[Hemodynamics of the lower extremity following kidney transplantation].
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Biomedical subjects
Publications and source records attributed to N Klüken.
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The effect of horse-chestnut seed extract (standardized on aescin; Venostasin retard) was assessed in a randomized placebo-controlled crossover double-blind trial of 22 patients with proven chronic venous insufficiency by measuring the capillary filtration coefficient and the intravascular volume of the lower leg by venous-occlusion plethysmography. Three hours after taking two capsules of Venostasin (600 mg; each capsule containing 50 mg aescin) the capillary filtration coefficient had decreased by 22%, whereas after administration of an identical-looking placebo capsule it rose but slightly over three hours. The difference in the effect of Venostasin and placebo is statistically significant (P = 0.006). The intravascular volume was reduced 5% more after Venostasin than the placebo, but this is not statistically significant. It is concluded that Venostasin has an inhibitory effect on oedema formation via a decrease in transcapillary filtration and thus improves oedema-related symptoms in venous diseases of the legs.
Ulcers of the lower legs caused by arteriovenous fistulae show, on one hand, that diagnoses are often made carelessly and, on the other, that the treatment initiated is often inadequate. In both cases reported, there were several small arteriovenous fistulae in the lower legs, although no symptoms were observed for a long time. The ulcers, which then recurred chronically, resulted from very minor injuries. Their characteristics remained unnoticed for many years. Surgical intervention to remove these fistulae is not always simple because they cannot all be removed at once. Lower leg ulcers caused by arteriovenous shunts are an example of how difficult it can be to prove the cause of such lower leg ulcers.
In a double-blind, randomised multicentre study buflomedil, a vasoactive substance, was compared with placebo in the treatment of 93 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either buflomedil (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the differences in the improvement between the two groups were highly significant and in favour of buflomedil: for the pain-free walking distance p less than 0.001 and for the total walking distance p less than 0.01. The results indicate that buflomedil has a beneficial effect on the symptoms and lengthens the walking distance in patients with arterial occlusive disease.
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