Peripheral Vascular Circulation Research Articles

Breaking the fast: first report of dives and ingestion events in molting southern elephant seals

Southern elephant seals (SES) experience a ‘catastrophic molt’, a costly event characterized by the renewal of both hair and epidermis that requires high peripheral vascular circulation. Molting animals are therefore constrained by high metabolic heat loss and are thought to fast and remain on land. To examine the ability of individuals to balance the energetic constraints of molting on land we investigate the stomach temperature and movement patterns of molting female SES. We find that 79% of females swam and 61% ingested water or prey items, despite the cost of cold-water exposure while molting. This behavior was related to periods of warm and low wind conditions, and females that dived and ingested more often, lost less body mass. We conclude that the paradigm of fasting during the molt in this species, and the fitness consequences of this behavior should be reconsidered, especially in the context of a changing climate.

THE NON-INVASIVE ASSESSMENT OF PERIPHERAL MICROVASCULAR AND ENDOTHELIAL FUNCTION IN WOMEN WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

THE NON-INVASIVE ASSESSMENT OF PERIPHERAL MICROVASCULAR AND ENDOTHELIAL FUNCTION IN WOMEN WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

Acute Changes in Peripheral Vascular Tonus and Systemic Circulation during Static Stretching

This study aimed to investigate the acute effect of static stretching (SS) on peripheral vascular tonus and to clarify the effect of SS on systemic circulation. Twenty healthy young male volunteers performed a 1-min SS motion of the right triceps surae muscle, repeated five times. The peripheral vascular tonus (|d/a| ratio) was obtained using second derivatives of the photoplethysmogram readings before, during, and after SS. Heart rate and blood pressure (BP) were also measured. The |d/a| ratio and BP were transiently, but significantly, elevated during SS and returned to baseline immediately after SS. Furthermore, we observed a significant correlation between the amount of change in the |d/a| ratio and the ankle range of motion during SS (r = 0.793 to 0.832, P = 0.01). These responses may be caused by mechanical stress during SS.

Pharmaco-proteomics opportunities for individualizing neurovascular treatment

Neurovascular disease often involves multi-organ system injury. For example, patent foramen ovale (PFO) related ischemic strokes involve not just the brain, but also the heart, the lung, and the peripheral vascular circulation. For higher-risk but high-reward systemic therapy (e.g., thrombolytics, therapeutic hypothermia (TH), PFO closure) to be implemented safely, very careful patient selection and close monitoring of disease progression and therapeutic efficacy are imperative. For example, more than a decade after the approval of therapeutic hypothermic and intravenous thrombolysis treatments, they both remain extremely under-utilized, in part due to lack of clinical tools for patient selection or to follow therapeutic efficacy. Therefore, in understanding the complexity of the global effects of clinical neurovascular diseases and their therapies, a systemic approach may offer a unique perspective and provide tools with clinical utility. Clinical proteomic approaches may be promising to monitor systemic changes in complex multi-organ diseases – especially where the disease process can be ‘sampled’ in clinically accessible fluids such as blood, urine, and CSF. Here, we describe a ‘pharmaco-proteomic’ approach to three major challenges in translational neurovascular research directly at bedside – in order to better stratify risk, widen therapeutic windows, and explore novel targets to be validated at the bench – (i) thrombolytic treatment for ischemic stroke, (ii) therapeutic hypothermia for post-cardiac arrest syndrome, and (iii) treatment for PFO related paradoxical embolic stroke. In the future, this clinical proteomics approach may help to improve patient selection, ensure more precise clinical phenotyping for clinical trials, and individualize patient treatment.

Thermic effects of acupuncture on Taixi ( Kl 3) evaluated by means of infrared telethermography

ObjectiveTo observe the eventual thermic effects of stimulating Tàixī (▪ Kl 3) by telethermography. MethodsNine individuals of both sexes, chosen randomly, participated in this study. The temperature of the room where the experiment was carried out was not above 21 °C. At the start of the experiment the volunteer stayed for exactly ten minutes in the room for acclimatization, then the first thermographic image was recorded for standardization purposes. Following this, an acupuncture needle was inserted at Kl 3 only in the right leg, whose depth was limited to obtain Deqi, only manual stimulation for 15 min permanence in the site. After this period, new images were recorded. ResultsSignificant reduction of all the right leg temperatures, by about 1.1 °C in all the volunteers that received the acupuncture at the Kl 3 was noted, with a coefficient variation of P<0.0001 that was statistically highly significant, while on the other not stimulated leg the variation that occurred was around 0.7 °C, with no significant coefficient variation of P>0.05. ConclusionThe results of this study demonstrate that manual stimulation of the Kl 3 influences significantly peripheral vascular circulation, by means of sympathetic stimulation causing vasoconstriction.

Tibetan Medicine: An Effective Botanical Supplement for Peripheral Vascular Circulation

This review provides an instructive example of how a botanical and mineral formula known in the tradition of Tibetan medicine as Gabyr-Nirynga (camphor combination), denoted as formula No. 28, has evolved into a contemporary application through scientific research. This developmental pathway has led to a standardized nutraceutical with clinically proven efficacy in alleviation of a form of atherosclerosis-peripheral arterial disease (PAD). The systematic scientific research began in Switzerland in 1970s and resulted in five, double-blind clinical studies conducted in various European countries on cardiovascular use of the formula. The formula’s mechanism of action has been described in Tibetan tradition based on its three groups of botanical and mineral ingredients: (1) main active ingredients, (2) auxiliary ingredients, and (3) components that offset the action of the first two groups and facilitate gastrointestinal absorption of the formula. Based on preclinical and clinical studies, several mechanisms of action relevant to alleviation of the PAD have been discussed, such as an increase in the threshold for platelet aggregation, lower total blood cholesterol and low-density lipoproteins (LDL), and prevention of blood lipid peroxidation. A study in an animal model of CNS inflammation, i.e. Experimental Allergic Encephalomyelitis (EAE), has shown that No. 28 can exert action as a biological response modifier improving response of the organism to chronic inflammation. This latter mechanism may be particularly relevant to the clinical benefits with No. 28 in patients with PAD, in view of cardiovascular disease increasingly considered as an outcome of a chronic inflammatory process. The integration of traditional knowledge of a botanical formula with science-derived pharmacology is referred in this paper as the Interactive Nutrients process.

Use of Fraction Flow Reserve to Predict Changes over Time in Management of Superficial Femoral Artery

Peripheral arterial disease is a condition characterized by progressive arterial narrowing, which affects patients' quality of life. The purposes of this study were to (1) establish the feasibility of obtaining peripheral fractional flow reserve (pFFR) in the peripheral vascular circulation, (2) demonstrate an association between baseline pFFR and peak systolic velocity (PSV) measured by duplex ultrasound, and (3) correlate postintervention pFFR with future restenosis using the change in PSV over time as a surrogate. Twenty patients underwent baseline ankle brachial index (ABI) and PSV testing. Pre- and postintervention pFFR was performed. Patients were followed with three ABI and PSV recordings during the 1 year follow-up period. The association between baseline PSV, ABI, and pFFR with changes in PSV over time were explored. Predictors of postprocedural PSV over time were determined. The baseline translesional-resting ratio was significantly different from the pFFR using adenosine (0.79 ± 0.08 vs. 0.71 ± 0.09, P = 0.01). Baseline PSV was significantly associated with preintervention pFFR (-0.77, P < 0.001). Compared to patients with a postprocedure pFFR > 0.95, patients with a postprocedure pFFR < 0.95 had a significantly more rapid rise in PSV over time (P = 0.009). This is the first study to demonstrate that the peripheral vascular bed does respond to vasodilatation thereby supporting the use of pFFR for this procedure. In our study, postintervention pFFR < 0.95 predicted a more rapid increase in PSV over time, which is a reasonably accepted surrogate for restenosis.

Deep Femoral Artery Aneurysm: Report of a Case

Aneurysms involving the deep femoral artery, otherwise known as the profunda femoris artery (PFA), are extremely rare. Rarer still are bilateral PFA aneurysms (PFAAs). The diagnosis is difficult, but it may be suggested by the presence of a pulsatile tumor in the region of the femoral artery or by symptoms resulting from complications such as rupture or thromboembolism. A high index of suspicion is essential to diagnose them because they may present atypically. Surgery remains the treatment of choice and should be carried out electively for asymptomatic aneurysms. Surgery in an emergency situation can be challenging, especially when it involves vascular reconstruction as dictated by the peripheral vascular circulation.

Effects of Pulse-Synchronized Massage With Air Cuffs on Peripheral Blood Flow and Autonomic Nervous System

There are almost no reports on the physiological effects of the various electric massage devices available on the market. This report describes the effects on peripheral vascular circulation and autonomic-nervous system activity of a pulse-synchronized air-massage (PS-AM) device in which cuffs apply air pressure cyclically to the lower limbs only during the cardiac diastolic phase. The PS-AM device consists of a main unit with a pulse-wave detector that uses the pulse-wave to activate an air pump only during the cardiac diastolic phase. Pressure is applied sequentially from the feet to the thighs by 4 pairs of cuffs attached to the main unit. The study was carried out on 55 volunteers (19 males, 36 females). A laser Doppler flow-meter attached to the subjects' toes was used to measure blood flow (BF), while ECG, blood pressure and cardiac autonomic nerve activity [parasympathetic nerve activity (high-frequency component (HF))] were measured by a multibiomedical recorder (TM2425). The measurements were made for a total of 45 min consisting of three 15-min periods: before massage, during PS-AM, and after massage. BF increased 139+/-33 (SD) % in males and 154+/-44% in females during PS-AM, with a significant correlation being observed between BF and HF during PS-AM (p<0.01). PS-AM significantly increased peripheral vascular BF in the lower extremities, a change that may affect venous return and cardiac parasympathetic nerve activity.

Clinical efficacy, tolerability, and cost savings associated with the use of open-label metronidazole plus ceftriaxone once daily compared with ticarcillin/clavulanate every 6 hours as empiric treatment for diabetic lower-extremity infections in older males

Background: Patients with diabetes mellitus, particularly those with poor glucose control, commonly experience various medical complications related to the disease (eg, renal impairment, decreased peripheral vascular circulation, suppressed immune function). Infections of the lower extremities can range from superficial cellulitis to ulcerative, deep soft-tissue infections to osteomyelitis that necessitates some degree of amputation. Objective: This study compared the efficacy, tolerability, and cost differences associated with the use of metronidazole plus ceftriaxone (MTZ/CTX) given once daily with those of ticarcillin/clavulanate potassium (T/C) given every 6 hours in hospitalized older males with diabetic lower-extremity infections. Methods: This prospective, open-label study was conducted at a Veterans Affairs Medical Center. Male patients with diabetes and a lower-extremity infection were randomized to receive MTZ/CTX 1 g once daily or T/C 3.1 g every 6 hours. Treatment success was determined at 96 hours or on discontinuation of antibiotic. Success was measured in terms of body temperature <38.3°C (100.6°F), normalization of the finger-stick blood sugar concentration, improvement in wound staging, or a white blood cell count <10,000 cells/mm 3. Medication acquisition costs per treatment arm were calculated and compared. Results: Seventy patients were enrolled in the study (36 MTZ/CTX, 34 T/C). The study population had a mean (SD) age of 63.8 (10.8) years, a duration of diabetes of 12.4 (9.1) years, 0.5 (0.7) diabetes-related comorbidities, and an initial creatinine clearance of 67.1 (26.0) mL/min. There were no significant differences between groups at randomization. At 96 hours, treatment success was achieved in 31 (86%) patients in the MTZ/CTX group, compared with 28 (82%) patients in the T/C group ( P = NS). Twenty-six patients were considered successfully treated on the final day of therapy in both the MTZ/CTX group (72%) and the T/C group (76%) ( P = NS). There were no significant differences in primary or secondary measures of success between the 2 groups. No single or multiple baseline factors predicted treatment success or failure. No patient experienced adverse events considered related to study medication. MTZ/CTX was associated with savings of $61.06 per hospital admission, or $2198.05 for all patients who received this combination. Conclusion: In this population of older males, once-daily MTZ/CTX was as well tolerated and effective as T/C in the treatment of diabetic lower-extremity infections and was associated with reduced institutional costs.

Uptake and vascular transport of ingested aflatoxin

The uptake and vascular transport of abomasally instilled aflatoxin b 1 (AFB1) was investigated in sheep. Aflatoxin uptake was compared with that of palmitate, a water-insoluble oil known to be absorbed into the intestinal lymphatic drainage which bypasses the liver to enter the peripheral vascular circulation via the thoracic duct. After instillation into the abomasum, aflatoxin was detected in inferior vena cava blood within 30 min, while palmitate was hot detected in vena cava blood at any time. Palmitate was detected in thoracic duct lymph after about 2 h. More than 95% of the palmitate in lymph was associated with the chylomicron fraction, while aflatoxin in either plasma or lymph was not detectably associated with any of the circulating lipoproteins. In addition, aflatoxin did not partition into plasma or lymph lipoproteins in vitro. Toxic lipophilic xenobiotics, such as benzo(a)pyrene and polychlorinated biphenyls (PCBs) do partition into lipoproteins, are absorbed into the intestinal lymphatic drainage, bypassing the liver to enter the peripheral vascular circulation directly, and are not specifically hepatotoxic. These data suggest that the mode of aflatoxin absorption from the gastrointestinal system results in its immediate transport to the liver, which may contribute to aflatoxin hepatotoxicity.

Thermal biofeedback and the treatment of tinnitus.

Thermal biofeedback and general relaxation procedures were employed to treat 32 patients with subjective tinnitus. Each patient received eight 1-hour biofeedback sessions over an eight-week period, while listening to standard Jacobsonian type relaxation tapes. Sixty-five percent of the patients experienced a reduction of their symptoms. While none reported worsening of their symptoms, only two reported total symptom abatement. Findings suggest relaxation and peripheral vascular circulation are inversely related to the intensity of tinnitus symptoms. The probability that an individual will benefit from biofeedback appears related to his/her ego strength (Es). No differences were noted between the performance of male and female patients. Although not fail-safe, biofeedback and relaxation treatment are excellent management tools in the treatment of tinnitus.

The Effects of Piperidine and Its Related Substances on Blood Vessels

Piperidine is an endogenous active amine. Intravenous or intra-arterial administration of piperidine produced vasodilation in anesthetized dogs. The vasodilative effect of piperidine was inhibited by atropine (0.3 mg/kg, i.v.). In the hind limb perfusion experiment in anesthetized dogs, piperidine produced vasodilation, while it showed no vasorelaxing action in various isolated canine arterial strip preparations. These results suggest that the vasodilation caused by piperidine may be produced through activation of muscarinic receptors and that piperidine may act on smaller resistance blood vessels but not on large conductance vessels. In addition, pipecolic acid and N-methyl piperidine, the respective precursor amino acid and metabolite of piperidine, were almost inactive, but nipecotic acid was 1/4 to 1/10 times as active as piperidine as vasodilators. It is suggested that the non-substituted amine moiety of piperidine is very important for the manifestation of vasodilative activity and that piperidine might play a role in regulation of peripheral vascular circulation.

Use of intra-aortic balloon pumping (IABP) in clinical cardiac surgery and management of patients with IABP.

One hundred thirty eight patients were reviewed which required IABP assist. Sixty nine (84 per cent) of 82 patients who had been able to come off cardiopulmonary bypass despite increasing pharmacologic support survived operation and 56 patients (68 per cent) discharged hospital. Twenty three (75 per cent) of 31 patients who took for elective coronary artery surgery as extremely high risk because of extensive three vessel coronary artery disease and severely compromised left ventricular function discharged hospital. In summary, hospital death was 35 per cent, late death 12 per cent and long term survivors 54 per cent. Severe complication concerned with inserting balloon catheter occurred in two cases (1.4 per cent) which were abdominal aortic dissection and laceration of iliac artery. At the present time, the primary indication for IABP is in assistance of the open heart surgical patient. Thre are three important factors in successfully managing the patients with IABP. First, begin IABP assist as soon as possible if indicated. Second, keep an adequate circulating volume with mean left atrial pressure being maintained around 20 mmHg and cardiac index at 2.1 L/min./M or greater. Third, improve the peripheral vascular circulation, which might need peripheral vasodilator.

Extending the vascular examination by noninvasive means

The noninvasive testing of the peripheral vascular circulation has reached the stage of development where it is practical, efficient, and significantly extends the value of the clinical examination.

A new approach to the evaluation of peripheral vascular disease using the gamma camera.

HomeRadiologyVol. 112, No. 1 PreviousNext Nuclear MedicineA New Approach to the Evaluation of Peripheral Vascular Disease Using the Gamma CameraHenri A. Gerritsen, Ismail Kazem, Arie Hasman, Peter J. KuypersHenri A. Gerritsen, Ismail Kazem, Arie Hasman, Peter J. KuypersAuthor Affiliations Department of Radiodiagnosis Catholic UniversityNijmegen, The NetherlandsHenri A. GerritsenIsmail KazemArie HasmanPeter J. KuypersPublished Online:Jul 1 1974https://doi.org/10.1148/112.1.115MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractA simple tracer technique for the evaluation of peripheral vascular disease is described, consisting of an intravenous bolus of 8 mCi of 99mTc pertechnetate. The arrival and distribution of activity in both calf muscles during maximum reactive hyperemia are continuously recorded, and the typical pattern of the time-activity curve obtained in normal subjects is compared with that seen in occlusive disease. This technique is clinically useful (a) as an atraumatic screening test prior to arteriography for the detection of impaired peripheral vascular circulation, (b) for selection of patients suitable for vascular surgery, (c) for postoperative evaluation of corrective surgery, and (d) for follow-up of patients.Article HistoryRevision received: Jan 1974Published in print: July 1974 FiguresReferencesRelatedDetailsCited ByQuantitative assessment of therapeutic effects in the critically ischemic limb using 99mTc-diethylene-triamine-pentaacetic acid human serum albumin8 January 2009 | Surgery Today, Vol. 39, No. 1British Journal of Surgery, Vol. 65, No. 9British Journal of Surgery, Vol. 63, No. 11European Journal of Clinical Pharmacology, Vol. 34, No. 3The American Journal of Surgery, Vol. 132, No. 6Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 112, No. 1 Metrics Altmetric Score PDF download

Peripheral Vascular Circulation in Patients with Rheumatoid Arthritis Influence of Papaverine

Peripheral Vascular Circulation in Patients with Rheumatoid Arthritis Influence of Papaverine

Failure of lumbar sympathectomy in the relief of hyperhidrosis.

S TIMULATION or overactivity of sympathetic nerve fibers supplying the extremities produces vasoconstriction, pallor, coolness of the skin, and sweating. Interruption of sympathetic innervation causes the reverse, namely, vasodilation, a red, warm skin, and anhidrosis. Sympathectomies have been performed in the past mainly for the improvement of the peripheral vascular circulation in Raynaud's disease or obliterative arterial conditions, for the alleviation of arterial hypertension, and, less frequently, for the relief of pain in causalgia and for the elimination of excessive sweating. An apparently adequate sympathectomy may fail to relieve the symptoms for which it was performed, either immediately or after a prolonged interval. Reinnervation or regrowth of severed sympathetic nerve fibers has been postulated as the cause of failure in the second instance. However, another cause of failure is due to the presence of aberrant sympathetic ganglia which do not synapse in the sympathetic ganglionic chain and are therefore preserved following technically adequate sympathectomies.

Thermography of smoking.

Thermography brings skin temperature recording into the space age. Instead of “loading” the skin by using contact thermometers, such as thermocouples, and obtaining inaccurate temperature readings or a record of an isolated area, thermographs furnish thermal maps of large areas of skin surface without touching the subject. These maps, or thermograms, are made with various types of apparatus. In one thermograph, thousands of point-to-point temperature readings are detected by a sensitive thermistor bolometer in a two-to four-minute scan and registered on photographic film. In another device, a photoconductive sensor assembles the temperature readings rapidly into a pattern on a television screen. The image can be viewed in seconds and can also be photographed for later analysis. About six thermographs are on the market or are being developed. They offer pictorial representations of skin temperatures whose interpretation opens entirely new fields for the study of abnormalities of peripheral vascular circulation.

Changes of Peripheral Vascular Circulation in Young and Old Aged against Hot and Cold Stimulations

Changes of Peripheral Vascular Circulation in Young and Old Aged against Hot and Cold Stimulations