RESUMEN
OBJECTIVE: To compare the obstetric outcome and incidence of procedure-related adverse events after embryo reduction (ER) vs fetal reduction (FR), in multifetal pregnancies undergoing reduction to twins or singletons. METHODS: We analyzed retrospectively data from multifetal pregnancies that underwent transvaginal ER (n = 181) at a mean gestational age of 7.6 weeks or transabdominal FR (n = 115) at a mean gestational age of 12.9 weeks between December 2006 and January 2017. FR was performed after a detailed fetal anomaly scan. The two groups were compared with respect to obstetric outcomes, such as incidence of miscarriage, early or late preterm delivery, maternal complications and fetal loss, and procedure-related adverse events, including incidence of subchorionic hematoma and procedure-related fetal loss. RESULTS: Compared with pregnancies that underwent ER, the incidence of procedure-related fetal loss was lower in the FR group (7.2% vs 0.9%; P = 0.039; odds ratio (OR), 0.12; 95% CI, 0.02-0.89). Mean gestational age at delivery for twins was 34.2 weeks in the ER group and 35.7 weeks in the FR group (P = 0.014). Compared with the ER group, the FR group had lower miscarriage (8.8% vs 2.6%; P = 0.045; OR, 0.28; 95% CI, 0.08-0.97) and overall fetal loss (13.3% vs 5.2%; P = 0.031; OR, 0.36; 95% CI, 0.14-0.91) rates. CONCLUSIONS: The FR procedure is, overall, a better and safer approach to reducing morbidity and mortality in multifetal pregnancies. Spontaneous demise of one fetus may occur after ER, and FR has the advantage that chorionic villus sampling and ultrasound screening for increased nuchal translucency and anatomical defects can be conducted before the procedure. The ER approach is still reasonable when a patient's religious or other ethical concerns are of primary importance. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Asunto(s)
Reducción de Embarazo Multifetal/métodos , Embarazo Múltiple/estadística & datos numéricos , Aborto Espontáneo/epidemiología , Aborto Espontáneo/etiología , Adulto , Muestra de la Vellosidad Coriónica/efectos adversos , Femenino , Fertilización In Vitro/efectos adversos , Fertilización In Vitro/estadística & datos numéricos , Edad Gestacional , Humanos , Embarazo , Reducción de Embarazo Multifetal/efectos adversos , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/etiología , Estudios RetrospectivosRESUMEN
The poly(methyl urethane) acrylate oligomer was obtained by the reaction of methyl acrylate oligomer and 2-isocyanatoethyl methacrylate. Synthesis of poly(methyl urethane) acrylate oligomer was done with 2-mercaptoethanol (2-MEOH), methyl acrylate, 2,2'-azobisisobutyronitrile (AIBN, initiator) and dibutyltin dilaurate as a catalyst. Then 2-MEOH was used for functional chain transfer agent. The structure and property of the synthesized oligomers were characterized by FT-IR, FT-NMR, rheometer, and DSC. In this study, by synthetic method including the addition of 2-isocyanatoethyl methacrylate, thermal behavior of synthesized material was improved more than that reported in the previous study. Poly(methyl urethane) oligomer can be used for UV curable coatings, inks and adhesives. UV curable coating have high resistance against weather, ozone, aging, frictional wear, and heat. Besides they can absorb the shock and resist rust according to the thickness of film. It is used as an adhesive, paint, optical fiber coating agent, and waterproof agent because of these advantages at the present time.
RESUMEN
Regarding the molecular mechanism of dynamin in receptor-mediated endocytosis, GTPase activity of dynamin has been thought to have a critical role in endocytic vesicle internalization. However, a recent report suggested that GTP-binding to dynamin itself activates the dynamin to recruit molecular machinery necessary for endocytosis. In this study, to investigate the role of GTP binding to dynamin II, we generated two mutant dynamin II constructs: G38V and K44E. G38V, its GTP binding site might be mainly occupied by GTP caused by reduced GTPase activity, and K44E mutant, its GTP binding site might be vacant, caused by its decreased affinity for GTP and GDP. From the analysis of the ratio of GTP vs GDP bound to dynamin, we confirmed these properties. To test the effect of these mutant dynamins on endocytosis, we performed flow cytometry and confocal immunofluorescence analysis and found that these two mutants have inhibitory effect on transferrin-induced endocytosis. Whereas fluorescent transferrin was completely internalized in wild-type (WT) dynamin II expressing cells, no intracellular accumulation of fluorescent transferrin was found in the cells overexpressing K44E and G38V mutant. Interestingly, the amount of GTP bound to K44E was increased when endocytosis was induced than that bound to WT. The present results suggested that the GTPase activity of dynamin II is required for formation of endocytic vesicle and GTP-binding to dynamin II per se is not sufficient for stimulating endocytosis.
Asunto(s)
Endocitosis/fisiología , GTP Fosfohidrolasas/metabolismo , Guanosina Trifosfato/metabolismo , Células 3T3 , Sustitución de Aminoácidos , Animales , Sitios de Unión/genética , Línea Celular Transformada , Dinaminas , Endocitosis/efectos de los fármacos , Citometría de Flujo , Técnica del Anticuerpo Fluorescente , GTP Fosfohidrolasas/genética , Expresión Génica , Guanosina Difosfato/metabolismo , Guanosina Trifosfato/farmacología , Humanos , Ratones , Mutagénesis Sitio-Dirigida , Unión Proteica/efectos de los fármacos , Unión Proteica/genética , Transfección , Transferrina/metabolismo , Transferrina/farmacologíaRESUMEN
Fluorescein and horseradish peroxidase-labeled monoclonal antibodies were used to localize the predominant toxic peptide CSTX-1 in the venom gland of the spider Cupiennius salei. There was no polarity of CSTX-1 expression in repleted glands, whereas the glands of previously milked spiders showed a decreasing immunofluorescent response from the distal to the proximal portion. Detailed investigation revealed a new structure in the venom-secreting epithelium, which is postulated to be an evolutionary adaptation to increasing gland volume. CSTX-1 was found to be synthesized and stored as a fully active toxin within complex units, composed of long interdigitating cells running perpendicular to the muscular sheath and extending into the central lumen of the gland. These venom-producing units were found in all sectors of the gland, including the transitional region between the main gland and the venom duct. The venom is liberated from the venom-producing units into the glandular lumen following the contraction of the surrounding muscle layer. Free nuclei or other cellular fragments, which would have provided evidence for a holocrine secretion process, were not found in the glandular lumen or in the crude venom obtained by electrical stimulation. The fine regulation of the spider's venom injection process is postulated to be the function of the bulbous ampulla, situated in the anterior third of the venom duct.