Abnormal Attachment Research Articles

Management of the Maxillary Labial Frenum

This study examined the maxillary labial frenum (MLF) and its clinical implications, focusing on its anatomy, developmental changes, and management strategies. The MLF functions as a connective tissue linking the upper lip to the alveolar ridge, facilitating essential processes such as speech production, food consumption, and the maintenance of proper dental alignment. Abnormal development or attachment can result in midline diastema, speech difficulties, and breastfeeding challenges. During growth, the MLF typically migrates from the alveolar crest in infancy to the mucogingival junction by adulthood; however, in some cases, this migration fails, leading to persistent diastema or other oral health concerns. The timing of frenectomy remains unclear. Certain experts advocate for early intervention to facilitate orthodontic treatment, while others recommend postponing surgical procedures until orthodontic efforts are completed, as the majority of diastemas close naturally with the eruption of permanent canines. In instances where diastema persists, frenectomy may be necessary to prevent relapse. Restrictive frenum attachments have been linked to breastfeeding difficulties; however, feeding outcomes can also be influenced by factors such as maternal technique and infant feeding patterns. This review highlights the need for individualized assessment and treatment planning, balancing surgical intervention with natural development, to ensure the best outcomes for each patient.

A case report of a first trimester missed abortion which unfolded into an emergency subtotal hysterectomy

Placenta Accreta Spectrum (PAS) encompasses various degrees of abnormal placental attachment, where the decidual basalis is compromised, allowing chorionic villi to invade into or beyond the myometrium. This invasion is difficult to diagnose in first trimester ultrasound. PAS results in incomplete separation of the placenta and subsequent hemorrhage which can be life threatening to the mother. We present a case of a woman with previous two LSCS presenting in first trimester with missed abortion wherein a Manual Vaccuum Aspiration was followed by uncontrollable hemorrhage necessitating a hysterectomy and a retrospective diagnosis of placenta increta. The primary modality of imaging in first trimester -the ultrasound - is not reliable to diagnose placenta accreta syndrome and additional inputs may be needed to make this diagnosis in the first trimester

Mari's novel T shaped incision in frenotomy technique with bilateral pedicle flap- an aesthetic approach

BackgroundAberrant frenum attachments often lead to mucogingival deformities, culminating in both functional impairments and aesthetic concerns. Traditional frenectomy procedures are associated with extensive incisions and resultant wound defects. To address these challenges, a novel T-shaped incision technique has been developed. This method enhances accessibility for removing vestibular and frenal attachments while creating a tripod layer of flaps, thereby promoting primary closure and improved blood supply for healing by primary intention. Case managementThis innovative technique is particularly suited for managing frenum variations such as bifid frenum, persistent tectolabial frenum, double frenum, and wider frenum. The procedure involves crafting two horizontal and two converging parallel incisions that form a “T" shape, facilitating effective fiber detachment. Bilateral pedicle flaps are then employed for primary closure, which concurrently enlarges the zone of attached gingiva. ConclusionThe T-shaped incision approach presents an advanced method for treating abnormal frenum attachments, ensuring efficient fiber separation and fostering healing by primary intention.

Uterine layers hypervascularization in atypical placentation: the comparison of magnetic resonance imaging with vascular pathomorphology

Rationale: One in five women worldwide delivers through cesarean section, which is associated to a high rate of placenta previa and abnormal placenta attachment to the uterine wall. The grade of placenta accreta spectrum (PAS) correlates with blood loss volume, which could be related to vascularization characteristics. Up to now, there have been no studies on the diagnostic value of magnetic resonance criteria for hypervascularization of the uterine wall and their correlation with an assumed grade of PAS according to the International Federation of Gynecology and Obstetrics (FIGO) classification. Also, abnormal vessels location and their wall structure have not been studied with state-of-the-art pathomorphological methods. Aim: To develop a classification for various types of the uterine wall hypervascularization depending on the depth of placental invasion assessed by magnetic resonance imaging (MRI). Methods: We retrospectively analyzed medical files of 66 patients aged 18 to 45 years, who were assumed to have PAS based on their sonography results. To clarify the extent and localization of the placental invasion, all patients had MRI performed at 24 to 32 weeks of gestation. In all patients, the PAS grade was verified pathologically; in 30 of them (45,5%), a detailed pathological examination was additionally performed. The PAS grades were classified according to Morbidly Adherent Placenta Imaging Reporting and Data System (MAPI-RADS). The MRI data were correlated with the PAS (FIGO) grade estimated from intraoperative data and with intraoperative blood loss. At the final study step, the MRI data was correlated with abnormal pathomorphology, with the assessment of the degree of vascularization and the visual picture of abnormal uteroplacental vasculature. Results: We have proposed a classification of MRI signs of hypervascularization in the lower uterine segment correlating with the depth of placenta accreta. Type 1. Single small vessels in the myometrium, medium caliber arteries in the projection of the uterine serosa (normal variation for the 3rd trimester of gestation). Type 2. Numerous small confluent vessels, mainly in the uteroplacental region, and retroplacental hematomas (typical for placenta accreta, or FIGO PAS 1). Type 3. Intrauterine hypervascularization with a deficient myometrium thickness, predominantly vessels of the middle layer (typical for placenta increta, or FIGO PAS 2). Type 4. Thinning of the lower uterine segment due to significant bulging of the placenta in the presence of curved anastomosing vessels of vast caliber over 4 mm (typical for placenta increta – FIGO PAS 2, as well as placenta percreta – FIGO PAS 3a). Type 5. Hypervascularization outside the uterus, over its surface and in the parametrial tissues: at the border with the bladder, uterine isthmus, including signs of fibrosis and growing into the posterior bladder wall (typical for various grades of placenta percreta – FIGO PAS 3b, 3c). Conclusion: The proposed classification of uterine wall hypervascularization in accordance with the grades of placenta accreta spectrum (FIGO PAS) could be useful for its practical implementation by radiologists.

A Modification of Fenestration Technique (MOFT) to Increase Vestibular Depth: A Case Series.

The most prevalent mucogingival issues include insufficient gingival width, decreased vestibular depth, abnormal frenal attachment, gingival recession, pockets that reach the mucogingival junction, excess gingival, inconsistent gingival margin, excessive gingival display and abnormal gingival colour. Numerous periodontal plastic operations have been used to treat these issues. However, each approach has its own drawbacks and is technique-dependent. Adequate depth of vestibule is necessary to maintain good oral health as shallow vestibule leads to accumulation of food and thus impedes oral hygiene maintenance. This case series describes a vestibular deepening procedure performed using modification of periosteal fenestration technique. This technique includes a series of eight cases of shallow vestibule where vestibular deepening was conducted by giving a full-thickness incision to expose the periosteum and create a window of fenestration followed by suturing the labial mucosa to the periosteum at the apical level. The results reported an excellent post-operative outcome showing increased depth of the vestibule.

Evaluation of potential links between phenotypic features and genetic variants in left ventricular outflow tract obstruction in hypertrophic cardiomyopathy using cardiovascular magnetic resonance imaging.

This study aimed to identify the phenotypic features contributing to the development of left ventricular outflow tract obstruction (LVOTO) in patients with hypertrophic cardiomyopathy (HCM) and to evaluate the genotype‒phenotype relationship. This cross-sectional study included 96 patients diagnosed with HCM (mean age: 56.9 ± 13.5 years, 32.3% female). The patients were divided into hypertrophic nonobstructive cardiomyopathy (HNCM; n = 60) and hypertrophic obstructive cardiomyopathy (HOCM; n = 36) groups. All patients underwent CMR. Patients (n = 77) who had previously provided formal approval underwent a genetic examination that included 18 genes. The anterior mitral leaflet (AML) length/LVOT diameter ratio, posterior mitral leaflet (PML) length/LVOT diameter ratio, and anterolateral papillary muscle (AL-PM) mobility were associated with LVOTO, independent of the basal IVS thickness, abnormal chordal attachment, and bifid PM. An AML length/LVOT diameter ratio of ≥ 2.30, a PML length/LVOT diameter ratio of ≥ 1.83, and an AL-PM mobility of ≥ 57.7% were predictors of LVOTO, with good sensitivity and specificity. Positive variants (VUS, LP, and P) were detected in 37.7% (29 of 77) of the patients who underwent genetic testing. The LP/P variant was detected in 20.8% (16 of 77) of patients. Three groups (variant-negative, VUS, and LP/P groups) had significant differences in the LVOT diameter (median 14, 12, and 10mm, respectively; p = 0.021), AML length (mean 25.3, 26.5, and 27.5mm, respectively; p = 0.029), AML length/LVOT diameter ratio (median 1.74, 2.33, and 2.85, respectively; p = 0.006), PML length/LVOT diameter ratio (median 1.29, 1.82, and 2.10, respectively; p = 0.045), and abnormal chordal attachment (6.3%, not observed, and 31.3%, respectively; p = 0.009). The AML length/LVOT diameter ratio, PML length/LVOT diameter ratio, and AL-PM mobility were associated with LVOTO. In addition, genetic testing results may provide information regarding the phenotypic expression of patients with HCM.

A case of isolated malrotation without midgut volvulus diagnosed prenatally and treated by laparoscopic surgery

BackgroundMalrotation is a congenital condition that predisposes individuals to midgut volvulus, which can result in significant bowel resection. While most cases of malrotation are diagnosed by the age of 1 year, typically presenting with symptoms related to volvulus or bowel obstruction, some cases remain asymptomatic. In children with visceral malposition, gastroschisis, omphalocele, or diaphragmatic hernia, malrotation may be suspected before symptoms manifest. However, isolated malrotation without midgut volvulus diagnosed prenatally is rare. We herein present a case of isolated malrotation without midgut volvulus that was prenatally diagnosed and successfully treated with laparoscopic surgery.Case presentationA 30-year-old woman (gravida 3, para 1) underwent routine obstetric ultrasound, which revealed increased blood flow in the lower uterine segment and abnormal placental attachment. To rule out placenta percreta, magnetic resonance imaging was performed at 34 weeks of gestation. Incidentally, abnormal fetal intestinal arrangement was noted, with the colon localized in the left hemi-abdomen and the small intestine distributed in the right hemi-abdomen, raising suspicion of malrotation. Postnatal contrast studies confirmed the diagnosis of malrotation without midgut volvulus. Given the risk of midgut volvulus, a laparoscopic Ladd’s procedure was performed on day 6 of life. The postoperative course was uneventful, and the patient was still symptom-free 1 year postoperatively.ConclusionsThis case illustrates that malrotation can be prenatally diagnosed using fetal magnetic resonance imaging. Considering the risk of midgut volvulus, prophylactic Ladd’s procedure should be performed in neonatal period. In cases where malrotation is not complicated by midgut volvulus, a laparoscopic Ladd procedure can be safely performed in neonates.

Assessment and Management of Maxillary Labial Frenum-A Scoping Review.

The maxillary labial frenum (MLF) is a soft tissue fold connecting the upper lip to the alveolar process. Abnormal attachment can cause periodontal, functional, and esthetic problems. Differential diagnosis is important and can prevent unnecessary interventions. This study aims to summarize the current evidence on the assessment and management of abnormal MLF. A thorough review of the literature was conducted. Five online databases were searched for relevant peer-reviewed human studies. Article screening and data extraction were performed independently by two reviewers using predefined inclusion/exclusion criteria. Information about article type, study design, participants' characteristics, interventions, and outcomes was extracted and synthesized. 52 articles met the review criteria. MLF is a dynamic structure characterized by a wide normal morphological variation. MLF assessment in infants has not been standardized. Studies in pre-adolescents reported a change in the thickness and position of the MLF observed over time, resulting in a lower prevalence of abnormal MLF morphology. Studies in adolescents and adults reported variable differential diagnosis criteria. Lasers appear as the most advantageous frenectomy modality. There is a need for more objective MLF diagnostic protocols and treatment guidelines, which could prevent unnecessary surgical interventions.

Fangchinoline inhibits mouse oocyte meiosis by disturbing MPF activity

Fangchinoline (FA) is an alkaloid derived from the traditional Chinese medicine Fangji. Numerous studies have shown that FA has a toxic effect on various cancer cells, but little is known about its toxic effects on germ cells, especially oocytes. In this study, we investigated the effects of FA on mouse oocyte maturation and its potential mechanisms. Our results showed that FA did not affect meiosis resumption but inhibited the first polar body extrusion. This inhibition is not due to abnormalities at the organelle level, such as chromosomes and mitochondrial, which was proved by detection of DNA damage and reactive oxygen species. Further studies revealed that FA arrested the oocyte at the metaphase I stage, and this arrest was not caused by abnormal kinetochore-microtubule attachment or spindle assembly checkpoint activation. Instead, FA inhibits the activity of anaphase-promoting complexes (APC/C), as evidenced by the inhibition of CCNB1 degeneration. The decreased activity of APC/C may be due to a reduction in CDC25B activity as indicated by the high phosphorylation level of CDC25B (Ser323). This may further enhance Maturation-Promoting Factor (MPF) activity, which plays a critical role in meiosis. In conclusion, our study suggests that the metaphase I arrest caused by FA may be due to abnormalities in MPF and APC/C activity.

Delicate threads: A case study on velamentous placenta and its clinical significance

Velamentous placenta insertion is a rare and potentially serious pregnancy complication involving the abnormal attachment of the umbilical cord to the fetal membranes rather than to the placenta.This case report details the management of a 23-year-old primigravida at 38 weeks of gestation who presented to the labor room in spontaneous labor.Initial examination revealed a term-size uterus, vertex presentation, and moderate contractions,with a fetal heart rate of 144/min. Despite an unremarkable start to labor, persistent fetal heart decelerations post-amniotomy led to the discovery of velamentous insertion of the placental cord.This case discusses the challenges, decision-making process, and outcomes associated with this rare condition, ultimately resulting in an uneventful postoperative period and successful discharge on the 5th day for both mother and baby.

Disparities in Indications and Outcomes Reporting for Spinal Column Shortening for Tethered Cord Syndrome: The Need for a Standardized Approach.

Systematic review. To identify commonly reported indications and outcomes in spinal column shortening (SCS) procedures. SCS is a surgical procedure used in patients with tethered cord syndrome-characterized by abnormal attachment of neural components to surrounding tissues-to shorten the vertebral column, release tension on the spinal cord/neural elements, and alleviate associated symptoms. PubMed and EMBASE searches captured SCS literature published between 1950 and 2023. Prospective/retrospective cohort studies and case series were included without age limit or required follow-up period. Review articles without new patient presentations, meta-analyses, systematic reviews, conference abstracts, and letters were excluded. Studies included adult and pediatric patients. The 29 identified studies represented 278 patients (aged 5-76yr). In 24.1% of studies, patients underwent primary tethered cord syndrome intervention through SCS. In 41.4% of studies, patients underwent SCS after failed previous primary detethering (24.1% of studies were mixed and 10.3% were unspecified). The most commonly reported nongenitourinary/bowel surgical indications were back pain (55.2%), lower-extremity pain (48.3%), lower-extremity weakness (48.3%), lower-extremity numbness (34.5%), and lower-extremity motor dysfunction (34.5%). Genitourinary/bowel symptoms were most often described as nonspecific bladder dysfunction (58.6%), bladder incontinence (34.5%), and bowel dysfunction (31.0%). After SCS, nongenitourinary/bowel outcomes included lower-extremity pain (44.8%), back pain (31.0%), and lower-extremity sensory and motor function (both 31.0%). Bladder dysfunction (79.3%), bowel dysfunction (34.5%), and bladder incontinence (13.8%) were commonly reported genitourinary/bowel outcomes. In total, 40 presenting surgical indication categories and 33 unique outcome measures were reported across studies. Seventeen of the 278 patients (6.1%) experienced a complication. The SCS surgical literature displays variability in operative indications and postoperative outcomes. The lack of common reporting mechanisms impedes higher-level analysis. A standardized outcomes measurement tool, encompassing both patient-reported outcome measures and objective metrics, is necessary. Level IV.

Abstract SY22-01: A strategy to intervene mitotic kinases to induce mitotic catastrophe in cancer cells

Abstract Chromosomal instability (CIN) is an outstanding feature of cancer, which relates to intratumor heterogeneity, therapeutic resistance, and poor prognosis. While cancer cells can proliferate with CIN, experimentally induced aneuploidy is known to suppress cell growth, leading to the idea that extreme ploidy changes are detrimental to cancer cells. One of the major etiologies of CIN is abnormal kinetochore microtubule attachments, followed by chromosome missegregation. To avoid this, cells have evolved a robust system including two molecular networks for stabilizing and destabilizing microtubule attachments. Two mitotic kinases are involved in this system which have opposite but balanced mode of actions. We previously found that a wide range of cancer cells are defective for destabilization and results in an elevated rate of missegregation. In this study, we aimed to manipulate this kinase balance and found that weighing the balance to stabilizers can cause catastrophic chromosome segregation in mitosis, and such effect could be induced predominantly in cancer cells. These findings prompted us to undertake a screen for small molecules targeting the balanced activity of mitotic kinases. Citation Format: Motoko Takahashi, Minji Jo, Nana Kamakura, Chang Liu, Utako Kato, Toru Hirota. A strategy to intervene mitotic kinases to induce mitotic catastrophe in cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr SY22-01.

Internal hernia a preoperative diagnostic challenge in virgin abdomen: case report

Internal hernias are classified in congenital or acquired. Congenital arises from abnormalities during embryonic development, whereas acquired result from trauma, surgical procedures, or another. Gastric surgical procedures can increase susceptibility to internal hernias. A 85-year-old female, denies previous surgeries. Went to the emergency department due to vomiting, adding colicky abdominal pain. Was discharged with a diagnosis of acute gastroenteritis. Came back 12 hours after discharge due to mesogastric pain accompanied by general malaise, abdominal distention and hyporexia, reporting a lack of evacuation. She was algid, pale, abdomen globose, distended, tympanic colonic frame, peristalsis increased. An evaluation was requested from general surgery for probable appendicitis in the elderly vs. secondary ileus. Went to operation room, finding an internal hernia. Transomental herniations are rare conditions. An abnormal omental opening can be either acquired following abdominal surgery, trauma, inflammatory conditions, low body mass index (BMI) and be associated with a long mesentery, intestinal malrotation, or abnormal peritoneal attachments. Although internal hernias are extremely rare (between 1 and 4% of acute or intermittent intestinal obstructions) it is essential not to miss this diagnosis, even in patient whit no previous surgeries. Management of omental hernias are critical as the postoperative mortality rate is over 30% and even 50% if strangulation is present. The lack of current literature on this rare condition, particularly for lesser omental hernias (because can present with nonspecific signs and symptoms) makes diagnosis and management difficult.

External Validation of a Multivariable Prediction Model for Placenta Accreta Spectrum

(Anesth Analg. 137(3):537–547) Placenta accreta spectrum (PAS) encompasses various forms of abnormal placental attachment and uterine invasion. PAS is a leading cause of severe postpartum hemorrhage and often leads to an emergency hysterectomy. Managing PAS and its associated complications, such as preterm birth, maternal morbidity, and neonatal intensive care unit admissions, is best achieved in tertiary-level hospitals equipped with specialized multidisciplinary care. To ensure the highest quality of care, proactive planning is essential. This involves identifying risk factors associated with PAS, facilitating rapid transfers to appropriate delivery facilities, efficient resource allocation, and minimizing the occurrence of life-threatening postpartum hemorrhage and its associated complications.

Using deep learning and large protein language models to predict protein-membrane interfaces of peripheral membrane proteins.

Characterizing interactions at the protein-membrane interface is crucial as abnormal peripheral protein-membrane attachment is involved in the onset of many diseases. However, a limiting factor in studying and understanding protein-membrane interactions is that the membrane-binding domains of peripheral membrane proteins (PMPs) are typically unknown. By applying artificial intelligence techniques in the context of natural language processing (NLP), the accuracy and prediction time for protein-membrane interface analysis can be significantly improved compared to existing methods. Here, we assess whether NLP and protein language models (pLMs) can be used to predict membrane-interacting amino acids for PMPs. We utilize available experimental data and generate protein embeddings from two pLMs (ProtTrans and ESM) to train classifier models. Overall, the results demonstrate the first proof of concept study and the promising potential of using deep learning and pLMs to predict protein-membrane interfaces for PMPs faster, with similar accuracy, and without the need for 3D structural data compared to existing tools. The code is available at https://github.com/zoecournia/pLM-PMI. All data are available in the Supplementary material.

Anesthetic Management in Obese Patients with Placenta Accreta Undergoing Cesarean Section: Case Report

Background: Placenta accreta is a condition of abnormal attachment of the placenta that could cause massive bleeding complications and increase mortality in patients. Proper anesthetic management and transfusion protocol are required for the patient. Case: A patient with placenta previa total with Placenta accreta Index score is 9 and obesity. The patient is planned to have a cesarean section followed by a total hysterectomy. For anesthetic management, general anesthesia was performed with the insertion of an endotracheal tube as an anticipatory for massive bleeding in this patient. Total bleeding during the operation was 2100 ml, and two bags of Packed Red Cells (PRC) were transfused during the operation. Postoperatively, the patient underwent treatment in the intensive care unit for one day to stabilize his general condition before being transferred to the regular ward. The patient was discharged after 2 days of treatment in the ward. Conclusion: that case can be drawn from this case is the importance of early detection of patients with a high risk of Placenta accreta, so that early treatment and comprehensive preparation can be carried out before termination is done.

Акушерская тактика при различных типах врастания плаценты

This study presents a case series demonstrating obstetric strategies for different types of placenta accreta spectrum (PAS). In the first case, there was grade 1 abnormal attachment of the accessory placental lobe (PAS 1) according to the FIGO classification. The diagnosis was made on the third day after delivery when a control pelvic ultrasound was performed. The patient underwent hysteroresectoscopy with removal of the accessory lobe within intact tissues and complete fertility preservation. In the second case, there was grade 2 placental invasion (PAS 2) according to the FIGO classification and type 3 according to the topographic classification – invasion into the anterior wall of the lower uterine segment and the anterior section of the cervix. In conditions of selective balloon-assisted occlusion of the common iliac arteries, excision of the uterine aneurysm and the anterior section of the cervix with subsequent metroplasty was performed. The final option of surgical hemostasis was ligation of the internal iliac arteries. The third case presented grade 3 placental invasion (PAS 3) according to the FIGO classification and type 4 according to the topographic classification – placental invasion into the anterior wall of the lower uterine segment, invading the serous membrane and the posterior wall of the bladder, as well as the cervix, vaginal vaults, parametrium and the lower third of the left ureter. Simultaneous surgical intervention was performed by a multidisciplinary team of gynecologists, urologists and endovascular surgeons with hysterectomy, resection of the posterior wall of the bladder with its subsequent plasty and ureteral stenting. Key words: placental invasion, hysterectomy, FIGO classification of placenta accreta spectrum, uterine aneurysm, metroplasty, Placenta Accreta Spectrum, topographic classification of placenta accreta spectrum

Molecular Pathways and Animal Models of Ebstein's Anomaly.

Ebstein's anomaly is a congenital malformation of the tricuspid valve characterized by abnormal attachment of the valve leaflets, resulting in varying degrees of valve dysfunction. The anatomic hallmarks of this entity are the downward displacement of the attachment of the septal and posterior leaflets of the tricuspid valve. Additional intracardiac malformations are common. From an embryological point of view, the cavity of the future right atrium does not have a direct orifice connected to the developing right ventricle. This chapter provides an overview of current insight into how this connection is formed and how malformations of the tricuspid valve arise from dysregulation of molecular and morphological events involved in this process. Furthermore, mouse models that show features of Ebstein's anomaly and the naturally occurring model of canine tricuspid valve malformation are described and compared to the human model. Although Ebstein's anomaly remains one of the least understood cardiac malformations to date, the studies summarized here provide, in aggregate, evidence for monogenic and oligogenic factors driving pathogenesis.

A COMPARATIVE ANALYTICAL STUDY OF MATERNAL MORBIDITY AND MORTALITY INDICATORS BETWEEN PLACENTA ACCRETA SPECTRUM (PAS) AND NORMAL PLACENTATION DURING CAESAREAN SECTION

Introduction: The Placenta Accreta Spectrum (PAS) has emerged as a complex and increasingly prevalent condition, presenting formidable challenges in the field of obstetrics. PAS refers to a range of pathological conditions characterized by abnormal placental attachment to the uterine wall, leading to potentially life-threatening complications during pregnancy and childbirth. This condition has garnered significant attention from researchers, clinicians, and healthcare providers due to its rising incidence and the critical management decisions it demands. Methods: This was a Case-Control study which was conducted at the department of Obstetrics and Gynecology in a tertiary care referral center in Akola, India between January 2020, and June 2021, over a period of 18 months (about 1 and a half years). Sample size calculation were considered based on the incidence of Placenta Accreta Spectrum as outlined by the study done by Wu S et al [4]. Result: As noted by earlier studies, our study also found an increase in the overall morbidity of the patients of Placenta Accreta Spectrum disorders over patients with normal placentation, during and after caesarean section. Conclusion: Placenta Accreta Spectrum leads to significant maternal morbidity and mortality compared to normal placentation at caesarean section, as established by and increased rate of Obstetric Hysterectomies, longer operating times, increased need for blood and blood products, longer ICU stay, and increased rates of postpartum fever.

METTL16-mediated N6-methyladenosine modification of Soga1 enables proper chromosome segregation and chromosomal stability in colorectal cancer.

N6-methyladenosine (m6A) is the most prevalent internal modification in mammalian messenger RNAs and is associated with numerous biological processes. However, its role in chromosomal instability remains to be established. Here, we report that an RNA m6A methyltransferase, METTL16, plays an indispensable role in the progression of chromosome segregation and is required to preserve chromosome stability in colorectal cancer (CRC) cells. Depletion or inhibition of the methyltransferase activity of METTL16 results in abnormal kinetochore-microtubule attachment during mitosis, leading to delayed mitosis, lagging chromosomes, chromosome mis-segregation and chromosomal instability. Mechanistically, METTL16 exerts its oncogenic effects by enhancing the expression of suppressor of glucose by autophagy 1 (Soga1) in an m6A-dependent manner. CDK1 phosphorylates Soga1, thereby triggering its direct interaction with the polo box domain of PLK1. This interaction facilitates PLK1 activation and promotes mitotic progression. Therefore, targeting the METTL16-Soga1 pathway may provide a potential treatment strategy against CRC because of its essential role in maintaining chromosomal stability.