Optimal intensity and duration of cupping for minimizing possible mechanical skin deformation.

OBJECTIVE: To identify the optimal intensity and duration of cupping that would minimize mechanical skin deformation. METHODS: We developed an optical measurement probe and system for measuring skin color values in real time. We applied cupping at the following five Bladder Meridian acupoints. To investigate optimal intensity, negative pressure intensity was increased every 2 min up to 80 kPa. To investigate optimal time, 10 measurement sites were selected and negative pressure intensities of 30, 60, and 80 kPa were applied for 5 min each. Skin color information was analyzed by the following skin color values: red color saturation, erythema index, and melanin index. RESULTS: The red color saturation and erythema index increased steadily up to 60 kpa negative pressure intensity, then decreased between 60 and 80 kPa. Therefore, maximal values were observed at 60 kPa. The melanin index consistently increased with increasing negative pressure intensity. The red color saturation and erythema index did not change after 20 s at 60 kPa negative pressure intensity. For negative pressure intensities below 80 kPa, significant changes in melanin index were not observed after 20 s. At 80 kPa negative pressure intensity, the melanin index exhibited an increasing pattern for 200 s, then showed no changes. CONCLUSIONS: To minimize skin deformation, 60 kPa and 20 s were the appropriate intensity and duration when using red color saturation and erythema index as diagnostic indexes. Because of the increasing pattern up to 80 kPa negative pressure intensity, the optimal intensity of melanin index could not be determined. When applying 80 kPa negative pressure intensity and using melanin index as the diagnostic index, we recommend a duration of 200 s.

Palpation Device for the Identification of Kidney and Bladder Cancer: A Pilot Study

PURPOSE: To determine the ability of a novel palpation device to differentiate between benign and malignant tissues of the kidney and bladder by measuring tissue elasticity. MATERIALS AND METHODS: A novel palpation device was developed, mainly composed of a micromotor, a linear position sensor, a force transducer, and a hemisphere tip and cylindrical body probe. Motion calibration as well as performance validation was done. The tissue elasticity of both benign and malignant tissues of the kidney and bladder was measured using this device. A single investigator performed the ex-vivo palpation experiment in twelve kidneys and four bladder specimens. Malignant tissues were made available from partial nephrectomy specimens and radical cystectomy specimens. Palpations for benign renal parenchyma tissue were carried out on nephroureterectomy specimens while non-involved areas in the radical cystectomy specimens were used for benign bladder samples. Elastic modulus (Young's modulus) of tissues was estimated using the Hertz-Sneddon equation from the experimental results. These were then compared using a t-test for independent samples. RESULTS: Renal cell carcinoma tissues appear to be softer than normal kidney tissues, whereas tissues from urothelial carcinoma of the bladder appear to be harder than normal bladder tissues. The results from renal cell carcinoma differed significantly from those of normal kidney tissues (p=0.002), as did urothelial carcinoma of the bladder from normal bladder tissues (p=0.003). CONCLUSION: Our novel palpation device can potentially differentiate between malignant and benign kidney and bladder tissues. Further studies are necessary to verify our results and define its true clinical utility.