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Biomedical subjects

P Scheffler

Publications and source records attributed to P Scheffler.

At least 37 records · Page 2Linked to original sources
PubMed1991

[The value of 31 P nuclear magnetic resonance spectroscopy in follow up of Fontaine stage IIb peripheral arterial occlusive disease].

The method of nuclear magnetic resonance (NMR) spectroscopy compared to the parameters absolute-, pain-free walking distance and ankle/arm coefficient in Doppler pressure was used for observation of patients with peripheral arterial occlusive disease stage IIb according to Fontaine. While the classic parameters (walking distances, ankle/arm coefficient) described a homogenous group, NMR-spectroscopy parameters showed marked inter- and intraindividual variations during exercise. Further studies on high magnetic power fields, exercise patterns and muscle recreation analysis have to be carried out to develop a reliable system of non invasive muscle energy monitoring in vascular diseases.

Aged↗
PubMed1991

[Controlled vascular training in IIb peripheral arterial occlusive disease: additive effect of intravenous PGE1 versus intravenous pentoxifylline during training].

An intensive 4-week vascular training (patients with PAOD IIb) leads to an effective amelioration of painfree walking distance (+120%). Additive i.v. Pentoxifylline was not more effective (+105%) whereas PGE1 showed a remarkable increase (+605%). After one year the results in all groups diminished: training group: +30%, Pentoxifylline group: +30%, PGE1 group: +149%.

Alprostadil↗
PubMed1990

[Iloprost in the treatment of ischemic tissue lesions in diabetics. Results of a placebo-controlled multicenter study with a stable prostacyclin derivative].

The efficacy of iloprost, a stable prostacyclin analog, was investigated in a placebo-controlled trial in 109 diabetics with ischemic lesions. 56 patients were randomly allocated to iloprost and 53 patients to placebo. Iloprost was intravenously applied for 6 hours daily on 28 consecutive days at an individually tolerated dose up to 2 ng/kg/min. The control group received identical solvent volumes. In addition all patients had an intensive basic, mainly local, therapy. At the end of the treatment in the iloprost group 31 of 50 patients (62%) showed partial (greater than 30%) or total healing of the lesion(s). In the placebo group this was the case in 12 of 51 patients (22.5%). The difference of 38.5% was statistically significant (p less than 0.05, chi 2-test, alpha = 0.05, beta = 0.1). The percentage of patients who were free of pain increased from 23% to 42% (+19%) in the iloprost group and from 38% to 48% (+10%) in the placebo group. After dose-titration iloprost was well tolerated. Flush, headache and abdominal complaints were the most frequent side effects. Heart rate and blood pressure were not influenced and the control of diabetes was not altered.

Adult↗
PubMed1990

[The value of corpus cavernosum sonography following administration of vasoactive substances in the diagnosis of patients with erectile impotence].

In 70 Patients with erectile dysfunction, ultrasound examination of both corpora cavernosa after intracavernous injection of papaverine was done using B-scan, Duplex scan and Doppler color. B-scan can detect morphological disease in a penis profundis, the higher degrees of cavernous muscle myopathia, and disease of the tunica albuginea. For the analysis of pulse curve and the measurement of blood-flow velocity, the Duplex scan is necessary. Doppler color imaging enables ultra sonographic examination of a dorsalis and a penis profundis and can detect intracavernous vascular pathology. The results show that ultrasonography is an important diagnostic tool in patients with erectile dysfunction. A differentiated therapeutic strategy can be based on this examination, especially when revascularization procedures are being discussed. Additionally, better follow-up of patients under self-injection therapy is possible.

Adult↗
PubMed1990

Coincidence of risk factors and early carotid lesions, detected with modern ultrasound techniques.

Using a multichannel pulsed Doppler ultrasound device, studies of flow kinetics and vessel wall motility at the beginning of the internal carotid artery (ICA) were carried out. Regarding the results of special computer analysis in 120 subjects with healthy vessels, a dilation of the proximal ICA and a decrease in mean flow velocity which was related to the age of the individual could be assessed. Depending on age and risk factors, wall dyskinetics and turbulences in the dorso-lateral part of the vessel could be detected and confirmed by the flow imaging method. In a second study of 100 subjects (between 15 and 50 years of age) without risk factors, an age-dependent dilatation of ICA could be diagnosed by high resolution Duplex system. In the same study an increased incidence of wall thickening and plaques formation in the dilated area of the ICA was observed. The study of 234 patients with different risk factors showed that hypertonics developed an extended dilatation of the ICA and that wall thickening and plaque formation occurred significantly more often than in other risk groups.

Adult↗
PubMed1989

Therapeutic efficacy of intravenously applied prostaglandin E1.

The pharmacological effects of intravenous PGE1 on the macro- and microcirculation were investigated in two independent studies. In the first study 10 healthy subjects were given one i.v. infusion of 2 and 3 ampoules of Prostavasin (40/60 mcg PGE1) respectively, each over 1 hour with at least 1 day wash-out phase. Before as well as 20', 30', 40', 60' and 90 min after the infusion had started measurements of the blood flow in the A. femoralis communis were performed by the means of a Doppler ultrasound technique combined with a computer program (Mavis). Furthermore, tcPO2, heart rate and blood pressure as well as possible adverse reactions were registered. In the second study 10 patients with PAOD stage IIb (mean age: 49.5 years) received one i.v. infusion of 1, 2 and 3 ampoules of Prostavasin (20, 40, 60 mcg PGE1) respectively, in 250 ml saline over 1 hour with at least 1 day wash-out phase. Before as well as 20', 40', 60', 120' and 180 min after the infusion had started, the arterial blood flow was recorded with the method described above. TcPO2, plasma viscosity, erythrocyte aggregation, blood pressures and heart rate just as possible side effects were also registered. All PGE1 regimens induced a significant dose-dependent increase in the femoral blood flow with a maximum of 68% after 40 mcg of PGE1 and 79% after 60 mcg of PGE1 in healthy subjects and a maximum of 60% after 20 mcg of PGE1, 128% after 40 mcg of PGE1 and 161% after 60 mcg of PGE1 in the patients with pAOD (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Indications for extra-intracranial bypass surgery. New orientation after the Toronto Bypass Study based on angiographic and non-invasive ultrasound flow measurements.

UNLABELLED: Angiographic and flow measurement results in 18 cases, who underwent extra-intracranial bypass surgery, are presented. The method was the Mavis ultrasound technique. MAIN RESULT: Patients with unilateral internal carotid artery (ICA) occlusion and additional contralateral ICA stenosis or occlusion had a permanent cerebral blood flow (CBF) increase as a consequence of the anastomosis. On the contrary, patients without contralateral flow impairment or with good spontaneous extra-intracranial anastomosis did not have a real CBF improvement but only a temporary flow increase on the anastomotic side with comparable flow decrease in the contralateral ICA. The so-called Toronto Bypass Study was designed to evaluate the effectiveness of extra-intracranial bypass surgery for stroke prevention but it did not prove its effectiveness in this regard. Intentionally it did not put or answer the question of possible haemodynamic benefit for special subgroups of patients with cerebrovascular occlusive disease. Our results suggest such a haemodynamic benefit, and in consequence an indication for bypass treatment may be given in cases with ICA occlusion and additional contralateral flow impairment and without sufficient spontaneous collateralization. The question of a stroke preventing effect in this special subgroup should be answered by another controlled study. But this will be almost impossible to realize because--as a consequence of the Toronto study--at least in our country almost no further patients are transferred to the neurosurgeon for possible bypass surgery.

Arterial Occlusive Diseases↗
PubMed1987

[Use of streptokinase and urokinase in deep venous thrombosis and pulmonary embolism: indications and clinical experience].

The efficacy of fibrinolysis in DVT is dependent upon the age and organization of the thrombus as well as its localization. In consequence, selective evaluation prior to determining the indication for thrombolytic therapy is just as important for therapeutic success as choosing the appropriate fibrinolytic agent. To improve the results of fibrinolysis a team of angiologists, hemostaseologists, radiologists and surgeons are cooperating in a special "thromboembolic care unit". Phlebographic criteria were defined which allow differentiation of fibrinolytic indications depending upon the site of the thrombus. Selection of the fibrinolytic agent and careful monitoring of the thrombolysis should ensure a maximum therapeutic effect with a minimum of bleeding complications. The duration of thrombolysis was established through phlebographic verification and functional tests with venous occlusion plethysmography. The cause and results of 108 cases of thrombolysis shall be presented.

Humans↗
PubMed1987

[Hemorheologic, micro- and macrocirculatory effects of hypervolemic infusions of middle molecular weight hydroxyethyl starch (10%, 200,000/0.62) in healthy probands].

During an open clinical trial the influence of hypervolemic hemodilution (Infusion of 500 cc Elohäst within 1 h) on macrocirculation, microcirculation and blood fluidity of healthy volunteers was investigated. Blood pressure and heart rate remained constant during the infusion period and later on. The decline in hematocrit after 6 h was four points, plasma viscosity and erythrocyte aggregation, however, increased significantly. Three hours after completion of the infusion a significantly elevated blood flow in the common carotid artery could be assessed with a return to approximately normal values after 6 h. The improvement of the microcirculatory flow took a longer period of time. After 6 h a significantly increased erythrocyte velocity in the nailfold capillaries along with a significant augmentation of transcutaneously measured partial oxygen pressure could be stated.

Adult↗