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Biomedical subjects

N H Lauersen

Publications and source records attributed to N H Lauersen.

At least 55 records · Page 3Linked to original sources
PubMed1978

Aryl hydrocarbon hydroxylase activity and microsomal cytochrome content of human fetal tissues.

Aryl hydrocarbon hydroxylase (AHH) and microsomal cytochromes were measured in tissues of human features aborted by prostaglandins. Cytochrome P-450 concentrations and AHH activity were about 4 times higher in adrenal glands than in liver. AHH was present in testes, ovaries, and vagina and uterus at levels equal to or greater than those in the liver. In lung, kidney, and intestines it was present at levels lower than those in the liver. Mean hepatic AHH and hepatic and adrenal cytochromes P-450 and b5 were not significantly different in prostaglandin and hysterotomy abortuses; mean adrenal AHH was significantly lower in prostaglandin abortuses, but the ranges in both groups were overlapping. Neither fetal sex nor maternal cigarette smoking affected hepatic or adrenal AHH activity or microsomal cytochrome concentrations or difference spectra. Hepatic and adrenal AHH activities were concentrated in microsomes and were correlated with microsomal P-450 content. These findings are constant with P-450 mediation of AHH in human fetal tissues. The data demonstrate the utility of prostaglandin abortuses for studies of fetal tissue mixed-function oxidase activity and point to the endocrine glands and target tissues in addition to the liver as potential sites for activating chemical carcinogens and cytotoxins in the human fetus.

Abortion, Induced↗
PubMed1977

Inhibition of premature labor: a multicenter comparison of ritodrine and ethanol.

A randomized controlled study was carried out at three medical centers to compare the efficacy and side effects of ethanol and ritodrine in the treatment of threatened premature labor. One hundred and thirty-five patients judged to be between the twentieth and thirty-sixth week of gestation and presenting with clinical symptoms of premature labor were included. Sixty-seven patients were treated with intravenous infusion of 10 per cent ethanol. Sixty-eight patients were treated with intravenous infusion of ritodrine for 12 hours followed by oral ritodrine. If labor recurred prematurely, up to two additional courses of ethanol or ritodrine were given. Delivery was postponed for more than 72 hours in 49 of 67 patients (73 per cent) with ethanol and in 61 of 68 patients (90 per cent) with ritodrine; this difference was significant. Patients in the ethanol group gained a mean of 27.6 days while patients in the ritodrine group gained a mean of 44.0 days. Fifty-four per cent of the ethanol group and 72 per cent of the ritodrine group carried their infants to 36 weeks of gestation. Five infants in the ethanol group and one infant in the ritodrine group died from respiratory distress syndrome. The most frequent side effect of ethanol were nausea and vomiting. The most frequent side effects of ritodrine were tachycardia and blood pressure changes which were easily controlled by lowering the infusion rate. Ethanol and ritodrine were both found to be effective inhibitors of premature labor with ritodrine giving the most favorable results.

Adult↗
PubMed1977

The abortifacient and oxytocic effects of an intravaginal silicone rubber device containing a 0.5% concentration of 15(S)-15-methyl-prostaglandin F2alpha methyl ester.

Abortion was successfully induced by intravaginal insertion of a silicone rubber device impregnated with an 0.5% concentration of 15(S)-15-methyl-prostaglandin F2alpha methyl ester in 20 of 25 patients by prostaglandin alone and in an additional three patients by prostaglandin with a concomitant oxytocin infusion. The mean abortion time for the 23 successful abortions was 15.46 hours. Uterine activity was monitored in six patients and uterine response to the vaginal insertion of the prostaglandin-impregnated device was characterized by a gradual rise in amplitude of contractions and intrauterine baseline tonus accompanied by a rapid increase in the frequency of contractions. Induction of abortion by intravaginal administration of a silicone rubber device impregnated with prostaglandin eliminates the hazards associated with intra-amniotic instillation and offers the advantage of a single administration with the option of reversibility if a patient should be hypersensitive to the drug.

Abortion, Induced↗
PubMed1977

Induction of labor in patients with missed abortion and fetal death in utero with protaglandin E2 suppositories.

Labor was successfully induced in 20 patients with a diagnosis of missed abortion or intrauterine fetal death (IUFD) by intravaginal administration of prostaglandin E2 suppositories. Fifteen patients delivered with the prostaglandin alone while a concomitant oxytocin infusion was employed to augment contractions in the other five patients. The mean induction-delivery time was 9.80 hours; nulliparous patients delivered in a mean time if 7.78 hours, parous patients in a mean time of 12.29 hours. The uterus appeared to be sensitive to the PGE2 stimulation in all patients and all were delivered completely without the need for surgical intervention. Fifty per cent of patients were delivered within 8 hours and 80 per cent by 12 hours. The side effects associated with prostaglandin administration--vomiting, diarrhea, and temperature elevation--were well tolerated and therapy did not have to be terminated in any patient. The administration of PGE2 vaginal suppositories offers an effective and safe technique for the induction of labor in patients with IUFD. Labor can be induced with PGE2 suppositories as soon as the diagnosis of IUFD is confirmed, which eliminates the need for waiting until spontaneous labor occurs.

Abortion, Missed↗
PubMed1977

The effect of a 10 cm2, 0.5% 15-ME-PGF2alpha methyl ester intravaginal silastic device on abortion and plasma prostaglandin concentration.

Intravaginal insertion of a 10 cm2 silastic device with an 0.5% concentration of 15(S)-15-methyl-prostaglandin F2alpha methyl ester alone successfully induced abortion in 27 of 48 patients in the midtrimester and in an additional 11 patients with a concomitant infusion of oxytocin. The mean abortion time for the 38 successful induction was 15.35 hours. In 8 of the 10 patients who failed to abort even with concomitant oxytocin therapy, abortion was induced by serial intramuscular injections of 15-ME-PCF2alpha; the remaining 2 failures underwent surgical evacuation. The plasma levels of 15-ME-PGF2alpha methyl ester in the 11 patients studied varied widely over the first 2 hours after insertion of the device. The maximum mean level was achieved at 2 hours, maintained at 4 hours and then dropped sharply at 8 hours and declined over the abortion period in undelivered patients. Vomiting and diarrhea were the most common side effects and in general well tolerated by the patients. However, there was an adverse reaction in a single patient who experienced almost constant nausea, vomiting and diarrhea. The device was removed 1 hour 50 minutes after insertion and the patient aborted spontaneously 7 hours later. Intravaginal insertion of a silastic device is an effective means of prostaglandin abortion, but further investigation is required to determine the most effective device which would provide a slow, continuous release of the prostaglandin.

Abortion, Induced↗
PubMed1977

Evaluation of danazol as an oral contraceptive.

The effect of Danazol as an oral contraceptive in doses of 50, 100, and 200 mg daily for 6 months was studied in 3 groups of 10 women. Both 50 and 100 mg Danazol daily were well tolerated, but one pregnancy occurred among the women receiving 50 mg daily, and 2 pregnancies occurred in women receiving 100 mg daily. There were no pregnancies in women taking 200 mg Danazol daily; however, the side effects were frequent and 5 of the 10 patients withdrew from the study prior to 6 months of therapy. Six patients in this study were followed intensively with blood hormone analysis, vaginal cytology, and pathologic evaluation, and these findings are detailed.

Acne Vulgaris↗
PubMed1977

The effects of intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha in failed abortions.

Intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha (15-Me-PGF2alpha) induced abortion in 38 patients who had failed to abort with other techniques, such as intra-amniotic instillation of saline or PGF2alpha and intravaginal insertion of prostaglandin-impragnated Silastic devices. The intramuscular injections of 15-Me-PGF2alpha were initiated when the original abortion techniques, even when augmented by intravenous oxytocin, failed to produce expulsion of the fetus. The dose schedule was 250 microgram or 500 microgram every 2 to 4 hours, and the concomitant intravenous oxytocin was continued at a rate of 167 mU/minute. Of the 38 patients, 26 aborted with two or fewer injections of 15-Me-PGF2alpha, and 30 patients required only 1 mg of the drug to expel the fetus successfully. The mean time from the first injection of 15-Me-PGF2alpha to the expulsion of the fetus was 5.25 hours; one-half of the patients aborted in less than 4 hours. The placenta was expelled spontaneously in 15 patients, removed manually from the vagina in 18, and removed by sponge forceps in 3. Two abortions were incomplete and surgical intervention was required. Twenty-eight patients (74%) experienced gastrointestinal disturbances, chiefly vomiting and diarrhea. Intramuscular administration of 15-Me-PGF2alpha eliminates the need for repeated amniocentesis, and the dose may be adjusted to meet the precise requirements of the clinical situation.

Abortion, Induced↗
PubMed1976

Evaluation of the accuracy of a new ultrasonic fetal heart rate monitor.

An indirect Doppler fetal monitoring system has been developed and validated by computer comparison of simultaneous fetal heart rate (FHR) with Doppler and scalp ECG of high-risk patients during labor. The difference in measurement of FHR averaged 0.3 b.p.m., and 93 per cent of the Doppler FHR measures were within 10 b.p.m. of the ECG FHR. If interinstrument difference is discounted, 96 per cent were within 10 b.p.m. All types of decelerations and variability were well approximated. Doppler FHR from the instrument described may be relied upon as valid clinical information and may be obtained from over 90 per cent of labor patients with 93 per cent accuracy.

Doppler Effect↗
PubMed1976

Luteolytic and abortifacient effects of serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha in early pregnancy.

Pregnancy was successfully terminated in 8 of 9 patients 5 to 6 weeks after the last menstrual period by serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha (15-ME-PGF2alpha). In one patient the treatment induced vaginal bleeding and a drop in hormone levels, but the patient did not completely abort and the uterus had to be evacuated. Serial intramuscular injections of 15-ME-PGF2alpha appeared to have some luteolytic effect, resulting in a significant drop in progesterone and estradiol levels. However, it is uncertain if the luteolytic effect of the prostaglandin was the precipitating factor in the abortion since the administration of 15-ME-PFG2alpha was accompanied by strong uterine activity which played a role in the abortion.

Abortifacient Agents↗
PubMed1976

Termination of midtrimester pregnancy by serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha.

Midtrimester abortion was successfully induced in 117 of 120 patients with serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha (15-me-PGF2alpha). The mean abortion time was 14.12 hours, and parous patients aborted in a mean of 12.85 hours-significantly faster than nulliparous patients who aborted in a mean of 15.24 hours. Ninety-four per cent of the 117 successfully induced abortions occurred in less than 24 hours and 46 per cent in less than 12 hours. Uterine activity was monitored and analyzed in nine patients. Uterine response to a single intramuscular injection of 100 mug of 15-me-PGF2alpha was characterized by the appearance of low-amplitude, high frequency contractions and a rapid increase in baseline intrauterine tonus. A high level of uterine activity, 900 Montevideo Units, was observed within 30 minutes of the first intramuscular injection of 15-me-PGF2alpha. This activity was not maintained and decreased by approximately 30 per cent at the time of the second injection at 1 hour. It was not until 6 hours of 15-me-PGF2alpha therapy that activity stabilized at approximately 500 Montevideo Units. Even though all patients were premedicated with antiemetic and antidiarrhea agents, 68 of 120 patients experienced gastrointestinal side effects related to the 15-me-PGF2alpha administration. Vomiting was the most prevalent side effect, occuring in 65 patients, but the episodes were not severe, were well tolerated by the patients and did not necessitate the termination of prostaglandin administration in any of the patients. In this study abortion was successfully induced between weeks 9 to 27 of gestation. It was observed that patients with gestations of 16 weeks or less aborted significantly faster than patients with gestations of 17 weeks or more, which indicates that this method is highly effective in the induction of abortion within the "gray zone", 12 to 16 weeks of gestation.

Abortifacient Agents↗
PubMed1976

The abortifacient effectiveness and plasma prostaglandin concentrations with 15(S)-15-methyl prostaglandin F2alpha methyl ester-containing vaginal silastic devices.

The abortifacient effectiveness of three intravaginal Silastic devices impregnated with 15(S)-15-methyl prostaglandin F2alpha (15(S)-Me-PGF2alpha) methyl ester in concentrations of 0.25%, 0.5%, and 1.0% was investigated. Each concentration was tested in 10 patients with gestations ranging from 8 to 19 weeks. Abortion was successfully induced by prostaglandin alone in 6 patients with the 0.25% device, in 9 patients with the 0.5% device, and all 10 patients treated with the 1.0% device. Additionally, three patients treated with the 0.25% device and one patient treated with the 0.5% device aborted with concomitant, continuous, intravenous oxytocin therapy. The mean abortion time with the 0.25% device was 16.43 hours; with the 0.5% device, 16.49 hours; and with the 1.0% device, 10.18 hours. The peripheral plasma levels of 15(S)-Me-PGF2alpha methyl ester were the most variable with the 0.5% device. The plasma levels of 15(S)-Me-PGF2alpha methyl ester of patients receiving the 0.25% device were similar to the levels of patients receiving the 1.0% device. The intravaginal Silastic device impregnated with 15(S)-Me-PGF2alpha methyl ester appears to be an effective abortifacient, but further study is indicated to determine the most efficient device with the fewest side effects.

Abortifacient Agents↗
PubMed1976

Management of failed prostaglandin abortions.

Midtrimester abortion was induced in 529 patients by administration of the naturally occurring prostaglandins E2 and F2alpha as well as the 15-methyl analogs, 15-ME-PGE2 and 15-ME-PGF2alpha. Ten patients failed to abort with prostaglandin therapy, even in association with intravenous oxytocin, a failure rate of 1.9%. Two failures were related to uterine malformation; 1 patient had the pregnancy in a blind uterine horn, and the second patient was pregnant in one horn of a uterus didelphys. Five of the 10 patients who failed to abort during prostaglandin administration were subsequently found to have uterine distortion due to myomata uteri. When abortion induced by prostaglandin fails to occur within the expected time for the agent and technic employed, the presence of uterine malformation or abnormality should be considered. Evaluation with ultrasonography is indicated along with a repeat test to confirm the pregnancy. If the sonogram is suggestive of uterin malformation, a hysterosalpinogram should be obtained to determine if there is communication between the cervix and the gestational sac. If no communication is present, an intravenous pyelogram should be performed in view of the 90% correlation of urogenital abnormalities, and an exploratory laparotomy should be performed. When a communication exists between the cervix and the gestational sac, the 24 hours of uterine activity induced by the prostaglandin will have resulted in cervical changes so that the cervix can easily be dilated to either a 14 or 16 Hegar dilator and the conceptus can be removed in parts with minimal bleeding.

Abortion, Induced↗
PubMed1976

The effect of danazol in the treatment of chronic cystic mastitis.

Danazol in a dose of 400 mg daily was administrated to 40 patients with chronic cystic mastitis and resulted in a marded improvement in both objective and subjective symptoms in 87.5% of the patients studied. Three patients showed partial relief of symptoms and 1 patient showed no improvement after 1 month of treatment at which time she withdrew from the study. One patient had a worsening of her condition and was withdrawn from the study after 3.5 months of therapy. Nineteen of the 40 patients in the study had a secondary diagnosis of pelvic endometriosis confirmed histologically, and all these patients showed a marked improvement of symptoms during the Danazol treatment. Patients developed amenorrhea after 3 to 4 months of Danazol therapy, and symptoms such as dysmenorrhea, premenstrual pelvic pain, and tension abated at the same time. A mild, but well-tolerated weight gain was the major side effect of Danazol administration. No significant changes in the levels of plasma E1, E2, FSH, LH, or progesterone could be demonstrated in specimens drawn from 11 patients before and during the course of Danazol administration.

Administration, Oral↗
PubMed1976

Hormone release and abortifacient effectiveness of a newly developed silastic device containing 15-ME-PGF2alpha methyl ester in concentrations of 0.5% and 1.0%.

Abortion was successfully induced by intravaginal administration of a newly developed silastic device impregnated with 15(S)-15-methyl-prostaglandin F2alpha methyl ester in a concentration of 0.5% in 26 of 35 women in the 12th to the 24th weeks of gestation and by prostaglandin with concomitant oxytocin infusion in an additional 5 patients. A second comparable group of 35 women, with gestational ages from 9 to 23 weeks, received a silastic device with a concentration of 1.0% of the prostaglandin. Twenty-six women in the second group aborted with prostaglandin alone and an additional 6 patients aborted with combined prostaglandin-oxytocin therapy. Seven patients of the 70 included in this study failed to abort with intravaginal administration of 15-ME-PGF2alpha methyl ester even with concomitant oxytocin therapy; this group included 4 patients receiving the 0.5% device and 3 patients with the 1.0% device. The mean abortion time for the 31 successful abortions with 0.5% device was 15.15 hours and multiparous patients aborted in a mean time of 9.69 hours, significantly faster than the nulliparous patients, mean time 18.49 hours. The mean abortion time for the 32 successful abortions with the 1.0% device was 15.61 hours and there was no significant difference in the mean abortion times between nulliparous and multiparous patients in this group. No significant difference could be demonstrated between the mean abortion times of patients receiving an 0.5% concentrations of prostaglandin and patients receiving a 1.0% concentration of the drug. In both groups more than 40% of the patients had aborted within 12 hours of the insertion of the prostaglandin device and more than 80% had aborted within 24 hours. The intravaginal device appeared to be effective in inducing abortion throughout the gestational ages tested in this series. Peripheral plasma levels of 15-ME-PGF2alpha were analyzed in 15 patients with the 0.5% device and 8 patients with the 1.0% device. In patients with the 0.5% device the mean plasma concentration of prostaglandin peaked 2 hours after insertion, while in patients with the 1.0% device the peak was achieved within 15 minutes of insertion followed by a rapid decline in plasma prostaglandin levels. Diarrhea was the most frequent side effect related to the intravaginal administration of the prostaglandin, and in this series the severity of this gastro-intestinal disturbance appeared to be significantly higher in patients receiving the 1.0% device.

Abortion, Induced↗
PubMed1975

Midtrimester abortion induced by serial intramuscular injections of 15(S)-15-methyl-prostaglandin E2 methyl ester.

Midtrimester abortion was successfully induced in 29 of 30 patients with serial intramuscular injections of 15(S)-15-methyl-prostaglandin E2 methyl ester (15-ME-PGE2). The mean abortion time was 9.52 hours; parous patients aborted somewhat faster (mean, 8.76 hours) than nulliparous patients (mean, 10.47 hours). Eight patients were monitored throughout the abortion procedure and uterine activity was calculated and analyzed. Uterine response to a single injection of 5 mug 15-ME-PGE2 was characterized by the rapid appearance of low-amplitude, high-frequency contractions accompanied by a rise in intrauterine baseline tonus. Uterine activity rose to a mean of 500 Montevideo Units within 40 minutes of the initial intramuscular injection of 15-ME-PGE2. The most frequently encountered side effect of intramuscular injections of 15-ME-PGE2 was temperature elevation of 2 degrees F. or higher, which occurred in 29 of 30 patients. Five patients complained of shaking and chills but only five patients had any gastrointestinal side effects. From this study it appeared that on a weight-for-weight basis 15-ME-PGE2 is at least 20 times more potent than 15-ME-PGE2alpha and 1,000 time more potent than the naturally occurring PGE2.

Abortifacient Agents↗