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Serum Free (serum + free)
Selected AbstractsSerum-free cultured keratinocytes fail to organize fibronectin matrix and possess different distribution of beta-1 integrinsEXPERIMENTAL DERMATOLOGY, Issue 2 2001G. Altankov Abstract: The development of serum free medium formulation for culturing keratinocytes was a breakthrough in achieving a high number of epidermal cells for experimental and therapeutic studies, in particular to support the wound healing process. It is not clear, however, if switching the cells to highly proliferative phenotype may reflect change in other cellular functions important for the wound repair as their adhesive interactions with the extracellular matrix components. Remodelling of the extracellular matrix, particularly of fibronectin plays an essential role for guiding the cells during wound healing. The molecular mechanisms for organization of this provisional fibronectin matrix, however, are still not clear. We found that keratinocytes in serum containing medium, although in fewer numbers than fibroblasts, were able to remove adsorbed fluorescent labelled fibronectin from the substratum and reorganize it in a fibrilar pattern along the cell periphery. After 3 days the secreted fibronectin had also been organized as matrix-like fibers and as clusters deposited on the substratum after migrating cells. In contrast, serum free cultured keratinocytes fail to organize pre-adsorbed fluorescent labelled fibronectin, as well as the secreted fibronectin, although they grow very well under these conditions. Switching the cells to serum containing medium initiates the removal of fluorescent labelled fibronectin from the substratum, however without reorganization in fibrillar pattern. Most likely, these keratinocytes remove fluorescent labelled fibronectin by the expression of proteolytic activity, rather than with the mechanical function of ,1 integrins. The latter were diffusely dispersed in serum containing conditions and tend to organize in focal adhesions in serum free cultured cells. We assumed their transient expression and different affinity state might be important for the keratinocyte migration and matrix assembly mechanism. [source] Maternal serum free-,-chorionic gonadotrophin, pregnancy-associated plasma protein-A and fetal nuchal translucency thickness at 10,13+6 weeks in relation to co-variables in pregnant Saudi womenPRENATAL DIAGNOSIS, Issue 4 2007Mohammed-Salleh M. Ardawi Abstract Objective To establish normative values and distribution parameters of first-trimester screening markers, namely, fetal nuchal translucency (NT), maternal serum free ,-human chorionic gonadotrophin (,-hCG) and pregnancy-associated plasma protein-A (PAPP-A), at 10 to 13+6 weeks of gestation in Saudi women and to evaluate the effect of co-variables including maternal body weight, gravidity, parity, fetal gender, twin pregnancy, smoking and ethnicity on these markers. Methods A cohort of Saudi women (first cohort n = 1616) with singleton pregnancies prospectively participated in the present study, and fetal NT together with maternal serum free ,-hCG and PAPP-A were determined at 10 to 13+6 weeks of gestation. The distribution of gestational age-independent multiples of the median (MoM) of the parameters was defined and normative values were established, and correction for maternal body weight was made accordingly. The influence of various co-variables was examined using the data collected from the first and the second (n = 1849) cohorts of women and 62 twin pregnancies, and compared with other studies. Results All markers exhibited log-normally distributed MoMs. Gestational age-independent normative values were established. Maternal body weight was corrected, particularly for maternal free ,-hCG and PAPP-A using standard methods. Fetal NT showed a negative relationship with increasing gravidity (r = ,0.296) or parity (r = ,0.311), whereas both free ,-hCG and PAPP-A exhibited a significant positive relationship. There was a significant increase in the MoM of free ,-hCG in female fetuses. Smoking decreased MoM values of free ,-hCG (by 14.6%; P < 0.01) and PAPP-A (by 18.8%; P < 0.001). Twin pregnancy showed significant increases in MoM values of free ,-hCG (by 1.87-fold) and PAPP-A (by 2.24-fold), with no significant changes in fetal NT MoM values. Fetal NT MoM values were lower in Africans and Asians but higher in Orientals, as compared to Saudi women (P < 0.05; in each case). MoM values (body weight-corrected) of free ,-hCG were 25.2% higher in Africans and 19.4% higher in Orientals but 6.8% lower in other Arabian and Asian (by 5.8%) women as compared to Saudi women (P < 0.05; in each case). Conclusions The normative values and distribution parameters for fetal NT, maternal serum free ,-hCG and PAPP-A were established in Saudi singleton pregnancies, the maternal body weight together with smoking, twin pregnancy and ethnicity being important first-trimester screening co-variables. Gravidity, parity and fetal gender are also considered to influence one or more of the first-trimester markers examined. Copyright © 2007 John Wiley & Sons, Ltd. [source] Maternal serum biochemistry at 11,13+6 weeks in relation to the presence or absence of the fetal nasal bone on ultrasonography in chromosomally abnormal fetuses: an updated analysis of integrated ultrasound and biochemical screeningPRENATAL DIAGNOSIS, Issue 11 2005Simona Cicero Abstract Background Screening for trisomy 21 by a combination of maternal age, fetal nuchal translucency (NT) thickness and maternal serum free ,-hCG and pregnancy associated plasma protein-A (PAPP-A) at 11,13+6 weeks of gestation is associated with a detection rate of 90%, for a false-positive rate of 5%. Recent evidence suggests that in about 70% of fetuses with trisomy 21 the nasal bone is not visible at the 11,13+6 week scan and that the frequency of absence of nasal bone differs in different ethnic groups. In addition, there is a relationship between absent nasal bone and nuchal translucency thickness. In a preliminary study we showed that while PAPP-A levels were lower and free ,-hCG levels were higher in trisomy 21 fetuses with an absent nasal bone, this difference was not statistically different. In fetuses with trisomy 13 and trisomy 18, there is also a high (57 and 67%) incidence of an absent nasal bone. The aim of this present study was to extend our examination of whether the level of maternal serum biochemical markers is independent of the presence or absence of the nasal bone in cases with trisomy 21 and to ascertain if any differences exist in cases with trisomies 13 and 18. Methods This study data comprised 100 trisomy 21 singleton pregnancies at 11,13+6 weeks of gestation from our previous study and an additional 42 cases analysed as part of routine OSCAR screening. A total of 34 cases with trisomy 18 and 12 cases with trisomy 13 were also available. Ultrasound examination was carried out for measurement of fetal NT and assessment of the presence or absence of the fetal nasal bone. Maternal serum free ,-hCG and PAPP-A were measured using the Kryptor rapid random access immunoassay analyser (Brahms Diagnostica AG, Berlin). The distribution of maternal serum free ,-hCG and PAPP-A in chromosomally abnormal fetuses with absent and present nasal bone was examined. Results The nasal bone was absent in 29 and present in 13 of the new trisomy 21 cases and in 98 (69%) and 44 respectively in the combined series. For the trisomy 18 cases, the nasal bone was absent in 19 (55.9%) cases and in 3 (25%) of cases of trisomy 13. There were no significant differences in median maternal age, median gestational age, NT delta, free ,-hCG MoM and PAPP-A MoM in trisomy 21 fetuses with and without a visible nasal bone, and similarly for those with trisomies 13 or 18. For a false-positive rate of 5%, it was estimated that screening with the four markers in combination with maternal age would be associated with a detection rate of 96% of cases with trisomy 21. For a false-positive rate of 0.5%, the detection rate was 88%. Conclusions There is no relationship between an absent fetal nasal bone and the levels of maternal serum PAPP-A or free ,-hCG in cases with trisomies 13, 18 or 21. An integrated sonographic and biochemical test at 11,13+6 weeks can potentially identify about 88% of trisomy 21 fetuses for a false-positive rate of 0.5%. Copyright © 2005 John Wiley & Sons, Ltd. [source] The influence of maternal insulin-dependent diabetes on fetal nuchal translucency thickness and first-trimester maternal serum biochemical markers of aneuploidyPRENATAL DIAGNOSIS, Issue 10 2005Kevin Spencer Abstract Objective To evaluate the influence of maternal insulin dependent diabetes mellitus (IDDM) on maternal serum free ,-hCG, PAPP-A and fetal nuchal translucency (NT), thickness at 11 to 13+6 weeks of gestation in a large cohort of women screened prospectively for chromosomal anomalies. Methods Information on maternal IDDM status, maternal serum biochemical marker levels and fetal NT were collected from the prenatal screening computer records in two first-trimester screening centres. In total the control group included 33 301 pregnancies of which 16 366 had NT and maternal serum biochemistry results and 16 305 with NT only. The IDDM group included 195 pregnancies of which 79 had NT and maternal serum biochemistry results and 127 with NT only. The median maternal weight corrected free ,-hCG and PAPP-A, expressed as multiple of the median (MoM), and fetal NT, expressed as delta values, in the IDDM and non-IDDM groups were compared. Results There were no significant differences between the IDDM and non-IDDM groups in median maternal weight corrected free ,-hCG (IDDM 0.87 MoM, 95% Confidence Interval 0.75 to 1.16 MoM, non-IDDM 1.00 MoM), median maternal weight corrected PAPP-A (IDDM 1.02 MoM, 95% Confidence Interval 0.83 to 1.05 MoM, non-IDDM 1.01 MoM), or mean delta NT (IDDM 0.0358 mm, non-IDDM 0.0002 mm). Conclusions In pregnancies with maternal IDDM, first-trimester screening for chromosomal defects does not require adjustments for the measured fetal NT. However, more data are required before the possible reduction in maternal serum free ,-hCG and the reduction of PAPP-A suggested by the published world series can be considered sufficiently important to take into account in the calculation of risks for chromosomal defects. Copyright © 2005 John Wiley & Sons, Ltd. [source] Second-trimester diagnosis of complete trisomy 9 associated with abnormal maternal serum screen results, open sacral spina bifida and congenital diaphragmatic hernia, and review of the literaturePRENATAL DIAGNOSIS, Issue 6 2004Chih-Ping Chen Abstract Objectives To present the prenatal diagnosis of complete trisomy 9 and to review the literature Case A 25-year-old primigravida woman was referred for amniocentesis at 19 weeks' gestation because of abnormal maternal screen results showing an elevated maternal serum alpha-fetoprotein (MSAFP) level and a low maternal serum free ,-human chorionic gonadotrophin (MSfree,-hCG) level. Results Genetic amniocentesis revealed a karyotype of 47,XX,+9 in the amniocytes and an elevated amniotic fluid AFP level. Ultrasonography demonstrated intrauterine growth restriction, left congenital diaphragmatic hernia, fetal ascites, a sacral spina bifida, a horseshoe kidney, and absence of amniotic fluid. Ultrafast magnetic resonance imaging scans further depicted detailed anatomical configurations of the major congenital malformations. The pregnancy was terminated subsequently. The proband postnatally manifested characteristic facial dysmorphism, limb deformities, and an open sacral spina bifida with myelomeningocele. Cytogenetic analysis of the skin fibroblasts revealed a karyotype of 47,XX,+9. Molecular studies of various uncultured fetal tissues using microsatellite markers confirmed a diagnosis of complete trisomy 9 resulting from a meiotic I nondisjunction error of maternal origin. Conclusion Complete trisomy 9 can be identified prenatally with advanced maternal age, sonographically detected fetal structural abnormalities, and abnormal maternal serum screen results. Fetuses with complete trisomy 9 may be associated with congenital diaphragmatic hernia, an open sacral spina bifida, elevated MSAFP, and low MSfree,-hCG. We suggest detailed prenatal imaging investigations and genetic analyses of multiple fetal tissues when a prenatal diagnosis of trisomy 9 is made. Copyright © 2004 John Wiley & Sons, Ltd. [source] Integrated ultrasound and biochemical screening for trisomy 21 using fetal nuchal translucency, absent fetal nasal bone, free ,-hCG and PAPP-A at 11 to 14 weeksPRENATAL DIAGNOSIS, Issue 4 2003Simona Cicero Abstract Background Screening for trisomy 21 by a combination of maternal age, fetal nuchal translucency (NT) thickness and maternal serum free ,-hCG and pregnancy-associated plasma protein-A (PAPP-A) at 11 to 14 weeks of gestation is associated with a detection rate of 90% for a false-positive rate of 5%. Recent evidence suggests that in about 70% of fetuses with trisomy 21, the nasal bone is not visible at the 11th- to 14th-week scan (Cicero et al., 2001). The aim of this study was to examine whether fetal NT thickness and the level of maternal serum biochemical markers is independent of the presence or absence of the nasal bone, and to estimate the performance of a screening test that integrates the two sonographic and the two biochemical markers. Methods This was a retrospective case-control study comprising 100 trisomy 21 and 400 chromosomally normal singleton pregnancies at 11 to 14 weeks of gestation. Ultrasound examination was carried out for measurement of fetal NT and assessment of the presence or absence of the fetal nasal bone. Maternal serum free ,-hCG and PAPP-A were measured using the Kryptor rapid random-access immunoassay analyser (Brahms Diagnostica GmbH, Berlin). The distribution of fetal NT, maternal serum free ,-hCG and PAPP-A in trisomy 21 fetuses with absent and present nasal bone was examined. Results The nasal bone was absent in 69 and present in 31 of the trisomy 21 fetuses. There were no significant differences in median maternal age, median gestational age, NT delta, free ,-hCG MoM and PAPP-A MoM in trisomy 21 fetuses with and without a visible nasal bone. For a false-positive rate of 5%, it was estimated that screening with the four markers in combination with maternal age would be associated with a detection rate of 97%. For a false-positive rate of 0.5%, the detection rate was 90.5%. Conclusions An integrated sonographic and biochemical test at 11 to 14 weeks can potentially identify about 90% of trisomy 21 fetuses for a false-positive rate of 0.5%. Copyright © 2003 John Wiley & Sons, Ltd. [source] Uptake of prenatal screening for chromosomal anomalies: impact of test results in a previous pregnancyPRENATAL DIAGNOSIS, Issue 13 2002Kevin Spencer Abstract Aim To assess whether the uptake of prenatal screening for trisomy 21 in a subsequent pregnancy is influenced by being classified in the ,increased risk' or ,not at increased risk' group in the first pregnancy. Setting District General Hospital Maternity Unit. Methods Amongst a group of women attending for maternity care at this hospital, the maternity records were examined to find women having at least two pregnancies. Any prenatal screening record for each pregnancy was retrieved from the prenatal screening database. Prenatal screening for trisomy 21 was by a combination of maternal serum ,-fetoprotein (AFP) and free ,-human chorionic gonadotrophin (,-hCG) in the second trimester and by maternal serum free ,-hCG and pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal translucency (NT) thickness in the first trimester. Women were stratified according to their trisomy 21 risk into an ,increased risk' group (1: <250 in the second trimester and 1: <300 in the first trimester) or ,not at increased risk' group based on their first pregnancy. In a second pregnancy, the records were examined to see if the mother accepted prenatal screening in the second pregnancy. The rate of acceptance of screening in a subsequent pregnancy, depending on whether ,at increased risk' or ,not at increased risk' in the first pregnancy, was examined using chi square tests. Results In the second trimester study, 4601 women were identified with two pregnancies during the study period. Of these, 4559 women had prenatal screening in a subsequent pregnancy. Initially, 273 women were identified in the high-risk group, and of these 252 (92.3%) elected to have prenatal screening in a subsequent pregnancy. This compared with 4307 of 4328 (99.5%) women in the low-risk group. In the first trimester study, 1077 women were identified with two pregnancies during the study period. Of these, 1072 had prenatal screening in a subsequent pregnancy. Initially, 60 women were identified in the high-risk group, and of these 56 (93.3%) elected to have prenatal screening in a subsequent pregnancy. This compared with 1016 of 1017 (99.9%) in the low-risk group. Statistically, there was no difference between the rate of declining prenatal screening in a second pregnancy amongst those in the high-risk group in a first pregnancy or those in the low-risk group (p = 0.429 for second trimester screening and p = 0.794 for first trimester screening). Similarly, no difference could be demonstrated between rates when screening in the first or second trimester (p = 0.961) for those in the high-risk group. Conclusion Despite the understandable anxiety associated with being identified in the high-risk group (as a false positive finding) in a previous pregnancy, this did not seem to deter women from accepting prenatal screening in a subsequent pregnancy. Copyright © 2002 John Wiley & Sons, Ltd. [source] Maternal serum human chorionic gonadotrophin and pregnancy-associated plasma protein A in twin pregnancies in the first trimesterPRENATAL DIAGNOSIS, Issue 3 2002Marko Niemimaa Abstract Objectives To determine the levels of free ,-human chorionic gonadotrophin (,-hCG) and pregnancy-associated plasma protein A (PAPP-A) in twin pregnancies in the first trimester. Methods Serum samples were obtained from 67 pregnant women with twin pregnancies and maternal serum free ,-hCG and PAPP-A concentrations were compared with those of 4279 singleton controls between the 8th and 13th weeks of gestation. Results The geometric means of chromosomally normal twin pregnancies were 1.85 MoM for free ,-hCG and 2.36 MoM for PAPP-A. There were no cases affected by Down syndrome in either group. Conclusion Twin pregnancies secrete more PAPP-A than expected on the basis of singleton controls whereas free ,-hCG production is not increased. The results of the present study can be used to establish normal reference values when introducing first trimester Down syndrome screening in prenatal care. Copyright © 2002 John Wiley & Sons, Ltd. [source] Screening for trisomy 21 in twin pregnancies in the first trimester: does chorionicity impact on maternal serum free ,-hCG or PAPP-A levels?PRENATAL DIAGNOSIS, Issue 9 2001Kevin Spencer Abstract In a study of 180 twin pregnancies I have examined the distribution of maternal serum free ,-human chorionic gonadotrophin (,-hCG) and pregnancy-associated plasma protein-A (PAPP-A), in addition to fetal nuchal translucency thickness (NT), in twins classified as monochorionic or dichorionic, based on ultrasound appearance at 10,14 weeks of gestation. In 45 monochorionic and 135 dichorionic twin pregnancies the median MoM free ,-hCG was not significantly different (1.00 vs 1.01), whilst that for PAPP-A was lower (0.89 vs 1.01) but again with no statistical significance. Previous reports of an increased fetal NT in monochorionic twins pregnancies could not be confirmed (1.03 vs 1.00). It is concluded that the existing pseudo risk twin correction algorithm is appropriate for both monochorionic and dichorionic twins in providing accurate first trimester risks for trisomy 21. Copyright © 2001 John Wiley & Sons, Ltd. [source] Maternal serum levels of dimeric inhibin A in pregnancies affected by trisomy 21 in the first trimesterPRENATAL DIAGNOSIS, Issue 6 2001Kevin Spencer Abstract Dimeric inhibin A was measured in maternal serum samples from 45 pregnancies affected by trisomy 21 and 493 samples from unaffected pregnancies at 10,14 weeks of gestation. Inhibin A levels in affected pregnancies were compared with levels of free ,-hCG and PAPP-A in the same series. In the trisomy 21 group, the median multiple of the median (MoM) inhibin A was not significantly elevated (1.28 vs 1.00) with only 15.5% being above the 95th centile. In contrast, the median MoM free ,-hCG was significantly increased (2.05 vs 1.00) with 36% above the 95th centile and PAPP-A was significantly reduced (0.49 vs 1.00) with 42% below the 5th centile. Inhibin A levels in the trisomy 21 group were significantly correlated with gestational age such that median levels rose from 1.04 at 11 weeks to 1.30 at 12 weeks and 1.67 at 13 weeks. These findings suggest that first trimester biochemical screening for trisomy 21, which is currently optimised using maternal serum free ,-hCG and PAPP-A and fetal nuchal translucency, will not benefit from the inclusion of inhibin A. Copyright © 2001 John Wiley & Sons, Ltd. [source] The effect of cigarette or sheesha smoking on first-trimester markers of Down syndromeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2007MSM Ardawi Objective, To investigate the influence of cigarette or sheesha smoking on first-trimester markers of Down syndrome. Design, A prospective observational study. Setting, Primary care centres and antenatal clinics of Maternity and Children Hospital, King Abdulaziz University Hospital and New Jeddah Clinic Hospital, Jeddah, Saudi Arabia. Population, Women with a singleton pregnancy who were either nonsmokers (n= 1736) or cigarette smokers (n= 420) or sheesha smokers (n= 181). Methods, Fetal nuchal translucency thickness (fetal NT), maternal serum free beta-human chorionic gonadotrophin (free ,-hCG) and pregnancy-associated plasma protein-A (PAPP-A) were measured at 11 weeks 0 days to 13 weeks 6 days of gestation in all women. Women were grouped according to smoking status, confirmed by maternal serum cotinine measurements, and analyte levels between groups were compared. Main outcome measures, Fetal NT, maternal serum free ,-hCG, PAPP-A and cotinine measurements. Results, Compared with nonsmoking women, fetal NT was significantly increased and free ,-hCG and PAPP-A levels were significantly decreased in both cigarette and sheesha smokers. There were significant relationships between all three markers and the number of sheeshas consumed per day. Conclusions, Cigarette and sheesha smoking significantly affect first-trimester markers of Down syndrome (fetal NT, free ,-hCG and PAPP-A). Correction for this effect in women who smoke might improve the effectiveness of first-trimester screening for Down syndrome in these women. The underlying mechanism(s) relating smoking to the changes in first-trimester markers require further studies. [source] First trimester maternal serum free , human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complicationsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2000Charas Y. T. Ong Research Fellow (Fetal Medicine) Objective To examine the value of first trimester maternal serum free , human chorionic gonadotrophin (, hCG) and pregnancy associated plasma protein A (PAPP-A) as predictors of pregnancy complications. Design Screening study. Setting Antenatal clinics. Population Singleton pregnancies at 10,14 weeks of gestation. Methods Maternal serum free , hCG and PAPP-A were measured at 10,14 weeks of gestation in 5584 singleton pregnancies. In the 5297 (94.9%) pregnancies with complete follow up free , hCG and PAPP-A were compared between those with normal outcome and those resulting in miscarriage, spontaneous preterm delivery, pregnancy induced hypertension or fetal growth restriction and in those with pre-existing or gestational diabetes. Results Maternal serum PAPP-A increased and , hCG decreased with gestation. The multiple of median maternal serum PAPP-A was significantly lower in those pregnancies resulting in miscarriage, pregnancy induced hypertension, growth restriction and in those with pre-existing or gestational diabetes mellitus, but not in those complicated by spontaneous preterm delivery. The level was < 10th centile of the reference range in about 20% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 27% of those that developed gestational diabetes. Maternal serum free , hCG was < 10th centile of the reference range in about 15% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 20% of those that developed gestational diabetes. Conclusion Low maternal serum PAPP-A or , hCG at 10,14 weeks of gestation are associated with subsequent development of pregnancy complications. [source] | ||||||||||