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Biomedical subjects

M Köhler

Publications and source records attributed to M Köhler.

At least 199 records · Page 11Linked to original sources
PubMed1987

[Doppler ultrasound determination of maximal blood flow velocity in the diagnosis of peripheral arterial occlusive diseases in diabetes mellitus].

Seventy-five diabetic and 40 nondiabetic subjects who were suffering from peripheral vascular disease were studied in order to determine whether the degree of the severity of their disease can be better calculated by Doppler ultrasound examinations of the peak velocity than by the systolic pressure of the peripheral bloodstream. In 46 examinations of normal controls the mean value of the peak velocity was 13.3 +/- 3.3 cm/s with a standard deviation of 15.4% +/- 13.2% on one day and 16.1% +/- 15.9% on different days. Considering patients with or without diabetes mellitus the velocity was significantly decreased in correlation to an increasing degree of severity of the vascular disease (P less than 0.001); however, the decrease was lower in diabetic than in nondiabetic subjects (6.9 +/- 2.8 vs 4.6 +/- 6.2, P less than 0.05). The systolic pressure hardly decreased, but remained higher in all stages of peripheral vascular disease of diabetics than in the nondiabetic subject (P less than 0.05 to P less than 0.005). There was a significant decrease of the systolic pressure only in diabetic subjects with the most advanced degree of the disease, i.e. stage IV (P less than 0.05). It is concluded from this study that Doppler ultrasound measurements of the peak velocity of the peripheral bloodstream are a useful parameter to calculate the degree of severity of the peripheral vascular disease. In addition, it is concluded than peak velocity is an even better prognostic indicator of peripheral vascular disease than is measurement of the systolic blood pressure at the feet.

Arterial Occlusive Diseases↗
PubMed1987

Lymphocytic plasmocytoid lymphoma with a three-banded gammopathy: reactivity of one of these paraproteins with cytomegalovirus.

We report the case of a 70-year-old woman suffering from small lymphocytic, plasmocytoid lymphoma with abdominal lymphomas and infiltration of the lung and the bone marrow. A three-banded, IgG lambda, IgM lambda and IgA lambda-paraproteinemia was determined using immunofixation. Because of the patient's high antibody titre against cytomegalovirus (CMV), the possible reactivity of these paraproteins with CMV was studied. The immunoglobulins were transferred to nitrocellulose sheets by a contact diffusion blotting system. CMV was applied to these sheets and the IgG lambda-paraprotein was shown to bind CMV. The reactivity of only one of the paraproteins with CMV suggests an oligoclonal origin of this gammopathy. In addition to the malignant disease an abnormal immune response to a CMV infection could be the cause of this three-banded gammopathy.

Aged↗
PubMed1987

High-dose systemic streptokinase and acylated streptokinase-plasminogen complex (BRL 26921) in acute myocardial infarction: alterations of the fibrinolytic system and clearance of fibrinolytic activity.

We report the results of two consecutive studies using intravenous bolus injections of streptokinase (SK) or acylated plasminogen-SK complex (BRL 26921) in patients with acute myocardial infarction (AMI). In the first study, 20 patients received either 750,000 units (U) SK (group IA, n = 10) or 1,500,000 U SK (group IB, n = 10) within 5-10 min intravenously. In the second study 10 consecutive patients received 750,000 U SK within 15 min (group IIA) intravenously. The following 10 consecutive patients received 30 mg BRL 26921 within 2 min (group IIB). Early reperfusion was found in 16 patients in the first study (8 in each group) and in 18 patients in the second study (9 in each group). The decrease of fibrinolytic activity was biphasic with a half-disappearance time of 112.5 min for BRL 26921 and 31 (IA) and 18 (IB) min for SK. alpha 2-Antiplasmin depletion and a decrease of fibrinogen was observed with no differences after bolus injections of SK and of BRL 26921.

Aged↗
PubMed1987

Measurement of factor VIII procoagulant antigen in normal subjects and in hemophilia A patients by an immunoradiometric assay and by an enzyme-linked immunosorbent assay.

Factor VIII coagulant antigen (FVIII:Ag) and FVIII coagulant activity (FVIII:C) were measured in 102 healthy individuals, in 5 hemophilia A carriers and in 21 hemophilia A patients before and after infusion of heat-treated high-purity FVIII concentrates. Factor VIII:Ag was determined by a solid-phase micro enzyme-linked immunosorbent assay (ELISA) using monoclonal antibodies and by a conventional solid-phase immunoradiometric assay (IRMA). Factor VIII:C was assessed using a one-stage assay. The micro ELISA was decidedly more precise than the IRMA. There was a close correlation between the results obtained by the three assays in the plasma of healthy subjects and in hemophilia A carriers. After transfusion of FVIII concentrates to hemophilia A patients, the FVIII:Ag recoveries were significantly lower than the FVIII:C recoveries and the biological half-life of FVIII:Ag was significantly shorter than for FVIII:C. The calculated half-life of FVIII:C was longer than in any previous study.

Adolescent↗
PubMed1986

Factor VIII: C (FVIII: C) recovery and half-life after infusion of steam-treated high purity factor VIII concentrate in severe hemophilia A--comparison of one-stage assay, two-stage assay and a chromogenic substrate assay.

Factor VIII:C recovery and half-life was measured in 16 hemophilia A patients under comprehensively standardized conditions. Each patient received the same lot of a steam-treated high purity FVIII concentrate at a dose of 19-33 U/kg body weight. A comparison was made between the one-stage assay, the two-stage assay and a chromogenic substrate test for FVIII:C determination using a FXa-sensitive chromogenic substrate. Factor VIII:C potency of the administered FVIII concentrate was measured using calibration curves derived from a concentrate standard and FVIII:C plasma levels were read from calibration curves derived from a plasma standard. The chromogenic assay showed a good reproducibility at FVIII:C levels between 0.015 and 0.50 U/ml. The FVIII:C recoveries calculated from the results of the one-stage assay, the two-stage assay and the chromogenic substrate test were 109 +/- 20, 92 +/- 14 and 81 +/- 11% (mean +/- SD), respectively. The elimination half-lives of FVIII:C were calculated by non-linear least square analysis using a modified computerized Gauss-Newton algorithm. The half-lives calculated from the FVIII:C plasma levels measured by the one-stage assay, the two-stage assay and the chromogenic test were 23.8 +/- 6.4, 22.2 +/- 5.7 and 17.1 +/- 4.8 h (mean +/- SD), respectively. No previous study has reported such long half-life values. Our findings indicate that measurements of recoveries and half-lives by the chromogenic FVIII:C assay and by computerized non-linear least square analysis allow the possibility of individualized FVIII replacement therapy.

Adolescent↗
PubMed1986

Dose response relationships of anticoagulant activities after subcutaneous administration of two low molecular weight heparins in healthy individuals.

This study was performed to estimate appropriate dosages of two low molecular weight heparins (LMWH) for clinical trials on subcutaneous perioperative thrombosis prophylaxis. Anticoagulatory activities and platelet function were investigated after single doses of two LMWH and of unfractionated sodium heparin (UFH) in 24 healthy individuals. Twelve subjects received subcutaneous injections of 1000, 1500, and 2500 i.u. (aPTT) of LMHW 1, and the other 12 received LMWH 2 at same dosages. The following parameters were determined before 30 min, 1 h, 90 min, 2 h, 3 h, 4 h, 6 h, 8 h, and 10 h after either LMWH or 5000 i.u. (aPTT) UFH: aPTT, thrombin time, anti-Xa activity (S 2222, Coatest heparin), and anti-IIa activity (Chromozym TH). Bleeding time, platelet count, and adrenalin-, collagen-, and ADP-induced platelet aggregation were assessed before and 3 h after administration. After application of 1500 i.u. LMWH 1 and LMWH 2, the anti-Xa and anti-IIa levels were already significantly higher than after 5000 i.u. UFH. 2500 i.u. LMWH 1 and LMWH 2 evoked significantly greater prolongations of aPTT and thrombin time values than did 5000 i.u. UFH. This was not the case after 1000 and 1500 i.u. LMWH. The half-lives of anticoagulatory effects after LMWH were markedly longer than after UFH. Platelet function was not altered by any of the heparins tested. Our results indicate that LMWH cause anticoagulatory effects in vivo that cannot be predicted by in vitro studies and that the appropriate single dosages of LMWH in subcutaneous perioperative thrombosis prophylaxis have to be estimated by dosage determinations in healthy subjects.

Adult↗
PubMed1986

Comparative study of intranasal, subcutaneous and intravenous administration of desamino-D-arginine vasopressin (DDAVP).

This study was performed to evaluate the influence of different routes of administration on the efficacy of DDAVP treatment. Ten healthy volunteers received DDAVP intranasally (i.n.), subcutaneously (s.c.) and intravenously (i.v.) in a randomized cross-over trial. Factor XII and high molecular weight (HMW)-kininogen levels increased only slightly after DDAVP administration. The mean increase of factor VIII: C was 3.1 (i.v.), 2.3 (s.c.), and 1.3 (i.n.) - fold over baseline. Ristocetin cofactor (von Willebrand factor antigen) increased 3.1 (2.5), 2.0 (2.3) and 1.2 (1.2) - fold over baseline mean values after i.v., s.c. and i.n. DDAVP, respectively. The half-disappearance time of factor VIII and von Willebrand factor (vWF) after DDAVP ranged from five (factor VIII:C) to eight hours (vWF). The mean increase of fibrinolytic activity was more pronounced after i.v. DDAVP. The antidiuretic effect was moderate with no apparent differences between the routes of application. This study provides further evidence that both i.v. and s.c. DDAVP administration result in an appropriate and reliable stimulation of haemostasis. An additional advantage of s.c. administration is its suitability for home treatment.

Adult↗
PubMed1986

[Prevention of nausea and emesis during cytostatic therapy. Antiemetic efficacy of high-dosage oral metoclopramide without and with prednisone].

In a randomized trial of 58 cancer patients receiving strongly emetogenic cytostatic drugs (cisplatin or comparable cytostatic agents, alone or in combination), the anti-emetic action of oral metoclopramide was tested, alone or combined with prednisone. Patients of group A (33 during 46 treatment cycles) received three times 50 mg metoclopramide and three times 25 mg prednisone. Those of group B (25 patients during 35 cycles) received three times 50 mg metoclopramide. The drug was given two hours before as well as two hours and six hours after administration of the cytostatic drugs. Good or satisfactory prophylaxis of nausea and vomiting (no or at most three vomits) was achieved during 37 cycles (80.5%) of group A patients and 30 (85.7%) of group B patients. Complete absence of vomiting was obtained in 52% of cycles in group A, 46% of cycles in group B; complete absence of nausea in 39% and 32%, respectively. There was no statistically significant difference between the two treatments in their preventive action. Three times 50 mg metoclopramide (with or without prednisone) four hours apart during one cytostatic-drug cycle was well tolerated by patients in both groups and can be recommended as a simple, practical prophylaxis of nausea and vomiting in the course of strongly emetogenic treatment of cancer.

Adult↗
PubMed1986

[Thrombolytic therapy with ultra-high doses of streptokinase].

Two pilot studies were carried out in patients suffering from acute myocardial infarction. They received high doses of streptokinase and acylated streptokinase-plasminogen activator complex intravenously as a bolus injection. Furthermore, the possibility of using streptokinase bolus therapy was examined in patients with acute vascular occlusion. Due to the limited number and the heterogenicity of cases the results obtained in patients with acute myocardial infarction are to evaluate with some reservation. In patients with acute vascular occlusion streptokinase bolus therapy at high doses proved to be a promising alternative to the conventional therapy.

Coronary Angiography↗
PubMed1986

[Clinical aspects of acquired antithrombin III deficiency].

The significance of acquired antithrombin III (AT III) deficiency must be interpreted in close relation to the underlying disease process. In patients with acute or chronic liver impairment, the AT III activity is related to a decrease of procoagulatory factors, whereas, in protein loss syndromes such as nephrotic syndrome, the AT III indicates an increased risk of thromboembolic events. The effect of oral contraceptives (OC) on AT III levels in young healthy females (n = 30) was determined prospectively. AT III decreases during OC usage could not be related to the estrogen content of the examined oral contraceptives, and there was no parallel decrease of AT III activity and concentration in each type of OC. In a prospective study, the extent of AT III decrease was determined in patients undergoing cardiopulmonary bypass operations (CPB) receiving different anticoagulant schedules during extracorporeal circulation (n = 49). There was no significant influence on the effectiveness of anticoagulation by the observed AT III decreases. AT III deficiency during CPB was primarily the result of hemodilution. However, the AT III kinetics were significantly influenced by the different protamin dosages and were not affected by the different heparin dosages. Correction of diminished AT III levels by substitution of AT III concentrates is beneficial in cases, in which an interruption of an enhanced coagulatory process such as disseminated intravascular coagulation is necessary or in patients requiring high dosage heparinization as in deep vein thrombosis. In those cases the quality of AT III correction correlates to the course of the disease. However, the potency of concentrates as well as the individual AT III recovery and half-life must be considered for an appropriate treatment with AT III substitution.

Adult↗
PubMed1986

[Fibrinolytic treatment of deep vein thrombosis and lung embolism].

Selective evaluation prior to determining the indication for thrombolytic therapy is just as important for therapeutic success as choosing the appropriate fibrinolytic agent. During this initial stage, the localization, age, extension, and possible consequences of the thrombosis must be determined with suitable as well as specific methods. Selection of the fibrinolytic agent and careful monitoring of the thrombolysis should ensure a maximum therapeutic effect with a minimum of bleeding complications.

Fibrinolysis↗
PubMed1986

[Effectiveness of ivermectin in Strongyloides westeri cases in foals].

Efficacy of Ivermectin in combating Strongyloides westeri infection of foal. The efficacy of Ivermectin and Mebendazol in combating spontaneous Strongyloides westeri infections in foals has been tested by examining faecal egg output reduction. Ivermectin as a paste formulation was given to sucking foals and pregnant mares in a single dosage of 200 micrograms/kg bodyweight by oral administration. A high efficacy of Ivermectin in combating patent Strongyloides westeri infection could be demonstrated; no side effects have been observed. Mebendazol at a dosage rate of 8 mg/kg did not yield satisfactory results.

Animals↗
PubMed1986

Influence of tasuldine and acetylcysteine on mucociliary clearance in patients with chronic airways obstruction.

In a single-blind intraindividual cross-over comparative study the influence of two systemic-mucolytic agents, 2-(pyridyl-3-methylthio)pyrimidine (tasuldine, HE 10004-succinate) vs. N-acetyl-L-cysteine (acetylcysteine) on the mucociliary clearance and lung function was investigated in 15 patients with chronic obstructive respiratory disease. The overall treatment period was 14 days with the drug being changed after 7 days in each group. Under tasuldine and acetylcysteine treatment a tendency to an improvement of mucociliary clearance was observed compared with the control pointing to an increase in adoral velocity. The direct comparison between both drugs revealed that 120 min after medication mucociliary clearance was stimulated significantly stronger by intake of tasuldine than by acetylcysteine. There was no influence on lung function.

Acetylcysteine↗