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Dissolved oxygen (DO) concentration in the water column is an environmental parameter that is crucial for the successful development of many pelagic organisms. Hypoxia tolerance and threshold values are species- and stage-specific and can vary enormously. While some fish species may suffer from oxygen values of less than 3 mL O2 L−1 through impacted growth, development and behaviour, other organisms such as euphausiids may survive DO levels as low as 0.1 mL O2 L−1. A change in the average or the range of DO may have significant impacts on the survival of certain species and hence on the species composition in the ecosystem with consequent changes in trophic pathways and productivity. Evidence for the deleterious effects of oxygen depletion on pelagic species is scarce, particularly in terms of the effect of low oxygen on development, recruitment and patterns of migration and distribution. While planktonic organisms have to cope with variable DOs and exploit adaptive mechanisms, nektonic species may avoid areas of unfavourable DO and develop adapted migration strategies. Planktonic organisms may only be able to escape vertically, above or beneath the Oxygen Minimum Zone (OMZ). In shallow areas only the surface layer can serve as a refuge, but in deep waters many organisms have developed vertical migration strategies to use, pass through and cope with the OMZ. This paper elucidates the role of DO for different taxa in the pelagic realm and the consequences of low oxygen for foodweb structure and system productivity. We describe processes in two contrasting systems, the semi-enclosed Baltic Sea and the coastal upwelling system of the Benguela Current to demonstrate the consequences of increasing hypoxia on ecosystem functioning and services.

Mesozooplankton collected during five sum- mer expeditions to the Arctic Ocean between 1987 and 1991 was analysed for regional patterns in biomass and species distribution, distinguishing between an epipela- gic (0-100 m) and a deeper (0-500 m) layer. A total of 58 stations was sampled mainly in the Nansen, Amundsen and Makarov Basins of the central Arctic Ocean and in areas of the Greenland Sea, West Spits- bergen Current and Barents Sea. Results from the dif- ferent expeditions were combined to create a transect extending from the Fram Strait across the Eurasian Basin into the Makarov Basin. Mesozooplankton dry mass in the upper 500 m decreased from 8.4 g m )2 in the West Spitsbergen Current to less than 2 g m )2 in the high-Arctic deep-sea basins. In the central Arctic Ocean, biomass was concentrated in the upper 100 m and was dominated by the large copepods Calanus hyperboreus and C. glacialis. In contrast, the mesozooplankton in the West Spitsbergen Current was more evenly distributed throughout the upper 500 m, with C. finmarchicus as the prevailing species. The distribution of abundant me- sopelagic species reflected the hydrographic regime: the calanoid copepod Gaetanus tenuispinus and the hyperiid amphipod Themisto abyssorum were most abundant in the Atlantic inflow, while Scaphocalanus magnus was a typical component of the high-Arctic fauna. The rela- tively high mesozooplankton biomass and the occur- rence of boreal-Atlantic species in the central Arctic Ocean are indicators for the import of organic material from allochthonous sources, especially from the north- ern North Atlantic. Hence, in spite of its enclosure by land masses, the Arctic Ocean is characterized by an exchange of water masses and organisms with the North Atlantic, and advection processes strongly influence the distribution of plankton species in this high-latitude ecosystem.

ZusammenfassungIn dieser Studie sollte bei Patienten mit tiefer Venenthrombose im Verlauf des akuten Ereignisses und bei ambulanter Nachuntersuchung die Beziehung zwischen bekannten hämostaseologischen Risikoindikatoren der Thrombophilie und der Akute-Phase-Reaktion untersucht werden. 73 Patienten mit phlebographisch gesicherter Venenthrombose wurden am Tag der Klinikaufnahme, am zweiten Tag und bei Entlassung aus dem Krankenhaus untersucht, bei 63 Patienten erfolgte eine ambulante Nachuntersuchung nach Abklingen der akuten Symptomatik. Bestimmt wurden die Parameter Plasminogenaktivator-Inhibitor (PAI), Ristocetin-Kofaktor, Plasminogen, Antithrombin III (AT III), Protein C, Protein S, Fibrinogen und C-reaktives Protein (CRP). Es zeigte sich ein deutlicher Abfall der bei 90% der Patienten pathologisch erhöhten CRP-Werte vom Zeitpunkt der Klinikaufnahme bis zur Entlassung aus dem Krankenhaus, 1/3 der Patienten hatte auch zum Zeitpunkt der ambulanten Nachuntersuchung noch erhöhte CRP-Konzehtrationen >0,5 mg/dl. Diese Patienten hatten eine Häufigkeit pathologisch erhöhter Werte von Fibrinogen (84,2%) und Ristocetin-Kofaktor (47,4%) wie zum Zeitpunkt der Akutveränderung bei Klinikaufnahme. Bei 2/3 der Patienten konnte bei der ambulanten Nachuntersuchung anhand unauffälliger CRP-Werte Fibrinogen, Ristocetin-Kofaktor und PAI sind auch als Risikoindikatoren arterieller Thrombosen bekannt. Dies führt zu dem Schluß, daß der Pathomechanismus und die Risikokonstellation bezüglich thromboembolischer Ereignisse zwischen arteriellem und venösem System ähnlicher sind als bisher angenommen.CRP hat sich nach den vorliegenden Ergebnissen als prognostisch wichtiger Risikomarker bei der tiefen Venenthrombose erwiesen. Die vorgelegten Daten können Hinweise darauf geben, daß die Entzündungsreaktion im Pathomechanismus der tiefen Venenthrombose eine kausale und nicht nur sekundäre Rolle spielt. Die prospektive Bedeutung dieser Ergebnisse muß noch durch weitere Untersuchungen geklärt werden.

Dissolved oxygen (DO) concentration in the water column is an environmental parameter that is crucial for the successful development of many pelagic organisms. Hypoxia tolerance and threshold values are species- and stage-specific and can vary enormously. While some fish species may suffer from oxygen values of less than 3 ml L−1 and show impact on growth, development and behaviour, other organisms such as euphausiids may survive DO levels as low as 0.1 ml L−1. A change in the average or the minimum or maximum DO in an area may have significant impacts on the survival of certain species and hence on the species composition in the ecosystem with consequent changes in trophic pathways and productivity. Evidence of the deleterious effects of oxygen depletion on species of the pelagic realm is scarce, particularly in terms of the effect of low oxygen on development, recruitment and patterns of migration and distribution. While planktonic organisms have to cope with different DOs and find adaptive mechanisms, nektonic species may avoid areas of inconvenient DO and develop adapted migrational strategies. Planktonic organisms may only be able to escape vertically, above or beneath the Oxygen Minimum Zone (OMZ). In shallow areas only the surface layer can serve as a refuge, in deep waters many organisms have developed vertical migration strategies to use, pass and cope with the OMZ. This paper elucidates the role of DO for different taxa in the pelagic realm and the consequences of low oxygen for foodweb structure and system productivity.

67 Patienten mit 68 durch Streptokinasebehandlung eroffneten Arterien wurden bis zu sechs Jahren spater nachuntersucht. In zehn der 68 Falle (=15%) war ein Reverschlus noch wahrend des stationaren Aufenthaltes aufgetreten. Das verbleibende Patientenkollektiv mit definitiv eroffneten Gefasen gliederte sich in drei Gruppen: Patienten, bei denen eine Beurteilung der Gefasverhaltnisse moglich war (A), Patienten, die in der Zwischenzeit verstorben waren (B) und Patienten, bei denen aus technischen Grunden eine Ermittlung des Gefasstatus ausgeschlossen war (C). Folgende Ergebnisse wurden in der Gruppe A ermittelt

Ten patients with 13 stenoses in the pelvic area were treated with low doses of streptokinase (30 000 U/h) for 72 hours. A significant improvement in the degree of stenosis was obtained as shown by post-stenotic pressure values. Biochemically there was a marked plasminaemia with moderately low fibrinogen levels. Streptokinase treatment with low doses could form an alternative method of treatment in arterial stenoses.

Two-day treatment with activator (equimolar streptokinase-human plasminogen complex) was given to 26 patients. Indications were chronic arterial occlusion and stenosis of the lower-limb arteries (25 patients), and thrombosis of the subclavian veins. The onset of claudication had on average been 7.5 months previously, average walking distance 288 metres. Five occlusions of iliac arteries and three of femoral arteries were removed. In addition, stenosis of the aorta (one case), the iliac artery (ten cases) and femoral artery (one case) was partly removed. Occlusion of the axillary vein was also removed. Average duration of the successfully treated occlusions was 4.3 months. Those stenoses that responded to activator had the well-known morphological criteria for fibrinolysis. The walking distance of the patients increased from an average of 288 to 401 metres. Activator treatment was well tolerated. No serious, especially cerebral, complications occurred. The most striking laboratory finding was of circulating plasmin during the entire duration of the infusion.

Mit Hilfe eines Clot-Lysis-Tests war es moglich, Streptokinasekonzentrationen in Humanplasma quantitativ zu erfassen. Das Testsystem bestand aus Rinderfibrinogen, Rinderplasminogen, Human-Euglobulin, EDTA, Humanplasma (mit unbekanntem Streptokinaseanteil) und Thrombin.

Subcutaneous Defibrase R administration permits reliable and safe reduction of fibrinogen values throughout weeks and months, and their maintenance on any desired level. 12 patients suffering from arterial occlusion with rest pain and necrosis were subjected to subcutaneous Defibrase therapy. 4 of them developed resistance to treatment after 1, 3, 4, and 6 weeks, respectively, i.e. fibrinogen levels started to rise again despite Defibrase administration. Arwin R was administered subcutaneously in an attempt to produce another drop in fibrinogen, which was successful in 2, but failed in the other 2 patients.

Streptokinase was dissolved in various solvents and the decay recorded. The method employed was a recently described clot lysis assay for quantitative streptokinase determination. The decrease in activity of 5 u streptokinase, 1500 u streptokinase, and 50,000 u steptokinase dissolved in one milliltre of different solvents (NaCl solution, glucose solution, laevulose solution, dextran solution (Rheomacrodex), gelatin solution (Haemaccel, starch solution (Plasmasteril,albumin solution, Michaelis buffer, heparin-glucose solution) and incubated over various periods of time (15 min, 30 min, 45 min, 60 min, 4h, 8h, 12h, 48h) was investigated. Solution media tested for streptokinase-potecting quality were broken down into three groups.-Group I: Solvents displaying excellent stabilizing properties (gelatin, albumin).-Group II: Solvents displaying medium stabilizing properties (dextran, levulose)--Group III: Solvents displaying properties (starch, NaCl, glucose, Michaelis buffer).--In testing streptokinase concentrations as used for therapeutic purpose (1500 u/ml, 50,000 u/ml), no decay was found to take place over observation periods as long as 48 h. This finding was independent of the different solvents (Group I, II or III) employed. Heparin stored with streptokinase at rooom temperature did not alter the streptokinase stability. From the clinical point of view, the choice of solvents for streptokinase infusion turned out to be of minor importance.

Fifty-three untreated borderline hypertensives and 73 normotensives were randomly selected from 1342 adolescents (age range 23-27 years) who were examined in 1975, 1976 and 1980 in an epidemiological study. Blood pressure was 127.2 +/- 1.0/79.0 +/- 0.8 mmHg in normotensives and 147.2 +/- 1.6/93.7 +/- 1.1 mmHg in hypertensives (P0.001). Erythrocyte deformability was measured with a positive pressure filter system (pore diameter 5 microns) at 37 degrees C. Erythrocyte deformability was significantly increased in hypertensives with a value of 1.77 +/- 0.05, compared with 1.64 +/- 0.04 in normotensives (P0.05). No difference in apparent whole blood viscosity, haematocrit and plasma fibrinogen was measurable between the groups. Although plasma noradrenaline and adrenaline concentration at rest and after 3 min standing were not different, excretion of urinary catecholamines was significantly elevated in hypertensives with 155.0 +/- 3.3 micrograms/24 h (normotensives: 100.7 +/- 5.3 micrograms/24 h; P0.001).

Twelve patients (age 33-77 years, mean age 68.4 years) with peripheral vascular disease (PVD) stage III-IV received continuous intravenous infusions of 5 ng prostacyclin (PGI2)/kg/min and physiological saline for 7 days. The administration was randomized and double-blind with an interval of 7 days between the infusions. During PGI2 infusion systolic blood pressure fell significantly from 147.8 +/- 4.8 mm Hg to 140.6 +/- 4.0 mm Hg (P less than 0.01) and returned to 144.5 +/- 4.9 mm Hg post infusion. Transcutaneous pO2 (tcpO2) measured on the instep of the affected limb increased significantly by 8.9 +/- 3.8 Torr during PGI2 infusion and remained elevated during the subsequent week. A significant reduction of pain was observed from the 5th day of PGI2 infusion, lasting for at least the following observation period. Platelet cAMP increased from 18.8 +/- 1.5 pmol/10(8) platelets to 24.7 +/- 1.6 pmol/10(8) platelets on the 3rd day of PGI2 infusion (P less than 0.01). Spontaneous platelet aggregation was also significantly reduced during PGI2 infusion. However, 7 days after the infusion thromboxane B2 (TXB2) in plasma and spontaneous platelet aggregation significantly increased in comparison with the preinfusion values, indicating a rebound phenomenon. The clinical outcome was favorable in 9 of 12 patients, was unchanged in two patients, while progressing to limb amputation in one patient.

Two-day treatment with activator (equimolar streptokinase-human plasminogen complex) was given to 26 patients. Indications were chronic arterial occlusion and stenosis of the lower-limb arteries (25 patients), and thrombosis of the subclavian veins. The onset of claudication had on average been 7.5 months previously, average walking distance 288 metres. Five occlusions of iliac arteries and three of femoral arteries were removed. In addition, stenosis of the aorta (one case), the iliac artery (ten cases) and femoral artery (one case) was partly removed. Occlusion of the axillary vein was also removed. Average duration of the successfully treated occlusions was 4.3 months. Those stenoses that responded to activator had the well-known morphological criteria for fibrinolysis. The walking distance of the patients increased from an average of 288 to 401 metres. Activator treatment was well tolerated. No serious, especially cerebral, complications occurred. The most striking laboratory finding was of circulating plasmin during the entire duration of the infusion.

Observational studies suggest that short term infusion of prostacyclin (PGI 2 ) may be of rapid and prolonged benefit in peripheral arterial disease. 10 patients with peripheral arterial disease received 72 hour intravenous infusions of PGI 2 and saline alone. The administration was randomized and single blind and 7 days separated the infusions. Calf muscle blood flow did not alter during PGI 2 or control infusions. Reactive hyperaemia improved slightly after PGI 2 but not significantly more so than after the control infusion. Leg pain improved during both infusions, but more so during PGI 2 infusion. Systolic pressure in the cubital, posterior tibial and dorsal pedal arteries was unaltered by PGI 2 infusion. Both the inhibition of spontaneous platelet aggregability and the aggregation response to ADP had returned to baseline 72 hours after PGI 2 , although platelet adhesion remained impaired. Coagulation, fibrinolysis and apparent viscosity were unaltered by PGI 2 infusion. Healing of ischaemic ulcers was not observed within 7 days of either infusion. However, within 8 weeks, 6 patients had undergone ulcer healing and 3 had progressed to amputation.

144 patients were treated with 50.000 or 100.000 fibrinolytic units (U) activator per hour over a period of up to 5 days. The drug is not yet available but in trial for the time being. We report on a survey of laboratory results in 32 of these patients. The plasminogen content of 100.000 U activator is comparable to the plasminogen content of 29 ml plasma. During activator infusion laboratory findings showed a moderate fall in plasminogen and fibrinogen. Plasmin activity was measurable during the whole period of treatment while antiplasmin was lowered considerably. There was a distinct hypocoagulabilty during activator infusion visible by a prolongation of the thrombin time and aPTT. Interestingly, no measurable activator or streptokinase activities appeared in the plasma during activator infusion. This is in contrast to findings with conventional streptokinase infusion schemes.

21 patients (aged 28-81 years) with recent subarachnoid hemorrhage (10 saccular aneurysms, 3 arteriovenous angiomas, 8 normal angiograms) were continuously infused with tranexamic acid at a dosage of 5 g daily for up to 14 days. Therapy was surveyed by daily measurement of the available plasminogen activity (aPl) with the chromogenic substrate S-2251 and by a modified bioassay, whereby the concentration of tranexamic acid was determined thrombelastographically and expressed as antifibrinolytic equivalent. In addition, a battery of blood coagulation tests was performed daily. 5 patients died, 1 after postoperative stroke, 3 as a result of general complications during intensive care treatment, but only 1 due to rebleeding. 4 patients were successfully operated during the first week, 1 patient after 2 weeks. aPl fell from 99.2% (SEM 3.0%, n = 21) before treatment to 72.9% (SEM 3.5%, n = 21) after 24 h and to the therapeutic level between 50 and 60% from day 2 on. The mean steady state of the antifibrinolytic equivalent corresponded to about 150 micrograms/ml of tranexamic acid during infusion. Intra- and interindividual changes were relatively small for aPl, when compared with the antifibrinolytic equivalent measured by the bioassay. In 2 elderly patients tranexamic acid infusion had to be terminated because of clinical and laboratory signs of disseminated intravascular coagulation, whereby aPl fell below the therapeutic range, elucidating that this method is a sensitive indicator for a hypercoagulable state and useful for the surveillance of therapy with antifibrinoltic agents.

Twenty patients (67.2 ± 12.3 yrs; aged 39-86 yrs, 10 males, 10 females) with stage IV of peripheral obliterative arterial disease received at random either a) BM 13.177, a thromboxane receptor antagonist, at a dose of 6 g/24 hrs for 7 days i.v., followed by oral treatment of 6.4 g/day in four doses for 2 weeks and a subsequent placebo week, or b) placebo alone with the same protocol. The clinical course was followed by measurement of blood pressure (by Riva-Rocci on the left brachial artery and by Doppler of the ankle artries), blood flow at restand after 3 min of tourniquet ischemia (by venous occlusion plethysmography), TcpCf2 at the wrist of the affected limb, and by subjective estimation of pain with visual analog scale before, at the end of the infusion period, as well as on day 7 and 14 of oral treatment, and 7 days after treatment while patients of both groups were on placebo. In addition spontaneous platelet aggregation by PAT III, induced platelet aggregation in whole blood by collagen and in PRP by ADP at different doses on the same days were measured on the same days as described above.Results: BM 13.177 completely inhibited aggregation in whole blood induced by collagen 0.3 (ig/ml, however one week after treatment a rebound phenomenon was observed with 16.0 ± 3.8 OHM compared to pretreatment value of 11.0 ± 3.8 OHM (p < 0.01). At a higher dose of 1.2 |ig/ml the same inhibiting effect on platelet aggregation was observed. Spontaneous platelet aggregation as measured by PAT III was evident in only 2/10 pat. pre-treatment, was abolished in all patients on i.v. BM 13.177, returned in 1/10 pat. during oral treatment, but in 4/10 pat. on day 7 after treatment, while being on placebo, again indicating a rebound phenomenon (p < 0.03) ADP induced platelet aggregation was not significantly affected by BM 13.177. In the placebo group, too, no significant differences were observable between the different treatment regimens. Clinical data did not show any significant alteration in either verum or placebo group during the six week period, indicating no benificial effect of thromboxane receptor antagonists in advanced stages of peripheral obliterative arterial disease, although platelet inhibiting effects were clearly demonstable.

10 patients with claudication pain, but without rest pain or necrosis, were treated for 3 weeks with Defibrase (R) ∗∗ , a snake-venom enzyme designed for clinical use in defibrinogenation therapy. Treatment was monitored by fibrinogen determination according to CLAUSS. Average fibrinogen values of around 60 mg% were obtained by daily Defibrase administration. Another 10 patients were given placebo treatment. Each patient was allocated at random to the respective group. The results, as assessed by determining the walking distance, the poststenotic systolic pressure, and the pressure gradient along the occlusion, failed to show any significant difference in the two groups treated with either defibrinogenating measures or placebo.

A most common complication of acute ischemic stroke is deep vein thrombosis (DVT), preferentially of the paralytic limb. Without prophylactic therapy an incidence of 33%–70% has been reported, according to the method used for detection, i.e., clinical symptomatology, phlebography, or 125I-fibrinogen scanning, the latter being most sensitive [1–4].

Bei 5 Gruppen, bestehend aus je 5 Patienten, wurden im Rahmen der therapeutischen Fibrinolyse mit Streptokinase verschiedene Dosierungsschemata angewandt.

Ten patients with 13 stenoses in the pelvic area were treated with low doses of streptokinase (30 000 U/h) for 72 hours. A significant improvement in the degree of stenosis was obtained as shown by post-stenotic pressure values. Biochemically there was a marked plasminaemia with moderately low fibrinogen levels. Streptokinase treatment with low doses could form an alternative method of treatment in arterial stenoses.

Controlled double-blind studies have shown, that the antifibrinolytic agent tranexamic acid significantly reduces both the mortality and the rate of rebleeding from a fresh ruptured subarachnoid aneurysm (1–3). KASTE and RAMSAY (4) did not observe this favourable result in a Finnish study. Rebleeding of a subarachnoid aneurysm occurs most often during the initial two weeks, i.e. at a time, where mortality is highest. Therefore, antifibrinolytic therapy is often carried out as a pre-operative procedure in order to overcome this critical period. While fibrinolytic activation is rarely observed in the blood after subarachnoid hemorrhage, it is generally seen in the cerebrospinal fluid. Here, raised concentration of fibrin degradation products indicate enhanced fibrinolytic activity, which may be responsible for a dissolution of the peri-aneurysmal fibrin plug and subsequent rebleeding. Tranexamic acid crosses the blood-brain barrier and inhibits the activation of plasminogen to plasmin.

In a multicentre study 15 physicians investigated the therapeutic efficacy and tolerance of Faktu suppositories and ointment (containing the active principle of Albothyl, a condensation product of m-cresolsulfonic acid and formaldehyde) in 585 patients with proctological affections. Highly satisfactory results were achieved in 486 patients (83.1%). The following were found to be the main indications: -treatment of wounds after proctological operations, -fresh and fissures, -bleeding internal haemorrhoids, -anal eczema and anal pruritus, -rhagades and perforated or prolapsed external haemorrhoids (perianal thrombosis). None of the investigators reported any persisting adverse side-effects. 16% of the patients complained of local discomfort of varying intensity such as pruritus, burning or irritation. The symptoms mostly appeared on commencement of the treatment and necessitated discontinuation of therapy in 5.3% only. The extremely favourable effect of Albothyl - the active principle of Faktu - is due to its unique mechanism of action: the markedly acid milieu of the substance. Furthermore the Faktu preparations do not contain any steroids and consequently they can be used without any misgivings over prolonged periods.

A new method ist presented for estimating the activator (plasminogenstreptokinase complex) concentration in the plasma of patients undergoing streptokinase infusion. The principle of the method is based on the clotlysis time as recorded by the thromboelastograph. The test clot constituents were bovine fibrinogen, bovine plasminogen, EDTA, human plasma (with unknown activator concentrations) and thrombin. In order to obtain a standardization curve, urokinase dissolved in NaCl solution was substituted for patient’s plasma. Thus, each lysis time could easily be converted into urokinase equivalent (CTA u/ml). Streptokinase treatment using a dosage scheme of 100,000 u SK/h was monitored by quantitative activator, plasminogen, and streptokinase measurements. During streptokinase infusion an average activator concentration of 20–120 CTA u UK-equ and a SK-concentration of 3–8 u/ml were recorded. Each drop in streptokinase was accompanied by a drop in activator, and each rise in streptokinase by a rise in activator. There was a strong correlation between streptokinase and activator concentrations (correlation coefficient r = 0.9).

A method of a quantitative determination of plasma streptokinase concentrations in patients undergoing streptokinase infusion is described. The principle of this method is based on the clot lysis time recorded by the thromboelastograph. The test clot constituents were bovine fibrin, bovine plasminogen, human euglobulin, EDTA, human plasma (of unknown streptokinase quantity) and thrombin. As rather high concentrations (fixed excess) of plasminogen (euglobulin) and fibrinogen were present in the test coagulum, no interference with changing plasminogen and fibrinogen levels of the patient's plasma was observed. Furthermore, due to high EDTA concentrations, no interaction with platelet functions and coagulation factors took place. The standard deviation in measuring 2 u streptokinase in 1 ml human plasma was determined as s = +/- 0.19 u/ml, of 5 u streptokinase at s = +/- 0.47 u/ml and of 20 u streptokinase at s = +/- 2.5 u in 1 ml of human plasma. Plasma samples of patients undergoing fibrinolytic treatment were investigated with regard to their streptokinase content. Streptokinase concentration values varied between 0.7 u and 15 u/ml plasma. The average half life of streptokinase in the organism was 18 min. The decay of streptokinase in plasma at different temperatures and over various periods of time was also determined. A considerable loss of streptokinase in the plasma during storage at room temperature could be observed. Therefore, the determination procedures should be carried out without delay.

Die Frage nach der Stabilitat von Streptokinase in verschiedenen Infusionsmedien hat fur den fibrinolytisch tatigen Arzt eine klinisch-relevante Bedeutung. Entsprechend einem vielfach benutzten Schema werden 750000 E Streptokinase in 500 ml Infusionsmedium uber 7 h infundiert. Bisher lagen nur wenig Informationen uber die Haltbarkeit derartiger Streptokinaselosungen vor, und es war keineswegs sicher, ob nach 7 h noch die am Anfang der Therapie vorhandene Streptokinasekonzentration im Infusionsmedium zu finden war. Noch scharfer stellte sich die Frage der Haltbarkeit bei einem Infusionsmodus, bei dem 2,5 Mill. E Streptokinase uber 24 h aus einer einzigen 50-ml-Unitaspritze i.v. appliziert wird.

435 arterial occlusions were treated with streptokinase over a period of 3 days. A continuous streptokinase regimen with a maintenance dose of 100 000 u SK/h was administered. The successful removal of femoral obstructions was possible in 8.9%. A complete dissolution of the iliac thrombus masses had been achieved in 19%. 41 aortic occlusions were treated. The treatment was capable of removing the aortic obstructions in 24%. It became evident that there was a close relationship between the average occlusion time and the respective clearance rate. Por example, in patients undergoing lysis treatment during the very first two weeks after femoral occlusion, clearance was established in 75% and best lytic results were achieved if the history of iliac occlusion was well below 3 months duration. The relationship of vessel clearance rate and walking distance showed, that on the average there was no lengthening in walking distance where treatment had failed (no vessel clearance obtained). On the other hand, a significant average rise in walking distance from initially 325 up to 800 meters (p < 0.05) was seen when vessels clearance had been recorded.