Biomedical subjects

N H Lauersen

Publications and source records attributed to N H Lauersen.

At least 73 records · Page 4Linked to original sources

PubMed1975

Danazol: an antigonadotropic agent in the treatment of pelvic endometriosis.

Danazol, an antigonadotropic agent, was administered in a dosage of 800 mg. daily for six months to 32 patients with pelvic endometriosis. Twenty-eight patients (87.5 per cent) were found to have a marked improvement of both clinical and subjective symptoms of endometriosis. Furthermore, Danazol was found to be effective in three patients with chronic cystic mastitis and one patient with fibrocystic disease. There was no change in uterine size in two patients with uterine adenomyosis and one patient with uterine myomas during the treatment period. Danazol was ineffective in relieving the symptoms of the menopausal syndrome in one patient. The main side effects of Danazol treatment were weight gain and water retention which were maximal at four months of treatment and then decreased. Other side effects such as acne, oiliness of skin, and voice change were rare in this series. Danazol therapy was found to be very effective in this study for the treatment of pelvic endometriosis, and the drug was well tolerated by the patients.

Body Weight↗

PubMed1975

Mid-trimester abortion induced by intravaginal administration of prostaglandin E2 suppositories.

Mid-trimester abortion was successfully induced in 70 of 71 patients by administration of vaginal PGE2 suppositories. The one patient who failed to abort with this method was pregnant in the blind horn of a duplex uterus. The mean abortion time for the successful inductions was 11.88 hours. Multiparous patients aborted somewhat faster than nulliparous patients, but the difference was not significant. Among the 70 successful inductions 42 patients aborted in 12 hours or less and only one patient had an abortion time of more than 24 hours. The drug appeared effective throughout the stages of gestation included in this series--from 8 to 27 weeks. Eight patients were monitored throughout the abortion procedure and uterine activity was calculated and analyzed. The development of uterine activity was gradual without the sudden rise in frequency of contractions and intrauterine baseline tonus that characterized prostaglandin administered by other methods. The most frequently encountered side effect of vaginal PGE2 suppositories was a temperature elevation, which returned to normal within a few hours of the last dose of the drug. Gastrointestinal disturbances--vomiting and diarrhea--were also common, despite a low initial dose of PGE2 and premedication with antiemetic and antidiarrheal agents. These side effects were in general well tolerated by the patients and never required termination of therapy. The cardiovascular effects of PGE2 in this series could be considered minimal. In a single patient surgical intervention was required to remove the placenta. In seven patients the placenta was removed by sponge forceps and in five patients the placenta was removed manually. There was an estimated blood loss exceeding 250 ml. in 10 patients, but transfusion was not required. Although white blood cell count rose significantly during the abortion period there were no significant changes in hematocrit or platelet count. Mid-trimester abortion with intravaginal administration of PGE2 suppositories appears to offer a valid alternative to the presently available techniques, with a rapid abortion time, high success rate, and low incidence of complications.

Abortion, Induced↗

PubMed1975

Hydatidiform mole with coexistent fetus.

Eight cases of hydatidiform mole with coexistent fetus are presented with special considerations of diagnosis and management. Although the incidence of this condition was one in 22,000 pregnancies, it is emphasized that the combination of a mole with a fetus should be included in the differential diagnosis of patients who have signs and symptoms of gestational trophoblastic disease in the presence of a fetus. Recommended treatment is immediate termination of the pregnancy. Appropriate follow-up with a sensitive and specific gonadotropin assay is required to differentiate minimal tumor activity rom normal levels of pituitary luteinizing hormone. None of the patients in this series developed maligant trophoblastic neoplasia.

Abortion, Therapeutic↗

PubMed1975

The effect of berotec (Th 1165a) on spontaneous and induced uterine activity in the pregnant baboon.

Berotec (Th 1165a), a specific beta-adrenergic agent, has been found to be a more potent agent than metaproterenol in the inhibition of uterine activity in animals and human beings. The effect of berotec on spontaneous (postinduced) and induced uterine activity in the pregnant baboon near term was investigated. Berotec administered intravenously in a dose of 5 mug per minute consistently and significantly reduced spontaneous uterine activity as well as uterine activity by either oxytocin or prostaglandin F2-alpha. The frequency of contractions was consistently reduced whereas the effect on the amplitude of contractions was less marked. There was no reduction of the baseline muscle tonus. Berotec infusion produced a marked increase in the maternal heart rate, averaging 40 beats per minute. Berotec appears to be a potent inhibitor of spontaneous, oxytocin-induced, and prostaglandin-induced uterine activity in the pregnant baboon, but it has considerable cardiovascular side effects.

Adrenergic beta-Agonists↗

PubMed1975

Midtrimester abortion induced by serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha.

Midtrimester abortion was successfully induced in 35 patients by serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha. The dose schedule in this series was an initial injection of 250 mug of 15-ME-PGF2alpha followed by another 250 mug in 2 hours, then 500 mug every 2 hours up to 24 hours; in patients who did not abort within 24 hours the dose was raised to 750 mug every 2 hours until abortion. The mean abortion time was 15.98 hours in this series and 86 per cent of the patients aborted in under 24 hours. Parous patients aborted faster (mean 14.81 hours) than nulliparous patients (mean 17.02 hours) and patients with lower gestational age, 13 to 16 weeks, aborted more quickly (mean 13.98 hours) than patients with gestational age 17 to 20 weeks (mean 16.35). These differences in this series, however, were not statistically significant. Gastrointestinal side effects occurred in 32 of the 35 patients and eight patients had a temperature elevation of more than 1 degree F. during the treatment period. The mean estimated blood loss was 137 plus or minus 42 ml. Thirty patients passed the fetal-placental unit intact, the placenta was removed by sponge forceps in three patients, and by surgical intervention in two patients. There were no failures of technique in this study and none of the patients developed endometritis.

Abortifacient Agents↗

PubMed1975

Water intoxication associated with oxytocin administration during saline-induced abortion.

Four cases of water intoxication in connection with oxytocin administration during saline-induced abortions are described. The mechanism of water intoxication is discussed in regard to these cases. Oxytocin administration during midtrimester-induced abortions is advocated only if it can be carried out under careful observations of an alert nursing staff, aware of the symptoms of water intoxication and instructed to watch the diuresis and report such early signs of the syndrome as asthenia, muscular irritability, or headaches. The oxytocin should be given only in Ringers lactate or, alternately, in Ringers lactate and a 5 per cent dextrose and water solutions. The urinary output should be monitored and the oxytocin administration discontinued and the serum electrolytes checked if the urinary output decreases. The oxytocin should not be administered in excess of 36 hours. If the patient has not aborted by then the oxytocin should be discontinued for 10 to 12 hours in order to perform electrolyte determinations and correct any electrolyte imbalance.

Abortion, Induced↗

PubMed1975

Midtrimester abortion induced by single intra-amniotic instillation of two dose schedules of 15(S)-15-methyl-prostaglandin F2alpha.

Midtrimester abortion was successfully induced in a series of 20 patient by intraamniotic instillation of 15(S)-15-methyl-prostaglandin F2alpha with a mean abortion time of 17.78 hours. The patients in this study was divided into two groups, Groups 1 received an initial dose of 2.5 mg 15-ME-PGF2alpha and aborted in a mean time of 16.26 hours. The patients in Group II received 3.0 mg 15-ME-PGF2alpha and aborted in a mean time of 18.94 hours. There was no significant difference in the abortion time, occurrence of side effects or the initiation of uterine activity between Group I and Group II. Parous patients aborted somewhat faster than nulliparous patients but this difference was not significant. In this study 80% of the patients aborted in 24 hours or less, and the intra-amniotic instillation of 15-ME-PGF2alpha was an effective abortifacient technique from the 15th to the 23rd week of gestation. The uterine response to intra-amniotic instillation of 15-ME-PGF2alpha was characterized by the gradual appearance of low amplitude, high frequency contractions accompanied by a rise in baseline intrauterine tonus. Uterine activity developed gradually and peaked at 1:50 hours after intraamniotic instillation of 15-ME-PGF2alpha. In this small series 15-ME-PGF2alpha administered via intra-amniotic instillation did not appear to have a distinct advantage over the naturally occuring PGF2alpha administered by the same method for the induction of midtrimester abortion; a large series in indicated to define the advantage of either technique.

Abortion, Induced↗

PubMed1975

Midtrimester abortion induced by serial intravaginal administration of prostaglandin E2 suppositories in conjunction with a contraceptive diaphragm.

Midtrimester abortion was successfully induced in 68 of 69 patients with serial intravaginal administration of prostaglandin E2 suppositories behind a contraceptive diaphragm. The mean abortion time for the successful inductions was 13.07 hours; multiparous patients aborted somewhat faster, mean 12.72 hours, as compared to nulliparous patients, mean 14.22 hours. In 36 patients the PGE2 suppositories were placed behind an intact diaphragm and the mean abortion time was 14.89 hours. In 33 patients the PGE2 suppositories were placed behind a diaphragm modified by having an opening incised in the center, the mean time in these patients was 11.96 hours. Of the 68 successful abortions 59% of the patients aborted in 12 hours or less and 88% aborted within 24 hours. The most frequently encountered side effect was temperature elevation of 2 degrees F or higher which occurred in 68% of the patients. Temperatures returned to normal levels within 4 to 6 hours after the last adminstration of PGE2. Gastrointestinal side effects occurred in 45% of patients, but these side effects were well tolerated and did not require termination of drug administration in any of the patients. Intravaginal administration of PGE2 suppositories is a very effective abortifacient technque during the midtrimester, however the use of PGE2 in conjunction with a diaphragm did not appreciabley improve the technique although the amount of drug administered and the incidence of side effects was somewhat lower than when the PGE2 suppositories are used alone. If a diaphragm is to be used, a modified diaphragm is indicated since it simplifies the clinical management of the abortion, eases administration of the suppositories and permits a more accurate estimation of cervical changes, vaginal bleeding and abortion.

Abortion, Induced↗

PubMed1975

Serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha in the induction of abortion.

Abortion was successfully induced in 62 of 68 patients in the 9th to the 26th week of pregnancy be serial intramuscular administration of 15(S)-15-methyl-prostaglandin F2alpha (15-ME-PGF2alpha). In 6 patients who failed to abort after 24 hours of prostaglandin administration, a concomitant infusion of oxytocin was initiated; 5 of these patients aborted within 12 hours of the combined therapy. A single patient failed to abort, even with the combined therapy, and underwent surgical evacuation. The mean abortion time in the 67 successful inductions was 14.56 hours. Parous patients aborted somewhat fasteter, mean 13.98 hours, as compared to nulliparous patients, mean 15.02 hours, but this difference was not statistically significant. In this study initial intramuscular injection of 100 mug 15-ME-PGF2alpha was followed in 1 hour by 250 mug and then 250 mug every 2 hours with concomitant oxytocin therapy initiated after 24 hours. The results with this dose schedule were compared to the results obtained in a previous study with a higher dose schedule, an initial dose of 100 mug 15-ME-PGF2alpha, followed in 1 hour by 250 mug then 500 mug every 2 hours. There was significant difference in the mean abortion time and the incidence of side effects between the 2 dose schedules. The mean abortion time for patients with gestational ages 16 weeks and less was the same with both dose schedules, however patients with gestational ages of 17 weeks and higher aborted somewhat faster with the higher dose schedule. It might therefore be advisable for patients with gestations of 17 weeks and higher to be treated with the higher dose schedule. In earlier gestations patients could be started on the lower schedule, and if abortion had not occurred within 15 hours the dose of 15-ME-PGF2alpha could then be increased to 500 mug every 2 hours.

Abortion, Induced↗

PubMed1975

Induction of midtrimester abortion by serial intravaginal administration of 15(S)-15-methyl-prostaglandin F2alpha (THAM) suppositories.

Midtrimester abortion was successfully induced in 13 of 22 patients by serial intravaginal administration of 15(S)-15-methyl-prostaglandin F2alpha (THAM) suppositories. Nine patients, 4 nulliparas and 5 multiparas, failed to abort after 24 hours of prostaglandin administration and a concomitant infusion of oxytocin was initiated. Seven of the nine patients aborted within 7 hours of the combined therapy and one patient on methadone maintainence aborted after 17.5 hours of combined therapy, 41.5 hours after the first dose of prostaglandin. A single patient failed to abort, despite the concomitant prostaglandin-oxytocin administration and underwent surgical evacuation. The mean abortion time for the 21 successful abortions was 22.56 hours. Nulliparous patients aborted somewhat faster, mean 21.79 hours, than multiparous patients, mean 23.80 hours, but this difference was not statistically significant. In this study, one patient aborted in less than 12 hours, and 62% of the successful cases aborted within 24 hours. The plasma levels of 15-ME-PGF2alpha were analyzed by radioimmunoassay in 10 patients. Plasma prostaglandin levels rose significantly 30 minutes after the insertion of the first suppository, but there was a wide variation in levels from patient to patient. It was observed that the 2 patients with the highest levels had the fastest abortion times and episodes of gastro-intestinal side effects appeared related to a rise in prostaglandin levels. Sixty-four percent of the patients in this study had no gastro-intestinal side effect related to prostaglandin administration.

Abortion, Induced↗

PubMed1975

The lh-hcg receptor of human ovary at various stages of the menstrual cycle.

Receptors specific for hCG were found in human corpora lutea and follicles. hCG and LH were found to bind at a similar receptor site. The dissociation constant for hCG ranged from 10-minus 10 to 10-minus 11 mol/1 in human corpora lutea. The number of binding sites for 125-I-hCG ranged from 10-minus 14 to 10-minus 15 moles/mg protein in human corpora lutea. The binding of 125-I-hCG to ovary was found to vary at different stages of the menstrual cycle. The binding of 125-I-hCG to human ovaries increased on days 13-15 of the cycle, then declined slightly, and increased again on days 22-23. Following day 23, there was a slow decline until day 27 when binding activity could no longer be measured. No binding could be measured by the corpus luteum after the onset of menstruation or in corpora albicans.

Binding Sites↗

PubMed1975