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Biomedical subjects

C A Jacobi

Publications and source records attributed to C A Jacobi.

105 records · Page 6Linked to original sources
PubMed1996

Videoendoscopic vascular surgery on aortoiliac vessels. An experimental study.

BACKGROUND: In order to avoid the postoperative complications following conventional surgical treatment of aortoiliac atherosclerotic occlusive disease, a new concept in videoendoscopic vascular surgery on the infrarenal aortoiliacal artery was created. METHODS: New instruments for endoscopic vascular surgery were therefore developed. Having elaborated the practicability of "videoendoscopic surgery" in four short-term pilot studies in piglets, we performed a standardized acute study in healthy male piglets (32 +/- 2 kg). Blood flow was monitored ultrasonically in the femoral arteries and systemic and hemodynamic parameters were evaluated in all animals. RESULTS: The investigation regarding ultrasonically monitored blood flow in the femoral arteries (four aortofemoral bypasses, four iliac patchplasties) and other systemic, hemodynamic parameters after videoendoscopic vascular reconstruction revealed positive results. The following series of standardized long-term animal experiments revealed that 2-7 weeks after the aortofemoral bypass grafting (n = 5), the animals were all doing well. The angiographic examination showed that the prostheses were patent. CONCLUSIONS: Even though it was possible to carry out the endoscopic vascular method according to the rules of conventional vascular surgery, further experimental research and development of endoscopic instruments have yet to be done in order to optimize the new surgical method. This is the subject of our ongoing long-term animal studies.

Animals↗
PubMed1996

"Candidatus comitans," a bacterium living in coculture with Chondromyces crocatus (myxobacteria).

We describe the phylogenetic position and some taxonomically relevant characteristics of a small pleomorphic gram-negative bacterium that was cocultured with some strains of the myxobacterium Chondromyces crocatus that were isolated from the same geographic and ecological habitat. A 16S ribosomal DNA analysis revealed that the companion was a member of the "Cytophaga-Flavobacterium-Bacteroides" complex and was most closely related to members of the genus Sphingobacterium. The results of a fatty acid analysis, an isoprenoid composition analysis, and a DNA G+C content analysis and the presence of sphingolipids confirmed that this bacterium is affiliated with the genus Sphingobacterium. As the companion bacterium survived for only a few generations on solid media and could not be maintained in pure culture, we assign to this novel taxon that lives in close association with the myxobacterium C. crocatus Candidatus status as "Candidatus comitans."

Bacteroidetes↗
PubMed1996

Anastomotic tissue oxygen tension during esophagectomy in patients with esophageal carcinoma.

Submucosal tissue oxygen tension (PtO2) was measured in 20 patients with cervical esophagogastrostomy after resection of esophageal carcinoma, using a Clark-type oxygen electrode. The mean gastric baseline PtO2 was 54.6 +/- 10.7 mm Hg. Following ligature of the vasa brevia and the left gastroepiploic artery PtO2 decreased to 45.8 +/- 9.9 mm Hg, ligature of the left gastric artery caused a decrease to 34.2 +/- 9.7 mm Hg and resection of the lesser curvature and pulling up of gastric tube led to 25.5 +/- 9.0 mm Hg. Clinical value and practicability of intraoperative PtO2 measurements could be proven.

Adult↗
PubMed1996

[Diagnosis and therapy of postoperative chyloperitoneum].

Chyloperitoneum is a rare complication of surgical procedures. We report a case of severe chyloperitoneum after abdominothoracic esophageal resection with two-field lymphadenectomy. After diagnosis was established, the lymph leak was located with oral iodine-marked fatty acids (123I-pentadecanoic acid) showing increased activation in the right middle abdomen. Because conservative treatment with total parenteral nutrition showed no decrease in chyle volume, relaparatomy was performed and the lymphatic fistula was successfully treated with suture ligatures. Pathophysiology and different options for localization and treatment of postoperative chyloperitoneum are discussed.

Carcinoma, Squamous Cell↗
PubMed1996

[Systematic lymphadenectomy in esophageal carcinoma--preliminary results of a prospective randomized study].

The influence of transhiatal blunt esophagectomy with dissection of all reachable lymph nodes (ESD) and en-bloc-esophagectomy (EB) on perioperative cardio-pulmonary stress and late results was analysed in a prospective randomized trial. Blunt dissection of the esophagus was performed without systematic lymph node dissection (SD) in patients with increased cardio-pulmonary dysfunctions. Until now 26 patients (ESD: 13, EB: 13) entered the study as well as 14 patients treated by blunt dissection. The number of dissected lymph nodes in each patient was 7.5 (SD), 19.9 (ESD) and 37.6 (EB). Ratio of invaded to removed lymph nodes was 0.26 (SD), 0.25 (ESD) and 0.1 (EB). The 30-day mortality rate was 8.0% in each group. Under the consideration of this mortality, one-year survival rate was 79% (SD), 70% (ESD) and 77% (EB). Patients with negative lymph node involvement showed a one-year survival of 85% and positive involvement lead to a survival rate of 70% after one year, independently of the surgical approach.

Adult↗
PubMed1996

[Assessment of quality of life after resection of colorectal carcinoma].

Quality of life (QL) following resection of carcinoma of the colon (n = 68) and rectum (n = 58) was studied in 126 patients 12 months postoperatively and in 34 patients at regularly intervals, starting with a preoperative assessment. QL was assessed by the patients themselves using the EORTC QL questionnaire (QLQ-30) and by a psychologist using the Spitzer index. Between self-assessment and evaluation by the independent observer, a significant but not very strong correlation (r = 0.48) was determined and QL was evaluated as being better by the observer. Although somatic and emotional problems were significantly more common in patients with rectal cancer following abdominoperineal resection and the Spitzer index was significantly lower in these patients, the subjectively perceived global QL did not differ from that after sphincter-preserving resection. Of several factors analysed, tumour recurrence was the decisive factor determining postoperative QL. In disease-free patients QL had deteriorated on discharge from hospital but was restored within 3-6 months postoperatively.

Activities of Daily Living↗
PubMed1995

Dissection of the Yersinia enterocolitica virulence plasmid pYVO8 into an operating unit and virulence gene modules.

The structural genes encoding the Yop proteins of Yersinia enterocolitica are scattered around on the virulence plasmid (pYV). The genes which are required for transactivation, secretion and translocation of the Yopos are encoded in one cluster known as the lcr-region of pYV. After the introduction of an additional SalI restriction site into pYV of Y. enterocolitica serotype O8, we were able to clone and isolate the whole lcr-region on the mobilizable low copy vector pSUP102. Analysis of this construct in a plasmidless WA-strain showed that all Yops being encoded inside the lcr-region (YopN, YopB, YopD and the V-antigen) were secreted into the culture supernatant. Moreover, this lcr-fragment was able to promote secretion of other Yops encoded by a second recombinant plasmid. Thus the translocation and function of single Yops can be studied.

Bacterial Outer Membrane Proteins↗
PubMed1995

Implantation metastasis of unsuspected gallbladder carcinoma after laparoscopy.

In a 73-year-old woman elective laparoscopic cholecystectomy for symptomatic cholelithiasis had to be changed to open cholecystectomy because of technical problems. Unsuspected microscopic adenocarcinoma of the gallbladder was found after operation. Two months later abdominal-wall metastasis developed at the periumbilical and the right abdominal laparoscopic tract through which the laparoscope and instruments had been introduced and removed. The paramedian abdominal wall incision for the laparotomy was free of tumor.

Abdominal Neoplasms↗
PubMed1995

[Should a pyloroplasty be carried out in stomach transposition after subtotal esophagectomy with esophago-gastric anastomosis at the neck? A prospective randomized study].

The effects of pyloroplasty following subtotal oesophagectomy and gastric substitution with cervical oesophago-gastric anastomosis were studied in a prospective randomized trial. 52 patients received extramucosal pyloroplasty and were compared to a control group of 55 patients, in whom no drainage procedure was performed. 6 patients died postoperatively. One of these patients died following the insufficiency of pyloroplasty. The other causes of death were not related to the performance or non-performance of pyloroplasty. Regarding to patients subjective self-assessment of abdominal discomfort and radiologic emptying of the gastric tube no statistical significant differences between both groups were noted 2 weeks and 6 months postoperatively. Two patients with pyloroplasty, but no patient of the control group, suffered 12 months postoperatively from severe vomiting due to fibrotic stricture of the pylorus. The results of this study suggest, that usually no pyloroplasty should be performed following subtotal oesophagectomy and interposition of a gastric tube with oesophagogastric anastomosis in the neck.

Adult↗
PubMed1994

[Myiasis of the scalp--an incidental finding in ambulatory surgery].

Because of the increase of travels to tropical countries the physician in Germany is more often confronted with parasitic tropical diseases. In an apparently routine case a 28 year old patient suffered from infected stitches of the scalp, caused by an unknown insect, after returning from Sri Lanka. Four larvae of Dermatobia hominis, which causes the cutaneous myiasis, were found into the pyogenic furuncles and were removed by surgical approach.

Adult↗
PubMed1994

[Chemical pleurodesis with iodized talcum in persistent therapy refractory bronchocutaneous fistula].

The common therapy of a persistent bronchocutaneous fistula is the operative endoscopic repair of the leak, the parietal pleurectomy or the endoscopic pleurodesis with different agents. Therefore the thoracotomy with all the risks for the patient can be avoid. Complications seen in the thoracoscopic treatment are low and often the result of techniqual problems. However there must be an alternative therapy for patients with a high operational risk. In our case we treated a bronchocutaneous persistent fistula by the instillation of iodized talc effectively. Although talc and others agents are used in the therapy of malignant pleural effusions, the talc poudrage in the therapy of bronchocutaneous fistulas is a good alternative treatment for patients in a bad condition.

Bronchial Fistula↗
PubMed1994

[Surgical therapy of cancer of the cervical esophagus].

Esophagectomy and reconstruction of the esophagus is the treatment of choice in carcinoma of the cervical esophagus. Although the type of resection is almost standardized, the methods of esophageal reconstruction, replacement by a gastric tube, a free intestinal or colonic graft are discussed controversial. Adjuvant radiation or chemotherapy did not improve long-term survival. Our experience with 19 patients is reported and discussed with other european results.

Adult↗
PubMedDate not supplied

Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: a prospective randomized study.

Postoperative radiation therapy following curative resection of squamous cell carcinoma of the esophagus was investigated in a prospective randomized study. A group of 33 patients received postoperative radiation therapy and were compared to a control group of 35 patients treated by surgery alone. No statistically significant differences were noted between the two treatment groups concerning overall and disease-free survival rates. Postoperative irradiation significantly increased the incidence of fibrotic strictures of the esophagogastric or esophagocolonic anastomoses and caused a delayed recovery of patients quality of life. Based on these results, we believe that postoperative radiation therapy alone cannot be advocated as a adjuvant therapy following curative resection of squamous cell carcinoma of the esophagus.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

The tranquilizing injection of Yersinia proteins: a pathogen's strategy to resist host defense.

Pathogenic bacteria of the genus Yersinia possess a type III secretion apparatus by which they can inject up to six effector proteins into host cells. These so-called effector Yops (Yersinia outer proteins) disrupt cellular immune defense functions such as TNF-alpha release, O2-production or phagocytosis and thereby allow Yersinia to grow extracellularly. Recent findings indicate that the effector Yops are highly active proteins that engage in crucial eukaryotic signaling mechanisms. For instance, the translocated tyrosine phosphatase YopH dephosphorylates the focal adhesion proteins paxillin and p130Cas within target cells. Furthermore, the Yersinia effector YopP is able to induce apoptosis in macrophages presumably by blocking MAP kinase and NFKB mediated signaling events. Here we discuss recent advances concerning the intracellular targets and biochemical signaling mechanisms regulated by the translocated Yersinia effectors.

Animals↗