Search PubMed⌕ Search

Biomedical subjects

K Winkler

Publications and source records attributed to K Winkler.

At least 199 records · Page 11Linked to original sources
PubMed1980

Total body and splanchnic thermogenesis in curarized man during a short exposure to cold.

To investigate thermoregulation independent of muscular contractions in adult man during a short period of exposure to cold, five examinations were carried out on four individuals who were unconscious due to persistent brain damage and who were totally curarized during the exposure. An increase was found in total body oxygen consumption of 0.043 mmol . kg-1 (range 0.038-0.049) or 25%, in plasma noradrenaline of 5.05 nmol . 1-1 (range: 2.48-6.73) or 132%, and in plasma non-esterified fatty acids of 0.6 mmol . -1 (range: 0.049-0.095) or 44%. No changes occurred in plasma adrenaline or plasma glucose. Splanchnic oxygen consumption increased and contributed significantly to that of the total body in only one of the four cases. These results indicate that regulatory nonshivering thermogenesis exits in adult man not acclimatized to cold, that it is mediated by noradrenaline, that the major fuel substrate for the increased energy demand is the triglycerides from the fat stores, and that the splanchnic area contributes only irregularly and to a small degree to this part of thermogenesis.

Adult↗
PubMed1980

Intraperitoneal pressure: ascitic fluid and splanchnic vascular pressures, and their role in prevention and formation of ascites.

Seventeen patients with ascites due to cirrhosis underwent hepatic venous catheterization and pressure measurement in the ascitic fluid. Intraperitoneal fluid hydrostatic pressure (IFP) ranged 3.5-22, mean 11.2 mm Hg, and correlated closely to the pressure in the inferior vena cava (r = 0.97, P < 0.001), which was on average 1.8 mmHg above that of ascitic fluid (P < 0.005). Wedged hepatic venous pressure (WHVP) (range 19-43, mean 32 mmHg) correlated directly to IFP (0.89, P < 0.001) and was significantly higher than that of ten cirrhotic patients without ascites (range 12-27, mean 20 mmHg, P < 0.005). After diuretic therapy WHVP decreased to an average of 20 mmHg. Mean plasma colloid osmotic pressures were 20 mmHg (range 18-24 mmHg)( and 23 mmHg (range 19-29 mmHg) in patients with and without ascites, the values being significantly different (P < 0.05). Colloid osmotic pressure of ascitic fluid ranged 1-14, mean 4.9 mmHg. Mean ratio between albumin concentration in ascitic fluid and plasma was 0.31 (range 0.12-0.77). In five pigs portal venous pressure (PVP) increased during infusion of fluid into the peritoneal cavity. The increase in PVP was smaller than that of IFP (P < 0.02), indicating that ascitic fluid stems the pressures in the splanchnic venous vascular bed up to a higher level, but that the transmural hydrostatic pressure difference decreases simultaneously. The results are discussed in relation to the local 'oedema-preventing' mechanisms: (a) increased interstitial hydrostatic fluid pressure, (b) decreased interstitial fluid colloid osmotic pressure, (c) increased lymph flow, and it is concluded that the peritoneal space can be considered as a special part of the interstitium in which IFP is considered to play an important role in regulation of ascitic fluid.

Adult↗
PubMed1980

Filtration as the main transport mechanism of protein exchange between plasma and the peritoneal cavity in hepatic cirrhosis.

Fractional peritoneal reabsorption rates (FPRR) were determined from the plasma activity after simultaneous intraperitoneal injection of 131I-labelled serum albumin (a) and 125I-labelled immunoglobulin G-IgG (g) in eight patients with cirrhosis (+ ascites 6, -ascites 2) and in one patient with carcinomatous ascites. Trans-vascular escape rates of albumin (TERa) and IgG (TERg) were determined in the cirrhotic patients from the disappearance of simultaneously intravenously injected 131I-labelled serum albumin and 124I-labelled IgG. Peritoneal space to plasma appearance times ranged 0.1-3.3 h, and the appearance times of albumin and IgG were almost identical. In patients with cirrhosis FPRRa and FPRRg were on average 1.27 and 1.21% of intraperitoneal protein masses returning to plasma per hour, respectively. Mean FPRRg/FPRRa ratio was 0.95 and this value was not significantly different from unity, but significantly higher (P < 0.001) than the ratio between the free diffusion coefficients of IgG and albumin (0.06). The calculated ascitic fluid flow rate was on average 61 ml/h. TERa and TERg were on average 9.6 and 8.6% of intravascular protein masses per hour, mean TERg/TERa ratio was 0.95. Peritoneal space to plasma protein flux averaged 0.4% of the intravascular protein mass per hour. The results point to filtration (convective flux) as the main transport mechanism responsible for protein passage into the peritoneal cavity as well as for the protein passage (lymphatic drainage) back into the plasma. Pressure measurements during catheterization confirmed pressure differences essential for convective flux.

Adult↗
PubMed1980

Filtration as the main mechanism of increased protein extravasation in liver cirrhosis.

Transvascular escape rates of albumin and immunoglobulin-G, IgG (TERalb and TERIgG, i.e, the fractions of intravascular mass of albumin and IgG passing to the extravascular space per unit time) were determined simultaneously from the disappearance of intravenously injected 131I-labelled human serum albumin and 125I-labelled human IgG in eight patients with cirrhosis of the liver. The mean wedged hepatic venous pressure was 22 mmHg (range 13-34). TERalb and and TERIgG/TERalb ratio was on average 8.4 +/- 0.8%/h (SD), and 7.4 +/- 1.9%/h (SD), respectively and these values are significantly increased compared to normal subjects [TERalb = 5.2 +/- 1.0 %/h (SD) and TERIgG = 3.0 +/- 0.7 %/h (SD), P less than 0.001]. The TERIgG/TERalb ratio was on average 0.88 +/- 0.20 (SD), which is significantly higher than that of normals [0.58 +/- 0.08 (SD), P less than 0.005]. The results indicated that increased filtration (bulk flow) is the dominant process of the increase microvascular protein escape in cirrhosis, due most likely to increased hepatic, but also to increased extrahepatic splanchnic transcapillary protein flux.

Adult↗
PubMed1980

Hepatic and extrahepatic elimination of ethanol in cirrhosis. With estimates of intrahepatic shunts and Km for ethanol elimination.

In eight patients with cirrhosis of the liver the hepatic and the extrahepatic ethanol elimination rate (EER) were studied by steady-state infusion during hepatic venous catheterization. EER measured by single injection overestimated total body EER by 15%. Hepatic and extrahepatic EER were significantly decreased to about two thirds in cirrhosis and were correlated to other variables indicating the severity of the disease. Differences in EER, however, diminish considerably when corrected for body weight, for reasons that are poorly understood. A maximal value of intrahepatic shunted blood could be calculated to 15% (3-38%) of hepatic blood flow. It was correlated to the transsinusoidal pressure gradient (r = 0.91). A rough estimate of the apparent Michaelis constant (Km) of hepatic and extrahepatic EER was in the range of 0.1--0.3 mmol x 1(-1). Forty percent of ethanol elimination occurred outside the liver. The large extrahepatic EER may be important in the development of extrahepatic organ injuries.

Ethanol↗
PubMed1979

Improved transvenous liver biopsy needle.

A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver.

Adult↗
PubMed1979

[Common ALL-associated antigen on cells and in the serum of common ALL patients: clinical relevance and biochemical characterization (author's transl)].

The clinical application of an antiserum recognizing common ALL associated antigen (cALL-AG) is very useful in classifying leukemias and diagnosing bone marrow relapse as well as CNS-leukemia. We could demonstrate that sera of common ALL (cALL) patients contain cALL-AG; its partial biochemical characterization is described. The anti cALL serum (cALL-AS) was raised in rabbits with cALL-cells precoated with rabbit antiserum against normal human lymphocytes. After appropriate absorbtion the cALL-AS was highly specific for cALL cells. The isolation of serum cALL-AG was performed by ammoniumsulfat precipitation, gel chromatography and affinity chromatography on agarose lens culinaris hemagglutinin A (lentil lectin). The apparent molecular-weight of the serum glycoprotein is 125 000. Two cALL-AG active structures could be solubilized from cALL cell membrane. The apparent molecular-weights were calculated to be 55 000 and 110 000.

Antigens, Neoplasm↗
PubMed1979

The physiologic basis for clearance measurements in hepatology.

Three hepatic clearance regimes (flow-limited, general, and enzyme-limited) can be defined from a model of hepatic perfusion-elimination relationships. Substances that can be used for clearance measurements can thus be classified into three categories according to the relation between their kinetic elimination constants (Vmax, Km) and hepatic blood flow. The pathophysiologic and clinical importance of the clearance regimes is discussed with special emphasis on the effect of changes in hepatic blood flow and liver function. The criteria for choosing test substances within each regime are stated. This choice depends on the object of study for a clearance measurement (blood flow, drug elimination, liver function). Only the enzyme-limited clearance regime is suited for direct assessment of quantitative liver function ('true clearance'), while the other regimes depend more or less on blood flow.

Animals↗
PubMed1979

[Analysis of normal and methylated urinary nucleobases: a new criterion for diagnosis and follow-up of malignancies (author's transl)].

The qualitative and quantitative analysis by high performance liquid chromatography of the normal and modified nucleobases excreted in urine represents a new and versatile tool. Its use for the diagnosis of malignancies, deliminating infectious diseases, and for the follow-up of the effects of a cytostatic therapy is shown. This method offers a chance to introduce the analysis of a series of fragments of primary gene products into the routine of clinical biochemistry.

Adenine↗
PubMed1978

Partial molecular characterization of an antigenic structure associated to cells of common acute lymphocytic leukaemia (ALL).

A heteroantiserum against common human acute lymphocytic leukaemia (ALL) cells was raised in rabbits. This antiserum was rendered specific for common ALL cells by extensive absorption with different human tissue. A specific antigen associated to common ALL cells was solubilized by sodium deoxycholate from ALL plasma membranes and identified by indirect immunofluorescence. By analytical chromatography, two antigenically active peaks were found. The apparent molecular weights were calculated to be 55,000 and 110,000.

Antigens, Neoplasm↗
PubMed1978

[Intestinal lymphangiectasia in exudative enteropathy (author's transl)].

Clinical symptoms and diagnostic procedures in a 12 1/2 years old girl with protein-losing enteropathy due to intestinal lymphangiectasia are reported. The child had suffered from intestinal protein loss, hypoproteinemia, hypocalcemia and lymphocytopenia. Dietary fat reduction and medium chain triglyceride formula diet made all the symptoms disappear.

Child↗