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Biomedical subjects

C Kurz

Publications and source records attributed to C Kurz.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Surgical treatment of recurrent stress incontinence: Burch versus lyodura sling operation--a prospective study].

This prospective randomised study involved 52 female patients suffering from recurrent stress urinary incontinence, objectively confirmed by means of clinical incontinence tests and urodynamic examinations. They alternatively underwent colposuspension according to Burch or suburethral sling procedure surgery. Urodynamic and sonographic examinations were carried out before and 2.5 years (i.e. within a range of 2-3) after surgery according to Burch or suburethral sling procedure. There was no significant difference between the two methods with respect to subjective and objective rate of cure, which amounted to 85% of the cases involving colposuspension and 88% of cases involving the suburethral sling procedure. Both methods resulted in a significant improvement of the depression quotient and a significant elevation of the internal urethral meatus (p < 0.05). Apart from an aggravation of urge symptoms in both groups, the patients with surgery according to Burch tended towards enterocele and rectocele in the medium range, whereas urination disorders had to be accepted in the patients operated on according to the sling procedure in the long term.

Collagen↗
PubMed1993

[Intravesical administration of estriol in sensory urge incontinence--a prospective study].

Local intravaginal application of oestriol is part of the therapeutical programme of sensory urge-incontinence. The effectiveness of a new method--intravesical administration of 1 mg oestriol versus a placebo--has been proved in a prospective randomised study. 21 patients each were treated over a period of three weeks with oestriol or with the placebo-substance intravesically. The effectiveness of the administered therapy was checked with clinical and urodynamic parameters. The intravesical administration of 1 mg oestriol proved to be efficient and free of side effects in respect of the parameters such as imperative micturition, bladder capacity, of the maximum urethral closure pressure as well as the number of micturitions per diem. The intravesical administration of oestriol may be considered as additional method of therapy for treatment of sensory urge-incontinence.

Administration, Intravesical↗
PubMed1993

Prognostic factors related to recurrent endometrial carcinoma following initial surgery.

Site of recurrence and histological type are significant prognostic factors for survival in recurrent endometrial carcinoma. The aim of this retrospective analysis of 56 patients suffering from recurrences of endometrial carcinoma following initial surgery was to establish the prognostic relevance that the following factors had on the survival rate: age, primary tumor stage, histological assessment (papillary vs non-papillary), postoperative adjuvant radiation therapy, recurrence free interval (< 24 months, > 24 months) and localisation of recurrence. The univariate analysis showed a significantly longer median survival time after recurrence for the following parameters: local recurrence vs extra vaginal recurrence (77.5 months vs 15.7 months, p = 0.02), non-papillary vs papillary carcinoma (36.1 months vs 7.7 months, p = 0.02), no adjuvant irradiation vs adjuvant irradiation (82.0 months vs 8.8 months, p = 0.007). Patients after adjuvant radiation treatment and patients suffering from papillary carcinomas have a significantly higher proportion of patients with distant metastasis (patients with adjuvant radiation treatment: Chi-square test: p = 0.001; patients suffering from papillary carcinomas: p = 0.033). In the case of local recurrences, a three year survival rate of 54% can be achieved with radiation treatment. Recurrences of papillary endometrial carcinomas and patients suffering from distant metastasis on the other hand, show very low survival rates if they are treated with radiation therapy (papillary carcinomas: three-year survival rate of 18%, patients suffering from distant metastasis: 19%). These patients should be included in randomised studies with a view to examining the therapeutic effects of either additional or exclusive treatment with chemotherapy.

Adult↗
PubMed1993

[Importance of platinum dose intensity in treatment of epithelial ovarian cancer. Austrian Study Group for Therapy of Ovarian Cancer].

In a retrospective analysis of 294 patients with FIGO stages III and IV epithelial ovarian cancer treated with different polychemotherapy regimens in two prospective randomised phase III trials between 1981 and 1988, we evaluated the importance of platinum dose intensity for survival. The median survival time of 55 patients who were treated without platinum was 11 months, whereas 205 patients who were treated with a polychemotherapeutic regimen with a platinum dose intensity of 8 mg/m2/week showed a median survival time of 26 months. Of 34 patients who were treated with a platinum dose intensity of 18 mg/m2/week, more than 50% are still alive and therefore the median survival time has not yet been reached (Mantel test p < 0.001). These findings support the hypothesis that an increase in platinum dose intensity during the first treatment regimen leads to an increase in survival of patients with advanced epithelial ovarian cancer. Since 1991 we have been investigating in a prospectively randomized clinical trial whether a combination of carboplatinum and cisplatinum with a planned dose intensity of 43.75 mg/m2/week is feasible and able to improve survival in comparison with standard polychemotherapy (cyclophosphamide/cisplatinum) with a planned dose intensity of 25 mg/m2/week. Evaluation of toxicity of 268 cycles of carboplatinum/cisplatinum in 58 patients showed that a platinum dose intensity of 33.4 mg/m2/week was achievable with acceptable toxicity. Results with regard to therapeutic efficacy of this high dose therapy are expected within the next year.

Adult↗
PubMed1993

[The CA-125 tumor marker in epithelial ovarian cancers of stage I].

A precondition for the early diagnosis of ovarian cancer by means of raised tumour marker levels is high sensitivity at an early stage of the disease. In this study the relationship of the levels of the tumour marker CA-125 to the variables age, grading and histological status was examined in 52 patients with verified FIGO stage I epithelial ovarian cancer. A liminal value of 35 U/ml was accepted and the patients were split into 2 groups according to whether the tumour marker exceeded this value or not. The survival probability was calculated for each group in order to gauge the prognostic significance of this serum marker. Although there was no statistically significant correlation between the CA-125 levels established preoperatively and the above-mentioned variables, in contrast to other studies we found a higher overall sensitivity of 62%. Of particular interest is the considerably higher sensitivity of CA-125 in the postmenopausal patients within our collective. The findings of this study suggest that marker-positive patients might have a poorer survival prognosis.

Adult↗
PubMed1993

Genital antisepsis--test methodology and efficacy of povidone-iodine.

Indications for antiseptic prophylaxis include use prior to urinary catheterization and other transurethral instrumentations, diagnostic or therapeutic instrumentation of the cavum uteri, and operations on the external genitalia and the vagina. Indications for antiseptic therapy include treatment of wounds and of infections of the genital tract and also include treatment of the vaginas of pregnant women to prevent infection in the newborn. For prophylactic antisepsis the aim is the optimal reduction of potentially pathogenic microorganisms. In some fields of application, e.g. before urinary catheterization, an immediate effect on the mucous membrane is required, but on other occasions, such as transvaginal operations, an additional sustained effect is desired. Testing the efficacy of mucous membrane antiseptics, especially for the genital tract, necessitates the establishment of standardized test methods. The variability in vaginal flora at various ages makes it reasonable to study women aged 20-50 years. Studies presented in this paper indicate that microorganism sampling using a cotton swab moistened with neutralizing fluid can be favoured compared to using a rinsing technique and that anaerobic culture techniques enable the measurement of the high reduction factors achieved by very efficient antiseptic procedures. Test methods validated for hand disinfectants are used for calculations and statistical evaluation. The antimicrobial efficacy of six vaginal antiseptic procedures were compared in patients prior to vaginal surgery. Three minutes after treatment, the highest mean reduction (log RF) of the normal vaginal flora as well as of potentially pathogenic microorganisms was obtained by povidone-iodine solution undiluted and povidone-iodine solution 1:10 (log RF 3.60 and 2.68, respectively). Out of three detergents with antimicrobial efficacy, octenidine 0.1% was the most effective preparation (log RF 2.32). Chlorhexidine 0.1%, hexetidine 0.1% and chlorhexidine 0.05% led to lower reduction factors (log RF 1.80, 1.62 and 1.02, respectively). After 30 minutes the log reduction factors were approximating each other in nearly all procedures (log RF 2.79-3.25) except the log RF derived from the procedure performed using chlorhexidine 0.05% (log RF 2.07). Povidone-iodine solutions seem to be the method of choice for mucous membrane antisepsis where an immediate effect is required. If a long period of action is needed all procedures examined, except chlorhexidine 0.05%, are acceptable.

Adult↗
PubMed1992

[Adjuvant hormonal therapy in lymph node-negative breast carcinoma patients in the postmenopause].

The effect of adjuvant treatment with tamoxifen on recurrence and survival rates was determined in a prospective randomized trial in 98 postmenopausal women (mean age 62.7 [49-77] years) with lymph node-negative breast cancer who had undergone modified radical mastectomy with axillary lymphadenectomy. The tamoxifen group (n = 48) received 10 mg of the drug twice daily for one year. After a mean period of 8 (6-11) years the tamoxifen group had a significantly higher rate of survival without recurrence than the control (no tamoxifen) group (83% vs 61.5%, P = 0.02) and a higher overall survival rate (95% vs 81.9%, P = 0.05). These results indicate that adjuvant tamoxifen favourably influences the prognosis for postmenopausal women with lymph node-negative breast cancer after radical mastectomy with axillary lymphadenectomy.

Breast Neoplasms↗