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Biomedical subjects

K H Kurth

Publications and source records attributed to K H Kurth.

At least 91 records · Page 5Linked to original sources
PubMed1992

Is preoperative transrectal ultrasonography of value in localised prostatic carcinoma? A blind comparative study between preoperative transrectal ultrasonography and the histopathological radical prostatectomy specimen.

Digital rectal examination (DRE) for staging is subjective and unreliable. Understaging has been reported in 25-72% and clinical overstaging of T3 tumors varies from 24-50%. In the present study of 15 patients, transrectal ultrasound (TRUS) staging was compared, in a blind comparative fashion, with pathological staging of the surgical specimen. Multifocal lesions were present in 8/15 patients (53%). A distinction was made between capsular involvement and 'clear' capsular penetration. TRUS was more sensitive in predicting capsular involvement than DRE (83% vs 17%), but the specificity was low (67% vs 100%). If capsular perforation was considered, the sensitivity and specificity of TRUS are 43% and 91%, respectively. Sensitivity and specificity for seminal vesicle tumor involvement by TRUS was 63% and 86%. Using TRUS the overall staging was improved by 33% compared with DRE and therefore TRUS is considered to be a valuable acquisition in localising and staging prostate cancer.

Aged↗
PubMed1991

[The use of lasers in the treatment of urolithiasis].

The treatment of calculi in the urinary tract has been subject to major changes over the last few years. Since extracorporeal shockwave lithotripsy (ESWL) is the first choice of treatment, there appears to be little need for endoscopic and surgical techniques. In case ESWL treatment is unsuccessful or inadequate, laser lithotripsy is a good alternative. In most cases, laser lithotripsy causes a good disintegration with use of very thin and flexible instrumentation. Hence, the risk of damage to the urinary tract is much less than with other endoscopic techniques such as ultrasonic and electrohydraulic lithotripsy. Our first results with 21 bladder and 18 ureter calculi in 25 patients were a successful disintegration of 84% of bladder calculi and a 70% success for ureter calculi. Only one complication of the ureteroscopic manipulation was observed. Disadvantages of laser lithotripsy are the high price of the equipment and the fact that not all calculi can be fragmented with one type of laser.

Adult↗
PubMed1990

Comparison of the effects of high dose Estramustine phosphate and mitomycin C on the time to progression and length of survival of patients with progressive, advanced endocrine-independent prostatic cancer: an interim analysis of EORTC-GU Group study no. 30865.

Patients with hormone escaped advanced progressive prostate cancer were randomized either to receive either high-dose Estramustine phosphate orally or Mitomycin C by i.v. injection every 6 weeks until signs of progression or death supervened. Patients on both arms progressed rapidly, with a median time to progression of 5 months and a median length of survival of only 10 months. Toxicity was very considerable in both arms.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Secondary hematologic neoplasm after intravesical chemotherapy for superficial bladder carcinoma.

Two cases are reported of patients who developed a hematologic malignancy several years after intravesical chemotherapy of superficial bladder cancer with etoglucid, doxorubicin, and mitomycin C. In one patient, karyotypic abnormalities (-5, 7q-) typical of a therapy induced malignancy were associated with rapid progression of a refractory anemia with excess blasts in transformation to an acute non-lymphocytic leukemia. Intravesical chemotherapy may be associated with a risk of secondary malignancy.

Aged↗
PubMed1990

Quality of life and treatment of hormone resistant metastatic prostatic cancer. The EORTC Genito-Urinary Group.

72 patients with hormone resistant, progressing prostatic cancer completed a self-administered questionnaire to assess subjective morbidity and quality of life before they were entered into a phase III trial of estramustine (34) vs. mitomycin (38). At least one post-treatment assessment was available in 43 patients. This considerable degree of non-compliance is explained by practical problems related to completion and collection of the questionnaires in these rapidly deteriorating patients. Doctors underestimated subjective morbidity (pain, decreased performance status, nausea) in 30-50% of the cases. Decreased functional status, fatigue and pain were identified as the most frequent major morbidities before study entry. In most patients, treatment did not reduce this morbidity. The routine application of self-administered quality of life questionnaires has considerable practical problems but yields clinically worthwhile information about subjective morbidity. Simple but relevant monitoring of subjective morbidity by the patient should be mandatory in cancer trials where palliation is a major endpoint.

Attitude of Health Personnel↗
PubMed1989

Treatment of distal ureteral stones in the horse riding position.

From August 1986 through March 1987, 102 patients with 110 distal ureteral stones were treated in 110 sessions with the standard Dornier HM-3 lithotriptor in the so-called horse riding position. The majority of the patients (70 of 110, 63.7%) were treated for distal stones alone, whereas in a third (40 of 110, or 36.3%) treatment was performed for distal and upper stone localization during the same session. Additional treatment besides extracorporeal shock wave lithotripsy was necessary in 12.7% of the patients. Of the 110 patients 89.4% were without residual stones after a mean of 17.3 days. This modified position of the patient, which is specific to the Dornier HM-3 lithotriptor, makes possible treatment of distal ureteral stones with results comparable to those of endoscopic management but with less major complications (4.7%). A total of 7 patients had anal blood loss in the early postoperative period. Rectal bleeding ceased within 36 hours after treatment. The position also allows for treatment of stones at other, more proximal locations without great modifications to the position during the same session.

Adolescent↗
PubMed1989

Human renal cell carcinoma in the six day subrenal capsule assay.

The applicability of the subrenal capsule assay (SRCA) as a method for chemosensitivity testing of human renal cell carcinoma (RCC) was assessed. Tissue fragments of about one mm3. in size, obtained from patients who had undergone nephrectomy because of renal cell carcinoma (RCC), were implanted in preirradiated mice. The change of the size of the implanted tissue as well as the histology of the tissue were determined six days later. Untreated control tumors were used to determine the evaluability of the individual assays using criteria based on 1) tumor growth (an increase in tumor size or a decrease not exceeding 0.05 mm.) and 2) tumor histology (presence of carcinoma cells in at least 70% of the tissues). The first criterion was fulfilled in 20/24 (83%) of the renal tumors; tumor histology was satisfactory in 9/24 (38%) of the tumors. Taken together, only 9/24 assays were considered to be evaluable. Discrepancies between measurement and histologic appearance were also found for individual tumors and for treated tumors. Due to the lack of correlation between measurement and histology change in tumor size therefore cannot be considered a reliable parameter for assessing viability or drug activity.

Animals↗
PubMed1989

Successful treatment of radiation cystitis with hyperbaric oxygen.

This report describes the results of hyperbaric oxygen therapy in 10 patients with radiation-induced cystitis. Severe macroscopic hematuria was present in all patients and was resistant to current therapy. Previously 8 patients had been treated for bladder carcinoma and 2 for prostatic carcinoma with 60 Gy radiotherapy. Hyperbaric oxygen therapy consisted of 20 sessions of 100% oxygen inhalation at 3 bar pressure for 90 min. In 6 patients the macroscopic hematuria stopped completely and it decreased in the other patients. These 4 patients had recurrent or residual bladder malignancies.

Aged↗
PubMed1988

[Which intravesical chemotherapy for what tumor of the bladder?].

The rationale for adjuvant chemoprophylaxis in superficial bladder cancer treated by transurethral resection is discussed. Many questions remain unsolved as far as chemoprophylaxis in concerned. The authors try to answer them through an analysis of the results of prospective and randomized studies undertaken by the EORTC genito-urinary group for 12 years. Advantages and disadvantages of the most common agents (Adriamycin, Epodyl, Mitomycin, Thiotepa, BCG) are analyzed; an attempt is done to define instillations regimens; indications and results of these adjuvant treatments are studied.

Administration, Intravesical↗
PubMed1988

In vivo and in vitro chemotherapy sensitivity testing for human kidney tumor lines: a comparative study.

In vivo and in vitro chemosensitivity testing has been applied to kidney carcinoma tumor lines. Serially transplantable tumors were implanted subcutaneously in nude mice and the animals were treated with cytostatic drugs. The results of this in vivo assay were compared with the results obtained with the subrenal capsule assay, the DNA precursor assay (3H-thymidine), and the colony-formation assay, utilizing the same tumor line in each case. Higher rates of resistant tumors were found in the in vivo assays than in the in vitro assays. The SRC assay and the DNA assay had the highest predictive value, as judged from comparison with the results obtained with the source tumor (human kidney carcinoma tumor line).

Animals↗