Biomedical subjects

R Winkel

Publications and source records attributed to R Winkel.

11 recordsLinked to original sources

PubMed2002

Impact of innervation and exercise on muscle regeneration in neovascularized muscle grafts in rats.

The direction of known staged process of regeneration of free muscle grafts was inverted in our experimental rat model from a centripetal to a centrifugal by central implantation of blood vessels into isolated free muscle grafts. The effects of innervation, reinnervation and exercise on muscle fiber regeneration were analyzed at various intervals from 4 to 90 days by morphological and morphometric methods. Reinnervation occurred as well in grafts with the motor nerve left intact as it did in grafts with a severed and reimplanted nerve. Reinnervation proved to be prerequisite for a lasting muscle regeneration. Denervated muscle grafts even after neovascularization underwent irreversible fibrosis. A positive effect of exercise on the early states (30 days) of muscle regeneration was revealed by morphometrical analysis. In the long term (90 days) fiber diameter assimilated in all groups. The animal model mimics a clinical situation of flap prefabrication demonstrating the relationship of functional tissue regeneration and neovascularization. It can be transferred into the acute clinical situation as well as in tissue engineering.

Animals↗

PubMed2000

[Surgical results of submandibular gland excision].

INTRODUCTION: Extirpation of the submandibular gland is the standard treatment for benign disease in cases where conservative treatment fails. This study attempts a follow-up focusing on: the effectiveness of the treatment, the number of complications and the long-term complaints related to this surgical procedure. MATERIAL AND METHODS: This study included 110 patients who, due to benign disease, underwent submandibular gland excision at our hospital during 1989-1995. All the patients had their charts reviewed and were invited for a follow-up consultation, with an examination and an interview about complaints arising after the procedure. RESULTS: Average follow-up time was 7.2 years (range 3.3 to 9.4 years) and 72 patients (65.5%) reported back for follow-up. Sixty-eight of the examined patients (92%) reported relief from their preoperative symptoms. Forty-three patients (42%) had complications in connection with their surgery and fifteen patients (15%) needed a reoperation. The most frequent postoperative complaints were dryness of the mouth and reduced function of the marginal branch of the facial nerve. DISCUSSION: Most of the patients achieved relief of symptoms after surgery. There were a high number of complications, but most of these were of minor severity and temporary. The frequency of palsy in the submandibular branch decreased with time after operation while the frequency of oral dryness increased with time. Excision of the submandibular gland is an effective low-risk treatment for benign disease in the submandibular gland.

Adenoma, Pleomorphic↗

PubMed1998

Platelet monoamine oxidase B activity in "de novo" and l-dopa treated parkinsonian patients and controls.

OBJECTIVE: Previous studies demonstrated controversial results regarding monoamine oxidase B (MAO-B) activity in platelets in the periphery in parkinsonian patients (PD). SUBJECTS AND METHODS: Therefore we determined platelet MAO-B activity in three age- and sex-matched groups of 17 untreated, so called "de novo" patients with Parkinson's disease (PD), 17 parkinsonian patients, receiving levodopa, and 17 controls by a radio enzymatic assay. RESULTS: No significant differences of MAO-B activity appeared. CONCLUSION: This result suggests that phenotypic determination of MAO-B activity in platelets may not be used as peripheral marker in PD and that levodopa treatment does not alter MAO-B activity in the periphery.

Aged↗

PubMed1998

High prevalence of parkinsonism after occupational exposure to lead-sulfate batteries.

Seven of nine postal workers exposed to lead-sulfate batteries over a period of up to 30 years developed parkinsonian symptoms. One of the remaining two showed left-hand bradykinesia and one was not available for examination. The high prevalence and cause of parkinsonism in these patients remains unexplained. Lead intoxication may play a role in the occurrence of parkinsonian symptoms, but involvement of sulfate and other sulfur compounds must also be considered.

Antiparkinson Agents↗

PubMed1997

Disgust implicated in obsessive-compulsive disorder.

Psychiatric classificatory systems consider obsessions and compulsions as forms of anxiety disorder. However, the neurology of diseases associated with obsessive-compulsive symptoms suggests the involvement of fronto-striatal regions likely to be involved in the mediation of the emotion of disgust, suggesting that dysfunctions of disgust should be considered alongside anxiety in the pathogenesis of obsessive-compulsive behaviours. We therefore tested recognition of facial expressions of basic emotions (including disgust) by groups of participants with obsessive-compulsive disorder (OCD) and with Gilles de la Tourette's syndrome (GTS) with an without co-present obsessive-compulsive behaviours (GTS with OCB; GTS without OCB). A group of people suffering from panic disorder and generalized anxiety were also included in the study. Both groups with obsessive-compulsive symptoms (OCD; GTS with OCB) showed impaired recognition of facial expressions of disgust. Such problems were not evident in participants with panic disorder and generalized anxiety, or for participants with GTS without obsessions or compulsions, indicating that the deficit is closely related to the presence of obsessive-compulsive symptoms. Participants with OCD were able to assign words to emotion categories without difficulty, showing that their problem with disgust is linked to a failure to recognize this emotion in others and not a comprehension or response criterion effect. Impaired recognition of disgust is consistent with the neurology of OCD and with the idea that abnormal experience of disgust may be involved in the genesis of obsessions and compulsions.

Adult↗

PubMed1997

[Intramedullary osteosynthesis of distal metacarpal fractures with curved wires].

When intramedullary pinning is used to treat metacarpal fractures, as recently described by Förstner (1994) and Foucher (1995), the closed reduction technique developed by Jahss (1938) is applied in the same way as for conservative fracture treatment. It is not always possible to achieve complete anatomical reduction using this closed technique. The intramedullary pinning technique, that we have applied since 1989, involves a Kirschner wire which is bent at one end. Apart from reducing the fracture, the pre-set Kirschner wire serves as a butressing internal fixator. The elastic clamping of the wire acts as an internal wire spring splint, permitting early mobilisation. We have operated on 62 metacarpal fractures using the above-mentioned technique over a period of 6 years until 1995. Anatomic reduction was realized in 50 of 62 fractures. In the follow-up of 32 fractures, we noticed four complications: one infection, two paraesthesias, and one non-union.

Adult↗

PubMed1996

Parenteral application of NADH in Parkinson's disease: clinical improvement partially due to stimulation of endogenous levodopa biosynthesis.

Exogenous application of levodopa is conventionally used to equalize the striatal dopamine deficit in idiopathic Parkinson's disease (PD). The stimulation of endogenous biosynthesis of levodopa via activation of tyrosine hydroxylase (TH) has been proposed as new therapeutic concept in PD. This may be achieved by exogenous supply with the reduced coenzyme nicotinamide adenine dinucleotide (NADH). Aim of this open prospective study was to investigate (1) the efficacy of a new developed, parenteral application form of NADH on Parkinsonian symptoms and (2) the influence of bioavailability of levodopa. 15 patients, suffering from idiopathic PD (11 male, 4 female, age: 61.40[mean] +/- 10.27[SD] range: 44-74 years, Hoehn and Yahr stage: 3.03 +/- 0.69, range 2-4) received intravenous infusions of NADH (10 mg a' 30 min) over a period of 7 days in addition to conventional Parkinsonian pharmacotherapy. Parkinsonian symptoms were scored before (day 1) and after NADH treatment (day 8). Levodopa plasma levels were estimated over a period of four hours on the day before and on the first day of NADH application by HPLC. Parkinsonian patients showed a significant response, evaluated by the Unified Parkinson's Disease Rating Scale Version 3.0 (p = 0.025; Wilcoxon test). Moreover application of NADH significantly increased bioavailability of plasma levodopa (AUC, p = 0.035; Cmax p = 0.025). In conclusion NADH in used galenic form may be a potent stimulator of endogenous levodopa biosynthesis with clinical benefit for Parkinsonian patients.

Adult↗

PubMed1995

Chronic intoxication with lead- and sulfur compounds may produce Parkinson's disease.

Parkinson's disease was found in three post office workers who were in close contact with lead-sulfate batteries over a period between 1947 and 1983. The workers had been working in a charging station for lead storage batteries used for the battery-traction of post wagons. Parkinson's disease was diagnosed by the characteristic features of rigidity, tremor and elements of hypo-, brady- and akinesia. Additional symptoms were: bradyphrenia (n = 3), memory deficits (n = 3), depressive symptoms (n = 2) and peripheral neuropathy (n = 2). We hypothesize that the parkinsonian symptoms of these post office workers are primarily caused by lead or lead compounds. However a possible toxicity of sulfur containing compounds cannot be ruled out.

Aged↗

PubMed1992

[Autologous blood transfusion in breast reduction].

Minimal risk blood transfusion is possible using autologous blood. When excessive blood loss is expected in reduction mammaplasty, autologous blood transfusion is recommended. Only three of eighty-one patients who underwent reduction mammaplasty in our department received homologous blood transfusions. Patients suffering from glandular hypertrophy are likely to loose significantly more blood during operation than patients with predominantly fatty breast tissue. Autologous blood transfusion should be recommended in cases of excessive breast hypertrophy, in patients afraid of transfusion-associated infections, and for forensic reasons.

Adult↗

PubMed1989

[Timing indications for plastic surgery interventions in burns in the area of the neck and across joints].

From 1985 to 1988, 120 patients underwent opertations. 200 times because of deep dermal or total dermal thermal injury. On the basis on the pathophysiology of tissue repair and scar contracture after burns as well as our experience we conclude that the first aim of the surgeon should be to avoid granulation tissue, the precursor of contracting scars. Only the immediate transplantation of autologous skin onto the surgically created wound after excision of burned tissue can halt the repair process. Flaps are the treatment of choice for reconstruction of existing contracturs deep in the fascia.

Burns↗

PubMed1988

Relevance of poor compliance for seizure control.

The relationship of poor compliance to seizure control was analyzed in 101 patients with self-reported poor compliance in 2 seizure clinics. There was a close correlation of poor compliance and the coefficient of variation for phenytoin (P = 0.001), primidone (P = 0.01) and carbamazepine (P = 0.01). In comparison with self-reported compliers no difference was noted in seizure control and other clinical variables. Patients who experienced an increase of several seizures in temporal relationship with poor compliance more often reported loss of sleep (P = 0.006) and more often had frequent (more than 5 per year) seizures (P = 0.001) than non-compliers with a single seizure relapse or no change in seizure control. Exacerbation of seizures through poor compliance occurs primarily in patients with frequent seizures and through loss of sleep.

Adolescent↗