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Biomedical subjects

K Bremme

Publications and source records attributed to K Bremme.

107 records · Page 6Linked to original sources
PubMed1982

Maternal serum hormone changes during abortion induced with 16,16-dimethyl-trans-delta 2-PGE1 methyl ester.

The PGE1 derivative 16,16-dimethyl-trans-delta 2-PGE1 methyl ester, administered to first trimester women to induce abortion, has been shown not to affect the maternal serum hormone levels of prolactin, TSH, and cortisol. The hCG drop noticed between 3 and 6 hours into therapy could have been induced by the prostaglandin or the chlorpromazine used to prevent prostaglandin side effects. It is suggested that a prostaglandin of the E1 type - in contrast to the PGE2 derivatives - does not interfere with the maternal pituitary secretion of prolactin and TSH.

Abortifacient Agents↗
PubMed1982

Proteins of human amniotic fluid. II. Mapping by two-dimensional electrophoresis.

In an earlier study we used various electrophoretic techniques to investigate the proteins in amniotic fluid, including two-dimensional electrophoresis. However, the high proportion of albumin dominated the pattern and tended to distort the pH gradient. Improved methodology, based upon the removal of albumin with Blue Sepharose CL6B and the silver-staining technique, has been used in the present work. These modifications have minimized problems of distortion. We have extended our work in a attempt to complete the two-dimensional map of the proteins in amniotic fluid. Over 200 proteins were seen, ranging in molecular mass from 10 000 to 100 000, including a relatively high proportion of polypeptides of low-molecular mass. The spots seen in the map are discussed in relation to some of the proteins, peptides, and hormones that have been reported in amniotic fluid. Eventually, it is hoped that polypeptides will be found that will provide better indicators of the condition of the fetus.

Albumins↗
PubMed1980

Catecholamine metabolites in amniotic fluid as indicators of intrauterine stress.

The catecholamine metabolites HMPG and VMA have been determined in samples of amniotic fluid in 38 uncomplicated pregnancies, seven cases of IUGR, and six cases of diabetes. A successive increase of HMPG and VMA was found toward the end of the pregnancy. HMPG and particularly the HMPG/VMA ratio were significantly higher in the amniotic fluid of the growth-retarded fetuses than in the uncomplicated cases. No significant difference was found between the diabetic and uncomplicated cases.

Amniotic Fluid↗
PubMed1980

Distribution of tumor-associated antigen CEA and cross-reacting NCA in fetal organs.

The organ distribution of the tumor-associated carcinoembryonic antigen (CEA), and that of the normal tissue component NCA (non-specific cross-reacting antigen) have been investigated in the fetus. Organ extracts from five fetuses between 14 and 21 weeks of age were analysed by radioimmunoassay using specific antisera. CEA was detected in large amounts (800--1,650 ng/g) in fetal colon and in barely detectable amounts in lung and placental tissue. This differed from NCA, which could be detected in almost all organ extracts analysed. The highest concentration of NCA was measured in fetal colon and the content increased with the gestational age of the fetus. High amounts of NCA were also found in the liver, spleen and placental tissue. The gel elution profiles of CEA and NCA from an amniotic fluid pool and a pool of colonic extracts were also determined. CEA eluted similarly to the marker 125I--CEA purified from liver metastasis of colonic carcinoma. The NCA-reactive material was found in three distinct peaks.

Amniotic Fluid↗
PubMed1980

A comparison of two stable prostaglandin E analogues for termination of early pregnancy and for cervical dilatation.

Termination of pregnancy with prostaglandin E analogues is in general associated with a lower frequency of gastrointestinal side effects than if corresponding F analogues are used. Their clinical use has, however, been limited by stability problems. In the present study the efficacy of different dose schedules of two new stable E analogues for termination of early pregnancy and for preoperative dilatation of the cervical canal was evaluated in 389 women. In early pregnant patients, vaginal administration of 75 mg of 9-deoxo-16, 16-dimethyl-9-methylene PGE2 repeated after six hours or three intramuscular injections of 0.5 mg 16-phenoxy-omega-17, 18, 19, 20-tetranor PGE2 methyl sulfonylamide administered in three-hour intervals resulted in a complete abortion in 94 to 100 per cent of the patients. Both treatments were associated with a low frequency of side effects. The 9-methylene analogue had the advantage of causing less uterine pain than 16-phenoxy-omega-17, 18, 19, 20-tetranor PGE2 methyl sulfonylamide with the dose schedules used. Single vaginal administration of 30 mg of 9-deoxo-16, 16-dimethyl-9-methylene PGE2 and one intramuscular injection of 0.5 mg of the methyl sulfonylamide analogue 12 hours prior to vacuum aspiration were equally effective in dilating the cervix in late first trimester pregnant patients. For both compounds, the frequency of side effects were lower than that previously reported for different PGF analogues administered by non-invasive routes.

16,16-Dimethylprostaglandin E2↗
PubMed1980

A comparative study of uterine activity and fetal heart rate pattern in labor induced with oral prostaglandin E2 or oxytocin.

Labor was induced for medical reasons at or near term in altogether 200 patients. The women were randomly assigned to low amniotomy and either oral PGE2 or intravenous infusion of oxytocin. The initial PGE2 dose was 0.5 mg, followed by 1.0 mg every hour for up to 24 hours. Oxytocin was given as an intravenous pump infusion, starting with 5 mIU/min and rising stepwise to 20 mIU/min. Uterine contractility and fetal heart rate (FHR) were recorded by cardiotocography in 61 women receiving oxytocin and in 63 given prostaglandin E2. A detailed analysis of the contractility pattern was performed in 16 women, eight from each group. Labor was established slightly earlier in the oxytocin group than in the prostaglandin group of patients. When in labor, frequency and amplitude of contractions as well as uterine contractility were the same in both treatment groups. The frequency of atypical contractility patterns was higher in labor induced with PGE2 than with oxytocin. One period of hypertonus was observed in one patient treated with PGE2 but it was not associated with alterations in FHR and disappeared without additional therapy. Both mild and more severe variations in FHR occurred but were equally common on both treatment groups. There was no perinatal mortality among the newborns and the Apgar score 5 minutes after delivery was 8 or more.

Administration, Oral↗
PubMed1980

Changes in serum hormone levels during labor induced by oral PGE2 or oxytocin infusion.

The hormonal changes in maternal serum during parturition induced by amniotomy and oxytocin (OXY) infusion or oral prostaglandin E2 (PGE2) medication have been compared in 68 patients (33 women in the PGE2 group, 35 in the oxytocin group). The effect of PGE2 differed from that of oxytocin. Thus the prostaglandin elicited increases in total estriol (p < 0.001) and decreases in prolactin (p < 0.01), TSH (p < 0.05) and HPL (p < 0.05) from the basal level to that immediately before parturition. Maternal serum cortisol levels rose to the same extent in both treatment groups (p < 0.001). The significant (p < 0.05) increase occurred earlier among women receiving PGE2 (two hours into therapy), even though labor pain was experienced later in this group. The serum estriol elevation in these patients was significant three hours after start of therapy (p < 0.05). A similar time course was noted for the decrease of serum prolactin in PGE2 treated patients. The drop in maternal serum levels of HPL and TSH in the PGE2 group was significant only immediately prior to partus. Neither PGE2 nor oxytocin induced changes in maternal serum levels of HCG or alpha-fetoprotein or estradiol. Oxytocin but not PGE2 lead to a decrease in maternal serum progesterone concentrations; this was significant (p < 0.05--p < 0.01) only late in labor. Mixed umbilical serum levels of the hormones mentioned above were the same regardless of method of induction. Hence the increased maternal estriol concentrations during PGE2 treatment were not reflected in fetal blood. It is suggested that increases in maternal estriol levels during PGE2 medication are due to effects on the maternal enterohepatic circulation rather than on the fetoplacental unit. Irrespective of maternal treatment umbilical serum from female newborns contained statistically higher (p < 0.05) levels of estradiol and HCG than serum from male children.

Administration, Oral↗
PubMed1980

Induction of labor by oral PGE2 administration--evaluation of different dose schedules.

The efficacy and safety of different oral doses of PGE2 in tablet form were evaluated in 30 women admitted to the hospital for labor induction at or near term. The aim was to select a recommendable dose schedule based on recording of uterine contractility, clinical outcome and measurement of the resulting plasma levels of the two prostaglandin metabolites 15-keto-13, 14-dihydro-PGE2 and 15-keto-13, 14-dihydro-PGE2 alpha by gas-chromatography-mass spectrometry and by radio-immunoassay. Measurements of uterine contractility and of plasma levels of the PGE2 metabolite both showed that the preferable interval between oral doses of PGE2 tablets is one hour. Following 1.0 mg PGE2, the plasma concentration peaked after 45 to 60 minutes and had returned to approximately pretreatment levels after 120 minutes. With a two-hour interval between doses there was above all a decreased frequency of contractions in the last part of the interval. No such variation in the contractility pattern was seen when 1.0 mg PGE2 was administered every hour. When the individual dose was increased to 2.0 mg, signs of overstimulation of uterine contractility were observed. The plasma concentration of the E2 metabolite increased in accordance with the oral dose. A slow rise in the plasma concentrations of the E2 and F2 alpha metabolites was found some hours following initiation of treatment, possibly indicating an increased endogenous prostaglandin biosynthesis, probably secondary to the stimulated uterine contractility.

Administration, Oral↗
PubMed1979

Serum beta-human chorionic gonadotrophin levels in the early diagnosis of ectopic pregnancy.

Beta-HCG in serum was analysed in 64 cases of ectopic tubal pregnancy who wree different groups; ruptured ectopic pregnancy, ectopic pregnancy accompanied by amenorrhea or adnexal mass and ectopic pregnancy without palpable adnexal mass and amenorrhea. The mean HCG levels for the three groups were 8 790 IU/l, 2 580 IU/l and 690 IU/l, respectively, which related more to the symptoms than to the estimated length of pregnancy. Eleven per cent of the women had an IUD and five per cent were taking low dose gestagens. Screening of cases with acute lower abdominal pain or irregular vaginal bleeding with beta-HCG in serum will facilitate an early diagnosis of ectopic pregnancy and be of special value in patients with less typical symptoms.

Amenorrhea↗
PubMed1979

Effects of the prostaglandins on the uterus. Prostaglandins and uterine contractility.

The effect of intravenous and intrauterine administration of PGE1 or PGE2 and PGF2 alpha as well as oral administration of PGE2 on the sensitivity and reactivity of the nonpregnant human uterus was studied. With the use of the flaccid microballoon technique or a micro transducer catheter, uterine recordings were made at frequent intervals throughout the menstrual cycle. Independently of the route of administration and of the phase of the cycle, treatment with PGF2 alpha invariably resulted in stimulation of uterine motility. A high sensitivity to PGF2 alpha was noted during the late secretory phase both in normal and dysmenorrheic women. A marked decrease in sensitivity to both PGE2 and PGF2 alpha administered by the intrauterine route was observed in the periovulatory phase. Inhibition of uterine contractility by PGE2 following both intrauterine and oral administration was noted during active menstrual bleeding in normal as well as in dysmenorrheic women. These findings suggest that endogenous prostaglandins may play a role in the regulation of the normal uterine motility during the menstrual cycle and that the main reason for the abnormal contractility pattern seen in dysmenorrheic women during menstrual bleeding is an increased PGF2 alpha/PGE2 ratio.

Administration, Oral↗
PubMed1977

Carcinoembryonic antigen in amniotic fluid.

Carcinoembryonic antigen (CEA), a substance which is known to occur in high amounts in the fetal gut and also in certain tumors of the gastrointestinal tract, has been demonstrated in amniotic fluids from different stages of pregnancy. Radioimmunoassays of CEA in amniotic fluids of 91 normal pregnancies showed a decrease from a mean of 53 ng/ml at 19 weeks to 25 ng/ml at the end of gestation. The CEA activity in amniotic fluid was eluted in the same volume as a standard 125I-CEA on a Sephadex G200 column. Amniotic fluid therefore contains CEA similar in molecular weight to the CEA purified from liver metastases of colonic cancer. Among 17 cases of abnormal pregnancies, CEA elevations were observed in five with anomalous fetuses.

Amniotic Fluid↗
PubMedDate not supplied

Maternal serum hormone changes during abortion induced with 9-deoxo-16, 16-dimethyl-9-methylene prostaglandin E2.

Serum hormone levels in women undergoing successful first and second trimester abortions induced by 9-deoxo-16, 16-dimethyl-9-methylene prostaglandin E2 vagitories have been measured. Significantly decreased levels of prolactin (p less than 0.01) and TSH (p less than 0.05) were seen in both groups of women but the drop appeared sooner, within two hours, in first trimester abortions. Regardless of gestational length there was a significant decrease in serum human chorionic gonadotropin (hCG) (p less than 0.01) concentrations in maternal serum six hours into treatment. In the second trimester abortions total estriol, alpha-fetoprotein and lactoplacental hormone hPL were analysed in maternal serum but the levels did not change over the eight hour investigation period. It is speculated that the PGE2-derivative most likely affects the maternal pituitary secretion of prolactin and TSH, possibly via direct or indirect interference with TRH mechanism(s).

16,16-Dimethylprostaglandin E2↗