Search PubMed⌕ Search

Biomedical subjects

T C Li

Publications and source records attributed to T C Li.

At least 109 records · Page 6Linked to original sources
PubMed1994

Endometrial structure after superovulation: a prospective controlled study.

OBJECTIVE: To demonstrate the effect of superovulation using a GnRH agonist (GnRH-a) and hMG and hCG on endometrial structure. DESIGN: Prospective, case-controlled study. SETTING: Tertiary referral assisted reproduction unit in an academic department. PATIENTS: Eleven women undergoing GIFT or IVF, without ET. INTERVENTIONS: All women were treated with a long stimulation regimen using the depot GnRH-a Goserelin (ICI, Macclesfield, United Kingdom) and hMG and hCG. MAIN OUTCOME MEASURES: Comparison of endometrial biopsy specimens taken 4 days after ovulation in an unstimulated cycle with specimens taken 4 days after oocyte recovery, using standard dating criteria and morphometric analysis. RESULTS: There was no difference in endometrial glandular development as assessed by either standard criteria or morphometric analysis. CONCLUSIONS: Superovulation preceded by pituitary down regulation is not associated with abnormal endometrial glandular development, even though supraphysiological levels of E2 and P are induced.

Adult↗
PubMed1994

Endometrial differentiation in the peri-implantation phase of women with recurrent miscarriage: a morphological and immunohistochemical study.

OBJECTIVES: To study endometrial differentiation in the peri-implantation phase of women with recurrent miscarriage and to compare the results with endometrium of normal fertile women. DESIGN: A prospective study of endometrial specimens precisely timed from the LH surge, using traditional histologic dating (Noyes' criteria), quantitative histologic measurement (morphometric analysis), and immunohistochemical techniques. RESULTS: Fifteen of 25 (60%) subjects in the recurrent miscarriage group had retarded endometrial development in the peri-implantation period as monitored by morphometry. The recurrent miscarriage group showed reduced levels of four mucin-related secretory epitopes, and greater reductions were associated with morphological retardation. Normal differentiation was observed in all of the 14 subjects in the control group. CONCLUSIONS: Women with idiopathic recurrent pregnancy loss may be divided into two distinct subgroups on the basis of their endometrial response in the peri-implantation period. Precisely timed endometrial biopsy should be incorporated in the investigation of recurrent miscarriage.

Abortion, Habitual↗
PubMed1994

Placental protein 14 in cycles with normal and retarded endometrial differentiation.

The purpose of this study was to investigate whether endometrium with retarded development differs, functionally, from endometrium with normal 'in-phase' development. Precisely timed endometrial biopsies were obtained from 24 women suffering from unexplained infertility at 4, 7, 10 and 13 days following the luteinizing hormone (LH) surge. Frozen sections were labelled with an anti-placental protein (PP) 14 monoclonal antibody using an avidin-biotin peroxidase technique and semi-quantification of endometrial PP14 was performed using a Quantimet 970 image analyser. Serum PP14 and saliva progesterone were measured for each patient. Data were analysed using one- and two-way analysis of variance. Normal and retarded endometrium were identified in 16 (group I) and eight (group II) women respectively. Both groups demonstrated a significant increase of the area of precipitate measured for PP14 from day LH + 4 to LH + 13. However, two-way analysis of variance showed that endometrial PP14 was significantly (P < 0.05) lower in the retarded endometrium group at LH + 10 and LH + 13. Serum PP14 was also significantly lower (P < 0.01) in women with retarded endometrial development at LH + 13. Women with normal endometrial development had a significantly higher (P < 0.05) concentration of cumulative saliva progesterone from LH + 3 to LH + 5. This study indicates that there are functional differences between normal and retarded endometrium. These differences may adversely affect uterine receptivity during implantation and the early placentation stage.

Adult↗
PubMed1994

The artificial cycle as an effective treatment of persistently retarded endometrium in the luteal phase.

The objective of this study was to examine the results of two hormonal treatment modalities on subjects who had persistently abnormal endometrial development in the luteal phase. A prospective study design was used to investigate 14 women who had persistently retarded endometrium associated with infertility (n = 11) or recurrent miscarriage (n = 3). Treatment A consisted of progesterone supplementation in the form of i.m. progesterone at a daily dose of 25-50 mg starting on day luteinizing hormone (LH) + 1 for 14 days. Treatment B consisted of artificial cycles produced after down-regulation of the hypothalamic-pituitary-ovarian axis with Goserelin (3.6 mg s.c.) followed by the administration of a standard hormone replacement therapy. Endometrial biopsy was taken on day 19 of the artificial cycle or days LH + 5 to +7 in the progesterone supplementation cycle. A histological study was made of the endometrial specimens by standard dating criteria and morphometry. The artificial cycle resulted in normal development in all subjects (n = 11), whereas progesterone supplementation restored normal endometrial development in only seven of 11 (64%) subjects. We conclude that persistently retarded endometrium could be treated more effectively with the artificial cycle than with progesterone supplementation.

Abortion, Habitual↗
PubMed1994

Lymphoid tissue in the endometrium of women with unexplained infertility: morphometric and immunohistochemical aspects.

The purpose of this study was to investigate whether the endometrium of women with unexplained infertility differs in some immunological aspects from the endometrium of normal fertile women. Endometrial biopsies were obtained from 24 normal fertile women (group I) and 24 women suffering from unexplained infertility (group II) at 4, 7, 10 and 13 days following the luteinizing hormone (LH) surge. Endometrial granulated lymphocytes were assessed morphometrically in 2 microns resin sections. A panel of 11 monoclonal antibodies was employed to characterize the leukocyte subsets in frozen sections. Semi-quantification was performed with a Quantimet 970 image analyser. Data were analysed using one- and two-way analysis of variance. Compared with fertile controls, women with unexplained infertility had significantly lower numbers of CD8+ (T suppressor/cytotoxic) cells at each post-LH date. In contrast, the number of CD4+ (T helper/inducer) cells was significantly higher in group II. Throughout the luteal phase, infertile women had fewer CD56+ cells than normal fertile controls. The volume fraction of endometrium occupied by the nuclei of endometrial granulated lymphocytes did not alter with the cycle stage but the mean nuclear diameter and axial ratio decreased from LH+7 to LH+13. The differences observed in endometrial leukocytic subpopulations between fertile and infertile women may contribute to unexplained infertility probably by affecting the embryonic maternal dialogue during the implantation and early placentation period.

ADP-ribosyl Cyclase↗
PubMed1994

Keratan sulphate as a secretory product of human endometrium: cyclic expression in normal women.

The distribution of keratan sulphate (KS) in normal endometrium has been studied by immunohistochemistry using monoclonal antibody 5D4. KS is present in association with glandular epithelium throughout the normal cycle. Production is hormonally regulated, as indicated by the significant increase observed in the secretory phase of the cycle. Intracellular immunoreactivity increases to a maximum 3 days after the luteinizing hormone (LH) peak. This is followed by an increase in secreted KS from 4 days after the LH peak, and essentially all endometrial glands showed immunoreactive deposits by 5 days after the LH peak. Beginning on day 7 after the LH peak, a fraction of glands was observed to have lost the epitope. Nevertheless, KS remained in a significant proportion of the gland lumens 9 days after the LH peak. The data suggest that analysis of secretory KS in women gives an index of hormonally regulated epithelial differentiation in the peri-implantation phase.

Adolescent↗
PubMed1994

Stimulation of human endometrial epithelial cell interleukin 6 production by interleukin 1 and placental protein 14.

The effect of interleukin 1 (IL1) and placental protein 14 (PP14) on the production of interleukin 6 (IL6) by cultured human endometrial epithelial cells prepared from endometrial biopsy material obtained at different stages in the menstrual cycle was investigated. Basal IL6 production by cells prepared from proliferative endometrium was greater than that produced by cells prepared from secretory endometrium (7.3 +/- 0.3 and 1.1 +/- 0.2 ng/well/24 h respectively, P < 0.001). IL1 (0.025-2.5 ng/ml) caused a dose-dependent increase in IL6 production by cells prepared from both proliferative and secretory endometrium, but cells prepared from secretory endometrium responded to a lower concentration of IL1 than those prepared from proliferative endometrium. IL-1-stimulated IL6 production by epithelial cells prepared from secretory endometrium typically reached 10 times basal values, while in cells prepared from proliferative endometrium stimulated levels were approximately twice the basal values. PP14 (1-50 micrograms/ml) also caused a dose-dependent increase in IL6 production by epithelial cells prepared from secretory endometrium, but had no effect on IL6 production by cells prepared from proliferative endometrium. Even in secretory cells PP14 was less effective than IL1 at stimulating IL6 production, with stimulated levels only reaching twice the basal values. This suggests that PP14 and IL1 act via different mechanisms in the stimulation of IL6 production. The results show that IL6 production by human endometrial epithelial cells is stimulated by other immunomodulatory peptides and this may be part of the network of such peptides in the endometrium which may influence embryo implantation.

Adult↗
PubMed1994

Detection of antibodies to ovarian antigens in women with premature ovarian failure.

Premature ovarian failure is a common condition of uncertain aetiology in most cases, although autoimmunity is thought to play a role in a proportion of cases. The frequency of ovarian antibodies, which may be markers for an autoimmune aetiology in this condition, remains unclear. To define this further, we have examined the sera of 45 women with premature ovarian failure (five with iatrogenic ovarian failure, nine with an associated autoimmune disease, and 27 with idiopathic ovarian failure), as well as four women with infertility due to Turner's syndrome and 41 pre- and post-menopausal controls. Using two human ovarian antigen preparations, 24% and 60% of the ovarian failure patients reacted in an ELISA (P < 0.05 and P < 0.001 compared with controls), but frequent cross-reactivity was found with fallopian tube antigens. The apparent aetiology of ovarian failure did not correlate with the presence of ovarian antibodies. Using bovine ovary as an antigen, there was a significant overall increase in binding by the ovarian failure patients, but this was almost identical to binding in an ELISA with bovine fallopian tube. In contrast to a previous report, there was no significant increase of binding to soluble or Triton-extracted membrane fractions of bovine corpora lutea containing the LH/hCG receptor by the patients with ovarian failure. These results suggest that ovarian antibodies are common in premature ovarian failure, but their specificity and pathogenic role are questionable.

Amenorrhea↗
PubMed1994

The value of an absorbable adhesion barrier, Interceed, in the prevention of adhesion reformation following microsurgical adhesiolysis.

OBJECTIVE: To determine whether Interceed, an absorbable adhesion barrier, confers any additional benefit over conventional microsurgery, including the use of an adjuvant (hydrocortisone), in the prevention of adhesion reformation after pelvic microsurgery. DESIGN: A prospective, randomised, controlled study. SETTING: Jessop Hospital for Women, Sheffield, UK. SUBJECTS: Twenty-eight women who underwent pelvic microsurgery for infertility or for chronic pelvic pain and who had bilateral pelvic adhesions and deperitonealised areas following adhesiolysis. INTERVENTIONS: Following microsurgical adhesiolysis, one side of the pelvis was randomised to have its deperitonealised areas covered with Interceed, whereas the contralateral side served as the control. A second look laparoscopy was carried out 3 to 14 weeks after microsurgery to evaluate adhesion reformation. MAIN OUTCOME MEASURE: The amount of adhesion reformation at second look laparoscopy compared with the amount of deperitonealised area exposed following microsurgical adhesiolysis. RESULTS: The use of Interceed resulted in a significant reduction of adhesion reformation over and above that achieved by conventional microsurgical techniques with hydrocortisone as an adjuvant. CONCLUSION: Interceed, an absorbable adhesion barrier, is of value in the prevention of adhesion reformation and may be used in conjunction with hydrocortisone instilled intraperitoneally at the conclusion of microsurgery.

Adult↗
PubMed1994

Changes in haematological indices, blood viscosity and inhibitors of coagulation during treatment of endometriosis with danazol.

The effects of treatment with danazol (600 mg daily) on haemostatic and haematological function were investigated in 18 pre-menopausal women with endometriosis. Blood samples were taken at 2 pre-treatment visits, at 6, 12 and 24 weeks on treatment, and at 6 weeks after discontinuation of the drug. Haemoglobin, red cell count, haematocrit and platelet count all rose significantly during treatment with danazol (p < 0.01 vs. baseline). Plasma fibrinogen levels fell significantly (p < 0.01), while whole blood viscosity increased during treatment and remained significantly elevated at follow-up. The prothrombin time shortened, but remained within normal limits, and there were no significant changes in factor VII:C, VIIa, or fibrinopeptide A. No significant changes were found in platelet function. Plasma B-beta 15-42 increased significantly. Functional levels of protein C, protein S, and antithrombin III, all rose significantly, above the normal range, while C4b-binding protein levels fell. We conclude that the observed changes in coagulation inhibitors and fibrinolytic activity may be considered beneficial in the context of venous thromboembolism. The rheological effects, however, indicate a degree of caution in the use of the drug in individuals considered to be at risk from arterial cardiovascular disease.

Adult↗
PubMed1994

HLA class II DNA typing and subsequent transplantation of an aplastic anemia patient using hair follicles as a DNA source.

Identification of HLA-DR, DQ and DP alleles at the DNA level is an important tool for bone marrow transplantation (BMT). We recently encountered an aplastic anemia patient for whom the ability of molecular HLA typing to utilize alternative sources of DNA proved to be fundamental for her treatment. After repeated failures to obtain HLA typing using peripheral blood, HLA-DR and DQ alleles were identified by molecular techniques utilizing two hairs as a source of DNA, ultimately resulting in successful BMT from a sibling donor. This case clearly illustrates the potential of DNA methodologies for HLA typing in patients whose condition precludes the use of more traditional methods.

Adult↗
PubMed1993

Placental protein 14 levels in uterine flushing and plasma of women with unexplained infertility.

OBJECTIVES: To measure concentrations of placental protein 14 (PP14) in uterine flushings and plasma samples obtained from patients with unexplained infertility and to compare the results of those of normal fertile women. DESIGN: Prospective study. SETTING: Infertility and gynaecology outpatient clinics at the Jessop Hospital for Women, Sheffield, United Kingdom. PATIENTS: Sixteen patients with unexplained infertility and 12 normal fertile women who had been previously sterilized. INTERVENTIONS: Daily monitoring of luteinizing hormone (LH) to detect the LH surge; uterine flushings and blood samples were obtained on days 7, 10, and 12 after the LH surge. MAIN OUTCOME MEASURES: The measurement of PP14 concentration in uterine flushings and plasma samples throughout the luteal phase. RESULTS: Levels of PP14 in uterine flushings of patients with unexplained infertility were significantly lower than those of normal fertile women on days LH +10 and LH +12. No significant differences were observed between the two groups in PP14 levels in uterine flushings on day LH +7 and plasma samples on days LH +7, LH +10, and LH +12. CONCLUSIONS: Patients with unexplained infertility have reduced concentrations of PP14 in uterine flushings but not in plasma samples as compared with normal fertile women. Placental protein 14 measurement in uterine flushings may be a more valuable method of assessing endometrial function in infertile patients than plasma levels of the protein.

Adult↗
PubMed1993

A simple, non-invasive method of Fallopian tube sperm perfusion.

This case report describes a simple non-invasive method of Fallopian tube sperm perfusion using a paediatric Foley catheter, which does not require cannulation of the Fallopian tube and can be performed on an outpatient basis. The patient achieved an intra-uterine pregnancy with demonstrable fetal heart beats. Subsequently, use of this method in 29 treatment cycles in 14 women with unexplained infertility has resulted in six singleton and one twin ongoing clinical pregnancies.

Adult↗
PubMed1993

The correlation of placental protein 14 concentrations in uterine flushing and endometrial morphology in the peri-implantation period.

The relationship between the concentrations of placental protein 14 (PP14) in uterine flushing and the endometrial morphology in the mid-luteal phase was assessed in a prospectively designed study involving the precise timing of all samples by the luteinizing hormone (LH) surge. A total of 29 regularly cycling women with unexplained infertility or recurrent miscarriage were studied. To flush the uterine cavity, 10 ml of physiological saline solution was used immediately prior to sampling of an endometrial specimen for morphological study, in the mid-luteal phase. PP14 concentrations were measured by radioimmunoassay in uterine flushings and plasma samples; the endometrium was assessed by the use of histological dating criteria and morphometric techniques. PP14 levels in uterine flushings were correlated with endometrial dating and volume fraction measurement of the glands. They were consistently below the sensitivity of the assay with histological dating of < day LH +5, or when the glandular lumen occupied < 20% of the gland. In contrast, PP14 concentrations in plasma were not related to histological dating or morphometric analyses, and did not differ in patients with normal endometrial development (20.8 ng/ml) and in those with retarded endometrial development (22.5 ng/ml). The presence of detectable concentrations of PP14 in uterine flushing was significantly associated with normal histological dating. Uterine flushing may therefore provide a reliable, non-invasive alternative to endometrial biopsy in the evaluation of endometrial function in the peri-implantation period.

Adult↗