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Biomedical subjects

A Creutzig

Publications and source records attributed to A Creutzig.

140 records · Page 8Linked to original sources
PubMed1984

[Incidence of peptic ulcer in an inpatient angiologic patient sample].

Incidence of peptic ulcers in hospitalized patients with arterial occlusive disease without history or clinical symptoms of ulcer disease was 32% and four times higher than in patients with acute phlebothrombosis. Possible etiological factors could be: decreased blood perfusion of gastric or duodenal mucosa because of generalized arteriosclerosis, intake of ulcerogenic drugs, chronic abuse of nicotine, and stress due to the underlying arterial occlusive disease. Patients with inflammatory vascular disease are affected as often as are patients with arteriosclerotic disease. Routine endoscopic examination of the upper GI-tract should be performed in such patients in order to exclude potential bleeding sources before treatment with fibrinogen lowering drugs is started.

Adolescent↗
PubMed1983

[Percutaneous transluminal angioplasty of the lower extremities in the elderly].

Results of percutaneous transluminal angioplasty (PTA) for peripheral arterial occlusion were compared between a group of 41 patients aged over 60 years and one of 39 patients under 60 years. In the older patients the proportion of those in a decompensated state was 61%, more than double that in the younger ones. 54% of the older patients were diabetics with a poor peripheral vascular outflow bed; conservative treatment failed in them and surgical intervention was not possible. A primary success rate of PTA was 87% in the older patients, no worse than in the younger ones. Long-term follow up of both groups indicated that PTA in the compensated stage achieved prolongation of pain-free walking distance or absence of symptoms in 74%. Threatened leg amputation could be avoided in 80% of the younger and 60% of the older patients. Limited amputation was performed in 20% of the older patients with decompensated vascular disorders. The most frequent complication of PTA was embolization into the small vessels of the lower leg, in nearly 30% of patients. But only once did this worsen the clinical state, and this was transitory.

Adult↗
PubMed1983

Frequencies of segmental perfusion and ventilation abnormalities in lung scintigraphy.

The segmental ventilation-perfusion mismatch is almost invariably a sign of pulmonary embolism (PE). As ventilation scintigraphy is an expensive and time-consuming procedure, it is rarely performed in patients presenting as emergencies. In such patients PE is diagnosed by the presence of a segmental perfusion defect (SPD) in combination with a normal chest X-ray. However, little is known about SPD frequencies in different groups of patients or its value in predicting a mismatch. To determine this frequency, as well as its predictive value for a mismatch (PVM), we examined 764 patients with suspected Pe (PE? group), 359 patients at low risk for PE (low risk group), and 234 patients without suspected PE but at high risk for PE (high risk group), all by perfusion and ventilation scintigraphy. Frequencies of SPD were determined in each group as a function of age. PVM was calculated for each age subgroup using Bayes' theorem. In the low risk group the frequency of segmental mismatches (SM) was about 4%, while one-third of patients at high risk had a SM. This was not age dependent in contrast to the PE? group, where the frequency decreased with age. In the youngest subgroups the PVM for a SPD was higher than 0.9 as well as in a subgroup of the PE? group with a known thrombo-embolic disease. In these subgroups a ventilation scintigraphy is not required for the scintigraphic diagnosis of PE; in all other patients an additional ventilation study is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

[Creation of reaction-less pseudoarthrosis on the ulna of the dog (author's transl)].

The model situation of so called "avital, avascular" pseudoarthrosis was surgiclly induced in 25 beagle dogs using defectosteotomy and heat-necrotization of both ulna bones. The clinical evolution was examined weekly using roentgengraphy and each 4th week by scintigraphy. According to roentgen pictures three stages can be identified: 1. Reaction of the bone on surgical trauma (until 4th week). 2. Sequestration or asepticosteolysis (until 18th week). 3. Consolidation of the pseudoarthrosis model-situation (after 18th week). Scintigraphy revealed by the continuing so called "avital" pseudoarthrosis an enhanced metabolism activity at the tips of both bone fragments. The cause for these active metabolic processes evoking enhanced activity on both fragment ends during scintigraphy wich is not demonstrable with roentgen device are the pulling, pushing and tensile strengths originating from a connective-tissue-cord existing between them. The results of scintigraphy lead us to use the term "reaction-less pseudoarthrosis" instead of "avascular" or "avital" for this model of pseudoarthrosis.

Animals↗
PubMed1977

[Comparative investigations of osteotropic radionucleides. IV. The dynamics of uptake in normal and abnormal bone (author's transl)].

The dynamics of uptake of osteotropic radionucleides in normal and abnormal bone were studied by means of sequential and functional scans. Various phosphate and phosphonate complexes were compared in vivo and in vitro. Only phosphonates were considered as suitable for bone scanning. In normal bones in beagles, radioactivity after HEDP fell to 65% after two hours, but was 105% with 18F. In relation to healing fractures, the curves differ quantitatively and qualitatively. In this situation, functional curves derived from dynamic scans provide a better parallel with histological findings than does static scintigraphy with an uptake quotient. Sequential and functional scanning are able to document the therapeutic effect of irradiation of bone metastases.

Animals↗
PubMedDate not supplied

Color and conventional image-directed Doppler ultrasonography: accuracy and sources of error in quantitative blood flow measurements.

Accuracy of two systems--conventional (DRF 400, Diasonics) and color-coded (Angiodynograph, Quantum/Phillips) image-directed Doppler ultrasonography--was investigated using an in vitro model that generated both monophasic and triphasic pulsatile flow patterns. Estimated and actual blood volume flow rates showed good correlations, but the sampling with a hand-held transducer led to wide variations in measurement error for the conventional (-69.2% to 50%) and the color-coded (-79.3% to 265.7%) systems. By performing multiple measurements, one could improve accuracy considering only the maximal values of a series instead of the mean values. Accuracy was impaired by interposed muscular or fatty tissue due to false low time-average velocity measurements caused by a loss of Doppler signal. Comparison of both systems revealed significant differences between pulsatility index values (p less than 0.001), blood flow velocities (p less than 0.001), and blood volume flow rates (p less than 0.05 for program flow, p less than 0.001 for manual and automatic flow program of the color-coded system).

Blood Flow Velocity↗
PubMedDate not supplied

Quantitative reflection spectrophotometry: spatial and temporal variation of Hb oxygenation in human skin.

Applying a fast scanning reflection spectrophotometer and multicomponent spectra analysis, oxygen saturation (SHb) and relative concentration (CHb) of hemoglobin in the skin were determined at eight skin sites in 11 healthy persons. SHb was significantly higher at the tip of the index finger and big toe (90 +/- 3.9 and 92 +/- 4.2%, respectively) compared with the forehead, volar forearm, back of hand, abdomen, calf and forefoot where mean values varied between 52 and 67% (p < 0.001). CHb also was higher at acral sites (big toe: 2.04 +/- 0.14 arbitrary units (AU); index finger: 2.13 +/- 0.19 AU) than at the other locations (p < 0.0001) where it was between 0.56 +/- 0.12 AU (abdomen) and 0.95 +/- 0.28 AU (forefoot). In the course of time, rhythmical oscillations of both parameters at a frequency of 3-5/min were seen in 68% of the measurements, predominantly at the six proximal sites. Heating the measuring site to 44 degrees C caused a biphasic increase of CHb and SHb which was significant at the proximal sites (p < 0.0001). SHb values came into the range of arterial blood. Temporal and spatial variation of both parameters decreased. Reflection spectrophotometry gives the possibility to directly assess dermal hemoglobin saturation, its physiological variability and reactions to provocation stimuli. Concentration and saturation of hemoglobin in dermal vessels appear definitely different at acral compared with proximal sites.

Hemoglobins↗
PubMedDate not supplied

Vital capillary microscopy of skin areas at the forefoot of diabetic patients using intraarterial injection of Na-fluorescein.

A modified technique of vital capillary microscopy with intraarterial application of Na-fluorescein has been introduced in the study of nutritional skin microcirculation to assess skin microcirculation of different diabetic patients, comprising one group without neurocutaneous complications (group 2; n = 9), one suffering only from neuropathy (group 3; n = 9) and one with trophic skin lesions in the contralateral foot (group 4; n = 8), all without macroangiopathy, compared to healthy controls (group 1; n = 9). Femoroarterial injection of small boli (10 mg) of Na-fluorescein allowed repeated investigation of the dye appearance times (AT) and capillary-filling times of forefoot skin capillaries within small periods of time before, during and after reactive hyperemia. At rest, AT was significantly shorter in patients of group 4 (16.8 +/- 4.4 s; p < 0.05) compared with groups 1-3 (34.3 +/- 12.8; 31.7 +/- 11.7 and 35.9 +/- 15.3 s). Fifteen seconds after the end of arterial occlusion, dye propagation to the skin was markedly accelerated in groups 1-3 (19.8 +/- 14.0; 14.4 +/- 7.6 and 18.7 +/- 10.6 s, respectively; p < 0.001), but prolonged in group 4 (18.4 +/- 7.4 s). After 10 min, the values at rest were reestablished. No differences between the four groups were found concerning capillary density and morphology. It is concluded that the development of skin lesions in diabetic patients without significant macroangiopathy may be favored by hyperperfusion and impaired vasoregulation. Intraarterial dye injection presents a valuable tool to assess dynamic alterations of the microcirculation at the level of skin capillaries.

Adult↗
PubMedDate not supplied

Prostanoids in therapy of peripheral arterial occlusive disease.

Therapy of chronical arterial occlusive disease primarily includes evaluation and treatment of risk factors as prophylaxis for preventing progression of arteriosclerosis. When patients suffer from claudication walking exercise is the therapy of choice. Only in cases with severe claudication (walking distance under 100 m) and rest pain or ischemic ulcers reopening procedures are necessary. Bypass surgery is supported by the different transluminal angioplasty techniques, which are suited even for the older and multimorbide patients. A pharmacological treatment of peripheral arterial occlusive disease should be introduced only for preventing progression of the disease or reocclusions following surgery or angioplasty or in those cases in whom reopening techniques are not possible or not successful. Here prostaglandin E1 has been proven to be effective in many clinical trials. The combination of surgery, angioplasty and pharmacological treatment allows to avoid major amputations in most patients with critical limb ischemia.

Arterial Occlusive Diseases↗