T. O. F. Wagner

Fibrinolytic therapy of massive pulmonary embolism on the 1st postoperative day following cholecystectomy

Two patients, aged 64 and 47 years, had a massive pulmonary embolism one day after cholecystectomy. Ultra-short fibrinolysis was undertaken with 1.5 million units of streptokinase. Both patients rapidly improved, with a fall in heart rate, pulmonary artery or central-venous pressure, and a rise in arterial pO2. There were no significant bleedings. Ultra-short fibrinolysis (maximally over one hour) can thus successfully lyse emboli--consisting of fresh plasminogen-rich coagulation thrombi in the early postoperative period--without re-opening wound- and capillary beds during this short period.

Episodic hormone secretion in the regulation and pathophysiology of the reproductive system in man

Publisher Summary This chapter describes the episodic hormone secretion in the regulation and pathophysiology of the reproductive system in man. The reproductive system has been extensively analyzed with respect to episodic hormone secretion, its underlying mechanisms of regulation, and pathophysiology. Infusions of testosterone and dihydrotestosterone at twice the daily production rate of testosterone in normal men significantly reduce LH pulse frequency and mean LH concentrations. As this approach may seem pharmacologic instead of physiologic, the use of anti-estrogens and anti-androgens may be preferred. Dopamine infusion reduces the mean LH level but does not influence LH pulse frequency. When gonadotropins are substituted, a continuous or a slow release from a depot of injection is sufficiently effective to normalize spermatogenesis in the same percentage of patients as with pulsatile LHRH infusion.