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Biomedical subjects

K Koppenhagen

Publications and source records attributed to K Koppenhagen.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Different effectiveness of two preparations of low molecular weight heparin in patients with elective hip joint replacement].

In an open randomised trial 3 regimen of prophylaxis for deep vein thrombosis were compared in 105 patients undergoing elective hip arthroplasty. One part of the patients received one injection daily of a low molecular weight heparin, another part was treated with one injection of a combination containing a different type of low molecular weight heparin + dihydroergotamine per day and a third part of the patients received 3 applications of 5000 IU unfractionated heparin per day. The frequency of DVT determined by the 125iodine-labelled fibrinogen uptake test and phlebography was 22.9% in patients receiving the combination and 50.0% in those receiving the low-molecular weight heparin alone. The difference was statistically significant with 2 p = 0.03. The incidence of DVT in patients receiving unfractionated heparin was 30.6%. No difference in the development of bleeding complications was found between the three treatment groups.

Adult↗
PubMed1991

[The hemodynamic effects of isradipine and nifedipine in hypertension].

Hemodynamic Effects of Isradipine and Nifedipine in Hypertension Myocardial wall tension is an important determinant of the oxygen demand, the function and the degree of hypertrophy of the left ventricle. Myocardial wall tension should be influenced more favourably by a non-cardiodepressive antihypertensive than by a potentially cardiodepressive one. Therefore, we investigated the effects of an intravenous infusion of the calcium antagonists isradipine (I; 0.4 mg; 3,5-pyridinecarboxylic acid, 4-[benzofurazanyl]-1,4-dihydro-2,6-dimethyl-,methyl-ethylester+ ++ [9CI]; CAS75695-93-1) and nifedipine (N; 2.0 mg) resp., on hemodynamics and myocardial wall tension in 12 hypertensives by an intraindividual comparison. The adrenergic reflex activation induced by vasodilation was limited by pre-medication with 0.1 mg propranolol/kg body weight (i.v.) before application of I and N. Baseline blood pressure of the patients and its changes in response to both calcium antagonists were statistically comparable, as were the left ventricular end-diastolic volumes. The end-systolic volumes, however, decreased significantly on I but not on N: before I: 69 +/- 7.0 (mean +/- standard error), after I: 61 +/- 6.1 ml, 2p less than 0,001; before N: 62 +/- 6.1, after N: 64 +/- 7.0 ml, n.s. (difference to I: 2 p less than 0.05). Stroke volume increased only on I (before I: 62 +/- 4.1, after I: 69 +/- 4.1 ml, 2p less than 0.001; before N: 64 +/- 3.5, after N: 65 +/- 3.8 ml, n.s. (difference to I: 2p less than 0.05)).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Prevention of thrombosis with low molecular weight heparin as the only substance and/or with DHE: results of clinical studies].

In aspect of the high incidence of thrombosis and the resulting risk of fulminant pulmonary embolism and late complications, there is a demand for a general medical prophylaxis in operative medicine. A new chance to reduce the incidence of thrombosis is the recently developed low weight molecular heparine (LWMH). Current studies of different LWMH in general and thoracic surgery prove, that an effective decrease of thrombosis can be achieved with a single daily injection. Effectiveness of LWMH in high risk patients have not been sufficient evaluated yet in some of the used preparations.

Dihydroergotamine↗
PubMed1990

[The evaluation of 123I-MIBG scintigraphy in medullary thyroid carcinoma (MTC)].

The diagnostic value of 123-I-MIBG (meta-iodobenzylguanidine) scintigraphy was investigated in six patients with recurrence and/or metastatic spread of a medullary thyroid carcinoma. In no case was there MIBG storage in tumor tissue. Thus, our results show that MIBG scintigraphy is not suitable as a screening method either in the primary diagnostics or the follow-up of medullary thyroid carcinoma. If, however, inoperable metastases have been detected by other diagnostic methods, MIBG scintigraphy is indicated in order to test a potential therapeutic application in these patients. In the imaging diagnostics and follow-up of medullary thyroid carcinoma, the examination with 99mTc(V)-DMSA (technetium-99m-dimercaptosuccinate) is markedly superior to MIBG scintigraphy. High-resolution cervical sonography is of major importance in the hands of an experienced examiner.

3-Iodobenzylguanidine↗
PubMed1989

Radioimmunoscintigraphy of ovarian cancer with 131-iodine labeled OC-125 antibody fragments.

Radioimmunoscintigraphy (RIS) with 131I labeled OC-125 F(ab')2 monoclonal antibody fragments was prospectively studied in 43 women for primary diagnosis and follow up of ovarian cancer. Total body planar photoscans with a scintillation camera were performed one to seven days after antibody application and results were compared with operation and or CT examination. By the region of interest technique the tumor to non tumor tissue ratio (T/N) was calculated in vivo. Sensitivity in primary diagnosis was 100% (10/10), specificity 33% (1/3). For local recurrency, sensitivity was 86% (19/22), for metastatic loci 80% (17/21). Specificity was 75% and 50%. T/N ratio was in the rage from 1.3 to 2.8. Sensitivity for ovarian cancer is high in primary diagnosis and follow up. By the region of interest technique it is possible to detect small recurrencies and to presume peritoneal carcinosis. Antibody accumulations in diseases different from ovarian cancer however diminish specificity.

Adult↗
PubMed1988

False-positive granulocyte scintigraphy in a patient with acute leukemia.

This study describes a 12-year-old patient who was hospitalized because of arthritislike symptoms. A scintigraphy performed with in vivo labelled granulocytes revealed, in addition to a few foci, an abnormal intravasal persistence of the labelled cells. An acute leukemia was found that was restricted to the bone marrow.

Acute Disease↗
PubMed1988

Antithrombotic defense during the postoperative period. Clinical documentation of low molecular weight heparin.

The incidence of postoperative thromboembolic complications depends on the type of basic disease, the surgical procedure as well as on various additional risk factors. Without perioperative prophylaxis about 10 to 70% of the patients develop deep vein thrombosis (DVT). After an extensive description of different methods to diagnose DVT, the practical use of the radiofibrinogen uptake test is illustrated by means of a clinical trial on low molecular weight heparin (LMWH). The study consisted in a randomized comparative trial on the peri-/postoperative thrombotic prophylaxis with LMWH 2,500 U s.c. once daily and unfractionated heparin (UFH) 5,000 U s.c. twice daily. 231 patients were recruited from the field of elective surgery and were characterized by a comparatively high postoperative risk of thrombosis. The medication of heparins was supplemented by dihydroergotamine (DHE) 0.5 mg s.c with the advantage to measure the prophylactic potential of short-chain heparin in comparison with UFH/DHE as a highly active antithrombotic regimen. The duration of prophylaxis with applications at 12- and 24-h intervals, respectively, covered a period of at least 7 days. Diagnosis of leg vein thrombosis was performed with the radiofibrinogen uptake test. Under standard prophylaxis with UFH/DHE twice a day 14 patients suffered postoperative thromboses, while with LMWH/DHE once a day only 4 patients suffered thromboses (p less than 0.025). Bleeding complications (wound hematome, re-operations, postoperative blood loss) were equally frequent in both groups and were in the normal range. Other side effects, in particular peripheral vasospasms and anginal attacks, were not observed.

Adult↗
PubMed1986

Low molecular weight heparin plus dihydroergotamine for prophylaxis of postoperative deep vein thrombosis.

In a prospective, double-blind investigation of the prophylaxis of deep vein thrombosis (DVT) in patients undergoing elective major abdominal surgery, 269 patients were randomized into two groups. One hundred and thirty-two patients received a fixed combination of heparin sodium 5000 units plus dihydroergotamine mesylate 0.5 mg (H/DHE) twice a day and 137 patients received a fixed combination of low molecular weight heparin 1500 units plus dihydroergotamine mesylate 0.5 mg (LMWH/DHE) once a day as well as one injection of placebo per day. Treatment was initiated 2 h pre-operatively in both groups and continued for 7-10 days. The frequency of DVT determined by the 125I-labelled fibrinogen uptake test and phlebography was 10.3 per cent in patients receiving H/DHE and 10.4 per cent in those receiving LMWH/DHE. DVT of the femoral vein was detected in four patients of the H/DHE group and in none of the LMWH/DHE group. Intra- and postoperative blood loss did not differ significantly between both groups. Also no difference in the development of wound haematoma and injection site haematoma was found. While intra-operative volume substitution was comparable in both groups, significantly more patients under H/DHE prophylaxis received volume substitution during the postoperative phase. These results show that once-daily prophylaxis with the combination of low molecular weight heparin and dihydroergotamine is equally as effective and as safe as the twice-daily regimen using a combination of unfractionated heparin and dihydroergotamine in patients undergoing elective, major abdominal surgery. The advantages of the once-daily regimen of LMWH/DHE include greater patient acceptance, less nursing time and greater cost effectiveness, provided the new combination can be sold at a cost which maintains this advantage.

Abdomen↗
PubMed1986

[Prevention of thromboembolism with heparin-DHE--safety and trends].

Perioperative thrombosis prophylaxis with low dose heparin-DHE. Efficiently protects against thromboembolic complications. Side effect such as haemorrhage or vasospasms are rarely seen. The known contraindications of DHE have been respected strictly. The latest development is low molecular heparin which has been tried out and evaluated on the ground of a controlled double blind study of 259 patients undergoing general surgery. The study shows the following advantages: thrombosis prophylaxis by one injection pro die only. This means less work for the staff and lower costs. Further studies on low molecular heparin are necessary.

Adult↗
PubMed1985

Clinical comparison of 99mTc-HMDP and 99mTc-MDP. A multicenter study.

99mTc-Hydroxymethylene diphosphonate (HMDP) was compared to 99mTc-methylene diphosphonate (MDP) with respect to image quality, lesion detectability, and the uptake ratios of normal bone to soft tissue (B/S), metastatic bone to soft tissue (M/S) and bone metastases to normal bone (M/B) at 2 and 3 h after injection in the same subjects. Thirty-three patients with bone metastases were examined in six nuclear-medicine departments, with each center using its usual bone-scanning protocol which was identical for both compounds in the same patient. The uptake of 99mTc-HMDP in normal bone (B/S) was significantly higher than that of MDP at 2 and 3 h, but there were no significant differences between the two compounds with regard to the M/S or M/B ratios. The M/B of HMDP at 2 h was not significantly different from that of MDP at 3 h, the latter showing a significantly higher B/S and M/S ratio. All lesions were detected with both compounds, even at 2 h. The image quality was rated as follows (in decreasing order): HMDP (3 h), MDP (3 h), HMDP (2 h), and MDP (2 h). HMDP was shown to be a useful bone-imaging agent, especially when shorter intervals between injection and recording are required.

Adult↗
PubMed1985

Clinical experience with the tumor marker Ca 19-9 in an unselected group of more than 300 tumor patients.

Since March, 1983, in vitro tests for the quantitative determination of the tumor-associated antigen Ca 19-9 (carbohydrate antigen 19-9) were performed in more than 300 patients with confirmed tumors. These tests had as a goal determination of the diagnostic value of this new potential tumor marker Ca 19-9 with regard to specificity and sensitivity of malignant growths in the gastrointestinal tract, breast, and lung. The applicability of Ca 19-9 RIA in posttherapeutic case control for early registration of recurrences and metastases was examined. First analyses of our patient collective confirmed the assumption that increased serum concentrations of Ca 19-9 are detectable in gastrointestinal tumors as well as in mammary and bronchial carcinoma. Thus Ca 19-9 is a nonspecific tumor-associated antigen that by itself does not allow an organ correlation of malignancies of the gastrointestinal tract, breast, and lung.

Antigens, Neoplasm↗
PubMed1984

[Central hemodynamics of antihypertensive agents. Studies on co-dergocrinmesylate].

The haemodynamic effects of a three-week-treatment with 4-8 mg co-dergocrinmesylate (Hydergin spezial) were investigated in 14 hypertensive patients with a mean age of 58 years and reduced ventricular function (exertional dyspnoea, enlarged cardiac opacity). Blood pressure values at rest and during physical exercise were reduced significantly. Marked cardiac relief was induced manifesting as decrease of enddiastolic and endsystolic volumes and at the same time as an increase of ejection fraction. Cardiac output remained largely constant, lowering of blood pressure was exclusively due to alteration of peripheral total vascular resistance. Cardiac frequency decreased significantly. There was no evidence of negative inotropic effects. Systolic wall tension as the main therapeutic target decreased at rest and during ergometry by 20% and 25%, respectively. Renal perfusion increased slightly, but significantly, in all patients.

Aged↗
PubMed1984

A randomized study of a semisynthetic heparin analogue and heparin in prophylaxis of deep vein thrombosis.

The prophylactic effect of a semisynthetic heparin analogue (SSHA) on deep vein thrombosis was investigated in a prospective double-blind multicentre trial. 440 major general surgical and gynaecological patients were randomized to one of three treatment groups: 50 mg SSHA, 37.5 mg SSHA and 5000 units sodium heparin subcutaneously 12-hourly. Deep venous thrombosis (DVT) was diagnosed with the fibrinogen uptake test and verified with phlebography. Bleeding complications and other side-effects were carefully monitored. There were no significant differences between the three treatment groups of patients in age, sex, type of operation or risk factors. A DVT was diagnosed in 16 patients (12 per cent) in the SSHA 50 mg group, in 21 patients (15 per cent) in the SSHA 37.5 mg group and 21 patients (14 per cent) in the heparin-treated group. No significant differences were found in the number of patients who bled unexpectedly in the postoperative period, required transfusion or developed wound haematomas. Blood loss at operation was similar in all three groups. Three pulmonary emboli were diagnosed by pulmonary scintigraphy, one in each group.

Adult↗
PubMed1984

10 years experience with consecutive measurement of thyrotropin binding inhibiting antibodies (TBIAb).

In the present study we reviewed 230 patients in whom thyrotropin-binding inhibiting antibodies (TBIAb) follow-up determinations had been performed up to 10 yr after hyperthyroidism had first developed. In 104 patients, Graves' ophthalmopathy occurred at some time in the course of the observation period. Fourty-four of these patients with Graves' ophthalmopathy had at least one, and up to four relapses after each one-year course of antithyroid drug therapy with methimazole. The addition of TBIAb-positive results over an observation period of 1-10 yr showed positive cumulative findings in 95% of the 44 patients with recurrences of Graves' disease. A single TBIAb determination during hyperthyroidism showed positive results in 70%. A detailed breakdown showed that TBIAb was detectable during all hyperthyroid phases in 48% of the patients with ophthalmopathy. Thirty-four per cent of the patients had sometimes positive, sometimes negative TBIAb findings in the various hyperthyroid states. In 18% of the patients, TBIAb was not detected in any of the hyperthyroid phases. However, some of these patients became TBIAb-positive for the first time during antithyroid drug therapy or during a remission confirmed by a suppression test. Only 2 of the 44 patients never had TBIAb positive results at any time during the observation period. In those patients without ophthalmopathy during the observation period, the "cumulative" frequency of TBIAb was 74% for patients with diffuse goiter and 52% for patients with diffuse-nodular goiter. However, in patients with ophthalmopathy, there was no difference in TBIAb detectability between those patients with a diffuse and those with a diffuse-nodular thyroid.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1984

Cerebral blood flow under hypobaric conditions: effects of pentoxifylline ('Trental' 400).

A single-blind, crossover study was carried out in 9 healthy subjects to investigate the effect of a single dose of 2 tablets of 400 mg pentoxifylline ('Trental' 400) or placebo on cerebral blood flow, cerebral perfusion quotient and mental functions under experimental hypobaric conditions. Subjects were exposed in a low pressure chamber to simulated atmospheric pressures at sea level, 4000 and 7000 metres, and tests were performed 2 hours after intake of the dose, using 99m technetium brain scintigraphy and psychometric tests, to assess acutely induced impairment of cerebral function. After placebo, cerebral blood flow was decreased, especially at the 7000 metre level, whereas there was significantly less decrease after pentoxifylline. The perfusion quotient was normal throughout the pentoxifylline period but was outside the normal range in 8 of the 9 subjects after placebo. Psychometric testing showed better performance by the subjects after drug than after placebo intake. The results suggest that pentoxifylline may protect cerebral blood flow, nutrition and function under impaired supply conditions.

Adult↗
PubMed1984

[Non-invasive determination of left ventricular ejection fraction using a mobile ECG-triggered scintillation measuring probe. Comparison of cineventriculography, echocardiography and radionuclide ventriculography].

In 29 unselected patients, the left ventricular ejection fraction was evaluated using a mobile ECG-gated scintillation probe (Nuclear Stethoscope) after in vivo labeling of the erythrocytes with 15 mCi technetium-99m. To validate the method, the Nuclear Stethoscope measurements were correlated to the results of: 1. Single-plane contrast cineventriculography in the right and left anterior oblique projections (RAO, LAO), 2. Radionuclide ventriculography with a gamma camera computer system, 3. Two-dimensional echocardiography from the apical two- and four-chamber views. The ejection fraction measured by the Nuclear Stethoscope showed a close correlation to the values obtained by cineventriculography in the RAO projection (r = 0.748) and radionuclide ventriculography (r = 0.785). In this group of unselected patients, the correlations with the results of two-dimensional echocardiography were poor (r = 0.451 and 0.557). Cineventriculographic findings and radionuclide ventriculography correlated well (RAO: r = 0.786; LAO: r = 0.758). The Nuclear Stethoscope provides a simple, reliable, and noninvasive method for measuring ventricular ejection fraction. Ongoing studies indicate that the Nuclear Stethoscope is a valid method even at a lower dose of 5 mCi technetium-99m.

Cardiac Output↗