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Biomedical subjects

G Ekman

Publications and source records attributed to G Ekman.

At least 73 records · Page 4Linked to original sources
PubMed1983

Local application of prostaglandin E2 in gel. A new technique to ripen the cervix during pregnancy.

The methods used to date to ripen the unfavorable cervix during pregnancy have considerable disadvantages, chiefly from the practical point of view. Intracervical application of a small dose (0.5 mg) of prostaglandin E2 (PGE2) in viscous gel is a safe, easily performed and effective method to ripen the cervix in both early and late pregnancy. A new starch-based gel seems to have solved the pharmaceutical problems associated with gel preparations used hitherto. The histological and biochemical changes induced by local application of PGE2 are similar to those occurring spontaneously during late pregnancy.

Abortion, Induced↗
PubMed1983

Human cervical connective tissue and its reaction to prostaglandin E2.

A survey of connective tissue in general and human cervical connective in particular is presented. It is concluded that about 90% of the human cervix consists of fibrous connective tissue which, according to the composition of the collagen and the proteoglycans, is very similar to that in skin and sclera. The high activity of collagenase probably gives the cervical connective tissue from pregnant women its potential to ripen following prostaglandin treatment. Electron microscopical examination has revealed an increased amount of amorphous substance after such treatment. This may be caused partly by degraded collagen fibers and partly by newly synthesized proteoglycans.

Animals↗
PubMed1983

The impact on labor induction of intracervically applied PGE2-gel, related to gestational age in patients with an unripe cervix.

In 54 patients with an unripe cervix in late third trimester, in which gestational age had been properly determined by repeated ultrasound scannings, labor was induced by intracervical application of 0.5 mg PGE2 in viscous gel. It was found that the outcome of the induced labor was not related to the gestational duration, but to the pre-inductive cervical score. Thus, the number of successful inductions was smaller and induction-delivery time longer, the lower the cervical score. Moreover, instrumental deliveries occurred most frequently in nulliparous women, with a low pre-inductive cervical score. Taking into consideration the difficulties of labor induction in the present type of patient, the overall proportion of instrumental deliveries (17%, including 7% cesarean sections) was low. No maternal or fetal side effects were observed. It is concluded that intracervical application a small dose of PGE2 in gel can be recommended for cervical priming and labor induction in pre- and post-term pregnancy.

Adult↗
PubMed1983

The effect of midodrine and its active metabolite ST 1059 on the human urethra in vitro and in vivo.

The directly acting alpha-receptor agonist midodrine is active through its metabolite ST 1059. The effects of ST 1059 were investigated in vitro on strips of human urethra and on small human omental arteries. ST 1059 was as potent as noradrenaline on the isolated urethra, but had only 40% of noradrenaline's maximum activity. In omental arteries noradrenaline was at least ten times more potent than ST 1059 which only had about one fourth of noradrenaline's maximum activity. Compared to its effect on the vessels ST 1059 was ten times more effective on the urethra, whereas noradrenaline was slightly more effective on the vessels than on the urethra. Thus, in vitro St 1059 exhibited some selectivity for urethral alpha-receptors. When midodrine was given to 13 female patients with stress incontinence in the doses 2.5 mg and 5 mg x 3 for two weeks, only two had a positive urethral closure pressure during treatment and were subjectively improved. There were no effects on blood pressure and heart rate; one patient complained of pilo-erection. Two further patients received 7.5 mg x 3 for two weeks; both were subjectively improved but complained of pronounced pilo-erection. Only one of them had a positive urethral closure pressure during treatment. Blood pressure or heart rate did not change. Although it cannot be excluded that midodrine can increase intraurethral pressure with minor effects on blood pressure, it seems as the doses needed cause pilo-erection to an extent that limits the clinical usefulness of the drug.

Adult↗
PubMed1982

Pharmacokinetics of terodiline in human volunteers.

The pharmacokinetics of terodiline HCl was studied in nine healthy volunteers given 12.5 mg i.v. and p.o. or 20 mg i.v. and 25 mg p.o. on two different occasions. The serum concentrations were measured by gas chromatography--mas spectrometry, using deuterated terodiline HCl as the internal standard. After i.v. administration the kinetics could be described by a two-compartment model with a mean distribution half life of 0.3 h and a mean elimination half life of 63 h. The serum clearance and apparent volume of distribution varied about 4-fold with mean values of 4.8 1/h and 417 1, respectively. After oral administration, the mean half life of absorption was 0.7 h and that of elimination 65 h. The absolute bioavailability varied between 64% and 105% with a mean of 92%. The long serum half life of terodiline should permit its once daily administration.

Administration, Oral↗
PubMed1982

Intracervical application of prostaglandin gel for induction of term labor.

A new gel for local application of prostaglandins has been elaborated. The new gel, based on a lyophilized prostaglandin E2 (PGE2) starch powder, seems to have solved most of the pharmaceutical and clinical problems associated with local administration of prostaglandins. In a randomized double-blind study, 50 nulliparous patients with an unfavorable cervical state at term were given 2 ml gel containing 0.5 mg PGE2 (PGE2 gel) or gel without PGE2 (placebo gel). The gel was deposited into the cervical canal. Among patients given PGE2 gel, 11 of 25 had induced labor, delivering without further stimulation within 24 hours. In patients given placebo gel, 2 of 25 were delivered with 24 hours. This difference is statistically significant (P less than .01). Patients undelivered after treatment with PGE2 gel achieved a considerable and statistically significant improvement of cervical score, whereas in patients in whom labor was not induced successfully by placebo gel treatment no significant changes in cervical score were registered. In a subsequent open study another 70 term patients of varied parity were given 0.5 mg PGE2 gel. Thirty-eight patients (54%) had successfully induced labor. Among the remaining undelivered patients, considerable ripening of the cervix occurred. Thus, the cervical score changed from a mean of 3.2 prior to treatment to a mean of 6.5 by 24 hours after treatment. Gastrointestinal discomforts were not observed. Signs of uterine hyperstimulation were registered in 1 patient.

Adolescent↗
PubMed1981

A new prostaglandin E2-gel for pretreatment of the cervix in nulliparous patients having a late first trimester termination of pregnancy.

A new PGE2-gel, based on a cross-linked starch powder, has been developed. This gel seems to have solved several of the pharmaceutical and practical problems connected with local administration of prostaglandins. In a three-center study 120 nulliparous patients were given 0.5 mg PGE2 in 2.2 ml gel intracervically prior to dilatation of the cervix and evacuation of the uterus in late first trimester. Considerable cervical dilatation was obtained within 15 h. The frequency of side effects, including pain and gastro-intestinal discomfort was low. The technique can be recommended for outpatients.

Abortion, Induced↗
PubMed1981

Some aspects of prophylactic oophorectomy and ovarian carcinoma.

The early diagnosis of ovarian carcinoma is as difficult and rare as ever before. Despite the appearance of sophisticated drugs and combinations of these with surgery and radiotherapy the prognosis still remains the same as during the last 30 years, i.e. overall survival between 20 to 30%. This study concerns the impact of prophylactic oophorectomy in Sweden. 4.6% of ovarian carcinoma patients had received pelvic surgery at some time prior to the diagnosis of ovarian cancer and after the age of 40. With the help of statistical data it is estimated that about one hundred out of the approximately thousand women per year who now develop ovarian cancer in Sweden could be saved if prophylactic oophorectomy were practised in our country. Various aspects of prophylactic oophorectomy and its effects are discussed. It is our opinion that every gynaecologist/surgeon should seriously take into consideration and discuss the possibility of prophylactic oophorectomy in the perimenopausal patient before operation. Not to perform prophylactic oophorectomy during pelvic surgery after the menopause seems to us to be an unreasonable practice.

Adult↗
PubMed1980

A double-blind, cross-over study of the effects of terodiline in women with unstable bladder.

In a double-blind, cross-over study, the effects of terodiline were evaluated in 12 women with motor urge incontinence. The patients were investigated by simultaneous urethro-cystometry before and after treatment fo 2-week periods with placebo and terodiline 12.5 mg twice daily. The effects on subjective symptoms were also assessed. In all patients but one, terodiline increased the bladder capacity and also the bladder volume at which urgency was experienced. No effects on the urethral pressure profile or residual urine were found. Subjective improvement was reported by all but one of the patients. Placebo treatment had no effect on the measured parameters or on the subjective symptoms. No side effects were reported during any of the treatment periods. --It is concluded that terodiline can be used for treatment of female motor urge incontinence, and that it is a promising alternative to drugs presently used for this disorder.

Adult↗
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↗