Laboratory options for risk assessment of pregnancy pathologies.

The most effective method of screening for chromosomal abnormalities and evaluating the risk of pregnancy pathologies in the first trimester is combined screening. The algorithm of screening is based on the combination of maternal age, measuring of the nuchal translucency and the fetal heart rate and analysis of the placental products of free ß-hCG and PAPP-A. For the screening of preeclampsia, placental growth factor (PlGF) is added. To distinguish between preeclampsia and other pathologies caused by placental dysfunction it is recommended to also extend the screening with selected immunological markers. We concluded that elevated biochemical and immunological markers can help to predict the threat of preeclampsia in the third trimester. Some markers can probably predict the development of particularly severe pathological conditions.

PVA and PCL nanofibers are suitable for tissue covering and regeneration.

The aim of the study was to evaluate the safety and efficacy of a new therapeutic approach to skin defects resulting from split thickness grafting. Within the study, nanofiber-based dressings fabricated using polyvinyl alcohol (PVA) and poly-ε-caprolactone (PCL) were used, with different mass density. The study was performed in 1 female minipig. Nine defects (approx. 4x4 cm) were made in the superficial skin layer. The tested materials were applied to the squared skin defect and covered by a Jelonet paraffin gauze, sutured in the corners of the defects. The animal was monitored daily during the healing process (21 days). On day 5, 12, and 27, the healing of the wound was evaluated, and a biopsy was performed for further histologic testing. At the end of the study (on day 27 after the procedure), the animal was euthanized, and a standard pathologic evaluation was performed. We can conclude that the nanofiber scaffold which was well tolerated, could be used as a smart skin cover which could be functionalized with another bioactive substances directly on the surgeon table, among potential bioactive substances belong platelet derivatives, antibiotics, etc.

The dead space after extirpation of rectum. Current management and searching for new materials for filling.

Pelvic surgeries such as extirpation of the rectum or pelvic exenteration lead to a creation of a dead space, which can be cause of complication, such as bowel obstruction, perineal hernia, abscess or hematoma. A growing incidence of complication is expected in connection with the increasing use of laparoscopic and robotic approaches or ELAPE method. Since the bone structures do not allow compression, the only way to deal with the dead space is to fill it in. Present methods provide the filling with omental or myofascial flaps. The length and the mobility of the omental flap can be the limitation. Myofascial flaps are technically more demanding and bring the complications of a donor place. Synthetic or biological meshes do not deal with dead space problematic. Modern technologies using nanomaterials offer the possibility to produce a material with specific properties for example shape, inner structure, surface, or time of degradation. The modified material could also satisfy the requirements for filling the dead space after surgeries.

Electrospun nanofibers as support for the healing of intestinal anastomoses.

The breakdown of intestinal anastomosis is a serious postsurgical complication. The worst complication is anastomotic leakage, resulting in contaminated peritoneal cavity, sepsis, multi-organ failure and even death. In problematic locations like the rectum, the leakage rate has not yet fallen below 10 %. Such a life-threatening condition is the result of impaired healing in the anastomotic wound. It is still vital to find innovative strategies and techniques in order to support regeneration of the anastomotic wound. This paper reviews the surgical techniques and biomaterials used, tested or published. Electrospun nanofibers are introduced as a novel and potential material in gastrointestinal surgery. Nanofibers possess several, unique, physical and chemical properties, that may effectively stimulate cell proliferation and collagen production; a key requirement for the healed intestinal wound.

Extracellular vesicles in blood, milk and body fluids of the female and male urogenital tract and with special regard to reproduction.

Extracellular vesicles (EVs) are released from almost all cells and tissues. They are able to transport substances (e.g. proteins, RNA or DNA) at higher concentrations than in their environment and may adhere in a receptor-controlled manner to specific cells or tissues in order to release their content into the respective target structure. Blood contains high concentrations of EVs mainly derived from platelets, and, at a smaller amount, from erythrocytes. The female and male reproductive tracts produce EVs which may be associated with fertility or infertility and are released into body fluids and mucosas of the urogenital organs. In this review, the currently relevant detection methods are presented and critically compared. During pregnancy, placenta-derived EVs are dynamically detectable in peripheral blood with changing profiles depending upon progress of pregnancy and different pregnancy-associated pathologies, such as preeclampsia. EVs offer novel non-invasive diagnostic tools which may reflect the situation of the placenta and the foetus. EVs in urine have the potential of reflecting urogenital diseases including cancers of the neighbouring organs. Several methods for detection, quantification and phenotyping of EVs have been established, which include electron microscopy, flow cytometry, ELISA-like methods, Western blotting and analyses based on Brownian motion. This review article summarises the current knowledge about EVs in blood and cord blood, in the different compartments of the male and female reproductive tracts, in trophoblast cells from normal and pre-eclamptic pregnancies, in placenta ex vivo perfusate, in the amniotic fluid, and in breast milk, as well as their potential effects on natural killer cells as possible targets.

Immunological and biochemical markers in preeclampsia.

A basic precondition for the development of preeclampsia is the presence of placental trophoblast cells in the maternal blood circulation. On the other hand, while trophoblast cells are present in the blood of all pregnant women, preeclampsia occurs in only 2-5% of them. Evidently, other factors play a crucial role. The aim of this study was to compare a set of selected immunological factors (anti-cardiolipin autoantibodies, trophoblast-induced cell-mediated immunity, C3 and C4 complement components) and biochemical factors (serum immunoglobulins IgA, IgG, IgM) among three groups of women with uncomplicated pregnancy, gestational hypertension, or preeclampsia. Blood samples were taken 2-12h before delivery. In the preeclampsia group, there was a significantly higher number of women positive for anti-cardiolipin autoantibodies, trophoblast-induced cell-mediated immunity was elevated, serum IgG was elevated and C4 complement component was reduced. We conclude that both elevated autoimmune reactivity and the higher immune reactivity to trophoblast may contribute to the onset of preeclampsia.