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PubMed1996

Direct lymphatic drainage from the skin of the forearm to a supraclavicular node.

Lymphoscintigraphy with Tc-99m antimony sulfur colloid was performed on a patient with cutaneous melanoma of the left forearm to define the sentinel nodes before surgery. The patient was found to have direct lymphatic drainage from the left forearm through a clearly seen lymph channel to a sentinel lymph node in the left supraclavicular fossa, and drainage through a separate channel to two sentinel nodes in the left axilla. Surprising patterns of lymphatic drainage can be seen from the forearm, as well as other parts of the skin, and lymphoscintigraphy will enable such patients to be identified before sentinel node biopsy.

Axilla↗
PubMed1983

Effect of local infusion of ouabain on human forearm vascular resistance and on response to potassium, verapamil and sodium nitroprusside.

The effect of local infusion of ouabain into the forearm vascular bed has been examined in 15 normotensive male volunteers in an attempt to define the nature of the functional abnormalities of the resistance vessels in primary hypertension. Ouabain and other drugs were infused into the brachial artery and forearm blood flow was measured by venous occlusion plethysmography. Infusion of ouabain at 2 micrograms/min for 1 h caused a 26% reduction in forearm blood flow with a small rise in systemic arterial pressure; the increase in vascular resistance was unaffected by prior treatment with phentolamine. After infusion of ouabain the dilator response to potassium was reduced by 33% but the responses to verapamil and sodium nitroprusside were unchanged. The results show that acute depression of sodium pump activity by ouabain reproduces the increased resting resistance and impaired response to potassium that are seen in hypertension. It does not reproduce the relative enhancement of responsiveness to verapamil that is also observed in the resistance vessels of patients with hypertension and this abnormality must have some other cause.

Adult↗
PubMed2003

Ca2+-activated K+ channels mediate relaxation of forearm veins in chronic renal failure.

BACKGROUND: In arteries, agonists such as acetylcholine release an endothelium-derived hyperpolarizing factor (EDHF) that is neither nitric oxide nor prostacyclin. OBJECTIVES: To examine the responses to acetylcholine in segments of forearm veins from patients with chronic renal failure who either had never received dialysis or had undergone long-term dialysis, and to determine the contribution of nitric oxide and EDHF to endothelium-dependent relaxation in veins from patients with chronic renal failure. METHODS: Isometric tension was recorded in rings of forearm vein from 34 non-dialysed patients, 27 dialysed patients and 14 multiorgan donors (controls). RESULTS: Relaxation in response to acetylcholine was reduced in veins of non-dialysed and dialysed patients. The inhibitors of nitric oxide synthase NG-monomethyl-l-arginine (l-NMMA) and NG,NG-dimethyl-l-arginine (ADMA) reduced by 50% the maximum relaxation in response to acetylcholine in veins from controls and non-dialysed patients; the remaining relaxation was inhibited by 20 mmol/l KCl or by the K+ channel blockers tetraethylammonium chloride, iberiotoxin, charybdotoxin and the combination of barium plus ouabain, but not by apamin or glibenclamide. Relaxation in veins from dialysed patients was inhibited by K+ channel blockade but not by l-NMMA or ADMA. CONCLUSIONS: The results demonstrate that the endothelium-dependent relaxation in forearm veins from controls and non-dialysed patients is mediated by release of nitric oxide and EDHF. In contrast, the relaxation in veins from dialysed patients is mediated mainly by EDHF. EDHF-induced relaxation involves activation of large-conductance Ca2+-activated K+ channels.

Acetylcholine↗
PubMed1992

Nonadrenergic sympathetic vascular control of the human forearm in hypertension: possible involvement of neuropeptide Y.

Animal experimental evidence suggests that neuropeptide Y (NPY) is coreleased with norepinephrine (NE) from sympathetic nerve endings and is involved in nonadrenergic neurogenic vascular control of skeletal muscle. We wished to determine whether these findings may be extended to humans. Forearm blood flow (venous occlusion plethysmography) and the regional overflows of NE and NPY-like immunoreactivity (NPY-LI) were studied at rest and during sympathetic nerve activation by lower body negative pressure (LBNP; -10 mm Hg, 10 min) in 10 hypertensive men before and after local alpha-adrenergic blockade by a dose of phenoxybenzamine (60 micrograms x 100 ml-1 x min-1 for 60 min), which most markedly attenuated responses to exogenous NE; propranolol (10 micrograms x 100 ml-1 x min-1) was present throughout. Phenoxybenzamine increased forearm blood flow at rest (11.5 +/- 1.0 vs. 3.9 +/- 0.3 ml x 100 ml-1 x min-1; p less than 0.001). LBNP-evoked reduction of forearm blood flow (37 +/- 2%, p less than 0.001) was attenuated (p less than 0.001) but not abolished (18 +/- 2%, p less than 0.001) by phenoxybenzamine. LBNP increased the overflow of NE from 5.0 +/- 1.7 to 8.2 +/- 3.0 pmol x 100 ml-1 x min-1 (p less than 0.05) and that of NPY-LI from -9.0 +/- 4.4 to 8.0 +/- 4.9 fmol x 100 ml-1 x min-1 (p less than 0.05) after phenoxybenzamine; effects on the evoked overflows of NE and NPY-LI before phenoxybenzamine were slight. Prejunctional inhibitory alpha-adrenoceptors may thus modulate NPY release as well.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Alpha-adrenergic and serotonergic receptors and forearm venous compliance in normal human subjects.

The effect of alpha-adrenergic and serotonergic receptor agonists and antagonists on forearm venous capacitance and vascular resistance was studied in normal subjects. Venous volumes were significantly decreased by phenylephrine, an alpha 1-adrenoceptor agonist, and norepinephrine, which stimulates both alpha 1- and alpha 2-adrenoceptors, but not by the alpha 2-adrenoceptor agonist clonidine. Vascular resistance was increased significantly by all three agonists. Both the alpha 2-adrenoceptor antagonist yohimbine and the alpha 1-adrenoceptor antagonist prazosin attenuated the venoconstrictor and vasoconstrictor response to norepinephrine, indicating that both adrenoceptors are present. 5-Hydroxytryptamine significantly decreased venous volumes, while vascular resistance was not affected. Ketanserin, a 5-HT2 and alpha 1-adrenoceptor antagonist, attenuated the venous volume responses to 5-hydroxytryptamine and phenylephrine. It is concluded that there are alpha 1- and alpha 2-adrenoceptors and 5-HT2 receptors in the forearm venous system. However, vasoactive doses of clonidine are not venoconstricting. Forearm veins are sensitive to doses of 5-hydroxytryptamine, which do not change vascular resistance compared to alpha-adrenoceptor agonists, which affect both.

Adrenergic alpha-Agonists↗
PubMed1993

Serotonin-induced vasodilatation in the human forearm is mediated by the "nitric oxide-pathway": no evidence for involvement of the 5-HT3-receptor.

The "nitric oxide (NO)-pathway" is presumed to be involved in acetylcholine (ACh)- and serotonin (5-hydroxytryptamine, 5-HT)-mediated vasodilatation. In addition, both the 5-HT-induced transient and persistent vasodilator responses in the forearm vascular bed are abolished by the 5-HT3/5-HT4-receptor antagonist ICS 205-930 ([1H]-indol-3-carbonic-acid-tropine-ester HCl, tropisetron). We studied 5-HT-mediated vasodilatation in the forearm vascular bed of normotensive volunteers, using venous occlusion plethysmography. Intraarterial (i.a.) infusions of 5-HT, ACh, and sodium nitroprusside (SNP) all caused an increase in forearm blood flow (FBF). Single infusions of ondansetron and granisetron also caused an increase in FBF. Infusion of the NO scavenger and guanylate-cyclase antagonist methylene blue (MB) did not change FBF, whereas the arginine analogue NG-monomethyl-L-arginine (L-NMMA) caused a decrease in FBF, which became less pronounced when infusions were repeated. Unlike ICS 205-930, concomitant infusions of the selective 5-HT3-receptor antagonists ondansetron (OND) and granisetron (GRAN) did not antagonize the transient or persistent vasodilator responses to 5-HT. These findings suggest the involvement of a 5-HT4-receptor. L-NMMA and MB both reduced the persistent vasodilator response to 5-HT, indicating involvement of the NO pathway. Neither MB nor L-NMMA influenced the endothelium-independent vasodilator response to SNP. ACh-induced vasodilatation was markedly potentiated by MB but was not affected by L-NMMA. The mechanism by which MB enhances the vasodilator response to ACh remains unclear.

Adult↗
PubMed1993

Comparison of angiotensin-converting enzyme inhibition with angiotensin II receptor antagonism in the human forearm.

The object of this study was to differentiate losartan, an AT1-selective angiotensin II (ANG II) receptor antagonist, from enalapril, an angiotensin-converting enzyme (ACE) inhibitor, by measuring forearm vascular responses to AI, AII, and bradykinin. Eight healthy men were studied in a randomised, 4-period crossover study in which placebo, enalapril (10 mg), losartan (20 mg) and losartan (100 mg) were given double-blind on separate occasions. Forearm blood flow was measured by venous occlusion plethysmography during sequential infusions of ANG I, ANG II, and bradykinin into the brachial artery 4-6 h after dosing. Analysis of variance for repeated measures indicated that losartan inhibited constriction to ANG I and ANG II (both p < 0.02) in a dose-dependent manner without significantly influencing vasodilator responses to bradykinin. Enalapril (10 mg) inhibited AI similarly to losartan 100 mg without significantly influencing responses to angiotensin II, and augmented vasodilator responses to bradykinin (p < 0.0001). In human forearm vasculature, oral losartan (20-100 mg) inhibits vasoconstriction to ANG I and ANG II without significantly influencing bradykinin-induced vasodilation, whereas enalapril selectively inhibits ANG I-induced vasoconstriction while potentiating the vasodilator effect of bradykinin.

Adult↗
PubMed1993

NG-monomethyl-L-ARG reduces the forearm vasodilator response to acetylcholine but not to methacholine in humans.

We compared the contribution of nitric oxide (NO) in methacholine (MCh)- and acetylcholine (ACh)-induced vasodilation using the NO-synthase inhibitor NG-monomethyl-L-arginine acetate (L-NMMA-acetate) in two groups (A and B) of 6 healthy male volunteers. The left brachial artery was cannulated for drug infusion and recording of mean arterial pressure (MAP). Forearm blood flow (FBF) was measured on both sides by venous occlusion mercury-in-silastic strain-gauge plethysmography. All measurements were performed with occluded hand circulation. Forearm vasodilator response to three increasing dosages of MCh (0.03, 0.3, and 1 micrograms/100 ml forearm/min; group A) or ACh (0.5, 2, and 8 micrograms/100 ml forearm/min; group B) was studied first. Forty-five minutes later, these infusions were repeated (after and during local administration of L-NMMA). L-NMMA-acetate infusion alone increased basal forearm vascular resistance (FVR, mean +/- SE) by 86.2 +/- 14.5 and 99.5 +/- 27.4% in groups A and B, respectively (p < 0.05) without significant FVR changes in the control arm. MCh-induced vasodilation was not attenuated by concomitant L-NMMA-acetate infusion. In contrast, L-NMMA-acetate significantly reduced the averaged percentage decrease in FVR during infusion of ACh from 55.7 +/- 9.1 to 35.4 +/- 11.8% (p < 0.05). L-NMMA-acetate increased basal vascular tone and reduced the vasodilator response to ACh. MCh induced vasodilation to a degree similar to that obtained with ACh. Nevertheless, MCh-induced vasodilation could not be attenuated by L-NMMA, suggesting that NO contributes differentially to methacholine- and ACh-induced vasodilation in humans.

Acetylcholine↗
PubMed1999

Improvement of bradykinin endothelium-mediated vasodilation of forearm resistance circulation by quinaprilat in patients with coronary artery disease with or without left ventricular dysfunction.

Angiotensin-converting enzyme (ACE) inhibition potentiates bradykinin and acetylcholine endothelium-mediated vasodilation. Three groups were studied. Group I (n = 10) was the reference group; group II was composed of nine patients with coronary artery disease; and group III of seven patients with coronary artery disease and left ventricular dysfunction. Forearm blood flow was measured with plethysmography. Acetylcholine and bradykinin were administered in a random order in the brachial artery at infusion rates of 40 and 80 microg/min and 10, 30, 100 pmol/min, respectively. Then quinaprilat was infused alone at the rate of 50 microg/min and then coinfused with acetylcholine and bradykinin. Five of the reference subjects were pretreated with acetylsalicylate. Acetylcholine and bradykinin increased forearm blood flow in a dose-dependent manner in the three groups. However, the vasodilator responses to both agents were significantly lower in the two groups of patients than in the reference group. Quinaprilat significantly enhanced the vasodilator response to acetylcholine only in subjects of the reference group, whereas it enhanced the vasodilator response to each dose of bradykinin, both in subjects of the reference group and in patients. Pretreatment with aspirin did not change the vasodilator responses in any group. In healthy persons, quinaprilat had no effect on its own on forearm blood flow but enhanced the response to bradykinin and even acetylcholine. In patients with coronary disease, short-term administration of quinaprilat was able to improve the impaired response to bradykinin. The response to acetylcholine, however, could not be significantly enhanced in contrast to that in healthy subjects.

Acetylcholine↗
PubMed2000

No evidence for functional involvement of 5-HT2B receptors in serotonin-induced vasodilatation in the human forearm.

The receptor involved in the serotonin (5-hydroxytryptamine [5-HT])-induced vasodilatation in the human forearm has not yet been identified. Experimental data point to the 5-HT2B receptor located on the endothelium. RS-127445 (2-amino-4-(4-fluoronaphthyl-1-yl)-6-isopropylpyrimidine) is a novel potent and selective 5-HT2B receptor antagonist. The effect of oral RS-127445 (500 mg) on 5-HT-induced vasodilatation was studied in a double-blind, randomized, placebo-controlled, crossover study in six healthy volunteers. On each study day 5-HT (0.5 ng/kg/min) was infused into the brachial artery for 8 min, before drug administration and at intervals of 20, 65, 110, 230, and 470 min after oral ingestion. At each infusion, plasma samples for study drug assay were taken and forearm blood flow was assessed using venous occlusion plethysmography. Although (log) drug concentrations exceeded pKi, there was no correlation between RS-127445 concentrations and 5-HT-induced vasodilatation. 5-HT-induced vasodilatation did not differ between treatments and time points. It appears that there is no functional involvement of 5-HT2B receptors in 5-HT-mediated vasodilatation in the human forearm.

Adult↗
PubMed2002

Tetrahydrobiopterin improves impaired endothelium-dependent forearm vasodilation in patients with heart failure.

Endothelium-dependent vasodilation is impaired in patients with chronic heart failure (CHF). However, the mechanisms responsible for this effect are not fully understood. The vasodilator response to acetylcholine (ACh) has been used to examine the endothelium-dependent vasodilation in humans and is known to be mediated by nitric oxide (NO). The impaired production of NO or an increase in its degradation is thought to be responsible for the endothelial dysfunction in CHF. The aim of this study was to determine whether the decrease in availability of tetrahydrobiopterin (BH(4)), an essential cofactor of NO synthase, contributes to the impairment of endothelium-dependent vasodilation in patients with CHF. Fourteen patients with CHF (New York Heart Association functional class II-IV, age: 59 +/- 4 years, ejection fraction: 28 +/- 3%) and seven age-matched control subjects were examined. Forearm blood flow (FBF) was measured by plethysmography during an intra-arterial infusion of a graded dose of ACh (4, 8, and 16 microg/min) and sodium nitroprusside (SNP) (0.8, 1.6, and 3.2 microg/min). These procedures were repeated during a co-infusion of BH(4) (400 microg/min). The forearm vasodilator response to ACh was significantly enhanced during co-infusion of BH(4) in patients with CHF, whereas no effect was observed in healthy subjects. In contrast, the response to SNP was not affected by BH(4) in either group. The administration of BH(4) did not alter the baseline FBF in either group. These results suggest that an acute administration of BH(4 ) improves endothelium-dependent forearm vasodilation in patients with CHF.

Acetylcholine↗
PubMed1989

Experience with the island radial forearm flap in local hand coverage.

Use of the island radial forearm flap (RFF) for soft-tissue coverage of hand and forearm following mutilating injuries, chemotherapeutic injection sloughs, and tumor excisions are discussed. Twenty-eight flaps were used in 28 injured upper extremities. Partial flap loss occurred in three patients. Minor sloughing of the skin graft of the donor site occurred in four. Twelve patients had persistent dysesthesias and paresthesias in the injured extremity. All patients complained of some degree of weakness in the injured extremity. Our experience supports the use of this flap for local hand and forearm coverage when local tissue is unavailable and skin grafting is deemed inadvisable. Donor site problems have been acceptable in our patient population.

Adolescent↗
PubMed2000

Pursestring closure of radial forearm fasciocutaneous donor sites.

BACKGROUND: The radial forearm fasciocutaneous free flap has become one of the most common methods of reconstructing defects after head and neck ablative surgery. The fasciocutaneous flap is an excellent replacement for the tissue that has been removed. Unfortunately, donor site morbidity remains a problem. Donor site morbidity is primarily related to poor skin graft take, cosmesis, and neural dysfunction. Decreasing the size of the donor site defect may allow for improved cosmesis with decreased morbidity. MATERIAL AND METHODS: Prospective evaluation of a pursestring closure of radial forearm fasciocutaneous donor sites over a 16-month period. RESULTS: Seventy-one radial forearm free flaps were used. Sixty-seven had a pursestring closure of the donor site. After flap elevation the mean size of the defect was 61 cm2 (range, 28-140 cm2). Pursestring closure decreased the mean of the defect to 34 cm2 (range, 10-104 cm2) (P <.0001). Defect size was decreased by a mean of 44.5% (range, 24.5%-66.7%) (P <.0001). COMPLICATIONS: The rate of skin graft loss (>25%) (9% of patients) was less than that reported in the literature. No patient required a second surgical procedure. Neural morbidity was equal in both groups. Cosmesis was much improved. CONCLUSIONS: Pursestring closure allowed for a significantly decreased donor defect, associated with better cosmesis and less skin graft loss.

Forearm↗
PubMed2001

A prospective comparison of scalpel versus bipolar scissors in the elevation of radial forearm fasciocutaneous free flaps.

OBJECTIVES/HYPOTHESIS: The radial forearm fasciocutaneous free flap has become the workhorse for reconstruction of head and neck ablative defects. A location distal to the head and neck allows this flap to be elevated concurrent with the ablation. Most commonly, the flap is elevated under tourniquet control. This involves a primary ischemic insult with a certain amount of hemorrhage after the tourniquet is released. Bipolar scissors are a new method of dissection. They may allow for a speedier dissection with a concomitant decrease in ischemic time. Their hemostatic properties may control hemorrhage after use of the tourniquet. STUDY DESIGN: A prospective study of patients undergoing radial forearm free flaps over a 12-month period at a tertiary care referral center was undertaken. RESULTS: Forty patients were entered into the study, flaps were elevated with scalpel (20) and with bipolar scissors (20). Mean time under tourniquet was 39 minutes (range, 30-56 min) with scalpel compared with 27 minutes (range, 21-31 min) with bipolar scissors (P <.001). Total mean time of elevation (including control of hemostasis and pedicle dissection) for scalpel elevation was 50 minutes (range, 35-61 min) compared with 32 minutes (range, 20-41 min) for bipolar scissors elevation (P <.001). Mean blood loss was 46 mL (range, 15-110 mL) in the scalpel elevation group compared with 14 mL (range, 0-50 mL) in the bipolar scissors elevation group (P <.001). Complications at the donor site were equal between groups. CONCLUSIONS: Bipolar scissors are a safe, efficient method for elevating radial forearm free flaps.

Dissection↗
PubMed2001

Radial forearm free flap pharyngoesophageal reconstruction.

OBJECTIVES: This study evaluates the outcome of pharyngoesophageal reconstruction using radial forearm free flaps with regard to primary wound healing, speech, and swallowing in patients requiring laryngopharyngectomy. STUDY DESIGN: Retrospective review in the setting of a tertiary, referral, and academic center. PATIENTS AND METHODS: Twenty patients underwent reconstruction of the pharyngoesophageal segment using fasciocutaneous radial forearm free flaps. RESULTS: All free flap transfers were successful. An oral diet was resumed in 85% of the patients after surgery. Postoperative pharyngocutaneous fistulas occurred in 4 patients (20%) with 3 resolving spontaneously. Distal strictures also occurred in 20% of the patients. Five patients who underwent tracheoesophageal puncture achieved useful speech. CONCLUSIONS: Advantages of radial forearm free flaps for microvascular pharyngoesophageal function include high flap reliability, limited donor site morbidity, larger vascular pedicle caliber, and the ability to achieve good quality tracheoesophageal speech. The swallowing outcome is similar to that achieved after jejunal flap pharyngoesophageal reconstruction. The main disadvantage of this technique relates to a moderately high incidence of pharyngocutaneous fistulas, which contributes to delayed oral intake in affected patients.

Carcinoma, Squamous Cell↗
PubMed2002

Use of AlloDerm for coverage of radial forearm free flap donor site.

OBJECTIVES: To evaluate and discuss the role of acellular human dermal matrix (AlloDerm, LifeCell Corp., Branchburg, NJ) graft for coverage of radial forearm free flap donor site. STUDY DESIGN: Prospective, nonrandomized study. METHODS: Fifty-two consecutive patients underwent harvest of 52 radial forearm fasciocutaneous free flaps. All 52 donor sites were covered by AlloDerm graft. Split-thickness skin graft was not used to reinforce the acellular dermal graft in the series. Clinical phases of healing, duration of healing, and donor site complications were studied. RESULTS: No donor site complications except seroma formation in five patients was noted. This was treated by conservative measures. Full range of hand motion was allowed in 3 days. Complete healing occurred within 8 to 12 weeks. Scar contracture after complete healing was minimum in all patients. Range of motion of the hand and fingers during flexion, extension, supination, and pronation was identical on the operated and nonoperated sides. CONCLUSION: AlloDerm graft is a viable alternative to split-thickness skin graft for coverage of the radial forearm free flap donor site.

Adult↗
PubMed2003

Functional outcomes after primary oropharyngeal cancer resection and reconstruction with the radial forearm free flap.

OBJECTIVE: To report prospectively collected aeromechanical, acoustical, and perceptual speech outcomes, as well as preliminary swallowing data, in patients having reconstruction with radial forearm free flaps after primary resection for oropharyngeal cancer. STUDY DESIGN: Prospective cohort study. METHODS: Acoustical, aeromechanical, and perceptual speech data and swallowing data were gathered at three evaluation times (preoperatively and before and after radiation therapy) for patients treated for oropharyngeal cancer by means of primary resection and reconstruction with a radial forearm free flap. Degree of involvement of the soft palate and base of tongue, along with reconstructive techniques, were entered as between-group factors in the analysis. RESULTS: There were no significant differences in speech intelligibility between the patient groups based on the degree of palate and tongue resected. However, patients with resections of half or more than half of the soft palate had significantly higher nasalance values and larger velopharyngeal orifice areas than individuals who had less than half of the soft palate resected. Significant within-subject differences were revealed across evaluation times for the dependent variables nasalance, velopharyngeal orifice area, and word intelligibility. Ninety-four percent of the patients were able to resume a normal or soft diet. There was a 6% incidence of aspiration in 128 swallows that were analyzed. The amount of base of tongue resected did not significantly affect any of the speech or swallowing parameters. CONCLUSIONS: Radial forearm free flaps are a good reconstructive option after oropharyngeal cancer extirpation. Our acoustic and aeromechanical results indicated that issues related to quality of the speech signal require further study for resections of half or more than half of the soft palate.

Adult↗
PubMed1997

Temporal inhomogeneity in brachial artery blood flow during forearm exercise.

The purpose of this study was to measure the influences of muscle contraction and exercise intensity on brachial artery blood flow during incremental forearm wrist flexion exercise to fatigue. Twelve subjects performed incremental forearm exercise (increments of 0.1 W every 5 min) with their nondominant arms. Doppler waveforms and two-dimensional images of the brachial artery were recorded during the last 2 min of each stage. Exercise intensities were expressed as a percent of the maximal workload achieved (%WLmax). Blood flow was calculated during each of the concentric (CP), eccentric (EP), and recovery phases (RP) of the contraction cycle. Blood flow during the CP of the contraction did not increase above resting values (25.0 +/- 10.5 mL.min-1) at any intensity (100%WLmax = 21.6 +/- 6.5 mL.min-1). Conversely, blood flow during the EP and RP increased from 25.6 +/- 3.0 to 169.1 +/- 12.8 (P < 0.05), and from 24.7 +/- 3.1 to 137.9 +/- 19.5 mL.min-1 (P < 0.05), respectively from rest to maximal exercise. Time averaged blood flow increased linearly from rest to maximal exercise (75.3 +/- 26.3 to 334.6 +/- 141.6 mL.min-1, P < 0.05). Thus, a significant impairment in blood flow occurs with concentric contractions during forearm dynamic exercise. The implications of a temporal disparity in blood flow to oxygen delivery and skeletal metabolism during exercise are discussed.

Adult↗