Biomedical subjects

J Brundin

Publications and source records attributed to J Brundin.

At least 19 recordsLinked to original sources

PubMed1993

Developmental steps for radionuclide hysterosalpingography.

The active oviductal transportation capacity was studied in 73 infertile women by the use of a new deposition technique of radioactive particles into the internal cervical os. The main reason for this study was that a previous observation had shown that such a transportation capacity was lacking in 41% of the infertile patients with a normal hysterosalpingogram. The examination was performed in the immediate preovulatory phase, i.e. on days -3 to 0 before the ovulation, as measured by the basal body temperature during two preceding cycles. The deposition of 99mTc-labelled albumin particles of 0.2-1.0 micron at the internal cervical os and the interpretation of the radionuclide images are described in detail. The results show that the bilateral active tubal transportation capacity was present in 42 patients. An impaired transportation capacity was diagnosed in 22 patients. In 9 patients, the particles never reached the uterine cavity, or all activity leaked back to the vagina.

Fallopian Tubes↗

PubMed1993

How the U.S. press covers the Canadian health care system.

The U.S. media dwell on what they perceive as the shortcomings of the Canadian health care system, and minimize the advantages of providing free medical care for all. Focusing on specialization and high-tech treatments as the most important measure of health care quality, the media overlook the importance of greater access to medical care in promoting health. At the same time, the U.S. media are reluctant to cite the higher infant mortality rates and lower life expectancy rates in the United States compared with Canada.

Canada↗

PubMed1992

Forces required for dilatation of human cervix in first trimester of pregnancy.

Cervical resistance to dilatation was measured in 76 patients undergoing first trimester legal abortion; a specially designed force-sensing instrument was used. No correlation between cervical resistance and patient age or gestational age was found. Increasing parity and earlier legal abortions were significantly correlated with a lowering of the cervical resistance. In patients dilated to 11 mm a lowering of resistance was noted suggesting a tear in cervical tissue.

Abortion, Legal↗

PubMed1992

Cervical dilatation before first trimester elective abortion: a comparison between laminaria and a newly developed hydrogel tent, the A rod.

The effect of cervical dilatation prior to first trimester abortion by laminaria tent and a newly developed hydrogel tent, the A rod, was studied on 50 patients undergoing first trimester legal abortion. The effect was measured both clinically and by the use of an objective measure of cervical resistance. No significant difference in cervical dilatation was found after 5 h of treatment.

Abortion, Induced↗

PubMed1992

Evaluation of the clinical method of measuring cervical dilatation after treatment of the cervix prior to first trimester abortion.

A comparison of the subjectively measured cervical dilatation and the dilatation measured objectively with a force-sensing instrument connected to metal dilators was made in two studies of cervical treatment prior to first trimester abortion. It was concluded that the subjective method is a sensitive and accurate method of measuring cervical dilatation but does not allow for comparison between different studies where an objective method of measurement should be used.

Anthropometry↗

PubMed1991

Transcervical sterilization in the human female by hysteroscopic application of hydrogelic occlusive devices into the intramural parts of the fallopian tubes: 10 years experience of the P-block.

The development of the hydrogelic occlusive device called the P-block is described including developmental steps of the design of the device as well as the experience gained concerning the hydrogel of the device, shelf life, animal and human toxicology, insertion techniques, analgesia, check-up for retention in situ, actual efficacy of the method, mode of action of the device, complication rates, patient acceptance, continuation rates, possible reversibility and future perspectives of the method. Over a period of 10 years more than 900 woman years were observed. The gross Pearl Index for the total series of nine different designs of P-blocks is 5, due to rejection of the device on either or both sides. The corresponding value for intact P-blocks in situ is 0.3. With the latest version of P-blocks--Mark 9--a total of 191 women have been observed over 637 woman years during a mean of 21 months with a maximum time of observation of 88 months in the single case. The continuation rate, when no pregnancy occurs is 99% over 10 years. After unilateral expulsion and intra-uterine pregnancy 48% return for reinsertion of P-blocks. The rate of complications, including extra-uterine pregnancies was neglectable as was the loss for follow-up. Life table analysis revealed that no pregnancy occurred after 30 months from the insertion of P-blocks.

Fallopian Tubes↗

PubMed1989

Radionuclide hysterosalpingography for measurement of human oviductal function.

A clinical method is described and claimed to evaluate the active transportation capacity of the luminal epithelium lining the human uterus and fallopian tube. After intracervical application of technetium-labelled human albumin spheres at 1-2 days before ovulation this radioactivity could be followed by gamma-camera when moved in ad ovarian direction. This method is called radionuclide hysterosalpingography (RN-HSG). The results were compared to the findings at normal hysterosalpingography (HSG). By use of this method it was possible to verify active passage in cases of tubal spasm at HSG, lack of transport in cases of normal patent oviducts at HSG as well as presence or absence of active transport through sactosalpinges with or without fimbrial passages to the abdominal cavity as seen at normal HSG. Congruent findings between HSG and RN-HSG was observed in 49%. The studied oviducts were found to be patent with normal HSG but lacked transportation capacity when studied by RN-HSG in 41%. The clinical use of this method is discussed in view of the selection of patients for different forms of in vitro fertilization and egg transfer (IVF-ET).

Adult↗

PubMed1989

Second look laparoscopy; evaluation of two different antibiotic regimens after treatment of acute salpingitis.

In order to have their diagnoses verified, etiology determined and treatment evaluated, 64 patients with suspected acute salpingitis (AS) underwent laparoscopy during which specimens were taken. The patients were referred to groups of either a mild (16/64), a moderate (26/64), or a severe (22/64) form of salpingitis. They were then randomized to one of two groups for treatment with either doxycycline/bensylpenicillin-procain (DC/BP) or trimethoprim-sulfamethoxazole (TMP-SMZ). The results were evaluated by second-look laparoscopy 3-6 months later when adhesions and tubal passage were looked for. Isolates from the cervix were culture positive for Chlamydia trachomatis (CT) in 36/64 (56%) (9/16 with a mild form, 13/26 with moderate form and 14/22 with a severe form of salpingitis). Neisseria gonorrhoeae (NG) was isolated from the cervix in 15/64 (23%) (5/16 with a mild form, 4/26 with a moderate form and 6/22 with a severe form of the disease). Oviductal cultures for CT were found in 12/64 (19%) (1/16 with a mild form, 4/26 with a moderate and 7/25 with severe form of salpingitis). Oviductal isolates for NG were found in 2/64 (13%) (2/16 from the group with a mild form of the disease). Second-look laparoscopy revealed totally occluded oviducts in two patients from the group with a severe form of salpingitis (one from each treatment group).

Acute Disease↗

PubMed1989

Cardiac gas embolism during carbon dioxide hysteroscopy: risk and management.

A relatively high number of fatal complications during hysteroscopy, where carbon dioxide was used as the uterine distension medium, plus a recent report on heart embolism during dog experiments with venous carbon dioxide infusion, audible by simple stethoscopic surveillance during the infusion, prompted the present study. Seventy women with no history of cardiac valvular disease or failure were observed during carbon dioxide hysteroscopy for the occurrence of the characteristic metallic heart sound caused by the intracardiac presence of free carbon dioxide during the heart contractions. In seven cases (10%) the typical metallic heart sounds appeared during the hysteroscopy, leading to immediate interruption of the hysteroscopy and withdrawal of the hysteroscope. This caused the pathological heart sounds to disappear, after which the hysteroscopy could continue. Heart auscultation should always be performed during carbon dioxide hysteroscopy in order to avoid serious cardiovascular complications. This simple precaution turns carbon dioxide hysteroscopy into a versatile and safe method for intra-uterine diagnosis and therapy.

Animals↗

PubMed1989

Sonographic localization of an intramurally placed intratubal device--the P-block.

Hysteroscopical application of hydrogelic non-medicated occlusive devices, P-blocks, in the intramural part of the human fallopian tube has become an alternative to abdominal sterilization. The check-up procedure involved repeated hysteroscopies at certain intervals. These check-ups had to be confined to the early proliferative phase of the menstrual cycle in order to get maximum vision. In view of this and as the number of patients increased, practical and administrative problems arose. The need for other methods to check the P-blocks in situ after the first insertion and later became very urgent. Linear-array ultrasound and hysterosalpingography were tried, both methods failing to reveal the exact intramural position of the P-blocks. Finally, transabdominal scanning by use of modern sonographic equipment (phase array electronic sector system) made it possible to detect the exact position of the P-blocks. Furthermore, transvaginal examination appeared to have a very high sensitivity as well as specificity even in cases with sharply retroflected uteri. Our achievements in the field of sonographic examination of intratubal devices are presented.

Fallopian Tubes↗

PubMed1989

Measurement of human cervical compliance.

A critical evaluation of the various methods for the measurement of the compliance of the human cervix uteri was made. The resistance of this tissue to a dilating force was measured by a previously constructed strain gauge instrument equipped with exchangeable Pratt cervical dilators. The dilating resistance offered by the cervical canal was recorded on a polygraph at a constant paper speed. Control experiments in which the dilating instrument was allowed to meet artificial cellulose tissue showed that the peak value recorded was of importance for estimating cellulose tissue resistance. Measurements of the area under the curve were shown to be of minor importance in this system. Using this technique in clinical applications, it was also shown that peak resistance provides the most accurate measurement of human cervical resistance.

Abortion, Induced↗

PubMed1988

Serum levels of estrogens and of five 'steroid sensitive' proteins in early normal pregnancy.

Serum concentrations of sex hormone binding globulin (SHBG), pregnancy associated alpha 2-glycoprotein (alpha 2-PAG), caeruloplasmin (Cp), alpha 1-antitrypsin (alpha 1-At) and transferrin (Tf), unconjugated and total estrone, and unconjugated estradiol-17 beta were measured twice at a 4-5 week interval in 43 cases of early normal pregnancy (gestational weeks 6-19). Significant correlations between estrogen and protein levels in the total material were observed for all proteins except for Tf. However, within 2-week intervals of pregnancy, significant correlations were obtained only in certain intervals between estrogens on one hand and SHBG, Cp and alpha 1-At on the other. Significant correlations between rates of increase of estrogens and of proteins were obtained only at certain occasions for SHBG, Cp, Tf and alpha 1-At. The results indicate that, although estrogens may have a modulatory function in 'steroid-sensitive' protein synthesis, they are probably not the main physiological regulator.

Ceruloplasmin↗

PubMed1988

Second look laparoscopy after treatment of acute salpingitis with doxycycline/benzylpenicillin procaine or trimethoprim-sulfamethoxazole.

To have their diagnosis verified, etiology determined and treatment evaluated, 64 patients with a suspected acute salpingitis underwent laparoscopy during which isolates were taken. The patients were then randomized to one of two groups for treatment; doxycycline/benzylpenicillin procaine (DC + BP) or trimethoprim-sulfamethoxazole (TMP-SMZ). The results were evaluated three to six months later by second look laparoscopy when adhesions and tubal passage were looked for. Isolates from the cervix were culture positive for Chlamydia trachomatis (CT) in 37 (58%) patients and for Neisseria gonorrhoeae (NG) in 15 (23%). Isolates from the oviducts were positive in 17 (27%) patients of whom 12 had CT and two had NG. Mild salpingitis (Grade I) was found in 16 patients, moderate (Grade II) in 26 and severe (Grade III) in 22 patients. At second look laparoscopy, two patients had totally occluded oviducts, 31 had adhesions but tubal passage on at least one side while 31 patients had healed without any signs of residue. Results at second look laparoscopy showed no statistical difference between the two treatment groups.

Acute Disease↗

PubMed1987

Observations on the mode of action of an intratubal device, the P-block.

A hydrogelic intratubal device, called P-block, Mark 9, was inserted hysteroscopically with local anesthesia in the intramural part of the fallopian tube of 25 women referred for the procedure as an alternative to abdominal sterilization. Hysterosalpingography revealing bilateral oviductal patency was followed by hysteroscopic checkup verifying bilateral presence of P-blocks, except in three patients who had expulsion of the P-blocks on one side. All of the 22 patients had retention of the P-blocks 6 to 7 months after insertion. None became pregnant. Thus it is suggested that an intratubal device in the isthmic part of the human fallopian tube acts as an intrauterine contraceptive device, preventing intratubal and intrauterine pregnancies. Endeavors to explain the contraceptive effect of a nonocclusive intratubal device are discussed on the basis of our present knowledge of tubal physiology. Distension of part of the human isthmus is likely to disturb normal gamete transport through the isthmus.

Adult↗

PubMed1987

Salpingitis; aspects of diagnosis and etiology: a 4-year study from a Swedish capital hospital.

359 patients underwent laparoscopy to verify the diagnosis of salpingitis. Pelvic inflammatory disease (PID) was found in 187 (52%) cases. Laparoscopy revealed normal conditions in 136 (37%) cases. Other diseases were diagnosed in 36 (10%) cases. Bacteriological cultures from the fimbrial lumen were positive in 24% of the PID cases. Chlamydia trachomatis (CT) was detected in 12%, Bacteroides species (BS) in 5%, Actinomyces israelii (AI) in 3%, Gardnerella vaginalis (GV) in 2%, Neisseria gonorrhoeae (NG) in 1%, and Ureaplasma urealyticum (UU) in 1%. Cervical cultures were positive for NG and/or CT in 71% of the PID cases but only in 19% of the non-PID cases. From these no positive intra-abdominal cultures were detected. Serological tests for CT were carried out. A positive acute titre of greater than or equal to 1/64 was noted in 37%, a seroconversion (X4) 2-3 weeks later was found in 14%. Positive serology despite a negative culture was registered in 19%.

Adolescent↗

PubMed1987

Oestrogen and thyroxine-binding globulin levels in early normal pregnancy.

Peripheral serum levels of thyroxine-binding globulin (TBG), unconjugated and total oestrone, and unconjugated oestradiol-17 beta were measured twice in 60 cases of early normal pregnancy (gestational weeks 6-19). Although highly significant correlations between TBG and oestrogen levels were obtained in the total material, the correlations within two-week intervals of pregnancy were rather poor and mostly insignificant. Furthermore, there were no associations at all between the increase rates of TBG and those of the oestrogens, either within two-week intervals or in the total material. The findings do not support the common concept of continuously rising oestrogen stimulation as the main factor affecting the TBG synthesis during pregnancy.

Estradiol↗

PubMed1986

Adenosine modulation of adrenergic neurotransmission in the human fallopian tube.

The effects of adenosine and adenosine analogues on nerve-induced contractile responses and [3H]noradrenaline ([3H]NA) release, were studied in the isthmic part of human oviducts. Adenosine and L-N6-phenylisopropyladenosine (L-PIA) could enhance neurogenic contractile responses in preparations obtained mainly in the proliferative phase. At higher concentrations, adenosine derivatives inhibited contractile responses to nerve stimulation in both proliferative and secretory phase, with the potency order: 5'-N-ethylcarboxamideadenosine (NECA) greater than or equal to L-PIA much greater than D-PIA. This indicated actions at both stimulatory A1- and inhibitory A2-receptors. Adenosine, L-PIA and NECA but not D-PIA inhibited [3H]NA release during nerve stimulation. The relative potency order for the prejunctional inhibition was compatible with an action at A1-receptors. Furthermore, adenosine was found to modulate nerve-induced contractions via postjunctional stimulatory A1- and inhibitory A2-like receptors. The postjunctional effects may be influenced by cyclic hormonal changes. The adenosine antagonist 8-p-sulfophenyltheophylline (PSøT) reversibly antagonized the stimulatory and inhibitory effects by adenosine and analogues.

Adenosine↗

PubMed1986

Therapeutic ureteral occlusion in advanced pelvic malignant tumors.

A technique for ureteral occlusion, combining insertion of nylon plugs with injection of polidocanol, is described. The method was used in 15 patients with vesicovaginal fistulas after operation and irradiation for advanced gynecological malignancy, or with severe malfunction and fibrosis of the bladder after radiotherapy for bladder carcinoma. The urinary leakage ceased in 11 patients, was greatly diminished in 2 and was unchanged in 2. Migration of plugs to the renal pelvis was the most serious complication and may have been the cause of pyelonephritis in 1 case. The technique is recommended for patients with a short life expectancy and uncontrolled, distressing leakage of urine.

Adult↗