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Biomedical subjects

R Winter

Publications and source records attributed to R Winter.

At least 253 records · Page 14Linked to original sources

The importance of an early diagnosis of fertilization disorders.

Typical possibilities of abnormal development in human oocytes cultured and fertilized in vitro were studied using phase-contrast microscopy. All oocytes were checked three times for maturity, fertilization and embryo development. A total of 180 non-cleaved oocytes and 30 embryos originating from polypronuclear oocytes are described. It is concluded that an exact inspection at the fertilization check is essential to avoid the transfer of abnormally developing oocytes and embryos.

Chorionic Gonadotropin↗

Lack of expression of HLA [corrected] class I and class II molecules on the human oocyte.

The expression of histocompatibility leukocyte antigen (HLA) class I and class II antigens on human oocytes was investigated by the indirect immunofluorescence assay using well-defined monoclonal antibodies. Oocytes were obtained from an in vitro fertilization program or were studied on frozen sections from human ovaries. Neither HLA class I, beta 2-microglobulin, nor HLA class II molecules were detected on cultured oocytes or frozen sections. The zona pellucida also lacked these antigens, but granulosa cells expressed HLA class I molecules. Our results also indicate the presence of certain types of class II molecules on granulosa cells. The present experiments demonstrate that the human oocyte belongs to those few cell types in the human body which are devoid of both types of HLA molecules.

Antibodies, Monoclonal↗

Gallbladder wall thickening: a frequent finding in various nonbiliary disorders--a prospective ultrasonographic study.

A comprehensive prospective ultrasonographic study was performed in 93 patients to investigate gallbladder wall thickness and gallbladder volumes in various nonbiliary disease states. Without changes in gallbladder volume, mean gallbladder wall thickness was significantly increased (p less than 0.01) in patients with liver cirrhosis, viral hepatitis, chronic congestive heart failure, hypoalbuminemia, and chronic renal failure (p less than 0.05) but not in patients with diabetes mellitus (n = 14) as compared to a control group. The present study confirms that a variety of nonbiliary disorders are associated with significant thickening of gallbladder walls and that this finding is not caused by incomplete gallbladder contraction.

Diabetes Mellitus↗

Vertebral artery Doppler sonography.

We have examined the vertebral and subclavian arteries in 1,205 patients using directional continuous-wave (c-w) Doppler sonography, and compared the sonographic findings with the results of unilateral or bilateral retrograde brachial arteriographies in the same patients. Doppler sonography revealed 33 false positives among 909 cases with normal angiographic findings. Some types of vertebral artery (VA) lesions allowed an excellent, others a fairly good differentiation by Doppler sonography: the complete subclavian steal syndrome with constant reversal of VA flow was reliably detected (16 cases). In the incomplete steal syndrome (5 cases) sonography was superior to angiography. Two bilateral distal VA occlusions and seven basilar artery occlusions - six in the proximal third and one in the rostral third - were detected sonographically; four basilar occlusions sparing the caudal third and one case exhibiting rete mirabile anastomoses were not identified by Doppler sonography. Our acoustically defined sonographic criteria did not permit an unequivocal assignment to an anatomical variant or a vascular lesion. The sensitivity in the detection of a severe stenosis at the VA origin amounted to 16 out of 31, and to 12 of 25 in cases with a proximal VA occlusion and reconstitution of the distal VA through cervical collaterals. Our results confirm that the conventional hand-held c-w Doppler sonography cannot replace angiography in the evaluation of vertebro-basilar insufficiency. It rather serves as an aid to the decision for or against angiography, and in the follow-up of angiographically proven lesions. However, several therapeutically important lesions are readily diagnosed by sonography.

Angiography↗

Measurements of regional cerebral blood flow in patients following superficial temporal artery-middle cerebral artery anastomosis.

Regional cerebral blood flow (rCBF) was measured using the inhalation xenon 133 technique in 25 patients undergoing superficial temporal artery-middle cerebral artery anastomotic surgery. rCBF was measured once before and 3 times after operation, up to one year. Data were compared to rCBF-measurement in 16 patients with similar diagnosis, age distribution and medical treatment except that they were not operated on. Mean rCBF increased in some patients 4-8 weeks after surgery on the ipsilateral side. Compared to the non-surgical patients mean rCBF at this time was higher over both hemipheres. However, taking a flow increase of at least 15% as being significant only one third of all patients presented with a significant flow increase. Regional flow data indicated that the amount of hypoaemic areas in the operated side decreased significantly. Areas with normal flow increased in number from CBF 1 to the 4-8th week. There were no significant changes in flow distribution over the contralateral side. It was concluded that extracranial-intracranial bypass improves flow in patients with TIA or PRIND respectively only in some cases. Also a return to normal flow distribution can be achieved in only a few cases.

Cerebral Revascularization↗

High-dose systemic streptokinase and acylated streptokinase-plasminogen complex (BRL 26921) in acute myocardial infarction: alterations of the fibrinolytic system and clearance of fibrinolytic activity.

We report the results of two consecutive studies using intravenous bolus injections of streptokinase (SK) or acylated plasminogen-SK complex (BRL 26921) in patients with acute myocardial infarction (AMI). In the first study, 20 patients received either 750,000 units (U) SK (group IA, n = 10) or 1,500,000 U SK (group IB, n = 10) within 5-10 min intravenously. In the second study 10 consecutive patients received 750,000 U SK within 15 min (group IIA) intravenously. The following 10 consecutive patients received 30 mg BRL 26921 within 2 min (group IIB). Early reperfusion was found in 16 patients in the first study (8 in each group) and in 18 patients in the second study (9 in each group). The decrease of fibrinolytic activity was biphasic with a half-disappearance time of 112.5 min for BRL 26921 and 31 (IA) and 18 (IB) min for SK. alpha 2-Antiplasmin depletion and a decrease of fibrinogen was observed with no differences after bolus injections of SK and of BRL 26921.

Aged↗

Corneal endothelial cell damage associated with contact to gas bubbles during YAG laser application.

Corneal endothelial cell damage was generated in freshly enucleated pig's eyes by multiple applications of YAG laser bursts in the anterior chamber focussed 2 mm behind the corneal endothelium. With 100 X 5 bursts at an energy of 5 mJ focussed 2 mm behind the endothelium, a considerable number of gas bubbles were generated at the site of optical breakdown in the aqueous humor. Variable areas of scattered endothelial cell damage or necrosis were observed. By selecting two different experimental settings, a possible harmful effect of the gas bubbles on the corneal endothelium could be demonstrated.

Animals↗

The corneal endothelium as a standard for the assessment of complications in microsurgery.

Endothelial cell morphology is an important parameter for the quality control of different surgical techniques, especially in the anterior segment. The minimizing effect of hyaluronic acid in implant surgery can be demonstrated by the decrease of endothelial cell loss as compared to standard techniques. Besides, we can show that the implantation of artificial lenses into the capsular bag is less traumatizing to the cornea than anterior chamber lenses. Other factors to control the surgical techniques are the keratoplastics, especially modified to different trephination techniques and last but not least YAG laser surgery of the cataract membranes. In the latter, there is a direct correlation between endothelial trauma and distance of focus and total energy. Even in isolated cases we can draw conclusions from endothelial morphology to intra-postoperative complications. New surgical techniques which could lead to damage of the cornea should be tested by endothelial cell analysis.

Cataract Extraction↗

Scheuermann kyphosis. Follow-up of Milwaukee-brace treatment.

From 1960 through 1978, a total of 274 patients who had a diagnosis of Scheuermann kyphosis were treated with a Milwaukee brace at the Twin Cities Scoliosis Center. We analyzed the long-term results in 120 patients who had used the Milwaukee brace and had been followed for at least five years after the completion of treatment. The average age of the patients at the initiation of treatment was twelve years and five months, the average age at the completion of treatment was sixteen years and one month, and the average age at the last follow-up examination was twenty-four years. Of the patients who wore the brace consistently, seventy-six showed improvement in the kyphosis between the initial evaluation and the evaluation at final follow-up, while twenty-four showed worsening and ten were unchanged. Seven of the twenty-four patients who were worse had had surgery before the review for this study. The indication for surgery was a kyphosis of more than 60 degrees that was increasing and was not controlled by the brace. Ten patients were inconsistent in their use of the brace. Two of the ten patients had improvement and eight had worsening of the kyphosis; three of the latter eight had a spinal fusion. This study showed that the Milwaukee brace is usually an effective method of treatment for patients who have Scheuermann kyphosis; however, four of fourteen patients who had an initial kyphosis of more than 74 degrees required a spinal fusion.

Adolescent↗

A new category of lethal short-limbed dwarfism.

We describe a first cousin marriage between Asians which resulted in 13 pregnancies; 4 of the offspring were normal, 5 were stillborn dwarves, 3 pregnancies resulted in miscarriage, and one was terminated for dwarfism detected prenatally. The radiology and histology are unique and the pedigree suggests autosomal recessive inheritance.

Consanguinity↗