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H E Pawel

Publications and source records attributed to H E Pawel.

4 recordsLinked to original sources

Poststenotic flow velocity changes as a function of stenosis geometry.

We used an in vitro pulsatile flow model to examine the velocity profile distal to a variable nonaxisymmetric stenosis. Using a continuous-wave Doppler velocimeter, the peak systolic frequency was determined distal to the stenosis and in planes parallel and perpendicular to the long axis of the stenosis. In both planes, an exponential regression best describes the relationship between peak systolic frequency and reduction in cross-sectional area. Regressions at each point of insonation diverged as a direct function of reduction in cross-sectional area and as an indirect function of distance from the stenosis. At each point of insonation, regressions representing the relationship in the mutually perpendicular planes diverged in direct proportion to reduction in cross-sectional area. Slopes were greater in parallel planes of insonation. These data demonstrate that two variables, distance and geometry, may influence the results of spectral analytic studies.

Arterial Occlusive Diseases

Microprocessor-controlled pulsatile flow loop for hemodynamic studies.

Validation of spectral analytic techniques in the clinical assessment and quantitation of vascular stenoses has been aided by use of in vitro flow loops. We have used a recently developed microprocessor-controlled pulsatile flow model to examine the influence of varying stenoses on Doppler-shifted peak systolic frequencies. A nonaxisymmetric, vertically oriented stenosis was produced by extrinsic compression of latex rubber tubing 12 mm in diameter, reducing the cross-sectional area (CSA) by 25, 40, 50, 60, 70, 85, and 97%. A rolling diaphragm pump, driven through a slider-crank mechanism by a microprocessor-controlled stepper motor, generated characteristic arterial pulse waves at a rate of 75 cycles per minute. Using an 8 MHz, continuous-wave, directional Doppler velocimeter, the Doppler-shifted frequencies were recorded at the stenosis. Four sets of observations were made at each of the stenoses, and the peak systolic frequency (PSF) was determined using a spectrum analyzer. The PSF in the absence of an obstructing stenosis was 2.56 +/- 0.03 (KHz +/- SEM). This increased significantly (P less than 0.05) to 4.80 +/- 0.09 when the CSA was reduced by 50%, to 5.90 +/- 0.37 when the CSA was reduced by 60% (P less than 0.05), to 8.40 +/- 0.10 when the CSA was reduced by 70% (P less than 0.05), and to 17.84 +/- 0.89 when the CSA was reduced by 85% (P less than 0.05). These data establish the utility of this pulsatile flow model, confirming the direct relationship between the Doppler-shifted PSF and the percentage reduction in CSA.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity

Doppler-derived percentage systolic window and the quantitation of arterial stenosis.

Peak systolic frequency (PSF) and percentage systolic window (%SW) are spectral parameters used to characterize poststenotic flow velocity patterns. The PSF, obtained using a continuous-wave (CW) Doppler velocimeter, has been used more frequently, however, in the quantitation of carotid occlusive disease. The authors have employed a microprocessor-driven pulsatile flow model to evaluate more completely the relationship between stenosis and the %SW. Using an 8 MHz CW Doppler probe, the Doppler-shifted frequencies were recorded at 1, 2, 3, 4, and 5 diameters distal to a variable, nonaxisymmetric stenosis, which reduced the cross-sectional area (CSA) 25, 40, 50, 60, 70, 85, and 97 per cent. Four sets of observations were made and the %SW derived using a spectrum analyzer. At one diameter from the stenosis, the relationship between the %SW (Y) and the reduction in CSA (X) is best described by two first-order regressions (Y = MX + B). The slope of the relationship from 0 to 60 per cent reduction in CSA is nearly flat, -0.052, while there is a significant (P less than 0.05) decrease in the slope, -1.538, when the CSA is further reduced from 60 to 97 per cent. Beyond 1 diameter, the relationship is best described by a single linear regression, the gradual slope of which does not permit clinically useful comparisons. These data explain the lack of strong correlation between CSA and %SW when the data are evaluated over the entire range of stenoses. However, they do indicate that the %SW may be a useful correlate if it is obtained within one diameter of the stenosis.

Arterial Occlusive Diseases

The facial plethysmograph: a new instrument to measure facial swelling volumetrically.

A critical review of methods used to evaluate postoperative facial swelling is presented. A new, noninvasive method using a feeler arm to trace and measure facial contours is described. The overall accuracy and reproducibility of this method was tested by measuring acrylic "mock swellings." The results suggest that the method was accurate to within 5% in measuring swellings of known volume. The reproducibility of replicate measures also showed a low level of error (3.3%). This device may provide a unique method for the systematic study of treatments designed to minimize postoperative facial swelling.

Edema