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Biomedical subjects

J Herczeg

Publications and source records attributed to J Herczeg.

At least 19 recordsLinked to original sources
PubMed1993

Premedication and pain relief with Nubain during second trimester therapeutic pregnancy terminations.

OBJECTIVE: To determine the analgesic efficacy of the opioid agonist-antagonist Nubain during midtrimester therapeutic terminations with intra-amniotic PGF2 alpha or i.m. administration of the PGE2 derivative sulprostone. METHOD: Following osmotic predilatation with laminaria tents patients were given as a premedication 10 mg Valium, 10 mg Nubain and 0.5 mg atropine i.m. prior to prostaglandin treatment, and sequential doses of Nubain during the uterine contractility period. Patients indicated their own perception of uterine pain on a differential graphic rating scale, and the attending physician also evaluated patients' discomfort on a 5-grade scale. RESULT: In 55% of the cases patients experienced only 'mild' or 'moderate' pain. The mean induction-to-abortion interval was short (11.6 +/- 1.3 h). The well known gastrointestinal side-effects of the prostaglandins were avoided. CONCLUSION: Nubain proved effective in stabilizing patients' condition during intra-amniotic instillation of prostaglandin, effectively relieved uterine pain during the myometrial contractility period, prevented the occurrence of prostaglandin-related side-effects, and provided simple and good anesthesia during instrumental removal of the already detached but retained placenta.

Abortion, Therapeutic↗
PubMed1990

[Weather front sensitivity as an influencing factor in the onset of labor].

The connection between meteorological stimuli and the onset of labor was examined on the basis of the patients' front-sensitivity. Front-sensitivity was tested by a questionary containing 60 questions. Converse relation was observed between the degree of sensitivity and the gestational age. A sudden rise of onsets of labors could be shown during frontal changes, occurred after meteorologically quiet periods. During frontal changes the ratio of onsets of labors rose significantly among those patients who were sensitive tho the given front. This effect could be observed during a longer period of frontal influence. By the authors opinion also meteorological stimuli can be regarded as one of the factors, determining the actual date of onset of labor among front-sensitive women.

Female↗
PubMed1988

Physiological and biochemical implications of prostaglandins from the perspective of developing safer first and second-trimester obstetrics.

Hungary has experienced one of the highest prematurity rate of the world due to the large number of induced abortions carried out by rapid mechanical dilation of the cervix during the last three decades. With the pioneering work of Professor Sune Bergström in the identification and isolation of the primary, naturally occurring prostaglandins and in elucidating their chemical structure, it became possible also in Hungary to start research with the help of the Swedish investigators and WHO assistance on the clinical application of PGs. Recently growing understanding of cervical physiology promotes their use for cervical dilatation and for pharmacological uterine stimulation which is especially important in Hungary from the perspective of changing the recent situation, i.e. preventing cervical incompetence and subsequent "short-gestations" in future pregnancies. The physiologic importance of the development of the PG-analogues with slowed-down metabolic degradation is outlined here. The implications of the PGs in cervical ripening is reviewed, and the role of the cervix,--as an endocrine gland, playing a biochemically preprogrammed role in controlling a wide array of physiological processes throughout human gestation--, is discussed.

Abortion, Induced↗
PubMed1986

Randomized comparison of different prostaglandin analogues and laminaria tent for preoperative cervical dilatation. World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction: Task Force on Prostaglandins for Fertility Regulation.

In an eleven-centre study, 627 nulliparous subjects in the 8th to 12th week of gestation admitted for termination of pregnancy were allocated to one of five treatments to induce pre-operative cervical dilatation. The treatments were: 0.5 mg PGE2 methyl sulphonylamide; 1.0 mg PGE1 methyl ester; 30 mg 9-methylene PGE2 free acid, 0.5 mg 15-methyl PGF2 alpha; a single medium-sized laminaria tent. The results indicate that the three PGE analogues are at least equally effective as one medium sized laminaria tent and more effective than 0.5 mg 15-methyl PGF2 alpha in producing adequate pre-operative cervical dilatation prior to vacuum aspiration. It is concluded that both pre-treatment with prostaglandin analogues and laminaria tent are effective methods for preoperative cervical dilatation and both types of treatment are associated with a low incidence of side effects. Prostaglandin analogue treatment can be administered by paramedical personnel but laminaria tent insertion has to be performed by medical staff.

16,16-Dimethylprostaglandin E2↗
PubMed1986

Pre-evacuation dilatation of the pregnant uterine cervix by Laminaria japonica.

Laminaria japonica was used as pre-dilator of the pregnant uterine cervix prior to termination of pregnancy in the first and second trimester. In the first trimester (6-11 weeks, n=26) no other method was used, while in the second trimester pharmacological stimulation--prostaglandin F2 alpha or the prostaglandin analogue Sulprostone was used after or simultaneously with the laminaria insertion (12-18 weeks n=34 and 40, respectively). The dilatatory effect of laminaria was an obvious help in termination of both first and second trimester pregnancies.

Abortifacient Agents, Nonsteroidal↗
PubMed1985

Increased lysosomal fragility in the human uterine cervix following estrogen therapy.

In vitro stability of the lysosomal membrane complex was studied in non-pregnant human uterine cervices. The oestrogen therapy caused markedly enhanced lability of the lysosomal membrane complex as evidenced by higher activity of the "marker" enzyme when the preparations were challenged by mechanical or detergent stress. Oestradiol-17 beta might be implicated in altering the metabolism of the proteoglycan complex which may result in the "ripening" of the pregnant cervix.

Acid Phosphatase↗
PubMed1985

Betamimetic effects on the electro-mechanical characteristics of the pregnant and postpartum myometrium in vitro.

Myometrial strips were studied in the two extremes of regulatory conditions by measuring isometric tension and resting potentials in vitro. The effects of isoproterenol (IP) and PGF2 alpha were studied on pregnant and postpartum rabbit uteri. Lower IP concentrations inhibited the activity of the pregnant uterus as compared to the postpartum myometrium. Both pregnant and postpartum myometrium could be hyperpolarized by IP, however, lower concentrations were needed during pregnancy. The inhibiting effect on mechanical activity of IP developed without any hyperpolarization at its lower concentration.

Animals↗
PubMed1985

A possible "communication line" between the conceptus and the uterus.

A possibility of a model in which the conceptus utilizes membrane-like vesicles for transmembrane signaling between the chorioamnion (CA) and decidua (D) was tested in vitro. Tissue slices of CA and D from first and second trimester pregnancy material were exposed to liposomes (LUVS) encapsulating pBR 322 bacterial plasmid DNA radiolabelled with 32P alpha-ATP by nick translation. The corresponding CA and D cells yielded different amounts of incorporated radioactivity which was significantly (p less than less than 0.01) higher in the decidua as compared to the CA. Our data provides the first evidence that CA and especially decidual cells could actively pick up membrane-like vesicles. In spite of the fact that CA is an avascular tissue, such processes could readily operate on the outer surface of the conceptus and might play a role in the chain of events which leads to parturition.

Amnion↗
PubMed1984

Karyotyping from uncultured human trophoblast in the first trimester of pregnancy.

Chorionic villi were sampled by transcervical aspiration after ultrasonic localization of the chorion frondosum. Sampling was successful in 82 of 98 women. Subsequent karyotyping of the chorionic material was done by the modified Evans method. Mitoses of reasonable quality were obtained providing an easy cytogenetic diagnosis from human cytotrophoblast. A second trimester chorionic plate biopsy and direct karyotyping in case of severe oligohydramnios and malformed fetus revealing numerical (45, XO) chromosomal abnormality is also reported.

Chorionic Villi↗
PubMed1983

Premature labor and coincident acute appendicitis not resolved by betamimetic but surgical treatment.

Three cases--one of them fatal--of betamimetic "resistant" premature labor with coincident acute appendicitis are presented. These case histories support the opinion held by the authors that in the recent era of widespread use of betamimetics, during the second and third trimester, appendicitis can be concealed by increased uterine contractility which could be secondary to the intra-abdominal inflammatory process or triggered by genuine premature motor activity of the myometrium. We consider that the obstetrician should revise his decision regarding betamimetic treatment on the basis of continuous observation. There is a clinical message in these cases which should be incorporated into the decision-making process: if a patient presents herself with premature labor, betamimetics should not be given before the diagnosis has been established.

Adult↗
PubMed1982

"Menstrual induction" with Sulproston.

The PGE2-analogue Sulproston (16-phenoxy-omega-17,18,19,20-tetranor-PGE2-mythylsulfonylamide) was administered to 200 medically and gynecologically normal women who were 17 +/- 0.4 days beyond their expected menstrual period and who had a positive pregnancy test. The intramuscular impact dose (500 micrograms repeated after 4 hours) caused an immediate tonic uterine contraction which compromised the estradiol 17 beta, progesterone and chorionic gonadotropin production within the fetoplacental unit, and thereby allowed the evolution of cyclic uterine activity, cervical dilatation and tissue expulsion. Pregnancy termination was complete in 92% of women, 5.5% required surgical curettage and 2.5% were given a second Sulproston treatment 2-3 weeks after the first to remove retained tissue from the uterus. The medical induction of menstruation was preferred by 83% of the women who had previously experienced surgical termination of pregnancy. Normal menstruation resumed in all women after 36 +/- 0.9 days. The majority of 42 women questioned found Sulproston a satisfactory, safe, simple and effective drug regimen for "menstrual induction".

Abortifacient Agents, Nonsteroidal↗
PubMed1981

Uterine progesterone levels and intrauterine pressure in ovariectomized post partum rats.

Porter and Challis reported that the intrauterine pressure (IUP) of ovariectomized post partum rats was not suppressed by progesterone (P) treatment which increased uterine P levels. This experiment was repeated under rigorously controlled conditions. The exogenously induced increase in uterine P levels from 36 +/- 3 ng/g to 135 +/- 9 ng/g (p less than 0.001) reduced IUP from 61 +/- 3 mm Hg (p less than 0.001). When after 96 hours the P levels returned to pretreatment value, IUP also recovered from suppression.

Animals↗
PubMed1980

Prostaglandin synthesis and metabolism in the human uterus and midtrimester fetal tissues.

Prostaglandin (PG) synthesis and metabolism was studied in human fetal kidney, lung, small intestine, heart, brain and liver (gestational ages: 10, 12, 14, 18 and 23 weeks) and pregnant uterus (4-40 weeks of pregnancy). PG synthesis was increased in the myometrium during pregnancy while the capacity of metabolism did not change. PG synthesis increased in lung and kidney (4-fold), brain (20-fold) and small intestine (2-fold) but not in heart or liver. Metabolic activity increased only in fetal kidney and lung.

Female↗
PubMed1979

[Normal values of fetal heart rate in the 5th to 18th weeks of pregnancy (in vivo and in vitro studies)].

The normal values of the foetal heart rate (FHR) in early pregnancy were determined in utero by Doppler ultrasound technique and in vitro on isolated, in nutrient solution surviving, foetal hearts obtained from termination of pregnancy. The early heart rate was found to be surprisingly high in 354 successful ultrasonic examinations. In the eighth week the average FHR was 178 min-1. In the course of pregnancy there was a gradual decrease in FHR and in the 17th-18th week it reached 140 min-1 characteristic of the human foetus. Similar data were obtained under in vitro conditions.

Doppler Effect↗