[Neonatal viral meningitis--experiences from an epidemic in Malmö].
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Cross Infection↗
Biomedical subjects
U Ulmsten
Publications and source records attributed to U Ulmsten.
Treatment of normotensive and hypertensive patients with preterm labor using oral nifedipine, a calcium antagonist.
The calcium antagonist nifedipine was tried on 28 patients with preterm labor. In eight patients the disorder was also accompanied by hypertension. In 80% of the patients delivery could be postponed for more than 3 days during which time corticosteroids were given to accelerate fetal lung maturation. On average, delivery occurred 12 days after start of treatment (delay beyond 36 weeks gestation not being included in the calculations). All patients with increased blood pressure were normotensive within 12 h of the start of treatment. There were no serious maternal or fetal side effects and no perinatal deaths. At 2 and 6 months after delivery all women were normotensive and all children were alive and well.
Adult↗
Intravaginal versus intracervical application of prostaglandin E2 in viscous gel for cervical priming and induction of labor at term in patients with an unfavorable cervical state.
Sixty term pregnant women with unripe cervix were randomly given either 0.5 mg of prostaglandin E2 (PGE2) in 2 ml of gel intracervically or 4 mg of PGE2 in 3 ml of gel intravaginally to prime the cervix and/or to induce labor. In patients with a highly unfavorable cervix (cervical score less than or equal to 3), the intracervical application was significantly more effective than the intravaginal. In patients with a more favorable cervical state (cervical score 4 or 5), the two routes of application were equipotent. Gastrointestinal side effects were registered after intravaginal but not after intracervical application. Myometrial activity was significantly more increased after intravaginal than after intracervical gel application. All children were born in good condition with an Apgar score greater than 7 within 5 minutes.
Adult↗
Ripening of the human uterine cervix related to changes in collagen, glycosaminoglycans, and collagenolytic activity.
Connective tissue in biopsy specimens taken from the lower part of the uterine cervix in 40 pregnant women at various gestational ages was compared to that in similar biopsy specimens from 15 nonpregnant women. The concentrations of collagen, sulfated glycosaminoglycans, and hyaluronic acid decreased during pregnancy. At the gestational age of 10 weeks, the collagen concentration was 70%, and at term 30%, of that in the nonpregnant cervix. After delivery, no further decrease was observed. The extractability of collagen increased during pregnancy, as well as during labor. Also, the water concentration increased. An increase in the collagenolytic activity was observed with advancing gestational age. The 2,4-dinitrophenyl-Pro-Gln-Gly-Ile-Ala-Gly-Gin-D-Arg hydrolytic activity (collagenase) and the concentration of leukocyte elastase increased gradually by a factor of 10. The physiologic importance of the collagen was also demonstrated, since the cervical dilatation time during spontaneous labor was long in women with high concentrations of collagen and short in women with low concentrations of collagen.
Adult↗
Isolation and characterization of human cervical-mucus glycoproteins.
Mucus glycoproteins (mucins) were extracted from human cervical pregnancy mucus by 6 M-guanidinium chloride in the presence of proteinase inhibitors. Purification was subsequently achieved by isopycnic density-gradient centrifugation in CsCl/ guanidinium chloride gradients. The purified macromolecules represented approx. 85% of the total and were devoid of nucleic acids and proteins, as judged by analytical density-gradient centrifugation, disc electrophoresis and u.v. spectroscopy. Sedimentation-velocity centrifugation revealed a single unimodal peak with S20,W 50.1S in 0.2M-NaCl and 37.0S in 6 M-guanidinium chloride. Molecular weights obtained by light-scattering were 9.7 X 10(6) and 5.9 X 10(6) in 0.2M-NaCl and 6 M-guanidinium chloride respectively. The chemical analyses were typical of those of epithelial mucins. The macromolecules contained approx. 20% (w/w) of protein, and 65% (w/w) was accounted for as carbohydrate. Serine and threonine constituted 32 mol/100 mol and proline 10 mol/100 mol of the amino acids. The major sugars found were N-acetylglucosamine (12.8%), N-acetylgalactosamine (9.7%), galactose (18.7%), sialic acid (15.0%) and fucose (7.5%).
Amino Acids↗
Isolation and characterization of dermatan sulphate proteoglycan from human uterine cervix.
Proteoglycans were extracted from human uterine cervix with 4 M-guanidinium chloride in the presence of proteinase inhibitors. They were purified by density-gradient centrifugation in 4 M-guanidinium chloride/CsCl (starting density 1.32 g/ml) followed by DEAE-cellulose and Sepharose chromatography. Only one polydisperse proteoglycan was found. s020,w was 2.1S and the weight-average molecular weight was 73 000 (sedimentation-equilibrium centrifugation) to 110 500 (light-scattering). The core protein was monodisperse, with an apparent molecular weight of 47 000. The proteoglycan contained about 30% protein and probably two or three glycosaminoglycan side chains per molecule. High contents of aspartate, glutamate and leucine were found. The glycan moiety of the proteoglycan was exclusively dermatan sulphate, with a co-polymeric structure with approximately equal quantities of iduronic acid- and glucuronic acid-containing disaccharides.
Aged↗
Experience with an industrially manufactured gel PGE2 for cervical priming.
An industrially manufactured ready-to-use PGE2 gel for cervical ripening was clinically evaluated. The study included 42 primiparous and eight multiparous women with an unfavourable cervix (Bishop score less than or equal to 5) admitted to hospital for induction of labour on medical grounds. PGE2, 0.5 mg, in 2 ml triacetin gel was instilled into the cervical canal. In nine patients (18%) the gel induced labour and subsequent delivery. In the remaining women the mean Bishop score increased from 3.0 to 7.7 during a 24-h period and labour was induced by either i.v. oxytocin or PGF2 alpha. None of the 50 patients experienced gastrointestinal side effects during pretreatment with PGE2. In 50% of the patients slight uterine contractility was noticed. All patients went into labour. The incidence of Cesarean section was 10%. Except for two patients treated because of intrauterine fetal death there was no perinatal mortality. The 5-min Apgar score was 8 or more in all newborn but 1. The main advantage of the new gel is that it is ready to use without any mixing procedure. Moreover, the stability of PGE2 is sufficient to allow routine clinical use.
Adolescent↗
Intracervical application of PGE2-gel combined with early intravenous infusion of oxytocin for induction of term labor in women with unripe cervix.
Fifty-four women with an unripe cervix at term were given 0.5 mg intracervical prostaglandin E2 (PGE2) gel. In 37 of them (70%) the cervix ripened within 5 h and seven of them were in labor at that time. Of the remaining 30 patients, 15 were randomly given an i.v. oxytocin infusion and 13 were delivered within 12 h. In 17 women (30%) the cervix was still unfavorable 5 h after PGE2-gel application but seven of them had a favorable cervix when reassessed 24 h after PGE2-gel instillation. All these patients went into labor with an i.v. infusion of oxytocin. The remaining 10 patients required another dose of PGE2-gel and subsequent i.v. oxytocin. Only in two of these patients did induction fail so that delivery by Caesarean sections was required. All infants were born in good condition.
Administration, Topical↗
Intracervical instillation of PGE2-gel in patients with missed abortion or intrauterine fetal death.
A single intracervical instillation of prostaglandin E2 (1.0 mg or 0.5 mg in viscous gel) was given to dilate the cervix before dilatation and evacuation in patients with missed abortion or intrauterine fetal death in late pregnancy. The 1.0-mg dose of PGE2 gave more prominent cervical dilatation in early pregnancy. In late pregnancy 1.0 mg PGE2 induced labor in the majority of patients and with shorter induction delivery time than in patients given 0.5 mg PGE2. There was no uterine hypertonus and no patients complained of gastrointestinal symptoms. We conclude that intracervical instillation of 1.0 mg of PGE2 in viscous gel is a safe and effective method both for dilating the cervix before dilatation and evacuation and as a method of inducing labor in patients with intrauterine fetal death.
Abortion, Missed↗
Depth localization of thrombi and dynamic studies of postoperative thrombosis using the 125I-fibrinogen-sum-coincidence method.
Forty-one patients subjected to gynecologic surgery were investigated by means of the 125I-fibrinogen-sum-coincidence (FSC) method, which allows depth determination as well as absolute activity measurements of the thrombi. In 14 patients with postoperative deep venous thrombosis there was a good correlation between the depths of thrombi measured on phlebograms and those determined by the FSC test. The new technique allows differentiation between superficial thrombophlebitis and deep venous thrombosis, thereby eliminating the main disadvantage that has limited the use of the original fibrinogen uptake test. The FSC test makes it possible to calculate the absolute net activity of 125I-fibrinogen in a thrombus and to measure its elimination rate. The courses of individual thrombi could be followed up for as long as 1 month after surgery.
Female↗
The ripening of the human uterine cervix in terms of connective tissue biochemistry.
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Cervix Uteri↗
Pharmacology of labor.
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Adrenergic beta-Agonists↗
Local application of prostaglandin E2 for cervical ripening or induction of term labor.
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Cervix Uteri↗
Dynamic urethrocystography in women.
A technique for video urethrocystography in women is described and evaluated from the results of examinations on 76 subjects. The patients were examined seated in the lateral position and investigations were carried out at rest, and during straining and coughing, micturition and holding-back maneuvers. Special attention was paid to the overall morphology and the position of the bladder base, the bladder neck and the urethra. Apart from the contour of the symphysis, which in some patients was difficult to identify, the various structures were easily displayed. Also the dynamics of the function of the bladder base, the bladder neck and the urethra were visualized. Almost all patients were able to carry out all parts of the examination including micturition without difficulty. TLD dosimeters in the vagina and uterus showed a low radiation dose to the ovaries.
Adult↗
Dermatan sulphate and mucin glycopeptides from the human uterine cervix.
High molecular weight glycopeptides and glycosaminoglycans were isolated from the human uterine cervix. The major part of the material (82%) was derived from cervical mucins. The remainder contained hyaluronic acid (3%), heparan sulphate (2%) and dermatan sulphate (13%). Chondroitin sulphate and keratan sulphate were not present, but chondroitin sulphate-like segments were included in the dermatan sulphate. The composition of the cervix apart from the mucus-filled crypts is similar to that of other fibrous connective tissues.
Adult↗
Increased postpartum collagenolytic activity in cervical connective tissue from women treated with prostaglandin E2.
Cervical biopsies obtained from 7 patients immediately following parturition induced by intracervical application of 0.5 mg prostaglandin E2 (PGE2) in viscous gel were compared with similar biopsies from 11 spontaneously delivered women. A DNP-peptide hydrolytic activity (collagenase) was significantly increased in cervical tissue from the PGE2-induced patients compared with controls. In patients with prompt clinical response, the increase was nearly twofold. No differences were found in the concentrations of water, sulfated glycosaminoglycans, hyaluronic acid, hydroxyproline or leukocyte elastase. Thus, PGE2-induced cervical priming seems to be associated with an increased collagenolytic activity.
Adult↗
Comparison of the effects of nicardipine and nifedipine on isolated human myometrium.
The effects of nicardipine, a calcium-entry blocker which also has a potent phosphodiesterase inhibitory action, were investigated on isolated human term-pregnant and nonpregnant myometrium, and compared with those of nifedipine. Both drugs relaxed pregnant and nonpregnant myometrial preparations contracted by potassium (127 mM), and also reduced or abolished contractions occurring spontaneously, or induced by prostaglandin F2 alpha, oxytocin and vasopressin. However, the effect of nicardipine had a slower onset of action than that of nifedipine, and the drug was significantly more potent than nifedipine is at least as effective as nifedipine. If the differences between the drugs can be reproduced also in vivo, nicardipine offers an interesting alternative to nifedipine for inhibition of undesired uterine activity.
Adult↗
Biochemical changes in human cervical connective tissue after local application of prostaglandin E2.
Intracervical application of prostaglandin E2 in the late first trimester induces (1) softening of the cervix tissue; (2) increase in sulfated glycosaminoglycans (18 +/- 12%, mean +/- SEM); (3) no change in hyaluronic acid and water; (4) decrease in pepsin-extractable collagen, and (5) apparent decrease in collagenase. A high activity of collagenase in combination with a replacement of collagen with sulfated glycosaminoglycans may be of importance for the ripening process.
Body Water↗