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Background: The use of human amniotic membrane transplantation is rapidly increasing for the management of various ocular surface disorders. Despite its numerous advantages, amniotic membrane is not widely available due to the lack of awareness among ophthalmologists regarding its preparation and preservation techniques. Purpose: To provide an instructional video demonstrating the technique of harvesting, preparation, preservation of human amniotic membrane, and its uses in the management of ocular surface diseases. Synopsis: The amniotic membrane is the innermost layer of the human placenta. Properties of the amniotic membrane, like the presence of various growth factors, anti?inflammatory and anti?angiogenic factors, and its low immunogenicity, contribute to its ability to promote epithelial growth and differentiation with the reduction in fibrosis during healing. To harvest amniotic membrane, informed consent is obtained from a patient undergoing an elective caesarian section, and the donor is screened to exclude the risk of infections. Under sterile precautions, the amniotic membrane is separated from the chorion and washed free of blood clots. With the epithelial surface up, the amniotic membrane is spread uniformly without folds or tears on individually sterilized 0.22 ?m nitrocellulose filter papers of the required sizes. The prepared filter paper with the adherent amniotic membrane is placed in freshly prepared Dulbecco’s Modified Eagle’s Medium and stored at ?80°C. The amniotic membrane can be used for surgical procedures like symblepharon release, pterygium or dermoid excision, perforated ulcers, nonhealing epithelial defects, etc. Highlights: Instructional videos demonstrating the preparation and preservation of amniotic membrane are very sparse. This video clearly explains how any ophthalmologist can learn to prepare and preserve the human amniotic membrane and gives a glimpse of its properties, advantages, and scope of use
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【Objective】 To systematically evaluate the effect of applied muscle tension (AMT) exercises on reducing vasovagal reactions(VVRs) among blood donors by meta-analysis. 【Methods】 Nine related databases including MEDLINE, Web of Science and CINAHL were searched using "applied muscle tension" and "vasovagal reactions" as keywords to collect clinical studies on the effects of AMT exercise on VVRs during blood donation. Two researchers independently screened, evaluated the quality and extracted data from the retrieved literature according to the inclusion and exclusion criteria. RevMan 5.4 was used to conduct meta-analysis on the extracted data. 【Results】 A total of 7 articles were finally included, 5 in English and 2 in Chinese, covering 6 808 blood donors. The experimental group performed AMT during blood donation, while the control group did not. Compared with the control group, the difference in reducing the incidence of VVRs [ RR = 0.60, 95%CI (0.42, 0.87), P<0.01] was statistically significant in the AMT group. 【Conclusion】 AMT can effectively reduce the incidence of VVRs during blood donation. However, due to the limitation in the included studies, high-quality studies with perspectiveness, multicenter, large-sample size are further needed for validation in the future.
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Nonketotic hyperglycinemia (NKH) is a rare congenital metabolic disorder with low diagnostic rate. This article reported a case of NKH caused by AMT gene mutation. The child started with suspected neonatal sepsis, and then the condition deteriorated rapidly, including apnea, hiccup, coma, convulsion, etc. Blood glucose, ketone body, blood gas analysis of electrolytes, blood ammonia and so on were generally normal. Blood and urine screening results showed that glycine was slightly higher, and the ratio of cerebrospinal fluid to serum glycine concentration increased. Electroencephalogram showed outburst suppression. High total exome sequencing results showed that the maternal exon 3 c.664C>T(p.Arg222Cys) of AMT gene was pathogenic, and the paternal exon 3 c.793C>T(p.Arg265Cys) was suspected to be pathogenic, which was an autosomal recessive genetic disease with complex heterozygosis. The clinical diagnosis and treatment of this child and the characteristics of gene mutation are summarized.
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Blood-brain barrier (BBB) strictly controls matter exchange between blood and brain, and severely limits brain penetration of systemically administered drugs, resulting in ineffective drug therapy of brain diseases. However, during the onset and progression of brain diseases, BBB alterations evolve inevitably. In this review, we focus on nanoscale brain-targeting drug delivery strategies designed based on BBB evolutions and related applications in various brain diseases including Alzheimer's disease, Parkinson's disease, epilepsy, stroke, traumatic brain injury and brain tumor. The advances on optimization of small molecules for BBB crossing and non-systemic administration routes (
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Various boron-containing drugs have been approved for clinical use over the past two decades, and more are currently in clinical trials. The increasing interest in boron-containing compounds is due to their unique binding properties to biological targets; for example, boron substitution can be used to modulate biological activity, pharmacokinetic properties, and drug resistance. In this perspective, we aim to comprehensively review the current status of boron compounds in drug discovery, focusing especially on progress from 2015 to December 2020. We classify these compounds into groups showing anticancer, antibacterial, antiviral, antiparasitic and other activities, and discuss the biological targets associated with each activity, as well as potential future developments.
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Abstract This study evaluated the production of endoxylanases by Streptomyces malaysiensis AMT-3 in submerged fermentation using by-products of the food industry at 28ºC. In shake-flasks experiments, the highest endoxylanase activity of 45.8 U.mL-1 was observed within 6 days in a medium containing (w/v) 2.5% wheat bran and 1.2% corn steep liquor. The same culture conditions were used to evaluate the enzyme production in a 2 L stirred tank reactor under different agitation (300, 450 and 600 rev.min-1) and aeration (30 and 60 L.h-1) conditions. The use of 450 rev.min-1 coupled to an aeration of 90 L.h-1 resulted on 81.3 U.mL-1 endoxylanase activity within 5 days. The effect of temperature and pH on endoxylanase activity and stability showed the highest activity at 60 ºC and pH 6.0. Zymography showed the presence of three xylanolytic bands with molecular masses of 690, 180 and 142 kDa. The results showed that the thermotolerant actinobacterial endoxylanase can be produced in high titers using by-product of the food industry.
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Streptomyces/enzymology , Temperature , Food Industry , Endo-1,4-beta Xylanases/biosynthesis , FermentationABSTRACT
La hiperglicinemia no cetósica es un raro trastorno metabólico autosómico recesivo hereditario causado por una deficiencia en el sistema enzimático de división de la glicina mitocondrial. Se desconoce la incidencia general de la hiperglicinemia no cetósica, aunque es mayor en ciertas poblaciones, como las del norte de Finlandia (1/12 000) y de la Columbia Británica (1/63 000). Se sabe que son tres los genes que causan hiper-glicinemia no cetósica: GLDC, AMT y GCSH. Las mutaciones en el gen AMT son responsables del 20% de los casos de hiperglicinemia no cetósica. En este artículo describimos una mutación novedosa del codón de terminación (c.565C>T, p.Q189*) del gen AMT en un niño de cuatro meses de vida con hiperglicinemia no cetósica.
Nonketotic hyperglycinemia is a rare autosomal recessively inherited metabolic disorder, caused by a deficiency in the mitochondrial glycine cleavage system. The overall incidence of nonketotic hyperglycinemia is unknown, but is higher in certain populations such as north Finland (1/12,000) and British Colombia (1/63,000). Three genes (GLDC, AMT and GCSH) are known to cause nonketotic hyperglycinemia. Mutations in the AMT gene are responsible for 20% of nonketotic hyperglycinemia cases. We describe a novel stop codon mutation (c.565C>T, p.Q189*) in AMT gene in a four-month male infant with nonketotic hyperglycinemia.
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Humans , Male , Infant , Hyperglycinemia, Nonketotic/genetics , Aminomethyltransferase/genetics , MutationABSTRACT
Acupuncture and moxibustion are not fully or well-utilized in the medical system, particularly in the hospitals of Japan. If they were more commonly practiced in hospitals, disorders and disease conditions that are not improved by modern Western medicine might be better treated. In addition, collaboration between acupuncturist and Western medical doctors would promote the research of acupuncture, moxibustion, and related techniques.<br>However, to achieve these aims, improvements in the quality of acupuncture and moxibustion education would be needed. Also, hospitals that are presently using acupuncture and moxibustion for routine treatment would have to demonstrate their usefulness and how this is contributing to patients' health.<br>Having acupuncture and moxibustion therapists (AMT), as a defined occupation in hospitals, was proposed in 1981, although this has not yet been realized. However, we believe that hospital AMTs would be necessary for the progress of acupuncture and moxibustion, as well as for national health care and the medical system in Japan.
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PURPOSE: To examine the effects, complications, and safeties of sclera allograft and amniotic membrane transplantation with fibrin glue as surgical treatment methods for scleromalacia. METHODS: The study included 14 eyes of 14 scleromalacia patients who needed surgical treatment. Among them, seven eyes of seven patients whose scleral defect was small (6 mm) were operated on using fibrin glue and minimum suturing. Amniotic membrane transplantation was performed at the site of the conjunctival defect. RESULTS: In all of the cases, the results of grafting were successful throughout the follow-up period, which was 14.6+/-4.4 months, on average (ranging from 12 to 27 months). No particular complication was observed during the follow-up period after using fibrin glue. CONCLUSIONS: For scleromalacia patients, sclera allograft and amniotic membrane transplantation were performed using fibrin glue. The grafted sclera survived successfully, allowing this treatment modality to be considered an effective and safe option without complications.
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Humans , Amnion , Eye , Fibrin , Fibrin Tissue Adhesive , Follow-Up Studies , Safety , Sclera , Transplantation, Homologous , TransplantsABSTRACT
Positron Emission Tomography (PET) has an advantage in localizing epileptogenic zones for successful surgery in several epileptic syndromes. Among the most radiopharmaceutical used in PET studies in epilepsy are [18F] fluorodeoxyglucose (FDG) and [11C]flumazenil (FMZ). Unilateral temporal hypometabolism (UTH) seen in FDGPET was shown to correlate well with ictal EEG origins in 60-90 % of temporal lobe epilepsy (TLE) patients. PET aids in surgical decision-making in TLE patients with discordant data from initial presurgical evaluation, in bitemporal disease and in nonlesional TLE. However, PET adds little in lesional TLE with congruent data. The extent of glucose hypometabolic area was shown to correlate with post-operative outcomes. PET may reduce the need for invasive EEG in bitemporal epilepsy. Abnormal FMZ binding has been proposed to guide the location of subdural electrode placement in extratemporal epilepsy (ETE). FMZ-PET and FDG-PET were shown to be sensitive in visualizing areas of cortical dysgenesis. Focal FDG-PET abnormality was demonstrated in 20 % of children with West’s syndrome and has provided a revolutionary approach for surgical treatment. Resection of the focal hypometabolism has rendered good control of infantile spasms and restoration of developmental delay. PET use of alpha-[11C] methyl-L-tryptophan (AMT), a serotonin precursor, has been shown to selectively localize epileptogenic tuber in the tuberous sclerosis complex as well as in identifying epileptic residual tissue following surgical failure. PET has potential in determining eloquent brain areas and in studying mechanisms of epilepsy. In epilepsy surgery, PET can be used with worthwhile cost-benefit even in a country with limited resources.
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PURPOSE: To describe the clinical outcome of amniotic membrane transplantation(AMT) for various ocular surface diseases. METHODS: We reviewed the medical records of 52 eyes from 46 patients which had underwent AMT for various ocular surface diseases. We scored each eyes from 0 to 4 for subjective symptoms (symptom score) and epithelial healing (epithelial grade) at three months after AMT. The clinical score was calculated as the symptom score time the epithelial grade. RESULTS: The mean clinical score among all ocular surface disease was 10.41+/-4.26. The mean clinical scores for each disease are as follows: 7.71+/-3.56 for corneal ulcers, 14.43+/-3.1 for persistent epithelial defects, 12.83+/-2.71 for exposure keratitis, 12.86+/-3.18 for herpes keratitis, 5.85+/-2.5 for bullous keratopathy, 10.53+/-4.27 for chemical corneal burns and 16.0+/-0.0 for shield ulcers. Subjective symptoms subsides and epithelial healing progressed in all patients treated by AMT. No complications occurred. CONCLUSIONS: AMT is an effective method for treating various ocular surface diseases, because AMT improves the subjective symptoms of patients and promotes the healing of epithelial lesions.
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Humans , Amnion , Burns , Keratitis , Medical Records , UlcerABSTRACT
PURPOSE: To describe the clinical outcome of amniotic membrane transplantation(AMT) for various ocular surface diseases. METHODS: We reviewed the medical records of 52 eyes from 46 patients which had underwent AMT for various ocular surface diseases. We scored each eyes from 0 to 4 for subjective symptoms (symptom score) and epithelial healing (epithelial grade) at three months after AMT. The clinical score was calculated as the symptom score time the epithelial grade. RESULTS: The mean clinical score among all ocular surface disease was 10.41+/-4.26. The mean clinical scores for each disease are as follows: 7.71+/-3.56 for corneal ulcers, 14.43+/-3.1 for persistent epithelial defects, 12.83+/-2.71 for exposure keratitis, 12.86+/-3.18 for herpes keratitis, 5.85+/-2.5 for bullous keratopathy, 10.53+/-4.27 for chemical corneal burns and 16.0+/-0.0 for shield ulcers. Subjective symptoms subsides and epithelial healing progressed in all patients treated by AMT. No complications occurred. CONCLUSIONS: AMT is an effective method for treating various ocular surface diseases, because AMT improves the subjective symptoms of patients and promotes the healing of epithelial lesions.
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Humans , Amnion , Burns , Keratitis , Medical Records , UlcerABSTRACT
PURPOSE: To investigate the effect of amniotic membrane transplantation (AMT) on recurrent herpetic keratitis with unhealed corneal epithelial erosion. METHODS: We performed AMT on 5 cases of herpetic keratitis from February 2004 to August 2005. We had applied two layers of fresh amniotic membrane over the corneal lesion and anchored by running suture technique with 10-0 nylon. RESULTS: After AMT, visual acuity improved in 5 eyes of 5 herpetic keratitis patients. In all patients the persistent epithelial erosion was healed and pain was subsided after surgery. CONCLUSIONS: The AMT shortened the usage of antiviral agents and antibiotics, increased compliance, and decreased corneal opacity and neovascularization. The AMT is an effective method for managing recurrent herpetic keratitis with unhealed corneal epithelial erosion that are refractory to conventional treatment.
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Humans , Amnion , Anti-Bacterial Agents , Antiviral Agents , Compliance , Corneal Opacity , Keratitis, Herpetic , Nylons , Running , Suture Techniques , Visual AcuityABSTRACT
PURPOSE: To describe the clinical outcome of AMT (amniotic membrane transplantation) for corneal ulcers, persistent epithelial defects, corneal perforations, and neurotropic ulcers. METHODS: We performed AMT on 10 cases of corneal ulcer, 5 cases of persistent epithelial defect, 2 cases of corneal perforation, and 3 cases of neurotropic ulcer from Agust 1999 to May 2002. Amniotic membrane was obtained from the women undergoing elective Cesarean section or normal delivery. We had applied one or two layers of fresh amniotic membrane, that is used within 4hours after resection, over the ulcer bed and anchored by interrupted and running suture technique with 10-0 Nylon. After AMT, Topical eye drops was used three times a day. RESULTS: After AMT, Visual acuity was improved in 6 eyes of 10 corneal ulcer patients and maintained in 3 eyes. In all patients the persistent epithelial erosion was healed and pain was subsided between 6 and 12 days after surgery. There were no leakage in corneal perforation patients, and stable ocular surface were achieved after mean period 15.5 days. The ocular surface was restored by AMT in all neurotropic ulcer patients. CONCLUSIONS: The AMT is an effective method for managing corneal ulcer or ocular surface diseases, that are refractory to conventional treatment. The AMT shortened the usage of broad spectrum antibiotics , increased compliance, and decreased corneal opacity and neovascularization.
Subject(s)
Female , Humans , Pregnancy , Amnion , Anti-Bacterial Agents , Cesarean Section , Compliance , Corneal Opacity , Corneal Perforation , Corneal Ulcer , Membranes , Nylons , Ophthalmic Solutions , Running , Suture Techniques , Ulcer , Visual AcuityABSTRACT
PURPOSE: to investigate the effect of amniotic membrane transplantation (AMT) on corneal epithelial healing. METHODS: A 4-mm epithelial debridement was made in central rabbit cornea. Then, human amniotic membrane was transplanted (AMT group) or a contact lens was applied (contact lens group). The contralateral eyes were unwounded as controls. After surgery 5-bromo-2'-deoxyuridine (BrdU) was injected via ear vein. Each corneal tissue including the limbus was obtained on postoperative 12, 24 and 48 hours. Proliferating cell nuclear antigen (PCNA) in limbal and peripheral corneal epithelium and keratinocyte growth factor (KGF) in limbal stroma were immunolocalized by immunohistochemical method. Incorporation of BrdU in limbal and peripheral corneal epithelium was visualized by indirect immunofluorescent method. RESULTS: AMT group significantly accelerated the expression of PCNA and BrdU at limbal and peripheral corneal epithelial cells. The expression of PCNA and BrdU showed a peak at 24hr in both groups and increased in limbal epithelial cells more than peripheral corneal epithelial cell in AMT group. The expression of KGF on limbal keratocyte increased in AMT group more than contact lens group and coincided wiht the expression pattern of PCNA and BrdU. The number of keratocyte in significantly decreased in contanct lens group compared wiht AMT group. CONCLUSION: AMT enhanced corneal epithelial wound healing in vivo by stimulating limbal epithelial proliferation which is indirectly mediated in part by upregulating the expression of KGF, which is a potent epithelial mitogen secreted by limbal keratocytes.
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Humans , Amnion , Bromodeoxyuridine , Cornea , Debridement , Ear , Epithelial Cells , Epithelium, Corneal , Fibroblast Growth Factor 7 , Proliferating Cell Nuclear Antigen , Veins , Wound HealingABSTRACT
PURPOSE: Untill now, AMT at the early stage of corneal ulcer has been prohibited by the reasons that measurement of progression of ulcer by active pathogens was difficult through the transplanted amniotic membrane and anxiety about worsening by decreased permeability of antibiotics. This study has investigated the effect of early AMT in the bacterial corneal ulcer. METHODS: We made experimental bacterial corneal ulcer in 10 rabbits with Staphylococcus epidermidis, which typically has a more indolent clinical course. After certification of infection, fresh amniotic membranes, soaked by fortified antibiotics was transplanted to 5 eyes to which we dropped fortified antibiotics. And to another 5 eyes we applied only fortified antibiotics. After observing the progression of corneal ulcer for 4 weeks, we compared the degree of corneal opacity and histopathologic changes between the two groups to measure the effect of early AMP in the bacterial corneal ulcer. RESULTS: Corneal ulcer was healed in the all 5 cases of early AMT-performed group, And compared with the group without AMT, successful decrement of corneal opacity was observed in the 4 cases of early AMT-performed group. Histopathologic observation has revealed only mild inflammation and the maintenance of parallel architecture of stromal collagens. CONCLUSIONS: In the experimental corneal ulcer with Staphylococcus Epidermidis, we observed healing of the ulcer with decrement of corneal opacity, result from early transplantation of amniotic membrane, soaked in fortified antibiotics followed by dropping of fortified antibiotics at an early stage of ulcer.
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Rabbits , Amnion , Anti-Bacterial Agents , Anxiety , Certification , Collagen , Corneal Opacity , Corneal Ulcer , Inflammation , Permeability , Staphylococcus epidermidis , Staphylococcus , UlcerABSTRACT
To evaluate the efficacy of amniotic membrane ransplantation(AMT) in the cornea that was perforated or impending perforation due to recalcitrant corneal ulcer or trauma, we performed AMT on 1 case of acid burn, 2 cases of thermal burn, 1 case of corneoscleral staphyloma with bullae due to previous ocular trauma, 2 cases of keratolysis as a graft rejection after keratoplasty, 3 cases of corneal ulcer. We used one or several layers of amniotic membrane(AM) that preserved in DMEM solution and 10% glycerin(1:1) under-70 degrees C or lyophylized form. As a result, the corneal perforations were prevented and the stable ocular surface were achieved. However, in case of neurotrophic keratopathy, epithelial rebreakdown was occurred after AMT, eventually epithelalization was fulfilled. Therefore, AMT may be a effective alternative method for treating corneal perforation or impending perforation that are refractory to conventional treatment.