Taking family history of anaesthetic problems.
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Biomedical subjects
Publications and source records attributed to K W Hancock.
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Unconjugated oestrone and unconjugated oestradiol-17 beta were measured in 24 h urine specimens from twenty normal men. The concentrations of non-protein-bound oestrone and non-protein-bound oestradiol-17 beta, in samples of blood obtained from these subjects during the time in which the urine was collected, were measured by equilibrium dialysis (using a correction for plasma dilution). The mean excretion of unconjugated oestrone (0.44+/- 0.36 nmol/24 h, mean +/- SD) was significantly greater (Pless than 0.01) than that of unconjugated oestradiol-17 beta (0.20 +/- 0.13 nmol/24 h). The concentrations of non-protein-bound oestrone and non-protein-bound oestradiol-17 beta in plasma were 5.52 +/- 2.69pmol/1 and 2.42 +/- 0.73 pmol/1, respectively. There was no correlation between the quantity of unconjugated oestrone excreted and the concentration of non-protein-bound oestrone in plasma (r=0.27) nor between the quantity of unconjugated oestradiol-17 beta in the urine and the concentration of non-protein-bound oestradiol-17 beta in plasma (r=0.05). Therefore in normal men, estimation of unconjugated oestrone or oestradiol-17 beta in urine provides no guide to the concentration of the corresponding non-protein-bound oestrogen in plasma.
A mongol child suffereing from hypothyroidism who presented with precocious puberty is described. A presumptive diagnosis of idiopathic precocious puberty was first made and she was treated initially with medroxyprogesterone acetate, and later, with cyproterone acetate. The diagnosis of primary hypothyroidism was made late because of misleading results of protein bound iodine estimations. Subsequently, thyroid medication resulted in a prompt return to the normal range of the previously elevated levels of plasma gonadotrophins, thyroid stimulating hormone and plasma and urinary oestrogens, but the serum prolactin remained elevated for several months after therapy was begun.
A cross-sectional study is presented of biochemical changes in the third trimester of normal pregnancy and puerperium during the wet season in the tropical climate of Lagos, Nigeria. These changes are less marked in first than in subsequent pregnancies, and although qualitatively similar, in some respects they differ from those observed in the temperate climatic zone. The indications are that quantitative differences may exist which could be relevant to the management of pregnancy in the tropics.
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The effects on the haemostatic mechanism of rises in circulating human oestrogen in a group of women being treated for infertility with pituitary hormones were studied. Despite large but brief rises in oestrogen levels no changes were found.
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A synthetic and a natural oestrogen were administered alternately for three months to nine women with primary amenorrhoea using a randomized cross-over schedule. Measurements of haemostatic function were performed before and at the end of each treatment period. No significant change in haemostatic function was observed after treatment with the 'natural' oestrogen, oestriol succinate. In contrast, treatment with a synthetic oestrogen, ethinyloestradiol, caused shortening of the prothrombin time and an increase in plasma concentration of factor VII and plasminogen. These data support other observations in suggesting that natural oestrogens may have fewer potentially adverse effects on haemostatic function than synthetic oestrogen.
We describe two patients with Nelson's syndrome in whom pregnancy progressed normally to spontaneous delivery of normal infants. One patient, who subsequently was found to have a basophil adenoma of the pituitary, developed diabetes insipidus in late pregnancy and the diabetes insipidus regressed spontaneously after delivery.
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The case reports are presented of two patients who developed water intoxication after high-dose oxytocin infusions. Plasma sodium and urine flow were studied in two further patients given high-dose oxytocin infusions. The findings are related to previously published observations.
Changes were assessed in lymphocyte sub-populations in various stages of human pregnancy. The percentage and absolute number of E-RFC decreased during pregnancy. There was a concomitant rise in the percentages of EAC-RFC and cells bearing SmIg with little change in their absolute numbers. EAC-RFC continued to rise post-natally.
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In a group of patients who developed ovulatory dysfunction on stopping oral contraception the mean body weight of those with previosly regular cycles was significantly lower than that of women who had had ovulatory dysfunction beforeoral contraception and also that of a control group. Women of low body weight may be at particular risk of developing post-pill amenorrhoea even when there is no history pointing to ovulatory dysfunction. This should be considered when selecting a form of contraception in such women.
Maternal lymphocyte reactivity to human trophoblast antigens was studied in placentas of gestational ages 8 to 14 weeks and 32 to 34 weeks, respectively. Significant trophoblast lysis became apparent after 24 hours' incubation in the latter case compared with a time lag of 72 hours in the terminated gestations. Maternal cellular immunity, therefore, was not detected during the first 3 1/2 months of pregnancy, but was detectable by the time of parturition. The possible significance is discussed with respect to the antigenic stimulus and survival of the fetal allograft.