Biomedical subjects

T I Wagstaff

Publications and source records attributed to T I Wagstaff.

13 recordsLinked to original sources

PubMed1999

A prospective follow up study of women with colposcopically unconfirmed positive cervical smears.

OBJECTIVE: To examine a cohort of women with positive cervical smears, but negative colposcopy, in order to ascertain whether there is a subsequent difference in the incidence of squamous dyskaryosis and cervical intraepithelial neoplasia when compared with a control group. DESIGN: Prospective follow up study. SETTING: Colposcopy clinics, antenatal clinics, GP surgeries. METHODS: A study group of 255 women with reported abnormal cervical smears but negative colposcopy was subdivided into three groups according to referral smears suggesting high grade dyskaryosis (n = 34), mild dyskaryosis (n = 120) and borderline changes (n = 101). They were followed for at least five years and were compared with a control group of 726 women followed up after a negative smear, using the first and worst follow up smears over a five year recall period. MAIN OUTCOME MEASURES: Incidence of subsequent cervical cytological and histological abnormalities. RESULTS: The control group had a similar incidence of squamous dyskaryosis as that expected in the screening population. Forty-six per cent of the study group with colposcopically unconfirmed ('false positive') cervical smears subsequently had abnormal smears. When the three groups were compared with controls using a chi2 test, their incidence of abnormal smears was significantly increased. Cervical intrepithelial neoplasia was found in 19% of the study group, and in 3% of the control group (P < 0.0001). CONCLUSIONS: The analysis demonstrates that women with so-called 'false positive' smears defined by negative colposcopy have an increased risk of subsequent abnormal smears and cervical intrepithelial neoplasia, suggesting that lesions may have been missed on colposcopy. However, in a significant proportion of women, further abnormalities were not detected during the follow up period, indicating that there may be other causes for positive smears and negative colposcopy.

Colposcopy↗

PubMed1993

A retrospective analysis of 94 patients with CIN and false negative cervical smears taken at colposcopy.

This report investigates the reasons for false negative cervical cytology in 94 out of 630 patients (15%) in whom cervical intraepithelial neoplasia (CIN) was diagnosed on colposcopically directed biopsy. Cervical smears were taken immediately before biopsy and the cases with false negative cytology were compared with those whose cytology was abnormal. Patients with false negative cytology were more likely to have been younger (P < 0.01), to have had fewer pregnancies (P < 0.001), to have had a less severe grade of dyskaryosis on their referral smear (P < 0.001), to have had no endocervical cells on the smear (P < 0.05), to have had a less severe grade of CIN on biopsy (P < 0.001), to have had no punctation visible at colposcopy (P < 0.01), and to have had no mosaic pattern seen at colposcopy (P < 0.05). We found no effect attributable to the patient's menstrual history, the interval between referral smear and colposcopy clinic visit, the smear taker or the type of spatula used to take the smear.

Adult↗

PubMed1987

Relationship between serum immunoglobulin G and alpha-fetoprotein levels during human pregnancy.

The immunoregulatory processes operating during pregnancy that allow the survival of the semiallogeneic conceptus are at present far from understood. alpha-fetoprotein (AFP) is a biological component of the body produced in high amounts during pregnancy mainly by the fetal liver, and in certain clinical pathological states. The biological function of AFP is still unknown, but some investigators postulate an immunosuppressive role for the protein during pregnancy. In this study, serum immunoglobulin G, M and A levels of 101 gravidas at different stages of gestation (26 from 11-14 weeks, 37 from 32-34 weeks and finally 38 from 38-40 weeks) were determined and compared to 57 age matched nonpregnant females. Before being included in the study, patients were checked for various conditions which potentially alter immunoglobulin and AFP serum levels. Maternal serum samples showed a significant decreased concentration of immunoglobulin G (IgG) as compared to non-pregnancy serum samples (table I). AFP levels were also quantitated in the pregnancy sera and correlated with immunoglobulins levels. A strongly negative correlation between AFP and IgG was found throughout gestation (table II). When gestational age was fixed and the partial coefficients of correlation calculated, the inverse correlation persisted. In addition, the relationship between AFP and IgG at the various periods of gestation (11-14 weeks, 32-34 weeks and 38-40 weeks), calculated in order to detect where the association was stronger, revealed significant and uniform negative correlations (table III).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1986

Inhibition of mitogen and allogeneic stimulated lymphocyte growth by human amniotic fluid: lack of correlation between alpha-fetoprotein level and in vitro immunosuppression.

The influence of human amniotic fluid from women at 16-18 wk gestation on the in vitro proliferation of human peripheral lymphocytes stimulated with various mitogens (PHA, Con A and PWM) and with allogeneic cells in the one- and two-way mixed lymphocyte reaction (MLR) was studied. It was seen that amniotic fluid inhibits nonspecifically the responsiveness of the various subpopulations of cells induced to proliferate. It was also demonstrated that the suppression depends on the concentration of the immunosuppressive agent(s), since diluted amniotic fluids showed less inhibitory capacity. In order to detect a possible immune action for alpha-fetoprotein (AFP), the levels of the protein in the amniotic fluid supplemented cultures were correlated with the inhibitory properties of the fluids. No correlation was encountered, indicating that AFP is not mainly responsible for the in vitro immunosuppressive properties of human amniotic fluid on the in vitro test of cell-mediated immunity here utilized.

Amniotic Fluid↗

PubMed1983

Inhibition of lymphocyte transformation by serum from pregnant women: lack of correlation with levels of alpha-fetoprotein.

Lymphocytes from pregnant and non-pregnant women were stimulated with optimal doses of phytohaemagglutinin (PHA) in order to detect any possible suppression of the maternal cellular immune capabilities. No major differences were observed. Similar cultures using lymphocytes from normal healthy individuals were exposed to sera from pregnant and non-pregnant women. A consistent inhibitory influence, more pronounced at the end of gestation, was identified in the sera from pregnant women. No correlation was found between the levels of alpha-fetoprotein in the pregnant sera and the degree of inhibition observed in the cultures.

Female↗

PubMed1983

Response of human peripheral blood lymphocytes in the presence of cord sera: relationship of lymphocyte transformation with number of pregnancies and levels of alpha-fetoprotein.

Peripheral blood lymphocytes were stimulated with various mitogens (PHA, Con A and PWM) and allogenic cells in the presence of cord serum. The cord sera suppressed more effectively certain T cell populations. This immunoregulatory response of cord serum was compared with nonpregnant and pregnant sera from different gestations. Although the cord sera showed significantly higher inhibition compared to normal adult serum but the serum from gravidae in late gestation proved more inhibitory compared to cord serum. No correlation was found between the levels of alpha-fetoprotein (AFP) in the cord sera and the degree of inhibition observed in the cultures. As previously described for pregnant sera the cord serum obtained from women with different numbers of pregnancies did not correlate with the inhibition of cellular proliferation. Our results suggest a possible different suppressor factor in pregnant and cord sera and also excludes the possibility of AFP in cord sera as a suppressor agent of cell-mediated immunity.

Cells, Cultured↗

PubMed1980

Cord serum AFP and the immunological status of the mother: a lack of correlation.

Cord serum from 139 newborns was analysed for alpha-fetoprotein and immunoglobulin G and the results correlated with the obstetric records of the mothers. No significant correlation was found in comparing either alpha-fetoprotein or immunoglobulin G levels with the previous obstetric experiences of the mothers. A previously reported sex difference of alpha-fetoprotein levels at birth was not found in this study. These results are discussed in the light of the possible immunosuppressive effects of alpha-fetoprotein.

Birth Weight↗

PubMed1974