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Biomedical subjects

H Wolff

Publications and source records attributed to H Wolff.

At least 19 recordsLinked to original sources
PubMed2007

Repeated epicutaneous exposures to ovalbumin progressively induce atopic dermatitis-like skin lesions in mice.

BACKGROUND: Atopic dermatitis (AD) is a chronic skin disease in which environmental factors play a great role. A widely used murine model for AD has provided a useful tool to study the disease. OBJECTIVE: The purpose of this study is to investigate kinetically the induction of this AD model and the processes involved in the development of AD due to extrinsic allergen exposures. METHODS: BALB/c mice were epicutaneously exposed to ovalbumin (OVA) for 3 weeks; each week was separated by a 2-week resting period. Mice were killed after each exposure week. Skin biopsies and blood were obtained for histological study, RNA isolation and antibody analysis. RESULTS: There was a progressive and significant thickening of the epidermis and dermis in OVA-exposed mice. Significantly increased dermal cell infiltration of eosinophils, mast cells and total inflammatory cells, including CD3 and CD4 cells, was found after each OVA exposure week. Total IgE, IgG2a and OVA-specific IgE were significantly increased after the second and third exposure week, while OVA-specific IgG2a was significantly induced after the third exposure week. Gradual and/or significant increases in mRNA expression of IL-1beta, TNF-alpha, IL-4, IL-10, IL-13, IFN-gamma and IL-12p35 were found after each exposure week. Chemokines and their receptors involved in both T-helper type 1 (Th1)- and Th2-type cell recruitment (CCL1, CCL8, CCL11, CCL24, CXCL9, CXCL10, CCR1, CCR3, CCR5, CCR8 and CXCR3) were up-regulated significantly at different time-points. CONCLUSION: This study provides an insight into the dynamic nature and time-dependent transition of skin inflammation and systemic immune responses in a murine AD model induced by repeated epicutaneous exposures to OVA.

Allergens↗
PubMed2006

[Social inequalities and access to health care: consequences of the revision of the Swiss insurance law (art 64A)].

The revision of the Swiss health insurance law (article 64A) excludes an increasing portion of the Swiss population from access to health care, and specifically to medications. From May to August 2006, 84 patients were referred to the University Hospital's primary care outpatient clinic to receive medications. These patients had a low socio-economic position, suffered from chronic diseases (88%) and had a high prevalence of psychiatric diseases (59%). This change in the Swiss insurance law mainly has an impact on the more fragile members of society and threatens the concept of equal access of the whole population to the national health care system.

Health Services Accessibility↗
PubMed2005

[Social inequalities and health: experiences of a mobile health care unit in Geneva].

Health care professionals are in contact with patients of all social horizons. Healthcare professionals come into contact with patients from all social backgrounds. Low socio-economic status is a well-known determinant of morbidity and mortality. A mobile community health care unit ("Umsco") was created in Geneva in 1996 with the aim of providing health care to very low-income patients who aren't catered for by the traditional healthcare system in Switzerland. The Mobile Unit's patients are mainly female South American illegal immigrants, but also the city' homeless. This article explains how the Unit functions on a day-to-day basis. We describe socio-demographic characteristics of the patients and their main presenting complaints. We also discuss how health care professionals in general can adapt to the specific needs of socially deprived and vulnerable patients.

Community Health Services↗
PubMed2003

Larval therapy--an effective method of ulcer debridement.

Since ancient times, larval therapy has been reputed to help wound healing. Its use has recently been rediscovered and it is now enjoying increasing interest in clinical practice, as well as in research. We have investigated the effects of larval therapy on wounds in an open study of 74 patients with necrotic or sloughy chronic ulcers of different aetiologies. We found larval therapy to effectively debride 86% of the necrotic ulcers, and a single application was clinically beneficial in two-thirds of the patients. Failure to debride was mostly attributable to larval death. No ulcer type was shown to be more suited to larval therapy than others; however, there was an excellent response in all 29 patients with diabetes. Larval therapy was also noted to reduce odour in 58% of the 31 foul-smelling ulcers of mixed aetiology. No serious side-effects were observed. One-quarter of the study group experienced less pain during treatment, while 41% felt no difference in pain, and, although 34% noted an increase in pain, most of these patients wanted to continue the treatment because of subjective and objective visual improvement in wound debridement. In conclusion, we found larval therapy to be effective for debriding ulcers, easy to use and well accepted by the patients.

Adult↗
PubMed2003

Surgical treatment of tinea capitis in childhood.

Fungal infections of the scalp can cause kerion, pus-filled swellings, that may look like bacterial abscesses. We report on two children who underwent incision and drainage of their kerions under local and general anesthesia. This treatment was inappropriate: it carried the risk associated with general anesthesia and surgery without providing the therapeutic chance linked to adequate antimicrobial chemotherapy. We recommend that children who are present at emergency departments with pus-filled swellings on the scalp should be referred to a dermatology unit where appropriate clinical and laboratory investigations and antifungal treatment can be provided, if considered adequate.

Abscess↗
PubMed2003

[Evolution of the treatment of pancreatic cancer].

Cancer of the pancreas was not diagnosed until the nineteenth century, and the first surgical attempts were not carried out until the end of that century, and then only within the framework of local tumour removal. Already in 1898, however, Codivilla described the operative method that is today considered the standard operation and which, in the form of partial duodenopancreatectomy, is the most commonly performed procedure on the pancreas. Evolutionary change in this area represents nothing more than the gradual introduction of minor modifications which, however, had no impact on the " heart" of the surgical approach. The particular feature of surgical treatment of pancreatic cancer--since 1935 known as Whipple's procedure--is the considerable length of time of 80 years that it took before it finally found widespread acceptance. Further several decades passed until, by the end of the 20th century, recognizable successes were reported, for example, a resection rate of 30%, a hospital mortality rate of less than 5% in specialized centers, and a reported 5-year survival rate varying from 1% to 20%. Even after the last 100 years of slow evolution, surgeons have by no means conquered cancer of the pancreas, and the low 5-year survival rates, together with the recurrences and late metastases prompted Trede in the year 2002 to remark: "we have to conclude that surgery alone cannot cure pancreatic carcinoma".

History, 16th Century↗
PubMed2003

Studies of cytokine levels in bronchoalveolar fluid lavage from patients with interstitial lung diseases.

Cytokine levels in bronchoalveolar lavage fluid from patients with eosinophilic pneumonia (n = 7), allergic alveolitis (n = 11), (cryptogenic) fibrosing alveolitis (n = 8), sarcoidosis (n = 10) were determined, as well as levels in control samples from healthy non-smoking volunteers (n = 11). Fibronectin levels were increased in all the patient categories, the highest absolute levels of fibronectin (100-fold increase) being found in eosinophilic pneumonia and allergic alveolitis. TGF-beta (transforming growth factor-beta) was significantly elevated in allergic alveolitis only. There was a significant difference between allergic alveolitis on the one hand and both sarcoidosis and fibrosing alveolitis on the other. Tumour necrosis factor-alpha (TNF-alpha) was significantly increased in eosinophilic pneumonia and allergic alveolitis; allergic alveolitis and fibrosing alveolitis differed significantly in this respect. Platelet-derived growth factor-BB (PDGF-BB) levels were significantly elevated in allergic alveolitis and fibrosing alveolitis. It was found that the level of PDGF-BB was significantly decreased in the case of sarcoidosis, with no overlapping with allergic alveolitis or fibrosing alveolitis. Interferon-gamma (IFN-gamma) was decreased in all patient categories. A significant difference in extent of the decrease was found between allergic alveolitis and sarcoidosis. The interstitial lung diseases thus differed in the pattern of cytokines expressed, indicating that these cytokines could well be a part of the pathogenic process, and also that the measurement of cytokine levels could be diagnostically useful.

Adult↗
PubMed2002

[Kossard frontal fibrosing alopecia in a man].

In 1994 Steven Kossard described a new and peculiar type of hair loss that he named postmenopausal frontal fibrosing alopecia. In 6 elderly women he observed a symmetric regression of the frontal hair line. Often the eyebrows were also affected. Histology showed lichen planopilaris. There were no clinical signs of lichen planus on the rest of the body. Since the original description by Kossard, several cases of frontal fibrosing alopecia have been described--almost all of them in elderly women. We report a man with frontal fibrosing alopecia of the Kossard type.

Aged↗
PubMed2002

[Hypertrichosis and hirsutism].

Facial hypertrichosis and hirsutism may cause severe cosmetic and psychologic problems. There are several therapeutic options, both on the cosmetic and medical level. Hirsutism with androgen-excess should be diagnosed and treated by gynecologists. Although frequently used, systemic antiandrogens have not yet proven their efficacy against unwanted hypertrichosis in clinical studies using modern and objective endpoints. Conventional methods of hair removal include plucking, waxing and chemical depilation by thiogycolates, as well as electrolysis and thermolysis. A new medical treatment of hypertrichosis is eflornithine cream. It inhibits the enzyme ornithine-decarboxylase which is essential for the rapidly dividing cells of the hair follicle. Permanent depilation by photothermolysis with lasers and pulsed flash-light systems is currently the most promising treatment.

Clinical Trials as Topic↗
PubMed2002

[On the history of surgical treatments of peritonitis].

The surgical treatment of peritonitis started with the first laparotomy for an infected ovarian cyst by McDowell in the beginning of the 19(th) century. Thereafter the surgical approach developed parallel to the advances in abdominal surgery. In the last decade of the 19(th) century Mikulicz felt that laparotomy was indicated in all patients with purulent peritonitis. In the beginning of the 20(th) century Körte and Kirschner defined the principles of surgery for peritonitis that are valid up to this day: early surgical intervention, elimination of the source of infection, and peritoneal toilet. Since that time surgeons have discussed the utility of draining and irrigating the peritoneal cavity. Postoperative lavage was already advocated in the beginning of the last century, but generally regarded ineffective. Thirty years ago postoperative lavage was again strongly advocated, but evidence for its benefit is still missing. The history of the treatment of peritonitis examplifies that basic concepts which have been discovered in the past often remain valid and can serve as guidance for a long time. Such discoveries deserve recognition and should give reason for a critical appraisal of current practice. Thus, the statement of Trendelenburg made one hundred years ago remains true: "...in medicine, too, the today is based on the yesterday, and to follow a gradual development is of immense interest. In daily practice, especially in surgery and obstetrics, many things are much older than an ignorant can imagine."

Europe↗
PubMed2001

[Current treatment of hypertrichosis].

Facial hypertrichosis and hirsutism may cause severe cosmetic and psychologic problems. In the following, new developments in the treatment of hypertrichosis will be presented. Permanent depilation by photothermolysis is currently the most promising treatment. A new topical treatment of hypertrichosis is eflornithine cream. It inhibits the enzyme ornithine decarboxylase which is essential for the rapidly dividing cells of the hair follicle. Furthermore, other methods of hair removal such as plucking, waxing, chemical depilation by thioglycolates, electrolysis, thermolysis and systemic therapies of hirsutism will be discussed.

Eflornithine↗
PubMed2001

[Bleomycin prick in therapy-resistant verruca vulgaris].

Common warts can be highly resistant to conventional treatments such as cryotherapy, laser surgery, salicylic acid and mechanical removal. Intralesional bleomycin has been described as an effective treatment for common warts since 1970. We treated a 27-year-old woman with Sharp's syndrome who was on immunosuppressive drugs and had suffered for nine years from therapy-resistant warts on palms and soles. A bleomycin-prick technique using a bifurcated needle to introduce bleomycin sulfate (1 mg/ml sterile saline solution) into the warts resulted in almost complete remission after 16 treatment sessions.

Adult↗