Ectopic Pregnancy as a Model to Identify Endometrial Genes and Signaling Pathways Important in Decidualization and Regulated by Local Trophoblast

The endometrium in early pregnancy undergoes decidualization and functional changes induced by local trophoblast, which are not fully understood. We hypothesized that endometrium from tubal ectopic pregnancy (EP) could be interrogated to identify novel genes and pathways involved in these processes. Gestation-matched endometrium was collected from women with EP (n = 11) and intrauterine pregnancies (IUP) (n = 13). RNA was extracted from the tissue. In addition, tissues were prepared for histological analysis for degree of decidualization. We compared a) the samples from EP that were decidualized (n = 6) with non-decidualized samples (n = 5), and b) the decidualized EP (n = 6) with decidualization-matched IUP (n = 6) samples using an Affymetrix gene array platform, with Ingenuity Pathway Analysis, combined with quantitative RT-PCR. Expression of PRL and IGFBP1 was used to confirm the degree of decidualization in each group. There were no differences in PRL or IGFBP1 expression in the decidualization-matched samples but a marked reduction (P<0.001) in the non-decidualized samples. Decidualization was associated with increased expression of 428 genes including SCARA5 (181-fold), DKK1 (71-fold) and PROK1 (32-fold), and decreased expression of 230 genes including MMP-7 (35-fold) and SFRP4 (21-fold). The top canonical pathways associated with these differentially expressed genes were Natural Killer Cell and Wnt/b-Catenin signaling. Local trophoblast was associated with much less alteration of endometrial gene expression with an increase in 56 genes, including CSH1 (8-fold), and a reduction in 29 genes including CRISP3 (8-fold). The top associated canonical pathway was Antigen Presentation. The study of endometrium from tubal EP may promote novel insights into genes involved in decidualization and those influenced by factors from neighboring trophoblast. This has afforded unique information not highlighted by previous studies and adds to our understanding of the endometrium in early pregnancy

Full-length human placental sFlt-1-e15a isoform induces distinct maternal phenotypes of preeclampsia in mice

<div><p>Objective</p><p>Most anti-angiogenic preeclampsia models in rodents utilized the overexpression of a truncated soluble fms-like tyrosine kinase-1 (sFlt-1) not expressed in any species. Other limitations of mouse preeclampsia models included stressful blood pressure measurements and the lack of postpartum monitoring. We aimed to 1) develop a mouse model of preeclampsia by administering the most abundant human placental sFlt-1 isoform (hsFlt-1-e15a) in preeclampsia; 2) determine blood pressures in non-stressed conditions; and 3) develop a survival surgery that enables the collection of fetuses and placentas and postpartum (PP) monitoring.</p><p>Methods</p><p>Pregnancy status of CD-1 mice was evaluated with high-frequency ultrasound on gestational days (GD) 6 and 7. Telemetry catheters were implanted in the carotid artery on GD7, and their positions were verified by ultrasound on GD13. Mice were injected through tail-vein with adenoviruses expressing hsFlt-1-e15a (n = 11) or green fluorescent protein (GFP; n = 9) on GD8/GD11. Placentas and pups were delivered by cesarean section on GD18 allowing PP monitoring. Urine samples were collected with cystocentesis on GD6/GD7, GD13, GD18, and PPD8, and albumin/creatinine ratios were determined. GFP and hsFlt-1-e15a expression profiles were determined by qRT-PCR. Aortic ring assays were performed to assess the effect of hsFlt-1-e15a on endothelia.</p><p>Results</p><p>Ultrasound predicted pregnancy on GD7 in 97% of cases. Cesarean section survival rate was 100%. Mean arterial blood pressure was higher in hsFlt-1-e15a-treated than in GFP-treated mice (∆MAP = 13.2 mmHg, p = 0.00107; GD18). Focal glomerular changes were found in hsFlt-1-e15a -treated mice, which had higher urine albumin/creatinine ratios than controls (109.3±51.7μg/mg vs. 19.3±5.6μg/mg, p = 4.4x10^-2; GD18). Aortic ring assays showed a 46% lesser microvessel outgrowth in hsFlt-1-e15a-treated than in GFP-treated mice (p = 1.2x10^-2). Placental and fetal weights did not differ between the groups. One mouse with liver disease developed early-onset preeclampsia-like symptoms with intrauterine growth restriction (IUGR).</p><p>Conclusions</p><p>A mouse model of late-onset preeclampsia was developed with the overexpression of hsFlt-1-e15a, verifying the <i>in vivo</i> pathologic effects of this primate-specific, predominant placental sFlt-1 isoform. HsFlt-1-e15a induced early-onset preeclampsia-like symptoms associated with IUGR in a mouse with a liver disease. Our findings support that hsFlt-1-e15a is central to the terminal pathway of preeclampsia, and it can induce the full spectrum of symptoms in this obstetrical syndrome.</p></div

Disorders of the central nervous system

In this article, we have reviewed the most common CNS abnormalities seen in perinatal medicine. The prognosis in ventriculomegaly is most closely related to the presence or absence of associated anomalies. The current treatment for DWM consists of shunting of either the posterior fossa cyst or lateral ventricles. Facial abnormalities can frequently aid in distinguishing holoprosencephaly from other CNS lesions. Anencephaly is one of the most severe fetal anomalies and is incompatible with life. Spina bifida represents a spectrum of NTDs with a variable outcome depending on the size and location of the defect, as well as the presence of other anomalies

Υδατικοί πόροι της νήσου Χίου. Υφιστάμενη γνώση και προτάσεις

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) "Επιστήμη και Τεχνολογία Υδατικών Πόρων"146 σ.Η παρούσα μεταπτυχιακή εργασία, έχει ως αντικείμενο την ανάδειξη του υδατικού καθεστώτος που επικρατεί στη νήσο Χίο, με αναφορές στην ποιότητα του νερού, στα αποθέματα που υπάρχουν, στα προβλήματα που έχουν εμφανιστεί και γενικά στον τρόπο διαχείρισής του νερού. Αρκετές μελέτες έχουν γίνει, κυρίως από το 1980 και μετά, με σχετικές αναφορές σε διάφορες θέσεις του νησιού αλλά κυρίως σχετικές με την ποιότητα του νερού που καλύπτει τις ανάγκες ύδρευσης της πόλης της Χίου. Στα 9 κεφάλαια που περιλαμβάνει η εργασία, γίνεται αρχικά αναφορά, σε θέματα γεωλογικά, μορφολογικά, υδρολογικά και τέλος περιβαλλοντικά με την παρουσίαση των πιθανών ρυπογόνων εστιών που βρίσκονται στο νησί. Ιδιαίτερη έμφαση δίνεται στην υδρολογική λεκάνη του Κορακάρη, που καλύπτει το μεγαλύτερο μέρος για τις ανάγκες ύδρευσης της πόλης της Χίου, και δίνεται η εικόνα των προβλημάτων που αντιμετωπίζει η ευρύτερη περιοχή, τα τελευταία χρόνια. Περιγράφονται τα τεχνικά έργα που έχουν γίνει ή πρόκειται να υλοποιηθούν στο νησί και παρουσιάζονται πολύ γενικά, για όλο το εύρος του νησιού, οι θέσεις που υπάρχει νερό, τα διάφορα προβλήματα που αντιμετωπίζουν κατά περιοχή και ο τρόπος που εξυπηρετούνται τα χωριά της Χίου για να καλυφτούν οι ανάγκες τους. Ιδιαίτερες αναφορές και επισημάνσεις, γίνονται για το έντονο φαινόμενο της υφαλμύρινσης των νερών σαν φυσιολογικό επακόλουθο των υπεραντλήσεων, στην εμφάνιση υδραργύρου στο νερό, στις μεγάλες απώλειες προς την θάλασσα και στα δίκτυα μεταφοράς νερού σε συνδυασμό με τα τεχνικά έργα. Στο τέλος της εργασίας, παρουσιάζονται μια σειρά από συμπεράσματα και προτάσεις, που σκοπό έχουν την ορθολογική αξιοποίηση των υδατικών πόρων του νησιούIn the present master thesis, reference is made to water resources of the Island of Chios, from 1981 to the present. Many are the problems that have arisen, not only due to lack of rainfall on the island but also due to the mismanagement of whatever water is available. The significantly large number of drilling that has taken place at various locations on the island has exacerbated the situation. The effect of overpumping -without any consideration of the consequences- on the underground water reserves, has had a series of devastating effects on the aquifers. The increasing concentration of chloride, is the direct result of excessive pumping, creating adverse conditions with negative effects on the quality of the groundwater systems of Chios. The Office of the Northeastern Aegean Region in cooperation with the Municipality of Chios, in the course of implementing a comprehensive plan to address problems related to water resources of the island, started technical construction projects throughout the island a few years ago. The plan proposes the construction of desalination plants, reservoirs and dams in order to exploit surface water runoff. The study covers the entire island. Emphasis is placed on the hydrological conditions of the Korakaris mountain basin, which covers most of the water and irrigation needs of the capital city of Chios. GENERAL DATA OF THE ISLAND The island has an area of 844 km2 and a coastline of 227 km in length. It is the fifth area largest island in size with a population of about 60,000 residents. ix RAINFALL DATA AND AVAILABLE WATER RESOURCES Rainfalls in various areas of Chios have had wide fluctuations in recent years, as it is shown in the graph below, which reflects the annual rainfall in the three sections of the Prefecture of Chios for the years 1996 to 2008. Image: Amount of annual rainfalls on the island of Chios What is remarkable is the very low precipitation during the period 1999 - 2000, with rainfalls in the south not exceeding 200 mm (intense drought), while the higher rainfall (1.675 mm) occurred in the period 1995 -1996 in the northern part of the island . The rainfall data are derived from the official raingauge stations of the Ministry of Rural Development and Food which operate on the island of Chios. Structure of the master thesis The present master thesis contains 9 chapters, presented in a particular order in order to arrive at conclusions and make some proposals on the management of water resources. In the first chapter, introductory data relating to the framework upon which this master thesis was realized are presented. In the second chapter, reference is made to the geology and geomorphology of the island and presents the main characteristics of both the subsoil and the topography of the island. The third chapter presents the hydrolithology of the island. In the second part of the chapter, reference is made to the hydrogeological data with particular reference to the main hydrological basins, which meet the needs of the capital city of Chios. In part three the hydrological basin of Korakaris mountain is presented, with the most recent data available up to 2003 and the fourth part of the chapter refers to the aquifers of the island. The fourth chapter, outlines the areas of water sampling points with recent data from the study of Mr. P. Giannoulopoulos & Mr. I. Lappas, with EU funding, by the Institute of Geology & Mineral Exploration of Greece (IGME). In the fifth chapter, reference is made to the surface runoff and the streams of the island. It also refers to the hydrological balance of the Parthenis river basinfor the year 1981. Furthermore , the hydrological balance of the principal river basins of Chios, is presented with recent data from the year 2008. The research was condused by Mr. P. Giannoulopoulos & Mr. I. Lappas, with EU funding, by the Institute of Geology & Mineral Exploration of Greece (IGME). The sixth chapter, outlines the main technical works for the exploitation of surface runoffs (desalination plants, filter stations, reservoirs and dams) already constructed or planned to be constructed. The seventh chapter, refers to comprehensive report on the general water conditions whist exists on the island, according to the president of Municipal Company of Chios for Water Supply & Wastewaster Disposal, Mr. Michael Futousis. The eighth chapter presents the water quality of Chios, with data gathered between 1969 and 2008 and the possible water contamination sources are pinpointed. Reference is also made to the existence of Mercury (Hg) in the underground water. The ninth and final chapter, presents the general conclusions resulting from this thesis and makes all the appropriate recommendations which ensue.Γεώργιος Μ. Παΐδα

Rhesus sensitization and alloimmune thrombocytopenia

Significant progress has unquestionably occurred in the diagnosis and treatment of fetal and neonatal alloimmune thrombocytopenia. However, fundamental aspects of this disease are still not fully understood, especially those factors that account for the diverse clinical spectrum of this disease. This impacts our ability to counsel patients regarding the ultimate outcome of fetuses affected with AIT. IVIG appears to be a promising treatment for fetuses affected with this disease. In all likelihood, fetuses affected with AIT are at higher risk for serious bleeding complications related to fetal blood sampling procedures, but this risk remains to be further defined

Platelet disorders in pregnancy: implications for mother and fetus

Platelet disorders in pregnancy are not uncommon. Most often, obstetricians are faced with a patient with undiagnosed thrombocytopenia and have the responsibility of deciding if the condition is ITP, gestational thrombocytopenia, or a process related to pre-eclampsia. Correct diagnosis is important because ITP can be associated with fetal thrombocytopenia, making route of delivery important. In alloimmune thrombocytopenia, the mother develops antibodies to a specific platelet antigen present on the fetal platelet but absent on her own. Severe AIT can cause intracranial hemorrhage and have disastrous consequences for the fetus and neonate. In preliminary studies antenatal intravenous gamma globulin therapy has shown promise in preventing the development of intracranial hemorrhage and ameliorating fetal thrombocytopenia. Essential thrombocythemia with a platelet count of greater than 600 x 10(9) platelet/L can occur in pregnancy; therapy consists of antiplatelet aggregating agents such as aspirin, and plateletpheresis. Platelet function disorders can be acquired or inherited. Acquired platelet dysfunction disorders are usually caused by drugs such as aspirin or indomethacin, or by a systemic disease. Hereditary disorders of platelet function can be diagnosed in utero, but cordocentesis may represent an unacceptably high risk. For prenatal diagnosis, other methods, such as chorionic villus sampling or amniocentesis, should be investigated as an alternative to the potentially high risk of cordocentesis