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Biomedical subjects

H Wolff

Publications and source records attributed to H Wolff.

At least 19 recordsLinked to original sources
PubMed1992

High levels of IL-2 alter signal transduction in cloned IL-4-producing CD4 T cells.

Cloned CD4 T cells of the Th2 type make IL-4 and related cytokines upon receptor cross-linking, whereas cloned CD4 T cells of the Th1 type make IL-2, IFN-gamma, and TNF-beta. These two types of CD4 T cell are also reported to use distinct mechanisms of signal transduction. It has been reported that Th1 cells flux Ca2+ upon receptor cross-linking, whereas Th2 cells do not. We have noted that when cloned Th2 cells are exposed to high levels (20 U/ml) of IL-2, they show an altered phenotype. Such cells are much more sensitive to activation by certain antireceptor antibodies, they flux calcium upon receptor ligation without additional cross-linking with anti-Ig antibodies, and they make much larger amounts of IL-4. In addition, the organization of their TCR is altered, with increased levels of the TCR-eta chain and an increase in the extent of association of CD4 with CD3 and CD45, changes similar to those found in Th1 cells. These results suggest that there is no fundamental difference in the signal transduction apparatus of Th1 and Th2 cells; rather, the IL-2 made by Th1 cells may create similar phenotypic changes in these cells and thus create the impression of altered signal transduction mechanisms. These results do show that exposure to high levels of IL-2 can profoundly affect signal transduction in T cells. Furthermore, we found that the Ca2+ signal caused by CD3 antibodies seemed to differ in character from that caused by TCR antibodies suggesting that the use of CD3 antibodies is not always a good model for activation through the TCR.

Biological Assay↗
PubMed1992

Comparison of three methods to detect white blood cells in semen: leukocyte esterase dipstick test, granulocyte elastase enzymeimmunoassay, and peroxidase cytochemistry.

Comparison of three methods for the detection of WBC in semen revealed a low concordance of positive test results. Among 557 semen samples, most positives were observed with the leukocyte esterase dipstick test (n = 95; 17.1%) followed by the peroxidase test (n = 51; 9.2%). There was little overlap between positives in the esterase-dipstick and the peroxidase method (29/117; 24.8%). With only 4 of 557 samples (0.7%), the PMN-elastase ELISA showed a surprisingly low incidence of positives. Because of lack of a gold standard, none of the three methods could be identified as superior. Because of its simplicity, specificity, and cost-effectiveness, the peroxidase method appeared most suited for clinical application.

Carboxylic Ester Hydrolases↗
PubMed1992

[Experiences with surgical therapy of Budd-Chiari syndrome].

The obstruction of the hepatic venous outflow tract with or without involvement of the inferior vena cava results in the Budd-Chiari syndrome (BCS). With its very heterogenous etiology and variable epidemiology the rare disease either takes a chronic or an acute foudroyant clinical course. In general the prognosis is poor. Together with the clinical signs the diagnosis is based on radiological measures and the histology of the hepatic parenchyma. The exact etiological investigation of the BCS is of great significance. Typical findings are discussed and a diagnostic scheme is developed. Between 1979 and 1991, altogether 16 operations were carried out in 13 patients with a BCS. Predominantly there were undertaken a porto-systemic shunt procedure or an orthotopic liver transplantation, respectively, in 6 cases each. The need for an always individually tailored therapeutic strategy of the BCS is underlined by a case history. An overview analyzes the different therapeutic modalities of the BCS and their differential indications.

Adolescent↗
PubMed1992

A comparison of HIV-1 antibody classes, titers, and specificities in paired semen and blood samples from HIV-1 seropositive men.

Twenty-eight paired blood and semen samples obtained from human immunodeficiency virus type 1 (HIV-1) seropositive men at various stages of disease progression were evaluated for titer and immunoglobulin (Ig) class by an enzyme-linked immunosorbent assay (ELISA). Blood antibody titers ranged from 40,000 to 4,000,000 with a median of 40,000. Semen titers ranged from 400 to 40,000 with a median of 400. HIV-1 antibody titers in matched semen and blood samples showed a strong positive correlation (r = 0.963). The ratio of semen:blood titers ranged from 1:1000 to 1:10 with a median of 1:100. There was no correlation between blood or semen antibody titer and stage of disease of the patients. However, there was a trend toward higher (greater than or equal to 4000) semen antibody titers in men with evidence of genital tract inflammation greater than 10(6) white blood cells/ml semen; 3/5 versus 5/23, p greater than 0.1 Fisher exact test). All HIV-1 antibodies detected were of the IgG class; no IgA or IgM class antibodies of titers greater than or equal to 40 were found in either blood or semen. Thirteen paired blood and semen samples from individual patients were analyzed for antibody specificity by Western blot. In some cases antibody profiles in semen were different from those in blood; strong antibody reactivity against the gp160 viral coat antigen band was consistently detected in semen and blood, whereas the prevalence of detectable antibody reactivity against the p55 and p17 HIV-1 antigen bands was significantly reduced in semen.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibody Specificity↗
PubMed1991

[Pancreas transplantation with exocrine bypass to the gallbladder as receiver. Experimental results and the first clinical case].

A new procedure for intraperitoneal pancreas transplantation, donor-pancreatoduodenectomy/receiver-cholecystectomy, is described. The pancreas, with a segment of the duodenum, is placed dorsally in the peritoneal cavity. The portal vein is anastomosed to the sub-hepatic caval vein and the long aortic segment of the graft is anastomosed with the receiver's aorta. Pancreas exocrine excretion is deviated to the receiver's gallbladder via a duodenobladder bypass.

Anastomosis, Surgical↗
PubMed1991

Chlamydia trachomatis induces an inflammatory response in the male genital tract and is associated with altered semen quality.

U. urealyticum with 15.8% and C. trachomatis antibodies with 15.4% were the most prevalent microbiological findings in 209 male infertility patients. The inflammatory marker granulocyte-elastase was significantly increased in men with C. trachomatis; these men also showed significantly decreased citric acid levels indicating inflammatory damage of the prostate induced by C. trachomatis.

Antibodies, Bacterial↗
PubMed1991

[The accuracy of the imaging procedures (sonography, MRT, CT, angio-CT,nuclear medicine) in characterizing liver tumors].

In a prospective study, an attempt was made to determine the specificity of various imaging methods for defining tumours of the liver rather than their ability to demonstrate them. It was based on 130 patients with histologically confirmed lesions (33 haemangiomas, 17 FNH, 4 hepatocellular adenomas, 28 HCC, 36 adenocarcinoma metastases). The methods were MRT (130 cases), sonography (119), CT (122), dynamic arterial angio-CT (15), 99TC-EHIDA or blood pool scintigraphy (4 FNH, haemangiomas, HCC, 44 cases). MRT showed somewhat better results (accuracy 80%) than CT (73%) and angio-CT (73%) in demonstrating the type of lesion. The results of scintigraphy (53%) and sonography (69%) were rather worse. The range of accuracy for MRT, CT and sonography varied from 94% (haemangiomas with MRT) to 47% (FNH with sonography).

Biopsy↗
PubMed1991

[Diagnosis and surgical therapy in congenital ectasias of the intra- and extrahepatic bile ducts].

31 patients with congenital ectasias of extra- and intrahepatic bile ducts have been diagnosed and treated between 1980 and 1991 at the Charité. 7 ectasias belonged to type I, two to type II, three to type III, four to type IV and fifteen to type V of classification by Alonso-Lej/Todani. The age of affection was between 8 and 80 years. Symptoms are not specified and directed to affection of liver or bile ducts. Main symptoms of type I--III were complaints in the upper abdomen and jaundice, of type IV--especially after previous surgery--fever and also jaundice. Complaints in the upper abdomen and fever dominated in type V. The right diagnosis succeeds at 27 out of 31 patients with direct cholangiography. Sonography and computerized tomography were not always in a position to attach the clinical picture to congenital ectasias. In extrahepatic ectasias is the resection of bile duct cysts--carried out in 2/3 of all cases--the therapy of choice. Once was found a carcinoma in a resected bile duct cyst 23 years after a choledochocysto-jejunostomy. By Caroli syndrome the therapy must be fixed individually. 6 patients were supplied operative (liver resection, choledochotomy, papillotomy, extraction of lithiasis). Instrumentally were carried out 9 endoscopic papillotomies with extraction of concrements and 6 lay ins of internal drainage catheters were done.

Adolescent↗
PubMed1991

[Anomaly of the pancreatico-biliary junction and etiology of choledochal cysts].

The etiology of choledochal cysts isn't yet clarified unequivocably. Numerous theories have been worked out. One of them is the 1969 by Babbitt postulated "common-channel"-theory, which is based on an anomaly of the pancreaticobiliary connection. In case of a fusion of ductus choledochus and ductus pancreaticus widely before the papilla of Vater and the formation of a common channel with a minimum length of 15 mm the reflux of pancreatic secretion into the off-leading biliary ducts may occur and choledochal cysts may develop. In order to check up this hypothesis we evaluated retrospectively pictures of a direct cholangiography (ERCP, PTC and/or intraoperative cholangiography) of 26 patients suffering from type I, IV and V ectasias of the biliary ducts according to Todani. We found a common channel with an abnormal length in 8 of 12 patients suffering from extrahepatic ectasias of the biliary duct type I and IV (66%), but we didn't find it in patients with type V intrahepatic ectasias of the biliary duct. This analysis may be recognized as a reference to the truth of the Babbitt-theory.

Cholangiography↗
PubMed1991

[Laparoscopic cholecystectomy. An alternative procedure in the treatment of symptomatic cholecystolithiasis].

The authors report about their first experiences concerning the treatment of gallbladder stones using a laparoscopic approach. 40 patients (33 female, 7 male) were treated with this new method. The age of the patients, who had undergone this procedure, varied from 24 to 76 years, the average age was 42 years. Our current indication is the symptomatical chronic gallbladder lithiasis. The average time of operation was 60 to 90 minutes. The mortality rate was zero. Slight operative bleeding from an accessory artery and vein occurred in two cases. This was controlled by electrocoagulation. We observed no complications in the postoperative phase. The patients were dismissed from the hospital on the 3. to 5. day. This method is very favourable with regard to the operative strain on the patients.

Adult↗
PubMed1991

[Experiences and results in 200 laparoscopic cholecystectomies].

Laparoscopic guided cholecystectomy was attempted in 200 patients from September 1990 until May 1991. Wound infection rate was 6% in first 100 operations. In the second group of 100 operations the wound infection rate was 1%. Antibiotic prophylaxis was used in this group. Mortality was 0%. Complications were 7 wound infections, 1 urinary tract infection and 1 bile fistula treated by drainage. Five patients required conversion to a standard laparotomy, due to 3 cases of bleeding of a. cystica, 1 biliodigestive fistula and 1 extensive meteorism. Laparoscopic cholecystectomy is now a routine operation.

Adolescent↗
PubMed1991

[Cardiopulmonary risk factors in patients with sleep apnea].

Since the interaction between disorders of the respiratory coordination and cardiovascular or cardiopulmonary regulation is still largely unknown the intention of the present investigation is to point out the coincidence of cardiac arrhythmias, such as premature ventricular capture (PVC) beats and conduction blocks, with obstructive sleep apnea (OSA). For the first time a group of more than 300 patients with suspected OSA is examined concerning risk factors and frequent diagnoses as obesity, hypertension, coronary heart disease (CHD), heart insufficiency, chronic obstructive pulmonary disease (COPD), and daytime hypoxaemia. Summarizing the results of lung function test, blood gas analysis, strain-ECG, Holter-ECG and inductive plethysmography with oxygen partial pressure measurement by ambulatory work-up the following statements can be made: PVC beats occurring markedly during sleep give hints for OSA being the underlying cause, especially if the patients are young and overweight. Hypoxaemia increasing during the apnea episodes should be considered as one possible pathogenetic mechanism. Second- and third degree conduction blocks and sinus arrest coincident very often with OSA. They suggest to be life-limiting factors the more so since they often go along with CHD or heart insufficiency. Systemic arterial hypertension and overweight have the highest prevalence in OSA, signs for heart insufficiency and daytime hypoxaemia are also significantly more frequent than in non-OSA patients. We could find no hints for direct pathogenetic coherence between CHD and OSA or between COPD and OSA, nevertheless pronounced nocturnal changes in blood gases and intrathoracic hemodynamics have important influence on the cardiopulmonary and cardiovascular system, as partly illuminated in other more pathogenetic oriented studies by the present time.

Arrhythmias, Cardiac↗
PubMed1991

[Post-traumatic hemobilia in childhood].

We observed three patients with a hemobilia after surgically or conservatively treated liver lacerations. The diagnosis was suspected on clinical grounds and verified by ultrasonography, computed tomography or angiography or a combination thereof. Depending on the findings therapy was planned reaching from conservative treatment to liver resection. Because this complication is rare it should be cared for in a specialized institution.

Child↗