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Early atherosclerosis can be easily dedected in arteries accessable to ultrasound. The main localisations are the carotid and femoral arteries, which can be deseased alone or together. The progression seems to be higher in the femoral vessels. There is the impression that the growth can be influenced by drugs which lower blood cholesterol or are partial inhibitors of serotonin receptors (S 2).

In 2400 male and 1400 female persons the proximal femoral and saphenal venous vessels have been monitored and measured with a Ultramark 4, build by ATL, by use of 7.5 megacycle/s. transducer. Moreover, we took the venous calibers at the junction of the saphenous veins into femoral veins. In patients with marked varices or less symptomatic patients as well as clinically asymptomatic persons with positive family history there could be found significantly bigger dilatation of vessel calibers in those patients laying than those standing up, in contrast to healthy persons. B-Scan ultrasound consequently in future offers a new range of diagnostic values in examination of venous vessels, that is to say a non-invasive, reproducible and haemodynamically tolerable method which helps to improve secondary prevention.

The arteries of the thigh of 126 male marathon runners at the age of 41.6 +/- 11.3 years were examined with B-Scan-ultrasound. 32 (62.1%) persons were found with arteriosclerotical plaques. All of them were older than 35 years, so the number of arteriosclerosis in this group increases to 36.4 percent (n = 88). 38 persons were younger than 35 years. Persons with plaques started training about 10.9 years later than those without plaques. Correlations of plaques and age, age of starting training, years of training and km/year were found. The numbers of riskfactors showed significant differences between both groups but the correlation of "having no risk factor" and arteriosclerotical plaques was higher than the correlations of nicotine, hypertension, hypercholesterolemia and plaques. It seems that marathon running itself is a risk factor of developing arteriosclerotical plaques in the femoral arteries particularly if the age of starting training is higher than 30 years.

The sudden occlusion of a vein by thrombosis almost always leads to irreversible damage or loss of function unless early diagnosis, proper primary care, and rapidly initiated surgical or medical treatment succeed in preserving the organ and reestablishing function. There are many uncertainities concerning the optimal way of treatment in preserving the venous valves essential for the venous function but it seems clear that only emergency approach and immediate treatment can be the right way reducing the amount of emerging postthrombotic syndromes and acute and chronic pulmonary disease after dvt.

With the help of high-resolution real-time sonography, we examined the carotid and femoral arteries in 3,500 asymptomatic persons to assess early states of atherosclerosis an to prove the utility of B-Scan-Sonography in this aim. We found 384 people having plaques, totally 769 pl. 68 p.c. of all plaques we were found in the femoral arteries, 32 p.c. in the carotid arteries, in each case with preference of the bifurcation and the pre-bifurcation-region. This seems to confirm earlier studies on this theme. As regards to the morphology, we found 67 p.c. (of all plaques) being faintly-echogenic ("fatty-streaks" or intermediär type). 73 p.c. of all plaques showed a smooth or faintly irregular surface-character. More than 75% of all plaques had a volume less than 0.3 ccm. Altogether, the results verify the assessment of mostly early states of atherosclerosis with the help of real-time-ultrasound and underline this method being a good and sufficient non-invasive-technique for screening-examinations on an asymptomatic collective.

Holter-monitoring offers a possibility to detect asymptomatic coronary-heart-disease-patients, suffering from peripher-arteric-occlusion stadium II-IV, and introduce them to effective medication. It became evident, that about 30% of all patients with unknown coronary-heart-disease, even as patients who were therapied against coronary-heart-disease, have had silent myocard ischemia.

In a epidemiological study 3840 clerks of state of North Rhein Westfalia were investigated concerning the frequency of atherosklerotic leasions of the carotid and femoral arteries in duplex scanning. 17% of all investigated showed independency to age, sex and risk factors alterations of the vessel walls. Men had twice as much plaques as women and male subjects with multiple risk factors had four times more plaques than those without.

To assess the clinical efficacy of i.v. PGE1 in the treatment of refractory venous ulcers a double-blind, placebo-controlled study was carried out. 42 patients were given at random either one i.v. infusion of 3 ampoules of Prostavasin (60 micrograms PGE1) or 3 ampoules of placebo (1940.1 micrograms alpha-CD) daily, soluted in 250 ml saline over 3 h. The treatment period was 6 weeks. In the PGE1 group (n = 20) there was a significant improvement in the ulcer status compared to placebo (n = 22) (p less than 0.001) being assessed by a detailed, multivariated score. Ulcers healed completely in 8 out of 20 patients on PGE1 (40%) compared to only 2 out of 22 patients on placebo (9%). Concomitant clinical symptoms improved accordingly. Whereas in the PGE1 group edema were completely resolved in 17 out of 20 patients (85%) this was the case in 7 out of 20 patients of the placebo group (35%). Calf cramps and eczema vanished in 80% and 87.5% respectively under PGE1, but only in 50% and 9% respectively under placebo. Parallel to this an increase of the tcPO2 in the ulcer area of a mean of 45.9% was observed. Throughout the whole treatment period no side effects were noted after PGE1 infusion.