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1.
J Hazard Mater ; 422: 126759, 2022 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-34391970

RESUMO

Human labor is associated with feto-maternal-derived signals that coordinate to initiate delivery. Exposure to environmental chemicals can prematurely trigger labor-initiating signals at the feto-maternal interface (FMi: decidua, amniochorion), leading to spontaneous preterm birth (PTB). Testing the association between environmental chemical exposure and PTB is difficult due to many limitations in vivo or in vitro. Physiological organ-on-chips (OOCs) are potential alternatives for studying mechanisms leading to PTB. The presented study tested the effect of maternal exposure to cadmium (Cd), an environmental toxin, using the FMi-OOC that incorporates maternal decidua cells and three different fetal cells (chorion, amnion mesenchymal, and amnion epithelial cells). Cd transport through the FMi and its impact on cell cycle, cell death, and inflammation were analyzed. Cd treatment resulted in significant cell death and a pro-inflammatory environment in the maternal decidua, but had minimal effect on the fetal chorion cells, and no effect in the fetal amnion cells compared to controls. The maternal response, but lack of fetal response, indicates that Cd-mediated adverse effects originate from maternal pathophysiology rather than fetal-derived triggers of preterm labor. This study demonstrates that the FMi-OOC can indeed predict the response of FMi upon exposure to chemicals, opening the possibility for using OOC models for environmental toxin screens.


Assuntos
Decídua , Nascimento Prematuro , Âmnio , Cádmio/toxicidade , Córion , Feminino , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/induzido quimicamente
2.
Artigo em Inglês | MEDLINE | ID: mdl-34547066

RESUMO

Barrier membranes are critical to the success of guided bone regeneration (GBR). Though not directly involved in bone regeneration, barrier membranes hold bone graft materials at the surgical site during the slow process of bone regeneration and prevent the infiltration of fibrotic gingival tissues that would compromise new bone formation. Many options are available on the market, but membranes derived from placental tissues are gaining rapid adoption due to their unique biologic and handling properties. In this case series, a dehydrated human deepithelialized amnion-chorion membrane (ddACM) was used in combination with freeze-dried bone allograft (FDBA) for two-stage GBR procedures. Data from 1-year and 5-year follow-up appointments are presented, as well as predictable indications for the use of ddACM. Using ddACM with FDBA for GBR cases led to predictable bone regeneration with osseointegrated implants at 5-year postoperative visits.


Assuntos
Implantes Dentários , Regeneração Tecidual Guiada Periodontal , Âmnio , Regeneração Óssea , Transplante Ósseo , Córion , Implantação Dentária Endo-Óssea , Feminino , Seguimentos , Humanos , Membranas Artificiais , Placenta , Gravidez
3.
J Obstet Gynaecol Res ; 47(11): 3813-3820, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34490692

RESUMO

AIM: This study aimed to evaluate changes in prenatal testing among women with twin pregnancies before and after the introduction of noninvasive prenatal testing (NIPT). To date, no consensus on prenatal testing for twin pregnancies has been reached in Japan. METHODS: Women pregnant with twins who requested prenatal testing at Kyushu Medical Center from 2005 to 2018 were included in this study. Genetic counseling was provided to all participants. Their chosen methods of testing were collected and classified as invasive diagnosis (ID), noninvasive screening (NIS), and no test requested (NR). Parity, chorionicity, and methods of conception were assessed as attributes. The study period was divided into three terms according to testing availability in our center. RESULTS: After NIPT was introduced in our center, the use of ID methods decreased and eventually disappeared while NIS came to the forefront. NR was also the preferred choice of women with twin pregnancies before the introduction of NIPT and decreased but did not disappear after introducing NIPT. Women with twin pregnancies who underwent assisted reproduction initially showed hesitation to undergo testing but showed a strong preference for NIS after the introduction of NIPT. Differences in choice according to parity, chorionicity, and methods of conception were found before the introduction of NIPT but disappeared after introducing NIPT. CONCLUSION: Increasing information about NIPT has apparently influenced the attitudes of women with twin pregnancies to prenatal testing in Japan. In particular, those who conceive through assisted reproductive technologies exhibited a strong preference for NIPT.


Assuntos
Aconselhamento Genético , Gravidez de Gêmeos , Aneuploidia , Atitude , Córion , Feminino , Testes Genéticos , Humanos , Japão , Gravidez , Diagnóstico Pré-Natal
4.
Obstet Gynecol ; 138(3): 348-352, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34352858

RESUMO

OBJECTIVE: To compare mode of delivery between monochorionic and dichorionic twin pregnancies. METHODS: This was a retrospective cohort study of women undergoing delivery of diamniotic twins in a single maternal-fetal medicine practice in New York City between 2005 and 2021. We compared baseline characteristics and delivery outcomes between monochorionic and dichorionic gestations. The primary outcome was mode of delivery. For monochorionic-diamniotic twin pregnancies at or after 34 weeks of gestation, we also compared neonatal outcomes between women who did and did not attempt vaginal delivery. Data were analyzed using the χ2 test, Fisher exact test, and t test when appropriate. RESULTS: A total of 1,121 diamniotic twin pregnancies were identified, of which 202 (18%) were monochorionic and 919 (82%) were dichorionic. Mode of delivery did not differ between monochorionic and dichorionic pregnancies, both in the overall cohort (cesarean delivery rate 61% vs 63%, P=.54) and in the subgroup of women who attempted vaginal delivery (cesarean delivery rate 22% vs 21%, P=.80). For patients with a vaginal delivery of twin A, the mode of delivery for twin B did not differ between the groups. Among the patients with monochorionic pregnancies at or after 34 weeks of gestation, neonatal outcomes did not differ between women who did and did not attempt vaginal delivery. CONCLUSION: Monochorionic-diamniotic pregnancies are not at an increased risk of cesarean delivery when compared with their dichorionic-diamniotic counterparts.


Assuntos
Córion , Parto Obstétrico/estatística & dados numéricos , Gravidez de Gêmeos , Cuidado Pré-Natal , Adulto , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Cidade de Nova Iorque/epidemiologia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos
5.
J Vet Med Sci ; 83(9): 1448-1453, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34373372

RESUMO

Several studies have reported methods to estimate the parturition date of dogs using ultrasonographic measurements. However, these prediction models were mainly determined using ultrasonographic measurements of naturally pregnant small- and medium-sized dogs, and no such studies have been performed using dogs carrying cloned fetuses produced via somatic cell nuclear transfer. The present study evaluated the abilities of three reference formulas (Luvoni and Grioni, Milani et al., and Groppetti et al.), all of which were developed using data from naturally occurring pregnancies, to accurately predict the parturition date in surrogates carrying cloned German Shepherd (GS) fetuses. All three formulas were based on the use of inner chorionic cavity diameter (ICC) measurements, obtained via ultrasonography. For evaluation, a total of 54 ICC measurements were collected from 14 pregnant bitches carrying cloned GS fetuses. We found that the clinical accuracy of the breed-specific Groppetti et al. formula was highest among those of the three formulas tested, with 87% and 100% of the estimated parturition dates (calculated based on the ICC measurements) being within 1 and 2 days, respectively, of the actual delivery date. By contrast, the Luvoni and Grioni formula showed relatively low accuracy, and the Milani et al. formula showed higher accuracy than that reported previously for natural pregnancies.


Assuntos
Parto , Ultrassonografia Pré-Natal , Animais , Córion/diagnóstico por imagem , Cães , Feminino , Feto , Idade Gestacional , Gravidez , Ultrassonografia Pré-Natal/veterinária
6.
Sci Rep ; 11(1): 16963, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34417521

RESUMO

Suppressor of Hairy wing [Su(Hw)] is an insulator protein that participates in regulating chromatin architecture and gene repression in Drosophila. In previous studies we have shown that Su(Hw) is also required for pre-replication complex (pre-RC) recruitment on Su(Hw)-bound sites (SBSs) in Drosophila S2 cells and pupa. Here, we describe the effect of Su(Hw) on developmentally regulated amplification of 66D and 7F Drosophila amplicons in follicle cells (DAFCs), widely used as models in replication studies. We show Su(Hw) binding co-localizes with all known DAFCs in Drosophila ovaries, whereas disruption of Su(Hw) binding to 66D and 7F DAFCs causes a two-fold decrease in the amplification of these loci. The complete loss of Su(Hw) binding to chromatin impairs pre-RC recruitment to all amplification regulatory regions of 66D and 7F loci at early oogenesis (prior to DAFCs amplification). These changes coincide with a considerable Su(Hw)-dependent condensation of chromatin at 66D and 7F loci. Although we observed the Brm, ISWI, Mi-2, and CHD1 chromatin remodelers at SBSs genome wide, their remodeler activity does not appear to be responsible for chromatin decondensation at the 66D and 7F amplification regulatory regions. We have discovered that, in addition to the CBP/Nejire and Chameau histone acetyltransferases, the Gcn5 acetyltransferase binds to 66D and 7F DAFCs at SBSs and this binding is dependent on Su(Hw). We propose that the main function of Su(Hw) in developmental amplification of 66D and 7F DAFCs is to establish a chromatin structure that is permissive to pre-RC recruitment.


Assuntos
Córion/metabolismo , Cromatina/metabolismo , Proteínas de Drosophila/genética , Drosophila melanogaster/genética , Amplificação de Genes , Loci Gênicos , Proteínas Repressoras/genética , Animais , Montagem e Desmontagem da Cromatina/genética , Análise por Conglomerados , Replicação do DNA/genética , Proteínas de Drosophila/metabolismo , Feminino , Modelos Biológicos , Mutação/genética , Nucleossomos/metabolismo , Oogênese/genética , Folículo Ovariano/metabolismo , Ligação Proteica
7.
Int J Mol Sci ; 22(12)2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34205622

RESUMO

The present study investigates telomere length (TL) in dividing chorionic cytotrophoblast cells from karyotypically normal and abnormal first trimester miscarriages and ongoing pregnancies. Using Q-FISH, we measured relative TLs in the metaphase chromosomes of 61 chorionic villous samples. Relative TLs did not differ between karyotypically normal samples from miscarriages and those from ongoing pregnancies (p = 0.3739). However, among the karyotypically abnormal samples, relative TLs were significantly higher in ongoing pregnancies than in miscarriages (p < 0.0001). Relative TLs were also significantly higher in chorion samples from karyotypically abnormal ongoing pregnancies than in those from karyotypically normal ones (p = 0.0018) in contrast to miscarriages, where relative TL values were higher in the karyotypically normal samples (p = 0.002). In the karyotypically abnormal chorionic cytotrophoblast, the TL variance was significantly lower than in any other group (p < 0.05). Assessed by TL ratios between sister chromatids, interchromatid TL asymmetry demonstrated similar patterns across all of the chorion samples (p = 0.22) but significantly exceeded that in PHA-stimulated lymphocytes (p < 0.0001, p = 0.0003). The longer telomere was predominantly present in the hydroxymethylated sister chromatid in chromosomes featuring hemihydroxymethylation (containing 5-hydroxymethylcytosine in only one sister chromatid)-a typical sign of chorionic cytotrophoblast cells. Our results suggest that the phenomena of interchromatid TL asymmetry and its association to 5hmC patterns in chorionic cytotrophoblast, which are potentially linked to telomere lengthening through recombination, are inherent to the development programme. The TL differences in chorionic cytotrophoblast that are associated with karyotype and embryo viability seem to be determined by heredity rather than telomere elongation mechanisms. The inheritance of long telomeres by a karyotypically abnormal embryo promotes his development, whereas TL in karyotypically normal first-trimester embryos does not seem to have a considerable impact on developmental capacity.


Assuntos
Aborto Espontâneo/patologia , Homeostase do Telômero , Telômero/patologia , Trofoblastos/patologia , 5-Metilcitosina/análogos & derivados , 5-Metilcitosina/metabolismo , Estudos de Casos e Controles , Córion/patologia , Metilação de DNA , Feminino , Humanos , Linfócitos/patologia , Gravidez , Primeiro Trimestre da Gravidez
8.
Int J Mol Sci ; 22(13)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34281205

RESUMO

The placental tissue, due to its angiogenic, anti-inflammatory, antioxidative, antimicrobial, and anti-fibrotic properties, has become a compelling source towards a solution for several indications in regenerative medicine. However, methods to enhance and capture the therapeutic properties with formulations that can further the applications of viable placental tissue have not been explored. In this study, we investigated the regenerative effects of a hypoxia primed flowable placental formulation (FPF), composed of amnion/chorion and umbilical tissue, in two in vivo injury models. Laser Doppler data from rodent ischemia hindlimbs treated with FPF revealed significant tissue perfusion improvements compared to control ischemic hindlimbs. To further corroborate FPF's effects, we used a rodent ischemic bipedicle skin flap wound model. FPF treatment significantly increased the rate of wound closure and the quality of wound healing. FPF-treated wounds displayed reduced inflammation and an increase in angiogenesis. Furthermore, quantitative PCR and next-generation sequencing analysis confirmed these changes in the FPF-treated group at both the gene and transcriptional level. The observed modulation in miRNAs was associated with angiogenesis, regulation of inflammatory microenvironment, cell migration and apoptosis, reactive oxygen species generation, and restoring epithelial barrier function, all processes involved in impaired tissue healing. Taken together, these data validate the tissue regenerative properties of the flowable placental formulation configuration tested.


Assuntos
Hipóxia Celular/fisiologia , Regeneração Tecidual Guiada/métodos , Placenta/metabolismo , Placenta/transplante , Âmnio/metabolismo , Animais , Córion/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Precondicionamento Isquêmico/métodos , Gravidez , Pele/lesões , Cicatrização/fisiologia
9.
Acta Obstet Gynecol Scand ; 100(10): 1814-1821, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34255864

RESUMO

INTRODUCTION: Vaginal colonization with Streptococcus agalactiae (group B streptococci) is hypothesized to constitute a risk factor for preterm prelabor rupture of membranes. In vitro studies have shown that S. agalactiae strains isolated from infants with neonatal sepsis adhere to chorion cells of the human chorioamniotic membrane. However, it is still unknown whether S. agalactiae strains penetrate the chorioamniotic membranes and whether S. agalactiae colonization affects the biomechanical properties of the membranes and thus contributes to increased risk of preterm prelabor rupture. The aim of this in vitro study was to explore if different strains of S. agalactiae penetrate and affect the biomechanical properties of human chorioamniotic membranes. MATERIAL AND METHODS: Three different strains of S. agalactiae were obtained, one from an early-onset neonatal infection, one from a case of preterm prelabor rupture of membranes and one from a healthy pregnant carrier. Chorioamniotic membranes from elective cesarean deliveries were either incubated with S. agalactiae or mounted in a two-chamber incubation cell generating a "maternal" and a "fetal" chamber and incubated with S. agalactiae in the maternal chamber. Subsequently the membranes were examined to evaluate S. agalactiae attachment, penetration and the effect on the biomechanical properties. RESULTS: At 5 h after incubation, S. agalactiae adhered to the chorioamniotic membranes with increased number at 20 h. Streptococcus agalactiae did not penetrate the membranes even after 20 h of incubation. Streptococcus agalactiae increased the ultimate tensile stress needed to rupture the membranes and increased the work needed to rupture the membranes as well as the elastic modulus. CONCLUSIONS: Human chorioamniotic membranes constitute a physical barrier against S. agalactiae infections. Moreover, S. agalactiae infection leads to increased strength of the membranes.


Assuntos
Córion/microbiologia , Ruptura Prematura de Membranas Fetais/microbiologia , Complicações Infecciosas na Gravidez , Infecções Estreptocócicas , Streptococcus agalactiae/patogenicidade , Feminino , Humanos , Técnicas In Vitro , Gravidez
10.
Taiwan J Obstet Gynecol ; 60(4): 791-793, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34247829

RESUMO

OBJECTIVE: A monochorionic dizygotic (MCDZ) twin is rare, especially when complicated with twin-twin transfusion syndrome (TTTS) and treated by laser therapy. CASE REPORT: A pregnancy achieved from oocyte donation and intracytoplasmic sperm injection resulted in two embryos transferred. A monochorionic diamniotic twin pregnancy was diagnosed by an early ultrasound; however, at 16 weeks of gestation, instead of the same sex, the ultrasound suspected there was sex discrepancy between the twins. TTTS with severe polyhydramnios occurred at 22 weeks, leading to a laser therapy, which was followed with a smooth post-operation course. Then the Cesarean section was performed at the gestational age of 29 weeks due to severe preeclampsia, giving birth to two live newborns: one female and one male baby both without neurological sequelae at the time of discharge. Blood chromosomes obtained at delivery and 65 days after delivery all revealed an XX and XY chimera from both babies. CONCLUSION: Laser therapy is also effective in MCDZ twin complicated with TTTS. Determination of chorionicity in early pregnancy could timely prompt us to watch out for complications unique to monochorionic twin pregnancy.


Assuntos
Terapias Fetais/métodos , Transfusão Feto-Fetal/terapia , Terapia a Laser/métodos , Gravidez de Gêmeos , Gêmeos Dizigóticos , Adulto , Cesárea , Córion/anormalidades , Feminino , Transfusão Feto-Fetal/embriologia , Transfusão Feto-Fetal/etiologia , Humanos , Recém-Nascido , Nascido Vivo , Masculino , Doação de Oócitos/efeitos adversos , Gravidez , Injeções de Esperma Intracitoplásmicas/efeitos adversos
11.
ACS Appl Mater Interfaces ; 13(28): 32662-32672, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34240610

RESUMO

The lack of small-diameter vascular grafts (inner diameter <5 mm) to substitute autologous grafts in arterial bypass surgeries has a massive impact on the prognosis and progression of cardiovascular diseases, the leading cause of death globally. Decellularized arteries from different sources have been proposed as an alternative, but their poor mechanical performance and high collagen exposure, which promotes platelet and bacteria adhesion, limit their successful application. In this study, these limitations were surpassed for decellularized umbilical cord arteries through the coating of their lumen with graphene oxide (GO). Placental and umbilical cord arteries were decellularized and perfused with a suspension of GO (C/O ratio 2:1) with ∼1.5 µm lateral size. A homogeneous GO coating that completely covered the collagen fibers was obtained for both arteries, with improvement of mechanical properties being achieved for umbilical cord decellularized arteries. GO coating increased the maximum force in 27%, the burst pressure in 29%, the strain in 25%, and the compliance in 10%, compared to umbilical cord decellularized arteries. The achieved theoretical burst pressure (1960 mmHg) and compliance (13.9%/100 mmHg) are similar to the human saphenous vein and mammary artery, respectively, which are used nowadays as the gold standard in coronary and peripheral artery bypass surgeries. Furthermore, and very importantly, coatings with GO did not compromise the endothelial cell adhesion but decreased platelet and bacteria adhesion to decellularized arteries, which will impact on the prevention of thrombosis and infection, until full re-endothetialization is achieved. Overall, our results reveal that GO coating has an effective role in the improvement of decellularized umbilical cord artery performance, which is a huge step toward their application as a small-diameter vascular graft.


Assuntos
Prótese Vascular , Materiais Revestidos Biocompatíveis/química , Grafite/química , Artérias Umbilicais/química , Aderência Bacteriana/efeitos dos fármacos , Plaquetas/efeitos dos fármacos , Adesão Celular/efeitos dos fármacos , Córion/irrigação sanguínea , Feminino , Células Endoteliais da Veia Umbilical Humana , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Placenta/irrigação sanguínea , Gravidez
12.
BMJ Case Rep ; 14(7)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34326114

RESUMO

In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.


Assuntos
Córion , Ultrassonografia Pré-Natal , Âmnio/diagnóstico por imagem , Âmnio/cirurgia , Córion/diagnóstico por imagem , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Gravidez de Gêmeos , Gêmeos , Gêmeos Monozigóticos
13.
Taiwan J Obstet Gynecol ; 60(4): 639-652, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34247801

RESUMO

OBJECTIVE: No information exists about whether acute histologic chorioamnionitis (acute-HCA) is more advanced and severe, and intra-amniotic inflammation is more frequent and intense according to outside in neutrophil migration within the same chorio-decidua. The objective of current study is to examine this issue. MATERIALS AND METHODS: We included 106 singleton preterm-births (gestational age at delivery: 20-34 weeks) due to either preterm-labor or preterm-PROM in the context of acute chorio-deciduitis. Study-population was divided into 3 groups according to outside-in neutrophil migration within chorio-decidua as follows: 1) group-1: 'inflammation restricted to the decidua' (n = 22); 2) group-2: 'inflammation restricted to the MT of chorion and the decidua' (n = 31); 3) group-3: 'inflammation in the CT of chorion' (n = 53). We examined the frequency of inflammation in each placental compartment beyond chorio-decidua (i.e., amnion, umbilical cord, and chorionic-plate), and total grade (1-8) of acute-HCA. Moreover, the frequency of intra-amniotic infection (defined as positive amniotic-fluid culture for aerobic and anaerobic bacteria and genital mycoplasmas) and intra-amniotic inflammation (defined as amniotic fluid WBC ≥ 19 cells/mm3), and an intra-amniotic inflammatory response gauged by amnioticfluid WBC count (cells/mm3) were examined in 50 amniotic fluid samples within 7 days of birth. RESULTS: Amnionitis, funisitis and chorionic plate inflammation were more frequent (each for P < 0.01) and median total grade of acute-HCA was increased (P < 0.001) according to outside-in neutrophil migration within chorio-decidua (group-1vs.group-2vs.group-3). Moreover, intra-amniotic infection and inflammation were more frequent (each-for P < 0.05) and median amniotic-fluid WBC count was increased (P < 0.01) according-to outside-in neutrophil-migration within chorio-decidua (group-1 vs. group-2 vs. group-3). CONCLUSION: Acute-HCA is more advanced and severe, and intra-amniotic inflammation is more frequent and intense according to outside in neutrophil migration within the same chorio-decidua. This finding suggests that what is now acute chorio-deciduitis should be subdivided.


Assuntos
Movimento Celular/fisiologia , Corioamnionite/sangue , Neutrófilos/fisiologia , Índice de Gravidade de Doença , Doença Aguda , Adulto , Âmnio/metabolismo , Líquido Amniótico , Córion/metabolismo , Decídua/metabolismo , Feminino , Ruptura Prematura de Membranas Fetais/fisiopatologia , Humanos , Recém-Nascido , Inflamação , Contagem de Leucócitos , Trabalho de Parto Prematuro/fisiopatologia , Gravidez , Nascimento Prematuro/fisiopatologia
14.
ACS Biomater Sci Eng ; 7(7): 3423-3433, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34097827

RESUMO

The increase of both arterial occlusive diseases and coronary heart diseases leads to a higher demand for small-diameter vascular grafts (<6 mm). The gold standard for small-diameter vessel replacement is the use of autologous veins. Nevertheless, up to 30% of these patients need to use vascular grafts. Although synthetic polymers have been successfully used for the replacement of large-diameter vascular grafts (>6 mm), they are associated with thrombosis, intimal hyperplasia, calcification, and chronic inflammation when used as small-diameter vascular grafts. Therefore, natural materials have been studied for this application. In this study, a decellularized human chorion membrane (dHCM) vascular graft with a 3-4 mm diameter was created. Herein, the biocompatibility of dHCM with endothelial cells was demonstrated in vitro and ex ovo. Blood biocompatibility of dHCM was also shown by studying plasma protein adsorption, platelet adhesion and activation, and its hemolytic potential. Furthermore, dHCM antibacterial properties against Staphylococcus aureus were also studied. In summary, the dHCM reticular layer side presented all the needed characteristics to be used in the inner side of a vascular graft. Additionally, the mechanical properties of the dHCM tubular construct were studied, being similar to the ones of the saphenous vein, the gold standard for autologous small-diameter vessel replacement.


Assuntos
Bioprótese , Enxerto Vascular , Bioprótese/efeitos adversos , Prótese Vascular/efeitos adversos , Córion , Células Endoteliais , Humanos
15.
Environ Pollut ; 287: 117637, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34182391

RESUMO

In toxicology, standard sigmoidal concentration-response curves are used to predict effects concentrations and set chemical regulations. However, current literature also establishes the existence of complex, bimodal concentration-response curves, as is the case for arsenic toxicity. This bimodal response has been observed at the molecular level, but not characterized at the whole organism level. This study investigated the effect of arsenic (sodium arsenite) on post-gastrulated zebrafish embryos and elucidated effects of bimodal concentration-responses on different phenotypic perturbations. Six hour post fertilized (hpf) zebrafish embryos were exposed to arsenic to 96 hpf. Hatching success, mortality, and morphometric endpoints were evaluated both in embryos with chorions and dechorionated embryos. Zebrafish embryos exhibited a bimodal response to arsenic exposure. Concentration-response curves for exposed embryos with intact chorions had an initial peak in mortality (88%) at 1.33 mM arsenic, followed by a decrease in toxicity (~20% mortality) at 1.75 mM, and subsequently peaked to 100% mortality at higher concentrations. To account for the bimodal response, two distinct concentration-response curves were generated with estimated LC10 values (and 95% CI) of 0.462 (0.415, 0.508) mM and 1.69 (1.58, 1.78) mM for the 'low concentration' and 'high concentration' peaks, respectively. Other phenotypic analyses, including embryo length, yolk and pericardial edema all produced similar concentration-response patterns. Tests with dechorionated embryos also resulted in a bimodal toxicity response but with lower LC10 values of 0.170 (0.120, 0.220) mM and 0.800 (0.60, 0842) mM, respectively. Similarities in bimodal concentration-responses between with-chorion and dechorionated embryos indicate that the observed effect was not caused by the chorion limiting arsenic availability, thus lending support to other studies such as those that hypothesized a conserved bimodal mechanism of arsenic interference with nuclear receptor activation.


Assuntos
Arsênio , Peixe-Zebra , Animais , Arsênio/toxicidade , Córion , Embrião não Mamífero
16.
Artigo em Inglês | MEDLINE | ID: mdl-34076634

RESUMO

This article describes a novel approach for horizontal guided bone regeneration (GBR) using a dehydrated amnion/chorion membrane (dHACM) in conjunction with a composite mixture of cortical autogenous particulate bone scrapings and mineralized bovine bone particulate in the anterior maxilla, allowing for placement of dental implants in a previously deficient alveolar ridge. The grafted region was reentered 8 months after GBR surgery, and a substantial increase in horizontal bone width was observed. Endosseous dental implants were placed with excellent primary stability in a prosthetically driven manner (which could not have been done prior to GBR) and successfully restored with a screw-retained bridge prosthesis. To the authors' knowledge, this is the first reported documentation of successful horizontal GBR using dHACM with subsequent implant placement and restoration, and the first to demonstrate the excellent clinical potential of this biomaterial.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Âmnio , Animais , Regeneração Óssea , Transplante Ósseo , Bovinos , Córion/diagnóstico por imagem , Implantação Dentária Endo-Óssea , Regeneração Tecidual Guiada Periodontal , Humanos
17.
Obstet Gynecol ; 137(6): 1102-1108, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33957658

RESUMO

OBJECTIVE: To evaluate the accuracy and diagnostic value of genome-wide noninvasive prenatal testing (NIPT) for the detection of fetal aneuploidies in multiple gestations, with a focus on dichorionic-diamniotic twin pregnancies. METHODS: We performed a retrospective cohort study including data from pregnant women with a twin or higher-order gestation who underwent genome-wide NIPT at one of the eight Belgian genetic centers between November 1, 2013, and March 1, 2020. Chorionicity and amnionicity were determined by ultrasonography. Follow-up invasive testing was carried out in the event of positive NIPT results. Sensitivity and specificity were calculated for the detection of trisomy 21, 18, and 13 in the dichorionic-diamniotic twin cohort. RESULTS: Unique NIPT analyses were performed for 4,150 pregnant women with a multiple gestation and an additional 767 with vanishing gestations. The failure rate in multiple gestations excluding vanishing gestations ranged from 0% to 11.7% among the different genetic centers. Overall, the failure rate was 4.8%, which could be reduced to 1.2% after single resampling. There were no common fetal trisomies detected among the 86 monochorionic-monoamniotic and 25 triplet cases. Two monochorionic-diamniotic twins had an NIPT result indicative of a trisomy 21, which was confirmed in both fetuses. Among 2,716 dichorionic-diamniotic twin gestations, a sensitivity of 100% (95% CI 74.12-100%) and a specificity of 100% (95% CI 99.86-100%) was reached for trisomy 21 (n=12). For trisomy 18 (n=3), the respective values were 75% (95% CI 30.06-95.44%) sensitivity and 100% (95% CI 99.86-100%) specificity, and for trisomy 13 (n=2), 100% (95% CI 20.65-100%) sensitivity and 99.96% (95% CI 99.79-99.99%) specificity. In the vanishing gestation group, 28 NIPT results were positive for trisomy 21, 18, or 13, with only five confirmed trisomies. CONCLUSION: Genome-wide NIPT performed accurately for detection of aneuploidy in dichorionic-diamniotic twin gestations.


Assuntos
Síndrome de Down/diagnóstico , Reabsorção do Feto , Teste Pré-Natal não Invasivo , Gravidez Múltipla , Síndrome da Trissomia do Cromossomo 13/diagnóstico , Síndrome da Trissomía do Cromossomo 18/diagnóstico , Amniocentese , Âmnio/diagnóstico por imagem , Ácidos Nucleicos Livres/análise , Córion/diagnóstico por imagem , Erros de Diagnóstico , Reações Falso-Negativas , Feminino , Reabsorção do Feto/diagnóstico , Reabsorção do Feto/genética , Genoma Humano , Humanos , Gravidez , Gravidez de Quadrigêmeos , Gravidez de Trigêmeos , Gravidez de Gêmeos , Estudos Retrospectivos , Sensibilidade e Especificidade , Trissomia
18.
Biomed Pharmacother ; 139: 111637, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33965732

RESUMO

Methotrexate (MXT) is a chemotherapeutic drug that has been used in a wide range of clinical practices. Unfortunately, the administration of MXT during pregnancy may induce abortion, fetal deformities, and intrauterine growth retardation. Vitamin E is an antioxidant agent that can ameliorate free radical damage. The current work aimed to shed more light on the possible protective effect of vitamin E against MXT induced placental toxicity and to determine the possible mechanisms; biochemically, histologically, and immunohistochemically. Four groups were used: control pregnant, Vitamin E (VIT E) pregnant, Methotrexate (MXT) pregnant, and Vitamin E Methotrexate (VIT E-MXT) pregnant. The placental tissues were processed for light, immunohistochemical, and electron microscopic study. Other samples were obtained for biochemical study; the placental oxidant/antioxidant status was evaluated. The results showed that MXT caused various placental morphological changes in the form of distorted chorionic projection with an accumulation of hemosiderin granules in the trophoblastic cells. Maternal blood vessels showed a homogenous acidophilic material Edema of the extra-embryonic fetal membranes was noticed. A significant decreased in placental weight as well as increase in the oxidative and inflammatory markers were detected. Increased COX2 and decreased eNOS expressions were observed in the MXT group if compared to the control group. VIT E significantly restored the normal histological and immunohistochemical appearance, placental weight, and oxidant/antioxidant balance. It could be concluded the biochemical, morphological, and morphometric findings suggested that vitamin E coadministration is promising in attenuating the placental toxic effect of methotrexate. In this study, VIT E decreased the inflammatory and oxidative stress effect of methotrexate on the placental tissue by enhancing the level of eNOS.


Assuntos
Antioxidantes/uso terapêutico , Metotrexato/antagonistas & inibidores , Placenta/lesões , Vitamina E/uso terapêutico , Animais , Córion , Ciclo-Oxigenase 2/metabolismo , Edema , Feminino , Sequestradores de Radicais Livres , Imuno-Histoquímica , Metotrexato/toxicidade , Tamanho do Órgão/efeitos dos fármacos , Estresse Oxidativo , Placenta/patologia , Gravidez , Ratos , Trofoblastos/patologia
19.
Obstet Gynecol ; 137(6): e145-e162, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34011891

RESUMO

The incidence of multifetal gestations in the United States has increased dramatically over the past several decades. For example, the rate of twin births increased 76% between 1980 and 2009, from 18.9 to 33.3 per 1,000 births (1). However, after more than three decades of increases, the twin birth rate declined 4% during 2014-2018 to 32.6 twins per 1,000 total births in 2018 (2). The rate of triplet and higher-order multifetal gestations increased more than 400% during the 1980s and 1990s, peaking at 193.5 per 100,000 births in 1998, followed by a modest decrease to 153.4 per 100,000 births by 2009 (3). The triplet and higher-order multiple birth rate was 93.0 per 100,000 births for 2018, an 8% decline from 2017 (101.6) and a 52% decline from the 1998 peak (193.5) (4). The long-term changes in the incidence of multifetal gestations has been attributed to two main factors: 1) a shift toward an older maternal age at conception, when multifetal gestations are more likely to occur naturally, and 2) an increased use of assisted reproductive technology (ART), which is more likely to result in a multifetal gestation (5). A number of perinatal complications are increased with multiple gestations, including fetal anomalies, preeclampsia, and gestational diabetes. One of the most consequential complications encountered with multifetal gestations is preterm birth and the resultant infant morbidity and mortality. Although multiple interventions have been evaluated in the hope of prolonging these gestations and improving outcomes, none has had a substantial effect. The purpose of this document is to review the issues and complications associated with twin, triplet, and higher-order multifetal gestations and present an evidence-based approach to management.


Assuntos
Gravidez Múltipla , Nascimento Prematuro/prevenção & controle , Córion/diagnóstico por imagem , Aberrações Cromossômicas , Parto Obstétrico , Feminino , Morte Fetal , Humanos , Gravidez , Resultado da Gravidez , Redução de Gravidez Multifetal , Nascimento Prematuro/diagnóstico , Técnicas de Reprodução Assistida , Ultrassonografia Pré-Natal
20.
J Morphol ; 282(7): 1080-1122, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33991358

RESUMO

We review morphological features of the amniote egg and embryos in a comparative phylogenetic framework, including all major clades of extant vertebrates. We discuss 40 characters that are relevant for an analysis of the evolutionary history of the vertebrate egg. Special attention is given to the morphology of the cellular yolk sac, the eggshell, and extraembryonic membranes. Many features that are typically assigned to amniotes, such as a large yolk sac, delayed egg deposition, and terrestrial reproduction have evolved independently and convergently in numerous clades of vertebrates. We use phylogenetic character mapping and ancestral character state reconstruction as tools to recognize sequence, order, and patterns of morphological evolution and deduce a hypothesis of the evolutionary history of the amniote egg. Besides amnion and chorioallantois, amniotes ancestrally possess copulatory organs (secondarily reduced in most birds), internal fertilization, and delayed deposition of eggs that contain an embryo in the primitive streak or early somite stage. Except for the amnion, chorioallantois, and amniote type of eggshell, these features evolved convergently in almost all major clades of aquatic vertebrates possibly in response to selective factors such as egg predation, hostile environmental conditions for egg development, or to adjust hatching of young to favorable season. A functionally important feature of the amnion membrane is its myogenic contractility that moves the (early) embryo and prevents adhering of the growing embryo to extraembryonic materials. This function of the amnion membrane and the liquid-filled amnion cavity may have evolved under the requirements of delayed deposition of eggs that contain developing embryos. The chorioallantois is a temporary embryonic exchange organ that supports embryonic development. A possible evolutionary scenario is that the amniote egg presents an exaptation that paved the evolutionary pathway for reproduction on land. As shown by numerous examples from anamniotes, reproduction on land has occurred multiple times among vertebrates-the amniote egg presenting one "solution" that enabled the conquest of land for reproduction.


Assuntos
Vertebrados , Saco Vitelino , Animais , Córion , Membranas Extraembrionárias , Feminino , Filogenia , Gravidez
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