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Biomedical subjects

S Winkler

Publications and source records attributed to S Winkler.

At least 145 records · Page 8Linked to original sources
PubMed1993

Acute effects of insulin-like growth factor I on inter-organ amino acid flux in protein-catabolic dogs.

The effects of acute administration of human recombinant insulin-like growth factor-I (rhIGF-I) on amino acid (AA) flux between hindlimbs, liver and gut were investigated in anaesthetized post-operative dogs. rhIGF-I produced about a 10-fold increase in plasma IGF-I concentrations above baseline values (P < 0.001), increased the plasma levels of glucagon and adrenaline (P < 0.05), and evoked a fall in plasma glucose (-55 +/- 8%; (P < 0.001) and plasma total AA levels (-23 +/- 8%; P < 0.05). AA flux in post-absorptive dogs under NaCl infusions was characterized by an efflux of AA from the hindlimbs (as a result of the protein-catabolic situation), an equal AA balance across the gut and an AA uptake by the liver. The administration of rhIGF-I increased hepatic AA uptake in the NaCl group from 3.51 +/- 0.8 to 7.5 +/- 0.4 mumol/min per kg (P < 0.01) and in the AA-infused group from 16.8 +/- 0.6 to 22.4 +/- 1.5 mumol/min per kg (P < 0.05), but did not influence the AA balance across hindlimbs and gut. Glucose infusions normalized the plasma concentrations of counter-regulatory hormones without influencing the inter-organ AA balances. We conclude that hypoaminoacidaemia caused by rhIGF-I infusions is the result of a stimulated AA uptake by the liver, but is unrelated to alterations of AA exchange across the hindlimbs.

Amino Acids↗
PubMed1993

The edentulous mandible opposing maxillary natural teeth: treatment considerations utilizing implant overdentures.

The restoration of the edentulous mandible opposing all or part of the maxillary natural dentition with implant overdentures is described. There are many situations in which the maxillary teeth opposing an edentulous mandible can and should be retained. Mandibular implant overdentures can be utilized as long as health considerations, morphologic features of the resorbed mandible, and maxillomandibular jaw relationships are satisfactory.

Alveolar Bone Loss↗
PubMed1993

Curing of chloroquine-resistant malaria with clindamycin.

A randomized comparative trial for treating adult patients with Plasmodium falciparum malaria was performed in Lambarene, Gabon. Forty-two patients received chloroquine (25 mg/kg for 48 hr) and 38 patients received clindamycin (5 mg/kg twice a day, for five days). Chloroquine treatment cured 15 patients (36%). Twenty patients (48%) showed recrudescent malaria by day 28 of follow-up (RI resistance) and seven patients (17%) showed persistent parasitemia after chloroquine treatment (RII/III resistance). In contrast, clindamycin treatment cured 37 of 38 patients (97%) and only one (3%) showed a recrudescence by day 28 (P < 0.001). Although the parasite clearance time was significantly longer after clindamycin treatment (median five days, range 3-6) than after chloroquine treatment (median four days, range 2-8) (P < 0.01), no differences were seen in the duration of symptoms after chemotherapy. In both treatment groups, no severe side effects occurred. Clindamycin can be used as a safe alternative to achieve radical cure in semi-immune adult patients with chloroquine-resistant P. falciparum malaria in Central Africa.

Adolescent↗
PubMed1993

Perioperative TNF alpha and IL-6 concentrations correlate with septic state, organ function, and APACHE II scores in intra-abdominal infection.

OBJECTIVE: To find out if concentrations of tumour necrosis factor a (TNF alpha) and interleukin-6 (IL-6) play a part in the pathophysiology of intra-abdominal infection, and try to identify patients who would benefit from immunotherapy against TNF alpha. DESIGN: Prospective open study. SETTING: University hospital. SUBJECTS: 19 consecutive patients (septic shock, n = 4; sepsis syndrome, n = 6; and no sepsis syndrome, n = 9, classified by the APACHE II score and the criteria of the Methyl-prednisolone Severe Sepsis Study Group) who were to undergo their first operation for intra-abdominal infection. MAIN OUTCOME MEASURES: Correlation between median (interquartile) concentrations of TNF alpha and IL-6 (pg/ml), and APACHE II score, plasma lactate concentration, and organ function. RESULTS: Perioperative concentrations of both TNF alpha (p = 0.001) and IL-6 (p = 0.006) were significantly higher in patients with septic shock. Preoperative cardiovascular and respiratory failure were associated with significantly raised TNF alpha (p < 0.001 in both cases) and IL-6 concentrations (p = 0.02 and p < 0.001, respectively). The preoperative APACHE II score correlated with the increased TNF alpha concentration (r = 0.5, p < 0.001) and plasma lactate concentration with that of IL-6 (r = 0.7, p = 0.003). CONCLUSION: Perioperative TNF alpha and IL-6 concentrations correlated with the severity of intra-abdominal infection, so it is possible that patients who present with either septic shock or the sepsis syndrome may benefit from immunotherapy against TNF alpha.

Abdomen↗
PubMed1993

[Mefloquine and sulfadoxine/pyrimethamine overdose in malaria tropica].

A 39 year-old man with malaria due to Plasmodium falciparum received 3500 mg mefloquine over 3 days, in addition to 3250 mg chloroquine and 175/3500 mg sulfadoxine/pyrimethamine. He developed severe neuropsychiatric symptoms and had to be hospitalized. Treatment with diazepam, haloperidol and thioridazine achieved relief of the severe symptoms after 4 days. The patient was still suffering from discrete neuropsychiatric symptoms 8 months after treatment.

Adult↗
PubMed1992

Laboratory wear investigation of resin posterior denture teeth.

This investigation compared the wear resistance of three "improved" resin posterior denture tooth formulations with two conventional products on a mechanical toothbrush abrasion machine. The ability of the teeth to resist this type of abrasion was evaluated by determination of the weight loss during 339 hours of brushing with firm nylon bristle toothbrushes. All brands exhibited negligible loss, with the conventional brands performing better than the "improved" formulations.

Acrylic Resins↗
PubMed1992

[Sequential parenteral and oral therapy with ofloxacin in urogenital infections].

125 hospitalized patients (56 men and 69 women) suffering from urinary tract infection (UTI) and 15 women with endometritis or pelvic inflammatory disease were treated with ofloxacin 6 mg/kg/d i.v. divided into 2 doses. Two thirds of the patients were switched to oral ofloxacin using the same dose regimen after 4 days. The median duration of treatment was 10 days. 98 patients were evaluable for efficacy: 45 had complicated lower UTI, 32 had upper UTI (75% of them with complications), 13 had endometritis and 8 an uncomplicated lower UTI. The most frequent complications of UTI were: obstruction (n = 27), indwelling catheters (n = 23), urinary concrements (n = 12), residual urine (n = 8) and a neurogenic bladder (n = 6). 22 patients had diabetes mellitus. A total of 103 pathogens was isolated from the urine of 85 patients, the most frequent being E. coli, Proteus spp. and Enterococcus faecalis. 98% of patients with UTI and 85% of patients with endometritis were clinically cured. Adverse drug events were observed in 6 patients.

Adolescent↗
PubMed1991

Effect of alpha-ketoglutarate infusions on organ balances of glutamine and glutamate in anaesthetized dogs in the catabolic state.

1. The salt complex of L-(+)-ornithine and alpha-ketoglutarate (2-oxoglutarate) has recently been proposed for the treatment of patients in the catabolic state. As yet, it is unclear which of the two substrates (ornithine or alpha-ketoglutarate) is responsible for the anticatabolic effect. We infused alpha-ketoglutarate into anaesthetized post-operative dogs in order to investigate whether infusion of alpha-ketoglutarate affects the flux of glutamine and glutamate between skeletal muscle and the splanchnic bed. We used three infusion rates: 3, 10 and 20 mumol min-1 kg-1. A steady state of alpha-ketoglutarate concentration in arterial whole-blood was attained only when the infusion rate was 3 mumol min-1 kg-1. 2. Arterial whole-blood concentrations of alpha-ketoglutarate were 8.8 +/- 1.2 mumol/l in the basal period and rose to 208 +/- 41, 344 +/- 61 and 1418 +/- 315 mumol/l after 60 min infusions of alpha-ketoglutarate at 3, 10 and 20 mumol min-1 kg-1, respectively. 3. alpha-Ketoglutarate uptake was measured in skeletal muscle, liver, gut and kidneys in the basal period and during the infusion of alpha-ketoglutarate. The net uptake of infused alpha-ketoglutarate was highest in the skeletal muscle, followed by kidneys, liver and gut. 4. The alpha-ketoglutarate load increased the muscular tissue content of alpha-ketoglutarate from 49.5 +/- 5 to 142 +/- 15 nmol/g of dry substance (P less than 0.001), but did not alter the muscular glutamate or glutamine contents.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

The eosinophilic granulocyte count in the respiratory secretions of children with chronic nonspecific respiratory diseases.

We performed cytologic evaluations of 6116 nasal and/or bronchial smears from 4510 patients (average age: 7.6 years; 3 months--17 years) suffering from different kinds of chronic nonspecific respiratory diseases (CNSRD); in 137 children (average age: 4.8 years) undergoing bronchologic examinations under general anesthesia we compared the findings with those for bronchoalveolar lavage (BAL). Nasal smears of 77 healthy children at a day care center (control group) were analysed four times per year for "significant secretory eosinophilia" (SEE; i.e. more than 13% eosinophils). We found: 1. Healthy children do not have such "SSE" in contrast to children with CNSRD who show different frequencies of "SSE" depending on the age of the child and the specific kind (diagnosis) of CNSRD. 2. 4.6% of infants (first year of life) were found to have SSE with a statistically significant correlation to increase in the following 10 years up to 50% of all children (p less than 0.001). 3. We found SSE in 4.41% of cases with relapsing bronchitis, in 7.14% (8.3% resp.) with chronic bronchitis, in 6.49% (9.2% resp.) with relapsing or chronic obstructive bronchitis and in 46.05% (55.3% resp.) with bronchial asthma (p less than 0.001). 4. The intensity of obstructive symptoms (nose: rhinitis; bronchus: dyspnoea) did not correlate with the number of eosinophils in the secretions. 5. Only the smear cytograms (nose/bronchus) enabled us to detect "SSE" whereas BAL cytograms were too insensitive (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Diagnostic value of skin tests in children with bronchial asthma and/or atopic eczema].

Positive test results with relevance to the patients' history resp. illness' development were seen in all age groups of patients suffering from asthma. In cases with atopic dermatitis, but without asthma or bronchitis, positive test reactions were not relevant; in these cases hyperreagibility of the skin is supposed. The results confirmed that cutaneous testing is indicated in children suffering from asthma, even in those cases with associated atopic dermatitis provided that testing is carried out in lesion-free skin-area and beyond exacerbation of eczema. Test-results should be interpreted only with regard to the patients' history, clinical picture and its development.

Adolescent↗
PubMed1990

Comparison of the lipoprotein and hemostatic changes after a triphasic and a monophasic low dose oral contraceptive in premenopausal middle-aged women.

Metabolic and hemostatic effects of 2 low dose oral contraceptives (OCs), a triphasic (ethinylestradiol + (-)-norgestrel) and a monophasic (ethinylestradiol + desogestrel) preparation, were compared in a cross-over trial in fertile women over 35 years of age. Both combinations moderately affected plasma lipids, with 17-24% increases of total triglyceridemia. Triglycerides accumulate in low density lipoproteins, thus suggesting the possible formation of an atherogenic lipoprotein particle. Only the monophasic preparation increased high density lipoprotein (HDL)-cholesterol levels significantly, with a rise in HDL3 mass and cholesterol. OC treatment led to slight changes in HDL2 and HDL3 structure, with a rise of the cholesteryl ester and triglyceride contents, indicative of a stimulated cholesterol esterification and reverse transport. Changes in the hemostatic indexes (fibrinogen, antithrombin III and protein C) were negligible. The new low dose OCs, even when prescribed to relatively older women, affect to a relatively small extent lipid/lipoprotein metabolism, with the exception of changes in the low density lipoprotein composition.

Adult↗
PubMed1990

The edentulous mandible opposing maxillary natural teeth. Treatment considerations.

Treatment of a patient who requires a mandibular complete prosthesis opposing a natural maxillary dentition presents a unique set of problems for the clinician. Proper prosthodontic care can not only result in a functional and comfortable prosthesis, but may reduce the rate of resorption of the remaining mandibular ridge.

Dental Occlusion, Balanced↗
PubMed1989

[Leiomyoma of the breast in the male].

A macroscopically not sure classifiable solitary tumour on the nipple was observed in a 68 year old man. Histologically a pure leiomyoma was found. Therapy of choice is the tumour resection, if requested.

Aged↗