Axel Ingelman-Sundberg

The Effect of Prostaglandin E2 and E3 on the Human Uterus and the Fallopian Tubes in Vitro

(PGE1) Prostaglandin E1 was tested on the uterus (21 patients) and fallopian tubes (33 patients) who were classified according to proliferatory group secretory group and postmenopausal group. No differences in response were detected between tubes in the different sexual phases; however PGE1 did produce a stimulatory effect in the proximal segment with an increase in tonus and amplitude and an inhibitory effect in segments 2-4 with a decrease in tonus and amplitude. In the uterus the PGE1 exerted an inhibitory effect as evidenced by a decrease in all corpus parameters. This inhibitory effect on corpus tonus was most pronounced in the proliferatory phase; no differences in response were demonstrated in the other phases. It is evident that PGE1 exerts a stimulatory action on the proximal part of the tube and an inhibitory effect on the rest of the oviduct and the uterus. These effects of PGE1 correspond to those produced by PG a concentration of the lipid soluble acidic material of human semen tested on the tube and uterus. It is likely that the specific action of PGE1 promotes fertilization of the ovum and an hypothesis for this is presented.

The Effect of Prostaglandin F1α, F1β, F2α, and F2β, on the Human Uterus and the Fallopian Tubes in Vitro

In two previous papers (Sandberg e t al., 1963 and 1964) the effects of prostaglandin El, E, and E, on the human uterus and the Fallopian tubes have been studied in vitro. These investigations have now been extended to prostaglandin F,,, FIB, F,, and F2p. (=PGF,,, PGF,p, PGF,,, PGF,p). These substances constitute two pairs of stereoisomers (Fig. I ) . Prostaglandin F,, and F,, are naturally occurring substances, found in human semen (Bergs t rom and Samuelsson , 1962). PGF,, has also been isolated from lung tissue and menstrual fluid (Bergstrom, 1964; E g l i n t o n e t al., 1963; P i c k l e s et al., 1965). Prostaglandin FIp and F2p have been prepared synthetically by reduction of the keto group of PGE, and PGE, respectively (Bergs t rom et al., 1962 a, b). Prostaglandin F,,, Flp, F,, and F2, were kindly supplied by Professor S. Bergstrom and Dr B. Samuelsson, Stockholm.

Pressure transmission to the pre-urethral space in stress incontinence.

SummaryPressure transmission from the abdomen to the pre-urethral space has been studied in stress-incontinent women and in some women following pubococcygeal repair for stress incontinence. Pressure was recorded at different levels of the pre-urethral space and simultaneously in the bladder. Simultaneous measurements inside and outside the urethra at different levels above the external urethral meatus showed that an intra-abdominal pressure rise was transmitted via the pre-urethral space to the urethra. Pressure was transmitted almost in full to the surroundings of the lower-most part of the bladder, but outside the functional urethra, transmission was successively more defective along the urethra towards the external meatus. Therefore, a short functional length and a distal maximal pressure plateau in the urethra, as in stress incontinence, is a disadvantage. Pressure losses amount to 1/3 or more. Pressure transmission could be improved to “supranormal” values by establishing firm support for the urethra, thereby allowing a minimum of rotational descent with stress and providing good counterpressure.

Acridine Orange in Gynecologic Cancer: II. The Effect of Stain Receptors on some Proton Magnetic Resonance Parameters

Abstract. The methyl line of the proton magnetic resonance spectrum of acridine orange zinc trichloride, dissolved in heavy water, has been studied. This line consists of two overlapping components with different widths. A mathematical technique has been developed to resolve the two components quantitatively. Their relative proportion depends on the acid‐base state of the molecular environment. If the stain is adsorbed on albumin the narrow component quickly disappears, while adsorption on RNA gives rise to a broadening of the narrow line. With large amounts of albumin or RNA, both components disappear. DNA strongly adsorbs acridine orange with complete disappearance of all NMR spectral lines. Mitochondria, submitochondrial particles and microsomes cause some broadening of the narrow component of the methyl line. Due to the obvious alterations of the NMR spectrum, in the circumstances mentioned, this type of spectroscopy may be used for the biophysical characterization of interaction mechanisms between acridine orange and various proteins, nucleic acids and cell fractions.

Urethral pressure profile before, during and after pubococcygeal repair for stress incontinence.

Abstract. In two groups of women the urethral pressure profile was recorded using a microtransducer catheter. Both groups were of approximately the same age, one consisting of continent women, the other of women with severe stress incontinence. Sixteen stress incontinent women were examined before and after pubococcygeal repair and 10 of these were also examined during the operation. The two groups were compared for differences in the urethral pressure profile in the continent and incontinent states. The stress incontinent women had a significantly shorter functional length of the urethra (10 mm) but the same maximal urethral pressure as continent women. Remarkable changes in these parameters were seen during the operation. However, at the examination 3 months postoperatively, they had totally disappeared. The only change in the urethral pressure profile which persisted after the operation was a higher pressure in the proximal part of the urethra, so that a urethral maximal pressure plateau had been established. This plateau was also seen, on a higher level, in the continent state.

In vitro Studies of the Motility of the Human Fallopian Tube

The effect of methylergometrine and papaverine on the motility of the human Fallopian tube has been studied by the Magnus-Kehrer technique.Methylergometrine exerts a weak and undecided effect, whereas papaverine has a strong spasmolytic action on the whole tube, irrespective of the phase of the menstrual cycle or the age of the patient.

THE ABSORPTION OF TRITIUM‐LABELLED PROSTAGLANDIN E1 FROM THE VAGINA OF NON‐PREGNANT WOMEN

Tritium labelled prostaglandin E1 was deposited for 6 hours in the posterior fornix of 7 normally menstruating volunteers who were without any signs of infection. 10-25% of the radio activity administered was recovered in the urine within 24-32 hours. The application of a cervical cup to the cervix failed to influence the absorption which was estimated to be 20-50%. The physiological significance of this absorption remains uncertain. No conclusion can be drawn from this investigation regarding the absorption rate during this period since elimination through the kidney is so slow.

THE IN VIVO EFFECT OF OXYTOCIN AND VASOPRESSIN ON THE NON PREGNANT HUMAN UTERUS

IN a previous study (Sandberg et al., 1959) in which the response of myometrial strips from non-pregnant patients to large doses of oxytocin was examined, difference in sensitivity was encountered between tissue from the corpus and that of the isthmus, the isthmic myometrium being almost insensitive to the polypeptide. The principal effect was an increase in tonus which was more pronounced when the specimen was obtained during the proliferative than the secretory phase. Recently Fuchs and Fuchs (1963) have presented additional data regarding the in vitro response of human myometrium to oxytocin. The authors showed that oxytocin had no visible effect during the proliferative phase but a definite, though weak and transient, effect on the frequency of the contractions during the secretory phase. McGaughey and co-workers (1964) have tested the effect of oxytocin as well as vasopressin on nonpregnant human uterus (corpus musculature) in vitro, using doses in the range of 0.004-40.000 m u . per ml. They were unable to demonstrate any difference in response between the myometria1 preparations obtained during the first and the second half of the menstrual cycle. Oxytocin produced a decrease in tonus and, in high concentrations, also a decrease in amplitude. With increasing doses there was a progressive reduction in the frequency of contractions. According to their findings oxytocin acted as a depressant on the non-pregnant human uterus. Vasopressin, on the contrary, was found to provoke a significant increase in tonus and a decrease in amplitude. The alteration in frequency was phasic and showed a decrease at low concentrations and an increase at high concentrations. Several investigators have shown that in the uterus of the rabbit the results obtained in vitro are similar to those in vivo (Schofield, 1955; Bengtsson, 1957; Fuchs and Fuchs, 1960). The in vitro results for human myometrium, however, do not correspond to those obtained from studies in situ (Moir, 1944; Garrett, 1954, 1955) and the findings have been at variance (Sandberg et al., 1958). Therefore the in vivo effect of oxytocin and vasopressin has been studied, paying particular attention to the separate responses of the uterine corpus and isthmus.

Urge Incontinence in Women

Abstract. A survey has been presented of the authors personal methods to treat urge incontinence in women caused by neurogenic disturbances or by urethritis. Denervation of the bladder by unilateral or bilateral resection of the inferior hypogastric plexus is used for neurogenic disturbances with uninhibited bladder contractions or hypertonic bladders and in cases of interstitial cystitis, if a preoperative blockade with local anaesthesia has given a favourable result. Urethral diverticula are extirpated. Urethritis is treated with careful dilatation of the urethra and massage in combination with local treatment of the mucosa with 1% solution of silver nitrate. In cases with a narrow urethral orifice a meatotomy is made. Women with wide external urethral orifice and recurrent urethritis following intercourse are operated upon. A structure similar to the frenulum of the prepuce in the male is constructed, which closes the orifice at the introduction of the penis.

Proton Magnetic Resonance Studies on the Structure of Water in the Myometrium

The physico-chemical state of water in the smooth muscle of the uterus at rest and during contraction is to a great extent still unknown. As information of the types of bonding and movement of water molecules in tissues can be gained from investigations with proton magnetic resonance (0 d e b 1 a d, I 959, and references contained therein) this method was applied on uterine musculature from animals and humans. As in other organs, part of the water is intracellular and part is extracellular (Fig. I ) . It might be expected that only the intracellular fraction would be the subject of primary changes, related to muscular contraction. Other complications arise from the fact that pieces of uterus also contain other tissues, notably connective tissue, which are not directly engaged in the process of contraction. No great effect of contraction on the magnetic resonance signals therefore can be expected.