PubMed Health⌕ Search

Biomedical subjects

C Hottenrott

Publications and source records attributed to C Hottenrott.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Regional chemotherapy of liver metastases].

Intraarterial regional chemotherapy of the liver by implantable pumps and port-systems is currently applied predominantly in patients with isolated colorectal metastases. Therapy and evaluation of results must consider the following factors: natural course of the disease; classification of tumor extent in the liver; evidence of isolated liver metastases; vascular anatomy, optimal catheter-implantation technique, complete perfusion; choice of drugs and dosage; technical complications; local toxicity, extra-hepatic recurrence, definition of therapeutic success. Our own experiences with regional chemotherapy in 145 patients with metastases to the liver and in 9 patients with hepatocellular carcinoma are reported. Using different therapeutic modalities we found a significantly enlarged response rate and at this time a true prolongation of life of about 8 months. Further prospective studies are necessary. The use of regional chemotherapy for liver metastases seems to be recommended at this time only under study conditions.

Antineoplastic Agents↗
PubMed1987

[Controlled study comparing mechanical and manual esophago-jejunostomy following gastrectomy].

40 patients with gastric malignancies were entered into a prospective randomised study of mechanical stapling (EEA) vs. manual single layer suturing of the esophago-jejunostomy following total gastrectomy. The groups were well matched with respect to clinical features, medical risk factors and tumor stage. Following manual technique, no anastomotic leak was observed. In the group with automatic mechanical suturing one technical failure and one insufficiency was seen. This difference, however, is not statistically significant. One patient died (cardiac infarction). The analysis of operating time, morbidity and hospital stay showed no significant differences. These results indicate that by use of a precise standardized conventional suture technique the same security performing an esophago-jejunostomy can be achieved as with mechanical staplers.

Adenocarcinoma↗
PubMed1987

[Locoregional chemotherapy of liver metastases of colorectal cancer].

Intraarterial regional chemotherapy for non-resectable, isolated colorectal metastases to the liver was performed in 121 patients via implantable pumps or infuse-a-ports. FUDR alone or in combination with 5-FU and Mitomycin C was administered in different modalities. Partial response rate ranged between 35 and 71%. Median survival since starting chemotherapy was so far 8-16 months. Extrahepatic relapse occurred in 45%, technical complications in 23% (pump) and 46% (infuse a port). Local toxic side effects strongly depended on drug dosage and application modus. These results corresponded with those of 647 German collective cases and 490 cases from American literature.

Antineoplastic Agents↗
PubMed1987

[Gastric acid, pepsin secretion and mucosal blood flow--their modification by the sympathetic nervous system].

The effects of surgical and chemical sympathectomy on various gastric functions was studied in rats. From the results it is concluded that the sympatho-adrenal system inhibits gastric acid secretion and mucosal blood flow. The regulation of pepsin secretion by the sympathetic nervous system appears controversial: under normal conditions an inhibitory effect is prevailing, whereas under stress an increase in pepsin secretion is observed.

Adrenal Medulla↗
PubMed1987

[Status of regional chemotherapy of the liver].

The review of the literature and of own results show, that the local chemotherapy of hepatic only metastasis from colorectal or breast cancer and of primary liver carcinoma may result in a prolongation of life of six to eight months. There are no statistical advantages of different treatment modalities. Metastases from colorectal primaries show complete remission in about 10%. Other tumors are not suitable or need further interest. The advantage of the shown patients has to be bought by additional surgery and occasional local toxicity. The method still can not be seen as standard treatment, but should further be examined and developed by specialized centers. There is no more doubt that the surgical resection of localized tumors is of great value.

Antineoplastic Agents↗
PubMed1987

Morphological changes after intra-arterial chemotherapy of the liver.

The livers of twenty patients given intra-arterial chemotherapy to treat malignant tumors of the liver or liver metastases, were examined histologically. The results show that cytostatic chemotherapy primarily affects tumor cells, but also causes toxic damage to liver tissue. Besides necrosis of single cells or groups of cells and cholestasis in about one-third of the cases sclerosing cholangitis is a major complication. After chemoembolization, which produces a more marked therapeutic effect with regard to tumor necrosis, extensive necrosis of liver tissue, arteries, bile ducts, and nerves is most conspicuous. Nevertheless, in view of the positive therapeutic effects observed, intra-arterial chemotherapy is recommended for palliative therapy.

Antineoplastic Agents↗
PubMed1986

[Lithotripsy of intrahepatic gallstones].

After placement of a T-drain near some intrahepatic gallstones their fragmentation was successfully accomplished by extracorporeal shock-wave lithotripsy in a 35-year-old man. The fragments passed through the outside via both the drain and stool. A few fragments which remained in the T-drain and the distal bile duct were easily flushed out later.

Adult↗
PubMed1986

[Continuous intravenous or intra-arterial administration via a subcutaneous implantable infusion chamber. Preliminary clinical experiences with particular reference to intra-arterial chemotherapy].

An infusion chamber was implanted subcutaneously in 18 patients for intravenous systemic treatment and in 20 for intra-arterial treatment of the liver. Intravenous catheters were introduced via the cephalic vein, intra-arterial ones via the gastroduodenal artery, after exclusion of extrahepatic metastases. Six manageable complications were observed during a total implantation time of 102 months for i.v. treatment and usage over 500 days: three temporary occlusions; one infection; two extravasations. The intra-arterial chemotherapy, largely for hepatic metastases of breast carcinoma, was undertaken according to a modified FAM schema (fluorouracil, adriamycin, mitomycin C): It achieved a high response rate with two full and eleven partial remissions. Complications were rare, except for 4 temporary occlusions. Systemic side effects were almost completely absent, local toxicity was low. One problem was the fixation of the needle which connects to the infusion chamber. This was true for both intravenous and intra-arterial treatment.

Catheterization↗
PubMed1986

[Clinical evaluation of the tumor marker CA 19-9 in comparison with carcinoembryonic antigen (CEA) in surgical pre- and postoperative diagnosis].

A new tumor marker (CA 19-9) was investigated. CA 19-9 is a tumor-associated antigen which is detected by a monoclonal antibody. CA 19-9 (CIS-Centocor) was compared simultaneously with CEA (carcinoembryonic antigen) in 347 patients. 123 patients with gastrointestinal tumors showed a sensitivity of 31% for CA 19-9 (CEA 49%), combination increased sensitivity to 58%. The highest sensitivity was found in pancreas carcinoma (CA 19-9 75%, CEA 66%, combination 92%); it was lower in gastric, colon, and oesophagus carcinomas. In relapsed colorectal carcinomas sensitivity was 53% (CEA 78%, combination 85%). In cases of relapse, tumor markers may become positive even if they were not detectable before resection of the primary tumor. Specificity for CA 19-9 was 100% (CEA 84%) compared to a group of non-malignant diseases including patients with inflammations and patients with nicotin abuse (n = 102). Because of its high specificity and superior sensitivity to CEA in pancreas carcinomas CA 19-9 should be determined in primary and relapse diagnosis in combination with CEA.

Antigens, Neoplasm↗
PubMed1984

[Biochemical parameters of hepatic ischemia in experimental animals].

It was the aim of this study to define biochemical parameters of hepatic ischemia. In seven dogs portal vein and hepatic artery were occluded subsequently. During this ischemia the lactate concentration in the hepatic veins rose from a basal value of 15 mg% to 57 mg%. Lactate levels measured in portal vein, femoral artery, and femoral vein were significantly lower. Furthermore, hepatic ischemia caused an increase in potassium and glucose levels in the hepatic vein. Primarily, production of lactate by the liver seems to be an appropriate parameter for hepatic ischemia. Measuring lactate metabolism could be used to examine patients with portal hypertension before performing a shunt procedure. By cannulating the umbilical vein it is possible to occlude the portal vein with a balloon catheter. Portal vein occlusion with hepatic vein blood sampling may identify those patients in whom hepatic arterial reserve is inadequate to support portosystemic shunting.

Animals↗
PubMed1984

The influence of autonomous nervous activity on total and regional gastric blood flow.

Using 8 mu radioactive microspheres total and regional gastric blood flow were measured in dogs under electrical splanchnic stimulation (SS), following splanchnicectomy (SE), under electrical stimulation of the vagal truncs (VS) and following truncal vagotomy (VE). The values were compared to controls and were taken while cardiac output (CO) and mean aortic pressure ( AOBP ) were registered. Total GBF was 16 +/- 4 ml/100g/min. in 8 animals. Regional flows were highest in the mucosa of corpus and fundus (35 +/- 7 and 27 +/- 6 ml/100g/min.) and lowest in the seromuscularis (4 +/- 1 ml/100g/min.) SS decreased total GBF to 7 +/- 2 ml/100g/min. and this was due to a most dramatic fall in corpus and fundus mucosal flow by 75%. In contrast SE increased total GBF to 30 +/- 11 and regional corpus mucosal flow achieved 85 +/- 24 ml/100g/min. Blood flow changes under VS were similar to those following SE but were less elevated. In the same manner flow reduction following VE was similar to the changes seen after SS but in average less profound. CO and AOBP increased during SS (less than 30% of control) but were almost the same for SE, VS and VE.

Animals↗
PubMed1984

How to achieve total gastric sympathectomy.

Experimental examinations on acute, stress induced gastric ulcers have shown the outstanding role of the sympathetic innervation in the pathogenesis of this ischemic disease. As reduction of sympathetic tonus resulted in a significant prophylaxis against "stress ulcers", further experimental work was done to achieve total but selective gastric sympathectomy. In a histomorphological study in dogs (Method: Hillarp and Falck in the modification of Heene ) the effects of three different surgical procedures on gastric sympathetic denervation were investigated: 1. Selective proximal vagotomy (= SPV, 8 dogs) 2. SPV and periarterial denervation of the main gastric arteries with severance of the gastrolineal ligament (= PASD , 8 dogs) 3. PASD alone (7 dogs) Selective proximal vagotomy resulted in a sympathetic denervation of major parts of the right site of the fundus and corpus. Following selective proximal vagotomy with periarterial denervation ( PASD ) there was a complete sympathetic denervation of the entire stomach. Only a minimal area of resting sympathetic innervation was observed on the esophago-cardial border when periarterial denervation ( PASD ) was performed alone.

Animals↗