[Pathophysiology of lung embolism].
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Biomedical subjects
Publications and source records attributed to H G Lasch.
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3.6 g acetylsalicylic lysin was injected into 30 patients daily after operative replacement of the hip-joint. Pulmonary embolism and (or) deep-vein thrombosis were diagnosed in 19 patients. Low-dose heparin (3 X 5000 IU/24 h) significantly reduced the incidence of deep-vein thrombosis (ten of thirty patients: P less than 0.05) compared with the acetylsalicylic acid group. The results demonstrate not only the inadequate thrombosis prophylaxis provided by acetylsalicylic acid, but also that low-dose heparin prophylaxis in these specially at risk patients is of limited efficacy.
A new case of dysfibrinogenemia is reported which shows no signs of a haermorrhagic diathesis (dysfibrinogenemia Giessen III). The abnormal fibrinogen was detected by only slight but characteristic alterations of some parameter of the coagulation analysis (prolonged clotting times after addition of thrombin, Reptilase and thrombin coagulase; low fibrinogen concentration determined by methods based on clot formation in comparison to the immunological fibrinogen determination; delayed fibrin polymerization). In addition, clinical features and diagnosis of dysfibrinogenemia are described in general.
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In the rabbit the application of a non-lethal, sleep-inducing dose of bromisovalerianyl carbamide (0.5 g/kg body weight) causes an activation of the coagulation system. This activation is manifested by shortened thrombin and partial thromboplastin times and a decrease of fibrinogen concentration and Factor V activity. In contrast, pentobarbital sodium at a dose (62.5 mg/kg) which causes the same changes in arterial partial oxygen pressure and arterial pH does not influence the coagulation system. The bromocarbamide-induced changes in the coagulation system are not to be considered as a result of hypoxia and acidosis but seem to be caused by early endothelial and tissue lesions which result in the release of procoagulatory substances. In healthy test persons a single dose of 1.5 g bromisovalerianyl carbamide has no demonstrable influence on the system of hemostasis.
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A new case of facultative hemorrhagic diathesis is described in a 19 year old female and the coagulatory anomaly examined. The experiments show that the coagulatory disturbance should be ascribed to a defective aggregation of fibrin monomers associated with hypofibrinogenemia. Some of its characteristics are the markedly prolonged thrombin-, reptilase-time as well prolonged prothrombin and partial thromboplastin time. The plasma fibrinogen concentration measured by the immunologic method is reduced. The streptokinase induced digestion of fibrinogen Giessen II plasma occurred at a slower rate than normal plasma with persistence of the large fibrinogen degradation products. Fibrinogen Giessen II appears to be a congenital hypodysfibrinogenemia with abnormality of fibrinogen resulting in delayed coagulation and a retarded fibrinogenolysis rate.
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