア機能（明暗レベルの延伸）を使用して強化されています。 </li><li>毛細血管密度を定量化するために、デジタル顕微鏡写真postocclusive反応性充血時に、休息ベースラインで、3段階のそれぞれの間にすべての3から5秒を取り、静脈閉塞時にされています。 （a）の休息ベースラインでは、顕微鏡写真は安静時灌流毛細血管を検出するために3分かけて取得されます。 （b）はpostocclusive反応性充血時には、顕微鏡写真は、次のように機能的に灌流毛細血管（ベースラインプラスリザーブ毛細血管）を定量化するために取られる。まず、左上腕のオクルージョンカフは10分間の収縮期血圧は40 mmHgでに膨張される。顕微鏡写真は、その後、目の中に取られる電子最初の分はすぐに全ての機能灌流毛細血管を可視化、動脈閉塞の解除後。反応性充血次のような下位毛細血管密度が低下し、機能キャピラリー動員を示し、したがって機能希薄。 （c）は静脈閉塞の顕微鏡写真中に両方灌流し（アクティブ赤血球（RBC）モーション付き）と次のように毛細血管3（停滞、非移動赤血球で満たされた）かん流されないを含む最大の毛細血管密度を定量化するために取られる。 postocclusive反応性充血手順後残りの10分後、腕の袖口はこの時間の間に撮影された受動的にすべての特許毛細血管が存在し、顕微鏡写真に血液を強制的に、60秒の場合は60 mmHgでに膨張される。最大の毛細血管密度が含まれているので、構造的に存在するすべての毛細血管、最大の毛細血管密度の低下は構造的希薄化を示しています。 </li><li>毛細血管密度は平方パーミル毛細血管の数として定義されるnailfold皮膚のlimeter、少なくとも運動によってゆがめ4最も明確に焦点を当てた画像から得られた4つの測定値の平均として計算されます。虚血後、静脈閉塞のために90から105のための65から90まで、我々の研究では、キャピラリーカウント（毛細管/ mm 2）のための典型的な値は、ベースラインの55から80となっている。パーセントキャピラリー募集のための値は、5％および25％（〜10から15パーセントを意味する）の間で、70％とnormotensivesより高血圧の間に低い値である95％（〜80から90パーセントを意味する）との間に毛細管灌流％が典型的である。カウント手順の再現性は10の異なる被験者（ 図2）の写真の独立したマニュアルアセスメントを行われた3つのオブザーバーで検証されています。オブザーバーは、これらの科目のアイデンティティと血圧に盲検化された。訓練の後、独立して実行、その後のカウントが合意の高いレベルを示した。平均評価者間および評価者内不一致はオードであった2月3日毛細血管/ mm 2であり、級内相関係数rが0.90より大きいすべてだった。 capillaroscopy対策の短期変動は、評価者間および評価者内の矛盾（約2毛細管/ mm 2）のように同程度の大きさであったが、2〜3年にわたって観察し、長期的な変動が大きさの順に大きかった（約15毛細血管/ mm 2）で、長手方向の変更が容易に評価者変動と区別することができることを示す。 2キャピラリー機能対策の信頼性（内相相関係数パーセントキャピラリー募集や毛細血管灌流％を0.82用= 0.84）も高かった。 </li><li>調査官は今やイメージ-プロプラスイメージングソフトウェア（ 図3：バージョン6.2、メディアサイバネティクス社、ベセスダ、MD）を用いて毛細血管密度を定量化するためのコンピュータベースの手法を利用しています。ベースライン、虚血後、と静脈の間のピアソンの相関10名の被験者におけるソフトウェアと対応するマニュアルカウントで行わ達混雑カウントは2つの方法の間の合理的な合意を示す（いずれもp &lt;0.05）はそれぞれ0.78、0.78、および0.71であった。コンピュータベースのカウントの信頼性はマニュアルカウントのそれよりもわずかに低いが（静脈閉塞のためのベースラインの内相相関係数= 0.91、虚血後のために0.86、および0.84）依然として高い。我々はまた、我々が現在公表の準備をしている高血圧、などの複数の心血管危険因子を有する自動カウントの関連を実証する未発表のデータを持っています。 </li><li> 表1は、毛細血管密度測定および計算をまとめたものです。パーセントキャピラリー募集は受動的な静脈の間に観察された最大毛細血管密度（によって、postocclusive反応性充血（postocclusive反応性充血毛細血管密度マイナス基線毛細血管密度）によって誘導される毛細血管密度の増加を分割することにより評価される私達閉塞）。毛細血管の灌流％が（機能的に活性な）灌流されており、最大の毛細血管密度によってpostocclusive反応性充血毛細血管密度で割って計算されているすべての毛細血管に存在する割合を表しています。パーセントキャピラリー募集およびパーセントはどちらも毛細血管が機能して毛細血管の数を反映して灌流した。これらの施策の値が小さいと、機能的なキャピラリー希薄化を示しています。 </li></ol> 2。内皮機能評価<ol><li>内皮機能は、血管拡張を誘発する反応性充血の内皮依存性の刺激を利用しSivertsson、4の方法に従って、前腕血流量の非侵襲スモグラフィ測定を使用して、postocclusive反応性充血の前と後に評価される。 </li><li>仰臥位安静の10分後に座った状態で、件名がその静止長さを超えて10％に伸ばし水銀のゴムひずみゲージはarounをループしている5センチメートル肘前窩下dは、被験者の前腕。 </li><li>順番にドップラーレコーダー（; DEホカンソン株式会社; Belleveue、ワシントン州、CW-1）に接続されている、;ひずみゲージはプレチスモグラフ（ベルビュー、ワシントン州のDEホカンソン株式会社EC-4）に接続されています。 </li><li>上腕閉塞カフが適用され、アームが調整可能な静脈内極に接続スリング包帯を使用して心臓レベルで快適に中断されています。収縮期および拡張期血圧と心拍数は反対の腕に置かDinamap ProCare 100自動血圧計カフ（GEヘルスケア、Piscataway、NJ）を用いて得られる。 </li><li>手首周り小児カフが手への流れを閉塞するHgの200ミリメートルまで膨らませている。上腕カフは1.5秒間収縮さ50ミリメートルHgのに膨らませた後、それぞれの前腕血流量測定の前に急速に再膨張前腕の周囲に配置されたひずみゲージの拡大を通じて得られる。さ</li><li>前腕血流量（FBF）を再び休ん基線（FBF ベース ）で測定され、トンpostocclusive充血誘起最大血管拡張（FBF max）です。ベースラインの血流測定のために、4つの連続したFBF曲線は、30秒（FBF ベース ）内で得られる。 </li><li>閉塞カフは、その後、10分間の収縮期血圧は40 mmHgでに膨張される。動脈閉塞（postocclusive反応性充血）のリリースに続いて、4つの連続したFBF曲線は、フローの最初の30秒（FBF 最大 ）以内に得られている。 </li><li>比FBF 最大 / FBF ベースは 4 FBF ベース値の平均で4 FBF 最大値の平均値で割って、血管拡張作用の推定値として計算されます。最大の血管拡張（FVR MAX）で5前腕血管抵抗は次のように計算されFBF マックスで割った動脈圧（MAP）を意味する。反応性充血時のFBF マックス直接動脈内アセチルコリン、内皮依存性血管拡張薬の最大投与後FBFに関連しています6 </sup&gt;のため、FBF maxと比FBF / 最大 FBF ベースは内皮機能の非侵襲的な措置を受け付けています6月8日はまた、FBF maxおよびFVR maxの両方に抵抗動脈構造変化を（壁/ルーメン比を増加）を反映する。9 </li></ol>

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C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+aging+and+hypertension+on+the+microcirculation.">Effects of aging and hypertension on the microcirculation.</a> Hypertension. 47, 968-9674 (2006).</li><li>Debbabi, H., Uzan, L., Mourad, J. J., Safar, M., Levy, B. I., Tibirica, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+skin+capillary+density+in+treated+essential+hypertensive+patients.">Increased skin capillary density in treated essential hypertensive patients.</a> Am. J. Hypertens. 19, 477-483 (2006).</li><li>Serne, E. H., Gans, R. O., ter Maaten, J. C., Tangelder, G. J., Donker, A. J., Stehouwer, C. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impaired+skincapillary+recruitment+in+essential+hypertension+is+caused+by+both+functional+and+structural+capillary+rarefaction.">Impaired skincapillary recruitment in essential hypertension is caused by both functional and structural capillary rarefaction.</a> Hypertension. 38, 238-242 (2001).</li><li>Carpentier, P. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+techniques+for+clinical+assessment+of+the+peripheral+microcirculation.">New techniques for clinical assessment of the peripheral microcirculation.</a> Drugs. 58, 17-22 (2001).</li><li>Shore, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Capillaroscopy+and+the+measurement+of+capillary+pressure.">Capillaroscopy and the measurement of capillary pressure.</a> Br. J. Clin. Pharmacol. 50, 501-513 (2000).</li></ol>

著者らは、開示することがこの仕事の遂行またはパブリケーションに関連する興味のない金融対立を持っていません。

Capillaroscopy（毛細管顕微鏡）は毛細管構造の非標準的な尺度である。しかし、現在、キャピラリーstructure.Furthermoreを直接評価するための標準的な方法はありません、毛細血管顕微鏡は広く出版された仕事12、13、10、11、14から18の大規模で成長し、体内のcapillarydensityの直接評価に用いられてきた。さらに、当社は、前腕血流量、血管機能の十分に確立された測定、10、11とcapilla...

non-invasive assessment of microvascular and endothelial function

著者らは、心血管疾患の病因に微小血管機能障害の役割を調べるためにcapillaroscopyと前腕の血流のテクニックを利用してきた。 Capillaroscopyは直接微小循環を可視化するための非侵襲的、比較的安価な方法論です。パーセントキャピラリー募集は最大の毛細血管密度（受動的な静脈閉塞中に観察された）により、postocclusive反応性充血（postocclusive反応性充血毛細血管密度マイナス基線毛細血管密度）によって誘導される毛細血管密度の増加を分割することにより評価される。毛細血管の灌流％が（機能的に活性な）灌流されており、最大の毛細血管密度によってpostocclusive反応性充血毛細血管密度で割って計算されているすべての毛細血管に存在する割合を表しています。パーセントキャピラリー募集およびパーセントはどちらも毛細血管が機能して毛細血管の数を反映して灌流した。前腕血流量（FBF）技術PRovidesは内皮機能の非侵襲的な措置を受け入れ：FBF比の最大値 / FBF ベースは 4 FBF ベース値の平均で4 FBF 最大値の平均値で割って、血管拡張作用の推定値として計算されます。最大の血管拡張（FVR MAX）における前腕血管抵抗はFBF マックスで割った平均動脈圧（MAP）として計算されます。 capillaroscopyと前腕の両技術は、患者に容易に許容され、迅速に学習することができます。 微小血管および血管内皮機能は、本稿で述べた手法を用いて得られたが、臨床患者の心血管リスク低減のための戦略の将来有用性を有することができる測定します。我々は微小血管および内皮機能不全を示すレポートが高血圧前症を含む高血圧の初期の段階で発見され公開されてきたように、微小血管および血管内皮機能指標は、最終的に早期発見に役立つことができるは、その潜在的に致命的な結果を伴う末期の血管病変のリスク層別化と防止、。

正常血圧と高血圧の個体間の微小血管系の外観の違いは、図4と図5を比較することによって容易に明らかである。図4は、正常血圧者でよく整理された行のストレート毛細血管の典型的なネットワークを示しています。これとは対照的に、 図5に縮んだ、コイル状の毛細血管より乱さパターンを示します。 著?...

Watch this Scientific Journal Video about Non-invasive Assessment of Microvascular and Endothelial Function at JoVE.com

Non-invasive Assessment of Microvascular and Endothelial Function

Capillaroscopyは直接微小循環を可視化するための非侵襲的、比較的安価な方法論です。前腕血流技術は、内皮機能の受け入れ、非侵襲的な対策を提供します。

微小血管と内皮機能の非侵襲的評価

The authors have utilized capillaroscopy and forearm blood flow techniques to investigate the role of microvascular dysfunction in pathogenesis of ...

non-invasive-assessment-of-microvascular-and-endothelial-function

Research

JoVE Journal

Medicine

16.1K ビュー.  Thomas Jefferson University. Capillaroscopyは直接微小循環を可視化するための非侵襲的、比較的安価な方法論です。前腕血流技術は、内皮機能の受け入れ、非侵襲的な対策を提供します。

ビデオ: Non-invasive Assessment of Microvascular and Endothelial Function

An in vivo Rodent Model of Contraction-induced Injury and Non-invasive Monitoring of Recovery

Muscle strains are one of the most common complaints treated by physicians. A muscle injury is typically diagnosed from the patient history and physical exam alone, however the clinical presentation can vary greatly depending on the extent of injury, the patient's pain tolerance, etc. In patients with muscle injury or muscle disease, assessment of muscle damage is typically limited to clinical signs, such as tenderness, strength, range of motion, and more recently, imaging studies. Biological markers, such as serum creatine kinase levels, are typically elevated with muscle injury, but their levels do not always correlate with the loss of force production. This is even true of histological findings from animals, which provide a "direct measure" of damage, but do not account for all the loss of function. Some have argued that the most comprehensive measure of the overall health of the muscle in contractile force. Because muscle injury is a random event that occurs under a variety of biomechanical conditions, it is difficult to study. Here, we describe an in vivo animal model to measure torque and to produce a reliable muscle injury. We also describe our model for measurement of force from an isolated muscle in situ. Furthermore, we describe our small animal MRI procedure.

An in vivo Rodent Model of Contraction-induced Injury and Non-invasive Monitoring of Recovery

An in vivo animal model of injury is described. The method takes advantage of the subcutaneous position of the fibular nerve. Velocity, timing of muscle activation, and arc of motion are all pre-determined and synchronized using commercial software. Post injury changes are monitored in vivo using MR imaging/spectroscopy.

アン in vivoで</em収縮で誘起された損傷と回復の非侵襲的モニタリングの>齧歯類モデル

Muscle strains are one of the most  common complaints treated by physicians. A muscle injury is typically diagnosed from the patient history and  physical ...

医学

Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants

Perinatal brain injury remains a significant cause of infant mortality and morbidity, but there is not yet an effective bedside tool that can accurately screen for brain injury, monitor injury evolution, or assess response to therapy. The energy used by neurons is derived largely from tissue oxidative metabolism, and neural hyperactivity and cell death are reflected by corresponding changes in cerebral oxygen metabolism (CMRO2). Thus, measures of CMRO2 are reflective of neuronal viability and provide critical diagnostic information, making CMRO2 an ideal target for bedside measurement of brain health.
Brain-imaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) yield measures of cerebral glucose and oxygen metabolism, but these techniques require the administration of radionucleotides, so they are used in only the most acute cases.
Continuous-wave near-infrared spectroscopy (CWNIRS) provides non-invasive and non-ionizing radiation measures of hemoglobin oxygen saturation (SO2) as a surrogate for cerebral oxygen consumption. However, SO2 is less than ideal as a surrogate for cerebral oxygen metabolism as it is influenced by both oxygen delivery and consumption. Furthermore, measurements of SO2 are not sensitive enough to detect brain injury hours after the insult 1,2, because oxygen consumption and delivery reach equilibrium after acute transients 3. We investigated the possibility of using more sophisticated NIRS optical methods to quantify cerebral oxygen metabolism at the bedside in healthy and brain-injured newborns. More specifically, we combined the frequency-domain NIRS (FDNIRS) measure of SO2 with the diffuse correlation spectroscopy (DCS) measure of blood flow index (CBFi) to yield an index of CMRO2 (CMRO2i) 4,5.
With the combined FDNIRS/DCS system we are able to quantify cerebral metabolism and hemodynamics. This represents an improvement over CWNIRS for detecting brain health, brain development, and response to therapy in neonates. Moreover, this method adheres to all neonatal intensive care unit (NICU) policies on infection control and institutional policies on laser safety. Future work will seek to integrate the two instruments to reduce acquisition time at the bedside and to implement real-time feedback on data quality to reduce the rate of data rejection.

We combined frequency-domain near-infrared spectroscopy measures of cerebral hemoglobin oxygenation with diffuse correlation spectroscopy measures of cerebral blood flow index to estimate an index of oxygen metabolism. We tested the utility of this measure as a bedside screening tool to evaluate the health and development of the newborn brain.

乳幼児の脳代謝と血行動態の非侵襲的光計測

Perinatal brain injury remains a significant cause of infant mortality  and morbidity, but there is not yet an effective bedside tool that can  accurately ...

Murine Spinotrapezius Model to Assess the Impact of Arteriolar Ligation on Microvascular Function and Remodeling

The murine spinotrapezius is a thin, superficial skeletal support muscle that extends from T3 to L4, and is easily accessible via dorsal skin incision. Its unique anatomy makes the spinotrapezius useful for investigation of ischemic injury and subsequent microvascular remodeling. Here, we demonstrate an arteriolar ligation model in the murine spinotrapezius muscle that was developed by our research team and previously published1-3. For certain vulnerable mouse strains, such as the Balb/c mouse, this ligation surgery reliably creates skeletal muscle ischemia and serves as a platform for investigating therapies that stimulate revascularization. Methods of assessment are also demonstrated, including the use of intravital and confocal microscopy. The spinotrapezius is well suited to such imaging studies due to its accessibility (superficial dorsal anatomy) and relative thinness (60-200 &mu;m). The spinotrapezius muscle can be mounted en face, facilitating imaging of whole-muscle microvascular networks without histological sectioning. We describe the use of intravital microscopy to acquire metrics following a functional vasodilation procedure; specifically, the increase in arterilar diameter as a result of muscle contraction. We also demonstrate the procedures for harvesting and fixing the tissues, a necessary precursor to immunostaining studies and the use of confocal microscopy.

We demonstrate a novel arterial ligation model in murine spinotrapezius muscle, including a step-by-step procedure and description of required instrumentation. We describe the surgery and relevant outcome measurements relating to vascular network remodeling and functional vasodilation using intravital and confocal microscopy.

微小血管機能およびリモデリングに動脈結紮の影響を評価するためにネズミSpinotrapeziusモデル

The murine spinotrapezius is a thin, superficial skeletal support muscle that extends from T3 to L4, and is easily accessible via dorsal skin incision. ...

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

The endothelium is the innermost lining of the vasculature and is involved in the maintenance of vascular homeostasis. Damage to the endothelium may predispose the vessel to atherosclerosis and increase the risk for cardiovascular disease. Assessments of peripheral endothelial function are good indicators of early abnormalities in the vascular wall and correlate well with assessments of coronary endothelial function. The present manuscript details the important methodological steps necessary for the assessment of microvascular endothelial function using laser Doppler imaging with iontophoresis, large vessel endothelial function using flow-mediated dilatation, and carotid atherosclerosis using carotid artery ultrasound. A discussion on the methodological considerations for each of the techniques is also presented, and recommendations are made for future research.

The present article describes the methodological considerations for several non-invasive assessments of vascular function and morphology that are commonly used in medical research to assess different stages of atherosclerosis.

血管機能と形態の非侵襲的なアセスメントに方法論的アプローチ

The endothelium is the innermost lining of the vasculature and is involved in the maintenance of vascular homeostasis.  Damage to the endothelium may ...

Non-invasive Assessment of the Efficacy of New Therapeutics for Intestinal Pathologies Using Serial Endoscopic Imaging of Live Mice

Animal models of inflammatory bowel disease (IBD) and colorectal cancer (CRC) have provided significant insight into the cell intrinsic and extrinsic mechanisms that contribute to the onset and progression of intestinal diseases. The identification of new molecules that promote these pathologies has led to a flurry of activity focused on the development of potential new therapies to inhibit their function. As a result, various pre-clinical mouse models with an intact immune system and stromal microenvironment are now heavily used. Here we describe three experimental protocols to test the efficacy of new therapeutics in pre-clinical models of (1) acute mucosal damage, (2) chronic colitis and/or colitis-associated colon cancer, and (3) sporadic colorectal cancer. We also outline procedures for serial endoscopic examination that can be used to document the therapeutic response of an individual tumor and to monitor the health of individual mice. These protocols provide complementary experimental platforms to test the effectiveness of therapeutic compounds shown to be well tolerated by mice.

We describe methods for longitudinal monitoring of the efficacy of therapeutics for the treatment of colonic pathologies in mice using a rigid endoscope. This protocol can be readily used for the characterization of the therapeutic response of an individual tumor in live mice and also for monitoring potential disease relapse.

生きたマウスのシリアル内視鏡イメージングを使用して、腸の異常のための新しい治療の有効性の非侵襲的評価

Animal models of inflammatory bowel disease (IBD) and colorectal cancer (CRC) have provided significant insight into the cell intrinsic and extrinsic ...

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies.
Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events.
Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.

The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered.

内皮機能の超音波評価：フロー依存性血管拡張テストの技術ガイドライン

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a ...

Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy

While obesity is closely linked to the development of metabolic and cardiovascular disease, little is known about mechanisms that govern these processes. It is hypothesized that pro-atherogenic mediators released from fat tissues particularly in association with central/visceral adiposity may promote pathogenic vascular changes locally and systemically, and the notion that cardiovascular disease may be the consequence of adipose tissue dysfunction continues to evolve. Here, we describe a unique method of videomicroscopy that involves analysis of vasodilator and vasoconstrictor responses of intact small human arterioles removed from the adipose depot of living human subjects. Videomicroscopy is used to examine functional properties of isolated microvessels in response to pharmacological or physiological stimuli using a pressured system that mimics in vivo conditions. The technique is a useful approach to gain understanding of the pathophysiology and molecular mechanisms that contribute to vascular dysfunction locally within the adipose tissue milieu. Moreover, abnormalities in the adipose tissue microvasculature have also been linked with systemic diseases. We applied this technique to examine depot-specific vascular responses in obese subjects. We assessed endothelium-dependent vasodilation to both increased flow and acetylcholine in adipose arterioles (50 - 350 &#181;m internal diameter, 2 - 3 mm in length) isolated from two different adipose depots during bariatric surgery from the same individual. We demonstrated that arterioles from visceral fat exhibit impaired endothelium-dependent vasodilation compared to vessels isolated from the subcutaneous depot. The findings suggest that the visceral microenvironment is associated with vascular endothelial dysfunction which may be relevant to clinical observation linking increased visceral adiposity to systemic disease mechanisms. The videomicroscopy technique can be used to examine vascular phenotypes from different fat depots as well as compare findings across individuals with different degrees of obesity and metabolic dysfunction. The method can also be used to examine vascular responses longitudinally in response to clinical interventions.

Videomicroscopy systems are used to examine functional properties of isolated adipose tissue arterioles in response to physiological and pharmacological stimuli. This technique can be used to examine microvascular phenotypes in different adipose tissue domains in obese humans.

顕微鏡を用いたひと脂肪組織血管機能評価

While obesity is closely linked to the development of metabolic and cardiovascular disease, little is known about mechanisms that govern these processes. ...

Assessment of Kidney Function in Mouse Models of Glomerular Disease

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function in diabetic nephropathy and podocyte-specific VEGF-A knock-out mice; therefore, this protocol describes the full kidney work-up used in our lab to assess these mouse models of glomerular disease, enabling a vast amount of information regarding kidney and glomerular function to be obtained from a single mouse. In comparison to alternative methods presented in the literature to assess glomerular function, the use of the method outlined in this paper enables the glomerular phenotype to be fully evaluated from multiple aspects. By using this method, the researcher can determine the kidney phenotype of the model and assess the mechanism as to why the phenotype develops. This vital information on the mechanism of disease is required when examining potential therapeutic avenues in these models. The methods allow for detailed functional assessment of the glomerular filtration barrier through measurement of the urinary albumin creatinine ratio and individual glomerular water permeability, as well as both structural and ultra-structural examination using the Periodic Acid Schiff stain and electron microscopy. Furthermore, analysis of the genes dysregulated at the mRNA and protein level enables mechanistic analysis of glomerular function. This protocol outlines the generic but adaptable methods that can be applied to all mouse models of glomerular disease.

This protocol describes a full kidney work-up that should be carried out in mouse models of glomerular disease. The methods allow for detailed functional, structural, and mechanistic analysis of glomerular function, which can be applied to all mouse models of glomerular disease.

糸球体疾患のマウス ・ モデルにおける腎機能の評価

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function ...

Non-invasive Assessment of Dorsiflexor Muscle Function in Mice

Assessment of skeletal muscle contractile function is an important measurement for both clinical and research purposes. Numerous conditions can negatively affect skeletal muscle. This can result in a loss of muscle mass (atrophy) and/or loss of muscle quality (reduced force per unit of muscle mass), both of which are prevalent in chronic disease, muscle-specific disease, immobilization, and aging (sarcopenia). Skeletal muscle function in animals can be evaluated by a range of different tests. All tests have limitations related to the physiological testing environment, and the selection of a specific test often depends on the nature of the experiments. Here, we describe an in vivo, non-invasive technique involving a helpful and easy assessment of force frequency-curve (FFC) in mice that can be performed on the same animal over time. This permits monitoring of disease progression and/or efficacy&#160;of a potential therapeutic treatment.

Measurement of rodent skeletal muscle contractile function is a useful tool that can be used to track disease progression as well as efficacy of therapeutic intervention. We describe here the non-invasive, in vivo assessment of the dorsiflexor muscles that can be repeated over time in the same mouse.

マウスで内がえし筋機能の非侵襲的評価

Assessment of skeletal muscle contractile function is an important measurement for both clinical and research purposes. Numerous conditions can negatively ...

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.