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Biomedical subjects

W F Hendry

Publications and source records attributed to W F Hendry.

At least 91 records · Page 5Linked to original sources
PubMed1989

Detection and treatment of antispermatozoal antibodies in men.

Autoimmunity to spermatozoa results in the production of antisperm antibodies that usually reduce the fertility of human males. Many laboratory tests have been devised to detect antisperm antibodies, but the results of such tests do not always correlate well with each other, particularly when the tests are conducted with patients' own spermatozoa rather than donor sperm. Experience over the past 12 years at Chelsea Hospital for Women and St Bartholomew's Hospital in London has led to at Chelsea Hospital for Women and St Bartholomew's Hospital in London has led to the development of an effective method for testing and treating subfertile males. This involves using the mixed antiglobulin reaction test and the post-coital test as initial screening tests, followed by serum and seminal plasma agglutination tests (both gelatin and tray) and the sperm-cervical mucus contact tests. Suitable patients are then put on one of three steroid regimens--long-term low-dose prednisolone, intermittent high-dose methylprednisolone, or intermediate graduated-dose prednisolone. Such treatment is useful not only in cases of spontaneous autoimmunity, but also in cases involving genital infection, testicular obstruction, and in vitro fertilization or gamete intrafallopian transfer.

Autoantibodies↗
PubMed1989

Retrograde ejaculation: successful treatment with artificial insemination.

Between 1977 and 1987, 14 couples in whom the male partner had retrograde ejaculation were treated with artificial insemination using the husband's sperm (AIH). There were 6 pregnancies in 4 couples, giving a cumulative probability of pregnancy at 12 months of 72%. The success rate depended on a number of factors, including semen quality, methods of sperm extraction from the urine, timing of ovulation and other complicating fertility factors.

Adult↗
PubMed1989

Hypogastric plexus stimulators for obtaining semen from paraplegic men.

Radio-linked devices to stimulate the hypogastric plexus have been implanted into 7 patients with spinal injuries and 1 with primary anorgasmia. They caused seminal emission in all patients and still do so in the spinal injury patients. Insemination with semen thus obtained has yielded 5 pregnancies (2 live births) in the wives of 4 patients. The range of application is discussed.

Adult↗
PubMed1988

The management of advanced testicular teratoma.

Of 320 patients with metastatic malignant non-seminomatous germ cell tumours of the testis (NSGCT) treated with chemotherapy, 266 (83%) are alive and well after a median follow-up of 39 months. Deaths from treatment-related causes occurred in 9 patients and were related to intensity of chemotherapy. Relapse after chemotherapy was rare except in presentations with large tumour volume and high serum marker concentrations and a strategy has been developed of risk-related choice of chemotherapy in order to reduce treatment toxicity in good prognosis sub-groups of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Seminal analysis after orchiectomy in stage I teratoma.

Seminal analysis was performed within 2 months of orchiectomy on 97 patients with clinical Stage I malignant testicular teratoma managed by surveillance following orchiectomy. Relapse of malignant disease occurred in 28% of 47 patients with a sperm count less than 10 X 10(6)/ml and in 32% of 50 patients with a sperm count greater than or equal to 10 X 10(6)/ml. Of 11 patients with azoospermia, 4 relapsed and 1 developed contralateral testicular germ cell tumour. Of 35 patients with malignant teratoma undifferentiated the relapse rate was 68% in 16 patients with a sperm count less than 10 X 10(6)/ml and 42% in 19 patients with a sperm count greater than or equal to 10 X 10(6)/ml. It was concluded that sperm count analysis is non-contributory in estimating the risk of relapse in clinical Stage I teratoma.

Humans↗
PubMed1988

Influence of antisperm antibodies on human sperm function.

Antisperm antibodies have been found in about 8% of men with infertility and in 60 to 80% of patients following vasectomy. In order to investigate the way antibodies influence sperm function we studied serum and seminal plasma from patients with infertility (n = 61) or undergoing vasovasostomy (n = 25). These antisera were characterised to determine their TAT titre, the nature of the target antigens and their capacity to interfere directly with fertilisation. The results indicate that antibodies from both groups of patients exhibit a capacity to stimulate or suppress sperm/oocyte fusion. The proportion of samples showing stimulatory activity was higher (50%) in the vasovasostomised population than in patients with infertility (21%). The remainder of the antisera suppressed sperm/oocyte fusion. There was no correlation between the titre of antisperm antibodies and their capacity to influence sperm function, indicating that it is the nature of the target antigens which is of significance rather than the antibody concentration. Western blot analysis indicated that these antisera targeted a group of sperm surface antigens with molecular weights of 30kD (35,45,66,90 and 115kD). Monoclonal antibodies are now being prepared in order to determine which of these specific components are involved in the suppression of sperm function.

Antibodies↗
PubMed1988

Efficacy of "mucoregulatory" agents in Young's syndrome.

Eight patients with Young's syndrome were treated with four "mucoregulatory" agents for eight weeks in a randomised, open crossover study. There was no improvement in tracheobronchial clearance, pulmonary function, or sperm count.

Adult↗
PubMed1987

The use of myocutaneous flaps following radical excision of the external genitalia.

Myocutaneous and fascio-cutaneous flaps have enabled single stage combined surgical resections and reconstructive procedures to be carried out for locally advanced, non-metastatic carcinoma of the external genitalia. The need for delayed repair procedures with their associated morbidity and prolonged hospital stay is minimised. Functional loss resulting from the removal of the supporting muscle is rarely a problem.

Adenocarcinoma↗
PubMed1987

Surveillance after orchiectomy for stage I seminoma of the testis.

Between February 1983 and July 1985, 52 patients with Clinical Stage I seminoma were observed after orchiectomy without lymph node irradiation. Seven patients (13%) have relapsed, six in retroperitoneal lymph nodes and one with abdominal node and pulmonary metastases. Relapses were diagnosed 6 to 23 months after orchiectomy, four occurring in the first year and three in the second year. Of eight patients with raised serum concentrations of HCG prior to orchiectomy none has relapsed, whereas of 14 patients with normal HCG levels one has relapsed. The significance of these observations for future management policy is discussed.

Chorionic Gonadotropin↗
PubMed1987

Idiopathic retroperitoneal fibrosis. A retrospective analysis of 60 cases.

Sixty patients with idiopathic retroperitoneal fibrosis presenting between 1965 and 1984 are reviewed. Their mean age at presentation was 56 years and the male:female ratio was 3:1. The commonest presenting symptoms were flank and abdominal pain, weight loss, nausea and polyuria. Physical examination was usually normal, expect for the presence of hypertension. Anaemia and elevation of erythrocyte sedimentation rate were usually present. Proteinuria was found in less than a third of patients at presentation and significant bacteriuria was uncommon. The correct diagnosis was made or suspected in very few patients before referral. The cumulative actuarial survival rate was 86% at 1 year and 78% at 2 years. Seventeen patients died; they were significantly older and more uraemic at the time of referral than those who survived. A few patients did well with either corticosteroid therapy or ureterolysis alone. In the majority, both operation and steroid treatment were necessary. In bilateral obstruction with residual function in both kidneys, bilateral ureterolysis proved superior to unilateral operation (each followed by steroid therapy) in conserving renal function. Operation alone or steroid therapy alone should be considered in cases where steroids or surgery respectively present particular hazards. The less traumatic unilateral operation should be considered in poor risk patients and in those whose renal function is absent on one side. In many survivors, disease activity has persisted for many years. Life-long follow-up is recommended.

Adrenal Cortex Hormones↗
PubMed1987

The accuracy and limitations of ultrasound in the assessment of venous extension in renal carcinoma.

Ultrasound was used to assess venous extension in 28 patients with renal carcinoma, with particular reference to involvement of the inferior vena cava. The findings were correlated with surgical findings in all except two patients who had gross caval involvement and metastatic disease and in whom surgery was considered inappropriate. In 10 of the 28 patients (36%), a diagnostic ultrasound examination of the cava from the renal veins to the diaphragm was obtained. In four of these, ultrasound showed tumour involvement of the vena cava. In 12 cases (43%) only the intrahepatic part of the cava was seen, but the examination nonetheless excluded tumour involvement of the upper cava. Visualisation of the vena cava was impossible in six cases (21%), usually because of bowel gas or obesity; CT scanning provided valuable additional information in two of these cases. Inferior vena cavography confirmed the findings of the less invasive imaging procedures in 10 patients and was falsely positive once. Cavography is now seldom necessary in the assessment of renal carcinoma.

Aged↗
PubMed1987

Antisperm antibodies detected by ZER enzyme-linked immunosorbent assay kit are not those detected by tray agglutination test.

Antisperm antibodies may play a role in the pathogenesis of infertility, particularly in the male. One of the standardized methods for detecting antisperm antibodies is the tray agglutination test (TAT). Unfortunately, this assay requires fresh motile spermatozoa. Tests for binding of antibody to fixed sperm or sperm extracts have been developed as enzyme-linked immunosorbent assays (ELISA), and we compared the results of using one such ELISA method with the TAT to detect antisperm antibodies in a panel of known positive and negative sera from infertile and control patients. With respect to the TAT assay, the ELISA gave a 75% false-positive test rate and a 63% false-negative rate. It is important to validate new assays such as the ELISA before widespread application to patient screening particularly since patients judged to have antisperm antibodies may be treated with high-dose corticosteroid drugs that are not without significant side effects.

Antibodies↗
PubMed1986

The first clinical use of depot buserelin for advanced prostatic carcinoma.

The agonist analogues of the gonadotrophin-releasing hormone now provide an alternate medical treatment of prostatic cancer. For effect repeated administration is required, either by five or six times daily intranasal or once daily subcutaneous treatment. There is an obvious disadvantage to such regimens in elderly patients who may have difficulty complying with therapy. In order to circumvent these difficulties, sustained release formulations of the agonist analogues have been synthesized. We report the first clinical use of a long-acting formulation of D-Ser (TBU)6-LHRH Ethylamide (buserelin) using a novel polymer material. Twelve symptomatic patients with previously untreated carcinoma of the prostate were treated with depot buserelin, administered once monthly. In all patients, depot buserelin suppressed serum testosterone into the range seen in castrate men at a rate equivalent to that provided by five times daily intranasal therapy. No significant increase in serum testosterone, luteinizing hormone or follicle-stimulating hormone concentrations occurred during the period of follow-up. Long-acting formulations of buserelin offer an advance in the management of prostatic cancer with agonist analogues of the gonadotrophin-releasing hormone.

Aged↗
PubMed1986

Cyclic prednisolone therapy for male infertility associated with autoantibodies to spermatozoa.

Seventy-six subfertile men with significant titers of antisperm antibodies were treated with a new corticosteroid regimen, consisting of prednisolone, 40 mg daily, rising to 80 mg daily if antibody titers did not fall, given from days 1 to 10 of the partner's menstrual cycle, for up to nine cycles. Twenty-five (33%) of the partners became pregnant during a treatment cycle, more than twice the expected incidence without treatment. No serious complications occurred, although one half of the patients had transient minor side effects. This regimen appears to be encouraging and suitable for further assessment in a prospective controlled trial.

Adult↗