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Biomedical subjects

K T Nielsen

Publications and source records attributed to K T Nielsen.

At least 19 recordsLinked to original sources

In vitro effects of bladder mucosa and an enkephalinase inhibitor on tachykinin induced contractility of the dog bladder.

Tachykinin-induced contractility of smooth muscle strips from dog bladders was studied in vitro, and the presence of substance P-like immunoreactivity and neurokinin A and neurokinin B-like immunoreactivity was examined in bladder sections. Nerve fibers with substance P-like immunoreactivity were present in the mucosa, submucosa and smooth muscle. Fibers were also found in nerves, intramural ganglia, and around blood vessels. Neurokinin A-like immunoreactivity had similar distribution, and no neurokinin B-like immunoreactivity was observed. Removal of the mucosa significantly enhanced the sensitivity and the maximum responses to the tachykinins. After removing the mucosa, the sensitivity to these tachykinins increased 0.4 to 0.5 log units (p less than 0.02). The responses to carbachol were not altered by mucosa removal. The leftward shifts of the concentration-response curves for neurokinin A were of similar magnitude after removal of the mucosa, and after pretreatment with phosphoramidon (10 microM), an enkephalinase inhibitor, in the presence of mucosa. However, phosphoramidon did not alter the sensitivity of the bladder strips to neurokinin B, and slightly changed the sensitivity to substance P (0.2 log units). Additional shifts of the substance P and neurokinin A curves to the left were observed in the presence of phosphoramidon when the mucosa was removed (0.6 and 0.5 log units, p less than 0.005). The order of potency for the tachykinins (neurokinin A greater than substance P) was not altered by mucosa removal, addition of phosphoramidon, or both. Neurokinin A was degraded by enkephalinase located in the bladder mucosa and addition of phosphoramidon or mucosa removal resulted in an inhibition or loss of enkephalinase activity. It is concluded that the responses to neurokinin A, which acts on NK-2 type of receptors, prevail on the dog bladder.

Animals

Radical prostatectomy versus expectant primary treatment in stages I and II prostatic cancer. A fifteen-year follow-up.

A fifteen-year follow-up of a prospective, randomized study comparing placebo with radical prostatectomy as the primary treatment of early prostatic cancer is presented. A total of 111 patients with clinical Stage I or II prostatic cancer, normal acid phosphatase levels, and negative findings on skeletal x-ray film were evaluable. Thirty Stage I patients and 20 Stage II patients received placebo only; 31 Stage I and 30 Stage II patients underwent radical prostatectomy. The survival status for 95 patients (86%) was established at the fifteen-year follow-up. No significant differences in crude survival occurred in either stage or in both stages combined. Moreover, the survival curves closely followed reference curves based on expected U.S. mortality for men of comparable ages and races. A statistically significant association between a high Gleason histologic score and poor survival was established. In this study, initial treatment with radical prostatectomy did not yield longer survival than initial placebo treatment alone. However, the findings should be interpreted with caution, since sample size was small and staging procedure was simplified.

Adenocarcinoma

[Fathers of first infants--preparatory courses about delivery, experience of delivery and paternity leave].

In the Central Hospital in Randers, 233 fathers of first infants replied to a questionnaire which illustrated their attitudes to the preparatory courses about delivery, experience of delivery and attitudes to paternity leave. 65% of the fathers participated in the course and 74% stated that they considered that this had been profitable. Where 77% of the men were concerned, these considered that participation in delivery had been a positive experience. 73% of the men had planned paternity leave around the time of delivery, which emphasizes the need for this arrangement.

Delivery, Obstetric

Quinolones in urology.

The new quinolones have broad antimicrobial spectra covering all aerobic gram-negative and gram-positive bacteria encountered in urinary tract infections. All are administered orally, some also parenterally, low degree of resistance, few side effects and bacteriological and clinical cure rates similar to or higher than traditional antimicrobials make them especially suitable for treatment of complicated urinary tract infections including bacterial prostatitis. Non-critical use of quinolones in simple infections where standard drugs may be equally effective and safe should be discouraged.

4-Quinolones

Female urinary incontinence treated by transvaginal urethral closure and suprapubic catheter.

A new technique for transvaginal closure of the urethra and placement of a suprapubic catheter in 4 patients with total urinary incontinence gave excellent results with all patients remaining dry and accepting the suprapubic catheter. Suspension of the invaginated, closed urethra by sutures, passed through the bladder, is believed to reduce the risk of inadequate healing of the urethra. However, extreme obesity and extensive fibrosis of the periurethral tissue especially with adhesions to the pubic bone are contraindications to the transvaginal approach.

Catheters, Indwelling

Symptom analysis and uroflowmetry 7 years after transurethral resection of the prostate.

The long-term result after transurethral resection of the prostate is not well documented. From 1981 to 1983, 84 consecutive consenting patients completed detailed symptom analysis and urodynamic examination before transurethral resection of the prostate. These studies were repeated 3 and 12 months postoperatively. Of the 84 patients 44 were interviewed at 86 months: 75% reported improvement compared to preoperative symptoms. In addition, 23 patients underwent uroflowmetry at 7 years. For this group the maximum urine flow rate remained virtually unchanged from 1 to 7 years postoperatively). When uroflowmetry results from all patients undergoing testing at the various followup intervals are considered, the maximum urine flow rate was 9.5 ml. per second preoperatively, 17.0 ml. per second at 3 months and 19.6 ml. per second at 1 year. Of the 44 patients 7 (16%) underwent repeat transurethral resection of the prostate.

Aged

Bladder neck suspension material investigated in a rabbit model.

Different principles for providing stable and durable suspension of the bladder neck and proximal urethral tissue are employed in endoscopic bladder neck suspension for female stress urinary incontinence. Six different anchor materials, some of which are currently used as tissue bolsters (anchors) for endoscopic bladder neck suspension, were implanted in the abdominal wall muscle of 45 rabbits. Tension on the anchors was measured and maintained by springs positioned between pairs of anchors. At two months evaluation, vascular graft and loops of suture retained 40% of the starting tension, while two sizes of screw anchors lost all tension. Silicone pads and kink free silicone tubing rapidly pulled through the tissue in 83% and 100% of the cases, respectively. Local tissue reaction with scar formation, physical characteristics of the anchor material (silicone, stainless steel, dacron or polypropolene) and cross sectional area of the anchor were identified as the important factors for anchor stabilization of tissue which has been repositioned under tension.

Abdominal Muscles

Artificial urinary sphincter implantation after pubectomy for bone tumor.

We report 2 cases of unilateral and bilateral excision of pubic bone tumors (chondrosarcoma and giant cell tumor). Postoperative stress incontinence was corrected by implantation of an artificial sphincter (AMS800) following which both patients were continent. The etiology of the incontinence was lack of bladder and urethral support, which was not correctable by bladder neck suspension procedures.

Adult

Urethral strictures after transurethral bladder tumor resection.

The charts on 241 patients, consecutively undergoing a total of 2043 transurethral resections of bladder tumors and subsequent controls, were reviewed to find the incidence and possible causes of postoperative urethral stricture. The incidence of urethral stricture was 15% in males and 4% in females, but less than one-third were symptomatic. The strictures were found distally in the urethra in 83% of the patients and were treated with optical urethrotomy. Cumulated duration of postoperative catheterization was significantly longer and size of resectoscope used larger in patients with stricture. Repeated transurethral instrumentations may increase the risk of stricture development.

Female

Semirigid and malleable rod penile prostheses.

Rod penile prosthesis implantation has a high functional success rate, and the devices have a low mechanical failure rate. The rods are easily implanted. Transient problems, such as pain or penile edema lasting longer than 4 weeks, occur in 10 to 15 per cent of patients, and serious complications such as infection or prosthesis erosion occur in 1 to 5 per cent.

Consumer Behavior

Urodynamics of the lower urinary tract.

The principles and techniques of uroflowmetry, cystometry, pressure-flow studies and urethral pressure profilometry are reviewed. The interpretation of urodynamic tests depends on the methodology used and whether the patients usual voiding symptoms during the examination. The more complicated urodynamic tests may require computer assistance both for data storage but also for test interpretation. One of the main challenge in future urodynamic is to transform these tests to clinical usable tools.

Humans

Breech position, delivery route and congenital hip dislocation.

The purpose of this study was to investigate whether the mode of delivery for fetuses in breech presentation in any way influenced the frequency of congenital hip dislocation. In 13,559 singleton births 583 fetuses were in breech position, and the cesarean section rate was 39.1%. Eighty-three infants were born with congenital hip dislocation, 11 of whom had been in breech position. Of these 11, cesarean section was required in 5 cases. There was no difference in frequency of congenital hip dislocation between fetuses in breech presentation delivered by cesarean section vs. by the vaginal route. The frequency of breech presentation in congenital hip dislocation was 13.3%. Including 7 external versions, the rate was 21.7%. Female to male ratio was 4:1. The frequency of congenital hip dislocations in infants born in vertex presentation was 5.5 per mille and for infants born in breech presentation it was 18.9 per mille.

Breech Presentation

Devices for monitoring intravesical pressure during transurethral resection of the prostate.

The importance of maintaining a low intravesical pressure during transurethral resection of the prostate has been demonstrated in studies of the relationship between bladder pressure and the amount of irrigating fluid absorbed during the procedure. Several methods of monitoring pressure are described, and the advantages and disadvantages of each are discussed.

Electronics, Medical

Endometriosis in the groin.

Recently we found one case of endometriosis in the extraperitoneal part of the round ligament (EERL). We found 30 cases previously described in the literature. A comparison showed that 90% were right-sided and often associated with an inguinal hernia. Fertility seemed to be below normal. In four of the cases a laporotomy was done. All had intraperitoneal endometriosis. In cases of EERL and claimed sterility therefore, the presence of intraperitoneal endometriosis should also be considered.

Adnexa Uteri