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Biomedical subjects

G H Jacobi

Publications and source records attributed to G H Jacobi.

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

Radical cystectomy--often too late?

From 1967 to 1985, 246 cystectomies for treatment of transitional cell carcinoma of the urinary bladder were performed. Perioperative mortality decreased from 15% in the early years to 0% in 1985. Preoperative radiotherapy was not given. Patients who underwent cystectomy immediately following the diagnosis of invasive bladder carcinoma had a significantly better prognosis than those having cystectomy after recurrence of a transurethrally resected invasive carcinoma in spite of identical G and T criteria. A total of 26 patients who were cystectomized because of tumor recurrence after definitive radiotherapy (salvage cystectomy) represented the group with the worst prognosis: they had a 5-year survival rate of less than 10%. It is concluded from these results that recurrence of an infiltrating bladder tumor is an indication of poor prognosis. Early cystectomy after diagnosis of tumor infiltration can improve survival rates. Transurethral resection without adjuvant therapy cannot be regarded as reliable curative treatment of bladder cancer infiltrating the lamina propria (pT1). Modern surgical techniques of continent urinary diversion or total bladder replacement combined with sparing of the pelvic nerves (and thus preservation of potency) reinforce our view that radical cystoprostatectomy need no longer be regarded as mutilating surgery.

Carcinoma, Transitional Cell↗
PubMed1986

The Mainz pouch (mixed augmentation ileum and cecum) for bladder augmentation and continent diversion.

The surgical technique for construction of the Mainz (mixed augmentation ileum and cecum) ileocecal pouch for bladder augmentation or continent urinary diversion focuses on 3 functional features: creation of a low pressure reservoir of adequate capacity from cecum and 2 ileal loops, which are split open longitudinally, antirefluxing ureteral implantation into cecum or ascending colon, achieved by a standard submucosal tunnel technique, and in cases of bladder augmentation continence depends on competence of the bladder neck and urethral closure mechanisms, while in urinary diversion continent closure of the pouch is achieved by isoperistaltic ileoileal intussusception or implantation of an alloplastic stomal prosthesis. Of 11 patients with Mainz pouch bladder augmentation (5 of which were undiversions) 10 are completely dry day and night with normal intervals of bladder evacuation. Two patients with myelomeningocele are on intermittent catheterization for bladder evacuation, while the remainder void spontaneously without significant residual urine. Of 12 patients with Mainz pouch urinary diversion 6 have an ileoileal intussusception valve and are completely continent, as are 3 of 4 with an alloplastic stomal prosthesis. Two patients still are awaiting implantation of a sphinteric prosthesis.

Adolescent↗
PubMed1986

Coincident vesical transitional cell carcinoma and prostatic carcinoma. Clinical features and treatment.

Twenty-two patients with vesical urothelial carcinoma associated with prostatic carcinoma were reviewed. They represented 1.5% of the bladder and prostatic tumours treated in our department within a 12-year period from 1968 to 1979. Their management included several treatment policies, based on the separate assessment of each tumour variant. For non-infiltrating bladder tumours, transurethral tumour resection was combined with hormonal treatment, external radiotherapy or resection of the prostate depending on the stage of the prostatic tumour. Radical cystoprostatectomy was performed for two cases of infiltrating bladder tumour with well localised prostatic tumours. A conservative primary approach seems justifiable in the management of double carcinoma of the bladder and prostate. The coincidence of bladder urothelial carcinoma and prostatic carcinoma per se is not an adverse prognostic factor; prognosis is more closely related to the pathological stage and grade of the bladder tumour. Cystoprostatectomy for patients with infiltrating bladder tumours could be curative, in selected cases, for the prostatic cancer as well.

Aged↗
PubMed1986

Effect of lectins on 3H-uridine and 3H-thymidine uptake by cultured renal cell carcinoma and normal renal cells.

The effect of lectins on cultured renal cell carcinoma and normal renal cells was studied. Ricin II showed effective inhibition of 3H-uridine and 3H-thymidine uptake by renal cell carcinoma and normal renal cells in all cases. Normal renal cells were more resistant to the inhibitory effect of ricin II as compared to renal cell carcinoma. Concanavalin agglutinin and wheat germ agglutinin led to stimulation of 3H-uridine and 3H-thymidine uptake by renal cell carcinoma and normal renal cells at low concentrations (0.2 micrograms/ml), and to suppression at high concentrations (2 and 20 micrograms/ml).

Carcinoma, Renal Cell↗
PubMed1986

[Renal cell carcinoma--a classification based on cytomorphological criteria].

535 human renal cell carcinomas were classified using a classification system based on defined tumor cell types. The following tumor cell types were distinguished: clear cells (with variants: clear cell-eosinophilic, plasma-rich), chromophobe cells (with variants: eosinophilic, relatively light), chromophilic cells (basophilic, eosinophilic), spindleshaped/-pleomorphic cells. A group "still unclassified" is added. This classification largely rejects the term "granular" (which as a rule was combined with "eosinophilic"), because in our view this term referred to a heterogenic group of variants of different cell types. A cytological grading--based on nuclear morphology--is conducted using 3 grades (GI - III). Preliminary results from follow up studies (survival rates, metastases) suggest that this classification may also have clinical importance for tumor prognosis.

Adolescent↗
PubMed1985

Tumor-specific monoclonal antibodies for renal cell carcinoma.

Monoclonal antibodies, tumor-specific for renal cell carcinoma (RCC), were produced in Balb/C mice, hyperimmunized with tumor cell suspensions from a histological grade II tumor. Boosting with lectin-immobilized tumor-antigen rendered high yields of specific antibody-producing hybrids. Hybridoma supernatants were screened for specificity using a solid-phase enzyme-linked immunoassay. Testing in parallel for reactivity with tumor tissue and corresponding autologous normal kidney material, only those hybrids producing antibodies exclusively reactive with RCC were propagated, resulting in 4 stable, highly productive subclones. Using the immunoperoxidase staining technique, tissue sections from 97 different RCC specimens and corresponding normal kidneys were evaluated for reactivity with the monoclonal antibodies. Over 90% of RCC were strongly positive, whereas normal kidney tissue did not react. Other normal human organ sections, including pancreas, liver, lung, stomach, small intestine, spleen, lymph node, arteries, veins, skeletal muscle, heart, skin and fetal tissues were negative for tumor-associated antigens. Mucous substances and Panet's granular cells in colon mucosa showed nonspecific binding suppressible by addition of normal human serum. Adenocarcinoma of the stomach, colon, pancreas or breast did not demonstrate cross-reactivity with the antibodies to RCC. These monoclonal antibodies apparently recognize a tumor-associated antigen possibly specific for RCC. They could prove to be potent tools in the search for specific tumor markers applicable in the early diagnosis of the disease and immunotargeting cancer therapy.

Animals↗
PubMed1985

The Mainz pouch (mixed augmentation ileum 'n zecum) for bladder augmentation and continent urinary diversion.

A new technique for fashioning an ileocecal pouch, applicable for both bladder augmentation and continent urinary diversion, is described. A low pressure reservoir is achieved by antimesenteric longitudinal transsection of ileum and cecum and formation of a pouch from the cecum and two ileal loops. The antireflux procedure consists of submucosal tunnel implantation of the ureters into the cecum. Clinical application of the operative technique in 4 cases for bladder augmentation and in another 6 cases for urinary diversion has proven the validity of our functional concept: all patients with Mainz pouch bladder augmentation are completely dry day and night with normal intervals of bladder evacuation. Of the 6 patients with Mainz pouch urinary diversion, 2 rely on a an all alloplastic stomal prosthesis for continence, another 2 have achieved continence with isoperistaltic ileo-ileal invagination, and the remainder are awaiting implantation of a sphincteric device.

Adult↗
PubMed1985

Long-term endocrine profiles of prostatic carcinoma patients under pernasal as well as intramuscular Gn-RH analogue treatment.

The treatment with supraphysiological doses of the gonadotropin releasing hormone analogue Buserelin results in the suppression of serum testosterone to castration range with a probability of 95% after 28 days. This decrease is paralleled by a decline of the intracellularly active androgen dihydrotestosterone, a decrease of the unbound fraction of testosterone and a drop of the production rate of testosterone to values as low as after bilateral orchiectomy. The adrenal steroids androstenedione, DHEA-S and cortisol and the non-steroidal hormones prolactin and thyroxin are not affected by Gn-RH analogue treatment. The beneficial effect of Buserelin in the treatment of prostatic carcinoma is due to medical castration only. Further improvement, regarding practicability and cost effectiveness can be expected by intramuscular depot preparations.

Administration, Intranasal↗
PubMed1985

Intravesical adriamycin instillations--what happens to the drug?

Intravesical instillations of ADM have local and systemic effects: Locally a chemocystitis can be seen with a frequency of 10 - 40%. It can usually be treated conservatively and only rarely the therapy has to be discontinued. Urothelial dysplasia, proliferation and - in rats - the development of epithelial bladder tumors following repeated instillation need further investigations. ADM is absorbed mainly by exophytic tumors with a large surface area and changes in membrane characteristics and - less - by the normal urothelium and solid tumors. Whether the local cellular uptake of ADM can be enhanced by the use of adjuvant substances such as surfactants, enzymes or detergents is presently subject of animal investigations (Engelmann 1984). Systemically neither in animal studies nor in investigations in humans relevant concentrations are detected so that untoward side effects like cardiotoxicity will not occur. The increase in absorption that has been documented due to TUR or cystitis does not lead to a clinically significant rise of serum concentrations.

Absorption↗
PubMed1984

Digital subtraction angiography in staging renal cell carcinoma: comparison with computerized tomography and histopathology.

Digital subtraction angiography was compared to computerized tomography and histopathological findings for staging renal cell carcinoma in 24 patients. Injection of contrast material through a 16 gauge angiocatheter into the femoral vein provided digital subtraction cavography, digital subtraction arteriography and excretory urography during 1 investigation. Computerized tomography established the diagnosis in all patients, while digital subtraction angiography showed all angiographic signs of renal cell carcinoma in 14 (58 per cent). T staging was correct on computerized tomography in 18 patients and on digital subtraction angiography in 16. Absence or presence of venous involvement was indicated correctly by computerized tomography in 20 patients and by digital subtraction angiography in 21. In small tumors the combination of ultrasonography, digital subtraction angiography and excretory urography is sufficient for an operation. In all other tumors digital subtraction angiography cannot replace computerized tomography but adds useful information about arterial distribution, possible venous tumor thrombus and the anatomical relationship of vessels.

Angiography↗
PubMed1984

Fibrinogen degradation products in urological malignant tumors.

Fibrinogen degradation products (FDP) were determined in a series of 98 patients with malignant urological tumors using a staphylococcal clumping test. The results are compared with the FDP of 61 urological patients without malignant tumors. No difference between the series of radically operated tumor patients and the control group could be found. The FDP in a series of patients with persistent tumors were clearly higher than those of the control group: especially the results for patients with renal cell carcinoma were significantly higher. The highest concentration of FDP was found in patients with metastases. Therefore, FDP in serum could be a possible tumor marker for patients with renal cell carcinoma.

Adenocarcinoma↗
PubMed1984

[The effect of cisplatin on the healing of intestinal anastomosis in the rat. Microangiography and light microscopy studies].

The influence of a single dose cisplatin on wound healing of enterostomies in rats was investigated by measurement of the wound-breaking strength, microangiographically and histologically. Cisplatin (5 mg/kg body weight) was given on day-1 or day-5 preoperatively. Cisplatin led to a significant reduction of the wound-breaking strength, mostly marked on day +14 after operation. The reasons are: a reduced induction of connective tissue proliferation; an inhibition of proliferation of fibroblasts and endothelial cells, and a retardation of vessel proliferation.

Animals↗