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Biomedical subjects

J D Gruss

Publications and source records attributed to J D Gruss.

At least 37 records · Page 2Linked to original sources
PubMed1989

Intravenous prostaglandin E1 versus pentoxifylline therapy in chronic arterial occlusive disease--a controlled randomised multicenter study.

In a controlled multicenter study 70 patients with chronic arterial occlusive disease stage IV according to Fontaine's classification were randomised to treatment with prostaglandin E1 (PGE1) or pentoxifylline (PX), administered over 4 weeks. Parameters of effectiveness were the reduction of analgesics, the relief of rest pain according to an analogue scale, the improvement of the ulceration according to an ulcer score and the healing of necrotic area. The results show that both forms of treatment produced a significant reduction in analgesic consumption and rest pain. Moreover in both groups a significant reduction of the ulcer score and healing of the necrotic area were observed. Side effects occurred in six patients of the PGE1-group and in ten patients of the PX-group, which required premature discontinuation of treatment in four patients of the PX-group. The study also demonstrated that PGE1 is more effective in the treatment of severe arterial occlusive disease than PX. With respect to the analgesic consumption, the reduction of ulcer score and the healing of necrotic area a significant difference was found in favour of PGE1. In accordance the six months follow-up examinations showed a marked deterioration in the PX-group opposed to the PGE1-group. The intravenous application of PGE1 over a period of 4 weeks in patients with severe arterial occlusive disease seems to be an effective therapeutical principle.

Aged↗
PubMed1988

[Reconstruction of unilateral iliac vein occlusion].

From 1 July 1971 through 6 June 1987, 46 of 10,644 reconstructive vascular interventions were Palma-operations. The morphological operability was ascertained by ascending phlebography and the functional indication by phlebodynamometry. The autologous contralateral saphenous vein was used in 19 patients as a transplant, whereas 27 patients received a spiral-wrap polytetrafluoraethylene (PTFE) prosthesis. All patients were given a temporary av-fistula. Followup was possible in 15 of the 19 autologous operations and in 25 of the 27 PTFE operations. Ten vein transplants and 21 PTFE transplants were still patent.

Adult↗
PubMed1987

[Prostaglandin E1 in stage III and IV arterial occlusive diseases. results of a multicenter study].

In a controlled randomized trial at four centers, using a common protocol, 57 patients with advanced chronic arterial occlusive disease (21 in stage III, 36 in stage IV) were treated with prostaglandin E1 (PGE1) or adenosine triphosphate (ATP) for three weeks. Both substances were administered intraarterially over 60 min. Daily dose of PGE1 was 20 micrograms, of ATP 30 mg. Both produced a significant reduction in resting pain at the end of the treatment phase, in stage III significantly better with PGE1. There was also a clear reduction in the use of analgesics, significantly more so with PGE1. Healing or improvement of ulcers was significantly better with PGE1, while there was no significant differences between the two drugs as regards stage improvement. Three amputations had to be performed in the PGE1 group, nine in the ATP group, a significant difference. Side effects in the form of reddening, pain and swellings occurred in 15 patients of the PGE1 group and six of the ATP group. Final verdict by the treating doctor about the success of treatment was significantly more favorable for PGE1.

Adenosine Triphosphate↗
PubMed1985

[10 years' experience with the in situ bypass].

From October 1, 1974 to March 31, 1984 467 femoropopliteal and femorotibial in situ vein bypasses were performed. Valvular incompetence is produced by the use of modified Hall strippers. The intraoperative angiography is mandatory to localize the tributaries and to detect pathological findings of the vein and technical errors. Overall cumulative patency rates were 84, 76, 71, and 67%, at 2, 5, 8 and 10 years. Cumulative patency rates for 117 tibial bypasses separately were 72, 68, and 68% at 2, 5 and 8 years.

Angiography↗
PubMed1983

[Continuous intra-arterial perfusion of prostaglandin E1 in inoperable stage-IV arteriopathies].

Inoperable stage IV arteriopathies have been treated by intra-arterial PGE1 infusion since January 1978. Inoperability was established in all cases by angiography or by attempted exploration and angiography during operation. Strict criteria for therapy were applied with the result that treatment was administered to only 100 patients among 3,335 cases undergoing vascular surgery. Dosage was 0.1 to 0.2 ng of PGE1 per kilo of body weight and per minute, mean duration of treatment being 34 days. Of the 100 limb extremities probably requiring wide amputations, 47 were saved from immediate amputation, the majority of patients in whom amputation could not be avoided being diabetic. Follow-up in July 1982, 1 to 4 years after treatment, showed that 24 extremities were still intact. Best results were noted in patients with endangiitis obliterans, and long-term results no longer demonstrated differences in patients with or without diabetic arteriopathy. Intra-arterial therapy can be repeated if necessary.

Acute Disease↗
PubMed1982

Conservative treatment of inoperable arterial occlusions of the lower extremities with intra-arterial prostaglandin E1.

Prostaglandin E1 has a strong vasodilator effect, it inhibits the aggregation of platelets and improves the microcirculation. The hormone is synthesized from arachidonic acid and 80-90 per cent is eliminated in the first transit of the pulmonary circulation. From 1 January 1978 to 30 June 1981 100 patients suffering from inoperable occlusion of the arteries of the lower limbs and facing amputation were treated with intra-arterial PGE1 by prolonged perfusion over an average period of 34 days. PGE1 0.1-0.2 ng kg-1 body weight min-1 was administered. Forty-seven of 100 legs were saved; 22 of 29 patients suffering from diabetes requiring insulin had to undergo amputation, but only 1 of 18 patients suffering from thromboangiitis obliterans had to have an amputation. The results of treatment in the 52 cases of uncomplicated arteriosclerosis lie in between, with 18 amputations. The complications that followed treatment were haemorrhage, arterial thrombosis, infection and mycotic aneurysms.

Adult↗
PubMed1977

[Treatment of the post-thrombotic syndrome: modification of May's femoral by-pass (author's transl)].

During May's femoral by-pass, one should avoid by sapheno-popliteal anastomosis, obstruction of the femoral vein damaged by the post-thrombotic syndrome. After the early work of Kunlin, arterio-venous fistulas are often found in reconstructive venous surgery. By making a transverse end-to-side anastomosis between the main peripheral saphenous vein and the posterior tibial artery behind the internal malleolus, one may obtain a protective effect on the sapheno-popliteal anastomosis, increasing the blood flow towards the main saphenous vein across the perforating veins down to the deep leg veins. The protective effect of the arterio-venous fistula seems to be of interest during inactivity of the muscular pump of the calf (postoperative phase and during rest at night).

Femoral Vein↗