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Biomedical subjects

T Bilde

Publications and source records attributed to T Bilde.

At least 19 recordsLinked to original sources

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↗

Retroperitoneal fibrosis treated with methylprednisolon pulse and disease-modifying antirheumatic drugs.

The conventional treatment of patients with ureteric obstruction due to retroperitoneal fibrosis (RF) is surgery in combination with long-term corticosteroids. This report describes 11 cases of RF with ureteric obstruction treated with methyl-prednisolon pulse therapy (MPPT) in combination with azathioprine or penicillamine following initial insertion of ureteral stents. The medial treatment suggested was successful in 7 patients, but only moderately effective in the last 4 patients. This principle of non-operative management of RF has not been previously reported.

Adult↗

Trends in a Danish urologic department during the years 1979 and 1984.

During recent years several international studies have shown increasing rates of prostatectomy over the past decade. In Denmark the number of prostatectomies increased by 43% in the period 1977-85. This development is still unexplained, but one of the answers is very intriguing, proposing a shift in indications for prostatectomy. Therefore we retrospectively examined the records of 207 patients in 1979 and 243 patients in 1984, admitted with a diagnosis of benign hyperplasia of the prostate (BPH). In these patients respectively 164 and 149 prostatectomies were performed in the same years, at the Department of Urology, Glostrup County hospital. We found no evidence of a change in indications towards a more liberal attitude as suspected, but in contrast, we discovered a more conservative attitude. Because the national rates since 1984 have been stable, we conclude, that the development in a specialized urologic Department can serve as a predictor for the development on a larger national scale.

Aged↗

A new patient weighted symptom score system (DAN-PSS-1). Clinical assessment of indications and outcomes of transurethral prostatectomy for uncomplicated benign prostatic hyperplasia.

A patient weighted symptom score system, the Danish Prostatic Symptom Score (DAN-PSS-1), including a disease specific self administered quality of life questionnaire, is presented. The model was evaluated pre- and postoperatively in 29 patients apparently suffering from uncomplicated benign prostatic hyperplasia. The score system is based on the severity of 12 symptoms related to bladder storage and voiding function, and three questions related to sexual function (symptom score). For each of these parameters the patient must also evaluate its influence on his daily life (bother score). In the 29 patients with uncomplicated benign prostatic hyperplasia (BPH) bother scores exceeded symptom scores for the irritative symptoms but not for the obstructive symptoms, and surprisingly the symptom score was less improved than the bother score 6 months after transurethral resection of the prostate (TUR-P). Furthermore the postvoiding dribble was worsened after the operation. We find that this model, DAN-PSS-1, assists in creating a solid base for the indication for and the evaluation of treatment of uncomplicated BPH.

Aged↗

Prostatectomy in Denmark. Regional variation and the diffusion of medical technology 1977-1985.

In many countries prostatectomy is one of the most common surgical operations in elderly men. We used administrative data for the entire male population of Denmark to study temporal and regional variations in the use of prostatectomy from 1977 to 1985. The total annual number of prostatectomies increased by 43% during the period, when the transurethral procedure (TURP) gradually replaced traditional open surgery. TURP accounted for 56% of all operations in 1977 but increased its share to 92% in 1985. Substantial regional variations occurred with index values for prostatectomy in 72 recruitment areas ranging from 0.56 to 1.62 (SCV x 100 = 5.3). The amount of variation decreased during the process of technology diffusion, but remained at a relatively high level (as in other countries) even after the process had been completed (SCV x 100 = 5.1).

Denmark↗

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↗

Is micturition disorder a pathogenic factor in acute epididymitis? An evaluation of simultaneous bladder pressure and urine flow in men with previous acute epididymitis.

We evaluated 22 men 22 to 70 years old with previous acute epididymitis by pressure-flow study 3 to 12 months after the inflammation had resolved. Nine healthy men 20 to 62 years old were evaluated as controls. The patients had no symptoms from the lower urinary tract except for 2 men with slight prostatism. The maximum intravesical and maximum voiding pressures were elevated significantly in the patients compared to the controls (p less than 0.05). In most patients and in all of the controls the maximum urinary flow rates were within the normal range according to age. Because of the frequency of high voiding pressures in patients with previous acute epididymitis, this condition may be a pathogenic factor by promoting urethrovasal reflux. The high voiding pressures may be transmitted to the proximal urethra or in cases of a narrow and rigid bladder neck they may produce increased turbulence in the urine stream.

Adult↗

Prevention of urethral stricture formation after transurethral resection of the prostate: a controlled randomized study of Otis urethrotomy versus urethral dilation and the use of the polytetrafluoroethylene coated versus the uninsulated metal sheath.

Stricture formation after transurethral prostatectomy was studied in a randomized clinical trial including 185 patients. The patients were allocated to either a 2-day urethral catheter-dilation or internal Otis urethrotomy and to an operation with either a polytetrafluoroethylene coated or an uninsulated metal resectoscope. Urethral stricture was defined as an obstruction resulting in a maximum urine flow rate of less than 15 ml. per second and not permitting the passage of a 21F cystoscope. The frequency of urethral strictures was significantly lower after Otis internal urethrotomy (4 per cent) than after a 2-day urethral catheter dilation (16 per cent). The incidence of stricture formation was similar in patients operated on with a polytetrafluoroethylene coated (8 per cent) and with an uninsulated metal (12 per cent) resectoscope sheath. The incidence of stricture formation was unrelated to age, duration of preoperative and postoperative catheterization, operating time and presence of urinary tract infection.

Aged↗

Biocompatibility of urinary catheters. Effect on complement activation.

The ability of 2 brands of urinary catheters to activate the complement system in vitro as a marker of biocompatibility was investigated. Pieces of a silicone/latex catheter and an all-silicone catheter were incubated in human serum. Complement activation was tested in 2 enzyme immunoassays, one evaluating C3 activation and the other the terminal complement complex (TCC) formation. The silicone/latex catheter caused considerably more complement activation in both assays than did the all-silicone one. The findings are in agreement with previous results of tissue toxicity tests. The methods presented may prove valuable for the practical purpose of testing the biocompatibility of urinary catheters.

Biocompatible Materials↗

Ureteroscopy: results and complications.

The results and complications of 100 consecutive ureteroscopy studies are reported. Introduction through the orifice or the intramural ureter failed in 11 per cent of the patients and in 14 per cent the ureteroscope could not be advanced up to the level of the lesion. Ureteroscopy was successful in 75 per cent of the patients and stone extraction was successful in 69 per cent. Complications occurred in 9 patients: 4 had an uncomplicated urinary tract infection, 4 had a ureteral perforation and 1 presented with ureteral stenosis at the site of the extracted stone a few weeks later. At followup 1 to 3 months after ureteroscopy clinical examination, excretory urography and/or renography revealed no further late sequelae.

Endoscopes↗

Human umbilical vein for vascular access in chronic hemodialysis.

Since 1979 we have used human umbilical vein graft as the ultimate vascular access for hemodialysis in patients with chronic renal failure. In 24 patients 33 graft fistulas were performed. Several complications were encountered. Among these infection was the most serious, occurring in seven grafts. All these grafts were removed and never used for hemodialysis. Thrombosis occurred 25 times, and five grafts were lost because of this, whereas 20 grafts had successful thrombectomy and continued to function. Aneurysm formation occurred four times, two grafts were lost. Stenosis was seen in three cases, one graft was lost. In the material 26 grafts were used for hemodialysis and a median function time of 8.5 months was obtained. At the end of the observation period 10 grafts were open, eight were used for hemodialysis, two were not used because of successful transplantation. The umbilical vein graft is an acceptable alternative as vascular access where conventional methods of fistula formation have been exhausted.

Adolescent↗