Pulse Examination by an Ultrasonic Method

Yao, See Tao; Hobbs, J. T.; Irvine, W. T.

doi:10.1136/bmj.4.5630.555

Cited by 44 publications

(14 citation statements)

References 5 publications

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“…Venous disease was considered present when the refilling time was less than 25 seconds as previously established for this laboratory 25 . Arterial disease was determined by measuring the arterial Doppler pressures and was defined as an ankle/brachial ratio less than 0.9 26 . Blood tests were also carried out to complete the diagnosis, these included a full blood panel, urea and electrolytes, liver function tests, blood sugar levels and rheumatoid serology.…”

Section: Methodsmentioning

confidence: 99%

Analysis of the acute and chronic wound environments: the role of proteases and their inhibitors

Trengove

Stacey

Macauley

et al. 1999

Wound Repair Regeneration

788

631

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To assess the differences in proteolytic activity of acute and chronic wound environments, wound fluids were collected from acute surgical wounds (22 samples) and chronic wounds (25 samples) of various etiologies, including mixed vessel disease ulcers, decubiti and diabetic foot ulcers. Matrix metalloproteinase (MMP) activity measured using the Azocoll assay was significantly elevated by 30 fold in chronic wounds (median 22.8 microg MMP Eq/ml) compared to acute wounds (median 0.76 microg MMP Eq/ml) (p < 0.001). The addition of the matrix metalloproteinase inhibitor Illomostat decreased the matrix metalloproteinase activity by approximately 90% in all samples, confirming that the majority of the activity measured was due to matrix metalloproteinases. Gelatin zymograms indicated predominantly elevated matrix metalloproteinase-9 with smaller elevations of matrix metalloproteinase-2. In addition tissue inhibitor of metalloproteinase-1 levels were analyzed in a small subset of acute and chronic wounds. When tissue inhibitor of metalloproteinase-1 levels were compared to protease levels there was an inverse correlation (p = 0.02, r = - 0.78). In vitro degradation of epidermal growth factor was measured by addition of 125I labelled epidermal growth factor to acute and chronic wound fluid samples. There was significantly higher degradation of epidermal growth factor in chronic wound fluid samples (mean 28.1%) compared to acute samples (mean 0.6%). This also correlated to the epidermal growth factor activity of these wound fluid samples (p < 0. 001, r = 0.64). Additionally, the levels of proteases were assayed in wound fluid collected from 15 venous leg ulcers during a nonhealing and healing phase using a unique model of chronic wound healing in humans. Patients with nonhealing venous leg ulcers were admitted to the hospital for bed rest and wound fluid samples were collected on admission (nonhealing phase) and after 2 weeks (healing phase) when the ulcers had begun to heal as evidenced by a reduction in size (median 12%). These data showed that the elevated levels of matrix metalloproteinase activity decreased significantly as healing occurs in chronic leg ulcers (p < 0.01). This parallels the processes observed in normally healing acute wounds. This data also supports the case for the addition of protease inhibitors in chronic wounds in conjunction with any treatments using growth factors.

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Section: Methodsmentioning

confidence: 99%

Analysis of the acute and chronic wound environments: the role of proteases and their inhibitors

Trengove

Stacey

Macauley

et al. 1999

Wound Repair Regeneration

788

631

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“…Several studies have shown good correlations between arteriography and Doppler blood pressure or waveform examination (17,18). Several studies have shown good correlations between arteriography and Doppler blood pressure or waveform examination (17,18).…”

Section: Discussionmentioning

confidence: 98%

The association of peripheral arterial disease with hostility in a young, healthy veteran population.

Joesoef

Wetterhall²,

DeStefano³

et al. 1989

Psychosomatic Medicine

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The association of peripheral arterial disease (PAD) with hostility, a component of Type A behavior, has not been investigated. Previous studies have found an association between coronary arterial disease and hostility. We used Doppler tests to define PAD as consisting of a resting index less than 0.9, absence of posterior tibial waveform, or presence of a femoral bruit. Among 4,462 male veterans, the prevalence and odds ratio of PAD increased statistically significantly with an increase in the Cook-Medley hostility scale. The prevalence of PAD was 0.7%, 1.1%, 1.4%, and 1.6% in the first, second, third, and fourth quartiles of the hostility scale, respectively. Using the first quartile as a reference group, we found that odds ratios of PAD were 1.6, 1.9, and 2.2 for the second, third, and fourth quartiles, respectively. Odds ratios, adjusted for age, race, cigarette smoking, hypertension, familial ischemic heart disease, diabetes, and elevated LDL/HDL were 1.4, 1.6, and 1.8, respectively. The magnitude of the odds ratios and their statistically significant trend suggest an association between PAD and hostility.

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“…The pulse wave abnormalities are more likely to have been related to the relatively high volume flow conducted through narrowed and inelastic atherosclerotic arteries and diffusely delivered to the foot at low pressure by collateral channels emptying into abnormally dilated regional vessels with a low peripheral resistance. Yao, Hobbs, and Irvine (1968), in studies of arterial blood flow velocity pulse by ultrasound, showed that a significant number of leg arteries in patients with peripheral vascular disease had a detectable blood flow though no pulse was clinically palpable. Yao (1970) reported a correlation between the reduced systolic blood pressure in atherosclerotic arteries and the symptoms of peripheral vascular disease.…”

Section: Discussionmentioning

confidence: 99%