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Biomedical subjects

H Mörl

Publications and source records attributed to H Mörl.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Calcium antagonists for the treatment of Raynaud's phenomenon].

The effectiveness of a new, nifedipine-like calcium antagonist (Bay K 9320) on the severity and frequency of episodic digital vasospasms was studied in a randomized double-blind trial of 24 patients (10 women, 14 men) with Raynaud's phenomenon. During the winter months the patients took one tablet three times daily for three weeks, each tablet either containing 20 mg of the calcium antagonist or a placebo. Three patients had collagen disease, 21 a primary form of Raynaud's phenomenon. Subjective improvement was reported by nine of twelve patients receiving the drug, while no improvement occurred in nine patients on the placebo. Light-plethysmography demonstrated under calcium antagonist treatment a reduction in the cold-provoked acral blood flow decrease more than four-fold compared with the unchanged value in the placebo group.

Adult↗
PubMed1983

Isosorbide dinitrate ointment in Raynaud's disease.

In a double-blind, cross-over study the efficacy of isosorbide dinitrate (ISDN) ointment was studied in 12 patients (eight men, four women) with vasospastic Raynaud's phenomenon during the winter. ISDN (200 mg) and placebo respectively were applied to the fingers three times a day for 3 weeks. The efficacy of the drug was judged by patients' reports on the number and duration of Raynaud's attacks, measurements of digital systolic pressures (Doppler method), and photoplethysmography of the fingers before and 3 min after local cooling in ice water. No difference in severity or duration of vasospastic attacks was found in patients treated with ISDN or placebo. There was only a slight, nonsignificant increase (+15%) in digital systolic pressure and amplitudes of digital pulse in the ISDN group. It was concluded that topical ISDN ointment seems to be ineffective for patients with Raynaud's phenomenon.

Blood Pressure↗
PubMed1983

[Effects of metoprolol on the peripheral circulation in patients with peripheral vascular disease].

Up to now betablockers were regarded as relatively contraindicated in patients with peripheral vascular disease (PVD). The effects of metoprolol were studied in hypertensive patients (stage I, WHO) with PVD of pelvic and thigh type (stage II according to Fontaine). An initial dose of 100 mg metoprolol followed by 100 mg 90 min after the first oral administration, twice a day was administered for 8 weeks. Blood pressure decreased from 181/105 to 163/96 mm Hg. Pulse rate was lowered from 72 to 68/min (p less than 0.001). Estimated doppler pressure in the posterior tibial artery decreased from 123 to 119 mm Hg. Venous occlusion plethysmography showed a slight but not significant decrease at rest and during reactive hyperemia. During long-term treatment the pain-free walking distance increased significantly from 225 to 348 m. No side effects were seen. Thus, metoprolol as a beta 1-selective betablocker is not contraindicated in patients with intermittent claudication.

Arterial Occlusive Diseases↗
PubMed1982

[Fibrinolytic therapy of lower limb deep vein thrombosis with urokinase (author's transl)].

In 81 patients with deep vein thrombosis of the lower limb, urokinase therapy was performed in combination with heparin according to a new regimen at higher dosages. When urokinase was administered at an initial maintenance dosage of 1,000-2,000 IU/kg/h (loading dose 150,000-250,000 IU), phlebographically documented complete or partial recanalization could be observed in 68% of the cases. The higher dosage schedule induced a more pronounced deobliteration especially in treatment of iliac vein thromboses (67% recanalization) in comparison to the lower dosage regimen (only 43% recanalization). Nearly comparable therapeutic results could be achieved in therapy of popliteal or saphenous vein thromboses. The data suggest that the higher dosage schedule examined here is indicated in treatment of extensive and large volume thromboses. The dosage of urokinase was further adjusted to attain a reduction of fibrinogen to 50-100 mg/dl. The concentration should not fall below 50 mg/dl. Therapy with urokinase proved practicable. Serious side effects did not occur. 8.6% of the patients showed hematuria and 6% a decrease of the Hb by more than 2 g/dl. The high proportion of older thromboses and the only low rate of recanalization (23%) in these cases suggest the necessity of an early commencement of fibrinolyses in therapy of deep vein thrombosis.

Anticoagulants↗
PubMed1981

[Peripheral arterial vasoocclusive disease: no absolute contraindication to beta receptor blockers (author's transl)].

An initial dosis of 40 mg followed by 40 mg propranolol (Dociton) t.i.d. for 4 weeks was administered to 16 hypertensive patients with manifest arterial vasoocclusive disease of the pelvic and thigh type (stage II according to Fontaine). Blood pressure decreased 90 minutes after the first oral administration from 174/106 to 155/93 mm Hg. Cardiac frequency was lowered significantly from 75 to 66/min. Occlusion plethysmography and Doppler pressure estimation were not changed significantly either in the acute nor in long-term assessment. The painfree walking distance remained constant 90 minutes after propranolol initially (baseline value 230 m, after 90 minutes 220 m). It rose to 330 m after two weeks and to 350 m after four weeks. Use of beta receptor blocker in arterial vasoocclusive disease is thus not contraindicated, at least as far as stage II is concerned.

Arterial Occlusive Diseases↗
PubMed1981

[Ambulant treatment of hypertension with cardiotensin (author's transl)].

A fixed combination preparation consisting of a betablocker and diuretics was tested in 25 outpatients suffering from essential hypertension grades I and II (WHO). The raised blood pressures of the placebo phase fell highly significantly to normal values in th course of the 8 weeks' treatment. The ergometric load testing under standardized conditions showed a significant reduction of blood pressure increase, a significant rise in load capacity, and a decrease in the pressure rate product. Apart from the increase in serum acid in one case, no clinically relevant changes in the laboratory values were observed. Tolerance was good. The side effects mentioned by 10 patients were mild and did not influence the course of treatment. Patient compliance, measured twice in th course of the trial by means of urine fluorescence, was very high (95%).

Adult↗
PubMed1981

Urokinase therapy of subclavian-axillary vein thrombosis.

In 18 cases with primary subclavian-axillary vein thrombosis fibrinolytic therapy was performed with urokinase in combination with heparin. The thrombolytic efficacy clearly depended on the thrombus age and the dose of urokinase applied. Under treatment with a median initial maintenance dosage of urokinase of 1,000-2,000 IU/kg/h (loading dose 150,000-250,000 IU urokinase) in combination with heparin (15-17 U kg/h) in mine of 11 patients (82%) with recently developed (8 days or less) thrombosis, a nearly complete deobliteration of the venous system was observed. In the case with thrombosis of more than 10 days no alteration of the venous occlusions could be seen. Relevant side effects did not occur. Our results emphasize urokinase therapy of acute subclavian-axillary vein thrombosis and permit general inferences concerning the efficacy and the dosage requirements of the thrombolytic substance urokinase.

Adolescent↗
PubMed1981

[Fibrinolytic treatment of severe thrombosis of the basilar artery (author's transl)].

Thrombosis of the basilar artery occurred in a 27-year-old woman after physical exercise (bowling). She became deeply unconscious without change so that four days after onset urokinase was administered. The neurological status than markedly improved, with partial regression of the paresis and the cranial nerve deficits, and she became responsive again. Angiography after four-day urokinase administration demonstrated complete recanalisation of the basilar artery. Subsequent rehabilitative measures led to almost complete disappearance of all symptoms. Later neurological tests revealed merely very discrete left hemiparesis, mainly of the arm.

Adult↗
PubMed1981

Plasma C-peptide and insulin in trained and untrained subjects.

Plasma insulin and C-peptide were simultaneously determined under various conditions in 11 endurance-trained athletes and 12 nonathletes. Both groups performed an exhaustive ergometer test and an endurance test with 38% of the maximal achieved work load for 45 min. An intravenous glucose tolerance test was also performed. In the basal state, athletes had low plasma insulin and C-peptide concentrations. During exercise, insulin and C-peptide decreased similarly in both groups. In the recovery period, insulin and C-peptide rose within a few minutes. There were differences between the extent as well as the time course of this "rebound" effect after exhaustive or endurance exercise that might be related to glucose alterations. The insulin response but not the C-peptide response after glucose injection was blunted in trained subjects. Results indicate that basal plasma insulin concentrations are lower in athletes due to reduced insulin secretion. During exercise, insulin secretion is diminished independent of the training state. The blunted response of insulin after glucose administration in athletes is due to an enhanced plasma clearance.

Adult↗