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Biomedical subjects

U B Knudsen

Publications and source records attributed to U B Knudsen.

At least 19 recordsLinked to original sources
PubMed2001

First trimester abortion with mifepristone and vaginal misoprostol.

This study assessed the efficacy and side effects of first trimester medical abortion using mifepristone and vaginally administered misoprostol. Medical abortion was first introduced in Denmark in December 1997, and the acceptability of this new approach in a Danish population was evaluated. The study included the first 100 women seeking medical abortion. The gestational age was from 33 to 56 days. All received 600 mg mifepristone (RU 486) orally followed 2 days later by vaginally administered misoprostol 400 microg. Success was defined as achieving complete abortion without the need for surgical evacuation. Ninety-three percent achieved a successful medical termination of pregnancy. Side effects were few, and the acceptability was high. Ninety percent of the women would prefer medical abortion in case of a new unwanted pregnancy. The combination of mifepristone and vaginally administrated misoprostol is effective, safe, has few side effects and is well accepted by Danish women.

Abortifacient Agents, Nonsteroidal↗
PubMed2001

Telomerase activity, MIB-1, PCNA, HPV 16 and p53 as diagnostic markers for cervical intraepithelial neoplasia.

The present investigation evaluated the relationship between dysplasia of the uterine cervix and telomerase activity, expression of p53, MIB-1 and PCNA. Telomerase activity was measured on cervical cytobrush material from 126 women suspected of having dysplasia and 61 controls using the telomeric repeat amplification protocol. Immunohistochemistry was used to detect the tumor suppressor protein p53 and cell proliferation, the latter by MIB-1 and PCNA expression. Infection with human papillomavirus 16 was detected by PCR amplification and Southern blot hybridization of DNA extracted from the same brush material. Positive telomerase activity was found in 5 of 43 (11.6%) normal samples, 12 of 57 (21.1%) samples with inflammation or koilocytosis, 7 of 17 (41.2%) CIN 1 (cervical intraepithelial neoplasia, grade 1), 8 of 20 (40.0%) CIN 2, and 25 of 42 (59.5%) CIN 3/ CIS. Telomerase activity was significantly related to the level of dysplasia (p<0.001) and proliferation measured by MIB-1 (p=0.019), but not to the level of PCNA (p=0.445), HPV 16 status (p=0.098) or staining for p53 (p=0.271). Dysplasia was also related to PCNA, MIB1, p53, and presence of HPV 16. A sequential increase in the examined parameters, paralleling the progression of abnormality, was observed. PCNA and telomerase showed an increase in CIN 1, MIB-1 and HPV16 in CIN 2, and finally p53 in CIN 3/CIS.

Adolescent↗
PubMed1999

A simple one-stop menstrual problem clinic with use of hysterosonography for the diagnosis of abnormal uterine bleeding.

BACKGROUND: The purpose of the present study was to evaluate a one-stop outpatient bleeding disorder clinic in a Scandinavian population. METHODS: One hundred and fourteen women under the age of 60 years referred to the clinic for bleeding disorders. The consultation included pelvic ultrasound, hysterosonography and, when indicated, endometrial sampling. RESULTS: In 93% of the patients a sufficient diagnosis of the uterine cavity was attained at a one-stop visit. Eighty-six percent of the patients were investigated according to the one-stop program, and in 73% of the patients a treatment plan could be formulated during the consultation. Twenty-one percent had selective resection of intracavitary abnormalities. In 3% no intracavitary abnormality was found at hysteroscopy, even though hysterosonography had indicated this. CONCLUSIONS: Most patients under the age of 60 with bleeding disorders can be investigated by a one-stop out-patient procedure with the use of hysterosonography and endometrial sampling. Diagnostic or operative hysteroscopy was needed in cases of insufficient hysterosonography and suspicion of intracavitary abnormalities. This procedure can assist in determining the therapeutic approach and can often lessen the extent of surgical intervention or obviate it altogether.

Adult↗
PubMed1998

Length tension relationships in the nonpregnant and pregnant rat uterus and the effect of antiprogestin.

Length-tension relationships and the tissue composition of the corpus and the cervix uteri were investigated in a rat model. Four groups of rats were used: nonpregnant (n = 12); day 18 of pregnancy treated with vehicle (n = 8); day 18 of pregnancy treated with the antiprogestin ZK 98 299 (Onapristone) for 19 h (n = 8); and day 22 of pregnancy during spontaneous labour (n = 8). Increased extensibility and maximal contractility in both corpus and cervix uteri were demonstrated with increased gestational age. The collagen concentration was reduced significantly in corporal preparations from pregnant rats compared with those from nonpregnant rats but not in specimens from the cervix. Antiprogestin treatment tended to increase the contractile ability.

Animals↗
PubMed1997

Eosinophils in human cervical ripening.

OBJECTIVE: Cervical ripening has many similarities to an inflammatory reaction. Eosinophil granulocytes are involved in several inflammatory responses. The objective was to investigate the presence of eosinophils in human cervix uteri during different conditions. STUDY DESIGN: Cervical biopsies were obtained from non-pregnant (n = 6), women in early pregnancy (n = 11) and from three groups of women at term: spontaneous vaginal deliveries (n = 5); vaginal deliveries after pretreatment with Prostaglandin E2 (n = 7); and from women who underwent planned Caesarean section (n = 7). Immunohistochemical staining for eosinophil granulocytes (ECP, EG2) were performed. The biopsies were analysed blinded. RESULTS: Eosinophils showing degranulation in the tissue were found in all specimens from vaginal deliveries. No eosinophils, or very few were seen in the biopsies from non-pregnant, early pregnant women or planned caesarean section. Prostaglandin treatment had no effect on the results. CONCLUSION: Eosinophils participate in cervical ripening at term in women, and seem to arise mainly after labour.

Blood Proteins↗
PubMed1997

Mast cells in cervical ripening--an immunohistochemical and biomechanical study in rats.

Cervical ripening purportedly involves different cell types and mediators normally associated with inflammatory reactions. The purpose of the present study was to determine the presence of mast cells in rat cervices during spontaneous and antigestagen induced ripening and to test whether a mast cell stabilizer was able to inhibit the antigestagen induced cervical ripening. Immunohistochemical examinations demonstrated an increased number of mast cells in pregnant and intrapartum rats. Furthermore, mast cell degranulation was found to be prominent after antigestagen treatment. The degranulation was completely abolished by co-treatment with the mast cell stabilizer. Biomechanical analysis showed that the mast cell stabilizer also inhibited the antigestagen induced cervical ripening to some extent. Thus, it is concluded that mast cell stabilizers might constitute a new approach in the treatment of preterm cervical ripening.

Animals↗
PubMed1994

[Phantom breast syndrome].

Phantom breast syndrome following mastectomy has been reported by other authors. However, the temporal course, character and extent of this phenomena have not been elucidated. In a prospective study we have investigated the incidence, clinical picture and temporal course of phantom breast syndrome. One hundred and twenty women who started postoperative control or treatment at the Oncology Department over a one-year period were interviewed by a standard questionnaire three weeks after the operation. One year later 110 patients and six years later 68 patients were interviewed again. The incidence of phantom pain and non-painful phantom sensations was respectively 13.3% and 15.0%, respectively three weeks after the mastectomy. 12.7% and 11.8% after one year, and 17.4% and 11.8% after six years. A significant relationship between preoperative pain and phantom breast syndrome was found, but neither age, cancer treatment or postoperative sequelae seemed to affect the occurrence of phantom breast syndrome. Scar pain was found to persist in 30.9% of the patients six years after the operation. The present incidence of phantom-related phenomena is close to the incidence reported by others. However, persistent phantom pain after mastectomy may be more common than usually expected. Also, the persistence of scar pain seems to be more common than generally expected.

Adult↗
PubMed1994

Biomechanical analysis of cervix uteri in nonpregnant, pregnant and antigestagen (ZK 98 299) treated pregnant rats.

The biomechanical properties of the cervix uteri of the rat were studied under different pharmacological conditions. Four groups of rats were enrolled: A. non-pregnant (N = 12), B. 18 days pregnant treated with vehicle (N = 14), C. 18 days pregnant treated with the antigestagen ZK 98 299 (Onapristone) for 19 hours (N = 15), D. 22 days pregnant during spontaneous labor (N = 12). Load-dimension curves of two 2 mm ring-preparations from each cervix were obtained by a material testing machine. The results showed that the sampling position, the cervical ripening process, and the influence of antigestagen treatment were reflected in the biomechanical and compositional parameters. In conclusion the methodology in the present study constitute a model in which the effect of pharmaca on cervical ripening can be tested. The study demonstrated that antigestagen treatment induced biomechanical changes in the cervix comparable to those occurring during physiological cervical ripening at term.

Animals↗
PubMed1993

The effect of aging and ovariectomy on the vertebral bone mass and biomechanical properties of mature rats.

Ovariectomy has a proven pronounced effect on bone mass, as has been shown in several animal models and in clinical studies. The aim of this study was to investigate the effect of ovariectomy on both vertebral bone mass and biomechanical competence. The study was performed on a long-term mature rat model. One hundred and five, three-month-old female Wistar rats were randomized into seven groups. One group was killed at the start of the study and was used as a baseline group. Three groups were ovariectomized and followed for one, three, or six months after the operation. Three groups were sham-operated and followed for the same periods. At death, three lumbar vertebrae were obtained from each rat, and changes in bone mass (ash content, trabecular bone volume (TBV)), bone structure, and biomechanical competence were assessed from these vertebrae. The results revealed an age-related (three-nine months) increase in bone mass and biomechanical competence in the sham-operated control groups. In the ovariectomized groups, an age-related decrease in TBV was disclosed. The ash content remained constant, whereas the biomechanical parameters--after an initial increase--showed decreasing values with age in the ovariectomized groups. When age-matched control and ovariectomized rats were compared, an increasing difference in both bone mass and bone biomechanical competence was disclosed. The study has shown that ovariectomy has a pronounced effect not only on vertebral bone mass, but also on bone quality, and that this mature rat model forms an excellent basis for evaluating potential therapeutic regimens for the treatment of osteoporosis.

Aging↗
PubMed1992

Long-term phantom breast syndrome after mastectomy.

UNLABELLED: Phantom breast syndrome after mastectomy has already been reported by us and other authors. The temporal course, character, and extent of these phenomena, however, have not yet been elucidated. OBJECTIVE: To investigate in a prospective study the incidence, clinical picture, and temporal course of phantom breast syndrome during a 6-year period. DESIGN: One-hundred twenty women who embarked on consecutive postoperative control or treatment at our department during a 1-year period were interviewed by a standard questionnaire 3 weeks after the operation. Of these, 110 patients were interviewed 1 year later and 69 were interviewed again 6 years later. PATIENTS: The median age at the first interview was 54 years (Quartile (Q)1 = 45 years; Q3 = 62 years) and at the third interview 6 years later, 60 years (Q1 = 51 years; Q3 = 68 years). RESULTS: The incidence of phantom pain and nonpainful phantom sensations was 13.3% and 15.0%, respectively, 3 weeks after mastectomy, 12.7% and 11.8%, respectively, after a year, and 17.4% and 11.8%, respectively, after 6 years. We found significant relationships between preoperative pain and phantom breast syndrome, but no significant relationship between age and the occurrence of this syndrome. Neither postoperative sequelae nor cancer treatment including radiotherapy seemed to affect the occurrence of phantom breast syndrome. Pain in the scar, which was clearly distinguishable from phantom pain, was present in 35.0% of the patients 3 weeks postoperatively, in 22.7% after 1 year, and persisted in 30.9% 6 years later. CONCLUSIONS: The present incidence of phantom-related phenomena is close to the incidence reported by others. However, persistent phantom pain after mastectomy may be more common than usually expected. Also, the persistence of pain in the scar seems to be more common than generally expected.

Age Factors↗
PubMed1991

Prognosis of a new pregnancy following previous spontaneous abortions.

The risk for a clinical spontaneous abortion in a pregnancy following 0 to 4 consecutive spontaneous abortions was estimated in a large, unselected, Danish population, including approximately 300,500 pregnancies. The overall risk for spontaneous abortion was 11% and the risk for a spontaneous abortion was 16, 25, 45 and 54% after 1 to 4 previous consecutive spontaneous abortions, respectively. For women over 35 years, the risk for spontaneous abortion was significantly increased, but the almost identical abortion rates after repeated abortions in both young and old women indicate a risk factor which is not age-related.

Abortion, Habitual↗
PubMed1991

Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study.

Eight patients with monosymptomatic nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and urinary osmolality were found after this long-term treatment. Overall no changes in either body weight, blood pressure, or hematological variables were demonstrated. This supports previous findings that the treatment appears to be well tolerated and free of side effects in longer term.

Adolescent↗
PubMed1991

Diurnal variation of plasma atrial natriuretic peptide in normals and patients with enuresis nocturna.

The circadian variation of plasma atrial natriuretic peptide (ANP) in relation to urinary excretion of sodium (UNa) and potassium (UK) as well as clearance of creatinine (Ccrea) was assessed in 15 juvenile patients with enuresis nocturna and compared with 11 age-, sex-, and weight-matched normal subjects. Normal juveniles showed a highly significant diurnal variation (p less than 0.001) of plasma ANP with diurnal peak levels at midnight (0000 hours) and minimum levels at 0400 hours. Enuretic patients showed a similar diurnal rhythmicity with normal levels during day and night. In normals both UNa and UK showed significant diurnal rhythmicity with a marked reduction from daytime to night-time. Although the total diurnal excretions of UNa and UK were similar to normals, patients with enuresis showed abnormal diurnal variation in both UNa (p less than 0.05) and UK (p less than 0.01). The abnormal circadian rhythm of UNa and UK in enuretics seemed to be caused by abnormal tubular handling as similar abnormalities were found in the fractional excretions and as the circadian variation of Ccrea was normal. Especially during the first hours of sleep (2200 hours to 0000 hours), the patients showed polyuria (230 +/- 138 ml vs 116 +/- 58 ml, p less than 0.01), natriuresis (20.9 +/- 16.3 mmol l-1 vs 10.7 +/- 6.8 mmol l-1, p less than 0.01), and kaliuresis (7.3 +/- 6.3 mmol l-1 vs 3.7 +/- 2.3 mmol l-1, p less than 0.05), despite normal levels of plasma ANP. In conclusion, the study describes the diurnal variation of plasma ANP in relation to urinary excretion of sodium and potassium in a juvenile normal population. Patients with nocturnal enuresis show abnormal diurnal rhythmicity in the urinary excretion of sodium and potassium that is not correlated to the plasma levels of ANP.

Adolescent↗
PubMed1991

Influence of bilateral oophorectomy and estrogen substitution on the striated anal sphincter in adult female rats.

A quantitative histologic analysis of the striated anal sphincter of 24-month-old virgin female rats was performed to evaluate the effect of oophorectomy and estrogen substitution. The oophorectomized rats had a 21% (11-31%, 95% confidence limits) reduction in the cross-sectional area of the striated muscle tissue compared with controls. This was due to a reduction in the mean cross-sectional area of the muscle fiber, whereas the number of fibers was unchanged. Although the relative amount of stromal tissue was increased in the oophorectomized rats, the total stromal tissue was unchanged. No difference in the cross-sectional area of muscle tissue was found between the estrogen-substituted, oophorectomized rats and controls. This indicates that the estrogen depletion in the oophorectomized rats has induced the reduction in muscle tissue in the striated anal sphincter.

Anal Canal↗
PubMed1991

Age-related changes in the striated anal sphincter in female rats. A quantitative morphometric study.

A quantitative histologic analysis of the striated anal sphincter of virgin female rats aged 2 months and 24 months was performed to evaluate age-related changes. A 27% (8% to 46%, 95% confidence limits) increase in the cross-sectional area of the muscle in the older rats was observed compared with the young. This was due to an increase in both muscle and connective tissue. There was hypertrophy of both the small and large muscle fibres without change in the number with age. No evidence of age-related degenerative changes in this muscle in the virgin female rat was found.

Aging↗
PubMed1989

Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis.

The diurnal variation of plasma vasopressin (AVP), urinary excretion rate, urinary osmolality, and serum osmolality was studied twice in 15 patients with enuresis and in 11 age, weight, and sex matched nonenuretic normal subjects. A diurnal rhythm of AVP with constant levels during the day (8 AM-10 PM) and a highly significant increase during the night (10 PM-8 AM) was found in normal subjects. In contrast, enuretics showed a significantly less pronounced nocturnal increase in AVP with significantly lower nocturnal levels than normal subjects. Normal subjects showed a diurnal rhythm in urinary excretion rate reciprocal to urinary osmolality with a low and highly concentrated nocturnal urinary output. In enuretics, however, this normal diurnal rhythm was absent. In conclusion, an abnormal diurnal rhythm of AVP seems to be an important pathophysiological factor in enuresis, explaining the abnormally high nocturnal urinary volume and the low nocturnal urinary osmolality found in these patients.

Adolescent↗