Browsing by Author "Terzic, Milan (55519713300)"

Angiomatosis is defined as a hemangioma that affects a large segment of the body in a contiguous fashion, either by vertical extension to involve multiple tissue planes (eg, skin, subcutis, muscle, bone) or by crossing muscle compartments to involve similar tissue types (eg, multiple muscles). Such lesions usually present in the first 2 decades of life and have a highly characteristic but not totally specific histological pattern. Histology usually shows a haphazard mixture of small and medium-sized vessels, fat, connective tissue, and lymphatics. Large amounts of mature fat frequently accompany the vascular elements, suggesting that the lesion may possibly be a more generalized mesenchymal proliferation rather than an exclusively vascular lesion. Here we present what we believe to be the first case of angiomatosis showing osseous metaplasia. © 2009 by Lippincott Williams & Wilkins.

Purpose: Evaluation of simplified Bishop score and ultrasound cervicometry in the assessment of labor induction success in nulliparous women. Methods: Prospective cohort study included 146 nulliparous women with singleton pregnancy and indications for labor induction. Prior to labor induction, cervicometry and Bishop score were determined. Upon delivery, patients were classified as those delivered vaginally and by cesarean section (CS) after unsuccessful labor induction. Results: Bishop score >5 was found in 47.95% of vaginally delivered women and 12.33% of patients delivered by CS (p <.01). Cervicometry had appropriate findings in 34.2% of vaginally delivered women and 75.3% of those delivered by CS (p <.01). Bishop score (>5 versus ≤5) had lower sensitivity (52.05%) and specificity (12.33%) than cervicometry (good versus unfavorable findings) (sensitivity 65.75%, specificity 75.34%) for prediction of labor induction success. If Bishop score was ≤5, cervicometry had 50.0% sensitivity and 78.13% specificity, while if Bishop score was >5, 82.86% sensitivity and 55.56% specificity. Obtained model for predicting labor induction outcome in nulliparous women based on their clinical and ultrasonographical characteristics identified the Bishop score as the most important predictor. Conclusions: Study confirmed the usefulness of simplified Bishop score and ultrasound cervicometry in the assessment of labor induction success in nulliparous women. © 2019 Informa UK Limited, trading as Taylor & Francis Group.

[No abstract available]

Well-balanced and adequate maternal nutrition prior conception and during pregnancy affects the course and outcome of pregnancy, and enables achievement of a: 1) healthy pregnancy, 2) uncomplicated delivery of a full-term and well-developed baby, 3) lower risk of maternal postpartum complications, and 4) sufficient source for lactation. Adequate maternal nutrition also improves future maternal health in general and reproductive health in particular. As it is now widely recognized that the risk of various chronic diseases in adulthood might have their origins in intrauterine life, the new goal of the contemporary approach in pregnancy nutrition is to establish the nutritional foundations for a healthy adults during intrauterine life. Pregnancy represents a special maternal demand for high-quality nutrients, as it is regarded as a metabolic stress that is increasing according to the course of the gestation. Although it is not completely clear how nutritional status of the mother influences her own health as well as fetal growth/development, nutrition imbalance could be harmful to the pregnant woman, influencing both the outcome of pregnancy and the composition of breast milk. In well-nourished women these increased needs are best met by biological and metabolic adaptation to pregnancy. Increasing demands should be achieved by appropriate dietary intake, which contains all nutrition requirements. In cases of imbalanced dietary intake, preexisting deficiencies of micronutrients, previous adverse pregnancy outcomes, and in all cases of high-risk pregnancies micronutrient supplementation is especially important. However, until now there is insufficient evidence to define whether there is a need for routine antepartum supplementation or should nutritional intervention be restrained to deficient populations and high-risk pregnancies. As the data on the effectiveness of supplementation in preventing or treating pregnancy-related disorders and perinatal complications are contradictory, future well designed randomized control trials would try to solve this dilemma. Micronutrient supplementation supporters have a standpoint that the potential benefits of routine supplementation overweigh any potential adverse reaction that can be attributed. In the other hand, the daily requirements are easily met in all individuals having a balanced diet. Although deficiency states are rare, several pharmaceutical companies produce over-the-counter vitamin - plus-mineral nutritional supplements, despite the lack of clear evidence to support their supplemental consumption. Currently, micronutrient supplementation should be chosen on an individual basis. In the near future, the goal would be to estimate micronutrient status prior to conception or in the early pregnancy, in order to define patients who must receive appropriate micronutrient supplementation. © 2008 by Nova Science Publishers, Inc. All rights reserved.

Well-balanced and adequate maternal nutrition prior conception and during pregnancy affects the course and outcome of pregnancy, and enables achievement of a: 1) healthy pregnancy, 2) uncomplicated delivery of a full-term and well-developed baby, 3) lower risk of maternal postpartum complications, and 4) sufficient source for lactation. Adequate maternal nutrition also improves future maternal health in general and reproductive health in particular. As it is now widely recognized that the risk of various chronic diseases in adulthood might have their origins in intrauterine life, the new goal of the contemporary approach in pregnancy nutrition is to establish the nutritional foundations for a healthy adults during intrauterine life. Pregnancy represents a special maternal demand for high-quality nutrients, as it is regarded as a metabolic stress that is increasing according to the course of the gestation. Although it is not completely clear how nutritional status of the mother influences her own health as well as fetal growth/development, nutrition imbalance could be harmful to the pregnant woman, influencing both the outcome of pregnancy and the composition of breast milk. In well-nourished women these increased needs are best met by biological and metabolic adaptation to pregnancy. Increasing demands should be achieved by appropriate dietary intake, which contains all nutrition requirements. In cases of imbalanced dietary intake, preexisting deficiencies of micronutrients, previous adverse pregnancy outcomes, and in all cases of high-risk pregnancies micronutrient supplementation is especially important. However, until now there is insufficient evidence to define whether there is a need for routine antepartum supplementation or should nutritional intervention be restrained to deficient populations and high-risk pregnancies. As the data on the effectiveness of supplementation in preventing or treating pregnancy-related disorders and perinatal complications are contradictory, future well designed randomized control trials would try to solve this dilemma. Micronutrient supplementation supporters have a standpoint that the potential benefits of routine supplementation overweigh any potential adverse reaction that can be attributed. In the other hand, the daily requirements are easily met in all individuals having a balanced diet. Although deficiency states are rare, several pharmaceutical companies produce over-the-counter vitamin - plus-mineral nutritional supplements, despite the lack of clear evidence to support their supplemental consumption. Currently, micronutrient supplementation should be chosen on an individual basis. In the near future, the goal would be to estimate micronutrient status prior to conception or in the early pregnancy, in order to define patients who must receive appropriate micronutrient supplementation. © 2008 by Nova Science Publishers, Inc. All rights reserved.

Objective. The study aim was to investigate the diagnostic value of preoperative serum tumor markers in patients with adnexal masses. Methods. Study included all (358) consecutive patients treated for adnexal tumors at the Clinic of Ob/Gyn, Clinical Center of Serbia in 12 months. Tumor marker levels (Ca 125, CEA, HE 4, Ca 19.9, and Ca 15.3), taken from all women on admission, were compared with postoperative histopathological findings of extracted tumors. Results. Women with malignant tumors had the highest levels of Ca 125, CEA, and HE 4 (p<0.01). Mucinous adenocarcinoma produced the highest amounts of Ca 19.9 and CEA. Ca 15.3 was the highest in women with endometrioid carcinoma. There were no significant differences in the levels of all examined tumor markers (p>0.05) between women with benign and borderline tumors. Ca 125, HE 4, and Ca 15.3 can discriminate the malignant from other tumor types well. The highest sensitivity, specificity, positive and negative predictive values (91.04%, 87.6%, 67.9%, 77.2%, respectively) were achieved for the combination of Ca 125 and HE 4. Conclusions. Blood levels of examined tumor markers can be good predictors of the adnexal masses nature. For the most precise evaluation the combination of serum tumor markers should be used. © 2014 Versita and Springer-Verlag.

Objective: The study aim was to investigate the diagnostic value of measuring preoperative serum tumor markers in patients with adnexal masses. Methods: The study included all (358) consecutive patients treated for adnexal tumors at the Clinic of Obstetrics and Gynecology, Clinical Center of Serbia during 12 months. Tumor-marker levels (Ca 125, CEA, HE 4, Ca 19.9 and Ca 15.3) obtained from all women on admission were compared with histopathological findings in cases in which tumors were removed. Results: Women with malignant tumors had the highest levels of Ca 125, CEA and HE 4 (p<0.01). Mucinous adenocarcinoma produced the highest amounts of Ca 19.9 and CEA. Ca 15.3 was the highest in women with endometrioid carcinoma. There were no significant differences in the levels of all serum tumor markers between women with benign and borderline tumors (p>0.05). Malignant forms of tumors were well indicated by Ca 125, HE 4 and Ca 15.3 levels. The combination of Ca 125 and HE 4 resulted in the highest sensitivity, specificity, and positive or negative predictive value (91.04%, 87.6%, 67.9%, 77.2%, respectively). Conclusions: Blood levels of tumor markers can be effective? predictors of the nature of adnexal masses. For the most precise evaluation, a combination of serum tumor markers should be used. © 2014 Versita and Springer-Verlag.

Endometriosis, a common condition in women of reproductive age, is very frequently associated with infertility. The causes of infertility in women with endometriosis range from anatomical distortions to endocrine abnormalities and immunological disturbances: a) disturbance of pelvic anatomy especially in women with severe disease; b)prostaglandin overproduction and inflammatory mediators determining a hostile peritoneal environment; c) altered endometrial receptivity; d) myometrium structure changes in adenomyosis; e) decreased ovarian reserve and oocyte quality due to the presence of endometrioma or as a consequence of the surgically related damage; and f) hormonal dysregulation with anovulation and premature luteinization. Despite the extensive and interdisciplinary investigations already conducted, all the listed pathophysiological mechanisms in infertility patients with endometriotic ovarian cyst have not always been clearly understood. Nonetheless, endometriosis significantly interferes with women's overall health and well-being, and it is also linked with a decreased ovarian reserve and adverse outcomes of infertility management procedures. Treatment strategies for endometriotic ovarian cyst in infertility patients are different, depending on a number of factors. The surgical approach remains controversial, as it has been associated with ovarian reserve impairment. Medications alone have little or no effect and should be combined with assisted reproductive technology procedures. IVF is an efficient treatment option in patients with a mild and moderate stage of the disease. Although recently published studies have shown that a combination of medical, surgical, and psychological treatment was found beneficial in patients suffering from endometriosis-related infertility, there is still a lack of consensus that this specific combination can enhance the fertility success rate. Generally, management of endometriotic ovarian cyst in infertility patients includes a surgical procedure (usually with a minimally invasive approach) and ovulation induction with intrauterine insemination or in vitro fertilization. Fertility preservation technologies also include oocyte or embryo freezing and ovarian tissue cryopreservation. As the management of patients with endometriotic cysts remain controversial, a multidisciplinary approach is a key factor in achieving the best outcome, along with appropriate patient counselling. © 2021 by Nova Science Publishers, Inc. All rights reserved.

Approximately 15% of the world population is impacted by infertility. Recent research has shown that environmental and occupational factors have profound effects on the population's overall health and fertility status. While cigarette smoking and its component chemicals are known toxic agents affecting the quality and quantity of oocytes, other toxic substances ubiquitous in our environment appear to have toxic effects on the reproductive system at environmentally relevant levels. Certain industrial chemicals, environmental pollutants, and radiation are known to contribute to or cause infertility. Lead poisoning, for example, has long been associated with infertility in both men and women. Chemotherapy and x-ray therapy used in cancer treatment can be extremely toxic to sperm and oocytes and can cause permanent infertility. In some countries, fertility programs recommend that men who will be undergoing chemotherapy store their sperm before treatment. Similarly, oocyte retrieval before a woman's cancer treatment and freezing the oocytes or embryos for later use, is also advised. Long soaks in the bathtub or hot tub or long hours of sitting and excessive bicycling can cause the temperature in the scrotum to increase enough to impair sperm production. A febrile illness can also lead to a significant decline in sperm motility. Considering all these elements, the influence of environmental and occupational conditions on reproductive well-being has generated a considerable amount of interest among researchers. Recent studies have aimed to clarify the association and possible mechanisms between reduced fertility and exposure to environmental and occupational contaminants. This chapter summarizes the recently published, epidemiological findings referring to the impact of environmental (air pollution, heavy metals, pesticides, endocrine disruptors and other chemicals, radiation) and occupational factors on fecundity and fertility. Daily exposure to environmental and occupational hazards has negative ramifications for fertility via several sources such as biological, physical (radiation), and toxic (chemicals, endocrine-disrupting chemicals, heavy metals). Future studies are needed to better elucidate the additional associations and potential mechanisms between these environmental chemicals and fertility outcomes in men and women. © 2021 by Nova Science Publishers, Inc. All rights reserved.

Introduction: Inflammation plays a key role in the development of benign prostatic hyperplasia. Prostaglandin E2 (PGE2) is an important inflammation factor found in enlarged prostatic tissue that can be the main cause of inflammatory pain. The aim of this study was to investigate whether epidural anesthesia can block the negative effects of prostaglandin mediators during prostate surgery. Materials and methods: The study included 60 patients who underwent open prostatectomy. All patients were randomly allocated to one of two study groups. The first group received general anesthesia and the second group a combination of general and epidural anesthesia. Main outcome measures were plasma concentration of PGE2, adrenaline, noradrenaline, and dopamine, before induction of anesthesia and at the time of enucleation. Results: Preoperative serum concentrations of PGE2 were high in both groups. During enucleation, serum concentrations of adrenaline, noradrenaline, and dopamine increased, followed by a rise of systolic and diastolic blood pressure in the group of patients that received only general anesthesia. Serum concentration of PGE2 was at the same level as before induction of anesthesia in both groups. Conclusion: Epidural anesthesia blocks transmission of painful stimulus through the spinal cord caused by prostaglandin release and prevents the rise of catecholamines and blood pressure. Open prostatectomy can become a safer procedure performed under a combination of general and epidural anesthesia. Negative intraoperative effects of inflammatory prostate mediators during other techniques for prostate surgery could also be blocked with epidural anesthesia. © The Canadian Journal of Urology™.

Purpose: To evaluate the potential influence of clinical characteristics on survival of patients with advanced-stage of ovarian malignancies. Methods: The study included 163 women with FIGO stages 3 and 4 ovarian malignancies. Detailed history (family history of malignancies, age, menopausal status, body mass index (BMI), parity, comorbidities, symptoms/signs) was taken from all patients including tumor histopathological findings. Patients were postoperatively followed up to 5 years and adverse events were recorded. Univariate and multivariate survival analyses were applied. Results: Patient median survival was 22.77 months (range 1-91). Almost 74% of women survived in the first postoperative year, but only 12.9% had 5-year survival. In the postoperative period, each additional 6 months presented significant risk for unfavorable outcome. Women who were menopausal (p=0.033) and especially if older than 65 years (p=0.016) had worse prognosis. Patients with BMI ?25 kg/ m 2 had significantly longer postoperative survival (p=0.005; obesity hazard ratio/HR=1.525). Women with other gynecological or chronic illnesses had a significantly shorter postoperative survival (p=0.038; hazard ratio/HR=1.450). There were no significant differences in postoperative survival regarding patients’ parity, presence of symptoms or positive family history. Two significant models adjusted for FIGO stage (p=0.046) and histological tumor type (p=0.003) encompassing all assessed patient characteristics that could influence survival were obtained. Conclusions: The most important clinical characteristics that can be predictors of survival of patients with advanced ovarian malignancies are comorbidities and being overweight. © 2017 Zerbinis Publications. All rights reserved.

Purpose: To evaluate the potential influence of clinical characteristics on survival of patients with advanced-stage of ovarian malignancies. Methods: The study included 163 women with FIGO stages 3 and 4 ovarian malignancies. Detailed history (family history of malignancies, age, menopausal status, body mass index (BMI), parity, comorbidities, symptoms/signs) was taken from all patients including tumor histopathological findings. Patients were postoperatively followed up to 5 years and adverse events were recorded. Univariate and multivariate survival analyses were applied. Results: Patient median survival was 22.77 months (range 1-91). Almost 74% of women survived in the first postoperative year, but only 12.9% had 5-year survival. In the postoperative period, each additional 6 months presented significant risk for unfavorable outcome. Women who were menopausal (p=0.033) and especially if older than 65 years (p=0.016) had worse prognosis. Patients with BMI ?25 kg/ m 2 had significantly longer postoperative survival (p=0.005; obesity hazard ratio/HR=1.525). Women with other gynecological or chronic illnesses had a significantly shorter postoperative survival (p=0.038; hazard ratio/HR=1.450). There were no significant differences in postoperative survival regarding patients’ parity, presence of symptoms or positive family history. Two significant models adjusted for FIGO stage (p=0.046) and histological tumor type (p=0.003) encompassing all assessed patient characteristics that could influence survival were obtained. Conclusions: The most important clinical characteristics that can be predictors of survival of patients with advanced ovarian malignancies are comorbidities and being overweight. © 2017 Zerbinis Publications. All rights reserved.

Objective: There are still contradictory opinions on the success rates of uterine artery embolization (UAE) for the treatment of myomas. In this scenario, our study aims to assess the effect of UAE on myoma shrinkage. Materials and Methods: The study included 337 women in reproductive age affected by a single symptomatic intramural myoma and declined surgery, undergoing UAE. The uterus and myoma diameters and volumes were determined on ultrasonographic scans before and 3, 6, and 12 months after the procedure. Results: The mean uterine volume before intervention was 226.46 ± 307.67 mm3, whereas myoma volume was 51.53 ± 65.53 mm3. Further myoma progression was registered in only four patients. In remaining women, uterus volume in average decreased for 149.99 ± 156.63 mm3, whereas myomas decreased for 36.57 ± 47.96 mm3. The mean volume reduction rate of the uterus was 49.54 ± 35.62 and for myoma was 57.58 ± 30.71. A significant decrease in both uterine and myoma volume was registered in every stage of the follow-up. The highest average decrease in uterine volume was in the first 3 months and myoma volume between 3 and 6 months following UAE. After 12 months follow-up, successful outcome (volume regression >50% respect to the baseline) was registered for uterus in 97.4% and for myoma in 67.9% of investigated patients. Conclusion: UAE was proven to allow a good success rate and can be considered as an effective alternative procedure for myoma treatment. © 2019 Gynecology and Minimally Invasive Therapy.

This study assessed factors associated with quality of life (QOL) among Serbian peri- and postmenopausal women using two menopause-specific scales. This cross-sectional study included 500 women aged 40–65 years who had a gynecologic check-up in one of two Community Health Centers in Belgrade during February 2014 to January 2015. Women completed: a questionnaire about socio-demographics, habits, and health status; a menopause-specific questionnaire, Utian’s Quality of Life Scale (UQOL); and a Women’s Health Questionnaire (WHQ) and Beck’s Depression Inventory (BDI). Higher education was associated with better occupational UQOL and memory/concentration, but with lower emotional UQOL and more anxiety/fears. City center residency was associated with better occupational and sexual UQOL. Being employed was associated with better occupational UQOL and lower anxiety/fears. Higher income was associated with better emotional UQOL. Not having uterine prolapse, insomnia, or tachycardia was associated with better occupational UQOL and fewer sleep problems. Higher parity was associated with better sexual UQOL. Having regular recreation was associated with better health and sexual UQOL but with more frequent vasomotor symptoms. Leaner women felt more attractive. QOL during the menopausal transition does not entail only somatic symptoms and therefore requires a more comprehensive approach that includes psychosocial underpinnings. © 2018 Taylor & Francis.

Purpose: To assess factors associated with better sexual quality of life (QOL) in midlife period among women who are and are not sexually active. Methods: Participants were 500 women aged 40–65 years from Belgrade, Serbia. Data were collected through general questionnaire (regarding socio-demographic characteristics, lifestyle habits, general medical, and gynecological history) in which one item investigated having partnered sexual activity (heterosexual intercourses). The sexual domain of the Utian Quality of Life Scale was used to assess the sexual QOL. The sexual QOL consisted of reflections on the satisfaction with frequency of sexual interactions, as well as sexual and romantic life in general. Higher scores indicated better sexual QOL. Results: Most women were sexually active in midlife (81.6%). The mean sexual QOL score for the overall sample was 9.99 (range 3–15). The level of sexual QOL did not differ between sexually active and non-active women. Factors associated with better sexual QOL in sexually active menopausal women were being married or coupled, being physically active, having more children, having hot flushes, and not having tachycardia. Factors associated with better sexual QOL in sexually inactive menopausal women were drinking alcohol, being physically active, not having insomnia or skin rash. Conclusions: Sexual QOL among Serbian urban midlife women was good and did not differ between women who were sexually active and those who were not. Further studies are needed to determine in what manner women who are not sexually active in midlife achieve high level of satisfaction with their sexual QOL. © 2017, Springer International Publishing Switzerland.

[No abstract available]

Introduction: Numerous parameters can affect the quality of life (QL) during pregnancy. Goal: The aim of the study was to evaluate QL in healthy pregnant women. Methods: Study involved every sixth woman who gave birth in Clinic of Gynecology and Obstetrics Clinical Center of Serbia, Belgrade, during the year 2010. They filled in the SF-36 questionnaire, Beck's Depression Inventory (BDI), Fatigue Severity Scale (FSS), Pregnancy Symptom Scale (PSS), Multidimensional Personal Support Scale (MSPSS) and Acceptance of Illness Scale (AIS). Results: There were 604 women included in the study. Mean scores of the scales were: total SF-36-70.7, BDI-3.8, FSS-3.5, PSS-2.1, MSPSS- 70.3, AIS-14.0. The values of total QL, PSS and MSPSS scores were highly significantly correlated with all other examined scale scores. BDI and FSS were not correlated only with MSPSS. Significant models of correlation were obtained for SF-36 scores: total QL (R=0.597; adjR2=0.351; F=66.281; p=0.000). Conclusion: The QL during pregnancy was good. Examined women did not have significant levels of depression, fatigue and symptoms during pregnancy. Women had good social support and tolerated pregnancy well. However, depression, fatigue, pregnancy tolerance and social support can all significantly affect the quality of life during pregnancy. Most attention should be directed to pregnancy-related depression and fatigue.

Objective: The aim of the study was to assess which clinical, laboratory and ultrasound characteristics of adnexal masses might predict the histopathological nature of the disease. Materials and Methods: The study involved all women treated at the Clinic of Gynecology and Obstetrics Clinical Centre of Serbia for adnexal tumors between July 1, 2010 and December 31, 2011. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan performed and RMI was calculated for all patients. Data were related to histopathological findings and statistically analyzed. Results: The study included 540 women out of which 85 had malignant (seven diagnoses), 435 benign (seven diagnoses) and 20 borderline tumors. All types of malignant and borderline tumors were more frequent in postmenopausal women (p=0.000). Only papillary adenocarcinoma significantly more often produced early metastases (p=0.000). Ascites is a common finding in Krukenberg tumors, granulose cell tumors and papillary adenocarcinomas. There were significant differences between tumor diagnoses regarding the levels of Ca 125 and CEA, erythrocyte sedimentation rate (ESR) and risk of malignancy index (RMI) (p<0.05). No significant differences were found within the group of malignant tumor types regarding the levels of all examined tumor markers, ESR as well as RMI (p>0.05). Conclusions: In the light of our results, patient age, menopausal status, blood levels of Ca 125, CEA and ESR, as well as calculated RMI, can predict the nature of adnexal masses. Unfortunately, none of the examined parameters can accurately determine the exact histopathological diagnosis of the adnexal tumor. © Polskie Towarzystwo GinekoLogiczne.

Introduction: Mesenchymal stem cells from Wharton's Jelly of a human umbilical cord (WJ-MSCs) are a potential tool in regenerative medicine based on their availability, proliferative potential and differentiation capacity. Since their physiological niche contains low oxygen levels, we investigated whether cultivation of WJ-MSCs at 3% O2 affects their main features. Methods: WJ-MSCs were cultured under 21% and 3% O2. Proliferation rate was followed by short and long term proliferation assays, clonogenic capacity by CFU-F assay and cell cycle and death by flow cytometry. Differentiation capacity was investigated by histochemical staining after induced differentiation. Pluripotency and differentiation markers' expression was determined by RT-PCR. Migration capacity was followed by scratch assay and mobilization from collagen, and the activity of proteolytic enzymes by zymography. Specific inhibitors of MAPK and Wnt/β-catenin pathways were used to investigate underlying molecular mechanisms. Results: Compared to standard 21% O2, cultivation of WJ-MSCs at 3% O2 did not influence their immunophenotype, while it modulated their differentiation process and enhanced their clonogenic and expansion capacity. 3% O2 induced transient change in cell cycle and prevented cell death. The expression of NANOG, OCT4A, OCT4B and SOX2 was increased at 3% O2. Both cultivation and preculturing of WJ-MSCs at 3% O2 increased their in vitro migratory capacity and enhanced the activity of proteolytic enzymes. ERK1/2 mediated WJ-MSCs’ mobilization from collagen regardless of oxygen levels, while Wnt/β-catenin pathway was activated during migration and mobilization at standard conditions. Conclusion: Culturing of WJ-MSCs under 3% O2 should be considered a credible condition when investigating their properties and potential use. © 2019 Elsevier Ltd

Introduction: Mesenchymal stem cells from Wharton's Jelly of a human umbilical cord (WJ-MSCs) are a potential tool in regenerative medicine based on their availability, proliferative potential and differentiation capacity. Since their physiological niche contains low oxygen levels, we investigated whether cultivation of WJ-MSCs at 3% O2 affects their main features. Methods: WJ-MSCs were cultured under 21% and 3% O2. Proliferation rate was followed by short and long term proliferation assays, clonogenic capacity by CFU-F assay and cell cycle and death by flow cytometry. Differentiation capacity was investigated by histochemical staining after induced differentiation. Pluripotency and differentiation markers' expression was determined by RT-PCR. Migration capacity was followed by scratch assay and mobilization from collagen, and the activity of proteolytic enzymes by zymography. Specific inhibitors of MAPK and Wnt/β-catenin pathways were used to investigate underlying molecular mechanisms. Results: Compared to standard 21% O2, cultivation of WJ-MSCs at 3% O2 did not influence their immunophenotype, while it modulated their differentiation process and enhanced their clonogenic and expansion capacity. 3% O2 induced transient change in cell cycle and prevented cell death. The expression of NANOG, OCT4A, OCT4B and SOX2 was increased at 3% O2. Both cultivation and preculturing of WJ-MSCs at 3% O2 increased their in vitro migratory capacity and enhanced the activity of proteolytic enzymes. ERK1/2 mediated WJ-MSCs’ mobilization from collagen regardless of oxygen levels, while Wnt/β-catenin pathway was activated during migration and mobilization at standard conditions. Conclusion: Culturing of WJ-MSCs under 3% O2 should be considered a credible condition when investigating their properties and potential use. © 2019 Elsevier Ltd