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Biomedical subjects

N J Secher

Publications and source records attributed to N J Secher.

At least 127 records · Page 7Linked to original sources
PubMed1978

Haemodynamic effects of oxytocin (syntocinon) and methyl ergometrine (methergin) on the systemic and pulmonary circulations of pregnant anaesthetized women.

The haemodynamic effects of oxytocin (Syntocinon) and methyl ergometrin (Methergin) were studied in 9 healthy females in the first trimester of pregnancy. The patients were anaesthetized with sodium thiomebumal, pethidine and pancuronium bromide and ventilated on a Manley respirator. 10 i.u. oxytocin given as an i.v. bolus brought about a fall in femoral arterial pressure of 40%, systemic resistance 59% and pulmonary resistance 44% 30 sec after injection. However, the heart rate increased 31% and stroke volume 17%, so that the cardiac output increased by 54%. The pulmonary arterial pressure and wedge pressure were increased by 33% and 35%, respectively 150 sec after injection. No changes were seen in the haemodynamic parameters during infusion of 80 mU oxytocin for 10 min. 0.2 mg Methergin brought about an increase in the femoral arterial pressure of 11%, pulmonary arterial pressure 27% and wedge pressure 31%, with no changes in the other measured parameters. The use of oxytocic drugs in patients with compromised circulation is discussed.

Adult↗
PubMed1977

Midtrimester and missed abortion treated with intramuscular 15 (s)-15 methyl PGF2alpha.

Abortion was successfully induced in 79 of 80 patients in midtrimester, by the serial administration of 250 microgram of 15 (S)-15 methyl PGF2alpha intramuscularly every second hour until abortion occurred. All 12 patients with missed abortion and 87% of the legal abortion patients aborted within 24 hours. The average period until abortion occurred in the missed abortion group was 8.2 hours (+/- 4.5 SD), and in the legal abortion group 16.4 hours (+/- 7.3 SD). All the patients were given prophylactic treatment for vomiting, using prochlorperazine. The average number of episodes of vomiting was 2.8 per ptient. All but 3 patients were given loperamide or diphenoxylate for "diarrhoea". The average number of episodes of diarrhoea was 2.5 per patient. The frequency of complications was low apart from a case of low uterine rupture.

Abortion, Legal↗
PubMed1977

Changes in the pattern of regional pulmonary blood flow after PGF2alpha infusion in pregnant women.

The central haemodynamics and regional lung function were measured in the sitting position before and after infusion of prostaglandin F2alpha (PGF2alpha) in seven healthy women in the first trimester of pregnancy. The dosage level of PGF2alpha was: 100mug/min for 10 minutes followed by 300mug/min for 5 minutes. The pulmonary arterial pressure, wedge pressure, and cardiac output were measured by means of a flow direct Swan-Ganz catheter introduced through an antecubital vein. The regional perfusion of the lungs was determined, in the sitting position, by external counting over the chest following intravenous injection of Xe133. The thoracic impedance was measured with the Minnesota Impedance Cardiograph Model 304A and the impedance was considered as an expression of the thoracic fluid volume. A significant redistribution of the pulmonary blood flow after PGF2alpha administration was found, ie an increase in the apical blood flow and a reduction in the basal blood flow. Further, the point of maximal blood flow moved in direction of the apex. A significant increase in both arterial [1.92-2.76 kPa (14.4-20.7 mmHg)] and wedge pressures [0.56-0.83 kPa (4.2-6.2 mmHg)] was found at the highest dosage level, whereas no changes were seen in the cardiac output and thoracic impedance. The findings indicate vasoconstriction of the arterial and possibly on the venous side of the pulmonary vascular bed during PGF2alpha infusion.

Blood Pressure↗
PubMed1977

Prostaglandin-induced diarrhoea treated with loperamide or diphenoxylate. A double-blind study.

Loperamide was compared double-blind with diphenoxylate and a placebo in 59 women with diarrhoea due to prostaglandin administration for mid-trimester abortion. Treatment was started with the intake of two capsules two hours before the first intramuscular injection of 15(S-)15 methyl prostaglandin F2alpha and was then adapted individually, i.e. one capsule after each unformed stool, with a maximum of ten per 24 hours. Both antidiarrhoeals were significantly more effective than the placebo in preventing diarrhoea, and loperamide was found to be more active than diphenoxylate. The course of abortion, BP and vital signs, or prostaglandin side-effects other than diarrhoea were not affected by either antidiarrhoeal, nor could any adverse experience be specifically attributed to them.

Abortion, Induced↗
PubMed1977

Measurement of rapid changes in cardiac stroke volume. An evaluation of the impedance cardiography method.

One hundred and twenty-nine simultaneous measurements were carried out on seven patients, 67 at rest and 62 during the Valsalva manoeuvre, in order to compare impedance cardiography with the thermodilution method, during rapid changes in cardiac stroke volume and pulmonary blood volume. A coefficient of correlation of 0.86 was found following linear regression analysis of the whole material. Analysis of the individual patient showed that the mean coefficient of correlation was 0.94 (range 0.91-0.97), and that the slope of the regression lines was 0.41 to 1.82, and further that the mean intercept was 0.2 ml. It is concluded that impedance cardiography can be employed for measuring the relative intraindividual changes in cardiac stroke volume during the Valsalva manoeuvre, and it is suggested that it may be of use in other situations, such as during haemorrhage or continuous positive pressure ventilation.

Adolescent↗
PubMed1977

Changes in serum lipids during treatment with norgestrel, oestradiol-valerate and cycloprogynon.

The serum concentrations of triglycerides, cholesterol, and free glycerol were determined in 23 climacteric women, before and after the administration of three different steroid drugs. Each drug was given within a period of 12 weeks (3 cycles). Period I: Norgestrel, 0.5 mg daily from the 12th to 21st day of each cycle. Period II: Oestradiol-valerate (Progynon) 2 mg daily from the 2nd to 21st day of each cycle. Period III: Oestradiol-valerate 2 mg from the 1st to 11th day followed by oestradiol-valerate 2 mg+0.5 mg dl-norgestresl from day 12 to 21 of each cycle (Cycloprogynon). A significant decrease in triglycerides was observed following the administration of norgestrel and Cycloprogynon, whereas oestradiol-valerate had no effect on the triglyceride levels. On the other hand, oestradiol-valerate, following a period of norgestrel, produced an increase in serum cholesterol levels.

Adult↗
PubMed1976

Termination of pregnancy in cases of fetal death in utero by intravenous prostaglandin F2alpha.

Delivery was induced by an intravenous infusion of prostaglandin F2alpha (PGF2alpha) in gradually increasing doses in 30 consecutive cases of fetal death in utero after the 28th week of gestation. Twenty patients delivered during the first day of prostaglandin administration, 9 on the second day, and 1 patient not until the third day of infusion. It is concluded, that intravenous PGF2alpha appears to be superior to oxytocin in termination of pregnancy under these conditions.

Abortion, Induced↗
PubMed1976

Pattern of total and regional lung function in subjects with bronchoconstriction induced by 15-me PGF2 alpha.

Closing volume (single breath nitrogen test), regional ventilation and perfusion (using intravenous xenon-133), and total lung function (TLC, VC, and FEV) were measured before and after intramuscular administration of 250 mug 15-methyl prostaglandin F2alpha (15-me PGF2alpha) in 10 healthy women. The cardiac output was measured with the Minnesota impedance cardiograph model 304A and the transthoracic impedance was used as an expression of the thoracic fluid volume. The slope of the alveolar plateau on the closing volume tracing showed a 271% increase 20 minutes after the prostaglandin administration, at which time the closing volume per cent (CV%) had decreased (P less than 0-01) and the closing capacity (CC%) had increased (P less than 0-05). Vital capacity (VC) decreased (P less than 0-01), residual volume (RV) increased (P less than 0-01), and the total lung capacity (TLC) remained unchanged. The maximal decrease (9%) in FEV1 was seen after 20 minutes. All these measurements except the slope of the alveolar plateau returned to control levels after 60 minutes. The redistribution of regional ventilation was more pronounced than that of the regional pulmonary blood flow. No change was observed in cardiac output and transthoracic impedance. None of the patients experienced any dyspnoea. Our results are consistent with a more pronounced effect of prostaglandin F2alpha on the small airways (the alveolar plateau) than on the larger airways (FEV1). In cases where an increase in the slope of the alveolar plateau is observed, the closing volume per cent should not be used as a measurement of the lung disease. It is concluded that the single breath nitrogen test (N2 closing volume) is more sensitive than the conventional tests.

Bronchi↗
PubMed1975

Midtrimester abortion induced by serial intramuscular injections of 15(S)-15-methyl-prostaglandin E2 methyl ester.

Midtrimester abortion was successfully induced in 29 of 30 patients with serial intramuscular injections of 15(S)-15-methyl-prostaglandin E2 methyl ester (15-ME-PGE2). The mean abortion time was 9.52 hours; parous patients aborted somewhat faster (mean, 8.76 hours) than nulliparous patients (mean, 10.47 hours). Eight patients were monitored throughout the abortion procedure and uterine activity was calculated and analyzed. Uterine response to a single injection of 5 mug 15-ME-PGE2 was characterized by the rapid appearance of low-amplitude, high-frequency contractions accompanied by a rise in intrauterine baseline tonus. Uterine activity rose to a mean of 500 Montevideo Units within 40 minutes of the initial intramuscular injection of 15-ME-PGE2. The most frequently encountered side effect of intramuscular injections of 15-ME-PGE2 was temperature elevation of 2 degrees F. or higher, which occurred in 29 of 30 patients. Five patients complained of shaking and chills but only five patients had any gastrointestinal side effects. From this study it appeared that on a weight-for-weight basis 15-ME-PGE2 is at least 20 times more potent than 15-ME-PGE2alpha and 1,000 time more potent than the naturally occurring PGE2.

Abortifacient Agents↗
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

Serum lipids during oestradiol-valerate/norgestrel treatment of menopausal women. Double-blind study of a sequential preparation.

Thirty-three women aged 38-56 years, all with menopausal complaints, were treated after randomization during three cycles either with oestradiolvalerate/norgestrel suquential therapy or a placebo and then during three cycles with the opposite drug. Serum cholesterol, triglycerides, glycerol as well as plasma FFA and lipoprotein electrophoresis were studied before the institution of treatment, after each cycle, and 4 weeks after the intake of the last tablet. During the treatment period the triglyceride level was significantly lower than during the placebo period, whereas no changes occurred in other parameters. The decrease was at a maximum after 8 weeks' treatment; 4 weeks after the discontinuation of treatment the levels were as before its institution. It cannot be decided whether the decrease was due to the natural oestrogen or to the gestagen.

Adult↗