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At least 937 records · Page 52Linked to original sources
PubMed1994

Diurnal variations in total forearm and skin microcirculatory blood flow in man.

The aim of the present study was to determine diurnal variations in total forearm and skin microcirculatory blood flow in healthy man. At six time points between 08.00 and 18.00 hours was measured: blood pressure, forearm blood flow (FBF; strain gauge plethysmography), skin thermoregulatory blood flow (LDF; laser-Doppler fluxmetry), and skin nutritive blood flow (CBV: Capillary Blood Cell Velocity; intravital capillary microscopy) in 15 healthy, fasting, and resting men. FBF increased gradually from 2.8 in the morning to 4.3 ml 100 ml min-1 in the afternoon (p < 0.001). In contrast, LDF decreased, predominantly in the morning, from 18.3 at 09.00 hours to 13.1 at 12.00 hours and to 12.1 perfusion units at 17.30 hours (p < 0.001). However, performing the same protocol starting in the afternoon resulted in a similar initial decrease in LDF, suggesting an acclimatization phenomenon. Although not statistically significant, the decrease in CBV showed a similar pattern as compared to LDF. Blood pressure did not change. In conclusion, forearm blood flow increased during the day, probably due to diurnal variation in muscle flow. The initial decrease we observed in skin thermoregulatory blood flow is probably not related to diurnal variation but due to long-term acclimatization to the experimental conditions. These data suggest different regulatory mechanisms for the different vascular beds studied. Measurements of forearm blood flow should preferably be performed at the same time of day, and skin microcirculatory haemodynamic measurements should be performed after a standard period of acclimatization.

Adult↗
PubMed2002

Lack of rapid aldosterone effects on forearm resistance vasculature in health.

OBJECTIVES: Systemic infusions of aldosterone cause an acute increase in systemic vascular resistance (SVR) in healthy subjects. It is not clear whether this is due to a direct effect on the vasculature or the result of increased sympathetic tone. We investigated the short-term effects of locally infused aldosterone on the forearm resistance bed. METHODS: In this dose response study, we assessed the effects of incremental doses (10, 50, 100 ng/minute) of intrabrachial aldosterone on forearm blood flow (FBF), using conventional strain gauge plethysmography. Arterial blood pressure was monitored continuously, using finger photo- plethysmography. Forearm vascular resistance (FVR) was calculated. FBF and FVR were also measured in the non-infused arm. Changes in FBF and FVR in the infused arm were corrected for those occurring in the control arm. RESULTS: Plasma aldosterone levels in the venous effluent of the infused arm increased in a dose-dependent fashion, from 113.3+/-17.9 pg/ml at baseline to 297.8+/-51.8 pg/ml at 10 ng/minute (p=<0.01), 743.9+/-105.9 pg/ml at 50 ng/min (p=<0.001 vs. baseline) and 1230.6+/-73.7 pg/ml at 100 ng/min (p=<0.0005 vs. baseline). Plasma concentrations of aldosterone in the control arm did not change significantly vs. baseline. The corrected FBF (+4.1+/-10.3%) and corrected FVR (+4.3+/-11.3%) did not change significantly even at peak infusion rates. CONCLUSIONS: Local intra-arterial infusion of aldosterone had no acute effect on forearm resistance vessels in healthy male volunteers.

Adult↗
PubMed1999

Mid-third forearm fractures in children: an unorthodox treatment.

Twenty children with fractures of both bones in the middle third of the forearm were immobilized in extension after closed reduction. Unlike distal-third fractures, these fractures are prone to develop rotary and angular deformities that may lead to permanent functional impairment and visible deformity. Mid-third forearm fractures with the radius fracture proximal to the ulnar fracture are even more troublesome. Nineteen patients had no clinical deformity at cast removal, and by 1 year, there was no difference in forearm rotation. Extension casting can be used initially for proximal fractures or to salvage forearms that lost reduction in flexed elbow casts. Extension cast application is easy while the reduction is maintained, whereas the problems are often encountered while applying a flexed elbow cast. This unorthodox treatment is safe and effective and may alleviate the need for surgical intervention.

Casts, Surgical↗
PubMed1998

[Long-term result of free forearm skin flap for repair of soft tissue defects of the oral and maxillofacial regions].

To evaluate the long-term result of free forearm skin flap in the repair of soft tissue defects of the oral and maxillofacial regions, 26 cases which had received radical resection of maxillofacial tumors were follow-up for 4.5 years. Twenty cases, having complete data were analyzed. In this series, There were 8 males and 12 females, with ages ranged from 40 to 69 years old. The size of the flaps ranged from 4 cm x 5 cm-6 cm x 13 cm. The radial artery and the cephalic vein were used as the donor vessels, and the maxillary artery, superior thyroid artery, external jugular vein and the anterior jugular vein were prepared as the recipient vessels. According to the shape, colour, temperature, sensation, mucosoid degree of the flap, the blood supply and function of hand and the configuration of the forearm, the overall results of the recepient regions in 20 cases were all satisfactory and the overall results of 16 cases donor regions were satifactory in 16 cases. The results were poor in 4 cases. The conclusion were: 1. Free forearm skin flap was worth trying in the repair of soft tissue defects of oral region; 2. The radial artery need not to be reconstructed because of the abandant vascular net-work in the upper limb and 3. The residual scar on the forearm was the main shortcoming, but most of the patients could tolerate it because of the obvious advantages received from the operation.

Adult↗
PubMed1999

[Ambulatory and domiciliary cancer chemotherapy with forearm implant catheter system and low-dose CDDP + 5-FU therapy].

Shortening the period of hospitalizations and improving QOL attracting a great deal of attention in the field of medicine recently. Therefore, ambulatory and domiciliary treatment has become more important. This is not an exception in cancer therapy; the conversion from hospital treatment to ambulatory and domiciliary treatment is promoted. However, there is the danger of a lowered QOL as a resistant side effect, when the conventional cancer chemotherapy in the hospital is used as the ambulatory and domiciliary treatment. Recently, low-dose CDDP + 5-FU therapy (LFP therapy) that applies biochemical modulation has been developed for advanced gastrointestinal cancers. This therapy is thought to have a good antitumor effect and slight side effects, so it can be widely used. However, this therapy needs the continuous injection of 5-FU, so the hospital treatment was necessary, and ambulatory treatment was difficult with the usual administration method. Thus, we implanted a forearm central venous catheter system (forearm IVH reservoir), through which we can administer medication safely and conveniently without limiting the patient activity. LFP therapy was attempted in ambulatory and domiciliary treatment. Low-dose FP therapy consisted of 5-FU (160 mg/m2/day every day by continuous infusion) and cisplatin (3 mg/m2/day in 100 ml of normal saline by infusion over 30 minutes on days 1-5/W). Patients were treated for 4 consecutive weeks with a subsequent one-week rest period. The overall response rate was 52.1%. Grade 3 toxicity was observed in 5% of patients. An advantage was that in the ambulatory and domiciliary cancer chemotherapy the hematotoxicity was slight, and LFP therapy could be continued safely. In addition, it was also possible to attempt the improvement in QOL with the forearm IVH reservoir system. LFP therapy using the forearm IVH reservoir system may develop as a standard method of ambulatory and domiciliary cancer chemotherapy in the future.

Adult↗
PubMed2000

[Vasodilator effects of bradykinin on the resistive circulation of the forearm of coronary patients].

This study was undertaken to determine the vascular effects of bradykinin and its modes of action on the resistive circulation of the forearms of coronary patients and healthy volunteers. Two groups were studied: Group I comprising 8 coronary patients with normal left ventricular function and Group II with 8 healthy volunteers. The method of measurement of forearm blood flow was occlusive venous plethysmography with a mercury strain gauge. The vasodilatory response of the two groups to local arterial perfusion of acetylcholine (40 and 80 micrograms/min), bradykinin (10, 30, 100 pmoles/min), then the association of L-Ng-monomethyl-L-arginine (L-NMMA) at 8 microG/min, an inhibitor of the synthesis of nitric oxide, with acetylcholine and bradykinin. Five subjects of the control group received oral aspirin (250 mg/day) for one week before the study. Acetylcholine and bradykinin increased forearm flow in a dose-dependent manner but the increase was significantly less in coronary patients than in the healthy volunteers (p < 0.05). The L-NMMA inhibited the vasodilatory response to acetylcholine by about 40% in the two groups but had no significant effect on the vasodilatation induced by bradykinin. Aspirin had no effect on the vasodilatation induced by acetylcholine or bradykinin. These data show that the vasodilatory response to bradykinin is decreased in coronary patients and suggest that nitric oxide is not the second main messenger of bradykinin in the resistive circulation of the forearm.

Acetylcholine↗
PubMed2001

The secondary hemodialysis vascular access created through the basilic vein transition on the forearm.

Hemodialysis vascular access related problems account for most hospitalizations in chronic hemodialysis patients. Having exhausted classic, primary radio-cephalic fistula on the forearm the secondary vascular access can be created. The secondary access was achieved through a subcutaneous displacement of the basilic vein and through surgical creation of end-to-end fistula between this venous and radial artery on the forearm. The subject of the study were eight patients undergoing chronic hemodialysis. In all patients the type of anastomosis and early and late complications were studied. The preferred route for exposure of the basilic vein was making the single incision along the forearm. Next, the basilic vein was transferred to the subcutaneous tunnel on the anterior side of the forearm. In four cases the classic end-to end anastomosis between the basilic vein and radial artery was performed. In other four patients, the telescopic method of fistula creation was done. In all eight cases the regular flow was observed. In postoperative period no complications were noted.

Anastomosis, Surgical↗
PubMed2002

Use of a simple forearm tourniquet as an adjunct to an intravenous regional block.

Intravenous regional anesthesia (IVRA) is a well-recognized technique for producing anesthesia during surgical procedures of the extremities. It has been suggested that the application of a tourniquet to the forearm may improve the quality of the block. The purpose of this investigation was to determine whether the application of a forearm tourniquet would accelerate onset time and improve the density and quality of an intravenous regional block. Twenty volunteer subjects were enrolled and randomly assigned in this crossover investigation. Control subjects received a standard IVRA technique; experimental subjects received IVRA technique with the application of a simple forearm tourniquet. Pain was elicited by means of an electrical stimulus, and assessments were performed using a 100-mm Visual Analogue Scale (VAS). Paired t tests were used to examine differences between groups on the variables studied. It was noted that the arm with the tourniquet had a shorter time for the onset of anesthesia (P = .0008) and had lower 10-minute VAS tolerance (P = .0469). This investigation suggests that the application of a simple forearm tourniquet as an adjunct to IVRA provides a more rapid onset of anesthesia than when no tourniquet is applied and may improve the density and quality of the block.

Adult↗
PubMed2002

[The repair of bulky tissue defect of forearm with skin flaps].

OBJECTIVE: To evaluate the repairing methods of bulky tissue defect of forearm with flaps. METHODS: Twenty-one burned patients with wounds in the forearm were enrolled in this study. The injury causes were high-voltage electricity, hot press or crush injury. After local debridement, the forearm defects were repaired with pedicled complex flaps, latissimus dorsi musculocutaneous island flaps or large thoraco-abdominal flaps immediately. RESULTS: All the flaps survived very well with satisfactory results except for 1 patient in whom local ischemic necrosis and sub-flap infection at the distal end of the flap occurred. CONCLUSION: Early debridement followed by skin flaps with pedicles or musculocutaneous flaps transfer could be simple, safe and reliable treatment strategies in the management of bulky tissue defects of the forearm due to burn, electric injury, or other devastating injuries.

Adolescent↗
PubMed2003

Forearm blood flow in pre-eclampsia.

UNLABELLED: OBJECTIVE 1. To characterise the forearm vascular reactivity of women with pre-eclampsia in the third trimester of pregnancy and compare it with that in normal or gestational hypertensive pregnancies. 2. To document female sex steroid (oestradiol, progesterone, oestriol and betahCG) levels in the three groups of women. DESIGN: Forearm blood flow was measured by venous occlusion plethysmography during intra-arterial infusion of saline and vasoactive substances: angiotensin II, sodium nitroprusside, acetylcholine and N(G)-monomethyl-L-arginine (L-NMMA). SETTING: Research laboratory at St George Hospital, Kogarah, Sydney, Australia. SAMPLE: Fifteen non-pregnant women in the follicular phase of the menstrual cycle, 15 third trimester normal pregnant women, 13 women in the third trimester with gestational hypertension and 15 women with pre-eclampsia. MAIN OUTCOME MEASURES: Changes in forearm blood flow in response to vasoactive substances. RESULTS: Normal pregnant women had higher baseline forearm blood flow than non-pregnant women, decreased vasodilator responses to sodium nitroprusside and reduced vasoconstrictor responses to angiotensin II. No difference in response to angiotensin II, sodium nitroprusside or L-NMMA was found among normal pregnant, pre-eclampsia or gestational hypertension women, but vasodilatory responses of pre-eclamptic women to acetylcholine were reduced compared with normal pregnant women. Higher serum progesterone levels were found in women with pre-eclampsia and gestational hypertension than in normal pregnancy. CONCLUSION: The hyperdynamic circulation of normal pregnancy is characterised by refractoriness to angiotensin II but this is not altered in pre-eclampsia. Pre-eclamptic women demonstrate a reduced vasodilator response to acetylcholine which, in the absence of any alteration in response to L-NMMA, implies that factors other than nitric oxide deficiency mediate the vasoconstriction of pre-eclampsia.

Acetylcholine↗
PubMedDate not supplied

Measurement of maximum voluntary pinch strength: effects of forearm position and outcome score.

The purpose of this study was to determine the effects of forearm position and outcome score on key, fingertip, and three-jaw chuck pinch strength. Maximum voluntary key, fingertip, and three-jaw chuck pinches were performed by 135 healthy adults (20-88 years old) three times in a pronated, supinated, and neutral forearm position with the right and left hand using a B&L (B&L Engineering, Tustin, CA) pinch gauge. The highest, first, and mean scores of three pinch forces were recorded. Three 3 x 3 factorial repeated-measures analyses tested each type of pinch strength. Forearm position affected key and fingertip pinches (p<0.017; effect sizes <0.14) but not three-jaw chuck pinch. The highest score ranked highest followed by the first and then the mean of the three scores (p<0.017; effect sizes >0.53). Although the effects of type of outcome score were consistent, the statistically significant effects of forearm position and outcome score may be too small (<1 lb) to be clinically relevant. Standardized positioning during pinch strength measurement is still recommended despite these findings.

Adult↗
PubMed1992

Comparison of the forearm and calf blood flow response to thermal stress during dynamic exercise.

To examine the hypothesis that the skin blood flow response to body heating is not uniform over the entire body surface, we compared forearm (FBF) and calf (CBF) blood flow responses to an increase in core temperature (esophageal temperature, Tes) during dynamic exercise. We studied 13 physically active men during semi-recumbent one leg exercise and/or intermittent supine cycle exercise at 35 degrees C. During 30 min of one leg exercise, Tes, FBF, and CBF in the nonactive leg increased from 36.94 +/- 0.09 degrees C, 5.7 +/- 1.2, and 5.6 +/- 0.6 ml.(min.100 ml)-1 at rest to 37.97 +/- 0.10 degrees C, 27.0 +/- 2.4, and 11.1 +/- 0.8 ml.(min.100 ml)-1, respectively. The increase in blood flow per unit increase in Tes was much less in the calf than in the forearm. The ratio of the peak to resting blood flow averaged 6.5 in the forearm and 2.5 in the calf. During 60 min of intermittent supine two leg exercise, Tes, FBF, and CBF increased from 36.96 +/- 0.06 degrees C, 7.9 +/- 1.5, and 5.6 +/- 0.7 ml.(min.100 ml)-1 at rest to 37.91 +/- 0.07 degrees C, 23.6 +/- 3.0, and 11.4 +/- 1.9 ml.(min.100 ml)-1, respectively. Skin blood flow (SkBF) in the forearm and calf was estimated by using a simple cylindrical model, assuming skin thickness and resting muscle blood flow to be 0.2 cm and 2 ml.(min.100 ml)-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

[Evaluation of SMBG values using various instruments and clinical significance of forearm SMBG measurement].

Whole blood or plasma glucose values were compared between those measured using various instruments for SMBG and automated analyses in samples (antecubital vein) from 20 approximately 70 years old obtained at cookie tests. A good correlation between values in whole blood SMBG and plasma automated analyses values greater than r = 0.94 was observed for instruments A, C, F, and H, and the per cent difference from the automated values was less than 5% for A, B, E and H. Per cent difference of SMBG values by I was -16% in whole blood and -9% in plasma, suggesting the possibility of measuring real values in whole blood. With plasma, a good correlation greater than r = 0.95 was noted for A, C, F and K, and the per cent difference less than 10% was noted for C, E, F and I. A relatively good correlation (r: 0.63 approximately 0.90) between forearm SMBG value and plasma automated values was noted with the % difference of the mean less than 11%. During cookie test, there is no significant difference between forearm SMBG values and antecubital plasma automated values. Values at finger tips are significantly greater by 5 approximately 20% over automated plasma values. In conclusion, whole blood values by most of the SMBG instruments are well correlated with plasma automated values, although some disagreement was noted. Values at forearm are not different from plasma val ues of antecubital vein, while at finger tip SMBG values showed higher levels. The measurement at forearm is therefore recommended, and in addition the pain is less.

Adult↗
PubMed2005

Pediatric fractures of the forearm.

Forearm fractures are common injuries in childhood. There are a number of important principles that should be followed to achieve the ideal goal of fracture healing without deformity or dysfunction. I will review the general principles, classifications, diagnosis, treatment, and complications of pediatric forearm fractures, including some specific injuries such as Monteggia fractures, Galeazzi injuries, and open fractures. The basic principle is to accurately align the fracture fragments and to maintain this position until the fracture is united. Forearm fractures in children can be treated differently from adult fractures because of continuing growth in both bones (radius and ulna) after the fracture has healed. As long as the physes are open, remodeling can occur. However, generally it is thought that rotational deformity does not remodel. Undisplaced fractures may be treated in a cast until the fracture site is no longer painful. Most displaced fractures of the forearm are best maintained in a long arm cast. However, redisplacement occurs in 7 to 13% of cases, usually within 2 weeks of injury. Unstable metaphyseal fractures should be percutaneously pinned. Unstable diaphyseal fractures can be stabilized by intramedullary fixation of the radius and ulna. If none of these techniques is helpful, plate and screw fixation is the best choice.

Adolescent↗
PubMed2006

Effects of dopamine infusion on forearm blood flow in critical patients.

BACKGROUND: In critical care, dopamine is administered by infusion at low doses ( or=5 microg/kg/min) for assessment of hemodynamics. The present study was conducted to explore the effects of dopamine infusion on the vast microvascular network of skeletal muscle in the early phases of sepsis. MATERIAL/METHODS: An observational study was performed which included twelve critically ill patients. Patients' response to dopamine infusion (3 microg/kg/min) was studied within 24 hours from admission to the ICU. The forearm blood flow (FBF) and vascular resistance (FVR) were measured by near-infrared spectroscopy (NIRS). RESULTS: Dopamine did not ameliorate forearm regional oxygenation. The infusion of dopamine caused an increase in MAP, while FBF decreased with the resistance increase (p>0.05). CONCLUSIONS: NIRS was suitable to measure bedside the vascular resistance and to test the effects of low doses of dopamine on forearm blood flow. A dopamine infusion of 3.0 microg/kg/min caused a reduction in forearm blood flow and an increase in vascular resistance in our patients.

Adult↗
PubMed1991

Carotid baroreceptor influence on forearm vascular resistance during low level lower body negative pressure.

The degree of forearm vasoconstriction induced by low levels of lower body negative pressure (LBNP) provides a measure of the responsiveness of the cardiopulmonary baroreflex. The validity of this measurement is based on the assumption that this vasoconstriction response is not influenced by unloading of carotid baroreceptors. To test the hypothesis that arterial baroreceptor unloading does not alter the degree of forearm vascular resistance during low levels of LBNP, we exposed 12 subjects to -15 and -20 mm Hg LBNP with and without additional artificial (+10 mm Hg neck pressure) unloading of the carotid baroreceptors. There was no measurable influence of carotid unloading on forearm vascular resistance at either level of LBNP. We conclude that forearm vascular resistance measured during cardiopulmonary baroreceptor unloading is unaffected by carotid baroreceptor unloading within the magnitude encountered during low levels of LBNP.

Adult↗
PubMed1989

[An anatomic study of the septofascial layer in the forearm].

In the anatomical investigation the authors dissected 20 fresh cadaveric forearms to study septofascial layers. It's vascularization was based on radial artery and concomitant veins. We perfused those flaps with methylene blue in the proximal part of radial artery. In 10 cases we found fine vascular network colored in blue. In the second group we isolated free septofascial tissue which was perfused with radiopaque contrast Hexabrix. Five flaps were perfused in the proximal part of vascular pedicle and five in the distal part. Afterwards the radiographs confirmed good vascular network, independent of flow direction. Fascia dimension in the proximal part of the forearm varied from 7-15 cm and in the distal part from 6-10 cm, depending on the forearm size. Fascia length varied from 21-27 cm. The authors found thicker and stronger fascia in the ulnar part of the forearm. The length of vascular pedicle was reversely proportional with the flap dimension. This anatomical investigation may find it's greatest application in plastic and reconstructive surgery.

Adolescent↗
PubMed1989

Forearm blood flow measurements using technetium-99m human serum albumin following brachial arteriotomy.

A simple, low cost method for measuring forearm blood flow during reactive hyperemia has been developed. Subjects are seated with hands and forearms over a large field-of-view gamma camera. Blood pressure cuffs inflated above the elbows isolate the blood in the forearms and hands and induce a hyperemic response. The remaining blood pool is labeled with technetium. The rate of increase of activity following release of the cuffs is measured from the gradient of time-activity curves and is calibrated for flow by counting a venous blood sample. The technique has been applied to a group of normal controls and to symptomatic and asymptomatic patients following right brachial arteriotomy. Forearm blood flow in normal subjects was 32.9 +/- 6.4 ml/100 ml/min and for subjects with occlusion of the brachial artery was 6.4 +/- 2.1 ml/100 ml/min. The method is simple, widely available, and reproducible. The good signal to noise ratio allows it to be used in cases of very low flow either as an aid to diagnosis or to measure treatment response.

Adult↗