Biomedical subjects

H Winter

Publications and source records attributed to H Winter.

At least 19 recordsLinked to original sources

PubMed2006

Transoral diverticulostomy with a modified Endo-Gia stapler: results after 4 years of experience.

BACKGROUND: The incidence of Zenker's diverticulum is low (2/100,000). Standard surgical treatment is cricopharyngeal myotomy with diverticulectomy. Various minimally invasive surgical approaches pursued recently have treated Zenker's diverticulum adequately. The functional minimally invasive therapy is performed alternatively using an Endo-Gia stapler inserted transorally to perform an esophageal diverticulostomia, or using thermal coagulation applied by a carbon dioxide (CO2) or argon plasma laser. The key to a successful procedure is adequate exposure of the diverticulum by insertion of a pharynx spreader before the surgery. METHODS: Since 1996, 31 patients who underwent minimally invasive diverticulostomies performed in our clinic have been included prospectively in the current study. All the patients were examined endoscopically before and after surgery. Furthermore, the intraesophageal and intragastric pressure was examined by transesophageal manometry, and the pH in the esophagus and stomach was determined by pH-metry. A barium swallow was performed to exclude leakage at the stapler suture line as proof of sufficient anastomoses. Manometry showed that the upper esophageal sphincter functioned normally before and after surgery. The results were compared with those of patients undergoing conventional procedures. RESULTS: The median follow-up period after resection of the diverticulum was 46 months. Both the Gastrointestinal Quality-of-Life Index (GQLI) (p < 0.001) and the modified dysphagia score (GHDS) increased significantly, indicating that the operations were successful. The minimally invasive procedure is faster than cricopharyngeal myotomy and significantly safer. It is better tolerated by patients, and they are discharged earlier. CONCLUSION: Transoral esophagodiverticulosomy has become the standard procedure for Zenker's diverticulum in the authors' department. The endoscopic minimally invasive approach proved to be safer than standard surgical procedures. It offers a significantly shorter operation time and postoperative hospital stay (p < 0.001).

Adult↗

PubMed2006

Two classes of outer hair cells along the tonotopic axis of the cochlea.

The molecular basis of high versus low frequency hearing loss and the differences in the sensitivity of outer hair cells depending on their cochlear localization are currently not understood. Here we demonstrate the existence of two different outer hair cell phenotypes along the cochlear axis. Outer hair cells in low frequency regions exhibit early sensitivity for loss of Ca(v)1.3 (alpha1 subunit 1.3 forming the class D L-type voltage-gated Ca(2+) channel), while high frequency regions display a progressive susceptibility for loss of the Ca(2+)-activated large conductance K(+) (BK) channel. Despite deafness, young Ca(v)1.3-deficient mice displayed distortion-product otoacoustic emissions (DPOAEs), indicating functional outer hair cells in the higher frequency range of the cochlea. Considering that DPOAEs are also found in the human deafness syndrome DFNB9 caused by mutations in the synaptic vesicle protein otoferlin, we tested the expression of otoferlin in outer hair cells. Surprisingly, otoferlin showed a distinct tonotopic expression pattern at both the mRNA and protein level. Otoferlin-expressing, Ca(v)1.3 deletion-sensitive outer hair cells in the low frequency range could be clearly separated from otoferlin-negative, BK deletion-sensitive outer hair cells in the high frequency range. In addition, BK deletion led to a higher noise vulnerability in low frequency regions, which are normally unaffected by the BK deletion alone, suggesting that BK currents are involved in survival mechanisms of outer hair cells under noise conditions. Our findings propose new mechanisms and candidate genes for explaining high and low frequency hearing loss.

Acoustic Stimulation↗

PubMed2006

Auger neutralization of He ions at an Al(100) surface using isotope effect.

He atoms and ions of the isotopes 3He and 4He are scattered with keV energies under a grazing angle of incidence from a flat and clean Al(100) surface. For the two isotopes we investigate Auger neutralization of incident He+ and He2+ ions via fractions of surviving ions. Pronounced effects for the different isotopes are observed which can be attributed to different time scales concerning the neutralization process of He ions in front of a metal surface. From the analysis of the data obtained for singly and doubly charged ions we find evidence that charge fractions for scattering of He+ ions from an Al surface result predominantly from a direct (Auger) electron capture event.

Journal Article↗

PubMed2005

Surface structure of ultrathin Fe films on Cu(001) revisited.

The structure and magnetism of ultrathin Fe films epitaxially grown on a Cu(001) surface are investigated by grazing scattering of fast H and He atoms or ions. By making use of a new variant of ion beam triangulation based on the detection of the number of emitted electrons, we obtain direct information on the structure of the film surface. We observe for room temperature growth a dominant and defined fcc-like structure. Complex surface reconstructions as reported in recent STM and LEED studies are observed only for cooling and H2 dosing.

Journal Article↗

PubMed2005

Evidence for noncollinearity between surface and bulk magnetization in ultrathin Co films.

The magnetization reversal of ultrathin Co films on Cu(001) has been investigated by grazing ion scattering and magneto-optical Kerr effect. Differences in the behavior of surface and bulk magnetization are found and attributed to the reduced coordination and site symmetry at the surface. The reversal behavior of the surface magnetization depends on the chemical surface composition. For pure Co films, the reversal of the bulk magnetization is preceded by a complete reversal of the surface magnetization. A particular magnetic state of the surface is suggested as a precursor for magnetization reversal.

Journal Article↗

PubMed2005

Flammability limits and explosion characteristics of toluene-nitrous oxide mixtures.

Flammability limits and explosion characteristics of toluene-nitrous oxide mixtures are experimentally determined in an 8l spherical vessel, and are compared with corresponding values of toluene-air mixtures. The experiments, performed at atmospheric pressure and at an initial temperature of 70 degrees C, show that the flammable range of toluene in nitrous oxide (0.25-22.5 mol%) is about three times as wide as the corresponding range of toluene in air (1.3-7.1 mol%). Maximum values of the explosion pressure ratio and the deflagration index, K(G), are clearly higher when nitrous oxide is applied as an oxidizer. This can be attributed to the increased flame temperature and burning velocity of toluene-nitrous oxide flames. Moreover, extremely high values of K(G) for near-stoichiometric mixtures in combination with strong acoustic oscillations in the pressure signals of these mixtures indicate the existence of a flame accelerating mechanism. These phenomena are enhanced when an initial pressure of 6 bara is applied. Finally, when evaluating the lower flammability limit, it was found that pure nitrous oxide decomposes at pressures above 4.5 bara when applying an ignition energy of about 10 J.

Atmospheric Pressure↗

PubMed2005

How safe are laparoscopic intracorporeal anastomoses?

BACKGROUND: A recent German Multicenter Study comprising 3 070 laparoscopic colorectal resections indicates that complete intracorporeal anastomoses are performed in only 1.8 % cases. The aim of our study was to review and analyse the safety of complete intracorpeal anastomosis. METHODS: In a literature survey we searched for complete intracorporeal anastomosis with different key words. RESULTS: In agreement with the literature, technically demanding hand-sutured anastomoses are no common practice. Intracorporeal anastomosis is usually done using endoscopic linear stapling devices or a conventional circular stapler by performing end-to-end, end-to-side, and side-to-side anastomoses. These techniques are more frequently used in the upper than in the lower gastrointestinal tract. CONCLUSIONS: The data published so far, however, indicates that completely intracorporeal performed anastomoses are safe in the hands of laparoscopically experienced surgeons. This technique implies very low percentages of postoperative stenoses (0-10 %) and, furthermore, very low percentages of postoperative anastomotic leakages (0-8 %).

Anastomosis, Surgical↗

PubMed2003

Esomeprazole administered through a nasogastric tube provides bioavailability similar to oral dosing.

AIM: To determine if nasogastric tube administration of the enteric-coated pellets from an opened esomeprazole capsule provides bioavailability similar to oral dosing with the intact capsule. METHODS: A randomized, single-centre, open-label, two-period crossover pharmacokinetic study consisting of two 5-day dosing periods separated by a 7- to 14-day washout period was conducted. Healthy subjects between the ages of 18 and 50 years received esomeprazole 40 mg once daily either orally as an intact capsule, or as a suspension of the enteric-coated pellets from an opened capsule in water through a nasogastric tube. RESULTS: In 47 evaluable subjects, the 90% confidence intervals were 0.87-1.08 and 0.93-1.25 for the geometric mean of the ratio of nasogastric tube administration relative to administration of the intact capsule for the area under the plasma concentration-time curve and for maximum plasma concentration, respectively, on day 1, demonstrating bioequivalence. Oral and nasogastric administration also demonstrated similar bioavailabilities on day 5. Esomeprazole was well tolerated regardless of the mode of administration. CONCLUSIONS: Nasogastric tube administration of the enteric-coated pellets from an opened esomeprazole 40 mg capsule provides bioavailability similar to oral dosing. Administration of the contents of an opened esomeprazole 40 mg capsule in water through a nasogastric tube is a practical alternative for patients with feeding tubes who require effective gastric acid suppression, but cannot swallow an oral preparation.

Administration, Intranasal↗

PubMed2003

Non-arrhenius behavior of the island density in metal heteroepitaxy: Co on Cu(001).

We present a combined theoretical and experimental study of island nucleation and growth in the deposition of Co on Cu(001)-a prototype for understanding heteroepitaxial growth involving intermixing. Experimentally, ion scattering is employed. Using density-functional theory, we obtain energy barriers for the various elementary processes and incorporate these into a kinetic Monte Carlo program to simulate the heteroepitaxial growth. Both the simulations and the experiments show a unique N-shape dependence of the island density on temperature that stems from the interplay and competition of the different processes involved.

Journal Article↗

PubMed2003

Ion beam triangulation of ultrathin Mn and CoMn films grown on Cu(001).

Total target currents for grazing scattering of keV protons from a crystal target are used to investigate the structure of surfaces and ultrathin films. This current shows pronounced maxima whenever the azimuthal incidence angle coincides with close-packed rows of atoms in the surface and subsurface layers. The real-space method is applied to study monolayer and bilayer films of Mn and of CoMn epitaxially grown on a Cu(001) surface.

Journal Article↗

PubMed2003

Survival of He+ ions during grazing scattering from a Ag(111) surface.

He+ ions as well as neutral He atoms with keV energies are scattered under a grazing angle of incidence from a clean and atomically flat Ag(111) surface. From a comparison of ion fractions observed after scattering of He+ ions and He atoms we find for energies below some keV small but defined fractions of ions that have survived the complete scattering event with the surface. This feature allows us to clear up the microscopic interaction scenario for Auger neutralization of He+ ions at a Ag(111) surface. The Auger neutralization rates are 2 to 3 orders of magnitude smaller than conventional rates derived from experiments for He+-metal systems and agree with recent calculations.

Journal Article↗

PubMed2003

Microbiological removal of hydrogen sulfide from biogas by means of a separate biofilter system: experience with technical operation.

The "BIO-Sulfex" biofilter of ATZ-EVUS removes hydrogen sulfide from biogas in a biological way. Hydrogen sulfide causes massive problems during power generation from biogas in a power plant, e.g. corrosion of engines and heat exchangers, and thus causes frequent and therefore expensive engine oil changes. The BIO-Sulfex module is placed between the digester and the power-plant and warrants a cost-effective, reliable and fully biological desulfurization. In the cleaned gas concentrations of less than 100 ppm can be achieved. Power-plant manufacturers usually demand less than 500 or less than 200 ppm. At present, several plants with biogas flow rates between 20 and 350 m3/h are in operation.

Air Pollution↗

PubMed2002

Temporary shielding of hot spots in the drainage areas of cutaneous melanoma improves accuracy of lymphoscintigraphic sentinel lymph node diagnostics.

Detection of the "true" sentinel lymph nodes, permitting correct staging of regional lymph nodes, is essential for management and prognostic assessment in malignant melanoma. In this study, it was prospectively evaluated whether simple temporary shielding of hot spots in lymphatic drainage areas could improve the accuracy of sentinel lymph node diagnostics. In 100 consecutive malignant melanoma patients (45 women, 55 men; age 11-91 years), dynamic and static lymphoscintigraphy in various views was performed after strict intracutaneous application of technetium-99m nanocolloid (40-150 MBq; 0.05 ml/deposit) around the tumour (31 patients) or the biopsy scar (69 patients, safety distance 1 cm). The images were acquired with and without temporary lead shielding of the most prominent hot spots in the drainage area. In 33/100 patients, one or two additional sentinel lymph nodes that showed less tracer accumulation or were smaller (<1.5 cm) were detected after shielding. Four of these patients had metastases in the sentinel lymph nodes; the non-sentinel lymph nodes were tumour negative. In 3/100 patients, hot spots in the drainage area proved to be lymph vessels, lymph vessel intersections or lymph vessel ectasias after temporary shielding; hence, a node interpreted as a non-sentinel lymph node at first glance proved to be the real sentinel lymph node. In two of these patients, lymph node metastasis was histologically confirmed; the non-sentinel lymph nodes were tumour free. In 7/100 patients the exact course of lymph vessels could be mapped after shielding. In one of these patients, two additional sentinel lymph nodes (with metastasis) were detected. Overall, in 43/100 patients the temporary shielding yielded additional information, with sentinel lymph node metastases in 7%. In conclusion, when used in combination with dynamic acquisition in various views, temporary shielding of prominent hot spots in the drainage area of a malignant melanoma of the skin leads to an improvement in the accuracy of identification and localisation of sentinel lymph nodes by lymphoscintigraphy.

Adolescent↗

PubMed2002

Evidence for F(-) formation by simultaneous double-electron capture during scattering of F(+) from a LiF(001) surface.

Slow F(+) ions (v<0.1 a.u.) scattered from a clean and flat LiF(001) surface under a grazing angle of incidence exhibit a high probability for forming F(-) ions in the reflected beam, whereas no negative ions are found for neutral F(0) projectiles. From detailed studies of projectile energy loss and charge transfer, we find evidence for a correlated double-electron capture process in the formation of the F(-) ions.

Journal Article↗

PubMed2002

Auto-ignition hazard of mixtures of ammonia, hydrogen, methane and air in a urea plant.

The auto-ignition of NH(3)/CH(4)/H(2)/air mixtures constitutes a hazard that is of much concern in urea plants. In this study, the auto-ignition behaviour of NH(3)/CH(4)/H(2)/air mixtures is investigated experimentally for pressures up to 7500 kPa. The experiments were carried out in a closed spherical vessel with a volume of 8 dm(3). The concentration and the pressure dependence of the auto-ignition temperature (AIT) were determined for four types of mixtures: NH(3)/air, NH(3)/CH(4)/air, NH(3)/H(2)/air and NH(3)/CH(4)/H(2)/air. The most ignitable NH(3)/air mixtures were situated between stoichiometry and the upper flammability limit. Small amounts of methane and hydrogen decrease the AIT of NH(3)/air mixtures to a large extent. The pressure dependence of the AIT could be correlated by a Semenov relationship. For the multi-fuel mixtures, a distinct deviation from the Semenov correlation was observed at the lowest temperatures. With respect to the explosion hazard in urea plants, the experimental results were used to assess realistic AIT values in the pool reactor and the ammonia scrubber, operating at a pressure of 15,000 kPa.

Ammonia↗

PubMed2001

The catalog of human hair keratins. II. Expression of the six type II members in the hair follicle and the combined catalog of human type I and II keratins.

The human type II hair keratin subfamily consists of six individual members and can be divided into two groups. The group A members hHb1, hHb3, and hHb6 are structurally related, whereas group C members hHb2, hHb4, and hHb5 are rather distinct. Specific antisera against the individual hair keratins were used to establish the two-dimensional catalog of human type II hair keratins. In this catalog, hHb5 showed up as a series of isoelectric variants, well separated from a lower, more acidic, and complex protein streak containing isoelectric variants of hair keratins hHb1, hHb2, hHb3, and hHb6. Both in situ hybridization and immunohistochemistry on anagen hair follicles showed that hHb5 and hHb2 defined early stages of hair differentiation in the matrix (hHb5) and cuticle (hHb5 and hHb2), respectively. Although cuticular differentiation proceeded without the expression of further type II hair keratins, cortex cells simultaneously expressed hHb1, hHb3, and hHb6 at an advanced stage of differentiation. In contrast, hHb4, which is undetectable in hair follicle extracts and sections, could be identified as the largest and most alkaline member of this subfamily in cytoskeletal extracts of dorsal tongue. This hair keratin was localized in the posterior compartment of the tongue filiform papillae. Comparative analysis of type II with the previously published type I hair keratin expression profiles suggested specific, but more likely, random keratin-pairing principles during trichocyte differentiation. Finally, by combining the previously published type I hair keratin catalog with the type II hair keratin catalog and integrating both into the existing catalog of human epithelial keratins, we present a two-dimensional compilation of the presently known human keratins.

Amino Acid Sequence↗

PubMed2001

Immunotherapy of melanoma: a dichotomy in the requirement for IFN-gamma in vaccine-induced antitumor immunity versus adoptive immunotherapy.

The mechanism by which tumors are rejected following the adoptive transfer of tumor-specific T cells is not well characterized. Recent work has challenged the requirement for cytotoxicity mediated by either the perforin/granzyme or Fas/Fas ligand pathway in T cell-mediated tumor regression. Many reports, including ours, suggest that tumor-specific production of IFN-gamma is critical for T cell-mediated tumor regression. However, in most of these studies the evidence to support the role for IFN-gamma is only indirect. We have directly examined the requirement for IFN-gamma using IFN-gamma knockout (GKO) mice. The results show an interesting dichotomy in the requirement for IFN-gamma: Antitumor immunity induced by active-specific immunotherapy (vaccination) required IFN-gamma, whereas adoptive immunotherapy did not. In GKO mice vaccination with the GM-CSF gene-modified B16BL6-D5 tumor (D5-G6) failed to induce protective immunity against parental D5 tumor. However, adoptive transfer of effector T cells from GKO mice cured 100% of GKO mice with established pulmonary metastases and induced long term antitumor immunity and depigmentation of skin. Furthermore, in vivo neutralization of IFN-gamma by mAb treatment or adoptive transfer into IFN-gamma receptor knockout mice failed to block the therapeutic efficacy of effector T cells generated from wild-type or perforin knockout mice. Analysis of regressing metastases revealed similar infiltrates of macrophages and granulocytes in both wild-type and GKO mice. These results indicate that in this adoptive immunotherapy model, neither a direct effect on the tumor nor an indirect effect of IFN-gamma through activation of myeloid or lymphoid cells is critical for therapeutic efficacy.

Animals↗

PubMed2001

Natural history of cervical human papillomavirus infection in young women: a longitudinal cohort study.

BACKGROUND: Laboratory and epidemiological research suggests an association between human papillomavirus (HPV) and cervical intraepithelial neoplasia (CIN). We studied the natural history of incident cervical HPV infection and its relation to the development of CIN. METHODS: We recruited 2011 women aged 15-19 years who had recently become sexually active. We took a cervical smear every 6 months and stored samples for virological analysis. We immediately referred all women with any cytological abnormality for colposcopic assessment, but postponed treatment until there was histological evidence of progression to high-grade CIN. FINDINGS: In 1075 women who were cytologically normal and HPV negative at recruitment, the cumulative risk at 3 years of any HPV infection was 44% (95% CI 40-48): HPV 16 was the most common type. The cumulative risk at 3 years of detecting an HPV type not present in the first positive sample was 26% (20-32). 246 women had an abnormal smear during follow-up, of whom 28 progressed to high-grade CIN. The risk of high-grade CIN was greatest in women who tested positive for HPV 16 (risk ratio 8.5 [3.7-19.2]); this risk was maximum 6-12 months after first detection of HPV 16. All HPV types under consideration were associated with cytologically abnormal smears. Although abnormality was significantly less likely to be associated with low-viral-load samples, the cumulative risk at 3 years of a high-viral-load sample after a low-viral-load sample was 45% (95% CI 35-56). Five women who progressed to high-grade CIN consistently tested negative for HPV. INTERPRETATION: Our findings suggest that attempts to exploit the association between cervical neoplasia and HPV infection to improve effectiveness of cervical screening programmes might be undermined by the limited inferences that can be drawn from the characterisation of a woman's HPV status at a single point in time, and the short lead time gained by its detection.

Adolescent↗