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At least 721 records · Page 40Linked to original sources
PubMed1998

Comparison of responses evoked by mild indirect cooling and by sound in the forearm vasculature in patients with homozygous sickle cell disease and in normal subjects.

In normal individuals, novel or noxious stimuli commonly evoke the pattern of the alerting or defence response which includes cutaneous vasoconstriction, but vasodilatation in forearm skeletal muscle. We have compared cardiovascular responses evoked by sound and by indirect cooling in 60 patients with homozygous sickle cell (SS) disease and in 30 control subjects with normal haemoglobin genotype (AA). A sound of 90 dB, 1 kHz for 30s evoked an increase in hand and forearm cutaneous vascular resistance (HCVR and FCVR) in SS patients and an increase in HCVR in AA subjects, as assessed from Doppler flowmetry. Meanwhile, a decrease in forearm vascular resistance (FVR) assessed by venous occlusion plethysmography, occurred in 14 out of 30 AA subjects and 25 out of 60 SS patients, indicating vasodilatation in forearm muscle; an increase in FVR occurred in the remainder. The proportions of SS patients and AA subjects who showed an increase in FVR (53% vs 57%) were not significantly different. Cooling increased HCVR and FCVR in SS patients and increased FCVR in AA subjects; a decrease in FVR indicating vasodilatation, occurred in 12 out of 30 AA subjects, but in only 10 out of 60 SS patients. The proportion of SS patients who showed an increase in FVR to cooling was greater than in AA subjects (83% vs 60%, P < 0.05). Thus, SS patients are just as capable of showing the muscle vasodilatation of the alerting response to sound as AA subjects. That few SS patients showed muscle vasodilatation in response to cooling is consistent with the view that reflex vasoconstrictor responses to cooling are particularly strong in SS patients. This, in turn, is consistent with our hypothesis that the reflex vasoconstrictor response to cooling acts as a trigger for the painful crisis of SS disease by diverting blood flow away from active bone marrow.

Acoustic Stimulation↗
PubMed2006

Reactive hyperemia increases forearm vein area.

PURPOSE: To determine the effect of reactive hyperemia on human forearm vein area. METHODS: After obtaining ethics approval and informed consent, an automatic tourniquet was applied to the forearms of 20 healthy subjects for one, two, and three minutes, at pressures of 25 mmHg, 200 mmHg, then 25 mmHg. A blinded radiographer measured the cross-sectional area of the cephalic vein at the wrist using ultrasonography. Measurements were recorded prior to tourniquet application and every minute thereafter for ten minutes, at each pressure setting and each time interval. RESULTS: The mean vein cross-sectional area (mm2) increased from 8.22 +/- 3.09 to 10.77 +/- 3.50 after one minute of ischemia, from 8.31 +/- 2.78 to 10.61 +/- 2.77 after two minutes of ischemia, and from 8.39 +/- 3.34 to 10.94 +/- 3.46 after three minutes of ischemia (P < 0.05 for all). A tourniquet inflated to 25 mmHg for 13 min produced a mean vein cross-sectional area of 10.71 +/- 3.25 mm2. CONCLUSIONS: Reactive hyperemia causes human forearm vein cross-sectional area to increase. A low pressure tourniquet will also increase forearm vein area, but veins dilate more quickly during reactive hyperemia. This may have important clinical implications for attempting venous cannulation in patients with difficult venous access.

Adolescent↗
PubMed1997

[Functional fracture treatment of the forearm. The indications and results].

In a retrospective study from 1986 to 1995, 64 forearm fractures were treated with brace. Clinical and roentgenographic follow-up data were available for 49 patients (76.6%). There were 49.0% ulna shaft, 38.9% radius and 12.2% forearm fractures. The average time to healing was 10.2 weeks. Functional results were excellent in 57.1%, good in 34.7% and poor in 8.2% of cases. Two (4.1%) fractures (radius, forearm shaft) were not considered as healed and were re-operated with plate osteosynthesis. The ideal indication for fracture bracing is ulna shaft fracture. Radius and forearm shaft fractures can also be treated, but patients must be informed about the long time to healing and operative alternatives.

Adult↗
PubMed2003

Hormone replacement therapy and risk for foot, distal forearm, proximal humerus, and pelvis fractures.

This case-control epidemiologic study examines the relationship between hormone replacement therapy (HRT) and risk for fractures of four sites among women 45 years of age and older. From October 1996 to May 2001, incident patients with distal forearm ( n=744), foot ( n=618), proximal humerus ( n=331), and pelvis ( n=109) fractures were recruited from five Kaiser Permanente Medical Centers in northern California. Controls ( n=1617) were selected at random from the same five medical centers over the same time period within strata defined by 5-year age group, gender, and white versus nonwhite or unknown recorded race/ethnicity. Trained interviewers collected information using a standardized questionnaire. Compared with postmenopausal women who never used HRT, postmenopausal women currently using HRT for at least 3 months had a decreased risk of fracture at the distal forearm (adjusted OR=0.55, 95% CI: 0.43, 0.72), proximal humerus (adjusted OR=0.51, 95% CI: 0.36, 0.74), and pelvis (adjusted OR=0.51, 95% CI: 0.27, 0.95), but not the foot (adjusted OR=1.05, 95% CI: 0.81, 1.35). Past use of HRT for more than 7 years also appeared to be associated with a reduced risk of fracture at the distal forearm and proximal humerus. The longer a woman went without HRT after her last menstrual period, the greater her risk of fracture in the distal forearm, proximal humerus, and pelvis. The findings of this study support long-term, current use of HRT for the prevention of osteoporotic fractures, but other risks and benefits also need to be considered.

Aged↗
PubMed2002

No vasodilator response to low-dose heparin in the forearm skeletal-muscle vascular bed.

OBJECTIVE: Recent reports show that heparin induces vasodilation. This heparin-induced vasodilation might interfere with the results of vascular studies using the perfused-forearm technique because the arterial catheter is often flushed with a heparin solution in those experiments. Therefore, we investigated the vascular effects of flushing an arterial catheter with a heparin solution compared with a placebo solution (NaCl 0.9%) in six healthy volunteers. METHODS: During the first half of each experiment, the arterial catheter was flushed several times with the placebo solution. In the second half, identical flushes were performed with a solution of heparin diluted in NaCl 0.9% (4U x ml(-1)). RESULTS: Forearm blood flow (venous occlusion plethysmography) response was similar with heparin and placebo after all flushes. CONCLUSION: We conclude that low-dose heparin in the solution to flush an arterial catheter has no short-term vasodilator effect in the human forearm vascular bed. Therefore, the results of studies using the perfused-forearm technique are not confounded by flushes with a low-dose heparin solution.

Adult↗
PubMed2006

Treatment of traumatic forearm bone loss with Ilizarov ring fixation and bone transport.

Bone loss in the forearm results from high-energy trauma or follows non-union with infection. Ilizarov methodology provides stable fixation without implantation of permanent foreign bodies while permitting wrist and elbow movement. We are reporting our experience using distraction osteogenesis in the treatment of traumatic bone loss in the forearm. From 1991 to 2000, 11 consecutive patients with traumatic forearm bone loss were treated with Ilizarov ring fixation. Records were reviewed retrospectively. All patients were contacted 2-10 years after surgery at the Ilizarov Clinic in Lecco, Italy. Eleven atrophic non-unions with bone loss were treated. The time from injury to Ilizarov treatment averaged 2.1 years. Follow-up averaged 6.2 years. The union rate with Ilizarov treatment alone was 64%. Thirty-six percent of the patients were converted to a hypertrophic non-union and underwent compression plating. The overall rate of union was 100%. There were four unplanned reoperations and no refractures, neurovascular injuries or deep infections. Three patients had significant limitations of wrist function. Nine patients described their function as excellent. Ilizarov fixation with bone transport is a viable treatment option for atrophic forearm non-unions with bone loss. Treatment resulted in ablation of infection, healing of atrophic non-unions with minimal complications and early extremity use.

Adolescent↗
PubMed2003

Direct biochemical evidence for eNOS stimulation by bradykinin in the human forearm vasculature.

OBJECTIVE: Although it has been shown recently that acetylcholine (ACh)-induced vasodilation of forearm resistance vessels is predominantly mediated by nitric oxide, direct biochemical evidence for eNOS stimulation by bradykinin (BK) in the human arterial circulation is still lacking. Therefore, the present study was designed to test the hypothesis that in the human forearm vasculature eNOS stimulation significantly contributes to BK-induced vasodilation. METHODS: BK was infused in the presence and absence of the NOS inhibitor L-NMMA (8 micromol/min) into the brachial artery of 16 healthy volunteers and the effects compared to muscarinergic eNOS stimulation following acetylcholine infusion. Forearm blood flow (FBF) was measured by venous occlusion plethysmography, and plasma nitrite (NO(2)(-)), which represents a sensitive and specific marker of regional eNOS activity, was determined in the antecubital vein and brachial artery by flow injection analysis. Nitric oxide production was calculated as product of the veno-arterial difference of NO(2)(-) concentration times FBF. RESULTS: Kininergic (BK: 20, 60, 200 ng/min) as well as muscarinergic (ACh: 1, 3, 10 microg/min) stimulation resulted in a dose-dependent increase in FBF and NO(2)(-) in each individual. The relationship between FBF and NO production upon BK infusion was comparable to that obtained with ACh (r = 0.98; n = 64, p < 0.01). Moreover, NOS inhibition reduced both flow responses and NO production (BK: 54 and 75 %; ACh: 57 and 72 %) to a similar extent. CONCLUSIONS: These data provide direct biochemical evidence for the involvement of eNOS in bradykinin-induced vasodilation of forearm resistance vessels in humans.

Acetylcholine↗
PubMed1997

Arterial blood pressure and forearm vascular conductance responses to sustained and rhythmic isometric exercise and arterial occlusion in trained rock climbers and untrained sedentary subjects.

Cardiovascular responses to sustained and rhythmic (5 s on, 2 s off) forearm isometric exercise to fatigue at 40% maximal voluntary contraction (MVC) and to a period of arterial occlusion were investigated in elite rock climbers (CLIMB) as a trained population compared to non-climbing sedentary subjects (SED). Blood pressure (BP), monitored continuously by Finapres, and forearm blood flow, by venous occlusion plethysmography, were measured and used to calculate vascular conductance. During sustained exercise, times to fatigue were not different between CLIMB and SED. However, peak increases in systolic (S) BP were significantly lower in CLIMB [25 (13) mmHg; (3.3 (1.7) kPa] than in SED [48 (17) mmHg; (6.4 (2.3) kPa] (P < 0.05), with a similar trend for increases in diastolic (D) BP. Immediately after sustained exercise, forearm conductance was higher in CLIMB than SED (P < 0.05) for up to 2 min. During rhythmic exercise, times to fatigue were two fold longer in CLIMB than SED [853 (76) vs 420 (69) s, P < 0.05]. Increases in SBP were not different between groups except during the last quarter of exercise when they fell in CLIMB. Conductance both during and after rhythmic exercise was higher in CLIMB than in SED. Following a 10-min arterial occlusion, peak vascular conductance was significantly greater in CLIMB than SED [0.597 (0.084) vs 0.431 (0.035) ml x min(-1) x 100 ml(-1) x mmHg(-1); P < 0.05]. The attenuated BP response to sustained isometric exercise could be due in part to enhanced forearm vasodilatory capacity, which also supports greater endurance during rhythmic exercise by permitting greater functional hyperaemia in between contraction phases. Such adaptations would all facilitate the ability of rock climbers to perform their task of making repetitive sustained contractions.

Adaptation, Physiological↗
PubMed1999

A genome-wide scan for loci linked to forearm bone mineral density.

Osteoporosis is a chronic disorder characterized by low bone mass and fragility fractures. It affects more than 25 million men and women in the United States alone. Although several candidate genes, such as the vitamin-D-receptor gene or the estrogen-receptor gene, have been suggested in the pathogenesis of osteoporosis, the genetic dissection of this disorder remains a daunting task. To search systematically for chromosomal regions containing genes that regulate bone mineral density (BMD), we scanned the entire autosomal genome by using 367 polymorphic markers among 218 individuals (153 sibpairs) from 96 nuclear families collected from three townships of Anqing, China. In these 96 families, DNA samples from both parents were available for 82 (85.4%) families. By using age- and gender-adjusted forearm BMD measurements, a peak on chromosome 2 near D2S2141, D2S1400, and D2S405, a region previously linked to spinal BMD, showed evidence of linkage to both proximal and distal forearm BMD (multipoint LOD=2.15 and 2.14 for proximal and distal forearm BMD, respectively). One region on chromosome 13 (multipoint LOD=1.67) in the proximity of D13S788 and D13S800 showed evidence of linkage to distal forearm BMD only. Possible candidate genes included CALM2 (calmodulin 2) at 2p21.3-p21.1, a putative STK (serine/threonine kinase) at 2p23-24, POMC (pro-opiomelanocortin) at 2p23.3, and COL4A1 and COL4A2 (collagen IV alpha-1 and alpha-2 subunits) at 13q34. Because of the limited sample size, the suggestive evidence of linkage of this study should be considered as tentative and needs to be replicated in other larger populations.

Adolescent↗
PubMed1989

Vasodilation and reduction in forearm vascular resistance after acute administration of dilevalol.

Dilevalol is a long-acting antihypertensive drug that has been demonstrated in animals to combine specific beta 2-agonist-mediated vasodilation with nonspecific beta blockade. To document vasodilation in humans, single oral doses of dilevalol, 200 mg, and placebo were randomly administered to 12 untreated hypertensive patients. Dilevalol produced significant reductions (p less than or equal to 0.01) in diastolic blood pressure throughout a 24-hour period relative to placebo, without changing heart rate. Forearm blood flow, measured hourly over the initial 4 hours after dosing, demonstrated a shift to a more vasodilated state after dilevalol administration, with significant increases in minimal forearm blood flow (4.0 vs 2.9 ml/dl tissue/min, dilevalol vs placebo, respectively; p = 0.05) and in mean average forearm blood flow (5.3 vs 4.0 ml/dl tissue/min, dilevalol vs placebo; p = 0.04). Similarly, dilevalol produced a decrease in mean forearm vascular resistance (26.5 vs 34.6 mm Hg/ml/dl tissue/min, dilevalol vs placebo; p = 0.02). In the absence of a change in heart rate, the acute hypotensive response to dilevalol in these patients appears to have resulted primarily from vasodilation and reduced vascular resistance.

Administration, Oral↗
PubMed1992

Free medial gastrocnemius myocutaneous flap transfer with neurovascular anastomosis to treat Volkmann's contracture of the forearm.

Some articles have reported the use of medial gastrocnemius transfer to repair soft-tissue defects caused by trauma and inflammation (Morris, 1978; Feldman et al., 1978; Arnold and Mixter, 1983). However, we have not found any report describing the use of free medial gastrocnemius myocutaneous flap transfer with neurovascular anastomosis to treat Volkmann's contracture of the forearm. Since 1982, 20 cases of Volkmann's contracture of the forearm have been treated by transfer of medial gastrocnemius flap with neurovascular anastomosis. These 20 patients ranged in age from 6-18 years, with a mean of 10 years. There were 18 males and 2 females. All cases resulted from ischaemia of the extrinsic and intrinsic muscles of the forearm and hand. The most common causes were severe supracondylar fractures or, less frequently, fracture-dislocations of the elbow. Six to twenty months after operation, the transplanted muscles exhibited normal electromyographic potentials, good volume and contractile power with satisfactory functional recovery of the forearms. The deformities of the hand and wrist were also corrected. In this paper we describe the anatomy of the donor site and the operative procedure.

Adolescent↗
PubMed1989

Measurement of the subcutaneous fat in the distal forearm by single photon absorptiometry.

The influence of subcutaneous fat on single photon (125I) absorptiometry (SPA) measurement of bone mineral content of the distal forearm was investigated. A fat correction model was tested by measurements on eight lean subjects with different amounts of porcine fat around their forearm, and further validated from measurements on 128 females. In addition, it is shown that the fat content in the distal forearm can be measured by SPA with a short-term precision at 1.9% in an obese subject and that it correlates well with total body fat (r2 = .7) measured by dual photon absorptiometry, skinfold thickness (r2 = .5), and body mass index (r2 = .6). By using this method in a double-blind placebo-controlled trial, hormonal substitutional therapy significantly decreased the forearm fat content without affecting the body weight in postmenopausal osteoporotic women.

Adipose Tissue↗
PubMed1982

Transient vasodilatation in forearm on stimulation of carotid baroreceptors in man.

Carotid baroreceptor modulation of forearm vascular resistance was examined in 6 healthy subjects, each subject participating in 6 identical experimental runs. Forearm vascular resistance was calculated from simultaneous measurements of blood pressure and forearm blood flow (venous occlusion plethysmography). Carotid baroreceptor activity was modified by neck suction technique. To compare the effects of dynamic and static changes of baroreceptor activity neck suction was increased as a ramp lasting 6 s from -10 mm Hg (control) to -40 mm Hg and then maintained at this level. Measurements were started 15 s before and 9 s ('early') and 30 s ('late') after the onset of the suction ramp. Vascular resistance showed a significant (P less than 0.01) decrease during 'early' suction; but recovered partially and during 'late' suction there was no significant difference from control. The results indicate that carotid baroreceptors do modulate vascular resistance in the forearm and that the effect is more pronounced in response to dynamic than to static changes in baroreceptor input.

Adrenergic Fibers↗
PubMed1985

Effects of nifedipine on forearm vascular resistance and venous capacitance in normal subjects and in patients with congestive heart failure.

The effects of oral nifedipine on limb hemodynamics were studied in 7 normal subjects, 8 patients with congestive heart failure and 2 patients who underwent sympathectomy of unilateral limb. Forearm venous capacitance remained unchanged both in normal subjects and in patients with congestive heart failure. In normal subjects, systemic vascular resistance decreased without change in forearm vascular resistance. On the other hand, both systemic and forearm vascular resistance decreased simultaneously in patients with congestive heart failure. In 2 patients with normal left ventricular function undergoing sympathectomy, limb vascular resistance decreased in the denervated side and increased in the contralateral innervated side. These findings indicate that the effects of nifedipine on forearm vascular resistance are dependent upon the circulatory state of the patient at the time the drug is administered, while venous dynamics were not changed by nifedipine, and that the difference in the density of sympathetic innervation results in a reordering of territorial blood flow by modifying the vasodilatation due to the calcium antagonistic action of nifedipine.

Adult↗
PubMed1996

Conduction velocity in the forearm segment of the median nerve in patients with impaired conduction through the carpal tunnel.

Conduction velocity, in the forearm segment of the median nerve, has been investigated in a group of patients with carpal tunnel syndrome. Motor conduction velocity was reduced below 50 m/s in 18% of the sample. Although a correlation between severity of compression and forearm motor conduction velocity was demonstrated, it was weak (r = 0.51) and slow forearm velocities occurred in some patients who had only a minor abnormality at the carpal tunnel itself. In patients with uncomplicated carpal tunnel syndrome, slow motor conduction in the forearm segment of the median nerve was accompanied by only a small reduction (approx. 5 m/s) in mixed nerve conduction velocity. By contrast, in patients whose abnormality at the carpal tunnel was accompanied by evidence of a more widespread sensorimotor neuropathy, mixed nerve conduction velocity was reduced in parallel with the change in motor conduction velocity.

Adult↗
PubMed2006

Contractile hyporesponsiveness to norepinephrine of forearm veins in chronic renal failure.

BACKGROUND: We recently reported that endothelium-dependent relaxation is impaired in forearm veins from patients with chronic renal failure. However, assessment of responses to norepinephrine remains controversial. We examined the contractile response to norepinephrine in forearm veins from patients on chronic hemodialysis and the role of nitric oxide (NO), prostanoids, and Ca(2+)-activated K(+) channels in this response. METHODS: Isometric contraction curves were obtained in rings of forearm vein from 21 dialyzed patients and 12 multiorgan donors in response to norepinephrine (1 nmol/L to 10 micromol/L) or KCl (5 to 100 mmol/L). RESULTS: Veins from uremic patients were markedly less responsive to norepinephrine (7.6 +/- 0.6 g) and KCl (6.0 +/- 0.3 g) than those from organ donors (12.0 +/- 0.7 g and 10.4 +/- 0.5 g, respectively, P < .05). Treatment with N(G)-monomethyl-l-arginine (100 micromol/L), an inhibitor of NO synthase, or indomethacin (10 micromol/L), an inhibitor of prostacyclin synthesis, increased the response to norepinephrine in veins from control subjects but not in veins from dialyzed patients. Additional blockade of Ca(2+)-activated K(+) channels did not correct the hyporesponsiveness. In veins incubated in Ca(2+)-free solution containing either 100 mmol/L KCl or 1 micromol/L norepinephrine, addition of calcium chloride (0.1 to 30 mmol/L) elicited contractile responses that were significantly lower in veins from dialyzed patients. CONCLUSIONS: The results demonstrate that norepinephrine-mediated contractions of forearm veins are markedly decreased in dialyzed patients. Endothelium-derived relaxing factors are not involved in this effect. The reduced contractile response is most likely caused by a decreased calcium entry through voltage- and receptor-dependent calcium channels.

Dose-Response Relationship, Drug↗
PubMed2006

[Compound tissue reconstruction of the forearm in emergency. About 17 clinical cases].

The authors report a serial of 17 patients with complex trauma of the forearm treated in emergency by means of compound tissue reconstruction. Every patient present a cutaneous defect associated with multiple lesions or defects of the subjacent tissues. The management consisted of a large debridement with excision of all contuse tissues, a stable osteosynthesis witch permit an early mobilization of the hand and fingers, a revascularization of the hand by a by-pass procedure or a vascular bridge free flap, reconstruction of the muscles, tendons, and the nerves at the same time as possible, a coverage of the tissues by free flaps or forearm pedicle flaps and a physiotherapy by a specialized team undertaken immediately after surgery. The functional results have been evaluated satisfying in the whole serial. The authors conclude that the compound tissue reconstruction of the forearm in emergency with an early physiotherapy permits an optimal functional recovery within short period. It authorizes a rapid socioprofessional return of these patients with complex trauma of the forearm.

Adolescent↗
PubMed2004

Forearm endothelial function and bone mineral loss in postmenopausal women.

It is widely believed that the vasculature plays an important role in bone remodeling. We investigated the relationship between forearm endothelial function and bone mass in the lumbar spine in early postmenopausal women without a history of smoking or diabetes mellitus. We studied the forearm resistance artery endothelial function in 110 Japanese women-52 postmenopausal women with normal spinal bone mineral density (BMD), 36 postmenopausal women with osteopenia, and 22 osteoporotic postmenopausal women. Forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin (NTG) administration was measured by strain-gauge plethysmography. BMD of the lumbar spine (L2-L4) was measured by dual-energy X-ray absorptiometry. After adjustment for age, body mass index, years since the start of menopause, and basal FBF, women with osteoporosis had a lower maximal FBF response to reactive hyperemia (28.4 +/- 3.8 mL/min per 100 mL tissue) than those with normal BMD (39.8 +/- 2.8 mL/min per 100mL tissue) or osteopenia (35.6 +/- 2.5 mL/min per 100mL tissue) (P = 0.029). A significant increase in serum angiotensin-converting enzyme (ACE) activity (P = 0.042) and a significant decrease in the serum concentrations of nitrite/nitrate (P = 0.041) were noted in osteoporotic women compared to women with normal BMD or osteopenia. The present findings suggest that postmenopausal women with low BMD, especially those with osteoporosis, have impaired endothelial function in the forearm resistance arteries.

Absorptiometry, Photon↗