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Biomedical subjects

K Molne

Publications and source records attributed to K Molne.

At least 37 records · Page 2Linked to original sources

Long-term effectiveness of the Burch colposuspension in female urinary stress incontinence.

Of 91 women who underwent Burch colposuspension, 86 were available for clinical, urodynamic and isotope renographic follow-up examinations 5 years after surgery for evaluation of late complications and long-term effectiveness in urinary stress incontinence. A repeat urodynamic examination was accepted by 76 patients. Stress incontinence was cured in 71% of the patients with a stable bladder preoperatively, and in 57% with stress incontinence and detrusor instability (non-significant difference). Cure rate was not significantly related to age, hormonal status or previous anterior vaginal repair. The urodynamic measurements at follow-up showed a significant increase in the functional urethral length in the cured group, as compared with the improved group. The mean maximum urethral closure pressure was reduced in both groups. Symptomatic detrusor instability was found in 18% of the preoperative stable bladders, while 67% of the unstable bladders had become stable. Only 29% of the patients with a preoperative unstable bladder had a normal lower urinary tract function at follow-up. Late voiding difficulties were observed in 3% of the study group; enterocele, requiring surgical repair, developed in 7%. One patient suffered a damaged kidney due to undetected ureteral obstruction after surgery. Irritative bladder symptoms such as urgency, frequency, stranguria and nocturia represent a long-term problem after colposuspension. At the 5-year follow-up, only 52% of the study group were completely dry and free of complications, and about 30% needed further incontinence therapy. This may be due to some neurogenic factor which is not corrected by surgery.

Adult↗

Is routine pre-treatment cryopreservation of semen worthwhile in the management of patients with testicular cancer?

Post-treatment fertility was evaluated in 147 patients with testicular cancer, All had pre-treatment sperm cell analysis following orchiectomy during the years 1979 to 1987. For only 17 patients was the question of future fertility of no importance. Pre-treatment semen cryopreservation was requested by 91 patients, but poor semen parameters made this procedure impossible in 38. Of 99 evaluable patients, 44 had a post-treatment sperm count greater than or equal to 10 x 10(6)/ml and 22 of these fathered a child after treatment. Post-treatment fertility was observed to the same degree in patients who had pre-treatment semen cryopreservation as in those in whom this procedure could not be performed. Four of 53 patients used their deep-frozen semen but only 1 pregnancy resulted. The intensity of treatment, especially the extent of retroperitoneal surgery, had a significant effect on post-treatment fertility in the individual patient. Pre-treatment cryopreservation of semen may be psychologically useful in patients with newly diagnosed testicular cancer, but its clinical significance is doubtful.

Adult↗

A spleen pregnancy.

Non-tubal ectopic pregnancy is very rare. We report a case of spleen pregnancy, difficult to recognize clinically. The tests and investigations which led to the diagnosis and treatment are described briefly.

Adult↗

Can we cure testicular cancer and retain fertility?

1. 30-40% of the patients with newly diagnosed testicular cancer want to father a child after the treatment. 2. At least half of the patients with testicular cancer who at the time of diagnosis state the desire for future paternity, can expect to father a child after treatment. 3. The intensity of treatment is the most determinant parameter for post-treatment fertility. Unnecessary over-treatment, in particular extended retroperitoneal surgery, should be avoided. 4. The overall role of sperm banking is questionable in the management of testicular cancer.

Adult↗

Intrauterine insemination: a European collaborative report.

This report summarizes the data collected in the European Collaborative Report on intrauterine insemination (IUI) with pretreated sperm. A questionnaire concerning methods and results of IUI was sent to European infertility clinics and evaluable data were obtained from 29 of these clinics. A total of 196 pregnancies was reported from a total of 20 clinics. Pregnancy rates per treatment cycle were on average 7.4% of all male infertility, 10.8% for infertility due to hostile cervical mucus and 12.9% for idiopathic infertility, giving an overall pregnancy rate per treatment cycle of 8.4%. The clinical abortion rate was on average 12.2%. The mean number of years of primary infertility in the patient group of the clinics reporting pregnancies was 4.8 years and the mean number of years of primary infertility in the patient group conceiving was 5.2 years. A total of 127 births was reported with a sex ratio (male/female) of 0.512. One congenital malformation was reported. In many clinics, treatment of male infertility with IVF or IUI gave comparable results per treatment cycle. No single factor in the procedure for performing IUI was identified accounting for the different pregnancy rates obtained in the clinics included in this study.

Adult↗

Intrauterine insemination.

Fifty-six couples with infertility due either to subnormal sperm (n = 40), hostile cervical mucus (n = 5) or idiopathic infertility (n = 11), were treated with intrauterine insemination of washed sperm. A total of 78 treatment cycles were completed. Nine pregnancies resulted from these insemination cycles, giving an overall pregnancy rate of 8.3% per treatment cycle. Eight pregnancies occurred in the andrologic group after 56 treatment cycles. One pregnancy was established in the patient group with idiopathic infertility after 15 treatment cycles, while no pregnancy occurred in the patient group with infertility due to cervical mucus hostility. The mean number of years of infertility in the couples conceiving following treatment was 7 years (range 3-11). The spontaneous pregnancy rate in this patient group is low. The data obtained in this study suggest that in selected patients intrauterine insemination will result in an acceptable pregnancy rate. There is a need for a randomized prospective study designed to compare the efficacy of intrauterine insemination with that of alternative treatment modalities.

Cervix Mucus↗

Induced abortion: Chlamydia trachomatis and postabortal complications. A cost benefit analysis.

The overall prevalence of Chlamydia trachomatis among 873 abortion-seeking women was 9.3% during 1985. Significantly higher age-specific prevalences of C. trachomatis occurred among younger women (p less than 0.001). None of 17 women treated for C. trachomatis before the abortion was carried out, was readmitted to the hospital. Of 64 Chlamydia-positive women, who commenced treatment within the first 2 weeks after the abortion was carried out, 14.1% were readmitted to the hospital, compared with 5.7% of Chlamydia-negative women (p less than 0.02). Postabortal salpingitis was verified at readmission among 10.9% of Chlamydia-positive women and 3.2% of Chlamydia-negative women (p less than 0.01). An analysis of screening of all abortion-seeking women is estimated to be worthwhile when the prevalence of C. trachomatis exceeds 4.3%. We recommend screening for Chlamydia trachomatis of all abortion-seeking women, 30 years or younger, at the pre-abortion visit, provided that treatment can be completed before the abortion is carried out.

Abortion, Induced↗

The concentrations of ceftazidime and thiopental in maternal plasma, placental tissue and amniotic fluid in early pregnancy.

Studies on the transfer of drugs from mother to fetus in the first trimester of pregnancy are important because of the possible teratogenic effect on the fetus as well as possible therapeutic effect on both sides of the feto-maternal barrier. The purpose of this study was to measure drug concentrations in maternal plasma, placental tissue and amniotic fluid in a group of first-trimester abortion patients. Ceftazidime and thiopental were chosen as experimental drugs. The analyses were done with high pressure liquid chromatography. The penetration of ceftazidime into placental tissue and amniotic fluid was 20.6 and 2.2% from 1 to 4 h after drug administration. The corresponding values for thiopental were 54.3-71 and 1.5-7.4% from 5 to 15 min after drug administration, indicating a rapid transfer of both drugs across the feto-maternal barrier during this period in pregnancy.

Abortion, Induced↗

Menstrual dysfunction in Norwegian top athletes.

Of 301 Norwegian female top athletes, all members of the national team in 27 different sports, who were approached with a questionnaire about menstrual function, 278 (92.4%) responded. Ninety-nine of the respondents who used oral contraceptives were excluded. Of the remaining 179, 18 (10.1%) reported secondary amenorrhea (greater than 4 months since the last period) and were chosen for further studies. Blood samples were drawn for hormonal analyses between 10 and 12 a.m. and at least 12 hours after the last training session. Their mean age was 20.8 years (range 18-27), mean height 169.8 cm (160-180), mean weight 58.5 kg (51-67), and their mean age at menarche 14.6 years (13-16.5), significantly older than that of the other top athletes: 13.5 years (p less than 0.05). Their mean number of training hours per week was 16.1 (12-24). Hormonal changes were consistent with simple normoprolactinemic hypothalamic suppression, characterized by low values of FSH, estradiol-17 beta and prolactin. The androgen hormones demonstrated high levels of dihydrotestosterone. Testosterone levels were within normal limits, but in the upper part of the range, whereas sex hormone-binding globulin was in the lower normal range.

Adolescent↗

Ultrasound observations in patients on gonadotrophin therapy.

Twenty-four courses of ovulation induction with HMG-HCG were accompanied by ultrasound sector scanning. The results of cross-sectional studies did not deviate from those reported for normal cycles. Cross-sectional studies indicate smaller peak follicular volumes than repeated measurements of the same follicles. Results may, however, be influenced by frequency and time of measurements, as well as frequency and time of coitus for the patients. Peak-size follicular volumes in patients who became pregnant were relatively large. Peak volumes connected with subsequent pregnancies may therefore have another range of variation than follicles releasing oocytes which will remain unfertilized.

Amenorrhea↗