In order to study the effect of hematocrit (lit) on the photoelectric plethysmograms of fingers and toes, an experimental model study and a clinical study were carried out. Ex perimentally, it was found that the height of the plethysmograms increased when the values of Ht were lowered. In the clinical study, 3 groups of patients with different Ht values ranging from 27 to 55% were examined. A reverse relationship was found between the Ht value and pulse height of the plethysmogram. The physical effects of the blood flow and contents upon the plethysmograms were discussed.
The collateral circulation of the limbs was investigated by injection of radioiodinated macroaggregated serum albumin (131I-MAA) into the brachial and femoral arteries of 31 patients with occlusive vascular diseases. The method was found useful as a subsidiary means in evaluating the peripheral circulation in these diseases. In 80% of cases of sympathectomy, arteriovenous shunts were increased by 25% of the control.Higher leakage of 131I-MAA of approximately 90% over the control was observed in a congenital arteriovenous fistula of the leg, which was confirmed by scintiscanning.Linear scanning along the body axis displayed accumulation of 131I-MAA in the lung of control and patients with vascular diseases, suggesting that 131I-MAA had passed through the arteriovenous shunts. Abnormally high radioactivity was observed occasionally at the toes and finger tips with chronic ulcers. collateral circulation; radioiodinated macroaggregated serum albumin; arteriovenous shunt In order to detect occlusions of arterial trees of the limbs without using arteriography in patients with peripheral arterial occlusive lesions, scanning of a suspected area of the extremities with a scintillation detector after injection of 1311 macroaggregated serum albumin (131I-MAA) into the main artery has been introduced into the diagnostic use. Occasionally, the site of occlusion of the main artery as demonstrated by arteriography is consistent with the findings by scintiscanning.1'2 However, the agreement is not always satisfactory. Jones et al.3 reported in 1965 that when 131I-MAA was injected into the femoral artery, normal and abnormal patterns of regional blood flow could be distinguished. Our study revealed that regional blood flow was greatly influenced by the collaterals, of which development depended on the site, extent and period of occlusion. In the present paper the anatomical and functional collateral blood flow in patients with occlusive diseases is described.
This report concerns with a one year and 3 months old female infant. She was thought to have seizure attacks and right hemiparesis due to kinking of the internal carotid artery which was found by carotid angiography. The left laternal angiogram showed a marked tortuous course of the internal carotid artery imediately above the carotid bifurcation. Pneumoencephalogram suggested severe degree of atrophy of the left cerebral hemisphere. An operation was performed to correct the buckling of this vessel by traction and fixation to straighten its course. Postoperative course was un eventful. Previous convulsions disappeared with improvement of the right hemiparesis.
The effect of laser irradiation to alleviate pain was studied by thermography. The following apparatus was used for laser irradiation: GaAlAs laser diode: wavelength 780 nm, power density 1.4 x 102 mj/sec/cm2, continuous wave (SKL-101 Seirin-Kasei Co., Shimizu, Japan); for thermographie studies: Thermotracer (NECSanei Co., Tokyo). One hundred twenty-four patients with pain were included in the study. Laser irradiation was performed for 120-300 seconds one to three times a week for an average of seven to eight times. The site of pain was studied before and after irradiation. Effective pain relief was obtained in 45 of 63 patients (71 %) in the group with laser irradiation (group A) and in 8 of 61 patients (13%) in the group without laser irradiation (group B). A statistical difference was found between groups A and B (x2 test = 42.4, p < 0.01). Thermography was carried out on 20 patients for a total of 92 times. In group A, 16 of 29 thermograms (55%) showed a rise of skin temperature after 1 minute and 8 of 18 (44%) after 5 minutes. Of 20 patients, 15 were measured successively 'Und for 5 minutes, of which 7 of 16 (43%) showed a continuous rise of skin temperature. Laser irradiation accelerated microcirculation, which may be due to direct action on the vasomotor nerve.
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