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Biomedical subjects

U Ulmsten

Publications and source records attributed to U Ulmsten.

At least 73 records · Page 4Linked to original sources

Changes in paraurethral connective tissue at menopause are counteracted by estrogen.

OBJECTIVE: To study whether the transition to menopause is accompanied by changes in the paraurethral connective tissue and if these changes are modified by estrogen replacement therapy. STUDY DESIGN: Biopsies were obtained from the paraurethral tissue from 34 women; 12 menstruating, 14 postmenopausal without estrogen treatment, and 8 with estrogen treatment. Collagen concentration and collagen extractability by pepsin digestion were measured. Proteoglycan composition and concentration were analysed using Alcian blue. The mRNA levels for collagen I and III, the small proteoglycans (PGS) decorin and biglycan, and the large proteoglycan versican, were estimated. RESULTS: The paraurethral biopsies consisted of fibrous connective tissue, with collagen fibers as dominating structure. Several proteoglycans were identified; versican, heparansulphate proteoglycans, biglycan and decorin. The small proteoglycan decorin represented 85% of all proteoglycans. The collagen concentration was almost doubled in postmenopausal biopsies compared to premenopausal. The collagen fibril organization was also changed with higher cross-linking after menopause whereas the amount and the composition of the proteoglycans were unchanged. The proteoglycan/collagen ratio was significantly decreased. Estrogen replacement therapy resulted in decreased collagen concentration, decreased cross-linking of the collagen and reversal of the PGS/collagen ratio to almost premenopausal level. The therapy resulted in increased levels of mRNA for collagen I and III which suggests that the changes are due to an increased turnover. CONCLUSION: The decrease in estrogen levels at menopause results in a connective tissue with different qualities after menopause. Estrogen replacement therapy tends to restore the metabolism of the genitourinary connective tissue to premenopausal conditions.

Adult↗

Progesterone, oestradiol and oxytocin and their in vitro effect on maintaining the number of gap junction plaques in human myometrium at term.

Previous studies by electron microscopy and laser confocal microscopy of immunohistochemically stained sections have shown that during pregnancy the extent of gap junction formation in human myometrium is low, but that an increase occurs in the active stages of labour despite a high concentration of progesterone in maternal blood. The present investigation focused on the effect of in vitro exposure of isolated myometrial tissue to progesterone, oestradiol and oxytocin, on the number of gap junction plaques in human myometrium at term. Myometrial biopsies were obtained at term from 13 pregnant women who had an elective caesarean section in the 37th or 40th week of pregnancy. The biopsies were immersed immediately in Hepes buffer and buffer containing 0.5, 5.0 micrograms mL-1 of progesterone, and 0.1 micrograms mL-1 of oestradiol. The muscle biopsies were trimmed under a stereo microscope into strips along the bundles of smooth muscle cells and mounted in tissue baths, superfused with Hepes buffer supplemented with glucose (0.01 mM); subsequently the strips were exposed to buffer containing different concentrations of progesterone, oestradiol and oxytocin. Incubation of the muscle strips for 180 min resulted in a significant decrease of the number of gap junctions (P < 0.01). Neither oestradiol or oxytocin, alone or in combination, had a significant effect on the maintenance of the number of gap junctions. The progesterone concentration of 5.0 micrograms mL-1, combined with oxytocin, and with or without oestradiol has a significantly positive effect on the number of gap junction plaques in strips of human myometrium at term (P < 0.05 vs. buffer alone). The high concentration of progesterone in the superfusion medium during in vitro experiments may be responsible for the maintenance of high numbers of gap junction complexes in term human myometrium. This finding is of interest in the light of findings of persisting high progesterone levels in maternal blood during labour.

Estradiol↗

Steroid hormone effects on intercellular communication between term pregnant human myometrial cells before labor.

The appearance of gap junctions (GJs) between myometrial smooth muscle cells is one of the major events associated with the onset of labor. We have employed dye-coupling and electrical-current injection techniques to study the mechanisms by which steroid hormones regulate GJs in term pregnant myometrium of women before labor. Progesterone (P4) did not alter the input resistance (Ro) of the tissues when added to Tyrode's solution, which was used as control treatment. Octanol, the putative gap junctional uncoupling agent, increased the Ro of the cells compared to the control and P4-treated groups. The membrane potential (Em) did not differ between these groups. However, when P4 was applied after the tissue was perfused with estradiol (E2), the results changed dramatically: the Em hyperpolarized, and the Ro increased. Octanol increased the Ro in E2-treated tissues, but did not affect the Em. Consecutive application of E2, octanol, E2, and P4 resulted in rapid changes in the Ro of the cells. Dye-coupling was mostly detected between cells from controls and E2-treated tissues. These results indicate that P4 exerts its effects in the presence of E2 and that P4 has rapid effects on the intercellular communication between human myometrial cells.

Cell Communication↗

Ultrasonographic measurement of the symphysis pubis: a potential method of studying symphyseolysis in pregnancy.

The width of the symphysis pubis was measured in a skeleton model using slide rule, ultrasonography and x-ray. Ultrasonography gave a 0.5-mm and x-ray a 1.0-mm narrower gap than the slide rule. Further, 15 nonpregnant females undergoing urography volunteered for an extra ultrasonography of the symphysis pubis. The widths of the symphysis as measured from the x-ray exposures and the ultrasonography were compared. Regression analysis gave a regression coefficient of 0.979 and a correlation coefficient of 0.850. Ultrasonography offers at least the same precision as x-ray for assessing the width of the symphyseal gap.

Adult↗

Neutral and cationic amino acids in striated rectus muscle are generally in excess of those in smooth uterine muscle of term pregnant women.

The concentrations of 24 amino acids and four other related compounds were determined in extracts of biopsy specimens from myometrium and musculus rectus abdominis of 10 healthy term pregnant women during elective cesarean sections. The total free amino acid pool did not differ significantly between the two muscle types. There was a myometrial abundance of the two anionic amino acids glutamate and aspartate and the two aromatic amino acids tyrosine and phenylalanine, but most neutral and cationic amino acids in striated skeletal muscle tissue were found in excess of those in uterine muscle tissue.

Adult↗

Effects of estradiol and interaction with progesterone or oxytocin on term human myometrial contractile activity.

BACKGROUND: To investigate the effects of estradiol (E2) alone and in combination with progesterone or oxytocin on contractile activity of term human myometrium in vitro. METHODS: Myometrial specimens were obtained from 24 term pregnant women not in labor who underwent elective cesarean. Biopsies were kept in ice-cold and oxygenated Hepes buffer and buffer containing different hormonal solutions. The biopsies were dissected and mounted in tissue baths at 37 degrees C and isometric tension was recorded. RESULTS: (1) Estradiol at 0.1 and 1 microgram/mL increased the contractile frequency (p < 0.01 for each), decreased the tonus (p < 0.05 and p < 0.01) and suppressed the activity area of contractions (p < 0.05 and p < 0.01) as compared to control. (2) No significant differences in frequency and activity area of contractions between strips superfused with E2 plus progesterone and progesterone alone were recorded. Myometrial tonus was decreased by 0.1 microgram/mL or 1 microgram/mL E2 plus progesterone as compared to progesterone alone (p < 0.05 and p < 0.01). (3) There were no significant differences in frequency between strips superfused with E2 plus oxytocin and oxytocin alone. Myometrial tonus was decreased by 0.1 microgram/mL or 1 micrograms/mL E2 plus oxytocin as compared with oxytocin alone (p < 0.05 and p < 0.01). Estradiol at 0.1 microgram/mL or 1 micrograms/mL plus oxytocin reduced the activity area of contractions compared to oxytocin (p < 0.05 and p < 0.01). CONCLUSIONS: These data suggest that E2 had both stimulatory and inhibitory effects on term human myometrial contractility and that E2 altered the myometrial response to progesterone and oxytocin mainly by decreasing tonus.

Adult↗

A national center for sexually abused women in Sweden.

Sexual violence is a significant global problem. The unequal power between men and women is considered to be the main reason for violence against women. Women who are exposed to sexual assault are great consumers of medical and social care. The Swedish government has reacted to the problem by establishing an expert center for battered and raped women. The center has three main tasks: treatment in a professional and empathic way; research into and development of medical and psychosocial treatment of patients and the underlying causes of sexual violence; education and information of the general public.

Adult↗

X-ray microanalysis of myometrium in parturient women at term.

The purpose of this study was to investigate the elemental composition of myometrial cells from term parturient women with normal and dysfunctional labour. Myometrial biopsies were obtained from forty-four term pregnant women undergoing Cesarean section. The patients were categorized according to uterine activity as follows: before labour, normal labour, labour successfully augmented by oxytocin, oxytocin-resistant labour, and labour arrested by terbutaline. X-ray microanalysis of freeze-dried sections (16 mu m thick) of the myometrium was carried out. An increase in intracellular phosphorus level (p < .01) was noted in the normal labour group compared to before labour. In patients with normal labour, higher phosphorus (p < .009) and potassium (p < .005) were found compared to oxytocin resistant labour. Patients with oxytocin resistant labour had lower intracellular potassium (p < .0006) and phosphorus (p < .02), and higher chloride (p < .05) and sodium (p < .03) compared to levels found in patients who responded to oxytocin treatment. In dysfunctional (oxytocin-resistant) labour the ion distribution in the myometrial cells might be disturbed. The reduced level of potassium and phosphorus together with the high sodium and chloride levels found in patients with oxytocin resistant labour may be connected to an impairment in sodium-potassium pump and muscle dysfunction, clinically diagnosed as dystocia.

Biopsy↗

Urethral pressure increase on effort originates from within the urethra, and continence from musculovaginal closure.

The aim of the study was to determine the contribution of intra-abdominal pressure transmission to urinary continence in the female. Five patients with genuine stress incontinence (GSI) were studied. Pressure transmission was measured in equivalent positions inside and outside the urethra and bladder during the Intravaginal Slingplasty procedure, a surgical operation used for treatment of urinary incontinence, and performed under local anaesthesia. A 6 mm diameter channel was created alongside the urethra. Two separate microtransducer catheters appropriately marked for length were inserted, one inside the urethra, and the other inside the described channel. With the vaginal hammock intact, an average of 10 simultaneous pressure measurements were made intraoperatively in response to coughing and straining in equivalent positions inside the urethra, and directly outside. Significantly higher pressure readings were found inside the urethra (P = 0.0025), indicating that an active component within the urethra may have created this pressure rise. After opening out two suburethral vaginal flaps, large quantities of urine were lost on coughing in all patients. Continence was achieved on tightening the suburethral vagina, indicating that an adequately tight vaginal hammock is a critical element in the continence process. The findings of this study question intraabdominal pressure as a mechanism contributing to continence, but support an alternative mechanism, musculovaginal closure of the urethra.

Aged↗

Dye-coupling between term pregnant human myometrial cells before labor: carboxyfluorescein versus lucifer yellow.

Term pregnant human myometrial cells in whole mounts were microinjected by pressure with the fluorescent probes Lucifer Yellow and carboxyfluorescein. Tissues obtained from acute and elective sections displayed weak dye-coupling when injected with Lucifer Yellow. Injection of carboxyfluorescein into cells from the elective sections resulted in a more extensive dye-coupling than that observed with Lucifer Yellow. These results indicate that term pregnant human myometrial cells are metabolically coupled before labor and carboxyfluorescein is superior to Lucifer Yellow in detecting the coupling.

Cell Communication↗

Effects of an implant of nomegestrol acetate, a 19-nor-progesterone derivative, on thyroid function.

This study was undertaken to assess tri-iodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), T3 uptake, free T3 and free T4 in nomegestrol acetate implant (Uniplant) users. A total of eighteen volunteers of reproductive age who wanted to avoid conception were enrolled in the study. All subjects were investigated before starting treatment. Blood samples for hormonal analysis were taken prior to insertion of the implant. Thereafter, blood samples were drawn at 3, 6, 12, 18 and 24 months of Uniplant use. All subjects had used non-hormonal contraceptives for at least 6 months prior to insertion of the implant. The results observed in this study showed that there was no significant difference in tri-iodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) during two years of Uniplant use. No significant difference was found in free T3 levels during two years of Uniplant use. A significant decrease was observed in T3 uptake (p < 0.05) in month 24 and in free T4 (p < 0.05) in month 3 of Uniplant use. All changes observed in this study were inconsistent and all levels were within the normal range.

Adult↗

Energy economy of human uterine muscle strips under different in vitro conditions and its dependence on tissue redox potential.

OBJECTIVE: To study the energy economy of human myometrium in vitro. STUDY DESIGN: Myometric biopsies were kept for 10 min or 4 h in a buffer solution at +4 degrees C before preparation into 'early' and 'late' strips, respectively. The strips were perifused at +37 degrees C for different periods of time. Adenylates, energy charge (EC), adenosine and NAD+ were determined in individual strips. RESULTS: Mean EC and ATP values were low, the 'late' strips displaying 5% and 20% lower values than the 'early' strips, respectively. During perifusion the EC increased slightly, ADP decreased significantly and the strips began to contract. A correlation fitting a multiplicative function was evident between EC and NAD+ (r = 0.89, P < 0.001). CONCLUSION: Human myometrium, being operative at an unusually low EC level, maintained its energy economizing and contractile functions in vitro for 4 h, displaying a tight relationship between EC and NAD+, suggestive of a compromised energy balance.

Adenosine Diphosphate↗

Different energy metabolite pattern between uterine smooth muscle and striated rectus muscle in term pregnant women.

OBJECTIVE: To study the energy metabolite pattern in term pregnant myometrium and to compare it with that of a striated skeletal muscle. STUDY DESIGN: Metabolites of carbohydrates, triglycerides and nucleotides were determined in biopsies from myometrium and rectus abdominis muscle from ten healthy term pregnant women before onset of labour. The metabolite concentrations in the two types of muscle were compared by two tailed Student's t-test for paired values and correlations were calculated by Pearsson's correlation test. RESULTS: Comparison of the two muscle types revealed a higher concentration of glucose and a higher lactate/pyruvate ratio in the myometrium but a lower concentration of triglyceride metabolites. Adenosine was found in 36-fold higher concentration in the uterine compared with the rectus muscle and an inverse relationship between adenosine and glucose concentrations was observed in the myometrium. CONCLUSION: The results indicated that the pregnant uterine smooth muscle utilized glucose as the principal nutritive metabolite rather than lipids and that the anaerobic pathway of the glucose metabolism was more active in the myometrium compared with the striated rectus muscle. Also, it is suggested that glucose has a critical role as the principal fuel for ATP formation and the involvement of the adenylate kinase and 5'-nucleotidase reactions in any event of glucose shortage.

Adult↗

The prevalence of urogenital symptoms in postmenopausal women.

Lower urogenital tract disorders, such as vaginal athropy, urethritis, dyspareunia, recurrent urinary tract infections and urinary incontinence symptoms, are more prevalent in postmenopausal women. While these disorders are attributed to the ageing process as well as estrogen deficiency, knowledge of the relationship between estrogen status and symptomatology is scarce and hard to investigate due to the complexity of the problem. Little is known about the epidemiology of urogenital symptoms and their relationship to estrogen status and treatment. Studies of the prevalence of urogenital symptoms in postmenopausal women have been rare and results divergent. Through reviewing existing literature and relating findings to our own prevalence studies of 61-, 71- and 81-year-old women, we can conclude that many of the symptoms accounted for in our study are those known to be due to the loss of estrogen and easily dealt with by estrogen therapy. However, there is a need for more adequate information about postmenopausal symptoms and the effect of estrogens, as only a minority of postmenopausal women are currently treated.

Aged↗

The effects of nomegestrol acetate subdermal implant (Uniplant) on carbohydrate metabolism, serum lipoproteins and on hepatic function in women.

This study was undertaken to assess possible variations in body weight, blood pressure, fasting glucose, HbA1C, insulin, total cholesterol, HDL-C, LDL-C, triglycerides, SGPT, SGOT, GGT and bilirubin in women bearing a single subdermal Silastic implant containing 55 mg (10%) of nomegestrol acetate during two years. A total of eighteen volunteers of reproductive age who desired to avoid conception were enrolled in this study. Subjects were healthy women with no contraindications to hormonal contraception. All women were investigated before starting treatment and were followed up for one year. At the end of one year the capsules were removed and a new capsule was inserted. Fasting blood samples were drawn at 8:00 to 8:30 am twice prior to implant insertion and then at the first, third, sixth and twelfth months and every six months thereafter. Body weight increased from 54.9 +/- 1.5 kg at admission to 55.3 +/- 2.0 kg at 12 months of use (p < 0.05) and to 56.0 +/- 2.7 kg at 24 months of use. A slight increase in both systolic and diastolic blood pressure was recorded at month 12 (p < 0.01). At month 24, blood pressure was not significantly different from admission values. All levels were within the normal range. Insulin, HbA1C, LDL-C and GGT remained unchanged during twenty-four months of Uniplant use. A significant decrease in total cholesterol (p < 0.05) was observed in the third month while a significant decrease in HDL-C (p < 0.01) was observed only in the sixth month of Uniplant use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗