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Biomedical subjects

F Mahler

Publications and source records attributed to F Mahler.

At least 109 records · Page 6Linked to original sources
PubMed1987

[Microcirculation in clinical practice].

Capillary microscopy at the nailfold, the calf, and the dorsum of the foot and toes, in connection with local cold exposure test and fluorescence microlymphography, are methods with clinical applicability. Investigations of the microcirculation have shown clinically relevant results on the following questions: Differential diagnosis of Raynaud's phenomenon, evaluation of follow-up and therapeutic effects. Prognosis and evaluation of therapy in severe occlusive disease of the peripheral arteries. Differential diagnosis of leg edema and classification of lymphedema. Microcirculatory methods represent a promising approach to the questions surrounding diabetic microangiopathy and disorders of capillary permeability.

Aged↗
PubMed1987

Evaluation and clinical application of the flying spot method in clinical nailfold capillary TV-microscopy.

A video flying spot device was developed for the measurement of red blood cell velocity for clinical skin capillarscopy. The method relies on the advancing of a light spot on the TV-screen utilizing horizontal and vertical synchronized video pulses. Practical evaluation showed satisfactory accuracy in comparison to the frame-to-frame technique as well as reproducibility in the velocity range from 0 to 1.1 mm/s (correlation coefficients = 0.94). The advantage of this device lies in its simplicity and low cost. The suitability for application in the clinical laboratory is demonstrated in normal subjects and patients with Raynaud's phenomenon during a local cooling test using both the flying spot and the frame-to-frame technique.

Blood Flow Velocity↗
PubMed1987

Combination of short- and long-term catheter thrombolysis for peripheral arterial occlusion.

To save time and expenses we developed a combined program of local short-term catheter thrombolysis (CTL) in the angiographic laboratory followed by a long-term CTL on the ward if necessary to achieve patency. Out of 66 patients with arterial occlusion in the femoro-popliteal region the occluded segment was re-opened by short-term CTL alone in 22 patients (36%), and in 24 out of the remaining 44 patients by long-term CTL, giving a total primary success rate of 71%. Angiographic analysis showed that primary clinical success depended on the patency of run-off vessels in the calf after CTL. Complications occurred in five patients, necessitating surgical revision in only one. Two years after intervention 64% of the primarily recanalized arteries were still patent as shown by non-invasive examination.

Aged↗
PubMed1986

Renal artery embolism treated with intra-arterial streptokinase infusion results in patent but small renal arteries.

A low intra-arterial dose of streptokinase was used to dissolve a renal artery embolus in 2 patients. Angiography at the end of the streptokinase therapy disclosed patent renal arteries. Arteriograms performed 3 months and 2 years later demonstrated patent but small renal arteries. These cases confirm the limited experience reported in the literature that even though initial restoration of renal artery patency is possible, the ultimate renal function is poor after intra-arterial streptokinase therapy.

Adult↗
PubMed1986

Complications in percutaneous transluminal dilatation of renal arteries.

We propose a classification of the complications in renal artery percutaneous transluminal angioplasty (PTA) according to their severity and their direct or indirect relationship to PTA. Minor complications are reversible within the normal recovery period after PTA, while major complications are irreversible or reversible but necessitate extended hospitalization or surgery. The following complications are reported in the literature as being directly related to PTA: hemorrhage at the puncture site, hemorrhage from renal or access artery perforation or rupture, occlusive or nonocclusive dissection of the renal or access arteries, renal artery thrombosis, renal artery spasm or embolism leading to segmental renal infarction, peripheral artery embolisation, and balloon rupture complications. The indirectly related complications include transient or irreversible renal insufficiency, contrast media hypersensitivity, pressure-drop-related cerebral or myocardial ischemia, and anticoagulation-related hemorrhage infections. In our own series of 105 PTA in 80 patients, complications occurred in 11% of which 4% were major, 1% indirectly related to PTA leading to death. In the reports available, the rate of major complication ranges between 3 and 10%, and the death rate around 1%.

Adult↗
PubMed1985

[Effects of the Tibetan herbal preparation Padma 28 in intermittent claudication].

In a placebo-controlled double blind study the effect of Padma 28, a Tibetan herbal prescription, on patients with intermittent claudication was investigated. After two weeks without vasoactive therapy 23 patients were treated by Padma 28 and 20 by placebo. The patients had a disease history of at least 8 months, a steady state for symptoms (maximum walking distance below 250 m), and were distributed randomly in the two groups. After 16 weeks the patients treated with Padma 28 exhibited on standardized ergometry an increase of some 100% (p less than 0.01) in the maximum as well as painfree walking distance. The control patients showed increases of 21% in maximum (p less than 0.05 as compared to Padma 28), and 46% in painfree walking distance. The drug was well tolerated and no drop-out ensued because of side effects.

Clinical Trials as Topic↗
PubMed1985

Radionephrographic follow-up with hypertensive patients after angioplasty of renal artery stenosis.

Radionephrographies were performed in 23 hypertensive patients before and after 28 transluminal dilatations (PTD) of their stenosed renal arteries. The changing clearances for both kidneys (global = Clgl) and for stenosed and contralateral kidneys (Clst and Clco) were followed for three groups, dependent on their clinical outcome, as well as the parenchymal transit time (re-entry time) for the diseased (Rtst) and contralateral kidneys (Rtco): (A) Normalized hypertension: for 9 patients the preoperative Clco was never lower than 150 ml/min, but increased significantly after PTD. Rtst fell significantly, Rtco remained constant. Mean increase in Clgl = 91 ml/min (+25%). (B) Improved hypertension: in 12 patients Clst and Clco had been lower than with those in group A; postoperatively Clst increased, Rtst fell significantly. The Rtco was prolonged early after PTD but normalized later. (C) Permanent hypertension: for 7 of these patients there were no preoperative criteria for a discrimination against the other groups. But in all Rtst did not normalize, and Rtco increased early after PTD. Even in later examinations Rtco remained higher than preoperatively. These results imply that the success of PTD depends mainly on the behavior of the contralateral kidney. The examination 1 day after the PTD gives an optimal prognosis concerning the end result.

Angioplasty, Balloon↗
PubMed1984

[Acute ischemic syndrome of the foot following sclerotherapy of varicose veins].

The inadvertent injection of the sclerosant into an artery is the most serious complication of sclerotherapy. Four cases are presented, in all of which the posterior tibial artery was involved with resulting necrosis of portions of the foot. In one case a below-knee amputation was necessary. The necrosis depends mainly on the amount of the injected sclerosant. A noteworthy improvement due to specific therapy seems rare and was seen in only one of our cases. In this instance regional fibrinolysis was performed, whereas in a second case this approach proved detrimental. It appears to be much simpler to prevent this severe complication by adequate injection technique.

Acute Disease↗
PubMed1984

Percutaneous transluminal angioplasty of the arteries of the lower limbs: a 5 year follow-up.

A total of 482 percutaneous transluminal angioplasties (PTAs) of the arteries of the lower limbs were performed in 411 patients between 1977 and 1983. The 5 year patency rate, calculated by the life table method, was 83% for iliac and 58% for femoropopliteal PTA. Clinical improvement after the procedure was confirmed by a significant drop of the arm-ankle pressure difference: 48 +/- 5 mm Hg before vs 17 +/- 5 mm Hg 2 years after iliac PTA (p less than .01) and 73 +/- 5 mm Hg before vs 28 +/- 6 mm Hg after femoropopliteal PTA (p less than .01). The majority of reocclusions occurred within the first year after angioplasty. Patients with stenoses or occlusions of less than 3 cm had a favorable long-term patency rate of 74%. Conversely, patients with femoropopliteal occlusions presenting with pain at rest, diabetes, occlusions of greater than 3 cm, or poor distal runoff had an elevated rate of reocclusion. Complications, which occurred in 8% of the patients in whom PTA was attempted, included local hemorrhage, dissection, embolism, and spasm necessitating surgical intervention in 2%. No deaths or amputations were a direct consequence of PTA. PTA of arteries of the lower limbs may thus be regarded as a valid complementary treatment to vascular surgery in patients with occlusive disease of the peripheral arteries.

Aged↗