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1.
J Contemp Dent Pract ; 25(2): 160-167, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38514414

RESUMEN

AIM: Amnion and chorion membranes possess unique inherited biological properties that enhance wound healing and may accelerate periodontal regeneration. The present study aims to evaluate and compare the efficacy of amnion and chorion membranes in the treatment of furcation defects. MATERIALS AND METHODS: A total of 20 patients were selected and were randomly allocated to group I and group II with 10 subjects in each group. Amnion and chorion membranes are placental-derived membranes that accelerate regeneration by having natural growth factors with their antimicrobial and inflammation reduction properties. Group I was treated using bone grafting with decalcified freeze-dried bone allograft (DFDBA) and placement of amnion as a membrane for guided tissue regeneration (GTR) whereas group II was treated using bone grafting with DFDBA and placement of chorion as a membrane for GTR. The patients were followed for clinical and radiographic parameters and were evaluated between 3 and 6 months after surgery. RESULT: In intragroup comparison, a significant difference was evident in both the groups for all the clinical and radiographic parameters within the groups. (p = 0.01) This means both amnion and chorion membranes showed statistically significant regenerative efficacy. In intergroup comparison, the results show that all the clinical parameters and radiographic parameters show no significant difference between the groups. CONCLUSION: The amnion and chorion membranes had similar regenerative efficacy in combination with DFDBA in patients with buccal degree II furcation defects in mandibular molars. CLINICAL SIGNIFICANCE: The amnion and chorion membranes have shown significant improvement in clinical and radiographic parameters when used for the treatment of buccal degree II furcation defects in mandibular molars. How to cite this article: Mallapragda S, Gupta R, Gupta S, et al. Evaluation of Regenerative Efficacy of Amnion and Chorion Membrane in Treatment of Mandibular Molar Furcation Defects: A Clinico-radiographic Study. J Contemp Dent Pract 2024;25(2):160-167.


Asunto(s)
Defectos de Furcación , Embarazo , Humanos , Femenino , Defectos de Furcación/cirugía , Amnios/trasplante , Regeneración Tisular Guiada Periodontal/métodos , Placenta/cirugía , Diente Molar/cirugía , Trasplante Óseo/métodos , Corion/cirugía , Membranas Artificiales
2.
Gen Dent ; 68(2): 26-29, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32105222

RESUMEN

The vestibular incision subperiosteal tunnel access (VISTA) technique, a minimally invasive procedure, achieves multitooth recession coverage with only a single access incision. Use of fetal membranes such as the amnion and chorion has become increasingly popular in the field of dentistry due to their lack of immunogenicity and added advantage of growth factors. The present case series aimed to provide information regarding the potential advantage of placing a chorionic membrane in combination with the VISTA technique to achieve recession coverage. Eight healthy adult patients presenting with 24 Miller Class I multitooth gingival recession defects were surgically treated with the VISTA technique and a chorionic membrane. The clinical parameters measured at baseline and 1, 3, and 6 months postoperatively were probing depth, clinical attachment level, width of keratinized gingiva, thickness of attached gingiva, and height of gingival recession. A repeated-measures analysis of variance with a post hoc Bonferroni test was carried out to compare the baseline values with the 1-, 3-, and 6-month postoperative values. The mean (SD) height of gingival recession was significantly reduced from 2.04 (0.67) mm at baseline to 0.71 (0.71) mm at 6 months (P < 0.001). In addition, there were statistically significant gains in the clinical attachment level, width of keratinized gingiva, and thickness of attached gingiva from baseline to 6 months postoperatively (P < 0.001). The probing depth remained the same at all measurement times. The VISTA technique provided good results in terms of recession coverage. Although there was an improvement in the gingival biotype, the placement of a chorionic membrane did not provide any advantage in terms of percentage of root coverage.


Asunto(s)
Recesión Gingival/cirugía , Adulto , Aloinjertos , Corion/cirugía , Tejido Conectivo , Estudios de Seguimiento , Encía , Humanos , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
3.
Radiographics ; 39(7): 2146-2166, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31697621

RESUMEN

The twin birth rate is increasing in the United States. Twin pregnancies can be dichorionic or monochorionic (MC). MC twins account for 20% of twin pregnancies but 30% of all-cause pregnancy-related complications. This article describes the imaging findings that establish chorionicity and amnionicity. Ideally, these are established in the first trimester when accuracy is high, but they can also be determined later in pregnancy. Complications unique to MC twin pregnancy include twin-twin transfusion syndrome, twin anemia polycythemia sequence, twin reversed arterial perfusion sequence, and selective fetal growth restriction. The US features, staging systems, and management of these complications are reviewed, and the consequences of MC twin demise are illustrated. Ongoing surveillance for these conditions starts at 16 weeks gestation. Monoamniotic (MA) twins are a small subset of MC twins. In addition to all of the MC complications, specific MA complications include cord entanglement and conjoined twinning. Radiologists must be able to determine chorionicity and amnionicity and should be aware of potential complications so that patients may be referred to appropriate regional specialized centers. A proposed algorithm for referral to specialized fetal treatment centers is outlined. Online supplemental material is available for this article. ©RSNA, 2019.


Asunto(s)
Amnios/diagnóstico por imagen , Corion/diagnóstico por imagen , Embarazo Gemelar , Ultrasonografía Prenatal/métodos , Amnios/cirugía , Corion/cirugía , Enfermedades en Gemelos/diagnóstico por imagen , Enfermedades en Gemelos/terapia , Femenino , Muerte Fetal , Enfermedades Fetales/diagnóstico por imagen , Terapias Fetales , Transfusión Feto-Fetal/diagnóstico por imagen , Transfusión Feto-Fetal/cirugía , Fetoscopía , Humanos , Terapia por Láser , Embarazo , Trimestres del Embarazo , Gemelos Siameses , Gemelos Dicigóticos , Gemelos Monocigóticos , Ultrasonografía Doppler en Color/métodos
4.
Fetal Diagn Ther ; 45(5): 285-294, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30554214

RESUMEN

BACKGROUND/PURPOSE: We report a case study of jejunal atresia and the results of a systematic literature review of all reported cases of bowel complications occurring after fetoscopic laser ablation (FLA) for the treatment of twin-to-twin transfusion syndrome (TTTS). METHODS: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines. RESULTS: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations. Recipient twins were more likely to be affected by small bowel atresia (7 recipient and 4 donor cases) and NEC (3 recipient and 2 donor twins). Prenatal ultrasonographic abnormalities were demonstrated in 7 out of 9 cases with bowel atresia and in both cases of bowel perforation. The overall survival rate for neonates with bowel complications after FLA is 72%, but is much lower for co-twins at 22%. The survival rates for jejunoileal atresia and NEC are 91 and 40%, respectively. CONCLUSIONS: It is uncertain as to whether these bowel anomalies are due to bowel ischaemia associated with TTTS, the treatment with FLA, or a combination of both. Cases with prenatal abdominal ultrasonographic abnormalities after FLA should have close prenatal and postnatal assessment to detect bowel complications.


Asunto(s)
Anemia/diagnóstico por imagen , Ascitis/diagnóstico por imagen , Transfusión Feto-Fetal/diagnóstico por imagen , Fetoscopía/métodos , Atresia Intestinal/diagnóstico por imagen , Terapia por Láser/métodos , Adulto , Anemia/cirugía , Ascitis/cirugía , Corion/diagnóstico por imagen , Corion/cirugía , Femenino , Muerte Fetal , Transfusión Feto-Fetal/cirugía , Fetoscopía/efectos adversos , Humanos , Recién Nacido , Atresia Intestinal/cirugía , Terapia por Láser/efectos adversos , Embarazo , Embarazo Gemelar , Recurrencia
5.
BJOG ; 125(9): 1154-1162, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29380497

RESUMEN

OBJECTIVES: Preterm premature rupture of membranes (PPROM) is a leading complication following fetoscopic laser coagulation (FLC) for twin-twin transfusion syndrome (TTTS). Our primary objective was to describe the impact of improvements in surgical technique on survival and rate of PPROM over time. The secondary objective was to assess potential risk factors for PPROM. DESIGN AND SETTING: Single-centre retrospective observational study. POPULATION: 1092 consecutive cases of TTTS operated by FLC between 2000 and 2016, with a 6.8% rate of loss to follow up. METHODS: The incidence of PPROM and potential risk factors were analysed using competing risks models. MAIN OUTCOME MEASURES: PPROM, neonatal survival and neurological damage at 28 days. RESULTS: PPROM <32 weeks increased from 15 to 40% between 2000 and 2016 along with an overall improvement of perinatal outcomes: dual survival rose from 42 to 66% whereas dual losses dropped two-fold, from 19 to 9%. Gestational age at surgery at <17 weeks was a significant risk-factor for PPROM, with an additional risk of 10% within the first week of surgery. Although early PPROM at <20 weeks carried a 56% risk of miscarriage, the occurrence of PPROM at >20 weeks did not affect survival, despite an increase in preterm birth at <32 weeks. CONCLUSIONS: With significant improvement in perinatal outcomes, possibly related to improvements in surgical technique, postoperative complications have shifted to non-lethal obstetric complications such as PPROM, with rather reassuring postnatal outcomes, despite an increase in preterm birth and, potentially, morbidity. Early surgeries (<17 weeks) are at higher risk of postoperative PPROM. TWEETABLE ABSTRACT: Following laser/TTTS, rates of PPROM increased with perinatal survival; surgeries at <17 weeks are at highest risk.


Asunto(s)
Rotura Prematura de Membranas Fetales/etiología , Transfusión Feto-Fetal/cirugía , Fetoscopía/efectos adversos , Coagulación con Láser/efectos adversos , Corion/irrigación sanguínea , Corion/cirugía , Femenino , Fetoscopía/métodos , Humanos , Coagulación con Láser/métodos , Embarazo , Resultado del Embarazo , Embarazo Gemelar , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Gemelos Monocigóticos
6.
Fetal Diagn Ther ; 34(4): 206-10, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24051494

RESUMEN

OBJECTIVES: To describe the results of a technique of laser ablation of placental vessels in the treatment of severe twin-twin transfusion syndrome (TTTS), which is characterized by separation of the fetoplacental vascular territories and dichorionization of the placenta. PATIENTS AND METHODS: Descriptive analysis of TTTS cases treated with the endoscopic laser dichorionization of the placenta (ELDP) procedure. The variables evaluated were the occurrence of reversal of the donor-recipient phenotype, persistence of TTTS or twin anemia-polycythemia sequence (TAPS); gestational age at delivery; discharge from the hospital of at least 1 or 2 live neonates, and incidence of neurological alterations among survivors. RESULTS: 67 patients were treated with the ELDP procedure. There was no persistence of TTTS, reversal of the donor-recipient phenotype or TAPS. The median gestational age at delivery was 33.0 (23.6-37.7) weeks. The rate of discharge from the hospital of at least 1 or 2 live neonates was 88.2% (67/76) and 71.1% (54/76), respectively. Among survivors, 17 (17/121 = 14.0%) children presented with neurodevelopmental alterations during clinical follow-up. CONCLUSIONS: The major contribution of this study was the demonstration that the ELDP technique appears to be associated with a low risk of persistence or recurrence of TTTS and TAPS.


Asunto(s)
Corion/irrigación sanguínea , Corion/cirugía , Transfusión Feto-Fetal/cirugía , Terapia por Láser/métodos , Placenta/irrigación sanguínea , Placenta/cirugía , Endoscopía/efectos adversos , Endoscopía/métodos , Femenino , Muerte Fetal/etiología , Transfusión Feto-Fetal/complicaciones , Fetoscopía/efectos adversos , Fetoscopía/métodos , Edad Gestacional , Humanos , Recién Nacido , Terapia por Láser/efectos adversos , Masculino , Enfermedades del Sistema Nervioso/etiología , Embarazo , Resultado del Embarazo , Estudios Retrospectivos
7.
Artículo en Inglés | MEDLINE | ID: mdl-37294857

RESUMEN

This retrospective case series investigated the clinical and radiographic outcomes in 19 intrabony defects treated with periodontal regenerative therapy utilizing a combined approach. Placing an amnion-chorion membrane (ACM) as a biologic modifier on the root surface of the periodontally diseased tooth, combined with bone substitutes and an additional ACM as a barrier membrane, the treated sites were examined 8 to 24 months after the therapy. The preoperative (baseline) mean probing pocket depth (PPD) was 7.21 ± 1.08 mm, and the mean clinical attachment level (CAL) was 7.68 ± 1.49 mm. A mean PPD reduction of 4.05 ± 1.22 mm, CAL gain of 3.68 ± 1.34 mm, and 73.91% ± 22.02% of bone fill were recorded postoperatively. Without any adverse events, root-surface application of ACM as a biologic material in periodontal regenerative therapy could be a safe and cost-effective approach.


Asunto(s)
Pérdida de Hueso Alveolar , Productos Biológicos , Humanos , Amnios , Estudios Retrospectivos , Regeneración Tisular Guiada Periodontal , Corion/cirugía , Pérdida de la Inserción Periodontal/cirugía , Pérdida de Hueso Alveolar/cirugía , Estudios de Seguimiento , Resultado del Tratamiento
8.
Ultrasound Obstet Gynecol ; 39(4): 407-13, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22173905

RESUMEN

OBJECTIVE: To review the experience of performing selective feticide with bipolar cord coagulation (BCC) in complicated monochorionic (MC) twin pregnancies at a single center. METHODS: This was a retrospective analysis of BCC performed using 3-mm bipolar forceps under ultrasound control in cases complicated by twin-to-twin transfusion syndrome, selective growth restriction, discordant anomaly or twin reversed arterial perfusion sequence. RESULTS: The series comprised 118 cases with a median gestational age at the time of the procedure of 22 (range, 16-30) weeks. There were 14 (12%) intrauterine deaths of the cotwin, eight (7%) miscarriages and one (1%) termination of pregnancy. When BCC was performed before 19 weeks of gestation, the rate of miscarriage was 45%, whereas it was 3% (P < 0.001) when BCC was performed after 19 weeks. Preterm prelabor rupture of membranes (PPROM) occurred in 45 (38%) cases. The median interval between BCC and PPROM was 4 (interquartile range, 2-9) weeks. In 15 (13%) cases, PPROM occurred within 2 weeks after the procedure. Median gestational age at delivery was 34 (range, 24-41) weeks. The median birth weight was 2103 (range, 480-3875) g. Neonatal death occurred in 11 (9%) cases, and two (2%) children had severe neurologic morbidity. The overall survival rate was 71% (84/118). CONCLUSION: BCC is an effective procedure in complicated MC twin pregnancies for selective feticide or when one fetus is severely jeopardized and delivery is not yet an option. Better outcomes can be achieved when this procedure is performed after 19 weeks.


Asunto(s)
Transfusión Feto-Fetal/cirugía , Reducción de Embarazo Multifetal/métodos , Cordón Umbilical/cirugía , Amnios/cirugía , Corion/cirugía , Enfermedades en Gemelos/mortalidad , Femenino , Muerte Fetal , Transfusión Feto-Fetal/complicaciones , Transfusión Feto-Fetal/mortalidad , Humanos , Recién Nacido , Recien Nacido Prematuro , Embarazo , Reducción de Embarazo Multifetal/psicología , Embarazo Gemelar , Estudios Retrospectivos , Factores de Riesgo , Gemelos Monocigóticos
9.
Ultrasound Obstet Gynecol ; 35(3): 337-43, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20054828

RESUMEN

OBJECTIVE: To examine the incidence of preterm premature rupture of membranes (PPROM) in pregnancies affected by twin-twin transfusion syndrome (TTTS) treated with laser photocoagulation where an absorbable gelatin sponge was used as a chorioamnion sealant of the fetoscopic access port. METHOD: A retrospective review was undertaken of consecutive cases undergoing fetoscopic directed laser surgery for TTTS between October 2006 and November 2008 at Texas Children's Fetal Center, in which an absorbable gelatin sponge, used as a chorioamnion 'plug', was placed at the conclusion of the intervention as a possible prophylactic measure to prevent PPROM. We excluded cases that had a failure of plug placement and those in which it was not attempted. PPROM was defined as rupture of membranes before 34 weeks' gestation. A comparison was performed between the PPROM group and a no-PPROM group to determine risk factors and outcomes. RESULTS: Successful plug placement occurred in 79 of 84 cases (94%) in which it was attempted after laser surgery, with a rate of PPROM of 34% in these patients. PPROM occurred at an average gestational age of 26.5 +/- 3.6 weeks, with an average procedure-to-PPROM interval of 5.2 +/- 3.5 weeks. There were no statistically significant differences between the PPROM group and the no-PPROM group in maternal demographics or preoperative parameters including: amniotic fluid volumes in the recipient twin's gestational sac, volume of amnioreduction, and location of the placenta. The procedure-to-delivery interval for the total cohort (n = 79) was 9.2 +/- 4.7 weeks, without a significant difference between the two groups (P = 0.08). However, after exclusion of one PPROM outlier, the PPROM group had an average procedure-to-delivery time 2 weeks shorter than the group with no PPROM (P = 0.03). The live birth rates were similar in the PPROM and no-PPROM groups, at 77 and 73%, respectively. However, the average recipient's weight in the PPROM group was significantly lower than in the no-PPROM group (1321 +/- 493 vs. 1705 +/- 576 g; P = 0.02). CONCLUSION: The rate of PPROM and the mean gestational age at delivery in pregnancies in which an absorbable gelatin sponge was used as a sealant of the fetoscopic port following laser photocoagulation for TTTS were comparable to those that have been reported by other laser centers where membrane sealants were not used. A randomized controlled trial should be considered to evaluate the effect of chorioamnion plugging.


Asunto(s)
Corion/cirugía , Rotura Prematura de Membranas Fetales/etiología , Transfusión Feto-Fetal/cirugía , Fetoscopía/efectos adversos , Coagulación con Láser/efectos adversos , Adulto , Corion/diagnóstico por imagen , Femenino , Rotura Prematura de Membranas Fetales/diagnóstico por imagen , Rotura Prematura de Membranas Fetales/cirugía , Transfusión Feto-Fetal/complicaciones , Transfusión Feto-Fetal/diagnóstico por imagen , Edad Gestacional , Humanos , Incidencia , Embarazo , Estudios Retrospectivos , Factores de Riesgo , Texas , Resultado del Tratamiento , Gemelos , Ultrasonografía
10.
Am J Obstet Gynecol ; 198(1): 62.e1-6, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18166308

RESUMEN

OBJECTIVE: This study was undertaken to correlate selectivity of surgery and perinatal outcome in twin-to-twin transfusion syndrome treated by endoscopic laser coagulation, using a quantitative definition of selectivity. STUDY DESIGN: 287 consecutive cases of severe twin-to-twin transfusion syndrome were reviewed. A selectivity index was built as the ratio of selective over nonselective coagulations per procedure. Outcome measures were survival at 28 days and failure of surgery as defined by recurrence of twin-to-twin transfusion syndrome or fetofetal hemorrhage. RESULTS: Two populations were identified: a high selectivity group (63.8%) and a low selectivity group (36.2%). Survival of at least one twin and survival of both twins were higher in the high-selectivity group (p = .007 and p = .04 respectively). Failure of surgery rates were similar in both groups. CONCLUSION: A quantitative definition of selectivity appears justified by the large variations found in the practice of a single center and by significant differences in outcome. Survival is significantly improved in highly selective procedures.


Asunto(s)
Corion/cirugía , Transfusión Feto-Fetal/cirugía , Coagulación con Láser/métodos , Ultrasonografía Prenatal , Anastomosis Quirúrgica/métodos , Femenino , Transfusión Feto-Fetal/diagnóstico por imagen , Estudios de Seguimiento , Edad Gestacional , Humanos , Recién Nacido , Atención Posnatal , Embarazo , Resultado del Embarazo , Reducción de Embarazo Multifetal , Embarazo Múltiple , Probabilidad , Sistema de Registros , Estudios Retrospectivos , Medición de Riesgo , Estadísticas no Paramétricas
11.
J Gynecol Obstet Hum Reprod ; 46(10): 731-736, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28964964

RESUMEN

INTRODUCTION: The objective was to report on a consecutive series of monochorionic diamniotic pregnancies complicated by selective Intra-Uterine Growth Restriction (sIUGR) and to describe perinatal outcomes based on whether or not there were umbilical Doppler findings, and specifically to study those pregnancies treated by laser. MATERIAL AND METHODS: This was a retrospective cohort study enrolling monochorionic diamniotic pregnancies presenting isolated sIUGR after 16 weeks' gestation (WG). RESULTS: Of the 25 cases of sIUGR, 16 were type I and 9 type II or III. Types II and III occurred earlier than type I (22.3 versus 24.3 WG), were more severe (discordance of 37% versus 23%), and delivered earlier (31.3 versus 33.9 WG). Survival was 12/18 (66.7%) for types II or III versus 32/32 (100%) for type I. Five laser photocoagulation procedures were attempted and allowed the survival of both twins in 2 cases. Overall survival after laser was 6/10 (60%). DISCUSSION: Isolated sIUGR is associated with high perinatal morbidity and mortality. Laser photocoagulation treatment is feasible and may enable survival of both twins in some cases, but may be technically difficult.


Asunto(s)
Corion/cirugía , Retardo del Crecimiento Fetal/cirugía , Coagulación con Láser/métodos , Evaluación de Procesos y Resultados en Atención de Salud , Resultado del Embarazo , Adulto , Enfermedades en Gemelos , Estudios de Factibilidad , Femenino , Humanos , Embarazo , Embarazo Gemelar , Estudios Retrospectivos , Ultrasonografía Prenatal
13.
Am J Obstet Gynecol ; 194(3): 790-5, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16522414

RESUMEN

OBJECTIVE: This study was undertaken to detect missed anastomoses on the chorionic surface as well as hidden connections in the depth of the cotyledons in placentas after laser coagulation for twin-to-twin transfusion syndrome (TTTS) and to correlate these findings to clinical outcome. STUDY DESIGN: All cord vessels were injected with dyed barium sulphate. A digital photograph of the chorionic surface angioarchitecture and single-shot digital X-ray (Rx) angiograms were made. The presence and diameter of any missed anastomoses on the chorionic surface and of any hidden angiographic connections were determined. RESULTS: Fifty placentas were analyzed, 7 of double intrauterine fetal death (IUFD) and 43 of double survivors. In 9 of 43 (21%) cases with double survival and in all 7 cases of double IUFD, missed anastomoses were identified that should have been ablated by laser coagulation (P < .001). There appeared to be a correlation between the type and diameter of missed anastomoses on the chorionic surface and the clinical outcome. Placentas with missed large arteriovenous/venoarterial anastomoses (AV/VA) (N = 8) were from cases with recurrent TTTS or double IUFD (unless compensated by a large arterioarterial anastomosis [AA]). Next, missed small AV/VA (N = 4) without AA resulted in isolated (ie, without TTTS) discordant hemoglobin levels requiring intrauterine transfusion. Finally, when there were no missed anastomoses (N = 34), TTTS had resolved in all cases and outcome was good, although 1 case had discordant hemoglobin values treated with a single intrauterine transfusion and 4 others had discordant hemoglobin at birth. On Rx angiography, potential hidden connections were present, all but 1 case. CONCLUSION: Coagulation of all anastomoses visible on the chorionic surface seems adequate to treat TTTS. However, hidden connections in the depth of the cotyledon could not be excluded and may be involved in lesser degrees of intertwin transfusion.


Asunto(s)
Corion/irrigación sanguínea , Corion/cirugía , Transfusión Feto-Fetal/cirugía , Fetoscopía , Coagulación con Láser , Placenta/irrigación sanguínea , Placenta/cirugía , Fístula Vascular/cirugía , Corion/patología , Femenino , Humanos , Coagulación con Láser/métodos , Placenta/patología , Embarazo , Sobrevivientes
14.
Methods Mol Med ; 121: 241-72, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16251748

RESUMEN

Despite the importance of the definitive chorio-allantoic placenta in fetal survival, fetal development, and long-term health of the adult, little is known about how the placenta's individual components, the allantois and the chorion, proliferate and develop. In this chapter, two techniques will be described: (1) explanting murine allantoises for culture in isolation, and (2) grafting murine allantoises into living whole mouse embryos. Together, these will enable study of differentiation of allantoic mesoderm into the umbilical vasculature, and the mechanism(s) by which the allantois unites with the chorion to form the chorio-allantoic placenta.


Asunto(s)
Alantoides/irrigación sanguínea , Alantoides/embriología , Corion/embriología , Alantoides/citología , Alantoides/cirugía , Animales , Recolección de Muestras de Sangre , Diferenciación Celular , Corion/citología , Corion/cirugía , Medios de Cultivo , Disección , Femenino , Ratones , Neovascularización Fisiológica , Placenta/citología , Placenta/embriología , Placenta/cirugía , Ratas , Ratas Sprague-Dawley , Instrumentos Quirúrgicos , Técnicas de Cultivo de Tejidos , Cordón Umbilical/citología , Cordón Umbilical/embriología
15.
Invest Ophthalmol Vis Sci ; 26(11): 1533-42, 1985 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-2414249

RESUMEN

Several studies have shown that total body irradiation decreases the angiogenic response to corneal cauterization. This inhibition could be due to alterations in angiogenic stimuli within injured corneas and/or to a decreased ability of irradiated animals to respond to such stimuli. To determine whether total body irradiation specifically affects angiogenic stimuli within injured corneal tissue, cauterized corneas from mice exposed to 900 rads of total body irradiation and from non-irradiated controls were grafted onto the chorioallantoic membranes (CAM) of chick embryos and their abilities to stimulate the ingrowth of healthy embryonic blood vessels were compared. Cauterized corneas incorporated into CAM mesenchymal tissue were invaded by blood vessels in 34.6% of the irradiated group and in 75% of the non-irradiated controls. This difference in the two groups was statistically significant (P less than 0.03). Total body irradiation significantly decreased the frequency of vascular invasion of cauterized corneal tissues by healthy CAM blood vessels. This finding suggests that total body irradiation can specifically affect the stimulus for angiogenesis within cauterized corneas.


Asunto(s)
Alantoides/cirugía , Corion/cirugía , Córnea/irrigación sanguínea , Membranas Extraembrionarias/cirugía , Neovascularización Patológica , Irradiación Corporal Total , Animales , Córnea/patología , Trasplante de Córnea , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos DBA , Neovascularización Patológica/patología , Ratas
16.
Placenta ; 23(2-3): 116-31, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-11945078

RESUMEN

Fundamental to placental morphogenesis is union between the allantois and the chorion, two tissues initially separated in the conceptus. Results of previous studies in the mouse have suggested that chorio-allantoic union is driven by the developmental maturity of the allantois and involves molecular interactions between Vascular Cell Adhesion Molecule (VCAM-1) in the allantois and alpha4-integrin in the chorion. Little more is known about the cellular and/or molecular control of this important morphogenetic event in any species.Gross, histological, microsurgical and immunohistochemical analyses in the mouse conceptus revealed that placental ontogeny took place in three major steps. The first, chorio-allantoic contact, was not enduring and was mediated by the allantois' mesothelial surface and the mesodermal component of the chorion. Modest amounts of VCAM-1 were found in distal allantoic mesothelium, whilst levels of alpha4-integrin were high throughout chorionic mesoderm. The second step, chorio-allantoic fusion, was more enduring. During this time, the distal allantoic region contained maximal levels of VCAM-1, and all allantoises had expanded far enough to reach the posterior chorion from where they spread toward a central chorionic depression. The last step, breakdown of chorio-allantoic fusing surfaces, was dependent upon chorio-allantoic fusion and resulted in the intimate juxtaposition of allantoic endothelium and chorionic ectoderm, possibly as a result of VCAM-1-mediated interactions. The umbilical connection was thereafter fixed at its perimeter to the chorionic surface by large amounts of VCAM-1 in disto-lateral allantoic mesothelium and alpha4-integrin in the remaining peripheral mesodermal component of the chorion.Thus, chorio-allantoic union is highly regulated, taking place in multiple steps. It is dependent upon the developmental maturity of distal allantoic mesothelium and involves the mesodermal component of the chorion. Breakdown of fusing surfaces enables penetration of the allantoic vasculature into the chorion. These findings provide a secure developmental foundation in which to elucidate the genetic control of early placentation.


Asunto(s)
Alantoides/embriología , Corion/embriología , Placentación , Alantoides/metabolismo , Animales , Antígenos CD/metabolismo , Corion/metabolismo , Corion/cirugía , Femenino , Inmunohistoquímica , Técnicas In Vitro , Integrina alfa4 , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Microcirugia , Morfogénesis , Placenta/metabolismo , Placenta/cirugía , Embarazo , Molécula 1 de Adhesión Celular Vascular/metabolismo
17.
Tissue Eng ; 9(6): 1263-70, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14670114

RESUMEN

A volume-persistent culture of adipose tissue under in vivo conditions can be achieved only by early vascularization after cell transplantation. Cotransplantation of autologous preadipocytes with endothelial cells may enable the early formation of a capillary network. Investigations were performed in vivo in a specially adapted chorioallantoic membrane (CAM) model. Fertilized White Leghorn eggs were incubated and opened on day 3 of incubation and human dermal microvascular endothelial cell (HDMVEC) spheroids and preadipocytes were transferred in a fibrin matrix to the CAM. On day 7 after incubation the composites were explanted and immunohistologically investigated. Numerous vessels consisting of HDMVECs could be detected and the lumena of these vessels were perfused by chick erythrocytes. These results show the formation of a capillary network consisting of transplanted HDMVECs. The microcirculation of chick erythrocytes in vessels consisting of human endothelial cells proves the continuity of a newly formed capillary system to the host vessel system. The experiments demonstrate the first patent connection of tissue-engineered microvessels in adipose tissue to a host vessel system without applying exogenous angiogenic growth factors or transient transfection. The cotransplantation of endothelial cell spheroids with angiogenic mesenchymal cells may lead to the engineering of complex three-dimensional implants.


Asunto(s)
Adipocitos/citología , Adipocitos/trasplante , Endotelio Vascular/citología , Endotelio Vascular/trasplante , Supervivencia de Injerto/fisiología , Microcirculación/citología , Neovascularización Fisiológica/fisiología , Ingeniería de Tejidos/métodos , Adipocitos/fisiología , Tejido Adiposo/irrigación sanguínea , Tejido Adiposo/citología , Tejido Adiposo/fisiología , Tejido Adiposo/trasplante , Alantoides/irrigación sanguínea , Alantoides/citología , Alantoides/fisiología , Alantoides/cirugía , Animales , División Celular/fisiología , Células Cultivadas , Embrión de Pollo , Corion/irrigación sanguínea , Corion/citología , Corion/fisiología , Corion/cirugía , Técnicas de Cocultivo/métodos , Técnicas de Cultivo/métodos , Endotelio Vascular/fisiología , Humanos , Microcirculación/fisiología , Trasplantes
18.
J Reprod Med ; 35(8): 811-4, 1990 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-2213744

RESUMEN

A prospective, randomized investigation was undertaken in a low-risk group of pregnant women at term (38-42 weeks' gestation) to determine if stripping the fetal membranes would safely result in earlier delivery. Ninety-nine patients entered the study; 51 underwent stripping of the membranes, and 48 controls did not. Fifty-nine percent of the patients in the stripped group delivered within one week as compared to 21% in the nonstripped group (P less than .0003). Two pregnancies in the stripped group advanced beyond 42 weeks' gestation as compared to six pregnancies in the control group (P = .12). A single gravida in the control group developed chorioamnionitis during labor. There were no other infections or other complications. Stripping the membranes was associated with earlier delivery and was not associated with any complications.


Asunto(s)
Corion/cirugía , Trabajo de Parto Inducido/métodos , Resultado del Embarazo , Corioamnionitis/etiología , Parto Obstétrico/métodos , Femenino , Edad Gestacional , Humanos , Trabajo de Parto Inducido/efectos adversos , Embarazo , Estudios Prospectivos
19.
J Fr Ophtalmol ; 26(5): 493-7, 2003 May.
Artículo en Francés | MEDLINE | ID: mdl-12819609

RESUMEN

The presence of a chorioretinal anastomosis in the setting of age-related macular degeneration is known as a sign of poor prognosis. No treatment has proven to be effective. We describe a 71-year-old female patient presenting with exudative age-related macular degeneration, a chorioretinal anastomosis with two retinal feeder vessels (arteriole and veinule), a serous retinal pigment epithelium detachment, and a suspected early subretinal neovascular membrane. She was treated with ICG-guided laser photocoagulation directed to the hot spot, with treatment-zone enlargement directed to the retinal feeder vessels and followed up for 6 months. Although a second laser treatment for the reperfused subretinal neovascular membrane was needed, the clinical and angiographic end result was beneficial. Visual acuity improved by two lines, the chorioretinal anastomosis was occluded, and the pigment epithelium reattached. Taking into account the low therapeutic success rate described in the literature, we suggest that the specific treatment of the retinal feeder vessels, which to our knowledge has not been described before, may be a valuable treatment option.


Asunto(s)
Envejecimiento/fisiología , Corion/cirugía , Fotocoagulación , Degeneración Macular/cirugía , Retina/cirugía , Vasos Retinianos/cirugía , Anciano , Anastomosis Quirúrgica , Femenino , Humanos
20.
J Vis Exp ; (46)2010 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-21206472

RESUMEN

Medaka is a small egg-laying freshwater fish that allows both genetic and embryological analyses and is one of the three vertebrate model organisms in which genome-wide phenotype-driven mutant screens were carried out (1). Divergence of functional overlap of related genes between medaka and zebrafish allows identification of novel phenotypes that are unidentifiable in a single species (2), thus medaka and zebrafish are complementary for genetic dissection of the vertebrate genome functions. Manipulation of medaka embryos, such as dechorionation, mounting embryos for imaging and cell transplantation, are key procedures to work on both medaka and zebrafish in a laboratory. Cell transplantation examines cell autonomy of medaka mutations. Chimeras are generated by transplanting labeled cells from donor embryos into unlabeled recipient embryos. Donor cells can be transplanted to specific areas of the recipient embryos based on the fate maps (3) so that clones from transplanted cells can be integrated in the tissue of interest during development. Due to the hard chorion and soft embryos, manipulation of medaka embryos is more involved than in zebrafish. In this video, we show detailed procedures to manipulate medaka embryos.


Asunto(s)
Trasplante de Células/métodos , Corion/cirugía , Oryzias/embriología , Oryzias/cirugía , Quimera por Trasplante/embriología , Animales , Oryzias/genética , Quimera por Trasplante/genética , Pez Cebra/embriología , Pez Cebra/genética
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