| 1. |
- Abrahamsson, Gun, 1947, et al.
(author)
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Ovarian cyst formation in women of reproductive age receiving mitotane as part of the treatment of adrenocortical carcinoma: Clinical and experimental observations
- 2020
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In: Acta Obstetricia Et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 99:10, s. 1297-1302
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Journal article (peer-reviewed)abstract
- Introduction Mitotane is an adrenolytic drug that is used as an adjuvant to treat adrenocortical carcinoma. This study aimed to evaluate the clinical course and pathogenetic mechanisms underlying ovarian cyst formation in women of reproductive age diagnosed with adrenocortical carcinoma and being treated with mitotane as an adjuvant to surgery. Material and methods Five women presented with stage III-IV adrenocortical carcinoma and ovarian cyst formation during mitotane treatment. The clinical course of the disease was followed during and after treatment. The effects of mitotane on progesterone production and cell proliferation were studied in cultured human ovarian granulosa cells. Results Computed tomography and vaginal ultrasonography during mitotane treatment repeatedly demonstrated ovarian cysts of varying size without solid intralocular structures. Two women became amenorrheic during the treatment period. After mitotane cessation, the ovarian cysts disappeared and normal menstrual cycles resumed. One woman had an uncomplicated pregnancy two years after mitotane treatment. In one woman, who underwent salpingo-oophorectomy, histological analysis demonstrated benign ovarian cysts. Mitotane impeded the synthesis of progesterone, reduced the stimulatory effect of gonadotropins on progesterone formation, and reduced labeling with [H-3]thymidine in cultured granulosa cells. Conclusions Therapeutic concentrations of mitotane are associated with the formation of benign ovarian cysts and amenorrhea. Mitotane-induced suppression of ovarian steroidogenesis and impediment of the proliferative capacity of steroid-producing cells are suggested potential pathogenetic mechanisms underlying mitotane-induced ovarian dysfunction and cyst development. Mitotane treatment does not compromise future ovarian function.
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| 2. |
- Andersch-Björkman, Ylva, et al.
(author)
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Large scale identification of proteins, mucins, and their O-glycosylation in the endocervical mucus during the menstrual cycle.
- 2007
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In: Molecular & cellular proteomics : MCP. - 1535-9476. ; 6:4, s. 708-16
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Journal article (peer-reviewed)abstract
- The mucus filling the human cervical opening blocks the entry to the uterus, but this has to be relative and allow for the sperm to penetrate at ovulation. We studied this mucus, its content of proteins and mucins, and the mucin O-glycosylation in cervical secretions before, during, and after ovulation. Cervical mucosal secretions from 12 subjects were collected, reduced-alkylated, separated with polyacrylamide or agarose/polyacrylamide gel electrophoresis, and stained with silver, Alcian blue, or Coomassie Blue stain. Protein and mucin bands from before and during ovulation were digested and subsequently analyzed by nano-LC-FT-ICR MS and MS/MS. We identified 194 proteins after searches against the NCBI non-redundant protein database and an in-house mucin database. Three gel-forming (MUC5B, MUC5AC, and MUC6) and two transmembrane mucins (MUC16 and MUC1) were identified. For the analysis of mucin O-glycosylation, separated mucins from six individuals were blotted to PVDF membranes, and the O-glycans were released by reductive beta-elimination and analyzed with capillary HPLC-MS and -MS/MS. At least 50 neutral, sialic acid-, and sulfate-containing oligosaccharides were found. An increase of GlcNAc-6GalNAcol Core 2 structures and a relative decrease of NeuAc residues are typical for ovulation, and NeuAc-6GalNAcol and NeuAc-3Gal- epitopes are typical for the non-ovulatory phases. The cervical mucus at ovulation is thus characterized by a relative increase in neutral fucosylated oligosaccharides. This comprehensive characterization of the mucus during the menstrual cycle suggests mucin glycosylation as the major alteration at ovulation, but the relation to the altered physicochemical properties and sperm penetrability is still not understood.
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| 3. |
- Bullarbo, Maria, 1958, et al.
(author)
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Isosorbide mononitrate induces increased cervical expression of cyclooxygenase-2, but not of cyclooxygenase-1, at term
- 2007
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In: Eur J Obstet Gynecol Reprod Biol. ; 130:2, s. 160-4
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Prostaglandin and nitric oxide (NO) are both known to be involved in cervical ripening at term. The aim of the study was to investigate if NO has an effect on cervical expression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), the two main isoenzymes involved in prostaglandin synthesis, and to localize these enzymes within the cervix. STUDY DESIGN: Women with an unripe cervix scheduled for elective caesarean section at term were randomly selected to receive vaginally either the NO donor isosorbide mononitrate (IMN) or placebo 4h before surgery. At the operating theatre, cervical tissue specimens were obtained for immunoblotting and immunohistochemistry. RESULTS: Increased expression of COX-2 was found in specimens exposed to IMN compared to specimens obtained from women in the placebo group. There was no difference in the expression of COX-1. Immunohistochemistry revealed similar localization of the two enzymes in treated and untreated women. CONCLUSIONS: Vaginal administration of IMN induces increased cervical expression of COX-2, but not of COX-1. This pathway may be of importance in the process of cervical ripening at term.
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| 4. |
- Bullarbo, Maria, 1958, et al.
(author)
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Nitroglycerin for management of retained placenta: a multicenter study.
- 2012
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In: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9597 .- 1687-9589. ; 2012
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Journal article (peer-reviewed)abstract
- The primary aim was to determine if sequential administration of oxytocin and nitroglycerin is effective for management of retained placenta when performed by obstetricians with no experience of the method. Secondary aims were to examine possible adverse effects of nitroglycerin. One hundred and five women with retained placenta were randomly selected to receive either 1mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin had failed to expel the placenta. At two of the hospitals some of the midwives were familiar with the use of nitroglycerin. The other midwives and all the participating obstetricians had no clinical experience of the method. In the treatment group, detachment of placenta following nitroglycerin occurred in 37.3% of the women compared to 20.4% in the placebo group (P = 0.056). In the two hospitals with some experience of the method, placenta was removed in 9 of 19 (47.4%) women in the nitroglycerin group compared to 3 of 17 (15.0%) women in the placebo group. No adverse effects of clinical importance were registered. Although the difference between the two groups did not reach statistical significance, the higher success rate in the two hospitals with some experience could indicate that clinical experience is of importance in order to achieve placental detachment.
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| 5. |
- Bullarbo, Maria, 1958, et al.
(author)
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Outpatient vaginal administration of the nitric oxide donor isosorbide mononitrate for cervical ripening and labor induction postterm: a randomized controlled study
- 2007
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In: Am J Obstet Gynecol. ; 196:1
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Our aim was to examine the efficacy, safety, and acceptability of isosorbide mononitrate for cervical ripening and labor induction in women in an outpatient setting. STUDY DESIGN: Two hundred pregnant women of at least 42 weeks' gestation with an unripe cervix were randomly selected to receive vaginally either 40 mg isosorbide mononitrate or placebo tablets. RESULTS: Twenty-two women treated with isosorbide mononitrate went into labor within 24 hours compared to 8 women in the placebo group (P < .05). In women who did not go into labor, cervical status was similar in the 2 groups the next day. Headache was a common side effect. No maternal or fetal side effects of clinical importance were registered. CONCLUSION: Outpatient cervical ripening and labor induction with isosorbide mononitrate seems to be an effective, safe, and well tolerated procedure. The definitive clinical efficacy and safety needs to be evaluated in larger series of patients.
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| 6. |
- Bullarbo, Maria, 1958, et al.
(author)
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Sublingual nitroglycerin for management of retained placenta
- 2005
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In: Int J Gynaecol Obstet. ; 91:3, s. 228-32
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of the study was to investigate the effect of sublingual nitroglycerin for management of retained placenta and to assess possible adverse effects of the treatment. METHOD: Twenty-four women were randomly selected to receive either 1 mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin and controlled umbilical cord traction had failed to expel the placenta. Success rate for delivery of placenta, blood pressure, pulse rate, blood loss, and various side effects were examined. RESULT: All 12 women in the nitroglycerin group had successful delivery of placenta, while removal of placenta was successful in only one of the 12 women in the placebo group. No adverse effects of clinical importance were registered. CONCLUSION: Sublingual nitroglycerin for treatment of retained placenta seems to be effective without causing serious adverse effects. However, the definite clinical value needs to be evaluated in larger series of patients.
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| 7. |
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| 8. |
- Ekerhovd, Erling, et al.
(author)
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Sublingual nitroglycerin seems to be effective in the management of retained placenta
- 2008
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 87:2, s. 222-5
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Journal article (peer-reviewed)abstract
- BACKGROUND: A common approach in the management of retained placenta is administration of oxytocin followed by controlled cord traction. Previously it has also been demonstrated that intravenously administered nitroglycerin facilitates manual extraction of retained placenta. The purpose of the present trial was to examine the success rate and safety of sequential administration of intravenous oxytocin in combination with sublingual nitroglycerin for the delivery of retained placenta. METHODS: The report is a chart review of 24 women with retained placenta despite intravenously administered oxytocin. The women were given sublingual nitroglycerin (1 mg) to promote detachment of the placenta. Some 5 min after resorption of the tablets, controlled cord traction was carried out for a maximum of 5 min. In addition, changes in blood pressure following treatment with nitroglycerin and total blood loss during delivery were registered. RESULTS: Twenty-one of the women delivered the placenta successfully following sublingual administration of nitroglycerin. The procedure failed in 3 women and operative manual removal under regional or general anesthesia was undertaken. No complications due to nitroglycerin were registered. CONCLUSIONS: Sequential administration of oxytocin and nitroglycerin seems to be an effective and safe procedure in the management of retained placenta. However, larger studies are needed to confirm the encouraging results of the present trial.
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| 9. |
- Ekerhovd, Erling, et al.
(author)
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Swedish sperm donors are driven by altruism, but shortage of sperm donors leads to reproductive travelling.
- 2008
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In: Upsala journal of medical sciences. - 2000-1967. ; 113:3, s. 305-13
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Journal article (peer-reviewed)abstract
- Swedish legislation requires that sperm donors are identifiable to offspring. In Denmark sperm donors remain anonymous. The aim of this study was to examine sperm donation in Sweden by identifying socio-demographic backgrounds, motivations and attitudes among donors and to describe options and plans of sperm recipients. Furthermore, the willingness of Swedish health care providers to assist in treatment abroad, where sperm from an anonymous donor were to be used, was assessed. The extent of travelling to Denmark for reproductive purposes was also examined.
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| 10. |
- Ekerhovd, Erling
(author)
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[Use of GnRH antagonist for in vitro fertilization]. : Bruk av GnRH-antagonist ved in vitro-fertilisering.
- 2011
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In: Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række. - : Norwegian Medical Association. - 0807-7096. ; 131:17, s. 1649-52
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Journal article (peer-reviewed)abstract
- For many patients, the typical treatment protocol for in vitro fertilization (IVF) is both physically and psychologically demanding. An alternative approach to use of gonadotropin-releasing hormone (GnRH)-agonists traditionally used to prevent premature ovulation, is use of GnRH-antagonists. The aim of this article is to describe advantages and disadvantages of using GnRH-antagonists in IVF.
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