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Biomedical subjects

U Ulmsten

Publications and source records attributed to U Ulmsten.

At least 127 records · Page 7Linked to original sources
PubMed1990

Low energy charge in human uterine muscle.

Six pregnant and 10 non-pregnant patients undergoing Caesarean section and laparatomy, respectively participated in this study which was aimed at determining the energy status of human uterine muscle and comparing it to that of striated muscle from the same individual. Biopsies were taken from the fundus uteri between the ligamenta rotunda and from the rectus abdominis muscle. A low energy charge of 0.55 in pregnant patients and 0.64 in non-pregnant patients was observed in uterine biopsies, compared to the expected value of 0.90 found in rectus biopsies. The main determinant of this finding was a 4-8 times lower level of ATP in uterine biopsies compared to that in rectus biopsies. The same pattern was apparent for total nucleotide content and creatine phosphate. The ADP and AMP contents were of the same order of magnitude in both tissues. The lactate content in uterine biopsies from pregnant patients was significantly higher than that found in biopsies from rectus muscle and from uterine tissue of non-pregnant patients, indicating an increased glycogenolysis in pregnant uterus. The low energy charge and low level of phospho-compounds observed in uterine muscle, regardless of the functional state, are new and unexpected findings.

Abdominal Muscles↗
PubMed1990

Myometrial activity after local application of prostaglandin E2 for cervical ripening and term labor induction.

Twelve pregnant women at term with unfavorable cervices (less than or equal to 5 points according to Bishop score) were given prostaglandin E2 for cervical priming and labor induction. Prostaglandin E2 was given in the following manner: 0.5 mg in gel strictly intracervically (n = 4), extraamniotically (n = 4), or prostaglandin E2 (4 mg) in gel vaginally (n = 4). The myometrial activity was registered over a period of 30 minutes before and at least 3 hours after gel application by means of an extraamniotic microtransducer catheter. After both extraamniotic and vaginal gel application, myometrial activity was significantly increased compared with intracervical application. All the women had favorable cervical states 6 hours after treatment and were delivered vaginally within 24 hours. All infants were delivered in good condition with 1-minute Apgar scores greater than 7. From these results we conclude that proper intracervical prostaglandin E2 gel application, in contrast to extraamniotic or vaginal application, induces cervical ripening without significant myometrial activity. Because careful intracervical application appears to avoid or minimize the risks of myometrial hyperstimulation, this technique should be considered particularly in women with unfavorable cervices and delicate fetuses.

Administration, Intravaginal↗
PubMed1990

The physiology of cervical ripening and cervical dilatation and the effect of abortifacient drugs.

The mechanical properties of the human uterine cervix are determined mainly by the connective tissue component, whereas it is doubtful whether the scanty smooth muscle component is of any physiological importance. Histological and biochemical analyses reveal a fibrous connective tissue similar to that found in skin and tendon. Degradation of the collagen and an increase in some special dermatan sulphate proteoglycans can at least partly explain the pregnancy-associated softening of this connective tissue. Relatively high oestrogen levels seem to be an absolute condition for the process, even when it is induced pharmacologically. Treatment with progesterone-receptor blockers, PGE2, PGF2 alpha or relaxin in pregnancy induce cervical softening as well as histological and biochemical changes which cannot be distinguished from the physiological cervical softening which takes place in late pregnancy. Prostaglandins and relaxin might interact and could include cytokines such as interleukin-1 during the process. The effect of cervical tents cannot be explained only by the radial pressures they exert. Most probably stimulation of local prostaglandin synthesis is also involved.

Abortifacient Agents↗
PubMed1990

Steroid hormone receptors in pelvic muscles and ligaments in women.

Using monoclonal antibody assay techniques estrogen receptors (ER) and progesterone receptors (PgR) were quantitated in female pelvic floor muscles, urogenital ligaments and uterus (myometrium). Receptors were detected in all these structures. In addition qualitative assessment showed distinct nuclear staining in the same structures. ER and PgR were not found in the musculus rectus abdominis with either method. The findings provide a rationale for estrogen treatment in women with urogenital disorders.

Adult↗
PubMed1990

Effect of combined treatment with phenylpropanolamine and estriol, compared with estriol treatment alone, in postmenopausal women with stress urinary incontinence.

Twenty-nine postmenopausal women with slight to severe stress urinary incontinence and estrogen deficiency symptoms in the urogenital tract were treated with estriol, p.o. 4 mg once daily, and either phenylpropanolamine (PPA), p.o. 50 mg twice daily, or placebo for periods of 6 weeks according to a randomized double-blind crossover schedule. At urodynamic recordings the maximum urethral closure pressure increased by 22% with combined treatment (p less than 0.001) and an additional effect of PPA to estriol was shown (p = 0.022). The pressure transmission ratio increased, by about 15%, with both treatments (p less than 0.07). The number of leakage episodes was reduced by 28% with combined treatment (p = 0.007), but not with estriol alone (p = 0.08). Both combined treatment and estriol alone reduced significantly (p less than 0.01) the urinary incontinence complaints. Twelve women (43%) preferred combined treatment, while 7 (25%) preferred estriol alone. In women with initially slight to very severe urine loss, combined treatment reduced also (p = 0.02) the amount of urine loss, measured at a standardized physical stress test. Signs of estrogen deficiency in vulva, vagina and urethra were reduced, 75% (p less than 0.001) or 65% (p = 0.001) with estriol given in combination with PPA or alone. Maturation index of both urethral and vaginal epithelium displayed significant changes. It is concluded that the combined treatment, PPA + estriol, by affecting both the muscular and mucosal factor of the urethra, is more effective than estriol alone for treatment of female stress urinary incontinence in the postmenopausal ages.

Double-Blind Method↗
PubMed1989

Measurement of human cervical compliance.

A critical evaluation of the various methods for the measurement of the compliance of the human cervix uteri was made. The resistance of this tissue to a dilating force was measured by a previously constructed strain gauge instrument equipped with exchangeable Pratt cervical dilators. The dilating resistance offered by the cervical canal was recorded on a polygraph at a constant paper speed. Control experiments in which the dilating instrument was allowed to meet artificial cellulose tissue showed that the peak value recorded was of importance for estimating cellulose tissue resistance. Measurements of the area under the curve were shown to be of minor importance in this system. Using this technique in clinical applications, it was also shown that peak resistance provides the most accurate measurement of human cervical resistance.

Abortion, Induced↗
PubMed1989

Changes in the connective tissue of corpus and cervix uteri during ripening and labour in term pregnancy.

The composition of the connective tissue of human cervix and corpus uteri was studied in tissue specimens from seven nonpregnant women and 14 pregnant women, delivered at term by section, to examine spontaneous cervical ripening and labour-induced changes in both the uterine and the cervical connective tissue. The main finding in both the cervix and the corpus was a large (40-60%) decrease of the collagen concentration. The collagen extractability, obtained by pepsin digestion, was increased twofold, suggesting a change of the organization of the collagen fibrils. This reorganization process could also be demonstrated by a large increase of the collagenolytic activity demonstrated with an artificial DNP-peptide substrate. The concentrations of sulphated glycosaminoglycans was lower in pregnant women than in non-pregnant women. The results show that both the cervix and the corpus uteri contain substantial amounts of connective tissue components (collagen, sulphated glycosaminoglycans and hyaluronic acid) and that during ripening, reconstruction of the connective tissue components occurs in both sites. This indicates that the cervical state reflects that of the myometrium.

Adolescent↗
PubMed1989

Influence of progesterone on the sodium and potassium concentrations of rat uterine fluid investigated by microdialysis.

Currently used techniques to measure the chemical composition of the rat uterine fluid are accompanied by interference with the physiology of the uterus, and the sampling procedure creates a methodological problem as the amount of uterine fluid is small. The aim of the present study was to investigate the utility of a new in vivo technique, microdialysis. A microdialysis probe, which functions as an 'artificial blood vessel' was implanted into the uterine lumen and perfused with a Ringer solution. This perfusion technique makes it possible to study ions and other components in the uterine fluid without withdrawal of any liquid. Compared to previous techniques it offers the advantage of continuous monitoring of the chemical composition of the uterine fluid over time. The sodium and potassium concentrations in the uterine fluid of 10 rats were monitored during oestrous. After 1-2 h of baseline perfusion an intramuscular injection of progesterone was given. The mean sodium concentration was 124.9 +/- 2.4 mEq/l before and increased in all 10 rats to 133.9 +/- 2.3 mEq/l (p less than 0.001) after injection. The mean potassium concentration was 22.3 +/- 2.4 mEq/l before and decreased to 17.9 +/- 2.1 mEq/l (p less than 0.001) after injection. This study proves the validity and applicability of microdialysis to the monitoring of chemicals in uterine fluid and especially to follow dynamic changes.

Animals↗
PubMed1989

Intravenous infusion of 15 methyl-prostaglandin F2 alpha (Prostinfenem) in women with heavy post-partum hemorrhage.

Post-partum hemorrhage is a serious complication in obstetric practice. The aim of this study was to investigate, in vivo, the effects of 15 methyl-prostaglandin F2 alpha (Prostinfenem, Upjohn, Sweden) on uterine activity and hemorrhage. Twenty-seven women were included in the study and, in accordance with our clinical routine, all were given oxytocin (10 IE Syntocinon) intramuscularly immediately after delivery. In cases of heavy bleeding and signs of uterine atony, ethylergometrine (0.2 mg Methergin) and oxytocin (40 i.e. Syntocinon in 500 ml, 5.5% glucose) were administered intravenously. If this therapy failed, the woman was given an intravenous infusion of 15-methyl-prostaglandin F2 alpha (0.25 mg Prostinfenom, in 500 ml, 5.5% glucose). Myometrial activity was quantitated in 5 women by a micro-transducer introduced into the uterine cavity. The treatment resulted in a contracted uterus and cessation of bleeding within 12.5 min (mean). The intra-uterine pressure registered a prompt effect regarding both amplitude and frequency of uterine contractions.

Adult↗
PubMed1988

Relationship between placental shape, cord insertion, lobes and gestational outcome.

Singleton placentas from 330 consecutive births were examined for size, shape, cord insertion, allanto-chorial vascular pattern and lobes. These factors were considered regarding possible interactions and correlation to pregnancy and perinatal outcome. Marginal cord insertion was correlated to extrachorial and bilobate placenta and to magistral wr mixed allanto-chorial vascular pattern. A paucity of lobes (less than 15) was associated with extrachorial placenta, marginal cord insertion, pre-eclampsia, gestational age less than 38 weeks and small for gestational age infants. The common denominator for abnormal configuration and marginal cord insertion seemed to be the paucity of lobes.

Female↗
PubMed1987

Maternal perception of sound-provoked fetal movements as a measure of fetal well-being.

Maternal perception of sound-provoked fetal movements was studied on 613 occasions in 259 risk pregnancies. The response was compared with a non-stress (N-S) test performed immediately after the sound stimulation. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 534 occasions (87%) and was always accompanied by a normal N-S test; sensitivity 100%. An inconclusive (3%) or negative response to sound (10%) had a specificity of 89% and a predictive value for a pathological N-S test of 19%. There was a positive correlation between inconclusive or negative test results and fetal growth retardation (P less than 0.01), fetal hypoxia (P less than 0.05) and neonatal mortality (P less than 0.05). This rapid test may have a place as a simple first-line screening test.

Acoustic Stimulation↗
PubMed1987

Outbreak of coxsackievirus A-14 meningitis among newborns in a maternity hospital ward.

During the late winter of 1983, 16 newborns with vague symptoms of failure to thrive, reluctance to feed and a slight rise in body temperature, were found to have meningitis caused by Coxsackievirus A-14. The cerebrospinal fluid showed pleocytosis with polymorphonuclear cells in excess but was otherwise normal. The clinical course was uneventful in all infants, but two of them demonstrated clinical signs of incipient cerebral oedema during the acute phase of the illness. An electroencephalogram (EEG) during the initial course of the disease and at nine months of age was normal in all. During a follow-up period of 2 1/2 years they all developed normally and no sequelae were noted. The presentation also demonstrates the usefulness of Vero cells for the propagation of the responsible virus.

Coxsackievirus Infections↗
PubMed1987

Evaluation of the urethral mucosa before and after oestrogen treatment in postmenopausal women with a new sampling technique.

Using a new type of nylon brush (Cytobrush) for sampling of cells, the state of the urethral mucosa was evaluated before and after oestrogen treatment in 10 patients suffering from urinary incontinence. In 4 other patients the results obtained were compared with those using the conventional cotton swab technique. The brush specimens were found to be much more cellular and consequently more informative than those obtained with the conventional technique. The cytologic examination based on brush samples also demonstrated that oestrogen treatment within 3 weeks induced a proliferation of the atrophic urethral mucosa in postmenopausal women suffering from urinary incontinence.

Cytological Techniques↗