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Biomedical subjects

B Fredricsson

Publications and source records attributed to B Fredricsson.

At least 37 records · Page 2Linked to original sources
PubMed1989

Bacterial vaginosis is not a simple ecological disorder.

Eighty-four patients with bacterial vaginosis were examined in an open randomized trial, the aim of which was to define clinical results and the microbiological panorama after topical treatment for 1 week with either an acetic acid jelly (A), an estrogen cream (B), a fermented milk product (C) or metronidazole (D). After exclusion because of chlamydia infection (15 cases) or for other reasons, 61 cases remained for complete evaluation 4 weeks after the start of treatment. Clinical cure was obtained in 3 cases out of 17 on regimen A, in 1 out of 16 on regimen B, in 1 of 14 on regimen C, and in 13 out of 14 on regimen D. The patients were conclusively either symptomless or symptomatic when examined on 113 occasions. Statistically significant reduction after treatment resulting in relief of symptoms was observed in the numbers of corynebacteria and anaerobic cocci, whereas lactobacilli increased in numbers. The instillation of high numbers of Lactobacillus acidophilus (C) into the vagina cured only 1 patient and did not influence the predominance of lactobacilli in the vagina at the follow-up examination. The difference in microbiological profile of women in symptomatic and asymptomatic conditions becomes still more apparent when the results of the present and previously published studies on the subject by the present group of investigators are combined. The symptomatic woman is significantly more often harboring corynebacteria, Gardnerella vaginalis, peptostreptococci, peptococci, eubacteria and Bacteroides species. Lactobacilli are significantly reduced in numbers. However, only 51% of our previously symptomatic, but now symptomless women show predominant growth of lactobacilli, which is less than expected for healthy women.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗
PubMed1989

Scheduled intermittent periods of in vitro fertilization treatments.

Organization and results of an in vitro fertilization program at the Huddinge University Hospital are given from its beginning in August 1985: 6 months in advance a scheme is scheduled with 2 weeks open for treatment followed by free intervals of 3-4 weeks. Follicular development is stimulated with clomiphene citrate and hMG, and assessed by analyses of estradiol and LH in serum combined with ultrasound examinations. Following the administration of hCG, eggs are collected by transvesical aspiration guided by ultrasound. The ova are inseminated with about 50,000 motile spermatozoa, and cultured for 48 h. Up to four eggs are transferred transcervically to the uterine cavity. 158 egg pickups have been performed (August 1985 to December 1987) in 106 patients resulting in fourteen intrauterine and two ectopic pregnancies, biochemical pregnancies not counted. This protocol has restricted routine work load allowing these treatments to be part of the clinical routine. It has also allowed the application of research programs and thus optimized limited resources.

Adult↗
PubMed1987

Systemic concentrations of metronidazole and its main metabolites after intravenous oral and vaginal administration.

Metronidazole kinetics was studied in 5 healthy women after a single dose given intravenously, orally or vaginally, 500, 400 and 500 mg, respectively. Serum levels of the drug and of its hydroxy and acid metabolites were assessed. The results after intravenous and oral boluses were consistent with previous reports. After vaginal dose maximum serum levels of about 1 microgram/ml of the drug were obtained between 9 and 24 h after the dose. Maximum concentration of the hydroxy metabolite was about 0.3 microgram/ml after 24 h. Bioavailability of the drug was 19 +/- 3% after the vaginal dose as compared to 100 +/- 5% after the oral dose. Daily insertion into the vagina of 500 mg metronidazole resulted in a maximum serum concentration of 1.2 +/- 0.2 microgram/ml of the parent drug and of 0.6 +/- 0.1 microgram/ml of the hydroxy metabolite after about 3 days (range 2-4) after which no accumulation was noted. Urinary excretion of the metabolites was considerably lower after vaginal than after intravenous or oral administration, but the proportion between the two metabolites in the urine was constant.

Administration, Intravaginal↗
PubMed1986

Increase in progressive motility and improved morphology of human spermatozoa following their migration through Percoll gradients.

Human spermatozoa were separated on the basis of their motility in a discontinuous Percoll-gradient made up in tissue culture medium containing 10% (v/v) human serum (TCMS). Portions of ejaculates were placed on top of the gradients. After 3 h at 37 degrees C the bottom 1.5 ml was collected and the sperm washed free of the Percoll solution by centrifugation at 240 X g after dilution in TCMS. In this way the spermatozoa were separated from seminal fluid by means of the swimming rate of the sperm. When semen samples from normal men were used, total recovery of sperm after separated on a Percoll gradient was 21 +/- 2.3%. The progressive motility index increased by a factor of 15 +/- 1 when comparing separated samples with the same unseparated ejaculate, and the frequency of sperm with normal morphology increased from 60 to 85%. The improvements in these semen samples was attributable to the Percoll separation as the washing procedure itself was without effect. Using this method sperm of relatively unifirm motility and morphology can be collected. These may then be used for further biochemical and physiological studies. Improved sperm quality was also obtained when samples from patients with abnormal semen profiles were separated in this way, although the degree of improvement was much more variable than that obtained with semen from normal fertile men. This indicates that this method can be used in clinical practice in selected cases for the preparation of sperm for insemination or for in-vitro fertilization.

Adult↗
PubMed1986

On the use of adenosine triphosphate for estimation of motility and energy status in human spermatozoa.

Following the development of a reliable technique for analysis of total ATP in semen, the ATP concentration of untreated human ejaculates was compared with progressive sperm motility during 3 continuous days following ejaculation. As correlation was poor between these variables, spermatozoa were separated by self-migration on Percoll gradients and washed free of Percoll solution. ATP concentration and sperm motility was then assessed. Aliquots of separated sperms were transferred to separate tubes, and increasing concentrations of sera were added prior to incubation at 37 degrees C for 4 days. Under these conditions a good correlation between specific progressive motility and specific ATP content was found (r = 0.88). A high concentration of human blood serum (10% v/v) was found to be necessary for maintainance of motility, but neither the addition of bovine serum albumin nor an increase in the glucose concentration had any effect on sperm motility or on the ATP concentration. Addition of different fractions of human blood serum indicated that the components mainly responsible for maintaining sperm motility are greater than 10,000 daltons. Our findings strongly indicate that ATP assessment can be used to estimate the energetic condition of a human sperm population after its separation from seminal plasma. It is suggested that this in vitro system can be used to define optimal conditions for sperm function.

Adenosine Triphosphate↗
PubMed1986

Comparison of oral and vaginal metronidazole therapy for nonspecific bacterial vaginosis.

A prospective, randomized, nonblind study was performed to compare the efficacy of a 7-day vaginal regimen with 500 mg metronidazole (Flagyl) once a day and that of oral treatment with 400 mg metronidazole twice daily for 7 days in the treatment of nonspecific bacterial vaginosis. No treatment was given to the sexual partners and there was no restriction of sexual intercourse. 38 women completed the study and at follow-up after 4 weeks, women receiving vaginal therapy had a cure rate of 79% compared with 74% in the women on oral therapy. Cure rates were lower among users of an intrauterine contraceptive device (57 versus 88% among nonusers). The occurrence of lactate-producing bacteria (lactobacilli and aerobic streptococci) in the vagina was significantly higher in women after vaginal compared with oral therapy. Gardnerella vaginalis was isolated in 58% of the women after vaginal and in 44% of the women after oral treatment. It is concluded that vaginal application of 500 mg metronidazole daily for 7 days is equally effective as oral administration in the treatment of bacterial vaginosis.

Administration, Oral↗
PubMed1986

Clinical experience with a low-dose combination of estradiol valerate and levonorgestrel. Double-blind comparative study between SH D 386 F and Cyclabil. Effects on symptoms, lipids and endometrial condition.

In a double blind study of the effects of hormone replacement therapy in climacteric women, two different dosages of estradiol--17 beta valerate and levonorgestrel, with the same ratio between the amounts of the two steroids (Cyclabil and the trial preparation having the code number SH D 386 F respectively), were compared. The differences in effects on symptoms, certain humoral parameters including serum lipids, and endometrial histology before and after 12 months of therapy were evaluated. The study population consisted of 120 healthy women in the age range 41-63 years, many of whom had undergone previous estrogen treatment. All had typical climacteric symptoms and were peri- or postmenopausal. There were no significant differences between the two preparations as regards the effects on symptoms--except for episodes of hot flushes and depression (loss of confidence), which were more frequent during treatment with the higher dosage. One of the main objects of the study was to determine whether the lower dosage would be sufficient to prevent the development of endometrial hyperplasia. To this end, endometrial samples were collected before and after 12 months of treatment, using "Mi-markTM" disposable equipment for endometrial cytology/histology. No significant endometrial hyperplasia was found in either of the groups during the period of investigation. The serum lipid pattern was evidently more influenced in the group treated with Cyclabil. The drop-out rate was 20%, most of them being due to side effects of mild to moderate severity such as undesirable withdrawal bleedings or unsatisfactory relief of symptoms, which sometimes resulted in a wish to return to earlier treatment regimens.

Adult↗
PubMed1986

Surgical correction of female infertility. An analysis of results and failures in 101 cases.

During the 1970s, surgery undertaken to remedy infertility at Sabbatsberg Hospital in Stockholm involved macrosurgical techniques. The patients described here had the same pathology on either side. Sixty-three underwent different procedures for the correction of tubal pathology at laparotomy, while 20 patients had lysis of adhesions performed at laparoscopy. A further 18 patients were operated on for ovarian endometriosis. The results in terms of conceptions (ranging from 43 to 60%, depending upon the type of operation) were similar to those reported from microsurgery, but the incidence of ectopic pregnancy was higher. Second-look laparoscopy revealed the presence of adhesions and tubal block in a significant number of patients, though less often in those who ultimatively conceived. There was no difference in semen findings between patients who conceived and those who did not. Postoperative adhesions are responsible for many surgical failures, but refined methods of surgery may reduce the risk of future ectopic gestation. Only a limited number of cases remain where persistence of infertility may be due to minor anatomical or functional defects not amenable to present-day clinical evaluation.

Adult↗
PubMed1986

Successful tubal reimplantation after rupture of the uterus.

A 29-year-old woman with primary infertility caused by bilateral isthmical tubal block was operated upon with bilateral cornual resection and tubal implantation. After one uncomplicated childbirth a second fullterm pregnancy ended in fetal catastrophe: the uterus ruptured at both sites of tubal implantation and a stillborn fetus was delivered by emergency cesarean section. One oviduct was detached from the uterus and the other one had to be removed. However, the maternal condition never became critical. Later on, a second tubal reimplantation was performed on the remaining side, and after a first-trimester spontaneous abortion a second healthy infant was born at elective cesarean section.

Adult↗
PubMed1986

Bacterial vaginosis treated with metronidazole. Effects on the vaginal microbiology by a single dose versus a five days regimen.

The microbiological vaginal flora was studied in 42 women with clinical findings consistent with the concept bacterial vaginosis (BV). The women and their consorts were treated with metronidazole (Flagyl), either a single dose of 2,000 mg or 400 mg three times daily for five days. Effect of treatment was assessed four weeks after its initiation. Clinical cure was attained in more than 80% of the cases and was the same irrespective of treatment. The microbiologic flora changed by treatment in direction to normal, i.e. lactobacilli regained predominance and reduction of Gardnerella vaginalis and anaerobic grampositive cocci was evident. There was no difference evident in the microbiological changes induced by the two treatment regimens. The findings support previous conclusions that BV represents a disorder of the vaginal milieu and is not the result of an infection with pathogenic microorganisms.

Adult↗
PubMed1985

Incomplete androgen insensitivity: asymmetry in morphology and steroid profile and metabolism of the gonads. An analysis of a case.

A patient with clinical manifestations of the incomplete androgen insensitivity syndrome was studied with respect to peripheral blood levels of steroids and steroid sulphates before, during and after gonadectomy. Steroid and steroid sulphate concentrations were also analyzed in spermatic venous blood and gonadal tissue collected during surgery. The metabolic capacity of gonadal tissue was also studied in vitro using progesterone, dehydroepiandrosterone sulphate and oestrone sulphate as substrates. Profound differences between the two gonads were noted with respect to both steroid content and release into pampiniform veins and to in vitro conversion of progesterone and oestrone sulphate. Histological examination revealed the presence of seminiferous tubules with carcinoma in situ in both gonads. It is suggested that the differences between the gonads may be due to an autonomous steroid production in the right gonad in spite of adequate or even elevated gonadotrophic stimulation resulting in a steroidogenic situation resembling the complete androgen insensitivity syndrome, while the conditions found in the left gonad more resembles the incomplete form of the disease.

Adenoma↗
PubMed1984

Gardnerella-associated vaginitis and anaerobic bacteria.

12 patients with mild or moderate symptoms of Gardnerella-associated vaginitis were examined clinically and microbiologically on 52 different occasions, 27 of which were asymptomatic. The symptomatic state was defined by fulfilling at least three of the following criteria: (1) subjective symptoms; (2) pH above 4.5; (3) positive amine test, and (4) clue cells in wet smear. Variation of the vaginal microflora was considerable. No causative bacterial species could be identified. Microorganisms of the genus Bacteroides were significantly (p less than 0.02) more often found in the symptomatic condition. The presence of either peptococci , peptostreptococci or anaerobic streptococci was similarly related to symptoms (p less than 0.01). Lactobacilli were significantly more often present when the patient was free of symptoms (p less than 0.05). Gardnerella vaginalis was a common isolate whether the patient suffered from symptoms or not. It is concluded that the presence of this microorganism indicates a disturbed ecologic situation within the vagina, resulting in loss of predominance of lactobacilli and hence liability to develop symptoms.

Adult↗
PubMed1984

Morphology of live seminal and postcoital cervical spermatozoa and its bearing on human fertility.

Various seminal variables were studied in two groups of infertile couples and in one fertile control group. Sperm morphology was emphasized. Patients with normal postcoital tests and sperm counts exceeding 5 mill/ml were selected and followed prospectively. The two clinical groups could then be identified: a. couples who were persistently infertile during the 3 years of observation and whose infertility was not explained by the clinical investigation, and; b. couples where conception was achieved during the period of observation, either spontaneously or after treatment of the woman. In the latter group all the variables of semen analysis were identical with those of the control group. Differences between the two groups of infertile patients were noted only with respect to the morphology of live spermatozoa of the semen sample and of postcoital spermatozoa within the cervical secretion. It is concluded that these two variables of sperm evaluation are of prognostic significance with regard to future fertility.

Adult↗
PubMed1984

Can Gardnerella vaginalis and anaerobic curved rods attach to vaginal epithelial cells in vitro, resulting in clue cells?

Vaginal epithelial cells were taken from asymptomatic patients and from patients with non-specific vaginosis. Four bacterial species-Gardnerella vaginalis, Wolinella succinogenes and short and long anaerobic curved rods-were tested in vitro regarding attachment to the epithelial cells. In most experiments the curved rods and W. succinogenes attached to the cells. Less often, incubation with G. vaginalis resulted in cell attachment. There was no difference in attachment ability between the short and long rods. Clue cells were not often produced in these in vitro experiments.

Bacteria, Anaerobic↗
PubMed1983

Metabolism of estrone sulfate in human endometrium.

The metabolism of [3H] estrone sulfate was studied in endometrial tissue obtained from postmenopausal women with atrophic endometrium (I), benign endometrial proliferative changes (II) and endometrial carcinoma (III) and in perimenopausal women with proliferative (IV) and secretory (V) endometrium. Total hydrolysis (i.e. formation of [3H] estrone + [3H] estradiol-17 beta) of [3H] estrone sulfate as well as formation of [3H] estradiol-17 beta only was significantly less in group I than in the other groups. The formation of [3H] estradiol-17 beta was greater in group V than in the other groups. It is speculated that formation of estradiol-17 beta in the endometrium from estrone sulfate may be of importance in the genesis of endometrial disorders in the postmenopausal woman.

Aged↗