Pro-angiogenic potential of human chorion-derived stem cells: in vitro and in vivo evaluation.

Human chorion-derived stem cells (hCDSC) were previously shown to demonstrate multipotent properties with promising angiogenic characteristics in monolayer-cell culture system. In our study, we investigated the angiogenic capability of hCDSC in 3-dimensional (3D) in vitro and in vivo angiogenic models for the purpose of future application in the treatment of ischaemic diseases. Human CDSC were evaluated for angiogenic and endogenic genes expressions by quantitative PCR. Growth factors secretions were quantified using ELISA. In vitro and in vivo vascular formations were evaluated by histological analysis and confocal microscopic imaging. PECAM-1(+) and vWF(+) vascular-like structures were observed in both in vitro and in vivo angiogenesis models. High secretions of VEGF and bFGF by hCDSC with increased expressions of angiogenic and endogenic genes suggested the possible angiogenic promoting mechanisms by hCDSC. The cooperation of hCDSC with HUVECS to generate vessel-like structures in our systems is an indication that there will be positive interactions of hCDSC with existing endothelial cells when injected into ischaemic tissues. Hence, hCDSC is suggested as the novel approach in the future treatment of ischaemic diseases.

Endogenous and induced angiogenic characteristics of human chorion-derived stem cells.

Cell-based therapy using stem cells has emerged as one of the pro-angiogenic methods to enhance blood vessel growth and sprouting in ischaemic conditions. This study investigated the endogenous and induced angiogenic characteristics of hCDSC (human chorion-derived stem cell) using QPCR (quantitative PCR) method, immunocytochemistry and fibrin-matrigel migration assay. The results showed that cultured hCDSC endogenously expressed angiogenic-endogenic-associated genes (VEGF, bFGF, PGF, HGF, Ang-1, PECAM-1, eNOS, Ve-cad, CD34, VEGFR-2 and vWF), with significant increase in mRNA levels of PGF, HGF, Ang-1, eNOS, VEGFR-2 and vWF following induction by bFGF (basic fibroblast growth factor) and VEGF (vascular endothelial growth factor). These enhanced angiogenic properties suggest that induced hCDSC provides a stronger angiogenic effect for the treatment of ischaemia. After angiogenic induction, hCDSC showed no reduction in the expression of the stemness genes, but had significantly higher levels of mRNA of Oct-4, Nanog (3), FZD9, ABCG-2 and BST-1. The induced cells were positive for PECAM-1 (platelet/endothelial cell adhesion molecule 1) and vWF (von Willebrand factor) with immunocytochemistry staining. hCDSC also showed endothelial migration behaviour when cultured in fibrin-matrigel construct and were capable of forming vessels in vivo after implanting into nude mice. These data suggest that hCDSC could be the cells of choice in the cell-based therapy for pro-angiogenic purpose.

Laparoscopic salpingectomy in tubal pregnancy: prospective randomized trial using endoloop versus electrocautery.

AIM: Ectopic pregnancy is conventionally managed by laparoscopic salpingectomy. Electrocautery has been used widely to secure hemostasis during salpingectomy. However, this method is associated with a risk of thermal injury to the visceral organs. Endoloop, a pre-tied suture used in laparoscopic surgery may be an alternative treatment tool and its potential use in the management of ectopic pregnancy is explored here. Our study aims to compare the effectiveness of the endoloop technique to electrocautery during laparoscopic salpingectomy for tubal pregnancy. METHODS: A prospective randomized controlled study was conducted over 24 months at the Hospital Universiti Kebangsaan Malaysia. One hundred and two patients with tubal pregnancy were randomized into two treatment groups: those treated with endoloop and those treated with electrocautery during laparoscopic salpingectomy. RESULTS: The use of an endoloop was associated with a shorter operating time (48.85 min +/- 21.019 vs 61.14 min +/- 22.603, 95% CI -20.864 to -3.724), lower visual analog scores for postoperative pain at day 1 (2.02 +/- 0.960 vs 2.74 +/- 0.828, 95% CI -1.074 to -0.368) and day 7 (0.85 +/- 0.802 vs 1.44 +/- 0.837, 95% CI -0.916 to -0.272), and lesser total analgesia required by patients at day 7 after the operation (7.65 +/- 6.119 vs 15.32 +/- 8.326, 95% CI -10.529 to -4.804). There was no significant difference in the ability to secure hemostasis when both techniques were compared. Duration of hospitalization (2.37 days +/- 0.817 vs 2.34 days +/- 0.519, 95% CI -0.245 to -0.296) and interval from operation to discharge were similar. CONCLUSION: The endoloop appeared to be as effective as electrocautery and is a safe alternative to electrocautery for laparoscopic salpingectomy in tubal pregnancy.

Imperforate hymen: report of an unusual familial occurrence.

Imperforate hymen is an uncommon obstructive anomaly of the female reproductive tract, which usually presents with intermittent and cyclical abdominal pain. Although it is usually sporadic, four cases of familial occurrence of imperforate hymen have been reported so far. Imperforate hymen is seldom associated with complications if it is detected early. In view of the possible familial occurrence, it is important to have a high index of suspicion in women who present with imperforate hymen. A detailed menstrual history of other female family members is necessary to enable early detection.