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H W Kuhlmann

Publications and source records attributed to H W Kuhlmann.

16 recordsLinked to original sources
PubMed2001

Association between polymorphisms in candidate genes and morbid obesity.

Polymorphisms in a number of candidate genes have been reported to be associated with obesity. We have determined the incidence of the following polymorphisms in the following candidate genes in a group of 388 morbid obese patients (mean body mass index (BMI) 52+/-8.01) who underwent gastric banding surgery: lipoprotein lipase (LpL) t-93 g and N291S; peroxisome proliferator receptor gamma (PPARgamma), P12A, P115Q and c1431t; peroxisome proliferator receptor alpha (PPARalpha) L162V; beta-adrenergic receptor 2 (beta-AR 2), Q27E; beta-adrenergic receptor 3 (beta-AR 3) W64R; uncoupling protein 1 (ucp-1), a-3826g, ucp-2, 45 bp insertion. Only for the ucp2 polymorphism did we find a statistically significant association with obesity. The beta-AR 3 W64R and ucp-1 a-3826g polymorphisms influenced the rate of the development of obesity and may act synergistically.

Adult↗
PubMed2001

Results of bariatric surgery.

OBJECTIVE: To present the results of bariatric surgery performed in our hospital over the last ten years. DESIGN: Longitudinal, clinical intervention with obesity surgery. SUBJECTS: To date in our hospital we have performed bariatric surgery on 496 patients. Ninety-seven percent of them received a restrictive method and 3% a combined procedure. The mean age of our patients was 39+/-9 y. The mean weight was 144+/-28 kg which corresponds to a mean BMI of 51+/-8 kg/m(2). The gender distribution is 18% male and 82% female patients. MEASUREMENTS: Success of surgery with early and late complications, no laboratory measurements. RESULTS: The early postoperative complications were the following: wound infection 3%, lethality 1.2%, pleural infusion 0.7% and evisceration 0.5%. The important late complications were pouch dilatation and stomastenosis in 18% and staple line disruption in 11%. Slippage of the adjustable silicone gastric banding (ASGB) amounted to 5% and hernias emerged in 7% of patients. A migration and band infection occurred in 0.7%. Reoperations were necessary in 10% of the silastic ring vertical gastroplasty (SRVG) and in 39% of the ASGB patients. Patients were followed up every two months in the first year and later, annually. Blood samples were taken after 25%, 50%, 75% and 100% loss of excess weight. To date, 91% of our patients have reached an excess weight loss of 25%. 71% lost half of their overweight and one third (32%) were able to reduce it by 75%. 8% of our patients attained normal weight. CONCLUSIONS: For long term compliance and to avoid regain of weight, a close follow-up is necessary. We therefore offer special care which, in addition to the postoperative surgical care, includes visits by dieticians, internists, psychologists as well as exercise therapy. Knowledge of morbid obesity and skill in bariatric surgery are prior conditions to avoid complications and for success in bariatric surgery.

Adult↗
PubMed2000

Phototaxis in the ciliated protozoan Ophryoglena flava: dose-effect curves and action spectrum determination.

The sensitivity of positive phototactic orientation of cells of the ciliated protozoan Ophryoglena flava has been measured for white light, broad-band blue and red light, and narrow-band monochromatic light, using a laboratory-developed computer aided system. The white-light fluence rate-response curve shows that there is no negative phototaxis in the fluence rate range investigated (0-15 W/m2) and no adaptation phenomena; it is very well fitted by a hyperbolic function; the fluence rate curves under broad band blue and red light (full width at half maximum, FWHM= 100 nm) can be fitted by the same model. The saturation level is, within experimental errors, the same for the three curves, indicating that there are no chromaticity effects and that if there is more than one photoreceptor pigment, they act independently of each other. The fluence rate-response curves determined under narrow band monochromatic light (FWHM = 10 nm) can also be fitted by the same model and show, within experimental errors, the same saturation level. An action spectrum for positive phototaxis at 10-nm intervals has been calculated from fluence rate-response curves: it shows three maxima, at 420, 540 and 590 nm. This action spectrum is significantly different from the ones for photomotile responses in Blepharisma japonicum, Stentor coeruleus and Chlamydodon mnemosyne, whereas it resembles the ones of Paramecium bursaria and Fabrea salina.

Animals↗
PubMed2000

BAROS: an effective system to evaluate the results of patients after bariatric surgery.

BACKGROUND: Success in bariatric surgery is most often evaluated by a sufficient loss of excess weight and an improvement in the medical conditions. The expected increase in quality of life (QoL) after weight loss, however, has not often been systematically analyzed. BAROS (Bariatric Analysis and Reporting Outcome System) is a scoring system which, along with easy handling, allows comparisons to be made internationally. METHODS: 386 morbidly obese patients who had undergone bariatric surgery in our hospital were evaluated with BAROS. Five categories- failure, fair, good, very good, excellent- were taken from the scoring system that BAROS offers. This system has three major points: excess weight loss, medical co-morbidities and QoL. Points are subtracted for reoperations and defined complications. The operations performed were silastic ring vertical gastroplasty (72%), adjustable gastric banding (23%), biliopancreatic diversion (3%), vertical banded gastroplasty (1%) and gastric banding of Molina (1%). RESULTS: In 1991 and 1993, we had a fair result in 3% and 10% of the patients. A good score with a mean of 3.6 to 4.1 was reached in 1992, 1994 and 1995. In the last 3 years, 1996 to 1998, the mean score was 5.0 to 5.7, which is a very good result when compared with the scoring key. CONCLUSION: BAROS is a valuable tool to access the QoL of patients who have undergone bariatric surgery.

Adult↗
PubMed2000

Cost-effective bariatric surgery in Germany today.

BACKGROUND: The reason for this inquiry was to assess the actual state of Bariatric Surgery in Germany, especially relating to the much discussed economic aspect. METHOD: A questionnaire was sent to those hospitals in Germany in which we knew that obesity surgery was performed, concerning the year 1997. RESULTS: To our regret, the feedback was only 37%, although this must be considered an adequate response for Germany. Nevertheless, some interesting trends are easily seen. CONCLUSION: Bariatric Surgery in Germany could pay for itself by saving the costs associated with conservative therapy and preventing co-morbidities in patients with morbid obesity.

Biliopancreatic Diversion↗
PubMed1999

Intra- and intercellular communication systems in ciliates.

Intracellular signaling and cell-cell interactions are basic features of living organisms. Ciliated protozoa show complex mechanisms of intracellular signaling, as is demonstrated for the phagosomal pathway. Although unicellular, ciliates also communicate with other cells, for example, with invading or symbiotic micro-organisms, some of which are dwelling in the nuclei. In predator-prey interactions chemical signals (kairomones) released by certain predators induce defensive morphological or behavioral changes in the prey ciliates. In intercellular communication sensu strictu ciliate cells communicate with each other, for example, in sexual propagation. A variety of sexual signals have been found to function in preconjugant interaction. Many phenomena of cellular communication in ciliates appear to be similar to those found in multicellular organisms.

Amino Acid Sequence↗
PubMed1998

Does gastric restriction surgery reduce the risks of metabolic diseases?

BACKGROUND: Certain risk factors for arteriosclerosis are associated with obesity, e.g. hypertension, insulin resistance, the high triglyceride - low HDL pattern. One aim in treating morbid obesity is to reduce these risk factors. This study was designed to follow metabolic risk factors after weight loss in 165 morbidly obese patients who underwent a gastric restriction operation. METHODS AND PATIENTS: Lipid and hormone levels were analyzed before surgery and after 25, 50, 75 and 100% loss of excess weight. Mean cholesterol and triglyceride levels were normal or slightly elevated. HDL cholesterol was also normal (41 mg/dl). Thirty eight percent of the patients had elevated cholesterol and triglyceride levels. Insulin levels were measured as an indicator of potential insulin resistance, and with a mean of 21 microU/ml it was at the upper normal level. RESULTS: After reaching 75% reduction of overweight in a mean time of 10 months, serum cholesterol levels were unchanged. Serum triglycerides, however, decreased by 35% (P<0.0001) and HDL cholesterol increased by 24% (P<0.0001). Insulin levels decreased to 8 microU/ml (P<0.0001). CONCLUSION: We found an amelioration in the metabolic parameters in 75% of the patients. Nevertheless morbidly obese patients were found to have fewer abnormalities in lipid and glucose metabolism than expected from data of overweight patients with metabolic syndrome. Further long-term studies with careful evaluation of the metabolic parameters as risk factors in patients with morbid obesity need to be performed.

Adult↗
PubMed1998

Low-dose iloprost infusions compared to the standard dose in patients with peripheral arterial occlusive disease Fontaine stage IV. DAWID Study Group.

BACKGROUND: Intravenous iloprost, titrated from 0.5 up to 2.0 ng/kg/min has been shown in patients with PAOD III/IV to significantly improve healing of trophic lesions, relief of rest pain, and reduce the rate of major amputation or death at 6 months as compared to placebo. The effect is considered related to improvement of the microcirculation. The aim of the present trial was to identify an optimum dose regarding treatment response and tolerability, by studying 4 doses of 25, 50, 75 and 100 micrograms iloprost daily. PATIENTS AND METHODS: 302 patients with PAOD IV were randomised via a double-blind fashion to one of the 4 doses. The primary endpoint was the responder rate at end of treatment. Responders were defined as patients with very good or good global efficacy, as judged by lesion healing and pain relief. Side effects were documented and a pre-defined benefit/risk index was calculated. RESULTS: No dose-dependency of iloprost regarding primary or secondary endpoints was observed. The rate of responders ranged between 48.7-53.5%. Side effects, mainly related to vasodilation, increased dose-dependently (p < 0.001, chi 2-test), with a significant decrease of the benefit/risk index from 2.19 +/- 1.19 to 1.64 +/- 0.97 (p = 0.012, ANOVA). Responders had a better outcome at 6 months than non-responders (2.6 fold higher rate of major amputation or death; life table analysis). CONCLUSIONS: It is concluded that iloprost should be titrated to the optimum rather than maximum tolerated dose, since a higher incidence of side effects not associated with an increased treatment response was observed at higher doses.

Aged↗
PubMed1997

Pheromones of the ciliate Euplotes octocarinatus not only induce conjugation but also function as chemoattractants.

Cells of the ten mating types of the ciliate Euplotes octocarinatus communicate by pheromones before they enter conjugation. The pheromones induce homotypic pairing when applied to mating types that do not secrete the same pheromone(s). Heterotypic pairs (i.e., those between cells of different mating types) are formed only when both mating types in a mixture secrete a pheromone that the other does not. The genetics of mating types is based on four codominant mating type alleles, each allele determining production of a different pheromone. Here we report that the pheromones not only induce pair formation but also attract cells. This was shown by placing cells of various mating types in neighboring agar wells so that the pheromones could diffuse from one well to the next. We found that the cells accumulated on the side of the well where a pheromone entered by diffusion. This response was observed only if the pheromone had the capacity to induce the cells to conjugate. That the pheromones and not some other substances attract the cells was shown by placing pheromone 3, expressed in Escherichia coli, in wells next to tester strains. Mating types known to respond to pheromone 3 by pair formation also showed accumulation on the side of the well at which the pheromone entered by diffusion. Since the pattern of cell attraction corresponds with the pattern of conjugation induction, we suggest that not only conjugation induction but also cell attraction is governed by pheromone-specific receptors. In addition, we describe a succession of changes in the behavior of cells affected by the pheromones.

Animals↗
PubMed1996

[Obesity].

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Adult↗
PubMed1985

Is the initiation of macronuclear DNA synthesis in Euplotes dependent on micronuclear functions?

To determine whether the micronucleus makes essential contributions during asexual reproduction, observations were made on cells of Euplotes octocarinatus from which the micronucleus had been removed with a micropipette. Most cells underwent one postenucleation division, then became arrested in macronuclear G1, slowed down in food uptake, developed macronuclear deformations, and finally died. Such cells could be rescued if a micronucleus was reimplanted before macronuclear deformations had developed. When provided with a new micronucleus, cells initiated macronuclear DNA synthesis about 12-16 h later. The data suggest that the micronucleus is involved in the control of the cell's transition from macronuclear G1 to S, and a model is proposed which postulates that in Euplotes macronuclear DNA synthesis is initiated when a micronucleus-encoded "initiator protein" has accumulated to a critical amount.

Animals↗