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Biomedical subjects

E U Poulsen

Publications and source records attributed to E U Poulsen.

At least 19 recordsLinked to original sources
PubMed1996

[Anderson-Hynes pyeloplasty in hydronephrosis].

The purpose of the study was to evaluate pyeloplasty a.m. Anderson-Hynes in the treatment of hydronephrosis in a large series of patients. In 175 patients, consecutively operated for ureteropelvic junction obstruction, we found 24 (14%) with minor postoperative complications, mostly urinary tract infection. Six patients (3%) were reoperated because of continued pain and obstructed drainage postoperatively. There was a small, but statistically significant increase in renal functional share on the operated side. We found a highly significant correlation between postoperative changes in total GFR and single kidney GFR on the operated side, which suggests a real improvement in renal function, rather than a simple reallocation of function between the two kidneys. We conclude that newer treatment modalities known as "minimally invasive surgery" must give comparably good results in order to be an acceptable alternative to traditional dismembered pyeloplasty.

Adolescent↗
PubMed1995

99mTc-MAG3 kinetics in the normal pig. A comparison to 131I-OIH and 125I-iothalamate after single injection and during continuous infusion.

An invasive comparative study of some pharmacokinetic aspects of 99mTc-mercaptoacetyltriglycine (MAG3), 131I-orthoiodohippurate (OIH), and 125I-iothalamate (iothalamate) was performed in six pigs 0-150 min after a simultaneous single injection (SI) and during a subsequent 90 min of continuous infusion (CI). The total plasma clearance and the renal clearance of MAG3 were about 75% that of OIH. The renal clearance of MAG3 was about 2 1/2 times the glomerular filtration rate. The distribution volume of MAG3 was 71% that of iothalamate and only 47% that of OIH. There was a significant hepatic plasma clearance of MAG3 of 5.9 ml min-1 and 3.9% of the injected dose was excreted in the bile. HPLC analysis revealed that technetium was excreted in urine and bile mainly labelled to MAG3. The average red blood cell (RBC) binding after single injection/during continuous infusion was 1.0%/2.3% for MAG3, 13.5%/9.0% for OIH, and 3.1%/5.3% for iothalamate. The binding of OIH to RBC in arterial blood increased from 8% at 1 min post-injection to 21% at 150 min post-injection. The RBC binding was higher in the renal vein, indicating incomplete back diffusion from RBC to plasma. The protein binding was 90% for MAG3, 49% for OIH and 16% for iothalamate. The renal plasma extraction of MAG3 was constant but significantly smaller after SI (0.54) than during CI (0.62). Following SI, the renal plasma extraction of OIH decreased continuously from 0.85 to 0.52, 3-150 min post-injection. On the average there was no significant difference in renal plasma extraction after SI and during CI of either OIH (0.72 versus 0.77) or iothalamate (0.26 versus 0.27). It is concluded that MAG3 is preferential to OIH as a tracer for renal function studies using a single injection technique mainly due to the constant renal extraction of MAG3.

Animals↗
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↗
PubMed1990

[Infusion cavernosography and erectile dysfunction].

Infusion cavernosography with the object of quantitating the rate of venous drainage from the penis and localization of possible abnormities in drainage was employed as a routine investigation in examination of erectile dysfunction in 46 patients. "Infusion to obtain erection" (IOE) and "infusion to maintain erection" (IME) were determined. In five patients, IOE was found to be greater than 180 ml/minute which was considered to be diagnostic of venous leakage. Infusion cavernosography could be assessed in 31 patients. Filling of the glans with the radio-opaque medium was found before rigidity was obtained in 27 whereas, in 19 filling of the glans occurred after rigidity was obtained. No localizing fistulae were demonstrated. It is concluded that routine employment of infusion cavernosography in investigation of impotence is unnecessary. Filling of the glans with the radio-opaque medium in infusion cavernosography does not appear to be a sign of a cavernoso-spongious fistula but rather a physiological phenomenon.

Erectile Dysfunction↗
PubMed1990

[Burns. An epidemiologic casualty ward study].

Four hundred eighty five persons were treated for burns at the casualty ward of Aarhus County Hospital between 1 January and 31 December 1986. Compared to a previous study from the municipality of Copenhagen only minor differences were found concerning the distribution of patient sex and age, and the cause and scene of accident. Small children aged 0-5 years constituted a high risk group, representing more than 18% of all burn injuries. Ninety one per cent of the accidents in this group took place in the home, and the need for further prophylactic measures is evident. Our suggestions include better insulation of oven doors, and protective shields at the front of electric stoves. Further, we emphasize that children should never be left alone in the kitchen without proper supervision.

Accidents, Home↗
PubMed1989

[Priapism. New diagnostic and therapeutic methods].

Priapism (P) may develop from unknown causes or may occur secondary to other disease or as a side effect of medication. The occurrence of pharmacologically induced erection by intracavernous injection of drugs has resulted in a number of cases of iatrogenic priapism. Priapism may be ischaemic or non-ischaemic and determination of the acid-base status in the cavernous blood may be of value in the choice of treatment. The non-ischaemic cases should be treated primarily by aspiration of blood, possibly followed by intracavernous injection of a vaso-constrictive agent, eg 15 micrograms adrenaline or noradrenaline, repeated if necessary. Cases which do not respond to this and severe ischaemic cases should be treated with glando-cavernous anastomosis.

Humans↗
PubMed1989

Urethral pressure variations in healthy male volunteers.

Urethral pressures are usually considered to be static and only few authors have emphasized time-related pressure changes. We conducted a study on 10 healthy male volunteers, monitoring the urethral pressures at maximal urethral closure pressure, 2.5 cm proximal (bladder neck) and 2.5 cm distal (pars bulbosa) respectively over 30 min periods. At the bladder neck only sporadic waves were seen. At maximal closure pressure almost permanent oscillations were found, the wavelengths and amplitudes showing big differences. At the pars bulbosa 2 persons showed only sporadic oscillations and in 7 we found permanent pressure variations. The pressure variations are proposed to represent peristaltic activity with the ability of expelling the last drops of urine after micturition and posing a mechanical barrier to ascending microorganisms.

Adult↗
PubMed1989

Short- and long-term reproducibility of cystometry.

We investigated 8 male patients, age 28-51 years, mean 35, with symptoms of bladder neck dysfunction by means of repeated water-cystometry. We made four cystometries with different patient positions and filling rates followed by a further two cystometries after an interval of 8 days. We found no difference in bladder volumes at first sensation and maximal capacity between the different investigations, irrespective of patient position and filling rate. It was concluded that data obtained by water cystometry may be regarded as absolute.

Adult↗
PubMed1989

Urodynamic effect of acute alpha-receptor blockade in patients with bladder neck dysfunction.

Forty-nine male patients, median age 35 years (range 16-59) with bladder neck dysfunction (BND) were investigated before and after intravenous administration of phentolamine to evaluate the effect of acute alpha-blockade on micturition parameters and to identify patients, who might benefit from alpha-blocking therapy. Under the influence of phentolamine we found a significant decrease in the mean values of maximal urethral closure pressure (MUCP), pressure at the bladder neck and prostatic profile length (PPL), a decreased bladder capacity, a more complete bladder emptying, and a small but significant improvement in peak flow rate (PFR). However, according to a flow-rate nomogram analysis with correction for voided volume, only two patients significantly improved their PFR. A subgroup of 20 "responders", defined as patients with any improvement of PFR after phentolamine, not caused by increased detrusor pressure was characterized by significantly longer opening time and lesser maximal flow rate before phentolamine (more severe BND). All other pressure-flow parameters as well as the static pressure at bladder neck niveau were not different. We conclude that it is not possible before phentolamine administration to select a group of patients, which might benefit from alpha-blockade and it is suggested that this procedure might be included in the evaluation of patients with suspected BND.

Adult↗
PubMed1989

Vesico-ureteral reflux. I. Renal function and morphology in relation to anamnestic and urodynamic parameters.

Hundred and one children aged 12 years or less were consecutively referred with non-neurogenic vesico-ureteral reflux. None of the patients were previously operated for reflux. Based on the degree of reflux and the degree of nephropathy judged from urograms or renoscintigrams the patients were assigned an index defined as the sum status of both nephro-ureteric units. We found no correlation between VUR index, nephropathy index and GFR on one side, and bladder function parameters (spontaneous voiding, cystometry, bladder activity during sleep) on the other. Further, no correlation was found to history concerning urinary tract infections or enuresis the year before admittance. Possible reasons for the lack of correlation are discussed.

Child↗
PubMed1989

Vesico-ureteral reflux. II. The longterm outcome of kidney function in non-surgical treatment.

Seventy one patients were included in a prospective study of non-surgical treatment of vesico-ureteral reflux (VUR). We found 111 refluxing ureters, with 20 grade 1, 4 grade 2, 41 grade 3, 5 grade 4 and 1 grade 5. There was no correlation between presenting symptoms and degree of VUR or nephropathy, or between renal function in terms of glomerular filtration rate. During followup the patients were treated with long-term low-dose antibiotic prophylaxis and voiding disorders were corrected pharmacologically or by micturitional training. With a median follow up time of 6 years (3-10) 63% of the patients had cessation or down grading of VUR, irrespective of initial VUR degree. There was no correlation between cessation rate and urodynamic parameters, GFR, history of enuresis or previous urinary infections. The study supports a non-surgical attitude towards VUR patients irrespective of VUR degree, with prophylaxis of urinary infections and possibly correction of voiding disorders.

Child↗
PubMed1989

Symptomatology and urodynamic findings in younger males with bladder neck dysfunction.

We studied consecutively 46 males, median age 36 years (range 16-59), diagnosed as bladder neck dysfunction (BND) according to a urodynamic investigation. The diagnosis was based on a prolonged opening time (greater than 04 sec) in the pressure-flow investigation and absence of organic obstruction and neurologic disease. Median duration of symptoms was 24 months (range 1-240). The most frequent symptoms were poor stream (in 70%), frequency (50%) and dribbling (37%), while 30 % had nocturia, and 20% urgency, dysuria or perineal pain during voiding. Thirty-two % had one or more urinary tract infections. We found no correlation between urodynamic findings and symptomatology in terms of total symptom-score or -duration. Median opening time was 10 sec. Patients with shorter opening time were found to have significantly greater Qmax, while the rest of the parameters did not differ. Concerning single symptom-items we found a significant correlation between small bladder capacity and frequency and nocturia but no correlation between obstructive symptoms and the pressure at the bladder neck or the urethral resistance factor. Previously used classifications of BND patients on basis of micturition pressure or response to acute alpha-blockade were not found to be of use and it is concluded that future research should be directed towards a better definition of outflow resistance which then may be used both diagnostically, prognostically and as a therapeutic aid.

Adult↗
PubMed1989

Combined pressure and drainage studies in hydronephrosis.

Current evaluation of hydronephrosis includes pressure-flow studies as well as isotope renography with induced diuresis. A case is presented where a new approach of combining these two methods gave opposing results concerning the significance of obstruction. Some of the implications are discussed.

Child↗
PubMed1988

Cortical blood-flow in the porcine kidney. A radioactive microsphere study.

Renal cortical blood-flow distribution was measured by means of radiolabeled microscopheres in eight kidneys from 4 pigs of mixed Yorkshire and Danisk landrace. We found a pronounced intracortical variation in the perfusion pattern of 28 sections of outer cortex. Three consequetive flow determinations with an interval of 45 minutes showed that the heterologous perfusion pattern was plastic, changing between the flow-determinations. In addition, we found a significantly reduced perfusion in the renal poles, compared to the rest of the outer cortex. It is speculated that the reduced polar perfusion is a contributing aetiological factor to the increased incidence of polar scar formation secondary to reflux nephropathy.

Animals↗
PubMed1988

Preoperative symptomatology and diagnostic findings in relation to outcome of pyeloplasty in patients with primary hydronephrosis.

Sixty-seven patients, aged 3-71 years, with primary hydronephrosis were operated at our department during a 5-year period. All patients had Anderson-Hynes pyeloplasty. The primary clinical result of surgery was excellent in 63 patients (94%). Of the patients with reduced renographic uptake fraction preoperatively, 38% had a significant gain 6 months after reconstruction, while only 1 patient had a reduction. There was no correlation between the outcome of reconstruction and preoperative history, degree of hydronephrosis on IVP, preoperative functional share on renography or the peroperative finding of aberrant vessels compressing the ureter. It was concluded that surgery should be undertaken on rather wide indications as reconstruction leads to stable or improved renal function regardless of preoperative symptoms or diagnostic findings.

Adolescent↗
PubMed1988

Erectile dysfunction in multiple sclerosis.

In a sample of 29 impotent men with multiple sclerosis and erectile problems, penile arterial inflow and venous outflow were within normal limits. In 26 patients, the pudendal evoked potential (PEP) was abnormal, and eight of these also had abnormal bulbocavernous reflex (BCR). Three patients had abnormal PEP and normal BCR, and of these, two had normal and one had abnormal nocturnal erectile activity. The validity of PEP/BCR testing was supported by normal findings in six patients with MS and without erectile problems. Nocturnal erectile activity was normal in 11 patients, of whom nine had abnormal PEP and/or BCR. A high disability score corresponded poorly with both reduced sexual function, insufficient nocturnal erectile activity, and abnormal PEP and/or BCR. Intracavernous injection of papaverine gave erection in 27 patients, the dose needed to create an erection being inversely related to the level of disablement. PEP and BCR testing may be more sensitive in defining neurogenic erectile dysfunction (ED) than nocturnal erectile activity. We considered 26 of the cases to have a neurogenic cause of ED and three to have mainly a psychogenic cause.

Adult↗
PubMed1988

Pharmacologically induced erection in patients with multiple sclerosis.

Intracavernous injection of papaverine was tested in a group of 29 patients with multiple sclerosis and erectile dysfunction. Acceptable rigidity was obtained in 27 patients of whom 23 started to use self-injections as treatment. During an observation period of 5-12 months (mean 8.5 months) a total of 297 injections (3-35 per patient) were reported and 272 injections (92%) produced rigidity in 8-480 min. One case of priapism was seen. Minor haematomas or ecchymoses were reported in 16 cases. Two patients developed penile indurations after 6 and 19 injections respectively; one of these indurations resolved spontaneously. Self-injection with papaverine was found to be a safe and well-accepted treatment of erectile dysfunction in multiple sclerosis but long term side effects need further elucidation before the treatment is to be used as a routine procedure.

Adult↗