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Biomedical subjects

P Bischof

Publications and source records attributed to P Bischof.

At least 127 records · Page 7Linked to original sources

Are vaginal fluid concentrations of prolactin, alpha-fetoprotein and human placental lactogen useful for diagnosing ruptured membranes?

Vaginal fluid levels of prolactin (Prl), alpha-fetoprotein (AFP) and human placental lactogen (hPL) were assayed to investigate their usefulness in the diagnosis of ruptured membranes. Fifty-two patients at term were divided into those with intact membranes, and those with ruptured membranes. In patients with intact membranes the concentration of all three substances was low with few exceptions. The mean vaginal concentrations of the three proteins were significantly higher in patients with ruptured membranes, but low values were also found in this group. It is concluded, that because of the overlap between the values, Prl, AFP and hPL measurements in vaginal fluid do not represent a useful advance in the assessment of rupture of the membranes.

Body Fluids↗

Circulating levels of pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotrophin (hCG) in intrauterine and extrauterine pregnancies.

Pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotrophin (hCG) have been measured in the plasma of pregnant and non-pregnant women attending the outpatient clinic for suspicion of pregnancy. The plasma concentrations obtained were grouped into intrauterine or extrauterine pregnancies and compared with values obtained in non-pregnant patients with similar periods of amenorrhoea. Patients with ectopic pregnancies had slightly lower PAPP-A levels and significantly lower hCG concentrations than those in women with normal intrauterine pregnancies. Non-pregnant women had very low hCG and PAPP-A levels compared with those in pregnant patients. These data suggest that in patients with extrauterine pregnancies the poorly sustained ectopic trophoblast is unable to produce normal concentrations of hCG and probably PAPP-A and that the slightly diminished levels of PAPP-A in ectopic pregnancies might be derived from a decidual production.

Chorionic Gonadotropin↗

Relation between pregnancy-associated plasma protein A and fetal sex and blood group.

Maternal pregnancy-associated plasma protein A (PAPP-A) concentration was estimated in 272 pregnancies. Paired samples at 34 weeks of gestation and within 48 h before delivery were compared in relation to fetal and maternal blood group and fetal sex. The PAPP-A values were significantly higher both at 34 weeks and near delivery in rhesus-negative bearers. Mothers of male babies had higher PAPP-A values near delivery but not significantly higher at 34 weeks. This supports earlier findings that some placental hormones are higher in male bearers.

ABO Blood-Group System↗

Clinical relevance of urethral stress profile using microtransducers after surgery for stress incontinence in females.

The value of the urethral stress profile after surgery for urinary stress incontinence in females was prospectively analyzed using microtransducers. 95 patients were clinically and urodynamically assessed at least 6 months after surgery. The success of the operation was based on subjective (patient's history) and objective (no urine loss, erect, with full bladder, on coughing and during a Urilos nappy test) criteria. In 20% of the cases, the interpretation of the urethral profiles did not correlate with the clinical objective criteria. Possible explanations for this discrepancy are discussed.

Diagnostic Errors↗

Human seminal plasma contains a protein that shares physicochemical, immunochemical, and immunosuppressive properties with pregnancy-associated plasma protein-A.

Pregnancy-associated plasma protein-A (PAPP-A) was detected by RIA in human seminal plasma. This was not due to interference with proteases or binding to seminal plasma proteins, since immunoreactivity was not affected by treatment with protease inhibitors, and the elution of [125I]PAPP-A was not altered by preincubation with seminal plasma. The major component of the seminal plasma PAPP-A coeluted with pure PAPP-A or plasma PAPP-A from pregnant and nonpregnant women. In the RIA, serial dilutions of seminal plasma gave parallel displacement curves to pregnancy plasma. Removing PAPP-A-like material from seminal plasma by adsorbtion to heparin-Sepharose reduced the inhibitory effect of seminal plasma on phytohemagglutinin-induced lymphocyte transformation. The source of seminal plasma PAPP-A-like immunoreactive material remains to be elucidated, but it is unlikely to be the testis, since PAPP-A levels in semen of vasectomized men were similar to those in nonvasectomized men.

Female↗

Circulating levels of pregnancy proteins and depression of lymphoblastogenesis during pregnancy.

Plasma was obtained from 287 normal pregnant women at different times of gestation. Alpha-foetoprotein (AFP), human chorionic gonadotrophin (hCG), human placental lactogen (hPL) and pregnancy associated plasma protein-A (PAPP-A) were measured by radioimmunoassay. The capacity of those plasmas to inhibit phytohaemagglutinin (PHA) induced lymphocyte transformation was also tested. Between the 7th and the 12th week, pregnancy plasma has a relatively small inhibitory effect on lymphoblastogenesis. Plasmas taken between the 13th week and term pregnancy inhibit much more lymphocyte transformation. The factor which increases this inhibition is unknown. None of the proteins measured were significantly correlated with the inhibitory effect. Two explanations are proposed: either AFP, hCG, hPL and PAPP-A are not responsible for the in vitro inhibition of lymphoblastogenesis or else these factors exert a combined effect so that the concentration of each protein taken separately cannot account for the overall inhibitory effect observed with pregnancy plasma.

Female↗

Is pregnancy-associated plasma protein A a tumor marker?

Pregnancy-associated plasma protein A (PAPP-A) was measured in 159 patients with various nontrophoblastic tumors. In three patients with trophoblastic tumors, PAPP-A and human chorionic gonadotropin (hCG) were measured before operation and weekly thereafter. Circulating levels of PAPP-A in patients with nontrophoblastic tumors were not significantly different from the levels in the matched control groups. Circulating levels of PAPP-A and hCG were significantly elevated preoperatively in patients with trophoblastic tumors, whereas the postoperative concentrations of both proteins gradually decreased. The conclusion is that, probably, PAPP-A cannot be considered to be a marker for nontrophoblastic disease, and that measurements of PAPP-A in patients with trophoblastic cancers do not provide any advantage over measurements of hCG.

Chorionic Gonadotropin↗

Tissue and plasma concentrations of pregnancy-associated plasma protein-A (PAPP-A): comparison with other fetoplacental products.

Human placental lactogen (hPL), alpha fetoprotein (AFP), prolactin (PRL) and pregnancy-associated plasma protein-A (PAPP-A) were measured by radioimmunoassay in plasma, in homogenates of trophoblast, decidua, chorion, amnion and in amniotic fluid from 10 patients after non-complicated term delivery. Plasma samples and homogenates of trophoblast and decidua were also collected from 10 patients undergoing surgical termination of pregnancy between 7 and 12 weeks gestation. In addition, plasma and endometrial samples from 10 patients undergoing hysterectomy for other indications than malignancy were analysed for comparison. The highest tissue concentrations of hPL, AFP and PRL corresponded in each case to the known site of synthesis. For PAPP-A the highest concentration was found in maternal plasma at term [238.8 +/- 75.6 (SEM) micrograms/ml]. The highest tissue concentration was found at term in the decidua (57.0 +/- 2.0 micrograms/g), more than three times higher than that in the trophoblast (16.9 +/- 5.4 micrograms/g). The concentrations of PAPP-A in endometrial samples from non-pregnant women (1.9 +/- 0.6 micrograms/g) was 40 times higher than that in the corresponding plasma samples (0.05 +/- 0.02 microgram/ml). These observations point to the decidua as a possible source of PAPP-A.

Amniotic Fluid↗

Amniotic fluid and plasma concentrations of pregnancy-associated plasma protein-A (PAPP-A) throughout pregnancy: comparison with other fetoplacental products.

The development of a sensitive radioimmunoassay has enabled measurements of pregnancy-associated plasma protein-A (PAPP-A) to be performed from early pregnancy. The present paper compares the plasma concentrations of PAPP-A with the levels of two trophoblastic proteins, human placental lactogen (hPL) and the beta-subunit of human chorionic gonadotrophin (beta-hCG), with a steroid of fetoplacental origin, total oestriol (total E3), and with a fetal protein, alpha-fetoprotein (AFP). PAPP-A was also measured in amniotic fluid and in maternal urine. In contrast with the secretion of the other substances studied, which either reach a plateau or even decrease during the last 4 weeks of pregnancy, PAPP-A steadily increased in the maternal circulation from 7 to 40 weeks gestation. It is proposed that PAPP-A production is either not related to placental mass or that PAPP-A is not of trophoblastic origin. The increase of PAPP-A in amniotic fluids parallels the increase in maternal blood; virtually no PAPP-A is excreted in urine.

Amniotic Fluid↗

Endometrial and plasma concentrations of pregnancy-associated plasma protein-A (PAPP-A).

Pregnancy-associated plasma protein-A (PAPP-A), oestradiol and progesterone levels have been measured by radioimmunoassay in plasma and in endometrial homogenates of 20 women undergoing hysterectomy. Results were grouped according to the histological stages of the endometrium. In plasma, oestradiol and progesterone concentrations changed from proliferative to secretory stages in the well-established pattern of the menstrual cycle, but PAPP-A levels did not change. In endometrium, oestradiol levels were high during the proliferative stage and low in inactive and secretory endometrium. Endometrial PAPP-A and progesterone concentrations increased from inactive to secretory stages, but only the increase in PAPP-A was statistically significant. A positive correlation observed between endometrial PAPP-A concentrations and plasma oestradiol/progesterone ratio suggests a possible hormonal control for the presence of PAPP-A in the uterus.

Adult↗

[Amiodarone and the thyroid gland].

In an estimated 5% of patients, antiarrhythmic therapy with amiodarone (Cordarone) may have side effects involving thyroid function. These unwanted effects on the thyroid gland can be classified into three entirely different categories. In addition, amiodarone invariably interferes in a characteristic way with the peripheral metabolism of thyroid hormones at the cellular level. These effects are reviewed. 1. Amiodarone contains 39% of iodine. Since its metabolism involves deiodination to inorganic iodide, classical iodine-induced thyrotoxicosis may occur in patients with nodular goiters containing autonomous follicles. 2. An entirely different form of thyrotoxicosis, resembling Graves' disease, may be induced by amiodarone in individuals with previously normal thyroid. The pathogenesis of this phenomenon is unknown. 3. In rare patients of the thyroid gland is unable to cope with pharmacological quantities of iodide, possibly due to genetic anomaly of thyroid metabolism. In these individuals amiodarone may induce hypothyroidism. 4. In contrast to the possible side effects of amiodarone involving the thyroid gland, the drug has an obligate impact on the metabolism of thyroid hormones at the level of the peripheral cells. It inhibits the peripheral conversion of thyroxin to triiodothyronine (T3) and favours the generation of reverse T3, which has no T3 activity. This and other arguments favour the assumption that the effects on the heart observed after prolonged amiodarone treatment are in fact due to selective local hypothyroidism.

Adult↗

Pregnancy-associated plasma protein-A (PAPP-A) and hCG in early pregnancy.

Pregnancy-associated plasma protein-A (PAPP-A) is a recently described glycoprotein of unknown biological function. The development of a radioimmunoassay enabled us to measure plasma levels of PAPP-A and human chorionic gonadotrophin (hCG) in 12 non-pregnant volunteers and in 159 women in early pregnancy attending the outpatient clinic for legal abortion. PAPP-A but not hCG was measurable in all non-pregnant women. In pregnant patients (with 36 to 86 days of amenorrhea) hCG reached a peak value (163.1-197.6 ng/ml) between the 9th and the 13th week whereas PAPP-A steadily increased throughout this period of pregnancy. Between the 6th and the 13th week after the last menstrual period, levels of PAPP-A increased proportionally more than hCG. This work provides the first evidence of a PAPP-A production in non-pregnant subjects and the very early marked increase of PAPP-A secretion during pregnancy.

Adolescent↗

Relationship of obstetric parameters to the concentration of pregnancy-associated plasma protein A.

Pregnancy-associated plasma protein A (PAPP-A) was measured by rocket immunoelectrophoresis in 272 patients at 34 weeks of pregnancy and within 48 hours before delivery. The values obtained have been compared to maternal parameters (age, weight, weight gain, blood group, rhesus factor, and parity) and to fetal parameters (sex, weight, Apgar score, rhesus factor, blood group, and placental weight). Maternal age, increased parity, and increased body weight are related to decreased PAPP-A levels. On the other hand, mothers carrying male fetuses, rhesus-negative children, and babies with Apgar scores higher than 7 at 1 minute have increased PAPP-A concentrations. These findings are discussed in relation to PAPP-A's involvement in the maternal immunologic system.

Adult↗

Assay of a placental protein to determine fetal risk.

Plasma concentrations and total amounts of pregnancy associated plasma protein A were determined in 272 patients at 34 weeks' gestation by immunoelectrophoretic assay. The mean plasma concentration and mean total amount of this protein were closely related (r = 0.9643) and were significantly raised in patients who subsequently developed pre-eclampsia (28 patients), went into premature labour (12), or suffered from antepartum haemorrhage (10). Mean values in all patients delivering growth-retarded babies were also raised, but when the results for such patients who also had other complications were excluded there were no differences between the sets of means. The assays were easily performed, and they may be a useful technique for screening pregnant women to detect those at risk of developing pre-eclamptic toxaemia, although the full potential of these assays cannot be realised until the protein's function is known.

Female↗

Tests of fetal wellbeing in the third trimester of pregnancy.

Five different products secreted by the fetoplacental unit into the maternal circulation were measured in 272 patients when they were 34 weeks pregnant. The most useful indicator of present pathology or future complications of pregnancy was a placental protein, pregnancy associated plasma protein. A which was raised in pre-eclamptic toxaemia, antepartum haemorrhage and premature labour. The highest values were recorded in pre-eclampsia before any signs of the disease were evident. Schwangerschafts protein 1 was also raised in pre-eclampsia and antepartum haemorrhage but only after the disease had presented. Placental lactogen was also raised in pre-eclampsia and its measurement may have some predictive value. Total oestriol was lowered in fetal growth retardation and the unconjugated steroid raised in pre-eclampsia and lowered in retarded fetal growth.

Estriol↗