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Biomedical subjects

A Ek

Publications and source records attributed to A Ek.

At least 37 records · Page 2Linked to original sources
PubMed1983

Effects of prazosin in patients with benign prostatic obstruction.

Prazosin, a selective alpha-1-adrenoceptor blocker, was used in a double-blind crossover study in 20 men with benign prostatic obstruction. Maximum and average flow rates increased, and residual volume and obstructive symptoms were reduced. Voiding pressure parameters, bladder capacity and irritative symptoms did not change significantly. No side effects were noted. We conclude that prazosin seems to be an effective therapeutic alternative in patients with benign prostatic obstruction.

Aged↗
PubMed1983

Nocturnal penile rigidity measured by the snap-gauge band.

Nocturnal penile tumescence is used commonly to evaluate erectile dysfunction. However, this test is not equivalent to erection since it measures circumferential change only rather than the crucial variable of penile rigidity. We present a new concept in the measurement of penile rigidity--the capability of a patient during sleep to break a band furnished with pre-set snap-gauges with different release-force constants applied around the penile shaft. The snap-gauge band was tested simultaneously with the recording of nocturnal penile tumescence measuring penile rigidity rather than tumescence.

Adult↗
PubMed1983

History of cystometry.

Looking back on the changes in the conceptualization of micturition and the development of cystometry, it is reasonable to arrive at several conclusions. Considering their poor technical equipment, Budge's and Goltz's neurophysiologic observations in the 19th century were impressive. The pontine center for micturition, found by Budge, was later confirmed, by Barrington, to have a facilitating and coordinating function. Goltz's demonstration that micturition could be partially accomplished by a spinal reflex was unfortunately given too little attention by clinicians practicing cystometry in the beginning of this century. Dubois' careful pioneering investigations of bladder pressure, and Mosso and Pellacani's studies in bladder motility were outstanding. From Born's and Genouville's contributions, continuously recordable filling cystometry was developed as early as the end of the last century. However, due to a fixation on "bladder tone" and the concept of "crossed innervation" by succeeding investigators, development of cystometry was at a standstill for almost forty years before gradually attaining its modern interpretation. Compared to our century, it is striking how carefully all investigators from the 19th century cited each other and knew about each other's work. This was possible, in spite of poor communication, because of the small number of investigators involved in studies of bladder function. Although cystometry today is quite informative in many cases, two main points, the presence of detrusor contraction reflex and the patient's capacity to suppress its occurrence, are still highly dependent on the technique used and the subject's cooperation. The more complicated urodynamic investigations flourishing during the last fifteen years have been met with the same uncertainty as the preceding ones since they are partially or completely dependent on patient compliance. Frequently, findings in the laboratory do not relate to the clinical situation. Hopefully, future development of monitoring of bladder-urethral function and the use of neurophysiologic electrodiagnostic methods will reduce these difficulties. The authors believe that modern cystometry began in the 1950s, and that discussion of this period and up to the present is more appropriately the subject of a review on modern methodologies. Further, it is difficult to place modern technology and investigators in historical perspective when events are evolving.

Egypt↗
PubMed1981

Estrogen receptors in the human female lower uninary tract.

Cytosolic and nuclear fractions prepared from the urethra, urinary bladder, and trigonum of the bladder obtained at urethrocystectomy from four female patients were analyzed for the presence of estrogen receptors. High-affinity estradiol receptors (KD 0.7 x 10(-9)M) could be detected in both cytosolic and nuclear fractions of the urethra from all four patients. Estradiol receptors could be detected in only the nuclear fractions of the urinary bladder in two of the four preparations. In the trigonum, cytosolic and nuclear receptors could be measured in one and three preparations, respectively. The receptor concentrations in both trigonum and the bladder were lower than those in the urethra. By providing experimental evidence for the presence of estradiol receptors in the lower uninary tract, the present data advance the case for estradiol therapy in incontinent patients.

Adult↗
PubMed1981

Effects of prazosin on isolated human urethra and in patients with lower motor neurons lesions.

In isolated human urethra, prazosin competitively inhibited contractions induced by noradrenaline, but had no effect on contractions elicited by potassium (127 mM), suggesting an action solely on alpha-adrenoceptors. Seven patients with lower motor neuron lesions and micturition disturbances were treated with 2 mg of prazosin twice daily. Five were investigated by simultaneous urethrocystometry before and during treatment. Prazosin reduced the intraurethral pressure, the intravesical pressure during bladder filling, and autonomous bladder waves. Voiding and incontinence improved in five patients. In one, voiding was facilitated, but continence deteriorated, and in one, no clinical effects were observed. In all patients, residual urine decreased. There were no side effects, except one case of nasal congestion. It is concluded that prazosin effectively reduces alpha-adrenoceptor mediated hyperactivity in the smooth muscle of the lower urinary tract, and that it may be an effective treatment of micturition disturbances in patients with lower motor neuron lesions.

Adolescent↗
PubMed1980

Intracavitary Epodyl for multiple non-invasive, highly differentiated bladder tumours.

Multiple, recurrent cancer of the bladder grade I-II (WHO), stage T1 (UICC) was treated with regular intravesical instillation of ethoglucid (Epodyl) in 39 patients. In ten of them cystitis necessitated withdrawal of the treatment. The therapeutic schedule could be followed in 29 cases, with eradication of the tumours in 27. Nine patients who continued the treatment on a prophylactic basis were still recurrence-free after 18-60 (mean 37) months. Myelosuppression did not occur, but cystitis was a serious problem that frequently jeopardized therapy.

Aged↗
PubMed1980

Effects of oestradiol and combined norephedrin and oestradiol treatment on female stress incontinence.

Thirteen postmenopausal stress incontinent women were treated with oestradiol for one month, and then with oestradiol in combination with norephedrine or placebo according to a double-blind, cross-over schedule. Therapeutic results were assessed by measuring changes in urethral closure pressure profile (UCPP) by means of micro transducer catheters, and by the patient's subjective assessment of the effects. Oestradiol had no effect on the symptom stress incontinence or on UCPP. Norephedrine in combination with oestradiol had a statistically significant therapeutic effect on the symptoms of the patients, and increased UCPP. However, the combination did not increase UCPP more than did norephedrine alone.

Adult↗
PubMed1979

Carcinoembryonic antigen in urine in patients with urothelial carcinoma. An expression for the extent of inflammatory reaction of the urinary tract.

The concentration of carcinoembryonic antigen (CEA) in urine and serum was determined repeatedly during one year in 213 patients followed because of previously treated urothelial carcinoma of the bladder. The findings were correlated to grade and stage of previously treated tumour, given therapy, recurrence and the cytological evaluation of a midstream urine specimen. During the period of follow up 43 recurrences were clinically observed. With the exception for the content of inflammatory cells no correlation was found between the CEA levels in urine or blood and the parameters studied. Thus CEA in urine and/or serum cannot substitute for cystourethroscopy, urography and exfoliative cytology in the follow-up of patients previously treated for urothelial carcinoma.

Adult↗
PubMed1978

Adrenergic innervation and adrenergic mechanisms. A study of the human urethra.

Adrenergic nerves studied by a histochemical method were uniformly distributed along the whole extent of the male and female urethra. Corresponding to the adrenergic innervation a preponderance of contraction-mediating alpha-adrenoceptors was found in vitro studying urethral strips and in vivo recording the urethral closure pressure profile (UCPP). Norephedrine significantly reduced incontinence and increased UCPP in stress-incontinent women.

Adrenergic Fibers↗
PubMed1978

The effects of norephedrine and bethanechol on the human urethral closure pressure profile.

In twelve women with urinary stress incontinence simultaneous measurements were made of the intravesical and intra-urethral pressures, including the urethral closure pressure profile (UCPP), before and after oral administration of norephedrine or subcutaneous injection of bethanechol. The investigations were carried out at various bladder volumes in the supine position and at bladder volume 300 ml in erect position. Irrespective of bladder volume or body position, norephedrine caused a statistically significant rise in maximum urethral pressure (MUP) and in maximum urethral closure pressure (MUCP). The intravesical pressure was not affected. After intravenous injection of phentolamine, MUP and MUCP fell to levels below the original readings, but here too the intravesical pressure was unaffected. Injection of bethanechol was followed by significant increase in the intravesical pressure, irrespective of bladder volume or body position. There were no consistent changes in the intra-urethral pressure. As a consequence of the rise in intravesical pressure, however, the MUCP fell slightly. The results of the study suggest that orally administered norephedrine causes an increase in the MUCP in women with stress incontinence of urine, an increase that may prove therapeutically useful. Bethanechol, in doses that significantly increased intravesical pressure, did not alter the intra-urethral pressure.

Administration, Oral↗
PubMed1978

The effects of long-term treatment with norephedrine on stress incontinence and urethral closure pressure profile.

Twenty-five women with stress incontinence of urine were given an alpha-adrenoceptor stimulating agent (norephedrine) and a placebo during respective 14-day periods according to a double-blind cross-over schedule. The results were classified as the patient's own assessment of therapeutic effect and as change in urethral closure pressure profile measured by a microtransducer catheter. Norephedrine had a significant therapeutic effect on the symptom stress incontinence and produced significant increase in maximum urethral pressure and maximum urethral closure pressure in the lithotomy and the erect position. Reduction of incontinence was associated with increase in maximum urethral closure pressure. The sum therapeutic effect was of moderate degree.

Adult↗
PubMed1978

The use of dimethyl-sulfoxide (DMSO) in the treatment of interstitial cystitis.

Dimethyl-sulfoxide (DMSO) was used in 17 patients with interstitial cystitis. The diagnosis was made on the basis of clinical and laboratory findings and the characteristic picture with Hunner ulcera. The majority of the patients had responded poorly to other forms of conservative treatment. Subjective symptoms were controlled in 2/3 of the cases but repeated treatment was needed and 5 patients did not respond to the therapy. The DMSO treatment is an alternative worth to try and has in some cases a dramatic and lasting effect.

Administration, Topical↗
PubMed1977

Effects of prostaglandins on the isolated human bladder and urethra.

The effects of prostaglandins F2 alpha (PGF2 alpha), E1 (PGE1) and E2 (PGE2) on the human lower urinary tract were studied in vitro in preparations obtained from patients undergoing total cystourethrectomy because of bladder malignancy. Tissue specimens were taken from different parts of the urethra, the urethrovesical junction, and the bladder. From these specimens, smooth muscle preparations were dissected and mounted in organ baths, that were filled with Krebs solution (37 degrees C) and bubbled with carbogen. Isometric tension was recorded. Preparations from the bladder and all parts of the urethra were contracted by PGF2 alpha. This effect was not affected by tetrodotoxin, phenoxybenzamine, or atropine; isoprenaline relaxed the PGF2 alpha induced contractions. PGE1 and PGE1 both contracted strips from the bladder. However, urethral preparations contracted by PGF2 alpha or noradrenaline were relaxed by these agents. This relaxing effect was at least as pronounced as that produced by isoprenaline; it was not affected by propranolol.

Aged↗
PubMed1977

Adrenergic and Cholinergic Nerves of the Human Urethra and Urinary Bladder. A histochemical study.

The occurrence and distribution of adrenergic and acetylcholine esterase (AChE) positive nerves in the human urethra and urinary bladder were studied histochemically with the fluorescence method of Falck and Hillarp, and the copper thiocholine method of Koelle and Friedenwald. Both types of nerves were mainly confined to the layers of smooth muscle cells in the walls of the organs. In all parts of the urethra, there was a scanty supply of adrenergic nerves. Few adrenergic nerves were also found in the urinary bladder, except in the trigone area, where they were abundant. AChE-positive nerves were uniformly and richly distributed in the urinary bladder. Throughout the urethra the distribution of AChE-positive nerve fibres was uniform, but the number was clearly less than in the urinary bladder. No intrmurally located adrenergic or AChE-Positive ganglion cells could be demonstrated.

Acetylcholinesterase↗