红外热图温度与肿瘤中医证型的关系

目的通过对特定穴位的热图分析,寻求疾病早期诊断的方法。方法选取病例58例。根据文献研究对于特定疾病,选取特定穴位进行温度测量,观察热图有无异常,试图找到规律。结果平均温度比较结果显示:气血两虚>实证>虚实夹杂>阴虚>气阴两虚>气虚>阳虚。肿瘤患者在特定穴位会出现异常热区。结论红外热图显示的整体温度可以作为证型诊断的一个参考,但由于病例数不足,没有确切的温度标准,故不能作为诊断的确切指标。     

Delay of 6 weeks between aprotinin injections for tendinopathy reduces risk of allergic reaction

Aprotinin is a collagenase inhibitor previously shown to be effective for treating tendinopathies but associated with systemic allergic reactions. This historical cohort study aimed to determine whether or not the injection regime used affected the risk of allergic reaction and outcome. It compared 223 tendinopathy cases (group R) generally treated with a rapid series of aprotinin injections spaced one to two weekly and 158 cases (group D) generally given a single injection or a delay in their repeat injection(s) of over 6 weeks. Side effects and outcome measures were documented by questionnaire with a response rate of 75%. Systemic allergic reactions occurred in 7% of group R cases compared with 2% in group D (NS). Injections given 2-4 weeks after a previous injection were significantly more likely to lead to allergic reactions (6%) than initial injections (0.3%) and injections given >6 weeks after a previous injection (0.9%) (P<0.05). Overall patient rated satisfaction and outcome measures were similar between groups. In summary the current published regime of multiple aprotinin injections over a period of a few weeks has a fairly high rate of systemic allergic reactions. This can be reduced by minimising repeat injections and recommending a delay of at least 6 weeks between injections. Practitioners using aprotinin must have available facilities to treat anaphylaxis.     

Men with unilateral Achilles tendinopathy have impaired balance on the symptomatic side

Objectives

To investigate single leg standing balance in males with mid-portion Achilles tendinopathy (AT).

红外热象图在颈椎病诊断和非手术治疗疗效评定中的应用

本研究用红外热象图检查正常人４０例和颈椎病患者４８例。方法是以脊柱为中线，按解剖学标志在两侧对应部位取颈、背、肩、上臂、前臂、手点等６个测温点，检测每个测温点温度，求出左右对称的两个测温点温差。统计表明，正常人躯体两侧各对应测温点的温度基本相同。而颈椎病患者除颈点外，其他各点温差明显增大，与正常组对比有显著性差异。对其中３８例颈椎病患者治疗前后的热象图检查结果进行统计分析表明，临床治疗有效的患者两侧温差较治疗前明显缩小，且缩小的幅度与疗效的等级呈一定的正相关。实验结果表明，红外热象图检查作为颈椎病辅助诊断和疗效评定的方法之一，具有较高的临床实用价值。     

采用远红外热成像技术评估运动效果初步实验研究

目的:采用远红外热成像技术监测运动效果,无损实时考察人体局部温度与运动量之间的关系.方法:设计定量负荷和最大负荷上肢负重力量训练实验,双手持重物同时向前上方举起直至与视线平行,每10次动作为1组,每组实验后采集被试正背面上半身及左右侧面的红外热图数据,结合人体二维解剖学结构图谱进行定性分析,解读运动发力肌群表面温度动态...     

红外热像图鉴别诊断乳腺良恶性病变的价值

目的探讨红外热像图对乳腺病变性质的鉴别诊断价值.材料与方法对133例单侧乳腺病变患者(经术后病理证实恶性病变53例,良性病变80例)术前进行红外热像图扫描.分析热像图像,并记录病变区温度(T)及其与周围区的温差(△T1),患侧乳头、乳晕及全乳与对侧相应区域的温差(依次△T2,△T3及△T4).结果乳腺癌患者T、△T1、△T2、△T3及△T4值均明显高于乳腺良性病变患者.乳腺恶性病变诊断符合率为90.6%(48/53);良性病变诊断符合率为88.8%(71/80).其良恶性鉴别诊断总符合率为89.5%.结论红外热像图是鉴别诊断乳腺良恶性病变的有效影像学方法,可为临床治疗提供可靠的诊断依据.     

Influence of fat pad removal on patellar tendon length during growth

During various knee operations, the changes caused by the surgical invasion to the infrapatellar fat pad (IPF) is still unknown. If any changes exist, it will have great influence especially on growing generations. Eighty-four Japanese white rabbits (6-month-old) were divided into three groups: the resection group involving resection of the IPF, the graft group involving resection and reimplantation of the IPF, and the no-surgery group. All these surgical procedures were done in right knees. In all left knees, only arthrotomy was performed, serving as the sham side. After 3, 6, 12, and 24 weeks of the operation, the rabbits were killed. Lengths of the patellar tendon and patellar were measured in lateral X-ray. In order to eliminate individual differences in the patellar height, we defined a new index as percent patellar height (PPH) which indicated the percentage of the patellar height of surgery side compared with that of the sham side. The PPH was 90.6% (3 weeks), 83.0% (6 weeks), 73.6% (12 weeks), and 74.7% (24 weeks) in the resection group, while it was 88.4% (6 weeks), and 88.9% (24 weeks) in the graft group. Postsurgical scar tissue formation occurring where the IPF was removed prevented the normal growth of the patellar tendon. Reimplantation of the IPF lessened the adhesion of the patellar tendon to the surrounding tissue, and better growth of the tendon. These results showed that preservation of the IPF in young individuals could be crucial for the normal growth of the patellar tendon, and critical as well for the prevention of the degeneration of the articular surface.     

Second-look arthroscopic findings of 208 patients after ACL reconstruction

The aim of this study is to report the arthroscopic subjective findings of reconstructed anterior cruciate ligament (ACL) with good clinical outcome. Graft used for reconstruction was either patella bone-tendon-bone (PBTB) autograft or hamstring tendon [quadrupled semitendinous and gracilis tendon (QSGT)] autograft. From March 1997 to September 2003, among 716 ACL reconstructions 209 knees (208 patients) were available for second-look arthroscopy at a mean 21.2-month (range, 14–70 months) postoperative period. The second-look arthroscopy focused on the evaluation of (1) continuity of the reconstructed ACL graft, (2) subjective graft tension using a probe, (3) the extent of synovial coverage, (4) the prevalence of cyclops or cyclops-like lesion, and (5) bony change after notchplasty. Patellar tendon autograft was used in 80 knees, hamstring tendon autograft in 129 knees. Just prior to second-look arthroscopy two objective clinical evaluations, KT-2000 arthrometer and Lysholm knee score, were performed to verify good clinical outcomes. A comparison between the hamstring tendon group and the patella tendon group, hamstring group showed slightly better results in Lysholm knee scores and KT-2000 arthrometer but there were no statistically significant differences (p>0.05). Undetected partial graft tear was seen in 21 knees (10%). With regard to graft tension, a total of 181 grafts (87%) showed normal tension and 28 (13%) showed slight lax tension. The overall synovial coverage was poor in nine (4%) knees. The synovial coverage was slightly better in the hamstring tendon group. A total of 45 knees (21.5%) showed cyclops-like lesion in variable sizes and locations. Reformation of the notch was seen in 85 knees (40%). In conclusion, the findings of second-look arthroscopy of reconstructed ACL in good clinical outcome patients showed approximately 10% partial graft tear, 5% poor synovial coverage, 20% cyclops-like lesion, and 40% some notch reformation.     

Magnetic resonance imaging of the Achilles tendon using ultrashort TE (UTE) pulse sequences

AIM: To assess the potential value of imaging the Achilles tendon with ultrashort echo time (UTE) pulse sequences. MATERIALS AND METHODS: Four normal controls and four patients with chronic Achilles tendinopathy were examined in the sagittal and transverse planes. Three of the patients were examined before and after intravenous gadodiamide. RESULTS: The fascicular pattern was clearly demonstrated within the tendon and detail of the three distinct fibrocartilaginous components of an "enthesis organ" was well seen. T2* measurements showed two short T2* components. Increase in long T2 components with reduction in short T2 components was seen in tendinopathy. Contrast enhancement was much more extensive than with conventional sequences in two cases of tendinopathy but in a third case, there was a region of reduced enhancement. CONCLUSION: UTE pulse sequences provide anatomical detail not apparent with conventional sequences, demonstrate differences in T2* and show patterns of both increased and decreased enhancement in tendinopathy.     

Alpha‐2 adrenergic stimulation triggers Achilles tenocyte hypercellularity: Comparison between two model systems

The histopathology of tendons with painful tendinopathy is often tendinosis, a fibrosis‐like condition of unclear pathogenesis characterized by tissue changes including hypercellularity. The primary tendon cells (tenocytes) have been shown to express adrenoreceptors (mainly alpha‐2A) as well as markers of catecholamine production, particularly in tendinosis. It is known that adrenergic stimulation can induce proliferation in other cells. The present study investigated the effects of an exogenously administered alpha‐2 adrenergic agonist in an established in vivo Achilles tendinosis model (rabbit) and also in an in vitro human tendon cell culture model. The catecholamine producing enzyme tyrosine hydroxylase and the alpha‐2A‐adrenoreceptor (α_2A AR) were expressed by tenocytes, and alpha‐2 adrenergic stimulation had a proliferative effect on these cells, in both models. The proliferation was inhibited by administration of an α_2A AR antagonist, and the in vitro model further showed that the proliferative alpha‐2A effect was mediated via a mitogenic cell signaling pathway involving phosphorylation of extracellular‐signal‐regulated kinases 1 and 2. The results indicate that catecholamines produced by tenocytes in tendinosis might contribute to the proliferative nature of the pathology through stimulation of the α_2A AR, pointing to a novel target for future therapies. The study furthermore shows that animal models are not necessarily required for all aspects of this research.     

面瘫与面部温度对称性关系的热像图研究

为增加周围性面瘫的临床评价指标，探讨简便、直观、无创的热像图方法评定病变程度和恢复程度的可能性，本文对３８４例患者进行了面部热像图的观察和随访。结果显示：（１）面瘫患者面部热像图表现为双侧明显不对称；（２）面部双侧温度差值定量化统计显示，病程短、病变重者面部双侧温度差明显地大于病变轻和病程长且恢复者；（３）病变期面部双侧温度差明显地大于痊愈后；随恢复程度的增加，面部双侧温度对称性加强，双侧温差值减小。结果表明，面部双侧温度差值与病变程度和恢复程度有着直接的对应关系，用该温度差和面瘫患者面部热像图的直观分析，进行面瘫病变程度和恢复状况的评价是可行并有实用价值的。     

Thermographic characterization of masticatory muscle regions in volunteers with and without myogenous temporomandibular disorder: preliminary results

Objectives:

This study aims to conduct a non-invasive measurement of the cutaneous temperature of selected masticatory muscle regions of volunteers with and without myogenous temporomandibular disorder (TMD), using infrared thermography.

Methods:

23 females (10 myogenous TMD volunteers and 13 controls) were recruited and studied. The temperature at the surface of the facial area over the anterior temporalis and masseter muscles was assessed by medical thermography, using regional lateral views and clinical examination.

Results:

The temperature levels measured at the masseter and anterior temporalis muscle regions in myogenous TMD volunteers (32.85 ± 0.85 and 34.37 ± 0.64 ºC, respectively) were significantly lower (p < 0.05) than those measured in controls (33.49 ± 0.92 and 34.78 ± 0.44 ºC, respectively). Medical infrared imaging indicated a mean difference of 1.4 ºC between the masseter and anterior temporalis regions. Analysis of the comparison between the absolute and normalized mean temperatures was performed using the pairwise comparison of receiver operating characteristic curves, and no statistically significant difference was observed (p > 0.05). The sensitivity and specificity of the thermographic assessment for the masseter region was of 70% and 73%, respectively and for the anterior temporalis region was of 80% and 62%, respectively.

Conclusions:

This method of evaluating masticatory muscle regions of this preliminary study seems to indicate that it can be used as an aid in complimentary diagnosing of TMDs.     

红外热成像对动力性颈椎管狭窄项肩背软组织疼痛疗效的评价

目的探讨远红外热成像检查对动力性颈椎管狭窄项、肩、背软组织疼痛征疗效评价的意义。方法对66例临床诊断为动力性颈椎管狭窄项、肩、背软组织疼痛征的患者进行治疗前后的红外热成像的检查,运用配对t检验的方法进行统计分析。结果治疗前后存在显著正相关关系(r=0.703,P<0.001),治疗前后颈肩部两侧温度的比较值有统计学意义(t=4.736,ν=65,P<0.001)。结论远红外热成像检查可较好地反映颈、项、肩、背软组织疼痛血供状态与症状改善的变化,为临床疗效评价提供客观依据。     

红外热成像在神经根型颈椎病定位诊断的临床观察

目的探讨红外热成像对神经根型颈椎病的定位诊断价值。方法选择神经根型颈椎病的患者36例,运用红外热像图仪采集人体项背、上肢的红外热像图进行对比分析。结果36例神经根型颈椎病患者的红外热像图改变与临床相应节段的根性临床症状基本相似,病变区域呈现低温区。C4神经根受累热节变化区域在肩部,C5神经根受累热节变化区域在肱三头肌处,C6神经根受累热节变化区域在大鱼际,拇指及食指,C7神经根受累热节变化区域在前臂尺侧缘和手掌,C8神经根受累热节变化区域在肩胛部、上肢的伸侧和手的背侧。结论 红外热像图对神经根型颈椎病有很好的定位诊断价值,尤其是多节段颈椎间盘突出压迫硬膜囊或神经根的患者提供了客观评价的方法。     

急、慢性周围性面瘫患者头面部远红外热像的变化

目的 了解急、慢性周围性面瘫患者头面部远红外热像的变化,为临床诊治周围性面瘫提供无创性客观评价指标.方法 周围性面瘫的患者14例;接受健康体检者19例,作为正常对照组.应用ATIR-M301B非制冷焦平面医用远红外热像仪(热敏度为0.05℃),在环境温度为20～25℃的检查室中,采取头、面部远红外热图.采用本机提供的分析软件,分别比较同一受检者左、右两侧面颊、内眦、眶上及额等测温区远红外热像的温度差,并行统计学分析.结果 (1)头面部远红外热像显示正常组面颊、内眦、眶上及额部4个测温区左、右两侧的温度无明显差异(P＞0.05).(2)头面部远红外热像的变化显示急性周围性面瘫患者患侧面颊、内眦、眶上及额等测温区温度明显高于健侧(P＜0.05,P＜0.001).(3)3例病程为25 d至1年的慢性周围性面瘫患者头面部远红外热像的变化显示慢性周围性面瘫患者患侧面颊、内眦、眶上及额等测温区的温度显示低于健侧.不同患者各测温区的温度呈现不同的差异,如2例患者呈现患侧下颌区、口区温度明显低于对侧;1例患者呈现患侧内眦区、眶上区及额区的温度明显低于对侧.结论 远红外热像可较好地反映周围性面瘫患者头面部供血状态的变化,急性期面瘫侧呈充血性改变,慢性期面瘫侧呈缺血性改变.表明远红外热像可为临床诊治周围性面瘫提供无创的客观评价指标.