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Biomedical subjects

W Droegemueller

Publications and source records attributed to W Droegemueller.

At least 55 records · Page 3Linked to original sources

Urea and dilatation of the cervix.

The minimal elasticity of the uterine cervix has been related to its high collagen content. By interfering with cohesive forces that hold the collagen fiber bundle together, it is possible to diminish the physical strength of collagen. Urea has been used in collagen chemistry to dissociate collagen by interfering with hydrophobic linkages and hydrogen bonds. This results in a change of mechanical properties such as a decrease in tensile strength and an increase in elasticity. Basic studies of rat tail tendon demonstrated the additive effects of pH, concentration of urea, and temperature on the mechanical characteristics of collagen fibers. In vitro testing was performed using an injection of 30 per cent urea at pH 4. Serial measurements with a spring gauge instrument showed a reduction in cervical resistance. A cervical injection technique has been developed and toxicity of urea studied.

Animals↗

Cryocoagulation of the endometrium at the uterine cornua.

A cryoprobe that will produce coagulation necrosis and subsequent scar formation of the cornual areas of the uterus has been tested. A discussion is made of the developmental program, including the design of the instrument, efficacy and safety testing in baboons, and preliminary investigations of the safety of this procedure in man.

Animals↗

Bronchoconstriction and pulmonary hypertension during abortion induced by 15-methyl-prostaglandin F2alpha.

Patients have experienced severe breathlessness during second trimester abortion initiated by the intramuscular injection of 15-methyl-prostaglandin F2alpha (15-me-PGF2alpha). In four healthy women given 400 mug of 15-me-PGF2alpha to induce abortion, pulmonary function tests showed reductions in arterial oxygen tension, maximum expired air flow and vital capacity. Residual lung volume and the slope of phase III of the closing volume curves increased.

Abortion, Induced↗

Absence of bacteremia after insertion or removal of intrauterine devices.

A prospective study of the risk of bacteremia in 84 women having insertion and in 16 women having removal of intrauterine devices was performed. Bacteremia was not found in any of these 100 women at 1 to 3, 15, or 30 minutes after the procedure or in any of 57 women studied again 1.5 hours later. Because of the remote risk of bacteremia, the presence of congenital or valvular heart disease need not be an absolute contraindication to the use of an intrauterine device for contraception in an otherwise healthy young woman. Prophylactic antimicrobial therapy during insertion or removal of an intrauterine device appears to be unnecessary in the absence of evident pelvic infections. The risk of bacteremia during removal of an intrauterine device from an infected uterus cannot be determined from this study.

Female↗

The synergistic effect of calcium and prostaglandin F2alpha in second trimester abortion. A pilot study.

A clinical use of the basic science phenomenon that prostaglandin is synergistic with calcium in increasing uterine contractility has been demonstrated. Twenty-five women had midtrimester abortions induced with intraamniotic calcium gluconate followed by prostaglandin F2alpha. All patients aborted within 21 hours with minimal toxicity. The mean injection-to-abortion interval was 13.5 hours in the group of women without a preinjection laminaria and 10.1 hours in patients when a laminaria was included in the protocol.

Abortion, Induced↗

The intrauterine device and tubo-ovarian abscess.

During the past 4 years, 16 patients have been seen who developed a unilateral tubo-ovarian abscess while wearing, or soon after removal of, an IUD. None of the patients had gonorrhea. There appears to be a prodromal syndrome before abscess formation of 2 to 5 weeks during which the patient complains of vague lower abdominal pain, pelvic tenderness, and dyspareunia. A few patients had a rapid onset of symptoms. The device should be removed when prodromal symptoms arise and the patient should be treated with antibiotics. Should a tubo-ovarian abscess develop, surgical intervention is necessary.

Abortion, Septic↗

Conjugated estrogens and hypercoagulability.

A group of 11 menopausal women receiving 1.25 mg. of conjugated estrogens daily had coagulation tests to determine the development of hypercoagulability after taking 5 and 21 tablets. There was no essential change in thrombin generation or fibrinolytic activity as measured by euglobin lysis time. There was a shift toward hypercoagulability in all three parameters of the thrombelastograms. The decrease of the antithrombin III activity was not as pronounced following the administration of conjugated estrogens as had been the change associated with oral contraceptives. Fibrin monomers were observed in some women during the first week of Premarin therapy.

Adult↗

Preliminary experience with 15 (S) 15-methyl prostaglandin F2 alpha for midtrimester abortion.

Twenty-six women received intramuscular or intra-amniotic 15 (S) 15-methyl prostaglandin F2 alpha to induce midtrimester abortion. The median initial injection-abortion interval was 10 hours and 25 minutes. The advantages of intramuscular analogue are somnolence and reduced discomfort during labor. Disadvantages include severe gastrointestinal toxicity in the majority of patients and symptoms of acute respiratory distress in two patients.

Abortion, Induced↗

15-Methylation augments the cardiovascular effects of prostaglandin F-2alpha.

Intramuscular injection of the 15-methyl analogue of prostaglandin F-2alpha (15-ME-PGF-2alpha) is being used to initiate second trimester abortion. The natural prostaglandin F-2alpha (PGF-2alpha) is a known pulmonary pressor agent but there is little information about the cardiovascular effects of the analogue. Consequently, we compared the hemodynamic responses to the two forms in twenty-three anesthetized dogs. Given I.M. or I.V. 15-me-PGF-2alpha produced a greater and more sustained rise in pulmonary arterial pressure than PGF-2alpha. Intramuscular 15-me-PGF-2alpha also elicited a more prolonged increase in pulmonary vascular resistance than prostaglandin F-2alpha given I.M. or I.V. The methyl analogue (I.M. or I.V.) causes a greater initial fall in systemic arterial oxygen tension and cardiac output, and a greater increase in systemic resistance than I.M. PGF-2alpha. Breathlessness seen during abortion induced by prostaglandin F-2alpha or its methyl analogue may be caused by acute pulmonary hypertension in addition to bronchoconstriction.

Animals↗

Gynecologic malignancies in immunosuppressed organ homograft recipients.

Immunosuppressed organ homograft recipients have a 5 to 6% incidence of de novo malignancies at some time after transplantation. Gynecologic cancers were encountered in 21 of 224 patients (9%) with these tumors. The predominant lesion was carcinoma of the cervix (18 cases), of which 16 were intraepithelial and 2 were invasive. Gynecologic malignancies have also been encountered in non-transplant patients who were treated with immunosuppressive agents or cancer chemotherapy. All such individuals require gynecologic examination before commencement of treatment and at regular intervals thereafter so that malignancies may be diagnosed at an early stage and treated effectively. Most neoplasms respond well to conventional cancer therapy, but high-grade malignancies may necessitate reduction or cessation of immunosuppressive therapy as well.

Adolescent↗