RESUMO
OBJECTIVE: We reviewed women with previable spontaneous premature rupture of membranes (sPPROM) in whom an amniopatch was performed and compared their pregnancy outcomes with a conservative management group. METHODS: Amniopatch, an amnioinfusion of autologous platelet concentrate followed by cryoprecipitate, was performed in 7 women with sPPROM diagnosed at 17-23 weeks' gestation, including one twin pregnancy. Three patients had incompetent cervices and the other 4 patients had sPPROM without incompetent cervices. Pregnancy outcomes of the cases were compared with the controls who were managed conservatively (n = 22). RESULTS: Amniopatch treatment was successful in 1 of 7 cases (14.3%), in which the ruptured membranes were completely sealed and the patient delivered a healthy baby at 39 weeks' gestation. No procedure-related complications were observed. Overall, neonatal outcome was similar in the amniopatch and conservatively managed groups, although the incidences of early neonatal sepsis and respiratory distress syndrome were lower in the amniopatch group. CONCLUSION: The overall success rate of amniopatch among our small number of cases was low. However, if successful, amniopatch may prolong a pregnancy with previable sPPROM to term.
Assuntos
Ruptura Prematura de Membranas Fetais/cirurgia , Transfusão de Plaquetas , Adulto , Transfusão de Sangue Autóloga , Feminino , Ruptura Prematura de Membranas Fetais/etiologia , Humanos , Plasmaferese , Gravidez , Nascimento Prematuro/prevenção & controle , Estudos Retrospectivos , Incompetência do Colo do ÚteroRESUMO
In the course of screening anti-dementia agents from natural products, two beta-secretase (BACE1) inhibitors were isolated from the ethyl acetate soluble fraction of Sanguisorbae Radix by the activity-guided purification using silica gel, Sephadex LH-20, and RP-HPLC. They were identified as 1,2,3-trigalloyl-4,6-hexahydroxydiphenoyl-beta-D-glucopyranoside (Tellimagrandin II, 1) and 1,2,3,4,6-pentagalloyl-beta-D-glucopyranoside (2) and were shown to non-competitively inhibit beta-secretase (BACE1) with the IC50 values of 3.10x10(-6) M and 3.76x10(-6) M, respectively. The Ki values of 1 and 2 were 6.84x10(-6) M and 5.13x10(-6) M. They were less inhibitory to alphasecretase (TACE) and other serine proteases such as chymotrypsin, trypsin, and elastase, suggesting that they were relatively specific inhibitors of BACE1.
Assuntos
Endopeptidases/metabolismo , Ácido Gálico/análogos & derivados , Glucosídeos/farmacologia , Taninos Hidrolisáveis/farmacologia , Inibidores de Proteases/farmacologia , Sanguisorba , Doença de Alzheimer/prevenção & controle , Secretases da Proteína Precursora do Amiloide , Ácido Aspártico Endopeptidases , Relação Dose-Resposta a Droga , Ácido Gálico/isolamento & purificação , Ácido Gálico/farmacologia , Glucosídeos/isolamento & purificação , Humanos , Taninos Hidrolisáveis/isolamento & purificação , Técnicas In Vitro , Concentração Inibidora 50 , Cinética , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Inibidores de Proteases/isolamento & purificação , Sanguisorba/químicaRESUMO
In the course of screening for anti-dementia agents from natural products, two beta-secretase (BACE1) inhibitors were isolated from the husk of pomegranate (Punica granatum) by activity-guided purification. They were identified as ellagic acid and punicalagin with IC50 values of 3.9 x10(-6) and 4.1x10(-7) M and Ki values of 2.4x10(-5) and 5.9x10(-7) M, respectively. The compounds were non-competitive inhibitors with a substrate in the Dixon plot. Ellagic acid and punicalagin were less inhibitory to alpha-secretase (TACE) and other serine proteases such as chymotrypsin, trypsin, and elastase, thus indicating that they were relatively specific inhibitors of BACE1.