This proposal investigates the clinical application of 20 MHz pulsed ultrasonic Doppler velocity meter (PUCVM) methodology in the adult human upper extremity. Arterial blood flow parameters (blood velocities, flow stream geometry, and calculated blood flow) are assessed transcutaneously, non-invasively, and painlessly. The purpose is specifically to: 1) describe blood flow parameters in the brachial, radial, ulnar and selected digital arteries in normal adult forearms and hands, 2) determine whether contralateral extremities function satisfactorily as controls, 3) measure blood flow distribution within the upper extremity arterial system, 4) assess the long-term hemodynamic consequence of arteriorrhaphy in trauma management with attention to the effects of wound healing on arterial performance and to compensatory flow in parallel arterial systems, and 5) measure the arterial hemodynamics in selected pathologic conditions, i.e. cavernous hemangiomas of the upper extremity and occupationally induced Raynaud's phenomenon of the fingers. The investigational method utilizes of 20 MHz PUDVM and currently operational VAX 730 computer based data collecting, processing, and display programs. The 20 MHz PUDVM, with variable range and width control of the sample volume, measures frequency shifts, which are proportional to directional blood velocities. From the temporal mean of spatial mean velocities and from measured velocity profiles, blood flow is calculated (Vsm A=Q). The data processing system contains innovative, programmed rapid range control advance instrumentation and contains programs to temporally average instantaneous spatial average velocities and to best fit parabolas to measured velocity profiles. The method precisely and reproducibly assesses blood flow in arteries of the dimensions herein proposed. The long-term objectives of this proposal are to improve 20 MHz PUDVM methodology, and to expand the knowledge of normal and pathologic arterial hemodynamics in adult upper extremities. Further, this proposal will begin to assess the efficacy of the treatment of selected hemodynamically pathologic conditions.
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