Ultrasound measurements of the maximal diameter can be obtained with a high degree of accuracy. Inexperienced sonographers may achieve acceptable performance given appropriate training and surveillance.

No abstract

Lower leg blood flow was measured at rest and both during and after graduated bicycle exercise in five healthy men and in seventeen patients suffering from various degrees of obliterating arteriosclerosis of the lower limbs. A thermodilution technique was used for flow determinations. The subject exercised in the sitting position and the work load was increased stepwise from a starting load of 100 kpm/min (100 kpm/min load increment every second minute until exhaustion). Three flow phases were depicted during and after the exercise: the aerobic phase, the phase of relative ischaemia and a postexercise phase. During exercise, lower leg blood flow increased approximately twenty times in healthy subjects, while in the arteriosclerotic subjects there was a two-fold to ten-fold increase in flow. In patients with serious distal and proximal stenoses a proximal steal phenomenon was demonstrated during submaximal and maximal exercise. A close correlation was found between maximum individual work load capacity and maximum lower leg blood flow (r = 0.71, P less than 0.001). In the patient group lower leg blood flow at a certain work load was 45% (P less than 0.001) higher in the sitting than in the supine position.

The central treatment-related measures were the same in the retrospective and prospective studies: global satisfaction with treatment (GS), perceived quality of contact with the nursing (QCN) and medical staff (QCM) and provision of adequate treatment information (INF). More of the variance in GS was explained in the prospective study (48.7% versus 36.3%). GS was most influenced by treatment-related factors with QCN as the strongest predictor in both studies. Only a small portion of the variance in QCN and QCM could be accounted for by the characteristics of the patients. INF was predicted by characteristics of the patients, their illness and life situation and by treatment-related factors. QCN was the strongest predictor of INF. The relationships with the nursing and medical personnel appear to be the major determinants of both patient treatment satisfaction and patients' reception of adequate information about their condition and its treatment.

Adenosine instead of hyperkalemia in cold crystalloid cardioplegia is safe, gives more rapid cardiac arrest, and affords similar cardioprotection and maintenance of hemodynamic parameters, together with a marked reduction in the incidence of postoperative atrial fibrillation.