[Results of the quantitative evaluation of the rheoencephalogram].
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Biomedical subjects
Publications and source records attributed to K Grossmann.
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The various physical methods are described which shall promote an improvement of the venous backflow from the lower extremities within the prevention of thromboembolism. Reviewing the recent results from literature the external pneumatic compression therapy is regarded as most effective method and a newly developed device for the intermittent pneumatic compression treatment is described.
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In an expert opinion of disturbance of the arterial blood supply concerning invalidity the vascular disease must be proved with sufficient ascertainment as well as the functional capacity remained must be estimated. Every expert opinion should contain as far as possible concrete data already in the angiologic-diagnostic minimum programme. In problematic cases supplementations by a special angiological diagnostics are necessary. The criteria of evaluation of arterial obstructive diseases for an expert opinion concerning invalidity are also summarized in theses. Also the relations between disturbances of the peripheral blood supply and effects of injury are discussed. The paper concludes with references to the acknowledgement of a disability card in arterial obstructive diseases and to the motor-car driving ability of patients with vascular diseases.
The coincidence of arterial and venous vascular diseases in the region of the extremities is demonstrated. The frequency and the pathophysiological connections are explained and a subdivision of the different forms of combination is made. The therapy has to orient itself at the pathophysiological processes of the individual case, where the arterial as well as the venous vascular region is to be included in the treatment.
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In 1981, percutaneous transluminal angioplasty (PTA) of the subclavian artery was performed in 10 patients. 8 stenotic lesions were localized in the first segment and two in the third segment respectively. Dilatation was performed with the Grüntzig balloon-catheter ranging from 4 to 7 French. PTA was successful in 9 of the 10 cases. Success of dilatation was documented by recording blood pressure, normalization in the pre- and poststenotic segment and by clinical results. Success of PTA depends on exact angiographic studies, adequate indication and subsequent anticoagulation treatment. Early results after PTA are excellent. PTA of stenotic subclavian arteries has proved an alternative to surgical management.
A system of data acquisition and computer analysis for pulse wave measurements, realized by means of electronic oscillography (Boucke-Brecht system) or impedance rheography, is described. The system includes: 1. Computer-compatible data acquisition and registration 2. Conversion of data into digital form 3. Data processing and evaluation of parameters 4. Classification. Records are taken from equivalent points of left and right lower extremities. Computer analysis is performed off-line using a small computer (TPA-i). The computer program evaluates the following parameters: 1. Time intervals and amplitudes of pulse propagation time, inclinations, crest time, peak width, maximum and minimum of dicrotic wave 2. Areas between pulse curve and baseline 3. Extremes of 1st and 2nd derivates for the dynamic characterization of signal 4. Fourier coefficients All parameters are computed for 12 single pulse cycles and finally averaged, printed out, and stored in a data bank. The diagnostic significance of all these parameters was examined and evaluated for separation of normal and pathological curves. With linear discriminance analysis a correct classification of about 90% was obtained. Advantages of computer analysis are: 1. Time-consuming visual evaluation is avoided. 2. Accuracy and reliability of diagnosis are improved. 3. Additional parameters offer more diagnostic information. Further investigations are directed toward reducing the number of parameters and developing an efficient screening method for early diagnosis of peripheral arterial obstructions.
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Issuing from 33 patients with traumatic peripheral arteriovenous fistulas on the basis of an impressive case is reported on pathophysiological changes and it is referred to a possibly early operative correction of these peripheral arteriovenous shunt connections.
The authors give a report on their first results of percutaneous transluminal angioplasty of aortic arch branches in 4 patients. In 3 cases, stenosis of left subclavian arteries were treated by PTA with good result. One patient had a stenosis of both carotid arteries which were dilated with moderate effect. In all patients symptoms were removed. There were no complications.
The venoconstrictor effect of dihydroergotamine and dihydroergotoxine was compared in ten volunteers and in tne patients suffering from varicosis of the leg veins. The dihydrogenated ergot alkaloids were administered subcutaneously in a dose of 0.5 mg each. The influence on the capacitance reaction was determined by occlusion plethysmography of the calf. In addition, the arterial resistance was measured in the same region. Dihydroergotamine reduces the capacitance reaction in volunteers only at the high occlusion pressure levels 8.0 and 10.7 kPa after a lag of 40 min, whereas dihydroergotoxine does not show any significant influence. On the other hand, dihydroergotamine and dihydroergotoxine lead to a significant decrease in capacitance reaction in the patients after 20 and 60 min, respectively. However, the effect if dihydroergotamine (2.1 ml/100 ml tissue) is significantly greater than that of dihydroergotoxine (1.2 ml/100 ml tissue) and nearly normalizes the increased capacitance reaction. The two drugs increase the arterial resistance more clearly in the volunteers than in the patients, and dihydroergotoxine more often than dihydroergotamine tends to decrease resistance when the pre-existent resistance value is low.
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