Wireless optical monitoring system identifies limb induration characteristics in patients with Kawasaki disease

Kuo, Ho-Chang; Lo, Chun-Chih; Lin, Pin Xing; Kao, Chien Chun; Huang, Ying; Lin, Bor-Shyh

doi:10.1016/j.jaci.2018.04.018

Cited by 9 publications

(11 citation statements)

References 9 publications

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“…In our previous study, we used NIRS to detect tissue Hb and H 2 O in the extremities of children with Kawasaki disease. We found that tissue H 2 O was significantly higher, but tissue Hb was lower in patients with Kawasaki disease than in healthy controls (24). In the present study, we applied NIRS to simultaneously detect and quantify regional tissue Hb and H 2 O content in adult patients with severe sepsis and healthy volunteers.…”

Section: Introductionmentioning

confidence: 62%

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Increased tissue water in patients with severe sepsis affects tissue oxygenation measured by near-infrared spectroscopy: a prospective, observational case-control study

Lin¹,

Leu²,

Tsai³

et al. 2022

Quant Imaging Med Surg

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Background: Tissue oedema affects tissue perfusion and interferes with the monitoring of tissue oxygenation in patients with severe sepsis. However, the underlying mechanisms remain unclear. We used a wireless near-infrared spectroscopy (NIRS) device that transmits tri-wavelength light to quantify tissue haemoglobin (Hb) and water (H 2 O) content. We estimated tissue H 2 O in severe sepsis patients and healthy controls, compared their difference, and investigated the correlation of tissue H 2 O with systemic haemodynamics and its impact on tissue oxygenation.Methods: Seventy-seven adult patients with new-onset severe sepsis admitted to the intensive care unit within 72 h and 30 healthy volunteers (controls) were enrolled. The NIRS device was placed on the participant's leg to estimate the relative tissue concentrations of oxy-Hb ([HbO 2 ]), deoxy-Hb ([HbR]), total Hb ([HbT]), and H 2 O ([H 2 O]) at rest for three consecutive days. Two-sample t-test or Mann-Whitney U test, chi-square test, and generalised estimating equations (GEEs) were used for comparisons.Results: In severe sepsis patients, the [H 2 O] in the anterior tibia was higher [mean (standard deviation, 95%

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Section: Introductionmentioning

confidence: 62%

“…There were a total of 30 healthy controls recruited for the study (Figure 2). Among the healthy controls, 20 (67%) were men with a median [IQR] age of 24 [23][24][25] years, which was significantly lower than the age of patients with sepsis (P<0.001) (Table 1).…”

Section: Demographic Characteristics and Clinical Data Of Patients Wi...mentioning

confidence: 99%

Increased tissue water in patients with severe sepsis affects tissue oxygenation measured by near-infrared spectroscopy: a prospective, observational case-control study

Lin¹,

Leu²,

Tsai³

et al. 2022

Quant Imaging Med Surg

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“…3 KD is a kind of excessive inflammatory activation of autoimmune disease, but the mechanisms resulting in immune dysfunction remain unknown. [4][5][6] The activation of the immune system and the cascade of inflammatory factors are considered as important features of KD. A large number of T cells, mononuclear cells, macrophages, and plasma cells, with a smaller number of neutrophils, are observed in various organ tissues of fatal cases in acute KD.…”

Section: Introductionmentioning

confidence: 99%

Kawasaki disease OX40–OX40L axis acts as an upstream regulator of NFAT signaling pathway

Chen

et al. 2019

Pediatr Res

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BACKGROUND: We investigated a costimulatory molecule OX40-OX40L acting as an upstream regulator to regulate the nuclear factor of activated T cell (NFAT) in the acute phase of Kawasaki disease (KD). METHODS: One hundred and one samples were collected and divided into six groups: coronary artery lesion (KD-CAL) before intravenous immunoglobulin (IVIG), KD-CAL after IVIG, KD without CAL (KD-nCAL) before IVIG, KD-nCAL after IVIG, fever of unknown (Fou), and Healthy. In vitro OX40-stimulating and OX40L-inhibiting tests were conducted in Healthy and KD groups, respectively. Both the messenger RNA (mRNA) and protein expression levels of OX40, OX40L, NFAT1, and NFAT2 were investigated using quantitative reverse transcription PCR and immunoblotting assay, respectively. RESULTS: The mRNA and protein expression levels of NFAT1, NFAT2, OX40, and OX40L were significantly increased in KD-CAL and KD-nCAL groups before IVIG compared with Fou and Healthy groups and decreased after IVIG. A positive correlation was found between them in KD. In vitro OX40-stimulating test demonstrated the significantly increased mRNA and protein expression levels of NFAT1 and NFAT2 in the peripheral blood mononuclear cells of the Healthy group. Meanwhile, OX40L-inhibiting test showed significantly decreased expression levels of NFAT1 and NFAT2 in the KD group. CONCLUSION: OX40-OX40L acts as an upstream regulator in the NFAT signaling pathway involved in KD.

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“…From our previous report, the relative water (H 2 O) concentrations in the palm tissue of patients with KD showed to be better understand the status of blood circulation and angioedema. The increased relative water concentrations found in KD patients than control subjects are due to patients with KD presenting with angioedema or tissue swelling, which is not a common symptom in other fever illness of children [10].…”

Section: Introductionmentioning

confidence: 83%

“…Therefore, the NIRS technique can monitor the state of blood circulation and angioedema in the tissue and has the potential to further evaluate the state of KD. From our previous report, lower relative total hemoglobin (HbT) concentrations and greater relative water concentrations were found in the acute stage of KD patients when compared with control subjects [10]. Liu et al [8] reported that anemic condition alone does not allow an unambiguous KD diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Near Infrared Spectroscopy Detects Change of Tissue Hemoglobin and Water Levelsin Kawasaki Disease and Coronary Artery Lesions

et al. 2022

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Background: Kawasaki disease (KD) is a form of systemic vasculitis that mainly affects children under the age of five years old. Limb swelling and redness are among the primary symptoms of KD. Previous studies have reported that wireless optical monitoring systems can identify limb indurations characteristics in patients with KD. Therefore, we conducted this study to monitor the dynamic changes in different stages of KD and the disease outcome of coronary artery lesions (CAL).Methods: KD patients who were admitted for intravenous immunoglobulin (IVIG) treatment and controls with or without fever were enrolled in this study. Near infrared spectroscopy data were collected for KD patients at different stages, including before (within one day before IVIG treatment, KD1) and shortly after IVIG treatment (within three days, KD2), at least 21 days after IVIG (KD3), 6 months later (KD4), 1 year later (KD5), 2 years later (KD6), and 3 years later (KD7).Results: This study included a total of 350 pieces of data, including data from 20 healthy controls, 64 fever controls, 53 KD1, 67 KD2, 58 KD3, 28 KD4, 25 KD5, 15 KD6, and 20 KD7. The relative HbO2 of the KD1 group were significantly lower than those of the healthy group (0.298 ± 0.01 vs. 0.304 ± 0.05, p = 0.028) but no significant differences were found with the fever group. The HbT concentrations of KD1 group showed significantly lower than health group (0.632 ± 0.019 vs. 0.646 ± 0.021, p = 0.001) but no significant difference with fever control. Relative levels of HbO2, HbT and Hb showed significant difference between KD1 and health control while StO2 and H2O showed difference between KD1 and fever control. The relative H2O concentration was significantly higher in KD patients with CAL formation than without (p < 0.005). Conclusion: This report is the first to use near infrared spectroscopy to detect changes in tissue hemoglobin and water levels at different stages of KD in patients and showed that water content was significantly associated with CAL formation. This non-invasive device may benefit physicians by serving for early identification of KD from fever illness.

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Wireless optical monitoring system identifies limb induration characteristics in patients with Kawasaki disease

Cited by 9 publications

References 9 publications

Increased tissue water in patients with severe sepsis affects tissue oxygenation measured by near-infrared spectroscopy: a prospective, observational case-control study

Increased tissue water in patients with severe sepsis affects tissue oxygenation measured by near-infrared spectroscopy: a prospective, observational case-control study

Kawasaki disease OX40–OX40L axis acts as an upstream regulator of NFAT signaling pathway

Near Infrared Spectroscopy Detects Change of Tissue Hemoglobin and Water Levelsin Kawasaki Disease and Coronary Artery Lesions

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