PubMed Health⌕ Search

Biomedical subjects

P J Kolari

Publications and source records attributed to P J Kolari.

At least 19 recordsLinked to original sources
PubMed1999

The role of low resistance blood flow pathways in the pathogenesis and healing of venous leg ulcers.

In an attempt to clarify the pathophysiology of haemodynamics in legs with venous ulcer we investigated the effect of a single intermittent pneumatic compression treatment on the peripheral resistance of leg arteries and the cutaneous laser Doppler flux in the leg. Eight patients with venous leg ulcers and 10 subjects with healthy legs were investigated. Doppler waveforms of the leg arteries and laser Doppler flux of the leg skin were recorded before and after a single intermittent pneumatic compression treatment with the subjects in a recumbent position. In the legs with venous ulcer, the peripheral resistance of the arteries was lower and the laser Doppler flux was greater, compared with healthy legs (p = 0.003 and p = 0.002, respectively). A single intermittent pneumatic compression treatment raised the peripheral resistance in the arteries of legs with ulcer and laser Doppler flux of the skin more in ulcer legs than in healthy legs (p = 0.046 and p = 0.034, respectively). These findings suggest that removal of oedema causes redistribution of skin blood flow in the legs with venous ulcer favouring the superficial capillary perfusion. This could explain why compression treatment promotes the healing of venous leg ulcers.

Adult↗
PubMed1998

The venoarteriolar response of the skin in healthy legs measured at different depths.

The venoarteriolar response (VAR) of the skin in healthy legs of 20 subjects was investigated. The laser Doppler flux (LDF), at an experimental venous hypertension of 30 mmHg, 45 mmHg and 60 mmHg, produced by a pneumatic cuff around the thigh in a recumbent position, was compared with the LDF in a sitting position. The LDF of the skin was measured simultaneously at the same site of the superficial capillary layer (with 543 nm) and of the deeper capillary layer (with 780 nm). At 543 nm the LDF did not differ significantly at any cuff pressure from the LDF recorded in a sitting position, whereas at 780 nm the LDF was significantly higher at the cuff pressure of 30 mmHg than the LDF in a sitting position (P = 0.002). The VAR was much weaker at 543 nm than at 780 nm, and the scatter of the VAR values was high. In a sitting position the VAR at 543 nm was 9.3% and at 780 nm 34.6% (P < 0.001). The VAR at 543 nm at the cuff pressure of 30 mmHg did not differ significantly from the VAR caused by the sitting position, whereas at 780 nm the VAR at the cuff pressure of 30 mmHg was significantly less than the VAR caused by the sitting position (P = 0.001). Despite the high scatter of the VAR values, these findings suggest that the VAR in the superficial capillary layer is smaller, and that it reached maximum at lower venous hypertension, than the VAR in the deeper capillary layer.

Adult↗
PubMed1998

Blood flux and venoarteriolar response of the skin in legs with chronic venous insufficiency measured at two different depths by using a double-wavelength laser Doppler technique.

The laser Doppler flux (LDF) and the venoarteriolar response (VAR) of the skin in legs with chronic venous insufficiency (CVI) was measured by using a new double-wavelength probe technique (543 nm and 780 nm). The recordings were taken in a recumbent and in a sitting position. Ten patients with CVI and 20 control subjects with healthy legs were investigated. The LDF was found to be significantly enhanced in a recumbent position at 543 nm and in a sitting position at 780 nm in legs with CVI compared with healthy legs (P<0.05 and P=0.02, respectively). The authors could not find the VAR to be impaired in either wavelength in legs with CVI compared with healthy legs. The double-wavelength probe technique makes it possible to record simultaneously the LDF in the superficial and deep layers of the skin on the same place in the leg.

Aged↗
PubMed1998

Venoarteriolar response to experimental venous hypertension in legs with chronic venous insufficiency and in healthy legs, measured using a double-wavelength laser Doppler technique.

The venoarteriolar response (VAR) of the skin in legs caused by experimental venous hypertension was measured using a new, double-wavelength laser Doppler probe technique (543 nm and 780 nm). This enables the measurement of the laser Doppler flux in the superficial and deep layers of the skin simultaneously. The recordings were obtained from the leg with the patient in a recumbent position with a sphygmomanometer cuff around the thigh. The VAR was recorded at the cuff pressures of 30 mmHg and 60 mmHg. Ten patients with chronic venous insufficiency (CVI) and 20 control subjects with healthy legs were investigated. The VAR increased in relation to the increase of cuff pressure at both wavelengths. There were no significant differences in the VAR between the cuff pressures within or between the legs with CVI and healthy legs. The VAR measured at 780 nm was very significantly greater than the VAR measured at 543 nm in legs with CVI (p<0.005), as well as in healthy legs (p<0.001). The VAR depends both on the wavelength of the laser Doppler light used and on the degree of venous hypertension. The VAR is not impaired in legs with CVI compared with healthy legs.

Adult↗
PubMed1997

The peripheral resistance in arteries of legs is inversely proportional to the severity of chronic venous insufficiency.

There are conflicting reports in the literature about the existence of arteriovenous shunting in legs with chronic venous insufficiency. Using duplex scanning, we have earlier shown that there is lowered peripheral resistance in the arteries of legs with venous ulcer together with premature venous filling in angiography. In the present study we investigated the peripheral resistance in the arteries of 16 legs with chronic venous insufficiency without present ulcer. We compared the results with those obtained from 12 healthy legs and from 18 legs with venous ulcer. There was a highly significant inverse correlation between the severity of chronic venous insufficiency and the peripheral resistance in the popliteal, the dorsal pedal and the posterior tibial arteries (p < 0.001). These results suggest that there is arteriovenous shunting in legs with chronic venous insufficiency and that this phenomenon correlates with the degree of chronic venous insufficiency.

Arteries↗
PubMed1993

A model approach for calculating the net capillary filtration rate during venous occlusion.

The venous occlusion method is commonly used to measure the net capillary filtration rate, calculated from the slope of the increasing volume curve of the limb at a given time. However, this technique does not take variation in the rate of venous filling into account. In the present study, a model of sum of two cumulative exponential functions was developed to describe the venous filling phase and the increase in interstitial fluid volume due to the net capillary filtration rate. The model was tested on 15 normal subjects and eight patients with post-thrombotic venous insufficiency. The cumulative exponential model gave a good description of the changes in volume that occur during venous occlusion. The model also enabled determination of the net CFR at the same phase of the maximal venous capacity.

Adult↗
PubMed1991

Edema and lower leg perfusion in patients with post-traumatic dysfunction.

Impedancegraphy and laser Doppler flowmetry were used to measure whether limb circulation changes following post-traumatic immobilization and edema. Intermittent pneumatic compression was used for edema treatment. Limb blood flow due to edema was unchanged compared to the contralateral healthy leg. Intermittent pneumatic compression reduced edema very significantly (p less than 0.001). Intermittent compression showed a slight but significant (p less than 0.01) improvement in impedancegraph blood flow after treatment. Laser Doppler skin blood flow decreased non-significantly following the compression treatment.

Adult↗
PubMed1991

Laser Doppler vasomotion among patients with post-thrombotic venous insufficiency: effect of intermittent pneumatic compression.

Laser Doppler fluxmetry (LDF) was used to measure skin blood flux and its vasomotion, i.e. rhythmical variations in nineteen patients with post-thrombotic venous insufficiency, and in eight healthy control subjects before and after a single intermittent pneumatic compression treatment session. Following the compression treatment session skin blood flux increased and vasomotion was seen in all the patients. The transcutaneous oxygen tension also increased slightly, but significantly, from 25.4 (range 3-56) mmHg to 30.8 (range 7-61) mmHg (p less than 0.01). It is suggested that IPC treatment decreases venous distention and venous pressure thereby decreasing vasocontrictor stimulus. This seems to restore normal skin blood flow including vasomotion.

Adult↗
PubMed1991

Intermittent pneumatic compression therapy in posttraumatic lower limb edema: computed tomography and clinical measurements.

The purpose of our study was to assess the amount of posttraumatic lower limb edema and its distribution between subcutaneous and subfascial compartments before and after intermittent pneumatic compression (IPC) therapy in patients with fractures of the lower leg immobilized with a cast for six to 12 weeks. Computed tomography (CT) was used as an objective method of measuring the compartmental distribution of edema. Sixteen patients with a mean age of 37 years (range 19 to 64 years) were investigated by clinical measurement of the leg circumference and by CT at the ankle joint and at three equidistant (10cm) levels above it. The unaffected leg served as a control for the evaluation of the amount of edema and density of the tissues. Edema was found primarily in subcutaneous tissue. The IPC treatment decreased relative edema from 23% to 15.9% (p less than 0.01) as measured by CT, and from 23.5% to 13.2% as measured clinically. The density of muscle tissue increased 9% (p less than 0.01) and that of subcutaneous tissue decreased 5.6% (p less than 0.05). The IPC treatment influenced both the amount of edema and the density of tissue compartments.

Adult↗
PubMed1990

Cancer mortality of granite workers 1940-1985.

A retrospective cohort study was undertaken to investigate the cancer mortality of granite workers. The study comprised 1026 workers who took up such work between 1940 and 1971. The number of person-years was 23,434, and the number of deaths was 296. During the total follow-up period, 59 tumours were observed as compared with 54.4 expected. An excess mortality from tumours was observed in workers followed up for 20 years or more. Of the 59 tumours, 31 were lung cancers (expected 19.9), and 18 gastrointestinal cancers (expected 11.6), nine of which were stomach cancers (expected 7.1). Mortality from lung cancer was excessive for workers followed up for at least 15 years (28 observed, 12.7 expected). The results indicate that granite exposure per se may be an etiological factor in the initiation or promotion of malignant neoplasms.

Adult↗
PubMed1990

Elastic bandages and intermittent pneumatic compression for treatment of acute ankle sprains.

The efficacy of elastic bandage alone and with intermittent pneumatic compression (IPC) treatments in the rehabilitation of 44 acute ankle sprains was studied. Lower-leg dysfunction was assessed by measurements of edema, degree of ankle motion, pain, and limb dysfunction when the patient was first included in the study, after treatment for one week, and after a four-week follow-up. For all the parameters studied, elastic bandage with IPC treatment resulted in highly significantly (p less than 0.001) faster rehabilitation during the four-week follow-up than did elastic bandage treatment alone. The limb dysfunction improved significantly (p less than 0.01) during the follow-up on the study group receiving IPC with elastic bandage compared to elastic bandage alone. The results suggest that IPC treatment is effective in acute posttraumatic therapy.

Adult↗
PubMed1989

Cleansing of hands with emulsion--a solution to skin problems of hospital staff?

In this study of hand cleansing, nursing staff with skin problems used emulsion followed by rinsing with water, while control groups, with or without skin problems, used liquid soap and water. Clinical evaluation of the without skin problems, used liquid soap and water. Clinical evaluation of the skin by a dermatologist, as well as by self-assessment, suggested that when the staff with skin problems used emulsion their skin was in better condition than that of controls with similar skin problems. This favourable effect on skin was later confirmed in extended use of emulsion for hand cleansing in other hospital wards. Objective evaluation of skin condition with biophysical measurements was unsuccessful. Emulsion cleansing of the hands seems to offer a favourable alternative to washing with soap and water, especially for persons with skin problems.

Adult↗
PubMed1988

Transcutaneous oxygen tension in patients with post-thrombotic leg ulcers: treatment with intermittent pneumatic compression.

Transcutaneous oxygen tension (TcPO2) and the effect of intermittent pneumatic compression on tissue oxygenation were studied in 10 patients with post-thrombotic leg ulcers. Oxygen tension was measured near the edge of the leg ulcer before and after 60 min of intermittent compression at 50 mmHg. The control group consisted of nine subjects with no evidence of peripheral vascular disease. The mean TcPO2 for the controls was 59.7 (SEM2.9) mmHg and for the study group 26.2 (SEM7.0) mmHg before treatment and 42.7 (SEM6.4) mmHg after treatment (p less than 0.005). Oxygen tension increased in nine patients in the study group. The change in TcPO2 correlated highly significantly (r = 0.912, p less than 0.002) with the reduction of oedema and the inverse change of skin temperature. The results suggest that intermittent pneumatic compression decreases interstitial fluid volume and venous stasis, both of which may lead to increased tissue oxygenation.

Aged↗
PubMed1988

Treatment of post-traumatic oedema in lower legs using intermittent pneumatic compression.

Post-traumatic oedema after 6-12 weeks immobilization in a cast was treated using intermittent pneumatic compression. The study group comprised 18 patients with 19 distal fractures of the lower leg. They were given compression treatment on five consecutive days for about 1 h daily. Reduction in oedema was assessed by measuring leg circumferences at three levels: the malleolus; 20 cm proximally from the malleolus; and the Chopart joint. The untreated control group consisted of five patients. Changes in oedema were followed daily for one week. A significantly greater reduction in oedema occurred in the study group at all three measurement levels (p less than 0.001) as compared with the control group.

Adult↗
PubMed1987

Silica exposure and rheumatoid arthritis: a follow up study of granite workers 1940-81.

The incidence and prevalence of subjects awarded disability pensions and the prevalence of subjects receiving free medicines because of rheumatoid arthritis were studied in a Finnish cohort of 1026 granite workers hired between 1940 and 1971 and followed up until 31 December 1981. The incidence of awards of disability pensions because of rheumatoid arthritis during 1969-81, the prevalence of rheumatoid arthritis on 31 December 1981, and the prevalence of subjects receiving free medicines for rheumatoid arthritis at the end of 1981 were significantly higher among the granite workers than in the general male population of the same age. Retrospective analysis of the records of all patients with rheumatoid arthritis in the cohort showed a predominance of a severe, serologically positive and erosive form of rheumatoid arthritis, usually with an age at onset of 50 or over. The possible aetiological or pathophysiological role of granite dust in rheumatoid arthritis may be based on the effects of quartz on the immune system.

Adolescent↗