ABSTRACT
The assessment of completeness of a sympathectomy can be objectively recorded and documented by dermofluorography. This method enables measurement of increased skin perfusion which leads to an earlier appearance time and steeper initial rise in fluorescence of intravenously administered sodium fluorescein. The most significant parameters are the quotients of the average appearance time and the initial rise in fluorescence of the untreated versus treated leg. Following a successful lumbar sympathectomy, these parameters were outside 3 standard deviations of the values obtained from healthy test persons.
Subject(s)
Blood Circulation/physiology , Fluorescein Angiography/methods , Pain/physiopathology , Skin/blood supply , Sympathectomy , Adult , Aged , Female , Fluorescein , Fluoresceins , Humans , Image Processing, Computer-Assisted , Leg/blood supply , Leg/innervation , Lumbosacral Plexus/surgery , Male , Pain/diagnosis , Pain/surgeryABSTRACT
Sodium fluorescein is an organic dye widely used as a diagnostic aid. This article reports a case of a photosensitivity reaction associated with intravenous administration in a healthy volunteer. To our knowledge, this is the 1st case of a photosensitivity reaction of the immediate type due to fluorescein reported in the literature, which probably indicates its very low incidence. The literature on photosensitization to fluorescein is reviewed.
Subject(s)
Fluoresceins/adverse effects , Fluorescent Dyes/adverse effects , Photosensitivity Disorders/etiology , Adult , Female , Fluorescein , Fluoresceins/administration & dosage , Fluorescent Dyes/administration & dosage , Fluoroscopy , Humans , Injections, Intravenous , Microcirculation , Skin/blood supplyABSTRACT
We report a new technique for visualizing and measuring skin perfusion on a macroscopic scale using low doses of indocyanine green (0.3 mg/kg body weight). The method was first evaluated in the rat random cutaneous flap model and subsequently applied to determine skin perfusion in a patient with peripheral arterial occlusive disease (PAOD), a patient with forefoot necrosis due to diabetic microangiopathy, and a healthy volunteer. The observed kinetics of fluorescence appearance could only be explained by transition of the dye to a third compartment different from the blood plasma and having a greater affinity for indocyanine green. In PAOD reduced skin perfusion in the tissue surrounding the arterial ulcer could be clearly demonstrated, whereas skin perfusion in diabetic microangiopathy seems to be unaffected. Other potential clinical applications for the technique in dermatology and vascular and reconstructive surgery are briefly discussed.
Subject(s)
Angiography/methods , Diabetic Angiopathies/diagnosis , Leg Ulcer/diagnosis , Models, Biological , Photofluorography/methods , Skin/blood supply , Adult , Animals , Arteries , Diabetic Angiopathies/metabolism , Diabetic Angiopathies/surgery , Female , Humans , Indocyanine Green , Infrared Rays , Leg/blood supply , Leg Ulcer/metabolism , Leg Ulcer/surgery , Male , Middle Aged , Perfusion , Random Allocation , Rats , Rats, Sprague-Dawley , Surgical Flaps , Video RecordingSubject(s)
Image Processing, Computer-Assisted , Leg Ulcer/pathology , Humans , Male , Middle Aged , Skin/pathology , Wound HealingABSTRACT
A 39-year-old woman with cutis marmorata telangiectatica congenita (CMTC) on the back presented with a 5-year history of pain in the involved area which initially occurred only on touch and cold exposure but was ultimately virtually constant. Histological examination of a skin biopsy specimen revealed an increased number of nerve fibres. The phlebectatic subcutaneous veins were demonstrable by NIR (near infrared) venoscopy.
Subject(s)
Hyperesthesia/congenital , Skin/blood supply , Telangiectasis/congenital , Varicose Veins/congenital , Adult , Capillaries/pathology , Diagnosis, Differential , Female , Humans , Hyperesthesia/pathology , Skin/innervation , Skin/pathologySubject(s)
Fluoresceins , Image Processing, Computer-Assisted/instrumentation , Microcomputers , Scleroderma, Systemic/diagnosis , Skin/blood supply , Video Recording/instrumentation , Fluorescein , Hand/blood supply , Humans , Microcirculation/physiopathology , Scleroderma, Systemic/physiopathologyABSTRACT
For this two-site immunochemiluminometric assay of intact human parathyrin (hPTH), the luminescent tracer was synthetic hPTH(53-84), conjugated via succinimide linkage to (aminobutyl)ethyl-isoluminol hemisuccinimide (abei-h). Purification of the labeled hPTH(53-84) by reversed-phase high-performance liquid chromatography allowed isolation of the conjugate having the highest incorporation of abei-h, 1.6 mol per mole of hPTH(53-84). The solid-phase antibody directed against the N-terminal part of hPTH was immobilized by adsorption onto the polystyrene surface of the assay tube and extracted the intact hPTH and N-terminal fragments. Another antibody against synthetic hPTH(53-84), which bound to the C-terminal part of intact hPTH, was indirectly labeled at its second free binding site with the abei-h-labeled hPTH(53-84). The assay has a detection limit of 0.5 pmol/L; it is accurate, precise, and reliable; and it shows a linear response for samples containing up to 100 pmol of hPTH per liter. The normal reference interval ranged from 1.8 to 5.9 pmol/L; 56 patients with primary hyperparathyroidism had concentrations ranging from 5.9 to 113 pmol/L. The concentrations detected in patients with idiopathic hypoparathyroidism were below the normal reference interval.
