Biomedical subjects

Pius Wyss

Publications and source records attributed to Pius Wyss.

6 recordsLinked to original sources

PubMed2006

Immunohistochemical differentiation and localization analysis of sweat glands in the adult human axilla.

BACKGROUND: The classic concept of axillary glands differentiates between eccrine glands, producing abundant clear, nonodorous sweat; and apocrine glands, excreting small amounts of turbid, odorous milky sweat. A third type of sweat glands, the "apoeccrine" glands, were recently identified. To define the different types of sweat glands and their location and number, the authors carried out a prospective histologic study on adult human axillary skin, including various immunohistochemical markers. METHODS: Forty-three consecutive Caucasian, subjectively normhidrotic patients, who underwent a surgical procedure in the axilla unrelated to the axillary glands, were included in the study. For verification of normhidrosis, the gravimetric test was carried out by measuring the amount of sweat secretion per minute. Then, a 1 x 1-cm measuring piece of skin and subcutaneous tissue was excised in the apex of the axilla, divided into three samples--altogether, 129 samples--and processed for histologic examination. RESULTS: In the dermis, the authors found only very few eccrine (average, 0.3 gland/cm in only 12 percent of all patients) and apocrine glands (average, 0.1 gland/cm in only 4.7 percent of patients), and no apoeccrine glands in any patient. In the subcutaneous tissue, the mean number of glands per centimeter squared was 10 for the eccrine glands, nine for the apocrine glands, and six for the apoeccrine glands. CONCLUSIONS: In the authors' Caucasian subjects, all or most of the sweat glands were found in the subcutaneous tissue near the border to the dermis and not in the dermis. For extremely hyperfunctioning sweat glands, the authors recommend less radical surgical methods, with the preservation of skin, based on the knowledge that most glands are localized in the subcutaneous tissue.

Adult↗

PubMed2005

Influence of the menstrual cycle on aminolevulinic acid induced protoporphyrin IX fluorescence in the endometrium: in vivo study.

BACKGROUND AND OBJECTIVES: In vitro studies indicated that compared to postmenopausal women, premenopausal women had increased aminolevulinic acid induced protoporphyrin IX (ALA-induced PpIX) fluorescence expression in the endometrium. The aim of this study was to evaluate menstrual cycle dependency of ALA-induced PpIX fluorescence in the endometrium in vivo. STUDY DESIGN/PATIENTS AND METHODS: Thirteen patients were included for in vivo spectrofluorometric measurements of ALA-induced PpIX in the endometrium and 51 patients for fluorescence hysteroscopy. Two milliliter of a 2% 5-ALA-solution at pH = 4.0 (ASAT AG/Zug, Switzerland) was topically administrated just before spectrofluorometry and 4 hours before hysteroscopy. Spectrofluorometry: Optical fiber based. Fluorescence hysteroscopy: STORZ-D-Light system (Storz, Tuttlingen, Germany). Histological classification of curettage and bioptic endometrial tissue stained with hematoxylin and eosin (H&E). RESULTS: Hysteroscopic and in vivo spectrofluorometric measurements showed an increase of ALA-induced PpIX fluorescence in the secretory and hyperplastic endometrium compared to proliferative and atrophic endometrium. CONCLUSIONS: The accuracy of fluorescence hysteroscopy and the success of the photodynamic endometrial ablation using ALA-induced PpIX may depend on the hormonal influence of the menstrual cycle. The mechanisms responsible for the increased ALA-induced PpIX fluorescence in the secretory versus proliferative phase of the menstrual cycle deserve further studies.

Adult↗

PubMed2004

Photodynamic endometrial ablation for the treatment of dysfunctional uterine bleeding: a preliminary report.

BACKGROUND AND OBJECTIVES: To evaluate feasibility and functional effects of photodynamic endometrial ablation (PEA) in patients. STUDY DESIGN/PATIENTS AND METHODS: A total of 15 PEAs has been performed in 11 patients using topically applied 5-aminolevulinic acid (ALA) solutions and a balloon-light diffuser (160 J/cm(2), 635 nm). Uterine bleeding intensity has been determined on a daily basis 3 months prior to and up to 6 months after endometrial ablation using an analogous scale scoring from 1 (spotting) to 6 U (severe bleeding). Statistical analysis by unpaired Student's t-test. RESULTS: The mean number of bleeding units per cycle (n = 44) was 35.7 prior to PEA. The decrease in bleeding units was significant for the months 1-3 (24.4 U per cycle; P = 0.03), but not for the months 4-6 (25.9 U; P = 0.11) following PEA. CONCLUSIONS: PEA is feasible and provides a significant short-term reduction of uterine bleeding.

Adult↗

PubMed2003

Photodynamic endometrial ablation: morphological study.

BACKGROUND AND OBJECTIVES: Endometriumablation provides an alternative treatment modality to hysterectomy for dysfunctional uterine bleeding (DUB). Its feasibility was demonstrated in animal studies. The purpose of this study was the evaluation of histological changes following photodynamic endometrial ablation in patients. STUDY DESIGN/MATERIALS AND METHODS: 5-Aminolevulinic acid (ALA) was topically applied in three premenopausal and one postmenopausal patient 4-6 hours before laser-illumination. ALA-concentration: 100-400 g/ml, NaOH-titration (pH 5.5). Volume applied, 1.5-2.0 ml; intrauterine balloon-lightdiffuser; wavelength, 635 nm; lightdose, 160 J/cm(2). Hysterectomy was performed 3-152 days after photodynamic ablation. Histological examination was carried out on endometrium sections stained with hematoxylin and eosin (H&E). RESULTS: Necrosis including the full thickness of the endometrium was found 3 days after photodynamic endometrial ablation. Specimens collected after 35 and 152 days did not exhibit fibrosis or adhesions. Foci of preserved endometrium were detected in all patients. CONCLUSIONS: Photodynamic endometrial ablation is selective and does not cause endometrial fibrosis or adhesions.

Adult↗

PubMed2003

Fluorescence hysteroscopy using 5-aminolevulinic: a descriptive study.

BACKGROUND AND OBJECTIVES: To assess the feasibility of fluorescence hysteroscopy following topical ALA application and to describe the optical appearance of normal and neoplastic endometrium. STUDY DESIGN/MATERIALS AND METHODS: Fifty-four patients scheduled for routine hysteroscopy and D&C were assigned to the study group using topically applied ALA. Two milliliters of a 2% 5-ALA-solution at pH = 4.0 (ASAT AG/Zug, Switzerland) was administrated into the uterine cavity 4 hours before fluorescence hysteroscopy, using a STORZ-D-Light (Tuttlingen, Germany) system. Hysteroscopic findings were compared to the histological diagnosis of hematoxylin & eosin (H&E) stained sections. In the study group, 60 histological specimens were taken (47 materials of curettage and 13 targeted biopsies). The percentage of fluorescence positive patients was calculated. RESULTS: The rate of fluorescent endometrial samples was low in atrophic endometrium 1/16 (6.2%). Endometrial carcinoma were diagnosed in two patients. Both cases exhibited selective and intense PpIX-mediated red fluorescence. Fluorescence hysteroscopy could not differentiate between hyperplastic areas with or without atypia. Minimal uterine cramps or discomfort following ALA instillation were complained by 30 (56%) patients, no pain was indicated by 24 patients (44%). CONCLUSIONS: Fluorescence hysteroscopy following intrauterine application of ALA is feasible. Cancerous, hyperplastic, and secretory endometrial tissue showed high red fluorescence.

Administration, Topical↗

PubMed2002

Photodynamic therapy of vulvar and vaginal condyloma and intraepithelial neoplasia using topically applied 5-aminolevulinic acid.

BACKGROUND AND OBJECTIVES: To determine the feasibility of photodynamic therapy (PDT) of vulvar and vaginal condyloma and intraepithelial neoplasia (VIN, VAIN) and to compare PDT results with conventional treatments. STUDY DESIGN/MATERIALS AND METHODS: Thirty-eight patients with vulvar or vaginal intraepithelial neoplasia (VIN) grade II/III (n = 22) or condyloma (n = 16) had 10% 5-aminolevulinic acid (ALA)-gel applied topically. After 2-4 hours, 80-125 J/cm(2) laser light at a wavelength of 635 nm was applied. PDT was compared to conventional treatments for condyloma (CO(2) laser evaporation) and for VIN III (laser evaporation, surgical excision). RESULTS: The complete clearance rate for condyloma treated by PDT was 66% and the rate for IN was 57% (as determined by biopsy). Of the neoplasia patients, none with hyperkeratotic VIN (n = 4) responded, and only one of four with increased pigmentation cleared. No scarring occurred, and postoperative discomfort lasted 4.9 +/- 3.4 days. Reduced disease-free survival (DFS) was associated with multifocal VIN (P = 0.02, OR 2.17, 95% CI 1.15-4.08), but DFS did not vary with treatment mode. CONCLUSIONS: Although PDT is not equally efficacious for all subgroups, PDT for condyloma and intraepithelial neoplasia appears to be as effective as conventional treatments, but with shorter healing time and excellent cosmetic results.

Administration, Topical↗