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Biomedical subjects

G Winkler

Publications and source records attributed to G Winkler.

At least 55 records · Page 3Linked to original sources
PubMed1998

Elevated serum tumor necrosis factor-alpha concentrations and bioactivity in Type 2 diabetics and patients with android type obesity.

The role of tumor necrosis factor-alpha in insulin resistance has been studied in 59 patients with Type 2 diabetes, 28 with android type obesity and 35 healthy lean controls. Immunoreactive concentrations and bioactivity of serum tumor necrosis factor-alpha have repeatedly been determined in 8 weeks intervals for 12 months, five times per patients, by using ELISA and L929 cell cytotoxicity bioassay. Significantly higher immunoreactive tumor necrosis factor-alpha concentrations and bioactivity have been found in both, the Type 2 diabetic and obese groups as compared to the healthy persons. Tumor necrosis factor-alpha concentrations and bioactivity have showed a significant positive linear correlation with the elevated basal serum C-peptide levels and body mass indexes in both groups of patients. According to these data the cytokine might play a role in insulin resistance in obesity as well in Type 2 diabetes.

Adipose Tissue↗
PubMed1998

Dietary intake of middle-aged men from an East and a West German city after the German reunification: do differences still exist?

OBJECTIVE: To compare the diets of men from East and West Germany after the reunification under the new food market conditions in the East. DESIGN: Both dietary surveys were part of the third MONICA surveys in population based random samples. SETTING: City of Erfurt in the Federal State of Thuringia, East Germany (dietary survey in 1991/92) and city of Augsburg in the Federal State of Bavaria, West Germany (dietary survey in 1994/95). SUBJECTS: Comparable samples of 185 Erfurt vs 331 Augsburg men, aged 45-64 y. MEASURES: Data on food and nutrient intakes and percentage of users of foods are derived from 3 d weighed records from Erfurt and three matching days of 7 d weighed records from Augsburg. RESULTS: Nutrient intakes show the pattern of a typical Western diet in both samples with 15.2 en% from protein, 39.5 en% from fat, 38.8 en% from carbohydrates and 6.2 en% from alcohol in Erfurt. Corresponding figures for Augsburg are 16.4 en%, 37.9 en%, 39.0 en% and 6.5 en%. Intake of animal protein, cholesterol, water and selected micronutrients is distinctly higher in Augsburg. CONCLUSIONS: Dietary differences still exist, but the pattern of difference has changed. It is unclear, whether differences between East and West exceed regional differences in the West.

Alcohol Drinking↗
PubMed1998

[Incidence of disposition for malignant hyperthermia in patients with neuromuscular diseases].

PURPOSE: It has been suggested that malignant hyperthermia (MH) occurs more frequent in patients with neuromuscular diseases (NMD) than in patients without NMD when they are exposed to volatile anaesthetics and/or succinylcholine. However, whereas central core disease (CCD) and MH susceptibility (MHS) are closely associated, the relationship between MH and other NMD is still uncertain. The purpose of this study was to evaluate the MH status of individuals with specific NMD with the in vitro contracture test (IVCT) and to ascertain the risk for MH in individuals with NMD. METHODS: After institutional approval and informed consent, 29 patients of 3-59 years of age (27.2 +/- 17.3) with clinical suspicion for NMD and MH were enrolled in this prospective study. After excision of a skeletal muscle sample from M. vastus lateralis, patients were first classified as MHS, MH-equivocal (MHE) and MH-normal (MHN) by the IVCT according to the European MH protocol. Additionally, small muscle samples were excised from each patient for histological, histochemical and morphometric examination. RESULTS: Fourteen patients were diagnosed by the IVCT as MHS and 9 as MHN. In 6 patients MH status was equivocal. In six patients CCD was diagnosed, in 14 individuals muscular dystrophies and in 5 patients myotonias. Two patients had unspecific myopathies and one patient a carnitine deficiency syndrome. One patient with Friedreich's ataxia was investigated because of a MH crisis and classified as MHE. All CCD patients and two of three individuals with Duchenne's muscular dystrophy were tested as MHS. CONCLUSION: In this study 69% of the NMD patients were diagnosed as susceptible to MH with the IVCT. These results suggest, that NMD patients bear a high risk for MH. On the other hand, it has been discussed that in vitro contracture testing is not specific in NMD patients because skeletal muscle specimens from these patients have an elevated in vitro sensitivity. However, regarding our results and from a clinical point of view, patients with NMD should be treated like MHS individuals, unless they have undergone IVCT and were classified as MH-normal.

Adolescent↗
PubMed1998

Rhabdomyolysis following severe physical exercise in a patient with predisposition to malignant hyperthermia.

A 21-year-old man suffered from exertional heat stroke with impaired consciousness and rhabdomyolysis after strenuous physical exercise. Within two weeks the patient recovered completely without any specific therapy. Based on the symptoms and laboratory investigations, this episode suggested a moderate form of malignant hyperthermia. An in vitro contracture test was performed and a predisposition to malignant hyperthermia was diagnosed; other muscular diseases were excluded by histological examination. At present, the in vitro contracture test is the only method used to determine susceptibility to malignant hyperthermia and should be performed when the diagnosis is suggested on clinical grounds.

Adult↗
PubMed1997

[Experience with benazepril, a long-acting ACE inhibitor, in the management of diabetic hypertension].

The therapeutic advantage of the long acting ACE-inhibitor benazepril in a 12 weeks intervention period on 23 diabetic (3 IDDM, 20 NIDDM) patients with essential hypertension was studied. Participants-giving informed consent before beginning the study-on the base of repeated casual blood pressure measurements were divided into "slightly" (n = 8) and "moderately" (n = 15) hypertonic groups. Type of diabetes, time elapsed since its manifestation, actual antidiabetic therapy, period of existence of the hypertension (newly discovered vs known and treated for a time) were independent from the point of view of entering the study. Initial dose of benazepril was 5-10 mg/day depending on the blood pressure level, followed by a stepwise dose elevation according to the control investigations (at weeks 2, 4, 8 and 12 casual blood pressure control, at weeks 4 and 12 ambulantory blood pressure monitoring, ABPM as well) to a maximal daily dose of 20 mg. In the majority of patients benazepril was given in a morning single dose, in some cases because of a better tolerability divided into two parts. 20 patients received benazepril in monotherapy, 3 patients combined with other antihypertensive preparations. Parameters indicating severity of hypertension-hypertonic time index, hyperbaric impact-showed significant improvement already at week 4 when analysed in the total of patients and the moderately hypertonic group respectively. As a tendence the same was observed also in the slightly hypertonic group. No remarkable side effects, or alterations of the metabolic state and in the investigated laboratory parameters appeared. Based on these results benazepril is an effective choice in the treatment of diabetic hypertensive patients.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1997

[Myocardial infarct and diabetes mellitus: incidence, management and prognosis].

The authors analyse the data of the Myocardial and Diabetes Register, where 2436 diabetic patients (pts) and 1448 pts with acute myocardial infarction (AMI) were registered between 1st of January, 1992 and 31st of December 1994. In the history of diabetic patients previous AMI was present in 14.4% of the cases. The 21.6% of the AMI pts had diabetes mellitus as well. According to the type of diabetes (IDDM and NIDDM) the prevalence of AMI in the history of the registered persons was significantly different: among pts with NIDDM the previous AMI was found 14.8% of the pts and only 2% of pts with IDDM (p = 0.012). The clinical picture of AMI was also different of AMI pts with and without diabetes: chest pain suggesting AMI was present 10.9% of pts with proved AMI and diabetes mellitus, and 86.2% of pts with AMI without diabetes (p < 0.0001). The Streptokinase treatment was more common among AMI pts without diabetes (18.2% versus 12.5% p = 0.022). The hospital lethality was significantly higher among AMI pts with diabetes (42.8% versus 29.4% (p < 0.0001). The poorer prognosis was independent of age.

Adult↗
PubMed1997

[Change of trend in the treatment of type 2 non-insulin-dependent diabetics].

Medical opinion about the significance of non-insulin-dependent diabetes has been recently changed for three reasons: epidemiological evidence about the continuously increasing disease-prevalence, accumulation of new intriguing details on the pathophysiology of the disease, and the growing clinical evidence about the importance of accelerated atheromatosis related to any stage of the disease. The new theoretical approach resulted in some new aspects of therapeutical management as well. There is an emphasis on the early recognition, the very strict metabolic control and the individualized form of the therapy. Well organized regular medical care for the diabetics, recognition and effective treatment of comorbidities (dyslipidemia, high blood pressure), self-involvement of the patients in the management (ie. patient education) are the corner stones of this approach. The authors give a short review about the armamentura of the therapy available nowadays, including rules of indication for different sulfonylurea drugs, combined sulfonylurea-insulin treatment and single insulin regimes as well.

Arteriosclerosis↗
PubMed1997

Presence of cyclophilin A in synovial fluids of patients with rheumatoid arthritis.

Cyclophilins have been suggested to act as leukocyte chemotactic factors produced in the course of inflammation. Therefore we looked for the presence of cyclophilins in the synovial fluids (SF) from patients with rheumatoid arthritis (RA). Peptidyl prolyl cis-trans isomerase activity (PPIase) was measured in SF from knee punctures of 26 patients with RA and five patients with knee osteoarthritis (OA). PPIase was detected in SF from RA patients, but not in samples from OA patients. Enzyme activity was sensitive to inhibition by cyclosporin A (IC50 = 28-50 nM). Estimated concentrations of the SF-derived cyclophilin based on the enzyme activity were in the range of 11 to 705 nM. The presence of cyclophilin in the SF showed disease correlation; its concentration correlated with the number of cells in the SF (r = 0.91, P < 0.0001) and with the percentage of neutrophils in the cellular infiltrate and was higher in more acute cases of joint swelling. In immunoblots of partially purified preparations of SF from RA patients, an approximately 18-kD protein band reacted with polyclonal antibodies that recognize cyclophilin A and B, but not with antibodies specific for cyclophilin B. Sequencing of this protein revealed identity of the NH2-terminal amino acids with those of human cyclophilin A. The finding is unexpected since cyclophilin B rather than A is generally regarded as the secreted isoform, the presence of cyclophilin A being confined to the cytoplasm. Our data support the hypothesis that cyclophilins may contribute to the pathogenesis of inflammatory diseases, possibly by acting as cytokines. This may offer a possible explanation of the effectiveness of cyclosporin A in RA, in addition to the known immunosuppressive effects of the drug.

Adult↗
PubMed1997

[Results of a dietary survey in adults in Erfurt in 1991/92: nutritional intake].

A dietary survey using weighted 3-day-records was carried out in the sample of the third MONICA risk-factor survey in the Thuringian city of Erfurt (eastern Germany) in 1991/92. The aim was to collect detailed intake data in a defined population after the first phase of consolidation on the food market after the German reunification. The dietary sample consisted of 1,118 men and 1,179 women aged 20-64 years; we received 469 acceptable records from men and 333 from women. The German national nutrient datafile BLS (version 2.1) was used to code the records and for the transformation into nutrients. Mean energy intake in men was 2,624 kcal per day, 15.3% came from protein, 40.0% from fat, 38.5% from carbohydrates and 6.0% from alcohol. Corresponding figures for women were 1,916 kcal per day, 15.8%, 40.5%, 41.5% and 2.1%. Only a small percentage of participants achieved the recommendations of the German Society for Nutrition for the intake of selected nutrients.

Adult↗
PubMed1997

[Results of a dietary survey in adults in Erfurt 1991/92: food and supplement intake].

A dietary survey using 3-day weighed records was carried out in the sample of the third MONICA risk-factor-survey in the Thuringian city of Erfurt (former East Germany) in 1991/92 consisting of 1,118 men and 1,179 women aged 20-65 years. Mean daily food intake, the contribution of food groups to nutrient intake and the percentage of participants using supplements are shown here. For instance, men have a mean daily intake of meat and meat products of 199 g, delivering 20.7% of energy, 31.8% of fat and 42.7% of cholesterol. In women 18.6% of energy, 26.8% of fat and 37.2% of cholesterol origin from their mean daily intake of 130 g meat and meat products. Women in older age groups consume distinctly more meat than women in younger age groups. 0.4% of men and 2.6% of women use supplements during their three recording days.

Adult↗
PubMed1997

Characteristics of coronary endothelial dysfunction in experimental diabetes.

OBJECTIVE: To study the influence of diabetes on the endothelium-dependent vasodilation in the coronary arterial bed. METHODS: The effects of acetylcholine (ACh 2-36 pmol.kg-1; 18 nmol.1(-1)-9.8 mumol.1(-1); 0.1-10 mumol.1(-1), L-arginine (1 mmol.1(-1) and sodium nitroprusside (1 nmol.1(-1)-100 mumol.1(-1)) were measured on coronary conductivity, vascular tone and cGMP release (RIA) in healthy and diabetic dogs. RESULTS: ACh-mediated (in cumulative intra-arterial infusion) increase in coronary conductivity was reduced (P < 0.01) in the diabetic dogs in vivo, whereas no increase in cGMP release was observed in isolated diabetic coronaries (P < 0.05) which could not be enhanced by L-arginine (P < 0.05). Inhibition of cyclo-oxygenase after 20 min further impaired (P < 0.01) responsiveness to ACh in vivo and diminished the ACh response in isolated coronary strips of the diabetic dogs, but not in those of the controls. Relaxation in response to sodium nitroprusside was not altered by diabetes. CONCLUSIONS: Diminished vasodilation in diabetes is due to a defect in endothelial nitric oxide production and action. Vasodilating prostanoids do not sufficiently compensate this defect.

Acetylcholine↗
PubMed1997

Trends in food intake in adults from the city of Erfurt before and after the German reunification.

Three-day weighed dietary records from two surveys conducted in independent random population samples from Erfurt (East Germany) in 1987/88 (S1) and in 1991/92 (S2) were used to analyze trends in food intake before and after the German reunification. Structured records of 281 men and 256 women from S1 and open-ended records of 353 men and 252 women from S2, all aged 25-64, were included into the comparison. Distinct changes were found for most foods. For instance, for men mean daily intake of fruit and fruit products increased from 115 to 154 g, intake of bread and baked goods decreased from 286 to 249 g and intake of meat from 91 to 77 g. Respective figures for women were 137 vs. 180 g; 209 vs. 174 g and 62 vs. 53 g. Surprisingly similar changes in eating habits were observed with men and women. The majority of changes could be explained by the improved variety in food supply after the reunification.

Adult↗