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Biomedical subjects

C Kainz

Publications and source records attributed to C Kainz.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Mild cervix dysplasia: does diagnostic biopsy have a "therapeutic" effect?].

The aim of the study was, to evaluate the possible curative effect of punch biopsy on low grade cervical intraepithelial dysplasia (CIN I) as indicated by the literature. After a three-month interval, 115 women with PAP-smears indicating CIN I were subsequently controlled by cytologic cervical smears. Additional colposcopically directed punch biopsies were taken in 26 patients at the first examination. The remission rate was similar in patients with or without punch biopsy (54% to 49%), as well as the progression rate (8% to 7%). In addition we performed in-situ hybridisation in all biopsy specimens for the detection of human papillomavirus (HPV)-DNA. On comparing the progression and remission rate of women with HPV-positive and HPV-negative dysplastic tissue, we found no difference between these two groups. Punch biopsy does not seem to have a therapeutic effect either in HPV positive or HPV negative CIN I.

Biopsy↗
PubMed1991

Cervical neoplasia and human papilloma virus infection in prostitutes.

OBJECTIVES: To evaluate the prevalence and incidence of PAP smears indicating cervical dysplasia as well as human papillomavirus (HPV) infection in prostitutes. DESIGN: Prevalence and incidence study of cervical dysplasia and HPV infection in prostitutes. For detection and typing of HPV-DNA In Situ Hybridisation (ISH) was performed in tissue samples with CIN gained by colposcopically directed punch biopsies. SETTING: Second Department of Obstetrics and Gynecology, University of Vienna Medical School and STD Clinic of the Public Health Office, Vienna. SUBJECTS: Registered prostitutes attending the STD Clinic of the Public Health Office and a control group. RESULTS: 978 prostitutes and 5493 women with unknown cytological anamnesis were compared. Frequency of positive PAP smears was significantly higher in prostitutes (6.13% versus 1.43%). To determine the pick-up rate of cervical dysplasia during one year after negative cytology we compared 722 prostitutes and 3162 controls. Prostitutes showed a significant higher dysplasia pick-up rate (3.05% to 1.07%) compared with controls. HPV detection rate in prostitutes was similar to that in the control group. The distribution of HPV types revealed a higher frequency of "high risk" HPV 16/18 and 31/33 in prostitutes. CONCLUSION: The results demonstrate a higher incidence and prevalence of cervical dysplasia in prostitutes and therefore suggest regular cervical PAP smear screening in registered prostitutes twice a year.

Cervix Uteri↗
PubMed1989

[Pathologic oocytes within the scope of in vitro fertilization].

Data of 67 patients, in whom 114 inseminated oocytes with morphological abnormalities were registered by means of light microscopy, were compared with those of a control group consisting of 69 patients where in vitro fertilization (IVF) proved successful. Significant correlations were found between certain parameters of the IVF attempt and the appearance of the described pathological changes in the oocytes. A significantly higher incidence of oocyte pathology was found with elevated progesterone and also LH values during the follicular phase. With a great number of follicles and in the case of small-sized follicles there were significantly more pathological ova--both degenerated and pathologically fertilized. A good oestrogen increase after ovulation induction with human chorionic gonadotrophin (HCG) was associated with fewer morphological abnormalities of the inseminated oocytes. When spermatozoa with lower total motility (less than or equal to 40%) or an increased percentage of pathological forms (greater than 60%) were used for IVF, significantly more pathological oocytes appeared. A pathological spermiogram was noticeably correlated with an increased occurrence of a solitary decayed nuclear structure of the mature ovum. The significance of these connections and a hypothesis of the development of the described nuclear structure are discussed.

Adult↗
PubMed1988

Development of mouse embryos following conventional and ultra rapid cryopreservation.

A conventional computer-controlled program for cryopreservation of mouse embryos at the 4 to 8 cell stage was compared with various methods of ultra rapid cooling. 104 embryos were frozen by using the conventional cooling program. 79% of the embryos developed to blastocysts after thawing. Sixty-three embryos were vitrified and 81% reached the blastocyst stage within 2 days of culture. Using the ultra rapid cooling program A (4-step equilibration of embryos in cryoprotectant) 62% of embryos survived after freezing and thawing. Only 12% survival rate could be achieved by employing the ultra rapid program B (2-step equilibration of embryos in cryoprotectant). The significantly higher survival rate of program A compared to program B was due to the longer equilibration time and therefore presumably higher intracellular concentration of cryoprotectant. In program B the short equilibration time with the cryoprotectant seemed to result in an inadequate dehydration of blastomeres leading to intracellular ice formation and cell destruction.

Animals↗
PubMedDate not supplied

CT and MR accuracy in the detection of tumor recurrence in patients treated for ovarian cancer.

OBJECTIVE: The aim of this prospective study was to evaluate the accuracy of clinical examinations (palpation/determination of serum tumor-associated antigen CA125 level), CT, and MRI in the detection of tumor recurrence in patients with treated ovarian cancer. MATERIALS AND METHODS: Twenty-four patients who had been treated for ovarian carcinoma were prospectively examined by clinical means (palpation/serum tumor-associated antigen CA125 level), CT, and MRI to assess their accuracy in detecting recurrent disease; results were correlated with surgical/bioptic/pathoanatomic findings. Nine patients had relapse; 15 women were disease-free. RESULTS: Examinations were true-negative in 14 patients (on palpation/CA125, CT, and MRI) and true-positive in 9 on palpation/CA125, in 6 on CT, and in 7 patients on MRI. False-positive examinations occurred in one patient on palpation/CA125, CT, and MRI and false-negative in zero on palpation/CA125, in three on CT, and in two on MRI, a sensitivity of 100% for palpation/CA125, 66.6% for CT, and 77.7% for MRI and a specificity of 93.3% for palpation/CA125, CT, and MRI. Accuracy of palpation/CA125 examinations was 95.8% in comparison with 83.3% for CT and 87.5% for MRI. CONCLUSION: Our results suggest that in the follow-up of ovarian cancer patients, assessment of serum tumor-associated antigen CA125 level is accurate in the determination of patients with tumor recurrence. Computed tomography is the primary imaging modality to prove macroscopic disease recurrence and can spare these patients from invasive restaging second-look laparotomy; MRI should be performed in women with questionable macroscopic recurrent tumor and negative CT examination. Neither CT nor MRI can confidently exclude microscopic disease.

Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Serum concentrations of tissue polypeptide antigen in patients with vulvar intraepithelial neoplasia and vulvar cancer.

The aim of the present study was to evaluate the clinical usefulness of the cytokeratin tumor marker tissue polypeptide antigen (TPA) in patients with vulvar cancer. This retrospective study comprises 41 patients with vulvar cancer FIGO stages I-III, 17 patients with vulvar intraepithelial neoplasia (VIN) III, and 40 healthy female controls. Serum concentrations of TPA were measured using a microparticle enzyme immunoassay. Results were correlated to clinical data. Median serum concentrations of TPA in healthy female controls, patients with VIN III, and patients with vulvar cancer were 42 U/l (range 12-192), 53 U/l (range 17-127.9) and 57 U/l (range 4.2-423), respectively (Mann-Whitney U test, p = 0.8). Serum concentrations of TPA were not associated with stage of disease, histological grade, and age at the time of diagnosis. In vulvar cancer patients, elevated serum concentrations of TPA prior to therapy were not associated with a shortened disease-free or overall survival (log-rank test: p = 0.5 and p = 0.9, respectively). In a multivariate Cox regression model comprising tumor stage and TPA, tumor stage, but not TPA revealed a statistically significant influence on disease-free (Cox proportional hazard regression model, p = 0.05 and p = 0.6, respectively) and overall (Cox proportional hazard regression model, p = 0.04 and p = 0.8, respectively) survival of patients with vulvar cancer. We conclude that cytokeratin expression, as reflected by serum concentrations of TPA, does not play a role in the natural history of vulvar cancer. The evaluation of serum concentrations of TPA prior to therapy is not recommended.

Age Factors↗
PubMedDate not supplied

Tumor anemia and thrombocytosis in patients with vulvar cancer.

The aim of our study was to determine the prevalence of tumor anemia and thrombocytosis in patients with vulvar cancer, and to evaluate the prognostic value or pretreatment hemoglobin (Hb) and platelet count regarding disease-free and overall survival of patients with vulvar cancer. We measured pretreatment Hb and platelet count in 62 patients with squamous cell vulvar cancer. The results were correlated to clinical data. Median Hb and platelet count in patients with vulvar cancer were 13.1 g/dl (range 8.3-16.2) and 268, 500/microl (range 88,000-778,000), respectively. Cut-off levels of 12 g/dl and 300,000/microl were selected for tumor anemia and tumor thrombocytosis, respectively according to published criteria. Tumor anemia and tumor thrombocytosis were present in 30.6 and 27.4% of patients with vulvar cancer, respectively. In a univariate analysis tumor stage and tumor thrombocytosis were significantly associated with a shortened disease-free (log-rank test, p < 0.001 and p = 0. 003, respectively) and overall survival (log-rank test, p < 0.001 and p < 0.001, respectively). Tumor anemia was not associated with a shortened disease-free, but with a shortened overall survival of patients with vulvar cancer (log-rank test, p = 0.1 and p = 0.002, respectively). A multivariate Cox regression model considering tumor stage, tumor anemia, and tumor thrombocytosis showed, however, that pretreatment Hb and platelet count did not confer additional prognostic information to that already obtained by the established prognosticator tumor stage on disease free (multivariate Cox regression model, p = 0.8, p = 0.2, and p = 0.003, respectively) and overall survival (multivariate Cox regression model, p = 0.4, p = 0. 5, and p = 0.04, respectively). Pretreatment tumor anemia and tumor thrombocytosis were associated with a poor prognosis, but were not an independent predictor of outcome in patients with vulvar cancer.

Adult↗
PubMedDate not supplied

Humoral p53 antibody response is a prognostic parameter in ovarian cancer.

BACKGROUND: Mutant p53 protein may become the target of a tumor-specific humoral and cellular immune response. MATERIAL AND METHODS: We used a specific qualitative p53 antibody ELISA to investigate serum samples of 33 patients with ovarian cancer taken prior to therapy. Additionally, we sought to evaluate whether p53 antibodies are also present in the sera of 17 patients with benign ovarian tumors. RESULTS: p53 antibodies were detected in 36% of serum samples. There was a statistically significant association between p53 serum antibody response and poor overall survival (p < 0.006). No significant associations were found between p53 antibody status and histological type, histological grade, and tumor stage. In 81% of serum samples, no changes from p53 antibody negativity to positivity or vice versa during follow-up were observed. p53 antibodies were also detected in the sera of 18% of patients with benign ovarian tumors. CONCLUSIONS: The results of this preliminary study suggest that a p53 antibody response in patients with ovarian cancer is associated with poor prognosis. A qualitative method of p53 antibody detection cannot be used to monitor the clinical course of ovarian cancer.

Antibodies, Neoplasm↗
PubMedDate not supplied

Prognostic significance of CA 125 and TPS levels after chemotherapy in ovarian cancer patients.

The analysis of survival data of patients with epithelial ovarian cancer proved that both CA 125 and TPS were good markers for clinical outcome prediction. Patients receiving chemotherapy were analyzed for 2-year overall survival (OS). Kaplan-Meier survival analysis showed highly significant differences in OS between patients with stage I+II (survival for 2 years 68%) and stage III+IV (survival for 2 years 33%; p = 0.0008). CA 125 levels above or below 35 kU/I and TPS levels above or below 80 U/l after 3 chemotherapy courses were not significantly correlated with OS in stage I+II patients (p = 0.06 respectively 0.07). However, in the subgroup of patients with stage III+IV the cut-off levels of CA 125 and TPS were excellent discriminators of OS: With CA 125 levels below the cut-off 52% of the patients survived, while with CA 125 levels above the cut-off only 13% survived (p < 0.0001). With TPS levels below the cut-off 49% of the patients survived, while with levels above the cut-off only 19% of the patients survived (p < 0.0001). In the subset of patients with CA 125 levels less than 35 kU/I after 3 chemotherapy courses (n = 50) analysis of their TPS levels allowed further discrimination of the prognostic significance. With TPS levels below the cut-off 63% of the patients survived, while 35% of the patients survived with TPS levels above the cut-off. The sum value of CA 125 and TPS cut-off values (115) as discriminator correlated even better with survival rate: With levels below this sum value 63% of the patients survived, while this was only 17% with sum values above the summed cut-off level (p = 0.0004). The extent to which the tumor was removed at operation also correlated with the 2 years survival rate. None of the patients with a staging laparotomy (n = 10) showed a 2-years survival. The difference in OS between patients with complete debulking and partial debulking was significant: OS 51% versus 23% (p = 0.027). Prognosis was not significantly correlated with histological type.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

P53 antibody response in patients with vulvar cancer.

BACKGROUND: Mutations in the p53 tumor suppressor gene are the most common genetic changes identified in cancer cells. Several studies report alterations of the p53 gene in vulvar cancer. As observed in a wide variety of human malignomas, mutant p53 protein may provoke a specific humoral immune response. The possible occurrence of p53 antibodies in patients with vulvar cancer has not been investigated so far. MATERIALS AND METHODS: We used a specific p53 antibody ELISA to investigate serum samples of 41 patients with vulvar cancer taken prior to therapy and serum samples of 17 healthy controls. RESULTS: Of the 41 patients with vulvar cancer, 4 (10%) were found to be positive for serum p53 antibodies, contrary to the 17 healthy volunteers without p53 serum antibodies (chi-square test, p = 0.2). No significant correlations were found between p53 antibody status and tumor stage (p = 0.64), histological grade (p = 0.89), and patients' age (p = 0.87). We found no significant association between the p53 serum antibody status in vulvar cancer patients and disease-free (p = 0.67) and overall survival (p = 0.7). CONCLUSIONS: In summary, it is the first time that p53 antibodies have been detected in the sera of patients with vulvar cancer. However, p53 serum antibodies did not serve as prognostic markers in vulvar cancer.

Adult↗
PubMedDate not supplied

Knowledge of tumor markers and the psychological consequences of tumor marker sampling in patients with gynecologic cancers.

BACKGROUND: The aim of this study was to investigate the extent of knowledge about serum tumor markers in patients suffering from gynecologic cancer. MATERIALS AND METHODS: 360 women with a median age of 60 years (range: 26-88 years) visiting the oncological outpatient clinic of the Department of Gynecology and Obstetrics of the University of Vienna, between February and July 1998, were asked to complete a self-report questionnaire. RESULTS: The majority of patients (85.2%) believed it was important to know about tumor markers and felt safe when they knew the recent level of the tumor marker (71.6%). On the other hand, many patients felt they were insufficiently informed (43%). 88.9% of the patients did not know the recent serum level of the tumor marker. The patients who had been informed by a physician were significantly better informed about tumor markers than women relying on other sources such as nurses, relatives or other patients (p < 0.001). Patients with an age of more than 65 years significantly less frequently knew the meaning of tumor markers (p < 0.001). Fewer women suffering from ovarian cancer were uninformed about tumor markers as compared to women suffering from other malignancies (p < 0.001). CONCLUSION: We conclude that the majority of patients in oncological follow-up are interested in tumor markers and want to be informed about these substances. Periodical serum tumor marker sampling is regarded as a safety measure by patients, but information about tumor markers should be improved.

Adult↗
PubMedDate not supplied

Paclitaxel/carboplatin as first-line chemotherapy in advanced ovarian cancer: efficacy and adverse effects with special consideration of peripheral neurotoxicity.

BACKGROUND: The aim of this study was to investigate the response and survival probability of patients with advanced ovarian cancer treated with a combination of paclitaxel and carboplatin as first-line chemotherapy. Additionally we investigated the extent of adverse effects due to chemotherapy with special consideration for peripheral neurotoxicity. MATERIALS AND METHODS: Thirty-seven women with epithelial ovarian cancer, treated with a combination chemotherapy consisting of paclitaxel and carboplatin, were included in the analysis. A total of 234 courses of paclitaxel/carboplatin were applied. Paclitaxel was administered at a dose of 175 mg/m2, infused over 3 hours, every 21 days. Carboplatin was administered at an area under the concentration-time curve (AUC) of 6. RESULTS: Thirty of the 37 patients responded to the chemotherapy, demonstrating an overall response of 81%. Seven patients died of the disease (19%). The mean overall survival was 20 months (25% quartile: 19, median and 75% quartile not reached). Thirteen patients (34%) developed peripheral neurotoxicity. In 10 cases (76%) neurotoxicity occurred after the fifth and sixth chemotherapy cycle. In all cases of severe neurotoxicity pathologic sensory nerve conduction-measurements were observed. In one patient a weakness of the left leg was observed. Apart from alopecia, other adverse effects were rare. CONCLUSION: This study confirmed the therapeutic benefit of the combination of paclitaxel and carboplatin as first-line chemotherapy in patients with ovarian cancer. Neurologic toxicity, increasing with every cycle of the chemotherapy, was a clinically significant adverse effect in our study. However, peripheral neuropathy mainly affected sensory fibers, without involving motor nerves.

Adenocarcinoma↗
PubMedDate not supplied

A paclitaxel-containing chemotherapy does not cause central nervous adverse effects: a prospective study in patients with ovarian cancer.

BACKGROUND: The objective of this study was to evaluate the possible effects of a paclitaxel containing chemotherapy on different neuropsychological parameters in women with ovarian cancer. MATERIALS AND METHODS: Twenty-eight women with histologically documented epithelial ovarian carcinoma and treated with a combination chemotherapy consisting of paclitaxel and carboplatin entered the study. The patients were tested with a battery of different neuropsychological tests before, after 3 cycles and at the end of the chemotherapy. RESULTS: Twenty of the 28 patients responded to the chemotherapy (71%). Eleven patients (39%) developed peripheral neurotoxicity. The median values of 6 tests performed before the first chemotherapy cycle scored out of the normal range. These patients with deviant test results at the beginning of the paclitaxel/carboplatin infusions did not deteriorate during chemotherapy. We found a statistically significant improvement of the alphabetical cross out test from the first to the third measurement (mean increase = 4.07; 95% confidence interval = [0.99; 7.15]) (p < 0.05), indicating an improvement of the short-term attention, the concentration and the constancy of working during chemotherapy. The other tests failed to show statistically significant changes during chemotherapy (p > 0.05). CONCLUSION: According to our results, a chemotherapy consisting of paclitaxel/carboplatin caused no signs of acute central nervous toxicity or neuropsychological deterioration.

Adenocarcinoma↗
PubMedDate not supplied

Paclitaxel-carboplatin chemotherapy does not cause encephalopathy in patients with ovarian cancer: a prospective EEG mapping study in 28 patients.

BACKGROUND: The objective of this study was to evaluate possible effects of a paclitaxel containing chemotherapy, on the central nervous system (CNS) in women with ovarian cancer. MATERIALS AND METHODS: Twenty-eight women with histologically documented epithelial ovarian carcinoma and treated with a combination chemotherapy consisting of paclitaxel and carboplatin entered the study. Patients were tested with resting EEG (R-EEG) before and after chemotherapy. RESULTS: Twenty of the 28 patients responded to the chemotherapy (71%). Eleven patients (39%) developed peripheral neurotoxicity. A decrease of beta power and an increase of delta and theta power as well as a deceleration of the total centroid frequency clearly demonstrated a reduced vigilance in patients with ovarian cancer compared to healthy controls. On the other hand, the observed increase of beta power, a decrease of delta and theta power, and an acceleration of the total centroid from pre- to post-treatment demonstrated an improvement of vigilance in patients with ovarian cancer after treatment with paclitaxel/carboplatin. CONCLUSIONS: The results of this study suggest that chemotherapy consisting of paclitaxel and carboplatin does not cause adverse effects on the central nervous system. Improved vigilance was measured in patients with ovarian cancer after chemotherapy.

Adenocarcinoma↗