Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Apr 1983
[Preliminary results of prostaglandin E1 therapy in peripheral obliterating arteriopathy].
Prostaglandin E1 was given intraarterially to twenty persons with severe peripheral ischaemia at risk of requiring amputation of a limb for ischaemic ulcers or necrosis. All patients had received conventional therapy without success before PG E1 treatment. An average dose of 6.14 ng/kg/min of PG E1 was given intraarterially for 2 hrs daily over a period of six days. ⋯ No beneficial effects of PG E1 treatment were seen in five patients. In these cases cases multiple arterial occlusions, caused by arteriosclerosis and diabetes mellitus, existed, in more than three levels. Side effects like pain in the infused limb and swelling of the extremity occurred in fourteen patients, but were reversible in each case.
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Wien. Klin. Wochenschr. · Mar 1983
[Neopterin, a new biochemical marker for the detection of activated T lymphocytes].
In this review evidence is summarized indicating that the pteridine compound, neopterin represents a new and clinically useful biochemical tool to detect activated T-lymphocytes. T-cells stimulated in vivo or in vitro by allogeneic or virally or chemically modified autologous cells produce large amounts of this molecule. ⋯ These findings suggested that evaluation of neopterin levels might represent a means for the biochemical monitoring of disease states mediated by or associated with activated T-cells. Our clinical data obtained on patients suffering from allograft rejection, viral disease, or autoimmune states strongly support this concept.
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Wien. Klin. Wochenschr. · Sep 1982
Case Reports[Idiopathic medial necrosis of intracranial and cervical arteries. A report of 3 cases].
Two cases of stroke and one of subarachnoid haemorrhage are reported in women of child-bearing age, in which histological examination of the cervical and intracranial arteries revealed idiopathic medial necrosis. In the first case there was a dissecting aneurysm of a vertebral artery in the neck, caused by medial necrosis of this vessels. Two further dissecting aneurysms were found of the cervical arteries and partial rupture of the posterior cerebral artery, as well as focal medial degeneration of the aortic arch. ⋯ In the third case a massive subarachnoid haemorrhage occurred after several years of severe migraine. Histological examination of an "aneurysm" of a vertebral artery revealed complete rupture and focal medial necrosis. The scanty literature on this subject is reviewed and the significance of idiopathic medial necrosis in stroke and unexplained subarachnoid haemorrhage is emphasized.
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In peripheral vascular surgery a patient not infrequently becomes a high-risk case on account of local causes (morphological, haemodynamic), especially during long operations. Hence, low-risk procedures like partial or palliative operations, including extraanatomical procedures, and appropriate anaesthesiological methods are very important. ⋯ The distribution of extraanatomical procedures in a high-risk and a local or angiological-morphological situation showed that after one year only 50% of high-risk patients were still alive compared with 85% of the latter group. Local anaesthesia was very suitable for embolectomies, whilst for other indications we prefer spinal and peridural or combined regional and general anaesthesia, with the proviso that the patient is in the hands of a skilled anaesthesiologist.
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Wien. Klin. Wochenschr. · Mar 1982
Case Reports[Epithelioma cuniculatum. A special form of verrucous carcinoma (author's transl)].
The case report is presented of a patient with epithelioma cuniculatum, which developed on the sole of the foot following a poorly-healed war injury sustained years previously. The histological picture was that of a well-differentiated, locally invasive squamous cell carcinoma. It must be distinguished from other verrucous carcinomas in the differential diagnosis.