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Biomedical subjects

E Minar

Publications and source records attributed to E Minar.

At least 145 records · Page 8Linked to original sources
PubMed1986

Sensitivity of 125J-fibrinogen uptake test for diagnosis of established venous thrombosis in heparinized patients.

The sensitivity of the radiofibrinogen test was investigated to determine the accuracy of the test in diagnosis of venographically proven venous thrombosis in 70 heparinized patients. 125J-fibrinogen was administered between 2 h and 4 days (mean: 1.5 days) after initiating heparin therapy. There were two criteria for a positive test: if the difference between the counts for adjacent points on the same leg or equivalent sites on opposite legs was at least 15%; and/or if there were three adjacent points each with counts greater than 5% that of the same three points on the other leg. The fibrinogen uptake test was positive at the first examination in 67 of 70 patients, giving a sensitivity of 96%. The respective frequencies of truly abnormal results for the 3 X 5% and the 1 X 15% criteria were 94% and 71%. As far as localization and extension of thrombosis were concerned, the fibrinogen uptake test agreed with phlebography in 73% of the cases, when the counts in the groin and the upper third of the thigh were ignored. The 125J-fibrinogen uptake test is an accurate method for detecting established deep leg vein thrombosis even in anticoagulated patients.

Adult↗
PubMed1986

[Percutaneous transluminal angioplasty (PTA) in peripheral arterial occlusive disease of the lower extremities].

The results of 185 percutaneous transluminal angioplasties (PTA) of the iliac (n = 62) and femoropopliteal segment (n = 123) with a double-lumen balloon catheter (Olbert) are presented. The mean age of the 150 patients was 64 years (range 39 to 91). While there were 87% stenoses and only 13% occlusions of the iliac segment, in the femoropopliteal segment the respective ratios were 46% and 54%. 71% of the patients suffered from intermittent claudication and 29% were severely ischaemic cases (Fontaine stages III and IV). Platelet inhibition was induced by means of acetylsalicylic acid 1 g/day prior to and during the procedure, and afterwards heparin was also administered for 4 days. The primary success rate in the iliac segment of 88.7% (of which 12.9% were classified as a partial success) was identical with that in the femoropopliteal region. Stenoses were successfully treated in 94.6% cases (9.9% being partial successes), occlusions in 79.7% (partial success in 16.2% of these cases). Complications occurred in 8.6% of cases, whereby surgical correction was required in half of these. When the procedure was complicated by major embolization into the distal popliteal artery, this was handled successfully by means of local thrombolytic therapy. Over the follow-up period of up to 21 months reocclusion--or high-grade restenosis--occurred in 26 patients. The cumulative patency rate 1 year after PTA was 92% for the iliac and 70% for the femoropopliteal segment.

Adult↗
PubMed1986

Influence of anticoagulant treatment in preventing graft occlusion following saphenous vein bypass for femoropopliteal occlusive disease.

Seventy-one patients underwent a classical reversed saphenous vein graft for femoropopliteal occlusive disease and were enrolled in a controlled clinical trial. During the second postoperative week the patients were allocated randomly into one of two groups; group 1 consisted of 34 patients who received coumarin, group 2 (37 patients) served as a control group without any anticoagulant treatment. The mean follow-up was 18 months. After 12 months the cumulative patency rate was 81 per cent and after 18 months 75 per cent; for patients receiving coumarin treatment, the respective figures were 90 and 82 per cent and for those with no anticoagulant treatment 72 and 67 per cent, the decrease being significant. When the bypass operation was performed for limb salvage (clinical stages III and IV) the overall results were worse (12 months, 72 per cent; 18 months, 68 per cent) than in stage II and stage II-III (12 months, 90 per cent; 18 months, 85 per cent). In limb salvage surgery the positive effects of anticoagulant treatment were significant (with treatment: 12 months, 87 per cent; 18 months, 87 per cent; without treatment: 12 months, 60 per cent; 18 months, 53 per cent). The site of the distal anastomosis (above knee: 12 months, 81 per cent; 18 months, 73 per cent versus below knee: 12 months, 80 per cent; 18 months, 75 per cent) did not have any demonstrable influence on the patency rate.

Aged↗
PubMed1986

Early postoperative changes after desobliteration of the carotid artery. Subsequent diagnostic control using a high resolution ultrasonic-real-time-duplex-scanner.

The ultrasonic morphology of the carotid artery following 55 endarterectomies in 50 patients (36 males, 14 females, mean age 68 (53-83) years) was studied using a high resolution ultrasound duplex system (HUDS). The examinations were done 1-3 days before as well as 2-4 days and 1, 2, 4 and 8 weeks after surgery, respectively. The following typical appearance after carotid endarterectomy was found: At the site of endarterectomy the new vessel wall showed the following details: lack of the "sonographic tunica intima" the thickness of the vessel wall was reduced with less pronounced ultrasonic structure compared with healthy subjects the surface toward the lumen was less smooth "ultrasonic soft" thrombotic layers with irregular surface, individual distribution (sometimes only spots) and thickness (0.5 to 4.0 mm) were seen in the majority of patients. The edge of the tunica intima was always visible in the common carotid (edge of endarterectomy) whereas in the internal carotid artery there was often an interference of the jaw. The change of caliber at the site of the edge of the tunica intima was dependent on the thickness of the "sonographic intima" as well as on the layer of the vessel wall in which endarterectomy was done. At the site of arterial clamping, intramural hematomas, lesions of the tunica intima with thrombotic layers causing some stenosis were observed after 9 of 55 procedures. Vascular sutures were always visible as bright spots. A "normalization" of local flow patterns could be seen in dependence on the morphological "normalization".(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[Complete AV block in a heart catheter study using a Swan-Ganz catheter].

A case of complete heart block during right heart Swan-Ganz balloon-tipped flow-directed catheterization in a patient with intermittent left bundle branch block after aortic valve replacement is reported. After entrance into the right ventricle with the catheter tip as well as after insertion of a temporary balloon-floated pacemaker electrode symptomatic complete heart block occurred. This case demonstrates that in a patient with intermittent left bundle branch block a complete AV block may occur and therefore the possibility of cardiopulmonary resuscitation and temporary pacing has to be taken in account.

Aged↗
PubMed1986

Plasma concentrations of ketanserin in chronic hemodialysed patients.

Six patients on chronic hemodialysis received 20 mg ketanserin p.o. twice daily for 3 days. Plasma levels were measured daily 2 hours after application of the morning dose; however, on the third day, plasma levels were taken before, during and after dialysis. On the 4th day elimination was measured after a single dose of 20 mg ketanserin for 24 hours. Mean plasma levels ranged from 19 to 31 ng/ml. Both ketanserin and reduced ketanserin were not eliminated by dialysis. Elimination half-life was about 12 hours.

Adult↗
PubMed1985

[Comparative pharmacokinetics of the beta-1 receptor blookader celiprolol after a single oral administration in subjects with health kidneys and in patients with impaired renal function].

Pharmacokinetic parameters were determined after the oral administration of a single tablet containing 200 mg celiprolol HCl to 8 healthy volunteers with normal kidney function and 6 patients with stable impaired renal function of different degrees of severity. The plasma levels and the urinary excretion of celiprolol were followed up for 48 hours after administration with the help of specific chemo-analytical methods. The substance was equally well absorbed both by healthy volunteers and patients with renal disease. While the cumulative renal excretion (0 to 48 hours after administration) was reduced from 18.2% in healthy volunteers to 2.3% of the applied dose in kidney patients, the global elimination constant k fell from 0.104 h-1 in healthy volunteers to 0.072 h-1 in the patients with renal disease. It can be assumed that in patients with impaired renal function at least a part of the lacking renal elimination of celiprolol can be taken over by "extrarenal elimination". According to the method of Dettli a reduction in dosage of the beta 1-blocker, celiprolol is not necessary in patients with more or less impaired kidney function.

Administration, Oral↗
PubMed1985

Local hirudin application--an aid in preventing occlusion of an arteriovenous fistula in dialysis patients?

In this pilot study we tested the effect of an ointment containing hirudin in a high concentration [20,000 ATU (anti-thrombin units)/100 g ointment] in ten patients on maintenance haemodialysis (six men, four women: mean age: 51 years; mean duration of dialysis treatment: 20.4 months). The duration of hirudin application was 4.5 months, the observation period in the total group was 43 months. During the total dialysis period of 204 months - before hirudin application - in these ten patients a shunt thrombectomy was necessary 18 times because of shunt occlusion. A shunt-thrombosis occurred in none of the ten patients during the period of application of the hirudin-containing ointment.

Administration, Topical↗
PubMed1985

[Primary biliary cirrhosis and scleroderma: long-term benign course of a complex autoimmune disease].

A 57 year old female patient suffered from Raynaud's syndrome and relapsing necrotizing lesions of the finger tips. Diagnosis of sclerodermia was established by angiography and biopsy. A spotty brownish coloration of the skin and cirrhosis of the liver were observed in addition. Clinical chemistry showed increased alkaline phosphatase and increased titers of antimitochondrial antibodies. Histology of liver tissue was compatible with a diagnosis of primary biliary cirrhosis. After a course of several years a Sicca syndrome appeared. On investigation of family members an increased incidence of positive antinuclear and antimitochondrial antibodies was found. The patient has now been followed for 5 years. Prognosis may be considered to be good.

Autoimmune Diseases↗
PubMed1984

Elevated plasma fibronectin levels in nephrotic syndrome.

In nine patients with nephrotic syndrome the behaviour of plasma fibronectin was studied. Of nine patients seven showed elevated plasma fibronectin levels while the plasma fibrinogen level was increased in eight of the nine investigated patients. A positive correlation was found between plasma fibronectin levels and fibrinogen (P less than 0.01), cholesterol (P less than 0.01) and proteinuria (P less than 0.05). The results indicate that elevated plasma fibronectin levels could be an additional factor responsible for hypercoagulability in nephrotic syndrome.

Adolescent↗
PubMed1984

Effect of combination therapy with cimetidine and pirenzepine on plasma parathyroid hormone and calcitonin levels in hemodialyzed patients.

In this study we evaluated the effects of an oral combination therapy with cimetidine and pirenzepine on plasma parathyroidhormone (PTH) and calcitonin (CT) levels in 24 patients on maintenance hemodialysis (mean age: 50 years; mean duration of dialysis treatment: 23 months). As compared to the pre-treatment plasma levels of PTH and CT, there were no significant changes of their plasma concentrations during a 4-week administration of 800 mg cimetidine or 100 mg pirenzepine daily, and the concentrations also did not change significantly during the following 4 weeks of combination therapy with cimetidine and pirenzepine in the above mentioned dosage. Serum concentrations of calcium and phosphate and the activity of the alkaline phosphatase showed no significant changes either. Therefore, we suggest that this therapeutic approach cannot be considered for the treatment of uremic hyperparathyroidism.

Adolescent↗
PubMed1984

[Hematologic changes in patients under long-term hemodialysis and hemofiltration treatment with special reference to serum concentrations of folic acid and vitamin B 12].

The incidence of macrocytic anemia has been investigated in 32 patients on maintenance hemodialysis (mean age 46 years, mean duration of dialysis treatment 27.5 months), in 18 patients with combined hemodialysis (HD) and hemofiltration (HF) treatment (mean age 42 years, mean duration of combined HD and HF treatment 6.3 months) and in 32 patients after renal transplantation (mean age 41 years, mean observation period since successful renal transplantation 55.2 months). Also investigated were serum levels of vitamin B12 (radioassay kit 57Co) and folic acid (radioassay kit 125J). Macrocytosis (MCV greater than 96 fl) was observed in 38% of the patients on maintenance hemodialysis, in 44% of the patients with combined HD and HF treatment, and in 47% of the renal transplant recipients. In the chronically dialysed patients, in contrast to the patients with combined HD and HF treatment, the mean serum folic acid level was significantly lower (p less than 0.005) than that of healthy controls. Serum levels of vitamin B12 were within the normal range in all patients. There were no significant differences in serum levels of folic acid and vitamin B12 between the patients with MCV greater than 96 fl and MCV less than or equal to 96 fl. Nor was there a correlation between the serum levels of folic acid or vitamin B12 and mean corpuscular volume. These results suggest that folic acid deficiency is of minor importance in the complex pathogenesis of anemia in hemodialysed patients.

Adult↗