Document Detail

Standard and near-surface laser-Doppler perfusion in foot dorsum skin of diabetic and nondiabetic subjects with and without coexisting peripheral arterial disease.
MedLine Citation:
PMID:  7731398     Owner:  NLM     Status:  MEDLINE    
Appropriate assessment of microvascular function is now recognized as an important adjunct to the diagnostic workup and medical follow-up for a variety of conditions. Laser Doppler fluxmetry (LDF)-derived rbc perfusion (Q) and the volume (V) and velocity (U) components are useful in this regard but the fact that the sampled volume includes both nutritional and nonnutritional components may limit its specificity and range of usefulness. It was reasoned that if the depth of penetration could be reduced without significantly altering essential optical transmission features, then the detected signal would better represent the nutritional component. A 0.68-mm-thick Delrin spacer was fabricated and used to compare LDF values with (WITH) and without (WITHOUT) its use on the foot dorsum of 71 limbs of 44 diabetic (DM) and nondiabetic (NO-DM) subjects with lower extremity arterial disease (LEAD, n = 39) and without disease (NORM, n = 32). Overall LDF values WITH as compared to WITHOUT had a slightly greater U (1.01 vs 0.89 mm/sec, P < 0.01) and much lower V (0.06 vs 0.63%, P < 0.001) and Q (0.25 vs 1.88 ml/min/100 g, P < 0.001). In NO-DM subjects, WITH detected a lower Q in limbs with LEAD (0.14 vs 0.27, P < 0.05) but WITHOUT did not (1.48 vs 1.47, ns). In DM subjects, WITH measured a significantly lower U in LEAD limbs (1.05 vs 1.22 mm/sec, P < 0.05), which was not detected WITHOUT. Without the spacer, NORM limb LDF values were all greater in DM vs NO-DM subjects. With spacer use, only the DM velocity component was significantly greater. Use of a modified LDF procedure has shown both utility and promise as a method for evaluation of skin microcirculation and appears to offer some potential benefits as compared with the currently used standard method. Previously undocumented differences between LEAD and NORM limbs in DM and NO-DM patients as herein reported represent initial findings using a 0.68-mm spacer.
H N Mayrovitz; P B Larsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Microvascular research     Volume:  48     ISSN:  0026-2862     ISO Abbreviation:  Microvasc. Res.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1995-05-30     Completed Date:  1995-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0165035     Medline TA:  Microvasc Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  338-48     Citation Subset:  IM    
Miami Heart Research Institute, Vascular Laboratory and Wound Healing Center, Florida 33140.
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MeSH Terms
Diabetic Foot / complications,  diagnosis*,  physiopathology
Foot / blood supply
Laser-Doppler Flowmetry / methods*
Peripheral Vascular Diseases / complications,  diagnosis*,  physiopathology
Reference Values
Skin / blood supply*

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