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Biomedical subjects

H Ehringer

Publications and source records attributed to H Ehringer.

At least 73 records · Page 4Linked to original sources
PubMed1989

Hemorheology in systemic ultrahigh-dose thrombolytic therapy with streptokinase and urokinase.

The course of fibrinogen (Fgen), red cell aggregation (RCA), plasma viscocity (PV), platelet aggregation (PA) and hematocrit (Hc) was studied in patients with ultrahigh - dose thrombolytic therapy (1.5 x 10(6) units/hour for 6 hours = 1 cycle) with streptokinase (SK) or urokinase (UK) over a period of 3 cycles. Both ultrahigh - dose SK and UK produced significant changes in the course of Fgen, RCA and PV, whereas PA (spontaneous and ADP-induced) and Hc remained unchanged. After termination of each cycle Fgen progressively increased while RCA and PV further decreased. The extent of alteration in cycle 1 - concerning the baseline values - was more pronounced with SK than with UK, but the overall effect of SK decreased through the consecutive cycles because of more rapid increase during the SK-free period. In UK-therapy hemorheological alterations were initially moderate but increased from cycle to cycle.

Adult↗
PubMed1989

Platelet deposition at angioplasty sites and its relation to restenosis in human iliac and femoropopliteal arteries.

The amount and time course of platelet accumulation at angioplasty sites and influence of these platelets on restenosis after percutaneous transluminal angioplasty (PTA) in peripheral arteries were determined in 92 patients, who received either a high or low dose of aspirin. Platelet deposition was quantitated by means of dual-radiotracer scintigraphy and calculation of a platelet accumulation index (PAI). The PAI was higher (P less than .05) 4-6 hours after PTA compared with that on subsequent days. There was a trend toward greater platelet accumulation in vessels with extensive dissection. Platelet accumulation at the PTA site occurred with both doses of aspirin, with no differences between the two dosage groups. Twenty-one of 67 patients who underwent PTA in the femoropopliteal segment developed restenosis during a median follow-up of 14 months. The median PAI at 4-6 and 22-24 hours after PTA was significantly less in these 21 patients than in the 46 without restenosis. The data suggest that use of antiplatelet agents to prevent platelet deposition after PTA may not be useful for prevention of restenosis.

Angioplasty, Balloon↗
PubMed1989

Deep vein thrombosis: scintigraphic diagnosis with In-111-labeled monoclonal antifibrin antibodies.

Fifty-two patients suspected of having deep vein thrombosis under-went scintigraphy with an indium-111-labeled monoclonal antifibrin antibody. Venography disclosed deep vein thrombosis in 31 patients. With the whole limb considered an anatomic entity, antifibrin antibody scintigrams obtained 2 hours after injection had a specificity and sensitivity of 81% and 84%, respectively. A higher sensitivity (92%) was found for a subgroup of patients (n = 44) with symptoms for less than 10 days. Regional sensitivities for all patients and for the subgroup, respectively, were 92% and 100% in the calf, 82% and 94% in the popliteal region, 63% and 71% in the thigh, and only 18% and 13% in the pelvis. Additional imaging performed 6 hours and 21 hours after injection in 12 patients and quantitative analysis done from scintigrams with and without blood-pool (technetium-99m human serum albumin) correction did not improve sensitivity. In-111-antifibrin antibody scintigraphy is an accurate method for diagnosis of acute established deep vein thrombosis of the calf and popliteal region; its sensitivity in the thigh is lower, and it is not feasible for diagnosis in the pelvic area.

Adolescent↗
PubMed1989

Indium-111-labeled platelet scintigraphy in carotid atherosclerosis.

We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index. There were no significant differences between patients receiving high-dose (1.0 g/day) or low-dose (1.0 g/day) acetylsalicylic acid in scintigraphic results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Lack of influence of low-dose acetylsalicylic acid (100 mg daily) on platelet survival time, beta-thromboglobulin and platelet factor 4 in patients with peripheral arterial occlusive disease.

In this study we investigated the influence of low-dose (100 mg daily) acetylsalicylic acid (ASA) on 111-In-platelet survival time (PST) and on plasma levels of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF 4) in 30 patients (median age: 60 years) with arteriographically proven peripheral arterial occlusive disease in a chronic stable phase. We observed no significant changes of PST during therapy with ASA (weighted mean: 169.8----166 [median] hours; multiple hit: 168.3----170.6 hours), and also the plasma levels of beta-TG (median: 31.8----32.3 ng/ml) and of PF 4 (3.6----3.9 ng/ml) remained unchanged.

Adult↗
PubMed1988

[Hemorheology and acute phase reaction following thrombendarterectomy of the extracranial carotid artery].

In 39 patients with hemodynamically significant stenoses of the internal carotid artery thrombendarterectomy was performed. Hemorheological properties and plasma protein levels were studied pre- and postoperatively over a period of 14 days. In comparison to age-matched healthy controls preoperative plasma viscosity, red cell aggregation, fibrinogen, haptoglobin and alpha-1-antitrypsin were significantly elevated. After surgical trauma there was an increase in fibrinogen, alpha-1-antitrypsin, haptoglobin and ceruloplasmin, whereas alpha-2-macroglobulin, immunoglobulin A and immunoglobulin G decreased significantly. Plasma viscosity, red cell aggregation, red cell filterability, fibronectin and immunoglobulin M remained unchanged. We conclude that our patients showed a non specific chronic "hematological stress syndrome" with raised acute phase reactants and corresponding hemorheological changes preoperatively; despite postoperative acute phase reaction no further deterioration of the rheological parameters could be observed; this might be caused by a decrease of plasma proteins with high frictional ratios compensating the increase of acute phase proteins. Besides, tissue damage and consecutive acute phase reaction in carotid arterial surgery seem to be of relatively minor degree.

Acute-Phase Proteins↗
PubMed1988

Influence of postoperative anticoagulant treatment on patient survival after femoropopliteal vein bypass surgery.

To examine whether anticoagulants given after autologous saphenous bypass surgery influenced patient survival 119 patients who received such a graft for obliterative arterial disease were recruited for a controlled clinical trial. Patients were randomly assigned to start, in the second postoperative week, phenprocoumon (60 patients) or no treatment (59 patients). The median duration of survival for all patients was greater than 60 months, and the 75%-quartile was 39.0 (SE of the median 3.9) months. 10 patients died in the treated group and 20 in the control group. The treated group had a greater probability of survival (p less than 0.023, Breslow; p less than 0.043, Mantel). Graft occlusions occurred in 11 patients in the treatment group and in 17 controls. When these patients were excluded from the analysis, the difference in probability of survival between the two groups remained significant (p less than 0.009, Breslow; p less than 0.013, Mantel).

Aged↗
PubMed1988

[Percutaneous transluminal angioplasty in peripheral arterial occlusive disease].

Non-surgical recanalization of arterial obstructions has gained world wide acceptance since the development of the balloon dilatation catheter by Gruentzig. The indication for this treatment depends on the clinical stage of the disease, on the location and extension of the occlusion and on the general clinical situation of the patient. Ideal situations with excellent short- and long-term results are stenoses of the iliac arteries and stenoses and short occlusions of the femoropopliteal arteries, whereas treatment of long occlusions of this region is less successful. Definite recommendations concerning additional medical therapy to improve the early and longterm patency rate cannot be given because of lacking studies. The most important advantage of PTA--compared to surgical recanalization--is the lower complication rate. A further improvement of early and late results can be expected by the combined use of different non-surgical recanalization procedures.

Angioplasty, Balloon↗
PubMed1988

[Changes in stomach and duodenal mucosa caused by acetylsalicylic acid therapy].

The ulcerogenic effect of acetylsalicylic acid on the gastric and duodenal mucosa is well known. In a retrospective survey we analysed 1203 gastroscopic investigations from 1980 to 1986. Of these patients 47 were under therapy with acetylsalicylic acid for at least 4 weeks and 39 of them (82.9%) showed pathologic changes of the gastric and duodenal mucosa. The residual 1156 patients received no therapy; among these only 426 patients (36.8%) showed pathologic changes of the gastric and duodenal mucosa. The significant difference in the incidence of peptic lesions of the gastroduodenal mucosa between the two patient groups confirms the existence of an ulcerogenic side effect of acetylsalicylic acid.

Aspirin↗
PubMed1987

Reproducibility of platelet survival time measurements in patients with peripheral arterial occlusive disease.

In this study we investigated the reproducibility of 111-In-platelet survival time (PST) measurements and of plasma levels of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF 4) in 30 patients (median age: 60.5 years) with arteriographically proven peripheral arterial occlusive disease (PAOD) in a chronic stable phase. PST calculated by both the weighted mean - WM - (1. investigation: 187.1 [median] hours - repeat investigation: 188.3 hours) and multiple hit - MH - model (181.4----177.4 hours) demonstrated only a small spontaneous variation. The median coefficient of variation (CV) was 3.0 (WM) and 3.2 (MH), respectively. The reproducibility of beta-TG (CV: 6.1) was also satisfactory. We conclude that the good reproducibility of PST and plasma levels of beta-TG make them well suited to judge the influence of platelet-suppressant drugs on these parameters in patients with PAOD.

Adult↗
PubMed1987

[Role of postoperative anticoagulant treatment following femoro-popliteal venous bypass. Interim evaluation of a controlled clinical study].

Eighty-eight patients underwent a classical reversed saphenous vein graft for femoro-popliteal occlusive disease and were enrolled in a controlled clinical trial. During the second postoperative week the patients were allocated randomly into one of two groups: group I consisted of 42 patients who received dicumarol and group II (46 patients) served as a control group without any anticoagulant treatment. The mean follow-up time was 24 months. After 12 months the cumulative patency rate was 82%, after 18 months 76% and after 24 months 76%; for patients receiving dicumarol treatment the respective figures were 92%, 86% and 86% and for those with no treatment 70%, 67% and 67%, the difference being significant. When the bypass operation was performed for limb salvage (clinical stages III and IV) the overall results were worse (12 months: 72%, 18 months: 68%, 24 months: 68%) than in stages II, II-III (12 months: 90%, 18 months: 85%, 24 months: 85%). In limb salvage surgery the positive effects of anticoagulant treatment were significant (with treatment: 12 months 87%, 18 months 86%, 24 months 86%; without treatment: 12 months 58%, 18 months 54%, 24 months 54%).

Aged↗