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Biomedical subjects

I Manyonda

Publications and source records attributed to I Manyonda.

17 recordsLinked to original sources
PubMed2005

Comparison of particle penetration with non-spherical polyvinyl alcohol versus trisacryl gelatin microspheres in women undergoing premyomectomy uterine artery embolization.

AIM: The purpose of this study was to compare the depth of vascular penetration of non-spherical polyvinyl alcohol (PVA) versus trisacryl gelatin microspheres (MS) in women undergoing uterine artery embolization (UAE) immediately before transabdominal myomectomy. MATERIALS AND METHODS: A total of 17 patients who had been referred for embolization before myomectomy underwent bilateral uterine artery embolization using either 355-500 microm PVA (group A) or 700-900 microm MS (group B). The depth of penetration of the particles was assessed by identifying their presence and location in the resected specimen. RESULTS: Of the 17 women enrolled in this study, 10 were in group A and 6 in group B. One woman underwent embolization using both types of particle and was excluded from the analysis. Embolic particles were significantly (p = 0.048) more frequently located within the fibroid (4/6, 67%) in Group B than Group A (1/10, 10%). Particles were also identified in the perifibroid tissues in 4/6 (67%) in Group B and 4/10 (40%) in Group A, with no statistical difference. There were no procedural complications. CONCLUSION: MS particles (700-900 microm) penetrate significantly deeper into leiomyomata compared with non-spherical PVA (355-500 microm). MS may therefore confer advantages in UAE, as they may more specifically target the fibroid, allowing an earlier end-point to embolization and minimizing ischaemic damage to normal myometrium and ovaries.

Acrylic Resins↗
PubMed2000

Women's sexual health after childbirth.

OBJECTIVE: To investigate the impact of childbirth on the sexual health of primiparous women and identify factors associated with dyspareunia. DESIGN: Cross-sectional study using obstetric records, and postal survey six months after delivery. SETTING: Department of Obstetrics and Gynaecology, St George's Hospital, London. POPULATION: All primiparous women (n = 796) delivered of a live birth in a six month period. METHODS: Quantitative analysis of obstetric and survey data. MAIN OUTCOME MEASURES: Self reported sexual behaviour and sexual problems (e.g. vaginal dryness, painful penetration, pain during sexual intercourse, pain on orgasm, vaginal tightness, vaginal looseness, bleeding/irritation after sex, and loss of sexual desire); consultation for postnatal sexual problems. RESULTS: Of the 484 respondents (61% response rate), 89% had resumed sexual activity within six months of the birth. Sexual morbidity increased significantly after the birth: in the first three months after delivery 83% of women experienced sexual problems, declining to 64% at six months, although not reaching pre-pregnancy levels of 38% . Dyspareunia in the first three months after delivery was, after adjustment, significantly associated with vaginal deliveries (P = 0 x 01) and previous experience of dyspareunia (P = 0 x 03). At six months the association with type of delivery was not significant (P = 0 x 4); only experience of dyspareunia before pregnancy (P < 0 x 0001) and current breastfeeding were significant (P = 0 x 0006). Only 15% of women who had a postnatal sexual problem reported discussing it with a health professional. CONCLUSIONS: Sexual health problems were very common after childbirth, suggesting potentially high levels of unmet need.

Adolescent↗
PubMed1999

Reactivity and assay restriction profiles of monoclonal and polyclonal antibodies to acid phosphatases: a preliminary study.

The development of secure diagnostic immunoassays requires, among others, rigorous characterisation of potential antibody reagents. The reactivity profiles of seven antibodies (six monoclonal [MAb] and one polyclonal [PAb]) with putative specificity for tartrate-resistant acid phosphatase (TRAP) and/or osteoclasts were evaluated in enzyme-linked immunosorbent assay (ELISA) and/or immunocytochemistry. MAbs 2H1, 4E6 and 5Cl demonstrated assay restriction: exhibiting reactivity only in ELISA. The remaining three MAbs (G211D, G312G and V35B) and the PAb 8023 recognised recombinant TRAP (rTRAP) in ELISA and native acid phosphatases in selected tissues and cell lines. The latter were cytochemically assessed for both tartrate-sensitive acid phosphatase (TSAP) and TRAP. V35B showed reactivity against the monocytic leukaemia cell line U937 and guinea pig kidney tissue (both TSAP+ and TRAP+) and ECV304 (TSAP+) cells. Interestingly, the reactivity of MAb G211D co-localised with TRAP activity in the membrane of osteoclasts but also detected cytoplasmic components in U937 cells and human embryonic lung fibroblasts (TRAP+ and TRAP+). G211D exhibited immunoreactivity against placental trophoblasts (positive for total AP). Intriguingly, MAbs 2H1, 4E6, 5Cl and PAb 8023 cross-reacted with potato acid phosphatase in ELISA, suggesting reactivity to conformationally similar epitopes. Thus, some of these reagents could be used in the development of standardised diagnostic immunoassays or as drug-targeting agents for conditions in which the pathological process involves bone resorption, the MAbs G211D, 2H1, 4E6, 5Cl and PAb 8023 being useful in ELISA but not immunocytochemical detection of TRAP.

Acid Phosphatase↗
PubMed1999

Women's sexuality after childbirth: a pilot study.

A pilot study was carried out investigating women's sexual health in the postnatal period. Postal questionnaires were sent to a cohort of 158 primiparous women approximately 7 months after delivery. Women who had resumed sexual intercourse were asked a detailed set of questions about problems experienced, sexual practices, frequency of intercourse, satisfaction with sex life, and consultation for postnatal sexual problems. All women were asked about the information they received on postnatal health prior to the birth and any information or help and advice they received from health professionals on the subject after the birth. Ninety-eight women (62%) responded. Women experienced significant levels of morbidity in the postnatal period; 3 months after delivery 58% experienced dyspareunia, 39% experienced vaginal dryness, and 44% suffered loss of sexual desire. These figures had reduced to 26, 22, and 35%, respectively, by the time of answering the questionnaire (approximately 8 to 9 months after delivery). Compared to before pregnancy, there was a decrease in frequency and satisfaction with sexual intercourse, although sexual practices changed little. Of the 67 women who reported a postnatal sexual problem, only 19% discussed this with a health professional. Conversations with health professionals in routine postnatal health contacts were mainly about contraception, and only rarely discussed problems with intercourse.

Adolescent↗
PubMed1999

Towards the modern management of ectopic pregnancy: a complete audit cycle of practice in a London teaching hospital.

We carried out a complete audit cycle of the management of ectopic pregnancy at a London teaching hospital over 2 years. Case notes of women presenting to St George's Hospital, London in 1995 with ectopic pregnancy were examined and management was assessed. The targets were low rates of rupture, high rates of sonographic diagnosis of ectopic pregnancy, acceptable rates of tubal conservation and laparoscopic surgery. We also considered levels of training of junior doctors in laparoscopic surgery for ectopic pregnancy and the acceptable duration of hospital stay for patients. Recommendations were made, the standards were modified, and the audit repeated for the year 1996. A substantial improvement in the quality of care of women with ectopic pregnancy was achieved. The main improvement was in the ultrasonographic diagnosis of ectopic pregnancy. There was also a reduction in ectopic pregnancies which were ruptured, possibly due to earlier diagnosis. The percentage of cases treated laparoscopically remained stable. More junior doctors performed laparoscopic surgery for the condition. Finally, we confirmed that laparoscopic management of ectopic pregnancy significantly reduces duration of hospital stay, conferring advantages to both patient and hospital.

Journal Article↗
PubMed1998

Total versus subtotal hysterectomy: a survey of current views and practice among British gynaecologists.

This paper reports the results of a postal questionnaire, with a response rate of 61 per cent. It is clear from the results that subtotal hysterectomy is an unpopular operation in the United Kingdom. Although a majority of consultants felt that subtotal hysterectomy was less likely to affect urinary, bowel and sexual function, this did not seem to affect decision making. Seventy-eight per cent of female gynaecologists would prefer a total hysterectomy for themselves rather than a subtotal procedure.

Journal Article↗
PubMedDate not supplied

In vitro HIV1 infection of human cervical tissue.

Heterosexual intercourse is the major mode of transmission of the human immunodeficiency virus (HIV) worldwide. Heterosexual transmission of HIV is particularly important in Africa and is increasing in the developed world. The mechanism of HIV infection of the female genital tract with HIV and subsequent events leading to clinical infection are not fully understood. In particular, the primary cellular targets of HIV infection in the female genital tract have not been determined. We have established an in vitro model for studying HIV infection of the human adult cervix by HIV. Human cervical mucosal explants were briefly exposed to HIV strains of different tropism and maintained in organ culture for 7 days. HIV infection detected by immunohistochemistry and in situ hybridization was only observed in cervical explants exposed to macrophage tropic strain HIV1Ba-L. HIV-infected cells were located in submucosa and had the morphology and distribution of macrophages. While CD4+/CD3+ T cells were still present at day 7 in the organ culture tissue, no infection of cervical explants was seen with T cell tropic strains even in the presence of phytohaemagglutinin and IL2. This model system will enable study of the dynamics of HIV infection of the human cervix and analysis of possible prophylactic or therapeutic strategies.

Adult↗
PubMedDate not supplied

The development of a genetic profile of placental gene expression during the first trimester of pregnancy: a potential tool for identifying novel secreted markers.

OBJECTIVES: Many of the maternal serum markers used in prenatal screening have been developed or evolved based on serendipity. This study determines the feasibility of developing a genetic profile of placental gene expression during early pregnancy; such a gene repertoire may serve as a tool for identifying novel secreted markers. METHODS: RNA fingerprinting was used to produce a differential expression map in normal aborted placentae of weeks 9 and 13. RESULTS: Out of 212 gene expression differences, 115 were up-regulated at week 9 and the remaining 97 up-regulated at week 13. Ninety-four were found to be previously characterised genes and 118 were expressed sequence tags or novel genes. Seven of the known genes were found to be secreted proteins and included well-characterised pregnancy markers. mRNA levels of these secreted proteins were found to correlate with levels found in maternal serum. CONCLUSION: This approach enabled the identification of known secreted markers leaving open the possibility of finding new markers. With the human genome project nearing completion, it will be vital to use a systematic approach to understand the actual pattern of gene expression during pregnancy. This will also allow a more ordered and precise identification of novel prenatal diagnostic markers.

Amino Acid Sequence↗