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  • 1
    Electronic Resource
    Electronic Resource
    Prolonged infusion of prostacyclin in patients with advanced stages of peripheral vascular disease: A placebo-controlled cross-over study (1984)
    Springer
    Journal of molecular medicine 62 (1984), S. 1108-1114 
    Details
    ISSN: 1432-1440
    Keywords: Prostacyclin infusion ; Peripheral vascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twelve patients (age 33–77 years, mean age 68.4 years) with peripheral vascular disease (PVD) stage III–IV received continuous intravenous infusions of 5 ng prostacyclin (PGI2)/kg/min and physiological saline for 7 days. The administration was randomized and double-blind with an interval of 7 days between the infusions. During PGI2 infusion systolic blood pressure fell significantly from 147.8±4.8 mm Hg to 140.6±4.0 mm Hg (P〈0.01) and returned to 144.5±4.9 mm Hg post infusion. Transcutaneous p 2 O (tcp 2 O ) measured on the instep of the affected limb increased significantly by 8.9±3.8 Torr during PGI2 infusion and remained elevated during the subsequent week. A significant reduction of pain was observed from the 5th day of PGI2 infusion, lasting for at least the following observation period. Platelet cAMP increased from 18.8±1.5 pmol/108 platelets to 24.7±1.6 pmol/108 platelets on the 3rd day of PGI2 infusion (P〈0.01). Spontaneous platelet aggregation was also significantly reduced during PGI2 infusion. However, 7 days after the infusion thromboxane B2 (TXB2) in plasma and spontaneous platelet aggregation significantly increased in comparison with the preinfusion values, indicating a rebound phenomenon. The clinical outcome was favorable in 9 of 12 patients, was unchanged in two patients, while progressing to limb amputation in one patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01782467
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  • 2
    Electronic Resource
    Electronic Resource
    Arteriosklerotische Veränderungen der Carotiden bei Patienten mit hypersensitivem Carotissinusreflex (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 20-25 
    Details
    ISSN: 1432-1440
    Keywords: Hyperactive carotid sinus reflex ; Carotid-artery sonography ; Arteriosclerosis ; Carotid arteries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirty-seven patients (15 female, 22 male; aged 46–89 years, mean age 68.8 years) with III or IV grade carotid sinus reflex carotid arteries were investigated by sonography (B-scan and CW-Doppler). It was demonstrated that stenoses or arteriosclerotic plaques, localized in the region of the carotid bulb or bifurcation, were present on both sides in 27 patients and on one side only in four patients. Five patients did not show these changes and four of them had thickening of common carotid artery endothelium. Thus, vascular changes occurred in 35 patients. Occlusions and stenoses 〉50% were visible in five patients. Primarily bilateral changes were shown as well as unilateral and bilateral pathologic reflex response; main localization was the posterior wall of the carotid bulb. Thus, arteriosclerotic changes seem to be important in the development of pathologic carotid sinus reflex. Cerebral complications (left-sided PRIND) occurred in one patient who did not have high degree carotid stenosis. In comparison to other authors who investigated only with CW-Doppler a much higher rate of arteriosclerotic wall changes and a greater occurrence of bilateral changes could be demonstrated by application of the highly sensitive B-scan sonography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01537482
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  • 3
    Electronic Resource
    Electronic Resource
    Antithrombin III deficiency in ischaemic stroke (1983)
    Springer
    Journal of molecular medicine 61 (1983), S. 617-620 
    Details
    ISSN: 1432-1440
    Keywords: AT III deficiency ; Ischaemic stroke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary AT III activity and concentration were measured in 36 patients (mean age 65.5 yrs, range 43–77 yrs) with ischaemic stroke within maximally 48 h of the acute event. In 12 patients (=33%) AT III activity was reduced below 18.4 IU/ml: 50% of these patients showed normal and 50% reduced AT III concentration of less than 22 mg/dl. In 15 patients AT III activity and concentration were measured in the acute phase on admission to hospital and 12 months later. In the acute phase, AT III activity was reduced when compared with AT III concentration (y=0.19x+15.5) and did not correlate with the latter. 12 months later, however, AT III activity and concentration correlated significantly (r=0.92;p〈0.001) and the regression line was steeper (y=0.8x). During the acute phase of ischaemic stroke, intravascular coagulation is evidently increased and inactive AT III-thrombin complexes are formed, whereby the concentration of active AT III decreases. A patient with progressive stroke and reduced AT III activity of 14.2 IU/ml was therefore substituted with AT III concentrate. The further neurological course was favourable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01487340
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  • 4
    Electronic Resource
    Electronic Resource
    Antiplatelet effects of intravenous iloprost in patients with peripheral arterial obliterative disease (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 545-551 
    Details
    ISSN: 1432-1440
    Keywords: Iloprost ; Antiplatelet actions ; Blood pressure ; Regional perfusion ; Peripheral arterial obliterative disease (PAOD) ; Dose-response study ; Controlled trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The dose-dependent inhibition of platelet aggregation by the chemically stable, prostacyclin-mimetic, iloprost, was studied in patients suffering from stage II–III peripheral arterial obliterative disease (PAOD). The study was designed as a randomized placebo-controlled cross-over trial. Iloprost was administered i.v. to six patients at doses of 0.5, 1.0, 2.0 or 3.0 ng/kg×min for 4 h, with an interval of 2–3 days between the infusions. During iloprost infusion, systolic and diastolic arterial blood pressure, heart rate and blood flow in the affected limb remained unchanged. In contrast, there was a considerable, dose-dependent inhibition of ADP- and thrombin-induced platelet aggregation and secretion ex vivo at doses of 0.5–2.0 ng/kg×min iloprost, indicating that iloprost reduced platelet stimulation by 50%–70%. The antiplatelet action of iloprost remained unchanged during infusion but ceased with 2 h after administration had ended. The agent was tolerated by the patients without unacceptable side-effects at doses up to 2 ng/kg × min. It is concluded that iloprost administered i.v. at doses of 1–2 ng/kg×min in patients with stage II–III PAOD does not involve haemodynamic side-effects and might be considered an effective antiplatelet agent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01735317
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  • 5
    Electronic Resource
    Electronic Resource
    High-resolution real-time ultrasound of the carotid bifurcation in patients with hyperactive carotid sinus syndrome (1985)
    Springer
    Journal of neurology 232 (1985), S. 318-325 
    Details
    ISSN: 1432-1459
    Keywords: Carotid bifurcation ; Common carotid artery ; Hyperactive carotid sinus syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The carotid bifurcations and the common carotid arteries of 36 patients with the diagnosis hyperactive carotid sinus syndrome (HCSS) were investigated by continuous wave (CW) Doppler ultrasonography and high-resolution real-time B-scan. Using these non-invasive tests, the functional impact of luminal stenosis and the morphological changes resulting from arteriosclerotic deformities could be established. Significant differences were found in comparison with a reference group of 199 patients with a high risk of arteriosclerosis. In the HCSS group, 5 patients had a stenosis of more than 50% at the origin of the internal carotid artery on both sides, or on one side in combination with large plaques or a complete occlusion on the contralateral side. Seventy-five per cent of patients in the HCSS group, as compared to only 23.5% of the control group, had effective arteriosclerotic changes in the carotid bifurcation on both sides; 4 patients had such changes only unilaterally. Marked additional bilateral arteriosclerotic depositions were detected in the common carotid arteries of 17 patients (47.2%). In 5 patients no arteriosclerotic lesions were detectable in the carotid bifurcations, but marked changes were found in both common carotid arteries. These data indicate that bilateral arteriosclerotic changes in the carotid bifurcations and/or the common carotid arteries represent an important pathophysiological factor for the development of an HCSS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313874
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  • 6
    Electronic Resource
    Electronic Resource
    The role of cerebral blood flow for the recovery of the brain after prolonged ischemia (1973)
    Springer
    Journal of neurology 204 (1973), S. 281-299 
    Details
    ISSN: 1432-1459
    Keywords: Autoregulation ; Carbon dioxide ; Cerebral ischemia ; Cerebral blood flow ; Drug effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An normothermen Katzen wurde die Durchblutung des Gehirns für eine Dauer von 30 und 60 min durch Abklemmen der Aa. innominata und subclavia sinistra bei gleichzeitiger Blutdrucksenkung vollständig unterbrochen. Die Auswirkung der Ischämie auf das Hirn wurde elektrophysiologisch verfolgt. Bei Tieren ohne funktionelle Erholung war die Blutrezirkulation im Anschluß an die Ischämie erheblich vermindert. Traten jedoch Zeichen funktioneller Erholung auf, so war die Durchblutung nach der Ischämie erhöht und normalisierte sich erst, wenn die ersten spontanen EEG-Wellen zurückkehrten. Zu diesem Zeitpunkt hatte sich die Autoregulation, nicht aber die CO2-Reaktivität der Hirngefäße normalisiert. In der postischämischen Phase konnte eine Steigerung der Hirndurchblutung durch vasoaktive Substanzen (Papaverin, Aminophyllin, Alpha-Receptoren-blokkierende Substanzen, Hydergin) nicht erzielt werden.
    Notes: Summary Complete cerebral ischemia of 30 and 60 min was produced in normothermic cats by arterial clamping and lowering of the blood pressure. The functional impact was monitored by electrophysiological methods. In animals without functional recovery blood flow was not fully restored after ischemia. In the animals in which signs of neuronal function returned, ischemia was followed by a transient phase of hyperemia, the termination of which coincided with the return of spontaneous EEG activity. At this time cerebrovascular autoregulation was present, but CO2 responsiveness was still completely abolished, and vasoactive drugs (papaverine, aminophylline, alpha adrenergic blocking agents, hydergine) failed to increase cerebral blood flow.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00316009
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  • 7
    Electronic Resource
    Electronic Resource
    Microsphere analysis of local cerebral and extracerebral blood flow after complete ischemia of the cat brain for one hour (1978)
    Springer
    Journal of neurology 218 (1978), S. 275-285 
    Details
    ISSN: 1432-1459
    Keywords: Cerebral blood flow ; Microsphere analysis ; Cerebral ischemia ; Reactive hyperemia ; Arteriovenous shunts
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An normothermen Katzen wurde die Durchblutung des Gehirns für eine Dauer von 60 min vollständig unterbrochen. Anschließend wurden die Hirne 30 min bis 4h lang mit Blut rezirkuliert. Vor und nach der Ischämie wurde die gesamte und lokale Durchblutung des Gehirns sowie die Durchblutung von Niere, Herz und Leber mit radioaktiv markierten Mikrosphären gemessen. Vor der Ischämie betrug die Durchblutung des Hirnes 39,1±2,3 ml/100 g/min, der Niere 307,2±28,3 ml/100 g/min, des Herzens 241,1±32,5 ml/100 g/min und der Leber 87,8±25,6 ml/100 g/min. Die lokalen Flußwerte des Hirnes schwankten zwischen 35 und 51 ml/100 g/min. 30 min nach Beginn der Rezirkulation im Anschluß an die Ischämie bestand eine ausgeprägte reaktive Hyperämie des Hirnes. Die lokalen Flußwerte stiegen auf das 3- bis 5fache des Ausgangswertes an. 2–4 Std nach der Ischämie sank die Durchblutung auf den Ausgangswert oder leicht darunter, gleichzeitig kam es zu einer deutlichen Umverteilung der Durchblutung innerhalb des Hirnes. Die Filterkapazität des Hirnes für Mikrosphären von 15 und 50 μ Durchmesser veränderte sich nach der Ischämie nicht, woraus geschlossen wird, daß während der Rezirkulation nach Ischämie keine arterio-venösen Shunts auftreten.
    Notes: Summary In normothermic anesthetized cats complete cerebral circulatory arrest for one h was produced and followed by blood recirculation of the brain for 30 min to 4h. Total and local blood flow of the brain, kidney, heart and liver were measured before and after ischemia using radioactive labelled microspheres. Before ischemia blood flow of the brain was 39.1±2.3 ml/100 g/min, of the kidney 307.2±28.3 ml/100 g/min, of the heart 241.1±32.5 ml/100 g/min and of the liver 87.8±25.6 ml/100 g/min (means±SEM). Regional flow rates within the brain varied between 35 and 51 ml/100 g/min. Reactive hyperemia was present in the brain 30 min after the beginning of recirculation following ischemia for 1h. Local cerebral flow rates increased three to five times above the control flow, depending on the respective region. Mean cerebral blood flow returned to or slightly below normal, 2 to 4h after ischemia, but there was considerable redistribution of flow rates within the brain. The filter capacity of the brain for microspheres of 15 μ and 50 μ diameter did not change after ischemia indicating that postischemic blood recirculation was not accompanied by an opening of arteriovenous shunts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00312883
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  • 8
    Electronic Resource
    Electronic Resource
    Effect of intravascular platelet aggregation on blood recirculation following prolonged ischemia of the cat brain (1980)
    Springer
    Journal of neurology 222 (1980), S. 159-170 
    Details
    ISSN: 1432-1459
    Keywords: Platelet aggregates ; Intravascular coagulation ; Microcirculation ; Cerebral ischemia ; Postischemic recirculation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An normothermen Katzen wurde die Durchblutung des Gehirns für eine Dauer von 60 min vollständig unterbrochen. Anschließend wurden die Hirne 30 min bis 4 h lang mit Blut rezirkuliert. Das Blutvolumen in exzidierten Hirn- und Organgewebestücken wurde durch vorangehende intravenöse Injektionen von 125 Jod-Albumin gemessen und die Plättchenanzahl durch Markierung autologer Blutplättchen mit 51 Chrom bestimmt. Die im Gewebe zurückgehaltenen Plättchen wurden quantitativ in der Weise erfaßt, daß von der Gesamtzahl der in der Gewebeprobe gemessenen Plättchen diejenige abgezogen wurde, die sich im durch 125 Jod-Albumin errechneten Blutvolumen befand. In scheinoperierten Tieren ließen sich nach 60minütiger Rezirkulation mit autologen 51 Chrom-markierten Blutplättchen keine überschüssigen Thrombozyten in den Hirngefäßen nachweisen, und die Gesamtzahl der Plättchen und der Fibrinogenkonzentration im venösen Blut änderte sich nicht. Bei Katzen mit Rezirkulation nach einstündiger kompletter Ischämie stieg die Zahl der im Hirn zurückgehaltenen Blutplättchen nach 30 min Rezirkulation, also der Periode der maximalen postischämischen Vasodilatationen und Hyperämie, signifikant an, wobei die höchsten Konzentrationen in der Grenzzone mit 270±60×104 und im Hirnstamm mit 240±70×104 Plättchen pro g Gewebe gefunden wurden. Die Anzahl der Plättchen im Blut und die Fibrinogenkonzentration fiel signifikant von 288±37×106/ml bzw. 299±50 mg% auf 186±25×106/ml bzw. 112±22 mg% ab. Nach 4h Rezirkulationszeit waren die zurückgehaltenen Plättchen im Gehirn fast komplett ausgewaschen. Die höchsten Konzentrationen von Blutplättchen wurden in der Niere, der Lunge und der Leber nach 30minütiger Rezirkulation gefunden. Diese Ergebnisse machen deutlich, daß die intravaskuläre Koagulation nach länger dauernder zerebraler Ischämie die extrazerebralen Organe mehr als das Hirn selber schädigt.
    Notes: Summary Reversible complete cerebro-circulatory arrest was produced in normothermic, anesthetized cats for 1 h by clamping the innominate and subclavian arteries, followed by blood recirculation of the brain for 30 min to 4 h. Blood volume of tissue samples was measured by intravenous injection of 125I-albumin and the platelet number by labelling of autologous platelets with 51Cr. The number of platelets trapped in the tissue was determined by subtracting from the total platelet count of the tissue sample those contained in the streaming blood, calculated from the blood volume by 125I-albumin. In sham-operated animals, after recirculation of autologous 51Cr labelled platelets for 60 min, no platelets were entrapped in the brain vasculature and total platelet number and fibrinogen concentration in the venous blood did not change. In animals submitted to complete cerebral ischemia for 1 h the number of trapped platelets increased significantly in the whole brain after 30 min of recirculation, i.e. the period of maximal postischemic vasodilatation and hyperemia, and highest concentrations were found in the border zone with 270±60×104 platelets/g tissue and in the brainstem with 240±70×104 platelets/g tissue. Blood platelets and fibrinogen concentration in the venous blood decreased significantly from 288±37×106/ml and 299±50 mg% to 186±25×106/ml platelets and 112±22 mg% of fibrinogen, respectively. Platelets were nearly completely washed out of the brain after 4h of recirculation. The highest increase of platelets was found in the kidney, lung and liver after 30 min of recirculation, indicating that intravascular coagulation following prolonged cerebral ischemia affects the extracerebral organs more than the brain itself.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313114
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  • 9
    Electronic Resource
    Electronic Resource
    Recovery of cerebral energy metabolism after complete ischemia of one hour's duration (1973)
    Springer
    Naturwissenschaften 60 (1973), S. 53-54 
    Details
    ISSN: 1432-1904
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Natural Sciences in General
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00591774
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