Modifications of interdental papilla microcirculation: a possible cause of periodontal disease in Hashimoto's thyroiditis?

BACKGROUND: Hypothyroidism is defined by a decrease in thyroid hormone production and thyroid gland function. The aim of the present research has been to evaluate the morphologic interdental papilla microcirculation of patients suffering from Hashimoto thyroiditis (HT) and to evaluate a possible correlation with the associated periodontal disease. METHODS: Fifteen healthy subjects and 15 patients suffering from HT were examined. The patients who showed conditions known to compromise microcirculation, such as diabetes, hypertension and pharmacological treatments, were not included in the group of healthy patients. All patients were non-smokers. Gingival capillaroscopy was used to investigate the characteristics of microcirculation. Visibility, course, tortuosity, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. RESULTS: An interdental papilla vascular modification results in HT. In patients suffering from HT, it was possible to observe a reduced caliber of capillaries, as well as a greater number and tortuosity of capillary loops. CONCLUSIONS: This study shows that capillary alterations in patients suffering from HT occur in gingival microcirculation.     

Microvascular characteristics of the human filiform papillae: a videocapillaroscopic study

The aim of this study was to observe the microcirculation characteristics of the human filiform papillae in healthy patients in vivo. Twenty healthy patients were examined using lingual capillaroscopy to investigate the characteristics of microcirculation of the human filiform papillae. Visibility, course, tortuosity, as well as the possible presence of microhemorrhages, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. The investigation was simple, non-invasive and repeatable for each patient. Microcirculation architecture was characterized by a network of capillaries in polygonal mesh with parallel orientation in regard to the surface. Rare microhemorrhages were observed. The caliber of visible capillary loops was 12.50 +/- 1.46 microm (mean +/- SD). The number of visible capillaries was 9.88 +/- 1.06 (mean +/- SD). Our study shows that capillaroscopy of lingual filiform papillae is a practicable method. Future studies might evaluate whether microcirculation in that area is compromised or not during systemic pathologies involving peripheral microcirculation alterations. This method could also be applied to the study of microcirculation in pathologies which strictly pertain to the dental stomatological field.     

Smoking habit and labial microcirculation

Smoking habit is an important risk factor in oral diseases. In the last years, many studies tried to evaluate smoking effects on the microcirculation. It had never been used such a simple not invasive technique, like the video-capillaroscopic one. The aim of the research is to analyse "in vivo", the microcirculation labial characteristics, and to evaluate the smoking effects by means of computerised videocapillaroscopy techniques. 35 healthy no-smoker patients and 35 healthy smoker patients were examined. The characteristics of the microcirculation in the areas of labial mucous were examined using computerised videomicroscopic techniques. For each patient we evaluated the visibility, the course, the tortuosity and any images characteristic of capillary loops, besides the possible presence of microhaemorrhages, the average calibre of capillary loops and the number of capillary loops visible per square millimetre. The investigation was non invasive and repeatable for each patient. In both groups the investigation of labial mucous revealed a course of capillary loops parallel to the surface. In smoker patients, it was possible to underline capillaries of a smaller calibre (P<.001), and a higher number of detectable capillaries compared with no-smoker patients (P<.001). We observed an important correlation between the capillary tortuosity and the smoking habit (P<.001). Our research highlighted, that today it is possible to carry out a capillaroscopic investigation of labial mucous in a simple and reliable way. Furthermore, smoking habit represents a real risk factor of oral disease, greatly affecting the microcirculation.     

Study of the microcirculation of oral mucosa in healthy subjects

The research has the following aims: 1: to verify the applicability of capillaroscopic investigation to oral mucosa; 2: to propose oral mucosa as an alternative to the fingernail fold for capillaroscopic investigation; 3: to describe the characteristics of the microcirculation of oral mucosa in healthy subjects. 100 healthy patients were examined. The characteristics of the micro-circulation in the areas of gum mucosa and the mucosa covering of the lower lip were examined using computerised videomicroscopic techniques. For each patient we evaluated the visibility, the course, the density, the tortuosity and any images characteristic of capillary loops, besides the possible presence of microhaemorrhages, the average calibre of capillary loops and the number of capillary loops visible per square millimetre. The investigation was simple, non invasive and repeatable for each patient. An investigation of gum mucosa has revealed a course of capillary loops both parallel and perpendicular to the surface: often the tops of the capillary loops appear as regularly distributed dots or commas. Microcirculatory architecture in the area of the mucosa covering is characterised by capillary loops with a variable diameter, course and length; next to typical capillary loops with the appearance of horse stirrups, there are other loops similar to hairpins, commas and cork screws; there are also rare microhaemorrhages with the aspect of reddish stains, that could be caused by microtraumas. Visibility was very good in the area of the mucosa covering of the lower lip: mediocre in the area of gum mucosa. Our research has highlighted, that today it is possible to carry out a capillaroscopic investigation of oral mucosa in a simple and reliable way. Future research could evaluate how "normal microcirculation", that we describe in this paper, is modified during pathology     

雷诺现象患者的区域血流量及微循环变化

目的:探讨雷诺现象(RP)患者甲襞区域血流量和微循环的变化。方法:对30例RP患者和34例健康对照者进行甲襞区域血流量和甲襞微循环(NFM)检测。结果:RP患者的甲襞区域血流量明显低于健康对照组(P<0.01)。RP患者NFM检测中见管袢模糊不清,管袢缩短,交叉管袢增多,出现宽大畸形管袢,血流速度减慢,多呈粒流、粒线流,血管运动性增强,红细胞聚集多呈中、重度,乳头浅平,汗腺导管增多,血色暗红,严重者袢周有渗出、出血;管袢数减少,输入枝、输出枝、袢顶均增宽;与健康对照组相比有显著性差异(P<0.01)。RP患者NFM积分值明显高于健康对照组(P<0.01)。结论:甲襞区域血流量检测和微循环检查有助于判断RP患者的病情和预后。     

Anatomical evaluation of oral microcirculation: Capillary characteristics associated with sex or age group

BackgroundThere are various types of oral mucosa specific to different parts of the mouth and each of these has a unique histological structure. The variations in the epithelial structure are consistently related to observable differences in the underlying microcirculation: i.e. differences in the course, conformation, and density of capillaries. The aim of this research has been to investigate oral microcirculatory differences between men and women as well as between various age groups, in order to map the oral mucosa, and to highlight changes occurring during aging.MethodsA total of 45 healthy subjects were enrolled for this study (12 men and 33 women; mean age 60.37; range 30–82). A complete in-vivo videocapillaroscopic mapping of the oral mucosa was done on each subject.ResultsThe capillaroscopic patterns of the various areas differ particularly in the course of the loops in relation to the mucosal surface. On the basis of statistical analysis of the collected data, it emerges that there are many differences in capillary loop density between men and women and between different age groups.ConclusionThis study demonstrates the necessity of approaching the investigation of patient microcirculation in different ways depending on sex or age.     

牙周炎大鼠毛细血管铸型构建

目的　通过毛细血管灌注的方法,构建Wistar大鼠牙周炎模型的牙周毛细血管铸型,为牙周炎的微循环研究提供形态学方法。 方法　8周龄Wistar大鼠,从左心室的主动脉入口插管灌注颗粒状材料,皮肤肿胀发红灌注结束。灌注材料充分聚合24 h后,用腐蚀方法去除软组织。制成牙周炎的毛细血管铸型标本。S-3000N扫描式电子显微镜观察牙周毛细血管铸型。 结果　成功构建了牙周炎毛细血管铸型模型,在30、2000、4500倍扫描电镜下清晰地观察到了龈缘、龈沟及龈乳突等部位的毛细血管三维空间形态分布与走形。 结论　Wistar大鼠牙周炎的毛细血管铸型成功构建,为牙周炎微循环的研究提供了形态学方法,有助于从不同方面揭示牙周炎的各种病理变化。     

真性红细胞增多症的微循环研究

通过首次对109例真性红细胞增多症进行微循环系列检测探讨其发病机理,结果发现:患者甲襞微血管袢呈"等扩型"者78例(71.6%),血色暗红、血细胞浓密、流速减慢者88例(80.7%),袢顶出血者70例(64.8%);球结膜微循环观察41例患者,其中37例(90.2%)呈"密网状",微血管口径扩张以细静脉和毛细血管为著,25例(60.9%)口径粗细不匀,37例血液流态类似甲襞所见,20例(48.8%)可见微池;指腹皮肤血细胞灌流量增加脉动幅度减低。结果提示:RBC升高是上述改变的关键。RBC升高使ηb升高,外周阻力增大,心脏负荷增大、功能受损,三者互为因果、相互促进,形成恶性循环,影响组织供氧和代谢,构成临床表现的病理生理基础。     

化疗对恶性肿瘤患者甲襞微循环影响的临床观察

目的:观察化疗对恶性肿瘤患者甲襞微循环的影响。方法:采用自身对照方法,检测43例恶性肿瘤患者化疗前后甲襞微循环指标的动态变化,并设30例健康者作为对照组。结果:恶性肿瘤患者化疗前甲襞微循环形态积分、流态积分、管周状态积分和总积分值较健康对照组显著增高(P<0.05或P<0.01)。经过4个疗程化疗后,患者甲襞微循环的流态积分和总积分值明显增加,与化疗前相比,其差异有统计学意义(P<0.01)。结论:恶性肿瘤患者术后存在甲襞微循环障碍,化疗后可使患者这种微循环障碍加重。甲襞微循环检查可以作为肿瘤血瘀证诊断和疗效观察的客观指标之一。     

偏头痛患者血液微循环特征探讨

目的 探讨偏头痛患者的血液微循环特征。方法 观察50例偏头痛患者的红细胞流变性、血液流变性及甲襞微循环变化，并与50例健康人作对照。结果 偏头痛患者红细胞流变性异常，表现为红细胞聚集性增高、红细胞变形性降低；血液黏度增高，呈高黏高凝状态；甲襞微循环异常，主要表现为流态异常、襻顶瘀血、异型管襻数量增多、红细胞聚集、管襻长度缩短、开放管襻数量减少、襻周渗出等。结论 红细胞流变性异常、血液呈高黏高凝状态、微循环障碍是偏头痛患者的血液微循环特征。偏头痛患者血液微循环的异常改变可能是偏头痛的病因之一。     

微循环障碍与激素性股骨头坏死相关性实验研究

目的 研究激素性股骨头坏死的发病原因。方法 用糖皮质激素诱导出股骨头缺血坏死的兔子模型,对比检测实验组和对照组的微循环状况以及与微循环有关的毛细血管内血液的流速,血液粘滞度,成份改变和病理组织学改变,弄清发病的主要相关因素。结果 实验组毛细血管中红细胞聚集,血液流速明显缓慢;血脂、血浆蛋白含量增高;股骨头内毛细血管数量减少,血管襻迂曲变长。结论 激素性股骨头缺血坏死的发病与微循环障碍有明显的关系。     

不同病程2型糖尿病患者甲襞微循环状态比较

目的:观察不同病程2型糖尿病(T2DM)患者甲襞微循环障碍程度。方法:600例住院T2DM患者,依病程分为新诊断组、3月～5年组、6年～10年组和>10年组。选取30例健康体检者为对照组。用徐州产HD-WX-10型微循环显微仪,在22～24℃室温下,检测所有对象的左手无名指,观察甲襞微循环形态、流态和袢周状态,并对各组加权积分值、不同程度异常率和部分指标异常进行统计学分析比较。结果:(1)不同病程各组T2DM患者甲襞微循环形态、流态和袢周状态积分均高于对照组,以管袢减少、白微栓、渗出和出血等改变较明显(P<0.01),中度异常患者比例较高。(2)病程10年以内各组患者积分值、部分指标异常率及异常程度无统计学差异(P>0.05)。(3)>10年组患者甲襞微循环流态及袢周形态积分和总积分较其它组增加(P<0.05),中度异常患者比例较高(P<0.01),管袢明显减少,白微栓和渗出显著增多(P<0.01)。结论:T2DM患者存在微循环障碍,病程>10年者较重。     

葛根素注射液改善冠心病微循环的临床观察

目的观察葛根素注射液改善冠心病微循环障碍的临床疗效。方法30例符合冠心病诊断标准患者 ,使用葛根素注射液400mg加入生理盐水250ml中静脉滴注 ,每日1次 ,15d为1疗程。观察治疗前后管襻形态、襻周状态及血液流态等指标。结果经葛根素治疗两周后 ,微血管动脉扩张 ,血流加快 ,甲襞微循环流态积分值明显降低 ,襻周形态明显改变 ,总积分值下降。结论葛根素注射液对冠心病微循环障碍有一定疗效 ,无毒副作用     

正常人足与手甲襞微循环之异同

通过１２０例健康人足、手甲襞微循环对比检查，发现足甲襞微循环管袢排列、数目、长度、管径、形态、乳头等指标与手甲襞有显著差异（ｐ＜０．０１）。指出：足甲襞微循环有其自身特点，为足甲襞的临床应用提供客观指标。     

吸、戒烟对人体甲襞微循环的影响

对３０例吸烟者、３０例有吸烟史现戒烟者以及３０例无吸烟史者行甲襞微循环观测。结果表明，吸烟组甲襞微循环有明显改变，总积分值高于戒烟组和无吸烟的对照组（Ｐ＜００１）。其主要改变为：管袢输入枝、输出枝管径增宽，管袢扭曲、分叉，血流速度减慢，红细胞聚集度增加。戒烟组各项指标均明显改善，但与吸烟组比较差异显著（Ｐ＜００１）。与对照组比较，其形态改变尚未完全恢复（Ｐ＜００１）。以上结果提示，吸烟可引起机体的慢性微循环障碍，戒烟可对其造成的损害有所改善     

34例高血压患者激光照射人迎穴前后微循环观察及其治疗作用

目的 :观察高血压患者氦氖 (HE Ne)激光照射两侧人迎穴前后微循环及血压的变化。方法 :用微循环显微镜观察 3 4例高血压患者氦氖 (HE Ne)激光照射 15min两侧人迎穴前后球结膜、甲襞微循环的变化 ,并量取血压。结果 :照射后与照射前比 ,球结膜毛细血管开放数、微动脉的口径、甲襞管袢数、袢长均有增加 (P <0 .0 1)。球结膜微血管血流 ,流经 1mm所需的时间及甲襞血流 ,流经全袢所需的时间均缩短 (P <0 .0 1)。收缩压、舒张压均下降 (P <0 .0 1)。并发现两例球结膜扭曲的微血管有“跳摆现象”。结论 :HE Ne激光照射高血压患者两侧人迎穴可有效改善球结膜、甲襞微循环 ,降低高血压     

运动神经元病微循环与血液流变学的关系

对８６例运动神经元病和３６例同龄健康人进行甲襞微循环对比观察，同时对其中４７例运动神经元病和３６例同龄健康人进行血液流变性检查。结果：患病组甲襞微循环管袢细，以输入枝为甚，畸形血管比例大，管壁薄，流态多为粒流或粒缓流，乳头较平坦，较对照组有显著性差异（Ｐ＜０．０１），而二组血液流变检查则无明显差异（Ｐ＞０．０５）。提示：该病微循环障碍与微血管的病理性改变有密切的关系，为今后进一步开展对该病的基础与临床研究提供一定的依据。     

Pseudo three-dimensional vision-based nail-fold morphological and hemodynamic analysis

In this study, a Pseudo three-dimensional Vision-based Nail-fold Morphological and Hemodynamic Analysis (PTVNMHA) is proposed to automatically extract morphological/hemodynamic features from a microscopic nail-fold image sequence, reconstruct the corresponding pseudo three-dimensional microvascular models, and visualize the dynamic blood flow in the model constructed. The morphological features extracted include the number, width/height, density, arteriolar limb caliber, curved segment caliber, venular limb caliber, blood color, tortuosity, and width of the curved segment of capillaries. The hemodynamic features identified are blood flow velocity and blood flow rate. All are significant pathological indicators with a spatial precision up to 1.6μm. The diameters of cross-sections along the centerlines of capillaries are identified and employed to reconstruct the pseudo three-dimensional microvascular surface meshes. The microscopic image sequence acquired is mapped to the corresponding microvascular model constructed to perform dynamic blood flow visualization. Compared with laser Doppler velocimetry, PTVNMHA can derive blood flow velocities for each capillary across the microscopic range separately in much higher precision and obtain diversified morphological and hemodynamic features of capillaries with a low-cost equipment setup. In addition to the blood flow velocity, blood flow rate, which keeps almost constant no matter where the measuring position is in a capillary, has also been measured and proposed as a useful feature to discriminate patients with hypertension from the normal with great significance (p<0.001). In the future, large scale experiments will be conducted to diagnose patients with anemia as well as patients with essential and secondary hypertension to verify effectiveness of the PTVNMHA system.     

Fine structural capillary changes and basal lamina thickening in scleroderma (progressive systemic sclerosis) and Raynaud's disease

Capillary abnormalities were found by electron microscopy in labial salivary gland biopsies obtained from 20 patients with progressive systemic sclerosis (PSS). They consisted of marked thickening and multilayering of basal lamina, degenerative and adaptative endothelial cell changes, alterations of pericytes and perivascular mononuclear cell infiltration. There was no correlationship between the intensity of the capillary abnormalities and the duration of the disease. In 12 patients with Raynaud's disease (RD) such changes were not found. Thus capillaries displayed normal-looking ultrastructural appearances. Mean capillary basal lamina width was consistently thicker in the PSS group than in the RD group (p less than 0.001). These observations are consistent with the hypothesis that the primary event in PSS occurs in the microvessels. It is suggested that labial salivary gland biopsy may be helpful for early recognition of PSS among subjects with Raynaud's syndrome.     

高海拔地区儿童急性呼吸衰竭的微循环变化

本文报告高海拔地区急性呼吸衰竭患儿37例，在入院24小时内进行甲襞微循环视察，并与正常组进行对比研究。结果表明；甲襞微循环的血管形态、血流状态、襻周状态等多项指标有明显改变，输入枝明显收缩变细，输出枝随缺氧程度加重变宽。血流速度减慢、血流摆动、停滞，红细胞聚集，襻周出血、渗出等改变使微循环正常流态发生紊乱。这些可能是构成儿童急性呼吸衰竭微循环障碍的病理学基础。