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Biomedical subjects

F Wolff

Publications and source records attributed to F Wolff.

At least 19 recordsLinked to original sources
PubMed1999

Protective effects of RU 41740, a bacterial immunomodulator, against experimental infections: induction of cytokine and immunoglobulin release in mice after oral administration.

RU 41740 (Biostim) is an immunomodulator extracted from Klebsiella pneumoniae (strain O1:K2). In humans, it is able to reduce the number and duration of infectious exacerbations of chronic bronchitis. Using a mouse model of experimental infection, we found that oral RU 41740 administration strongly protected against gram-negative infections by preventing lethal septicemia, and, to a lesser extent, protected against the gram-positive intracellular pathogen L. monocytogenes. Oral administration of RU 41740 leads to the mobilization of newly dividing T and B cells in the thoracic duct lymph, reflecting the ability of the drug to induce an immune response in gut-associated lymphoid tissue. In cells isolated from mesenteric lymph nodes and spleen, RU 41740 leads to preferential release of the proinflammatory cytokines interleukin (IL)-12 and/or interferon (IFN)-gamma, as well as IL-10, a cytokine involved in inhibiting the synthesis of these latter cytokines. RU 41740 also increases the serum total immunoglobulin (Ig)M concentration and elicits IgM and IgG antibodies against the drug. Infection of mice with Klebsiella pneumoniae has similar functional consequences. Pretreatment of infected mice with RU 41740 leads to a fall in the high levels of proinflammatory cytokines (which could be detrimental), and to an increase in IgG antibodies (which are protective).

Adjuvants, Immunologic↗
PubMed1999

Esophageal dysplasias are detected by endoscopy with Lugol in patients at risk for squamous cell carcinoma in southern Brazil.

Diagnosis of squamous cell carcinoma of the esophagus is usually late. Staining of the mucosa with Lugol's solution during endoscopy has been suggested to identify early cancer/dysplasia and may improve prognosis. Lugol was tested during endoscopy in 96 asymptomatic subjects at risk for this tumor, who were found to have atypias after exfoliative cytology in southern Brazil. Biopsies were obtained in Lugol's 'stained' and 'unstained' areas in the esophageal mucosa and the histologic results were compared. 'Unstained' areas were present in 64 (66.7%) instances: 44 'unstained' areas over mucosa with normal appearance revealed seven dysplasias (four high and three low grade), whereas 20 'unstained' areas with visible lesions contained only one dysplasia (low grade). 'Stained' areas in 96 (100%) subjects showed two additional dysplasias (one high and one low grade). In this study, Lugol 'unstained' areas were of great value for detection of dysplasias (sensitivity = 80%; specificity = 63%; p = 0.01, Fisher's exact test; CI = 95%; odds ratio = 6.7).

Aged↗
PubMed1999

Efficacy on climacteric symptoms of a new estradiol transdermal patch with active matrix in comparison with a reference reservoir patch. Two long-term randomized multicenter parallel-group studies.

METHODS: Two randomized prospective multicentre parallel group studies were performed (one in Germany and the other in Italy) in symptomatic postmenopausal women. The goal was to assess the efficacy on climacteric symptoms and the safety of a new estradiol (CAS 50-28-2) transdermal patch with solid active matrix (SAM) in comparison to a conventional liquid reservoir (LR) type estradiol transdermal patch. Both patches released 50 micrograms/day estradiol. One group of patients received the SAM patch and the other the LR patch in 4-week cycles, with a twice-weekly application of the patches for 3 weeks, followed by one week without patches. Progestin opposition was achieved with medroxyprogesterone acetate 5 mg/day orally in the last 11 days of patch application in the German study and with 10 mg/day in the last 12 days of patch application in the Italian study. Both studies were divided into two Parts: Part 1 with three 4-week cycles for a total of 12 weeks and Part 2 for other ten 4-weeks cycles in which the patches could be applied also continuously. The total duration of the study was therefore 52 weeks. RESULTS: Germany study. 133 patients resulted randomized to the SAM group and 129 to the LR group. Both estradiol patches quickly relieved climacteric symptoms already during the first 3 weeks of patch application, as shown by the rapid decrease of the Kupperman Index. At the end of Part 1, in the SAM group 91% and in the LR group 96% of patients reported relief from climacteric symptoms. At the end of Part 2 the percentages were 98% and 95%, respectively. The two patches were therapeutically equivalent with a power greater than 99.7%. Both patches were systemically fairly well tolerated. Only 4.5% of patients in the SAM group and 3.9% in the LR group discontinued prematurely for possible adverse reactions related to estradiol. There was no significant difference between the two patches with regard to systemic tolerability. Conversely, with regard to local skin reactions, the SAM patch was significantly (p < 0.01) better tolerated than the LR patch. The adhesion to the skin of the SAM patches was better than that of the LR patches. RESULTS. Italian study. 139 patients resulted randomized to the SAM patch and 128 to the LR patch. Also in this study both types of patches relieved the climacteric symptoms already during the first 3 weeks of patch application, as shown by the rapid decrease of the visual analogue scale (VAS) recordings of severity of hot flushes and of sweats. At the end of Part 1 both patches relieved 95% of patients from climacteric symptoms. At the end of Part 2, i.e. after 52 weeks, 100% of patients were relieved from climacteric symptoms. Of these, 72% in the SAM group and 78% in the LR group reported complete disappearance of symptoms. Also in the Italian study, therefore, the two patches were found therapeutically equivalent. Both patches stopped or even reversed bone mineral loss in L2-L4 and had some favorable effects on lipid metabolism. Both patches were systemically equally fairly well tolerated with premature discontinuations for systemic adverse drug reactions in only 5.0% of patients in the SAM group and 3.9% in the LR group. Conversely, as in the German study, the SAM patches were significantly better tolerated by the skin (p < 0.0001). CONCLUSIONS: The two types of estradiol transdermal patches were equivalent in providing an effective and rapid relief from climacteric symptoms. Systemically both patches were fairly well tolerated. The SAM patches were significantly better tolerated by the skin. The better local tolerability combined with better adhesion and cosmetic properties render the SAM patches very patient friendly and improve the compliance in the long term estrogen replacement therapy required to reduce osteoporosis and cardiovascular risks.

Adhesiveness↗
PubMed1994

[Oligohydramnios--perinatal complications and diseases in mother and child].

In our study, complications of oligohydramnios were examined. In medical records of all 5,210 deliveries of our department between 1987 and 1990 181 cases of oligohydramnios were identified. The diagnosis was confirmed by ultrasound and based on the method described by Mannings and Platt: amniotic fluid depots of less than 1 cm were defined as oligohydramnios. All 181 cases met the above definition, which results in an incidence of 3.5% pregnancies with reduced amniotic fluid. We examined the records of mother and foetus, the delivery and perinatal complications and follow-up of the newborn. In more than 60%, foetal asphyxia, breech position and other anomalies during delivery were followed by Cesarean section or vaginal operative delivery by forceps or vacuum extraction. In 30 cases, oligohydramnios was caused by premature rupture of membranes. In the other cases, the diagnosis based on maternal or foetal complications such as gestosis (n = 7), abruptio placentae (n = 10), foetal growth retardation (n = 47) and malformations or chromosomal anomalies. 89 newborn were transferred to a paediatric hospital immediately after delivery. Potter's syndrome was the main anticipated diagnosed malformation (n = 20). The lack of amniotic fluid was furthermore followed by a higher rate of pulmonary complications such as RDS and hypoplasia of the neonatal lung (n = 21). In conclusion, our study underlines the fact, that oligohydramnios must be regarded as an important reason of high risk pregnancy followed by many complications for foetus and newborn. The incidence of perinatal mortality in our examination was 7.2%. This rate is 10 fold higher than in the total number of deliveries of our department.

Adolescent↗
PubMed1994

[Comparative thrombotic risk of two contrast agents in coronary angiography].

The thrombogenic risk of contrast agents in coronary angiography is still a topical issue, particularly in comparisons between ionic and nonionic contrast agents. As a complement to a preliminary study, the repercussions on sensitive markers of haemostasis were investigated in vivo in 38 patients undergoing a standard cardiac catheterisation. After randomization, an ionic low osmolality contrast agent (Ioxaglate 320) was used in 19 patients and a nonionic low osmolality contrast agent (Iopromide 370) was used in another 19 patients, according to an identical protocol. The following parameters were assayed in arterial blood samples obtained before and after the examination in each patient: platelet markers: beta-thromboglobulin (beta TG) and platelet factor IV (PF4); prethrombotic markers: thrombin-antithrombin 3 complex (TAT) and prothrombin fragments 1 and 2 (F1 + 2) as well as partial exploration of fibrinolysis: tissue plasminogen activator inhibitors (PAI). Comparison of the results demonstrated platelet activation and the presence of prethrombotic markers in both groups. No significant difference was detected between the two groups of patients. Consequently, there does not appear to be any difference in activation of coagulation between modern, low osmolality, ionic or nonionic contrast agents. This may suggest an equivalent thrombogenic risk.

Blood Coagulation Tests↗
PubMed1994

[Triple aneurysm of the Valsalva sinus complicated by right coronary occlusion: apropos of a case and review of the literature].

We report a case of aneurysm of all three aortic sinuses. The patient suffered from both cardiac failure and angina pectoris. The diagnosis, suggested by echocardiography, was confirmed by magnetic resonance imaging (MRI) which showed marqued dilatation of all three aortic sinuses. At operation, we observed dilatation of all three aortic sinuses, measuring 2 to 6 cm and partially thrombosed. We performed a Bentall operation with reimplantation of the left coronary artery ostium. The right coronary ostium was thrombosed and was revascularized by a saphenous vein bypass. Despite prolonged circulatory assistance and an intra-aortic balloon counterpulsation, cardiopulmonary bypass could not be stopped and the patient died. This is a new case of multiple aneurysms of the aortic sinuses and also a case of aortic sinus aneurysm (ASA) complicated by coronary insufficiency. This last complication has a poor prognosis, as demonstrated by a review of the 28 cases described in the literature. MRI was found to be important for the diagnosis of the ASA, in combination with echocardiography and angiography which can underestimate the aneurysm because of the frequently associated mural thrombus.

Aortic Aneurysm↗
PubMed1992

[A rare clinical manifestation of a combination tumor of cystosarcoma phylloides malignum and an intraductal cancer].

A combination of cystosarcoma phylloides and ductal carcinoma in the breast of a 47-year old woman is reported. Only few cases of this simultaneous tumour formation is described in the literature. Therapy, prognosis and follow-up are discussed. Current standard therapy is ablatio mammae, modified according to Patey, with axillary lymphnode dissection. Decision in respect of chemotherapy depends on the results of staging. Follow-up control of the patients for early detection and therapy of metastasis is recommended. The reported case underlines, that histological examination of every breast node is indicated, even if there is no sign of malignancy.

Breast↗
PubMed1991

[Contribution of imaging to the study of aortic aneurysms].

All aortic aneurysms require a positive diagnosis, a differential diagnosis and an assessment of extension. Several exploratory methods can be contemplated. In patients with warning symptoms, conventional radiology may point to the diagnosis. The reference method remains retrograde aortography which may be either conventional and seriographic or, better, radiocinematic with orthogonal projections and, if possible, digital. The site and morphology of the aneurysm, and in particular its inner channel are thus demonstrated. Computerized tomography is less invasive and usually of great value, notably for the horizontal, thoracic and abdominal aorta, not only to confirm the diagnosis but also to determine the size of the inner channel, parietal thrombi and aortic walls, as well as relations with nearby structures. Other, totally non-invasive methods are widely utilized to explore aortic aneurysms. These are ultrasonography and its variants (notably Doppler-echocardiography and the transoesophageal route), and magnetic resonance imaging which provides three-dimensional and anatomical views of the vessel. These last two examinations alone usually confirm and outline the aortic aneurysms. They must therefore be utilized as first-line examination, arteriography it is various forms being reserved for emergencies or special cases.

Aorta, Abdominal↗
PubMed1991

[Opiate analgesia in labor--use of nalbuphine in comparison with administration of the combination Dolantin/Atosil/Haldol].

Since July 1, 1990, Nalbuphine has been used as an obstetric analgesia at the Municipal Women's Hospital in Cologne-Holweide. The following differences were found between 2 groups of 122 patients each, one of which received Nalbuphine and the other a socalled cocktail, a combination of dolantin, haldol, and atosil. The number of spontaneous births in the Nalbuphine group was higher and the number of Caesarean sections and vagino-operative births were lower in comparison to the cocktail group. The pH-level of the arterial umbilical cord was higher in the Nalbuphine group, which can be explained by less stress on the child during birth. Overall, the post partum irregularities were less in the Nalbuphine group, whereas 6 children in the cocktail group had respiratory adaptation disturbances.

Analgesia, Obstetrical↗
PubMed1990

[Ambroxol versus betamethasone for the promotion of antepartum lung maturity in pathological pregnancies].

Although glucocorticoids have been universally implemented to stimulate fetal lung maturity, their effectiveness and side effects are still widely contested. In search of alternative drugs a double-blind study was conducted between June 1981 and June 1984 comparing betamethasone, a conventional corticoid, and ambroxol, a bromhexine metabolite for efficacy and tolerance in prenatal prevention of the respiratory distress syndrome (RDS) in premature infants and full-term neonates. The therapeutic efficacies of betamethasone and ambroxol for this indication proved to be comparable. Since the possible risks of corticoid therapy in abnormal pregnancies are repeatedly discussed in the literature and in daily clinical practice. 137 patients with EPH gestosis, placental insufficiency, diabetes mellitus, and premature rupture of the membranes were selected from the original group of 308 patients. Only minor side effects (e.g. nausea) were present in a few of the 137 cases undergoing treatment with the 2 test substances. No side effects were observed in the neonates. The incidence of fetal RDS was comparable in both groups (2.9% with ambroxol, 2.2% with betamethasone). Transient and mild RDS cases were slightly more frequent in the ambroxol group than in the betamethasone group. To date, contraindications to ambroxol treatment in abnormal pregnancies are unknown and since generally the rate of potential side effects is considered to be lower in comparison with corticoid treatment, the use of ambroxol especially in abnormal pregnancies corresponding indication can be recommended.

Ambroxol↗