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P Doenecke

Publications and source records attributed to P Doenecke.

At least 19 recordsLinked to original sources
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↗
PubMed1986

[Bolus injection of anisoylated plasminogen-streptokinase activator complex (BRL 26921) as an alternative concept of systemic lysis in acute myocardial infarct].

The thrombolytic properties of anisoylated plasminogen streptokinase activator complex (BRL 26921) and clinical results of the treatment were studied in 10 consecutive patients with acute myocardial infarction. Exclusion criteria were general contraindications against thrombolytic therapy and a time interval of more than 4 h between the onset of symptoms and admission to the hospital. All patients received a 250-mg bolus of prednisolone prior to intravenous injection of 30 mg BRL 26921 within 2 min. A continuous infusion of heparin at a dose of 1,000 USPU/h was started 2 h after the injection. Blood pressure was monitored via an arterial line. Arrhythmias and changes in the ST segments were documented by conventional ECG recording and computer-based ECG monitoring. Coronary arteriography and left ventriculography were carried out within 72 h. Besides routine laboratory tests, serial CK and CK-MB activity measurements were carried out. We determined the following hemostaseological parameters before and 15 min, 30 min, 1 h, 4 h, and 12 h after application of BRL 26921: prothrombin time, activated partial thrombosplastin time, thrombin time, thrombin coagulase time, fibrinogen, streptokinaseplasminogen activator activity, plasminogen and alpha-2-antiplasmin. Our results (reperfusion in all patients angiographically and in 7 to 8 of 10 patients from noninvasive criteria) show that BRL 26921 is a highly effective thrombolytic agent in patients with myocardial infarction, when compared with high-dose systemic fibrinolysis. Applied in dosages required for early reperfusion, it does not appear to be selectively thrombolytic and is not free of hypotensive effects in man. The decrease of fibrinolytic activity is biphasic with a half-disappearance time of 112 min.

Adult↗
PubMed1986

Noise reversion of a dual chamber pacemaker without noise.

Three patients are reported whose DDD pacemakers reverted to the asynchronous mode in the absence of skeletal muscle or electromagnetic (EMI) interference. In all three cases, the basic cardiac rhythm was atrial fibrillation with fast ventricular response due to intrinsic AV conduction. Noise reversion was triggered by the patients' own ventricular activity at cycle lengths shorter than the ventricular refractory period of the pulse generator. In one patient, asynchronous AV sequential pacing during atrial fibrillation was noted shortly after resuscitation from ventricular fibrillation; however, the initiation of the malignant ventricular arrhythmia by the pacemaker remains unproven. The mechanism of noise reversion by rapid cardiac activity and possible solutions to the problem by adequate pacemaker design are discussed.

Aged↗
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↗
PubMed1984

Sustained atrial flutter after cardiac surgery: successful termination by rapid atrial pacing.

For termination of sustained atrial flutter, 28 rapid atrial stimulations were performed in 26 patients undergoing cardiac surgery, including coronary bypass surgery, and valvular heart surgery as well as surgery for primum and secundum atrial septal defect and anomalous connection of the pulmonary veins. In 18 patients rapid atrial pacing was successful in directly converting a flutter to a sinus rhythm, in 5 patients after a short period of transient atrial fibrillation. Atrial flutter could be changed to atrial fibrillation in a further 3 patients who remained in permanent atrial fibrillation and subsequently underwent DC cardioversion. Our results demonstrate that rapid atrial pacing is very effective in the treatment of sustained atrial flutter in patients following cardiac surgery and may be used alternatively to DC countershock.

Adolescent↗
PubMed1983

Arterial and venous thrombosis and normal response to streptokinase treatment in a young patient with severe Hageman factor deficiency.

The case history of a patient with severe factor XII deficiency (factor XII activity and concentration below 1%) is described. The case reported gives further evidence that factor XII deficiency leads to a prolonged euglobulin lysis time. This might be a risk factor indicating a proneness to thromboembolic events. The young man suffered from arterial and venous thrombosis, and underwent lower extremity amputation without bleeding complications, as well as thrombolytic therapy to save the other leg. There was a normal response to streptokinase, heparin, and phenprocoumon treatment.

Adult↗
PubMed1979

Complications with retained transvenous pacemaker electrodes.

Out of a series of 1,734 pacemaker patients, the clinical course of 46 patients was reviewed in whom a functionless endocardial electrode was retained. Non-infected electrodes (25 patients) were generally well tolerated without complications, except in one patient who experienced fatal catheter embolism into the pulmonary artery. In cases of infected electrodes (21 patients) a mortality rate of 25% was encountered due to septic complications. Catheter migration was fatal in two out of three patients. It is concluded that entrapped electrode catheters should be removed by thoracotomy if persisting infection is present or if catheter migration has occurred.

Adult↗