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Biomedical subjects

J Jeekel

Publications and source records attributed to J Jeekel.

At least 235 records · Page 13Linked to original sources
PubMed1984

Clinical judgment versus delayed hypersensitivity skin testing for the prediction of postoperative sepsis and mortality.

In 59 patients operated upon for malignant disease of the gastrointestinal tract, skin testing with recall antigens was compared with assessments based upon clinical judgment alone for prediction of risk of postoperative septic complications. Clinical judgment alone could identify patients with a significantly increased risk for postoperative sepsis and mortality. Prediction based upon clinical judgment is superior to prediction based upon delayed hypersensitivity skin testing.

Adult↗
PubMed1983

Effect of treatment with interferon and cyclophosphamide on the growth of a spontaneous liposarcoma in rats.

A spontaneous non-immunogenic transplantable liposarcoma in BN rats was found to be sensitive to the antitumor effects of rat fibroblast interferon (RIF) when it was administered from the day of tumor implantation onwards. Treatment with RIF starting at 7 days after implantation was not effective. Tumor growth was markedly inhibited by cyclophosphamide (Cyclo). At the time and dose schedules used, Cyclo was more effective than RIF. When the growth of the tumor was inhibited by Cyclo, subsequent treatment with RIF did not lead to an additional retardation of tumor growth. Administration of RIF interfered with the beneficial effect of Cyclo when both agents were given concomitantly. RIF and Cyclo gave similar results to those obtained with RIF alone and these were inferior to those obtained with Cyclo alone.

Animals↗
PubMed1983

Modification of allograft survival in rats by blood transfusion to the donor.

In the BN/Ro-to-WAG/Ro rat donor-host combination, third-party blood transfusions given to the donor shortly before transplantation can markedly influence heart allograft survival if the immune response of the recipient has been modulated. The WAG recipients were either transfused with BN donor blood, which leads to a permanent graft survival, or postoperatively treated with a single i.m. injection of 15 mg/kg cyclosporine, which leads to a moderate prolongation of graft survival. In the transfused recipients, blood transfusions to the donor had a detrimental influence on graft survival. In the cyclosporine-treated recipients, blood transfusions to the donor had a beneficial effect. There was no significant difference in graft survival after a single transfusion or multiple transfusions to the donor. Recipient-type blood transfusion to the donor did not influence graft survival, nor did irradiated third-party blood or third-party erythrocytes. However, third-party leukocyte suspensions had a significant influence on heart allograft survival. It is concluded that third-party viable leukocytes are responsible for the induction of the donor transfusion phenomenon. It is also postulated that the third-party leukocytes interact with the dendritic cell population of the graft, leading to a reduction in its immunogenicity.

Animals↗
PubMed1983

Auxiliary transplantation of a partial liver graft in the dog and the pig.

Auxiliary, heterotopic transplantation of 60% of the liver was performed in 24 beagles and 24 pigs. Operative mortality was low and graft survival was greatly improved by DLA-matching in the dog. The graft supplied by arterial and portal blood gave excellent metabolic support after the host liver was rendered ischemic by six hours clamping of the hepatic artery.

Animals↗
PubMed1983

Surgical treatment of chronic pancreatitis by distal pancreatectomy.

No consensus exists on the best surgical treatment for chronic pancreatitis. In a retrospective study on 29 patients it was found that pain caused by chronic pancreatitis can be treated effectively by a 95% DP or a 40-80% DP. However, after a 40-80% DP the incidence of endocrine and exocrine pancreatic insufficiency is less frequent than after a 95% DP. Therefore, distal pancreatectomy can be advised as a treatment of pain, caused by chronic pancreatitis. In order to minimize the chance of pancreatic insufficiency resection should be done as conservatively as possible.

Chronic Disease↗
PubMed1983

Ultrasound-guided percutaneous drainage of 25 abscesses.

Twenty-four confirmed well-defined abdominal abscesses and one abscess in the thorax were percutaneously drained in 21 patients. In all, 28 puncture and drainage procedures were performed. Nineteen abscesses were drained without further surgery (76%). The high success rate, combined with minimal complications and low overall mortality (9.5%), indicates that ultrasound-guided percutaneous drainage is probably the method of choice in the treatment of well-defined, unilocular abscesses, avoiding the risk of major surgery.

Abdomen↗
PubMed1982

Operative approach to cancer of the head of the pancreas and the peri-ampullary region.

A retrospective study was made of 75 consecutive patients treated for a tumour of the head of the pancreas and the peri-ampullary region from January 1978 to August 1981. These patients underwent either pancreatic resection--pancreatoduodenectomy (n = 24) and total pancreatectomy (n = 10)--palliative procedures (n = 29) or exploratory laparotomy (n = 12). Clinical signs and diagnostic procedures, such as ultrasonography and coeliac arteriography, were studied for their value in preoperative assessment of operability. Vaso-invasion, as revealed by arteriography and, to a lesser extent, ultrasonographic signs of a tumour and the absence of jaundice were poor prognostic signs. The operative mortality was 8 per cent for the group as a whole, but somewhat higher (13 per cent) for the group that underwent pancreatoduodenectomy. No patient died after total pancreatectomy. The operative mortality was 27 per cent in all patients aged 70 years or older, but only 3 per cent in patients under 70 years. One-year patient survival was 94 per cent after pancreatoduodenectomy for peri-ampullary cancer and 57 per cent after resection for cancer of the head of the pancreas. The results of this study point to pancreatic resection as the treatment of choice for resectable tumours of the peri-ampullary region and the head of the pancreas in patients under 70 years of age. Coeliac arteriography and ultrasonography have been found to be useful for preoperative classification of tumour stage.

Adenocarcinoma↗
PubMed1982

Adverse effect of pretransplant blood transfusions on survival of matched kidney allografts in dogs.

Previous studies from our laboratory have already shown that pretransplant blood transfusions from third-party donors significantly prolong kidney allograft survival in mismatched unrelated immunosuppressed dogs. In the present study, a similar effect was found in related donor-recipient pairs mismatched for two haplotypes (P less than 0.05); no significant effect was observed in one-haplotype-mismatched combinations (P = 0.34). Pretransplant blood transfusions did not have a beneficial influence on kidney allograft survival in immunosuppressed DLA-identical, related donor recipient pairs. After withdrawal of immunosuppressive therapy, transfused dogs in this group rejected their kidneys even more frequently than did nontransfused dogs (P = 0.16). A comparable undesired effect of blood transfusions was found for recipients of unrelated kidneys which were identical with respect to DLA-A, B, and D: transfused recipients of those kidneys rejected the graft significantly more often than the untransfused controls (P less than 0.01). The most likely explanation for this adverse effect is that blood transfusions given to the recipient may cause crossimmunization for undefined, probably minor, antigens of the donor kidney. Apparently, differences arising from these minor histocompatibility antigens become manifest only after withdrawal of the immunosuppressive therapy. Furthermore, it appeared that the effect of histocompatibility matching on kidney allograft survival is less for transfused than for untransfused dogs. The most important conclusion is, however, that the beneficial effect of blood transfusions appears to be dependent on the degree of matching: while blood transfusions are on the whole beneficial for unmatched kidneys, they are likely to have no effect, or even to be harmful, for matched kidneys.

Animals↗
PubMed1982

Effect of blood transfusions on canine renal allograft survival.

In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Furthermore, no improvement in graft survival has been found after a peroperative transfusion of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion or irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

Animals↗
PubMed1982

Cell-mediated cytotoxicity toward canine kidney epithelial cells.

Cellular cytotoxicity toward kidney cell targets has been studied in a model using in vitro cultured canine kidney cells obtained after perfusion trypsinization of kidneys from one-haplotype-mismatched beagles. To study whether cytotoxic effector cells recognize identical antigens on kidney cells as on phytohemagglutinin (PHA)-stimulated lymphoblasts, adsorption studies with different monolayers have been performed. Both leukocyte and kidney cell monolayers reduced cytotoxicity against 51Cr-labeled PHA-stimulated lymphoblasts very effectively. The average reduction of cytotoxicity was 86% in six consecutive experiments after one adsorption on either one of these two types of target-specific monolayers. Nonspecific monolayers reduced cytotoxicity only for 13%. Specific kidney cell monolayers reduced cytotoxicity against kidney cells almost completely, however leukocyte monolayers reduced cytotoxicity toward kidney cells for only 40%. There results and cold target inhibition data strongly suggest that kidney cells present antigens to which a selective population of cytotoxic T lymphocytes (CTLs) is directed. These CTLs are not cytotoxic for PHA-stimulated lymphoblasts. It is discussed whether the relevant antigens on the kidney cells are organ-specific antigens comparable to the endothelial monocyte antigen system as described by Moreas and Stastny or that class II antigens are involved in cytotoxicity toward kidney cells.

Animals↗
PubMed1982

Lymphocyte stimulation by canine kidney cells.

Lymphocyte stimulation in mixed kidney cell-leukocyte cultures (MKLC) has been investigated in a canine model. Canine kidney cells were obtained by perfusion trypsinization. Cultured kidney cells, which appeared to be of epithelial origin by several criteria, have been used as stimulator cells. Maximal stimulation was obtained in the MKLC and mixed leukocyte culture (MLC) at stimulator to responder (S:R) cell ratios of 1:20 and 1 1/2:1, respectively. Lymphocyte proliferation has been observed in cultures with kidney cells in S:R cell ratios lower than 1:20. Stimulation has not been observed in MLCs at these low ratios. The addition of graded numbers of kidney cells of the responder to a one-way MLC inhibited the response gradually. The fact that kidney cells have both strong stimulator capacities and inhibitor capacities could explain the lower optimal S:R ratio. Lymphocyte stimulation has not been obtained in mixed kidney leukocyte cultures between major histocompatibility complex (MHC)-identical closely bred animals. The nature of the antigens present on canine kidney epithelial cells stimulatory to allogeneic lymphocytes is discussed.

Animals↗
PubMed1982

The effect of cyclosporin A and blood transfusions on cardiac allograft survival in rats.

Blood transfusions may have a beneficial or deleterious effect on graft survival. The purpose of the present study was to see whether cyclosporin A (CyA) could overcome the sensitizing effect of pretransplant blood transfusions and whether it would alter the beneficial effect of blood transfusions. Therefore, the effect of CyA was studied in transfused and nontransfused recipients by use of a rat cardiac allograft model. The BN/Ro and Wag/Ro strains were used. Each strain rejects a heart allograft from the other in 8 to 9 days when nontransfused recipients are involved. After conditioning with one donor-specific pretransplant blood transfusion, accelerated rejection is seen in the Wag/Ro to BN/Ro combination, whereas indefinite survival occurs in the reverse combination. CyA treatment results in indefinite graft survival in nonsensitized recipients of both strains but at a lower dosage in the BN/Ro to Wag/Ro combination. In transfused BN/Ro recipients, CyA prolongs heart allograft survival indefinitely, although higher doses are required (15 mg/kg) than in nonsensitized recipients; in the reverse combination, CyA does not interfere with the beneficial blood transfusion effect. The findings that CyA can prevent accelerated rejection in the Wag/Ro to BN/Ro combination and that it does not alter the beneficial effect in the reverse combination might mean that CyA is a useful drug even in sensitized recipients.

Animals↗
PubMed1982

Expression of beneficial blood transfusion effect in dogs is dependent upon immunosuppressants used.

To achieve the beneficial blood transfusion effect, postoperative immunosuppression with Aza/Pred is mandatory. When CY-A is used for immunosuppression during a limited time, the transfusion effect is not manifested; however CY-A does not lessen the effect in animals given Aza/Pred. In nontransfused recipients, the combination of Aza/Pred and CY-A did not give better graft survival than CY-A alone.

Animals↗
PubMed1981

A study on the mechanism of donor pretreatment: effect of procarbazine hydrochloride and methylprednisolone in immunocompetent cells.

Significantly prolonged canine renal allograft survival can be obtained by donor pretreatment with procarbazine hydrochloride and methylprednisolone. This is thought to be caused either by a reduced antigenicity of the graft or by a local immunosuppressive effect by drugs transplanted with the graft. In this study a decrease in the number of peripheral donor T and B lymphocytes was observed at the time of procuring. Leukocytes harvested from dogs pretreated with a combination of procarbazine hydrochloride and methylprednisolone showed a decrease in their ability either to stimulate or respond to mixed leukocyte cultures (MLCs). Complete restoration of MLC responses was obtained however by purification and washing of these leukocytes. Sera of pretreated animals were not able to reduce MLC responses. It was concluded that drug metabolites in or on the cells were apparently responsible. A local inhibition of the immunocompetence of host lymphocytes by small amounts of transplanted drug metabolites in or on the graft cells might be responsible for the beneficial effect of donor pretreatment with procarbazine hydrochloride and methylprednisolone. Furthermore, this postulation explains the abrogation of prolonged survival of pretreated grafts after systemic administration of nontreated donor blood or donor leukocyte-free blood, as we reported earlier.

Animals↗
PubMed1981

Pretransplant blood transfusions can harm matched kidneys in dogs.

The effect of pretransplant blood transfusion (PBT) and histocompatibility matching on kidney allograft survival was studied in immunosuppressed dogs. PBT was found to be beneficial for related and unrelated mismatched kidney grafts. In contrast, after withdrawal of the immunosuppressants, transfused recipients of related and unrelated matched grafts rejected the kidney significantly more often than non-transfused dogs. Crossimmunisation for minor histocompatibility antigens may be responsible for this adverse effect, but could not be demonstrated in vitro by serology or mixed lymphocyte reactions. The possible deleterious effect of PBT in this model argues against the routine use of pretransplant blood transfusions in man.

Animals↗