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Biomedical subjects

K M Jensen

Publications and source records attributed to K M Jensen.

At least 37 records · Page 2Linked to original sources
PubMed1995

Uroflowmetry in elderly men.

In the evaluation of lower-urinary-tract symptoms, uroflowmetry has played a major role for decades due to its noninvasiveness and simplicity to perform. However, several pitfalls have to be taken into account as mentioned in this review. They include artifacts, circadian changes, observer variation, minimal volume, association with infravesical obstruction, relevant variables, reference values, and clinical applicability. Thus, uroflow should be interpreted with proper caution.

Aged↗
PubMed1995

Voiding problems in patients with HIV infection and AIDS.

The prevalence and type of urinary voiding problems were prospectively investigated in 77 men and four women (median age 36 years) with HIV infection or AIDS consecutively attending an outpatient clinic. Urologic symptoms were registered from replies to a questionnaire and urologic evaluation was made when indicated. All patients were neurologically examined. In addition, urodynamic data from ten consecutively referred HIV/AIDS patients were retrospectively analyzed. Two of the 81 prospectively studied patients had severe, and eight had moderate voiding problems, while 19 had pathologic findings at neurologic examination. Of three patients referred for urodynamic investigation, two were found to have neurogenic bladder dysfunction. In three of the total 13 urodynamically studied patients the findings suggested neurogenic bladder dysfunction secondary to the infection. We conclude that HIV/AIDS infection affects voiding only in minor degree, and when it does the disease is often advanced and dominated by symptoms from other organs. The relevance of urologic/urodynamic investigation in HIV/AIDS patients thus seems limited.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Urethral condylomata, due to human papilloma virus (HPV) type 6/11., associated with transitional cell tumors in the bladder and ureter. A case report.

Condylomata in the urethra usually occur as a complication to genital warts on the external genitals and are most often situated in the distal part of the urethra. This is a report of a male patient with recurring papillomatous transitional cell tumors, stage Ta and T1, grade 2 and 3 in the bladder and the right ureter, who presented with extensive condylomatosis in the urethra from the meatus to the verumontanum, without simultaneous presence of condylomata at the external genitals. Condylomatous fragments were also present in the TUR specimen from the bladder, but may have been displaced from the urethra during cystoscopy. Using PCR technique and in situ hybridisation, HPV types 6/11 were detected in the condylomata, but no virus was present in the transitional cell tumors.

Adult↗
PubMed1994

[Varicocele of the testis. A comparison between laparoscopic and conventional surgery].

We compared the results of laparoscopic varicocelectomy in 11 patients with those of 11 conventional varicocelectomies. There was a significantly longer operating time for laparoscopic surgery (45 versus 35 minutes), but a shorter hospital stay (one versus two days) and a quicker return to normal activity (two versus four days). There was no statistically significant difference in the outcome of surgery in the two groups concerning symptomatology and objective findings, but three patients, all conventionally operated, had no effect of the operation. One patient, operated laparoscopically, had signs of genitofemoral nerve injury. We conclude that laparoscopic varicocelectomy may be superior to conventional surgery, but further evaluation in larger, prospective studies is warranted.

Adolescent↗
PubMed1994

[Evaluation of preoperative cavernosometry and cavernosography in erectile dysfunction of presumed venous origin].

During the period November 1988 to September 1992, 42 patients with erectile dysfunction underwent preoperative dynamic cavernosometry and cavernosography. Radiologically visible venous leakage was demonstrated in all cases but one. At a maintenance flow of more than 20 ml/min, venous leakage was always demonstrable and the types of veins opacified were stereotype. Therefore, clinically relevant leakage can be documented on the basis of cavernosometry. A surgical approach to penile venous leakage with resection of the deep dorsal vein and ligation of all superficial anastomoses including the superficial dorsal vein will eliminate the most common types of radiologically visible veins.

Adult↗
PubMed1994

[Penile vein surgery. A follow-up study of erectile dysfunction of presumed venous origin].

Forty patients who underwent penile venous surgery (PVS) because of suspected veno-occlusive dysfunction, were evaluated approximately 15 months (median) postoperatively as to their sexual capability. Although 47.5% were able to obtain penile rigidity, this was sufficient for intercourse in only 35%. Short-term subjective improvement was noted in 55% as opposed to long-term improvement in 35%. Analysis for predictive factors was negative. In conclusion, the indication for PVS should be reconsidered, as an insufficient theoretical concept might explain the low long-term success rate.

Adult↗
PubMed1994

Long-term probability of prostatism vs general morbidity and mortality. Prospectively obtained data in a randomly selected cohort aged > 50 years.

In a 7-year study of 178 randomly selected healthy men older than 50, data were respectively obtained concerning treatment for benign prostatic hypertrophy (BPH) and overall morbidity and mortality. Plain symptom scores were calculated in all cases and urinary voiding was recorded in 112. The maximum flow rate was read and the pattern of flow curve determined. Log rank test and survival curves were used in evaluation of results. The general risk of death or disease overshadowing BPH greatly exceeded the probability of surgery for prostatism. The only factor predicting need for prostatectomy was a symptom score higher than 6 points. If the symptom score is low and indications for treatment are otherwise, relative, an expectant attitude to surgery for BPH is advocated.

Age Factors↗
PubMed1994

Plasma concentrations of glyceryl trinitrate and its dinitrate metabolites after sublingual administration to volunteers. Simultaneous determination of glyceryl trinitrate and its dinitrate metabolites.

The plasma profiles of nitroglycerin (glyceryl trinitrate, GTN, CAS 55-63-0) and its dinitrate metabolites (1,2-GDN and 1,3-GDN) were estimated after sublingual administration of GTN tablets 0.5 mg (Nitromex) given in single doses to 20 volunteers. Blood samples (totally 20) were collected to 2 h after administration, and the plasma concentrations of GTN, 1,2-GDN, and 1,3-GDN were measured simultaneously by gas chromatography. The pharmacokinetic parameters, Cmax, tmax, t1/2, and the dinitrate ratio (AUC1,2-GDN/AUC1,3-GDN) were determined for each subject. The plasma concentrations of GTN reached a maximum of 1.38 ng/ml (mean) (range: 0.32-3.18 ng/ml) after 4.9 min (mean) (range: 3-8 min). The plasma concentrations of 1,2-GDN and 1,3-GDN reached a maximum of 3.11 ng/ml (mean) (range: 1.14-5.44 ng/ml) and 0.70 ng/ml (mean) (range: 0.33-1.19 ng/ml) after 13.7 min (mean) (range: 8-40 min) and 17.6 min (mean) (range: 8-40 min). The t1/2 values (mean) were 3.3, 35.5, and 38.1 min for GTN, 1,2-GDN, and 1,3-GDN, respectively. The dinitrate ratio was estimated to be 4.1 (mean).

Administration, Sublingual↗
PubMed1993

Longitudinal observations on normal and abnormal voiding in men over the age of 50 years.

A cohort of 200 men over the age of 50 years was selected at random. Initially 112 men participated. After 5 years 61 were participating, and 2 years later 34 men still had no voiding problems, while 19 had had treatment for prostatism. A history was obtained and all 112 had symptom analysis and uroflow examination. The uroflow variables Qmax, Qave, Qmax-time, Q "corrected", volume and the ratio Qmax/Qmax-time were recorded together with the symptom score and subjective evaluation. After 5 and 7 years all primary data were reviewed in the 61 and 34 men respectively, while a full history was obtained in the rest. The 3 sets of data were evaluated separately as 3 cross-sectional investigations and as paired data sets by means of non-parametrical statistical analysis. Comparing the 3 sets of data longitudinally, significant differences were found in Qmax, Qave, Qcor and Acc. A correlation analysis showed that Qmax, Qave, Q "corrected" and volume decreases significantly with advancing age in asymptomatic men, while no correlation with age was found in the 19 treated men. On the basis of the 93 men, untreated for 7 years, nomograms of Qmax, Volume and Acc were constructed using 2.5, 25, 50, 75 and 97.5% percentiles in 5-year groups. Likewise, a nomogram on symptom score was constructed on the basis of the 82 men, asymptomatic and untreated for 7 years. In conclusion, uroflow in subjectively normal men over the age of 50 years shows increasing abnormality with advancing age. At the same time elderly men tolerate a considerable amount of symptoms of infravesical obstruction. The severity of symptoms increased with advancing age, but differently in persons likely and not likely to need operation.

Aged↗
PubMed1992

[Testing an ultrasonic scanner for determination of urinary bladder volume].

Bladderscan BVI 2000 is a portable ultrasound scanner, specially constructed for determination of bladder volume. We have tested this scanner for accuracy, systematic errors and the training required to use it. The bladder volumes measured by ultrasound scanning were compared with the true volumes. Fifty-six measurements were made. We found the accuracy of BVI 2000 sufficient to determine bladder volumes as either small or large. We found no systematic errors. No special training is required to use the scanner. The device is thus useful in most clinical situations when greater accuracy than indicated here is not necessary.

Evaluation Studies as Topic↗
PubMed1992

Effects of sulfide and low redox potential on the inhibition of nitrous oxide reduction by acetylene in Pseudomonas nautica.

Membrane introduction mass spectrometry was used to investigate the inhibitory effect of acetylene on the nitrous oxide reductase activity of intact cells of Pseudomonas nautica. We studied the effects of the concentrations of nitrate and sulfide, and the redox potential, which have all been implicated in causing a decrease in the inhibitory effects of acetylene during measurements of denitrification in natural environments. There was no evidence that the concentration of nitrate influenced the effect of acetylene. Lowering the redox potential with the reductant Ti(III)-nitrilotriacetate caused a slight alleviation of acetylene inhibition. Much greater effects at the same redox potential were obtained with concentrations of sulfide in the range 1-10 microM.

Acetylene↗
PubMed1992

Age-related variation in urinary flow variables and flow curve patterns in elderly males.

A group of randomly selected males, over 50 years of age, was examined with regard to history and urinary flow rate. Originally, the group had comprised 93 men without voiding problems, 15 who, although suffering from voiding problems, had not yet contacted their doctor, and 4 who had contacted their doctor because of voiding problems. Five years later the data were re-examined and 61 men were fully investigated again; in the remaining 51 patients only the history was updated. The 2 sets of data were evaluated separately as 2 cross-sectional investigations and as paired data sets by means of non-parametric statistical analysis. All uroflow variables were considered, i.e. Qmax, Qave, Qmax-time, Q "corrected", volume and the ratio Qmax/Qmax-time. In addition, the flow curve configuration was classified as normal or abnormal. When compared as 2 cross-sectional investigations, the latter confirmed the results of the first. Qmax, Qave, Q "corrected" and volume decreased with advancing age, but no correlation could be demonstrated between Qmax-time and age. The flow curve pattern altered, so that a normal flow curve was seldom seem at an advanced age. Uroflow variables tended towards the abnormal with advancing years and symptoms increased concurrently. These changes were largely accepted by the elderly males. Thus the decision to operate for benign prostatic hyperplasia should be based on both history and urinary flow.

Aged↗
PubMed1991

[Clinical continuing education of younger physicians. A pedagogic trial with postgraduate clinical training using the clinical decision process].

The aim of this study was to improve the clinical training of the staff of a department of internal medicine. A total of 16 clinical pathological conferences with patient demonstrations were given. The doctor in charge of the conference motivated his choice of patient and made a critical review of the clinical decision process according to a 16 item check list. The median time used for planning of the presentation was five hours, range 2.5-8 hours. Sixteen of the participants (94%) found the training programme of very high or high quality while 1 (6%) found it less good. Fifteen (88%) of the doctors indicated higher clinical skill after than before the conferences (p less than 0.01). The registrars revealed a significantly better improvement of their clinical skills than did the senior registrars and consultants (p less than 0.05). The median educational value of the items of the check list was stated to be 1.3 (0-2). Statement of the probability of the final diagnosis of the patient, value judgement in clinical decisions and costs of diagnostic examinations were considered of highest educational value, 1.5-1.6. Postgraduate clinical pathological conferences with patient demonstrations including systematic reviews of the clinical decision process are valuable in the clinical training of doctors.

Clinical Competence↗
PubMed1991

In vivo 1H-spectroscopy of human intracranial tumors at 1.5 tesla. Preliminary experience at a clinical installation.

Magnetic resonance spectroscopy (MRS) may contribute to the characterization of intracranial tumors in vivo. Volume selective water suppressed proton spectroscopy offers the possibility to study a number of metabolites in the brain including choline (CHO), creatinine/phosphocreatinine (CR/PCR), N-acetylaspartate (NAA), and lactate. Using the stimulated echo technique we have studied 17 patients with intracranial tumors. In all cases the tumors were classified based on histologic evaluation. The tumor spectra differed considerably from those obtained in healthy brain tissue. The results indicate a relative decrease in the NAA and CR/PCR content. In many cases a lactate peak could be seen especially in the tumors with malignant growth characteristics. Our preliminary results suggest that proton spectroscopy may contribute to the differentiation of brain tumors with respect to benign or malignant growth. However, further research is warranted before a definite conclusion can be drawn.

Adult↗
PubMed1990

Significance of predominantly irritative symptomatology before a prostatic operation.

The prognostic value of an excess of preoperative irritative symptoms of prostatism was evaluated. The prospective study included 139 men treated for benign prostatic hyperplasia who were evaluated by symptom analysis, uroflowmetry, water cystometry and pressure-flow study preoperatively and 6 months postoperatively. The criterion for evaluation of postoperative success or failure was the subjective evaluation of the patient at 6 months. None of the single preoperative symptoms of prostatism predicted an eventual postoperative failure, nor did the preoperative predominance of irritative symptoms or the combination of irritative symptoms and detrusor instability attain prognostic significance.

Humans↗
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↗
PubMed1990

In vivo 1H spectroscopy of the human brain at 1.5 tesla. Preliminary experience at a clinical installation.

In vivo localized water suppressed proton spectroscopy of human brain was carried out on 15 healthy volunteers and 2 patients suffering from a brain tumour and an infarction, respectively. The measurements were performed on a whole body MR system, operating at 1.5 tesla using the stimulated echo technique. Our preliminary results indicate that it is possible to detect a number of metabolites in the brain within a total measurement time of one hour. The dominant peaks in the spectra from healthy volunteers are N-acetyl aspartate, choline and creatine/phosphocreatine. The spectra obtained from the brain tumour and the infarct, respectively, differed very much from those obtained in healthy brain tissue. Our preliminary results indicate that localized proton spectroscopy may contribute to non-invasive brain tumour classification and possibly also to the differentiation between tumours and infarcts in clinically doubtful cases.

Adult↗