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Biomedical subjects

K W Hancock

Publications and source records attributed to K W Hancock.

At least 19 recordsLinked to original sources
PubMed1995

Autoantibodies and antisperm antibodies in sera and follicular fluids of infertile patients; relation to reproductive outcome after in-vitro fertilization.

Immune reactions have effects at various concentrations in the reproductive process and autoantibodies may have an impact on fertility and the outcome of assisted conception. We measured the prevalence of and relation between antibodies to smooth muscle, nuclear, phospholipid and sperm antigens, and concentrations of immunoglobulins G, M and A and complement components C3 and C4, in the sera and follicular fluids of women with unexplained infertility (n = 30), endometriosis (n = 20), tubal infertility (n = 50) and the sera of 20 normal non-pregnant women. We assessed fertilization and successful pregnancy rates in relation to antibody status of infertile women after in vitro fertilization. All antibodies had a higher prevalence in infertile women compared with controls and this was significant for smooth muscle antibody in endometriosis (P < 0.05); anticardiolipin antibody in tubal infertility (P < 0.05); and antisperm antibody in all types of infertility (P < 0.001). There was no relation between presence of specific antibodies in serum or between serum and follicular fluids. Total biochemical pregnancy rate was higher with endometriosis (P = 0.05) but clinical pregnancy and live birth rates did not differ between groups or in relation to antibody status. Significant differences in immunoglobulin and complement components occurred in women with and without successful biochemical pregnancy.

Adult↗
PubMed1994

Expression of heat shock protein 70 kDa in human endometrium of normal and infertile women.

The expression of heat shock protein (hsp) 70 was investigated in endometrial samples from patients with unexplained infertility associated (n = 5) or not associated (n = 10) with endometriosis, and compared with a control group consisting of fertile women (n = 27) with reported menstrual disturbance. The expression of hsp, and in particular hsp 70, is up-regulated in response to many physico-biochemical insults as well as infection and possibly oncogenic transformation and is a good indicator of a biological system under stress. A significant over-expression of hsp 70 was found in the infertile groups (P < 0.001), suggesting that a stress response may be involved in the aetiology of unexplained infertility irrespective of the presence of endometriosis.

Adult↗
PubMed1993

Early discharge following vaginal hysterectomy.

OBJECTIVE: To assess the feasibility of discharging selected patients home within 72 h of vaginal hysterectomy. DESIGN: Women for whom vaginal hysterectomy was planned and who were invited to take part. Those who accepted were visited at home by a staff nurse experienced in gynaecology to assess home conditions and family support. If these were suitable, the general practitioner was informed and invited to comment. If the operation was uneventful women were discharged on the third post operative day and visited at home by the nurse until the seventh day. SETTING: Leeds Western Health Authority. MAIN OUTCOME MEASURES: The number of minor complications requiring treatment by the general practitioner, the readmission rate and the acceptability to the woman and her family. RESULTS: For 11 out of 61, home conditions proved unsuitable for early discharge. In six of the remaining 50, abdominal hysterectomy proved preferable to vaginal. Thirty women were discharged home on the third day after vaginal hysterectomy, five on the fourth and seven on the fifth. Two developed urinary tract infections, treated by their general practitioners. Two required readmission to hospital. Twenty-eight of 30 discharged on the third post operative day and nine of 12 discharged on the fourth or fifth post operative day were enthusiastic about the scheme. CONCLUSIONS: Early discharge following uncomplicated vaginal hysterectomy in selected patients appears to be a safe procedure, appreciated by the majority of women. Its adoption as a routine procedure would enable the surgical throughput in a unit to be maintained on a smaller bed complement.

England↗
PubMed1988

Autoantibodies to soluble cellular antigens in unexplained recurrent abortion and infertility.

In 36 women with unexplained primary recurrent abortion, 13 with secondary unexpained recurrent abortion, 25 with primary unexplained infertility, 7 with secondary unexplained infertility and two groups of control women, autoantibodies to soluble cellular antigens were measured by Western blotting to a disaggregated HeLa cell antigen preparation, by counter immunoelectrophoresis and by indirect immunofluorescence. Using Western blotting the women with primary infertility and those with secondary recurrent abortion had a significantly higher prevalence of autoantibodies (P less than 0.01 in each case). This was not shown using the other methods. It is possible that these antibodies could be causally related to the pathology of the conditions studied.

Abortion, Habitual↗
PubMed1985

Ovulation induction in clomiphene nonresponsive patients: the place of pulsatile gonadotropin-releasing hormone in clinical practice.

Seventy-three treatment courses of pulsatile gonadotropin-releasing hormone (GnRH) were given to 19 patients with clomiphene nonresponsive anovulatory infertility. Fifty cycles were given by the subcutaneous route, and 23 were given intravenously. Doses varied between 1 and 40 micrograms per pulse given at 60- or 90-minute intervals. Luteal support was either by continuation of the pulsatile GnRH or by human chorionic gonadotropin injections. In 16 cycles, potentially fertile ovulation occurred, and three pregnancies resulted, of which one continues normally. Only one of the three pregnancies occurred during intravenous GnRH treatment, and it is likely that this patient would have responded to subcutaneous treatment. The optimum dosage to induce ovulation ranged between 10 and 20 micrograms per pulse at a frequency of 60 to 90 minutes. Those patients who responded to treatment were all of normal or low body weight for their age and frame. Conversely, those who failed to respond to pulsatile GnRH with ovulation were obese except for one patient with the polycystic ovary syndrome. Because pulsatile GnRH treatment is simple and potentially safe to administer, a therapeutic trial is indicated in patients of low to normal body weight who fail to respond to clomiphene. Where patients are responsive to pulsatile GnRH, the ovulations produced are likely to be fertile, possibly because of the endogenous nature of the ovulatory luteinizing hormone surge.

Adult↗
PubMed1985

Non-protein-bound oestradiol and progesterone in human peripheral plasma before labour and delivery.

Plasma samples were obtained at weekly intervals from the peripheral circulation of 12 women in the last 2-7 weeks of pregnancy. The concentrations of oestradiol and progesterone (isolated by chromatography) were measured by radioimmunoassay; the proportion of each hormone which was not bound to protein was measured by steady-state gel filtration. From these, the apparent concentration of the non-protein-bound form of each hormone was calculated. The mean proportion of oestradiol not bound to protein varied from 0.84 to 2.71% in the different subjects, but within each subject variation was within experimental error. For progesterone, the mean proportion not bound to protein in the different subjects varied from 1.76 to 2.77%; within individuals the proportion remained essentially constant. There was no consistent, recognizable trend as labour approached in the concentration of oestradiol; the concentration of progesterone; the concentrations of non-protein-bound oestradiol or non-protein-bound progesterone; the ratio of the concentrations of progesterone and oestradiol; the ratio of the concentrations of non-protein-bound progesterone and oestradiol. In nine out of 12 subjects, the ratio of the concentration of non-protein-bound progesterone to that of non-protein-bound oestradiol was greater than the corresponding ratio based on total hormone concentrations. These results therefore provide no support for the hypothesis that human labour is preceded by alteration in the progesterone to oestradiol ratio which can be detected by measurement of these hormones in peripheral blood.

Chromatography, Gel↗
PubMed1984

Cycle initiation in amenorrhoea; the effect of progesterone and oestrogen administration on the pulsatile release of gonadotrophins.

The modulation of pulsatile gonadotrophin release by endogenous ovarian steroids during the normal menstrual cycle may be involved in the initiation of the following menstrual cycle. The absence of this cyclical variation may, in some cases, be the cause of, or contribute to the cause of, amenorrhoea. To assess this the modulatory effect of gonadal steroid administration on the pulsatile release of gonadotrophins was studied in fourteen amenorrhoeic and four oligomenorrhoeic women. Pulsatility was assessed by samples collected at 10 min intervals during a 4 h morning period before and after treatment with either progesterone or micronized oestradiol or a sequential combination of both. Ten patients with intact positive oestrogen-gonadotrophin feedback responded to progesterone treatment by both a significant reduction in LH pulse frequency, from a mean of 4.1 to a mean of 2.1 pulses within the 4 h study period and an increase in pulse amplitude. Progesterone therapy did not affect mean LH concentrations but there was a significant reduction in mean FSH concentrations. In the eight patients with absence of positive feedback, none of the treatment regimes elicited significant changes in LH release. No definable FSH pulses were detected before or after treatment in either group. Both the changes in LH and FSH concentrations and their release observed in this study, support the concept that cycle initiation may be related to a reduced pituitary exposure to LHRH associated with elevated progesterone concentration in the luteal phase of the cycle. This selectively induces FSH synthesis and storage. Release of this stored FSH may occur as a result of failure of the corpus luteum and falling progesterone concentrations.

Adult↗
PubMed1984

Pathological mechanisms in polycystic ovary syndrome: modulation of LH pulsatility by progesterone.

The pulsatile discharge of luteinizing hormone (LH) in nine patients with polycystic ovary syndrome (PCO) and nine patients with amenorrhoea but without PCO, who exhibited LH discharge in response to oestrogen provocation, were studied by 4-h measurement of gonadotrophin pulsatility before and after a course of progesterone injections. No significant differences were found in the gonadotrophin pulsatility patterns of the two groups, although the LH/FSH ratio rose significantly in the patients without PCO after progesterone but not in the patients with PCO, suggesting an abnormality of FSH storage. The ability to discharge gonadotrophins in response to oestrogen provocation has been reported to be present in patients with greater than or equal to 3 LH pulses in a 4-h study period. This, however, was not demonstrated in five of the nine PCO patients despite the presence of 'normal' gonadotrophin pulsatility patterns.

Adult↗
PubMed1983

Urine dopamine during normotensive and hypertensive pregnancies and the puerperium.

Urinary excretion of dopamine, sodium and creatinine have been studied during pregnancy and the puerperium in three groups of women, normotensive, pre-eclamptic and those exhibiting gestational hypertension. Differences in the pattern of dopamine and salt excretion are evident in the two hypertensive groups and lend support to the concept that women who develop gestational hypertension have a defect in the mobilisation of dopamine similar to that observed in males with essential hypertension.

Adolescent↗
PubMed1982

Urine dopamine in normal and hypertensive pregnancies.

Dopamine output in urine was determined in two groups of women with hypertension in pregnancy. A highly significant elevation of urine dopamine was detected in those women with pre-eclampsia compared with that in matched control subjects. In contrast, no difference in urine dopamine output was detected between a group of multigravidae with hypertension in pregnancy and matched control subjects.

Adolescent↗
PubMed1982

Blood pressure, plasma osmolarity and oedema in pregnancy.

Relations of mean arterial pressure to age, parity, plasma, osmolarity, sodium and albumin were examined in normal non-pregnant, normal pregnant and pre-eclamptic Nigerian women. Mean arterial pressure showed a positive correlation with age in non-pregnant subjects, but not in normal pregnant or pre-eclamptic women. There was no significant correlation of mean arterial pressure with parity, plasma sodium or albumin in any of the three groups. A weak positive correlation was found between mean arterial pressure and plasma osmolarity in non-pregnant women and, although this was absent in normal pregnancy, it reappeared as a significant negative correlation in pre-eclampsia. These observations were considered, with special reference to osmotic aspects of the changes involved, and biophysical aspects of oedema are discussed. It is suggested that the osmotic properties of interstitial fluid albumin play a key role in the development of both physiological and pathological oedema in pregnancy.

Adult↗
PubMed1982

Outcome in patients with post-pill amenorrhoea.

Ninety-six patients who developed amenorrhoea following the use of oral contraceptives were studied in two groups; one with a history of regular periods and the other with irregular periods prior to the use of oral contraceptives. Pregnancy rates were similar in patients with and without a previous history of menstrual dysfunction. Thirty-nine of 47 patients who desired pregnancy and in whom there was no definable factor inhibiting pregnancy, succeeded in conceiving.

Adolescent↗
PubMed1981

Urine free dopamine in normal primigravid pregnancy and women taking oral contraceptives.

1. Urine free dopamine was estimated at predetermined points of the menstrual cycle in normal volunteer subjects and in women taking a combined oral contraceptive. 2. There was no alteration in 24 h urine dopamine during the normal menstrual cycle but, in contrast, combined oral contraceptives produced a fall which recovered premenstrually. 3. In 19 primigravid subjects 24 h urine free dopamine was estimated at monthly intervals throughout pregnancy and at the time of the postnatal examination. 4. Urine dopamine was elevated throughout pregnancy when compared with postnatal values. Women receiving an oral progestogen contraceptive at the time of the postnatal examination showed a further fall in urine dopamine.

Adult↗
PubMed1981

Meteorological relations of eclampsia in Lagos, Nigeria.

A retrospective study of the meteorological relations of eclampsia in Lagos, Nigeria supports other observations that the incidence of this disease varies significantly with the weather. Protective action by arid conditions is consistent with the known effect of dehydration on convulsions of differing aetiologies and is attributable to increased pulmonary transpirational water loss. Exacerbation of eclampsia by cool, humid conditions may therefore reflect excessive water retention, due partly to suppressed pulmonary transpiration and partly to kidney malfunction in those women.

Eclampsia↗