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Biomedical subjects

T Krarup

Publications and source records attributed to T Krarup.

At least 37 records · Page 2Linked to original sources
PubMed1997

Biologic variability of prostate-specific antigen and its usefulness as a marker for prostate cancer: effects of finasteride. The Finasteride PSA Study Group.

OBJECTIVES: The effects of finasteride on prostate-specific antigen (PSA) variability and usefulness in prostate cancer detection were examined. METHODS: Percent change and crossover of PSA levels between the low (1.0 to 3.9 ng/mL) and high (4.0 to 10.0 ng/mL) ranges were evaluated in 72 men with benign prostatic hyperplasia (BPH) and 77 men with both BPH and prostate cancer (PCa) treated with finasteride or placebo for 6 months. Patients with PCa were studied as a model for evaluating the effects on PSA levels in patients with BPH and latent PCa. As recommended on the product label, PSA levels for finasteride-treated patients were doubled for interpretation. RESULTS: In patients with BPH, most placebo- and finasteride-treated patients with low PSA levels at baseline had subsequent PSA levels below 4.0 ng/mL throughout the study. Among patients with high baseline PSA levels, only 1 of 17 finasteride-treated patients compared with 8 of 13 placebo-treated patients crossed into the low range. In the BPH/PCa study, most placebo-treated patients maintained PSA levels in the same range (15 of 19 less than 4.0 ng/mL; 14 of 16 greater than 4.0 ng/mL). Almost one third of finasteride-treated patients with low PSA levels at baseline crossed into the high range (8 of 22), whereas most patients with high PSA levels at baseline were not masked with treatment, with PSA levels remaining high (12 of 15). CONCLUSIONS: PSA levels cross between the low and high PSA ranges in both finasteride- and placebo-treated patients with BPH and those with both BPH and PCa. Doubling the PSA levels in finasteride-treated patients allows appropriate interpretation of PSA values and does not mask the detection of PCa.

Adult↗
PubMed1996

Occlusion of K+ in the Na+/K+/2Cl- cotransporter of Ehrlich ascites tumor cells.

Proteins of n-octyl glucoside solubilized membrane vesicles derived from Ehrlich ascites tumor cells can occlude 86Rb+.K+ displaces 86Rb+ and it is assumed that 86Rb+ can be used as a tracer to measure K+ occlusion. The following observations indicate that the Na+/K+/2Cl- cotransporter is responsible for this occlusion: (1) Na+ does not compete for the K+ binding site, but rather stimulates 86Rb+ occlusion. (2) K+ occlusion saturates with increasing [Na+] and [K+], the respective K0.5 values being 50 +/- 7 microM for Na+ and 371 +/- 63 microM for K+. (3) Preincubation with 1 mM ouabain does not inhibit 86Rb+ occlusion, arguing against the Na+/K+-ATPase as being responsible for the occlusion. This notion is supported by the K0.5 value for K+ being higher than reported for Na+/K+-ATPase and by the stimulatory effect of Na+. (4) The K+ occlusion is sensitive to [Cl-], and the occluded ion is protected by the presence of bumetanide during cation exchange chromatography. Our results suggest that occlusion measurements of substrate ions could be a profitable way to study the ion binding mechanism(s) of the Na+/K+/2Cl- cotransporter.

Animals↗
PubMed1996

[Clinical consequences of intranasal insulin therapy in insulin-dependent diabetes mellitus].

Metabolic control, hypoglycaemia frequency and nasal mucosal physiology were evaluated in 31 insulin-dependent diabetics treated with intranasal insulin at mealtimes for one month and with subcutaneous fast-acting insulin for another month in a randomized crossover trial. During both periods the patients were treated with intermediate-acting insulin at bedtime. Six of the patients were withdrawn from the study during intranasal insulin therapy due to metabolic dysregulation. Insulin concentrations increased more rapidly and decreased more quickly during intranasal as compared with subcutaneous insulin administration. Metabolic control, assessed by haemoglobin A1c concentrations, deteriorated after intranasal as compared with subcutaneous insulin therapy. The bioavailability of intranasally applied insulin was low, since intranasal insulin doses were approximately 20 times higher than subcutaneous doses. The frequency of hypoglycemia was similar during intranasal and subcutaneous insulin therapy, and nasal mucosal physiology was unaffected after intranasal insulin. We conclude that due to low bioavailability and to a high rate of therapeutic failure, intranasal insulin treatment is not a realistic alternative to subcutaneous insulin injections at the present time.

Administration, Intranasal↗
PubMed1996

Reconstitution of calyculin-inhibited K-Cl cotransport in dog erythrocyte ghosts by exogenous PP-1.

Osmotic swelling of dog and other mammalian erythrocytes activates Cl-dependent K transport, K-Cl cotransport. This activation can be abolished by nanomolar concentrations of calyculin, a potent inhibitor of serine-threonine protein phosphatases. Therefore, K-Cl cotransport is probably activated by dephosphorylation by a type 1 and/or type 2A protein phosphatase (PP-1 and PP-2A, respectively). This was tested directly by incorporating exogenous protein phosphatases into resealed ghosts made from dog erythrocytes previously exposed to calyculin. K-Cl cotransport was nearly completely inhibited in the ghosts. Incorporation of PP-1 reconstituted K-Cl cotransport. Maximal reconstitution was up to 90% of the control flux in the ghosts and 0.1 U PP-1/ml lysate gave half-maximal reconstitution of cotransport. In contrast, PP-2A had no effect. This result with PP-1 provides direct evidence that K-Cl cotransport is activated by PP-1 in dog erythrocytes. Half-maximal activation of K-Cl cotransport required approximately 180 molecules of PP-1 per ghost.

Animals↗
PubMed1995

Intranasal insulin therapy: the clinical realities.

To evaluate metabolic control and safety parameters (hypoglycaemia frequency and nasal mucosa physiology), 31 insulin-dependent diabetic patients were treated with intranasal insulin at mealtimes for 1 month and with subcutaneous fast-acting insulin at meals for another month in an open, crossover randomized trial. During both treatment periods the patients were treated with intermediate-acting insulin at bedtime. Six of the patients were withdrawn from the study during intranasal insulin therapy due to metabolic dysregulation. Serum insulin concentrations increased more rapidly and decreased more quickly during intranasal as compared with subcutaneous insulin administration. Metabolic control deteriorated, as assessed by haemoglobin A1c concentrations, slightly but significantly after intranasal as compared with subcutaneous insulin therapy. The bioavailability of intranasally applied insulin was low, since intranasal insulin doses were approximately 20 times higher than subcutaneous doses. The frequency of hypoglycaemia was similar during intranasal and subcutaneous insulin therapy, and nasal mucosa physiology was unaffected after intranasal insulin. We conclude that due to low bioavailability and to a high rate of therapeutic failure, intranasal insulin treatment is not a realistic alternative to subcutaneous insulin injections at the present time.

Administration, Intranasal↗
PubMed1995

Percutaneous nephroscopic resection of renal pelvic tumors.

During a 7 1/2 years period 31 patients representing 32 renal units presented with filling defects of the renal pelvis at excretory urography. All were treated with percutaneous resection of the pelvis. In 26 renal units there was histologic evidence of transitional cell tumor of varying grade and stage. With a follow-up from 4 to 79 months 8 recurrences including 1 case of tract tumor implant were seen. No other serious procedure related or later complications have appeared. The indications for using the percutaneous approach are discussed, and the results according to grade and tumor-stage are presented. Percutaneous resection of renal pelvic transitional tumors is recommended for low grade, non-invasive tumors, and for carefully selected patients with superficially invasive tumors.

Aged↗
PubMed1995

Pelvic lymphadenectomy (staging) in patients with bladder cancer laparoscopic versus open approach.

In the period 01.01.93 to 01.02.95 a total number of 40 patients underwent a diagnostic pelvic lymphadenectomy. All patients had bladder carcinoma. Twenty-one had the procedure performed as an open operation and 19 had a laparoscopic approach. The groups were comparable as to age, sex and tumor stage. The median number of harvested lymph nodes was found to be the same in the two groups (median 5 lymph nodes). The percentage of lymph node positive patients was comparable -5 of 21 in the open and 4 of 19 in the laparoscopic group. One patient in the laparoscopy group had to be converted to an open procedure because of peroperative bleeding. In the open group one accidental ureteric lesion occurred. It was repaired intraoperatively. Only few postoperative complications were seen. In the open group two cases of troublesome lymphoceles occurred and one case of wound infection. In the laparoscopy group one patient experienced prolapse of an omental snip through a port incision and one patient had a scrotal haematoma which resolved spontaneously. The need for postoperative analgesia was significantly less in the laparoscopy group. The postoperative hospital stay was 8 days in the open versus 1 day in the laparoscopy group.

Aged↗
PubMed1994

Clean intermittent self-catheterization.

The pathogenesis and the symptomatology of the infrequent voiding syndrome is discussed. The acceptability of clean intermittent self-catheterization as a treatment modality for women with the infrequent voiding syndrome is documented through questionnaires and retrospective study of patient records in fifty-four women. This study is part of a study already published.

Adult↗
PubMed1992

The reactivity of anti-porcine gastric inhibitory polypeptide (GIP) rabbit serum R65 with synthetic human and porcine GIP.

Porcine gastric inhibitory peptide (GIP) has been used extensively as a standard and as [125I]-GIP in radio-immunoassays (RIAs) to determine immunoreactive GIP (IR GIP) in human plasma even though porcine and human GIP have slightly different amino acid sequences. A rabbit anti-porcine GIP serum (R65) which has been widely used in the RIA for IR GIP reacts with a part of the GIP molecule which is identical in human and porcine GIP. In order to validate the use of R65 the IR GIP contents of synthetic human and porcine GIP were measured, using natural porcine GIP as standard, and found to be 40% and 35% on a weight basis respectively. These materials were considered unsuitable for use as RIA standards. The IR GIP in samples of human plasma was then assayed with 125I-labelled synthetic human or porcine GIP using natural porcine GIP as standard. The values measured for IR GIP did not depend on the labelled peptide used (p = 0.84, n = 81) and were linearly correlated (r = 0.98, p less than 0.001, n = 81). It is concluded that the value of IR GIP measured in human plasma using R65 and standards of porcine GIP is linearly proportional to the level of human GIP in plasma.

Animals↗
PubMed1992

Transurethral prostatectomy compared with incision of the prostate in the treatment of prostatism caused by small benign prostate glands.

In a prospective, randomized study 60 patients with prostatism caused by small prostate glands (estimated weight < 20 g) had either transurethral prostatectomy (TURP, n = 31) or transurethral incision of the prostate (TUI, n = 29). Operating time and blood loss were significantly less in the group that underwent TUI. There were no differences between the groups in number of days with an indwelling catheter or days in hospital after operation. Eight patients in the TUI group required further operation, as did four in the TURP group, one of whom was discharged with a permanent indwelling catheter. In addition one patient developed a urethral stricture. Nine of the failures of treatment occurred within the first month. Fifty-one patients were followed up at 3 months and 47 were also seen at 12 months. Both operations significantly improved symptom scores and maximum flow rates compared with preoperatively, but the improvement in maximum flow rate was significantly better in the TURP group than in the TUI group. At 12 months TURP had also improved micturition time and voided volume, which TUI had not. Neither operation caused any significant change in sexual activity or erective potency postoperatively. Retrograde ejaculation was, however, seen in more than half of the patients in the TURP group, and only one in the TUI group. We recommend TUI for the treatment of prostatism caused by small prostate glands in patients who want to preserve normal ejaculation or are at poor surgical risk.

Aged↗
PubMed1991

[One year of experience with pulsed dye laser treatment of ureteral calculi].

During a period of one year, 18 patients with symptom-producing ureteric stones were treated with ureteroscopic laser lithotripsy. Pulsed dye laser was employed through a rigid ureteroscope. The laser emits impulses lasting for 2 microseconds with a wave-length of 504 nm. In 11 patients (61%), satisfactory disintegration could be observed and two further patients could be freed from stones by dormia extraction. In three patients treatment was concluded with ultrasound and two with ESWL = extracorporeal shock wave lithotripsy. Three slight perforations of the ureter did not require treatment apart from routine relief by a ureteric catheter or stent. With new thinner scopes, the technique can be simplified, trauma in the ureter reduced and the need for preparation of the ureter eliminated.

Adult↗
PubMed1991

[Experience from the first year of treatment of renal calculi with extracorporeal piezoelectric shockwave lithotripsy].

The experience of the first year with piezoelectric extracorporeal lithotripsy is described. One hundred and eighty-eight patients commenced treatment of 194 renoureteric stone units (a total of 328 stones). Twelve per cent required analgesics during therapy. The median number of treatments was two (1-6) and median number of shock waves 4,200 (450-24,606). One hundred and twenty-three stone units had concluded treatment and control schedules at the follow up end date. After six months, 59% of the stone units were stone-free, while 17% had residual fragments up to 2 mm, and additional 15% had residual fragments between 2 and 6 mm. Only few and insignificant complications were observed. Extracorporeal shock wave lithotripsy by the Wolf Piezolith 2300 is a well-tolerated, effective, relative painless and not complicated treatment of renal stones, and an important part of modern treatment of staghorn- and ureteric stones.

Adult↗
PubMed1991

Pulsed dye laser treatment of ureteral calculi.

During a period of 20 months 36 patients with symptomatic ureteric stones were treated ureteroscopically with laser lithotripsy. A pulsed dye laser was used through a rigid or a semi-rigid ureteroscope. The laser emits impulses at a duration of 2 microseconds and a wavelength of 504 nm. Complete disintegration was obtained in 20 patients (56%), and further 7 patients became stonefree after supplementary basket extraction of residual fragments. In 4 patients additional treatment with ultrasound probe was necessary and further 5 patients were finally treated with ESWL. Five cases of minor perforations of the ureter required no other treatment than stenting with a ureter-catheter or a double J stent. With the new generation of slender semirigid ureteroscopes based on fiberoptics the ureteroscopic procedure is simplified, as no dilatation of preoperative preparation of the ureter is needed.

Adult↗