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Biomedical subjects

H H Meyhoff

Publications and source records attributed to H H Meyhoff.

At least 37 records · Page 2Linked to original sources

The estrogen receptor expression in the male rabbit urethra and prostate following castration.

The influence of castration on estrogen receptor (ER) expression in the male rabbit prostate and urethra, was investigated immunohistochemically and biochemically in 18 mature male, rabbits 14 days after bilateral orchiectomy, and in 15 controls. Immunohistochemical scores of ER were increased significantly in the prostatic stroma and the urethral submucosa (p < 0.05 Mann-Whitney), while the increase in the urothelium was not significant. Biochemically, the ER content was 87.4 +/- 42.6 f mol/mg protein in the normal prostate, and 190.0 +/- 28.0 f mol/mg protein following castration. The corresponding values for the posterior urethra were 228.3 +/- 43.2 f mol/mg protein and 354.9 +/- 60.1 f mol/mg protein. In both cases the increase was not significant. We conclude, that ERs in the prostate and the urethra of the male rabbit can be modified by hormonal manipulation. ERs may therefore be functionally active and not rudimentary.

Animals↗

Alfuzosin in the treatment of benign prostatic hyperplasia: effects on symptom scores, urinary flow rates and residual volume. A multicentre, double-blind, placebo-controlled trial. ALFECH Study Group.

In order to assess the efficacy and safety of alfuzosin, a selective alpha-1 receptor antagonist, 205 patients with Benign Prostatic Hyperplasia (BPH) were randomly assigned in a double-blind, placebo-controlled manner, to receive either alfuzosin 2.5 mg TID or placebo TID during 12 weeks. After 12 weeks symptom scores-assessed according to the Madsen-Iversen scale were significantly reduced in the alfuzosin group and peak flow rate significantly increased compared to the placebo group. There were no significant differences concerning adverse events or withdrawals. Alfuzosin proved to have a beneficial effect in patients with symptomatic BPH with few and minor adverse events.

Adrenergic alpha-Antagonists↗

Retroperitoneal fibrosis treated with methylprednisolon pulse and disease-modifying antirheumatic drugs.

The conventional treatment of patients with ureteric obstruction due to retroperitoneal fibrosis (RF) is surgery in combination with long-term corticosteroids. This report describes 11 cases of RF with ureteric obstruction treated with methyl-prednisolon pulse therapy (MPPT) in combination with azathioprine or penicillamine following initial insertion of ureteral stents. The medial treatment suggested was successful in 7 patients, but only moderately effective in the last 4 patients. This principle of non-operative management of RF has not been previously reported.

Adult↗

The distribution of estrogen receptors in the urinary tract of the male rabbit. An immunohistochemical and biochemical study.

The distribution of estrogen receptors (ER) in the urinary system in the male rabbit were investigated in 18 mature and healthy rabbits by immunohistochemical examination of tissue samples taken from renal pelvis, mid-ureter, bladder-top, posterior urethra and the prostate. ER were detected in 17 out of 18 cases in the urothelial lining and the subepithelial stromal cells of the posterior urethra; and in 15 out of 18 cases in prostatic stromal cells. ER was not found in bladder-top, mid-ureter or renal pelvis. Receptor determination in the isolated cytosolic and nuclear fraction, showed that the mean prostatic receptor density were 151.5 f mol/mg protein in the nuclear and 51.4 in the cytosolic fraction. The corresponding mean values obtained from the posterior urethra were 128.2 and 88.9 f mol/mg protein. We conclude, that ER can be demonstrated in the urinary system of the male rabbit, and these are restricted to the posterior urethra and the prostatic stromal tissue.

Animals↗

A new patient weighted symptom score system (DAN-PSS-1). Clinical assessment of indications and outcomes of transurethral prostatectomy for uncomplicated benign prostatic hyperplasia.

A patient weighted symptom score system, the Danish Prostatic Symptom Score (DAN-PSS-1), including a disease specific self administered quality of life questionnaire, is presented. The model was evaluated pre- and postoperatively in 29 patients apparently suffering from uncomplicated benign prostatic hyperplasia. The score system is based on the severity of 12 symptoms related to bladder storage and voiding function, and three questions related to sexual function (symptom score). For each of these parameters the patient must also evaluate its influence on his daily life (bother score). In the 29 patients with uncomplicated benign prostatic hyperplasia (BPH) bother scores exceeded symptom scores for the irritative symptoms but not for the obstructive symptoms, and surprisingly the symptom score was less improved than the bother score 6 months after transurethral resection of the prostate (TUR-P). Furthermore the postvoiding dribble was worsened after the operation. We find that this model, DAN-PSS-1, assists in creating a solid base for the indication for and the evaluation of treatment of uncomplicated BPH.

Aged↗

[CT in preoperative assessment of renal tumors?].

The value of CT-scanning as part of the preoperative morphological investigation of patients with renal tumours was calculated in a material of 28 patients. In eight patients, operative treatment was not found to be indicated. In the 20 patients in whom operation was undertaken, the operative and histological findings were compared with the findings on CT-scanning. In cases of disagreement, the CT-scanning findings were reassessed. It was found that interpretation of the CT-scan was accurate in 40% of the cases while minor disagreements were present in 25% but these did not have any significance for the indications for operation. In the remaining 35% considerable disagreement was found between the CT-scan and the operative or histological findings such as invasion of neighbouring organs, cysts interpreted as solid tumours with necrosis and as regards interpretation of the retroperitoneal glands. The present authors consider that CT-scanning provides an important supplement to the conventional morphological investigation of renal tumours with intravenous urography and radiography of the thorax. CT-scanning appears to be preferable to ultrasonic scanning in cases which are difficult to review and where expert interpretation of ultrasonic findings is not available. In addition, routine preoperative biopsy of the tumour guided by ultrasound is recommended together with peroperative biopsy for freeze microscopic examination prior to nephrectomy.

Adult↗

Non-invasive management of impotence with transcutaneous nitroglycerin.

Nitroglycerin plasters were applied to the penis in 10 impotent men and the erectile effect assessed. During laboratory testing all patients achieved an erectile response. Self-administration of nitroglycerin patches restored potency in 4 patients and was preferred to papaverine auto-injection by 3. Headache was a common side effect during initial administration. An attempt to treat impotence with nitroglycerin plaster seems worthwhile before starting extensive investigations or invasive treatment.

Administration, Cutaneous↗

Late complications of Prostakath treatment for benign prostatic hypertrophy.

The self-retaining intra-urethral device "Prostakath" was inserted in a consecutive series of 29 men with obstructive benign prostatic hypertrophy. Fifteen patients were relieved of prostatic symptoms for an observation period of 22 weeks (range 2-60). The spiral was removed in 14 cases (48%) at an average of 14 weeks (range 1-82) after insertion; in 9 patients this was because of urinary retention and in 5 it followed dislocation of the stent into the bladder. Five stents removed after 44 weeks of treatment (range 21-82) were severely calcified. Light microscopic investigation of the Spirals that were removed revealed no damage to the gold-plated surface. All patients with calcification had chronic urinary infection resistant to antibiotic treatment. We believe that infected urine is the major factor responsible for the calcification. We suggest that patients with recurrent urinary infection after insertion of the Prostakath should be closely followed up and checked for stone formation by a plain X-ray of the bladder region. It may be advisable to change the Prostakath in patients with resistant urinary tract infection at 6-monthly intervals.

Aged↗

A patient weighted symptom score system in the evaluation of uncomplicated benign prostatic hyperplasia.

A new scoring system is presented for use in patients with uncomplicated benign prostatic hyperplasia. The system is based on the patients' information on the magnitude of twelve symptoms related to bladder and voiding function (symptom score), and three questions related to sexual function. Furthermore the patients are asked to grade the impact of these symptoms on their daily lives (bother score). Multiplication of the two scores related to bladder and voiding function gives the total score. The score related to sexual function is used only for comparing the situation before and after treatment. The new patient weighted total score may assist in creating a solid base for the indication for and evaluation of surgical and non-surgical treatment of uncomplicated benign prostatic hyperplasia.

Humans↗

Antiandrogenic treatment of benign prostatic hyperplasia: a placebo controlled trial.

In a randomized triple-blind multicentre study, injections with the anti-androgenic agent oxendolone were compared with placebo in the treatment of benign prostatic hyperplasia. Thirty patients were treated with weekly injections of oxendolone 200 mg during a 3 months' period, and 30 patients were allocated to placebo treatment. During oxendolone treatment the maximum urinary flow rate increased statistically significantly (from 6.8 ml/s to 8.2 ml/s). However compared to placebo, the oxendolone effect was statistically insignificant. A slight but statistically significant improvement of the symptoms "sensation of retention", "urgency" and "frequency", was observed following oxendolone treatment, but an almost identical effect was seen in the placebo group. Following either treatment no change was observed in the residual urine volumes, in prostatic volume as measured by transrectal ultrasonotomography, or in any other therapeutic parameters. Conservative treatment of benign prostatic hyperplasia with the antiandrogen oxendolone in a dose of 200 mg a week cannot be recommended for clinical use.

Aged↗

The effects of transurethral resection on the urodynamics of prostatism.

We studied 11 patients urodynamically before and 6 months after transurethral resection of the prostate. Bladder pressures were measured through a fine suprapubic catheter. Urinary stream force and flow rate were measured simultaneously. We calculated values for stream velocity, area of Schäfer's flow control zone, the vena contracta, stream energy loss, total bladder work, total stream power and the passive urethral resistance relationship. After prostatic resection improved voiding was documented in most physiological parameters. However, the total work capacity of the bladder remained constant and appeared to be a fixed property of the healthy bladder. An increase in the volume voided postoperatively was related to an increase in the bladder capacity associated with a decrease in detrusor instability, and was not related to a decrease in residual urine.

Energy Metabolism↗

The effect of hydroxyprogesterone on ureteral stones.

It has been suggested that dilatation of the ureter seen in pregnancy is caused by progesterone. Twenty-four patients with ureteral calculi, therefore, were given an intramuscular injection of 250 mg hydroxyprogesterone in order to facilitate the discharge of the stones. Irrespective of the duration of symptoms there was a potential effect of treatment in up to 66% of the patients. In patients with symptoms of less than three weeks duration the stones were discharged within three weeks after the first symptom in 75% of the cases, which is a much higher incidence rate than that stated in the literature for spontaneous stone discharge (18-30%). In patients with longstanding symptoms 50% of the stones had passed, as compared to 39% reported in the literature. Especially concrements with a diameter larger than 4 mm had a better discharge rate. As the treatment is simple, cheap and without side effects, it seems worthwhile trying it in order to avoid surgery.

Adult↗

Flexible fiberoptic versus conventional cystourethroscopy in bladder tumor patients. A prospective study.

In 30 bladder tumor patients flexible fiberoptic and conventional cystourethroscopy was undertaken by two urologists in a random sequence. The findings at conventional cystoscopy, including histologic findings in biopsy and operative specimens, were taken to represent the true pathologic condition. Concordance was found in all but three patients, with solitary superficial grade II bladder tumors less than 2 mm in diameter that were overlooked at flexible cystoscopy. No discordance was observed in the evaluation of grade III or invasive bladder tumors. Flexible fiberoptic cystourethroscopy with urine cytology is recommended 1) as a follow-up investigation under local anesthesia in patients with non invasive bladder tumors and negative random biopsies, and 2) as a diagnostic procedure in poor-risk patients as an alternative to transabdominal ultrasonography.

Aged↗