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Biomedical subjects

J Jeekel

Publications and source records attributed to J Jeekel.

At least 217 records · Page 12Linked to original sources
PubMed1985

Effects of treatment with azathioprine and cyclosporin A on interferon-gamma production by peripheral blood leukocytes of renal allograft recipients.

We have studied the concanavalin A (ConA)-induced interferon gamma (IFN-gamma) production of peripheral blood mononuclear cells (PBMC) of renal allograft recipients. Both under immunosuppressive treatment with azathioprine and with cyclosporin A (CsA) the PBMC of these patients proved deficient for IFN-gamma production when compared to those of healthy controls. After conversion from conventional azathioprine to CsA medication the ConA-induced IFN-gamma production increased.

Azathioprine↗
PubMed1985

Biliary drainage by ultrasound-guided puncture of the left hepatic duct.

Percutaneous transhepatic biliary drainage under ultrasonic guidance was performed in 38 patients with obstructive jaundice due to malignancy (49 intubations). The method was used for palliation in 33 patients and for pre-operative drainage because of cholangitis in five patients. Puncture of the left lobar ducts was the method of choice (35 patients). Only in cases of poor visualisation of the left biliary ducts was right-sided drainage performed (three patients). Combined left- and right-sided drainage was necessary in nine patients. All attempts with ultrasound-guided punctures were successful. There were no complications related to the punctures. Delayed complications were cholangitis (10 patients) and bleeding (one patient). The advantages of the method compared with conventional percutaneous transhepatic biliary drainage and the advantages of the left liver lobe drainage are outlined.

Adenoma, Bile Duct↗
PubMed1985

Percutaneous transhepatic cholecystostomy.

Ultrasound-guided percutaneous cholecystostomy was performed in 11 patients. Indications were acute cholecystitis in 7 patients, and obstructive biliary disease in 4 patients. A transhepatic approach was used in all patients. In one patient, bile leakage was noticed during cholecystectomy. No other complications were seen. Three of five patients with a acalculous cholecystitis had a normal post-drainage cholangiogram and the drainage catheter could be removed. A follow-up of 5.5, and 26 months respectively, showed no recurrent disease. Three patients underwent surgery and the remaining five patients were drained until death by their underlying disease. Percutaneous cholecystostomy can be a life-saving and curative procedure in the critically ill patient, and, in case of acalculous cholecystitis, the only one needed.

Acute Disease↗
PubMed1985

Long-term survival of auxiliary partial liver grafts in DLA-identical littermate beagles.

Auxiliary heterotopic transplantation of 60% of the liver in the beagle, using a technique in which all requirements for optimal graft survival are met, is described. The autologous liver is left in situ. Transplants were performed in non-tissue-typed and matched donor-recipient combinations. Postoperatively the recipients were treated with a standard schedule of 2 mg azathioprine and 1 mg prednisolone i.v. daily for 75 days--thereafter, the immunosuppressive drugs were gradually withdrawn. HIDA-hepatobiliary scanning proved to be useful for the assessment of graft function. In eight non-tissue-typed donor-recipient combinations, median graft survival was 7 days, most transplants being subject to acute rejection. However, in nine experiments in which donor and recipient were DLA-identical littermates, the median graft survival was 112 days (P less than 0.005). In these animals signs of chronic rejection developed after tapering the immunosuppressive drugs. It is concluded that, in this model, graft survival is improved by histocompatibility matching. The feasibility of partial heterotopic liver transplantation indicates that this method must be reconsidered for clinical application, especially for patients with acute liver failure. For the recipient, it is a relatively minor operation that--by its temporary life sustaining function--may allow for the regeneration or restoration of function of the recipient's own liver.

Animals↗
PubMed1985

Leukocyte adherence inhibition, natural killer cell activity, gamma-interferon production capacity and phytohemagglutinin response in patients treated with recombinant leukocyte A interferon.

10 patients with disseminated colorectal cancer were treated either chronically or cyclically with human recombinant leukocyte A interferon (IFl-rA) for 3 months. During this period, leukocyte adherence inhibition (LAI), natural killer (NK) cell activity, concanavalin A-induced gamma-interferon production capacity (GIPCA) and phytohemagglutinin response were sequentially monitored. In both chronically and cyclically treated patients, IFl-rA therapy led to a 'short-lived' augmentation of NK cell activity. In the chronically treated patients, there was a further depression in the NK cell activity during the course of therapy. The outcome of LAI remained unaltered irrespective of the mode of IFl-rA therapy. There was an inverse correlation between GIPCA and phytohemagglutinin response.

Aged↗
PubMed1985

Phase II trial of high-dose recombinant leukocyte alpha-2 interferon for metastatic colorectal cancer without previous systemic treatment.

Ten patients with metastatic colorectal cancer after resection of the primary tumor were treated with high-dose recombinant leukocyte alpha-2 interferon. For a period of 12 weeks the patients received up to 20 X 10(6) IU/m2 im twice weekly. Follow-up varied from 6 to 11 months after stopping treatment. All ten patients were evaluable for tumor response and toxicity. There was one partial response. Nine patients showed growth of metastatic marker lesions. Only three of these patients qualified as having progressive disease (greater than 25% increase in tumor mass). The response rate was 10%, with a 95% confidence interval of 0.3%-44.5%. Toxicity proved considerable and consisted of flu-like symptoms, fatigue, anorexia, and weight loss. Fatigue was the single most important dose-limiting factor. There were no drug-related deaths. Three patients died 3, 5, and 7 months after stopping treatment. Median survival was 18 months.

Aged↗
PubMed1985

Auxiliary transplantation of part of the liver improves survival and provides metabolic support in pigs with acute liver failure.

In pigs subtotal ischemic liver cell necrosis was induced 4 days after auxiliary transplantation of 60% of the liver of an MLC-compatible donor (ATPL group, n = 13). In control animals (n = 14) temporary liver ischemia was preceded by division of the hepatic ligaments and creation of an end-to-side portacaval shunt. In the ATPL group six animals died of gastric hemorrhage, intestinal strangulation, or sepsis. The remaining seven animals survived in excellent condition until sacrifice 26 days after the induction of liver ischemia. Excellent graft function was demonstrated by uptake and excretion of 99mTc-HIDA at cholescintigraphy, ammonia detoxification, synthesis of clotting factors and glucohomeostasis. EEG recordings in the animals that underwent transplantation did not change from preischemic levels. Evidence of hepatic regeneration was found in the transplanted livers but could not be demonstrated in the damaged host livers. The control animals died in coma within 72 hours. These results indicate that auxiliary transplantation of a partial liver provides metabolic support and improves survival in animals with induced acute liver failure.

Acute Disease↗
PubMed1985

Infections after transplantation of a contaminated kidney.

In a retrospective study of 350 consecutive cadaver renal transplants, at least 83 (24%) of the donor kidneys were found to be contaminated. This was associated with three perinephric abscesses, one mycotic aneurysm, one pseudomonas sepsis, and four superficial wound infections. As a result, three patients lost their grafts, and one patient died from septic complications. The one year graft survival of the remainder of the recipients of contaminated grafts did not differ from that of the whole series. It is concluded that contamination of donor kidneys is a frequent event, but serious complications are relatively rare.

Bacterial Infections↗
PubMed1985

The influence of preoperative jaundice, biliary drainage and age on postoperative morbidity and mortality after pancreatoduodenectomy and total pancreatectomy.

Details are given of the postoperative course of 56 patients after pancreatoduodenectomy, and 11 after total pancreatectomy. The main indication was adenocarcinoma (56 cases). The most serious complication was leakage from the pancreatojejunostomy, which occurred in nine patients and was fatal in seven of these (10%). This was the only cause of death in the group. The observed mortality was appreciably higher (38%) in the 13 patients aged over 70 years. Contrary to recent reports, jaundice was not found to influence postoperative mortality adversely, nor was preoperative biliary drainage found to reduce mortality.

Adenocarcinoma↗
PubMed1984

Interferon treatment of a transplantable rat colon adenocarcinoma: importance of tumor site.

The effect of partially purified rat interferon ( RIFN ) was evaluated in CC531 colon tumor-bearing rats. Tumor CC531 is a DMH-induced, transplantable adenocarcinoma exhibiting weak immunogenicity. When small tumor fragments were implanted under the renal capsule, daily treatment with RIFN for 5 days led to a highly significant (p less than 0.001) inhibition of tumor growth, measured 7 days after implantation. Cyclic treatment with RIFN (10(5) units/kg/day, for 7 days in weeks 2, 4, 6 and 8) significantly retarded the development of artificial lung metastases, induced by intravenous (i.v.) injection of 5 X 10(5) colon tumor cells. The median survival time was 177 days in the RIFN group as compared to 116 days in the control group. Three of eight animals treated with RIFN showed no sign of lung metastases when they were killed 250 days after tumor cell injection. The same cyclic RIFN treatment which was effective in the lung metastases model had no influence on the growth of liver metastases evoked by the intraportal injection of 5 X 10(5) tumor cells. Laparotomy performed at days 30 and 50 after inoculation revealed equal numbers of liver metastases in the RIFN -treated group and the control group. The mean survival times obtained in the two groups were 96 +/- 20 days and 108 +/- 14 days, respectively (0.05 less than p less than 0.10). The results indicate that (1) there is no inherent resistance of this solid tumor to RIFN therapy and (2) the effect of RIFN treatment is determined by the site of tumor development. The finding that the liver can provide a protective environment against tumor immunity may have important clinical implications.

Adenocarcinoma↗
PubMed1984

Recombinant leucocyte interferon A induces steroid-resistant acute vascular rejection episodes in renal transplant recipients.

In an attempt to determine the safety, tolerance, and prophylactic antiviral activity of high doses of recombinant DNA leucocyte interferon A a double-blind parallel-group study was started in 16 renal transplant recipients. All 16 patients had early rejection episodes. In all 8 interferon-treated patients and 1 placebo-treated patient this rejection, which was of the acute vascular humoral type, was steroid resistant. 3 interferon-treated patients also had transient nephrotic syndrome.

Acute Disease↗
PubMed1984

Detection of liver metastases. A prospective study comparing liver enzymes, scintigraphy, ultrasonography and computed tomography.

A prospective comparative study between liver enzymes, scintigraphy, ultrasonography and computed tomography for detection of liver metastases was performed in 113 patients who were eligible for operation for a carcinoma in the gastrointestinal tract. Twenty-three of the 113 patients (20 per cent) had liver metastases. The accuracy of scintigraphy was 79 per cent, of ultrasonography 85 per cent and of computed tomography 88 per cent. The results of these tests showed no statistical differences. Ultrasonography and computed tomography were significantly more accurate than alkaline phosphatase and gamma-glutamyl transpeptidase (respectively P less than 0.01 and P less than 0.05). Taking into account cost effectiveness, simplicity and patient tolerance, ultrasonography is the test of choice for the detection of liver metastases.

Gastrointestinal Neoplasms↗