Skip header and navigation

Refine By

   MORE

10 records – page 1 of 1.

Ectopic pregnancy and infertility following treatment of infertile couples: a follow-up of 929 cases.

https://arctichealth.org/en/permalink/ahliterature65024
Source
Eur J Obstet Gynecol Reprod Biol. 1991 Nov 3;42(1):33-8
Publication Type
Article
Date
Nov-3-1991
Author
L. Tuomivaara
L. Rönnberg
Author Affiliation
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Source
Eur J Obstet Gynecol Reprod Biol. 1991 Nov 3;42(1):33-8
Date
Nov-3-1991
Language
English
Publication Type
Article
Keywords
Abortion, Spontaneous - complications
Adhesions - complications
Adult
Endocrine System Diseases - complications
Fallopian Tubes - pathology
Female
Follow-Up Studies
Humans
Hysterosalpingography - adverse effects
Infertility, Female - etiology
Occupational Exposure - adverse effects
Pregnancy
Pregnancy, Ectopic - complications
Regression Analysis
Risk factors
Smoking - adverse effects
Abstract
A follow-up analysis was made of 929 infertile couples, with special attention paid to ectopic pregnancy. The conception rate was 46%, and 9% of the pregnancies were ectopic. Previous ectopic pregnancy, an industrial occupation and smoking reduced the fecundity and increased the risk of ectopic pregnancy. Tubal damage as a verified reason for infertility and its treatment also increased the risk of ectopic pregnancy. Stepwise logistic regression analysis showed the strongest association with ectopic pregnancy to exist in the case of women with a previous ectopic pregnancy (9.9-fold risk) rather than women with primary infertility. Treatment of tubal damage by salpingostomy entailed a 6.0-fold risk and treatment by other methods a 2.8-fold risk. Women working in industry had a 3.5-fold risk of ectopic pregnancy compared with those in other professions.
PubMed ID
1778288 View in PubMed
Less detail

Efficacy of gonadotropin-releasing hormone agonist (buserelin) in the treatment of endometriosis.

https://arctichealth.org/en/permalink/ahliterature65364
Source
Acta Obstet Gynecol Scand. 1989;68(1):49-53
Publication Type
Article
Date
1989
Author
L. Rönnberg
A. Koskimies
T. Laatikainen
T. Ranta
J. Saastamoinen
Author Affiliation
Department of Obstetrics and Gynecology, University Central Hospitals of Oulu, Finland.
Source
Acta Obstet Gynecol Scand. 1989;68(1):49-53
Date
1989
Language
English
Publication Type
Article
Keywords
Administration, Intranasal
Adult
Buserelin - adverse effects - therapeutic use
Clinical Trials
Endometriosis - blood - drug therapy - pathology
Female
Follow-Up Studies
Hormones - blood
Humans
Multicenter Studies
Pregnancy
Abstract
In a multicenter study, the efficacy of and tolerance of 6 months' intranasal gonadotropin-releasing hormone agonist (buserelin) treatment (300 micrograms x 3/day) on laparoscopically verified endometriosis was evaluated in 25 patients. At second-look laparoscopy at the end of medication, the mean endometriosis score had fallen by 82.2%. All endometriosis-associated symptoms and physical findings decreased or almost disappeared during buserelin administration. After discontinuing therapy, they showed a tendency to reappear, but nevertheless they were milder after one year of follow-up, than before treatment. Seven (54%) of the 13 women wishing pregnancy actually conceived. Vaginal irregular spotting bleedings during the first 2 months occurred in 7 patients. No patient withdrew from the trial because of side effects, although almost all women developed symptoms of estrogen deficiency (serum estradiol concentrations fell to menopausal levels).
PubMed ID
2508418 View in PubMed
Less detail

Elevated serum levels of endometrial secretory protein PP14 in patients with advanced endometriosis. Suppression by treatment with danazol and high-dose medroxyprogesterone acetate.

https://arctichealth.org/en/permalink/ahliterature65287
Source
Am J Obstet Gynecol. 1989 Oct;161(4):866-71
Publication Type
Article
Date
Oct-1989
Author
S. Telimaa
A. Kauppila
L. Rönnberg
A M Suikkari
M. Seppälä
Author Affiliation
Department of Obstetrics and Gynecology, University Central Hospital of Oulu, Finland.
Source
Am J Obstet Gynecol. 1989 Oct;161(4):866-71
Date
Oct-1989
Language
English
Publication Type
Article
Keywords
Adult
Combined Modality Therapy
Danazol - pharmacology
Endometriosis - blood - therapy
Female
Glycoproteins
Humans
Medroxyprogesterone - blood
Menstrual Cycle - blood
Pregnancy Proteins - blood
Research Support, Non-U.S. Gov't
Abstract
The circulating concentration of endometrial protein PP14 varied during the menstrual cycle in patients with endometriosis. The highest levels were found on days 1 to 4 of the cycle (176 +/- 123 micrograms/L; mean +/- SD), and the lowest on days 5 to 20 (44.1 +/- 29.7 micrograms/L). Rising levels were observed on days 21 to 30 (58.3 +/- 62.6 micrograms/L). On days 5 to 20 (i.e., during period of the lowest levels) patients with advanced endometriosis had higher PP14 levels (63.9 +/- 39.0 micrograms/L) than those with mild endometriosis (29.3 +/- 18.2 micrograms/L; p less than 0.01). Patients with mild endometriosis had slightly higher serum PP14 levels than apparently healthy control subjects (p less than 0.05), but overlapping of values between the two groups is remarkable. Conservative surgical elimination of endometriosis significantly decreased the serum PP14 levels. Treatment with danazol (600 mg/day), or with medroxyprogesterone acetate (100 mg/day) after laparoscopy also resulted in significant decreases in the serum PP14 concentration. After 6 months of treatment, conservative surgery in combination with danazol or with medroxyprogesterone acetate, yielded more pronounced declines in serum PP14 level than conservative surgery plus placebo. No significant difference was observed between the effects of danazol and medroxyprogesterone acetate. We conclude that endometriosis tissue contributes to the circulating PP14 level, and the decline in PP14 level during danazol and medroxyprogesterone acetate treatments reflects regression of intrauterine and ectopic endometrial tissues.
PubMed ID
2801831 View in PubMed
Less detail
Source
Ann Med. 1990 Apr;22(2):91-6
Publication Type
Article
Date
Apr-1990
Author
L. Rönnberg
Author Affiliation
Department of Obstetrics and Gynaecology, Oulu University Central Hospital, Finland.
Source
Ann Med. 1990 Apr;22(2):91-6
Date
Apr-1990
Language
English
Publication Type
Article
Keywords
Endometriosis - complications - surgery
Female
Humans
Infertility, Female - etiology
Abstract
The relationship of endometriosis, the most common benign gynaecological disease during reproductive life, to infertility is generally ill understood. The association between infertility and minimal to mild endometriosis, when no anatomical defect is evident, may be explained by the following possible mechanisms: alternations in peritoneal fluid (macrophages - immunoglobulins, Interleukin-1, protease inhibitors, prostanoids, an ovum capture inhibitor), ovulatory dysfunctions (anovulation, LUF syndrome), luteal phase defect, disturbed implantation, and spontaneous abortion. These possibilities are discussed. The latest prospective controlled studies offer strong evidence that endometriosis per se is not a direct cause of infertility. On the other hand, the disease usually deteriorates if not treated, and therefore medical or surgical interventions are often needed when expectant treatment or other infertility therapies, e.g., ovulation induction, fail to result in pregnancy. Women with minimal to mild endometriosis only should be diagnosed as having unexplained infertility, which today may be treated by in vitro fertilization.
PubMed ID
2193663 View in PubMed
Less detail

Laminin in the human embryo implantation: analogy to the invasion by malignant cells.

https://arctichealth.org/en/permalink/ahliterature24421
Source
Fertil Steril. 1992 Jul;58(1):105-13
Publication Type
Article
Date
Jul-1992
Author
T. Turpeenniemi-Hujanen
L. Rönnberg
A. Kauppila
U. Puistola
Author Affiliation
Department of Radiotherapy and Oncology, University of Oulu, Finland.
Source
Fertil Steril. 1992 Jul;58(1):105-13
Date
Jul-1992
Language
English
Publication Type
Article
Keywords
Adult
Antigens, CD29
Comparative Study
Embryo - chemistry - enzymology - physiology
Female
Fertilization in Vitro
Fibronectins - analysis
Humans
Immunoenzyme Techniques
Integrins - analysis
Laminin - analysis - physiology
Metalloendopeptidases - analysis
Microbial Collagenase - analysis - metabolism
Neoplasm Invasiveness - pathology
Organ Culture Techniques
Pregnancy
Receptors, Immunologic - analysis
Receptors, Laminin
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: To explore the possible similarities between the biochemical processes of embryo implantation and malignant invasion. DESIGN: The expression of a basement membrane (BM) glycoprotein laminin, a matrix binding cell surface receptor protein beta 1-integrin, and a BM collagen degrading metalloproteinase type IV collagenase, was studied in cultured human in vitro fertilized embryos. PATIENTS: Eight healthy women suffering from tubal infertility were participating in the IVF program in the Department of Obstetrics and Gynecology in University Hospital of Oulu. Twenty oocytes and 110 pre-embryos that were not transferred for the fertilizations were used in this study. MAIN OUTCOME MEASURES: Fibronectin, laminin, beta 1-integrin, and type IV collagenase immunoreactive proteins were studied in embryos by immunoperoxidase staining, and type IV collagen degrading activity was measured from the culture media of the embryos. RESULTS: Laminin and beta 1-integrin were expressed in the early human embryos before the time of implantation. Type IV collagen degrading activity and the 72 kd-type IV collagenase immunoreactive protein were expressed at the time of implantation. Laminin supported the expression of type IV collagenase. CONCLUSIONS: The expression of laminin, beta 1-integrin, and type IV collagenase in vitro are temporally in good correlation with the time of the implantation in vivo. Laminin and beta 1-integrin can relate to the attachment of the embryos to the uterine BM and type IV collagenase to the degradation of the BM collagen during the implantation. Laminin can augment the process locally.
PubMed ID
1378028 View in PubMed
Less detail

Mental impairment and utilization of community services: a study of the elderly in a parish of Stockholm.

https://arctichealth.org/en/permalink/ahliterature72853
Source
Scand J Soc Med. 1996 Sep;24(3):185-92
Publication Type
Article
Date
Sep-1996
Author
L. Rönnberg
L. Welin
B. Winblad
Author Affiliation
Department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Huddinge, Sweden.
Source
Scand J Soc Med. 1996 Sep;24(3):185-92
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Dementia
Female
Humans
Male
Research Support, Non-U.S. Gov't
Residential Facilities
Sweden
Abstract
Before the implementation of the health care reform of 1992 (The Adel Reform), a study of the frequency of mental impairment of people in different residential and care services was conducted in a parish of Stockholm. All residents, 65 years or older, registered with Primary Care Centres, Geriatric Hospitals and other institutions were assessed with respect to cognitive function according to the seven stage "Global Deterioration Scale" (GDS). The age-specific frequencies of mental impairment were similar to prevalences reported in earlier studies. The frequency of cognitive dysfunction of non-institutionalized and institutionalized elderly was 42% and 52%, respectively, and higher for women than for men. There was considerable variation in the prevalence of cognitive dysfunction among subjects in different types of accommodation. For the different stages of mental impairment the average age was about the same. With increasing need and demand for services, and limited resources, these variations in cognitive dysfunction have important implications for structuring appropriate support systems in a population with a rapidly rising proportion of elderly people.
PubMed ID
8878372 View in PubMed
Less detail

Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis.

https://arctichealth.org/en/permalink/ahliterature26159
Source
Gynecol Endocrinol. 1987 Mar;1(1):13-23
Publication Type
Article
Date
Mar-1987
Author
S. Telimaa
J. Puolakka
L. Rönnberg
A. Kauppila
Author Affiliation
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Source
Gynecol Endocrinol. 1987 Mar;1(1):13-23
Date
Mar-1987
Language
English
Publication Type
Article
Keywords
Adult
Antineoplastic Agents - administration & dosage - adverse effects
Clinical Trials
Comparative Study
Danazol - administration & dosage - adverse effects
Dose-Response Relationship, Drug
Double-Blind Method
Endometriosis - drug therapy
Female
Humans
Infertility, Female - drug therapy
Laparoscopy
Medroxyprogesterone - administration & dosage - adverse effects - analogs & derivatives
Medroxyprogesterone 17-Acetate
Ovarian Neoplasms - drug therapy
Pelvic Neoplasms - drug therapy
Pregnadienes - administration & dosage
Pregnancy
Random Allocation
Abstract
A prospective, double-blind, placebo-controlled study was designed to evaluate the clinical efficacy and tolerance of danazol and high-dose medroxyprogesterone acetate (MPA) in the treatment of mild-moderate endometriosis. After laparoscopical confirmation of endometriosis, 59 patients were randomized to receive danazol (200 mg 3 times daily), MPA (100 mg daily) or placebo for 6 months. Clinical examinations were done before and 1, 3, 6 and 12 months after the beginning of the study, and a 2nd laparoscopy 6 months after termination of the medication. Eighteen patients in the danazol group, 16 in the MPA group and 17 in the placebo group completed the trial. Total or partial resolution of peritoneal implants was observed in 60% of the patients receiving danazol and in 63% of the patients receiving MPA. In the placebo group, resolution was observed in 18%, while the size of the implants was estimated to be increased in 23% of the patients. In relation to placebo, danazol and MPA significantly alleviated endometriosis-associated pelvic pain, lower back pain and defecation pain, but they did not differ from each other in these actions. The appearance of acne, muscle cramps, edema, weight gain and spotting bleeding complicated MPA treatment. The present results indicate that because of good efficacy and tolerance, high-dose MPA is a useful alternative in the hormonal treatment of endometriosis.
PubMed ID
2972167 View in PubMed
Less detail
Source
Contrib Gynecol Obstet. 1987;16:40-7
Publication Type
Article
Date
1987
Author
A. Kauppila
H. Rajaniemi
L. Rönnberg
R. Vihko
Author Affiliation
Department of Obstetrics and Gynaecology, University of Oulu, Finland.
Source
Contrib Gynecol Obstet. 1987;16:40-7
Date
1987
Language
English
Publication Type
Article
Keywords
Cytosol - analysis
Endometriosis - analysis
Female
Humans
Ovary - analysis
Receptors, Estrogen - analysis
Receptors, LH - analysis
Receptors, Progesterone - analysis
Uterine Neoplasms - analysis
PubMed ID
3319398 View in PubMed
Less detail

Regression of endometriosis following shorter treatment with, or lower dose of danazol. Comparison of pre- and post-treatment laparoscopic findings in the Scandinavian multi-center study.

https://arctichealth.org/en/permalink/ahliterature241287
Source
Acta Obstet Gynecol Scand Suppl. 1984;123:51-8
Publication Type
Article
Date
1984
Author
A. Döberl
A. Bergqvist
S. Jeppsson
A I Koskimies
L. Rönnberg
E. Segerbrand
J. Starup
Source
Acta Obstet Gynecol Scand Suppl. 1984;123:51-8
Date
1984
Language
English
Publication Type
Article
Keywords
Adult
Amenorrhea - complications
Danazol - administration & dosage
Endometriosis - complications - diagnosis - drug therapy
Female
Humans
Laparoscopy
Pregnadienes - administration & dosage
Scandinavia
Abstract
One hundred and sixteen patients with laparoscopically confirmed primary or recurrent endometriosis were treated with danazol, either 600 mg daily for 4 months (group A, n = 76) or 600 mg daily for the first 2 months, followed by 400 mg daily for an additional 4 months (group B, n = 40). The only surgery performed before treatment was biopsies, resection of endometriomas greater than or equal to 3 cm and/or adhesiolysis. The extent of endometriosis before and after treatment was established laparoscopically and recorded by means of a modified AFSrecord as mean additive diameter of implants (mean ADI) in millimeters. This provided a uniform and reproducible quantitative registration for each type and location of endometriotic implant. Both treatment schemes resulted in a highly significant (p less than 0.001) reduction of endometriosis, by 79 and 89% in groups A and B, respectively. However, the reduction in mean ADI was significantly greater (p less than 0.025) in group B which had been treated for a longer period. Moreover, the proportion of patients with extensive pre-treatment lesions (mean ADI greater than or equal to 40 mm) was significantly greater in this group. Active residual endometriosis was found in 21 and 17.5% in groups A and B, respectively. These patients had significantly more extensive endometriosis before treatment. The regression of endometriotic implants was independent of type and/or location, i.e. superficial or scarred; peritoneal, ovarian, or tubal. There was no apparent correlation between the quantitative reduction of endometriosis and amenorrhea versus occasional spotting and/or irregular menstruations.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
6238497 View in PubMed
Less detail
Source
Acta Obstet Gynecol Scand Suppl. 1989;150:7-13
Publication Type
Article
Date
1989
Author
A J Kauppila
S. Telimaa
L. Rönnberg
Author Affiliation
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Source
Acta Obstet Gynecol Scand Suppl. 1989;150:7-13
Date
1989
Language
English
Publication Type
Article
Keywords
Antineoplastic Agents - therapeutic use
Comparative Study
Danazol - therapeutic use
Double-Blind Method
Endometriosis - drug therapy - pathology
Female
Genital Neoplasms, Female - drug therapy - pathology
Gestrinone - therapeutic use
Humans
Medroxyprogesterone - analogs & derivatives - therapeutic use
Medroxyprogesterone 17-Acetate
Norpregnatrienes - therapeutic use
Pregnadienes - therapeutic use
Pregnancy
Randomized Controlled Trials
Abstract
Progestins, including medroxyprogesterone acetate (MPA), danazol and gestrinone, are used in the medical management of endometriosis. Danazol and gestrinone, by inducing progestin-like effects, closely resemble MPA in their actions on intrauterine endometrium. Ectopic endometrium, on the other hand, does not respond to these hormonal stimuli (as determined by estrogen and progestin receptor assays and 17 beta-hydroxysteroid dehydrogenase activity measurements), indicating that the therapeutic effects of steroidal drugs may not be entirely due to an action on the endometrium. At therapeutic doses, these drugs also prevent the midcycle elevation in gonadotropic hormone secretion and suppress ovarian activity (as evidenced by follicular arrest and low and stable estrogen and progesterone secretion). These indirect actions of progestins are probably more important than their direct actions on the endometrium in the treatment of endometriosis. These steroidal drugs also have androgenic effects, though the increase in the free androgen index caused by danazol is significantly larger than that induced by gestrinone or by MPA. In a study involving treatment with danazol (200 mg three times a day), high-dose MPA (100 mg/day) or placebo for 6 months, danazol and MPA were found to have equal clinical efficacy (as judged by relief of symptoms and disappearance of lesions). Danazol therapy, however, caused more androgenic and metabolic side-effects. Those patients who were infertile were also examined at 30 months. The cumulative pregnancy rate in these patients over the duration of the trial was danazol 33%, MPA 42% and placebo 46%, with no significant difference between treatments. Hormonal therapy delayed conception by approximately 8 months.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
2533450 View in PubMed
Less detail

10 records – page 1 of 1.