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Biomedical subjects

C T Germer

Publications and source records attributed to C T Germer.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Overexpression of B7-1 amd B7-2 by LFA-1 positive lymphocytes in chronic inflammatory bowel diseases].

The B7/CD28 pathway is essential for initiating antigen-specific T-cell activation. LFA-1 (CD11a/CD18) is required for sufficient migration into inflammatory tissue. The aim of this study was to evaluate the role of B7 and LFA-1 in inflammatory bowel disease. Immunohistological single and double staining (PAP/APAAP) with monoclonal antibodies against HLA I/II, CD4, CD8, CD28, B7-1, B7-2, LFA-1 and CD68 were performed in tissue samples from patients with crohn's disease (n = 15), ulcerative colitis (n = 14), colorectal carcinoma (n = 5) and FAP (n = 3). The expression of B7-1 and B7-2 was generally much higher in ulcerative colitis and crohn's disease than in colorectal carcinoma and FAP. In crohn's disease multinucleated gigant cells in the granulomas express B7-1 and B7-2. Double staining showed a higher B7-1/B7-2 coexpression for CD4+ than for CD8+ T cells. In colitis ulcerosa and crohn's disease LFA-1 positive leucocytes showed a high coexpression of B7-1 and B7-2 in contrast to CD68 positive macrophages. These data suggest that overexpression of B7-1 and B7-2 on LFA-1 positive Leucocyts seems to play an important role in the pathogenesis of inflammatory bowel disease.

Adenomatous Polyposis Coli↗
PubMed1998

[Significant modification of the hyperthermic effect by starch microspheres (Spherex) of laser-induced hypertheria in the rat liver metastasis model].

This experimental study in an animal liver metastasis model (adenocarcinoma) investigated whether the "cooling effect" can be eliminated by temporary embolization with starch microspheres (Spherex) and the hyperthermic efficiency was improved. In this connection, groups of 15 test animals were treated with LITTmono, Embolizationmono or LITTembolization. In the LITTembolization group, 1/15 animals had vital tumor tissue after 24 h, 7 and 28 days, but tumor growth was found in the other 2 groups in 13/15 (LITTmono) and 14/15 (Embolization(mono)). These results demonstrate that the application of starch microspheres led to a significant increase in the hyperthermic effect of LITT under the selected testing conditions.

Adenocarcinoma↗
PubMed1998

[Endoscopic cholecystectomy as cost assessment--still a learning intervention?].

Economic considerations are putting increasing pressure on surgical departments to avoid intra- and postoperative complications and thus additional costs. Under this aspect, it was investigated whether laparoscopic cholecystectomy is a suitable training intervention for young prospective surgeons. These physicians in advanced training did not have a higher intra- or postoperative complication rate in a preselected patient population than senior physicians or specialists. The additional costs per surgical intervention due to longer operation times required by young physicians were acceptable so that laparoscopic cholecystectomy as a training intervention for young colleagues can be justified.

Cholecystectomy, Laparoscopic↗
PubMed1998

[Value of magnetic resonance tomography in preoperative staging of stomach carcinoma].

The value of MRI as a preoperative staging procedure in stomach carcinomas compared to CT and endosonography was examined in a prospective study and correlated with the pathohistological results. MRI showed better correlation with the pathohistological evaluation at the T3, T4, N and M stage than the other two test procedures. MRI is thus a suitable staging procedure for stomach carcinomas.

Adult↗
PubMed1998

[Optimized laser-induced thermotherapy in treatment of liver metastases of colorectal carcinomas, an interdisciplinary responsibility--a clinical study].

In a clinical study, it was investigated whether local tumor control is attainable with laser-induced thermotherapy (LITT) in the treatment of colorectal liver metastasis tumors. Local control of tumor growth was obtainable in completely hyperthermic tumors. Due to the small and inhomogeneous patient population (n = 32), an assessment of the method regarding prognostic gain for the patient is not possible in such a short follow-up period.

Adult↗
PubMed1997

[Hemobilia in cholecystolithiasis as a rare cause of massive upper gastrointestinal hemorrhage].

Haemobilia is defined as bleeding into the hepatobiliary system caused by a pathologic connection between blood vessels and biliary ducts. A rare cause of haemobilia is gallstone disease, with only 52 reported cases in the literature. The haemobilia is characterised by the classical triad: jaundice, colicky pain in the right upper quadrant and signs of gastrointestinal bleeding. Diagnosis can be made with endoscopic procedures and with angiography of the coeliac trunk, which has the highest sensitivity in localisation of bleeding source. The therapy of choice is cholecystectomy. We report the case of a patient with massive gastrointestinal haemorrhage caused by a solitary gallstone and present the diagnostic and therapeutic management of this disease, which is accompanied by a high mortality.

Aged↗
PubMed1997

Experimental study of laparoscopic laser-induced thermotherapy for liver tumours.

BACKGROUND: Laser-induced thermotherapy is a minimally invasive method that can be applied percutaneously or during laparotomy for the treatment of malignant liver tumours. The aim of this experimental study was to investigate whether the laparoscopic approach is suitable for laser-induced thermotherapy. Laparoscopic ultrasonography was tested as an aid to intrahepatic positioning of the applicators as well as for online monitoring during application. METHODS: A neodymium yttrium-aluminium-garnet laser was used to induce thermal lesions in the healthy liver of ten German hybrid pigs. The length of application was 840 s. Forty applications were performed with normal hepatic blood flow and 40 with hepatic blood flow interrupted by means of a laparoscopic Pringle's manoeuvre. RESULTS: A total of 20 simultaneous multifibre applications with 80 single applications were performed. Thermal necrosis with a total volume of 50.3 cm3 was induced with high precision when hepatic blood flow was interrupted temporarily. When hepatic blood flow was normal, the total volume of thermal necrosis was only 14.6 cm3 (P < 0.01). Laparoscopic ultrasonography was used successfully as an aid for exact applicator positioning and for online monitoring. Method-related complications did not occur. CONCLUSION: The laparoscopic approach is an attractive means of application for laser-induced thermotherapy and it seems that clinical testing is justified.

Animals↗
PubMed1997

[Preoperative routine chest x-ray: expensive and of little value].

In a retrospective analysis, we examined the findings of 3156 preoperative routine chest X-rays to define the indication of this cost-intensive examination. Pathological findings were seen only in 4% of all patients with no preexisting disease and in about 20% of patients with malignoma. Chest radiography is not routinely indicated in otherwise healthy patients, but should be performed if malignant disease is present.

Adolescent↗
PubMed1996

Primary malignant melanoma of the oesophagus.

We report the case of a 74-year-old female patient in whom a primary malignant melanoma of the oesophagus was detected at the time of investigation of phlebothrombosis. Therapy of choice for this extremely rare tumour is radical surgical resection of the oesophagus. Even after surgical resection, primary oesophageal melanomas have a very poor prognosis. According to the present state of knowledge, it remains unclear to what extent the prognosis could be improved by adjuvant therapeutic procedures with radiotherapy or chemotherapy and immunostimulation.

Aged↗
PubMed1996

[The fully implantable minimally invasive hepatic artery catheter for locoregional chemotherapy of nonresectable liver metastases in defective conventional implanted therapy catheters].

Dysfunction of arterial access devices used in association with intra-arterial chemotherapy for the treatment of unresectable liver metastases usually requires stopping the therapy or relaporotomy and reimplantation of a new arterial catheter. In this article our initial experience of a new technique, the so-called MIAH catheter (minimally invasive hepatic artery catheter) in 36 patients (age 37-78 years) are reported. The MIAH catheter was percutaneously inserted into the subclavian artery under sonographic guidance and advanced via the descending aorta selectively into the hepatic artery. Finally it was connected to a totally implantable pump. There were no deaths related to the operation. Operative or early complications occurred in 5 cases (13.8%); late complications were seen in 13 patients (36.1%). Nevertheless continuation of intra arterial chemotherapy was possible in all cases. In cases of dysfunction of conventional arterial access devices the MIAH catheter makes it possible to continue intra-arterial chemotherapy without requiring laporotomy.

Adult↗
PubMed1994

[Vascular malformations in the gastric fundus as a rare cause of fundus variceal hemorrhage].

In the differential diagnosis of the aetiology of portal hypertension arterio-portal fistulas as a rare cause have to be taken in account. The case of a 70-year-old male presenting with massive upper gastrointestinal bleeding secondary to gastric varices caused by a vascular malformation of the gastric fundus is reported and the problem of non-cirrhotic portal hypertension is discussed. In case of variceal bleeding aetiology of portal hypertension has to be clarified exactly before any kind of therapeutic intervention to avoid therapeutic pitfall.

Aged↗
PubMed1994

[Transperitoneal technique of preperitoneal mesh implantation in laparoscopic hernioplasty of direct and indirect inguinal hernias].

The method of transperitoneal application of a large polypropylene-mesh in the preperitoneal space for laparoscopic inguinal hernia repair is described. The own experiences with a total number of 64 inguinal hernias are presented. The technique takes the principle of conventional hernia repair into account and appears to be a safe and effective way to repair indirect and direct inguinal uni- or bilateral hernias. During a mean follow-up of 24 weeks one recurrence occurred resulting from an inadequate application of the mesh. The technique presented is effective for laparoscopic inguinal hernia repair with low morbidity. Long-term follow-up is needed to determine late recurrence rate.

Adult↗
PubMed1992

[Multivisceral and extended resection in tumor surgery: stomach cancer].

The aim of curative surgery in gastric cancer is the complete removal of all tumour bulk both macroscopically and microscopically (R0 resection). The operative strategy should consider the location of tumor, its histological character (Laurén classification), and the stage of disease according to the TNM-classification. Lymphadenectomy of compartments I and II does not increase operative morbidity and mortality if performed routinely, but seems to increase long-term survival in patients with stages II and IIIa disease. Routine removal of the spleen does not lead to better results. Gastrectomy in locally advanced gastric cancer with combined resection of adjacent organs can prolong survival in absence of peritoneal disseminating or distant metastases if R0 resection is achieved. The indication for gastrectomy of patients with an incurable stage of disease (peritoneal dissemination, distant metastases) should be determined after considering the individual status of the patient and surgical risk and can be performed as a so-called ultima ratio resection with the aim of palliation.

Follow-Up Studies↗
PubMed1989

[Experiences with endoscopic recanalization using the Nd-YAG laser in tumor ileus and inoperable rectal cancer].

In the time period from January 1, 1987 until October 1, 1988, a total of 17 patients with an advanced colorectal tumor underwent transendoscopic laser treatment with the Nd-YAG laser. Eight patients had a tumor-dependent passage disorder with a large intestinal ileus as initial finding. Recanalisation and decompression of the intestine were successfully performed in 7 cases, so that placement of an anus praeternaturalis could be avoided. In another 8 patients the advanced rectal tumors were subjected to laser irradiation, 6 times because of subtotal stenosis and 3 times because of tumor bleeding. A locoregional radiatio (afterloading) was performed in each case.

Aged↗