Efficacy of a new prostaglandin E1 regimen in outpatients with severe intermittent claudication: results of a multicenter placebo-controlled double-blind trial.

For the first time efficacy and safety of a new prostaglandin E1 (PGE1) regimen in the treatment of intermittent claudication were evaluated in a randomized, double-blind, placebo-controlled multicenter clinical trial. The study involved 213 outpatients with a maximum walking distance of 50 to 200 m measured on the treadmill (3 km/hr, 12% grade). After a 2-week run-in phase they received a 2-hour intravenous infusion of 60 micrograms PGE1 or placebo 5 days a week for 4 weeks. It was followed by a 4-week interval treatment with the same medication administered only twice a week. Patients were monitored for 3 months when they received no study medication. In the PGE1 group the intention-to-treat analysis (n = 208) revealed an increase in walking distance after 4 weeks of 75% (placebo, 43%). At the end of the interval treatment the walking distance had improved to 101% (placebo, 60%). The results remained virtually constant during follow-up (PGE1, 104%, placebo, 63%). Between-group comparisons showed significant differences in favor of PGE1 for all three time points of measurement (p < 0.05, p < 0.01, and p < 0.05). PGE1 was well tolerated; the rate of adverse reactions related to the treatment was 12.8% (placebo, 7.7%). In summary, these results show that the new PGE1 regimen is effective and safe in the treatment of outpatients with intermittent claudication.

[Thorotrastosis--a rare disease picture in internal medicine]. / Die Thorotrastose--ein seltenes Krankheitsbild in der Inneren Medizin.

The report deals with the late effects following administration of thorotrast in a 63-year-old patient: liver cirrhosis developed after application of thorotrast 25 years ago. The clinical findings are described and attention is drawn to the relevance of this disease at present time. The authors refer to the significance of the routine X-ray diagnosis and of the CT for finding a diagnosis with thorotrastosis.

[Ultrasound-controlled fine-needle puncture with a specially prepared puncture needle]. / Zur ultraschallgestützten Feinnadelpunktion mit einer speziell präparierten Punktionsnadel.

The described puncture needle with dual amplified point has been successfully applied at the Medical Clinic of the County Hospital Halle for more than half a year now. Better reflecting capacity in both vitro and vivo results from preparation of the needle point's surface. The more clear visibility of the needle point in the ultrasonic sectional view results in a better display during the whole process of puncture and makes possible a better locating also under difficult sonographic conditions. By the application of the described puncture needle the safety of the ultrasonic directed fine-needle puncture increases for both patient and examiner.