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Chou MM, Yuan JC, Lu YA, Chuang SW. Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder. Taiwan J Obstet Gynecol 2021; 59:956-959. [PMID: 33218421 DOI: 10.1016/j.tjog.2020.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We describe herein our experience of employing a hysterectomy and prophylactic internal iliac artery balloon occlusion (IIABO) strategy for the management of recurrent severe placenta increta at 8 weeks in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum (PAS) disorder. CASE REPORT A 40-year-old woman with a history of uterus-conserving surgery for PAS disorder underwent transvaginal ultrasound evaluation at 8 weeks of pregnancy, which showed a dichorionic/diamniotic pregnancy with viable embryos of a crown-rump length of 1.65 cm and 2.03 cm, respectively. Many irregularly-shaped grade 3+ lacunae were observed, and color Doppler imaging revealed diffuse intraplacental and perihypervascularity. A total abdominal hysterectomy was performed at 10 weeks, with an estimated blood loss of 1275 mL. Placenta increta was confirmed by histopathologic examination. CONCLUSION The high rate of recurrence of PAS disorder in a subsequent pregnancy should be discussed following an antenatal diagnosis of PAS disorder with patients who may be considering uterine conservation in order to retain the option of a future pregnancy.
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Affiliation(s)
- Min-Min Chou
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan.
| | - Jia-Chun Yuan
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
| | - Yaw-An Lu
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
| | - Sheng-Wei Chuang
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
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Chou MM, Yuan JC, Lu YA, Chuang SW. Successful treatment of placenta accreta spectrum disorder using management strategy of serial uterine artery embolization combined with standard weekly and a 8-day methotrexate/folinic acid regimens at 7 weeks of gestation. Taiwan J Obstet Gynecol 2021; 59:952-955. [PMID: 33218420 DOI: 10.1016/j.tjog.2020.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE We describe our experience with serial uterine artery embolization (UAE) combined with standard weekly methotrexate and a eight-day methotrexate/folinic acid (MTX/FA) treatment regimen in the management of placenta accreta spectrum (PAS) disorder at 7 weeks of gestation. CASE REPORT A 38-year-old woman, gravida 2 para 0, with a history of myomectomy, was referred for ultrasound (US) evaluation due to suspected cervico-isthmic pregnancy. Transvaginal US image showed a viable embryo with a disproportionately bigger placenta encircling the fetus and completely covering the internal os of the cervix at 7 weeks of gestation. Color Doppler imaging revealed diffuse intraplacental and periplacental vascularity. Patient chose to terminate the pregnancy but attempted to preserve the uterus for future fertility following counseling. Serial UAE procedures were performed using Gelfoam and metallic microcoils. Two courses of a standard weekly MTX and a eight-day MTX/FA treatment regimen were administered to accelerate placental regression. The beta-hCG gradually decreased to a normal level, and an ultimate resolution of the PAS disorder was observed at 110 days after treatment. CONCLUSION Early diagnosis of the PAS disorder could result in better obstetric outcome through earlier intervention using serial UAE combined with standard weekly and a eight day MTX//FA regimen in the first trimester of pregnancy.
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Affiliation(s)
- Min-Min Chou
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan.
| | - Jia-Chun Yuan
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Yaw-An Lu
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Sheng-Wei Chuang
- Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan
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Fu YX, Wang YH, Tong XS, Gong Z, Sun XM, Yuan JC, Zheng TT, Li C, Niu DQ, Dai HG, Liu XF, Mao YJ, Tang BD, Xue W, Huang YJ. EDACO, a derivative of myricetin, inhibits the differentiation of Gaoyou duck embryonic osteoclasts in vitro. Br Poult Sci 2019; 60:169-175. [PMID: 30722674 DOI: 10.1080/00071668.2018.1564239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
1. This study determined the effects of (E)-3-(2-(4-(3-(2,4-dimethoxyphenyl)acryloyl)phenoxy)ethoxy)-5,7-dimethoxy-2-(3,4,5-trimethoxyphenyl)-4H-chromen-4-one (EDACO) on the differentiation of Gaoyou duck embryonic osteoclasts cultured in vitro. 2. Bone marrow mononuclear cells (BM-MNC) were collected from 23-d-old Gaoyou duck embryos and induced by macrophage colony-stimulating factor and receptor activator of nuclear factor κB ligand in the presence of EDACO at different concentrations (i.e. 10, 20, 40, 80 and 160 µM). Tartrate-resistant acid phosphatase (TRAP) staining and resorption ability determination were conducted. 3. Results suggested that EDACO suppressed the shaping of positive multinucleated cells and the number of TRAP-positive cells in the 20, 40, 80 and 160 μM EDACO groups was significantly decreased (P < 0.05 or P < 0.01). Besides, the absorption activity of differentiated duck embryonic osteoclasts was significantly inhibited (P < 0.05) in both 80 and 160 μM EDACO groups. 4. Overall, EDACO can inhibit the differentiation of BM-MNC into mature osteoclasts in duck embryos.1.
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Affiliation(s)
- Y X Fu
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - Y H Wang
- b State Key Laboratory Breeding Base of Green Pesticide and Agricultural Bioengineering , Guizhou University , Huaxi District , Guiyang , 550025 , PR China
| | - X S Tong
- c College of Veterinary Medicine , Yangzhou University , Yangzhou , 225009 , PR China
| | - Z Gong
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - X M Sun
- d Department of Clinical Medicine , Bengbu Medical College , Bengbu , 233030 , PR China
| | - J C Yuan
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - T T Zheng
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - C Li
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - D Q Niu
- e Department of gynaecology and obstetrics , The Second Affiliated Hospital of Bengbu Medical College , Bengbu , 233030 , PR China
| | - H G Dai
- f Animal husbandry and veterinary bureau of Fengyang County , Chuzhou , 233100 , PR China
| | - X F Liu
- g Department of surgical oncology , The First Affiliated Hospital of Bengbu Medical College , Huaxi District , Bengbu , 233030 , PR China
| | - Y J Mao
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - B D Tang
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
| | - W Xue
- b State Key Laboratory Breeding Base of Green Pesticide and Agricultural Bioengineering , Guizhou University , Huaxi District , Guiyang , 550025 , PR China
| | - Y J Huang
- a Department of Bioscience , Bengbu Medical College , Bengbu , 233030 , PR China
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Yu Z, Liu J, Guo S, Xing C, Fan X, Ning M, Yuan JC, Lo EH, Wang X. Neuroglobin-overexpression alters hypoxic response gene expression in primary neuron culture following oxygen glucose deprivation. Neuroscience 2009; 162:396-403. [PMID: 19401220 DOI: 10.1016/j.neuroscience.2009.04.055] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 04/06/2009] [Accepted: 04/22/2009] [Indexed: 01/19/2023]
Abstract
Neuroglobin (Ngb) is a tissue globin specifically expressed in neurons. Our laboratory and others have shown that Ngb overexpression protects neurons against hypoxia/ischemia, but the underlying mechanisms remain poorly understood. Recent studies demonstrate that hypoxia/ischemia induces a multitude of spatially and temporally regulated responses in gene expression, and initial evidence suggested that Ngb might function in altering biological processes of gene expression. In this study, we asked how Ngb may help regulate genes responsive to hypoxia. Expression of hypoxic response genes following oxygen-glucose deprivation (OGD) was examined using mRNA arrays in neuroglobin-overexpressing transgenic (Ngb-Tg) and wild type (WT) mouse neurons. From a total of 113 genes on the microarray, mRNA expression of 65 genes was detected. Under rest condition, 14 genes were downregulated in Ngb-Tg neurons compared to WT. In WT neurons, after 4-h OGD followed by 4-h reoxygenation (O4/R4), 20 genes were significantly downregulated, and only Fos mRNA was significantly increased. However, out of the 20 downregulated genes in WT neurons, 12 of them were no longer significantly changed in Ngb-Tg neurons: Add1, Arnt2, Camk2g, Cstb, Dr1, Epas1, Gna11, Hif1a, Il6st, Khsrp, Mars and Rara. Among these 12 genes, 8 (Add1, Camk2g, Cstb, Dr1, Epas1, Gna11, Hif1a, Khsrp) were already reduced in Ngb-Tg neurons compared to WT under rest conditions. Additionally, three genes that initially showed no changes in WT neurons (Ctgf, Egfr and Pea15) were downregulated after OGD in the Ngb-Tg neurons. These findings suggest that Ngb overexpression modulates mRNA expression of multiple hypoxic response genes in the early phase after OGD/reoxygenation. Further studies on these gene networks and interactions may lead to better understanding of Ngb in signaling pathways that contribute to neuroprotection.
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Affiliation(s)
- Z Yu
- Neuroprotection Research Laboratory, Department of Neurology and Radiology, Massachusetts General Hospital, Program in Neuroscience, Harvard Medical School, 149 13th Street, Room 2411A, Charlestown, MA 02129, USA
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