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Biomedical subjects

F A Spengel

Publications and source records attributed to F A Spengel.

At least 55 records · Page 3Linked to original sources
PubMed1990

Spontaneous recanalization of a pseudoocclusion of the internal carotid artery in a 70-year-old woman.

A 70-year-old woman suffered paresis of the left hand with dysaesthesia of the head lasting about 12 hours. The Doppler-flow study and duplex scan of the carotid arteries performed 14 days later showed an occluded right internal carotid artery. She refused angiography. However, 7 days later she was willing to undergo further investigation. This time the Doppler flow study and duplex scan demonstrated regular flow without stenosis, which suggested spontaneous recanalization of the formerly occluded right internal carotid artery.

Aged↗
PubMed1990

[Simpson's atherectomy of the peripheral arteries: early results and follow-up].

Over a seventeen-month period, a percutaneous transluminal removal of stenosing plaque material from leg and pelvic arteries was performed successfully and without complication in 43 patients. A complete atherectomy in the femoropopliteal vessels succeeded in 99% of cases. In the pelvic region, the primary results were much lower (58%). After six months, the angiographically checked restenosis rate was 17% for femoropopliteal vessels and 11% for iliac arteries, and the corresponding Kaplan-Meier cumulative patency rates were 73.8 and 78.7% respectively. Simpson's atherectomy is the only method of its kind that is therapeutically effective and diagnostically significant, since the removed plaque can be used for further tests.

Aged↗
PubMed1990

[Atherosclerosis and possibilities of dietary prevention or therapy].

Hypercholesterolemia, hypertension, smoking and diabetes mellitus are the main risk-factors for the development of early atherosclerosis. The association of hypercholesterolemia and atherosclerosis is well established: there is a strong correlation of the duration and severity of atherosclerosis to the extend of plaque-formation. Dietetic measures in large populations show reduction in cardiovascular events, drastic lipid-lowering therapy (i.e. drugs, plasma exchange, ileum-bypass operation) may induce regression of plaque-formation.

Adult↗
PubMed1989

[Duplex sonography diagnosis of deep leg- and pelvic vein thromboses].

The diagnosis of thrombosis of the deep leg veins or pelvic veins is usually established on the basis of technical procedures. Clinical signs such as swelling, erythema or warming are unreliable. Plethysmographic measures have a low specificity, nuclear medicine studies enable assessment, limited to the lower leg, only after 24 hours. Continuous-wave Doppler sonography, as is the case with plethysmography, does not allow differentiation between intra- or extravascular cause of the obstruction to flow; hemodynamically-unimportant, floating thrombi cannot be detected. Ascending phlebography is an invasive procedure exposing the patient to contrast medium with its possible allergic reactions, radiation and thrombosis or local inflammation. Duplex-sonography enables the combination of high-resolution ultrasonic B-imaging with a pulsed Doppler unit which provides a noninvasive means for direct visualization of the involved vessel. For the examination, preferably, linear scanners are employed with a frequency of at least 5 megahertz. With the patient in the supine position, first, the iliac vein, medial to the artery, is imaged, then the common femoral vein and the great saphenous vein (Figure 1). Then the patient is turned and the popliteal vein and, as far as possible, the veins of the lower leg are examined from the back. Direct proof of thrombosis is considered the documentation of intraluminal echo-intense structures (Figure 2) associated with absence of complete compressibility of the vascular lumen in cross-section with slight pressure of the transducer (Figures 3a and 3b).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1988

[Actinomycosis of the skin in HIV infection].

A 29-year-old woman with HIV-infection developed disseminated abscesses of the skin, identified as an infection with Actinomyces israelii. To our knowledge, actinomycosis associated with HIV-infection (AIDS-related complex) has been reported only once previously.

AIDS-Related Complex↗
PubMed1988

Erythrocytapheresis. A method for rapid extracorporeal elimination of erythrocytes. Results in 65 patients.

We report on the progress of a new modified method of phlebotomy, erythrocytapheresis, as a means of fast therapeutic removal of erythrocytes from the circulation. We performed erythrocytapheresis in 65 patients. In 18 patients with central venous thrombosis of the eye, the beneficial effect of this procedure proved superior to the traditional approach. In 29 patients with primary or secondary polycythemia, hemoglobin, hematocrit, and blood viscosity could be lowered drastically for up to 11 months by a single erythrocytapheresis. We performed erythrocytapheresis in an effort to deplete the iron stores in patients with hemochromatosis (14 cases) and in patients with porphyria cutanea tarda (4 cases). Several consecutive erythrocytaphereses were necessary, however, to even slightly lower the amounts of stored iron as measured by serum iron, iron-binding capacity, and serum ferritin in these patients. The intervals between treatment were 2 to 11 months, thus much longer than the intervals between blood-lettings. We did not observe any adverse side effects. There was no significant influence on the clotting system, and no reactive thrombocytosis as described after phlebotomies.

Adult↗
PubMed1988

Changes of atherosclerosis of the carotid arteries due to severe familial hypercholesterolemia following long-term plasmapheresis, assessed by duplex scan.

Three males, aged 15, 22, and 25 years, have been followed for Familial hypercholesterolemia (FH) from 1968 and 1976 onward, being treated by plasmapheresis for 2 to 5 years continuously, at 1- to 2-week intervals. Whereas two patients have been continuously treated to date, the third discontinued plasma exchange after 4 years and has been reevaluated 6 years later. Discontinuation of plasma exchange led to progression of atherosclerosis of the carotid arteries documented by duplex scan, whereas one patient exhibited marked regression of former impressive soft plaque-formation and one patient showed no significant change. Two-dimensional computer-analysis suggested a reduction of plaque mass of up to 45% in one patient.

Adult↗
PubMed1988

Atherosclerosis of the carotid arteries in young patients with familial hypercholesterolemia.

Patients with heterozygous and homozygous Familial Hypercholesterolemia exhibit a high incidence of premature coronary heart disease, presumably due to atheromatous plaque-formation in the coronary arteries. Clinical symptoms develop when the disease has progressed to more severe stages of atherosclerosis. Aim of our study was to visualize and document early atheromatous lesions in the carotid arteries of asymptomatic patients with familial hypercholesterolemia under 30 years of age by Duplex-scan. Of 44 patients, 70% had detectable carotid plaques, while only 12% of the controls were affected. All patients with severe carotid disease had serum cholesterol levels above 350 mg/dl. In the age group 2-20 years, 66% of the patients exhibited plaques. Only 6% of the FH patients 21-30 years had normal carotid arteries. We conclude that the process of atheromatous plaque formation in patients with FH starts early in life, severity of atherosclerosis being a function of both extent and duration of hypercholesterolemia. Duplex-scan examination of the carotid arteries is efficient and precise non-invasive method suitable to visualize this process and, by measuring regression, monitor the efficacy of therapeutic measures.

Adolescent↗
PubMed1987

Atherosclerosis of the carotid arteries documented by duplex scan as a predictor of coronary artery disease in familial hyperlipidemias.

The degree of atherosclerotic plaques in the carotid arteries was evaluated in 85 patients with familial hypercholesterolemia and in 43 patients with familial combined hyperlipidemia by means of Duplex scan which recognizes early atherosclerosis. In patients older than 40 years carotid atherosclerosis of moderate degree was associated with coronary heart disease in 90% of cases. The extent of elevated cholesterol, age, cigarette smoking, and hypertension determined the degree of carotid atherosclerosis.

Adolescent↗
PubMed1982

Receptor-mediated low-density lipoprotein catabolism.

Low-density lipoprotein (LDL) receptors are demonstrable in cultured fibroblasts from normal subjects but are decreased or absent in cells from patients with heterozygous or homozygous familial hypercholesterolaemia. In vivo receptor-mediated LDL catabolism, determined as the difference between the turnover rates of 125I-LDL and 131I-LDL coupled with cyclohexanedione, is responsible for approximately one-third of the total catabolism of LDL in normal subjects, but less than one-fifth in heterozygotes and is totally absent in homozygotes. Receptor-mediated catabolism can be stimulated in normal subjects and in heterozygotes by measures that promote bile acid synthesis, namely, administration of anion-exchange resins or creating a partial ileal bypass. Studies in dogs have shown that such measures stimulate the high-affinity binding of LDL by liver cell membranes. Taken together, these observations suggest the existence of LDL receptors in human liver, the function of which is to maintain cholesterol homeostasis within the hepatocyte during periods of increased demand. Partial or complete absence of such hepatic receptors may play a major role in the pathogenesis of familial hypercholesterolaemia.

Cholestyramine Resin↗
PubMed1982

The effect of partial ileal bypass on receptor-mediated uptake and catabolism of low density lipoprotein in the rhesus monkey.

The fractional rates of catabolism (FCR) of 125I-labelled low-density lipoprotein (LDL) and 131I-labelled LDL coupled with 1,2-cyclohexanedione (LDL-CHD) were determined before and 6 weeks after partial ileal bypass in three Rhesus monkeys. Receptor-mediated catabolism, determined as the difference between the FCRs of 125I-LDL and 131I-LDL-CHD, increased significantly after partial ileal bypass. Analysis of tissue distribution of radioactivity in one monkey, killed at the conclusion of a third turnover study 6 months after partial ileal bypass, suggested that the liver was the main tissue site of accumulation of LDL, and that uptake had occurred mainly via a receptor-mediated mechanism. It is concluded that partial ileal bypass stimulates receptor-mediated LDL catabolism in the Rhesus monkey as in man, and that this increase is probably mediated via hepatic LDL receptors.

Animals↗
PubMed1981

Superiority of partial ileal bypass over cholestyramine reducing cholesterol in familial hypercholesterolaemia.

Low density lipoprotein (LDL) turnover studies were conducted on three occasions in each of six patients with heterozygous familial hypercholesterolaemia (FH)-on diet, after 1 month on cholestyramine 16 g/day, and 2 months after partial ileal bypass. Partial ileal bypass lowered total and LDL cholesterol levels and increased the fractional catabolic rate of LDL to a greater extent than did cholestyramine; this difference presumably reflects the greater increase in bile acid excretion induced by the surgical procedure. Studies in two other heterozygotes showed that partial ileal bypass specifically enhanced receptor-mediated catabolism of LDL. The findings support the concept that therapeutic stimulation of bile acid synthesis increases the rate of receptor-mediated uptake and degradation of LDL by the liver.

Adult↗