Special issue "Curative power from nature". 1988-1989
expressed by Professor Schilcher:
a requirement that any modern drug of herb origin (phytopharmacon)
should meet is that its raw materials be botanically definable and
their parameters be reproducible so that the quality of the product
can be ensured.
Cucurbita pepo (common pumpkin) has long been used as food
and a source of lamp oil and now it serves as a raw material of
Pumpkin, together with some 700 species, belongs
to the family of Cucurbitaceae. Cucurbitaceae include annual as
well as perennial, herbal as well as ligneous specie, usually with
creeping stalks and trailers. Their diclinous flowers are generally
monoecious, i.e. they are on the same plant. Both staminate and
pistillate flowers have a five member synsepalous perianth (calyx,
corolla); the staminates have five stamina and the pistillates have
a three-carpel low-position pistil developing into the fruit characteristic
of Cucurbitaceae. The family is chemically quite homogeneous generally
containing tetracyclic triterpenes (cucurbitacines) responsible
for the bitter taste, pentacyclic triterpenes (saponines), specific
fatty acids, phytosterols, proteins and minerals (selenium, copper
etc.) in the seeds. The seeds also contain chlorophyll derivatives
(more exactly, protochlorophylls), which give a greenish-grey colouring
to the seeds (without shell) and a greenish-brown colouring to the
thick fatty oil obtained from them. Cucurbitaceae include the genera
of Citrullus (e.g. C. lanatus = water melon), Cucumis (e.g. C. melo
= honeydew melon, C. sativus = cucumber) and Cucurbita, consisting
of species known and cultivated all over the world, which have probably
developed from C. texana or C. andreana still indigenous to the
American continent. According to literary sources, these plants
were known and grown by natives as long as 8-9000 years ago. They
appeared in Europe some time in the 16th or 17th century. From a
Hungarian point of view it is worth noting that Janos Lippai in
his book "Posoni kert" published in 1664 describes several
pumpkin species. In Europe, Cucurbitae must have become widely grown
only from the second half of the 18th century. First, even in the
beginning of this century, they were grown as companion crop; since
the 50's they have mostly been produced in monoculture.
The genus of Cucurbitae is divided as follows according to Terpo:
C. pepo - common pumpkin
a) convar. Microcarpina (wild forms and calabash)
b) convar. Pepo (food and oil pumpkin)
C. maxima - squash
C. moschata - cushaw
Although oil can be obtained from all these species, C. pepo convar.
Pepo var. styriaca (or var. oleifara), i.e. Styrian oil pumpkin,
grown in Southern Austria (on an area of 6000 hectares, according
to data from the year 1980), in Wendland.
These species are characterized by creeping clinging stems, jointed
and often spotty leaves, and round streaky fruit green in the beginning
and gradually turning orange as the fruit is ripening.
The most valuable parts of the fruit are the greenish-grey seeds
of a unique composition.
Another species is "tschermak" pumpkin, which is a dwarf
plant. This favourable property does not, however, asserts itself
in the seeds and, therefore, this variety is not cultivated at large
As mentioned earlier, the seeds of food and oil pumpkin species
- either shelled or shell-less - are raw materials of oil (the seed
mass accounts for 1.6-3.0% of the fruit and the ratio of shell and
core is 23:77). Earlier, shelled-seed species had been used for
obtaining oil as no other species had been cultivated. Alefeld's
monography published in 1866 contains the detailed description of
66 species but none of them had shell-less seeds.
By the 1950's, however, species with shell-less seeds, or with filmy
skin according to Buchinger, had become wide-spread. According to
literary sources, this variety of pumpkin had emerged as a result
of mutation and then was successfully multiplied. It is interesting
to note that both pumpkin types have multilayer skin the only difference
being that in shell-less seeds these layers do not get thick and
can easily be removed. In shell-less seeds the chlorenchyma layer
is thicker and the chlorophyll mass is also bigger. Protochlorophylls,
one of the active ingredients also responsible for the colour of
the oil, are formed and stored in special plastids and membrane
systems of this tissue.
Finally, a few words about oil and obtaining oil. In Europe several
vegetable raw materials have been used as a source of oil for the
past centuries. (since 1520). Naturally, production of oil from
pumpkin seeds started later; the first manufactures were probably
founded in the late 18th and early 19th century in Orseg region,
Wendland and Transylvania. Interestingly, larger manufactures soon
developing into factories were not interested in obtaining oil from
pumpkin seeds and, therefore, production of pumpkin-seed oil has
remained at a traditional manufacture level
Oil is obtained in the following way:
The shell-less (filmy skinned) seeds are separated from the fruit
and dried. In the case of shelled seeds, the shell is first removed,
which in old times as a social event in the village community just
like the plucking of feathers. Then the seeds are ground and mixed
with some hot water in a pan specially made for this purpose and
then roasted on fire with careful mixing until the ground seeds
become rusty brown. The roasted and hot grots are then put into
oil press. Until recently the oil thus obtained was exclusively
used in oil-lights or as food of the poor; now it serves as base
material for healthy food products and paramedicines, such as pumpkinsedds
oil capsules. The use of pumpkinseed oil for medical purposes is
based on popular experience confirmed by investigators specialized
in medicinal herbs as early as the 1920's (Klein in Vienna and Pater
in Kolozsvar) that pumpkin seeds and the oil obtained from them
have a beneficial effect on various inflammatory processes, prostatic
hypertrophy and arteriosclerosis.
The author's "ars poetica" relating to paramedicinal products
is very similar to that expressed by Professor Schilcher: a requirement
that any modern drug of herb origin (phytopharmacon) should meet
is that its raw materials be botanically definable and their parameters
be reproducible so that the quality of the product can be ensured.
information about Pumpkin seed oil
Oil produced from the seeds of the pumpkin is rich
in vitamins and minerals. PUMPKIN IS a fruit grown and eaten in
North America, China, Hungary, Austria, Mexico, Yugoslavia and several
Caribbean countries. The seeds of the pumpkin are a rich source
of vitamins A, B and E, omega-3 and omega-6,
zinc, selenium, carbohydrates and cholesterol-like molecules called
Countries such as Bulgaria, Turkey, Russia and Ukraine have reported
that eating a handful of pumpkin seeds is beneficial for the treatment
of prostatic hyperplasia. In this condition there is enlargement
of the prostate, an organ found encircling the urethra of males.
Monographs produced by the German Commission E have documented the
usefulness of pumpkin seed oil for the treatment of prostate enlargement
and a few clinical evaluations in Europe have confirmed that it
alleviates the associated urinary complications. In one clinical
trial, over 2000 men suffering from prostate enlargement were treated
with capsules containing pumpkin seed oil and found that there was
significant improvement in urinary function.
Using an animal model of prostate enlargement, researches in the
pharmacology section of the University of the West Indies have shown
that pumpkin seed oil can inhibit the growth of the prostate and
continue to assess the actions to elucidate the mechanism involved.
REDUCING BLOOD CHOLESTEROL
Pumpkin seed oil has also been reported in folklore to reduce blood
cholesterol concentration. High levels of cholesterol in the blood
are associated with chronic illnesses such as hypertension and stroke.
While scientific evidence of the effect of pumpkin seed oil on cholesterol
concentration in the blood is limited, it is known that including
phytosterols, as well as omega-3 and omega-6
fatty acids in the diet can significantly lower blood cholesterol
levels. Therefore, it is speculated that since pumpkin seed oil
is rich in these compounds, then it may have clinical usefulness
in reducing blood cholesterol levels. Researchers in the Pharmacology
Section at the UWI are currently investigating this possible action
of pumpkin seed oil on blood cholesterol concentrations.
in Patients with Prostatic Hyperplasia
Special issue "Curative power from nature". 1988-1989
Summary: No really effective drug is available
at present for the treatment of prostatic hyperplasia and therefore
surgery seems to be the only successful way of therapy. Authors
report on their experience with the administration of Peponen capsules
in patients with prostatic hyperplasia. They have found Peponen
equivalent with hormone products and are of the opinion that it
may be effective in younger patients with chronic prostatitis as
well. They especially recommend Peponen for treatment of elderly
male patients who are not considered for surgery because of their
general condition, or unwilling undergo surgery.
Prostatic hyperplasia is probably the most frequent benign neoplastic
growth in males. The size of the prostate in adult males does not
change until about the age of 45 years. Development of benign prostatic
hyperplasia (BHP) is a universal phenomenon in aging males but the
pathogenesis of the disease is not yet clear. A great majority of
patients over the age of 50 display histological signs of BPH and
suffer from urethral compression symptoms.
Unfortunately, no really effective drug is available at present
for the treatment of prostatic hyperplasia. Surgery appears to be
the only successful way of therapy. The efficacy of meditation is
difficult to evaluate as symptoms may remain stable for a long time
in patients receiving no treatment and, furthermore, there are frequent
spontaneous remissions of obstruction complaints.
PEPONEN capsules were used in 30 patients with prostatic hypertrophy.
Mean age of the patients was 65.4 (53-75) years.
Patients with sterile urine only were admitted to the trial. The
patients received one capsule three times daily for two months.
At the commencement of treatment the patients' dysuric complaints
had existed for an average of eight months. Prior to treatment urinary
sediment test, rectal prostatic examination, and urine residue measurement
were performed. In half of the patients uroflowmetric studies were
also carried out.
The findings were as follows:
1. There was no change in the size of the prostate as determined
by rectal examination.
2. The number of night urinations was reduced in two-third of the
cases and remained unchanged in one-third. Eight patients reported
complete disappearance of such symptoms.
3. Prior to treatment ten patients had urine residue of 34 (10-60)
ml on the average and 66% of the patients had no residue. The quantity
of residue was reduced in all the patients to one-third on the average
and three patients became free of residue.
4. The greatest improvement was observed in subjective symptoms.
Dysuric complaints were substantially reduced in 26 patients (86.7%).
5. Patients in whom uroflowmetry was performed demonstrated a 60%
increase in maximum flow (from 15 ml/s to 24 ml/s).
6. No side effects were observed during treatment. Similar results
were obtained by other authors using hormone products with severe
side-effects. We have found PEPONEN capsules as effective as hormone
products in prostatic hyperplasia. They would probably be effective
in younger patients with chronic prostatitis as well. PEPONEN capsules
are highly recommended for elderly male patients not considered
for surgery because their general condition or unwilling to undergo
surgery for some reason.
with Peponen Capsules in Benign Prostatic Hypertrophy
Special issue "Curative power from nature". 1988-1989
conducted a clinical trial with Peponen capsules containing pumpkin-seed
oil. Peponen was given long-term to 29 patients with prostatic hypertrophy
stages I-II and favourable results were obtained: subjective symptoms
were substantially reduced or disappeared and there was a reduction
in prostate size as determined by ultrasound in 29% of the patients.
The mechanism of urine discharge determined by uroflowmetry was
not affected significantly. Adverse side-effects were not observed.
Prostatic hypertrophy (PH) frequently occurs in elderly males. The
etiology of the disease is not clear; it is probably associated
with hormonal dysfunction. In the old age there is a reduction in
the production of male hormones leading to the growth of periurethral
glands in the prostatic section of the urether, which are sensitive
to female hormones and of female character evolutionary. The majority
of males over 50 years, therefore, develop adenoma either with or
On the bases of subjective complaints and symptoms associated with
the enlarged adenoma PH is divided into four stages.
In stages I and II either no or only moderate urine retention occurs.
Renal functions are not yet impaired and there is no risk of urinary
infection. In these stages the patients usually seek medical help
because of dysuric complaints the severity of which is related to
the size of the prostate but not directly proportional to the degree
of urine retention. Pronounced complaints force the doctor to use
conservative medication or, in some cases, resort to early surgery.
Drugs and natural products commonly used in these early stages of
the disease include the following:
1. Enzyme inhibitors blocking androgenic-estrogenic metabolism at
the level of the prostate (Permixon)
2. Progestogen hormones (Depostat, Hormofort)
3. Products containing animal or plant extracts (Raveron, Prostagutt,
The wide range of products that may be considered in prostatic hypertrophy
indicates that there is no "sure" drug equally effective
in all patients. Since none of these drugs are surely effective
and, furthermore, they are rather expensive and the hormonal products
may induce severe side-effects, it is justified to use an effective,
easily available and relatively in expensive product that is free
of side effects.
These considerations have led us to conduct a trial with Peponen
capsules containing pumpkin-seed oil.
We used Peponen in 42 patients between January 1 and October 1,
1988; no evaluable results were obtained in ten patients, who failed
to cooperate; 29 of the 32 evaluable patients had prostatic hypertrophy
(stages I and II) while the remaining three had chronic prostatitis.
Patients with prostatic hypertrophy stages III and IV, manifest
cardiac decompensation or concomitant urolithiasis as well as those
who had undergone prostatectomy were excluded from the trial.
The patients were divided into "target" and control groups
according to date of birth. Patients born in odd years were given
Peponen; the others (15 patients) were assigned to the control group
and received Depostat injections at the dosage of one ampoule weekly
for five weeks.
During treatment prostate size, changes in residual urine volume,
the mechanism of urine discharge, and the subjective symptoms were
The size of the prostate and the volume of residual urine were determined
by ultrasound; the mechanism of urine discharge was studied using
uroflowmetry (maximum flow, full duration of urination, and duration
of maximum flow).
These studies were complemented by laboratory tests (urinary sediment,
serum urea nitrogen, creatinine). Subjective symptoms were evaluated
on the bases of patients reports.
It should be noted here that prostatic hypertrophy is characterized
by occasional spontaneous remissions that may last for shorter or
Mean age of the patients was 63 (50-73) years. Mean body weight
was 70.8 kg. Mean duration of treatment was 8.2 (3-10) months,
The intial dose of Peponen was two capsules three times daily for
one month; the maintenance dose was one capsule three times daily
for the rest of the trial.
The patients were examined after a month's treatment and then every
Changes in the size of the prostate in patients receiving Peponen
and in the controls are presented in Table 1.
Changes of not less than 3 mm were considered as significant. There
was a reduction in transversal diameter in all eight patients in
whom change was detected; change in AP diameter was observed in
only one patient.
Urine flow was studied by uroflowmetry using Wolf's apparatus. At
baseline, the mean urine flow rate was 24 (10-45) ml/sec; duration
of maximum flow was between 3.75 and 5.0 sec while the full duration
of urination was 10-95 sec. In patients with prostatic hypertrophy
stages I and II the latter is more relevant and its mean value at
baseline was 39.5 sec.
The uroflowmetric tests did not reveal significant differences compared
with baseline (Table 2).
Peponen was primarily effective in reducing subjective symptoms.
The influence of Peponen on subjective symptoms is shown in Table
No significant change was observed in laboratory parameters either
among those on Peponen or among the controls.
Changes in prostate size as determined by ultrasound
No change Decrease Increase Total
Peponen group 21 8 - 29
Control group 15 - - 15
Changes in urine flow
No change Improvement Deterioration Total
Peponen group 23 3 3 29
Control group 11 1 3 15
Changes in urination complaints
Symptom free Improvement No change Deterioration
Peponen group 6 21 2 29
Control group 8 4 3 15
Complaints associated with prostatic hypertrophy have been observed
to occur less frequently in regions where the population consumes
large quantities of pumpkin seed (Klein, B. Pater).
In our study Peponen was found especially effective in reducing
subjective symptoms associated with prostatic hypertrophy; subjective
symptoms improved in nearly all patients and disappeared in six.
Peponen reduced the size of the prostate in a surprisingly high
number of the patients; this effect of Peponen may have been related
to its antiedematous activity.
The mechanism of urine discharge as determined by uroflowmetry was
not affected significantly.
Changes in urine retention were not evaluable as the majority of
the patients had either no or minimal retention at the beginning
of the trial.
Patient compliance was good. None of the patients reported side-effects
and allergic reactions did not occur.
Three patients experienced improvement of sexual functions, which
may be interpreted as a "beneficial" side-effect.
The low number of prostatitis cases did not allow to draw final
conclusions in this indication.
The patients reported quicker reduction in subjective symptoms with
the initial dose (two capsules three times daily) than with the
maintenance dose, an observation which makes the study of the correlation
between dose and effect worthwhile.
with the Peponen capsule in the management of benign prostatic hyperplasia
Int Urol Nephrol 1991;23(1):51-55
Authors report on their experience with the administration
of PEPONEN capsules to 60 patients with benign prostatic hypertrophy
(BPH) stages I and II. 26 patients took PEPONEN for ten months,
22 patients for at least seven months and 12 patients for at least
four months at a dosage of two capsules three times daily in the
first month and then one capsule three times daily. On the basis
of the results of urodynamic tests and the evaluation of changes
in subjective complaints, improvement was observed in more than
80% of the patients. There was an increase in urinary flow while
dysuric complaints, frequent and painful urination as well as the
frequency of nocturnal urination decreased.
Benign prostatic hypertrophy (BPH) is one of the
best known and most frequently encountered urological diseases in
males over the age of 45 years. It occurs in more than 50% of males
aged over 50 and may cause complaints in 10 to 30% of them. Over
the age of 64 years the incidence of BPH is as high as 90% and approximately
50% of all patients have complaints requiring treatment (1,2).
In the early stage of the disease, hypertrophy of the detrusor muscle
in the bladder compensates for the increased urination resistance
and therefore the patient does not usually experience any symptoms.
The first symptom the patient notices is the weakening of the urine
stream and, furthermore, he has difficulties in starting urination.
The patient experiences a sensation of fullness even after urination.
Insufficient urination leads to frequent day-time urination and
nycturia. Later complete retention and overflowing incontinentia
may develop. In the case of urinary tract infection, urination becomes
painful and renal insufficiency may develop as a consequence of
BPH is diagnosed by rectal palpation, uroflometry, abdominal ultrasound
examination and selective urography. BPH is divided into there stages
on the basis of subjective complaints and clinical symptoms (1,2,5,8).
Stage I is characterized by dysuric complaints (difficulties in
starting urination), frequent day-time urination and nycturia, without
residual urine. In stage II, dysuria becomes more pronounced and
imperative urination impulses develop with an increase in the frequency
of day-time and noctural urinations due to residual urine. In stage
III, dysuria and atonic bladder lead to overflowing incontinentia
and, occasionally, complete retention with uraemic symptoms may
Clinical experience indicates that BPH is not necessarily of progressive
character and therefore conservative therapy can successfully be
used in stages I and II. The aim of conservative therapy is to relieve
dysuric complaints and to reduce both the amount of residual urine
and the frequency of urination.
Ruszinco was the first to report on the beneficial effects of PEPONEN
capsules, an OTC product of BIOGAL Pharmaceutical Works containing
pumpkin-seed oil, in BPH (10). The present study was conducted as
part of a multi-centre trial organized by BIOGAL to evaluate the
efficacy of PEPONEN in BPH stages I and II.
Patients and method
PEPONEN capsules were used in 60 male patients
with bladder neck adenoma treated as ambulatory patients at the
Urological Department of Semmelweis University Medical School from
January to December, 1988. The diagnosis was established by rectal
palpation, uroflowmetry, catheter measurement of residual urine
or abdominal ultrasound examination. Ultrasound examinations were
performed with SONOTRON (Toitu-CO-600) apparatus. The size of the
prostrate was measured frontally and longitudinally at full bladder,
the quantity of residual urine was measured according to Rutihauser
and Rageth (12). The patients were divided into two groups according
to the stage of their disease. The patients in stage I had no residual
urine while those in stage II had residual urine. Of subjective
symptoms, dysuric complaints, pain and the frequency of urination
were evaluated. Pyuria, observed in some of the patients, was treated
with antibiotics. The patients did not receive any other conservative
medication from one month before the commencement of treatment with
Peponen. In the first month, the patients took two capsules three
times daily, then one capsule three times daily, independently of
body weight and general condition. The patients reported for control
after 4, 7, and 10 months. 26 patients for 7 months, and 12 patients
for at least 4 months.
Changes in urinary flow as a result of treatment with Peponen capsules
Tests I II (1 month) III (4 months) IV (7 months)
V (10 months)
n: 36/24 36/24 25/23 14/8 18/8
Average urinary flow (ml/sec) 9.5/8.6 11.2/10.5 12.5/11.5 12.3/11.5
Maximum urinary flow (ml/sec) 15.4/13.2 17.1/15 18.2/15.1 17.8/15.6
Residual urine (ml) --/35-90 --/0-70 0-30/0-80 --/0-40 --/0-50
Time (sec) 4/12 5/9 4/10 5/8 5/6
Changes in subjective complaints as a result of treatment with Peponen
I II III IV V
N: 36/24 36/24 26/23 14/8 18/8
Dysuria 16/11 8/9 7/9 7/8 5/7
Painful urination 5/6 2/4 0/3 0/4 ?+antibiotic
Frequent urination 22/18 15/15 10/12 7/5 5/4
Nycturia 18/22 12/17 10/15 6/5 8/5
The changes in urinary flow during treatment are
shown in Table 1. The quantity of discharged urine was 150 to 250
ml over the period of the study. As a result of treatment, there
was an increase in mean urinary flow as well as maximum urinary
flow in both groups. Both the mean amount of residual urine and
the time required for starting urination decreased in patients of
stage II, with the latter being reduced to half. In these patients
there was a more pronounced increase in urine flow than in patients
of stage I. The amount of residual urine was also reduced. No evaluable
changes were found in 19 out of 60 patients.
As regards subjective complaints, the condition of patients of stage
I showed pronounced improvement while those in stage II experienced
practically no change in dysuric complaints and the frequency of
nycturia (Table 2).
The patients' and investigators' judgments on the efficacy of treatment
were also compared. It seems that the patients considered the changes
more favourable as they actually were by the evidence of objective
tests (Table 3). Only 11 (18.3%) of all patients reported no improvement;
19 patients (31.6%) reported some improvement and 32 patients (53.3%)
found the treatment very effective.
Since the pathogenesis of BPH is not known yet,
treatment cannot be targeted as the actual cause of the disease.
Treatment is required when the condition causes complaints. Although
surgical removal of the adenoma seems to be the only way of achieving
complete recovery (1, 2, 8), conservative therapy is also used in
patients with BPH. In Hungary Szendro and Szelestei used hormonal
therapy in BPH (8, 9). Balogh reported on the administration of
Raveron to a greater number of patients (3). Romics had favourable
experience with the administration of Bazoton (Kanoldt), a product
containing Radix urticae extract (9). Frang et al. conducted a trial
with prazosin (Minipress, Pfizer) in BPH patients (6).
The use of phytotherapeutic agents, ie. products containing medicinal
plant extract, in BPH has a long history (5, 7, 11). The active
substance of PEPONEN capsules used in this study is pumpkin-seed
oil obtained from a pumpkin variety with shell-less seeds. The biological,
biochemical, and physiological effects of pumpkin-seed oil justify
its extensive usability. In BPH pumpkin-seed oil exerts a beneficial
effect through the regulation of prostaglandin production by its
beta-sitosterol, ergosterol, and camphosterol components. Pumpkin-seed
oil increases muscular tone in the bladder hence normalizing bladder
functions with a consequent reduction in inflammation and pain.
Linoleic acid, sterols, vitamins E and F, and selenium in pumpkin-seed
oil protect the hormones and vitamins from destruction. Thus PEPONEN
may affect androgenic and prolactin activity directly in the prostate.
It improves bladder function and exerts beneficial influence on
the inflammatory changes of the prostate (5, 6, 10).
In the present study some improvement was observed even after one
month of treatment as confirmed by the changes in clinical symptoms
and urinary flow as well as the patients' judgment. Lasting improvement
was achieved after four months of treatment. Later on, no further
change was recorded but deterioration in the patients' condition
was not observed either. Treatment with PEPONEN increased urinary
flow and decreased dysuric complaints as well as the frequency of
day-time and nocturnal urination in more than 80% of the patients.
The improvement was more pronounced in patients with BPH of stage
I. PEPONEN is regarded as equivalent with other medications in the
conservative therapy of BPH.
Effect of Peponen treatment
Patient's judgment Doctor's judgment
Very good 32 patients 25 patients
Good 12 patients 8 patients
Slight improvement 5 patients 8 patients
No change 11 patients 19 patients
n: 60 patients 60 patients
1. Altwein I.E., Jacobi, C.G.: Urologie. Enke Verlag,
2. Balogh F., ed: Urologia (Urology) Medicina, Budapest, 1986.
3. Balogh F.: A Raveron erteke egyes urologiai megbetegedesek kezeleseben.
(The Use of Raveron in Treatment of certain urological diseases)
Urol. Nephrol. Szle, 1987, 14, 195.
4. Bartsch G. et al: Light microscopic stereological analysis of
normal human prostate and of benign prostatic hyperplasia. J. Urol.
1979, 122, 487.
5. Eggerhart G., Gallyas, F: Klinische Erfahrungen mit Harzol-Kapseln
in der Behandlung des Prostate-Adenoms. Urologe (B). 1987, 27, 227.
6. Frang D., Hamvas, A., Nagy F: Az alfa-adrenoceptor blokkolo prazosin
(Minipress) helye a holyagnyak-adenomas begetek kezeleseben. [The
role of alpha-adrenoceptor blocking prazosin (Minipress) in treatment
of patients with bladder-neck adenoma] (Submitted for publication)
7. May P., Sokeland P: Phytopherapie in der Urologie-Editorial -
Ruologe (B) 1987, 27, 213.
8. Pinter J., ed: Prostata hyperplasia (Prostate hyperplasia) Magyar
Urologiai Tarsasag V. Kongresszusa, Debrecen, 1979.
9. Romics I: Observations with Bazoton in the management of prostatic
hyperplasia. Int. Urol. Nephrol., 1987, 19, 293.
10. Ruszinko B. et al: Peponen kapszula alkalmazasaval szerzett
tapasztalataink (Experience with administration of PEPONEN capsules)
Gyogyszereink. 1986. 1.
11. Sonneschein R.: Untersuchung der Wirksamkeit eines prostatotropen
Phytotherapeutikums (Urtica plus) bei Benigner Hyperplasie und Prostatitis-eine
multizentrische Studie. Urologe (B) 1987. 27. 232.
12. Khoury S., ed: Ultrasound in Urology, Int. Scient. 1985, 309.
Possibility in Treatment of Hyperlipidaemia with Peponen® of Natural
Horvath S, Bedo Z.
2nd Department of Surgery (1), 3rd Department
of Internal Medicine (2), Debrecen University Medical School, Debrecen,
According to popular experience, the incident of hypertension, atherosclerosis
and prostatic hypertrophy is lower in people regularly consuming
pumpkin-seed oil. Authors report on their experience with the administration
of Peponen capsules (Biogal) containing pumpkin-seed oil to hyperlipidaemic
patients and conclude that Peponen reduces the level of serum total
cholesterol, triglyceride, and LDL-cholesterol while increasing
the concentration of protective HDL-cholesterol. These beneficial
effects of Peponen are primarily observed in patients with Fredrickson
IIa and IIb hyperlipidaemia.
Vegetable oils are widely used as articles of food
and some of them are typical foodstuff in ethnic groups. Pumpkin-seed
oil is extensively used in Hungary and the neighboring countries
(e.g. Yugoslavia and Syria). In these areas, the incidence of prostate
hyperplasia, hypertension, and arterioslcerotic diseases is lower,
a phenomenon which has been connected with regular pumpkin-seed
The composition of pumpkin-seed oil has not yet been fully elucidated;
linoleic acid, linolenic acid, beta-carotene, lutein, beta- and
gamma-tocopherol, chlorophyll, and selenium have so far been identified
as components. Due to its special composition, pumpkin-seed oil
may indeed be able to delay arteriosclerotic processes, presumably
through a favourable influence on abnormal lipid metabolism. It
seemed obvious, therefore, to conduct clinical trials with pumpkin-seed
oil in patients with diagnosed hyperlipidaemia, including those
with coronary heart disease.
According to experimental studies in rats, pumpkin-seed oil is able
to reduce serum cholesterol levels thus reducing the lipid content
of vessel walls and tissues. It inhibits platelet aggregation, i.e.
it can delay the process of arteriosclerosis. Certain essential
fatty acids and prostaglandin precursors can reduce vascular reactivity
to rennin and angiotensin II so they may have an antihypertensive
Earlier, we had conducted a clinical trial with Peponen capsules,
a paramedicinal product of Biogal, containing 300 mg of pumpkin-seed
oil extract per capsule. The study was performed in 37 patients
with diagnosed coronary sclerosis who also suffered from hyperlipidaemia
of Fredrickson types II or IV.*
It can be seen that peponen reduces serum cholesterol levels as
well as triglyceride levels and increases HDL-cholesterol levels.
More precisely, it increases low HDL-cholesterol levels toward the
physiological range and does not affect normal HDL-levels. Its effect
on total serum cholesterol and triglyceride levels proved to be
The favourable results had encouraged us and Biogal to study the
effect of Peponen in a greater number of patients. In 1988, a clinical
study was conducted in the 2nd Department of Surgery and the 3rd
Department of Internal Medicine, Debrecen University Medical School,
as part of a multicentre trial designed to evaluate the effect of
Peponen in hyperlipidaemic patients.
The patients at the 2nd Department of Surgery were selected from
those who had undergone coronary bypass surgery. Surgery had taken
place at least half a year before treatment with Peponen was started.
30 patients were selected; distribution of the patients according
to the type of hyperlipidaemia is shown in figure 3.24 of the 30
patients had hyperlipdaemia of Fredrickson types IIa and IIb; type
had type I, two had type III, and two had type IV hyperlipidaemia.
The patients at the 3rd Department of Internal Medicine ere selected
at screening. The 38 hyperlipdaemic patients thus selected had no
complaints and took no medication; 14 patients belonged to Fredrickson
type IIa and 11 to type IIb; six patients had type I, six patients
had type III, and one had type IV hyperlipidaemia*.
The results are presented*.
Of patients who had undergone coronary bypass surgery, favourable
changes were found only those with Fredrickson types IIa and IIb
hyperlipidaemia but not in types I, III, and IV. In 8 of 14 patients
with type II hyperlipidaemia, serum cholesterol levels decreased
from 9.27 mmol/l to 8.02 mmol/l; the triglyceride levels were reduced
from 2.35 mmol/l to 1.68 mmol/l, LDL-levels from 6.93 mmol/l to
5.29 mmol/l, and VLDL-levels from 0.91 mmol/l to 0.43 mmol/l while
HDL-cholesterol levels increased from 0.93 mmol/l to 1.23 mmol/l.
These changes occurred in only about one-third of the patients.
The numbers below the columns in figure 4 indicate the number of
patients with favourable changes. The overall evaluation did not
reveal significant improvement; nevertheless, the changes observed
in some of the cases were important although not significant.
Data of patients having undergone coronary bypass surgery
Out of 30 patients
24 patients: Fredrickson type IIa
2 patients: Fredrickson type I
2 patients: Fredrickson type III
2 patients: Fredrickson type IV
The patients were on Colfarit and Betaloc.
Data of patients with symptom-free hyperlipidaemia
Out of 38 patients
14 patients: Fredrickson type IIa
11 patients: Fredrickson type IIb
6 patients: Fredrickson type I
6 patients: Fredrickson type III
1 patient: Fredrickson type IV
The results of patients with symptom-free hyperlipidaemia are shown
in figure 5*. It can be seen that favourable effects of Peponen
were observed in patients with hyperlipidaemia of Friedrickson type
II, but not in those with other types; no deterioration, however,
was observed in any of the tested parameters. In 14 patients with
hyperlipidaemia of type IIa, triglyceride decreased from 1.67±0.64
mmol/l to 1.51±0.1 mmol/l, total cholesterol levels from
7.55±0.82 mmol/l to 6.67±1.15 mmol/l, LDL cholesterol
levels from 5.53±0.72 mmol/l to 4.86±1.15 mmol/l and
VLDL from 0.50±0.16 mmol/l to 0.31±0.17 mmol/l after
two months' treatment. There was practically no change in HDL-cholesterol
levels, they moved from 1.57±0.37 mmol/l to 1.58±0.43
mmol/l. Interestingly, while significant changes (remarkable increase
in HDL-cholesterol) had been found in the lipid levels of patients
taking part in the 1987 study, in this study, the lipid lowering
effect of Peponen was not so pronounced although favourable changes
were undoubtedly observed in one-third of the patients, especially
in those with hyperlipidaemia of Fredrickson type II. All patients
in the coronary bypass group took Betaloc andColfarit and these
might have exerted an antilipaemic effect. The favourable changes
were not universal in the group of symptom-free patients either
although they did not take any other drug besides Peponen. The changes
were similar in both groups, except for HDL-levels. In the coronary
bypass group, 8 patients demonstrated an increase in HDL-levels.
Certain drugs may indeed influence the effect of Peponen but we
cannot exclude the possibility of differences in raw material used
for the production of Peponen capsules. Since the raw material of
Peponen is a natural substance, its composition may be influenced
by conditions such as the site of pumpkin production. These conditions
should be taken into account in the future.
On the basis of these findings, the conclusion can be drawn that
Peponen, a product of natural active substance, is a valuable contribution
to the range of therapeutic agents used in hyperlipdaemia. Several
drugs are available for the treatment of hyperlipidaemia but only
a few of them are of confirmed efficacy. The effects of Peponen
are remarkable and although it is not the drug of first choice,
it is worth trying in hyperlipdaemia of Fredrickson type II. Peponen
has no side effects; it improves the patients' general condition
and appetite without affecting the body weight. According to earlier
experience, it improves the symptoms of prostate hyperplasia and
it can even enhance sexual potency in males. Pepnone has also been
reported to potentiate the effect of lipid lowering drugs (lipathyl,
in the Treatment of Male Fertility Disorders
Corradi G, Hegedus M, and Frang D.
Department of Urology, Semmelweis University Medical School, Budapest
Effect of Peponen capsules was evaluated in 27 patients with andrological
disorders. Ten patients receiving low doses of testosterone served
as control. Peponen was of beneficial effect in fertility disorders
associated with prostatic dysfunction. Efficacy of Peponen in the
treatment of infertility of unknown origin was similar to that achieved
among the controls on conventional therapy. Further studies are
required to establish the therapeutic role of Peponen capsules.
Pumpkin-seed oil contains several of the hormones
and other substances that play an important role in the maintenance
of testicular functions. These substances include vitamin E, prostaglandin
precursor unsaturated fatty acids and, furthermore, sterolons and
squalens serving as intermediaries in the production of compounds
of sterane structure (1).
Prostatic secretion accounts for one-third of semen. Normal proteolytic
enzyme functions are indispensable for the liquefaction of semen.
Normal functioning of the prostate plays an important role in the
maintenance of fertility. The beneficial effects of pumpkin-seed
oil on prostate function, partly through the above biochemical pathways
and partly due to its anti-inflammatory activity, may also contribute
to the maintenance of fertility. These considerations have led us
to evaluate Peponen capsules (Biogal Pharamceutical Works) in andrology.
Material and method
Forty patients with fertility disorders visiting our andrological
consultations were given Peponen capsules (one capsule three times
daily for three months).
Twenty-seven patients completed the study. Prior to and on completion
of the three-month treatment andrological-spermatological tests
were performed according to WHO recommendations (3). Patients with
fertility disorders of unknown origins were selected for the study;
disorders of known etiology (variocele, hypogondism, etc.) were
excluded. Our results are summarized in Table 1.
In Table 2 the results are presented by groups established according
to cell count.
A group of ten patients receiving low doses of
testosterone as conventional andrological treatment served as control.
The criteria of selection were the same as for the Peponen group.
The results of controls are presented in Table 3.
Four of the control patients and ten of those on
Peponen showed improvement. Five of the latters had the highest
degree of improvement. These patients had a history of prostatic
complaints and slow liquefaction of semen was observed in them.
Their data are presented in Table 4.
No. of patients N=27 Before Peponen After Peponen Difference
Cell count million/ml 12.7 16.3 3.6
Motility % 43.4 55.5 12.1
Intensive movement % 25.4 37.3 11.9
Structure % 42.3 54.3 12.0
Cell count million/ml No. of patients No improvement Improvement
1-5 4 4 -- 0%
5-10 7 5 2 28.5%
10-15 9 4 5 55.5%
15-20 7 4 3 42.8%
Total 27 17 10 37.0%
No. of patients N=10 Before treatment After
Cell count million/ml 12.5 17.6 5.1
Motility % 62.5 65.5 3.0
Intensive movement % 33.6 46.5 12.9
Structure % 54.7 57.1 2.4
No. of patients N=5 Before treatment After treatment Difference
Cell count million/ml 12.6 19.4 6.8
Motility % 51.2 68.5 17.3
Intensive movement % 23.5 51.2 27.7
Structure % 44.6 65.2 20.6
Drug treatment of fertility disorders of idiopathic origin poses
serious problem. The number of andrological drugs presently available
is limited; there are not more than ten drugs that are currently
used with more or less success. Andrologists, therefore, look forward
with great interest to new drugs launched on the market.
The aim of our study was to evaluate Peponen capsules in andrological
patients. Patients receiving low doses of testosterone were used
as controls. After three months' treatment one-third of the patients
improved; improvement was manifested inc ell count, motility as
well as structure. In some cases the degree of improvement reached
that of the controls although these changes were not significant.
With drugs generally considered effective (2) a 20 to 40% improvement
can be expected; such percentage of improvement can be achieved
In view of spontaneous fluctuations in sperm count (2), the results
of this study should be confirmed in a higher number of patienets
followed up over a longer period of time. The results of the five
patients whose data are presented in Table 4 were found especially
promising. In this group of patients there was a definite and outstanding
improvement. These patients had a history of prostatic dysfunction
and prolongation of semen liquefaction was detected in them.
On the basis of our experience Peponen capsules seem to b useful
in the andrological practice. Favourable results may be expected
in one-sixth of the patients. Natural origin and the lack of side-effects
constitute a special advantage of the product.
1. Jancso S., A tokmagolaj biokemiai hatasai (Biochemical Effects
of Pumpkin-Seed Oil) Manuscript on file at BIOGAL Medical Division,
2. Bain, J., Schill, W.B., Schwartzstein, L., eds., Treatment of
Male Infertility, Springer Verlag, Berlin, Beidelberg, New York,
3. Belsey, M.A., Eliasson, R., Gallagos, A.J. et al, World Health
Organization Laboratory Manual for the Examination of Human and
Cervical Mucus Interaction. Singapore Press Concern, 1980.
in Patients with Chronic Renal Insufficiency on Conservative Therapy
Nephrological Unit, 1st Department of Internal Medicine, Debrecen
University Medical School, Debrecen, Hungary
Summary: Peponen capsules were used in 22
patients with chronic renal insufficiency, eight of whom received
conservative therapy while 14 were on haemodialysis. Peponen was
administered in a dose of two capsules three times daily over a
period of four months. The patients' general condition, physical
status, and laboratory parameters were regularly checked and changes
in appetite were recorded. The majority of the patients reported
beneficial effects with Peponen and there were favourable changes
in some laboratory parameters (thrombocyte count, haemoglobin, haematocrit,
serum total protein, albumin, serum uric acid, BUN alkaline phosphatase),
primarily in patients in stage II chronic renal insufficiency. In
view of the findings, author considersraising the dose of Peponen
to 3-4 capsules three times daily in future studies.
Clinical experience of the past few years has clearly
demonstrated that arteriosclerotic vascular diseases, including
accelerated coronary sclerosis, constitute an important cause of
morbidity and mortality in patients with impaired renal function
and those on dialysis (4,10).
In renal insufficiency, lipid metabolic disorders and the severity
of arteriosclerosis are closely correlated (1,4). In patients with
renal insufficiency erythrocyte deformity induces unfavourable haemorrheological
changes, which--when combined with lipid metabolic disorders-accelerate
the progression of renal disease (8).
Regular administration of polyunsaturated fatty acids of vegetable
and animal origin can, however, favourably affect these unwanted
changes (2,3,6,7,8,9). These observations have led us to use PEPONEN
capsules (BIOGAL, Debrecen/Hungary) containing essential fatty acids
and vitamin E (7) in patients with stage II renal insufficiency
receiving conservative therapy and those in stage III on dialysis,
with the purpose of improving the patients' general condition as
well as their renal function and metabolism.
Patients and methods
The most important clinical data of the eight patients on conservative
therapy (group A) are presented in Table 1. Mean age of the eight
patients was 49 (20-80) years. Most of the patients suffered from
glomerulonephritis. Their daily diet contained 0.4-0.8 g/kg body
weight of protein rich in essential amino acids and provided a calorie
intake of 35-40 cal/kg body weight. The patients were given antihypertensive
drugs when necessary but did not receive either vitamins or serum
cholesterol lowering drugs.
Clinical data of the 14 patients on haemodialysis (group B) are
shown in Table 2. Most of the patients had glomerulonephritis. Mean
age of the five female and nine male patients was 37 (24-60) years
and they had been on dialysis for an average of 43 (5-136) months.
The patients' diet supplied 40-45 cal/kg body weight daily and contained
1.2-1.5 g/kg body weight of protein rich in essential amino acids.
The patients were given antihypertensives when necessary. No serum
cholesterol lowering agents were administered to the patients during
the study. The patients were dialysed three times weekly for four
hours each using capillary dialysers with a surface of 1.25-1.3
Clinical data of the 14 patients on haemodialysis (group B) are
shown inTable 2. Most of the patients had glomerulonephritis. Mean
age of the first five female and nine male patients was 37 (24-60)
years and they had been on dialysis for an average of 43 (5-136)
months. The patients' diet supplied 40-45 cal/kg body weight daily
and contained 1.2-1.5 g/kg body weight of protein rich in essential
amino acids. The patients were given antihypertensives when necessary.
No serum cholesterol lowering agents were administered to the patients
during the study. The patients were dialysed three times weekly
for four hours each using capillary dialysers with a surface of
Patients in both group A and group B received two PEPONEN capsules
three times daily before meals. The patients took PEPONEN continuously
for four months. Patients with diffuse parenchymal liver disease
or taking drugs directly affecting serum lipid levels were excluded
from the study. Prior to commencement of the study, written consent
was obtained from each patient in accordance with relevant principles
of the Helsinki Declaration (1965).
Before the studies and at the end months 1, 2, and 4, the laboratory
parameters listed in Table 3 were checked.
The patients were regularly supervised; they reported for control
at the Nephrological Unit once a month or at the Dialysis Department
three times a week and were asked about their general condition,
sthenia, and appetite.
The laboratory results were statistically evaluated (student's one-sample
Patients in Group A (n=8)
Patient No. Diagnosis Age (years) Sex
1 Glomerulonephr. chr. 20 Male
2 Hypertonia ess. Nephroscler. 80 Male
3 Glomerulonephr. chr. 46 Male
4 Glomerulonephr. chr. 66 Male
5 St. p. transp. renis 38 Male
6 Pyelonophr. chr. 57 Male
7 Diabetes nephrop. 56 Male
8 Glomerulonephr. chr. 31 Male
49 (20-80) male = 8
GNC = 4
PNC = 1
Other = 3
Patients in Group B (n = 14)
Patient No. Diagnosis Age (Years) Duration of
haemodialysis treatment (months) Sex
1 Glomerulonephr. chr. 29 55 Female
2 Glomerulonephr. chr. 38 12 Male
3 Glomerulonephr. chr. 34 18 Female
4 Glomerulonephr. chr. 36 46 Female
5 Hereditaer nephr. 33 66 Female
6 Pyelonephr. chr. 43 33 Male
7 Glomerulonephr. chr. 54 47 Male
8 Pyelonephr. chr. 43 33 Male
9 Ren polycst 37 136 Male
10 Glomerulonephr. chr. 27 18 Male
11 Glomerulonephr. chr. 26 82 Male
12 Glomerulonephr. chr. 49 5 Female
13 Pyelonephr. chr. 33 26 Male
14 Glomerulonephr. chr. 24 35 Male
37 (24-60) 43 (5-136) female = 5
male = 9
GNC = 9
PNC = 3
Other = 2
Table 4 shows changes in the subjective parameters
including general condition, appetite, and physical activity. As
seen in the table, most patients reported favourable changes.
No statistically significant changes, either positive or negative,
were found in any of the laboratory parameters in group A or group
B. It should be noted, however, that some of the parameters in patients
with chronic renal insufficiency on conservative therapy tended
to improve during the study period; these parameters include haemoglobin,
haematrocrit, se. total protein, and albumin showing a moderate
increase, while se. uric acid, Bun, and alkaline phrosphatase demonstrating
a tendency of decrease (Fi. 1-8).
A slight increase in serum total protein and albumin and a decrease
in serum bilirubin represented positive changes in haemodialysed
patients (Fig. 9-11).
No adverse effects were observed during the four-month PEPONEN treatment.
WBC, haemoglobin (Hgb), haematocrit (Htcrt), thrombocyte count (Thrc)
Serum total protein, albumin, uric acid, BUN, creatinine,
Na, K, Ca, P
Serum lipids: serum cholesterol, triglyceride,
Liver function enzyme assays: gamma GT, SGOT, alkaline
phosphatase, serum bilirubin, blood glucose
Subjective Judgment General condition Appetite Physical activity
Improved 6 5 5 17
No change 2 2 3 7
Subjective Judgment General condition Appetite Physical activity
Improved 10 10 10 30
No change 4 4 4 12
Our study covering a total of 22 patients is regarded
as a preliminary investigation from which the following are concluded:
1. The majority of the patients, especially those
with stage II renal insufficiency, reported an improvement in general
condition, appetite, and physical activity. In uremic patients,
these changes alone deserve attention. It is still a question, however,
what mechanism underlies these positive subjective changes. Unsaturated
fatty acids also contained in PEPONEN capsules have been suggested
to favourably affect prostaglandin metabolism and haemorheological
2. Laboratory parameters did not show a significant change, either
positive or negative, but some of the parameters demonstrated a
favourable tendency, especially in group A. In view of the fact
that 3,000 mg of fish oil was used in similar studies (3), the applied
PEPONEN dosage (two capsules three times daily, corresponding to
1,800 mg daily intake of fish oil containing omega-3 polyunsaturated
fatty acids produced significant changes in lipid metabolism. On
the basis of these findings, in future studies we are going to use
PEPONEN in a dose of 10 capsules/day.
3. Use of PEPONEN is safe and without any unwanted side-effects.
It is especially recommended as a supplement to diet.
1. Bagdade J.P., Porte D., Burman J.R.: New Engl,
J. med. 279:181-185. 1968.
2. Barcelli U., Pollak V.E.: Nephron, 41:209-212. 1985.
3. Bilo H. J. G., Rustemeier C., Pop-Snijders C., Donker A. J. M.:
12. Nephrologisches Seminar, Heidelberg, 4-5. Febr. 1988 Eds. E.
Ritz and K. Andrassy.
4. Degoulet P., Legrain M., Reach J. et al: Nephron, 31:103-105.
5. Kikuchi Y., Koyama T., Tozawa S. et al: Nephron, 30:8-14, 1982.
6. Kromhout D., Bosschieter E.B., Coulander L.: New Engl. J. Med.
7. "Peponen Capsules" (Oleum Cucurbitae Pepo). Ed. S.
Jancso. Biogal Pharmaceutical Works, Medical Division, Debrecen,
8. Rylance P.B., Gordge M.P., Saymor R. et al: Nephron, 43:196-202.
9. Simpson L.O.: Nephron, 44:256-258. 1986.
10. Tomohito H. Nakazawa R., Tateno S. et al: Kidney Int. 26:81-84,