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Application of Tissue Engineering and Regenerative Medicine in Prelabor Rupture of Membranes: a Review of the Current Evidence
Jung YM, Park CW, Park JS, Jun JK, Lee SM
Reproductive sciences (Thousand Oaks, Calif.). 2021
Abstract
Preterm prelabor rupture of membranes (PPROM) is the main cause of preterm delivery, resulting in increased perinatal morbidity and mortality. Several techniques have been studied for the healing of ruptured membranes, with some success. Before new techniques using tissue/organ engineering are applied in clinical practice, these techniques must be validated in clinical trials. To address this issue, the objective of this study was to summarize the current literature on interventions to seal or heal the amniotic membranes after PPROM. An electronic search was conducted using the keywords "fetal membranes," "premature rupture," "amnion," "tissue engineering," "fibrin tissue adhesive," "regenerative medicine," "tissue adhesive," "wound healing," and "fetoscopy" through the MEDLINE, Embase, and Cochrane CENTRAL databases, with the limitation of English-language studies. Through a review of the identified studies, it was found that spontaneous healing of the fetal membrane has not been successful. Several efforts have been made to seal membranes before or after rupture using different methods, including amniopatches, collagen, tissue patches, fibrin sealant, mussel-mimetic sealant, engineered cell matrix, and immunological supplements. However, most studies have been conducted in ex vivo or in vivo settings, so the safety and applicability of these techniques to spontaneous rupture of membranes in clinical settings have not been sufficiently tested. Overall, the current evidence is limited regarding the safety and effectiveness of interventions against PPROM.
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2.
Use of TachoSil patches to prevent pancreatic leaks after distal pancreatectomy: a prospective, multicenter, randomized controlled study
Park JS, Lee DH, Jang JY, Han Y, Yoon DS, Kim JK, Han HS, Yoon YS, Hwang DW, Kang CM, et al
Journal of Hepato-Biliary-Pancreatic Sciences. 2016;23((2)):110-7.
Abstract
BACKGROUND/PURPOSE We performed a prospective, multicenter, randomized controlled study to investigate the clinical outcomes, including POPF, after using the TachoSil(R) patch in distal pancreatectomy (NCT01550406). METHODS Between June 2012 and September 2014, 101 patients at 5 centers were randomized into Control (n = 53) and TachoSil (n = 48) groups. In all patients, the pancreas was resected using a stapler with Endo-GIA staples. The TachoSil patch was wrapped around the pancreatic stump only in the TachoSil group, not in Control group. RESULTS The patient characteristics, including age and diagnosis, were comparable in both groups. The mean operation time (159.4 vs 172.3 min, P = 0.081) and postoperative hospital stay (10.0 vs 9.7 days, P = 0.279) were similar in the Control and TachoSil groups, respectively. The overall incidence of POPF was 62.4% (n = 63). The distribution of grades A, B, and C POPF was similar in the Control (14/14/1) and TachoSil (23/11/0) groups, as were the overall incidence (54.7% vs 70.8%, P = 0.095) and the incidence of grade B and C POPF (28.3% vs 22.9%, P = 0.536). CONCLUSION This study showed that the TachoSil patch did not reduce the incidence of POPF after distal pancreatectomy. This article is protected by copyright. All rights reserved.
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3.
Effect of increasing serum albumin on plasma D-dimer, von Willebrand factor, and platelet aggregation in CAPD patients
Kim SB, Chi HS, Park JS, Hong CD, Yang WS
American Journal of Kidney Diseases. 1999;33((2):):312-7.
Abstract
This study was performed to investigate the interrelation between blood albumin level and D-dimer (a marker of intravascular coagulation) and von Willebrand factor (vWF; a marker of endothelial injury) levels or platelet aggregation. Blood levels of albumin, D-dimer, vWF, and C-reactive protein (CRP) and the threshold aggregating concentration (TAC) of ristocetin were measured in 64 continuous ambulatory peritoneal dialysis (CAPD) patients and compared with 36 healthy controls. Twenty-two CAPD patients with albumin levels less than 3.0 g/dL were divided into experimental and disease-control groups. In the experimental group, levels were measured before and after repeated infusions of 20% albumin, 100 mL/d for 7 days. The same parameters were measured in the disease-control group that did not receive the albumin infusion. CAPD patients had higher D-dimer and vWF levels than the healthy controls. There were inverse correlations between albumin and D-dimer (r = -0.48; P < 0.001), vWF (r = -0.29; P < 0.05), or logCRP (r = -0.44; P < 0.001) in CAPD patients. There were positive correlations between logCRP and D-dimer (r = 0.38; P < 0.01) and between logCRP and vWF (r = 0.32; P = 0.01) in CAPD patients. No change was seen in D-dimer, vWF, and CRP levels in either group. The TAC of ristocetin in the 18 CAPD patients was not different from that in the 11 healthy controls (0.55 +/- 0.09 v 0.65 +/- 0.07 mg/mL). There was a correlation between albumin level and TAC in the CAPD patients (r = 0.59; P < 0.01). TAC increased from 0.50 +/- 0.09 to 0.62 +/- 0.13 mg/mL (123% +/- 17%; P < 0.05; n = 6) at the end of the repeated albumin infusions in the experimental group, whereas it did not change in the control group. CRP level did not change in either group. The results of this study indicate that hypoalbuminemia increases platelet aggregability. The observation that the albumin infusion was not associated with changes in D-dimer and vWF despite the inverse correlations suggests that these relationships may be secondary to other factors, such as inflammation.
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4.
Effect of increasing serum albumin on haemostatic factors synthesized in the liver in CAPD patients
Kim SB, Yang WS, Lee SK, Chi HS, Park JS
Nephrology Dialysis Transplantation. 1998;13((8):):2053-8.
Abstract
BACKGROUND This study was performed to evaluate the relationship between serum albumin and plasma concentration of haemostatic factors and the effect of raising serum albumin on haemostatic factors synthesized in the liver in CAPD patients. METHODS We measured blood levels of albumin, fibrinogen, factor II, factor VII, protein C, free protein S, plasminogen, alpha2-antiplasmin and antithrombin III in 103 CAPD patients and 30 normal controls. Twenty-two patients with albumin < 3.5 g/dl were divided into two groups. In the experimental group (n = 11), haemostatic factors and albumin were measured before, after repeated infusion of 20% albumin 100 ml three times per week for 2 weeks, and 4 weeks after withdrawal of albumin infusion. The same parameters were measured in the control group (n = 11) which did not receive albumin infusion. C-reactive protein and haematocrit were followed in both groups as an indicator of acute phase reactant and an indirect measure of volume status. RESULTS CAPD patients as a whole had lower albumin and higher fibrinogen and factor VII than normal controls. A significant inverse correlation was present between fibrinogen and albumin (r = -0.27, P < 0.01). Albumin in the experimental group increased from 2.7 +/- 0.4 to 3.5 +/- 0.6 g/l at the end of its repeated infusion and haematocrit decreased from 26.6 +/- 4.4 to 24.9 +/- 5.2%. Fibrinogen and factor VII decreased significantly, even after correction for haematocrit (624 +/- 96 vs 556 +/- 91 mg/dl, 160 +/- 36 vs 121 +/- 44%, P < 0.05). Four weeks after withdrawal of albumin infusion, serum albumin decreased to 2.7 +/- 0.5 g/dl, whereas fibrinogen and factor VII increased to 619 +/- 78 mg/dl and 158 +/- 32%, respectively (P < 0.05). Albumin, haematocrit and haemostatic factors in the control group did not change. CRP was stable during the study period in both groups. CONCLUSION These findings indicate that hypoalbuminaemia is an important trigger factor in the elevation of fibrinogen, and possibly factor VII, in CAPD patients.