PubMed · 245862
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E W Loendersloot. 1978-01-17. [Current developments in obstetrics. 1].. https://pubmed.ncbi.nlm.nih.gov/245862/
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OBJECTIVE: The aim of this study was to evaluate the role of transabdominal amnioinfusion in relieving oligohydramnios and improving pregnancy outcome. STUDY DESIGN: Pregnant women with oligohydramnios amniotic fluid index (AFI<5) and premature rupture of membranes (PROM) from <27 weeks gestation were managed with serial transabdominal amnioinfusions. Under ultrasonic guidance, a 20-gauge needle was instilled in the uterine cavity and normal saline was infused until the AFI was normal. Repeat amnioinfusion was done weekly if oligohydramnios recurred. Amnioinfused cases were compared to cases with pPROM and oligohydramnios who had standard management. RESULTS: The mean gestational age at first procedure was 22 weeks. The mean pre-procedure AFI was 1.1cm and post-procedure was 12 cm. The mean number of infusions was 2.4. The mean first infusion to delivery interval was 33 days. The amnioinfused group when compared to the control group had decreased perinatal mortality of 33% versus 83% (P=0.036, OR=0.4, 95% CI=0.17-0.93), neonatal mortality of 17% versus 71% (P=0.049, OR=0.26, 95% CI=0.07-0.97) and neonatal sepsis 86% versus 27%(P=0.049, OR=0.32, 95% CI=0.12-0.87) with no statistical difference in gestational age at rupture and delivery nor birthweight. Babies discharged home compared to non-survivors had a significant increase in gestational age at delivery, birthweight, NICU days and transabdominal amnioinfusions. Logistic regression showed that only transabdominal amnioinfusion and gestational age correlated with survival. CONCLUSION: In selected cases of oligohydramnios with pPROM, transabdominal amnioinfusions may be associated with fluid retention and improved neonatal survival.
Occurrence of two-dimensional chain melting phase transition in foam bilayers was established for the first time. Microscopic horizontal foam bilayers [Newton black films (NBF)] were investigated by the microinterferometric method of Scheludko-Exerowa. The foam bilayers were formed from water-ethanol solutions of dimyristoylphosphatidylcholine (DMPC) and dipalmitoylphosphatidylcholine (DPPC) and egg phosphatidylcholine (Egg PC) and samples of amniotic fluid (AF) at different temperatures. The influence of temperature on the foam bilayer thickness h(w) and on the critical concentration Cc for formation of foam bilayer was studied. It was shown that in the range of the main phase transition the temperature dependence of h(w) and C(c) changed specifically in the case of DMPC and DPPC foam bilayers. The thickness of the foam bilayers increased with decreasing temperature in the range of the main phase transition due to the melting of hydrocarbon tails of phospholipid molecules. These changes took place at the temperatures of the bulk chain-melting phase transitions, as determined by differential scanning calorimetry (DSC) for both aqueous, and water/ethanol DMPC, DPPC, and DPPC dispersions. An effect of the 'disperse medium' on h(w) was found for foam bilayers from DPPC. The results that foam bilayers could have different thickness at different temperatures disproved the current concept that NBF acquired constant thickness at concentrations higher than C(el,cr). The data for Cc were analysed on the basis of the hole-nucleation theory of bilayer stability of Kashchiev and Exerowa. This theory considered the amphiphile bilayer as a two-dimensional ordered system with short-range molecular interactions between the first neighbour molecules (as in a crystal). The short-range molecular interactions were presented by the parameter binding energy Q of an amphiphile molecule in the bilayer. The binding energy Q of two neighbouring phospholipids was calculated for the gel (30-60 kT) and liquid crystalline state (16-18 kT) of the bilayers from DMPC, DPPC, Egg PC, AF. Concentration/temperature phase diagram of DPPC foam bilayers that defined regions of gaseous (ruptured), gel and liquid crystalline foam bilayers were drawn. The values of Q obtained for various samples were very close and vary from 5.3 x 10(-20) to 9.4 x 10(-20) (approx. 13-22 kT) which indicated that in all cases the foam bilayers were in liquid-crystalline state. This is an important result since the parameter studied-threshold concentration (threshold dilution) is crucial for a very successful assessment of the risk for respiratory distress syndrome (RDS) in newborns and could be employed in medicine for assessment of other respiratory disturbances. It is to be expected that foam bilayers from phospholipids could be used as a model for investigation of short-range forces in biological structures, of interaction between membranes, etc.
Human kallikrein 11 (hK11) is a putative serine protease of the human kallikrein gene family. Currently, no methods are available for measuring hK11 in biological fluids and tissues. Our aim was to develop immunological reagents and assays for measuring hK11 and examine if the concentration of this kallikrein is altered in disease states. We produced recombinant hK11 protein in a baculovirus system and used it to develop monoclonal and polyclonal antibodies against hK11. We then developed an immunofluorometric procedure for measuring hK11 in biological fluids and tissue extracts with high sensitivity and specificity. We further quantified hK11 in various biological fluids and in serum of patients with various cancers. The hK11 immunofluorometric assay is highly sensitive (detection limit, 0.1 microg/l) and specific (no detectable cross-reactivity for other homologous kallikreins). We established the tissue expression pattern of hK11 at the protein level and found the highest levels in the prostate, followed by stomach, trachea, skin, and colon. We have immunohistochemically localized hK11 in epithelial cells of various organs. We further detected hK11 in amniotic fluid, milk of lactating women, cerebrospinal fluid, follicular fluid, and breast cancer cytosols. However, highest levels were seen in prostatic tissue extracts and seminal plasma. hK11 in seminal plasma and prostatic extracts is present at approximately 300-fold lower levels than prostate-specific antigen and at approximately the same levels as hK2. hK11 expression in breast cancer cell lines is up-regulated by estradiol. Elevated serum levels of hK11 were found in 70% of women with ovarian cancer and in 60% of men with prostate cancer. This is the first reported immunological assay for hK11. Analysis of this biomarker in serum may aid in the diagnosis and monitoring of ovarian and prostatic carcinoma.