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Biomedical subjects

F Jung

Publications and source records attributed to F Jung.

At least 145 records · Page 8Linked to original sources

[Recombinant human erythropoietin (rh-EPO) in chronic, dialysis-dependent renal failure: effects on macro- and microcirculation and hematologic parameters].

Recombinant human erythropoietin (rh-EPO) has been shown to be effective in the treatment of renal anemia. Additionally, rh-EPO improves the hemostatic defect of uremia. On the other hand, a hypertensinogen effect and an increased risk for thrombosis have been reported in hemodialysis (HD) patients with rh-EPO. 20 HD patients in Homburg were recruited for a multicenter, placebo-controlled study (MF 3981), aiming to assess the risk of rh-EPO. Initially, 10 patients received rh-EPO at a dose of 3 x 80 U/kg body weight and week which was subsequently adjusted according to the hematocrit. After 6 months, the patients receiving placebo were changed to rh-EPO therapy. Clinical and laboratory data were obtained before, as well as 1, 3, 6 and 12 months after beginning of the study. Erythrocyte counts increased significantly in the rh-EPO group. Also, an increase of platelet count, fibrinogen and plasma viscosity was observed during rh-EPO. Tissue type plasminogen activator and plasminogen activator inhibitor as well as von-Willebrand-factor remained unchanged, although a shortening of the bleeding time was observed. Blood pressure and arterial blood flow were not influenced by rh-EPO.

Blood Viscosity↗

[Effect of hemodilution on systemic and capillary hematocrit].

In a cross-over study including 10 clinically healthy male volunteers, the hematocrit in the macro- and microcirculation was investigated prior to and 1 h, 3 h, 6 h and 24 h after iso- or (3 months later) hypervolemic hemodilution using 500 ml hydroxyethyl starch. The dilution effect observed after isovolemic hemodilution is more pronounced than after hypervolemic hemodilution. While isovolaemic hemodilution with 500 ml medium molecular weight hydroxyethyl starch leads to a reduction in the systemic hematocrit by 8.5% by volume, the capillary hematocrit at the time of the most marked dilution (1 h after hemodilution) decreases by only 1.3 hematocrit points in the cutaneous capillaries. After hypervolemic hemodilution, the systemic hematocrit decreases significantly by maximally 5.4% by volume, while the capillary hematocrit does not change significantly.

Adult↗

Effects of garlic on blood fluidity and fibrinolytic activity: a randomised, placebo-controlled, double-blind study.

In summary, it can be said that the improvement of blood fluidity and the simultaneous increase in fibrinolytic activity are an ideal complement. While the increase in fibrinolytic activity supports the physiological reparation process in the microcirculation, the improvement of blood fluidity produces an increase in capillary perfusion that has, in some way, a cleaning effect, with a 'purification' of the microcirculation.

Adult↗

[Quantifying retinal capillary circulation using the scanning laser ophthalmoscope].

The quantitative picture analysis of video fluorescein angiograms allows one to evaluate retinal hemodynamics. However, this method does not permit us to quantify the retinal capillary perfusion. Now, for the first time, we are able to quantify capillary bloodflow directly and objectively by means of scanning laser ophthalmoscopy. Even the measurement of the bloodflow velocity in all capillaries is now possible. Using digital frame-to-frame picture analysis of digital recordings, bloodflow velocities can be measured on the basis of the movement of dye boluses.

Blood Flow Velocity↗

Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers.

In a randomized placebo controlled single-blind cross-over study of n = 10 apparently healthy subjects the influence of Ginkgo biloba (Kaveri) on blood fluidity and cutaneous microcirculation was studied. Microcirculation was measured before and every 30 min for 4 h after administration of Ginkgo biloba; fluidity of blood was determined before and after 1, 2 and 4 h. Significant changes in blood pressure or heart rate were found neither during Ginkgo phase nor placebo phase. Haematocrit, plasma viscosity, erythrocyte rigidity, thrombocyte and leukocyte count as well as thrombocyte aggregation and the number of circulating thrombocyte aggregates were also not influenced by the Ginkgo nor the placebo solution. In contrast a remarkable influence on the erythrocyte aggregation was observed: comparing two samples a significant decrease by 15.6% (p less than 0.001) with regard to the initial value was observed after 2 h. The blood flow in the nail fold capillaries also increased significantly by about 57% (p less than 0.004) 1 h after administration.

Adult↗

[Hemodilution in patients with multiple morbidity and peripheral arterial occlusive disease].

The treatment of multi-morbid patients suffering from peripheral arterial occlusive disease (PAOD) is rendered difficult due to concomitant diseases such as coronary heart disease, chronic obstructive pulmonary affection, arterial hypertension or diabetes mellitus. Haemodilution can be a clinically efficient therapy for some of the concomitant diseases as well. It is, however, necessary to use a weak colloidal solution which has no additional volume effect as an iso-oncotic substance. Hydroxyethyl starch 200/0.5 6% meets all these demands. In a double-blind, placebo-controlled study over a period of 6 weeks a marked and significant increase of almost 40% in painfree walking distance was achieved for 19 of 37 multi-morbid patients with PAOD II by moderate hypervolaemic haemodilution with venesections. Besides the clinical improvement, blood fluidity also increased through a reduction in haematocrit, plasma viscosity, and erythrocyte aggregation.

Adult↗

[Iso- and hypervolemic hemodilution with hydroxyethyl starch (HES 200/.05 10%) in patients with II b peripheral arterial occlusive disease].

The basic therapy in stage IIb of peripheral arterial occlusive disease (PAOD) according to Fontaine is exercise. The aim of this study was to test whether (given initial physiological hematocrit values of 43 to 46%) a mild hypervolemic to isovolemic to hematocrit values of 40% with HES 200/0.5 10% or Ringer lactate in combination with exercise is even more favorable. In order to answer this question, 3 groups of 25 patients each were formed. One group exercised three times weekly and the second group, in addition to exercise, underwent a mild, hypervolemic to isovolemic 6-week dilution therapy with HES. In the final group the hematocrit value was reduced to the same extent by means of venesection and volume substitution with Ringer lactate. The walking distance increased in the HES group from 216 to 311 m (44%), in the Ringer lactate group from 214 to 258 m (20%), and in the exercise group from 213 to 242 m (14%). In comparison of the groups, the increase in pain-free walking distances in the HES group is found to differ significantly from those in the other groups. It was clearly demonstrated that hemodilution with HES in combination with exercise brings about a clinical effect of an order three times of that achieved by exercise alone. Venesection with subsequent administration of Ringer lactate and exercise is superior to exercise alone, but is markedly inferior to the combination therapy with HES.

Adult↗

Video fluorescein angiography: method and clinical application.

Video fluorescein angiography, combined with a picture analyzing system, is a clinically applicable, objective method of evaluating the retinal blood-flow parameters. Optical density measurements were performed on videorecordings of fluorescence angiograms by means of a picture-analyzing system in order to determine the circulation parameters of the retina. These included: the arm-retina time (ART), the arteriovenous passage time (AVP), and the mean arterial dye-bolus velocity (MDV). Normal values for these parameters were derived from measurements in 75 healthy volunteers. The mean arm-retina time (ART) was 11.2 +/- 3.3 s, the mean arteriovenous passage time (AVP) 1.45 +/- 0.4 s and the mean arterial dye-bolus velocity (MDV) 6.39 +/- 1.7 mm/s. No significant correlation could be shown between pulse or blood pressure and one of the retinal circulation parameters. A group of ten healthy volunteers was examined twice in order to obtain the intraindividual variation for the measuring parameters. The coefficient of variation for the ART was 18%, 10% for the AVP, and 26% for the MDV.

Adolescent↗

[Video fluorescein angiography follow-up of patients with retinal artery occlusion].

Forty patients (age 67 +/- 9 years) with acute central artery obstruction (CAO; n = 20) or branch artery occlusion (BAO; n = 20) of the retina were examined in a prospective study. All patients received a hypervolemic or isovolemic hemodilution, depending on their hematocrit values, for a period of ten days. Clinical, hemodynamic, and rheological data of these patients were recorded before therapy, after ten days, and after six weeks. Under this therapy the central vision of 24 patients (CAO: n = 10; BAO: n = 14) improved by two or more stages. The extent of the circulatory disturbance was determined by arteriovenous passage time and dye bolus velocity. Compared with a control group, a significantly increased arteriovenous passage time and decreased dye bolus velocity were observed initially. The values after ten days of therapy and after six weeks were significantly improved (P less than 0.01) as compared to the initial values. Patients with longer latency showed almost normal retinal hemodynamics, even without therapy, after some weeks. However, in most cases the spontaneous improvement occurred too late. Therefore, it appears important to achieve early reperfusion by therapy.

Adult↗

[Rheologic findings in patients with Eales disease].

In a retrospective analysis of findings in 12 patients with Eales' disease significant changes in blood fluidity were established. The six female and six male patients, aged between 15 and 59, were examined in the acute and subclinical stages and when a recurrence occurred. The rheologic parameters plasma viscosity, erythrocyte rigidity, and erythrocyte aggregation were significantly increased in the acute stage and when there was a recurrence, while in the subclinical stage the rheologic values improved to normal. No correlation could be found between the severity of the clinical picture in the various phases and the rheologic values. None of the other biochemical, microbiologic, and immunologic parameters were pathologic in any stage of the disease. In particular, virus serology, protein, immune, and hemoglobin electrophoresis were normal in all patients. While the etiology of Eales' disease remains unknown, deteroration in erythrocyte rigidity appears to play a part in the pathophysiology of the disease.

Adolescent↗

Effects of fish oil capsules in two dosages on blood pressure, platelet functions, haemorheological and clinical chemistry parameters in apparently healthy subjects.

The effects of a fish oil concentrate with an omega-3 fatty acid content of 42% was determined in two dosages in a double-blind, placebo-controlled study with a parallel group comparison over a period of 5 weeks with 30 healthy subjects. The daily intake chosen was four and eight capsules corresponding to 1.26 or 2.52 g omega-3 fatty acids. Plasma viscosity, erythrocyte rigidity and systolic blood pressure were significantly decreased (p less than 0.01) after a 5-week administration of 2.52 g omega-3 fatty acid daily. The reduction in vitamin E concentration was significant (p less than 0.01) only in the low-dose fish oil group. Lipids and lipoproteins remained unchanged throughout this experiment.

Adult↗

[Intra- and postoperative effect of various plasma substitutes on blood rheology and conjunctival oxygen partial pressure in microsurgical intervertebral disk operations].

In a prospective, randomized, controlled, parallel group study the effect of different infusion solutions (HES 200/0.5 10%, dextran 40 10% and electrolyte solution) during and after intervertebral disc microsurgery on blood fluidity and conjunctival partial oxygen pressure was measured. At the beginning of the operation all patients showed a reduction in conjunctival oxygen pressure - independent of the infusion solution. Both fluidity of blood and oxygen partial pressure changed according to the plasma substitute used. Thus after the administration of medium molecular weight hydroxyethyl starch an improvement in the fluidity of blood with a consecutive significant increase in the conjunctival oxygen pressure could be observed, whereas there was no increase after the administration of electrolyte solution and only a slight one (according to tendency) after infusion of dextran.

Adult↗

[Hemorheologic, micro- and macrocirculatory effects of an infusion of 500 ml of 6% medium molecular weight hydroxyethyl starch (Haes 200,000/0.5)].

In an open study the influence of hypervolemic hemodilution (Infusion of 500 cc hydroxyethyl starch 200,000/0.5 6% within 1 h) on macro- and microcirculation, fluidity of blood and conjunctival oxygen tension was investigated. Blood pressure and heart rate remained unchanged during and after the infusion. One hour after the infusion there was a tendency towards an increase in blood flow in the common carotid artery which then returned to normal again. The capillary circulation as well as the conjunctival oxygen partial pressure were significantly increased after 3 h. This correlated well with the decrease in plasma viscosity and erythrocyte aggregation. The effect of hemodilution using 6% middle molecular weight hydroxyethyl starch with a substitution degree of 50% on microcirculation was probably due to the rheological and not to the hemodynamic effect.

Adult↗

Vascular effects of naftidrofuryl in a randomized placebo-controlled double-blind study.

In a randomized, placebo-controlled, double-blind, crossover study in 10 volunteers it was demonstrated that intravenous administration of 200 mg naftidrofuryl (Dusodril, Praxilene) produced a slight but significant increase in the erythrocyte column diameters of conjunctival arterioles (mean diameter 17.5 +/- 7.6 microns) of 6.9% which persisted until 1 h after administration. The venules (mean diameter of the erythrocyte column 35.4 +/- 11.5 microns) are not significantly affected at the concentration tested. In their time course the results are in good agreement with the former measurements of the peripheral resistance and with the kinetic characteristic of the drug.

Adult↗