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Biomedical subjects

H Mörl

Publications and source records attributed to H Mörl.

At least 19 recordsLinked to original sources
PubMed1993

[Severe Raynaud disease of all four extremities].

A 64-year-old woman presented with a serious Raynaud's disease affecting all four extremities and resulting in fingertip necroses. The symptoms had initiated after her second pregnancy in association with anorexia requiring treatment in a psychosomatic clinic and necessitating parenteral feeding. After successful sympatholysis a sympathectomy was performed. After initial success a recurrence in the right arm was treated by intraarterial prostaglandin infusion. This treatment brought a temporary benefit whereas intravenous infusions had been without effect. A further medical blockade of the stellate ganglion was followed by a complete disappearance of the symptoms. A subsequent re-operation was performed. Since all the cervical branches of the sympathetic nerve cord had been resected during the first intervention, a partial resection of the stellate ganglion (ganglion cervical inferior) was performed. There was a temporary benefit which lasted a few months. Medical long term treatment was unsuccessful. However, no further necroses occurred and the intermittent pain is tolerable.

Alprostadil↗
PubMed1991

[Diagnosis and therapy of deep phlebothrombosis of the extremities].

The typical symptoms of the deep phlebothrombosis are not always given, often we have to do with a quiescent or atypical form of the course. For this reason not only the classical symptoms but also the differential-diagnostic considerations were mentioned. Apart from the clinical examination the ultrasound Doppler sound and above all the phlebography will help us for finding the diagnosis. As to the therapy in particular the thrombolytic treatment is discussed. Hereby nowadays the so-called ultrahigh streptokinase treatment seems to preponderatell, since it also develops a shortening of the time of therapy, the conventional lysis with urokinase is reserved to the risk patients. Not only the immediate results as well as the long-term results concerning the formation of a postthrombotic syndrome are mentioned.

Combined Modality Therapy↗
PubMed1988

[Anatomic and functional diagnosis in arterial occlusive disease].

Arteriosclerosis is the most common cause of peripheral arterial disease (PAD); it begins in the second and third decades of life but first becomes manifest, however, many years later. The hemodynamic effects of arterial narrowing in the peripheral arteries are dependent on functional and morphological adaption, temporal and topographical factors and the prevailing metabolism. In the large arteries of the legs, luminal narrowing of more than 70% is required to render impairment of normal exercise capacity such that it can be assumed that even substantial vascular changes may not be associated with clinical symptoms. An acute peripheral vascular occlusion is regarded as a medical emergency. The most frequent cause is in-situ thrombosis or embolism; the most common sources of embolism are valvular lesions in the left side of the heart and thrombi in the left ventricle after myocardial infarction. Sites of predilection for emboli are acutely-angled branching points of arteries primarily in the lower extremities (aorta, iliac, femoral and popliteal arteries). With the exception of the deep femoral artery, the statement is generally valid that the more central the occlusion, the more severe are the effects anticipated. In-situ arterial thrombosis superimposed on a preexistent arteriosclerotic stenosis or after vascular reconstruction, leads to occlusions generally in the pelvic region or upper thigh. Further causes of acute local vascular occlusion are pressure, tension or kinking at the artery, rarely trauma, dissecting aneurysm or ergotism. In 90% of patients with PAD there is involvement of the lower extremity, apparently due to the effects of hydrostatic pressure. Three types of disease can be differentiated: the pelvic type which is observed in approximately one-third of all cases. Through occlusion of the distal aorta (Leriche syndrome) or the large iliac vessels, vice-like pain is incurred in the hip musculature which frequently radiates to the upper thighs; with bilateral occlusion, impotence develops.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMed1987

[Drug-induced hepatitis caused by Fansidar].

We report on a 27-year-old patient with recurrent cholestatic hepatitis in whom the symptoms developed each time after travelling in tropical areas. Our primary diagnosis was recurrent non-A-non-B-hepatitis after exclusion of other forms of infectious hepatitis, but careful exploration identified Fansidar as the causative agent of liver damage.

Adult↗
PubMed1987

Clinical effects of intravenous iloprost in patients with intermittent claudication.

In a randomized patient-blind study iloprost or hydroxy-ethyl starch 200/0.5 were given i.v. 5 h daily for 2 weeks to 24 patients suffering from severe intermittent claudication due to peripheral vascular disease. An increase in pain-free walking distance of more than 50% occurred in 6 of 11 patients after the iloprost infusions and in 7 of 12 patients after HES treatment. No significant effects on haemodynamic or clinical chemistry tests were observed.

Aged↗
PubMed1985

[Peripheral arteriosclerosis. Early diagnosis].

Pain ist not the major early symptom of peripheral vascular disease; often there is no pain at all or only with extreme physical load. Other frequently described symptoms are not characteristic. Thus even the most careful anamnesis is not entirely reliable. The simplest and quickest diagnosis is by the Doppler Ultrasonic method. The reactive hyperemia values obtained by venous occlusion plethysmography and tissue clearance with 133Xenon are also valuable in the diagnosis of beginning peripheral blood flow disturbances. Here the pulse curve analysis of the linear blood flow deserves special mention, important parameters being the peak-flow, the catacrote areal index, the peak delay, and the sum of pulse peak and pulse peak delay. The evaluation of cut-off values allows in a simple way to differentiate between normal, beginning pathological and clearly pathological conditions. However B-scanning and digital subtraction angiography will possibly be valuable supplementary procedures in future.

Arteriosclerosis↗
PubMed1985

[Effect of physical training on blood flow properties in patients with intermittent claudication].

Abnormal blood flow in patients with intermittent claudication can be normalized by physical training. We found a decrease in blood viscosity with a decrease in the erythrocyte-aggregation tendency and significant simultaneous improvement in erythrocyte filtrability. Improvement in these haemorheological properties led to a significant increase in physical performance after training. This positive result can be obtained by regular physical training; the application of rheologically effective medicaments is not necessary.

Adult↗
PubMed1984

[Naftidrofuryl in arterial occlusive disease. Controlled multicenter double-blind study with oral administration].

The efficacy of naftidrofuryl ( Dusodril ) for treatment of stage II arterial occlusive disease was evaluated in a controlled multi-centre study in a total of 104 out-patients with angiographically documented localization of occlusion. The therapeutic effect was assessed over three months by measurements of walking distance using standardized treadmill conditions. Further parameters were venoocclusive plethysmography and Doppler ultrasonography measurement of pressures. The complaint-free walking distance increased significantly during daily application of 600 mg naftidrofuryl orally (n = 54) during the 12-week assessment period when compared to the placebo group (n = 50). Taking the intraindividual variability of 17.2 m in assessment of walking distance into account, the increase of painless walking of 93 m after treatment for 12 weeks in the active-drug group is considered the result of treatment-induced increased performance.

Administration, Oral↗
PubMed1984

[Modification of blood coagulation and fibrinolysis through physical activity].

Physical conditioning appears to protect against the development of vascular disease. Although physical training often evokes favorable alterations in established cardiovascular risk factors, such as plasma lipids and lipoproteins, the metabolic sequelae of regular exercise that mediate a reduction in the risk of cardiovascular disease remain incompletely understood. Studies in recent years have shown physical training to have beneficial effects on blood coagulation and fibrinolytic activity. On general the data support the concept that blood clotting is potentiated by exercise. Mechanisms involved are an increased release of thromboplastine of tissue, increased coagulation with lactate accumulation during exercise, increased concentrations of plasma proteins owing to hemoconcentration, increased concentrations of specific clotting factors, e.g., Factor VIII and fibrinogen, and an alteration in platelet count and platelet function. The acceleration in coagulation is less in the well-exercised individual. There is evidence that an epinephrine mediated mechanism is responsible for the difference between individuals who have a lot of exercise and those who do not. Fibrinolytic activity seems to increase with exercise in a linear relationship with the heart rate during physical activity. An enhancement of the plasma fibrinolytic activity, stimulated experimentally by thrombotic stress such as venous occlusion, could be an important mechanism in the beneficial effect of habitual physical exercise on the risk of cardiovascular disease.

Arteriosclerosis↗
PubMed1984

Naftidrofuryl in chronic arterial disease. Results of a controlled multicenter study.

In a double blind, randomized multicenter study naftidrofuryl, a vasoactive substance, was compared with placebo in the treatment of 104 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either naftidrofuryl (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the difference in the improvement of the pain-free walking distance was significant (p less than 0.02) in favour of naftidrofuryl. There also was a difference in the improvement of the total walking distance in favour of naftidrofuryl which was not significant. The results indicate that naftidrofuryl has a beneficial effect on the symptoms and lengthens the painfree walking distance in patients with arterial occlusive disease.

Adult↗