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Biomedical subjects

J K Kristensen

Publications and source records attributed to J K Kristensen.

At least 19 recordsLinked to original sources
PubMed1999

[Quality assessment of diabetes care in a large general practice. Identification and biomedical status].

The aims of this study were to describe the diabetic population and to evaluate the routine diabetic care in one general practice. All patients with recognized diabetes were included. Information was collected from each patient's record and from patients' and doctors' questionnaire. One hundred an fourty (1.8%) of the patients had recognized diabetes and 81% of these diabetes had non-insulin-dependent diabetes (NIDDM). According to the records, HbA1c had been monitored in 85% of the NIDDM patients in the preceding year and in 76% of the IDDM patients. The corresponding figures for albuminuria were 84% vs. 76%, for S-creatinine 74% vs. 81%, for S-cholesterol 37% vs. 24%, for weight 47% vs. 43%, for blood pressure 60% vs. 48%, for foot care 67% vs. 62% and for eye examination 76% vs. 75%. International targets for good control were obtained for HbA1c in 42% of cases, for weight in 23%, for blood pressure in 30% and for S-cholesterol in 40% at the last control. The results of the study indicate that there is a continuous demand for quality monitoring and improvement of diabetic care in general practice.

Adolescent↗
PubMed1999

Effect of repeated ejaculation on semen quality in spinal cord injured men.

PURPOSE: We evaluate the effect of repeated ejaculations on semen quality in spinal cord injured men. MATERIALS AND METHODS: The study included 19 spinal cord injured men with anejaculation. Semen was obtained by penile vibratory stimulation in the clinic and patients were instructed in the technique. Optimized vibration parameters were used (2.5 mm. amplitude at 100 Hz.). Penile vibratory stimulation was performed at least once a week for 12 months. Semen quality was examined at baseline and every 3 months during the 1-year study period. Hormonal assays were also performed at each visit. In 9 patients unilateral testicular biopsy was done at baseline and at the end of the 12 months. RESULTS: Normal sperm counts and low motility were seen at baseline. No semen parameter significantly changed during the 12 months of repeated ejaculation. All hormonal assays during the entire study were within normal range and no significant change was observed. Of the 9 biopsies 6 (67%) showed normal spermatogenesis at baseline and no convincing qualitative changes in testicular histology were seen after repeated ejaculation. CONCLUSIONS: Repeated ejaculation in spinal cord injured men does not change the typically poor semen quality. Therefore, stagnation in the seminal ducts due to infrequent ejaculation is not the etiology of the poor semen quality in these patients.

Adult↗
PubMed1998

Seminal plasma PSA in spinal cord injured men: a preliminary report.

OBJECTIVE: The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration. MATERIAL: Semen obtained from normal controls (n = 20) and patients (n = 16) with spinal cord injury. RESULTS: The concentration of prostate specific antigen in seminal plasma depended on the level of spinal cord injury, with significantly lower concentrations in patients with spinal cord lesions below T7 compared to both normal age-matched controls (P = 0.007) and patients with spinal cord injuries at or above T7 (P = 0.017). CONCLUSIONS: The results add to the previously reported observations of the possible impact of neurogenic stimulation on prostate activity. More studies of neurogenic stimulation in prostate growth and development are warranted to further elucidate the possible impact of neurogenic factors in the development of prostatic diseases.

Adult↗
PubMed1998

Studies on mast cells and histamine release in psoriasis: the effect of ranitidine.

The purpose of this study was to investigate histamine and skin mast cells in psoriasis before and during 6 months of treatment with high-dose ranitidine. Sixteen psoriasis patients, presenting a mean PASI score of 15.4, were compared with 13 age- and sex-matched healthy controls. Resting extracellular skin levels of histamine and histamine release to mast cell secretagogues, as measured by the microdialysis technique, were increased in involved psoriasis skin compared to normal skin in the controls. Plasma histamine, but not basophil histamine release, was significantly increased in the patients. Mast cells and lymphocytes were significantly increased in numbers in involved versus non-involved skin in the patients, the lymphocytes being predominantly T-lymphocytes expressing HLA-DR activation. During 6 months of ranitidine treatment, mean PASI score of 15.4 decreased to 5.8. The lymphocyte infiltration, but not mast cell numbers, was significantly reduced during treatment, and histamine release to mast cell secretagogues was normalized. These observations suggest that skin mast cells in active psoriasis are functionally hyperreactive. The biochemical findings together with the clinical effect of ranitidine indicate that histamine may be involved in the pathophysiology of psoriasis.

CD4-CD8 Ratio↗
PubMed1997

[Clinical effect of ranitidine in psoriasis. An open prospective study].

We report the results of an open, prospective study of 20 patients with moderate to severe psoriasis (median PASI score: 15.7) treated with oral ranitidine 300 mg twice daily for six months. No other medication was allowed during the study period. The median PASI score was reduced to 14.5, 9.1 and 5.7 after one, three and six months of treatment, respectively (p < 0.00001). A mild to moderate worsening was observed in 15 patients within the first month of treatment, but this was not followed by exclusion from the study, and long-term treatment improved disease status in most patients. Eight patients continued therapy with ranitidine 300 mg twice daily after the study was completed. None of these patients relapsed during a follow-up period of 12-18 months. The results of the present study suggest that ranitidine may be beneficial in the treatment of some patients with psoriasis.

Adult↗
PubMed1997

Pregnancy after assisted ejaculation procedures in men with spinal cord injury.

OBJECTIVE: To present the results of fertility treatment in 28 men with spinal cord injury (SCI) and their partners. DESIGN: Retrospective analysis. SETTING: University hospital outpatient clinic and home. PATIENTS: Twenty-eight anejaculatory men with SCI and their partners seeking treatment for infertility. INTERVENTION: Penile vibratory stimulation and electroejaculation as semen retrieval methods. Assisted reproductive techniques used: vaginal self-insemination at home, intrauterine insemination, in vitro fertilization with or without intracytoplasmic sperm injection. MAIN OUTCOME MEASURES: Ejaculation rate; sperm count and motility; pregnancy rates. RESULTS: All of the men were able to ejaculate either by penile vibratory stimulation (79%) or electroejaculation (21%). Median total sperm count was 65 million (range, 0.1 to 480) with a median motility of 13% (range, 1% to 60%). Overall, 9 of 28 couples (32%) achieved 10 pregnancies (4 self-insemination, 3 intrauterine insemination, 1 in vitro fertilization, and 2 intracytoplasmic sperm injection). CONCLUSIONS: An ejaculation rate of 100% was achieved using penile vibratory stimulation as a first treatment option with electroejaculation as a second option. Motivated couples with adequate semen quality may be offered penile vibratory stimulation combined with self-insemination at home. Together with intrauterine insemination or fertilization techniques used in vitro, the pregnancy rate per treatment cycle for SCI couples may approach that of natural procreation in healthy and fertile couples.

Adult↗
PubMed1996

[Evaluation and treatment of patients with kidney calculi].

Renal stone disease is a common disorder causing much discomfort and high rates of sick-leave. Surgical treatment has improved dramatically with extracorporeal shock wave lithotripsy, but the recurrence rate is high, and it would be desirable to be able to offer the patients effective steps in prevention of further stone formation. The biochemical abnormalities associated with stone formation are complex and not fully elucidated. It should, however, be possible to reduce the recurrence rate with a relatively simple programme for investigation of the patients. The pathogenesis of renal stones is, therefore, reviewed with reference to a plan for the practical approach to the prevention and management of nephrolithiasis, that has recently been recommended by The National Kidney Foundation, USA.

Humans↗
PubMed1996

Quality of semen obtained by penile vibratory stimulation in men with spinal cord injuries: observations and predictors.

OBJECTIVES: To study the semen quality and to examine prognostic factors that may affect semen quality in men with spinal cord injuries (SCI) who respond to penile vibratory stimulation (PVS). METHODS: Fifty-one PVS responders were prospectively examined. Penile vibratory stimulation was induced with optimized vibration parameters. Semen quality was characterized by semen analysis. The gel agglutination test for the presence of antisperm antibodies and serum hormone assays were performed. Characteristics of the spinal lesions, type of bladder management, and hormone assays were compared to semen quality and incidence of azoospermia or total lack of motility. RESULTS: The mean semen parameters were: volume-1.9 mL (range 0.2 to 7.0); total sperm-457 million (range 0 to 10,900); motility-12.6% (range 0% to 55%); total motile sperm-39.3 million (range 0 to 401); normal morphology-50.1% (range 0% to 90%). Better sperm motility was seen in men with cervical lesions versus those with thoracic lesions (16% versus 7%) and incomplete versus complete lesions (19% versus 10%). There was a higher incidence of azoospermic specimens in men with thoracic lesions versus cervical level (26% versus 3%) and a lower incidence of finding any motile sperm in the specimen (47% versus 81%). Men voiding without catheters had a lower incidence of azoospermia (3% versus 28%). Abnormalities of hormone and antibody tests were rare. CONCLUSIONS: Better sperm specimens from PVS of men with SCI may be expected from men with higher neurologic level, incomplete lesions, and those voiding without the use of a catheter. Hormonal abnormalities and immunologic causes do not explain the poor sperm quality seen in men with SCI.

Adult↗
PubMed1996

Pressure-to-cross-sectional area relationships in the proximal urethra of men with bladder outlet obstruction.

PURPOSE: Related values of pressure and cross-sectional area in the proximal urethra were measured in patients with bladder outlet obstruction. Urethral opening pressure and elastance (the inverse of compliance) were estimated. MATERIALS AND METHODS: We studied 15 men with standard urodynamic examinations. The pressure-to-cross-sectional area relationship in the prostatic urethra was determined using a special probe. RESULTS: Elastance varied significantly along the studied portion of the urethra, with higher values found in the sphincter area. The estimated urethral opening pressure appeared high compared to that in unobstructed cases and without variation along the prostatic urethra. CONCLUSIONS: The most important effect of prostatic obstruction appears to be the increased urethral opening pressure.

Aged↗
PubMed1995

Tissue culture supernatants from human islets of Langerhans activate the oxidative burst response of human monocytes in vitro.

Macrophages play a major role in the pathogenesis of insulin-dependent diabetes mellitus in animals. These cells are the first to invade the pancreas and macrophage-eradicating treatments reduce the incidence of the disease. In humans, however, their role is less clear. In this study we investigated the hypothesis that the pancreatic environment per se could activate macrophages. Tissue culture supernatants from human islets of Langerhans were tested for chemotactic activity and oxidative burst response in monocytes isolated from healthy adults. Preincubation with the supernatants enhanced the oxidative burst response evoked by fMLP (up to 379%) and opsonized zymosan (up to 173%). The activity decreased by dilution and was no longer detectable at 1:16. No increased activity was seen in supernatants from a number of other human endocrine and non-endocrine primary cells, suggesting a factor specific for islet tissue. The increased oxidative burst response could partially be eliminated by heat- and proteinase K treatment, suggesting that the activity could be of polypeptide nature. The factor could not be absorbed by polyvalent rabbit antibodies directed towards a variety of cytokines not by a mixture of high-titer anti-cytokine antibodies. It is possible that islet factors could also promote such monocyte activation in vivo in monocytes attracted to the islets of Langerhans by other means. This could contribute to the development of insulin-dependent diabetes in humans.

Adolescent↗
PubMed1995

Systemic high-dose ranitidine in the treatment of psoriasis: an open prospective clinical trial.

We report the results of an open, prospective study on the efficacy of systemic ranitidine in the treatment of psoriasis. Twenty patients suffering from moderate to severe psoriasis were included in the study. The median pretreatment PASI score was 15.7 (range 6.0-24.7). The patients were treated with oral ranitidine 300 mg twice a day for 6 months; no other medication was allowed during the study period. Eighteen patients completed the study. The median PASI score was reduced from 15.7 to 14.5, 9.1 and 5.7, after 1, 3 and 6 months of treatment, respectively (P < 0.00001). A significant reduction in PASI score was evident at 3 months of treatment. A mild to moderate deterioration occurred in 15 patients within the first month of treatment, but this was followed by improvement during prolonged treatment in most patients. No other clinical and/or biochemical side-effects were observed. Eight patients continued therapy with ranitidine after the study was completed, and none of these patients relapsed during a follow-up period of 12-18 months. The results of the present study suggest that ranitidine may be a beneficial and safe treatment for psoriasis. In addition, high-dose, long-term ranitidine treatment appears to be free from severe adverse effects.

Administration, Oral↗
PubMed1995

Nocturnal temperature and subcutaneous blood flow in humans.

The aim of this study was to investigate the possible relationship between variations in local skin and body temperatures, and a subcutaneous hyperaemia response during sleep in humans. Nocturnal subcutaneous blood flow (SBF) was measured in the lower legs of 9 subjects for 8-12 h under outpatient conditions. The core temperature was measured by a tympanic membrane temperature sensor, and the local skin temperature was measured by a skin temperature sensor. The 133Xe wash-out technique with portable CdTe(Cl) detectors was used for measurement of the SBF. The SBF increased significantly (P < 0.0001) after 1 h sleep, with the hyperaemia persisting for 2 h. During the hyperaemic phase, the local skin temperature increased significantly (P < 0.0001) and then decreased again in the post-hyperaemic phase (P < 0.01). The core temperature decreased significantly during the measurement period (P < 0.01). Separate ordinary linear regression analyses revealed no significant correlations between the measured temperature parameters and the blood flow levels during sleep. The results indicate no governing role of the local skin or body temperatures on the local SBF. The local skin temperature increased significantly secondary to the nocturnal subcutaneous hyperaemia (i.e. active vasodilatation), which is believed to be involved in a thermoregulatory effector mechanism.

Adult↗
PubMed1995

Flavoxate treatment of micturition disorders accompanying benign prostatic hypertrophy: a double-blind placebo-controlled multicenter investigation.

To investigate the effect of flavoxate (Urispadol) treatment on patients with symptomatic benign prostatic hypertrophy (BPH), with the main weight on the irritative symptoms, a randomized, double-blind, parallel-group, placebo-controlled and multicenter investigation was carried out. Seventy patients entered the study, 37 were allocated to flavoxate treatment on a daily dose of 1,200 mg (400 mg t.i.d.) for 12 weeks, and 33 patients were allocated to placebo treatment. In spite of a sufficient power, the study did not discriminate the two treatment groups in a statistically significant way (p > 0.05), when considering the main endpoints: the irritative symptom score and the global patient evaluation. Conservative treatment of micturition disorders accompanying BPH with flavoxate in doses of 1,200 mg/day cannot be recommended for clinical use.

Aged↗
PubMed1995

Pressure/cross-sectional area relations in the proximal urethra of healthy males. Part 1: Elastance and estimated pressure in the uninstrumented urethra.

The pressure/cross-sectional area relation in the resting urethra during the storage phase was studied in 31 healthy male volunteers aged 23-85 years. Measurements were performed at 5-mm intervals from the bladder neck and beyond the region of high pressure, and the elastance and estimated pressure in the uninstrumented urethra (Po) were calculated at each measurement location. All subjects were further evaluated by means of symptom score, prostatic volume determined by rectal ultrasound, urethral pressure profile, cystometry, and pressure flow. The elastance and Po both varied along the urethra, with significantly higher values of both parameters in the sphincteric region as compared to the prostatic area. A significant positive correlation was found between Po and age in the prostatic parts of the urethra, whereas no correlation could be demonstrated between elastance and age in any part of the urethra. These results indicate that the prostatic parts of the urethra are readily distensible at modest intraluminal pressures as compared to the sphincteric segment, and that the intraluminal pressure required to obtain a given distension of this segment of the urethra seems to increase with age. It is suggested that the technique may prove of value in the elucidation of pathophysiological mechanisms related to benign prostatic hyperplasia, and that the technique may bring new insight into the mode of action of various treatment modalities for this disease.

Adult↗
PubMed1995

Pressure/cross-sectional area relations in the proximal urethra of healthy males. Part 2: Power generation during voluntary contraction.

The power generation in the proximal urethra during voluntary squeezing was studied in 30 healthy male volunteers aged 23-85 years. Measurements were performed at 5-mm intervals from the bladder neck and beyond the region of high pressure, and the maximum power generation during contraction was calculated at each measurement location. All subjects were further evaluated by means of symptom score, prostatic volume determined by rectal ultrasound, urethral pressure profile, cystometry, and pressure flow. There was a significant variation in power generation along the urethra, with minimum values in the prostatic segments and an approximately 5-fold increase in the high pressure zone. Power generation remained high in the urethral segment distal to the high pressure zone. No correlation between age and power generation could be demonstrated in any part of the urethra. The technique employed does not allow for a differentiation of the individual muscles involved, however, it is suggested that the pelvic floor dominates above the level of the perineal membrane, whereas the striated muscles of the penis may influence the proximal part of the spongious urethra. Physiologically, the contractile capability of the male urethra is probably important for the continence function, as well as it may be of significance for the normal ejaculatory function.

Adult↗
PubMed1994

Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries. The importance of the vibratory amplitude.

A total of 66 men with a spinal cord injury (SCI) and ejaculatory dysfunction were included in two different but comparable study populations I (n = 25) and II (n = 41). The level of lesion ranged from C2 to L1 (44 complete). Penile vibratory stimulation (PVS) to induce ejaculation was performed with two different types of vibrators in population I and considerably different ejaculation rates (antegrade+retrograde) occurred depending on the vibrator used. Our experience suggested discrepancies between the manufacturers' specifications and the actual vibrator outputs concerning frequencies and peak-to-peak amplitudes. Retrospectively performed determinations revealed that the manufacturers' specifications regarding the frequencies were accurate whereas the peak-to-peak amplitudes were inaccurate. With a frequency of 100 Hz and determined peak-to-peak amplitudes of 1 mm and 2.5 mm, ejaculation rates of 32% and 96%, respectively, were obtained in population I. This indicates that an adequate peak-to-peak amplitude is essential to exceed an 'ejaculatory threshold' in the majority of SCI men. Furthermore, an ejaculation rate of 83% obtained in a subsequent prospective study of 41 SCI men (population II) verified that a frequency of 100 Hz and a peak-to-peak amplitude of 2.5 mm seems to approach the ideal vibrator output. The ejaculation responses obtained by JS (first author) were reproduced when the PVS was performed by the patient or his partner, indicating that the vibrator output is more important than PVS experience. No major adverse reactions due to autonomic dysreflexia were observed. The lowest level of SCI where antegrade or retrograde ejaculation occurred was T9 and L1, respectively. No absolute predictors for ejaculatory success or failure in relation to patient age, years since lesion, completeness of SCI, urinary bladder management method, hip flexion and bulbocavernous reflexes were observed. Therefore, most SCI men with ejaculatory dysfunction should be considered candidates for PVS.

Adult↗
PubMed1994

Ureteroscopic management of transitional cell tumors.

Eighty-nine ureteroscopies, comprising 102 renal units, were performed on 31 patients for diagnosis, treatment or follow-up of transitional cell tumors of the upper urinary tract. The indications were hematuria or filling defect (29 endoscopies), treatment of tumor (19) and follow-up (41), i.e. 33, 21 and 48 renal units. Ureteroscopy (including 2 peroperative) was satisfactorily completed in 93 units. Tumor was suspected or diagnosed in 57 units, but later disproved in 11. Two tumors were overlooked at endoscopy. Surgery was performed in 21 cases (bilateral in 3), with indications based on ureteroscopic findings in 58%. Electroresection, laser photocoagulation or fulguration was done on ten units (average treatment sessions 2.6). Inadequate ureteroscopic treatment led to surgery in two of these units, but in seven open surgery was avoided (follow-up 6-47, mean 25 months). One old patient had no further treatment. Follow-up ureteroscopy was planned for 48 units and completed in 42. Complications occurred after 11 of 89 endoscopies. Ureteroscopic management of upper-tract urothelial tumors can be satisfactory, with long freedom from recurrence.

Adult↗