جستجوی مقالات مرتبط با کلیدواژه « amnion » در نشریات گروه « پزشکی »

The skin serves as the main defense barrier, protecting against injuries, and preventing infection and water loss. Consequently, wound healing and skin regeneration are crucial aspects of wound management. A novel hydrogel scaffold was developed by incorporating carboxymethyl cellulose (CMC) and gelatin (Gel) hydrogels cross-linked with 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) containing Sphingosine 1-phosphate (S1P). This hydrogel is applied topically to treat acute wounds and is covered with a human acellular amniotic membrane (hAAM) as a secondary dressing. 

The scaffold was subjected to in vitro cell viability, red blood cell hemolysis, blood clotting index, and in vivo assays. Real-time PCR was implemented to verify the expression of genes involved in skin wounds. The physical and chemical properties of the scaffolds were also tested using weight loss, swelling ratio, scanning electron microscopy (SEM), Fourier transform infrared (FTIR), and mechanical tensile analysis. 

The synthetic scaffold is biocompatible as evidenced by the high percentage of 3T3 cell viability (127%) after 72 hr. Additionally, excellent hemocompatibility with a low hemolytic effect (2.26%) was observed. Our in vivo wound healing assay demonstrated that CMC/Gel/S1P/hAAM wound dressing led to faster wound healing in treated rats compared to the control group over 14.Also, the mechanical tests showed that the amniotic membrane and the hAAM had very different Young’s modulus and elongation at break values.

This study demonstrates the effectiveness of the CMC/Gel/EDC hydrogel with S1P as a wound dressing. Additionally, hAAM exhibits excellent characteristics as a protective layer for the treatment of acute wounds.

Recent studies imply extensive applications for the human amniotic membrane (hAM) and its extract in medicine and ophthalmology. The content of hAM meets many requirements in eye surgeries, such as refractive surgery as the most important and commonly used method for treating the dramatically increasing refractive errors. However, they are associated with complications such as corneal haziness and corneal ulcer. This study was designed to evaluate the impact of amniotic membrane extracted eye drop (AMEED) on Trans-PRK surgery complications.

This interventional and historical study was performed during two years (July 1, 2019-September 1, 2020). Thirty-two patients (64 eyes), including 17 females and 15 males, aged 20 to 50 years (mean age of 29.59 ± 6.51) with spherical equivalent between -5 to -1.5 underwent Trans Epithelial Photorefractive Keratectomy (Trans-PRK) surgery. One eye was selected per case (case group) and the other eye was considered as control. Randomization was done using the random allocation rule. The case group was treated with AMEED, and the artificial tear drop every 4 hours. The control eyes received artificial tear drops instilled every 4 hours. The evaluation continued for three days after the Trans-PRK surgery.

A significant decrease in CED size was found in the AMEED group on the second day after surgery (P=0.046). Also, this group had a substantial reduction in pain, hyperemia, and haziness.

This study showed that AMEED drop can increase the healing rate of corneal epithelial lesions after Trans- PRK surgery and reduce the early and late complications of Trans-PRK surgery. Researchers and Ophthalmologists should consider AMEED as a selection in patients with persistent corneal epithelial defects and patients who have difficulty in corneal epithelial healing. We understood AMEED has a different effect on the cornea after surgery; therefore, the researcher must know AMEED’s exact ingredients and help expand AMEED uses.

Compare the recurrence rate of paresthesias in patients undergoing primary cubital tunnel surgery inthose with and without wrapping of the ulnar nerve with the human amniotic membrane (HAM). A retrospective investigation of patients undergoing primary cubital tunnel surgery with a minimum90-day follow-up was performed. Patients were excluded if the nerve was wrapped using another material, associated traumatic injury,simultaneous Guyon’s canal release, or revision procedures. Failure was defined as those patients who experiencedinitial complete resolution of symptoms (paresthesias) but then developed recurrence of paresthesias. A total of 57 controls (CON) and 21 treated with HAM met our inclusion criteria. There was a difference inthe mean age of CON (48.4 ± 13.5 years) and HAM (30.6 ± 15) (P< 0.0001). There was no difference in gender mix(P=0.4), the severity of symptoms (P=0.13), and length of follow-up (P=0.084). None of 21 (0%) treated with HAMdeveloped recurrence of symptoms compared to 11 of 57 (19.3%) (P=0.03) (CON). Using a multivariate regressionmodel adjusted for age and procedure type, CON was 24.4 (95% CI=1.26-500, P=0.0348) times higher risk than HAMof developing a recurrence of symptoms. The HAM wrapping used in primary cubital tunnel surgery significantly reduced recurrence rates ofparesthesias. Further prospective studies with randomization should be carried out to better understand the role HAMcan play in cubital tunnel surgery.Level of evidence: III

Statement of the Problem:

 The surgical repair of nasal septal perforation (NSP) has always been a challenging procedure and no consensus has been made about a definitive protocol.

In the current study, we investigated the use of cryopreserved amniotic membrane with mucosal rotational flap for the surgical repair of NSPs.

In this prospective clinical study, 12 patients with symptomatic NSP underwent primary surgical repair, between December 2018 and October 2019. The surgical procedure comprised of a rotational flap on one side of the defect and cryopreserved amniotic membrane as an interpositional graft in the mucoperichondrial pocket on the other side. The patency of defect was checked at a follow-up appointment at least 3 months after surgery.

Successful repair was perceived in 10 of 12 (83%) of patients. Reperforation occurred in two patients but the size of the defect was smaller than the original one. All of the patients reported elimination of all symptoms associated with NSP.

The use of cryopreserved amniotic membrane as an interpositional graft accompanied by a mucosal rotational flap seems to be efficient in alleviating the symptoms of NSP and closure of the defect.

Ischemic cardiomyopathies are the leading causes of mortality and morbidity. Stem cell therapy using amniotic membrane mesenchymal stem cells have emerged as a promising cardiac regeneration modality. They have shown great immunological advantage when used in allogeneic or xenogeneic transplantation. The aim of the current study is to accumulate evidence from published preclinical studies on the application of amniotic membrane derived mesenchymal stem cells (AMSCs) in the treatment of ischemic cardiomyopathies including myocardial ischemia and heart failure. The aim is to define if there is enough high-quality current evidence to support starting the use of these cells in clinical trials.

PubMed, SCOPUS, EMBASE, and ISI Web of Science databases were searched without temporal and language restrictions. Data were extracted from selected studies. The primary outcomes were left ventricular ejection fraction (LVEF) and LV fibrosis. The risk of bias (ROB) assessment was performed using SYRCLE’s ROB tool. After qualitative synthesis, provided that data meets the criteria for quantitative analysis, a meta-analysis was performed using Stata software V12 to investigate the heterogeneity of the data and to get an overall estimate of the effect size of the treatment on each outcome.

On primary search, 438 citations were retrieved. After screening, three studies were selected for quantitative analysis of each of the outcomes LVEF and LV fibrosis. Their administration in acute and chronic MI alleviates heart failure and improves LVEF (SMD=3.56, 95% CI: 2.24-4.87, I-squared=83.1%, p=0.003) and reduces infarct size (SMD= -4.41, 95% CI: (-5.68)-(-3.14), I-squared=79.0%, p=0.009). These observations were achieved in the acute MI model, HF following ischemia due to coronary artery stenosis and coronary artery occlusion with the early restoration of the perfusion.

Present low and medium quality evidence from preclinical studies confirm the efficacy of the AMSCs in the preclinical models of acute MI and HF following ischemia due to coronary artery stenosis and permanent/temporary coronary artery occlusion. High-quality preclinical studies are indicated to bridge the gaps in translation of the current findings of AMSCs research for the treatment of patients with acute and chronic myocardial ischemia and heart failure.

Tooth nonvitality is one of the frequently seen consequences of dental trauma that causes the arrest of root development. Amniotic membrane has received a lot of attention for its use in transplantation and regeneration procedures. This article reports a unique and novel case of successful regenerative endodontic procedure done using amniotic membrane in a traumatized immature right maxillary central incisor of an 8‑year‑old girl. The clinical and radiographic evaluation done during the recall visits at 1, 3, 6, 9 and 12 months showed a progressive root growth with apical closure.

Currently, scientists are looking for a solution to the problem of the couples who have a lack of germ cells by through cell therapy. It is found that human amniotic membrane mesenchymal stem cells (hAMSCs) could be a good candidate for solving this problem. In the present study, an attempt was made to show that hUMSCs can express the PGC markers in the presence of retinoic acid (RA).

Placenta was obtained from healthy mothers and amniotic stem cells were isolated by enzymatic method from amniotic membrane. The cells were treated by retinoic acid for 14 days. Mesenchymal properties of hAMSCs were assessed by flow-cytometry and expression of PGC markers was established by Q-PCR.

Mesenchymal stem cell properties were confirmed by antibodies against mesenchymal stem cell markers (CD73, CD90, and CD105). After that, the expression of the C-kit, Oct4, SSEA4, VASA genes were determined as primordial germ cell markers using quantitative PCR. It was found that the use of retinoic acid led to the highest expression of C-kit, SSEA4, VASA genes and lower expression of Oct4.

Our study indicates that retinoic acid can be used as a suitable factor for induction of hAMSCs into primordial germ cells (PGCs) and hAMSCs have enough potential to do that.

Human amnion-derived mesenchymal stem cells (hAMSCs) have been used in the treatment of acute myocardial infarction. In the current study, we investigated the efficacy of hAMSCs for the treatment of chronic model of myocardial ischemia and heart failure (HF) in rats. Male Wistar rats weighing between 250 to 350 g were randomized into three groups: sham, HF control and HF+hAMSCs. For HF induction, animals were anesthetized and underwent left anterior descending artery ligation. In HF+hAMSCs group, 2×106 cells were injected into the left ventricular muscle four weeks post ischemia in the border zone of the ischemic area. Cardiac function was studied using echocardiography. Masson’s trichrome staining was used for studying tissue fibrosis. Cells were transduced with green fluorescent protein (GFP) coding lentiviral vector. Immunohistochemistry was used for detecting GFP, vascular-endothelial growth factor (VEGF) and troponin T markers in the tissue sections. Assessment of the cardiac function revealed no improvement in the myocardial function compared to the control HF group. Moreover, tissue fibrosis was similar in two groups. Immunohistochemical study revealed the homing of the injected hAMSCs to the myocardium. Cells were stained positive for VEGF and troponin T markers. injection of hAMSCs 4 weeks after ischemia does not improve cardiac function and cardiac muscle fibrosis, although the cells show markers of differentiation into vascular endothelial cells and cardiomyocytes. In sum, it appears that hAMSCs are effective in the early phases of myocardial ischemia and does not offer a significant advantage in patients with chronic HF.

Along with an increase in the rate of cesarean sections, the complications and problems associated with this procedure have also increased in Iran. Factors such as complications associated with caesarean scars, the high cost of chemical treatments, and failure of medications in treatments have led to an increased use of traditional and biological therapies in the healing and preventing of cesarean wound infections.
To determine the effect of an amniotic membrane dressing on cesarean wound healing.
This study is a prospective, randomized double-blind clinical trial. Patients participating in the study were women who underwent cesarean sections at Amir-al-Momenin Hospital in Gerash, Iran. Patients were randomly divided into two groups (N = 45 for each group). In one group, the cesarean wound was dressed using an amniotic membrane; in the control group, the dressing was performed using a simple dressing. The wound healing was assessed by the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale 24 hours and 8 days after the cesarean procedure.
The average REEDA score, reflecting wound healing was significantly different between the groups 24 hours after the cesarean section, which proved to be less in the amniotic membrane group (.00 ± .00 vs. 0.60 ± 1.30; P = .003). However, on the 8th day after the cesarean section, there was no significant difference between the groups (P = 0.078).
The findings of this study showed that the application of an amniotic membrane dressing can be helpful in early stage wound healing of cesarean.

Incisional hernia repairs are among common abdominal wall surgeries, can be primarily required or being reconstructed using a synthetic or biological material.
This study aimed at evaluating intra-abdominal adhesions and incisional site healing after the repair of abdominal wall by fresh amniotic membrane-coated polypropylene mesh in comparison to only polypropylene mesh in an experimental rat study.
The study protocol was approved by Cumhuriyet University Institutional Ethics Committee for Animal Experiments (Sivas-Turkiye, date 24/06/2015). Sixteen pregnant female Wistar-Albino rats (mean weight, 275 g) were anesthetized on the 21st day of pregnancy, and a 1-cm area of the abdominal wall was excised. The pregnancy was terminated, emerging amniotic membranes were dissected, and eight pieces of the 1-cm2 polypropylene mesh were coated with these amniotic membranes without using any suture or adhesive. The polypropylene meshes were sutured on the abdominal wall of eight rats (control group), selected by simple random sampling. For the remaining eight rats, the same procedure was applied with the amniotic membrane-coated polypropylene meshes (experimental group). On the 28th postoperative day, the anterior abdominal wall was opened, and intra-abdominal adhesions were assessed macroscopically by Nair’s adhesion scoring system. Strip-shaped biopsy samples were taken from incision lines for histopathological examination.
The experimental group had significantly less intra-abdominal adhesions (i.e. Nair’s score of 2 to 4) compared to the control group (two and six rats, respectively; P = 0.046), and had significantly lower mean score for polymorphonuclear leukocyte infiltration (P = 0.039), hyperemia (P = 0.039), and epithelialization (P = 0.039). The score for the increase in connective tissue (P = 0.018) was significantly higher in the experimental group, and the scores for edema (P = 0.590) and macrophage infiltration (P = 0.590) were similar between the two groups.
The use of polypropylene mesh coated with fresh amniotic membrane provides advantage of decreasing postoperative intra-abdominal adhesions along with less inflammation and higher epithelialization after abdominal wall repair surgery.

Umbilical cord blood is a good source of the mesenchymal stem cells that can be banked, expanded and used in regenerative medicine. The objective of this study was to test whether amniotic membrane extract, as a rich source of growth factors such as basic-fibroblast growth factor, can promote the proliferation potential of the umbilical cord mesenchymal stem cells. The study design was interventional. Umbilical cord mesenchymal stem cells were isolated from voluntary healthy infants from hospitals in Shiraz, Iran, cultured in the presence of basic-fibroblast growth factor and amniotic membrane extracts (from pooled - samples), and compared with control cultures. Proliferation assay was performed and duplication number and time were calculated. The expression of stem cell’s specific markers and the differentiation capacity toward osteogenic and adipogenic lineages were evaluated. Amniotic membrane extract led to a significant increase in the proliferation rate and duplication number and a decrease in the duplication time without any change in the cell morphology. Both amniotic membrane extract and basic-fibroblast growth factor altered the expressing of CD44 and CD105 in cell population. Treating basic-fibroblast growth factor but not the amniotic membrane extract favored the differentiation potential of the stem cells toward osteogenic lineage. The amniotic membrane extract administration accelerated cell proliferation and modified the CD marker characteristics which may be due to the induction of differentiation toward a specific lineage. Amniotic membrane extract may enhance the proliferation rate and duplication number of the stem cell through changing the duplication time.

Mesenchymal Stem Cells (MSCs) are isolated from different sources like placenta. The placenta and its membranes like Amniotic Membrane (AM) are readily available and easy to work with. There is only limited knowledge on the immunomodulatory properties of human Amniotic Membrane-derived Mesenchymal Stem Cells (hAM-MSCs). The aim of this study was to survey the suppressive activity of hAM-MSCs on T lymphocytes in vitro. Human AMs were obtained after caesarean section births from healthy women. After enzymatic digestion, cells were cultured and hAM-MSCs were obtained. In addition, human T lymphocytes were isolated and co-cultured with hAM-MSCs for 72 hr in the presence or absence of phytohemagglutinin (PHA). Subsequently, proliferation of T cells was analyzed using BrdU and subsequently flow cytometry technique. Besides, the production of IL-4 and IFN-γ was examined by ELISA method. Additionally, the expression of activation markers (CD38, HLA-DR) was studied on T lymphocytes by flow cytometry technique. It was revealed that hAM-MSCs could significantly suppress the proliferation of T lymphocytes (p≤0.01) and significantly decrease the production of IFN-γ by T cells (p<0.05). hAM-MSCs also down regulated the expression of activation markers on the surface of T lymphocytes, CD38 and HLA-DR. The difference was significant between the case and control samples (p<0.05). All the comparisons were carried out between the case (Tcell+PHA+hAM-MSCs) and control (Tcell+PHA) groups. In conclusion, hAM-MSCs could inhibit the (mitogen-activated) T cells even in the absence of blood monocytes. Besides, hAM-MSCs-mediated inhibition of T lymphocytes was combined with down regulation of activation markers.

The objective of this study was to evaluate the antiinfl ammatory, antiinfective and clinical properties of amniotic membrane (AM) when used for guided tissue regeneration (GTR) in contained interdental defects. A total of 30 subjects participated in this study. Two sites in each subject were randomly assigned into each of the following experimental groups; test group: AM with bone graft and control group: Bone graft only. Clinical parameters included recording site specifi c measures of plaque, gingivitis, probing pocket depth (PPD), and clinical attachment loss (CAL). The levels of interleukin-1β (IL-1β) and human beta-defensin-2 (hBD-2) levels in gingival crevicular fl uid (GCF) from the test and control sites were measured by using commercially available enzyme linked immunosorbent assay kits. The evaluation of bone fi ll was performed by using digital subtraction technique and morphometric area analysis. One-way analysis of variance followed by the post-hoc test was used for intragroup and intergroup comparison. A P < 0.05 was considered as statistically signifi cant. Combination therapy using an AM increased bone fi ll and reduced PPD and CAL when compared to controls. AM also resulted in a signifi cant reduction of GCF IL-1β levels and insignifi cant increase in the hBD-2 levels. From this trial conducted over a period of 24 weeks, AM demonstrated a marked antiinfl ammatory effect and its use resulted in an improvement in periodontal parameters. AM has the potential to function as a barrier for GTR and the unique properties associated with this material can augment its potential as a matrix for periodontal regeneration.