RESUMO
Cancer immunotherapy using dendritic cells (DCs) able to induce specific immune responses to naïve T lymphocytes raises great research interest. However, the extremely complex and expensive methods used to produce DCs, combined with the limited number of autologous DCs in the circulation make any application almost impossible. Aim of the study is the development of an optimized and simplified system to easily produce in large scale cord blood-derived DCs, loaded with common tumor antigens, capable of promoting controlled Th1 immunoresponses following clinically approved maturation with vaccines. CD34+cells cultured in the presence of a cytokine cocktail in miniPERM® bioreactors and the generated DCs were matured using anti-flu vaccines. Autologous T cells plated with DCs pulsed with overlapping peptides CEA and WT1 for multiple stimulations. 200 billion of myeloid DCs were produced and matured in just 8 h in bioreactors, presenting an increased expression of the co-stimulatory molecules and also high levels of Th1 related cytokines. Upon just the 2nd stimulation, the T cells exhibited specificity following stimulation with the CEA/WT1 peptides and strong cytotoxic capacity in co-culture with a colorectal cancer (CRC)-cell line. The high produced doses of DCs, easily maturated with clinically approved agents, and capable of priming specific T cells, could potentially strengthen the further progress in DCs-mediated cancer immunotherapy field.
Assuntos
Neoplasias , Linfócitos T Citotóxicos , Antígeno Carcinoembrionário/metabolismo , Citocinas , Células Dendríticas/metabolismo , Humanos , Neoplasias/metabolismo , Linfócitos T Citotóxicos/metabolismoRESUMO
BACKGROUND: Recent studies highlight the existence of a population of cord blood (CB)-derived stem cells that bare embryonic features (very small embryonic-like stem cells [VSELs]) as the most primitive CB-stem cell population. In the present study, we present for the first time a novel and high purity isolation method of VSELs with in vitro hematopoietic capacity in the presence of Wharton's jelly-derived mesenchymal stromal cells (WJ-MSCs). METHODS: The experimental procedure includes isolation upon gradually increased centrifugation spins and chemotaxis to Stromal cell-derived factor 1a (SDF-1a). Τhis cell population is characterized with flow cytometry, alkaline phosphatase (ALP) staining and qRT-PCR. The functional role of the isolated VSELs is assayed following co-culture with WJ-MSCs or bone marrow-derived mesenchymal stromal cells (BM-MSCs), whereas the stimulation of the quiescent VSEL population is verified via cell cycle analysis. The in vitro hematopoietic capacity is evaluated in methylcellulose cultures and also through induction of erythroid differentiation. RESULTS: The final isolated subpopulation is characterized as a small-sized CD45/Lineage-/CXCR4+/CD133+/SSEA-4+cell population, positive in ALP staining and overexpressing the Oct3/4, Nanog and Sox-2 transcription factors. Upon the co-culture with MSCs, a stimulation of the quiescent VSEL population is observed. An impressive increase in the co-expression of the CD34+/CD45+ markers is observed following the co-culture with the WJ-MSCs, which is confirmed by the intense clonogenic ability suggesting in vitro differentiation toward all of the hematopoietic cell lineages and successful differentiation toward erythrocytes. DISCUSSION: Conclusively, we propose a novel, rapid and rather simplified isolation method of CB-VSELs, capable of in vitro hematopoiesis.
Assuntos
Separação Celular/métodos , Células-Tronco Embrionárias/fisiologia , Sangue Fetal/citologia , Hematopoese/fisiologia , Células-Tronco Mesenquimais/fisiologia , Geleia de Wharton/citologia , Células-Tronco Adultas , Antígenos CD34/metabolismo , Ciclo Celular , Diferenciação Celular/fisiologia , Separação Celular/economia , Células Cultivadas , Técnicas de Cocultura , Citometria de Fluxo , Transplante de Células-Tronco Hematopoéticas/métodos , HumanosRESUMO
OBJECTIVES: The aims of the study were to compare the contraceptive behaviour of Christian and Muslim adolescents who had an abortion in Thrace, Greece, and to examine whether extensive contraceptive counselling at the time of abortion modified their subsequent contraceptive practices. METHODS: Adolescents, aged 14-19 years, who had undergone an elective abortion in our department, were included in a prospective 12-year study. Extensive contraceptive counselling was offered before discharge from the hospital. Attitudes to contraception were assessed by means of a simple questionnaire at the time of abortion and at 1-year follow-up. RESULTS: The study population comprised of 95 Christian Orthodox adolescents (Group A) and 79 Muslim adolescents (Group B). At the time of abortion, contraceptive behaviour differed significantly between the two groups (p = .004). Contraceptive methods used in Group A in comparison with Group B were as follows: oral contraceptives (27.4% vs. 12.7%), condoms (22.1% vs. 38.0%), interrupted coitus (18.9% vs. 20.3%), periodic abstinence (16.8% vs. 25.3%) and emergency contraception (14.7% vs. 3.8%). The commonest source of information on contraception in Group A was the gynaecologist (17.9%) and family planning clinic (15.8%), whereas in Group B it was the individual's partner (25.3%) and parents (16.4%). Contraceptive behaviour was significantly modified in both groups at post-abortion follow-up (both p < .001). The original difference between the groups, however, persisted (p = .006). In Group A, oral contraceptives were the dominant method (48.4%), followed by condoms (30.5%), whereas in Group B, the order was still the reverse (24.1% and 46.8%, respectively). CONCLUSION: Cultural differences significantly affect the contraceptive behaviour. Nevertheless, interventions that promote contraception can still be successful in different populations.
Assuntos
Aborto Induzido/psicologia , Cristianismo/psicologia , Comportamento Contraceptivo , Aconselhamento , Conhecimentos, Atitudes e Prática em Saúde , Islamismo/psicologia , Adolescente , Comportamento do Adolescente/etnologia , Adulto , Anticoncepção/estatística & dados numéricos , Comportamento Contraceptivo/etnologia , Comportamento Contraceptivo/psicologia , Características Culturais , Serviços de Planejamento Familiar , Feminino , Grécia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hospitais Universitários , Humanos , Relações Médico-Paciente , Gravidez , Estudos Prospectivos , Religião e Psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
This is a case report and literature review regarding early diagnosis and management of a cervical heterotopic pregnancy. A 41-year-old gravida 2 para 0 with premature ovarian failure was treated successfully in an in vitro fertilization program with donor oocytes. A transvaginal ultrasound scan revealed the presence of a heterotopic pregnancy, with an intrauterine embryo and an intracervical embryo. Both embryos had positive heartbeats. Aspiration of the cervical pregnancy was followed by Foley catheter placement and cervical cerclage suturing. Monitoring of the patient resulted in elective uncomplicated cesarean section delivery at 38 weeks following an uneventful pregnancy. Given the lack of guidelines for the management of heterotopic cervical pregnancy, we reviewed the literature suggesting the most effective method. The value of early diagnosis and management is concluded from the literature, in support of our management principles.
Assuntos
Colo do Útero/cirurgia , Cesárea/métodos , Fertilização in vitro , Gravidez Ectópica , Gravidez Heterotópica , Adulto , Cerclagem Cervical , Colo do Útero/diagnóstico por imagem , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Gravidez Ectópica/cirurgia , Suturas , UltrassonografiaRESUMO
PURPOSE: Approximately 21 days after an abortion, ovulation occurs in 50 % of women. Installation of an IUD directly after induced or spontaneous abortion offers immediate contraceptive protection. The purpose of the present study was to weigh up contraceptive safety and adverse reactions of IUD inserted directly after first-trimester abortion under general or paracervical anesthesia as against the fitting of IUD in the days of the next menstrual cycle without anesthesia. METHOD: During the period May 1987 to October 2010, 73 women (Group A) underwent an immediate post-abortion insertion IUD after a first-trimester spontaneous or induced abortion under general or local paracervical anesthesia and 69 participants (Group B) received IUD during the next menstrual cycle without anesthesia. Questionnaires were completed by all the women of the study with respect to the effects of IUD. The women were examined every 3 months for 1 year after the fitting of the IUD in the out-patient department of the University Obstetrics Gynecological Department of Alexandroupolis, Democritus University of Thrace, Greece. RESULTS: The demographic characteristics of the women of the two groups were similar. The age of the women ranged between 19 and 44 years, while 61.98 % were women with one or two children and 38.02 % were women with three or more children. During the first menstrual cycles, with the exception of vaginal hemorrhages (5 %) and adnexitis (1 %), no serious adverse reactions were noted. During the transvaginal ultrasonography checks in both groups, no observation was made of any dislocation of the IUD, except for two cases in the subgroup of those women with paracervical anesthesia and one case in the women of Group B. As concerns the questionnaire with regard to the women's subjective evaluation of IUD, satisfactory answers were given. CONCLUSIONS: There were no differences between the two groups either with respect to the security of the supplied contraceptive methods or to the development of side effects.
Assuntos
Aborto Induzido , Aborto Espontâneo , Dispositivos Intrauterinos/efeitos adversos , Menstruação/fisiologia , Adulto , Anticoncepção/métodos , Feminino , Seguimentos , Grécia , Humanos , Expulsão de Dispositivo Intrauterino/etiologia , Dispositivos Intrauterinos/estatística & dados numéricos , Período Pós-Operatório , Gravidez , Primeiro Trimestre da Gravidez , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo , Hemorragia Uterina/complicações , Adulto JovemRESUMO
Fertility issues are becoming increasingly prevalent, leading many couples to seek fertility treatment at specialized centers. Infertility is a diverse clinical condition, with multiple potential etiologic factors and variable severity in its manifestation. Regardless of the underlying factors and severity, routine fertility assessment rarely differs between cases, with an essential step being fallopian tube patency assessment. Hysterosalpingo-foam sonography (HyFoSy) is the latest available diagnostic technique to assess this parameter, offering robust results, with reduced intra-procedural pain and equipment requirements, in the convenience of the office setting. However, apart from its diagnostic value, HyFoSy has also demonstrated a therapeutic tubal flushing effect, that may be the decisive factor for couples with mild infertility to spontaneously conceive. In this report, we present the case of a couple with mild infertility, who managed to spontaneously conceive after a HyFoSy examination, and in fact within the same cycle.
RESUMO
The approval of the first specific drug catumaxomab for the treatment of malignant ascites is the subject of this review. This trifunctional antibody is known to kill EpCAM-positive tumor cells and therefore attacks the primary cause of malignant ascites formation in the peritoneal cavity. Until today catumaxomab is the only EpCam-targeted antibody approved by the European Medicines Agency. Ovarian cancer is caused by epithelial tumors cells which overexpress epithelial cell adhesion molecule (EpCAM). The existing literature concerning the use of catumaxomab for the treatment of malignant ascites associated with ovarian cancer until today is reported in this article. It is very encouraging that different prospective studies from diverse scientific teams recently presented positive results concerning the efficacy and the safety of catumaxomab in the treatment of malignant ascites in patients with ovarian cancer. A case of a patient with ovarian cancer FIGO IIIc is also referred in this article. A complete remission and stable disease was found after 4 i.p. infusions of catumaxomab.
Assuntos
Anticorpos Biespecíficos/uso terapêutico , Ascite/tratamento farmacológico , Carcinoma/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Ascite/etiologia , Carcinoma/complicações , Feminino , Humanos , Infusões Parenterais , Neoplasias Ovarianas/complicaçõesRESUMO
Assisted reproduction technology (ART) has made considerable progress in recent years; in particular with regard to cryopreservation, long-term storage, successful thawing, and embryo transfer of cryopreserved embryos. Regarding gestational surrogacy, progress has been made in the areas of awareness, social acceptance, regulation, legislation, availability, streamlining, and optimization of cross-border care. The above is being highlighted in the current presentation of a particularly challenging and novel case. A 43-year-old woman visited our clinic in Greece, seeking international gestational surrogacy due to recurrent breast cancer which rendered her medically unfit for pregnancy. Ten years before her initial visit to our clinic the patient had undergone fertility preservation due to breast cancer, her oocytes had been fertilized with her husband's sperm, and the embryos were cryopreserved and stored in a fertility clinic based in the United Kingdom. The stored embryos were transported to Greece, thawed, and successfully implanted to the selected gestational surrogate. Following an uneventful pregnancy, the surrogate delivered a healthy girl. This successful outcome exemplified innovation, motivation, and hope and may represent a paradigm of team scientific excellence associated with positive patient outcomes. Furthermore, this case constitutes the successful culmination of major advances made in various different sectors of cross-border reproductive care; laboratory, clinical, legal, ethical, and logistical.
RESUMO
Hysteroscopic resection of ectopic cornual pregnancy following MRI imaging is a safe and effective treatment option without significantly impacting fertility potential or increasing the risk of future obstetrical complications.
RESUMO
Presentation of uterine prolapse is a rare event in a pregnant woman, which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. Recommendations regarding the management of this infrequent but potentially harmful condition are scarce and outdated. This review will examine the causative factors of uterine prolapse and the antepartum, intrapartum and puerperal complications that may arise from this condition as well as therapeutic options available to the obstetrician. While early recognition and appropriate prenatal management of uterine prolapse during pregnancy is imperative, implementation of conservative treatment modalities throughout pregnancy, these applied in accordance with the severity of the uterus prolapse and the patient's preference, may be sufficient to achieve uneventful pregnancy and normal, spontaneous delivery.