The use of photoplethysmography in the assessment of venous insufficiency: a comparison to venous pressure measurements.

In an attempt to develop a noninvasive test to assess objectively the magnitude of venous valvular dysfunction in pathologic states, photoplethysmography (PPG) was compared to venous pressure in the saphenous vein at the ankle. Simultaneous venous pressure and PPG recordings were taken before, during, and after exercise with subjects in the sitting position. In a total of 338 paired measurements in 24 normal, 25 postphlebitic, and 14 varicose limbs, PPG and venous pressure tracings appeared to be identical; data points had a correlation coefficient of great significance (r = 0.

Abdominal aortic salmonellosis.

A recent example of Salmonella mycotic abdominal aortic aneurysm is presented together with a review of the 24 other cases in the literature. Emphasis is placed on common modes of presentation, diagnosis, and surgical management. A review of current theories of etiology is presented along with a new, more descriptive classification of mycotic aneurysms.

Summary of cases of adventitial cystic disease of the popliteal artery.

Adventitial cystic disease of the popliteal artery is explored. The results of correspondence with authors reporting this condition are elaborated upon. This has provided an opportunity to discuss the history of the condition, the findings in 115 cases which have come to the attention of the Correspondence Office dealing with this entity, and the results of treatment.

Carotid endarterectomy: a follow-up study of the contralateral non-operated carotid artery.

In a study of 103 patients surviving carotid endarterectomy, follow-up information was obtained from all patients over a period of time extending to four years. This was done so that better decisions could be made regarding recommendations for contralateral carotid surgery. In this follow-up study, only three patients had contralateral surgery.

Rational approach to the differentiation of vascular and neurogenic claudication.

Lower extremity pain caused by exercise but relieved by rest is usually a reliable symptom of chronic arterial insufficiency. However, similar discomfort often occurs in patients with neurospinal compression. Furthermore, arterial occlusive disease and demonstrable spinal stenosis may be present simultaneously.

Hemodynamic and angiographic guidelines in selection of patients for femorofemoral bypass.

Although crossover femorofemoral grafts have had good long-term patency, all patients have not been symptomatically improved. Seventy-one patients underwent 80 femorofemoral bypasses from 1968 to 1978. Hemodynamic assessment included preoperative and postoperative segmental Doppler pressures and femoral artery waveform recordings.

The therapy of peripheral vascular ulcers--surgical management.

Venous ulcers are a common malady of the civilized world. The etiology and its pathogenesis has been presented for a better understanding of its appropriate therapy. A conservative and surgical approach is necessary for effective treatment, of which the final goal is to reduce ambulatory venous hypertension and the prevention of venous ulcer formation.

Vascular-laboratory diagnosis of clinically suspected acute deep-vein thrombosis.

Doppler ultrasound, impedance plethysmography, and contrast venography were performed in 207 lower limbs suspected of harbouring deep-venous thrombosis, to clarify the diagnostic value and limitations of the non-invasive methods. Doppler ultrasound and impedance plethysmography were accurate in 96% and 95% of normal limbs, respectively. In limbs with venographic evidence of thrombosis requiring treatment, Dopper ultrasound and impedance plethysmography correctly detected thrombosis in 60% and 97%, respectively.

Comparative nitrogen balance study between young and aged adults using three levels of protein intake from a combination wheat-soy-milk mixture.

The protein requirement and the efficiency of protein used were studied in young and old adult human subjects. Protein intake levels (N X 6.25) of 0.

A systematic approach to severe hand ischemia.

Because severely symptomatic hand ischemia is not common and because there are a wide variety of clinical conditions which can cause arterial insufficiency of the upper extremity, a retrospective study has been done to determine the efficacy of various diagnostic manipulations used in managing 65 patients with severe hand ischemia at the Northwestern University McGaw Medical Center, Traumatic, thermal, and iatrogenic causes of hand ischemia were diagnosed by simple history taking, as was advanced uremic arteritis. Doppler ultrasound and digital arterial pressure recording were confirmative, rather than diagnostic. These aided in defining precise degrees of ischemia and identifying proximal arterial occlusions.

Surgical treatment of nonocclusive mesenteric infarction.

Two cases of nonocclusive mesenteric vascular disease associated with stenosis of the superior mesenteric artery are described. In one patient with congestive heart failure and atrial fibrillation treated with digitalis, the first episode after a bout of sepsis was treated supportively, but a stricture of ileum secondary to full thickness intestinal infarction resulted. His second episode required emergency ileal resection for perforation.

Lymphatic disruption in varicose vein surgery.

In order to investigate the possibility of lymphatic disruption occurring during varicose vein surgery, lymphangiography performed by a modification of the Kinmonth technique was done in seven patients before and after standard surgical ablation of primary varicose veins. All seven patients demonstrated marked disruption of lymphatics. Extravasation of lymphangiogram contrast medium at the calf level and at the thigh level precluded demonstration of the groin lymphatics.

Improved dynamic and static imaging of abdominal aortic aneurysms.

The authors describe a technique for rapid, convenient in vivo labeling of circulating erythrocytes with 99mTc and the application of this technique to the evaluation of abdominal aortic aneurysms. Dynamic perfusion images and equilibrium blood pool images were obtained in 9 patients with documented aneurysm, and 7 of them indicated an aneurysm on the radionuclide study.

Pancreaticoduodenal arterial aneurysms.

Experience with four aneurysms of the pancreaticoduodenal artery is reviewed and compared to the reported experience of 19 other cases. In view of the common presentation of such lesions as intra-abdominal hemorrhage preceded by non-specific abdominal pain and other digestive symptoms, it is suggested that angiography perfomed preoperatively or intraoperatively allows definitive diagnosis and leads to specific therapy.

Cranial nerve injuring during carotid endarterectomy.

Injury to the greater auricular, hypoglossal and superior laryngeal nerves during carotid endarterectomy is preventable. A knowledge of regional anatomy and the mechanisms of such injury allows prevention of this complication. Unilateral individual nerve injury is generally well tolerated, but bilateral or combined nerve injuries can pose a serious threat to life.