[Isolated internal iliac vein thrombosis as a cause of recurrent pulmonary emboli (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Heidrich.
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Lormetazepam, a new short-acting benzodiazepine, was tested multicentrally in 15 general practices. The subjects were 62 chronically sleep-disturbed patients. The first 7 days served as a placebo baseline week, the next 14 days were either lormetazepam or placebo in a randomized double-blind design, and during the last week placebo was given again to measure rebound effects. Lormetazepam was found to be an effective hypnotic that causes virtually no hangover the next morning. In this study no rebound effects could be measured. Visual analogue scales, among others, were used for the assessment of sleep characteristics.
In 26 patients (11 women and 15 men) with acute retinal vascular occlusion, the courses of spontaneous and collagen-induced thrombocyte aggregation were investigated 1 to 14 days (mean 6.8 +/- 4.8 days) after the onset of the symptoms and before the start of treatment, by means of the platelet aggregation test (PAT III) described by Breddin et al. (1975a). The results were compared with those of a control group consisting of 37 age-matched glaucoma and cataract patients (20 women and 17 men) with no vascular occlusions. Thrombocyte aggregation was high in 59.5% of the patients in the control group and 100% of the patients with retinal vascular occlusion. This would appear to show that pathological elevation of thrombocyte aggregation has considerable pathogenetic significance as an inducing factor of retinal vascular occlusion in the presence of concomitant arterial sclerosis and that treatment with inhibitors of thrombocyte aggregation would be appropriate.
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In a randomised double-blind study involving 20 diabetics and 20 patients with normal carbohydrate metabolism, the influence of a 14 days' course of intravenous infusion of protein-free calf blood extract (0.5 ml Actovegin/kg/day) and equivalent amounts of physiological saline solution on blood sugar and serum insulin was investigated by the oral glucose tolerance test (100 g Dextro-OGTT). In diabetic carbohydrate metabolism Actovegin was shown to improve the glucose tolerance significantly without alteration of the serum insulin, thus possessing antidiabetogenic activities. With normal carbohydrate metabolism, however, the behaviour of blood sugar and serum insulim was not changed by Actovegin.
In 17 patients with peripheral arterial occlusive disease the influence of intra-veinously applicated Bencyclane (Fludilat) on cardiac output and central-hemodynamic parameter has been investigated. While 100 mg (n = 8) of Bencyclane almost do not influence cardiac output, 200 mg (n = 9) cause a significant decrease of minute-volume of the heart by-17.22% and of heartfrequency by-8.85%. With either dose there is also a significant increase of aortic pressure, pulmonary arterial pressure and pulmonary vessel resistance to be seen. These results correlate with the animal-experimental proof of a negative inotropy under Bencyclane, and they have to be considered in therapeutical use.
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20 patients with Raynaud's syndrome were examined psychiatrically, 15 of them psychometrically as well (Giessen test, Freiburg personality inventory). Psychiatrically, there were neither psychoses nor manifest neuroses, but a chronic overconformity, emotional restraint and a compulsive, often stiff way of life were found as group-characteristic features. Psychometrically, the group-personality profiles lay within normal range. Psychopathologically, they showed contours, uncertain at best, of obsessional structure. Coincidence of psychic conflict situations due to chronically social influences and frequent occurrences of Raynaud attacks was confirmed. Incorporation of psychotherapeutic and sociomedical measures into the therapy of Raynaud's syndrome is thus well founded and necessary.
44 patients were treated with subcutaneous ancrod (Arwin) for peripheral arterial occlusive disease (Fontaine stage III). An acute fulminating arterial occlusion occurred in two patients on the 10th and 23rd days respectively, and in a third patient a deep venous thrombosis developed in the leg on the 45th day after beginning treatment. Accordingly, vascular occlusion must be expected during defibrination in the presence of poor peripheral drainage conditions and if the serum fibrinogen can no longer be maintained below 1.0 g/1 in spite of increasing the ancrod dosage. Under these circumstances the treatment must be terminated.
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The effect on whole-blood viscosity and haematocrit was investigated in 54 persons during intravenous infusion of 500 ml Rheomacrodex 10% or 500 ml 0.9% sodium chloride solution for two, four and six hours. Rheomacrodex 10% led to a significant decrease in whole-blood viscosity after all infusion periods and up to two hours afterwards. The decrease in viscosity was definitely more marked at lower degrees of shear than at higher ones and with long-term infusion (four and six hours) than short-term infusion (two hours). Physiological saline caused significant decrease in viscosity compared with initial values at the end of four and six-hour infusions and only at shear of 230 s-1. During all infusion periods and for all degrees of shear the decrease in viscosity was significantly greater with Rheomacrodex 10% than physiological saline.
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