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Although amnionitis secondary to percutaneous umbilical blood sampling is extremely uncommon, a high index of suspicion should be maintained and a full evaluation should be initiated if nonspecific signs of infection appear within 2 weeks after the procedure is performed. In this case life-threatening adult respiratory distress syndrome was a sequela of this complication.
Early increase in RNA synthesis induced in human amnion U cells by infection with poliovirus is accompanied by an increased incorporation of amino acids into non-histone nuclear proteins with an approximate molecular weight of 40 000. These proteins are the main polypeptides of the 30-S nuclear ribonucleoprotein particles. After fractionation of nuclear proteins by extraction with solutions of different ionic strength, these polypeptides are present in the fraction of nuclear sap proteins soluble in 0.1 M Tris - HCl buffer, pH 7.6, and in the fraction of non-histone chromosomal proteins which are soluble in 0.35 M NaCl. The increase in synthesis of non-histone nuclear proteins with an approximate molecular weight of 40 000, observed in the infected cells, represents an increase in the synthesis of proteins concerned with post-transcriptional events and, therefore, is the result and not the cause of gene activation.
PCNA autoantibodies specific for cyclin/PCNA were used to determine the nuclear distribution of this protein in transformed human amnion cells (AMA) irradiated with ultraviolet light (254 nm) under conditions that induced nucleotide excision DNA repair synthesis. The results showed a striking increase in nuclear cyclin/PCNA antigen staining of non S-phase cells that was not abolished by cycloheximide (20 micrograms/ml, added 2 h before irradiation), and that is most likely due to a redistribution of pre-existing cyclin. These observations raise the possibility that cyclin/PCNA may play a role in nucleotide excision DNA repair synthesis in addition to its putative role in replicative DNA synthesis.
OBJECTIVE: To investigate the influence of culture proven intrauterine infection on preterm morbidity and to test the effect of antimicrobial treatment. METHODS: Retrospective cohort study conducted between October 1997 and February 2001 in patients with preterm premature rupture of membranes or preterm labor. Vaginal swabs were sampled and amniocentesis for microbiologic culture of the amniotic fluid was performed. Patients with Ureaplasma urealyticum in the amniotic fluid were treated with josamycin. Infants were followed post partum according to birth weight, gestational age, APGAR score and infant morbidity. RESULTS: In 49 eligible patients, 40% of cultures were positive, 22% for Ureaplasma urealyticum, 12% for other bacteria and 6% for candida. Children of mothers with positive amniotic fluid cultures had significantly lower gestational ages (26+4 weeks for Ureaplasma urealyticum [p=0.04] and 25+5 weeks for other microorganisms [p=0.0017] versus 28+6 weeks for mothers with negative amniotic fluid cultures) and lower birth weights (975 g [n.s.] and 828 g [p=0.0072] versus 1,041 g) but were appropriate for their gestational ages. 33.3% and 66.7% versus 24% of the children were mechanically ventilated [n.s.], duration of mechanical ventilation was 5.3 [p=0.02] and 10.1 days [p=0.04] versus 1.4 days, and prevalence of chronic lung disease was 38% and 33% versus 11% [n.s.]. Prevalence of severe intraventricular hemorrhage (12.5% [n.s.] and 33% [p=0.04] versus 3.4%) and nosocomial infections (50% for both groups of positive cultures versus 10.3% for negative cultures, p=0.02 and 0.03, respectively) was higher and median length of stay was significantly longer (121 [p=0.02] and 107 days [p=0.03] versus 60 days) in these patients. Maternal positive vaginal swab cultures were not associated with any of the above-mentioned factors. In none of the patients treated with macrolids for proven Ureaplasma urealyticum amnionitis could the microbes be eradicated. CONCLUSION: Maternal positive amniotic fluid cultures have been associated with lower gestational age and lower birth weight. Rate of infant morbidity was higher and length of stay was significantly longer in this group. Positive vaginal swabs were not predictive for infant morbidity. Treatment of mothers showing positive amniotic fluid cultures with macrolids was not effective.
Microcystins (MC), the potent inhibitor of protein phosphatase 1 and 2A, are hepatotoxins of increasing importance due to its high acute toxicity and potent tumor promoting activity. So far, the exact mechanisms of MC-induced hepatotoxicity and tumor promoting activity have not been fully elucidated. To better understand the mechanisms underlying microcystin-RR (MC-RR) induced toxicity as well as provide the possibility for the establishment of biomarkers for MC-RR exposure, differential proteome analysis on human amnion FL cells treated by MC-RR was carried out using two-dimensional gel electrophoresis (2-DE) followed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry. Image analysis of silver-stained 2-dimensional gels revealed that 89 proteins showed significant differential expression in MC-RR treated cells compared with control, and 8 proteins were unique to MC-RR treated cells and 8 proteins were only detected in control cells. Sixty-six proteins were further identified with high confidence by peptide mass fingerprinting. Some of the identified differentially expressed proteins have clearly relationship with the process of apoptosis, signal transduction, and cytoskeleton alteration which are consistent with the literature. The functional implications of alterations in the levels of these proteins were discussed. However, most of which have not been reported previously to be involved in cellular processes responded to MC-RR. Therefore, this work will provide new insight into the mechanism of MC-RR toxicity.
There is a growing demand in Turkey for human tissue to use in surgery and wound healing. However, our country does not have facilities for local production of tissue grafts and generally depends on imported products. Under a multi-year project initiated in 1997, the International Atomic Energy Agency has provided main equipment for tissue processing and experts on Tissue Banking as well as training on tissue processing methods.In this presentation, information on various stages of the project implementation is given. Details of lay out for the process laboratories and equipment are given. Donor selection and testing criteria, processing procedures for bone and amnion, setting up product design, implementation of quality system and radiation sterilisation are described briefly. Quality procedures included preparation of quality manual, record forms, document control, non-conformance and corrective actions, training records, equipment maintenance and calibration are all in line with GMP/GLP Standards. Clinical applications of tissue grafts and medico-legal position of organ and tissue donation in Turkey are also discussed briefly.
The management of moist skin desquamation (ulceration) following radiation therapy has been a concern since the inception of this therapy. The treatment of skin reactions focuses on promoting healing, improving patient comfort preventing infection and decreasing trauma to the area. Various dressings like topical preparations, hydrocolloid and gentian violet 1 % dressing have been used for its treatment. We present our experience with the use of amnion as a biological dressing in patients with radiation induced ulceration following pelvic radiation using megavoltage beam. The preliminary experience with treatment in 14 patients proved to be cost effective due to a shorter duration of ulcer healing (median of 7 days), fewer dressing changes (median of 4 dressings) and diminished use of analgesics.
Haemophilus influenzae is an uncommon cause of obstetric and neonatal infections. Three cases of amnionitis caused by H. influenzae are presented. These cases occurred in three maternal transports to our tertiary level hospital within an 11-day period. The organisms were analyzed for biotypes, penicillinase status, and composition of membrane fatty acids.
Extensive research has been done to investigate the effects of nutrients on placental and fetal development. It is now evident that environmental factors such as diet may exert a profound effect on gene expression during pregnancy. A low intake of vitamin C during pregnancy has been linked to a higher risk of premature rupture of the membranes (PROM) because of its well-known role in collagen biosynthesis. Here we report a new effect of ascorbic acid acting as a modulator of the 72-kDa type IV collagenase (matrix metalloproteinase-2; MMP-2). MMP-2 expression/activity is down-regulated by vitamin C in human amnion cultured cells. The regulatory effect is exerted at the transcriptional level and is specific for MMP-2. Matrix metalloproteinases are implicated in tissue remodeling, and our results allow us to suggest a molecular mechanism that relates poor availability of vitamin C during pregnancy and the development of PROM.
The purpose of this article is to report the case of a 10-year-old girl born with anophthalmia, bilateral oblique facial clefts, and missing scalp and bones over the temporal and parietal areas of the cranial vault bilaterally. Early amnion rupture seems to be the most probable cause of this rare combination of anomalies. Because no similar case has been reported in the literature so far, we describe here the clinical and psychosocial history of this unusual patient, who has been able to live the intellectually and socially normal life of a blind child in spite of the major craniofacial deformities. The already completed and possible future therapeutic strategies are discussed.
Hypotonic treatment of amnion fluid cell-nuclei was found to enhance demonstration of Y chromatin and of autosomal fluorescence in interphase cell-nuclei following quinacrine mustard staining. In contrast, visualization of the Barr body was not improved by this treatment. Nuclear sex determination on cellular material from 200 samples of amniotic fluid was unequivocal in 197 cases; in only 3 cases were the findings uncertain. There were no erroneous determinations. In one instance maternal cellular tissue was observed in smear preparations. Nuclear sex determination presents a simple method of supplementing and substantiating prenatal chromosomal diagnosis.
The successful application of an amniotic membrane graft in the treatment of congenital absence of the vagina is described. Follow up with vaginal smears and vaginal biopsies revealed that amnion when used alone with mesenchyme applied to the host gives protection to the underlying granulation tissue and facilitates epithelialization.
OBJECTIVE: To determine the metabolism of 3H-Platelet-activating factor (3H-PAF) during transfer through human fetal membranes. DESIGN: 3H-PAF was added to the fetal side of cultured intact fetal membranes, amnion and chorio-decidua obtained from three pregnancies ending in elective caesarean section. MAIN OUTCOME MEASURES: Radioactivity was measured on both sides of the tissue, and in the tissue itself. In some experiments, the metabolism of 3H-PAF was assessed by thin-layer chromatography. RESULTS: Very little 3H-PAF crossed the intact fetal membrane (< 2%) during 24 h of culture. Most of the 3H-PAF which accumulated in the membrane was converted to a range of metabolites in the chorio-decidua. CONCLUSIONS: These results suggest that PAF in amniotic fluid may not reach the decidua, and therefore is unlikely to be involved in the control of prostaglandin production from this tissue.
The development of polypoidal structures, derived from organization of amniotic squamous debris, in the middle-ear cavity of 3 infants is described. The lesions mimicked the development of amnion nodosum lesions of the placenta and were attached to either the tympanic membrane or the head of the stapes. They were accompained by atypical metaplastic changes in the middle-ear epithelium. While the clinical significance of the structural changes is uncertain, they strengthen the case for histopathological examination of the middle ear in infant necropsies.
The presented data suggest that PAPase may, indeed, be important in the biosynthesis of lung phospholipids. The observed increase in the specific activity of rabbit lung precedes the "surge" of phosphatidylcholine concentration and surfactant biosynthesis by at least 24 hours. In human amnionic fluid, PAPase specific activity was markedly increased in pregnancies of 35 weeks of gestation or more. The increase in the specific activity of PAPase preceded the "surge" of acetone precipitated phosphatidylcholine. The reported studies may provide an additional procedure to examine the problems associated with surfactant biosynthesis.
CASE DESCRIPTION: A 19-year-old Thoroughbred mare was evaluated at 265 days of gestation with a markedly distended abdomen and edema of the ventral portion of the abdomen. CLINICAL FINDINGS: The uterus was distended over the pelvic rim, making transrectal palpation of the fetus impossible. Transabdominal ultrasonography revealed excessive amounts of fetal fluid. Results of analysis of fluid obtained via amnio- and allantocentesis confirmed that the amniotic cavity was large. TREATMENT AND OUTCOME: The mare was monitored for signs of weakness of the prepubic tendon and abdominal wall. The fetus and placenta were monitored for signs of stress and pending abortion. Flunixin meglumine and altrenogest were administered to the mare. Parturition was attended and occurred at 321 days' gestation. Postpartum complications in the mare included hypovolemic shock and cardiac arrhythmias. Both conditions were treated, and the mare recovered. The foal was considered small, had bilateral angular limb deformities, and was unable to nurse. The foal was given plasma for failure of passive transfer of immunity. Ten months later, the foal underwent procedures to correct limb deformities. CONCLUSIONS AND CLINICAL RELEVANCE: Hydrops conditions are rare in horses, with hydrops allantois occurring more frequently than hydrops amnion; reportedly result in fetal or neonatal death; and may result in death of or injury to the mare. Close monitoring of maternal and fetal health in combination with supportive treatment of the mare can result in the safe progression of a hydrops pregnancy and the birth of a live foal.
Early rupture of the amnion with resultant oligohydramnios and subsequent development of mesodermal bands between the chorion and the fetus can cause various deformities. The degree of deformity depending on the extent of the band formation and the gestational age at which this occurs. The condition may involve all parts of the fetus and comprizes a spectrum ranging from clinically insignificant small constricting bands on the extremities to large craniofacial and visceral defects which may be fatal and cause abortion. Prenatal diagnosis relies mainly on ultrasonic investigation, and the treatment--quo ad vitam--consists mainly of reconstructive surgery. A case is reported.
Two cases of amnion rupture sequence resulting in grossly malformed stillborn infants are described. One baby had marked craniofacial defects while the other had a combination of craniofacial, abdominal wall and limb abnormalities. These are the first such cases to be reported in the English-speaking Caribbean; and aspects of the aetiology, pathogenesis, clinical and pathological features are discussed.