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Biomedical subjects

G Winkler

Publications and source records attributed to G Winkler.

At least 37 records · Page 2Linked to original sources
PubMed2000

Dose-dependent effects of inspiratory muscle training in neuromuscular disorders.

The goal of this study was to show whether a correlation exists between the intensity of specific respiratory muscle training and the improvement of strength and endurance in inspiratory musculature in patients with neuromuscular disorders (NMD). Sixteen patients with NMD (13 with Duchenne muscular dystrophy and 3 with spinal muscular atrophy) performed inspiratory muscle training (IMT) at home with a special training apparatus for 9 months. Maximal inspiratory mouth pressure (PI(MAX)) and 12s-maximum voluntary ventilation (12s-MVV) test served as parameters for inspiratory muscle strength and endurance, respectively. In patients whose inspiratory vital capacity (VC(in)) declined by less than 10% during the year before training began (n = 10), a significant positive correlation was found between the number of successfully completed strength and endurance exercises and the improvement of PI(MAX) (P < 0.05) and 12s-MVV (P < 0.05). In patients whose VC(in)-decline exceeded 10% (n = 6), indicating more progressive respiratory system involvement of the disease, no significant correlation between the improvement of PI(MAX) and 12s-MVV and the intensity of training was found. In patients with NMD, the effects of IMT-runs are dose-dependent, provided that the respiratory system involvement of the disease is only slowly progressive.

Adolescent↗
PubMed2000

Trends in dietary sources of nutrients among middle-aged men in southern Germany. Results of the MONICA Project Augsburg: dietary surveys 1984/1985 and 1994/1995. MONItoring trends and determinants in CArdiovascular disease.

The study analyses 10-year trends (1984/1985-1994/1995) in southern Germany in the food sources of nutrients. In two phases of the MONICA Project in Augsburg, dietary surveys were conducted in subsamples of 45 to 64 year-old men. Responses in 1984/1985 and 1994/1995 were 69.8% and 70.8% with eligible samples of 603 and 607, respectively. Seven-day records were collected and coded with the German food composition database. Percentage contribution of food groups to selected nutrient intakes were calculated. Meat and meat products and eggs decreased in importance as contributors to the intake of energy and several nutrients, whereas fish and fish products, milk and milk products and various food groups of plant origin became more important. In 1984/1985, for instance, meat and meat products delivered 23.4% of energy, 47.5% of protein and 38.1% of fat, whereas in 1994/1995 the respective contributions declined to 21.4%, 44.0% and 34.5%. The new product group of supplements has already become an important contributor to the intake of vitamin C. Both static intakes and changes in intake of certain nutrients can be explained by corresponding fluctuations in patterns of intake of the underlying food sources. Therefore it is recommended that dietary assessments use food source lists derived from the most recent dietary surveys.

Diet↗
PubMed2000

Vitamin D receptor gene BsmI polymorphism correlates with erbB-2/HER-2 expression in human rectal cancer.

Apart from the regulation of calcium metabolism, 1, 25-dihydroxyvitamin D(3) plays an essential role in cell proliferation and differentiation in several tissues. The vitamin D receptor (VDR) gene shows polymorphisms in humans that appear to be clinically significant in some pathological conditions. In the present study, the BsmI polymorphism of the VDR gene was studied in 59 Caucasian patients with rectal cancer (mean follow-up: 48 months). The relationship between VDR genotypes and the expression of oncogenes as well as their influence on survival were also investigated. VDR polymorphism was examined in tumor and normal mucosa cells by PCR technique. The expression of erbB-2/HER-2, p53, ras and epidermal growth factor receptor (EGFR) was also detected by immunohistochemistry and protein blotting. The presence of the VDR B allele significantly correlated with the overexpression of the erbB-2 oncogene. There was no difference in the VDR genotype between cancer and normal mucosal cells. Coexpression of erbB-2, pan-ras, p53 and EGFR internal and external domains was significantly higher in cancer cells than in normal mucosa. There was no significant correlation between VDR genotypes and age, gender, tumor infiltration depth, number and site of lymph node metastases and lymphatic or blood vessel infiltration. The VDR genotype alone did not influence survival. Overexpression of erbB-2 and EGFR was associated with a poor prognosis. In patients expressing only one oncogene in cancer cells, the presence of the VDR B allele showed a tendency to a poor prognosis. In conclusion, VDR gene BsmI polymorphism might affect the development and prognosis of rectal cancer by influencing erbB-2 oncogene expression.

Adult↗
PubMed1999

Assessing eating patterns-an emerging research topic in nutritional sciences: introduction to the symposium.

In order to stimulate food habit research in nutritional sciences, in 1994 the International Union of Nutritional Sciences (IUNS) established Committee II/2 on Nutrition and Food Habits, which has the charge "to review the impact of changing food choice and habits on nutritional status". Within this broad task, priority has been given to methodological aspects of studies on the spatio-temporal structure of food and drink intake. Some principles of the study of eating patterns and the status of this research topic nutrition are described as an introduction to selected papers of a workshop on "Methodology to Identify and to Assess Eating Patterns" organized by the IUNS committee and held during the 16th International Congress of Nutrition in Montreal (Canada) on 28 July 1997.

Feeding Behavior↗
PubMed1999

Meal patterns in middle-aged men in Southern Germany: results from the MONICA Augsburg dietary survey 1984/85.

Seven-day food records of the MONICA project Augsburg dietary survey, which were collected in 1984/85 from 899 men aged 45-64 years (random sample), were used to analyse meal patterns. The combination of the three traditional meals (breakfast, lunch, dinner) with one eating event between was most frequent, followed by two meals with two eating events between and three main meals without any other eating event (31.4 vs. 31.0 vs. 15.6% of all reported days). Breakfast delivered 17, lunch 29 and dinner 33% of the total daily energy intake; all other eating events delivered 21%. The mean contribution of the three meals, breakfast, lunch and dinner to daily protein intake was 14, 36 and 36%, to fat intake 17, 33 and 35% and to carbohydrate intake 23, 25 and 29%, respectively. Data on meal patterns are important in a comprehensive description of dietary habits of a population for a variety of reasons.

Diet↗
PubMed1999

Elevated serum TNF-alpha level as a link between endothelial dysfunction and insulin resistance in normotensive obese patients.

AIMS: The aim of the study was to analyse the role of tumour necrosis factor-alpha (TNF-alpha) in insulin resistance and endothelial dysfunction in patients with different types of obesity. PATIENTS AND METHODS: Fasting serum TNF-alpha immunoreactive concentration (enzyme-linked immunosorbent assay, ELISA) and bioactivity (L929 cell cytotoxicity assay), endothelin-1 and C-peptide levels (radioimmunoassay, RIA) were measured in 15 patients with android- and 13 patients with gynoid-type obesity and 15 lean healthy controls with normal glucose tolerance and blood pressure. RESULTS: Significantly (P<0.01) higher TNF-alpha concentration (8.92 +/- 0.44 pg/ml) and bioactivity (3.12 +/- 0.48 U/ml) were found in patients with android obesity as compared to patients with gynoid obesity (7.01 +/- 0.30 pg/ml, 0.97 +/- 0.11 U/ml) and to the lean controls (6.88 +/- 0.26 pg/ml, 0.88 +/- 0.08 U/ml). Serum endothelin-1 (5.38 +/- 0.30 pg/ml) and C-peptide levels (4.82 +/- 0.71 ng/ml) were also significantly higher (P < 0.01) in patients with android-type obesity than in controls (3.89 +/- 0.43 pg/ml, 1.46 +/- 0.25 ng/ml, respectively). In patients with gynoid-type obesity, only the C-peptide levels proved to be significantly higher (2.84 +/- 0.29 ng/ ml). Endothelin-1 levels, although were found to be slightly higher, did not differ statistically from in controls (4.56 +/- 0.31 pg/ml). There were significant positive linear correlations only in patients with android-type obesity between TNF-alpha, body mass index (BMI), serum endothelin-1 and C-peptide levels. CONCLUSIONS: TNF-alpha may be one of the factors contributing to insulin resistance and vascular dysfunction in patients with android obesity.

Adult↗
PubMed1999

Effectiveness of different benfotiamine dosage regimens in the treatment of painful diabetic neuropathy.

The therapeutic effectiveness of a benfotiamine (CAS 22457-89-2)-vitamin B combination (Milgamma-N), administered in high (4 x 2 capsules/day, = 320 mg benfotiamine/day) and medium doses (3 x 1 capsules/day), was compared to a monotherapy with benfotiamine (Benfogamma) (3 x 1 tablets/day, = 150 mg benfotiamine/day) in diabetic patients suffering from painful peripheral diabetic neuropathy (DNP). In a 6-week open clinical trial, 36 patients (aged 40 to 70 yrs) having acceptable metabolic control (HbA1c < 8.0%) were randomly assigned to three groups, each of them comprising 12 participants. Neuropathy was assessed by five parameters: the pain sensation (evaluated by a modified analogue visual scale), the vibration sensation (measured with a tuning fork using the Riedel-Seyfert method) and the current perception threshold (CPT) on the peroneal nerve at 3 frequencies: 5, 250 and 2000 Hz). Parameters were registered at the beginning of the study and at the end of the 3rd and 6th week of therapy. An overall bneneficial therapeutic effect on the neuropathy status was observed in all three groups during the study, and a significant improvement in most of the parameters studied appeared already at the 3rd week of therapy (p < 0.01). The greatest change occurred in the group of patients receiving the high dose of benfotiamine (p < 0.01 and 0.05, resp., compared to the othr groups). Metabolic control did not change over the study. It is concluded that benfotiamine is most effective in large doses, although even in smaller daily dosages, either in combination or in monotherapy, it is effective.

Adult↗
PubMed1999

Changes in serum osmolarity influence the function of outer hair cells.

Fast motility of outer hair cells (OHC) is thought to be based on a hydromechanic principle. In vitro, the function of OHCs can be disturbed by a change in the osmolarity of the culture medium. Whether changes in the serum osmolarity in vivo can also interfere with OHC motility has not been investigated as yet. Serum osmolarity of New Zealand White rabbits (n = 18) was elevated by a continuous infusion of glucose 40%, decreased by an infusion of aqua dest, or kept constant by an infusion of saline. OHC function was monitored using distortion products of otoacoustic emissions (DPOAE). Input output curves were established between 2 and 5 kHz (geometric mean of f2) with primaries of levels between 35 and 55 dB SPL. Cochlear perfusion was measured using a fluorescence microsphere method. Elevation of the serum osmolarity from 306 +/- 17 mosm/l to 365 +/- 23 induced a decrease of DPOAE between 3 and 12 dB SPL. Cochlear blood flow increased from 0.11 +/- 0.09 to 0.15 +/- 0.10 ml/min/g. When decreasing the serum osmolarity from 303 +/- 9 to 281 +/- 8 mosm/l, only slight changes of the DPOAE could be verified. As in the control group, cochlear perfusion was almost unchanged. In the control group, neither serum osmolarity nor DPOAE changed. Comparable to findings in vitro, increasing the serum osmolarity can lead to a disturbance of OHC function. In patients suffering from sudden hearing loss. dehydration due to physical or mental stress is often observed. This new and promising pathophysiological concept needs further clinical evaluation.

Acoustic Stimulation↗
PubMed1999

[External quality control in the Federal Health Survey: concept and site visits].

The results of the German National Health Interview and Examination Survey will be of great importance for health policy and research. Therefore, internal quality management was supplemented by an external quality control which was carried out by a private company (Bernhard Schwertner Feld organisation, Augsburg). The interviewer training, sampling and response, field work and data management were included into the external quality control. For each of these four areas, measures of control and detailed check-lists were provided by the external quality control. The aim was to find sources of potential and real errors and to arrive at recommendations for internal quality management. The general concept of external quality control is briefly presented and experiences and results from the quality control of the field work are described in the present paper.

Adolescent↗
PubMed1998

[Tumor necrosis factor-alpha; a possible pathogenic factor in obesity in insulin resistant and non-insulin-dependent diabetes mellitus?].

The role of tumor necrosis factor (TNF)-alpha in the development of insulin resistance has repeatedly been emphasized in the past few years. The present paper summarizes the data (including the authors' observations as well) focusing on the potential role of TNF-alpha in the pathogenesis of obesity and non-insulin-dependent diabetes mellitus: alteration of insulin receptor function, lipid metabolism, expression of sulphonylurea receptors, all of them suggested to be related to the TNF-alpha. The potential clinical relevances are shortly reviewed.

Cytokines↗
PubMed1998

Validation of a short qualitative food frequency list used in several German large scale surveys.

Our study aimed to test the validity of a short, qualitative food frequency list (FFL) used in several German large scale surveys. In the surveys of the MONICA project Augsburg, the FFL was used in randomly selected adults. In 1984/85, a dietary survey with 7-day records (DR) was conducted within the subsample of men aged 45 to 64 (response 70%). The 899 DR were used to validate the FFL. Mean weekly food intake frequency and mean daily food intake were compared and Spearman rank order correlation coefficients and classification into tertiles with values of the statistic Kappa were calculated. Spearman correlations range between 0.15 for the item "Other sweets (candies, compote)" and 0.60 for the items "Curds, yoghurt, sour milk", "Milk including butter milk" and "Mineral water"; values for statistic Kappa vary between 0.04 ("White bread, brown bread, crispbread") and 0.41 ("Flaked oats, muesli, cornflakes" and "milk including butter milk"). With the exception of two items, FFL data can be used for analysis on group level. Analysis on individual level should be done with caution. It seems, as if some food groups are generally easier to ask for in FFL than others.

Adult↗
PubMed1998

Dietary intake and smoking--results from a dietary survey in Erfurt in 1991/92.

Data relating to 422 men and 315 women aged 20 to 64 years were collected in 1991/92 using 3-day weighed records. The national German food composition file BLS 2.1 was used for food coding and calculation of nutrients. Age adjusted mean daily intakes were presented. Food intake habits of smokers and non-smokers showed distinct differences: for instance, non-smokers of both genders are more fresh fruit (m: 166 g vs. 119 g, p = 0.0001; f: 180 g vs. 147 g, p = 0.0009), more milk and milk products (m: 195 g vs. 121 g, p = 0.0108; f: 176 g vs. 136 g, p = 0.0004), and drank less coffee (m: 401 g vs. 457 g, p = 0.0103; f: 387 g vs. 491 g, p = 0.0003). As a result, intakes of various nutrients also differed. For example, smokers had lower intakes of fibre, selected vitamins, and minerals. The tendency toward an unhealthier dietary pattern in smokers was in accordance with findings from various industrialized Western countries.

Adult↗
PubMed1998

Supplements as a source of micronutrient intake in middle-aged men in southern Germany: results of the MONICA dietary survey 1994/95.

Survey data on contemporary supplement intake in Germany are scarce, and the contribution of supplements to nutrient intake is especially unclear. In the MONICA Project Augsburg a dietary survey using 7-day weighed records was carried out in a subsample of 607 eligible men aged 45-64 years from the city of Augsburg (participation 430 men = 71%) in 1994/95. Participants also reported their intake of supplements. The German national food data base BLS (version 2.1), which was used to code the records and calculate the nutrients, had to be complemented by nutrient data of supplements and fortified foods. On a group level the maximum mean percentage contribution of supplements to the intake of a micro nutrient was 4.0% (vitamin C). On an individual level, however, up to 4.0% of the men were found to receive more than 50% of their intake of selected micronutrients from supplements. It is, therefore, recommended to ask for supplement intake in future dietary surveys within Germany.

Databases, Factual↗