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H Stimpel

Publications and source records attributed to H Stimpel.

At least 19 recordsLinked to original sources

The prevalence and etiology of impotence in 101 male hypertensive outpatients.

Erectile dysfunction and impotence has a high prevalence among male hypertensive patients. Whether this relates mainly to specific drug side effects or to primary pathogenic disorders is unknown. In the present study 101 male patients from our outpatient hypertension clinic answered detailed questionnaires about hypertension and sexual function. Patients with perceived impotence were offered a thorough penile evaluation and examination performed by specialists in the urology department. Twenty-seven (27%) men had impotence. The main cause of impotence was an arterial dysfunction (89%). The prevalence of impotence was related to the degree of secondary organ manifestation, reflected by World Health Organization (WHO) classification I-III (P = .01). Intermittent claudication (P = .001) and ischemic heart disease (P = .005) were the best determinants in this respect. Twelve impotent patients (44%) ascribed onset of impotence to drug initiation. A variety of drugs were incriminated in the occurrence of drug-induced impotence. In summary our results indicate that impotence in hypertensive men is caused mainly by penile arterial vascular changes, probably atherosclerosis. Drug-induced impotence could well be the result of blood pressure reduction itself and not specific drug side effects.

Adult

Cimetidine as an adjuvant treatment in colorectal cancer. A double-blind, randomized pilot study.

PURPOSE: To evaluate the influence of a H2 receptor antagonist (cimetidine) on survival in patients with colorectal carcinoma, a randomized, controlled pilot study was performed in three university hospitals in Copenhagen, Denmark. METHODS: A total of 192 patients, who had undergone a resection or an exploratory operation for adenocarcinoma of the colon or rectum between May 1988 and May 1991, were enrolled in the study. After a median observation time of 40 months, outcome was noted for each patient concerning cancer-specific mortality rate. RESULTS: In patients operated with curative intent (n = 148), no difference was found in cancer-specific mortality between the two treatments. However, a tendency toward reduction in mortality rate was found in patients with curatively operated Dukes Stage C carcinoma (P = 0.11, log-rank test; difference, 29 percent; 90 percent confidence interval, 2 to 57 percent) in the cimetidine-treated group. In patients with disseminated disease no total difference was found between the two treatment groups. CONCLUSIONS: Cimetidine does not seem to reduce mortality in patients with colorectal cancer, but there seems to be a tendency toward a survival benefit in patients undergoing surgery for Dukes Stage C carcinoma. Results seem to justify trials in this patient category to reveal a benefit of H2 receptor antagonists in adjuvant therapy of colorectal carcinoma.

Adenocarcinoma

Estrogen receptors in the human male bladder, prostatic urethra, and prostate. An immunohistochemical and biochemical study.

The distribution and quantity of estrogen receptors (ERs) in the human male bladder, prostatic urethra and the prostate were studied in eight males with recurrent papillomas of the bladder or monosymptomatic hematuria (median age 61 years), 14 men undergoing transurethral resection due to benign prostatic hyperplasia (median age 70 years), and nine men undergoing cystectomy due to malignant tumour of the bladder (median age 70 years). In the first group of patients, biopsies for immunohistochemical examination were obtained from the bladder vault, bottom, both side-walls, the trigone area, and the mid-portion of the prostatic urethra, and in the second group from three locations of the prostatic urethra (bladder neck, mid-portion and veramontanum). In the third group, tissue specimens were taken from the vault of the bladder, prostatic urethra, and the prostate, for immunohistochemical as well as biochemical analysis. In the first group, ERs were found in three out of eight specimens of the prostatic urethra, and in one of these, ERs were confined to periurethral glands. ERs could not be demonstrated in any of the bladder-biopsies. In the second group, ERs were not found in the bladder neck, but were seen in four preparations from the veramontanum and in two from the midportion of the urethra. ERs were located in the urothelium and periurethral glands. In the third group, ERs were seen immunohistochemically in the prostatic urethra (two cases) and the prostatic stromal tissue (two cases). ERs could be demonstrated in the bladder neither by immunohistochemistry nor biochemically.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Treatment of primary spontaneous pneumothorax with intrapleural tetracycline instillation or thoracotomy. Follow-up of management program.

Spontaneous pneumothorax has a high incidence of recurrence if treated only with intercostal drainage. A series of 404 patients in a special treatment program is presented. Early thoracoscopy was performed in 97%. The 86 patients (21%) then found to have true cyst (> 2 cm) were subjected to thoracotomy with removal of cyst and mechanical pleurodesis, and in the others a dilute tetracycline solution was instilled intrapleurally, followed by intercostal tube drainage. There was no recurrence of pneumothorax in the group treated with thoracotomy, but 8% recurrence in the tetracycline-treated group. Repeated thoracoscopy was performed in 21 of the 25 patients with recurrent pneumothorax, and thoracotomy with resection of large cyst in four. The probable cause of recurrence was identified in 21 cases, making the true recurrence rate 1% (4 patients). The mean hospital stay was 7.6 days for the patients with thoracotomy and 4.3 days for the tetracycline-treated group.

Adult

Terodiline, emepronium bromide or placebo for treatment of female detrusor overactivity? A randomised, double-blind, cross-over study.

In a randomised, double-blind study, 20 women with idiopathic detrusor instability and associated symptoms were treated with terodiline 25 mg bd, placebo, and emepronium bromide 200 mg tds--each drug being given for 3 weeks with placebo as wash-out period before cross-over. The results were evaluated according to drug preference, frequency charts and elimination of detrusor instability on cystometry. Serum levels of both drugs were monitored as control of tablet intake. The preference for terodiline to placebo was statistically significant: 14/3 women (P less than 0.05), and the majority of women (12/4) preferred terodiline to emepronium. Terodiline also gave a small but significant reduction in 24 h micturition frequency and eliminated detrusor instability in almost 50% of the patients (P less than 0.05). Side effects were frequent but mild in all three treatment periods. It was concluded that terodiline offers an alternative in the treatment of female detrusor instability.

Adult

[Pneumothorax].

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Denmark

Decidual prolactin content and secretion at term. Correlations with the clinical data.

This study was conducted to describe the distributions of the initial decidual PRL content (D-PRL) and the decidual PRL secretion (D-PRL-s) in vitro at term and to ascertain whether the clinical data might influence these decidual PRL measures and their correlation with the amniotic fluid PRL concentration (A-PRL). Decidual tissue was obtained after 134 normal pregnancies at term. D-PRL and D-PRL-s into the medium after an 8 h incubation were determined. The distributions of D-PRL and D-PRL-s were skewed to the right. A logarithmic transformation generated symmetric distributions. Eight women who were delivered by vacuum extraction due to intra-uterine asphyxia had D-PRL values similar those in normal vaginal parturition, whereas D-PRL-s values were significantly reduced (p less than 0.02). No significant difference (p greater than 0.05) was found in the decidual PRL measures in the vaginal deliveries between those receiving labor stimulating medication and those without, or between women who gave birth vaginally and women undergoing elective cesarean section. Stepwise multiple regression analyses of data obtained from 30 women who gave birth after uncomplicated or various pathological pregnancies showed logarithmically transformed A-PRL to be closely correlated with D-PRL, and these correlations were improved by including the week of gestation as a second step (p less than 0.00001). After normal pregnancy, D-PRL-s was significantly correlated with D-PRL (p less than 0.01), and D-PRL was correlated with the week of gestation (p less than 0.05). None of the remaining clinical data improved the correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Effect of ouabain and bumetanide on the basal and the osmolality-affected prolactin secretion from human decidual cells in vitro.

Human decidual explants were incubated in vitro in media containing 10(-5) mol/l ouabain or 10(-4) mol/l ouabain or 0.5 X 10(-4) mol/l bumetanide to change the intracellular ionic concentrations. In isosmotic incubations (osmolality 315 mmol/kg), no significant effect of either 10(-5) mol/l ouabain or 0.5 X 10(-4) mol/l bumetanide was found on the decidual prolactin secretion (D-PRL-s). 10(-4) mol/l ouabain significantly decreased both decidual prolactin production and D-PRL-s (P less than 0.05) and was therefore not used for the following cross-over experiments. Hyperosmotic media (387 mmol/kg) were produced by changing the concentration of either sodium chloride, potassium chloride, or mannitol. All increased D-PRL-s compared with the isosmotic media (315 mmol/kg). 10(-5) mol/l ouabain significantly diminished the increase otherwise elicited by the sodium chloride and the mannitol hyperosmotic media. However, in the hyperosmotic potassium chloride medium with 10(-5) mol/l ouabain, the D-PRL-s remained increased. The hyperosmotic medium (252 mmol/kg) reduced D-PRL-s compared with the isosmotic media (315 mmol/kg) and no significant effect of ouabain was found. Bumetanide did not change the D-PRL-s into any of the hypo- or hyperosmotic media compared with the secretion at 315 mmol/kg. Based on experience from other cell types, the results further indicate that the intracellular ionic concentrations could be of importance to the secretion of decidual prolactin in vitro.

Bumetanide

Effect of soya bean oil on symptoms, gastric emptying and gut hormone release in patients with postvagotomy symptoms.

In a preliminary study the effect of an aperitif of a stable fat emulsion on symptoms, gastric emptying of a hypertonic glucose meal and associated release of insulin, neurotensin, enteroglucagon, gastric inhibitory polypeptide (GIP) and vasoactive intestinal polypeptide (VIP) was evaluated in 9 patients with postprandial gastrointestinal discomfort after vagotomy. In each patient gastric emptying of the glucose meal was measured twice: 20 min after intake of distilled water and after fat emulsion. On both occasions neurotensin, enteroglucagon and GIP rose significantly from fasting values. In contrast to distilled water, the fat emulsion was able to significantly activate the release of the hormones before ingestion of the glucose meal. All the patients had a rapid emptying of the glucose meal after distilled water and they experienced symptoms that corresponded with the nature of their spontaneous symptoms after ordinary meals. The fat emulsion reduced the early emptying of the meal and relieved the symptoms of the dumping patients, whereas gastric emptying and symptoms were variable in the patients with diarrhoea and other postvagotomy symptoms. The intake of an aperitif of soya bean oil seems to be an effective treatment only in patients with the dumping syndrome.

Adult

Histochemistry of sacrococcygeal chordoma.

A characteristic feature of chordomas is the content of a great amount of mucinous material. A sacrococcygeal chordoma surgically removed from a 76-year-old man was histochemically investigated in order to obtain some information about the composition of the mucopolysaccharides. From the results of the staining reactions, we concluded that they are of the acid category and probably a mixture of weakly sulphated and carboxylated glycoproteins.

Aged

Repeated bladder distension by the Cystomat in the treatment of detrusor instability.

Treatment of idiopathic detrusor instability with drugs and prolonged distension of the bladder is often unsatisfactory. Some amelioration of symptoms has previously been described by using the Cystomat. The present study showed that 1 week's treatment with the Cystomat produced convincing subjective improvement as well as an increase in bladder capacity. The improvements were statistically significant and persisted for 3 months. Although the mechanism by which bladder distension exerts its effect is poorly understood, the technique of repeated distension offers an alternative in the treatment of patients with idiopathic detrusor instability.

Adult

The dependence of human decidual prolactin production and secretion on the osmotic environment in vitro.

Human decidual tissue from uncomplicated term pregnancies was incubated in vitro using a cross-over design of incubation lasting for 72 h. The decidual issue of each membrane was added sequentially to media with the osmolalities 252, 315 and 387 mmol/kg, and the different osmolalities were in 33 experiments induced by changing the concentration either of sodium chloride, potassium chloride, mannitol, sucrose, or choline chloride. At 387 mmol/kg all substances elicited a significant increase in Prl secretion compared with the 315 mmol/kg media (14-27%) or the 252 mmol/kg media (26-46%). When the sodium chloride, potassium chloride, sucrose, and choline chloride media at 387 mmol/kg were compared in another 7 experiments, potassium chloride increased Prl secretion more effectively than the others (10%, P less than 0.05). The incubation cross-over design did not permit determination of the decidual Prl content after incubation in each of the various media, but in 28 experiments the mean decidual Prl content was 12.7 mIU per 100 mg dry tissue (range 4-30) before and 8.7 mIU per 100 mg dry tissue (1-17) after the experiments. The mean amount of Prl secreted during the successive incubations was 152.2 mIU per 100 mg dry tissue (19-672) which showed the secretion to be a result of continued Prl production. The effect of osmolality was independent of the basal production rate. These results indicate that the intracellular ionic concentrations, probably of potassium ion or of chloride ion, are of importance in the regulation of the synthesis and secretion of decidual Prl in vitro.

Cells, Cultured

Cholecystokinin-stimulated and postprandial serum concentrations of bile acids in alcoholic liver cirrhosis.

This investigation was undertaken to examine the alterations in serum bile acid concentration after intravenous administration of cholecystokinin and a standard meal in 13 patients with alcoholic cirrhosis. Total 3 alpha-hydroxy bile acids in serum (SBA) were monitored for 2 h after injection of cholecystokinin and for 3 h after the standard meal. The median fasting value of SBA was 39.9 mumol/l (range, 3.2-148 mumol/l). The increase in SBA after cholecystokinin started earlier and lasted shorter than after standard meal stimulation (median, 30 min and 120 min, respectively). The appropriate relative peak levels of SBA were 173% and 212% of the fasting value. The increments were significant (P less than 0.01) within groups but insignificant between groups. Day-to-day variation of postprandial SBA was more pronounced than after cholecystokinin stimulation. The difference, however, was insignificant. An inverse correlation was detected between both fasting and stimulated peak levels of SBA and P-coagulation factors 2, 7, and 10.

Adult