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Biomedical subjects

C Winkler

Publications and source records attributed to C Winkler.

At least 19 recordsLinked to original sources

Tophi as the initial manifestation of gout. Report of six cases and review of the literature.

The development of tophi in the absence of prior episodes of gouty arthritis is unusual. We present six such cases and review 26 previously published cases. These patients differ from those with typical gout in that they were older, more likely to be women, and usually had predominant or exclusive finger involvement. Most had renal insufficiency and many were receiving an anti-inflammatory or diuretic. Although several possibilities for the lack of gouty arthritis in the presence of tophi exist, usually no clear explanation is found.

Adult

Transient expression of foreign DNA during embryonic and larval development of the medaka fish (Oryzias latipes).

Species of small fish are becoming useful tools for studies on vertebrate development. We have investigated the developing embryo of the Japanese medaka for its application as a transient expression system for the in vivo analysis of gene regulation and function. The temporal and spatial expression patterns of bacterial chloramphenicol acetyltransferase and galactosidase reporter genes injected in supercoiled plasmid form into the cytoplasm of one cell of the two-cell stage embryo was promoter-specific. The transient expression was found to be mosaic within the tissue and organs reflecting the unequal distribution of extrachromosomal foreign DNA and the intensive cell mixing movements that occur in fish embryogenesis. The expression data are consistent with data on DNA fate. Foreign DNA persisted during embryogenesis and was still detectable in some 3- and 9-month-old adult fish; it was found in high molecular weight form as well as in circular plasmid conformations. The DNA was replicated during early and late embryogenesis. Our data indicate that the developing medaka embryo is a powerful in vivo assay system for studies of gene regulation and function.

Animals

Oncofetal antigen in Xiphophorus detected by monoclonal antibodies directed against melanoma-associated antigens.

Monoclonal antibodies (MAbs) directed against Xiphophorus melanoma cells were developed and tested by indirect immunofluorescence and immunoperoxidase staining for reactivity with a panel of 15 allogeneic tissues and 12 allogeneic cell lines. The reactivity of such MAbs was restricted to melanoma cells from tumor biopsies and melanoma-derived cell lines. In addition, all embryonic cells of all histiotypes from developmental stages later than mid-organogenesis and from corresponding short term in vitro cultures reacted with these MAbs. In contrast, normal tissues and organs from adult fish displayed no reactivity, thus implying that the melanoma-associated antigens detected by the MAbs described are oncofetal antigens.

Animals

[Afterloading contact therapy in childhood tumors].

Two examples are presented to apply high dose rate afterloading therapy in treatment of tumors in childhood. The AL-therapy can be indicated in tumors in natural or artificial openings of the body that are limited locoregionally or were operated in sano. Applying brachytherapy radiogenic late-effects can be prevented in normal tissue like gonads and skeleton predominantly. On the other hand a tumor dimension greater than the target volume attainable by contact therapy has to be excluded certainly to avoid local recurrences.

Bone Neoplasms

[Radiogenic pneumopathy in irradiated breast cancer--a follow-up assessment based on chest radiographs].

In 232 surgically treated and irradiated patients with breast carcinoma 27 cases of radiogeneous pneumopathia were found and analyzed in the chest radiograph. Special attention was given to the evaluation of the stage and the course of the radiation pneumonitis. No correlation between clinical results and x-ray symptoms was seen. Not every roentgenologically diagnosed pneumonitis is seen in the late follow-up as a fibrosis. The reasons for this are discussed. For the improved detectability of pneumonitic changes in the p.a. or lateral image no significant differences were found and no general rules. Additional CT-investigations of the chest demonstrated the radiogeneous lung changes more clearly and more exactly in its depths. Therefore an exact use of CT in the diagnostics of pneumonitis can be useful, but must be seen under the aspects of relevant therapy the availability of methods and economy.

Adult

[Results of an epidemiological study with subsequent specialized diagnostic studies in dust exposure].

Preparing a special occupational health follow-up a cross sectional study in 304 dust exposed workers was performed. According to these screening results 23% of the workers examined revealed as fit only under special conditions. Clinical examinations confirmed these judgements except a small group of 2.9%. In confirmed cases hygienic measures in regard of the working places and/or medical treatments were started. Effectivity will be studied in a longitudinal manner.

Adult

Genetic characterization of FLA, the cat major histocompatibility complex.

The major histocompatibility complex (MHC) of the domestic cat (termed FLA) has been refractile to genetic and serological definition largely because of repeated failure to detect cytotoxic antibodies in multiparous cats or to elicit antibody following allogeneic lymphocyte immunization. We have developed a protocol for producing cytotoxic alloantisera in the cat following rejection of multiple surgical skin grafts. Of 59 cats subjected to grafting, 13 produced lymphocytotoxic antisera which had varying specificities among a panel of outbred cat cells. A population cluster analysis of the 13 alloantisera permitted the identification of six clusters of overlapping FLA specificities. Serological analysis of cells from 12 cat kindreds led to the definition of 24 allogeneic haplotypes, which segregate as a single Mendelian complex. Feline FLA antisera were characterized as class I or class II specific by immunoprecipitation of FLA gene products on lymphocyte cell surfaces. Abundant antigenic polymorphisms for both class I and class II MHC determinants were discovered, a result consistent with precedence in other species and the common expectation of the adaptive value of MHC variation. Development of feline MHC typing reagents and the definition of haplotypes for the cat hold promise for experimental analysis of valuable feline models for virus-induced immune deficiencies.

Animals

[Nuclear medicine in Germany: a look back at the beginning].

The development of nuclear medicine in Germany from early approaches with 32P and 131I to the first radioiodine therapy of thyroid cancer up to the clarification of basic principles for current thyroid diagnostics and for functional scintigraphic imaging are presented. Selected references are used in portraying scientific stepping stones of our speciality as well as its establishment in clinical practice during the first two decades. Researchers, places, and facts are specified and interpreted in their relation to the state-of-the-art of nuclear medicine.

Germany

Magnetic resonance (MR) imaging of prostatic tumours, a comparison with X-ray CT and transrectal sonography (TRS).

A total of 7 healthy volunteers and 31 patients have been examined clinically, by MRI, TRS, and biopsy. In those patients with established carcinoma, a CT examination was also performed. For the MRI study, a superconducting MR 2000 imager (Picker International) operated at 0.15 T was used with multiplanar SE and IR sequences. SE sequences with long echo times detected prostatitis, adenoma and carcinoma of the prostate with a high degree of sensitivity. However, at present, differentiation between adenoma, prostatitis and carcinoma is not possible with sufficient accuracy. In these studies we were unable to establish a correlation between the signal pattern and staging and/or grading of the carcinoma. Reliable diagnosis of a prostate carcinoma still requires a biopsy. Because of the high soft tissue contrast and the possibility of selecting any orientation for the plane under investigation, however, MRI represents an improvement in the preoperative diagnosis of local spread.

Aged

Neurenteric cyst diagnosed by technetium-99m pertechnetate sequential scintigraphy.

Neurenteric cysts are rare congenital anomalies which present as mediastinal tumors associated with vertebra anomalies. Two-thirds of them are lined with gastric mucosa and are potentially life threatening. An exact differential diagnosis is difficult preoperatively but is absolutely necessary because of the grave prognosis if left untreated. We present a case in which [99mTc]pertechnetate sequential scintigraphy demonstrated gastric mucosa in the cyst and helped to confirm the diagnosis. The scintigraphic findings are correlated with radiologic, sonographic, and pathologic features.

Female

Effect of myocardial perfusion and metabolic interventions on cardiac kinetics of phenylpentadecanoic acid (IPPA) I 123.

The effect of regional myocardial perfusion and flow-independent adrenergic stimulation, as well as lactate-mediated inhibition of cardiac lipolysis, on cardiac IPPA uptake and metabolism was examined in canine hearts (flow studies) and in the isolated perfused Langendorff rat heart (metabolic interventions). In both normal and ischaemic myocardium, local perfusion is a major determinant of cardiac IPPA uptake. In pacing-induced hyperaemia, the strict flow-dependence of cardiac IPPA uptake is not preserved. Adrenergic stimulation raises the rate of oxidation of both palmitic acid 14C and IPPA. This change is reflected by increased metabolite production released into the perfusate and radioactivity clearance recorded externally. Lactate in high concentrations exerts the opposite effect on cardiac free fatty acid oxidation. IPPA is stored in this condition preferentially in tissue phospholipids and triglycerides.

Animals

Experimental basis of metabolic imaging of the myocardium with radioiodinated aromatic free fatty acids.

For the investigation of myocardial perfusion and left ventricular pump function, advanced radioisotopic techniques have been established. New developments in radiopharmacology and single-photon emission computed tomography have recently enabled the investigation of parameters of regional energy metabolism in well defined areas of the heart muscle. For this purpose, various iodine (123I)-labeled free fatty acids (FFA) have been synthesized. The diagnostic application of labeled FFA in heart disease may be important, since FFA are the preferred substrates for cardiac energy production at rest in the fasting state. In addition, regional myocardial FFA uptake and regional myocardial blood flow are tightly coupled in normal myocardium with beta-oxidation which is extremely sensitive to oxygen deprivation. This article outlines the basic physiologic pathways of FFA in normal and ischemic myocardium and reviews the results of animal experiments validating the application of these principles for metabolic imaging of the heart by means of the aromatic radioiodinated FFA, 15-(p-iodophenyl)pentadecanoic acid. In addition, the development, physiologic properties, and potential applications of a new generation of 3-methyl-substituted radioiodinated fatty acids that show high myocardial uptake but prolonged retention are discussed.

Animals

[Results of fatty acid SPECT of the myocardium in coronary disease].

New developments in radiopharmacology of 123I-labeled metabolic tracers and single-photon emission computerized tomography (SPECT) allow now-a-days the assessment of parameters of cardiac energy metabolism in well-defined areas of the heart muscle. This article will present a brief outline of the basic pathophysiological principles used in the application of 123I-labeled phenyl fatty acids for the evaluation of CAD. First clinical results suggest an important application of cardiac fatty acid metabolic imaging to the detection, localisation and conceivable quantitation of myocardial ischemia, myocardial infarction and assessment of tissue viability. In addition to the diagnostic applications in CAD, cardiac fatty acid metabolic imaging may provide new perspectives to pathophysiological investigations of the coupling of local flow and substrate utilisation in vivo and the effect of therapeutic interventions.

Coronary Disease