ABSTRACT. The results of streptokinase and heparin treatment are compared in a 4‐year prospective study with special reference to preservation of high valvular venous function. An objective assessment was based upon phlebographic examinations before, during and 1–2 months after therapy. Complete lysis was demonstrated in 44% of high thromboses treated with streptokinase and in 6% treated with heparin. Retrograde phlebography revealed normal function of the proximal femoral valves in 92% of streptokinase‐treated high thromboses, compared with 13% of those treated with heparin. These phlebographic results were considered to be a valid prognostic indicator of the eventual development of the postthrombotic syndrome. Allergic reactions were seen in 39% and minor haemorrhagic complications in 18% of the streptokinase‐treated cases. The therapeutic benefit of streptokinase therapy in this study was found to outweigh any disadvantages incurred by observed complications.
Fifty‐five patients with clinical signs of acute DVT were investigated with thermography, plethysmography and phlebography. A comparison between phlebography and thermography showed a diagnostic agreement of 84%. Thermography was found, however, to have a low reliability for the localization of acute thrombi and was therefore combined with plethysmography in an attempt to obtain better results in this respect. Compared to the invasive phlebography, the noninvasive combination of thermography and plethysmography adequately located acute DVT in 95% of the cases.
Development of side‐effects after long‐term treatment with busulfan is described in a 61‐year‐old woman with chronic myelogenous leukemia. She developed severe pulmonary fibrosis and bilateral cataracts. Cellular atypia in bronchial and uterine cervical epithelium was present after 4 years of busulfan treatment, and in addition cellular abnormalities in the convoluted and collecting tubules of the kidney as well as in the liver were demonstrated. An Addisonian‐like syndrome appeared with hyperpigmentation of the skin, fatigue, loss of weight and diarrheas. Her respiratory symptoms as well as her general clinical condition did not improve after therapy was discontinued. The side‐effects of busulfan treatment are discussed and the literature is reviewed.
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