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Biomedical subjects

A Norström

Publications and source records attributed to A Norström.

At least 37 records · Page 2Linked to original sources
PubMed1997

Carcinoma of the uterine cervix in pregnancy. A study of the incidence and treatment in the western region of Sweden 1973 to 1992.

OBJECTIVE: To review the incidence, treatment and outcome of cervical cancer during pregnancy in the Western region of Sweden. METHODS: Population based data on cervical cancer during pregnancy were collected from 1973 to 1992. RESULTS: Cervical carcinoma was diagnosed in 33 women in association with pregnancy, giving an incidence of 11.1 cases per 100,000 deliveries and 7.5 cases per 100,000 pregnancies. Pregnancy complicated one of every 55 cases of invasive carcinoma. Twelve women were in the 3rd trimester and nine women were post partum. Abnormal bleeding was the symptom that led to examination and diagnosis in 54.5% of the women and 45.5% of the women were asymptomatic but had an abnormal cervico-vaginal cytological test (39.4%) or abnormal finding at vaginal examination (6.1%) in association with pregnancy. In the 1st-2nd trimester all but one woman and in the 3rd trimester all but two women, had a stage I carcinoma. Post partum five women were in stage I, three women were in stage II and one woman had a stage III carcinoma. Histology revealed squamous cell carcinoma in 29 women, adenocarcinoma in three women and adenosquamous carcinoma in one woman. During the follow up period 1/12 women in the 1st trimester, 4/12 in the 3rd trimester and 2/9 women post partum have died of disease. CONCLUSION: During the years of this study different modalities of treatment were used, with a change from primary radiation to primary surgery.

Adult↗
PubMed1995

Effects of mifepristone and progesterone on collagen synthesis in the human uterine cervix.

Antiprogestins are used to induce first trimester abortion and to dilate the cervix before vacuum aspiration. Cervical dilatation is associated with profound changes in the connective tissue. In what respect antiprogestins interfere with this process has hitherto been sparsely investigated. The aim of present study was to examine the influence of the antiprogestin mifepristone on cervical collagen synthesis in nonpregnant, early and late pregnant women. The effects were compared with those of progesterone. The content of collagen in cervical tissue was determined by measuring hydroxyproline. Collagen synthesis was studied in vitro either by incubation of cervical tissue specimens from women, pretreated with mifepristone in vivo, in the presence of 14C-proline or by incubation of cervical tissue of not pretreated women in the presence of the isotope and mifepristone or progesterone. Pretreatment with mifepristone, but not progesterone, induced a significant increase in cervical dilatation. The cervical concentration of collagen was not altered after mifepristone administration. Pretreatment with mifepristone did not quantitatively influence the time course of radiolabeling in vitro or the pattern of radiolabeling in different protein components as revealed by electrophoresis. In vitro mifepristone, like progesterone, reduced the incorporation of 14C-proline. From the present data we conclude that mifepristone pretreatment in connection with first trimester abortion is not associated with any major changes, qualitatively or quantitatively, of collagen synthesis. However, we cannot exclude that mifepristone still may affect the de novo formation of collagen since mifepristone, administered in vitro, did reduce collagen synthesis.

Abortion, Induced↗
PubMed1995

Dilapan tent-gemeprost regimen vs. combinations of extra-amniotic Rivanol-Laminaria/Lamicel and oxytocin for second trimester abortion.

OBJECTIVE: To compare a new regimen for second trimester abortion using Dilapan and vaginal gemeprost suppositories with extra-amniotic Rivanol instillation and oxytocin i.v. immediately or 16 h after instillation. METHODS: A prospective study was performed in 153 women to analyze the induction-abortion interval, the use of analgesics and the complication rate. Wilcoxon's rank sum test was used for statistical evaluation. RESULTS: The mean induction-abortion interval was significantly shorter in the Dilapan-gemeprost-treated women than in the immediate or 16-h Rivanol-oxytocin-treated women, 12.5 vs. 23.3 and 26.8 h, respectively. The 24-h cumulative abortion rate was 91% in the former group vs. 49% and 61%, respectively. The use of analgesics was less frequent among the Dilapan-gemeprost-treated women, whereas the complication rate did not differ. CONCLUSIONS: The Dilapan-gemeprost treatment was advantageous with respect to a shorter induction-abortion interval and ease of handling. However a minority of women do not respond to this treatment and it is therefore necessary to employ alternative methods to complete the abortion in these cases.

Abortifacient Agents↗
PubMed1995

Cervical mucus concentration of prostaglandins E2 and F2 alpha after pretreatment with mifepristone in the first trimester of pregnancy.

Cervical dilatation and softening after pretreatment with mifepristone are well documented. As this effect is similar to that observed after local application of prostaglandin E2 (PGE2) it is tempting to speculate that the effect of mifepristone is mediated via an increase of the endogenous secretion of prostaglandins from the cervical mucosa. Eighteen healthy women in the first trimester of pregnancy were treated with oral mifepristone (200 mg) 48 and 24 hours before legal abortion by vacuum aspiration and 18 women in the same age of gestation without any pretreatment served as controls. Cervical mucus was collected for measurement of prostaglandins by radioimmunoassay before administration of the drug and in connection with vacuum aspiration. The cervical dilatation at the time of surgery was significantly increased in women given mifepristone as compared with untreated women (7.6 versus 5.8 mm). The wet weight of collected cervical mucus was significantly increased in mifepristone treated women. The amount of PGE2 and prostaglandin F2 alpha per sample was unchanged in mifepristone-treated women, whereas the concentration was lower as an effect of dilution due to an increased yield in cervical secretion observed after mifepristone treatment. The present observation does not give any support to the hypothesis that mifepristone-induced cervical maturation is mediated via an increase in cervical prostaglandin production.

Abortion, Legal↗
PubMed1995

In vitro production of cyclic AMP and steroids from an ovarian Sertoli-Leydig cell tumor. Notes on clinical management.

A 27 year old nulliparous woman with a history of chronic anovulation and signs of virilization with a markedly elevated serum level of testosterone, underwent a laparotomy with peroperative bilateral ovarian vein catheterization and bilateral bisection of both ovaries. A solid, 1.5 cm, well delimited tumor located centrally in the right ovary, was excised. Testosterone levels in ovarian venous blood from the tumor bearing side, were 88.4 nmol/l and from the contralateral ovary 3.9 nmol/l. Histopathological examination showed a Sertoli-Leydig cell tumor which was radically extirpated. Postoperatively, the serum levels of androgen normalized, the woman had regular cycles, became pregnant and delivered a normal female baby. Pieces of tumor tissue were incubated for 2 h, with and without addition of gonadotropins and adrenocorticotropic hormone (ACTH). Human chorionic gonadotropin (CG), follicle stimulating hormone (FSH) and adrenocorticotropic hormone (ACTH) caused significant increases in cyclic monophosphate (cAMP) production in tumor tissue in vitro, as compared to controls. Furthermore, ACTH also significantly stimulated 17 beta-estradiol production. In tumor cells cultured for 48 h, FSH slightly, but not significantly, increased the production of progesterone. In the cell culture, [3H]-thymidine incorporation into deoxyribonucleic acid (DNA) was stimulated by IGF1 alpha but not by hCG and FSH. It is concluded that Sertoli-Leydig cell tumors may be sensitive to gonadotropins and ACTH and that their small size, solid shape and intra-ovarian localization can cause diagnostic difficulties.

Adrenocorticotropic Hormone↗
PubMed1994

Cervical smooth muscle contractile activity after treatment with mifepristone and progesterone.

Contractile activity of the uterine cervix in vitro was studied in women pretreated with mifepristone 200 m chi 2 or progesterone suppositories 100 mg before cervical dilatation and vacuum aspiration in the first trimester. Mifepristone increased the dilatation of the cervix as measured prior to operation whereas progesterone had no effect. Spontaneous muscle activity and contraction frequency were not affected by either drug. Neither the inhibitory response to PGE2 nor the excitatory response to noradrenaline were significantly different from that in placebo-treated women. It is concluded that the cervical smooth muscle has no major role in the dilatatory effect of mifepristone in the cervical canal.

Abortion, Induced↗
PubMed1994

Dietary and ethanol induced alterations of the toxikokinetics of toluene in humans.

This study was undertaken to evaluate the influence of a carbohydrate restricted diet, a subacute ethanol intake, and their combined effect on the kinetics of toluene in humans. Eight healthy male volunteers were exposed by inhalation at four different occasions to 200 mg/m3 2H8-toluene for two hours at a work load of 50 W after a one week low (30%) carbohydrate (CH) diet or high (60%) CH diet with (+EtOH) or without (-EtOH) ethanol consumption (47 g ethanol) on the evening before exposure. Deuterium labelled toleune was used to measure the excretion of hippuric acid originating from toluene separately from hippuric acid from other sources. The results indicated that subacute ethanol consumption combined with a carbohydrate restricted diet, may enhance the metabolism of toluene in humans at an exposure concentration of 200 mg/m3. The cumulative amount of hippuric acid excreted in the urine up to 20 hours after the end of exposure in % of the net uptake of toluene was enhanced by 22% (p = 0.05) in the low CH + EtOH compared with the low CH-EtOH experiment. The apparent blood clearance of toluene was 37% higher in the low CH + EtOH than in the low CH-EtOH experiment, but this effect was not statistically significant (p = 0.1). There were no significant changes in the kinetics of toluene as a result of a low carbohydrate diet alone. Neither did subacute ethanol intake without the combination with a carbohydrate restricted diet influence the kinetics of toluene.

Adolescent↗
PubMed1993

Endovaginal scanning of the endometrium compared to cytology and histology in women with postmenopausal bleeding.

Endovaginal scanning (EVS) of the endometrium has recently been proposed as a method for the investigation of the endometrial mucosa. In this study, the specificity and sensitivity of EVS have been compared with endometrial cytology and D&C to discriminate between a normal and pathological endometrium. The study included 105 women who underwent preoperative endovaginal ultrasound investigation, endometrial cytology, and D&C because of postmenopausal bleeding. A specificity of 81% and a sensitivity of 97% in diagnosing morphological alterations by means of endovaginal ultrasound was found. The corresponding figures for cytological evaluation were 81 and 58%, respectively. We conclude that endovaginal ultrasound is a valuable diagnostic instrument for detecting pathological conditions in the uterine mucosa and as sensitive as endometrial cytology or D&C.

Aged↗
PubMed1993

Toxicokinetics of toluene and urinary excretion of hippuric acid after human exposure to 2H8-toluene.

Nine male volunteers were exposed to 2H8-toluene (200 mg/m3 for two hours during a workload of 50 W) via inspiratory air with the aid of a breathing valve and mouthpiece. Labelled toluene was used to differentiate between hippuric acid originating from exposure to toluene and hippuric acid normally excreted in urine. The total uptake of toluene was 2.2 (standard deviation (SD) 0.2) mmol, or 50% of the amount inhaled. Four hours after the end of exposure 1.4 (SD 0.3) mmol or 65% of the total uptake had been excreted in urine as 2H-hippuric acid and 20 hours after the end of exposure the cumulative excretion of 2H-hippuric acid was 1.8 (SD 0.3) mmol, or 78% of the total uptake. By contrast the cumulative excretion of labelled plus unlabelled hippuric acid exceeded the total uptake of toluene already after four hours. The excretion rate of 2H-hippuric acid was highest, about 5 mumol/min, during exposure and the SD between the subjects was low. The background concentrations of unlabelled hippuric acid in urine were high, however, and there were large differences between subjects. These findings confirm earlier indications that for low exposure, urinary hippuric acid concentration cannot be used for biological monitoring of exposure to toluene.

Adolescent↗
PubMed1993

Collagenolytic effect of disintegrated bacterial cell extracts on the human amniotic membrane at term pregnancy.

Bacterial ascending from the cervix may infect the membranes and amniotic fluid, contributing to their premature rupture. In the present in vitro study, isolated amniotic membranes were exposed to different concentrations of disintegrated bacterial cells. Collagenolysis was estimated by the ratio of acid-soluble/insoluble hydroxyproline. The amniotic membrane proteins were separated by electrophoresis after incubation with 14C proline and disintegrated bacterial cells. The proportion of soluble hydroxyproline increased with the bacterial concentration used, and the radioactivity decreased in proteins of the 30- to 80-kD range. The data support the notion that bacteria contain collagenolytic enzymes affecting human amniotic membranes.

Amnion↗
PubMed1992

The use of endovaginal ultrasound to diagnose invasion of endometrial carcinoma.

Endovaginal ultrasound was used in 30 women to characterize endometrial carcinoma with respect to myometrial invasion according to FIGO recommendations for surgical staging of endometrial cancer. The ultrasound data were correlated to macroscopic findings of the uterine specimen and to histopathology. Using endovaginal ultrasound, the sensitivity of detecting myometrial invasion of > 50% was 15/19 or 79%. However, the positive predictive value was 100%, in all cases when ultrasound suggested myometrial invasion of > 50%. This was confirmed on histopathological examination of the tumor specimen. Cervical tumor extension was correctly diagnosed in all six women in which it was present. Endovaginal ultrasound seems to be a reliable method of assessing tumor invasion and engagement of the cervix. This non-invasive method could be included as an important tool in the establishment of individualized treatment programs in women with endometrial carcinoma.

Journal Article↗
PubMed1992

Neuropeptide Y, its localization in the human cervix and possible effect on the contractile activity of cervix smooth muscle.

Immunochemical methods were used to identify neuropeptide Y (NPY) in the cervical tissue of women at early and term pregnancy. NPY-containing fibers could not be demonstrated in the upper and lower uterine segments at term, but the cervical innervation persisted during labor. Moreover, NPY alone did not affect cervical contractile activity, although the stimulatory effect of noradrenaline was enhanced.

Cervix Uteri↗
PubMed1991

Endovaginal ultrasound scanning to identify bladder tumors as the source of vaginal bleeding in postmenopausal women.

The increasing frequency of bladder tumors with increasing age is well documented, but the incidence of bladder tumors in a subgroup at potential risk, i.e. women with postmenopausal bleeding, is, however, not known. In a prospective study of 400 women with postmenopausal bleeding, endovaginal scanning (EVS) was performed the day before planned dilatation and curettage (D & C). Five bladder tumors were identified. For comparison, the medical records of 4500 women admitted for D & C due to postmenopausal bleeding, during a 15-year period, were reviewed. These women were not examined by ultrasound preoperatively. Eight bladder tumors were found in these women. The number of bladder tumors found in women with postmenopausal bleeding was high, especially in the group of women that underwent endovaginal ultrasound, compared to the known incidence (25/100,000 women) in this age group. On the basis of the present data, it appears evident that EVS contributes to an early detection of bladder tumors. We emphasize the importance of scanning all women with postmenopausal bleeding with endovaginal ultrasound.

Journal Article↗
PubMed1991

Endometrial thickness as measured by endovaginal ultrasonography for identifying endometrial abnormality.

Diagnostic curettage has for many years been the method of choice to diagnose endometrial cancer in women with postmenopausal bleeding. The costs for curettage performed today are huge, and approximately only 10% in this group of women will be diagnosed with endometrial cancer. Thus less expansive techniques to obtain endometrial samples have been evaluated, but all of them are invasive. The value of endovaginal ultrasonography for identifying endometrial abnormality in this group of women has not been evaluated until now. This study used endometrial thickness as measured by endovaginal ultrasonography as an indicator of endometrial abnormality. It was demonstrated in 205 women with postmenopausal bleeding that if the endometrium was less than 9 mm thick, no endometrial cancer was found at curettage. The mean endometrial thickness in those women with endometrial cancer was 18.2 +/- 6.2 mm as compared with 3.4 +/- 1.2 mm in those women with atrophic endometrium. If the cutoff limit for endometrial abnormality was 5 mm, the positive predictive value for identifying endometrial abnormality was 87.3%. If this limit had been used in this study, 70% of the curettage procedures could have been avoided.

Endometrium↗
PubMed1991

Adenosine 3',5'-monophosphate in relation to inhibition of cervical smooth muscle activity in early pregnant women.

Contractile activity was registered in strips of cervical tissue obtained by needle biopsy from women in the first trimester of pregnancy. Dibutyryl cyclic adenosine-3',5'-monophosphate (5 x 10(-6) mol/l), isobutyryl methylxanthine (10(-4) mol/l), and forskolin (10(-5)-10(-4) mol/l), the latter two drugs known to increase the levels of endogenous cAMP, inhibited spontaneous muscle activity. The levels of tissue cAMP were determined in strips during relaxation induced by prostaglandin E2 or purified porcine relaxin and compared with cAMP levels in strips from the same women during contractile activity. Exposure to prostaglandin E2 but not to relaxin was followed by increased levels of cAMP. It is suggested that cAMP has a role as a second messenger in the prostaglandin E2-mediated relaxation of cervical smooth muscle.

Cervix Uteri↗