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Biomedical subjects

W Theiss

Publications and source records attributed to W Theiss.

At least 55 records · Page 3Linked to original sources
PubMed1983

Systemic fibrinolytic activity and inhibitor levels during treatment of deep vein thrombosis with urokinase and streptokinase.

In a prospective, randomized trial 33 patients with deep vein thrombosis were treated either with 2,200 or 1,100 IU/kg/h urokinase or with 100,000 IU/h streptokinase for at least 6 days. While streptokinase was given continuously, urokinase was administered intermittently (12 hr urokinase alternating with 12 hr heparin). Urokinase treatment resulted in a dose-dependent fibrinolytic state with shortening of the euglobulin clot lysis time, easily demonstrable amidolytic activity and moderate decrease of plasminogen. At the end of each urokinase-free interval the fibrinolytic activity had mostly faded, but was reproducibly elicited again by each new urokinase administration. Streptokinase immediately evoked the customary, intense fibrinolytic state, which progressively tapered off as plasminogen fell to 1% of its pretreatment concentration. In all treatment groups alpha-2-antiplasmin dropped to approximately 40% of its initial value during the first 12 hr with a further decrease to about 20% after 6 days. alpha-2-macroglobulin fell only moderately with either urokinase regimen, whereas it decreased progressively to 45% under streptokinase. While the fibrinolytic activity decreased under streptokinase over the 6-day infusion period, it appeared to increase with each successive urokinase infusion particularly with 1100 IU/kg/h. Thus the final euglobulin clot lysis times and the final fibrinogen concentrations were similar in all three treatment groups on the sixth day.

Blood Coagulation Tests↗
PubMed1983

[Reactive leukemoid plasmacytosis with polyclonal hypergammaglobulinemia during streptokinase therapy].

Plasma cells are occasionally encountered in peripheral blood during fibrinolytic treatment with streptokinase. Leukaemoid plasmocytosis and increase of immunoglobulins were observed in a 44-year-old patient in connection with streptokinase treatment. Mature stages of plasma cells could be demonstrated in peripheral blood. The observed phenomena are considered as exaggerated immune response to foreign protein. They are of no disease value as they are only concomitant reactions to streptokinase treatment. Spontaneous regression occurred.

Adult↗
PubMed1983

The success rate of fibrinolytic therapy in fresh and old thrombosis of the iliac and femoral veins.

Since it is still a wide-held belief that fibrinolytic therapy can clear thrombi from deep veins only while they are fresh, we retrospectively analyzed the phlebographic results obtained in 85 patients with thrombosis of the iliac and/or femoral veins with symptoms present for 1 day to 8 weeks prior to treatment. Streptokinase, urokinase, or both drugs successively were administered in these patients for a mean of 9 days (range: 2 to 26 days). Complete or partial resolution of the thrombotic occlusion was obtained in 94%, 82%, and 69%, respectively, in those patients who presented within 3 days, 1 to 2 weeks, and 3 to 4 weeks after the first appearance of symptoms. With a delay of 5 to 8 weeks the results were uniformly poor with only 1 partial recanalization in 7 patients.

Adolescent↗
PubMed1982

[Fibrinolytic treatment of acute and subacute thromboses of the deep veins of the shoulder girdle (author's transl)].

19 patients were treated with streptokinase and (or) urokinase for primary thrombosis of the subclavian and (or) axillary vein (Paget-von-Schroetter-syndrome) of 2 to 28 days' duration. Phlebograms revealed significant improvement in 18 of the 19 patients (complete recanalization in 11, partial recanalization in 7). In those 17 patients whose symptoms had been present for up to 2 weeks the clinical outcome was entirely independent of the delay between the appearance of first symptoms and the start of fibrinolytic therapy, and even in the 2 patients wih an even longer delay complete recanalization was achieved in one (delay of 3 weeks) and partial recanalization in the other (delay of 4 weeks). However, since major clinical improvement occurs also spontaneously in most patients, a clear indication for fibrinolytic therapy exists only in particularly young patients and in those patients who depend on an absolutely perfect function of their upper extremities. In addition, the good results obtained with delayed fibrinolytic therapy justify extending this indication to those remaining patients in whom prior conservative management with elevation of the arm and anticoagulant therapy does not result in sufficient clinical improvement.

Adult↗
PubMed1980

[Deep venous thrombosis: streptokinase treatment with adaptation of the maintenance dosage].

Prolonged infusion of streptokinase at the customary dose of 100 000 u/h results in undesired plasminogen depletion in many patients. This can be avoided by adaptation of the streptokinase maintenance dose to the presumed rate of plasminogen synthesis of each individual patient. The practicability of this approach was tested in 52 patients who had streptokinase therapy of 3 to 9 days duration for deep vein thrombosis. Twice daily measurements of thrombin time and fibrinogen concentration were performed for immediate clinical surveyance and dosage adjustments. These led to a change from the original 100 000 u/h in most patients: in 65% the dose was reduced and in 10% it was increased. By this measure excessive plasminogen depletion was avoided in 88% of the patients. In them the final maintenance dose ranged from 40 000 to 150 000 u/h. Side effects were similar to those reported for the standard dosage scheme, and clinical results were good with a phlebographic success rate of 91% in recent and 65% in subacute or chronic deep vein thrombosis.

Adult↗
PubMed1980

[Coagulation studies and rheological measurements during streptokinase therapy of myocardial infarction (author's transl)].

In a multicenter, randomized trial of streptokinase in acute myocardial infarction one group of patients was given streptokinase for 24 h; the remainder served as controls and received a placebo infusion instead. Coagulation assays and rheological measurements were serially performed on patients entered into the trial at one of the participating centers. Streptokinase was found to improve considerably the flow properties of blood for a period of time exceeding the duration of its administration. These results may well explain the positive clinical effect of streptokinase therapy observed in this trial.

Acute Disease↗
PubMed1980

[Urokinase therapy of deep vein thrombosis (author's transl)].

30 patients with deep vein thrombosis were treated with a combination of urokinase and heparin. Clinically relevant improvement was achieved in 2/3 of them with appr. 40,000 IU/h (1,000,000 IU/d) urokinase administered over a period of several days. This indicates that urokinase at this dosage offers a valuable alternative or supplementation to fibrinolytic therapy with streptokinase. With the dosage employed, routine blood coagulation tests are only minimally affected, although a strong enhancement of fibrinolytic activity can be demonstrated by the euglobulin clot lysis time. Plasminogen depletion - as is usually observed with streptokinase therapy - does not occur. Urokinase is well tolerated and there is only a very moderate bleeding tendency. The cost per day of urokinase therapy at the dosage employed is approximately twice that of customary streptokinase therapy.

Adolescent↗
PubMed1979

[Lymphogranulomatosis in siblings (author's transl)].

In two similar pairs of siblings a histologically confirmed lymphogranulomatosis appeared at an interval of several years in each case. Such observations do not arise through purely coincidental familial frequency but siblings of granulomatosis patients have in fact a much higher risk of contracting Hodgkin's disease than other persons. This gives rise to important considerations for the etiology and pathogenesis of lymphogranulomatosis which are discussed in detail in the light of recent literature.

Adult↗
PubMed1979

Fibrin deposition and removal in disseminated intravascular coagulation induced by endotoxin and saline loading: radioautographic findings in rats.

In rats a single injection of endotoxin followed by an infusion of normal saline induced the generalized Shwartzman reaction. The presence of disseminated intravascular coagulation (DIC) was demonstrated by measuring plasma fibrinogen, platelet counts, schistocytes, plasma haemoglobin, fibrin(ogen) degradation products, and fibrin thrombi in the glomerular capillaries, 125I-fibrinogen was given after triggering DIC in order to examine the fibrinogen turnover in plasma and the kinetics of fibrin deposition and removal in kidney, liver, and spleen. 125I-fibrinogen turnover was found to be highly accelerated. Early deposition and removal were observed in the kidneys, while a later peak with a more delayed fall of radioactivity was noted in liver and spleen. On histological examination fibrin could be seen only in the glomerular capillaries and only in the early phase of DIC. In radioautographs radioactive material was localized in the glomerular capillaries, the Kupffer' cells of the liver, and in the perifollicular macrophages of the spleen. Comparing the results obtained by scintillation counting to those obtained by light microscopy it can be assumed that radioactivity in kidneys is correlated to fibrin deposition in glomerular capillaries and to an accumulation on fibrin(ogen) degradation products in liver and spleen.

Animals↗
PubMed1979

[Platelet suppressant therapy and oral anticoagulants in the secondary prevention of acute myocardial infarction (authors transl)].

First positive results with platelet suppressant drugs in the secondary prevention of acute myocardial infarction have engendered optimism in the medical and lay community alike. A review of the subject therefore seems appropriate. In the same context a critical reappraisal of the value of long-term anticoagulant therapy after acute myocardial infarction appears also warranted. Results with platelet suppressant therapy reported so far are favorable; however, they fall short from establishing definite proof of the value of such therapy after myocardial infarction. Accordingly, limited clinical use of platelet suppressants may be justifiable by now; it should be borne in mind, however, that such use at the present time still has to be considered experimental. In contrast, there has been statistically well-founded evidence that long-term anticoagulant therapy lowers the mortality after myocardial infarction. It is true, however, that the profit is rather small and that it can be achieved only under rigid control of anticoagulant therapy. Therefore the pros and the cons have to be weighed very carefully for every individual patient, before long-term therapy with oral anticoagulants is started after an acute myocardial infarction. Several large clinical studies are close to completion. It is to be hoped that their outcome will decide, whether platelet suppressant drugs will entirely replace oral anticoagulants in the secondary prevention of acute myocardial infarction.

Anticoagulants↗
PubMed1978

Mucopolysaccharidosis II (Hunter disease) with corneal opacities. Report on two patients at the extremes of a wide clinical spectrum.

Clinically visible corneal opacities were observed in a patient with an extremely severe form of mucopolysaccharidosis II. In a second patient with an unusually mild form of mucopolysaccharidosis II, discrete corneal opacities were detected by slit-lamp examination. Thus clear corneae can no longer be regarded as a hallmark of mucopolysaccharidosis II.

Adult↗