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Biomedical subjects

J N Fiessinger

Publications and source records attributed to J N Fiessinger.

At least 181 records · Page 10Linked to original sources
PubMed1986

Complications of intraarterial urokinase-lys-plasminogen infusion therapy in arterial ischemia of lower limbs.

Thirty-five patients with peripheral arterial occlusions were treated by intraarterial infusion of low-dose urokinase associated with bolus of lys-plasminogen. Thrombolysis was achieved in 26 cases (74%), but only 10 patients (28.5%) experienced sustained improvement. Complications of thrombolysis occurred in 11 patients: Five patients developed groin hematoma, five had distal emboli, and one experienced macroscopic hematuria. Catheter-related thrombosis was observed in 14 patients (40%) despite intravenous heparin. Nine patients suffered from recurrent thrombosis and three from proximal emboli. A patient died from catheter-related infection. Limited fibrinolysis could increase pericatheter thrombosis, and further work will be necessary to assess the local risk of intraarterial thrombolysis.

Adult↗
PubMed1986

[Low-molecular weight heparins. Prospects in 1985].

Interaction of low molecular weight heparin (LMW-Hep) along with coagulation system is characterized through an increase of the proportion between activity anti-Xa and anticoagulation activity. In animals, their antithrombotic role can be compared with the heparin one. Longer life of the biological effect (close to 100 p. 100) enables to act subcutaneously as well as to reduce posology: only one injection is then required so as to prevent from post-operative thrombosis. There are neither method nor international standard to control preparations efficacy. At the moment, posologies are better to be expressed in mg. Trials are assessed in the treatments of thrombosis with results increasing therapeutic efficacy. Too high posologies did supply hemorrhagic syndromes in surgical patients. A biological survey is thus required. As usual tests, such as "time" of cephalin are slightly sensible to LMW-Hep, only anti-Xa activity can be used. LMW-Hep with a low anticoagulant action thus demonstrate a new concept of antithrombotic therapy.

Animals↗
PubMed1986

[Treatment with the urokinase-lysyl plasminogen combination of developmental outbreaks of arteriopathies].

Thirty patients with acute severe lower limb arterial obstruction were treated with local administration of low dose Urokinase associated with Lysyl Plasminogen. Fifty-three per cent primary and 40 p. 100 secondary successes were obtained with few complications but one death due to cerebral embolism related to the catheterisation procedure. This intra-arterial therapeutic association seems to be as effective as local streptokinase infusion, but it is much better tolerated than other forms of treatment. It could be the treatment of choice in acute occlusive arterial disease of the lower limbs providing the therapeutic indications are strictly respected.

Adult↗
PubMed1986

[Phlebitis of the arm. Apropos of 45 cases].

We report in this retrospective study the data of 45 patients presenting with deep venous thrombosis of the upper extremities. This includes: 22 phlebitis due to strains, 3 traumatic phlebitis, 3 phlebitis combined with an adjacent injury, 7 phlebitis following endovenous therapeutic procedures and 10 spontaneous phlebitis (4 during adjacent medical pathologies), 3 pulmonary embolisms, including a septic one are thus demonstrated. No patient died. The follow-up date of 12 patients out of 32 exhibiting a spontaneous phlebitis or phlebitis due to a thoracic outlet syndrome have been documented: 25 p. 100 of them still presented with severe injuries. All patients underwent heparin therapy, but no fibrinolytic. A surgical procedure of the thoracic outlet syndrome was performed, when liable to the disease. Data of this series was then compared with those of previous reports on the subject.

Adult↗
PubMed1986

[Hereditary deficit of antithrombin III].

Antithrombin III is a well-known coagulation inhibitor. Its heterozygous deficit is demonstrated through concentrations reduced about by 50 p. 100. On a clinical level, about 40 p. 100 to 70 p. 100 patients present with deep venous thrombosis (visceral on the whole) and pulmonary embolisms from puberty. There are both qualitative and quantitative deficits, these appearing to be mostly frequent. Only calculation of activity in the presence of heparin (co-factor of heparin) enables to diagnose these two types of deficits. Treatment performed includes both AT III concentrated agents and heparin in severe cases. Recurrences prevention is performed thanks to antivitamins K. If surgical treatment or delivery, a prevention of any incidents thanks to a vicarious therapy (AT III concentrated agent) is to be used.

Adult↗
PubMed1985

A functional abnormal antithrombin III (AT III) deficiency: AT III Charleville.

An antithrombin III (AT III) functional defect (AT III Charleville) was discovered in a patient presenting with recurrent venous thrombosis. Both anti-activated factor X (anti Xa) and antithrombin activity were decreased, in the absence and in the presence of heparin, while protein concentration was normal in an immunological assay. The abnormal AT III copurified with functional AT III using insolubilized heparin affinity chromatography. Polyacrylamide gel electrophoresis (PAGE) and high pressure liquid chromatography (HPLC) on a TSK column suggest that AT III Charleville forms unstable complexes with thrombin from which a modified protein is rapidly released.

Adult↗
PubMed1985

[Biological profile of the 1st 4 hours of a thrombolytic treatment combining urokinase with lysyl-plasminogen].

The authors study the biological variations which accompany an oral, thrombolytic treatment in which urokinase and lysyl-plasminogen are combined. Fibrinogen, the products of degradation of fibrinogen or fibrin, plasminogen and rapid alpha 2 antiplasmin are studied as a function of time. Two dimensional electrophoreses were carried out at precisely determined times. The combination of the two therapeutic agents causes the appearance of plasmin in the circulation, but it is neutralised by its rapid inhibitor. This therapeutic protocol entails moderate circulating fibrinolysis and may easily be monitored by determination of the circulating fibrinogen.

Acute Disease↗
PubMed1985

Surface healing and histologic maturation of patent polytetrafluoroethylene grafts implanted in patients for up to 60 months.

Histologic, transmission, and scanning electron microscopic observations were made of 26 biopsy specimens from patent polytetrafluoroethylene grafts that had been implanted as arterial bypasses for up to 60 months. The results showed the rarity of host connective tissue ingrowth, the absence of neovascularization, and the limited neointimal proliferation. The defect of staining for factor VIII-related antigen by immunohistochemistry confirmed the absence of true endothelial cells at a distance from the anastomoses. Under electron microscopy the thin neointimal layer consisted mainly of fibrin, platelets, blood cells, and cellular debris. Even in prostheses implanted for the longest periods, mature collagen and elastin were not found. Tubular microfibrils (9- to 12-nm thick) could be observed. The source of such microfibrils, probably glycoproteins, remains under investigation.

Adult↗
PubMed1985

[Results of in situ arterial thrombolysis by the combination of urokinase and lysyl plasminogen in acute arterial occlusive diseases of the lower limbs].

35 patients with acute arterial occlusions [27] and graft thromboses [8], responsible for severe and recent ischemia, were treated by fibrinolytic therapy (Urokinase: 1 000 units/kg/hour, and Lys Plasminogen). These drugs were delivered at the site of occlusions using a 5 French catheter. Angiographically, initial success was obtained in 30 patients (85%) and a significant clinical benefit persisted 5 months later, in 20 patients (57%). 4 distal embolisms during the treatment were noted, and one woman died a few hours after the withdrawal of an axillary catheter of a cerebellar infarction. Only two minor (6%) and one severe (3%) groin hematoma were encountered. No patient had at any moment a fibrinogen concentration lower than 1 g/l. Thus, the thrombolytic treatment used in the study appears as effective as locally administered Streptokinase but better tolerated.

Acute Disease↗
PubMed1985

Relationship between nailfold capillary microscopy and salivary capillary basement membrane width in Raynaud's disease and progressive systemic sclerosis.

To assess the relationship between a nailfold scleroderma pattern and histopathological data, we compared the results of nailfold capillaroscopy with capillary basement membrane width of labial salivary glands in 25 patients with either a Raynaud's disease (RD: 12 patients) or a progressive systemic sclerosis (PSS: 13 patients). The sensitivity of a capillaroscopic scleroderma pattern for capillary basement membrane thickness is of 75%. These results confirm the usefulness of in vivo capillary examination for the early diagnosis of PSS.

Adolescent↗