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Wong Chi Ho. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 74-94). / Abstracts in English and Chinese. / Tittle / Table of contents / Acknowledgment / Abstract / Chapter Chapter 1. --- Introduction --- p.1 / Chapter Chapter 2. --- Literature Reviews --- p.2 / Chapter 2.1 --- Sonographic history --- p.2 / Chapter 2.1.1 --- Definition of ultrasound --- p.2 / Chapter 2.1.2 --- History of general ultrasonography --- p.2 / Chapter 2.1.3 --- Early history of fetal diagnostic ultrasonography --- p.4 / Chapter 2.2 --- Placental sonography --- p.10 / Chapter 2.2.1 --- Development of the placenta --- p.10 / Chapter 2.2.2 --- Sonographic placental development --- p.12 / Chapter 2.2.3 --- Placental grading --- p.14 / Chapter 2.2.3.1 --- Early studies of the placenta --- p.14 / Chapter 2.2.3.2 --- Placental grading --- p.16 / Chapter 2.2.3.3 --- Placental grading and gestational age --- p.18 / Chapter 2.2.3.4 --- Placental grade and neonatal outcome --- p.20 / Chapter 2.2.4 --- Placental thickness --- p.22 / Chapter 2.3 --- Amniotic fluid --- p.24 / Chapter 2.3.1 --- Amniotic fluid dynamics --- p.24 / Chapter 2.3.2 --- Methods of sonographic assessment of amniotic fluid --- p.28 / Chapter 2.3.3 --- Correlation of AFI with clinical oligohydramnios --- p.30 / Chapter 2.3.4 --- Clinical outcome associated with oligohydramnios --- p.32 / Chapter Chapter 3. --- Methodology --- p.34 / Chapter 3.1 --- Introduction --- p.34 / Chapter 3.2 --- Criteria for patients selection --- p.35 / Chapter 3.3 --- Calculation of the gestational age --- p.35 / Chapter 3.3.1 --- Measurement of bipatietal diameter (BPD) --- p.36 / Chapter 3.4 --- Ultrasonic measurements of the placenta and amniotic fluid --- p.37 / Chapter 3.4.1 --- Placental grading --- p.37 / Chapter 3.4.2 --- Placental thickness --- p.38 / Chapter 3.4.3 --- Amniotic fluid index --- p.39 / Chapter 3.5 --- Statistical analysis --- p.39 / Chapter 3.5.1 --- Amniotic fluid index --- p.39 / Chapter 3.5.2 --- Placental thickness --- p.40 / Chapter 3.5.3 --- Clinical outcome --- p.41 / Chapter Chapter 4. --- Results --- p.42 / Chapter 4.1 --- Overall obstetric demographic characteristics of study population --- p.44 / Chapter 4.2 --- "Gestation-related changes in placental grade, placental thickness and amniotic fluid index" --- p.48 / Chapter 4.2.1 --- "Amniotic fluid index, gestational age and maternal characteristics" --- p.48 / Chapter 4.2.2 --- Placental thickness --- p.53 / Chapter 4.2.3 --- Placental grades and gestational age --- p.57 / Chapter 4.3 --- The clinical outcomes and ultrasound parameters --- p.61 / Chapter Chapter 5. --- Discussion --- p.63 / Chapter 5.1 --- Gestation related change of AFI and maternal characteristics --- p.63 / Chapter 5.2 --- Placental grade and gestational age --- p.67 / Chapter 5.3 --- Placental thickness --- p.72 / Chapter Chapter 6. --- Reference --- p.74 / Graphics --- p.95 / Figure 1 Grannum's placental grading system / Figure 2 Amniotic fluid index against gestational age / Figure 3 Placental thickness versus gestational age / Figure 4 Graph of placental grades versus progressing gestational age / Figure 5 Median amniotic fluid index in four populations

BACKGROUND: Cells, growth factors (GFs), and scaffold are three essential factors for tissue engineering. Our previous studies suggested that multiple applications of human amnion growth factors (AGF) into osseous defects could “mimic in-utero” growth. However, micro-gaps still exist between the scaffold and recipient tissue. We hypothesized that hyaluronic acid (HA) could act an accessory scaffold and gradually release active components of AGF and improve bone healing. MATERIALS AND METHODS: Calvaria from 50 7–9-day old CD1 neonatal mice were harvested, and a 2 mm defect punch made in each one. A type I collagen membrane with AGF alone or with HA at different concentrations applied over the defect. The culture medium was changed every 2-3 days and collected for alkaline phosphatase (ALP) and protein analysis. RESULTS: A single dose of AGF combined with 0.125% HA increased cellular infiltration into the defect area more than AGF with no HA or a lower concentration of HA (0.0625%). A single dose of AGF with HA can improve bone healing. CONCLUSION: A single dose of AGF with HA as an extra scaffold and a carrier can achieve bone formation like multiple dosages of AGF and reduce the number of clinical applications needed.

Background: Since constrictive pericarditis is most often idiopathic and the pathophysiology remains largely unknown, both the diagnosis and the treatment can be challenging. However, by definition, inflammatory processes are central to this disease process. Amniotic membrane patches have been shown to possess anti-inflammatory properties and are believed to be immune privileged. Due to these properties, amniotic membrane patches were applied intraoperatively in a complicated patient presenting with constrictive pericarditis. Case presentation: A patient with a history of multiple cardiac surgeries presented with marked fatigue, worsening dyspnea and sinus tachycardia. He was found to have constrictive physiology during cardiac catheterization, with cardiac MRI demonstrating hepatic vein dilatation, atrial enlargement and ventricular narrowing. After amniotic membrane patch treatment and pericardiectomy, post-operative cardiac MRI failed to demonstrate any appreciable pericardial effusion or inflammation, with no increased T2 signal that would suggest edema. Conclusions: Given the positive results seen in this complex patient, we suggest continued research into the beneficial properties of amniotic membrane patches in cardiac surgery.

A membrana amniótica tem se consolidado no tratamento das afecções da superfície ocular. Assim, o objetivo deste estudo foi avaliar a viabilidade e a eficácia do implante de MA eqüina, preservada em glicerina a 98%, na reparação de ceratoplastias lamelares em cães, por meio do estudo da avaliação clínica pós-operatória dos animais, do tempo de cicatrização, da reconstrução da arquitetura da córnea, da resposta inflamatória, e da composição colágena do estroma corneal no local do implante. Foram selecionados 12 cães, sem raça definida, machos ou fêmeas, divididos em quatro grupos de três, que tiveram tempos de observação distintos: 2, 7, 21 e 40 dias. Foi realizada ceratoplastia lamelar de 5 mm de diâmetro em um dos olhos de cada animal, seguida da aplicação do implante de membrana amniótica eqüina de 6 mm. Durante o período de observação, exame clínico oftalmológico foi realizado nos cães, com intervalos de 48 horas e ao final deste período, foram submetidos á eutanásia. Os olhos em estudo foram enucleados e fixados para posterior análise. Foram utilizados três métodos de coloração para o estudo histológico do tecido implantado: hematoxilina-eosina (HE), ácido periódico de Schiff (PAS) e picrossirius. Além disso, procedeu-se a imunomarcação para colágenos tipo I, III, e V, com uso de pepsina para digestão das fibras colágenas heterotípicas exposição dos epítopos. Clinicamente os implantes foram completamente epitelizados em aproximadamente 10 dias, os neovasos apresentaram involução progressiva a partir dos 20 dias de pós-operatório, estando ausentes ao final dos 40 dias de observação, restando apenas uma nébula no local da lesão. À microscopia óptica, observou-se resposta inflamatória moderada, presença de epitélio pavimentoso estratificado aos sete dias e epitelização completa aos 21 dias. Aos 40 dias a membrana basal do epitélio apresentou-se reconstituída. O colágeno tipo I teve sua expressão no estroma intensificada aos 21 dias de pós- operatório. O colágeno tipo III está presente na membrana amniótica, sua a ausência no local do implante, aos 21 dias, mostrou remodelamento do tecido implantado. O colágeno tipo V, presente no estroma da córnea, teve sua expressão aumentada aos 7 e 21 dias, retornando à distribuição normal aos 40 dias de pós-operatório. Assim concluí-se que: a membrana amniótica eqüina é viável como implante em córnea de cão, sendo incorporada ao estroma, resultando em restabelecimento parcial da transparência no local de implante; o colágeno do tecido implantado é remodelado e substituído já aos 21 dias de pós-operatório; a pepsina foi eficiente na digestão das fibras e exposição dos epítopos dos colágenos nas fibras heterotípicas / The amniotic membrane has consecrated itself in the treatment of ocular surface diseases. The objective of this study was to evaluate the efficiency and viability of the equine amniotic membrane graft, preserved in glycerin at 98%, in the lamellar keroplasty recovery in dogs. Evaluation was based on clinical post-surgical exam, healing time, corneal architectural reconstruction, inflammatory response and collagen composition of the corneal stroma at the graft site. Twelve mixed-breed, male and female dogs were divided into four groups of three dogs. Each group was submitted to different observation periods of 2, 7, 21 and 40 days. Each dog was submitted to a 5 mm lamellar keratoplasty in one eye, followed by a 6 mm equine amniotic membrane graft. Each animal was submitted to clinical ophthalmologic exam every 48 hours. At the end of the evaluation period, the animal was euthanized and the grafted eye was removed and fixated for posterior analysis. For the histological study of the tissue graft, three methods of coloration were used: hematoxylin eosin (HE), periodic acid of Schiff (PAS) and picrosirius. Immunolocalization for the collagen types I, III and V using pepsin for fiber digestion of heterotypic fibrils and epitope exposure, was made. Clinically, the grafts were completely epithelized in approximately 10 days and neovascularization regressed progressively 20 days after surgery, being completely absent after 40 days, when only a nebula remained at the graft site. Optic microscopy revealed mild inflammatory response and presence of stratified pavement epithelium after 7 days and complete epithelization 21 days after surgery. At the end of 40 days the basal membrane was reconstituted. Type I collagen had its expression in the stroma intensified 21 days after the surgery. By day 21 the absence of collagen III in the corneal stroma showed graft remodeling, since this was formerly present in the amniotic membrane. The expression of type V fiber in the corneal stroma showed a mildly intensified expression at 7 and 21 days of observation, but returned to its normal distribution 40 days after surgery. Conclusion was that the equine amniotic membrane is a viable graft for the dog\'s cornea as it is incorporated to the stroma, resulting in partial transparency at the site of the graft. Twenty-one days after surgery, collagen from the graft is already remodeled and substituted. Pepsin is efficient for fiber digestion and collagen epitope exposure in heterotypical fibers.

Leung Yee Fong, Vivian. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 159-169). / Acknowledgments --- p.i / Legend for figures --- p.ii / Legend for tables --- p.v / List of abbreviations --- p.vii / Abstract --- p.viii / Chapter Ch 1 --- Introduction --- p.1 / Chapter 1.1 --- Embryology --- p.1 / Chapter 1.1.1 --- Embryology of amniotic cavity --- p.1 / Chapter 1.1.2 --- Embryology of kidney and bladder --- p.3 / Chapter Ch 2 --- Background: What is already known about amniotic fluid volume? --- p.7 / Chapter 2.1 --- Normal physiology --- p.7 / Chapter 2.1.1 --- The origin of amniotic fluid: Where does it come from? --- p.8 / Chapter 2.1.2 --- Where does the amniotic fluid go? How reabsorbed? --- p.14 / Chapter 2.1.3 --- How is amniotic fluid volume controlled? --- p.18 / Chapter 2.2 --- Abnormal physiology --- p.26 / Chapter 2.2.1 --- Too much liquor: polyhydramnios --- p.26 / Chapter 2.2.2 --- Too little liquor: oligohydramnios --- p.28 / Chapter 2.2.3 --- Diseases and gender differences that may be related to parity and amniotic fluid volume --- p.30 / Chapter 2.3 --- Techniques of measuring amniotic fluid volume --- p.32 / Chapter 2.3.1 --- History --- p.32 / Chapter 2.3.2 --- Current most popular technique: amniotic fluid index --- p.38 / Chapter 2.4 --- Summary of what is known and not yet known about amniotic fluid volume --- p.48 / Chapter Ch 3 --- Aims of this study --- p.49 / Chapter Ch4 --- Method --- p.50 / Chapter 4.1 --- Equipment --- p.50 / Chapter 4.2 --- Subject selection criteria --- p.50 / Chapter 4.2.1 --- Criteria --- p.50 / Chapter 4.2.2 --- Total number of subjects studied --- p.51 / Chapter 4.2.3 --- Total number of subjects selected fulfilling all criteria --- p.51 / Chapter 4.2.4 --- Subject preparation --- p.52 / Chapter 4.3 --- Technique --- p.53 / Chapter 4.3.1 --- "Standard measurement of BPD， AC, FL and EFW" --- p.53 / Chapter 4.3.2 --- Standard measurement of Doppler --- p.54 / Chapter 4.3.3 --- Amniotic fluid index --- p.55 / Chapter 4.3.4 --- Bladder volume --- p.59 / Chapter 4.3.5 --- Fetal renal pelvis --- p.61 / Chapter 4.3.6 --- Intra-observer error techniques and calculation --- p.63 / Chapter 4.4 --- Techniques used in analysis --- p.65 / Chapter Ch5 --- Results --- p.67 / Chapter 5.1 --- Fetal parameters --- p.68 / Chapter 5.1.1 --- Fetal biparietal diameter (BPD) --- p.68 / Chapter 5.1.2 --- Fetal abdominal circumference (AC) --- p.69 / Chapter 5.1.3 --- Fetal femur length (FL) --- p.70 / Chapter 5.1.4 --- Pulsatility index values of umbilical artery --- p.71 / Chapter 5.1.5 --- Birth weight (BW) --- p.74 / Chapter 5.1.6 --- Estimated fetal weight --- p.76 / Chapter 5.2 --- Amniotic fluid index --- p.79 / Chapter 5.2.1 --- Amniotic fluid index-overall --- p.79 / Chapter 5.2.2 --- Amniotic fluid index-male and female --- p.81 / Chapter 5.2.3 --- The ten segments of amniotic fluid index distribution --- p.83 / Chapter 5.2.4 --- Amniotic fluid index relationship to estimated fetal weight --- p.86 / Chapter 5.2.5 --- Amniotic fluid index with gravidity and parity --- p.89 / Chapter 5.2.6 --- Amniotic fluid index with estimated fetal weight of different parity (best fit line) for both male and female --- p.93 / Chapter 5.3 --- Fetal urinary bladder volume (BV) --- p.96 / Chapter 5.3.1 --- Bladder volume-overall --- p.96 / Chapter 5.3.2 --- Bladder volume-male and female --- p.97 / Chapter 5.3.3 --- Bladder volume with estimated fetal weight- overall --- p.100 / Chapter 5.3.4 --- Bladder volume with estimated fetal weight in both male and female --- p.101 / Chapter 5.3.5 --- Bladder volume with gravidity and parity --- p.103 / Chapter 5.3.6 --- Bladder volume with amniotic fluid index --- p.105 / Chapter 5.4 --- Anteroposterior diameter of the fetal renal pelvis --- p.106 / Chapter 5.5 --- Hydronephrosis index values --- p.107 / Chapter Ch 6 --- Discussion --- p.108 / Chapter 6.1 --- Review of the study --- p.108 / Chapter 6.2 --- Discussion on subject --- p.111 / Chapter 6.2.1 --- Gestational age chosen --- p.111 / Chapter 6.2.2 --- Subject preparation --- p.112 / Chapter 6.3 --- Discussion of method --- p.114 / Chapter 6.3.1 --- Equipment --- p.114 / Chapter 6.3.2 --- Technique --- p.117 / Chapter 6.4 --- Discussion on results --- p.128 / Chapter 6.4.1 --- Normality of population --- p.128 / Chapter 6.4.2 --- Low birth weight/ IUGR in Chinese and Caucasian --- p.129 / Chapter 6.4.3 --- Cut-off points to detect oligohydramnios and polyhydramnios --- p.132 / Chapter 6.4.4 --- Amniotic fluid index-relationship with fetal weight --- p.143 / Chapter 6.4.5 --- Amniotic fluid index-relationship to parity --- p.145 / Chapter 6.4.6 --- "Relationship between gender, estimated fetal weight and amniotic fluid index" --- p.147 / Chapter 6.4.7 --- Parity and cut-off points for oligohydramnios and polyhydramnios --- p.150 / Chapter 6.4.8 --- Relationship of amniotic fluid volume to urinary function --- p.152 / Chapter Ch 7 --- Conclusions --- p.157 / References --- p.159

Tout comme le placenta, les membranes amniotiques humaines sont des organes transitoires mais indispensables au développement fœtal. Parmi les nombreuses fonctions de ces membranes, le contrôle du volume de liquide amniotique est une des plus importantes. Les aquaporines (AQP), canaux aqueux transmembranaires permettant les transferts d’eau, ont déjà été décrites comme fortement impliquées dans ce phénomène. Afin d’éclaircir et d’approfondir leurs implications et leur importance au cours de la grossesse, nous nous sommes intéressé, dans un premier temps, à déterminer l’expression spatio‐temporelle des aquaporines dans les membranes fœtales tout au long de la grossesse, et, dans un second temps, à étudier les aquaporines comme gènes cibles des rétinoïdes. En effet, ces derniers sont des morphogènes impliqués dans le développement embryonnaire et dans la physiologie des annexes embryo‐fœtales et paraissaient être des candidats intéressants pour réguler l’expression des gènes des aquaporines. Nous avons ainsi mis en évidence que, parmi les treize AQPs décrites chez les mammifères, cinq sont exprimées, aussi bien à terme que tout au long de la grossesse, dans les deux feuillets membranaires (le chorion et l’amnion) et à des niveaux d’expression variables en fonction du stade gestationnel et du feuillet membranaire étudié. De plus, nous avons pu proposer un modèle de régulation de l’aquaporine 3 (AQP3) par les rétinoïdes dans les cellules épithéliales amniotiques humaines. Les modulations de l’expression des AQPs 1, 3, 8, 9, 11 tout au long de la grossesse ainsi que la mise en évidence de la régulation de l’AQP3 par les rétinoïdes confirme la nécessité d’une régulation fine de ces gènes au cours de la gestation ; et ce afin de permettre la régulation de l’homéostasie du liquide amniotique, phénomène physiologique essentiel au déroulement harmonieux de la grossesse. Toute altération de cette expression et/ou de cette régulation peut être à l’origine de pathologies du volume amniotique lors de la grossesse, comme l’oligoamnios ou le polyhydramnios. / As the placenta, human amniotic membranes are transitory but essential for the fetal development. Among their numerous functions, the regulation of the amniotic fluid volume is one of the most important. As previously described, this mechanism largely involves transmembrane water channels , the aquaporins (AQPs). In order to clarify and understand their implications and importance during pregnancy, we firstly investigated the spatio‐temporal expression of aquaporins in the fetal membranes throughout pregnancy. In a second time, we studied the aquaporin genes as targets of retinoids. These morphogenetic molecules involved in the fetal annexes and embryonic/fetal development appeared as interesting candidates to regulate aquaporins genes expression in fetal membranes. We have demonstrated that, among the thirteen AQPs described in mammals, five are expressed both at term and throughout pregnancy in both fetal membranes layers (chorion and amnion). Their expression levels vary with the gestational stage and the type of layer. In addition, we were able to propose a model of regulation of aquaporin 3 (AQP3) by retinoids in human amniotic epithelial cells. The modulation of the expression of AQPs 1, 3, 8, 9, 11 throughout pregnancy as well as the demonstration of the AQP3 regulation by retinoids suggests a fine regulation of these genes is necessary during gestation in order to allow the maintenance of amniotic fluid homeostasis, a physiological phenomenon essential to a harmonious pregnancy. Alterations of this expression and/or this regulation could cause diseases of amniotic volume during pregnancy, such as oligohydramnios or polyhydramnios.

The purpose of this study was to explore the behavioral effects of amniotic fluid (AF) and milk in the newborn rat. Previous research has documented behavioral effects in the fetal and neonatal rat. For example, oral exposure to AF and milk reduces the response to chemosensory stimulation in rat fetuses (Korthank & Robinson, 1998) and newborns (Méndez-Gallardo & Robinson, 2010). In addition, some of the behavioral effects of AF and milk are mediated by the endogenous opioid system in the perinatal rat, including modulation of the facial wiping response (Korthank & Robinson, 1998; Méndez-Gallardo & Robinson, 2010), the stretch response induced by milk in the fetal rat (Smotherman & Robinson, 1992b), and the effect of milk as an unconditioned stimulus (US) during associative learning in the fetal rat (Robinson et al., 1993). Taking into account the literature that suggests similarities between AF and milk, this study aimed to evaluate whether transnatal continuity in the behavioral effects of AF and milk could be found and whether mediation by the endogenous opioid system is the underlying mechanism of these effects. To fulfill this purpose, overall behavioral activation, crawling locomotion, oral responses to an artificial nipple, and associative learning were investigated in the newborn rat. Results showed that, (a) oral exposure to AF resulted in higher levels of behavioral activation than oral exposure to milk, (b) exposure to the odor of AF or milk did not produce significant behavioral activation, although the odor of milk seemed to evoke higher levels of behavioral activity than exposure to the odor of AF, (c) both AF and milk odor elicited crawling locomotion, (d) odor of AF or milk did not promote oral grasping of an artificial nipple, but promoted mouthing responses and distinctive movements of the forepaws, (e) contingent presentations of an artificial nipple as the conditioned stimulus (CS), with AF or milk as the US, promoted mouthing responses during reexposure to the CS, but facial wiping after CS reexposure was not modified as a result of conditioning, and (f) mediation of the opioid system was evident only during hindlimb activity after oral exposure to AF or milk and during mouthing responses to the CS after associative learning. These findings suggest that oral exposure to AF or milk consistently evoke opioid responses in the neonatal rat, but exposure to the odor of AF or milk alone does not. Through postnatal testing and the direct comparison of the behavioral effects of AF (a feature of the prenatal environment) with milk (a feature of the postnatal environment), this study contributes to a better understanding of mechanisms that promote behavioral continuity before and after birth.