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Kahl G, Hafner J. A blip-function calculation of the structure of liquid binary alloys. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/15/8/003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Igloi F, Kahl G, Hafner J. The freezing of simple liquid metals: density functional approach to the structural stability of the crystalline phase. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0022-3719/20/12/008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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106
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Hausleitner C, Hafner J. Soft-sphere reference system in thermodynamic variational calculations. II. Liquid transition metals. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/18/6/008] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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107
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108
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Hausleitner C, Hafner J. Soft-sphere reference system in thermodynamic variational calculations. I. Liquid simple metals. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/18/6/007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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109
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Hafner J, Jaswal SS. Interplay between atomic and electronic structure in metallic glasses: a first principles investigation. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/18/1/001] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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110
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Hafner J. Inherent structure theory of local order in liquid and amorphous alloys. I. The nearly-free-electron case. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/18/2/002] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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111
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Hafner J, Jaswal SS, Tegze M, Pflugi A, Krieg J, Oelhafen P, Guntherodt HJ. The atomic and electronic structure of metallic glasses: search for a structure-induced minimum in the density of states. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/18/12/010] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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112
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Hafner J, Jank W. Simple model for the structure and thermodynamics of liquid alloys with strong chemical interactions. III: phase separation. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0305-4608/18/3/006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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113
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Querings K, Fuchs D, Küng EE, Hafner J. [CO2-laser therapy of stigmatizing cutaneous lesions in tuberous sclerosis (Bourneville-Pringle) and in neurofibromatosis 1 (von Recklinghausen)]. SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT 2000; 130:1738-43. [PMID: 11109606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Tuberous sclerosis (Bourneville-Pringle) and type I neurofibromatosis (von Recklinghausen) are familial multiple tumour syndromes. Both entities have in common that the cutaneous manifestations can stigmatize the carriers and considerably reduce the quality of life. CO2-laser surgery (vaporisation) consistently yields good to excellent aesthetic results in the treatment of adenoma sebaceum in tuberous sclerosis. Patients with type I neurofibromatosis who carry several hundreds neurofibromas usually benefit from a numerical reduction in their skin lesions, despite the less predictable aesthetic result, ranging from excellent to fair. The present study reports on the treatment outcome of CO2-laser surgery in 8 patients with adenoma sebaceum and 8 with neurofibromatosis.
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Bae C, Freeman DL, Doll JD, Kresse G, Hafner J. Energetics of hydrogen chemisorbed on Cu(110): A first principles calculations study. J Chem Phys 2000. [DOI: 10.1063/1.1311293] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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116
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Przylipiak A, Hafner J, Przylipiak J, Köhn FM, Runnebaum B, Rabe T. Influence of 5-lipoxygenase on in vitro growth of human mammary carcinoma cell line MCF-7. Gynecol Obstet Invest 2000; 46:61-4. [PMID: 9692346 DOI: 10.1159/000010000] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to investigate the direct effect of 5-lipoxygenase (5-LO) on the growth of human mammary cancer cells MCF-7 in vitro. Cell growth was measured according to the level of 3H-thymidine incorporation. 5-LO was shown to inhibit 3H-thymidine incorporation. The inhibitory effect was 19, 42 and 78% when administered at concentrations of 0.1, 0.2 or 0.5 U/ml, respectively. Its effect was time- and dose-dependent and was statistically significant at concentrations of 0.2 and 0.5 U/ml. We have also shown that the specific 5-LO inhibitor MK-886 (1 microM) lifts the inhibitory effect of 5-LO (0.2 U/ml). Moreover, when treated with an activator of 5-lipoxygenase calcium ionophore A23187 (10 microM) MCF-7 cells synthesize LTB4. The results of this study are evidence of the role of 5-lipoxygenase in the regulation of human mammary cancer cells growth in vitro.
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Hafner J, Kunzi W, Weinreich T. Malignant fibrous histiocytoma and atypical fibroxanthoma in renal transplant recipients. Dermatology 2000; 198:29-32. [PMID: 10026398 DOI: 10.1159/000018060] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Allograft recipients are at increased risk for skin cancer. The incidence of cutaneous squamous cell carcinoma is 50-250 times higher than in the age-matched control population, and basal cell carcinoma is about 10 times more frequent. The incidence of Kaposi's sarcoma is increased 400 to 500 times over that in a control population of the same ethnic origin. However, the incidence of other types of cutaneous sarcoma in organ allograft recipients is largely unknown. CLINICAL OBSERVATION Within a 2-year-period, we observed 2 patients with cutaneous malignant fibrous histiocytoma and 1 patient with atypical fibroxanthoma among a cohort of 642 renal transplant recipients. For comparison, the incidence for dermatofibrosarcoma protuberans which is the commonest type of cutaneous sarcoma, is 0.45/100,000 persons/year in the non-immunocompromised population. Our observation represents an incidence of 156/100,000/ year (95% confidence interval Cl 28-489/100,000/year) for cutaneous malignant fibrous histiocytoma and of 78/100,000/year (95% CI 4-368/ 100,000/year) for atypical fibroxanthoma. CONCLUSION To our knowledge, this is the first report on an elevated incidence of cutaneous malignant fibrous histiocytoma and of atypical fibroxanthoma in renal transplant recipients. Future cohort studies on malignancies in organ allograft recipients should aim at defining this risk more exactly.
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Hafner J, Schütz K, Morgenthaler W, Steiger E, Meyer V, Burg G. Micrographic surgery ('slow Mohs') in cutaneous sarcomas. Dermatology 2000; 198:37-43. [PMID: 10026400 DOI: 10.1159/000018062] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Micrographic surgery (MS) results in very low local recurrence rates in all sorts of skin tumours that grow by extensive subclinical infiltration. Therefore, MS should prove useful in the treatment of cutaneous sarcomas. OBJECTIVE To treat cutaneous sarcoma with MS in order to minimize local recurrence rates. METHODS We treated 5 cases of dermatofibrosarcoma protuberans and 5 cases of cutaneous sarcomas of different origin (atypical fibroxanthoma, malignant fibrous histiocytoma, malignant peripheral nerve tumour) with micrographic surgery using paraffin-embedded sections. In primary cutaneous sarcomas, tumour extensions were readily detected in HE sections. In recurrent tumours, special stains were needed to distinguish tumour extensions from scar tissue. RESULTS All patients were treated successfully and have remained free of local recurrences as of yet. Solitary pulmonary metastasis occurred in 1 patient with high-grade malignant peripheral nerve tumour. CONCLUSION MS is an excellent procedure to minimize local recurrence in cutaneous sarcomas. Cutaneous sarcomas with low metastatic potential can be cured with MS.
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Hafner J, Schneider E, Burg G, Cassina PC. Management of leg ulcers in patients with rheumatoid arthritis or systemic sclerosis: the importance of concomitant arterial and venous disease. J Vasc Surg 2000; 32:322-9. [PMID: 10917993 DOI: 10.1067/mva.2000.106942] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We assessed the etiology and the prevalence of peripheral arterial and venous disease in leg ulcers in patients with rheumatoid arthritis and systemic sclerosis and analyzed the outcome after treatment of macrovascular disease. METHODS A clinical study on 15 consecutive patients with chronic leg ulcers in collagen vascular disease (nine patients with rheumatoid arthritis, six patients with systemic sclerosis) was carried out in a referral center. Angiography was used when the ankle-arm index was less than 0.8; venography was used when venous reflux was detectable by means of a hand-held Doppler examination. Therapies included percutaneous transluminal angioplasty (seven patients), femoropopliteal bypass grafting surgery (one patient), saphenectomy of the greater saphenous vein (six patients), and split skin graft (11 patients). RESULTS All patients with rheumatoid arthritis exhibited a multifactorial etiology of their ulcers: four of nine patients had peripheral arterial disease, and five of nine patients had venous insufficiency. In one of these patients, arterial and venous disease was combined. Five of six patients with systemic sclerosis exhibited a multifactorial etiology of their ulcers: three of six patients had peripheral arterial disease, and three of six patients had venous insufficiency. One of these patients had both arterial and venous disease. In patients with rheumatoid arthritis, healing was achieved in six of nine patients, and marked improvement occurred in two of nine patients. A below-knee amputation was necessary in one patient with rheumatoid vasculitis. In patients with systemic sclerosis, healing was achieved in three of six patients, and marked improvement occurred in the other three patients. CONCLUSION Most leg ulcers in patients with rheumatoid arthritis and systemic sclerosis disclose a multifactorial etiology. Relevant arterial and venous disease can be found in approximately half the patients. Our study suggests that revascularization and vein surgery improve the healing of leg ulcers in patients with collagen vascular disease. A prospective trial is now required to confirm these results.
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Hafner J, Botonakis I, Burg G. A comparison of multilayer bandage systems during rest, exercise, and over 2 days of wear time. ARCHIVES OF DERMATOLOGY 2000; 136:857-63. [PMID: 10890987 DOI: 10.1001/archderm.136.7.857] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To study the interface pressure between the leg and 8 different multilayer bandage systems during postural changes, exercise (walking), and over 2 days of wear time. DESIGN Comparison of 8 different compression bandages under standardized conditions. SETTING Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland. PARTICIPANTS A series of 10 healthy volunteers, 5 females and 5 males, aged 26 to 65 years. INTERVENTION An electropneumatic device was used to measure interface pressure at 12 points of the leg. MAIN OUTCOME MEASURES (1) Pressure changes from the standing to the sitting and supine position at rest, (2) pressure amplitude during exercise (200-m treadmill walk at 3.2 m/s, 0 degrees incline), and (3) pressure decrease over 2 days of wear time. RESULTS Results are given as median with the 10% to 90% confidence intervals. Multilayer bandages of short and medium stretch showed a larger pressure decrease when the patient was supine (eg, 3 short stretch bandages: 18.0 mm Hg [reference range, 15.5-19.5 mm Hg]) than systems of medium and long stretch bandages (eg, 4-layer bandage, 6.0 mm Hg [reference range, 4.5-7.0 mm Hg]) (P=.005). The amplitude of pressure waves during exercise was comparable among most multilayer bandage systems. The pressure loss over time was the smallest in elastic bandages (eg, 4-layer bandage, 6.0 mm Hg [reference range, 0.0-10.5 mm Hg]), compared with short stretch bandages (eg, 3 short stretch bandages, 18.0 mm Hg [reference range, 16.5-20.5 mm Hg]) (P=.005). CONCLUSIONS Highly elastic multilayer bandage systems showed the smallest pressure loss over several days, but the small pressure decrease when the patient was supine makes them potentially hazardous to patients with arterial occlusive disease. Short stretch bandages and the Unna boot with an inelastic zinc plaster bandage generate large pressure waves while walking and showed a marked pressure decrease when the patient was supine, but they lose a lot of their pressure within the first hours of wear. Multilayer systems composed of short stretch and cohesive medium stretch bandages represent a good compromise between elastic and inelastic bandage systems (moderate pressure loss over time, large pressure decrease on lying down). The clinical effectiveness of the different types of compression still remains to be studied.
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Hafner J, Lüthi W, Hänssle H, Kammerlander G, Burg G. Instruction of compression therapy by means of interface pressure measurement. Dermatol Surg 2000; 26:481-6; discussion 487. [PMID: 10816239 DOI: 10.1046/j.1524-4725.2000.99257.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Compression therapy of the leg is the cornerstone in the conservative treatment of venous ulcers. The application of compression bandages, however, is largely a matter of personal experience. OBJECTIVE To evaluate the interface pressure under compression bandages and to improve the technique. METHODS Six courses on wound healing with 24-28 participants as well as individual training at our hospital were provided. Interface pressure at the distal medial calf was measured using a simple, but accurate pressure sensor that was built for this purpose (accuracy: +/-3 mm Hg). RESULTS During the wound healing courses, the absolute difference from the target pressure of 35-45 mmHg improved from 8.4 mm Hg (95% CI 0.0-34.1) to 3.5 mm Hg (95% CI 0.0-14.0) (P = .0001). After four sessions, interface pressures greater than 60 mmHg were avoided. During individual training, even nurses with everyday experience in compression therapy improved their accuracy. CONCLUSION There is a need for objective measurement of interface pressure in the teaching of compression therapy with bandages. The principles can be taught during a few exercises. However, repeated practice over a longer period of time is necessary to reach a certain accuracy.
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Demuth T, Hafner J, Benco L, Toulhoat H. Structural and Acidic Properties of Mordenite. An ab Initio Density-Functional Study. J Phys Chem B 2000. [DOI: 10.1021/jp993843p] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bader U, Banyai M, Böni R, Burg G, Hafner J. Leg ulcers in patients with myeloproliferative disorders: disease- or treatment-related? Dermatology 2000; 200:45-8. [PMID: 10681614 DOI: 10.1159/000018315] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Leg ulcers are a relatively frequent problem in patients with myeloproliferative disorders under treatment with hydroxyurea (HU). The pathogenesis is currently unknown and may be multifactorial. Concomitant arterial or venous disease may play a contributing role in the development of these wounds. Vasculitis, cryoglobulinemia and pyoderma gangrenosum should be considered if typical clinical signs are present. We report on 3 patients with myeloproliferative disorders who developed HU-induced leg ulcers and review the literature. HU-induced leg ulcers share clinical features which can help to differentiate them from leg ulcers of other etiologies: occurrence under long-term treatment with HU at a dose of at least 1 g/day, localization in the malleolar region and spontaneous healing when HU is discontinued. We conclude that differentiation between disease-related and treatment-induced leg ulcers can be difficult and may not always be possible. In HU-induced leg ulcers, cessation of the drug typically leads to wound healing.
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Tóth P, Sipos J, Hafner J. [Castleman's disease]. Orv Hetil 2000; 141:729-32. [PMID: 10803015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Castleman's disease is an example of the so-called atypical lymphoproliferative disorders. The optimal therapy of this morphologically and clinically heterogeneous disease is largely unknown. The authors report three cases of multicentric Castleman's disease (two hyalin vascular and one mixed variant). They analyze the pathogenesis, clinicopathologic features and management of this rare entity and review the literature.
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Ciobîcǎ IM, Frechard F, van Santen RA, Kleyn AW, Hafner J. A DFT Study of Transition States for C−H Activation on the Ru(0001) Surface. J Phys Chem B 2000. [DOI: 10.1021/jp993314l] [Citation(s) in RCA: 139] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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126
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Fritz TM, Burg G, Hafner J. Eyebrow reconstruction with free skin and hair-bearing composite graft. J Am Acad Dermatol 1999; 41:1008-10. [PMID: 10570389 DOI: 10.1016/s0190-9622(99)70262-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We describe a surgical reconstruction after micrographic surgery of a recurrent basal cell carcinoma of the middle third of the left eyebrow. After micrographic surgery there was a 46- x 26-mm defect in the middle part of the eyebrow. To perform a cosmetically satisfactory repair a combined nude and hair-bearing full-thickness skin graft was harvested from the contralateral postauricular temporoparietal region and placed in the defect with hair growth direction of the graft and the recipient bed in the same direction. By using a combined nude and hair-bearing full-thickness skin graft, larger eyebrow defects can be repaired with an optimal functional and aesthetic result.
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Hafner J, Ramelet AA, Schmeller W, Brunner UV. Management of leg ulcers. CURRENT PROBLEMS IN DERMATOLOGY 1999; 27:4-7. [PMID: 10547721 DOI: 10.1159/000060630] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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128
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Hafner J. Management of arterial leg ulcers and of combined (mixed) venous-arterial leg ulcers. CURRENT PROBLEMS IN DERMATOLOGY 1999; 27:211-9. [PMID: 10547749 DOI: 10.1159/000060626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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129
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Schneider EL, Hafner J. Percutaneous transluminal angioplasty in the management of arterial leg ulcers. CURRENT PROBLEMS IN DERMATOLOGY 1999; 27:220-5. [PMID: 10547750 DOI: 10.1159/000060627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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130
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131
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Hafner J, Trüeb RM. Management of leg ulcers in rheumatoid arthritis and in systemic sclerosis. CURRENT PROBLEMS IN DERMATOLOGY 1999; 27:271-6. [PMID: 10547756 DOI: 10.1159/000060621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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132
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Hafner J, Trüeb RM. Management of vasculitic leg ulcers and pyoderma gangrenosum. CURRENT PROBLEMS IN DERMATOLOGY 1999; 27:277-85. [PMID: 10547757 DOI: 10.1159/000060622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Frechard F, van Santen RA, Siokou A, Niemantsverdriet JW, Hafner J. Adsorption of ammonia on the rhodium (111), (100), and stepped (100) surfaces: An ab initio and experimental study. J Chem Phys 1999. [DOI: 10.1063/1.480146] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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134
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Böni R, Hafner J, Krasovec M. [Acne and its treatment possibilities]. SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT 1999; 129:1496-503. [PMID: 10555254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Acne is a multifactorial disease affecting the pilosebaceous follicles. It is a treatable condition for which the aims of therapy are to reduce social isolation and to prevent or minimise scarring. Propionibacterium acnes is an anaerobic bacterium strongly implicated in the pathogenesis of acne. A gradual increase in the resistance of P. acnes to many antibiotics has been documented in the last decade, and there is thus a growing need to use either appropriate antibiotics or even change the therapeutic strategy in favour of other regimens, i.e. isotretinoin, antiandrogens. A treatment guide is presented and the side-effects of these regimens are discussed.
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136
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Ciobı̂că I, Frechard F, van Santen R, Kleyn A, Hafner J. A theoretical study of CHx chemisorption on the Ru(0001) surface. Chem Phys Lett 1999. [DOI: 10.1016/s0009-2614(99)00830-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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137
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Hafner J, Burg G. [Dermatological aspects in prevention and treatment of the diabetic foot syndrome]. PRAXIS 1999; 88:1170-1177. [PMID: 10444994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Diabetic neuropathy, osteoarthropathy, macro- and microangiopathy and susceptibility to infection are the major factors that contribute to the diabetic foot syndrome. Therefore, these patients benefit from a multidisciplinary treatment by the general practitioner, diabetologist, orthopaedic surgeon and shoemaker, angiologist and vascular surgeon. The role of the dermatologist is to recognize early diabetic foot lesions when the diabetic patient comes for a skin problem on his feet and more specifically to manage dermatologic aspects in diabetic foot patients. These should include recommendations for general skin care, examination and treatment for onychomycosis, patch testing in contact eczema or treatment of other dermatoses, such as plantar psoriasis. Therefore, dermatology has an important impact on the prevention of complications of the diabetic foot syndrome by keeping the skin intact and avoiding potential lesions of entry for bacterial soft tissue infection. The dermatologist must educate the diabetic patient to control his feet daily, to avoid foot-baths with hot water, to use hypoallergenic moisturizers for skin care. "Bathroom surgery" with sharp instruments for nail care or trimming of corns should be discouraged. Diabetics should wear wide, well-fitting shoes without sutures on the inner side. The inside of the shoes should always be checked for foreign bodies or irregular surfaces before they are put on. Diabetics should not walk barefoot. Callosities (calluses, corns) should be shown to the podologist or to the doctor. They are always a sign of increased mechanical stress and therefore, require an adjustment of footwear. Trimming of callosities can only aim at giving symptomatic relief and does not replace an appropriate correction of the mechanical stress. Semi-occlusive synthetic dressings have facilitated the treatment of non-infected chronic wounds. When probing of the bone is positive, however, osteomyelitis has to be assumed and empirical antibiotic therapy started. With the development of catheter-based interventional procedures and of cruro-pedal arterial bypasses the potiential of revascularization in diabetic foot with peripheral arterial occlusive disease has greatly improved. Retrograde intravenous antibiotic therapy under Bier's arterial arrest and the use of G-CSF improve the chance of healing bacterial soft tissue infection in a diabetic foot. In summary, optimization of prevention and treatment of the diabetic foot syndrome should allow for substantial reduction of amputations.
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138
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Bader U, Hafner J, Burg G. [Erythroderma and alcohol abuse]. SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT 1999; 129:508-13. [PMID: 10322564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We report on 7 patients with chronic alcohol abuse and ichthyosiform erythroderma. Dry skin (i.e. xerosis cutis) was a striking common feature in all patients who did not present any signs of fluid depletion. Two patients had exclusively exsiccational dermatitis; three had atopic disposition and one nummular eczema of the legs. In another patient a drug allergy could be demonstrated. Xerosis cutis seems to be an important precipitating aetiologic factor for erythroderma, and may be a consequence of alcohol-induced diuresis. All patients recovered rapidly under topical treatment with emollients and low potency steroids. We propose that ichthyosiform erythroderma be added to the known skin diseases caused by chronic alcohol abuse.
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139
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Hafner J, Künzi W. Full-thickness skin graft for combined skin and partial cartilage defect of the nose tip. Br J Dermatol 1999; 140:775-6. [PMID: 10233819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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140
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Raybaud P, Hafner J, Kresse G, Toulhoat H. Ab-initio energy profiles for thiophene HDS on the MoS2 (1010) edge-surface. STUDIES IN SURFACE SCIENCE AND CATALYSIS 1999. [DOI: 10.1016/s0167-2991(99)80422-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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141
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Hafner J. [Differential ulcus cruris diagnosis]. Ther Umsch 1998; 55:632-42. [PMID: 9828699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Most leg ulcers are of venous or arterial origin (85%). Advanced chronic venous insufficiency is the most common underlying condition (65%), followed by advanced peripheral arterial occlusive disease (10%), and combined chronic venous insufficiency and peripheral arterial occlusive disease (10%). Chronic ulcers in diabetic feet (5%) are of great socio-economic importance, as well. They are a consequence of diabetic polyneuropathy which in part of the patients may be combined with peripheral arterial occlusive disease, usually of the calf arteries. However, a leg ulcer can also be caused by a large array of other underlying conditions, such as ulcerating skin tumours, trauma followed by disturbed wound healing, infectious ulcerations, ulcerations in angiodysplasias, vasculitic ulcerations, pyoderma gangrenosum, cholesterol-embolism, idiopathic livedo reticularis with ulceration, primary and secondary antiphospholipid-antibody-syndrome, coumarin-necrosis, calciphylaxis in chronic renal insufficiency, necrobiosis lipoidica, different forms of panniculitis, hematologic disorders, autoimmun diseases and autoimmun-bullous dermatoses. The following article discusses the differential diagnosis, examination and treatment of leg ulcers in these less common underlying conditions.
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142
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Eichler A, Hafner J. Adsorption of CO on Rh(100) studied by ab initio local-density functional calculations. J Chem Phys 1998. [DOI: 10.1063/1.477176] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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143
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Bagdade JD, Liu XQ, Buchanan WF, Hafner J, Rosenson R. Accelerated cholesteryl ester transfer in patients with essential hypertension and the effect of ramipril treatment. Atherosclerosis 1998; 140:167-72. [PMID: 9733228 DOI: 10.1016/s0021-9150(98)00101-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although the transfer of cholesteryl ester (CE) from high-density lipoprotein (HDL) to the apolipoprotein B-containing lipoproteins (very-low-density lipoproteins + low-density lipoproteins) has been shown to be abnormally increased in a number of conditions associated with increased cardiovascular risk, it has not been studied in patients with essential hypertension (EH). To determine whether subjects with EH have increased CE transport, CE transfer (CET) was estimated isotopically and lipoprotein lipid and phospholipid composition determined in a group of 14 untreated normolipidemic (triglycerides 116+/-46, cholesterol 185+/-30, HDL 38+/-10 mg/dl) otherwise healthy ethnically diverse EH subjects. CET was significantly increased in EH subjects compared to a similar group of normotensive controls (EH: k = 0.27+/- 0.09 vs. control k = 0.11+/-0.02: P < 0.01). Lipoprotein concentration and composition were comparable in the two groups and closely resembled that of an age- and sex-matched reference group. The abnormal increase in CET persisted (k = 0.25+/-0.12) after 3 months of treatment with the angiotensin converting enzyme (ACE) inhibitor ramipril without a change in either plasma or lipoprotein lipids. Thus, CET is increased in normolipidemic subjects with EH and is not affected by the ACE inhibitor ramipril.
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144
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Hafner J, Keusch G, Wahl C, Burg G. Calciphylaxis: a syndrome of skin necrosis and acral gangrene in chronic renal failure. VASA 1998; 27:137-43. [PMID: 9747147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Calciphylaxis is a rare condition of rapidly extending ischemic skin necrosis or acral gangrene of fingers, toes or penis in patients with chronic renal failure. It may be accompanied by extensive metastatic calcification of soft tissues. Histology of infarcted tissues shows prominent medial calcification and intimal hyperplasia of subcutaneous arteries and/or digital arteries, respectively. The pathogenesis of calciphylaxis is only poorly understood. Most patients have hyperparathyroidism and an elevated calcium-phosphate-product, which is thought to be a major pathogenetic factor of calciphylaxis. PATIENTS AND METHODS All published cases of calciphylaxis including nine of own (155 patients in total) from 1936 through 1996 were reviewed and subjected to statistical meta-analysis (Fisher's exact test). RESULTS Proximal locations of necrosis (thighs, buttocks, trunk) carried an unfavourable prognosis (63% mortality) compared to distal locations (calves, forearms, fingers, toes, penis) with 23% mortality (p < 0.0001). Parathyroidectomy was associated with a favourable outcome (p < 0.004). Diabetics with chronic renal failure had acral gangrene in 61% compared to 34% of the non-diabetic calciphylaxis-patients (p < 0.007). CONCLUSIONS The present analysis of all published cases of calciphylaxis is limited by patient selection and publication bias. The unfavourable prognosis of patients with proximal necrosis is impressive and might justify an early and aggressive treatment in such cases. However, the general benefit of parathyroidectomy remains debatable. Hyperparathyroidism should be managed primarily by conservative means. Parathyroidectomy should be reserved for patients with very high parathyroid hormone level and calcium-phosphate-product or with a rapidly progressive disease.
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145
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Hafner J. [Therapy of non-melanocytic skin tumors]. Ther Umsch 1998; 55:515-21. [PMID: 9757819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Actinic keratosis on sun-damaged skin are very common in individuals with fair complexion. Management encompasses cryosurgery, tretinoin or 5-fluorouracil-cream. Bowen's disease, however, requires surgical excision or radiotherapy. Basal cell carcinoma and squamous cell carcinoma are the two most common malignant skin tumours in Western Europe. Typically these tumours can be managed either by excision and primary wound closure, by cryosurgery or by radiotherapy. The method of choice is determined by the type and location of the tumour and the general condition of the patient. For more difficult-to-treat malignant skin tumours surgical resection with histological margin control is required. Mohs' micrographic surgery is a specialized procedure. This method entails to a full work-up of the excisional margins. The defect is closed only after histological verification of tumour-free surgical margins. Difficult-to-treat tumours are recurrent, sclerodermiform and large (diameter more than 20 mm) basal cell carcinomas. Indications for margin control in squamous cell carcinomas are tumours with more than 20 mm of diameter, with more than 5 mm thickness and with poor histologic differentiation (Broders grade III and IV, desmoplastic squamous cell carcinoma). Therefore, a skin biopsy is often required to plan the optimal treatment of a malignant skin tumour. The collaboration of primary care providers and specialists is beneficial in the management of difficult skin tumours. Renal transplant recipients under immunosuppression are prone to have squamous cell carcinoma of a more aggressive type. Dermatofibrosarcoma protuberans is another good indication for Mohs' micrographic surgery. A regular follow-up for recurrences or secondary tumours, as well as an effective secondary prevention of sun damage are important for skin cancer patients.
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146
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Villeneuve P, Hafner J, Prenosil JE, Elsner P, Burg G. A novel culturing and grafting system for the treatment of leg ulcers. Br J Dermatol 1998; 138:849-51. [PMID: 9666833 DOI: 10.1046/j.1365-2133.1998.02224.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to develop and test an efficient culturing and grafting system for the treatment of leg ulcers. The culturing system consisted of a Petriperm culture vessel (20 cm2) aseptically placed in a larger standard Petri dish (60 cm2). Skin cultures were established and cultivated in the Petriperm dish. The cells grew on the bottom of the Petriperm dish, which was made of a gas-permeable 25-micron thick transparent Teflon film. Grafts were produced simply by cutting the film from the bottom of the Petriperm dish with a scalpel. The system was used to produce subconfluent epidermal autografts which were used to heal a 32 cm2 chronic rheumatoid arthritis leg ulcer. The cultured autografts were transferred cell side down on to the cleaned wound bed without an enzymatic digestion. The grafts consisted of autologous keratinocytes, melanocytes and fibroblasts. Caution was taken not to disturb the wound bed for 7-9 days at which time the Teflon film was removed. The wound closed 2 weeks after the last grafting and has remained closed for more than a year post-treatment. The culturing and grafting system presented here will make it possible to develop cellular-based therapies that were previously not possible.
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147
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Hafner J, von Felten A. Resistance to activated protein C in patients with venous leg ulcers. Dermatology 1998; 195:413-4. [PMID: 9529575 DOI: 10.1159/000246006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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148
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Przylipiak A, Hafner J, Przylipiak J, Runnebaum B, Rabe T, Köhn FM. Influence of leukotrienes on in vitro growth of human mammary carcinoma cell line MCF-7. Eur J Obstet Gynecol Reprod Biol 1998; 77:61-5. [PMID: 9550202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this work was to study the action of leukotrienes on the growth of human mammary cancer cells MCF-7. STUDY DESIGN The growth of the cells was measured by incorporation of 3H-thymidine. The action of leukotriene (LT)B4, LTD4, LTC4, LTE4 or arachidonate (AA) was tested in human mammary cancer cells MCF-7 in vitro. RESULTS LTB4 or LTD4 but not LTC4 or LTE4 reduced significant incorporation of 3H-thymidine in MCF-7 cells up to 52% or 56% respectively, when administered in concentrations 0.1-1000 pM. Agents in concentrations of 0.01 pM or 10000 pM did not effect 3H-thymidine incorporation. We have shown, that MCF-7 cells synthesise LTB4 when treated with calcium ionophor A23187 (10 microM). Leukotriene-antagonist LY171883 (10 microM) lifts inhibitory effects of LTB4 or LTD4. Arachidonic acid (10 microM) inhibits 3H-thymidine incorporation up to 72%. 5-lipoxygenase inhibitor MK-886 (100 nM) lifts the inhibitory effect of arachidonate. CONCLUSIONS LTB4 or LTD4 inhibits MCF-7 breast cancer cell growth. LT-receptors mediate the growth-inhibitory effect of LTB4 or LTD4.
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Przylipiak A, Hafner J, Przylipiak J, Runnebaum B, Rabe T, Köhn FM. Influence of leukotrienes on in vitro growth of human mammary carcinoma cell line MCF-7. Eur J Obstet Gynecol Reprod Biol 1998. [DOI: 10.1016/s0301-2115(97)00217-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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150
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Kleeman D, Kempf W, Burg G, Hafner J. Cutaneous polyarteritis nodosa. VASA 1998; 27:54-7. [PMID: 9540436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Here we present two characteristic cases of cutaneous polyarteritis nodosa (cutaneous PAN). Cutaneous PAN is characterized by a chronic relapsing benign course over many years. In its mild form it presents with live-do and multiple painful nodular skin lesions mainly of the legs. In its more severe form painful skin ulcerations occur that are often accompanied by discrete polyneuropathy. Progression to systemic PAN is the exception. Only the more severe kinds of cutaneous PAN require a low-dose immuno-suppression. Assessment and treatment of cutaneous PAN are discussed.
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