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J Jeekel

Publications and source records attributed to J Jeekel.

At least 127 records · Page 7Linked to original sources
PubMed1990

Solitary malignant Schwannoma: clinical aspects, immunohistochemistry and ultrastructure.

Solitary malignant Schwannoma is a rare tumor derived from cells of the nerve sheath, the Schwann cells. During the past 6 years we have treated six patients with this tumor, four males and two females ranging in age from 18 to 69 years. Five of them had their tumors located on the trunk, which is associated with a bad prognosis. In four of the six patients ultrastructural examination played an important role in making the diagnosis of malignant Schwannoma. Light microscopy alone is insufficient because the spindle-shaped cells growing in fascicles often closely resemble other sarcomatous tumors. Ultrastructural typical findings of Schwannomas are cytoplasmic processes, intercellular junctions and basal lamina. Surgery was the sole treatment in three patients. One patient only received chemotherapy because of disseminated disease. The other two were treated with surgery combined with radiotherapy. Four patients developed distant metastases for which chemotherapy was given, but all patients died within 3 years after their initial treatment. Only two patients are free of disease 56 and 72 months after treatment. Solitary malignant Schwannoma is a tumor with a grave prognosis, for which ultrastructural and immunohistochemical examination plays an important role in order to establish the diagnosis.

Adult↗
PubMed1989

[Analysis of the surgical treatment of pancreas head and peri-ampullary carcinoma in 236 patients].

Between 1978 and 1987, 236 patients were admitted for cancer in the pancreas or periampullary region. In 93 patients a resection of curative intent was performed, while 88 patients underwent a palliative procedure and 55 patients no operation. The operative mortality was 9%. In the complete group of patients, age above 70 years and preoperative jaundice were of prognostic significance. A tumour size greater than 3.5 cm after resection implies a better prognosis than tumours less than 3.5 cm. The 1-, 3- and 5-year survival rates of the resected patients with pancreatic head cancer were 59%, 12% and 8% respectively, those of patients with periampullary cancer 90%, 49% and 30% respectively. After a palliative procedure or only a laparotomy survival was significantly lower (p less than 0.001), with 1-year survival of 16% and 2-year survival of 4%. After resection of curative intent for cancer of the head of the pancreas 21 cases still had microscopical remnants of tumour (T3, N1b). Survival of these patients was not significantly different from that of patients with a curative resection. Surgical resection for cancer of the head of the pancreas has to be considered as a mainly palliative treatment, but given low operative mortality (less than 10%) it is still the treatment of choice to gain longer survival and in some cases definitive cure.

Adult↗
PubMed1989

[Surgical therapy of colon carcinoma with local invasion: a useful treatment?].

From 1977-1984, 56 patients with colon cancer adherent to other organs were operated. Twenty-three patients (41%) underwent palliative treatment without resection. The mean survival in this group was 6 months. In this retrospective study the results were analysed of 33 patients (59%) who underwent a resection with curative intent. Pathological staging was based on the Dukes, Astler & Coller classification. The 4-year survival rate was as follows: Dukes B 47%, Dukes C 29%, Dukes D 0%. The 4-year survival rate for the whole group was 33%. The postoperative morbidity and mortality were 6% and 3% respectively. Colon cancer with involvement of adjacent structures should not be regarded as an incurable Dukes D cancer: extended resection is indicated.

Colonic Neoplasms↗
PubMed1989

Anti-tumor effect of recombinant murine TNF-alpha (rMuTNFa) given by continuous i.v. infusion as compared to repeated i.v. injections in a rat liver metastasis model.

Anti-tumor effects of TNF in animal models are well documented. Therapeutic use of TNF, however, is hampered by its toxicity. In rats a single intravenous (i.v.) injection of 40 micrograms/kg is lethal. When given by continuous i.v. infusion, much higher doses are well tolerated. To compare the therapeutic efficacy of rMuTNF given either as repeated i.v. injections or as a continuous infusion, we have used a liver metastasis model (tumor CC531). The number of liver metastases at day 28 after tumor inoculation served as a parameter. The route of administration, administration schedule and dose, did, in general, not influence the effect produced by rMuTNFa. Only early continuous infusion had an effect on the number of liver metastases. A sublethal dose, given as a late continuous infusion, had no significant effect. It thus appears that rTNFa, even when administered at high doses, is not a very efficient anti-tumor agent. Attention should rather be focused on the use of rTNFa in combination with other substances, for example, interferons.

Adenocarcinoma↗
PubMed1989

Sutureless large bowel anastomosis: European experience with the biofragmentable anastomosis ring.

Sutureless colonic anastomosis using a biofragmentable anastomosis ring (BAR) has been evaluated in a prospective randomized comparison with sutures and staples for elective colorectal surgery. One hundred and one patients underwent BAR anastomosis, 85 a sutured anastomosis, and 16 a stapled anastomosis. There were two anastomotic leaks in the patients undergoing BAR anastomosis, seven in patients having a sutured anastomosis, and one in a patient who had a stapled anastomosis. Wound infection occurred in ten BAR patients, ten sutured patients and no stapled patient. There was no statistically significant difference in these or in other postoperative complications between the groups. The BAR was easy to use and is a safe alternative to sutures and staples for large bowel anastomosis.

Adolescent↗
PubMed1989

Adjuvant chemotherapy after resection of adenocarcinoma of the periampullary region and the head of the pancreas. A non-randomized pilot study.

From 1980 till 1984 16 patients were entered into a non-randomized pilot study, to investigate the feasibility of five courses of adjuvant 5-fluorouracil, Adriamycin and mitomycin C (FAM) after a curative resection of pancreatic or periampullary cancer. The survival of this group of patients was compared with that of 36 patients who underwent a curative resection alone between 1977 and 1984. Four patients received less than 20%, 4 patients 50%-60% and 7 patients greater than or equal to 80% of the calculated dose of adjuvant chemotherapy. The chemotherapy was badly tolerated. Only 1 patient resumed some of his normal activity during chemotherapy. The 3-year actuarial survival after curative resection with and without FAM was similar, i.e. 24% and 28% respectively. These data suggest that adjuvant FAM after a Whipple's operation or total pancreatectomy is not feasible because of additive postoperative and chemotherapy-induced morbidity.

Activities of Daily Living↗
PubMed1989

Treatment of colon cancer in rats with rMuTNF and the interferon-inducer bropirimine.

It is well documented that the antitumor activity of tumor necrosis factor (TNF) is improved by interferons (IFN's). Bropirimine (BP) is an immune response modifier which induces IFN. Both TNF and BP have the capacity to inhibit the growth of a transplantable colon tumor (CC531) in inbred WAG rats. In the present study their combined use was investigated in a one-week assay, with the tumor implanted under the renal capsule. The results indicate that BP, given on days 0 and 1, and 1 microgram TNF on days 0, 2 and 4 act additively, leading to an almost complete inhibition of tumor growth.

Animals↗
PubMed1989

Prevention of cytomegalovirus-related death by passive immunization. A double-blind placebo-controlled study in kidney transplant recipients treated for rejection.

In a double-blind placebo-controlled study, the value of prophylactic anti-CMV immunoglobulin administration was evaluated in 39 kidney transplant recipients treated for rejection with rabbit antithymocyte globulin. Passive immunization completely prevented CMV-related death, although it did not reduce the incidence of CMV isolation, viremia, or disease. The effect of passive immunization was exclusively observed in CMV-seronegative recipients of a CMV-seropositive kidney donor. It could be demonstrated even when instituted when antirejection therapy was started. Seropositive recipients did not benefit from immunoglobulin treatment. Moreover, CMV-seronegative recipients of a kidney from a seronegative donor were not at risk for CMV infection at all. Therefore passive immunization should be restricted to seronegative recipients of seropositive allograft donors treated for rejection.

Antibodies, Viral↗
PubMed1989

Increase of major histocompatibility complex class II--positive cells in cardiac allografts by interferon-gamma has no impact on graft survival.

The present study was initiated to study the efficacy of donor pretreatment with interferon-gamma to induce class II antigen expression in heart tissue, and to investigate whether this pretreatment would influence heart allograft survival. BN rats were used as donors, and LEW rats as recipients. During a period of 3 consecutive days prior to transplantation, IFN-gamma was administered to BN rats via continuous intravenous infusion at dosages of 10(3), 10(4), and 5.10(4) U/hr. Control animals were infused with PBS; each group consisted of 9 animals. Analysis of IFN-gamma induced class II expression by immunoperoxidase staining revealed a significant, fourfold increase in the number of dendriticlike cells, irrespective of the IFN-gamma dose given (controls: 15 +/- 4 vs. highest dose group: 57 +/- 9 cells/mm2; P less than 0.005). Endothelial cells of arteries and venules remained class II antigen negative. Grafting of hearts from IFN-gamma perfused donors to untreated recipients (6 animals per group), did not result in a shortened or prolonged survival time in any of the experimental groups, as compared to controls. These results indicate that upgrading of class II antigen expression on dendriticlike cells is not likely to be of importance for the process of rejection.

Animals↗