[Juvenile occlusion syndrome of the inferior vena cava with left renal deficiency]. / Juveniles Verschlusssyndrom der Vena cava inferior mit Defizienz der linken Niere.

In three juvenile patients, one female and two males aged 14 to 21 years, there were recent deep vein thromboses of the lower limbs due to previous infrahepatic occlusion of the inferior vena cava associated with a shrunken left kidney without clinical manifestation of a nephrotic syndrome. Possible reasons and impacts of this probably congenital peculiar vascular syndrome are discussed. Radiodiagnostic management in juvenile patients with recurrent venous thromboses of the lower part of the body is explained with special respect to secondary phenomena of other retroperitoneal organs like adrenals, inner pelvis and testicles.

[Bencyclane in stage II arterial occlusive disease. Results of a controlled study]. / Bencyclan bei arterieller Verschlusskrankheit im Stadium II. Ergebnisse einer kontrollierten Studie.

In a single-center, double-blind, randomized study, 19 patients with peripheral arterial occlusive disease stage II Fontaine were treated with bencyclan, and a further 19 patients with buflomedil for 10 weeks after a wash-out phase of 2 weeks. Both groups showed a significant increase in painfree and total walking distances. No significant difference was found between the two groups.

Intravenous prostaglandin E1 versus pentoxifylline therapy in chronic arterial occlusive disease--a controlled randomised multicenter study.

In a controlled multicenter study 70 patients with chronic arterial occlusive disease stage IV according to Fontaine's classification were randomised to treatment with prostaglandin E1 (PGE1) or pentoxifylline (PX), administered over 4 weeks. Parameters of effectiveness were the reduction of analgesics, the relief of rest pain according to an analogue scale, the improvement of the ulceration according to an ulcer score and the healing of necrotic area. The results show that both forms of treatment produced a significant reduction in analgesic consumption and rest pain. Moreover in both groups a significant reduction of the ulcer score and healing of the necrotic area were observed. Side effects occurred in six patients of the PGE1-group and in ten patients of the PX-group, which required premature discontinuation of treatment in four patients of the PX-group. The study also demonstrated that PGE1 is more effective in the treatment of severe arterial occlusive disease than PX. With respect to the analgesic consumption, the reduction of ulcer score and the healing of necrotic area a significant difference was found in favour of PGE1. In accordance the six months follow-up examinations showed a marked deterioration in the PX-group opposed to the PGE1-group. The intravenous application of PGE1 over a period of 4 weeks in patients with severe arterial occlusive disease seems to be an effective therapeutical principle.

[Phlebography of the upper extremity--examination technic, indications and results]. / Phlebographie der oberen Extremität--Untersuchungstechnik, Indikationen und Ergebnisse.

Three radiological methods of examination can be used in phlebography of the upper extremity: screening (fluoroscopy) combined with on-target x-ray film examination; sheet film angiography; digital subtraction phlebography (DSP). Phlebography of the veins of the forearm performed preoperatively for selecting suitable veins for a dialysis shunt, should be done by screening with on-target x-ray film takes in several planes. DSP should be given preference if there is suspicion of thrombosis of the shoulder veins and the superior vena cava.

[Prostaglandin E1 in stage III and IV arterial occlusive diseases. results of a multicenter study]. / Prostaglandin E1 bei arterieller Verschlusskrankheit im Stadium III und IV. Ergebnisse einer multizentrischen Studie.

In a controlled randomized trial at four centers, using a common protocol, 57 patients with advanced chronic arterial occlusive disease (21 in stage III, 36 in stage IV) were treated with prostaglandin E1 (PGE1) or adenosine triphosphate (ATP) for three weeks. Both substances were administered intraarterially over 60 min. Daily dose of PGE1 was 20 micrograms, of ATP 30 mg. Both produced a significant reduction in resting pain at the end of the treatment phase, in stage III significantly better with PGE1. There was also a clear reduction in the use of analgesics, significantly more so with PGE1. Healing or improvement of ulcers was significantly better with PGE1, while there was no significant differences between the two drugs as regards stage improvement. Three amputations had to be performed in the PGE1 group, nine in the ATP group, a significant difference. Side effects in the form of reddening, pain and swellings occurred in 15 patients of the PGE1 group and six of the ATP group. Final verdict by the treating doctor about the success of treatment was significantly more favorable for PGE1.

Effects of pro-urokinase and urokinase on the fibrinolytic system in man.

The fibrinolytic and fibrinogenolytic properties of kidney cell pro-urokinase (PUK) were compared with those of natural urinary urokinase in human volunteers. Comparable degrees of fibrinolysis were obtained at a concentration of 500,000 U UK and a concentration of 500,000 IU natural urokinase. Natural urokinase showed a strong activation of the fibrinolytic system in plasma, evidenced by plasminogen activation, alpha 2-antiplasmin consumption, and the rise in fibrinogen-fibrin degradation products. In contrast to UK, there was no fall in plasminogen, no consumption of alpha 2-antiplasmin, and only a slight amount of fibrinogen-fibrin degradation products produced with PUK. These findings with PUK reveal a high affinity for fibrin and may result in better clot selectivity.

[Two-dimensional ultrasonics--a non-invasive method for the diagnosis of arteriosclerotic changes in the region of the supra-aortic branches]. / Der zweidimensionale Ultraschall--eine nicht-invasive Methode in der Diagnostik von arteriosklerotischen Veränderungen im Bereich der supraaortalen Aste.

2-D ultrasound examinations were performed on 98 patients suspected of arteriosclerotic changes in the region of the extracranial arteries of the neck. The findings were compared with those obtained by angiography, including digital subtraction angiography. In 84 patients there was concordance between the results of 2-D ultrasound and angiography. In six patients the B-scan alone gave false results. In eight patients no definite diagnosis could be made. The addition of 2-D ultrasound with bidirectional Doppler reduced false diagnoses to three and uncertain diagnoses to five. The combination of 2-D ultrasound and bidirectional Doppler thus increases the diagnostic possibilities to detect arteriosclerotic changes in the region of the extracranial cervical arteries of the neck.