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M Winkler

Publications and source records attributed to M Winkler.

295 records · Page 17Linked to original sources
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Quality-of-life after curative surgery for gastric cancer: a comparison between total gastrectomy and subtotal gastric resection.

BACKGROUND/AIMS: Quality-of-Life has become an increasingly important factor for long term survivors after surgery for gastric cancer. Quality-of Life also includes social and psychological aspects. Many gastric carcinomas are located in the distal two thirds of the stomach. In these cases, a subtotal gastric resection may be adequate if a proximal safety margin of 5 cm in intestinal type tumors according to Laurén and 10 cm in diffuse type cancers respectively can be achieved. On the other hand total gastrectomy "de principe" has been advocated for all gastric malignancies because of high local recurrence rates after subtotal resection. The aim of the present study was to assess the Quality-of-Life in long term survivors after resection for gastric cancer comparing subtotal gastric resection with total gastrectomy. METHODOLOGY: One hundred ninety-five patients were examined with the Gastrointestinal Quality-of-Life-Index (GLQI). Hard clinical data such as postoperative weight loss, frequency of daily meals and bowel emptying were evaluated. One hundred five patients were submitted for total gastrectomy and in 90 patients a subtotal gastric resection was performed. None of the patients had clinical, radiological or endoscopic evidence of recurrence. RESULTS: After subtotal gastric resection, patients achieved statistically significant better scores concerning disease/therapy-related symptoms, physical functions resulting in a better overall score (p < 0.02). Following subtotal resection, patients had a significantly lower weight loss compared to patients after total gastrectomy (p < 0.02), a smaller number of daily meals (p < 0.001) and a lower frequency of bowel emptying/day (p = 0.031). There was no statistically significant difference in emotional status or social activities showing a similar acceptance of disease and therapy in both groups. CONCLUSIONS: In those cases where an adequate proximal safety margin can be achieved by a subtotal gastric resection, this procedure is preferable to a total gastrectomy. However preservation of the gastric stump should never be allowed to compromise oncological radicality.

Adult↗
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Purity testing of recombinant proteins by capillary electrophoresis.

Purity testing of recombinant DNA (rDNA) proteins using slab gel electrophoresis in conjunction with scanning densitometry is time consuming and labor intensive and is difficult to reproduce because the dyes used for visualizing proteins do not bind in a stoichiometric fashion for all proteins. The present report describes a micellar capillary zone electrophoresis (MCZE) procedure that overcomes these difficulties. The MCZE method was evaluated to estimate protein purity of hydrophobic cytomegalovirus proteins, expressed E. coli, and highly glycosylated hepatitis C virus proteins, expressed in Chinese hamster ovary cells. The results obtained by the MCZE procedure correlated very well with the purity results quantitated by the conventional slab gel electrophoresis method using purified Coomassie Brilliant Blue dye to reduce anomalies. MCZE may serve as an alternative method for in-process and purity testing of rDNA proteins.

Animals↗
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[Appearance of inflammatory cytokines interleukin-1 beta and interleukin-6 in amniotic fluid during labor and in intrauterine pathogen colonization].

Subclinical intrauterine infections have been proposed to be one of the leading causes of preterm labor. The determination of inflammatory cytokines IL-1 beta and IL-6 in the amniotic fluid may be useful to identify women who have infection-associated preterm labor. Amniotic fluid was collected from 99 women during amniocentesis, during cesarean section or at the time of amniotomy using sterile technique. IL-1 beta and IL-6 were determined by a specific ELISA. Fluid of each sample was cultured for aerobic and anaerobic bacteria and for Mycoplasma hominis and Ureaplasma urealyticum. Different populations were identified according to the criteria "gestational age", "active labor", "positive amniotic fluid cultures". Interleukin-6 was detectable in all samples of amniotic fluid. The second-trimester (weeks 14-27) amniotic fluid concentration of IL-6 (18-2270 pg/ml) was higher than in the third trimester (weeks 28-42, 4-329 pg/ml). The difference was significant. Women in active labor had higher levels of IL-6 in their amniotic fluid than women not in labor (p < 0.01). There is no significant difference between women with preterm labor and delivery (weeks 28-37, 597-8670 pg/ml) and with term labor and delivery (weeks 38-42, 24-8300 pg/ml). Only culture negative samples were included in this population. Interleukin-1 beta was not detectable in the majority (90%) of these samples. 30% of the women in labor had positive amniotic fluid cultures. The IL-6 concentration of this population was not elevated in comparison to women in labor with negative cultures. Interleukin-1 beta was present in high concentrations (5-1100 pg/ml) in all fluid samples with detectable bacteria. Our data suggest that IL-1 beta may indicate subclinical uterine infection. IL-6 is elevated in all fluid samples of women in active labor.

Amniocentesis↗
PubMedDate not supplied

[Cytokine concentrations and expression of adhesion molecules in the lower uterine segment during parturition at term: relation to cervical dilatation and duration of labor].

OBJECTIVE: To determine the concentrations of tumor necrosis factor (TNF)alpha, interleukin (IL)beta, IL-6 and IL-8 and the expression of endothelial leukocyte adhesion molecule-1 (ELAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in the lower uterine segment during parturition at term and to investigate correlations with the stage of cervical dilatation and with the duration of labor. PATIENTS AND METHODS: Biopsy specimens were taken from the lower uterine segment of 59 women undergoing non-elective cesarean sectin at term at different stages of cervical dilatation (< 2 cm, n = 17; 2-3 cm, n = 12; 4-6 cm, n = 13; > 6 cm, n = 17) after varying length of the time in labor (1-6 h, n = 18; > 6-12 h, n = 16; > 12-24 h, n = 15; > 24 h, n = 10). The concentrations of TNF alpha, IL-1 beta, IL-6 and IL-8 in protein extracts of these specimens were determined by enzyme linked immunosorbent assays and the expression of ELAM-1 and VCAM-1 was studied by immunohistochemistry. Staining was considered negative if < 5% of the endothelial cells were stained and positive if > or = 5% were stained. RESULTS: At < 2 cm dilated cervix the median concentrations of TNF alpha, IL-1 beta, IL-6 and IL-8 were 8.0 pg/mg total protein (TP), 1.3 pg/mg TP, 12.6 pg/mg TP and 17.2 pg/mg TP, respectively. At 4-6 cm dilatation the median concentrations were increased (TNF alpha: 22.2 pg/mg TP [P = 0.05], IL-1 beta: 22.2 pg/mg TP [P < 0.05], IL-6: 1226 pg/mg TP [P < 0.05], IL-8: 2081 mg/mg TP [P < 0.05]). At > 6 cm dilatation no further increase was observed. The expression of ELAM-1 and VCAM-1 was significantly greater at > 6 cm dilatation than < 2 cm dilatation (P < 0.001 and 0.05, respectively). With increasing duration of labor, the concentrations of IL-1 beta, IL-6 and IL-8 (but not of TNF alpha) increased and were significantly higher at > 6 cm dilatation than at < 2 cm (P < 0.05). Expression of ELAM-1 and VCAM-1 did not vary with duration of labor. CONCLUSIONS: These first investigations of cytokines and cell adhesion molecules in the lower uterine segment at both different stages of cervical dilatation and different duration of labor support the decisive role of cytokines for normal cervical dilatation. Local changes in the lower uterine segment independent from the effects of labor (e.g. increase of endothelial adhesivity) seem to be of special importance in this process.

Cell Adhesion Molecules↗