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Biomedical subjects

C A Jacobi

Publications and source records attributed to C A Jacobi.

At least 91 records · Page 5Linked to original sources
PubMed1998

The impact of laparoscopy with carbon dioxide versus helium on immunologic function and tumor growth in a rat model.

BACKGROUND: The pathogenesis of port site recurrences after laparoscopic surgery for malignant disease is still unknown. Whether different gases used to establish pneumoperitoneum have an influence on immunologic function and therefore on promotion of tumor growth has not yet been investigated. METHODS: Tumor growth of colon adenocarcinoma DHD/K12/TRb was evaluated in a rat model after insufflation either with CO2 (n = 25) or helium (n = 25) and in a control group (n = 25). Tumor growth was measured subcutaneously and intraperitoneally 5 weeks after insufflation. Beside tumor growth, immunologic changes (peripheral leukocyte subpopulations, plasma levels of TNFalpha and IL-10) were evaluated during the perioperative course in all animals. RESULTS: Subcutaneous tumor growth was promoted by the CO2 (99 +/- 55 mg; p < 0.01) compared to the helium (40 +/- 41 mg) and control groups (36 +/- 33 mg). Total intraperitoneal tumor weight was 718 +/- 690 mg in the CO2 group compared to the helium (549 +/- 233 mg) and control groups (521 +/- 221 mg). While peripheral leukocyte subpopulations only differed between the laparoscopic groups and the control group during the perioperative course, TNFalpha plasma levels were significantly decreased and IL-10 plasma levels significantly increased in the CO2 group compared to the helium and control groups in the postoperative course. CONCLUSION: The insufflation of CO2 promotes tumor growth compared to the helium and control groups in a rat model. In addition, increased tumor growth was associated with a significant increase in IL-10 and a decrease in TNFalpha plasma levels.

Adenocarcinoma↗
PubMed1998

[Effect of splenectomy on intra- and extraperitoneal tumor growth with reference to the immune system in a rat model].

In this model, splenectomy does not significantly influence the intra- and extraperitoneal tumor growth. Although the spleen accounts 25% of the cellular immune capacity, we found no difference in pro- or antiinflammatory cytokines but a significant increase of the white blood count after splenectomy compared with the control group. The influence of splenectomy on growth of intraperitoneal disseminated tumor cells must be investigated in further studies.

Adenocarcinoma↗
PubMed1998

[Effect of intra-abdominal pressure in laparoscopy on intraperitoneal tumor growth and development of trocar metastases. An animal experiment study in the rat model].

The results of the study indicate that elevated pressure during gas incubation in vitro leads to suppression of tumor growth probably due to direct damage of the cells. In vivo, laparoscopy with carbon dioxide and slightly elevated intraperitoneal pressure (5 and 10 mmHg) leads to promotion of intraperitoneal tumor growth while higher pressure (15 mmHg) causes again suppression of intraperitoneal tumor growth. Subcutaneous tumor growth is stimulated by carbon dioxide insufflation in all groups with elevated intraperitoneal pressures. The hypothesis that elevated intraperitoneal pressure might influence the immune system of the tumor host and increase immune suppression after laparoscopy remains theoretically and has to be investigated in further studies.

Air Pressure↗
PubMed1998

[Effect of alanyl-glutamine in postoperative total parenteral nutrition on postoperative immunosuppression and morbidity. Preliminary results of a prospective randomized study].

The impact of glutamine substitution on postoperative immunosuppression and morbidity was investigated in patients with surgical interventions and total parenteral nutrition in a prospective randomized trial. To analyze immune competence, the expression of CD3, CD4, and CD8 on lymphocytes and of HLA-DR and CD14 on monocytes as well as the plasma levels of IL-6 and IL-10 was evaluated before, 1, 2, 4, and 7 days after surgery. A total of 34 patients have been included (with glutamine: n = 18; without glutamine: n = 16). Patients with glutamine substitution showed decreased systemic inflammation, significant faster compensation for postoperative immunosuppression and a lower incidence of postoperative complications. Patients without postoperative complications showed no significant differences in postoperative immunosuppression.

Adult↗
PubMed1998

[Hormone therapy of postoperative recurrent pancreatic carcinoma with octreotide and tamoxifen].

In a prospective trial a combination of octreotide and tamoxifen was evaluated for its effect on tumour recurrence of R0-resected pancreatic carcinoma. Compared to the control group (n = 14), which was treated according to "best supportive care", the median survival times for the octreotide-tamoxifen group (n = 14) were 7 and 3.5 months respectively. In the octreotide-tamoxifen group patients suffered less from nausea, pain and fatigue (p < 0.05). Furthermore, there was a benefit of octreotide-tamoxifen therapy for global life quality.

Adenocarcinoma↗
PubMed1997

[Peritoneal instillation of taurolidine and heparin for preventing intraperitoneal tumor growth and trocar metastases in laparoscopic operations in the rat model].

BACKGROUND: Although port-site metastases occur after laparoscopic surgery, there is no generally accepted approach to prevent tumor implantation so far. METHODS: In order to prevent tumor metastases, the effect of taurolidine and heparin on the growth of colon adenocarcinoma DHD/K12/TRb was measured in vitro and in a rat model. After incubation of the cells with heparin, taurolidine or both substances, the cell kinetics were determined. In a second experiment, tumor cells were administered intraperitoneally in rats (n = 60) and pneumoperitoneum was established over 30 min. Rats were randomized into four groups (I: tumor cells; II: cells + heparin; III: cells + taurolidine; IV: cells + taurolidine + heparin). RESULTS: While tumor cell growth was not influenced by heparin in vitro, growth decreased significantly after incubation with taurolidine and taurolidine/heparin. In vivo, intraperitoneal tumor weight was lower in rats receiving heparin (298 +/- 155 mg) and taurolidine (149 +/- 247 mg) than in the control group (596 +/- 278 mg). When the two substance were combined, tumor growth was even less (21.5 +/- 36 mg). Trocar metastases were only lower in rats receiving taurolidine or the combination of taurolidine and heparin. CONCLUSION: In vivo, heparin inhibits intraperitoneal tumor growth only slightly, while taurolidine causes a significant decrease in tumor cell growth in vitro as well as intraperitoneal tumor growth and trocar metastases in vivo.

Adenocarcinoma↗
PubMed1997

[Comparison of local and systemic inflammation after laparotomy or laparoscopy in the rat sepsis model].

BACKGROUND: Laparoscopic techniques are frequently used in patients with peritonitis or intra-abdominal inflammatory diseases although increased intraperitoneal pressure may cause sepsis by promoting bacteraemia and systemic inflammatory response. METHODS: This experimental study investigates the influence of laparotomy and laparoscopy on bacteraemia, tumour necrosis factor (TNF)-alpha and endotoxin plasma levels. Standardized foecal inoculum was injected intraperitoneally and rats underwent either laparotomy (n = 20), laparoscopy (n = 20), or no further manipulation in the control group (n = 20). RESULTS: One hour after intervention, bacteraemia was significantly higher in both the laparotomy or laparoscopy groups than in the control group (P = 0.01). Foecal inoculum caused a significant increase in TNF-alpha and endotoxin plasma levels 1 h after intervention with the significantly highest levels after laparotomy (P < 0.05). In addition, the mean number of intraperitoneal abscesses were also significantly higher (P < 0.05) after laparatomy (n = 10) than after laparoscopy (n = 8) or in the control group (n = 5). CONCLUSIONS: Laparotomy and laparoscopy increased the incidence of bacteraemia and systemic inflammation compared to control group. However, inflammatory response and intraperitoneal abscess formation were significantly higher in the laparotomy group than in the laparoscopy group.

Abdominal Abscess↗
PubMed1997

Does laparoscopy increase bacteremia and endotoxemia in a peritonitis model?

BACKGROUND: Laparoscopy is increasingly used in patients with intraabdominal bacterial infection although pneumoperitoneum may increase bacteremia by elevated intraabdominal pressure. METHODS: The influence of laparotomy and laparoscopy on bacteremia, endotoxemia, and postoperative abscess formation was investigated in a rat model. Rats received intraperitoneally a standardized fecal inoculum and underwent laparotomy (n = 20), or laparoscopy (n = 20), or no further manipulation in the control group (n = 20). RESULTS: Bacteremia and endotoxemia were higher after laparotomy and laparoscopy compared to the control group (p = 0.01) 1 h after intervention. One hour after intervention, aerobic and anaerobic bacterial species were detected in the laparotomy group while only anaerobic bacteria were found in the other two groups. Although bacteremia and endotoxemia did not differ among the three groups after 1 week, the mean number of intraperitoneal abscesses was significantly higher (p < 0.05) after laparotomy (n = 10) compared with laparoscopy (n = 6) and control group (n = 5). CONCLUSION: Laparoscopy does not increase bacteremia and intraperitoneal abscess formation compared to laparotomy in an animal model of peritonitis.

Abscess↗
PubMed1997

The influence of laparotomy and laparoscopy on tumor growth in a rat model.

BACKGROUND: The effects of laparotomy and laparoscopy with different gases on subcutaneous and intraperitoneal tumor growth have not been evaluated yet. METHODS: Tumor growth of colon adenocarcinoma DHD/K12/TRb was measured in rats after laparotomy, laparoscopy with CO2 or air, and in control group. Cell kinetics were determined after incubation with carbon dioxide or air in vitro and tumor growth was measured subcutaneously and intraperitoneally after surgery in vivo. RESULTS: In vitro, tumor cell growth increased significantly after incubation with air and CO2. In vivo, intraperitoneal tumor weight was increased after laparotomy (1,203 +/- 780 mg) and after laparoscopy with air (1,085 +/- 891 mg) and with CO2 (718 +/- 690 mg) compared to control group (521 +/- 221 mg) (p < 0.05). Subcutaneous tumor growth was promoted after laparotomy (71 +/- 35 mg) and even more after laparoscopy with air (82 +/- 45 mg) and CO2 (99 +/- 55 mg) compared to control group (36 +/- 33 mg). CONCLUSIONS: Insufflation of air and CO2 promote tumor growth in vitro. In vivo, intraperitoneal tumor growth seems to be promoted primarily by intraperitoneal air and subcutaneous tumor growth by CO2.

Adenocarcinoma↗
PubMed1997

Inhibition of peritoneal tumor cell growth and implantation in laparoscopic surgery in a rat model.

BACKGROUND: The pathogenesis of portsite recurrences after laparoscopic surgery is still unknown, and a generally accepted approach to prevent tumor implantation does not exist. METHODS: The effect of taurolidine and heparin on growth of colon adenocarcinoma DHD/K12/TRb was measured in vitro and in vivo. After incubation of the cells with heparin or taurolidine or both substances, cell kinetics were determined. In a rat model (n = 60), tumor cells were administered intraperitoneally, and pneumoperitoneum was established over 30 minutes. Rats received tumor cells, tumor cells + heparin, tumor cells + taurolidine, or tumor cells + taurolidine + heparin. RESULTS: In vitro, tumor cell growth decreased after incubation with taurolidine and taurolidine/heparin. In vivo, intraperitoneal tumor weight was lower in rats receiving heparin (298 +/- 155 mg) and taurolidine (149 +/- 247 mg) compared with the control group (596 +/- 278 mg) but even less when both substances were combined (21.5 +/- 36 mg). CONCLUSION: Heparin inhibits intraperitoneal tumor growth in vivo slightly, while taurolidine causes significant decrease of tumor cell growth in vitro as well as tumor take and intraperitoneal tumor growth in vivo.

Adenocarcinoma↗
PubMed1997

Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells.

BACKGROUND: Port-site recurrences have often been reported after laparoscopic surgery for malignant disease, and the pathogenesis is unknown. Whether different gases used to establish pneumoperitoneum have an influence on tumor cell growth has not been investigated. METHODS: Tumor growth of colon adenocarcinoma DHD/K12/TRb was measured in a rat model after insufflation with either carbon dioxide or helium and in a control group. Tumor growth was evaluated in three experiments: (1) in vitro (n = 60), (2) ex vivo (n = 60), and (3) in vivo (n = 60). After insufflation, cell kinetics were determined in the first two experiments. In the third experiment, tumor growth was measured subcutaneously and intraperitoneally 5 weeks after insufflation. RESULTS: Tumor cell growth increased significantly after insufflation with carbon dioxide in vitro (p < 0.03) and ex vivo (p < 0.05) compared with the control group, whereas helium did not stimulate cell growth. In vivo, subcutaneous tumor growth was promoted by carbon dioxide (131 +/- 55 mg) (p < 0.01) compared with helium (35 +/- 34 mg) and the control group (36 +/- 33 mg). Total intraperitoneal tumor weight was 717 +/- 320 mg in carbon dioxide group compared with helium (549 +/- 231 mg) and control group (570 +/- 321 mg). CONCLUSIONS: The insufflation of carbon dioxide promotes tumor growth compared with helium and control in a rat model. Further studies should confirm these results before alternative gases should be recommended in laparoscopic surgery for malignant diseases.

Adenocarcinoma↗
PubMed1997

Surgical therapy of esophageal carcinoma: the influence of surgical approach and esophageal resection on cardiopulmonary function.

OBJECTIVE: The effects of the different surgical approaches (transhiatal esophagectomy and right-sided transthoracic esophagectomy) on perioperative cardiopulmonary function in the surgical treatment of esophageal carcinoma are discussed controversially and have not yet been evaluated. METHODS: In a prospective randomized study including 32 patients, we investigated the effects of the surgical approach (blunt dissection (n = 16) versus transthoracic en-bloc resection (EB) (n = 16)) in the treatment of esophagus carcinoma on perioperative cardiopulmonary function. The following parameters were measured in all patients: cardiac index (CI), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), intrapulmonary shunt (QS/QT), arterio-alveolar (aaDO2), arterio-venous oxygen pressure difference (avDO2), and blood gas analyses. Time of measurement were: after induction of anesthesia, beginning and end of esophagus resection, end of surgery, 1 h postoperatively, and then every 12 h until the third postoperative day. RESULTS: Compared to blunt dissection, en-bloc esophagectomy was found to be associated with a transient deterioration of pulmonary function during one-lung ventilation in the left-lateral position, which could already be compensated for during the intervention. No other significant differences in cardiopulmonary effects were seen between the two surgical techniques. The incidence of postoperative complications was identical in both groups. CONCLUSIONS: The results of our study show that en-bloc resection is only associated with an increased intraoperative pulmonary strain that is completely compensated during the operation and that there is no difference in cardiopulmonary functions between the two techniques in the postoperative course.

Adenocarcinoma↗
PubMed1997

Molecular evidence for association between the sphingobacterium-like organism "Candidatus comitans" and the myxobacterium Chondromyces crocatus.

Seven strains of the myxobacterium Chondromyces crocatus, isolated from widely separated geographic regions, were investigated for the presence of an associate gram-negative, rod-shaped companion bacterium that is phylogenetically related to the genus Sphingobacterium and has been named "Candidatus comitans" (C. A. Jacobi, E. Stackebrandt, H. Reichenbach, and B. J. Tindall, Int. J. Syst. Bacteriol. 46:119-122, 1996). Five of the Chondromyces strains were found to be associated with a companion bacterium, and one strain lost its companion during the study. A 16S ribosomal DNA (16S rDNA) clone library was generated for each Chondromyces culture. Sequence similarity was > 99.1% for all but one strain of C. crocatus and all but one strain of "Candidatus comitans". The three analyzed 16S rDNA clone sequences of the companion of Cm c7 indicated that this companion strain is slightly less related to the other companion strains. The association between the companion and the myxobacterium including the sporangioles was determined by in situ hybridization with fluorescently labeled rRNA probes and scanning confocal laser microscopy. Based on these results, there are indications that the companion strains may survive environmental stress by inclusion in the aggregates and in the sporangioles of the myxobacterium.

Bacteria↗
PubMed1997

[The plug and patch repair for managing the inguinal hernia of the adult].

The basic principles of the Plug and Patch Repair of inguinal hernia are positioning of a prolene plug behind the internal ring in combination with a prolene onlay patch on the fascia transversalis. From July 1994 until December 1996 243 inguinal hernias were operated in this technique in a consecutive series of 221 patients. There were 211 primary and 32 recurrent hernias. 187 operations were performed in local anesthesia and 34 patients wished general anesthesia. No intraoperative complications were noted. The average operation time was 36 +/- 14 minutes. Postoperative complications were 8 subcutaneous hematomas and 1 superficial wound infection, which healed spontaneously. The average stay in hospital was 2 +/- 2 days and the patients returned to work after 17 +/- 11 days. Patients' self assessment of postoperative pain and limitations of daily activities revealed an excellent comfort. The follow-up rate is 97% and no late complications were observed after a median follow-up time of 21 months. The Plug and Patch technique is a very promising procedure for inguinal hernia repair in adults.

Activities of Daily Living↗
PubMed1997

[Perspectives of minimal invasive surgery].

The rapid and often uncritical introduction of complex minimal invasive procedures in clinical routine has been increasingly criticized. Even established minimal invasive techniques as for instance laparoscopic cholecystectomy are discussed controversial. Causes hereof are the lack of basic research and the unstructured development of new operative techniques. The possibilities of physiology adjusted basic research in minimal invasive surgery and stepwise a structured testing of new operative techniques are demonstrated. The changing conditions of the next century demand critical evaluation of the effectiveness of video-endoscopic surgery in prospective randomized trials, if it will keep or expand its present clinical importance.

Forecasting↗
PubMed1996

Quality of life following resection of oesophageal carcinoma.

Quality of life following resection of oesophageal carcinoma was assessed by patients using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and by a psychologist using the Spitzer Index. Quality of life was evaluated in 119 patients on one occasion 12 months after operation and in 30 patients regularly, starting with a preoperative assessment. Self and external evaluation showed a significant correlation (r = 0.61), but quality of life was assessed as being higher by the external observer. Limited physical performance status and somatic complaints were the most important postoperative dysfunctions, whereas emotional, social and economic disorders were found to be less frequent and less severe. Of several factors analysed only tumour recurrence (P < 0.01) and anastomotic stricture (P < 0.05) lowered quality of life significantly. Compared with the preoperative assessment, quality of life had decreased on discharge from hospital but was restored within 6 months of operation in disease-free patients. Further studies are required to determine the impact of adjuvant therapy for quality of life in patients undergoing surgery for oesophageal cancer.

Activities of Daily Living↗
PubMed1996

[Diagnosis and therapy of leiomyoma of the upper gastrointestinal tract].

Leiomyoma of the upper gastrointestinal tract is a "soft tissue tumor" and is a rare and benign lesion. The incidence of leiomyoma in the upper G-I tract is 4% of all tumors of the esophagus and 1% of the stomach. However it is difficult to differentiate leiomyoma from leiomyoblastoma and malignant leiomyosarcoma. For this reason some surgeons prefer the resection of the tumor to enucleation. Between 1984 and 1994, 24 patients with leiomyoma were treated at the Department of Surgery of the University Charité (esophagus n = 4, stomach n = 18, ileum n = 2) by local enucleation/excision in 11 cases and by wide resection of the tumor in 13 cases. In the further follow-up (after 36-84 months) there was no lethality or local recurrence.

Adult↗