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Biomedical subjects

J T Andersen

Publications and source records attributed to J T Andersen.

At least 19 recordsLinked to original sources
PubMed1992

Overexpression and rapid purification of the orfE/rph gene product, RNase PH of Escherichia coli.

The pyrE gene, encoding the pyrimidine biosynthetic enzyme orotate phosphoribosyltransferase, is the promoter distal gene of the dicistronic orfE-pyrE operon. The promoter proximal orfE gene, whose transcription and translation is important for regulation of the pyrE attenuator, encodes a 238-amino acid residue protein which was recently identified as the phosphorolytic ribonuclease, RNase PH, that removes nucleotides from the 3' ends of tRNA precursors. In this paper we report the construction of a plasmid, which overexpresses the orfE and pyrE gene products substantially, as well as the purification of the OrfE protein by ammonium sulfate precipitation and chromatography on phosphocellulose. The highly purified protein catalyzes the phosphorolytic cleavage of poly(A) at a rate of 1.6 mumol/min/mg and the formation of CDP from tRNA-CCA-Cn and orthophosphate at a rate equal to 0.14 mumol/min/mg, as characteristic for RNase PH. OrfE/RNase PH contains helix-turn-helix motifs resembling those in DNA-binding proteins, and it binds nonspecifically to DNA. On SDS gels, OrfE/RNase PH migrates as two distinct protein bands. This heterogeneity might be caused by post-translational modification other than proteolysis, or may be an electrophoretic artifact. The native protein is composed of two or more subunits.

Amino Acid Sequence↗
PubMed1992

Attenuation in the rph-pyrE operon of Escherichia coli and processing of the dicistronic mRNA.

We have substituted on a plasmid the native promoter of the Escherichia coli rph-pyrE operon with an inducible transcription-initiation signal. The plasmid was used to study the mRNA chains derived from the operon at different intracellular concentrations of UTP and as a function of time following induction of transcription. The results showed that dicistronic rph-pyrE mRNA was formed when the UTP pool was low, and that a monocistronic rph mRNa was the major transcription product in high-UTP pools, thus supporting an UTP-controlled attenuation mechanism for regulation of pyrE gene expression. However, the dicistronic rph-pyrE transcript was rapidly processed into two monocistronic mRNA units, and a cleavage site was mapped near the attenuator in the intercistronic region, close to the site where transcription was terminated in high-UTP pools. Furthermore, the major 3' end of the pyrE mRNA was mapped near a palindromic structure of similarity to the family of repetitive extragenic palindromic sequences, 35 nucleotide residues after stop codon of the pryE gene.

Base Sequence↗
PubMed1992

[Surgery of penile deviation by Ebbehøj's method].

A questionnaire investigation to evaluate the results of surgery for penile angulation by plicature of tunica albuginea by Ebbehøj's method is presented. In 31 patients with congenital penile angulation, 24 (77%) were satisfied with the functional result and 20 (65%) with the cosmetic result of the operation. In 14 patients with Peyronie's disease, eight (57%) were satisfied with the functional result and six (43%) with the cosmetic result of the operation. This is in accordance with previously published surveys of the results of surgery using this method. However, a high prevalence of late sequelae was observed, especially penile shortening and pain. In conclusion, the method yields acceptable functional and cosmetic results and is easy to perform. However, optimal surgical technique is imperative to reduce the prevalence of late sequelae which also necessitate detailed preoperative information and restrictive indications for surgery.

Adult↗
PubMed1992

Anesthesia and complications of extracorporeal shock wave lithotripsy of urinary calculi.

The techniques of anesthesia for extracorporeal shock wave lithotripsy of urinary calculi and the associated complications in 600 treatments with the second generation lithotriptor Siemens Lithostar were studied. General anesthesia was used in 17 treatments (2.8%) and epidural anesthesia was applied in 73 (12%), primarily in children and patients in need of simultaneous surgical auxiliary procedures. A total of 510 treatments (85%) was performed with a combination of local infiltration anesthesia and supplementary intravenous opiates. In 65% of the cases only 2 injections of opiates were sufficient for pain relief. There were no complications in 394 treatments (77%) and minor complications, such as arrhythmia (9.2%) and nausea/vomiting (7.6%), were easily treated. Respiratory depression was observed in 10 cases (2%) and this potentially dangerous complication was associated with simultaneous administration of opiates and midazolam. Only 9 treatments (1.8%) had to be terminated due to complications. It is concluded that most treatments of urinary calculi with this second generation extracorporeal shock wave lithotriptor can be performed with local infiltration anesthesia combined with supplementary short-acting opiates intravenously for pain relief and sedation. When administering supplementary midazolam for sedation the risk of respiratory depression should be considered.

Adolescent↗
PubMed1992

Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration.

A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration anesthesia with 20 ml. 1% lidocaine with epinephrine. All patients received an intravenous dose of morphine just before ESWL. The patients were comparable with regard to age, sex, weight, morphine dosage, number of shock waves given and duration of treatment. Median pain score and the amount of supplementary analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly.

Adolescent↗
PubMed1991

Transurethral resection of very large prostates. A retrospective study.

Twenty-one patients with benign prostatic hypertrophy (BPH), and a weight of transurethrally resected tissue exceeding 80 g (Group 1), were compared to a control group of 30 patients with a weight of resected tissue less than 80 g (Group 2) with regard to the peri- and postoperative course and the symptomatic and urodynamic results of surgery. All patients were followed 12 months postoperatively. In both groups more than 90% of the patients were satisfied with the results of the operation. However, the obstructive symptoms were better relieved than the irritative symptoms. The group who had large resections performed had a longer operating time and a greater perioperative blood loss than the group of minor resections. No differences were found with regard to other peri- or postoperative complications or subjective results. Transurethral resection is safe and efficient in treating BPH, also with very large prostates.

Aged↗
PubMed1991

Role of transcription pausing in the control of the pyrE attenuator in Escherichia coli.

Expression of the Escherichia coli pyrE gene is regulated by transcription attenuation in the intercistronic orfE-pyrE region and modulated by the distance between the transcribing RNA polymerase and the leading ribosome as a function of the supply of UTP and GTP. In this communication we show that pyrE expression is hyper-repressed in vivo following addition of uracil in strains carrying the nusAcs10 mutation. This phenotype, previously seen in rpsL1204 strains whose ribosomes are pseudodependent on streptomycin and work at suboptimal elongation rate, indicates that RNA polymerase escapes from the ribosomes in the pyrE attenuator region in the nusA mutant. In vitro transcription studies revealed that the build-up of the full-length attenuated orfE transcript occurred more slowly in the presence of the NusA protein than in its absence. Moreover, the NusA protein enhanced several transcription pauses through the orfE gene. These effects were more pronounced when low concentrations of either UTP or GTP were used than at low concentrations of either CTP or ATP. The results indicate that the NusA protein is required for proper regulation of pyrE gene expression and is involved, together with the NTP pools, in maintaining the coupling between transcription and translation in the pyrE attenuator region by inhibiting RNA chain elongation.

Bacterial Proteins↗
PubMed1991

Benign prostatic hyperplasia: symptoms and objective interpretation.

Considerable new knowledge about benign prostatic hyperplasia has been gained over the past two decades, particularly with regard to its natural history, hydrodynamic changes in the lower urinary tract, and the symptomatic and urodynamic results of treatment. A survey of the literature has been undertaken with special attention to the results of interventional studies and suggestions for future research.

Aged↗
PubMed1991

Infrequent voiders syndrome (nurses bladder). Prevalence among nurses and assistant nurses in a surgical ward.

We evaluated the prevalence of infrequent voiders syndrome (defined as women with a mean voided volume above 400 ml) and predisposing factors among the female nursing staff in a busy 100 beds department of surgery. One hundred and five nurses and assistant nurses were invited to fill in a questionnaire and a frequency/volume chart for a 24-hour period. The infrequent voiders were further studied using uroflowmetry and medium-fill CO2 cystometry. Seventy-two women completed the study. Six (95% c.l. 3%-17%) were infrequent voiders, although fifty women (57%-80%) suppressed the desire to void during working hours. Main reasons for suppression of desire to void were busy work, poor toilet facilities and indolence. The frequency of micturition was higher during evening and night shifts than in the day shift. In the infrequent voiders the functional bladder capacity ranged from 550-1,100 ml, but none had residual urine exceeding 120 ml.

Adult↗
PubMed1991

A patient weighted symptom score system in the evaluation of uncomplicated benign prostatic hyperplasia.

A new scoring system is presented for use in patients with uncomplicated benign prostatic hyperplasia. The system is based on the patients' information on the magnitude of twelve symptoms related to bladder and voiding function (symptom score), and three questions related to sexual function. Furthermore the patients are asked to grade the impact of these symptoms on their daily lives (bother score). Multiplication of the two scores related to bladder and voiding function gives the total score. The score related to sexual function is used only for comparing the situation before and after treatment. The new patient weighted total score may assist in creating a solid base for the indication for and evaluation of surgical and non-surgical treatment of uncomplicated benign prostatic hyperplasia.

Humans↗
PubMed1991

Extracorporeal shock wave lithotripsy of urinary calculi. Results from the first 306 patients treated at the Copenhagen Municipal Stone Center with a second generation lithotriptor.

The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29% had residual stones. Corresponding rates after 3 and 6 months were 58%, 24% and 18% and 70%, 21% and 9% respectively. Septicemia occurred in 4 patients and cardial arrhythmia in 34 patients (11%). No serious intra- or perirenal hematomas were registered. In 9% additional procedures were required and 11 patients had residual stones removed at open surgery. The used second generation lithotriptor with X-ray based stone localisation is effective for treatment of both renal calculi and ureteral calculi in situ in all three segments of the ureter.

Adolescent↗
PubMed1990

[Urinary retention in connection with postoperative pain treatment with epidural opioids].

The incidence of retention of urine in cases of postoperative epidural opioid analgesia varies from 15% to 90%. The extent to which this phenomenon depends upon the dosage employed has not been elucidated. The cause of postoperative retention of urine (PU) is probably a combination of the central and peripheral effect of the opiate involving altered autonomic activity. Increased sympathetic activity resulting from surgery may, similarly, be a pathogenetic factor. The current methods of treatment are prophylactic or symptomatic alpha-receptor blockade, naloxon in refractory doses or catheterization. Inhibition of per- and postoperatively increased sympathetic activity may possibly prevent PU. Carbacholine is not effective in the treatment of postoperative retention of urine. In animal experimental studies, kappa-receptor agonists have an analgesic effect without urodynamic side-effects but no clinical trials on man have hitherto been undertaken. When postoperative retention of urine occurs after epidural opioid treatment, clean intermittent catheterization or introduction of a thin suprapubic catheter are recommended.

Analgesia, Epidural↗
PubMed1990

[Extracorporeal shock wave treatment of urinary calculi. Results after treatment of the first 207 patients at the Copenhagen City Stone Center with a second generation lithotriptor].

Early experience of extracorporeal shock wave lithotripsy (ESWL) using a second generation lithotriptor (Siemens Lithostar) is reported. Two hundred and seven patients underwent 272 treatments for 291 stones. There were 259 renal calculi, including three staghorn calculi and 32 ureteric calculi. Treatments were performed under local analgesia (78%) or epidural or general anaesthesia (22%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2,487 +/- 1,262 shocks. The first month stone clearance rate was 43%, 24% had fragments less than 6 mm and 33% had residual stones. The same figures after three and six months were 57%, 23% and 20% and 71%, 23% and 6%, respectively. Septicaemia occurred in four patients and cardiac arrhythmia in 24 patients (12%); no serious intra- or perirenal heamatomas were registered. In 7% additional procedures were required, seven patients had residual stones removed at an open operation. The Lithostar is an effective second generation lithotriptor which can be used for renal, staghorn and ureteric calculi in situ in all three segments without stone manipulation prior to ESWL.

Adolescent↗
PubMed1990

Extracorporeal shock wave lithotripsy of kidney stones does not induce transient bacteremia. A prospective study. The Copenhagen Extracorporeal Shock Wave Lithotripsy Study Group.

During 58 extracorporeal shock wave lithotripsies 161 blood cultures were drawn to evaluate the incidence of bacteremia during the procedure. Only 3 blood cultures drawn during the procedure yielded bacteria, in all cases probably skin flora contaminants. Post-lithotripsy fever was noted in 29% of the patients, and could not be associated with transient bacteremia and was not influenced by antimicrobial prophylaxis. Patients with a positive urine culture after extracoporeal shock wave lithotripsy may have an increased risk of septicemia.

Adult↗
PubMed1990

The intraprostatic spiral. New treatment for urinary retention.

In a series of 45 consecutive patients with acute or chronic urinary retention, 41 were treated by insertion of an intraprostatic spiral using ultrasonic guidance under local anaesthesia. Insertion was successful in 35 patients and in 6 the spiral was inserted endoscopically. During a follow-up period of 12 months 8 patients died, all with a functioning spiral. The device was removed in 16 patients; in 6 cases the reasons for removal were related to the spiral and in 10 they were not. The spiral remained in situ in 17 patients and all had satisfactory voiding. This device is a good alternative to an indwelling catheter in patients awaiting prostatic surgery and also in those who are either unfit or unwilling to undergo prostatectomy.

Aged↗
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↗