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Biomedical subjects

A Kriessmann

Publications and source records attributed to A Kriessmann.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Urokinase therapy of deep vein thrombosis (author's transl)].

30 patients with deep vein thrombosis were treated with a combination of urokinase and heparin. Clinically relevant improvement was achieved in 2/3 of them with appr. 40,000 IU/h (1,000,000 IU/d) urokinase administered over a period of several days. This indicates that urokinase at this dosage offers a valuable alternative or supplementation to fibrinolytic therapy with streptokinase. With the dosage employed, routine blood coagulation tests are only minimally affected, although a strong enhancement of fibrinolytic activity can be demonstrated by the euglobulin clot lysis time. Plasminogen depletion - as is usually observed with streptokinase therapy - does not occur. Urokinase is well tolerated and there is only a very moderate bleeding tendency. The cost per day of urokinase therapy at the dosage employed is approximately twice that of customary streptokinase therapy.

Adolescent↗
PubMed1979

[Frequency of peripheral arterial occlusive disease in patients with coronary heart disease with and without infarction (author's transl)].

In 107 consecutive patients the frequency of peripheral arterial occlusive disease in coronary heart disease was assessed by selective coronary angiography and sonographic Doppler pressure estimation. Among 75 patients with coronary heart disease 21 (28%) had arterial occlusive disease, among 32 patients without coronary heart disease only one (3%). There was no statistically significant correlation between the severity of both diseases. 40 out of 75 patients with coronary heart disease had suffered from cardiac infarction. Infarction frequency showed a highly significant correlation with increasing severity of the coronary heart disease, but none with increasing severity or frequency of arterial occlusive disease. When there was no arterial occlusive disease all degrees of severity of coronary heart disease were found. Analysing the literature it becomes evident that coronary heart disease is frequently an isolated or premature manifestation of arteriosclerosis.

Adolescent↗
PubMed1977

[Fibrinolytic therapy in deep venous thrombosis of the upper and lower extremity].

Fibrinolytic therapy was carried out in 59 patients suffering from a total of 60 deep venous thromboses of the iliac segment (n = 24), the femoropopliteal segment (n = 18), the deep calf veins (n = 2), or the subclavian vein (n = 16). 46 patients received streptokinase (SK), 4 were given urokinase (UK), and 10 were treated with streptokinase followed by urokinase (SK + UK). The duration of fibrinolytic therapy was between 19 and 596 hours (x = 166 +/- 111 hrs). Phlebographic examination was used to determine the location of the thrombotic occlusion as well as to evaluate therapeutic results. To assure sufficient anticoagulatory protection during therapy with streptokinase the dose of streptokinase was either reduced by steps of 20,000 U/hr to a minimum of 40,000 U/hr or heparin was added as a continuous infusion. Urokinase was administered with a mean loading dose of 75,000 IU followed by an average maintenance dose of 40,000 IU/hr; it was always given in combination with heparin. When therapeutic success was graded as complete/partial/no recanalisation, the following results were obtained: thrombotic occlusion up to 1 week old 35%/48%/17%; up to 2 weeks old 57%/14%/29%; 3 or 4 weeks old 12%/38%/50%; older than 4 weeks 13%/37%/50%. The two most common side effects were a fall of the hemoglobin and a rise of body temperature. Treatment with SK had to be interrupted for bleeding in two cases. One patient diet after rupture of the liver and of the spleen following development of subcapsular hematoma in these organs, 3 patients survived pulmonary embolism without major long-term impairment. Considering medical and social aspects (preservation of capability for working in young adults) it appears justified to administer fibrinolytic agents up to a thrombus age of 14 days, in some cases even up to a thrombus age of 28 days. Good results in cases of deep vein thrombosis of the lower limbs are often obtained only when fibrinolytic therapy is extended beyond 96 hours. It should be performed in intensive care units only. Follow-up examinations of the venous drainage capacity up to 2 years after fibrinolytic therapy document the good therapeutic effect that is warrented by streptokinase or urokinase induced complete recanalisation.

Adolescent↗
PubMed1976

[The influence of pregnancy on the venous return from the lower extremities (author's transl)].

Determination of intravenous pressure in the lower extremities revealed in 77 pregnant women a marked insufficiency of the venous drainage. In the last third of pregnancy the capacity of the venous drainage is reduced by approximately 30 per cent. Determination two to five days post partum showed a significant improvement but not yet complete normalization. The causes of the insufficiency of the venous drainage are hormonal influences, dilating the vessels, which are still active post partum. The insufficient venous return is a major factor in the genesis of varicosity during pregnancy. The disturbance of venous return by the large uterus will result in an increase of static venous pressure on the average of 10 mm Hg. In the upright position this is a qualitatively as well as quantitatively individually variable phenomenon. There ist no relation between the increase in static venous pressure and the occurrence of varicosity.

Adult↗
PubMed1975

[Dosage of long-term streptokinase fibrinolytic administration (author's transl)].

Using generalyy accepted dosage schedules during long-term fibrinolytic treatment with streptokinase, anticoagulatory protection against recurrent thromboses can no longer be guaranteed after two to three days, unless heparin is also administered. In contrast, no heparin was needed in 11 out of 13 patients on fibrinolytic treatment of at least five days when maintenance dose was adjusted in accordance with results of coagulation tests. In this way prolonged fibrinolysis was maintained together with adequate anticoagulation by circulating fibrin(ogen) breakdown products for the entire duration of streptokinase treatment. This required the gradual reduction of maintenance dose to between 40 000 U/h and 80 000 U/h in the majority of patients. This form of fibrinolytic treatment with individually adjusted dosages can be undertaken without undue strain on laboratory resources; the risk of haemorrhage is no higher than with the customary form using higher and constant maintenance doses.

Drug Therapy, Combination↗
PubMed1975

[Comparison of technical measuring methods for the diagnosis of arterial occlusive disease of the lower extremities (author's transl)].

Four technical methods of measurement were used simultaneously in angiographically established occlusions of the iliac artery (n = 9), long occlusions of the superficial femoral artery (n = 22), stenoses of the superficial femoral artery (n =14), isolated occlusions of the arteries of the lower limb (n = 6) and in an arteriographically inconspicuous control group (n = 11). The following parameters were used for the analysis of variance: time for return of resting pulse amplitude for oscillography under exertion, difference between arterial pressure in the arm and ankle for the ultrasonic Doppler pressure measurement, peak flow after arterial oppression for venous occlusion plethysmography and pressure equilibration time for the peripheral phlebodynamometry. All four methods were suitable for the differentiation of extremities with and without arterial insufficiency with greater statistical significance (p smaller than 0,001). Venous occlusion plethysmography appears to be particularly suitable for scientific problems. Ultrasonic Doppler pressure measurement is available as the method of choice for the rapid and reliable detection of arterial insufficiency.

Analysis of Variance↗