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Biomedical subjects

J Winkler

Publications and source records attributed to J Winkler.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Modification of pulmonary hypertension in patients with chronic obstructive lung diseases by trapidil (Rocornal) in an acute trial].

Acute effects of Trapidil (Rocornal, Deutsches Hydrierwerk Rodleben) on pulmonary hemodynamics were studied in 47 patients. A marked decrease of pulmonary artery pressure, pulmonary vascular resistance and of right ventricular stroke work at rest and during exercise in different degrees of severity of pulmonary hypertension was shown. Especially the influence on stable pulmonary hypertension is of interest, but there was no statistical significance during exercise because of the small number of patients. Considerable objective or/and subjective side effects were not noticed. Possible multifactorial mechanisms of these effects including the left ventricular function and the role of prostaglandins are discussed. The effect of trapidil is compared with other investigated pulmonary vasodilators, such as nitrates and nifedipine. Because of hitherto there are no other studies with Rocornal in patients with COPD, further acute studies and placebo controlled long term studies with monitoring of pulmonary hemodynamic are necessary. Than it will be possible to clarify the role of trapidil in therapeutical concepts of pulmonary hypertension.

Adult↗
PubMed1990

[Lactic acidosis].

The rare congenital lactic acidosis is a consequence of enzyme defects. The acquired form is relatively common in critically ill patients. The altered metabolism of pyruvate and the imbalance between lactate production and utilization have a central role in the pathogenesis of this disease. The physiologic compensating mechanisms are generally not sufficient for complete correction of acidosis. In most of the cases the basic disease is the one that should be treated. The correction of the acidosis must be careful, because overtreatment may worsen acidosis, or may cause severe post-treatment alkalosis.

Acidosis, Lactic↗
PubMed1990

[Value of preoperative fine needle puncture cytology in the diagnosis of highly malignant thyroid tumors].

Highly malignant thyroid tumours are frequently diagnosed only at an advanced stage where radical resection is no longer feasible. By the wide application of fine needle aspiration biopsy as a diagnostic tool in nodular thyroid diseases occasionally early stages of these tumours can be diagnosed. Despite early detection in 23% of our patients with anaplastic carcinomas and sarcomas of the thyroid gland and subsequent radical resection an improvement in the long-term outcome was not achieved. In contrast, thyroidectomy and appropriate oncologial therapy may result in long-term survival of patients with early stages of thyroid lymphomas.

Adult↗
PubMed1990

Imaging of cerebral arterio-venous malformations by transcranial colour-coded real-time sonography.

Transcranial color-coded real-time sonography (TCCS) is a new diagnostic method allowing the non-invasive imaging of parenchymal and vascular structures of the adult brain through the intact skull. A description of the sonographic findings in two patients presenting with a radiologically ascertained arterio-venous malformation is provided. The AVM's can be depicted in the two-dimensional B-mode image as echodense areas interspersed with zones of lower echodensity. Their extension correlated with corresponding MRI images. The color-coded illustration of intravascular flow phenomena allowed the distinct identification of the major afferent feeding vessels, the venous drainage and of the vascular convolution of both AVM's. Information on hemodynamics, as e.g. the blood supply of the angioma by the contralateral internal carotid artery, are obtained by color-coded identification of intravascular flow direction including analysis of the Doppler frequency spectrum. All findings obtained by TCCS complied with those established by angiography. We conclude, that TCCS is a suitable method for early diagnosis and long term follow up of cerebral AVM's.

Adult↗
PubMed1990

Nasal carriage of Staphylococcus aureus: correlation with hormonal status in women.

In view of recent observations on hormone-microorganism interactions, a study of Staphylococcus aureus nasal carriage in relation to sex-hormone status was undertaken. Prospectively in 479 women attending a colpocytologic clinic, hormonal status was assessed by determining the karyopyknotic index (KI) on smears stained by the Papanicolaou method. Rates of S. aureus nasal carriage were 29.3% in premenopausal women and 21.9% in postmenopausal women (P not significant). Carriage rates were significantly higher (P = .026, chi 2 7.32) for women with high KIs (40.7%) than for those with intermediate and low KIs (27.03% and 25.1%, respectively). S. aureus nasal carriage also correlated independently and significantly with previous antibiotic use and the presence of insulin-treated diabetes mellitus. This preliminary observation confirms an association between levels of sex hormones as reflected by the KI and S. aureus nasal carriage rates.

Adolescent↗
PubMed1990

Transcranial color-coded real-time sonography in adults.

We investigated the diagnostic potential of transcranial color-coded real-time sonography in 52 individuals using a phased-array ultrasound system with color-coded blood flow representation. Ultrasound scans in the axial and coronal planes were feasible through temporal acoustic bone windows in 49 subjects, enabling depiction of the main parenchymal and vascular structures as well as the ventricular system. Color-coded representation of blood flow in the cerebral vessels allowed unequivocal identification of the circle of Willis within the anatomic black-and-white B-mode image of the parenchymal structures. In Doppler mode, vascular blood flow phenomena may be analyzed semiquantitatively using the Doppler frequency spectrum. This noninvasive, serially applicable, mobile beside method may complement conventional neuroradiologic imaging methods, allowing on-line studies of functional processes within the adult brain.

Carotid Arteries↗
PubMed1990

The influence of nifedipine (Corinfar) on pulmonary hypertension in chronic obstructive lung disease.

Calcium antagonists may provide an effective approach to the treatment of pulmonary hypertension disorders. Under this aspect we examined 44 patients by right heart catheterisation at rest and at exercise before and after sublingual application of a single dose of 20 mg nifedipine (Corinfar) as well as under continuous dosage of 30-60 mg daily. In patients with latent pulmonary hypertension we ascertained an efficient significant decrease of PAP, 15 of 18 patients were responders. This protective effect persists in the longterm studies after 1 year as well as after 2 years at equal magnitude. In patients with manifest pulmonary hypertension the influence on pulmonary hemodynamics was not so efficient. This behaviour is caused by morphological fixation of pulmonary hypertension. Therefore the determination of magnitude of pulmonary hypertension by right heart catheterisation is necessary for evaluation of nifedipine therapy.

Adolescent↗
PubMed1989

Effects of 8-wk alpha-glucosidase inhibition on metabolic control, C-peptide secretion, hepatic glucose output, and peripheral insulin sensitivity in poorly controlled type II diabetic patients.

Miglitol (BAYm 1099), an alpha-glucosidase inhibitor, reduces the postprandial increase of blood glucose and serum insulin levels in type II (non-insulin-dependent) diabetes mellitus, as shown in short-term studies. In this study, the effects of long-term miglitol treatment on metabolic control, C-peptide secretion, hepatic glucose output, and peripheral insulin sensitivity (euglycemic clamp) were tested in 15 type II diabetic patients (8 receiving insulin, 7 receiving oral hypoglycemic agents). For 8 wk they received either miglitol (300 mg/day) or placebo with a double-blind crossover design that had a 4-wk washout period between treatments. Miglitol therapy induced a reduction of postprandial blood glucose levels (miglitol compared with placebo; areas under the curve; P less than .002), whereas fasting blood glucose levels were not influenced. Miglitol caused a slight reduction of glycosylated hemoglobin levels (mean +/- SE miglitol and placebo 9.50 +/- 0.3 and 10.0 +/- 0.4%, respectively; P less than .05), which was more pronounced in insulin-treated patients. Miglitol caused a reduction of postprandial C-peptide increase (P less than .03). Hepatic glucose output (both in the basal state and during euglycemic clamp conditions) and peripheral insulin sensitivity were not influenced by miglitol therapy. Specific side effects were observed in 11 patients; in 6 patients only to a moderate degree. Long-term miglitol treatment induces a persistent reduction of postprandial blood glucose increase. This effect is more pronounced in type II diabetic patients on insulin therapy, which can cause a moderate improvement of overall metabolic control.

1-Deoxynojirimycin↗
PubMed1987

Determinants of ventricular arrhythmias in mildly symptomatic patients with coronary artery disease and influence of inducible left ventricular dysfunction on arrhythmia frequency.

To determine the relation among ventricular arrhythmias, prognostic factors and reversible ischemia in coronary artery disease, 131 drug-free, minimally symptomatic patients were studied by radionuclide angiography and 24 hour Holter electrocardiographic monitoring. High grade ventricular arrhythmias (couplets, salvos of premature ventricular complexes and R on T phenomenon) were observed in 33 patients (25%) and were related to lower rest and exercise ejection fraction, greater number of stenotic coronary arteries and higher prevalence of regional wall motion abnormalities at rest (all p less than or equal to 0.1). Among patients with subnormal rest ejection fraction, high grade arrhythmias occurred with greater prevalence in those with reversible left ventricular dysfunction (reduction in ejection fraction) during exercise compared with those with a normal ejection fraction response (59 versus 23%, p less than 0.05), a relation observed principally in patients with multivessel disease. These data indicate that in minimally symptomatic patients with coronary artery disease, arrhythmias are related to both extent of disease and severity of regional and global ventricular dysfunction and are most prevalent in patients with ventricular dysfunction and evidence of inducible ischemia, factors indicating poor long-term prognosis during medical therapy.

Adult↗
PubMed1986

Maintaining ministry values in economic decisions.

In an increasingly market-driven economy, Catholic health care is confronted with the challenge of maintaining adequate care of the poor. To do this, Catholic health care decision makers must reach consensus on the priority that must be given to mission-oriented activities. This commitment must be economically measurable to ensure that decision makers' personal socioeconomic philosophies do not dictate priorities. A clear consensus on ministry values also is essential when Catholic organizations choose corporate partners and interact with other groups in society. Catholic health care's collective economic behavior will fail to give a meaningful societal witness to Christian values if ministry values are not demonstrated in the services that are provided. Moreover, if decision makers do not make a prior allocation of resources for the poor and mission-oriented activities, the organization will drift from its fundamental goals and instead provide services on the basis of their ability to make money.

Catholicism↗
PubMed1986

Protease inhibitor prevents bronchoconstriction in man.

In order to assess the potential role of protease inhibitors in airways regulation in asthma, we have studied the effects of para-aminomethylbenzoic acid (PAMBA) in 74 patients with various forms of bronchial asthma. The effects were assessed in challenge tests by changes in PEF or FEV1 following oral administration of analgesics, exercise or allergen inhalation. PAMBA was used in a single blind manner with lactose as placebo. PAMBA administered orally (1.0 g) was found to reduce significantly the maximal change in FEV1, PEF following challenge in patients with analgesic-induced asthma (n = 30; p less than or equal to 0.01), exercise-induced asthma (n = 37; p less than or equal to 0.01) or allergen-induced asthma (n = 7; p less than or equal to 0.05). We suggest that PAMBA reduces the accumulation of bronchoconstrictory metabolites of arachidonic acid via inhibition of phospholipase A2.

4-Aminobenzoic Acid↗
PubMed1986

[Temperature dependence of bronchial and tracheal reactivity of isolated respiratory tract preparations of the guinea pig].

The intrapulmonary loss of heat due to hyperventilation may be considered as essential pathogenetic factor in producing exercise induced asthmatic response. The temperature dependence of smooth muscle contraction was investigated using isolated trachea and isolated lung strips of guinea pigs. The measurements of the contraction responses to cumulative dose administrations of acetylcholine (10(-9) to 10(-3) M) were made in thermostated organ baths (isotonic contraction, modified Krebs-Henseleit solution, pH 7.4, air gassing). The standardized measurement data were adjusted to a non-linear function with the aid of a computer. The reactivity of the isolated trachea remained unchanged with a change of the bath temperature (from 37 degrees C to 30 degrees C), whereas a markedly increased contraction response to acetylcholine was observed in the lung strips. The results indicate that the contraction induced by the drop in temperature is localized in the small airways. The stabilization of reactive oxygen metabolites as an asthma-inducing mechanism is discussed as a possible explanation of the temperature-dependent effects.

Airway Obstruction↗
PubMed1985

Calcium channel block by phenytoin in neuroblastoma x glioma hybrid cells.

The action of phenytoin on the inward calcium current (ICa) was studied in cells of the clonal mouse neuroblastoma X rat glioma hybrid line 108CC5 by the suction pipette technique for internal perfusion and voltage clamp. The ICa was recorded after suppression of Na+ and K+ currents. Phenytoin, applied externally in concentrations of 50 to 500 microM, depressed the ICa in the investigated potential range of -60 to +30 mV in a concentration-dependent manner. When the cells were stimulated by depolarizing clamp steps, the extent of the ICa depression increased with the frequency and duration of the activating pulses. ICa was also inhibited on intracellular application of phenytoin.

Action Potentials↗
PubMed1984

Carp preproinsulin cDNA sequence and evolution of insulin genes.

The nucleic acid sequence of the preproinsulin cDNA of carp (Cyprinus carpio), cloned in the PstI site of pBR322 ( Liebscher et al. 1980), has been determined. The sequenced insert of 439 bp includes the complete coding information for carp preproinsulin (108 amino acids), 10 nucleotides of the 5'-and 105 nucleotides of the 3'-nontranslated regions. The nucleotide sequence confirms the previously established amino acid sequence of carp insulin ( Makower et al. 1982) and determines those of the signal 21 amino acids and C peptide (35 amino acids). The observed shortness of the signal peptide of carp preproinsulin and the N-terminal addition of 2 amino acids to the carp insulin B chain suggest that the cleavage site of the signal peptidase has moved. Calculations based on the comparison of known preproinsulin cDNA sequences showed that the evolutionary distance between fresh water and salt water teleostians is not smaller than that between man and chicken.

Amino Acid Sequence↗