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Biomedical subjects

P Küster

Publications and source records attributed to P Küster.

15 recordsLinked to original sources
PubMed1999

Dual versus triple therapy of Helicobacter pylori infection: results of a multicentre trial.

OBJECTIVE: To compare dual therapy (omeprazole and amoxicillin) with triple therapy (omeprazole, amoxicillin, and clarithromycin) in the treatment of Helicobacter pylori infection. The efficacy of 1 mg/kg/day omeprazole was randomly compared with 2 mg/kg/day. STUDY DESIGN: 252 patients (median age, 11.0 years; range, 3-18) presenting with chronic abdominal pain underwent endoscopy and a 13C-urea breath test. Gastric biopsy specimens were taken for histological examination and for the rapid urease test. Patients were treated for two weeks: group A (n = 63) received amoxicillin (50 mg/kg; maximum, 2 g/day), group B (n = 73) received amoxicillin and clarithromycin (20 mg/kg; maximum, 1 g/day). Both groups were randomly treated with either 1 or 2 mg/kg omeprazole (maximum, 80 mg/day). Diagnostic procedures were repeated four weeks after the end of treatment. RESULTS: 11 patients were excluded; 136 patients were H pylori positive (56%), 105 of whom were re-examined after treatment. Helicobacter pylori was eradicated in 52% of group A and 83% of group B. The dose of omeprazole had no influence on the eradication rate. Specificity and sensitivity of the rapid urease test were 94% and 93%, respectively. Specificity and sensitivity of the 13C-urea breath test were 93% and 95%, respectively. CONCLUSIONS: Dual therapy can no longer be recommended. Triple therapy is more effective than dual therapy in the eradication of H pylori infection. The lower dose of 1 mg/kg omeprazole was as effective as 2 mg/kg.

Adolescent↗
PubMed1995

[Sterile eosinophilic pustulosis (Ofuji). A rare entity in Europe].

This case report refers to a German patient with sterile eosinophilic pustulosis of the Ofuji type (SEP), which is rarely described in non-Japanese humans. The distinctive histomorphology, with intraepidermal eosinophilic abscesses and eosinophilic folliculitis, is complemented in this patient by marked eosinophilia, evident eosinophilic bone marrow reaction and involvement of the oral mucosa with eosinophilic spongiosis, which is a feature that had not previously been reported. Possible transitions between cutaneous and internal hypereosinophilic syndromes are discussed. Despite the initial good effect of topical corticosteroids on the cutaneous changes, long-term follow-up to check for internal involvement is necessary.

Biopsy↗
PubMed1990

[Results of treatment of malignant melanoma--a computer analysis of 772 patients].

The data of 772 patients with malignant melanoma, treated from 1.1.1972 to 30.6.1988 in the Regional Hospital Dresden-Friedrichstadt were analysed by computer. The probability of survival was estimated separately by the method of Kaplan and Meier in dependence on clinical stage in the time of the first treatment, pT and sex. The 10-year survival rate in clinical stage I amounts to pT1 = 100%; pT2 = 82.9% +/- 4.0%; pT3 = 67.1 +/- 4.3% and pT4 = 58.0 +/- 4.7%. There are significantly differences between women and men with melanomas of the category pT2 and pT3 in favour of women (pT2: 88.6%:70.0%; pT3: 75.8%: 53.4%). In the cases of pT4 melanoma there are no differences (61%:53%). The average time of survival from these patients who have died from melanoma shows also marked differences according to pT (pT2 = 46.6 month, pT3 = 36.6 month, pT4 = 30.2 month).

Female↗
PubMed1990

[Comparative analysis of narcosis and local anesthesia in surgery of malignant melanoma of the skin].

A nonrandomized trial was performed to compare the survival rate attained in patients with malignant melanoma who underwent their operations under general anaesthesia (g.a.) and in those who underwent surgery with only local anaesthesia (l.a.). All stage I patients were treated and followed up in our hospital exclusively. Data recorded in 190 patients operated on under g.a. from 1972 to 1980 and 376 patients operated on with l.a. from 1981 to 1987 were evaluated by computer. The 5-year survival rates calculated by the Kaplan-Meier method were as follows: Breslow's thickness up to 1.50 mm (pT1 and pT2): g.a. 91.4% l.a. 94.5%; 1.51-3.00 mm (pT3a) g.a. 64.1%, l.a. 84.5% (P less than 0.01); over 3.00 mm (pT3b and pT4) g.a. 57.9%, l.a. 62.2% (P greater than 0.05). Women with pT3a melanoma had more benefit from the operation in l.a. (93.1% to 69.7%) than did men (71.6% to 55.2%). The l.a. does not prejudice the prognosis, whether the l.a. improves the prognosis has to be stated. The available evidence that anaesthetic agents influence host defence could be an explanation for the better results with l.a.

Anesthesia, General↗
PubMed1988

[Spontaneous pneumothorax in cystic fibrosis].

The clinical course of 13 cystic fibrosis patients with a total of 24 episodes of pneumothorax was analysed. The study is based on 488 (273/215) patients seen over 20 respectively 10 years at the University Children's Hospitals Frankfurt/Main and Essen. A pneumothorax was observed with a frequency of 2.7% mainly in adolescents of young adults with advanced pulmonary disease (mean age 17.4 years). It was not seen before the age of 10 years. Thus among 255 patients at risk above 10 years a pneumothorax occurred in 5.1%. Presenting symptoms were acute chest pain (n = 17), dyspnea (n = 17) and irritating cough (n = 8). In two patients pneumothorax was an incidental diagnosis. A tension pneumothorax was seen in 7 (= 30%; 3 initial, 4 recurrences of which 3 were ipsilateral). Out of 11 recurrences (n = 6, ipsi- and n = 5, contralateral) 4 occurred only once, one twice and in one patient five times. Two patients died as a consequence of the event (one initially due to tension pneumothorax, one due to heart failure). The therapeutic approach was conservative. Without specific treatment pneumothorax resolved in 12 cases. Ten patients were treated by chest tube drainage and only one patient by pleurodesis with a sclerosing agent. Though the therapeutic results were favorable in the patients presented, the authors suggest more aggressive treatment in view of the high ipsilateral recurrence rate. Detailed recommendations are given.

Child↗
PubMed1986

[Varicocele and fertility--spermiographic and histologic findings].

The results of the treatment of 251 patients with varicocele are demonstrated. By means of spermiographic and histologic investigations the fertility-disturbing influence of this vascular disease of the testis shall be proved and the effect of the operative sanation shall be estimated. For many years the high ligature of the testicular vein has been favoured method of operation; since 1984 exclusively the percutaneous transfemoral occlusion of the testicular vein has been performed, when a left-sided varicocele is present. In 61% of the patients examined an improvement of the spermiogram is to be proved, in which case the most conspicuous rate of increase lies at the motility of spermatozoa with 58%. After removal if the varicocele the investigations of the testicular tissue reveal in 42% of the cases an improvement of the findings by decrease of the tubular atrophy and increase of the tubular cell number. Among the number of our patients the rate of conception is 49%. The treatment of varicocele is a fertility-protective measure and therefore should be performed in all adolescents and males at fertile age.

Adolescent↗