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Biomedical subjects

D Lockner

Publications and source records attributed to D Lockner.

At least 55 records · Page 3Linked to original sources
PubMed1984

Local venous infusion of streptokinase in DVT.

Fourteen patients with acute deep vein thrombosis (DVT) of the thigh were treated with different doses of streptokinase (SK) as a local venous infusion. Only the lowest SK-dose given, 4,000 U/h for 72 h, had any effect. Three out of 9 patients on this dose showed significant lysis. However, systemic hemorrhagic side effects occurred in 3 patients, local dermatitis in another 3. The reason for the limited thrombolytic effect and systemic side effects could be that the catheter is not in the immediate vicinity of the thrombus, and that the SK-infusion by-passes the occluded vein segments through collaterals. There is probably no advantage of local venous SK-infusion over systemic SK-therapy in DVT.

Drug Eruptions↗
PubMed1984

A comparative randomized trial of low-dose versus high-dose streptokinase in deep vein thrombosis of the thigh.

Fibrinolytic treatment of acute deep vein thrombosis (DVT) of the leg with high-dose streptokinase (SK) (100,000 U/h) in 39 cases, or low-dose SK (approx 10,000 U/h) in combination with low-dose heparin in 41 cases, was studied in a prospective randomized trial. The degree of thrombolysis was similar in both groups and did not correlate with age or size of the thrombus or with fibrinogen level. The degree of late recanalization was also similar in both groups. There were however significantly more patients with postthrombotic changes in the low-dose group than in the high-dose group after a mean follow-up time of 31 and 38 months respectively. In the low-dose group 2 intracranial hemorrhages occurred (one was fatal) and one patient died of pulmonary embolism, but there were significantly less allergic side effects to SK. There were no cases of such serious side effects in the highdose group. Although low-dose SK has equal thrombolytic effect it seems inferior to high-dose SK, since it probably causes more severe hemorrhagic side-effects.

Clinical Trials as Topic↗
PubMed1983

Intermittent high-dose melphalan/prednisone vs continuous low-dose melphalan treatment in multiple myeloma.

Patients with newly diagnosed multiple myeloma were randomly allotted to an intermittent high-dose melphalan/prednisone (MP) treatment (120 patients) or a continuous low-dose melphalan (M) regimen (99 patients). The median observation time was 59 months (range 33-84). Response to therapy was obtained in 45% of the MP group and 31% of the M group (P less than 0.05). No significant difference in response with regard to clinical stage was noted. Median survival was 36 months in the MP group and 29 months in the M group. Survival was longer in stage I and II myeloma than in the stage III cases, at least in the MP group. The median and 5-yr survival rates in stages I and II were significantly better in the MP than in the M group. Response to therapy was associated with length of survival, median survival being 62 months in responding patients and 20 months in non-responders. The MP and M groups did not differ in this respect.

Adult↗
PubMed1982

Prednimustine and vincristine compared with cytosine arabinoside and thioguanine for treatment of elderly patients with acute nonlymphoblastic leukemia.

Sixty-seven patients with acute nonlymphoblastic leukemia (ANLL) and above the age of 60 years were randomly allocated to treatment with either prednimustine + vincristine or cycles with cytosine arabinoside and thioguanine. Of the 67 patients, 13 (19%) entered a complete remission and four a partial remission. Of 33 patients randomized to prednimustine and vincristine (15 adequately treated), three entered a complete remission and one a partial remission. Four further patients went into complete remission after a switch to other treatment modalities. Of 34 patients randomized to cycles of ARA-C and thioguanine (22 adequately treated), four entered a complete remission and three a partial remission with the correct program. One patient entered a remission with intermittent cytosine arabinoside + thioguanine (wrong program) and one further patient entered a complete remission after a switch to prednimustine and vincristine. Prednimustine + vincristine did not appear to be superior to treatment with cytosine arabinoside thioguanine cycles for elderly patients with ANLL.

Acute Disease↗
PubMed1981

Reducing the cardiotoxicity of anthracyclines by complex-binding to DNA: report of three cases.

Three patients with acute myeloblastic leukemia received high doses of daunorubicin, first in the free form and later as complex with DNA. Two of the patients also received doxorubicin-DNA. Two patients showed symptoms of cardiotoxicity with signs of congestive heart failure after cumulative doses of 910 and 250 mg of noncomplexed daunorubicin/m2 body surface area, respectively. Thereafter they tolerated daunorubicin-DNA complex up to total doses of 1430 mg and 1200 mg daunorubicin/m2, respectively, with no further signs of cardiotoxicity. One of them entered another complete remission after therapy with the complex. The third patient had received 820 mg daunorubicin/m2 and was in his second relapse when he was switched to daunorubicin-DNA complex. A new remission was induced and the patient received a total daunorubicin dose of 1480 mg/m2 with no clinical signs of cardiotoxicity. However, a cardiac biopsy showed minor myocardial changes, which could have been due to daunorubicin. During a third relapse the patient received 270 mg/m2 doxorubicin-DNA. At autopsy still only minor signs of cardiomyopathy were seen. Thus, complex-binding of anthracyclines with the DNA appears to enhance the usefulness of these drugs in the treatment of patients with leukemia.

Adult↗
PubMed1981

Comparison of daunorubicin and daunorubicin-DNA complex in the treatment of acute nonlymphoblastic leukemia.

Sixty consecutive patients, 15-60 years old, with ANLL were divided randomly into three groups for induction treatment with one of the following regimens: R1, daunorubicin (DNR) 1.5 mg/kg on day 1 + ARA-C 2 mg/kg body weight on days 1-5; R2, DNR 1.5 mg/kg on days 1 and 2 + ARA-C 2 mg/kg on days 4-8; R3, DNR-DNA complex 1.5 mg/kg on days 1 and 2 + ARA-C 2 mg/kg on days 4-8. Maintenance treatment consisted of monthly courses of DNR 1.5 mg/kg (R1, R2) or DNR-DNA 1.5 mg/kg (R3) combined with ARA-C 1 mg/kg on days 1-5, alternating with thioguanine 2 mg/kg PO on days 1-5 combined with ARA-C 1 mg/kg IV on days 1-5. Fourteen patients of 20 went into complete remission with R1, 13 or 18 with R2, and 15 of 22 with R3. The overall remission frequency was 70% and there was no significant difference between the different groups. The median time in first remission and the median survival time were 300 and 510 days, respectively, with R1; 335 and 495 days with R2; and 295 and 677 days with R3. There was no statistically significant difference between the groups treated according to the different regimens concerning the time in first remission. Survival was slightly better with R3 than with R1. Treatment with the DNR-DNA complex caused less pronounced thrombocytopenia and fewer 'minor' cardiac abnormalities than treatment with free DNR in the same dosage schedule.

Acute Disease↗
PubMed1981

Thermography in the diagnosis of DVT.

161 consecutively admitted medical patients with the clinical suspicion of acute deep venous thrombosis (DVT) were thermographed and phlebographed in order to study the congruence of these methods. The sensitivity of thermography in the detection of DVT was found to be 99%, whereas the specificity was only 49%. The low specificity is explained by the fact that all thermographs suggestive of DVT were classified as pathologic to keep the sensitivity of the method as high as possible. Patients with dilated veins which may closely resemble DVT on thermography may in these cases give false positive results. Of 76 patients with phlebographically verified DVT, 22% became thermographically normal within 22 days, whereas 78% did not normalize within the mean observation time of 31 days. In another part of the study all medical patients (101) who were residing in our wards during a period of a week were screened by means of thermography. From this unselected group 17 patients were found to have thermographs suggestive of DVT. In 5 of these patients no reason for pathological thermography could be found. Thermography is a cheap and highly sensitive screening method for DVT, but findings of false positives caused by older thromboses and dilated veins are not unusual. The frequency of such false positives may be minimized by performing thermography after exercise.

Acute Disease↗
PubMed1979

Uptake of free and DNA-bound daunorubicin and doxorubicin into human leukemic cells.

Leukemic cells from seven patients with acute nonlymphoblastic leukemia and granulocytes, and mononuclear cells from three healthy controls were isolated by centrifugation on metrozoate-dextran. The intracellular accumulation of both the free and DNA-bound forms of daunorubicin and doxorubicin was studied in vitro. The uptake of unbound daunorubicin was higher than that of doxorubicin. At drug concentrations of 1.75 microM and higher the uptake of the free drugs was greater than that of the bound forms, but at lower drug concentrations the uptake was about the same. This could at least partly be explained by a greater dissociation of the DNA-drug complexes at lower drug concentrations. The uptake into normal leukocytes was of the same order of magnitude as that into leukemic cells. There was a great interindividual variation in the accumulation of both free and DNA-bound drugs in the cells from leukemic patients. This variation might be of importance for the prediction of individual sensitivity to the different drugs.

Bone Marrow Cells↗
PubMed1979

Treatment of acute nonlymphoblastic leukemia in adults with daunorubicin-DNA complex: a preliminary report.

Forty-four adult patients under 60 years of age with acute nonlymphoblastic leukemia were randomized for induction treatment with one of the following three regimens: R 1 = courses of daunorubicin on day 1 + ARA-C on days 1--5; R 2 = courses of daunorubicin on days 1 and 2 + ARA-C on days 4--8; R 3 = courses of daunorubicin-DNA complex on days 1--2 + ARA-C on days 4--8. Out of 14 patients, 9 went into remission on R 1, 6 out of 14 on R 2, and 8 out of 16 on R 3. The preliminary results suggest that daunorubicin-DNA complex has the same efficacy for inducing remission as daunorubicin alone, if the same time intervals and dosages are used.

Acute Disease↗
PubMed1979

Treatment of refractory anemias with methenolone.

A therapeutic trial with methenolone (Primobolan) in 19 consecutive patients with different types of refractory anemia is reported. The remission frequencies were: pancytopenia 3/6, bicytopenia 2/4, refractory anemia with hyperplastic marrow 1/5, myelofibrosis 1/4. There was no obvious prolongation of survival in the patients responding. Side-effects were negligible.

Aged↗
PubMed1979

Comparison of a new microcrystalline dicoumarol preparation with warfarin under routine treatment conditions.

1 To determine whether two different oral anticoagulants show difference under routine clinical conditions, 71 patients were randomized to treatment with Apekumarol, a microcrystalline dicoumarol preparation, and 72 patients to treatment with warfarin. 2 During the inpatient phase of treatment both drug groups remained for about 94% of their treatment time within prothrombin value limits of 5-25% (Simplastin A). No statistically significant difference was found between the drugs. 3 While under outpatient care, both drug groups remained for about 80% of their treatment time within prothrombin value limits of 5-25%. No statistically significant difference was found between the drugs. 4 The intensity of control and number of prothrombin-determinations did not differ significantly between the groups. 5 Variations in the daily dose did not differ significantly between the groups. 6 The mean daily dose could not be correlated to mean body weight. 7 The mean daily dose decreased with age for the male patients taking warfarin, not for the female patients. There was no such decrease for either male or female patients taking Apekumarol. An additional 137 patients who at the time of the trial were under routine treatment with warfarin were also studied with regard to mean daily dose, age and sex. In this additional group the mean daily dose could be correlated with age in both males and females. 8 No difference between Apekumarol and warfarin could be demonstrated when tested under routine clinical conditions according to the design of the present study. Sensitivity for warfarin, but not for Apekumarol, seems to increase with age, this sensitivity has been demonstrated in both sexes.

Adult↗
PubMed1977

Clinical trial of a new intramuscular iron preparation in iron deficiency anaemia.

A new intramuscular iron preparation (Ferastral) permitting high doses of iron (500 mg) to be given in two simultaneous of 250 mg, was tested in 20 courses given to 11 patients with iron deficiency anaemia. The total iron doses given ranged from 1 000-2 500 mg. The amount injected was calculated from the degree of haemoglobin deficiency. Additional 500-1 000 mg iron were given to fill the depots. Haemoglobin regeneration was satisfactory. Bone marrow aspiration to assess storage iron 2-14 weeks after treatment was carried out in most patients and showed restoration of stainable iron in bone marrow in those cases given Ferastral in doses of 500-1 000 mg greater than calculated to normalize haemoglobin concentrations. In two patients with persistent continued blood loss the bone marrow remained negative for stainable iron. Side-effects were negligible.

Adult↗