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Biomedical subjects

J Blume

Publications and source records attributed to J Blume.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Bag plasmapheresis in patients with stage IIb peripheral arterial occlusive disease].

The clinical effect of bag-plasmapheresis was investigated in 60 patients with peripheral arterial occlusive disease stage II according to Fontaine. The initial number of patients was subdivided in three groups of 20 individuals using a randomised double-blind placebo-controlled design. Each patient gave 300 ml of blood twice a week for a 6 week duration. Blood plasma was separated in two groups and replaced with Hydroxyethyl-starch (200/0.5 10%) in group 1 and with Laevulose 5% in group 2. Patients in group 3 received their whole blood without any processing. All patients had to undergo a physical training of 45 minutes three times a week. The group who received Hydroxyethylstarch presented a 20% increase in walking distance whereas the increase in the Laevulose group was 5% and approximately 1% in the group receiving whole blood. The increase in walking distance in the Hydroxyethylstarch-group was significant on the 0.1%-level and significantly better than the improvement in walking distance of the other groups. Additionally in this group plasma viscosity showed a 3% decrease, erythrocyte aggregation was reduced by 10%. Results in the Laevulose group were only half as good as in the Hydroxyethylstarch group while parameters remained unchanged in the whole-blood-group. Bag plasmapheresis with Hydroxyethylstarch as substitute leads to an improvement in the walking capacity and blood fluidity thus offering a promising therapy for peripheral vascular occlusive disease.

Adult↗
PubMed1987

[Walk training and drug therapy in peripheral arterial occlusive disease. A randomized, prospective, placebo-controlled double-blind study].

It was demonstrated in a prospective, randomized and placebo-controlled double-blind study of two groups of 15 patients each with peripheral arterial occlusive disease in stage IIb of Fontaine that the combination of intravenous and oral administration of Pentoxifylline with walk training was superior to walk training alone. Comparison of the two groups revealed a significant increase in pain-free walking capacity, as well as reduction in plasma viscosity and platelet aggregation in the patients of the combination group. A significant reduction in platelet aggregation and rigidity occurred with time in this group only, while there was no significant difference between the groups with regard to these two parameters at the end of the treatment period.

Administration, Oral↗
PubMed1987

[Hemodilution in patients with stage IIb peripheral arterial occlusive disease: prospective randomized double-blind comparison of middle-molecular weight hydroxyethyl starch and low-molecular weight dextran solution].

Isovolemic hemodilution is a simple method of treating patients with peripheral arterial occlusion disease and hematocrit values of 43% or more. Dextran, a plasma substitute, has been used for that purpose since the early 1950s. However, the use of dextran in some diseases, e.g., hemorrhagic diathesis, kidney insufficiency, and microangiopathy is not without risk. Anaphylactic reaction, too, has occurred in some cases. Since the end of the 1970s hydroxyethyl starch, a plasma substitute, is available for the therapy of microcirculatory disorders and hemorrhagic diathesis. The side effects of hydroxyethyl starch are less serious and anaphylactic reactions are less frequent and moderate in extent. The clinical efficacy of both substances was compared in this survey. It could be stated that middle molecular hydroxyethyl starch is even clinically superior to low molecular dextran because the distance that the patients could walk increased significantly.

Arterial Occlusive Diseases↗
PubMed1986

Conservative drug therapy and walking exercise in stage IIb peripheral arterial occlusion disease.

In cases of peripheral arterial occlusion disease in Fontaine's stage IIb (PAOD IIb) with a walking distance of less than 200 m, the therapy that has priority, besides removing risk factors, is physical exercise. Very often it seems that concomitant rheological treatment with drugs is advisable to support the therapy and to improve compliance. The experience gained in the last 30 months in the treatment of PAOD IIb in a large angiological outpatient establishment is presented. All the patients were given thorough medical examination before the start of the therapy, and their angiological and rheological status was recorded. Depending on the results of the examinations, the patients with PAOD IIb were given one of three treatment variants: Patients with a haematocrit less than 43% and moderately altered rheology (group I; therapy: physical exercise). Patients with a haematocrit less than 43% and severely altered rheology, in particular increased erythrocyte rigidity (group II; therapy: physical exercise combined with naftidrofuryl treatment). Patients with a haematocrit of 43% or more and severely altered rheology (group III; therapy: physical exercise with haemodilution combined with naftidrofuryl treatment). Before the drug treatment was started, the possibility of surgical reconstruction of the vessels or angioplasty was discussed and the conservative therapy was undertaken only after surgery or when surgery had been rejected. Every course of treatment included reducing the risk factors as far as possible. All three conservative therapies were implemented for a period of at least 6 months. The increase in the walking distance was 157% (n = 27) after physical exercise alone, 238% (n = 27) with the naftidrofuryl combination therapy and 311% (n = 27) with the naftidrofuryl/haemodilution combination therapy.

Adult↗
PubMed1986

[Isovolemic hemodilution in stage-IIb peripheral arterial occlusive diseases. Prospective randomized double-blind comparison of middle-molecule hydroxyethyl starch and electrolyte solution].

Blood-letting to a haematocrit of 0.40 to 0.42 was performed over a period of six weeks on 30 randomized patients with peripheral vascular disease (intermittent claudication), stage IIb (after Fontaine), in addition to standardized gymnastics and physical exercise (walking). Subsequently, 15 randomly selected patients received after each blood-letting middle-molecular hydroxyethyl starch solution, another 15 randomized patients received isotonic sodium chloride solution, both groups under a double-blind protocol, gymnastics and walking exercise being continued. At the beginning of the study both groups were comparable with respect to clinical and vascular parameters and results of laboratory tests. Those of the former group had a significantly greater increase in pain-free walking distance than the latter. Blood pressure levels remained unchanged in the former, but significantly rose in the latter. Peak flow during reactive hyperaemia increased significantly in both legs in the first group, remaining unchanged in the second. An increase in spontaneous platelet aggregation occurred only in the second group; alpha 2-macroglobulin concentration rose only in patients of the first group, while fibrinogen decreased significantly in both.

Adult↗
PubMed1986

[Comparative study of low molecular dextran or hydroxyethyl starch as a volume substitute in hemodilution therapy].

Rheological therapy, as an immediate treatment in conjunction with physical therapy and the removal of risk factors, plays a significant role in the management of patients with peripheral vascular disease experiencing reduced walking tolerance. An essential element of rheological therapy is hemodilution. Currently, is still uncertain which plasma substitute solution would be the most appropriate in such cases. This study compared the effectiveness of low molecular hydroxyethyl starch to low molecular dextran during a 16-day hemodilution in combination to physical therapy. The clinical improvement observed with both plasma substitute solutions was comparable, yet in view of the cardiac volume overload, dextran demonstrates greater circulatory stress due to the transient pressure increase and more side effects. For this reason, we prefer to administer low or middle molecular hydroxyethyl starch in the dilution treatment of peripheral arterial occlusive disease as a chronic degenerative vascular disease.

Adult↗
PubMed1984

[Middle-molecular hydroxyethyl starch as a volume substitute. Its rheological effect in peripheral arterial occlusive diseases].

The tolerance to and effectiveness of middle-molecular hydroxy-ethyl starch as volume replacement by isovolemic haemodilution over 6 weeks was tested in 15 patients with peripheral arterial obstructive disease, stages II and III. After 6 weeks of isovolemic haemodilution treatment the pain-free walking distance increased significantly, the peak-flow after reactive hyperaemia increased, blood pressure and pulse remained unchanged, blood fluidity was significantly improved. This pilot study indicates that middle-molecular hydroxy-ethyl starch as volume replacement through isovolemic haemodilution represents a good alternative to dextran. It may even be superior to dextran in the treatment of arterial obstructive disease.

Arterial Occlusive Diseases↗
PubMed1984

Assignment of hemorheological instruments in the angiologic ambulance: first results and experiences.

Patients with chronic arterial disorders (CAD) frequently exhibit rheological alterations of the blood beneath generalisated sclerosing of the vessels and restricted arterial diameters. Alterations of different rheological parameters were determined in more than 80% of the examined patients. The following parameters were measured: yield shear stress in the ESM, hematocrit level in the IHA, plasma viscosity in the CTPV, standardized erythrocyte aggregation index in the MEA and standardized erythrocyte rigidity index in the SER.

Adult↗
PubMedDate not supplied

An economic principle for regulating rhythms of plants.

Supposing that rhythms as biological events must be teleologically regulated, the phase relations of the rhythms in the leaf movement of Canavalia ensiformis, exposed to periodical light-darkness changes, are investigated. Pergressive Fourier analysis is applied because it is especially suitable for such analyses. In order to understand the demonstration, a short description of this method is given. It is a variant of the Schuster method, developing at the end of the last century. It is demonstrated in particular that the three parameters of a sine function can be calculated. The key for this calculation is a parallel effect in the phase diagram by which it is possible to calculate the period T of a sine even if the analysis interval p is not a whole-numbered multiple of the period T. Because this parallel effect occurs even if the parameters of a sine have more or less great random oscillations, a heuristic principle is defined for revealing sine-like rhythms hidden in a curve or data. Its approximation to the analyzed curve or data can be calculated by an application of the method of the error squares of Gauss or by drawing. By applying this method it is demonstrated that the leaf movement of Canavalia ensiformis follows an economic principle if the plant is exposed to artificial changes of light and darkness of different periods. The rhythm with the weaker amplitude is so regulated by the stronger rhythm that extreme values coincide as much as possible. By such movement of the leaves the plant applies the smallest amount of mechanical energy, to produce the weaker rhythm simultaneously with the stronger.

Circadian Rhythm↗