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Biomedical subjects

L K Petersen

Publications and source records attributed to L K Petersen.

At least 19 recordsLinked to original sources

Urogynaecological dysfunction after radical hysterectomy.

AIMS: To identify self-reported urogynaecological dysfunctions in women treated by radical hysterectomy, and predict risk factors. METHODS: A survey using questionnaires. Questionnaires were mailed to 396 patients. RESULTS: Symptoms of urinary incontinence and urinary retention were reported by more than one-third, respectively. One-third of the patients reported cystitis and dysuria. However, 78% of the women did not consider their symptoms as a problem. Analyses identified body mass index, at least one delivery, pre-operative urinary incontinence, and pulmonary disease as predictors for development of post-operative urinary incontinence. Predictive variables for urinary retention symptoms were age, cystitis and/or dysuria, previous rupture of the anal sphincter, fetal weight at delivery > or =4000 g, sensation of vaginal dryness, and pre-operative urinary retention symptoms. Considering post-operative cystitis and/or dysuria, fetal weight > or =4000 g, sensation of vaginal dryness, cystitis and/or dysuria before the operation, and physical activity were predictive variables. CONCLUSIONS: Patients can be informed and advised about possible urinary tract symptoms. Special attention in the pre- and post-operative period can be paid to a subgroup of patients at high risk of later urogynaecological problems.

Female↗

Patients with ovarian cancer have elevated (51)Cr-EDTA plasma clearance early post-operatively.

Plasma clearance of (51)Cr-EDTA (Clp(EDTA)) is widely used to determine glomerular filtration rate prior to carboplatin based chemotherapy. We have observed that many patients with ovarian cancer have elevated Clp in the early post-operative phase compared to later phases. The purpose of this study was to examine whether this observation reflects a systematic difference. We retrospectively analysed data from 53 patients who had undergone surgery for ovarian cancer. Twenty-six patients had Clp(EDTA) measured early after the operation (mean, 8 days (range, 3-16 days)) (early group), and 27 patients had Clp(EDTA) measured late post-operatively (mean, 32 days (range, 19-48 days)) (late group). Clp(EDTA) values was measured before the first, third and fifth course of chemotherapy. Additionally, age, height, weight, cancer stage, ascites and tumour histology were noted. Mean Clp(EDTA) in the early group was significantly higher than in the late group (104+/-4.4 vs 89+/-3.5 ml.min(-1) per 1.73 m(2); P =0.005). Clp(EDTA) declined significantly in the early group from the first measurement after the operation until measurement before the third course of chemotherapy but remained constant in the late group. Clp(EDTA) was not correlated to ascites, cancer stage or tumour histology. It is concluded that patients with ovarian cancer have significantly higher Clp(EDTA) in the early post-operative phase than similar patients with Clp(EDTA) measured late post-operatively.

Antineoplastic Agents↗

No effects of human relaxin on the active and passive biomechanical properties of isolated cervical specimens from nonpregnant women.

OBJECTIVE: To evaluate the effect of human relaxin (hRLX-2) on the active and passive biomechanical properties of cervical tissue in vitro. MATERIAL: Cervical samples were obtained from the middle part of the cervix in 22 nonpregnant women undergoing hysterectomy. METHODS: The effect of hRLX-2 (10(-7) M) on the active biomechanical properties was studied on vasopressin (10(-8) M) induced smooth muscle contractions in an organ bath model. The effect on the passive biomechanical properties were studied after incubation of the strips for 48 h with hRLX-2 (10(-8) M and 10(-9) M). Subsequently, the specimens were stretched in a material testing machine until they broke. The load applied and the elongation were simultaneously recorded and the results translated into stress-strain curves. RESULTS: hRLX-2 did not influence the vasopressin-induced contractility of cervical strips from nonpregnant women in this study. No synergistic effect of progesterone could be demonstrated. The passive biomechanical properties (tensile strength, extensibility, stiffness of failure energy) did not change significantly after relaxin incubation. The results obtained in vitro do not suggest an important physiological effect of relaxin on the human nonpregnant cervix.

Adult↗

Unmeasurable relaxin concentrations in repeated pregnancies after embryo transfer.

Unmeasurable serum relaxin concentrations were found in repeated serum samples taken during two subsequent pregnancies in a woman pregnant after in vitro fertilization in artificial cycles. Despite the absence of relaxin both pregnancies were carried out normally until term except for symptoms of pelvic girdle relaxation. Labour induction was attempted at term as placental insufficiency was suspected. However, the cervical score remained unfavourable and Cesarian section was performed. In the second pregnancy elective Cesarian section was performed due to mild preeclampsia. This case indicates that relaxin may not be important for either suppression of myometrial activity or pelvic girdle relaxation during human pregnancy.

Adult↗

Cervical collagen in non-pregnant women with previous cervical incompetence.

OBJECTIVE: To study the cervical collagen in non-pregnant women with a history of congenital cervical incompetence. SUBJECTS: Ten non-pregnant women with congenital cervical incompetence, defined as cervical incompetence in the first pregnancy in a woman without previous cervical trauma. Seventy-one normal non-pregnant women (31 nulligravidae, nine nulliparous and 31 parous women) served as controls. METHOD: Cervical biopsies were analysed for the hydroxyproline concentration and extractability to express the concentration and the stability of the collagen. RESULTS: Women with cervical incompetence had markedly lower median cervical hydroxyproline concentration when compared to normal parous women (11.1 (range 6.11-18.5) micrograms/mg wet weight vs. 16.9 (range 7.7-29.8) micrograms/mg wet weight; P = 0.003, Mann Whitney test) and the extractability was almost twice the value found in normal parous women (80.2% vs. 49.5%; P = 0.03, Mann Whitney test). Both pregnancy per ce and parturition caused a significant decrease in the hydroxyproline concentration when compared to values found in nulligravidae (P < 0.0001, Kruskall Wallis test). CONCLUSIONS: Congenital cervical incompetence seems associated with a low collagen concentration in the cervical connective tissue in the non-pregnant state.

Adult↗

Relaxin is not related to symptom-giving pelvic girdle relaxation in pregnant women.

BACKGROUND: The pregnancy associated hormone relaxin induces loosening of the pelvic ligaments in several species. This study was undertaken to evaluate whether pregnant women with symptom-giving girdle relaxation had increased serum relaxin concentrations during pregnancy. METHOD: Serum relaxin concentrations were measured in 38 pregnant women with symptom-giving pelvic girdle relaxation at the time of diagnosis, in the 30th and 38th week of pregnancy as well as 2 and 6 months after delivery. Fourteen pregnant women without symptoms served as a control group. Relaxin concentrations were measured by a homologous enzyme linked immuno-sorbent assay. All participants were clinically examined including tests for symptom-giving pelvic girdle relaxation. RESULTS: No differences in serum relaxin concentrations were found throughout pregnancy and after delivery. CONCLUSION: The present results do not suggest an important role for relaxin in symptom-giving pelvic girdle relaxation during human pregnancy.

Chronic Disease↗

Morphological, stereological, and biochemical analysis of the mini-pig urinary bladder after chronic outflow obstruction and after recovery from obstruction.

Chronic partial bladder outlet obstruction was created in nine mini-pigs by implanting a 6-7 mm ring around the proximal urethra. After a median obstruction period of 63 days, the ring was removed and after a recovery period of median 60 days the animals were sacrificed. Changes in muscle and connective tissue were assessed by unbiased, modern morphometry and biochemical analysis. After obstruction the results were as follows: (1) a 6-fold increase in bladder weight, (2) a 2.5-fold increase in smooth muscle cell size, (3) a 3-fold increase in smooth muscle cell number, (4) unchanged proportions between muscle and connective tissue, (5) unchanged hydroxyproline concentrations, (6) an 8-fold increase in total collagen content, (7) an increase in the ratio of type I/III collagen, and (8) a 7-8-fold increase in total content of type I and III collagen. All changes were markedly, though incompletely, reversed after recovery, except smooth muscle cell number and the ratio of type I/III collagen.

Animals↗

Variations in serum relaxin (hRLX-2) concentrations during human pregnancy.

STUDY OBJECTIVE: To study variations in serum relaxin concentrations during normal and abnormal human pregnancy and parturition and in umbilical cord blood. DESIGN AND PATIENTS: Diurnal variations were determined in samples collected every 2 hours for 24 hours (n = 4). Variations during pregnancy were studied in samples taken every 4th week from normal pregnant women (n = 26). Additionally samples were collected once a week from the 37th week of pregnancy and until spontaneously delivery (n = 5). Changes in relaxin during early pregnancy (gestational age: 30 to 97 days) were studied in serum from 12 normal pregnant women, 13 with spontaneous abortion and 38 with an ectopic pregnancy. Fetal serum was obtained at delivery from the umbilical vein (n = 20). All samples were analysed for relaxin by an ELISA based on human relaxin antibodies. MAIN RESULTS: No diurnal variation in relaxin concentrations were found. In normal pregnant women relaxin concentrations increased during the first 14 weeks of pregnancy. From week 14 to 24 a gradual decrease was found and the concentrations remained constant during the last part of pregnancy. No changes in concentrations were found immediately before or during spontaneous delivery. Women with abnormal pregnancies had lower serum relaxin values than normal early pregnant women. The relaxin concentration was significantly correlated to the serum HCG concentration in early pregnancy but not to the serum HPL levels after week 28. In the umbilical vein relaxin concentrations were low. CONCLUSION: The variation in circulating levels of relaxin during human pregnancy differs markedly from those found in other species. This suggests a different role for relaxin in human pregnancy.

Abortion, Spontaneous↗

Relaxin (hRLX-2)-induced weakening of human fetal membranes in vitro.

We examined the effect of human relaxin (hRLX-2) on the biomechanical properties of human fetal membranes in vitro. Intact chorioamniotic membranes were obtained from twelve elective cesarean sections before the onset of labor. Membrane strips with a fixed width were biomechanically tested after incubation for 20 h with hRLX-2 in concentrations of 10(-7) mol/l and 10(-9) mol/l. Incubation with hRLX-2 (10(-9) mol/l) changed the load-strain values as the membrane stiffness was decreased by 19% when compared with controls: median 2.45 N (range, 0.81-4.31) versus 3.03 N (1.28-5.46), P = 0.02 (Mann-Whitney test). For description of the membrane material as such, the stress-strain values were calculated by dividing the load-strain values with the cross sectional area of the membranes. Incubation with hRLX-2 (10(-9) mol/l) decreased the tensile strength of the membranes by 30%-0.817 N/mm2 (0.282-1.139) vs. 0.575 N/mm2 (0.101-1.150), P = 0.03--and reduced the elastic modulus by 31%--2.26 N/mm2 (0.82-5.08) versus 1.57 N/mm2 (0.51-3.71), P = 0.002. Less pronounced effects were found after incubation with hRLX (10(-7) mol/l). No quantitative or qualitative changes of the membrane collagen were found after relaxin incubation. Although the mechanism for rupture of the fetal membranes remains unknown, the present results suggest that relaxin might be involved in the process leading to rupture of the membranes.

Amnion↗

Normal serum relaxin in women with disabling pelvic pain during pregnancy.

As part of a case control within cohort study 472 pregnant women answered a questionnaire post partum. Serum relaxin concentrations were measured by a homologous ELISA in samples collected from the women in the 30th week of pregnancy. Serum relaxin concentrations were not associated with pregnancy-associated pelvic pain. Thus, normal pregnant women without pelvic pain (n = 118) had mean concentrations of 343 pg/ml compared to 332 pg/ml in women (n = 59) with pelvic pain and some restriction in daily activities and to 349 pg/ml in women (n = 9) with severe pregnancy-induced pelvic pain. The present results do not suggest a role for relaxin in symptom-giving pelvic relaxation during human pregnancy.

Case-Control Studies↗

Different biomechanical properties of human fetal membranes obtained before and after delivery.

The aim of this study was to elucidate whether the mechanical properties of fetal membranes change during late pregnancy and labour. Membranes delivered by elective caesarean section in week 38 showed different load-strain curves to membranes obtained after spontaneous vaginal delivery at term. A major change in mechanical properties was a decrease in strength of the intact chorioamniotic membrane from 1.39 N to 0.98 N (width of biopsy 4 mm), mainly due to loss of strength of the amniotic component, from 1.27 N to 0.72 N. Moreover, the extensibility of the chorionic component (epsilon Fmax) increased after vaginal delivery from 0.42 to 0.54, resulting in a two-component behaviour of the intact chorioamniotic membrane and further decrease of strength. Based on these observations it is suggested that the amnion is attached to the chorion, act biomechanically in parallel and possess relatively high mechanical strength during pregnancy. After vaginal delivery the two membranes are separated, and pronounced changes are induced in their mechanical properties.

Amnion↗

Carcinoma of the cervical stump.

Treatment, prognosis, and complication rate were retrospectively studied in 46 patients with cervical stump cancer. There were no differences in clinical stage distribution and histopathological findings between these patients and patients with cervical cancer of the intact uterus. However, 43 patients were treated by radiation therapy and only 3 patients had a cervical amputation. The 5-year survival rate was 62%, which is comparable to that of cervical cancers. Late complications were found in 22 patients: 3 (7%) had symptoms of severe radiation reactions of the bladder (necrosis or vesicovaginal fistels), 14 (31%) had severe radiation reactions in the rectum and the sigmoid (severe proctitis, stenosis, or rectovaginal fistels) and 7 (18%) had large vault necrosis. It is concluded that the frequency of cervical stump cancer is low, but cancer in the cervical stump is difficult to treat and the rate of severe late complications is so high that it should be considered when one is deciding between supravaginal and total hysterectomy. Moreover, screening for cervical cancer should be performed regularly after supravaginal hysterectomy.

Adult↗

Intra-articular fractures at the base of the fifth metacarpal. A clinical and radiographical study of 64 cases.

The treatment of 64 intra-articular fractures at the base of the fifth metacarpal was studied. 11 fractures with minimal displacement had been immobilised in a plaster cast without reduction. The position was improved in five of 25 fractures treated by closed reduction and a plaster cast, six of nine fractures after percutaneous pinning, and 12 of 19 fractures after open reduction and internal fixation. At follow-up after a median of 4.3 years, 19 of 50 patients answering a questionnaire had intermittent pain, especially on firm grip. 43 patients were re-examined clinically and radiographically: 21 (49%) had decreased grip power, and 28 had radiographical signs of osteoarthrosis.

Adolescent↗

Effects of thiopentone and chlormethiazole on human myometrial arteries from term pregnant women.

We have investigated the effects of thiopentone and chlormethiazole on maternal intramyometrial arteries dissected from myometrial biopsies taken during Caesarean section at term. Ring preparations were mounted in organ baths and isometric tension was recorded. Thiopentone 10(-4)-10(-3) mol litre-1 inhibited responses to K+ depolarization, noradrenaline and vasopressin. Chlormethiazole 3 x 10(-5)-3 x 10(-3) mol litre-1 inhibited responses to noradrenaline, while a concentration of 3 x 10(-3) mol litre-1 was required to attenuate responses to vasopressin and K+ depolarization. Neither of the two agents affected relaxant responses to prostacyclin. The results did not yield evidence that clinical use of thiopentone and chlormethiazole should impair uteroplacental vascular perfusion by a direct effect.

Arginine Vasopressin↗

Serum relaxin as a potential marker for preterm labour.

OBJECTIVE: To determine whether high serum relaxin concentrations in the 30th week of pregnancy were associated with preterm labour. DESIGN: Case-control study. SETTING: Two antenatal clinics of the Department of Obstetrics and Gynecology University Hospital of Aarhus. SUBJECTS: A cohort of 991 women (82% of 1203 eligible) in the 30th week of pregnancy attending one of the two antenatal clinics. The cases comprised 23 (2.4%) women without pre-eclampsia or small for gestational age babies, who were delivered spontaneously before 37 completed weeks gestation. The control group of 46 women was randomly selected from the rest of the cohort, all of them were delivered at term. INTERVENTIONS: Blood samples were collected at 30 weeks gestation and stored for analysis. MAIN OUTCOME MEASURES: Serum relaxin concentrations estimated by ELISA technique, length of gestation at delivery. RESULTS: The mean serum relaxin concentrations in the 30th week of pregnancy was 455 (SD 169) pg/ml and 327 (SD 139) pg/ml in the cases and controls, respectively (P = 0.003, t test). In women with preterm delivery a negative correlation was found between relaxin concentration in the 30th week of pregnancy and the gestational age at parturition (r = -0.53, P = 0.02). CONCLUSION: High relaxin concentrations may be associated with preterm delivery but the present results need confirmation in large scale studies.

Biomarkers↗

[Local estrogen premedication reduces the abortion time in prostaglandin E1 analogue-induced abortion in the 2nd trimester].

Twenty-eight patients (median gestational age 17 weeks) referred for induction of second trimester abortion, were randomized to intracervical preliminary treatment by either 50 mg 17 beta-oestradiol or placebo. Abortion was then induced by 1 mg prostaglandin E1 vagitories. The preliminary treatment caused a significant rise in cervical score and a significant reduction in induction-abortion time especially by reducing the number of patients with prolonged induction-abortion time.

Abortion, Induced↗

Effects of human relaxin on isolated rat and human myometrium and uteroplacental arteries.

We investigated the effects of synthetic human relaxin (hRLX-2) on isolated rat and human myometrium and on uteroplacental arteries from term pregnant women. The preparations were mounted in organ baths and isometric tension was recorded. In isolated myometrium from nonpregnant rats, hRLX-2 (10(-10)-10(-7) mol/L) produced concentration-dependent inhibition of contractile activity induced by vasopressin (10(-8) mol/L). In isolated human myometrium from the fundus or isthmus, hRLX-2 (10(-10)-10(-7) mol/L) did not influence spontaneous activity or contractions induced by oxytocin (10(-9) mol/L) and prostaglandin (PG) F2 alpha (10(-5) mol/L). Nor did it influence the tension induced in small intramyometrial arteries by U46619 (10(-7) mol/L), noradrenaline (10(-5) mol/L), and endothelin (10(-9) mol/L); or the tension induced in fetal stem villus arteries by U46619 (10(-7) mol/L), endothelin (10(-9) mol/L), and PGF2 alpha (10(-5) mol/L). The inhibitory effects of hRLX-2 in preparations of rat myometrium were not influenced by the presence of human myometrium in the organ bath or by pre-incubation of hRLX-2 with human myometrium. These results suggest that direct inhibitory effects of relaxin may be of minor importance for the regulation of myometrial activity and uteroplacental circulation in term human pregnancy.

Animals↗