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Sample records for sutureless amniotic membrane

  1. Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

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    Huang Zhang

    2014-09-01

    Full Text Available AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.METHODS:Totally 22 cases(22 eyeswith superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope. RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea

  2. Amniotic membrane allografts: development and clinical utility in ophthalmology

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    Rizzuti A

    2014-12-01

    Full Text Available Allison Rizzuti,1,2 Adam Goldenberg,1 Douglas R Lazzaro1,2 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, NY, USA Abstract: Amniotic membrane, the innermost layer of the placenta, is a tissue that promotes epithelialization, while decreasing inflammation, neovascularization, and scarring. It is used in the surgical management of a wide variety of ophthalmic conditions where it functions as a graft or patch in ocular surface reconstruction. The development of new preservation techniques, as well as a sutureless amniotic membrane, has allowed for easier, in-office placement, without the disadvantages of an operating room procedure. The purpose of this review is to describe the historical development of amniotic membrane in ophthalmology and to describe its current clinical applications, particularly focusing on recent advances. Keywords: ocular surface, cornea, stem cells, prokera, allograft, patch, transplantation

  3. Amniotic membrane for burn trauma

    International Nuclear Information System (INIS)

    Jamaluddin Zainol; Hasim Mohammad

    1999-01-01

    Amniotic membranes are derived from human placentae at birth. They have two layers mainly the amniotic and the chorionic surfaces which are separated by a thin layer of connective tissues. The two layers are separated during procurement, the placenta and the chorionic side are discarded and the amnion membranes are then further processed. Amnion membranes are normally procured from placentae which are normally free of infections, i.e; the mothers are antenatally screened for sexually transmitted diseases or AlDs related diseases. Intrapartum the mother should not be having chorioamnionitis or jaundice. Sometimes the amniotic membranes are acquired from fresh elective caeserian sections. After processing, the amniotic membranes are packed in two layers of polypropylene and radiated with cobalt 60 at a dose of about 25 kGy. The amniotic membranes are clinically used to cover burn surfaces especially effective for superficial or partial thickness burns. The thin membranes adhered well to the trauma areas and peeled off automatically by the second week. No change of dressing were necessary during these times because of the close adherence, there were less chance of external contamination or infections of these wounds. Due to their flexibility they are very useful to cover difference contours of the human body for example the face, body, elbows or knees. However our experience revealed that amniotic membranes are not useful for third degree bums because the membranes dissolves by the enzymes present in the wounds

  4. AMNIOTIC MEMBRANE TRANSPLANTATION FOR KERATITIS.

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    Snezhana Murgova

    2015-06-01

    Full Text Available Keratitis without proper management tends to perforate the cornea, resulting in severe adverse consequences. In recent studies, amniotic membrane is reported to have anti-inflammatory effect and promote wound healing of corneal ulcer. Purpose: To report on the efficacy of permanent amniotic membrane transplantation (AMT in the treatment of keratitis. Case report: A 58-year-old man with severe keratitis in both eyes caused by long term administration of topical anesthetic (alcaine for electric ophthalmia. Single layer of amniotic membrane (AM was placed on the defect and secured to the limbus with interrupted 10-0 nylon sutures. A bandage contact lens was applied on the AM. Postoperative medication included topical antibiotic, artificial tears and mydriatic. Three months later corticosteroid was included. There was an immediate decrease of patient’s pain after surgery. Complete epithelialization was noted after 1 month. Conclusion: AMT is an alternative adjunctive method of treatment of keratitis; it promotes epithelialization process, decreased inflammation, corneal haze and neovascularization.

  5. Methods of amniotic membrane fixation in ocular amniotic membrane surgeries

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    Shu-Rong Wang

    2016-05-01

    Full Text Available Various ocular surface disorders like alkali burns and corneal ulcers can all cause damage to the cornea and conjunctiva, and often induce corneal neovascularization(CNVthat affects the visual function. However, amniotic membranes(AMcan promote the rapid epithelization of acute injured corneas and conjunctiva defects, diminish scarring, and perform anti-inflammatory effect. Therefore, AM has been widely used in ocular surface reconstructions and treatment of CNV. But the key problem is how to fix the AM. Only ensuring the adhesive time and cover area with convenient operation and little stimulation can achieve the best curative effect. This article reviews the methods of AM fixation in AM patch technique.

  6. Tissue Banking in Malaysia-amniotic membrane

    International Nuclear Information System (INIS)

    Hashim bin Mohamad; Norimah binti Yusof

    1991-01-01

    Burn treatment using amniotic membranes in some of our patients initiate our own tissue bank starting with a pilot project on procurement, processing and clinical application of irradiated amniotic membrane. The irradiation of amniotic membrane was made possible by the availability of cobalt source at the Nuclear Energy Agency (UTN). With the technical help from the Inter-national Atomic Energy Agency (IAEA) we soon should be able to embark on bone bank to supply local surgeons. Thus the establishment of tissue bank at our institution will further enhance our programme which will include keratinocytes culture for burn, osteocytes culture for bone replacement as well as the use of animal skin for temporary coverage of open wounds

  7. Experience of Using Amniotic Membrane After Circumcision

    International Nuclear Information System (INIS)

    Manjas, Menkher; Ismal; Efmansyah, Dody

    2002-01-01

    It is compulsory, for boys to undergone circumcision before getting adult in Moslem region. It can be done by General Surgeon, General Practitioner, Nurse, Midwife or Quack. The place to carry out the circumcision can be inside or outside hospital. The utmost problems are injections, point for secondary wound covering and delay of using underpants. To overcome those problem amniotic membranes can be used as wound covering, based on : they are soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient, transparency which allows wound control without redressing of the wound. From January until December 1999, 165 boys at an age between 6-10 years, which have been carried out circumcision, were evaluated. Radiation sterilized lyophilized amniotic membranes were used in this work as wound covering Result show that amniotic membrane gave a good result in wound healing. All the patients observed, showed early mobilization as well as early using underpants. There is no different result between circumcision which had been done either inside or out hospital, carried out by surgeon or non-surgeon

  8. Human amniotic membrane as newly identified source of amniotic fluid pulmonary surfactant

    OpenAIRE

    Lemke, Angela; Castillo-S?nchez, Jos? Carlos; Prodinger, Florian; Ceranic, Asja; Hennerbichler-Lugscheider, Simone; P?rez-Gil, Jes?s; Redl, Heinz; Wolbank, Susanne

    2017-01-01

    Pulmonary surfactant (PS) reduces surface tension at the air-liquid interface in the alveolar epithelium of the lung, which is required for breathing and for the pulmonary maturity of the developing foetus. However, the origin of PS had never been thoroughly investigated, although it was assumed to be secreted from the foetal developing lung. Human amniotic membrane (hAM), particularly its epithelial cell layer, composes the amniotic sac enclosing the amniotic fluid. In this study, we therefo...

  9. Indications and Outcomes of Amniotic Membrane Transplantation

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    Alime Güneş

    2014-03-01

    Full Text Available Objectives: To investigate the indications and outcomes of amniotic membrane transplantation (AMT. Materials and Methods: A total of 87 eyes who underwent amnion membrane transplantation in our clinic between February 2010 and April 2013 were included in this study. Mean follow-up period was 7.49±7.84 months (range 1-29 months. Amnion membrane defrosted at room temperature and washed three times with saline covered all over the cornea independent of the position and size of the lesion and was sutured to the peripheral cornea circumferentially by 10/0 monofilament suture. At the end of the operation, therapeutic contact lens was placed. All cases were evaluated with respect to duration of surface epithelial healing, visual acuity, presence of recurrence, and infection. Results: Forty-six of the 87 patients (52.8% were men and 41 (47.1% were women. The mean age was 57.02±19.74 years (range 31-89 years in men and 66.69±16.56 years (range 8-88 years in women. The indications were: ulcers in 27 eyes, keratitis in 24 eyes, topical anesthetic abuse in 10 eyes, bullous keratopathy in 7 eyes, conjunctival mass in 7 eyes, symblepharon in 3 eyes, chemical burns in 3 eyes, pterygium in 2 eyes, endophthalmitis in 2 eyes, dellen in 1 eye, and conjunctival laceration in 1 eye. After AMT, 12 patients required second AMT, and 2 cases required third AMT. 2 eyes were eviscerated, 1 eye was exenterated. At the final follow-up visit, except for patients who underwent evisceration and exenteration, improved visual acuity was observed in 45 of the 84 eyes (53.5%. The average of healing time was between 4 and 6 weeks. No infectious, inflammatory, immunologic, or toxic/allergic reactions related to AMT was observed. Conclusion: Amniotic membrane transplantation is a safe and effective technique in ocular surface diseases. (Turk J Ophthalmol 2014; 44: 123-6

  10. Amniotic membrane in oral and maxillofacial surgery.

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    Kesting, Marco Rainer; Wolff, Klaus-Dietrich; Nobis, Christopher Philipp; Rohleder, Nils Hagen

    2014-06-01

    Following its renaissance in ophthalmology during the 1990s, preserved human amniotic membrane (HAM) has become an attractive biomaterial for all surgical disciplines. This article reviews the current and potential use of HAM in oral and maxillofacial surgery, its postulated properties and common preservation techniques. Literature was identified by an electronic search of PubMed in July 2012; this was supplemented from the reference lists of the consulted papers. HAM has been used in the field of oral and maxillofacial surgery from 1969 onwards because of its immunological preference and its pain-reducing, antimicrobial, mechanical and side-dependent adhesive or anti-adhesive properties. The effects of HAM on dermal and mucosal re-epithelialisation have been highlighted. Typically, HAM is applied after being banked in a glycerol-preserved, DMSO-preserved or freeze-dried and irradiated state. Whereas the use of HAM in flap surgery and in intra-oral and extra-oral lining is reported frequently, novel HAM applications in post-traumatic orbital surgery and temporomandibular joint surgery have been added since 2010. Tissue engineering with HAM is a fast-expanding field with a high variety of future options. Preserved HAM is considered to be a safe and sufficient biomaterial in all fields of oral and maxillofacial wound healing. Recently published novel indications for HAM application lack a high level of evidence and need to be studied further.

  11. Human amniotic membrane as newly identified source of amniotic fluid pulmonary surfactant.

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    Lemke, Angela; Castillo-Sánchez, José Carlos; Prodinger, Florian; Ceranic, Asja; Hennerbichler-Lugscheider, Simone; Pérez-Gil, Jesús; Redl, Heinz; Wolbank, Susanne

    2017-07-25

    Pulmonary surfactant (PS) reduces surface tension at the air-liquid interface in the alveolar epithelium of the lung, which is required for breathing and for the pulmonary maturity of the developing foetus. However, the origin of PS had never been thoroughly investigated, although it was assumed to be secreted from the foetal developing lung. Human amniotic membrane (hAM), particularly its epithelial cell layer, composes the amniotic sac enclosing the amniotic fluid. In this study, we therefore aimed to investigate a potential contribution of the cellular components of the hAM to pulmonary surfactant found in amniotic fluid. We identified that cells within the native membrane contain lamellar bodies and express all four surfactant proteins as well as ABCA3. Lipidomic profiling by nanoESI - MS/MS revealed the presence of the essential lipid species as found in PS. Also, the biophysical activity of conditioned cell culture supernatant obtained from hAM was tested with captive bubble surfactometry. hAM supernatant showed the ability to reduce surface tension, similar to human PS obtained from bronchoalveolar lavage. This means that hAM produces the essential PS-associated components and can therefore contribute as second potential source of PS in amniotic fluid aside from the foetal lung.

  12. Using Amniotic Membrane as Wound Covering After Cesarean Section Operation

    International Nuclear Information System (INIS)

    Manjas, Menkher; Helmi, Helfial

    2002-01-01

    Early mobilization and good wound operation healing are the other aim of all treatment for cesarean section operation. Especially for wound healing we can use amniotic membrane which is soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient transparency which allows wound control without secondary redressing. From July 1999 until December 1999 total of 196 patients undergoing cesarean section with amnion as would covering were evaluated for injection of amnion, sign of wound injection, and duration of wound healing. Amniotic membrane gives best results in wound healing, no sing of rejection and there is no different results between emergency operation and elective operation, clean and dirty operation

  13. The Amniotic Membrane: Development and Potential Applications - A Review.

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    Favaron, P O; Carvalho, R C; Borghesi, J; Anunciação, A R A; Miglino, M A

    2015-12-01

    Foetal membranes are essential tissues for embryonic development, playing important roles related to protection, breathing, nutrition and excretion. The amnion is the innermost extraembryonic membrane, which surrounds the foetus, forming an amniotic sac that contains the amniotic fluid (AF). In recent years, the amniotic membrane has emerged as a potential tool for clinical applications and has been primarily used in medicine in order to stimulate the healing of skin and corneal diseases. It has also been used in vaginal reconstructive surgery, repair of abdominal hernia, prevention of surgical adhesions and pericardium closure. More recently, it has been used in regenerative medicine because the amniotic-derived stem cells as well as AF-derived cells exhibit cellular plasticity, angiogenic, cytoprotective, immunosuppressive properties, antitumoural potential and the ability to generate induced pluripotent stem cells. These features make them a promising source of stem cells for cell therapy and tissue engineering. In this review, we discussed the development of the amnion, AF and amniotic cavity in different species, as well as the applicability of stem cells from the amnion and AF in cellular therapy. © 2015 Blackwell Verlag GmbH.

  14. Chitosan Cross-linked Reconstituted Amniotic Collagen Membrane ...

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Chitosan Cross-linked Reconstituted Amniotic Collagen Membrane – An Excellent Cell Substratum. The KERATINOCYTE proliferation and Differentiation into multiple layers is due to the presence of type - IV collagen in the amnion. Cultured FIBROBLASTS had good ...

  15. Accuracy of intraocular pressure by Tono-Pen XL over amniotic membrane patching in rabbits.

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    Kobayashi, Akira; Yoshita, Tsuyoshi; Shirao, Yutaka

    2003-04-01

    To report an accuracy of intraocular pressure (IOP) by Tono-Pen XL over amniotic membrane patching in rabbits. Experimental study. Seven male albino rabbits were used in this study. After general anesthesia, IOP was measured in both eyes using the Tono-Pen without amniotic membrane. A single layer amniotic membrane was then immediately placed over the rabbit eye, and the IOP measurement was repeated. The average IOP without amniotic membrane was 5.8 +/- 0.6 mm Hg (mean +/- SD). The average IOP through amniotic membrane was 6.0 +/- 0.4 mm Hg (mean +/- SD). There was no statistical difference in IOP measured on corneas with or without the amniotic membrane (P =.34). The accuracy of IOP measurement by Tono-Pen XL over a single layer of amniotic membrane patching was demonstrated using rabbit eyes. Further studies in human eyes may verify our findings in actual clinical settings.

  16. Transplantation of amniotic membrane to the subretinal space in pigs

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Scherfig, Erik; Prause, Jan Ulrik

    2012-01-01

    Purpose. To investigate the effect of transplanted amniotic membrane (AM) on subretinal wound healing. Methods. Nine Danish Landrace pigs had surgical removal of retinal pigment epithelium (RPE) and mechanical damage of Bruch's membrane (BM) and served as a control group. 15 pigs additionally had...... is well tolerated in the subretinal space, causes only limited inflammation, and is covered with a monolayer of pigmented cells when in contact with the host RPE. Conclusions. AM modifies choroidal neovascularisation after BM damage and may serve as a basement membrane substitute for the RPE....

  17. Amniotic membrane transplantation for ligneous conjunctivitis in a doberman.

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    O'Leary, Louise; Specht, Andrew; Isaza, Natalie; Kallberg, Maria; Barrie, Kathleen; Cottrell, Deborah; Plummer, Caryn

    2018-02-26

    An approximately 2-year-old female Doberman Pinscher was referred for the evaluation of bilateral, chronic proliferative conjunctivitis. Ophthalmic examination revealed bilateral thick, opaque pseudomembranes originating from the conjunctivae that prevented visualization of the cornea and interior structures of the eye. Histopathological findings of biopsies of the pseudomembranes were consistent with ligneous conjunctivitis. Serum plasminogen activity levels were within the normal range. Treatment with topical and systemic anti-inflammatory and immunosuppressive drugs did not improve the conjunctival lesions. The pseudomembranes were surgically excised, and the conjunctival surfaces were reconstructed with amniotic membrane. At final re-examination two years postsurgery, there was no evidence of recurrence of the pseudomembranes. To the authors' knowledge, this is the first reported case of the successful treatment of canine ligneous conjunctivitis with amniotic membrane transplantation. © 2018 American College of Veterinary Ophthalmologists.

  18. A skin substitute based on human amniotic membrane.

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    Tauzin, Hélène; Rolin, Gwenaël; Viennet, Céline; Saas, Philippe; Humbert, Philippe; Muret, Patrice

    2014-06-01

    Human amniotic membrane (HAM) has biological properties which are useful for wound healing. HAM is notably one of the therapeutic alternatives for venous leg ulcer care. Indeed, a prospective clinical study has demonstrated that cryopreserved HAM transplantation for leg ulcer is feasible, safe and has beneficial effects: 80 % of the patients had a significant clinical response. Nevertheless, at the end of the 3-month follow-up period, only 20 % of the ulcers were totally closed. The aim of this work was to create and characterize a model of epidermized HAM. The method of HAM desepithelialization was validated by histology, immunohistochemistry and scanning electron microscopy. Then, de-epithelialized HAM was seeded with primary keratinocytes. After 21 days of culture, 15 at the air-liquid interface, the model obtained was analyzed histologically and by immunohistochemistry. The amniotic basement membrane was preserved during enzymatic desepithelialization of HAM. Primary keratinocytes proliferated on HAM: the model obtained showed involucrin expression and had a good basement membrane. As re-epithelialization is an important step for ulcer closure, a model of epidermized HAM could be used to speed up the healing of such wounds.

  19. Reliability of intraocular pressure by Tono-Pen XL over amniotic membrane patch in human.

    Science.gov (United States)

    Yoshita, Tsuyoshi; Kobayashi, Akira; Takahashi, Mami; Sugiyama, Kazuhisa

    2004-10-01

    To determine the reliability of Tono-Pen XL in measuring intraocular pressure (IOP) over the amniotic membrane patch in human eyes. Ten healthy volunteers (nine males and one female) participated in this study. After topical anesthesia, IOP was measured using the Tono-Pen XL before and after the application of a single-layer amniotic membrane patch in the right eye and double-layer amniotic membrane patch in the left eye. We found no statistical difference between the IOP measured with and without a single layer amniotic membrane (P = 0.808). Nor did we find any statistical difference between the IOP measured with and without double-layer amniotic membrane patch (P = 0.813). The average thickness of the single- and the double-layer amniotic membrane patch measured by pachymetry was 131.9 +/- 31.4 microm (mean +/- SD) and was 246.1 +/- 69.3 microm (mean +/- SD), respectively. This study showed that it is reliable to measure IOP by Tono-Pen XL over single or a double layer of amniotic membrane patch on healthy human eyes. Further studies are required to determine the accuracy of IOP measurement over amniotic membrane patch on diseased corneas.

  20. Effect of amniotic membrane to reduce postlaminectomy epidural adhesion on a rat model.

    Science.gov (United States)

    Choi, Hyu Jin; Kim, Kyoung Beom; Kwon, Young-Min

    2011-06-01

    Epidural fibrosis and adhesion are the main reasons for post-laminectomy sustained pain and functional disability. In this study, the authors investigate the effect of irradiated freeze-dried human amniotic membrane on reducing epidural adhesion after laminectomy on a rat model. A total of 20 rats were divided into two groups. The group A did not receive human amniotic membrane implantation after laminectomy and group B underwent human amniotic membrane implantation after laminectomy. Gross and microscopic findings were evaluated and compared at postoperative 1, 3 and 8 weeks. The amount of scar tissue and tenacity were reduced grossly in group of rats with human amniotic membrane implantation (group B). On a microscopic evaluation, there were less inflammatory cell infiltration and fibroblast proliferation in group B. This experimental study shows that implantation of irradiated freeze-dried human amniotic membrane reduce epidural fibrosis and adhesion after spinal laminectomy in a rat model.

  1. A Simple Alkaline Method for Decellularizing Human Amniotic Membrane for Cell Culture

    Science.gov (United States)

    Saghizadeh, Mehrnoosh; Winkler, Michael A.; Kramerov, Andrei A.; Hemmati, David M.; Ghiam, Chantelle A.; Dimitrijevich, Slobodan D.; Sareen, Dhruv; Ornelas, Loren; Ghiasi, Homayon; Brunken, William J.; Maguen, Ezra; Rabinowitz, Yaron S.; Svendsen, Clive N.; Jirsova, Katerina; Ljubimov, Alexander V.

    2013-01-01

    Human amniotic membrane is a standard substratum used to culture limbal epithelial stem cells for transplantation to patients with limbal stem cell deficiency. Various methods were developed to decellularize amniotic membrane, because denuded membrane is poorly immunogenic and better supports repopulation by dissociated limbal epithelial cells. Amniotic membrane denuding usually involves treatment with EDTA and/or proteolytic enzymes; in many cases additional mechanical scraping is required. Although ensuring limbal cell proliferation, these methods are not standardized, require relatively long treatment times and can result in membrane damage. We propose to use 0.5 M NaOH to reliably remove amniotic cells from the membrane. This method was used before to lyse cells for DNA isolation and radioactivity counting. Gently rubbing a cotton swab soaked in NaOH over the epithelial side of amniotic membrane leads to nearly complete and easy removal of adherent cells in less than a minute. The denuded membrane is subsequently washed in a neutral buffer. Cell removal was more thorough and uniform than with EDTA, or EDTA plus mechanical scraping with an electric toothbrush, or n-heptanol plus EDTA treatment. NaOH-denuded amniotic membrane did not show any perforations compared with mechanical or thermolysin denuding, and showed excellent preservation of immunoreactivity for major basement membrane components including laminin α2, γ1-γ3 chains, α1/α2 and α6 type IV collagen chains, fibronectin, nidogen-2, and perlecan. Sodium hydroxide treatment was efficient with fresh or cryopreserved (10% dimethyl sulfoxide or 50% glycerol) amniotic membrane. The latter method is a common way of membrane storage for subsequent grafting in the European Union. NaOH-denuded amniotic membrane supported growth of human limbal epithelial cells, immortalized corneal epithelial cells, and induced pluripotent stem cells. This simple, fast and reliable method can be used to standardize

  2. A simple alkaline method for decellularizing human amniotic membrane for cell culture.

    Directory of Open Access Journals (Sweden)

    Mehrnoosh Saghizadeh

    Full Text Available Human amniotic membrane is a standard substratum used to culture limbal epithelial stem cells for transplantation to patients with limbal stem cell deficiency. Various methods were developed to decellularize amniotic membrane, because denuded membrane is poorly immunogenic and better supports repopulation by dissociated limbal epithelial cells. Amniotic membrane denuding usually involves treatment with EDTA and/or proteolytic enzymes; in many cases additional mechanical scraping is required. Although ensuring limbal cell proliferation, these methods are not standardized, require relatively long treatment times and can result in membrane damage. We propose to use 0.5 M NaOH to reliably remove amniotic cells from the membrane. This method was used before to lyse cells for DNA isolation and radioactivity counting. Gently rubbing a cotton swab soaked in NaOH over the epithelial side of amniotic membrane leads to nearly complete and easy removal of adherent cells in less than a minute. The denuded membrane is subsequently washed in a neutral buffer. Cell removal was more thorough and uniform than with EDTA, or EDTA plus mechanical scraping with an electric toothbrush, or n-heptanol plus EDTA treatment. NaOH-denuded amniotic membrane did not show any perforations compared with mechanical or thermolysin denuding, and showed excellent preservation of immunoreactivity for major basement membrane components including laminin α2, γ1-γ3 chains, α1/α2 and α6 type IV collagen chains, fibronectin, nidogen-2, and perlecan. Sodium hydroxide treatment was efficient with fresh or cryopreserved (10% dimethyl sulfoxide or 50% glycerol amniotic membrane. The latter method is a common way of membrane storage for subsequent grafting in the European Union. NaOH-denuded amniotic membrane supported growth of human limbal epithelial cells, immortalized corneal epithelial cells, and induced pluripotent stem cells. This simple, fast and reliable method can be used to

  3. Quantitative mapping of intracellular cations in the human amniotic membrane

    Science.gov (United States)

    Moretto, Ph.; Llabador, Y.; Simonoff, M.; Razafindrabe, L.; Bara, M.; Guiet-Bara, A.

    1993-05-01

    The effect of magnesium and taurine on the permeability of cell membranes to monovalent cations has been investigated using the Bordeaux nuclear microprobe. PIXE and RBS techniques have been used to provide quantitative measurements and ion distributions in the isolated amniotic membrane. This physiological model for cellular exchanges allowed us to reveal the distribution of most elements involved in cellular pathways and the modifications under different experimental conditions of incubation in physiological fluids. The PIXE microanalysis provided an original viewpoint on these mechanisms. Following this first study, the amnion compact lamina was found to play a role which was not, up to now, taken into account in the interpretation of electrophysiological experimentations. The release of some ionic species, such as K +, from the epithelial cells, during immersion in isotonic fluids, could have been hitherto underestimated.

  4. Use of amniotic membrane in ophthalmology surgery, first cases

    International Nuclear Information System (INIS)

    Aguirre, P.; Ogrodnik, M.T.; Zarate, H; Silva, S.; Azocar, M.; Hitschfeld, M.

    2008-01-01

    The results obtained with the implant of amniotic membranes have propitiated their use in different medical fields.One of the most important barriers that have to be solved is the risk to transmit illness from donor to patient. A cooperative work between the Comision Chilena de Energia Nuclear (CCHEN) and the Complejo de Salud San Borja Arriaran (CSSBA) has been done to prepare the membranes with the main purpose of assuring the quality and effectiveness of the tissue, since the procurement to the moment that it is used as biological apposite. In the production of this radiation sterilized tissue, we have followed a strict protocol that considers selection criteria for each donor, obtainment and processing of each membrane in aseptic conditions including the washing steps, cutting,drying in laminar flow hood, packing and identification.This is followed by sterilization with gamma radiation,quality controls which include the count of colonies formation units and the assurance of sterility. The average size of each membrane was 2 x 2 cm. The membranes have been used in 57 patients since 2002 up to date on surgical procedures of ophthalmology specialty: 38 Pterigeon, 3 Recoverment of anophthalmic cavity, 4 Corneal perforations, 2 Sclera ulcers, 1 extirpation of a conjunctiva inclusion cyst and 1 Reconstruction of Lachrymal sac, with very good results

  5. In vivo analysis of stromal integration of multilayer amniotic membrane transplantation in corneal ulcers.

    Science.gov (United States)

    Nubile, Mario; Dua, Harminder S; Lanzini, Manuela; Ciancaglini, Marco; Calienno, Roberta; Said, Dalia G; Pocobelli, Augusto; Mastropasqua, Rodolfo; Carpineto, Paolo

    2011-05-01

    To evaluate integration of amniotic membrane into the corneal stroma using laser scanning in vivo confocal microscopy and anterior segment optical coherence tomography (AS-OCT). Prospective noncomparative interventional case series. Twenty-two eyes of 22 consecutive patients (mean age 53.9 ± 9.2 years) presenting with noninfectious corneal ulcers and stromal thinning unresponsive to medical treatment were enrolled. Multiple layers of amniotic membrane were applied over the ulcer bed to fill the ulcer crater and held in place with an overlying amniotic membrane patch, which was anchored to the surrounding cornea with 10-0 nylon interrupted sutures. Outcome measures were healing of the corneal ulcers, corneal morphology and stromal thickness changes at the ulcer site as measured by AS-OCT and surface epithelialization, stromal repopulation, and structural modifications of the amniotic membrane grafts as evaluated by confocal microscopy. Follow-up extended to 12 months. Successful result was observed in 20 of 22 eyes (90.9%). AS-OCT showed that the mean residual stromal thickness at the ulcer bed was 222 ± 70 μm before surgery. The mean thickness of amniotic membrane layers at the same site was 394 ± 80 μm while the mean total corneal thickness was 623 ± 51 μm at day 1 post surgery. Thereafter a progressive reduction in thickness to 420 ± 61 μm at 6 months occurred, after which the thickness stabilized. Confocal microscopy showed that integration of the amniotic membrane tissues with corneal stroma was preceded by epithelialization over the amniotic membrane covering the ulcer. This occurred 15 ± 5 days post surgery in the successful cases. Confocal microscopy also showed that the amniotic membrane patch was degraded during the first few weeks after surgery, while the integrated amniotic tissues underwent progressive modifications characterized by early loss of amniotic epithelial cells, changes in fibrillar structure, and migration into the amniotic stroma

  6. Effect of Amniotic Membrane Combined with Ciprofloxacin in Curing the Primary Stages of Pseudomonal Keratitis

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Sharifi Yazdi

    2012-03-01

    Full Text Available Background: Keratitis caused by Pseudomonas aeruginosa is often resulted in severe corneal ulcers and perforation, which leads to losses of vision. Human amniotic membrane (HAM forms the inner wall of the membranous sac which surrounds and protects the embryo during gestation. The purpose of this study was to evaluate the effectiveness of the amniotic membrane's healing in rabbits with pseudomonas keratitis.Methods: In total 14 rabbits divided in 2 groups of: 1 as Control and 2 as experimental amniotic membrane combined with ciprofloxacin. A 0.05 ml suspension of Pseudomonas aeruginosa ATCC 27853 was injected into rabbit’s corneal stroma, with no interference in control group. In the second group, the amniotic membrane in pieces of 1.5 × 1.5 cm transplanted to the entire corneal surface by eight interrupted 10.0 nylon sutures. In the first day ciprofloxacin drop was injected to the second group every 30 minutes and through second to seventh days every 2 hours. The results of perforation in cornea and the amount of infiltration were registered.Results: The results showed that amniotic membrane transplantation (AMT + ciprofloxacin group had 0% perforation and the control group 85.6%. Average infiltrations were 5 mm in AMT + ciprofloxacin groups and 23.75 mm in control.Conclusion: The use of amniotic membrane with ciprofloxacin was effective in prevention of cornea perforation and controlling the process of pseudomonal keratitis remission. The improvement of inflammation rapidly happened in ciprofloxacin + AMT group.

  7. Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome

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    Ciralsky, Jessica B; Sippel, Kimberly C

    2013-01-01

    Background Stevens-Johnson syndrome is often associated with blinding ocular surface cicatricial sequelae. Recent reports have described markedly improved clinical outcomes with the application of amniotic membrane to the ocular surface during the acute phase. Here we describe the clinical outcome of a patient with acute Stevens-Johnson syndrome and severe ocular surface involvement in whom the evolving medical condition and family consent resulted in amniotic membrane application to each eye at differing intervals from disease onset. Methods We undertook a retrospective chart review of a woman with Stevens-Johnson syndrome who presented within hours of disease onset. She underwent application of amniotic membrane to the ocular surface of the left eye during the hyperacute phase (Stevens-Johnson syndrome proved superior. Application of amniotic membrane as soon as possible after disease onset, preferably in the hyperacute phase, appears to result in a significantly better clinical outcome than application later in the disease course. PMID:23754867

  8. Amniotic fluid cathepsin-G in pregnancies complicated by the preterm prelabor rupture of membranes.

    Science.gov (United States)

    Musilova, Ivana; Andrys, Ctirad; Drahosova, Marcela; Soucek, Ondrej; Pliskova, Lenka; Stepan, Martin; Bestvina, Tomas; Maly, Jan; Jacobsson, Bo; Kacerovsky, Marian

    2017-09-01

    The aim of this study was to evaluate the amniotic fluid cathepsin-G concentrations in women with preterm prelabor rupture of membranes (PPROM) based on the presence of the microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI). A total of 154 women with singleton pregnancies complicated by PPROM were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis. Amniotic fluid cathepsin-G concentrations were assessed by ELISA. MIAC was determined using a non-cultivation approach. IAI was defined as an amniotic fluid bedside interleukin-6 concentration ≥ 745 pg/mL. Women with MIAC had higher amniotic fluid cathepsin-G concentrations than women without MIAC (with MIAC: median 82.7 ng/mL, versus without MIAC: median 64.7 ng/mL; p = 0.0003). Women with IAI had higher amniotic fluid cathepsin-G concentrations than women without this complication (with IAI: median 103.0 ng/mL, versus without IAI: median 66.2 ng/mL; p G concentrations than women with colonization (MIAC without IAI) and women without both MIAC and IAI (p G concentrations in pregnancies complicated by PPROM. Amniotic fluid cathepsin-G appears to be a potential marker of IAI.

  9. [Biomechanic and biological activity assessment of concavity-convex amniotic membrane].

    Science.gov (United States)

    Shao, Yi; Yu, Yao; Tan, Gang; Peng, Juan; Zhou, Qiong; Pei, Chonggang; Dong, Wenjia; Gao, Guiping

    2012-12-01

    This paper conducted research on biomechanical characteristics and biological activity of concavity-convex amniotic membrane (CCAM) and discussed its superiority as ocular surface repair material. Folding and compression with vacuum of fresh amniotic membrane were used to prepare CCAM. After cutting the striga of CCAM, sixteen CCAM tissue section were chosen at random to test their tensile strength using electronic universal testing machine. The bilayer amniotic membrane (BAM), the double-deck amniotic membrane (DAM) and the monolayer amniotic membrane (MAM) were as controls. The test parameters included yield strength, tensile strength, elongation at break, elastic modulus and so on. The cytokines of fresh amniotic membrane (FAM), MAM and CCAM were analyzed by radioimmunoassay method. The CCAM was obviously thicker than MAM and DAM. After 15 min in PBS, the CCAM tissue can recover the normal shape. The tensile strength and the elongation at break of CCAM were higher than those of the MAM and the DAM (P biomechanical properties than the MAM and the DAM, showing the superiority as ocular surface repair material.

  10. Amniotic membrane can be a valid source for wound healing

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    ElHeneidy H

    2016-06-01

    Full Text Available Hossam ElHeneidy,1 Eman Omran,1 Ahmed Halwagy,1 Hesham Al-Inany,1 Mirvat Al-Ansary,2 Amr Gad3 1Department of Obstetrics & Gynecology, 2Department of Clinical Pathology, 3Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt Abstract: Amniotic membrane (AM can promote proper epithelialization with suppression of excessive fibrosis by creating a supportive milieu for regeneration of chronic ulcer bed.Objective: The objective of this study is to investigate whether AM scaffold can modulate the healing of a wound by promoting tissue reconstruction rather than promoting scar tissue formation.Subjects and methods: AM was obtained and prepared and then applied to patients with chronic leg ulcers who were randomly divided into two different groups. Group I (control group included eleven patients in whom ulcers were treated with conventional wound dressings that were changed daily for 8 weeks. Group II (study group included 14 patients in whom the AM was placed in contact with the ulcer and held in place with a secondary dressing, which was changed daily. Follow-up was done to detect healing rate and detection of ulcer size, assessment of pain, and to take ulcer images (days 0, 7, 14, 21, 30, 45, and 60.Results: In group I, all ulcers showed no reduction in their size, and ulcer floor remained the same. Healthy granulations were present in two ulcers (18.2% and absent in nine ulcers (81.8%. There was no improvement of pain level in the eleven ulcers. In group II, complete healing of 14 ulcers occurred in 14–60 days with a mean of 33.3±14.7; healing rate range was 0.064–2.22 and the mean 0.896±0.646 cm2/day. Healthy granulations were present in 13 ulcers (92.9% and absent in one ulcer (7.1%. Three ulcers (21.4% were of mild severity (grade 1 ulcers while eleven ulcers (78.6% were of moderate severity (grade 2 ulcers. The healing rate was faster in ulcers of mild severity (1.7±0.438 cm2/day in comparison to ulcers of moderate

  11. Treatment outcomes in the DRy Eye Amniotic Membrane (DREAM study

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    McDonald MB

    2018-04-01

    Full Text Available Marguerite B McDonald,1 Hosam Sheha,2–5 Sean Tighe,2,3 Susan B Janik,6 Frank W Bowden,7 Amit R Chokshi,8 Michael A Singer,9 Seema Nanda,10 Mujtaba A Qazi,11 Damon Dierker,12 Adam T Shupe,13 Brittany J McMurren14 1Ophthalmic Consultants of Long Island, Lynbrook, NY, USA; 2Ocular Surface Center and TissueTech, Inc., Miami, FL, USA; 3Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA; 4Hofstra University School of Medicine, Hempstead, NY, USA; 5Research Institute of Ophthalmology, Cairo, Egypt; 6Solinsky Eye Care, Kensington, CT, USA; 7Bowden Eye & Associates, Jacksonville, FL, USA; 8Florida Eye Specialists, Jacksonville, FL, USA; 9Medical Center Ophthalmology Associates, San Antonio, TX, USA; 10TX Eye Institute, Houston, TX, USA; 11Pepose Vision Institute, Chesterfield, MO, USA; 12Eye Surgeons of Indiana, Indianapolis, IN, USA; 13Royo Eye Care, Marysville, CA, USA; 14Gordon and Weiss Vision Institute, San Diego, CA, USA Purpose: To evaluate the efficacy of cryopreserved amniotic membrane (CAM in reducing signs and symptoms of dry eye disease (DED in a large patient population. Methods: A retrospective chart review at 10 clinical sites was done of patients with refractory DED who received CAM and completed at least 3 months of follow-up. Data collected were demographics; medical history including previous and current ocular treatment, diagnosis, clinical presentations, comorbidity, duration and frequency of treatment with CAM; and concomitant medications. The primary outcome was the change in dry eye workshop (DEWS score after treatment. Results: A total of 97 eyes of 84 patients exhibited severe dry eye despite maximal medical treatments including topical artificial tears, cyclosporine-A, serum, antibiotics, and steroids. Patients manifested with superficial punctate keratitis (86%, filamentary keratitis (13%, exposure keratitis (19%, neurotrophic keratitis (2%, and corneal epithelial defect (7%. After CAM

  12. Clinical evaluation of the accuracy of intraocular pressure measurement by Tono-Pen XL in eyes with amniotic membrane patching.

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    Onguchi, Tatsuya; Takano, Yoji; Dogru, Murat; Tsubota, Kazuo; Shimazaki, Jun

    2005-03-01

    To evaluate the influence of amniotic membrane on intraocular pressure (IOP) measurement with the Tono-Pen. Observational case series. Eight patients with partial limbal dysfunction who underwent penetrating keratoplasty were recruited. Amniotic membranes were patched just after keratoplasty. One week postoperatively, amniotic membranes were removed, and accuracy of IOP measurement with the Tono-Pen was evaluated with comparisons before and after the removal. No epithelial defects were detected after the removal of amniotic membrane. Mean IOPs with and without amniotic membranes were 16.6 +/- 3.0 mm Hg (mean +/- SD) and 16.0 +/- 3.7 mm Hg, respectively. The difference was not statistically significant. Assessment of IOP with the Tono-Pen was observed to be accurate even when used over an amniotic membranes patch in cases who underwent penetrating keratoplasty.

  13. Amniotic membrane inhibits squamous metaplasia of human conjunctival epithelium.

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    Tan, Yehui; Qiu, Fangfang; Qu, Yang-Luowa; Li, Cheng; Shao, Yi; Xiao, Qiguo; Liu, Zuguo; Li, Wei

    2011-07-01

    Squamous metaplasia is a common pathological process that occurs in the ocular surface epithelium. At present, there is no effective treatment for this abnormality. In the current study, we established an ex vivo conjunctival squamous metaplasia model by culturing human conjunctival tissues at an air-liquid interface for durations of up to 12 days. We then investigated the effects of amniotic membrane (AM) on squamous metaplasia through coculture of conjunctival tissues with AM or AM extract. We found that metaplasia features such as hyperproliferation and abnormal epidermal differentiation of conjunctival epithelium could be inhibited by AM or its extract. In addition, existing squamous metaplasia of conjunctival epithelium could be reversed to a nearly normal phenotype by AM. The mechanism by which AM prevents squamous metaplasia may involve downregulation of p38 mitogen-activated protein kinase and Wnt signaling pathways, which were activated in conjunctival explants cultured with an airlift technique. In conclusion, AM can inhibit and reverse squamous metaplasia of conjunctival epithelium. This finding may shed new light on prevention and treatment of diseases that involve epithelial squamous metaplasia.

  14. Amniotic fluid myeloperoxidase in pregnancies complicated by preterm prelabor rupture of membranes.

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    Kacerovsky, Marian; Tambor, Vojtech; Vajrychová, Marie; Lenco, Juraj; Hornychova, Helena; Musilova, Ivana; Menon, Ramkumar

    2013-03-01

    To determine amniotic fluid myeloperoxidase concentration in women with preterm prelabor rupture of the membranes with microbial invasion of the amniotic cavity and histological chorioamnionitis. One hundred eighty-one women with singleton pregnancies with a gestational age between 24+0 and 36+6 weeks were included in this study. Amniocenteses were performed, and myeloperoxidase concentration in the amniotic fluid was determined using ELISA. Women with microbial invasion of the amniotic cavity had higher median myeloperoxidase concentration than women without this condition (149.2 ng/mL vs. 54.6 ng/mL; p = 0.0006). Women with the presence of histological chorioamnionitis had higher median myeloperoxidase concentration than women without histological chorioamnionitis (103.7 ng/mL vs. 50.0 ng/mL; p = 0.0001). The presence of both microbial invasion of the amniotic cavity and histological chorioamnionitis was associated with higher median myeloperoxidase concentration (456.0 ng/mL vs. 52.9 ng/mL; p < 0.0001). The results remained significant after adjusting for gestational age. Increased amniotic fluid myeloperoxidase in microbial invasion of the amniotic cavity and histological chorioamnionitis confirm a role of myeloperoxidase in preterm prelabor rupture of the membranes pathophysiology.

  15. Proteomic analysis of equine amniotic membrane: characterization of proteins.

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    Galera, Paula D; Ribeiro, Cássio R; Sapp, Harold L; Coleman, James; Fontes, Wagner; Brooks, Dennis E

    2015-05-01

    Human amniotic membrane (AM) has been used as a biomaterial for surgical wound skin and ocular surface reconstruction for several years. Currently, equine AM has been used for corneal reconstruction in several animal species, and appears to have the same properties as human AM. Despite the observed positive healing abilities of this tissue in horses with ulcerative keratitis the proteins of equine AM have not been described. To identify proteins known to be associated with corneal healing from frozen equine AM. Placentas were acquired from healthy live foal births from a local Thoroughbred breeding farm. The amnion was removed from the chorion by blunt dissection, washed with phosphate-buffered saline (PBS), and treated with 0.05% trypsin and 0.02% ethylene diaminetetraacetic acid in PBS. Amnion was attached to nitrocellulose paper (epithelial side up), and cut into 4 × 4 cm pieces. The sheets were frozen at -80 °C. The protein samples were solubilized, and analyzed by 2D gel electrophoresis and shotgun proteomics. A reference identification map of the equine AM proteins was produced and 149 different proteins were identified. From gel-based proteomics, 49 spots were excised and 43 proteins identified by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Shotgun proteomics identified 116 proteins with an overlap of 10 proteins in both analyses. We have described a reference map for equine AM proteins that may provide a background to explain the positive results found in horses with ulcerative keratopathies using this biomaterial. © 2014 American College of Veterinary Ophthalmologists.

  16. [Amniotic membrane for ocular surface reconstruction after conjunctival squamous cell carcinoma resection].

    Science.gov (United States)

    Carvalho-Rêgo, Paulo Roberto de; Gomes, José Alvaro Pereira; Ballalai, Priscila Luppi; Cunha, Marcelo Carvalho; Sousa, Luciene Barbosa de; Erwenne, Clélia Maria

    2008-01-01

    This study was designed to evaluate the use of human amniotic membrane for ocular surface reconstruction after conjunctival squamous cell carcinoma resection. Amniotic membrane was obtained at the time of cesarean section and was preserved at -80 masculineC in glycerol and cornea culture media at a ratio of 1:1. The inclusion criteria were patients presenting proliferating lesions suggestive of squamous cell carcinoma (flat or elevated white lesions resembling "fish meat") that involve the conjunctiva, limbus and cornea. Eight eyes of 8 patients with conjunctival "squamous cell carcinoma" underwent tumor resection with amniotic membrane transplantation. Three of these cases underwent total corneal epitheliectomy and amniotic membrane transplantation associated with limbal autograft. Mean follow-up time was 17.8 months (range, 10-35 months). In four patients (71.4%) surgical treatment was successful, with good ocular surface stability. In two patients (28.6%) results were partially successful, with mild cicatricial alterations. One patient was excluded from the study due to aggressive tumor recurrence with intraocular invasion that needed to be removed with exenteration. This study suggests that amniotic membrane transplantation is a good alternative for ocular surface reconstruction after conjunctival squamous cell carcinoma resection.

  17. Study of Transected Sciatic Nerve Repair by Amniotic Membrane with Betamethasone in Adult Albino Wistar Rats.

    Science.gov (United States)

    Sadraie, Seyed Homayoon; Parivar, Kazem; Arabi, Farzaneh; Moattari, Mehrnaz; Kaka, Gholamreza; Mansouri, Korosh

    2016-09-01

    The aim of this study was to determine the effects of amniotic membrane impregnated with betamethasone on regeneration of transected sciatic nerve injury in adult albino Wister rats. In this research, 42 male adult rats were divided into six equal groups. 1) Normal (intact) group: healthy rats without any injury; 2) CONTROL GROUP: sciatic nerve was cut and sutured; 3) Sham group: 0.2 mL culture medium was injected on the epineurium in the injury; 4) Amniotic membrane group (AM): Acellular amniotic membrane was used around the damaged sciatic nerve; 5) Betamethasone group (B): 0.2 mL Betamethasone (4 mg/mL) was injected in the site of damaged nerve and 6) Amniotic membrane group and Betamethasone (AM/B) group: Acellular amniotic membrane impregnated with 0.2 mL betamethasone was used around the damaged sciatic nerve. The rate of recovery was studied by Sciatic Functional Index (SFI), withdrawal reflex latency (WRL) test and electroctrophysiological assessments at 2, 4, 6 and 8 weeks after surgery. Histological assessment was done 8 weeks after surgery. At 8 weeks after surgery, SFI, WRL test and electrophysiological values in AM/B group were significantly improved compared to control and sham groups (P nerve regeneration of transected sciatic nerve in a rat model.

  18. Long-term efficacy of glycerine-processed amniotic membrane transplantation in patients with corneal ulcer.

    Science.gov (United States)

    Uhlig, Constantin E; Frings, Charlotte; Rohloff, Nadine; Harmsen-Aasman, Christel; Schmitz, Ralf; Kiesel, Ludwig; Eter, Nicole; Busse, Holger; Alex, Anne F

    2015-09-01

    The aim of this study was to determine the long-term treatment efficacy of glycerine-preserved human amniotic membrane transplantation in patients suffering from corneal ulcers. This was a retrospective, non-controlled, monocentric analysis. Included were patients with corneal ulcers that were non-responsive to ointment or contact lenses and had been treated by amniotic membrane transplantation with either the overlay or sandwich procedure. Analysis parameters were visual acuity before and following treatment, recurrence rate and subjective comfort at the last follow-up. Of the 371 amniotic membrane transplantations that were conducted, 135 surgical treatments in 108 patients (51.9% male, 48.1% female; mean age 63.7 years) met the inclusion criteria. In total, 99 overlay and 36 multilayer amniotic membrane transplantations were performed. The follow-up period was 47.5 ± 66.7 weeks (mean ± SD). The recurrence rate at the last follow-up was 47.8% with overlay membranes and 51.8% with the sandwich technique. There was no significant change in best-corrected visual acuity following treatment with overlays (p = 0.219) or sandwich procedure (p = 0.703). At the last follow-up, 72.1% (overlay) and 78.3% (sandwich) of the patients reported either no pain or increased comfort. The recurrence rates and changes in visual acuity following overlay or sandwich amniotic membrane transplantation in patients suffering from corneal ulcer were lower than reported elsewhere in the literature. More than half of the patients profited from each of the amniotic membrane transplantation techniques with respect to recurrence and postoperative comfort. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Amniotic membrane transplantation for ocular surface reconstruction in neurotrophic corneal ulcera.

    Science.gov (United States)

    Iveković, B; Tedeschi-Reiner, E; Petric, I; Novak-Laus, K; Bradić-Hammoud, M

    2002-06-01

    The purpose of this study is to analyze clinical experience about the effects of human amniotic membrane transplantation in eyes with neurotrophic ulcers. In 11 eyes the application of amniotic membrane was performed since January 1999 because of neurotrophic ulcers. The follow up period was longer than 12 months: 19.7+/-6.0 months. The average healing period after the surgery was 1.6+/-0.6 weeks. All corneas were fluorescein negative even 12 months after operation. Visual acuity after the transplantation was similar to the one before the surgery in 8 eyes. In 3 eyes the visual acuity after the surgery was better than before. Amniotic membrane transplantation can be considered an effective alternative for treating persistent epithelial defects such as neurotrophic ulcers. It has some advantages over corneal transplantation: a relatively simple procedure, no allograft rejection and it could be particularly beneficial in countries where cornea shortage is apparent.

  20. Clinical analysis of amniotic membrane patches and grafts for acute ocular surface burn

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    Lin Li

    2015-01-01

    Full Text Available AIM: To investigate the effect and value of amniotic membrane patches and grafts for acute ocular surface burn at different degrees.METHODS: A retrospective analysis of 28 cases(28 eyesaffected by ocular chemical or thermal burn with different degree were included in our hospital from March 2007 to March 2012. Amniotic membrane patched was undergone in 13 eyes with fresh amnion that the patients corneal burns degree Ⅱ or Ⅲ with partial limbal buns at degree Ⅳ. Amniotic membrane grafts was performed in 15 eyes with fresh amnion that the patients all corneal burns at degree Ⅲ with the whole limbal necrosis without severe eyelid defect. The follow-up time ranged 6~24mo. The postoperative visual acuity, the condition of amniotic membrane transplant, renovation of cornea and complications were observed. RESULTS: Postoperative corrected visual acuity was improved in 20 eyes(71%, it was not changed in 5 eyes(18%, the visual acuity declined in 3 eyes(11%. The amniotic membrane survived in 23 eyes and the survival rate was up to 82%. The cornea of 4 eyes recovered to transparent, nebula emceed in 8 eyes eventually, corneal macula emerged in 10 eyes, 4 eyes ended up with leukoma, 2 eyes developed corneal melting after therapy, then received lamellar keratoplasty. Corneal surface become epithelization after amnion patches or grafts, but any of them have recurrent epithelial erosion, and become stable epithalization after repeat operation.CONCLUSION: Amniotic membrane patches and grafts is an effective method to deal with acute ocular surface burn.

  1. Supportive properties of basement membrane layer of human amniotic membrane enable development of tissue engineering applications.

    Science.gov (United States)

    Iranpour, Sonia; Mahdavi-Shahri, Nasser; Miri, Raheleh; Hasanzadeh, Halimeh; Bidkhori, Hamid Reza; Naderi-Meshkin, Hojjat; Zahabi, Ehsan; Matin, Maryam M

    2018-01-08

    Human amniotic membrane (HAM) has been widely used as a natural scaffold in tissue engineering due to many of its unique biological properties such as providing growth factors, cytokines and tissue inhibitors of metalloproteinases. This study aimed at finding the most suitable and supportive layer of HAM as a delivery system for autologous or allogeneic cell transplantation. Three different layers of HAM were examined including basement membrane, epithelial and stromal layers. In order to prepare the basement membrane, de-epithelialization was performed using 0.5 M NaOH and its efficiency was investigated by histological stainings, DNA quantification, biomechanical testing and electron microscopy. Adipose-derived stromal cells (ASCs) and a human immortalized keratinocyte cell line (HaCaT) were seeded on the three different layers of HAM and cultured for 3 weeks. The potential of the three different layers of HAM to support the attachment and viability of cells were then monitored by histology, electron microscopy and (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Moreover, mechanical strengths of the basement membrane were assessed before and after cell culture. The results indicated that the integrity of extra cellular matrix (ECM) components was preserved after de-epithelialization and resulted in producing an intact basement amniotic membrane (BAM). Moreover, all three layers of HAM could support the attachment and proliferation of cells with no visible cytotoxic effects. However, the growth and viability of both cell types on the BAM were significantly higher than the other two layers. We conclude that growth stimulating effectors of BAM and its increased mechanical strength after culturing of ASCs, besides lack of immunogenicity make it an ideal model for delivering allogeneic cells and tissue engineering applications.

  2. Preserved xenogenic amniotic membrane as a patch on the repair of superficial corneal ulcers in rabbits

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    Kelly Cristine de Sousa Pontes

    2012-06-01

    Full Text Available The aim of this study was to evaluate the effects of canine amniotic membrane, previously preserved in glycerin, used as a patch on the repair of experimentally-made superficial corneal ulcers and to compare corneal epithelization between the treated and non-treated groups. Xenogeneic amniotic membranes were collected aseptically and preserved in 99% glycerin at room temperature. Each animal was anesthetized and submitted to superficial corneal keratectomy of the left eye. The treated group received a fragment of canine amniotic membrane as a patch, while the control group had no treatment. The treated group showed blepharospasm, ocular discharge and conjunctival congestion. The membrane accelerated corneal repair in the beginning of the process, however, it delayed its conclusion (p<0.05. Treated eyes showed greater vessel formation and decreased corneal transparency (p<0.05. The stroma of the control group was thicker than that of the treated group (p<0.05. We suggest that amniotic membrane used in this manner can be applied as a therapy for superficial corneal ulcers in the beginning phases of the repair process.

  3. Amniotic membrane transplantation ineffective as additional therapy in patients with aggressive Mooren's ulcer.

    Science.gov (United States)

    Schallenberg, Maurice; Westekemper, Henrike; Steuhl, Klaus-Peter; Meller, Daniel

    2013-12-17

    Mooren's ulcer is a severe ulcerative inflammation of the cornea. The exact pathogenesis remains unclear. Therefore many therapies of Mooren's ulcer are recommended in literature. To shed more light on the ongoing question of optimal treatment of severe progressive Mooren's ulcer, we here report on a retrospective case series of patients treated with systemic immunosuppressive therapy and additional amniotic membrane transplantation. Medical records from seven patients (eleven eyes), 4 male and 3 female, with severe progressive Mooren's ulcer were analysed retrospectively. The mean follow up was 88.4 ± 80.8 months (range 12-232 month). A HLA-typing was performed in all patients. A systemic immunosuppressive therapy was administered in all patients. The amniotic membrane was transplanted after the base of the ulcer was resected. Multiple amniotic membrane transplantations were necessary in six patients. The visual outcome of all patients was poor. No patient achieved a visual acuity better than 20/630 Snellen chart. Five patients were positive for HLA-DQ2 and four patients were positive for HLA-DR17(3). The aggressive and highly inflammatory form of Mooren's ulcer is difficult to treat and the progression of the disease is hard to influence positively even under systemic immunosuppressive therapy. Therefore, the main intention of therapy is to achieve a stable epithelialized corneal surface without the risk of perforation. Amniotic membrane transplantation is not able to cure severe forms of Mooren's ulcer. However it supports the immunosuppressive therapy in acute situations as in critical corneal thinning.

  4. Use of hyperdry amniotic membrane in operations for cleft palate: a study in rats.

    Science.gov (United States)

    Tsuno, Hiroaki; Noguchi, Makoto; Okabe, Motonori; Tomihara, Kei; Yoshida, Toshiko; Nikaido, Toshio

    2015-04-01

    The growth of maxillary bone and the development of dentition are often impaired in patients who have had pushback operations for repair of a cleft palate. There has been considerable discussion about the most suitable technique or material used in such repairs to resolve the problem. Hyperdry amniotic membrane, a new preservable material derived from human amnion, has recently been introduced in several procedures. We have evaluated its use during pushback surgery in animal studies to try to correct the inhibition of growth and development of the maxilla. Mucosal defects were created in 3-week-old rats, and then covered with hyperdry amniotic membrane or not. Healing was assessed by histological and morphological examination at 1 week and 7 weeks postoperatively. In the group treated with hyperdry amniotic membrane, submucosal tissue was reconstructed successfully during the early postoperative period. Lateral palatal growth was not inhibited as much, and medial inclination of the teeth was less, after a period of growth using this material. The results suggest that hyperdry amniotic membrane is a suitable new dressing material for use in the treatment of cleft palate. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

    OpenAIRE

    Zhang, Ting; Wang, Yuexin; Jia, Yanni; Liu, Dongle; Li, Suxia; Shi, Weiyun; Gao, Hua

    2016-01-01

    Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded...

  6. Effect of the Human Amniotic Membrane on Liver Regeneration in Rats

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    Mesut Sipahi

    2015-01-01

    Full Text Available Introduction. Operations are performed for broader liver surgery indications for a better understanding of hepatic anatomy/physiology and developments in operation technology. Surgery can cure some patients with liver metastasis of some tumors. Nevertheless, postoperative liver failure is the most feared complication causing mortality in patients who have undergone excision of a large liver mass. The human amniotic membrane has regenerative effects. Thus, we investigated the effects of the human amniotic membrane on regeneration of the resected liver. Methods. Twenty female Wistar albino rats were divided into control and experimental groups and underwent a 70% hepatectomy. The human amniotic membrane was placed over the residual liver in the experimental group. Relative liver weight, histopathological features, and biochemical parameters were assessed on postoperative day 3. Results. Total protein and albumin levels were significantly lower in the experimental group than in the control group. No difference in relative liver weight was observed between the groups. Hepatocyte mitotic count was significantly higher in the experimental group than in the control group. Hepatic steatosis was detected in the experimental group. Conclusion. Applying the amniotic membrane to residual liver adversely affected liver regeneration. However, mesenchymal stem cell research has the potential to accelerate liver regeneration investigations.

  7. The potential of mesenchymal stem cells derived from amniotic membrane and amniotic fluid for neuronal regenerative therapy.

    Science.gov (United States)

    Kim, Eun Young; Lee, Kyung-Bon; Kim, Min Kyu

    2014-03-01

    The mesenchymal stem cells (MSCs), which are derived from the mesoderm, are considered as a readily available source for tissue engineering. They have multipotent differentiation capacity and can be differentiated into various cell types. Many studies have demonstrated that the MSCs identified from amniotic membrane (AM-MSCs) and amniotic fluid (AF-MSCs) are shows advantages for many reasons, including the possibility of noninvasive isolation, multipotency, self-renewal, low immunogenicity, anti-inflammatory and nontumorigenicity properties, and minimal ethical problem. The AF-MSCs and AM-MSCs may be appropriate sources of mesenchymal stem cells for regenerative medicine, as an alternative to embryonic stem cells (ESCs). Recently, regenerative treatments such as tissue engineering and cell transplantation have shown potential in clinical applications for degenerative diseases. Therefore, amnion and MSCs derived from amnion can be applied to cell therapy in neuro-degeneration diseases. In this review, we will describe the potential of AM-MSCs and AF-MSCs, with particular focus on cures for neuronal degenerative diseases.

  8. Cervical length and gestational age at admission as predictors of intra-amniotic inflammation in preterm labor with intact membranes.

    Science.gov (United States)

    Palacio, M; Cobo, T; Bosch, J; Filella, X; Navarro-Sastre, A; Ribes, A; Gratacós, E

    2009-10-01

    To evaluate cervical length and gestational age as predictors of intra-amniotic inflammation in patients admitted because of preterm labor and intact membranes. Ninety-three pregnant women with preterm labor and intact membranes were included in our study. Cervical length was measured on admission by transvaginal sonography and transabdominal amniocentesis was performed within the first 48 h following admission. Positive amniotic fluid cultures defined intra-amniotic infection. Levels of intra-amniotic interleukin-6 (IL-6) were measured, and a receiver-operating characteristics (ROC) curve was constructed to determine the best cut-off point of IL-6 for predicting intra-amniotic infection. This value was then used as a basis for determining a cut-off of IL-6 for defining intra-amniotic inflammation. Considering inflammatory status, perinatal outcomes were evaluated and compared. Logistic regression was used to investigate associations of different explanatory variables with inflammatory status. A non-invasive approach for detection of intra-amniotic inflammation in women admitted because of preterm labor with intact membranes was evaluated. Intra-amniotic infection and inflammation rates were 14% and 28%, respectively. ROC curve analysis showed that the best cut-off value for IL-6 was 13.4 ng/mL for predicting intra-amniotic infection, which was comparable to the cut-off of 11.3 ng/mL reported previously by other authors (which we used to define inflammation). Regardless of the intra-amniotic microbial status, perinatal outcomes in women who developed intra-amniotic inflammation were worse than in those who did not. Cervical length or= 28 and membranes.

  9. Comparative genomics of hormonal signaling in the chorioallantoic membrane of oviparous and viviparous amniotes.

    Science.gov (United States)

    Griffith, Oliver W; Brandley, Matthew C; Whittington, Camilla M; Belov, Katherine; Thompson, Michael B

    2017-04-01

    In oviparous amniotes (reptiles, birds, and mammals) the chorioallantoic membrane (CAM) lines the inside of the egg and acts as the living point of contact between the embryo and the outside world. In livebearing (viviparous) amniotes, communication during embryonic development occurs across placental tissues, which form between the uterine tissue of the mother and the CAM of the embryo. In both oviparous and viviparous taxa, the CAM is at the interface of the embryo and the external environment and can transfer signals from there to the embryo proper. To understand the evolution of placental hormone production in amniotes, we examined the expression of genes involved in hormone synthesis, metabolism, and hormone receptivity in the CAM of species across the amniote phylogeny. We collected transcriptome data for the chorioallantoic membranes of the chicken (oviparous), the lizards Lerista bougainvillii (both oviparous and viviparous populations) and Pseudemoia entrecasteauxii (viviparous), and the horse Equus caballus (viviparous). The viviparous taxa differ in their mechanisms of nutrient provisioning: L. bougainvillii is lecithotrophic (embryonic nourishment is provided via the yolk only), but P. entrecasteauxii and the horse are placentotrophic (embryos are nourished via placental transport). Of the 423 hormone-related genes that we examined, 91 genes are expressed in all studied species, suggesting that the chorioallantoic membrane ancestrally had an endocrine function. Therefore, the chorioallantoic membrane appears to be a highly hormonally active organ in all amniotes. No genes are expressed only in viviparous species, suggesting that the evolution of viviparity has not required the recruitment of any specific hormone-related genes. Our data suggest that the endocrine function of the CAM as a placental tissue evolved in part through co-option of ancestral gene expression patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Prevalence and Clinical Significance of Sterile Intra-amniotic Inflammation in Patients with Preterm Labor and Intact Membranes

    Science.gov (United States)

    Romero, Roberto; Miranda, Jezid; Chaiworapongsa, Tinnakorn; Korzeniewski, Steven J.; Chaemsaithong, Piya; Gotsch, Francesca; Dong, Zhong; Ahmed, Ahmed I.; Yoon, Bo Hyun; Hassan, Sonia S.; Kim, Chong J.; Yeo, Lami

    2014-01-01

    Problem Inflammation and infection play a major role in preterm birth. The purpose of this study was to: 1) determine the prevalence and clinical significance of sterile intra-amniotic inflammation; and 2) examine the relationship between amniotic fluid (AF) concentrations of high mobility group box-1 (HMGB1) and the interval from amniocentesis-to-delivery in patients with sterile intra-amniotic inflammation. Method of Study AF samples obtained from 135 women with preterm labor and intact membranes were analyzed using cultivation techniques as well as broad-range PCR and mass spectrometry (PCR/ESI-MS). Sterile intra-amniotic inflammation was defined when patients with negative AF cultures and without evidence of microbial footprints had intra-amniotic inflammation (AF interleukin-6 ≥ 2.6 ng/mL). Results 1) The frequency of sterile intra-amniotic inflammation was significantly greater than that of microbial-associated intra-amniotic inflammation [26% (35/135) vs. 11% (15/135); (p=0.005)]; 2) patients with sterile intra-amniotic inflammation delivered at comparable gestational ages, had similar rates of acute placental inflammation and adverse neonatal outcomes as patients with microbial-associated intra-amniotic inflammation; and 3) patients with sterile intra-amniotic inflammation and high AF concentrations of HMGB1 (≥ 8.55 ng/mL) delivered earlier than those with low AF concentrations of HMGB1 (p=0.02). Conclusions 1) sterile intra-amniotic inflammation is more frequent than microbial-associated intra-amniotic inflammation; and 2) we propose that danger signals participate in sterile intra-amniotic inflammation in the setting of preterm labor. PMID:25078709

  11. Annexin A2 in amniotic fluid: correlation with histological chorioamnionitis, preterm premature rupture of membranes, and subsequent preterm delivery.

    Science.gov (United States)

    Namba, Fumihiko; Ina, Shihomi; Kitajima, Hiroyuki; Yoshio, Hiroyuki; Mimura, Kazuya; Saito, Shigeru; Yanagihara, Itaru

    2012-01-01

    The aim of this study was to determine whether amniotic fluid levels of annexin A2, a phospholipid-binding protein that is abundant in amnion and regulates fibrin homeostasis, are associated with histological chorioamnionitis, preterm premature rupture of the membranes, and subsequent preterm delivery. Amniotic fluid was obtained from 55 pregnant women with preterm labor and/or preterm premature rupture of the membranes before 32weeks of gestation, and amniotic fluid levels of annexin A2 were measured with a sandwich enzyme-linked immunosorbent assay. Amniotic fluid levels of annexin A2 in patients with histological chorioamnionitis was higher than that in the remainder (P=0.053), whereas amniotic fluid levels of annexin A2 in patients with preterm premature rupture of the membranes was significantly higher than that in the remainder (P=0.002). Amniotic levels of annexin A2 was a fair test (area under receiver-operator characteristic curve=0.679), and amniotic fluid levels of annexin A2>878.2ng/mL had a sensitivity of 68.8%, a specificity of 65.2%, a positive predictive value of 73.3%, and a negative predictive value of 60.0% for predicting delivery within 2weeks after amniotic fluid sampling. Furthermore, the combined use of amniotic fluid cut-off levels of 878.2ng/mL for annexin A2 and 13.3ng/mL for interleukin-8 improved the specificity (91.3%) and the positive predictive value (89.5%). We identified amniotic fluid levels of annexin A2, especially in combination with amniotic fluid levels of interleukin-8, as a novel predictive marker for preterm delivery. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  12. Effect of Amniotic Membrane Suspension (AMS) and Amniotic Membrane Homogenate (AMH) on Human Corneal Epithelial Cell Viability, Migration and Proliferation In Vitro.

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    Wu, Ming-Feng; Stachon, Tanja; Langenbucher, Achim; Seitz, Berthold; Szentmáry, Nóra

    2017-03-01

    To analyze the effects of different concentrations of amniotic membrane suspension (AMS) or amniotic membrane homogenate (AMH) on human corneal epithelial cell (HCEC) viability, migration and proliferation. Amniotic membranes (AMs) of 13 placentas were prepared and stored at -80°C. For AMS preparation, following de-freezing, AM pieces were inserted in six-well plates and 5 ml Dulbecco's Modified Eagle's Medium (DMEM)/F12 (with 5% fetal bovine serum, FBS) per gram tissue was added for 96 h. After removal of the AM, the remaining supernatant was collected for experiments. For AMH preparation, following de-freezing, AMs were homogenized in liquid nitrogen and 5 ml DMEM/F12 (with 5% FBS) per gram tissue was added. Following centrifugation, the supernatant was collected for experiments. HCECs were expanded and incubated in DMEM/F12, 5% FBS supplemented by 15%, 30% or 100% AMS or 15% or 30% AMH. Viability was analyzed using Cell Proliferation Kit XTT, migration using wound healing assay and proliferation by the cell proliferation ELISA BrdU kit. HCEC viability remained unchanged using 15% or 30% AMS (p = 1.0 for both); however, it decreased significantly using 100% AMS (p < 0.001) or 15% (p = 0.041) or 30% AMH (p < 0.001), compared to controls. Using 15% or 30% AMS, HCEC migration increased significantly (p < 0.001 for both). Using 15% or 30% AMH (p = 0.153; p = 0.083), HCEC migration remained unchanged and 100% AMS inhibited HCEC migration (p < 0.001). Next, 15% and 30% AMS had no effect on HCEC proliferation (p = 0.454 and p = 0.119), but 100% AMS (p < 0.001) and 15% (p = 0.002) and 30% AMH (p = 0.001) inhibited HCEC proliferation significantly. With unchanged HCEC viability and proliferation and increased HCEC migration, 15% and 30% AMS application seems to be the most appropriate method to support epithelial healing.

  13. Retrospective analysis of the use of amniotic membranes and xenografts in spinal surgery and anterior cranial fossa operations

    International Nuclear Information System (INIS)

    Jafri Malim Abdullah

    1999-01-01

    To determine the suitability of amniotic membrane an bovine bone xenografts for the use in spinal surgery and anterior cranial for a generations. Fifteen patients with anterior cranial fossa defects and spinal bone fractures received bovine bone xenografts and 10 patients with meningomyeloceles received amniotic membranes (produced by the Malaysian National Tissue Bank) were analysed retrospectively. Clinical criterias like fever, signs of inflammation, breakdown of graft implant, non specific reaction to the nervous tissue were analysed haematological and radiologically. All patients who received the bovine grafts and amniotic membranes did not show any evidence of inflammation or fever. There were no graft implant breakdowns. There was no radiological or clinical evidence of specific or non specific reaction to the nervous tissue after 12-36 months followup Amniotic membranes and bovine xenografts may be used in the healing and reconstruction of spinal and cranial defects. Despite no evidence of rejection and infection after 36 months, a long term followup is still needed

  14. Nonpreserved amniotic membrane transplantation for bilateral toxic keratopathy caused by topical anesthetic abuse: a case report

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    Altinok Ayse

    2010-08-01

    Full Text Available Abstract Introduction Corneal damage associated with abuse of topical anesthetics is a rare clinic entity. Topical anesthetic abuse is one of the causes of ring keratitis. Ring keratitis is easily overlooked because it can mimic acanthamoeba keratitis or other infectious keratitis. The outcome is often poor, leading to persistent epithelial defects, corneal scarring, and perforations. Case presentation We report the clinical presentation, diagnosis, and treatment of a 65-year-old Caucasian man, who worked as a health care worker, with bilateral toxic keratopathy caused by topical anesthetic abuse. Nonpreserved amniotic membrane transplantation was performed for both eyes of the patient. Conclusion It is important to identify and treat patients who abuse topical anesthetics before permanent vision loss ensues. Nonpreserved amniotic membrane transplantation may be useful in relieving pain and improving corneal surface in anesthetic agent abusers.

  15. A Preliminary Study of Human Amniotic Membrane as a Potential Chondrocyte Carrier

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    L Boo

    2009-11-01

    Full Text Available PURPOSE: To investigate the feasibility of using processed human amniotic membrane (HAM to support the attachment and proliferation of chondrocytes in vitro which in turn can be utilised as a cell delivery vehicle in tissue engineering applications. METHODS: Fresh HAM obtained from patients undergoing routine elective caesarean sections was harvested, processed and dried using either freeze drying (FD or air drying (AD methods prior to sterilisation by gamma irradiation. Isolated, processed and characterised rabbit autologous chondrocytes were seeded on processed HAM and cultured for up to three weeks. Cell attachment and proliferation were examined qualitatively using inverted brightfield microscopy. RESULTS: Processed HAM appeared to allow cell attachment when implanted with chondrocytes. Although cells seeded on AD and FD HAM did not appear to attach as strongly as those seeded on glycerol preserved intact human amniotic membrane, these cells to be proliferated in cell culture conditions. CONCLUSION: Preliminary results show that processed HAM promotes chondrocyte attachment and proliferation.

  16. Impact of application of bio-amniotic membrane immersed in 5-fluorouracil solution in trabeculectomy on rabbit retina

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    Chenming Zhang

    2013-01-01

    Full Text Available Background : To observe the impact of application of bio-amniotic membrane immersed in 5-fluorouracil solution in trabeculectomy on the retina in a rabbit model. Materials and Methods : Healthy white New Zealand rabbits were randomly assigned into three groups with 20 in each group. Bio-amniotic membranes of 4 × 5 mm immersed in either physiological saline/water for 10 min, or 25 mg/mL 5-fluorouracil solution for 5 and 10 min, respectively, were applied on rabbit eyes during trabeculectomy. At 7, 14, 21, and 28 days of postoperation, five rabbits from each group were examined with electroretinogram (ERG. After being examined for eye pressure and bleb morphology, rabbits were sacrificed by air embolism and their retinas were collected and examined by transmission electron microscopy (TEM. In addition, 5-fluorouracil amount in bio-amniotic membranes was measured using high-performance liquid chromatography. Results: Each bio-amniotic membrane could absorb 59.004 μg and 75.828 μg 5-fluorouracil after being immersed in 5-fluorouracil solution for 5 and 10 min, respectively. Application of these bio-amniotic membranes in trabeculectomy could promote the formation of well-functioning bleb and maintain intraocular pressure, although it had no effect on retina structures as examined with ERG and TEM. Conclusion: Application of 5-FU soaked bio-amniotic membrane in rabbit eye trabeculectomy is effective and safe.

  17. Periodontal disease and intra-amniotic complications in women with preterm prelabor rupture of membranes.

    Science.gov (United States)

    Radochova, Vladimira; Kacerovska Musilova, Ivana; Stepan, Martin; Vescicik, Peter; Slezak, Radovan; Jacobsson, Bo; Kacerovsky, Marian

    2017-08-04

    Periodontal disease is frequently suggested as a possible causal factor for preterm delivery. The link between periodontal disease and preterm delivery is a possible translocation of periopathogenic bacteria to the placenta and amniotic fluid as well as a systemic response to this chronic inflammatory disease. However, there is a lack of information on whether there is an association between clinical periodontal status in women with preterm prelabor rupture of membranes (PPROM) and the presence of microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation (IAI). Therefore, the main aim of this study was to evaluate the incidence and severity of periodontal disease in women with PPROM. The secondary aim was to characterize an association between periodontal status and the presence of intra-amniotic PPROM complications (MIAC and/or IAI). Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks were included in this study. The samples of amniotic fluid were obtained at admission via transabdominal amniocentesis, and amniotic fluid interleukin (IL)-6 concentrations were determined using a point-of-care test. All women had a full-mouth recording to determine the periodontal and oral hygiene status. Probing pocket depth and clinical attachment loss were measured at four sites on each fully erupted tooth. In total, 45% (35/78) of women with PPROM had periodontal disease. Mild, moderate, and severe periodontal disease was present in 19% (15/78), 19% (15/78), and 6% (5/78) of women, respectively. The presence of MIAC and IAI was found in 28% (22/78) and 26% (20/78) of women, respectively. Periopathogenic bacteria (2 × Streptococcus intermedius and 1 × Fusobacterium nucleatum) was found in the amniotic fluid of 4% (3/78) of women. There were no differences in periodontal status between women with MIAC and/or IAI and women without these intra-amniotic complications. The presence of MIAC and IAI was not related

  18. Application of Amniotic Membrane in Ocular Surface Diseases: Clinical Features and Treatment Outcome

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    Derya Cindarik

    2012-05-01

    Full Text Available Pur po se: To investigate the effectiveness of amniotic membrane transplantation in cases with corneal thinning, desmatocele and refractive corneal ulcer. Ma te ri al and Met hod: Fifty-four eyes of 54 patients who were applied amniotic membrane transplantation for various ocular surface disease between January 2004 and February 2009 in Çukurova University Ophthalmology Department were included in the study. A complete ophthalmologic examination was performed. Corneal culture and corneal cytology samples were collected from the patients with the diagnosis of corneal ulcers. The patients were informed about the surgical procedure and the possible complications and informed consent was obtained. The amniotic membranes that were prepared under optimal conditions and protected in frozen forms were used in the operations. Follow-up examinations were done at postoperative 1st day, 1st week, 1st month, 3rd month, 6th month and then once in a year. Re sults: Of 54 patients, 26 (48.1% were men and 28 (51.8% were women. The mean age of patients was 52.53±19.75 (2-87 years. The cases were separated into 2 groups according to the etiology: group 1 - eyes with corneal ulcer (n:26 and group 2 - eyes with corneal stromal thinning, persistent epithelial defects and desmatocel (n:28. The transplantations were performed using cover technique in 17 eyes (31.4%, graft technique in 37 eyes (68.5% and graft technique with corneal patch in 2 eyes (3.7%. Partial penetrating keratoplasty was required in 38 of 54 eyes (70.3%. One eye was enucleated. Dis cus si on: The amniotic membrane transplantation has advantages like: it can be prepared easily and is cost-effective. It is a safe and effective procedure in ocular surface disease. (Turk J Ophthalmol 2012; 42: 177-82

  19. Amniotic Membrane Transplantation in Surgical Treatment of Conjunctival Melanoma: Long-term Results.

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    Palamar, Melis; Yaman, Banu; Akalın, Taner; Yağcı, Ayse

    2018-02-01

    To investigate the long-term efficacy and results of surgical management of conjunctival melanoma reconstructed with amniotic membrane transplantation. Conjunctival melanoma in 10 patients (5 female, 5 male) was totally excised with adjunctive cryotherapy to the surgical margins, corneal epitheliectomy with absolute alcohol in cases of corneal involvement, lamellar sclerectomy in cases with episcleral involvement, and ocular surface grafting with cryopreserved amniotic membrane. Complications and tumor control rates were evaluated. The mean age of the patients was 57.4±15.2 (range, 37-84) years. The mean diameter of the tumors was 15.5±4.9 (range, 10-25) mm and histopathologically confirmed complete excision was performed in all cases. Mild limbal stem cell deficiency (2 eyes) and subclinical symblepharon (3 eyes) were observed as long-term complications. In a mean follow-up of 56.7±40.4 (range, 30-132) months, only one local tumor recurrence was detected. Despite retreatment, exenteration was performed in this patient due to re-recurrence. One patient died due to disseminated metastasis despite the absence of local recurrence. In large conjunctival melanomas, reconstruction of the ocular surface is usually very challenging. The use of cryopreserved amniotic membrane for conjunctival defect repair is safe and effective with mild complications, and allows the excision of wider margins around the tumor.

  20. Amniotic Membrane Transplantation in Surgical Treatment of Conjunctival Melanoma: Long-term Results

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    Melis Palamar

    2018-02-01

    Full Text Available Objectives: To investigate the long-term efficacy and results of surgical management of conjunctival melanoma reconstructed with amniotic membrane transplantation. Materials and Methods: Conjunctival melanoma in 10 patients (5 female, 5 male was totally excised with adjunctive cryotherapy to the surgical margins, corneal epitheliectomy with absolute alcohol in cases of corneal involvement, lamellar sclerectomy in cases with episcleral involvement, and ocular surface grafting with cryopreserved amniotic membrane. Complications and tumor control rates were evaluated. Results: The mean age of the patients was 57.4±15.2 (range, 37-84 years. The mean diameter of the tumors was 15.5±4.9 (range, 10-25 mm and histopathologically confirmed complete excision was performed in all cases. Mild limbal stem cell deficiency (2 eyes and subclinical symblepharon (3 eyes were observed as long-term complications. In a mean follow-up of 56.7±40.4 (range, 30-132 months, only one local tumor recurrence was detected. Despite retreatment, exenteration was performed in this patient due to re-recurrence. One patient died due to disseminated metastasis despite the absence of local recurrence. Conclusion: In large conjunctival melanomas, reconstruction of the ocular surface is usually very challenging. The use of cryopreserved amniotic membrane for conjunctival defect repair is safe and effective with mild complications, and allows the excision of wider margins around the tumor.

  1. Microbiological viability of bovine amniotic membrane stored in glycerin 99% at room temperature for 48 months

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    Kelly Cristine de Sousa Pontes

    Full Text Available ABSTRACT The medium for storing biological tissues is of great importance for their optimal use in surgery. Glycerin has been proven efficient for storing diverse tissues for prolonged time, but the preservation of the bovine amniotic membrane in glycerin 99% at room temperature has never been evaluated to be used safely in surgical procedures. This study evaluated the preservation of 80 bovine amniotic membrane samples stored in glycerin 99% at room temperature. The samples were randomly divided evenly into four groups. Samples were microbiologically tested after 1, 6, 12 and 48 months of storage. The presence of bacteria and fungi in the samples was evaluated by inoculation on blood agar and incubation at 37 ºC for 48 hours and on Sabouraud agar at 25 ºC for 5 to 10 days. No fungal or bacterial growth was detected in any of the samples. It was concluded that glycerin is an efficient medium, regarding microbiology, for preserving pre-prepared bovine amniotic membrane, keeping the tissue free of microorganisms that grow in the media up to 48 months at room temperature.

  2. Amniotic membrane transplantation in surgical management of ocular surface squamous neoplasias: long-term results.

    Science.gov (United States)

    Palamar, M; Kaya, E; Egrilmez, S; Akalin, T; Yagci, A

    2014-09-01

    To evaluate the long-term efficacy of amniotic membrane transplantation for ocular surface reconstruction in the surgical management of ocular surface squamous neoplasia (OSSN). OSSN in 21 patients (7 female, 14 male patients) was managed with excisional biopsy, cryotherapy, corneal epitheliectomy with absolute alcohol application when the cornea is involved, lamellar sclerectomy and adjunctional absolute alcohol application to the base when episclera is involved, and ocular surface reconstruction with cryopreserved amniotic membrane transplantation. Tumor control and complications were evaluated. The mean age of the patients was 62.42 ± 20.9 (range, 16-84). The average diameter of the base of the tumors was 13.1 ± 4.8 (range, 9-21) mm and complete removal was achieved in all cases as revealed histopathologically. Ocular surface healing was achieved in all cases. At the postoperative period, limbal stem cell deficiency in three eyes and mild symblepharon in one eye were detected. In a mean follow-up of 30.95 ± 18.8 (range, 13-75) months, no recurrence was detected. For large or multifocal conjunctival tumors, the reconstruction of ocular surface and fornix is challenging. The amniotic-membrane use to repair conjunctival defects larger than 10 mm is a safe and effective technique with minimal complications allowing surgeons to make large enough excisions.

  3. Comparison of human mesenchymal stromal cells from four neonatal tissues: Amniotic membrane, chorionic membrane, placental decidua and umbilical cord.

    Science.gov (United States)

    Araújo, Anelise Bergmann; Salton, Gabrielle Dias; Furlan, Juliana Monteiro; Schneider, Natália; Angeli, Melissa Helena; Laureano, Álvaro Macedo; Silla, Lúcia; Passos, Eduardo Pandolfi; Paz, Ana Helena

    2017-05-01

    Mesenchymal stromal cells (MSCs) are being investigated as a potential alternative for cellular therapy. This study was designed to compare the biological characteristics of MSCs isolated from amniotic membrane (A-MSCs), chorionic membrane (C-MSCs), placental decidua (D-MSCs) and umbilical cord (UC-MSCs) to ascertain whether any one of these sources is superior to the others for cellular therapy purposes. MSCs were isolated from amniotic membrane, chorionic membrane, umbilical cord and placental decidua. Immunophenotype, differentiation ability, cell size, cell complexity, polarity index and growth kinetics of MSCs isolated from these four sources were analyzed. MSCs were successfully isolated from all four sources. Surface marker profile and differentiation ability were consistent with human MSCs. C-MSCs in suspension were the smallest cells, whereas UC-MSCs presented the greatest length and least width. A-MSCs had the lowest polarity index and UC-MSCs, as more elongated cells, the highest. C-MSCs, D-MSCs and UC-MSCs exhibited similar growth capacity until passage 8 (P8); C-MSCs presented better lifespan, whereas insignificant proliferation was observed in A-MSCs. Neonatal and maternal tissues can serve as sources of multipotent stem cells. Some characteristics of MSCs obtained from four neonatal tissues were compared and differences were observed. Amniotic membrane was the least useful source of MSCs, whereas chorionic membrane and umbilical cord were considered good options for future use in cell therapy because of the known advantages of immature cells. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  4. Antioxidant Vitamin Status in the Serum and Amniotic Fluid of Women with Premature Rupture of the Fetal Membranes.

    Science.gov (United States)

    Barrett, Bridget M.

    The purpose of this study was to examine the status of antioxidant vitamins in women with premature rupture of the fetal membranes. Specimens of blood and amniotic fluid were obtained from 80 pregnant subjects included both smokers and non-smokers during the third trimester. The concentrations of ascorbic acid (ASA), beta -carotene, retinol and alpha -tocopherol in serum and amniotic fluid were determined. The experimental group consisted of those subjects with PROM while the control subjects were those with normal pregnancy. No statistical differences were found between the PROM and control groups in retinol and vitamin E concentrations in amniotic fluid and serum. Serum ASA concentrations of PROM subjects were not different from controls, but the PROM subjects had significantly lower amniotic fluid ASA concentrations. However, in a study with fewer subjects a lower serum ASA concentration in the PROM subjects was observed. The ratio of amniotic fluid ASA concentration to ASA serum concentration was significantly lower in PROM patients than in controls in both studies. This suggests that low levels of ASA in the amniotic fluid, but not in serum is better associated with PROM. A low amniotic fluid concentration of ASA may reflect an inefficient transfer and/or increased fetal utilization. Alterations in ASA concentration in the amniotic fluid may affect the integrity of the chorioamnion leading to PROM. beta -Carotene was not found in the amniotic fluid. Serum beta-carotene levels were significantly lower in the PROM group compared to the control group. Low concentrations of beta-carotene in maternal serum in smokers not only associated with poor maternal outcome (PROM) but also compromised the fetal outcome (decreased birth weight). Maintenance of adequate serum beta-carotene concentration and amniotic fluid ASA in smokers may result in better maternal and fetal outcome. This study demonstrated that nutrition is an important factor in the prevention of PROM.

  5. Elaboration of amniotic membrane dressing dried by air and irradiated - Peruvian experience

    International Nuclear Information System (INIS)

    Gamero, E.C.; Perez Caballero, N.

    1999-01-01

    The purpose of this work is to prepare dressings from the amniotic membrane to be used in cases of skin damage principally due to superficial and intermediate second-degree burns. The amnion is a transparent membrane that lines the chorion. It is resistant and rich in collagen. Due to these characteristics it can be well used as biological dressing as it diminishes the loss of fluids, electrolytes and proteins, it also protects the growing epithelium and adheres well to the surface of the wound, improves mobility of the patient, diminishing pain and stimulating neovascularization. The ISN-IPEN Tissue Bank promoted by IAEA has processed amniotic membrane since July 1997. Initially dressings were prepared using antibiotics, after IAEA training at the MINT of Malaysia, it is processed dried by air, lyophylized and in both presentations, sterilized by gamma-rays. Amniotic membranes are procured from Lima Maternity. Tissues must comply with VDRL, HIV, Hepatitis B and C exclusion tests. The process is held in a laminar flow hood and amnion already separated from the chorion is washed with sterile distilled water, a solution of 0.05% sodium hypochlorite, and normal saline. Then it is cut into appropriate sizes and double packed in PE films. The dressings are then carried to the Peruvian Institute of Nuclear Energy for irradiation, depending on the number of samples either irradiated with gamma-rays at the Gammacell 220 or at the Irradiation Facility located in Santa Anita. The delivered dose is 25 kGy. The product is only released if it complies with the end product quality controls. Meanwhile, microbiological tests are carried out during all the processing stages, in order to monitor the microbial load during production. In conclusion we can state that dressings prepared as above mentioned have the following advantages: not complicated preparation; reliable and safe for clinical use; diminish infection rates and days spent in the hospital; easy to storage; and can be

  6. Outcome of application of amniotic membrane graft in ocular surface disorders.

    Science.gov (United States)

    Ashraf, Nargis Nizam; Adhi, Muhammad Idrees

    2017-07-01

    To determine the outcome of application of amniotic graft in ocular surface disorders. This cross-sectional study was conducted at Dow University of Health Sciences, Karachi, from January 2010 to December 2012, and comprised patients with ocular surface disorders. Patients' presenting symptoms and signs were recorded. Previously harvested and frozen amniotic graft was applied in different types of ocular surface disorders, such as corneal ulcers, pterygium, keratomalacia, Steven-Johnson syndrome, etc. Following the surgery, patients were assessed for improvement in symptoms and signs related to epithelialisation in corneal ulcers.. Of the 50 patients, 30(60%) were male and 20(40%) female. The overall mean age was 40±19.3 years (range: 9 months to 80 years). Out of the 18(36%) cases of pterygium, there was recurrence in 5(27.7%) cases. There were 26(52%) patients of corneal ulcers, of whom re-epithelialisation occurred in 21(80.7%) patients. Amniotic membrane grafting was found to be a safe procedure for ocular surface disorders.

  7. Amniotic fluid soluble Toll-like receptor 4 in pregnancies complicated by preterm prelabor rupture of the membranes.

    Science.gov (United States)

    Kacerovsky, Marian; Andrys, Ctirad; Hornychova, Helena; Pliskova, Lenka; Lancz, Kinga; Musilova, Ivana; Drahosova, Marcela; Bolehovska, Radka; Tambor, Vojtech; Jacobsson, Bo

    2012-07-01

    To determine amniotic fluid soluble Toll-like receptor 4 (sTLR4) levels in women with preterm prelabor rupture of the membranes according to the presence of microbial invasion of the amniotic cavity and histological chorioamnionitis and its relation to neonatal outcome. One hundred two women with singleton pregnancies with a gestational age between 24 + 0 and 36 + 6 weeks were included in a prospective cohort study. Amniocenteses were performed, and the concentrations of sTLR4 in the amniotic fluid were determined using sandwich enzyme-linked immunosorbent assay technique. Women with the presence of microbial invasion of the amniotic cavity had higher sTLR4 levels [median 54.2 ng/mL, interquartile range (IQR) 10.15-289.9] than those without this condition (median 18.1 ng/mL, IQR 8.1-29.9; p = 0.001). Women with the presence of histological chorioamnionitis had a higher sTLR4 level (median 28.0 ng/mL, IQR 11.15-178.1) compared with women without histological chorioamnionitis (median 13.0 ng/mL, IQR 7.8-28.7; p = 0.003). A mixed linear model was used to adjust for confounders. The difference was found only between women with and without microbial invasion of the amniotic cavity in this model. Microbial invasion of the amniotic cavity was associated with higher amniotic fluid sTLR4 levels independent of confounders.

  8. Amniotic membrane transplantation: Current indications in a tertiary eye hospital of eastern Nepal.

    Science.gov (United States)

    Hamal, Diwa; Singh, Sanjay Kumar; Lamichhane, Binaya; Sharma, Archana; Anwar, Afaque; Mahaseth, Vijay

    2016-07-01

    Amniotic membrane has unique properties that can be helpful to treat different ocular surface diseases. To report our experience with 100% glycerol preserved amniotic membrane at 4°C and fresh amniotic membrane transplantation (AMT) with and without limbal graft for ocular surface reconstruction. Retrospective case study of 211 eyes of 211 patients was conducted at Biratnagar Eye Hospital from June 2008 to March 2014. The cases were evaluated in terms of demographic parameters, preoperative diagnosis and the type of surgery performed. The most common indication for surgery was Pterygium (90 eyes, 42.65%), followed by symblepharon (57 eyes, 27.01%), chemical injury (35 eyes, 16.58%), socket reconstruction (9 eyes, 4.26%), shield ulcer (6 eyes, 2.84%), PED (4 eyes, 1.89%), Steven Jonson's syndrome (5 eyes, 2.36%), dry Eye (2 eyes, 0.94%), Corneal Degeneration (2 eyes, 0.94%), bullous keratopathy (1 eye, 0.47%). The mean age was 28.12 ±17.2 years (age range 3-78 years). More men (161, 76.30%) underwent surgery than women (50 eyes, 23.69%). Symblepharon (24 eyes, 36.36%) was the major cause of surgery in pediatric group. The mean follow-up was 7 months (range 2-36, months). Resurgery was needed in (18 eyes, 8.53%) of which symblepharon (7eyes, 39%) was the major cause. AMT was done in 189 (89.57%) eyes and AMT with conjunctival limbal graft was done in 22(10.42 %) cases. Infectious, inflammatory, or allergic reactions were not encountered in any patient. All patient experienced increased ocular comfort with anatomical restoration of corneal and conjunctival surfaces. AMT alone or in combination with limbal graft aids in ocular surface reconstruction. © NEPjOPH.

  9. [Successful treatment of surgically induced necrotizing sclerokeratitis (SINS) with systemic immunosuppresive agents and amniotic membrane grafting].

    Science.gov (United States)

    Cordero-Coma, M; Franco-Benito, M; García-Ruiz-de-Morales, J M; Alonso-Orcajo, N; Del Barrio-Manso, I

    2009-11-01

    We report the case of a 74-year-old female who developed a necrotizing sclerokeratitis affecting her left eye after uncomplicated cataract surgery. She had no previous history of systemic autoimmune disease. Histopathology of the lesion revealed necrotic granulomatosis with an increased number of plasma cells. Surgically induced necrotizing sclerokeratitis (SINS) is a serious entity which requires prompt and aggressive therapy to prevent its potential devastating ocular consequences. Conjunctival resection and amniotic membrane grafting may be necessary to temporarily interrupt local immunologic events in severe cases. However, associated systemic immunomodulatory therapy seems to be mandatory (Arch Soc Esp Oftalmol 2009; 84: 577-580).

  10. Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery

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    Tejsu Malla

    2018-03-01

    Full Text Available AIM: To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques: combined conjunctival autograft and overlay amniotic membrane transplantation (CAT with AMT, conjunctival autograft transplantation (CAT alone and amniotic membrane transplantation (AMT alone. METHODS: In this retrospective study, 142 eyes of 142 pterygium patients (104 primary, 38 recurrent who underwent CAT (group A, AMT (group B or CAT with AMT (group C respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS: The number of recurrence post-surgery were 17 (9 from primary, 8 from recurrent; the same description below, 18 (10, 8 and 2 (1, 1 in groups A, B, and C respectively; dry eyes were 22 (16, 6, 27 (18, 9 and 7 (3, 4; conjunctival inflammations were 30 (17, 13, 27 (16, 11 and 11 (6, 5. Patients in group C (either primary or recurrent or both mainly showed significantly better results than those in group A or B (P<0.05 regarding above-mentioned clinical effects. CONCLUSION: Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.

  11. Amniotic Membrane Transplant with a Special Technique (Motowa's Sandwich Technique) in Mooren's Ulcer.

    Science.gov (United States)

    Al Motowa, Saeed; Al Zobidi, Mohammed

    2015-01-01

    To illustrate amniotic membrane transplant (AMT) with a novel surgical technique ("sandwich technique") for treating patients with malignant Mooren's ulcer. A case report of a patient with bilateral, malignant Mooren's ulcer who had undergone systemic steroid therapy and topical immunosuppresive therapy to stabilize his condition. However, perforation of cornea occurred in one eye. AMT with a new surgical technique ("Motowa's sandwich technique") was performed to treat this case. On the 1(st) day postoperatively, there was no pain, no photophobia, and visual acuity was same as preoperatively. At 4 weeks postoperatively, visual acuity improved in the right eye to 20/160 with pinhole, and there was no fluorescein staining. The right eye was quiet. Amniotic membrane transplant with "Motowa's sandwich technique" resulted in the preservation of the anatomical integrity and progression of disease was halted along with an improved vision. This technique is a novel surgical modality in treating Mooren's ulcer. Further study on a large cohort of patients is required for evidence-based data to verify the outcome of this initial case report.

  12. Co-effect of silk and amniotic membrane for tendon repair.

    Science.gov (United States)

    Seo, Young-Kwon; Kim, Jun-Hyung; Eo, Su-Rak

    2016-08-01

    The objective of the present study was to determine the feasibility and biocompatibility of a silk scaffold and a composite silk scaffold in terms of new tendon generation using a rabbit Achilles tendon model. The silk scaffold was constructed using a weaving machine, then soaked in a 1% collagen-hyaluronan (HA) solution and air-dried, whereas the composite silk scaffold was composed of a silk scaffold containing a lyophilized collagen-HA substrate. Tenocytes were cultured in vitro to compare cell populations in the two groups. The cellular densities on composite silk scaffolds were 40% higher on average than those on silk scaffolds in 30-day tenocyte cultures. The tendon scaffolds had implanted into Achilles tendon defects in 16 white New Zealand rabbits. Rabbits were randomly divided into the following three groups: group I, silk scaffold alone; group II, composite silk scaffold; and group III, composite silk scaffold wrapped by an amniotic membrane. Implants were harvested 2, 8, and 12 weeks post-implantation. Histological examinations were conducted using hematoxylin-eosin (H&E), Masson's trichrome, and by performing immunohistochemical staining for CD34. After 12 weeks, the three groups were distinguishable based on gross examination. The histological examination revealed more organized collagen fibrils in groups III, which showed a dense, parallel, linear organization of collagen bundles. CD34 staining revealed neoangiogenesis in groups III. The results of this research showed that collagen-HA substrates with amniotic membrane accelerate cellular migration and angiogenesis in neotendons.

  13. Human Amniotic Membrane Dressing: an Excellent Method for Outpatient Management of Burn Wounds

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    Ali Akbar Mohammadi

    2009-03-01

    Full Text Available Background: Burns are among the most common traumas indeveloping countries, which consume large amounts of medicalresources. It is important to find an appropriate materialfor dressing of burn wounds that improves healing and is readilyavailable, easily applicable, and economical.Methods: In a single-blind randomized controlled clinicaltrial from March to October 2006, 211 patients with less than20% burn were enrolled into two groups. The first group contained104 patients with average burn of 11.90± 3.80% of totalbody surface area (TBSA for whom amnion dressing wasused. The second group composed of 107 patients with averageburn of 12.30± 4.14% of TBSA treated with routine silversulfadiazine dressing.Results: Amniotic membrane usage was accompanied by accelerationin wound healing, less need for skin graft, and lesspain. The mean healing time in superficial parts of burnwounds in the amnion group was significantly shorter than thecontrol group (9.50±2.13 v 14.30±2.60 days; P value < 0.01.The extent of the wound with granulation tissue which neededskin graft was less in the amnion group (2.10 ± 2.21% v 4.20±1.44%; P value < 0.01.Conclusion: Widespread use of amniotic membrane dressingis recommended for limited burn wound management.

  14. Management of temporomandibular joint degenerative disorders with human amniotic membrane: Hypothesis of action.

    Science.gov (United States)

    Guarda-Nardini, Luca; Trojan, Diletta; Paolin, Adolfo; Manfredini, Daniele

    2017-07-01

    Approaches providing the positioning of human amniotic membrane (HAM) within the intra-articular space of arthritic TMJs have never been investigated. This contrasts with the increasing amount of evidence suggesting the potential positive effects of HAM on a number of surgical conditions, even included the interpositional arthroplasty for TMJ ankylosis. Thus, the possible usefulness of HAM to restore joint functions in severely damaged TMJs could be hypothesized. Based on these premises, the clinical research question "Is human amniotic membrane positioning effective to reduce symptoms and restore jaw function in patients with severe inflammatory-degenerative disorders of the temporomandibular joint?" has been addressed by performing a systematic review of the literature. Out of potential 11988 and 8883 citations in the PubMed and Scopus databases, respectively, only five were of possible interest for inclusion in the review, but none of them addressed specifically the clinical research question. Thus, the hypothetical background for usefulness was discussed. The benefits of HAM positioning in TMJs with severe inflammatory-degenerative disorders could be related with its anti-inflammatory and anti-microbial and analgesic properties as well as its low immunogenicity. Studies in which HAM is positioned within the joint space of patients with severe TMJ degeneration, either as a disc-replacing film during major surgeries for discectomy and arthroplasty or as an injectable solution that can be needle-inserted after an arthrocentesis procedure, should be designed to test the hypothesis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The Application Of Human Amniotic Membrane In Repairmen Of Dura Mater In Dogs

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    Moein H

    2002-09-01

    Full Text Available This study was conducted to show the comparison of efficacy and survival of amniotic membrane grafts and homologous dura grafts."nMethods and Materials: In this study, ten dogs (age 6-9 months & weight 15 lo 20 kg have been chosen. The study was a single blind clinical trial. The dogs have been assigned into two groups by random allocation method. The amniotic membrane (A.M was taken from a placenta belonging to a 38 weeks fetus delivered in a cesarean section surgery. In one group the graft was a peace of dura mater and in the other one the graft was a homologous dura graft. Maintenance of all cases was the same. Forty-five days later, another surgeon who was not aware of the assignment, conducted the second exploratory surgery for evaluation of the results."nResults: None of cases in two groups had any infection, abscess formation, fistula, CSF leakage or any toxic status. The healing process was normal in both groups."nConclusion: There seems to be no difference between the (A.M grafts and homologous dura in the repairmen of dura mater. This is expected to occur only if the pregnant woman is carefully tested for the presence of certain clinical conditions and the preparation of A.M is contemplated in an ideal environment.

  16. Improvement of Amniotic Membrane Method for the Treatment of Corneal Perforation

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    Junhua Fan

    2016-01-01

    Full Text Available In our retrospective study we evaluated the efficacy of an improved amniotic membrane (AM roll-in filling technique (AMR combined with multilayer amniotic membrane cover to treat corneal perforation and included 46 cornea perforations ≤ 3 mm in diameter treated with AMR and 20% C3F8 mixed gas filling of the anterior chamber. Anterior chamber depth, aqueous leakage, bubble maintenance time, and cornea morphology were monitored after each operation. The mean diameter of corneal perforation was 1.60±0.55 mm (range 0.5–3 and the success rate of the AMR method for corneal perforation reconstruction was 100% after a single operation. Anterior chamber depth was normally reconstructed without AMR break-off, aqueous leak, or other complications. The mean time of the C3F8 gas bubble in the anterior chamber was 8.6±2.0 days (range 4–12. At the last follow-up, all patients’ visual acuity was improved to varying degrees. The mean follow-up time was 11.0±5.6 months (range 3–36. The AMR plugging combined with multilayer AM cover is a secure and easy intervention, which led to 100% success in our study. Various perforations ranging from trauma to infection can be treated with AMR, which is especially practical in those countries where donor cornea availability is limited.

  17. 'Perinatal outcome in preterm premature rupture of membranes with Amniotic fluid index < 5 (AFI < 5

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    Hantoushzadeh Sedigheh

    2004-08-01

    Full Text Available Abstract Background Our purpose was to determine whether AFI Methods We performed a prospective cohort study of 95 singleton pregnancies complicated by preterm premature rupture of the membranes (PPROM with delivery between 26 and 34 weeks gestation. Patients were categorized in two groups on the basis of amniotic fluid index2 and Fisher exact tests. Continuous data were evaluated for normal distribution and tested for significance with the student t test. All 2-sided p values Results Both groups were similar with respect to selected demographics, gestational age at rupture of the membranes, gestational age at the delivery, birth weight. Both groups were similar with respect to selected variable, latency until delivery, early onset neonatal sepsis, RDS and neonatal death. Patients with AFI Conclusions An AFI

  18. Amniotic membrane-derived stem cells: immunomodulatory properties and potential clinical application

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    Insausti CL

    2014-03-01

    Full Text Available Carmen L Insausti,1 Miguel Blanquer,1 Ana M García-Hernández,1 Gregorio Castellanos,2 José M Moraleda11Unidad de Trasplante Hematopoyético y Terapia Celular, 2Servicio de Cirugía, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, Campus Mare Nostrum, Universidad de Murcia, El Palmar, Murcia, SpainAbstract: Epithelial and mesenchymal cells isolated from the amniotic membrane (AM possess stem cell characteristics, differentiation potential toward lineages of different germ layers, and immunomodulatory properties. While their expansion and differentiation potential have been well studied and characterized, knowledge about their immunomodulatory properties and the mechanisms involved is still incomplete. These mechanisms have been evaluated on various target cells of the innate and the adaptive system and in animal models of different inflammatory diseases. Some results have evidenced that the immunomodulatory effect of AM-derived cells is dependent on cell-cell contact, but many of them have demonstrated that these properties are mediated through the secretion of suppressive molecules. In this review, we present an update on the described immunomodulatory properties of the derived amniotic cells and some of the proposed involved mechanisms. Furthermore, we describe some assays in animal models of different inflammatory diseases which reveal the potential use of these cells to treat such diseases.Keywords: epithelial cells, mesenchymal cells, cell therapy, immunomodulation

  19. Biological Activity Alterations of Human Amniotic Membrane Pre and Post Irradiation Tissue Banking.

    Science.gov (United States)

    Nemr, Waleed; Bashandy, A S; Araby, Eman; Khamiss, O

    Innate immunity of Human Amniotic Membrane (HAM) and its highly active secretome that rich with various types of growth factors and anti-inflammatory substances proposed it as a promising material for many medical studies and applications. This study evaluate the biological activity of cultivated HAM pre and post tissue banking process in which freeze-dried HAM was sterilized by 25 KGray (kGy) dose of γ radiation. The HAM's antimicrobial activity, viability, growth of isolated human amniotic epithelial cells (HAECs), hematopoietic stimulation of co-cultivated murine bone marrow cells (mammalian model), scaffold efficiency for fish brain building up (non-mammalian model) and self re-epithelialization after trypsin denuding treatment were examined as supposed biological activity features. Native HAM revealed viability indications and was active to kill all tested microorganisms; 6 bacterial species (3 Gram-positive and 3 Gram-negative) and Candida albicans as a pathogenic fungus. Also, HAM activity promoted colony formation of murine hematopoietic cells, Tilapia nilotica brain fragment building-up and self re-epithelialization after trypsin treatment. In contrary, radiation-based tissue banking of HAM caused HAM cellular death and consequently lacked almost all of examined biological activity features. Viable HAM was featured with biological activity than fixed HAM prepared by irradiation tissue banking.

  20. Combined Conjunctival Autograft and Overlay Amniotic Membrane Transplantation; a Novel Surgical Treatment for Pterygium

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    Siamak Zarei Ghanavati

    2014-01-01

    Full Text Available The authors report the long-term results of combined conjunctival autograft and overlay amniotic membrane transplantation (AMT for treatment of pterygium as a new surgical technique. Nineteen patients including 12 male and 7 female subjects with pterygium (primary, 14 cases; recurrent, 5 cases underwent combined conjunctival autograft and overlay AMT and were followed from 10 to 26 months. Mean age was 44.21±12.49 (range, 29.0-73.0 years. In one patient with grade T3 primary pterygium, the lesion recurred (5.2%, recurrence rate. No intra-and postoperative complication developed. This procedure seems a safe and effective surgical technique for pterygium treatment. Protection of the ocular surface during the early postoperative period reduces the friction-induced inflammation and might be helpful to prevent the recurrence.

  1. [Quantitative determination of vitamin A levels in frozen preserved human amniotic membrane].

    Science.gov (United States)

    Nozaki, Mayumi; Kawahara, Junichi; Muramatsu, Ryuji; Usui, Masahiko

    2005-11-01

    Retinoids are associated with cell proliferation and differentiation. The levels of retinoids (vitamin A and its derivatives) in human amniotic membrane (AM) were measured to investigate whether endogenous retinoids in AM might contribute to the process of wound healing of the keratoconjunctival epithelium in AM transplantation. Retinoids were extracted from AM obtained from three patients following cesarean section. Retinoids including retinol (ROL), retinylaldehyde (RAL), retinoic acid(RA), and retinyl palmitate(RP) were analyzed using a reverse-phase high performance liquid chromatograph equipped with a multi-wavelength detector or fluorescence detector. ROL was identified and detected in AM at a concentration of 9.42 2.75(mean +/- standard deviation) ng/g wet tissue. No other retinoids, were detected. Among the retinoids tested, only retinol was detected at low levels in human AM tissues. Based on these results, endogenous retinoids in AM probably have little effect on wound healing of the keratoconjunctival epithelium in AM transplantation.

  2. Donor age and gestational age influence on growth factor levels in human amniotic membrane.

    Science.gov (United States)

    López-Valladares, Maria J; Teresa Rodríguez-Ares, M; Touriño, Rosario; Gude, Francisco; Teresa Silva, M; Couceiro, Jose

    2010-09-01

    Amniotic membrane (AM) is used as a biomaterial for reconstruction in ocular surface surgery. This study investigated the influence of interdonor variations and processing and preservation procedures applied to the AM on growth factors and protein levels.  Samples of human AM from thirteen donors were analysed. Collected donor data were age, parity and gestational age. Total protein amount was measured in extracts of intact AM nonpreserved, lyophilized and cryopreserved, at -80°C and in liquid nitrogen. An enzyme-linked immunosorbent assay (ELISA) was used to assay growth factors protein levels for epidermal growth factor, basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), keratinocyte growth factor (KGF), transforming growth factor beta1 (TFG-β(1) ) and nerve growth factor (NGF). Univariate and multivariate statistical analyses were used to study the influence of the preservation method applied and interdonor variations on growth factors levels. We detected important variations in growth factors and protein concentrations between samples from different donors. Total protein amount, bFGF, HGF, KGF and TGF-β(1) showed lower levels in samples from donors with higher gestational ages and donor ages, for all groups. The variability in the biochemical composition of AM from different donors is considerable, and it is related with donor factors as donor age and gestational age. As AM biochemical composition has a role in its therapeutic effects, these variations could affect the clinical results of amniotic membrane transplantation and must be taken into account in donor selection processes. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

  3. Intraamniotic inflammatory response to bacteria: analysis of multiple amniotic fluid proteins in women with preterm prelabor rupture of membranes.

    Science.gov (United States)

    Kacerovsky, Marian; Musilova, Ivana; Khatibi, Ali; Skogstrand, Kristin; Hougaard, David M; Tambor, Vojtech; Tosner, Jindrich; Jacobsson, Bo

    2012-10-01

    To analyse whether intraamniotic inflammation in response to bacteria is different below and above gestational age 32 weeks in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). A prospective study was performed, and 115 women with singleton pregnancies complicated by PPROM at gestational ages between 24(0/7) and 36(6/7) weeks were included in the study. Transabdominal amniocenteses were performed. Amniotic fluid was analysed using polymerase chain reactions for genital mycoplasmas and cultured for aerobic and anaerobic bacteria. The concentrations of 26 proteins in the amniotic fluid were determined simultaneously using multiplex technology. Bacteria were found in the amniotic fluid of 43% (49/115) of the women. The women were stratified into two subgroups according to gestational age 32 weeks. The amniotic fluid levels of four (interleukin-6, interleukin-10, CC chemokine ligands 2, and 3) and one specific (CC chemokine ligands 2) proteins were higher in women with the presence of bacteria in the amniotic fluid below and above 32 gestational weeks, respectively. An intraamniotic inflammatory response to bacteria in pregnancies complicated by PPROM seems to be different below and above 32 weeks of gestation.

  4. Biomechanical and physical properties of human amniotic membrane after gamma irradiation and storage

    International Nuclear Information System (INIS)

    Norimah Yusof; Salahbiah Abd Majid

    1999-01-01

    At MINT Tissue Bank, amniotic membranes are procured routinely from placenta of screened healthy mothers. They are processed, dried, packed and sterilised using gamma irradiation at minimum dose of 17 kGy. The sterilised membranes are delivered to several hospitals and clinics, locally and even abroad. The membranes are effectively used on patients with first and second degree bums, superficial wounds and scalds. At present the membrane is given 2 years expiry date if stored in dark and cool place. A study was carried to validate this expiry period under the quality system by determining any changes in biomechanical properties of amnion after irradiation and at various storage times. Random samples of amnion, stored at room temperature in dark were picked up for physical tests including tensile strength and elongation using Instron Universal Testing Instrument (Model 43 1 0) at MINT. After 4 months storage, irradiated freeze-dried amnion (79.79+20.27 kg/cm sup 2) had significantly lower tensile strength compared to air-dried amnion (304.97+66.92 kg/cm sup 2) at P<0.05. As for elongation, there was no significant different between air-dried and freeze dried. Further studies on the stability of air-dried amnion over storage time showed that there was no significant reduction in tensile strength (432.37 +208.1 1 kg/cm sup 2) and elongation (I 1.68+1.63%) for radiation sterilised amnion up to 12 months storage. Combination of radiation and storage at room temperature also did not alter the stability of the products stored up to 20 months when compared to newly processed amnion. We could not find any changes in physical appearance such as colour for amnion which have been kept for almost 5 years. Therefore the expiry date of 2 years (24 months) given to our amnion is acceptable. At present, MINT Tissue Bank only process air-dried amnion since the cost of processing of amniotic membranes can be reduced by 40% compared to freeze drying. Water content for both drying

  5. Perioperative changes of the intraocular pressure during the treatment of epiretinal membrane by using 25- or 27-gauge sutureless vitrectomy without gas tamponade.

    Science.gov (United States)

    Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

    2017-01-01

    The purpose of this study was to compare perioperative intraocular pressures (IOPs) in 25- or 27-gauge microincision vitrectomy surgery (MIVS) and to evaluate the stability of postoperative sclerotomy closure. This is a retrospective review of 147 eyes treated for epiretinal membrane by using 25- or 27-gauge MIVS as the initial vitrectomy (25-gauge phacovitrectomy [25-P group]: 73 eyes, 25-gauge vitrectomy alone [25-A group]: 15 eyes, 27-gauge phacovitrectomy [27-P group]: 47 eyes, and 27-gauge vitrectomy alone [27-A group]: 12 eyes). Statistical analyses of perioperative IOPs on preoperative day (PreOp), postoperative day (POD)1, POD2, postoperative week 1, and postoperative month 1 were performed. All self-sealing sclerotomies were obtained without gas tamponade at the end of surgery. Also, no significant differences were noted in the age and axial length among the 4 groups and in the surgical time between 25-P and 27-P groups and between 25-A and 27-A groups. Significant decreases in IOP were found at POD1 and POD2 in the 25-P, 25-A, and 27-P groups compared with PreOP, but not in the 27-A group. Even though surgeons confirm that there is no leakage from sutureless sclerotomy and that a normal IOP is preserved at the end of 25- or 27-gauge MIVS, there is a possibility of postoperative sclerotomy leakage on the day of the surgery. Furthermore, postoperative sclerotomy self-sealing of the MIVS in previous intraocular lens implantation cases is considered to be acquired easily than that in phacovitrectomy.

  6. The experience of women in hospital rest with preterm premature rupture of de amniotic membranes

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    María del Mar Fernández Míguez

    2012-07-01

    Full Text Available Hospital bed rest in a preterm premature rupture of the amniotic membranes involves a crisis situation for women with very high emotional effects.To understand the needs felt of the gestantes with pregnancies of high risk on the part of the professionals, it will improve the quality of the attention and it can help to diminish the stress levels at this vulnerable period and to confronting the maternity.Aim: Investigate women´s experience when they are resting in hospital in cases de preterm premature rupture of membranes.Methodology: Phenomenological study, It has taken as a population of study to women hospitalized in the plant of obstetrics of high risk from Gregorio Marañón Hospital, with preterm premature rupture of membranes between 24 and 31 weeks of gestation.Data collection: Was be carried out by means of the individual interviews in hospitable environment; observation and withdrawal of notes during the accomplishment of this one.

  7. The use of Amniotic membrane in the treatment of Burns in Children a clinical trial at the university Teaching Hospital, Lusaka

    CERN Document Server

    Katebe, K R

    1995-01-01

    This is a clinical trial which was carried out at the University Teaching Hospital, Lusaka from the 1st of July to the 31st December, 1994. It involved treatment of burns in forty children using gamma irradiated amniotic membrane produced at the hospital. The results showed that it is feasible to produce Gamma irradiated biological dressings from amniotic membrane at this hospital. The amniotic membrane was easy to apply on burns and the treatment was acceptable to the majority of parents with burnt children. The use of amniotic membrane was non inflammatory to the wounds in all forty patients (100%), reduced wound infection in thirty three patients (82.5%), increased the rate of wound healing in thirty nine patients (97.5%), and resulted in good quality wound healing in thirty one patients (77.5%). Therefore, the treatment offers a good alternative in the treatment of burns in children at the hospital

  8. The use of Amniotic membrane in the treatment of Burns in Children: a clinical trial at the university Teaching Hospital, Lusaka

    International Nuclear Information System (INIS)

    Katebe, K.R.C

    1995-01-01

    This is a clinical trial which was carried out at the University Teaching Hospital, Lusaka from the 1st of July to the 31st December, 1994. It involved treatment of burns in forty children using gamma irradiated amniotic membrane produced at the hospital. The results showed that it is feasible to produce Gamma irradiated biological dressings from amniotic membrane at this hospital. The amniotic membrane was easy to apply on burns and the treatment was acceptable to the majority of parents with burnt children. The use of amniotic membrane was non inflammatory to the wounds in all forty patients (100%), reduced wound infection in thirty three patients (82.5%), increased the rate of wound healing in thirty nine patients (97.5%), and resulted in good quality wound healing in thirty one patients (77.5%). Therefore, the treatment offers a good alternative in the treatment of burns in children at the hospital

  9. Rapid cooling of the amniotic membrane as a model system for the vitrification of posterior corneal lamellae.

    Science.gov (United States)

    Krabcova, Ivana; Jirsova, Katerina; Bednar, Jan

    2014-03-01

    To vitrify human amniotic membrane specimens so that the maximum of epithelial cells survives in order to develop a procedure for the eventual vitrification of posterior corneal lamellae without using cryoprotective agents. To assess different methods of tissue sample preparation preceding vitrification. In group 1, the amniotic membrane specimens were stretched on nitrocellulose support. In group 2, mechanical pressure was used to remove the excess culture medium between the support and the membrane. The samples were frozen in liquid ethane (-183 °C) and stored in liquid nitrogen. The specimens in the control group were not vitrified. Re-warming was performed at 40 °C. The epithelial cell survival rate was assessed after 1, 3 and 7 days of storage following re-warming using calcein and ethidium homodimer-1 fluorescence. A wide range of values was observed among the different groups and among individual specimens within the groups. Resulting average survival rate was 41 % for group 1 and 53 % for group 2; in several samples the cell survival rate exceeded 70 %. The storage period did not significantly affect the survival rates. The results of the rapid cooling of amniotic membranes in liquid ethane indicate that significant percentage of epithelial cells remain viable after the re-warming.

  10. Clinical application of amniotic membranes on a patient with epidermolysis bullosa.

    Science.gov (United States)

    Martínez Pardo, M E; Reyes Frías, M L; Ramos Durón, L E; Gutiérrez Salgado, E; Gómez, J C; Marín, M A; Luna Zaragoza, D

    1999-01-01

    The case of a patient with dystrophic epidermolysis bullosa treated with radiosterilised amniotic membranes is presented. The disorder is a congenital disease characterised by a poor desmosomal junction in the keratinocyte membrane. After proper donor screening, amnios were collected at Hospital Central Sur de Alta Especialidad (HCSAE), PEMEX and microbiological analysis was performed at Universidad Nacional Autónoma de México, FQUNAM, (Biology Dept. of the Chemistry Faculty, National Autonomous University of Mexico), before and after radiation sterilisation. Processing, packaging and sterilisation were performed at Instituto Nacional de Investigaciones Nucleares, ININ, (National Nuclear Research Institute). The patient, a ten-year-old boy with severe malnutrition, extensive loss of skin and pseudomonad infection in the whole body, was treated with gentle debridement in a Hubbard bath. Later amnion application was performed with sterilised amnios by using two different processes, in one of which the amnion was sterilised with paracetic acid, preserved in glycerol, kindly donated by the German Institute for Tissue and Cell Replacement and applied by Dr. Johannes C. Bruck, IAEA visiting expert, and the other amnion was processed at ININ: air dried and sterilised by gamma radiation at dose of 30 kGy. After spontaneous epithelisation was successfully promoted for seven days, the pain was alleviated and mobility was improved in a few hours and the patient's general condition was so improved that in a month he was discharged. Unfortunately, because this disease is revertive and has malignant degeneration, the prognosis is not good.

  11. An epidermal stem cells niche microenvironment created by engineered human amniotic membrane.

    Science.gov (United States)

    Ji, Shi-zhao; Xiao, Shi-chu; Luo, Peng-fei; Huang, Guo-feng; Wang, Guang-yi; Zhu, Shi-hui; Wu, Min-juan; Xia, Zhao-fan

    2011-11-01

    How to amplify epidermal stem cells (ESCs) rapidly is a challenging crux in skin tissue engineering research. The present study describes the preparation of 3D micronized (300-600 μm) amniotic membrane (mAM) by means of repeated freeze-thawing cycles to deplete cell components and homogenized with a macrohomogenizer in liquid nitrogen. This newly prepared mAM not only possessed the characteristics of a microcarrier but completely retained the basement membrane structure and abundant active substances such as NGF, HGF, KGF, bFGF, TGF-β1 and EGF in the AM matrix. The result showed that mAM combined with rotary cell culture system (RCCS) was able to amplify ESCs quickly. The relative cell viability at day 7 and 14 was significantly higher than that of the conventional 2D plate culture (326 ± 28% and 535 ± 47% versus 232 ± 21% and 307 ± 32%, P human body favorable for ex vivo culture and amplification of ESCs but can be used as the dermal scaffold in constructing a skin substitute containing ESCs for the repair of full-thickness skin defects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Bone density of defects treated with lyophilized amniotic membrane versus colagen membrane: a tomographic and histomorfogenic study in a rabbi´s femur.

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    Liz Ríos

    2014-09-01

    Full Text Available The aim of this study was to compare the bone density of bone defects treated with lyophilizated amniotic membrane (LAM and collagen Membrane (CM, at 3 and 5 weeks. Two bone defects of 4mm in diameter and 6mm deep were created in left distal femoral diaphysis of New Zealand rabbits (n=12. The animals were randomly divided into 2 groups. One of the defects was covered with lyophilized amniotic membrane (Rosa Chambergo Tissue Bank/National Institute of Child Health-IPEN, Lima, Peru or collagen Membrane (Dentium Co, Seoul, Korea. The second was left uncovered (NC. The rabbits were killed after 3 and 5 weeks (3 rabbits/period. The results showed a high bone density and repair of the defect by new bone. The tomographic study revealed that the bone density of the defects treated with LAM at 3 weeks was equivalent to the density obtained with CM and higher density compared with NC (p0.05. The results show that lyophilizated amniotic membrane provides bone density equal or higher to the collagen membrane.

  13. INTERLEUKIN-6 TRANS-SIGNALING SYSTEM IN INTRA-AMNIOTIC INFLAMMATION, PRETERM BIRTH AND PRETERM PREMATURE RUPTURE OF THE MEMBRANES

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    Lee, Sarah Y.; Buhimschi, Irina A.; Dulay, Antonette T.; Ali, Unzila A.; Zhao, Guomao; Abdel-Razeq, Sonya S.; Bahtiyar, Mert O.; Thung, Stephen F.; Funai, Edmund F.; Buhimschi, Catalin S.

    2013-01-01

    Classic IL-6 signaling is conditioned by the transmembrane receptor (IL-6R) and homodimerization of gp130. During trans-signaling, IL-6 binds to soluble IL-6R (sIL-6R) enabling activation of cells expressing solely gp130. Soluble gp130 (sgp130) selectively inhibits IL-6 trans-signaling. To characterize amniotic fluid IL-6 trans-signaling molecules (IL-6, sIL-6R, sgp130) in normal gestations and pregnancies complicated by intra-amniotic inflammation (IAI) we studied 301 women during second trimester (n=39), third trimester (n=40) and preterm labor with intact (n=131, 85 IAI negative & 46 IAI positive) or preterm premature rupture of membranes (PPROM: n=91, 61 IAI negative & 30 IAI positive). ELISA, Western blotting and RT-PCR were used to investigate amniotic fluid, placenta and amniochorion for protein and mRNA expression of sIL-6R, sgp130, IL-6R and gp130. Tissues were immunostained for IL-6R, gp130, CD15+ (polymorphonuclear) and CD3+ (T-cell) inflammatory cells. The ability of sIL-6R and sgp130 to modulate basal and LPS-stimulated release of amniochorion matrix-metalloprotease-9 (MMP-9) was tested ex-vivo. We showed that in physiologic gestations amniotic fluid sgp130 decreases toward term. Amniotic fluid IL-6 and sIL-6R were elevated in IAI whereas sgp130 was decreased in PPROM. Our results suggested that fetal membranes are the probable source of amniotic fluid sIL-6R and sgp130. Immunohistochemistry and RT-PCR revealed increased IL-6R and decreased gp130 expression in amniochorion of women with IAI. Ex-vivo, sIL-6R and LPS augmented amniochorion MMP-9 release whereas sgp130 opposed this effect. We conclude that IL-6 trans-signaling molecules are physiologic constituents of the amniotic fluid regulated by gestational age and inflammation. PPROM likely involves functional loss of sgp130. PMID:21282511

  14. Allogeneic amniotic membrane-derived mesenchymal stromal cell transplantation in a porcine model of chronic myocardial ischemia

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    Kimura M

    2012-01-01

    Full Text Available Introduction. Amniotic membrane contains a multipotential stem cell population and is expected to possess the machinery to regulate immunological reactions. We investigated the safety and efficacy of allogeneic amniotic membrane-derived mesenchymal stromal cell (AMSC transplantation in a porcine model of chronic myocardial ischemia as a preclinical trial. Methods. Porcine AMSCs were isolated from amniotic membranes obtained by cesarean section just before delivery and were cultured to increase their numbers before transplantation. Chronic myocardial ischemia was induced by implantation of an ameroid constrictor around the left circumflex coronary artery. Four weeks after ischemia induction, nine swine were assigned to undergo either allogeneic AMSC transplantation or normal saline injection. Functional analysis was performed by echocardiography, and histological examinations were carried out by immunohistochemistry 4 weeks after AMSC transplantation. Results. Echocardiography demonstrated that left ventricular ejection fraction was significantly improved and left ventricular dilatation was well attenuated 4 weeks after AMSC transplantation. Histological assessment showed a significant reduction in percentage of fibrosis in the AMSC transplantation group. Injected allogeneic green fluorescent protein (GFP-expressing AMSCs were identified in the immunocompetent host heart without the use of any immunosuppressants 4 weeks after transplantation. Immunohistochemistry revealed that GFP colocalized with cardiac troponin T and cardiac troponin I. Conclusions. We have demonstrated that allogeneic AMSC transplantation produced histological and functional improvement in the impaired myocardium in a porcine model of chronic myocardial ischemia. The transplanted allogeneic AMSCs survived without the use of any immunosuppressants and gained cardiac phenotype through either their transdifferentiation or cell fusion.

  15. Histological chorioamnionitis in preterm prelabor rupture of the membranes is associated with increased expression of galectin-3 by amniotic epithelium.

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    Stefanoska, Ivana; Tadić, Jasmina; Vilotić, Aleksandra; Jovanović Krivokuća, Milica; Abu Rabi, Tamara; Vićovac, Ljiljana

    2017-09-01

    Gal-3, which can regulate immune responses upon infection and inflammation, was not studied so far in intrauterine infection leading to preterm prelabor rupture of the membranes (PPROM), although gal-1 was reported to be implicated in the process. Gal-3 mRNA and protein expression in amnion and its changes during histological chorioamnionitis were studied here. Fetal membranes were obtained from women with PPROM with (n =15) and without histological chorioamnionitis (n =15) during second and third trimester. Immunohistochemical reactivity was evaluated semiquantitatively and analyzed using t-test. Galectin profile of amniotic epithelia was determined by polymerase chain reaction (PCR) and change assessed in gal-3 in PPROM with (n =5) or without histological chorioamnionitis (n =5) by real-time PCR. Human amniotic epithelium was found to express gal-1, gal-3, gal-7 and gal-8 mRNA. Gal-3 mRNA and protein is increased in fetal membranes and in the amniotic epithelium in patients with chorionamnionitis. Histological chorioamnionitis is associated with increased gal-3 expression and strong immunoreactivity of the amnion. Gal-3 may participate in the regulation of the inflammatory responses to chorioamniotic infection and/or direct interaction with pathogens.

  16. Human umbilical cord mesenchymal stem cell-loaded amniotic membrane for the repair of radial nerve injury.

    Science.gov (United States)

    Li, Zhi; Qin, Hanjiao; Feng, Zishan; Liu, Wei; Zhou, Ye; Yang, Lifeng; Zhao, Wei; Li, Youjun

    2013-12-25

    In this study, we loaded human umbilical cord mesenchymal stem cells onto human amniotic membrane with epithelial cells to prepare nerve conduits, i.e., a relatively closed nerve regeneration chamber. After neurolysis, the injured radial nerve was enwrapped with the prepared nerve conduit, which was fixed to the epineurium by sutures, with the cell on the inner surface of the conduit. Simultaneously, a 1.0 mL aliquot of human umbilical cord mesenchymal stem cell suspension was injected into the distal and proximal ends of the injured radial nerve with 1.0 cm intervals. A total of 1.75 × 10(7) cells were seeded on the amniotic membrane. In the control group, patients received only neurolysis. At 12 weeks after cell transplantation, more than 80% of patients exhibited obvious improvements in muscular strength, and touch and pain sensations. In contrast, these improvements were observed only in 55-65% of control patients. At 8 and 12 weeks, muscular electrophysiological function in the region dominated by the injured radial nerve was significantly better in the transplantation group than the control group. After cell transplantation, no immunological rejections were observed. These findings suggest that human umbilical cord mesenchymal stem cell-loaded amniotic membrane can be used for the repair of radial nerve injury.

  17. Human umbilical cord mesenchymal stem cell-loaded amniotic membrane for the repair of radial nerve injury

    Science.gov (United States)

    Li, Zhi; Qin, Hanjiao; Feng, Zishan; Liu, Wei; Zhou, Ye; Yang, Lifeng; Zhao, Wei; Li, Youjun

    2013-01-01

    In this study, we loaded human umbilical cord mesenchymal stem cells onto human amniotic membrane with epithelial cells to prepare nerve conduits, i.e., a relatively closed nerve regeneration chamber. After neurolysis, the injured radial nerve was enwrapped with the prepared nerve conduit, which was fixed to the epineurium by sutures, with the cell on the inner surface of the conduit. Simultaneously, a 1.0 mL aliquot of human umbilical cord mesenchymal stem cell suspension was injected into the distal and proximal ends of the injured radial nerve with 1.0 cm intervals. A total of 1.75 × 107 cells were seeded on the amniotic membrane. In the control group, patients received only neurolysis. At 12 weeks after cell transplantation, more than 80% of patients exhibited obvious improvements in muscular strength, and touch and pain sensations. In contrast, these improvements were observed only in 55–65% of control patients. At 8 and 12 weeks, muscular electrophysiological function in the region dominated by the injured radial nerve was significantly better in the transplantation group than the control group. After cell transplantation, no immunological rejections were observed. These findings suggest that human umbilical cord mesenchymal stem cell-loaded amniotic membrane can be used for the repair of radial nerve injury. PMID:25206667

  18. Combined Excimer Laser Photoablation and Amniotic Membrane Overlay for Relief of Symptomatic Discomfort in Gelatinous Drop-like Corneal Dystrophy.

    Science.gov (United States)

    Alex, Anne F; Eter, Nicole; Uhlig, Constantin E

    2015-10-01

    To describe the efficacy of combined excimer laser photoablation and amniotic overlay membrane in the relief of symptomatic discomfort in a 17-year-old patient who had gelatinous drop-like corneal dystrophy. The best-corrected visual acuity (BCVA) was measured with Snellen letters. Slit-lamp examination of the ocular surface and anterior chamber was performed at baseline. Results were photodocumented. Excimer laser photoablation was performed and subsequently 2 amniotic membranes were transconjunctivally fixated with 10.0 nylon sutures. Investigations and documentation were performed at baseline, every 2 months in the first year, and then every 6 months. The duration of follow-up was 22 months. At baseline, the BCVA was 20/70 in the right eye and 20/200 in the left eye. The patient reported distinct photophobia. Slit-lamp examination was difficult because of blepharospasm. Although gelatinous drops developed again and the BCVA decreased to 2/200, the patient reported significant relief after both microsurgical treatments and remained comfortable at 20 and 22 months. Excimer laser photocoagulation combined with amniotic membrane overlay does not stop the development of gelatinous drop-like corneal dystrophy but may improve subjective comfort. Such treatment does not hinder subsequent lamellar or penetrating grafts and is helpful in providing the necessary time for preparation of matched keratoplasties.

  19. Application of Allogeneic Fibroblast Cultured on Acellular Amniotic Membrane for Full-thickness Wound Healing in Rats.

    Science.gov (United States)

    Mahmoudi Rad, Mahnaz; Talebpour Amiri, Fereshteh; Mirhoseini, Mehri; Ghasemi, Maryam; Mirzaei, Mansooreh; Mosaffa, Nariman

    2016-01-01

    Utilization of the autologous and allogeneic skin substitutes seems to be a promising treatment option. In this study, the authors used amniotic membrane covered with cultured allogenic fibroblast as a skin substitute in the treatment of acute wounds. Full-thickness wounds were created on rats' dorsum regions and treated with cultured allogenic fibroblast on an acellular amniotic membrane (AAM+F), an acellular amniotic membrane (AAM) alone, an allogenic fibroblast suspension (AFS), or normal saline as a control (C). Specimen biopsies were obtained 7 days after wounding. Quantitative wound healing parameters including the epidermal thickness, the mean number of keratinocytes, fibroblasts, and lymphocytes were assessed. All transplanted wounds exhibited significantly further contraction compared with the nontransplanted wounds. Wounds transplanted with AAM+F and AAM showed a significant increase in epidermal thickness compared to nontransplanted wounds. Wounds transplanted with AAM+F or AAM showed improved epidermal healing compared to nongrafted wounds. Furthermore, granulation of tissue formation in the AAM+F group was more organized when compared to AFS and the normal saline groups. Quantitative assessment of the full-thickness wounds showed transplantation of AAM+F and AAM better improve wound healing parameters when compared to treatment with AFS and the normal saline groups.

  20. Hyperdry amniotic membrane as a suitable biological dressing material for raw wounds in the oral cavity

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    Makoto Noguchi

    2016-06-01

    Full Text Available Raw wounds in the oral cavity are prone not only to infection but also contraction by scaring and often need a proper dressing to prevent these complications. Autografts using free mucosal and split-skin grafts, which seem biologically ideal, have been used to cover raw wounds in the oral cavity. Those grafts, however, require a separate surgical procedure at donor sites and often cause morbidity associated with delayed healing of the donor site. The amnion has been considered a suitable tissue for allografts, based on its low immunogenicity. It also possesses anti-inflammatory, would –protecting, and scar-reducing properties. Preserved amnions have been used for decades in various clinical fields.  However, there have been some problems in the storage and sterilization of the material. To resolve these problems, we developed hyperdry amniotic membrane (HAM, which can be stored at room temperature for a long period. In my lecture, I will share our clinical experiences of applying HAM into oral surgery, including results of experimental studies on would healing of the oral cavity.

  1. Dried Human Amniotic Membrane Does Not Alleviate Inflammation and Fibrosis in Experimental Strabismus Surgery

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    Bo Young Chun

    2013-01-01

    Full Text Available Purpose. The purpose of this study was to evaluate the efficacy of dried human amniotic membrane (AM in reducing the postoperative inflammatory response and scarring after strabismus surgery. Methods. The inflammatory response at the extraocular muscle reattachment site was analyzed after superior rectus (SR resection in 12 rabbits. Dried human AM (Ambiodry2 was applied between the resected SR muscle plane and Tenon’s capsule of the left eyes of rabbits. As a control, the right eyes of rabbits underwent SR resection only. The surgeon randomly ordered which eye gets operated first during the experiment. Two weeks later, enucleation was performed. Six sagittal sections were made for each eye at the insertion of the SR muscle. The grade of postoperative inflammation and the presence of fibrosis were evaluated in histological examinations. Results. There was no statistically significant difference in the intensity of inflammation and fibrous proliferation between the eyes treated with dried human AM after SR resection and those treated with SR resection only. Conclusions. The use of dried human AM was not effective in controlling the postoperative inflammation and scarring in rabbit eyes after extraocular muscle surgery. However, this may be due to the devitalized dry preparation of human AM (Ambiodry2, which may have lost the expected anti-inflammatory and anti-scarring properties, and further studies on humans may be necessary.

  2. Amniotic membrane extract ameliorates benzalkonium chloride-induced dry eye in a murine model.

    Science.gov (United States)

    Xiao, Xinye; Luo, Pingping; Zhao, Hui; Chen, Jingyao; He, Hui; Xu, Yuxue; Lin, Zhirong; Zhou, Yueping; Xu, Jianjiang; Liu, Zuguo

    2013-10-01

    Human amniotic membrane (AM) is avascular but contains various beneficial bioactive factors, its extract (AE) is also effective in treating many ocular surface disorders. In this study, we for the first time evaluated the therapeutic effects of AE on dry eye induced by benzalkonium chloride in a BALB/c mouse model. Topical application of AE (1.5 and 3 μg/eye/day) resulted in significantly longer tear break-up time on Day 3 and 6, lower fluorescein staining scores on Day 3, and lower inflammatory index on Day 6. AE reduced corneal epithelial K10 expression, inflammatory infiltration, and levels of TNF-α, IL-1β and IL-6 in BAC treated mice than that in the control mice. Moreover, decreased TUNEL positive cells in cornea and increased goblet cells in conjunctiva were also observed in AE treated corneas. Finally, AE induced more Ki-67 positive cells in corneal epithelium of dry eye mouse. Taken together, our data provide further support for BAC induced dry eye model as a valuable for dry eye study and suggest a great potential for AE as a therapeutic agent in the clinical treatment of dry eye. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

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    Ting Zhang

    2016-01-01

    Full Text Available Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT. Results. The primary diseases were herpes simplex keratitis (8 eyes, corneal graft ulcer (2 eyes, and Stevens-Johnson syndrome (1 eye. All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8±3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P=0.001. A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.

  4. Epithelial wound healing on keratin film, amniotic membrane and polystyrene in vitro.

    Science.gov (United States)

    Feng, Yaqing; Borrelli, Maria; Meyer-Ter-Vehn, Tobias; Reichl, Stephan; Schrader, Stefan; Geerling, Gerd

    2014-06-01

    Corneal epithelial wound healing is a major issue in ocular surface (OS) reconstruction. Aim of this study was to evaluate parameters of epithelial wound healing in vitro on transparent keratin films (KFs) derived from human hair in comparison with amniotic membrane (AM) and polystyrene. The human corneal epithelial cell line (HCE-T) was expanded on KF, AM and commercially available 24-well polystyrene cell culture plates in vitro to compare cell proliferation, migration and attachment by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, scratch-wound healing and adhesion assay. Cells cultured on KF and AM at an air-liquid interface for 14 d were stained with hematoxylin and eosin for histology. The highest proliferation of HCE-T cells was observed on polystyrene at all time points (p polystyrene at all time points (p polystyrene and KF (p = 0.032 and p = 0.001). No significant difference in cell attachment was observed between KF and polystyrene (p = 0.147). Histology demonstrated that HCE-T cells cultured on KF and AM at an air-liquid interface for 14 d form a multilayered epithelium similar to normal human corneal epithelium. Transparent KFs derived from human hair support proliferation, migration, adhesion and differentiation of HCE-T cells in vitro. Therefore, it could be a promising alternative to AM for OS reconstruction.

  5. Clinical observation of cryotherapy and amniotic membrane transplantation in the management of Fusarium corneal ulcer

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    Qiong Xie

    2014-10-01

    Full Text Available AIM:To examine the efficacy and safety of cryotherapy in the management of Fusarium corneal ulcer. METHODS: Retrospective contract analysis of the clinical data of 41 patients(41 eyeswho infected with Fusarium corneal ulcer. All of them underwent focal lesion keratectomy combined with amniotic membrane transplantation between January 2010 and May 2013. The cryotherapy treatment group of 22 cases(22 eyes, non-cryotherapy group of 19 cases(19 eyes. All the cases were followed up for 3~12mo. We analyzed the healing of corneal ulcer, corneal neovascularization, postoperative visual acuity, complications and ulcer recurrences. RESULTS: There were no significant difference for the two groups at the cure rate and the recovery rate, the corneal neovascularization and postoperative visual acuity(P>0.05. The total effective rate and corneal healing time in cryotherapy group was significantly higher than that in non-cryotherapy group(PPCONCLUSION: Cryotherapy is an effective and safe method for the treatment of Fusarium corneal ulcer.

  6. Cultured allogeneic fibroblast injection versus fibroblasts cultured on amniotic membrane scaffold for dystrophic epidermolysis bullosa treatment.

    Science.gov (United States)

    Moravvej, H; Abdollahimajd, F; Naseh, M-H; Piravar, Z; Abolhasani, E; Mozafari, N; Niknejad, H

    2018-01-12

    Different methods of fibroblast application have been examined to treat recessive dystrophic epidermolysis bullosa (RDEB). To compare the effects of intradermal injection of cultured allogeneic fibroblasts in healing RDEB wounds with that of fibroblasts seeded on amniotic membrane scaffolds (FAMS) or standard wound care (SWC) with Vaseline gauze as controls. Seven patients were recruited, and seven wounds were assessed in each patient: three wounds were treated with injection of intradermal fibroblasts, three were treated with FAMS, and one was dressed with SWC. Changes in wound size were assessed after 2 and 12 weeks of treatment. Qualitative wound scores (QWS) were used to assess wound severity. Additionally, biopsies and antigen mapping were performed to detect type-VII collagen in the dermoepidermal junction. In both treated areas, the QWS and wound size were significantly decreased (Pfibroblast injection compared with those treated with FAMS (PFibroblast injection has been shown to promote healing of RDEB wounds and is superior to FAMS or the control treatment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Comparison of trabeculectomy and trabeculectomy with amniotic membrane transplantation in the same patient with bilateral glaucoma

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    Qing-Shan Ji

    2013-08-01

    Full Text Available AIM: To observe effects of trabeculectomy with amniotic membrane transplantation (AMT in controlling postoperative intraocular pressure (IOP in patients with medically uncontrolled glaucoma.METHODS:This study included adult patients with requiring bilateral glaucoma surgery. Each patient underwent trabeculectomy (Non-AMT group in one eye and with AMT (AMT group in the other eye according to randomized principle. Success was defined as intraocular pressure (IOPRESULTS: Thirty-four eyes of 17 patients were investigated in this study. There was no statistically signifcant difference in pre-operative IOP between the two groups. The mean IOP was lower in AMT group compared with Non-AMT group on follow up months 12, 18, and 24.Postoperative complications were more frequent in Non-AMT group (35.3%, 6/17 compared with AMT group (5.9%, 1/17. The success rate of surgery was 88.2% (15/17 in Non-AMT group and 100% (17/17 in AMT group.CONCLUSION: Trabeculectomy with AMT is an effective procedure to reduce IOP and complications, thereby improving surgical success rates.

  8. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers.

    Science.gov (United States)

    Zhang, Ting; Wang, Yuexin; Jia, Yanni; Liu, Dongle; Li, Suxia; Shi, Weiyun; Gao, Hua

    2016-01-01

    Introduction . The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers. Material and Methods . Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT). Results . The primary diseases were herpes simplex keratitis (8 eyes), corneal graft ulcer (2 eyes), and Stevens-Johnson syndrome (1 eye). All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8 ± 3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR ( P = 0.001). A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion . Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.

  9. Nukbone® promotes proliferation and osteoblastic differentiation of mesenchymal stem cells from human amniotic membrane

    Energy Technology Data Exchange (ETDEWEB)

    Rodríguez-Fuentes, Nayeli; Rodríguez-Hernández, Ana G. [Depto. Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510 (Mexico); Enríquez-Jiménez, Juana [Depto. Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), México City 14000 (Mexico); Alcántara-Quintana, Luz E. [Subd. de Investigación, Centro Nacional de la Transfusión Sanguínea, Secretaria de Salud, Mexico City 07370 (Mexico); Fuentes-Mera, Lizeth [Depto. Biología Molecular e Histocompatibilidad, Hospital General “Dr. Manuel Gea González”, México City 4800 (Mexico); Piña-Barba, María C. [Depto. Materiales Metálicos y Cerámicos, Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México (UNAM), México City 04510 (Mexico); Zepeda-Rodríguez, Armando [Depto. Biología Celular y Tisular, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), México City 04510 (Mexico); and others

    2013-05-10

    Highlights: •Nukbone showed to be a good scaffold for adhesion, proliferation and differentiation of stem cells. •Nukbone induced osteoblastic differentiation of human mesenchymal stem cells. •Results showed that Nukbone offer an excellent option for bone tissue regeneration due to properties. -- Abstract: Bovine bone matrix Nukbone® (NKB) is an osseous tissue-engineering biomaterial that retains its mineral and organic phases and its natural bone topography and has been used as a xenoimplant for bone regeneration in clinics. There are not studies regarding its influence of the NKB in the behavior of cells during the repairing processes. The aim of this research is to demonstrate that NKB has an osteoinductive effect in human mesenchymal stem cells from amniotic membrane (AM-hMSCs). Results indicated that NKB favors the AM-hMSCs adhesion and proliferation up to 7 days in culture as shown by the scanning electron microscopy and proliferation measures using an alamarBlue assay. Furthermore, as demonstrated by reverse transcriptase polymerase chain reaction, it was detected that two gene expression markers of osteoblastic differentiation: the core binding factor and osteocalcin were higher for AM-hMSCs co-cultured with NKB in comparison with cultivated cells in absence of the biomaterial. As the results indicate, NKB possess the capability for inducing successfully the osteoblastic differentiation of AM-hMSC, so that, NKB is an excellent xenoimplant option for repairing bone tissue defects.

  10. Cryopreservation of human limbal stem cells ex vivo expanded on amniotic membrane.

    Science.gov (United States)

    Yeh, Hui-Jung; Yao, Chao-Ling; Chen, Hsin-I; Cheng, Huey-Chuan; Hwang, Shiaw-Min

    2008-04-01

    After cornea transplantation, the donor's limbal zone is currently discarded as medical waste. However, the limbal zone is rich in limbal stem cells and can be used in therapeutic applications of limbus loss. This study aimed to increase the availability of limbal stem cells and develop the optimal conditions of cryopreservation for ex vivo expanded limbal stem cells. Pieces of the limbus were cultured on amniotic membrane (AM) to outgrow limbal stem cells as cell sheets for 3 weeks. Different formulas of cryoprotectants were tested to preserve the expanded cell sheets in liquid nitrogen. Before and after cryopreservation, expanded cell sheets were assessed for cellular characteristics by viability, histologic examination, and expression of ABCG2, vimentin, and keratin 3. Expanded cell sheets usually exhibited 3-6 stratified layers after 3-week culture on AM and expressed specific markers of ABCG2 and vimentin for limbal stem cells. The effects of cryopreservation with different cryoprotectants were analyzed by histopathology, stem cell markers, and cell viability. The results showed that the optimal formula of cryoprotectants for expanded limbal cell sheets was 60% Dulbecco modified Eagle medium, 30% fetal bovine serum, and 10% dimethyl sulfoxide. After 8-week cryopreservation in liquid nitrogen, the characteristics of limbal stem cells were maintained, and the average viability of thawed cells was 53.8% +/- 5.8%. These results showed that limbal stem cells expanded on AM could be cryopreserved and provide a promising source without delay, if banking, for patients with limbal stem cell deficiency in the future.

  11. Augmented dried versus cryopreserved amniotic membrane as an ocular surface dressing.

    Directory of Open Access Journals (Sweden)

    Claire L Allen

    Full Text Available Dried amniotic membrane (AM can be a useful therapeutic adjunct in ophthalmic surgery and possesses logistical advantages over cryopreserved AM. Differences in preservation techniques can significantly influence the biochemical composition and physical properties of AM, potentially affecting clinical efficacy. This study was established to investigate the biochemical and structural effects of drying AM in the absence and presence of saccharide lyoprotectants and its biocompatibility compared to cryopreserved material.AM was cryopreserved or dried with and without pre-treatment with trehalose or raffinose and the antioxidant epigallocatechin (EGCG. Structural and visual comparisons were assessed using electron microscopy. Localisation, expression and release of AM biological factors were determined using immunoassays and immunofluorescence. The biocompatibility of the AM preparations co-cultured with corneal epithelial cell (CEC or keratocyte monolayers were assessed using cell proliferation, cytotoxicity, apoptosis and migration assays.Drying devitalised AM epithelium, but less than cryopreservation and cellular damage was reduced in dried AM pre-treated with trehalose or raffinose. Dried AM alone, and with trehalose or raffinose showed greater factor retention efficiencies and bioavailability compared to cryopreserved AM and demonstrated a more sustained biochemical factor time release in vitro. Cellular health assays showed that dried AM with trehalose or raffinose are compatible and superior substrates compared to cryopreserved AM for primary CEC expansion, with increased proliferation and reduced LDH and caspase-3 levels. This concept was supported by improved wound healing in an immortalised human CEC line (hiCEC co-cultured with dried and trehalose or raffinose membranes, compared to cryopreserved and fresh AM.Our modified preservation process and our resultant optimised dried AM has enhanced structural properties and biochemical stability

  12. Tissue transglutaminase (TG-2) modified amniotic membrane: a novel scaffold for biomedical applications

    International Nuclear Information System (INIS)

    Chau, David Y S; Brown, Sheridan V; Ghaemmaghami, Amir M; Mather, Melissa L; Hutter, Victoria; Tint, Naing L; Rose, Felicity R A J; Dua, Harminder S

    2012-01-01

    The amniotic membrane (AM) is considered as a natural cell culture substrate and has occasionally been exploited in regenerative medicine especially for ocular surface reconstruction and dermal wound healing applications. However, its use is limited by its relatively weak mechanical strength, difficulty during manual handling and susceptibility to proteolytic degradation in vivo. Therefore, in this study we aimed to enhance the mechanical and biological characteristics of the AM by enzymatically cross-linking it using tissue transglutaminase (TG)—a calcium-dependent enzyme capable of forming stable ε(γ-glutamyl)lysine cross-linkages. Using a biological catalyst such as TG does not only prevent denaturation during sample preparation but also minimizes the potential of residual chemical cross-linking agents compared to alternative methodologies. Human AM, sourced from elective caesarean sectioning, were treated with TG, bovine serum albumin and/or a no-treatment control. Samples were then compared in terms of their physical and (scanning electron microscopy (SEM), transparency, mechanical strength, susceptibility to proteolytic degradation) biological characteristics (in vitro cell culture, activation of dendritic cells (DC)) and their in vivo biocompatibility/angiogenic capacity (chick chorioallantoic membrane assay). TG-treated AM exhibited enhanced mechanical strength and greater resistance to proteolytic/collagenase degradation compared to the control(s). SEM imaging of the TG-treated membrane summarized a significantly closer association and greater interconnectivity of individual collagen fibres yet it had no effect on the overall transparency of the AM. In vitro cell culture demonstrated no detrimental effect of TG-treatment on the AM in terms of cell attachment, spreading, proliferation and differentiation. Moreover, an ‘immune response’ was not elicited based on extended in vitro culture with human-monocyte-derived DC. Interestingly, the TG

  13. Effects of ionizing radiation on glycerolated amniotic membranes as a substract for cultured human epithelium

    International Nuclear Information System (INIS)

    Paggiaro, Andre Oliveira

    2011-01-01

    The amniotic membrane (AM) is a biomaterial with biological properties that are beneficial to tissue repair. It has been used as a temporary coverage to threat burns and chronic wounds. Recently, it has been served as a substrate for keratinocytes culture to construct a living skin equivalent. However, MA is a biological material, and its transplantation could cause infectious disease for receptors. So, it must be preserved and sterilized before clinical use. The aim of this study was to evaluate the radiation effects on glycerol-preserved MA, considering its compatibility to support human keratinocytes culture. Four MA were stored in high concentrations of glycerol (> 85%) and half of them were radio sterilized with a dose of 25 kGy. Then, we established two groups: nonirradiated MA (MA-ni) and irradiated MA (MA-i). Both groups was deepithelialized by a standardized protocol and was investigated morphologically, immunohistochemical and ultrastructural. Subsequently human keratinocytes were cultivated immersed and in air-liquid interface on denuded surface of MA-i and MA-ni. The results were compared at 14 and 21 days of culture by light and electron microscopy. After epithelial denudation, analyses demonstrated the continuity of the basement membrane in MA-ni group, whereas in the irradiated group, there was no indication of the basement membrane’s presence on the surface of MA. The cell cultures showed that in the non-irradiated group, there was growth of a multi-layered and differentiated epithelium, with a stratum corneum’s formation in air-liquid interface. In the irradiated group, the epithelium had only two or three layer, little cell differentiation, with the same results immersed or air-liquid interface system. Glycerol-preserved MA was biocompatible with the growth of a cultivated epithelium, showing its potential as a skin substitute. Irradiation at 25 kGy cause structural damage to the tissue, making changes in basement membrane, that facilitates

  14. Survey of Pregnancy Outcome in Preterm Premature Rupture of Membranes with Amniotic Fluid Index <5 and ≥5

    Directory of Open Access Journals (Sweden)

    Fatemeh Tavassoli

    2010-04-01

    Full Text Available Objectives: Preterm premature rupture of membranes (PPROM is among the most important causes of perinatal morbidity and mortality. The aim of this study is to survey the pregnancy outcomes in preterm premature rupture of membranes with an amniotic fluid index of 5.Methods: This prospective cohort study was performed on 137 pregnant women complicated by preterm premature rupture of membranes (PPROM with a gestational age of 28-34 weeks during October 2006 to October 2008. The patients were divided in two groups according to their amniotic fluid index; AFI<5 (77cases, AFI≥5 (60cases. The Chi-squared test for qualitative variables and T-student test for quantitative variables were used to analyze the results.Results: The results showed that there was no significant difference in terms of the number of pregnancies, gestational age at rupture of membranes and birthweight between the two groups. However, the results demonstrated that the patients with AFI<5 exhibited a significantly shorter latency period (p=0.049, a higher rate of cesarean due to fetal distress (p=0.008, a lower neonatal Apgar score in the first minute (p=0.0127 and a higher rate of neonatal death during the first week (p=0.045.Conclusion: Overall, PPROM with oligohydroamnios is associated with shorter latency, higher rate of C/S, higher rate of early neonatal death and lower neonatal Apgar.

  15. Corneal regeneration by induced human buccal mucosa cultivated on an amniotic membrane following alkaline injury.

    Science.gov (United States)

    Man, Rohaina Che; Yong, Then Kong; Hwei, Ng Min; Halim, Wan Haslina Wan Abdul; Zahidin, Aida Zairani Mohd; Ramli, Roszalina; Saim, Aminuddin Bin; Idrus, Ruszymah Binti Hj

    2017-01-01

    Various clinical disorders and injuries, such as chemical, thermal, or mechanical injuries, may lead to corneal loss that results in blindness. PURPOSE : The aims of this study were to differentiate human buccal mucosa (BMuc) into corneal epithelial-like cells, to fabricate engineered corneal tissue using buccal mucosal epithelial cells, and to reconstruct a damaged corneal epithelium in a nude rat model. BMuc were subjected to 10 d of induction factors to investigate the potential of cells to differentiate into corneal lineages. Corneal stem cell markers β1-integrin, C/EBPδ, ABCG2, p63, and CK3 were upregulated in the gene expression analysis in induced BMuc, whereas CK3 and p63 showed significant protein expression in induced BMuc compared to the uninduced cells. BMuc were then left to reach 80% confluency after differential trypsinization. The cells were harvested and cultivated on a commercially available untreated air-dried amniotic membrane (AM) in a Transwell system in induction medium. The corneal constructs were fabricated and then implanted into damaged rat corneas for up to 8 weeks. A significant improvement was detected in the treatment group at 8 weeks post-implantation, as revealed by slit lamp biomicroscopy analysis. The structure and thickness of the corneal layer were also analyzed using histological staining and time-domain optical coherence tomography scans and were found to resemble a native corneal layer. The protein expression for CK3 and p63 were continuously detected throughout the corneal epithelial layer in the corneal construct. In conclusion, human BMuc can be induced to express a corneal epithelial-like phenotype. The addition of BMuc improves corneal clarity, prevents vascularization, increases corneal thickness and stromal alignment, and appears to have no adverse effect on the host after implantation.

  16. Failure of amniotic membrane transplantation in the treatment of acute ocular burns.

    Science.gov (United States)

    Joseph, A; Dua, H S; King, A J

    2001-09-01

    To report the failure of amniotic membrane transplantation (AMT) for ocular surface reconstruction in patients with severe acute chemical and thermal burns. Four eyes of three patients who suffered severe chemical (n=3) and thermal (n=1) burns were studied. The aim of AMT was to prevent symblepharon formation, promote conjunctival regeneration, inhibit corneal melting by promoting epithelialisation, and to protect the ocular surface while associated lid burns were treated. AMT was used to cover the entire ocular surface of all the severely burnt and ischaemic eyes, 2-3 weeks after the injury. Where indicated, AMT was repeated by itself or in combination with other procedures in all patients. Three of the four eyes developed symblepharon and progressive corneal melt requiring urgent tectonic keratoplasty. All four eyes had persistent epithelial defects. Less than 25% of conjunctival regeneration occurred in three eyes. Two eyes autoeviscerated, one patient underwent lid sparing exenteration for a painful blind eye and one eye became phthysical. AMT did not help to restore the ocular surface or preserve the integrity of the eye in all our patients with severe acute burns, when used by itself or in combination with other surgical procedures. This reflects the extreme severity of the ocular burns in these patients and, in turn, draws attention to the fact that the current classification system does not adequately reflect such severity. In the current system such burns would be grouped under grade IV injuries to the eye (more than 50% limbal ischaemia). The prognosis of patients with 100% limbal ischaemia is much worse than patients with just over 50% limbal ischaemia. This inadequacy of the classification system probably also explains the difference between outcomes of management of grade IV burns (with AMT) in this series, compared with others.

  17. Photo-cross-linking of amniotic membranes for limbal epithelial cell cultivation

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Jui-Yang, E-mail: jylai@mail.cgu.edu.tw

    2014-12-01

    In the present study, we developed photo-cross-linked amniotic membrane (AM) as a limbal stem cell niche. After ultraviolet (UV) irradiation for varying time periods, the biological tissues were studied by determinations of cross-linking structure, degradability, and nutrient permeation ability. Our results showed that the number of cross-links per unit mass of AM significantly increased with increasing illumination time from 5 to 50 min. However, the cross-link formation was inhibited by longer irradiation time (i.e., 150 min), probably due to the scission of tissue collagen chains through irradiation. The biological stability and matrix permeability of photo-cross-linked AM materials strongly depended on their cross-linking densities affected by the UV irradiation. In vitro biocompatibility studies including cell viability and pro-inflammatory gene expression analyses demonstrated that, irrespective of the irradiation time employed, the physically cross-linked biological tissues exhibited negligible cytotoxicity and similar interleukin-6 (IL-6) mRNA levels. The data clearly indicate that these AM matrices do not cause potential harm to the corneal epithelial cells. After the growth of limbal epithelial cells (LECs) on AM substrates, Western blot analyses were conducted to examine the expression of ABCG2. It was found that the ability of UV-irradiated AM to maintain the undifferentiated precursor cell phenotype was significantly enhanced with increasing extent of photo-cross-linking. In summary, the UV irradiation time may have a profound influence on the fabrication of photo-cross-linked AM matrices for LEC cultivation. - Highlights: • We report the development of photo-cross-linked AM as a limbal stem cell niche. • Cross-linked structure of tissue materials was controlled by UV irradiation time. • Biostability and matrix permeability of AM depended on cross-linking density. • All the studied photo-cross-linked AM showed good in vitro biocompatibility.

  18. Establishment of an untransfected human corneal epithelial cell line and its biocompatibility with denuded amniotic membrane.

    Science.gov (United States)

    Fan, Ting-Jun; Xu, Bin; Zhao, Jun; Yang, Hong-Shou; Wang, Rui-Xin; Hu, Xiu-Zhong

    2011-01-01

    To establish an untransfected human corneal epithelial (HCEP) cell line and characterize its biocompatibility with denuded amniotic membrane (dAM). The torn HCEP pieces were primarily cultured in DMEM/F12 media (pH 7.2) supplemented with 20% fetal bovine serum and other necessary factors, yielding an HCEP cell line which was its growth performance, chromosome morphology, tumorigenicity and expression of marker proteins analyzed. In addition, the biocompatibility of HCEP cells with dAM was evaluated through histological and immunocytochemistry analyses and with light, electron and slit-lamp microscopies. HCEP cells proliferated to confluence in 3 weeks, which have been subcultured to passage 160. A continuous untransfected HCEP cell line, designated as utHCEPC01, was established with a population doubling time of 45.42 hours as was determined at passage 100. The cells retained HCEP cell properties as were approved by chromosomal morphology and the expression of keratin 3. They, with no tumorigenicity, formed a multilayer epithelium-like structure on dAMs through proliferation and differentiation during air-liquid interface culture, maintained expression of marker proteins including keratin 3 and integrin β1 and attached tightly to dAMs. The reconstructed HCEP was highly transparent and morphologically and structurally similar to the original. An untransfected and non-tumorigenic HCEP cell line was established in this study. The cells maintained expression of marker proteins. The cell line was biocompatible with dAM. It holds the potential of being used for in vitro reconstruction of tissue-engineered HCEP, promising for the treatment of diseases caused by corneal epithelial disorders.

  19. Biomechanical assays amniotic membrane preserved in glycerol correlating with optical coherence tomography (OCT) and thermal gravimetric analysis (TG)

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Fernando Augusto N.; Santin, Stefany P.; Martino Junior, Antonio C.; Machado, Luci Diva B.; Freitas, Anderson Z.; Mathor, Monica B., E-mail: fernandonevessoares@yahoo.com.br [Instituto de Pesquisas Energetias Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    Amnion or amniotic membranes (AM) are interchangeable terms used in the literature being internal part of the fetal membranes, non-vascular and multicellular tissue. The amnion has been widely used as a graft ophthalmic surgical as well as carrier substrate stem cell tissue equivalent for ocular surface reconstruction. The AM reduces scar formation and inflammation on the ocular surface, promotes epithelization also been used as a biological bandage covering the wound or burns, reducing dehydration and allowing regeneration of these areas. The amnion has usually 0.02 to 0.5 mm thick and consists of five subsequent layers: epithelium, basement membrane, compact layer, fibroblast layer and spongy layer. The mechanical strength from the membrane structure as well as the elasticity are factors attractive to the use of amnion as a surgical graft. Higher levels of rigidity and strength may improve the graft resistance necessary to resist the stress induced during growth of the new tissue formed. The amniotic membrane is obtained at elective caesarean section and subsequently, under sterile conditions, sectioned and separated from chorion and placenta, and free blood clots. The serological tests are done at the time of collection of tissue and 6 months after delivery to confirm the results. There are different methods for storing MA in tissue banks as fresh, high concentrations of glycerol, among others. The use of fresh membrane has some limitations due to the need to rapid use and high risk of contamination, however the amniotic membrane in glycerol has antiviral and antibacterial property which is dependent on the concentration, time and temperature. The AM used in transplants must be sterile to prevent the transmission of any disease. Although sterilization by radiation is an effective procedure, it can interfere on the membrane structure. Thus, verification of potential changes caused by ionizing radiation in amnion was made using the tensile test by calculating the

  20. Biomechanical assays amniotic membrane preserved in glycerol correlating with optical coherence tomography (OCT) and thermal gravimetric analysis (TG)

    International Nuclear Information System (INIS)

    Soares, Fernando Augusto N.; Santin, Stefany P.; Martino Junior, Antonio C.; Machado, Luci Diva B.; Freitas, Anderson Z.; Mathor, Monica B.

    2013-01-01

    Amnion or amniotic membranes (AM) are interchangeable terms used in the literature being internal part of the fetal membranes, non-vascular and multicellular tissue. The amnion has been widely used as a graft ophthalmic surgical as well as carrier substrate stem cell tissue equivalent for ocular surface reconstruction. The AM reduces scar formation and inflammation on the ocular surface, promotes epithelization also been used as a biological bandage covering the wound or burns, reducing dehydration and allowing regeneration of these areas. The amnion has usually 0.02 to 0.5 mm thick and consists of five subsequent layers: epithelium, basement membrane, compact layer, fibroblast layer and spongy layer. The mechanical strength from the membrane structure as well as the elasticity are factors attractive to the use of amnion as a surgical graft. Higher levels of rigidity and strength may improve the graft resistance necessary to resist the stress induced during growth of the new tissue formed. The amniotic membrane is obtained at elective caesarean section and subsequently, under sterile conditions, sectioned and separated from chorion and placenta, and free blood clots. The serological tests are done at the time of collection of tissue and 6 months after delivery to confirm the results. There are different methods for storing MA in tissue banks as fresh, high concentrations of glycerol, among others. The use of fresh membrane has some limitations due to the need to rapid use and high risk of contamination, however the amniotic membrane in glycerol has antiviral and antibacterial property which is dependent on the concentration, time and temperature. The AM used in transplants must be sterile to prevent the transmission of any disease. Although sterilization by radiation is an effective procedure, it can interfere on the membrane structure. Thus, verification of potential changes caused by ionizing radiation in amnion was made using the tensile test by calculating the

  1. Noninvasive prediction of intra-amniotic infection and/or inflammation in preterm premature rupture of membranes.

    Science.gov (United States)

    Park, Kyo Hoon; Kim, Shi Nae; Oh, Kyung Joon; Lee, Sung Youn; Jeong, Eun Ha; Ryu, Aeli

    2012-06-01

    To develop a model based on noninvasive parameters to predict the probability of intra-amniotic infection and/or inflammation (IAI) in women with preterm premature rupture of membranes (PPROMs). Maternal blood was collected for determination of the C-reactive protein (CRP) level and white blood cell (WBC) count immediately after amniocentesis in 171 consecutive women with PPROMs. Intra-amniotic infection and/or inflammation was defined as a positive amniotic fluid (AF) culture and/or an elevated AF interleukin 6 level (≥2.6 ng/mL). A risk score based on a model including maternal blood CRP, WBC, parity, and gestational age was calculated for each patient. The model was shown to have an adequate goodness of fit (P = .516), and the area under the receiver-operating characteristic curve was 0.848, indicating very good discrimination. The noninvasive model based on maternal blood CRP, WBC, parity, and gestational age is highly predictive of IAI in women with PPROMs.

  2. Biocompatibility of quantum dots (CdSe/ZnS ) in human amniotic membrane-derived mesenchymal stem cells in vitro.

    Science.gov (United States)

    Wang, Gongping; Zeng, Guangwei; Wang, Caie; Wang, Huasheng; Yang, Bo; Guan, Fangxia; Li, Dongpeng; Feng, Xiaoshan

    2015-06-01

    Amniotic membrane-derived mesenchymal stem cells (hAM-dMSCs) are a potential source of mesenchymal stem cells which could be used to repair skin damage. The use of mesenchymal stem cells to repair skin damage requires safe, effective and biocompatible agents to evaluate the effectiveness of the result. Quantum dots (QDs) composed of CdSe/ZnS are semiconductor nanocrystals with broad excitation and narrow emission spectra, which have been considered as a new chemical and fluorescent substance for non-invasively labeling different cells in vitro and in vivo. This study investigated the cytotoxic effects of QDs on hAM-dMSCs at different times following labeling. Using 0.75, 1.5 and 3.0 μL between quantum dots, labeled human amniotic mesenchymal stem cells were collected on days 1, 2 and 4 and observed morphological changes, performed an MTT cell growth assay and flow cytometry for mesenchymal stem cells molecular markers. Quantum dot concentration 0.75 μg/mL labeled under a fluorescence microscope, cell morphology was observed, The MTT assay showed cells in the proliferative phase. Flow cytometry expression CD29, CD31, CD34, CD44, CD90, CD105 and CD106. Within a certain range of concentrations between quantum dots labeled human amniotic mesenchymal stem cells has good biocompatibility.

  3. Value of amniotic fluid IL-8 and Annexin A2 in prediction of preterm delivery in preterm labor and preterm premature rupture of membranes.

    Science.gov (United States)

    Jia, Xiaohui

    2014-01-01

    To investigate the clinical significance and value in the prediction of preterm delivery of combined amniotic fluid IL-8 and Annexin A2 levels in preterm premature rupture of membranes (PPROM) and preterm labor (PTL). Sixty pregnant women at < 32 gestational weeks who developed PTL were divided into a PPROM group and a non-PPROM group. Ten normal pregnant women served as a control group. IL-8 and Annexin A2 levels were measured in amniotic fluid samples from each patient. Amniotic fluid IL-8 and Annexin-A2 levels in PTL (PPROM and non-PPROM groups) were significantly higher than those of the controls (p < 0.05). The PPROM group displayed higher amniotic fluid Annexin-A2 levels than did the non-PPROM group, with a statistically significant difference (p < 0.05). The PPROM group showed higher amniotic fluid IL-8 levels than did the non-PPROM group; however, this was statistically insignificant (p = 0.56). Combined detection of amniotic fluid IL-8 and Annexin-A2 in the prediction of preterm delivery within 2 weeks of measurement showed sensitivity of 81.25%, specificity of 88.89% and PPV of 92.86%. Amniotic fluid IL-8 and Annexin-A2 levels are associated with the occurrence of PPROM and PTL. Combined detection of IL-8 and Annexin-A2 levels in identifying preterm delivery within 2 weeks in PTL and PPROM is of possible clinical and predictive value.

  4. Human Amniotic Membrane-Derived Products in Sports Medicine: Basic Science, Early Results, and Potential Clinical Applications.

    Science.gov (United States)

    Riboh, Jonathan C; Saltzman, Bryan M; Yanke, Adam B; Cole, Brian J

    2016-09-01

    Amniotic membrane (AM)-derived products have been successfully used in ophthalmology, plastic surgery, and wound care, but little is known about their potential applications in orthopaedic sports medicine. To provide an updated review of the basic science and preclinical and clinical data supporting the use of AM-derived products and to review their current applications in sports medicine. Systematic review. A systematic search of the literature was conducted using the Medline, EMBASE, and Cochrane databases. The search term amniotic membrane was used alone and in conjunction with stem cell, orthopaedic, tissue engineering, scaffold, and sports medicine. The search identified 6870 articles, 80 of which, after screening of the titles and abstracts, were considered relevant to this study. Fifty-five articles described the anatomy, basic science, and nonorthopaedic applications of AM-derived products. Twenty-five articles described preclinical and clinical trials of AM-derived products for orthopaedic sports medicine. Because the level of evidence obtained from this search was not adequate for systematic review or meta-analysis, a current concepts review on the anatomy, physiology, and clinical uses of AM-derived products is presented. Amniotic membranes have many promising applications in sports medicine. They are a source of pluripotent cells, highly organized collagen, antifibrotic and anti-inflammatory cytokines, immunomodulators, and matrix proteins. These properties may make it beneficial when applied as tissue engineering scaffolds, improving tissue organization in healing, and treatment of the arthritic joint. The current body of evidence in sports medicine is heavily biased toward in vitro and animal studies, with little to no human clinical data. Nonetheless, 14 companies or distributors offer commercial AM products. The preparation and formulation of these products alter their biological and mechanical properties, and a thorough understanding of these

  5. Comparative Study of Pregnancy Outcome in Premature Rupture of Membranes With Amniotic Fluid Indices of less and more than 5

    Directory of Open Access Journals (Sweden)

    F Tavassoli

    2010-03-01

    Full Text Available Introduction: Preterm premature rupture of the membranes (PPROM is one of the most important causes of perinatal morbidity and mortality. The aim of this study was to evaluate pregnancy outcome in preterm premature rupture of the membranes with amniotic fluid index less than 5 and more than 5. Methods: This prospective study was performed on 137 pregnant women with gestational age of 28-34 weeks with PPROM from Oct 2006 to Oct 2008. The patients were divided in two groups according to amniotic fluid index: AFI<5 (77 cases, AFI≥5 (60 cases. Chi-square test was used for qualitative variables, while T-student test was used for quantitative test. Results: Both groups were similar with respect to number of pregnancies, gestational age at rupture of the membranes and birth weight. In the group with AFI<5, applied latency was significantly shorter (PV=0.049, rate of cesarean section was higher due to fetal distress (PV=0.008, neonatal Apgar score in first minute was lower during the first week (PV=0.0127 and the rate of neonatal death was higher (PV=0.045 during the first week. Conclusion: An AFI<5 cm after PPROM is associated with earlier delivery, higher rate of cesarean due to fetal distress, higher rate of neonatal death, and lower neonatal Apgar score in first minute during the first week

  6. Amniotic Fluid Glucose Concentration: A Marker for Infection in Preterm Labor and Preterm Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    Gary A. Dildy

    1994-01-01

    Full Text Available Amniotic fluid Gram stain and culture have been utilized as laboratory tests of microbial invasion of the amniotic cavity. The Gram stain of amniotic fluid has a low sensitivity in the detection of clinical infection or microbial invasion of the amniotic cavity, and amniotic fluid culture results are not immediately available for management decisions. Glucose concentration is used to diagnose infection in other sites such as cerebrospinal fluid.

  7. The use of amniotic membrane/umbilical cord in first metatarsophalangeal joint cheilectomy: a comparative bilateral case study.

    Science.gov (United States)

    Ellington, John Kent; Ferguson, Chad M

    2014-11-01

    Hallux rigidus is marked by degenerative osteoarthritis of the first metatarsophalangeal (MTP) joint with pain and stiffness in the joint, with first ray plantarflexion and dorsiflexion, swelling and inflammation surrounding the first MTP joint, and reduced sagittal plane motion. Treatment of mild cases of hallux rigidus focuses on conservative, nonsurgical treatments such as rigid orthotic devices, physical therapy, pain relievers, and corticosteroid injections. Hallux rigidus recalcitrant to conservative management can be treated with dorsal cheilectomy to palliate pain at extremes of motion. Post-cheilectomy scarring and stiffness of the joint result in a diminished arc of motion over time. This clinical problem is not readily addressed by current treatment methods. Amniotic membrane/umbilical cord has the potential to modulate adult wound healing by suppressing stromal cellular-based inflammation and reducing scarring. Cryopreserved amniotic membrane/umbilical cord (AM/UC) tissue has been successfully used for minimizing postoperative inflammation, pain, and adhesion formation following various soft tissue reconstructive procedures, particularly in ophthalmology. Recently, the therapeutic potential of cryopreserved AM/UC has been expanded for use in lower extremity reconstructive procedures, specifically where wound healing and adhesion prevention are of clinical significance. This article reviews a bilateral case report experience of the novel utility of cryopreserved AM/UC tissue as an adhesion barrier and inflammatory modulator in conjunction with dorsal cheilectomy for treatment of hallux rigidus.

  8. Transplantation with cultured stem cells derived from the human amniotic membrane for corneal alkali burns: an experimental study.

    Science.gov (United States)

    Zeng, Wei; Li, Yanwei; Zeng, Guangwei; Yang, Bo; Zhu, Yu

    2014-01-01

    Amniotic membranes (AM) have been used in a wide range of clinical applications. We successfully extracted mesenchymal stem cells (MSCs) from human AM, but little is known about the use and efficacy of human amniotic membrane-derived mesenchymal stem cells (hAM-dMSCs) for the treatment of alkali burns. We utilized hAM-dMSCs transplantation, AM grafting, and their combined use in the treatment of alkali burns. An experimental model in rabbits was devised to analyze the use of these techniques with immunocytochemistry and ELISA. The survival and migration of hAM-dMSCs labeled by SPION in the host were assessed with Prussian blue staining. Compared with the control group, the treated groups demonstrated faster reconstruction of the corneal epithelium, and lower levels of corneal opacification and neovascularization within corneal alkali burns. Furthermore, dark blue-stained particles were detected in the limbus corneae at day 28. These results demonstrated the ability of hAM-dMSCs to enhance epithelial healing and reduce corneal opacification and neovascularization in corneal alkali wounds.

  9. Amniotic fluid concentrations of soluble scavenger receptor for hemoglobin (sCD163) in pregnancy complicated by preterm premature rupture of the membranes and histologic chorioamnionitis.

    Science.gov (United States)

    Kacerovsky, Marian; Drahosova, Marcela; Andrys, Ctirad; Hornychova, Helena; Tambor, Vojtech; Lenco, Juraj; Tosner, Jindrich; Krejsek, Jan

    2011-08-01

    To determine changes in the amniotic fluid, soluble form of scavenger receptor for hemoglobin (sCD163) concentrations during advancing gestation, and in patients with preterm premature rupture of membranes (PPROM) complicated by histological chorioamnionitis were studied. One hundred and fifty-two women with singleton pregnancies were enrolled. The concentration of sCD163 in amniotic fluid was determined using sandwich enzyme immunoassay technique. Women in the midtrimester had a significantly higher median amniotic fluid sCD163 concentration than those at term not in labor (308 ng/ml vs. 217 ng/ml; p = 0.04). Patients with PPROM and histological chorioamnionitis had a higher median amniotic fluid sCD163 level than those with PPROM without histological chorioamnionitis (885 ng/ml vs. 288 ng/ml; p < 0.0001). Amniotic fluid sCD163 concentrations decrease with advancing gestation. Amniotic fluid sCD163 concentrations are significantly higher in women with PPROM between 24 and 36 gestational weeks with histological chorioamnionitis than those without histological signs of inflammation.

  10. Transport-associated pathway responses in ovine fetal membranes to changes in amniotic fluid dynamics.

    Science.gov (United States)

    Cheung, Cecilia Y; Anderson, Debra F; Brace, Robert A

    2017-11-01

    Current evidence suggests that amniotic fluid volume (AFV) is actively regulated by vesicular transport of amniotic fluid outward across the amnion and into the underlying fetal vasculature in the placenta. Our objective was to determine whether gene expression profiles of potential stimulators, inhibitors, and mediators of vesicular transport are altered in response to changes in intramembranous absorption (IMA) rate. Samples of ovine amnion and chorion were obtained from fetal sheep with normal, experimentally reduced or increased AFVs and IMA rates. Amnion and chorion levels of target mRNAs were determined by RT-qPCR In the amnion, caveolin-1 and flotillin-1 mRNA levels were unchanged during alterations in IMA rate. However, levels of both were significantly higher in amnion than in chorion. Tubulin- α mRNA levels in the amnion but not in chorion were reduced when IMA rate decreased, and amnion levels correlated positively with IMA rate ( P  fluid and thus modulate IMA rate. Further, our results are consistent with the concept that the amnion is the rate-limiting layer for amniotic fluid transport. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  11. Peculiarity of Porcine Amniotic Membrane and Its Derived Cells: A Contribution to the Study of Cell Therapy from a Large Animal Model.

    Science.gov (United States)

    Lange-Consiglio, Anna; Corradetti, Bruna; Bertani, Sabrina; Notarstefano, Valentina; Perrini, Claudia; Marini, Maria Giovanna; Arrighi, Silvana; Bosi, Giampaolo; Belloli, Angelo; Pravettoni, Davide; Locatelli, Valentina; Cremonesi, Fausto; Bizzaro, Davide

    2015-12-01

    The aim of this work was to provide, for the first time, a protocol for isolation and characterization of stem cells from porcine amniotic membrane in view of their potential uses in regenerative medicine. From three samples of allanto-amnion recovered at delivery, the amniotic membrane was stripped from overlying allantois and digested with trypsin and collagenase to isolate epithelial (amniotic epithelial cells [AECs]) and mesenchymal cells, respectively. Proliferation, differentiation, and characterization studies by molecular biology and flow cytometry were performed. Histological examination revealed very few mesenchymal cells in the stromal layer, and a cellular yield of AECs of 10 × 10(6)/gram of digested tissue was achieved. AECs readily attached to plastic culture dishes displaying typical cuboidal morphology and, although their proliferative capacity decreased to the fifth passage, AECs showed a mean doubling time of 24.77 ± 6 h and a mean frequency of one fibroblast colony-forming unit (CFU-F) for every 116.75 plated cells. AECs expressed mesenchymal stem cell (MSC) mRNA markers (CD29, CD166, CD90, CD73, CD117) and pluripotent markers (Nanog and Oct 4), whereas they were negative for CD34 and MHCII. Mesodermic, ectodermic, and endodermic differentiation was confirmed by staining and expression of specific markers. We conclude that porcine amniotic membrane can provide an attractive source of stem cells that may be a useful tool for biomedical research.

  12. Anti-aging Effect of Transplanted Amniotic Membrane Mesenchymal Stem Cells in a Premature Aging Model of Bmi-1 Deficiency

    Science.gov (United States)

    Xie, Chunfeng; Jin, Jianliang; Lv, Xianhui; Tao, Jianguo; Wang, Rong; Miao, Dengshun

    2015-01-01

    To determine whether transplanted amniotic membrane mesenchymal stem cells (AMSCs) ameliorated the premature senescent phenotype of Bmi-1-deficient mice, postnatal 2-day-old Bmi-1−/− mice were injected intraperitoneally with the second-passage AMSCs from amniotic membranes of β-galactosidase (β-gal) transgenic mice or wild-type (WT) mice labeled with DiI. Three reinjections were given, once every seven days. Phenotypes of 5-week-old β-gal+ AMSC-transplanted or 6-week-old DiI+ AMSC-transplanted Bmi-1−/− mice were compared with vehicle-transplanted Bmi-1−/− and WT mice. Vehicle-transplanted Bmi-1−/− mice displayed growth retardation and premature aging with decreased cell proliferation and increased cell apoptosis; a decreased ratio and dysmaturity of lymphocytic series; premature osteoporosis with reduced osteogenesis and increased adipogenesis; redox imbalance and DNA damage in multiple organs. Transplanted AMSCs carried Bmi-1 migrated into multiple organs, proliferated and differentiated into multiple tissue cells, promoted growth and delayed senescence in Bmi-1−/− transplant recipients. The dysmaturity of lymphocytic series were ameliorated, premature osteoporosis were rescued by promoting osteogenesis and inhibiting adipogenesis, the oxidative stress and DNA damage in multiple organs were inhibited by the AMSC transplantation in Bmi-1−/− mice. These findings indicate that AMSC transplantation ameliorated the premature senescent phenotype of Bmi-1-deficient mice and could be a novel therapy to delay aging and prevent aging-associated degenerative diseases. PMID:26370922

  13. Evaluation of Human Amniotic Membrane as a Wound Dressing for Split-Thickness Skin-Graft Donor Sites

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    Denys J. Loeffelbein

    2014-01-01

    Full Text Available Human amniotic membrane (HAM has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG donor sites in a swine model (Part A and a clinical trial (Part B. Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU foil (n=8 each. Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker, von Willebrand factor (vWF: angiogenesis, Ki-67 (cell proliferation, and laminin (basement membrane integrity. Part B: STSG donor sites in 45 adult patients (16 female/29 male were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n=15 each. Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.

  14. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture.

    Science.gov (United States)

    Park, Jeong Woo; Park, Kyo Hoon; Jung, Eun Young

    2017-01-01

    To evaluate the effect of histological chorioamnionitis (HCA) with a negative amniotic fluid (AF) culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM). This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20-34 weeks) who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL)-6, IL-8, and metalloproteinase-9 (MMP-9) levels were determined. The placentas were examined histologically. The prevalence of HCA with negative AF culture was 23.5% (36/153). The women with HCA but with a negative AF culture (group 2) and those with a positive AF culture (group 3) had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1). Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age. In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

  15. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture.

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    Jeong Woo Park

    Full Text Available To evaluate the effect of histological chorioamnionitis (HCA with a negative amniotic fluid (AF culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM.This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20-34 weeks who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL-6, IL-8, and metalloproteinase-9 (MMP-9 levels were determined. The placentas were examined histologically.The prevalence of HCA with negative AF culture was 23.5% (36/153. The women with HCA but with a negative AF culture (group 2 and those with a positive AF culture (group 3 had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1. Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age.In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

  16. Sutureless repair of inguinal hernia.

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    Gilbert, A I

    1992-03-01

    Sutureless repair is successful for all but the largest of indirect inguinal hernias. After reduction of the peritoneal sac, the presenting indirect component of the hernia is immediately resolved by placement of a polypropylene mesh through the internal ring. The posterior wall is reinforced with a second swatch of Prolene mesh to prevent herniation, which often results from future degenerative changes. Both swatches of mesh are held in place in separate tissue planes by the body's internal hydrostatic forces. Being sutureless, no tension is placed on any layer; there is no damage to tissues from an errant suturing technique. This procedure has been used in 412 of the 1,091 inguinal hernia repairs over the past 36 months.

  17. Autologous transplantation of oral mucosal epithelial cell sheets cultured on an amniotic membrane substrate for intraoral mucosal defects.

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    Takeshi Amemiya

    Full Text Available The human amniotic membrane (AM is a thin intrauterine placental membrane that is highly biocompatible and possesses anti-inflammatory and anti-scarring properties. Using AM, we developed a novel method for cultivating oral mucosal epithelial cell sheets. We investigated the autologous transplantation of oral mucosal epithelial cells cultured on AM in patients undergoing oral surgeries. We obtained specimens of AM from women undergoing cesarean sections. This study included five patients without any history of a medical disorder who underwent autologous cultured oral epithelial transplantation following oral surgical procedures. Using oral mucosal biopsy specimens obtained from these patients, we cultured oral epithelial cells on an AM carrier. We transplanted the resultant cell sheets onto the oral mucosal defects. Patients were followed-up for at least 12 months after transplantation. After 2-3 weeks of being cultured on AM, epithelial cells were well differentiated and had stratified into five to seven layers. Immunohistochemistry revealed that the cultured cells expressed highly specific mucosal epithelial cell markers and basement membrane proteins. After the surgical procedures, no infection, bleeding, rejection, or sheet detachment occurred at the reconstructed sites, at which new oral mucous membranes were evident. No recurrence was observed in the long-term follow-up, and the postoperative course was excellent. Our results suggest that AM-cultured oral mucosal epithelial cell sheets represent a useful biomaterial and feasible method for oral mucosal reconstruction. However, our primary clinical study only evaluated their effects on a limited number of small oral mucosal defects.

  18. Effectiveness of the radio sterilized amniotic membrane transplantation vs conjunctival auto graft implant in the pterygium surgery with intraoperative mitomycin C

    International Nuclear Information System (INIS)

    Tellez Y, L.; Martinez P, M. E.; Vazquez M, L.

    2009-01-01

    At the present time the traditional surgical handling of the pterygium with conjunctival implant presents high frequency. In this work the obtained results of a controlled clinic practice blind double are presented of the period of December from 2008 to December 2009, realized in the Medical Unit of Ambulatory Attention 231 of the Mexican Institute of the Public Health located in Metepec, Mexico State, in order to demonstrate the effectiveness and security of the alternative use of the radio sterilized amniotic membrane and intraoperative mitomycin C. For the study was included patients with diagnostic of primary nasal pterygium in one or both eyes, adults of both genus with an age range of 20 to 60 years, and was used radio sterilized amniotic membrane processed in the Bank of Radio Sterilized Tissues of the National Institute of Nuclear Research. (Author)

  19. IL-6 trans-signaling system in intra-amniotic inflammation, preterm birth, and preterm premature rupture of the membranes.

    Science.gov (United States)

    Lee, Sarah Y; Buhimschi, Irina A; Dulay, Antonette T; Ali, Unzila A; Zhao, Guomao; Abdel-Razeq, Sonya S; Bahtiyar, Mert O; Thung, Stephen F; Funai, Edmund F; Buhimschi, Catalin S

    2011-03-01

    Classic IL-6 signaling is conditioned by the transmembrane receptor (IL-6R) and homodimerization of gp130. During trans-signaling, IL-6 binds to soluble IL-6R (sIL-6R), enabling activation of cells expressing solely gp130. Soluble gp130 (sgp130) selectively inhibits IL-6 trans-signaling. To characterize amniotic fluid (AF) IL-6 trans-signaling molecules (IL-6, sIL-6R, sgp130) in normal gestations and pregnancies complicated by intra-amniotic inflammation (IAI), we studied 301 women during second trimester (n = 39), third trimester (n = 40), and preterm labor with intact (n = 131, 85 negative IAI and 46 positive IAI) or preterm premature rupture of membranes (PPROM; n = 91, 61 negative IAI and 30 positive IAI). ELISA, Western blotting, and real-time RT-PCR were used to investigate AF, placenta, and amniochorion for protein and mRNA expression of sIL-6R, sgp130, IL-6R, and gp130. Tissues were immunostained for IL-6R, gp130, CD15(+) (polymorphonuclear), and CD3(+) (T cell) inflammatory cells. The ability of sIL-6R and sgp130 to modulate basal and LPS-stimulated release of amniochorion matrix metalloprotease-9 was tested ex vivo. We showed that in physiologic gestations, AF sgp130 decreases toward term. AF IL-6 and sIL-6R were increased in IAI, whereas sgp130 was decreased in PPROM. Our results suggested that fetal membranes are the probable source of AF sIL-6R and sgp130. Immunohistochemistry and RT-PCR revealed increased IL-6R and decreased gp130 expression in amniochorion of women with IAI. Ex vivo, sIL-6R and LPS augmented amniochorion matrix metalloprotease-9 release, whereas sgp130 opposed this effect. We conclude that IL-6 trans-signaling molecules are physiologic constituents of the AF regulated by gestational age and inflammation. PPROM likely involves functional loss of sgp130.

  20. Towards a Novel Patch Material for Cardiac Applications: Tissue-Specific Extracellular Matrix Introduces Essential Key Features to Decellularized Amniotic Membrane

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    Matthias Becker

    2018-03-01

    Full Text Available There is a growing need for scaffold material with tissue-specific bioactivity for use in regenerative medicine, tissue engineering, and for surgical repair of structural defects. We developed a novel composite biomaterial by processing human cardiac extracellular matrix (ECM into a hydrogel and combining it with cell-free amniotic membrane via a dry-coating procedure. Cardiac biocompatibility and immunogenicity were tested in vitro using human cardiac fibroblasts, epicardial progenitor cells, murine HL-1 cells, and human immune cells derived from buffy coat. Processing of the ECM preserved important matrix proteins as demonstrated by mass spectrometry. ECM coating did not alter the mechanical characteristics of decellularized amniotic membrane but did cause a clear increase in adhesion capacity, cell proliferation and viability. Activated monocytes secreted less pro-inflammatory cytokines, and both macrophage polarization towards the pro-inflammatory M1 type and T cell proliferation were prevented. We conclude that the incorporation of human cardiac ECM hydrogel shifts and enhances the bioactivity of decellularized amniotic membrane, facilitating its use in future cardiac applications.

  1. Modulation of amniotic fluid activin-a and inhibin-a in women with preterm premature rupture of the membranes and infection-induced preterm birth.

    Science.gov (United States)

    Rosenberg, Victor A; Buhimschi, Irina A; Dulay, Antonette T; Abdel-Razeq, Sonya S; Oliver, Emily A; Duzyj, Christina M; Lipkind, Heather; Pettker, Christian M; Buhimschi, Catalin S

    2012-02-01

    Activins and inhibins are important modulators of inflammatory processes. We explored activation of amniotic fluid (AF) activin-A and inhibin-A system in women with intra-amniotic infection and preterm premature rupture of the membranes (PPROM). We analyzed 78 AF samples: '2nd trimester-control' (n=12), '3rd trimester-control' (n=14), preterm labor with intact membranes [positive-AF-cultures (n=13), negative-AF-cultures (n=13)], and PPROM [positive-AF-cultures (n=13), negative-AF-cultures (n=13)]. Activin-A levels were evaluated ex-vivo following incubation of amniochorion and placental villous explants with Gram-negative lipopolysaccharide (LPS) or Gram-positive (Pam3Cys) bacterial mimics. Ability of recombinant activin-A and inhibin-A to modulate inflammatory reactions in fetal membranes was explored through explants' IL-8 release. Activin-A and inhibin-A were present in human AF and were gestational age-regulated. Activin-A was significantly upregulated by infection. Lower inhibin-A levels were seen in PPROM. LPS elicited release of activin-A from amniochorion, but not from villous explants. Recombinant activin-A stimulated IL-8 release from amniochorion, an effect that was not reversed by inhibin-A. Human AF activin-A and inhibin-A are involved in biological processes linked to intra-amniotic infection/inflammation-induced preterm birth. © 2011 John Wiley & Sons A/S.

  2. Amniotic membrane-derived mesenchymal cells and their conditioned media: potential candidates for uterine regenerative therapy in the horse.

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    Bruna Corradetti

    Full Text Available Amniotic membrane-derived mesenchymal cells (AMCs are considered suitable candidates for a variety of cell-based applications. In view of cell therapy application in uterine pathologies, we studied AMCs in comparison to cells isolated from the endometrium of mares at diestrus (EDCs being the endometrium during diestrus and early pregnancy similar from a hormonal standpoint. In particular, we demonstrated that amnion tissue fragments (AM shares the same transcriptional profile with endometrial tissue fragments (ED, expressing genes involved in early pregnancy (AbdB-like Hoxa genes, pre-implantation conceptus development (Erα, PR, PGRMC1 and mPR and their regulators (Wnt7a, Wnt4a. Soon after the isolation, only AMCs express Wnt4a and Wnt7a. Interestingly, the expression levels of prostaglandin-endoperoxide synthase 2 (PTGS2 were found greater in AM and AMCs than their endometrial counterparts thus confirming the role of AMCs as mediators of inflammation. The expression of nuclear progesterone receptor (PR, membrane-bound intracellular progesterone receptor component 1 (PGRMC1 and membrane-bound intracellular progesterone receptor (mPR, known to lead to improved endometrial receptivity, was maintained in AMCs over 5 passages in vitro when the media was supplemented with progesterone. To further explore the potential of AMCs in endometrial regeneration, their capacity to support resident cell proliferation was assessed by co-culturing them with EDCs in a transwell system or culturing in the presence of AMC-conditioned medium (AMC-CM. A significant increase in EDC proliferation rate exhibited the crucial role of soluble factors as mediators of stem cells action. The present investigation revealed that AMCs, as well as their derived conditioned media, have the potential to improve endometrial cell replenishment when low proliferation is associated to pregnancy failure. These findings make AMCs suitable candidates for the treatment of endometrosis in

  3. Transplantation of amniotic membrane-derived multipotent cells ameliorates and delays the progression of chronic kidney disease in cats.

    Science.gov (United States)

    Vidane, A S; Pinheiro, A O; Casals, J B; Passarelli, D; Hage, McFns; Bueno, R S; Martins, D S; Ambrósio, C E

    2017-04-01

    Chronic kidney disease (CKD) is a common clinical condition in domestic cats, characterized by tubulointerstitial, vascular and glomerular inflammation and severe fibrosis. Studies in rodent model of induced CKD have shown a decrease and stabilization of the clinical condition. In this study was evaluated the safety and effect of intrarenal and intravenous infusion of allogeneic mesenchymal stem cells (AMSCs) derived from feline amniotic membrane in cats with naturally occurring CKD. Cat AMSCs were harvested after mechanical and enzymatic digestion of amnion. A healthy cat received intrarenal injection of AMSCs guided by ultrasound in both kidneys (5 × 10 5  cells/kidney). Nine cats with CDK received repeated intravenous infusions of AMSCs (2 × 10 6 cells × 2 treatments). The clinical parameters of healthy cat did not change, but sedation and general anaesthesia was required. The number of interventions stressed the animal, and he developed transient haematuria after AMSC injection. Cats with CDK registered a significant improvement of renal function (decrease in serum creatinine and urine protein concentrations and increase in urine specific gravity). The kidney architecture and morphology did not change following the treatment. The feline AMSCs have a renoprotective effect and improve renal function in cats with naturally occurring CKD, stabilizing the clinical condition and disease progression. Thus, intravenous injection of AMSCs may be an important tool to provide welfare in cats with chronic kidney disease. © 2016 Blackwell Verlag GmbH.

  4. Reconstruction of limbal stem cell deficient corneal surface with induced human bone marrow mesenchymal stem cells on amniotic membrane.

    Science.gov (United States)

    Rohaina, Che Man; Then, Kong Yong; Ng, Angela Min Hwei; Wan Abdul Halim, Wan Haslina; Zahidin, Aida Zairani Mohd; Saim, Aminuddin; Idrus, Ruszymah B H

    2014-03-01

    The cornea can be damaged by a variety of clinical disorders or chemical, mechanical, and thermal injuries. The objectives of this study were to induce bone marrow mesenchymal stem cells (BMSCs) to corneal lineage, to form a tissue engineered corneal substitute (TEC) using BMSCs, and to treat corneal surface defects in a limbal stem cell deficiency model. BMSCs were induced to corneal lineage using limbal medium for 10 days. Induced BMSCs demonstrated upregulation of corneal stem cell markers; β1-integrin, C/EBPδ, ABCG2, and p63, increased protein expression of CK3 and p63 significantly compared with the uninduced ones. For TEC formation, passage 1 BMSCs were trypsinized and seeded on amniotic membrane in a transwell co-culture system and were grown in limbal medium. Limbal stem cell deficiency models were induced by alkaline injury, and the TEC was implanted for 8 weeks. Serial slit lamp evaluation revealed remarkable improvement in corneal regeneration in terms of corneal clarity and reduced vascularization. Histologic and optical coherence tomography analyses demonstrated comparable corneal thickness and achieved stratified epithelium with a compact stromal layer resembling that of normal cornea. CK3 and p63 were expressed in the newly regenerated cornea. In conclusion, BMSCs can be induced into corneal epithelial lineage, and these cells are viable for the formation of TEC, to be used for the reconstruction of the corneal surface in the limbal stem cell deficient model. Copyright © 2014 Mosby, Inc. All rights reserved.

  5. No midterm advantages in the middle term using small intestinal submucosa and human amniotic membrane in Achilles tendon transverse tenotomy.

    Science.gov (United States)

    Liu, Yushu; Peng, Yinbo; Fang, Yong; Yao, Min; Redmond, Robert W; Ni, Tao

    2016-11-24

    The study was aimed to compare the effects of small intestinal submucosa (SIS) and human amniotic membrane (HAM) on Achilles tendon healing. A total of 48 New Zealand white rabbits were divided into two groups. A full-thickness transverse tenotomy was made at the right leg of the rabbits. Then, the laceration site was wrapped with HAM (P/A group) or SIS (P/S group). The ultimate stress (US) and Young's modulus (E) of the tendons were detected for biomechanical analysis. Histological evaluation was performed using hematoxylin and eosin, immunohistochemical, and immunofluorescent stain. Expression of collagen I was detected by western blot analysis, and levels of inflammatory cytokines IL-1β, IL-6, and TNF-α were measured. Finally, adhesion formation was evaluated. There were no significant differences in filamentous adhesion, cross-sectional areas of the laceration sites, levels of inflammatory response, and collagen type I expression between the P/A and P/S groups (p > 0.05). Compared with the P/A group, the US and E values were significantly higher in the P/S group at day 7 (p Achilles tendon injury in the early stage of healing.

  6. Preterm prelabor rupture of membranes (PPROM) is not associated with presence of viral genomes in the amniotic fluid.

    Science.gov (United States)

    Bopegamage, Shubhada; Kacerovsky, Marian; Tambor, Vojtech; Musilova, Ivana; Sarmirova, Sona; Snelders, Eveline; de Jong, Arjan S; Vari, Sandor G; Melchers, Willem J G; Galama, Jochem M D

    2013-11-01

    The role of viral infections in preterm prelabor rupture of the membranes (PPROM) is not established. Studies on the presence of viral genomes in the amniotic fluid (AF) collected in pregnancies complicated by PPROM show contradictory outcomes. To investigate AF samples of PPROM pregnancies for the presence of viral genomes. AF samples from patients with PPROM were collected during a 4-year (2008-2012) observational study. 174 women were included with selection criteria of singleton pregnancy, PPROM, and maternal age of 18 years and above. PCR was used for detection of human cytomegalovirus (HCMV), herpes simplex virus (HSV), parvovirus B19, human adenoviruses (HAdV), enteroviruses (EV) and human parechovirus (HPeV). The selection of these viral targets was based on literature regarding screening of AF for presence of viral genomes. Only a single sample was positive out of the 174 tested AFs, HCMV DNA was detected. PPROM is not associated with active viral infections. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Outcomes following intra-amniotic instillation with indigo carmine to diagnose prelabor rupture of membranes in singleton pregnancies: a single center experience.

    Science.gov (United States)

    Adekola, Henry; Gill, Navleen; Sakr, Sharif; Hobson, Deslyn; Bryant, David; Abramowicz, Jacques S; Soto, Eleazar

    2016-01-01

    To evaluate clinical outcomes of women with singleton pregnancies that underwent intra-amniotic dye instillation (amniodye test) following equivocal diagnosis of prelabor rupture of membranes (PROM). Records of 34 pregnant women who underwent amniodye test for equivocal PROM were reviewed. Comparisons of characteristics, amniotic fluid (AF) cultures, AF interleukin (IL)-6 concentrations, and placenta pathology results between women who tested positive and those who tested negative were performed. A sub-analysis of women who were amniodye test-negative was also performed. (1) Commonest indication for amniodye test was a typical history of PROM with positive conventional tests and persistently normal AF volume, (2) amniodye test-positive women had a shorter procedure-to-delivery interval (p = 0.008), and a greater proportion of histologic acute chorioamnionitis (p = 0.04) and funisitis (p = 0.01) than amniodye-negative women, and (3) in addition to similarities to women with amniodye-positive test, amniodye test-negative women who delivered <34 weeks, had a greater proportion of women with risk for preterm birth (p = 0.04), than their counterparts who delivered between 34 0/7 and 36 6/7 weeks. Equivocal diagnosis of PPROM should warrant an amniodye test to avoid iatrogenic intervention in women with intact amniotic membranes. AF analysis should be performed in amniodye test-negative women.

  8. Cultured epithelial grafting using human amniotic membrane: the potential for using human amniotic epithelial cells as a cultured oral epithelium sheet.

    Science.gov (United States)

    Koike, Takeshi; Yasuo, Masanari; Shimane, Tetsu; Kobayashi, Hiroichi; Nikaido, Toshio; Kurita, Hiroshi

    2011-10-01

    Human amniotic cells are a valuable source of functional cells that can be used in various fields, including regenerative medicine and tissue engineering. The aim of this study was to investigate the utility of human amniotic epithelial (hAE) cells as a new cell source for culturing stratified epithelium sheets for intraoral grafting. Enzymatically isolated hAE cells were submerged in a serum-free, low-calcium-supplemented MCDB 153 medium without a feeder layer. The hAE cells were seeded onto a Millicell cell culture plate insert and cultured while submerged in a high-calcium medium for 4 days. Then, they were cultured at an air-liquid interface for 3 weeks. Cultures of hAE cells proliferated at the air-liquid interface. After 3 weeks, the hAE cells cultivated using the air-liquid interface method lead to almost 10 continuous layers of stratified epithelium without parakeratinization or keratinization. It confirmed immunohistochemically that the presence of CK10/13 and Ki-67 positive cells were spread throughout almost all the epithelial layer, and that CK19 positive cells were expressed throughout the entire epithelial layer in the cultured hAE cell sheets. Cultured hAE cells sheets showed a staining pattern similar to that of uncultured oral mucosa: ZO-1 and occludin were located in the intercellular junctions throughout all the epithelial layers. It was suggested that the hAE sheets consisted of highly-active proliferating cells and undifferentiated cells, and had a barrier function. These results suggested that hAE cells may be a promising cell source for the development of stratified epithelium allograft sheets using a human cell strain. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Amniotic Membrane Modifies the Genetic Program Induced by TGFß, Stimulating Keratinocyte Proliferation and Migration in Chronic Wounds.

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    Antonia Alcaraz

    Full Text Available Post-traumatic large-surface or deep wounds often cannot progress to reepithelialisation because they become irresponsive in the inflammatory stage, so intervention is necessary to provide the final sealing epidermis. Previously we have shown that Amniotic Membrane (AM induced a robust epithelialisation in deep traumatic wounds.To better understand this phenomenon, we used keratinocytes to investigate the effect of AM on chronic wounds. Using keratinocytes, we saw that AM treatment is able to exert an attenuating effect upon Smad2 and Smad3 TGFß-induced phosphorylation while triggering the activation of several MAPK signalling pathways, including ERK and JNK1, 2. This also has a consequence for TGFß-induced regulation on cell cycle control key players CDK1A (p21 and CDK2B (p15. The study of a wider set of TGFß regulated genes showed that the effect of AM was not wide but very concrete for some genes. TGFß exerted a powerful cell cycle arrest; the presence of AM however prevented TGFß-induced cell cycle arrest. Moreover, AM induced a powerful cell migration response that correlates well with the expression of c-Jun protein at the border of the healing assay. Consistently, the treatment with AM of human chronic wounds induced a robust expression of c-Jun at the wound border.The effect of AM on the modulation of TGFß responses in keratinocytes that favours proliferation together with AM-induced keratinocyte migration is the perfect match that allows chronic wounds to move on from their non-healing state and progress into epithelialization. Our results may explain why the application of AM on chronic wounds is able to promote epithelialisation.

  10. Transvaginal cervical length and amniotic fluid index: can it predict delivery latency following preterm premature rupture of membranes?

    Science.gov (United States)

    Mehra, Suwan; Amon, Erol; Hopkins, Sarah; Gavard, Jeffrey A; Shyken, Jaye

    2015-03-01

    We sought to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict delivery latency within 7 days in women presenting with preterm premature rupture of membranes (PPROM). This was a prospective observational study of TVCL measurements in 106 singleton pregnancies with PPROM between 23-33 weeks. Delivery latency was defined as the period (in days) from the initial TVCL after PPROM to delivery of the infant, with our primary outcome being delivery within 7 days of TVCL. The independent predictability of significant characteristics for delivery within 7 days was determined using multiple logistic regression. Sensitivity, specificity, and predictive values were used to examine whether the presence of a short TVCL, AFI, or a combination of both affected the risk of delivery within 7 days. Delivery within 7 days occurred in 51/106 (48%) of pregnancies. Median duration (interquartile range) from PPROM to delivery and TVCL to delivery was 8 days (4.0-16.0) and 8 days (3.0-15.0), respectively. Using multiple regression TVCL as a continuous variable (odds ratio, 0.65; 95% confidence interval, 0.44-0.97; P 7 days for TVCL >2 cm alone was 61%. This predictive value changed when analyzed in conjunction with an AFI ≤5 cm and >5 cm at 42% and 89%, respectively. A shorter TVCL and an AFI ≤5 cm independently predict delivery within 7 days in women presenting with PPROM. The combination of an AFI >5 cm and TVCL >2 cm greatly improved the potential to remain undelivered at 7 days following cervical length assessment. These findings may be helpful for counseling and optimizing maternal and neonatal care in women with PPROM. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Effect of Human Amniotic Membrane on Prevention of Colorectal Anastomosis Leakage in Cases with Neoadjuvant Radiotherapy: An Experimental Animal Study

    Directory of Open Access Journals (Sweden)

    Sam Moslemi

    2016-11-01

    Full Text Available Background: Radiotherapy is one of the most important factors which results in negative effects on wound healing and increases anastomosis leakage. Diverting loop ileostomy has been usually performed after colorectal anastomosis in cases of colorectal cancer with a history of neoadjuvant radiotherapy to decrease the chance of leakage. Considering the side effects of diverting loop ileostomy, the objective of the present study is to investigate the effect of human amniotic membrane (HAM on colorectal anastomosis leakage after neo-adjuvant radiotherapy. Methods: In this experimental animal study, 20 crossbreed rabbits were randomly divided into two groups (case group: 13 rabbits, control group: 7 rabbits after receiving an equal dose of external beam radiation. Four weeks after irradiation, resection of 4 cm of colorectal segment and end-to-end single layer anastomosis were conducted. In the case group, a 2×2 cm wrap of HAM applied around the site of anastomosis. Eight weeks later, all the survived rabbits were sacrificed. A segment of anastomotic sites was resected in all expired and survived rabbits and sent for pathological evaluation. Mann-Whitney U Test (SPSS for Windows, Ver. 16, Chicago, IL was applied to analyze healing scores between the two groups. Results: Due to anastomosis dehiscence, 5 rabbits expired in the control group, but all the 13 rabbits (case group survived after 8 weeks and showed no leakage. In addition, pathological evaluation revealed significant epithelialization and neovascularization in the case group. Statistically, healing score was higher in the case group rather than the control group (P<0.001. Conclusion: To prevent post irradiation colorectal anastomosis leakage, the use of HAM might play a significant role and a feasible technical approach.

  12. Comparison of Amniotic Membrane Transplantation and Umbilical Cord Serum in Acute Ocular Chemical Burns: A Randomized Controlled Trial.

    Science.gov (United States)

    Sharma, Namrata; Singh, Divya; Maharana, Prafulla K; Kriplani, Alka; Velpandian, Thirumurthy; Pandey, Ravindra Mohan; Vajpayee, Rasik B

    2016-08-01

    To compare the efficacy of topical umbilical cord serum drops (UCS) and amniotic membrane transplantation (AMT) in acute ocular chemical burns. Randomized controlled trial. setting: Tertiary care hospital. Forty-five eyes with acute chemical burns of grade III, IV, and V (Dua's classification) presenting within the first week of injury were randomized into 3 groups (15 each). Patients with perforation/impending corneal perforation were excluded from the study. Groups 1, 2, and 3 received UCS with medical therapy (MT), AMT with MT, and MT alone, respectively. Time to complete epithelialization. The mean time to complete epithelialization was 56.7 ± 14.9, 22.0 ± 10.2, and 22.9 ± 10.1 days in MT, AMT, and UCS groups, respectively, with a significant difference between MT and AMT (P = .001) and between MT and UCS (P = .001), but not between UCS and AMT (P = .9). Improvement in pain score was better with UCS than AMT (P value: .012, .002, and .012 on days 7, 14, and 21, respectively). Corneal clarity was better in the UCS group at 21 (P = .008) and 30 days (P = .002), but not at 3 months (P = .9). By month 3, visual outcome, symblepharon, tear film status, and lid abnormalities were comparable between the 3 groups. UCS and AMT, as an adjuvant to standard medical therapy in acute chemical injury, are equally efficacious. UCS has the advantage of faster improvement in corneal clarity, better pain control, and avoidance of surgery in an inflamed eye. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Therapeutic efficacy of amniotic membrane stem cells and adipose tissue stem cells in rats with chemically induced ovarian failure

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    Fouad, Hanan; Sabry, Dina; Elsetohy, Khaled; Fathy, Naglaa

    2015-01-01

    The present study was conducted to compare between the therapeutic efficacies of human amniotic membrane-derived stem cells (hAM-MSCs) vs. adipose tissue derived stem cells (AD-MSCs) in cyclophosphamide (CTX)-induced ovarian failure in rats. Forty-eight adult female rats were included in the study; 10 rats were used as control group. Thirty-eight rats were injected with CTX to induce ovarian failure and divided into four groups: ovarian failure (IOF) (IOF group), IOF + phosphate buffer saline (PBS group), IOF + hAM-MSCs group and IOF + AD-MSCs group. Serum levels of FSH and estradiol (E2) were assessed. Histopathological examination of the ovarian tissues was performed and quantitative gene expressions of Oct-4, Stra8 and integrin beta-1 genes were conducted by quantitative real time PCR. Results showed that IOF and IOF + PBS rat groups exhibited decreased ovarian follicles, increased interstitial fibrosis with significant decrease of serum E2, significant increase serum FSH level and significant down-regulation of Stra8 and integrin beta-1. In hAM-MSCs and AD-MSCs rat groups, there were increased follicles and corpora with evident the presence of oocytes, significant increase in serum E2, significant decrease in serum FSH levels (in hAM-MSCs treated group only) and significant up-regulation of the three studied genes with higher levels in hAM-MSCs treated rats group when compared to AD-MSCs treated rats group. In Conclusion, administration of either hAM-derived MSCs or AD-MSCs exerts a significant therapeutic efficacy in chemotherapy induced ovarian insult in rats. hAM-MSCs exert higher therapeutic efficacy as compared to AD-MSCs. PMID:26966564

  14. In Vitro Evaluation of the Drug Reservoir Function of Human Amniotic Membrane Using Moxifloxacin as a Model Drug.

    Science.gov (United States)

    Yelchuri, Madhavi Latha; Madhavi, Bhagyashree; Gohil, Nilam; Sajeev, Hitha Sara; Venkatesh Prajna, Namperumalsamy; Srinivasan, Senthilkumari

    2017-05-01

    To evaluate the in vitro, extended drug reservoir function of human amniotic membrane (HAM) of different thicknesses impregnated with moxifloxacin. HAM buttons (12 mm) were soaked with freshly prepared 0.5% wt/vol topical moxifloxacin at different soaking time intervals: 3 hours (group I), 6 hours (group II), 12 hours (group III), 24 hours (group IV), and 48 hours (group V). They were then transferred into 1 mL of fresh simulated tear fluid (pH-7.4) and incubated at 37°C. The release kinetics of moxifloxacin was studied by analyzing the amount of drug in simulated tear fluid collected at different time intervals from each pretreated HAM for 3 weeks. In another experiment, thin and thick HAMs were selected based on weight and soaked with moxifloxacin for 24 hours, and the release kinetics was studied for 7 weeks. All samples were stored at -80°C until analysis by high-performance liquid chromatography. No significant difference was observed between different soaking times and the release of moxifloxacin. The cumulative amount of moxifloxacin released from thick HAM was found to be statistically significant compared with thin HAM (P < 0.05). Our in vitro data showed that the sustained release of moxifloxacin from HAM was achieved up to 7 weeks. The entrapment efficiency of moxifloxacin was significantly higher in thicker HAM than in thin HAM. Moxifloxacin-impregnated HAM application can be considered in bacterial keratitis to provide sustained drug delivery through a biological bandage system for up to a period of 7 weeks.

  15. The Effects of Intravenous Hydration on Amniotic Fluid Index in Pregnant Women with Preterm premature Rupture of Membranes: A Randomized Clinical Trial

    Science.gov (United States)

    Shahnazi, Mahnaz; Tagavi, Simin; Hajizadeh, Khadije; Farshbaf Khalili, Azize

    2013-01-01

    Introduction: Preterm premature rupture of membranes (PPROM) can result in fetal complications such as oligohydramnios. This study aimed to determine the effects of intravenous (IV) fluid bolus on amniotic fluid index (AFI) in pregnant women with PPROM. Methods: 24 women with PPROM during singleton live pregnancy of 28 to 34 weeks whose baseline AFI was ≤ 5cm were randomized into two groups. The study group received one liter intravenous fluid bolus of isotonic Ringer serum during 30-minute period. Reevaluations of amniotic fluid index in both groups were made 90 minutes and 48 hours after baseline measurement. Independent t-test and paired t-test were used to compare the two groups and mean amniotic fluid index before and after treatment, respectively. Results: The results of this study demonstrate that AFI decreased statistically significant in both the control and study groups. AFI decreased in both groups at 48 hours later. This decrease was not statistically significant in any group. The mean change in AFI (90 minutes and baseline) and (48 hours and baseline) between the two groups were not significant. The time between mean baseline measurements and delivery were 196.41 and 140.58 hours in the study and control groups, respectively. This difference was not statistically significant. Conclusion: This study did not find significant impact of hydration On AFI as a prophylactic method on oligohydramnios in pregnant women with PPROM. PMID:25276709

  16. Non-invasively collected amniotic fluid as a source of possible biomarkers for premature rupture of membranes investigated by proteomic approach.

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    Consonni, Sara; Mainini, Veronica; Pizzardi, Agnese; Gianazza, Erica; Chinello, Clizia; Locatelli, Anna; Magni, Fulvio

    2014-02-01

    Preterm delivery is one of the main causes of perinatal morbidity and mortality and it accounts for 75 % of perinatal mortality and more than half of the long-term morbidity. We applied a proteomic approach based on mass spectrometry (MS) for biomarkers discovery of preterm premature rupture of membranes (pPROM) by investigating amniotic fluid (AF) invasively and non-invasively collected. Amniotic fluid was obtained from vagina of women with pPROM (group 1), PROM at term (group 2) and by genetic amniocentesis (group 3). Pre-fractionated AF proteome was analyzed through matrix assisted laser desorption ionization-time of flight (MALDI-TOF) MS. The characterization of proteins/peptides of interest was obtained by high performance liquid chromatography-electrospray tandem MS. Three peptides overexpressed in pPROM and able to discriminate the groups 1 and 2 were detected. One peptide was identified as the fragment Gly452LAVPDGPLGLPPKPro466 of the protein KIAA1522, expressed by fetal brain and liver. This peptide was overexpressed in a patient of the group 3, completely asymptomatic at the time of the amniocentesis, who later developed pPROM. Amniotic fluid invasively and non-invasively collected can be analyzed by MALDI-TOF MS to obtain proteomic profiles. Proteomic analysis identified a peptide with promising diagnostic capability for pPROM.

  17. Term amniotic membrane is a high throughput source for multipotent mesenchymal stem cells with the ability to differentiate into endothelial cells in vitro

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    Pasquinelli Gianandrea

    2007-02-01

    Full Text Available Abstract Background Term Amniotic membrane (AM is a very attractive source of Mesenchymal Stem Cells (MSCs due to the fact that this fetal tissue is usually discarded without ethical conflicts, leading to high efficiency in MSC recovery with no intrusive procedures. Here we confirmed that term AM, as previously reported in the literature, is an abundant source of hMSCs; in particular we further investigated the AM differentiation potential by assessing whether these cells may also be committed to the angiogenic fate. In agreement with the recommendation of the International Society for Cellular Therapy, the mesenchymal cells herein investigated were named Amniotic Membrane-human Mesenchymal Stromal Cells (AM-hMSC. Results The recovery of hMSCs and their in vitro expansion potential were greater in amniotic membrane than in bone marrow stroma. At flow cytometry analysis AM-hMSCs showed an immunophenotypical profile, i.e., positive for CD105, CD73, CD29, CD44, CD166 and negative for CD14, CD34, CD45, consistent with that reported for bone marrow-derived MSCs. In addition, amniotic membrane-isolated cells underwent in vitro osteogenic (von Kossa stain, adipogenic (Oil Red-O stain, chondrogenic (collagen type II immunohistochemichal detection and myogenic (RT-PCR MyoD and Myogenin expression as well as desmin immunohistochemical detection differentiation. In angiogenic experiments, a spontaneous differentiation into endothelial cells was detected by in vitro matrigel assay and this behaviour has been enhanced through Vascular Endothelial Growth Factor (VEGF induction. According to these findings, VEGF receptor 1 and 2 (FLT-1 and KDR were basally expressed in AM-hMSCs and the expression of endothelial-specific markers like FLT-1 KDR, ICAM-1 increased after exposure to VEGF together with the occurrence of CD34 and von Willebrand Factor positive cells. Conclusion The current study suggests that AM-hMSCs may emerge as a remarkable tool for the cell

  18. Evaluation of the Cepheid Xpert GBS Assay for Rapid Detection of Group B Streptococci in Amniotic Fluids from Pregnant Women with Premature Rupture of Membranes

    Science.gov (United States)

    Bourgeois-Nicolaos, Nadege; Cordier, Anne-Gael; Guillet-Caruba, Christelle; Casanova, François; Benachi, Alexandra

    2013-01-01

    The Xpert GBS real-time PCR assay for the detection of group B streptococci (GBS) in antepartum screening samples was evaluated on amniotic fluid samples collected from 139 women with premature rupture of membrane at term. When any intrapartum positive result from the Xpert GBS or culture was considered a true positive, the sensitivities of the Xpert GBS and culture were 92.3% and 84.6%, respectively. This assay could enhance exact identification of candidates for intrapartum antibiotic prophylaxis. PMID:23390279

  19. A clinical trial on the treatment of burns in children at the University Teaching Hospital using amniotic membrane sterilized by gamma radiation (July to December 1994)

    International Nuclear Information System (INIS)

    Katebe, K.R.C.

    1995-01-01

    About six hundred patients are admitted to the University Teaching Hospital every year. Most of the burns are from water and fire with a high mortality rate in children. This study was centred on the feasibility of using amniotic membrane for wound dressing. The method of Gamma radiation was employed to sterilize this biological tissue before utilising it on patients. The results of the study show more superior healing rate compared with other methods. There was lack of hypersensitivity reactions and reduced wound infection and good quality wound healing. The method is easy to use and has been accepted by the patients and nursing staff. (n.m.). 20 refs., tabs., 6 graphs

  20. Comparison of rapid MMP-8 and interleukin-6 point-of-care tests to identify intra-amniotic inflammation/infection and impending preterm delivery in patients with preterm labor and intact membranes.

    Science.gov (United States)

    Chaemsaithong, Piya; Romero, Roberto; Docheva, Nikolina; Chaiyasit, Noppadol; Bhatti, Gaurav; Pacora, Percy; Hassan, Sonia S; Yeo, Lami; Erez, Offer

    2018-01-01

    Among patients presenting with preterm labor and intact membranes, those with intra-amniotic inflammation have adverse obstetrical and neonatal outcomes. The diagnosis of intra-amniotic inflammation can easily be made by detecting an elevated concentration of the cytokine interleukin (IL)-6 or the enzyme neutrophil collagenase, also known as matrix metalloproteinase (MMP)-8. The diagnostic performances of MMP-8 and IL-6 enzyme-linked immunosorbent assay tests are similar. Recently, a rapid test has become available for point-of-care determination of either MMP-8 or IL-6. The objectives of this study were to compare the diagnostic indices and predictive values between the rapid MMP-8 and IL-6 tests for the identification of intra-amniotic inflammation in patients with preterm labor and intact membranes. We performed a retrospective cohort study including 124 women with singleton pregnancies who presented with symptoms of preterm labor and underwent transabdominal amniocentesis for the evaluation of microbial invasion of the amniotic cavity (MIAC). MIAC was defined according to amniotic fluid culture results (aerobic and anaerobic bacteria as well as genital Mycoplasmas). Amniotic fluid white blood cell (WBC) counts were determined using a hemocytometer chamber. An elevated amniotic fluid MMP-8 concentration was assessed using Yoon's MMP-8 Check ® (cutoff: 10 ng/mL). An elevated amniotic fluid IL-6 concentration was scored when there was a positive result for the lateral flow-based immunoassay (cutoff: ≥745 pg/mL and ≥1000 pg/mL). In order to objectively compare rapid MMP-8 and rapid IL-6 tests to identify intra-amniotic inflammation, an amniotic fluid WBC count of ≥50 cells/mm 3 was used to define intra-amniotic inflammation. (1) The rapid tests had the same sensitivity for the detection of intra-amniotic inflammation [85.7% (18/21) for all]; (2) the specificity of the rapid MMP-8 test was higher than that of the rapid IL-6 test (cutoff: 745

  1. Transplanted human amniotic membrane-derived mesenchymal stem cells ameliorate carbon tetrachloride-induced liver cirrhosis in mouse.

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    DingGuo Zhang

    Full Text Available BACKGROUND: Human amniotic membrane-derived mesenchymal stem cells (hAMCs have the potential to reduce heart and lung fibrosis, but whether could reduce liver fibrosis remains largely unknown. METHODOLOGY/PRINCIPAL FINDINGS: Hepatic cirrhosis model was established by infusion of CCl₄ (1 ml/kg body weight twice a week for 8 weeks in immunocompetent C57Bl/6J mice. hAMCs, isolated from term delivered placenta, were infused into the spleen at 4 weeks after mice were challenged with CCl₄. Control mice received only saline infusion. Animals were sacrificed at 4 weeks post-transplantation. Blood analysis was performed to evaluate alanine aminotransferase (ALT and aspartate aminotransferase (AST. Histological analysis of the livers for fibrosis, hepatic stellate cells activation, hepatocyte apoptosis, proliferation and senescence were performed. The donor cell engraftment was assessed using immunofluorescence and polymerase chain reaction. The areas of hepatic fibrosis were reduced (6.2%±2.1 vs. control 9.6%±1.7, p<0.05 and liver function parameters (ALT 539.6±545.1 U/dl, AST 589.7±342.8 U/dl,vs. control ALT 139.1±138.3 U/dl, p<0.05 and AST 212.3±110.7 U/dl, p<0.01 were markedly ameliorated in the hAMCs group compared to control group. The transplantation of hAMCs into liver-fibrotic mice suppressed activation of hepatic stellate cells, decreased hepatocyte apoptosis and promoted liver regeneration. More interesting, hepatocyte senescence was depressed significantly in hAMCs group compared to control group. Immunofluorescence and polymerase chain reaction revealed that hAMCs engraftment into host livers and expressed the hepatocyte-specific markers, human albumin and α-fetoproteinran. CONCLUSIONS/SIGNIFICANCE: The transplantation of hAMCs significantly decreased the fibrosis formation and progression of CCl₄-induced cirrhosis, providing a new approach for the treatment of fibrotic liver disease.

  2. Human amniotic membrane, best healing accelerator, and the choice of bone induction for vestibuloplasty technique (an animal study

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    Ahad Khoshzaban

    2010-12-01

    Full Text Available Mohammad H Samandari1, Shahriar Adibi2, Ahad Khoshzaban3, Sara Aghazadeh5, Parviz Dihimi4, Siamak S Torbaghan6, Saeed H Keshel5, Zohreh Shahabi71Department of Oral and Maxillofacial Surgery, Dentistry Faculty, 2Dental Research of Torabinejad Research Centre, 3Iranian Tissue Bank Research and Preparation Centre, Imam Khomeini Hospital Complex, 4Department of Oral and Maxillofacial Pathology, Dentistry Faculty, Isfahan University of Medical Sciences, Isfahan, Iran; 5Stem Cells Preparation Unit, Eye Research Center, Farabi Hospital, 6Department of Pathology, Imam Khomeini Medical Centre, 7BMT Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranObjective: To investigate the effects of amniotic membrane (AM in bone induction and wound healing after vestibuloplasty surgery on animal samples while receptacle proteins such as growth factors were considered as accelerators for wound healing and bone induction after these operations.Material and methods: Ten adult dogs (5 females, 5 males; race, Iranian mixed; weight, 44 pounds were included, which underwent surgery for transplantation on mandible and maxillary. AM was used for promoting bone induction and healing.Results: The tissue samples were obtained after 2, 8, and 12 weeks for histology survey. No significant differences were observed between male and female or left and right jaws. AM decreased fibrinoleukocytic exudates and inflammation in the experimental group, had significant effects on bone formation, considerably improves wound healing, and gives rise to bone induction (P < 0.0001.Conclusions: Our study findings indicate that the AM is a suitable cover for different injuries and acellular AM has the potential for rapid improvement and bone induction. The AM contains collagen, laminin, and fibronectin, which provide an appropriate substrate for bone induction. This substrate promoted bone induction and might contribute to induction of the progenitor cells and/or stem

  3. Women's expectations and experiences of rupture of membranes and views of the potential use of reagent pads for detecting amniotic fluid.

    Science.gov (United States)

    Spiby, Helen; Borrelli, Sara; Hughes, Anita J

    2017-12-01

    To explore first-time mothers' expectations and experiences regarding rupture of membranes at term and their views on the potential use of reagent pads that detect amniotic fluid. There is little information available on women's experiences of spontaneous rupture of membranes, or interest in using methods to confirm rupture of membranes (e.g. reagent pads). Descriptive qualitative study, using focus groups and telephone interviews with women during pregnancy and after the birth of their first baby. Thematic analysis was undertaken to analyse women's responses. Ethics committee approval was obtained. Twenty-five women participated in the study of whom 13 contributed both during pregnancy and postpartum between October 2015-March 2016. Three overarching themes were identified from the data from women's expectations and experiences: uncertainty in how, when and where membranes may rupture; information which was felt to be limited and confirmation of rupture of membranes. The potential use of reagent pads met with varied responses. Women were interested in having facts and figures regarding rupture of membranes, such as characteristics of liquor; volume and probability of membranes rupturing spontaneously at term. Use of a pad as a means of confirmation was viewed as helpful, although the potential for increasing anxiety was raised. © 2017 John Wiley & Sons Ltd.

  4. Utilización de la membrana amniótica radioesterilizada en cirugía de pterigium Use of membrane amniotic radio sterilized in pterigium surgery

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    Belmary Aragonés Cruz

    2006-12-01

    Full Text Available Introducción: La cirugía de pterigium sin recurrencias continúa siendo un dilema pues se desconoce la técnica ideal tanto para el primario como para el recidivante. El uso de la membrana amniótica ha pasado por diferentes etapas de uso y desuso. La problemática de su empleo radica en los procedimientos de conservación. El propósito de esta investigación fue evaluar la eficacia y la seguridad del injerto de membrana amniótica radio-esterilizada como una terapia quirúrgica tras la remoción del pterigium primario y recidivanteIntroduction: The pterigium surgery, without continuous recurrences, continues being a dilemma because the ideal technique is still ignored for the primary and recurrent pterigium. The amniotic membrane technique has gone through several moments in its development. The key to its use lies in preservation procedures. The purpose of this research is to evaluate the effectiveness of the implant of radio sterilized amniotic membrane as a surgical therapy after the removal of the primary and recurrent pterigium

  5. Usos de la membrana amniótica humana en oftalmología Some uses of human amniotic membrane in Ophthalmology

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    Jaime Alemañy González

    2006-06-01

    Full Text Available Se realizó una revisión bibliográfica sobre el uso de la membrana amniótica en oftalmología con los propósitos de conocer sus mecanismos de acción y aplicaciones, así como los resultados publicados sobre el transplante de membrana amniótica humana en la superficie ocular. Se estudiaron textos y artículos publicados sobre este tipo de tratamiento en las enfermedades y traumas de córnea, conjuntiva, esclera y párpados. Se concluye que es una alternativa terapéutica valida que puede ser de gran utilidad en nuestro medioA literature review was made on the use of amniotic membrane in ophthalmology, with the objective of finding out its mechanisms of action and applications as well as the results of human amniotic membrane transplantation for ocular surface reconstruction. A number of texts and articles published on this type of treatment for cornea, conjunctiva, sclera and eyelids diseases and traumas were studied. It was concluded that this is a valid therapeutical alternative that may be very beneficial in our context

  6. An Open-label, Single-center, Retrospective Study of Cryopreserved Amniotic Membrane and Umbilical Cord Tissue as an Adjunct for Foot and Ankle Surgery.

    Science.gov (United States)

    Warner, Meredith; Lasyone, Lukas

    2014-11-01

    The primary aim of this study was to compare preoperative assessments with postoperative outcomes from patients undergoing foot and ankle revisions and/or complex reconstructions with tendon and/or nerve involvement using cryopreserved human amniotic membrane and umbilical cord (cHAM/UC). We hypothesized complex foot and ankle surgery using amniotic membrane would be an effective treatment leading to reduced pain and improved functional outcomes. Fourteen patients (6 male and 8 female) underwent open foot and ankle surgery during the study period. All 14 patients included in this cohort reported improvement, namely, lessened pain intensity both on the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and the pain numeric rating scale (NRS), as well as improved functional status. The mean AOFAS score improved from 50 (range, 17-79) preoperatively to 85 (range, 67-100) postoperatively. The mean NRS score also improved from 8 (range, 4-10) preoperatively to 2 (range, 0-6) postoperatively with a mean percent change in pain NRS of 78% (range 17-100%). Both outcome-scoring systems showed statistically significant differences (p < .0001) when we compared the preoperative and postoperative results. All patients included in the cohort showed improvement in both outcome measures. Further study of long-term endpoints is warranted.

  7. Membrana amniótica nas cirurgias reconstrutivas da superfície ocular nas ceratoconjuntivites cicatriciais Amniotic membrane for ocular surface reconstruction in cicatricial keratoconjunctivitis

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    José Alvaro Pereira Gomes

    1999-10-01

    Full Text Available Objetivo: A membrana amniótica tem se consolidado como útil adjuvante no tratamento de afecções da superfície ocular. Sua utilização baseia-se na capacidade de beneficiar o processo de epitelização, além de reduzir os processos inflamatório, angiogênico e cicatricial. O objetivo deste trabalho foi investigar a utilização da membrana amniótica como adjuvante no tratamento das ceratoconjuntivites cicatriciais. Métodos: A membrana amniótica foi captada a partir de parto cesárea e conservada em meio de preservação de córnea e glicerol 1:1 e conservada à -80ºC. Onze olhos de 10 pacientes portadores de ceratoconjuntivite cicatricial grave foram submetidos à cirurgia reconstrutiva da superfície ocular empregando membrana amniótica associada (8 casos ou não (3 casos a transplante de limbo e conjuntiva. Dos 10 pacientes, 3 tinham diagnóstico de síndrome de Stevens-Johnson (SSJ (4 olhos, 6 queimadura ocular por álcali (6 olhos e 1 trauma mecânico (1 olho. Resultados: O tempo médio de seguimento foi de 5,22 meses (variação entre 2 e 13 meses. Um caso de SSJ apresentou infecção pós-operatória e foi excluído da análise dos resultados. Dos outros 10 casos, obtivemos êxito na reconstrução da superfície ocular em 8 casos (80%. Insucesso foi observado em 2 casos de SSJ que apresentavam necrose de córnea no momento da cirurgia (20%. Em relação à acuidade visual, observamos que todos os pacientes apresentaram melhora ou manutenção da acuidade visual. Conclusões: O uso de membrana amniótica constitui uma opção alternativa de grande utilidade na reconstrução da superfície ocular dos casos graves de ceratoconjuntivites cicatriciais que não estejam apresentando necrose estromal. Estudos com maior casuística e tempo de seguimento são necessários para melhor avaliar esse procedimento.Purpose: Amniotic membrane has been consolidated as an useful adjunct in the treatment of ocular surface disorders. Its use is

  8. Intra-amniotic administration of exogenous pulmonary surfactant for improving in lung maturity of fetal rabbits with intrauterine infection caused by premature rupture of membranes

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    Jing Liu

    2011-05-01

    Full Text Available This study was to investigate the effect of intra-amniotic administration of pulmonary surfactant (PS on lung maturation in conditions of experimentally induced premature rupture of membranes (PROM and intrauterine infection of rabbits. To establish animal (rabbit models of intrauterine infection caused by PROM, E. coli was intrauterinely injected in 24-and 26-day pregnant animals. Twenty healthy pregnancy adult Japanese white rabbits were divided into three groups: the infection group (8 rabbits, infection group with intra-amniotic PS administration (8 rabbits and healthy controls (4 rabbits. Ultrastructure changes in the lung were observed under an electron microscope 19.5 hours after intervention. The results showed that the lung infection levels of fetal rabbits in the infection group and the infection group with PS had no significant difference. Bacillus bodies and infiltrated inflammatory cells can be occasionally seen in the alveoli, bronchial lumen, and cytoplasm. The type II alveolar epithelial cells (AT-II were decreased in the infection group than that in control group. Lamellar bodies showed vacuolation changes and different levels of apoptosis. In the infection group with PS, the count of AT-II did not show an obvious decrease. Lamellar bodies increased, and different secretion forms appeared. Also, there was little apoptosis and no obvious collagen fiber hyperplasia in antenatal administration of PS group. We believe that once PROM has happened, intrauterine infection and inflammation stimulated a cascade reaction on the fetal lung, leading to abnormal changes in the alveolar ultrastructure. Intra-amniotic administration of PS can improve the fetal lung ultrastructure and its maturity.

  9. Group B streptococcal infection of the choriodecidua induces dysfunction of the cytokeratin network in amniotic epithelium: a pathway to membrane weakening.

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    Jeroen P Vanderhoeven

    2014-03-01

    Full Text Available Early events leading to intrauterine infection remain poorly defined, but may hold the key to preventing preterm delivery. To determine molecular pathways within fetal membranes (chorioamnion associated with early choriodecidual infection that may progress to preterm premature rupture of membranes (PPROM, we examined the effects of a Group B Streptococcus (GBS choriodecidual infection on chorioamnion in a nonhuman primate model. Ten chronically catheterized pregnant monkeys (Macaca nemestrina at 118-125 days gestation (term = 172 days received choriodecidual inoculation of either GBS (n = 5 or saline (n = 5. Cesarean section was performed in the first week after GBS or saline inoculation. RNA extracted from chorioamnion (inoculation site was profiled by microarray. Single gene, Gene Set, and Ingenuity Pathway Analysis results were validated using qRT-PCR (chorioamnion, Luminex (amniotic fluid, AF, immunohistochemistry, and transmission electron microscopy (TEM. Despite uterine quiescence in most cases, significant elevations of AF cytokines (TNF-α, IL-8, IL-1β, IL-6 were detected in GBS versus controls (p2-fold change, p<0.05. Remarkably, GBS exposure was associated with significantly downregulated expression of multiple cytokeratin (CK and other cytoskeletal genes critical for maintenance of tissue tensile strength. Immunofluorescence revealed highly significant changes in the CK network within amniocytes with dense CK aggregates and retraction from the cell periphery (all p = 0.006. In human pregnancies affected by PPROM, there was further evidence of CK network retraction with significantly shorter amniocyte foot processes (p = 0.002. These results suggest early choriodecidual infection results in decreased cellular membrane integrity and tensile strength via dysfunction of CK networks. Downregulation of CK expression and perturbations in the amniotic epithelial cell intermediate filament network occur after GBS

  10. Sutureless Intrascleral Fixated Intraocular Lens Implantation.

    Science.gov (United States)

    Karadag, Remzi; Celik, Haci Ugur; Bayramlar, Huseyin; Rapuano, Christopher J

    2016-08-01

    To review sutureless intrascleral intraocular lens (IOL) fixation methods. Review of published literature. Sutureless intrascleral IOL fixation methods are newer and have been developed to eliminate the suture-related complications of sutured scleral fixation methods such as suture-induced inflammation or infection and IOL dislocation or subluxation due to suture degradation or suture breakage. Sutureless intrascleral fixation methods aim for intrascleral haptic fixation to achieve stability of the IOL. Various methods of sutureless scleral fixation have been described. Using a needle, a blade, or a trochar, sclerostomies are created in all techniques for intraocular access. Some surgeons prefer to create scleral tunnels, whereas others use scleral flaps for scleral fixation of haptics. The stability of IOLs is attained by the scar tissue formed around the haptics. Short-term results of these new methods are acceptable; studies including more cases with longer follow-up are needed to determine their long-term success. [J Cataract Refract Surg. 2016;32(9):586-597.]. Copyright 2016, SLACK Incorporated.

  11. Term Amniotic membrane is a high throughput source for multipotent Mesenchymal Stem Cells with the ability to differentiate into endothelial cells in vitro

    DEFF Research Database (Denmark)

    Alviano, Francesco; Fossati, Valentina; Marchionni, Cosetta

    2007-01-01

    BACKGROUND: Term Amniotic membrane (AM) is a very attractive source of Mesenchymal Stem Cells (MSCs) due to the fact that this fetal tissue is usually discarded without ethical conflicts, leading to high efficiency in MSC recovery with no intrusive procedures. Here we confirmed that term AM...... II immunohistochemichal detection) and myogenic (RT-PCR MyoD and Myogenin expression as well as desmin immunohistochemical detection) differentiation. In angiogenic experiments, a spontaneous differentiation into endothelial cells was detected by in vitro matrigel assay and this behaviour has been...... enhanced through Vascular Endothelial Growth Factor (VEGF) induction. According to these findings, VEGF receptor 1 and 2 (FLT-1 and KDR) were basally expressed in AM-hMSCs and the expression of endothelial-specific markers like FLT-1 KDR, ICAM-1 increased after exposure to VEGF together with the occurrence...

  12. Combined HLA matched limbal stem cells allograft with amniotic membrane transplantation as a prophylactic surgical procedure to prevent corneal graft rejection after penetrating keratoplasty: case report

    Directory of Open Access Journals (Sweden)

    Paolo Capozzi

    2014-09-01

    Full Text Available Purpose. To determine if the use of combined HLA matched limbal stem cells allograft with amniotic membrane transplantation (AMT is a safe and effective prophylactic surgical procedure to prevent corneal graft after penetrating keratoplasty (PK. Methods. We report the case of a 17 years old patient with a history of congenital glaucoma, trabeculectomy and multiple corneal graft rejections, presenting total limbal cell deficiency. To reduce the possibility of graft rejection in the left eye after a new PK, a two step procedure was performed. At first the patient underwent a combined HLA matched limbal stem cells allograft (LAT and AMT and then, 10 months later, a new PK. Results. During 12 months of follow-up, the corneal graft remained stable and smooth, with no sign of graft rejection. Conclusions. In our patient, the prophylactic use of LAT from HLA-matched donors and AMT before PK, may result in a better prognosis of corneal graft survival.

  13. Comparison of placental alpha microglobulin-1 in vaginal fluid with intra-amniotic injection of indigo carmine for the diagnosis of rupture of membranes.

    Science.gov (United States)

    Sosa, Claudio G; Herrera, Edward; Restrepo, Juan C; Strauss, Alexander; Alonso, Justo

    2014-09-01

    The purpose of this study was to compare the diagnostic performance of an immunoassay for placental alpha microglobulin-1 (PAMG-1) in vaginal fluid with the intra-amniotic instillation of indigo carmine for the diagnosis of membrane rupture in patients with an equivocal status. A prospective multi-site study was performed involving women reporting signs, symptoms, or complaints suggestive of rupture of membrane (ROM) between 21 and 42 weeks of gestation without obvious leakage of fluid from the cervical os during sterile speculum examination and without confirmation of ROM by traditional methods. A total of 140 patients were recruited with a prevalence of ROM of 19.3%. The PAMG-1 test had a sensitivity of 100.0% [confidence interval (CI) 0.87-1.0], specificity of 99.1% [(CI) 0.95-0.99], positive predictive value of 96.3% [(CI) 0.82-0.99], negative predictive value of 100.0% [(CI) 0.97-1.0], and ± likelihood ratios of 74.6 [(CI) 20.31-274.51] and 0.0 [(CI) 0.00-0.98]. The PAMG-1 immunoassay in vaginal fluid yielded results that were comparable to those of the instillation of indigo carmine into the amniotic cavity; therefore, we propose that PAMG-1 is a sensitive and specific test to assess ROM in patients with an equivocal diagnosis based on simple tests. This finding prompts consideration for the use of the noninvasive PAMG-1 test in situations where the use of the invasive dye test is not practical.

  14. Aortic Root Enlargement or Sutureless Valve Implantation?

    Directory of Open Access Journals (Sweden)

    Nikolaos G. Baikoussis

    2016-11-01

    Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

  15. Early Outcomes of Sutureless Aortic Valves

    Directory of Open Access Journals (Sweden)

    Muhammet Onur Hanedan

    2016-06-01

    Full Text Available Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA valves were used. Results: The mean age of the patients was 71.15±8.60 years. Forty-four patients (67.7% were female. The average preoperative left ventricular ejection fraction was 56.9±9.93. The CPB time was 96.51±41.27 minutes and the cross-clamping time was 60.85±27.08 minutes. The intubation time was 8.95±4.19 hours, and the intensive care unit and hospital stays were 2.89±1.42 days and 7.86±1.42 days, respectively. The mean quantity of drainage from chest tubes was 407.69±149.28 mL. The hospital mortality rate was 3.1%. A total of five patients (7.69% died during follow-up. The mean follow-up time was 687.24±24.76 days. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

  16. Hair Follicle Morphogenesis in the Treatment of Mouse Full-Thickness Skin Defects Using Composite Human Acellular Amniotic Membrane and Adipose Derived Mesenchymal Stem Cells

    Directory of Open Access Journals (Sweden)

    Wu Minjuan

    2016-01-01

    Full Text Available Early repair of skin injury and maximal restoration of the function and appearance have become important targets of clinical treatment. In the present study, we observed the healing process of skin defects in nude mice and structural characteristics of the new skin after transplantation of isolated and cultured adipose derived mesenchymal stem cells (ADMSCs onto the human acellular amniotic membrane (AAM. The result showed that ADMSCs were closely attached to the surface of AAM and grew well 24 h after seeding. Comparison of the wound healing rate at days 7, 14, and 28 after transplantation showed that ADMSCs seeded on AAM facilitated the healing of full-thickness skin wounds more effectively as compared with either hAM or AAM alone, indicating that ADMSCs participated in skin regeneration. More importantly, we noticed a phenomenon of hair follicle development during the process of skin repair. Composite ADMSCs and AAM not only promoted the healing of the mouse full-thickness defects but also facilitated generation of the appendages of the affected skin, thus promoting restoration of the skin function. Our results provide a new possible therapy idea for the treatment of skin wounds with respect to both anatomical regeneration and functional restoration.

  17. Safety analysis of cryopreserved amniotic membrane/umbilical cord tissue in foot and ankle surgery: a consecutive case series of 124 patients.

    Science.gov (United States)

    DeMill, Shyler L; Granata, Jaymes D; McAlister, Jeffrey E; Berlet, Gregory C; Hyer, Christopher F

    2014-11-01

    Cryopreserved amnion tissues derived from amniotic membrane/umbilical cord (AM/UC) have been used extensively in ophthalmology for minimizing postoperative inflammation, pain, and adhesion formation following various surgical procedures. There is limited data in the current literature regarding the use of amnion tissue product in foot and ankle surgery. The purpose of this retrospective study is to report the short-term safety profile after in vivo application of cryopreserved AM/UC tissue use in foot and ankle surgery. A retrospective consecutive case series was performed for cases where amnion tissue was used with a minimum follow-up of 120 days between 2011 and 2012. The clinical outcomes of interest were postoperative infections, delayed or nonhealing wounds, adverse surgical site reactions, and repeat surgery for formal irrigation and debridement. One hundred twenty-four patients qualified for inclusion. Cryopreserved AM/UC tissue was introduced into the surgical wound and placed adjacent to the compromised and repaired tendons, most frequently in peroneal and Achilles tendon repairs. In this level IV consecutive case series cohort, there was an overall wound complication rate of 5.64%, with a re-operation rate of 1.6% (2/124). In each of these cases, patients had an irrigation and debridement with ultimate successful wound healing. The results of this study demonstrate that the use of amnion tissue in the foot and ankle setting is safe with a decreasing trend in overall complication rates compared with historically published norms.

  18. Sutureless Deep Sclerectomy: A Preliminary Report.

    Science.gov (United States)

    Abdelrahman, Ahmed M; ElTanamly, Rasha; Sabry, Mohamed

    2017-11-01

    This study describes a modification of deep sclerectomy, making it completely sutureless, with a 6-month follow-up period. This was a prospective pilot phase that included 24 eyes of 16 patients, 13 male individuals and 3 female individuals, with medically uncontrolled open-angle glaucomas despite maximally tolerated medical therapy. After excising the deep flap, no sutures are added to the superficial scleral flap or to the conjunctiva. A statistically significant reduction of the intraocular pressure was reported during all the follow-up visits without serious complications.

  19. Decellularized human amniotic membrane: more is needed for an efficient dressing for protection of burns against antibiotic-resistant bacteria isolated from burn patients.

    Science.gov (United States)

    Gholipourmalekabadi, M; Bandehpour, M; Mozafari, M; Hashemi, A; Ghanbarian, H; Sameni, M; Salimi, M; Gholami, M; Samadikuchaksaraei, A

    2015-11-01

    Human amniotic membranes (HAMs) have attracted the attention of burn surgeons for decades due to favorable properties such as their antibacterial activity and promising support of cell proliferation. On the other hand, as a major implication in the health of burn patients, the prevalence of bacteria resistant to multiple antibiotics is increasing due to overuse of antibiotics. The aim of this study was to investigate whether HAMs (both fresh and acellular) are an effective antibacterial agent against antibiotic-resistant bacteria isolated from burn patients. Therefore, a HAM was decellularized and tested for its antibacterial activity. Decellularization of the tissue was confirmed by hematoxylin and eosin (H&E) and 4,6-diamidino-2-phenylindole (DAPI) staining. In addition, the cyto-biocompatibility of the acellular HAM was proven by the cell viability test (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide, MTT) and scanning electron microscopy (SEM). The resistant bacteria were isolated from burns, identified, and tested for their susceptibility to antibiotics using both the antibiogram and polymerase chain reaction (PCR) techniques. Among the isolated bacteria, three blaIMP gene-positive Pseudomonas aeruginosa strains were chosen for their high resistance to the tested antibiotics. The antibacterial activity of the HAM was also tested for Klebsiella pneumoniae (American Type Culture Collection (ATCC) 700603) as a resistant ATCC bacterium; Staphylococcus aureus (mecA positive); and three standard strains of ATCC bacteria including Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27833), and S. aureus (ATCC 25923). Antibacterial assay revealed that only the latter three bacteria were susceptible to the HAM. All the data obtained from this study suggest that an alternative strategy is required to complement HAM grafting in order to fully protect burns from nosocomial infections. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  20. Does reduction of amniotic fluid affect fetal movements?

    NARCIS (Netherlands)

    Sival, D A; Visser, G H; Prechtl, H F

    The effect of the amount of amniotic fluid on the form of fetal general movements was studied longitudinally in 19 pregnancies complicated by premature rupture of the amniotic membranes (PROM). Before birth, general movements were studied weekly by means of 1-h ultrasound observations, performed

  1. Changes in the cytokine profile of patients blood with premature rupture of amniotic membranes and their pathogenic significance

    Directory of Open Access Journals (Sweden)

    Mikhaylov А.V.

    2013-06-01

    Full Text Available Purpose: Pathogenetic study of new diagnostic and prognostic criteria for evaluation of pregnancy in terms of the cytokine profile of blood. Materials and methods: The analysis of anti-inflammatory and pro-inflammatory cytokines in the blood of 50 pregnant women with preterm rupture of membranes in gestation of 22-34 weeks, who were treated at the Department of Pathology in pregnancy of Saratov Perinatal Center in 2012, was performed. The method of enzyme linked immunosorbent assay using test systems «Vector— Best» (Novosibirsk, Russia. Results:.Clinical and laboratory examination revealed an increase levels of IL-1(3, IL-2, IL-6, IL-8, TNF-a, while reducing the content of IL-4, IL-10 in blood. Conclusion: Manifest signs of possibility of prenatal rupture of membranes and premature labour in 22-34 weeks gestation are combined with increasing of IL-1(3, IL-6, IL-8, TNF-a, IL-2 and with decreasing of IL-10, IL-4 level in the blood, which indicates the need for monitoring the content of these cytokines in the blood for the diagnosis and prognosis of pregnancy.

  2. A new approach for sutureless 20-G vitrectomy

    Directory of Open Access Journals (Sweden)

    Dikran G Hovaghimian

    2015-01-01

    The new approach of 20-G sutureless vitrectomy utilizing N-butyl-2-cyanoacrylate is a safe and effective technique for the surgical treatment of a variety of vitreoretinal pathologies. Conversion to this technique is very simple. A very short learning curve is required, with no need for new expensive instrumentation. It combines all the advantages of 20-G vitrectomy, adding to it the sutureless advantage of the technique.

  3. Human β-Defensin-2: A natural anti-microbial peptide present in amniotic fluid participates in the host response to microbial invasion of the amniotic cavity

    Science.gov (United States)

    Soto, Eleazar; Espinoza, Jimmy; Nien, Jyh Kae; Kusanovic, Juan; Erez, Offer; Richani, Karina; Santolaya-Forgas, Joaquin; Romero, Roberto

    2012-01-01

    OBJECTIVE Human β-defensin-2 (HBD-2) is a potent anti-microbial peptide that is part of the innate immune response. The purpose of this study was to determine whether HBD-2 is present in amniotic fluid and if its concentration changes with microbial invasion of the amniotic cavity (MIAC) and labor. STUDY DESIGN Amniotic fluid was retrieved by amniocentesis from 318 patients in the following groups: 1) mid-trimester (n=75); 2) term not in labor (n=28) and in labor (n=51); 3) preterm labor and intact membranes without MIAC who delivered at term (n=36), who delivered preterm without MIAC (n=52), and preterm labor with MIAC who delivered preterm (n=25); and 4) preterm premature rupture of membranes (PPROM) with (n=25) and without MIAC (n=26). MIAC was defined as a positive amniotic fluid culture for microorganisms. Amniotic fluid HBD-2 concentrations were determined using a sensitive and specific ELISA. Non-parametric statistics were used for analysis. RESULTS 1) HBD-2 was detected in all amniotic fluid samples; 2) the concentration of HBD-2 did not change with gestational age from midtrimester to term (p=0.8); 3) Intra-amniotic infection was associated with a significant increase in amniotic fluid concentrations of HBD-2 in both women with preterm labor and intact membranes, and women with preterm PROM (p100 cell per ml) had a higher median amniotic fluid concentration of HBD-2 than those without this condition (panti-microbial peptide, and this may account for some of the anti-microbial activity of amniotic fluid; 2) Amniotic fluid HBD-2 concentrations are increased in women with MIAC, regardless of the membrane status (intact membranes or PROM); and 3) We propose that amniotic fluid HBD-2 is part of the innate immune system within the amniotic cavity. PMID:17437194

  4. Amniotic fluid water dynamics

    NARCIS (Netherlands)

    Beall, M. H.; van den Wijngaard, J. P. H. M.; van Gemert, M. J. C.; Ross, M. G.

    2007-01-01

    Water arrives in the mammalian gestation from the maternal circulation across the placenta. It then circulates between the fetal water compartments, including the fetal body compartments, the placenta and the amniotic fluid. Amniotic fluid is created by the flow of fluid from the fetal lung and

  5. The use of amniotic membrane in the repair of duodenal wounds in Wistar rats Uso da membrana amniótica no reparo de feridas duodenais em ratos Wistar

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    Luciano Rodrigues Schimidt

    2010-02-01

    Full Text Available Purpose: In the search of a new material to repair duodenal wounds, a trial was conducted to assess the behavior of human amniotic membrane in the repair of the duodenal wall in rats. METHODS: Fifty Wistar rats weighing between 250 and 350g, male, were submitted to duodenotomy and randomly distributed into two groups. Group A (n=8 had no treatment and was used as the control group. In Group B (n=42 the duodenal wound was treated with a patch of human amniotic membrane. RESULTS: All animals in Group A died. In Group B no changes were observed with regards to death or the formation of duodenal fistula. All animals presented peritoneal adherences in the region on the duodenal wall repair and intestinal obstruction was observed in two animals. Healing of the duodenal wall in the region of the patch took place progressively as the post-operatory period increased, with regeneration of the mucosa and of the smooth muscle layer. CONCLUSION: From the clinical standpoint, the amniotic membrane proved to be a biological tissue which served as a temporary seal and allowed the wound to heal by second-intention, with re-establishment of the duodenal wall structure.OBJETIVO: Na busca de um novo material para o reparo dos ferimentos duodenais, foi efetuado um estudo para avaliar o comportamento da membrana amniótica humana no reparo da parede duodenal em ratos. MÉTODOS: Foram utilizados 50 ratos Wistar, com peso entre 250 e 350g, machos, distribuídos, aleatoriamente, em dois grupos. Grupo A (n=8, submetido à duodenotomia sem tratamento, utilizados como controle. Grupo B (n=42, submetido a um remendo de membrana amniótica humana para tratamento de ferimento duodenal provocado. RESULTADOS: Todos os animais do grupo A foram a óbito. No grupo B não foram observadas alterações quanto a óbito ou formação de fístula duodenal. Observaram-se em todos os animais aderências peritoneais à região do reparo da parede do duodeno e obstrução intestinal em

  6. Processo de reparação de lesões da córnea e a membrana amniótica na oftalmologia Repair process of corneal damage and the amniotic membrane in ophthalmology

    Directory of Open Access Journals (Sweden)

    Kelly Cristine de Sousa Pontes

    2011-12-01

    Full Text Available Os eventos que fazem parte do processo de reparação de lesões da córnea ocorrem simultaneamente e envolvem proliferação, migração, diferenciação e apoptose celular, além da comunicação intercelular. Vários fatores solúveis, além de proteínas da matriz mesenquimal, proteoglicanos, enzimas proteolíticas e alguns tipos celulares são abordados nesta revisão, na qual explicam-se os processos de reparação de lesões superficiais ou penetrantes da córnea. A membrana amniótica, muito utilizada na cirurgia oftálmica, foi estudada por apresentar funções que colaboram com o processo de reparação. Entretanto, tais funções poderão ser perdidas quando tal tecido for submetido à conservação. Assim, torna-se importante conhecer o processo de reparação de lesões que envolvem, ou não, a córnea em toda a sua espessura e escolher a melhor forma de utilização da membrana amniótica quando ela for indicada na terapia para estas lesões.The events included in the process of repair of corneal damage occur simultaneously and involve proliferation, migration, differentiation, cell apoptosis and intercellular communication. Several soluble factors, mesenchymal matrix proteins, proteoglycans, proteolytic enzymes and some cell types are covered in this review, which explains the processes of repair of corneal wounds, either superficial or penetrating. The amniotic membrane, used in ophthalmic surgery, was studied because of the contribution of its functions to the repair process. However, these functions may be lost when the amniotic membrane is subjected to conservation. Therefore, it is important to understand the repair process of lesions involving or not the entire thickness of the cornea, and choose the best use of the amniotic membrane, when it is indicated for the treatment of these lesions.

  7. Amniotic fluid inflammatory cytokines

    DEFF Research Database (Denmark)

    Abdallah, Morsi; Larsen, Nanna; Grove, Jakob

    2013-01-01

    The aim of the study was to analyze cytokine profiles in amniotic fluid (AF) samples of children developing autism spectrum disorders (ASD) and controls, adjusting for maternal autoimmune disorders and maternal infections during pregnancy.......The aim of the study was to analyze cytokine profiles in amniotic fluid (AF) samples of children developing autism spectrum disorders (ASD) and controls, adjusting for maternal autoimmune disorders and maternal infections during pregnancy....

  8. Carcinoembryonic antigen as a biomarker for meconium-stained amniotic fluid.

    Science.gov (United States)

    Mor, Amir; Tal, Reshef; Irani, Mohamad; McCalla, Sandra; Haberman, Shoshana; Garg, Deepika; Wajntraub, Birgitta

    2016-03-01

    To assess whether elevated carcinoembryonic antigen (CEA) concentration in amniotic fluid can indicate meconium-stained amniotic fluid (MSAF). In a prospective cohort study, women with a term singleton pregnancy who were in labor but had intact membranes were recruited at a center in Israel over a 5-month period in 2013. Only women who subsequently underwent artificial rupture of membranes following a clear medical indication were included. Samples of amniotic fluid, urine, and serum were collected. Amniotic fluid was examined by sight and classified as clear, MSAF, or undetermined. CEA concentration in the samples was measured. Among 81 participants, 45 had clear amniotic fluid, 28 had MSAF, and eight had undetermined amniotic fluid. Mean CEA concentration was more than 10 times higher in MSAF (2658 μg/L, standard error 250) than in clear amniotic fluid (238 μg/L, standard error 29; P<0.001). Receiver operating characteristic curve analysis demonstrated a sensitivity of 96% and a specificity of 100% for distinguishing MSAF from clear amniotic fluid at a CEA cutoff of 799.2 μg/L. CEA concentrations in urine and serum were all within the normal range (≤5 μg/L), irrespective of amniotic fluid status. High CEA concentrations in amniotic fluid can assist in the diagnosis of MSAF. These findings could provide the basis for a bedside test to detect MSAF following rupture of membranes. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Paediatric sutureless circumcision-an alternative to the standard technique.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

  10. Timing of Histologic Progression from Chorio-Deciduitis to Chorio-Deciduo-Amnionitis in the Setting of Preterm Labor and Preterm Premature Rupture of Membranes with Sterile Amniotic Fluid.

    Science.gov (United States)

    Park, Chan-Wook; Park, Joong Shin; Norwitz, Errol R; Moon, Kyung Chul; Jun, Jong Kwan; Yoon, Bo Hyun

    2015-01-01

    Histologic chorio-deciduitis and chorio-deciduo-amnionitis (amnionitis) in extra-placental membranes are known to represent the early and advanced stages of ascending intra-uterine infection. However, there are no data in humans about the time required for chorio-deciduitis to develop and for chorio-deciduitis without amnionitis to progress to chorio-deciduitis with amnionitis, and the effect of prolongation of pregnancy on the development of chorio-deciduitis and amnionitis in patients with preterm labor and intact membranes (PTL) and preterm premature rupture of membranes (preterm-PROM). We examined these issues in this study. The study population consisted of 289 women who delivered preterm (133 cases with PTL, and 156 cases with preterm-PROM) and who had sterile amniotic fluid (AF) defined as a negative AF culture and the absence of inflammation as evidenced by a matrix metalloproteinase-8 (MMP-8) level membranes (i.e., inflammation-free extra-placental membranes, choroi-deciduitis only, and chorio-deciduitis with amnionitis) in patients with PTL and preterm-PROM. Amniocentesis-to-delivery interval was longer in cases of chorio-deciduitis with amnionitis than in cases of chorio-deciduitis only in both PTL (median [interquartile-range (IQR)]; 645.4 [319.5] vs. 113.9 [526.9] hours; P = 0.005) and preterm-PROM (131.3 [135.4] vs. 95.2 [140.5] hours; Pmembranes. Moreover, prolongation of pregnancy is an independent predictor of the development of both chorio-deciduitis and amnionitis in cases of PTL with sterile AF.

  11. Effectiveness of the radio sterilized amniotic membrane transplantation vs conjunctival auto graft implant in the pterygium surgery with intraoperative mitomycin C;Eficacia del trasplante de membrana amniotica radioesterilizada vs injerto autologo conjuntival en la cirugia de pterigion con mitocomina C intraoperatoria

    Energy Technology Data Exchange (ETDEWEB)

    Tellez Y, L.; Martinez P, M. E. [ININ, Banco de Tejidos Radioesterilizados, Carretera Mexico-Toluca s/n, Ocoyoacac 52750, Estado de Mexico (Mexico); Vazquez M, L. [Hospital General de Mexico, Departamento de Cornea, Dr. Balmis No. 148, Col. Doctores, 06726 Mexico D. F. (Mexico)

    2009-07-01

    At the present time the traditional surgical handling of the pterygium with conjunctival implant presents high frequency. In this work the obtained results of a controlled clinic practice blind double are presented of the period of December from 2008 to December 2009, realized in the Medical Unit of Ambulatory Attention 231 of the Mexican Institute of the Public Health located in Metepec, Mexico State, in order to demonstrate the effectiveness and security of the alternative use of the radio sterilized amniotic membrane and intraoperative mitomycin C. For the study was included patients with diagnostic of primary nasal pterygium in one or both eyes, adults of both genus with an age range of 20 to 60 years, and was used radio sterilized amniotic membrane processed in the Bank of Radio Sterilized Tissues of the National Institute of Nuclear Research. (Author)

  12. Membrana amniótica canina utilizada como bandagem em úlcera superficial de córnea de coelhos: aspectos clínicos Canine amniotic membrane used as a bandage on rabbit superficial corneal ulceration: clinical aspects

    Directory of Open Access Journals (Sweden)

    K.C.S. Pontes

    2008-10-01

    Full Text Available Realizou-se a ceratectomia superficial em 28 coelhos, distribuídos em dois grupos. No grupo tratado, composto por 14 animais, utilizou-se a membrana amniótica canina como bandagem, suturada com sua face epitelial voltada contra a superfície corneana. O grupo controle não recebeu tratamento. A avaliação clínica foi realizada 24 horas após a cirurgia, a cada dois dias durante uma semana e a cada quatro dias até 180 dias. Avaliaram-se os efeitos da membrana amniótica como bandagem, comparando-se o tempo de epitelização da córnea entre os grupos e verificando o período necessário para que a córnea apresentasse transparência completa. A opacidade corneana esteve presente em todos os animais durante o período observado. O tratamento instituído resultou clinicamente em neovascularização corneana, opacidade de córnea mais intensa no período inicial de reparação, retardou o processo de epitelização e causou mais dor e desconforto que nos animais do grupo-controle.Twenty-eight rabbits were submitted to superficial keratectomy. The treated group consisted of 14 animals received canine amniotic membrane as a bandage, sutured in a way that its epithelial surface was in contact with the corneal surface. The control group did not receive any treatment. The animals were submitted to clinical evaluations 24 hours after surgery, at each two-day interval during one week and at each four-day interval during 180 days. The amniotic membranes were evaluated as a bandage comparing the time needed for corneal epithelization in the treated and non-treated groups and determining the period necessary for the cornea to become completely transparent. The corneal opacity was present during the entire time of observation. The treated animals presented more opaque cornea in the early period of regeneration, with neovascularization and more pain and discomfort than the animals from control group, showing a delayed epithelization.

  13. [Heterogeneity of costs and performance for penetrating eye injuries and suturing amniotic membranes under DRG conditions : Analysis of case constellations of the G-DRG C01B of the Regensburg University eye clinic].

    Science.gov (United States)

    Franz, D; Mrosek, M; Mrosek, S; Helbig, H; Framme, C

    2012-01-01

    Patients with penetrating eye injuries are a very heterogeneous group both medically and economically. Since 2009, treatment involving sutures for open eye injuries and cases requiring amniotic membrane transplantation (AMT) were allocated to DRG C01B of the German diagnosis-related group system. However, given the significant clinical differences between these treatments, an inhomogeneity of costs to performance is postulated. This analysis describes case allocation problems within the G-DRG C01B category and presents solutions. A retrospective analysis was conducted from the standardized G-DRG data of 277 patients with open eye injuries and AMT between 2007 and 2008, grouped under the 2008 G-DRG system version to the G-DRG C01Z category. This data was provided by the Department of Ophthalmology at the University Hospital Regensburg. Additionally case-based data of the following were supplemented: length of surgery, time of anesthesia and intensity of patient care. Fixed and variable costs were determined for surgery and other inpatient treatment. Finally, an analysis of the heterogeneity of costs within the G-DRG C01B of the G-DRG system 2009 was implemented. Inhomogeneity was evident within the G-DRG C01B of the G-DRG system 2009 for the two groups suture of open eye injuries and AMT concerning the parameters length of stay, proportion of high outliers and cost per case. Multiple surgeries during an inpatient stay lead to an extended length of stay and increasing costs, especially within the AMT group. Intensity of patient care and the consideration of patient comorbidity did not yield relevant differences. The quality of the G-DRG system is measured by its ability to obtain adequate funding for highly complex and heterogeneous cases. Specific modifications of the G-DRG structures could increase the appropriateness of case allocation for patients with open eye injuries within the G-DRG C01B of the German DRG system 2009. As a result of the present study, cases

  14. Análise ultraestrutural e de fatores de crescimento de diferentes métodos de preservação da membrana amniótica utilizada em cirurgia ocular Ultrastructural and growth factor analysis of amniotic membrane preserved by different methods for ocular surger

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    Janethe Deolinda de Oliveira Pena

    2007-10-01

    the presence of growth factors and cytokines of amniotic membrane preserved in glycerol/MEM (1:1 or undiluted dimethyl sulfoxide through electron microscopy. METHODS: Amniotic membrane preserved in glycerol/MEM (1:1 or undiluted dimethyl sulfoxide were processed for transmission and scaning electron microscopy. As control, freshly collected amniotic membrane was fixed and processed for electron microscopy. The cytokines and growth factors assessed were: TGF-beta (transforming growth factor beta; TGF-b activ (activated transforming growth factor beta; EGF (epidermal growth factor; FGF-4 (fibroblast growth factor 4; bFGF (basic fibroblast growth factor; IL-4 (interleukin 4; PGE2 (prostaglandin E2; IL-10 (interleukin 10; KGF (keratinocyte growth factor; HGF (hepatocyte growth factor. RESULTS: Amniotic membrane from the control group showed intact epithelium, with surface microvilli and junctional complexes between the cells and the basal membrane. Glycerol/MEM preserved amniotic membrane had similar aspect to the control, with higher epithelial cells. Those amniotic membranes preserved in dimethyl sulfoxide disclosed less intercellular junction and detachment of the epithelium from the basal membrane. The cytokines and growth factors did not disclose significant differences, except for FGF-4, bFGF, PGE2 and KGF. CONCLUSIONS: Amniotic membrane preserved in glycerol/MEM showed a better tissue structure, with less detachment of the epithelium from the basal membrane, in comparison to undiluted dimethyl sulfoxide. The majority of the growth factors and cytokines were kept with both techniques of preservation.

  15. Timing of Histologic Progression from Chorio-Deciduitis to Chorio-Deciduo-Amnionitis in the Setting of Preterm Labor and Preterm Premature Rupture of Membranes with Sterile Amniotic Fluid.

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    Chan-Wook Park

    Full Text Available Histologic chorio-deciduitis and chorio-deciduo-amnionitis (amnionitis in extra-placental membranes are known to represent the early and advanced stages of ascending intra-uterine infection. However, there are no data in humans about the time required for chorio-deciduitis to develop and for chorio-deciduitis without amnionitis to progress to chorio-deciduitis with amnionitis, and the effect of prolongation of pregnancy on the development of chorio-deciduitis and amnionitis in patients with preterm labor and intact membranes (PTL and preterm premature rupture of membranes (preterm-PROM. We examined these issues in this study.The study population consisted of 289 women who delivered preterm (133 cases with PTL, and 156 cases with preterm-PROM and who had sterile amniotic fluid (AF defined as a negative AF culture and the absence of inflammation as evidenced by a matrix metalloproteinase-8 (MMP-8 level <23 ng/ml. We examined the association between amniocentesis-to-delivery interval and inflammatory status in the extra-placental membranes (i.e., inflammation-free extra-placental membranes, choroi-deciduitis only, and chorio-deciduitis with amnionitis in patients with PTL and preterm-PROM.Amniocentesis-to-delivery interval was longer in cases of chorio-deciduitis with amnionitis than in cases of chorio-deciduitis only in both PTL (median [interquartile-range (IQR]; 645.4 [319.5] vs. 113.9 [526.9] hours; P = 0.005 and preterm-PROM (131.3 [135.4] vs. 95.2 [140.5] hours; P<0.05. Amniocentesis-to-delivery interval was an independent predictor of the development of both chorio-deciduitis and amnionitis after correction for confounding variables such as gestational age at delivery in the setting of PTL, but not preterm-PROM.These data confirm for the first time that, in cases of both PTL and preterm-PROM with sterile AF, more time is required to develop chorio-deciduitis with amnionitis than chorio-deciduitis alone in extra-placental membranes. Moreover

  16. [Amniotic fluid, amniocentesis, postmaturity].

    Science.gov (United States)

    Almazán Díaz, M

    1979-01-01

    The exchange among the elements of amniotic liquid is a dinamic process which keeps stable the concentration of their components, showing a variable relation with the maternal plasma in the differents stages of gestation. Thus the formations of the kidneys modifies the amniotic liquid with the urine excretion and then, factors as swallowing; the secretions of the skin and bronchi are factors which are implicated in its production. The amniocentesis is important in the study of high risk fetus, particulary with a prognostic value in the pregnancy sensitized to the Rh factor. The non cultivated celle give us information about the sexual chromatine and enzymes, to get a quick diagnosis, but this has to be confirmed with a culture cells for a final diagnosis, especially in diseases caused by inborn errors of metabolism.

  17. [Biologic tests for the diagnosis of amniotic fluid embolism].

    Science.gov (United States)

    Van Cortenbosch, B; Huel, C; Houfflin Debarge, V; Luton, D; Lambaudie, E; Porquet, D; Guibourdenche, J

    2007-01-01

    Amniotic fluid embolism is a rare, unpredictable and often lethal complication of pregnancy and childbirth. Because of its variable presentation, an early biologic test would help to establish the diagnosis. We investigated in maternal serum 4 components of amniotic fluid, i.e., alpha-fetoprotein (AFP), l'insuline like growth factor binding protein-1 (IGFBP-1), fetal fibronectin (fFN) and placental alpha1-microglobulin (PAMG-1). On the 6 cesareans controls involved, none of the makers increased after membranes section. PAMG-1 is unsuitable because its detection is always positive or doubtful even in the baseline. On the 7 cases suspected of amniotic fluid embolism, no detectable increase in any of those markers was noted in 3 cases, which is not in favour of this diagnosis. In the remaining cases, IGFBP-1 and fFN became detectable, confirming histological evidences of amniotic fluid embolism in 2 cases. The follow up of those markers in maternal blood confirmed the suspicion of amniotic fluid embolism at 21 wg in one case of ongoing pregnancy. These preliminary results point out the potential interest to assay maternal serum AFP, IGFBP-1 and fFN to confirm amniotic fluid embolism using rapid laboratory tests.

  18. Detection of microbial invasion of the amniotic cavity by analysis of cervicovaginal proteins in women with preterm labor and intact membranes.

    Science.gov (United States)

    Combs, C Andrew; Garite, Thomas J; Lapidus, Jodi A; Lapointe, Jerome P; Gravett, Michael; Rael, Julie; Amon, Erol; Baxter, Jason K; Brady, Kim; Clewell, William; Eddleman, Keith A; Fortunato, Stephen; Franco, Albert; Haas, David M; Heyborne, Kent; Hickok, Durlin E; How, Helen Y; Luthy, David; Miller, Hugh; Nageotte, Michael; Pereira, Leonardo; Porreco, Richard; Robilio, Peter A; Simhan, Hyagriv; Sullivan, Scott A; Trofatter, Kenneth; Westover, Thomas

    2015-04-01

    Microbial invasion of the amniotic cavity (MIAC) is common in early preterm labor and is associated with maternal and neonatal infectious morbidity. MIAC is usually occult and is reliably detected only with amniocentesis. We sought to develop a noninvasive test to predict MIAC based on protein biomarkers in cervicovaginal fluid (CVF) in a cohort of women with preterm labor (phase 1) and to validate the test in an independent cohort (phase 2). This was a prospective study of women with preterm labor who had amniocentesis to screen for MIAC. MIAC was defined by positive culture and/or 16S ribosomal DNA results. Nine candidate CVF proteins were analyzed by enzyme-linked immunosorbent assay. Logistic regression was used to identify combinations of up to 3 proteins that could accurately classify the phase 1 cohort (N = 108) into those with or without MIAC. The best models, selected by area under the curve (AUC) of the receiver operating characteristic curve in phase 1, included various combinations of interleukin (IL)-6, chemokine (C-X-C motif) ligand 1 (CXCL1), alpha fetoprotein, and insulin-like growth factor binding protein-1. Model performance was then tested in the phase 2 cohort (N = 306). MIAC was present in 15% of cases in phase 1 and 9% in phase 2. A 3-marker CVF model using IL-6 plus CXCL1 plus insulin-like growth factor binding protein-1 had AUC 0.87 in phase 1 and 0.78 in phase 2. Two-marker models using IL-6 plus CXCL1 or alpha fetoprotein plus CXCL1 performed similarly in phase 2 (AUC 0.78 and 0.75, respectively), but were not superior to CVF IL-6 alone (AUC 0.80). A cutoff value of CVF IL-6 ≥463 pg/mL (which had 81% sensitivity in phase 1) predicted MIAC in phase 2 with sensitivity 79%, specificity 78%, positive predictive value 38%, and negative predictive value 97%. High levels of IL-6 in CVF are strongly associated with MIAC. If developed into a bedside test or rapid laboratory assay, cervicovaginal IL-6 might be useful in selecting patients in

  19. Short term results of pterygium surgery with adjunctive amniotic ...

    African Journals Online (AJOL)

    One patient developed dellen 1 week post‑operatively with complete resolution following conservative large soft contact lens application. Conclusion: Short term results suggests that adjunctive amniotic membrane transplant with pterygium excision is effective and safe. A larger randomized clinical trial with a longer ...

  20. Membrana amniótica preservada em glicerina no reparo de feridas cutâneas de membros locomotores de eqüinos Equine amniotic membrane preserved in glycerin in reparing the equine limbs cütaneous wounds

    Directory of Open Access Journals (Sweden)

    Valdemir Alves de Oliveira

    1998-12-01

    Full Text Available Neste estudo experimental, avaliou-se o uso de membrana amniótica eqüina preservada em glicerina 98%, à temperatura ambiente, em feridas com cura por segunda intenção, nos membros locomotores de eqüinos. Foram provocadas cirurgicamente feridas de 9,6cm² na face lateral da articulação metacarpo-falangeana, face medial do terço proximal do metacarpo e face lateral do terço médio do metatarso de ambos os membros locomotores de cinco eqüinos adultos, perfazendo total de trinta feridas. Foram constituídos dois grupos experimentais com quinze feridas cada, sendo um destes grupos tratado com membrana amniótica, e o outro, grupo controle, tendo recebido apenas gaze umidecida em solução fisiológica. Os curativos foram trocados a cada 48horas, tendo sido a membrana amniótica e a gaze umidecida substituídas. Em todas as feridas foram mensurados a área, o grau de secreção, a formação de tecido de granulação exuberante e o tempo para a epitelização se completar. Realizou-se também exame bacteriológico e histopatológico em um grupo de feridas, tratadas e controle. Na membrana amniótica, fez-se determinação bioquímica de proteínas e identificação de fator de crescimento de fibroblasto. Em todas as feridas tratadas, observou-se: menor tempo para cicatrização, menor formação de tecido de granulação exuberante, menor incidência de bactérias patológicas e menor aumento na área total.In the present experimental study, the use of the equine amniotic membrane preserved in glvcerol 98%, at room temperature, in wounds with secound intention healing of equine limbs were evaluated. Surgical wounds of the size of 9.6cm² were made on the fetiock joint, medial aspect of the proximal third of the metacarpus and lateral aspect of the medium third of the metatarsus ofboth limbs offive adult horses, making a total of thirty wounds. Two experimental groups were made with fifteen wounds in each group, where one of these groups was

  1. Effects of ionizing radiation on glycerolated amniotic membranes as a substract for cultured human epithelium; Efeitos da radiacao ionizante em membranas amnioticas gliceroladas empregadas como substrato ao cultivo de epitelio humano

    Energy Technology Data Exchange (ETDEWEB)

    Paggiaro, Andre Oliveira

    2011-07-01

    The amniotic membrane (AM) is a biomaterial with biological properties that are beneficial to tissue repair. It has been used as a temporary coverage to threat burns and chronic wounds. Recently, it has been served as a substrate for keratinocytes culture to construct a living skin equivalent. However, MA is a biological material, and its transplantation could cause infectious disease for receptors. So, it must be preserved and sterilized before clinical use. The aim of this study was to evaluate the radiation effects on glycerol-preserved MA, considering its compatibility to support human keratinocytes culture. Four MA were stored in high concentrations of glycerol (> 85%) and half of them were radio sterilized with a dose of 25 kGy. Then, we established two groups: nonirradiated MA (MA-ni) and irradiated MA (MA-i). Both groups was deepithelialized by a standardized protocol and was investigated morphologically, immunohistochemical and ultrastructural. Subsequently human keratinocytes were cultivated immersed and in air-liquid interface on denuded surface of MA-i and MA-ni. The results were compared at 14 and 21 days of culture by light and electron microscopy. After epithelial denudation, analyses demonstrated the continuity of the basement membrane in MA-ni group, whereas in the irradiated group, there was no indication of the basement membrane’s presence on the surface of MA. The cell cultures showed that in the non-irradiated group, there was growth of a multi-layered and differentiated epithelium, with a stratum corneum’s formation in air-liquid interface. In the irradiated group, the epithelium had only two or three layer, little cell differentiation, with the same results immersed or air-liquid interface system. Glycerol-preserved MA was biocompatible with the growth of a cultivated epithelium, showing its potential as a skin substitute. Irradiation at 25 kGy cause structural damage to the tissue, making changes in basement membrane, that facilitates

  2. Upper Eyelid Silicone Oil Migration After Sutureless 23-Gauge Vitrectomy

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    Alireza Dehghani

    2017-01-01

    Full Text Available To report a case of upper eyelid swelling and ptosis caused by silicone oil migration in a patient after sutureless 23-gauge pars plana vitrectomy and silicone oil injection. A 36-year-old female was referred to eye clinic with total retinal detachment (RD and superotemporal giant dialysis secondary to trauma in the left eye. Transconjunctival sutureless 23-gauge pars plana vitrectomy and intraocular silicone oil (1300 centistokes injection were performed. After about 5 months, she came back with the left upper eyelid and periorbital swelling. Palpation of the eyelid revealed soft and mobile subcutaneous small lumps that were not attached to the skin. Computed tomography scan of the orbit showed an 11 mm × 8 mm soft tissue density mass in lateral aspect of the left orbit. Transcutaneously surgical exploration was performed. The patient was seen after 1 week postoperatively and there was a significant improvement of the ptosis. Eyelid swelling and ptosis caused by silicone oil migration after RD surgery are very rare and this is one of the few reports in literature.

  3. Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

    Science.gov (United States)

    Pavlidis, Mitrofanis; de Ortueta, Diego; Scharioth, Gabor B

    2011-05-01

    To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus. A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus. Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis. Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction. Copyright 2011, SLACK Incorporated.

  4. Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation.

    Science.gov (United States)

    Scharioth, Gabor B; Prasad, Som; Georgalas, Ilias; Tataru, Calin; Pavlidis, Mitrofanis

    2010-02-01

    To report the intermediate multicenter results of a technique of sutureless intrascleral fixation of a standard 3-piece posterior chamber intraocular lens (PC IOL) in the ciliary sulcus. Four European ophthalmology centers. A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PC IOL was retrospectively evaluated. The technique uses standardized maneuvers to fixate the PC IOL without need for special haptic architecture or preparation or haptic suturing. All patients having IOL implantation by the technique were evaluated for preoperative status (visual acuity, refractive error, preexisting ocular conditions, optical biometry), postoperative status, complications, and need for further surgery. The study evaluated 63 consecutive patients from 4 institutions (4 surgeons). The median follow-up was 7 months. Two dislocated PC IOLs (3.6%) were decentered; the other 61 IOLs (96.8%) were stable and well centered. There were no cases of recurrent dislocation, endophthalmitis, retinal detachment, or glaucoma. Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases. Copyright 2010 ASCRS and ESCRS. All rights reserved.

  5. Outcomes of Sutureless Iris-Claw Lens Implantation.

    Science.gov (United States)

    Choragiewicz, Tomasz; Rejdak, Robert; Grzybowski, Andrzej; Nowomiejska, Katarzyna; Moneta-Wielgoś, Joanna; Ozimek, Małgorzata; Jünemann, Anselm G M

    2016-01-01

    Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2). The mean preoperative CDVA was 0.25 (SD 0.21). The final mean CDVA was 0.46 (SD 0.27). No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was -0.27 Dsph (-3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28). The mean postoperative astigmatism was -1.82 Dcyl (min -0.25, max -5.5; median -1.25, SD 1.07). Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4). Conclusion. Retropupilary iris-claw intraocular lens (IOL) implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction.

  6. Outcomes of Sutureless Iris-Claw Lens Implantation

    Directory of Open Access Journals (Sweden)

    Tomasz Choragiewicz

    2016-01-01

    Full Text Available Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2. The mean preoperative CDVA was 0.25 (SD 0.21. The final mean CDVA was 0.46 (SD 0.27. No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was −0.27 Dsph (−3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28. The mean postoperative astigmatism was −1.82 Dcyl (min −0.25, max −5.5; median −1.25, SD 1.07. Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4. Conclusion. Retropupilary iris-claw intraocular lens (IOL implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction.

  7. Aortic valve replacement with sutureless prosthesis: better than root enlargement to avoid patient-prosthesis mismatch?

    Science.gov (United States)

    Beckmann, Erik; Martens, Andreas; Alhadi, Firas; Hoeffler, Klaus; Umminger, Julia; Kaufeld, Tim; Sarikouch, Samir; Koigeldiev, Nurbol; Cebotari, Serghei; Schmitto, Jan Dieter; Haverich, Axel; Shrestha, Malakh

    2016-06-01

    Aortic valve replacement in patients with a small aortic annulus may result in patient-prosthesis mismatch (PPM). Aortic root enlargement (ARE) can reduce PPM, but leads to extended cardiac ischaemia times. Sutureless valves have the potential to prevent PPM while reducing cardiac ischaemia times. Between January 2007 and December 2011, a total of 128 patients with a small aortic annulus underwent surgery for aortic valve stenosis at our centre. Thirty-six (17% male, n = 6) patients received conventional valve replacement with ARE and 92 (16% male, n = 18) subjects received sutureless valve implantation (Sorin Perceval). We conducted a comparative, retrospective study with follow-up. The sutureless group showed a significantly higher age (79 years) than the ARE patients (62 years, P body surface area was 0.91 ± 0.2 cm(2)/m(2) in ARE patients and 0.83 ± 0.14 cm(2)/m(2) in sutureless patients (P = 0.040). The rate of patients with severe PPM was 6% (n = 2) in ARE patients and 11% (n = 8%) in sutureless patients (not significant, n.s.). The 30-day mortality rates were 2% (n = 2) in sutureless patients and 6% (n = 2) in ARE patients (n.s.). The 1- and 5-year survival rates of the sutureless group were 92 and 54% years, respectively, whereas the 1- and 5-year survival rates of the ARE group were 76% (n.s.). Although the sutureless valve patients received significantly more concomitant procedures, all operation-associated times were significantly shorter. Despite sutureless valve patients being older, the 30-day mortality and survival rates were comparable in the two groups. Since the indexed EOA was only slightly lower and the incidence of severe PPM was not significantly higher in the sutureless valve patients, we conclude that sutureless valve implantation is an alternative to conventional ARE to treat a small aortic annulus and avoid PPM, especially in geriatric patients who benefit from the quick implantation process. © The Author 2016. Published by Oxford

  8. Investigation of postoperative intraocular pressure in cases of silicone oil removal using 25-gauge transconjunctival sutureless vitrectomy with oblique incisions.

    Science.gov (United States)

    Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

    2015-01-01

    The purpose of this study was to investigate postoperative intraocular pressure (IOP) in cases of silicone oil (SO) removal when using 25-gauge transconjunctival sutureless vitrectomy (TSV) with oblique incisions. We enrolled ten consecutive eyes with SO removal (SO group) and eleven consecutive eyes with idiopathic epiretinal membrane (ERM) as the initial vitrectomy (ERM group) in cases using 25-gauge TSV with oblique incisions. Postoperative IOPs were compared between the two groups at each of the four examination periods. No significant differences were identified in any of the periods examined. The use of 25-gauge TSV with oblique incisions resulted in almost equivalent postoperative IOPs between cases with SO removal and idiopathic ERM as the initial operation. Self-sealing sclerotomy in 25-gauge TSV with oblique incisions may primarily involve the valve architecture, and be complemented by vitreous incarceration.

  9. Membrana amniótica e pericárdio canino como curativos biológicos na preparação do leito receptor para enxertia cutânea autógena Canine amniotic membrane and pericardium as a biological wound dressing in the preparation of the recipient site to autogenous skin graft

    Directory of Open Access Journals (Sweden)

    M.L. Aceto

    2007-04-01

    Full Text Available Avaliou-se o tecido de granulação formado com o uso de membrana amniótica e pericárdio canino como curativo biológico oclusivo em feridas cutâneas experimentais. Utilizaram-se 15 cães; em cada animal, foram produzidas três feridas na região torácica dorsal. As feridas craniais e caudais receberam aloenxerto de membrana amniótica e pericárdio canino, respectivamente, e as feridas intermediárias (controle curativo não aderente. No sétimo dia, sobre todas as feridas, foram feitas auto-enxertias cutâneas. Foram realizadas avaliações clínicas, histológicas, incluindo contagem e diâmetro médio dos vasos sangüíneos do tecido de granulação bem como coleta de secreção das feridas e dos enxertos. Concluiu-se que a aplicação do curativo de membrana amniótica e de pericárdio canino sobre feridas cutâneas durante sete dias não estimula o aparecimento da granulação necessária para a aplicação à enxertia cutânea, podendo, apenas, ser utilizado como curativo biológico oclusivo.The granulation tissue formed with the use of amniotic membrane (ME and canine pericardium (PE as an occlusive biological dressing in experimental cutaneous wounds was evaluated Fifteen dogs, having three wounds on the dorsal thoracic region of each (FA -amniotic, FC -control and FP-pericardium were used. Clinical and histological evaluations were carried out, including counting and measuring the average diameter of the blood vessels of the granulation tissue, as well as bacteriological exams (swabs of the wounds and the grafts. The granulation tissue formed after seven days of using the canine amniotic membrane showed a vascular histological aspect, being able to be favorable to the cutaneous grafting. It was concluded that the use of amniotic membrane and canine pericardium dressing on cutaneous wounds during seven days did not stimulate the presence of granulation necessary for the use of cutaneous grafting, however, it can be used as an

  10. RESEARCH ON REDUCING PREMATURITY RUPTURE OF MEMBRANE

    OpenAIRE

    Maria URSACHI (BOLOTA); Emil ANTON; Sorana Caterina ANTON

    2016-01-01

    The membranes surrounding the amniotic cavity are composed from amnion and chorion, tightly adherent layers which are composed of several cell types, including epithelial cells, trophoblasts cells and mesenchyme cells, embedded in a collagenous matrix. They retain amniotic fluid, secret substances into the amniotic fluid, as well as to the uterus and protect the fetus against upward infections from urogenital tract. Normally, the membranes it breaks during labor. Premature rupture of the amn...

  11. Sutureless versus Transfemoral Transcatheter Aortic Valve Implant: A Propensity Score Matching Study.

    Science.gov (United States)

    Santarpino, Giuseppe; Vogt, Ferdinand; Pfeiffer, Steffen; Dell'Aquila, Angelo M; Jessl, Jürgen; Cuomo, Federica; von Wardenburg, Che; Fischlein, Theodor; Pauschinger, Matthias; Schwab, Johannes

    2017-05-01

    Transcatheter aortic valve implantation (TAVI), especially via the transfemoral (TF) route, is increasingly performed in patients considered in the 'gray zone' between TAVI and surgery. However, the best treatment option in this patient population remains to be established. Since 2010, a total of 923 patients underwent either TAVI (n = 538) or sutureless aortic valve replacement (AVR) (n = 385) at the authors' institutions. Among these patients, 79 treated with TF-TAVI were compared with 79 propensity score-matched patients who had undergone elective isolated AVR with the sutureless Perceval bioprosthesis. In-hospital mortality did not differ significantly between patients who underwent sutureless AVR or TF-TAVI (none versus three; 3.8%; p = 0.123). Similarly, postoperative complications were comparable between groups. Atrioventricular block requiring postoperative pacemaker implantation occurred in seven patients (9.2%) of the sutureless group and in eight patients (11.1%) of the TF-TAVI group (p = 0.455). The use of blood products varied between groups in terms of red blood cell transfusions (1.7 ± 2 versus 0.3 ± 0.9 units for the sutureless group versus TF-TAVI group; p <0.001). Paravalvular leakage at discharge was present in three patients (3.8%) in the sutureless group and in 26 patients (32.9%) in the TF-TAVI group (p <0.001). The mean follow up was longer for sutureless AVR (36 ± 21 versus 27 ± 20 months; p = 0.003). Survival rates were 97.5% and 84.8% in the sutureless and TF-TAVI groups, respectively (p = 0.001). Both, TF-TAVI and sutureless AVR are well-standardized, safe and effective procedures. TF-TAVI seems to be a valuable alternative to surgical AVR for frail patients, reducing the need for perioperative blood transfusion. In contrast, in patients with a favorable long-term survival outcome, minimally invasive AVR remains the procedure of choice as it is associated with better long-term results.

  12. Evaluation of a poly(L-lactic acid) stent for sutureless vascular anastomosis.

    Science.gov (United States)

    Nakano, Yoshiyuki; Hori, Yoshio; Sato, Akira; Watanabe, Tetsuo; Takada, Shuji; Goto, Hitoshi; Inagaki, Akiko; Ikada, Yoshito; Satomi, Susumu

    2009-03-01

    We have developed a sutureless anastomosis device consisting of a biodegradable stent and stainless steel band for end-to-end anastomosis. The aim of this acute phase study was to evaluate the feasibility of a sutureless anastomotic procedure with a bioabsorbable stent during a 4-week period in a swine model. The porcine infrarenal aorta was replaced with an expanded polytetrafluoroethylene graft. A proximal anastomosis was completed using a sutureless anastomotic procedure employing a bioabsorbable stent made of poly(L-lactic acid) (PLLA) and a stainless steel plate. A distal anastomosis completed by manual suturing served as a control. At 4 weeks after surgery, angiography was performed. The animals were then killed, and the specimens were evaluated histologically. The sutureless anastomotic procedure required significantly less time than the suturing technique. Angiograms showed patency of the grafts, and no signs of either stenosis or leakage. Both pressure-proof and tensile tests confirmed the adequate mechanical strength of the anastomoses. Sutureless anastomosis with a PLLA stent appears to be feasible, at least within an observation period of 4 weeks. This simple procedure shortened the time of surgery and would contribute to reducing the risks of operation-related complications.

  13. Membrana amniótica na reconstrução da superfície ocular após exérese de carcinoma de células escamosas da conjuntiva Amniotic membrane for ocular surface reconstruction after conjunctival squamous cell carcinoma resection

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    Paulo Roberto de Carvalho-Rêgo

    2008-02-01

    Full Text Available OBJETIVO: Investigar a utilização da membrana amniótica humana na reconstrução da superfície ocular após exérese de carcinoma de células escamosas da conjuntiva. MÉTODOS: A membrana amniótica foi captada a partir de parto cesárea, conservada em meio de preservação de córnea e glicerol 1:1 e armazenada a -80º C. Os critérios de inclusão foram: pacientes portadores de lesão proliferativa conjuntival com características de carcinoma de células escamosas (lesão esbranquiçada plana ou elevada com aspecto em "carne de peixe", envolvendo conjuntiva, limbo e córnea. Oito olhos de 8 pacientes portadores de "carcinoma de células escamosas" da conjuntiva foram submetidos a cirurgia de exérese do tumor conjuntival, associado a transplante de membrana amniótica. Destes, 3 foram submetidos a epiteliectomia total da córnea e a transplante de limbo do olho contralateral. RESULTADOS: O tempo médio de seguimento foi de 17,8 meses (variação entre 10 e 35 meses. Cinco pacientes (71,4% obtiveram sucesso com o tratamento cirúrgico, com adequada reconstrução da área conjuntival retirada. Dois pacientes (28,6% obtiveram sucesso parcial, com presença de alterações cicatriciais leves (simbléfaro pequeno ou pequena fibrose. Um paciente foi excluído porque apresentou recidiva agressiva do tumor, com invasão intraocular, necessitando ser submetido a exenteração. CONCLUSÃO: O uso de membrana amniótica humana pode constituir uma importante opção para a reconstrução da superfície ocular após remoção de carcinoma de células escamosas.PURPOSE: This study was designed to evaluate the use of human amniotic membrane for ocular surface reconstruction after conjunctival squamous cell carcinoma resection. METHODS: Amniotic membrane was obtained at the time of cesarean section and was preserved at -80ºC in glycerol and cornea culture media at a ratio of 1:1. The inclusion criteria were patients presenting proliferating lesions

  14. Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatch?†.

    Science.gov (United States)

    Belluschi, Igor; Moriggia, Stefano; Giacomini, Andrea; Del Forno, Benedetto; Di Sanzo, Stefania; Blasio, Andrea; Scafuri, Antonio; Alfieri, Ottavio

    2017-06-01

    The aim of this study is to compare the theoretical incidence of patient-prosthesis mismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matching. Between May 2012 and March 2016, 65 patients with severe symptomatic aortic stenosis underwent a sutureless aortic valve replacement with the Perceval bioprosthesis in 2 centres. Moreover, 177 aortic valve replacements with conventional sutured bioprosthesis were performed between August 2003 and September 2015. Perceval and sutured patients were 1:1 exactly matched for sex and body surface area (BSA), resulting in 62 couples (sutureless: BSA 1.77 ± 0.16 m 2 , female 62.9% vs sutured: BSA 1.77 ± 0.15 m 2 , female 62.9%). After matching, the indexed effective orifice area was 1.50 ± 0.18 cm 2 /m 2 and 0.81 ± 0.19 cm 2 /m 2 in the sutureless and the sutured group, respectively ( P  < 0.001). No PPM occurred in patients who received a Perceval bioprosthesis ( n  = 62). In the sutured group ( n  = 62), 38 patients (61.3%) developed a PPM, which was moderate in 41.9% ( n  = 26) and severe in 19.4% ( n  = 12) ( P  < 0.001). The indexed effective orifice area of the sutureless group was significantly larger than in the sutured one. The incidence of PPM with the conventional sutured biprosthesis was 61.3%, while it decreases to 0% in the sutureless group. No PPM was reported in the sutureless valve group. Therefore, the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reduce the risk of a PPM. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Development of trans-1, 4-polyisoprene for sutureless vascular anastomosis

    Science.gov (United States)

    Yang, Hou-Ching; Silverman, Joseph

    Radiation crosslinked trans-1,4-polyisoprene (t-PIP) is shown to be effective as a heat shrinkable connector for severed blood vessels. The sutureless vascular anastomosis system (SVAS) requires a plastic sleeve with the following requirements: biocompatibility, heat shrinkability, melting point 50 to 60°C, and proper mechanical properties. The effects of irradiation by cobalt-60 gammas on pertinent physical properties were determined. The measurements of gel fraction, thermal and mechanical properties demonstrate that at appropriate dose levels t-PIP meets initial SVAS requirements. The ability of processed t-PIP to retain its structural integrity after aging was measured in various oxidizing environments for twenty weeks. The results show no change in the gel fraction and mechanical strength. An in-vitro test of the processed t-PIP with intravenous saline solution demonstrates that the material undergoes no physical property changes after five months. Also, biocompatibility of the crosslinked t-PIP sleeve was established by tests performed at the University of Tennessee. Both in-vitro in in-vivo tests were performed at The Johns Hopkins University. In the in-vivo test, an SVAS operation was performed on the carotid artery of a live dog. The results of all the tests demonstrated that the procedure and the t-PIP sleeve were effective and safe.

  16. Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers.

    Science.gov (United States)

    Wang, Yu-Chun; Hsieh, Chi-Hsun; Lo, Hung-Chieh; Su, Li-Ting

    2014-08-01

    Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU.

  17. Prompt 27-gauge sutureless transconjunctival vitrectomy for bleb-associated endophthalmitis.

    Science.gov (United States)

    Xiao, Bo; Yang, Jin; Chu, Yanhua; Han, Quanhong

    2017-10-23

    To summarize the characters of 6 bleb-associated endophthalmitis (BAE) cases and to report the outcomes of prompt 27-gauge sutureless transconjunctival vitrectomy to treat these cases. Retrospective, non-randomized, consecutive case series of patients diagnosed with bleb-associated endophthalmitis who underwent prompt 27-gauge vitrectomy. The interval to get bleb-associated endophthalmitis from previous surgery was variant from 2 weeks to 36 months. Most of the patients experienced eye pain. The visual acuity was affected quickly. All the patients presented with hypopyon, fibrinous reaction, and vitreous wick. The size of the hypopyon was from 2 to 4 mm. Two patients came with intraocular lenses. Prompt 27-gauge sutureless transconjunctival vitrectomy was performed on all patients with bleb-associated endophthalmitis. None of the patients experienced complications of sutureless vitrectomy such as hypotony or wound leak. The improvement of best corrected visual acuity (BCVA) was significant in four of six patients. The improvement of BCVA was statistically calculated by using logMAR VA (p  21 mmHg) and received pressure-lowering agents. BAE is associated with substantial visual morbidity. Prompt 27-gauge sutureless transconjunctival vitrectomy is an effective and safe way for treating bleb-associated endophthalmitis.

  18. Clinical effect of 23G transconjunctival sutureless vitrectomy for idiopathic macular hole

    Directory of Open Access Journals (Sweden)

    Wei Cao

    2014-06-01

    Full Text Available AIM: To observe the clinical effects of 23-gauge(23Gtransconjunctival sutureless vitrectomy for idiopathic macular hole.METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.RESULTS: The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation(χ2=8.65, P=0.003; χ2=10.33, P=0.001. The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases(18%. There was no statistically significant difference in intraocular pressure between pre-operation and post-operation. No post-operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up. CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

  19. Proteomic profiling of the amniotic fluid to detect inflammation, infection, and neonatal sepsis.

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    Catalin S Buhimschi

    2007-01-01

    Full Text Available Proteomic analysis of amniotic fluid shows the presence of biomarkers characteristic of intrauterine inflammation. We sought to validate prospectively the clinical utility of one such proteomic profile, the Mass Restricted (MR score.We enrolled 169 consecutive women with singleton pregnancies admitted with preterm labor or preterm premature rupture of membranes. All women had a clinically indicated amniocentesis to rule out intra-amniotic infection. A proteomic fingerprint (MR score was generated from fresh samples of amniotic fluid using surface-enhanced laser desorption ionization (SELDI mass spectrometry. Presence or absence of the biomarkers of the MR score was interpreted in relationship to the amniocentesis-to-delivery interval, placental inflammation, and early-onset neonatal sepsis for all neonates admitted to the Newborn Special Care Unit (n = 104. Women with "severe" amniotic fluid inflammation (MR score of 3 or 4 had shorter amniocentesis-to-delivery intervals than women with "no" (MR score of 0 inflammation or even "minimal" (MR score of 1 or 2 inflammation (median [range] MR 3-4: 0.4 d [0.0-49.6 d] versus MR 1-2: 3.8 d [0.0-151.2 d] versus MR 0: 17.0 d [0.1-94.3 d], p 100 cells/mm3, whereas the combination of Gram stain and MR score was best for rapid prediction of intra-amniotic infection (positive amniotic fluid culture.High MR scores are associated with preterm delivery, histological chorioamnionitis, and early-onset neonatal sepsis. In this study, proteomic analysis of amniotic fluid was shown to be the most accurate test for diagnosis of intra-amniotic inflammation, whereas addition of the MR score to the Gram stain provides the best combination of tests to rapidly predict infection.

  20. Amniotic Band Syndrome, Perinatal Hospice, and Palliative Care versus Active Management

    Directory of Open Access Journals (Sweden)

    Shadi Rezai

    2016-01-01

    Full Text Available Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence. The pregnancy was subsequently complicated by preterm premature rupture of membranes with oligohydramnios, resulting in a surviving neonate scheduled for rehabilitative treatment. Conclusion. Amniotic band syndrome is an uncommon congenital anomaly resulting in multiple disfiguring and disabling manifestations. Several theories are proposed with most involving early rupture of the amnion and entanglement of fetal parts by amniotic bands. This syndrome can be manifested by development of multiple malformations, with the majority of the defects being limb abnormalities of a disorganized nature, as in the case we present. In the absence of a clear etiology of consequential congenital abnormalities, obstetric management guidelines should use shared decision models to focus on the quality of life for the offspring.

  1. Side-to-side sutureless vascular anastomosis with magnets.

    Science.gov (United States)

    Erdmann, Detlev; Sweis, Ranya; Heitmann, Christoph; Yasui, Koji; Olbrich, Kevin C; Levin, L Scott; Sharkawy, A Adam; Klitzman, Bruce

    2004-09-01

    Abbe and Payr introduced vascular techniques and devices to facilitate vessel anastomosis over a century ago. Obora published the idea of a sutureless vascular anastomosis with use of magnetic rings in 1978. The purpose of this study was to assess the performance of a new magnetic device to perform a side-to-side arteriovenous anastomosis in a dog model. Male fox hounds (25 kg) were treated preoperatively and daily postoperatively with clopidogrel bisulfate (Plavix) and aspirin. The femoral artery and vein were exposed unilaterally in 3 dogs and bilaterally in 4 dogs (n = 11 anastomoses). A 4-mm arteriotomy was performed, and 1 oval magnet 0.5 mm thick was inserted into the lumen of the artery and a second magnet was applied external to the artery, compressing and stabilizing the arterial wall to create a magnetic port. An identical venous magnetic port was created with another pair of oval magnets. When the 2 ports were allowed to approach each other, they self-aligned and magnetically coupled to complete the arteriovenous anastomosis. Patency was assessed for the first hour with direct observation, again after 9 weeks with duplex ultrasound scanning, and at 10 weeks under direct open observation. The anastomoses were explanted after 10 weeks. Hydrodynamic resistance was measured ex vivo on the final 8 anastomoses by measuring the pressure drop across an anastomosis with a known flow rate. After implantation, very high flow created visible turbulence and palpable vibration. All 11 anastomoses were patent under direct observation and palpation. Ten of 11 anastomoses were clearly patent on duplex scans, and patency of 1 anastomosis was questionable. Hydrodynamic resistance averaged 0.73 +/- 0.33 mm Hg min/mL (mean +/- SEM). Vascular anastomoses performed with magnets demonstrated feasibility; exhibited 100% patency after 10 weeks in a dog arteriovenous shunt model; lacked apparent aneurysm or other potentially catastrophic failure; demonstrated remodeling of the

  2. Gender-Typed Play and Amniotic Testosterone

    Science.gov (United States)

    Knickmeyer, Rebecca Christine; Wheelwright, Sally; Taylor, Kevin; Raggatt, Peter; Hackett, Gerald; Baron-Cohen, Simon

    2005-01-01

    Sex differences in play are apparent in a number of mammalian species, including humans. Prenatal testosterone may contribute to these differences. The authors report the first attempt to correlate gender-typed play in a normative sample of humans with measurements of amniotic testosterone (aT). Testosterone was measured in the amniotic fluid of…

  3. Prenatal diagnosis of amniotic band syndrome

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    Laxmi Devi Padmanabhan

    2016-01-01

    Full Text Available Amniotic band can cause a broad spectrum of anomalies ranging from simple band constrictions to major craniofacial and visceral defects. It can cause significant neonatal morbidity. Accurate diagnosis will help in the management of the present pregnancy and in counseling with regard to future pregnancies. Here we report three cases of amniotic band syndrome detected in the prenatal period.

  4. Prevalence of human papillomavirus and herpes simplex virus in amniotic fluid from pregnant women of Eastern Poland

    Directory of Open Access Journals (Sweden)

    Mariusz Skoczyński

    2015-12-01

    Full Text Available Background: The exact route of human papillomavirus (HPV and herpes simplex virus (HSV transmission from a pregnant woman to her fetus has not been clearly established thus far. The data of many studies raise the possibility of intrauterine infection. In order to clarify our knowledge about virus vertical transmission in pregnant women, viral prevalence in amniotic fluid cannot. To the best of our knowledge, this is the first study on HPV DNA and HSV DNA detection in amniotic fluid in Poland.Material and methods: The study covered 138 samples of amniotic fluid from patients undergoing invasive prenatal diagnostic procedures (for medical indications during the second trimester of gestation. The aim of the study was to assess the prevalence of HPV and HSV in the amniotic fluid samples obtained from asymptomatic women with intact amniotic membranes. To identify viral DNA of HPV and HSV in collected material, polymerase chain reaction (PCR was performed.Results: We did not find HPV or HSV DNA in any of the examined specimens of amniotic fluid.Conclusion: Our investigation did not confirm the prenatal transmission of HPV and HSV to the amniotic fluid.

  5. Psychobiology of the amniotic environment.

    Science.gov (United States)

    Benassi, Luigi; Accorsi, Francesca; Marconi, Lorenza; Benassi, Gianluca

    2004-01-01

    Water, basic element of amniotic fluid (A.F.), is closely related to Life, Fertility and Motherhood in several cultures and religions. Through material evidences of an essential growth medium and useful diagnostic source, a new concept grow up: the fluid as a first real environment in which fetus lives and acts. Many studies confirm that in A.F. fetus starts his character-building, his memory and his intelligence. The fluid seems to be the first means of learning and acknowledgement. Sounds, smells and tastes are perceived as well as emotions and fears. Urinoterapy and staminal cells sampling shows how A.F. can be considered as an additional terapeutic resource.

  6. Amniotic fluid embolism mortality rate.

    Science.gov (United States)

    Benson, Michael D

    2017-11-01

    The objective of this study was to determine the mortality rate of amniotic fluid embolism (AFE) using population-based studies and case series. A literature search was conducted using the two key words: 'amniotic fluid embolism (AFE)' AND 'mortality rate'. Thirteen population-based studies were evaluated, as well as 36 case series including at least two patients. The mortality rate from population-based studies varied from 11% to 44%. When nine population-based studies with over 17 000 000 live births were aggregated, the maternal mortality rate was 20.4%. In contrast, the mortality rate of AFE in case series varies from 0% to 100% with numerous rates in between. The AFE mortality rate in population-based studies varied from 11% to 44% with the best available evidence supporting an overall mortality rate of 20.4%. Data from case series should no longer be used as a basis for describing the lethality of AFE. © 2017 Japan Society of Obstetrics and Gynecology.

  7. Cytological examination of rat amniotic epithelial cells and cell transplantation to the liver.

    Science.gov (United States)

    Nakajima, T; Enosawa, S; Mitani, T; Li, X K; Suzuki, S; Amemiya, H; Koiwai, O; Sakuragawa, N

    2001-01-01

    It is hoped that amniotic epithelial cells can be useful in cell-mediated gene therapy. We report here an experimental cell transplantation model of amniotic cells in rats. There is an anatomical difference between human and rodent embryos. We established a method to isolate amniotic cells that are equivalent to human amniotic epithelial cells. An amniotic membrane distinct from the yolk sac was carefully collected and teased in saline containing deoxyribonuclease and hyaluronidase, followed by collagenase digestion. The cell yield was approximately 10(6) cells per pregnant female (10(5) cells per fetus), roughly in proportion to the age of fetus used, and 60% of the isolated cells were attached to the dish under culture conditions. Telomerase activity was higher in the cells isolated from fetuses in the middle stage (day 13.5 to 15.5) than in the late stage (day 17.5 to 21.5). Adherent cells exhibited two to three times more cell division, resulting in a ninefold increase in the number of cells. Immunohistochemical analysis revealed that approximately half of the adherent cells were albumin positive and formed clusters. The senescent cells survived for 2 months without apparent morphological changes. The adherent cells were able to be stored in liquid nitrogen and had a viability of 70% when thawed. Gene transduction with adenovirus vector was highly effective for rat amniotic cells. Transplantation of lacZ transfected amniotic cells into syngeneic rat liver resulted in the integration of the transplanted cells in the liver structure and the cells survived for at least 30 days.

  8. Sutureless implantation of the perceval s aortic valve prosthesis through right anterior minithoracotomy.

    Science.gov (United States)

    Gilmanov, Daniyar; Miceli, Antonio; Bevilacqua, Stefano; Farneti, Pierandrea; Solinas, Marco; Ferrarini, Matteo; Glauber, Mattia

    2013-12-01

    Many new, less invasive strategies are proposed for aortic valve operation in elderly patients. Rapid deployment sutureless aortic valve prosthesis has been recently introduced. We analyzed our experience with a sutureless valve implanted through a minimally invasive approach. A retrospective observational study with prospectively registered data was conducted on 137 patients undergoing aortic valve replacement through a right anterior minithoracotomy. Between April 2011 and January 2013, 137 consecutive patients underwent aortic valve replacement with a recently introduced, rapid deployment, sutureless pericardial valve in minithoracotomy access (47 men; mean age, 76.6 ± 7.1 years). There were 35 obese patients with a body mass index of more than 30 kg/m(2). Mean logistic EuroSCORE I was 10.0; 74 (54%) patients were in New York Heart Association functional class III and IV. In all, 19 (13.9%), 45 (32.8%), and 73 (53.3%) patients received 21-, 23-, and 25-mm valve prostheses, respectively. The mean aortic cross-clamp and cardiopulmonary bypass times were 59.3 ± 19 min and 92.3 ± 27 min, respectively. No operative mortality occurred. Median stay in the intensive care unit was 1 day, with assisted ventilation necessary for a median of 6 hours. Three cases of postoperative ischemic stroke were observed (1 patient with a previous history of an ischemic cerebral event). Median hospital length of stay was 6 days. A sutureless valve for minimally invasive aortic valve replacement is a feasible, effective, and safe tool. Ultimately amplifying indications for less invasive aortic valve replacement in a high surgical risk subset of patients, it can become a valid alternative for transcatheter aortic valve implantation. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. 23-Gauge Sutureless Vitreo-Retinal Surgery for Superior Rhegmatogenous Retinal Detachment

    International Nuclear Information System (INIS)

    Zafar, S.; Mal, W.; Shakir, M.; Kamil, Z.; Bokhari, S. A.; Rizvi, S. F.

    2014-01-01

    Objective: To determine the results of 23-gauge sutureless vitreo-retinal surgery for superior/supero-temporal rhegmatogenous retinal detachment (RRD). Study Design: Quasi experimental study. Place and Duration of Study: LRBT, Free Base Eye Hospital, Karachi, from January 2010 to December 2011. Methodology: Adult patients who underwent 23-gauge sutureless vitreo-retinal surgery along with use of Perfluoropropane (C3F8) gas as internal tamponading agent for fresh (upto 3 weeks) superior/supero-temporal RRD was reviewed. Major outcome measures were anatomical success, best corrected visual acuity (BCVA) with Log Mar and complications during and after surgery. Postoperative follow-up was done on 1st day and at 1st, 4th, 8th and finally at 12th week. Results: Sixty eyes of 60 patients, age between 30 - 60 years including 37 (61.67%) males and 23 (38.33%) females having superior or superatemporal RRD underwent 23-guage sutureless vitreo-retinal surgery with the use of perfluoropropane (C3 F8) gas as internal temponade at the end of procedure. Anatomical success rate was 81.66% (49 out of 60 eyes) with first surgery and raised to 90% (54 cases) with second surgery. Log Mar BCVA significantly improved from mean baseline 0.93 to 0.49 with mean difference of 0.43 (p < 0.001), 95% confidence interval. Postoperative complications were sub-conjunctival haemorrhage in 11 eyes (18.33%), wound leak in 7 eyes (11.66%), anterior chamber became shallow in 6 eyes (10%), cataract developed in 5 eyes (8.33%), re-retinal detachment in 4 eyes (6.66%), ocular hypotony and sterile inflammatory reaction in 3 eyes (5%) each, while iatrogenic breaks developed in 2 eyes (3.33%). Conclusion: The 23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment achieved high anatomical success and significant visual improvement. Sub-conjunctival haemorrhage was the most frequent procedural complication. (author)

  10. Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device

    OpenAIRE

    Tetsuro Uchida, MD, PhD; Azumi Hamasaki, MD, PhD; Yoshinori Kuroda, MD; Atsushi Yamashita, MD; Jun Hayashi, MD; Mitsuaki Sadahiro, MD, PhD

    2017-01-01

    Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif) to create the proximal anastomosis, eliminating...

  11. The future of surgical aortic valve replacement and the role of sutureless technology.

    Science.gov (United States)

    Isbir, Selim

    2018-04-01

    Aortic valve stenosis has become the most frequent type of valve disease in worldwide. Surgical aortic valve replacement is still the gold standard therapy. More recently transcatheter aortic valve implantation has been demonstrated to be not inferior in patients with high and intermediate risk patients. Sutureless aortic valves were designed to simplify the surgical aortic valve replacement. With the aid of this new technology, the invasiveness of surgery can be reduced with potential improvements in outcome.

  12. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification for rhegmatogenous retinal detachment repair

    Directory of Open Access Journals (Sweden)

    Hoseok Moon

    2015-02-01

    Full Text Available AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment (RRD repair. METHODS: This was a retrospective, consecutive, non-comparative, interventional case series of 30 eyes of 30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications. RESULTS: Primary reattachment was achieved in 27 eyes (90.0%. The reasons for redetachment (3 eyes, 10% were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy, respectively. The logarithm of the minimum angle of resolution visual acuity (mean±SD improved from 0.76±0.74 preoperatively to 0.21±0.37 6 months’ postoperatively (PCONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.

  13. Primary correction of total anomalous pulmonary venous return with a modified sutureless technique.

    Science.gov (United States)

    Mueller, Christoph; Dave, Hitendu; Prêtre, René

    2013-03-01

    The objective was to evaluate primary sutureless repair of total anomalous pulmonary venous return (TAPVR) in neonates using a modified technique that minimizes hypothermia and circulatory arrest times. From 2009 to 2011, seven consecutive patients underwent primary sutureless repair for the treatment of TAPVR, by which the prepared posterior pericardium was sutured to an opening in the left atrium. Three patients had the obstructed infracardiac type, and four patients had the unobstructed supracardiac type of TAPVR. Moderate hypothermia was used in all patients with a median temperature of 28°C (26-32). Circulatory arrest was not used except for the opening of the collector, which lasted between 3 and 5 min. The connecting vein was ligated in all seven patients (five during repair and two early postoperatively). The follow-up was 100% complete, with a median duration of 652 (range 370-1023) days. There was no operative mortality and no late death. No patient required reoperation. Postoperative echocardiography showed unobstructed pulmonary venous flow in all patients. Recurrent pulmonary venous stenosis was not seen during the follow-up in any patient. The sutureless technique is an effective technique with potential advantages even for the primary correction of TAPVR. With the described technique, the need for circulatory arrest is substantially reduced. Not handling the pulmonary venous collector by avoiding a direct anastomosis may contribute to better compliance, better growth and the absence of subsequent stenosis.

  14. Multidimensional proteomics analysis of amniotic fluid to provide insight into the mechanisms of idiopathic preterm birth.

    Directory of Open Access Journals (Sweden)

    Irina A Buhimschi

    2008-04-01

    Full Text Available Though recent advancement in proteomics has provided a novel perspective on several distinct pathogenetic mechanisms leading to preterm birth (inflammation, bleeding, the etiology of most preterm births still remains elusive. We conducted a multidimensional proteomic analysis of the amniotic fluid to identify pathways related to preterm birth in the absence of inflammation or bleeding.A proteomic fingerprint was generated from fresh amniotic fluid using surface-enhanced laser desorbtion ionization time of flight (SELDI-TOF mass spectrometry in a total of 286 consecutive samples retrieved from women who presented with signs or symptoms of preterm labor or preterm premature rupture of the membranes. Inflammation and/or bleeding proteomic patterns were detected in 32% (92/286 of the SELDI tracings. In the remaining tracings, a hierarchical algorithm was applied based on descriptors quantifying similarity/dissimilarity among proteomic fingerprints. This allowed identification of a novel profile (Q-profile based on the presence of 5 SELDI peaks in the 10-12.5 kDa mass area. Women displaying the Q-profile (mean+/-SD, gestational age: 25+/-4 weeks, n = 40 were more likely to deliver preterm despite expectant management in the context of intact membranes and normal amniotic fluid clinical results. Utilizing identification-centered proteomics techniques (fluorescence two-dimensional differential gel electrophoresis, robotic tryptic digestion and mass spectrometry coupled with Protein ANalysis THrough Evolutionary Relationships (PANTHER ontological classifications, we determined that in amniotic fluids with Q-profile the differentially expressed proteins are primarily involved in non-inflammatory biological processes such as protein metabolism, signal transduction and transport.Proteomic profiling of amniotic fluid coupled with non-hierarchical bioinformatics algorithms identified a subgroup of patients at risk for preterm birth in the absence of intra-amniotic

  15. Early postoperative intraocular pressure stability after combined 23-gauge sutureless vitrectomy and cataract surgery in patients with proliferative diabetic retinopathy.

    Science.gov (United States)

    Lee, Jong Yeon; Jeong, Hoon Seok; Lee, Dae Yeong; Sohn, Hee Jin; Nam, Dong Heun

    2012-10-01

    To compare rates of early postoperative hypotony and intraocular pressure (IOP) elevation between 23-gauge sutureless vitrectomies with and without phacoemulsification and intraocular lens implantation in patients with proliferative diabetic retinopathy. This study reviewed the medical records of 302 eyes of patients who underwent primary 23-gauge sutureless vitrectomy for the complications of proliferative diabetic retinopathy. A case series of 207 eyes that underwent combined vitrectomy and cataract surgery (combined group) was compared with that of 95 eyes that underwent vitrectomy only (vitrectomy group): The eyes that remained phakic after the vitrectomy were excluded from this study. The main outcome measures were postoperative hypotony (IOP 30 mmHg). Postoperative hypotony was identified in 4 (1.9%) of 207 eyes in combined group, but in 7 (7.4%) of 95 eyes in vitrectomy group (P = 0.048). Rate of IOP elevation was very low and not different between the two groups. The multivariate analysis showed that vitrectomy without cataract surgery was associated with the postoperative hypotony (odds ratio = 4.6, P = 0.045). The incidence of early postoperative hypotony was lower in combined sutureless vitrectomy and cataract surgery than in sutureless vitrectomy alone and that of IOP elevation was very low in both groups. The maintenance of a stable IOP with a low risk of IOP fluctuation may be an additional advantage of sutureless diabetic vitrectomy combined with cataract surgery.

  16. The presence of vaginal Lactobacillus species does not contribute to a measureable difference in amniotic fluid lactate levels collected from the vaginal tract of laboring women.

    Science.gov (United States)

    Hall, Beverley; Wong, Diana; Healy, Clare; Tracy, Mark B; Tracy, Sally K; Rawlinson, William D

    2017-04-01

    Amniotic fluid lactate research is based on the hypothesis that a relationship exists between fatigued uterine muscles and raised concentrations of the metabolite lactate, which is excreted into the amniotic fluid during labor. To assess potentially confounding effects of lactate-producing organisms on amniotic fluid lactate measurements, we aimed to determine if the presence of vaginal Lactobacillus species was associated with elevated levels of amniotic fluid lactate, measured from the vaginal tract of women in labor. Results from this study contribute to a large prospective longitudinal study of amniotic fluid lactate at a teaching hospital in Sydney, Australia. Amniotic fluid lactate measurement was assessed at the time of routine vaginal examination, after membranes had ruptured, using a hand-held lactate meter StatStripXPress (Nova Biomedical). Vaginal swab samples were collected at the time of the first amniotic fluid lactate measurement and stored for later detection and quantification of Lactobacillus species using a TaqMan real-time PCR assay. Swab sample and amniotic fluid lactate results were paired and analyzed. The PCR assay detected Lactobacillus species in 48 of 388 (12%) vaginal swab specimens (8% positive, 4% low positive) collected from women in labor after membranes had ruptured. There was no significant difference in median and mean (respectively) amniotic fluid lactate levels with (8.35 mmol/L; 8.95 mmol/L) or without (8.5 mmol/L; 9.08 mmol/L) Lactobacillus species detected. There was no association between the presence or level of vaginal Lactobacillus species and the measurement of amniotic fluid lactate collected from the vaginal tract of women during labor. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Transplante de membrana amniótica em casos agudos graves de queimadura ocular química e síndrome de Stevens-Johnson Amniotic membrane transplantation for severe acute cases of chemical ocular burn and Stevens-Johnson syndrome

    Directory of Open Access Journals (Sweden)

    José Reinaldo da Silva Ricardo

    2009-04-01

    .PURPOSE: To study the therapeutic potential of amniotic membrane transplantation in cases of severe acute chemical ocular burn and Stevens-Johnson syndrome. METHODS: We retrospectively reviewed the records of eight patients, with a total of ten eyes, submitted to amniotic membrane transplantation for treatment of ocular chemical burns and Stevens-Johnson syndrome in the acute phase between January 1999 and May 2008 in the Ophthalmology Department of UNIFESP. Data relating to sex, age, degree of chemical burns, etiology, affected eye, ophthalmological findings, extension of amniotic membrane, surgeries, additional time between the injury and surgery in days, visual acuity before and after surgery, epithelial defect healing (days, complications and time of follow-up in months were collected. RESULTS: The average age of patients was 35.7 ± 23.04 years, with six men and two women. Three patients (four eyes had Stevens-Johnson syndrome and five patients (six eyes had chemical ocular burn. The epithelial defect was healed at an average of 27.8 ± 4.7 days (ranging from 20 and 35 days. All patients presented limbal stem cell deficiency in a median follow-up of 7.8 ± 2.8 months (ranging from six and twelve months and four eyes developed symblepharon. CONCLUSIONS: The results suggest that the amniotic membrane transplantation represents an additive that can be carried out in the serious cases of ocular chemical burn and Stevens-Johnson syndrome with the finality of promoting the epithelialization and abolishing the inflammation and its consequences, if compared with other studies that treated similar cases with medical therapy only. On the other hand, it is not possible to avoid the limbic deficiency in these cases, which in the future will need limbal stem cell transplantation or other surgeries for correction of the ocular surface.

  18. Transplante de células-tronco epiteliais límbicas alógenas expandidas ex vivo sobre membrana amniótica: relato de caso Transplantation of allogenic limbal epithelial stem cells cultivated ex vivo on amniotic membrane: case report

    Directory of Open Access Journals (Sweden)

    José Álvaro Pereira Gomes

    2009-04-01

    Full Text Available Paciente apresentou falência de transplante de limbo e conjuntiva de doador vivo alógeno no olho direito após ceratoconjuntivite epidêmica. Após alguns meses, foi submetida a transplante de células-tronco epiteliais límbicas alógenas cultivadas ex vivo sobre membrana amniótica (primeiro caso no Brasil, tendo evoluído com epitelização total da córnea e melhora da acuidade visual. Após o 3º mês da cirurgia, iniciou-se neovascularização superficial periférica com piora da transparência corneana. A visão manteve-se 0,1 após um ano de cirurgia.Case report of a patient who developed failure of an allogenic living related conjunctival limbal transplantation in the right eye after an episode of epidemic keratoconjunctivitis. After a few months, she underwent transplantation of allogenic limbal epithelial stem cells cultivated ex vivo on amniotic membrane (first case in Brazil. The patient evolved with total corneal epithelialization and improvement of the visual acuity. Three months after the surgery, peripheral superficial neovascularization with worsening of the corneal transparency was observed. The vision remained 0.1 after one year of the transplantation.

  19. Identification of emergent motion compartments in the amniote embryo.

    Science.gov (United States)

    Loganathan, Rajprasad; Little, Charles D; Joshi, Pranav; Filla, Michael B; Cheuvront, Tracey J; Lansford, Rusty; Rongish, Brenda J

    2014-01-01

    The tissue scale deformations (≥ 1 mm) required to form an amniote embryo are poorly understood. Here, we studied ∼400 μm-sized explant units from gastrulating quail embryos. The explants deformed in a reproducible manner when grown using a novel vitelline membrane-based culture method. Time-lapse recordings of latent embryonic motion patterns were analyzed after disk-shaped tissue explants were excised from three specific regions near the primitive streak: 1) anterolateral epiblast, 2) posterolateral epiblast, and 3) the avian organizer (Hensen's node). The explants were cultured for 8 hours-an interval equivalent to gastrulation. Both the anterolateral and the posterolateral epiblastic explants engaged in concentric radial/centrifugal tissue expansion. In sharp contrast, Hensen's node explants displayed Cartesian-like, elongated, bipolar deformations-a pattern reminiscent of axis elongation. Time-lapse analysis of explant tissue motion patterns indicated that both cellular motility and extracellular matrix fiber (tissue) remodeling take place during the observed morphogenetic deformations. As expected, treatment of tissue explants with a selective Rho-Kinase (p160ROCK) signaling inhibitor, Y27632, completely arrested all morphogenetic movements. Microsurgical experiments revealed that lateral epiblastic tissue was dispensable for the generation of an elongated midline axis- provided that an intact organizer (node) is present. Our computational analyses suggest the possibility of delineating tissue-scale morphogenetic movements at anatomically discrete locations in the embryo. Further, tissue deformation patterns, as well as the mechanical state of the tissue, require normal actomyosin function. We conclude that amniote embryos contain tissue-scale, regionalized morphogenetic motion generators, which can be assessed using our novel computational time-lapse imaging approach. These data and future studies-using explants excised from overlapping anatomical

  20. Sutureless Aortic Prosthesis Implantation: the First Brazilian Experience with Perceval Device.

    Science.gov (United States)

    Tagliari, Ana Paula; de Moura, Leandro; Dussin, Luiz Henrique; Saadi, Eduardo Keller

    2016-01-01

    This is a report of the first Brazilian experience with the Perceval sutureless aortic prosthesis in two patients with severe aortic stenosis. Transesophageal echocardiography was used during the procedure. The aortotomy was performed 1 cm above the sinotubular junction, followed by leaflets removal and decalcification. Correct valve size was selected, device released and an accommodation balloon used. The cardiopulmonary bypass times were 47 and 38 min and the cross-clamp times were 38 and 30 min. There was a significant decrease in mean gradients (41 and 75 mmHg preoperatively; 7 and 8 mmHg postoperatively). There was no major complication or paravalvular leak.

  1. Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device.

    Science.gov (United States)

    Uchida, Tetsuro; Hamasaki, Azumi; Kuroda, Yoshinori; Yamashita, Atsushi; Hayashi, Jun; Sadahiro, Mitsuaki

    2017-12-01

    Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif) to create the proximal anastomosis, eliminating the need for aortic clamping. This system is thought to make direct proximal aortic anastomosis safe and easy in patients requiring surgical reconstruction of celiac artery aneurysms.

  2. Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device

    Directory of Open Access Journals (Sweden)

    Tetsuro Uchida, MD, PhD

    2017-12-01

    Full Text Available Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif to create the proximal anastomosis, eliminating the need for aortic clamping. This system is thought to make direct proximal aortic anastomosis safe and easy in patients requiring surgical reconstruction of celiac artery aneurysms.

  3. Assessment of the use of cryopreserved x freeze-dried amniotic membrane (AM for reconstruction of ocular surface in rabbit model Avaliação do uso da membrana amniótica (MA criopreservada x liofilizada na reconstrução da superfície ocular em coelhos

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    Rodrigo Doyle Libera

    2008-10-01

    Full Text Available PURPOSE: To determine the efficacy of freeze-dried amniotic membrane (AM for reconstruction of the ocular surface in rabbit eyes. METHODS: The sterilized, freeze-dried amniotic membrane (lyophilized or FD-AM is a preservative method that uses the drying by freezing process to maintain the AM well preserved for a long time even at room temperature. This paper is an experimental animal interventional study. One eye of each of 15 male New Zealand rabbits (1.5 - 3.0 kg had the central cornea marked with a 6.0 mm trephine. The marked area was deepithelialized with a No.15 blade. The denuded corneal surface was covered as follows: Group 1: cryopreserved AM (n=6; Group 2: freeze-dried AM (n=6; and Group 3: not covered (control group, n=3. The AM in group 1 and 2 and the periphery of the denuded area in group 3 were secured with continuous 10-0 nylon sutures. The clinical evaluation was made by a blinded observer and graded on a four-point scale (1= minimal, 4= marked for conjunctival and ciliary hyperemia, eyelid edema, corneal neovascularization, corneal opacity and reepithelialization on postoperative (PO days 1, 7 and 30 . After PO day 30, the rabbits were euthanized and their corneas were sent for histopathological and ultrastructural analysis to evaluate tissue inflammation, reepithelialization, and basement membrane integrity. RESULTS: Two eyes in group 2 had a corneal infection and were excluded from the analysis. No statistically significant differences among the three groups were found (p>0.05 regarding the clinical evaluation on 1st, 7th and 30th PO days. On transmission electron microscopy, the basement membrane in lyophilized and control groups was more continuous and homogeneous than in the glycerol group. CONCLUSIONS: The freeze-drying method seems to be a good option to preserve human amniotic membrane to be used in ocular surface reconstruction. This preservative method reduces the preservation costs and may enhance the use of AM

  4. Sources of amniotic fluid erythropoietin during normoxia and hypoxia in fetal sheep.

    Science.gov (United States)

    Brace, Robert A; Cheung, Cecilia Y; Davis, Lowell E; Gagnon, Robert; Harding, Richard; Widness, John A

    2006-07-01

    , urinary erythropoietin concentration increased almost 10-fold (P = .0023) but remained a small fraction (3.7% +/- 0.4%) of plasma concentration; at 12 hours of hypoxic hypoxia, lung liquid erythropoietin concentration did not vary with the severity of the hypoxia and remained low relative to plasma concentration (4.2% +/- 2.1%). Erythropoietin is present in ovine amniotic fluid, urine, and lung liquid. With only 3 potential sources, the fetal membranes appear to be the primary source of amniotic fluid erythropoietin in the nonhypoxic ovine fetus because basal urine and lung liquid erythropoietin concentrations are much lower than amniotic fluid concentrations. Although unchanged during mild-to-moderate fetal hypoxia, amniotic fluid erythropoietin concentration increases modestly during severe fetal hypoxia. In sheep, fetal urinary erythropoietin may contribute to this rise in amniotic fluid erythropoietin concentration during severe hypoxia, because fetal urinary and plasma concentrations increase in parallel during anemia.

  5. Role of Echogenic Amniotic Fluid Particles and Optical Density in ...

    African Journals Online (AJOL)

    This study was aimed to correlate echogenic amniotic fluid particle size (AFPS) in late third trimester to fetal lung maturity and amniotic fluid optical density (AFOD) at labor. AFPS were measured with specified criteria by real time transabdominal USG (3.5MHz) while Amniotic Fluid Index (AFI) was measured during routine ...

  6. In vitro culture of mouse embryos amniotic fluid ID human

    African Journals Online (AJOL)

    1989-07-15

    Jul 15, 1989 ... Human amniotic fluid was compared with Ham's F-10 culture medium as a possible alternative for use in in vitro fertilisation. The cleavage success of mouse embryos in human amniotic fluid (experimental group) was 92% compared with 86% in. Ham's F-10 medium. It is concluded that human amniotic.

  7. Changes in day 1 post-operative intraocular pressure following sutureless 23-gauge and conventional 20-gauge pars plana vitrectomy.

    Science.gov (United States)

    Gosse, Emily; Newsom, Richard; Hall, Peter; Lochhead, Jonathan

    2013-01-01

    The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy. Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher's exact and chi-square tests. Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOPgauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50). Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.

  8. Sutureless aortic valve replacement using a novel autologous tissue heart valve with stent (stent biovalve): proof of concept.

    Science.gov (United States)

    Kishimoto, Satoru; Takewa, Yoshiaki; Nakayama, Yasuhide; Date, Kazuma; Sumikura, Hirohito; Moriwaki, Takeshi; Nishimura, Motonobu; Tatsumi, Eisuke

    2015-06-01

    We developed an autologous, trileaflet tissue valve ("biovalve") using in-body tissue architecture technology to overcome the disadvantages of current bioprosthetic valves. We designed a novel biovalve with a balloon-expandable stent: the stent biovalve (SBV). This study evaluated the technical feasibility of sutureless aortic valve replacement using the SBV in an orthotopic position, as well as the functionality of the SBV under systemic circulation, in an acute experimental goat model. Three adult goats (54.5-56.1 kg) underwent sutureless AVR under cardiopulmonary bypass (CPB). The technical feasibility and functionality of the SBVs were assessed using angiography, pressure catheterization, and two-dimensional echocardiography. The sutureless AVR was successful in all goats, and all animals could be weaned off CPB. The mean aortic cross-clamp time was 45 min. Angiogram, after weaning the animals off CPB, showed less than mild paravalvular leakage and central leakage was not detected in any of the goats. The mean peak-to-peak pressure gradient was 6.3 ± 5.0 mmHg. Epicardial two-dimensional echocardiograms showed smooth leaflet movement, including adequate closed positions with good coaptation; the open position demonstrated a large orifice area (average aortic valve area 2.4 ± 0.1 cm2). Sutureless AVR, using SBVs, was feasible in a goat model. The early valvular functionalities of the SBV were sufficient; future long-term experiments are needed to evaluate its durability and histological regeneration potential.

  9. Sutureless functional end-to-end anastomosis using a linear stapler with polyglycolic acid felt for intestinal anastomoses

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    Masanori Naito, MD, PhD

    2017-05-01

    Conclusion: Sutureless functional end-to-end anastomosis using the Endo GIA™ Reinforced appears to be safe, efficacious, and straightforward. Reinforcement of the crotch site with a bioabsorbable polyglycolic acid sheet appears to mitigate conventional problems with crotch-site vulnerability.

  10. Keratometric alterations following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy.

    Science.gov (United States)

    Citirik, Mehmet; Batman, Cosar; Bicer, Tolga; Zilelioglu, Orhan

    2009-09-01

    To assess the alterations in keratometric astigmatism following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy. Sixteen consecutive patients were enrolled into the study. Conventional vitrectomy was applied to eight of the cases and 25-gauge transconjunctival sutureless vitrectomy was performed in eight patients. Keratometry was performed before and after the surgery. In the 25-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were not observed in the corneal curvature in any post-operative follow-up measurement (p > 0.05); whereas in the conventional pars plana vitrectomy group, statistically significant changes were observed in the first postoperative day (p = 0.01) and first postoperative month (p = 0.03). We noted that these changes returned to baseline in three months (p = 0.26). Both 25-gauge transconjunctival sutureless and conventional pars plana vitrectomy are effective surgical modalities for selected diseases of the posterior segment. Surgical procedures are critical for the visual rehabilitation of the patients. The post-operative corneal astigmatism of the vitrectomised eyes can be accurately determined at least two months post-operatively.

  11. Amniotic fluid embolism: A diagnostic dilemma.

    Science.gov (United States)

    Kulshrestha, Ashish; Mathur, Megha

    2011-01-01

    Amniotic fluid embolism (AFE) is a rare obstetric catastrophe with an incidence of 7.7 per 100 000 deliveries and mortality as high as 60% to 80%. We describe a case of perioperative cardiac arrest in a young parturient undergoing an emergent cesarean section. Just after delivery of live healthy male baby, patient developed disseminated intravascular coagulation not responding to resuscitation with fluids and blood products. Her autopsy revealed edematous lungs with amniotic fluid debris within pulmonary vessels thus establishing the diagnosis of AFE. Amniotic fluid embolism is life threatening and difficult to predict or prevent condition, which should be always be kept in mind in a parturient with sudden cardiovascular collapse, so that resuscitation commences immediately, as early intervention is essential for a positive outcome.

  12. Clinical aspects of the 360 º conjunctival graft and amniotic membrane cryopreserved transplantation in corneal ulcers in dogsAspectos clínicos do enxerto conjuntival 360º e do implante da membrana amniótica criopreservada no tratamento de úlceras de córnea em cães

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    Gabriel Thadeu Nogueira Martins Ferreira

    2013-06-01

    Full Text Available To evaluate the clinical application of implant of the canine cryopreserved amniotic membrane (DMEM plus DMSO 1:1 and 360° conjunctival flap in the treatment of progressive corneal ulceration. 10 dogs of the different breeds, males and females, aging four months to four years old with deep corneal ulceration and different clinical progression were divided in two groups: G1=360° conjunctival graft (n=5 and G2=implant of amniotic membrane, sutured at the edge of the ulcer with epithelial side facing up, associated with the third eyelid flap (n=5. The comparative analysis between groups was: complications, blepharospasm, ocular secretion, corneal vascularization, epithelial defect and corneal opacification in six moments (first emergency care, surgery and 3, 7, 15 and 30 days of postoperative. Without epithelial defect was evaluated quality of the scar. It was used score scale for subjective to qualify of the ocular signs. In G1, it was observed the non-adherence of the conjunctival graft to the ulcer (n=2, dehiscence of the suture (n=2, anterior synechia (n=2 and intense chemosis (n=1. In G2, it was not observed these complications. It was not significant difference between the groups to others ocular parameters, but it was different among the start and end moments of the same groups (ocular secretion, corneal vascularization, epithelial defect. The corneal opacity was more intense in G1. According to the clinical results, the cryopreserved amniotic membrane implant proved to be as effective in the corneal ulceration in comparison to the 360° conjunctival flap, because probably, the membrane promoted a trophic support for epithelialization, anti-inflamatory effect associated with important to the end result phenotype. Avaliar a aplicação clínica do implante da membrana amniótica canina criopreservada em DMEM (Dulbecco’s Modified Eagle’s Médium e DMSO4 (dimetilsulfóxido na proporção 1:1 e do enxerto conjuntival 360º no tratamento de

  13. Gram-Negative Bacterial Lipopolysaccharide Stimulates Activin A Secretion from Human Amniotic Epithelial Cells

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    Yumiko Abe

    2013-01-01

    Full Text Available Activin A is involved in inflammation. The present study was performed to clarify if lipopolysaccharide, a component of Gram-negative bacteria, stimulates activin A secretion from human amniotic epithelial cells and to determine if activin A plays a role in amnionitis. Fetal membranes were obtained during elective cesarean sections performed in full-term pregnancies of patients without systemic disease, signs of premature delivery, or fetal complications. Amniotic epithelial cells were isolated by trypsinization. The activin A concentrations in the culture media were measured by enzyme-linked immunosorbent assay, and cell proliferation was assessed by 5-bromo-2′-deoxyuridine incorporation. Amniotic epithelial cells secreted activin A in a cell density-dependent manner, and lipopolysaccharide (10 μg/mL enhanced the secretion at each cell density. Lipopolysaccharide (10–50 μg/mL also stimulated activin A secretion in a dose-dependent manner. Contrary to the effect of activin A secretion, lipopolysaccharide inhibited cell proliferation in amniotic epithelial cells. The present study suggests that lipopolysaccharide stimulation of activin A secretion may be a mechanism in the pathogenesis of amnionitis.

  14. Amniotic Fluid Soluble Myeloid Differentiation-2 (sMD-2) as Regulator of Intra-amniotic Inflammation in Infection-induced Preterm Birth.

    Science.gov (United States)

    Dulay, Antonette T; Buhimschi, Catalin S; Zhao, Guomao; Oliver, Emily A; Abdel-Razeq, Sonya S; Shook, Lydia L; Bahtiyar, Mert O; Buhimschi, Irina A

    2015-06-01

    TLR4 mediates host responses to pathogens through a mechanism that involves protein myeloid differentiation-2 (MD-2) and its soluble form sMD-2. The role of sMD2 in intra-amniotic inflammation-induced preterm birth has not been previously explored. Human amniotic fluid (AF) sMD-2 was studied by Western blotting in 152 AF samples of patients who had an amniocentesis to rule-out infection (yes infection, n = 50; no infection, n = 50) or women with normal pregnancy outcome (second trimester genetic karyotyping, n = 26; third trimester lung maturity testing, n = 26). Histological localization and mRNA expression of MD2 in fetal membranes were studied by immunohistochemistry and RT-PCR. The ability of fetal membrane to release sMD-2 and inflammatory cytokines was studied in vitro. Human AF contains three sMD-2 proteoforms whose levels of expression were lower at term. Intra-amniotic infection upregulated sMD-2. MD-2 mRNA and immunohistochemistry findings concurred. In vitro, LPS and monensin increased, while cycloheximide decreased sMD-2 production. Recombinant sMD-2 modulated TNF-α and IL-6 levels in a dose- and time-dependent fashion. sMD2 proteoforms are constitutively present in human AF. The intensity of the intra-amniotic inflammatory response to bacteria or perhaps to other TLR4 ligands may be facilitated through synthesis and release of sMD2 by the amniochorion. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Sutureless vascular anastomoses by N-butyl-2 cyanoacrylate adhesive: an experimental animal study.

    Science.gov (United States)

    Saba, D; Yilmaz, M; Yavuz, H; Noyan, S; Avci, B; Ercan, A; Ozkan, H; Cengiz, M

    2007-01-01

    The purpose of this animal study was to find out whether sutureless anastomoses using N-butyl-2-cyanoacrylate were effective in the suppression of neointimal hyperplasia or not. Ten male adult mongrel dogs were used in this animal study. The animals were randomly divided into a control group (n = 5) and a study group (n = 5). The study group underwent sutureless anastomoses using N-buthyl-2-cyanoacrylate adhesive. Infrarenal aortoaortic graft was interposed using polytetrafluoroethylene. In the study group, the mean intimal thickness at the proximal anastomosis was 27.4 +/- 1.94 microm and 27.4 +/- 1.51 microm at the distal anastomosis. In the control group, the mean intimal thickness was 138.4 +/- 5.02 mum at the proximal anastomosis and 67.6 +/- 6.42 microm at the distal anastomosis. Intimal thickness at the proximal and distal anastomoses in the control group was significantly (p anastomoses using with N-butyl-2-cyanoacrylate adhesive might be a good alternative to conventional suture technique. Copyright 2007 S. Karger AG, Basel.

  16. Active Silicone Oil Removal with a Transconjunctival Sutureless System: Is the 23-Gauge System Safe and Effective?

    Directory of Open Access Journals (Sweden)

    Mahmut Kaya

    2016-01-01

    Full Text Available Objectives: To evaluate the safety and efficacy of active silicone oil removal with a 23-gauge (G transconjunctival sutureless system. Materials and Methods: One hundred sixteen eyes of 113 patients who had previous retinal detachment surgery with pars plana vitrectomy and silicone oil injection surgery, and underwent silicone oil removal surgery with 23-G transconjonctival sutureless technique in our clinic between January 2009 and April 2014 were reviewed retrospectively. The patients were evaluated with regard to postoperative changes in best corrected visual acuity and intraocular pressure (IOP, and complications that occurred during and after surgery. Results: Of the 113 patients with mean age of 61.1±9.7 years (29-88 years, 62 (54.8% were males and 51 (45.2% were females. Silicone oil removal was performed 8.43±5.24 months after the initial surgery. Mean follow-up was 13.38±4.35 months. Visual acuity improved in 69 eyes (59.48%. Anatomic success was achieved in 113 eyes (97.41%. Mean IOP was 16.2±7.2 mmHg at baseline and 14.4±2.6 mmHg at postoperative day 1 (p=0.643. Eight eyes needed suturation of at least one sclerotomy. Retinal redetachment occurred in 3 eyes (2.5% resulting in a decrease in vision. There were no cases of choroidal detachment, endophthalmitis, clinically significant corneal endothelial decompensation, or macular edema. Conclusion: Active removal of 1,300-centistoke silicone oil with a 23-G transconjunctival sutureless system is a simple, sutureless technique causing minor surgical trauma. Active removal of silicone oil with the 23-G transconjunctival sutureless technique was found to be effective and safe in both phakic and pseudophakic eyes

  17. The amniotic band syndrome: antenatal sonographic diagnosis and potential pitfalls.

    Science.gov (United States)

    Mahony, B S; Filly, R A; Callen, P W; Golbus, M S

    1985-05-01

    Amniotic band syndrome causes a variety of fetal malformations involving the limbs, craniofacial region, and trunk. Six prenatally diagnosed cases of amniotic band syndrome are discussed. The diagnosis was based on sonographic visualization of either amniotic sheets or bands associated with fetal deformation or deformities in nonembryologic distributions known to characterize the amniotic band syndrome. Seven additional cases are considered in which an aberrant sheet of tissue with a free edge was visualized within the amniotic cavity but no restriction of fetal motion or subsequent deformity was demonstrated.

  18. Estudo por microscopia eletrônica do epitélio de neovaginas confeccionadas com membrana amniótica e pesquisa de receptores para estrogênios Electron microscope study of the epithelium of neovagina constructed with amniotic membrane: estrogen receptor evaluation

    Directory of Open Access Journals (Sweden)

    Mauri José Piazza

    1999-06-01

    cortes histológicos obtidos em biópsias de neovaginas revestidas com membrana amniótica.Purpose: to verify changes in amnion epithelia after neovaginoplasty and the presence of estrogen receptor in this tissue using electron microscopy (TEM. Methods: a group consisting of 33 young patients with vaginal agenesy, most of them amenorreic, either incapable or having difficulty to adequately perform sexual activity, underwent surgical correction of the anomaly by the McIndoe-Banister technique. In each woman, a cavity was created through an opening of the vesicorectal space. A mold made of artificial sponge with a condom recovered by amniotic membrane was introduced into the cavity. After eight days, the mold was removed, leaving a developing neoepithelium from the amniotic membrane. Results: The TEM conducted in samples of tissue obtained from neovaginas showed similar results in all three layers of these epithelia, either in the cytoplasm or the cellular microstructures in comparison with normal women. The intensity of staining of the estrogen receptors on the vaginal neoepithelium of the group of women who underwent the surgical procedure was similar to that of normal women. The estrogen receptors were heterogeneously distributed in the three layers of the tissue in all women. The analysis of the vaginal neoepithelium obtained from amniotic membrane revealed, through the TEM, all the characteristics of a regular vaginal epithelium.

  19. Amniotic amputation | Ayadi | Pan African Medical Journal

    African Journals Online (AJOL)

    Amniotic band syndrome (ABS) is an uncommon, congenital fetal abnormality. Lower extremity limb defects are the common manifestations of ABS. The most common features include congenital distal ring constrictions, intrauterine amputations, and acrosyndactyly. Rare cases of craniofacial and visceral defects were ...

  20. Polyhydramnios in Lrp4 knockout mice with bilateral kidney agenesis: Defects in the pathways of amniotic fluid clearance.

    Science.gov (United States)

    Tanahashi, Hiroshi; Tian, Qing-Bao; Hara, Yoshinobu; Sakagami, Hiroyuki; Endo, Shogo; Suzuki, Tatsuo

    2016-02-05

    Amniotic fluid volume during mid-to-late gestation depends mainly on the urine excretion from the foetal kidneys and partly on the fluid secretion from the foetal lungs during foetal breathing-like movements. Urine is necessary for foetal breathing-like movements, which is critical for foetal lung development. Bilateral renal agenesis and/or obstruction of the urinary tract lead to oligohydramnios, which causes infant death within a short period after birth due to pulmonary hypoplasia. Lrp4, which functions as an agrin receptor, is essential for the formation of neuromuscular junctions. Herein, we report novel phenotypes of Lrp4 knockout (Lrp4(-/-)) mice. Most Lrp4(-/-) foetuses showed unilateral or bilateral kidney agenesis, and Lrp4 knockout resulted in polyhydramnios. The loss of Lrp4 compromised foetal swallowing and breathing-like movements and downregulated the expression of aquaporin-9 in the foetal membrane and aquaporin-1 in the placenta, which possibly affected the amniotic fluid clearance. These results suggest that amniotic fluid removal was compromised in Lrp4(-/-) foetuses, resulting in polyhydramnios despite the impairment of urine production. Our findings indicate that amniotic fluid removal plays an essential role in regulating the amniotic fluid volume.

  1. of Membranes Is Associated With Early Onset Neonatal Sepsis

    Directory of Open Access Journals (Sweden)

    Michael J. Kupferminc

    1995-01-01

    Full Text Available Objective: This study was to determine the significance of meconium in the amniotic fluid of pregnancies complicated by preterm premature rupture of membranes (PPROM without labor.

  2. Outcomes of transconjunctival sutureless 27-gauge vitrectomy for vitreoretinal diseases

    Directory of Open Access Journals (Sweden)

    Jie Li

    2018-03-01

    Full Text Available AIM: To evaluate the safety and efficacy profile of 27-gauge (27G pars plana vitrectomy (PPV for the treatment of various vitreoretinal diseases. METHODS: The clinical outcomes of 61 eyes (58 patients with various vitreoretinal diseases following 27G PPV were retrospectively reviewed. RESULTS: Surgical indications included rhegmatogenous retinal detachment (n=24, full-thickness macular hole (n=12, diabetic retinopathy (n=11, vitreous hemorrhage (n=6, Eales disease (n=4, pathological myopia-related vitreous floater (n=2, and macular epiretinal membrane (n=2. The mean follow-up was 166.4±61.3d (range 98-339d. The mean logMAR best-corrected visual acuity (BCVA improved from 1.7±1.1 [0.02 decimal visual acuity (VA equivalent] preoperatively to 1.2±1.0 (0.06 decimal VA equivalent at the last postoperative visit (P<0.001. The mean operative time was 49.9min. With the exception of complicated cataract in one eye, no intraoperative complications were encountered. No case required conversion to conventional 20-, 23- or 25G instrumentation in all surgical maneuvers except for silicone oil infusion, which required a 25G oil injection syringe. Postoperative complications included transient ocular hypertension, vitreous hemorrhage, persistent intraocular pressure elevation, subconjunctival oil leakage, and recurrent retinal detachment. No cases of hypotony, endophthalmitis, and sclerotomy-related tears were observed. CONCLUSION: The current results suggest that 27G PPV system is a safe and effective treatment for various vitreoretinal diseases. When learning to perform 27G PPV, surgeons may encounter a learning curve and should gradually expand surgical indications from easy to pathologically complicated cases.

  3. Intraoperative iatrogenic peripheral retinal break in 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge conventional vitrectomy.

    Science.gov (United States)

    Cha, Dong Min; Woo, Se Joon; Park, Kyu Hyung; Chung, Hum

    2013-06-01

    To compare the incidence of intraoperative iatrogenic peripheral retinal breaks (IPRBs) during 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various indications. This was a single-center, comparative, retrospective, interventional case series of 973 23-gauge TSVs and 402 conventional 20-gauge vitrectomies done by two surgeons between January 2004 and December 2009. The incidence rate of intraoperative IPRBs and risk factors were analyzed in association with various clinical and surgical factors. IPRBs occurred significantly less often during 23-gauge TSV (16 of 973 cases, 1.6 %) than during conventional vitrectomy (25 of 402 cases, 6.2 %, Pgauge TSV procedure with the trocar system has a lower incidence of intraoperative IPRBs than conventional 20-gauge vitrectomy. Longer operation time and induction of PVD are also independent risk factors of the complication.

  4. Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for dislocated intraocular lenses.

    Science.gov (United States)

    Bajgai, Priya; Tigari, Basavraj; Singh, Ramandeep

    2017-10-04

    To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs). Retrospective, non-consecutive, comparative, interventional case series. Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments. The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued. Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9). 25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

  5. A new infusion sustainer that stabilizes perfusion during sutureless 25-gauge vitrectomy.

    Science.gov (United States)

    Hattori, Takayuki; Shimada, Hiroyuki; Nakashizuka, Hiroyuki; Mori, Ryusaburo; Mizutani, Yoshihiro; Yuzawa, Mitsuko

    2010-12-01

    To stabilize perfusion during sutureless 25-gauge (25G) vitrectomy, we designed an infusion sustainer and examined its usefulness. A reusable infusion sustainer was constructed by soldering a piece of metal wire to a metal paper clip and curling the two ends of the wire. For use, the sustainer was clipped onto the lip retractor, and the infusion line and chandelier fiber were passed through the wire loops. 25G vitrectomy was conducted in three porcine eyes, with insertion of a tonometer to monitor intraocular pressure (IOP). The relation between infusion port direction and IOP was examined. In a clinical study, 30 eyes that underwent 25G vitrectomy using the infusion sustainer and 30 eyes without using the infusion sustainer were compared for IOP maintenance and complications. In the porcine eye, after angled incision, the infusion tip was pointing toward the basal vitreous on the anterior side of the eyeball. Under these conditions, vitreous resection was accompanied by IOP lowering. When the infusion tip was moved so as to be directed toward the central vitreous, IOP was maintained. In the clinical study, among the eyes undergoing vitrectomy without the infusion sustainer, IOP decreased during operation in 30 eyes, and infusion fluid or air flowed into the anterior chamber in four eyes. In the 30 eyes in which the sustainer was used, no IOP lowering and no infusion fluid or air flow into the anterior chamber were detected, due to stabilization of the infusion port. Use of the infusion sustainer orients the infusion port toward the central vitreous, stabilizes IOP and prevents flow of infusion fluid or air into the anterior chamber. This infusion sustainer is useful to perform sutureless 25G vitrectomy safely.

  6. Amniotic Fluid β2- Microglobulin Measurements

    Directory of Open Access Journals (Sweden)

    Emine Aydın

    2016-02-01

    Full Text Available OBJECTIVE: To determine β2-microglobulin levels in amniotic fluid during the course of second trimester. STUDY DESIGN: One hundred patient’s amniotic fluid β2-microglobulin levels had been evaluated retrospectively (March-October 2009. The most common amniocentesis indication was advanced maternal age (33.3%. Others were; high risk result for triple test (18.5%, high risk result for double test (6.48%, ventriculomegaly (5.55%, obstetric history for fetus with down syndrome (4.62%, the presence of soft markers on ultrasound (13.8%, others (17.8%. Patients average gravida was 2.66 (range: 1-6, parity was 0.75 (range: 0-3, abortion was 0.65 (range: 0-3. RESULTS: All patients were at second trimester and the average gestational week was 17.7 (range 15- 22. Patients were divided into four groups (15th, 16th, 17-18th and 19-20th gestational weeks. We have demonstrated that amniotic fluid β2-microglobulin levels are increased progressively throughout the second trimester. We have specified normal β2-microglobulin values of each gestational week/period in order to be used in clinical practice. CONCLUSION: We have demonstrated that amnionic fluid β2-microglobulin levels are increased progressively throughout the second trimester.

  7. Estudo retrospectivo da utilização do transplante de membrana amniótica em um serviço terciário de Oftalmologia Retrospective study of amniotic membrane transplantation in a terciary ophthalmic health care service

    Directory of Open Access Journals (Sweden)

    Eduardo Conforti de Oliveira

    2008-08-01

    ável. CONCLUSÃO: O enxerto de membrana amniótica nas diferentes doenças avaliadas apresentou resultados favoráveis na maioria delas. Esta técnica pode ser considerada como boa alternativa terapêutica a ser empregada nestas situações, além de ser um método barato e de fácil execução cirúrgica.OBJECTIVE: During the last years amniotic membrane (AM autograft has been frequently used for reconstruction of the ocular surface in many diseases. This study intends to analyze the major indications for AM as well the results of this procedure. METHODS: Data of 107 patients who had done AM autograft surgery were retrospectively analised regarding the indications and postoperatory follow-up. RESULTS: The indications for AM autograft was ptherygium 33.64% (n=36, persistent epithelial defect 29.90% (n=32, simblepharum 18.69% (n=20, chemical injury 6.54%(n=7, vernal conjunctivitis 4.67% (n=5, Stevens-Johnson 2.80% (n=3, ocular cicatricial penfigoid 1.86% (n=2, bullous keratopathy 1.86%(n=2. At the follow-up of ptherygium was observed recurrence between 6,25%(in primary ptherygium and 15% (in recurrence ptherygium. No recurrence was observed in simblepharum surgery for complications due ptherygium. Recovery of epithelial integrity was between 50 and 80% depending the disease. In the acute phase of chemical burns recovery was observed in 50%, however in chronic chemical burns the recovery was only in 33% of the cases. The AM in vernal conjunctivitis to resolve giant papillae, 80% of the cases showed good evolution. In 100% of the case due bullous keratopathy the patients had improvement of the pain. In Steven-Johnsons syndrome (SJS at the acute phase the patients had improevment of the inflammatory component. In the chronic phase of SJS, 50% of the patients had favorable evolution after the procedure. CONCLUSION: Amniotic membrane autograft showed promising results for the majority ocular surface diseases enrroled in this study. This surgical tecnic cheap and easy doing asweel a

  8. Clinical and hemodynamic outcomes of Perceval S sutureless bioprostheses implanted through a mini-approach in the aortic position

    Directory of Open Access Journals (Sweden)

    A. N. Molchanov

    2017-11-01

    Full Text Available Aim. Aortic valve disease is one of three most common cardiovascular problems. Aortic stenosis is responsible for 70% of valve disease. Aortic valve replacement is the most effective treatment for aortic stenosis nowadays. A traditional suture technique of aortic valve replacement is associated with a high risk of complications. Most of these complications occur due to ischemic aortic cross-clamp time and comorbidities. Perceval S sutureless aortic valves to be implanted in selected patients are supposed to meet the challenge. The study was aimed at assessing Perceval S sutureless aortic valve hemodynamic and clinical parameters, its intraoperative advantages and postoperative complication rates.Methods. A prospective cohort study of Perceval S sutureless aortic valve implanted via J-sternotomy (n = 22 and median sternotomy (n = 10 was conducted. Early and medium postoperative clinical and functional outcomes were obtained and evaluated.Results. A decrease in the transaortic gradient was observed in early (peak gradient 21.6±4.2 (p = 0.1, mean gradient 11.3±2.8 (p = 0.58 and medium (peak gradient 15.8±5.5 (p = 0.342, mean gradient 8.8±1.9 (p = 0.54 follow-up. The myocardial mass index tended to be reduced throughout the entire follow-up (p = 0.01. There were no prosthesis dysfunctions or biodegradation. No patient died in the postoperative period. Survival at 36 months of follow-up was 93.75%.Conclusion. Perceval S xenopericardial sutureless aortic bioprostheses adequately resolve hemodynamic problems and improve left ventricle functional parameters in early and median follow-up. They may be recommended for elderly patients. Sutureless aortic valve implantation is technically feasible through J-sternotomy and contributes to an eventless follow-up.Received 17 February 2017. Revised 16 August 2017. Accepted 28 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

  9. A prenatal test for the cerebro-hepato-renal (Zellweger) syndrome by demonstration of the absence of catalase-containing particles (peroxisomes) in cultured amniotic fluid cells

    NARCIS (Netherlands)

    Wanders, R. J.; Schrakamp, G.; van den Bosch, H.; Tager, J. M.; Schutgens, R. B.

    1986-01-01

    In this paper we show that whereas acyl-CoA: dihydroxyacetone phosphate acyltransferase, a membrane-bound peroxisomal enzyme, is deficient in homogenates of cultured amniotic fluid cells of fetuses with Zellweger syndrome, catalase a soluble peroxisomal matrix enzyme is present in normal amounts.

  10. In vitro culture of mouse embryos amniotic fluid ID human

    African Journals Online (AJOL)

    1989-07-15

    Jul 15, 1989 ... Because human amniotic fluid is a physiological, balanced ultrafiltrate, it has been considered as an inexpensive alternative culture medium in. IVF. A study of the development of mouse embryos in human amniotic fluid was undertaken to assess the suitability of this as an optional culture medium in human ...

  11. Major complication after intrauterine vesico-amniotic shunting ...

    African Journals Online (AJOL)

    Major complication after intrauterine vesico-amniotic shunting. A Springer, R Fartacek, CA Reck, E Horcher, D Bettelheim. Abstract. Bilateral foetal uropathy is the leading cause of chronic renal failure in childhood. Vesico-amniotic shunting (VAS) is a simple, feasible, and widely used procedure for decompressing the foetal ...

  12. Amniotic fluid embolism in an HIV-positive parturient

    African Journals Online (AJOL)

    2010-02-01

    Feb 1, 2010 ... Case Studies: Amniotic fluid embolism in an HIV-positive parturient. 2010;16(4). S Afr J Anaesthesiol Analg. Abstract. We present a case of a parturient infected with human immunodeficiency virus, who developed amniotic fluid embolism during the delivery of her twins by elective Caesarean section.

  13. Phthalates and perfluorooctanesulfonic acid in human amniotic fluid

    DEFF Research Database (Denmark)

    Jensen, Morten Søndergaard; Nørgaard-Pedersen, Bent; Toft, Gunnar

    2012-01-01

    Measures of prenatal environmental exposures are important, and amniotic fluid levels may directly reflect fetal exposures during hypothesized windows of vulnerability.......Measures of prenatal environmental exposures are important, and amniotic fluid levels may directly reflect fetal exposures during hypothesized windows of vulnerability....

  14. ViPS (Viabahn Padova Sutureless) technique: preliminary results in the treatment of peripheral arterial disease.

    Science.gov (United States)

    Ferretto, Luca; Piazza, Michele; Bonvini, Stefano; Battocchio, Piero; Grego, Franco; Ricotta, Joseph J

    2012-01-01

    To describe early results of a novel technique (ViPS, Viabahn Padova Sutureless) that connects a vascular prosthetic graft to a target artery in a sutureless fashion. A consecutive series of five patients with peripheral arterial occlusive disease (Rutherford class IV and V) underwent six ViPS procedures (one bilateral) for limb revascularization. Angiography in all cases demonstrated complete superficial femoral artery (SFA) occlusion with reconstitution of a circumferentially calcified above-knee popliteal artery. Ultrasonography revealed no adequate vein for autogenous bypass creation. In all cases, a previous attempt of SFA endovascular recanalization was unsuccessful. A Viabahn (W.L. Gore, Flagstaff, AZ) endoprosthesis was partially deployed, and its proximal end was sutured to a polytetrafluoroethylene graft. After surgical exposure, the circumferentially calcified popliteal artery, which could not be safely sutured, was transected and the undeployed distal portion of the Viabahn was inserted into the popliteal artery supported by a stiff guidewire. The distal portion of the Viabahn graft was then deployed 2.5 cm into the popliteal artery with optimal apposition. The proximal end of the polytetrafluoroethylene graft was then sutured to the common femoral artery. The distal portion of the Viabahn was ballooned to ensure apposition with the popliteal artery. The mean time for surgical modification of the device was 6.6 minutes with a mean time for ViPS anastomosis deployment of 7 seconds. Mean operative time for ViPS procedure was 61 minutes (range: 48-74). Completion angiogram in all cases demonstrated a patent graft with no sign of dissection. The patients' symptoms resolved in all cases, with complete ulcer healing occurring in five patients within 3 weeks. Follow-up imaging (mean = 2.6 months, range: 1-5) with eco-color-Doppler and computed tomography angiogram demonstrated a patent graft with no loss of device integrity in all cases. The ViPS technique is

  15. A sutureless method for digestive tract reconstruction during pancreaticoduodenectomy in a dog model.

    Science.gov (United States)

    Cui, Xiaohai; Lei, Peng; Liu, Shiqi; Liu, Xuemin; Wu, Zheng; Lv, Yi

    2015-01-01

    Development of pancreatic fistulas as a result of anastomotic gaps is still a major complication after pancreaticoduodenectomy, and can cause post-operative death. Therefore, safer and more effective methods of anastomosis are needed to avoid leakage and decrease mortality. Twenty domestic dogs with body weights ranging from 15 to 25 kg were used, regardless of gender. A model of common bile duct and pancreatic duct dilatation was surgically prepared in these dogs. Pancreaticobiliary stents combined with magnetic anastomoses (PB-MA), and controls were treated with fibrin glue were studied in terms of and efficacy by measurement of serum amylase, incidence of complications, and survival times. The mean time required to create the fibrin glue pancreaticoenterostomy was 9 ± 2.05 min, while the mean time required to create the magnet cholangioenterostomy was 5 ± 0.9 min. The total operative time was 2.7 ± 0.6 h. Eighty percent of the dogs that underwent the operations were still alive for 15 days after the operations and none developed pancreatic fistulas. Examination by macroscopic observation, and hematoxylin and eosin staining of the pathological specimens showed that the anastomoses were completed healed. The use of a PB-MA in sutureless digestive tract reconstruction for pancreatoduodenectomy resulted in an elimination of pancreatic fistulas, and shortening of the stent removed time. In addition, the procedure is simple to perform, fast, and appears to be safe in this dog model.

  16. Sutureless femtosecond anterior lamellar keratoplasty: A 1-year follow-up study

    Directory of Open Access Journals (Sweden)

    Rohit Shetty

    2014-01-01

    Full Text Available Aim: To study the safety and efficacy of sutureless femtosecond anterior lamellar keratoplasty (FALK in patients with corneal stromal opacities. Materials and Methods: Eleven eyes of 11 consecutive patients with corneal stromal opacities involving < 250 μ due to various pathologies were included in the study. Preoperatively, all underwent anterior segment imaging with spectral domain optical coherence tomography (SD-OCT (Bioptigen Inc., Durham, North Carolina, USA to measure the depth of the stromal opacity. All patients underwent FALK, and bandage contact lens was placed for a period of 2 weeks. Postoperatively, uncorrected visual acuity, best corrected visual acuity (BCVA, and SD-OCT evaluation were performed. Results: All patients showed significant improvement in BCVA. The mean postoperative BCVA (in decimals improved from 0.11 ± 0.06 preoperatively to 0.59 ± 0.08. There were no intraoperative or significant postoperative complications that were noticed. Conclusion: FALK is a safe and effective alternative to deep anterior lamellar keratoplasty or penetrating keratoplasty in the treatment of anterior stromal opacities.

  17. The evolution of tail weaponization in amniotes.

    Science.gov (United States)

    Arbour, Victoria M; Zanno, Lindsay E

    2018-01-31

    Weaponry, for the purpose of intraspecific combat or predator defence, is one of the most widespread animal adaptations, yet the selective pressures and constraints governing its phenotypic diversity and skeletal regionalization are not well understood. Here, we investigate the evolution of tail weaponry in amniotes, a rare form of weaponry that nonetheless evolved independently among a broad spectrum of life including mammals, turtles and dinosaurs. Using phylogenetic comparative methods, we test for links between morphology, ecology and behaviour in extant amniotes known to use the tail as a weapon, and in extinct taxa bearing osseous tail armaments. We find robust ecological and morphological correlates of both tail lashing behaviour and bony tail weaponry, including large body size, body armour and herbivory, suggesting these life-history parameters factor into the evolution of antipredator behaviours and tail armaments. We suggest that the evolution of tail weaponry is rare because large, armoured herbivores are uncommon in extant terrestrial faunas, as they have been throughout evolutionary history. © 2018 The Author(s).

  18. Amniotic fluid CA-125 as a marker of intra-amniotic inflammation associated with preterm delivery: a preliminary single center study.

    Science.gov (United States)

    Seong, Won Joon

    2016-01-01

    The purpose of this study was to investigate whether amniotic fluid (AF) CA-125 in patients with preterm labor or preterm premature rupture of membranes can help predict intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC) and imminent delivery. We recruited 36 women who admitted with impending preterm delivery and suspicious AF infection. AF matrix metalloproteinase-8 (MMP-8), white blood cell (WBC) count, glucose levels, and CA-125 levels were measured, and the MMP-8 bedside rapid test was also performed. AF culture and PCR were subsequently performed to confirm MIAC. We compared AF CA-125 levels according to the presence of IAI or MIAC and assessed its predictive value for delivery within 7 days of admission. AF CA-125 levels were significantly higher in the IAI group than in the non-IAI group (mean ± standard deviation: 5608 ± 864 vs 904 ± 84 IU/ml; p = 0.001). AF CA-125 levels showed a negative correlation with gestational age and a positive correlation with AF WBC counts and MMP-8 levels. AF CA-125 levels were higher in the MIAC group, though this difference was not statistically significant (p = 0.064). Delivery within 7 days of admission was significantly more common in patients with higher AF CA-125 levels (cut-off: 1650 IU/ml, sensitivity: 71.4 %, specificity: 86.4 %, p = 0.005). AF CA-125 levels are increased in patients with AF inflammation and can be a predictor of imminent preterm delivery.

  19. High MMP-9 and TNF-α expression increase in preterm premature rupture of membranes

    Directory of Open Access Journals (Sweden)

    Sri Sulistyowati

    2016-05-01

    Expression of MMP-9 and TNF-α was higher in the amniotic membrane of preterm delivery subjects with PROM than in preterm delivery subjects without PROM and can thus be used as predictor to avoid PPROM.

  20. Management of small aortic annulus in the era of sutureless valves: A comparative study among different biological options.

    Science.gov (United States)

    Ghoneim, Aly; Bouhout, Ismail; Demers, Philippe; Mazine, Amine; Francispillai, Mary; El-Hamamsy, Ismail; Carrier, Michel; Lamarche, Yoan; Bouchard, Denis

    2016-10-01

    Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging problem. The objective of this study was to compare 4 surgical approaches in terms of hemodynamics and perioperative outcomes. A retrospective single-center study included 351 consecutive patients with a small aortic annulus (≤21 mm) who underwent aortic valve surgery between January 2007 and December 2014. Surgical techniques included standard AVR in 259 (74%) patients, aortic root enlargement in 20 (6%), implantation of a stentless bioprosthesis in 23 (6%), and sutureless AVR in 49 (13%). Three hundred and eleven (89%) patients were female. The mean Logistic EuroSCORE II varied significantly among the groups and ranged from 6.5% ± 5.4% in the standard AVR group to 9.2% ± 4.7% in the stentless group. Early mortality occurred in 26 (7%) patients. Patients in the stentless group had the lowest aortic valve mean gradients on predischarge transthoracic echocardiography (10.9 ± 6.2 mm Hg; P < .001). In the stented group, the Trifecta prosthesis displayed the lowest postoperative mean transaortic gradient (10.3 ± 3.6; P < .001) with no severe prosthesis-patient mismatch. Postoperative gradients of the sutureless group were comparable with stented prostheses. In our study, stentless AVR and Trifecta bioprostheses had the best hemodynamic outcomes. The Perceval sutureless prosthesis provides reasonable hemodynamic performance and is a safe alternative. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  1. Comparison of 25-gauge sutureless vitrectomy and 20-gauge vitrectomy in the treatment of posterior capsule opacification in pseudophakic children.

    Science.gov (United States)

    Wu, Xiao-Ming; Xie, Li-Xin

    2015-01-01

    To compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO) in pseudophakic children. Retrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes). Patients in the control group (34 eyes) underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y). Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded. The surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5%) in the study group and in 28 eyes (87.5%) in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909). Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo). During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other complications were noted. Pars plana

  2. Comparison of 25-gauge sutureless vitrectomy and 20-gauge vitrectomy in the treatment of posterior capsule opacification in pseudophakic children

    Directory of Open Access Journals (Sweden)

    Xiao-Ming Wu

    2015-12-01

    Full Text Available AIM: To compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO in pseudophakic children. METHODS: Retrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes. Patients in the control group (34 eyes underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA, intraocular pressure (IOP, and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y. Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded. RESULTS: The surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5% in the study group and in 28 eyes (87.5% in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909. Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo. During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other

  3. Amniotic fluid embolism and isolated coagulopathy: atypical presentation of amniotic fluid embolism.

    LENUS (Irish Health Repository)

    Awad, I T

    2012-02-03

    A 41-year-old multigravida presented at 32 weeks of gestation with polyhydramnios and an anencephalic fetus. Abnormal bleeding as a result of disseminated intravascular coagulation complicated an emergency Caesarean section for severe abdominal pain thought to be due to uterine rupture. Massive transfusion with blood products was necessary and the abdomen packed to control bleeding. The patient was transferred to the intensive care unit where she made a slow but complete recovery. Amniotic fluid embolism with atypical presentation of isolated coagulopathy is the likely diagnosis in this case. The case serves to demonstrate that amniotic fluid embolism may present with symptoms and signs other than the classical pattern of dyspnoea, cyanosis and hypotension.

  4. GROUP B STREPTOCOCCUS CIRCUMVENTS NEUTROPHILS AND NEUTROPHIL EXTRACELLULAR TRAPS DURING AMNIOTIC CAVITY INVASION AND PRETERM LABOR

    Science.gov (United States)

    Boldenow, Erica; Gendrin, Claire; Ngo, Lisa; Bierle, Craig; Vornhagen, Jay; Coleman, Michelle; Merillat, Sean; Armistead, Blair; Whidbey, Christopher; Alishetti, Varchita; Santana-Ufret, Veronica; Ogle, Jason; Gough, Michael; Srinouanprachanh, Sengkeo; MacDonald, James W; Bammler, Theo K; Bansal, Aasthaa; Liggitt, H. Denny; Rajagopal, Lakshmi; Waldorf, Kristina M Adams

    2016-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. Although microbial invasion of the amniotic cavity (MIAC) is associated with the majority of early preterm births, the temporal events that occur during MIAC and preterm labor are not known. Group B Streptococci (GBS) are β-hemolytic, gram-positive bacteria, which commonly colonize the vagina but have been recovered from the amniotic fluid in preterm birth cases. To understand temporal events that occur during MIAC, we utilized a unique chronically catheterized nonhuman primate model that closely emulates human pregnancy. This model allows monitoring of uterine contractions, timing of MIAC and immune responses during pregnancy-associated infections. Here, we show that adverse outcomes such as preterm labor, MIAC, and fetal sepsis were observed more frequently during infection with hemolytic GBS when compared to nonhemolytic GBS. Although MIAC was associated with systematic progression in chorioamnionitis beginning with chorionic vasculitis and progressing to neutrophilic infiltration, the ability of the GBS hemolytic pigment toxin to induce neutrophil cell death and subvert killing by neutrophil extracellular traps (NETs) in placental membranes in vivo facilitated MIAC and fetal injury. Furthermore, compared to maternal neutrophils, fetal neutrophils exhibit decreased neutrophil elastase activity and impaired phagocytic functions to GBS. Collectively, our studies demonstrate how a unique bacterial hemolytic lipid toxin enables GBS to circumvent neutrophils and NETs in placental membranes to induce fetal injury and preterm labor. PMID:27819066

  5. The Perceval Sutureless Aortic Valve: Review of Outcomes, Complications, and Future Direction.

    Science.gov (United States)

    Powell, Ramsey; Pelletier, Marc P; Chu, Michael W A; Bouchard, Denis; Melvin, Kevin N; Adams, Corey

    Surgical aortic valve replacement with a stented prosthesis has been the standard of care procedure for aortic stenosis. The Perceval (LivaNova, London, United Kingdom) is a sutureless aortic valve bioprosthesis currently implanted in more than 20,000 patients. The purpose of this article was to review the literature available after 9 years of clinical experience of the Perceval aortic valve. PubMED, Embase, and the Cochrane Library databases were searched. A meta-analysis of summary statistics from individual studies was conducted. A total of 333 studies were identified and 84 studies were included. Thirty-day mortality and 5-year survival ranged from 0% to 4.9% and 71.3% to 85.5%, respectively. Compared with stented prosthesis, pooled analysis demonstrated a statistically significant reduction in aortic cross-clamp and cardiopulmonary bypass times (minutes) with Perceval (38.6 vs 63.3 and 61.4 vs 84.9, P < 0.00001, respectively). Compared with transcatheter aortic valve implantation, pooled analysis demonstrated a statistically significant reduction with Perceval in paravalvular leakage (1.26% vs 14.31%) and early mortality (2.3% vs 6.9%). Favorable hemodynamics, acceptable valve durability, and ease of implantation in minimally invasive cases were reported as benefits. A trend toward increased rates of permanent pacemaker implantation and low postoperative platelet count were identified. Special use and off-label procedures described included bicuspid aortic valves, valve-in-valve for homograft and stentless prosthesis failure, concomitant valvular procedures, porcelain aorta, and endocarditis. The Perceval valve has shown safe clinical and hemodynamic outcomes. Outcomes support its continued usage and potential expansion.

  6. Outcomes of 23-gauge transconjunctival sutureless vitrectomy for acute postoperative endophthalmitis.

    Science.gov (United States)

    Hsu, Chia-Ming; Chen, Shih-Chou; Wu, Tsung-Tien; Sheu, Shwu-Jiuan

    2017-08-01

    To report our 3-year experience of 23-gauge transconjunctival sutureless vitrectomy (TSV) for acute postoperative endophthalmitis at a tertiary referral center in southern Taiwan. This retrospective chart review study included 19 patients with acute postoperative endophthalmitis who underwent 23-gauge TSV from January 2011 to January 2015 at Kaohsiung Veterans General Hospital, Taiwan. Bacterial and fungal cultures from aqueous samples, vitreous samples, or both were performed. Nineteen patients (12 male; 7 female) were included. The mean age was 72.4 ± 8.29 years. Acute postoperative endophthalmitis was noted in 18 patients after cataract surgery and in 1 patient after 23-gauge vitrectomy for a rhegmatogenous retinal detachment. Upon presentation, visual acuity was less than hand movement for 80% of the patients. Chief complaints included blurred vision (19 patients, 100%), followed by pain (10 patients, 52.6%) and red eye (4 patients, 21%). All patients were administered an intravitreal injection (IVI) of antibiotics and 23-gauge TSV, and the average number of IVIs was 2.68 ± 1.73 (1-9 IVIs). The interval between their initial eye symptoms and vitrectomy was 4.11 ± 4.73 days (0-2 days), and the interval between diagnosis with endophthalmitis and a vitrectomy was 1.11 ± 1.52 days (0-6 days). The final visual acuity was no light perception for 1 patient (5.3%), between 6/60 and 6/12 for 8 patients (42.1%), and 6/12 or better for 9 patients (47.4%). No retinal detachment or hypotony was noted postoperatively in any case. 23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome. Copyright © 2017. Published by Elsevier Taiwan LLC.

  7. Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection

    Directory of Open Access Journals (Sweden)

    Erakgun Tansu

    2009-01-01

    Full Text Available Aims: To evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV with Silicone oil (SO tamponade in complex vitreoretinal diseases. Settings and Design: Ege university hospital ophthalmology department. Retrospective case series. Materials and Methods: Forty eyes of 40 patients with diabetic tractional retinal detachment (DTRD and proliferative vitreoretinopathy (PVR were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated. Statistical analysis used: Paired Student′s t-test. Results: Simultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (±2.7. Pre- and postoperative mean visual acuity was 2.22±0.91 logMAR and 1.11±0.8 logMAR, respectively ( P< 0.001. Mean intraocular pressure (IOP on the first postoperative day was lower than preoperative IOP (11.3 ±3.2 versus 14.0 ±2.4 mmHg ( P< 0.001. Conclusions: Twenty-three gauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases.

  8. Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection

    Science.gov (United States)

    Erakgun, Tansu; Egrilmez, Sait

    2009-01-01

    Aims To evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV) with Silicone oil (SO) tamponade in complex vitreoretinal diseases. Settings and Design Ege university hospital ophthalmology department. Retrospective case series. Materials and Methods Forty eyes of 40 patients with diabetic tractional retinal detachment (DTRD) and proliferative vitreoretinopathy (PVR) were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated. Statistical analysis used Paired Student's t-test. Results Simultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg) were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (±2.7). Pre- and postoperative mean visual acuity was 2.22±0.91 logMAR and 1.11±0.8 logMAR, respectively (Ppressure (IOP) on the first postoperative day was lower than preoperative IOP (11.3 ±3.2 versus 14.0 ±2.4 mmHg) (Pgauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases. PMID:19237782

  9. Testosterone determination in amniotic fluid for sec diagnosis

    International Nuclear Information System (INIS)

    Quiroa C, M.M.

    1985-11-01

    This study was carried on 50 samples of amniotic fluid obtained from pregnant patients with gestation old of 38 to 40 weeks; diagnosis of the foetus sex was made by measuring the testosterone levels by radioimmunoassay technique. It was found that 94% of the cases were correctly diagnosed. The testosterone levels found in the amniotic fluid of male and female foetus were significantly different (L<0.01) these confirm the efficacy of the method. (author)

  10. Serum-Free Cryopreservation of Human Amniotic Epithelial Cells

    OpenAIRE

    H. Niknejad; H. Peirovi; B. Jambar Noushin

    2013-01-01

    Introduction & Objective: One of the important issues in long term storage of cells is removal of animal serum from cell culture environments. The aim of this study was to evaluate amni-otic fluid (AF), which is full of growth factors, as substitute for fetal bovine serum (FBS) in the cryopreservation protocol. Materials & Methods: In this experimental study human amniotic epithelial cells were isolated from placentas which were seronegative for microbial infections. The cells were preserved ...

  11. Amniotic Fluid Cells Proliferation in Normal and Down Syndrome Subjects

    Directory of Open Access Journals (Sweden)

    Honcea Adina

    2016-02-01

    Full Text Available Down Syndrome/Trisomy 21 is the most common chromosomal anomaly, and it represents the most common congenital cause of infants’ intellectual disability. Subjects with this syndrome are affected by degenerative processes caused by accelerated aging or unknown ethyologies. In recent years, accumulating evidence revealed increased potential of amniotic fluid-derived stem cells to be used in regenerative therapy. Our aim was to assess differences in immunophenotype, cell morphology and proliferation of amniotic fluid cells from normal and Down Syndrome pregnancies using a quantitative cytometry approach. Results revealed the emergence of a population of small sized cells in Down Syndrome derived amniotic fluid cells that are readily visible upon microscopic inspection. Hence, the fluorescence–based quantitative image cytometry determinations showed a tendency of decrease in both cell and nuclei size in trisomy, with no significant modification in nuclei circularity, as measured following actin cytoskeleton and nuclei labeling. The propensity of Ki67 positive cells was found to be increased in Down Syndrome derived cells (48.92% as compared to normal specimens (28.68%. However, cells in S and G2/M cell cycle phases decreased from 32.91% to 4.49% in diseased cells. Further studies are devoted to understanding the molecular basis of the observed differences in the proliferation ability of Down Syndrome amniotic cells, in order to evaluate the potential therapeutic effect of amniotic fluid stem cells for tissue regeneration in subjects with trisomy and to find correlations between amniotic cells phenotype and patient prognosis.

  12. Pup retrieval and maternal attraction to canine amniotic fluids.

    Science.gov (United States)

    Dunbar, I; Ranson, E; Buehler, M

    1981-10-01

    Three purebred female beagles were observed with both their first and second litters. Dams were given three separate simultaneous-choice retrieval tests: In addition, the maternal response to amniotic fluids was observed when one pup in the litter was treated with amniotic fluids and all other pups were treated with water. There was no evidence to suggest that pups were retrieved preferentially on the basis of their sex. One female retrieved her own but not alien pups, whereas another female made no such discrimination and readily retrieved alien pups in addition to her own. Retrieval behavior developed at the time of each whelping and normally lasted until the pups were about 5 days old, although a bitch would retrieve younger (alien) pups up to 14 days post partum. Maternal bitches were strongly attracted towards amniotic fluids: they investigated pups daubed with amniotic fluids to a significantly greater extent than control pups treated with water. The attraction of maternal females towards amniotic fluids developed at the time of each whelping and persisted for up to 30 days, well beyond the time that a whelping bitch would normally be exposed to her own fetal fluids. A possible role for amniotic fluids in the development of maternal behaviour and the establishment of the maternal/puppy bond is discussed. Copyright © 1981. Published by Elsevier B.V.

  13. Effects of topical 0.2% Cyclosporine A on corneal neovascularization induced by xenologous amniotic membrane implantation into a corneal stroma micropocket of rats Efeitos do uso tópico da Ciclosporina A (CsA 0,2% na neovascularização corneal induzida pelo implante de membrana amniótica xenógena em microbolsa no estroma da córnea de ratos

    Directory of Open Access Journals (Sweden)

    Juliana F. Milani

    2008-08-01

    Full Text Available The objective of the study was to evaluate the topical effects of 0.2% Cyclosporine A (CsA on corneal neovascularization of rats following surgical implantation of equine amniotic membrane into a corneal stroma micropocket. The implantation of xenologous amniotic membrane was performed bilaterally in 90 rats. In the same day of the surgery each right eye started receiving topical CsA twice a day. The left eye received no medication and served as a control. The evaluation of corneal neovascularization was performed by computerized image analysis and histopathological evaluation at 1, 3, 7, 15, 30 and 60 days postoperatively. For the image analysis 10 animals were used per time period, and for the histopathological examination, five animals were used per time period. Image analysis found that corneal neovascularization began on the 3rd postoperative day, reached its peak on the 7th day, and then progressively and rapidly decreased. Statistic analysis indicated that neovascularization of the CsA treated eye on the 7th day was significantly higher than that observed in untreated eyes. On the 30th day, however, this pattern was reversed with the neovascularization observed in the CsA treated eyes declining to the low levels observed on the 3rd day. The degree of neovascularization in the untreated eyes on the 30th day declined to the baseline levels found on day 3 at the 60th day. Histopathological analysis indicated that deposition of collagen in the implanted tissue was completed by the 15th day. Therefore, we concluded that (1 equine amniotic membrane in rat corneal stroma produced an intense neovascularization until the 15th day postoperatively and then regressed, (2 deposition of collagen of the implanted tissue was completed on the 15th day postoperatively, and (3 use of CsA was associated with increase in the corneal neovascularization initially, followed by a quick and intense regression.Este estudo teve como objetivo a avaliação dos

  14. Antibiotic Therapy Increases the Risk of Preterm Birth in Preterm Labor without Intra-Amniotic Microbes, but may Prolong the Gestation Period in Preterm Labor with Microbes, Evaluated by Rapid and High-Sensitive PCR System.

    Science.gov (United States)

    Yoneda, Satoshi; Shiozaki, Arihiro; Yoneda, Noriko; Ito, Mika; Shima, Tomoko; Fukuda, Kaori; Ueno, Tomohiro; Niimi, Hideki; Kitajima, Isao; Kigawa, Mika; Saito, Shigeru

    2016-04-01

    To examine the efficacy of the use of antibiotics in preterm labor (PTL) with intact membranes, after evaluating intra-amniotic microbes by our rapid and bacteria-free polymerase chain reaction (PCR) system. One hundred and four PTL patients before 32 weeks of gestation were recruited. Until 2012, antibiotics were empirically prescribed based on the clinical severity of PTL. Intra-amniotic microbes in stored samples were evaluated later by our newly established PCR system, and the efficacy of the use of antibiotics in PTL was evaluated. In the amniotic fluid (AF) microbe-negative patients (n = 67), antibiotic therapy significantly shortened the gestation period (P antibiotic therapy (proper antibiotic selection against identified AF microbes) was significantly associated with an increase in gestation period (P antibiotic therapy in PTL with intact membranes prolonged the gestation period. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Autologous Transplantation of Amniotic Fluid-Derived Mesenchymal Stem Cells into Sheep Fetuses.

    Science.gov (United States)

    Shaw, S W Steven; Bollini, Sveva; Nader, Khalil Abi; Gastaldello, Annalisa; Mehta, Vedanta; Filppi, Elisa; Cananzi, Mara; Gaspar, H Bobby; Qasim, Waseem; De Coppi, Paolo; David, Anna L

    2016-03-01

    Long-term engraftment and phenotype correction has been difficult to achieve in humans after in utero stem cell transplantation mainly because of allogeneic rejection. Autologous cells could be obtained during gestation from the amniotic fluid with minimal risk for the fetus and the mother. Using a sheep model, we explored the possibility of using amniotic fluid mesenchymal stem cells (AFMSCs) for autologous in utero stem cell/gene therapy. We collected amniotic fluid (AF) under ultrasound-guided amniocentesis in early gestation pregnant sheep ( n = 9, 58 days of gestation, term = 145 days). AFMSCs were isolated and expanded in all sampled fetal sheep. Those cells were transduced using an HIV vector encoding enhanced green fluorescent protein (GFP) with 63.2% (range 38.3-96.2%) transduction efficiency rate. After expansion, transduced AFMSCs were injected into the peritoneal cavity of each donor fetal sheep at 76 days under ultrasound guidance. One ewe miscarried twin fetuses after amniocentesis. Intraperitoneal injection was successful in the remaining 7 fetal sheep giving a 78% survival for the full procedure. Tissues were sampled at postmortem examination 2 weeks later. PCR analysis detected GFP-positive cells in fetal tissues including liver, heart, placenta, membrane, umbilical cord, adrenal gland, and muscle. GFP protein was detected in these tissues by Western blotting and further confirmed by cytofluorimetric and immunofluorescence analyses. This is the first demonstration of autologous stem cell transplantation in the fetus using AFMSCs. Autologous cells derived from AF showed widespread organ migration and could offer an alternative way to ameliorate prenatal congenital disease.

  16. Application of human amniotic mesenchymal cells as an allogeneic transplantation cell source in bone regenerative therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsuno, Hiroaki [Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Yoshida, Toshiko [Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Nogami, Makiko [Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Department of Orthopedic Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Koike, Chika; Okabe, Motonori [Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Noto, Zenko [Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Arai, Naoya; Noguchi, Makoto [Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan); Nikaido, Toshio, E-mail: tnikaido@med.u-toyama.ac.jp [Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194 (Japan)

    2012-12-01

    Autogenous mesenchymal stem cells (MSCs) have therapeutic applications in bone regenerative therapy due to their pluripotency. However, the ability of MSCs to proliferate and differentiate varies between donors. Furthermore, alternative sources of MSCs are required for patients with contraindications to autogenous cell therapy. The aim of this study was to evaluate the potential of mesenchymal cells from the human amniotic membrane (HAM) as a source of cells for allogeneic transplantation in bone regenerative therapy. Cells that retained a proliferative capacity of more than 50 population doubling level were distinguished from other HAM cells as HAM{alpha} cells and induced to osteogenic status-their in vivo osteogenesis was subsequently investigated in rats. It was found that HAM{alpha} cells were spindle shaped and were positive for MSC markers and negative for hematopoietic stem cell markers. Alkaline phosphatase activity and calcium deposition increased with osteogenic status of HAM{alpha} cells. The expression of osteocalcin mRNA was increased in HAM{alpha} cells cultured on calcium phosphate scaffolds. Moreover, xenografted HAM{alpha} cells remained viable and produced extracellular matrix for several weeks. Thus, this study suggests that human amniotic mesenchymal cells possess osteogenic differentiation potential and could be applied to allogeneic transplantation in bone regenerative therapy. - Highlights: Black-Right-Pointing-Pointer Human amniotic mesenchymal cells include cells (HAM{alpha} cells) that have the properties of MSCs. Black-Right-Pointing-Pointer HAM{alpha} cells have excellent osteogenic differentiation potential. Black-Right-Pointing-Pointer Osteogenic differentiation ability of HAM{alpha} was amplified by calcium phosphate scaffolds. Black-Right-Pointing-Pointer HAM{alpha} cells can be applicable to allogeneic cell transplantation in bone regenerative therapy.

  17. Proteomic profiling of amniotic fluid in preterm labor using two-dimensional liquid separation and mass spectrometry.

    Science.gov (United States)

    Bujold, Emmanuel; Romero, Roberto; Kusanovic, Juan Pedro; Erez, Offer; Gotsch, Francesca; Chaiworapongsa, Tinnakorn; Gomez, Ricardo; Espinoza, Jimmy; Vaisbuch, Edi; Mee Kim, Yeon; Edwin, Samuel; Pisano, Mike; Allen, Beth; Podust, Vladimir N; Dalmasso, Enrique A; Rutherford, Jennifer; Rogers, Wade; Moser, Allan; Yoon, Bo Hyun; Barder, Tim

    2008-10-01

    Simultaneous analysis of the protein composition of biological fluids is now possible. Such an approach can be used to identify biological markers of disease and to understand the pathophysiology of disorders that have eluded classification, diagnosis, and treatment. The purpose of this study was to analyze the differences in protein composition of the amniotic fluid of patients in preterm labor. Amniotic fluid was obtained by amniocentesis from three groups of women with preterm labor and intact membranes: (1) women without intra-amniotic infection/inflammation (IAI) who delivered at term, (2) women without IAI who delivered a preterm neonate, and (3) women with IAI. Intra-amniotic infection was defined as a positive amniotic fluid culture for microorganisms. Intra-amniotic inflammation was defined as an elevated amniotic fluid interleukin (IL)-6 (> or =2.3 ng/mL). Two-dimensional (2D) chromatography was used for analysis. The first dimension separated proteins by isoelectric point, while the second, by the degree of hydrophobicity. 2D protein maps were generated using different experimental conditions (reducing agents as well as protein concentration). The maps were used to discern subsets of isoelectric point/hydrophobicity containing differentially expressed proteins. Protein identification of differentially expressed fractions was conducted with mass spectrometry. Enzyme-linked immunosorbent assays (ELISA) as well as surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS)-based on-chip antibody capture immunoassays were also used for confirmation of a specific protein that was differentially expressed. (1) Amniotic fluid protein composition can be analyzed using a combination of 2D liquid chromatography and mass spectrometry for the identification of proteins differentially expressed in patients in preterm labor. (2) While total insulin-like growth factor-binding protein-1 (IGFBP-1) concentration did not change, IGFBP-1

  18. Osteogenic differentiation of amniotic epithelial cells: synergism of pulsed electromagnetic field and biochemical stimuli.

    Science.gov (United States)

    Wang, Qian; Wu, Wenchao; Han, Xiaoyu; Zheng, Ai; Lei, Song; Wu, Jiang; Chen, Huaiqing; He, Chengqi; Luo, Fengming; Liu, Xiaojing

    2014-08-11

    Pulsed electromagnetic field (PEMF) is a non-invasive physical therapy used in the treatment of fracture nonunion or delayed healing. PEMF can facilitate the osteogenic differentiation of bone marrow mesenchymal stem cells in vitro. Amniotic epithelial cells (AECs) have been proposed as a potential source of stem cells for cell therapy. However, whether PEMF could modulate the osteogenic differentiation of AECs is unknown. In the present study, the effects of PEMF on the osteogenic differentiation of AECs were investigated. AECs were isolated from amniotic membrane of human placenta by trypsin digestion and were induced by PEMF and/or osteo-induction medium. After 21 days we used real time RT-PCR and immunocytochemistry to study the expression of osteoblast markers. The signal transduction of osteogenesis was further investigated. The PEMF stimulation, or osteo-induction medium alone could induce osteogenic differentiation of AECs, as shown by expression of osteoblast specific genes and proteins including alkaline phosphatase and osteocalcin. Furthermore, a combination of PEMF and osteo-induction medium had synergy effects on osteogenic differentiation. In our study, the gene expression of BMP-2, Runx2, β-catenin, Nrf2, Keap1 and integrinβ1 were up-regulated in the osteogenic differentiation of AECs induced by PEMF and/or osteo-induction medium. Combined application of PEMF and osteo-induction medium is synergistic for the osteogenic differentiation of AECs. It might be a novel approach in the bone regenerative medicine.

  19. Stem cells from amniotic fluid--Potential for regenerative medicine.

    Science.gov (United States)

    Loukogeorgakis, Stavros P; De Coppi, Paolo

    2016-02-01

    Regenerative medicine has recently been established as an emerging field focussing on repair, replacement or regeneration of cells, tissues and whole organs. The significant recent advances in the field have intensified the search for novel sources of stem cells with potential for therapy. Recently, researchers have identified the amniotic fluid as an untapped source of stem cells that are multipotent, possess immunomodulatory properties and do not have the ethical and legal limitations of embryonic stem cells. Stem cells from the amniotic fluid have been shown to differentiate into cell lineages representing all three embryonic germ layers without generating tumours, which make them an ideal candidate for tissue engineering applications. In addition, their ability to engraft in injured organs and modulate immune and repair responses of host tissues suggest that transplantation of such cells may be useful for the treatment of various degenerative and inflammatory diseases affecting major tissues/organs. This review summarises the evidence on amniotic fluid cells over the past 15 years and explores the potential therapeutic applications of amniotic fluid stem cells and amniotic fluid mesenchymal stem cells. Copyright © 2015. Published by Elsevier Ltd.

  20. Staphylococcus lugdunensis cultured from the amniotic fluid at Caesarean Section.

    Directory of Open Access Journals (Sweden)

    Zbigniew Marchocki

    Full Text Available Staphylococcus lugdunensis is a virulent coagulase-negative staphylococcus. It behaves like and can be mistaken in culture for Staphylococcus aureus. While originally thought to be a skin commensal rarely responsible for opportunistic infection, it was rapidly established as a significant human pathogen. It has been mainly associated with native and prosthetic valve endocarditis, osteomyelitis, and skin and soft tissue cellulitis, but has also been reported as a cause of fasciitis as well as peritonitis. Staphylococcus lugdunensis has been reported as a cause of endometritis but has not been previously isolated from amniotic fluid. Here, amniotic fluid samples were collected in the course of a larger study on amniotic fluid bacteriology, with prior ethical approval and informed patient consent. Amniotic fluid was obtained at Caesarean Section by direct needle aspiration from the intact amnion. Analysis with Staphylococcal API test kits led to identification of Staphylococcus lugdunensis in two cases. The clinical significance of the finding in these reported cases is undetermined. Staphylococcus lugdunensis has been shown to be a cause of serious and potentially fatal morbidities, but this is the first report of its culture from amniotic fluid. As caesarean delivery is accepted as the single most important factor associated with post-partum infectious complications in both mother and neonate, the identification of this pathogen is a new concern.

  1. Serum-Free Cryopreservation of Human Amniotic Epithelial Cells

    Directory of Open Access Journals (Sweden)

    H. Niknejad

    2013-04-01

    Full Text Available Introduction & Objective: One of the important issues in long term storage of cells is removal of animal serum from cell culture environments. The aim of this study was to evaluate amni-otic fluid (AF, which is full of growth factors, as substitute for fetal bovine serum (FBS in the cryopreservation protocol. Materials & Methods: In this experimental study human amniotic epithelial cells were isolated from placentas which were seronegative for microbial infections. The cells were preserved in 24 different patterns for 12 months in -196 ?C (liquid nitrogen and viability of cells were determined before and after cryopreservation by trypan blue and MTT assay. Moreover, Oct-4 expression was studied to determine pluripotency before and after cryopreservation with immunocytochemistry. Results were compared between groups with ANOVA (Tukey Post-Test. P.value under 0.01 and 0.05 was considered statistically significant. Results: The presence of DMEM, FBS or AF is necessary for amniotic cell cryopreservation. Trypan-blue, MTT and immunocytochemistry showed that there isn’t significant difference between using AF and FBS in viability and pluripotency of cells. Moreover, results showed that DMSO is a better cryoprotectant compared to glycerol. Conclusion : Results showed that amniotic fluid can be a proper substitute for FBS in amniotic epithelial cells cryopreservation. (Sci J Hamadan Univ Med Sci 2013; 20 (1:15-24

  2. Meconium-Stained Amniotic Fluid as an Independent Risk Factor for Fever and Postpartum Infection in Term Pregnancy

    Directory of Open Access Journals (Sweden)

    M Valadan

    2008-06-01

    Full Text Available Background: The aim of this study was to statistically evaluate the hypothesis that the presence of meconium-stained amniotic fluid is associated with postpartum maternal infection.Methods: This prospective cohort study included 573 term pregnant women in labor, with no other medical problems, that underwent cesarean section for pregnancy termination. Women with prolonged active-phase labor, prolonged rupture of membranes, complicated cesarean section and pre-operative infections were excluded from this study.The subjects were divided into two groups: 280 women with meconium-stained amniotic fluid (M group, and 293 women with clear amniotic fluid (C group. A comparison was done regarding postpartum fever, endometritis and wound infection between the two groups. Students t-test and chi square test were used for data analysis, along with linear regression, with p<0.05 indicating significance.Results: Among the 573 women, a total of 82 women (14% had fever after cesarean; 42 women from the M group, and 40 women from the C group (p= 0.3. Among the 82 women who had fever, 33 women had continuous fever, 6.5% in group M and 2.7% in group C (p<0.05, RR: 1.98, 95% CI 1.3-3.1. Among the 573 women, 4% developed endometritis 5% in group M and 2% in group C (p<0.05, RR: 2.3, 95%, CI 1.3-3.4. Similarly, among the 573 women, a total of 5 women (1% developed wound infection, 1.7% in group M and 0.68% in group C (p=0.7.Conclusion: Meconium-stained amniotic fluid is associated with increased postpartum infection independent of other risk factors for infection.

  3. In vitro culture of mouse embryos in human amniotic fluid | Coetzee ...

    African Journals Online (AJOL)

    Human amniotic fluid was compared with Ham's F-10 culture medium as a possible alternative for use in in vitro fertilisation. The cleavage success of mouse embryos in human amniotic fluid (experimental group) was 92% compared with 86% in Ham's F-10 medium. It is concluded that human amniotic fluid is a viable ...

  4. A rare combination of amniotic constriction band with osteogenesis imperfecta.

    Science.gov (United States)

    Shah, Krupa Hitesh; Shah, Hitesh

    2015-11-11

    Amniotic constriction bands and osteogenesis imperfecta are disorders arising from a collagen defect. We report a rare association of amniotic bands with osteogenesis imperfecta in a child. The child was born with multiple amniotic bands involving the right leg, both hands and both feet. Multiple fractures of long bones of lower limbs occurred in childhood due to trivial trauma. Deformities of the femur and tibia due to malunion with osteopenia and blue sclerae were present. The patient was treated with z plasty of constriction band of the right tibia and bisphosphonate for osteogenesis imperfecta. This rare association of both collagen diseases may provide further insight for the pathogenesis of these diseases. 2015 BMJ Publishing Group Ltd.

  5. Amniotic fluid as a vital sign for fetal wellbeing

    Science.gov (United States)

    Magann, Everett F

    2015-01-01

    Abstract Introduction: Amniotic fluid, once thought to merely provide protection and room for necessary movement and growth for the fetus, is now understood to be a highly complex and dynamic system that is studied as a data point to interpret fetal wellbeing. Methods: Assessment of amniotic fluid volume is now routine when performing a sonographic evaluation of fetal status and is an important consideration in the assessment and management of perinatal morbidity and mortality. 1 , 2 In this review, we will cover the dynamics that affect amniotic fluid volume, review methods for measurement and quantification of volume, review definitions for normative data as related to neonatal outcomes, and provide evidence based guidance on the workup and management options for oligoydramnios and polyhydramnios in singleton and twin pregnancies. Conclusions: When abnormalities of fluid exist, appropriate workup to uncover the underlying etiology should be initiated as adverse fetal outcomes are sometimes associated with these variations from normalcy. PMID:28191176

  6. Dielectric properties of human placenta, umbilical cord and amniotic fluid

    Science.gov (United States)

    Peyman, A.; Gabriel, C.; Benedickter, H. R.; Fröhlich, J.

    2011-04-01

    The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 °C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields.

  7. Dielectric properties of human placenta, umbilical cord and amniotic fluid

    Energy Technology Data Exchange (ETDEWEB)

    Peyman, A [Physical Dosimetry Department, Health Protection Agency, Chilton, Didcot OX11 0RQ (United Kingdom); Gabriel, C [MCL-P, Newbury RG14 5PY, Berkshire (United Kingdom); Benedickter, H R; Froehlich, J, E-mail: Azadeh.peyman@hpa.org.uk [Electromagnetic Fields and Microwave Electronics Laboratory, Swiss Federal Institute of Technology, Zurich (Switzerland)

    2011-04-07

    The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 deg. C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields. (note)

  8. Clinical relevance of sonographically estimated amniotic fluid volume: polyhydramnios.

    Science.gov (United States)

    Sandlin, Adam T; Chauhan, Suneet P; Magann, Everett F

    2013-05-01

    Polyhydramnios is an excessive amount of amniotic fluid within the amniotic cavity. The etiology of polyhydramnios may be idiopathic, the consequence of fetal structural anomalies, or the consequence of various fetal and maternal conditions. The clinical importance of polyhydramnios is found in its association with adverse pregnancy outcomes and the risk of perinatal mortality. The antenatal management of polyhydramnios can be challenging as there are no formalized guidelines on the topic. The purpose of this review is to provide a literature-based overview on the subject of polyhydramnios in singleton pregnancies, demonstrate its clinical implications, and describe a practical approach to its management.

  9. Meconium "aspiration" (or respiratory distress associated with meconium-stained amniotic fluid?).

    Science.gov (United States)

    Vain, Nestor E; Batton, Daniel G

    2017-08-01

    The designation meconium aspiration syndrome (MAS) reflects a spectrum of disorders in infants born with meconium-stained amniotic fluid, ranging from mild tachypnea to severe respiratory distress and significant mortality. The frequency of MAS is highest among infants with post-term gestation, thick meconium, and birth asphyxia. Pulmonary hypertension is an important component in severe cases. Prenatal hypopharyngeal suctioning and postnatal endotracheal intubation and suctioning of vigorous infants are not effective. Intubation and suctioning of non-breathing infants is controversial and needs more investigation. Oxygen, mechanical ventilation, and inhaled nitric oxide are the mainstays of treatment. Surfactant is often used in infants with severe parenchymal involvement. High-frequency ventilation and extracorporeal membrane oxygenation are usually considered rescue therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Amniotic mesenchymal stem cells display neurovascular tropism and aid in the recovery of injured peripheral nerves.

    Science.gov (United States)

    Li, YongNan; Guo, Longzhe; Ahn, Hyun Sook; Kim, Moo Hyun; Kim, Sung-Whan

    2014-06-01

    Recently, we reported that human amniotic membrane-derived mesenchymal stem cells (AMMs) possess great angiogenic potential. In this study, we determined whether local injection of AMMs ameliorates peripheral neuropathy. AMMs were transplanted into injured sciatic nerves. AMM injection promoted significant recovery of motor nerve conduction velocity and voltage amplitude compared to human adipose-derived mesenchymal stem cells. AMM implantation also augmented blood perfusion and increased intraneural vascularity. Whole-mount fluorescent imaging analysis demonstrated that AMMs exhibited higher engraftment and endothelial incorporation abilities in the sciatic nerve. In addition, the higher expression of pro-angiogenic factors was detected in AMMs injected into the peripheral nerve. Therefore, these data provide novel therapeutic and mechanistic insights into stem cell biology, and AMM transplantation may represent an alternative therapeutic option for treating peripheral neuropathy. © 2014 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  11. Is vitamin C able to prevent premature rupture of membranes?

    OpenAIRE

    Citra Aryanti

    2016-01-01

    Premature rupture of membranes (PROM) is leakage of amniotic fluid through ruptured chorioamniotic membranes that occur before starting the labor pain at any gestational age. This is one of the most common problems in obstetrics with many adverse pregnancy outcomes. Main and final mechanisms of membrane rupture is disturbances in its collagen content metabolism. Vitamin C is found to stabilize the cross link triple helix collagen structure and scavange oxidant that involved in PPROM. Associat...

  12. Congenital Amniotic Band Syndrome: Clinico-Epidemologic Study ...

    African Journals Online (AJOL)

    Congenital amniotic band syndrome (CABS) is an uncommon clinical entity with a global incidence of 1: 1, 200 to 1: 15, 000 live births. They nevertheless pose great functional, cosmetic and reconstructive challenge. There has been only one case report of this condition from our centre. This paper reviews the ...

  13. Amniotic Fluid MMP-9 and Neurotrophins in Autism Spectrum Disorders

    DEFF Research Database (Denmark)

    Abdallah, Morsi; Pearce, Brad D; Larsen, Nanna

    2012-01-01

    Evidence suggests that some developmental disorders, such as autism spectrum disorders (ASDs), are caused by errors in brain plasticity. Given the important role of matrix metalloproteinases (MMPs) and neurotrophins (NTs) in neuroplasticity, amniotic fluid samples for 331 ASD cases and 698...

  14. Amniotic fluid as a source of engraftable stem cells

    Directory of Open Access Journals (Sweden)

    Cesar V Borlongan

    2017-01-01

    Full Text Available The ability of stem cells to differentiate into various lineages has made them powerful tools of regenerative medicine and applicable to multiple human diseases. Of particular interest, amniotic fluid-derived stem cells (AFSC have been characterized to express both adult and embryonic cell markers, indicating them as cells within an intermediate stage between embryonic and adult phenotype. AFSC can differentiate into cells of all three germ layers, including hepatic, myogenic, osteogenic, and neurogenic cell types. Furthermore, AFSC have minimal replicative senescence, retaining the ability to divide effectively for over 250 doublings. These facts indicate that amniotic fluid may exist as a promising donor source of stem cells for the treatment of multiple clinically relevant conditions. Of particular interest is the convenience of harvesting stem cells from the amniotic fluid stem for the treatment of newborns, as well as for banking or cryopreserving purposes to be used at a later date. Importantly, the promise of amniotic fluid as a source of stem cells merits ongoing research into their potential therapeutic applications. This paper is a review article. Referred literature in this paper has been listed in the references section. The datasets supporting the conclusions of this article are available online by searching various databases, including PubMed. Some original points in this article come from the laboratory practice in our research center and the authors' experiences.

  15. Clinical significance of amniotic fluid glucose concentration in polyhydramnios.

    Science.gov (United States)

    Ogawa, Masaki; Sato, Akira; Mori, Koutaro; Nagao, Daisuke; Kamada, Kumiko; Sato, Megumi; Terada, Yukihiro

    2012-07-01

    To evaluate whether amniotic fluid glucose concentration can predict poor neonatal outcome in cases with polyhydramnios as an overall assessment. In this retrospective study, we have reviewed 42 consecutive pregnant women with singleton gestations complicated with polyhydramnios who gave birth at one tertiary care center between January 2003 and September 2010. Perinatal clinical findings were reviewed, and the neonatal outcome, such as livebirth or stillbirth and early neonatal death, was compared. A p value less than 0.05 was considered to be significant. Thirteen of 42 neonates had a poor outcome, including stillbirth or early neonatal death. Multiple logistic regression analysis showed that amniotic fluid glucose (p = 0.042) was significant factor influencing poor neonatal prognosis [odds ratio 0.66; 95% confidence interval 0.44-0.98]. Receiver operating characteristics curve and sensitivity and specificity curve showed that the optimal cut-off value of amniotic fluid glucose concentration for predicting poor neonatal outcome was 17 mg/dl. Amniotic glucose concentration less than 17 mg/dl and the presence of congenital heart anomaly were better predictors for a poor postnatal outcome in cases with polyhydramnios.

  16. Effects of fructose feeding on maternal and amniotic fluid ...

    African Journals Online (AJOL)

    Dr Olaleye

    pregnancies using corticotrophin releasing hormone. (CRH), a stress marker produced by the placenta and C. - reactive protein (CRP) an inflammatory response marker by evaluating the effect of fructose-induced insulin resistance on maternal serum and amniotic fluid insulin, CRH, CRP, IGF-1 and IGF-2 on days 12, 15.

  17. Amniotic band syndrom at Bobo Dioulasso university teaching ...

    African Journals Online (AJOL)

    ... a Z-plasty. The functional outcome was satisfactory with the acquisition of a plantar support for both children. Through these two observations, epidemiological, diagnostic, and particularities of the management of this condition are discussed in the Burkina-Faso. Key words: Amniotic band syndrom, surgery, birth defects ...

  18. Effects of fructose feeding on maternal and amniotic fluid ...

    African Journals Online (AJOL)

    Effects of fructose feeding on maternal and amniotic fluid corticotropin releasing hormone and C-reactive protein in pregnant female Sprague-dawley rats. ... The results suggest that stress and inflammatory mechanisms may be implicated in the role maternal nutrition plays in developmental plasticity. Keywords: Insulin ...

  19. RESEARCH ON REDUCING PREMATURITY RUPTURE OF MEMBRANE

    Directory of Open Access Journals (Sweden)

    Maria URSACHI (BOLOTA

    2016-12-01

    Full Text Available The membranes surrounding the amniotic cavity are composed from amnion and chorion, tightly adherent layers which are composed of several cell types, including epithelial cells, trophoblasts cells and mesenchyme cells, embedded in a collagenous matrix. They retain amniotic fluid, secret substances into the amniotic fluid, as well as to the uterus and protect the fetus against upward infections from urogenital tract. Normally, the membranes it breaks during labor. Premature rupture of the amniotic sac (PRAS is defined as rupture of membranes before the onset of labor. Premature rupture of the fetal membrane, which occurs before 37 weeks of gestation, usually, refers to preterm premature rupture of membranes. Despite advances in the care period, premature rupture of membranes and premature rupture of membranes preterm continue to be regarded as serious obstetric complications. On the term 8% - 10% of pregnant women have premature rupture of membranes; these women are at increased risk of intrauterine infections, where the interval between membrane rupture and expulsion is rolled-over. Premature rupture of membranes preterm occurs in approximately 1% of all pregnancies and is associated with 30% -40% of preterm births. Thus, it is important to identify the cause of pre-term birth (after less than 37 completed weeks of "gestation" and its complications, including respiratory distress syndrome, neonatal infection and intraventricular hemorrhage. Objectives: the development of the protocol of the clinical trial on patients with impending preterm birth, study clinical and statistical on the socio-demographic characteristics of patients with imminent preterm birth; clinical condition of patients and selection of cases that could benefit from the application of interventional therapy; preclinical investigation (biological and imaging of patients with imminent preterm birth; the modality therapy; clinical investigation of the effectiveness of short

  20. An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

    Directory of Open Access Journals (Sweden)

    Fenglin Song

    2014-01-01

    Full Text Available To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV were less than those in the control group (using Gore-Tex. The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility.

  1. An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

    Science.gov (United States)

    Song, Fenglin; Zhou, Wenwu; Tang, Tao; Li, Xiaobing; Wu, Xiaoming; Yang, Jinfu

    2014-01-01

    To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV) were less than those in the control group (using Gore-Tex). The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility. PMID:24696856

  2. Comparison of postoperative intraocular pressure changes between 23-gauge transconjunctival sutureless vitrectomy and conventional 20-gauge vitrectomy

    Science.gov (United States)

    Ahn, S J; Woo, S J; Ahn, J; Park, K H

    2012-01-01

    Purpose To compare the intraocular pressure (IOP) after 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various vitreoretinal diseases. Methods This was a retrospective interventional case series including 338 cases of 23-gauge TSV and 476 cases of 20-gauge vitrectomy with minimum follow-up period of 1 month. Postoperative 1 day, 1 week and 1 month IOPs were compared. Multiple regression analysis to assess the actual effect of gauge of vitrectomy on postoperative IOP was performed including intraoperative and postoperative factors influencing postoperative IOP as covariates. Results The mean IOP of 20-gauge vitrectomy was significantly higher than that of 23-gauge TSV (20.6±8.02 mm Hg vs12.8±4.48 mm Hg, Pgauge TSV demonstrated more stable course than that of 20-gauge vitrectomy. At 1 day post vitrectomy, the incidence of hypertony was higher in 20-gauge, whereas that of hypotony was higher in 23-gauge. Among risk factors, the 20-gauge vitrectomy showed the strongest association with postoperative 1 day IOP rise. Conclusion Twenty-three-gauge TSV has stable and lower IOP in the early postoperative period than the 20-gauge vitrectomy. In patients whose retina and optic nerves are vulnerable to higher or fluctuating IOP, 23-gauge TSV may be more beneficial. PMID:22388595

  3. Influence of sutureless 23-gauge sclerotomy architecture on postoperative intraocular pressure decrease: results of a multivariate analysis.

    Science.gov (United States)

    Tahiri Joutei Hassani, Rachid; El Sanharawi, Mohamed; Adam, Raphael; Monin, Claire; Dupont-Monod, Sylvère; Baudouin, Christophe

    2013-05-01

    To evaluate the factors affecting the postoperative intraocular pressure (IOP) decrease in 23-gauge (23-G) sutureless vitrectomy, including incision architecture evaluated by anterior segment spectral-domain optical coherence tomography (SD-OCT). A prospective cohort study of 43 patients who underwent primary transconjunctival 23-G pars plana vitrectomy. All sclerotomy wounds were imaged 1 day after surgery using the anterior segment module of SD-OCT (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany). 23-G sclerotomy architecture, preoperative and postoperative medical data were also prospectively collected. Multivariate logistic regression analysis, with backward elimination, found that surgery duration (adjusted OR = 9.17, p = 0.020) and loss of wound apposition (adjusted OR = 15.12, p = 0.022) were risk factors for significant postoperative IOP decrease (≥3 mmHg) 1 day after surgery; while age, gender, myopia, and gas tamponade were not risk or protective factors for postoperative IOP decrease. In 23-G pars plana vitrectomy, the early postoperative decrease in IOP is mainly influenced by surgery duration and the self-sealing nature of the sclerotomy. The IOP decrease was not influenced by the presence or the absence of gas tamponade.

  4. Comparison of postoperative intraocular pressure changes between 23-gauge transconjunctival sutureless vitrectomy and conventional 20-gauge vitrectomy.

    Science.gov (United States)

    Ahn, S J; Woo, S J; Ahn, J; Park, K H

    2012-06-01

    To compare the intraocular pressure (IOP) after 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various vitreoretinal diseases. This was a retrospective interventional case series including 338 cases of 23-gauge TSV and 476 cases of 20-gauge vitrectomy with minimum follow-up period of 1 month. Postoperative 1 day, 1 week and 1 month IOPs were compared. Multiple regression analysis to assess the actual effect of gauge of vitrectomy on postoperative IOP was performed including intraoperative and postoperative factors influencing postoperative IOP as covariates. The mean IOP of 20-gauge vitrectomy was significantly higher than that of 23-gauge TSV (20.6 ± 8.02 mm Hg vs 12.8 ± 4.48 mm Hg, Pgauge TSV demonstrated more stable course than that of 20-gauge vitrectomy. At 1 day post vitrectomy, the incidence of hypertony was higher in 20-gauge, whereas that of hypotony was higher in 23-gauge. Among risk factors, the 20-gauge vitrectomy showed the strongest association with postoperative 1 day IOP rise. Twenty-three-gauge TSV has stable and lower IOP in the early postoperative period than the 20-gauge vitrectomy. In patients whose retina and optic nerves are vulnerable to higher or fluctuating IOP, 23-gauge TSV may be more beneficial.

  5. An experimental study to replace the thoracic descending aorta for pigs with a self-made sutureless blood vessel.

    Science.gov (United States)

    Song, Fenglin; Zhou, Wenwu; Tang, Tao; Li, Xiaobing; Wu, Xiaoming; Yang, Jinfu

    2014-01-01

    To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV) were less than those in the control group (using Gore-Tex). The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility.

  6. RIA of alpha-fetoprotein in serum and amniotic fluid

    International Nuclear Information System (INIS)

    Fingerova, H.; Talas, M.; Stroufova, A.

    1979-01-01

    An own modification of the double antibody radioimmunoassay for AFP using 125 I-labelled AFP as a tracer, rabbit anti-AFP obtained from SEVAC, Prague and precipitating antibodies prepared by the authors is described. The AFP levels measured in the serum and the amniotic fluid using the method were in agreement with those obtained by the means of the AFPK RIA kit by SORIN in the Institute for the Care of Mother and Child in Prague. The AFP concentrations found in the cord serum and the amniotic fluid were confirmed also by the rocket electroimmunoassay according to Laurell. The described AFP RIA seems suitable for the clinical application in prenatal screening for congenital malformations, in difficult pregnancies, in hepatology and the diagnosis and the evaluation of therapy of some human malignancies. (author)

  7. Multilineage Potential Research of Bovine Amniotic Fluid Mesenchymal Stem Cells

    Directory of Open Access Journals (Sweden)

    Yuhua Gao

    2014-02-01

    Full Text Available The use of amnion and amniotic fluid (AF are abundant sources of mesenchymal stem cells (MSCs that can be harvested at low cost and do not pose ethical conflicts. In human and veterinary research, stem cells derived from these tissues are promising candidates for disease treatment, specifically for their plasticity, their reduced immunogenicity, and high anti-inflammatory potential. This work aimed to obtain and characterize bovine amniotic fluid mesenchymal stem cells (AFMSC. The bovine AF from the amniotic cavity of pregnant gilts in the early stages of gestation (3- and 4-m-old bovine embryos was collected. AFMSCs exhibit a fibroblastic-like morphology only starting from the fourth passage, being heterogeneous during the primary culture. Immunofluorescence results showed that AFMSCs were positive for β-integrin, CD44, CD73 and CD166, but negative for CD34, CD45. Meanwhile, AFMSCs expressed ES cell markers, such as Oct4, and when appropriately induced, are capable of differentiating into ectodermal and mesodermal lineages. This study reinforces the emerging importance of these cells as ideal tools in veterinary medicine; future studies aimed at a deeper evaluation of their immunological properties will allow a better understanding of their role in cellular therapy.

  8. Results of six years of cytogenetic studies in amniotic fluid

    Directory of Open Access Journals (Sweden)

    Enelis Reyes Reyes

    2015-10-01

    Full Text Available Background: research into different genetic diseases is one of the preventive programs of paramount importance at public health level. The early detection of chromosomopathies and the establishment of an appropriate strategy reduce the morbidity-morality rate and improve the patients’ quality of life.Objective: to describe the behavior of the results of the cytogenetic studies in the amniotic fluid of pregnant women from Las Tunas province during six years: from 2008 to 2014.Methods: a retrospective and descriptive study was carried out to assess the results of cytogenetic studies in amniotic liquid during six years: from 2008 to 2014. The statistical records were checked and the results, the indication criteria, the behavior of the age groups in women advanced in age and the diagnosed chromosomopathies were assessed.Results: the samples with results that exceeded the non-conclusive and positive women prevailed; 2, 3 positive cases of chromosomopathies were diagnosed out of 100 studied women at risk; pregnant women of advanced gestational years prevailed as indication criterion, being the 37 to 40 years old age group the predominant one; in the positive cases, numeric chromosomopathies of the type trisomy 21 or Down’s syndrome prevailed, with a frequency of 1, 2 out of 100 pregnant women at risk.Conclusions: the program of the cytogenetic diagnosis in the amniotic fluid has been an effective tool to detect congenital prenatal defects by chromosomopathies, very useful in the process of genetic advice.

  9. Amniotic fluid index and estimated fetal weight for prediction of fetal macrosomia: a prospective observational study.

    Science.gov (United States)

    El Khouly, Nabih I; Elkelani, Osama A; Saleh, Said A

    2017-08-01

    The purpose of this study was to assess the value of combining the estimated fetal weight (EFW) and amniotic fluid index (AFI) measured in term patients early in labor with intact membranes for prediction of macrosomia. In a single center, prospective observational study, 600 patients in the first stage of labor before rupture of membranes in whom ultrasonography was performed to measure AFI and EFW, and these data were analyzed statistically to evaluate prediction of fetal macrosomia. Macrosomia occurred in 64 cases (10.6%). The AFI was significantly higher in the macrosomic group (p = 0.001). It was noted that the area under receiver operating characteristic (ROC) curves for EFW was 0.93 and that of AFI was 0.67. Based on suggested combined EFW and AFI cutoffs of 4000 g and 164 mm, respectively, the positive predictive value (PPV) for combined parameters (92.3%) was higher than that of EFW (75%) and that of AFI (27%) and the likelihood ratio for combination (93.7%) was higher than that of EFW (24.7%) and that of AFI (21%). Combined use of EFW and AFI improves prediction of macrosomia at birth rather than the EFW alone.

  10. A Randomized Controlled Trial of Foley Catheter, Extra-Amniotic Saline Infusion and Prostaglandin E2 Suppository for Labor Induction

    Science.gov (United States)

    Ghanaie, Mandana Mansour; Jafarabadi, Mina; Asgary, Seyed Alaedin; Karkan, Morteza Fallah

    2013-01-01

    Objective The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction. Materials and methods Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI) and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed. Results From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients’ demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001). The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05).rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001) and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05). The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05).there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity. Conclusion Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes. PMID:24971103

  11. A randomized controlled trial of foley catheter, extra-amniotic saline infusion and prostaglandin e2 suppository for labor induction.

    Directory of Open Access Journals (Sweden)

    Mandana Mansour Ghanaie

    2013-06-01

    Full Text Available The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction.Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed.From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients' demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001. The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05.rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001 and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05. The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05.there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity.Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes.

  12. A step-by-step diagnosis of exclusion in a twin pregnancy with acute respiratory failure due to non-fatal amniotic fluid embolism: a case report

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    Papaioannou Vasilios E

    2008-05-01

    Full Text Available Abstract Introduction Respiratory failure may develop during the later stages of pregnancy and is usually associated with tocolysis or other co-existing conditions such as pneumonia, sepsis, pre-eclampsia or amniotic fluid embolism syndrome. Case presentation We present the case of a 34-year-old healthy woman with a twin pregnancy at 31 weeks and 6 days who experienced acute respiratory failure, a few hours after administration of tocolysis (ritodrine, due to preterm premature rupture of the membranes. Her chest discomfort was significantly ameliorated after the ritodrine infusion was stopped and a Cesarean section was performed 48 hours later under spinal anesthesia; however, 2 hours after surgery she developed severe hypoxemia, hypotension, fever and mild coagulopathy. The patient was intubated and transferred to the intensive care unit where she made a quick and uneventful recovery within 3 days. As there was no evidence for drug- or infection-related thromboembolic or myocardial causes of respiratory failure, we conclude that our patient experienced a rare type of non-fatal amniotic fluid embolism. Conclusion In spite of the lack of solid scientific support for our diagnosis, we conclude that our patient suffered an uncommon type of amniotic fluid embolism syndrome and we believe that this report highlights the need for extreme vigilance and a high index of suspicion for such a diagnosis in any pregnant individual.

  13. Amniotic fluid cathelicidin in PPROM pregnancies: from proteomic discovery to assessing its potential in inflammatory complications diagnosis.

    Science.gov (United States)

    Tambor, Vojtech; Kacerovsky, Marian; Andrys, Ctirad; Musilova, Ivana; Hornychova, Helena; Pliskova, Lenka; Link, Marek; Stulik, Jiri; Lenco, Juraj

    2012-01-01

    Preterm prelabor rupture of membranes (PPROM) complicated by microbial invasion of the amniotic cavity (MIAC) leading to histological chorioamnionitis (HCA) significantly impacts perinatal morbidity. Unfortunately, no well-established tool for identifying PPROM patients threatened by these disorders is available. We performed an unbiased exploratory analysis of amniotic fluid proteome changes due to MIAC and HCA. From among the top five proteins that showed the most profound and significant change, we sought to confirm results concerning cathelicidin (P49913, CAMP_HUMAN), since an ELISA kit was readily available for this protein. In our exploratory proteomic study, cathelicidin showed a ∼6-fold higher concentration in PPROM patients with confirmed MIAC and HCA. We verified significantly higher levels of cathelicidin in exploratory samples (women without both MIAC and HCA: median 1.4 ng/ml; women with both conditions confirmed: median 3.6 ng/ml; p = 0.0003). A prospective replication cohort was used for independent validation and for assessment of cathelicidin potential to stratify women with MIAC leading to HCA from women in whom at least one of these conditions was ruled out. We confirmed the association of higher amniotic fluid cathelicidin levels with MIAC leading to HCA (the presence of both MIAC and HCA: median 3.1 ng/ml; other women: median 1.4 ng/ml; p<0.0001). A cathelicidin concentration of 4.0 ng/ml was found to be the best cut-off point for identifying PPROM women with both MIAC and HCA. When tested on the validation cohort, a sensitivity of 48%, a specificity of 90%, a likelihood ratio of 5.0, and an area under receiver-operating characteristic curve of 71% were achieved for identification of women with MIAC leading to HCA. Our multi-stage study suggests cathelicidin as a candidate marker that should be considered for a panel of amniotic fluid proteins permitting identification of PPROM women with MIAC leading to HCA.

  14. Amniotic fluid cathelicidin in PPROM pregnancies: from proteomic discovery to assessing its potential in inflammatory complications diagnosis.

    Directory of Open Access Journals (Sweden)

    Vojtech Tambor

    Full Text Available BACKGROUND: Preterm prelabor rupture of membranes (PPROM complicated by microbial invasion of the amniotic cavity (MIAC leading to histological chorioamnionitis (HCA significantly impacts perinatal morbidity. Unfortunately, no well-established tool for identifying PPROM patients threatened by these disorders is available. METHODOLOGY/PRINCIPAL FINDINGS: We performed an unbiased exploratory analysis of amniotic fluid proteome changes due to MIAC and HCA. From among the top five proteins that showed the most profound and significant change, we sought to confirm results concerning cathelicidin (P49913, CAMP_HUMAN, since an ELISA kit was readily available for this protein. In our exploratory proteomic study, cathelicidin showed a ∼6-fold higher concentration in PPROM patients with confirmed MIAC and HCA. We verified significantly higher levels of cathelicidin in exploratory samples (women without both MIAC and HCA: median 1.4 ng/ml; women with both conditions confirmed: median 3.6 ng/ml; p = 0.0003. A prospective replication cohort was used for independent validation and for assessment of cathelicidin potential to stratify women with MIAC leading to HCA from women in whom at least one of these conditions was ruled out. We confirmed the association of higher amniotic fluid cathelicidin levels with MIAC leading to HCA (the presence of both MIAC and HCA: median 3.1 ng/ml; other women: median 1.4 ng/ml; p<0.0001. A cathelicidin concentration of 4.0 ng/ml was found to be the best cut-off point for identifying PPROM women with both MIAC and HCA. When tested on the validation cohort, a sensitivity of 48%, a specificity of 90%, a likelihood ratio of 5.0, and an area under receiver-operating characteristic curve of 71% were achieved for identification of women with MIAC leading to HCA. CONCLUSIONS: Our multi-stage study suggests cathelicidin as a candidate marker that should be considered for a panel of amniotic fluid proteins permitting identification

  15. Ophthalmology case

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    Fábio Barroso

    2017-07-01

    Discussion: The diagnosis of limbal dermoids is established by the presence of a yellow/white solid tumour located at the limbus. These lesions have been classified into three grades. The treatment for grade I pediatric limbal dermoids is initially conservative. In stages II and III, a combination of simple excision, lamellar keratoplasty, sutureless amniotic membrane and limbal stem cell tranplantation may be necessary. Prognosis is generally favourable.

  16. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Amedo AO

    2016-04-01

    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  17. In vivo comparison of 23- and 25-gauge sutureless vitrectomy incision architecture using spectral domain optical coherence tomography.

    Science.gov (United States)

    Teixeira, Anderson; Rezende, Flavio A; Salaroli, Camila; Souza, Nonato; Sousa, Benedito Antonio; Allemann, Norma

    2013-01-01

    Purpose. To investigate the in vivo incision architecture using spectral domain optical coherence tomography (SD-OCT) in 23-gauge and 25-gauge transconjunctival sutureless pars plana vitrectomy (TSPPV). Methods. A prospective observational study of 22 eyes of 22 patients that underwent three-port 25-gauge (10 eyes) or 23-gauge (12 eyes) TSPPV was performed. The three sclerotomies sites in each eye were analyzed by Corneal Adapter Model (CAM) RTVue SD-OCT (Optovue Inc., Fremont, CA, USA) with wound cross-section images (longitudinal and transversal) on days 1, 7, and 30 postoperatively. Transversal and longitudinal length, location, angle between the conjunctival surface tangent and the incision plane, and architecture deformations were evaluated. Results. All patients (22 eyes) completed the study and surgeries lasted less than 60 minutes. All wounds were obliquely performed, 23-gauge mean angle was 23 ± 5°, and 25-gauge angule was 21 ± 4°. Twenty-three-gauge sclerotomy transversal mean length was 1122 ± 242  μ m and 25-gauge transversal sclerotomy mean length was 977 ± 174  μ m; 23-gauge longitudinal mean length was 363 ± 42  μ m and 25-gauge longitudinal sclerotomy mean length was 234 ±19  μ m; 23-gauge open wound thickness mean was 61 ± 28  μ m and 25-gauge open wound thickness mean was 22 ± 6  μ m. All results were statistically significant (P gauges. Conclusions. The 23-gauge and 25-gauge architectural wound constructions were well visualized using CAM SD-OCT. Statistical differences between the two gauges were observed throughout the study period.

  18. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms

    NARCIS (Netherlands)

    Umur, Asli; van Gemert, Martin J. C.; Ross, Michael G.

    2002-01-01

    Clinical evidence suggests that increased amniotic fluid volume due to polyhydrarnnios increases placental vascular resistance. We have sought to model the possible effects of an increased amniotic fluid volume oil the net fetofetal transfusion in monochorionic twin pregnancies. We wanted to compare

  19. Amniotic oxytocin and vasopressin in relation to human fetal development and labour

    NARCIS (Netherlands)

    Oosterbaan, H. P.; Swaab, D. F.

    1989-01-01

    Previous experiments in rats revealed increased amniotic oxytocin (OXT) levels in the course of normal development and increased vasopressin (AVP) levels in retarded fetal growth. In order to see whether similar changes would also occur in human, OXT and AVP levels were determined in amniotic fluid,

  20. A cryopreservative procedure for storing cultivated and uncultivated amniotic fluid cells in liquid nitrogen.

    OpenAIRE

    Pentz, S; Hörler, H

    1980-01-01

    The cryopreservation of cultured and uncultured amniotic fluid cells is of special importance in prenatal diagnosis. The freezing procedure presented gave a cell recovery of about 95% for cultivated human amniotic fluid cells combined with a rapid appearance of mitosis after inoculation.

  1. Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate.

    Science.gov (United States)

    Tabbara, Malek; Genser, Laurent; Bossi, Manuela; Barat, Maxime; Polliand, Claude; Carandina, Sergio; Barrat, Christophe

    2016-02-01

    To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh "Adhesix™" and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17-84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

  2. Ichthyosis prematurity syndrome with separation of fetal membranes and neonatal asphyxia

    Science.gov (United States)

    Dereksson, Kristjan; Kjartansson, Sveinn; Hjartardóttir, Hulda; Arngrimsson, Reynir

    2012-01-01

    Ichthyosis prematurity syndrome (IPS) is a rare inherited skin disorder. Children are born prematurely with thick skin and have been found to develop neonatal asphyxia due to occlusions in the bronchial tree from debris in the amniotic fluid. At 31 weeks of gestation, separation of amniotic and chorionic membranes was identified as well as polyhydramnion. The child was born 2 weeks later, with thickened skin with a granular appearance and required immediate ventilation and intensive care. At 2 years of age, the patient has developed an atopic skin condition with severe itching, recurrent skin infections, food intolerance and periods of wheezing. Prenatal observation of separation of foetal membranes or dense amniotic fluid may be signs of IPS and severe complication immediately after birth. PMID:22927265

  3. Ichthyosis prematurity syndrome with separation of fetal membranes and neonatal asphyxia.

    Science.gov (United States)

    Dereksson, Kristjan; Kjartansson, Sveinn; Hjartardóttir, Hulda; Arngrimsson, Reynir

    2012-08-27

    Ichthyosis prematurity syndrome (IPS) is a rare inherited skin disorder. Children are born prematurely with thick skin and have been found to develop neonatal asphyxia due to occlusions in the bronchial tree from debris in the amniotic fluid. At 31 weeks of gestation, separation of amniotic and chorionic membranes was identified as well as polyhydramnion. The child was born 2 weeks later, with thickened skin with a granular appearance and required immediate ventilation and intensive care. At 2 years of age, the patient has developed an atopic skin condition with severe itching, recurrent skin infections, food intolerance and periods of wheezing. Prenatal observation of separation of foetal membranes or dense amniotic fluid may be signs of IPS and severe complication immediately after birth.

  4. Frequency and clinical significance of short cervix in patients with preterm premature rupture of membranes.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available Cervical length measurement has been uggested as a useful tool for predicting intra-amniotic infection/inflammation in preterm labor, but little information is available in the setting of preterm premature rupture of membranes (pPROM. We aimed to determine whether a short cervical length is independently associated with an increased risk of intra-amniotic infection or inflammation and impending preterm delivery in women with pPROM.This was a retrospective cohort study involving 171 consecutive singleton pregnant women with pPROM (21+0-33+6 weeks' gestation, who underwent amniocentesis. Amniotic fluid (AF was cultured, and assayed for interleukin (IL-6 and IL-8. Cervical length was measured at the time of amniocentesis by transvaginal ultrasonography with an aseptic technique. Short cervical length was defined as a cervical length of ≤15 mm. Intra-amniotic infection was defined as a positive AF culture for microorganisms and intra-amniotic inflammation was defined as elevated AF concentrations of IL-6 or IL-8 (IL-6 ≥1.5 ng/mL and/or IL-8 ≥1.3 ng/mL.Fifty (29.2% women had a sonographic cervical length of ≤15mm. On univariate analysis, short cervical length was associated with an increased risk for intra-amniotic infection and/or inflammation; no other parameters studied showed a significant association. Multivariable analyses indicated that short cervical length was significantly associated with a higher risk of impending preterm delivery (within 2 days of measurement, within 7 days of measurement, and before 34 weeks, and remained significant after adjustment for potential confounders.In women with pPROM, short cervical length is associated with an increased risk for intra-amniotic infection/inflammation and associated with impending preterm delivery, independent of the presence of intra-amniotic infection/inflammation.

  5. Adenovirus E1A/E1B Transformed Amniotic Fluid Cells Support Human Cytomegalovirus Replication

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    Natascha Krömmelbein

    2016-02-01

    Full Text Available The human cytomegalovirus (HCMV replicates to high titers in primary human fibroblast cell cultures. A variety of primary human cells and some tumor-derived cell lines do also support permissive HCMV replication, yet at low levels. Cell lines established by transfection of the transforming functions of adenoviruses have been notoriously resistant to HCMV replication and progeny production. Here, we provide first-time evidence that a permanent cell line immortalized by adenovirus type 5 E1A and E1B (CAP is supporting the full HCMV replication cycle and is releasing infectious progeny. The CAP cell line had previously been established from amniotic fluid cells which were likely derived from membranes of the developing fetus. These cells can be grown under serum-free conditions. HCMV efficiently penetrated CAP cells, expressed its immediate-early proteins and dispersed restrictive PML-bodies. Viral DNA replication was initiated and viral progeny became detectable by electron microscopy in CAP cells. Furthermore, infectious virus was released from CAP cells, yet to lower levels compared to fibroblasts. Subviral dense bodies were also secreted from CAP cells. The results show that E1A/E1B expression in transformed cells is not generally repressive to HCMV replication and that CAP cells may be a good substrate for dense body based vaccine production.

  6. Peptidome analysis of amniotic fluid from pregnancies with preeclampsia.

    Science.gov (United States)

    Qian, Yating; Zhang, Lei; Rui, Can; Ding, Hongjuan; Mao, Pengyuan; Ruan, Hongjie; Jia, Ruizhe

    2017-11-01

    Preeclampsia (PE), a life‑threatening, complicated pregnancy‑associated disease, has recently become a research focus in obstetrics. However, the peptidome of the amniotic fluid in PE patients has rarely been investigated. The present study used peptidomic profiling to perform a comparative analysis of human amniotic fluid between normal and PE pregnancies. Centrifugal ultrafiltration and liquid chromatography‑tandem mass spectrometry (LC‑MS/MS) was combined with isotopomeric dimethyl labels to gain a deeper understanding of the role of proteins and the peptidome in the onset of PE. Following ultrafiltration and LC‑MS/MS, 352 peptides were identified. Of these, 23 peptides were observed to be significantly differentially expressed (6 downregulated and 17 upregulated; Pamniotic fluid of PE and normal pregnancies. A comprehensive peptidome analysis is more efficient than a simple biomarker analysis at revealing deficiencies and improving the detection rate in diseases. These analyses therefore provide a substantial advantage in applications aimed at the discovery of disease‑specific biomarkers.

  7. Isolation and Partial Characterization of Human Amniotic Epithelial Cells: The Effect of Trypsin

    Science.gov (United States)

    Tabatabaei, Meraj; Mosaffa, Nariman; Nikoo, Shohreh; Bozorgmehr, Mahmood; Ghods, Roya; Kazemnejad, Somaieh; Rezania, Simin; Keshavarzi, Bahareh; Arefi, Soheila; Ramezani-Tehrani, Fahimeh; Mirzadegan, Ebrahim; Zarnani, Amir-Hassan

    2014-01-01

    Background Despite the extensive information available in the literature, cell surface marker signature of human Amniotic Epithelial Cells (hAECs) remains controversial. The aim of the present study was to characterize immunophenotypic features, proliferative capacity and immunogenicity of hAECs. We also tested whether expression of some cell surface markers is influenced by the type of trypsin used for tissue digestion. Methods Single cell suspensions of amniotic membranes from four human placentas were isolated by enzymatic digestion and expression of CD9, CD10, CD29, CD34, CD38, CD44, CD45, CD73, CD105, CD133, HLA-I, HLA-DR, HLA-G, SSEA-4, STRO-1 and OCT-4 was then evaluated by flow cytometry. The differential impact of four trypsin types on the yield and expression of CD105 and HLA-I was also determined. The proliferative capacity of cultured hAECs was assessed and compared in the presence and absence of Epidermal Growth Factor (EGF). To test their immunogenicity, hAECs were injected into Balb/c mice and the reactivity of hyperimmunized sera was examined by immunofluorescence staining. Results Nearly all purified cells expressed mesenchymal markers, CD9, CD10, CD29, and CD73 and the embryonic marker, SSEA-4. A large proportion of the cells also expressed STRO-1 and OCT-4. The purified cells also expressed HLA-G and HLA-I. A very small proportion of hAECs expressed CD34, CD38, CD44, CD133 and HLA-DR. The type of trypsin used for enzymatic digestion affected both the percentage and expression of HLA-I and CD105. hAECs revealed substantial proliferative capacity only when cultured in the medium supplemented with EGF. These cells were shown to be capable of inducing high amounts of anti-donor antibodies. Conclusion Here we provided evidence that hAECs are immunogenic cells with high level of HLA-I expression. Furthermore, this work highlighted the impact of isolation procedure on the immunophenotype of hAEC. PMID:24523953

  8. Human amniotic epithelial cells combined with silk fibroin scaffold in the repair of spinal cord injury

    Directory of Open Access Journals (Sweden)

    Ting-gang Wang

    2016-01-01

    Full Text Available Treatment and functional reconstruction after central nervous system injury is a major medical and social challenge. An increasing number of researchers are attempting to use neural stem cells combined with artificial scaffold materials, such as fibroin, for nerve repair. However, such approaches are challenged by ethical and practical issues. Amniotic tissue, a clinical waste product, is abundant, and amniotic epithelial cells are pluripotent, have low immunogenicity, and are not the subject of ethical debate. We hypothesized that amniotic epithelial cells combined with silk fibroin scaffolds would be conducive to the repair of spinal cord injury. To test this, we isolated and cultured amniotic epithelial cells, and constructed complexes of these cells and silk fibroin scaffolds. Implantation of the cell-scaffold complex into a rat model of spinal cord injury resulted in a smaller glial scar in the damaged cord tissue than in model rats that received a blank scaffold, or amniotic epithelial cells alone. In addition to a milder local immunological reaction, the rats showed less inflammatory cell infiltration at the transplant site, milder host-versus-graft reaction, and a marked improvement in motor function. These findings confirm that the transplantation of amniotic epithelial cells combined with silk fibroin scaffold can promote the repair of spinal cord injury. Silk fibroin scaffold can provide a good nerve regeneration microenvironment for amniotic epithelial cells.

  9. Sutureless closure of scleral wounds in animal models by the use of laser welded biocompatible patches

    Science.gov (United States)

    Rossi, Francesca; Matteini, Paolo; Menabuoni, Luca; Lenzetti, Ivo; Pini, Roberto

    2011-03-01

    The common procedures used to seal the scleral or conjunctival injuries are based on the traditional suturing techniques, that may induce foreign body reaction during the follow up, with subsequent inflammation and distress for the patient. In this work we present an experimental study on the laser welding of biocompatible patches onto ocular tissues, for the closure of surgical or trauma wounds. The study was performed ex vivo in animal models (porcine eyes). A penetrating perforation of the ocular tissue was performed with a surgical knife. The wound walls were approximated, and a biocompatible patch was put onto the outer surface of the tissue, in order to completely cover the wound as a plaster. The patches were prepared with a biocompatible and biodegradable polymer, showing high mechanical strength, good elasticity, high permeability for vapour and gases and rather low biodegradation. During preparation, Indocyanine Green (ICG) was included in the biopolymeric matrix, so that the films presented high absorption at 810 nm. Effective adhesion of the membranes to the ocular tissues was obtained by using diode laser light emitted from an 810 nm diode laser and delivered by means of a 300 μm core diameter optical fiber, to produce spots of local film/tissue adhesion, due to the photothermal effect at the interface. The result is an immediate closure of the wound, thus reducing post-operative complications due to inflammation.

  10. Prenatal sex determination by radioimmunoassay of testosterone with and without chromatography of the amniotic fluid

    International Nuclear Information System (INIS)

    Distler, W.; Boniver-Ollmann, U.; Tigges, J.; Terinde, R.; Claussen, U.

    1979-01-01

    Amniotic fluid testosterone measured by radioimmunoassay (RIA) without chromatography (immunoreactive testosterone) seems not to be a definitive test for prenatal sex determination in all cases. In this study testosterone (T) levels measured by RIA with chromatography of the amniotic fluid samples were compared with immunoreactive testosterone (iT) values, to determine the predictive accuracy of the two methods. In 111 amniotic fluid samples between 15 and 19 weeks of gestation iT and T were measured parallelly. There are significant differences between iT- and T-means of both sexes (p [de

  11. Amniotic fluid and development of the immature intestine

    DEFF Research Database (Denmark)

    Østergaard, Mette Viberg

    in demand. Amniotic Fluid (AF) is the natural source of fetal EN throughout gestation in ammals. Fetal AF swallowing stimulates somatic and gastrointestinal growth during fetal development, and modulates the development of the intestinal mucosa. In addition, AF protects the fetus against infections......Premature birth is a health concern worldwide as it is associated with increased morbidity and mortality of the newborn. In the most developed countries, improved neonatal care has allowed for the survival of ever smaller premature infants and raised the survival rates of infants born very...... and maintains homeostasis in the amnion sac through anti-inflammatory mechanisms. The growth promoting and protective effects of AF in utero are ascribed to bioactive proteins including growth factors, anti-inflammatory cytokines, and antimicrobial peptides, which may exert similar beneficial effects ex utero...

  12. Amniotic fluid phthalate levels and male fetal gonad function

    DEFF Research Database (Denmark)

    Jensen, Morten Søndergaard; Anand-Ivell, Ravinder; Nørgaard-Pedersen, Bent

    2015-01-01

    BACKGROUND: Prenatal exposure to phthalates may pose a threat to human male reproduction. However, additional knowledge about the in vivo effect in humans is needed, and reported associations with genital abnormalities are inconclusive. We aimed to study prenatal di(2-ethylhexyl) phthalate (DEHP......) and diisononyl phthalate (DiNP) exposure in relation to cryptorchidism, hypospadias, and human fetal Leydig cell function. METHODS: We studied 270 cryptorchidism cases, 75 hypospadias cases, and 300 controls. Second-trimester amniotic fluid samples were available from a Danish pregnancy-screening biobank (n = 25......,105) covering 1980-1996. We assayed metabolites of DEHP and DiNP (n = 645) and steroid hormones (n = 545) by mass spectrometry. We assayed insulin-like factor 3 by immunoassay (n = 475) and analyzed data using linear or logistic regression. RESULTS: Mono(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP, DEHP...

  13. Amniotic fluid and development of the immature intestine

    DEFF Research Database (Denmark)

    Østergaard, Mette Viberg

    in demand. Amniotic Fluid (AF) is the natural source of fetal EN throughout gestation in ammals. Fetal AF swallowing stimulates somatic and gastrointestinal growth during fetal development, and modulates the development of the intestinal mucosa. In addition, AF protects the fetus against infections...... gastrointestinal structure and function in preterm pigs”. Accordingly, the aim was to test the effects of enteral administration of AF as MEN during PN, as a supplement to a suboptimal enteral diet, or both in a preterm pig model of NEC. To evaluate the effects of AF, NEC sensitivity, intestinal digestive...... function and innate immunity of the small intestine, and to establish an experimental model to investigate the inflammatory responses of the small intestine to microbial-associated molecular patterns (MAMPs) ex vivo. The expression of certain host defense genes was affected by gestational age...

  14. Antibiotics for neonates born through meconium-stained amniotic fluid.

    Science.gov (United States)

    Kelly, Lauren E; Shivananda, Sandesh; Murthy, Prashanth; Srinivasjois, Ravisha; Shah, Prakeshkumar S

    2017-06-28

    Approximately 1 in 10 pregnancies is affected by meconium passage at delivery, which can result in meconium aspiration syndrome (MAS). MAS can cause respiratory complications and, very rarely, death. Antibiotics have been prescribed for neonates exposed to meconium in amniotic fluid, with the intention of preventing infection due to potential bacterial contaminants. We conducted this review to assess the efficacy and safety of antibiotics for:1. prevention of infection, morbidity, and mortality among infants born through meconium-stained amniotic fluid (MSAF) who are asymptomatic at birth; and2. prevention of infection, morbidity, and mortality among infants born through MSAF who have signs and symptoms compatible with meconium aspiration syndrome (MAS). We performed a literature search using the following databases: MEDLINE (1966 to July 2016); Embase (1980 to July 2016); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to July 2016); and the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library. We also searched clinical trials databases, conference proceedings, and reference lists of retrieved articles. We included randomised and quasi-randomised controlled trials that compared antibiotics administered via any route versus placebo or no treatment for prevention of infection among neonates exposed to MSAF, or who developed MAS. We excluded cohort, case control, and any other non-randomised studies and applied no language restrictions. We included studies of term and preterm infants, and we included studies examining use of any antibacterial antibiotics. We included studies that reported on any outcomes of interest. We assessed the methodological quality of included trials by reviewing information provided in study reports and obtained by personal communication with study authors. We extracted data on relevant outcomes, estimated effect size, and reported values as risk ratios (RRs), risk

  15. Amniotic Fluid Stem Cells: A New Era in Regenerative Medicine.

    Science.gov (United States)

    Srivastava, Mala; Ahlawat, Neha; Srivastava, Ankita

    2018-02-01

    Regenerative medicine has become an emerging field which focuses on repair, replacement or regeneration of cells, tissues and the entire organs. The regeneration may occur in patient's own body by using their system as a bioreactor, e.g., cell therapy that involves transplantation of stem cells capable of proliferating, differentiating and replacing damaged host cells. As the field of regenerative medicine advances, and sources of stem cells has been intensified. Though embryonic and adult tissues can be used for isolation of pluripotent stem cells, the amniotic fluid (AF) has been proposed as an alternative source of stem cells for tissue regeneration. AF cells could be banked and used for either allogeneic or autologous transplantation.

  16. Tackling the Issue of High Postoperative Pacemaker Implantation Rates in Sutureless Aortic Valve Replacement: Should Balloon Inflation be Removed from the Implantation Method of the Perceval Prosthesis?

    Science.gov (United States)

    Charles Blouin, Mathieu; Bouhout, Ismail; Demers, Philippe; Carrier, Michel; Perrault, Louis; Lamarche, Yoan; El-Hamamsy, Ismail; Bouchard, Denis

    2017-05-01

    Sutureless aortic valve replacement (AVR) is an emerging alternative to standard AVR in elderly and high-risk patients. This procedure is associated with a high rate of postoperative permanent pacemaker implantation (PPI). The study aim was to assess the impact on the rate of PPI of implanting the Perceval prosthesis without using balloon inflation. A total of 159 patients who underwent sutureless AVR using the Perceval prosthesis was included. Balloon inflation was used in 132 patients (Balloon group) and not used in the remaining 27 (No-Balloon group). Clinical, echocardiographic and electrocardiographic outcomes were assessed. There was no significant difference in PPI rate between the two groups (26% for Balloon group versus 22% in No-Balloon group; p = 0.700). Balloon inflation had no significant impact on the incidence of paravalvular leaks (p = 0.839), or on the need to return to cardiopulmonary bypass (CPB) intraoperatively due to paravalvular leak or unsatisfactory deployment (p >0.999). Mean and peak transaortic pressure gradients were similar between the two groups (p = 0.417 and p = 0.522, respectively). Cross-clamp and CPB times were shorter in the No-Balloon group (49.6 ± 15.9 min versus 61.1 ± 25.6 min and 64.1 ± 26.3 min versus 79.6 ± 35.4 min, respectively; p = 0.027 and p = 0.012, respectively). The two groups had similar postoperative PPI rates. Implanting the Perceval prosthesis without balloon inflation is safe and had no impact on paravalvular leaks, intraoperative complications or hemodynamic results. Reductions in aortic cross-clamp time and CPB time were observed when the balloon was not used.

  17. Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments.

    Science.gov (United States)

    Berreklouw, Eric; Koene, Bart; De Somer, Filip; Bouchez, Stefaan; Chiers, Koen; Taeymans, Yves; Van Nooten, Guido J

    2011-05-01

    Nitinol attachment rings (devices) used to attach mechanical aortic valve prostheses suturelessly were studied in long-term (90 days) pig experiments. The aortic valve was removed and replaced by a device around a St Jude Medical mechanical valve prosthesis in 10 surviving pigs. Supravalvular angiography was done at the end of the operation. No coumarin derivates were given. No or minimal aortic regurgitation was confirmed in all surviving pigs at the end of the operation. Total follow-up was 846 days. In 4 pigs, follow-up was shorter than 90 days (28-75 days); the other 6 pigs did reach 90 days' survival or more. Repeat angiography in 4 pigs at the end of follow-up confirmed the unchanged position of the device at the aortic annulus, without aortic regurgitation. At autopsy, in all pigs the devices proved to be well grown in at the annulus, covered with endothelium, and sometimes tissue overgrowth related to not using coumarin derivates. There was no case of para-device leakage, migration, or embolization. No damage to surrounding anatomic structures or prosthetic valves was found. Nitinol attachment rings can be used to replace the aortic valve suturelessly with St Jude Medical mechanical aortic valve prostheses, without para-device leakage, migration, or damage to the surrounding tissues, in long-term pig experiments during a follow-up of 90 days or more. Refraining from anticoagulation in pigs with mechanical valve prostheses can lead to tissue overgrowth of the valve prosthesis. Further studies are needed to determine long-term feasibility of this method in human beings. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  18. A study of chromosomal aberrations in amniotic fluid cell cultures.

    Science.gov (United States)

    Wolstenholme, J; Crocker, M; Jonasson, J

    1988-06-01

    This paper represents the analysis of 1916 routine amniotic fluid specimens harvested by an in situ fixation technique in a prospective study with regard to cultural chromosome anomalies. Excluding constitutional abnormalities, 2.9 per cent of 19,432 cells analysed showed some form of chromosome anomaly, terminal deletions (57 per cent) and chromatid/chromosome breaks and gaps (18 per cent) being the most frequent, followed by interchange aberrations (13 per cent) and trisomy (5 per cent). No case was found of more than one colony from the same culture showing the same anomaly without it being present in other cultures from the same fluid. The wholly abnormal colonies had a surplus of trisomies and from the mathematical considerations presented one may infer that these are likely to reflect the presence of abnormal cells in the amniotic fluid. Partly abnormal colonies appeared at a frequency that would correspond to virtual absence of selection against chromosomally abnormal cells when cultured in vitro. The aberrations found were similar to those seen as single cell anomalies, except for chromatid breaks and exchanges. The data suggest a basic preferential induction of trisomy for chromosomes 2, 18, 21, and the Y-chromosome. Structural aberrations showed a marked clustering of breakpoints around the centromeres. The frequency of mutant cells was low (1.4 X 10(-3)) before culture was initiated. At harvest, the frequency of abnormal cells was much higher (3 X 10(-2)) corresponding to 3 X 10(-3) mutations per cell per generation accumulating over approximately ten generations in vitro.

  19. Sex Chromosome Evolution in Amniotes: Applications for Bacterial Artificial Chromosome Libraries

    Directory of Open Access Journals (Sweden)

    Daniel E. Janes

    2011-01-01

    Full Text Available Variability among sex chromosome pairs in amniotes denotes a dynamic history. Since amniotes diverged from a common ancestor, their sex chromosome pairs and, more broadly, sex-determining mechanisms have changed reversibly and frequently. These changes have been studied and characterized through the use of many tools and experimental approaches but perhaps most effectively through applications for bacterial artificial chromosome (BAC libraries. Individual BAC clones carry 100–200 kb of sequence from one individual of a target species that can be isolated by screening, mapped onto karyotypes, and sequenced. With these techniques, researchers have identified differences and similarities in sex chromosome content and organization across amniotes and have addressed hypotheses regarding the frequency and direction of past changes. Here, we review studies of sex chromosome evolution in amniotes and the ways in which the field of research has been affected by the advent of BAC libraries.

  20. Matrix metalloproteinase-2 is elevated in midtrimester amniotic fluid prior to the development of preeclampsia

    Directory of Open Access Journals (Sweden)

    Daniel-Spiegel Etty

    2009-08-01

    Full Text Available Abstract Objective To evaluate levels of matrix metalloproteinases (MMP and their inhibitors (TIMP in second trimester amniotic fluid of women with hypertensive disorders compared to normotensive women. Study Design Amniotic fluid was obtained from 133 women undergoing genetic second trimester amniocentesis. Zymography was performed for MMP characterization and an MMP-2 ELISA kit was used to determine MMP-2 levels. TIMP-2 expression was evaluated using western blot. Results Mean amniotic fluid MMP-2 and TIMP-2 levels were significantly higher in women who developed a hypertensive disorder compared to normotensive women (P Conclusion Higher amniotic fluid MMP-2 and TIMP-2 levels are found in women who eventually develop preeclampsia.

  1. Consequences of meconium stained amniotic fluid: What does the evidence tell us?

    NARCIS (Netherlands)

    Hutton, E.K.; Thorpe, J.

    2014-01-01

    Background: Meconium stained amniotic fluid (MSAF) is common and associated with meconium aspiration syndrome (MAS). Other consequences of meconium passage before birth are less well understood. Methods: We reviewed the literature for original papers reporting on outcomes associated with MSAF.

  2. Diagnóstico laboratorial do líquido amniótico Laboratory diagnosis of amniotic fluid

    Directory of Open Access Journals (Sweden)

    Sabrina Gonçalves Campana

    2003-09-01

    Full Text Available O presente trabalho tem como objetivos a definição e a fisiologia do líquido amniótico, ressaltando aspectos citológicos e principais técnicas para diagnóstico laboratorial das patologias mais freqüentes. A metodologia utilizada foi a revisão bibliográfica atualizada relacionando os aspectos citológicos com a idade gestacional e técnicas laboratoriais para diagnóstico das principais patologias em que são observadas alterações do líquido amniótico, concluindo-se que este é um importante componente do ambiente intra-uterino. Sua produção e absorção dependem de uma série de mecanismos interdependentes entre o feto, a placenta, as membranas e o organismo materno. Atualmente este fluido pode fornecer inúmeras informações sobre a saúde fetal, realizando-se diversas técnicas, entre elas a amniocentese e a dosagem de alfafetoproteína, que pode detectar defeitos do tubo neural e trissomia do cromossomo 21. A análise do líquido amniótico reforça a importância da realização adequada de um pré-natal, sendo importante relacionar os resultados laboratoriais com a clínica.This present paper aims the definition of the amniotic fluid and its physiology standing out cytological aspects and main techniques for laboratorial diagnosis of the most frequent pathologies. The methodology was based on updated bibliographical research relating the cytological aspects with the pregnancy age and laboratorial techniques for diagnosis of the main pathologies in which alterations of the amniotic fluid are observed, concluding that this is an important component of the intrauterine environment. Its production and absorption depend on a series of interdependent mechanisms among the fetus, the placenta, the membranes and the maternal organism. Currently this fluid can supply innumerable information on the fetal health by the use of diverse techniques, among which, amniocentesis and dosage of alpha-fetoprotein, which can detect defects of the

  3. Maternal and fetal characteristics associated with meconium-stained amniotic fluid

    DEFF Research Database (Denmark)

    Balchin, Imelda; Whittaker, John C; Lamont, Ronald F

    2011-01-01

    To estimate the rates of meconium-stained amniotic fluid (AF) and adverse outcome in relation to gestational age and racial group, and to investigate the predictors of meconium-stained AF.......To estimate the rates of meconium-stained amniotic fluid (AF) and adverse outcome in relation to gestational age and racial group, and to investigate the predictors of meconium-stained AF....

  4. Peptidomic Analysis of Amniotic Fluid for Identification of Putative Bioactive Peptides in Ventricular Septal Defect

    OpenAIRE

    Xing Li; Li-Jie Wu; Meng Gu; Yu-Mei Chen; Qi-Jun Zhang; Hua Li; Zi-Jie Cheng; Ping Hu; Shu-Ping Han; Zhang-Bin Yu; Ling-Mei Qian

    2016-01-01

    Background: Ventricular septal defect (VSD) is one of the most common congenital heart diseases and to date the role of peptides in human amniotic fluid in the pathogenesis of VSD have been rarely investigated. Methods: To gain insight into the mechanisms of protein and peptides in cardiovascular development, we constructed a comparative peptidomic profiling of human amniotic fluid between normal and VSD fetuses using a stable isobaric labeling strategy involving tandem mass tag reagents, fol...

  5. Efficiency expectant management in women with premature rupture of membranes

    OpenAIRE

    ISMAILOVA SAVRINISА SULTANOVNA

    2016-01-01

    The aim of this study is to evaluate the effectiveness of the monitoring of pregnant women with preterm rupture of membranes, including the determination of the level of white blood cells, ESR in the blood, assessment of vaginal flora and the presence of elements of amniotic fluid in vaginal discharge (every 12 hours), thermometry (every 3 hours). Also assessed the condition of the fetus: Doppler and cardiotocography utero-placental and fetal blood flow.

  6. Intracervical fibrin sealants: a potential treatment for early preterm premature rupture of the membranes.

    Science.gov (United States)

    Sciscione, A C; Manley, J S; Pollock, M; Maas, B; Shlossman, P A; Mulla, W; Lankiewicz, M; Colmorgen, G H

    2001-02-01

    We report our experience with a transvaginally applied intracervical fibrin sealant at <24 weeks' gestation. This is an observational study of a referred patient population, with preterm premature rupture of the membranes at <24 weeks' gestation. Twelve women consented to our protocol. The mean gestational age at preterm premature rupture of membranes was 19 weeks 4 days (range, 13-23 weeks); the mean gestational age at treatment was 20 weeks 5 days (range, 17-23 weeks). All women had a diminution in the amount of amniotic fluid leakage with an increase in amniotic fluid index. Among the 12 pregnancies (13 fetuses), there were 7 surviving neonates. Two women had apparent "resealing" of the membranes. Fibrin sealants in midtrimester rupture of the membranes may lead to improved outcomes and now warrant formal evaluation.

  7. Amniotic fluid paraoxonase-1 activity, thyroid hormone concentration and oxidant status in neural tube defects.

    Science.gov (United States)

    Sak, Sibel; Agacayak, Elif; Tunc, Senem Yaman; Icen, Mehmet Sait; Findik, Fatih Mehmet; Sak, Muhammet Erdal; Yalinkaya, Ahmet; Gul, Talip

    2016-09-01

    The aim of this study was to investigate the potential association between neural tube defects and paraoxonase-1 activity in amniotic fluid. We studied total oxidant status, total antioxidant capacity, paraoxonase-1 activity and thyroid hormone amniotic fluid concentration in fetuses with neural tube defects. The present study was performed at the Department of Obstetrics and Gynaecology and the Department of Clinical Biochemistry of Dicle University between September 2011 and June 2013. The study group included 37 amniotic fluid samples from pregnant women (16-20 weeks of gestation) with fetuses affected by neural tube defects. The control group consisted of 36 pregnant women who were diagnosed with a high-risk pregnancy according to first or second trimester aneuploidy screening and were later confirmed on amniocentesis to have genetically normal fetuses. Amniotic fluid paraoxonase-1 activity and total oxidant status were significantly higher (P = 0.023, P = 0.029, respectively) whereas free T4 was significantly lower (P = 0.022) in fetuses with neural tube defects compared with control subjects. In fetuses with neural tube defects, amniotic fluid paraoxonase-1 activity correlated positively with total oxidant status (r = 0.424**, P = 0.010), and amniotic fluid total antioxidant capacity correlated positively with free t4 (r = 0.381*, P = 0.022). This is the first study in the literature to show an association between paraoxonase-1 activity and thyroid hormone concentration and neural tube defects. © 2016 Japan Society of Obstetrics and Gynecology.

  8. An assessment of the accuracy of visual diagnosis of meconium-stained amniotic fluid

    International Nuclear Information System (INIS)

    Sanlialp, C.; Caglar, G.S.; Tapisiz, O.L.; Avsar, A.F.

    2004-01-01

    Objective: The assessment of meconium content in the amniotic fluid depends on visual observation by clinicians at the bedside. The aim of the present study was to compare visual evaluation of meconium-stained amniotic fluid with spectrophotometer evaluation. Study Design: Ten gram of meconium was added to 100 ml of amniotic fluid and mixed. The solution was serially two-fold diluted with amniotic fluid. The serially diluted tubes' absorbance spectrum was measured at 420 nm and thus a standard scale was established. Ninety five samples of meconium- stained amniotic fluid were collected from labouring women and the grade of meconium was deter- mined visually at the bedside. The samples' absorbance spectrum was measured at 420 nm and recorded. Spectrophotometer was considered gold standard and the ranges of optical density in the standard scale was used to test the accuracy of visual categorization of the samples. In the statistical analysis chi-square test was used and significance was p<0.05. Results: The accuracy rate of visual diagnosis of meconium-stained amniotic fluid were found as statistically significant (accuracy rate=54.74%, p<0.001). Visual evaluation was correct in 19.4% of thin, 53.1 % of moderate and 90.6% of thick meconium samples when examined with spectrophotometer. Conclusion: Visually diagnosed thin meconium can be moderate or thick meconium when examined objectively. The visual diagnosis at bedside is not always reliable and should be replaced with an objective method like spectrophotometry. (author)

  9. Evolution and homology of the astragalus in early amniotes: new fossils, new perspectives.

    Science.gov (United States)

    O'Keefe, F Robin; Sidor, Christian A; Larsson, Hans C E; Maga, Abdoudaye; Ide, Oumarou

    2006-04-01

    The reorganization of the ankle in basal amniotes has long been considered a key innovation allowing the evolution of more terrestrial and cursorial behavior. Understanding how this key innovation arose is a complex problem that largely concerns the homologizing of the amniote astragalus with the various ossifications in the anamniote tarsus. Over the last century, several hypotheses have been advanced homologizing the amniote astragalus with the many ossifications in the ankle of amphibian-grade tetrapods. There is an emerging consensus that the amniote astragalus is a complex structure emerging via the co-ossification of several originally separate elements, but the identities of these elements remain unclear. Here we present new fossil evidence bearing on this contentious question. A poorly ossified, juvenile astragalus of the large captorhinid Moradisaurus grandis shows clear evidence of four ossification centers, rather than of three centers or one center as posited in previous models of astragalus homology. Comparative material of the captorhinid Captorhinikos chozaensis is also interpretable as demonstrating four ossification centers. A new, four-center model for the homology of the amniote astragalus is advanced, and is discussed in the context of the phylogeny of the Captorhinidae in an attempt to identify the developmental transitions responsible for the observed pattern of ossification within this clade. Lastly, the broader implications for amniote phylogeny are discussed, concluding that the neomorphic pattern of astragalus ossification seen in all extant reptiles (including turtles) arose within the clade Diapsida.

  10. Amniotic band syndrome and/or limb body wall complex: split or lump

    Directory of Open Access Journals (Sweden)

    Ashutosh Halder

    2010-02-01

    Full Text Available Ashutosh HalderDepartment of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, IndiaAbstract: Six cases of amniotic band syndrome/limb body wall complex were studied in respect to clinicopathologic characteristics. The diagnosis was based on two out of three of the following manifestations: cranio facial clefts; limb body wall defects and amniotic band attachment. Four cases were stillborn and associated with internal defects, including central nervous system. Two cases had facial and limb defects and were live born (3–5 years old at examination. Phenotypic features of the stillborn cases were craniofacial clefting, thoracoabdominoschisis, amputation, ring constriction, amniotic band adhesion, placental adhesions, and internal malformations. Histology of bands revealed fibroconnective tissue as well as flattened epithelial cells together with neuroectodermal elements. Umbilical cord section revealed an abnormal number of vessels. When analyzing the observed data in relation to their etiology, it was found that amniotic disruption, vascular disruption or genetic disruption could explain the amniotic band syndrome/limb body wall complexes, alone or in combinations. A brief review of literature in search of pathogenesis is offered along with an etiopathogenetic model.Keywords: amniotic band syndrome, limb body wall complex and pathogenesis

  11. Nicotine and its metabolites in amniotic fluid at birth--assessment of prenatal tobacco smoke exposure.

    Science.gov (United States)

    Köhler, E; Avenarius, S; Rabsilber, A; Gerloff, C; Jorch, G

    2010-05-01

    Amniotic fluid was collected from 78 pregnant women at birth additionally with their urine prior to delivery as well as neonatal urine and meconium. The smoking markers, nicotine and its metabolites cotinine and trans-3'-hydroxycotinine (OH-cotinine), were determined using high-performance liquid chromatography (HPLC). The self-reported smoking status during pregnancy determined by means of a questionnaire was verified by measurement of maternal urine. In all smokers, nicotine metabolites were detected in amniotic fluid and in 80% of them nicotine as well. However, the sum of the nicotine metabolites (Sum(met)) was significantly lower (p amniotic fluid (704 +/- 464 nmol/L) than in meconium (921 +/- 588 nmol/L), neonatal urine (1139 +/- 813 nmol/L) and maternal urine (4496 +/- 3535 nmol/L). Concentrations of nicotine metabolites in amniotic fluid correlated well (p amniotic fluid but only in maternal and neonatal urine. Analysis of amniotic fluid at birth lends itself to verifying smoking habits during pregnancy and clearly discriminating from ETS exposure, but it is not a suitable approach to differentiating between ETS exposure and non-exposure.

  12. Towards an understanding of the evolution of the chorioallantoic placenta: steroid biosynthesis and steroid hormone signaling in the chorioallantoic membrane of an oviparous reptile.

    Science.gov (United States)

    Cruze, Lori; Kohno, Satomi; McCoy, Michael W; Guillette, Louis J

    2012-09-01

    Amniotes, mammals, reptiles, and birds form common extraembryonic membranes during development to perform essential functions, such as protection, nutrient transfer, gas exchange, and waste removal. Together with the maternal uterus, extraembryonic membranes of viviparous (live-bearing) amniotes develop as an endocrine placenta that synthesizes and responds to steroid hormones critical for development. The ability of these membranes to synthesize and respond to steroid hormone signaling has traditionally been considered an innovation of placental amniotes. However, our laboratory recently demonstrated that this ability extends to the chorioallantoic membrane (CAM) of an oviparous (egg-laying) amniote, the domestic chicken, and we hypothesized that steroidogenic extraembryonic membranes could be an evolutionarily conserved characteristic of all amniotes because of similarities in basic structure, function, and shared evolutionary ancestry. In this study, we examined steroid hormone synthesis and signaling in the CAM of another oviparous amniote, the American alligator (Alligator mississippiensis). We quantified mRNA expression of a steroidogenic factor involved in the regulation of steroidogenesis (NR5A1), the key steroidogenic enzymes involved in the synthesis of progestins (HSD3B1), androgens (CYP17A1), and estrogens (CYP19A1), and the receptors involved in the signaling of progestins (PR), androgens (AR), estrogens (ESR1 and ESR2), and glucocorticoids (GR). Furthermore, we performed protein immunolocalization for PR and ESR1. Collectively, our findings indicate that the alligator CAM has the capability to regulate, synthesize, and respond to steroid hormone signaling, thus, supporting our hypothesis that the extraembryonic membranes of Amniota share a unifying characteristic, that is, the ability to synthesize and respond to steroid hormones.

  13. In vitro tissue engineering of lamellar cornea using human amniotic epithelial cells and rabbit cornea stroma

    Directory of Open Access Journals (Sweden)

    Xiao-Yong Liu

    2013-08-01

    Full Text Available AIM:To reconstruct the lamellar cornea using human amniotic epithelial (HAE cells and rabbit cornea stroma in vitro using tissue engineering technology.METHODS: Human amnia taken from uncomplicated caesarean sections were digested by collagenase to obtain HAE cells, and the cells were cultured to proliferate. Rabbit corneal epithelial cells were removed by n-heptanol to make lamellar matrix sheets. The second passage of HAE cells were cultured on the corneal stroma sheets for 1 or 2 days, then transferred to an air-liquid interface environment to culture for 2 weeks. Tissue engineered lamellar cornea (TELC morphology was observed by Hematoxylin-eosin (HE staining; its ultrastructure was observed by transmission electron microscopy (TEM and scanning electron microscopy (SEM; corneal epithelial cell-specific keratin 3 and keratin 12 were detected with immunofluorescence microscopy.RESULTS:HAE cells grew on the rabbit corneal stroma, forming a monolayer after 1-2 days. About 4-5 layers of epithelial cells developed after 2 weeks of air-liquid interface cultivation, a result similar to normal corneal epithelium. Rabbit corneal stromal cells were significantly reduced after one week, then almost completely disappeared after 2 weeks. TEM showed desmosomes between the epithelial cells; hemidesmosomes formed between the epithelial cells and the basement membrane. SEM revealed that the HAE cells which grew on the lamellar cornea had abundant microvilli. The tissue-engineered cornea expressed keratin 3 and keratin 12, as detected by immunofluorescence assay.CONCLUSION: Functional tissue-engineered lamellar corneal grafts can be constructed in vitro using HAE cells and rabbit corneal stroma.

  14. In vitro tissue engineering of lamellar cornea using human amniotic epithelial cells and rabbit cornea stroma.

    Science.gov (United States)

    Liu, Xiao-Yong; Chen, Jian; Zhou, Qing; Wu, Jing; Zhang, Xiao-Ling; Wang, Li; Qin, Xiao-Yan

    2013-01-01

    To reconstruct the lamellar cornea using human amniotic epithelial (HAE) cells and rabbit cornea stroma in vitro using tissue engineering technology. Human amnia taken from uncomplicated caesarean sections were digested by collagenase to obtain HAE cells, and the cells were cultured to proliferate. Rabbit corneal epithelial cells were removed by n-heptanol to make lamellar matrix sheets. The second passage of HAE cells were cultured on the corneal stroma sheets for 1 or 2 days, then transferred to an air-liquid interface environment to culture for 2 weeks. Tissue engineered lamellar cornea (TELC) morphology was observed by Hematoxylin-eosin (HE) staining; its ultrastructure was observed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM); corneal epithelial cell-specific keratin 3 and keratin 12 were detected with immunofluorescence microscopy. HAE cells grew on the rabbit corneal stroma, forming a monolayer after 1-2 days. About 4-5 layers of epithelial cells developed after 2 weeks of air-liquid interface cultivation, a result similar to normal corneal epithelium. Rabbit corneal stromal cells were significantly reduced after one week, then almost completely disappeared after 2 weeks. TEM showed desmosomes between the epithelial cells; hemidesmosomes formed between the epithelial cells and the basement membrane. SEM revealed that the HAE cells which grew on the lamellar cornea had abundant microvilli. The tissue-engineered cornea expressed keratin 3 and keratin 12, as detected by immunofluorescence assay. Functional tissue-engineered lamellar corneal grafts can be constructed in vitro using HAE cells and rabbit corneal stroma.

  15. Adaptation of group A Streptococcus to human amniotic fluid.

    Directory of Open Access Journals (Sweden)

    Izabela Sitkiewicz

    Full Text Available BACKGROUND: For more than 100 years, group A Streptococcus has been identified as a cause of severe and, in many cases, fatal infections of the female urogenital tract. Due to advances in hospital hygiene and the advent of antibiotics, this type of infection has been virtually eradicated. However, within the last three decades there has been an increase in severe intra- and post-partum infections attributed to GAS. METHODOLOGY: We hypothesized that GAS alters its transcriptome to survive in human amniotic fluid (AF and cause disease. To identify genes that were up or down regulated in response to growth in AF, GAS was grown in human AF or standard laboratory media (THY and samples for expression microarray analysis were collected during mid-logarithmic, late-logarithmic, and stationary growth phases. Microarray analysis was performed using a custom Affymetrix chip and normalized hybridization values derived from three biological replicates were collected at each growth point. Ratios of AF/THY above a 2-fold change and P-value <0.05 were considered significant. PRINCIPAL FINDINGS: The majority of changes in the GAS transcriptome involved down regulation of multiple adhesins and virulence factors and activation of the stress response. We observed significant changes in genes involved in the arginine deiminase pathway and in the nucleotide de novo synthesis pathway. CONCLUSIONS/SIGNIFICANCE: Our work provides new insight into how pathogenic bacteria respond to their environment to establish infection and cause disease.

  16. Atypical Amniotic Fluid Embolism Managed with a Novel Therapeutic Regimen

    Directory of Open Access Journals (Sweden)

    Shadi Rezai

    2017-01-01

    Full Text Available Amniotic fluid embolism (AFE is the second leading cause of maternal mortality in the USA with an incidence of 1 : 15,200 births. The case fatality rate and perinatal mortality associated with AFE are 13–30% and 9–44%, respectively. This rare but devastating complication can be difficult to diagnose as many of the early signs and symptoms are nonspecific. Compounding this diagnostic challenge is a lack of effective treatment regimens which to date are mostly supportive. We present the case of a 26-year-old woman who suffered from suspected AFE and was successfully treated with the novel regimen of Atropine, Ondansetron, and Ketorolac (A-OK. The authors acknowledge that this case does not meet the new criteria proposed, by Clark in 2016, but feel that it is important to share this case report, due to dramatic patient response to the provided supportive therapy presented in this case report. We hope this case report will prompt further research into this novel approach to treating AFE with Atropine, Ondansetron, and Ketorolac.

  17. Sealing of Corneal Lacerations Using Photo-Activated Rose Bengal Dye and Amniotic Membrane

    Science.gov (United States)

    2017-01-10

    stages. Following euthanasia , the treated globes were isolated and the AM 140 was removed. The globes were fixed in Modified Davidson’s solution for 24...not. 182 The rabbits were sacrificed on day I or 28. Prior to euthanasia , fundus fluorescein angiography 183 (FFA) was performed on day 28 after...agent but not as a treatment agent; thus further safety documentation would be 314 beneficial. In all applications a strong seal was produced

  18. Sealing of Corneal Lacerations Using Photo Activated Rose Bengal Dye and Amniotic Membrane

    Science.gov (United States)

    2017-04-22

    unaffected and no evidence of 35 breakdown of the blood retina barrier was detected. Retina from grccnlight laser treated eyes 36 showed normal RPE...diffuse retina -safe light levels while provid ing sufficient energy for sealing corneal wounds 98 (Verter et al, 2011 ). All studies employed a...then expand the beam to impinge on a larger area of 170 the retina to minimize potential light-initiated damage as previously described (Zhu et aJ, 20

  19. Development of a Sterile Amniotic Membrane Tissue Graft Using Supercritical Carbon Dioxide

    Science.gov (United States)

    2015-03-04

    diluted 1:400 in TBS with 1% BSA at 4C overnight. Next, sections were rinsed in TBS/0.025% Triton X-100 and then incubated in 0.3% hydrogen peroxide...biotinylated horse anti-mouse IgG secondary antibody (1:250 dilution ; Vector, Burlingame, CA) at room temperature for 1 h, rinsed in TBS again, then...Inactivation Amount of PAA (mL) Duration of exposure to SCCO2 (min) Staphylococcus epidermidis Clostridium sporogenes 0 10 Fail Fail 0 20 Fail Fail 0 30 Fail

  20. Sealing of Corneal Lacerations Using Photo-Activated Rose Bengal Dye and Amniotic Membrane

    Science.gov (United States)

    2017-05-05

    Department of Defense contracts W81XWH-09-2-0i l 3. IS THIS MATERIAL CLASSIFIED? 0 YES [gj NO 4. IS THIS MATERIAL SUBJECT TO ANY LEGAL RESTRICTIONS FOR...59TRS/59TRG/OGC EE 59MDW Timothy A. Soeken b.Hong Zhu n/a nla Massachusetts General Hospital c. Sheri DeMartelaere 0 -6 d. Brett W. Davies 0-4 59...59MDW e. Rose Grimm 0-4 f. Irene E. Kochevar nla n/a Massachusetts General Hospital g.Anthony J. Johnson reti red 0 -6 I CERTIFY ANY HUMAN OR

  1. Synergic activation of toll-like receptor (TLR 2/6 and 9 in response to Ureaplasma parvum & urealyticum in human amniotic epithelial cells.

    Directory of Open Access Journals (Sweden)

    Martha Triantafilou

    Full Text Available Ureaplasma species are the most frequently isolated microorganisms inside the amniotic cavity and have been associated with spontaneous abortion, chorioamnionitis, premature rupture of the membranes (PROM, preterm labour (PL pneumonia in neonates and bronchopulmonary dysplasia in neonates. The mechanisms by which Ureaplasmas cause such diseases remain unclear, but it is believed that inappropriate induction of inflammatory responses is involved, triggered by the innate immune system. As part of its mechanism of activation, the innate immune system employs germ-lined encoded receptors, called pattern recognition receptors (PRRs in order to "sense" pathogens. One such family of PRRs are the Toll like receptor family (TLR. In the current study we aimed to elucidate the role of TLRs in Ureaplasma-induced inflammation in human amniotic epithelial cells. Using silencing, as well as human embryonic kidney (HEK transfected cell lines, we demonstrate that TLR2, TLR6 and TLR9 are involved in the inflammatory responses against Ureaplasma parvum and urealyticum serovars. Ureaplasma lipoproteins, such as Multiple Banded antigen (MBA, trigger responses via TLR2/TLR6, whereas the whole bacterium is required for TLR9 activation. No major differences were observed between the different serovars. Cell activation by Ureaplasma parvum and urealyticum seem to require lipid raft function and formation of heterotypic receptor complexes comprising of TLR2 and TLR6 on the cell surface and TLR9 intracellularly.

  2. Amniotic Mesenchymal Stem Cells: A New Source for Hepatocyte-Like Cells and Induction of CFTR Expression by Coculture with Cystic Fibrosis Airway Epithelial Cells

    Directory of Open Access Journals (Sweden)

    Valentina Paracchini

    2012-01-01

    Full Text Available Cystic fibrosis (CF is a monogenic disease caused by mutations in the CF transmembrane conductance regulator (CFTR gene, with lung and liver manifestations. Because of pitfalls of gene therapy, novel approaches for reconstitution of the airway epithelium and CFTR expression should be explored. In the present study, human amniotic mesenchymal stem cells (hAMSCs were isolated from term placentas and characterized for expression of phenotypic and pluripotency markers, and for differentiation potential towards mesoderm (osteogenic and adipogenic lineages. Moreover, hAMSCs were induced to differentiate into hepatocyte-like cells, as demonstrated by mixed function oxidase activity and expression of albumin, alpha1-antitrypsin, and CK19. We also investigated the CFTR expression in hAMSCs upon isolation and in coculture with CF airway epithelial cells. Freshly isolated hAMSCs displayed low levels of CFTR mRNA, which even decreased with culture passages. Following staining with the vital dye CM-DiI, hAMSCs were mixed with CFBE41o- respiratory epithelial cells and seeded onto permeable filters. Flow cytometry demonstrated that 33–50% of hAMSCs acquired a detectable CFTR expression on the apical membrane, a result confirmed by confocal microscopy. Our data show that amniotic MSCs have the potential to differentiate into epithelial cells of organs relevant in CF pathogenesis and may contribute to partial correction of the CF phenotype.

  3. Biochemical composition of amniotic fluid in normal puppies at term of pregnancy: preliminary data

    Directory of Open Access Journals (Sweden)

    Barbara Bolis

    2017-05-01

    Full Text Available The full knowledge of the normal fetal fluids composition could be useful in the dog for the better management of newborns. The aim of the present study was to define the biochemical composition of amniotic fluid of puppies born by elective Caesarean section (CS at term of pregnancy. The study enrolled 24 purebred bitches, classified into small size (20kg. All the bitches were healthy and clinically monitored from mating until parturition. For all the bitches an elective CS at term of pregnancy was performed [1]. For each puppy, the amniotic fluid was collected, immediately centrifuged and frozen at – 20° C until analysis for ALB, AMY, TB, CHOL, CK, ALP, GGT, AST, ALT, LDH, Mg, Ca, K, Na, Trig, BUN, Glc, TP, CREA, LIP, Cl, and GLOB. Data were analyzed by ANCOVA to verify the possible effects of parity, breed body size and newborn gender on amniotic biochemical composition. A total of 69 amniotic fluid samples were collected. The amniotic mean±SD and min-max values for each parameter were defined. LDH (p<0.01 and CK activity (p<0.05, as well as Glc concentrations (p<0.0001 were negatively influenced by the parity. AMY activity was significantly (p<0.05 higher in large sized (44.2±20.87 U/L respect to small sized dogs (30.3±19.89 U/L, while lower (p<0.05 CHOL amniotic concentrations were found in small sized (3.0±2.71 mg/dl as compared to large sized (3.9±2.93 mg/dl dogs. Gender of the newborn did not influence the amniotic biochemical composition. The preliminary results of this study showed some similarities as well as some differences concerning the biochemical composition of the amniotic fluid in dogs at term of pregnancy if compared to data reported for the cat [2]. Furthermore, the results suggested that, in dogs, some amniotic parameters could be influenced by breed body size and by parity.

  4. Amniotic fluid biochemistry in isolated polyhydramnios: a series of 464 cases.

    Science.gov (United States)

    Allaf, Bichr; Dreux, Sophie; Schmitz, Thomas; Czerkiewicz, Isabelle; Le Vaillant, Claudine; Benachi, Alexandra; Houfflin-Debarge, Véronique; Maréchaud, Martine; Oury, Jean-François; Muller, Françoise

    2015-12-01

    To report amniotic fluid biochemistry in a large series of 464 cases of isolated polyhydramnios in order to analyze both the outcome and the benefit of amniotic fluid biochemistry. This retrospective cohort (2008-2012) included polyhydramnios cases for which amniotic fluid samples were sent to our laboratory for biochemical analysis (total protein, alpha-fetoprotein and gamma-glutamyl transpeptidase) so as to investigate the etiology. A Bartter index and an esophageal atresia index were defined. Final diagnoses were compared between groups to determine the association between these indices and the frequency and type of adverse outcomes. Among 464 cases of polyhydramnios considered isolated at ultrasound examination, severe fetal diseases were diagnosed in 136 (29.3%): 46 (9.9%) chromosomal anomalies, 28 (6%) Bartter syndrome, 23 (4.95%) other genetic syndromes, 22 (4.75%) swallowing disorders and 17 (3.7%) uro-nephrological disorders. Amniotic fluid biochemistry identified esophageal atresia with 66.6% (10/15) sensitivity and 100% specificity and Bartter syndrome with 85.7% (24/28) sensitivity and 84.2% specificity. Isolated polyhydramnios is associated with a high risk of severe fetal diseases. Molecular cytogenetics and amniotic fluid biochemistry are helpful tools. © 2015 John Wiley & Sons, Ltd.

  5. Amniotic fluid gamma-glutamyl transpeptidase activity during the second trimester.

    Science.gov (United States)

    Legge, M; Potter, H C

    1986-03-12

    Gamma glutamyl transpeptidase (GGTP) activity was determined in second trimester amniotic fluid taken from normal fetuses and those with fetal abnormalities. GGTP activity decreased with advancing gestation. Increasing meconium contamination correlated with an increase in GGTP activity as did increasing fetal blood contamination. Maternal blood did not affect GGTP activity. Anencephaly did not significantly alter the GGTP activity, however, fetuses with spina bifida had significantly lower activity. Klinefelters and Turners syndromes both had GGTP activity close to the 50th percentile, and two trisomy 21 fetuses had GGTP activity below the 40th percentile. Two trisomy 18 fetuses and two translocation Downs syndromes (46 XY, t (14;21) had GGTP activities considerably lower than the 20th percentile as did a fetus with gastroschisis. Second trimester amniotic fluid GGTP activity may provide an easy preliminary test to screen amniotic fluids for the possibility of certain fetal chromosome abnormalities.

  6. Trans-amniotic stem cell therapy (TRASCET) minimizes Chiari-II malformation in experimental spina bifida.

    Science.gov (United States)

    Dionigi, Beatrice; Brazzo, Joseph A; Ahmed, Azra; Feng, Christina; Wu, Yaotang; Zurakowski, David; Fauza, Dario O

    2015-06-01

    We sought to study the impact of trans-amniotic stem cell therapy (TRASCET) in the Chiari-II malformation in experimental spina bifida. Sprague-Dawley fetuses (n=62) exposed to retinoic acid were divided into three groups at term (21-22 days gestation): untreated isolated spina bifida (n=21), isolated spina bifida treated with intra-amniotic injection of concentrated, syngeneic, labeled amniotic fluid mesenchymal stem cells (afMSCs) on gestational day 17 (n=28), and normal controls (n=13). Analyses included measurements of brainstem and cerebellar placement on high resolution MRI and histology. Statistical comparisons included ANOVA. In parallel to the expected induced coverage of the spina bifida in the afMSC-treated group (Pspina bifida by TRASCET minimizes the Chiari-II malformation in the retinoic acid rodent model, further suggesting it as a practical alternative for the prenatal management of spina bifida. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Concise Review: Amniotic Fluid Stem Cells: The Known, the Unknown, and Potential Regenerative Medicine Applications.

    Science.gov (United States)

    Loukogeorgakis, Stavros P; De Coppi, Paolo

    2017-07-01

    The amniotic fluid has been identified as an untapped source of cells with broad potential, which possess immunomodulatory properties and do not have the ethical and legal limitations of embryonic stem cells. CD117(c-Kit)+ cells selected from amniotic fluid have been shown to differentiate into cell lineages representing all three embryonic germ layers without generating tumors, making them ideal candidates for regenerative medicine applications. Moreover, their ability to engraft in injured organs and modulate immune and repair responses of host tissues, suggest that transplantation of such cells may be useful for the treatment of various degenerative and inflammatory diseases. Although significant questions remain regarding the origin, heterogeneous phenotype, and expansion potential of amniotic fluid stem cells, evidence to date supports their potential role as a valuable stem cell source for the field of regenerative medicine. Stem Cells 2017;35:1663-1673. © 2016 AlphaMed Press.

  8. Membrane dynamics

    DEFF Research Database (Denmark)

    Bendix, Pól Martin

    2015-01-01

    Current topics include membrane-protein interactions with regard to membrane deformation or curvature sensing by BAR domains. Also, we study the dynamics of membrane tubes of both cells and simple model membrane tubes. Finally, we study membrane phase behavior which has important implications...

  9. A randomized comparison of extra-amniotic saline infusion and intracervical dinoprostone gel for cervical ripening.

    Science.gov (United States)

    Goldman, J B; Wigton, T R

    1999-02-01

    To compare extra-amniotic saline infusion to intracervical dinoprostone gel for preinduction cervical ripening. Women with Bishop scores less than 5 were assigned randomly to either extra-amniotic saline infusion (n = 26) or intracervical dinoprostone gel (n = 26) for preinduction cervical ripening. A sample size of 50 would have 80% power to detect a 10-hour difference in the mean time from start of cervical ripening to delivery for the two methods of intervention, with a type I error of .05. The study populations were similar in age, gestational age, and initial Bishop score. They differed in parity, with 22 nulliparas in the extra-amniotic saline infusion group versus 13 in the dinoprostone gel group (relative risk [RR] 1.69, 95% confidence interval [CI] 1.11, 2.57). The number of women achieving a favorable Bishop score at 6 hours was greater with extra-amniotic saline infusion (n = 20) than dinoprostone gel (n = 9) (RR 2.14, 95% CI 1.22, 3.75). Mean time from start of ripening to delivery was 25.9 hours with extra-amniotic saline infusion and 30.2 hours with dinoprostone gel (P = .25). Birth weight, Apgar scores, umbilical artery pH, and infectious morbidity were similar between groups. More women achieved a favorable Bishop score at 6 and 12 hours after the start of cervical ripening with extra-amniotic saline infusion compared with dinoprostone gel. Saline infusion is as safe as dinoprostone gel for preinduction cervical ripening.

  10. Relationship Between Ultrasound Estimated Amniotic Fluid Index and Fetal Weight in Healthy Pregnant African Women

    Directory of Open Access Journals (Sweden)

    Ademola A Adeyekun

    2013-01-01

    Full Text Available Introduction: Fetal weight (FW estimation in late pregnancy is an important guide in obstetric care. Amniotic fluid protects the fetus against traumatic and infective insults. There possibly exists a relationship between FW and amniotic fluid index (AFI that can be estimated by ultrasonography. Materials and Methods: Two hundred and fifty-eight low-risk pregnancies were prospectively studied by means of ultrasound over a 12-month period. FW was estimated using a combination of fetal parameters; bi-parietal diameter, fetal trunk cross sectional area, and femur length. AFI was assessed using the 4-quadrant method. Spearman′s correlation was used to test possible relationship between amniotic fluid indices and estimated FW pairs. The level of statistical significance was set at P ≤ 0.05. Results: The mean AF1 and estimated fetal weight (EFW pairs were as follows: at 27-29 weeks the values were 172.1 mm and 1,250.2 g; at 30-32 weeks AF1 and EFW values were 170.3 mm and 1,648.0 g; at 33-35 weeks values were 162.3 mm and 2,273.5 g; at 36-38 weeks values were 144.09 mm and 2,906.1 g; at 39-40 weeks AF1 and EFW values were 125.0 mm and 3,222.6 g. Overall, there was no statistically significant relationship between AFI and EFW ( P > 0.05; r = 0.241. Conclusion: While FW calculations and amniotic index showed variations in value in late pregnancy, there does not appear to be a linear relationship between ultrasound estimate of FW and amniotic index. The implication of this is that fetal size need not be taken into cognizance when alterations in amniotic fluid values are noted.

  11. The evolution of body size, Cope's rule and the origin of amniotes.

    Science.gov (United States)

    Laurin, Michel

    2004-08-01

    The evolution of body size in tetrapods is assessed using a database that includes 107 early stegocephalian species ranging in time from the Frasnian (Upper Devonian) to the Tatarian (Upper Permian). All analyses use methods that incorporate phylogenetic information (topology and branch lengths). In all tests, the impact of alternative topologies and branch lengths are assessed. Previous reports that raised doubts about the accuracy of squared-change parsimony assessment of ancestral character value appear to have used datasets in which there was no phylogenetic signal. Hence, squared-change parsimony may be more reliable than suggested in recent studies, at least when a phylogenetic signal is present in the datasets of interest. Analysis using random taxon reshuffling on three reference phylogenies shows that cranial and presacral length include a strong phylogenetic signal. Character optimization of body size in stegocephalians using squared-change parsimony on a time-calibrated phylogeny incorporating branch length information is used to test a previously published scenario on the origin of amniotes and of the amniotic egg that implies that the ancestors of amniotes were small (no more than 10 cm in snout-vent length), and that their size increased subsequent to the appearance of the amniotic egg. The optimization suggests that first amniotes were somewhat larger than previously hypothesized; the estimated snout-vent length is about 24 cm, and the lower end of the 95% confidence interval of the phylogeny that yields the smallest inferred size suggests that no ancestor of amniotes measured less than 12 cm in snout-vent length. Character optimization, permutational multiple linear regressions, and independent contrast analyses show that Cope's rule of phyletic size increase applies to early reptiliomorphs but that it does not apply to early stegocephalians globally.

  12. Amniotic fluid chemokines and autism spectrum disorders: An exploratory study utilizing a Danish Historic Birth Cohort

    DEFF Research Database (Denmark)

    Abdallah, Morsi; Larsen, Nanna Brink; Grove, Jakob

    2012-01-01

    Elevated levels of chemokines have been reported in plasma and brain tissue of individuals with Autism Spectrum Disorders (ASD). The aim of this study was to examine chemokine levels in amniotic fluid (AF) samples of individuals diagnosed with ASD and their controls.......Elevated levels of chemokines have been reported in plasma and brain tissue of individuals with Autism Spectrum Disorders (ASD). The aim of this study was to examine chemokine levels in amniotic fluid (AF) samples of individuals diagnosed with ASD and their controls....

  13. Amniotic fluid and colostrum as potential diets in the critical care of preterm infants

    DEFF Research Database (Denmark)

    Støy, Ann Cathrine Findal; Viberg Østergaard, Mette; Torp Sangild, Per

    2015-01-01

    Amniotic fluid is the enteral “diet” of the developing fetus, while the first mammary gland secretion, colostrum, is the natural diet of the newborn mammal. Both diets contain nutrients but also growth factors, immune-modulating components, and antibacterial agents that support perinatal organ...... be species independent, maybe allowing colostrum from one species (i.e., lactating cows) to be used as the first enteral diet for infants for whom mother’s milk is lacking. The use of amniotic fluid and bovine colostrum in the critical care of neonates is still at an experimental stage, but animal studies...

  14. Direct Reprogramming of Human Amniotic Fluid Stem Cells by OCT4 and Application in Repairing of Cerebral Ischemia Damage.

    Science.gov (United States)

    Qin, Mingde; Chen, Ruihua; Li, Hong; Liang, Hansi; Xue, Qun; Li, Fang; Chen, Ying; Zhang, Xueguang

    2016-01-01

    Amniotic fluid stem cells (AFSCs) are a type of fetal stem cell whose stemness encompasses both embryonic and adult stem cells, suggesting that they may be easily and efficiently reprogrammed into induced pluripotent stem cells (iPSCs). To further simplify the reprogramming process, the creation of AFSC-derived iPSCs using a single factor is desirable. Here we report the generation of one-factor human AFSC-iPSCs (AiPSCs) from human AFSCs by ectopic expression of the transcription factor OCT4. Just like human embryonic stem cells, AiPSCs exhibited similar epigenetic status, global gene expression profiles, teratoma formation and in vitro & in vivo pluripotency. Our results indicate that the OCT4 is necessary and sufficient to directly reprogram human AFSCs into pluripotent AiPSCs. Moreover, reflecting the similar memory characteristics of AFSCs and neural stem cells, we show that AiPSC membrane-derived vesicles (MVs) repair cerebral ischemia damage. We anticipate that the successful generation of one-factor AiPSCs will facilitate the creation of patient-specific pluripotent stem cells without the need for transgenic expression of oncogenes. Moreover, MVs from tissue-specific AiPSCs have potential in tissue repair, representing a novel application of iPSCs.

  15. Membrane Vesicles of Group B Streptococcus Disrupt Feto-Maternal Barrier Leading to Preterm Birth.

    Directory of Open Access Journals (Sweden)

    Manalee Vishnu Surve

    2016-09-01

    Full Text Available Infection of the genitourinary tract with Group B Streptococcus (GBS, an opportunistic gram positive pathogen, is associated with premature rupture of amniotic membrane and preterm birth. In this work, we demonstrate that GBS produces membrane vesicles (MVs in a serotype independent manner. These MVs are loaded with virulence factors including extracellular matrix degrading proteases and pore forming toxins. Mice chorio-decidual membranes challenged with MVs ex vivo resulted in extensive collagen degradation leading to loss of stiffness and mechanical weakening. MVs when instilled vaginally are capable of anterograde transport in mouse reproductive tract. Intra-amniotic injections of GBS MVs in mice led to upregulation of pro-inflammatory cytokines and inflammation mimicking features of chorio-amnionitis; it also led to apoptosis in the chorio-decidual tissue. Instillation of MVs in the amniotic sac also resulted in intrauterine fetal death and preterm delivery. Our findings suggest that GBS MVs can independently orchestrate events at the feto-maternal interface causing chorio-amnionitis and membrane damage leading to preterm birth or fetal death.

  16. Membrane Vesicles of Group B Streptococcus Disrupt Feto-Maternal Barrier Leading to Preterm Birth

    Science.gov (United States)

    Sthanam, Lakshmi Kavitha; Srivastava, Rohit; Basu, Bhakti; Dutta, Suryendu; Sen, Shamik; Modi, Deepak

    2016-01-01

    Infection of the genitourinary tract with Group B Streptococcus (GBS), an opportunistic gram positive pathogen, is associated with premature rupture of amniotic membrane and preterm birth. In this work, we demonstrate that GBS produces membrane vesicles (MVs) in a serotype independent manner. These MVs are loaded with virulence factors including extracellular matrix degrading proteases and pore forming toxins. Mice chorio-decidual membranes challenged with MVs ex vivo resulted in extensive collagen degradation leading to loss of stiffness and mechanical weakening. MVs when instilled vaginally are capable of anterograde transport in mouse reproductive tract. Intra-amniotic injections of GBS MVs in mice led to upregulation of pro-inflammatory cytokines and inflammation mimicking features of chorio-amnionitis; it also led to apoptosis in the chorio-decidual tissue. Instillation of MVs in the amniotic sac also resulted in intrauterine fetal death and preterm delivery. Our findings suggest that GBS MVs can independently orchestrate events at the feto-maternal interface causing chorio-amnionitis and membrane damage leading to preterm birth or fetal death. PMID:27583406

  17. What Is New in Amniotic Fluid Embolism?: Best Articles From the Past Year.

    Science.gov (United States)

    Benson, Michael D

    2017-05-01

    This month, we focus on current research in amniotic fluid embolism. Dr. Benson discusses four recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts.

  18. Concentration of amoxicillin in maternal serum, cord blood, amniotic fluid and the placenta after vaginal administration.

    Science.gov (United States)

    Zaręba-Szczudlik, Julia; Romejko-Wolniewicz, Ewa; Lewandowski, Zbigniew; Różańska, Hanna; Czajkowski, Krzysztof

    2015-01-01

    The aim of this study was to assess the amoxicillin concentration in maternal serum, cord blood, amniotic fluid and the placenta, 2 h following vaginal administration and the factors influencing the drug level. Twenty-eight full-term pregnant women who qualified for elective cesarean delivery were included in the study. Vaginal suppositories containing 250 mg of amoxicillin were administered 2 h prior to the operation. Amoxicillin levels were determined using the diffusion microbial assay. The amoxicillin level in amniotic fluid was significantly higher in comparison to that of maternal serum, cord blood or the placenta. Maternal age positively and gestational weight gain negatively correlated with the amoxicillin concentration in maternal serum. The maternal serum hemoglobin level and red blood cell count were positively correlated with amoxicillin concentration in the amniotic fluid. Neonatal birth weight was positively correlated with maternal serum and cord blood amoxicillin levels. Hypertensive women had significantly higher amoxicillin concentrations in amniotic fluid, and women with thrombocytopenia presented significantly higher cord blood amoxicillin concentrations. Amoxicillin presented poor concentration in maternal-fetal compartments after vaginal administration, but the factors influencing the drug level in different compartments require further investigation.

  19. Amniotic fluid RNA gene expression profiling provides insights into the phenotype of Turner syndrome.

    Science.gov (United States)

    Massingham, Lauren J; Johnson, Kirby L; Scholl, Thomas M; Slonim, Donna K; Wick, Heather C; Bianchi, Diana W

    2014-09-01

    Turner syndrome is a sex chromosome aneuploidy with characteristic malformations. Amniotic fluid, a complex biological material, could contribute to the understanding of Turner syndrome pathogenesis. In this pilot study, global gene expression analysis of cell-free RNA in amniotic fluid supernatant was utilized to identify specific genes/organ systems that may play a role in Turner syndrome pathophysiology. Cell-free RNA from amniotic fluid of five mid-trimester Turner syndrome fetuses and five euploid female fetuses matched for gestational age was extracted, amplified, and hybridized onto Affymetrix(®) U133 Plus 2.0 arrays. Significantly differentially regulated genes were identified using paired t tests. Biological interpretation was performed using Ingenuity Pathway Analysis and BioGPS gene expression atlas. There were 470 statistically significantly differentially expressed genes identified. They were widely distributed across the genome. XIST was significantly down-regulated (p Turner syndrome transcriptome from other aneuploidies we previously studied. Manual curation of the differentially expressed gene list identified genes of possible pathologic significance, including NFATC3, IGFBP5, and LDLR. Transcriptomic differences in the amniotic fluid of Turner syndrome fetuses are due to genome-wide dysregulation. The hematologic/immune system differences may play a role in early-onset autoimmune dysfunction. Other genes identified with possible pathologic significance are associated with cardiac and skeletal systems, which are known to be affected in females with Turner syndrome. The discovery-driven approach described here may be useful in elucidating novel mechanisms of disease in Turner syndrome.

  20. Stable isotope dilution analysis of orotic acid and uracil in amniotic fluid

    NARCIS (Netherlands)

    Jakobs, C.; Sweetman, L.; Nyhan, W.L.; Gruenke, L.; Craig, J.C.; Wadman, S.K.

    1984-01-01

    Rapid, sensitive and accurate stable isotope dilution assays were developed for the measurement of orotic acid and uracil in amniotic fluid. The method utilizes [15N2]orotic acid and [15N2]uracil as internal standards, isolation by liquid partition chromatography and quantitation by chemical

  1. Peptidomic Analysis of Amniotic Fluid for Identification of Putative Bioactive Peptides in Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Xing Li

    2016-05-01

    Full Text Available Background: Ventricular septal defect (VSD is one of the most common congenital heart diseases and to date the role of peptides in human amniotic fluid in the pathogenesis of VSD have been rarely investigated. Methods: To gain insight into the mechanisms of protein and peptides in cardiovascular development, we constructed a comparative peptidomic profiling of human amniotic fluid between normal and VSD fetuses using a stable isobaric labeling strategy involving tandem mass tag reagents, followed by nano liquid chromatography tandem mass spectrometry. Results: We identified and quantified 692 non-redundant peptides, 183 of which were differentially expressed in the amniotic fluid of healthy and VSD fetuses; 69 peptides were up regulated and 114 peptides were down regulated. These peptides were imported into the Ingenuity Pathway Analysis (IPA and identified putative roles in cardiovascular system morphogenesis and cardiogenesis. Conclusion: We concluded that 35 peptides located within the functional domains of their precursor proteins could be candidate bioactive peptides for VSD. The identified peptide changes in amniotic fluid of VSD fetuses may advance our current understanding of congenital heart disease and these peptides may be involved in the etiology of VSD.

  2. Peptidomic Analysis of Amniotic Fluid for Identification of Putative Bioactive Peptides in Ventricular Septal Defect.

    Science.gov (United States)

    Li, Xing; Wu, Li-Jie; Gu, Meng; Chen, Yu-Mei; Zhang, Qi-Jun; Li, Hua; Cheng, Zi-Jie; Hu, Ping; Han, Shu-Ping; Yu, Zhang-Bin; Qian, Ling-Mei

    2016-01-01

    Ventricular septal defect (VSD) is one of the most common congenital heart diseases and to date the role of peptides in human amniotic fluid in the pathogenesis of VSD have been rarely investigated. To gain insight into the mechanisms of protein and peptides in cardiovascular development, we constructed a comparative peptidomic profiling of human amniotic fluid between normal and VSD fetuses using a stable isobaric labeling strategy involving tandem mass tag reagents, followed by nano liquid chromatography tandem mass spectrometry. We identified and quantified 692 non-redundant peptides, 183 of which were differentially expressed in the amniotic fluid of healthy and VSD fetuses; 69 peptides were up regulated and 114 peptides were down regulated. These peptides were imported into the Ingenuity Pathway Analysis (IPA) and identified putative roles in cardiovascular system morphogenesis and cardiogenesis. We concluded that 35 peptides located within the functional domains of their precursor proteins could be candidate bioactive peptides for VSD. The identified peptide changes in amniotic fluid of VSD fetuses may advance our current understanding of congenital heart disease and these peptides may be involved in the etiology of VSD. © 2016 The Author(s) Published by S. Karger AG, Basel.

  3. Detection of otoacoustic emissions in chinchilla when the middle ear contains amniotic fluid.

    Science.gov (United States)

    Akinpelu, Olubunmi V; Funnell, W Robert J; Daniel, Sam J

    2015-04-01

    Otoacoustic emissions have frequently been used for newborn hearing screening. However, they have low specificities and high referral rates. The presence of amniotic fluid in the middle ear is one reason for these problems. The aim of this study was to determine the effects of human amniotic fluid on otoacoustic emissions and on middle-ear function. Forty-six chinchillas were randomly divided into eight groups based on the type (amniotic fluid or normal saline) and volume (0.5, 1, 1.5, 2 ml) of liquid introduced into the middle ear. Distortion product otoacoustic emission (DPOAE) and wideband reflectance (WBR) measurements were taken under inhalational anaesthesia before and after introduction of middle-ear liquid. The differences in these measurements were subjected to statistical analyses. Prospective controlled animal study. Significant reductions of DPOAE levels and increases in WBR occurred across all frequencies when there was liquid in the middle ear, and the changes became greater for increased volumes of liquid. Changes in the noise level had important effects on the otoacoustic-emission signal-to-noise ratio at the three lowest frequencies. Both human amniotic fluid and saline in the chinchilla middle ear resulted in changes in otoacoustic-emission detection patterns and WBR that may be relevant to newborn hearing screening. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Amnion and Chorion Membranes: Potential Stem Cell Reservoir with Wide Applications in Periodontics

    Directory of Open Access Journals (Sweden)

    Akanksha Gupta

    2015-01-01

    Full Text Available The periodontal therapy usually aims at elimination of disease causing bacteria and resolution of inflammation. It involves either resective or regenerative surgery to resolve the inflammation associated defects. Over the years, several methods have been used for achievement of periodontal regeneration. One of the oldest biomaterials used for scaffolds is the fetal membrane. The amniotic membranes of developing embryo, that is, amnion (innermost lining and chorion (a layer next to it, have the properties with significant potential uses in dentistry. This paper reviews the properties, mechanism of action, and various applications of these placental membranes in general and specifically in Periodontics.

  5. Membrane fusion

    DEFF Research Database (Denmark)

    Bendix, Pól Martin

    2015-01-01

    At Stanford University, Boxer lab, I worked on membrane fusion of small unilamellar lipid vesicles to flat membranes tethered to glass surfaces. This geometry closely resembles biological systems in which liposomes fuse to plasma membranes. The fusion mechanism was studied using DNA zippering...... between complementary strands linked to the two apposing membranes closely mimicking the zippering mechanism of SNARE fusion complexes....

  6. Biobased Membrane

    NARCIS (Netherlands)

    Koenders, E.A.B.; Zlopasa, J.; Picken, S.J.

    2015-01-01

    The present invention is in the field of a composition for forming a bio-compatible membrane applicable to building material, such as concrete, cement, etc., to a meth od of applying said composition for forming a bio-compatible membrane, a biocompatible membrane, use of said membrane for various

  7. Clinical chorioamnionitis at term VIII: a rapid MMP-8 test for the identification of intra-amniotic inflammation.

    Science.gov (United States)

    Chaiyasit, Noppadol; Romero, Roberto; Chaemsaithong, Piya; Docheva, Nikolina; Bhatti, Gaurav; Kusanovic, Juan Pedro; Dong, Zhong; Yeo, Lami; Pacora, Percy; Hassan, Sonia S; Erez, Offer

    2017-07-26

    Clinical chorioamnionitis is the most common infection/inflammatory process diagnosed in labor and delivery units worldwide. The condition is a syndrome that can be caused by (1) intra-amniotic infection, (2) intra-amniotic inflammation without demonstrable microorganisms (i.e. sterile intra-amniotic inflammation), and (3) maternal systemic inflammation that is not associated with intra-amniotic inflammation. The presence of intra-amniotic inflammation is a risk factor for adverse maternal and neonatal outcomes in a broad range of obstetrical syndromes that includes clinical chorioamnionitis at term. Although the diagnosis of intra-amniotic infection has relied on culture results, such information is not immediately available for patient management. Therefore, the diagnosis of intra-amniotic inflammation could be helpful as a proxy for intra-amniotic infection, while results of microbiologic studies are pending. A rapid test is now available for the diagnosis of intra-amniotic inflammation, based on the determination of neutrophil collagenase or matrix metalloproteinase-8 (MMP-8). The objectives of this study were (1) to evaluate the diagnostic indices of a rapid MMP-8 test for the identification of intra-amniotic inflammation/infection in patients with the diagnosis of clinical chorioamnionitis at term, and (2) to compare the diagnostic performance of a rapid MMP-8 test to that of a conventional enzyme-linked immunosorbent assay (ELISA) interleukin (IL)-6 test for patients with clinical chorioamnionitis at term. A retrospective cohort study was conducted. A transabdominal amniocentesis was performed in patients with clinical chorioamnionitis at term (n=44). Amniotic fluid was analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital Mycoplasmas) and broad-range polymerase chain reaction (PCR) coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). Amniotic fluid IL-6 concentrations were determined by ELISA, and rapid

  8. Nutritional intra-amniotic therapy increases survival in a rabbit model of fetal growth restriction

    Science.gov (United States)

    Illa, Miriam; Pla, Laura; Zamora, Monica; Crispi, Fatima; Gratacos, Eduard

    2018-01-01

    Objective To evaluate the perinatal effects of a prenatal therapy based on intra-amniotic nutritional supplementation in a rabbit model of intrauterine growth restriction (IUGR). Methods IUGR was surgically induced in pregnant rabbits at gestational day 25 by ligating 40–50% of uteroplacental vessels of each gestational sac. At the same time, modified-parenteral nutrition solution (containing glucose, amino acids and electrolytes) was injected into the amniotic sac of nearly half of the IUGR fetuses (IUGR-T group n = 106), whereas sham injections were performed in the rest of fetuses (IUGR group n = 118). A control group without IUGR induction but sham injection was also included (n = 115). Five days after the ligation procedure, a cesarean section was performed to evaluate fetal cardiac function, survival and birth weight. Results Survival was significantly improved in the IUGR fetuses that were treated with intra-amniotic nutritional supplementation as compared to non-treated IUGR animals (survival rate: controls 71% vs. IUGR 44% p = 0.003 and IUGR-T 63% vs. IUGR 44% p = 0.02), whereas, birth weight (controls mean 43g ± SD 9 vs. IUGR 36g ± SD 9 vs. IUGR-T 35g ± SD 8, p = 0.001) and fetal cardiac function were similar among the IUGR groups. Conclusion Intra-amniotic injection of a modified-parenteral nutrient solution appears to be a promising therapy for reducing mortality among IUGR. These results provide an opportunity to develop new intra-amniotic nutritional strategies to reach the fetus by bypassing the placental insufficiency. PMID:29466434

  9. [Lamellar body count in amniotic fluid for assessing fetal lung maturity].

    Science.gov (United States)

    Visnjevac, Jovana; Novakov-Mikić, Aleksandra; Nikolić, Aleksandra; Visnjevac, Nemanja

    2010-01-01

    Respiratory distress syndrome (RDS) of the newborn infant caused by immaturity of fetal lung is a very serious clinical problem. Surfactant is stored in the form of lamellar bodies. They are secreted into alveolar space and passed into amniotic fluid where they can be found. The similarity of lamellar body size to platelet size permits the use of a standard automated hematologic cell counter to estimate the number of lamellar bodies in amniotic fluid. We conducted a prospective clinical study from 2005-2006 on amniotic fluid samples. Amniotic fluid samples were collected near delivery by transvaginal amniotomy, amniotomy during Cesarean section and 72 hours before delivery by amniocentesis. A hematology analyzer (Nikon-Kohden) was used to determine the lamellar body counts. After birth of newborns we compared their complete clinical examination results particularly emphasizing the prediction of the method of RDS by lamellar body count. Maximally specific lamellar body cutoffs for maturity and immaturity were determined using ROC curves. Of 232 amniotic fluid samples which were tested, 112 samples were collected by transvaginal amniotomy, 88 were taken during Cesarean delivery and 32 samples were collected by amniocentesis. The incidence of RDS was 14.6%. ROC curves were used to identify cut points for the test. We found that LBC is a good screening test for predicting fetal lung maturity with the area under the curve of 0.751. LBC cutoff of 42 x 10(3)/microl, with sensitivity of 82.4% and specificity of 64.6%, proved best for predicting fetal lung maturity. LBC is a good screening test for predicting fetal lung maturity. The advantages of LBC are speed, objectivity, low price, low sample volume required and universal availability.

  10. Development of a novel method for amniotic fluid stem cell storage.

    Science.gov (United States)

    Zavatti, Manuela; Beretti, Francesca; Casciaro, Francesca; Comitini, Giuseppina; Franchi, Fabrizia; Barbieri, Veronica; Bertoni, Laura; De Pol, Anto; La Sala, Giovanni B; Maraldi, Tullia

    2017-08-01

    Current procedures for collection of human amniotic fluid stem cells (hAFSCs) indicate that cells cultured in a flask for 2 weeks can then be used for research. However, hAFSCs can be retrieved directly from a small amount of amniotic fluid that can be obtained at the time of diagnostic amniocentesis. The aim of this study was to determine whether direct freezing of amniotic fluid cells is able to maintain or improve the potential of a sub-population of stem cells. We compared the potential of the hAFSCs regarding timing of freezing, cells obtained directly from amniotic fluid aspiration (D samples) and cells cultured in a flask before freezing (C samples). Colony-forming-unit ability, proliferation, morphology, stemness-related marker expression, senescence, apoptosis and differentiation potential of C and D samples were compared. hAFSCs isolated from D samples expressed mesenchymal stem cells markers until later passages, had a good proliferation rate and exhibited differentiation capacity similar to hAFSCs of C samples. Interestingly, direct freezing induced a higher concentration of cells positive for pluripotency stem cell markers, without teratoma formation in vivo. This study suggests that minimal processing may be adequate for the banking of amniotic fluid cells, avoiding in vitro passages before the storage and exposure to high oxygen concentration, which affect stem cell properties. This technique might be a cost-effective and reasonable approach to the process of Good Manufacturing Process accreditation for stem-cell banks. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  11. Phacoaspiration with a Cionni ring versus pars plana lensectomy, vitrectomy and sutureless transscleral IOL fixation in pediatric patients with a subluxated lens.

    Science.gov (United States)

    Thapa, Bikram Bahadur; Agarwal, Aniruddha; Singh, Ramandeep; Gupta, Parul Chawla; Ram, Jagat

    2016-05-01

    To compare outcomes of phacoaspiration (PA) with Cionni ring-assisted posterior-chamber intraocular lens implantation (PCIOL) versus pars plana lensectomy (PPL) with anterior vitrectomy (AV) and sutureless transscleral fixation of the IOL (TSFIOL) assisted with fibrin glue in the management of a subluxated lens. In this prospective and comparative interventional study, one eye of children with a bilateral subluxated lens was randomized to undergo PA with PCIOL using a Cionni ring (group A: n = 14 eyes), and the other eye underwent PPL + AV with glue-assisted TSFIOL (group B: n = 14 eyes). The outcome measures included best-corrected visual acuity (BCVA) in logMAR units and rates of complications at 12-month follow-up visits. 28 eyes of 14 children (age: 8.06 ± 4.49 years) were included in the study. BCVA improved from preoperative value of 1.21 to 0.4 (p = 0.001) in group A and from 1.53 to 0.31 (p = 0.001) in group B at month 12. There was no significant difference in the BCVA on comparing the two groups at month 12 (p > 0.411). Postoperative complications in group A included corneal edema (two eyes), Cionni hook capture (one eye), elevated IOP (one eye), and posterior capsular opacification (five eyes). In group B, corneal edema was seen in two eyes, hypotony in one eye, vitreous hemorrhage in one eye and pupillary optic capture in four eyes. Head-to-head comparison of the two techniques demonstrates no significant difference in the rates of complications at month 12. The decision to choose either technique may be based on the operating surgeon's skill, experience and preference.

  12. Membranous nephropathy

    Science.gov (United States)

    ... check for hepatitis B, hepatitis C, and syphilis Complement levels Cryoglobulin test Treatment The goal of treatment ... not as helpful for people with membranous nephropathy. Medicines used treat membranous nephropathy include: Angiotensin-converting enzyme ( ...

  13. Metal-based particles in human amniotic fluids of fetuses with normal karyotype and congenital malformation--a pilot study.

    Science.gov (United States)

    Barošová, H; Dvořáčková, J; Motyka, O; Kutláková, K Mamulová; Peikertová, P; Rak, J; Bielniková, H; Kukutschová, J

    2015-05-01

    This study explores the inorganic composition of amniotic fluid in healthy human fetuses and fetuses with congenital malformation with a special attention to presence of metal-based solid particles. Amniotic fluid originates from maternal blood and provides fetus mechanical protection and nutrients. In spite of this crucial role, the environmental impact on the composition of amniotic fluid remains poorly studied. The samples of human amniotic fluids were obtained by amniocentesis, including both healthy pregnancies and those with congenital malformations. The samples were analysed using several techniques, including Raman microspectroscopy, scanning electron microscopy with energy-dispersed spectrometry (SEM-EDS), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) analysis. Several metal-based particles containing barium, titanium, iron, and other elements were detected by SEM-EDS and Raman microspectroscopy. XRD analysis detected only sodium chloride as the main component of all amniotic fluid samples. Infrared spectroscopy detected protein-like organic components. Majority of particles were in form of agglomerates up to tens of micrometres in size, consisting of mainly submicron particles. By statistical analysis (multiple correspondence analysis), it was observed that groups of healthy and diagnosed fetuses form two separate groups and therefore, qualitative differences in chemical composition may have distinct biological impact. Overall, our results suggest that metal-based nanosized pollutants penetrate into the amniotic fluid and may affect human fetuses.

  14. Prenatal imaging of amniotic band sequence: utility and role of fetal MRI as an adjunct to prenatal US

    Energy Technology Data Exchange (ETDEWEB)

    Neuman, Jeremy [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Staten Island University Hospital, Department of Radiology, Staten Island, NY (United States); Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Bitters, Constance; Merrow, Arnold C.; Guimaraes, Carolina V.A. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Department of Fetal Surgery, Cincinnati, OH (United States)

    2012-05-15

    Amniotic band sequence and its US manifestations have been well-described. There is little information, however, regarding the accuracy and utility of fetal MRI. To describe the MRI findings in amniotic band sequence and to compare the diagnostic accuracy of MRI and US. Prenatal MRI and US studies were retrospectively reviewed in 14 consecutive pregnancies with confirmed amniotic band sequence. Both studies were evaluated for amniotic band visualization, body part affected, type of deformity, umbilical cord involvement and vascular abnormality. Amniotic bands were confidently identified with MRI in 8 fetuses (57%), suggested with MRI in 3 fetuses (21%) and confidently seen by US in 13 fetuses (93%). Neither modality detected surgically proven bands on one fetus. Both techniques were equally able to define the body part affected and the type of deformity. At least one limb abnormality was visualized in all cases and truncal involvement was present in two cases. Cord involvement was identified in seven cases, with one case detected only by MRI. Fetal MRI is able to visualize amniotic bands and their secondary manifestations and could be complementary to prenatal US when fetal surgery is contemplated. (orig.)

  15. [Determination of tramadol and its active metabolite O-desmethyltramadol in plasma and amniotic fluid using LC/MS/MS].

    Science.gov (United States)

    Zhao, Li-mei; Chen, Xiao-yan; Cui, Jian-jun; Sunita, Maleku; Zhong, Da-fang

    2004-06-01

    To determinate tramadol and O-desmethyltramadol in human plasma and amniotic fluid by LC/MS/MS, and distribution of tramadol and O-desmethyltramadol in maternity and fetus were studied. Samples containing tramadol, O-desmethyltramadol and diphenhydramine (internal standard, IS ) were extracted using liquid-liquid extraction, followed by liquid chromatographic separation and on-line MS/MS using atmospheric pressure chemical ionization as an interface detection. The analytes were detected in the selected reaction monitoring mode. The calibration curves for tramadol and O-desmethytramadol in plasma and amniotic fluid were linear in the range from 8.0 to 800.0 microg x L(-1) (plasma) and 1.0 to 400.0 microg x L(-1) (amniotic fluid). The method was applied to the measurement of tramadol and O-desmethytramadol concentrations in maternal vein, umbilical vein, umbilical artery and amniotic fluid. Following intramuscular pre-operative administration 1.5 mg x kg(-1) doses of tramadol to parturients, plasma concentrations of tramadol were significantly higher than those in amniotic fluid. The concentrations of O-desmethyltramadol in plasma were lower, and were not detected in amniotic fluid. The method is shown to be accurate, robust and convenient, and suitable for clinical pharmacokinetics studies of tramadol and O-desmethyltramadol.

  16. Germline development in amniotes: A paradigm shift in primordial germ cell specification

    Science.gov (United States)

    2016-01-01

    In the field of germline development in amniote vertebrates, primordial germ cell (PGC) specification in birds and reptiles remains controversial. Avians are believed to adopt a predetermination or maternal specification mode of PGC formation, contrary to an inductive mode employed by mammals and, supposedly, reptiles. Here, we revisit and review some key aspects of PGC development that channelled the current subdivision, and challenge the position of birds and reptiles as well as the ‘binary’ evolutionary model of PGC development in vertebrates. We propose an alternative view on PGC specification where germ plasm plays a role in laying the foundation for the formation of PGC precursors (pPGC), but not necessarily of PGCs. Moreover, inductive mechanisms may be necessary for the transition from pPGCs to PGCs. Within this framework, the implementation of data from birds and reptiles could provide new insights on the evolution of PGC specification in amniotes. PMID:27273724

  17. Thoraco-amniotic shunting for fetal pleural effusion--a case series.

    LENUS (Irish Health Repository)

    Walsh, J

    2011-11-15

    Fetal pleural effusion is a rare occurrence, with an incidence of 1 per 10-15,000 pregnancies. The prognosis is related to the underlying cause and is often poor. There is increasing evidence that in utero therapy with thoraco-amniotic shunting improves prognosis by allowing lung expansion thereby preventing hydrops and pulmonary hypoplasia. This is a review of all cases of fetal pleural effusion managed over an eight year period the National Maternity Hospital Dublin. Over the nine year period there were 21 cases of fetal pleural effusion giving an overall incidence of 1 per 9281 deliveries. Of these, 15 underwent thoraco-amniotic shunting. There were associated anomalies diagnosed in 5 (33%) of cases. The overall survival in our cohort was 53%. The presence of hydrops was a poor prognostic factor, with survival in cases with hydrops of 33% (3\\/9) compared to 83% (5\\/6) in those cases without associated hydrops.

  18. [Imbalance of system of glutamin - glutamic acid in the placenta and amniotic fluid at placental insufficiency].

    Science.gov (United States)

    Pogorelova, T N; Gunko, V O; Linde, V A

    2014-01-01

    Metabolism of glutamine and glutamic acid has been investigated in the placenta and amniotic fluid under conditions of placental insufficiency. The development of placental insufficiency is characterized by the increased content of glutamic acid and a decrease of glutamine in both placenta and amniotic fluid. These changes changes were accompanied by changes in the activity of enzymes involved in the metabolism of these amino acids. There was a decrease in glutamate dehydrogenase activity and an increase in glutaminase activity with the simultaneous decrease of glutamine synthetase activity. The compensatory decrease in the activity of glutamine keto acid aminotransferase did not prevent a decrease in the glutamine level. The impairments in the system glutamic acid-glutamine were more pronounced during the development of premature labor.

  19. Membrane Biophysics

    CERN Document Server

    Ashrafuzzaman, Mohammad

    2013-01-01

    Physics, mathematics and chemistry all play a vital role in understanding the true nature and functioning of biological membranes, key elements of living processes. Besides simple spectroscopic observations and electrical measurements of membranes we address in this book the phenomena of coexistence and independent existence of different membrane components using various theoretical approaches. This treatment will be helpful for readers who want to understand biological processes by applying both simple observations and fundamental scientific analysis. It provides a deep understanding of the causes and effects of processes inside membranes, and will thus eventually open new doors for high-level pharmaceutical approaches towards fighting membrane- and cell-related diseases.

  20. Accuracy of real-time polymerase chain reaction for Toxoplasma gondii in amniotic fluid.

    Science.gov (United States)

    Wallon, Martine; Franck, Jacqueline; Thulliez, Philippe; Huissoud, Cyril; Peyron, François; Garcia-Meric, Patricia; Kieffer, François

    2010-04-01

    To provide clinicians with information about the accuracy of real-time polymerase chain reaction (PCR) analysis of amniotic fluid for the prenatal diagnosis of congenital Toxoplasma infection. This was a prospective cohort study of women with Toxoplasma infection identified by prenatal screening in three centers routinely carrying out real-time PCR for the detection of Toxoplasma gondii in amniotic fluid. The data available were gestational age at maternal infection, types and dates of maternal treatment, results of amniocentesis and neonatal work-up and definitive infectious status of the child. We estimated sensitivity, specificity and positive and negative predictive values both overall and per trimester of pregnancy at the time of maternal infection. Polymerase chain reaction analysis was carried out on amniotic fluid for 261 of the 377 patients included (69%). It was accurate with the exception of four negative results in children who were infected. Overall sensitivity and negative predictive value were 92.2% (95% confidence interval [CI] 81-98%) and 98.1% (95% CI 95-99.5%), respectively. There was no significant association with the trimester of pregnancy during which maternal infection occurred. Specificity and positive predictive values of 100% were obtained for all trimesters. Real-time PCR analysis significantly improves the detection of T. gondii on amniotic fluid. It provides an accurate tool to predict fetal infection and to decide on appropriate treatment and surveillance. However, postnatal follow-up remains necessary in the first year of life to fully exclude infection in children for whom PCR results were negative. III.

  1. A New Candidate Substrate for Cell-Matrix Adhesion Study: The Acellular Human Amniotic Matrix

    OpenAIRE

    Guo, Qianchen; Lu, Xuya; Xue, Yuan; Zheng, Hong; Zhao, Xiaotao; Zhao, Huajian

    2012-01-01

    In vivo adhesions between cells and the extracellular matrix play a crucial role in cell differentiation, proliferation, and migration as well as tissue remodeling. Natural three-dimensional (3D) matrices, such as self-assembling matrices and Matrigel, have limitations in terms of their biomechanical properties. Here, we present a simple method to produce an acellular human amniotic matrix (AHAM) with preserved biomechanical properties and a favorable adhesion potential. On the stromal side o...

  2. Osteogenic differentiation of amniotic epithelial cells: synergism of pulsed electromagnetic field and biochemical stimuli

    OpenAIRE

    Wang, Qian; Wu, Wenchao; Han, Xiaoyu; Zheng, Ai; Lei, Song; Wu, Jiang; Chen, Huaiqing; He, Chengqi; Luo, Fengming; Liu, Xiaojing

    2014-01-01

    Background Pulsed electromagnetic field (PEMF) is a non-invasive physical therapy used in the treatment of fracture nonunion or delayed healing. PEMF can facilitate the osteogenic differentiation of bone marrow mesenchymal stem cells in vitro. Amniotic epithelial cells (AECs) have been proposed as a potential source of stem cells for cell therapy. However, whether PEMF could modulate the osteogenic differentiation of AECs is unknown. In the present study, the effects of PEMF on the osteogenic...

  3. Characteristics of human amniotic fluid mesenchymal stem cells and their tropism to human ovarian cancer.

    Directory of Open Access Journals (Sweden)

    Liru Li

    Full Text Available The mesenchymal stem cells (MSCs derived from amniotic fluid (AF have become an attractive stem cells source for cell-based therapy because they can be harvested at low cost and avoid ethical disputes. In human research, stem cells derived from AF gradually became a hot research direction for disease treatment, specifically for their plasticity, their reduced immunogenicity and their tumor tropism regardless of the tumor size, location and source. Our work aimed to obtain and characterize human amniotic fluid mesenchymal stem cells (AFMSCs and detect their ovarian cancer tropsim in nude mice model. Ten milliliters of twenty independent amniotic fluid samples were collected from 16-20 week pregnant women who underwent amniocentesis for fetal genetic determination in routine prenatal diagnosis in the first affiliated hospital of Harbin medical university. We successfully isolated the AFMSCs from thirteen of twenty amniotic fluid samples. AFMSCs presented a fibroblastic-like morphology during the culture. Flow cytometry analyses showed that the cells were positive for specific stem cell markers CD73,CD90, CD105, CD166 and HLA-ABC (MHC class I, but negative for CD 45,CD40, CD34, CD14 and HLA-DR (MHC class II. RT-PCR results showed that the AFMSCs expressed stem cell marker OCT4. AFMSCs could differentiate into bone cells, fat cells and chondrocytes under certain conditions. AFMSCs had the high motility to migrate to ovarian cancer site but didn't have the tumorigenicity. This study enhances the possibility of AFMSCs as drug carrier in human cell-based therapy. Meanwhile, the research emphasis in the future can also put in targeting therapy of ovarian cancer.

  4. Amniotic tissue transplantation as a trial of treatment in some lysosomal storage diseases.

    Science.gov (United States)

    Tylki-Szymańska, A; Maciejko, D; Kidawa, M; Jabłońska-Budaj, U; Czartoryska, B

    1985-01-01

    This communication reports the clinical and biochemical results in six patients: four with mucopolysaccharidosis, one with GM1 gangliosidosis (Morquio B) and one with I-cell disease, who were treated by amniotic tissue transplantation. The sole evident clinical result was the diminishing of corneal clouding in three cases. A slight increase of beta-galactosidase activity in one patient's plasma was observed. The time of improvement was about 2 months after the transplantation and was transitory.

  5. Committee Opinion No.689 Summary: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.

    Science.gov (United States)

    2017-03-01

    In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. However, the 2005 guidelines did support intubation of the trachea and suctioning of meconium or other aspirated material from beneath the glottis in nonvigorous newborns. In 2015, the guidelines were updated. Routine intubation and tracheal suctioning are no longer required. If the infant is vigorous with good respiratory effort and muscle tone, the infant may stay with the mother to receive the initial steps of newborn care. If the infant born through meconium-stained amniotic fluid presents with poor muscle tone and inadequate breathing efforts, the initial steps of resuscitation should be completed under the radiant warmer. Appropriate intervention to support ventilation and oxygenation should be initiated as indicated for each infant. Infants with meconium-stained amniotic fluid should no longer routinely receive intrapartum suctioning, whether they are vigorous or not. In addition, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation. Resuscitation should follow the same principles for infants with meconium-stained fluid as for those with clear fluid.

  6. RESPIRATORY PROBLEMS IN NEWBORNS ASSOCIATED WITH MECONIUM-STAINED AMNIOTIC FLUID

    OpenAIRE

    Sudha Menon

    2017-01-01

    BACKGROUND Perinatal morbidity and mortality resulting from aspiration of Meconium-Stained Amniotic Fluid (MSAF) is due to the respiratory problems ranging from mild respiratory distress to meconium aspiration syndrome and meconium pneumonitis. The aim of the study is to define the respiratory problems and to identify the determinants of respiratory distress in babies born through light, moderate and thick MSAF. MATERIALS AND METHODS This was a prospective observational st...

  7. Committee Opinion No 689: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.

    Science.gov (United States)

    2017-03-01

    In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. However, the 2005 guidelines did support intubation of the trachea and suctioning of meconium or other aspirated material from beneath the glottis in nonvigorous newborns. In 2015, the guidelines were updated. Routine intubation and tracheal suctioning are no longer required. If the infant is vigorous with good respiratory effort and muscle tone, the infant may stay with the mother to receive the initial steps of newborn care. If the infant born through meconium-stained amniotic fluid presents with poor muscle tone and inadequate breathing efforts, the initial steps of resuscitation should be completed under the radiant warmer. Appropriate intervention to support ventilation and oxygenation should be initiated as indicated for each infant. Infants with meconium-stained amniotic fluid should no longer routinely receive intrapartum suctioning, whether they are vigorous or not. In addition, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation. Resuscitation should follow the same principles for infants with meconium-stained fluid as for those with clear fluid.

  8. Characterization of [3H]mazindol binding sites in cultured monkey amniotic epithelial cells.

    Science.gov (United States)

    Elwan, M A; Sakuragawa, N

    2000-01-21

    Our previous studies showed that monkey amniotic epithelial cells (MAEC) synthesize and release catecholamines and possess D1 and D2 dopamine (DA) receptors (Elwan, M.A., Ishii, T., Ono, F. and Sakuragawa, N., Evidence for the presence of dopamine D1 receptor mRNA and binding sites in monkey amniotic epithelial cells. Neurosci. Lett., 262 (1999) 9-12; Elwan, M.A., Ishii, T. and Sakuragawa, N., Detection of dopamine D2 receptor mRNA and binding sites in monkey amniotic epithelial cells. J. Neurosci. Res., 56 (1999) 316-322; Elwan, M.A., Thangavel, R., Ono, F. and Sakuragawa, N., Synthesis and release of catecholamines by cultured monkey amniotic epithelial cells. J. Neurosci. Res., 53 (1998) 107-113). In the present study we tested the presence of DA transporter (DAT) in MAEC using radioligand binding experiments. Saturation studies showed that [3H]mazindol binds to a high affinity site with K(D) and Bmax values of 7.85 +/- 1.25 nM and 123.22 +/- 18.34 fmol/mg protein, respectively. Competition studies indicated that selective DAT inhibitors are potent displacers of [3H]mazindol binding, compared to inhibitors of other types of transporters. The rank order of potency of the competing drugs is consistent with the pharmacology of DAT. These results provide, for the first time, clear evidence that MAEC natively possess DAT binding sites and suggest that MAEC may provide a potential primate cell model to study DA release and uptake processes and to explore new drugs active at this site.

  9. Isolation, Characterization, Cryopreservation of Human Amniotic Stem Cells and Differentiation to Osteogenic and Adipogenic Cells.

    Directory of Open Access Journals (Sweden)

    Shiva Gholizadeh-Ghaleh Aziz

    Full Text Available Human stem cells and progenitor cells can be used to treat cancer and replace dysfunctional cells within a tissue or organ. The objective of this study was to identify the appropriate cells type in regenerative medicine and targeted therapy. As an alternative to embryonic and bone marrow stem cells, we examined human amniotic fluid stem cells (hAFSCs, one of the potential source of multipotent stem cells isolated from both cell pellet (using single-stage method, and supernatant of human amniotic fluid. Source of isolation and unique property of the cells emphasize that these cells are one of the promising new tools in therapeutic field. Double sources for isolation and availability of the left over samples in diagnostic laboratory at the same time have less legal and ethical concerns compared with embryonic stem cell studies. Cells were isolated, cultured for 18th passage for 6 months and characterized using qPCR and flow cytometry. Cells showed good proliferative ability in culture condition. The cells successfully differentiated into the adipogenic and osteogenic lineages. Based on these findings, amniotic fluid can be considered as an appropriate and convenient source of human amniotic fluid stem cells. These cells provide potential tools for therapeutic applications in the field of regenerative medicine. To get a better understanding of crosstalk between Oct4/NANOG with osteogenesis and adipogenesis, we used network analysis based on Common Targets algorithm and Common Regulators algorithm as well as subnetwork discovery based on gene set enrichment. Network analysis highlighted the possible role of MIR 302A and MIR let-7g. We demonstrated the high expression of MIR 302A and low expression of MIR let7g in hAFSCs by qPCR.

  10. [Cultivation of amniotic fluid cells for the purpose of diagnosing certain metabolic diseases].

    Science.gov (United States)

    Zolotukhina, T V; Tsvetkova, I V

    1980-03-01

    A method for preparing amniotic fluid cell culture has been developed. The optimal conditions for the culture involved the incubation period averaging 17.9 days. Normal activity values were obtained for 8 glycosidases whose deficiency is responsible for the development of hereditary accumulation diseases. The data obtained allow a prenatal diagnosis of glycolipidoses (Tay-Sachs, Fabrys, Gaucher's diseases, etc.). The evidence on prenatal diagnosis of Tay-Sach's disease is presented.

  11. Characteristics of human amniotic fluid mesenchymal stem cells and their tropism to human ovarian cancer.

    Science.gov (United States)

    Li, Liru; Wang, Dejun; Zhou, Jun; Cheng, Yan; Liang, Tian; Zhang, Guangmei

    2015-01-01

    The mesenchymal stem cells (MSCs) derived from amniotic fluid (AF) have become an attractive stem cells source for cell-based therapy because they can be harvested at low cost and avoid ethical disputes. In human research, stem cells derived from AF gradually became a hot research direction for disease treatment, specifically for their plasticity, their reduced immunogenicity and their tumor tropism regardless of the tumor size, location and source. Our work aimed to obtain and characterize human amniotic fluid mesenchymal stem cells (AFMSCs) and detect their ovarian cancer tropsim in nude mice model. Ten milliliters of twenty independent amniotic fluid samples were collected from 16-20 week pregnant women who underwent amniocentesis for fetal genetic determination in routine prenatal diagnosis in the first affiliated hospital of Harbin medical university. We successfully isolated the AFMSCs from thirteen of twenty amniotic fluid samples. AFMSCs presented a fibroblastic-like morphology during the culture. Flow cytometry analyses showed that the cells were positive for specific stem cell markers CD73,CD90, CD105, CD166 and HLA-ABC (MHC class I), but negative for CD 45,CD40, CD34, CD14 and HLA-DR (MHC class II). RT-PCR results showed that the AFMSCs expressed stem cell marker OCT4. AFMSCs could differentiate into bone cells, fat cells and chondrocytes under certain conditions. AFMSCs had the high motility to migrate to ovarian cancer site but didn't have the tumorigenicity. This study enhances the possibility of AFMSCs as drug carrier in human cell-based therapy. Meanwhile, the research emphasis in the future can also put in targeting therapy of ovarian cancer.

  12. Therapeutic effect of human amniotic epithelial cell transplantation into the lateral ventricle of hemiparkinsonian rats.

    Science.gov (United States)

    Yang, Xin-xin; Xue, Shou-ru; Dong, Wan-li; Kong, Yan

    2009-10-20

    Human amniotic epithelial cells (HAECs) are able to secrete biologically active neurotrophins such as brain-derived neurotrophic factor and neurotrophin-3, both of which exhibit trophic activities on dopamine neurons. Previous study showed that when human amniotic epithelial cells were transplanted into the striatum of 6-hydroxydopamine (6-OHDA)-induced Parkinson disease rats, the cells could survive and exert functional effects. The purpose of this study was to investigate the survival and the differentiation of human amniotic epithelial cells after being transplanted into the lateral ventricle of Parkinson's disease (PD) rats, and to investigate the effects of grafts on healing PD in models. The Parkinson's model was made with stereotactic microinjection of 6-hydroxydopamine (6-OHDA) into the striatum of a rat. The PD models were divided into two groups: the HAECs group and the normal saline (NS) group. Some untreated rats were taken as the control. The rotational asymmetry induced by apomorphine of the HAECs group and the NS group were measured post cell transplantation. The expression of nestin and vimentin in grafts were determined by immunohistology. Ten weeks after transplantation the density of tyrosine hydroxylase positive cells in the substantia nigra of the HAECs group, NS group and the untreated group was determined. The differentiation of grafts was determined by TH immunohistology. High performance liquid chromatography (HPLC) was used to determine monoamine neurotransmitter levels in the striatum. The rotational asymmetry induced by apomorphine of the HAECs group was ameliorated significantly compared to the NS group two weeks after transplantation (P Human amniotic epithelial cells could be used to ameliorate the rotational asymmetry induced by apomorphine of the PD models. This could have been due to the increased content of dopamine and its metabolic products, DOPAC and HVA, in the striatum in the PD models.

  13. Borderline amniotic fluid index and perinatal outcomes in the uncomplicated term pregnancy.

    Science.gov (United States)

    Choi, Soo Ran

    2016-01-01

    To determine perinatal outcomes in uncomplicated term pregnancies with a borderline amniotic fluid index (AFI). A retrospective review was conducted of uncomplicated singleton pregnancies at term (>37 weeks). Borderline and normal AFI were defined as 5.1 ≤ AFI ≤ 8.0 cm and 8.1 ≤ AFI ≤ 24 cm, respectively. Adverse perinatal outcomes, cesarean delivery for non-reassuring fetal heart rate testing, meconium-stained amniotic fluid, a 5-min Apgar score of borderline and normal AFI groups. Borderline AFI was not significantly associated with cesarean delivery for non-reassuring fetal heart rate testing (p = 0.513), meconium-stained amniotic fluid (p = 0.641), admission to the NICU (p = 0.368), or a 5-min Apgar score of borderline group. Multiple logistic regression analysis showed that borderline AFI was not associated with cesarean delivery for non-reassuring fetal heart rate testing (odds ratio [OR] = 0.72, 95% confidence interval [CI] 0.27-1.91, p = 0.52). In uncomplicated term pregnancies, a borderline AFI does not increase the risk of adverse perinatal outcomes.

  14. A microfluidic device for separation of amniotic fluid mesenchymal stem cells utilizing louver-array structures.

    Science.gov (United States)

    Wu, Huei-Wen; Lin, Xi-Zhang; Hwang, Shiaw-Min; Lee, Gwo-Bin

    2009-12-01

    Human mesenchymal stem cells can differentiate into multiple lineages for cell therapy and, therefore, have attracted considerable research interest recently. This study presents a new microfluidic device for bead and cell separation utilizing a combination of T-junction focusing and tilted louver-like structures. For the first time, a microfluidic device is used for continuous separation of amniotic stem cells from amniotic fluids. An experimental separation efficiency as high as 82.8% for amniotic fluid mesenchymal stem cells is achieved. Furthermore, a two-step separation process is performed to improve the separation efficiency to 97.1%. These results are based on characterization experiments that show that this microfluidic chip is capable of separating beads with diameters of 5, 10, 20, and 40 microm by adjusting the volume-flow-rate ratio between the flows in the main and side channels of the T-junction focusing structure. An optimal volume-flow-rate ratio of 0.5 can lead to high separation efficiencies of 87.8% and 85.7% for 5-microm and 10-microm beads, respectively, in a one-step separation process. The development of this microfluidic chip may be promising for future research into stem cells and for cell therapy.

  15. Amniotic fluid volume: Rapid MR-based assessment at 28-32 weeks gestation

    Energy Technology Data Exchange (ETDEWEB)

    Hilliard, N.J.; Hawkes, R.; Patterson, A.J.; Graves, M.J.; Priest, A.N.; Hunter, S.; Set, P.A.; Lomas, D.J. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Lees, C. [Imperial College Healthcare NHS Trust, Department of Obstetrics and Fetal Medicine, London (United Kingdom)

    2016-10-15

    This work evaluates rapid magnetic resonance projection hydrography (PH) based amniotic fluid volume (AFV) estimates against established routine ultrasound single deepest vertical pocket (SDVP) and amniotic fluid index (AFI) measurements, in utero at 28-32 weeks gestation. Manual multi-section planimetry (MSP) based measurement of AFV is used as a proxy reference standard. Thirty-five women with a healthy singleton pregnancy (20-41 years) attending routine antenatal ultrasound were recruited. SDVP and AFI were measured using ultrasound, with same day MRI assessing AFV with PH and MSP. The relationships between the respective techniques were assessed using linear regression analysis and Bland-Altman method comparison statistics. When comparing estimated AFV, a highly significant relationship was observed between PH and the reference standard MSP (R{sup 2} = 0.802, p < 0.001). For the US measurements, SDVP measurement related most closely to amniotic fluid volume, (R{sup 2} = 0.470, p < 0.001), with AFI demonstrating a weaker relationship (R{sup 2} = 0.208, p = 0.007). This study shows that rapid MRI based PH measurement is a better predictor of AFV, relating more closely to our proxy standard than established US techniques. Although larger validation studies across a range of gestational ages are required this approach could form part of MR fetal assessment, particularly where poly- or oligohydramnios is suspected. (orig.)

  16. Evaluation of two real time PCR assays for the detection of bacterial DNA in amniotic fluid.

    Science.gov (United States)

    Girón de Velasco-Sada, Patricia; Falces-Romero, Iker; Quiles-Melero, Inmaculada; García-Perea, Adela; Mingorance, Jesús

    2018-01-01

    The aim of this study was to evaluate two non-commercial Real-Time PCR assays for the detection of microorganisms in amniotic fluid followed by identification by pyrosequencing. We collected 126 amniotic fluids from 2010 to 2015 for the evaluation of two Real-Time PCR assays for detection of bacterial DNA in amniotic fluid (16S Universal PCR and Ureaplasma spp. specific PCR). The method was developed in the Department of Microbiology of the University Hospital La Paz. Thirty-seven samples (29.3%) were positive by PCR/pyrosequencing and/or culture, 4 of them were mixed cultures with Ureaplasma urealyticum. The Universal 16S Real-Time PCR was compared with the standard culture (81.8% sensitivity, 97.4% specificity, 75% positive predictive value, 98% negative predictive value). The Ureaplasma spp. specific Real-Time PCR was compared with the Ureaplasma/Mycoplasma specific culture (92.3% sensitivity, 89.4% specificity, 50% positive predictive value, 99% negative predictive value) with statistically significant difference (p=0.005). Ureaplasma spp. PCR shows a rapid response time (5h from DNA extraction until pyrosequencing) when comparing with culture (48h). So, the response time of bacteriological diagnosis in suspected chorioamnionitis is reduced. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The epithelial mesenchymal transition process may contribute to the pathogenesis of amniotic band syndrome.

    Science.gov (United States)

    Romero-Valdovinos, M; Bobadilla-Sandoval, N; Flisser, A; Vadillo-Ortega, F

    2014-09-01

    The etiology of the amniotic band syndrome is unknown, and has been subject of debate since the time of Hippocrates. The most accepted theories fail to cover all the abnomalities found in affected children. During organogenesis the epithelial-mesenchymal transition process (EMTP) participates in adequate formation of different organs from three embryo layers. Altered activation of EMTP occurs when the epithelial homeostasis is disturbed, the resulting myofibroblasts are able to secrete extracellular matrix proteins and deposit them on the tissues contributing to a fibrotic phenotype. If injury occurs during organogenesis, wound healing could be exaggerated and fibrotic response could be triggered. The molecule that regulates both of these processes (EMTP and fibrosis) is the transforming growth factor β (TGFβ); indeed null animals for TGFβ isoforms show similar defects than those seen in the amniotic band syndrome. Based on documented evidence this review intends to explain how the epithelial mesenchymal transition process may contribute to the pathogenesis of amniotic band syndrome. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Maternal Plasma and Amniotic Fluid Chemokines Screening in Fetal Down Syndrome

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    Piotr Laudanski

    2014-01-01

    Full Text Available Objective. Chemokines exert different inflammatory responses which can potentially be related to certain fetal chromosomal abnormalities. The aim of the study was to determine the concentration of selected chemokines in plasma and amniotic fluid of women with fetal Down syndrome. Method. Out of 171 amniocentesis, we had 7 patients with confirmed fetal Down syndrome (15th–18th weeks of gestation. For the purpose of our control, we chose 14 women without confirmed chromosomal aberration. To assess the concentration of chemokines in the blood plasma and amniotic fluid, we used a protein macroarray, which allows the simultaneous determination of 40 chemokines per sample. Results. We showed significant decrease in the concentration of 4 chemokines, HCC-4, IL-28A, IL-31, and MCP-2, and increase in the concentration of CXCL7 (NAP-2 in plasma of women with fetal Down syndrome. Furthermore, we showed decrease in concentration of 3 chemokines, ITAC, MCP-3, MIF, and increase in concentration of 4 chemokines, IP-10, MPIF-1, CXCL7, and 6Ckine, in amniotic fluid of women with fetal Down syndrome. Conclusion. On the basis of our findings, our hypothesis is that the chemokines may play role in the pathogenesis of Down syndrome. Defining their potential as biochemical markers of Down syndrome requires further investigation on larger group of patients.

  19. Anti-inflammatory Elafin in human fetal membranes.

    Science.gov (United States)

    Stalberg, Cecilia; Noda, Nathalia; Polettini, Jossimara; Jacobsson, Bo; Menon, Ramkumar

    2017-02-01

    Elafin is a low molecular weight protein with antileukoproteinase, anti-inflammatory, antibacterial and immunomodulating properties. The profile of Elafin in fetal membranes is not well characterized. This study determined the changes in Elafin expression and concentration in human fetal membrane from patients with preterm prelabor rupture of membranes (PPROM) and in vitro in response to intra-amniotic polymicrobial pathogens. Elafin messenger RNA (mRNA) expressions were studied in fetal membranes from PPROM, normal term as well as in normal term not in labor membranes in an organ explant system treated (24 h) with lipopolysaccharide (LPS), using quantitative reverse transcription-polymerase chain reaction (RT-PCR). Enzyme-linked immunosorbent assay (ELISA) measured Elafin concentrations in culture supernatants from tissues treated with LPS and polybacterial combinations of heat-inactivated Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Gardnerella vaginalis (GV). Elafin mRNA expression in fetal membranes from women with PPROM was significantly higher compared to women who delivered at term after normal pregnancy (5.09±3.50 vs. 11.71±2.21; Pmembranes showed a significantly increased Elafin m-RNA expression (Pmembranes also showed no changes in Elafin protein concentrations compared to untreated controls. Higher Elafin expression in PPROM fetal membranes suggests a host response to an inflammatory pathology. However, lack of Elafin response to LPS and polymicrobial treatment is indicative of the minimal anti-inflammatory impact of this molecule in fetal membranes.

  20. Surgical induced astigmatism correlated with corneal pachymetry and intraocular pressure: transconjunctival sutureless 23-gauge versus 20-gauge sutured vitrectomy in diabetes mellitus.

    Science.gov (United States)

    Shao, Yan; Dong, Li-Jie; Zhang, Yan; Liu, Hui; Hu, Bo-Jie; Liu, Ju-Ping; Li, Xiao-Rong

    2015-01-01

    To determine the difference of surgical induced astigmatism between conventional 20-gauge sutured vitrectomy and 23-gauge transconjunctival sutureless vitrectomy, and the influence of corneal pachymetry and intraocular pressure (IOP) on surgical induced astigmatism in diabetic patients. This retrospective, consecutive case series consisted of 40 eyes of 38 diabetic subjects who underwent either 20-gauge or 23-gauge vitrectomy. The corneal curvature and thickness were measured with Scheimpflug imaging before surgery and 1wk; 1, 3mo after surgery. We compared the surgical induced astigmatism (SIA) on the true net power in 23-gauge group with that in 20-gauge group. We determined the correlation between corneal thickness change ratio, IOP and SIA measured by Pentacam. The mean SIAs were 1.082±0.085 D (mean±SEM), 0.689±0.070 D and 0.459±0.063 D at postoperative 1wk; 1, 3mo respectively in diabetic subjects. The vitrectomy induced astigmatisms were declined significantly with time (F 2,36=33.629, P=0.000) postoperatively. The 23-gauge surgery group induced significantly less astigmatism than 20-gauge surgery group (F -1,37=11.046, P=0.020). Corneal thickness in diabetes elevated after surgery (F 3,78=10.532, P=0.000). The linear regression analysis at postoperatively 1wk went as: SIA=-4.519+4.931 change ratio (Port3) +0.026 IOP (R(2)=0.46, P=0.000), whereas the rate of corneal thickness change and IOP showed no correlation with the change of astigmatism at postoperatively 1 and 3mo. There are significant serial changes in both 20-gauge and 23-gauge group in diabetic subjects. 23-gauge induce less astigmatism than 20-gauge and become stable more rapidly than 20-gauge. The elevation of corneal thickness and IOP was associated with increased astigmatim at the early postoperative stage both in 23-gauge and 20-gauge surgery group.

  1. "Birdlime" technique using TachoSil tissue sealing sheet soaked with fibrin glue for sutureless vessel transposition in microvascular decompression: operative technique and nuances.

    Science.gov (United States)

    Otani, Naoki; Toyooka, Terushige; Fujii, Kazuya; Kumagai, Kosuke; Takeuchi, Satoru; Tomiyama, Arata; Nakao, Yasuaki; Yamamoto, Takuji; Wada, Kojiro; Mori, Kentaro

    2017-08-11

    , or dysfunction of the cranial nerves was observed in any of the patients. Postoperative MRI showed that the offending vessels were displaced and fixed in the appropriate position. CONCLUSIONS The described transposition technique provides an easy and adjustable way to perform MVD safely and effectively. In addition, this transposition and fixation technique is simple and avoids the risk of needle injury close to the cranial nerves and vessels. This simple sutureless technique is recommended for MVD to reduce the risk of intraoperative neurovascular injury.

  2. RESPIRATORY PROBLEMS IN NEWBORNS ASSOCIATED WITH MECONIUM-STAINED AMNIOTIC FLUID

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    Sudha Menon

    2017-04-01

    Full Text Available BACKGROUND Perinatal morbidity and mortality resulting from aspiration of Meconium-Stained Amniotic Fluid (MSAF is due to the respiratory problems ranging from mild respiratory distress to meconium aspiration syndrome and meconium pneumonitis. The aim of the study is to define the respiratory problems and to identify the determinants of respiratory distress in babies born through light, moderate and thick MSAF. MATERIALS AND METHODS This was a prospective observational study conducted in a university tertiary maternity care institute in Kerala. 150 term pregnancies with meconium-stained amniotic fluid were selected of which 50 cases were each of light, moderate and thick meconium staining. RESULTS Meconium-stained amniotic fluid was seen frequently in the age group between 20-25 years age than above age of 25 years (p<0.0001. Post-dated pregnancies and pregnancies complicated by pregnancy-induced hypertension and anaemia also showed a trend in increase occurrence of meconium-stained liquor. Severe birth asphyxia as indicated by Apgar score of <3 was seen in 72.7% of thick meconium staining compared to 18.2% and 9.1% with moderate and light staining of meconium (P=0.004. Respiratory distress in newborn was severe (meconium aspiration syndrome in babies with thick meconium staining (80% compared to 15% with moderate meconium and 5% with light meconium staining (P<0.0001. The hazard ratio for death was 8 times higher with meconium aspiration syndrome compared to newborns with aspiration of moderate or light meconium-stained amniotic fluid aspiration. The odds ratio was also very high with aspiration of thick meconium-stained amniotic fluid than the other groups (OR 11.43; 95%, CI 1.33 to 98.35; Z statistic 2.22; P=0.03. CONCLUSION Meconium staining of the liquor is an important warning signal of foetal distress and the likelihood is increased if associated with alterations in the foetal heart rate. Increased morbidity and mortality was found with

  3. Impedance-matching hearing in Paleozoic reptiles: evidence of advanced sensory perception at an early stage of amniote evolution.

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    Johannes Müller

    Full Text Available BACKGROUND: Insights into the onset of evolutionary novelties are key to the understanding of amniote origins and diversification. The possession of an impedance-matching tympanic middle ear is characteristic of all terrestrial vertebrates with a sophisticated hearing sense and an adaptively important feature of many modern terrestrial vertebrates. Whereas tympanic ears seem to have evolved multiple times within tetrapods, especially among crown-group members such as frogs, mammals, squamates, turtles, crocodiles, and birds, the presence of true tympanic ears has never been recorded in a Paleozoic amniote, suggesting they evolved fairly recently in amniote history. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, we performed a morphological examination and a phylogenetic analysis of poorly known parareptiles from the Middle Permian of the Mezen River Basin in Russia. We recovered a well-supported clade that is characterized by a unique cheek morphology indicative of a tympanum stretching across large parts of the temporal region to an extent not seen in other amniotes, fossil or extant, and a braincase specialized in showing modifications clearly related to an increase in auditory function, unlike the braincase of any other Paleozoic tetrapod. In addition, we estimated the ratio of the tympanum area relative to the stapedial footplate for the basalmost taxon of the clade, which, at 23:1, is in close correspondence to that of modern amniotes capable of efficient impedance-matching hearing. CONCLUSIONS/SIGNIFICANCE: Using modern amniotes as analogues, the possession of an impedance-matching middle ear in these parareptiles suggests unique ecological adaptations potentially related to living in dim-light environments. More importantly, our results demonstrate that already at an early stage of amniote diversification, and prior to the Permo-Triassic extinction event, the complexity of terrestrial vertebrate ecosystems had reached a level that

  4. Impedance-matching hearing in Paleozoic reptiles: evidence of advanced sensory perception at an early stage of amniote evolution.

    Science.gov (United States)

    Müller, Johannes; Tsuji, Linda A

    2007-09-12

    Insights into the onset of evolutionary novelties are key to the understanding of amniote origins and diversification. The possession of an impedance-matching tympanic middle ear is characteristic of all terrestrial vertebrates with a sophisticated hearing sense and an adaptively important feature of many modern terrestrial vertebrates. Whereas tympanic ears seem to have evolved multiple times within tetrapods, especially among crown-group members such as frogs, mammals, squamates, turtles, crocodiles, and birds, the presence of true tympanic ears has never been recorded in a Paleozoic amniote, suggesting they evolved fairly recently in amniote history. In the present study, we performed a morphological examination and a phylogenetic analysis of poorly known parareptiles from the Middle Permian of the Mezen River Basin in Russia. We recovered a well-supported clade that is characterized by a unique cheek morphology indicative of a tympanum stretching across large parts of the temporal region to an extent not seen in other amniotes, fossil or extant, and a braincase specialized in showing modifications clearly related to an increase in auditory function, unlike the braincase of any other Paleozoic tetrapod. In addition, we estimated the ratio of the tympanum area relative to the stapedial footplate for the basalmost taxon of the clade, which, at 23:1, is in close correspondence to that of modern amniotes capable of efficient impedance-matching hearing. Using modern amniotes as analogues, the possession of an impedance-matching middle ear in these parareptiles suggests unique ecological adaptations potentially related to living in dim-light environments. More importantly, our results demonstrate that already at an early stage of amniote diversification, and prior to the Permo-Triassic extinction event, the complexity of terrestrial vertebrate ecosystems had reached a level that proved advanced sensory perception to be of notable adaptive significance.

  5. The Effects of Intravenous Hydration on Amniotic Fluid Volume and Pregnancy Outcomes in Women with Term Pregnancy and Oligohydramnios: A Randomized Clinical Trial

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    Mahnaz Shahnazi

    2012-08-01

    Full Text Available Introduction: Amniotic fluid is an important factor in the prediction of fetal survival. The aim of this research was to evaluate the effects of intravenous hydration of mothers on amniotic fluid volume and in turn on pregnancy outcomes. Methods: The current single blind controlled clinical trial was conducted on 20 pregnant mothers with amniot-ic fluid index of lower or equal to 5 cm and gestational age of 37-41 weeks. The subjects were divided into two groups of case and control through simple random sampling. Am-niotic fluid index was measured in all participants. The case group received one liter of isotonic saline during 30 minutes by the bolus method. Reevaluations of amniotic fluid index in both groups were made 90 minutes after baseline measurement. Independent t-test and paired t-test were used to compare the two groups and mean amniotic fluid in-dex before and after treatment, respectively. Results: Hydration of mothers significantly increased the amniotic fluid index in the case group (mean change: 1.5 cm; 95%CI: 0.46 - 2.64; P = 0.01. The mean change of amniotic fluid index in the control group did not significantly increase (P = 0.06. The elevation of amniotic fluid index in the hydra-tion group (32% was significantly higher than the control group (1% (P = 0.03. Conclusion: In this study intravenous hydration increased amniotic fluid index of mothers with term pregnancy and oligohydramnios. Since it caused no complications for the moth-er and the fetus, it can be used as an effective method in management of oligohydramnios.

  6. Retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy Cirurgia de descolamento de retina com injeção de óleo de silicone no sistema de vitrectomia transconjuntival sem sutura de 23-gauge

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    Rubens Camargo Siqueira

    2007-12-01

    Full Text Available PURPOSE: To report a surgical technique for retinal detachment surgery using transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection. METHODS: Thirty-one patients with retinal detachment underwent vitreoretinal surgery using a transconjunctival sutureless 23-gauge vitrectomy system. At the end of the procedure silicone oil was injected into all eyes through a microcannula. After removing the microcannula, a bipolar cautery was used in the conjunctiva over the wound to prevent silicone oil reflux. RESULTS: In all patients retinal reattachment and injection of silicone oil through transconjunctival sutureless 23-gauge vitrectomy system was possible. Retinal re-detachment occurred in 8 patients (25.80% who were submitted to a new vitreoretinal surgery by the technique described above, however, more extensive retinotomy was necessary in all cases, specially inferiorly. Three patients (9.67% presented silicone oil leakage in subconjuntival compartment. Another surgical procedure was necessary to remove the subconjuntival silicone oil. CONCLUSIONS: The retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy is a safe and efficient technique to repair retinal detachment and it has the advantage of being minimally invasive.OBJETIVOS: Relatar técnica cirúrgica para descolamento de retina utilizando sistema de 23-gauge com injeção de óleo de silicone. MÉTODOS: Trinta e um pacientes com descolamento da retina foram submetidos a cirurgia vitreorretiniana usando o sistema 23-gauge de vitrectomia transconjuntival sem sutura. Ao final do procedimento o óleo de silicone foi injetado em todos os olhos através de uma microcânula. Após a retirada da microcânula, foi utilizado cautério bipolar na incisão conjuntival para prevenir o vazamento do óleo de silicone. RESULTADOS: Em todos os pacientes foi possível reaplicar a retina e injetar o óleo de silicone através do sistema 23

  7. Membrane paradigm

    International Nuclear Information System (INIS)

    Price, R.H.; Thorne, K.S.

    1986-01-01

    The membrane paradigm is a modified frozen star approach to modeling black holes, with particles and fields assuming a complex, static, boundary-layer type structure (membrane) near the event horizon. The membrane has no effects on the present or future evolution of particles and fields above itself. The mathematical representation is a combination of a formalism containing terms for the shear and bulk viscosity, surface pressure, momentum, temperature, entropy, etc., of the horizon and the 3+1 formalism. The latter model considers a family of three-dimensional spacelike hypersurfaces in one-dimensional time. The membrane model considers a magnetic field threading the hole and undergoing torque from the hole rotation. The field is cleaned by the horizon and distributed over the horizon so that ohmic dissipation is minimized. The membrane paradigm is invalid inside the horizon, but is useful for theoretically probing the properties of slowly evolving black holes

  8. Membrane processes

    Science.gov (United States)

    Staszak, Katarzyna

    2017-11-01

    The membrane processes have played important role in the industrial separation process. These technologies can be found in all industrial areas such as food, beverages, metallurgy, pulp and paper, textile, pharmaceutical, automotive, biotechnology and chemical industry, as well as in water treatment for domestic and industrial application. Although these processes are known since twentieth century, there are still many studies that focus on the testing of new membranes' materials and determining of conditions for optimal selectivity, i. e. the optimum transmembrane pressure (TMP) or permeate flux to minimize fouling. Moreover the researchers proposed some calculation methods to predict the membrane processes properties. In this article, the laboratory scale experiments of membrane separation techniques, as well their validation by calculation methods are presented. Because membrane is the "heart" of the process, experimental and computational methods for its characterization are also described.

  9. Second trimester amniotic fluid myo-inositol concentrations in women later developing gestational diabetes mellitus or pregnancy-induced hypertension.

    Science.gov (United States)

    Santamaria, Angelo; Corrado, Francesco; Baviera, Giovanni; Carlomagno, Gianfranco; Unfer, Vittorio; D'anna, Rosario

    2016-01-01

    To evaluate myo-inositol concentrations in amniotic fluid in women later developing gestational diabetes and hypertension. A retrospective study was carried out with three groups of amniotic fluid samples (15-18 gestational weeks): 30 gestational hypertension pregnancies, 30 gestational diabetes pregnancies, and 30 normal pregnancy. A significant difference was observed in myo-inositol concentrations between the median gestational diabetes values (124.0 µmol/L, IQR 90.0-162.5) and the control group values (79.0 µmol/L, IQR 62.0-107.5), but also with gestational hypertension median values (79.0 µmol/L, IQR 67.75-92.0) (p inositol concentrations in amniotic fluid increased significantly in women later developing gestational diabetes compared to the control group.

  10. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery

    Science.gov (United States)

    Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    Objective The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. Methods This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14–19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. Results The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6–36+6) weeks in women with spontaneous PTD and 40+0 (39+1–40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Conclusions Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA. PMID:27214132

  11. Identification of a novel Gig2 gene family specific to non-amniote vertebrates.

    Directory of Open Access Journals (Sweden)

    Yi-Bing Zhang

    Full Text Available Gig2 (grass carp reovirus (GCRV-induced gene 2 is first identified as a novel fish interferon (IFN-stimulated gene (ISG. Overexpression of a zebrafish Gig2 gene can protect cultured fish cells from virus infection. In the present study, we identify a novel gene family that is comprised of genes homologous to the previously characterized Gig2. EST/GSS search and in silico cloning identify 190 Gig2 homologous genes in 51 vertebrate species ranged from lampreys to amphibians. Further large-scale search of vertebrate and invertebrate genome databases indicate that Gig2 gene family is specific to non-amniotes including lampreys, sharks/rays, ray-finned fishes and amphibians. Phylogenetic analysis and synteny analysis reveal lineage-specific expansion of Gig2 gene family and also provide valuable evidence for the fish-specific genome duplication (FSGD hypothesis. Although Gig2 family proteins exhibit no significant sequence similarity to any known proteins, a typical Gig2 protein appears to consist of two conserved parts: an N-terminus that bears very low homology to the catalytic domains of poly(ADP-ribose polymerases (PARPs, and a novel C-terminal domain that is unique to this gene family. Expression profiling of zebrafish Gig2 family genes shows that some duplicate pairs have diverged in function via acquisition of novel spatial and/or temporal expression under stresses. The specificity of this gene family to non-amniotes might contribute to a large extent to distinct physiology in non-amniote vertebrates.

  12. Life History Traits, Protein Evolution, and the Nearly Neutral Theory in Amniotes.

    Science.gov (United States)

    Figuet, Emeric; Nabholz, Benoît; Bonneau, Manon; Mas Carrio, Eduard; Nadachowska-Brzyska, Krystyna; Ellegren, Hans; Galtier, Nicolas

    2016-06-01

    The nearly neutral theory of molecular evolution predicts that small populations should accumulate deleterious mutations at a faster rate than large populations. The analysis of nonsynonymous (dN) versus synonymous (dS) substitution rates in birds versus mammals, however, has provided contradictory results, questioning the generality of the nearly neutral theory. Here we analyzed the impact of life history traits, taken as proxies of the effective population size, on molecular evolutionary and population genetic processes in amniotes, including the so far neglected reptiles. We report a strong effect of species body mass, longevity, and age of sexual maturity on genome-wide patterns of polymorphism and divergence across the major groups of amniotes, in agreement with the nearly neutral theory. Our results indicate that the rate of protein evolution in amniotes is determined in the first place by the efficiency of purifying selection against deleterious mutations-and this is true of both radical and conservative amino acid changes. Interestingly, the among-species distribution of dN/dS in birds did not follow this general trend: dN/dS was not higher in large, long-lived than in small, short-lived species of birds. We show that this unexpected pattern is not due to a more narrow range of life history traits, a lack of correlation between traits and Ne, or a peculiar distribution of fitness effects of mutations in birds. Our analysis therefore highlights the bird dN/dS ratio as a molecular evolutionary paradox and a challenge for future research. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Timing of organogenesis support basal position of turtles in the amniote tree of life.

    Science.gov (United States)

    Werneburg, Ingmar; Sánchez-Villagra, Marcelo R

    2009-04-23

    The phylogenetic position of turtles is the most disputed aspect in the reconstruction of the land vertebrate tree of life. This controversy has arisen after many different kinds and revisions of investigations of molecular and morphological data. Three main hypotheses of living sister-groups of turtles have resulted from them: all reptiles, crocodiles + birds or squamates + tuatara. Although embryology has played a major role in morphological studies of vertebrate phylogeny, data on developmental timing have never been examined to explore and test the alternative phylogenetic hypotheses. We conducted a comprehensive study of published and new embryological data comprising 15 turtle and eight tetrapod species belonging to other taxa, integrating for the first time data on the side-necked turtle clade. The timing of events in organogenesis of diverse character complexes in all body regions is not uniform across amniotes and can be analysed using a parsimony-based method. Changes in the relative timing of particular events diagnose many clades of amniotes and include a phylogenetic signal. A basal position of turtles to the living saurian clades is clearly supported by timing of organogenesis data. The clear signal of a basal position of turtles provided by heterochronic data implies significant convergence in either molecular, adult morphological or developmental timing characters, as only one of the alternative solutions to the phylogenetic conundrum can be right. The development of a standard reference series of embryological events in amniotes as presented here should enable future improvements and expansion of sampling and thus the examination of other hypotheses about phylogeny and patterns of the evolution of land vertebrate development.

  14. Maternal plasma and amniotic fluid sphingolipids profiling in fetal Down syndrome.

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    Karol Charkiewicz

    Full Text Available Sphingolipids can be potentially involved in the formation of the central and peripheral nervous systems, which are particularly connected with the pathogenesis of Down syndrome. The aim of the study was to determine the concentration of selected sphingolipids in the plasma and amniotic fluid of pregnant patients with fetal Down syndrome.Out of 190 amniocentesis we had 10 patients with confirmed Down syndrome. For the purpose of our control we chose 14 women without confirmed chromosomal aberration. To assess the concentration of 11 sphingolipids in the blood plasma and amniotic fluid we used an ultra-high performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC/MS/MS.We showed a significant increase in the concentration of 2 ceramides, C22-Cer and C24:1-Cer, in the plasma of women with fetal Down syndrome. Furthermore we showed a decrease in the concentration of 7 ceramides--C16-Cer, C18-Cer, C18:1-Cer, C20-Cer, C22-Cer, C24:1-Cer, and C24-Cer--in the amniotic fluid of women with fetal Down syndrome. We created ROC curves for all significant sphingolipids in maternal plasma, which set the threshold values and allowed for predicting the likelihood of Down syndrome in the fetus with specific sensitivity and specificity. We demonstrated a significantly higher risk of Down syndrome when the plasma concentration of C22-Cer > 12.66 ng/100 ul (sens. 0.9, sp. 0.79, P value = 0.0007 and C24:1-Cer > 33,19 ng/100 ul (sens. 0.6, sp. 0.86, P value = 0.0194.On the basis of our findings, it seems that the sphingolipids may play a role in the pathogenesis of Down syndrome. Defining their potential as biochemical markers of Down syndrome requires further investigation on a larger group of patients.

  15. Metabolomics of Human Amniotic Fluid and Maternal Plasma during Normal Pregnancy.

    Directory of Open Access Journals (Sweden)

    Magdalena Orczyk-Pawilowicz

    Full Text Available Metabolic profiles of amniotic fluid and maternal blood are sources of valuable information about fetus development and can be potentially useful in diagnosis of pregnancy disorders. In this study, we applied 1H NMR-based metabolic profiling to track metabolic changes occurring in amniotic fluid (AF and plasma (PL of healthy mothers over the course of pregnancy. AF and PL samples were collected in the 2nd (T2 and 3rd (T3 trimester, prolonged pregnancy (PP until time of delivery (TD. A multivariate data analysis of both biofluids reviled a metabolic switch-like transition between 2nd and 3rd trimester, which was followed by metabolic stabilization throughout the rest of pregnancy probably reflecting the stabilization of fetal maturation and development. The differences were further tested using univariate statistics at α = 0.001. In plasma the progression from T2 to T3 was related to increasing levels of glycerol, choline and ketone bodies (3-hydroxybutyrate and acetoacetate while pyruvate concentration was significantly decreased. In amniotic fluid, T2 to T3 transition was associated with decreasing levels of glucose, carnitine, amino acids (valine, leucine, isoleucine, alanine, methionine, tyrosine, and phenylalanine and increasing levels of creatinine, succinate, pyruvate, choline, N,N-dimethylglycine and urocanate. Lactate to pyruvate ratio was decreased in AF and conversely increased in PL. The results of our study, show that metabolomics profiling can be used to better understand physiological changes of the complex interdependencies of the mother, the placenta and the fetus during pregnancy. In the future, these results might be a useful reference point for analysis of complicated pregnancies.

  16. Transcriptome adaptation of group B Streptococcus to growth in human amniotic fluid.

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    Izabela Sitkiewicz

    Full Text Available BACKGROUND: Streptococcus agalactiae (group B Streptococcus is a bacterial pathogen that causes severe intrauterine infections leading to fetal morbidity and mortality. The pathogenesis of GBS infection in this environment is poorly understood, in part because we lack a detailed understanding of the adaptation of this pathogen to growth in amniotic fluid. To address this knowledge deficit, we characterized the transcriptome of GBS grown in human amniotic fluid (AF and compared it with the transcriptome in rich laboratory medium. METHODS: GBS was grown in Todd Hewitt-yeast extract medium and human AF. Bacteria were collected at mid-logarithmic, late-logarithmic and stationary growth phase. We performed global expression microarray analysis using a custom-made Affymetrix GeneChip. The normalized hybridization values derived from three biological replicates at each growth point were obtained. AF/THY transcript ratios representing greater than a 2-fold change and P-value exceeding 0.05 were considered to be statistically significant. PRINCIPAL FINDINGS: We have discovered that GBS significantly remodels its transcriptome in response to exposure to human amniotic fluid. GBS grew rapidly in human AF and did not exhibit a global stress response. The majority of changes in GBS transcripts in AF compared to THY medium were related to genes mediating metabolism of amino acids, carbohydrates, and nucleotides. The majority of the observed changes in transcripts affects genes involved in basic bacterial metabolism and is connected to AF composition and nutritional requirements of the bacterium. Importantly, the response to growth in human AF included significant changes in transcripts of multiple virulence genes such as adhesins, capsule, and hemolysin and IL-8 proteinase what might have consequences for the outcome of host-pathogen interactions. CONCLUSIONS/SIGNIFICANCE: Our work provides extensive new information about how the transcriptome of GBS responds

  17. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery.

    Science.gov (United States)

    Hallingström, Maria; Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6-36+6) weeks in women with spontaneous PTD and 40+0 (39+1-40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.

  18. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery.

    Directory of Open Access Journals (Sweden)

    Maria Hallingström

    Full Text Available The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD in mid-trimester amniotic fluid from asymptomatic women.This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases and 40 randomly selected healthy women delivering at term (controls. An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples.The median (interquartile range (IQR: 25th; 75th percentiles gestational age at delivery was 35+5 (33+6-36+6 weeks in women with spontaneous PTD and 40+0 (39+1-40+5 weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR CRP level was 95.2 ng/mL (64.3; 163.5 in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8 in women delivering at term (p = 0.37; t-test.Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.

  19. Amniotic band syndrome with sacral agenesis and umbilical cord entrapment: A case report emphasizing the value of evaluation of umbilical cord.

    Science.gov (United States)

    Gupta, Kanika; Venkatesan, Bhuvaneswari; Chandra, Tushar; Rajeswari, Kathiah; Devi, Thangammal Kandasamy Renuka

    2015-03-01

    Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts by fibrous amniotic bands in utero. The congenital anomalies seen in this syndrome vary widely and defects may be isolated or multiple and do not follow a specific pattern. Asymmetric distribution of defects is the hallmark of this syndrome. The diagnosis is difficult to make on ultrasound and relies on identification of amniotic bands. We report a case of amniotic band syndrome with sacral agenesis diagnosed on routine antenatal ultrasound scan in the second offspring of a recently diagnosed diabetic mother. The associated features were entrapment of umbilical cord, caudal adhesions and lower limb anomalies. Medical termination of pregnancy was done and all the fetal anomalies as well as umbilical cord abnormalities were confirmed. The importance of meticulous scanning to evaluate for amniotic bands and the umbilical cord in addition to the fetal structures is emphasized.

  20. Isolation of a somatomedin binding protein from human preterm amniotic fluid: development of a radioimmunoassay

    International Nuclear Information System (INIS)

    Drop, S.L.S.

    1983-01-01

    This thesis investigates the nature and biological behaviour of a somatomedin binding protein, identified in preterm amniotic fluid (AF). For that purpose a double antibody radioimmunoassay was developed. Purified AF binding protein (AFBP) was iodinated by the chloramine-T method, and dilutions of partially purified AFBP were designated as the standard, with the results expressed in μg equivalent protein/ml. The sensitivity of the assay was improved by adoption of the nonequilibrium procedure. AFBP values were twice as high in preterm AF as in term AF. (Auth.)

  1. Consequences of meconium stained amniotic fluid: what does the evidence tell us?

    Science.gov (United States)

    Hutton, Eileen K; Thorpe, Julia

    2014-07-01

    Meconium stained amniotic fluid (MSAF) is common and associated with meconium aspiration syndrome (MAS). Other consequences of meconium passage before birth are less well understood. We reviewed the literature for original papers reporting on outcomes associated with MSAF. Among preterm infants MSAF is more prevalent than previously believed and is associated with higher neonatal morbidity. Intrauterine exposure to meconium is associated with inflammation of tissues of the lung, chorionic plate and umbilical vessels and through various mechanisms may contribute to neonatal morbidity, independent of MAS. No compelling evidence supported an association between MSAF and increased neurological impairment, including early seizure activity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms

    Science.gov (United States)

    Umur, Asli; van Gemert, Martin J. C.; Ross, Michael G.

    2002-06-01

    Clinical evidence suggests that increased amniotic fluid volume due to polyhydramnios increases placental vascular resistance. We have sought to model the possible effects of an increased amniotic fluid volume on the net fetofetal transfusion in monochorionic twin pregnancies. We wanted to compare these effects with the results of previous simulations, which aimed to explain why the twin-twin transfusion syndrome (TTTS) placentas more often include bidirectional arteriovenous (AV) rather than AV plus arterioarterial (AA) anastomoses. We extended our mathematical model of TTTS by simulating two different mechanisms that increase the placental vascular resistance as a consequence of polyhydramnios. First, there is an increase in the placental capillary resistance and hence in deep AV and opposite AV (denoted as VA) resistances due to polyhydramnios. Second, there is an increase in the resistance of chorionic veins due to polyhydramnios, assuming that these veins act as Starling resistors. We then simulated the effects of polyhydramnios on different placental anastomotic patterns. The results were as follows. In the first mechanism (polyhydramnios affects AV-VA resistances), an increased amniotic fluid volume hardly affected bidirectional AV, but slightly decreased fetofetal transfusion in AV plus AA anastomoses. However, for these effects to change the natural development of the pregnancy, polyhydramnios needed to persist for approximately 4 weeks, and by comparing the effects of polyhydramnios with the effects of amnioreduction, amnioreduction was more beneficial for normalizing the donor amniotic fluid volume. Therefore, these beneficial effects due to polyhydramnios have no practical clinical significance. In the second mechanism (Starling resistor for chorionic veins), polyhydramnios slightly increased fetofetal transfusion and hence slightly increased TTTS severity in bidirectional AV and AV plus VV, but did not affect AV plus AA anastomoses. In conclusion, we

  3. Primordial membranes

    DEFF Research Database (Denmark)

    Hanczyc, Martin M; Monnard, Pierre-Alain

    2017-01-01

    Cellular membranes, which are self-assembled bilayer structures mainly composed of lipids, proteins and conjugated polysaccharides, are the defining feature of cell physiology. It is likely that the complexity of contemporary cells was preceded by simpler chemical systems or protocells during...... the various evolutionary stages that led from inanimate to living matter. It is also likely that primitive membranes played a similar role in protocell 'physiology'. The composition of such ancestral membranes has been proposed as mixtures of single hydrocarbon chain amphiphiles, which are simpler versions...

  4. First report of distal obstructive uropathy and prune-belly syndrome in an infant with amniotic band syndrome.

    Science.gov (United States)

    Chen, C P; Liu, F F; Jan, S W; Wang, K G; Lan, C C

    1997-01-01

    We describe the first report of distal obstructive uropathy and prune-belly syndrome in an infant with amniotic band syndrome. Prenatal ultrasonographic examination in the third trimester revealed intermittent oligohydramnios, bilateral hydronephrosis, and megacystis. Postnatally, the infant was found to have a scalp defect, a skin pedicle, pseudosyndactyly and constriction rings on the hands, marked distention of the abdomen, a fibrous band attached to the proximal urethra causing urethral stricture, a swollen penile shaft, bilateral talipes equinovarus, and syndactyly of the feet. Multiple fibrous amniotic bands could be identified in the placenta. Our case shows that fetal distal obstructive uropathy can be associated with the congenital constriction band syndrome.

  5. Intravaginal Misoprostol Versus Intra-amniotic 15 Methyl PG F2 a for Termination of Second Trimester Pregnancy

    OpenAIRE

    N. Vimala, V. Dadhwal, S. Kumar, S. Mittal, S. Vinekar

    2005-01-01

    To compare the efficacy of intravaginal application of misoprostol and intra-amniotic injection ofprostaglandin 15-methyl F2 alpha (PG F2α) in terminating second trimester pregnancies, eightypregnant women at 14-20 weeks of gestation with single live fetuses and requesting for terminationof pregnancy were randomised into two groups.Women in group I: received four tablets of vaginalmisoprostol (200 mg/tablet) and in group II : intra-amniotic injection of (10 ml) 2.5 mg 15 methyl -PGF2α. Failur...

  6. TRANSCONJUNCTIVAL NONVITRECTOMIZING VITREOUS SURGERY VERSUS 25-GAUGE VITRECTOMY IN PATIENTS WITH EPIRETINAL MEMBRANE: A Prospective Randomized Study.

    Science.gov (United States)

    Reibaldi, Michele; Longo, Antonio; Avitabile, Teresio; Bonfiglio, Vincenza; Toro, Mario D; Russo, Andrea; Viti, Francesca; Nicolai, Michele; Saitta, Andrea; Giovannini, Alfonso; Mariotti, Cesare

    2015-05-01

    To compare the clinical outcomes and the rate of complications of 27-gauge transconjunctival nonvitrectomizing vitreous surgery (NVS) and of 25-gauge transconjunctival sutureless vitrectomy surgery for idiopathic epiretinal membrane removal. In this prospective randomized study, 83 phakic eyes of 83 consecutive patients with an idiopathic epiretinal membrane were randomized to receive 27-gauge NVS (NVS-group) or 25-gauge vitrectomy (Standard-group). Main outcome measures were best-corrected visual acuity, central retinal thickness, nuclear density units' changes, and rate of complications. Thirty-nine eyes of the Standard-group and 40 of the NVS-group were considered in final analysis. Mean best-corrected visual acuity improved significantly in both groups, with a significant better result at 12 months in NVS-group (P = 0.039; t-test). Central retinal thickness decreased significantly in both groups (P gauge NVS is an effective surgical procedure in eyes with epiretinal membrane and it induces less progression of nuclear sclerosis than 25-gauge vitrectomy.

  7. Gap Junctions Are Involved in the Rescue of CFTR-Dependent Chloride Efflux by Amniotic Mesenchymal Stem Cells in Coculture with Cystic Fibrosis CFBE41o- Cells

    Directory of Open Access Journals (Sweden)

    Annalucia Carbone

    2018-01-01

    Full Text Available We previously found that human amniotic mesenchymal stem cells (hAMSCs in coculture with CF immortalised airway epithelial cells (CFBE41o- line, CFBE on Transwell® filters acquired an epithelial phenotype and led to the expression of a mature and functional CFTR protein. In order to explore the role of gap junction- (GJ- mediated intercellular communication (GJIC in this rescue, cocultures (hAMSC : CFBE, 1 : 5 ratio were studied for the formation of GJIC, before and after silencing connexin 43 (Cx43, a major component of GJs. Functional GJs in cocultures were inhibited when the expression of the Cx43 protein was downregulated. Transfection of cocultures with siRNA against Cx43 resulted in the absence of specific CFTR signal on the apical membrane and reduction in the mature form of CFTR (band C, and in parallel, the CFTR-dependent chloride channel activity was significantly decreased. Cx43 downregulation determined also a decrease in transepithelial resistance and an increase in paracellular permeability as compared with control cocultures, implying that GJIC may regulate CFTR expression and function that in turn modulate airway epithelium tightness. These results indicate that GJIC is involved in the correction of CFTR chloride channel activity upon the acquisition of an epithelial phenotype by hAMSCs in coculture with CF cells.

  8. Amniotic Fluid Stem Cells: A Novel Source for Modeling of Human Genetic Diseases

    Directory of Open Access Journals (Sweden)

    Ivana Antonucci

    2016-04-01

    Full Text Available In recent years, great interest has been devoted to the use of Induced Pluripotent Stem cells (iPS for modeling of human genetic diseases, due to the possibility of reprogramming somatic cells of affected patients into pluripotent cells, enabling differentiation into several cell types, and allowing investigations into the molecular mechanisms of the disease. However, the protocol of iPS generation still suffers from technical limitations, showing low efficiency, being expensive and time consuming. Amniotic Fluid Stem cells (AFS represent a potential alternative novel source of stem cells for modeling of human genetic diseases. In fact, by means of prenatal diagnosis, a number of fetuses affected by chromosomal or Mendelian diseases can be identified, and the amniotic fluid collected for genetic testing can be used, after diagnosis, for the isolation, culture and differentiation of AFS cells. This can provide a useful stem cell model for the investigation of the molecular basis of the diagnosed disease without the necessity of producing iPS, since AFS cells show some features of pluripotency and are able to differentiate in cells derived from all three germ layers “in vitro”. In this article, we describe the potential benefits provided by using AFS cells in the modeling of human genetic diseases.

  9. Human amniotic fluid contaminants alter thyroid hormone signalling and early brain development in Xenopus embryos

    Science.gov (United States)

    Fini, Jean-Baptiste; Mughal, Bilal B.; Le Mével, Sébastien; Leemans, Michelle; Lettmann, Mélodie; Spirhanzlova, Petra; Affaticati, Pierre; Jenett, Arnim; Demeneix, Barbara A.

    2017-03-01

    Thyroid hormones are essential for normal brain development in vertebrates. In humans, abnormal maternal thyroid hormone levels during early pregnancy are associated with decreased offspring IQ and modified brain structure. As numerous environmental chemicals disrupt thyroid hormone signalling, we questioned whether exposure to ubiquitous chemicals affects thyroid hormone responses during early neurogenesis. We established a mixture of 15 common chemicals at concentrations reported in human amniotic fluid. An in vivo larval reporter (GFP) assay served to determine integrated thyroid hormone transcriptional responses. Dose-dependent effects of short-term (72 h) exposure to single chemicals and the mixture were found. qPCR on dissected brains showed significant changes in thyroid hormone-related genes including receptors, deiodinases and neural differentiation markers. Further, exposure to mixture also modified neural proliferation as well as neuron and oligodendrocyte size. Finally, exposed tadpoles showed behavioural responses with dose-dependent reductions in mobility. In conclusion, exposure to a mixture of ubiquitous chemicals at concentrations found in human amniotic fluid affect thyroid hormone-dependent transcription, gene expression, brain development and behaviour in early embryogenesis. As thyroid hormone signalling is strongly conserved across vertebrates the results suggest that ubiquitous chemical mixtures could be exerting adverse effects on foetal human brain development.

  10. Evolution of the hypoxia-sensitive cells involved in amniote respiratory reflexes.

    Science.gov (United States)

    Hockman, Dorit; Burns, Alan J; Schlosser, Gerhard; Gates, Keith P; Jevans, Benjamin; Mongera, Alessandro; Fisher, Shannon; Unlu, Gokhan; Knapik, Ela W; Kaufman, Charles K; Mosimann, Christian; Zon, Leonard I; Lancman, Joseph J; Dong, P Duc S; Lickert, Heiko; Tucker, Abigail S; Baker, Clare V H

    2017-04-07

    The evolutionary origins of the hypoxia-sensitive cells that trigger amniote respiratory reflexes - carotid body glomus cells, and 'pulmonary neuroendocrine cells' (PNECs) - are obscure. Homology has been proposed between glomus cells, which are neural crest-derived, and the hypoxia-sensitive 'neuroepithelial cells' (NECs) of fish gills, whose embryonic origin is unknown. NECs have also been likened to PNECs, which differentiate in situ within lung airway epithelia. Using genetic lineage-tracing and neural crest-deficient mutants in zebrafish, and physical fate-mapping in frog and lamprey, we find that NECs are not neural crest-derived, but endoderm-derived, like PNECs, whose endodermal origin we confirm. We discover neural crest-derived catecholaminergic cells associated with zebrafish pharyngeal arch blood vessels, and propose a new model for amniote hypoxia-sensitive cell evolution: endoderm-derived NECs were retained as PNECs, while the carotid body evolved via the aggregation of neural crest-derived catecholaminergic (chromaffin) cells already associated with blood vessels in anamniote pharyngeal arches.

  11. Amniotic fluid for ex vivo skin preservation: a comparative study of tissue preservation solutions.

    Science.gov (United States)

    Buseman, Jason; Rinker, Alexander B; Rinker, Brian

    2013-12-01

    Ex vivo skin preservation is important for skin banks, burn centers, and in research; however, the optimal preservation solution is not known. Human amniotic fluid (HAF), in addition to its role in fetal wound healing, has promise as an effective and readily available preservation solution. The purpose of this study was to compare the efficacy of several solutions, including HAF, in full-thickness skin preservation. Human amniotic fluid was obtained from patients undergoing amniocentesis. Full-thickness skin obtained during abdominoplasty was divided into 1-cm(2) samples. These specimens were preserved in either saline, HAF from a single patient, pooled HAF, University of Wisconsin solution, or custodial histidine-tryptophan-ketoglutarate solution at 4°C. There were 5 samples in each group. Specimens were examined for keratinocyte survival at 7, 14, 21, 28, and 35 days using the trypan blue assay. The first 200 cells identified were counted to calculate the degree of cell death. Comparisons were made between the groups, and a multivariable repeated-measures analysis was performed to determine statistical significance, which was defined as P skin banks, burn centers, and research.

  12. Prooxidant-Antioxidant Balance in Umbilical Cord Blood of Infants with Meconium Stained of Amniotic Fluid

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Arjmand

    2013-01-01

    Full Text Available Objective. Using a novel assay termed prooxidant-antioxidant balance (PAB assay to determine prooxidant-antioxidant balance in umbilical cord blood of infants with meconium stained of amniotic fluid (MSAF. Passage of meconium in