Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 1992
Case Reports[Subarachnoid hemorrhage with pulmonary edema and electrocardiographic changes. The differential diagnosis of myocardial infarct].
A 32-year-old man (weight 132 kg, height 190 cm) suddenly became unconscious and cyanosed with an unrecordable pulse and ventricular flutter on ECG. After resuscitation, the blood pressure was 200/100 mm Hg; the patient moved his arms and legs at times, but he did not regain consciousness. Focal neurological signs and meningism were not demonstrable. ⋯ Despite implantation of an epidural pressure gauge, hyperventilation and administration of dexamethasone, osmotic diuretics and thiopental, the patient died 14 days after collapsing. At autopsy the heart showed no signs of myocardial infarction. The cause of the subarachnoid haemorrhage was a ruptured aneurysm of the anterior communicating artery.
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Dtsch. Med. Wochenschr. · Apr 1992
Randomized Controlled Trial Comparative Study Clinical Trial[A therapeutic comparison between hemodilution and pentoxifylline in arterial obstructive disease. An objective assessment by quantitative Doppler sonography].
The effects of a five-week course of haemodilution or pentoxifylline were compared in two matched groups of 10 patients each (18 men, 2 women; mean age 63 [47-77] years) with peripheral vascular disease of the legs, using clinical findings and Doppler ultrasound measurements as the criteria. Ten patients (group I) had six venesections of 400 ml each followed by the injection of 500 ml low-molecular dextran (10%), while the other ten (group II) received 400 mg pentoxifylline four times daily by mouth after initial intravenous loading. ⋯ Only in group I was there a significant prestenotic maximal and effective increase in blood flow velocity (by 66%: P less than 0.001 and 68%: P less than 0.05, respectively), while the poststenotic effective velocity also increased significantly by 66% (P less than 0.01). There was no significant change in group II patients.
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Dtsch. Med. Wochenschr. · Mar 1992
Case Reports[Presumed "successful" fibrinolysis in unrecognized acute aortic dissection].
Thrombolysis (1,500,000 IU streptokinase during 60 minutes and 500 mg acetylsalicylic acid was started in a 43-year-old woman with Turner's syndrome who had chest pain lasting for more than 45 min accompanied by ST elevations of 0.2 mV or more in leads II, III, aVF and V1-V5. Pain disappeared within an hour and the ST segments became isoelectric. Severe back and upper abdominal pain occurred 24 hours later. ⋯ Intraoperatively the rupture was found to extend to an apparently single left coronary ostium. The aortic valve was bicuspid and incompetent. After aortic valve replacement, resection of the ascending aorta and implantation of a vascular prosthesis the patient's condition gradually improved and she was discharged from hospital.