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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 13 (2005), S. 0 
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The normal ripening of the human cervix is characterized by rapid degradation of the extracellular matrix, where fibroblasts play an important role. To accomplish this, the fibroblasts undergo phenotypic changes, generally characterized by decreased synthesis of ECM molecules and increased production of degrading enzymes. The hypothesis of this study is that fibroblasts from cervices at different stages of remodeling are of different phenotypes. Fibroblasts were obtained from nonpregnant women, women after 36 weeks of pregnancy and women directly after partus (postpartal) and kept for at least three–four passages to obtain stable conditions prior experiments were performed. The cells were immunostained for differentiation markers, screened for cytokine and MMP expression and production, followed by a global proteomic search. In accordance with in vivo data, a decrease of α-smooth muscle actin and 4-prolyl-hydroxylase was noted by immunohistochemical staining with time of pregnancy. The fibroblasts established from postpartal donors had a three- to fourfold increase of interleukin 6 (IL-6). The production of the chemotactic interleukin 8 (IL-6) was increased even further, five- to sixfold, in postpartal fibroblast cultures. This correlates well to the events in vivo, where IL-6 and Il-8 is produced in high amounts by cervical fibroblast. In addition also the secretion metalloproteinase 1 and 3 are increased threefold in postpartal cultures, which is in agreement with in vivo events. Intermediate amounts of interleukins and metalloproteinases are produced in culture obtained after 36 weeks of pregnancy. A global proteomic approach resulted in regulated proteins involved in Ca-signaling, cytoskeletal mobility and apoptosis. Taken together these data suggest that remodeling of cervix is achieved by a transient activation or recruitment or differentiation of active fibroblasts usually found in inflammatory conditions, characterized by increased MMP and cytokine expression.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the true analgesic effect of morphine and pethidine on labour pain.Design The analgesic and sedative effects of intravenous morphine or pethidine and their effect on anxiety were compared in a prospective, double-blind, randomised dose-response study.Setting A Stockholm teaching hospital obstetric unit.Participants Ten healthy nulliparous parturients in active labour were included in each group.Results Even after repeated doses (up to 0.15 mgkg body weight morphine and up to 15 mag body weight pethidine) the findings were uniform, with very high pain scores maintained in each group as assessed with visual analogue scale. The parturients were all significantly sedated and several fell asleep but were awakened by pain during contractions.Conclusion It is concluded that labour pain is not sensitive to systemically administered morphine or pethidine. These drugs only cause heavy sedation. It therefore seems unethical and medically incorrect to meet parturients' requests for pain relief by giving them sedation. Considering the well documented negative effects on newborn infants we also believe systemic pethidine should be avoided in labour.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-3023
    Keywords: Collagen ; Intravaginal slingplasty ; Pubourethral ligament ; Stress urinary incontinence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The intravaginal slingplasty procedure (IVS) was carried out on 75 patients with genuine stress urinary incontinence. The main aims of the operation are to create an artificial pubourethral ligament and to tighten the suburethral vaginal wall. An important ingredient in the supportive structures of the genitourinary region is fibrous connective tissue, consisting mainly of collagen. To analyse thi component biopsies were obtained transvaginally, close to the position of the sling, both preoperatively and 2 years after surgery, from 6 patients. Collagen was analysed for concentration and extractability. Extractability by pepsin digestion was increased by 60% 2 years following surgery. Postoperative follow-up studies from 12 months to 3 years showed complete restoration of continence in 63 patients (84%) and considerable improvement in 4 others (5%). The 8 failures (9%) were all related to early rejection of the sling. The IVS procedure is an attractive surgical procedure as it necessitates minimum invasion and can be performed under local anesthesia, with a short hospital stay and sick-leave period. The enhanced collagen extractability indicates a changed metabolism, most likely induced by the implanted sling, resulting in a restoration of the elastic properties of the connective tissue.
    Type of Medium: Electronic Resource
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