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Biomedical subjects

T Chard

Publications and source records attributed to T Chard.

At least 235 records · Page 13Linked to original sources

Mid-trimester levels of alphafetoprotein in the screening of low birthweight.

Elevated maternal levels of alphafetoprotein (AFP) in midtrimester are believed by some to be a useful screening test for premature labour, low birthweight and low birthweight for gestation. In a prospective study on 887 randomly selected pregnant women we found that although there was an association between low birthweight and elevated AFP, the test would miss five out of every six cases of low birthweight and there would be nine false-positives for every case correctly identified. The test is not therefore sufficiently predictive of low birthweight to be of value as a screening test for this condition.

False Positive Reactions↗

Alpha interferon in human pregnancy.

The concentration of interferon-alpha was measured by a specific two-site immunoradiometric assay in a variety of fluids and tissues collected during human pregnancy. Maternal blood and blood and tissues from non-pregnant adults contained little or no interferon-alpha. Fetal blood, fetal organs, placenta, membranes, amniotic fluid and decidua all contained significant and roughly equivalent amounts ranging from 1.1 to 10 u/ml (or per g of tissue). These findings demonstrate that the fetus and its immediate surroundings are permeated with interferon. It is suggested that this may play a role in regulation of the maternal-fetal graft relation.

Amniotic Fluid↗

Synthesis of placental protein 12 by decidua from early pregnancy.

The synthesis and secretion of placental protein 12 (PP12) by early pregnancy decidua and trophoblast were studied in vitro from tissues obtained by curettage during elective termination of pregnancy (weeks 8-14). The tissue explants were incubated in Ham's F-10 medium for a 27-h period, and the PP12 levels in media and tissue homogenates were measured by RIA. De novo synthesis of PP12 was assessed by measuring the incorporation of radioactivity into PP12 after 20 h of incubation of tissues with 20 microCi/ml [35S]methionine. PP12 from the culture medium was immunoprecipitated with anti-PP12(A) antiserum, and the immunoprecipitate was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The initial tissue content of PP12 was 10- to 72-fold higher in decidua than in trophoblast. The total amount of radioimmunoassayable PP12 released into medium by decidual explants during the 27-h incubation period together with that present in the tissues at the end of incubation exceeded the initial tissue content by 242.7 +/- 63.7% (mean +/- SE). Only small amounts of PP12 were detected in media from trophoblast cultures. During the first 7 h of incubation, inclusion of cycloheximide had no effect on PP12 release by decidual explants in three of four experiments. Between 7 and 27 h, the amount of PP12 released by cycloheximide-treated tissues was 20.0 +/- 7% of that released by control tissues (P less than 0.01). Cycloheximide had no effect on PP12 release by trophoblasts. Decidual explants incorporated [35S]methionine into PP12, but trophoblasts did not. In sodium dodecyl sulfate-gel electrophoresis, the newly synthesized PP12 comigrated with the major band of purified PP12 corresponding to mol wt 29,000. These data clearly confirm that PP12 is a protein of decidual rather than trophoblastic origin, and indicate that decidua from early pregnancy has the ability to synthesize it.

Decidua↗

Maternal oestriol levels reflect placental function rather than foetal function.

We have examined the relationship between foetal levels of E3 and DHEA-SO4 and the birthweight of the child. Levels of these steroids do not relate to birthweight--although the concentration of DHEA-SO4 was marginally but not significantly higher in infants of lower birthweight. These findings suggest that the placental conversion of foetal precursors, and not the level of the precursors themselves, determines the concentration of E3 in the mother. Measurement of E3 as a clinical test reflects the function of both the foetus and the placenta.

Birth Weight↗

Which is the best placental function test? A comparison of placental lactogen and unconjugated oestriol in the prediction of intrauterine growth retardation.

Serum placental lactogen (hPL) and unconjugated oestriol (E3) levels were measured in 392 women at weekly intervals from 36-40 wk gestation. The levels of both hPL and E3 were reduced in subjects delivering a growth-retarded child. The clinical significance of this observation was similar for the two compounds, with a marginal advantage to hPL. There was a higher incidence of falling levels of hPL and E3 in cases of growth retardation but the finding had very little predictive value in an individual patient.

Adult↗

Use of a microcomputer network for history taking in a prenatal clinic.

A stand-alone microcomputer was installed at St. Bartholomew's Hospital to obtain the booking (first prenatal) history. This system has many well-documented advantages over the manual method, particularly with respect to the completeness and quality of the history produced. However, a single microcomputer system is unable to deal with the load of a busy clinic, and initially, several independent terminals were required. We now describe the installation of a local area network to link several microcomputers with a single database in the Antenatal Clinic at Queen Charlotte's Maternity Hospital.

Computers↗

Human chorionic gonadotrophin and subunits--heterogeneity in serum of male patients with tumours of the genital tract.

The pattern of secretion of human chorionic gonadotrophin (hCG) and its subunits in male subjects with tumours of the genital tract was examined by gel filtration, radioimmunoassay, immunoradiometric assay, bioassay and binding to Concanavalin A. The predominant form of hCG was the intact molecule but all patients had increased levels of free beta subunit. The intact hCG was active in a mouse Leydig cell bioassay and was normally glycosylated. High concentrations of free alpha subunit were not found and the ratio of alpha subunit: beta subunit was less than that in normal pregnancy. It is concluded that hCG-secreting tumours of the male genital tract are similar to choriocarcinoma in the female in that large quantities of intact hormone are produced with a disproportionate increase in free beta sub-unit.

Adult↗

Dramatic increase of placental protein 5 levels following injection of small doses of heparin.

In the course of an investigation on the effects of thyroid releasing hormone in pregnant women we noted a dramatic increase in the levels of placental protein 5 (PP5) in maternal blood. This increase ranged from 10 times to over 40 times the basal levels. Further study showed that the rise was associated with the use of heparin to maintain the patency of the cannula through which the samples were collected. Furthermore, the phenomenon appeared to be systemic rather than local, and may well be due to a direct effect of heparin on PP5 secretion by the placenta.

Female↗

Computerized histories facilitate patient care in a termination of pregnancy clinic: the use of a small computer to obtain and reproduce patient information.

An inexpensive microcomputer has been programmed to obtain histories from patients attending a pregnancy termination clinic. The system is nurse-interactive; yes/no and multiple-choice questions are answered on the visual display unit by a light pen. Proper nouns and discursive text are typed at the computer keyboard. A neatly formatted summary of the history is then provided by an interfaced printer. The history follows a branching pattern; of the 370 questions included in the program, only 68 are answered in the course of an average history. The program contains numerous error traps and the user may request explanations of questions which are not immediately understood. The system was designed to ensure that no factors of anaesthetic or medical importance would be overlooked in the busy out-patient clinic. The computer provides a much more complete history with an average of 42 more items of information than the pre-existing manual system. This system is demanding of nursing time and possible conversion to a patient-interactive system is discussed. A confidential questionnaire revealed a high degree of consumer acceptance.

Abortion, Therapeutic↗

Placental protein 12 (PP12): a new test for the prediction of the small-for-gestational-age infant.

The circulating levels of placental protein 12 (PP12) and placental lactogen (hPL) were measured in 501 women between 36 and 41 weeks gestation. There was a significant positive association between hPL levels and infant birthweight and a significant negative association in the case of PP12 levels. The clinical efficiency of elevated PP12 levels in the prediction of low-birthweight infant at term compared favourably with that of reduced hPL levels.

Birth Weight↗

Monoclonal antibodies to human chorionic gonadotropin: implications for antigenic mapping, immunoradiometric assays, and clinical applications.

Monoclonal antibodies to intact hCG and free beta-subunit of hCG permit the recognition of different individual antigenic sites on the hCG molecule. At least seven different epitopes may be recognized on the native molecule and a further two on the free beta-subunit. These antibodies were used in a mouse Leydig cell bioassay system to compare the degree of inhibition of hCG-induced testosterone production. Two antibodies were particularly potent at inhibiting hCG action, suggesting that they bind near to the receptor-recognition site on the hCG molecular. One antibody had little effect on biological action and was presumably binding distant from the biologically active site on the hCG. Combinations of monoclonal antibodies in immunoradiometric assays were used to develop highly sensitive and specific assays to intact hCG, free beta-subunit of hCG, and beta-subunit as part of intact hCG. Using these assays it was possible to detect 0.1 ng/ml hCG in the presence of high levels of LH. In 106 serum samples from pregnant woman free beta-subunit was considerably higher in samples with low concentrations of intact hCG, suggesting that free beta-subunit is not a limiting factor in placental production of intact hCG in early pregnancy. Comparison of urinary to serum ratios of hCG and free beta-subunit using specific immunoradiometric assays showed a good correlation for intact hCG but not for free beta subunit which was present in very high concentrations in urine.

Animals↗

Maternal and fetal alphafetoprotein (AFP) levels at term. Relation to sex, weight and gestation of the infant.

Serum alpha-fetoprotein (AFP) was measured in maternal, cord arterial and venous blood. Samples were collected at the time of vaginal delivery from 105 women at 36-42 weeks' gestation. There was a significant correlation between maternal, cord arterial and venous AFP. Umbilical cord arterial and venous AFP levels were considerably higher in male infants than in females. Umbilical AFP levels declined with lengthening gestation and increasing birthweight for both male and female infants and a similar pattern was seen in the mother. Fetal AFP levels were significantly higher in subjects giving birth at 40 weeks whose infants had a birthweight below the population mean vis-à-vis those above the mean. It is concluded that the absolute size of the fetus as well as gestational age may play a significant role in determining maternal and fetal AFP concentration.

Birth Weight↗