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Biomedical subjects

R Koppensteiner

Publications and source records attributed to R Koppensteiner.

At least 73 records · Page 4Linked to original sources
PubMed1989

Hemorheology in systemic ultrahigh-dose thrombolytic therapy with streptokinase and urokinase.

The course of fibrinogen (Fgen), red cell aggregation (RCA), plasma viscocity (PV), platelet aggregation (PA) and hematocrit (Hc) was studied in patients with ultrahigh - dose thrombolytic therapy (1.5 x 10(6) units/hour for 6 hours = 1 cycle) with streptokinase (SK) or urokinase (UK) over a period of 3 cycles. Both ultrahigh - dose SK and UK produced significant changes in the course of Fgen, RCA and PV, whereas PA (spontaneous and ADP-induced) and Hc remained unchanged. After termination of each cycle Fgen progressively increased while RCA and PV further decreased. The extent of alteration in cycle 1 - concerning the baseline values - was more pronounced with SK than with UK, but the overall effect of SK decreased through the consecutive cycles because of more rapid increase during the SK-free period. In UK-therapy hemorheological alterations were initially moderate but increased from cycle to cycle.

Adult↗
PubMed1989

Course of cerebral lesions in a patient with periarteritis nodosa studied by magnetic resonance imaging.

The course is reported of a patient with periarteritis nodosa who initially presented with neurological symptoms. Multiple cerebral lesions were documented by the first magnetic resonance imaging (MRI) investigation. The majority of these had disappeared completely in the follow-up MRI studies. In contrast to neurological improvement the patient eventually died due to multiorgan failure. Postmortem histological examination revealed no pathological findings in the brain except one single necrotic area already known from MRI. Remissions of histological and angiographic alterations in periarteritis nodosa have been described as "local healing" leading to fibrosis and scarring. Our findings suggest that restitutio ad integrum may occur, at least in cerebral lesions.

Adult↗
PubMed1989

Accidental overdose of mitoxantrone in three patients.

Mitoxantrone is a new effective antineoplastic agent with activity against a wide range of tumors. Compared with the anthracycline drugs doxo- and daunorubicin, it exhibits a clearly lower toxicity and, most importantly, a reduced cardiotoxicity. The analysis of the side-effects recorded after accidental overdosage of the drug gives additional insight into its tolerability. Here we describe our observations in three patients who inadvertently received 100 mg m-2 (two pts) and 183 mg m-2 (one pt) as single slow bolus injections. The main side-effects were moderate nausea and vomiting, shaking chills, and profound but reversible neutro- and thrombocytopenia. There was no immediate cardiac toxicity. One patient with extensive previous daunomycin exposure developed congestive heart failure after 4 months. Two patients were not evaluable for late cardiac complications because of early death due to tumor progression.

Adult↗
PubMed1989

Platelet deposition at angioplasty sites and its relation to restenosis in human iliac and femoropopliteal arteries.

The amount and time course of platelet accumulation at angioplasty sites and influence of these platelets on restenosis after percutaneous transluminal angioplasty (PTA) in peripheral arteries were determined in 92 patients, who received either a high or low dose of aspirin. Platelet deposition was quantitated by means of dual-radiotracer scintigraphy and calculation of a platelet accumulation index (PAI). The PAI was higher (P less than .05) 4-6 hours after PTA compared with that on subsequent days. There was a trend toward greater platelet accumulation in vessels with extensive dissection. Platelet accumulation at the PTA site occurred with both doses of aspirin, with no differences between the two dosage groups. Twenty-one of 67 patients who underwent PTA in the femoropopliteal segment developed restenosis during a median follow-up of 14 months. The median PAI at 4-6 and 22-24 hours after PTA was significantly less in these 21 patients than in the 46 without restenosis. The data suggest that use of antiplatelet agents to prevent platelet deposition after PTA may not be useful for prevention of restenosis.

Angioplasty, Balloon↗
PubMed1989

Deep vein thrombosis: scintigraphic diagnosis with In-111-labeled monoclonal antifibrin antibodies.

Fifty-two patients suspected of having deep vein thrombosis under-went scintigraphy with an indium-111-labeled monoclonal antifibrin antibody. Venography disclosed deep vein thrombosis in 31 patients. With the whole limb considered an anatomic entity, antifibrin antibody scintigrams obtained 2 hours after injection had a specificity and sensitivity of 81% and 84%, respectively. A higher sensitivity (92%) was found for a subgroup of patients (n = 44) with symptoms for less than 10 days. Regional sensitivities for all patients and for the subgroup, respectively, were 92% and 100% in the calf, 82% and 94% in the popliteal region, 63% and 71% in the thigh, and only 18% and 13% in the pelvis. Additional imaging performed 6 hours and 21 hours after injection in 12 patients and quantitative analysis done from scintigrams with and without blood-pool (technetium-99m human serum albumin) correction did not improve sensitivity. In-111-antifibrin antibody scintigraphy is an accurate method for diagnosis of acute established deep vein thrombosis of the calf and popliteal region; its sensitivity in the thigh is lower, and it is not feasible for diagnosis in the pelvic area.

Adolescent↗
PubMed1989

Indium-111-labeled platelet scintigraphy in carotid atherosclerosis.

We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index. There were no significant differences between patients receiving high-dose (1.0 g/day) or low-dose (1.0 g/day) acetylsalicylic acid in scintigraphic results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Lack of influence of low-dose acetylsalicylic acid (100 mg daily) on platelet survival time, beta-thromboglobulin and platelet factor 4 in patients with peripheral arterial occlusive disease.

In this study we investigated the influence of low-dose (100 mg daily) acetylsalicylic acid (ASA) on 111-In-platelet survival time (PST) and on plasma levels of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF 4) in 30 patients (median age: 60 years) with arteriographically proven peripheral arterial occlusive disease in a chronic stable phase. We observed no significant changes of PST during therapy with ASA (weighted mean: 169.8----166 [median] hours; multiple hit: 168.3----170.6 hours), and also the plasma levels of beta-TG (median: 31.8----32.3 ng/ml) and of PF 4 (3.6----3.9 ng/ml) remained unchanged.

Adult↗
PubMed1988

Hypothermia in Hodgkin's disease after exploratory laparotomy.

Hypothermia is a rare complication of unknown origin in Hodgkin's disease which has been reported after the administration of antineoplastic agents, chlorpromazine and paracetamol. We report a highly febrile patient with stage IV-B Hodgkin's disease of mixed cellularity type who underwent exploratory laparotomy. Because of suspected septic shock high-dose prednisolone was given during surgery. Postoperatively the patient's body temperature fell progressively to 32.9 degrees C and remained at less then 35.5 degrees C for the following 5 days. There seems to be some functional disorder of thermoregulation in Hodgkin's disease. Physical factors during surgery or certain drugs, especially cytotoxics, corticosteroids, anesthetics or antipyretics may lead to prolonged hypothermia.

Body Temperature Regulation↗
PubMed1988

[Hemorheology and acute phase reaction following thrombendarterectomy of the extracranial carotid artery].

In 39 patients with hemodynamically significant stenoses of the internal carotid artery thrombendarterectomy was performed. Hemorheological properties and plasma protein levels were studied pre- and postoperatively over a period of 14 days. In comparison to age-matched healthy controls preoperative plasma viscosity, red cell aggregation, fibrinogen, haptoglobin and alpha-1-antitrypsin were significantly elevated. After surgical trauma there was an increase in fibrinogen, alpha-1-antitrypsin, haptoglobin and ceruloplasmin, whereas alpha-2-macroglobulin, immunoglobulin A and immunoglobulin G decreased significantly. Plasma viscosity, red cell aggregation, red cell filterability, fibronectin and immunoglobulin M remained unchanged. We conclude that our patients showed a non specific chronic "hematological stress syndrome" with raised acute phase reactants and corresponding hemorheological changes preoperatively; despite postoperative acute phase reaction no further deterioration of the rheological parameters could be observed; this might be caused by a decrease of plasma proteins with high frictional ratios compensating the increase of acute phase proteins. Besides, tissue damage and consecutive acute phase reaction in carotid arterial surgery seem to be of relatively minor degree.

Acute-Phase Proteins↗
PubMed1986

Sensitivity of 125J-fibrinogen uptake test for diagnosis of established venous thrombosis in heparinized patients.

The sensitivity of the radiofibrinogen test was investigated to determine the accuracy of the test in diagnosis of venographically proven venous thrombosis in 70 heparinized patients. 125J-fibrinogen was administered between 2 h and 4 days (mean: 1.5 days) after initiating heparin therapy. There were two criteria for a positive test: if the difference between the counts for adjacent points on the same leg or equivalent sites on opposite legs was at least 15%; and/or if there were three adjacent points each with counts greater than 5% that of the same three points on the other leg. The fibrinogen uptake test was positive at the first examination in 67 of 70 patients, giving a sensitivity of 96%. The respective frequencies of truly abnormal results for the 3 X 5% and the 1 X 15% criteria were 94% and 71%. As far as localization and extension of thrombosis were concerned, the fibrinogen uptake test agreed with phlebography in 73% of the cases, when the counts in the groin and the upper third of the thigh were ignored. The 125J-fibrinogen uptake test is an accurate method for detecting established deep leg vein thrombosis even in anticoagulated patients.

Adult↗