Among patients awaiting LT, the presence of RV systolic dysfunction before ECMO initiation along with worsening renal functions, low albumin levels, and volume overload is associated with poor outcomes.
Recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL) are distressing conditions without effective treatments. The luminal epithelium (LE) is integral in determining receptivity of the endometrium, whereas functionalis glands and stroma aid in nurturing early embryo development. Calcium signalling pathways are known to be of vital importance to embryo implantation and pregnancy establishment, and anterior gradient protein 3 (AGR3) and S100 calcium-binding protein P (S100P) are involved with these pathways. We initially examined 20 full-thickness endometrial biopsies from premenopausal women across the menstrual cycle to characterize levels of AGR3 protein in each endometrial sub-region at the cellular level. A further 53 endometrial pipelle biopsies collected in the window of implantation were subsequently assessed to determine differential endometrial AGR3 and S100P levels relevant to RIF (n = 13) and RPL (n = 10) in comparison with parous women (n = 30) using immunohistochemistry. Significantly higher AGR3 and S100P immunostaining was observed in ciliated cells of the LE of women with recurrent reproductive failure compared with parous women, suggesting aberrant subcellular location-associated pathophysiology for these conditions. The nuclear localisation of S100P may allow transcriptional regulatory function, which is necessary for implantation of a viable pregnancy. Further work is thus warranted to assess their utility as diagnostic/therapeutic targets.
Despite a large volume of literature concerning platelet aggregation, very few attempts have been made to control the acidbase environments of platelet-rich plasma (EWP) during such studies (1, 3-6). A method to control the pH of PRP using CO, gas was described from this laboratory recently (2). In this study it was demonstrated that platelet aggregation in response to a threshold challenge with epinephrine was greatly enhanced by alkalosis and inhibited by acidosis within clinical ranges of pH change. Since the pH was controlled by varying pC0, in these experiments, the question remained as to whether this was a property of pH change per se or of changes in the pC0,. Accordingly, in the present studies, platelet aggregation in response to threshold challenge with epinephrine, and with ADP, was measured in samples of PRP in which the pH was altered while the pC0, was maintained constant. The results indicate that the important determinant in platelet response is pH rather than pC0,.
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