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  • 1
    Electronic Resource
    Electronic Resource
    Immunoreactivity of cytokeratins (CK7, CK20) and mucin peptide core antigens (MUC1, MUC2, MUC5AC) in adenocarcinomas, normal and metaplastic tissues of the distal oesophagus, oesophago–gastric junction and proximal stomach (2003)
    Oxford, UK : Blackwell Science Ltd
    Histopathology 43 (2003), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aims:  Adenocarcinomas of the distal oesophagus and especially the oesophago–gastric junction have shown an increasing incidence during the last decade. Definition of subgroups according to different sites of development, histogenesis or aetiology may prove to be valuable for clinical diagnosis and treatment. Previous studies have shown differences in cytokeratin patterns between Barrett's metaplasia of the oesophagus and intestinal metaplasia in the stomach. The aim of our study was to investigate whether the expression of certain cytokeratins (CK7, CK20) and mucins (MUC1, MUC2, MUC5AC) exhibit clear-cut patterns, thus allowing a subclassification of adenocarcinomas of the oesophago–gastric junction. The possibility of a relationship between antigen expression and the presence or absence of Barrett's metaplastic epithelium was also studied.Methods and results:  CK7, CK20, MUC1, MUC2 and MUC5AC were visualized in six adenocarcinomas of the distal oesophagus, 29 adenocarcinomas of the oesophago–gastric junction and eight adenocarcinomas of the proximal stomach. CK7, CK20 and MUC1 were strongly expressed in the great majority of all neoplasms under study, whereas MUC2 and MUC5AC were absent or only faintly detectable. CK20 exhibited a significantly stronger expression in poorly differentiated tumours (G3) and MUC1 immunoreactivity correlated with tubular and papillary versus signet-ring cell histopathology. Other statistically significant correlations between antigens and histopathological features (pTNM stage, grading, histopathological subtype, presence/absence of Barrett's epithelium) were not observed.Conclusions:  According to our results, most adenocarcinomas of the oesophago–gastric junction show a CK7+, CK20+, MUC1+ phenotype irrespective of the presence or absence of Barrett's epithelium. The immunohistochemical data suggest a similar histogenesis of these tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2003.01680.x
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  • 2
    Electronic Resource
    Electronic Resource
    Comparative evaluation of the prognostic value of MUC1, MUC2, sialyl-Lewisa and sialyl-Lewisx antigens in colorectal adenocarcinoma (2002)
    Oxford UK : Blackwell Science Ltd
    Histopathology 40 (2002), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Comparative evaluation of the prognostic value of MUC1, MUC2, sialyl-Lewisa and sialyl-Lewisx antigens in colorectal adenocarcinoma Aims: The significance of MUC1, MUC2 and sialylated Lewis blood group antigens as prognostic markers in colorectal adenocarcinoma was investigated in a large series of patients because previous investigations revealed inconsistent results due to unrelated tumour samples from different patient groups and methodological differences. Methods and results: Tissues from 243 patients with colorectal adenocarcinoma were stained immunohistochemically. MUC1 showed a strong immunoreactivity (in more than 35% of the tumour area) in 32.5%, MUC2 in 51.0%, sialyl-Lewisx in 67.9% and sialyl-Lewisa in 73.7% of the cases, respectively. MUC1 immunoreactivity displayed a significant correlation with tumour progression as reflected by advancing pTNM staging and poor differentiation. MUC2 expression was significantly stronger in mucinous adenocarcinomas. Sialyl-Lewisx immunostaining correlated with the extent of lymph node metastasis as well as low cytological differentiation. According to univariate and multivariate analysis (P 〈 0.0001) only MUC1 reactivity represented a marker of worse survival probability, opposed to the sialylated Lewis antigens that did not exert a predictive value. Conclusions: According to our data, MUC1 and sialyl-Lewisx immunoreactivity exhibit statistically significant correlations with established markers of tumour progression. However, only MUC1 presents as an independent prognostic factor of colorectal adenocarcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2002.01389.x
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  • 3
    Electronic Resource
    Electronic Resource
    Expression of MMP-2 is associated with progression and lymph node metastasis of gastric carcinoma (2001)
    Oxford UK : Blackwell Science Ltd
    Histopathology 39 (2001), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Expression of MMP-2 is associated with progression and lymph node metastasis of gastric carcinoma Aims: One important step in tumour invasion is the penetration of the basement membrane. Matrix metalloproteinases (MMPs) play a key role in the migration of normal and malignant cells through the basement membrane. The aim of this study was to investigate correlations between matrix metalloproteinase 2 (MMP-2) immunoreactivity and currently used classification systems and possible relationships between lymph node metastasis and MMP-2 expression. Methods and results: This prospective study analysed specimens obtained from 114 gastric cancer patients (mean age 64 years; range 33–86 years) who underwent gastrectomy with extended lymphadenectomy. All specimens were categorized according to UICC classification, WHO classification, tumour differentiation, Laurén classification, Ming classification and Goseki classification. Formalin-fixed paraffin-embedded tumour specimens were stained using an avidin–biotin complex peroxidase assay. MMP-2 expression in the tumour epithelium was studied by immunohistochemistry with semiquantitative (score 0–3) evaluation. The MMP-2 staining pattern was positive (score 1–3) in 93 (81.6%) specimens and negative (score 0) in 21 (18.4%) samples. No significant correlations were found between MMP-2 expression and other variables such as age, tumour differentiation, WHO, Lauren, Goseki, and Ming classifications. In contrast, the intensity of MMP-2 staining in tumour cells correlated significantly with depth of tumour infiltration (T-stage), lymph node metastasis (N-stage), distant metastasis (M-stage), and UICC stage. Conclusions: Expression of MMP-2 is strongly associated with tumour progression and lymph node metastasis in gastric cancer. Therefore MMP-2 staining may be clinically useful as predictor of tumour progression, especially for lymph node metastasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2001.01306.x
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  • 4
    Electronic Resource
    Electronic Resource
    Perioperative treatment with Filgrastim stimulates granulocyte function and reduces infectious complications after esophagectomy (2000)
    Springer
    Annals of hematology 79 (2000), S. 143-151 
    Details
    ISSN: 1432-0584
    Keywords: Neutrophil function ; Esophageal cancer ; Filgrastim ; Infection ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: n =27) were measured on days −2, 2, and 10. Neutrophil function was enhanced in the Filgrastim-treated group by factor 1.2 for phagocytosis (p=0.016) and 1.4 for oxidative burst (p=0.154). Leukocyte counts increased from 7.6×109/l (day −2) to a maximum of 45×109/l on day 6. No infection was reported in the study group (mean age 59.7 years; 13 men, seven women) up to 10 days after surgery. In contrast, 23 patients (29.9%) in a historical control group (mean age 56 years; 67 men, ten women) treated at the same center developed infections within the first 10 days (p=0.008). In addition, no postoperative deaths occurred in the study group, compared with 9.1% in the group of historical controls. Thus, in this study, administration of Filgrastim stimulated neutrophil function in patients undergoing esophagectomy, and it might be effective in reducing infectious complications related to the surgical procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050570
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  • 5
    Electronic Resource
    Electronic Resource
    Surgical therapy of Zenker's diverticulum: Low risk and high efficiency (1990)
    Springer
    Dysphagia 5 (1990), S. 13-19 
    Details
    ISSN: 1432-0460
    Keywords: Zenker's diverticulum ; Cervical myotomy ; Diverticulectomy ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgery for the treatment of Zenker's diverticulum was performed at our institution in a total of 43 patients over 6½ years. Cervical myotomy with diverticulectomy was performed in 32 of the patients and myotomy alone in 11. Mortality totaled 0%, with a reversible lesion of the recurrent nerve occurring in 7%. In 60% of the cases investigated preoperatively (N=40), motility disorders of the upper esophageal sphincter (UES) could be demonstrated using manometry as well as with cineradiography in 92% of the patients. Follow-up studies in 39 of the cases 25 months (mean) postprocedure indicated 82% of the patients to be symptom-free, with the remaining 18% demonstrating a marked improvement. Postoperative manometry as well as cineradiography carried out in 12 patients revealed the presence of UES motility dyscoordination in 8% and 25%, respectively. There were, however, no signs of recurrence of the diverticulum. The high number of patients in our study group demonstrating motility disorders of the UES emphasizes the need for cervical myotomy as part of the surgical therapy for Zenker's diverticulum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02407389
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  • 6
    Electronic Resource
    Electronic Resource
    The role of esophageal motility in gastroesophageal reflux disease: Technique and clinical results of ambulatory 24-hour Mano/-pH-Metry (1993)
    Springer
    Dysphagia 8 (1993), S. 112-117 
    Details
    ISSN: 1432-0460
    Keywords: Gastroesophageal reflux ; Esophageal motility ; Ambulatory esophageal manometry ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The interplay between esophageal motility and gastroesophageal reflux (GER) was investigated with a new ambulatory system of 24-h monitoring of intraesophageal pressures and pH (MP24). The technique allows for simultaneous digital recordings and off-line data analysis. Both computer-aided and visual analyses were used, and algorithms for intercorrelation of mano- and pH-metry were developed. In a group of normal volunteers the physiological response of esophageal motility on GER was defined. In unselected patients suffering from GER disease, the esophageal motility prior to and during GER events was analyzed. In healthy people, most GER episodes occurred spontaneously and were cleared from the distal esophagus by peristaltic contractions. In GER patients, reflux episodes were often preceded by irregular contractions; during GER, esophageal motility was less often peristaltic compared with controls. Therefore, we conclude that MP24 gives relevant information in GER disease which might help in selecting patients for medical or surgical therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02266990
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  • 7
    Electronic Resource
    Electronic Resource
    pH monitoring: The gold standard in detection of gastrointestinal reflux disease? (1993)
    Springer
    Dysphagia 8 (1993), S. 118-121 
    Details
    ISSN: 1432-0460
    Keywords: Gastroesophageal reflux disease ; Diagnosis ; pH monitoring ; Diagnostic studies ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastroesophageal reflux disease (GERD) is one of the most frequent benign diseases of the gastrointestinal tract and in some cases the diagnosis may be very difficult. There are many diagnostic procedures but none of them could prove or definitely exclude the disease. The 24-h pH-monitoring is the “gold standard” for detection of gastroesophageal reflux and in many patients the reflux correlates with the GERD. The evaluation of a diagnostic method has to be done in a similar manner to the evaluation of therapeutic study (phase 1 to phase 4). For the definition of the “gold standard” for detection of a special diagnosis (e.g., the gastroesophageal reflux disease), the results of phase 3 studies for different methods had to be compared. The method with the best values for sensitivity and specificity is yet to be discovered. Until now, pH monitoring has been the gold standard for the diagnosis of GERD. However, there are many problems connected with using this method in clinical practice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02266991
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  • 8
    Electronic Resource
    Electronic Resource
    Intraoperative ultrasonographic detection of occult liver metastases in colorectal cancer (1991)
    Springer
    Surgical endoscopy and other interventional techniques 5 (1991), S. 36-40 
    Details
    ISSN: 1432-2218
    Keywords: Colorectal cancer ; Liver metastases ; Intraoperative ultrasonography ; Preoperative ultrasonography ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The efficacy of intraoperative ultrasonographic detection of colorectal cancer liver metastases was evaluated in 85 patients undergoing operation for primary colorectal tumors or liver secondaries. The results of intraoperative ultrasonography were compared with those of preoperative ultrasonography and computed tomography, as well as the intraoperative appearances of the liver. Additional information about the number of metastases was obtained in 12 cases (14.1%); 17 (24.3%) out of 70 metastases could only be detected by intraoperative ultrasonography. In 4 cases (4.7%) these lesions were solitary. As a result, the operative procedure of choice was changed in 15.3% of the patients. We conclude that intraoperative ultrasonography has a significantly higher ability to detect colorectal cancer liver metastases than preoperative methods or intraoperative inspection and palpation. Intraoperative ultrasonography should be performed in patients without preoperative evidence of liver metastases and in all patients with planned resection of metastases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00591385
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  • 9
    Electronic Resource
    Electronic Resource
    Bewirken Leitlinien eine Verbesserung des perioperativen Ablaufs? – Untersuchung anhand der perioperativen Antibioticaprophylaxe (2000)
    Springer
    Der Chirurg 71 (2000), S. 702-706 
    Details
    ISSN: 1433-0385
    Keywords: Keywords: Perioperative antibiotic prophylaxis ; Guidelines ; Quality assurance. ; Schlüsselwörter: Perioperative Antibioticaprophylaxe ; Leitlinienerstellung ; Qualitätssicherung.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Einleitung: Die Effektivität der perioperativen Antibioticagabe ist nachgewiesen, die Prophylaxe wird jedoch häufig inadäquat angewandt. Ziel der Studie war es daher zu überprüfen, inwieweit Leitlinien in der Lage sind, die Qualität der perioperativen Gabe von Antibiotica zu verbessern. Methoden: In einer retrospektiven Analyse stellten wir bei 280 Operationen den Ist-Zustand der Antibioticaprophylaxe hinsichtlich der Kriterienwahl des Antibioticums, Dosis, Zeitpunkt, Stop nach Operationsende und 2. Gabe bei einer Operationsdauer 〉 3 Std fest. Nach Leitlinienerstellung und klinikinterner Fortbildung erfolgte eine erneute Überprüfung im Rahmen einer prospektiven Beobachtungsstudie (n = 245). Gruppenunterschiede wurden mit dem χ 2-Test berechnet. Das Signifikanzniveau wurde auf p 〈 0,05 festgelegt. Ergebnisse: Der Anteil der indizierten, aber nicht durchgeführten Antibioticaprophylaxe konnte von 15,5 % auf 8,4 % (p 〈 0,05) reduziert werden. Die Prophylaxe wurde im Vergleich zur retrospektiven Analyse signifikant häufiger adäquat zur Anwendung gebracht (35,7 % vs. 63,5 %; p 〈 0,05). Dies war vor allem auf die genauere Berücksichtigung der Dosis und der Operationsdauer zurückzuführen. Diskussion: Krankenhausinterne Leitlinien können zu einer Verbesserung der perioperativen Antibioticaprophylaxe beitragen. Um ein optimales Ergebnis zu erreichen, müssen Leitlinien durch weitere Maßnahmen, wie z. B. computerassistierte Programme, ergänzt werden.
    Notes: Abstract. Introduction: Although the effectiveness of perioperative antibiotic prophylaxis is proven, it is not used adequately. The aim of this study was to evaluate whether hospital-based guidelines are useful tools to improve the management of perioperative antimicrobial prophylaxis. Material: In a retrospective study the actual quality of perioperative antibiotic prophylaxis as given by the criteria choice of drugs, dosage, timing, continuation and 2nd dose after 〉 3 h was evaluated. After information and establishment of adequate guidelines we started a prospective analysis to test compliance and rate of adequate prophylaxis. Differences were calculated according to the χ 2-test with P 〈 0.05 significance niveau. Results: The percentage of cases in which antibiotics were indicated but not administered was reduced from 15.5 % to 8.4 %. Compared to the result of the retrospective analysis, the prospective study showed a significantly higher percentage of adequately administered antibiotics (35.7 % vs. 63.5 %). This was mainly due to the compliance with dosage recommendations and to the 2nd dose in longer surgical procedures. Discussion: Guidelines lead to a significant improvement in perioperative antibiotic prophylaxis. To increase this effect, further approaches such as integration of guidelines into computer-based systems should be evaluated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040051123
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  • 10
    Electronic Resource
    Electronic Resource
    En-bloc Oesophagektomie — wann soll die Speisepassage rekonstruiert werden? (1990)
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 166-170 
    Details
    ISSN: 1435-2451
    Keywords: En-bloc esophagectomy ; Esophageal cancer ; Reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven Studie wurde die einzeitige Speiseröhrenrekonstruktion mit der 4872 h nach Oesophagektomie durchgeführten verglichen. In beiden Gruppen (26/24 Patienten) wurde eine transthorakale en-bloc Oesophagektomie durchgeführt. Als weitere Vergleichsgruppe wurden 45 Patienten mit transmediastinaler Oesophagektomie and einzeitiger Rekonstruktion, die ebenfalls während der Studiendauer operiert wurden, herangezogen. Es ergaben sich in Hinblick auf postoperative Komplikationen (26,9%; 29,1%; 22,2%) and auf die postoperative 30-Tage-Letalität (0%; 4,1%; 2,1%) sowie die Kliniksletalität (3,2%; 4,1%; 4,2%) keinerlei Unterschiede. Somit führt die Rekonstruktion mit aufgeschobener Dringlichkeit zu keiner weiteren Risikoverminderung; andererseits stellt sie aber auch keine Risikoerhöhung dar, so daß sie in das Verfahrensspektrum der Oesophaguschirurgie aufgenommen werden kann.[/p]
    Notes: Summary In a prospective study direct reconstruction of the esophagus was compared to reconstruction 48–72 h after esophagectomy. In both groups (26/24) transthoracic en-bloc esophagectomy was performed. During the same time period of the study another group of 45 patients had transmediastinal esophagectomy and direct reconstruction and this group was also used as comparison. There were no differences concerning postoperative complications (26.9%; 29.1 %; 22.2%), postoperative 30-days mortality (0%; 4.1%; 2.1%), and hospital mortality (3.2%; 4.1%; 4.2%). Thus reconstruction with delayed urgency does not lead to a further decrease of risk; on the other hand there is also no increase of risk and therefore it can be included in the spectrum of procedures of esophageal surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00206811
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