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Biomedical subjects

S Shionoya

Publications and source records attributed to S Shionoya.

At least 127 records · Page 7Linked to original sources
PubMed1980

A prospective study of hemodynamic changes associated with distal arterial bypass in the leg.

Twelve limbs with Buerger's disease were examined by measurement of segmental blood pressure, digital arterial oxygen saturation and flow velocity in the foot, before and after distal arterial bypass grafting. Eight out of 12 grafts were patent in a follow-up of 6 months to 2 years and one month. Patients with low distal blood pressure before operation obtained a small increase of the foot and toe pressures postoperatively, whereas patients with relatively good initial distal blood pressure were likely to acquire a remarkable recovery of the foot and toe blood pressures. In all 8 limbs with successful revascularization, blood flow velocity in the foot returned to normal, while the foot or the toe pressures remained pathological in 7 of the 8 limbs and digital arterial oxygen saturation did not revert to normal in 4 limbs, with ulceration after healing of the lesion. Postoperative normalization of the foot flow velocity was predictive of limb salvage. The most characteristic feature of peripheral arterial occlusive disease is a stagnation in the microvascular circulation and improvement of the reduced flow velocity is a goal of surgical or conservative treatment.

Adult↗
PubMed1980

Development of a bladder-free cuff for measuring the blood pressure of the fingers and toes.

In the present study, we investigated the technique and reliability of measuring digital blood pressure by means of a rigid, airtight container (a bladder-free cuff) and a photocell placed on the digit. As cuff pressure increased, the position of digits in the cuff was maintained in the hand by fixing one or two fingers inside the cuff and, in the foot, by using a supporting stick to keep the distance from the cuff to the bed constant. An airtight seal inside the cuff was achieved using a thin rubber sleeve and adhesive tape. Blood pressures determined by the bladder-free cuff correlated well with those obtained by the conventional cuff with bladder. By using the bladder-free cuff, blood pressure could be measured at the distal phalanx of the fingers and in all toes.

Adult↗
PubMed1979

Arterial obstruction of the upper limb in Buerger's disease: its incidence and primary lesion.

In the present study, the incidence of upper extremity involvement and the primary lesion of the arm in Buerger's disease were investigated with special regard to arteriographic findings in the upper limb. Of 34 patients with Buerger's disease admitted to our hospital during the 12-month period from March 1977 to February 1978, in 31 cases (91 per cent) the existence of arterial obstruction of the upper limb was confirmed. From the results of arteriographic study in 78 arms, the primary lesion of Buerger's disease appears to develop most frequently in the digital arteries. However, it is possible for the disease to develop independently in the arteries of the hand, or in the radial or ulnar artery. Although the aetiology of Buerger's disease is not definitely known, it is suggested that repeated blunt injury to the hand or fingers is involved in the evolution of the disease as well as in the appearance of symptoms.

Adult↗
PubMed1979

Long-term prognosis for reconstruction of arterial lesions due to arteriosclerosis.

Out of 769 patients with arterial diseases, reconstructive surgery was performed on 100 limbs of 79 patients for arteriosclerosis. The overall patency rate was 59 per cent over a period of 3 to 8 years. Long-term patency was influenced by the condition of the run-off arteries, the site of the operation, and the method of surgery. No relation was found between patency rate and hypertension, cardiac insufficiency, total serum cholesterol, diabetes mellitus, or age. The survival rate was 62 per cent at 5 years and 48 per cent at 7 years. These rates were significantly poor (p less than 0.001), compared with those in the normal population. Mortality was related to the degree of hypertension, with cardiac and renal failure being responsible for 72 per cent of deaths. Aggressive reconstruction may be indicated in cases with hypertension of stage 2 or below based on the WHO classification. However, especially in patients with associated diabetes mellitus close long-term observation of the cardiovascular system is necessary.

Adult↗
PubMed1979

Structure of lymphatics in the aorta and the periaortic tissues, and vascular lesions caused by disturbance of the lymphatics.

In the cases of obstruction of the lymphatics alone, vascular lesions were slighter compared with those of obstruction of the arterial vasa vasorum (5). However, in the cases of severe disturbances of flow from the vascular wall with marked increase of the connective tissues, vascular lesions such as wide intimal thickening progressed. So, disturbance of lymphatics in the aorta and the periaortic tissue seemed to give an influence on the microcirculation in the vascular wall and vascular lesions.

Animals↗
PubMed1978

Segmental blood pressure of the leg and its clinical use.

Systolic blood pressure at various levels of the leg was measured in 80 normal subjects by photoelectric plethysmography with a blood pressure cuff. Due to the higher pressure value at the thigh, calf, ankle, and foot and lower pressure value at the toe, the pressure gradient between each proximal site and the toe was significantly higher in the older (50-82) than in the younger age group (17-49). Therefore, normal values were determined separately in these two groups. In 64 limbs of 42 patients with arterial occlusive disease, a comparison between segmental blood pressure and arteriographic findings was made. Segmental blood pressure may be a rough indicator of the severity of arterial occlusion present and may refrect the status of the major conduits of the leg. An abnormal ankle-toe pressure gradient was found in only 52 per cent of limbs, although all 64 limbs had undergone an occlusive process distal to the ankle. In limbs with significantly low ankle blood pressure due to proximal lesions, less frequency and severity of an abnormal ankle-toe pressure gradient were seen than in limbs with normal ankle blood pressure. When pressure gradients between two different levels are used in clinical work, the blood pressure at the more proximal level should be always considered.

Adolescent↗
PubMed1976

Vascular reconstruction in Buerger's disease.

In 23 of 148 patients with Buerger's disease, it was possible to undertake 27 arterial reconstructive procedures: bypass in 22 and thrombo-endarterectomy in 5. In a follow-up of 10 months to 8 years, the overall patency rate was 26 per cent. The long term patency rate of bypass grafting was good in obstruction of main vessels, but unsatisfactory with multiple occlusions. Bypass grafting was preferred to thromboendarterectomy. To obtain long term patency of revascularaized segments, complete abstinence from tobacco is absolutely essential. The preparatory manoeuvres for antogenous venous graft should be as atraumatic as possible. A functional diagnosis is indispensable when considering operative indications and for follow-up study of patients with peripheral arterial occlusive disease.

Adult↗
PubMed1976

Onset and clinicopathological course in Buerger's disease.

From clinicopathological study, vasculitis of Buerger's disease seemed to start at small branch arteries and veins and progress to the trunk artery with thrombus. Progress of vascular lesions in trunk artery was gradual in general; the pathogenesis was briefly discussed.

Adult↗