On the efficacy of piracetam in geriatric patients with acute cerebral ischemia: a clinically controlled double-blind study.

Using a randomized, double blind group comparison, the efficacy and tolerance of piracetam as an additional therapy of hydroxyethyl starch, venous infusion and low dose heparin treatment, which are the basis of therapy in our hospital, has been studied in patients displaying acute cerebral ischemia. A total of 56 patients were enrolled, of whom 27 were given piracetam and 29 served as a control during a 28-day period. Using single photon emission computer tomography (SPECT) analysis, we observed that in 23 piracetam-treated patients (85.2%) a reduction in the area of brain regions displaying an impaired flow rate occurred (P < 0.001; Fisher's exact two-sided test). Only six of placebo-treated patients (20.7%) showed an improved flow rate. Analysis of the recorded computer tomography map gave an improvement coefficient >2 (flow rate marginally or better improved) for 23 piracetam patients as compared with 5 placebo patients (P < 0.001, Uleman test).

[Contrast medium clearance as a measure of kidney function in patients with renal artery stenoses]. / Kontrastmittel-Clearance als Mass der Nierenfunktion bei Patienten mit Nierenarterienstenosen (NAST).

The quantitative estimation of the characteristic radiation from 127I following external stimulation by 241americium photons makes it possible to estimate iodine concentration. The plasma concentration of non-ionic contrast media handled by glomerular filtration was measured in 16 patients with renal artery stenosis. This was done during diagnostic angiography or percutaneous dilatation, either at an early stage (one to two hours) or at a late stage (five to eight hours). Assuming an exponential excretory function, a clearance value could be calculated. The results were compared with the clearance values of a tubular excreted radiopharmaceutical (99m technetium-MAG3). Despite the different excretory mechanisms, there was a statistically significant correlation between the scintigraphic and contrast clearances at the later time (r = 0.85, p is less than 0.001). At the earlier stage, there was no signification correlation (r = 0.46, p is greater than 0.05). The correlation between the later values and the serum creatinin level was moderately significant (r = 0.55, p less than 0.05).

Transvenous perfusion cooling of the kidney: a new technique of local renal hypothermia.

In an experimental study involving ten dogs, the feasibility of transvenous perfusion cooling of the kidney is proven. The theoretical basis of this new method of regional renal hypothermia is presented; the technique is easy to perform and requires cannulation of the renal vein. The perfusate leaves the kidney either via the capsular veins which have been divided during renal exposure, or through the proposed nephrotomy. Renal vein thrombosis or tearing of the venous vasculature was not observed. The only complication encountered in one instance was hemorrhage from the puncture site of the renal vein.

[Congenital dyserythropoietic anemia type II. Another case report]. / Kongenitale dyserythropoetische Anämie Typ II. Eine weitere Beobachtung

Hematologic evaluation of a 29-year old man with jaundice since childhood demonstrated the characteristic findings of congenital dyserythropoietic anemia (CDA) type II. This type is characterized by ineffective erythropoiesis, multinuclearity of erythroblasts, electron-microscopic abnormalities of the red cell membrane, and abnormal serological reactions. Because of severe anemia repeated transfusions were necessary. After splenectomy thrombosis of the portal vein occurred. The patient died from hemorrhage due to ruptured esophageal varices.