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Biomedical subjects

U Ulmsten

Publications and source records attributed to U Ulmsten.

At least 235 records · Page 13Linked to original sources
PubMed1980

Effects of oestradiol and combined norephedrin and oestradiol treatment on female stress incontinence.

Thirteen postmenopausal stress incontinent women were treated with oestradiol for one month, and then with oestradiol in combination with norephedrine or placebo according to a double-blind, cross-over schedule. Therapeutic results were assessed by measuring changes in urethral closure pressure profile (UCPP) by means of micro transducer catheters, and by the patient's subjective assessment of the effects. Oestradiol had no effect on the symptom stress incontinence or on UCPP. Norephedrine in combination with oestradiol had a statistically significant therapeutic effect on the symptoms of the patients, and increased UCPP. However, the combination did not increase UCPP more than did norephedrine alone.

Adult↗
PubMed1980

Factors maintaining the intraurethral pressure in women.

To determine the components of the intraurethral pressure at rest, five continent women were studied with simultaneous urethrocystometry, including urethral pressure profile measurements, before, during and after curarization, as well as after clamping of the arterial blood supply to the urethra. The results showed that the striated muscle component in the urethra and pelvic floor is responsible for one-third of the total intraurethral pressure. Another one-third is exerted by the urethral vascular bed. The remaining one-third is most probably attributable to the smooth musculature and connective tissues in the urethra and the periurethral tissues.

Adult↗
PubMed1980

Estrogens and postoperative thrombosis evaluated by the radioactive iodine method.

Women who were to be operated upon for prolapse of the uterus were treated preoperatively with estrogens for atrophic vaginal mucosa and examined postoperatively by the 125I-fibrinogen uptake test and phlebography. Among 11 women who received 50 micrograms of ethinyl estradiol daily for three weeks, fibrin deposits were found in six. Of eight women receiving 200 micrograms daily for 12 days, such deposits developed in four. Corresponding figures for the control group were 18 of 157, p < 0.001. Estrogens, therefore, should not be given preoperatively, and those patients treated with preparations containing estrogens should have such therapy discontinued preoperatively.

Estradiol↗
PubMed1980

Termination of pregnancy in patients with missed abortion and intrauterine dead fetuses by a single intracervical application of prostaglandin E2 in viscous gel.

To terminate pregnancy 15 women with an established diagnosis of missed abortion or intrauterine dead fetuses were treated with 1.0 mg Prostaglandin E 2 in viscous gel applied as a single intracervical dose. -- Abortion was induced after a mean of 7.0 hours in 8 patients with a mean gestational age of 15.0 weeks, and a subsequent evacuation of the uterine cavity was easily performed. -- Complete abortion/delivery was obtained in 7 patients with a gestational age of 33 weeks. The over-all mean induction/delivery time was 7.5 hours. -- Apart from pain related to uterine contractions no side effects were observed and no complications occurred. It is concluded that the present technique represents a promising alternative in the treatment of patients with missed abortion or intrauterine dead fetuses.

Abortion, Missed↗
PubMed1979

Trial of the calcium antagonist nifedipine in the treatment of primary dysmenorrhoea.

The effect of the calcium antagonist, nifedipine, on menstrual pain was investigated in 40 women with severe, primary dysmenorrhoea and 36 of them were observed over 3 consecutive menstrual cycles. Twenty-six patients experienced good pain relief, 10 moderate relief and 4 reported no benefit. The frequency of symptoms associated with menstrual pain was not reduced. Fifteen women regularly suffering from migraine during the menstrual period reported increased headache after intake of the drug. Due to this side effect four of these patients did not continue treatment for more than one cycle. All patients had transient facial flushing occurring 15--30 min after drug intake; this was well tolerated. An increase in pulse rate was also invariably found. However, only 5 patients complained of palpitations. Twenty-five of the 36 women completing the three-month trial wanted to continue nifedipine therapy regularly. It is concluded that calcium antagonists like nifedipine can be used for treatment of severe primary dysmenorrhoea, and that further evaluations of these drugs are indicated.

Adolescent↗
PubMed1979

Inhibition of prostaglandin-induced uterine activity by nifedipine.

The effects of the calcium antagonist, nifedipine, on uterine activity induced by prostaglandins F2 alpha (PGF2 alpha) and E2 (PGE2) were studied in women undergoing therapeutic midtrimester abortion, and in patients with a missed abortion in the 16th to 27th week of pregnancy. In the five subjects receiving intra-amniotic PGF2 alpha (25 to 40 mg) for midtrimester abortion, nifedipine (30 mg orally) decreased uterine activity from a mean of 372 to 203 Montevideo Units. The effect on the intensity of the contractions was pronounced; frequently and basal tone were little affected. In patients with missed abortion, uterine contractions were induced by extra-amniotic application of PGE2 (0.5 to 1.5 mg) in a viscous gel. The activity was often more irregular than that in the women receiving intra-amniotic PGF2 alpha. However, nifedipine (30 mg orally) had a marked inhibitory effect on the uterine contractions. It is concluded that nifedipine can be used for treatment of uterine hyperactivity induced by prostaglandins. Combined treatment with beta 2-adrenoceptor stimulants might be considered.

Abortion, Therapeutic↗
PubMed1979

Relaxant effects of nifedipine on isolated, human myometrium.

Myometrial tissue was obtained from non-pregnant women subjected to hysterectomy because of various gynaecological disorders, and from women undergoing caesarean section. Strip preparations were dissected and isometric tension was recorded. Nifedipine (2.9 X 10(-8)--2.9 X 10(-6)M) inhibited spontaneous contractile activity, mainly by reducing the amplitude of contraction in both non-pregnant and pregnant myometrium. The drug also inhibited potassium induced contractions in a concentration dependent manner. This effect seemed to be more pronounced in pregnant than in non-pregnant tissue. In preparations of pregnant human myometrium, normally polarized or potassium depolarized, oxytocin induced a contractile activity that was effectively inhibited by nifedipine. Nifedipine also relaxed contractions induced by vasopressin in isolated non-pregnant myometrium. It is concluded that the relaxant effect of nifedipine on isolated pregnant and non-pregnant human myometrium can be explained by inhibition of calcium influx. The results thus support the view, that calcium influx is an important step in the initiation of contractile activity in human uterine smooth muscle.

Adult↗
PubMed1979

Combined urethrocystometry and cinefluorography in continent and incontinent women.

Intravesical and intra-urethral pressures were recorded in 5 continent women and 10 women with urinary stress incontinence using combined urethrocystometry and cinefluorography. At rest, two types of stress incontinence could be recognized; one involved widening of the proximal urethra and the other did not. Under stress, the proximal urethra was rather mobile in the incontinent women. Artifacts caused by axial movement of the urethral microtransducer were eliminated by fixation of the catheter against the external meatus.

Adult↗
PubMed1979

Effects of nifedipine in women with unstable bladders.

A study of the effect of the calcium antagonist nifedipine on the detrusor contractions of 10 women with an unstable bladder is reported. An inhibiting effect was observed in all patients after intake of nifedipine. The number of contractions and the contraction amplitudes decreased, and the bladder capacity increased. Resting intraurethral and intravesical pressures were not affected. Subjective improvement was reported by all patients during a week of continuous nifedipine treatment. Side effects were few and tolerable. It is suggested that nifedipine can be of value in the treatment of unstable bladder.

Adolescent↗
PubMed1979

Determination of myometrial tension during labor by combined microtransducer IUP-rcording and ultrasonic examination of the uterine cavity.

In twelve women, in whom labor was induced by oxytocin infusion, intra-uterine pressure (IUP) was recorded by micro-transducers, and simultaneously the diameter of the uterine cavity was estimated by means of ultrasound. Myometrial tension was calculated according to the law of Laplace. In the ten women who were delivered within eight hours after the start of induction, myometrial tension was clearly higher than in the two in whom induction failed. No technical problems were encountered during the registrations, which in some cases lasted for more than five hours. It is suggested that with the described technique, a more accurate determination of myometrial activity is possible than with the generally used methods for IUP recording. The technique might facilitate evaluation of drug effects on the uterus during labor, and improve the IUP-part of intrapartum clinical monitors.

Adult↗
PubMed1979

Multichannel intrauterine pressure recording by means of microtransducers.

Intrauterine pressures (IUP) were recorded simultaneously at the fundus, the isthmus, and cervix uteri by means of three micro-transducers (in 20 healthy, nonpregnant women, and in 5 patients with severe, primary dysmenorrhoea). Recordings were performed during the first 3 days of the menstrual cycle. Both incoordinate and coordinated myometrial activity was recognized. When coordination was present, the contraction wave as a rule started in fundus and was propagated towards the isthmus and cervix. Pinching and/or palpation of the cervix elicited retrograde contractions, i.e. the contraction wave started in the cervix and moved towards the fundus. It was frequently observed that during vigorous contractions of the fundus, the pressure increase in the isthmus was small; in some cases even a decrease in pressure occurred in this region. The pressure recording technique functioned perfectly during all recordings and seems to facilitate detailed studies of myometrial activity in the non-pregnant uterus.

Adult↗
PubMed1979

Aspects on ripening of the cervix and induction of labor by intracervical application of PGE2 in viscous gel.

In this survey the effect of intracervically applied prostaglandin E2 (PGE2) on the pregnant uterus is outlined. It is concluded that PGE2 decreases cervical resistance and stimulates the myometrium to contract. In small doses (0.25 mg and 0.5 mg) PGE2 produces a rapid and prominent ripening of the cervix without systemic side effects and indepedent of prominent uterine contractions. Prostaglandin E2 applied intracervically in viscous gel seems to be superior to previously used methods for treatment of patients with an unfavorable cervical state.

Abortion, Induced↗
PubMed1979

Ripening of the cervix and induction of labor in patients at term by single intracervical application of prostaglandin E2 in viscous gel.

Prostaglandin E2 (PGE2) suspended in a viscous gel was deposited intracervically to 115 patients at term with an unripe cervix. 45 of these patients were given a single dose of 1.0 mg PGE2, whereas the remaining 70 received only half that dose, i.e. 0.5 mg. Irrespective of dose greater than 60 per cent of the patients were induced into labor and delivered without further stimulation within less than 24 hours. The mean induction delivery time was 10 hours. In the remaining patients a considerable ripening of the cervix was registered. Hypercontractility did occur in one patient given 1.0 mg PGE2, otherwise no maternal side effects were observed. There were no adverse effects on the fetuses. The number of instrumental deliveries was 19 per cent including 9 per cent cesarean sections. It is concluded that locally applied PGE2-gel can be used to produce ripening of the cervix and/or induce labor in patients at term with an unripe cervix. Since there was practically no difference in efficiency between the two doses but one case of hyperstimulation in patients given 1.0 mg PGE2, the smaller dose, i.e. 0.5 mg is recommended.

Adolescent↗
PubMed1979

Ripening of the cervix by intracervical application of PGE2-gel before termination of pregnancy with dilatation and evacuation.

In a randomized double-blind study a viscous gel, containing 0.25 mg prostaglandin E2 (PGE2-gel) or without prostaglandin (placebo gel), was applied intracervically in twenty-two nulliparous patients just before termination of early pregnancy by dilatation and evacuation (D & E). Within twelve hours a marked ripening of the cervix was found in all the eleven patients receiving PGE2-gel. Thus, a significant change in cervical dilatation from mean 5.4 mm to mean 10.7 mm occurred. Furthermore, a considerable softening of the cervix was registered. In the eleven patients receiving placebo gel, no significant changes in cervical dilatation or consistency were found. The subsequent D & E was easily performed in all patients treated with PGE2-gel. However, in three of the patients given placebo gel, D & E was difficult to carry out because of an unfavorable cervical state. To eliminate or decrease myometrial activity the calcium antagonist nifedipine was given orally to eight patients at application and five hours after application of 0.25 mg PGE2-gel. None of the patients recognized uterine contractions. However, also in these patients significant changes in cervical consistency and dilatation occurred within twelve hours. No side effects of the treatment were observed. It is concluded, that a preoperative, intracervical single application of 0.25 mg PGE2 seems to be useful to ripen the unfavorable cervix before subsequent termination of early pregnancy by D & E.

Abortion, Induced↗
PubMed1979

A new gel for intracervical application of prostaglandin E2.

A new gel-formulation for intracervical application of prostaglandin E2 (PGE2) has been prepared. As a vehicle for the gel a cross-link starch polymer is used. PGE2 substance is added to the starch polymer and after homogenization and lyophilization a PGE2 powder is obtained. The powder can be stored at room temperature for more than four months without inactivation of the prostaglandin. Before clinical application a few ml of saline is added to the powder giving, within 30 seconds, an easily-handled ready to use PGE2-gel. Chemical analysis by spectrophotometric technique reveals that the amount of unchanged PGE2 is the same in the new gel-formulation as in a conventional cellulose gel. In a randomized double-blind study the new PGE2-gel was intracervically applied to twenty nulliparae before abortion by dilatation and evacuation (D & E). Ten women were given a gel containing 0.25 mg PGE2 (PGE2-gel) and ten a gel without PGE2 (placebo gel). It was found that the PGE2-gel, in contrast to the placebo gel, produced a rapid ripening of the cervix facilitating the subsequent D & E. No adverse systemic or local reactions were found during or after the treatment.

Abortion, Induced↗
PubMed1979

Initiation of micturition: a study of combined urethrocystometry and urethrocystography in healthy and stress incontinent females.

Six continent and 4 incontinent females were examined by a combined technique of simultaneous urethrocystometry and rapid X-ray-film exposures. The study confirmed that pressure changes occurring in the urethra and bladder at initiation of voiding were not caused by artefacts of the measuring technique. It was found that the continent females initiated micturition mainly by a rapid decrease in urethral pressure followed by an increase in the bladder pressure. The stress incontinent females strained out the urine without initial urethral relaxation. Since the X-ray-technique did not add any new clinical information about micturition in females the pressure recording technique is recommended for routine investigation of micturition in females.

Adult↗