Recent Advances in Medical Thermology

Recent Advances in Medical Thermology Edited by

E. Francis]. Ring Royal National Hospital for Rheumatic Diseases Bath, United Kingdom

and

Barbara Phillips St. Martin's Hospital Bath, United Kingdom

PLENUM PRESS • NEW YORK AND LONDON

Library of Congress Cataloging in Publication Data

International Congress of Thermology (3rd: 1982: Bath, Avon) Recent advances in medical thermology.

"Proceedings of the Third International Congress of Thermology, held March 29-April 2, 1982, in Bath United Kingdom." - T.p. verso.

Includes bibliographical references and index. 1. Medical thermography-Congresses. 2. Thermography-Congresses. 3. Body

temperature-Regulation-Congresses. 1. Ring, E. F. J. II. Phillips, Barbara (Barbara Helen) III. Title. [DNLM: 1. Body temperature-Congresses. 2. Heat-Therapeutic use-Congresses. 3. Thermography-Congresses. W3 IN579 3rd 1982r/ WB 469 161 1982r] RC78.7.T5155 1982 616.07'2 84-3366 ISBN 978-1-4684-7699-6 ISBN 978-1-4684-7697-2 (eBook) DOI 10.1007/978-1-4684-7697-2

Proceedings of the Third International Congress of Thermology, held March 29-April 2, 1982, in Bath, United Kingdom

© 1984 Plenum Press, New York Softcover reprint of the hardcover lst edition 1984

A Division of Plenum Publishing Corporation 233 Spring Street, New York, N.Y. 10013

Ali rights reserved

No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

FOREWORD

I am delighted to have been invited to Bath for the opening of this Third International Congress of Thermology. The connection between the Congress and the City of Bath is significant. The properties of sunlight have been recognized throughout the centuries. Indeed, many ancient religions were based on the worship of the sun gods. The study of radiant heat was pioneered by Sir William Herschel, whose experiments led him to the study of heat and ultimately of infrared radiation. His son, John, furthered these experiments and formed an image by evaporating alcohol with carbon. In modern technology, infrared radiation plays a vital role in a wide range of applications. Thermal imaging is widely used in the manufacturing industries, especially plastics, glass and paper. The motor industry, for example, employs thermography in the design of windscreens and tire development. Chemical plants and refineries also use it in the important control of expensive energy losses. The communications industry makes extensive use of thermal imaging since overheating and cracks in insulation may cause the unscheduled shut-down of expensive equipment. There is now a special thermal imaging system for the examination of very large scale integrated circuits to help in the development of diagnostic tools for examining circuits which now have features of 1 micron in size, making the conventional method of mechanical probing impossible. This revolution in probing will enable us to maintain the high levels of quality control which are essential in the communications industry.

In medicine, the connection between temperature and disease has, of course, been recognized for centuries, and for a long time the thermometer was the principal tool for medical thermography, but the last twenty years have brought about a technical revolution. Thermal imaging has gone beyond the natural limits of human sight and allowed us to reach into the invisible world of infrared radiaiton. At the sametime, other techniques for viewing the human body have developed, using X-rays, gamma rays, ultrasound and now magnetic fields. But infrared imaging has the great advantage that the doctor realizes the information through a natural source of energy and it is, therefore, completely safe to use it for examination.

v

vi FOREWORD

This conference brings together experts from a wide range of technical and medical disciplines. Medical research has increasingly become a team exercise. Disease and sickness know no frontiers and medical science cannot meet the world's needs without a continuing committment to exchange and fertilize ideas and concepts. The understanding of body temperature from childhood to old age, and the effects of disease, is still developing, and the purpose of this International Congress is to compare and discuss recent progress in these subjects. Three main areas of medicine - diseases of the circulation, arthritis and cancer - form special parts of the Congress programme and a forum is provided for doctors, scientists and engineers to collaborate in furthering the knowledge of medical thermography.

In opening this Congress, I wish you all the best of success and would ask you to give some thought to the immortal words of that great poet Milton:

"Accuse not nature, she hath done her part; Do thou but thine, •.• "

His Royal Highness Prince Michael of Kent

Opening Address Third International Congress of Thermology Bath, United Kingdom

PREFACE

Increasing interest in human body temperature has derived from the development of improved technology. Thermal imaging in particular has opened up many areas for study in the last 20 years. This book contains a collection of papers based on the Third International Congress of Thermology. The Congress, opened by His Royal Highness the Duke of Kent, was held in Bath, United Kingdom, in April 1982.

A comprehensive review of new thermal technology applied to clinical medicine was given. The main themes of thermal physiology, instrumentation and technology, and their applications in vascular, locomotor and malignant diseases were represented. As this Congress is held every four years under the auspices of the European Association of Thermology, it forms a valuable basis for evaluating techniques of research interest. It also indicates those techniques which are more applied to clinical diagnosis. Since the majority of these procedures are non-invasive, an increasing trend to monitoring disease in response to treatment is shown.

Acknowledgements are especially due to those colleagues who applied their expertise in the scientific programme and the review of the many manuscripts. They are:

Dr R P Clark Physiology Dr C H Jones Instrumentation and Technique Dr E D Cooke Vascular diseases Dr D P Page Thomas Locomotor diseases Dr A M Stark Malignant diseases.

We are particularly grateful to Dr R P Clark and Mr M Goff for their sustained assistance in preparing the many figures and illustrations found in this book. A considerable proportion of the work has been carried by Miss J Elswood and Miss F A H Davies in typing and preparing the many and varied manuscripts.

vii

viii PREFACE

We are grateful to His Royal Highness Prince Michael of Kent for opening the Congress and to the Congress Chairman Mr K Lloyd-Williams of Bath.

Francis J Ring Barbara Phillips

Royal National Hospital for Rheumatic Diseases and Royal United Hospital, Bath

CONTENTS

THERMAL PHYSIOLOGY

Thermal Physiology - Introduction ••.•.. ..... .......... ................. .•••.•••••... 1 R. P. Clark

Human Skin Temperature and its Relevance in Physiology and Clinical Assessment

R. P. Clark

The Special Thermal Physiology of Newborn Infants J. K. Stothers

Skin Temperature Changes and Their Significance

5

17

in the Human N ewborn .•.......•...••......•....•...•...•.•..•.•..•..•....... 25 J. K. Stothers, R. P. Clark, M. R. Goff

S. J. Linnett and A. J. Livingston

Changes in Thermal Physiology with Advancing Age K. J. Collins

Body Cooling and the Treatment of Heat Stroke K. J. Collins, .J. C. Easton, S. D. Rowlands

and the late J. S. Weiner

The Physiology of Heat Production Y. Houdas and G. Carette

Thermoreception and Temperature Regulation

31

39

43

in Man .... ...................... ....... ..... .......... ............................. ... 51 The late H. Hensel and K. Schafer

ix

x CONTENTS

Cold Fiber Discharge Pattern under In Vitro Conditions: Ouabain and K+ Effects ................................. 65

K. Schafer, H. A. Braun and the late H. Hensel

Physical Principles Governing Body Heat Exchange ••••••••.•.••.......•• 73 D. McK. Kerslake

Environmental Heat Loss K. Cena

Thermographic Estimation of the Effective Heat Exchange Area between a Subject

81

and Substrate ................................•..•.......................••..... 95 A. Solon, W. Stepniewski and K. Cena

Heat Loss from Patients During Anesthesia ................................ 99 E. Sliwinska, J. Laszczynska and K. Cena

Environmental Influence on the Vascular Response of the Hands to Cold Challenge: Ambient Temperature and Time .................................................... 105

E. D. Cooke and S. A. Bowcock

Temperature Changes Caused by Drugs J. Frens

Monitoring the Facial Flush: A Methodological Study S. A. Bowcock, S. Medbak and E. D. Cooke

111

115

Temperature Changes in Skin Disease ••••••.•.•....••.•...••.•...•....•.•••..• 121 G. Stuttgen

Influence of Tissue Injury on Skin Temperature ••.••••••••.••••••....•... 129 L. D. Reed and R. C. Black

Development and Application of an Improved Thermal Dolorimeter ...................................................... 139

I. Fukumoto, M. Saito and K. Ono

TECHNICAL DEVELOPMENTS AND INSTRUMENTATION

Technical Developments in Thermology - Introduction .....••..••..•.• 147 C. H. Jones

The Development of Thermal Imaging Systems ........................... 151 E. H. Putley

Physical Aspects of Infrared Thermography................................ 167 J. Steketee

CONTENTS xi

Physical and Physiological Influence of Medical Ointments on Infrared Thermography............................... 177

J. M. Engel

Quality Control in Infrared Thermography................................... 185 E. F. J. Ring

Computer Processing of Thermographic Images M. Negin

Information Theory and Thermographic Quantification D. P. Page Thomas

Microcomputer Standardization of the AGA 680M

195

205

System .............................................................................. 211 G. Parr, M. Prees, R. Salisbury, P. Page Thomas

and B. L. Hazelman

Microprocessor-Assisted Breast Thermography P. Bosiger, P. Scaroni and M. Geser

215

Digit.al Thermography System ...................................................... 221 A. Tanaka, T. Inoue, T. Yoshimura and

H. Horikawa

Development of a Thermographic Skin Blood Flowmetry System ............................................................. 227

H. Miyake, I. Fujimasa, M. Iwatani and K. Atsumi

A New Device for Thermography A. Nagasawa

235

Pyroelectric Infrared Sensors ...................................................... 241 D. E. Burgess

Microwave Thermal Imaging: Technical Advances and Clinical Findings ............................................................... 251

M. Gautherie, J-L. Guerquin-Kern and A. Kotewicz

Progress in Microwave Thermography.......................................... 267 M. Robillard, A. Mamouni, J. J. Fabre,

J. C. Van de Velde and Y. Leroy

Temperature Distributions by Microwave Radiometric Measurements •.•••••.•.•.••.•••••.••.••••.•••.••••..••••••.•• 271

S. Caorsi

xii CONTENTS

The Measurement of Permittivity and Temperature of Tissues ......................... ..... ..................................... ..... 277

R. J. Sheppard

Thermographic Techniques with Liquid Crystals in Medicine •.•....•.•.•..•••..•.•.•••.••••.•..••.•••.••••.••••.••.•..•....•...•.•.... 283

U. Flesch

Non Sterol Liquid Crystal Thermographic Screen K. G. Archer

301

New Thermochromic Liquid Crystals .......................................... 305 D. G. McDonnell and I. Sage

BTD: Progress in Plate Thermography A. Johnsen

A Cheap and Simple Temperature Transducer: Its

313

Application in Monitoring Breast Disease .......................... 315 U. Flesch and H. Witt

A Device for Thermal Clearance of the Skin ............................. 321 E. F. J. Ring

An Assessment of the Thermal Clearance Method for Measuring Perfusion .................................................... 327

N. F. Britton, J. R. Barker, E. F. J. Ring

VASCULAR AND ENDOCRINE DISEASES

Vascular Diseases - Introduction E. D. Cooke

331

The Concept of a Vascular Service ••••••••••••••••••••..••••••••••••••••••••••• 333 H. Partsch

An Assessment of Thermography in Arterial Disease •••••••••.••••••••• 337 V. A. Spence and W. F. Walker

The Role of Thermography in the Assessment of the Ischemic Limb ................................................................. 345

M. Dewar, T. Coddington, P. Jarman and K. Robinson

The Correlation between After-Exercise Thermography (AET) and Deep Venous Insufficiency .................................................................... 351

T. Hallbook, D. Bergqvist, A. Lindhagen and B. Lindroth

CONTENTS xiii

Thermography and Raynaud's Syndrome ....................................... 355 M. V. Kyle, G. Parr, R. Salisbury,

P. Page Thomas, B. L. Hazleman

Comparison between Acute and Chronic Administration of a Combined Alpha-and Beta-Adrenoceptor Blocker (LabetoloI) and a Beta-Adrenoceptor Blocker (Propranolol) in Hypertensive Subjects .............................. 361

E. D. Cooke and S. A. Bowcock

A Pilot Study in the Evaluation of B-Blockers in Hypertensive Patients with Thermography........................ 365

N. J. Aarts and J. Rijpert

Thermography of Face and Neck of Patients after Cerebral Apoplexy ........................................................... 369

K. Yanagi

Cardiac Muscle Thermography •.•.•..•...•.••••.•..•••...•.•.•..•......•.•...•..... 375 I. Fujimasa, K. Imachi, Y. Kajiyama and

K. Atsumi

Telethermography in the Diagnosis of the Reflex Sympathatic Dystrophy......................................... 379

S. Uematsu

Information from Scrotal Thermography...................................... 397 E. D. Cooke

Thermographic Examination of the Scrotum: Physical Factors ............................................................... 407

C. H. Jones, W. F. Hendry and L. Hughes

Thermographic Characteristics of the Scrotum in the Infertile Male .. ... ........................................ .......... 415

V. Vlaisavljevic

The Role of Liquid Crystal Thermography in the Diagnosis of Testicular and Thyroid Disorders

P. Goblyos, I. Szabolcs, I. Szilvasi, Z. Kopcsanyi, G. Vydra, G. Irsy, M. Goth and G. Szilagyi

LOCOMOTOR DISEASES

Locomotor Diseases - Introduction D. P. Page Thomas

Thermography in Rheumatology J. M. Engel

421

423

425

xiv CONTENTS

Thermography and Muscular Injuries in Sports Medicine ...................•...................................................... 439

M. Schmitt and Y. Guillot

Thermology in the Assessment of Physical Therapy.................... 447 D. Rusch

Heat Distribution over Joints:- the Normal and Abnormal Pattern .••..•••.....•.....•.........•..•••..••.....•••••.•.•......• 453

R. S. Salisbury, G. R. Parr, B. L. Hazleman and D. P. Page Thomas

Thermal Patterns of Osteoarthritic Knees and Hands ••.•.•••..•••..... 459 P. A. Dieppe, E. F. J. Ring and B. Cadge

Thermal Imaging in Assessment of Drugs in Rheumatology .........................•...........•......................•...... 463

P. A. Bacon and E. F. J. Ring

Thermography in Ankylosing Spondylitis ...................................... 475 H. Tauchmannova, V. Svec and D. Zlnay

Thermography and Radio-Isotopes in the Assessment of Sacroiliac Inflammation .............................................. 481

D. M. Grennan, R. Bennett, L. Taylor, C. W. Johns and J. D. Kingsley Brown

Lumbar, Thoracic and Cervical Thermography C. Wexler

Liquid Crystal Thermography of the Spine and Extremities - Its Value in the Diagnosis of

485

Spinal Root Syndrome ....................................................... 493 R. Pochaczevsky, C. E. Wexler, P. H. Meyers,

J. A. Epstein and J. A. Marc

Differential Diagnosis of Pain using Thermography W. B. Hobbins

Thermographic Diagnosis of Low Back Pain:­Relationship of Low Back Pain to

503

Thermographic Changes in the Leg .................................. 507 K. Kawai, S. Takehiro, S. Sadamistu, A. Tanaka

and Y. Matsuo

Thermography of Tennis Elbow.................................................. 513 A. I. Binder, G. R. Parr, P. Page Thomas

and B. L. Hazleman

CONTENTS xv

A Finger Osteoid Osteoma: A Thermographic Investigation .................................................................... 51 9

L. Zorzin, M. Capone and M. G. Maira

Infrared Thermography in the Assessment of Intradermal Skin Tests in Man" ....................................... 525

L. Settas, G. M. Papadimitriou, D. G. Macfarlane M. Doherty, P. A. Dieppe and E. F .• J. Ring

Comparative Thermographic Assessment of Lower Leg Baths in Medicinal Mineral Waters (N auheim Springs) .•..........••.•...••..•......••.•..••...•...........•....... 535

D. Rusch and G. Kisselbach

Thermography of Headaches P. M. Ruegsegger

MALIGNANT DISEASES

541

Malignant Diseases - Introduction ..........••.•••••••....•..........••.......••• 549 A. M. Stark

A Thermographic Prognostic Index •.•••.....•.••.•.••....•.••.....•............. 551 K. Lloyd Williams

Breast Cancer Detection by Absolute Temperature Thermography and Computer Techniques ••.•.•..••.••............ 557

J. Haberman, J. Goin, T. Love, F. Ohnsorg and R. Aggarwal

Breast Thermography as an Adjunct to Clinical Evaluation of the Breasts ..•......•..••••.•••.......•.....•....•..•....•.. 569

I. Nyirjesy

Detection of Subclinical Breast Cancers by Infrared Thermography ...........•.....•.•...•...•.•....••••••••••.••...•. 575

R. Amalric, D. Giraud, L. Thomassin, C. Altschuler and J. M. Spitalier

Glucose Tests with Thermography in the Diagnosis of Breast Cancers ............................................................. 581

B. Guduric

Combined Diagnosis: Thermography, Mammography and Aspiration Cytology in Breast Disease ..........•......•.... 587

I. D. Sharma, N. C. Misra, A. Charan, P. C. Dubey and S. Kumar

Thermography in a Breast Screening Unit .•.•..•..............•••...•....... 593 G. V. Griffin

xvi CONTENTS

Correlation of Breast Images ...... '................................................ 597 H •• J. Isard

Bayesian Analysis of Thermographic Diagnosis of Breast Cancer ....•.•.•.......•••.......•........•...•....•.............•. 599

D. Malatin

Study of Breast Tumors by Thermography, 67 Gallium Citrate and ECAT using 13N-Ammonia ................................................................... 605

L. de Thibault de Boesinghe and K. Schel')traete

The Prognostic Value of Infrared Thermography for Operable Breast Cancer .•..•....•....••........•....•••.•.••.••..•.•. 609

J. M. Spitalier, R. Amalric, D. Giraud, H. Brandone, Y. Ayme, J. F. Pollet and F. Amalric

Results of Contact Thermography using the BTD System in 1500 Patients with 100 Mam mary Carcinomas •.......•.•......••....•.•..••.•.............••....•.•. 613

M. Bauer, V. D. Fournier, R. Schulz-Wendtland F. Kubli and U. Spah

Breast Cancer Screening Indicator (BSCI): A Home­Use Device for the Detection of Breast Pathology ......................................................................... 617

H. L. Karpman, B. Hamilton and S. Cutler

Value of Infrared Thermography in the Assessment of Malignant Melanomas of the Skin ................................ 623

R. Amalric, C. Altschuler, D. Giraud, L. Thomassin and J. M. Spitalier

Value of Thermography in the Diagnosis of Malignant Melanomas of the Skin .................................... 631

M. Cristofolini, S. Boi, B. Perani, G. Recchia and G. Zumiani

HYPERTHERMIA

Hyperthermia - Introduction ........................................................ 635 P. Carnochan

Infrared Thermography and Hyperthermia P. Carnochan and C. H. Jones

637

CONTENTS

Progress in Microwave and Radiofrequency Hyperthermia Controlled by Microwave

xvii

Thermography ..•.•.••...•...••.•............•.....•..................••.••••••. 647 M. Chive, M. Plancot, Y. Leroy, G. Giaux

and B. Prevost

Experimental and Clinical Studies of Hyperthermia in Oncology using Different Electromagnetic Systems •.•..•.•...••••...•...•...••.•........••••.....•.......•.......•..........•. 653

J. L. Guerquin-Kern, H-M. Lauche, P. Pillement, G. Methlin and M. Gautherie.

Kaliomimetic Ion Transport by Injured Membrane During In Vitro Hyperthermia of Tumor Cells

J. Robert, C. Marchal, F. Brunotte, L. Anghileri and P. Thouvenot

Effect of Localised Hyperthermia on Tumor

663

Blood Flow and Oxygenation ...•.••......••.....••....•..................• 669 W. Mueller-Klieser, R. Manz, J. Otte

P. Vaupel

Immunological Response to Whole Body Microwave Hyperthermia in Normal and Tumor -Bearing Animals .•...•.•.......••..•....•..•..•••••..•..•....•.....••.......•... 677

S. Szmigielski

Treatment of Malignant Neoplasms with Radiofrequency Hyperthermia -Clinical Experience •..•••......•............•.........•............••......... 679

Z. Dreznik, R. E. Falk, U. Ambus, V. Howard, D. Venturi and L. Makowka

Radiofrequency Hyperthermia (13.56 MHz) Associated with Radiotherapy or Chemotherapy in the Treatment of Cancer, with Atraumatic Control by Microwave Thermometry (2.4 GHz) ..................................................... 689

G. Giaux, B. Prevost, Y. Leroy and M. Chive

Hyperthermia Combined with Immune-Modulation in Cancer Therapy ..................•..•.......................................... 693

P. Pontiggia, G. M. Pigliucci, N. Gentiloni, G. Follini, R. Cervellin

Author Index ••••••••••••••••••••••••.••••••.•.•••••.••••••. 701

Subj ect Index ••.••.••.••••••••••••.••••••••••••••••••••.••• 705