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1

Methods of evaluation of microvascular structure: state of the art

100%

Nardin M., Coschignano M. A., Rossini C., De Ciuceis C., Caletti S., Rizzoni M., Docchio F., Porteri E., Rizzoni D.

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2018

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vol. 1

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issue 1

9-19

EN

Cardiovascular diseases represent the leading cause of death in Western Countries. Among them, a key role is played by arterial hypertension, which causes macro- and microvascular alterations. Specifically, hypertension is associated with structural alterations in the microvessels, such as an increased ratio of the tunica media thickness to internal lumen (M/L ratio) in small resistance arteries and a reduction of capillary density. In order to evaluate the small resistance artery structure, the direct measurements of M/L ratio through wire or pressure micromyography has been considered the gold-standard method. Despite the availability of convincing evidence about the prognostic relevance of the M/L ratio, the invasiveness of these methods has limited its implementation in the daily clinical practice. Therefore, non-invasive techniques have been developed to evaluate microvascular morphology, particularly in the retina, since it is perhaps the most accessible microvasculature. Scanner laser Doppler flowmetry (SLDF) and adaptive optics (AO) represent the most promising approaches for the evaluation of morphological characteristics of retinal arterioles, in particular for the measurement of their wall-to-lumen ratio (W/L ratio). The possibility to evaluate microvascular morphology by non-invasive techniques represents a major clinical advancement, with possibly favorable implications in research and in stratification of cardiovascular risk. In this review we will address the different methods to investigate the microcirculation as well as their clinical usefulness.

2

Methods of evaluation of microvascular structure: state of the art

100%

Nardin M., Coschignano M. A., Rossini C., De Ciuceis C., Caletti S., Rizzoni M., Docchio F., Porteri E., Rizzoni D.

European Journal of Translational and Clinical Medicine

|

2018

|

vol. 1

|

issue 1

9-19

EN

Cardiovascular diseases represent the leading cause of death in Western Countries. Among them, a key role is played by arterial hypertension, which causes macro- and microvascular alterations. Specifically, hypertension is associated with structural alterations in the microvessels, such as an increased ratio of the tunica media thickness to internal lumen (M/L ratio) in small resistance arteries and a reduction of capillary density. In order to evaluate the small resistance artery structure, the direct measurements of M/L ratio through wire or pressure micromyography has been considered the gold-standard method. Despite the availability of convincing evidence about the prognostic relevance of the M/L ratio, the invasiveness of these methods has limited its implementation in the daily clinical practice. Therefore, non-invasive techniques have been developed to evaluate microvascular morphology, particularly in the retina, since it is perhaps the most accessible microvasculature. Scanner laser Doppler flowmetry (SLDF) and adaptive optics (AO) represent the most promising approaches for the evaluation of morphological characteristics of retinal arterioles, in particular for the measurement of their wall-to-lumen ratio (W/L ratio). The possibility to evaluate microvascular morphology by non-invasive techniques represents a major clinical advancement, with possibly favorable implications in research and in stratification of cardiovascular risk. In this review we will address the different methods to investigate the microcirculation as well as their clinical usefulness.

3

Long-Term Follow up of the Effects of Extracorporeal Shockwave Therapy (ESWT) on Microcirculation in a Denervated Muscle Flap

72%

Krokowicz Ł., Mielniczuk M., Drews M., Siemionow M.

Polish Journal of Surgery

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2011

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vol. 83

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issue 6

325-333

EN

Extracorporeal Shock Wave Therapy (ESWT) is a golden standard for treatment of kidney and urinary calculi. It is also widely used in a number of orthopedic pathologies and other fields of medicine. Although clinical success the exact mechanism of shock wave technology is not well established. Cremaster muscle model used in our experiment is structurally and functionally similar to other skeletal muscles (striated muscle).The aim of the study was to evaluate influence of ESWT treatment on microcirculation and leukocyte-endothelial interactions after longer time period post ESWT application.Material and Methods: In experiment we used 34 Lewis rats weighting 125-160 grams. Animals were divided into 4 groups - Group 1 (n=10) control, without ESWT application, group 2 (n=8), in which measurements were performed 3 days after application of 500 impulses of ESWT; group 3 (n=8) in which measurements were performed 7 days after application of 500 impulses of ESWT; group 4 (n=8), in which measurements were performed 21 days after application of 500 impulses of ESWT.Results. The experiment showed a decrease in functional capillaries activity, we also observed the reduction in leukocyte rolling over the endothelium and an increase in flow velocity in V1 venules.Conclusions. ESWT therapy after 3, 7 and 21 days decreases inflammatory process in the muscle, the other of its effect is weakened. This confirms that the treatment had a positive effect if ESWT is applied repeatedly, because only in this case a wave maintains its beneficial effects.

4

Erytromelalgia – bolesny rumień kończyn w obrazowaniu termograficznym

58%

Nurowska-Wrzosek B., Kalicki B., Wachnicka-Bąk A., Jung A., Żuber J., Gadomska vel Betka Ł., Gaciong Z.

Pediatria i Medycyna Rodzinna

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2013

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vol. 9

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issue 1

97-101

EN

Erythromelalgia is a rare disease of unclear etiology, characterized by recurrent erythema, burning pain and warmth of the affected extremities. In erythromelalgia we can distinguish primary and secondary form. Secondary forms occur in the course of myeloproliferative disorders, systemic connective tissue disease, diabetes mellitus type 1 and 2, multiple sclerosis, neuropathies, infectious diseases, embolism, as well as trauma. Symptoms of EM result from pathological misdistribution of skin microvascular blood flow and dysfunction of adrenergic neurons. Primary EM develops due to mutation in SCN9A, the gene that encodes alpha subunit of the voltage-gated channel Nav 1.7. Erythromelalgia diagnosis based on clinical criteria. May the pain recurring character, usually occur symmetrically, often on the lower extremities than the upper, increases with increased ambient temperature during exercise, leaving the limbs down at night and after drinking alcohol. Only brings cool relief. Although described many trials of EM there is no conclusive data to support the efficacy of any of the drug. Due to the nagging aches and pains, and as a consequence of the significant impairment of the people affected by this disease erythromelalgia treatment focuses on the use of analgesics. In this paper authors reported 2 cases of primary familial erythromelalgia and difficulties with achieving a significant improvement with the currently available treatment, in an attempt to monitor the thermographic study treatment.

PL

Erytromelalgia jest rzadką chorobą o niejasnej etiologii, charakteryzującą się napadowym zaczerwienieniem i wzmożonym uciepleniem kończyn z towarzyszącym piekącym, silnym bólem kończyn. W erytromelalgii możemy wyróżnić postać pierwotną oraz wtórną. Postacie wtórne występują w przebiegu zespołów mieloproliferacyjnych, chorób układowych tkanki łącznej, cukrzycy typu 1. i 2., stwardnienia rozsianego, neuropatii, chorób zakaźnych, zatorowości obwodowej, jak również po urazach. Objawy omawianego schorzenia powstają najpewniej w wyniku patologicznej redystrybucji skórnego mikrokrążenia i dysfunkcji w obwodowych neuronach adrenergicznych. U podłoża erytromelalgii pierwotnej, idiopatycznej leży mutacja w obrębie genu SCN9A kodującego podjednostkę alfa kanału sodowego bramkowanego napięciem Nav 1.7. Rozpoznanie choroby opiera się na kryteriach klinicznych. Dolegliwości bólowe mają charakter nawracający, zazwyczaj występują symetrycznie, częściej dotyczą kończyn dolnych niż górnych, nasilają się przy zwiększonej temperaturze otoczenia, podczas ćwiczeń fizycznych, opuszczaniu kończyn w dół, w nocy i po spożyciu alkoholu. Ulgę przynosi jedynie ochłodzenie. Mimo opisywanych wielu prób leczenia erytromelalgii brak jest jednoznacznych danych potwierdzających skuteczność któregokolwiek stosowanego leku. Z uwagi na dokuczliwe dolegliwości bólowe oraz będące konsekwencją tego znaczne upośledzenie funkcjonowania ludzi dotkniętych tym schorzeniem leczenie erytromelalgii skupia się głównie na stosowaniu leków przeciwbólowych. W artykule opisano dwa przypadki klinicznie rodzinnej, pierwotnej erytromelalgii oraz trudności z uzyskaniem trwałej remisji przy zastosowaniu obecnie dostępnej terapii, z próbą monitorowania leczenia w badaniu termograficznym.

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2 European Journal of Translational and Clinical Medicine

1 Pediatria i Medycyna Rodzinna

1 Polish Journal of Surgery

2 2018

1 2013

1 2011

2 Caletti S.

2 Coschignano M. A.

2 De Ciuceis C.

2 Docchio F.

2 Nardin M.

2 Porteri E.

2 Rizzoni D.

2 Rizzoni M.

2 Rossini C.

1 Drews M.

1 Gaciong Z.

1 Gadomska vel Betka Ł.

1 Jung A.

1 Kalicki B.

1 Krokowicz Ł.

1 Mielniczuk M.

1 Nurowska-Wrzosek B.

1 Siemionow M.

1 Wachnicka-Bąk A.

1 Żuber J.

Methods of evaluation of microvascular structure: state of the art

Methods of evaluation of microvascular structure: state of the art

Long-Term Follow up of the Effects of Extracorporeal Shockwave Therapy (ESWT) on Microcirculation in a Denervated Muscle Flap

Erytromelalgia – bolesny rumień kończyn w obrazowaniu termograficznym