[Latent ischaemic disease in workers of the motor car industry with a high risk score (author's transl)].
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Biomedical subjects
Publications and source records attributed to V Puchmayer.
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In 81 patients arteriographically by means of the Doppler-method and oscillographically altogether 130 lower extremities were examined. Comparing the two non-invasive methods with the arteriography we have established their good diagnostic possibilities, which on an average were not lower than 84%. Isolated obstructions and stenoses of several arterial segments are to be recognized practically in 100%. With increasing number of lesions the diagnostic possibilities decrease. The two methods supplement themselves very well and are an important functional enrichment of the arteriography. These two together achieve the 90%-level of reliability (covered by the reliability interval of 95%) and are fully sufficient for diagnosing in conservative therapeutic methods. But for a reconstructive intervention is always necessary a complete aorto- and arteriography of the whole extremity.
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Clinical, angiological, and biochemical examinations were performed in 981 men and 30 women with organic afflictions of peripheral arteries, and in 411 men and 50 women without any signs of peripheral arterial lesions. Their family histories were thoroughly recorded with particular reference to the occurrence of myocardial infarction, cerebral accidents before and after the age of 60 years, and death of these causes; further, of hypertension, diabetes mellitus, obliterations and gangraenes, in each patient's siblings, parents, and all four grandparents. Furthermore, the significance of positive family history in combination with other risk factors was investigated. Family history can be considered positive with respect to obliterative atherosclerosis when in anyone of the patient's grandparents, parents, or siblings an obliteration of peripheral arteries is present or when anyone of them died of myocardial infarction or apoplexy, especially when aged under 60 years. Presence of several factors in the specified next of kin accelerates the obliterative process in the patient. A positive family history, however, plays no decisive role either alone or in combination with any other single risk factor, but only in combination with two or more other factors, one of which is always tobacco smoking; it is not significant in any combination with obesity.
With an oscillograph according to Gesenius and Keller, the authors investigated the oscillographic waves in lower limbs and their reductions after exposition to cold and exercise in 27 men and 22 women with gastric or duodenal ulcer as well as in 18 healthy men and 12 healthy women. Both groups were subdivided into age categories from 19 to 30 and from 45 to 54 years. It was found that 1) peripheral arteries in men in the lower age category with duodenal ulcer reacted to cold stimulus by a more marked vasoconstriction than the arteries in healthy men in the same age category; 2) in women with duodenal ulcer the same observation was made in not only the younger, but also in the higher age category; 3) peripheral vasoconstriction after application of cold in women with duodenal ulcer, aged up to 30 years and 45-54 years was higher than in women with gastric ulcer in the corresponding age categories; 4) peripheral arteries of the younger men as well as of the younger and older women with duodenal ulcer reacted often more strongly to exercise and to exercise following application of cold in comparison with corresponding controls, and in the case of the women, in addition, with those with gastric ulcer.
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