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Biomedical subjects

R Verhaeghe

Publications and source records attributed to R Verhaeghe.

70 records · Page 4Linked to original sources
PubMed1979

Action of brinase on human fibrinogen and plasminogen.

Brinase added to human plasma in vitro caused a decrease in fibrinogen concentration, positive paracoagulation tests and formation of a friable clot in sequence. Agarose gel filtration of these samples revealed the presence of fibrinogen derivatives both larger and smaller than the parent molecule. Infusion of the enzyme in vivo resulted in a decreased fibrinogen level, a prolonged thrombin time and an increase in fibrinogen related antigen (FRA) in serum. The elution pattern of FRA in the plasma samples obtained after infusion of Brinase was similar to that of the in vitro samples. The plasma pool of fibrinogen was partially consumed by infusion of Brinase, but the turnover of plasminogen remained unaffected. Purified plasminogen was partially degraded by addition of the enzyme but this was accompanied by a generation of proteolytic activity. These findings confirm that Brinase induces a proteolytic degradation of fibrinogen in plasma without activation of the plasminogen-plasmin system. Exposure of polymerization site(s) in the fibrinogen molecule is probably responsible for the reported clot promoting effect of the enzyme.

Antigens↗
PubMed1979

Clinical trial of brinase and anticoagulants as a method of treatment for advanced limb ischemia.

A randomized, single-blind trial of repeated intravenous infusion of Brinase was carried out in 70 petients with severe chronic limb ischemia, who were candidates for lumbar sympathectomy or amputation. The enzyme caused s significant increase in calf and ankle pressure index. At six months follow-up, the clinical results were statistically significant in favour of Brinase when all patients were considered, but not if 10 patients with Buerger's disease were omitted from the analysis. Patients treated with a combination of Brinase and coumarins had a better clinical outcome than patients receiving either treatment on its own.

Aged↗
PubMed1979

Medical treatment in intermittent claudication.

A variety of measures advocated in the treatment of intermittent claudication are critically reviewed. Daily leg exercises increase the walking ability but the mechanism of this effect remains controversial. To date, doubt persists whether drugs, either vasodilating or antithrombotic, are of any clinical value in this condition.

Exercise Therapy↗
PubMed1976

Molecular size distribution of fibrinogen derivatives formed in vitro and in vivo: a chromatographic study.

Using gel chromatography, fibrinogen derivatives present in purified systems or in biological fluids were separated and partially characterized. Eight groups of fibrinogen derivatives could be separated by gel filtration through 6% agarose in large columns, four with an elution volume smaller and four groups with an elution volume larger than that of fibrinogen. Careful calibration of the column allowed estimation of the diffusion coefficients of some of the derivatives and, thus, comparison with derivatives previously identified. Three, rather than two, groups of intermediate derivatives were observed during the degradation of human fibrinogen by plasmin in vitro or in vivo. One of these had a marked tendency to polymerize. A rather distinct difference in elution pattern was found between plasma obtained during streptokinase administration and from patients with intravascular coagulation.

Blood Coagulation↗
PubMedDate not supplied

Controlled trial of suloctidil in intermittent claudication.

Forty-five patients with intermittent claudication were first treated with placebo tablets for 3 months and then randomly allocated to double-blind therapy with either suloctidil or placebo for 6 months. Walking distance improved significantly in both groups during the 3 months of placebo treatment. During the 6 months of double-blind treatment with a further significant improvement occurred only in the placebo group when all patients were analyzed. However, when patients who stopped for reasons unrelated to claudication such as angina and exhaustion during repeated walking tests were eliminated, only suloctidil-treated patients improved significantly. The evolution of leg flow and distal pressure was similar in the two treatment groups whether all legs or only legs with abnormal flow and pressure values were considered. By contrast, when the analysis was limited to legs with claudication pain, a significant improvement occurred only in the suloctidil-treated group. These findings suggest that suloctidil may improve the claudication symptoms of patients with chronic arterial obstructive disease and in particular the perfusion of legs experiencing claudication pain. However, the clinical significance of this improvement appears limited.

Clinical Trials as Topic↗
PubMedDate not supplied

Acute effect of ketanserin on the leg perfusion assessed by Doppler pressure measurements and 201Tl scintigraphy in patients with intermittent claudication.

Ketanserin, a serotonin2-receptor blocker, was administered intravenously (10 mg) to 10 patients suffering from unilateral intermittent claudication in a double-blind, placebo-controlled, cross-over design. The acute effect of the drug was studied by doppler systolic pressure (SP) measurements at arm and ankle at rest (10 min after injection) and after exercise, and by radioactive thallium (201Tl) stress scintigraphy of the legs. Resting ankle-arm SP ratio was significantly higher after ketanserin compared with placebo. This was due to a lowered systemic SP with unchanged ankle SP. This difference was not seen after exercise. In addition, the drug did not influence significantly the postexercise accumulation of thallium in the distal leg on the affected or healthy side, although the difference between these two became significantly larger in favour of the healthy leg. Thus, acute administration of ketanserin improves peripheral hemodynamics in claudicating patients at rest, but muscle exercise abolishes this response. A beneficial effect of ketanserin in intermittent claudication cannot be anticipated from these results.

Adult↗
PubMedDate not supplied

A vitamin K antagonist rapidly reverses a blue toe syndrome in a patient with lupus anticoagulant and antiprothrombin antibodies.

A 30-year old male was admitted to the hospital with extremely painful blueish discoloration of his toes. After clinical and laboratory evaluation the diagnosis of a blue toe syndrome due to primary antiphospholipid syndrome (APS) was made. Complete resolution of the blue toe syndrome occurred within 72 hours following 9 mg phenprocoumon. APS consists of the association of lupus anticoagulant or antiphospholipid antibodies with arterial or venous thrombosis, thrombocytopenia, and spontaneous abortion. The exact pathways leading to thrombosis are still unknown. Our group has previously proposed that membrane-associated immune complexes contribute towards clinical symptoms in the antiphospholipid syndrome. The case presented strengthens that concept.

Adult↗
PubMedDate not supplied

Assessment of the patency of deep leg veins with duplex.

To evaluate the accuracy of venous duplex, results obtained in 101 patients are compared with venography. A first group consisted of 48 patients with clinically suspected deep vein thrombosis. In 30 of them a positive duplex scan was obtained and all had subsequently a positive venography. Eighteen patients with a normal duplex scan had a normal venography. Another group of 53 patients were tested preoperatively for varicose vein surgery. No obstruction of the venous system was withheld with duplex but 3 patients had an old thrombosis on venography. Thus duplex is a highly reliable method to detect proximal thrombosis in clinically suspected patients but detection of late sequelae of thrombosis may be more difficult.

Adolescent↗
PubMedDate not supplied

Arterial obstructive disease of the lower limbs in the elderly: is angiography required?

A retrospective study of 61 hospitalized elderly patients with peripheral arterial disease revealed that a large majority of them presented with restpain and/or skin defects and gangrene. A palpable popliteal artery was usually indicative of severe distal disease and a poor outlook for revascularisation. In the other patients, angiography was required to clearly delineate good from poor candidates for arterial repair. Yet, only one third of the patients submitted to angiography could ultimately benefit from vascular reconstruction.

Age Factors↗