ISSN:0001-6349    

DOI:10.3109/00016349609065728

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Background.Complement is activated in preeclampsia and complement products are known to activate macrophages. The aim of this study was to determine whether the macrophage derived cytokines, interleukin‐1ß, interleukin‐6 and tumor necrosis factor‐alpha, are released in patients with a form of severe preeclampsia characterized by the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome).Methods.Complement activation and plasma levels of cytokines were studied in 11 women with HELLP syndrome and in 11 controls with uncomplicated pregnancies. To further evaluate the connection between complement activation and cytokine release anin vitrostudy on heparinized whole blood incubated with recombinant C5a was performed.Results.In the HELLP group, complement anaphylatoxin C5a was increased in plasma at delivery (p<0.01) and one day after delivery (p<0.05), terminal C5b‐9 complement complex was elevated in plasma at delivery (p<0.001) and one day after (p<0.01), plasma levels of interleukin‐6 were increased one day after delivery (p<0.01), and plasma concentrations of tumor necrosis factor‐alpha were elevated at delivery (p<0.01), compared with corresponding levels in controls. All parameters normalized within one week. Interleukin‐16 did not differ between the groups.In vitro, recombinant C5a incubated in whole blood gave a dose‐dependent release of interleukin‐6. No increased release of interleukin‐1 or tumor necrosis factor‐alpha was seen after incubation.Conclusions.Since cytokine release occurs in severe preeclampsia, inflammatory mechanisms may participate in the pathophysiology

ISSN:0001-6349    

DOI:10.3109/00016349609065729

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective.To examine the expression of sex steroid receptors (ER: estrogen receptor; PR: progesterone receptor) in the postmenopausal endometrium (PMEM) and the relationship to clinical data for studying its characters.Methods.The immunohistochemical reactivity of the PMEM was studied using monoclonal antibodies against ER and PR, in 33 postmenopausal patients.Results.The endometrium was thicker in patients who were postmenopausal for 1 to 10 years (1.48±1.31mm) than in patients who were postmenopausal for more than 10 years (0.79 ± 0.37mm) (p<0.05). Among the 33 postmenopausal endometrial samples, ER positivity was found in the glands in 26 cases (78.8%) and PR positivity was detected in 18 cases (54.5%). The average age of the patients with ER positive reactivity in the glands (61.69±7.26 years) was significantly lower than that of the patients with ER negative reactivity (66.00±3.56 years) (p<0.05). Furthermore, the endometrial thickness of the patients with ER or PR positive reactivity in the glands (1.24± 1.09mm and 1.47±1.20mm, respectively) was significantly greater than that of the patients with ER or PR negative reactivity (0.67± 0.26mm and 0.70± 0.40mm, respectively) (p<0.05).Conclusion.ER in the glands of the PMEM was determined to decrease gradually with increased aging. The presence of ER and PR in the gland cells seemed likely to determine the thickness of t

ISSN:0001-6349    

DOI:10.3109/00016349609065730

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Background.The aim of this study was to evaluate the action of tamoxifen on the endometrium in states of chronic anovulation.Methods.Thirty‐eight rats inducted to persistent estrous (testosterone propionate) confirmed by hormonal colpocytology were divided into a control and an experimental group; the latter received tamoxifen and had fragments of the uterine horns processed for morphological and morphometrical analysis. Data were analysed statistically by the Mann‐Whitney and Student's t tests.Results.Our findings revealed minor uterine weight, epithelial thickness; number of endometrial glands and low eosinophil counts in the group that received tamoxifen. These results were statistically significant. We often observed areas of metaplasic stratified squamous epithelium between cylindrical epithelial cells in both groups.Conclusions.Our results indicate that antiestrogenic effect of tamoxifen was only partial in persistent estrous, since there was no blocking against the squamous metaplasia of the endometr

ISSN:0001-6349    

DOI:10.3109/00016349609065731

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Background.To evaluate whether the doppler flow velocity waveforms reflect the fetal hematocrit and to assess the changes of the umbilical artery doppler indices before and after the puncture of the umbilical cord.Material and methods.In this prospective‐study, Pulsed‐Doppler examinations of blood flow velocities in the umbilical artery were carried out before and after 22 diagnostic cordocentesis and 14 fetal blood transfusions into the umbilical vein.Results.There were decreases in the systolic/diastolic ratio (p<0.001), the pulsatility index (PI) (p<0.001), and the resistance index (RI) (p<0.003) after cordocentesis but not after fetal blood transfusion. There were no correlations between the initial hematocrit and the umbilical artery doppler indices in both fetal blood transfusion group and fetal blood sampling group. There was no correlation between the increase in hematocrit and changes in umbilical artery blood‐velocity waveform indices following fetal blood transfusion. The umbilical artery doppler flow‐velocity indices did not predict the fetal hematocrit.Conclusion.These findings suggest that acute changes in blood viscosity following intravascular transfusion are not associated with an increase in resistance to flow as assessed by doppler velocimetry. Umbilical blood samplingper semay be associated with a humorally mediated reduction in placental vascular resistance

ISSN:0001-6349    

DOI:10.3109/00016349609065732

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective.To investigate the effect of normal pregnancy and hypertensive disorders of pregnancy on the maternal renal artery Doppler blood flow velocity indices.Methods.The patient material consisted of 30 normal pregnant women, 29 women with pregnancy induced hypertension, 43 women with preeclampsia and 22 pregnant women with chronic hypertension. Blood flow velocities in the segmental renal arteries from the right kidney were analysed by pulsed and color Doppler. The systolic/diastolic (s.d.) ratio, resistance index (RI) and pulsatility index (PI) were used for Doppler waveform analysis.Results.In all of the groups of hypertensive pregnant women renal artery Doppler indices were significantly lower compared to the normal pregnant women group. There was a significant negative relationship between renal artery PI and mean arterial pressure in the preeclampsia group and in the chronic hypertension group.Conclusion.The present results demonstrate that the mechanism of renal autoregulation in preeclampsia might be altered, leaving glomerulus unprotected from increased blood pressure. It seems that the concept of renal vasoconstriction in preeclampsia might be disputed and needs further investigation.

ISSN:0001-6349    

DOI:10.3109/00016349609065733

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Background.External cephalic version at term is not always successful. This trial was done to ascertain whether tocolysis has any effect on the success rate.Methods.A randomized, double blind, controlled trial, with continuous paired sequential analysis. Fifty‐one consecutive patients with a singleton fetus in a breech presentation between 36 and 38 weeks gestation, external version being attempted on each. Ritodrine infusion or placebo was infused before attempt at external cephalic version.Setting.A university teaching hospital with 8000 confinements annually.Results.Version was successful in 17 of the 25 patients given tocolysis, but in only eight of the 25 given placebo (p<0.01). A positive benefit for tocolysis was shown after version had been completed in 10 pairs of patients. However the trial was continued until 25 pairs had been analyzed. The benefit deteriorated during analysis of the last 15 pairs suggesting that the initial benefit may reflect a learning curve for the procedure.Conclusion.Tocolysis is likely to improve the success rate of external cephalic version in late pregnancy, especially in nulliparous mothers or where doctors are learning the techniqu

ISSN:0001-6349    

DOI:10.3109/00016349609065734

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective.To investigate whether zinc supplementation during pregnancy improves maternal and fetal outcome.Design.Controlled clinical trial started at registration until discharge of mother and child from hospital. Two thousand volunteer mothers were randomly assigned to receive zinc supplementation or placebo in a double blind trial.Patients.Women less than 20 weeks pregnant at the first visit who agreed to take part in the study. One thousand two hundred and six mothers were available for study.Interventions.Volunteers were randomly selected to receive two tablets of zinc (44mg zinc in total) or two placebo tablets containing inert substances, indistinguishable in appearance and taste from the zinc tablets.Outcome measure.Large for gestational age (LGA), small for gestational age (SGA), premature rupture of the membrane (PROM), preterm labor (PL), preeclampsia and bleeding in the second or third trimester.Results.There were no differences between mothers given zinc supplementation concerning the outcome parameters and those given placebo.Conclusion.Zinc supplementation in pregnancy in a normal healthy middle class population in Denmark does not seem to offer any benefits to the mother or her fetus.

ISSN:0001-6349    

DOI:10.3109/00016349609065735

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Background.The objective of this study was to investigate the effectiveness of a single nasal spray administration of 0.8 mg bromocriptine in reducing PRL serum levels.Methods.Eighteen physiologically hyperprolactemic women in the early days of puerperium were randomized to receive nasal bromocriptine or placebo; PRL serum levels were measured by RIA at 45, 30 and 15 minutes before the administration and after the following times: 15, 30, 45, 60, 120, 180, 240, 300, and 480 minutes.Results.After the administration of bromocriptine serum levels of PRL decreased rapidly; the reduction was statistically significant after 45 minutes. Four hours after the administration mean serum levels of PRL resulted in the normal range (<20 μg/1); at the eighth hour the PRL levels were still normal. No one patient complained of any local or systemic side‐effects.Conclusion.Nasal route seems to be an effective and probably safe administration route for bromocripti

ISSN:0001-6349    

DOI:10.3109/00016349609065736

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Background.Due to the need for cost containment in the national health services in many countries, there is a demand for analysis of both medical and cost benefits of new technologies. Intracytoplasmic sperm injection has in recent years been proved to be the method of choice for treating severe infertility. It also needs to be shown that intracytoplasmic sperm injection is a cost‐effective treatment.Aim and methods.The aim of this study was to evaluate the cost‐effectiveness of intracytoplasmic sperm injection over a two‐year period and to compare it with the cost‐effectiveness of donor insemination. The mean direct and indirect costs of the two modes of treatment were compared with the outcome of the subsequent pregnancies and the cost per delivery in the two groups were calculated.Results and conclusions.The cost analysis showed a direct and indirect cost per delivery after intracytoplasmic sperm injection of 264.300 SEK in 1993, decreasing to 174.900 SEK in 1994. The corresponding cost of donor insemination was 88.900 SEK during the two‐year period. The cost analysis showed a 34% increase in cost‐effectiveness of intracytoplasmic sperm injection from the first to the second year, an increase that will most probably continue. In the near future intracytoplasmic sperm injection will be a cost‐effective treatment and, in addition, intracytoplasmic sperm injection will have the advantage of resulting in genetic children in a majority of the treated couples suffering from severe male

ISSN:0001-6349    

DOI:10.3109/00016349609065737

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY