Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FOREARM”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed1999

Radial forearm free-flap reconstruction following radiotherapy and total laryngectomy.

The authors' experience with six patients who underwent radial forearm free-flap reconstruction following radiotherapy and total laryngectomy is presented. All patients had undergone previous irradiation of 57.8 Gy on average as primary treatment for laryngeal cancer. A patch graft of the radial forearm free flap was used for pharyngoesophageal wall reconstruction in three patients, a radial forearm free flap for cervical soft tissue in one patient, and a double-folded radial forearm free flap for simultaneous pharyngoesophageal wall and cervical soft tissue in two patients. The free-flap transfers were successful in all patients. There was one patient who developed a small pharyngocutaneous fistula, which closed spontaneously. The radial forearm free flap is demonstrated to be a versatile technique for reconstruction of a moderate-sized defect in the treatment of laryngeal cancer.

Aged↗
PubMed1999

Two modifications of the radial forearm flap for reconstruction of complex facial defects.

The free radial forearm flap has been one of the most common free flaps of recent decades. This flap is employed predominantly in head and neck reconstruction. The possibility of combining bone, muscle, and nerves with the fasciocutaneous flap greatly enhanced reconstructive options. However, the frequently unsightly donor site and the development of other readily available free flaps have led to a decline in the use of the radial forearm flap. Nevertheless, for reconstruction in head and neck surgery, with the need for thin, pliable tissues and a long vascular pedicle, the radial forearm flap still remains a prime choice. Two modifications of the standard forearm flap are presented. The first patient had two large defects at the nose and mental area after radical resection of a basal-cell carcinoma. Soft-tissue reconstruction was achieved with a conventional forearm flap and a second additional skin island based on a perforator vessel originating proximally from the pedicle. Both skin islands were independently mobile and could be sutured tension-free into the defects after tunneling through the cheek, with vascular anastomosis to the facial vessels. The second patient required additional volume to fill the orbital cavity after enucleation of the eye due to an ulcerating basal-cell carcinoma. In this case, the body of the flexor carpi radialis muscle was included in the skin flap to fill the defect. The skin island was used to reconstruct the major soft-tissue defect.

Aged↗
PubMed1984

Free forearm flap for reconstruction of soft tissue defects concurrent with improved peripheral circulation.

The free forearm flap is an accepted procedure for covering defects due to osteitis in the lower leg. End-to-end anastomoses have usually been preferred, if the diameters of the donor and recipient arteries are more or less equal. However, if one or more arteries of the lower leg are absent, end-to-end anastomosis is not indicated, because further disturbances of blood circulation will ensue. We present a procedure in which the flap vessels act as an arterial and venous bypass, thus improving the circulation in the lower leg, while concurrently perfusing the flap. Following full thickness skin graft, cosmetic results at the donor site are not especially pleasing. Results can be improved by a split skin graft (used as a mesh graft), and by situating the donor site on the upper third of the forearm. At the recipient site, the flap can be infolded and connected in anatomic right or reverse directions, depending on the required length of the flap vascular pedicle needed for reconstruction. This can lead to a reverse blood flow in he vessels of the transferred free forearm flap. The radial artery can be restored by vein graft from the same forearm. In 25 free forearm flaps to the lower leg, arterial bypass was performed in 14 cases, venous bypass as well in four cases, with reverse blood flow in three cases.

Adult↗
PubMed2000

Big endothelin-3 constricts forearm resistance vessels but not hand veins in humans.

BACKGROUND: Endothelin-3 (ET-3) and its inactive precursor, big endothelin-3 (big ET-3), are both found in human plasma. We investigated whether big ET-3 is converted to ET-3 in the human forearm resistance vessels and dorsal hand veins in vivo. METHODS: In a 4-phase study, 6 subjects received 90 minute intrabrachial artery infusions of big ET-3 (50 and 100 pmol x min(-1)) and ET-3 (5 and 10 pmol x min(-1)) in random order. Forearm blood flow was measured by venous occlusion plethysmography. In a second 3-phase study, 6 subjects received 90-minute dorsal hand vein infusions of saline solution, big ET-3 (50 pmol x min(-1)) and ET-3 (5 pmol x min(-1)) in random order. In a third 2-phase study, 6 subjects received 90-minute dorsal hand vein infusions of big ET-3 (100 pmol x min(-1)) and ET-3 (10 pmol x min(-1)). In the dorsal hand vein studies, vessel diameter was measured by the Aellig technique. RESULTS: Intra-arterial ET-3 caused local forearm vasoconstriction of 20%+/-9% (P = .009) at 5 pmol x min(-1) and 20%+/-10% (P = .001) at 10 pmol x min(-1) after 90 minutes, with no difference between doses (P = .69). Intra-arterial big ET-3 also caused local forearm vasoconstriction of 22%+/-6% at 50 pmol x min(-1) (P = .004) and 18%+/-3% at 100 pmol x min(-1) (P<.0001) after 90 minutes, with no difference between doses (P = .44). There were no significant differences between the responses to intra-arterial big ET-3 and ET-3 at these doses. Local intravenous ET-3 caused a constriction of 9%+/-2% at 5 pmol x min(-1) (P = .04) and 22%+/-8% at 10 pmol x min(-1) (P = .002) after 90 minutes. Big ET-3 at 50 pmol x min(-1) and 100 pmol x min(-1) did not affect hand vein tone. All responses were slowly progressive. CONCLUSIONS: Based on vasoconstriction, measurable conversion of big ET-3 to ET-3 occurs in forearm resistance vessels but not in dorsal hand veins in vivo. An endothelin-converting enzyme, capable of converting exogenously administered big ET-3 to ET-3, appears to be present in upper limb resistance arteries but not in capacitance vessels in humans.

Adult↗
PubMed2000

Preoperative evaluation of the radial forearm free flap patient with the objective Allen's test.

OBJECTIVE: The conventional subjective Allen's test (SAT) can be problematic because of its subjective nature. The objective Allen's test (OAT) was used before surgery to reliably and objectively assess forearm vascular flow in anticipation of harvesting a radial forearm free flap (RFFF) for use in head and neck reconstruction. STUDY DESIGN AND SETTING: Retrospective analysis of 65 patients undergoing both preoperative SAT and OAT was completed at the University of Kansas Medical Center between December 1994 and March 1998. RESULTS: The sensitivity and specificity of the SAT compared with the sensitivity and specificity of the OAT were only 65% and 76%, respectively. In 40 patients with at least 1 forearm with a positive SAT, only 1 (2.5%) patient was found by OAT to have vasculature that would not have allowed safe RFFF harvest in either forearm. In contrast, of the 25 patients with equivocal or negative SAT results in both arms, 18 (72%) were found by OAT to be safe candidates for RFFF harvests. CONCLUSIONS: The OAT is an objective measure of forearm vascular flow and is superior to conventional SAT in RFFF donor-site selection.

Adult↗
PubMed2001

Comparison of reliability between the modified groin flap and the forearm flap in oral reconstruction.

OBJECTIVE: The groin flap has the advantage of minimum donor-site morbidity, while having the disadvantage of short vascular pedicle of small caliber. Modification of the groin flap has improved the former disadvantage, but the latter one remains. The purpose of this study was to compare the reliability of the modified groin flap with the forearm flap. STUDY DESIGN: Eleven modified groin flaps and 40 forearm flaps consecutively performed by a single surgeon in a hospital for patients with oral cancer were retrospectively reviewed. RESULTS: The rate of total flap loss in the modified groin flap group (8.3%) was higher than that in the forearm flap group (2.5%). The rates of partial flap loss in both flaps were similar to those of total flap loss. The failures of the modified groin flap and the forearm flap were due to arterial and venous complications, respectively. CONCLUSION: The modified groin flap appears to be a little less reliable than is forearm flap; nevertheless, it could be a good option for patients who desire less conspicuous postoperative scars.

Adult↗
PubMed2007

Primary hyperparathyroidism is common in postmenopausal women with forearm fracture and low bone mineral density.

OBJECTIVE: The most common etiologies of osteoporosis in women are estrogen deficiency and, later on in life, the functional changes caused by aging. There are, however, numerous causes of secondary bone loss. Little is known about the prevalence of concomitant disease in women with distal forearm fracture, which is the most common of the classical osteoporotic fractures. METHOD: Postmenopausal healthy women between 45 and 65 years of age with a forearm fracture were invited to join a prospective randomized study evaluating the effect of physical training on bone mineral density. The main inclusion criteria were previous forearm fracture and BMD T-score in the interval -1 to -3.0. Of the 167 postmenopausal women with a forearm fracture, 23% had a normal BMD, 59% had osteopenia, and 18% had osteoporosis. RESULTS: Of the 119 patients meeting the BMD criteria for inclusion, one patient was found to have sprue, two were diagnosed with thyreotoxicos, and eight had primary hyperparathyroidism. The prevalence of primary hyperparathyroidism in this population was 6.7%, and thus three times higher than that previously observed in healthy Swedish postmenopausal women. CONCLUSION: The data suggest an increased prevalence of primary hyperparathyroidism in women with forearm fracture and low bone mass, and imply the importance of basic laboratory screening in this population.

Aged↗
PubMed2006

Prediction of forearm muscle activity during gripping.

Occupational exposure is typically assessed by measuring forces and body postures to infer muscular loading. Better understanding of workplace muscle activity levels would aid in indicating which muscles may be at risk for overexertion and injury. However, electromyography collection in the workplace is often not practical. Therefore, a set of equations was developed and validated using data from two separate days to predict forearm muscle activity (involving six wrist and finger muscles) from grip force and posture of the wrist (flexed, neutral and extended) and forearm (pronated, neutral, supinated). The error in predicting activation levels of each forearm muscle across the range of grip forces, using the first day data (root mean square error; RMSEmodel), ranged from 8.9% maximal voluntary electrical activation (MVE) (flexor carpi radialis) to 11% MVE (extensor digitorum communis). Grip force was the main contributor to predicting muscle activity levels, explaining over 70% of the variance in flexor activation levels and up to 60% in extensor activation levels, respectively. Inclusion of gender as a variable in the model improved estimates of flexor but not extensor activity. While posture itself explained minimal variance in activation without grip force (< 10% MVE), wrist and forearm posture were required (with grip force) to explain over 70% of the variance of all six muscles. The validation process indicated good day-to-day reliability of each equation, with similar error for flexor muscle models but slightly higher error in the extensor models when predicting activity levels for the second day of data (RMSEvalid ranging from 8.9% to 12.7% MVE). Detailed error analysis during validation revealed that inclusion of posture in the model effectively decreased error at grip forces above 25% maximum, but was detrimental at very low grip forces. This study presents a potential new tool to estimate forearm muscle loading in the workplace using grip force and posture, as a surrogate to use of a complex biomechanical model.

Female↗
PubMed2004

Is calcaneal stiffness more sensitive to physical activity than forearm bone mineral density? A population-based study of persons aged 20-79 years.

AIMS: The aim of this study was to investigate the associations between forearm bone mineral density (BMD), calcaneal stiffness, and physical activity levels in a normal population using different non-invasive methods. METHODS: The participants were invited to undergo bone measurements using single photon absorptiometry of the forearm and quantitative ultrasound (QUS) of the calcaneal bone, and also to complete a questionnaire. Physical activity levels were designated low, moderate, and high in the question on leisure-time activity. RESULTS: There were 956 participants included in the present study. Forearm BMD in the eighth age decade was 0.40 g/cm2 (95% CI 0.33-0.46 g/cm2) lower than in the third decade among women and 0.28 g/cm2 (95% CI 0.18-0.37 g/cm2) lower among men. The differences in calcaneal stiffness between the same age decades were 22.4 (95% CI 17.5-27.4) among women and 15.8 (95% CI 8.0-23.5) among men. The correlation between forearm BMD and calcaneal stiffness was 0.58 (95% CI 0.52-0.64) in women and 0.34 (95% CI 0.25-0.42) in men. Reported moderate and high leisure-time activity levels in both genders were associated with higher calcaneal stiffness but not with forearm BMD. CONCLUSIONS: The QUS may be used to measure the effect of present physical activity levels on calcaneal bone at the population level. Further longitudinal studies are warranted in order to determine the most appropriate non-invasive method in population-based studies.

Absorptiometry, Photon↗
PubMed1991

Influence of sex and body weight on forearm hemodynamics in patients with sustained essential hypertension.

Forearm hemodynamics using pulsed Doppler flowmeter measurements were studied in 60 hemodynamics men (30 nonobese and 30 obese) and in 45 hypertensive women (15 nonobese and 30 obese subjects). Age and blood pressure of nonobese and obese patients were identical in men as well as in women. Blood flow, expressed in milliliters/minute or corrected for body surface area, was significantly higher in obese hypertensive patients. When blood flow was expressed per unit liter of forearm volume, the difference was no longer present. The increased blood flow in milliliters/minute in obese hypertensive patients was due to an increased blood velocity, while arterial diameter was similar in nonobese and obese hypertensive patients. Forearm vascular resistance, expressed either in absolute values or in normalized values was significantly higher in nonobese than in obese hypertensive patients. When men and women with similar body weight and mean arterial pressure were compared, women were characterized by lower values of arterial diameter, body surface area and forearm volume, whereas vascular resistance in absolute value or corrected for body surface area was higher. This increase was no longer present when vascular resistance was normalized for forearm volume. This study provides evidence that body composition and body mass index evolve as determinants of arterial blood velocity whereas the gender of the patient seems to influence the arterial diameter.

Adult↗
PubMed1991

Arterial and venous effects of atrial natriuretic peptide in the human forearm.

Atrial natriuretic peptide (ANP) has direct vasodilating properties in addition to its diuretic and natriuretic effects. Furthermore, vascular permeability may be influenced. Because relatively little is known about the venous and capillary actions of ANP in humans, we investigated the spectrum of vascular actions of ANP in the human forearm. In seven healthy subjects, ANP was infused intraarterially in consecutive doses of 0, 10, 50, and 250 ng/100 mL tissue/min together with vehicle or norepinephrine 1 ng/kg/min. In seven other subjects, 0.5 ng/kg/min angiotensin II and 10 ng/kg/min serotonin were used as a constrictor. Venous occlusion plethysmography was used to measure forearm blood flow, venous compliance, capillary filtration rate, and maximum venous outflow. Intraarterial infusion of ANP induced a dose-dependent increase of forearm blood flow but the relative increases were not influenced by concomitant vasoconstriction. Venous compliance was not affected by the infusions, but serotonin and angiotensin II decreased the changes of both forearm volume and venous pressure. ANP antagonized these effects of angiotensin II. Capillary filtration rate was not affected by ANP infusion. ANP alone had no effect on the maximum venous outflow, but it attenuated the decrease induced by norepinephrine and angiotensin II. These results indicate that in the human forearm ANP has predominantly arterial effects, whereas the venous actions become manifest only in the presence of vasoconstriction. The venous effect of ANP may therefore gain importance in disease states with elevated levels of vasoconstrictors, for instance, in congestive heart failure.

Adult↗
PubMed1980

Central haemodynamic and forearm vascular effects of morphine in patients after open heart surgery.

Central haemodynamic and forearm vascular changes following administration of morphine i.v. were studied in patients 24--30 h after open heart surgery. Right atrial pressure, heart rate, mean arterial pressure, cardiac output and stroke volume were measured before and after morphine 5 and 10 mg per 70 kg in 14 subjects. In a further group of eight subjects, forearm blood flow was measured after morphine 10 mg per 70 kg. Total systemic and forearm vascular resistance were derived from these measurements. In spite of wide individual variations, significant decreases in mean arterial pressure occurred in most of the patients and appeared to be dose related. Significant decreases in mean cardiac index were noted only after morphine 10 mg per 70 kg. Forearm blood flow increased consistently and significantly and there was a corresponding decrease in vascular resistance. The decrease in mean arterial pressure and the change in forearm vascular resistance indicated that vasodilatation was probably the principle cause of the decrease in arterial pressure, whereas the sustained decrease in cardiac output seemed to indicate an effect on venous capacitance. The predominant action of morphine appears to be peripheral, causing a decrease in vascular resistance and, possibly, an increase in venous capacitance.

Cardiac Surgical Procedures↗
PubMed1995

Effect of interference current on forearm vascular resistance in asymptomatic humans.

BACKGROUND AND PURPOSE: Several case reports suggest that transcutaneous application of interference current (IC) produces physical blockade of sympathetic vasoconstrictor fibers in peripheral nerves. To test this theory, we studied the effects of IC on forearm vascular resistance in asymptomatic humans. SUBJECTS: One man and four women, aged 21 to 44 years (mean = 33, SD = 12), served as subjects. METHODS: We measured forearm blood flow during IC applications over the left stellate ganglion. Forearm vascular resistance was calculated by dividing mean arterial pressure by forearm blood flow. RESULTS: Interference current did not alter flow (mean = 5.6 [SD = 1.0] versus 6.2 [SD = 1.1] mL/100 mL/min) or resistance (mean = 15.4 [SD = 3.1] versus 13.8 [SD = 2.4] units). When sympathetic outflow was augmented using lower-body suction, IC again failed to alter flow or resistance. CONCLUSION AND DISCUSSION: Interference current applied over the stellate ganglion does not alter forearm hemodynamics in asymptomatic individuals. These findings challenge the concept that IC can block sympathetic vasoconstrictor impulses in peripheral nerves.

Adrenergic Fibers↗
PubMed1983

Muscle musculocutaneous and fasciocutaneous flaps in forearm reconstruction.

Four cases of forearm defects requiring reconstruction are presented to demonstrate the usefulness of muscle musculocutaneous and fasciocutaneous flaps in forearm reconstruction. The forearm is divided into four zones--cubitoolecranon, proximal and middle one-third, distal one-third, and wrist--for purposes of discussing the scope of these different flaps. Muscle flaps are useful for defects in all zones except the distal forearm, where fasciocutaneous flaps are available; however, the superficial forearm muscles and tendons should be included to prevent interference with fascial blood supply.

Adult↗
PubMed1996

Use of a monitor muscle flap in buried free forearm flap transfer.

The free forearm flap is a reliable and versatile tool in head and neck reconstruction. However, the patency of the microvascular anastomosis is difficult to monitor when the flap is buried in the reconstruction of the esophagus or orbital floor. We used a portion of forearm muscle on a branch of the radial artery and vein as a monitor flap. After the free forearm flap transfer, the monitor muscle flap was placed externally through a small skin incision. Flap viability was assessed by observing the color of the bleeding elicited from the muscle flap. Monitor muscle flaps are raised easily during elevation of the forearm flap. This technique was used successfully in 5 patients. This monitoring method provides a simple and reliable assessment of viability when direct monitoring of the forearm flap is not possible.

Aged↗
PubMed1993

Growth hormone after abdominal surgery attenuated forearm glutamine, alanine, 3-methylhistidine, and total amino acid efflux in patients receiving total parenteral nutrition.

OBJECTIVE: The study clarified the effects of growth hormone treatment on forearm amino acid efflux in patients with full nutritional support after gastrointestinal surgery. SUMMARY BACKGROUND DATA: Growth hormone attenuates net nitrogen loss after surgical trauma. An increase in net protein synthesis has been described, whereas the results regarding protein breakdown have been conflicting. METHODS: Elective patients undergoing abdominal surgery were double blindly randomized to treatment with recombinant human growth hormone (GH, n = 9) 24 IU or placebo (PL, n = 10) the first 5 postoperative days. All received parenteral nutrition (nitrogen = 5.7 +/- .1 g/m2, energy = 1018 +/- 12 kcal/m2 (125 +/- .7% of BMR) and epidural analgesia. Amino acid plasma levels and forearm fluxes were measured. RESULTS: The second postoperative day, growth hormone abolished forearm efflux of total amino acid nitrogen (GH: 170 +/- 117, PL: -785 +/- 192 nmol/100 mL/min, p = .0007) due to reduced losses of both essential and nonessential amino acids. Glutamine release was abolished (13 +/- 15 vs. -137 +/- 43 nmol/100 mL/min, p = .007) and alanine release attenuated (-61 +/- 17 vs. -211 +/- 51 nmol/100 mL/min, p = .01). 3-Methyl-histidine release was attenuated (-.20 +/- .11 vs. -.62 +/- .09 nmol/100 mL/min, p = .04). Growth hormone also induced decreased venous plasma amino acid levels. CONCLUSIONS: When given after gastrointestinal surgery in patients treated with total parenteral nutrition, growth hormone treatment abolished glutamine, 3-methylhistidine, and total amino acid nitrogen loss from forearm tissue. Alanine loss from forearm tissue was attenuated.

Abdomen↗
PubMed1998

Median mixed nerve conduction studies in the forearm: evidence against retrograde demyelination in carpal tunnel syndrome.

Motor conduction velocity (CV) measurements often show conduction velocity slowing in the forearm segment of the median nerve in carpal tunnel syndrome (CTS). This is thought to be caused by either retrograde demyelination in the forearm or conduction block of the fastest fibers within the carpal tunnel. Direct measurement of the forearm segment of the median nerve should distinguish these two possibilities. Standard motor conduction studies and mixed nerve action potential (MNAP) recordings were performed on the forearm segment of the median nerve in patients (n = 32 limbs, aged 24 to 76) and controls (n = 15 limbs, aged 33 to 76). CVMot and CVMNAP were compared between patients and controls. The CVMot was significantly slower in patients with CTS than controls (patients 48+/-5 msec, controls 54+/-5 m/s, P = 0.001), but the CVMNAP showed no difference (patients 59+/-5 m/s, controls 60+/-5 m/s, P = 0.5) in the two groups. Additionally, the difference between CVMNAP and CVMot in a given patient was significantly larger in the patient group than in the controls (patients 11+/-4 m/s, controls 6+/-2 m/s, P < 0.0001). These results strongly support the hypothesis that the slowing seen in the forearm is caused by conduction block of the fastest conducting fibers within the carpal tunnel and is not caused by retrograde demyelination.

Adult↗
PubMed1990

Reactive hyperemia during short-term blood flow and pressure changes in the hypertensive forearm.

The aim of the present study was to further validate our method for the determination of minimal forearm vascular resistance after ischemia (13 min arterial occlusion and 1 min hand exercise) in patients with hypertension. This parameter, calculated as the ratio of mean blood pressure (intra-arterial recordings on the experimental side) to forearm blood flow (strain-gauge venous plethysmography), was measured basally and after either increasing (through unrelated vasodilators such as sodium nitroprusside or the calcium antagonist nicardipine in six mild-to-moderate uncomplicated hypertensives) or decreasing (norepinephrine, n = 4) flow without changes in systemic pressure. In spite of the divergent starting flow values, minimal postischemic forearm vascular resistance was unchanged, indicating a lack of relationship with functional arteriolar tone and the achievement of maximal dilatation. In two additional groups of patients, systemic arterial pressure was decreased by approximately equipotent oral doses of either nifedipine, a calcium antagonist (n = 6), or captopril, an angiotension converting enzyme inhibitor (n = 5). Under these conditions, minimal forearm vascular resistance was unchanged from pretreatment values, suggesting that local autoregulatory mechanisms were overridden during the reactive hyperemia, and that the vessel lumen was dependent on the distending pressure. Overall, the data show that our experimental conditions are suitable for measuring minimal forearm vascular resistance as a functional correlate of the morphological status of systemic arterioles in arterial hypertension.

Adult↗