Narrow Results

Pulse wave velocity (PWV), based on two-site measurement, is a well-known predictor of arterial stiffness. Interest focused increasingly on simplifying the PWV measurement results in attempts at determining it at a single site. We aimed to validate a new tonometric method (IIM-2010A) for assessment of PWV at radial artery in healthy subjects <65 years of age. PWV measurements were performed in 46 healthy adults (25 men and 21 women) aged 21–65 years (39.6 ± 15.5 years) using Complior device and IIM-2010A respectively. In a subgroup of 21 humans, the measurements were repeated after 1 week using IIM-2010A with the same protocol. There was a strong correlation between PWV obtained by IIM-2010A and PWV obtained by Complior, as well as between pulse transit time (PTT) measurements (r = 0.79 and r = 0.85, respectively, P < 0.01 for both). Although PTT was significantly lower measured by IIM-2010A, no significant difference was found in PWV. The mean difference of PWV with SD was -0.1 ± 1.2 m/s between two repeated measurements at intervals of 1 week. Bland–Altman's plot indicated no trend for the reproducibility of measurements to vary with their underlying mean value. Intraclass correlation coefficient (= 0.87) confirmed this excellent week-to-week reproducibility of PWV. The method provides a simple, easily-obtainable, and reproducible measurement of PWV in young and middle-aged subjects, and has potential to detect premature arterial aging for the management of primary prevention.

Aortic subendocardial viability ratio (SEVR), an index of myocardial oxygen demand relative to supply, has been used for the early detection of hemodynamic changes. We aimed to validate a new method for determining SEVR directly from radial pressures. Hemodynamic parameters were measured in 231 outpatients (108 males and 123 females) for physical examination, aged from 20–77 years (45.9 ± 17.3 years), including 210 healthy and 21 hypertensive subjects. Aortic SEVR was obtained using a validated device (SphygmoCor; AtCor Medical, Sydney, Australia), and radial SEVR was obtained using a portable vascular testing device (IIM-2010A; Institute and Intelligent of Machines, Hefei, China). Radial SEVR was strongly related to aortic SEVR (r = 0.824, p < 0.01), with approximately 15.7% lower value. Aortic and radial SEVR had similar independent predictors, including diastolic time fraction (DTF), systolic blood pressure, diastolic blood pressure, age, and height. DTF exerted the most influence on both of them. In healthy subjects, there were significant changes in aortic and radial SEVR between age groups in both males and females (p < 0.05 for both). Changes in aortic and radial SEVR with aging were parallel though the differences between them increased. These results suggested that the simple and easily obtainable radial SEVR could provide equivalent information to aortic SEVR, and has potential for the primary prevention of cardiovascular disease in health screening.

In this article, we report two cases in which recurrent adhesive hand neuropathy with allodynia were successfully treated with radial and ulnar artery adipofascial perforator flap coverage. Treatment of recurrent neuropathy, such as recurrent carpal tunnel syndrome and re-adhesion after neurolysis using free and pedicle flaps to cover the nerves, has been reported to show good results. However, for severe painful nerve disorders, such as complex regional pain syndrome, the efficacy of this treatment was unclear. We present two cases diagnosed with recurrent adhesive hand neuropathy with allodynia, resulting from wrist cutting; these cases were treated with neurolysis and flap coverage with good results and no recurrence. This suggests that neurolysis and flap coverage are effective methods for treating complex regional pain syndrome.

Upper extremity adventitial cystic disease is rare, but the characteristic findings of this lesion should be known to the hand surgeon and used to guide treatment. We present a case of a young adult male who developed a painless mass in his distal forearm. Diagnostic imaging workup revealed a cystic mass that extended within and encased the radial artery. Both MRI and direct intraoperative visualization confirmed the presence of a stalk connecting the intra-mural radial artery mass to the radiocarpal joint. The mass and stalk were excised en bloc with fenestration of the volar capsule to prevent recurrence. This case demonstrates a less common example of upper extremity adventitial cystic disease and supports the articular theory of origin of these lesions. When surgical excision is performed, an attempt should be made to identify and excise the articular stalk in an effort to minimize risk of recurrence.

Traditional arterial tonometry permits noninvasive and continuous recording of the arterial pressure waveform, by applanating a superficial artery supported by a bone. In the paper, we present an arterial tonometer to simultaneously register the blood pressure waveform and the arterial time-varying volume. The tonometer consisted mainly of a chamber filled with a conductive fluid, a flexible diphragm in touch with an artery, and a pressure sensor used to detect the underlying arterial pressure. In addition, four electrodes were in parallel diposed in the chamber, two of them were triggered with a constant-current source, and the voltage difference between the other two inner electrodes was assocated with the amount of change in the arterial volume. The pressure calibration curve performed with a mercury sphygmomanometer showed a fairly linear relationship (r = 0.998) between the tonometer's chamber pressure and the voltage output of the pressure-sensing circuit. The volume calibration was carried out with vessel-like cylinders of various diameters and a linear relationship (r = 0.884) of the change in vessel volume to the voltage output of the volume-sensing circuit was obtained. Clinical testing results revealed that the noninvasive blood pressure measurement with the tonometer was appreciably consistent with the invasive measurement with the catheter-tipped pressure transducer. In summary, the arterial applanation tonometer developed may be used to reliably determine the full arterial blood pressure waveform and the change in the arterial volume, and to make the wall compliance assessment of a superficial artery possible.