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Hand-ischemia and artery-thrombosis are serious complications of hand artery cannulation/grafting. Screening the patency of hand arteries reduces the complications. Modified Allen Test (MAT), Barbeau's test, and Doppler/Duplex-ultrasonic test screen hand arterial patency. Each of them, however, either lacks objectivity, requires subject cooperation, or is not readily available in operating rooms. In this pilot study, we aim to provide a novel, objective, reliable, and inexpensive alternative using differential photo-plethysmography (PPG) measurement, and an artery selection algorithm. For 11 participants, MAT was executed, and PPG measurements of the thumb and little fingers were recorded for left and right hands separately. For each hand, four evaluations were conducted, then fed into the artery selection algorithm. Our proposed procedure has shown congruent results with the anatomy of blood circulation. It identified two arteries in two participants causing >50% blood reduction in the hand due to their occlusion. It also showed an elevated risk of accessing an artery in another 8 participants. Once the results of this study are confirmed in larger samples, the proposed procedure/algorithm may provide many indicators of the hand blood circulation, the effect of an artery occlusion on the hand, and a recommendation for selecting the best artery to access with the lowest possible complications. [ABSTRACT FROM AUTHOR]

Aspergillosis is known for the variety of unusual presentations in immuno-suppressed patients. We report a patient in whom aspergillosis caused the superior vena cava (SVC) syndrome. A 37-year-old woman became febrile soon after bone marrow transplantation (BMT). Chest radiography demonstrated a 5-cm mass extending from the right lung apex to the right supraclavicular fossa beside her Hickman catheter. She then developed SVC syndrome, which progressed despite treatment. Despite recovery of the white blood cell count, the patient continued to deteriorate, became comatose, suffered a cardiac arrest and died 31 days after BMT. Autopsy revealed Aspergillus infection at the apex of the right lung associated with innominate artery thrombosis. [ABSTRACT FROM AUTHOR]