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Biomedical subjects

J T Andersen

Publications and source records attributed to J T Andersen.

At least 73 records · Page 4Linked to original sources
PubMed1991

Infrequent voiders syndrome (nurses bladder). Prevalence among nurses and assistant nurses in a surgical ward.

We evaluated the prevalence of infrequent voiders syndrome (defined as women with a mean voided volume above 400 ml) and predisposing factors among the female nursing staff in a busy 100 beds department of surgery. One hundred and five nurses and assistant nurses were invited to fill in a questionnaire and a frequency/volume chart for a 24-hour period. The infrequent voiders were further studied using uroflowmetry and medium-fill CO2 cystometry. Seventy-two women completed the study. Six (95% c.l. 3%-17%) were infrequent voiders, although fifty women (57%-80%) suppressed the desire to void during working hours. Main reasons for suppression of desire to void were busy work, poor toilet facilities and indolence. The frequency of micturition was higher during evening and night shifts than in the day shift. In the infrequent voiders the functional bladder capacity ranged from 550-1,100 ml, but none had residual urine exceeding 120 ml.

Adult↗
PubMed1991

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↗
PubMed1991

Extracorporeal shock wave lithotripsy of urinary calculi. Results from the first 306 patients treated at the Copenhagen Municipal Stone Center with a second generation lithotriptor.

The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29% had residual stones. Corresponding rates after 3 and 6 months were 58%, 24% and 18% and 70%, 21% and 9% respectively. Septicemia occurred in 4 patients and cardial arrhythmia in 34 patients (11%). No serious intra- or perirenal hematomas were registered. In 9% additional procedures were required and 11 patients had residual stones removed at open surgery. The used second generation lithotriptor with X-ray based stone localisation is effective for treatment of both renal calculi and ureteral calculi in situ in all three segments of the ureter.

Adolescent↗
PubMed1990

[Urinary retention in connection with postoperative pain treatment with epidural opioids].

The incidence of retention of urine in cases of postoperative epidural opioid analgesia varies from 15% to 90%. The extent to which this phenomenon depends upon the dosage employed has not been elucidated. The cause of postoperative retention of urine (PU) is probably a combination of the central and peripheral effect of the opiate involving altered autonomic activity. Increased sympathetic activity resulting from surgery may, similarly, be a pathogenetic factor. The current methods of treatment are prophylactic or symptomatic alpha-receptor blockade, naloxon in refractory doses or catheterization. Inhibition of per- and postoperatively increased sympathetic activity may possibly prevent PU. Carbacholine is not effective in the treatment of postoperative retention of urine. In animal experimental studies, kappa-receptor agonists have an analgesic effect without urodynamic side-effects but no clinical trials on man have hitherto been undertaken. When postoperative retention of urine occurs after epidural opioid treatment, clean intermittent catheterization or introduction of a thin suprapubic catheter are recommended.

Analgesia, Epidural↗
PubMed1990

[Extracorporeal shock wave treatment of urinary calculi. Results after treatment of the first 207 patients at the Copenhagen City Stone Center with a second generation lithotriptor].

Early experience of extracorporeal shock wave lithotripsy (ESWL) using a second generation lithotriptor (Siemens Lithostar) is reported. Two hundred and seven patients underwent 272 treatments for 291 stones. There were 259 renal calculi, including three staghorn calculi and 32 ureteric calculi. Treatments were performed under local analgesia (78%) or epidural or general anaesthesia (22%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2,487 +/- 1,262 shocks. The first month stone clearance rate was 43%, 24% had fragments less than 6 mm and 33% had residual stones. The same figures after three and six months were 57%, 23% and 20% and 71%, 23% and 6%, respectively. Septicaemia occurred in four patients and cardiac arrhythmia in 24 patients (12%); no serious intra- or perirenal heamatomas were registered. In 7% additional procedures were required, seven patients had residual stones removed at an open operation. The Lithostar is an effective second generation lithotriptor which can be used for renal, staghorn and ureteric calculi in situ in all three segments without stone manipulation prior to ESWL.

Adolescent↗
PubMed1990

Extracorporeal shock wave lithotripsy of kidney stones does not induce transient bacteremia. A prospective study. The Copenhagen Extracorporeal Shock Wave Lithotripsy Study Group.

During 58 extracorporeal shock wave lithotripsies 161 blood cultures were drawn to evaluate the incidence of bacteremia during the procedure. Only 3 blood cultures drawn during the procedure yielded bacteria, in all cases probably skin flora contaminants. Post-lithotripsy fever was noted in 29% of the patients, and could not be associated with transient bacteremia and was not influenced by antimicrobial prophylaxis. Patients with a positive urine culture after extracoporeal shock wave lithotripsy may have an increased risk of septicemia.

Adult↗
PubMed1990

The intraprostatic spiral. New treatment for urinary retention.

In a series of 45 consecutive patients with acute or chronic urinary retention, 41 were treated by insertion of an intraprostatic spiral using ultrasonic guidance under local anaesthesia. Insertion was successful in 35 patients and in 6 the spiral was inserted endoscopically. During a follow-up period of 12 months 8 patients died, all with a functioning spiral. The device was removed in 16 patients; in 6 cases the reasons for removal were related to the spiral and in 10 they were not. The spiral remained in situ in 17 patients and all had satisfactory voiding. This device is a good alternative to an indwelling catheter in patients awaiting prostatic surgery and also in those who are either unfit or unwilling to undergo prostatectomy.

Aged↗
PubMed1990

Urodynamic implications of benign prostatic hyperplasia.

By the age of 60, about 70% of men have developed benign prostatic hyperplasia (BPH), and 85%-95% of these have symptomatic dysfunction of the lower urinary tract, 10%-20% undergoing prostatectomy. Although transurethral resection of the prostate is generally considered to be a safe and effective surgical procedure, it has recently been shown that immediate surgery, as opposed to a wait-and-see strategy, leads to a 1-month reduction in life expectancy. In 10%-15% of the patients who undergo surgery, the postoperative result is unsatisfactory as symptoms persist. Between 4% and 40% of patients undergoing prostatectomy become impotent. A urodynamic study with a scope extending beyond that of the standard urological examination is therefore needed to help reduce the number of treatment failures. The value of preoperative cystometry is questionable, since preoperative documentation of detrusor instability has no bearing on the postoperative result. Measurement of urinary flow, in contrast, is of predictive value in BPH, patients in whom the maximum urinary flow before surgery is more than 15 ml/s having significantly worse results of surgery than those with a maximum urinary flow of less than 15 ml/s before surgery. Further data relevant to the prognosis are yielded by pressure-flow investigations, which allow a quantitative estimate of the degree of obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1989

[The prostate coil. A new form of treatment of urinary retention in men. Clinical experiences during a 6-month observation period].

A prostate spiral developed in Denmark may be introduced with a special catheter under local anaesthesia under the guidance of transabdominal ultrasonic scanning. Forty-four consecutive patients with retention of urine were treated with the prostate spiral. Ultrasonic-guided introduction was successful in 33 patients (73%). Cystoscopy proved necessary for introduction of the spiral in six patients and, in two cases, it was introduced over a ureteric catheter. In four patients the spiral could not be introduced on account of pronounced curving of the prostatic urethra. On follow-up examination after six months, eight patients had died with spirals which functioned well. The spiral had been removed in 12 patients and, in six of these, the problems could be attributed to the spiral. Nineteen out of 21 patients with the spiral in situ had subjectively satisfactory miction. The median maximal flow was 9.4 ml/s (range 1.0-21.3 ml/s). Ultrasonically-guided introduction of the prostate spiral under local anaesthesia is an easy and rapid procedure. The spiral is a good alternative to urethral indwelling catheter, also during the waiting time before prostatectomy.

Aged↗
PubMed1989

[Erective dysfunction. Therapeutic consequences of a basal program of investigation].

During a period of nine months, 50 men aged 21-75 years were investigated on account of erective dysfunction by means of a simple outpatient programme of investigation. Five patients could be discharged after the primary contact with history-taking and information about further investigation and treatment. Forty-five patients were submitted to the programme of investigation which consisted of measurement of penile blood pressure, Doppler investigation of the penile arteries and the papaverine test. After this, ten patients (20%) could be referred for sexological advice while five were discharged as they did not desire further treatment. Sixteen patients (32%) were taught self injection. Out of the six patients (12%) in whom arterial insufficiency was demonstrated, penile prostheses were introduced operatively in four. Venous leakage from the corpus cavernosum was demonstrated in seven patients (14%) by means of cavernosometry and cavernosography. Venous ligature was performed in five with good effect in two. Thus, specific treatment could be offered to 35 men (70%) with satisfactory therapeutic results in 22 (44%).

Adult↗
PubMed1989

The intraprostatic spiral: a new device for insertion with the patient under local anesthesia and with ultrasonic guidance with 3 months of followup.

Acute or chronic urinary retention (median retention volume 1,000 ml.) was relieved successfully in 41 of 45 consecutive patients by insertion of an intraprostatic spiral with the patient under local anesthesia and with ultrasonic guidance. Insertion guided by ultrasound was successful in 35 patients (77 per cent). In 6 patients the spiral was inserted via the traditional endoscopic technique. During 3 months of followup the spiral remained in situ in 27 patients and in 6 it was repositioned. These 33 patients had free voiding with a median maximum flow rate of 13.6 ml. per second. Residual urine volume 1 month after insertion of the spiral was low (median 27 ml.). In 8 patients the spiral was removed during the observation period due to urinary incontinence or retention. The intraprostatic spiral is a favorable alternative to an indwelling catheter in patients awaiting an operation and in those with a high operative risk.

Aged↗
PubMed1989

Molecular and mutational analysis of three genes preceding pyrE on the Escherichia coli chromosome.

The nucleotide sequence of two kilobase pairs (kb) 5' to the orfE-pyrE operon has been determined. The sequence revealed two open reading frames, orfX and orfY, consisting of 286 and 274 codons, respectively, and having a transcriptional orientation opposite that of the orfE-pyrE operon. Analysis of transcription initiations showed that the promoters of orfE and orfX constitute a pair of divergent promoters with overlapping -35 regions and that orfY is transcribed from an independent promoter. Translational analysis indicated that the orfs are expressed in Escherichia coli. The orfE, orfX, and orfY genes were inactivated on the bacterial chromosome by deletion-insertion mutagenesis using a kanamycin resistance cassette. The mutants were all viable. However, the orfE deletion caused a dramatic reduction in the level of pyrE expression and a partial pyrimidine requirement, because this mutation prevented transcription of pyrE. the orfE protein seemed without significance for pyr-gene expression in E. coli, and the mutations in orfX and orfY were without detectable phenotypes.

Amino Acid Sequence↗
PubMed1989

Value of monitoring serum gastrin after renal transplantation.

Serum concentration of gastrin was measured before and after renal transplantation in 97 consecutive patients in order to assess possible correlations to gastrointestinal bleeding, allograft function, or graft rejection. In patients with transient signs of allograft rejection (N = 29) or upper gastrointestinal bleeding (N = 12) there was a nonsignificant trend towards higher postoperative gastrin levels, and in patients in whom the graft was removed (N = 29), this tendency was more pronounced (p = 0.06). The study demonstrated that monitoring of serum concentrations of gastrin following renal transplantation is of little clinical value. However, increased gastrin levels in serum may indicate that graftectomy may be the ultimate result.

Cadaver↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1987

The effect of parenteral emepronium bromide (Cetiprin) on postoperative vesical tenesms after transurethral resection of the prostate. A randomized, placebo-controlled study.

Sixty patients were randomized to treatment with either emepronium bromide (Cetiprin) 25 mg t.i.d. or placebo, both medications administered intramuscularly, after transurethral resection of the prostate. Postoperatively, the number of episodes with vesical tenesms and the need for adjuvant analgesic medication were registered. No significant differences in the number of episodes with vesical tenesms or the need for adjuvant analgesic medication were found between the patients treated with emepronium bromide and those treated with placebo.

Aged↗